Estadísticas

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  "cita" => "Cir Esp. 1999;66:50-2"
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      "titulo" => "Análisis de la situación actual de paro y subempleo en los cirujanos españoles"
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          "titulo" => "ANALYSIS OF UNEMPLOYMENT AND UNDEREMPLOYMENT AMONG SPANISH SURGEONS"
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          "autoresLista" => "P Marín Rodríguez"
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              "apellidos" => "Marín Rodríguez"
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      "titulo" => "Hematoma epidural diferido. Revisión de 12 casos"
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          "titulo" => "DELAYED EPIDURAL HEMATOMA. REVIEW OF 12 CASES"
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          "autoresLista" => "M Gelabert González, A García Pravos"
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    "titulo" => "Ensayo clínico aleatorizado, prospectivo, doble ciego, placebo-gliceriltrinitrato en el tratamiento de la fisura de ano"
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        "autoresLista" => "M Ferrández Rivera, LM Rial Rodríguez"
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        "titulo" => "A PROSPECTIVE, RANDOMIZED, DOUBLE-BLIND CLINICAL TRIAL TO COMPARE PLACEBO AND GLYCERYLTRINITRATE IN THE TREATMENT OF ANAL FISSURE"
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        "resumen" => "Antecedentes&#46; La fisura anal es tratada habitualmente mediante esfinterotom&#237;a lateral interna&#46; Los donantes de &#243;xido n&#237;trico como el gliceriltrinitrato &#40;GTN&#41; han demostrado su eficacia en peque&#241;as series de fisura de ano mediante la denominada esfinterotom&#237;a qu&#237;mica reversible&#46; Este estudio es un ensayo cl&#237;nico prospectivo&#44; aleatorizado&#44; doble ciego&#44; placebo-GTN&#44; dise&#241;ado para comprobar la hip&#243;tesis de que la aplicaci&#243;n t&#243;pica de GTN es un tratamiento m&#233;dico eficaz&#46; <br/> <span class="elsevierStyleBold">Pacientes y m&#233;todos&#46;</span> Se aleatorizaron 40 pacientes consecutivos para recibir tratamiento con GTN al 0&#44;2&#37; o placebo&#46; Se efectuaron revisiones cl&#237;nicas semanales hasta un total de 4 semanas&#44; determinando la intensidad del dolor y la curaci&#243;n de la fisura&#46; <br/> <span class="elsevierStyleBold">Resultados&#46;</span> En el grupo GTN el alivio del dolor fue significativo en el 65&#37; de los casos y se consigui&#243; la curaci&#243;n de la fisura en el 55&#37;&#46; Fue necesaria la intervenci&#243;n quir&#250;rgica en el 35&#37;&#46; En el grupo placebo&#44; el alivio del dolor fue significativo en el 44&#37; de los enfermos&#44; s&#243;lo en un caso se consigui&#243; la curaci&#243;n de la fisura y fueron intervenidos el 55&#37;&#46; <br/> <span class="elsevierStyleBold">Conclusiones&#46;</span> La aplicaci&#243;n t&#243;pica de GTN al 0&#44;2&#37; es el tratamiento m&#233;dico de elecci&#243;n de la fisura de ano&#44; reduciendo la necesidad de esfinterotom&#237;a al menos en el 65&#37;&#46; Las causas de fracaso son la cronicidad &#173;ausencia de espasmo&#44; infecci&#243;n&#44; fibrosis&#173; y la enfermedad asociada&#46; Se necesitan estudios a largo plazo para comprobar la frecuencia de recurrencia&#46;"
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        "resumen" => "<span class="elsevierStyleBold">Background&#46;</span> Anal fissures are usually treated by internal lateral sphincterotomy&#46; Nitric oxide donors like glyceryltrinitrate &#40;GTN&#41; have shown their efficacy in small series of patients with anal fissure treated means of the so-called reversible chemical sphincterotomy&#46; The present study deals with a prospective&#44; randomized&#44; double-blind clinical trial to test whether the topical application of GTN is an effective medical treatment&#46; <br/> <span class="elsevierStyleBold">Patients and methods&#46;</span> Forty consecutive patients were randomized to receive 0&#46;2&#37; GTN or placebo&#46; Weekly clinical check-ups were performed over a 4-week period to assess the intensity of pain and the healing process&#46; <br/> <span class="elsevierStyleBold">Results&#46;</span> In the GTN group&#44; 65&#37; of the patients reported significant pain relief and the fissure healed in 55&#37;&#46; Surgery was necessary in 35&#37; of cases&#46; In the placebo group&#44; pain relief was significant in 44&#37;&#44; the fissure healed in only 1 case and 55&#37; of the patients required surgery&#46; <br/> <span class="elsevierStyleBold">Conclusions&#46;</span> The topical application of 0&#46;2&#37; GTN is the medical treatment of choice in anal fissure&#44; reducing the need for sphincterotomy by at least 65&#37;&#46; The causes for failure are chronicity &#40;absence of reflex response&#44; infection&#44; fibrosis&#41; and the associated disease&#46; Long-term studies should be performed to determine the recurrence rate"
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