Axion Paradigm with Color-Mediated Neutrino Masses.

We propose a generalized Kim-Shifman-Vainshtein-Zakharov-type axion framework in which colored fermions and scalars act as two-loop Majorana neutrino-mass mediators. The global Peccei-Quinn symmetry under which exotic fermions are charged solves the strong CP problem. Within our general proposal, various setups can be distinguished by probing the axion-to-photon coupling at helioscopes and haloscopes. We also comment on axion dark-matter production in the early Universe.

Ligilactobacillus salivarius V4II-90 eradicates Group B Streptococcus colonisation during pregnancy: a randomised, double-blind, placebo-controlled trial.

Group B Streptococcus (GBS) is the leading cause of bacterial neonatal sepsis. This study aimed to confirm the effect of Ligilactobacillus salivarius V4II-90 on GBS colonisation during pregnancy. A randomised, multicentre, double-blind, placebo-controlled, parallel-group study was conducted in seven hospitals in Madrid, Spain. The sample was broken down into two groups with 20 participants each (n = 40) in order to show reduced GBS colonisation frequency in the probiotic versus the placebo group. Pregnant participants positive for vaginal-rectal colonisation before or during the 13th week of gestation were randomly assigned to either the placebo or the probiotic group. The probiotic, L. salivarius V4II-90 at 1 × 109 cfu/day was administered for 12 weeks, starting at week 21-23 of gestation. The primary outcome was the percentage of participants with vaginal and/or rectal GBS colonisation at the end of the intervention period (35 weeks of gestation). Secondary outcomes were changes in the microbial composition of vaginal and rectal exudates; premature delivery; premature rupture of membranes; intrapartum antibiotics; new-borns with early or late-onset GBS sepsis; adverse events (AEs); and GBS test results performed at the hospital at week 35 of gestation. Of the 481 participants included, 44 were vaginal-rectal colonised with GBS and randomised. 43 completed the study (20 in the probiotic group and 23 in the placebo group). After intervention, GBS was eradicated in six participants (27%) from the placebo group and in twelve participants (63%) from the probiotic group ( P = 0.030). None of the 185 AEs reported were identified as possibly, probably, or definitely related to the investigational product. In conclusion, oral administration of L. salivarius V4II-90 is a safe and successful strategy to significantly decrease the rates of GBS colonisation at the end of pregnancy and, therefore, to reduce the exposure of subjects and their infants to intrapartum antibiotic prophylaxis. Trial registered at ClinicalTrials.gov: number NCT03669094.

A Study of PLA Thin Film on SS 316L Coronary Stents Using a Dip Coating Technique.

The dip coating process is one of the recognized techniques used to generate polymeric coatings on stents in an easy and low-cost way. However, there is a lack of information about the influence of the process parameters of this technique on complex geometries such as stents. This paper studies the dip coating process parameters used to provide a uniform coating of PLA with a 4-10 µm thickness. A stainless-steel tube (AISI 316L) was laser-cut, electropolished, and dip-coated in a polylactic acid (PLA) solution whilst changing the process parameters. The samples were characterized to examine the coating's uniformity, thickness, surface roughness, weight, and chemical composition. FTIR and Raman investigations indicated the presence of PLA on the stent's surface, the chemical stability of PLA during the coating process, and the absence of residual chloroform in the coatings. Additionally, the water contact angle was measured to determine the hydrophilicity of the coating. Our results indicate that, when using entry and withdrawal speeds of 500 mm min-1 and a 15 s immersion time, a uniform coating thickness was achieved throughout the tube and in the stent with an average thickness of 7.8 µm.

Ecological disturbance alters the adaptive benefits of social ties.

Extreme weather events radically alter ecosystems. When ecological damage persists, selective pressures on individuals can change, leading to phenotypic adjustments. For group-living animals, social relationships may be a mechanism enabling adaptation to ecosystem disturbance. Yet whether such events alter selection on sociality and whether group-living animals can, as a result, adaptively change their social relationships remain untested. We leveraged 10 years of data collected on rhesus macaques before and after a category 4 hurricane caused persistent deforestation, exacerbating monkeys' exposure to intense heat. In response, macaques demonstrated persistently increased tolerance and decreased aggression toward other monkeys, facilitating access to scarce shade critical for thermoregulation. Social tolerance predicted individual survival after the hurricane, but not before it, revealing a shift in the adaptive function of sociality.

Protocolo de extubación ultra-fast track tras cirugía cardiovascular: predictores de fracaso y resultados / Ultra-fast track extubation protocol following cardiovascular surgery: Predictors of failure and outcomes

Objetivos: Identificar los factores predictores independientes de fracaso de la extubación ultra-fast track (UFT) y comparar los resultados hospitalarios de la extubación UFT frente a la extubación fast track en pacientes adultos sometidos a cirugía cardiovascular. Material y métodos: Análisis retrospectivo de 1.498 pacientes consecutivos mayores de 18 años sometidos a cirugía cardiovascular en un solo centro. Entre diciembre 2014 y diciembre 2016 se utilizó la extubación fast track (n=713), mientras que, entre diciembre 2016 y diciembre 2018 todos los pacientes fueron considerados preoperatoriamente aptos para extubación UFT (n=785). En este caso se empleó el mismo protocolo anestésico estandarizado en todos los pacientes. La decisión de extubar o no en quirófano se basó exclusivamente en parámetros hemodinámicos y ventilatorios. Resultados: La extubación en quirófano fue posible en 699 (89%) pacientes. Los factores predictores independientes de fracaso de la extubación UFT fueron: clase funcional preoperatoria iii-iv de la NYHA, infarto agudo de miocardio dentro de los 2 días previos a la cirugía, balón de contrapulsación intraaórtico preoperatorio, cirugía urgente o emergente, transfusión intraoperatoria de plaquetas y soporte intraoperatorio con fármacos inotrópicos y vasopresores. La extubación UFT se asoció con una menor tasa de complicaciones cardiovasculares, como insuficiencia cardiaca congestiva (OR: 1,57; IC 95%: 1,13-2,19; p=0,008) y fibrilación auricular postoperatoria de novo (OR: 1,40; IC 95%: 1,06-1,86; p=0,020). Los pacientes extubados en quirófanos presentaron un menor riesgo de complicaciones globales, menor estancia en la UCI y mayor supervivencia a corto plazo, aunque no se encontraron diferencias estadísticamente significativas al realizarse el ajuste multivariante. Conclusiones: La extubación inmediata rutinaria en quirófano tras cirugía cardiovascular en adultos es una...(AU)

Objectives: Identifying independent predictor factors of failure of ultra-fast track (UFT) extubation and to compare in-hospital outcomes with UFT extubation versus fast track (FT) extubation after cardiovascular surgery in adults. Material and methods: Retrospective analysis of 1,498 consecutive patients aged over 18 years-old undergoing cardiovascular surgery at a single institution. Between December 2014 and December 2016, FT extubation was used (N=713) while, between December 2016 and December 2018, all patients were preoperatively considered suitable for UFT extubation (N=785). In this instance, a standardized anaesthetic protocol was applied in all cases. The decision to not extubate in the operating room (OR) was based on intraoperative haemodynamic and ventilation. Results: Extubation in the OR was possible in 699 (89%) patients. Significant independent predictors factors of UFT extubation failure were: preoperative NYHA class III-IV, myocardial infarction within two days prior to surgery, preoperative intra-aortic balloon counterpulsation, urgent/emergent surgery, intraoperative transfusion of platelets and intraoperative inotropic and vasopressor support. UFT extubation was associated with lower rates of cardiovascular complications such as congestive cardiac insufficiency (OR: 1,57; 95% CI: 1,13-2,19; P=0,008) and new-onset postoperatory atrial fibrillation (OR: 1,40; 95% CI: 1,06-1,86; P=0,020). Patient extubated in the OR presented lower risk of overall complications, shorter intensive care unit stay and higher short-term survival, although, no statistically significance was found when performing the multivariate adjustment. Conclusions: A routine immediate extubation in the OR following adult cardiovascular surgery is a feasible and safe practice, associated with low cardiovascular morbidity.(AU)

Luxación de la articulación interfalángica proximal del hallux con interposición de un hueso sesamoideo: una revisión bibliográfica / Dislocation of the proximal hallux interphalangeal joint with interposition of a sesamoid bone: a blibliographic review

Resumen: La luxación irreductible de la articulación interfalángica del hallux es una patología poco frecuente y hay pocos casos descritos. Se presenta como una luxación dorsal con interposición del sesamoideo; éste puede ser radiológicamente indetectable. Reportamos el caso de un paciente de 29 años que tras un traumatismo deportivo presentó una luxación interfalángica del hallux que pasó desapercibida hasta el octavo día. Al igual que en varios casos descritos en la literatura, no se pudo realizar una reducción cerrada, por lo que se procedió a una reducción abierta por una incisión dorsal. Una revisión bibliográfica revela que existen varias opciones terapéuticas, al igual que múltiples tipos de abordajes, y que estas lesiones generalmente presentan un buen pronóstico.

Abstract: The irreducible dislocation of the hallux interphalangeal joint is an infrequent condition and only a few cases have been described. It presents as dorsal dislocation with interposition of the sesamoid bone, which has the possibility of being radiologically undetectable. We present the case of a 29 year-old patient who, after a sports trauma sustained a hallux interphalangeal dislocation that went unnoticed for eight days. Since, closed reduction was not possible, as occurred in several cases reported in the literature, open reduction was performed through a dorsal incision. Based on a bibliographic review, it is possible to state that there are several treatment options and multiple approaches, and that these lesions usually have a good prognosis.

Relación entre autoconcepto físico, ansiedad e IMC en estudiantes universitarios mexicanos / The relation of physical self-concept, anxiety, and BMI among Mexican university students

El propósito de la investigación es conocer y relacionar los resultados del autoconcepto físico, con diferentes tipos de ansiedad y el IMC en los estudiantes de enfermería y educación física dela península de Yucatán (México). La muestra estuvo formada por 264 participantes, de los cuales 91 eran varones y 173 mujeres, con edades comprendidas entre 18 y 25 años. Nuestros datos revelan que en el autoconcepto físico, los valores obtenidos por los estudiantes de educación física son superiores al de los estudiantes de enfermería. Los estudiantes de enfermería presentan mayores valores de ansiedad estado que los de educación física. La percepción que tienen los estudiantes de ciclos superiores en prácticamente todas las dimensiones del autoconcepto es superior a la del alumnado de ciclos inferiores. Los niveles de ansiedad disminuyen conforme pasan de ciclos inferiores a superiores (AU)

The purpose of this paper is to know and relate the results of the various dimensions formed by the physical self-concept with respect to the different types of anxiety and the BMI among nursing and physical education students in the area of the Yucatán peninsula in Mexico. The study is based on a sample of 264 people, being 91 men and 173 women between the ages of 18 and 25. The outcome shows that the values obtained by physical education students are higher than those obtained by nursing students regarding the physical self-concept. Nursing students present a higher level of anxiety compared to physical education students. The perception showed by junior and senior students with regard to almost all dimensions of self-concept is higher than that of freshmen and sophomore students. Anxiety level among students decreases throughout the years (AU)

Impacto de la creación de una sala de hemodinámica, una unidad coronaria y un programa de angioplastia primaria en el pronóstico del síndrome coronario agudo en un hospital comarcal / Impact of creating a haemodynamics room, a coronary unit and a primary angioplasty programme on the prognosis of acute coronary syndrome in a district hospital

Objetivo Analizar el pronóstico y mortalidad de los pacientes ingresados en un hospital por síndrome coronario agudo antes y después de la implantación de la unidad coronaria, la sala de hemodinámica y el programa de angioplastia primaria (Código corazón). Métodos Estudio observacional y retrospectivo. Se analizaron las características epidemiológicas, las estrategias de reperfusión, los eventos adversos cardiovasculares y la mortalidad durante 5 años de seguimiento. Los resultados del periodo post-código (1 marzo 2012-31 diciembre 2012; n=471) se compararon con la etapa precódigo (1 marzo 2009-31 diciembre 2009; n=432). Resultados No hubo diferencias en las características basales de ambos grupos, pero en la fase poscódigo se observó un incremento del síndrome coronario agudo con elevación del ST (SCACEST) del 17,6 al 34,8% (p<0,001). Se generalizó el intervencionismo coronario percutáneo, que alcanzó cifras del 64,8% en el síndrome coronario agudo sin elevación del ST (SCASEST) y del 95,5% en el SCACEST. Se redujeron los reingresos (38,2 vs. 25,1% en el SCASEST, p=0,001 y 23,7 vs. 11% en el SCACEST, p=0,018), la variable pronóstica combinada de eventos adversos cardiovasculares y mortalidad en 5 años de seguimiento (58,7 vs. 45%, p=0,001 en el SCASEST y 40,8 vs. 23,8%, p=0,009 en el SCACEST) y, además, en el SCACEST disminuyó la mortalidad a los 30 días (11,8 vs. 3,7%, p=0,021). Conclusiones Con los cambios estructurales realizados en el hospital se ha generalizado el intervencionismo coronario percutáneo y ha mejorado el pronóstico de los pacientes con síndrome coronario agudo, disminuyendo los ingresos, los eventos adversos cardiovasculares y la mortalidad (AU)

Objective This work aims to analyze the prognosis and mortality of patients hospitalized for acute coronary syndrome before and after the implementation of a coronary care unit, hemodynamics room, and the Código Corazón [Infarction Code] primary angioplasty program Methods We conducted an observational, retrospective study that analyzed the epidemiological characteristics, reperfusion strategies, adverse cardiovascular events, and mortality over a follow-up period of five years. The results from the post-code period (March 1 – December 31, 2012; n=471) were compared with those from the pre-code period (March 1 – December 31, 2009; n=432). Results There were no differences in the baseline characteristics of the two groups. However, an increase in ST-elevation acute coronary syndrome (STE-ACS) from 17.6% to 34.8% (p<.001) was observed during the postcode phase. The use of percutaneous coronary intervention was made widespread at the hospital and was used in 64.8% of non-ST-elevation acute coronary syndrome (NSTE-ACS) cases and in 95.5% of STE-ACS cases. A reduction was observed in readmissions (from 38.2% to 25.1% for NSTE-ACS (p=.001) and from 23.7% to 11.0% for STE-ACS (p=.018)), the composite prognostic variable of adverse cardiovascular events and 5-year mortality (from 58.7% to 45% (p=.001) for NSTE-ACS and from 40.8% to 23.8% (p=.009) for STE-ACS), and a decrease in 30-day mortality in STE-ACS (from 11.8% to 3.7%; p=.021). Conclusions With the structural changes in the hospital, the use of percutaneous coronary intervention was made widespread and improved the prognosis of patients with acute coronary syndrome, decreasing admissions, adverse cardiovascular events and mortality (AU)

Imitadores del ictus: un reto para el médico de urgencias / Stroke mimics: a challenge for the emergency physician

Fundamento: Estudiar el número de pacientes diagnosticados de ictus en el servicio de urgencias hospitalario de un hospital de primer nivel y la proporción de estos pacientes que finalmente eran pseudoictus, así como describir y analizar las variables que pueden ayudar en el diagnóstico diferencial en los servicios de urgencias hospitalarios. Método: Estudio prospectivo de 9 meses. Se incluyeron todos los pacientes valorados en el servicio de Urgencias e ingresados con el diagnóstico de ictus. Se analizaron diversas variables clínicas que incluían la historia previa, la historia del evento actual, el examen físico general y neurológico y la clasificación del NIHSS y de la Oxforshire Community Stroke. El diagnóstico final se realizó por un panel de expertos con acceso a las características clínicas, estudios de imagen y otras pruebas. El análisis univariante y multivariado determinó las características que ayudan a distinguir los ictus de los pseudoictus. Resultados: Se registraron 144 casos de ictus; la muestra final la conformó 140 pacientes. El diagnóstico final fue de ictus en 103 de 140 (73,6%) y de pseudoictus en el resto. Once variables predecían el diagnóstico en pacientes que se presentaban con sospecha de ictus: la edad superior a 70 años (p=0,012), una clasificación del NIHSS > 5, lograr una clasificación clínica (p=0,019) capaz de determinar el comienzo exacto (p=0,000), hallazgos vasculares anormales (p=0,014), desviación de la mirada (p=0.042), pérdida de la visión (p=0,052) y reflejo plantar extensor (p=0,025) favorecían el diagnóstico de ictus, mientras que las crisis comiciales (p=0,029), los síntomas neurológicos no congruentes con el territorio vascular (p=0,022) y los hallazgos anormales en otros sistemas (p=0,14) favorecían el diagnostico de pseudoictus. Conclusión: Los pseudoictus constituyeron un tercio de los pacientes ingresados desde el servicio de Urgencias como ictus siendo la etiología muy variada. Lograr una historia clínica adecuada y un examen físico preciso es de gran importancia y puede ayudar a facultativos menos experimentados (AU)

Background: To study the number of patients diagnosed with a stroke in the emergency service of a first level hospital and the proportion of these patients who were finally stroke mimics, as well as to describe and analyze the variables that can help in differential diagnosis in hospital emergency services. Method: Nine month prospective study. All patients evaluated in emergency services and admitted with a diagnosis of stroke were included. Different clinical variables were analyzed that included prior history, history of the current event, general physical and neurological examination, NIHSS classification and Oxford shire Community Stroke Project Classification. The final diagnosis was made by a panel of experts with access to clinical characteristics, image studies and other tests. The univariate and multivariate analysis determined the characteristics that help in distinguishing strokes from stroke mimics. Results: One hundred and forty-four cases of stroke were registered; the final sample was made up of 140 patients. The final diagnosis was stroke in 103 out of 140 (73.6%) and stroke mimic in the rest. Eleven variables predicted the diagnosis in patients with a suspected stroke: age over 70 years (p=0.012),NIHSS classification > 5, reaching a clinical classification (p=0.019) capable of determining the exact start (p=0.000), abnormal vascular findings (p=0.014), gaze deviation (p=0.042), sight loss (p=0.052) and extensor plantar response (p=0.025) favored diagnosis of stroke, while epileptic seizures (p=0.029), neurological symptoms not congruent with the vascular territory (p=0.022) and abnormal findings in other systems (p=0.14) favored diagnosis of stroke mimic. Conclusion: Stroke mimics constitute one-third of the patients admitted from emergency services as strokes, with a highly varied etiology. Achieving a suitable clinical history and a precise physical examination is of great importance and can help less experienced doctors (AU)

Diversidade genética de populações naturais de pariparoba [Pothomorphe umbellata (L. ) Miq.] por RAPD / Genetic diversity of natural populations of pariparoba [Pothomorphe umbellata (L. ) Miq.] according to RAPD analysis

O objetivo desse trabalho foi analisar a estrutura genética de populações de Pothomorphe umbellata (L.) Miq. com base em polimorfismos moleculares do tipo RAPD. Foram analisadas quatro populações naturais do estado de São Paulo (Jacareí, Jundiaí, Piquete e Ubatuba) e uma população do Paraná (Adrianópolis). Foram identificados 25 locos polimórficos (96,15%). Elevados índices de diversidade genética foram observados dentro das populações (Hs = 0,2220). Verificou-se que 65,33% da variabilidade genética total encontra-se dentro das populações e 34,67% entre as populações; índices estes, obtidos a partir do cálculo da divergência genética (G ST = 0,3467). Os resultados sugerem que essas populações possuem níveis elevados de variabilidade genética, a qual pode ser fortemente impactada pela ação humana.

The aim of this study was to analyze the genetic structure of populations of Pothomorphe umbellata (L.) Miq. based on RAPD molecular polymorphisms. Analysis included four natural populations from São Paulo State (Jacareí, Jundiaí, Piquete, Ubatuba) and one population from Paraná State (Adrianópolis). Twenty-five polymorphic loci (96.15%) were identified. There were high levels of genetic diversity within populations (Hs = 0.2220). Of the total genetic variability, 65.33% is within populations and 34.67% among populations (G ST = 0.3467). Results suggest that these populations have high levels of genetic variability, which can be strongly impacted by human action.

Detección de genes shv y tem en cepas de Escherichia coli productoras de B-lactamasas de espectro extendido procedentes de dos centros hospitalarios de Chiclayo- Perú: enero- agosto 2011

Describir la frecuencia de distribucion de los genes blaTEM y blaSHV en cepas de Escherichia coli productoras de �À- lactamasas de espectro extendido (BLEE) procedentes de dos centros hospitalarios de Chiclayo. Material y Metodos: Estudio de tipo descriptivo, trasversal. Las cepas de Escherichia coli productoras de BLEE fueron seleccionadas de pacientes con infeccion urinaria internados en los servicios de Cuidados Intensivos, Ginecologia, Medicina Interna y Cirugia de los hospitales Almanzor Aguinaga Asenjo y Las Mercedes. Las cepas fueron confirmadas previamente en los laboratorios de los dos hospitales usando las prueba fenotipica de Jarlier (Hospital Las Mercedes) y el sistema automatizado Vitek 2 (Hospital Nacional Almanzor Aguinaga Asenjo); el analisis de deteccion de los genes blaTEM y blaSHV se hizo por PCR en el Laboratorio de Genetica de la Universidad Catolica Santo Toribio de Mogrovejo. Resultados: Un total de 66 cepas de Escherichia coli recolectadas desde Enero a Agosto del 2011 fueron confirmadas como BLEE; de estas se confirmo que 40 cepas (60,61%) presentaron el gen blaTEM, 8 cepas (12,12%) presentaron el gen blaSHV y 18 cepas (27,27%) no presentaron ninguno de los dos. Ninguna de las cepas presento ambos genes. Conclusión: los genes blaTEM y blaSHV fueron frecuentes en las cepas BLEE de ambos hospitales, siendo más frecuente el gen blaTEM.(AU)

Objective: To describe the distribution frequency of blaTEM and blaSHV genes in extended spectrum À-lactamase producing Escherichia coli strains of two hospitals of Chiclayo.Material and Methods: Transversal, descriptive study.Extended spectrum À- lactamase (ESBL) Escherichia coli strains were initially obtained from urine cultures of patients with urinary tract infection from the services of Internal Medicine, Surgery, Intensive care unit and Urology from two hospitals of Chiclayo. The strains were previously confirmed in the laboratories using Jarlier's phenotypic method (Hospital las Mercedes) and the Vitek 2 automated system (Hospital Nacional Almanzor Aguinaga Asenjo); the genetic detection analysis of blaTEM and blaSHV genes was done by PCR (Polymerase chain reaction) in the Genetics Laboratory of Universidad Catolica Santo Toribio de Mogrovejo. Results: A total of 66 strains of Escherichia coli isolated since January to August 2011 were classified as ESBL; by PCR, the blaTEM gen was found in 40 strains (60.61%), the blaSHV gen in 8 strains (12.12%), and both genes were absent in 18 strains (27.27%).Conclusion: blaTEM and blaSHV genes were frequently detected in ESBL strains from both hospitals; being the blaTEM the most frequent.(AU)

Regulación de la ingesta alimentaria y del balance energético; factores y mecanismos implicados / Regulation of dietary intake and energy balance; factors and mechanisms involved

La regulación de la ingesta energética representa un proceso de vital importancia en el organismo ya que posibilita el mantenimiento de un equilibrio entre la cantidad de energía almacenada en forma de grasa corporal y el catabolismo de la misma. Objetivo: El objetivo de este trabajo ha sido analizar los principales factores implicados en la regulación de la ingesta alimentaria, el balance energético y su fisiopatología. Metodología: Se realizó una búsqueda en Medline y Ebsco de artículos publicados en inglés y español en el período comprendido entre enero de 2009 y enero de 2012. Los términos de búsqueda fueron "food intake", "energy balance", "regulation", "nutritional homeostasis". Resultados: Se encontraron un total de 198 estudios científicos, de los cuales únicamente 70 cumplían los requisitos de la búsqueda. Todos los estudios consultados coinciden en la importancia de las hormonas gastrointestinales como principales agentes moduladores de la homeostasis energética. Dicho efecto modulador sobre el apetito y la saciedad tiene lugar mediante su acción directa sobre el hipotálamo o el núcleo del tracto solitario a nivel del tronco encefálico (sistema nervioso vegetativo). Únicamente la ghrelina, ha sido relacionada con el inicio de la ingesta considerándola una de las principales señales orexigénicas en los modelos animales estudiados y en humanos. Discusión: La regulación de la ingesta alimentaria y el balance energético constituye un proceso extremadamente complejo cuyo funcionamiento y equilibrio es posible gracias a la acción de las distintas señales endocrinas del tracto gastrointestinal (AU)

The regulation of energy intake is a vital process in the body as possible to maintain a balance between the amount of energy stored as body fat and the catabolism of the same. Objective: The objective of this study was to analyze the main factors involved in regulating food intake, energy balance and pathophysiology. Methods: We searched Medline and Ebsco of articles published in English and Spanish in the period between January 2009 and January 2012. Search terms were "food intake", "energy balance", "regulation", "nutritional homeostasis." Results: There were a total of 198 scientific studies, of which only 70 met the requirements of the search. All studies consulted agree on the importance of gastrointestinal hormones modulating agents as primary energy homeostasis. Such a modulatory effect on appetite and satiety is mediated by direct action on the hypothalamus or the nucleus of the solitary tract at the brainstem (autonomic nervous system). Only ghrelin has been linked to the start of the intake considering a major orexigenicas signals studied in animal models and humans. Discussion: The regulation of food intake and energy balance is an extremely complex process whose operation and balance is made possible by the action of various endocrine signals of the gastrointestinal tract (AU)

Análisis del estado nutricional en escolares; estudio por áreas geográficas de la provincia de Granada (España) / Analysis of the nutritional state of school children in different districts of the province of Granada (Spain)

Introducción: En España la prevalencia de obesidad muestra un patrón de distribución norte-sur. En la provincia de Granada se desconoce su distribución. Objetivos: Los objetos del presente trabajo son estudiar la prevalencia de sobrepeso y obesidad en una población de escolares representativa de toda la provincia de Granada. Verificar diferencias significativas entre las comarcas de la provincia. Comprobar una correlación entre el estado nutricional de los alumnos y el de sus progenitores. Métodos: 977 escolares de entre 9 y 17 años de edad, pertenecientes a 13 centros educativos públicos de la provincia de Granada (España). Estudio analítico y multicéntrico, en el que se realizó una valoración del estado nutricional mediante antropometría. Además, mediante un cuestionario, se evaluó la existencia de antecedentes familiares de sobrepeso u obesidad. Resultados: Se encontró una elevada prevalencia de sobrepeso y obesidad entre la población estudiada. En chicas, la mayor prevalencia tanto de sobrepeso como de obesidad se situaba entre los 12 y los 14 años de edad. En los chicos, se observó un repunte en la prevalencia de sobrepeso a los 12 años. Respecto de la obesidad, sus tasas fueron considerablemente inferiores a las descritas entre las chicas. Se encontraron diferencias estadísticamente significativas para el peso (F = 4,154; p = 0,003), pero no para la estatura (F = 1,928; p = 0,105). En cambio, para la variable IMC se observaron diferencias estadísticamente significativas (F = 5,037; p < 0,001) entre las diferentes comarcas geográficas estudiadas. Aquellos alumnos con antecedentes familiares de obesidad mostraron un significativo (p < 0,01) peor estado nutricional. Discusión: Existe una elevada prevalencia de obesidad, especialmente entre las chicas. Existe un patrón de distribución geográfico posiblemente derivado de las características socioeconómicas de cada comarca. La existencia de antecedentes familiares de obesidad constituye un factor determinante para su desarrollo entre los jóvenes (AU)

Background: In Spain the prevalence of obesity shows a north-south distribution. In the province of Granada its distribution is unknown. Objectives: (1) To study the prevalence of overweight and obesity in a sample population of school children and adolescents from different districts in the province of Granada. (2) To verify whether there are significant differences, depending on the district where the students reside. (3) To find a possible correlation between the nutritional state of the students and that of their parents. Methods: The population sample was composed of 977 school children and adolescents from 9 to 17 years of age, attending 13 public elementary schools and high schools in the city and province of Granada (Spain). In this analytical and multicentric study, the nutritional state of the subjects was evaluated by means of anthropometric measurements. Furthermore, data were collected by means of questionnaire to discover whether the respondents had a family history of overweight or obesity. Results: We found a high prevalence of overweight and obesity among the studied population. In girls, the greater prevalence of both overweight and obesity ranged from 12 to 14 years of age. In boys, there was an increase in the prevalence of overweight at twelve years of age. Regarding obesity, their rates were significantly lower than those described among girls. There were statistically significant differences for weight (F = 4,154; p = 0,003) but not for height (F = 1,928; p =0,105). But for the variable BMI was statistically significant difference (F = 5.037; P < 0.001) between the studied geographical areas. The results showed that the nutritional state of students with a family history of obesity was significantly worse (p < 0.01). Discussion: A high prevalence of obesity was found in the sample, especially among the girls. There exists a geographical distribution pattern, possibly derived from the socioeconomic characteristics of each area in the province. The existence of a family history of obesity is an important factor that can determine whether the child will also become obese in the future (AU)

Análisis del estado nutricional y composición corporal de una población de escolares de Granada / Analysis of the nutritional state and body composition of school children in Granada (Spain)

Los objetivos de este estudio fueron determinar el estado nutricional de la población de escolares estudiada. En segundo lugar, analizar el patrón de distribución de la grasa subcutánea entre dicha población. La muestra estaba constituida por 977 escolares de Granada capital y provincia (524 chicas y 452 chicos), todos ellos con edades comprendidas entre los 9 y los 17 años. Para el estudio del estado nutricional y distribución del componente graso subcutáneo se realizó una evaluación antropométrica completa incluyendo una valoración del peso, estatura, índice de masa corporal, pliegues cutáneos y perímetros corporales. Los resultados obtenidos muestran la existencia de una prevalencia de sobrepeso del 23,01% en chicas frente a un 20,81% en chicos. Asimismo, se encontró una prevalencia de obesidad del 12,70% entre las chicas frente a un 4,98% en chicos. El análisis del patrón de distribución de la grasa subcutánea evidenció una distribución del componente graso de predominio eminentemente central. La existencia de una prevalencia importante de sobrepeso y obesidad unida al desarrollo de un patrón de distribución graso de predominio central, ponen de manifiesto el potencial riesgo cardiovascular al que se encuentran expuestos dichos alumnos (AU)

The objective of this study was to first determine the nutritional state of a sample population of school children, and then analyze the distribution pattern of their subcutaneous fat layer. The sample was composed of 977 school children from the city and province of Granada (Spain). All of the children (524 girls and 452 boys) were 9-17 years of age. To study their nutritional state and the distribution of the subcutaneous fat layer, they were given a complete anthropometric evaluation, which included measuring their weight, height, body mass index, skin folds, and body perimeters. The results obtained showed a 23.01% prevalence of overweight in the female subjects and 20.81% in the male subjects. Furthermore, the female subjects had an obesity prevalence of 12.70% in comparison to the male subjects, whose obesity prevalence was 4.98%. The distribution pattern of subcutaneous fat was found to be mainly located in the central part of body. The high percentage of overweight and obesity along with the development of a central fat distribution pattern (neck, chest, and abdomen) in these school children is clear evidence of potential cardiovascular risk (AU)

Tuberculosis activa en una cohorte de reclusos infectados por VIH en una cárcel de la Ciudad de México: características clínicas y epidemiológicas / Active tuberculosis in a cohort of HIV-infected inmates in a prison in Mexico City: clinical and epidemiological characteristics

OBJETIVO: Determinar las características clínicas y epidemiológicas de los casos con tuberculosis (TB) activa en población de cárceles con VIH, que se ve especialmente afectada por ambas epidemias. La infección por VIH incrementa significativamente la probabilidad del desarrollo de TB. MATERIAL Y MÉTODOS: Se realizó un estudio de cohorte en sujetos infectados por VIH e internados en un reclusorio de la Ciudad de México. RESULTADOS: Se encontraron 172 pacientes con VIH, 28 con TB activa (16.3%) - 21 (12.2%) con afección pulmonar - con una tasa de incidencia de 7.7 por 100 sujetos/año para TB activa y de 4.7 por 100 sujetos/ año para TB pulmonar. No se encontró drogorresistencia. Dieciocho aislados fueron tipificados por RFLP, con una tasa de transmisión calculada de 11%. CONCLUSIÓN: Se encontró una prevalencia de TB en esta población mil veces superior a la observada en la población general y datos sugerentes de transmisión al interior de la cárcel.

OBJECTIVE: To determine the clinical and epidemiological characteristics of prison inmates with active tuberculosis in HIV-positive prison populations. MATERIALS AND METHODS: We conducted a cohort study in HIV-infected subjects in a prison in Mexico City, with the aim of determining clinical and epidemiological characteristics of cases with active TB. RESULTS: We detected 172 HIV infected inmates and TB in 28 of them (16.3%) - 21 (12.2) with pulmonary TB - with an incidence rate of 7.7/100 persons/year for active TB and 4.7/100 persons/year for pulmonary TB. No drug resistance was found. Two clusters (4 and 2 subjects) were observed after RFLP-typing of 18 isolates, with a transmission rate of 11% by molecular and clinical analysis. CONCLUSIONS: The prevalence of active TB was found to be a thousand times greater than in the general population. Evidence of transmission inside the prison was also found.

Ictericia secundaria a cistoadenoma seroso pancreático gigante / Jaundice secondary to giant pancreatic serous cystoadenoma

El cistoadenoma seroso es el segundo tumor quísticomás frecuente del páncreas y representa el 1-2% detodas las neoplasias exocrinas pancreáticas. Recientemente,gracias a las mejoras en las técnicas de imagen,la identificación de las lesiones quísticas pancreáticases cada vez más frecuente. El diagnóstico diferencial hade hacerse con el cistoadenoma mucinoso, debido alpotencial maligno de esta última entidad. En esta notaclínica describimos el caso de una paciente con ictericiaindolora y colestasis, con diagnóstico final de cistoadenomaseroso pancreático (AU)

Serous cystadenoma is the second most frequentpancreatic cystic neoplasm and accounts for 1-2% ofexocrine neoplasms of the pancreas. Recently, theyhave been identified more frequently, due to the improvementin imaging techniques. Differential diagnosisshould be performed with mucinous cystoadenoma,due to the latter´s potential for malignant transformation.We present the case of a female patient whounderwent examination for painless jaundice and cholestasis,with a final diagnosis of pancreatic serous cystoadenoma (AU)

Recambio de polietileno mediante la cementación de un nuevo componente sobre el metal-back osteointegrado / Polyethylene replacement by cementing a new component over the osseointegrated metal-back

Objetivo. Ante una cirugía de revisión de artroplastia total de cadera no cementada por desgaste de polietileno está indicado mantener el cotilo metálico cuando se compruebe intraoperatoriamente su estabilidad, sustituyendo únicamente el polietileno que se cementa si el anclaje no es posible. El objetivo del presente estudio fue evaluar los resultados clínicos y radiográficos a medio plazo de la cementación de polietileno dentro de un componente acetabular metálico osteointegrado. Material y método. Se analizaron retrospectivamente 15 pacientes cuya indicación para la cirugía fue el desgaste de polietileno, con un periodo de seguimiento medio de 6,1 años (rango 3,5-9,7 años). El Harris Hip Score se utilizó para valorar los resultados clínicos antes de la intervención y al final del seguimiento. Se realizaron radiografías anteroposteriores y axiales de cadera para descartar complicaciones. Resultados. La puntuación media en el Harris Hip Score mejoró, pasando de los 64,7 puntos en el preoperatorio a los 80,3 al final del seguimiento. Las lesiones osteolíticas desaparecieron, o al menos no aumentaron de tamaño, en los controles radiográficos. Una paciente (6,7%) sufrió 2 episodios de luxación, que se trataron sin necesidad de cirugía. Otro paciente presentó aflojamiento aséptico del vástago femoral, que requirió el recambio. Conclusiones. La cementación del polietileno, cuando no sea posible su anclaje, en un cotilo metálico no cementado osteointegrado es una técnica que ofrece buenos resultados a medio plazo, y que minimiza las complicaciones que conlleva el recambio del componente acetabular, sin comprometer su estabilidad (AU)

Objective. In uncemented revision total hip replacement due to polyethylene wear, the metal cup needs to be maintained when its stability is checked during surgery, only replacing the polyethylene that is cemented if anchoring is not possible. The aim of the present study was to evaluate the medium-term clinical and radiological results of a polyethylene liner cemented into an osseointegrated acetabular shell component. Material and method. A retrospective analysis was performed on 15 patients in whom the surgical indication was polyethylene wear, with a mean follow-up of 6.1 years (range 3.5-9.7 years). The Harris Hip Score was used to assess the clinical results before surgery and at the end of follow-up. Anteroposterior and axial X-rays of the hip were taken to rule out complications. Results. The mean Harris Hip Score improved, increasing from 64.7points before the surgery to 80.3 at the end of follow-up. The osteolytic lesions disappeared, or at least the size did not increase, in the follow-up X-rays. One patient (6.7%) suffered 2 dislocation episodes that were treated without the need for surgery. Another patient presented with aseptic loosening of the femoral stem that required a replacement. Conclusions. Cementing the polyethylene liner, when anchoring is not possible, in an uncemented osseointegrated metal shell is a technique that offers good results in the medium term, and which may minimise the complications that may occur with the replacement of the shell component, without compromising its stability (AU)

Úlcera de Martorell: complicación infrecuente de la hipertensión de larga evolución / Martorell's ulcer: an unusual complication of long-term hypertension

Las úlceras de causa hipertensiva representan una complicación poco frecuente dela hiperpresión arterial de larga evolución. Clínicamente se conocen con el nombre de úlcerahipertensiva o de Martorell, ya que fue este el primero en describirlas en 1945. El diagnóstico de confirmación se basa en la hialinosis entre el endotelio y la capa elástica interna de las arteriolas de la zona afectada. Esta característica es un hallazgo común a las lesiones encontradas en otros órganos diana afectados de pacientes hipertensos. El único tratamiento preventivo eficaz es el buen control de la presión arterial, acompañado de tratamiento local óptimo de la herida mediante curas periódicas y posterior tratamiento quirúrgico si fuese preciso. Presentamos el caso de una mujer de 59 anos que padece esta infrecuente complicación de hiperpresión arterial no controlada de larga evolución (AU)

Hypertensive-induced ulcers are an unusual complication of long-term systemic arterial hypertension. They are clinically known as hypertensive ulcer or Martorell’s ulcer, since he was the first to describe this condition in 1945. Confirmation diagnosis is based on the hyalinization between the endothelium and the elastica interna of the arteriola of the affected zone. This characteristic is a common finding for injuries found in other affected target organs of hypertensive patients. Good control of blood pressure is the only effective preventive treatment ,accompanied of local wound care and surgical treatment if necessary. We present the case of a 59-year old woman who had this rare, non-controlled long-termarterial hypertension complication (AU)