ABSTRACT
Con el objetivo principal de aportar información sobre la eficacia/efectividad del cribado neonatal de la hiperplasia suprarrenal congénita, se ha llevado a cabo una revisión sistemática de la literatura mediante un protocolo previamente establecido. Se incluyeron 17 artículos originales y 2 revisiones sistemáticas. Los estudios analizados ponen de manifiesto que el cribado neonatal de la hiperplasia suprarrenal congénita consigue un adelanto de la fecha de diagnóstico de la enfermedad y detectar a la mayoría de los niños con riesgo de crisis por pérdida salina antes de que ésta aparezca. Hay discrepancias acerca de cuál es el protocolo más adecuado para el desarrollo del programa de cribado neonatal. Los aspectos más críticos son: el umbral de 17-hidroxiprogesterona por encima del cual se debe considerar anormal un resultado y el momento de tomar la muestra. Para la puesta en marcha de este programa de cribado es necesario tener en cuenta, además de los resultados del conocimiento científico, las circunstancias y las consecuencias reales en una población determinada (AU)
To provide information on the efficacy/effectiveness of neonatal screening for congenital adrenal hyperplasia, we performed a systematic review of the literature according to a previously established protocol. Seventeen original articles and 2 systematic reviews were included. The studies analyzed reveal that neonatal screening for congenital adrenal hyperplasia leads to earlier diagnosis and identifies most children at risk of salt-wasting crises before these occur. Discrepancies exist on the most appropriate protocol for the development of this type of screening program. The most critical features are the threshold of 17-hydroxyprogesterone that should be considered an abnormal result and the timing of sampling. The introducing of this type of screening program should take into account not only the results of scientific knowledge, but also the circumstances and real consequences in a particular population (AU)
Subject(s)
Infant, Newborn , Humans , Adrenal Hyperplasia, Congenital/diagnosis , Neonatal Screening/methods , Reference Values , SpainABSTRACT
Informe que contiene una síntesis actualizada de la evidencia científica sobre las próstesis de hombro, tipos de artoplastia protésica, indicaciones y contraindicaciones.
Subject(s)
Arthroplasty, Replacement , Joint Prosthesis , Shoulder , Technology Assessment, BiomedicalABSTRACT
Informe cuyo objetivo es evaluar la eficacia diagnóstica de la FDG-PET en la recurrencia de cáncer de mama y ovario, compararla con la de otras técnicas y determinar su utilidad clínica en el manejo de este tipo de pacientes.
Subject(s)
Positron-Emission Tomography , Diagnostic Imaging , Breast Neoplasms , Ovarian Neoplasms , Technology Assessment, BiomedicalABSTRACT
Trabajo cuyo objetivo principal es determinar los factores que pueden influir en los niveles de TSH en el periodo neonatal, bien sea modificando los resultados del programa de cribado neonatal del hipotiroidismo congénito o con independencia de su repercusión en el mismo.
Subject(s)
Hypothyroidism , Infant, Newborn , Congenital, Hereditary, and Neonatal Diseases and Abnormalities , Receptors, Thyrotropin , Technology Assessment, BiomedicalABSTRACT
Intensity-modulated radiation therapy (IMRT) is an advanced form of radiotherapy for the treatment of cancer that allows, on one hand, to administer a more homogeneous dose to the patients on the volume to irradiate (which would increase the local control of the disease), and on the other hand, to diminish the toxicity in the organs at risk. This type of treatment is based on imaging techniques, on computer dosimetry programs, and on more precise immobilization accessories. Before delivering IMRT it is necessary to establish a protocol that includes the different phases of the treatment process, that is, the obtaining of anatomical data, beam definition, calculation, dose distribution, and treatment performance and control. In this article we present the basic standards for the IMRT treatment for prostate and head-neck cancer agreed upon a consensus meeting. The follow-up of the recommendations settled down in this document will help in the establishment of a standardized clinical practice -assuring the quality- and a better evaluation of the results of the clinical intervention.
Subject(s)
Adenocarcinoma/radiotherapy , Head and Neck Neoplasms/radiotherapy , Prostatic Neoplasms/radiotherapy , Radiotherapy, Intensity-Modulated , Clinical Protocols , Contraindications , Female , Humans , Male , Radiotherapy Dosage , Radiotherapy, Intensity-Modulated/methods , Radiotherapy, Intensity-Modulated/standardsABSTRACT
No disponible
Intensity-modulated radiation therapy (IMRT) isan advanced form of radiotherapy for the treatmentof cancer that allows, on one hand, to administer amore homogeneous dose to the patients on the volumeto irradiate (which would increase the localcontrol of the disease), and on the other hand, to diminishthe toxicity in the organs at risk. This type oftreatment is based on imaging techniques, on computerdosimetry programs, and on more precise immobilizationaccessories. Before delivering IMRT itis necessary to establish a protocol that includes thedifferent phases of the treatment process, that is, theobtaining of anatomical data, beam definition, calculation,dose distribution, and treatment performanceand control.In this article we present the basic standards for theIMRT treatment for prostate and head-neck canceragreed upon a consensus meeting. The follow-up ofthe recommendations settled down in this documentwill help in the establishment of a standardizedclinical practice -assuring the quality- and abetter evaluation of the results of the clinical intervention
