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1.
Phys Rev Lett ; 132(23): 239901, 2024 Jun 07.
Artículo en Inglés | MEDLINE | ID: mdl-38905699

RESUMEN

This corrects the article DOI: 10.1103/PhysRevLett.130.051902.

2.
Phys Rev Lett ; 130(5): 051902, 2023 Feb 03.
Artículo en Inglés | MEDLINE | ID: mdl-36800462

RESUMEN

We establish the existence of the long-debated f_{0}(1370) resonance in the dispersive analyses of meson-meson scattering data. For this, we present a novel approach using forward dispersion relations, valid for generic inelastic resonances. We find its pole at (1245±40)-i(300_{-70}^{+30}) MeV in ππ scattering. We also provide the couplings as well as further checks extrapolating partial-wave dispersion relations or with other continuation methods. A pole at (1380_{-60}^{+70})-i(220_{-70}^{+80}) MeV also appears in the ππ→KK[over ¯] data analysis with partial-wave dispersion relations. Despite settling its existence, our model-independent dispersive and analytic methods still show a lingering tension between pole parameters from the ππ and KK[over ¯] channels that should be attributed to data.

3.
Community Health Equity Res Policy ; 44(1): 99-107, 2023 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-35944130

RESUMEN

AIM: This study assessed the level of adherence to antiretroviral drugs and the associated factors among clients who have a follow-up at public health facilities in central Ethiopia. METHOD: A multi-site cross-sectional study was conducted from August 1-30, 2020 at seven public health institutions. A systematic random sampling method was used to recruit 385 participants. Data was collected using a structured interviewer-administered questionnaire. Analysis was done using descriptive statistics, and binary logistic regression model. The OR with its 95% C.I was employed to present analytic outputs. Statistical significance for the multivariable model was considered at p ≤ 0.05. RESULTS: Of the 371 participants, the majority were females (233, 62.8%), attended health centers (215, 58.0%), and were married (173, 46.6%). Eighty-nine (89, 24.0%) of the participants have at least one comorbidity. About 72 (19.0%) and 50 (13.5%) of the respondents stated that the COVID-19 has posed challenges on their follow-ups and availability of medications respectively. Nearly a half of the people living with HIV and comorbid T2DM or hypertension (29, 48.0%) reported that they had encountered an increase in the price of medications compared to the pre-COVID-19 times. About half of the respondents in the study setting have perfect adherence to antiretroviral therapy (ART) (200, 54.0%). Basic education (aOR = 3.02: 95% CI: 1.57-5.80), marriage (aOR = 2.27: 95% CI: 1.24-4.15), attendance to a health center (aOR = 0.59: 95% CI: 0.36-0.98) and sleep disturbance (aOR = 0.47: 95% CI: 0.26-0.84) showed a statistically significant association with adherence to ART. CONCLUSION: About half of the respondents in the study settings have perfect adherence to their ART medications. As multiple factors interplay in the success rate of adherence to ART, stakeholders should place and strengthen practices, such as active follow-up and tracing of cases, ensuring medication affordability (access and low pricing), and psycho-social support to patients.


Asunto(s)
COVID-19 , Infecciones por VIH , Femenino , Humanos , Masculino , Etiopía/epidemiología , Estudios Transversales , Pandemias , COVID-19/epidemiología , Infecciones por VIH/tratamiento farmacológico , Antirretrovirales/uso terapéutico
4.
Phys Rev Lett ; 124(17): 172001, 2020 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-32412267

RESUMEN

In this work we present a precise and model-independent dispersive determination from data of the existence and parameters of the lightest strange resonance κ/K_{0}^{*}(700). We use both subtracted and unsubtracted partial-wave hyperbolic and fixed-t dispersion relations as constraints on combined fits to πK→πK and ππ→KK[over ¯] data. We then use the hyperbolic equations for the analytic continuation of the isospin I=1/2 scalar partial wave to the complex plane, in order to determine the κ/K_{0}^{*}(700) and K^{*}(892) associated pole parameters and residues.

5.
Ethiop J Health Sci ; 30(6): 1017-1026, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-33883848

RESUMEN

BACKGROUND: Discussing potentially bad outcomes is a standard communication task in clinical care. Physicians' awareness on ways to communicate bad news is considered low. SPIKES protocol is the most popular strategy used by physicians, but its practice and patients' perception are not known. This study attempted to fill the knowledge gap on protocol implementation, patient preference and physician effects. METHODS: Hospital-based descriptive cross-sectional study was conducted at SPHMMC from May 1 to June 30 using structured interviews administered to patients and physicians. Three hundred and sixty patients and 111 physicians were included. Assessment of SPIKES performance, patient satisfaction, patient preference, and physician awareness, attitude and effects were studied. RESULTS: Performance of SPIKES protocol was setting (74.5%), perception (51.1%), invitation (56.3%), knowledge (15.9%), emotion (22.3%) and summary (10.1%). Only 30.6% of the patients were entirely satisfied with the interaction, and 19.2% with knowledge attained. Patient satisfaction was associated with physician asking how much information they like (P=0.025). Patient desire and report showed variation. Eighty-two percent of the physicians were not aware of the protocol, and 83.8% had no training. Half of the physicians feel depressed after disclosure. CONCLUSIONS: Patient satisfaction with communication process and knowledge is poor, as is performance of SPIKES components. Satisfaction is related to being asked how much patients want to know. Patients' desires on how to be told news is different from how it is done. Breaking bad news increases feeling of depression. Awareness and training on the protocol are deficient; medical schools should incorporate it into their studies and implement proper follow-up.


Asunto(s)
Médicos , Revelación de la Verdad , Estudios Transversales , Etiopía , Hospitales de Enseñanza , Humanos , Relaciones Médico-Paciente
6.
Eur Phys J C Part Fields ; 79(12): 1008, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31885492

RESUMEN

We provide global parameterizations of π π → π π scattering S0 and P partial waves up to roughly 2 GeV for phenomenological use. These parameterizations describe the output and uncertainties of previous partial-wave dispersive analyses of π π → π π , both in the real axis up to 1.12 GeV and in the complex plane within their applicability region, while also fulfilling forward dispersion relations up to 1.43 GeV . Above that energy we just describe the available experimental data. Moreover, the analytic continuations of these global parameterizations also describe accurately the dispersive determinations of the σ / f 0 ( 500 ) , f 0 ( 980 ) and ρ ( 770 ) pole parameters.

7.
Rev. esp. cir. ortop. traumatol. (Ed. impr.) ; 63(2): 86-94, mar.-abr. 2019. ilus, tab
Artículo en Español | IBECS | ID: ibc-188890

RESUMEN

Objetivo: El objetivo de este estudio es presentar nuestra serie de casos de sarcoma de Ewing y los datos de supervivencia obtenidos a medio plazo utilizando un protocolo de terapia multidisciplinar. Material, método y resultados: Cuarenta y un sarcomas de Ewing fueron diagnosticados, tratados y evolucionados en nuestro centro entre 2004 y 2009 con una media de edad de 18,29 años. Hasta un 78% correspondieron a Ewing óseo siendo el fémur la localización más frecuente. El 68% presentó un estadio localizado en el momento del diagnóstico. Al final del seguimiento la supervivencia no llegó al 40% de los pacientes, falleciendo la mayoría en los primeros 5 años de seguimiento. Discusión: En España, el sarcoma de Ewing es el tumor óseo maligno primario más frecuente en la infancia, por delante del osteosarcoma. Su tasa de supervivencia ha aumentado mucho en los últimos 40 años, mejoría atribuible fundamentalmente al uso agresivo de la quimioterapia y al tratamiento mutidisciplinar, pero su pronóstico sigue siendo muy pobre sobre todo en aquellos que presentan metástasis al diagnóstico, principal factor pronóstico adverso. Dada su alta mortalidad, son muchos los autores que lo consideran como una enfermedad diseminada desde el principio, con micrometástasis no detectables que son las que condicionan la supervivencia final. Conclusiones: El diagnóstico precoz y el tratamiento multidisciplinar en centros de referencia son las mejores estrategias con las que contamos en la actualidad para proporcionarles a los pacientes las máximas posibilidades de curación de esta enfermedad


Purpose: The purpose of this study is to present our series of Ewing sarcoma cases and the survival data obtained in the medium term, using a multidisciplinary therapy protocol. Material, methods and results: Forty-one Ewing sarcomas were diagnosed, treated and followed-up in our hospital between 2004 and 2009 with an average age of 18.29 years. Seventy-eight percent were to Ewing sarcoma of the bone, the femur being the most frequent location. Sixty-eight percent had a localized stage at the time of diagnosis. At the end of follow-up, 40% of the patients did not survive, most died within the first 5 years of follow-up. Discussion: In Spain, Ewing sarcoma is the most common primary malignant bone tumour in childhood, ahead of osteosarcoma. Its survival rate has increased greatly in the last 40 years, improvement attributable mainly to the aggressive use of chemotherapy and to multidisciplinary treatment, but its prognosis remains very poor, especially for those with metastasis at diagnosis, the main adverse prognostic factor. Because of its high mortality, many authors consider it a disseminated disease from the beginning, with non- detectable micrometastasis that condition final survival. Conclusions: Early diagnosis and multidisciplinary therapy in referral centres are the best strategies currently available to us to provide these patients the maximum possibilities of cure of this disease


Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Adulto Joven , Adulto , Persona de Mediana Edad , Neoplasias Óseas/mortalidad , Neoplasias Óseas/terapia , Grupo de Atención al Paciente , Sarcoma de Ewing/mortalidad , Sarcoma de Ewing/terapia , Estudios Retrospectivos , Análisis de Supervivencia , Factores de Tiempo
8.
Phys Rev Lett ; 122(4): 042002, 2019 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-30768338

RESUMEN

Mapping states with explicit gluonic degrees of freedom in the light sector is a challenge, and has led to controversies in the past. In particular, the experiments have reported two different hybrid candidates with spin-exotic signature, π_{1}(1400) and π_{1}(1600), which couple separately to ηπ and η^{'}π. This picture is not compatible with recent Lattice QCD estimates for hybrid states, nor with most phenomenological models. We consider the recent partial wave analysis of the η^{(')}π system by the COMPASS Collaboration. We fit the extracted intensities and phases with a coupled-channel amplitude that enforces the unitarity and analyticity of the S matrix. We provide a robust extraction of a single exotic π_{1} resonant pole, with mass and width 1564±24±86 and 492±54±102 MeV, which couples to both η^{(')}π channels. We find no evidence for a second exotic state. We also provide the resonance parameters of the a_{2}(1320) and a_{2}^{'}(1700).

9.
Artículo en Inglés, Español | MEDLINE | ID: mdl-30642764

RESUMEN

PURPOSE: The purpose of this study is to present our series of Ewing sarcoma cases and the survival data obtained in the medium term, using a multidisciplinary therapy protocol. MATERIAL, METHODS AND RESULTS: Forty-one Ewing sarcomas were diagnosed, treated and followed-up in our hospital between 2004 and 2009 with an average age of 18.29 years. Seventy-eight percent were to Ewing sarcoma of the bone, the femur being the most frequent location. Sixty-eight percent had a localized stage at the time of diagnosis. At the end of follow-up, 40% of the patients did not survive, most died within the first 5 years of follow-up. DISCUSSION: In Spain, Ewing sarcoma is the most common primary malignant bone tumour in childhood, ahead of osteosarcoma. Its survival rate has increased greatly in the last 40 years, improvement attributable mainly to the aggressive use of chemotherapy and to multidisciplinary treatment, but its prognosis remains very poor, especially for those with metastasis at diagnosis, the main adverse prognostic factor. Because of its high mortality, many authors consider it a disseminated disease from the beginning, with non- detectable micrometastasis that condition final survival. CONCLUSIONS: Early diagnosis and multidisciplinary therapy in referral centres are the best strategies currently available to us to provide these patients the maximum possibilities of cure of this disease.


Asunto(s)
Neoplasias Óseas/mortalidad , Neoplasias Óseas/terapia , Grupo de Atención al Paciente , Sarcoma de Ewing/mortalidad , Sarcoma de Ewing/terapia , Adolescente , Adulto , Niño , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Análisis de Supervivencia , Factores de Tiempo , Adulto Joven
10.
Rev. ing. bioméd ; 11(21): 21-25, ene.-jjun. 2017. graf
Artículo en Español | LILACS | ID: biblio-901811

RESUMEN

Objetivo: Realizar un diagnóstico del estado de la gestión del mantenimiento de equipos biomédicos en el área de urgencias de tres (3) instituciones de nivel tres de complejidad médica de la ciudad de Medellín, Colombia, dentro del proyecto de investigación producción más limpia en salud. Metodología: Se diseñó una encuesta a partir de la Guía Sectorial de Producción más Limpia, en hospitales, clínicas y centros de salud, donde se obtuvo una lista de chequeo para la revisión del estado de la gestión de mantenimiento de los equipos biomédicos más complejos utilizados en urgencias. Resultados: La gestión de mantenimiento de los equipos biomédicos más complejos es muy buena en el hospital 1 y excelente en los hospitales 2 y 3; la metrología y gestión de mantenimiento en los equipos biomédicos del área de urgencias de los tres hospitales es excelente. Conclusión: La gestión de mantenimiento es muy importante para el ahorro económico en las instituciones, ya que se pueden reducir tiempos muertos de los equipos sin afectar la prestación de los servicios, aparte de que se reducen gastos en la compra de repuestos, y generación de residuos causantes de impactos negativos al medio ambiente.


Objective: to perform a diagnosis of the state of biomedical equipment maintenance management in the emergency areas of three (3) institutions of level three of medical complexity in the city of Medellín, Colombia. The realm is within the cleaner production in health research project. Methodology. A survey was designed based on the Cleaner Production Sector. Guide: in hospitals, clinics and health centers, where a check list was obtained to review the state of maintenance management of the most complex biomedical equipment used in the emergency room. Results: maintenance management of the most complex biomedical equipment is very good in hospital 1 and excellent in hospitals 2 and 3. Metrology and maintenance management in the biomedical equipment of the emergency area of all three hospitals is excellent. Conclusion: maintenance management is very important for financial savings in institutions, since they can thus reduce equipment downtime without hindering the provision of services, along with reducing costs in the purchase of spare parts and generation of waste, which causes a negative impact on the environment.


Objetivo: Realizar um diagnóstico do estado da gestão da manutenção de equipamentos biomédicos na área de urgências de três (3) instituições de nível três de complexidade médica da cidade de Medellín, Colômbia, dentro do projeto de investigação produção mais limpa em saúde. Metodologia: Desenhou-se uma pesquisa a partir da Guia Setorial de Produção mais limpa, em hospitais, clínicas e centros de saúde, onde se obteve uma lista de verificação para a revisão do estado da gestão de manutenção dos equipamentos biomédicos mais complexos utilizados em urgências. Resultados: A gestão de manutenção dos equipamentos biomédicos mais complexos é muito boa no hospital 1 e excelente nos hospitais 2 e 3; a metrologia e gestão de manutenção nos equipamentos biomédicos da área de urgências dos três hospitais é excelente. Conclusão: A gestão de manutenção é importantíssima para a poupança económica nas instituições, já que podem-se reduzir tempos mortos dos equipamentos sem afetar a prestação dos serviços, aparte de que se reduzem despesas na compra de repostos, e geração de resíduos causantes de impactos negativos ao meio ambiente.

11.
Cir. mayor ambul ; 21(1): 10-15, ene.-mar. 2016. tab
Artículo en Español | IBECS | ID: ibc-153534

RESUMEN

Introducción y objetivo: La evidencia científica muestra la necesidad de tratar la ansiedad del niño antes de iniciar una anestesia para conseguir una mayor colaboración y una inducción menos traumática. La evaluación de la ansiedad se basa por lo general en el juicio, habilidad o experiencia del personal asistencial para determinar la necesidad de medicación sedativa. El objetivo de este estudio es evaluar la habilidad de la enfermera en valorar la ansiedad del niño antes de la inducción de la anestesia. Materiales y métodos: Se seleccionaron 8 pacientes de 2 a 12 años de edad que debían ser operado en una Unidad de Cirugía Ambulatoria. Las enfermeras evaluaron la ansiedad del niño utilizando una escala de dos valores y la escala `modified Yale Preoperative Anxiety Scale`(mYPAS), que había sido previamente validada al español por nuestro grupo. Esta herramienta se usó como gold standard para calcular los índices de sensibilidad y especificidad de la evaluación de la enfermera. Resultados: La habilidad de la enfermera para detectar al niño ansioso obtuvo una especificidad muy elevada pero una sensibilidad baja. Conclusiones: La habilidad de la enfermera para detectar la detección del niño con alto grado de ansiedad se muestra muy eficiente, pero en niños con ansiedad enmascarada por diversas actitudes o falta de verbalización se muestra insuficiente, por lo que se precisa de herramientas de diagnóstico más precisas. Son muchos los factores involucrados en el diagnóstico de la ansiedad, lo que obliga a más estudios para poder realizar una correcta detección (AU)


Introduction and objective: Scientific evidence shows the need to treat the child’s anxiety before starting anesthesia to have a child more partner and less traumatic induction. To determine the need for sedative medication the assessment of anxiety is usually based on the judgment, skill or experience of the caregivers. The aim of this study is to evaluate the ability of the nurse in assessing the child’s anxiety before induction of anesthesia. Material and methods: 81 patients aged 2 to 12 years old were selected; they should be operated in an ambulatory surgery unit. The nurses evaluated the child’s anxiety on a scale of two items and scale `modified Yale Preoperative Anxiety Scale`(mYPAS), which had been previously validated by our group to Spanish. This tool was used as the gold standard for calculating the indices of sensitivity of the evaluation of the nurse. Results: the ability of the nurse to classify the anxious child got a very specificity and low sensitivity. Conclusions: The ability of the nurse for detection the child with a high degree of anxiety is very efficient, but in children with anxiety masked by various attitudes or lack of verbalization is shown insufficient, so it requires more accurate diagnostic tools. There are many factors involved in the diagnosis of anxiety, which require more study to make a correct detection (AU)


Asunto(s)
Humanos , Niño , Evaluación en Enfermería/métodos , Ansiedad/enfermería , Procedimientos Quirúrgicos Ambulatorios/estadística & datos numéricos , Evaluación Preoperatoria/enfermería , Hospitales Pediátricos/estadística & datos numéricos , Calidad de la Atención de Salud
12.
J. venom. anim. toxins incl. trop. dis ; 17(2): 190-198, 2011. graf, tab
Artículo en Inglés | LILACS | ID: lil-587779

RESUMEN

Plathymenia reticulata Benth has an anti-inflammatory effect and is capable of neutralizing the neuromuscular blockade induced by Bothrops jararacussu or Crotalus durissus terrificus venoms, probably by precipitating venom proteins (an effect caused by plant tannins). The present study aimed to evaluate the mutagenic activity of P. reticulata by using the Salmonella mutagenicity assay (Ames test) and the micronucleus test in CHO-K1 cells. P. reticulata extract concentrations of 2.84, 5.68, 11.37, and 19.90 mg/plate were assayed by the Ames test using TA97a, TA98, TA100 and TA102 bacterial strains, with (+S9) and without (-S9) metabolic activation. Concentrations of 5, 1.6 and 0.5 ìg/mL of P. reticulata extract were used for the micronucleus test. P. reticulata extract was mutagenic to TA98 (-S9) and showed signs of mutagenic activity in TA97a and TA102 (both -S9) strains. Micronucleus test CBPI values showed that the endogenous metabolic system increased the number of viable cells when compared to the non-activated samples and the micronucleus frequency increased when the cells were treated in the absence of S9. We concluded that P. reticulata extract may present direct mutagenic properties.


Asunto(s)
Antiinflamatorios , Bothrops , Venenos de Crotálidos , Crotalus cascavella , Solución Hidroalcohólica , Bloqueantes Neuromusculares , Plantas Medicinales , Pruebas de Mutagenicidad/métodos
13.
Artículo en Español | IBECS | ID: ibc-81508

RESUMEN

Esta hoja de valoración pediátrica prehospitalaria es una herramienta desarrollada para la correcta valoración del paciente pediátrico. La hoja de valoración prehospitalaria del paciente pediátrico sigue una secuencia lógica que comprende la primera impresión (triángulo de evaluación pediátrica), la valoración inicial, los signos vitales, el código CIPE, la anamnesis, la historia SAMPLE, y la exploración física, e incluye todos los aspectos fundamentales para una correcta atención de las necesidades del paciente pediátrico. Además, incluye algunas de las tablas y reglas mnemotécnicas pediátricas más utilizadas en el ámbito de la emergencia prehospitalaria(AU)


This sheet is a prehospital pediatric assessment tool for proper assessment of the pediatric patient. The prehospital assessment sheet for the pediatric patient follows a logical sequence that includes the general assessment (pediatric assessment triangle), initial assessment, vital signs, the code CIPE, the Additional assessment, SAMPLE history and physical examination, and includes all the fundamentals for proper care of the needs of pediatric patients. It also includes some of the tables and more pediatric mnemonics used in the field of prehospital emergency(AU)


Asunto(s)
Humanos , Masculino , Femenino , Niño , Servicios Médicos de Urgencia/métodos , Servicios Médicos de Urgencia/organización & administración , Anamnesis/métodos , Servicios Médicos de Urgencia/tendencias
14.
Rev Neurol ; 40(5): 303-16, 2005.
Artículo en Español | MEDLINE | ID: mdl-15782363

RESUMEN

INTRODUCTION: Up to 5% of the population suffers from neuropathic pain (NP). A bibliographical search in several databases revealed that, to date, there are no protocols to guide physicians who are not specialists in pain that enable them to treat NP and thus improve patients' quality of life. AIMS: The aim of this study is to provide Spanish-speaking physicians who are not specialists in pain with a set of guidelines for the treatment of NP. A bibliographical search was performed in order to base the results and conclusions on the evidence-based medicine methodology. DEVELOPMENT: First, we review the most effective clinical and paraclinical methods for diagnosing NP, and the LANSS pain scale is reported as the most appropriate method of clinically evaluating NP. The anatomical paths and the physiology of pain are then described and we review the molecular variables involved. Finally, we point out the current therapeutic options and propose an algorithm for the treatment of NP. CONCLUSIONS: There is no specific set of guidelines for the treatment of NP. At the present time, the keystone of NP treatment consists in the use of antidepressant and anticonvulsive drugs. There is a need for further clinical trials to prove the effectiveness of using combined medication.


Asunto(s)
Enfermedades del Sistema Nervioso , Dolor , Árboles de Decisión , Humanos , Enfermedades del Sistema Nervioso/diagnóstico , Enfermedades del Sistema Nervioso/tratamiento farmacológico , Enfermedades del Sistema Nervioso/etiología , Enfermedades del Sistema Nervioso/fisiopatología , Dolor/diagnóstico , Dolor/tratamiento farmacológico , Dolor/etiología , Dolor/fisiopatología , Guías de Práctica Clínica como Asunto
15.
Rev Neurol ; 40(4): 229-36, 2005.
Artículo en Español | MEDLINE | ID: mdl-15765318

RESUMEN

AIMS: The aim of this study is to develop a set of guidelines for the clinical management of neuropathic pain (NP), a disorder suffered by up to 5% of the population, specifically for use by the Spanish-speaking community, in order to improve the quality of medical care and to standardise the treatments offered in medical centres. DEVELOPMENT: The paper describes the methodology used to search for guidelines concerning the clinical management of NP in databases, written communications and other resources, and the results of this search are presented. The research group is split into three groups: anatomical-physiological, diagnosis and therapeutic approach, each of which defines the nature of the papers that used to design the protocol.


Asunto(s)
Manejo del Dolor , Guías de Práctica Clínica como Asunto , Adulto , Bases de Datos Bibliográficas , Humanos , Informática Médica/normas , Guías de Práctica Clínica como Asunto/normas , Garantía de la Calidad de Atención de Salud
16.
Rev. neurol. (Ed. impr.) ; 40(5): 303-316, 1 mar., 2005. ilus, tab
Artículo en Es | IBECS | ID: ibc-037045

RESUMEN

Introducción. El dolor neuropático (DN) se presenta hasta en el 5% de la población. Después de una búsqueda bibliográfica en varias bases de datos, se determinó que hasta la fecha no existen protocolos que orienten al médico que no es especialista en dolor para tratar el DN y mejorar la calidad de vida de los pacientes. Objetivo. Presentar unas guías de tratamiento del DN dirigidas a médicos no especialista en dolor de habla hispana. Se realizó una búsqueda bibliográfica para fundamentar los resultados y las conclusiones con la metodología de la medicina basada en la evidencia. Desarrollo. En primera instancia se revisan los métodos clínicos y paraclínicos más eficaces para el diagnóstico del DN y se describe la escala de LANSS como la opción más adecuada para la evaluación clínica del DN. Posteriormente, se describen las vías anatómicas y la fisiología del dolor y se revisan las variables moleculares involucradas. Finalmente, se señalan las opciones terapéuticas actuales y se propone un algoritmo de tratamiento del DN. Conclusiones. No existe un esquema específico para el tratamiento del DN. Actualmente, los antidepresivos y los anticonvulsionantes son la piedra angular del tratamiento. Se requieren ensayos clínicos que evidencien la eficacia del uso de medicamentos combinados


Introduction. Up to 5% of the population suffers from neuropathic pain (NP). A bibliographical search in several databases revealed that, to date, there are no protocols to guide physicians who are not specialists in pain that enable them to treat NP and thus improve patients’ quality of life. Aims. The aim of this study is to provide Spanish-speaking physicians who are not specialists in pain with a set of guidelines for the treatment of NP. A bibliographical search was performed in order to base the results and conclusions on the evidence-based medicine methodology. Development. First, we review the most effective clinical and paraclinical methods for diagnosing NP, and the LANSS pain scale is reported as the most appropriate method of clinically evaluating NP. The anatomical paths and the physiology of pain are then described and we review the molecular variables involved. Finally, we point out the current therapeutic options and propose an algorithm for the treatment of NP. Conclusions. There is no specific set of guidelines for the treatment of NP. At the present time, the keystone of NP treatment consists in the use of antidepressant and anticonvulsive drugs. There is a need for further clinical trials to prove the effectiveness of using combined medication


Asunto(s)
Humanos , Enfermedades del Sistema Nervioso/diagnóstico , Enfermedades del Sistema Nervioso/tratamiento farmacológico , Enfermedades del Sistema Nervioso/fisiopatología , Enfermedades del Sistema Nervioso/etiología , Dolor/diagnóstico , Dolor/tratamiento farmacológico , Árboles de Decisión , Guías de Práctica Clínica como Asunto
17.
Rev. neurol. (Ed. impr.) ; 40(4): 229-236, 16 feb., 2005.
Artículo en Es | IBECS | ID: ibc-037033

RESUMEN

Objetivo. Desarrollar unas guías de práctica clínica para el dolor neuropático (DN), un trastorno que se manifiesta hasta en el 5% de la población, específicamente para la comunidad de habla hispana, con el fin de mejorar la calidad del cuidado médico y estandarizar los tratamientos en los centros clínicos. Desarrollo. Se describe la metodología de búsqueda de guías de práctica clínica de DN en bases de datos, comunicaciones escritas y otros recursos, y se muestran los hallazgos. El grupo investigador se distribuye en tres grupos: aproximación anatomofisiológica, aproximación diagnóstica y aproximación terapéutica, cada uno de los cuales define la pertinencia de los artículos que se utilizarán para diseñar el protocolo


Aims. The aim of this study is to develop a set of guidelines for the clinical management of neuropathic pain (NP), a disorder suffered by up to 5% of the population, specifically for use by the Spanish-speaking community, in order to improve the quality of medical care and to standardise the treatments offered in medical centres. Development. The paper describes the methodology used to search for guidelines concerning the clinical management of NP in databases, written communications and other resources, and the results of this search are presented. The research group is split into three groups: anatomical-physiological, diagnosis and therapeutic approach, each of which defines the nature of the papers that used to design the protocol


Asunto(s)
Humanos , Práctica Profesional , Calidad de la Atención de Salud , Cuidados Paliativos/tendencias , Dolor/clasificación , Terapia Combinada , Protocolos Clínicos , Dimensión del Dolor , Neuralgia/diagnóstico , Neuralgia/tratamiento farmacológico , Investigación sobre Servicios de Salud , Medicina Basada en la Evidencia , Conflicto de Intereses , Bases de Datos Bibliográficas
18.
Int J Syst Evol Microbiol ; 55(Pt 1): 197-207, 2005 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-15653876

RESUMEN

One hundred and seventy-eight lactobacilli isolated from wine were characterized by a polyphasic approach. Strains were phenotypically identified at genus and species level by classical tests including the analysis of cell morphology, homo/heterofermentative character, sugar fermentation patterns, growth at different temperatures and the optical nature of the isomer of lactic acid produced from glucose. Molecular techniques such as random amplification of polymorphic DNA (RAPD), amplified 16S rDNA restriction analysis (16S-ARDRA), PFGE-RFLP and ribotyping were used to characterize strains, and their potential for identification and/or typing was evaluated. The information obtained with these techniques was processed with the BioNumerics software in order to analyse relationships existing between isolated strains and various reference species of the genus. Then, taxonomic dendrograms were obtained, and this information allowed the proposal of molecular procedures suitable for the identification and typing of these wine micro-organisms. The techniques useful for both identification and typing were RAPD and ribotyping, while 16S-ARDRA was only useful for identification and PFGE-RFLP only for typing purposes. The wine strains were identified as Lactobacillus brevis (19 strains), Lactobacillus collinoides (2 strains), Lactobacillus hilgardii (71 strains), Lactobacillus paracasei (13 strains), Lactobacillus pentosus (2 strains), Lactobacillus plantarum (34 strains) and Lactobacillus mali (10 strains).


Asunto(s)
Lactobacillus/clasificación , Vino/microbiología , Técnicas de Tipificación Bacteriana , ADN Bacteriano/análisis , ADN Ribosómico/análisis , Electroforesis en Gel de Campo Pulsado , Fermentación , Lactobacillus/genética , Lactobacillus plantarum/clasificación , Lactobacillus plantarum/genética , Datos de Secuencia Molecular , Fenotipo , Polimorfismo de Longitud del Fragmento de Restricción , ARN Ribosómico 16S/genética , Técnica del ADN Polimorfo Amplificado Aleatorio , Ribotipificación , Análisis de Secuencia de ADN , Vitis/microbiología
19.
Trans R Soc Trop Med Hyg ; 96(1): 48-52, 2002.
Artículo en Inglés | MEDLINE | ID: mdl-11925991

RESUMEN

The prevalence of human infection by Trypanosoma cruzi was assessed using an enzyme-linked immunosorbent assay (ELISA) in a serological survey in 1998 of 2 rural communities (SMH and PS) in Guatemala. In SMH (Department of Zacapa), where Rhodnius prolixus was the principal vector, the seroprevalence amongst 373 people tested was 38.8%. In PS (Department of Santa Rosa), where the main vector was Triatoma dimidiata, 8.9% of the 428 people tested were seropositive. The overall prevalence of seropositivity was higher in females than in males in both SMH (40% vs 36%) and PS (11.9% vs 4.9%), although this difference was significant only in PS. Historical seroconversion rates, estimated retrospectively by fitting a transmission model to the age-prevalence curves, were 3.8% per year in SMH and 0.5% per year in PS. There was some indication of a recent reduction in incidence in both villages. In PS, but not in SMH, both the observed prevalence and the estimated incidence rates were significantly higher in females than in males.


Asunto(s)
Enfermedad de Chagas/epidemiología , Trypanosoma cruzi , Adolescente , Adulto , Distribución por Edad , Anciano , Animales , Niño , Preescolar , Estudios Transversales , Ensayo de Inmunoadsorción Enzimática , Femenino , Guatemala/epidemiología , Humanos , Incidencia , Lactante , Recién Nacido , Masculino , Persona de Mediana Edad , Prevalencia , Salud Rural , Distribución por Sexo
20.
Mem Inst Oswaldo Cruz ; 96(4): 503-5, 2001 May.
Artículo en Inglés | MEDLINE | ID: mdl-11391422

RESUMEN

PCR detection of Trypanosoma cruzi in Rhodnius prolixus using fresh tissue or fecal drops on filter paper showed comparable results: 38.7% infection rate using the fresh tissue sample and 37.9% by dried fecal drop.


Asunto(s)
Heces/parasitología , Intestinos/parasitología , Reacción en Cadena de la Polimerasa/métodos , Rhodnius/parasitología , Trypanosoma cruzi/aislamiento & purificación , Animales , Electroforesis en Gel de Agar , Filtración , Insectos Vectores/parasitología , Papel
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