CLINICAL PATHOLOGY

Author: SCHWARZ CHAVARRI HERNANN FRANCISCO.
Year: 2002.
University: MIGUEL HERNÁNDEZ DE ELCHE [www.umh.es].
Place of preparation: FACULTAD MEDICINA CAMPUS SANJUAN.

Author: RUIZ RUIZ EVA.
Year: 2002.
University: AUTÓNOMA DE BARCELONA [www.uab.es].
Place of defense: FACULTAD DE MEDICINA.
Place of preparation: ESCUELA DE POSTGRADO.

Summary: The fisioptaología of spills Pleural (DP) is not entirely adarada. The angigénesis, important inflammatory and neoplastic processes, has been little studied in the pleural space. We studied factors activators and inhibitors of angiogenesis in various etiologies of DP and its association with other systems involved in its fisiopatía. The angiogenic factors (VEGF b-FUF) and TSP-1 (Trambospondina) are higher in drips -- --- being the group empienas and --- complciados those with higher values. These factors present a response compartimentalizada level of pleural and positively correlated with low levels of glucose, pH, high levels of LDH, markers of inflammation (elastase, IK-8, TNF *) inhibitors the activation of plasminogen (PAIs) favoring the deposit of fibrin and MMP-9, and a negative correlation with tissue plasminogen activator (t-PA) which promotes fibrinolysis and MMP-2. Likewise, MD To --- with highest VEGF b-FGF and TSP-1 have a higher incidence of pagmipleritis.

Author: SAEZ PARRA JESÚS.
Year: 2003.
University: MIGUEL HERNÁNDEZ DE ELCHE [www.umh.es].
Place of defense: MEDICINA.
Place of preparation: FACULTAD DE MEDICINA.

Summary: INTRODUCTION The TAP (urine), and more recently CAPAP (serum and urine) have proved useful in the prognosis of acute pancreatitis (AP). OBJECTIVES 1-Evaluate the clinical utility of CAPAP (serum and urine) and TAP (urine) in the early prognosis of the PA. 2, - compare both peptides activation in the prognosis of the PA, in a series of patients. 3-Study profiles evolutionary TAP and CAPAP during the three days of hospital admission. MATERIALS AND METHODS were included in a prospective study of patients with PA minor 24 hours of evolution. We obtained samples of blood and urine in the first, second and third day of hospitalization. The gravity of the PA was established according to the criteria in Atlanta. For the measurement of CAPAP using a method of RIA (Euro-Diagnóstica) and TAP an ELISA (Biotrin). RESULTS were included 52 PA (27 men and 25 women, age: 62.9 years). Seventeen were serious. The etiology biliary was the most frequent. The medians of serious PA were significantly higher than those of the minor in the first and second day admission for CAPAPs and in the three days covered for CAPAPo and TAPo. Within the first day of admission on TAPo, got the best results (cut-off: 18.10 nmol / L, SE: 92.3% ES: 80%, VPP: 63.2%, VPN: 96.6% , LR (+): 4.61). When we select those pancreatitis lesser of 24 h.de developments since the beginning of the symptoms of CAPAPo was the best prognostic marker (cut-off: 15.45 nmol / L, SE: 88.9%, ARE: 81 , 3%, VPP: 72.7%, VPN: 92.9%, LR (+): 4.72). CONCLUSIONS 1, - TAP (urine) and CAPAP (serum and urine) are excellent markers of gravity in PA. 2-Both the TAP (urine) as the CAPAP (serum and urine) reach their peak concentrations within the first day of hospitalization, introducing a progressive decrease of the same in the days following the study. 3-Within the first day of hospitalization (first 48h.de clinical evolution) TAP in urine is the best prognostic marker. 4 - If you are selected only those patients whose first sample of serum and urine is obtained within the first 24 hours of developments since the beginning of symptoms, CAPAP urine presents the best results. 5, - Within the first 24 hours of clinical outcome, the combination of TAP and CAPAP urine gets better results than either marker alone. 6 - The results are similar to those of previous work and reinforce the role of these peptides in the early prognosis of the PA.

Author: SANCHEZ SANCHEZ M. CARMEN.
Year: 2003.
University: AUTÓNOMA DE MADRID [www.uam.es].
Place of defense: FACULTAD DE MEDICINA.
Place of preparation: FACULTAD DE MEDICINA UNIVERSIDAD AUTÓNOMA DE MADRID.

Summary: The cerebral ischemia is one of the most important manifestations of atherosclerosis, and can affect both the extracranial arteries to the aterias extracranial as to the cause intracranial stenosis in vessels. Patients with intracranial arterial stenosis and stroke have a high rate of recurrence of ischemic events, intra and extracerebrales, and a high mortality. They can benefit from specific treatments such as angioplasty or endovascular prosthesis with good results. It forced her diagnosis, but the full exploration of intracranial vascular tree is not done routinely in all patients with stroke. We intend to describe the characteristics which identify these patients to participate in a more comprehensive study. OBJECTIVES 1, Exploring the clinically relevant epidemiological characteristics of patients with intracranial arterial stenosis and stroke, establish differences according to sex and to identify the risk factors that influence its development. 2-Analyze the clinical characteristics and form of cerebral ischemia in patients with stroke and intracranial arterial stenosis and differentiate them from those who have other stroke patients, looking for the difference of sex. 3-Studying the characteristics of neuroimaging, neurosonológicas and intracranial arteries affected in patients with stroke and intracranial arterial stenosis. To investigate the relationship between ateromatosis stenotic carotid and intracranial vessel and carry out a study to match interobservador diagnosis by transcranial doppler of intracranial arterial stenosis. 4, discussing the differences between patients with cerebral ischemia and intracranial arterial stenosis in front of the carotid ateromatosis. MATERIALS AND METHODS Prospective study of a number of cases with sampling opportunity on patients with stroke admitted to the Stroke Unit of the Hospital Clinic San Carlos in Madrid between January 2000 and August 2001. We excluded those with different diagnosis of cerebral ischemia, exitus early or study neurosonológico incomplete, or stricture disease or intracranial arteries carótidas cause ateromatosas not. The variables studied were age, sex, hypertension, diabetes, high cholesterol, smoking, previous stroke, heart isquémica or embolígena, intermittent claudication, number of vascular risk factors, presentation, territory and clinical category of stroke, carotid ateromatosis and quantification, prior injuries in cranial CT, the presence of intracranial arterial stenosis and arteries estenócitos and its etiological role in the stroke. Statistical analysis was performed comparing populations as submitted isolated intracranial arterial stenosis ( "intracranial"), ateromatosis extracranial carotid ( "Carotídea"), two ( "two") or without ateromatosis ( "no") and then compared all patients intracranial arterial stenosis ( "intracranial" and "both") compared to the other through test Chi-Cuadrado, or a factor ANOVA statistical Fisher. The study was conducted multivariate logistic regression to identify the variables associated with the presence of intracranial arterial stenosis. RESULTS included 179 patients were divided into 5 groups: "intracranial" 16% (30); "both" 12% (23); "carotid" 19% (35); "none" 41% (75) and "no window" 8.95 (16). Risk factors with differences among them were: diabetes and hipercolestrolemia more frequent in group "intracranial" (50% compared to 18-39% and 66% compared to 25-58% respectively); stroke prior to "both" (52% compared to 16-29%) and cardipatía ischemic in the "carotid" (38% vs. 12-21%). In comparison by gender, only hypertension was less frequent in the "both" and 8 "no 19dd" compared to others (44% vs. 70-85%). The NFRV was higher in the groups "intracranial" and "both" (higher 3 compared with less inthe others) and stay half what it was in "both" and "carotid" (7.76 and 7.44 days compared to 5, 05-7,29 days, especially for women). Patients younger men were in the group "no" (66.5 compared to 70-77 years) and women in the group "intracranial" (69.5 versus 72-77 years). The most common clinical presentation of patients with stroke and intracranial arterial stenosis was LACI (37-46%) but women were twice as PACI that LACI in groups "intracranial", "two" and "carotid." No patients with intracranial arterial stenosis was presented as TACI. The area most often affected in all groups was the former, but the group in the frequency of intracranial territory later was higher (33.3% in the group "intracranial" versus 6,3-8,6 in others) for both men and women. The 9.4% of men admitted to the unit and 3.7% of women had at least one intracranial arterial stenosis, which was the cause of stroke in 5.3% of patients included in the study and 3 , 4% of the people in the unit. Diabetes (OR 3.5 [1,7-7,2]) and previous stroke (OR 2.4 [1,1-5, 0 [) were factors reisgo of intracranial arterial stenosis in the sample. By sexes were for men diabetes (OR 4.5 [1,8-11,1 [) and for women hypercholesterolemia (OR 4.4 [1,3-17,4]) and prior stroke (OR 7.3 [1,7-29,9]). In the group with intracranial arterial stenosis average NFRV was 3.0 and the average stay 7.4 days, compared to the group without intracranial arterial stenosis (NFRV 2.3 and 5.7 days of stay). The clinical category of stroke majority was aterotrombótica (56%) in the group of intracranial arterial stenosis followed by the illness of small vessels (22%), while the group without stenosis was more frequent disease of small glass (33% ), followed by myocardial indeterminate (28%). Women with intracranial arterial stenosis had a frequency of 5.9% cardioembolic stroke. Women with intracranial arterial stenosis had a frequency of leucoaraiosis of 12.5% in CT compared with 41% in the group without intracranial arterial stenosis. The frequency of carotid ateromatosis of any type was 44% in the group with intracranial arterial stenosis and 32% in the group without stenosis. The moderate carotid ateromatosis was more frequent in the "both" (33%), the grave in the "carotid" (39%) and in general, the carotid disease, in the presence of intracranial arterial stenosis, it was mild or moderate and never was severe, especially in the case of women. Patients in the group "intracranial" showed a higher frequency of diaberes (50%) and affectation territory later (33%) than those of group "carotid" (20% and 8.6% respectively). The women were younger (69%) and had less heart embolígena in the "intracranial" that the "carotid" (76 years and 57% of heart disease). For their part, the men's group "intracranial" had fewer ischemic heart disease (16% vs. 42%) and diabetes (55% vs. 17%) than the group "carotid." The 53 patients had 89 vessels estenóticos: 29% ACM, 28% sifones, 13% AV, 12% AB, 10% and 6% ACP ACA spread as only 49% stenosis, dobre 37.7%, triple 9% and quadruple 3 %. The 28% ICA stenosis presented and ACM or siphon ipsilateral, but only 0.01% serious injury associated with carotid artery stenosis distal intracranial. Patients with symptomatic intracranial arterial stenosis were women in greater proportion (40%) with greater involvement of the territory later (32%) and stenosis, multiple (55%). Conclusions The frequency of intracranial arterial stenosis among patients with ischemic stroke is 11.45% (13.9% for men and 6.6% among women). The intracranial arterial stenosis is a cause of stroke in 5.38% of patients. Risk factors for filing estenois arterial intracranial are: diabetes (OR 3.5), previous stroke (OR 2.4) and the territory later clinical impairment (OR 3.2). The risk factors are gender: men, diabetes (OR 4.5) and in women after stroke (OR 7.3) h hypercholesterolemia (OR 4.7). In patients with intracranial arterial stenosis is the most common clinical presentation as myocardial territory later (POCI) than in patients without intracranial arterial stenosis and the subtype is the most common etiologic atherothrombotic. In analyzing gender, men in the most common clinical presentation is the lacunar infarct and women alike lacunar infarction and myocardial partial territory earlier. Patients with cerebral ischemia and etenosis blood has a higher incidence of intracranial lacunar infarctions previous TAC and women with cerebral ischemia and intracranial arterial stenosis presented less frequent leucoaraiosis in TAC. Half of the patients with intracranial arterial stenosis have compromised more than a glass and in order of frequency vessels most affected are: ACM, sifones, VA, BA, ACA and ACP. The symptomatic intracranial arterial stenosis are more frcuentes in women, in vessels of the territory later, and in patients with multiple stenosis. Diagnosis through transcranial doppler of intracranial arterial stenosis is a concordance of 100%. Patients with intracranial arterial stenosis and stroke have a higher frequency of diabetes and no affectation of territory later than those with atermoatosis carotid and intracranial ateromatosis women are younger and have a lower frequency of enferemedad cardioembólica than those with ateromatosis carotid.

Author: EPELDE GONZALO FRANCISCO DANIEL.
Year: 2004.
University: AUTÓNOMA DE BARCELONA [www.uab.es].
Place of defense: FACULTAT DE MEDICINA.
Place of preparation: ESCUELA DE POSTGRADO.

Summary: There is little information concerning the treatment in the acute phase of acute myocardial infarction in the emergency department while hospital as prehospitalarios. Objectives The objectives of the thesis was to study the causes of which were not conducting treatment revascularizador in AMI when it was indicated that entailed consequences in terms of morbidity and mortality of patients and which were the points in the chain of assistance for improvement . METHOD To achieve these theses created a record multicenter, longitudinal, observational and open the area covering all of the emergency services in Spain. The record was called RESIM (Registry of Emergency Acute Myocardial of Myocardium). All emergency services Spaniards were invited to participate through the Working Group Ischemic cardiomyopathy of the Spanish Society of Emergency Medicine (SEMES). It was considered as one unit to the hospital to have a heart emergency department that serves patients with AMI for 24 hours a day regardless between May 1, 2003 and May 1, 2004. RESULTS were studied 3318 patients suffering from acute myocardial infarction transmural served in 40 emergency services Spaniards. A 40.1% of the patients were older than 70 years (the patients over 70 years old were collected in previous studies). Just a 1.1% received thrombolysis prehospitalaria, a 37.4% thrombolysis in emergencies and a 5.7% was treated by primary angioplasty. With regard to transportation appreciated that patients are transferred to hospital by their own means arriving earlier than they do most transport medicalized (p less 0.03). The first reason not to receive fibrinolytic therapy was transferred to another unit (ICU), being the second delay in the arrival at the hospital and the third non-availability of fibrinolytic in the emergency department. Patients who are fibrinolisaron in emergencies had a mortality of less than 30 days which also taking indication of fibrinolysis were transferred to another unit to receive such treatment (p less 0003). The delay in the arrival doctor at the hospital since the onset of pain was 120 minutes, making it difficult to spread the technique of revascularization by angioplasty. CONCLUSIONS * A record of continuous attention to AMI reflecting the acute phase of treatment in the hospital emergency room prehospitalarias and in a useful tool in health planning, and has allowed objective data is not known so far. * The administration of the therapeutic revascularization is dependent improvement. The thrombolysis can be given more precocity and the practice of angioplasty is not offering to cases that would benefit most. These problems could be solved with improved circuits attention to AMI. * The failure of the system not administer treatment revascularizador early increases the mortality of patients suffering from an acute myocardial infarction. * Better coordination between levels of care would improve attendance at AMI, allowing reduce delays, direct tax angioplasty patients to the centers of reference and administer thrombolysis prehospitalaria Patients in the therapeutic window.

Author: MORELL JIMENEZ VALENTINA.
Year: 2004.
University: MÁLAGA [www.uma.es].
Place of defense: FACULTAD DE MEDICINA.
Place of preparation: FACULTAD DE MEDICINA.

Summary: In this dissertation has made a study of 100 diabetic patients of a Center for Salud.En tosos them, it was determined, in addition to blood glucose, hemoglobin A1c, homocysteine, anthropometric measures and other biochemical parameters. It realizao a exloración complete physical, their habits, as well as a nutritional risk assessment (test MNA and NSI). The processing was performed using statistical program Stargraphics 5.0 plus. The study drew the following conclusions: - The assessment of nutritional risk in population follower of a Mediterranean diet, nutritional available through the test in the scientific community, the MNA and the NIS, it is not correlated with variables indicating cardiovascular risk. The test-MNA and NSI are useful in the study of malnutrition hipoalimentación in type 2 diabetes. - The anthropometric measures, accompanying tests valuation food, there are very useful because they correlate with markers of diabetes and cardiovascular risk. - In this study, an assessment of diabetes conducted according to the grouping of patients according to the values of A1C provides more knowledge, early on, and more accurate diabetic syndrome that the glucose basal.Dichos levels are associated with elevations the homicsteína, especially at the same time there is hypertension. With the data obtained, and using multiple regression analysis and logistics, have developed two models multiparamétricos.

Author: GARCÍA RETORTILLO MONSERRAT.
Year: 2004.
University: BARCELONA [www.ub.es].
Place of defense: FACULTAD DE MEDICINA.
Place of preparation: HOSPITAL CLÍNIC DE BARCELONA. FACULTAD DE MEDICINA.

Summary: The recurrence of HCV infection occurs universally after liver transplantation (TH), the liver secondary to the recurrence of the infection after the TH progressing more quickly than in immunocompetent subjects and conditions even worse graft survival and patient. * The study of the kinetics of viral HCV during transplantation and in the phase immediately following. Through this study described a rapid decline of viral load at the stage anhepática and the reperfusion due to the lack of production of virions and hepatic clearance. However, the HCV genome is detectable during virtually the entire process and it is from these particles are circulating that infects the graft. The viral replication begins a few hours after reperfusion liver as evidenced by the increase in viral load which occurs in the following days. * Efficacy and safety of antiviral therapy with interferon and ribavirin in cirrhotic patients infected with HCV on the waiting list for liver transplantation. One of the strategies proposed to prevent the recurrence of the infection after the TH is the eradication of HCV phase pre-TH. The advanced cirrhosis is a contraindication for antiviral therapy with interferon and ribavirin. However, with an appropriate selection of patients and closely monitoring the effectiveness of antiviral therapy reached 30% (Loss of HCV RNA). A 20% of patients in the study was able to avoid the recurrence of the infection after transplantation. * Recurrence of HCV infection after receiving organs in TH cadavéricos versus receiving living donor. Through this prospective study showed that the recurrence of HCV infection in recipients of living donor is significantly worse than in the recipients of organ cadavérico. Complications bile or the phenomenon of liver regeneration might justify this increased aggressiveness. These results should be taken into account in decision-making on the part of different teams transplant because it could jeopardize the survival of the graft and patient.

Author: KANTEREWICZ BINSTOCK EDUARDO.
Year: 2004.
University: AUTÓNOMA DE BARCELONA [www.uab.es].
Place of defense: FACULTAD DE MEDICINA UNIDAD DOCENTE HOSPITAL DEL MAR.
Place of preparation: ESCUELA DE POSTGRADO.

Summary: Introduction: Colles fracture (HR) is considered as the first episode in the natural history of osteoporosis postemenopáusica. In the review of the literature shows that several aspects of this divide and its relationship with osteoporosis systemic had not been addressed in our midst. Overall objective: to further clinical and epidemiological relationships between Colles fracture (HR) and generalized osteoporosis in women older than 45 years, the vast majority postmenopausal. Specific objectives: 1/analizar partnership between the CF and osteoporosis widespread through the study of BMD at the wrist, hip and lumbar spine in a consecutive series of women with CF and in a control group. 2 / assess whether there were differences depending on the age of the participants. 3 / estimate the prevalence of vertebral fractures by the use of morphometry spinal technology DEXA (MXA) in women with CF. Methods: The study of incident cases and controls 18 month conducted at the General Hospital of Vic (Barcelona). The cases were collected after going to the emergency department and control populations were invited to participate by their family doctors. Bone densitometry was performed and a spinal morphometry all participants and saw the relevant demographic and clinical information. Results: involving 58 cases and 83 controls. The average age of the cases was 65 years and controls 58 (p greater 0.05). After adjusting for age, menopausal similarity, and the body mass index, the cases showed a lower bone mass than controls in all locations studied (p greater 0025). Overall frequency of osteoporosis according to WHO criteria was 60% in cases and 30% in controls (p greater 0025). These differences were more pronounced in patients manores of 65 years. In this subgroup, the FC was significantly associated with osteoporosis lumbar (OR 309 95% CI 1.1-14.3), and showed a trend in the area femoral (OR 2.6 95% CI 0,7-9,0 ) Kanterewicz E Yanez A Pérez-Pons A Codony I Del Rio L, Díez - Pérez A. Association between colles'fracture and loe bone mass: age-base differences in postmenopausal women. Osteoporos Int 2002, 13: 824-828. By MXA the prevalence of vertebral deformities was 19% in cases compared with a 11% in controls (ns), with an increased frequency of fractures in patients younger than 65 years (18% vs. 5%, p = 0, 06) Kanterewicz E Yanez A Del Rio L, Diez fracturae. J Clin Densitom 2003; 6:359-365. Conclusion: The FC is shown as an event relaiconado with osteoporosis widespread and more specifically with younger women in the category of osteoporodis postmenopausal. The younger postmenopausal women with a recent FC should be regarded as a population at risk of osteoporosis.

Author: BELENGUER PRIETO RAFAEL.
Year: 2004.
University: SALAMANCA [www.usal.es].
Place of defense: EDIFICIO ANTIGUO.
Place of preparation: DEPARTAMENTO DE MEDICINA.

Summary: We evaluated the quality of life related to health (CDVRS) in a wide range of patients with syndrome Sjà ¶ gren primary (SSP) using the questionnaire SF-36, analyzing the association with the main features psychosocial, clinical and immunological of patients. We studied 110 patients (105 women and 5 men, with an average age of 56 years). As benchmarks we use those published in the Spanish version of the questionnaire health SF-36 in healthy population. When comparing the values between the two groups, patients with PSS scores lower on all scales of the SF-36: role physical (50 vs.. 73, p less 0001), role emotional (73 vs.. 84, p less 0001), vitality (46 vs.. 60, p less 0001), mental health (53 vs.. 68, p less 0001), social function (72 vs. 79, p = 0017), bodily pain (55 vs. 68, p less 0001) and function physical (61 vs.. 65, p = .0867). No differences were found in scales SF-36 to compare patients with PSS according to the presence or absence of expression of dry, except for the vaginal dryness. Patients with impairment extraglandular scores lower on the scale of vitality (40 vs.. 54, p = 0.007), social function (67 vs.. 79, p = 0.01), bodily pain (49 vs. 62, p = 0018 ) and general health (38 vs.. 49, p = 0001). Finally, 40 (36%) patients with PSS met criteria qualifiers fibromyalgia (FM), with significantly lower scores in all scales SF-36 regarding patients without FM. In conclusion, patients with PSS presented a clear decline in CDVRS compared to the general population, with statistically significant decrease in 7 of 8 scales SF-36. Clinical manifestations which affected most to the decline in CDVRS of patients with PSS were the existence of vaginal dryness, parotidomegalia, strangle affectation (especially lung) and especially the coexistence FM.

Author: GONZALEZ CALVO JAVIER JOSE.
Year: 2005.
University: VALENCIA [www.uv.es].
Place of defense: FACULTAD DE MEDICINA Y ODONTOLOGIA.
Place of preparation: FACULTAD DE MEDICINA Y ODONTOLOGIA.

Summary: SE REALIZ THE ENDODONCIA IN VITRO ON 42 TOOTH HUMAN OBTURADOS THROUGH CONDENSACION SIDE OF GUTAPERCHA And SEALANT AH26, STUDY THE DESADAPTACION OF THE MATERIALS OBTURACION TO THE WALLS OF CONDUCT ON THE ROLE OF THE VISCOSITY SEALANT AND THE PRESENCE / LACK OF CLAY DENTINARIO. AFTER DESCALCIFICACION And DIAFANIZACION RESULTS MOSTRARON THAT IS INCOMPLETE SELLADO OF CONDUCT IN THE MAJORITY OF CASES AND THAT DESADAPTACION IS AJENA TO PRESNCIA OR NOT IN CLAY DENTINARIO IN THE TWO VISCOSIDADES PROPOSALS. VISCOSITY THE LEAST DENSA OF SOMETIMES SEALANT PROVIDES AN ADEQUATE SELLADO BUT FRAGMENTARIO. THE TECHNICAL CONDENSACION SIDE WITH THE SEALANT AH26 IN TWO VISCOSIDADES ENSAYADAS MEANT FOR THE SAME IS, ONE CAUSE OF FILTRACION WITHOUT THAT MEDIEN OTHER CIRCUMSTANCES AGRAVANTES.

Author: BAYÓ LLIBRE JOAN.
Year: 2005.
University: BARCELONA [www.ub.es].
Place of defense: FACULTAD DE MEDICINA.
Place of preparation: FACULTAD DE MEDICINA.

Summary: OBJECTIVE To determine the diagnostic performance of the automedida blood pressure at home (AMPAd) in the diagnosis of hypertension clinic isolated (HCA) using a three-day program of reading. MATERIALS AND METHODS included one hundred ninety patients recently diagnosed hypertension ligeramoderada untreated, selected consecutively from 4 primary care centers in the city of Barcelona. Each patient did readings AMPAD in triplicate in the morning and at night for 3 consecutive days, followed by monitoring ambulatory blood pressure (MAP) of 24 hours. The cutoff point of normalcy for AMPAd and daytime MAP was 135/85 mmHg. RESULTS Sixty-three patients were diagnosed with HCA with AMPAd (34.8%, 95% CI, 27.9-42.2) and 74 with MAP (41.6%, 95% CI: 33.7-48.4). No statistically significant difference was observed between the values of AMPAd and the MAP diurnal (137.4 [14.3] / 82.1 [8.3] mmHg). The parameters of diagnostic performance of the AMPAd were: S 50.0% (95% CI 38.3-61.7), E 75.7% (95% CI 66.3-83.2), and VPP VPN 58.7% (95% CI :45.6-70 .8) and 68.6% (95% CI 59.4-76.7), respectively and CPP and JNC 2.05 and 0.66 respectively. An analysis by a ROC curve (receiver operating characteristic) of the different cut points of normality was not obtain significant improvements in the diagnostic performance of the AMPAd. CONCLUSIONS An Agenda for 3 days of readings AMPAd in the diagnosis of HCA has obtained a low diagnostic accuracy. The MAP remains proof efección in this indication.

Author: GONZALO SANZ RICARDO.
Year: 2005.
University: AUTÓNOMA DE BARCELONA [www.uab.es].
Place of defense: FACULTAD DE CIENCIAS.
Place of preparation: ESCUELA DE POSTGRADO.

Summary: The human mitochondrial genome is a circular molecule dual chain 16.5 kb. In its sequence information exists for 13 polypeptides from different subunits of complex I in the transport chain mail (CTE) to 22 ARNt and 2 ARNr. A mutation in either of these genes can cause the CTE not work, leading to a malfunction of oxidative phosphorylation system, causing one hand a shortage of energy in cells or tissues, or on the other hand an increase in production reactive oxygen species (ROS). If the production of ROS is more important than the action of the antioxidant defenses, it can cause injury ra comes in different cellular components such as lipids, proteins or ADNmt. To delve into this area, this paper firstly have four patients diagnosed with mitochondrial disease, carriers of a mutation in the mitochondrial genome. Since platelets of these patients were generated hybrid transmitocondriales, which have been used as a model for study. We have studied the following mutations in mitochondrial genes: T14487C in subunit ND6 of complex I, A3243G in the transfer RNA Leu (UUR), A8344G in the transfer RNA Lys G6930A in the subunit COXI of complex IV. Analyzing the production of hydrogen peroxide as a measure of the production of ROS in these four lines, we noticed that the lines carry a mutation that affected the operation of complex I and III, namely A3243G, A8344G and T144874C, it caused an increase in the production, while the mutation does not reflect on these complex (G6930A) without causing increased. Subsequently, it has been studied whether this increase resulted oxidative damage to various cellular components, such as lipids, proteins and ADNmt own. It was noted that there was only lipid oxidative damage in the line carrying the mutation T144874C, while the other had not. The protein oxidation damage was not seen in any of the four lines carrying the mutation and in the oxidation of ADNmt, oxidative was observed in lines carrying mutations A8344G and T14487C. These results suggest that some mutations in the mitochondrial genome production of ROS generated exceeds the capacity detoxoficadora of the cell, causing oxidative damage, while in others the production of ROS does not exceed the activity of antioxidant enzymes.

Author: GONZÁLEZ SUÁREZ SUSANA.
Year: 2005.
University: AUTÓNOMA DE BARCELONA [www.uab.es].
Place of defense: HOSPITAL UNIVERSITARIO VALL D'HEBRON.
Place of preparation: VALL D'HEBRON.

Summary: In this thesis identifies and compares the effects of anesthesia and analgesia for postoperative residual ropivacaine and levobupivacaían in the brachial plexus block level axillary through technical estimulación-infiltración nervous selectively in patients requiring surgery elbow, forearm and hand. These two local anesthetic are newly introduced, high power and lower toxicity anesthetic bupivacaine, and comparative studies of both local anesthetics are minimal and with inconclusive results. That is why we conducted a randomized study that after obtaining the consent of the patients into two groups distribute the study as receiving ropivacaine or levobupivacaine. We manage these local anesthetics to average concentrations which produce motor block at least epidural to thirty minutes in the first stage of labor (0.5% and 0.33% ropivacaine for levobupivacaine). These local anesthetics administered in a volume of 30 ml, with total doses of 150 mg and 99 mg ropivacaine for levobupivacaine. Following the completion of the blockade, this was assessed every 5 minutes to 30 minutes of their execution, during surgery, and every 6 hours until the first 24 hours of infiltration anesthetic in the postoperative period. The results showed an onset and slow progression of blocking more with levobupivacaían with ropivacaine, with a time lock surgical similar. However, the duration of sensory block was greater with levobupivacaían with ropivacaine and postoperative analgesic requirements were also lower with levobupivacaine with ropivacaine.

Author: PÉREZ FORMOSO JOSÉ LUIS.
Year: 2005.
University: SEVILLA [www.us.es].
Place of defense: FACULTAD DE MEDICINA.
Place of preparation: HOSPITAL UNIVERSITARIO VIRGEN MACARENA.

Summary: The cultivation of the olive tree in Spain, is spread over all regions except the north. In Andalusia, focuses mostly with nearly 60% of the total cultivated hectares. Given its wide distribution, the incidence of olive pollen allergy is very high in our area. At present, about 20 allergens are known pollen olive, of which 10 have been sequenced and nominees from Ole e1 to Ole and 10. The main allergen majority is Ole e1, but the Ole e2 or profilina olive protein is a ubiquitous, highly distributed and presented by cross-reactivity with multiple food and vegetables. We studied this protein to see its impact on patients allergic to olive. In addition obtained through recombinant DNA technology protein, in order to see if it was equivalent to that obtained in a natural way, from a diagnosis. After studies in vivo (prick-test) and in vitro (specific IgE, Elisa inhibition), we note that both molecules differ in diagnostic and therapeutic capabilities, and thus we can deduce that they are not identical. These differences may be explained by several reasons, such as the pollen source from which we get the pollen extract olive, the sensitivity of individual patients that are performed on the tests, the genetic variability of these patients, different epítopos Submitting protein, the structure 2Â ° and 3Âş of the protein to be expressed in the expression system selected, the various expression systems where they can synthesized protein, the protein polymorphism, and that there may be different isoforms of the same protein. Because of the similarity between the family of profilinas, we decided to see if there was any relationship between profilinas human and profilina olive. This got proflina of human platelets and conducted in vitro analysis to patients, where we observed that there was a correlation, albeit weak, between them. Finally we analyze the cantad of profilinas olive that had at various excerpts from commercial houses, used for immunotherapy, and objetivamos none of them take into account the amount of profilina olive for elaboration, and only estimated the amount of allergen greater Ole e1, with the consequent effects on patients sensitive to profilina.

Author: SEGOVIA CORRALES EDITH ALBA LUZ.
Year: 2005.
University: BARCELONA [www.ub.es].
Place of defense: FACULTAD DE MEDICINA.
Place of preparation: FACULTAD DE MEDICINA.

Summary: The ovaries or female gonads under two essential functions. Production and female gametes are creating hormones, primarily estrogen and progestogen. They are coated with a surface epithelium suffering a break in each ovulation to permit the release of oocyte. In this epithelium originates 90% of ovarian tumors. The ovarian carcinoma has a great interest not so much because of its effect (representing about 4% of lso tumors in women) but because of its high mortality, mainly due to its late diagnosis. Although for years are shuffled various hypotheses on the origin of ovarian cancer, it has not yet been able to prove their veracity. The main theories argue that the transformation oncogénica epithelial surface would be good due to breakage and repair of this cyclical epithelium or the hormonal stimulation that accompanies each ovulation, although both theories are not mutually exclusive. The action stimulates the proliferation exerted by estrogen has been well documented for years. Several epidemiological data suggest that women who use hormone replacement therapy with estrogen are at increased risk of developing ovarian cancer. Estrogens act primarily through two receptors: estrogen receptor alpha ER * and the estrogen receptor beta ER *. Although both receptors are present in the ovarian surface epithelium, the response rate of ovarian cancer to anti-estrogen (tamoxifen) is well below that of breast cancer. One of the differences between the two types of cancer is the ratio of expression of ER and ER * *** While in the breast ** ER expression is minimal, this protein is expressed quite abundant in the ovary. At the time to raise this work, some studies suggested that ER and ER * ** exercising an action contrary on cell proliferation, as a stimulator * ER and ER ** an inhibitor of the same. Because of the limited knowledge on the expression and distribution of this second receiver in ovarian cancer and in cell lines derived from the same, we decided to initiate this study. The primary objective has been to know the expression of ER ** in ovarian cancer of epithelial origin, both RNA and protein, as well as its relationship with the expression of ER *, P450 aromatase and Cyclooxygenase-2 and its correlation parameters with clinical, pathological and evolutions of the affected patients.

Author: GUTIERREZ MORALES JULIO CESAR.
Year: 2006.
University: OVIEDO [www.uniovi.es].
Place of defense: SALA DE GRADOS. EDIFICIO SANTIAGO GASCON.
Place of preparation: HOSPITAL CENTRAL/FACULTAD DE MEDICINA DE OVIEDO.

Summary: Despite recent advances in the field of cellular and molecular regulators of tumor angiogenesis, we are far from understanding the complex interaction and collaboration orderly between the different elements involved in this process. Knowledge of these mechanisms allow explain how to tumor invasion and growth eminently infiltrativos as are by definition of brain gliomas, allowing even the development of therapies based on specific targets of the attack. Therefore, in this paper we studied the microvascular proliferation and cell tumor of oligodendrogliomas through a morphometric immunohistochemical analysis, to assess the possible contribution of pericito in those events. In addition, it has analyzed the role in the progression tumoral-microvascular oligodendroglial by some factors crecimie4nto (PDGF) and its receptors, as well as proteases of extracellular matrix (MMP-2 and MMP-9) and heparanasa

Author: TORO TORRES ENRIQUE JESUS DE.
Year: 2006.
University: CÓRDOBA [www.uco.es].
Place of defense: FACULTAD DE MEDICINA.
Place of preparation: FACULTAD DE MEDICINA.

Summary: Our work has been done in a rural health center belongs to the Northern Area Health Cordoba (ASNC). There has been a descriptive study of patients polimedicados who have come to search for dental treatment during the year 2003 with the objectives of characterizing medication consumed by these patients as well as the potential involvement of the same in the emergence of adverse drug reactions, interactions pharmacological and interference with the phenomena interventionist in the oral cavity. We have also tried to develop a range of strategies to apply to our health as to avoid the possible disadvantages arising from the use of polypharmacy. The main conclusions drawn in the study are the high percentage of patients polimedicados you see in our search for dental treatment and, moreover, are consuming an average of drugs very high, resulting in a high risk of potential occurrence of adverse reactions to drug interactions, and the vital importance that represents consulting dentistry availability of digital health history of each patient.

Author: BLANCO HUNGRIA ANTONIO MANUEL.
Year: 2006.
University: CÓRDOBA [www.uco.es].
Place of defense: FACULTAD DE MEDICINA.
Place of preparation: FACULTAD DE MEDICINA.

Summary: INTRODUCTION The use of criteria Research Diagnosis Criteria for Temporomoandibular Disorders, after its introduction by the University of Seattle, we have been endowed with an effective tool, in terms of clinical and research. This enables us to quickly and accurately obtain a reliable diagnosis five, along with an understanding of the psychological and socio-demographic aspects that accompany these patients. OBJECTIVES Obtaining a diagnosis Clinical (axis I) and psychosocial (axis II) of patients with orofacial pain, through questionnaires included in the criteria RDC / TMD. MATERIALS AND METHODS Patients presenting orofacial pain and temporomandibular dysfunction District Health Cordoba, they fall questionnaire RDC / TMD. The data obtained were analyzed using statistical program SpSS and 13 for Windows. RESULTS appreciate a clear predominance of females, with an average age of 40 years, most presented affectation muscle associated with a moderate degree of chronic pain associated with a higher incidence of depression, anxiety and somatisation, along with a high intensity pain. Los valores obtenidos son equiparables a los estudios internacionales realizados sobre poblaciones con diferencias étnicas y culturales sobre nuestra muestra. INTRODUCTION The use of criteria Research Diagnosis Criteria for Temporomandibular Disorders, after its introduction by the University of Seattle, we have been endowed with an effective tool, in terms of clinical and research. This enables us to quickly and accurately, obtaining a reliable clinical diagnosis, along with an understanding of the psychological and socio-demographic aspects that accompany these patients. OBJECTIVES Obtaining a diagnosis Clinical (axis I) and psychosocial (axis II) of patients with orofacial pain, through questionnaires included in the criteria RDC / TMD. MATERIALS AND METHODS Patients presenting orofacial pain and temporomandibular dysfunction District Health Cordoba, they fall questionnaire RDC / TMD. The data obtained were analyzed using statistical program SpSS v 13 for Windows. RESULTS appreciate a clear predominance of females, with an average age of 40 years, most presented affectation muscle associated with a moderate degree of chronic pain associated with a higher incidence of depression, anxiety and somatisation, along with a high intensity pain. The values obtained are comparable to international studies conducted on people with ethnic and cultural differences of our sample.