Valor actual de la ecografía en la caracterización de los nódulos tiroideos. Revisión de las últimas guías clínicas de actuación / Review of the current value of ultrasonography in the characterization of thyroid nodules

Debido al uso generalizado de la imagen médica para estudiar las enfermedades del cuello, la prevalencia de los nódulos tiroideos ha alcanzado el 67%. Esto es un problema sociosanitario relevante porque, después de evaluar las características del nódulo, hay que decidir cuándo hacer una aspiración con aguja fina ecoguiada para determinar cuáles son malignos. En este trabajo, revisamos la técnica ecográfica y la de la punción, las diferentes guías de actuación para caracterizar los nódulos tiroideos y los criterios que ayudan a determinar qué pacientes necesitan la punción diagnóstica y evitar procedimientos invasivos innecesarios. Colaborar estrechamente con los diferentes especialistas implicados en el manejo del nódulo tiroideo permite optimizar los recursos y obtener más rendimiento diagnóstico (AU)

The widespread use of medical imaging to study diseases of the neck reveals the prevalence of thyroid nodules can be as high as 67%. This is an important problem for the healthcare system because after analyzing the characteristics of the nodules a decision must be made regarding whether to perform fine-needle aspiration cytology to determine whether the lesion is malignant. In this article, we review the techniques for ultrasonographic study and fine-needle aspiration. We discuss the different guidelines for characterizing thyroid nodules and the criteria that help determine which patients need fine-needle aspiration for diagnosis and when an invasive procedure is unnecessary and can be avoided. Close collaboration with the different specialists involved in the management of thyroid nodules helps optimize resources and diagnostic performance (AU)

[Review of the current value of ultrasonography in the characterization of thyroid nodules]. / Valor actual de la ecografía en la caracterización de los nódulos tiroideos. Revisión de las últimas guías clínicas de actuación.

The widespread use of medical imaging to study diseases of the neck reveals the prevalence of thyroid nodules can be as high as 67%. This is an important problem for the healthcare system because after analyzing the characteristics of the nodules a decision must be made regarding whether to perform fine-needle aspiration cytology to determine whether the lesion is malignant. In this article, we review the techniques for ultrasonographic study and fine-needle aspiration. We discuss the different guidelines for characterizing thyroid nodules and the criteria that help determine which patients need fine-needle aspiration for diagnosis and when an invasive procedure is unnecessary and can be avoided. Close collaboration with the different specialists involved in the management of thyroid nodules helps optimize resources and diagnostic performance.

Malformación venosa. ¿De qué se trata? «Sinus pericranii» asociado a una malformación compleja del desarrollo venoso cerebeloso / Venous malformation, what is it? Sinus pericranii associated complex venous malformation of cerebellar development

Introducción: El sinus pericranii (SP) es una rara malformación vascular que consiste en una comunicación venosa entre los senos durales intracraneales y las venas epicraneales, que se suelen dilatar. Caso clínico: Presentamos el caso de un niño de 2 años de edad con una lesión vascular en la región parietal derecha, de coloración azulada, que de forma progresiva se ingurgitaba en decúbito lateral derecho y con el llanto. En las pruebas de imagen se detectó una lesión de localización subgaleal con adelgazamiento local de la calota, acompañada de 2 angiomas venosos cerebelosos. Se sospechó un SP asociado a una malformación venosa cerebelosa. El SP se intervino quirúrgicamente y la malformación se mantiene bajo control multidisciplinario. Conclusión: Destacamos que el SP puede asociarse a otras malformaciones del desarrollo vascular intracraneal. El tratamiento quirúrgico del sinus puede estar indicado por problemas estéticos y posibles complicaciones locales, principalmente la trombosis, el sangrado o la ulceración. El abordaje de las malformaciones intracraneales extensas resulta complejo, ya que pueden drenar zonas funcionalmente significativas del cerebro (AU)

Introduction: The sinus pericranii (SP) is a rare vascular malformation consists of a venous communication between the intracranial dural sinuses and epicranial veins, which are usually dilated. Clinical case: We report the case of a tolder with a vascular bluish lesion in his right parietal region, which progressively engorged when patient lies down to right lateral decubites or while is in tears. Findings images detected a subgaleal lesion location with a local shell thinning, together with two cerebellar venous angiomas. SP was suspected with complex cerebellar vascular malformation. The SP was surgical removed and the malformation is kept under multidisciplinar control. Conclusion: We emphasize that the SP may be associated with other intracranial vascular malformations development. The sinus surgical may be indicated for cosmetic problems and local complications particularly thrombosis, bleeding or ulceration. The approach of extensive intracranial malformations is complex, since they can drain functionally brain areas (AU)

Grado de cumplimiento de los objetivos de control metabólico y de los factores de riesgo cardiovascular en pacientes diabéticos tipo 2 en un área de Atención Primaria / Degree of fulfillment of the objectives of control metabolico and the factors of diabetic cardiovascular risk in patients type 2 in an area of Primary Attention

La diabetes mellitus tipo 2 (DM2) representa un importante problema de salud pública, debido a su elevada prevalencia y alta morbimortalidad, que se incrementa, aún más, por su asociación a determinados factores de riesgo cardiovascular (FRV). Por ello es importante una acción conjunta sobre todas estas alteraciones, ya que su control previene las manifestaciones vasculares. Objetivo: Se basa en la detección y determinación del grado de control de los factores de riesgo asociados a pacientes con DM2, según los datos dados por las diferentes organizaciones internacionales, estudiados en un Centro de Salud de Valladolid. Método: Se trata de un estudio transversal descriptivo para evaluar el control de distintos FRV en pacientes diagnosticados y tratados de DM2 de acuerdo a los diferentes criterios establecidos. La muestra está formada por 74 pacientes adultos (41 varones y 33 mujeres), incluidos en el Programa de Diabetes Mellitus de un “cupo” perteneciente al Centro de Salud de Rondilla 2, del Área Este de Atención Primaria de Valladolid, para la consulta programada de control de riesgo cardiovascular. Resultados y conclusiones: Se detecta un pobre control de la mayoría de los FRV, por lo que deberán indicarse medidas de control más estrictas, con el fin de prevenir las complicaciones vasculares relacionadas con ellos

Diabetes mellitus type is one of de most important health problem in the world, due to its high prevalence and morbidity and its relation with several cardiovascular risk factors. That´s why a global action, aimed to prevent these vascular syndromes, is needed. Objective: the goal of this study is to detect and determine how cardiovascular risk factor are controlled in diabetic type 2 patients, according to the date supplied by several international organization that have been studied at a Health Centre of Valladolid. Methods: It is a descriptive cross-sectional study to evaluate the control of several cardiovascular risk factors in diabetic patients according to the different stablished criteria. The sample is formed by 74 adult patients (41 men and 33 women), included in the Diabetes Mellitus Programm at Health Centre of Rondilla 2, at East Area of Primary Care of Valladolid, in the programmed consultation of cardiovascular risk factors control. Results and conclusion: I has been observed that the majority of these cardiovascular risk factors are not well controlled. In this way, stringent mesures of control should be considered in order to prevent the cardiovascular complications related to them

[Degree of fulfillment of the objectives of metabolic control and cardiovascular risk factors in patients with type 2 diabetes in an area of primary attention]. / Grado de cumplimiento de los objetivos de control metabólico y de los factores de riesgo cardiovascular en pacientes diabéticos tipo 2 en un área de Atención Primaria.

UNLABELLED: Diabetes mellitus type is one of de most important health problem in the world, due to its high prevalence and morbidity and its relation with several cardiovascular risk factors. That s why a global action, aimed to prevent these vascular syndromes, is needed. OBJECTIVE: the goal of this study is to detect and determine how cardiovascular risk factor are controlled in diabetic type 2 patients, according to the date supplied by several international organization that have been studied at a Health Centre of Valladolid. METHODS: It is a descriptive cross-sectional study to evaluate the control of several cardiovascular risk factors in diabetic patients according to the different established criteria. The sample is formed by 74 adult patients (41 men and 33 women), included in the Diabetes Mellitus Program at Health Centre of Rondilla 2, at East Area of Primary Care of Valladolid, in the programmed consultation of cardiovascular risk factors control. RESULTS AND CONCLUSION: I has been observed that the majority of these cardiovascular risk factors are not well controlled. In this way, stringent measures of control should be considered in order to prevent the cardiovascular complications related to them.