MEDICAL SCIENCE (7)

Author: QUEIPO ZARAGOZÁ ALFONSO.
Year: 2005.
University: VALENCIA [www.uv.es].
Place of defense: FACULTAT DE MEDICINA I ODONTOLOGIA DE VALÈNCIA.
Place of preparation: FACULTAT DE MEDICINA I ODONTOLOGIA.

Summary: INTRODUCTION: changes in sex hormones that occur in the male aging is associated with the clinical syndrome ADAM with sphincter psychological symptoms, somatovegetativos and sexual. We asked whether this clinic may be related to these hormonal changes OBJECTIVES: To assess changes in sex hormones in men older than 50 years, establishing baselines for total testosterone, free and bioavailable representative of male hypogonadism in the wholesale and analyze the relationship between hormonal changes with respect to the clinical syndrome is associated ADAM together with the effect on the different dimensions of quality of life. MATERIALS AND METHODS: We analyzed sociodemographic variables, clinics, test ADAM, sexual health, quality of life MOS SF-36, anthropometric parameters, parameters of bone resorption and bone densitometry. As analytical parameters determine the lipid profile, including cholesterol, LDL-c, HDL-cy triglycerides. The profile included the determination of hormone testosterone and its bioactive forms determined by the mathematical method, besides the DHEA-s, androstendiona, estradiol, SHBG, LH, FSH and prolactin. CONCLUSIONS: aging is accompanied by a gradual hypogonadotrophic with a decline in total testosterone and greater, as well as free of DHEA-s. We found no changes in relation to the androsténdiona and estradiol. This hypogonadism seems to have a primary origin to be increased gonadotropins. The free testosterone is linked, regardless of age, with a clinical diagnosis of andropausia conducted by the test ADAM. The lower limit of normal for testosterone was 2.5 ng / mL for the free 0228 nmol / L for bioavailable of 5.13 nmol / L. The most important risk factor for erectile dysfunction and lowered libido is the age, but the decline in free testosterone can influence the increase in erectile dysfunction. The decline in DHEA-s correlated both with the increase in erectile dysfunction with lowered libido. The low levels of androgens no relation to the decrease of bone density or the lipid profile. The progressive decrease of free testosterone levels can influence the bodily changes associated with envejecimiento.El deficit of free testosterone and DHEA-s may cause a deterioration in the quality of life both in terms of physical, psychological and social consequences.

Author: RAUSELL FONTESTAD NURIA.
Year: 2005.
University: VALENCIA [www.uv.es].
Place of defense: FACULTAD DE MEDICINA Y ODONTOLOGIA.
Place of preparation: FACULTAD DE MEDICINA Y ODONTOLOGÍA.

Summary: Today is considered by human papillomavirus infection (PVH), the sexually transmitted disease more common. Its significance lies not only in its frequency, but also on their ability oncogénica because it has shown HPV DNA by more than 99% of invasive carcinomas of the cervix. The risk of HPV infection in women, not only depends on their sexual behavior, but also sexual behavior of their male sexual partners, in various studies support the role of man as a vector of the virus. DNA has been identified in the PVH throughout the lower male genitourinary tract in humans and mammals, except in the testicles. HIPÓTESIS.El PVH as in other locations can be detected in the testis. OBJECTIVES. Detection and genotipado of HPV DNA in testicular biopsies of patients with male infertility rate azoospermia no-obstructiva. Determine the location intratesticular of HPV DNA in individual cells of the testis. To determine a possible causal relationship of PVH with azoospermia no-obstructivas. MATERIALS AND METHODS We reviewed the medical records of 252 patients with azoospermia no-obstructivas from an infertility clinic from January 1995 to December 2000. Of these, identified HPV DNA using PCR molecular method (reaction polymerase chain), 289 biopsies testicular for 192 patients. HPV DNA was detected in 12 biopasias testis, which was conducted separately by PCR to detect HPV DNA in different areas of the testis. RESULTS HPV DNA was detected in the testicular parenchyma of 12 biopasias that corresponded to 12 patients, corresponding to 6.25% of the patients studied. The type of HPV DNA was detected more frequently type 16. In 5 cases. The DNA was detected in the testicular parenchyma, in a location extratubular in cells Leyding as intratubular in cells Sertolí. Unable to dismiss or affirm their presence in the germ cells. There is detected HPV DNA in both testes of patients undergoing bilateral biopsies.

Author: Parejo Montell Martín.
Year: 2005.
University: VALENCIA [www.uv.es].
Place of defense: Facultad de Medicina de valencia.
Place of preparation: Facultad de Medicina de Valencia.

Summary: Work hypothesis: the implementation of a maneuver intervention at the level of public opinion will have an impact on better recognition of the symptoms characteristic of acute coronary disease and an early implementation of specific treatment for each case. MAIN OBJECTIVES compare the precocity in the specific treatment of Acute Syndrome Crown in lapoblación on which conducts intervention on which it does not receive. SIDE 1 .- The identification of symptoms by the population, as measured by the delay between the onset of symptoms and seeking medical care. 2 .- The precodidad and place of administration of aspirin therapy useful as a first step. 3 .- The delay between the request for assistance assistance and arrival at hospital (restraso extrahospitalario). 4 .- The delays have occurred since the arrival to the hospital until the pattern of fibrinolytic therapy (delay hospital). 5 .- The use of the various means of medical care in extrahospitalaria Coronario Acute Syndrome. MATERIALS AND METHODS Design quasi-experimental type pre-test to post-test control group not equivalent. * Population target that receives assistance: Population older than 30 years of area health 03. * A town that does not receive the intervention: Population adult ayor of 30 years of area health 11. Study Group: Patients older than 30 years with acute myocardial infarction served inthe UMI Hospital de Sagunto. Control group: Patients older than 30 years with acute myocardial infarction served inthe UMI Hospital Gandia. * Community Involvement addressed to the entire adult population, so much a person as your personal environment to be able to recognize the symptoms and seek health care delamanera more effective. She will be actions on two levels: Community Education: press, radio, television, talks in civic centers, large enterprises, recreational entities .. * Individual Education: Council individual patients with a history of ischemic heart disease or with risk factors. Messages: recognition of symptoms and type of response to the emergence of these. MAIN FINDINGS The statement made at the community level with the coordination of sanitary facilities in elára study, reduced the retaso in the administration of fibrinolytic therapy, being significantly reduced after arriving at the hospital. In the control group did not take place this decline. SIDE 1 .- In the study group intervention reduced the time from the onset of symptoms until the application for healthcare. This reduction is significant in patients who went through themselves. 2 .- In the study group intervention increased the proportion of patients with treatment prehospitalario ASA, but not significantly. The main component of that increase was due to self-medication. 3 .- In the study group significantly increases the delay from the first contact prehospitalario until the arrival of the patient to the hospital. 4 .- The delay since the arrival of the patient at the hospital until the administration of fibrinolytic decreased significantly in the study group. 5 .- The intervention group in the study has prompted a significant increase in the use of the system prehospitalario by patients. The first contact was established with preference at the health center, which significantly increases their use. This occurs regardless of age, gender or background of ischemic heart disease patients.

Author: Gómez Bustos Ma. Isabel.
Year: 2005.
University: VALENCIA [www.uv.es].
Place of defense: Facultad de Medicina Y Odontología.
Place of preparation: Facultad de Medicina.

Summary: The working thesis studies presented by the expression of Fos, the influence that the pain and administering analgesics, considered both as incentives not fóticos they exert on structures involved in the control of circadian rhythms, and that usually respond to the stimulus lighting. Among the structures studied included the core supraquiasmático and area retroquiasmática both hypothalamic location; lamina intergeniculada the thalamus and the gray periacueductal (CPA) as substrate anátomico the path of pain. The fact that the foil intergeniculada showing a marking intense significantly different from the rest of structures circadianas but in correspondence with the marking submitting the sidebar of the CPA points to the need for further study of connections and neurotransmission to clarify the mechanism of participation the structures identified showing marked inmunorreactividad to FOS

Author: Priego Álvarez Heberto.
Year: 2005.
University: AUTÓNOMA DE BARCELONA [www.uab.es].
Place of defense: Fac. Medicina. Hospital Valle de Hebrón.
Place of preparation: Facultat de Medicina.

Summary: The consumer health. Also known as consumer healthcare involves a whole process of acquisition and use of goods and services in health care in order to obtain satisfaction or direct in terms of improved standard of living. In this thesis, marketing dimension sicel external analyzes consumer behavior primary (sick or user of health services), pretending to clarify its attitude towards consumption (use of health services) in two variants antagonistic: consumerism versus consumerista. Therefore, the work is divided into two main sections, a first character terocio conceptually built through the first three chapters, and a second of empirical research, which provides analysis methodologies attitudes towards consumption carried out Mexican state of Tabasco

Author: UTGÉS NOGUÉS MAITE.
Year: 2005.
University: AUTÓNOMA DE BARCELONA [www.uab.es].
Place of defense: HOSPITAL VALL D'HEBRON DE BARCELONA.
Place of preparation: HOSPITAL VALL D'HEBRÓN DE BARCELONA.

Summary: In recent years it has substantially increased the concern about the diagnosis and treatment of patients suffering from drug abuse, trastomos of personality and seroconversion to HIV (human immunodeficiency virus). There has been a cross-sectional study, 349 patients included in a program with Methadone Maintenance. These patients met the criteria for the Unit Opiaceos and may have consumption of other substances, according to DSM IV criteria. And they may also have a second diagnosis than their consumption, as psychiatric pathology associated. It has been used as a tool for the classification and diagnosis of personality disorders eIIPDE. All patients were moved to the questionnaire IPDE. In the questionnaire, patients speak answered three or more items of a disorder, the evolution in this disorder was positive and was interviewed with questions from the same IPDE, but on an exclusive basis for this disorder and confirm their diagnosis. In all patients, are proposed to test HIV. Accedieron to its realization 319 patients. For its anáisis was used SPSS statistical program. It has completed an analysis univariente starting to detect the possible presence of anomalous values and to describe the distribution of each variable according to the group. Subsequently bivariate analysis has been developed to determine the presence or absence of relationship between the dependent variables (comorbidity and determination HIV). OPor finally have developed models bivariate and multivariate logistic regression to identify as dependent variables comorbidity and the determination of HIV separately . The results were in when the comorbidity, more than half of patients have some sort of patologla psychiatric addition to having a diagnosis of addiction to substances, the group of trastomos of personality is the most important accounting for 41.8% of total within this group of antisocial personality disorder is the most common affecting an 29.5% of them and finally the 50% of HIV-negative patients presented psychiatric comorbidity with respect to those who were not, whereas in the case of HIV positive this proportion is estadlsticamente higher 63.6%. Regarding HIV positivity, patients affected by trastomo of antisocial personality presented a risk 2.3 times higher than having VlH positive patients without comorbidity associated, regardless of the route of administration of the substance. In conclusion we note that the antisocial personality is a risk factor for infection VlH among drug addicts (both vla parenteral or not), and since the beginning of trastomo mentally before seroconversion, it would important for the implementation of programs the diagnosis of tratomos of personality at an early age, also in treatment centers should be encouraged to Clinical the need for routine assessment of symptoms pSiquiátricos of these patients and the importance of an adequate psychiatric counseling and .

Author: Roura Olmeda Pilar.
Year: 2005.
University: AUTÓNOMA DE BARCELONA [www.uab.es].
Place of defense: Escola de Postgrau.
Place of preparation: Centro de Atenció Primaria Badia del Vallés.

Summary: Introduction type 2 diabetes is a chronic disease of high prevalence, primary care for their accessibility features, fairness, integrity and continuity of care is appropriate level for follow-up. Attention to diabetic whose prevalence is increasing. Attention to diabetic type 2 requires the implementation of measures and procedures that can cope better with a program to improve quality. Studies on continuous quality improvement in diabetic note that the attention of the Public Notary with structured activities improve the clinical process indicators and add patient-oriented interventions in conjunction with the ongoing evaluation with feedback has been shown effective in improving outcomes. The non-urban areas (semi-urban, rural and mountain) display features socio (lower accessibility to health centers, dispersion, increased aging of the poblaciónâ |) which may justify differences in the attention given to diabetics. Objectives The objectives of this study: 1 .- To evaluate the quality of care provided to patients with type 2 diabetes treated in the core areas of health (ABS) in urban areas and urban i not describe the changes to the 10 years of program for Continuous Improvement of Quality GedapS. 2 .- To analyze the evolution of the degree of monitoring indicators through the five avaluaciones (1993-1995-1998-2000-2002). 3 .- Describe the degree of monitoring a variable joint process on the 2 areas of the ABS which allows a comprehensive view of the changes in the urban and non-urban. 4 .- analyze changes in cardiovascular risk factors in both areas with a variable together. 5 .- Describing the interventions made during this period in the two areas .. 6 .- To determine the reasons to explain intense least an improvement in some indicators process (fund eye examination of the feet, albuminuria annual determination, determination 2 times a year in hemoglobin glicada, 3 educational content differently annually) the two fields through a Delphi study. Assumptions: The quality of care for type 2 diabetics is different in the urban areas ABS respect to ABS-urban area. The quality of care is better for the 10 years of implementing the program to improve the quality (MCC) GedapS. Design Method: The present study used 2 methodologies have on the one hand a descriptive study prospective multicentrico from 1993 to 2002 with 5cortes tranversales with a frequency of every 2 years to determine the causes of the improvement intesa least some indicators has been used delphi methodology. Scope core areas of health (ABS) of Catalonia, study subjects: diabetics treated at the ABS. Measuring instruments for assessing the quality of care compliance indicators of process and outcome; interventions the number of training activities and feedback of results and to determine the causes of the lack of progression indicators delphi study. Variables: date of birth, sex, characteristics own diabetes (year of diagnosis and treatment) the number of nursing visits, number of views of doctors, the number of educational visits, glicada hemoglobin values, values of total cholesterol, cholesterol values HDL, blood pressure figures sistólica and diabolical, weight, height, values albuminúria, tabáquico habit, presence of stroke, presence of ischemic cardiopatía, revenue decompensation of diabetes, presence of blindness in one or both eyes, screening albuminuria, the dondo eye examination, examination of the feet. Number of training, type, year, evaluation and number of dosiers of assessment results distributed. Results The particicipación the ABS has been in 57 (44% non-urban) at baseline by the year 1993, 75 (44% non-urban) in the 8 years 199 a2e 6; 75 (44% non-urban) in the year 1998; 78 (47% non-urban) in the year 2000 and 96 (43% non-urban) in the year 2002. The sample of diabetics has been 20371: 2239 (33% urban) in 1993, 3532 (44% non-urban) in 1995, 4217 (45% non-urban) in 1998, 4564 (42% non-urban) in 2000 and 5819 (41% non-urban) in 2002. At baseline, the percentage of diabetic of ABS urban versus non-urban areas receiving less than three visiting nurses was 19.5% vs. 12.1% (7.4, 95% confidence interval 4.1 / 10.7 ), less than three years educational interventions was 71.8% vs. the 80.2% (-8.4, 95% CI -12/-4, 7) determining annual glicada hemoglobin was 58.9% vs. 37, 1% in the non-urban (21.8, 95% confidence interval 17.6 / 26.1), the two determinations glicada hemoglobin was 33.5% and 22.3% (11.2, CI 95%: 6.6 / 15.9), with values of total cholesterol above 259 mg / dl was 29.2% vs. 22.5% (6.7, 95% confidence interval 2.4 / 11). At the end of the study to 10 years of follow-up notes that: ABS urban areas the percentage of diabetics who presents: less than three educational interventions drops 6.1 percentage points (71.8% to 65.7% CI : 95%: 3.4 / 8.9), less than three nursing visits increased 18.8 percentage points (19.5 to 38.3%, 95% confidence interval 16.1 / 21.5), identifying total cholesterol increased 10.9 percentage points (74.8% to 85.7%, 95% confidence interval 8.4 / 13.4), the determination of hemoglobin glicada increased 25.2 percentage points (58.9% to 84 , 1%, 95% confidence interval 22.3 / 27.9), the two determinations hemoglobin glicada increased 10.3 percentage points (33.5% to 45.6%, 95% confidence interval 6.9 / 13, 7), determination albuminuria increased 26.2 percentage points (31.9% to 58.1%, 95% confidence interval 23.3 / 29.1), examination of the feet increased 3.5 percentage points (49.4% at 52.9% CI 0.4 / 6.5), pressió arterial <140/90mmHgincrementa 12.8 percentage points (46.1% to 58.9%: 95% CI 9.8 / 15.8 ), colesteroltotal> 250 mg / dl descends -15.6 percentage points (29.2% to 13.5%:

Author: BAHILLO CURIESES MARÍA DEL PILAR.
Year: 2005.
University: VALLADOLID [www.uva.es].
Place of defense: FACULTAD DE MEDICINA. UNIVERSIDAD DE VALLADOLID.
Place of preparation: UNIVERSIDAD DE VALLADOLID.

Summary: Introduction: The epidemiology of diabetes type 1 is target of numerous studies, knowing at the moment that their impact is highly variable and has large swings, with the largest numbers in some Northern European countries (Finland) and in some isolated region as Sardinia and children in other countries such as China and Venezuela. However there are few studies that provide figures prevailed. The aim of our study is to investigate the incidence of type 1 diabetes child in Castile and Leon over the period 2003-2004, and the predominance of the same at the beginning and end of the study. Materials and methods: To study the incidence collected all newly diagnosed type 1 diabetes in children under 15 years occurred in Castilla y Leon in the years 2003 and 2004. The data were collected through various sources (primary and secondary) use the capture-recapture method to determine completeness. The incidence obtained was adjusted according to the world's population, obteniéridose incidence standardized, which allows comparing the values obtained with the study. For the prevalence study were collected every type 1 diabetic children under 15 years existing in Castilla y Leon at the start of the study (1-1-2003) and at the end of it (31-12-2004). Was utilizarón data population census in the year 2001. Results: 1 .- impact. The cumulative incidence of type 1 diabetes in children under 15 years in Castilla y Leon dutante the period 2003-2004 was 22.2 / 100,000 / yr (95% CI 14.57-29.81) with adjusted incidence of 22.01 / 100,000 / yr (95% CI 18,18-25, 83). The highest incidences were observed in Segovia 38.47 / 100,000 / yr (95% CI 0-46,09) with adjusted incidence 38.77 / 100,000 / yr (95% CI 19,0-58,54) AND Valladolid 32, 09/100.000 / yr (95% CI 21.93-42.22) cOn adjusted incidence 32.07 / 100,000 / yr (95% CI 21.93-42.22) and the lowest in Zamora 9.11 / 100,000 / year (95% CI 0-16,73) with adjusted incidence 8.14 / 100,000 / yr (95% CI 0.07-16.21). The age group in which there was greater impact was that of 5-9 years. Despite that has been classically described the type 1 diabetes presents seasonality in its appearance, with the largest number of cases in n1 ~ cold, in our study did not appear to be a clear seasonality. 2 .- prevalence. At the beginning of the study (1-1-2003) existed in Castile and Leon 297 children suffering from type 1 diabetes by age 15 years, prevailed in 1.01 / 1,000. The highest prevalence was observed in the age group 10-14 years (1.56 / 1,000) and the lowest in the group of 0-4 years (0.32 / 1,000). The province with the highest prevalence was Zamora (1.55 / 1,000) and the provinces with the lowest prevalence were Surgos (0.75 / 1,000) and Soria (0.83 / 1,000). In all provinces with the exception of Avila, the age group most prevalent was that of 10-14 years. At the end of the study period (31-12-2004) existed in Castile and Leon 348 type 1 diabetic patients aged below 15 years, with a prevalence of 1.18 / 1,000. The highest prevalence continues to be observed in the group of 10-14 years (1.81 / 1,000) and the lowest in the 0-4 years old (0.32 / 1,000). The provinces with the highest prevalence were Segovia (1.54 / 1,000), Valladolid (1.41 / 1,000) and Avila (1.38 / 1,000) and the provinces with the lowest prevalence were Surgos (0.91 / 1.0QO) and Soria (0.93 / 1,000). The highest prevalence continues to be observed in the age group 10-14 years. Conclusions. Castile and Leon has an incidence of diabetes tipo1 infant higher than those offered by most of the studies published in Spain until now. Also, this incidence was significantly lower than that published in some Northern European countries, but much higher than in the Mediterranean countries. The prevalence figures are similar to those issued by some studies Spanish recently.

Author: OLIVER GOMIS JESUS ANGEL.
Year: 2005.
University: MURCIA [www.um.es].
Place of defense: FACULTAD DE MEDICINA.
Place of preparation: MURCIA.

Summary: Since the antigà ¼ age there is concern the assessment of physical injury as well as repair. Comprise the first data for 4000 years aJc in 2050 aJC: Sumerian tables, through the Law of Moses from 1250 to 600 aJC passing by all different cultures Greek, Roman, barbaric, Arabs until Jurisdiction of Castile old in the year 1250 which created the first schedule of compensation based on the Spanish court judge. Due to the existing legal vacuum and the absence of adequate criteria for the systematic assessment of bodily harm in the system buccal have done: 1-Analysis criíto 'tables and sweep the current 2-Review bibliografica of endpoints estomatologica 3-Revisión the baremop of Law traffic 30/95 and its upgrade to the same 4-Elaboración a valuation methodology adapted for damage to the clinic dental 5-Proposed criteria for assessment of damage anatomofuncional 6-See the impact of each injury and valuing its impact as a function of group agents that cause them harm or injury. 1-Extermos which can be: Mechanical, physical, chemical, biological, psychological and social 2-Internal: is the effort that leads into a muscular contraction as mechanical energy is able to cause harmful agents of some importance. Requirements for the valuation of bodily harm: 1-Current must have occurred near the time of his assessment 2-Own: compensation leads to recovery of the damage and will be requested by the injured 3-Direct direct link between injury and the fact questioned and it has been made by the person complained of 4-True and accredited, the damage must be true and accredited as a whole so that they can compensate valuation of the damage is done by means of Systems and Scales 1-Systems: is the method of evaluation in self apreciacio expert without aplidar a rule 1-A systems empirical: He was the first to be used in field and legal work. Requires extensive experience disadvantages of the expert subjectivity and lack of standardization of terminology medical 1B Effect of pleasure: The empirical system applied to the injury extra 2-Baremos: It must be a tool to measure damage to persons 2 - A functional Scales: According to the physiological functions include method of Fernando Rozas and Method Mcbride 2-B Scales percentage based on the previous normal people, where's the general Scales include guides and WADA, Melennec and rates of road traffic crashes dende this Act traffic 30/95. The expert should be borne in mind: 1-establish a diagnosis current 2-valuing the causes pre 3-Determine the etiologia of that diagnosis 4-Establecer prognosis, time Cured 5-Valorar the weakening of the real aftermath 6-Produce a report The methodology of the above: 1-Anmnesis: understand aspects personal, employment and treatments received, it is necessary to analyze well the documents produced by the patient, reports, etc. 2-Examen clinical assistances the objective determination of the integrity of the apparatus estomagtognatico in his Overall, peer review of cranial providing sensitive information, 3-palpation muscle 4-Testing Radio 5 photos, models 6-Other tests Del study it is clear the inadequacy of existing tables for the current rating of bodily harm in the system mouth - The schedule of traffic 30/95 does not include the movement of laterality or protrusion in the system articular bone of the face - The movements of the laterality not covered in our system of scale, we attach a range of 1 to 10 points-No it seems to us reasonable to allocate the same punctuation to different parts dental and orthodontic the premolar in the piece is chosen for the extraction-believe that the canine group and incisive assign 1.5 points, 1 point to the molar 8 and 0.5 to 2 a9 l premolar -Debe covered by the system, an exploration of the functional chewing on all facial trauma, including a kinetic analysis of the chewing-and we believe the necessary updating and revision of the current criteria in different scales.

Author: SALCEDO ABIZANDA SALVADOR.
Year: 2005.
University: SANTIAGO DE COMPOSTELA [www.usc.es].
Place of defense: FACULTAD DE MEDICINA Y ODONTOLOGÍA.
Place of preparation: UNIVERSIDAD DE SANTIAGO. FACULTAD DE MEDICINA.

Summary: During recent years we have noticed a marked improvement in the outcome of mortality and morbidity in preterm infants throughout the developed world. She is a result of improved perinatal care, obstetric and neonatal, and primarily by the ability to induce maturation of fetal parenchyma by the administration of steroid (betamethasone) to the pregnant woman. Despite all the advances of Obstetrics, the rate of prematurity has remained unchanged, between 7 and 8%, even in the most developed countries. Two of the most frequent complications associated with premature birth are premature rupture of membranes and prolonged ovulares (RPM) and chorioamnionitis (CoAm). In both situations the course of gestation may be complicated by the appearance of inflammatory phenomena fetal level. In recent years have published several papers on the role of fetal inflammatory response in the pathogenesis of many of the complications that appear in the evolution of newborn premature and that overshadow its prognosis. The objective of our study was to analyze the morbidity of our patients early and the consequences of RPM and the CoAm at present, when the administration of antenatal steroids to the mother and adminístración postnatalde surfactant newborn are in our usual practices hospital. From the results we can draw the following main conclusions: 1. In our service Neonatal population of preterm birth weight increased 1500 gY gestational age of less than or equal to 34 weeks involves 13.3% (599 patients) of the total number of children admitted during the study period (three years and a half). 2. Of all the patients enrolled in the study, 88.3% had been ripened prenatalmente by betamethasone administration to the mother. This practice involves greater likelihood of survival in the global nature of the study population and all subgroups (RPM, CoAm not RPM or CoAm). 3. There was a history of RPM and / or CoAm in 202 patients (34% of total sample). 4. The incidence of hyaline membrane disease was 38.3% in the study population. 5. In the study population, 73.6% of patients did not develop periventricular haemorrhage and 12.5% in the developed grade III / IV classification Papille. They demonstrated periventricular leukomalacia in 89.4% of patients. 6. The background RPM involves a decrease in the risk of developing hyaline membrane disease, patent ductus arteriosus, hemorrhage and periventricular necrotizing enterocolitis. It lessens the need to indicate pressure continuous positive airway, mechanical ventilation and oxygen dependence at 36 weeks post-menstrual age. 7. The antecedent of CoAm carries an increased risk of developing hyaline membrane disease, hypotension during the first 72 hours of life, patent ductus arteriosus, periventricular hemorrhage, periventricular leukomalacia and necrotizing enterocolitis. It increases the need to identify high-frequency ventilation, use of nitric oxide, administration of one or more doses of surfactant and oxygen dependence at 36 weeks post-menstrual age. 8. In the group of patients with a history of RPM more than seven days and beginning 8 after 321 a week 27, e118% developed pulmonary hypoplasia (three ways transítoria and two the lethal).

Author: CALDUCH RODRÍGUEZ LUIS JAVIER.
Year: 2005.
University: VALENCIA [www.uv.es].
Place of defense: FACULTAD DE MEDICINA Y ODONTOLOGÍA DE LA UNIVERSIDAD DE VALENCIA.
Place of preparation: HOSPITAL CLÍNICO UNIVERSITARIO DE VALENCIA.

Summary: INTRODUCTION The hypothesis of intermittent closure of the neural tube justify the association of congenital aplasia cutis scalp (ACCCC) raquistisis at lumbo-sacro without defects of the skin suprayacente at that level, the fact that there is no precedent in the literature. OBJECTIVES 1-Study of 35 cases diagnosed at the University Teaching Hospital in Valencia between September 1993 and December 2004. 2, - Statistical analysis of partnerships between different patient characteristics. 3-Evaluate whether ACCCC is marker defects of the neural tube closure and / or other congenital defects, especially of the median line, as both underlying distance. 4-New diagnostic protocol. 5-Dermatoscopia. 6-New classification of the ACCC. CONCLUSIONS there a relationship between the presence of collarette around the ACCCC and raquisquisis or cranio-raquisquisis. This is collarette marker raquisquisis hidden distance. The shape of ACCCC associated hypertrophic more raquisquisis distance that atrophic form and membranous. The lesions larger tendency to have more family aggregation. The membranous type is the least that is inherited and atrophic the most. The presence of ACCC outside the vertex increases the risk of injury causes. The membranous usually located in vertex. The smaller lesions more often associated with underlying injuries. The group 1 of Frieden has lesions smaller. There is significant relationship between clinical type and area of the lesion (atrophic larger type). The presence of collarette is more common in cases abnormalities of the median line. The group 1 of Frieden have less chance of default underlying groups 2 and 3. The membranous not associated underlying defects. The clinical type Atrophicans is most commonly associated with the presence of other birth defects beyond the median line. The forms and membranous hypertrophic can asimilares group 1 of Frieden. It can be said without doubt that the presence of ACCCC itself is a marker of raquisquisis or what is displayed only when associated with other dfectos of the median line. There are more likely to find raquisquisis in patients with ACCCC than in the general population. Besides this raquisquisis appears remote without any alteration skin suprayacente in most patients. The protocol should include diagnostic techniques to investigate the possible presence of raquisquísis hidden distance or other hidden defects of the middle distance. The dermatoscopia may be useful in the diagnosis of ACCCC and other birth defects with the sign of collarette. The new proposed classification according to three clinical (membranous, atrophic and hypertrophic), facilitates the study of the ACCC and improvement in some aspects classification Frieden.

Author: SASTRE SOLSONA SERGI.
Year: 2005.
University: BARCELONA [www.ub.es].
Place of defense: FACULTAD DE MEDICINA.
Place of preparation: FACULTAD DE MEDICINA.

Summary: Through this work has been done a morphological study of the surface of osteocondral condyle grafts osteocartilaginosos from domestic rabbit race New Zealand. We have designed three study groups, a control group, which corresponds to the grafts in fresh and two study groups corresponding to the grafts oripreservados by half RPMI without L-Glutamine and grafts cryopreserved using KREBS-HENSELEIT changed. There have been 100 images surface of each group through an electron microscope tracking environmental and have been classified using a validated by our research group. There have been subsequent to the evaluation and comparison of these images using a statistical analysis. It has been concluded in this study that the average cryopreservation KREBS-HENSELET amended shows images of electron microscopy environmental tracking closer to fresh than its counterpart in the midst criopreservado RPMI without L-Glutamine.

Author: PLANAGUMÁ FERRER ANNA.
Year: 2005.
University: BARCELONA [www.ub.es].
Place of defense: FACULTAD DE MEDICINA.
Place of preparation: FACULTAD DE MEDICINA.

Summary: Currently inhibition of the cyclooxygenase (COX) is a therapeutic target of great interest in a large number of diseases, especially those which have a component infamatorio. That is why this thesis focuses on the effects of different compounds antiinflamatoriois in preventing the development and progression of liver damage. The objectives of this thesis is summarized as follows: 1-To assess the effects of an anti-inflammatory drug (NSAID) not esteroidal non-selective, aspirin (ASA) in the synthesis of eicosanoides and proinflamatorios and anti-inflammatory products in liver cells in culture and study of possible courses of action of NSAIDs in this context liver. 2-To study the role of a selective inhibitor of COX-2, the SC - 236, an experimental model of liver fibrosis and liver cells characterize involved and the mechanism by which it came to the resolution of this pathology. The results obtained in this thesis are of major importance because the main anti-inflammatory strategies are based on the inhibition of COX. In the first study provides new molecular mechanisms highlighting the answer pleiotrópica to the ASA showing that NSAIDs promotes the formation of endogenous anti-inflammatory compounds (15-epi-LXs) and modulaba activity of the 5-lipooxigenasa (LO) and the Receiver activated proliferators peroxisomales (PPAR) alpha and levels ZINC-1 cells sinusoidal rat. As products of arachidonic acid in conjunction with its regulators transcripcionales, PPARalfa, and together with its target genes, such as ZINC-1, play a central role in controlling inflammation, our results provide an important contribution to understanding the mechanisms of action of one of the most widely used NSAIDs: ASA. Unfortunately, the administration of NSAIDs in cirrhotic patients is typically associated with acute renal failure. And that COX-2 is sobreexpresada in patients with chronic hepatitis and liver cirrhosis, the new anti-inflammatory compounds that have been developed for clinical use them selectively inhibit the activity of COX-2 in vitro are effective, like conventional NSAIDs, in a large number of in vivo models of inflammatory but are less effects sencundarios kidney and gastrointestinal. The results of the second study showed the potential antifibrogénico of selective inhibitor of COX-2, SC - 236, and also provide new evidence in the cellular mechanisms emphasizing the impact hepato-protectores SC - 236, which includes the inhibition of hepatic activity the MMP-2 and 9 and levels of alfa-SMA, as well as the stimulation of PPARgama and induction of apoptosis in HSCs. The SC - 236 also causes apoptosis in KCs, resulting in a decrease in the secretion of pro-inflammatory mediators. These mechanisms are probably middle, in part, by the ability of SC - 236 to unite and activate PPARgama.

Author: MORENO-ARIAS GERARDO ANTONIO.
Year: 2005.
University: BARCELONA [www.ub.es].
Place of defense: FACULTAD DE MEDICINA.
Place of preparation: FACULTAD DE MEDICINA.

Summary: It has confirmed the effect telogenizante of intense pulsed light in the follicular cycle from the first treatment session, as well as the added effect of the additional sessions of treatment, a significant correlation between the number of treatment sessions and the rate depilatoria. Moreover, it has demonstrated the structural damage specific follicular unit, especially epithelial sheath, a situation that affects the stability of the results (2 years) because of a loss of communication between the system and papilla follicular germination. The significant presence of inflammatory infiltrates perifolicular, fibers of collagen in the dermis and around half of the hair follicle, fibrous pathways in the dermis, and finally elastic fibers around the hair follicle damage confirm nonspecific term and the process alopécico induced by pulsed light intense.

Author: ÁLVAREZ RAMOS BEGOÑA ARÁNZAZU.
Year: 2005.
University: VALLADOLID [www.uva.es].
Place of defense: FACULTAD DE MEDICINA VALLADOLID.
Place of preparation: FACULTAD DE MEDICINA DE VALLADOLID.

Summary: We studied adult patients with hip fracture surgically treated at the hospital in Medina del Campo (Type 1) (service cot) from January 1999 to December 2003 (294 episodes of hospitalization). This disease was chosen because of their importance in the services of trauma (high incidence, morbidity and mortality associated high consumption of resources and impact funcinalproducida in the elderly) grd system is characterized by episodes included in each group of hospitalization with the same cost to high. Patients were classified according to the AP version GPD 18.0, resulting in four groups. 210211558 and 818. We are studying these four GRDS, coding errors exist, the cost in terms of homogeneity within each GRD and finally components of the cost and homogeneity. None of the groups GRDS studied turned out to be homogeneous in terms of cost and was not due to coding errors. The main components of cost were estanci and type of implant used. Neither the cost of the stay nie l implant had homogeneous distribution in the groups studied. The weight GRD was not proportional to the cost in any of the GRDS studied. Using predictive models are estuadió variability of stay and costs and the predictive ability of GRDS respect wing stay and the cost in addition to the factors associated with the hospital stay. Knowing all variables demonstration related to the stay can only predict a quarter of the variability gracious. The predictive ability of GRDS regard to the stay and resolved very low cost. The variables that showed greater connection with the stay were medical complications prerioperatorias (nosocomial infections, surgical wound complications and ulcers cecúbito) that the complications are called by the older system GRD. It proposes a new model weights and changes in the classification system that reflects the cost of the implant and the presence or absence of major complications. It is conducting a study on mortality after hip fracture and the factors that affect it.

Author: PLANAGUMÀ i VALLS JESÚS.
Year: 2005.
University: AUTÓNOMA DE BARCELONA [www.uab.es].
Place of defense: HOSPITAL DE LA VALL D'HEBRON.
Place of preparation: HOSPITAL DE LA VALL D'HEBRON.

Summary: ANALYSIS OF THE DIFFERENTIAL GENE EXPRESSION IN CANCER ENDOMETRIO The endometrial carcinoma is a malignant tumor of the female genital tract more common in industrialized countries. Approximately 80% of the cases correspond to endometrioides adenocarcinomas, moderate to distinct, confined to the uterine body at the time of diagnosis, and usually with a favorable prognosis accompanied by an appropriate therapy. The tumors were classified as type I endometrial carcinoma endometrioide (EECs) and represent the majority in the model dualístico of tumorogénesis endometrial widely accepted. CSE tumors are low grade and estrogen dependent, usually developed in perimenopausal and postmenopausal women recently, and coexist or are preceded by complex and atypical endometrial hyperplasia. In contrast to the EECs there carcinomas type II endometrial carcinomas not endometrioides (NEECs), which account for 10-20% of endometrial carcinoma, high-grade carcinomas are normally conducted in postmenopausal women, following a path independent estrogen and originate from atrophic endometrium. Molecular studies have provided evidence for this classification scheme showing the genetic processes that could be involved in the development and progression of both types of carcinomas. The microsatellite instability and mutations of PTEN, K-ras, -catenina and gene repair of the pairings erroneous DNA have been associated with the CSE, while the aneuploidia, mutations of p53 and amplification her2 / neu have been identified in the NEEC. But the precise molecular events that occur during the development of endometrial carcinoma are still without characterize and has little knowledge of them. In this paper, has been trying to identify new genes, which can cause cell transformation in the CSE. We analyzed the differential expression profiles between endometrios of tumor and non-tumor type using cDNA array hybridization. Of all the 53 genes with altered expression in the CSE, the protooncogene acute myeloid leukemia 1, RUNX1/AML1 and the transcription factor ets variant gene 5, ETV5/ERM, genes were more highly sobre-expresados. The levels of gene expression RUNX1/AML1 yd'ETV5 / MRA, were quantified by real-time quantitative PCR (RT-Q-PCR), and the level of protein expression were marked by immunohistochemistry on tissue arrays (AMT). The RT-Q-PCR validated overexpression of RUNX1/AML1 and ETV5/ERM in the CSE and showed a strong overexpression specific and meaningful participation in those stadiums tumor associated with the invasion miometrial. In addition, the MRI showed that the overexpression of RUNX1/AML1 and ETV5/ERM correlacionaba with the process tumorogénesis, des Atrophicans of normal tissue via hyperplasia simple and complex to reach carcinoma. These results demonstrate for the first time that overexpression of RUNX1/AML1 and ETV5/ERM in CSE correlated with the initial miometrial infiltration. Similarly, overexpression of RUNX1/AML1 correlated with overexpression of ETV5/ERM. This set of results allows propose a cooperative role between RUNX1/AML1 and ETV5/ERM during the first event tumorogénesis endometrium, which may be associated to the initial process of infiltration miometrial. Finally, we have begun to analyze gene target RUNX1/AML1 and ETV5/ERM to explain the possible route of regulating overexpression of RUNX1/AML1 yd'ETV5 / MRA in the CSE. It has analyzed the expression of p21WAF1/CIP1 from RT-Q-PCR and TMA, in a broad panel of CSE samples and evaluated the extent to which RUNX1/AML1 and p21WAF1/CIP1 8 cooperate 3d5 in endometrial cancer. The high correlation found between RUNX1/AML1 and p21WAF1/CIP1 suggests a cooperative role during the initial tumor dissemination of CSE, possibly through infiltration miometrial and / or promotion of the invasive phenotypes.

Author: Pons Pujol Elisenda.
Year: 2005.
University: AUTÓNOMA DE BARCELONA [www.uab.es].
Place of defense: Facultat de Medicina.
Place of preparation: Facultat de Medicna.

Summary: Background: Colorectal cancer is one of the most common cancers in our country as well as in most Western societies. In stark contrast, the incidence of this cancer is up to 10 times smaller than in some Asian and African countries. The environmental factors play a decisive role in the development of this cancer. Nutrients, specifically fats, would be among the most important factors. Thus, a large number of case-control studies, environmental and experimental, have shown an association between high consumption of saturated fat and animal life and the development of colorectal cancer. On the other hand, unsaturated fatty acids seem to have an effect clearly different. Thus, the type of fatty acid would be even more crucial for the risk of developing colorectal cancer than the total amount of fat consumida.Aunque in Greenland, Finland and parts Mediterranean diets have a high fat content, the incidence of cancer colorectal is relatively low compared with other Western countries. A major dietary difference between the regions mentioned and the rest of the Western countries, is the high consumption of fish and fish oil (rich in the fatty acids of the resie n-3, eicosapentaenoic (EPA) and docosahexaenoic (DHA), the case of the Nordic countries and fish and olive oil (which contains mostly oleic acid, c18: 1, n-9), in the Mediterranean basin. Objectives: This thesis is based on the assumption that the olive oil and fish oil is able to modulate the development of colorectal cancer. The objective of this study was to assess the mechanisms by which exercise this effect oils and the involvement of fatty acids present in these oils in the development of colorectal cancer. Result: power respondeer the objectives were used two strategies. The first is based on in vitro studies with cell lines of human colorectal adenocarcinoma. Caco-2 and HT-29. Moreover, we used an animal model of induction of colorectal carcinogenesis to determinae the effects of these nutrients in vivo. fish oil and olive oil induce differentiation of the cells Caco-2.Estas cells have the habit of differentiating when subjected to distintops stimuli. As a result of differentiation these cells begin to express enzymes Sucrasa-Isomaltasa and Dipeptidilpeptidasa IV. We have shown that cells fed olive oil and to show greater expression of these two enzymes. regulation of colonic tissue homeostasis depends on a westrecha relationship between cell proliferation and apoptosis or programmed cell death. Through studies of tritium - thymidine incorporation, we have shown that fish oil has a significant inhibitory effect on cell proliferation Caco-2 and HT-29. seems to be that these serian effect due to n-3 fatty acids DHA and EPA main constituent of fish oil. modulatory effect of the development of colorectal cancer by the olive has its greatest effect on the induction of apoptosis. index has apoptosis determined to analyze the morphological changes of the cells (DAPI staining). fish oil, olive oil and the DHA, EPA and oleic acid (the main component of olive oil) are able to increase apoptosis very significantly . was subsequently identified the mechanisms involved in this apoptosis through studies of expression of COX-2 in these cell lines. expression of the protein anti-apoptótica Bcl-2 decreased following the inhibition of COX-2 which suggests the involvement of these genes in effect antineóplásicos of these fatty acids. on the other hand showed a clear involvement of the protein Bax in the induction of apoptosis, and that by administering an inhibitor of this, there was an 8 to dismin 69f ución significant apoptosis. The fish oil and olive have a major protective effect on the induction of carcinogenesis cocorrectal in animals treated with azoximetano. we observed that the animals that received a diet with olive oil or fish as a major source of fat, had a index increased apoptosis. Moreover, the fish oil could have a preventive effect to be able to affect the turnover of the colonic epithelium healthy, increasing apoptosis of these cells. Conclusions: The fish oil is able to modulate in a clear development of colorectal cancer affecting directly in the processes of cell differentiation, proliferation and apoptosis. fish oil could have a preventive effect the development of colorectal cancer by changing the regeneration of healthy colonic epithelium. Olive oil can modulate the development of colorectal cancer but not having its effect on all of the mechanisms studied.

Author: SUAREZ GARCIA INES MARIA.
Year: 2005.
University: AUTÓNOMA DE MADRID [www.uam.es].
Place of defense: FACULTAD DE MEDICINA.
Place of preparation: FACULTAD DE MEDICINA.

Summary: Objective: To assess endothelial function using ultrasound study of the flow-mediated dilation of the brachial artery in patients infected with HIV-1 on antiretroviral treatment and have a low cardiovascular risk. Materials and Methods: A cross-sectional study performed at the University Hospital La Paz, in one year. Inclusion criteria: Patients infected with HIV-1 (either without any prior or current antiretroviral therapy, or treatment with a unique combination of antiretroviral drugs for at least 6 months); healthy controls not HIV-infected, age greater than 18 years. Exclusion criteria: history of stroke, ischemic heart disease, peripheral arterial disease or diabetes mellitus; alcohol or drugs; obesity; opportunistic infection or malignancy associated; statin therapy, antioxidants or hormone replacement therapy, hypertension, triglycerides pasmáticos> 170 mg / dl; cholesterol> 240 mg / dl; glucose> 110 mg / dl; serum creatinine> 1.8 mg / dL; coronary risk moderate, high or very high according scale 2Â fourth working group of European Societies for Coronaria Prevention. We included 40 subjects divided into 3 groups: 1. Patients infected with HIV on antiretroviral treatment (15 patients), 2. Patients infected with HIV without antiretroviral therapy (13 patients), 3. Controls healthy (12 subjects). Ultrasound Study: study was performed by flow-mediated dilation of the brachial artery in accordance with the method of Celermajer. We compared the values of flow-mediated dilation between the three groups. It also compared the proportion of respondents reduced vasodilator (flow-mediated dilation of less than or equal to 10%). Results: The values of flow-mediated dilation was 5.93% (3.56%), 8.76% (5.72%) and 10.64% (3.08%) in each group, respectively (p = 0008; significant difference between group 1 and group 3). The proportion of respondents reduced vasodilator was 25%, 69% and 93% in each group, respectively (p = 0001). Conclusions: 1. Patients infected with HIV-1 in antiretroviral treatment of mild and low cardiovascular risk and no alterations in plasma lipids, have endothelial dysfunction compared with healthy controls uninfected, as measured by flow-mediated dilation of the brachial artery. 2. Compared with healthy controls, patients infected with HIV-1 untreated have a higher risk of endothelial dysfunction, as measured by reduced vasodilator response less than 10% in the brachial artery (OR = 6.75, 95% confidence interval 1 , 16 to 39.2). 3. Compared with healthy controls, patients infected with HIV-1 in antiretroviral therapy have a higher risk of endothelial dysfunction, as measured by reduced vasodilator response less than 10% in the brachial artery (OR = 41.99, 95% confidence interval 3.76 to 468.9). This risk is even higher than that of patients infected with HIV-1 is not treated with respect to healthy controls.

Author: SERRANTES VERGARA ROCIO.
Year: 2005.
University: AUTÓNOMA DE MADRID [www.uam.es].
Place of defense: FACULTAD DE MEDICINA.
Place of preparation: FACULTAD DE MEDICINA.

Summary: The EAS is a frequent and early neurological complication in septic patients with sphincter reduced brain activity and has a negative influence on the survival, in spite of this, experimental studies have failed to establish its pathogenesis. Clinical data obtained prior nuesro group in septic patients, with or without encephalopathy showed an association between elevated levels of IL-1beta and neurological impairment. Therefore in this paper established as assumptions IL-1beta could contribute to the genesis of the EAS through an alteration of brain synaptic transmission. We focus on the interaction of the cytokine receptor GABAa, the receiver medium fast synaptic transmission in most of the inhibitory synapses in the brain of mammals. To perform this work we combinadouna series of techniques, including those of immunocytochemistry and confocal microscopy, inmunoblot, electrophysiological, and molecular. They have been used in hippocampal neurons in culture and in Xenopus oocytes injected with mRNA in the rat brain, two cellular models that express receptors GABAa native or foreign, respectively. Confocal images of neurons or oocytes show that IL-1beta increases the expression of receptors GABAa on the cell surface. Moreover, short pulses IL-1beta applied oocytes produces enhanced flow-mediated receptor GABAa. Such empowerment is started slowly, in line with the gradual redeployment of recipients GABAa on the cell surface. In the quest for a mechanism that connects IL-1beta with redistribution receptor GABAa found that the cytokine activated via PI3K/Akt which, in turn, induces translocation receptor GABAa to the cell surface.

Author: TABARES RODRIGUEZ BEATRIZ.
Year: 2005.
University: AUTÓNOMA DE MADRID [www.uam.es].
Place of defense: FACULTAD DE MEDICINA.
Place of preparation: CENTRO DE FARMACOLOGIA.

Summary: The allelic frequencies detected in the Spanish population are for the allele CYP2D6 * 4 of 20.8% (95% CI: 16.3 - 25.2%), the allele CYP2C9 * 2 of 13.8% (95% CI: 10 - 17.6%), the allele CYP2C9 * 3 of 6.6% (95% CI: 3.9 - 9.3%) for the allele CYP2C19 * 2 of 14.8% (95% CI: 10.9 - 18.7%), and the allele CYP2C19 * 3, 0%. From genotypes detected can classify the Spanish population as MLs for CYP2D6 to 5.7% for CYP2C9 to 5.03% and CYP2C19 to 3.8%; MIs for CYP2D6 to 30.2 % for CYP2C9 to 30.8% and CYP2C19 to 22% and as MRs for the CYP2D6 and CYP2C9 to 64.2%, and CYP2C19 to 74.2%. The frequencies of different genotypes detected are within the expected Hardy - Weinberg law. The frequency of MLs for CYP2D6 among the subjects studied Spanish does not differ statistically from that published in other phenotypic studies in different regions of Spain, neither of which is described in other Caucasian populations. Our work brings the prevalence of genotype ML, unpublished so far for the Spanish population. The genotypic and allelic frequencies found in the Spanish population for CYP2C9 are very similar to those of other white European populations, but they are statistically different from those already published in populations of southern Spain. The pattern of polymorphism of CYP2C19 found in the Spanish population is no different from other groups no-asiáticos characterized so far in different continents. Our work provides the genotypic and allelic frequencies of this cytochrome, unpublished so far for the Spanish population. For drugs metabolized by CYP2D6 analyzed there an increase in its provision in the face of slow metabolizers fast metabolizers, while the AUC0-t increased by 22% for mirtazapine and a 164% for venlafaxine. For the drug metabolized by CYP2C9 analyzed, ibuprofen, the bioavailability is increased in the MIs against the MRs in a 17% in terms of AUC0-t, with the greatest influence of allele * 3 to the allele * 2. For drugs metabolized by CYP2C19 analyzed bioavailability in the intermediate metabolizers / slow is increased compared to the fast metabolizers presented for the omeprazole and citalopram for an increase in the AUC0-t of 119% and 50% respectively. Although in most cases we did not find statistically significant differences, it is conceivable that has been due to the large interindividual variability in kinetics of the drugs evaluated as well as the small sample size with which we have enjoyed. Given that the effectiveness and adverse effects due to treatment with a wide variety of drugs depend on the activity of enzymes polymorphic CYP2D6, CYP2C9, and CYP2C19, genotyping of these CYPs can become a part of the individualization of drug treatment in those patients to be treated by drugs with a narrow therapeutic range.