Uso de parches de capsaicina al 8 % para el tratamiento del dolor neuropático lumbar / Use of 8 % capsaicin patches for the treatment of lumbar neuropathic pain

Introducción: El dolor neuropático lumbar es una patología frecuente en la clínica diaria, con un tratamiento complejo, tanto farmacológico como intervencionista. Estos tratamientos podemos complementarlos con un parche transdérmico de capsaicina al 8 %. La capsaicina es agonista selectivo de los receptores TRPV1 (receptor transitorio vanilla de 1) cuya activación bloquea la liberación de sustancia P, muy implicada en el proceso de la inflamación. Objetivos: Valorar la utilidad del parche de capsaicina al 8 % como complemento en pacientes con dolor neuropático lumbar. Como objetivo secundario, valorar los efectos adversos del parche de capsaicina tanto en el momento de aplicación como a los 3 meses. Pacientes y métodos: Estudio retrospectivo, observacional y descriptivo, en el que se incluyeron 20 pacientes con dolor neuropático lumbar, tratados con parche de capsaicina al 8 % (Qutenza® como complemento al tratamiento habitual de esta patología. Se utilizaron 3 test para valorar el dolor: EVA (escala visual analógica del dolor), DN4 y LANSS para dolor neuropático. Los 3 test fueron pasados a los pacientes antes de la aplicación del parche y a los 3 meses de este. Resultados: Al inicio, el 95 % de los pacientes incluidos en el estudio presentaban dolor muy severo (EVA 8-9). A los 3 meses, el 85 % de los pacientes refieren dolor moderado (EVA 5-6). Con respecto al test DN4 observamos una disminución de los valores de algo más de 2 puntos. En el test LANSS encontramos una disminución de más de 5 puntos en estos 3 meses. La aplicación del parche no causó efectos secundarios significativos. Conclusiones: El parche de capsaicina al 8 % se ha mostrado eficaz y seguro como tratamiento complementario para el dolor neuropático lumbar.(AU)

Introduction: Lumbar neuropathic pain is a common pathology in daily clinical practice, with a complex treatment, both pharmacological and interventional. These treatments can be complemented with an 8 % capsaicin transdermal patch. Capsaicin is a selective agonist of TRPV1 receptors (transient receptor vanilla 1) whose activation blocks the release of substance P, which is heavily involved in the inflammatory process. Objectives: To assess the usefulness of the capsaicin 8 % patch as an adjunct in patients with lumbar neuropathic pain. As a secondary objective, to assess the adverse effects of the capsaicin patch both at the time of application and after 3 months. Patients and methods: Retrospective, observational and descriptive study, which included 20 patients with lumbar neuropathic pain, treated with capsaicin patch 8 % (Qutenza® as an adjunct to the usual treatment of this pathology. Three tests were used to assess pain: VAS (visual analogue pain scale), DN4 and LANSS for neuropathic pain. The 3 tests were administered to the patients before the application of the patch and 3 months after the patch was applied. Outcomes: At baseline, 95 % of patients included in the study had very severe pain (VAS 8-9). At 3 months, 85 % of patients reported moderate pain (VAS 5-6). With respect to the DN4 test, we observed a decrease in values of slightly more than 2 points. In the LANSS test we found a decrease of more than 5 points in these 3 months. The application of the patch did not cause significant side effects. Conclusions: The 8 % capsaicin patch has been shown to be effective and safe as an adjunctive treatment for lumbar neuropathic pain.(AU)

Identification of the Photoreceptor Transcriptional Co-Repressor SAMD11 as Novel Cause of Autosomal Recessive Retinitis Pigmentosa.

Retinitis pigmentosa (RP), the most frequent form of inherited retinal dystrophy is characterized by progressive photoreceptor degeneration. Many genes have been implicated in RP development, but several others remain to be identified. Using a combination of homozygosity mapping, whole-exome and targeted next-generation sequencing, we found a novel homozygous nonsense mutation in SAMD11 in five individuals diagnosed with adult-onset RP from two unrelated consanguineous Spanish families. SAMD11 is ortholog to the mouse major retinal SAM domain (mr-s) protein that is implicated in CRX-mediated transcriptional regulation in the retina. Accordingly, protein-protein network analysis revealed a significant interaction of SAMD11 with CRX. Immunoblotting analysis confirmed strong expression of SAMD11 in human retina. Immunolocalization studies revealed SAMD11 was detected in the three nuclear layers of the human retina and interestingly differential expression between cone and rod photoreceptors was observed. Our study strongly implicates SAMD11 as novel cause of RP playing an important role in the pathogenesis of human degeneration of photoreceptors.

[Use of non-mydriatic retinography to determine the prevalence of diabetic retinopathy in diabetic patients]. / Estudio de prevalencia de retinopatía diabética en pacientes diabéticos mediante retinógrafo no midriático.

OBJECTIVES: To establish the prevalence and severity of diabetic retinopathy (DR) in a sample of patients from "Health Area 3" in the Community of Madrid using non-mydriatic retinography and telemedicine. METHODS: All patients who had their ocular fundus examined due to one of the following conditions were included in the sample: type 1 diabetes (DM1), type 2 non- insulin-dependent diabetes (DM2NID), and type 2 insulin-dependent diabetes (DM2ID). In all cases, 3-field retinographies were taken of both eyes to be evaluated for the presence of DR, and its severity, by an ophthalmologist at the hospital. RESULTS: No DR was observed in 79% of the patients examined, 9% had a mild non-proliferative DR, 9% had a moderate non-proliferative DR, and 1% had a severe non-proliferative DR. The estimated prevalence of DR in "Health Area 3" of the Community of Madrid was thus 21%. In 12% of the examinations the retinographies were considered "low quality", thus requiring a second evaluation at hospital. CONCLUSIONS: The use of non-mydriatic retinography and telemedicine is an adequate method for the screening of DR among the diabetic population.

[Isolated conjunctival involvement in Langerhans cell histiocytosis]. / Histiocitosis de células de Langerhans con afectación conjuntival aislada.

CASE REPORT: A 43-year-old woman referred for a hyperemic node in the inferior conjunctival fornix. No improvement was observed after 10 days of antibiotic and anti-inflammatory topical treatment, so biopsy-extirpation was performed. Histopathological and immunohistochemical findings suggested the diagnosis of Langerhans cell histiocytosis (LCH). No findings of extraocular manifestations were shown after an intensive clinical and analytical investigation. DISCUSSION: LCH is a disease with different organ manifestations whose diagnosis depends on histological findings. We present a patient with isolated conjunctival affectation, which to our knowledge is the third case published in the literature.

Histiocitosis de células de Langerhans con afectación conjuntival aislada / Isolated conjunctival involvement in langerhans cell histiocytosis

Caso clínico: Mujer de 43 años que consulta por unnódulo hiperémico en fondo de saco conjuntivalinferior. Tras diez días de tratamiento antibiótico yantiinflamatorio tópico no se observa mejoría, porlo que se realiza una biopsia-extirpación. El resultadoanatomopatológico e inmunohistoquímico esinformado como histiocitosis de células de Langerhans(HCL), procediéndose a realizar un estudiosistémico con diferentes pruebas complementarias,sin hallar afectación a otro nivel.Discusión: La histiocitosis de células de Langerhanses una enfermedad de afectación muy variada,cuyo diagnóstico se establece mediante hallazgoshistológicos. Presentamos un caso de implicaciónexclusivamente conjuntival, habiéndose publicadosólo tres casos previamente en la literatura médica consultada(AU)

Case report: A 43-year-old woman referred for ahyperemic node in the inferior conjunctival fornix.No improvement was observed after 10 days ofantibiotic and anti-inflammatory topical treatment,so biopsy-extirpation was performed. Histopathologicaland immunohistochemical findings suggestedthe diagnosis of Langerhans cell histiocytosis(LCH). No findings of extraocular manifestationswere shown after an intensive clinical and analyticalinvestigation.Discussion: LCH is a disease with different organmanifestations whose diagnosis depends on histologicalfindings. We present a patient with isolatedconjunctival affectation, which to our knowledge isthe third case published in the literature(AU)

Indicadores de calidad: estudio estructura personal académico en escuelas universitarias públicas de fisioterapia / Quality assurance indicators: research of academic staff in public universities where there is physiotherapy career

El objetivo del estudio es analizar la dotación de personal docente de las universidades públicas españolas que imparten el título de fisioterapia así como la ratio alumnos-profesor como indicador de calidad. Material y método. Se envió por correo electrónico un cuestionario a los directores de las 23 Escuelas Universitarias públicas que imparten la titulación de fisioterapia en el año 2004, siendo el número de cuestionarios válidos (n = 15). Resultados. La media de profesores que imparten docencia teórico-práctica en la titulación es de 38,13 (DS 15,11) con un coeficiente de variación de 39,6 %. La media de profesores que imparten docencia clínica es de 20,07 (DS 10,99) y el coeficiente de variación 54,7 %. La ratio alumnos-profesor en docencia teórico-práctica tiene un valor medio de 6,68 (DS 2,80) un coeficiente de variación de 41,9 %. Mientras que la media de la ratio en docencia clínica es 8,36 alumnos por profesor (DS 3,3) con un coeficiente de variación del 39,7 %. Conclusiones. Se observan diferencias marcadas entre universidades tanto en número como en estructura del personal docente. Estas diferencias también se producen en las ratios de alumnos por profesor tanto en docencia teórica como clínica

The goal of this research is to analyse the staff of professors in the spanish public universities where there is Physiotherapy career, besides the rate student-professor as a sign of quality. Setting and apparatus. One questionnaire was sent by e-mail to the Deans of the 23 public Universities teaching Physiotherapy studies during the year 2004. The number of valid questionnaires was n = 15. Results. The mean of professors who teach both theoretical and practical lesson in the Physiotherapy career is 38.13 (DS 15.11), with a variation quotient of 39,6 %. The mean of professors teaching clinical trainning is 20.07 (DS 10.99), and the variation quotient is 54.7 %. The rate student-professor in the theoretical and practical lessons is 6.68 on average (DS 2.8), and the variation quotient is about 41.9 %. However, the rate mean of clinical training is 8.36 students per each professor (DS 3.3), and the variation quotient is about 39.7 %. Conclusions. Several importants differences were found between the Universities, not only in the number but also in the structure of the professors staff. There were also those differences between the rates student-professor both in theoretical and in clinical training lessons

Ausencia de efectos secundarios en una sobredosificación accidental de ropivacaína / Absece of sid effects after an accidental ropivacaine overdose

No disponible

Tratamiento de lumbalgias en el puerperio mediante reeducación sensitivo-perceptivo-motriz / Treatment back pain in the puerperant with sensory-perceptive-motor re-education

Durante el embarazo se producen una serie de alteraciones mecánicas en el segmento lumbopélvico que conllevarán una lesión total o parcial de algunos receptores, con la consiguiente modificación de la cantidad y calidad del mensaje aferente sensorial, que a su vez alterará la percepción y en consecuencia los programas motores. Esto puede provocar una lumbalgia mecánica crónica debido a una perturbación del bucle funcional sensitivo perceptivo motor entre el sistema nervioso y el efector (músculo, articulación). Para resolver el problema no debemos contentarnos con reeducar únicamente el aspecto motor, ya que no es suficiente estimular una parte del bucle para que el paciente se recupere de la patología, hay que estimular el conjunto funcional. Para prevenir nuevos episodios lumbálgicos enseñaremos al paciente cómo proteger mecánicamente su segmento lumbopélvico mediante ejercicios de reeducación sensitivo perceptivo motriz, para ello atenderemos a una serie de etapas: estimulación de receptores cutáneos, estimulación de receptores articulares y musculares, toma de conciencia de la posición del raquis lumbar, solicitaciones sobre planos estables y posteriormente sobre planos inestables. (AU)

Synchronous-derivative phosphorimetric determination of 1- and 2-naphthol in irrigation water by employing beta-cyclodextrin.

A room-temperature phosphorimetric (RTP) study of the inclusion process between 1- and 2-naphthol, beta-cyclodextrin (beta-CD) and 3-bromo-1-propanol as heavy atom pertuber has been performed. Experimental conditions were optimized for the formation of trimolecular complexes with lifetimes of 10.82 and 9.41 ms for 1- and 2-naphthol, respectively. A synchronous-derivative room-temperature phosphorimetric method has been proposed to the analysis of both naphthols in synthetic mixtures and irrigation water in the ratio 1:10 to 10:1; the limit of detection is 0.02 mug ml(-1) and the relative standard deviation (RSD) is about 6%.