ABSTRACT
La evaluación de los tratamientos de psicoterapia psicoanalítica infantil es el objetivo principal de este trabajo. Del análisis de las variables de la población en tratamiento se destaca que aquellas psicoterapias que obtienen mejores resultados son las que su duración se acerca más a la preestablecida, las que se realizan en población de menor edad y en paciente con trastornos en que la ansiedad ocupa en papel predominante en la sintomatología clínica que presentan (AU)
This paper presents a Project of evaluation of child psychoanalytical psychotherapy treatments. The data analysis of the population studied revealed that psychotherapies obtaining the best results were those psychotherapies whose length came closest to the pre-established length, those undertaken with the youngest population groups and those with patients where anxiety had a predominant role amongst clinical symptoms (AU)
Subject(s)
Humans , Psychotherapeutic Processes , Neurodevelopmental Disorders/therapy , Evaluation of Results of Therapeutic Interventions/methods , Anxiety Disorders/psychologyABSTRACT
El cerclaje istmicocervical por vía abdominal es una técnica escasamente utilizada, de mayor riesgo que el cerclaje convencional, pero que puede constituir la única opción terapéutica en determinados casos de insuficiencia istmicocervical. En este trabajo presentamos nuestra primera experiencia con esta técnica, realizada en la semana 11 a una paciente con mala historia obstétrica y que permitió una evolución favorable del embarazo (AU)
Subject(s)
Adult , Female , Humans , Suture Techniques , Pregnancy Complications/diagnosis , Pregnancy Complications/physiopathology , Conization/methods , Diabetes, Gestational/complications , Diabetes, Gestational/diagnosis , Diabetes, Gestational/drug therapy , Uterine Cervical Incompetence/surgery , Uterine Cervical Incompetence/diagnosis , Abortion/etiology , Progesterone/administration & dosage , Tocolysis/methodsABSTRACT
OBJECTIVE: To analyze the results of hysteroscopic myomectomy in our center and to compare the results to those published in the literature. METHODS: We performed a retrospective study of the clinical histories of patients who had undergone hysteroscopic myomectomy with a resectoscope between January 1992 and December 1999. Procedures were performed at a hysteroscopic clinic in the Department of Obstetrics and Gynecology at the University Public Hospital in Madrid's south zone. One hundred twenty pre-, peri-, and postmenopausal women with submucous myomas were included in the study. All patients underwent hysteroscopic resection with a monopolar loop. RESULTS: We performed 120 hysteroscopic myomectomies. The patients' median age was 44.8 years (23 to 74). Abnormal uterine bleeding (AUB) was the most frequent indication (84.1%). Inability to reproduce was the indication in 14 (11.6%) cases. GnRH analogue preparation was used in 60% of cases. We operated on 52 (43.3%) type 0, 51 (42.5%) type I, and 17 (14.1%) type II myomas, according to Wamsteker and Blok classification. A median of 32.5 (10 to 105) minutes was required for the interventions. The myomectomy was combined with another operation (12 polypectomies, 24 endometrial resections, and 1 laparoscopic ovarian cystectomy) in 32 patients. The median retention of glycemia was 281 cc (0 to 1300). We could not complete the resection in 22 patients. Twelve underwent reoperation (3 hysterectomies and 9 second myomectomies). No serious complications occurred, and the median hospital stay was 25.4 hours. The histological study confirmed leiomyoma in all the cases. The intervention results were satisfactory after a follow-up period of 12 months to 7 years, AUB being controlled in 88.5% of the patients. CONCLUSION: Hysteroscopic myomectomy is a reliable procedure that is effective in controlling abnormal uterine bleeding. It is a good alternative to hysterectomy and has an acceptable surgical time and minimum hospital stay. To reduce the need of reintervention, appropriate patient selection and improved technique are necessary. The technique also offers significant economic savings compared with the conventional surgical methods.
Subject(s)
Hysteroscopy/methods , Leiomyoma/surgery , Uterine Neoplasms/surgery , Adult , Aged , Female , Humans , Leiomyoma/complications , Length of Stay , Middle Aged , Retrospective Studies , Treatment Outcome , Uterine Hemorrhage/etiology , Uterine Neoplasms/complicationsABSTRACT
En la práctica diaria y por el advenimiento de los programas de detección mamaria, el diagnóstico de carcinoma in situ de mama es cada vez más frecuente. En nuestro material del 10 por ciento en el primer período analizado (1984-1989), hemos pasado al 55 por ciento en el período 1996-2001.La valoración de los carcinomas en función del VNPI fue la siguiente: VN 3 o 4 en 16 casos (17 por ciento); VN 5,6 o 7 en 34 casos (35 por ciento); VN 8 o 9 en 18 casos (19 por ciento) y VN no valorable en 28 casos (29 por ciento).El empleo de puntuación (en este caso el VNPI) nos permite individualizar el tratamiento adecuando nuestro árbol de decisión al tamaño de la lesión, márgenes de seguridad y el grado de diferenciación histológica, unida a la presencia o no de necrosis tumoral. Por tanto, en nuestra casuística la progresión del tratamiento conservador ha pasado del 43 al 65 por ciento en los períodos estudiados (AU)
