La visión de enfermería en la intervención del tabaquismo / The view of nursing in smoking cessation intervention

No disponible

Estudio piloto: "Programa de soporte a la vinculación hacia dispositivos socio-sanitarios y formativo-laborales, para pacientes esquizofrénicos" / No disponible

Introducción: este estudio piloto pretende evaluar la eficacia de un programa multimodal y multi-terapéutico, dirigido principalmente a fomentar la adherencia hacia dispositivos de rehabilitación vocacional y soporte al empleo, así como dispositivos socia-sanitarios ambulatorios en salud mental. Aglutina algunos de los principales elementos terapéuticos señalados por la literatura científica (Pfammatter, Junghan et al. 2006), aplicándose tanto a los pacientes como a sus familiares simultáneamente. Material y método: 2 grupos terapéuticos fueron reclutados: el grupo de pacientes estaba compuesto por 8 pacientes con esquizofrenia, quienes asistieron a 16 sesiones (semanales); el grupo familiar incluía 8 de sus allegados, acudiendo a 6 sesiones. Ambos grupos se desarrollaron paralelamente (durante 5 meses). Resultados: todos los 8 participantes (asistencia media = 85,19%) completaron el grupo. No se consignó ningún ingreso hospitalario ni cambio de tratamiento farmacológico. Se detectaron mejoras en la asistencia hacia actividades de ocio y sociales, formativas, así como en varias escalas de la SFS (Tabla 1). Sin embargo, ningún cambio significativo a nivel clínico fue detectado en trabajo, Escala GAF y el uso de servicios en salud mental comunitarios. Conclusiones: Esta Aproximación terapéutica multimodal piloto mejora parcialmente el funcionamiento social en pacientes con esquizofrenia, manteniéndose esta mejora a los 6 meses de la intervención

Introduction: This pilot study pretends to test the efficacy of a multimodal therapy program, primarily aimed at fostering the adherence to work, vocational and ambulatory mental heath services. It encompasses the key therapeutic elements signalled on scientific literature (Pfammatter, Junghan et al. 2006), and applied to both patients and their families at the same time. Material and Methods: 2 therapeutic groups were recruited: Patients group was composed for 8 schizophrenic patients who underwent 16 sessions (weakly); the family group included 8 of their relatives, who took 6 sessions. Both groups were executed in parallel and at the same time (over 5 months). Results: All 8 patients finished the group (assistance mean = 85,19%). No hospital entrances and significant pharmacology treatment changes were reported. Improvements in assistance to leisure and social activities, formative activities and several SFS scales (table 1) were detected. Nonetheless, no significant clinical improvement were detected in work, GAF scale, and the use of communitarian health services. Conclusions: This pilot multimodal therapeutic approach partially improves social functioning in schizophrenic patients, for more than 6 months

Sprouty1 induces a senescence-associated secretory phenotype by regulating NFκB activity: implications for tumorigenesis.

Genes of the Sprouty family (Spry1-4) are feedback inhibitors of receptor tyrosine kinase (RTK) signaling. As such, they restrain proliferation of many cell types and have been proposed as tumor-suppressor genes. Although their most widely accepted target is the Extracellular-regulated kinases (ERK) pathway, the mechanisms by which Spry proteins inhibit RTK signaling are poorly understood. In the present work, we describe a novel mechanism by which Spry1 restricts proliferation, independently of the ERK pathway. In vivo analysis of thyroid glands from Spry1 knockout mice reveals that Spry1 induces a senescence-associated secretory phenotype via activation of the NFκB pathway. Consistently, thyroids from Spry1 knockout mice are bigger and exhibit decreased markers of senescence including Ki67 labeling and senescence-associated ß-galactosidase. Although such 'escape' from senescence is not sufficient to promote thyroid tumorigenesis in adult mice up to 5 months, the onset of Phosphatase and tensin homolog (Pten)-induced tumor formation is accelerated when Spry1 is concomitantly eliminated. Accordingly, we observe a reduction of SPRY1 levels in human thyroid malignancies when compared with non-tumoral tissue. We propose that Spry1 acts as a sensor of mitogenic activity that not only attenuates RTK signaling but also induces a cellular senescence response to avoid uncontrolled proliferation.

Las primeras sociedades neurológicas catalanas y sus protagonistas / The first Catalan Neurological Societies and their protagonists

Introduction: El conocimiento de las sociedades neurológicas anteriores a la Sociedad Española de Neurología (año 1949) es escaso. Las analizamos partiendo de la pionera Sociedad de Psiquiatría y Neurología de Barcelona, fundada en 1911. Desarrollo: Efectuamos una búsqueda bibliográfica mediante MEDLINE a partir de la palabra clave neurological societies, utilizando también la tesis doctoral de M.G. Fabregas «Història de la Neurologia a Catalunya. De l’any 1882 a l’any 1949» y de fuentes bibliográficas históricas originales de la Biblioteca de la Acadèmia de Ciències Mèdiques de Catalunya i Balears de Barcelona. En Cataluña y en España, la primera sociedad neurológica se creó hace un siglo, y fue la Sociedad de Psiquiatría y Neurología de Barcelona, fundada por Artur Galcerán i Granés en 1911. Posteriormente, se denominaría Societat Catalana de Psiquiatria i Neurologia y en 1934 estaría presidida por Belarmino Rodríguez Arias. Con la guerra civil se disolvió y reaparecería con el nombre de Asociación de Psiquiatría y Neurología y estaría presidida por José Córdoba Rodríguez (1941). Dicha sociedad sería precursora de la Asociación de Ciencias Neurológicas de Barraquer Bordas (año 1968) y ésta lo sería de la Societat Catalana de Neurología, fundada por Codina Puiggrós en 1973. Conclusiones: La Sociedad de Psiquiatria y Neurologia de Barcelona fundada en 1911 por Galcerán i Granés, y precursora de la Societat Catalana de Neurologia, fue la primera sociedad neurológica. Se debe remarcar que en el año 2011 se cumplen 100 años de la fundación de la primera sociedad neurológica catalana y española (AU)

Introduction: Little is known about the first Catalan neurological societies. Our aim was to analyse them from the formation of the pioneering Society of Psychiatry and Neurology of Barcelona founded in 1911. Development: We performed a literature search using MEDLINE using the key words: neurological societies, using the doctoral thesis of MG Fabregas: «History of Neurology in Catalonia: from 1882 to 1949» and original historical bibliographical sources of the Library of the Academy of Sciences Mèdiques de Catalunya i Balears. The presence of neurological societies in Catalunya is relatively recent. The first society was established a century ago, and was the Society of Psychiatry and Neurology of Barcelona, founded by Artur Galcerán i Granés in 1911. This became the Catalan Society of Neurology and Psychiatry in 1934 under the presidency of Belarmino Rodriguez Arias. With the civil war, the society broke up and reappeared under the name Association of Psychiatry and Neurology presided over by José Córdoba Rodríguez (1941), emerging in 1968 as the Association of Neurological Sciences with Lluís Barraquer Bordas as President. In 1973 it assumed the current name of Catalan Society of Neurology under Agustí Codina Puiggrós.Conclusions: The Society of Psychiatry and Neurology of Barcelona founded in 1911 by Galcerán i Granés was the first neurological society and was a precursor of the Catalan Society of Neurology. It should be highlighted that in 2011 it will be 100 years since the founding of the first neurological society in Catalonia and Spain (AU)

[The first Catalan Neurological Societies and their protagonists]. / Las primeras sociedades neurológicas catalanas y sus protagonistas.

INTRODUCTION: Little is known about the first Catalan neurological societies. Our aim was to analyse them from the formation of the pioneering Society of Psychiatry and Neurology of Barcelona founded in 1911. DEVELOPMENT: We performed a literature search using MEDLINE using the key words: neurological societies, using the doctoral thesis of MG Fabregas: «History of Neurology in Catalonia: from 1882 to 1949¼ and original historical bibliographical sources of the Library of the Academy of Sciences Mèdiques de Catalunya i Balears. The presence of neurological societies in Catalunya is relatively recent. The first society was established a century ago, and was the Society of Psychiatry and Neurology of Barcelona, founded by Artur Galcerán i Granés in 1911. This became the Catalan Society of Neurology and Psychiatry in 1934 under the presidency of Belarmino Rodriguez Arias. With the civil war, the society broke up and reappeared under the name Association of Psychiatry and Neurology presided over by José Córdoba Rodríguez (1941), emerging in 1968 as the Association of Neurological Sciences with Lluís Barraquer Bordas as President. In 1973 it assumed the current name of Catalan Society of Neurology under Agustí Codina Puiggrós. CONCLUSIONS: The Society of Psychiatry and Neurology of Barcelona founded in 1911 by Galcerán i Granés was the first neurological society and was a precursor of the Catalan Society of Neurology. It should be highlighted that in 2011 it will be 100 years since the founding of the first neurological society in Catalonia and Spain.

Sprouty1 is a candidate tumor-suppressor gene in medullary thyroid carcinoma.

Medullary thyroid carcinoma (MTC) is a malignancy derived from the calcitonin-producing C-cells of the thyroid gland. Oncogenic mutations of the Ret proto-oncogene are found in all heritable forms of MTC and roughly one half of the sporadic cases. However, several lines of evidence argue for the existence of additional genetic lesions necessary for the development of MTC. Sprouty (Spry) family of genes is composed of four members in mammals (Spry1-4). Some Spry family members have been proposed as candidate tumor-suppressor genes in a variety of cancerous pathologies. In this work, we show that targeted deletion of Spry1 causes C-cell hyperplasia, a precancerous lesion preceding MTC, in young adult mice. Expression of Spry1 restrains proliferation of the MTC-derived cell line, TT. Finally, we found that the Spry1 promoter is frequently methylated in MTC and that Spry1 expression is consequently decreased. These findings identify Spry1 as a candidate tumor-suppressor gene in MTC.

La faceta neurológica del Dr. Artur Galcerán i Granés (1850-1919) / The neurological work of Artur Galcerán i Granés (1850-1919)

Introducción: Analizar la faceta neurológica que es poco conocida de Artur Galcerán i Granés (Girona 1850-Barcelona 1919), fundador de la Sociedad de Psiquiatría y Neurología de Barcelona en 1911.Fuentes: Se efectúa una búsqueda bibliográfica mediante MEDLINE sin límite de fecha a partir de las palabras clave: “Galceran Granés” y “Society of Psychiatry and Neurology of Barcelona”, utilizando también la tesis doctoral de M. G. Fabregas Camps: “Història de la Neurologia a Catalunya. De l’any 1882 a l’any 1949”, y de fuentes bibliográficas históricas originales de la Biblioteca de la Acadèmia de Ciències Mèdiques de Catalunya i Balears de Barcelona. Desarrollo:Artur Galcerán i Granés se denominaba “neurólogo y mentalista”. Discípulo de la escuela de Psiquiatria de Joan Giné i Partagàs. Su obra neurológica fue notable, destacando: 1)“Algunas inducciones sobre estàtica y dinàmica del cerebro, que pueden servir para el esclarecimiento del concepto de localización”; 2) “Tratamiento de las epilepsias”, y 3) “Neuropatología y Psiquiatría generales”. Dirigió “Archivos de Terapéutica de las enfermedades nerviosas y mentales” y “Anales de la Sociedad de Psiquiatría y Neurología”. Fue director del sanatorio mental de Sant Boi de Llobregat y de Pere Mata de Reus. Fundó la primera sociedad neurológica catalana y española en Barcelona en el año 1911.Conclusiones: La faceta neurológica de A. Galcerán i Granés es remarcable y significativa. Fue el fundador de la primera sociedad neurológica catalana y española: la Sociedad de Psiquiatría y Neurología de Barcelona en el año 1911 precursora de la Societat Catalana de Neurologia (AU)

Introduction: To analyze the neurological work of Artur Galcerán i Granés (Girona 1850-Barcelona 1919) founder of the Society of Psychiatry and Neurology of Barcelona in 1911.Methods: We performed a literature search using MEDLINE from the Keywords ‘‘Galceran Granés’’ and ‘‘Society of Psychiatry and Neurology of Barcelona’’, using the doctoral thesis of M. G. Fabregas Camps: ‘‘History of Neurology in Catalonia. From 1882 to 1949 ’’, and original historical bibliographical sources of the Library of the Academy of Sciences Mèdiques de Catalunya i Balears. Results: Artur Galcegán i Granés was a disciple of the school of psychiatry of Dr. Joan Giné iPartagàs. His highlighting eurological work was: 1) ‘‘Some static and dynamic inferences aboutthe brain, which may serve to clarify the concept of localization’’, 2) ‘‘Treatment of epilepsy’’and 3) ‘‘Neuropathology and General Psychiatry’’. He was editor of ‘‘Archivos de Terapeúticade las enfermedades nerviosas y mentales’’ and ‘‘Anales de la Sociedad de Psiquiatría y Neurología’’. He was director of the mental asylum in Sant Boi of Llobregat and Pere Mata of Reus.In 1911 he founded the first Catalan and Spanish neurological society in Barcelona. Conclusions: The neurological work of Artur Galcerán i Granes is remarkable and significant. He was the founder of the first Catalan and Spanish neurological society: The Society of Psychiatry and Neurology of Barcelona in 1911, the forerunner of the Catalan Society of Neurology (AU)

The neurological work of Artur Galcerán i Granés (1850-1919).

INTRODUCTION: To analyze the neurological work of Artur Galcerán i Granés (Girona 1850-Barcelona 1919) founder of the Society of Psychiatry and Neurology of Barcelona in 1911. METHODS: We performed a literature search using MEDLINE from the keywords"Galceran Granés" and "Society of Psychiatry and Neurology of Barcelona", using the doctoral thesis of M. G. Fabregas Camps: "History of Neurology in Catalonia. From 1882 to 1949 ", and original historical bibliographical sources of the Library of the Academy of Sciences Mèdiques de Catalunya i Balears. RESULTS: Artur Galcerán i Granés was a disciple of the school of psychiatry of Dr. Joan Giné i Partagàs. His highlighting neurological work was: 1) "Some static and dynamic inferences about the brain, which may serve to clarify the concept of localization", 2) "Treatment of epilepsy" and 3) "Neuropathology and General Psychiatry". He was editor of "Archivos de Terapeútica de las enfermedades nerviosas y mentales" and "Anales de la Sociedad de Psiquiatría y Neurología". He was director of the mental asylum in Sant Boi of Llobregat and Pere Mata of Reus. In 1911 he founded the first Catalan and Spanish neurological society in Barcelona. CONCLUSIONS: The neurological work of Artur Galcerán i Granes is remarkable and significant. He was the founder of the first Catalan and Spanish neurological society: The Society of Psychiatry and Neurology of Barcelona in 1911, the forerunner of the Catalan Society of Neurology.

Guía práctica para el manejo y tratamiento ante la cistitis radical / Practical treatment approach of radiation induced cystitis

Objetivo: Establecer una pauta de actuación y un algoritmo terapéutico ante la aparición de hematuria en pacientes con antecedentes de radioterapia pélvica, revisando para ello las diferentes opciones de tratamiento reflejadas en la literatura médica. Material y métodos: A través de PubMed se realiza una revisión bibliográfica de artículos relacionados con la cistitis rádica, incluyendo términos de búsqueda referidos a las diferentes opciones de tratamiento: ácido hialurónico endovesical; estrógenos conjugados, pentosan polisulfato, ácido aminocaproico oral, factor VIIa recombinante, cámara hiperbárica, embolización, aluminio endovesical, balón Helmstein y formolización. Se limita la búsqueda a publicaciones en castellano e inglés y se excluyen aquellas referidas a la experimentación animal. Resultados: Se expone cada una de las opciones citadas, haciendo referencia al mecanismo de acción, pauta y dosis de administración, efectos secundarios y prevención de los mismos si es posible así como eficacia del tratamiento. Tras conseguir estabilizar hemodinamicamente al paciente y descartar la presencia de lesiones neoformativas vesicales y/o hematurias originadas en tramo urinario superior, se debe iniciar un tratamiento escalonado. Conclusiones: El conocer diferentes opciones de tratamiento y sus pautas de administración permitirá al urólogo obtener una mayor tasa de éxitos en el difícil manejo de esta patología (AU)

Objective: Establish a pattern of behavior and treatment algorithm at the onset of hematuria in patients with a previous history of pelvic radiation, checking for this different treatment options reflected in the literature. Material and methods: Through performing a PubMed literature review of articles related to IC lies, searching items includes the different treatment options: intravesical hyaluronic acid, conjugated estrogens, pentosan polysulfate, oral aminocaproic acid, recombinant factor VIIa, hyperbaric chamber, embolization, aluminum intravesical, Helmstein ball and formalin. Limits the search to english or spanish publications and excluding those related to animal experimentation. Results: Every option is exposed, referring to the physiopathology, dosage regimen and administration, side effects and treatment efficacy. Conclusions: Once patient hemodynamic stabilization is achieved, and after rule out bladder tumors injuries and /or haemathuria originating from the upper urinary tract, treatment should start rolling. To know different treatment options and patterns of administration will allow the urologist to obtain a higher rate of success in the difficult management of this condition (AU)

Factores predictores de mortalidad en pacientes con enfermedad pulmonar obstructiva crónica y exacerbaciones frecuentes / Precipitating factors of mortality in chronic obstructive pulmonary disease patients with frequent exacerbations

Objetivo. Identificar las características de pacientes con una agudización de la enfermedad pulmonar obstructiva crónica (AEPOC) capaces de predecir en un plazo corto de tiempo la mortalidad por EPOC. Material y método. Estudio retrospectivo caso-control de pacientes ingresados por AEPOC para la identificación de factores predictores de mortalidad. El grupo control estaba formado por pacientes vivos a los 6 meses. Las variables recogidas incluían antecedentes, comorbilidad, estado de salud y nutricional, disnea basal, dependencia, agudizaciones, exploración física, función pulmonar, radiología, electrocardiograma, microbiología y tratamiento. Las diferencias entre grupos se compararon con los test de la χ2 y de la T-Student. La capacidad predictiva se analizó con regresión logística, estableciendo como variable dependiente la mortalidad. Resultados. Se incluyeron 125 pacientes (44 éxitus/81 vivos) (10 mujeres/115 varones) de 74±10 años. Ambos grupos eran similares en edad, sexo y gravedad de la enfermedad. De todas las variables, encontramos diferencias significativas en la disnea basal (p<0,01), los niveles de proteína C reactiva (p<0,007), la hemoglobina (p<0,037) y las plaquetas (p<0,041), en la actividad física (p<0,036), el uso de musculatura accesoria (p<0,007), el aislamiento microbiológico positivo (p<0,013) y el tratamiento con anticolinérgicos (p<0,029) y con digoxina (p<0,039). Ninguna de estas variables, sin embargo, era capaz de predecir la mortalidad en el análisis de regresión logística. Conclusiones. Con los datos que se manejan para el seguimiento habitual de los pacientes con EPOC no parece posible identificar predictores de mortalidad a corto plazo (6 meses) en un ingreso hospitalario, diferentes a la propia gravedad de la agudización. Únicamente algún parámetro que expresaría mayor inflamación crónica y la menor tolerancia al ejercicio parecen ser diferentes en el grupo de pacientes fallecidos en la AECOP(AU)

Objective. To identify the main characteristics in patients with COPD exacerbation, capables to predict the short-term COPD mortality. Matherials and methods. This is a case-control retrospective study of admitted patients with COPD to identify risk factors of mortality. The control group was constituted by alive patients after 6 months. The variables studied were clinical antecedents, comorbility, health and nutritional status, basal dyspnea, dependency, exacerbations, physical examination, pulmonary function, radiology, ECG, microbiology and treatment. Both groups were compared with the Chi-square and the T tests. The predictive capacity was analyzed with logistic regression for which the dependent variable was mortality. Results. 125 patients were enrolled (44 exitus and 81 alive) (10 females and 115 males) with mean age of 74+10 years. No significant differences were found between groups in age, sex and disease severity. On the other hand, we found statistically significant differences in basal dyspnea (p<0,01), RCP levels (p<0,007), Hb (p<0,037) and platelets (p<0,041), physic activity (p<0,036), accessory muscles use (p<0,007), positive microbiological culture (p<0,013) and treatment with anticholinergic agents (p<0,029) and digoxin (p<0,039). However, none of these variables was able to predict mortality in the logistic regression analysis. Conclusions. The usual data managed in the follow-up of COPD patients are not useful to identify short-term mortality predictors (6 months) during a hospital admittance. Only some variables that would represent a higher chronic inflammation and a lower exercise tolerance showed a statistical tendence in the dead patients group in a exacerbation of COPD(AU)

[Practical treatment approach of radiation induced cystitis]. / Guía práctica para el manejo y tratamiento ante la cistitis radical.

OBJECTIVE: Establish a pattern of behavior and treatment algorithm at the onset of hematuria in patients with a previous history of pelvic radiation, checking for this different treatment options reflected in the literature. MATERIAL AND METHODS: Through performing a PubMed literature review of articles related to IC lies, searching items includes the different treatment options: intravesical hyaluronic acid, conjugated estrogens, pentosan polysulfate, oral aminocaproic acid, recombinant factor VIIa, hyperbaric chamber, embolization, aluminum intravesical, Helmstein ball and formalin. Limits the search to english or spanish publications and excluding those related to animal experimentation. RESULTS: Every option is exposed, referring to the physiopathology, dosage regimen and administration, side effects and treatment efficacy. CONCLUSIONS: Once patient hemodynamic stabilization is achieved, and after rule out bladder tumors injuries and /or haemathuria originating from the upper urinary tract, treatment should start rolling. To know different treatment options and patterns of administration will allow the urologist to obtain a higher rate of success in the difficult management of this condition.

[Precipitating factors of mortality in chronic obstructive pulmonary disease patients with frequent exacerbations]. / Factores predictores de mortalidad en pacientes con enfermedad pulmonar obstructiva crónica y exacerbaciones frecuentes.

OBJECTIVE: To identify the main characteristics in patients with COPD exacerbation, capables to predict the short-term COPD mortality. MATERIALS AND METHODS: This is a case-control retrospective study of admitted patients with COPD to identify risk factors of mortality. The control group was constituted by alive patients after 6 months. The variables studied were clinical antecedents, comorbility, health and nutritional status, basal dyspnea, dependency, exacerbations, physical examination, pulmonary function, radiology, ECG, microbiology and treatment. Both groups were compared with the Chi-square and the T tests. The predictive capacity was analyzed with logistic regression for which the dependent variable was mortality. RESULTS: 125 patients were enrolled (44 exitus and 81 alive) (10 females and 115 males) with mean age of 74+10 years. No significant differences were found between groups in age, sex and disease severity. On the other hand, we found statistically significant differences in basal dyspnea (p<0,01), RCP levels (p<0,007), Hb (p<0,037) and platelets (p<0,041), physic activity (p<0,036), accessory muscles use (p<0,007), positive microbiological culture (p<0,013) and treatment with anticholinergic agents (p<0,029) and digoxin (p<0,039). However, none of these variables was able to predict mortality in the logistic regression analysis. CONCLUSIONS: The usual data managed in the follow-up of COPD patients are not useful to identify short-term mortality predictors (6 months) during a hospital admittance. Only some variables that would represent a higher chronic inflammation and a lower exercise tolerance showed a statistical tendence in the dead patients group in a exacerbation of COPD.

Tumor necrosis factor alpha and interferon gamma cooperatively induce oxidative stress and motoneuron death in rat spinal cord embryonic explants.

The accumulation of reactive microglia in the degenerating areas of amyotrophic lateral sclerosis (ALS) tissue is a key cellular event creating a chronic inflammatory environment that results in motoneuron death. We have developed a new culture system that consists in rat spinal cord embryonic explants in which motoneurons migrate outside the explant, growing as a monolayer in the presence of glial cells. The proinflammatory cytokines tumor necrosis factor alpha (TNF-alpha) and interferon gamma (IFN-gamma) have been proposed to be involved in ALS-linked microglial activation. In our explants, the combined exposure to these cytokines resulted in an increased expression of the pro-oxidative enzymes inducible nitric oxide synthase (iNOS), the catalytic subunit of the nicotinamide adenine dinucleotide phosphate (NADPH) oxidase, gp91(phox) and cyclooxygenase-2 (COX-2), as compared to each cytokine alone. This effect was related to their cooperation in the activation of the transcription factor nuclear factor kappa B (NF-kappaB). TNF-alpha and IFN-gamma also cooperated to promote protein oxidation and nitration, thus increasing the percentage of motoneurons immunoreactive for nitrotyrosine. Apoptotic motoneuron death, measured through annexin V-Cy3 and active caspase-3 immunoreactivities, was also found cooperatively induced by TNF-alpha and IFN-gamma. Interestingly, these cytokines did not affect the viability of purified spinal cord motoneurons in the absence of glial cells. It is proposed that the proinflammatory cytokines TNF-alpha and IFN-gamma have cooperative/complementary roles in inflammation-induced motoneuron death.

Can infundibular height predict the clearance of lower pole calyceal stone after extracorporeal shockwave lithotripsy?

PURPOSE: To evaluate the efficacy of extracorporeal shock wave lithotripsy (SWL) on lower calyceal calculi in relation to the renal anatomical factors and determine which of these factors can be used to select patients who will benefit from SWL. MATERIALS AND METHODS: We analyzed retrospectively 78 patients with single radiopaque lower calyceal stones treated with SWL. The patients were evaluated 3 months after lithotripsy with a simple abdominal X-ray and a kidney ultrasound scan. The success of the treatment, removal of all fragments, was correlated with renal anatomical factors measured in the pre-treatment intravenous urography: infundibulopelvic angle, lower infundibulum width, lower infundibulum length, ratio length/width, infundibulum height, and number of minor calyces in the lower calyceal group. RESULTS: Three months after SWL treatment, 39 patients were stone-free (NR group) and 39 had residual fragments (R group). Both groups presented no differences in relation to infundibulopelvic angle, width and length of the lower calyceal infundibulum, length/width ratio of the lower infundibulum or number of lower calyces. Height of the infundibulum, described as the distance between the line passing through the lowest part of the calyx containing the calculus and the highest point of the lower lip of renal pelvis, was the only parameter in which significant differences (p = 0.002) were found between the NR and R groups. CONCLUSIONS: Lower Infundibular height could be a good measurement tool for deciding which patients with lower calyceal lithiasis would benefit from SWL treatment. Height of less than 22 mm suggests a good outcome from lithotripsy.

Can infundibular height predict the clearance of lower pole calyceal stone after extracorporeal shockwave lithotripsy?

PURPOSE: To evaluate the efficacy of extracorporeal shock wave lithotripsy (SWL) on lower calyceal calculi in relation to the renal anatomical factors and determine which of these factors can be used to select patients who will benefit from SWL. MATERIAL AND METHODS: We analyzed retrospectively 78 patients with single radiopaque lower calyceal stones treated with SWL. The patients were evaluated 3 months after lithotripsy with a simple abdominal X-ray and a kidney ultrasound scan. The success of the treatment, removal of all fragments, was correlated with renal anatomical factors measured in the pre-treatment intravenous urography: infundibulopelvic angle, lower infundibulum width, lower infundibulum length, ratio length/width, infundibulum height, and number of minor calyces in the lower calyceal group. RESULTS: Three months after SWL treatment, 39 patients were stone-free (NR group) and 39 had residual fragments (R group). Both groups presented no differences in relation to infundibulopelvic angle, width and length of the lower calyceal infundibulum, length/width ratio of the lower infundibulum or number of lower calyces. Height of the infundibulum, described as the distance between the line passing through the lowest part of the calyx containing the calculus and the highest point of the lower lip of renal pelvis, was the only parameter in which significant differences (p = 0.002) were found between the NR and R groups. CONCLUSIONS: Lower Infundibular height could be a good measurement tool for deciding which patients with lower calyceal lithiasis would benefit from SWL treatment. Height of less than 22 mm suggests a good outcome from lithotripsy.

¿Procesamiento cognitivo, procesamiento fonémico o procesamiento temporal? / Cognitive, phonemic or temporal processing?

Introducción. Procesamiento cognitivo, procesamiento temporaly procesamiento fonémico son términos aplicados al procesamientodel lenguaje y la lectoescritura.Objetivo. Comprobar si el procesamiento fonémico se relacionacon el procesamiento temporal y con el procesamiento cognitivo.Métodos. Previo examen médico, se seleccionaron 36 niños condificultades fonémicas entre 7 y 14 años, niños/niñas en proporciónde 2:1, utilizando pruebas de procesamiento fonémico. Por cada sujetose seleccionaron con las mismas pruebas fonológicas dos controlesnormales. A los sujetos se administró la batería cognitiva DN:CASpara diagnóstico de procesamiento cognitivo y a sujetos y controlesuna prueba de procesamiento temporal acústica creada en laboratoriocuyos ítems eran dos tipos de sílabas: unas con período de transiciónde 40 ms y otras con más de 40 ms. Frecuencias y medias se analizaronestadísticamente. Se aplicó también análisis factorial con laspuntuaciones del DN:CAS y la prueba acústica.Resultados. Los sujetos cometieron más errores en comparacióncon controles en la prueba acústica (z=6,73; p<0,0000). La puntuaciónmedia en el DN:CAS de los sujetos fue inferior al grupo controlnormativo (t=3,64; p=0,001). El análisis factorial identificó la pruebaacústica como una prueba secuencial, con una explicación de lavarianza del 77%.Conclusiones. Se argumenta que las disfunciones fonológica,temporal y cognitiva pueden ser distintas expresiones de un mismomecanismo, lo que es de aplicación diagnóstica y terapéutica independientementede la edad. Se sugiere la posible utilidad práctica dela prueba acústica (AU)

Objective. To test whether temporal, phonemic, and cognitiveprocessing are interrelated.Methods. After medical screening, 36 subjects with phonemic difficulties,7 to 14 years-old, boy/ girl ratio of 2:1, were selected with phonemicprocessing tests. For every subject, two normal controls were alsoselected with the same phonemic tests. DN:CAS cognitive battery fordiagnosing of cognitive processing was administered to the subjectsand both subjects and controls were examined with an acoustic temporalprocessing test made in laboratory. This consisted of two kinds ofitems, syllables with transition period of 40 milliseconds and anotherlonger one. Proportions and means were statistically analyzed. Factorialanalysis was applied to scores in DN:CAS and syllabic acoustic tests.Results. When compared to the controls, the subjects mademore errors in the acoustic test (z=6.73; p<0.000). The DN:CASmean obtained by the subjects was lower than the standardardizedgroup (t=6.73; p=0.001). The factorial analysis accountingfor 77% of the variance identified the acoustic test as a sequentialprocessing test.Conclusions. Arguments are presented that suggest that phonemic,temporal, and cognitive processing may be differentexpressions of the same central neurological mechanism regardlessof the age. This implies diagnostic and therapeutic considerations.On the other hand, the acoustic test is suggested as a usefultest in assessing cognitive function (AU)

[Cognitive, phonemic or temporal processing?]. / ¿Procesamiento cognitivo, procesamiento fonémico o procesamiento temporal?

INTRODUCTION: Cognitive, temporal and phonemic processing are different terms applied to language and, in particular, reading- writing processing. OBJECTIVE: To test whether temporal, phonemic, and cognitive processing are interrelated. Methods. After medical screening, 36 subjects with phonemic difficulties, 7 to 14 years-old, boy/ girl ratio of 2:1, were selected with phonemic processing tests. For every subject, two normal controls were also selected with the same phonemic tests. DN:CAS cognitive battery for diagnosing of cognitive processing was administered to the subjects and both subjects and controls were examined with an acoustic temporal processing test made in laboratory. This consisted of two kinds of items, syllables with transition period of 40 milliseconds and another longer one. Proportions and means were statistically analyzed. Factorial analysis was applied to scores in DN:CAS and syllabic acoustic tests. RESULTS: When compared to the controls, the subjects made more errors in the acoustic test (z=6.73; p<0.000). The DN:CAS mean obtained by the subjects was lower than the standardized group (t=6.73; p=0.001). The factorial analysis accounting for 77% of the variance identified the acoustic test as a sequential processing test. CONCLUSIONS: Arguments are presented that suggest that phonemic, temporal, and cognitive processing may be different expressions of the same central neurological mechanism regardless of the age. This implies diagnostic and therapeutic considerations. On the other hand, the acoustic test is suggested as a useful test in assessing cognitive function.

[Arteriovenous fistula of the renal stump after nephrectomy]. / Fistula arteriovenosa renal secundaria a la ligadura en bloque del pedículo renal.

An arteriovenous fistula of the renal pedicle is a rare complication after nephrectomy. Most of cases we identify it time along after surgery. We present a case of an arteriovenous fistula of the right renal pedicle after nephrectomy done for pyonephrosis 40 years before. We comment the clinical features, treatment and evolution of the patient. We also review the actual literature.