MEDICAL SCIENCE (15)

Author: MARTÍNEZ-ZALDÍVAR MORENO MARGARITA.
Year: 2006.
University: GRANADA [www.ugr.es].
Place of defense: FACULTAD DE MEDICINA.
Place of preparation: FACULTAD DE MEDICINA.

Summary: The province of Granada is located on a dangerous earthquake zone, in fact, is the most exposed area of the Iberian Peninsula along with the provinces of Almeria, Malaga and the Levant. It lies in a set of four faults: the Fargue, Grenada, Gabias-Santa Fe and failures in the sector of Sierra Elvira. The latter have the largest concentration of earthquakes in the basin of Grenada. It is in this area where historically there have been very destructive earthquakes R? VIII, such as occurred in 1431 (I = IX-X) at Pines Bridge, the 1,806 (I = VIII-IX) with epicenter Pines Bridge and between Santa Fe and the 1,884 in Arenas del Rey, known as the earthquake in Andalusia (R = IX), which came to destroy many towns of Granada and Malaga producing more than 1,300 deaths and about 1,500 wounded . The urgent medical care in disaster situations such as those that can cause major earthquakes and of moderate intensity, are now a necessity and a challenge from the standpoint of health emergencies Experience tells us that plans sanitary actions are necessary to minimize the damage caused by seismic disasters, and especially to save the maximum number of victims, since a structured and organized, trying to fill the possible shortcomings of previous plans and not forgetting the new facilities with those who can count at the moment. The report of this thesis is structured in 6 chapters: Chapter I: Introduction. As we have seen in this chapter have reviewed the basic concepts of hazard, vulnerability and risk seismic, in order to understand the analysis of the seismicity of Grenada, after making a historical overview of the major earthquakes that have occurred in our area . Here are defined scenarios seismic damage, and the models to estimate victims in the world, needed to know the impact on individuals and the geographical distribution of the wounded, based on good health planning along with the knowledge of the vulnerability of key buildings such as hospitals and determination of the actual capacity of health centers. He then describes major injuries and diseases that cause earthquakes and we will find that at the time of making health care to the victims and what are the major factors which determine the morbidity and mortality of these earthquakes. Finally, it describes the preliminary studies on emergency planning and seismic proceedings health in the province of Grenada and elsewhere in the country. Chapter II: Rationale and objectives. This chapter highlights the importance and necessity of this work, because Grenada is in the most exposed area of the Iberian Peninsula and history tells us that there has been very destructive earthquakes in Southern Spain. So it is absolutely necessary to develop a Plan of Action Health with the objectives that are raised here, because until now has not carried out any work of this kind. Chapter III: Materials and Methods. There is a detailed description of the methods for estimating damages and casualties have been employed, highlighting the simulator scenarios Seismic SES 2002 and its application to Grenada. Besides analyzing the classification methods and health care for victims and the organization of the Emergency Operations and Sanitary earthquakes in Granada, following the legislation in force, to take him to Health Plans of Actions. Chapter IV: Results. It discusses the results of the implementation of the estimated impact of earthquakes kind to the population of the metropolitan area of Grenada. Using the methodology of the previous chapter, you have a estimates 8 ion tant 6c5 or quantitatively and qualitatively and classification of the victims, depending on the gravity and grade lesion of the victims. This allows us to establish the system of organization and coordination of the resources of public and private services, as well as the valuation of victims and the attention that must be paid from the triage is done until they are evacuated to hospital, passing through the location of the Base Areas, Advanced Health Posts and other structures deployment of immediate intervention necessary for proper medical care. In addition takes into account the psychological care of victims and medico problems that cause the seismic catastrophe. Chapter V: Discussion. It highlights new and relevant aspects of this study, the results are assessed by comparing them with other work. Chapter VI: Conclusion. In this final chapter summarizes the main findings of this work, related to the objectives mentioned in the second chapter.

Author: Albornoz Cabello Manuel.
Year: 2006.
University: SEVILLA [www.us.es].
Place of defense: Escuela Universitaria de Ciencias de la Salud.
Place of preparation: Escuela Universitaria de Ciencias de la Salud de la Universidad de Sevilla.

Summary: This study circinscribe in what we call a process of scaling psychophysical. That is, creating a scale of the levels of perception are obtained by applying the current rectangular symmetrical biphasic, with the aim of strengthening muscle. Levels perceptive and bounded studied are: level of sensitivity, and level of contraction tolerance level. The sample was made up of 900 steps, 300 for each level of perception, obtained from 150 healthy subjects and normal, 93 women and 57 men, aged between 18 and 35 years. To quantify these levels perceptive we have developed a deseño two factors inter-intrasujetos with repeated measurements by a factor. Therefore, each subject has been discussed on two separate occasions by two different experimenters, in the first and second. This design allows us to study the quality of measurements obtained: validity and reliability. Together, we have developed a range of instruments, underlining the scale of apprehension psychological staff (EAPP), which has allowed us to quantify the extent of this factor in the personality of individuals. The results have shown that this is a sample of healthy subjects and within the normal ranges of the general population. The differences found in the measurements of the two experimenters are attributable to the self and not subject to the influence of systematic experimenters. In addition, it has been confirmed that individuals do not have a high score in the EAPP, so that the sample has been validated for establishing the scale psychophysics. The perceptive levels are well defined in the following ranges: level of sensitivity [6,7-7,2] + / -1 mA, level of contraction [23,2-24,6] mA and tolerance level [42, 1-43,7] + /-2.5 mA. Finally, the scale psychophysics has phased and gradual in the intervals described above, for a young adult population, male and female, healthy and normal, the analysis of which has been the subject of this thesis.

Author: de Cáceres Bustos Ana Isabel.
Year: 2006.
University: VALLADOLID [www.uva.es].
Place of defense: Facultad de Medicina.
Place of preparation: Facultad de Medicina.

Summary: The carotid body (CA) is a small body and highly vascularized inervado which is located in the fork of the carotid artery. The quimiorreceptor blood is more important in mammals and its main function is to detect the pressure of oxygen (as well as CO2 levels and pH) in arterial blood. When it detects a decrease in PO2 blood, the CC responded by increasing the level of discharges of fibers quimiosensoriales within the nerve carotído. In this way, information on the oxygen content in blood is quickly transmitted to the respiratory center of the brain, changes occur in the respiratory and cardiovascular response to correct the alteration detected by the CC. In this work we have characterized Doctoral Thesis adaptations of the CC and other tissues sensitive to oxygen situations of chronic hypoxia and hiperoxia perinatal. We have studied the molecular mechanisms involved in the adaptation to analyze a series of changes in the expression of genes encoding various ion channels sodium, potassium and calcium and other proteins associated with the response to hypoxia and sensitivity to oxygen such as hemoxigenasas. We have also marked changes in the functionality of CA during chronic hypoxia and we found some of the mechanisms involved in the increased excitability of the same. The ultimate goal of this work has been to help clarify how they affect situations of hypoxia in mammals to understand what is happening with people living at high elevations or suffer from respiratory disorders such as sleep apnea or chronic obstructive pulmonary disease.

Author: HERNÁNDEZ HERNÁNDEZ ESTHER BELÉN.
Year: 2006.
University: GRANADA [www.ugr.es].
Place of defense: FACULTAD DE FARMACIA. SALÓN DE GRADOS.
Place of preparation: FACULTAD DE FARMACIA. UNIVERSIDAD DE GRANADA.

Summary: THIS THESIS, REFERENCE AS TAKING THE LAW AND THE CASE LAW, IDENTIFIES POSSIBLE CONFLICT OF POINTS SUSCEPTIBLE TO PHARMACIST RESPONSIBILITY FOR GENERATING FROM MAKING UP FARMACOTERAPÉUTICO, ASSESSING THE STATUS OF THESE POINTS OF CONFLICT IN PRACTICE REAL.

Author: JIMÉNEZ LOZANO GEORGINA.
Year: 2006.
University: GRANADA [www.ugr.es].
Place of defense: FACULTAD DE MEDICINA.
Place of preparation: FACULTAD DE MEDICINA.

Summary: Smoking is an important public health problem that carries a

Author: RODRIGUEZ LARA MARIA ISABEL.
Year: 2006.
University: GRANADA [www.ugr.es].
Place of defense: FACULTAD DE MEDICINA.
Place of preparation: DEPARTAMENTO DE FISIOLOGIA. FACULTAD DE MEDICINA.

Summary: The aging can be defined as a multifactorial process that includes progressive cell loss, endocrine and metabolic deficits, declining defenses and functional loss that increases the risk of death. Many theories have been proposed to explain this and classifications aging process, but we will focus on:-Theory of free radio (Harman, 1956). Mitochondrial-Theory (Miquel, 1975). Theory - inflammatory (Chung, 2001). Mitochondrial-Theory / Inflammatory proposed by our group and which will build our work. The free radical theory of aging is postulated that the unintended harmful effects caused by the tissue reactions of free radicals during aerobic respiration. To protect themselves from the harmful effects of free radicals, cells have developed mechanisms based on 1 complex defense system consisting of antioxidant agents.

Author: Manzanera Pastor David.
Year: 2006.
University: VALENCIA [www.uv.es].
Place of defense: Facultad de Medicina y odontología.
Place of preparation: Facultad de medicina y estomatologia.

Summary: The determination of the need for orthodontic treatment has not been tenidi into account in most studies epidiomiológicos in dentistry.

Author: SANCHEZ HERNANDEZ JUAN ANTONIO.
Year: 2006.
University: AUTÓNOMA DE BARCELONA [www.uab.es].
Place of defense: HOSPITAL DE LA SANTA CREU I SANT PAU.
Place of preparation: HOSPITAL DE LA SANTA CREU I SANT PAU. UNIVERSITAT AUTONOMA DE BARCELONA..

Summary: Available data on the status of vitamin D in patients with morbid obesity are scarce so far and little clarifying, as it almost always has been associated with this inadequacy bariatric surgery, without considering that this hypovitaminosis D and can precede the surgery. In this regard, the association of vitamin D deficiency secondary hyperparathyroidism with morbid obesity has been described in patients treated with and without bariatric surgery prior mechanisms exist patofisiológicos that have been associated with this deficit of vitamin D. Los estudios transversal y longitudinal realizados en esta Tesis demuestran que la deficiencia de vitamina D está presente en la mayoría de los pacientes con obesidad mórbida antes de la cirugía y, en una proporción importante de estos pacientes, existe el hiperparatiroidismo secundario que está claramente relacionado con this degree of deficiency of vitamin D. The results of the longitudinal study suggest that the mixed type of bariatric surgery (restrictiva-malabsortiva) does not appear to significantly affect on those alterations and even conducting gastric bypass determines an upward trend later in the levels of calcidiol and declining the parathormona, especially in the most serious deficits. The most plausible mechanisms patofisiológicos major deficit of vitamin D in these patients might relate to inadequate exposure to the sun and / or the low bioavailability of vitamin D secondary to the excessive adiposity in obesity severe The results of these studies have implications in practice clinical associated with the monitoring of serum calcium, phosphate and vitamin D in all patients with severe obesity to establish supplementation of calcium and vitamin D in those with deficits. This practice is justified, in addition to the high prevalence of vitamin deficit Of secondary hyperparathyroidism, the potential associated morbidity and the availability of effective and economical treatment that also reverse the situation.

Author: García Sánchez Ma. José.
Year: 2006.
University: MURCIA [www.um.es].
Place of defense: Hospital Universitario Virgen de la Arrixaca.
Place of preparation: Facultad de Medicina.

Summary: The precepts of the Law 41/2002 constitute a potential source of risk if we do not take appropriate steps to meet the obligations to the health administrations, professionals and health centers. Objectives: To design an assessment protocol that includes indicators that directly or indirectly involve compliance with the rights of patients and families. Carry out an assessment based on previous protocol at the Hospital Universitario Virgen de la Arrixaca to ascertain compliance and analyze what values influence the same. Materials and Methods: A description of the rights and to assess the criteria used. Methods of evaluation: 1. Direct Observation of the evaluator: Made by three evaluators who have previously agreed criteria to analyze. We analyzed sections of the center's programming schedules, outpatient, hospital, interview the coordinator of quality and access. 2. Analysis of medical records: We evaluated 500 medical records of patients undergoing proceedings health risk. 3. Survey of patients and their families: We 1500 satisfaction surveys to patients with the following stratification: 500 patients discharged from hospital, 500 patients treated in outpatient and 500 patients treated in emergency rooms. Statistical Analysis: Program SPSS 14.0. Results: In obseravación directly observe that there is no exposure of place and time information. Delete the call by megaphone. No information is given on how to get information. Analysis of the clinical history: High percentage of the presence of the informed consent document and report high. It is noted that in the medical record that information to the patient. Survey posthospitalización: Male patients receive more information than women. Suitable timeout. Patients are considered to be well informed and well cared for, except how to get more information and performance standards of l hospital. The information has been greatest in pediatrics and surgical services and higher incomes programmed urgent. Outpatient Survey: They receive more women, younger and subsequent consultations. More than 80% are served before 45 days. Patients are considered well informed except how to get more information. The 30% of patients are not attended on time. Inquiry in emergencies: The pediatric service is the one that gives more information. More than 80% served before 30 minutes. Attention and information are adequate, excpeto in alternative diagnostic and regular information on patients under observation. Conclusions: 1. The weakness is the most important record in the medical record that the patient has been informed, getting the rest of the rights evaluated acceptable levels. 2. The age, gender of the patient and hospital service established significant differences in the information received and obtaining informed consent. 3. The percentage of families reported is greater than the patient, including information about the inconvenience or complications of supplementary evidence, violated the principle of ownership of the right to information. We believe that there are areas for improvement in the following areas: Unify and report form, place and time to be delivering information to relatives. Implement measures to improve the patient's right to confidentiality as to avoid the public address system. Ensure that in the case of planned surgery obtain a copy of including surgical waiting list. Establish measures to improve information on how to obtain further information and the rules of operation of the hospital. 4. Improve the training of professionals on the rights of patients.

Author: García Martínez Olga.
Year: 2006.
University: GRANADA [www.ugr.es].
Place of defense: Escuela Universitaria de Ciencias de la Salud.
Place of preparation: Escuela Universitaria de Ciencias de la Salud.

Summary: The osteoblast cells are responsible for bone formation and remodeling. Our results show that this population presents a profile characteristic antigenic cuts tissue with the expression of a number of constituent molecules (CD10, CD44 and alkaline phosphatase) and a series of modular antigens (CD54, CD80, CD86 and HLA-DR) as expersión gives this cell population certain properties of immunocompetent cells, as had been described in cell cultures. The PRP is a source of autologous growth factors used in oral surgery recently. Our results show that this compound enhances cell proliferation, modulates the expression antigenic without affecting the cell cycle. Lastly, Paracetamol, Ibuprofen and Methylprednisolone, analgesics commonly used in daily clinical practice dentistry, exert an inhibitory effect on the rate of crecimietno of osteoblasts through studies in primary cultures. Without

Author: PEÑA SÁNCHEZ MANUEL.
Year: 2006.
University: GRANADA [www.ugr.es].
Place of defense: UNIVERSIDAD DE GRANADA.
Place of preparation: UNIVERSIDAD DE GRANADA.

Summary: INTRODUCTION: ulcerative colitis is a chronic inflammatory disease

Author: Godoy Santana Santiago.
Year: 2006.
University: MURCIA [www.um.es].
Place of defense: Facultad de Medicina.
Place of preparation: Facultad de Medicina.

Summary: The determination contingency is the administrative process by which the INSS, covered in the DR 1300/1995 of 21 July (section 1a and 3.1f) decides on whether a doctor is derived from accident and occupational diseases, or common illness. Since in relation to cardiovascular disease were collected all records ended with a final ruling, between the years 1990 and 2000, analyzing all the variables of these records, and being subjected to statistical program 14.0. In the univariate and bivariate analysis try to objectify and assessing alternative approaches that exist at the time the decision is taken, either adminbistrativa as legal, and that generate the current legal undetermined. Different concepts for the same term (accident, injury, injury, etc.), different pay depending on the case of industrial accident or illness common concept of Work Accident (Art. 115 of the LGSS) presumption Iuris Tantum and so, generate a conflict médico-jurídico where settle the responsibility for providing the National Institute of Social Security (INSS) and the Mutual Accident Working (MATEPSS), a fact inconsistent when it comes to a manager and the Entity another Contributing Entity, both Social Security. Conclusions: 1. The concept of an accident at work is confusing in its implementation. 2. Currently, the conflicts between two institutions with overlapping objectives but with conflicting interests budget is resuleven by a party in litigation, which contradicts the most basic principles of independence and impartiality in decision-making. It would be desirable to an arbitration system independent and objective than the judicialization of the process. 3. With current scientific procedures, the state of the systems and coverage of social protection and the legal framework for refrencia allow us to define a system of worker protection, without forcing the scientific arguments that hamper the work of professionals involved in the process. 4. The real Dcereto 1300/1995 of 21 July is confusing in establishing the concepts of determination contingency, while allowing an excessively subjective interpretation of biological processes. 5. We must give the judge the scientific support sufficient to respond to questions under the process of determining underlying contingency.

Author: Marcos Puig Ma. Beatriz.
Year: 2006.
University: VALENCIA [www.uv.es].
Place of defense: Facultat de Medicina i Odontologia.
Place of preparation: Facultat de Medicina i Odontologia.

Summary: INTRODUCCION.El ovarian hyperstimulation syndrome (OHSS) is a phenomenon rare, but potentially very serious, it appears almost always complication iatrógena the use of gonadotropins for multiple follicular development in patients undergoing TRA.Desconocemos its pathophysiology, but it is the administration of exogenous hCG in the completion of the cycle that would lead to early SHO, or hCG endogenous from sincitiotrofoblasto of women who become pregnant that would lead to late SHO, which triggers the syndrome in its two forms of presentación.Entre the 0.1-2% of patients develop severe forms of OHSS (Navot et al, 1992). have been proposed various mediators of hCG to be responsible for the increased vascular permeability, which characterizes the syndrome and who is responsible for extravasation fluid and its accumulation in a third space in the form of ascites hidrótorax even anasarca.De among them seems to play a very important role VEGF and the system that are known vasoactive properties, in particular its action on the receiver increases capillary permeability and favors the departure of protein rich fluid to the third space. It also induces endothelial cell proliferation and angiogenesis in vivo.Se dealing with a system formed by a series of ligands and receptors with different roles according to their unions. The most important is the VEGF isoforms with several A (Neufeld et al, 1999) remains the most important isoform 121 and 165 because they are specifically expressed in the ovary. The VEGF receptor belongs to the family of receptors tyrosin-kinasa (De Vries et al, 1992) and have been described mainly two endothelial membrane receptors, VEGFR-1 also known as Flt-1 and VEGFR-2 also called flk -1 / KDR (Waltenberg et al, 1994; Shalaby et al, 1995). The VEGFR-1 also occurs in a soluble form (sVEGFR-1) acting as a modulator of the bioactivity of VEGF to ligarlo and reduce their number free f-VEGF.Existen various risk factors for the SHO: younger patients, low BMI, history of allergies, and SOP hyperinsulinism aspect ultrasound ovarian type PCOS. But we do not know why some women hiperestimulan and others not in the presence of the same factors riesgo.El OHSS can be characterized as self-limited both in its form as early as late without knowing what are the mechanisms by which self. HIPÓTESIS.Nuestra working assumption is based on previous publications of the group (Pellicer et al; Gomez et al, 2002; Gomez et al, 2003) makes us assume that the system VEGF plays a key role in the development and maintenance of OHSS. We assume that variations of this system are responsible for two phenomena very important in the pathophysiology of SHO: self-regulation and why some women develop it and others do not. In this regard, we presume that the relationship between levels of circulating VEGF inhibitor and its natural sVEGFR-1, which ultimately determine the availability of f-VEGF, will be the key to answering both questions. OBJETIVOS.Objetivo main study variations in plasma levels of VEGF system peripheral (VEGF total VEGF free and sVEGFR-1) in women undergoing ART, comparing groups of women with and without risk of OHSS. Among the risk, we will look at those who eventually developed and which not. Study women luteal phase and the first trimester of pregnancy covering periods in which it appears and disappears syndrome so as early as late. With all this prestendemos ascertain the implications of VEGF system in the onset of the syndrome to give certain patients and their auto-regulación.Objetivos side: to study the role steroidal luteal phase of assisted reproduction cycles to compare luteolisis with variations VEGF system, explore the role of alpha-2 Macroglobulina (A2M) as secuestradora of VEGF, explore variations in the VEGF system in a group of gest 8 before tr 1ff8 as donation of oocytes to evaluate the role of different bodies in the contribution systemic different parts of VEGF with the intent to delimit the last true role in ovarian syndrome late onset. MATERIALS AND METHODS. Prospective cohort study of women undergoing in the TRA IVI Valencia between February 2002 and October 2005. The study was approved by the Ethics Committee of Clinical Trials of that institution. To study the early OHSS only included patients who could not be pregnant or because the risk of hyperstimulation was so high they were frozen embryos, either because there was no suitable embryos or because they were patients donors of oocytes. It established three groups: group 1 (n = 11) comprised of patients without risk of OHSS, group 2 (n = 18) formed by risk patients who did not actually hiperestimularon and group 3 (n = 8) formed by patients risk finally did hiperestimularon. It was considered risk patients to the presence of some type PCO ovaries baseline and gaining 20 or more eggs the day of punción.Seguimiento: ultrasound scan to assess the presence of ascites and blood samples for the measurement of parameters basic hematology and for obtaining serum and plasma that were frozen at -20Â ° C for later analysis. All this took place days 0, 3, 6, 10 and 14 after obtaining ovocitarioPara study of OHSS late included pregnant after FIV-ICSI all risk and were divided into 2 groups: group 4 (n = 8) those that not developed the syndrome and group 5 (n = 4), which developed it. It included an additional group called OJ (n = 4) formed by pregnant after donating oocytes in women without role ovárica.Estas patients were monitored weekly to evaluate the clinical status of its SHO and obtain blood, which was processed as previously described. Inmunoensayos: measuring all parts of VEGF was conducted in plama by ELISA measurement of A2M was conducted in serum by nefelometría and measurement of steroid hormones in serum was conducted by ELISA.Análisis statistics: Data were expressed as the average over the less standard error of the mean. It was the calculation of sample size to get differences in average levels of sVEGFR-1 among pacientesexpuestas and not exposed to the SHO of 65 ng / ml, with a statistical power of 80% and significance as the defining p? 0.05. Statistical analysis was done using SPSS version 11.0. In the early SHO, the job is analysis of variance (ANOVA) waS AND POST-HOC Tukey analysis to identify differences between groups in each of the time points studied. The SHO late, using the t test student. In addition to the chi-square test was used in both studies when she indicated. RESULTADOSSHO temprano.En regard to the clinical characteristics of the different groups found that the patients in group 3 were younger, requiring fewer doses of gonadotropins and showed more ovocitos.Los levels of total VEGF were higher in group 3 with Turning to the other 2 on day 6. Likewise free VEGF levels were significantly higher in the grupo3 with respect to group 2 on day 6. The sVEGFR-1 was less secreted by the group 3 with respect to group 2 on day 6. With regard to the levels of estradiol and progesterone in both luteal phase showed levels of functional corpus luteum to 14 days in the group 3; hence auto-resolución syndrome in these cases can not be ascribed to the luteolisis. The relationship between the levels of VEGF s free and VEGFR-1 suffered a drop in groups 2 and 3 to 14 days, or in those who are at risk. What could explain how self. SHO tardío.Las clinical characteristics of the two groups showed that the group 5 were significantly younger. The patients in group 5 secretaron largest amounts of VEGF total of the group 4. The plasma levels of VEGF free were higher in group 5 and this difference was due to the reduced capacity of secretion of soluble receptor in patients in group 5 mainly from week 9. Of the relationship between VEGF and its receptor soluble free in these groups, did not obtain any pattern to explain the mechanism by which auto-regula the SHO tardío.Sistema VEGF in donating ovocitos.Las patients included in the groups 4 and 5 were grouped together in a group we call FIV-ICSI to compare parts of VEGF with pregnant patients after ovodonación.Los nieles peripherals free VEGF were even higher in the group of ovodonation being similar to the VEGF total. The soluble receptor levels increased in both groups from week 7 but to a lesser extent in the group ovodonation which points to a functioning placental defectuoso.Los serum A2M were analyzed for both the SHO early as late. It did not deliver significant difference between the group 1.2 and 3. The study of OHSS late levels were even higher in Group 5, ie those hiperestimularon in group 4, demonstrating the little protective role that this protein may have. Regarding Aboriginal of the same, was much higher in patients following FIV-ICSI after ovodonation, signaling their ovarian origin. CONCLUSIONESLas women at risk of getting the early OHSS are young and with a special sensitivity to gonadotropins, as shown in its response to ovarian stimulation with fewer doses and the large number of oocytes obtenidos.De among women with these characteristics and thus have padecerlo risk, the difference between the development or not lies in the ability of s secretion of VEGFR-1 (antagonist natural system VEGF). A2 Macroglobulina that had been defined by others as a differentiator who suffers from the syndrome it is not at all relevant in the SHO temprano.La luteolisis is not the cause of self-regulation SHO early, since there are no women hiperestimuladas. By contrast, appears to be a sharp decline in the relationship between the self and its VEGF receptor soluble which induces its regulación.En the late SHO also see a reduced production of soluble receptor those subject to it, but in this case seems decisive the role of placenta.La A2 Macroglobulina does not play any role because it was even higher in women who suffer from the SHO tardío.El self-regulatory mechanism is unknown to us because we have not found the same trends in the levels of VGF free with the SHO temprano.Durante pregnancy there is an increase in circulating levels of VEGF and total soluble receptor, so that levels of VEGF free are not distorted. This points to an essential contribution to the placenta.Del analysis of pregnancies achieved through donation of oocytes, we learned that the VEGF that is the free movement must act only at the level of the ovary and not at sistémico.Finalmente these gestations after donation of oocytes have a production defective receptor antagonist, but we know well if it is due to lack of functioning ovaries or placental defective functioning.

Author: JÒ¼rschik Giménez María Pilar.
Year: 2006.
University: LLEIDA [www.udl.es].
Place of defense: Facultad de Medicina. Universidad de LLeida.
Place of preparation: Facultad de Medicina. Universidad de Lleida.

Summary: The objectives of this study were: 1) to assess the nutritional status by MNA scale of users who go to health centers and social-in the city of Lleida. 2) Establish the factors that may be associated with risk of malnutrition in those users. 3) To assess the clinical utility of the scale MNA as a tool for screening nutritional centers studied. With this goal, a prevalence study on a representative sample of the population aged 65 years and over from different levels of care, socio centers, hospital acute, assisted residence and primary care center. Altogether were evaluated 398 people of which 46.2% were male and 53.8% female, with an average age of 77 years. 1) According to the MNA categories, we see that 22.6% of individuals were malnourished, 35.4% at risk of malnutrition and 42% were well nourished. The highest prevalence of malnutrition at the centers fell socio (middle and long stay) and in the service of Medicine hospital acute, followed by the residence and assisted service surgery hospital acute. No individuals were found malnourished at the heart of primary care, although it occurred at risk of malnutrition. All this confirms that with increasing the level of care, nutritional status deteriorates. Likewise we see that as the advancing age, older people have a higher risk of malnutrition or be malnourished. 2) After entering into logistic regression all factors were associated with poor nutritional status note that weight loss, the couple live without, functional disability, cognitive impairment, found only subjectively, lung pathology, background heart disease and the presence of vomiting, were the only independent factors associated with risk of malnutrition or malnutrition established. 3) It confirms the significant clinical utility of the scale MNA in its full version for the nutritional assessment of our elderly population. It also confirms the usefulness of the short version, but are needed in this direction more studies investigavión reinforce this hypothesis. The MNA is a handy tool, fast, simple and non-invasive it can be easily administered by any health professional, and that can help you understand and compare different groups from the perspective nutritional care. L

Author: SOLER I CANET MARÍA DEL CARME.
Year: 2006.
University: CARDENAL HERRERA CEU [www.uch.ceu.es].
Place of defense: FACULTAD DE CIENCIAS EXPERIMENTALES Y DE LA SALUD.
Place of preparation: UNIVERSIDAD CARDENAL HERRERA CEU VALENCIA.

Summary: The first stage of repair condral are crucial to influence the upcoming feature tissue repair. Today, despite that have been implemented multitude of therapies aimed at treating this disease, have not yet been fully achieved satisfactory results. The objective of this study was to assess the initial response in repairing tissue condral after application Plasma Rico Platelets comparing with other treatments widely studied (Chondroitin sulfate and hyaluronic acid) and repair natural (placebo). It used 96 rabbits immature divided into 6 groups according to the treatment (Placebo, Plasma rixco in Platelets, Condroitin sulfate, hyaluronic acid, platelet-rich plasma + Chondroitin sulfate, in platelet rich plasma + Acid hiañurónico) divided into two subgroups according to the survival time. The elevation of tissue was performed from a histological assessment by macroscopic, and histological inmunohistoquímica. The results showed a positive effect after application of PRP and only associated with AH in the quality of tissue repair. These results indicate an increase in migration and the presence of mesenchymal cells indifference after the application of PRP in the early stages of the repair condral, so you can guess that his upcoming feature might resemble more healthy articular cartilage.

Author: SERRA AGUADO CLAUDIO IVAN.
Year: 2006.
University: CARDENAL HERRERA CEU [www.uch.ceu.es].
Place of defense: FACULTAD DE CIENCIAS EXPERIMENTALES Y DE LA SALUD.
Place of preparation: UNIVERSIDAD CARDENAL HERRERA CEU.

Summary: The regeneration of articular cartilage represents today a challenge to the scientific community. Multiple therapies have pursued this end without results entirely satisfactory. The objective of this study was to evaluate the application of autologous platelet rich plasma activated, acts on the repair of this tissue valuing their characteristics from a biomechanical and histological. For this study used 36 rabbits were divided into three groups depending on the treatment (control, Placebo and Blood Platelets Rico), divided into two subgroups according to the survival time. Histologically, a study of the macroscopic and microscopic samples that were valued variables as cellularity, staining of the matrix filling the defect, .. and biomecanicamente were obtained direct measurements of instantaneous load and balance from tests identación and measures indirect through a mathematical model: Coefficients Poisson, Module Youngy Module A Shear. The results showed a tendency evolutionary behavior of mechanical and histological similar between the control group and the group Blood Platelets in Pico, and opposed to these two Placebo Group, which was a significant trend degenerative articular cartilage of this group. We therefore concluded that treatment with plasma rich in platelets utólogo was a treatment that results in tissue repair similar to immature healthy cartilage in evolutionary terms.

Author: MARTÍNEZ HERVÁS SERGIO.
Year: 2006.
University: VALENCIA [www.uv.es].
Place of defense: FACULTAD DE MEDICINA DE VALENCIA.
Place of preparation: FACULTAD DE MEDICINA DE VALENCIA.

Summary: The HFC is a very common disease, with an estimated prevalence of 1-3% in the general population and up to 20% in patients with ischemic heart disease early. Your metabolic and genetic basis has not yet been identified, the most likely being the interplay of different genes and the environment. It was characterized by several phenotypes lipoproteicos in the same family, and even within the same individual, throughout its evolution, generally by changes in exogenous factors. The diagnosis is based on the household survey and phenotypic expression variable with the elevated plasma apo B. The pathogenic mechanisms involved in the very heterogénos and HFCs are not entirely known. Considered fundametnalmente: hiperproducción hepatic VLDL, defects in the activity of lipoprotein lipase, alterations in the esterificción of lso fatty acids in adipose tissue and the presence of insulin resistance (IR). However, the organic damage and the initiation and development of cardiovascular disease is heterogeneous in this patient group, indicating that necessarily must exisitr other risk factors, admeás of dyslipidaemia, justifying this variability. Ste Jan sense, two factors are emerging little studied and the level of oxidative stress (OS) and inflammation. The HFC is a genetic model of mixed hyperlipidemia RI, alteration of the postprandial lipemia and early atherosclerosis. In this regard, the working assumption is: "HFCs should exist in oxidative stress and activation of fctores inflammatory implicated in the initiation and development of the EA that will be related to the degree of IR and its clinical determinants." To assess these scenarios, were planted two key objectives: 1 .- Knowing the level of EO factors and inflammation associated with the EA in subjects with HFCs and controls. 2 .- To analyze the relationship between anthropometric parameters and degree of RI with the EO and inflammation in subjects with HFCs and controls. We studied 42 subjects with HFCs in primary prevention, non-diabetic, non-smoking, non-hypertensive and untreated (Because all these situations are able to Generate EO and inflammation) selected consecutively, and 24 controls. They all determianron parameters clinical sy anthropometric (pressure, age, weight, height and BMI), biochemical parameters (lipid profile and hidrocabonado) parameters of oxidative stress (8-oxo-dG, MDA, GSSG and GSSG / GSH, as oxidation systemic markers; SOD, catalase and GPX, as antioxidant systems and GSH, as a marker reduction) and parameters of inflammation (NF-kbeta, adiponectina, IL-1, IL-6 and PCRas). After analyzing the results we note that: * The HFC is a genetic model of mixed dyslipidaemia RI. * In subjects with HFC there elevation of the products of oxidation and decrease in antioxidant systems. * In subjects with HFC there elevation of the systemic inflammation. * NF-kbeta, as a key factor in regulating the processes of oxidation and inflammation, is high in subjects with HFC. * The anthropometric variables (type and degree of obesity) have no significant effect on the oxidation and inflammation in subjects with HFCs, nor in the larger group. * IR was independently associated with parameters of oxidation and inflammation in subjects with HFC. * The inflammation is the main predictor regardless dela RI HFCs and not subject to the type and degree of obesity and dyslipidaemia.

Author: MATAIX BORONAT JORGE.
Year: 2006.
University: VALENCIA [www.uv.es].
Place of defense: FACULTAD DE MEDICINA Y ODONTOLOGIA.
Place of preparation: FACULTAD DE MEDICINA Y ODONTOGIA.

Summary: The Macular Degeneration associated with the Age (AMD) is a degenerative disease and dystrophic that affects the macula is all its thickness. It is the leading cause of legal blindness in older than 55 years in Western countries. The form of AMD is the more aggressive wet form, in which there is a proliferation of neovasos coroides across different layers of the macula affecting all its structures, causing a loss of central vision, irreversible in many cases without treatment. The first treatment demonstrated a reduction in the risk of loss of vision moderate to severe in these patients was Therapy Fotodinámica (PDT) with verteporfin. The main objective of this thesis is to analyze the evolution of the vision in patients suffering from choroidal neovascularization (CNV) secondary to AMD, treated with therapy Fotodinámica. Likewise analyze the effectiveness of PDT and identify factors significantly more influential in the final visual prognosis of patients suffering from AMD with CNV treated with PDT. We analyzed the evolution of the vision in 273 patients with CNV secondary to AMD treated with PDT, for a minimum period of 24 months and a maximum of 48, making revisions every 3 months. To analyze the effectiveness of treatment analyzed 33 patients with CNV secondary to AMD submit in the contralateral eye a scar disciforme she had not received any treatment. The scar disciforme is how evolved NVC. To identify factors that are most influential in the visual prognosis end, we conducted a multivariate logistic regression analysis, which includes various independent factors: type, location, size of the initial CNV, age, sex and vision initial patient. In the aggregation, patients with exudative AMD treated with therapy Fotodinámica tend to lose vision despite treatment. The loss of vision is particularly important to 3 months of initiating treatment, and subsequent developments more attenuated, stabilizing from 2 years. Nevertheless, we got more than 70% of the patients have a loss of less than 3 lines to 4 years. The size of the neovascular membrane increases significantly in the first three months after therapy Fotodinámica coinciding with a sharp decline of vision. This growth is continuing but more attenuated up to 24 months, from which stabilized and even decreased slightly until the end of the track. In our environment dominated by classic component of the MNV which this is the best response to treatment with Therapy Fotodinámica. Patients with membrane neovascular yuxtafoveal have better visual acuity that subfoveal both the initiation of therapy and at the end of follow-up. But its evolution in terms of lines of vision loss is much worse in the former than in the latter. The age of patients with exudative AMD influence on the evolution of the vision behind Therapy Fotodinámica. In older, the losses visuals are more important. Sex does not change the patient's visual response after treatment. The initial size of neovascular membrane affects in a significant way in the visual prognosis of the patient. The smaller its diameter is less lines of vision and lose the higher end their vision. Patients with exudative AMD parts with better visual acuity, lose more lines of vision, but it is the largest AV reach the final. The PDT is an effective treatment in the exudative AMD, because in the eyes treated to achieve a better visual acuity and a smaller end of the lesion than in the untreated. The most influential factors for a good prognosis visual 8 final in 396 eyes with choroidal neovascularization secondary to AMD treated with PDT, in order of importance are: a.

Author: PÉREZ ENGUIX DANIEL BERNARDO.
Year: 2006.
University: VALENCIA [www.uv.es].
Place of defense: FACULTAD DE MEDICINA Y ODONTOLOGÍA.
Place of preparation: FACULTAD DE MEDICINA.

Summary: OBJECTIVES: To establish the role of the studies of Computed Tomography (CT) in evaluating pre-lung transplantation. MATERIALS AND METHODS: We conducted a prospective study has, for two years, from a sample of 71 patients are candidates for lung transplantation. It collected data from: studies of CT / TCAR, cardiological assessment (catheterization and echocardiography), considered to be at risk surgical patients (background on pre-invasive thoracic cavity); result histological studies (AP) Parts of explant of patients eventually transplanted (54 Comparisons are established between quantitative and qualitative variables of the most common diseases of the series, between the various signs of CT / TCAR; between TCAR signs of pulmonary arterial hypertension (PAH) and variable cardiológicas; background on pre-invasive cavity torácia and incidences peroperatorias ; predictive ability of a group of determined signs of TCAR with the findings AP; excluded from the transplant patients by radiographic findings. RESULTS: TCAR signs of patients in the series have been consistent with those described in the literature for each disease, the combination of signs of TCAR of PAHs have submitted a high specificity (92%) in patients with PAH associated with the series; there was no relationship between background and invasive incidences peroperatorias; demonstrated positive correlations between the signs of TCAR and data macroscopic AP, with a capacity of the personal judgment of predictive tests TCAR above the predictive ability of the prevalence of finding PA and there was exclusion from the transplant malignancy detection and affectation pleuro-parenquimatosa extensive. CONCLUSIONS: It reaffirms the role of the studies of CT / TCAR made in the previous evaluation lung transplantation. The new equipment will allow multidetector CT in a single examination almost global assessment of such patients with valuations cardiológicas precise and even calculating parenchymal perfusion.

Author: FORT ROS JUAN.
Year: 2006.
University: AUTÓNOMA DE BARCELONA [www.uab.es].
Place of defense: HOSPITAL VALL D'HEBRON BARCELONA.
Place of preparation: HOSPITAL UNIVERSITARIO VALL D'HEBRON.

Summary: The renal artery embolism (EAR) is a pathology not negligible loss of renal function in patients monorrenos functional mainly suffering from heart embolígena or atrial fibrillation. Its incidence is the highest reported since the diagnosis often go unnoticed or confused with renal colic. Determining Lacto dehydrogenase (LDH) has proven useful in the diagnosis. The therapeutic options remain a matter of dispute. Following approval after one year in an emergency diagnostic and therapeutic algorithm by determining LDH, has been taken on a prospective basis for twelve years, the incidence of RAS in a tertiary university hospital. The study concludes that the use of a diagnostic algorithm using LDH is useful in the diagnosis of patients with RAS. With regard to treatment, in patients with RAS principal in patients monorrenos without contraindication for surgery, it gets the best results within the shortest time. The EAR intrarrenal indication of fibrinolysis local or anticoagulation should be deterrminada taking into account the extent and severity of embolism of renal failure, however embolism in patients monorrenos or bilaterally, the local fibrinolysis is the treatment of choice. In patients with contraindiccaión both for surgery and for fibrinoliticos is advised anticoagulation with heparin to prevent future episodes embólicos.