OCCUPATIONAL MEDICINE

Author: REDONDO GARCIA M. ANGELES.
Year: 2003.
University: COMPLUTENSE DE MADRID [More theses of this university] [www.ucm.es].
Place of defense: FACULTAD DE MEDICINA.

Summary: The Muscular Dystrophy - Duchenne (DMD) is a hereditary disease linked to the X chromosome, whether degeneratico, which affects both smooth muscles how estriados, causing fitiga muscle without effective treatment at present, but without a rehabilitation program comprehensive and left to its natural evolution occurs gradually paresis, the greater imbalance between the muscles agonists and antagonists, including the right / left, retraciones and deformations in mienbros and spine, etc. functional losses, leading to a unit for all activities of daily living, the confianmento in bed, and a insuficiendia respiratory rrestrictiva responsible in a large percentage of cases of deaths usually in the second decade of life. The affectation multisitémica in the evolution of the DMD Beyond fiber musculoskeletal, cardiovascular impairment, respiratory system, etc., has generated new lines of research and new prospects for treatment. We propose to initiate a new treatment for these patients in Spain, Mechanical Ventilation Night with nasal mask at home, and wanted to know whether it was useful, its beneficial effects and side effects. Following the literature review of the subject, has been trying Night Mechanical Ventilation through a group of 23 patients with Duchenne Muscular Dystrophy, in and through the changes in respiratory parameters obtained. For three years we analyze semestramente them young and the results are satisfactory.

Author: CABRERA MARTIN M. NIEVES.
Year: 2004.
University: COMPLUTENSE DE MADRID [More theses of this university] [www.ucm.es].
Place of defense: MEDICINA.

Summary: The objective of this thesis was to determine the usefulness of PET 18F-FDG in the diagnosis of residual disease, recurrent or metastatic carcinoma in patients with Thyroid Differential (CDT) after trataimento initial tiroidectomia and total dose ablativas of radioiodo present in clinical follow-up high concentrations of Tiroglobulina (Tg) plasma and Tastreo Corporal Total (RCT) with 131I negative. It selected a group of 58 patients with these conditions, which had made 64 studies PET1 8F-FDG and analyzed the validity of this technique on the basis of the Evidence-Based Medicine (MBE), the impact of the same in the therapeutic management of these patients as determined by Hicks et al, and the efficacy of PET 18F-FDG depending on the model of efficiency described by Fryback and Thornbury for diagnostic tests. We studied if there was a significant difference between the mean values of Tg plasma studies PET 18F-FDG positive for malignancy and in studies PET 18F-FDG with negative results, and if there was correlation between values catchment 18F-FDG quantified through Standardized Uptake Value (SUV) and the values of plasma triglycerides. It also carried out a systematic review of literature for relevant studies published between 1987 and October 2004 in which evaluate the usefulness of PET 18F-FDG in patients with suspected residual disease, recurrent or metastatic of CDT with high Tg RCT and negative. In work that met the inclusion criteria methodological quality was assessed according to criteria Huebner and compliance criteria MBE and the contribution of this technique to patient management along the lines of Fryback and Thornbury. We conducted a meta-analysis of the results obtained in this work, determining rates of sensitivity and specificity and overall rates calculated as weighted averages of individual indices. To assess the performance of a diagnostic test based on the results of the studies reviewed were developed curves receive-operating-characteristic (ROC) abstract.

Author: ABAD FERNANDEZ CARMEN.
Year: 2004.
University: COMPLUTENSE DE MADRID [More theses of this university] [www.ucm.es].
Place of defense: FACULTAD DE MEDICINA.
Place of preparation: FACULTAD DE MEDICINA.

Summary: Based on the essential characteristics of c.XVIII, is a comprehensive review of the work of painter Francisco de Goya y D. Lucientes.Se distinguish the cases set of disability, defined data directly with the disease and Works; explaining this relationship the documents written by the author and his críticos.Se defines invalid in the c.XVIII from a detailed analysis of the texts of medicine algebraic the time and their relationship to disease discapacidad.Se specify the origin of works of painter's features according to this selection criterion for inclusion. Finally, attention is determined to be invalid in the Corps Invalides documenting the socio-sanitaria assistance by the existing regulations of the time.

Author: MONTES DE OCA HERNÁNDEZ MARIA JESUS.
Year: 2005.
University: LA LAGUNA [More theses of this university] [www.ull.es].
Place of defense: UNIVERSIDAD DE LA LAGUNA.
Place of preparation: UNIVERSIDAD DE LA LAGUNA.

Summary: A sample of 416 construction workers on the island of Tenerife, are studied with a alergológica and evidence epicutáneas using the standard battery G. EIDC, finding positividades in 15.8% of cases. Of the positividades found for the 65% unrelated to the job and 35% are related to allergens present in the working environment. Of these highest positividades is obtained for the rosin 9.4% potassium 8.6% dichromate and nickel 4.7%.

Author: GARCÍA ALONSO M. PILAR.
Year: 2005.
University: COMPLUTENSE DE MADRID [More theses of this university] [www.ucm.es].
Place of defense: FACULTAD DE MEDICINA.
Place of preparation: FACULTAD DE MEDICINA DE LA UNVIERSIDAD COMPLUTENSE.

Summary: The systematic practice of ultrasound in monitoring the pregnant woman carries increased as the early detection of congenital malformations; hidrnefrosis is the anomaly detected more frequently assuming approximately, 50% of all injuries are. So in a 1-2% of all pregnancies are detected hydronephrosis in the fetus, and some, 50% of them are caused by stenosis of the union pieloureteral. The biggest benefit of prenatal diagnosis of hydronephrosis is in identifying those patients at risk of loss dela renal function secondary to obstructive uropathy. At present, the detection of obstruction of union pieloureteral asymptomatic has altered the natural history of this condition, the degree of obstruction render the clinical course of the same pretendiéndose at any time, the preservation of renal function. Despite the fact that the larger the magnitude of the renal pelvis greater likelihood there obst4rucción, ultrasound does not establish the diagnosis of obstruction or predicts the evolution of hydronephrosis toward spontaneous resolution or its progression. The hydronephrosis is an anatomical alteration requiring functional assessment due to its broad clinical spectrum: from a complete or partial obstruction to the simple expansion without obstruction. The isotopic renograma diuretic provides simultaneous information on renal function on drainage and urinary tract, it seems reasonable to use it to determine the functional significance of hydronephrosis. In our work we studied, quantitatively and qualitatively, the role of isotopic renograma diuretic in the stratification of the risk of loss of renal function and in the management of patients with prenatal diagnosis of unilateral hydronephrosis. In 40 of the 44 patients studied had ruled obstruction of union pieloureteral as the cause of hydronephrosis. In 32 cases of these 40 patients the study gammagráfico "not arise obstruction" (Patterns "normal" and "estasia not obstructive"), one hidronegrosis ultrasound grade III and one grade IV, and only one clear pieloplastia by an infectious complication intercurrent. In one of the 40 patients the study gammagráfico basal presented a "pattern undetermined" in the curve of eliminating radiotrazador with renal function on "normal" and explained surgery deterioration in the elimination of radiotrazador in renograma isotopic diuretic tracking. And, in 7 of 40 patients, the curve of eliminating radiotrazador in the baseline study showed a "pattern of obstruction suggestive" means all but one function supranormal had a renal function on "normal". 4 of these 7 patients required pieloplastia obstruction of the union pieloureteral; 3 per decline in renal function relative and 1 for increased hydronephrosis in subsequent studies. Of these 4 patients had a grade II hydronephrosis ultrasound in the study baseline. This allows us to conclude that should realizares renograma isotopic diuretic all patients with a diagnosis of prenatal ultrasound hydronephrosis regardless of the degree of it, because patients with low grade may submit a functionally significant obstruction. Moreover, the isotopic renograma diuretic provides high value in the stratification of the risk of loss of renal function relative infants with hydronephrosis and in the management of these patients because patterns elimination gammagráficos "normal" and "non-obstructive ectasia" rarely develop obstructive hydronephrosis and may undergo follow-up studies with ultrasound alone, performing other diagnostic tests when doubts persist. Patterns gammagráficos "undetermined" and "suggestive of obstruction" in infants require strict monitoring in the 8 who ad 1d8 emás of ultrasound, it must include renograma isotopic diuretic.

Author: ENCINAS MEJÍAS MARTA.
Year: 2005.
University: COMPLUTENSE DE MADRID [More theses of this university] [www.ucm.es].
Place of defense: FACULTAD DE MEDICINA.
Place of preparation: FACULTAD DE MEDICINA.

Summary: OBJECTIVES Define predictive markers that can identify those patients with DCL to evolve towards a probable AD. MATERIALS AND METHODS We conducted a prospective cohort study with 42 patients who met criteria for DCL. The study included the following neuropsychological test: MEC, CAMCOG, Rivermead and Benton and scale of WAIS. We calculated the regional cerebral blood flow through 99mTc-ECD-SPECT and identified 17 areas of interest (ADI). It was determined the polymorphism of APOE. Clinical follow-up was performed medium of the 42 patients for at least two years (IQR p25-p75: 21-36 months). 21 patients came to meet criteria for probable AD (group I) and 21 patients had a diagnosis of DCL (group II). COR curves were constructed and calculated rates of sensitivity, specificity, positive and negative predictive values and likelihood ratios of positive and negative post. RESULTS There were no significant differences in socio-demographic data between the two groups. Group I showed significant differences in test scores MEC, Rivermead, CAMCOG overall and its items: orientation, language, memory, perception and calculation of the scales of Benton and Blessed regard to group II. The variables that best distinguished the two groups are the CAMCOG overall and its items: perception, memory and orientation. The group has an index of flow (IRF) between 7-10% less than that in group II areas PFD, IPP, FRD, FRI, DBP, PAI, FPTD, FPTI, TED TEI and telpi. The areas showing greater sensitivities and specificities of 75% and areas under the curve CIR close to 80% are: IPP, PAI, FRI, FRD and PFD. Scores CAMCOG overall, their item Guidance and IRF area FRI are independent predictors of the risk of progression of DCL to EA. There was no difference in frequency of the APOE allelic regard to developments between the two groups. CONCLUSIONS Certain neuropsychological tests and certain ADIs are markers of progression to dementia. Combining the results of neuropsychological tests with cerebral flow improves prediction of the evolution of patients with DCL to EA. The APOE polymorphism is not useful as a marker of evolution.

Author: VALLEJO DE LA HOZ GORKA.
Year: 2005.
University: PAÍS VASCO [More theses of this university] [www.ehu.es].
Place of defense: FACULTAD DE FARMACIA.
Place of preparation: FACULTAD DE FARMACIA.

Summary: Health is influenced by gender and working conditions. In the area of Health there are certain diseases with a high prevalence, such as cardiovascular disease, musculoskeletal disorders and chronic venous insufficiency. This paper has examined the influence of gender in certain determinants of health workers and administrative cleanup. The study was based on an analysis of data obtained from medical work carried out during the year 2003 in Vizcaya. There has been a descriptive study, apareando by sex and age extensive samples of workers, and then make a comparison between groups of study using a test of homogeneity of percentages. The results show the state of health of these groups and their labor differences, especially in the case of women, to guide us in the main priorities and prevention are necessary to prevent the pathology resulting from the work.

Author: IÑESTA MENA CLAUDIA JOSEFA.
Year: 2005.
University: OVIEDO [More theses of this university] [www.uniovi.es].
Place of defense: FACULTAD DE MEDICINA.
Place of preparation: FACULTAD DE MEDICINA.

Summary: The physiological demand for a professional activity maintained a long time, as is the case with professional musicians, it is difficult valuation. One possible approach would be to measure the response of heart rate (HR) in connection with the instrumental music. This response has been very poorly studied and little evidence are controversial. The purpose of this study was to analyze the frequency response of the Heart (CT) in professional musicians during their actual activity. This worked voluntarily 62 professional musicians (20 women and 42 men). The musicians recorded their FC through pulsómetros Sport Tester PE4000 (Polar Finland), while playing in his usual occupation: Essays or studies and public concerts. The maximum theoretical FC (FCMT) of the subjects were obtained by the formula 220-edad. In addition to a subgroup were performed Test ergométrico incrementally up to volorar its actual maximum FC. Result: The professional musicians studied show averaged during public concerts a CF average 60.2% of its FCMT, and some FC maximum 76.8% of the FCMT, values higher than those described previously and that equivaldrian a rank intensity work Mooderado to Fort. The FC is significantly higher in public concerts in trials for the same piece of music.

Author: GUILLEN VICENTE MERCEDES.
Year: 2005.
University: COMPLUTENSE DE MADRID [More theses of this university] [www.ucm.es].
Place of defense: MEDICINA.
Place of preparation: MEDICINA.

Summary: It made a presentation on major diseases that may be treated by procedures of physical medicine and rehabilitation. It eventually develops study design under the degenerative pathology of the patient with multiple sclerosis (Sorting individuals in the sample according to the criteria of the scale EDDS). They show the specifications of the various respiratory parameters and their clinical implications. Subsequently, undergoing physical therapy and rehabilitation medicine, there are the change obtained for each group, we discuss them and finally sets out the conclusions of the work.

Author: LÓPEZ RODRÍGUEZ ÁLVARO.
Year: 2005.
University: COMPLUTENSE DE MADRID [More theses of this university] [www.ucm.es].
Place of defense: MEDICINA.
Place of preparation: MEDICINA.

Summary: This paper is based on the study fotogramétrico the image laden plant, in digital photography. The region of greatest burden of body weight on the footprint plant, represented by the surface dela plant that appears more lívida not always correspond with a difference. In these cases the correspondence between the podoscopia and fotopodograma is not accurate. In this paper we study the correspondence over and over. It designed a computer image capture podoscópica and software necessary measure. It validates the aforementioned software, and with him, there is a correlation between this action and the image obtained by fotopodograma. With this team identifies indexes linking the ischemic region of the footprint or region where there is the greatest support from one's own body weight and footprint, with indices of homogeneity of the burden on the plant. In addition indexes are derived linking the total area planted in the region with the ischemic region from him or maximum body weight support.