Efectividad de dos medicamentos intrarticulares en pacientes con artrosis de rodilla: colágeno polimerizado versus hylano gf 20 / Effectiveness of two intraarticular drugs in patients with knee arthrosis: polymerized collagen versus hylan GF 20

El tratamiento de la osteoartrosis se enfoca en mejorar el dolor y la calidad de vida de los portadores. Los antiinflamatorios no esteroideos son la primera elección pero su efectividad es cuestionable por el riesgo de gastropatía y falla renal secundarias. Los medicamentos de uso intrarticular, son una alternativa segura y efectiva para mejorar los síntomas y la función; pueden retrasar la cirugía pero desconocemos si son modificadores de la enfermedad. Nuestro objetivo fue comparar la función y dolor de rodilla en pacientes con osteoartrosis al término del tratamiento asignado. Nuestra hipótesis es que no existe diferencia en los resultados entre ambos grupos. Material y métodos: Estudio prospectivo, aleatorio simple, no cegado, estudiamos a dos grupos de pacientes con osteoartrosis de rodilla. El Grupo 1 fue tratado con colágeno PVP y el Grupo 2 recibió hylano GF-20. Se les aplicó el cuestionario subjetivo del Comité Internacional de Rodilla IKDC y el dolor se midió mediante escala visual análoga, al inicio del tratamiento, al mes y tres meses posteriores al término del mismo. Resultados: La disminución en el dolor medido con escala visual análoga resulta estadísticamente significativa en ambos grupos; sin embargo, al comparar ambos grupos no encontramos diferencias. Así mismo se comportan los resultados del IKDC en ambos grupos, no hay diferencia: sólo se encuentra diferencia entre las mediciones basales y el resultado final.

The purpose of osteoarthrosis treatment is to improve patient's pain and quality of life. Non-steroidal anti-inflammatory drugs are the first choice but their effectiveness is questionable due to the risk of secondary gastric disease and renal failure. Intra-articular drugs are a safe and effective alternative to improve symptoms and function; they may delay surgery but we don't know if they are disease modifying. Our objective was to compare knee function and pain in patients with osteoarthrosis until treatment is finished. Our hypothesis is that there is no difference in the results of both groups. Material and methods: A prospective, simple, randomized non blinded trial where we studied two groups of patients with knee osteoarthrosis. Group 1 was treated with Collagen PVP and Group 2 received hylan GF-20. We gave patients a subjective questionnaire of the International Knee Committee IKDC and pain was measured using the visual analog scale at the beginning of treatment, after one month and after three months. Results: Decrease in pain measured with the visual analog scale is statistically significant in both groups, however, when comparing both groups we did not find differences. The results of the IKDC were the same in both groups, there was no difference except in baseline measurements and in the final result.

[Effectiveness of two intraarticular drugs in patients with knee arthrosis. Polymerized collagen versus hylan]. / Efectividad de dos medicamentos intrarticulares en pacientes con artrosis de rodilla: colágeno polimerizado versus hylano gf 20.

UNLABELLED: The purpose of osteoarthrosis treatment is to improve patient's pain and quality of life. Non-steroidal anti-inflammatory drugs are the first choice but their effectiveness is questionable due to the risk of secondary gastric disease and renal failure. Intra-articular drugs are a safe and effective alternative to improve symptoms and function; they may delay surgery but we don't know if they are disease modifying. Our objective was to compare knee function and pain in patients with osteoarthrosis until treatment is finished. Our hypothesis is that there is no difference in the results of both groups. MATERIAL AND METHODS: A prospective, simple, randomized non blinded trial where we studied two groups of patients with knee osteoarthrosis. Group 1 was treated with Collagen PVP and Group 2 received hylan GF-20. We gave patients a subjective questionnaire of the International Knee Committee IKDC and pain was measured using the visual analog scale at the beginning of treatment, after one month and after three months. RESULTS: Decrease in pain measured with the visual analog scale is statistically significant in both groups, however, when comparing both groups we did not find differences. The results of the IKDC were the same in both groups, there was no difference except in baseline measurements and in the final result.

Hamartoma folicular basaloide linealunilateral / Lineal unilateral basaloid follicular hamartoma

El Hamartoma Folicular Basaloide (HFB) es una rara malformación con un patrón histopatológico distintivo, caracterizado por la presencia de cordonesramificados e islotes de células basaloides en una disposición radial. Clínicamente esta lesión puede presentar diversas formas. Aportamos el caso deuna mujer de 21 años con un HFB de distribución lineal unilateral (AU)

Basaloid Follicular Hamartoma (BFH) is a rare malformation with distinctive histopathologic pattern characterized by the presence of branching cordsand strands of basaloid cells in a radial arrangement. Clinically, this lesion can assume differents forms. We report a 21 year-old woman with a linearand unilateral BFH (AU)

Tratamiento con antidiabéticos orales durante el embarazo en mujeres con diabetes pregestacional. A propósito de un caso / Treatment with oral Antidiabetics in pregestational diabetes. Apropos of a case

¿Son los antidiabéticos orales (ADO) una alternativa a la insulina en el tratamiento de la diabetes pregestacional? A propósito del caso de una inmigrante árabe en tratamiento con una sulfonilurea hasta la semana 20 de gestación, que alumbró un feto sano y sin alteraciones morfológicas visibles, hemos llevado a cabo una revisión bibliográfica acerca de estudios comparativos entre grupos de mujeres gestantes diabéticas tratadas con ADO y otras que recibieron insulina, pero éstos son muy escasos debido al poder teratogénico que se les atribuye. En concreto, hay uno llevado a cabo con 404 mujeres entre las semanas 11 y 13 de gestación, a las que se trató de forma aleatoria con Glyburide® o con insulina. Como resultado de este estudio, no se obtuvieron diferencias clínicamente significativas en cuanto a control de glucemias de las gestantes, tamaño y peso de los recién nacidos o complicaciones neonatales, en concreto la incidencia de anomalías fetales fue similar en ambos grupos. Por lo tanto, el uso de ADO puede constituir en el futuro una alternativa clínicamente eficaz a la insulina en el tratamiento de la diabetes gestacional, aunque hasta la fecha no está recomendado su uso en las guías clínicas sobre diabetes y embarazo, y es necesario realizar más estudios que permitan determinar su seguridad y eficacia (AU)

Are oral antidiabetic agents an alternative to insulin therapy in pregestational diabetes? Apropos of the case of an Arab immigrant under sulfonylurea treatment until the 20th week of gestation, who delivered a healthy child with no apparent morphologic alterations, we reviewed comparative studies performed in pregnant diabetics treated with oral antidiabetic agents and pregnant diabetic women treated with insulin therapy. Few studies have been performed with oral antidiabetic agents in pregnant women due to the teratogenic potential attributed to these drugs. One study included 404 women randomly assigned between 11 and 13 weeks of gestation to receive glyburide or insulin. No significant differences were found between the two groups in glycemic control, the infants' length and weight, or neonatal complications. No differences in the incidence of fetal anomalies were observed in the two groups. Therefore, oral antidiabetics may become an effective alternative to insulin therapy in gestational diabetes. However, the use of these drugs is not recommended in clinical guidelines published to date, since further studies are required to determinate their safety and efficacy (AU)