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1.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-38848948

RESUMO

OBJECTIVE: This descriptive study examines quality of life in women undergoing placement of a midurethral sling for stress urinary incontinence. MATERIALS AND METHODS: This was a retrospective cohort study based on data from 51 women consecutively undergoing this procedure at a tertiary hospital in the years 2014 and 2015. The main outcome variable was quality of life assessed through the Sandvick severity test and International Consultation on Incontinence Short Quality of Life Questionnaire (ICIQ-IU-SF) at the time points baseline or presurgery, and 6 months and 5 years postsurgery. Factors associated with treatment failure were determined through binary logistic regression. RESULTS: At 5-year follow up we obtained an absolute reduction of 8.78 points (95% CI 6.43-11.14; p < 0.001) in the ICIQ-IU-SF questionnaire and 4.54 (95% CI 3.25-5.83; p < 0.001) in the Sandvick severity test score, compared to baseline, in the 35 patients that completed follow-up. Out of the 51 patients that were followed, the rate of success in incontinence correction was 86.3% (44/50) with a failure rate of 12% (6/50). Multiparity and previous gynaecological surgery were identified as predisposing factors for treatment failure. Obesity was associated with a worse treatment outcome. CONCLUSION: Sling treatment for incontinence was successful in 86.3% (44/50) of participants and remained effective 5 years after surgery in terms of quality of life.

2.
Actas Dermosifiliogr ; 115(3): T237-T245, 2024 Mar.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-38242435

RESUMO

BACKGROUND: Although the Spanish Ministry of Health prepares national therapeutic positioning reports (TPRs) and drug reimbursement policies, each of the country's 17 autonomous communities (ACs) is responsible for health care services and prescription requirements in its territory. The aim of the EQUIDAD study was to describe and explore potential differences in prescription requirements for new dermatology drugs across the autonomous communities. MATERIAL AND METHODS: Cross-sectional study conducted in April and May, 2023. Two dermatologists with management responsibilities from each autonomous community reported on territorial and more local prescription requirements for drugs covered by national TPRs issued between 2016 and 2022. RESULTS: Thirty-three researchers from 17 autonomous communities participated. The data submitted revealed between-community inequities in access to new drugs. Overall, 64.7% of the regions imposed additional prescription requirements to those mentioned in the TPRs for psoriasis. This percentage was lower for atopic dermatitis (35.3%) and melanoma (11.8%). The most common requirement for accessing a new drug was a previous prescription for another drug. Differences and additional requirements were also detected at the local level (i.e., differences between hospitals within the same autonomous community). CONCLUSIONS: Spain's autonomous communities have multiple regional and local prescription requirements that are not aligned with national TPR recommendations. These differences result in inequitable access to new drugs for both patients and practitioners across Spain.


Assuntos
Dermatologia , Humanos , Espanha , Estudos Transversais
3.
Actas Dermosifiliogr ; 115(3): 237-245, 2024 Mar.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-37890617

RESUMO

BACKGROUND: Although the Spanish Ministry of Health prepares national therapeutic positioning reports (TPRs) and drug reimbursement policies, each of the country's 17 autonomous communities (ACs) is responsible for health care services and prescription requirements in its territory. The aim of the EQUIDAD study was to describe and explore potential differences in prescription requirements for new dermatology drugs across the autonomous communities. MATERIAL AND METHODS: Cross-sectional study conducted in April and May, 2023. Two dermatologists with management responsibilities from each autonomous community reported on territorial and more local prescription requirements for drugs covered by national TPRs issued between 2016 and 2022. RESULTS: Thirty-three researchers from 17 autonomous communities participated. The data submitted revealed between-community inequities in access to new drugs. Overall, 64.7% of the regions imposed additional prescription requirements to those mentioned in the TPRs for psoriasis. This percentage was lower for atopic dermatitis (35.3%) and melanoma (11.8%). The most common requirement for accessing a new drug was a previous prescription for another drug. Differences and additional requirements were also detected at the local level (i.e., differences between hospitals within the same autonomous community). CONCLUSIONS: Spain's autonomous communities have multiple regional and local prescription requirements that are not aligned with national TPR recommendations. These differences result in inequitable access to new drugs for both patients and practitioners across Spain.


Assuntos
Dermatologia , Humanos , Espanha , Estudos Transversais
6.
Clin Rheumatol ; 40(7): 2985-2989, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33244722

RESUMO

Calcinosis cutis (CC) is defined as the deposition of calcium salts on the skin and subcutaneous tissue. It is associated with different conditions, including some autoimmune diseases, and it can generate significant inflammation, pain, and functional impairment. Different therapies have been tried with limited results. Intralesional sodium thiosulfate seems a promising therapeutic option. We report a patient with diffuse systemic sclerosis who presented with two symmetrical plaques on both axillae, which caused pain and skin retraction. The clinical diagnosis was consistent with CC, which was confirmed by skin biopsy and ultrasound. The patient was treated with a 250 mg/ml solution of sodium thiosulfate injected into the plaques. Complete resolution was achieved after three monthly sessions. The only reported adverse effect was a transient burning sensation during the injections. Given its effectiveness and safety, we believe that intralesional sodium thiosulfate could become a valid first-line option for the treatment of CC.


Assuntos
Calcinose , Escleroderma Sistêmico , Dermatopatias , Calcinose/diagnóstico por imagem , Calcinose/tratamento farmacológico , Humanos , Escleroderma Sistêmico/complicações , Escleroderma Sistêmico/tratamento farmacológico , Dermatopatias/tratamento farmacológico , Tiossulfatos
7.
Neth J Med ; 77(2): 90, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30895937
8.
Clin Exp Dermatol ; 39(8): 888-93, 2014 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-25142297

RESUMO

BACKGROUND: Tuberous sclerosis complex (TSC) is an autosomal dominant neurocutaneous disorder characterized by the development of multisystem hamartomatous tumours. Topical sirolimus has recently been suggested as a potential treatment for TSC-associated facial angiofibroma (FA). AIM: To validate a reproducible scale created for the assessment of clinical severity and treatment response in these patients. METHODS: We developed a new tool, the Facial Angiofibroma Severity Index (FASI) to evaluate the grade of erythema and the size and extent of FAs. In total, 30 different photographs of patients with TSC were shown to 56 dermatologists at each evaluation. Three evaluations using the same photographs but in a different random order were performed 1 week apart. Test and retest reliability and interobserver reproducibility were determined. RESULTS: There was good agreement between the investigators. Inter-rater reliability showed strong correlations (> 0.98; range 0.97-0.99) with inter-rater correlation coefficients (ICCs) for the FASI. The global estimated kappa coefficient for the degree of intra-rater agreement (test-retest) was 0.94 (range 0.91-0.97). CONCLUSIONS: The FASI is a valid and reliable tool for measuring the clinical severity of TSC-associated FAs, which can be applied in clinical practice to evaluate the response to treatment in these patients.


Assuntos
Angiofibroma , Antibióticos Antineoplásicos/uso terapêutico , Neoplasias Faciais , Imunossupressores/uso terapêutico , Índice de Gravidade de Doença , Sirolimo/uso terapêutico , Esclerose Tuberosa/complicações , Angiofibroma/tratamento farmacológico , Angiofibroma/etiologia , Angiofibroma/patologia , Neoplasias Faciais/tratamento farmacológico , Neoplasias Faciais/etiologia , Neoplasias Faciais/patologia , Humanos , Variações Dependentes do Observador , Reprodutibilidade dos Testes
10.
Clin Exp Dermatol ; 37(7): 707-11, 2012 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-22998541

RESUMO

Heparin use is associated with various cutaneous reactions, with the most common being immune-mediated skin lesions and bleeding complications. In this review, we compile the dermatological side-effects of heparin reported in the literature, and provide a clear approach to their adequate management.


Assuntos
Anticoagulantes/efeitos adversos , Toxidermias/etiologia , Fibrinolíticos/efeitos adversos , Heparina/efeitos adversos , Hipersensibilidade Tardia/induzido quimicamente , Dermatopatias/induzido quimicamente , Humanos , Hipersensibilidade Tardia/diagnóstico , Hipersensibilidade Tardia/terapia , Dermatopatias/imunologia , Dermatopatias/terapia
12.
Med. cután. ibero-lat.-am ; 40(2): 58-61, mar.-abr. 2012. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-103011

RESUMO

Los corticoides tópicos representan el escalón principal en el tratamiento de muchas enfermedades dermatológicas no infecciosas. Si se usan de forma apropiada son seguros y efectivos, pero sin una supervisión médica adecuada pueden producir efectos secundarios graves, tanto locales como sistémicos. Presentamos dos pacientes adultos diagnosticados de síndrome de Cushing iatrogénico en nuestro hospital. Aunque es una complicación poco frecuente, se debe tener en cuenta en pacientes con dermatosis inflamatorias de larga evolución, ya que puede ser de difícil diagnóstico si no se sospecha (AU)


Topical corticosteroids are the mainstay of treatment for many non- infectious dermatoses. If used appropriately they are a safe and effective therapy, but without medical supervision severe local and systemic adverse effects may occur. We report two patients followed at our Dermatology unit that developed iatrogenic Cushing's syndrome after using topical corticosteroids. Although it's an extremely rare complication in adults, we must be aware of this adverse effect in patients with chronic inflammatory dermatoses, as diagnosis requires a high grade of suspicion (AU)


Assuntos
Humanos , Masculino , Feminino , Adulto , Idoso , Síndrome de Cushing/diagnóstico , Corticosteroides/efeitos adversos , Administração Tópica , Fatores de Risco
17.
Breast Cancer Res Treat ; 122(2): 371-80, 2010 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-19842031

RESUMO

Studies of gene regulated by estrogen in breast cancer 1 (GREB1) have focused on mRNA levels with limited evidence about GREB1 protein expression in normal and breast cancer cells. A monoclonal antibody that recognizes GREB1 protein in breast tissues could be applied to correlate protein expression with established mRNA expression data. A hybridoma expressing a murine monoclonal antibody targeting a 119 amino acid peptide specific to human GREB1 was generated. The novel monoclonal GREB1 antibody (GREB1ab) was validated for use in Western blotting as well as immunohistochemical (IHC) applications. GREB1ab detects a 216 kDa protein corresponding to GREB1 in estrogen receptor alpha (ERalpha+) breast cancer cells as well as ERalpha- breast cancer cells transduced with a GREB1 expression vector. GREB1ab specificity was verified using an ERalpha antagonist to prevent GREB1 induction as well as a silencing siRNA targeting GREB1 mRNA. GREB1ab was further validated for detection of GREB1 by IHC in breast cancer cell lines and breast tissue microarrays (TMA). ERalpha+ cell lines were observed to express GREB1 while ERalpha- cell lines did not express detectable levels of the protein. Using breast cancer tissue whole sections, IHC with the GREB1ab identified protein expression in ERalpha+ breast cancer tissue as well as normal breast tissue, with little GREB1 expression in ERalpha- breast cancer tissue. Furthermore, these data indicate that GREB1 mRNA expression correlates well with protein expression. The novel monoclonal GREB1ab is specific for GREB1 protein. This antibody will serve as a tool for investigations focused on the expression, distribution, and function of GREB1 in normal breast and breast cancer tissues.


Assuntos
Anticorpos Monoclonais/biossíntese , Especificidade de Anticorpos , Neoplasias da Mama/metabolismo , Regulação Neoplásica da Expressão Gênica , Proteínas de Neoplasias/metabolismo , RNA Mensageiro/metabolismo , Animais , Anticorpos Monoclonais/genética , Western Blotting , Neoplasias da Mama/genética , Neoplasias da Mama/imunologia , Linhagem Celular Tumoral , Estradiol/metabolismo , Antagonistas de Estrogênios/farmacologia , Receptor alfa de Estrogênio/antagonistas & inibidores , Receptor alfa de Estrogênio/metabolismo , Feminino , Regulação Neoplásica da Expressão Gênica/efeitos dos fármacos , Humanos , Hibridomas , Imuno-Histoquímica , Camundongos , Camundongos Endogâmicos BALB C , Proteínas de Neoplasias/genética , Proteínas de Neoplasias/imunologia , Interferência de RNA , Receptor ErbB-2/metabolismo , Reprodutibilidade dos Testes , Análise Serial de Tecidos
20.
Br J Radiol ; 82(980): e160-3, 2009 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-19592399

RESUMO

Nasal and paranasal malignant tumours account for less than 5% of all head and neck malignancies. Epithelial malignancies overwhelmingly predominate, with squamous cell carcinomas representing the most frequent histological subtype in this location. Soft-tissue sarcomas of the nasal cavity and paranasal sinuses are exceedingly rare. Here, we report two cases of myxoid liposarcomas that occurred in the nasal and paranasal regions, both of which presented diagnostic challenges and could not be diagnosed definitively from intraoperative frozen sections. These cases reinforce the notion that, while they are uncommon, sarcomas in general and liposarcomas in particular should still be considered as part of the differential diagnosis in patients presenting with obstructive symptoms in the nasal and paranasal sinuses.


Assuntos
Lipossarcoma Mixoide/diagnóstico , Neoplasias dos Seios Paranasais/diagnóstico , Seio Esfenoidal , Idoso , Meios de Contraste , Diagnóstico Diferencial , Feminino , Humanos , Lipossarcoma Mixoide/patologia , Imageamento por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Neoplasias dos Seios Paranasais/patologia , Tomografia Computadorizada por Raios X
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