ABSTRACT
The skin has the distinction of being the largest, visible and accessible part of the human body, and it hides a close and old relationship with the human psyche, and so has been demonstrated in the last years, where more elements of the Mental Health are elucidated playing a role in the pathogenesis of skin diseases, as well as there are some descriptions of the inverse relationship, this is, on how the skin diseases affect Mental Health of the individual. In this paper we propose to emphasize the importance of the issue, to consider a comprehensive approach to everyday Dermatology in Primary Care Medicine.
Subject(s)
Humans , Dermatology , Primary Health Care , Skin Diseases/psychology , Acne Vulgaris/psychology , Alopecia Areata/psychology , Delusional Parasitosis/psychology , Dermatitis/psychology , Neurodermatitis/psychology , Psoriasis/psychology , Trichotillomania/psychology , Vitiligo/psychologyABSTRACT
La utilización de quimioterapia como coadyuvante terapéutico es de valiosa ayuda al prolongar la sobrevida de los pacientes con tumores del Sistema Nervioso Central (S.N.C.), sin embargo presenta la desventaja de la resistencia a la droga utilizada. Para resolver este problema se han desarrollado ensayos in vitro para cuantificar la sensibilidad de cultivos de células a drogas con el objeto de predecir la respuesta clínica y la posibilidad de dirigir la selección de la droga en forma específica. El cultivo de células tumorales se ha revelado como una poderosa herramienta útil en el estudio de la resistencia a drogas, debido a que aproximadamente el 100 por ciento de los tumores malignos pueden ser cultivados
Subject(s)
Humans , Brain Neoplasms , Cells, Cultured , Central Nervous System , CerebrumABSTRACT
Swallowing disorders can be caused by cervical spine diseases, such as diffuse skeletal hyperostosis (DISH). This entity is diagnosed as a cause of dysphagia only after excluding all other possible causes. We report a case in which dysphagia was the initial symptom of DISH. The most important clinical and diagnostic aspects of the disease are discussed.
Subject(s)
Deglutition Disorders/diagnosis , Hyperostosis, Diffuse Idiopathic Skeletal/diagnosis , Spine/pathology , Aged , Humans , Male , Radiography , Spine/diagnostic imagingABSTRACT
The possible cerebral sparing effect of thiopental was evaluated in 32 severely asphyxiated neonates randomly assigned to either a thiopental treatment or control group. All infants had neurologic manifestations of asphyxia and required assisted ventilation. Thiopental was begun at a mean age of 2.3 hours and was given as a constant infusion that delivered 30 mg/kg over 2 hours. Treatment was continued at a lower dose for 24 hours. Seizure activity occurred in 76% of infants given thiopental and 73% of control infants at a mean age of 1.5 and 2.5 hours, respectively. Although initial arterial blood pressure was similar in both groups, hypotension occurred in 88% of treated and 60% of control infants. The amount of blood pressure support required was significantly greater (P less than 0.005) in the thiopental treatment group. Three infants died in the control group, and five in the treatment group. Developmental assessment was performed at a minimum of 12 months of age in 22 infants. There were no significant differences in neurologic, cognitive, or motor outcome between groups. Deteriorating performance over time was a consistent trend in both groups. These findings indicate that treatment of severe perinatal asphyxia with thiopental does not appear to have a cerebral sparing effect and may be associated with significant arterial hypotension.
Subject(s)
Asphyxia Neonatorum/drug therapy , Thiopental/therapeutic use , Apgar Score , Asphyxia Neonatorum/complications , Asphyxia Neonatorum/therapy , Brain/drug effects , Brain/metabolism , Brain Ischemia/prevention & control , Child Development , Clinical Trials as Topic , Follow-Up Studies , Gestational Age , Humans , Infant, Newborn , Infusions, Parenteral , Intracranial Pressure/drug effects , Neurologic Examination , Outcome and Process Assessment, Health Care , Random Allocation , Seizures/etiology , Seizures/therapy , Thiopental/administration & dosage , Thiopental/adverse effectsABSTRACT
Elevation and maintenance of the head in an elevated, midline position reduces cerebral venous and intracranial pressure (ICP) in adult neurosurgical patients. To determine the possible effect of head position on ICP in the neonate, we studied 26 neonates less than 2500 g at birth and less than or equal to 10 days of age. ICP was measured in each of 4 different head positions: head turned to the right and bed horizontal (R-0 degrees); head turned to the right and head of the bed elevated 30 degrees (R-30 degrees); head in the midline and bed horizontal (M-0 degrees); and head in the midline and head of the bed elevated 30 degrees (M-30 degrees). ICP results were as follows: R-0 degrees, 10.0 +/- 1.2 (mean +/- SEM), cm H2O; R-30 degrees, 8.6 +/- 1.3 cm H2O; M-0 degrees, 6.9 +/- 1.2 cm H2O, and M-30 degrees, 5.3 +/- 1.0 cm H2O. ICP was significantly lower in the M-0 degrees and M-30 degrees positions when compared to either R-0 degrees and R-30 degrees. When the effect of elevating the head of the bed 30 degrees was evaluated for infants whose ICP was greater than or equal to 7 cm H2O in the R-0 degrees and M-0 degrees positions, it was noted that there was a significant drop in ICP in the elevated positions. These data suggest that head position influences ICP significantly in the neonate probably due to venous congestion caused when the neck is turned, and hydrostatic pressure changes when the head of the bed is elevated. ICP fluctuations due to changes in head position may be deleterious to the infant at risk for intracranial hemorrhage (ICH) or cerebral edema.