CLINICAL SCIENCES (2)

Author: BAQUERO ARANDA ISABEL MARIA.
Year: 2005.
University: MÁLAGA [www.uma.es].
Place of defense: FACULTAD DE MEDICINA.
Place of preparation: FACULTAD DE MEDICINA.

Summary: Analyzing macular retinal thickness, and the layer thickness of nerve fibers peripapilar and morphological study of the head of the optic nerve in 20 eyes of subjects emetropes in 20 eyes of subjects -1 A -5 Dioptrias of myopia, 20 eyes as subjects of -6 to -10 Dioptrias of myopia, in another group of 20 eyes of -11 to -15 dipotiras of myopia in 20 eyes of subjects over -15 diotrias of ametropiua miopica. Getting no statistically significant variation in the thickness foveal between groups, as well as a statistically significant decrease in the thickness retinal parafoveal with increasing ametropia. The thickness peripapilar midst of layers of nerve fibers decreases in average increases ametropia so statistically significant, and the thickness in the quadrants and lower peripapilar of upper layer of nerve fibers. With regard to morphological study of the optic nerve head of the single vertical excavation and the area of the excavation showed differences between groups of statistically significant.

Author: MARTÍN REYES GUILLERMO.
Year: 2005.
University: MÁLAGA [www.uma.es].
Place of defense: FACULTAD DE MEDICINA - UNIVERSIDAD DE MALAGA.
Place of preparation: FACULTAD DE MEDICINA - UNIVERSIDAD DE MÁLAGA.

Summary: Descriptive epidemiological studies on 1919 patients included in substitution therapy on renal function in the province of Malaga during the years 1973-2002: incidence and prevalence, primary disease, Provenance, comorbidity associated techniques used, causes of death. It analyzed patients' survival as a whole and the population transplanted to find predictive variables. Finally we calculated crude mortality rates and standardized by age for the entire population and for each technique (Hemodialysis, peritoneal dialysis and renal transplantation). The incidence of patients in chronic renal failure in substitution therapy in the province of Malaga is growing at a rate between 3 to 6% cancels and is pr3evisible to maintain this pace of growth. Men predominate on women: 58.5% versus 41.5%. The average age at entry into the program has been rising from 46 years in 1985 to 58.42 years in 2002. In recent years, the incidence has increased mostly at the expense of the higher incidence in the age group of over 60 years and has been stable for those under 40. There had been no differences in access to treatment between different regions of the province. The prevalence of substitution therapy in patients has been growing in a linear and parallel to the incident. Over the past ten years grows to 8% annual doubling the number of patients in less than ten years. The 70-75% of patients come from the service Negrología, 30-25% of non-specialist services. The disease causes the most common chronic renal insufficiency category was not filiada, followed by glomerulonephritis. The diabetes and renal vascular its incidence has doubled in the past ten years representing each accounted for 20% of the patients who enter the program. Two thirds of patients in the past ten years representing each accounted for 20% of the patients who enter the program. Two thirds delos patients in the past decade have some comorbidity associated with the most common cardiovascular. The frequency of C virus positive patients in this population is low (6%), which explains the low number of seroconversions (10 patients). The most common cause of death was cardiovascular which has remained constant over the past fifteen years and is independent of the primary disease or age group. Deaths from social cause (suspension of treatment) have doubled in the past five years, accounting for 10% of all deaths. In transplant patients the most common cause of death is cardiovascular deaths from infectious causes have been declining over the past fifteen years while deaths from cancer have nearly tripled in the past five years. The median survival was 9.24 years and an average of 12.56 years. Variables predictive of survival for all patients were: Primary disease, the presence Comorbidity of any kind, Cardiovascular Comorbidity per se, Quinquennium start of treatment and age at onset of treatment. Over the past ten years also were predictive: the first technique used, the source patient and serology for the virus C. The median survival for transplant patients in this study was 13.67 years. The predictive variables for survival in renal transplant recipients were: Age transplantation, the presence of diabetes and quiquenio in which he had conducted the transplant. In the last ten years alone were predictive variables waiting time and the presence of comorbidity. The Hemodialysis is more durable than peritoneal dialysis. The election of the first technique does not affect the survival of patients. Mortality rates adjusted for age have remained stable over the past 25 years.

Author: MELGAREJO CORDERO FRANCISCO.
Year: 2005.
University: MÁLAGA [www.uma.es].
Place of defense: FACULTAD DE MEDICINA - UNIVERSIDAD DE MÁLAGA.
Place of preparation: FACULTAD DE MEDICINA - UNIVERSIDAD DE MÁLAGA.

Summary: This thesis is based on the method of research, which seeks to anticipate the information to improve strategies for training (planning, intervention from implemented, reflection and improvement strategies / revised plan). So from a qualitative research supported in perspective, and at times also with the quantitative method, is developed in this project res stages, following the methodology referred, through training with virtual simulation and scenic dela activity endoscópia gastrointestinal, in different learning environments considered on six doctors and residents in training endoscopic belonging to a university teaching hospital. The simulation training for doctors in training to improve; manual skills in the techniques, the doctor patient relationship in processes related to gastrointestinal endoscopy, the detection of critical points in their training and ability diagnóstico-descriptiva images, all through study of the various issues considered in the successive action plans designed. The definition of different indicators to assess the training strategies implemented and the training, to evaluate town of medical training postgraduada taught at the various stages of training MIR program, and define a plan of continuous quality improvement training dela based gastrointestinal endoscopic in management processes.

Author: MORALES RUIZ ENRIQUE.
Year: 2005.
University: COMPLUTENSE DE MADRID [www.ucm.es].
Place of defense: FACULTAD DE MEDICINA.
Place of preparation: H. 12 DE OCTUBRE. SERVICIO NEFRONOLOGÍA. MED. INTERNA.

Summary: In most developed countries obesity is reaching epidemic proportions. Recent studies show that nephropathy associated with obesity is an increasingly common diagnosis. In studies we have been able to demonstrate the following conclusions: 1 - The wide variations of body weight (above or below 10%) induce drastic changes in the amount of proteinuria. 2, - Patients with glomeruloesclerosis sementaría and focal associated with obesity display features clínico-analíticas (proteinuria minor that glomeruloesclerosis idiopathic absence of edema and nephrotic syndrome biochemist even in the presence of massive proteinuria) and histological (glomerulomegalia) allow your differentiation with idiopathic forms. The prediction of glomeruloesclerosis associated with obesity is far from benign, since nearly half of the patients progressed to advanced renal insufficiency. The presence of renal failure at the start of follow-up was the only parameter to predict the progression of renal failure, which reinforces the need for early diagnosis. 3-Although the majority of patients undergoing unilateral nephrectomy maintained normal renal function, a minority develops proteinuria and renal insufficiency even a very slowly progressive. Obesity plays a decisive role in the onset of proteinuria and renal failure after uninefrectomía, being the only parameter clinical or analytical were statistically associated with the risk of developing these complications. Therefore, obese subjects undergoing unilateral nephrectomy sovereignty be periodically reviewed. 4-Those overweight patients who suffer from a chronic nephropathy proteinuric of any etiology, a modest weight loss achieved through hypocaloric diet normoproteica induces a significant decrease proteinuria. The reduction of proteinuria induced weight loss was accompanied by a stabilization of renal function and improved lipid profile. In conclusion, a proper assessment, prevention and treatment of obesity is fundamentally important prognostic and therapeutic in nephropathy proteinúricas Chronicles of any etiology.

Author: JOYANES ABANEENS BELEN.
Year: 2005.
University: COMPLUTENSE DE MADRID [www.ucm.es].
Place of defense: FACULTAD DE MEDICINA.
Place of preparation: FACULTAD DE MEDICINA.

Summary: BASIS AND OBJECTIVES haemoglobinopathies structural congenital with sickle cell anemia as the most important, are a group of diseases whose incidence is increasing in recent years because of the growing phenomenon of immigration is living in Madrid, Spain. For the problems of morbidity and mortality imply that these pathologies, and the possibility of early prophylactic therapy to decrease the morbidity and mortality, we consider it necessary to conduct a study that demonstrates the need for the inclusion of screening hemoglopatías in this Commonwealth. These studies have already been conducted in various countries, mainly those in the existence of different races ago Frequently these diseases. Therefore the objectives will be to:-Establish the incidence of children born in haemoglobinopathies Clinical Hospital in San Carlos May 2003 to June 2004. B-Studying the adequacy of the introduction of neonatal screening. C-Analyze which of the techniques used scrutiny is the best suited for the realization of screening. MATERIAL AND MÉMTODOS Study cohort ambispectivo, recruiting 3,365 newborns at the Hospital Clínico San Carlos between high 2003 and April 2004. Sociodemographic data were collected related haemoglobinopathies and was conducted simultaneously at a routine screening tests high performance liquid chromatography (HPLC) ion exchange for the separation of hemoglobin present, using for that purpose a VariantTM (Bio-Rad) and program Sickle-cell. In pathological samples has been made a high performance liquid chromatography (HPLC) Phase reservation for the separation and study of globin chains. For the identification of abnormal hemoglobin S is not, not C and not D, has been precise sequencing of genomic DNA. Parallel 279 samples have been studied by HPLC chain, to analyze the validity of HPLC hemoglobin VariantTM. RESULTS have been found hemoglobinopatía in 26 samples through VariantTM, which gives an overall incidence of 7.7 out of 1000 newborns, with a case of HbS homozygous, 18 cases HbS heterozygote, 1HbE/A2 later unconfirmed, 1 case of HbC and 5 abnormal peaks, all confirmed by HPLC chains. 4 cases were in children of Spanish origin, none hemoglobinopatía type C. So In the 279 children analyzed by HPLC hemoglobin has been the incidence of 28 per 1000 samples. All cases of hemoglobin SyC have been confirmed, and has not found any new in this second sample. CONCLUSIONS believe that the newborn screening haemoglobinopathies in Madrid is necessary because of the impact that we found, the HPLC and ion exchange VariantTM is suitable for the screening of henmoglobinopatías more prevalent in the immigrant population (SyC), save time.

Author: DOMINGO GORDO BLANCA.
Year: 2005.
University: COMPLUTENSE DE MADRID [www.ucm.es].
Place of defense: FACULTAD COMPLUTENSE DE MADRID.
Place of preparation: UCM. FACULTAD DE MEDICINA.

Summary: OBJECTIVES Knowing the incidence and characteristics associated with patients who have glaucoma following a queratoplastia penetrating. MATERIALS AND METHODS We conducted a retrospective descriptive study of 174 patients with queratoplastia penetrating (QPP) with an incidence of glaucoma associated in 25.28% (44 cases). We have studied the cause of queratoplasita the existence of glaucoma surgeries and filter; factors related to the transplant surgery, the situation fáquica and corticoterapia. We evaluate the drop in IOP treatment, complications and rejection episodes. RESULTS growing incidence of glucoma in drilling (45%) and trauma corneal (44%), existence of pre - glaucoma, eye surgeries as pseudofaquia with intraocular lens (Lio) anterior chamber (71%), withdrawal of Lio (54%) , afaquia (37%), virectomía (38%), type of suture (loose points). We found no significant differences depending on the size of graft, type and time of the corticoterapia. We evaluate the response to antihypertensive treatment, complications and rejection episodes. The relative risk of glaucoma before the existence of previous peripheral synechias was four times higher. CONCLUSION glaucoma associated represents a serious problem for the frequency difficult for recognition, disease severity and complexity of management. It produces a significant deterioration of visual acuity, and it would be advisable to take precautions in patients with endothelial commitment intrinsic factors or secondary or previous ocular surgeries. KEYWORDS Queratoplastia penetrating glaucoma.

Author: ROIG VILASECA DANIEL.
Year: 2005.
University: BARCELONA [www.ub.es].
Place of defense: FACULTAT DE MEDICINA.
Place of preparation: FACULTAT DE MEDICINA (BELLVITGE).

Author: SEVILLA HERNANDEZ ANA.
Year: 2005.
University: SALAMANCA [www.usal.es].
Place of defense: CENTRO DE INVESTIGACION DEL CANCER.
Place of preparation: INSTITUTO DE MICROBIOLOGIA BIOQUIMICA.

Summary: The family of kinases VRK presents a significant homology with the kinase B1R virus Vaccinia essential for the replication of viral DNA. This family consists of three members VRK1, VRK2 and VRK3. VRK1 is capable of fosforilar various transcription factors associated with response to cell stress, such as p53, c-Jun and ATF2. In this paper we address the characterization of the phosphorylation of ATF2 and c-Jun by the kinase VRK1 and their physiological function in the cell. VRK1 phosphorylated in ATF2 in the waste of Thr73 and Ser62 stabilizing protein and activating its transcriptional activity. We have also noted that VRK1 is capable of activating the gene dose dependent manner of colagenasa whose activation is dependent on binding sites for ATF-2. In addition, VRK1 and JNK to suboptimal doses presents an additive effect on the transcriptional activity of ATF2. That is why ATF2 can integrate different signs of cell stress mediated by different kinases. VRK1 also phosphorylated at c-Jun inducing stability and accumulation of the protein. VRK1 activates transcription dependent c-Jun, which is dependent on the phosphorylation of residues Ser63 and Ser73. Both VRK1 as JNK presented an additive effect on the transcriptional activation of c-Jun indicating a possible cooperation between the two kinases. Therefore, we can conclude that the kinase human VRK1 (Vaccinia-related Kinase1) cooperates with JNK in the regulation of transcriptional activity of ATF2 as c-Jun. And both factors play an important role in cell survival and that activate the expression of genes involved in repair processes of damage to DNA as well as genes that allow re-entrada and progression of cells in the cell cycle.

Author: Bonilla Bartret Francisco José.
Year: 2006.
University: VALENCIA [www.uv.es].
Place of defense: F.de Medicina y Odontologia.
Place of preparation: Facultad de Medicina y Odontologia.

Summary: OBJECTIVE .- through ultrasound 2D, doppler, 3D and 4D of the various fetal movements, including respiratory movements. Identify patterns of fetal behavior. MATERIAL AND METHOD .- For the study of respiratory movements: Survey of 223 gestations, divided into two groups (Group A: without pathology; Group B: with some pathology). It made 487 records of ultrasound fetal movements in fichas-protocolo, which also included details of ultrasound scanning, monitoring cardiotocográfica, explorations and complementary way of completion of the pregnancy. As variables were studied the incidence, frequency and amplitude of movement breathing, as well as the presence or absence of specific patterns such as hiccups, panting, and the presence / absence and duration of apneas. It also studied the evolution of these parameters along the pregnancy. The data obtained were subjected to analysis at the Institute of Quantitative Decisions The Faculty of Medicine of Valencia. The study used various ecógrafos 2D picture of the methods A, B, Doppler, TM, TD, ecógrafos 3D and 4D (Aloka 5000, Advanced Voluson General Electric and Voluson 750). For the study of embryonic and fetal movements not breathing:-Study of 50 gestations of normal development. Records are stored ultrasound of fetal movements of 14 minutes duracón over 30 minutes of study. We evaluated patterns of specific movements described by De Vries and Kurjak, studied the time of occurrence and frequency of submission along gestation. For the study ultrasound was used ecógrafos the same as described for the study of respiratory movements. RESULTS .- With respect to respiratory movements:-All variables change over of gestation. - All of them are on the rise along the pregnancy. Only the frequency and incidence appeared to diminish at the end of pregnancy, although this was not statistically significant in the overall assessment of each parameter, given the broad ranges which have been obtained for variables. - Apneas markers were not wrong pronótico statistically significant, probably because of the type of gestations studied, but that a tendency was observed to be present most frequently in fetuses with certain conditions. - The presence of hiccups and panting was not conclusive either as a marker of poor prognosis fetal regarded more as a way of developing breathing, Frequency 20-50 mrf / min 40mrf/min Amplitude 2 mm 3.7 mm Length 0.5 sec 1.9 sec Incidence 57.9% 23.8% Apneas Uncommon. Not MP Hiccups, panting not conclusive. Maturation As for the overall fetal movements:-It was studying all types of fetal movements described by DeVries and Kurjak. - In the first trimester of gestation, increase according tables thesis movements in general, sobresalto, outreach, insulated from upper and lower limbs or their combination, anteflexión and lateroflexión the head. They reduce the rotation of the head. - In the second quarter, decreased fetal movements at the end of the third quarter. Showing frequency tables along the pregnancy to yawn movements, swallowing, retroflexión head, rotating head, anteflexión head movements mano-cabeza, mano-boca, hand-eye, mano-cara, mano-oreja . - Objetivan various facial expressions or gestures fetal described by Kurjak. The eye movements are recorded by means of ultrasound 2D, using the 4D for the movement of the eyelids. CONCLUSION .- The unborn child interacts with his environment, being able to respond to various stimuli. Thus understood fetal behavior, it is the development and maturation of the central nervous system. The fetal movements show a vari 8 ation to bae over fetal development. With gestational age describes various patterns of movement that relate to the maturation of various nuclei nervous. This is primarily related to eye movements and the alternation of REM and non-REM stages, as well as the occurrence of slow movements of the mouth and not REM periods. The sequential appearance of various patterns of fetal movement reflects the development of fetal central nervous system, with emergence of circadian rhythms and maturation of devices, such as breathing. The presence of fetal movements related to fetal well-being, both in early stages of development as in the second half of gestation. Studies of ultrasound fetal movements compared with malformed fetuses show changes in the frequency and characteristics of fetal movements (in breadth, home, tone, â |. Ecográficas New techniques complement to the former and improve the ability to describe specific patterns of fetal movements, while not allow itself to establish the ability to determine through the same grade and the existence of a possible fetal brain damage. Where is consensus that a decrease in fetal movements below a threshold is bad prognosis. respiratory movements are related to fetal stage. however, his study is not easy for clinical practice. This is determined in part because changes in terms of frequency, incidence, duration and amplitude along pregnancy shows broad ranges of variability. addition, the methodology for the study is complicated, making it difficult to compare studies. Our results, which are consistent with those of other authors, indicate that the threshold of normalcy that have been established so far are to fetal fetuses with a very bad prognosis, but there is no way to detect early changes through these movements. fetal behavior, which includes fetal movements, it develops along the fetal life. alterations System central nervous, which depends, are a reflection on their development, even though there is no practical clinical markers for the diagnosis of early neuronal damage.

Author: Barrachina Tortajada Rosa María.
Year: 2006.
University: VALENCIA [www.uv.es].
Place of defense: Facultat de Medicina i Odontologia.
Place of preparation: Facultat de Medicina i Odontologia.

Summary: I INTRODUCTION. The figure Francisco Bonilla Marti had special relevance in gynecology Spanish. The beginning stage of its teaching and most of the years of Pr (decades of the 50 and 60) coincided with an obvious shortage at the University Spanish, but his immense capacity for work and his generosity got a start, in some cases frantic activity investigadora.Los several fronts scientists who took over thirty years of Professor Valencia helped to raise the level of gynecology Spanish bringing fresh ideas which in some cases were pioneers at the time and that cemented the reputation of the Valencia School of ginecologíaNo it has been clarified nor objectified the importance and influence of the figure of Don Francisco Bonilla Marti gynecology in Spanish, although his immense prestige widely recognized. It has conducted a systematic collection, management and valuation of their publications in order to obtain more precise information on their impact on the knowledge of the time and origin of lines of inquiry. It is the objective of this thesis explain the impact of their work in gynecology at the time, the possibilities offered and future lines of inquiry and the impact it had on the formation of the Spanish gynecologists and particularly valencianos.Francisco Bonilla Marti born the September 01, 1911 and died on March 16, 1997, he was a Professor from May 11, 1948 until May 5, l978 in who retired voluntarily. II. MATERIAL AND MÉTODO.Durante phase of its Chair of Valencia was virtually impossible to carry out the objective evaluation of the publications of any member of the scientific community. The reason was twofold in the case of a Spanish:-Lack of bibliometric indicators .- The difficulty for the Spanish scientists to publish their work in journals internacionales.Aceptando these difficulties, the purpose of the thesis has been: 1-Analyze different publications Don Francisco Bonilla Martí.2- Distinguirlas according to different lines trabajo.3- Emphasize the situation where these skills were in the national and international context and the input of Don Francisco Bonilla.4- Objetivar his participation in the training of other teachers who have occupied important positions at the University Hispaniola (Researchers, Professors headlines) or chieftainship Service hospitals of the National Health System. The work is grouped into 5 chapters, distinguishing one part Bio where they are recorded further charges institutional and organizational Service Obstetrics and Gynecology as well as meet the disciples who achieved important posts in the University or in the National Health System and the second consists of various sections that discusses scientific fronts where the provision of teacher Bonilla was significant, analyzing the state of knowledge at the time. The lines of research are: "Cytogenetics." Gynecological Endocrinology. "Endocrinology gestational" Play. "Miscellany, which includes lines of work with the minor prior. III. RESULTS AND DISCUSIÓN.III.1 BIOGRAFÍAFrancisco Bonilla Marti was born in Knives (Castellón) 1/9/11. Advised by his uncle Dr. Marti Michael Shepherd, then a professor of gynecology and obstetrics in Valencia, began studying medicine at just 15 years. was a brilliant student at the end of the race and won the special prize degree. En 1934 se moves to Madrid to make the thesis under the direction of prof. Gregorio Maranon, whose title was "The action of the ovary on the metabolism of carbohydrates," which will read the same year, with the outstanding rating. in 1 8 935 with 1797 funds from Monte de Piedad, the School of Medicine offered some grants to expand study abroad. after opposition Francisco Bonilla gets the scholarship and chose Frankfurt University Clinic which was led by Seitz, where he focused on the study of thyroid possible influence in the etiology of eclampsia. During his stay in Frankfurt published 3 articles in the German magazine Monatschrift. Ended civil war, the current 39/40 returns to Valencia as an assistant professor of practice, the professor who directs his uncle, Prof.. Marti Shepherd contacting again with his cousin Ignacio Marti. opposition in 1941 obtained by the square of the provincial director of the maternity Albacete. there through a local gynecologist, Dr. Jose MÂ th Sanchez Ibanez for the organization the service, a pioneer of HSG in Spain. Albacete His stage was enormously successful, doing important work and care modernizing tocurgia exists. Back to Valencia in 1948, upon the retirement of his uncle Professor Marti Shepherd, claimed by the university faculty. was convened opposition to assistant professor and then got by the opposition chair of Valencia, this time it won Francisco Bonilla Marti in November 1948. Francisco Bonilla bet on teamwork. After joining the chair organizes service sections, led by experts with a clear vocation interdisciplinary. special Her organizational skills and leadership succeeded in defining a structure of service is maintained to this day. School Valencian gynecology formed during the professor Francisco Bonilla stresses within Marti specialty because of the impact of their work as well as his disciples, spread over the last 50 years throughout the national geography. Having emerged from his school 8 professors. Throughout his academic life directed 71 doctoral dissertations, of which the first 15 will be defended at the Central University of Madrid, and since 1955 has already been read in Valencia. Nevertheless them was unique director (the law then did not allow co). Published 80 magazine articles 3 books, 9 papers and 11 communications conference. III.2 CITOGENÉTICAFue in 1964, only 8 years after the precise knowledge of the human karyotype when the group headed by Valencian Bonilla presented at the Fourth National Congress of Gynecologists Spaniards held in San Feliu de Guixols a paper entitled " Chromosomes in gynecology "which was an important input and update to the study of cytogenetic in Spain. for studies in this field Bonilla enjoyed the cooperation of Geronimo Forteza, training eminently haematological and conducted techniques his laboratory particularly initially, and later in the research center of which was a founding cytologic. Rafael Báguena And Candela, a professor of genetics. III.3 ENDOCRINOLOGÍA GINECOLÓGICA.La technical laboratory for the study of hormone metabolites in urine was extremely complex, So in the early 60 only carried out in Madrid, in the cynical de la Concepción whose laboratory led the dr. Vivanco. Thus, at the moment, endocrinology was a little discipline studied by gynecologists. Early the 60 Prof.. Bonilla contact with a pharmacist from Castellon, Dr. Jesus Calderon Gomez, who had managed to mount the technique for determination of metabolites in urine hormone. soon realized Bonilla of research possibilities open to them. He started work mainly focusing on the study of 17 cetosteroides, precisely because of the difficulty that offered at the time to represent circulating androgens which are metabolites. thesis reflects the work and conclusions drawn from them III.4 ENDOCRINOLOGÍA GRAVÍDICA . Given that the technique of determining through the HCG test Galli Mainini was not standardized because of unbridgeable differences as the kind of batracio used or climatic conditions, each laboratory adopted criteria. was applied to the study of the production of HCG in normal and pathological gestations, focusing on abortion and the mola hidatiforme III.5 REPRODUCCIÓNEl interest Bonilla for examining the uterine cavity as etiological factor of abortion dates back to his days of starting a job with Albacete Sanchez Ibanez which saw the doctoral dissertation it (1948) The results published concerning pathological findings were an enormous variability, mainly by the existing confusion in the interpretation of radiological images and had only general agreement in the diagnosis of major malformations (bicorne, septum, subsepto , unicorne). was raised analyze the morphology of the uterus in order to obtain fetal deductions clinics to enable it to the exact description of its anomalies and along with Garcia Serrano studied 74 wombs of dead fetuses intraútero or dead newborn whose dispersion chronological ranged from 4 and 10 months of gestation. III.6 MISCELÁNEA.Agrupo under this heading lines of inquiry minor that the four prior.

Author: López Sánchez Mara.
Year: 2006.
University: VALENCIA [www.uv.es].
Place of defense: Facultat de Medicina i Odontologia.
Place of preparation: Facultat de Medicina i Odontologia.

Summary: INTRODUCTION: The umbilical cord blood (SCU) is a source of progenitors hemopoyéticos able to reconstitute hemopoyesis of an individual. It is an alternative to the use of bone marrow or peripheral blood from unrelated donors or donor family with HLA disparity in transplants hematopoietic precursors. Justification: One of the major problems posed transplants SCU, is the low cellularity and delaying the apprehension myeloid and plaquetar, compared with bone marrow transplants but has undoubted advantages, such as its easy availability and its immaturity cell. Knowing obstetric factors that improve the quality of the WCS is important to circumvent the incoveniente content restricted progenitor cells. This optimizes the selection of donors and the collection of blood to increase its capacity and that samples are not discarded by the banks before their WCS cryopreservation. SCENARIOS FOR WORK is that hypoxia mediaría an increase in hematopoietic progenitors useful for transplant and the extraction intraútero in case of caesarean sections would improve the quality of blood. The prospective cohort study was carried out at the University Hospital Maternal Faith in coordination with the Bank for Umbilical Cord Blood of the Community of Valencia. OBJECTIVES: To obtain samples of WCS higher quality to be useful for transplantation (depending on quantity and quality of hematopoietic progenitors). - To determine the influence of obstetric parameters on the quality of the cord blood. - Comparing two forms of collection of cord blood units (with placenta intraútero and after the expulsion of the same) in Cesarean section. - Determine whether the pathology maternal influences on the quality of the blood of umbilical cord. MATERIALS AND METHODS: We collected 759 samples from WCS donations routine and pathology: 7 EHD, 4 oligohydramnios, 6 DM 19 DMID, 128 premature 7 twins, 14 hypothyroidism, 4 Lupus, 8 ETS. We conducted a survey among haematological parameters that define the quality of WCS and the factors that we think can modify its cellularity (quantitative and qualitative maternofetales) CONCLUSIONS 1. The weight of the placenta is the factor that best defines obstetric comprehensive manner the quality of cord blood for transplantation hematopoietic precursors. Any pregnant woman with desire to donate should first be assessed ecograficamente for estimating fetal weight and taking it as a surrogate in placental weight, target as a possible candidate for donation. 2. In order to optimize the work of the Banks of WCS, the decision to include it as a candidate for donation might take to spite the newborn in paritorio, the cutoff point could be 3320 grams. 3. The strategy in utero for collecting units SCU, it is preferable to the former uterus because optimized to maximize human resources and the results indicate a higher quality of the WCS regardless of route of delivery. 4. The route or mode of delivery does not alter in a significant way the quality of the samples of cord so in this sense any donation is suitable for the bank. 5. The liquid meconium should not be an exclusion criterion and should be accepted for donation delivery with fetal stress. 6. The sex of the newborn has no bearing on the quality of the samples of the WCS. 7. Prematurity itself should not be a factor of exclusion, but it seems reasonable to maintain the standard of greater than or equal to 34 weeks as a criterion obstetric inclusion / exclusion as a younger gestational although the percentage of cells CD34 + is high, it is likely that figure CNT does not exceed the minimum threshold established by the bank to store the sample. 8. The various pathologies studied do not have a clear influence sob 8 re AC 449 bility of the WCS, which should not be excluded in the selection criteria donor (hypothyroidism, NIDDM, pre-eclampsia, hypertension, oligohydramnios), except the donations coming patients with LES and DMID which have proved less content CFU. 9. The pathology associated obstetric that chronic hypoxia has not shown to increase the quality of the cord blood, which dismisses one of our working hypotheses.

Author: CANOVACA VEGA ANA MARIA.
Year: 2006.
University: CÓRDOBA [www.uco.es].
Place of defense: FACULTAD DE MEDICINA.
Place of preparation: FACULTAD DE MEDICINA.

Summary: The Clinical Interview is the basic tool of professional Primary Care. Following a series of studies have shown that this communication often involves inadequate patient dissatisfaction among other effects. The analysis of the communication becomes so much importance in assessing the quality of care. There are methodological difficulties for assessment, including the lack of development and limited suitable measuring instruments. In Spain the Group Health Communication and created an instrument rating, the questionnaire GATHA-base through consensus of a group of professionals. This questionnaire has not been validated yet in a position with real patients. This paper aims at presenting the content validity and reliability intravoservador questionnaire GATHA-real so that it can be a useful tool to know the profile of communications professionals primary. It has done an observational study validation of an instrument on average. The study population have been doctors Care Primara of health centers in the province of Cordoba. We studied through interviews with real patients who came consultation demand. We chose a random sample of 23 doctors with a total of 230 interviews evaluated. To check the validity of the content of the questionnaire was a factor analysis. Relations between the various subscales of the questionnaire were measured with the Pearson correlation coefficient. To assess the internal consistency was calculated with the Cronbach alpha test to ascertain the degree of homogeneity of the new questionnaire. For analysis dela intraobservador reliability indices were calculated Kappa and Correlation Coefficient Intraclase (ITC) to estimate the degree of agreement reached in the total score of the same. The results of the reliability intraobservador was an ITC axis of 1 to 0.92 (95% CI, 0.86-0.93) in the shaft 2 º of 0.85 (95% CI, 0.74-0.91) and the 3 rd of 0.72 (95% CI, 0.55-0.91), with an overall ITC among the first and second displays in a random sample of the total interviews, which was 086 (95% CI from 0 ,76-0, 92). After the factor analysis conducted on 32 items result, we identified 13 factors leading to the 64.31% of the variance with a cut-off point in the correlation coefficient of 0.35. As findings have been described that the questionnaire GATHA real has proved to be a reliable tool, construct validity and content as well as feasible and reproducible for use in the stadium of the relationship médico-pacientes in real interviews.

Author: QUESADA VILASECA MARIELA DEL CARMEN.
Year: 2006.
University: AUTÓNOMA DE BARCELONA [www.uab.es].
Place of defense: INSTITUTO UNIVERSITARIO PARC TAULÍ.
Place of preparation: FACULTAD DE BIOCIENCIAS.

Summary: For the diagnosis of Helicobacter pylori using invasive methods (if required for the conduct of an gastroduodenoendoscopía) and non-invasive if not used this technique. The overall aim of the thesis was to evaluate various methods of non-invasive diagnosis of infection by H. Pylori in patients with different diseases. We evaluated the diagnostic reliability of Premier Platinum HpSA, Amplified IDEIA Hp StAR- former FemtoLab H. Pylori-, RAPID Hp StAR, ImmunoCard STAT! HpSA and Simple H. Pyl. We included 75 patients with dyspepsia, 97 who had received treatment to eradicate the infection and 86 with chronic renal failure. Evidence reference dyspeptic patients were used in the rapid urease test and histology. To determine whether or not the patient was still infected after eradicating therapy was used exhaled breath test (UBT) and / or histology of 2 and 6 months of treatment is finished. In patients with chronic renal failure were used UBT, or the approach provides the results of this test together with those obtained from the serology. In dyspeptic patients, the ImmunoCard STAT! HpSA and FemtoLab H. Pylori were highly reliable, can be useful in the diagnosis of primary infection in patients with uninvestigated dyspepsia. The first of these might be useful in primary care, and the second to study the infection in large populations. In the study in patients receiving treatment to eradicate the infection proved that the methods ImmunoCard STAT! HpSA, Amplified IDEIA Hp StAR and RAPID Hp StAR are highly reliable. In the study conducted in patients with chronic renal failure was observed that the UBT is the most reliable method and that the methods of identifying antigens in faeces, FemtoLab H. Pylori was the one who showed higher values of sensitivity, specificity and reproducibility.

Author: ROSSI IZQUIERDO MARCOS.
Year: 2006.
University: SANTIAGO DE COMPOSTELA [www.usc.es].
Place of defense: FACULTAD DE MEDICINA.
Place of preparation: FACULTAD DE MEDICINA Y ODONTOLOGIA DE LA UNIVERSIDAD DE SANTIAGO DE COMPOSTELA.

Summary: INTRODUCTION Parkinson's disease is a progressive and degenerative central nervous system. Within the clinical symptomatology are alterations in the balance that originate a large number of falls. We have various explorations to record and quantify these changes, as well as to determine its location ground. Through the vestibular rehabilitation can try to improve its overall stability. MATERIALS AND METHODS We conducted with 45 patients with Parkinson's disease and 20 healthy subjects a study postulated through the creaneocorpografía, posturografía dynamic computerized test and timed up and go. Then they conducted an exploration of reflection vestibuloocular (tests calorie and rotating) and evidence oculomotoras. Finally on 10 patients with Parkinson's disease and increased risk of falls them perform vestibular rehabilitation. RESULTS Patients with Parkinson's disease show worse scores than the control group on tests of sensory organization (both in the overall balance in the use of visual and vestibular information). It also presents some lower limits of stability and require a longer time in testing timed up and go. In the exploration of reflection vestibuloocular the majority of patients have some evidence calorie normal, with a rotating and oculomotoras altered. The vestibular rehabilitation shows significant improvements in posturografía dynamic computed in the test timed up and go and the dizziness handicap inventory. DISCUSSION Patients with Parkinson's disease have an altered balance primarily at the expense of the poor use of information visual and vestibular. Having reduced limits of stability, will have a decline in its base of support and it will be easier to fall. The combined analysis of the evidence and rotating suggest that calorie information vestibular poor, is mainly due to a problem of the central nervous system, this scenario varies be supported for the alterations that show evidence oculomotoras. The vestibular rehabilitation in patients with Parkinson's disease is helpful to improve the activities of daily living, speed and balance of gracious way, as well as to reduce the risk of falls. The exploration instrumental posturografía dynamic computer detects impaired balance in patients with Parkinson's disease that shows no routine clinical examination. For many appropriate to construct a new classification of balance in these patients based on the criteria of both clinical examination as instrumental.

Author: PEREZ BENAVENTE MMa. ASUNCION.
Year: 2006.
University: AUTÓNOMA DE BARCELONA [www.uab.es].
Place of defense: Hosp. Uni. Materno-Infantil del Valle de Hebron.
Place of preparation: UNIVERSIDAD AUTONOMA BARCELONA.

Summary: We evaluated the results made to the therapeutic surgical patients in advanced stages of ovarian cancer incurred in the period from 1995 to the year 2004. Following the evaluation of these results have been presented different patterns of surgery and / or adjuvant chemotherapy / neoadjuvant for each type of patient. In this thesis, meets a large number of cases and a follow-up period sufficient for the assessment of therapeutic response in terms of disease-free period and the survival of patients. It performs a detailed epidemiological study of the study population, an assessment of the positive predictive value of major additional tests for the diagnosis of the disease and for the value of determining the degree of surgical resectability, since one of the main factors prognosis for the survival of these patients is to obtain, at the end of the intervention, the degree of surgery citoreductora optimally. When primary surgery can not reach the value of citoreducción optimal neoadjuvant chemotherapy allows postpone this goal in a small percentage of patients without increasing morbidity and mortality primary surgery. You also get different prognostic factors for survival and disease-free period overall for the linfadenctomía and for the heterogeneous group involved in clinical response Stadium IIIC ovarian cancer. Likewise, it makes a comprehensive review of the most recent literature on the epithelial ovarian cancer.

Author: GARCÍA RUIZ ELENA.
Year: 2006.
University: MÁLAGA [www.uma.es].
Place of defense: FACULTAD DE MEDICINA.
Place of preparation: FACULTAD DE MEDICINA UCA.

Summary: INTRODUCTION hepatotoxicity is an "orphan disease" and barely recognized because of the absence of a "gold standard" diagnostic and inability to know the mechanisms etiopatológicos. However, it is a major cause of withdrawal from the market of a product. Objectives To establish a network of hepatológos and clinical pharmacologists to collect on a prospective basis and standardized information about cases of liver toxicity detection of pharmacological groups more frequent and factors determining susceptibility to liver damage by drugs, as well as developments serious or fatal. METHOD was established in 1994 in Spain a Registry to gather, through a protocol structured and consensual, the cases of liver toxicity that took place within the partner units. The liver damage was classified in hepatocellular, and mixed colestásico following analytical preset criteria, unless there histological data. Implemented the escla CIOMS for attributing causality. RESULTS From April 1994 to August 2004, 461 cases were included. The group was the most common drug of antibiotics and the drug most often involved amoxicilina-clavulánico (12.8%). The damage was the most frequent hepatocellular (58%) that is inversely correlated with age (P less 0001) and had worse evolution (Cox regression, P less 034). In this group, patients with jaundice in the presentation, evolved into a 11.7% to transplant and death. The female (P less 0001), hepatocellular injury (P less 009) and high plasma levels of bilirubin (P 001) were associated to the development of FHF. Conclusions Patients with hepatocellular injury and jaundice in the presentation evolve into a 11.7% transplant or death. The amoxicilina-clavulánico is the drug most commonly associated with hepatotoxicity.

Author: García Cerecedo Tomás.
Year: 2006.
University: LLEIDA [www.udl.es].
Place of defense: Facultad de Medicina.
Place of preparation: Facultad de Medicina. Universidad de.

Author: López Posadas Blanca.
Year: 2006.
University: VALLADOLID [www.uva.es].
Place of defense: Facultad de Medicina.
Place of preparation: Facultad de Medicina, Universidad de Valladolid.

Summary: Fragile X Syndrome (FRAXA, OMIM 309550) is one of the human disease

Author: Manrique Ruiz Francisco.
Year: 2006.
University: VALLADOLID [www.uva.es].
Place of defense: Facultad de Medicina.
Place of preparation: Facultad de Medicina de Valladolid.

Summary: INTRODUCTION: The premature birth is the biggest problem of Obstetrics and Spain in the last decades is increasing, reaching 7.1% of all births. The objectives of this study were, the value of the vaginal ultrasound as a method of forecasting premature delivery, effectiveness of different measures ultrasonographic cervical relation to preterm birth and curves of the normal uterine cervical length. MATERIALS AND METHODS: We conducted a cohort study of initiation, prospective fetus in pregnant women with single. Three measurements were made along the pregnancy, in 22.28 and 32 weeks in 430 pregnant. They were to measure the length of the cervix, the dilation of the internal cervical os, if any, and the index neck. RESULTS: The length of the cervix is decreasing, both in deliveries at term and in preterm deliveries. The length of the cervix at week 22 gives a sensitivity of 27.8%, a specificity of 95.1%, Positive Predictive Value of 20% and a ratio of Positive Verosimilitud of 5.7. To do not improve in the following measurements. The dilation of the internal cervical os presents a worst values, which are improving along the pregnancy. The index cervical presents very poor performance and highly irregular. CONCLUSIONS: vaginal ultrasound as a screening test of preterm labor is not effective. Measuring the length of the cervix is the one that best result. The curves of the normal length of the cervix have great breadth and fall along the pregnancy.

Author: DEL RÍO SOLÁ MMa.LOURDES.
Year: 2006.
University: VALLADOLID [www.uva.es].
Place of defense: FACULTAD DE MEDICINA DE VALLADOLID.
Place of preparation: FACULTAD DE MADICINA DE VALLADOLID.

Summary: EFFECT OF ACID ACETILSALICÍLICO IN ÚLCERA VENOSA OF EXTREMIDAD LOWER AND EXPRESSION IN GENE QUEMOQUINAS PROINFLAMATORIAS IN VENAS VENOSA FAILURE WITH CHRONIC. Introduction: The concept of chronic venous insufficiency (CVI) indicates the existence of a malfunction of the venous system of the lower limb caused by valvular incompetence associated with or without obstruction of venous flow in the presence of clinical signs and symptoms resulting from venous hypertension (HTV). The interest in understanding the pathophysiological mechanisms of chronic venous disease is to establish targets pharmacological interveners to improve their treatment. Assuming that the leukocyte activation is an important mechanism in the perpetuation of venous insufficiency and platelets, as a reflection of the systemic inflammatory response, can be relevant in the genesis of venous disease, the inhibitor drugs and leukocyte activation!