Association of ambient air pollution and pesticide mixtures on respiratory inflammatory markers in agricultural communities.

Air pollution exposure is associated with adverse respiratory health outcomes. Evidence from occupational and community-based studies also suggests agricultural pesticides have negative health impacts on respiratory health. Although populations are exposed to multiple inhalation hazards simultaneously, multidomain mixtures (e.g. environmental and chemical pollutants of different classes) are rarely studied. We investigated the association of ambient air pollution-pesticide exposure mixtures with urinary leukotriene E4 (LTE4), a respiratory inflammation biomarker, for 75 participants in four Central California communities over two seasons. Exposures included three criteria air pollutants estimated via the Community Multiscale Air Quality model (fine particulate matter, ozone, and nitrogen dioxide) and urinary metabolites of organophosphate (OP) pesticides (total dialkyl phosphates (DAPs), total diethyl phosphates (DE), and total dimethyl phosphates (DM)). We implemented multiple linear regression models to examine associations in single pollutant models adjusted for age, sex, asthma status, occupational status, household member occupational status, temperature, and relative humidity, and evaluated whether associations changed seasonally. We then implemented Bayesian kernel machine regression (BKMR) to analyse these criteria air pollutants, DE, and DM as a mixture. Our multiple linear regression models indicated an interquartile range (IQR) increase in total DAPs was associated with an increase in urinary LTE4 in winter (ß: 0.04, 95% CI: [0.01, 0.07]). Similarly, an IQR increase in total DM was associated with an increase in urinary LTE4 in winter (ß:0.03, 95% CI: [0.004, 0.06]). Confidence intervals for all criteria air pollutant effect estimates included the null value. BKMR analysis revealed potential non-linear interactions between exposures in our air pollution-pesticide mixture, but all confidence intervals contained the null value. Our analysis demonstrated a positive association between OP pesticide metabolites and urinary LTE4 in a low asthma prevalence population and adds to the limited research on the joint effects of ambient air pollution and pesticides mixtures on respiratory health.

The Role of Immunomodulatory Therapy with Oxiris in COVID-19 with Renal Failure and Immune Dysfunction.

INTRODUCTION: The main objective of this study was to evaluate the impact of hemoadsorption on the elimination of inflammatory mediators. METHODS: A prospective, bicenter, observational cohort study was conducted between March 2020 and February 2022 to explore the immunomodulatory response, demographic and clinical characteristics of individuals with COVID-19 admitted to the ICU with severe acute respiratory failure and in need of CRRT with Oxiris® with or without AKI. RESULTS: Sixty-four patients were analyzed. Statistically significant differences were observed between exposed and unexposed groups, in relation to the reduction in D-dimer levels -15,614 (24,848.9) versus -4,136.5 (9,913.47) (p 0.031, d: 1.59, 95% CI: -21,830, -1,126). An increase in PCT was observed 0.47 (2.08) versus -0.75 (2.3) (p 0.044 95% CI: 0.03, 2.44). No differences were found in a decrease in CRP -4.21 (7.29) versus -1.6 (9.02) (p 0.22) nor in the rest of inflammatory parameters fibrinogen, IL-6, ferritin, lymphocytes, and neutrophils. Subgroup analysis in patients exposed to therapy also showed a significant decrease in D-dimer of 55% from baseline: 6,000 (1,984.5-27,750) pre-therapy versus 2,700 (2,119.5-6,145) (95% CI: -23,000, -2,489) post-therapy with a strong effect size (p 0.001, d: 0.65). CONCLUSION: The hemoadsorptive therapy in COVID-19 was associated with a significant decrease in D-dimer parameters without showing decreases in the rest of the clinical, inflammatory parameters and severity scales analyzed.

Effects of PEEP on intracranial pressure in patients with acute brain injury: An observational, prospective and multicenter study.

OBJECTIVE: To analyze the impact of positive end-expiratory pressure (PEEP) changes on intracranial pressure (ICP) dynamics in patients with acute brain injury (ABI). DESIGN: Observational, prospective and multicenter study (PEEP-PIC study). SETTING: Seventeen intensive care units in Spain. PATIENTS: Neurocritically ill patients who underwent invasive neuromonitorization from November 2017 to June 2018. INTERVENTIONS: Baseline ventilatory, hemodynamic and neuromonitoring variables were collected immediately before PEEP changes and during the following 30 min. MAIN VARIABLES OF INTEREST: PEEP and ICP changes. RESULTS: One-hundred and nine patients were included. Mean age was 52.68 (15.34) years, male 71 (65.13%). Traumatic brain injury was the cause of ABI in 54 (49.54%) patients. Length of mechanical ventilation was 16.52 (9.23) days. In-hospital mortality was 21.1%. PEEP increases (mean 6.24-9.10 cmH2O) resulted in ICP increase from 10.4 to 11.39 mmHg, P < .001, without changes in cerebral perfusion pressure (CPP) (P = .548). PEEP decreases (mean 8.96 to 6.53 cmH2O) resulted in ICP decrease from 10.5 to 9.62 mmHg (P = .052), without changes in CPP (P = .762). Significant correlations were established between the increase of ICP and the delta PEEP (R = 0.28, P < .001), delta driving pressure (R = 0.15, P = .038) and delta compliance (R = -0.14, P = .052). ICP increment was higher in patients with lower baseline ICP. CONCLUSIONS: PEEP changes were not associated with clinically relevant modifications in ICP values in ABI patients. The magnitude of the change in ICP after PEEP increase was correlated with the delta of PEEP, the delta driving pressure and the delta compliance.

Current perspectives on the use of artificial intelligence in critical patient safety.

Intensive Care Units (ICUs) have undergone enhancements in patient safety, and artificial intelligence (AI) emerges as a disruptive technology offering novel opportunities. While the published evidence is limited and presents methodological issues, certain areas show promise, such as decision support systems, detection of adverse events, and prescription error identification. The application of AI in safety may pursue predictive or diagnostic objectives. Implementing AI-based systems necessitates procedures to ensure secure assistance, addressing challenges including trust in such systems, biases, data quality, scalability, and ethical and confidentiality considerations. The development and application of AI demand thorough testing, encompassing retrospective data assessments, real-time validation with prospective cohorts, and efficacy demonstration in clinical trials. Algorithmic transparency and explainability are essential, with active involvement of clinical professionals being crucial in the implementation process.

Age and growth of the blue shark Prionace glauca (Linnaeus, 1758) in the Ecuadorian Pacific: Bayesian multi-models.

The blue shark Prionace glauca plays a critical role as a predator in marine ecosystems but is threatened by by-catch. To obtain more precise biological data, a Bayesian approach was used, and 536 vertebrae samples collected during 1 year at the landing stage called "Playita Mía" Manta, Ecuador, were analysed. The objective was to estimate the age and growth parameters of the species. The size of the specimens varied between 116 and 310 cm in total length (TL). Using a Bayesian approach based on the Markov Chain Monte Carlo (MCMC) method, growth parameters were evaluated. The von Bertalanffy model was the one that best fitted the data and provided more adequate estimates (females: L ∞ = 325.50 cm, L 0 = 53.23 cm, and k = 0.12 years; males: L ∞ = 331.47 cm, L 0 = 51.59 cm, k = 0.12 years -1; combined sexes: L ∞ = 329.65 cm, L 0 = 53.64 cm, k = 0.11 year-1). The results indicated that females and males have a similar growth, and that the species has a slow growth. Further studies using multi-model Bayesian approaches and covering a broader range of sizes in the Pacific Ocean are suggested. These studies will provide crucial information for the management and conservation of this species.

Evaluation of mango residues to produce hyaluronic acid by Streptococcus zooepidemicus.

Mango processing generates significant amounts of residues (35-65%) that may represent environmental problems owed to improper disposal. The use of mango byproducts as substrates to produce hyaluronic acid (HA) is an attractive alternative to reduce the cost of substrate. In this study, we evaluated the potential of hydrolyzates from mango peels and seeds to produce HA by Streptococcus equi. subsp. zooepidemicus. The physicochemical characterization of mango residues showed that the seeds contain a higher amount of holocellulose (cellulose and hemicellulose), which amounts 54.2% (w/w) whereas it only represents 15.5% (w/w) in the peels. Mango peels, however, are composed mainly of hot water-extractives (62% w/w, that include sucrose, fructose, glucose and organic acids). A higher concentration of monosaccharides (39.8 g/L) was obtained from the enzymatic hydrolysis (with Macerex) of peels as compared to seeds (24.8 g/L with Celuzyme). From mango peels, hydrolyzates were obtained 0.6 g/L HA, while 0.9 g/L HA were obtained with hydrolyzates from mango seeds. These results demonstrate that mango byproducts have the potential to be used for production of HA.

Description of a new species of Engraulicola George 1960 (Monogenea: Gastrocotylidae) parasitizing gills of Chloroscombrus chrysurus (Carangidae) from Veracruz, southern Gulf of Mexico / Descrição de uma nova espécie de Engraulicola George 1960 (Monogenea: Gastrocotylidae) parasito de brânquias de Chloroscombrus chrysurus (Carangidae) de Veracruz, Sul do Golfo do México

Abstract Engraulicola lamothei n. sp. (Monogenea: Gastrocotylidae) is described from the gills of Chloroscombrus chrysurus (Teleostei: Carangidae) from Veracruz, southern Gulf of Mexico. This monogenean is 1110-1670 (1328) µm long and 260-550 (363) µm wide. The haptor is asymmetrical, the long side has several clamps (35-42), and the short side has a single clamp; the posterior end has a small lappet armed with two dissimilar pairs of hooks. Male and female genital pores open near the anterior body end; the male genital pore is ventral, armed with a corona of 12 spines; the female pore is dorsal and unarmed. The new species differs from Engraulicola forcipopenis George, 1960 and from Engraulicola micropharyngella Unnithan, 1967 by lacking a pair of pointed forceps-like spines at the end of the penis amid the corona spines, and from Engraulicola thrissocles Tripathi, 1959 by the number of clamps on both sides, the number the hook pairs on the terminal lappet and the testis number. This is the first record of the genus Engaulicola George, 1960 on the Atlantic West Coast.

Resumo Engraulicola lamothei n. sp. (Monogenea: Gastrocotylidae) é descrito a partir das brânquias de Chloroscombrus chrysurus (Teleostei: Carangidae) de Veracruz, Sul do Golfo do México. Este monogêneo tem 1110-1670 (1328) µm de comprimento e 260-550 (363) µm de largura. O "haptor" é assimétrico, o lado longo tem vários grampos (35-42), e o lado curto tem um único grampo, e a extremidade posterior tem um pequeno "lappet" armado com dois pares de ganchos diferentes. Os poros genitais masculino e feminino são abertos perto da extremidade anterior do corpo; o poro genital masculino é ventral, armado com uma coroa de 12 espinhos; o poro feminino é dorsal e desarmado. A nova espécie difere de Engraulicola forcipopenis George, 1960 e de Engraulicola micropharyngella Unnithan, 1967, pela ausência de um par de fórceps pontiagudos como espinhos localizados na extremidade do pênis, em meio aos espinhos da coroa; e de Engraulicola thrissocles Tripathi, 1959, pelo número de pinças em ambos os lados, pelo número de pares de ganchos no "lappet" terminal, e pelo número de testículos. Este é o primeiro registro do gênero Engaulicola George, 1960 para a costa oeste do Atlântico.

Reproductive biology aspects of Alopias pelagicus and A. superciliosus (Lamniformes: Alopiidae) in the Ecuadorian Pacific

ABSTRACT The reproductive biology of thresher shark species of the Ecuadorian Pacific was analysed based on 1236 specimens of Alopias pelagicus (711 females and 525 males) and 354 of A. superciliosus (164 females and 190 males) landed in Playita Mía, from January to December of 2019. The length of A. pelagicus females ranged between 67.2 and 184 cm PCL (precaudal length) and the males between 69.0 and 178.4 cm PCL, A. superciliosus registered a minimum and maximum size of 76.0 and 202.2 cm PCL for females and 94.0 and 204.8 cm PCL for males. The most frequently captured size class for A. pelagicus was 147.2157.2 cm PCL and for A. superciliosus was 156.0-166.0 cm PCL. The sex ratio (F:M) for A. pelagicus and A. superciliosus was 1.35F:1M and 0.86F:1M respectively. For A. pelagicus males the inflection point of the clasper length adjustment, was 134.2 cm PCL and size at first sexual maturity (L 50 ) was estimated at 136.0 cm PCL. For A. superciliosus males the inflection point of the clasper length adjustment, was 136.8 cm PCL, and the first sexual maturity (L 50 ) was estimated at 138.7 cm PCL.

RESUMO A biologia reprodutiva de espécies de tubarão debulhador do Pacífico Equador foi analisada com base em 1236 exemplares de Alopias pelagicus (711 fêmeas e 525 machos) e 354 de A. superciliosus (164 fêmeas e 190 machos) desembarcados em Playita Mía, entre janeiro e dezembro de 2019. O comprimento das fêmeas de A. pelagicus variou entre 67,2 e 184 cm PCL (comprimento pré-corte) e os machos entre 69,0 e 178,4 cm PCL, A. superciliosus registrou um tamanho mínimo e máximo de 76,0 e 202,2 cm PCL para as fêmeas e 94,0 e 204,8 cm PCL para machos. A classe de tamanho mais frequentemente capturada para A. pelagicus foi 147,2157,2 cm PCL e para A. superciliosus foi 156,0-166,0 cm PCL. A proporção sexual (F:M) para A. pelagicus e A. superciliosus foi de 1,35F:1M e 0,86F:1M, respectivamente. Para machos de A. pelagicus, o ponto de inflexão do ajuste do comprimento do grampo foi de 134,2 cm PCL e o tamanho na primeira maturidade sexual (L 50 ) foi estimado em 136,0 cm PCL. Para machos de A. superciliosus o ponto de inflexão do ajuste do comprimento do grampo foi de 136,8 cm PCL, e a primeira maturidade sexual (L 50 ) foi estimada em 138,7 cm PCL.

PARASITIC HELMINTHS INFECTING Eucinostomus melanopterus AND Eugerres plumieri (PERCIFORMES: GERREIDAE), FROM BOCA DEL RIO, VERACRUZ, MÉXICO / Helmintos parásitos de Eucinostomus melanopterus y Eugerres plumieri (Perciformes: Gerreidae), de Boca del Río, Veracruz, México

ABSTRACT A helminthological examination was carried out on 14 specimens of Eucinostomus melanopterus (flagfin mojarra) and 19 Eugerres plumieri (striped mojarra), of which a total of 461 helminths were collected. As a result, and 12 taxa were registered (five species, five genus and tow family), as follows: four monogeneans, five digeneans (four adults, one metacercaria), one cestode (larva) and tow nematodes (larvae). The highest prevalence was for Neodiplectanum mexicanum (29 %) infecting E. melanopterus and Aristocleidus hastatus (37 %) infecting E. plumieri. Both hosts shared 50 % of recorded species, and none of the identified helminthes represents a zoonotic risk.

RESUMEN Se efectuó un examen helmintológico a 14 especímenes de Eucinostomus melanopterus (mojarra bandera) y 19 Eugerres plumieri (mojarra rayada), de los cuales se recolectaron un total de 461 helmintos. Se identificaron 12 taxones (cinco a nivel de especie, cinco a género y dos a familia) como sigue: cuatro monogéneos, cinco digéneos (cuatro adultos, una metacercaria), un céstodo (plerocercoide) y dos nemátodos (larvas). La prevalencia más alta fue para Neodiplectanum mexicanum (29 %) en E. melanopterus y Aristocleidus hastatus (37 %) en E. plumieri. Ambos hospederos comparten el 50 % de los taxones de parásitos. Ninguno de los helmintos representa un riesgo zoonótico.

Factores de riesgo que influyen en el fracaso al tratamiento individualizado de tuberculosis multidrogorresistente en la provincia de Ica. 2000-2014 / Risk factors that influence in the failure to the individualized treatment of multidrug-resistant tuberculosis in the province of ica. 2000-2014

Objetivo: Determinar los factores de riesgo que influyen en el fracaso al tratamiento individualizado de Tuberculosis Multidrogorresistente en la provincia de Ica. 2000-2014. Materiales y métodos: Estudio observacional, retrospectivo, tipo analítico, de casos y controles. La muestra estuvo conformada por 19 casos de fracaso al tratamiento individualizado, y por cada caso se tuvo dos controles de pacientes que curaron con tratamiento individualizado. Se realizó el análisis bivariado con un nivel de significancia del 5% se calculó del Odds Ratio (OR) con intervalo de confianza (IC) al 95%. Se realizó análisis de regresión logística. Resultados: En el análisis multivariado resultaron 4 factores de riesgo asociados a fracaso al tratamiento individualizado: resistencia a 5 o más drogas (OR=6,67, p=0,027), tener IMC menor de 18.5 al inicio del tratamiento (OR=7,61 p=0,023), presentar hemoptisis durante el tratamiento (OR= 19,89, P=0,001) y la presencia de cavernas en la radiografía de tórax inicial (OR=27,95, p=0,005). Conclusiones: Los pacientes con resistencia a 5 o más drogas antituberculosas, con IMC menor a 18.5, con hemoptisis durante el tratamiento y los que presentan caverna en la radiografía de tórax, tienen mayor riesgo de fracasar al tratamiento individualizado. (AU)

Objective: To determine the risk factors that influence the failure to individualized treatment of multidrug-resistant tuberculosis in the province of Ica. 2000-2014. Materials and methods:Observational, retrospective study, analytical type, of cases and controls. The sample consisted of 19 cases of failure to individualized treatment, and for each case there were two controls of patients who cured with individualized treatment. The bivariate analysis was performed with a level of significance of 5% was calculated from the Odds Ratio (OR) with 95% confidence interval (CI). Logistic regression analysis was performed. Results: In the multivariate analysis, there were 4 risk factors associated with failure to individualized treatment: resistance to 5 or more drugs (OR = 6.67, p = 0.027), having a BMI less than 18.5 at the beginning of treatment (OR = 7, 61 p = 0.023), presenting hemoptysis during treatment (OR = 19.89, P = 0.001) and the presence of caverns on the initial chest radiograph (OR = 27.95, p = 0.005). Conclusions: Patients with resistance to 5 or more antituberculous drugs, with a BMI less than 18.5, with hemoptysis during treatment and those who have a cavern on chest radiography, have a higher risk of failing individualized treatment. (AU)

An ethnobotanical survey of spice, aromatic and medicinal plants used in La Molana, Atrato-Choco, Colombia: Basis for biodiversity conservation

A characterization and analysis of the production systems of aromatic, medicinal and spice plants (AMSP) was carried out in La Molana, Atrato-Chocó, Colombia throughout the identification of their biophysical, socioeconomic and financial characteristics, in order to propose agroecological alternatives that solve the problems and identified needs in said systems; applying methodologies and evaluation indicators of agricultural systems addressed to sustainable rural development, design, implementation and evaluation of agroforestry arrangements, agroforestry systems accompanied by WOST analysis, and agroforestry planning of productive units (APPU), this information was collected through the application of a focal workshop and semi-structured questionnaires to 40 smallholders. Therefore, eight productive units (UP) with four plots and four rooftop, which was characterized throughout a simple random sampling without replacement. The results indicate that these smallholders destine 15.6 ha to AMSP production, from which 11 ha are crops structured in plots within native forests and 4.6 ha are destined to crops in rooftops around the houses. The units produce on average, 110 units (bunches) per week, which are offered to informal vendors in the market place of Quibdo-Choco, Colombia with prices which ranged from COP $ 1000 to COP $ 3000 according to plant size and species. Likewise, was determined that the economic incomes of the AMSP units depend mainly on the following planted species: Cilantro cimarrón (Eryngium foetidum L.), cimarron (Eryngium foetidum L.), Albahaca (Ocimum basilicum L.) and Oregano (Origanum vulgare L.), which are the most economically important species in the study area.

Jugo de caña de azúcar en dietas de crecimiento y finalización para cerdos: efectos en el comportamiento productivo y rasgos de canal / Sugar cane juice in growing and finishing diets for pigs: effects on growth performance and carcass trait

Se realizó un estudio para evaluar el comportamiento productivo y rasgos de la canal en 50 cerdos (peso inicial, 25 kg) alimentados con dietas basadas en jugo de caña de azúcar (JCA) dado ad libitum, como principal fuente de energía, desde el peso inicial de 25; 30; 40 o 55 kg, comparada con una dieta control a base de maíz como principal fuente de energía. Durante la fase de crecimiento no hubo ventajas en el comportamiento cuando los cerdos fueron alimentados con JCA desde los 55 kg, e igualmente durante la fase de finalización y durante todo el experimento. Los rasgos de la canal no revelaron ninguna diferencia como resultado de la introducción del JCA en la dieta de los cerdos. Los resultados indicaron que el JCA puede ser dado ad libitum a los cerdos desde las primeras fases de crecimiento y que posiblemente, el aporte dietético de proteína pueda ser reducido.

Factores de riesgo para tuberculosis multidrogorresistente en la provincia de Ica. Dirección Regional de Salud. Ica. 2000-2002 / Factors of risk for tuberculosis multidrug-resistant in Ica's province. Regional direction of Health. Ica. 2000-2002

Objetivo: Determinar los factores de riesgo para resistencia a medicamentos antituberculosos en pacientes con tuberculosis pulmonar multidrogorresistente. Material y Métodos: El dise±o del estudio es analítico, de casos y controles, pareados por edad, procedencia y sexo. Se incluyó en el estudio 51 casos y 102 controles. Se definió como caso, a todo paciente con diagnóstico de tuberculosis pulmonar multidrogorresistente, y como controles a los pacientes con diagnóstico de Tuberculosis Pulmonar que egresaron al término de tratamiento como curados. Todos los pacientes fueron registrados en el Comité de evaluación de retratamiento del Programa de control de Tuberculosis. Resultados: Los factores de riesgo encontrados en este estudio fueron los abandonos de tratamiento (OR= 7.54,P = 0.0001), tener antecedentes de tratamiento (OR= 6.91, P = 0.0000001) , haber tenido tratamiento inicial con drogas de segunda línea para Tuberculosis (OR = 10.98, P = 0.008) , tener tratamiento con esquemas diferentes al normado por el Programa de Control de Tuberculosis (OR= 7.07, P = 0.001), tomar medicamentos en casa sin supervisión(OR=5.19, P =0.000008), tener contacto domiciliario con pacientes con Tuberculosis Multidrogorresistente, (OR = 15.09, P = 0.000005), tener contacto extradomiciliario con pacientes con Tuberculosis multidrogorresistente (OR12.49, P =0.000005) y tener un familiar fallecido de Tuberculosis (OR= 8.78,p= 0.000008). Conclusiones: Es importante tener presente los factores de riesgo para Tuberculosis Multidrogorresistente encontrados en el presente estudio, para evitar nuevos casos dentro de los contactos, y usar esquemas basados en los lineamientos del Programa de control de Tuberculosis.

Balon intragástrico: una alternativa en el tratamiento de la obesidad estudio preliminar / Intragastric balloon: an alternative in the obesity treatment preliminary study

El balón intragástrico (BIG) es un método alternativo para el tratamiento de no quirúrgico la obesidad. Determinar la utilidad del BIG en la pérdida de peso en el paciente con obesidad. Descriptivo y longitudinal de una muestra inicial de 23 pacientes, se completó el estudio con 16 pacientes, 4 del sexo masculino y 12 del femenino, en edades comprendidas entre 22 a 60 años. La pérdida de peso promedio al final de los seis meses fue de 16,1 Kg, que representa el 15 por ciento del sobrepeso. La circunferencia de cintura disminuyó 11,5 cm y de brazo 4,5 cm. Los hombres tuvieron una pérdida de peso de 21,3 kg y las mujeres de 13,7 kg. No hubo complicaciones, sólo se observaron dolor abdominal tipo cólico leve, acidez, regurgitación, náuseas y vómitos. El BIG puede considerarse un método efectivo en la pérdidad de peso en los pacientes con obesidad

Helmintos del pez Dormitator maculatus (Osteichthyes: Eleotridae) de Alvarado, Veracruz, México / Helminths from the fish Dormitator maculatus (Osteichthyes: Eleotridae) from Alvarado, Veracruz, Mexico

Dormirator maculatus (n=184) was collected in the Alvarado Lagoon, Mexico during a year period (Oct. 1993-1994). In the helminthologic review, the presence of Clinostomum complanatum (82.3%), Neoechinorhynchus golvani (76.1%), Spiroxys sp. (21.3 %), and Camallanus sp. (6.2%) was registered. Reduction of the hematocrit caused by such infection is significant (t, a= 0.05).

Leiomioma del estomago: reporte de un caso con crecimiento exogástrico / Leiomyoma of stomach: report a case with exogastric growth

Reportamos un caso de un leiomioma del estómago de crecimiento exogastrico pediculado. Se realiza revisión de la literatura con descripción de la clínica, aspectos terapéuticos y dificultades diagnósticas de esta relativamente rara patología gástrica

Enfoque actual de la problemática salud-sociedad en pacientes con mastectomía / Current approach of the health-society problem in patients undergoing mastectomy

Se presenta una valoración socio-ética sobre los problemas psicológicos, familiares, económicos y laborales a los que están expuestas las pacientes con cáncer mamario y se les realiza mastectomía. El estudio realizado permitió corroborar cómo los problemas antes mencionados inciden de forma significativa en la vida de estas pacientes. Se confiere gran importancia al diagnóstico precoz de la enfermedad, la rehabilitación integral de estas pacientes y la función predominante que tiene la sociedad y el estado cubano en la búsqueda de una mejor calidad de vida de estas enfermas

Herido por quemaduras en situaciones de contingencia bélica y tiempo de paz / Wounds caused by burns in war contingencies and peace times

Se presenta una revisión del manejo del herido por quemaduras en situaciones de contingencia bélicas y tiempo de paz. Se expone y actualiza la conducta a seguir en las diferentes etapas de tratamiento y evacuación

Clasificación del herido por quemaduras en condiciones normales y situaciones de contingencia

Se realizó una revisión bibliográfica de las clasificaciones de pronóstico de vida del herido por quemadura en condiciones normales y situaciones de contingencia. Se analizó de forma particular la clasificación cubana de pronóstico que tiene un aval de más de 25 años de aplicación en el Servicio de Caumatología del Instituto Superior de Medicina Militar "Dr. Luis Díaz Soto" y se tuvo en cuenta el criterio de experto, con la fundamentación referida se propuso 2 clasificaciones, una para situaciones de contingencia en 3 tipos de pacientes quemados: leves, moderados y graves, así como las prioridades para la evacuación. Para tiempo de paz la clasificación se establece en 2 grupos: grupo 1- herido por quemadura hasta el 4 % y grupo 2- herido por quemadura de más de 4 %. Estas clasificaciones que se basan en la extensión, permiten un flujo más adecuado para la atención del paciente según los niveles de prioridad.

A bibliographic review of the classifications of the prognoses of life of the wounded as a result of burns under normal conditions and contingencies is made. The way used in Cuba to classify the prognosis, which has been applied at the Burns Service of "Dr. Luis Díaz Soto" Higher Institute of Military Medicine for more than 25 years, was particularly analyzed and the critreria of experts were taken into account to propose 2 classifications, one for contingencies into 3 types of burned patients: mild, moderate and severe, including the priorities for evacuation, and the other to be used in times of peace with 2 groups of patients: group 1) the wounded by burns affecting up to 4 % of the body surface, and group 2) the wounded by burns affecting more than 4 % of the body surface. These classifications that are based on the burn size allow a more adequate flow to give attention to the patient according to the levels of priority.