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Upconverting nanoparticles are essential in modern photonics due to their ability to convert infrared light to visible light. Despite their significance, they exhibit limited brightness, a key drawback that can be addressed by combining them with plasmonic nanoparticles. Plasmon-enhanced upconversion has been widely demonstrated in dry environments, where upconverting nanoparticles are immobilized, but constitutes a challenge in liquid media where Brownian motion competes against immobilization. This study employs optical tweezers for the three-dimensional manipulation of an individual upconverting nanoparticle, enabling the exploration of plasmon-enhanced upconversion luminescence in water. Contrary to expectation, experiments reveal a long-range (micrometer scale) and moderate (20%) enhancement in upconversion luminescence due to the plasmonic resonances of gold nanostructures. Comparison between experiments and numerical simulations evidences the key role of Brownian motion. It is demonstrated how the three-dimensional Brownian fluctuations of the upconverting nanoparticle lead to an "average effect" that explains the magnitude and spatial extension of luminescence enhancement.
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INTRODUCTION: Research into the transplantation of solid organs from animals (xenotransplantation) is generating interest and curiosity given that this could be a way of resolving the shortage in transplant organs. However, the fact is that currently xenotransplantation is far from becoming a clinical practice. OBJECTIVE: To analyse the attitude of medical students from Spanish universities towards the donation of organs from animals and to determine the factors affecting their attitudes. TYPE OF STUDY: A sociological, interdisciplinary, observational and multicentre study in Spain. STUDY POPULATION: Students enrolled on the medical degree in Spain (n = 34 000). SAMPLE SIZE: A sample of 9598 students (a confidence level of 99% and precision of ± 1%) stratified by geographical area and academic year. Instrument of measurement: A validated questionnaire of attitude towards organ xenotransplantation (PCID-XenoTx RIOS) which was self-administered and completed anonymously. RESULTS: A completion rate of 95.7% (n = 9275) was obtained. If the results of xenotransplantation were as good as in human donation, 81% (n = 7491) would be in favour, 3% (n = 308) against and 16% (n = 1476) undecided. The following variables affected this attitude: sex (P < 0.001); academic year (P < 0.001); discussion of transplantation with one's family (P < 0.001) and friends (P < 0.001); the opinion of one's partner (P < 0.001); the respondent's attitude towards organ donation (P < 0.001); religion (P < 0.001); and participation in altruistic activities (P < 0.001). The following variables persisted in the multivariate analysis: (1) being a female (OR = 1.794; P < 0.001); (2) academic year (OR = 2.487; P < 0.001); (3) having spoken about the issue with one's family (OR = 1.200; P = 0.019); (4) the favourable opinion of one's partner (OR = 1.526; P = 0.028); (5) an attitude in favour of donation (OR = 2.087; P < 0.001); (6) being an atheist/agnostic, (OR = 2.5; P < 0.001); and (7) a belief that one's religion is in favour of transplantation (OR = 1.317; P = 0.005). CONCLUSIONS: Spanish medical students have a favourable attitude towards xenotransplantation. This willingness and interest could be a decisive platform for the development and strengthening of research, both for centres with a pre-clinical xenotransplantation programme and new healthcare centres.
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Atitude , Doadores Vivos , Estudantes de Medicina/psicologia , Inquéritos e Questionários , Obtenção de Tecidos e Órgãos , Transplante Heterólogo/estatística & dados numéricos , Humanos , Faculdades de Medicina/estatística & dados numéricos , Espanha , Obtenção de Tecidos e Órgãos/métodosRESUMO
INTRODUCTION: Depression is not uncommon among infertile couples. The objective of the study is to analyze factors that predict depression in these couples, when they are in Assisted Reproduction Techniques programs. MATERIALS AND METHOD: We analyze the level of depression in couples referred from the Human Reproduction Unit to study the male factor using the Beck Depression Inventory and the clinical information contained in the SARAplus program. RESULTS: Depressive ranges appear in approximately half of the participants. The degree of depression correlates in a statistically significant way between both members of the couple. Among the analyzed clinical factors, we observed relational tendency between depression and obesity and depression and smoking. CONCLUSIONS: Depression in infertile couples is a fact. ART specialists should be on the lookout for symptoms of depression in order to provide patients psychological and psychiatric care and treatments, as part of the overall therapeutic framework for infertility.
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Depressão , Infertilidade , Humanos , Masculino , Depressão/diagnóstico , Infertilidade/terapia , Escalas de Graduação Psiquiátrica , Técnicas de Reprodução Assistida/psicologia , PsicoterapiaRESUMO
Purpose of Review: No specific guidelines have been developed for acute cystitis management during the COVID-19 pandemic. This review aims to provide up-to-date information about treatment and follow-up in patients with symptoms suggesting lower urinary tract infection. Recent Findings: Uncomplicated cystitis does not need microbiological confirmation; thus, clinical diagnosis via telephone interview or questionnaires may be done. When complicated infections are suspected, in-person evaluation or close follow-up is mandatory. Antibiotic treatment is still the gold standard for treatment, although non-pharmacological strategies have also been suggested and further investigations are warranted. Summary: Urinary tract infections are still a frequent reason for consultation that needs to be addressed in both primary care and specialized levels. Their management during the pandemic is similar than in precedent years, but telehealth options have emerged which can facilitate diagnosis and treatment.
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INTRODUCTION: In multicenter studies, the protocolization of data is a critical phase that can generate biases.The objective is to analyze the concordance and reliability of the data obtained in a clinical multicenter study between the protocolization in the center of origin and the centralized protocolization of the data by a data -manager. METHODS: National multicenter clinical study about an infrequent carcinoma. A double protocolization of the data is carried out: (a) center of origin; and (b) centralized by a data manager: The concordance between the data is analyzed for the global data and for the two groups of the project: (a) study group (Familiar carcinoma, 30 researchers protocolize); (b) control group (Sporadic carcinoma, 4 people protocolize). Interobserver variability is evaluated using Cohen's kappa coefficient. RESULTS: The study includes a total of 689 patients with carcinoma, 252 in the study group and 437 in the control group. Regarding the concordance analysis of the tumor stage, 2.5% of disagreements were observed and the concordance between people who protocolize was near perfect (Kappa = 0.931). Regarding the evaluation of the recurrence risk, disagreements occurred in 7% of the cases and the concordance was near perfect (Kappa = 0.819). Regarding the sonography evaluation (TIRADS), the disagreements were 6.9% and the concordance was near perfect (Kappa = 0.922). Also, 4.6% of transcription errors were detected. CONCLUSIONS: In multicenter clinical studies, the centralized data protocolization o by a data-manager seems to present similar results to the direct protocolization in the database in the center of origin.
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Carcinoma , Humanos , Reprodutibilidade dos TestesAssuntos
Anti-Infecciosos Locais , Clorexidina , Infecção Hospitalar/microbiologia , Surtos de Doenças , Contaminação de Medicamentos , Infecções por Serratia/microbiologia , Serratia marcescens , Infecção Hospitalar/epidemiologia , Humanos , Estudos Retrospectivos , Retirada de Medicamento Baseada em Segurança , Infecções por Serratia/epidemiologia , Serratia marcescens/genética , Serratia marcescens/isolamento & purificação , Espanha/epidemiologiaRESUMO
Background: Although most women start breastfeeding after delivery, difficulties often arise. One of the main reasons is nipple soreness, which contributes greatly to early cessation of breastfeeding. A soreness evaluation through validated scales, performed by health care professionals during the first few days, can contribute to improve breastfeeding and support for the mothers. Research Aim: Knowing the prevalence of nipple soreness during breastfeeding at 48 hours postpartum at the Infanta Cristina University Hospital (Madrid, Spain) through a cross-sectional descriptive study. Materials and Methods: The study took place between February and March 2019. A survey of 58 postpartum second day mothers was conducted including the Visual Analogue Scale (VAS) and Lactation Assessment Scale (LATCH) score for breastfeeding assessment. A descriptive analysis of secondary variables and subsequent bivariate inferential was performed for 95% confidence interval (CI). Results: The prevalence of nipple soreness observed is 97% (95% CI = 92-100%). It was found, significantly (p = 0.001), that the higher the score on LATCH, the lower the score on VAS and therefore the less pain. We found a relationship between women who were in skin-to-skin contact with their babies for 2 hours without interruption after birth and a higher pain score (p = 0.046). No other associations were found between VAS and other variables such as parity, type of birth, artificial milk supplements for the newborn, or using a pacifier. Conclusions: The high percentage of nipple soreness detected highlights that breastfeeding can be unpleasant in the first days after delivery. It is important to include in clinical practice the assessment of nipple soreness and the effectiveness of breastfeeding using validated scales.
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Aleitamento Materno , Mamilos , Estudos Transversais , Feminino , Humanos , Lactente , Recém-Nascido , Dor/epidemiologia , Dor/etiologia , Período Pós-Parto , Gravidez , PrevalênciaRESUMO
INTRODUCTION: A favorable attitude toward organ donation and transplantation (ODT) is fundamental among health professionals at the time of transplant promotion. In this sense, the training and awareness of professionals are fundamental. OBJECTIVE: To analyze the differences in the attitude toward ODT and the factors that condition it among Andalusian medical and nursing students. METHODS AND DESIGN: The study is a sociologic, multicenter, observational study. The population includes medical and nursing students in Andalusian universities. Database of the Collaborative International Donor Project is used and data are stratified by geographic area and academic course. The instrument of measurement was a validated questionnaire (PCID-DTO-RIOS) that was handed out to every student in a compulsory session. Completion of the questionnaire was anonymous and self-administered. The sample included Andalusian medical and nursing students (99% confidence and precision of ±1%) stratified by geographic area and year of study. RESULTS: There was a completion rate of 91%; 79% (n = 2879) of Andalusian students were in favor of donation and 21% were not in favor. The attitude toward ODT is more favorable in medical compared with nursing students (80% vs 77%; P = .021). The psychosocial profile toward donation is similar in both groups relating to the following variables (P < .05): knowing a transplant patient, having received information about the subject, attitude toward family donation, and having discussed transplantation with family and friends. CONCLUSION: Andalusian medical students favored organ donation more than Andalusian nursing students, and the favorable attitude is associated with having an awareness of the subject.
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Conhecimentos, Atitudes e Prática em Saúde , Transplante de Órgãos/psicologia , Estudantes de Medicina/psicologia , Estudantes de Enfermagem/psicologia , Obtenção de Tecidos e Órgãos , Adulto , Feminino , Humanos , Masculino , Espanha , Inquéritos e Questionários , Adulto JovemRESUMO
The knowledge acquired during university education about organ donation and transplantation (ODT) decisively influences the information future health professionals transmit. This is important in ODT where the participation of the general public is essential to obtain organs. OBJECTIVE: To determine notions of Spanish medicine and nursing students on ODT and its relationship with attitude toward ODT. METHODS AND DESIGN: and design. We conducted a sociologic, multicenter, and observational study. The population for our study consisted of medical and nursing students in Spanish universities. Our database was the Collaborative International Donor Project, stratified by geographic area and academic course. A validated questionnaire (PCID-DTO-RIOS) was self-administered and completed anonymously. Our sample consisted of 9598 medical and 10,566 nursing students (99% confidence interval; precision of ±1%), stratified by geographic area and year of study. RESULTS: The completion rate for our study was 90%. Only 20% (n=3640) of students thought their notions on ODT were good; 41% (n=7531) thought their notions were normal; 36% (n=6550) thought their notions were scarce. Comparing groups, there were differences between those who believed that their notions on ODT were good (44% nursing vs 56% medical students; P < .000), and those who believed it scarce (54% nursing vs 46% medical students; P < .000). Notions on ODT were related with attitude toward the donation of one's own organs: those who considered their notions were good were more in favor then those who considered it scarce (88% vs 72%; P < .000). CONCLUSION: Only 20% of Spanish medical and nursing students thought their notions on ODT were good. Having good knowledge is related to a favorable attitude towards ODT. Receiving specific information on the subject could improve their knowledge about ODT during their training.
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Conhecimentos, Atitudes e Prática em Saúde , Transplante de Órgãos/psicologia , Estudantes de Medicina/psicologia , Estudantes de Enfermagem/psicologia , Obtenção de Tecidos e Órgãos , Adulto , Feminino , Humanos , Masculino , EspanhaRESUMO
A primary care physician (PCP) not only accompanies the patient in the process of an illness, but throughout his or her life. The confidence we have in these health professionals is fundamental, and their favorable attitude toward organ donation and transplantation (ODT) has a significant influence on the population. OBJECTIVE: To analyze trust in PCPs among Spanish medical and nursing students, the relationship with their attitude toward ODT, and the factors that condition it. METHODS AND DESIGN: A sociologic, multicenter, and observational study. POPULATION: medical and nursing students in Spanish universities. DATABASE: Collaborative International Donor Project, stratified by geographic area and academic course. A validated questionnaire (PCID-DTO-RIOS) was self-administered and completed anonymously. A sample of 9598 medical and 10,566 nursing students (99% confidence and precision of ±1%), stratified by geographic area and year of study. RESULTS: Completion rate: 90%. With respect to students' trust in their physician, 18% (n = 3267) of them totally trust (completely), 45% (n = 8101) trust enough, 30% (n = 5478) of them have not enough trust, and 7% not at all. Comparing groups, medical students totally trust more in PCPs than nursing students (55% vs 45%; P < .000), however, nursing students have less than enough trust in their PCP than medical students (53% vs 47%; P < .000). Students that totally trust in their PCP were more in favor toward ODT than students with not enough trust (83% vs 77%; P < .000). CONCLUSION: Only 18% of Spanish medical and nursing students totally trust in their PCP. Attitude toward ODT is related to a higher level of trust in PCPs among these students.
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Conhecimentos, Atitudes e Prática em Saúde , Transplante de Órgãos/psicologia , Médicos de Atenção Primária , Obtenção de Tecidos e Órgãos , Confiança , Adulto , Feminino , Humanos , Masculino , Comportamento Social , Espanha , Estudantes de Medicina/psicologia , Estudantes de Enfermagem/psicologia , Inquéritos e QuestionáriosRESUMO
INTRODUCTION: Information provided by health care professionals is crucial to create a climate of social opinion. This is important in organ donation and transplantation (ODT), where the participation of the general public is essential to obtain organs. OBJECTIVE: To determine the attitude toward the Law of Presumed Consent (LPC) among Spanish university students and to analyze their relation with attitude toward ODT. METHODS: and design. The type of study was a sociologic, multicenter, observational study. The population included medical and nursing students in Spanish universities. Database of Collaborative International Donor Project was used stratified by geographic area and academic course. A validated questionnaire (Collaborative International Donor Project, organ donation and transplantation questionnaire in Spanish [PCID-DTO-RIOS]) was self-administered and completed anonymously. A sample of 9598 medical and 10,566 nursing students was analyzed (99% confidence and precision of ±1%) and stratified by geographic area and year of study. RESULTS: Completion rate was 90%. Regarding attitude toward LPC, 66% of the students were against the law, whereas 34% accepted it. Of the students surveyed, 9% considered the law as a gesture of solidarity, 25% as an effective way of not wasting organs, 48% as an abuse of power, and 18% as offenses against the family. Those students who were in favor of LPC also had a more favorable attitude toward ODT (86% vs 76%; P < .001). Comparing groups, nursing students were less in favor of LPC than medical students (32% vs 36%; P < .000). CONCLUSION: Sixty-six percent of Spanish university medical and nursing students were against the LPC. The favorable attitude toward ODT is associated with considering the law as a gesture of solidarity or as an effective way of not wasting organs.
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Conhecimentos, Atitudes e Prática em Saúde , Transplante de Órgãos/legislação & jurisprudência , Consentimento Presumido , Obtenção de Tecidos e Órgãos/legislação & jurisprudência , Adulto , Feminino , Humanos , Masculino , Estudantes de Medicina , Estudantes de Enfermagem , Inquéritos e Questionários , UniversidadesRESUMO
BACKGROUND AND OBJECTIVE: Our objectives were to detect asymptomatic cases involved in an outbreak of hepatitis B, to assess the seroprevalence of hepatitis B (HB) in orienteers and to establish recommendations. PATIENTS AND METHOD: One hundred sixteen orienteers who had competed in the categories involved in the previous outbreak as well as a stratified random sample of 166 of the remaining orienteers in other competition categories were included in a cross-sectional serological prevalence study. HB surface antigen (anti-HBs); total antibody to HB core antigen (total anti-HBc); HB surface antigen (Ag HBs); and antibody IgM to HB core antigen (anti-HBcIgM) along with the history of vaccination for hepatitis B were analyzed. The results were weighted. RESULTS: The seroprevalence of HB (total anti-HBc positive) was 6.7% (n=12, 95% CI 0.6-12.9). No case of acute HB or chronic infection was observed. All the serological markers were negative for 61.1% (n=64, 95% CI 46.3-75.6), and 31.5% (n=29, 95% CI 18.2-46.4) had markers of immunity due to vaccination. Among individuals under 25 years of age, 28.4% were unvaccinated, although they were covered by vaccination programs. CONCLUSION: Our results suggest that the seroprevalence of HB among orienteers is not different from the general population in Spain. However, it is necessary to reinforce the vaccination among adolescents and young adults. General recommendations for the prevention of HB were made to orienteering federations.
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Surtos de Doenças , Anticorpos Anti-Hepatite B/sangue , Hepatite B/sangue , Hepatite B/epidemiologia , Esportes , Adulto , Estudos Transversais , Feminino , Antígenos do Núcleo do Vírus da Hepatite B/imunologia , Humanos , Masculino , Estudos Soroepidemiológicos , Espanha/epidemiologia , Adulto JovemRESUMO
INTRODUCTION: Metabolomics is a well-established tool in systems biology, especially in the top-down approach. Metabolomics experiments often results in discovery studies that provide intriguing biological hypotheses but rarely offer mechanistic explanation of such findings. In this light, the interpretation of metabolomics data can be boosted by deploying systems biology approaches. OBJECTIVES: This review aims to provide an overview of systems biology approaches that are relevant to metabolomics and to discuss some successful applications of these methods. METHODS: We review the most recent applications of systems biology tools in the field of metabolomics, such as network inference and analysis, metabolic modelling and pathways analysis. RESULTS: We offer an ample overview of systems biology tools that can be applied to address metabolomics problems. The characteristics and application results of these tools are discussed also in a comparative manner. CONCLUSIONS: Systems biology-enhanced analysis of metabolomics data can provide insights into the molecular mechanisms originating the observed metabolic profiles and enhance the scientific impact of metabolomics studies.
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We have evaluated the agronomic performance of table cassava cultivars fertilized with phosphorus doses in the Brazilian Semiarid Region. Two agricultural crops were grown at the Rafael Fernandes Experimental Farm, Mossoró, RN, from June/2018 to April/2019 and from June/2019 to April/2020. The experimental design was in randomized blocks, arranged in subdivided plots, with four replications. In the plots, doses of phosphorus were applied (0, 60, 120, 180 and 240 kg P2O5 ha-1), and in the subplots, the table cassava cultivars (Água Morna, BRS Gema de Ovo, Recife and Venâncio). The following were evaluated: dry matter of leaf, stem, and commercial root; harvest index; commercial root number; commercial productivity and aerial part productivity. The cultivars used had high root and aerial part productivities indicating that their irrigated cultivation is appropriate under the conditions of the Semiarid region of Rio Grande do Norte. The cultivars Água Morna, BRS Gema de Ovo and Recife are more efficient in the use of phosphorus, obtaining high productivity even in the absence of phosphate fertilization. The cultivar Venâncio is more responsive to phosphate fertilization, as it needs an input of this nutrient to increase its productivity.
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The Spanish National Network of Proteomic Facilities--ProteoRed has been created as an initiative for the coordination, integration and development of the proteomics facilities and laboratories distributed throughout Spain. ProteoRed's main objective is to give support to the scientific community allowing them wide access to emerging proteomics technologies and thus encouraging the science of proteomics. In addition, standardization of protocols and robustness of workflows are addressed by multi-centric laboratory activities. Educational, training and dissemination issues are part of the core activities of ProteoRed. To reach these objectives, specific activities have been developed through six working groups (WG1-WG6) covering functional, technical, educational and scientific aspects of proteomics.
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Proteômica , Biologia Computacional , Eletroforese em Gel Bidimensional/normas , Humanos , Cooperação Internacional , Estudos Multicêntricos como Assunto , Proteômica/métodos , Proteômica/organização & administração , Proteômica/normas , Padrões de Referência , Espanha , Manejo de Espécimes/normasRESUMO
RESUMEN Resulta un gran desafío encontrar una vía que le otorgue un valor real a las publicaciones científicas desde su impacto y calidad. Esta realidad exige el uso de indicadores bibliométricos y más reciente, algunos alternativos para la evaluación, tanto de los autores como de sus publicaciones. En este sentido se realiza un estudio de ambos sistemas de indicadores y sus metodologías, desde el análisis de debilidades y potencialidades para su integración en un único índice, de modo que permita una evaluación más integral y justa de su impacto en la comunidad científica. Se indagó además sobre la importancia, necesidad y nivel de información que se posee sobre este tema en profesores cubanos de varias universidades, durante el período 2018-2019. El objetivo del presente trabajo es argumentar algunas ideas para el acercamiento gradual del Sistema de Evaluación y Acreditación de la Educación Superior de la República de Cuba (SEAES) a estos indicadores, teniendo en cuenta el nivel de atención que reciben por bases de datos reconocidas globalmente. Los resultados son parte del proyecto de investigación El impacto social de la formación continua como parte de los procesos de mejora de la calidad en la Universidad de Camagüey.
ABSTRACT It is a great challenge to find a way that gives real value to scientific publications based on their impact and quality. This reality has required the use of bibliometric indicators and more recent some alternative ones for the evaluation of both the authors and their publications. In this sense, an analysis of both systems of indicators and their methodologies is carried out, from the analysis of weaknesses and potentialities for their integration in an only index, so that it allows a more comprehensive evaluation. and just about its impact on the scientific community. It also inquired about the importance, need and level of information that is possessed on this subject in Cuban university professors from various universities, during the period 2018-2019. The objective of the present work is to argue some ideas are proposed for the gradual approach of SEAES to these indicators, taking into account the level of attention they receive through globally recognized databases. The exposed results are part of the research project The social impact of continuous training as part of the quality improvement processes at the University of Camagüey.
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AIM: To analyze the attitude of Spanish medical students toward living liver donation (LLD) and to establish which factors have an influence on this attitude. STUDY TYPE: A sociological, interdisciplinary, multicenter and observational study. STUDY POPULATION: Medical students enrolled in Spain (n = 34000) in the university academic year 2010-2011. SAMPLE SIZE: A sample of 9598 students stratified by geographical area and academic year. Instrument used to measure attitude: A validated questionnaire (PCID-DVH RIOS) was self-administered and completed anonymously. Data collection procedure: Randomly selected medical schools. The questionnaire was applied to each academic year at compulsory sessions. STATISTICAL ANALYSIS: Student´s t test, χ(2) test and logistic regression analysis. RESULTS: The completion rate was 95.7% (n = 9275). 89% (n = 8258) were in favor of related LLD, and 32% (n = 2937) supported unrelated LLD. The following variables were associated with having a more favorable attitude: (1) age (P = 0.008); (2) sex (P < 0.001); (3) academic year (P < 0.001); (4) geographical area (P = 0.013); (5) believing in the possibility of needing a transplant oneself in the future (P < 0.001); (6) attitude toward deceased donation (P < 0.001); (7) attitude toward living kidney donation (P < 0.001); (8) acceptance of a donated liver segment from a family member if one were needed (P < 0.001); (9) having discussed the subject with one's family (P < 0.001) and friends (P < 0.001); (10) a partner's opinion about the subject (P < 0.001); (11) carrying out activities of an altruistic nature; and (12) fear of the possible mutilation of the body after donation (P < 0.001). CONCLUSION: Spanish medical students have a favorable attitude toward LLD.
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Atitude do Pessoal de Saúde , Transplante de Fígado , Doadores Vivos , Estudantes de Medicina , Adolescente , Adulto , Fatores Etários , Altruísmo , Feminino , Humanos , Transplante de Rim , Modelos Logísticos , Masculino , Fatores Sexuais , Espanha , Inquéritos e Questionários , Obtenção de Tecidos e Órgãos , Adulto JovemRESUMO
En las cirugías sobre la glándula tiroides se ha prestado mucha atención al manejo del nervio laríngeo inferior y de las glándulas paratiroides, no así del ramo lateral del nervio laríngeo superior, el cual es satélite del pedículo vascular superior de la glándula tiroides. El manejo del polo superior de la glándula tiroides requiere de un conocimiento acabado de su anatomía topográfica del área y está determinada por sus relaciones más importantes, dadas por el citado nervio y la arteria tiroidea superior principalmente. En este trabajo se pretende estudiar estas relaciones en base a la disección meticulosa del triángulo laringo-esternotiroideo ("Triángulo de Joll") de 25 cadáveres adultos formolizados. Como hallazgo relevante se informa que los "nervios en riesgo", según la clasificación de Cernea, que se basa en una distancia menor a un centímetro en el entrecruzamiento del nervio con la arteria tiroidea superior con respecto al polo superior de la glándula tiroides, es del 52 % para el lado derecho y 44 % para el lado izquierdo del cuello. El origen bajo de la arteria a nivel de la bifurcación carotídea se presenta asociada a un mayor número de "nervios en riesgo" en el lado izquierdo. Según el punto de penetración del ramo lateral del nervio laríngeo superior en el músculo constrictor inferior de la faringe se establece la clasificación de Friedman, muy útil sobre todo en cirugías ayudadas por la neuroestimulación. En esta clasifiacción los "nervios en riesgo" son aquellos que transcurrren superficial al músculo, mientras que los "nervios protegidos" serían aquellos que perforan el músculo en su porción superior. En este trabajo los "nervios en riesgo" se presentaron del lado izquierdo en el 56 % de los casos y del derecho en el 60 %, mientras que los "nervios protegidos" en el 24 % y 16 %, respectivamente.
In surgeries on the thyroid gland, much attention has been given to the management of the inferior laryngeal nerve and parathyroid glands, but not the external branch of the given by the aforementioned nerve and the superior thyroid artery. This paper intends to study these relationships based on the meticulous dissection of the larynx-sternothyroid triangle ("Joll triangle") of 25 formolized adult corpses. As a relevant finding, it is reported that the " nerves at risk" according to the Cernea classification, which is based on the distance less than one centimeter at the intersection of the nerve with the superior thyroid artery with respect to the upper pole of the gland, is 52 % for the right side and 44 % for the left side of the neck. The low origin of the artery at the level of the carotid bifurcation is associated with a greater number of "nerves at risk" on the left side. According to the penetration point of the external branch of the superior laryngeal nerve in the inferior pharyngeal constrictor muscle, the Friedman classification is established, very useful especially in surgeries aided by neurostimulation. In this classification the "nerves at risk" are those that run superficially to the muscle, while the protected nerves would be those that pierce the muscle in its upper part. In tis work, the "nerves at risk" presented on the left side in 56 % of the cases and the right side in 60 %, while those "protected" in 24 % and 16 % respectively.
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Humanos , Masculino , Feminino , Glândula Tireoide/irrigação sanguínea , Nervos Laríngeos/anatomia & histologia , Artérias , Cadáver , Estudos TransversaisRESUMO
Introducción. Las muertes prematuras por trauma se han considerado como una epidemia mundial. Una de las alternativas para reducir la letalidad es el entrenamiento, no solo del personal médico sino también de grupos especiales que pueden responder a estos eventos. El proyecto para la "Formación e Investigación en Apoyo Vital en Emergencias y Desastres" (FIAVED) puede ser un marco académico para lograrlo. Objetivo. Actualizar para el proyecto, las guías y estrategia docente para la enseñanza del apoyo vital avanzado al traumatizado. Método. Taller nacional con 18 expertos y 6 informantes clave, realizado el 10-11 de julio del 2018 en Cienfuegos. Técnica de tormenta de ideas y grupo nominal; cuestionario semiestructurado y revisión documental previa. Resultados. Se proponen para la enseñanza del apoyo vital al traumatizado en el posgrado: los objetivos, aspectos didácticos, estrategia docente, contenidos, alcance, habilidades a desarrollar, futuras investigaciones y áreas para la colaboración interinstitucional. Se define la estructura de un curso prototipo para la enseñanza del tema y las principales consideraciones para su ejecución. Conclusiones. Las propuestas académicas para el curso "Apoyo Vital Avanzado al Traumatizado" permiten el abordaje de la enseñanza en la atención al trauma para el personal médico de asistencia.
Introduction: premature deaths due to trauma have been considered worldwide epidemics. An alternative to reduce lethality is training, not only the medical personnel but also special groups of which can respond before these events. The Project for training and research in life support in emergencies and disasters may be an academic framework to achiev it. Objective: to update for the Project, the guidelines and the teaching strategy for training in life support to the traumatized patient. Method: National Workshop with 18 experts and 6 key informers, carried out the 10th and 11th of July 2018 in Cienfuegos. Technique brain storming and nominal group, semi-structured questionnaire and previous documentary review. Results: for teaching life support to the traumatized patient in postgraduate education: objectives, didactic elements, teaching strategy, content, abilities to develop, future research, and areas for inter-institutional collaboration. A structure for a prototype course was defined for teaching this topic and the main considerations for its execution. Conclusion: academic answers for the course ¨Advanced Life Support to the traumatized patient¨ allow approaching teaching in caring traumatized patients for the medical personnel.