Transcultural adaptation and validation of IMPACT-III and IMPACT-III-P in Spanish families: a multicenter study from SEGHNP.

IMPACT-III and IMPACT-III-P are health-related quality of life (HRQoL) questionnaires for patients with pediatric inflammatory bowel disease (p-IBD) and their parents/caregivers. We aimed to perform a transcultural adaptation and validation for the Spanish context. Translation, back-translation, and evaluation of the questionnaires were performed by an expert committee and 12 p-IBD families. We recruited p-IBD patients aged 10-17 and their parents/caregivers. Utility, content, and face validity were considered. Validation was performed with Cronbach's alpha coefficient and varimax rotation. We confirmed the adequacy of the factor analysis using Kaiser-Meyer-Olkin (KMO) and Bartlett's sphericity tests. A confirmatory factor analysis was performed using the following goodness indexes: chi-square, Normed Fit Index (NFI), Root Mean Square Error of Approximation index (RMSEA), Standardized Root Mean Square Residual (SRMR), and Comparative Fit Index (CFI). The correlation coefficient between IMPACT-III and IMPACT-III-P was analyzed. We included 370 patients and 356 parents/caregivers (37 hospitals). Both questionnaires had good content and face validity and were considered user-friendly. The KMO measure (0.8998 and 0.9228, respectively) and Bartlett's sphericity test (p-value < 0.001 for both) confirmed the adequacy of the factor analysis. The 4-factor model, complying with Kaiser's criterion, explained 89.19% and 88.87% of the variance. Cronbach's alpha (0.9123 and 0.9383) indicated excellent internal consistency. The CFA showed an adequate fit (NFI 0.941 and 0.918, RMSEA 0.048 and 0.053, SRMR 0.037 and 0.044, and CFI 0.879 and 0.913). The correlation coefficient was excellent (0.92). CONCLUSION: The SEGHNP versions of IMPACT-III and IMPACT-III-P are valid and reliable instruments for Spanish p-IBD families. WHAT IS KNOWN: • IMPACT-III and parent-proxy IMPACT-III (IMPACT-III-P) are useful questionnaires for assessing health-related quality of life (HRQoL) in pediatric inflammatory bowel disease (p-IBD) patients and their parents/caregivers and have been translated and validated in several countries. • To date, no transcultural adaptation and validation of these questionnaires have been published for Spanish patients with p-IBD and their families. WHAT IS NEW: • This is the first transcultural adaptation and validation of IMPACT-III and IMPACT-III-P for Spanish p-IBD families. • These are valid and reliable instruments for assessing HRQoL in Spanish families of patients with p-IBD.

Reservoir Effect of Textile Substrates on the Delivery of Essential Oils Microencapsulated by Complex Coacervation.

Microcapsules are being used in textile substrates increasingly more frequently, availing a wide spectrum of possibilities that are relevant to future research trends. Biofunctional Textiles is a new field that should be carefully studied, especially when dealing with microencapsulated essential oils. In the final step, when the active principle is delivered, there are some possibilities to quantify and simulate its doses on the skin or in the environment. At that stage, there is a phenomenon that can help to better control the delivery and the reservoir effect of the textile substrate. Depending on the chemical characteristics of the molecule to be delivered, as well as the structure and chemical nature of the fabric where it has been applied, there is physicochemical retention exerted by fibers that strongly controls the final rate of principle active delivery to the external part of the textile substrate. The study of this type of effect in two different substrates (cotton and polyester) will be described here regarding two different essential oils microencapsulated and applied to the substrates using padding technology. The experimental results of the final drug delivery demonstrate this reservoir effect in both essential oils.

Trends in Faecal Zonulin Concentrations in Paediatric Patients with Celiac Disease at Baseline and on a Gluten-Free Diet: Exploring Correlations with Other Faecal Biomarkers.

Celiac disease (CeD) is an autoimmune condition triggered by gluten in genetically predisposed individuals, affecting all ages. Intestinal permeability (IP) is crucial in the pathogenesis of CeD and it is primarily governed by tight junctions (TJs) that uphold the intestinal barrier's integrity. The protein zonulin plays a critical role in modulating the permeability of TJs having emerged as a potential non-invasive biomarker to study IP. The importance of this study lies in providing evidence for the usefulness of a non-invasive tool in the study of IP both at baseline and in the follow-up of paediatric patients with CeD. In this single-centre prospective observational study, we explored the correlation between faecal zonulin levels and others faecal and serum biomarkers for monitoring IP in CeD within the paediatric population. We also aimed to establish reference values for faecal zonulin in the paediatric population. We found that faecal zonulin and calprotectin values are higher at the onset of CeD compared with the control population. Specifically, the zonulin levels were 347.5 ng/mL as opposed to 177.7 ng/mL in the control population (p = 0.001), while calprotectin levels were 29.8 µg/g stool compared to 13.9 µg/g stool (p = 0.029). As the duration without gluten consumption increased, a significant reduction in faecal zonulin levels was observed in patients with CeD (348.5 ng/mL vs. 157.1 ng/mL; p = 0.002), along with a decrease in the prevalence of patients with vitamin D insufficiency (88.9% vs. 77.8%). We conclude that faecal zonulin concentrations were higher in the patients with active CeD compared with healthy individuals or those following a gluten-free diet (GFD). The significant decrease in their values over the duration of the GFD suggests the potential use of zonulin as an additional tool in monitoring adherence to a GFD.

Proof of concept for a new sensor to monitor marine litter from space.

Worldwide, governments are implementing strategies to combat marine litter. However, their effectiveness is largely unknown because we lack tools to systematically monitor marine litter over broad spatio-temporal scales. Metre-sized aggregations of floating debris generated by sea-surface convergence lines have been reported as a reliable target for detection from satellites. Yet, the usefulness of such ephemeral, scattered aggregations as proxy for sustained, large-scale monitoring of marine litter remains an open question for a dedicated Earth-Observation mission. Here, we track this proxy over a series of 300,000 satellite images of the entire Mediterranean Sea. The proxy is mainly related to recent inputs from land-based litter sources. Despite the limitations of in-orbit technology, satellite detections are sufficient to map hot-spots and capture trends, providing an unprecedented source-to-sink view of the marine litter phenomenon. Torrential rains largely control marine litter inputs, while coastal boundary currents and wind-driven surface sweep arise as key drivers for its distribution over the ocean. Satellite-based monitoring proves to be a real game changer for marine litter research and management. Furthermore, the development of an ad-hoc sensor can lower the minimum detectable concentration by one order of magnitude, ensuring operational monitoring, at least for seasonal-to-interannual variability in the mesoscale.

Successful ultrasound-guided ovum pick-up (OPU) and subsequent in vitro embryo production in a domestic cat.

Ovum Pick Up (OPU) is a minimally invasive technique widely used in cattle and mares for oocyte retrieval, involving ultrasound-guided puncture of ovarian follicles. It has been demonstrated that this technique is safe for its repeated use in the same female without affecting her reproductive health, allowing for the retrieval of oocytes in individuals regardless of their reproductive status. The oocytes obtained through OPU can subsequently be used for in vitro embryo production (IVP) using assisted reproductive techniques (ARTs) or be cryopreserved in biobanks for their future use. Traditionally, the minimally invasive technique of choice performed in vivo in domestic and wild felines was LOPU (laparoscopic-guided ovum pick up). The present study was designed to explore if ultrasound-guided OPU in the domestic cat is safe and effective. In an initial series of ex vivo experiments (n = 92 ovaries, n = 434 oocytes), the effect of different aspiration pressures for oocyte collection was explored. These experiments identified 43 mmHg as the optimal aspiration pressure, resulting in the highest recovery rate and a favorable maturation and blastocyst rate. Subsequently, 16 grade I and II oocytes were retrieved by OPU and 101 oocytes were retrieved following ovariectomy and slicing. Sixteen oocytes obtained with each technique were subjected to in vitro maturation (IVM) and in vitro fertilization (IVF). A total of 14 presumptive zygotes were selected for in vitro culture (IVC) from each group (OPU and slicing), obtaining a cleavage rate of 57.1 % and 64.2 %, a morula rate of 28.5 % in both groups, and a blastocyst rate of 7.14 % and 14.2 % respectively. The hormonal stimulation protocol was well-tolerated, with no adverse effects observed. Moreover, no complications arose during the ovariectomy performed post-OPU. The use of this technique in domestic cats represents a significant step forward in terms of safety, replicability, and invasiveness, serving as a valuable model for its application in wild felids species. Additional research involving a greater number of animals is required to validate these encouraging findings.

Efecto de la suplementación oral con vitamina D sobre la gravedad de la psoriasis: ¿Genera beneficios significativos? / Effect of oral vitamin D supplementation on psoriasis severity: Does it generate significant benefits?

RESUMEN La psoriasis es una enfermedad crónica de la piel mediada por el sistema inmunológico con una base genética y patogénica compleja, que frecuentemente conduce a comorbilidades significativas y una reducción en la calidad de vida. Su prevalencia varía a nivel global y muestra una tendencia creciente con el tiempo. Comorbilidades como la artritis psoriásica, enfermedades cardiovasculares y problemas de salud mental complican aún más la carga de la psoriasis. Las opciones de tratamiento van desde terapias tópicas hasta agentes sistémicos, siendo los agentes biológicos prominentes en los últimos años. Sin embargo, la seguridad y eficacia de estos tratamientos se evalúan continuamente a través de datos del mundo real. La vitamina D ha llamado la atención como un posible objetivo terapéutico debido a su papel en la regulación inmunológica y la función de barrera de la piel. Esta revisión tiene como objetivo evaluar la eficacia de la suplementación oral de vitamina D en mejorar la gravedad de la psoriasis. Después de una búsqueda bibliográfica, se encontró que la psoriasis es una condición multifacética con significativas implicaciones globales. Los agentes biológicos han transformado su manejo, y la suplementación oral de vitamina D es un camino prometedor para una mayor exploración. Un enfoque integral centrado en el paciente que tenga en cuenta las comorbilidades y los resultados a largo plazo es crucial para optimizar el cuidado de la psoriasis. Se necesita más investigación para comprender completamente el papel de la vitamina D en la psoriasis y su potencial como intervención terapéutica.

ABSTRACT Psoriasis is a chronic immune-mediated skin disease with a complex genetic and pathogenic basis, often leading to significant comorbidities and a reduced quality of life. Its prevalence varies globally and exhibits an increasing trend over time. Comorbidities such as psoriatic arthritis, cardiovascular diseases, and mental health issues further compound the burden of psoriasis. Treatment options range from topical therapies to systemic agents, with biologics playing a prominent role in recent years. However, the safety and efficacy of these treatments are continuously assessed through real-world data. Vitamin D has gained attention as a potential therapeutic target due to its role in immune regulation and skin barrier function. This review aims to evaluate the efficacy of oral vitamin D supplementation in ameliorating the severity of psoriasis. After bibliographic search, it was found that psoriasis is a multifaceted condition with significant global implications. Biologics have transformed its management, and oral vitamin D supplementation is a promising avenue for further exploration. A comprehensive, patient-centered approach that considers comorbidities and long-term outcomes is crucial for optimizing psoriasis care. Further research is needed to fully understand the role of vitamin D in psoriasis and its potential as a therapeutic intervention.

¿Neoplasia de células de Hürtle o de células oncocíticas? Denominación actual y su manejo. Reporte de caso / Hürtle cell or oncocytic cell neoplasm? Current denomination and its management. Case report

Introducción: Las células de Hürtle fueron descritas por Max Askanazy en 1898, aunque su denominación inapropiada ha permanecido en el léxico. Pueden observarse en una amplia variedad de lesiones tiroideas, desde afecciones no neoplásicas hasta francamente malignas. Caso clínico: Femenina de 62 años de edad, asmática e hipertensa controlada, alérgica al yodo y a la penicilina, quien inicia enfermedad actual 1 año previo al presentar aumento de volumen en región anterior del cuello. Ecografía tiroidea reportó glándula aumentada de tamaño, con nódulo tiroideo derecho, complejo de 4 cm; y nódulo tiroideo izquierdo, complejo de 2 cm, TI-RADS 4C. Tomografía computarizada reportó lesión ocupantne de espacio del lóbulo tiroideo derecho de 6 cm y nódulos tiroideos izquierdos de 3 y 2 cm. Pruebas tiroideas sin alteraciones. Se realizó tiroidectomía total. Diagnóstico histopatológico: adenoma de células de Hürtle. Conclusión: En la actualidad, el término correcto es neoplasia de células oncocíticas, bien sea para el adenoma o para el carcinoma. Este tipo de tumores se presenta con mayor frecuencia en mujeres de mediana edad y con un tamaño considerable al momento del diagnóstico. Es necesario establecer un protocolo de acción ante el diagnóstico presuntivo mediante punción por aspiración por aguja fina, debido a la dificultad para diferenciar entre patología benigna y maligna, con la finalidad de garantizar una conducta terapeútica adecuada(AU)

Introduction: Hürtle cells were described by Max Askanazy in 1898, although their inappropriate name has remained in the lexicon. They can be seen in a wide variety of thyroid lesions, from non-neoplastic to frankly malignant conditions. Clinical case: A 62-year-old female, asthmatic and controlled hypertensive, allergic to iodine and penicillin, who started the current disease 1 year before presenting volume increase in the anterior region of the neck. Thyroid ultrasound reported an enlarged gland, with a 4-cm complex right thyroid nodule; and left thyroid nodule, 2 cm complex, TI-RADS 4C. Computed tomography reported a 6 cm space-occupying lesion of the right thyroid lobe and 3 and 2 cm left thyroid nodules. Thyroid tests without alterations. Total thyroidectomy was performed. Histopatological diagnosis: Hürtle cell adenoma. Conclusion: Currently, the correct term is oncocytic cell neoplasm, either for adenoma or for carcinoma. This type of tumors occurs more frequently in middle-aged women and with a considerable size at the time of diagnosis. It is necessary to establish a protocol of action before the presumptive diagnosis by means of fine needle aspiration procedure, due to the difficulty to differentiate between benign and malignant pathology, with the purpose of guaranteeing an adequate therapeutic conduct(AU)

Caracterización y tipos de familias productoras de maíz local en la Frailesca, Chiapas / Typological characterization of the maize producing families from la Frailesca, Chiapas

Resumen Las Unidades de Producción Familiar (UPF) están conformadas por capitales natural, físico, financiero, humano y social. Los dos últimos constituyen la base del funcionamiento del resto y de la unidad de producción. En México, Chiapas y la Frailesca, la producción de maíces, particularmente de maíces locales, tiene valor cultural, agronómico y económico. El objetivo de esta investigación fue caracterizar las Unidades de Producción Familiar que cultivan maíces locales en la región Frailesca del estado de Chiapas, sobre la base cultural del manejo de los capitales humano y social. Se estudiaron 80 UPF de 20 comunidades seleccionadas mediante un muestreo por redes. Se utilizó el enfoque Modos de Vida Sustentable como marco de referencia. Se aplicaron entrevistas semiestructuradas y se realizaron observaciones participantes. En el estudio predominaron las familias nucleares con líderes de edad avanzada. Los jóvenes no priorizan la conservación de los maíces locales sino actividades más rentables como la ganadería, los maíces híbridos y el café. Existe un excesivo uso de agroquímicos que afecta los recursos suelo, agua y biodiversidad. Se distinguieron 6 tipos de UPF de acuerdo con sus capitales humano y social. El grupo 3 (G3) mostró un mejor equilibrio entre ambos por la participación familiar, destacándose entre los de mayor experiencia en el cultivo de maíces locales y por tener relaciones locales y de cooperación más sólidas. Se concluye que las UPF presentan características que contribuyen o afectan la conservación de los maíces locales, como la continuidad generacional, el deterioro de los recursos naturales que sostienen el cultivo a través de la fusión de las prácticas tradicionales con las modernas y la dependencia de recursos externos.

Abstract The Family Production Units (FPU) are made up of natural, physical, financial, human and social capital. The last two constitute the basis for the functioning of the rest of the capitals and of the production unit. In Mexico, Chiapas and La Frailesca, the production of corn, and particularly local corn, has cultural, agronomic, and economic value. The objective of this research was to characterize the UPF that cultivate local corn, in the Frailesca region of the State of Chiapas, on the cultural basis of the management of human and social capital. 80 UPF from 20 communities were studied, selected through network sampling. The Sustainable Livelihoods approach was used as a frame of reference. Semi-structured interviews were applied, and participant observations were made. In the predominant study in nuclear families with elderly leaders predominated. Young people do not prioritize the conservation of local corn, but rather more profitable activities such as livestock, hybrid corn and coffee. There is an excessive use of agrochemicals that affects soil, water and biodiversity resources. Six types of UPF were distinguished according to their human and social capital. The third category (G3) shows a better balance between human and social capital due to their family involvement, standingout among those with more experience in growing local corn and having stronger local relationships. It is concluded that the UPF present characteristics that foster or impair the preservation of local corn such as generational continuity, the deterioration of the natural resources that sustain the cultivation through the fusion of traditional and modern practices and dependence on external resources.

Actitudes frente a la prevención del cáncer de cuello uterino en mujeres de un centro de educación técnica / Attitudes towards the prevention of cervical cancer in women in a technical education center

Objetivo: el objetivo de la presente investigación, es describir las actitudes frente a la prevención del cáncer de cuello uterino en mujeres del instituto Formarte, de la ciudad de Cali- Colombia. Materiales y métodos: se realizó un estudio de corte transversal. Se incluyeron 138 mujeres matriculadas en cualquiera de los programas académicos, a quienes se les realizó una encuesta con el fin de medir las variables propósito de la investigación. Resultados: se encontró una media de edad de 33,7 años (DE 13,2). De estas, 22,5% iniciaron relaciones por debajo de los 14 años, 42,8% informó haber tenido al menos 3 compañeros sexuales, 48% rara vez recurre al uso del condón, 28,3% refirió el consumo de cigarrillo. El 23,2% ha recibido algún tipo de educación respecto a la prevención del cáncer de cérvix, aunque el 82,6% reconoce la importancia de la citología y en su mayoría, 42% se realiza el examen anualmente. Conclusiones: se encontraron deficiencias respecto a actitudes en la prevención del cáncer de cuello uterino, las cuales parecen estar relacionadas con el contexto cultural particular de la población estudiada y que guardan disimilitud con las observadas en otras localizaciones geográficas..(AU)

Objective: the objective of the present investigation is to describe the attitudes towards the prevention of cervical cancer in women from Formarte Institute in the city of Cali- Colombia. Materials and methods: a cross-sectional study was carried out. We included 138 women enrolled in any of the academic programs, who were surveyed in order to measure the variables of the research. Results: an average age of 33,7 years was found (SD 13,2). Of these, 22,5% began relationships below 14 years of age, 42,8% reported having had at least 3 sexual partners, 48% rarely resorted to condom use,28,3% reported smoking. 23,2% have received some type of education regarding the prevention of cervical cancer, although 82,6% recognize the importance of cytology and in the majority, 42% perform the exam annually. Conclusions: We found deficiencies regarding attitudes in the prevention of cervical cancer, which seem to be related to the particular cultural context of the population studied and that are dissimilar to those observed in other geographical locations..(AU)

¿Qué hacer con los médicos extranjeros? / What to do with foreign physicians?

The arrival of Venezuelan anesthesiologists to Colombia has raised concerns among their Colombian colleagues, who see this as a threat to their employment status.

Large mammal community composition and density under a disturbance gradient in Northeast Costa Rica / Composición y densidad de las comunidades de grandes mamíferos bajo un gradiente de alteración en el noreste de Costa Rica

Abstract:Large mammal communities, integral components of Neotropical ecosystems, are increasingly threatened by habitat fragmentation and degradation due to anthropogenic pressures and climate change. Lowland Neotropical palm forests harbor diverse mammal communities, including threatened and endangered species. We monitored three transects in the Barra del Colorado Wildlife Refuge in Northeast Costa Rica from February 2014 until April 2015 documenting large terrestrial mammal and primate detections. Following established large mammal survey methodology, each transect was walked weekly alternating between early morning and late afternoon to maximize detection. The three transects represent three levels of anthropogenic disturbance with highest disturbance at the Cerro, followed by Caño Palma Biological Station (CPBS), and lowest levels in Tortuguero National Park (TNP). Overall we found higher diversity and increased presence of endangered species in TNP and the lowest diversity and lower presence of those species in the Cerro. Overall we detected 25 species; 19 at the Cerro, 22 in TNP and 23 at CPBS. TNP had the highest diversity as calculated by Simpson index (28.3) followed by CBPS (27.9), and the Cerro had the lowest diversity of mammals (2.27). The most influential species driving the differences of communities between the three transects included the white-lipped and collared peccaries, which were both present in higher densities in transects with lower disturbance and higher levels of protection, and domestic dogs which were present in higher densities at the Cerro. This study has documented baseline densities of large mammal communities in the wildlife refuge which can be used as preliminary data for future comparisons. As development is continuing in the region, including construction of a tourist trail at the Cerro, a continued monitoring is recommended to understand the effect of development on mammal communities. Rev. Biol. Trop. 64 (4): 1553-1564. Epub 2016 December 01.

Resumen:Las comunidades de grandes mamíferos, componentes integrales de los ecosistemas neotropicales, se encuentran cada vez más amenazadas debido a la fragmentación del hábitat y a su degradación por presiones antropogénicas y por el cambio climático. Los bosques de palmeras de zonas bajas neotropicales albergan comunidades diversas de mamíferos, incluyendo especies amenazadas y en peligro. Hemos monitoreado tres transectos en el Refugio Nacional de Vida Silvestre Barra del Colorado en el noreste de Costa Rica, desde febrero 2014 hasta abril 2015, registrando grandes mamíferos terrestres y primates. Siguiendo métodos establecidos de muestreos de mamíferos grandes, caminábamos cada transecto una vez por semana alternando entre la maña y la tarde para maximizar la detección. Estos tres transectos representan tres niveles de alteración antropogénica, encontrándose la más fuerte en el Cerro, seguido de la Estación Biológica Caño Palma (CPBS) y, con la menor presión, el Parque Nacional Tortuguero (TNP). En general, hemos encontrado una mayor diversidad y mayor presencia de especies en peligro de extinción en TNP y una menor diversidad y una menor presencia de estas especies en el Cerro. En esta investigación, detectamos 25 especies en total; 19 en el Cerro, 22 en el TNP, y 23 en CPBS. TNP tenía el más alto nivel de diversidad según el índice Simpson (28.3) seguido por CBPS (27.9), y el Cerro tenía el nivel de diversidad más bajo (2.27). Las especies que influyen en mayor medida con la diferenciación de las comunidades entre los tres transectos incluyen los pecarís cariblanco y de collar, ambos encontrados en mayor densidad en los transectos con menores alteraciones y altos niveles de protección, y los perros domésticos, los cuales aparecen en mayor densidad en el Cerro. Este estudio sirve de base para documentar las comunidades de grandes mamíferos en el refugio y puede ser usado para futuras comparaciones. Debido al continuo desarrollo de la región, incluyendo la construcción de un sendero para turistas en el Cerro, el monitoreo continuo es imprescindible para el entendimiento de los efectos del desarrollo en las comunidades de mamíferos.

Comportamiento de las crisis hipertensivas en el Área Intensiva Municipal de Centro Habana / Behavior of hypertensive crises in the intensive care area of Centro Habana municipality

Introducción: la Hipertensión Arterial continúa siendo una de las enfermedades crónicas más comunes en nuestro país y el mundo, llegando a tener un rol protagónico como factor de riesgo importante para el padecimiento o agravamiento de otras enfermedades letales. Objetivo: caracterizar el comportamiento de las crisis hipertensivas en los pacientes ingresados en el Área Intensiva del Policlínico Docente "Dr. Joaquín Albarrán". Métodos: se realizó una investigación descriptiva, de corte transversal, en el período comprendido entre diciembre de 2010 a diciembre de 2012. El universo estuvo constituido por los 767 pacientes de 15 y más años de edad, de ambos sexos, que acudieron al Servicio de Urgencia del policlínico y requirieron ingreso en la Unidad de Cuidados Intensivos. Los resultados se mostraron en tablas estadísticas de frecuencias absolutas y relativas. Resultados: predominó el ingreso en los grupos de edades de 40-49 años (23,8 %), seguido del grupo de 60 y más (22,1 %). La principal modalidad de crisis se correspondió con las Urgencias Hipertensivas, 442 (57,6 %). El medicamento de mayor uso como tratamiento de la crisis fue el Captopril en tableta con un total de 562 (93,2 %). El principal órgano diana afectado fue el corazón. Conclusiones: el mayor número de ingresos se produjo en los pacientes de 40-49 años de edad con mayoría del sexo masculino; la modalidad de crisis hipertensiva que más se presentó fue las Urgencias Hipertensivas, y el medicamento de mayor uso como tratamiento fue el Captopril en tableta.

Introduction : blood hypertension remains one of the most common chronic diseases in our country and worldwide, being a leading significant factor for suffering from or severity of other lethal diseases. Objective: to characterize the behavior of hypertensive crises of patients admitted to the intensive care area of "Dr Joaquin Albarran" teaching polyclinics. Methods : adescriptive cross-sectional research was conducted from December 2010 through December 2012. The universe of study was 767 patients aged 15 years old and over of both sexes, who had gone to the polyclinic emergency service and required hospitalization at the intensive care unit. The results were shown in statistical absolute and relative frequency tables. Results: the hospitalization of the 40-49 y age group (23.8%) prevailed followed by the 60 y and over group (22.1%). The main variant was hypertensive emergencies occurring in 442 patients (57.6%). The most used drug for treatment was Captopril pills totaling 562(93.2%). The main affected target organ was the heart. Conclusions: the highest number of hospitalizations was observed in 40-49 years-old male patients, the prevailing hypertensive crisis variant was hypertensive urgencies and the most used drug was Captopril pills.

A propósito de un caso de amiloidosis vesical / Presentation of a case of bladder amyloidosis

Se presentó el caso de un paciente, de 38 años de edad, con hematurias macroscópicas desde 3 años antes de su ingreso, acompañadas de síntomas disúricos. Se comprobó, por cistoscopia, la existencia de una lesión vegetante que ocupaba todo el trígono y parte lateral derecha de la vejiga. Tras su resección endoscópica y estudio histológico se diagnosticó como amiloidosis vesical. Se observó buena evolución posquirúrgica. No se halló afección amiloidótica en otras regiones del organismo...

A case of a male 38 year-old patient, with macroscopic hematuria for 3 years before admission is presente here. This hematuria is accompanied by dysuria symptoms. It was found by cystoscopy, the existence of a vegetative lesion occupying the entire right side of trigone and bladder. After endoscopic resection and histological study, bladder amyloidosis was diagnosed. Good surgical outcome was observed. No amyloid disease was found in other body areas...

El control de la hipertensión arterial: un problema no resuelto / The high blood pressure control: A problem not solved

Motiva la redacción de este artículo el pobre control de la hipertensión arterial que se reporta en la mayoría de los países del mundo. Se aclararon los criterios que se siguen para considerar a un paciente hipertenso como controlado y se revisaron varios trabajos de investigación sobre prevalencia de hipertensión arterial y porcentaje de control en distintas poblaciones. Se expusieron las experiencias de los autores en la atención protocolizada de la hipertensión arterial refractaria como expresión de inadecuado control de esta afección y se señalaron las principales situaciones o causas que inciden en el pobre control de la enfermedad, tanto por parte del paciente como por parte del médico. Se insistió en la necesidad de que los sistemas de salud de los países den prioridad a la atención de la hipertensión arterial con la participación del propio paciente y la mayor preocupación por médicos e instituciones en garantizar la mejor y más efectiva atención a los casos con dificultades en el control de su afección

The aim of present paper is to analyze the poor control of high blood pressure reported in many countries at world scale. The criteria followed to consider that a patient be hypertensive and under control were clarified and some papers related to a research on the high blood pressure prevalence and the control percentage in different populations were reviewed. Author's experiences with the formalized care of refractory high blood pressure as expression of a inappropriate control of this affection designating the main situations or causes falling into the poor control of this disease by patient on the one hand and by physician by the other. We emphasize on the need that the health systems of the countries give priority to high blood pressure care with the involvement of patient and a greater preoccupation by the physicians and institutions to guarantee a better and more effective care to those cases with difficulties in the control of its affection

Promoción de la salud y estrategias educativas para la prevención contra la violencia sexual, e infecciones de transmisión sexual en adolescentes / Health promotion and education strategies to prevent sexual violence, and sexually transmitted infections among adolescents

El presente artículo describe la investigación desarrollada durante los meses de noviembre y diciembre del a¤o 2009 con una población escolar de 106 estudiantes que cursaron el sexto año de la Escuela Napoleón Quesada. La metodología empleada obedece a la investigación acción cualitativa y es implementada por 10 estudiantes de la Universidad de Costa Rica. Los resultados en sus diferentes etapas demostraron que la falta de conocimiento y manejo te¢rico sobre derecho a la salud y enfermedades de transmisión sexual, por parte de la muestra obedecía al pobre trabajo de información al que deben enfrentarse en sus diferentes ámbitos de vida...

Estesioneuroblastoma / Estesioneuroblastoma

Se expuso el caso de una paciente, de 73 años de edad, que asiste a consulta de Medicina Interna del Hospital Hermanos Ameijeiras refiriendo obstrucción de la fosa nasal derecha desde hace aproximadamente 1 año, asociada a intensa cefalea. Se realizó examen físico que sólo mostró tumoración en la fosa nasal derecha. Se indicó rinoscopia anterior donde apareció secreción nasal serohemática, cornetes congestivos en la fosa nasal derecha y se observó tumoración de color rosa pálido. Se estudió el caso, con el planteamiento de una entidad que no es frecuente en la práctica cotidiana. Se emitió diagnóstico histológico por resección completa del tumor y, posteriormente, se envió al servicio de Oncología para tratamiento radiante posquirúrgico y con quimioterapia.

Malonildialdehido y peso al nacer en la pre-eclampsia: breve revisión y asociación entre ambos / Malondialdehyde and birth weight in preeclampsia. Brief review and association between them

Los trastornos hipertensivos del embarazo (THE), causan frecuente morbilidad y mortalidad perinatal en el mundo y en Cuba y se han vinculado al estrés oxidativo. Objetivos: determinar las características evolutivas de las concentraciones de malonildialdehido en las gestantes sanas (GS) entre las 16-20 semanas (MDA 1) y= 36 semanas (MDA 2), las características de la concentración plasmática de malonildialdehido [MDA] determinadas en las muestras de las preeclámpticas (MPE) al ingreso, en comparación con las gestantes sanas (MDA 2), así como la relación de [MDA] con el peso al nacer (PN) en preeclámpticas (PE). MÉTODOS: se hallaron las [MDA] en 25 gestantes de acuerdo a criterios de inclusión. Estadísticas: Se determinó medias y desviaciones estándar, comparando resultados de las [MDA] (Mann-Whitney, IC: 94 por ciento, p< 0,06). Se analizó la edad, el IMC, las presiones arteriales diastólica y media, la paridad y el PN (Kruskall-Wallis, IC: 95 por ciento, p< 0,05). Lugar: Departamento de Investigaciones Especiales del Hospital Dr Luis Díaz Soto. Período: enero 2004-enero 2007. Resultados: las [MDA] fueron mayores en M2 con relación a las muestras M1. Las [MDA] en PE (MPE) (n= 15) > [MDA] en gestantes sanas (n= 10) (M2). Las [MDA] (MPE) se correlacionaron inversamente con el PN en las preeclámpticas. CONCLUSIONES: la [MDA] se incrementó significativamente (p< 0,06) en las gestantes controles entre las muestras M1 y M2. El peso al nacer se correlacionó inversamente con [MDA] y MPE, cuando se comparó con lo ocurrido en las gestantes sanas. Es necesario profundizar en el estudio del estrés oxidativo en la preeclampsia lo que permitiría incrementar su comprensión y diseñar estrategias de intervención para disminuir sus efectos.

The hypertensive disorders of pregnancy (HDP) cause frequent perinatal morbidity and mortality in the world and in Cuba and they have been linked with oxidative stress. Objectives: to determine the evolutive characteristics of the concentrations of malondialdehyde in healthy pregnant women between 16 and 20 weeks (MDA 1) and = 36 weeks (MDA 2), the characteristics of the plasmatic concentration of malondialdehyde [MDA] determined in the sample of the preeclamptic women (SPE) on admission compared with healthy pregnant women (MDA 2), as well as the association of MDA concentrations with birth weight in preeclamptic patients (PE). Methods: The MDA concentrations were calculated in 25 pregnant women according to inclusion criteria. Statistics: Means and standard deviations were determined by comparing the results of the MDA concentrations (Mann-Whitney, CI: 94 percent, p< 0.06). Age, BMI, diastolic and mean arterial pressures, parity and birth weight were analyzed (Kruskall-Wallis, CI: 95 percent, p< 0.05). Place: Department of Special Research of "Dr. Luís Díaz Soto Hospital. Period: January 2004-January 2007. RESULTS: MDA concentrations were higher in M2 in comparison with the samples M1. MDA concentrations in preeclamptic patients (SPE) (n= 15) > MDA concentrations in healthy pregnant women (n= 10) (M2). The MDA concentrations (SPE) were inversely correlated with birth weight in the preeclamptic patients. Conclusions: MDA concentrations were significantly higher (p < 0.06) in the controls between M1 and M2. Birth weight was inversely correlated with MDA concentrations (SPE) in the preeclamptic patients when it was compared with what happened in the healthy pregnant women. It is necessary to go deep into the study of oxidative stress in preclampsia in order to increase its understanding and to design intervention strategies to reduce its effects.

Tuberculosis ganglionar a forma de fiebre de origen desconocido: a propósito de un caso / Ganglionary tuberculosis as fever of unknown origin: apropos of a case

La tuberculosis, tanto en su forma pulmonar como extrapulmonar constituye una enfermedad reemergente al nivel mundial, asociada con insuficiencias de los programas de control sanitario o con el síndrome de inmunodeficiencia adquirida. El modo de presentación de las formas extrapulmonares se relaciona con síntomas constitucionales, que incluyen la fiebre y con signos dependientes del órgano afectado. Se presentó el caso de una adenitis granulomatosa en etapa o categoría 3, grupo integrado por aquellos casos nuevos de formas menos grave de tuberculosis extrapulmonar (TBe) con confirmación histopatológica del bacilo. Se enfatizó sobre la presentación a forma de fiebre de origen desconocido (FOD), al reunir los criterios necesarios por haber estado ingresada en otro centro hospitalario por más de 1 mes, sin haber llegado al diagnóstico a pesar de haber sido estudiada, y se resaltó la necesidad imperiosa de la búsqueda de este diagnóstico ante todo paciente con cuadro adénico febril e historia familiar de TB.

Tuberculosis, both in its pulmonary and extrapulmonary form is a reemerging disease in the world associated with insufficiencies of the health control programs or with the acquired immunodeficiency syndrome. The mode of presentation of the extrapulmonary forms is related to constitutional symptoms that include fever, and to signs depending on the affected organ. The case of a stage III granulomatous adenitis, a group composed of those new cases of less severe forms of extrapulmonary tuberculosis with histopathological confirmation of the bacillus, was presented. Emphasis was made on the presentation as a FUO, on having the necessary criteria for having been admitted in another hospital for more than a month without a definitive diagnosis despite having been studied. The pressing need to search this diagnosis in every patient with febrile adenic picture and family history of TB was stressed.

Hipertensión arterial secundaria a coartación de la aorta: a propósito de 1 caso / Blood hypertension secondary to aorta coarctation: a propos of a case

Se presentó 1 caso con forma de hipertensión arterial refractaria secundaria a coartación de la aorta diagnósticada a los 41 años de edad. Se trató de un paciente masculino con historia de hipertensión arterial desde los 19 años que no lograba control de las cifras tensionales, a pesar de una terapéutica antihipertensiva de más de 3 drogas que incluía un diurético. Al realizar el examen físico se destacó la ausencia de pulso femoral, poplíteo y pedio bilateral y marcada caída de la presión arterial en miembros inferiores, elementos de alta sospecha de coartación aórtica. Se comentó la importancia de medios diagnósticos como el Eco Doppler de miembros inferiores, la radiografía de tórax, el ecocardiograma, la angio-TAC y la aortografía, en el diagnóstico de estos casos. Se concluyó que la coartación de la aorta constituye una causa curable de hipertensión arterial secundaria que, aunque poco frecuente, debemos tener en consideración ante todo paciente joven con cifras elevadas de presión arterial y se enfatizó en la necesidad casi mandatoria de realizar un examen físico minucioso que incluya la palpación de pulsos y toma de presión arterial en miembros inferiores para lograr un diagnóstico precoz y evitar sus complicaciones potenciales.

Here is the case of a man with refractory blood hypertension secondary to aorta coarctation diagnosed at the age of 41 years. This patient had had a history of blood hypertension since he was 19 years-old but he had not managed to get his blood pressure figures under control despite hypertensive therapeutics comprising 3 drugs and one diuretic. On physical exam, there were no femoral, popliteal and pedo bilateral pulses and the fall in blood pressure of lower limbs was marked, so these elements strongly indicated aorta coarctation. Comments were made on diagnostic tools like EchoDoppler applied to the lower limbs, thoracic radiography, echocardiogram, angiography and aortography for the diagnosis of these cases. It was concluded that coarctation of the aorta is a curable cause of secondary blood hypertension that, though rare, should be taken into account in the event of a young patient with high blood pressure and that a detailed physical exam including pulse palpation and blood pressure taking in the lower limbs is almost an imperative in order to make an early diagnosis and avoid potential complications.