Preguntas y respuestas relacionadas con tabaquismo en pacientes con EPOC. Aplicación de metodología con formato PICO

The ALAT and SEPAR Treatment and Control of Smoking Groups have collaborated in the preparation of this document which attempts to answer, by way of PICO methodology, different questions on health interventions for helping COPD patients to stop smoking.The main recommendations are: (i) moderate-quality evidence and strong recommendation for performing spirometry in COPD patients and in smokers with a high risk of developing the disease, as a motivational tool (particularly for showing evidence of lung age), a diagnostic tool, and for active case-finding; (ii) high-quality evidence and strong recommendation for using intensive dedicated behavioral counselling and drug treatment for helping COPD patients to stop smoking; (iii) high-quality evidence and strong recommendation for initiating interventions for helping COPD patients to stop smoking during hospitalization with improvement when the intervention is prolonged after discharge, and (iv) high-quality evidence and strong recommendation for funding treatment of smoking in COPD patients, in view of the impact on health and health economics.     

Immediate and long-term results of implantation of the new platinum coronary stent (atlas stent) in patients with coronary artery disease

BACKGROUND AND OBJECTIVES: We evaluated the technical and clinical results of implantation of the Atlas stent, the hospital stay, and the short and long-term clinical and angiographic outcome. PATIENTS AND METHOD: The study included 169 patients (60.1 10.8 year-old), 60.3% of which had acute coronary syndromes and complex lesions. Immediate success was achieved in 98% of cases. The clinical follow-up in 85.7% of the patients at 14.3 6.8 months, revealed that 89% remained free of adverse events and most (94.4%) were functional class I of the CCS. Angiographic follow-up at 8.4 4.1 months of 40.9% of the cases revealed restenosis in 27.9%. There were 2 cases of subacute thrombosis. CONCLUSIONS: The application of the Atlas stent in patients with a diverse clinical spectrum demonstrated good immediate and long term results, with a rate of restenosis similar to that of other stents available on the market.     

Natural-cycle in vitro fertilization (IVF) combined with in vitro maturation in infertile patients with polycystic ovarian syndrome (PCOS) requiring IVF

Objective

In this study, we report an experience of 59 natural-cycle IVF combined with in vitro oocyte maturation (IVF/M) cycles in patients with PCOS requiring IVF recruited based on limitations to afford a conventional IVF treatment in a 9-years period. Results of IVF/M were compared with 164 cycles of IVF in PCOS patients.

Auditory steady-state responses in infants with perinatal brain injury

Infants with perinatal brain injury present impairments in motor, visual, auditory, and cognitive functions. The most useful methods for detecting auditory alterations are auditory brainstem responses and otoacoustic emissions. Auditory steady-state responses have been reported as a reliable and objective technique for evaluating the hearing threshold. Auditory brainstem responses and auditory steady-state responses were carried out in 53 infants with perinatal brain injury and abnormal neurologic findings. With auditory brainstem responses, 33 (62.26%) infants presented normal and 20 abnormal results; 8 (15.09%) exhibited mild alterations, 8 (15.09%) moderate, and 4 (7.54%) severe alterations. With auditory steady-state responses, 17 (32.0%) infants were normal and 36 (67.9%) had abnormal results. When auditory steady-state responses were compared with auditory brainstem responses gold standard, the assessment gave 100% sensitivity, 51.51% specificity, 55.55% positive predictive value, and 100% negative predictive value. Abnormalities were mild in 21 (39.6%) infants, moderate in 10 (18.9%), and 5 (9.4%) exhibited severe hearing loss. We conclude that hearing loss is a frequent abnormality in infants with perinatal brain injury, and auditory steady-state responses have a high sensitivity for detecting hearing impairment, which is more evident in mild hearing loss for specific frequencies.     

Hemorrhagic adrenal pseudocyst: case report and a review of the literature

Adrenal cysts are rare entities, and hemorrhagic pseudocysts are even less frequent. Generally, they are unsuspected during first patient evaluation and can suggest acute abdomen. We present the case of a hemorrhagic pseudocyst with sudden onset of abdominal pain and features compatible with acute appendicitis.     

Studies of human lymphocytes in the newborn and the aged

Proportions and absolute numbers of T and B lymphocytes were determined among 30 newborn infants and a group of 77 elderly patients 60 to 95 years of age. Total lymphocytes in the cord blood of the newborn showed a distinct elevation in total numbers of T and B lymphocytes (p < 0.005) as compared to that in blood from normal adult controls, reflecting the relative lymphocytosis of infancy. Proportions of cord blood T lymphocytes as reflected by the sheep cell rosette technic were considerably lower than those in lymphocytes from normal adult controls, however, proportions of cord blood T lymphocytes as determined by indirect immunofluorescence were not significantly different from those in controls. Old people showed a significant reduction in total numbers of lymphocytes (p < 0.005) when compared with those in normal adult controls 18 to 51 years of age. Moreover, there was a significant increase in the relative proportions of peripheral blood B lymphocytes in the elderly although the absolute numbers of B cells did not differ from those in younger controls. A significant decrease in total numbers of T cells as measured both by sheep cell rosettes and indirect immunofluorescence was recorded among older patients (p < 0.001). In addition, there was a broad increment in the incidence of various autoantibodies (antinuclear, anti-IgG, antismooth muscle, antimitochondrial and antiparietal cell) among the old people studied. No direct correlation could be determined between relative B-cell percentage increase or T-cell decrease and the presence of various autoantibodies in individual patients. Diminution in total lymphocyte counts as well as absolute numbers of T cells in the elderly may provide the cellular basis for an increased susceptibility to neoplasia and infection.     

Sonoran propolis: chemical composition and antiproliferative activity on cancer cell lines

In this study, we have analyzed the chemical composition and antiproliferative activity of propolis from three different arid and semiarid regions of Sonora, Mexico. We identified and quantitated the main chemical constituents of propolis by HPLC-MS. The most abundant constituents of propolis were pinocembrin, pinobanksin 3-acetate, and chrysin. Sonoran propolis had a strong antiproliferative activity on both murine and human cancer cell lines in a concentration-dependent manner. The propolis constituents CAPE, galangin, xanthomicrol and chrysin showed significant antiproliferative activity on most of the cancer cells tested. DNA harvested from cancer cell cultures treated with Sonoran propolis exhibited a ladder of internucleosomal DNA cleavage characteristic of apoptosis. In summary, we have identified and quantitated the main constituents of Sonoran propolis. These propolis samples possess a strong antiproliferative activity on cancer cell lines.