Clinical and molecular characteristics of pediatric low-grade glioma complicated with ventriculo-peritoneal shunt related ascites.

INTRODUCTION: Ventriculo-peritoneal shunt (VPS) related ascites is a rare complication of pediatric low grade gliomas (pLGG). Physiopathology of this complication is not fully understood and there is paucity of data regarding the molecular profile of pLGG gliomas complicating with ascites and the optimal management of this unusual event. METHODS: International multi-institutional retrospective analysis of patients diagnosed with BRAF altered pLGG and ascites arising as a complication of VPS. Demographics, tumor characteristics, therapeutic approaches and outcomes were recorded. RESULTS: Nineteen patients were identified. Median age at diagnosis was 14 months (R: 2-144). Most patients (17; 89.4%) presented with lesions involving the optic pathway. Mean tumor standard volume was 34.8 cm2 (R: 12.5-85.4). Pilocytic Astrocytoma was the most frequent histological diagnosis (14;7 3.7%). Eight (42.1%) tumors harbored BRAF V600-E mutation and seven (36.8%) KIAA1549 fusion. The onset of ascites was documented at a median time of 5 months following VPS insertion. Four (21%) patients were managed with paracentesis only, 7(36.8%) required both paracentesis and shunt diversion, 7(36.8%) required only a shunt diversion and 1 (5.2%) patient was managed conservatively. Chemotherapy regimen was changed in 10 patients following ascites. Eight patients received targeted therapy (4 dabrafenib/4 trametinib) and 5 were radiated. There were eleven survivors with a median OS of 69 months (R: 3-144). CONCLUSIONS: Ascites is an early feature in the clinical course of young patients with midline BRAF altered pLGG, with high mortality rate observed in our cohort. The hypothesis of ascites as an adverse prognostic factor in pLGG warrants further prospective research.

Primary Ewing's sarcoma of the skull: radical resection and immediate cranioplasty after chemotherapy. A technical note.

PURPOSE: The current standard treatment of Ewing's sarcoma is chemotherapy followed by surgery, making an immediate cranial reconstruction in a one-step surgical procedure possible. METHODS: We describe the technique used to repair a cranial defect after the resection of a primary Ewing's sarcoma of the skull in a one-step surgical procedure. RESULTS: Bone repair with a custom-made cranioplasty immediately after resection of a primary Ewing's sarcoma of the skull avoids deformities and late complications associated with reconstructive surgery after radiotherapy and not interfere with radiotherapy and neither with follow-up. CONCLUSION: A one-step surgical procedure after chemotherapy for primary Ewing's sarcoma of the skull could be safer, less aggressive and more radical; avoiding deformities and late complications.

Redes sociales y calidad de vida relacionada con la salud en estudiantes universitarios / Social networks and quality of life in relation to university students' health / Redes sociais e qualidade de vida relacionada à saúde em estudantes universitários

Introducción: Las redes sociales permite a los jóvenes estar en contacto con la sociedad y su entorno, gran cantidad del tiempo lo emplean en su uso, buscando aceptación por sus pares. Materiales y Métodos: Investigación descriptiva, transversal, correlacional. La muestra estuvo conformada por 400 estudiantes. La información se recolectó, mediante la utilización de dos cuestionarios. Para la comparación entre las variables, se empleó el coeficiente de correlación de Spearman y Chi cuadrado. Resultados: 354 (88,5%) de los universitarios tienen un dispositivo móvil con conexión a internet; 184 (46%) consultan entre 3 a 4 redes sociales, aproximadamente de 1 a 4 horas diarias 196 (49%). 157 (39.2%) manifestaron no ver afectada la academia por el uso de redes sociales. La salud general, en una escala de 0 a 100, obtuvo una puntuación de 58,5 por los colombianos y de 38,3 en los mexicanos. Discusión: Los jóvenes dedican mayor cantidad de su tiempo en el uso de redes sociales, siendo su interés especial, las relaciones entre pares. Algunos estudios coinciden en que existe una asociación entre el mal uso del internet y problemas de salud físicos y psicosociales. Conclusiones: El comportamiento de uso de las redes sociales y la percepción de calidad de vida es similar en Colombia y en México; además consideran que son usadas moderadamente como herramienta académica y de socialización. Es necesario espacios para compartir con iguales, en los cuales no se necesite de las redes sociales como mediador.

Introduction: Social networks provide young people with the opportunity to be in touch with society and their environment, for which they spend a great amount of time to seek acceptance from their peers. Materials and Methods: A cross-sectional descriptive correlational study was conducted on a sample of 400 students. Two questionnaires were used to collect information. For variable comparison, Spearman's rank correlation coefficient and Chi-squared test were used. Results: 354 (88.5%) of university students have a mobile device with internet connection; 184 (46%) use 3 to 4 social networks and 196 (49%) use them for about 1 to 4 hours a day. 157 (39.2%) claimed that their studies were not affected by using social networks. As for general health, Colombians scored 58.5 and Mexicans 38.3 on a scale of 0 to 100. Discussion: Young people spend most of their time using social networks, being particularly interested in social relationships with their peers. Some studies suggest an association between internet misuse and physical and psychosocial health problems. Conclusions: Social network use behavior and quality of life perception are similar in Colombia and Mexico. In addition, social networks are moderately used as an academic and socialization tool. There is a need for opportunities to share with peers in which social networks are not used as a mediator.

Introdução: As redes sociais permitem que os jovens entrem em contato com a sociedade e seu ambiente, para o qual passam muito tempo a procurar a aceitação por parte dos seus semelhantes. Materiais e Métodos: Um estudo transversal descritivo e correlacional foi realizado em uma amostra de 400 alunos. As informações foram coletadas por meio de dois questionários. Para a comparação de variáveis, foram utilizados o coeficiente de correlação de postos de Spearman e o teste do qui-quadrado. Resultados: 354 (88,5%) dos universitários possuem telefone celular com conexão à Internet; 184 (46%) utilizam de 3 a 4 redes sociais e 196 (49%) as utilizam por cerca de 1 a 4 horas por dia. 157 (39,2%) afirmaram que a academia não foi afetada pelo uso de redes sociais. A saúde geral, em uma escala de 0 a 100, obteve 58,5 para os colombianos e 38,3 para os mexicanos. Discussão: Os jovens passam mais tempo usando redes sociais, com seu interesse especial nas relações com os seus semelhantes. Alguns estudos sugerem uma associação entre uso indevido da internet e problemas de saúde físicos e psicossociais. Conclusões: O comportamento de uso das redes sociais e a percepção de qualidade de vida são semelhantes na Colômbia e no México. Além disso, as redes sociais são usadas ​​moderadamente como uma ferramenta acadêmica e de socialização. Você precisa de espaços para compartilhar com iguais, nos quais não precisa de redes sociais como mediador.

Aldosterone synthase gene polymorphism and renal histopathologic changes in kidney transplant patients receiving a calcineurin inhibitor.

INTRODUCTION: Aldosterone participates in the pathogenesis of calcineurin inhibitor nephrotoxicity (CIN), producing renal vasoconstriction and transforming growth factor beta (TGFß) expression. The objective of this study was to assess aldosterone polymorphisms and relationships to plasma aldosterone levels and the development of renal histological lesions in kidney transplant patients. MATERIAL AND METHODS: Patients with kidney graft biopsy were divided according to the presence or absence of CIN. We determined aldosterone synthase (AS) -344 T/C and int 2 W/C gene polymorphisms and plasma aldosterone levels. Histological, biochemical and clinical variables were measured. RESULTS: Calcineurin inhibitor (CI) levels were significantly higher in patients with the int 2 WW genotype than in patients with WC or CC genotypes. There was a greater degree of interstitial fibrosis in patients with int 2 CC genotype. No relationship was found between the different polymorphisms and a higher degree and/or frequency of CIN. There was also no relationship with plasma aldosterone levels. CONCLUSION: The frequency of the different polymorphisms studied was not related to plasma aldosterone levels or the development of CIN; however, the int 2 CC genotype was related to a greater degree of interstitial fibrosis, whereas the WW genotype was related to higher CI serum levels.

Determinantes sociales en el consumo de sustancias psicoactivas en estudiantes universitarios en 2016 / Determinantes sociais no consumo de substâncias psicoativas em estudantes universitários 2016 / Social determinants in the consumption of psychoactive substances in university students in 2016

Resumen: En este artículo se dan a conocer los resultados de una investigación que tuvo como objetivo describir los determinantes sociales asociados al consumo de sustancias psicoactivas (SPA) en estudiantes de una universidad pública de Colombia, modalidad presencial diurna. Se realizó un estudio descriptivo, cuantitativo, transversal, con una muestra de n= 341 estudiantes; se realizó muestreo estratificado, con selección aleatoria y se aplicó el cuestionario utilizado en el II Estudio Epidemiológico Andino sobre Consumo de Drogas en la Población Universitaria, Proyecto PRADICAN (Programa Antidrogas Ilícitas en la Comunidad Andina), previa autorización de los participantes de estudio. Se realizó un análisis descriptivo y se calcularon frecuencias relativas. Los resultados mostraron que el 61% de los encuestados pertenecen al estrato socioeconómico 1, el más bajo; el 77,4% se dedica exclusivamente a sus estudios; el 22,6% trabaja además de estudiar. La relación con sus padres es buena (90%). 56% tienen amigos consumidores y el 20,5% tienen familiares cercanos consumidores de SPA ilegales. Los resultados permitieron establecer que se debe aumentar la cobertura de los programas de apoyo que ofrece la universidad a través de Bienestar Universitario para intervenir positivamente los determinantes identificados, diseñar y desarrollar estrategias que permitan generar cultura de autocuidado y prevención del consumo de SPA.

Resumo: Este artigo divulgou os resultados de uma investigação que teve como objetivo descrever os determinantes sociais associados ao uso de substâncias psicoativas (SPA) em estudantes de uma universidade pública, modalidade dia. Foi realizado um estudo descritivo, quantitativo, transversal, com uma amostra de n = 341 alunos; amostragem estratificada foi realizada com seleção aleatória, foi aplicado o questionário do Estudo Epidemiológico II Andino sobre Uso de Drogas na Cidade Universitária, Projeto PRADICAN (Programa de Combate às Drogas ilegal na Comunidade Andina), a aprovação prévia dos participantes do estudo. Uma análise descritiva foi realizada, as frequências relativas foram calculadas. Os resultados mostraram que 61% dos respondentes pertencem ao estrato socioeconômico 1; 77,4% são dedicados exclusivamente a seus estudos; 22,6% trabalham além de estudar. O relacionamento com os pais é bom (90%). 56% têm amigos do consumidor e 20,5% têm parentes próximos que usam SPA ilegal. Os resultados permitiram estabelecer que a cobertura dos programas de apoio oferecidos pela universidade através do Bem-Estar Universitário deve ser ampliada para intervir positivamente nos determinantes identificados; conceber e desenvolver estratégias para gerar uma cultura de autocuidado e prevenção do consumo de SPA.

Abstract: In this article we present the results of an investigation aimed to describe the social determinants associated with the consumption of psychoactive substances (SPA) in students of a public university in Colombia, in face-to-face modality. A descriptive, quantitative, cross-sectional study was carried out with a sample of n = 341 students; stratified sampling was used, with random selection, applying the questionnaire used in the II Andean Epidemiological Study on Drug Use in the University Population, Project PRADICAN (Illicit Anti-Drug Program in the Andean Community), with prior authorization of the study participants. A descriptive analysis was carried out and the relative frequencies were calculated. The results showed that 61% of the respondents belong to the socioeconomic stratum 1, the lowest one; 77.4% are dedicated exclusively to their studies and 22.6% work in addition to studying. The relationship with their parents is good (90%). 56% have substance consuming friends and 20.5% have close relatives who use illegal SPA. The results allowed to establish that the coverage of the support programs offered by the university through University Welfare should be increased in order to positively intervene the identified determinants, design and develop strategies to generate a culture of self-care and prevention of SPA consumption.

Comportamiento de indicadores de calidad en Instituciones Prestadoras de Servicios de Salud. Montería, 2015 / Behavior of quality indicators in Health Services Providers. Montería, 2015

Objetivo. Determinar el comportamiento de los indicadores de calidad en Instituciones Prestadoras de Servicios de Salud (IPS) de segundo y tercer nivel de atención, en la ciudad de Montería.Metodología. Estudio descriptivo cuantitativo, se realizó análisis retrospectivo del comportamiento de los resultados de una serie de indicadores de calidad. La información se obtuvo de la Base de datos de indicadores de calidad en salud del Ministerio de Salud y Protección Social. La población y muestra fue de 13 IPS de segundo y tercer nivel de atención, que reportaron información ante el Ministerio de Salud y de la Protección Social, el estudio se realizó en el año 2015; sin embargo, se encontraron datos hasta el año 2013, por lo tanto, se recolectó información de los tres últimos períodos (2011 -2013). Resultados. El 57% de los reportes corresponden a IPS de tercer nivel. La tasa de reingresos de pacientes hospitalizados, fue de 5,06 X 100; la mortalidad intrahospitalaria después de 48 horas fue de 6,8 x 1000, el promedio de infecciones asociadas a la atención fue de 7,5 por cada 100 pacientes hospitalizados, la gestión de los eventos adversos obtuvo un promedio de 84%, además se evidenció la falta de reporte de datos por parte de algunas IPS. Conclusiones. Las IPS deben establecer mecanismos, que garanticen el análisis de indicadores lo más cercano al tiempo real, para tomar decisiones oportunas. La medición de indicadores de calidad, permitirá un mejor monitoreo a los entes de control

Objective: To determine the performance of quality indicators in Health Services Providers (IPS) of second and third level of care, in Monteria.Methodology: Quantitative descriptive study, a retrospective analysis of the performance of the results of a series of quality indicators was carried out. The information was obtained from the Health Quality Indicators Database of the Ministry of Health and Social Protection. The population and sample was 13 IPS of the second and third level of care, which reported information to the Ministry of Health and Social Protection. The study was conducted in 2015; however, data were also found from year 2013, therefore, information was collected from the last three periods (2011-2013).Results: 57% of the reports correspond to IPS of the third level. The rate of readmissions of hospitalized patients was 5.06 X 100; In-hospital mortality after 48 hours was 6.8 x 1000, the average number of infections associated with care was 7.5 per 100 hospitalized patients, the management of adverse events threw an average of 84%, it was also evident the lack of data reported by some IPS.Conclusions: IPS must establish mechanisms that guarantee the analysis of indicators as close to real time as possible, in order to make timely decisions. The measurement of quality indicators will allow for a better monitoring of the control entities.

Residuos sólidos en viviendas de interés social / Solid waste in social interest housing

Objetivo. Determinar el conocimiento y actitud, acerca del manejo de los residuos sólidos domiciliarios, que tienen los habitantes de unas viviendas de interés social del municipio de Montería. Materiales y métodos. Estudio descriptivo, cuantitativo, transversal, coninformación recolectada mediante aplicación de un cuestionario, que evaluó aspectos relacionados con el conocimiento y actitud de las personas acerca del manejo de los residuos sólidos domiciliarios. Se realizó en 24 torres de apartamentos de viviendas de interés social; se tomó una muestra aleatoria de 175 apartamentos, en donde se aplicó un cuestionario a los jefes de hogar para la recolección de la información, la cual fue recolectada en físico y procesada en SPSS. Resultados. Los hallazgos indican que el 68% de los jefes de hogar manifiestan que tienen conocimiento de algunas técnicas de reciclaje; el 60% refieren que no separan los residuos; el 70% no separa los desechos tecnológicos; 65,7% no tiene claridad acerca de cuáles son los llamados residuos sólidos; el 63,5% no conoce el código de colores que permite una clasificación adecuada de los residuos. Conclusiones. En las viviendas objeto de estudio, es necesario implementar estrategias para mejorar el conocimiento de los habitantes que contribuya a una adecuada separación en la fuente de los residuos sólidos domiciliarios, para favorecer la reducción en la producción de basura y el desarrollo de una conciencia del cuidado al ambiente.

Objective. Determine the knowledge of and attitude to ward the management of solid house hold waste that the inhabitants of social housing have in the municipality of Monteria. Materials and methods. This was a descriptive, quantitative, and cross-sectional study with information collected through the application of a question naire, which evaluated aspects related to the knowledge of and attitude of people toward the man agement of solid house hold waste. The study was carried out in 24 apartment towers of social-interes thousing. Arandom sample of 175 apartments was chosen, and a questionn aire was administered to the heads of house holds forthe collection of the information, which was collected inphysical formand process edin SPSS. Results. The finding sindicated that 68% of heads of households have knowledge of somere cycling techniques; 60% reported that they do not separate the waste; 70% of them did not separate technological waste; 65.7 % of the respondents were not cleara bout what is called solid waste; and 63.5% of them did not know the color code that allows an adequate classification ofwaste. Conclusion. In the home sunder study, it is necessary to implement strategies to improve the knowledge of the inhabitants that contribute to an adequate separation in the source of the household solid waste to favor the reduction in the production of garbage and the development of anawareness of the care for the environment.

Seguridad del paciente en cuatro Empresas Sociales delEstado de segundo nivel del Departamento de Córdoba / Patient safety in four health institutions on the second-level of complexity from the State of Córdoba

Determinar el nivel de implementación de la política de seguridad del paciente eidentificar en la plataforma estratégica su articulación con la política institucional, encuatro instituciones de salud de segundo nivel de complejidad.MetodologíaEstudio de tipo descriptivo, cuantitativo, transversal, cuya información se recolectómediante la aplicación de lista de chequeo a los líderes de calidad y seguridad del pacientey la realización de una encuesta en línea, en las cuatro instituciones objeto de estudio.ResultadosTodas las instituciones cuentan con la política formalmente documentada y disponendel comité de seguridad del paciente, tienen definidas las funciones y los responsables,a quienes se han comunicado las responsabilidades asignadas de acuerdo con su perfil;tres instituciones disponen del referente de seguridad, realizan reuniones periódicas delcomité y hacen reporte de eventos adversos a través del aplicativo sugerido por la OPS yadoptado por el Ministerio de Salud; sólo dos instituciones cumplen con los lineamientosexigidos por la normatividad, han realizado capacitaciones y entrenamiento al personal.RecomendaciónEs necesario tener una política de seguridad del paciente formalmente documentadade acuerdo con los lineamientos exigidos por la normatividad, que permita mejorar ymantener la seguridad en el tiempo...

To determine the level of implementation of the patient safety policy and identify on thestrategic platform its articulation with the institutional policy in four health institutions onthe second level of complexity.MethodologyDescriptive study, quantitative, cross-sectional. Information was collected by applying achecklist to the leaders of quality and patient safety along with an online survey in the fourinstitutions subject to study.ResultsAll the institutions have the policy formally documented and also have the patient safetycommittee. Functions and responsible parties have been assigned and informed about theirduties according to their profiles. Three institutions count on the safety referent, conductregular committee meetings and report adverse events through the application suggestedby WHO and adopted by the Ministry of Health. Only two institutions meet the guidelinesrequired by the regulations, and have provided staff training.RecommendationIt is necessary to have a patient safety policy formally documented according to theguidelines required by the regulations that allows to improve and maintain safety in time...

Valor diagnóstico de la mamografía digital en la detección de cáncer de mama. Hospital Nacional Dos de Mayo. Enero - Octubre 2012 / Diagnostic value of digital mammography in the detecting of breast cancer. National Hospital Dos de Mayo. January-October 2012

Objetivo: Determinar el valor diagnóstico de la mamografía digital en la detección de cáncer de mama en el Hospital Nacional Dos de Mayo. En el periodo de Enero a Octubre del año 2012 basado en los resultados mamográficos y anatomopatológicos (biopsias). Material y métodos: Se realizó un estudio de tipo observacional, descriptivo, retrospectivo y de corte transversal, en el cual se revisaron las historias clínicas de las pacientes que comprendían una edad de entre 35 y 65 años que ingresaron al hospital Nacional Dos de Mayo entre los meses de Enero y Octubre del año 2012 y que presentaron signos y síntomas compatibles con tumoración en cualquiera de las dos mamas, concluyendo al final con 67 pacientes que contaban con un informe mamográfico sugerente de neoplasia maligna y con un informe anatomopatológico (biopsia), a fin de valorar la eficacia de la técnica mamográfica en el diagnóstico de cáncer de mama. Resultados: Se incluyeron en el estudio 67 pacientes que cumplieron con los criterios de selección, analizando cada caso y obteniendo los siguientes resultados: sensibilidad del 90.48 por ciento, una especificidad del 89.13 por ciento, valor predictivo positivo del 79.17 por ciento y valor predictivo negativo del 95.35 Conclusiones: El valor diagnóstico de la mamografía digital en el Hospital Nacional Dos de Mayo cumple con los estándares mínimos establecidos por el ACR, probando ser una prueba diagnóstica confiable en la detección de pacientes con neoplasias malignas.

Objective: To determine the diagnostic value of digital mammography in detecting breast cancer in the National Hospital Dos de Mayo. In the period from January to October of 2012 based on mammographic and pathologic results (biopsies). Material and Methods: We conducted an observational study, descriptive, retrospective and cross-sectional, in which medical records of patients included age between 35 and 65 who entered the National Hospital Dos de Mayo between the months of January and October 2012 and who had signs and symptoms consistent with lump in either breast, concluding at the end with 67 patients who had a mammography report suggestive of malignancy and a pathology report (biopsy), in order to assess the effectiveness of the technique in mammographic diagnosis of breast cancer. Results: The study included 67 patients who met the selection criteria, analyzing each case and with the following results: sensitivity of 90.48 per cent, a specificity of 89.13 per cent, positive predictive value of 79.17 per cent and negative predictive value of 95.35. Conclusions: The diagnostic value of digital mammography in the National Hospital Dos de Mayo meets the minimum standards set by the ACR, proving to be a reliable diagnostic test for the detection of patients with malignancies.

Sindrome cardiorrenal: Revisión de la Literatura / Cardiorenal Syndrome: A Review of the Literature

La disfunción renal es altamente prevalente, en pacientes con falla cardiaca aguda de descompensación de la falla cardiaca crónica. El tratamiento de la disfunción renal concomitante a falla cardiaca aguda sigue siendo un reto; la comprención de la interacción del corazon y riñon es fundamental en las desiciones terapéuticas de estos pacientes. Hemos examinado la fisiopatologia el papel neurohormonal así como los biomarcadores y los predictores de mortalidad del sindrome crdiorrenal ya que la función renal es el factor pronostico más importante en el resultado de estos pacientes, comprensión de la fisiopatología, elección de una terapia apropiada y reduccion de la tasa de mortalidad.