Seguridad alimentaria, subalimentación y canasta alimentaría en el contexto de las políticas públicas en Venezuela. Período2017-2022 / Food security, undernourishment and food basket in thecontext of public policies in Venezuela. Period 2017-2022

El presente estudio tiene como objetivo analizarla relación entre los indicadores de seguridad alimentaria,subalimentación y costo de la canasta alimentaria en el contextode las políticas públicas en materia alimentaria en Venezuela,durante el periodo comprendido entre 2017 y 2022. Para ello, sellevó a cabo un análisis exhaustivo de los datos disponibles sobrela seguridad alimentaria en Venezuela, incluyendo informaciónsobre la subalimentación, y el costo de la canasta alimentaria.Asimismo, se analizaron las políticas públicas implementadas enel país en materia alimentaria durante el periodo de estudio, conel fin de entender su impacto en los indicadores de seguridadalimentaria. Ninguna de las asociaciones estudiadas resultó sersignificativa a nivel estadístico (p>0,05), por lo que, aunqueteóricamente existe una relación entre estos indicadores en elperíodo estudiado, el carácter multidimensional prevalece y hacecompleja la posibilidad de comparaciones. Se identificaron laspolíticas públicas que requieren mejoras o ajustes para proteger laseguridad alimentaria del venezolano. Estos resultados obtenidospodrán ser de utilidad para los responsables de la toma dedecisiones en el país, así como para los investigadores yprofesionales interesados en el tema de la seguridad alimentariay la nutrición

EL objective of this study is to analyzethe relationship between the indicators of food security,undernourishment and the cost of the food basket in thecontext of public policies on food in Venezuela, during theperiod between 2017 and 2022. For this, an exhaustive analysisof the available data on food security in Venezuela wascarried out, including information on undernourishment, andthe cost of the food basket. Likewise, the public policiesimplemented in the country regarding food during the studyperiod were analyzed, in order to understand their impacton food security indicators. None of the associations studiedturned out to be statistically significant (p>0.05), therefore,although theoretically there is a relationship between theseindicators in the period studied, the multidimensional natureprevails and makes comparability complex. Public policies that require improvements or adjustments to protect Venezuelanfood security were identified. These results obtained may beuseful for those responsible for decision-making in the country,as well as for researchers and professionals interested in thesubject of food security and nutrition.

Intervención educativa con elementos de Educación Popular en Salud para prevenir la picadura de alacrán / Educational intervention with elements of Popular Health Education to prevent scorpion stings

Resumen Objetivo: Evaluar la implementación de una intervención educativa con elementos de Educación Popular en Salud sobre el empoderamiento y los cambios en salud para la prevención de la picadura de alacrán, en mujeres del municipio de Tetecala, Morelos. Material y métodos: La intervención educativa se realizó en mujeres adscritas al programa PROSPERA, con 16 participantes, así, consistió en cinco sesiones de manera semanal, con tiempo de dos horas, aproximadamente, cada una. Se realizó un triple diagnóstico sobre los conocimientos y las causas de la picadura de alacrán, con esa información, se diseñan los principales componentes de la estrategia educativa (1. Conocimiento del alacrán; 2. Riesgos para la picadura de alacrán; 3. Prevención de la picadura de alacrán), lo que se lleva a cabo en los meses de febrero y marzo del 2019. Se evalúan dos categorías, empoderamiento y cambios en salud, ahondando en elementos descritos por Noelle Wiggins, mediante metodología mixta. Las mediciones se realizan al mismo grupo previo y posterior a la intervención educativa; la evaluación cualitativa se realiza mediante el análisis de registro etnográfico, asimismo, la parte cuantitativa se aplica cuestionario sobre conocimientos y prácticas. Resultados: Se identifican cambios en elementos de empoderamiento, así como cambios en salud. Conclusiones: Emplear elementos de Educación Popular en Salud tiene efectos similares a estrategias donde se emplea la metodología pura, así, en la prevención de la picadura de alacrán, muestra resultados similares con otros problemas en salud.

Abstract Objective: To evaluate implementation of an educational initiative with elements of Popular Health Education on empowerment and changes in health for prevention of scorpion stings, in women from municipality of Tetecala, Morelos. Material and methods: Educational initiative was carried out in women assigned to PROSPERA program, with 16 participants. It consisted of 5 weekly sessions, with a time of approximately 2 hours each. A diagnosis was made on the knowledge and causes of the scorpion sting, with this information the main components of educational strategy were designed (1. Knowledge of scorpion; 2. Risks for scorpion sting; 3. Prevention of scorpion sting). It was carried out in the months of February and March 2019. Two categories, empowerment and changes in health, were evaluated, delving into elements described by Noelle Wiggins, using a mixed methodology. The measurements were made to the same group before and after educational initiative. Qualitative evaluation was carried out by analyzing ethnographic record. Quantitative part was applied questionnaire on knowledge and practices. Results: Changes in elements of empowerment were identified, as well as changes in health. Conclusions: Using elements of Popular Health Education has similar effects than strategies where pure methodology is used. In the prevention of Scorpion stings, it showed similar results to other health problems.

Prospective Evaluation of Bone Remodeling in Full-Arch Rehabilitations with Morse Taper Implants: A Case Series Study with One-Year Follow-Up.

This case series study evaluated the survival, success rate and marginal bone remodeling of Morse taper hydrophilic implants placed for full-arch rehabilitations over a 1-year follow-up period. Ten patients in need of maxillary and/or mandibular full-arch rehabilitation were selected. Sixty-six Morse taper implants and sixty-six abutments were inserted. All implants were placed using a surgical flap approach without bone regeneration and were immediately loaded with definitive prostheses according to the passive fitting technique. The patients underwent clinical and radiographic follow-up at different postoperative periods: T0 = immediate (up to 1 month after surgery); T1 = 3-4 months after surgery; T2 = 6-8 months after surgery; and T3 = 1 year after surgery. The survival and success rate of the implants and the marginal bone remodeling were evaluated. Normal distribution of the outcomes was verified by Kolmogorov-Smirnov tests. Therefore, changes in vertical and horizontal marginal bone levels were assessed with paired t-tests. Results were considered significant for P < 0.05. Survival and success rates of 100% and 92.4%, respectively, were observed. Statistically significant vertical bone level changes were shown for all periods. From T0 to T3, there was a mean difference in vertical bone loss of -1.02 mm on the mesial surface and of -0.93 mm on the distal surface, for horizontal bone loss in the same period, it was observed mean changes of -0.14 mm on the mesial surface and -0.09 mm on the distal surface. This 1-year case series follow-up of immediate full-arch rehabilitation, using one-step hybrid passive fitting supported by four to six hydrophilic tapered implants, suggests predictability with high survival and success rates in edentulous patients.

Novel treatment of endobronchial inflammatory myofibroblastic tumor in a child.

Isolated endobronchial inflammatory myofibroblastic tumors (IMT) are rare, accounting for about 1% of primary endobronchial tumors in children. The mainstay of treatment for this tumor has been surgical resection. Recently, the identification of anaplastic lymphoma kinase (ALK) gene mutations in half of IMTs and promising results of treatment with ALK inhibitors in other ALK-positive tumors have opened the possibility of alternative approaches. We present a 4-year-old child with an ALK-positive endobronchial IMT, treated with endoscopic resection and neoadjuvant therapy with crizotinib, without evidence of tumor recurrence 2 years after the initial resection.

Reliability and Reproducibility of Sacro-Femoro-Pubic Angle Measurements on Anteroposterior Pelvis Radiographs.

BACKGROUND: The sacro-femoro-pubic (SFP) angle is a surrogate measurement for pelvic tilt obtained on anteroposterior (AP) pelvis radiographs. It is unknown whether the SFP angle can be measured reliably by senior surgeons and trainees alike. METHODS: We conducted an intrareader and interreader reliability study using preoperative AP pelvis radiographs. Using our hospital electronic database, we randomly selected 31 subjects undergoing primary total hip arthroplasty. An attending orthopedic surgeon and two orthopedic surgery residents performed two separate SFP angle measurements for each subject. Intrareader and interreader agreement were measured using intraclass correlation coefficients (ICC). RESULTS: Pairwise intrareader and interreader ICCs ranged from 0.91 to 0.99. Overall ICC was 0.94. Interreader ICCs between the attending surgeon and each orthopedic resident were 0.93 and 0.98, and the ICC between orthopedic residents was 0.91. Interreader mean differences for SFP angle measurements were 2.32 degrees or less: -2.03 (standard deviation: 2.23) and 0.29 (1.64) between the attending surgeon and each orthopedic resident, and 2.32 (2.44) between orthopedic residents. CONCLUSION: SFP angle may be measured reliably on AP pelvis radiographs by senior clinicians and trainees. SFP angle measurement may prove helpful as an alternative to pelvic tilt measurements when lateral pelvic radiographs are not available.

Efficacy and safety of bariatric revisions in patients older than 65 years old.

BACKGROUND: Bariatric surgery in advanced age patients (>65-years-old) has been proven safe and effective. Revisional bariatric surgery is infrequently required for cases of refractory obesity. However, there is a paucity of data regarding revisional surgery for the elderly. We hypothesize that revisional bariatric surgery is viable and safe in elderly patients. METHODS: Retrospective chart review of all bariatric revisions performed at two high-volume bariatric centers of excellence between 2011 and 2018. Perioperative and long-term outcomes were compared between patients >65 and those <65-years-old. RESULTS: 145 bariatric revisions were performed for weight loss. 10% (N = 15) were >65 years old. There were no differences in mortality between the two groups There was a longer median length of stay in the younger cohort (2 vs 1 day, p = 0.001). Percent excess weight loss was similar at 12-months, as was resolution of comorbidities. CONCLUSIONS: Bariatric revisions in elderly patients appears to be safe and effective. Revisional surgery in this population was not shown to have increased morbidity or mortality with similar excess body weight loss when compared to a younger cohort.

Previsibilidade na Instalação Imediata de Implante Cone Morse pelo Planejamento Digital e Provisionalização Imediata: Relato de Caso / Predictability in Immediate Implant Placement of Morse Taper by Digital Planning and Immediate Provisionalization: Case Report

A instalação imediata de implantes em região estética é uma prática frequente, pois reduzir a remodelação óssea e tecidual. Os implantes com interface cone Morse apresentam resultados biológicos e estéticos satisfatórios a longo prazo, pois apresentam gap reduzido entre implante e componente protético e a interface fica distante do tecido ósseo. Este artigo tem como objetivo relatar a reabilitação estética de um incisivo central superior comprometido através da instalação de um implante cone Morse utilizando a técnica da cirurgia guiada com provisionalização imediata. Paciente com 40 anos de idade, do sexo masculino, apresentava incisivo central superior (#21) com tratamento endodôntico prévio, recessão gengival vestibular, escurecimento coronário e mobilidade. O caso clínico apresentado mostrou que, após 12 meses, resultados precisos e estéticos são possíveis de alcançar com a instalação de implantes em alvéolos pós-extração e instalação de um dente provisório imediato em regiões estéticas.

The immediate placement of implant in fresh sockets in the aesthetic area is a frequent practice as it reduces bone and tissue remodeling. Morse taper implants present satisfactory biological and aesthetic results in the long term, since they present a reduced gap between implant and prosthetic component and this interface is distant from bone. This article aims to report the aesthetic restoration of a compromised central upper incisor with the placement of a Morse taper implant using guided surgery with immediate provision. A 40-year-old male patient had a central upper incisor (#21) with previous endodontic treatment, vestibular gingival recession, coronary browning, and mobility. The clinical case presented showed that, after 12 months, precise and aesthetic results are possible to achieve with the placement of implants in post-extracting alveolus and installation of an immediate provisional tooth in esthetic regions.

Descripción del problema de dengue con enfoque de la determinación social de la salud en una comunidad: estudio de campo / Description of the dengue problem with a focus on the social determinants of health in a community: field study

Este trabajo quiere contribuir con otra perspectiva a la solución del problema del Dengue en México. El objetivo fue determinar tipos de criadero de Aedes aegypti, condiciones de la vivienda e identificar dimensiones que determinen la enfermedad con enfoque integral social en la colonia centro de Mazatepec, Morelos. El estudio es de corte transversal descriptivo, se llevó a cabo en temporada de sequía (2015), se realizó colecta entomológica para identificar criaderos del vector, aplicación de Índice de Condición de Vivienda (ICV) y cuestionario con perspectiva de la Determinación Social de la Salud a 80 casas. Se detectaron 3,221 recipientes sin agua y 655 con agua, 25.34% tratables (tanques, tinacos), 9.46% controlables (botes y cubetas) y 4.7% diversos chicos, el ICV identificó 14 casas positivas (57.69%-tratables), 47.5% de medio riesgo para crecimiento del vector, el 83.3% atribuyó el problema a condiciones de vida y posesión de recursos, 40.83% responsabilizó a la comunidad, falta de interés y mala organización. Las estrategias y políticas en salud deben de tomar en cuenta la perspectiva social y análisis de las comunidades, mejorar las condiciones de vivienda, trabajo y organización comunitaria para preservar la salud(AU)

This work aims to contribute to the solution to the dengue problem in Mexico with a different approach. The objectives of the research were to determine the types of hatcheries for Aedes aegypti and housing conditions, as well as to identify the dimensions that determine the disease with an integral social approach in the Colonia Centro of Mazatepec, Morelos, Mexico. This is a descriptive cross-sectional studycarried out during the dry season in 2015, an entomological collection was made to identify the vector hatcheries, the Housing Condition Index (HCI) and a questionnaire were applied to establish the Social Determinants of Health for 80 houses. A total of 3,221 containers without water and 655 with water were detected, out of these 25.34% were tagged as manageable (water tanks), 9.46% as controllable (buckets and cans) and 4.7% as various small items. The HCI identified 14 positive houses (57.69% as manageable), 47.5% as medium risk for the development of the vector. Eighty three point three percent of the questionnaire participants attributed the problem to life conditions and resources property, 40.83% to the community, the lack of interest and disorganization as responsible. Health strategies and policies must take into account the social approach and analysis of the communities, improving housing, work and community organization conditions to preserve health(AU)

Prevención y control de la hipertensión arterial en estudiantes de la escuela "Antonio Rodríguez". Colón 2016 / Prevention and control of arterial hypertension in students from "Antonio Rodríguez" school. Colón 2016

Introducción: la hipertensión arterial es la más común de las condiciones que afectan mundialmente la salud de los individuos adultos, por lo que es importante que aumente la percepción de riesgo desde edades pediátricas. Objetivo: diseñar un proyecto de intervención educativa en adolescentes de la ESBU "Antonio Rodríguez", de Colón, para prevenir la hipertensión arterial en edades adultas y promover estilos de vida y entornos saludables. Materiales y métodos: constituyó un corte de un proyecto comunitario del Policlínico "Dr. Carlos J. Finlay". Se realizó un estudio descriptivo transversal, durante febrero-mayo de 2016. La muestra fueron 158 adolescentes, de 9no grado, de la ESBU "Antonio Rodríguez" del municipio Colón. Se efectuaron las mediciones correspondientes y se elaboró una encuesta para la recogida de datos. Se estudiaron las variables siguientes: edad, sexo, raza, índice de masa corporal, hábitos tóxicos y hábitos alimentarios. Resultados: predominó el sexo femenino y los estudiantes de raza blanca. Se diagnosticaron 58 pre-hipertensos y 3 hipertensos grado 1, que se estudiaron y trataron. Los factores de riesgo alimentario más frecuentes fueron la ingestión de potasio, calcio y sodio de riesgo. El tabaquismo pasivo prevaleció, y aunque, el estado nutricional normal fue el más frecuente, resultó alarmante el número de adolescentes bajo peso. Conclusiones: los malos hábitos alimentarios y estilos de vida poco saludables fueron los factores de riesgo que más incidieron en los adolescentes de la muestra estudiada (AU).

Background: arterial hypertension is the most common of the conditions that affect health of adult persons all over the world, therefore it is very important to increase risk perception since pediatric ages. Objective: to design a project of educative intervention in teenagers from "Antonio Rodríguez" secondary school in the municipality of Colón to prevent arterial hypertension in adult ages and to promote healthy life styles and surroundings. Materials and methods: it was made a cut of a communitarian project of the polyclinic "Dr Carlos J. Finlay". A cross-sectional, descriptive study was carried out during the period February-May 2016. The sample were 158 ninth-grade teenagers belonging to "Antonio Rodríguez" secondary school of Colón municipality. The corresponding measures were taken and an inquiry was elaborated for collecting data. The studied variables were the following: age, sex, race, corporal mass index, toxic habits, and alimentary habits. Results: the female sex and white students predominated. 58 pre-hypertensive students and 3 grade-1 hypertensive ones were diagnosed. They were studied and treated. The most frequent alimentary risk factors were the ingestion of risk levels of potassium, calcium and sodium. Passive smoking prevailed and, although the normal nutritional status was the most frequent, it was alarming the number of low weight teenagers. Conclusions: bad alimentary habits and unhealthy life styles were the risk factors that stroke the most on the teenagers of the studied sample (AU).

Association of dengue fever with Aedes spp. abundance and climatological effects / Asociación de casos de dengue con variación en la abundancia de Aedes y clima

Abstract: Objective: To analyze the association of dengue fever incidence with Aedes mosquito's abundance, and the effect of climatological and geographical variables, in a region in Morelos State, Mexico. Materials and methods: Weekly data during the period 2010 to 2014 was used. Mosquito abundance was determined using ovitraps. Confirmed dengue cases were obtained from the Epidemiological Surveillance System. Climatic variables were obtained from weather monitoring stations. The correlation between climate variables and ovitraps data was estimated using a multivariate regression model. Results: A correlation of mosquito abundance with dengue fever incidence, and a yearly pattern with seasonal variations were observed. The daily mean temperature, relative humidity and rainfall parameters were associated with mosquito egg abundance. Time lags of three and four weeks between egg counts and dengue fever incidence were observed. Conclusion: Time lags between egg counts and dengue incidence could be useful for prevention and control interventions.

Resumen: Objetivo: Analizar la asociación de la incidencia de dengue con la abundancia de mosquitos Aedes y el efecto de variables climatológicas, en una región de Morelos, México. Material y métodos: Se utilizaron datos semanales durante el 2010-2014. La abundancia de mosquitos se determinó utilizando ovitraps. Los casos de dengue se obtuvieron del Sistema de Vigilancia Epidemiológica. Las variables climáticas se obtuvieron de estaciones climatológicas locales. La correlación entre las variables climáticas y los datos de ovitrampas se estimó mediante un modelo de regresión multivariado. Resultados: Se observó una correlación de la abundancia de mosquitos con la incidencia de dengue. La temperatura media diaria, humedad relativa y la precipitación pluvial se asociaron con abundancia de mosquitos. Se observó un desfase temporal de tres a cuatro semanas entre cuentas de huevos y la incidencia de dengue. Conclusión: Los intervalos entre las cuentas de huevos y la incidencia de dengue podrían ser utilizados para planear intervenciones de prevención y control.

Design and efficacy of an Ecohealth competency-based course on the prevention and control of vector diseases in Latin America / Diseño y eficacia de un curso de Ecosalud basado en competencias para el control de enfermedades transmitidas por vector en América Latina

Abstract: Objective: To design and analyze the efficacy of an Ecohealth competency-based course on the prevention and control of vector-borne-diseases for specific stakeholders. Materials and methods: Multiple stakeholders and sectors of the region were consulted to identify Ecohealth group-specific competencies using an adjusted analysis matrix. Eight courses based on the competencies were implemented to train EA tutors. The effectiveness of the course was evaluated through the use of paired- t-tests by intervention group. Results: Strategic, tactical, academia and community stakeholder groups and their competencies were identified. An overall gain of 43 percentage points (p<0.001) was observed in terms of competencies score in trained tutors, which further trained 1 033 people. Conclusion: The identification of the stakeholders and their competencies proved to be useful to guide training courses to significantly improve the initial competencies and create a critical mass to further advance the EA in the region.

Resumen: Objetivo: Diseñar y analizar la eficacia de un curso basado en competencias de Eco-Salud para la prevención y control de enfermedades transmitidas por vectores, para actores específicos. Material y métodos: Se consultaron múltiples actores y sectores de la región para identificar las competencias específicas del enfoque de Ecosalud, que deberían de tener los grupos clave utilizando un análisis de matriz ajustado. Se implementaron cursos de capacitación utilizando las competencias para capacitar a tutores en el enfoque. La efectividad del curso se evaluó mediante el uso de pruebas t pareadas por grupo de intervención. Resultados: Se identificaron los grupos clave para la prevención y control de las ETVs: estratégico, táctico, académico y comunitario, así como sus competencias. Se capacitaron tutores y se obtuvo un incremento en relación con las competencias iniciales de 43 puntos porcentuales (p <0.001). Conclusión: La identificación de los grupos clave y sus competencias demostró ser útil en el diseño de un curso para incrementar el nivel inicial de competencias y crear una masa crítica para Ecosalud en la región.

Ángel Florencio Duque Pérez, microbiólogo colombino / Ángel Florencio Duque Pérez, a Colombinan microbiologist

Muchos han sido los médicos cubanos que se han dedicado al estudio de la microbiología médica, entre ellos algunos muy conocidos como el matancero Juan Guiteras Gener. Con este trabajo los autores pretendieron resaltar la figura del microbiólogo colombino Ángel Florencio Duque Pérez, primer microbiólogo matancero formado por la revolución y con una esmerada labor. Fallecido hace varios años, este excelente profesional es poco conocido y prácticamente ha quedado en el olvido. Para todos aquellos que lo conocieron y para los que no tuvieron ese enorme placer se les hace llegar esta síntesis biográfica (AU).

There have been many Cuban doctors who have devoted themselves to the study of Medical Microbiology, including well-known ones as the Matanzasan Juan Guiteras Gener. With this work the authors pretended to highlight the figure of the Colombinan microbiologist Florencio Angel Duque Pérez, the first microbiologist trained after the Revolution, with an important work. Deceased several years ago, this excellent professional is scarcely known and has been virtually forgotten. This biography is intended to all those who knew him and to all those who did not have that great pleasure (AU).

Digital Joint Reconstruction with Osteotendinous Joint Allograft: Experimental Study in Rats.

BACKGROUND: Fresh or frozen nonvascularized osteotendinous joint allografts (OTJA) have not been used previously, clinically or experimentally, for metacarpophalangeal joint reconstruction. Therefore, we evaluated the viability of OTJA for metatarsophalangeal joint (MTJ) reconstruction in rats. METHODS: In the experimental group of 12 Lewis rats, we reconstructed the MTJ of the third digit of the hindlimb with a fresh, nonvascularized OTJA obtained from the same digit from 12 donor rats. In the control group of 6 Lewis rats, an autologous composite osteotendinous graft of the MTJ of the same digit was obtained and repositioned in situ as an auto-transplant. Weight, pain, edema, dehiscence, and wound infection were evaluated every 24 hours for 30 days postoperatively. At the end of 30 days, we evaluated digit position, flexion and extension, passive mobility, radiological bone healing, and histological grades of rejection. RESULTS: We found no statistically different changes in weight, edema, pain, digit position, or radiological bone healing in either group. No wound dehiscence or infection was seen in any of the rats. Ten degrees of flexion and extension mobility were lost in the control group; the experimental group lost up to 30 degrees (P = 0.009). Histologically, 9 of the experimental group rats (9/12, 75%) showed rejection reactions compared with none of the controls (0%) (P = 0.009). CONCLUSIONS: Fresh nonvascularized OTJA caused an immune reaction without exposure of the graft, but with bone resorption. However, the rats maintained digital form and alignment with decreased passive flexion and extension of 10-30 degrees.

[Functional and radiological evaluation of patients with midshaft clavicle fracture surgically treated]. / Evaluación funcional y radiológica de pacientes con fractura diafisiaria de clavícula manejados quirúrgicamente.

BACKGROUND: Functional and radiographic evaluation at midshaft clavicle fractures is better with surgical than conservative management. The aim of this paper is to describe the functional and radiological evaluation of patients with midshaft clavicle fracture surgery at the Hospital de Traumatología y Ortopedia of the Instituto Mexicano del Seguro Social. METHODS: Descriptive studies, conducted during the period June 2014 to June 2015, patients undergoing surgical treatment for midshaft clavicle fracture were included. Constant-Murley and Montoya Scales were used to evaluate the functionality and radiological consolidation 6 months after the treatment. RESULTS: There were 90 patients, average age was 33.63 years, 78.9% were men, left side affected in 53.3% patients. At 6 months after surgery, functional results were excellent in 87.8% of patients, in 91% there was disappearance of fracture line regardless callus. The group of patients aged 18 and 40 years present better functional and radiographic results compared to the other groups (p <0.05). CONCLUSIONS: The management of patients with diaphyseal clavicle fracture should be surgical, ages between 18 to 40 years and between 61 to 76 years have better functional outcomes with greater consolidation of fracture line regardless of the callus.

Introducción: el manejo quirúrgico de las fracturas diafisiarias de clavícula da buenos resultados funcionales y una consolidación radiológica adecuada. El objetivo de este trabajo es describir la evaluación funcional y radiológica de los pacientes con fractura diafisiaria de clavícula operados en el Hospital de Traumatología y Ortopedia del Instituto Mexicano del Seguro Social. Métodos: estudio descriptivo, realizado durante el período de julio 2014 a junio 2015, en el que se incluyeron pacientes sometidos a tratamiento quirúrgico por fractura diafisiaria de clavícula. Se aplicaron las escalas Constant-Murley y Montoya para evaluar la funcionalidad y la consolidación radiológica a los 6 meses. Resultados: fueron 90 pacientes, con edad promedio de 33.63 años, 78.9% fueron hombres, el lado izquierdo estuvo afectado en el 53.3% de los pacientes. A los 6 meses de operados, los resultados funcionales fueron excelentes en el 87.8% de los pacientes, en el 91% hubo desaparición del trazo fracturarlo, independientemente del callo óseo. El grupo de pacientes de edades entre 18 y 40 años presentan mejores resultados funcionales y radiográficos que los otros grupos de edades (p < 0.05). Conclusiones: el manejo quirúrgico de los pacientes con fractura diafisiaria de clavícula ofrece buenos resultados funcionales y consolidación radiográfica. Las edades entre 18 a 40 años y entre 61 a 76 años tienen mejores resultados funcionales con una mayor consolidación del trazo fracturario independientemente del callo óseo.

Bilateral Forearm Transplantation in Mexico: 2-Year Outcomes.

BACKGROUND: Patients with proximal forearm and arm transplantation have obtained and/or maintained function of the elbow joint and full active range of motion of the extrinsic muscles of the hand, but with diminished protective sensibility and a lack of good function of the intrinsic muscles. These patients have improved function, as measured by the Disabilities of the Arm, Shoulder and Hand questionnaire. METHODS: We report the case of a 52-year-old man who suffered a high-voltage electrical burn requiring amputation of his upper limbs. He underwent bilateral proximal forearm transplantation in Mexico City in May 2012. RESULTS: At 2-year follow-up, immunosuppressive treatment has not led to metabolic, oncologic, or infectious complications. Keloid scars developed at the graft-recipient interface. There have been 4 acute rejections: the fourth was treated with methylprednisolone, rituximab, and immunoglobulin. Chronic rejection has not been detected. The extrinsic muscles of the wrist and digits have good function. Although the intrinsic muscles demonstrated electrical activity 15 months postoperatively, clinically, they are nonuseful. After 2 years, hand function is sufficient to allow the patient to grasp lightweight and medium-sized objects. The patient's Disabilities of the Arm, Shoulder and Hand questionnaire score improved from 50.00 points to 30.83 points, and his Hand Transplantation Score System rating is good, at 69/73 (right/left) of 100. The patient and his family are very satisfied with the functional and aesthetic outcomes. CONCLUSIONS: Upper arm or proximal forearm transplantation is a reconstructive option for patients who have experienced amputation because of trauma.

Digital Reconstruction with a Nonfrozen Osteotendinous Allograft, Nerve Allografts, and Autogenous Radial Free Flap.

A 21-year-old man underwent amputation of his second to fifth fingers at the proximal phalanx level on the right hand. The third and fourth fingers were reconstructed with 2 toe-to-hand free transfers. The fifth digit was reconstructed with a nonfrozen osteotendinous allograft, nerve allografts, and autogenous radial free flap without immunosuppression. The patient was lost to follow-up for 19 years. He received no rehabilitation. He reported that he had experienced no adverse reactions to the materials or the graft, or infection, or fractures. No additional surgical procedures were performed. Today, the digit is functional and has acceptable aesthetic appearance. This outcome is similar to those obtained in digits reconstructed with frozen osteotendinous allografts and autologous cutaneous covers and opens the possibility for future research.

Evaluación de plantas de Curcuma longa L. obtenidas por cultivo de tejidos en condiciones de organopónico / Evaluation of Curcuma longa L. plants obtained by tissue culture in organoponic conditions

La cúrcuma es una planta utilizada como condimento y colorante que posee múltiples propiedades medicinales. La evaluación de la estabilidad genética y la respuesta en condiciones de producción constituye una etapa muy importante en los sistemas de propagación de plantas por cultivo de tejidos. En este trabajo se evaluó la respuesta morfoagronómica de plantas de cúrcuma obtenidas por cultivo de tejido y por rizomas en condiciones de organopónico. Los resultados muestran una alta supervivencia (100%), para las plantas provenientes del cultivo in vitro, así como para las obtenidas a partir de los rizomas. Se logró un mayor crecimiento de las plantas propagadas por el cultivo de tejidos durante todo el ciclo de cultivo, sin cambios en las características morfológicas evaluadas. Los rendimientos en las plantas provenientes del cultivo de tejidos fueron superiores en comparación con las plantas propagadas por el método tradicional.

Turmeric is a plant uses like condiment and coloring. It has multiples medicinal properties. The genetic stability and response in production conditions is an important stage in plant propagation system by tissue culture. In this paper was evaluated the morphoagronomic response of turmeric plants obtained by tissue culture in organoponic conditions. Results show a high survival (100%) for a plant from in vitro culture as well as for the plant obtained by rizomes . A bigger growth of the plants obtained by tissue culture was observed during the whole cultured cycle without changes in the morphologycal characteristic evaluated. The yields of the plants obtained by tissue culture were higher that the plants planted by the traditional method.

Seroepidemiología del paludismo en un grupo de migrantes en tránsito (Chiapas, 2008)

OBJETIVO: Conocer la prevalencia del paludismo y los factores asociados con la infección de migrantes en la frontera sur de México, durante 2008. MATERIAL Y MÉTODOS: En 706 migrantes, se investigó la infección activa mediante prueba rápida y PCR o pasada, mediante serología y se aplicó un cuestionario para investigar las condiciones asociadas con la infección. RESULTADOS: 85.6% provenía de Centroamérica. Ninguno presentó infección activa; 4.2% fue seropositivo y la mayoría provenía de los países con mayor incidencia de paludismo en la región. La seropositividad se asoció con el número de episodios previos de paludismo (RM=1.44; IC95% 1.04-2.00), años de permanencia en su comunidad de origen (RM=1.03; IC95% 1.00 -1.07) y conocimiento y automedicación con antipalúdicos (RM=3.38; IC95% 1.48-7.67). CONCLUSIONES: La exposición previa de migrantes al paludismo y las dificultades para su detección indican la necesidad de nuevas estrategias para la vigilancia epidemiológica para estas poblaciones.

OBJECTIVE: To know the prevalence of malaria and the factors associated with the infection in migrants in the southern border of Mexico, during 2008. MATERIALS AND METHODS: In 706 migrants, active malaria infection was investigated using a rapid diagnostic test and PCR and past infection using serology. A questionnaire was applied to investigate the conditions associated to infection. RESULTS: 85.6% originated from Central America, none presented an active infection, although 4.2% were seropositive, most of these came from the countries with the highest malaria incidence in the region. Seropositivity was associated with the number of previous malaria episodes (OR=1.44; IC95% 1.04-2.00), years living in their community of origin (OR=1.03; IC95% 1.00-1.07), and knowledge and self-medication with anti-malaria drugs (OR=3.38; IC95% 1.48-7.67). CONCLUSIONS:. The previous exposure of migrants and the difficulties for their detection indicate the need of new strategies for the epidemiological surveillance for these populations.