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1.
Forensic Sci Int ; 329: 111087, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34736052

RESUMO

An important demand exists in the field of forensic analysis to objectively determine the post-mortem interval (PMI) when human skeletal remains are discovered. It is widely known that bones undergo different chemical and physical processes after death, mainly due to their interaction with the environment in which they are found, although it is not known exactly what these processes consist of. Multiple techniques have been used so far to follow up these and other post-mortem changes and thus establish the time elapsed since the individual's death, but they present important drawbacks in terms of reliability and accuracy. The aim of this research was to propose an analytical methodology capable of determining the PMI by using non-destructive Raman spectroscopy measurements of human skeletal remains. The recorded Raman spectra provided valuable and potentially useful information from which a multivariate study was performed by means of orthogonal partial least squares regression (OPLSR) in order to correlate the PMI with the detected spectral modifications. A collection of 53 real human skeletal remains with known PMI (15 years ≤ PMI ≤ 87 years) was analysed and used for building and validating the OPLS model. The PMI of 10 out of 14 validation samples could be determined with an accuracy error of less than 30%, demonstrating the adequate predictive performance of the OPLS model even in spite of the large inter-individual variability it handled. This opens up the possibility of applying the OPLS model in combination with non-destructive techniques to the determination of the PMI of human skeletal remains that have been buried in conditions similar or equal to those of cemetery niches and in a geographic location with a Mediterranean climate, which is an important achievement for forensic medicine and anthropology.


Assuntos
Restos Mortais , Análise Espectral Raman , Quimiometria , Humanos , Mudanças Depois da Morte , Reprodutibilidade dos Testes
2.
Talanta ; 205: 120114, 2019 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-31450424

RESUMO

In recent years the interest and demand for artworks has been increasing as they are an interesting commercial investment due to their growing value in the market. This explains the increasing number of counterfeits dealing with artworks that has led to the development of new methodologies for their characterization. The material characterization of these types of works can provide relevant information for both authentication and conservation/restoration. Thus, in this study multivariate chemometric methods were applied to FTIR-ATR spectroscopic data for artwork dating purposes. To that end, ageing prediction models were developed for Liquitex® and Hyplar® brands. Paint samples containing the green synthetic organic pigment (PG7), were exposed to artificial ageing and analysed with FTIR-ATR and Py-GC/MS for characterization and monitorization of the main components (binding medium, pigment and additives). Although the OPLS ageing models were mainly characterized by the modifications suffered by both the binder and the surfactants, a universal model could not be developed due to differences in the modification trends of the different brands. The applicability of the OPLS modelling for artwork dating purposes was tested in artworks provided by internationally recognized contemporary Basque artists. For Liquitex® a significant correlation (p < 0.05) between natural and accelerated ageing could be established, in which approximately 50 h of accelerated ageing under the applied conditions were equivalent to one natural year. This correlation might have possible applications in the dating of artworks for up to at least 22 years. Thus, the study demonstrates that FTIR-ATR combined with chemometrics is a potential method for artwork dating and a valuable source of information about the chemical processes involved in paint ageing, which can be of great help in the conservation and restoration steps.

3.
Actas Dermosifiliogr (Engl Ed) ; 109(4): 346-350, 2018 May.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-29373111

RESUMO

BACKGROUND: Regesmohs registry is a nationwide registry including patients evaluated for Mohs surgery in 17 Spanish centres since July 2013. Given that Mohs surgery is the therapy with best results for high risk basal cell carcinoma (BCC) and other skin tumours, we wanted to describe the reasons that lead to some patients being excluded from this therapy and the alternative treatments that they received. These data may be useful to avoid excluding patients for Mohs surgery use, to estimate the healthcare demand of these patients and the demand for Hedgehog inhibitors therapy in this group. OBJECTIVE: To describe patients excluded for Mohs surgery after pre-surgical assessment, and the treatments that they received. METHODS: Regesmohs includes all consecutive patients assessed for Mohs surgery in the participating centres, collecting data on patient characteristics, intervention, and short and long-term results. Patients excluded for Mohs surgery after pre-surgical evaluation were described. RESULTS: 3011 patients were included in Regesmohs from July 2013 to October 2016. In 85, Mohs surgery was not performed as they were considered inadequate candidates. 67 had BCC. Reasons for exclusion were: medical contraindication (27.1%, n=23) low-risk tumour in (18.8%, n=16) and giant tumour and bone invasion (15.3%, n=13). Only 1 patient (1.2%) showed lymph node involvement and no patients had visceral metastases. Of the 85 excluded patients, 29 (34.1%) were treated with conventional surgery, 24 (28.3%) with radiotherapy, 4 (4.7%) with inhibitors of the Hedgehog pathway (only indicated for BCC), and 2 (2.4%) received palliative care. We had no follow-up data on 14 patients (16.5%). CONCLUSION: Medical comorbidities were the most common reason for withholding Mohs surgery. Withholding therapy on the basis of distant extension is uncommon. Most excluded patients received simpler therapies: conventional surgery or radiotherapy, with hedgehog inhibitors being a new option.


Assuntos
Cirurgia de Mohs , Seleção de Pacientes , Neoplasias Cutâneas/cirurgia , Suspensão de Tratamento , Idoso , Idoso de 80 Anos ou mais , Carcinoma Basocelular/tratamento farmacológico , Carcinoma Basocelular/radioterapia , Carcinoma Basocelular/cirurgia , Carcinoma de Células Escamosas/tratamento farmacológico , Carcinoma de Células Escamosas/radioterapia , Carcinoma de Células Escamosas/cirurgia , Comorbidade , Contraindicações de Procedimentos , Feminino , Proteínas Hedgehog/antagonistas & inibidores , Humanos , Masculino , Proteínas de Neoplasias/antagonistas & inibidores , Cuidados Paliativos , Estudos Prospectivos , Sistema de Registros , Neoplasias Cutâneas/tratamento farmacológico , Neoplasias Cutâneas/radioterapia , Espanha
4.
J Pharm Biomed Anal ; 145: 178-185, 2017 Oct 25.
Artigo em Inglês | MEDLINE | ID: mdl-28666164

RESUMO

A novel gradient reverse phase high performance liquid chromatography tandem mass spectrometry (HPLC/MS-MS) was performed as a method for the determination of dobutamine hydrochloride (DOB) in newborn pig plasma samples. It was developed and validated after optimization of sample treatment and various chromatographic and mass spectrometric conditions. Trimethoxydobutamine (TMD) was used as internal standard. Heptafluorobutyric acid (HFBA) and ethyl acetate were used for the treatment of plasma samples. The separation of dobutamine and internal standard was done using a Kinetex F5 (50×2.1mm, 2.6µm, 100Å) analytical column. The mobile phase was a mixture of acetonitrile and HCOOH 0.01%. The column oven temperature was optimized at 40° C and the flow rate was 0.25mL/min. DOB and TMD were detected by multiple reaction monitoring (MRM) mode in ESI+, using a cone voltage (CV) of 25V and a collision energy (CE) of 25eV. The weighted calibration curve (1/x2) was found to be linear over the concentration range of 1-100ng/mL (r2>0.999). The limit of quantification (LLOQ) of the method was 1ng/mL. The values of selectivity, carryover, LLOQ, linearity, accuracy, precision, matrix effect, stability and recovery obtained meet the acceptable range according to European Medicines Agency (EMA) and Food and Drug Administration (FDA) guidelines. The method was efficiently applied to quantify DOB in plasma samples from a pharmacokinetic/pharmacodynamic study in a disease model of newborn piglet.


Assuntos
Dobutamina/sangue , Animais , Calibragem , Cromatografia Líquida de Alta Pressão , Suínos , Espectrometria de Massas em Tandem
5.
Sci Total Environ ; 565: 795-803, 2016 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-27102275

RESUMO

Commercial stabilized slurry of zero-valent iron nanoparticles (nZVI) as well as laboratory-synthesized polymer-stabilized NZVI nanoparticles were used for lindane (γ-hexachlorocyclohexane) degradation studies in aqueous solution. In the present study, polymer-stabilized iron nanoparticles were stabilized using polyethylene glycol (PEG, Mn ~400 and ~950-1050) and polytetrahydrofuran (PTHF, Mn ~650). To study the effectiveness of the different nanoparticles, a quantitative monitorization of lindane degradation by using solid-phase extraction (SPE) and a qualitative measurement of generated volatile by-products by headspace-solid phase microextraction (HS-SPME) followed by GC/MS were carried out. The obtained data were compared and contrasted with the results obtained in previous work. Results showed that the nanoparticles studied in this work possess superior dechlorination performance compared with previous observations. The freshly prepared Fe(0)-PEG400, Fe(0)-PEG1050 and Fe(0)-PTHF exhibited high reactivity during the dechlorination process of lindane in a very short time. The results obtained with the synthesized nanoparticles were similar to those obtained with commercial nanoparticles. However, in all cases reactivity decreased at reaction's late stage. Degradation of lindane by the studied nanoparticles removed 99.9% of the lindane initial concentration after 72h, except for Fe(0)-PTHF nanoparticles, for which the reaction stopped after 5min. In all cases, the reaction followed a second order kinetics. Finally, comparing the results from this study with our previous work, where different nature polymers were considered (Fe(0)-CMC, Fe(0)-PAA and Fe(0)-PAP), more gradual degradation profile of lindane was observed for Fe(0)-PAA and Fe(0)-CMC. It should be noted that in the present case, the reaction of lindane was speeded up with commercial and Fe(0)-PEG nanoparticles. Nevertheless, in the later case, the composition of by-products was affected by the presence of partially degraded intermediates. Taking into account the current technologies, the high removal rates obtained and the acceptable degradation times required, the proposed technology is suitable for its aimed purpose.


Assuntos
Hexaclorocicloexano/química , Ferro/química , Nanopartículas Metálicas/química , Polieletrólitos/química , Poluentes Químicos da Água/química , Inseticidas/química
6.
Environ Manage ; 57(6): 1139-52, 2016 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-26884142

RESUMO

We explored the capacity of the biological and hydromorphological indices used in the Water Framework Directive (WFD) to assess ecosystem services by evaluating the ecological status of Spanish River Basins. This analysis relies on an exhaustive bibliography review which showed scientific evidence of the interlinkages between some ecosystem services and different hydromorphological and biological elements which have been used as indices in the WFD. Our findings indicate that, of a total of 38 ecosystem services analyzed, biological and hydromorphological indices can fully evaluate four ecosystem services. In addition, 18 ecosystem services can be partly evaluated by some of the analyzed indices, while 11 are not related with the indices. While Riparian Forest Quality was the index that was able to assess the largest number of ecosystem services (N = 12), the two indices of macrophytes offered very poor guarantees. Finally, biological indices related to diatoms and aquatic invertebrates and the Fluvial Habitat Index can be related with 7, 6, and 6 ecosystem services, respectively. Because the WFD indices currently used in Spain are not able to assess most of the ecosystem services analyzed, we suggest that there is potential to develop the second phase of the WFD implementation taking this approach into consideration. The incorporation of the ecosystem services approach into the WFD could provide the framework for assess the impacts of human activities on the quality of fluvial ecosystems and could give insights for water and watershed management in order to guarantee the delivery of multiple ecosystem services.


Assuntos
Conservação dos Recursos Naturais/métodos , Ecossistema , Monitoramento Ambiental/métodos , Política Ambiental/legislação & jurisprudência , Rios , Animais , Conservação dos Recursos Naturais/legislação & jurisprudência , Diatomáceas/crescimento & desenvolvimento , Ecologia , Monitoramento Ambiental/legislação & jurisprudência , Atividades Humanas , Invertebrados/crescimento & desenvolvimento , Espanha , Qualidade da Água
7.
Actas Dermosifiliogr ; 106(10): 823-9, 2015 Dec.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-26381434

RESUMO

BACKGROUND AND OBJECTIVE: Anti-tumor necrosis factor therapy for moderate to severe psoriasis can increase the risk of active tuberculosis in patients who have latent tuberculosis infection (LTBI). The main objective of this study was to estimate the prevalence of LTBI in patients with moderate to severe plaque psoriasis being treated in dermatology clinics in Spain. MATERIAL AND METHOD: Non-interventional, cross-sectional, national epidemiological study conducted in Spain in 2011-2012. Patients with moderate to severe plaque psoriasis were included if they had undergone at least one tuberculin skin test (TST) and/or been evaluated with an interferon-γ release assay (IGRA) based on enzyme-linked immunosorbent assay (QuantiFERON(®) TB Gold In-Tube) in the 2 years preceding the study. RESULTS: Data for 440 patients were valid for analysis. In total, 97.7% of the patients had undergone a TST, with a positive result in 23%. Of the 238 patients in whom the initial result was negative, 5% converted to positive on re-testing for a booster effect. IGRA results were available for 16.8%, 20.5% of them positive. Two of the patients with positive IGRA results had a negative TST. The prevalence of LTBI in the whole sample was 26.6%. The degree of concordance between the TST and the IGRA was moderate (κ=0.516; P<.001). CONCLUSIONS: The prevalence of LTBI in this study was similar to previous estimates for Spain.


Assuntos
Tuberculose Latente/epidemiologia , Psoríase/epidemiologia , Adulto , Antirreumáticos/uso terapêutico , Vacina BCG , Contraindicações , Estudos Transversais , Emigrantes e Imigrantes , Feminino , Humanos , Testes de Liberação de Interferon-gama , Tuberculose Latente/diagnóstico , Masculino , Pessoa de Meia-Idade , Prevalência , Psoríase/tratamento farmacológico , Psoríase/genética , Espanha/epidemiologia , Teste Tuberculínico , Vacinação/estatística & dados numéricos
8.
Anal Chim Acta ; 892: 105-14, 2015 Sep 10.
Artigo em Inglês | MEDLINE | ID: mdl-26388480

RESUMO

Establishing the approximate age of an ink entry from a questioned document is often a complicated task and a controversial issue in forensic sciences. Among the existing approaches, the analysis of solvents in ballpoint inks may be a useful parameter for determining the age of ink on paper. In recent years, several ink dating methods have been proposed. These methods have been based on the analysis of common ink solvents using gas chromatography/mass spectrometry (GC/MS) as the analytical platform. Despite these recent methods, several questions remain. The aim of this work was to develop an ink dating methodology (DATINK) for documents written by ballpoint pens based on the disappearance of volatile solvents from the ink entry. Multiple solid-phase microextraction (MHS-SPME) coupled to GC/MS was used to measure the solvents from ink entries made with four BIC(®) ballpoint pens. The ß parameter, the remaining fraction of the analyte in the system after one equilibration, corresponding to the successive extractions was considered for modelling a mathematical equation for later ink age dating. Preliminary tests of DATINK method showed that it was possible to detect the presence of ink solvents on documents up to the studied five years. The analyses of different real samples of known age were analyzed in terms of ß values, which provided a mean relative error of 21%. The proposed use of ß parameter for estimating the absolute age of ballpoint ink entries has shown promising results with a standard deviation of ß ranging from 0.002 to 0.004.

9.
Talanta ; 123: 207-17, 2014 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-24725884

RESUMO

Headspace (HS) and headspace solid phase microextraction (HS-SPME) analysis by gas chromatography-mass spectrometry (GC/MS) have been found to be suitable methods for the analysis of volatile organic compounds. The objectives of this paper are to study the possibilities of multiple headspace extraction (MHE) for the quantitative determination of volatile compounds in mushroom samples and to compare the results obtained using three different sample treatment techniques. For this purpose, HS with two different injection techniques (pressure-loop system and gas-tight syringe autosampling system) and HS-SPME have been studied. Three processes were optimized for the analysis of 20 volatile compounds by experimental design technique based on Central Composite Design (CCD) and Full Factorial Design depending on the used methodology. Once the designs were finished, a trade off among optimum conditions for each compound analyzed was reached. At optimum conditions, appropriate extraction time and sample amount for the three techniques used were established. Finally, the methods were validated in terms of linearity, detection and quantitation limits and repeatability. The most suitable method was then applied to the quantitative analysis of seven mushroom samples. A detailed comparison of the analytical performance characteristics of HS and HS-SPME as sample treatment techniques for final GC/MS determination is given. In addition, MHE has been proved to be an adequate technique to avoid matrix effects in complex samples quantitation. Its applicability to the determination of volatile mushroom components, along with its limitations, is discussed in this work.


Assuntos
Agaricales/química , Odorantes/análise , Microextração em Fase Sólida/métodos , Compostos Orgânicos Voláteis/análise , Cromatografia Gasosa-Espectrometria de Massas/métodos , Reprodutibilidade dos Testes , Olfato , Compostos Orgânicos Voláteis/classificação , Compostos Orgânicos Voláteis/isolamento & purificação
10.
Chemosphere ; 93(7): 1324-32, 2013 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-23972910

RESUMO

Zero-valent iron nanoparticles (NZVI) as well as polymer-stabilized nanoparticles were synthesized and used for lindane (γ-hexachlorocyclohexane) degradation in aqueous solution. To study the effectiveness of the different coated nanoparticles, simple and rapid analytical methods have been developed to measure and to detect lindane and its by-products. For the monitorization of lindane degradation solid-phase extraction (SPE) was used, while volatile by-products formation measurement was carried out by headspace-solid phase microextraction (HS-SPME) followed by GC/MS. The SPE-GC/MS method provides low detection limits (0.2 µg L(-1)), high recovery (above 95%) and it is a valuable tool for kinetic studies of the degradation process for each polymer used, while HS-SPME-GC/MS has proved to be an effective tool for the extraction and evaluation of volatile degradation by-products.


Assuntos
Hexaclorocicloexano/análise , Ferro/química , Nanopartículas/química , Poluentes Químicos da Água/análise , Cromatografia Gasosa-Espectrometria de Massas , Hexaclorocicloexano/química , Microextração em Fase Sólida , Eliminação de Resíduos Líquidos/métodos , Poluentes Químicos da Água/química
11.
Nature ; 491(7425): 566-9, 2012 Nov 22.
Artigo em Inglês | MEDLINE | ID: mdl-23172214

RESUMO

Pluto and Eris are icy dwarf planets with nearly identical sizes, comparable densities and similar surface compositions as revealed by spectroscopic studies. Pluto possesses an atmosphere whereas Eris does not; the difference probably arises from their differing distances from the Sun, and explains their different albedos. Makemake is another icy dwarf planet with a spectrum similar to Eris and Pluto, and is currently at a distance to the Sun intermediate between the two. Although Makemake's size (1,420 ± 60 km) and albedo are roughly known, there has been no constraint on its density and there were expectations that it could have a Pluto-like atmosphere. Here we report the results from a stellar occultation by Makemake on 2011 April 23. Our preferred solution that fits the occultation chords corresponds to a body with projected axes of 1,430 ± 9 km (1σ) and 1,502 ± 45 km, implying a V-band geometric albedo p(V) = 0.77 ± 0.03. This albedo is larger than that of Pluto, but smaller than that of Eris. The disappearances and reappearances of the star were abrupt, showing that Makemake has no global Pluto-like atmosphere at an upper limit of 4-12 nanobar (1σ) for the surface pressure, although a localized atmosphere is possible. A density of 1.7 ± 0.3 g cm(-3) is inferred from the data.

12.
Talanta ; 100: 246-53, 2012 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-23141333

RESUMO

A simple, easy-to-use, efficient and environmentally friendly method has been developed for the simultaneous analysis of nine pirethroid pesticides in water samples by the combination of hollow fibre-based liquid-phase microextraction (HF-LPME) and gas chromatography-mass spectrometry (GC/MS). For the developed method, nine pirethroid pesticides (esbiothrin, prallethrin, bifenthrin, tetramethrin, phenothrin, permethrin, cyfluthrin, cypermethrin and deltamethrin) were concentrated and well separated under optimal conditions. Several factors that influence the efficiency of HF-LPME were investigated and optimized by means of experimental design. The proposed method has good linearity in the concentration range of 10-400 µg L(-1) with correlation coefficients between 0.995 and 0.999. Overall enrichment factors for the optimized method ranged from 139 to 255 times except for cypermethrin and deltamethrin which ranged from 35 to 128. Detection and quantitation limits of the chromatographic method were in the range of 0.002-0.012 µg L(-1) and 0.003-0.026 µg L(-1) respectively, with RSD values between 4.2% and 18.4%. The recoveries varied in the range of 69.4%-122.7% except for cypermethrin and deltamethrin (17.5%-64.1%) with relative standard deviations between 1.0% and 24.0% for intra and inter-day experiments at different concentrations (0.1 µg L(-1), 0.5 µg L(-1), 1 µg L(-1)). The HF-LPME method optimized was applied to the analysis of three spiked real water samples with good results.

13.
Med. cután. ibero-lat.-am ; 38(5): 198-202, sept.-oct. 2010. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-97221

RESUMO

La urticaria de contacto localizada por calor es una enfermedad poco frecuente, de la que existen menos de 60 pacientes referidos. Presentamos el caso de una cocinera de 64 años con episodios de eritema y edema pruriginosos circunscritos a las zonas de contacto de la piel con el agua caliente. La positividad de la intradermo-reacción con suero autólogo a 55º C apoyaría la hipótesis que contempla la existencia de alguna molécula sérica, activada por el calor y responsable del cuadro clínico (AU)


Heat contact urticaria is an unusual disease, with nearly 60 cases reported. A 64 years old female, who works as a cook, and developed episodes of well-demarcated, reddish, itchy and edematous lesions, limited to areas of the skin exposed to hot water is reported. The autologous serum skin test(ASST) at 55ºC was performed and was positive, supporting the existing hypothesis of an unknown heat activated protein in serum, as responsible of the etiology of this disorder (AU)


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Urticária/diagnóstico , Dermatite Fotoalérgica/diagnóstico , Edema/fisiopatologia , Angioedema , Corticosteroides/uso terapêutico
14.
Rheumatology (Oxford) ; 47(8): 1151-5, 2008 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-18524806

RESUMO

OBJECTIVE: The pathophysiology of non-traumatic osteonecrosis (ON) or avascular necrosis (AVN) of the femoral head remains poorly understood. Some studies have suggested the contribution of underlying thrombophilia as a mechanism; however, no specific thrombophilic factor has been consistently found in association with the disease. We are presenting data suggesting a role for endothelial cell activation rather than thrombophilia in ON. METHODS: A prospective consecutive cohort of 49 patients with a diagnosis of ON. The disease was considered idiopathic in five and secondary in 44 patients. The investigation included a coagulation and thrombophilia profile, endothelial cell activation and non-specific inflammatory markers as well as a biochemical profile. Statistical analysis using Fisher's exact test was obtained to assess correlation between endothelial cell markers and variables of inflammation. RESULTS: Patients with non-traumatic ON were not found to have a specific underlying thrombophilic factor compared with the general population. Out of 49 patients,19 had elevation of at least one endothelial cell markers. We found that activation of endothelial cell markers was independently correlated to ON but not correlated to the presence of inflammation (P = 1.0000). CONCLUSION: These results suggest that non-traumatic ON is not associated with a specific thrombophilic abnormality in those affected. This study demonstrates a potential association between regional endothelial dysfunction and ON. More studies are needed at a molecular level to further investigate the specific role of endothelium in the physiopathology of ON. A better understanding of the underlying mechanism could lead to potential preventive and therapeutic strategies of this devastating disease.


Assuntos
Endotélio Vascular/fisiopatologia , Necrose da Cabeça do Fêmur/fisiopatologia , Trombofilia/complicações , Adolescente , Adulto , Biomarcadores/sangue , Células Endoteliais/fisiologia , Endotélio Vascular/patologia , Feminino , Necrose da Cabeça do Fêmur/etiologia , Necrose da Cabeça do Fêmur/patologia , Humanos , Inflamação/complicações , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos
15.
Rev Esp Enferm Dig ; 100(1): 17-23, 2008 Jan.
Artigo em Espanhol | MEDLINE | ID: mdl-18358056

RESUMO

OBJECTIVES: To compare subjective tolerance and secondary adverse events to bowel cleansing prior to colonoscopy with polyethylene glycol (PEG) and sodium phosphate (NaP) in adult patients and in those 65 or more years old. MATERIAL AND METHODS: Retrospective matched study, choosing 140 patients among all of those who underwent colonoscopy from March 2004 to May 2005. We investigated the presence of the next adverse events during bowel preparation: Fever, low digestive bleeding, abdominal pain, perianal pain, nausea, vomiting, thirst, somnolence, agitation, tremor and convulsions. We considered bad objective tolerance if the patient presented any one of these events. We also asked patients about subjective tolerance to preparation. RESULTS: Seventy patients prepared with PEG and seventy with NaP were included (69 women and 71 men, mean age 60.6 +/- 14.8 years). There was no relationship between subjective tolerance or the presence of adverse events and bowel cleansing with any of the products in general population or in elderly patients (p = 0.09 and p = 0.45 in the elderly). However, patients prepared with NaP showed more nausea than those who employed PEG (p < 0.009), overall women of 65 or more years old. There were no severe adverse events in patients prepared with NaP. Elderly showed better tolerance than younger patients, and women worst tolerance than men, irrespective of the lavage preparation employed. Patients prepared with PEG unfinished bowel cleansing more frequently than those with NaP. Cleanliness achieved with NaP was significantly better than that obtained with PEG. CONCLUSIONS: Bowel cleansing prior to colonoscopy with NaP is as well tolerated, safe and effective as with PEG, even in elderly healthy patients, although it causes more nausea. Cleanliness with NaP is better than that achieved with PEG.


Assuntos
Colonoscopia , Fosfatos/efeitos adversos , Polietilenoglicóis/efeitos adversos , Cuidados Pré-Operatórios , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Satisfação do Paciente/estatística & dados numéricos , Estudos Retrospectivos
18.
Cienc. ginecol ; 10(1): 41-47, ene.-feb. 2006. ilus, graf
Artigo em Es | IBECS | ID: ibc-042462

RESUMO

La histeroscopia permite observar directamente el interior del útero, La hiperplasia endometrial definida como una proliferación de glándulas, de forma y tamaño irregular, no presenta patrón histeroscópico determinado para cada tipo de hiperplasia. Cuando valoramos eficacia y correlación del diagnostico clínico con el histológico, la eficacia diagnóstica para hiperplasia oscila entre el 56 y el 83%, La normalidad de imagen histeroscópica no excluye la posibilidad de patología. La sensibilidad es del 98% con una especificidad del 99.9% en determinados grupos especialmente entrenados, entre los que nos encontramos, en el adenocarcinoma endometrial hacen a la histeroscopia herramienta imprescindible. La afectación cervical es diagnosticada con una sensibilidad que oscila entre el 64-100%, especificidad 73-98%. El VPN es de 100% y un VPP entre el 38.4 y 93.3%. La histeroscopia es el método de elección en el diagnostico y manejo de la patología maligna endometrial, favoreciendo el hallazgo temprano y el estadiaje del cáncer endometrial. Precisa entrenamiento y aprendizaje para la obtención de su mejor rendimiento diagnostico. Con una elevada sensibilidad, especificidad


The hysteroscopy allows to observe the interior of the uterus directly. The endometrial hyperplasia defined as a proliferation of glands, of form and irregular size, it doesn’t present hysteroscopic patron certain for each hyperplasia type. When we value effectiveness and correlation of the diagnose clinical with the histology, the effectiveness diagnostic for hyperplasia oscillates between the 56 and 83%. The normality of image hysteroscopic doesn’t exclude the pathology possibility. The sensibility is of 98% with a specificity of 99.9% in certain specially trained groups, in those that we find ourselves , the carcinoma endometrial makes to the hysteroscopy indispensable tool. The cervical affectation is diagnosed with a sensibility that oscillates between 64-100%, specificity 73-98%. The VPN is of 100% and a VPP between the 38.4 and 93.3%. The hysteroscopy is the election method in the diagnose and manage of the pathology wicked endometrial, favoring the early discovery and the stage of the endometrial cancer. It is necessary a training and a learning for the obtainig of their best yield diagnose. With a high sensibility, specificity


Assuntos
Feminino , Adulto , Idoso , Pessoa de Meia-Idade , Humanos , Hiperplasia Endometrial/diagnóstico , Histeroscopia/métodos , Neoplasias do Endométrio/diagnóstico , Sensibilidade e Especificidade , Adenocarcinoma/diagnóstico , Adenoma/diagnóstico
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