[Clinical and radiographic factors associated with the severity of paraspinal fatty infiltration in patients with degenerative low back disease]. / Factores clínicos y radiográficos asociados a la severidad de infiltración grasa paraespinal en pacientes con enfermedad lumbar degenerativa.

INTRODUCTION: Degenerative lumbar disease (DLE) is a spectrum of pathological changes from disc degeneration, herniated disc, spondylolisthesis and lumbar canal stenosis. The pain associated with it is multifactorial. Muscle cramps are among the most frequent causes. The relationship between muscle degeneration and DLE has already been studied in the past in multiple studies, highlighting the one carried out by Kjaer & cols. OBJECTIVE: to determine the prevalence and severity of fatty degeneration in mutifidus spinae, and to study its relationship with clinical and radiographic factors. MATERIAL AND METHODS: observational and analytical study. Patients diagnosed with: herniated disc, lumbar canal stenosis or degenerative scoliosis were included. They were classified according to the Kjaer scale for paraspinal fatty infiltration in one of three groups. Clinical variables were analyzed: age, smoking, obesity, the presence of axial pain, temporality of pain, severity expressed with a visual analog scale (VAS); and radiographic: number of diseased segments, involved segments, diagnostic imaging and the presence of spondylolisthesis. RESULTS: 56 patients with an average age of 52.5 years (16 to 80) with a predominance of females with 62.5% were included. The diagnoses were nonspecific low back pain (1.8%), herniated disc (42.9%), narrow lumbar duct (46.4%) and lumbar duct with degenerative scoliosis deformity (8.9%). The distribution among the three groups described by Kjaer was as follows: 44.6% were classified with a fat infiltration score of 2. In groups 1 and 0, 39.3% and 16.1% were classified respectively. The variables significantly related to greater fat infiltration were: age > 60 years, diagnoses of lumbar canal stenosis and herniated disc; obesity, spondylolisthesis < 2 vertebral segments involved. Axial pain and VAS > 8 points were not related to greater muscle degeneration. CONCLUSIONS: fatty infiltration is present in all patients with some of the forms of DLE. Most patients > 60 years of age with advanced degenerative processes have a greater severity of infiltration. Other related variables are: obesity, spondylolisthesis and disease of < 2 vertebral segments. There is no relationship between a higher percentage of fatty infiltration and axial pain or higher VAS scores.

INTRODUCCIÓN: la enfermedad lumbar degenerativa (ELD) es un espectro de cambios patológicos desde la degeneración discal, la hernia discal, la espondilolistesis y el conducto lumbar estrecho. El dolor que se le asocia es multifactorial. Los espasmos musculares son de las causas más frecuentes. La relación que guarda la degeneración muscular y la ELD ya ha sido estudiada en múltiples trabajos, destacando el realizado por Kjaer y colaboradores. OBJETIVO: determinar la prevalencia y severidad de la degeneración grasa en el mutifidus spinae, y estudiar su relación con variables clínicas y radiográficas. MATERIAL Y MÉTODOS: estudio observacional y analítico. Se incluyeron pacientes diagnosticados con: hernia discal, conducto lumbar estrecho o escoliosis degenerativa. Se clasificaron de acuerdo con escala de Kjaer para infiltración grasa paraespinal en alguno de tres grupos. Se analizaron variables clínicas: edad, tabaquismo, obesidad, presencia de dolor tipo axial, temporalidad del dolor, severidad del dolor expresada con escala visual análoga (EVA); y radiográficas: número de segmento enfermos, segmentos involucrados, diagnóstico por imagen y presencia de espondilolistesis. RESULTADOS: se incluyeron 56 pacientes con edad promedio de 52.5 años (rango 16 a 80) con predominio del sexo femenino (62.5%). Los diagnósticos fueron lumbalgia inespecífica (1.8%), hernia discal (42.9%), conducto lumbar estrecho (46.4%) y conducto lumbar con deformidad en escoliosis degenerativa (8.9%). La distribución entre los tres grupos descritos por Kjaer fue la siguiente: 44.6% fueron clasificados con un puntaje de infiltración grasa de 2. En los grupos 1 y 0, se clasificaron 39.3 y 16.1%, respectivamente. Las variables relacionadas con mayor infiltración grasa fueron: edad > 60 años, diagnósticos de conducto lumbar estrecho y hernia discal; obesidad, espondilolistesis < 2 segmentos vertebrales involucrados. El dolor mecánico y EVA > 8 puntos no se relacionaron con mayor degeneración muscular. CONCLUSIONES: la infiltración grasa está presente en todos los pacientes con alguna de las formas de ELD. La mayoría de los pacientes > 60 años con procesos degenerativos avanzados tienen mayor severidad de infiltración. Otras variables relacionadas son: obesidad, espondilolistesis y enfermedad < 2 segmentos vertebrales. No hay relación entre mayor porcentaje de infiltración grasa y dolor axial o puntajes más altos de dolor.

[Hidden posterior tibial tendon dislocation after ankle sprain: case report]. / Luxación del tendón tibial posterior oculta tras un esguince de tobillo: reporte de caso.

INTRODUCTION: traumatic posterior tibial tendon dislocation is a rare entity that can go unnoticed in our usual clinical practice. MATERIAL AND METHODS: a 31-year-old man, with no relevant medical history, suffered a high-energy traffic accident. He presented a dislocation of the posterior tibial tendon that went unnoticed. After an early diagnosis, a primary repair of the flexor retinaculum was performed and the anatomical reduction of the tendon was achieved. RESULTS: the patient was able to resume sports activity three months after the injury with good functional results. CONCLUSIONS: we should suspect this entity after high-energy trauma with ankle sprains. Surgical treatment of this lesion offers good functional results.

INTRODUCCIÓN: la luxación traumática del tendón tibial posterior es una entidad poco frecuente que puede pasar desapercibida en nuestra práctica clínica habitual. MATERIAL Y MÉTODOS: un hombre de 31 años, sin antecedentes médicos de interés, sufrió un accidente de tráfico de alta energía. Presentaba una luxación del tendón tibial posterior que pasó desapercibida. Tras un diagnóstico precoz se consiguió realizar una reparación primaria del retináculo flexor y se logró la reducción anatómica del tendón. RESULTADOS: el paciente pudo retomar la actividad deportiva a los tres meses de la lesión con buen resultado funcional. CONCLUSIONES: debemos sospechar esta entidad tras un traumatismo de alta energía con entorsis de tobillo. El tratamiento quirúrgico de esta lesión ofrece buenos resultados funcionales.

Luxación del tendón tibial posterior oculta tras un esguince de tobillo: reporte de caso / Hidden posterior tibial tendon dislocation after ankle sprain: case report

Resumen: Introducción: la luxación traumática del tendón tibial posterior es una entidad poco frecuente que puede pasar desapercibida en nuestra práctica clínica habitual. Material y métodos: un hombre de 31 años, sin antecedentes médicos de interés, sufrió un accidente de tráfico de alta energía. Presentaba una luxación del tendón tibial posterior que pasó desapercibida. Tras un diagnóstico precoz se consiguió realizar una reparación primaria del retináculo flexor y se logró la reducción anatómica del tendón. Resultados: el paciente pudo retomar la actividad deportiva a los tres meses de la lesión con buen resultado funcional. Conclusiones: debemos sospechar esta entidad tras un traumatismo de alta energía con entorsis de tobillo. El tratamiento quirúrgico de esta lesión ofrece buenos resultados funcionales.

Abstract: Introduction: traumatic posterior tibial tendon dislocation is a rare entity that can go unnoticed in our usual clinical practice. Material and methods: a 31-year-old man, with no relevant medical history, suffered a high-energy traffic accident. He presented a dislocation of the posterior tibial tendon that went unnoticed. After an early diagnosis, a primary repair of the flexor retinaculum was performed and the anatomical reduction of the tendon was achieved. Results: the patient was able to resume sports activity three months after the injury with good functional results. Conclusions: we should suspect this entity after high-energy trauma with ankle sprains. Surgical treatment of this lesion offers good functional results.

Terapia cognitivo conductual para pacientes con riesgo clínico de psicosis / Cognitive behavior therapy for young patients at clinical risk for psychosis

INTRODUCCIÓN. Los estudios de tratamiento indican que el riesgo de transición a un trastorno psicótico puede al menos retrasarse en la población clínica de alto riesgo de psicosis (CHR), además de mejorar variables relacionadas con la calidad de vida de los pacientes, existiendo evidencia a favor de la terapia cognitivo conductual (TCC). MÉTODOS. Se realizó una síntesis narrativa, basada en la búsqueda de artículos originales, que abordasen la efectividad de la TCC en pacientes CHR, publicados en los últimos cinco años, incluidos en esta síntesis. RESULTADOS. Se incluyeron un total de 10 artículos que evalúan la TCC en CHR, siendo un tratamiento efectivo y ampliamente utilizado, lo que se asocia a una disminución en las consecuencias psicosociales que conlleva el retraso en la presentación del cuadro clínico y/o la disminución de síntomas comórbidos. CONCLUSIÓN. Actualmente, la TCC se ha convertido en el tratamiento de primera elección para CHR, existiendo una gran variedad de estrategias psicoterapéuticas específicas dentro de este grupo de intervención.

INTRODUCTION. Treatment studies indicate that the risk of transition to a psychotic disorder can at least be delayed in the clinical population at high risk for psychosis (CHR), in addition to improving variables related to the quality of life of patients, with evidence in favor of cognitive behavioral therapy (CBT). METHODS. A narrative synthesis was carried out, based on the search for original articles, which addressed the effectiveness of CBT in CHR patients, published in the last five years, included in this synthesis. RESULTS. A total of 10 articles that evaluate CBT in CHR were included, being an effective and widely used treatment, which is associated with a decrease in the psychosocial consequences that the delay in the presentation of the clinical picture and/or the decrease in symptoms entails. comorbid. CONCLUSION. Currently, CBT has become the treatment of first choice for CHR, with a wide variety of specific psychotherapeutic strategies within this intervention group.

Microencapsulation of Renealmia alpinia (Rottb.) Maas pulp pigment and antioxidant compounds by spray-drying and its incorporation in yogurt.

Renealmia alpinia (Rottb.) Maas pulp was processed by spray drying using Maltodextrin (MDX), and Gum Arabic (GA), and the mixture of both encapsulating agents (MDX-GA). Yield, moisture, water activity (a w ), apparent and bulk densities, size and morphology of capsules, color, and antioxidant potential (antioxidant activity, total carotenoids, and phenolic compounds) were analyzed. The encapsulates were incorporated as pigments in yogurt and the stability of antioxidant compounds (1, 7, 14, 21, and 28 days of storage) and the sensory properties were evaluated. The yields of all formulations (MDX, GA, MDX-GA) were around 17.86% with low moisture and a w range values (2.62-3.29% and 0.276-0.309, respectively). The microcapsules presented multiples particle sizes (0.67-27.13 µm) with irregular and smooth surfaces. Furthermore, these capsulates preserved yellow color and the retention of carotenoids was significantly higher with MDX (34.12 mg/100 g of powder), while the phenolic compounds and antioxidant activity increased with GA (474.17 mg GAE/100 g and 552.63 mg TE/100 g of powder, respectively). The main compounds ß-carotene and gallic acid were identified and quantified in positive and negative mode respectively using LC-MS/MS. Finally, the addition of the encapsulated pigments to yogurt allowed to obtain a yellow coloration and the yogurt added with MDX-GA presented the best formulation with not significant changes in antioxidant activity and acceptable sensory attributes up 28 days of storage.

Mutations in the John Cunningham virus VP1 gene could predispose to the development of progressive multifocal leukoencephalopathy in multiple sclerosis patients undergoing treatment with natalizumab.

BACKGROUND: Patients with Multiple Sclerosis (MS) undergoing treatment with natalizumab (NTZ) are at risk of developing progressive multifocal leukoencephalopathy (PML) due to the reactivation of John Cunningham (JC) virus. A relevant characteristic among PML cases is the development of single nucleotide mutations in the VP1 gene of the causal JC virus. The identification of such mutations in timely manner can provide valuable information for MS management. OBJECTIVE: To identify mutations along the JC virus VP1 gene in MS patients undergoing treatment with NTZ, and correlate them with anti-JC virus antibody index. METHODS: Eighty-eight MS patients, one hundred twenty controls, and six patients with diagnosis of Human Immunodeficiency Virus (HIV) with and without secondary PML were included. JC virus was identified in peripheral blood mononuclear cells and cerebrospinal fluid by PCR. Amplification and sequencing of the entire length of the VP1 gene were performed in all positive clinical samples. RESULTS: In MS cases no mutations were observed in the JC virus VP1 gene, but it was positive in HIV controls with PML. Interestingly, the JC virus VP1 gene sequence derived from the HIV patients exhibited a non-silent substitution in position 186 (G â†’ C), leading to an amino acid change (Lys â†’ Asp). We did not find correlation between anti-JC virus antibody index and DNA viral detection. CONCLUSIONS: . The identification of single nucleotide mutants in the JC virus VP1 gene might be an early predictive marker to PML for efficient patient treatment and follow-up.

A management algorithm for vertebral destruction syndrome by multiple myeloma and metastatic spinal cord compression.

INTRODUCTION: Multiple myeloma represents 1% of all cancers and 10% of hematological cancers. Up to 80-90% of cases will have skeletal involvement and the spine is the most frequently involved site. Any intervention must be aimed to improve the patients functional prognosis and will impact their quality of life. OBJECTIVE: To describe the clinical presentation of vertebral destruction syndrome due to multiple myeloma and to present the management algorithm used for the study and decision-making in treatment. MATERIAL AND METHODS: Study design: Retrospective cross-sectional. A search was made in the hospitals clinical file in search of patients with a histological diagnosis of multiple myeloma attended by the Spinal Surgery Service. Clinical characteristics of the initial presentation were obtained such as: presence of pain, ASIA scale and it was categorized according to the Durie-Salmon classification at diagnosis; the levels involved and type of surgery were described. RESULTS: The study included ten patients with an average age of 61.4 years, 70% were male subjects. All patients were approach according to the modified protocol for vertebral destruction syndrome and fluoroscopy-guided percutaneous biopsy. Most had pain at diagnosis, after neurologic examination only 30% were classified as ASIA A. Most of the patients were staged III according to Durie Salomon. The most frequently vertebral segment involved was thoracic. In only one patient more than two vertebrae were involved. After diagnosis of multiple myeloma, nine patients were managed according to a NOMS framework. In the majority they were treated with fusion by posterior approach, six of them were augmented with vertebroplasty. Only one patient of the total, was treated with vertebroplasty alone. CONCLUSIONS: The use of systematized management algorithms will allow better decisions to be made in conjunction with a multidisciplinary group for the care of multiple myeloma with vertebral involvement.

INTRODUCCIÓN: El mieloma múltiple representa 1% de todos los tipos de cáncer y 10% de los cánceres hematológicos. Hasta en 80-90% de los casos se involucrará el sistema esquelético, siendo la columna el sitio más frecuentemente afectado. Cualquier intervención planeada deberá ser dirigida a mejorar el pronóstico funcional del paciente e impactará en su calidad de vida. OBJETIVO: Describir la presentación clínica del síndrome de destrucción vertebral por mieloma múltiple y presentar el algoritmo de manejo empleado para el estudio y la toma de decisiones en el tratamiento. MATERIAL Y MÉTODOS: Diseño de estudio: Retrospectivo, transversal. Se realizó una búsqueda en el archivo clínico del hospital en búsqueda de pacientes con diagnóstico histológico de mieloma múltiple atendidos por el Servicio de Cirugía de Columna. Se obtuvieron características clínicas de la presentación inicial como: presencia de dolor, escala de ASIA y se categorizó de acuerdo con la clasificación de Durie-Salmon al diagnóstico; se describen los niveles involucrados y tipo de cirugía. RESULTADOS: El estudio incluyó 10 pacientes con una edad promedio de 61.4 años, 70% de los cuales fueron varones. Todos los pacientes se abordaron de acuerdo al protocolo de síndrome de destrucción vertebral y con biopsia percutánea guiada por fluoroscopía. La mayoría de los pacientes tenían dolor al diagnóstico, tras la exploración neurológica sólo el 30% fueron clasificados como ASIA A. La mayoría de los pacientes se estadificaron como III de acuerdo con Durie-Salmon. El segmento vertebral más comúnmente afectado fue el torácico. En sólo un paciente se involucraba más de dos vértebras. Tras el diagnóstico de mieloma múltiple, nueve pacientes fueron manejados de acuerdo con el marco de trabajo NOMS. La mayoría fueron tratados con fusión por un abordaje posterior, seis de ellos con aumentación con vertebroplastía. Sólo un paciente del total, fue tratado sólo con vertebroplastía. CONCLUSIONES: El empleo de algoritmos de tratamiento sistematizado permitirá la toma de mejores decisiones en conjunto con un grupo multidisciplinario para el tratamiento de mieloma múltiple con afección vertebral.

p>Taxonomic revision of the Colombian Tityus (Archaeotityus) (Scorpiones, Buthidae) species: a morphological and morphometric approach, with a description of a new species.

We present a taxonomic revision of the Colombian Tityus (Archaeotityus) species based on morphological and morphometric evidence. We examined more than 385 specimens and evaluated new and previously used qualitative and quantitative morphological characters. We redescribe the Colombian species and present morphological characters for both sexes and an emended diagnosis for the subgenus Tityus (Archaeotityus). We describe a new species Tityus guane sp. nov. from Santander department, Colombia, Tityus betschi Lourenço 1992 is synonymized with Tityus parvulus Kraepelin, 1914, and Tityus wayuu Rojas-Runjaic Armas, 2007 is synonymized with Tityus tayrona Lourenço, 1991. We measured 186 specimens and performed a multivariate principal component analysis (PCA) for 34 selected morphometric ratios for each sex. We found that a few morphological ratios support species level distinctions within the Colombian species. We provide updated distributional maps with new records and an identification key for both sexes. Furthermore, we provide an updated checklist for the subgenus and a discussion about the character systems used within Tityus (Archaeotityus). The new morphological characters proposed and the traditional morphometry examined with a PCA are useful for studying Tityus (Archaeotityus) taxonomy.

Predictores del comportamiento de automanejo en personas con enfermedades crónicas de Tamaulipas / Self-management behavior predictors among persons with chronic diseases in Tamaulipas / Preditores do comportamento de automanejo em pessoas com doenças crônicas de Tamaulipas

Resumen Introducción: Dado el carácter prioritario de atención a las enfermedades no transmisibles, la Organización Mundial de la Salud propuso el Modelo de Cuidados Crónicos. En este modelo incluye el automanejo como un elemento principal en el combate de dichas enfermedades. Objetivo: Identificar las variables predictoras del comportamiento de automanejo en usuarios con Diabetes Mellitus, Hipertensión Arterial y Obesidad. Métodos: La muestra no probabilística e intencional fue de 386 usuarios de la Secretaría de Salud de Tamaulipas (Ciudad Victoria y Tampico). El diseño de estudio fue no experimental, transversal. Resultados: casi la mitad (42.2%) de los participantes con ECNT refieren síntomas de trastorno depresivo en el continuo de leve a grave, la categoría que obtuvo mayor porcentaje de IMC fue sobrepeso con 33.2% y más de un tercio de la población (36.8%) percibe algún grado de disfunción familiar. Así también se aplicó un análisis de Regresión Lineal Múltiple con el método de pasos, el modelo indica que fueron siete predictores del comportamiento de Automanejo (varianza explicada R2=.325); la variable autoeficacia fue el más importante (β=38) y el apoyo social percibido el predictor con carga más baja (β=.10). Conclusiones: estos predictores representan elementos importantes para ampliar el conocimiento y entender el comportamiento del automanejo, área que es promovida en el modelo de atención a crónicos de la Organización Mundial de la Salud y en la actualidad es liderada por el área de enfermería.

Abstract Introduction: Considering the priority regarding the attention of non transmissible diseases, the World Health Organization proposed the Chronic Care Model which, by encompassing self-management as one main element, is intended to address these diseases. Objective: To identify predictor variables related to behavior on self-management among patients with Diabetes Mellitus, Hypertension, and Obesity. Methods: The intentional and non probabilistic simple included 386 patients from the Health Secretariat in Tamaulipas, Mexico (Ciudad Victoria and Tampico). The study design was non experimental and transversal. Results: About half (42.2%) of the participants with Chronic Non Transmissible diseases referred having depressive disorder ranging from mild to severe. Regarding the BMI, 33.2% showed overweight. Moreover, 36.8% perceived some degree of family dysfunction. A Multiple Linear Regression was calculated. The model indicated that there were seven predictors of the behavior on self-management (explained variance R2 =.325); being self-efficacy the most important (β=38), and perceived social support the lowest in load (β=.10). Conclusions: These predictors represent important elements to consider when building on the knowledge and understanding the behavior related to self-management, an area which is highlighted in the Chronic Care Model of the World Health Organization, particularly within nursing.

Resumo Introdução: Dado o caráter prioritário de atenção às doenças não transferíveis, a Organização Mundial da Saúde propôs o Modelo de Cuidados Crônicos. Neste modelo inclui-se o automanejo como um elemento principal no combate de tais doenças. Objetivo: identificar as variáveis preditoras do comportamento de automanejo em usuários com Diabetes Mellitus, Hipertensão Arterial e Obesidade. Métodos: A amostra não probabilística e intencional foi de 386 usuários da Secretaría de Salud de Tamaulipas (Ciudad Victoria e Tampico). O desenho de estudo foi não experimental, transversal. Resultados: quase a metade (42.2%) dos participantes com ECNT referem sintomas de transtorno depressivo no continuo de leve a grave, a categoria que obteve maior porcentagem de IMC foi sobrepeso com 33.2% e mais de um terço da população (36.8%) percebe algum grau de disfunção familiar. Assim também se aplicou uma análise de Regressão Linear Múltipla com o método de passos, o modelo indica que foram sete preditores do comportamento de Automanejo (variância explicada R 2 =.325); a variável autoeficácia foi a mais importante (β=38) no apoio social percebido e o preditor com carga mais baixa (β=.10). Conclusões: estes preditores representam elementos importantes para ampliar o conhecimento e entender o comportamento de automanejo, área que é promovida no modelo de atenção a crônicos da Organização Mundial da Saúde e na atualidade é liderada pela área de enfermagem.

Image Registration Measures and Chronic Osteoarthritis Knee Pain Prediction: Data from the Osteoarthritis Initiative / Métricas de Registro de Imágenes y Predicción de Dolor de Rodilla por Osteoartritis Crónica: Datos de la Osteoarthritis Initiative

Abstract Osteoarthritis (OA) is the most common type of arthritis, is a growing disease in the industrialized world. OA is an incapacitate disease that affects more than 1 in 10 adults over 60 years old. X-ray medical imaging is a primary diagnose technique used on staging OA that the expert reads and quantify the stage of the disease. Some Computer-Aided Diagnosis (CADx) efforts to automate the OA detection have been made to aid the radiologist in the detection and control, nevertheless, the pain inherits to the disease progression is left behind. In this research, it's proposed a CADx system that quantify the bilateral similarity of the patient's knees to correlate the degree of asymmetry with the pain development. Firstly, the knee images were aligned using a B-spline image registration algorithm, then, a set of similarity measures were quantified, lastly, using this measures it's proposed a multivariate model to predict the pain development up to 48 months. The methodology was validated on a cohort of 131 patients from the Osteoarthritis Initiative (OAI) database. Results suggest that mutual information can be associated with K&L OAI scores, and Multivariate models predicted knee chronic pain with: AUC 0.756, 0.704, 0.713 at baseline, one year, and two years' follow-up.

Resumen La osteoartritis (OA) es el tipo de artritis más común. OA es una enfermedad limitante que afecta a 1 de 10 adultos con 60 años o más. Las imágenes de rayos-x son una técnica de diagnóstico primario que permite conocer el estado de OA, las cuales el experto lee y cuantifica así la etapa de la enfermedad. El Diagnóstico Asistido por Computadora (CADx, por sus siglas en inglés) ha buscado automatizar el diagnóstico de OA para ayudar al radiólogo en la detección y control; sin embargo, el dolor provocado por la progresión de la enfermedad es dejado atrás. En este trabajo se propone un sistema de CADx que cuantifica la similitud bilateral de las rodillas de los pacientes, con el fin de correlacionar el grado de asimetría con el dolor. Inicialmente, las imágenes de las rodillas fueron alineadas usando el algoritmo B-spline para su registro, después, un conjunto de métricas estándar fue cuantificado; finalmente, con estas métricas se propone un modelo multivariado para predecir el dolor de rodilla desarrollado en 48 meses. La metodología fue validada con 131 pacientes obtenidos de la base de datos de la Osteoarthritis Initiative (OAI). Los resultados sugieren que las métricas pueden ser asociadas con los puntajes de KellgrenLawrence; además, los modelos predicen significativamente el dolor crónico de rodilla con: AUC 0.756, 0.704 y 0.7113, al inicio, un año y dos años después, respectivamente.

Speed Bump Detection Using Accelerometric Features: A Genetic Algorithm Approach.

Among the current challenges of the Smart City, traffic management and maintenance are of utmost importance. Road surface monitoring is currently performed by humans, but the road surface condition is one of the main indicators of road quality, and it may drastically affect fuel consumption and the safety of both drivers and pedestrians. Abnormalities in the road, such as manholes and potholes, can cause accidents when not identified by the drivers. Furthermore, human-induced abnormalities, such as speed bumps, could also cause accidents. In addition, while said obstacles ought to be signalized according to specific road regulation, they are not always correctly labeled. Therefore, we developed a novel method for the detection of road abnormalities (i.e., speed bumps). This method makes use of a gyro, an accelerometer, and a GPS sensor mounted in a car. After having the vehicle cruise through several streets, data is retrieved from the sensors. Then, using a cross-validation strategy, a genetic algorithm is used to find a logistic model that accurately detects road abnormalities. The proposed model had an accuracy of 0.9714 in a blind evaluation, with a false positive rate smaller than 0.018, and an area under the receiver operating characteristic curve of 0.9784. This methodology has the potential to detect speed bumps in quasi real-time conditions, and can be used to construct a real-time surface monitoring system.

Aversiones alimentarias en adolescentes de la Secundaria Básica José Martí en municipio Cerro. 2015 / Food aversions of teenagers from the Junior High School Jose Marti in the municipality Cerro. 2015

Introducción: la adolescencia es considerada una etapa compleja no solo por los cambios que ocurren en el organismo desde todos los puntos de vista, sino por la complejidad que presupone el manejo psicológico de la misma, de esta forma también influye, lo relacionado con su hábitos alimenticios. Objetivo: describir el comportamiento de las aversiones alimentarias en 94 adolescentes, de la escuela Secundaria Básica "José Martí". Materiales y Métodos: se realizó un estudio descriptivo transversal, con 94 adolescentes de la escuela Secundaria Básica "José Martí" del municipio Cerro, que cursaban el 7mo grado, cuyas edades oscilaron de 11 a 15 años de edad, durante el período de septiembre a octubre del 2015. Resultados: los grupos de alimentos más detestados fueron los vegetales y las frutas. El pescado a pesar de su importancia nutricional fue el alimento más rechazado y el menos consumido. Las viandas, las legumbres, los cereales, las carnes blancas, el huevo y los lácteos fueron los grupos de alimentos por los que menos aversión mostraron. Continúa siendo un factor de riesgo para la población adolescente, la ingestión de dulces y azúcares por ser uno de los alimentos preferidos y de mayor consumo. Conclusiones: las aversiones alimentarias detectadas sitúan a este grupo atareo en una situación vulnerable desde el punto de vista nutricional, y ratifica que los alimentos con mayores valores nutricionales son los menos aborrecidos, a pesar de las consecuencias actuales y futuras que pueden generar en su salud, así como el incremento de la incidencia de enfermedades relacionadas con los hábitos dietéticos (AU).

Introduction: the adolescence is considered a complex stage not only because of the changes occurring in the organism from all the points of view, but also due to the complexness of its psychological management. Eating habits belong to this field. Objetive: to describe the behavior of food aversions in 94 teenagers of the Junior High School "José Martí." Materials and Methods: a cross-sectional, descriptive study was carried out during the period September-October 2015, with 97 7th-grade students of the Junior High school "José Martí", municipality Cerro, whose age ranged from 11 to 15 years. Results: the most detested food groups were vegetables and fruits. Fish, in spite of its nutritional importance, was the most rejected food and the less consumed one. Vegetables, legumes, cereals, white meats, eggs and dairy products are the food groups for which they showed less aversion. It is still a risk factor for the adolescent population the consumption of sweets and sugar because they are their preferable food and the ones they consume the most. Conclusions: the detected food aversions locate this age group in a vulnerable situation from the nutritional point of view, and ratifies foods with higher nutritional values are the less detested ones, in spite of the current and future consequences that could generate in their health, and also indicates the raise of the incidence of diseases related with dietary habits (AU).

Aversiones alimentarias en adolescentes de la Secundaria Básica José Martí en municipio Cerro. 2015 / Food aversions of teenagers from the Junior High School Jose Marti in the municipality Cerro. 2015

Introducción: la adolescencia es considerada una etapa compleja no solo por los cambios que ocurren en el organismo desde todos los puntos de vista, sino por la complejidad que presupone el manejo psicológico de la misma, de esta forma también influye, lo relacionado con su hábitos alimenticios. Objetivo: describir el comportamiento de las aversiones alimentarias en 94 adolescentes, de la escuela Secundaria Básica "José Martí". Materiales y Métodos: se realizó un estudio descriptivo transversal, con 94 adolescentes de la escuela Secundaria Básica "José Martí" del municipio Cerro, que cursaban el 7mo grado, cuyas edades oscilaron de 11 a 15 años de edad, durante el período de septiembre a octubre del 2015. Resultados: los grupos de alimentos más detestados fueron los vegetales y las frutas. El pescado a pesar de su importancia nutricional fue el alimento más rechazado y el menos consumido. Las viandas, las legumbres, los cereales, las carnes blancas, el huevo y los lácteos fueron los grupos de alimentos por los que menos aversión mostraron. Continúa siendo un factor de riesgo para la población adolescente, la ingestión de dulces y azúcares por ser uno de los alimentos preferidos y de mayor consumo. Conclusiones: las aversiones alimentarias detectadas sitúan a este grupo atareo en una situación vulnerable desde el punto de vista nutricional, y ratifica que los alimentos con mayores valores nutricionales son los menos aborrecidos, a pesar de las consecuencias actuales y futuras que pueden generar en su salud, así como el incremento de la incidencia de enfermedades relacionadas con los hábitos dietéticos (AU).

Introduction: the adolescence is considered a complex stage not only because of the changes occurring in the organism from all the points of view, but also due to the complexness of its psychological management. Eating habits belong to this field. Objetive: to describe the behavior of food aversions in 94 teenagers of the Junior High School "José Martí." Materials and Methods: a cross-sectional, descriptive study was carried out during the period September-October 2015, with 97 7th-grade students of the Junior High school "José Martí", municipality Cerro, whose age ranged from 11 to 15 years. Results: the most detested food groups were vegetables and fruits. Fish, in spite of its nutritional importance, was the most rejected food and the less consumed one. Vegetables, legumes, cereals, white meats, eggs and dairy products are the food groups for which they showed less aversion. It is still a risk factor for the adolescent population the consumption of sweets and sugar because they are their preferable food and the ones they consume the most. Conclusions: the detected food aversions locate this age group in a vulnerable situation from the nutritional point of view, and ratifies foods with higher nutritional values are the less detested ones, in spite of the current and future consequences that could generate in their health, and also indicates the raise of the incidence of diseases related with dietary habits (AU).

Relación entre automanejo y percepción de funcionalidad familiar en personas con diabetes mellitus tipo 2 / Relationship between self-management and family functionality perception among persons with type 2 diabetes mellitus / Relação entre auto manejo e percepção de funcionalidade familiar em personas com diabetes mellitus tipo 2

Introducción: La diabetes mellitus es uno de los principales problemas de salud a nivel mundial debido a sus altos índices de incidencia, prevalencia, los costes que genera a la economía de cada país, las complicaciones que derivan de esta y los altos índices de mortalidad. Esta enfermedad concierne a la familia, ya que los cambios en el estilo de vida del paciente demandan apoyo familiar, orientación en la toma de decisiones y acciones necesarias para el adecuado manejo de la enfermedad. Asociado a lo anterior, algunos estudios han demostrado los beneficios de un adecuado automanejo en enfermedades crónicas, que implica: adherencia al tratamiento, reconocer síntomas de la enfermedad, hábitos de alimentación saludable, ejercicio y visitas al médico. Objetivo: Analizar la relación entre el automanejo y la percepción de funcionalidad familiar en personas con diabetes tipo 2 que reciben atención en los centros de salud de la Jurisdicción n. 2 de Tampico, Tamaulipas, México. Métodos: Estudio transversal-correlacional, muestreo no probabilístico por conveniencia con una N = 100. Se aplicaron los instrumentos Partners in Health Scale y APGAR familiar. Resultados: Los resultados muestran una correlación significativa entre el APGAR familiar total y el índice de automanejo. Conclusiones: Con base en los resultados se concluye que la relación entre automanejo y percepción de funcionalidad familiar debe ser explorada con mayor detalle, ya que podría ser un elemento de suma importancia en el diseño de estrategias de combate a la diabetes, no exclusivamente desde la labor de la enfermería sino en colaboración con el equipo multidisciplinario de salud.

Introduction: Diabetes mellitus is one of the main health problems worldwide due to its high rates of prevalence, its costs to the economies, its complications, and its high rate of mortality. This illness also involves the family because the changes in the lifestyles of patients demand the support from the family, orientation on decisionmaking, and actions for an adequate management of the illness. In this regard, some studies have demonstrated the benefits of adequate self-management of chronic illness, which includes: adherence to treatments, acknowledgment of the symptoms, healthy diet habits, exercise, and regular visits to the medical personnel. Objective: To analyze the relationship between self-management and perception of family functionality among persons with type 2 Diabetes Mellitus who are receiving attention in the health centers of Jursidicción 2, Tampico, Tamaulipas, Mexico. Methods: This is a transversal and correlational study with not-probabilistic by convenience sampling involving 100 participants. The Partners in Health Scale and Family APGAR instruments were used. Results: Findings show a significant correlation between total family APGAR and the Self- Management index. Conclusions: Based on the results, it is concluded that the relationship between selfmanagement and perception of family functionality should be explored in greater detail because this knowledge could help in the design of strategies to address Diabetes Mellitus from a perspective of multidisciplinary health team.

Introdução: A diabetes mellitus é um dos principais problemas de saúde a nível mundial devido a sus altos índices de incidência, prevalência, os custos que gera à economia de cada país, as complicações que derivam desta e os altos índices de mortalidade. Esta doença refere-se à família, já que os câmbios no estilo de vida do paciente demandam apoio familiar, orientação na toma de decisões e ações necessárias para a adequada direção à doença. Associado ao anterior, alguns estudos têm demostrado os benefícios de um adequado auto manejo em doenças crónicas, que implica: aderência ao tratamento, reconhecer sintomas da doença, hábitos de alimentação saudável, exercício e visitas ao médico. Objetivo: Analisar a relação entre o auto manejo e a percepção de funcionalidade familiar em pessoas com diabetes tipo 2 que recebem atenção nos centros de saúde da Jurisdição No. 2 de Tampico, Tamaulipas, México. Métodos: Estudo transversal-correlacional, amostragem não probabilística por conveniência com uma N = 100. Aplicaram-se os instrumentos Partners in Health Scale e APGAR familiar. Resultados: Os resultados mostram uma correlação significativa entre o APGAR familiar total e o Índice de Auto manejo. Conclusões: Com base nos resultados conclui-se que a relação entre auto manejo e percepção de funcionalidade familiar deve ser explorada com maior detalhe, já que poderia ser um elemento de grande importância no desenho de estratégias de combate à diabetes, não exclusivamente desde a labor da enfermagem, mas também em colaboração com a equipe multidisciplinar de saúde.

Experiencia en grupos de apoyo, autocuidado y psicoeducativos como estrategias de intervención complementarias al tratamiento médico en epilepsia / Experience of self-help group activities as supplementary support to medical treatment in patients with epilepsy and their families

Los grupos de autoayuda (como por ejemplo de apoyo, autocuidado y psicoeducativos), definidos como un espacio de contención emocional, aprendizaje y transferencia de experiencias, que reúne a un grupo de personas que comparte una vivencia común, en este caso una enfermedad llamada epilepsia. Se revisan las características, objetivos, beneficios y riegos de estos grupos. Además se analiza la experiencia que la Liga Chilena contra la Epilepsia, ha tenido en estos últimos 15 años con grupos de autoayuda, especialmente a la luz de los desafíos que nos plantea la propuesta de la OPS, ILAE/IBE, de la Estrategia y Plan de Acción sobre Epilepsia para las Américas. Palabras claves: autocuidado, interacción social, grupo de autoayuda, epilepsia, psicoeducativo.

Self-help groups are a form of social organization defined as a space of emotional, learning and social interaction that can make collaboration and mutual aid possible, when people who suffer certain situations in isolation, meet and become able to offer each other support, in this case people with epilepsy and their families. We analyse characteristics, objetives, benefits and risks of self-help groups. We comment on the Chilean League against Epilepsy's experience during the last 15 years, looking at the Strategy and Plan of Action on Epilepsy, from the Pan AmericanHealth Organization/ILAE/IBE proposition. Key words: self-help groups, social interaction, epilepsy, learning interaction, selfcare.

Lessons from collaborative governance and sociobiology theories for reinforcing sustained cooperation: a government food security case study.

OBJECTIVES: This research aimed to understand how cooperation and collaboration work in interagency arrangements using a case study of the public management of food security and nutrition in Bogotá, Colombia. STUDY DESIGN: This study explored the available scientific literature on Collaborative Governance within the Public Management body of knowledge and the literature on Cooperation from the Sociobiology field. Then, proposals were developed for testing on the ground through an action-research effort that was documented as a case study. Finally, observations were used to test the proposals and some analytical generalizations were developed. METHODS: To document the case study, several personal interviews, file reviews and normative reviews were conducted to generate a case study database. RESULTS: Collaboration and cooperation concepts within the framework of interagency public management can be understood as a shared desirable outcome that unites different agencies in committing efforts and resources to the accomplishment of a common goal for society, as seen in obtaining food and nutrition security for a specific territory. Collaboration emerges when the following conditions exist and decreases when they are absent: (1) a strong sponsorship that may come from a central government policy or from a distributed interagency consensus; (2) a clear definition of the participating agencies; (3) stability of the staff assigned to the coordination system; and (4) a fitness function for the staff, some mechanism to reward or punish the collaboration level of each individual in the interagency effort. CONCLUSIONS: As this research investigated only one case study, the findings must be taken with care and any generalization made from this study needs to be analytical in nature. Additionally, research must be done to accept these results universally. Food security and nutrition efforts are interagency in nature. For collaboration between agencies to emerge, a minimum set of characteristics that were established during the merging of the public management and sociobiology fields of knowledge and validated by means of a case study must be accomplished.

Dermatitis atópica: actualización en el diagnóstico y tratamiento / Atopic dermatitis: update on diagnosis and treatment

La Dermatitis Atópica es una dermatosis inflamatoria crónica y pruriginosa, muy frecuente en todo el mundo. En esta actualización revisamos aspectos históricos que consideramos relevantes para el entendimiento de la patología, buscando consenso en los criterios diagnósticos, que cada vez son más concordantes entre las diferentes escuelas y por otra parte revisamos la importancia de la terapia tópica y sus novedades.

Atopic dermatitis (AD) A is a chronic, pruritic, inflammatory dermatosis, very common in all parts of the world. In this update we review the historical aspects that we consider relevant for the understanding of the pathology, seeking consensus in the great variety of diagnosis criteria that are every day more similar among different dermatological groups. We also review the importance of topical therapy and the new findings.

Histopathology image representation for automatic analysis: a state-of-the-art review / Representación de imágenes de histopatología utilizada en tareas de análisis automático: estado del arte / Representação de imagens histopatológicas pelo análise automático: revisão do estado da arte

This paper presents a review of the state-of-the-art in histopathology image representation used in automatic image analysis tasks. Automatic analysis of histopathology images is important for building computer-assisted diagnosis tools, automatic image enhancing systems and virtual microscopy systems, among other applications. Histopathology images have a rich mix of visual patterns with particularities that make them difficult to analyze. The paper discusses these particularities, the acquisition process and the challenges found when doing automatic analysis. Second an overview of recent works and methods addressed to deal with visual content representation in different automatic image analysis tasks is presented. Third an overview of applications of image representation methods in several medical domains and tasks is presented. Finally, the paper concludes with current trends of automatic analysis of histopathology images like digital pathology.

Este artículo presenta una revisión del estado del arte en la representación de imágenes de histopatología utilizada en tareas de análisis automático. El análisis de imágenes hispatológicas es importante en la construcción de herramientas para el diagnóstico asistido por computador, sistemas de mejoramiento automático de imágenes y sistemas de microscopía virtual, entre otras aplicaciones. Estas imágenes tienen una gran mezcla de patrones visuales con características particulares que hacen de su análisis una tarea difícil. El artículo discute estas particularidades, el proceso de adquisición y los retos particulares al realizar un análisis automático. En la segunda sección se presenta una revisión de trabajos y métodos recientes enfocados a la representación del contenido visual en diferentes tareas de análisis automático. En tercer lugar, se presenta una visión general de las aplicaciones para los métodos de representación en diferentes dominios médicos. Finalmente el trabajo concluye con las actuales tendencias del análisis automático de imágenes de histopatología como la patología digital.

Este artigo é uma revisão do estado da arte na representação de imagens histopatológicas utilizadas nas tarefas de análise automáticos. O análise de imagens histopatológicas é importante na construção de ferramentas para o diagnóstico assistido por computador, sistemas de melhoramento automático de imagens e sistemas de microscopia virtual. Essas imagens tem uma grande mistura de padrões visuais com caraterísticas particulares, que fazem do análise uma tarefa difícil. O artigo discute essas particularidades, o processo de aquisição, e os desafios particulares no momento de realizar uma análise automático. Na segunda seção se apresenta uma revisão dos trabalhos e métodos recentes, com foco à representação do conteúdo visual em diferentes tarefas de análise automático. Na terceira, se apresenta uma visão geral das aplicações para os métodos de representação em diferentes domínios médicos. Finalmente, o artigo conclui com as atuais tendências do análise automático de imagens histopatológicas como a patologia digital.

Emergence of KPC-producing Klebsiella pneumoniae in Uruguay: infection control and molecular characterization.

We describe the first outbreak of Klebsiella pneumoniae carbapenemase-producing K. pneumoniae (KPC-KP), the infection control measures adopted and the shift in resistance patterns of isolates during antibiotic treatment. The ST258 KPC-KP strain exhibited a multiresistant antibiotic phenotype including co-resistance to gentamycin, colistin and tigecycline intermediate susceptibility. Isolates before and after treatment had different behaviour concerning their antibiotic susceptibility and the population analysis profile study. A progressive increase in the aminoglycosides (acquiring amicacin resistance) and ß-lactam MICs, and a decreased susceptibility to fosfomycin was observed throughout the administration of combined antimicrobial regimens including meropenem. A high meropenem resistance KPC-KP homogeneous population (MIC 256 Jg/mL), could arise from the meropenem heterogeneous low-level resistance KPC-KP population (MIC 8 Jg/mL), by the selective pressure of the prolonged meropenem therapy. The kpc gene was inserted in a Tn4401 isoform a, and no transconjugants were detected. The core measures adopted were successful to prevent evolution towards resistance dissemination.

Anxiolytic-like effects of a new 1-N substituted analog of melatonin in pinealectomized rats.

In spite of the wide variety of drugs available for treating anxiety, this disorder continues to represent a worldwide health problem that is classified within the first 10 causes of disability. Therefore, the search continues for new antianxiety agents, particularly those not related to benzodiazepines. Even though melatonin has been prescribed as an anxiolytic drug, its use is currently limited due to its short half-life and photo-sensitivity, among other disadvantages. The present study explores the antianxiety properties of a new 1-N substituted melatonin analog, M3C, in pinealectomized rats submitted to two behavioral tests (the cumulative burying behavior paradigm and the elevated plus-maze). Results from both tests show that M3C is effective as an anxiolytic-like agent, at doses lower than any other melatonin analog previously reported. The blocking of these actions by luzindole together with the available data suggests that the anxiolytic properties of M3C are mediated by MT1 and MT2 receptors.