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1.
Med Oral Patol Oral Cir Bucal ; 29(5): e704-e710, 2024 Sep 01.
Artículo en Inglés | MEDLINE | ID: mdl-39088717

RESUMEN

BACKGROUND: To assess the feasibility of maximizing negative margins with minimal resection of healthy tissue, as confirmed by intraoperative assessment. This approach aims to be safe, effective, and to be considered a standard procedure. MATERIAL AND METHODS: A prospective pilot study. Peritumoral ink marking aided in identifying margins. Transtumoral incisions were made along the central line until healthy tissue was visible. If positive or close margins were identified, an extension was performed only in the involved area. The tumor bed and outer part of the tumor were inked to determine margins for intraoperative assessment of the specimen. RESULTS: Twelve patients with oral squamous cell carcinoma participated in the study, comprising 3 men and 9 women, with a mean age of 58 years. Four patients were diagnosed with clinical stage I (T1N0), while eight were classified as stage II (T2 N0). All patients underwent ipsilateral neck dissection (levels I-III). Intraoperative outcomes included negative, positive, or close margins. The number of tissue blocks varied based on the size of the tongue tumor and the segments that required expansion to ensure a tumor-free margin (>1 mm), which was necessary in 8 patients. All final pathological reports indicated negative margins of >1 mm. CONCLUSIONS: Piecemeal resection emerges as a feasible and oncologically sound procedure for achieving margins >1mm, which are deemed safe. Precisely identifying positive areas within the tumor proves significantly safer than en bloc resections. The prognoses observed in this series depended more on regional disease factors than on specific characteristics of the primary tumor.


Asunto(s)
Carcinoma de Células Escamosas , Estudios de Factibilidad , Estadificación de Neoplasias , Neoplasias de la Lengua , Humanos , Proyectos Piloto , Masculino , Persona de Mediana Edad , Femenino , Estudios Prospectivos , Neoplasias de la Lengua/cirugía , Neoplasias de la Lengua/patología , Anciano , Carcinoma de Células Escamosas/cirugía , Adulto , Márgenes de Escisión , Procedimientos Quirúrgicos Orales/métodos
2.
J Healthc Qual Res ; 39(5): 306-314, 2024.
Artículo en Español | MEDLINE | ID: mdl-39085011

RESUMEN

OBJECTIVE: To analyze the impact on patient health outcomes after implementing 4 Good Practice Guidelines (GPG) in a level II public university hospital. METHOD: A quasi-experimental pre-post study was carried out at the Hospital Universitario Fundación Alcorcón, belonging to the Servicio Madrileño de Salud (SERMAS) of the Community of Madrid. Anonymized patient health indicator data from February 2018 to December 2022 from a total of 4853 patient records were analyzed. Inclusion criteria all patients defined in the scope of each GBP. The sample analyzed was patients discharged in the last 5 working days of the month for all GBPs, except in Ostomy and Stroke, for which 100% of patients discharged during the month were included. RESULTS: The main results were: incidence of pressure injury from 2.70% (2017) to 1.03% (2022); stoma marking from 66.67% (2017) to 75% (2022); exclusive breastfeeding from 50% (2017) to 61.54% (2022); neurological assessment on admission from 75.56% (2017) to 85.60% (2022). CONCLUSIONS: The implementation of the GBPs led to an improvement in the health indicators of patients admitted to the target units. Improvements were observed in both process and outcome indicators.


Asunto(s)
Hospitales Públicos , Guías de Práctica Clínica como Asunto , Humanos , Hospitales Públicos/normas , España , Femenino , Masculino , Persona de Mediana Edad , Estomas Quirúrgicos , Hospitales Universitarios , Lactancia Materna , Adulto , Evaluación de Resultado en la Atención de Salud
3.
J Public Health Policy ; 45(3): 471-483, 2024 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-38858538

RESUMEN

The incidence of skin cancer is increasing worldwide even though its main risk factor is preventable. This study evaluated the impact of the Distintivo Soludable pilot intervention on implementation of photoprotection policies and practices in preschool and primary schools in Andalusia, Spain. We completed two rounds of a Sun Protection Policies and Practices Survey (SPPPS) nine months apart. At baseline, 67 Andalusian schools earned a median score of 3/12 points (range 0-8; IQR: 2). Ten schools involved in Distintivo Soludable intervention group significantly increased their scores from 4 to 7.5/12 points (p = 0.014). We also detected a modest positive effect in 57 control group schools, an increase from 2 to 3 points (p = 0.002). This pilot study demonstrated that the main achievement of the Distintivo Soludable intervention was implementation of organizational policies regarding sun protection, an essential starting point for establishing positive attitudes toward sun protection in school communities.


Asunto(s)
Instituciones Académicas , Neoplasias Cutáneas , Protectores Solares , Humanos , España , Neoplasias Cutáneas/prevención & control , Proyectos Piloto , Instituciones Académicas/organización & administración , Niño , Quemadura Solar/prevención & control , Política de Salud , Encuestas y Cuestionarios , Masculino , Femenino , Preescolar
4.
Acta Ortop Mex ; 38(3): 164-171, 2024.
Artículo en Español | MEDLINE | ID: mdl-38862146

RESUMEN

INTRODUCTION: different variables have been associated with a worse prognosis of patients with osteosarcoma (OS), highlighting tumor size, location in the axial skeleton and the presence of metastases. The objective of this study is to analyze the prognostic impact of diagnostic delay in osteosarcoma in adults in the Mexican population in a center specialized in sarcomas. MATERIAL AND METHODS: retrospective cohort study from January 1, 2005, to December 31, 2016, 96 patients over 21 years of age with a diagnosis of osteosarcoma were analyzed. RESULTS: the median time to diagnosis from the onset of symptoms was six months (range: 2-36). This variable was dichotomized by applying the operator-dependent curve (ROC) analysis and we determined a cut-off value greater than five months, with an area under the curve (AUC) = 0.93 [95% CI 0.86-0.97], sensitivity 93.2% and specificity 94.6%. CONCLUSION: time until diagnosis is a critical factor in the survival of adult patients with osteosarcoma, highlighting its influence on disease progression and the appearance of metastasis. The correlation between diagnostic delay and an unfavorable prognosis reinforces the need for rapid and efficient evaluation in suspected cases of osteosarcoma.


INTRODUCCIÓN: diferentes variables se han asociado con un peor pronóstico de los pacientes con osteosarcoma, destacando el tamaño tumoral, la localización en esqueleto axial y la presencia de metástasis. El objetivo de este estudio fue analizar el impacto pronóstico del retraso diagnóstico en osteosarcoma en adultos en población mexicana en un centro especializado en sarcomas. MATERIAL Y MÉTODOS: estudio de tipo cohorte retrospectiva del 1 de Enero del 2005 al 31 de Diciembre de 2016, se analizaron 96 pacientes mayores de 21 años con diagnóstico de osteosarcoma. RESULTADOS: la mediana de tiempo al diagnóstico desde el inicio de síntomas fue de seis meses (rango: 2-36). Esta variable se dicotomizó aplicando el análisis de curva dependiente de operador (ROC) y determinamos un valor de corte mayor a cinco meses con un área bajo la curva (AUC) = 0.93 [IC95% 0.86-0.97], sensibilidad 93.2% y especificidad 94.6%. CONCLUSIÓN: el tiempo hasta el diagnóstico es un factor crítico en la supervivencia de los pacientes adultos con osteosarcoma, destacando su influencia en la progresión de la enfermedad y la aparición de metástasis. La correlación entre el retraso diagnóstico y un pronóstico desfavorable refuerza la necesidad de una evaluación rápida y eficiente en casos sospechosos de osteosarcoma.


Asunto(s)
Neoplasias Óseas , Diagnóstico Tardío , Osteosarcoma , Humanos , Osteosarcoma/diagnóstico , Osteosarcoma/patología , Osteosarcoma/mortalidad , Estudios Retrospectivos , Masculino , Adulto , Femenino , Neoplasias Óseas/diagnóstico , Neoplasias Óseas/patología , Pronóstico , Persona de Mediana Edad , Adulto Joven , Anciano , México , Factores de Tiempo , Sensibilidad y Especificidad , Estudios de Cohortes , Progresión de la Enfermedad , Curva ROC
5.
Acta Ortop Mex ; 38(1): 15-21, 2024.
Artículo en Español | MEDLINE | ID: mdl-38657147

RESUMEN

INTRODUCTION: reconstruction of large bone defects using modular knee arthroplasty (MKA) presents a significant challenge in terms of functionality. The objective of the present work was to identify the different prognostic factors associated with failure of MKA in cancer patients. MATERIAL AND METHODS: a retrospective cohort study was conducted, including patients with a diagnosis of musculoskeletal tumor in the distal femur or proximal tibia, who underwent MKA between January 1, 2010, and December 31, 2021. RESULTS: 49 patients were included, of which 25 (51.02%) were women and 24 (48.98%) men, with a mean age of 29.57 years. Of these, 14 (28.57%) patients experienced some type of MKA failure. The most frequent complication that led to failure was periprosthetic infection, observed in seven (14.29%) patients. Variables associated with MKA failure included biopsies performed outside our hospital (HR 3.2, 95% CI 1.4-6.4, p = 0.02), the length of the long axis of the tumor (HR 2.1, 95% CI 1.2-4.6, p = 0.01) and a prolonged surgical time (HR 3.37, 95% CI 1.1-8.6, p = 0.04). CONCLUSION: the most significant prognostic factors associated with MKA failure in our cohort were tumor size, prolonged surgical time, and performance of the diagnostic biopsy in a center not specialized in the management of this type of patient. These findings highlight the importance of considering these variables to improve outcomes in patients undergoing MKA.


INTRODUCCIÓN: la reconstrucción de grandes defectos óseos mediante artroplastía modular de rodilla (AMR) representa un desafío significativo en términos de funcionalidad. El objetivo del presente trabajo fue identificar los diferentes factores pronósticos asociados al fracaso de la AMR en pacientes oncológicos. MATERIAL Y MÉTODOS: se realizó un estudio de cohorte retrospectiva, incluyendo pacientes con diagnóstico de tumor musculoesquelético en el fémur distal o la tibia proximal, que fueron sometidos a AMR entre el 1 de Enero de 2010 y el 31 de Diciembre de 2021. RESULTADOS: se incluyeron 49 pacientes, de los cuales 25 (51.02%) eran mujeres y 24 (48.98%) hombres, con una edad media de 29.57 años. De éstos, 14 (28.57%) pacientes experimentaron algún tipo de fracaso de la AMR. La complicación más frecuente que condicionó el fracaso fue la infección periprotésica, observada en siete (14.29%) pacientes. Las variables asociadas con el fracaso de las AMR incluyeron biopsias realizadas fuera de nuestro hospital (HR 3.2, IC95% 1.4-6.4, p = 0.02), longitud del eje mayor del tumor (HR 2.1, IC95% 1.2-4.6, p = 0.01) y tiempo quirúrgico prolongado (HR 3.37, IC95% 1.1-8.6, p = 0.04). CONCLUSIÓN: los factores pronósticos asociados al fracaso de las AMR en nuestra cohorte fueron el tamaño del tumor, un tiempo quirúrgico prolongado y la realización de la biopsia diagnóstica en un centro no especializado en el manejo de este tipo de pacientes. Estos hallazgos resaltan la importancia de considerar estas variables en pacientes sometidos a AMR.


Asunto(s)
Artroplastia de Reemplazo de Rodilla , Humanos , Masculino , Femenino , Estudios Retrospectivos , Artroplastia de Reemplazo de Rodilla/métodos , Adulto , Pronóstico , Persona de Mediana Edad , Neoplasias Óseas/cirugía , Adulto Joven , Infecciones Relacionadas con Prótesis/etiología , Tempo Operativo , Falla de Prótesis , Tibia/cirugía , Adolescente , Prótesis de la Rodilla , Insuficiencia del Tratamiento
6.
Rev Esp Quimioter ; 37(2): 170-175, 2024 Apr.
Artículo en Español | MEDLINE | ID: mdl-38245868

RESUMEN

OBJECTIVE: The objectives of this work were to know the prevalence of methicillin-resistant S. aureus (MRSA) infections in the paediatric population of our health department, to describe the risk factors for infection by MRSA compared to those produced by methicillin-susceptible S. aureus (MSSA) and to know the antibiotic sensitivity profile of MRSA and MSSA isolates. METHODS: A retrospective, descriptive and analytical study of infections produced by MRSA versus those produced by MSSA was carried out during the years 2014 to 2018. Risk factors for MRSA infection were studied using a binary logistic regression model. RESULTS: 162 patients with S. aureus infections were identified. Of these, 25 (15.4%) were MRSA. The highest percentages of MRSA infection occurred among children who required hospital admission (23.4%). In the univariate analysis the need of hospital admission, antibiotic treatment in the last 3 months, the kind of infection and past MRSA infection or colonisation reached statistical significance. However, only the need of hospital admission and antibiotic treatment in the last 3 months maintained statistical significance in the binary logistic regression model. Correct antibiotic treatment was only prescribed in 26.7% of the MRSA infection cases admitted to the hospital. CONCLUSIONS: Our results suggest the need to review empirical local treatment regimen using drugs active against MRSA in infections of probable staphylococcal origin admitted to the hospital, especially if they have received antibiotic treatment in the last 3 months.


Asunto(s)
Staphylococcus aureus Resistente a Meticilina , Infecciones Estafilocócicas , Niño , Humanos , Staphylococcus aureus , Estudios Retrospectivos , Prevalencia , Infecciones Estafilocócicas/tratamiento farmacológico , Infecciones Estafilocócicas/epidemiología , Meticilina/uso terapéutico , Antibacterianos/farmacología , Antibacterianos/uso terapéutico , Factores de Riesgo
7.
Rev Gastroenterol Mex (Engl Ed) ; 89(1): 42-51, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-36973121

RESUMEN

INTRODUCTION AND AIMS: Distal pancreatectomy is a frequent procedure and postoperative fistula, its most common complication, has an incidence of 30 to 60%. The aim of the present work was to study the role of the neutrophil-to-lymphocyte ratio and the platelet-to-lymphocyte ratio, as indicators of inflammatory response in the setting of pancreatic fistula. METHODS: A retrospective observational study was conducted on patients that underwent distal pancreatectomy. The diagnosis of postoperative pancreatic fistula was made according to the definition proposed by the International Study Group on Pancreatic Fistula. The relation of postoperative pancreatic fistula to the neutrophil-to-lymphocyte ratio and the platelet-to-lymphocyte ratio was determined in the postoperative evaluation. SPSS v.21 software was utilized for the statistical analysis and a P<.05 was considered statistically significant. RESULTS: A total of 12 patients (27.2%) developed grade B or grade C postoperative pancreatic fistula. ROC curves were constructed and a threshold of 8.3 (PPV 0.40, NPV 0.86) was established for the neutrophil-to-lymphocyte ratio, with an area under the curve of 0.71, sensitivity of 0.81, and specificity of 0.62, whereas a threshold of 33.2 (PPV 0.50, NPV 0.84) was established for the platelet-to-lymphocyte ratio, with an area under the curve of 0.72, sensitivity of 0.72, and specificity of 0.71. CONCLUSION: The neutrophil-to-lymphocyte ratio and the platelet-to-lymphocyte ratio are serologic markers that can aid in identifying patients that will present with grade B or grade C postoperative pancreatic fistula, thus helping to provide an opportune focus on care and resources.

9.
mBio ; 14(5): e0159823, 2023 Oct 31.
Artículo en Inglés | MEDLINE | ID: mdl-37607060

RESUMEN

IMPORTANCE: A new class of bacterial protein sensors monitors intracellular levels of S-adenosylmethionine to modulate cell morphology, chemotaxis, and biofilm formation. Simultaneous regulation of these behaviors enables bacterial pathogens to survive within their niche. This sensor, exemplified by Treponema denticola CheWS, is anchored to the chemotaxis array and its sensor domain is located below the chemotaxis rings. This position may allow the sensor to directly interact with the chemotaxis histidine kinase CheA. Collectively, these data establish a critical role of CheWS in pathogenesis and further illustrate the impact of studying non-canonical chemotaxis proteins.


Asunto(s)
Quimiotaxis , Proteínas de Escherichia coli , Quimiotaxis/fisiología , Spirochaetales/metabolismo , Proteínas Bacterianas/genética , Proteínas Bacterianas/metabolismo , Histidina Quinasa/genética , Histidina Quinasa/metabolismo , Bacterias/metabolismo , Proteínas Quimiotácticas Aceptoras de Metilo
10.
Av. odontoestomatol ; 39(1)ene.-mar. 2023. tab, ilus
Artículo en Español | IBECS | ID: ibc-220507

RESUMEN

Introducción: El quiste óseo aneurismático (QOA) tiene una diversidad de características clínicase imagenológicas. Existe poca información respecto a la posible relación entre algunas de estas características y los patrones histopatológicos del QOA. El propósito de la presente revisión fue analizar la clínica, epidemiología e imagenología de casos de QOA, y determinar qué características podrían tener relación con algún tipo de patrón histopatológico del QOA en el territorio craneofacial. Materiales y métodos:Se realizó una búsqueda de casos de QOA en el territorio craneofacial publicados desde el año 2000, en PubMed, Scopus y Web of Science, mediante la búsqueda ("Aneurysmal bone cyst") AND ("Skull" OR "Jaw" OR "Mandible" OR "Maxilla"). Los casos debían tener información histopatológica, clínica, epidemiológica e imagenológica. Revisión: Se incluyó 40 artículos con 41 lesiones, siendo 34 de patrón clásico y 7 de patrón mixto-sólido (M-S). El patrón M-S se presentó mayoritariamente sin dolor y en el sexo masculino, mientras que el patrón clásico con dolor asociado y en el sexo femenino. Respecto a la imagenología, el patrón M-S se presentó sin límites definidos-corticalizados y generó perforación ósea con mayor frecuencia que el patrón clásico. Conclusiones: Los patrones histopatológicos del QOA tienen características clínicas, epidemiológicas e imagenológicas similares. Sin embargo, difieren en sexo, dolor asociado, límites definidos corticalizados y perforación ósea, lo que permitiría orientar al diagnóstico hacia un patrón histopatológico. (AU)


Introduction: The aneurysmal bone cyst (ABC) has a variety of clinical and imaging characteristics. There is little information regarding the possible relationship between some of these characteristics and its histopathological patterns. The aim of this review was to analyze the clinical, epidemiology and imaging characteristics of ABC cases, and determine what characteristics might be related to some type of histopathological pattern of ABC in the craniofacial territory. Materials and methods: A search was conducted for ABC cases in the craniofacial territory published since 2000, on PubMed, Scopus and Web of Science, by searching ("Aneurysmal bone cyst") AND ("Skull" OR "Jaw" OR "Mandible" OR "Maxilla"). Cases had to have histopathological, clinical, epidemiological, and imaging information. Review: 40 articles with 41 ABC lesions were included, with 34 being classic pattern and 7 mixed-solid (M-S). The M-S pattern was mostly painless and in males, while the classic pattern, with associated pain was mostly in females. Regarding imaging, the M-S pattern was without defined-corticated limits and with bone perforation more frequently than the classic pattern. Conclusions: Histopathological patterns of ABC have similar clinical, epidemiological and imaging characteristics. However, they differ in sex, associated pain, defined-corticated limits and bone perforation, which would allow the diagnosis to be directed towards a specific histopathological pattern. (AU)


Asunto(s)
Humanos , Quistes Óseos Aneurismáticos/epidemiología , Quistes Óseos Aneurismáticos/patología , Quistes Óseos Aneurismáticos/diagnóstico por imagen
12.
Acta Ortop Mex ; 37(6): 331-337, 2023.
Artículo en Español | MEDLINE | ID: mdl-38467453

RESUMEN

INTRODUCTION: chondrosarcoma is the second most common primary malignant tumor, constitutes approximately one quarter of all primary bone sarcomas. Surgical margins in pelvic chondrosarcoma have a direct impact as a prognostic factor, both on overall survival and on recurrence-free survival of this disease. OBJECTIVES: to analyze the impact of surgical margins as a prognostic factor in pelvic chondrosarcoma. MATERIAL AND METHODS: a retrospective database cohort with prospective follow-up of sarcomas in patients diagnosed with primary pelvic chondrosarcoma who underwent surgical treatment. Clinical-demographic variables were obtained, a descriptive analysis of each variable was performed, and these were contrasted with the outcome variables. RESULTS: seventeen patients were included, of which nine were female. The median age was 41 years, ranging from 23 to 65 years. The average tumor size was 20.9 cm (range 5 to 46 cm). The average surgical margin was 5.3 mm, ranging from 1 to 30 mm, with 58% positive margins. The average overall survival was 64 months (range 7 to 108 months). The distribution of pelvic involvement was as follows: zone I in nine patients (52.9%), zone II in two (11.8%), a combination of zones I-III in two (11.8%), I+II in one (5.9%), II+III in one (5.9%), I-III plus sacrum in one (5.9%) and I plus sacrum in one (5.9%). Tumor grades were classified as low in seven patients (41.2%), intermediate in sven (41.2%), high in two (11.8%), and dedifferentiated in one (5.9%). Regarding the type of resection, 12 patients (70.6%) underwent internal hemipelvectomy and five (29.4%) external hemipelvectomy. Recurrence was recorded in five cases (29.4%), metastasis in three (17.6%), and mortality in four (23.5%). CONCLUSIONS: this series represents the largest cohort reported in Latin America of primary pelvic chondrosarcomas. A more favorable prognosis was observed in patients with surgical margins greater than 1 mm. The presence of chondrosarcoma in multiple pelvic zones was associated with a worse oncological prognosis. Additionally, a higher incidence of positive surgical margins and local recurrence rates were identified in pelvic chondrosarcomas compared to those located in the extremities.


INTRODUCCIÓN: el condrosarcoma (CS), el segundo tumor maligno óseo primario más común, constituye aproximadamente una cuarta parte de todos los sarcomas óseos primarios. Los márgenes quirúrgicos en el condrosarcoma pélvico tienen un impacto directo como factor pronóstico, tanto en la supervivencia global como en la supervivencia libre de recurrencia de esta enfermedad. OBJETIVOS: analizar el impacto de los márgenes quirúrgicos como factor pronóstico en el condrosarcoma de la pelvis. MATERIAL Y MÉTODOS: cohorte de base de datos retrospectiva con seguimiento prospectivo de sarcomas de pacientes con diagnóstico de condrosarcoma primario de la pelvis que fueron sometidos a tratamiento quirúrgico. Se obtuvieron variables clínico-demográficas, se realizó un análisis descriptivo de cada variable y se contrastaron con las variables desenlace. RESULTADOS: se incluyeron 17 pacientes, de los cuales nueve eran mujeres. La mediana de edad fue de 41 años (rango de 23 a 65 años). El tamaño promedio del tumor fue de 20.9 cm (rango de 5 a 46 cm). El margen quirúrgico promedio fue de 5.3 mm, variando entre 1 y 30 mm, con 58% de márgenes positivos. La supervivencia global promedio fue de 64 meses (rango de 7 a 108 meses). La distribución de la afectación pélvica fue: zona I en nueve pacientes (52.9%), zona II en dos (11.8%), combinación de zonas I-III en dos (11.8%), I+II en uno (5.9%), II+III en uno (5.9%), I-III más sacro en uno (5.9%) y I más sacro en uno (5.9%). Los grados tumorales se clasificaron en bajo en siete pacientes (41.2%), intermedio en siete (41.2%), alto en dos (11.8%) y desdiferenciado en uno (5.9%). Respecto al tipo de resección, 12 pacientes (70.6%) se sometieron a hemipelvectomía interna y cinco (29.4%) a hemipelvectomía externa. Se registró recurrencia en cinco casos (29.4%), metástasis en tres (17.6%) y mortalidad en cuatro (23.5%). CONCLUSIONES: esta serie representa la cohorte más extensa reportada en Latinoamérica de condrosarcomas primarios de la pelvis. Se observó un pronóstico más favorable en pacientes con márgenes quirúrgicos superiores a 1 mm. La presencia de condrosarcoma en múltiples zonas pélvicas se asoció con un peor pronóstico oncológico. Además, se identificó una mayor incidencia de márgenes quirúrgicos positivos y tasas de recurrencia local en condrosarcomas de la pelvis en comparación con aquellos ubicados en las extremidades.


Asunto(s)
Neoplasias Óseas , Condrosarcoma , Huesos Pélvicos , Sarcoma , Humanos , Femenino , Adulto , Masculino , Márgenes de Escisión , Pronóstico , Estudios Retrospectivos , Estudios de Cohortes , Estudios Prospectivos , Huesos Pélvicos/cirugía , Huesos Pélvicos/patología , Neoplasias Óseas/cirugía , Neoplasias Óseas/diagnóstico , Sarcoma/patología , Sarcoma/cirugía , Condrosarcoma/cirugía , Pelvis , Recurrencia Local de Neoplasia/patología , Recurrencia Local de Neoplasia/cirugía
14.
Farm. comunitarios (Internet) ; 14(Supl 1): 1, junio 2022. ilus
Artículo en Español | IBECS | ID: ibc-209373

RESUMEN

JUSTIFICACIÓN: diferentes estudios muestran que mayor pobreza y peor salud de la población son dos factores directamente relacionados. La pandemia además, se ha cebado con esta población aumentando la situación de pobreza y a su vez dificultando el acceso al sistema sanitario. Por otra parte, la misión de la estrategia social del farmacéutico en la agenda 2030 es promover e impulsar la acción y la innovación social en las actuaciones de los profesionales farmacéuticos mediante el desarrollo y la coordinación de iniciativas sociales alineadas con los Objetivos de Desarrollo Sostenible, con especial atención a pacientes y colectivos vulnerables y la cooperación al desarrollo.OBJETIVOS: mejorar la asistencia sanitaria y la alfabetización en salud de los pacientes del barrio a través del acompañamiento farmacéutico y de sesiones formativas. Potenciar la comunicación con las farmacias colaboradoras y el CS (Centro de Salud).Material y métodos: Población diana: Usuarios de Cáritas pertenecientes a dos parroquias de un barrio desfavorecido que solicitan ayuda con la aportación económica de sus medicamentos y productos sanitarios durante los meses de septiembre, octubre y noviembre de 2021.Proponemos que ese servicio lo preste un farmacéutico que aprovecha para hacer entrevistas, revisiones de botiquines, tomas de parámetros, recomendaciones nutricionales, consejos de lactancia. Se establece comunicación telefónica directa con un pediatra y una médica de Atención Primera del CS y con las dos farmacias colaboradoras. Se imparten charlas a madres y mayores. Material: salones y despachos parroquiales o domicilios de los pacientes. Registro y tratamiento de datos: programa ItCon de Cáritas: base de datos donde registramos las intervenciones, ayudas y entrevistas.(AU)


Asunto(s)
Humanos , Pobreza , Salud , Farmacéuticos , Desarrollo Sostenible , Atención a la Salud , Pacientes , Farmacias
15.
Crit Rev Oncol Hematol ; 174: 103685, 2022 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-35460913

RESUMEN

Bone sarcoma are infrequent diseases, representing < 0.2% of all adult neoplasms. A multidisciplinary management within reference centers for sarcoma, with discussion of the diagnostic and therapeutic strategies within an expert multidisciplinary tumour board, is essential for these patients, given its heterogeneity and low frequency. This approach leads to an improvement in patient's outcome, as demonstrated in several studies. The Sarcoma European Latin-American Network (SELNET), aims to improve clinical outcome in sarcoma care, with a special focus in Latin-American countries. These Clinical Practice Guidelines (CPG) have been developed and agreed by a multidisciplinary expert group (including medical and radiation oncologist, surgical oncologist, orthopaedic surgeons, radiologist, pathologist, molecular biologist and representatives of patients advocacy groups) of the SELNET consortium, and are conceived to provide the standard approach to diagnosis, treatment and follow-up of bone sarcoma patients in the Latin-American context.


Asunto(s)
Neoplasias Óseas , Osteosarcoma , Sarcoma , Neoplasias de los Tejidos Blandos , Adulto , Neoplasias Óseas/diagnóstico , Neoplasias Óseas/patología , Neoplasias Óseas/terapia , Humanos , Osteosarcoma/diagnóstico , Osteosarcoma/patología , Osteosarcoma/terapia , Guías de Práctica Clínica como Asunto , Sarcoma/diagnóstico , Sarcoma/patología , Sarcoma/terapia , Neoplasias de los Tejidos Blandos/patología
16.
Rev Esp Quimioter ; 35(2): 171-177, 2022 Apr.
Artículo en Español | MEDLINE | ID: mdl-35067009

RESUMEN

OBJECTIVE: Staphylococcus epidermidis (SE) is a common cause of bacterial keratitis in certain geographic areas. A high percentage of resistance to methicillin is shown, which gives it cross resistance to beta-lactams and sometimes resistance to other antibacterial groups. We analyzed clinical and microbiological variables in patients with infectious keratitis due to SE. METHODS: Medical records of 43 patients with suspected infectious keratitis and microbiological confirmation for SE, between October 2017 and October 2020, were retrospectively studied. Clinical characteristics (risk factors, size of lesions, treatment, evolution) and microbiological (susceptibility to antibiotics) were analyzed, and groups of patients with methicillin-resistant (MRSE) and methicillin-susceptible (MSSE) infection were compared. RESULTS: MRSE was present in 37.2% of infectious keratitis. All isolates were sensitive to vancomycin and linezolid. Rates of resistance to tetracyclines and ciprofloxacin were 50% and 56% in the MRSE group, and 11% and 7% in the MSSE group. The clinical characteristics, including size of lesion, visual axis involvement, inflammation of anterior chamber, presence of risk factors and follow-up time, did not show statistically significant differences between groups. CONCLUSIONS: MRSE is a common cause of infectious keratitis caused by SE and shows a high rate of multidrug resistance. Clinically, it does not differ from MSSE keratitis. Additional work is needed to confirm these findings.


Asunto(s)
Queratitis , Staphylococcus aureus Resistente a Meticilina , Infecciones Estafilocócicas , Antibacterianos/farmacología , Antibacterianos/uso terapéutico , Humanos , Queratitis/tratamiento farmacológico , Queratitis/epidemiología , Queratitis/microbiología , Resistencia a la Meticilina , Pruebas de Sensibilidad Microbiana , Estudios Retrospectivos , Infecciones Estafilocócicas/tratamiento farmacológico , Infecciones Estafilocócicas/epidemiología , Infecciones Estafilocócicas/microbiología , Staphylococcus epidermidis
18.
BMC Infect Dis ; 21(1): 917, 2021 Sep 06.
Artículo en Inglés | MEDLINE | ID: mdl-34488671

RESUMEN

BACKGROUND: HIV incidence can be estimated with cross-sectional studies using clinical, serological, and molecular data. Worldwide, HIV incidence data in only men who have sex with men (MSM) are scarce and principally focus on those with healthcare or under treatment. However, better estimates can be obtained through studies with national representativeness. The objective was to estimate the prevalence, incidence, and factors associated with acquiring HIV in a national sample of MSM who attend meeting places, considering geographical regions. METHODS: A nationally representative survey of MSM attending meeting places was performed in Mexico. Participants answered a questionnaire, and a dried blood spot (DBS) was collected. Samples were classified as recent infections using an algorithm with HIV status, antiretroviral therapy, and the result of BED-EIA assay. Parameters were analysed considering regions and demographic and sexual behaviour characteristics. RESULTS: The national HIV prevalence was 17.4% with regional differences; the highest prevalence (20.7%) was found in Mexico City, and the lowest prevalence was found in the West region (11.5%). The incidence was 9.4 per 100 p/y, with regional values from 6.2 to 13.2 for the Northeast and the Centre regions, respectively. Age, age at sexual debut, low wealth index, and rewarded sex were associated with HIV prevalence. Centre region, use of private clinics as health services, and having sex exclusively with men were associated with recent HIV infections. CONCLUSIONS: The incidence and prevalence showed regional differences, suggesting a difference in the dynamics of HIV transmission; some regions have a greater case accumulation, and others have a greater rate of new infections. Understanding this dynamic will allow developing health programs focused on HIV prevention or treating people already living with HIV.


Asunto(s)
Infecciones por VIH , Minorías Sexuales y de Género , Estudios Transversales , Infecciones por VIH/epidemiología , Homosexualidad Masculina , Humanos , Incidencia , Masculino , Prevalencia , Conducta Sexual
19.
Int J Hyperthermia ; 38(1): 447-460, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33730953

RESUMEN

PURPOSE: The localized heating of magnetic nanoparticles (MNPs) via the application of time-varying magnetic fields - a process known as magnetic field hyperthermia (MFH) - can greatly enhance existing options for cancer treatment; but for broad clinical uptake its optimization, reproducibility and safety must be comprehensively proven. As part of this effort, the quantification of MNP heating - characterized by the specific loss power (SLP), measured in W/g, or by the intrinsic loss power (ILP), in Hm2/kg - is frequently reported. However, in SLP/ILP measurements to date, the apparatus, the analysis techniques and the field conditions used by different researchers have varied greatly, leading to questions as to the reproducibility of the measurements. MATERIALS AND METHODS: An interlaboratory study (across N = 21 European sites) of calorimetry measurements that constitutes a snapshot of the current state-of-the-art within the MFH community has been undertaken. Identical samples of two stable nanoparticle systems were distributed to all participating laboratories. Raw measurement data as well as the results of in-house analysis techniques were collected along with details of the measurement apparatus used. Raw measurement data was further reanalyzed by universal application of the corrected-slope method to examine relative influences of apparatus and results processing. RESULTS: The data show that although there is very good intralaboratory repeatability, the overall interlaboratory measurement accuracy is poor, with the consolidated ILP data having standard deviations on the mean of ca. ± 30% to ± 40%. There is a strong systematic component to the uncertainties, and a clear rank correlation between the measuring laboratory and the ILP. Both of these are indications of a current lack of normalization in this field. A number of possible sources of systematic uncertainties are identified, and means determined to alleviate or minimize them. However, no single dominant factor was identified, and significant work remains to ascertain and remove the remaining uncertainty sources. CONCLUSION: We conclude that the study reveals a current lack of harmonization in MFH characterization of MNPs, and highlights the growing need for standardized, quantitative characterization techniques for this emerging medical technology.


Asunto(s)
Hipertermia Inducida , Humanos , Hipertermia , Campos Magnéticos , Magnetismo , Reproducibilidad de los Resultados
20.
J. healthc. qual. res ; 36(1): 3-11, ene.-feb. 2021. tab, graf
Artículo en Español | IBECS | ID: ibc-196570

RESUMEN

OBJETIVO: Describir el proceso de planificación y ejecución de un estudio masivo de seroprevalencia para SARS-CoV-2 en los profesionales del Hospital Universitario Fundación Alcorcón (HUFA) (España). MÉTODO: Se efectúa una descripción del plan diseñado y desarrollado en el HUFA para la realización de las extracciones de las muestras para serología en el total de los profesionales que prestan servicio en el hospital, entre el 14 y el 29 de abril del 2020. Se lleva a cabo un análisis descriptivo de la participación de los profesionales en el estudio. De igual manera, se planificaron zonas de extracción, personal sanitario y tiempos de ejecución. Se asignaron 2.326 extracciones a personal sanitario, el resto fueron a trabajadores de las empresas externas. RESULTADOS: Participaron en el estudio 2.641 trabajadores (90,5%) de 2.918 candidatos. La categoría profesional que más se analizó globalmente fue la de enfermería con un 28,3% (n = 590). El porcentaje de cumplimiento de la organización de los horarios fue del 28,6%. Se planificó hasta un máximo de 298 extracciones diarias. El día con más afluencia fue el cuarto con 399 extracciones. CONCLUSIONES: El hecho de organizar un dispositivo tan grande con un alcance al 100% de los trabajadores que prestan servicio en el hospital, y con una respuesta tan mayoritaria por parte de ellos, ha permitido que el estudio de seroprevalencia realizado obtenga unos resultados con alta fiabilidad. Aunque el porcentaje de participación fue muy alto, el grado de cumplimiento de la planificación fue reducido


OBJECTIVE: To describe the planning and execution process of a massive seroprevalence study for SARS-CoV-2 in professionals of the Hospital Universitario Fundación Alcorcón (HUFA) (Spain). METHODS: A description is presented of the plan designed and developed at the HUFA for the execution of the extraction of the samples for serology from all the professionals who worked in the hospital between 14 and 29 April 2020. A descriptive analysis of the participation of the professionals in the study is carried out. Extraction areas, health personnel, and execution times were planned. A total of 2326 extractions were assigned to health personnel, the remaining extractions were assigned to workers from external companies. RESULTS: A total of 2641 workers (90.5%) out of 2918 candidates participated in the study. The professional category most analysed was nursing with 28.3% (n = 590). The percentage of compliance with schedule planning was 28.6%. Up to a maximum of 298 daily extractions were planned. The busiest day was the 4th day of the study with 399 extractions. CONCLUSIONS: The organising of such a large study, with a 100% coverage of those who worked in the hospital, and with such a great response from the workers involved, has led to obtaining results of high reliability in the seroprevalence study carried out. Although the percentage of participation was very high, the level of compliance with the planning was low


Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Infecciones por Coronavirus/epidemiología , Neumonía Viral/epidemiología , Pandemias , Personal de Hospital/estadística & datos numéricos , Hospitales Públicos/estadística & datos numéricos , Estudios Seroepidemiológicos , España/epidemiología
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