ABSTRACT
INTRODUCTION: Ataxia and hereditary spastic paraplegia are rare neurodegenerative syndromes. We aimed to determine the prevalence of these disorders in Spain in 2019. PATIENTS AND METHODS: We conducted a cross-sectional, multicentre, retrospective, descriptive study of patients with ataxia and hereditary spastic paraplegia in Spain between March 2018 and December 2019. RESULTS: We gathered data from a total of 1933 patients from 11 autonomous communities, provided by 47 neurologists or geneticists. Mean (SD) age in our sample was 53.64 (20.51) years; 938 patients were men (48.5%) and 995 were women (51.5%). The genetic defect was unidentified in 920 patients (47.6%). A total of 1371 patients (70.9%) had ataxia and 562 (29.1%) had hereditary spastic paraplegia. Prevalence rates for ataxia and hereditary spastic paraplegia were estimated at 5.48 and 2.24 cases per 100 000 population, respectively. The most frequent type of dominant ataxia in our sample was SCA3, and the most frequent recessive ataxia was Friedreich ataxia. The most frequent type of dominant hereditary spastic paraplegia in our sample was SPG4, and the most frequent recessive type was SPG7. CONCLUSIONS: In our sample, the estimated prevalence of ataxia and hereditary spastic paraplegia was 7.73 cases per 100 000 population. This rate is similar to those reported for other countries. Genetic diagnosis was not available in 47.6% of cases. Despite these limitations, our study provides useful data for estimating the necessary healthcare resources for these patients, raising awareness of these diseases, determining the most frequent causal mutations for local screening programmes, and promoting the development of clinical trials.
Subject(s)
Cerebellar Ataxia , Spastic Paraplegia, Hereditary , Male , Humans , Female , Middle Aged , Spastic Paraplegia, Hereditary/epidemiology , Spastic Paraplegia, Hereditary/genetics , Cross-Sectional Studies , Retrospective Studies , Spain/epidemiologyABSTRACT
INTRODUCTION: The clinical course in patients with prostate cancer (PCa) after biochemical failure (BF) has received limited attention. This study analyzes survival time from recurrence, patterns of progression, and the efficacy of salvage therapies in patients treated with radical or postoperative radiotherapy (RT). METHODS: This is a multicenter retrospective comparative study of 1135 patients diagnosed with BF and treated with either radical (882) or postoperative (253) RT. Data correspond to the RECAP database. Clinical, tumor, and therapeutic characteristics were collected. Descriptive statistics, survival estimates, and comparisons of survival rates were calculated. RESULTS: Time to BF from initial treatment (RT or surgery) was higher in irradiated patients (51 vs 37 months). At a median follow-up of 102 months (14-254), the 8-year cause-specific survival (CSS) was 80.5%, without significant differences between the radical (80.1%) and postoperative (83.4%) RT groups. The 8-year metastasis-free survival rate was 57%. 173 patients (15%) died of PCa and 29 (2.5%) of a second cancer. No salvage therapy was given in 15% of pts. Only 5.5% of pts who underwent radical RT had local salvage treatment and 71% received androgen deprivation (AD) ± chemotherapy. The worst outcomes were in patients who developed metastases after BF (302 pts; 26.5%) and in cases with a Gleason > 7. CONCLUSIONS: In PCa treated with radiotherapy, median survival after BF is relatively long. In this sample, no differences in survival rates at 8-years have been found, regardless of the time of radiotherapy administered. AD was the most common treatment after BF. Metastases and high Gleason score are adverse variables. To our knowledge, this is the first study to compare outcomes after BF among patients treated with primary RT vs. those treated with postoperative RT and to evaluate recurrence patterns, treatments administered, and causes of death. The results allow avoiding overtreatment, improving quality of life, without negatively affecting survival.
Subject(s)
Brachytherapy/mortality , Databases, Factual , Neoplasm Recurrence, Local/mortality , Prostatic Neoplasms/mortality , Registries/statistics & numerical data , Adult , Aged , Aged, 80 and over , Follow-Up Studies , Humans , Male , Middle Aged , Neoplasm Recurrence, Local/pathology , Neoplasm Recurrence, Local/radiotherapy , Prognosis , Prostatic Neoplasms/pathology , Prostatic Neoplasms/radiotherapy , Retrospective Studies , Survival RateABSTRACT
We have bombarded crystalline silicon targets with a 40 keV Fe+ ion beam at different incidence angles. The resulting surfaces have been characterized by atomic force, current-sensing and magnetic force microscopies, scanning electron microscopy, and x-ray photoelectron spectroscopy. We have found that there is a threshold angle smaller than 40° for the formation of ripple patterns, which is definitely lower than those frequently reported for noble gas ion beams. We compare our observations with estimates of the value of the critical angle and of additional basic properties of the patterning process, which are based on a continuum model whose parameters are obtained from binary collision simulations. We have further studied experimentally the ripple structures and measured how the surface slopes change with the ion incidence angle. We explore in particular detail the fluence dependence of the pattern for an incidence angle value (40°) close to the threshold. Initially, rimmed holes appear randomly scattered on the surface, which evolve into large, bug-like structures. Further increasing the ion fluence induces a smooth, rippled background morphology. By means of microscopy techniques, a correlation between the morphology of these structures and their metal content can be unambiguously established.
ABSTRACT
Interrupted coarsening (IC) has recently been identified as an important feature for the dynamics of the typical length-scale in pattern-forming systems on surfaces. In practice, it can be beneficial to improve pattern ordering since it combines a certain degree of defect suppression with a limited increase in the typical pattern wavelength. However, little is known about its robustness with respect to changes in the preparation of the initial system for cases with potential applications. Working in the context of nano-scale pattern formation by ion-beam sputtering (IBS), we prove that IC properties do not depend on sample preparation. Specifically, interface dynamics under IBS is quantitatively compared on virgin amorphous and crystalline silicon surfaces, using 1 keV Ar(+) ions at normal incidence where nanodot pattern formation is triggered by concurrent co-deposition of Fe atoms during processing. Atomic force microscopy shows that dot patterns with similar spatial order and dynamics are obtained in both cases, underscoring the key dynamical role of the amorphous surface layer produced by irradiation. Both systems have been quantitatively described by an effective interface equation. We employ a new procedure based on the linear growth of the initial surface correlations to accurately estimate the equation coefficients. Such a method improves the predictive power of the interface equation with respect to previous studies and leads to a better description of the experimental pattern and its dynamical features.
ABSTRACT
We report on the appearance of two new cases of radio-induced bullous pemphigoid (BP), a rare complication of radiotherapy. Both were elderly women, were treated for breast cancer and suffered (BP) during the irradiation, the evolution was favorable with steroid therapy (AU)
Subject(s)
Humans , Female , Aged, 80 and over , Carcinoma, Ductal, Breast/radiotherapy , Pemphigoid, Bullous/etiology , Radiation Injuries/diagnosis , Breast Neoplasms/radiotherapy , Pemphigoid, Bullous/diagnosis , Radiation Injuries/etiology , Radiotherapy DosageABSTRACT
La conducta antisocial se está convirtiendo en unproblema serio entre la infancia y la adolescencia. Losjóvenes con comportamiento antisocial presentan conductasagresivas repetitivas, vandalismos y rupturas conlas normas establecidas que impiden un desarrollosocial y de la personalidad adecuado.Existe un amplio consenso entre los investigadoresacerca de la naturaleza multicausal de la conducta antisocial.Aunque si bien es cierto que cualquier abordajepreventivo y/o de intervención de estas conductas enadolescentes debe centrarse en factores multidimensionales(biopsicosocial), en este artículo nos centraremosen la identificación de cuáles son las variables psicológicasde riesgo influyentes en el inicio y el mantenimiento de las mismas(AU)
The antisocial behavior is transforming into a seriousproblem between the childhood and the adolescence.The youths with antisocial behavior present aggressiverepetitive behaviors, vandalisms and ruptures with theestablished norms that impede a social development andan adapted personality.A wide consent exists among the investigators aboutthe nature multicausal of the antisocial behavior.Although it is certain that any preventive and/or interventionboarding of these behaviors in adolescentsshould be centered in a multidimensional factors (biopsycho-social). In this article we will center in the identificationof the psychological risk variables responsiblefor the beginning and the maintenance of the antisocialbehavior(AU)
Subject(s)
Humans , Male , Female , Adolescent , Social Behavior Disorders/epidemiology , Adolescent Behavior , Psychometrics/instrumentation , Risk Factors , Adjustment Disorders/epidemiology , Age and Sex DistributionABSTRACT
Extrapulmonary small cell carcinoma in breast and prostate are uncommon neoplasms. In the literature most of the data come from case reports and these show that these tumours are highly aggressive. Histologically, they bear striking similarities to small cell carcinomas of the lung and usually show evidence of additional histologies. Treatment, which may include surgery, radiotherapy and chemotherapy, is based on the clinical stage. We present the evolution of two cases (AU)
No disponible
Subject(s)
Humans , Male , Female , Adult , Aged , Carcinoma, Small Cell/pathology , Breast Neoplasms/pathology , Prostatic Neoplasms/pathology , Carcinoma, Small Cell/therapy , Breast Neoplasms/therapy , Combined Modality Therapy/methods , Combined Modality Therapy , Prostatic Neoplasms/therapy , Treatment OutcomeABSTRACT
El trastorno por déficit de atención/hiperactividad(TDAH) constituye una derivación frecuente en lasUnidades públicas de Salud Mental Infanto-Juvenil. Sinembargo, en muchas ocasiones esta derivación no esadecuada, magnificándose el número de casos incluidosbajo este epígrafe.El diagnóstico de TDAH debe hacerse atendiendo aunos criterios estrictos y siguiendo una metodologíaespecífica. La realización de evaluaciones eficaces seráclave a la hora de implementar tratamientos más efectivosa nivel cognitivo, emocional, comportamental, deaprendizaje social y escolar, generalizándose los resultadosa los dos contextos más habituales del niño: familiay escuela.Desde la Unidad de Salud Mental Infanto-Juvenil delInstituto Psiquiátrico José Germain, hemos detectado lanecesidad de establecer un protocolo de intervenciónmultiprofesional para nuestra zona que optimice la evaluacióne intervención en los casos de TDAH, presentándoseen este trabajo sus principales directrices
The Attention Hiperactivity Deficit Disorder (TDAH) constitutes a frequent derivation in the public Units ofInfant-Juvenile Mental Health. However, in many occasionsthis derivation is not accepted, being magnified thenumber of cases included under this epigraph.The diagnosis of TDAH should be made assisting tosome strict criteria and following a specific methodology.The realization of effective evaluations will be crucialto implement more effective treatments in theselevels: cognitive, emotional, comportamental, socialand school learning; being generalized the results to thetwo more habitual contexts of the children: family andschool.From the Infant-Juvenile Unit of Mental Health ofthe Psychiatric Institute José Germain, we have detectedthe necessity to establish a protocol of intervention withseveral proffesionals for our area that optimizes theevaluation and intervention in the TDAH cases, showingup in this work their main guidelines (AU)
Subject(s)
Humans , Male , Female , Adolescent , Child , Clinical Protocols , Hyperkinesis/diagnosis , Hyperkinesis/psychology , Attention Deficit Disorder with Hyperactivity/diagnosis , Attention Deficit Disorder with Hyperactivity/psychology , Diagnostic and Statistical Manual of Mental Disorders , Psychometrics/history , Psychometrics/methods , Evaluation Study , Outcome and Process Assessment, Health Care , Mental Health , Neuropsychology/methods , Neuropsychology/trends , Community Health Services , Comorbidity , Audiometry/psychology , AudiometryABSTRACT
El propósito de este estudio es examinar las diferenciasde personalidad normal y patológica que aparecenen una muestra de 320 participantes drogodependientesen tratamiento ambulatorio por su problema adictivo. Separte de una división de los participantes en dos gruposdenominados tipo A (consumidor funcional) y tipo B(consumidor crónico) obtenidos a partir del análisis deconglomerados. El tipo B se caracteriza por una mayoredad media y mayor tasa de desempleo, mayor gravedaden su problemática de consumo de drogas y aspectosmédicos, de empleo-soportes, con la ley, familiares/sociales y psiquiátricos, frente al tipo A. En esteúltimo grupo, la principal fuente de ingresos era elempleo activo y tenían menos años de consumo de drogas.Además, presentaban mayor gravedad asociada alconsumo de alcohol.Al comparar la personalidad de ambos grupos, seencuentra que el tipo B presenta mayor, neuroticismo yrasgos de personalidad patológica esquizoides y disocialesfrente al tipo A, que presentaba mayor extraversióny amabilidad. Se concluye la importancia de profundizaren el conocimiento de las tipologías, ya que unadecuado sustrato teórico ha de servir para un mejorconocimiento de los aspectos diagnósticos y de elecciónde tratamientos en drogodependientes
The aim of this paper is to analyze the differences innormal and pathological personality that appear in a sampleof 320 drug abusers in ambulatory treatment for itsaddictive problem. There is a division of the participantsin two groups denominated type A (functional consumer)and type B (chronic consumer) obtained from conglomeratesanalysis. The type B is characterized by a biggerage, unemployment rate, graveness in its problem ofdrugs abuse; and in medical, employment-supports, law,family/social and psychiatric aspects compared with typeA. In this last group, the main revenues source was theactive employment and they had less years of drugsabuse. Also, they presented bigger graveness associatedto the consumption of alcohol.When comparing the personality of both groups, wefound that the type B presents bigger neuroticism andpathological personality traits (schizoid and dissocial).Lastly, the importance of the knowledge in drug typologiesis discussed. It must be good to improve in diagnosticaspects and election of treatments in drugabusers
Subject(s)
Humans , Substance-Related Disorders/epidemiology , Substance-Related Disorders/psychology , Personality Disorders/epidemiology , Personality Disorders/diagnosis , Alcohol Drinking , Personality Inventory , Age Factors , ComorbidityABSTRACT
El síndrome de Stevens-Johnson es una enfermedad inflamatoria aguda originada por una hipersensibilidad que incluye la piel y las membranas mucosas.Puede ser inducida por muchos factores precipitantes, desde agentes farmacológicos hasta una infección. La incidencia de reacciones cutáneasseveras secundarias a amifostina es inferior al 1%, siendo el síndrome de Stevens-Johnson una de ellas. Nosotros comunicamos un caso de síndromede Stevens-Johnson en probable relación con la administración subcutánea de amifostina subcutánea durante radioterapia
The Stevens-Johnson syndrome is an acute inflammatory disease, caused by hipersensitivity of the skin and mucous membrane. It can be induced bymany precipitant factors, including pharmacological agents and infections. The incidence rate of severe secondary cutaneous reactions is less than1%, the Stevens-Johnson syndrome being one of them. We report a case of Stevens-Johnson syndrome probably related to subcutaneous amifostineadministration during radiotherapy procedure
Subject(s)
Humans , Male , Middle Aged , Stevens-Johnson Syndrome/chemically induced , Amifostine/adverse effects , Radiotherapy/adverse effects , Tonsillar Neoplasms/radiotherapyABSTRACT
Este estudio tiene por objetivo analizar la influencia y el peso diferencial de determinadas variables psicológicas en la conducta antisocial de los adolescentes. Se utilizó una muestra de 1.851 adolescentes de ambos sexos (49,92 % hombres y 50,08 % mujeres) de la Comunidad Autónoma de Madrid. Se realizaron varios análisis de regresión por pasos teniendo en cuenta tres grupos diferentes de edad (14-15, 16 y 17-18 años) con las variables criterio y se confirmó que los principales factores de riesgo psicológicos para explicar la conducta antisocial eran variables vinculadas al constructo búsqueda de sensaciones (desinhibición, impulsividad, búsqueda de excitación, etc.), mientras que los factores de protección estaban representados por variables como la empatía y la práctica religiosa. Se consideraron los grupos de edad teniendo en cuenta su importancia para el diseño de programas de prevención óptimos de carácter psicológico
The aim of this paper is to analyze the influence and differential weight of some specific psychological variables on adolescent antisocial behavior. A sample of 1,851 adolescents (49.92 % men and 50.08 % women) from the Autonomous Community of Madrid was assessed. Several stepwise regression analyses were conducted, considering three different age groups (14-15, 16 and 17-18 years), with the criterion variables and the results showed that the main psychological risk factors associated with antisocial behavior were variables linked to sensation seeking construct (impulsiveness, disinhibition, excitement seeking, etc.), while the protective factors identified were variables such as empathy and religious practices. The age groups were considered, keeping a design of optimum prevention programs with psychological character in mind
Subject(s)
Adolescent , Humans , Antisocial Personality Disorder/prevention & control , Antisocial Personality Disorder/psychology , Antisocial Personality Disorder/diagnosis , Exploratory Behavior , Psychology , Surveys and Questionnaires , Regression Analysis , Risk FactorsABSTRACT
Desde la antigüedad, los niños han sido víctimas de maltrato aunque no era reconocido como tal por la sociedad. En la actualidad es motivo de preocupación por parte de los Servicios Sanitarios y Sociales, debido a que los niños son seres humanos iguales ante la ley y que tienen el derecho de vivir con un mínimo de necesidades cubiertas y cierta calidad de vida, por no hablar de evitar cualquier tipo de daño físico hacia su persona que provocase graves consecuencias conductuales y socioemocionales. Resulta necesario aplicar medidas de protección para los niños en situación de desamparo, tales como la prevención y al mismo tiempo rehabilitar a las familias, siempre que se pueda, para que intenten convivir de nuevo con su hijo (AU)
Subject(s)
Female , Male , Child , Humans , Child Abuse/rehabilitation , Family Therapy/methods , Child Welfare/trends , Quality of Life/psychology , Child Abuse/psychologyABSTRACT
La hiperactividad ha sido y sigue siendo uno de los trastornos más visibles en la consulta de un psicólogo clínico. Sin embargo, en la mayoría de las ocasiones, no acude a consulta un verdadero trastorno hipercinético. El diagnóstico de la hiperactividad ha de realizarse atendiendo a unos criterios estrictos. Una correcta evaluación determinará una intervención más eficaz. El objetivo de la intervención será producir mejoras en aspectos cognitivos, emocionales, comportamentales, de aprendizaje social y escolar en los niños hiperactivos realizando el proceso de forma contextualizada, es decir, en escuela y hogar familiar. Una adecuada orientación/intervención educativa ha de ser la base para que no se incurra en una generalización excesiva de la etiqueta "hiperactividad" (AU)
Subject(s)
Female , Male , Child , Humans , Clinical Trial , Psychopharmacology/methods , Methylphenidate/administration & dosage , Social Behavior , Attention Deficit Disorder with Hyperactivity/complications , Attention Deficit Disorder with Hyperactivity/diagnosis , Attention Deficit Disorder with Hyperactivity/psychology , Psychotic Disorders/complications , Psychotic Disorders/diagnosis , Psychotic Disorders/psychologyABSTRACT
INTRODUCTION: The executive function is a collection of cognitive abilities that allow the anticipation and establishment of goals, the formation of plans and programs, the beginning of activities and mental operations, the auto regulation of tasks, and the ability to carry on them efficiently. Both psychopathy and disexecutive syndrome have been considered as prototypes of frontal lobe damage, although they have been related very recently. DEVELOPMENT: Psychopathy construct is not clear defined in the international classifications of mental disorders. They have focused only in the antisocial disorder of personality. A clear conceptual delimitation of psychopathy is necessary. The typical behaviours of psychopaths could be related with structural and functional brain alterations showed by the neuroimaging techniques and neuropsychological tests. These deficits are the neurological support of the inability of psychopaths to the integration of reasoning process with emotions, and specifically, of the presence of symptoms as impulsivity, inattention, context dependency, pathological perseverations and metacognitive alteration. CONCLUSION: The relevant conclusion of this study is the close relationship between reasoning and emotion. Executive function could be the explaining nexus of this connection.
Subject(s)
Antisocial Personality Disorder/physiopathology , Cognition Disorders/physiopathology , Prefrontal Cortex/physiopathology , Antisocial Personality Disorder/pathology , Cognition Disorders/pathology , Diagnostic Imaging , Electroencephalography , Emotions/physiology , Humans , Neuropsychological Tests , Prefrontal Cortex/pathology , SyndromeABSTRACT
La conducta antisocial mostrada por los jóvenes ha sido ampliamente investigada, concluyéndose una naturaleza multicausal del fenómeno. Por esto, es imprescindible conocer aquellas teorías explicativas relevantes para la comprensión de la génesis y/o mantenimiento de las conductas antisociales desde un punto de vista psicosocial. Los factores que las integran constituyen los aspectos más relevantes a tener en cuenta como base de cualquier investigación psicológica encaminada a la prevención de las conductas antisociales. Dentro de las teorías explicativas cabe citar las aproximaciones basadas en el aprendizaje, los modelos del desarrollo socio-cognitivo, los modelos sociológicos y los modelos integradores de los planteamientos anteriores. Mediante la integración de estas teorías, se discuten las implicaciones preventivas de la revisión realizada para la población adolescente en riesgo (AU)
Subject(s)
Adolescent , Female , Male , Humans , Antisocial Personality Disorder/diagnosis , Antisocial Personality Disorder/psychology , Psychosocial Deprivation , Social Support , Adolescent Behavior/psychology , Learning/physiology , Social Behavior , Psychology, Adolescent/methods , Psychology, Adolescent/organization & administration , Antisocial Personality Disorder/prevention & control , Antisocial Personality Disorder/epidemiology , Philosophy , Effluent NeutralizationABSTRACT
Los beneficios económicos directos derivados de enfermedades o problemas relacionados con el trabajo y las recompensas indirectas a nivel emocional y social vinculadas a la determinación de incapacidad, hacen que la simulación de problemas funcionales sea, para mucha gente, una solución atractiva para todo tipos de problemas personales, sociales y económicos. Los déficits funcionales suelen tomar la forma de quejas y síntomas neurológicos, ya que muchas de estas afecciones se confunden fácilmente con las quejas psicógenas que acompañan a problemas emocionales comunes y fallos sensoriales o de memoria. Se expone el caso de un hombre de 53 años que es objeto de una evaluación neuropsicológica a raíz de quejas subjetivas de déficits mnésicos y atencionales, así como problemas emocionales. En la discusión, se muestra la utilidad de pruebas individuales habitualmente utilizadas para el diagnóstico diferencial de los problemas presentados por pacientes que están bajo la sospecha de simulación de errores de respuesta exagerados (AU)
Subject(s)
Male , Middle Aged , Humans , Attention Deficit and Disruptive Behavior Disorders/diagnosis , Memory Disorders/diagnosis , Neuropsychological Tests , Diagnosis, Differential , Diagnostic Errors , Vision Disorders/etiology , Psychometrics/methods , Dizziness/etiologyABSTRACT
El alcoholismo es uno de los mayores problemas en la sociedad actual. Entre sus consecuencias más nefastas se encuentra un incremento de la violencia y la agresividad asociado a estados de dependencia, abuso, intoxicación, abstinencia y otra psicopatología. Esta relación no ha de ser interpretada causalmente, sino como la de interacciones complejas y múltiples abordables desde distintos paradigmas y enfoques como las teorías ambientalistas y las motivacionales, la aproximación cognitiva y el modelo biosocial. (AU)
Subject(s)
Adolescent , Adult , Female , Male , Humans , Alcoholism/psychology , Alcoholism/therapy , Violence/psychology , Psychopathology/methods , Psychopathology/standards , Aggression/psychology , Socialization , Motivation , Models, Psychological , Cognitive Science/methods , Delirium/complications , Delirium/psychology , Anxiety/complications , Anxiety/psychology , Social Adjustment , Social Support , Social Behavior , Adrenocorticotropic Hormone , Diagnosis, Dual (Psychiatry)/psychologyABSTRACT
La fibromialgia es una enfermedad crónica que produce dolor en múltiples localizaciones del cuerpo y cansancio generalizado. Las manifestaciones clínicas más frecuentes se agrupan en síntomas de diversa índole. Los estudios de prevalencia no arrojan cifras muy claras debido a la falta de especificidad y sensibilidad de los criterios aplicados en la evaluación. Tampoco se ha establecido un factor etiológico capaz de explicar el síndrome. Pese a esto, un conjunto de factores predisponentes y precipitantes se sitúan en la base del entendimiento de la patología, discutiéndose el papel de los factores de naturaleza psicológica. El establecimiento de un diagnóstico adecuado va a ser la base para un tratamiento eficaz en el que será necesario considerar aspectos psicológicos, farmacológicos y ambientales (AU)
Subject(s)
Adolescent , Adult , Female , Male , Middle Aged , Humans , Comorbidity/trends , Fibromyalgia/psychology , Fibromyalgia/diagnosis , Fibromyalgia/therapy , Prognosis , Sleep Wake Disorders/complications , Pain/psychology , Pain/therapy , Fibromyalgia/etiology , Fibromyalgia/history , Fibromyalgia/epidemiology , Quality of Life , Diagnosis, DifferentialABSTRACT
Objetivo: Evaluar las alteraciones biológicas de pacientes diagnosticados de obesidad mórbida (OM) y la potencial reversibilidad de las mismas tras la pérdida de peso posterior a la cirugía (bypass gástrico de Capella). Material y métodos: Estudio retrospectivo de 92 pacientes intervenidos por OM en nuestro centro entre junio de 1999 y septiembre de 2001. Se recogen variables antropométricas (peso, talla, IMC) y datos analíticos (perfil bioquímico, proteínas plasmáticas y micronutrientes), previos a la cirugía y tras 6 (2-15) meses de seguimiento. Resultados: Previo al bypass encontramos hiperglucemia, dislipemia e hiperuricemia posiblemente asociado al síndrome plurimetabólico que parece existir en estos pacientes y que mejora significativamente con la pérdida de peso. Se observan frecuentes alteraciones proteicas (hipoproteinemia) y niveles séricos bajos de marcadores de nutrición que se acentúan tras el bypass. Los niveles de proteína C reactiva (PCR) (factor de riesgo cardiovascular independiente) disminuyen significativamente con la disminución del IMC. Se detectan valores disminuidos de ferritina, vitamina D3, folato y cinc, no observándose mejoría en el seguimiento. Discusión: El descenso del IMC, la normalización de los niveles de PCR y de las variables asociadas al síndrome plurimetabólico parecen indicar que la cirugía puede ser un buen método para la reducción de peso y la consiguiente disminución del riesgo cardiovascular, diabetes mellitus y otras enfermedades metabólicas en estos pacientes (AU)
