Sensory strategies of postural sway during quiet stance in patients with haemophilic arthropathy.

INTRODUCTION: The sensory strategies of postural control in adult haemophilic arthropathy patients are still poorly understood. AIM: To determine sensorial posture-control strategies through postural sway frequency analysis when in a bipedal quiet stance with and without visual stimulus deprivation in healthy subjects and patients with haemophilic arthropathy. Secondarily, to determine the irregularity of postural balance control through sample entropy (SampEn). METHODS: A triaxial accelerometer attached at the L3 level determined the displacement and acceleration of the centre of mass (DCoM and ACoM, respectively) under open- and closed-eyes conditions. Sensorial strategies were studied by spectral analysis of the DCoM signal, divided into low, medium and high frequencies for visual/vestibular, cerebellum and somatosensory strategies respectively. DCoM irregularity was also analysed by SampEn. RESULTS: Fifteen young, healthy subjects and fifteen young, haemophilia patients were included. The mediolateal DCoM and anteroposterior ACoM differed between groups. During the open-eyes condition, haemophiliacs presented limited high and medium frequencies, and more low frequency bands as compared to non-haemophiliacs (P<.05). In the closed-eyes condition, haemophiliacs had a minor percentage of high frequencies but an elevated percentage of low frequencies as compared to non-haemophiliacs (P<.05). Non-haemophiliacs had higher SampEn than haemophiliacs in the mediolateral axis with open- and closed-eyes (P<.05 and <.001, respectively). CONCLUSIONS: The presented results indicate that patients with haemophilic arthropathy, as compared to healthy subjects, have less postural control irregularity and poor somatosensory system contributions that are compensated by more vestibular inputs.

[The 2013 Seville Consensus Document on alternatives to allogenic blood transfusion. An update on the Seville Document]. / 2013. Documento Sevilla de Consenso sobre Alternativas a la Transfusión de Sangre Alogénica. Actualización del Documento Sevilla.

Since allogeneic blood transfusion (ABT) is not harmless, multiple alternatives to ABT (AABT) have emerged, though there is great variability in their indications and appropriate use. This variability results from the interaction of a number of factors, including the specialty of the physician, knowledge and preferences, the degree of anemia, transfusion policy, and AABT availability. Since AABTs are not harmless and may not meet cost-effectiveness criteria, such variability is unacceptable. The Spanish Societies of Anesthesiology (SEDAR), Hematology and Hemotherapy (SEHH), Hospital Pharmacy (SEFH), Critical Care Medicine (SEMICYUC), Thrombosis and Hemostasis (SETH) and Blood Transfusion (SETS) have developed a Consensus Document for the proper use of AABTs. A panel of experts convened by these 6 Societies have conducted a systematic review of the medical literature and have developed the 2013 Seville Consensus Document on Alternatives to Allogeneic Blood Transfusion, which only considers those AABT aimed at decreasing the transfusion of packed red cells. AABTs are defined as any pharmacological or non-pharmacological measure aimed at decreasing the transfusion of red blood cell concentrates, while preserving patient safety. For each AABT, the main question formulated, positively or negatively, is: « Does this particular AABT reduce the transfusion rate or not?¼ All the recommendations on the use of AABTs were formulated according to the Grades of Recommendation Assessment, Development and Evaluation (GRADE) methodology.

Association of CAPN1 316, CAPN1 4751 and TG5 markers with bovine meat quality traits in Mexico.

We examined allele and genotype frequencies for the molecular markers CAPN1 316, CAPN1 4751 and TG5, and determined whether they are associated with beef quality traits in Mexican cattle. One hundred and twenty-four longissimus dorsi muscle samples were collected from cattle from north, central and southern Mexico. CAPN1 316 and CAPN1 4751 frequencies were determined using the allelic discrimination assay and the TG5 marker was typed by PCR-RFLP. Meat quality traits included intramuscular fat content (IMF) and tenderness determined by Warner-Bratzler shear force (WBSF) at 24 h postmortem. The association test was made using a mixed model, including genotypes, genetic group, and sampling location as fixed effects. Least squares means and significant interactions were compared using least significant differences based on the mixed procedure. CAPN1 316 CC was found at a low frequency (0.03) and has been reported as a favorable genotype associated with tenderness meat. Genotype frequencies for CAPN1 4751 were similar in favorable (CC) and unfavorable (TT) genotypes (0.26 and 0.28, respectively). The TG5 CC genotype had a frequency of 0.73, while the TT genotype frequency was 0.01. The means for WBSF and IMF were 4.08 ± 1.35 kg and 5.23 ± 2.14%, respectively. Sampling site and the CAPN1 316 genotypes significantly affected WBSF (P < 0.05). Samples collected from Hermosillo, Sonora, had the lowest WBSF (P < 0.05), while those collected in Veracruz were toughest (WBSF = 5.267 kg). The effect of GG and TG5 genotypes on IMF was significant (P < 0.05). CAPN1 316 and TG5 markers were found to be significantly associated with beef quality traits and thus will be useful for Mexican beef characterization.

[Assessment of maternal satisfaction with epidural analgesia for pain control during labour]. / Valoración de la satisfacción materna con la analgesia epidural para el control del dolor del trabajo de parto.

BACKGROUND: To determine the level of satisfaction and the sociodemographic characteristics of patients who receive epidural analgesia during labour. MATERIAL AND METHODS: A SERVQHOS questionnaire administered, with consecutive sampling, to 140 patients who had received an epidural anaesthetic for pain control during labour between January and June 2014, at the Hospital San Pedro. RESULTS: A total of 140 questionnaires were completed. The mean overall satisfaction (SERVQHOS scale) was 4.4 with standard deviation (SD):±0.9, with the best results being obtained in the subjective ítems: (4.3; SD 0.81) compared to the objective ítems (4; SD: 0.9). The large majority (84.3%) showed satisfaction with the epidural anaesthetic, and 100% would ask for it again. No significant differences were found in epidural satisfaction or pain perception related to socioeconomic variables (age, nationality, employment conditions, education level or marital status). As regards nationality, 119 (85%) were Spanish, and 14.3% (20) of other nationalities, with 1 patient not answering the nationality question. As regards marital status, 79.3% (111) were married, 1.4% (2), single, and 2.9% (4) were widows or separated, and 2.9% (4) did not answer. The mean age was 33.3 years (SD: 4.4). Prior to the administration of the epidural anaesthetic 93.2% of the Spanish citizens group described the pain as severe compared to 95% of the other nationalities group, but this difference had no statistical significance (p=.279). CONCLUSION: The level of satisfaction reported by the patients with this technique was high, with subjective items (good manners and trust) being appreciated more.

[Radical hysterectomy in a patient with Steinert disease: spinal anaesthesia, ketamine and TAP and rectus sheath blocks]. / Histerectomía radical en paciente con enfermedad de Steinert: raquianestesia, ketamina y bloqueos TAP y de la vaina de los rectos.

The case of a patient with Steinert disease who underwent surgery for radical hysterectomy is presented. Because of her advanced disease, she suffered from chronic respiratory failure which required non-invasive ventilation (NIV) at night. Spinal anaesthesia was chosen as an anaesthetic treatment. At the time of aortic lymphadenectomy, the patient reported moderate pain at hypogastrium, which was well controlled with boluses of 10 mg of ketamine. Postoperatively, opioid administration was avoided by applying abdominal wall blocks: transverse abdominis plane (TAP) block and sheath of rectus abdominis muscle block. The evolution of the patient was satisfactory and she was discharged on the fifth day after surgery.

Pulse radiolysis studies of WR-1065.

WR-1065, the dephosphorylated sulfhydryl form of WR-2721 has been suggested as the metabolite responsible for the radioprotective abilities of the latter and as being active during the radiation chemical stage of damage production. Hence this study was performed to determine some of the radiation chemical parameters of the compound. Pulse radiolysis techniques, developed for use with SH compounds, were employed in the current work: Three systems were used to attempt to measure the rate constant for reaction of OH. radicals with WR-1065; (a) Competition with phenylalanine, in which the decrease in the amount of RSSR- caused by the addition of phenylalanine is monitored; this failed because of the absence of an absorbance attributable to RSSR-. (b) Competition with 2,2'-Azinobis-(3-ethylbenzthiazoline-6-sulfonate) (ABTS), monitoring the decrease in OH. induced ABTS absorbance caused by WR-1065 addition. This was unsuccessful due to reaction of RS. with ABTS. (c) Competition with CNS-, observing the decrease in (CNS)-2 caused by WR-1065 addition indicates that the second order rate constant for reaction of OH. with WR-1065 is 9.2 +/- 0.3 X 10(9) M-1 s-1. To investigate the ability of WR-1065 to react with DNA radicals the yield of ABTS radicals was monitored in a situation where DNA scavenges 50% of the OH. radicals in the presence of ABTS (20%) and WR-1065 (30%). DNA radicals were shown not to react with ABTS but WR-1065 radicals do, the absence of additional ABTS absorbing species indicates that DNA radicals do not react with WR-1065 under the experimental conditions used. An attempt was made to investigate the possibility that WR-1065 is concentrated close to DNA macromolecules in solution: The rate constant for reaction Br2- with WR-1065 was measured in the presence and in the absence of excess DNA (with which Br2- was not observed to react). The observed rates of reaction were independent of the presence of DNA indicating that the latter does not affect the availability of WR-1065 for reaction with Br2- radical. Reaction of WR-1065 with Br2- was used as a probe for determining the pK of the SH group. The rate of reaction increases from 1.8 X 10(8) M-1 s-1 at pH 6.3 to 1.6 X 10(9) M-1 s-1 at pH 8.4, the mid-point of the increase indicates a pK of 7.3.

Telemedicina como herramienta de enseñanza de la endocrinología en estudiantes de medicina / Telemedicine as a teaching tool for endocrinology in medical students

INTRODUCCIÓN: El estudiante de medicina actualmente está inmerso en una sociedad altamente tecnologizada, dónde la telemedicina podría ser utilizada como un instrumento hacia un mayor aprendizaje. OBJETIVO: El objetivo del estudio es analizar el logro de competencias y el grado de satisfacción de los estudiantes medicina con la utilización de la telemedicina como estrategia didáctica en la enseñanza de la endocrinología. MATERIAL Y MÉTODO: Estudio preexperimental, correlacional, transversal y con medición posterior a la intervención. La muestra estuvo constituida por los 40 estudiantes de tercer año de medicina (24 hombres y 16 mujeres) que realizaron su práctica de endocrinología durante el segundo semestre del 2017. Se les evaluó los logros alcanzados en las competencias a través de una escala de apreciación y se midió el grado de satisfacción con la actividad docente a través de un cuestionario validado (α de Cronbach de 0,9565). RESULTADOS: El rendimiento de los estudiantes en el módulo de teleendocrinología al evaluar las competencias de analizar, sintetizar y presentar un caso clínico teleconsultado fue de 6,1 en una escala de 1 a 7, y no se encontraron diferencias según sexo. El 90% de los estudiantes consideró muy motivadora la metodología de enseñanza basada en la telemedicina y el 82,5% consideró que esta metodología favorece la integración de los contenidos. CONCLUSIONES: La telemedicina puede ser utilizada como una herramienta para evaluar competencias académicas de endocrinología en los estudiantes de pregrado de medicina, y que estos muestran un alto grado de satisfacción con este tipo de actividad docente.

INTRODUCTION: The medical student is currently immersed in a highly technological society, where telemedicine could be used as an instrument towards greater learning. OBJECTIVE: The objective of the study is to analyze the achievement of competences and the degree of satisfaction of medical students with the use of telemedicine as a didactic strategy in the teaching of endocrinology. MATERIAL AND METHOD: Pre-experimental, correlational, cross-sectional study and measurement after the intervention. The sample consisted of 40 third-year medical students (24 men and 16 women) who performed their endocrinology practice during the second semester of 2017. They were evaluated the achievements in the competences through a scale of appreciation and The degree of satisfaction with the teaching activity was measured through a validated questionnaire (Cronbach's de 0.9565). RESULTS: The performance of the students in the teleendocrinology module when evaluating the competences of analyzing, synthesizing and presenting a teleconsultated clinical case was 6.1 on a scale of 1 to 7, and no differences were found according to sex. 90% of the students considered the teaching methodology based on telemedicine very motivating and 82.5% considered that this methodology favors the integration of the contents. CONCLUSIONS: Telemedicine can be used as a tool to evaluate endocrinology academic competences in undergraduate medical students, and that they show a high degree of satisfaction with this type of teaching activity.

[The 2013 Seville Consensus Document on alternatives to allogenic blood transfusion. An update on the Seville Document]. / 2013. Documento Sevilla de Consenso sobre Alternativas a la Transfusión de Sangre Alogénica. Actualización del Documento Sevilla.

Since allogeneic blood transfusion (ABT) is not harmless, multiple alternatives to ABT (AABT) have emerged, though there is great variability in their indications and appropriate use. This variability results from the interaction of a number of factors, including the specialty of the physician, knowledge and preferences, the degree of anemia, transfusion policy, and AABT availability. Since AABTs are not harmless and may not meet cost-effectiveness criteria, such variability is unacceptable. The Spanish Societies of Anesthesiology (SEDAR), Hematology and Hemotherapy (SEHH), Hospital Pharmacy (SEFH), Critical Care Medicine (SEMICYUC), Thrombosis and Hemostasis (SETH) and Blood Transfusion (SETS) have developed a Consensus Document for the proper use of AABTs. A panel of experts convened by these 6 Societies have conducted a systematic review of the medical literature and have developed the 2013 Seville Consensus Document on Alternatives to Allogeneic Blood Transfusion, which only considers those AABT aimed at decreasing the transfusion of packed red cells. AABTs are defined as any pharmacological or non-pharmacological measure aimed at decreasing the transfusion of red blood cell concentrates, while preserving patient safety. For each AABT, the main question formulated, positively or negatively, is: "Does this particular AABT reduce the transfusion rate or not?" All the recommendations on the use of AABTs were formulated according to the Grades of Recommendation Assessment, Development and Evaluation (GRADE) methodology.

[The planning of higher or university education and the concept of politics, strategy and planning]. / La planificación de la educación superior o universitaria y los conceptos de política, estrategia y plan

The phenomenon of mass education and the crisis of university education in Latin America, in particular in the 1960's, are broadly analyzed. From the facts that characterized the period in question, two conclusions may be drawn: (1) that the basic role of the university must be redefined on the basis of new principles and different content; and (2) that a university must be administered by a system other than improvization. The concepts of policy, strategy, and plan are considered in depth and then explained as they apply to curriculum planning and design.