Caracterización de la calidad de vida relacionada con la salud en pacientes con artrosis de miembro inferior y validación de nuevas herramientas para su elevación

Tesis inédita de la Universidad Complutense de Madrid, Facultad de Medicina, leída el 25-04-2022La artrosis de miembro inferior (OAMI) es la primera causa de dolor y discapacidad funcional en la población mundial, suponiendo una pérdida en años de vida ajustados por discapacidad del0,69% de todos los AVAD perdidos en la población mundial en 2010.El impacto de la artrosis sobre la calidad de vida puede valorarse con herramientas que incorporan la perspectiva del propio paciente.Por ello se pretende estudiar el impacto sobre la salud de la OAMI desde la perspectiva del paciente y evaluar el desempeño de nuevas herramientas de valoración de la CVRS, como el cuestionario Oxford Hip Score (OHS) o el Oxford Knee Score (OKS), específicas para estas condiciones...Osteoarthritis of the lower limb (OALL) is the major cause of pain and functional disability in the world population and its impact in the form of disease burden is extraordinary, assuming a loss in disability-adjusted life years (DALYs) of 0.69% of all DALYs lost in the world population in 2010.The impact of osteoarthritis on quality of life can be assessed with tools that incorporate the patient's own perspective.The generic tools to assess Health-Related Quality of Life (HRQoL) have a high degree of development and use, but those instruments specific to a certain clinical condition, such as the Oxford Hip Score (OHS) questionnaire or the Oxford Knee Score (OKS), can be more useful to discriminate the situation of subjects with said disease and more sensitive to the changes that occur.The use of these tools requires a process that ensures that they are useful for their purpose, so their psychometric properties must be evaluated. These conditions lead us to find pertinent the study of the impact on health, from the patient's perspective, of lower limb osteoarthritis and the evaluation of new HRQL assessment tools, specific for this clinical condition...Fac. de MedicinaTRUEunpu

Diastereoselective Synthesis of C60/Steroid Conjugates

The design and synthesis of fullerene–steroid hybrids by using Prato’s protocol has afforded new fullerene derivatives endowed with epiandrosterone, an important naturally occurring steroid hormone. Since the formation of the pyrrolidine ring resulting from the 1,3-dipolar cyloaddition reaction takes place with generation of a new stereogenic center on the C2 of the five-membered ring, the reaction proceeds with formation of a diastereomeric mixture [compounds 6 and 7 in 70:30 ratio, 8 and 9 in 26:74 ratio (HPLC)] in which the formation of the major diasteroisomers 6 and 9 is consistent with an electrophilic attack of [60]fullerene on the Re face of the azomethine ylide directed by the steroidic unit. The chiroptical properties of these conjugates reveal typical Cotton effects in CD spectra that have been used to assign the absolute configuration of the new fulleropyrrolidines. The electrochemical study of the new compounds reveals the presence of four quasi-reversible reduction waves which are cathodically shifted in comparison with the parent C60, thus ascertaining the proposed structures.Financial support by the Ministerio de Ciencia e Innovación (MINECO) of Spain (CTQ2011-24652, CTQ2011-27253, PIB2010JP-00196, and CSD2007-00010 projects) and CAM (Madrisolar-2) is acknowledged; A.R. thanks UCM for financial support; M.S. is indebted to Programa del Grupo Santander 2012

Generación coordinada e integración en la docencia de objetos y recursos virtuales de aprendizaje en las asignaturas de Didáctica de la Matemática del Grado en Educación Primaria

Tras la experiencia adquirida en el curso pasado en el uso de herramientas y recursos para la docencia online provocada por la suspensión de la actividad presencial debido a la pandemia, arrancamos este PID que buscaba el diseño, generación e integración en la docencia de objetos y recursos virtuales de aprendizaje, que fuesen útiles en cualquier modalidad de docencia (presencial, semipresencial u online) y con el objetivo de maximizar las oportunidades de aprendizaje de los estudiantes en dos asignaturas del grado en Educación Primaria. Por ello, mediante el presente PID se han desarrollado varios objetos de aprendizaje, a saber: cuestionarios de Moodle para la autoevaluación de los alumnos, que han sido muy bien aceptados y utilizados por los estudiantes, guiones de prácticas basados en materiales y recursos online, y varias píldoras en el formato “Saber, extender” que servirán tanto de material para varias asignaturas del área como de medio de difusión de conocimiento para la comunidad educativa. Aunque el objetivo inicial, además de desarrollar estos materiales, también incluía su implementación en el curso actual, solo se han podido implementar los cuestionarios de Moodle, pues los diferentes compromisos de los integrantes del equipo de trabajo han ralentizado el trabajo de diseño y generación. No obstante, gracias a la coordinación que se ha promovido entre el profesorado participante, creemos que este proyecto, inicialmente ambicioso, solo es el comienzo de futuras colaboraciones para el desarrollo de otros materiales y su implementación en los próximos cursos.Didáctica de las Ciencias Experimentales, Sociales y de la Matemátic

Paraneoplastic vasculitis associated to pelvic chondrosarcoma: a case report

Vasculopathic syndromes have been associated with hematological and solid organ malignancies. The pathogenesis of these syndromes remains largely unknown and there are no biologic markers identified. Whether it is or is not a paraneoplastic syndrome is under discussion, the close temporal relationship of cancer and vasculitis suggests that these vasculitides are a paraneoplastic condition. We report a case of a 45-year-old female patient with pelvic chondrosarcoma who underwent surgical treatment and started to present visual loss, systemic inflammatory response syndrome (SRIS), cardiac insufficiency, hepatosplenomegaly, cholestasis as well as pulmonary bleeding suggesting a sarcoma-associated vasculitis. All antibodies were negative as in secondary vasculitis. After corticoideal therapy the vasculitis resolved and at 3-year follow-up the patient had not showed any further medical complications or recurrences of the vasculitis. The parallel evolution of the vasculitis and the solid tumor combined with the resolution of the vasculitis after corticotherapy enhances the likelihood of a paraneoplastic vasculitis associated with a chondrosarcoma according to literature review

Paraneoplastic vasculitis associated to pelvic chondrosarcoma: a case report

Vasculopathic syndromes have been associated with hematological and solid organ malignancies. The pathogenesis of these syndromes remains largely unknown and there are no biologic markers identified. Whether it is or is not a paraneoplastic syndrome is under discussion, the close temporal relationship of cancer and vasculitis suggests that these vasculitides are a paraneoplastic condition. We report a case of a 45-year-old female patient with pelvic chondrosarcoma who underwent surgical treatment and started to present visual loss, systemic inflammatory response syndrome (SRIS), cardiac insufficiency, hepatosplenomegaly, cholestasis as well as pulmonary bleeding suggesting a sarcoma-associated vasculitis. All antibodies were negative as in secondary vasculitis. After corticoideal therapy the vasculitis resolved and at 3-year follow-up the patient had not showed any further medical complications or recurrences of the vasculitis. The parallel evolution of the vasculitis and the solid tumor combined with the resolution of the vasculitis after corticotherapy enhances the likelihood of a paraneoplastic vasculitis associated with a chondrosarcoma according to literature review

Cross-cultural adaptation and validation of the Spanish version of the Oxford Hip Score in patients with hip osteoarthritis

Abstract Background Osteoarthritis (OA) of the hip is a disease that entails a major burden for patients and the society as a whole. One way of measuring this burden for the patient is through impact on Health-related Quality of Life (HRQL). The Oxford Hip Score (OHS) is a well-known tool to measure HRQL in patients with OA of the hip. This study aims to assess the psychometric properties of the Spanish-adapted version of the OHS, including its reliability, validity, and sensitivity to change. Methods Prospective observational study that included 361 patients diagnosed with hip OA (according to the criterion of the American College of Rheumatology) from 3 different Spanish regions. Their HRQL was assessed using a generic questionnaire, the EQ-5D-5 L, and two specific ones (the Western Ontario and McMaster Universities Osteoarthritis Index, WOMAC, and the OHS) adapted to Spanish. There was a follow-up period of 6 months, and the acceptability, psychometric properties, presence of ceiling and floor effects, validity, reliability, and sensitivity to changes of the OHS were measured. Results The OHS was fully answered in 99.4% of cases with no indication of ceiling or floor effects. Its factor structure can be explained in a single dimension. Its discriminative capacity was very good compared to the groups generated by the WOMAC and the EQ-5D-5 L. The correlation between the OHS and dimensions of the WOMAC or EQ-5D-5 L utilities was ≥0.7. Excellent test-retest reliability (ICC = 0.992; CI95%: 0.994–0.998) and internal consistency (Cronbach’s α = 0.928) were observed. The minimal clinically important difference (MCID) was 7.0 points, and the minimum detectable change (MDC) was 5.5 points. The effect size for moderate improvement in perceived HRQL was 0.73, similar to that of WOMAC dimensions and higher than the EQ-5D-5 L. Conclusions The Spanish-adapted version of the OHS is a useful, acceptable tool for the assessment of perceived HRQL in patients with hip OA, and has psychometric properties similar to those of the WOMAC that allow for discriminating both a patient’s condition at a given moment and changes that can occur over time

Impact of lower limb osteoarthritis on health-related quality of life: A cross-sectional study to estimate the expressed loss of utility in the Spanish population.

OBJECTIVE:Osteoarthritis of the lower limb (OALL) worsens health-related quality of life (HRQL), but this impact has not been quantified with standardized measures. We intend to evaluate the impact of OALL on HRQL through measures based on individual preferences in comparison to the general population. METHODS:A cross-sectional study was designed. A total of 6234 subjects aged 50 years or older without OALL were selected from the Spanish general population (National Health Survey 2011-12). An opportunistic sample of patients aged 50 years or older diagnosed with hip (n = 331) or knee osteoarthritis (n = 393), using the American Rheumatism Association criteria, was recruited from six hospitals and 21 primary care centers in Vizcaya, Madrid and Tenerife between January and December 2015. HRQL was measured with the EQ-5D-5L, and the results were transformed into utility scores. Sociodemographic variables (age, sex, social group, cohabitation), number of chronic diseases, and body mass index were considered. The clinical stage of OALL was collected using the Western Ontario and McMaster Universities Osteoarthritis Index and the Oxford hip score and Oxford knee score. Generalized linear models were constructed using the utility index as the dependent variable. RESULTS:HRQL expressed by OALL patients was significantly worse than this of the general population. After adjustment for sociodemographic and clinical characteristics, the mean utility loss was -0.347 (95% CI: -0.390, -0.303) for osteoarthritis of the hip and -0.295 (95% CI: -0.336, -0.255) for osteoarthritis of the knee. OALL patients who were treated at a hospital had an additional utility loss of -0.112 (95% CI: -0.158, -0.065). CONCLUSION:OALL has a great impact on HRQL. People with OALL perceive a utility loss of approximately 0.3 points compared to the general population without osteoarthritis, which is very high in relation to the utility loss reported for other chronic diseases and for arthritis in general

Additional file 1: of Validation of the Spanish version of the Oxford knee score and assessment of its utility to characterize quality of life of patients suffering from knee osteoarthritis: a multicentric study

Spanish-adapted version of the Oxford Knee Score - Spanish (Spain). (DOCX 23 kb