Tratamiento del lupus eritematoso cutáneo resistente

Lupus erythematosus (LE) is an autoimmune inflammatory disease that includes a broad spectrum of manifestations, ranging from systemic disease (systemic lupus erythematosus [SLE]) to purely cutaneous forms (cutaneous lupus erythematosus [CLE]).Cutaneous involvement occurs in 90% of patients with SLE.Based on morphological and histopathological features, CLE can be divided into three categories: chronic CLE, subacute CLE and acute CLE.The precise etiology of LE is not fully understood, but the disease occurs when environmental factors, drugs and infectious agents trigger an abnormal immune response in an individual with predisposing genetic factors.To assess cutaneous involvement, several scores have been developed over the years. A recent study, called CLASI (Cutaneous Lupus Erythematosus Disease Area and Severity Index), staged mucocutaneous damage and disease activity separately, allowing assessment of therapeutic response to be standardized.The management of CLE is challenging. Although treatment traditionally consists of photoprotection, topical steroids and antimalarial agents, these measures are sometimes ineffective in subgroup of patients, giving rise to what is called resistant CLE.This article reviews the topical and systemic treatment options, both the classical and new treatment alternatives currently available.     

Recursos bibliográficos para Atención Primaria en las bibliotecas virtuales de salud de las comunidades autónomas

The Statement by the Spanish Society of Family and Community Medicine (SemFYC) on access to scientific information, highlights the need for providing digital libraries with certain resources in Autonomous Regions.The primary goal is to study the evidence-based medicine (EBM) coverage that SemFYC recommends regional virtual libraries. The regional health virtual libraries were identified and the access provided to health professionals, Internet presence, remote access and resources were studied.The results suggest there is ample coverage in 8 Autonomous Regions. At the top of the list was, Health Sciences Virtual Library of Navarre, the Balearic Islands Health Sciences Virtual Library, and Virtual Library of the Andalusian Public Health System.The present study needs to be extended to the other biomedical sciences, in order to obtain more accurate results.     

Validation of the self-confidence scale of nursing care in urinary retention

Objective:

to validate an instrument to measure self-confidence of nursing care in urinary retention.

Methods:

methodological research study, carried out after ethical approval. A Likert-like scale of 32 items related to nursing care in urinary retention was applied to students of the graduate nursing course. For instrument validation, analysis of the sample adequacy and main components, Varimax orthogonal rotation and internal consistency analyses were developed.

Results:

in a sample of 305 students, there was high correlation of all items with the total scale and Cronbach''s alpha of 0.949. The scale items were divided into five factors with internal consistency: Factor 1 (0.890), Factor 2 (0.874), Factor 3 (0.868), Factor 4 (0.814) and Factor 5 (0.773), respectively.

Conclusion:

the scale meets the validity requirements, demonstrating potential for use in evaluation and research.     

Dialectical Behavior Therapy in the Treatment of Borderline Personality Disorder and Eating Disorders Comorbidity: A Pilot Study in a Naturalistic Setting

Dialectical behavior therapy (DBT) has been shown to be successful in the treatment of borderline personality disorder and eating disorders separately. The present study compares Standard Dialectical Behavior Therapy with a Treatment as Usual Cognitive Behavior Therapy (TAU CBT) for the treatment of borderline personality disorder and eating disorders comorbid features. A total of 118 women diagnosed with borderline personality disorders and eating disorders were assigned to one of two treatment groups in a naturalistic setting (DBT?=?71; TAU CBT?=?47). DBT showed a greater decrease in dysfunctional behaviors used to regulate emotions and related to borderline personality disorder (i.e. substance abuse, impulsive money spending, unprotected sex, etc.), non-suicidal self-injuries, and depressive symptoms, as well as an increase in cognitive reappraisal and global functioning. DBT and TAU CBT showed similar improvements in suicide attempts, dysfunctional eating behaviors (i.e. binge eating, purgative behaviors, and restriction), hospitalizations, negative and positive affect, and expressive suppression. Results of this study support the utility and effectiveness of standard DBT for comorbid borderline personality disorder and eating disorders in naturalistic settings. Replications of this study and randomized controlled trials are needed.     

Positional accommodative intraocular lens power error induced by the estimation of the corneal power and the effective lens position

Purpose:

To evaluate the predictability of the refractive correction achieved with a positional accommodating intraocular lenses (IOL) and to develop a potential optimization of it by minimizing the error associated with the keratometric estimation of the corneal power and by developing a predictive formula for the effective lens position (ELP).

Materials and Methods:

Clinical data from 25 eyes of 14 patients (age range, 52–77 years) and undergoing cataract surgery with implantation of the accommodating IOL Crystalens HD (Bausch and Lomb) were retrospectively reviewed. In all cases, the calculation of an adjusted IOL power (P_IOLadj) based on Gaussian optics considering the residual refractive error was done using a variable keratometric index value (n_kadj) for corneal power estimation with and without using an estimation algorithm for ELP obtained by multiple regression analysis (ELP_adj). P_IOLadj was compared to the real IOL power implanted (P_IOLReal, calculated with the SRK-T formula) and also to the values estimated by the Haigis, HofferQ, and Holladay I formulas.

Results:

No statistically significant differences were found between P_IOLReal and P_IOLadj when ELP_adj was used (P = 0.10), with a range of agreement between calculations of 1.23 D. In contrast, P_IOLReal was significantly higher when compared to P_IOLadj without using ELP_adj and also compared to the values estimated by the other formulas.

Conclusions:

Predictable refractive outcomes can be obtained with the accommodating IOL Crystalens HD using a variable keratometric index for corneal power estimation and by estimating ELP with an algorithm dependent on anatomical factors and age.     

Brief Report: Delayed Diagnosis of Treatable Inborn Errors of Metabolism in Children with Autism and Other Neurodevelopmental Disorders

Journal of Autism and Developmental Disorders - The objective of our study was to evaluate the frequency of treatable inborn errors of metabolism (IEM) in a clinical sample of Mexican children and...     

Drug-resistant and immune-escape hepatitis B virus mutants, occult hepatitis B infection and coinfections in public hospital patients from Argentina

Virus Genes - Argentina exhibits low serological prevalence for Hepatitis B virus (HBV); however, occult hepatitis B infection (OBI) has been reported in blood donors, Amerindians and individuals...