Differential item functioning by language on the PROMIS® physical functioning items for children and adolescents.

PURPOSE: To assess the equivalence of self-reports of physical functioning between pediatric respondents to the English- and Spanish-language patient-reported outcomes measurement information system (PROMIS®) physical functioning item banks. METHODS: The PROMIS pediatric physical functioning item banks include 29 upper extremity items and 23 mobility items. A sample of 5091 children and adolescents (mean age = 12 years, range 8-17; 49% male) completed the English-language version of the items. A sample of 605 children and adolescents (mean age = 12 years, range 8-17; 55% male; 96% Hispanic) completed the Spanish-language version of the items. RESULTS: We found language (English versus Spanish) differential item functioning (DIF) for 4 upper extremity items and 7 mobility items. Product-moment correlations between estimated upper extremity and mobility scores using the English versus the equated Spanish item parameters for Spanish-language respondents were 0.98 and 0.99, respectively. After excluding cases with significant person misfit, we found DIF for the same 4 upper extremity items that had DIF in the full sample and for 12 mobility items (including the same 7 mobility items that had DIF in the full sample). The identification of DIF items between English- and Spanish-language respondents was affected slightly by excluding respondents displaying person misfit. CONCLUSIONS: The results of this study provide support for measurement equivalence of self-reports of physical functioning by children and adolescents who completed the English- and Spanish-language surveys. Future analyses are needed to replicate the results of this study in other samples.

[¿Azitromicina como tratamiento contra Chlamydia trachomatis?]

Azithromycin and doxycycline effectiveness has been demonstrated in the treatment of urogenital chlamydiasis, which has remained unchanged for a long time. Autoinoculation has been proposed as a method of reinfection and persistence of the disease in women and probably also owing to azithromycin pharmacokinetics in this tissue. With the new diagnostic methods and tests of cure, a difference has been demonstrated in favor of doxycycline in the treatment of rectal chlamydiasis Antimicrobial resistance has not played a relevant role since no treatment-resistant strains have been found in vivo. Nevertheless, azithromycin remains a first-choice drug, since it can be administered as a single dose, which favors therapeutic adherence.

Se ha demostrado la efectividad de la azitromicina y la doxiciclina en el tratamiento de la clamidiasis urogenital, lo que se ha mantenido sin cambios por mucho tiempo. Se ha propuesto la autoinoculación como método de reinfección y persistencia de la enfermedad en las mujeres y también debido a la farmacocinética de la azitromicina en este tejido. Con los nuevos métodos diagnósticos y las pruebas de curación se ha comprobado una diferencia a favor de la doxiciclina en el tratamiento de la clamidiasis rectal. La resistencia antimicrobiana no ha desempeñado un papel relevante porque no se han encontrado cepas resistentes in vivo al tratamiento. A pesar de ello, la azitromicina sigue siendo un fármaco de primera elección ya que puede administrarse como una dosis única, lo que favorece el apego terapéutico.

Derivation and validation of a new formula for plasma osmolality estimation.

BACKGROUND: Plasma osmolality is a physic and chemical property of interest in emergency medicine. This magnitude can be measured at the laboratory, but it is usually estimated with equations. A huge variety of formulas for calculating osmolality have been published, most of them relying on sodium, urea and glucose. The purpose of this study is to develop a new equation for plasma osmolality calculation. In addition we assess the new equation in a sample of healthy individuals. METHODS: We used results of sodium, potassium, glucose, urea and osmolality recovered from our patient's database. Multivariate lineal regression was carried-out, considering sodium and potassium as separated variables and as unique variable. In a second phase the obtained equations were tested in a sample of healthy blood-donors. Osmolality was measured by freezing point depression. RESULTS: In the first phase, 1362 plasma determinations for sodium, potassium, glucose, urea and osmolality were analyzed. All of included variables had a significant correlation with measured osmolality, being the highest correlation with sodium plus potassium and the lowest one was with potassium alone. The formulas obtained for the osmolality estimation were 1.86*Na + 1.6*(Glucose/18) + 1.12*(Urea/6) + 21 (A) and 1.88*(Na + K) + 1.59*(Glucose/18) + 1.08*(Urea/6) + 10.6 (B). Assess of the new equations in a sample of healthy individuals showed better results than equations previously published. The lowest difference versus measured osmolality was produced by formula B. CONCLUSION: The equations produced in this study perform better in the estimation of plasma osmolality than previously published formulas. We recommend introducing formula B in the clinical chemistry routine.

The development and psychometric evaluation of the Survey of Obstructive Sleep Apnea Functional Health Literacy.

OBJECTIVE AND OBJECTIVE: Obstructive Sleep Apnea (OSA) is a highly prevalent disorder that disparately affects racial/ethnic minorities. OSA functional health literacy can contribute to health disparities. Documenting poor OSA functional health literacy is needed to inform research agendas, policy, and advocacy efforts. The objective of this study is to develop a scale for measuring OSA functional health literacy among diverse audiences and a variety of reading levels and to ascertain its reliability and validity. METHODS: Development of the 18-item Survey of OSA Functional Health Literacy (SOFHL) was guided by literature review and input from experts. A convenience sample of persons enrolled in a clinical trial completed the survey (n=194). The psychometric evaluation was conducted using factor analysis to identify the number of dimensions in the SOFHL and their relationship to other domains that are relevant to OSA functional health literacy. RESULTS: Internal consistency reliability (alpha) was estimated for the resulting scale and correlations with educational attainment and income completed. All respondents were Black and 29% reported average household income less than $10,000 USD. Confirmatory factor analysis provided support for two dimensions: OSA general knowledge (alpha=0.81) and self-efficacy for OSA self-management (alpha=0.71). CONCLUSIONS: Higher educational attainment and socioeconomic status were associated with better OSA functional health literacy. These results provide preliminary support for the SOFHL, a measure that can be used to assess OSA functional health literacy.

Applying an expanded set of cognitive design principles to formatting the Kidney Early Evaluation Program (KEEP) longitudinal survey.

BACKGROUND: The National Kidney Foundation Kidney Early Evaluation Program (KEEP) is a free community-based health-screening program targeting populations at greatest risk of chronic kidney disease (CKD), those with high rates of diabetes and hypertension, and a high proportion of racial/ethnic minorities. The KEEP Longitudinal Survey will adopt methods similar to those used in KEEP to gather follow-up data to measure CKD-related heath status and gauge program effectiveness for repeated KEEP participants with evidence of CKD stages 3 to 5. KEEP has defined objectives to enhance follow-up survey response rates and target vulnerable populations who bear the greatest CKD risk-factor burdens. METHODS: The KEEP Follow-up Form was assessed for adherence to 6 cognitive design principles (simplicity, consistency, organization, natural order, clarity, and attractiveness) considered to summate the techniques guiding good survey development and for the additional cognitive design principles of readability and variation of readability across survey items. RESULTS: The KEEP Follow-up Form was found to include violations of each cognitive design principle and readability principle, possibly contributing to item nonresponse and low follow-up rates in KEEP. It was revised according to empirically substantiated formatting techniques guided by these principles and found during qualitative assessment to be more user friendly, simpler, better organized, more attractive, and easier to read. Subsequent development of the KEEP Longitudinal Survey form also was guided by these principles. CONCLUSION: To ensure ease of use by populations with limited literacy skills, poor health literacy, and limited survey literacy, survey researchers must apply cognitive design principles to survey development to improve participation and response rates.

Glomerular filtration rate estimation in people older than 85: Comparison between CKD-EPI, MDRD-IDMS and BIS1 equations. / Estimación del filtrado glomerular en personas mayores de 85 años: comparación de las ecuaciones CKD-EPI, MDRD-IDMS y BIS1.

BACKGROUND: The evidence of glomerular filtration rate (GFR) estimating with serum creatinine based formulae in the elderly population is scarce. The purpose of this study is to compare CKD-EPI, MRD4-IDMS and BIS1 equations to analyse correlation and concordance in a population older than 85 years old. PATIENTS AND METHODS: We designed a retrospective cross-sectional study, which included data from 600 patients older than 85 years. GFR was estimated by the following equations: CKD-EPI, MDR4-IDMS and BIS1, using as variables sex, age and serum creatinine concentration. Statistics analysis included Wilcoxon test, Bland-Altman plot, non-parametric Passing-Bablok method and kappa statistic (simple and weighted). RESULTS: The patients' median (range) age was 87 (interval 85-98). The median GFR (range) was 42.4 (5.2-127.4) mL/min/1.73 m2, when it was estimated with MDRD-IDMS, 40.0 (4.5-93.1) for CKD-EPI and 36.9 (7.6-83.7) for BIS1. The comparison of BIS1 and CKD-EPI and MDRD-IDMS using the Wilcoxon test was significant (P<.001). The regression analysis yielded the following equations: MDRD-IDMS= 1,025×CKD-EPI+1.360; BIS1= 0.688×CKD-EPI+9.074 and BIS1= 0.666×MDRD-IDMS+8.401. The weighted coefficient was 0.958 for the concordance between MDRD-IDMS and CKD-EPI, 0.812 for the concordance between MDRD-IDMS and BIS1 and 0.846 for CKD-EPI and BIS1. CONCLUSIONS: The GFR estimations obtained with BS1 equation are not interchangeable with MDRD-IDMS or CKD-EPI equations. BIS1 estimates lower GFR values than MDRD-IDMS and CKD-EPI and tends to classify the patients in a more advanced chronic kidney disease stage, especially for estimated GFR higher than 29mL/min/1.73 m2.

A survey of kidney disease and risk-factor information on the World Wide Web.

BACKGROUND: Chronic kidney disease (CKD) is epidemic, and informing those at risk is a national health priority. However, the discrepancy between the readability of health information and the literacy skills of those it targets is a recognized barrier to communicating health information that may promote good health outcomes. Because the World Wide Web has become one of the most important sources of health information, we sought to assess the readability of commonly available CKD information. METHODS: Twelve highly cited English-language, kidney disease Web sites were identified with 4 popular search engines. Each Web site was reviewed for the availability of 6 domains of information germane to CKD and risk-factor information. We estimated readability scores with the Flesch-Kincaid and Flesch Reading Ease Index methods. The deviation of readability scores for CKD information from readability appropriate to average literacy skills and the limited literacy skills of vulnerable populations (low socioeconomic status, health disparities, and elderly) were calculated. RESULTS: Eleven Web sites met the inclusion criteria. Six of 11 sites provided information on all 6 domains of CKD and risk-factor information. Mean readability scores for all 6 domains of CKD information exceeded national average literacy skills and far exceeded the fifth-grade-level readability desired for informing vulnerable populations. Information about CKD and diabetes consistently had higher readability scores. CONCLUSION: Information on the World Wide Web about CKD and its risk factors may not be readable for comprehension by the general public, especially by underserved minority populations with limited literacy skills. Barriers to health communication may be important contributors to the rising CKD epidemic and disparities in CKD health status experienced by minority populations.

Structure and content of chronic kidney disease information on the World Wide Web: barriers to public understanding of a pandemic.

Chronic kidney disease (CKD) is a pandemic and the need to inform those at risk has never been more important. The World Wide Web (WWW) is no w considered a key source of health information, but the quality and utility of this information has been challenged. In this article, we assess structural, content, and linguistic barriers to accessed CKD information and discuss the implications of limited Internet access to communicating health. Technical (number of hyperlinks), content (number of six core CKD and risk factor information domains included), and linguistic (readability and variation in readability) barriers were assessed for websites offered by 12 kidney disease associations. The Flesch Reading Ease Index method was used to estimate readability scores, and variation in the readability of information was assessed. Eleven websites met inclusion criteria. Six of 11 websites provided information in all 6 domains of CKD information. A mean of 4 hyperlinks (range 3-5) was clicked before CKD information was available and a mean of 6 hyperlinks (range 4-12) was clicked to access all available CKD information. Mean readability scores for all six domains of CKD information exceeded national average literacy skills and far exceeded the 5th grade level readability desired for informing vulnerable populations. Information about CKD and diabetes consistently had higher readability scores. The WWW currently has little utility for informing populations at greatest risk for CKD. Barriers to accessing CKD information on the WWW are socioeconomic, technical, and linguistic. Having lower socioeconomic status, less access to computers and the WWW, multiple website hyperlinks, incomplete information, difficult readability, and significant variation in readability of CKD information on the WWW are social, structural, and content barriers to communicating CKD information. This may contribute to the growing epidemics of diminished public understanding about CKD, and disparities in CKD health status experienced by racial/ethnic minority populations globally.

Epidemiología de las intoxicaciones agudas por drogas de abuso en las urgencias de un hospital del Centro de España basada en datos de análisis toxicológico de orina / Epidemiology of acute poisonings for drugs of abuse in the emergency room of a hospital from the Center of Spain based on analysis data toxicological urine

Introducción: las intoxicaciones agudas son motivo de consulta cada vez más frecuente en los Servicios de Urgencia hospitalarios (SUH) debido a la mayor disponibilidad y acceso a productos químicos tóxicos. Se observan diferentes patrones en cada área sanitaria según el tipo de población, geografía y perfil epidemiológico de consumo. Material y métodos: el objetivo de nuestro estudio es realizar un perfil epidemiológico y describir el manejo del paciente que acude por clínica compatible con intoxicación aguda por drogas de abuso (IA) basado en la determinación de tóxicos en orina para seis sustancias (cannabis, opiáceos, cocaína, anfetaminas, benzodiazepinas y éxtasis) solicitados en el período de estudio 2010-2012. Resultados: se solicitaron 2755 peticiones, de las cuales fueron positivas 1429, y se estudiaron al azar 661 historias clínicas. El perfil de paciente intoxicado de nuestra área es el de varón de entre 30 y 40 años, consumidor preferentemente de cannabis y cocaína; las benzodiazepinas son el tóxico más frecuente en las mujeres, con clínica mayoritariamente neurológica, sin diferencias en cuanto a la franja horaria o el mes del año en que recibió el alta desde el propio SUH en casi el 60% de los casos. Discusión: las IA en los SUH representan casi el 1% de las consultas y tienen una escasa mortalidad. En algunos casos, el médico de urgencias comienza el tratamiento antes de conocer el resultado toxicológico, lo que nos hace plantearnos la utilidad real y el coste-efectividad de estas determinaciones en todos los pacientes con alteración del nivel de conciencia. (AU)

Introduction: acute intoxications are a rising and common query demand on the emergency rooms because of the easy access and disponibility to toxic substances, where we can observe different patterns attending to type of population, geography and epidemiologic consume profile. Material and methods: our objective is to analyze the epidemiology and patient handling coming to the Emergency Room (ER) with compatible symptoms of street drugs abuse, based on the determination of cannabis, cocaine, amphetamine, benzodiazepine, opiates and ectasy urine levels in the period 2010-2012. Results: the ER requested 2755 determinations being positive 1429 and randomly examined 661 clinical histories. The profile of intoxicated patient was male, 30 to 40 years old, preferently cannabis and cocaine consumer (benzodiazepine in women), mostly with neurological symptoms when arrive, without differences between months or day time and, almost 60% of them, discharged directly from the ER. Conclusions: acute intoxications barely represent 1% of ER demands and produce poor or scarce mortality. Sometimes, doctors in charge start with therapeutic measures before knowing the results of toxicology, what leads us to ask about actual usefulness and cost-efficiency of the toxicology assay to every patient with low conscious level. (AU)

A community-based pilot study of a diabetes pharmacist intervention in Latinos: impact on weight and hemoglobin A1c.

Type 2 diabetes disproportionately affects Latinos increasing their risk of diabetes-related complications. This study used a randomized controlled design with a community-based approach to evaluate the impact of a culturally tailored pharmacist intervention on clinical outcomes in Latino diabetics. The intervention included a focused discussion and two individual pharmacist counseling sessions on medication, nutrition, exercise, and self-care to promote behavior changes. Sessions were culturally adapted for language, diet, family participation, and cultural beliefs. Clinical outcomes were measured at baseline and three months. Nineteen intervention and 24 control participants completed the study. Mean BMI reduction was greater for intervention than for control group participants (-0.73 ± 0.07 kg/m2 versus + 0.37 ± 0.02 kg/m2 p<.009 respectively). Hemoglobin A1c was significantly reduced by 0.93 ± 0.45% in the intervention group only. There was no significant difference in blood glucose, blood pressure, or lipid levels. An innovative culturally-sensitive pharmacist intervention improved selected clinical outcomes among Latino diabetics.

[Fetal experimentation, transplantations, cosmetics and their connection with induced abortion]. / Experimentación fetal, trasplantes, cosmética y su relación con el aborto provocado.

The increase in induced abortion produces large numbers of cells, tissues and organs, which are used in several fields of Medicine, either in research or in treatment. The main uses are in Cardiology, Hematology, Metabolism, Embryology, Neurology, Immunology, Ophthalmology, Dermatology and Transplantations. Flavor enhancers and cosmetics also benefit. Utilitarianism has led to an increase in abortion-originated cell and tissue banks. Abortion is justified through the manipulation of language. Vested interests give rise to complicity in researchers and society as a whole. Abortion and tissue 'donation' cannot be split; since fresh tissues are involved there is a symbiotic relationship between them. Valid consent is not possible. A contradiction emerges, the nasciturus is not desired or valued but fetal organs are. When someone is deprived of his rights it is because another wants to enslave them. Research must have a moral base. Knowledge should not be increased at any price. Something that is legal and well intentioned is not always morally acceptable. The duty of omission is applicable. Means to achieve a goal must be ethical means. Educational efforts to restore respect for the human embryo and fetus must be promoted. Technical advances are not always in accordance with human nature and dignity. Research and treatment that do not resort to cells, tissues and organs obtained from induced abortions should be promoted.

Ácido acetilsalicílico (AAS) inhibe angiogénesis en membrana alantocorionica de pollo (MAC) / Acetyl-salicylic acid inhibits angiogenesis in alanto chorionic chicken membrane

Introducción: El ácido acetilsalicílico (AAS) es ampliamente utilizado en el manejo de patología cardiovascular. En modelos "in vitro" el AAS restringe la angiogénesis, atribuyéndose este efecto al bloqueo de ciclooxigenasa-1, manteniendo íntegra la zona adhe-rente endotelial, citotoxicidad directa y otras vías de señalización. Hipótesis: El AAS en concentración terapéutica antiplaquetaria utilizada en humanos ejerce un efecto antiangiogénico en modelo de membrana alantocorió-nica de pollo (MAC). Objetivo: Comparar la capacidad antiangiogénica del AAS en distintas concentraciones en MAC utilizando como punto de comparación la angiogénesis fisiológica de la MAC. Método: Se incubaron 46 huevos fecundados de gallinas White Leghorn, en cámara temperada a 37°C, provenientes del Instituto de Salud Pública de Chile. Mediante procedimiento descrito por Ribatti (2006), se instiló sobre filtro de metilcelulosa 10uL de Dimetilsulfóxido al 0.1% + m199, sin fármaco al control, asociado a AAS y ácido salicílico (AS) a los grupos de estudio en concentraciones 2mM y 5 mM. Posteriormente se fijó y analizó la muestra en forma ciega. Resultados: El promedio de vasos del control fue 21.8. Para el grupo AAS 2mM y 5mM fue 11.3 y 10, siendo para el grupo AS 2mM y 5mM 15.6 y 12.4. El análisis estadístico mediante ANOVA y t-Student muestra que todos los grupos que recibieron fármacos tuvieron una disminución significativa en el numero de vasos sanguíneos en relación al grupo control. No hubo diferencias significativas entre ambo grupos de AAS. El AS demostró tener mayor potencia antiangiogénica dosis dependiente. Discusión: En este estudio se demuestra que el AAS ejerce un efecto antiangiogénico en concentración terapéutica en condiciones fisiológicas de un modelo "in vivo".

Background: Acetylsalicylic acid (ASA) is widely used in the treatment of various cardiovascular disorders. In vitro, AAS decreases angiogenesis, through cyclo-oxigenase-1 blockade while keeping active the adherent endothelial zone, direct toxicity and other signaling pathways. Hypothesis: AAS at therapeutic anti plaquetary doses exerts an anti-angiogenic effect in the alanto choronic chicken membrane (ACM) Method: 46 fertilized eggs form White Leghorn hens were incubated at 37oC. 10 uL of 0.1% Dimethyl sulfoxide +Ml 19 with no drug were used as control, while experimental groups received ASA and Salicylic acid (SA), 2mM. After fixation, samples were analyzed in a blind fashion Results: The mean number of vessels was 21.8 for controls, 11.3 and 10 for ASA 2mM and ASA 5mM, respectively. Corresponding values for SA 2 and SA 5mM were 15.6 and 12.4, respectively. Thus, a statistically significant (ANOVA and Student's t) decrease in the number of vessels was observed in both ASA groups. SA showed had a greater potential for anti-angiogenesis in a dose dependent way. Conclusion: This study shows that ASA in therapeutic concentrations has an anti-angiogenic effect in a physiologic model in vivo.

A comparison of two educational methods on immigrant Latinas breast cancer knowledge and screening behaviors.

UNLABELLED: Underutilization of screening mammography by Latinas continues unabated and may contribute to disparities in disease-free survival and mortality. OBJECTIVE: Comparison of two discussion group-centered educational interventions at enhancing breast cancer knowledge, breast self-exams (BSE), and screening mammography. METHODS: Pre-test post-test study design. Two cohorts of 200 Latinas each participated in survey screening and discussion groups at baseline. One cohort also viewed an animated video and had BSE training. Breast cancer knowledge, self-reported BSE and mammography history were measured at baseline and three months post-intervention. RESULTS: Breast cancer knowledge scores were good for both groups at baseline, and significantly increased at three month follow-up for both groups (p<.05) but no significant difference was observed between groups at baseline or post-intervention. CONCLUSION: Community-based discussion groups are a cost-effective method for improving breast cancer knowledge and promoting screening behaviors.

[Vaccines, biotechnology and their connection with induced abortion]. / Vacunas, Biotecnología y su Relación con el Aborto Provocado.

Diploid cells (WI-38, MRC-5) vaccines have their origin in induced abortions. Among these vaccines we fi nd the following: rubella, measles, mumps, rabies, polio, smallpox, hepatitis A, chickenpox, and herpes zoster. Nowadays, other abortion tainted vaccines cultivated on transformed cells (293, PER.C6) are in the pipeline: flu, Respiratory Syncytial and parainfluenza viruses, HIV, West Nile virus, Ebola, Marburg and Lassa, hepatitis B and C, foot and mouth disease, Japanese encephalitis, dengue, tuberculosis, anthrax, plague, tetanus and malaria. The same method is used for the production of monoclonal antibodies and other proteins, gene therapy and genomics. Technology enables us to develop the aforementioned products without resorting to induced abortion. Full disclosure of the cell origin in the labelling of vaccines and other products must be supported. There are vaccines from non-objectionable sources which should be made available to the public. When no alternative vaccines exist, ethical research must be promoted. Non-objectionable sources in the production of monoclonal antibodies, gene therapy and genomics must be encouraged. It is not be consistent to abstain from products originated in embryonic stem cells and at the same time approve of products obtained from induced abortions. It is of paramount importance to avoid that induced abortion technology seeps into every field of Medicine.

Influencia de la percepción visual en el aprendizaje / Influence of visual perception on learning

La percepción es el proceso activo de localización y extracción de la información obtenida del medio externo que se organiza en sistemas perceptuales, los cuales realizan el proceso de búsqueda y obtención de la información. Las habilidades perceptuales visuales son las encargadas de la organización y el procesamiento de la información a nivel visual formando parte de la percepción visual y colaborando en el desarrollo cognitivo. El entrenamiento de las habilidades perceptuales visuales y su integracion con dispositivos básicos de aprendizaje es una forma de mejorar el aprendizaje viso-perceptual y por ende la adaptación al medio, aun cuando todavía no se conocen completamente los mecanismos neuronales que dan el sustrato de la integración visoperceptual.

Perception is the active process of locating and extracting data from the outer environment. It is organized in perceptual systems in charge of searching and acquiring information. Visual perceptual skills are responsible for organizing and processing information on a visual level as part of visual perception and supporting cognitive development. Training of visual perceptual skills and its integration to basic learning devices is a way to improve visual perception learning and thusthe adaptation to the environment, despite not knowing the neuronal mechanisms that generate visual perception.

Prevalencia de disfunciones visomotoras y visoperceptuales en niños entre cinco y nueve años de colegios de las localidades de Fontibón, Puente Aranda y Usaquén / Prevalence of visualmotor and visualperceptual dysfunctions

Objetivo: determinar la prevalencia de disfunciones visomotoras y visoperceptuales en niños entre 5 y 9 años de las localidades de Fontibón, Puente Aranda y Usaquén. Metodología: se realizó un estudio descriptivo transversal. Se evaluaron 128 pacientes, que estudiaban en colegios representativos de cada localidad. A cada niño se le aplicó el test TVPS-3 y Beery VMI. El análisis estadístico se realizó por tablas de contingencia. Resultados: la prevalencia de disfunciones visomotoras fue de 20,5% (9/44) para el Colegio Pablo Neruda, de Fontibón; 31.6% (12/38) para el Colegio España, de Puente Aranda, y 8,7% (4/46) para el Colegio de La Salle, de Usaquén. La prevalencia de disfunciones visoperceptuales encontradas fue de 47,7% (21/44) para el Colegio Pablo Neruda,de Fontibón; 68,4 % (26/38) para el Colegio España,de Puente Aranda, y 8,7% (4/46) para el Colegio de La Salle, de Usaquén. Conclusiones: la prevalencia de disfunciones visomotoras y visoperceptuales fue mayor en las localidades de Fontibón y Puente Aranda que en la localidad de Usaquén.

Objective: to determine the prevalence of visual motor and visual perceptual dysfunctions in children between 5 and 9 years of Fontibón, Puente Aranda and Usaquén towns. Methods: it was made a transversal descriptive study in which were evaluated 128 patients with the TVPS-3 and Beery VMI tests. The statistic analysis was done by contingency charts, chi square y association degree with Rho Spearman´s correlation coefficient Results: the prevalence of visual-motor dysfunctions was: 20.5% for Pablo Neruda school of Fontibon, 31.6% for España School of Puente Aranda y 8.7% for De La Salle School of Usaquén.The prevalence of visoperceptual dysfunctions was: 52.6% for Pablo Neruda School of Fontibon,66.6% for España School of Puente Aranda and 14.2%for De La Salle School of Usaquén. The spearman´s rho showed that there is a low but significant correlation coefficient between the test results; it means that, as one test score high, the other one is high too.Conclusions: the prevalence of visual motor and visualperceptual dysfunctions was major in Fontibón and Puente Aranda than Usaquén.

A report on student abuse during medical training.

The purpose of this study was to determine the incidence, and the consequences, of abusive situations as perceived by students during the course of their medical training. A descriptive study was carried out surveying the entire 2000 fifth-year class of 181 in the Medical School of the University of Chile. The questionnaire was answered by 144 students. Results showed that 91.7% of the students who responded had suffered at least one episode of abuse while enrolled in medical school. The main offenders were teachers and peers. Verbal abuse was the most common (85.4%), followed by psychological (79.9%), sexual(26.4%) and physical (23.6%) abuse. Students reported that abuse had effects on their mental health, social life and the image they had of physicians; 17% considered dropping out of school as a consequence of this experience. Efforts should be addressed to prompt educators to reflect on their role.

Incidencia de tumores de laringe en el Hospital Regional Honorio Delgado, periodo 1960 a 1994

Se realizó un estudio retrospectivo descriptivo de 43 casos de tumores de laríngeos en consultorio externo de Otorrinolaringología del Hospital Regional Honorio Delgado de Arequipa durante 34 años. Fue efectuada una revisión teórica remarcando la importancia de la etiopatogenia, diagnóstico y tratamiento; asimismo, en la revisión clínica de los pacientes en estudio se analizaron cada una de las variables mostradas a continuación. Los tumores de laringe se presentaron 4.29 casos de tumores benignos cada 5 años 1.86 para tumores malignos, la proporción de su malignidad fue de 2.3 benignos a 1 maligno. La mayor frecuencia de presentación fue en pacientes del sexo masculino; los tumores benignos se presentaron a cualquier edad y los tumores malignos a partir de la cuarta década, con una edad promedio de 62.5 años. Más de la mitad de los pacientes proceden de Arequipa, en su mayor porcentaje se ocuparon en su casa. En cuanto a hábitos nocivos la mayoría no tuvo antecedentes. Más de la mitad de los pacientes acudieron a consulta médica antes de los 12 meses. La disfonía se presentó en el total de pacientes estudiados. Se enfatiza la utilidad de laringoscopía indirecta y biopsia en el diagnóstico clínico. Se remarca que las lesiones se localizaron con mayor frecuencia en la región glótica. La papilomatosis laríngea fue la más frecuente de tumores benignos. El tratamiento aplicado fue con fines curativos, siendo la cirugía el procedimiento terapéutico más empleado. Finalmente, se efectuó la comparación de nuestros resultados con los obtenidos por otros autores al revisar la bibliografía nacional y extranjera a nuestro alcance. Se ilustra el presente trabajo con esquemas de aspecto anatómico de larínge