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Samaniego E.,Complejo Asistencial Universitario Of Leon | Redondo P.,Clinica Universitaria de Navarra
Actas Dermo-Sifiliograficas | Year: 2013

Lentigo maligna is a type of in situ melanoma. It develops mainly in middle-aged and elderly individuals on areas of the skin chronically exposed to sunlight. It progresses to its invasive form, lentigo maligna melanoma, in 5% to 50% of cases. Management of lentigo maligna is open to debate, with a notable lack of randomized trials and specific guidelines and protocols. Early diagnosis and treatment is necessary to achieve cure if possible and prevent progression to invasive melanoma with the corresponding risk of metastasis. The treatment of choice for lentigo maligna is surgery. When surgery is not possible, other alternatives are available although outcomes and rates of recurrence are variable. The objective of this study was to review the diagnostic methods and criteria for lentigo maligna, as well as the different surgical options and alternatives to surgery, in order to provide information on the best approach in each case. © 2012 Elsevier España, S.L. y AEDV. Todos los derechos reservados.

Angioplasty is a feasible, safe, and effective procedure, and can be the procedure of choice for treatment of critical limb ischemia. Targeted primary angioplasty following the angiosome model may prove beneficial in terms of better wound healing and subsequent limb salvage. This concept may allow deliberately focusing arterial flow reconstruction in specific limb ischemia areas that exhibit tissue loss and fluctuating "rescue-vessels" supply. Further technical improvements and large comparative studies and prospective data are also needed to make a proper clinical validation. As well as appropriate revascularization, aggressive control of concurrent risk factors in wound healing also play an important role. The present paper proposes a review of the main contemporary publications that share this theory on the treatment of critical limb ischemia. © 2011 SEACV. Publicado por Elsevier España, S.L. Todos los derechos reservados.

To determine the agreement between verbal numerical and visual analog scale assessments of acute postoperative pain on 3 consecutive days. Pain data were recorded for 2 months for sequentially enrolled patients receiving parenteral opioids or neuraxial blocks for analgesia after major surgery in a tertiary level hospital. Each patient was asked to assess pain on the visual analog and verbal numerical scales every 24 hours for 3 consecutive days. Agreement was estimated by the intraclass correlation coefficient and the Spearman correlation coefficient. The results were analyzed in 2 age strata: age 65 years or younger and older than 65 years. Data for 159 patients (105 < or =65 years; 54 >65 years) were analyzed. The visual analog scale could not be used with 12 patients; all patients were able to assess pain on the verbal numerical scale. The intraclass correlation coefficient was > 0.70 for all 3 days; the highest coefficients were for patients over 65 years of age. Agreement between pain assessments on the visual analog and verbal numerical scales can be considered good or very good on all 3 days, with stronger agreement when the scales are used in patients over the age of 65 years. Cooperation was better for the numerical scale than for the visual analog scale. Scores on the verbal numerical scale were consistently higher than scores on the visual analog scale.

Ariza-Miguel J.,Leon Institute of Technology | Hernandez M.,Leon Institute of Technology | Fernandez-Natal I.,Complejo Asistencial Universitario Of Leon | Fernandez-Natal I.,University of Leon | And 2 more authors.
Journal of Clinical Microbiology | Year: 2014

We report for the first time mecC-positive methicillin-resistant Staphylococcus aureus (mecC-MRSA) in livestock in Spain. One isolate (sequence type 130) was found in milk samples among 601 S. aureus isolates obtained from 229 dairy sheep farms. This finding highlights the potential for zoonotic transmission of mecC-positive MRSA and the need for surveillance programs to monitor its presence and clonal evolution. Copyright © 2014, American Society for Microbiology. All Rights Reserved.

Mata-Zubillaga D.,Complejo Asistencial Universitario Of Leon | Oulego-Erroz I.,Complejo Asistencial Universitario Of Leon
Journal of Perinatology | Year: 2012

We want to illustrate the difficulty of establishing a brain death diagnosis in newborn children and how an easy and useful tool, the transcranial Doppler ultrasonography, can leave an unexpected result that complicates the process despite the rest of the diagnostic tests. We describe a 36-week gestation newborn male who was diagnosed of brain death after asphyxiated and offered for donation. After initial stabilization at admission, we established brain death diagnosis by checking and meeting every criterion. The donation process was complicated because of persistent blood flow on transcranial Doppler ultrasonography. Transcranial Doppler ultrasonography is a very useful method to assess cerebral blood flow. However, caution and individualization are needed when interpreting this complementary exam, especially in highly conflictive situations like brain death diagnosis. © 2012 Nature America, Inc. All rights reserved.

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