Enfoques big data para la comunicación en salud: análisis de redes y análisis de sentimientos a gran escala / Big data approaches in health communication: Network analysis and large-scale supervised sentiment analysis

Resumen Se exponen los dos principales enfoques metodológicos para la investigación con big data en comunicación en salud: el análisis de redes y el análisis de sentimientos. Primeramente, se explica el cambio de paradigma que está sufriendo el campo de la comunicación en salud gracias a los métodos computacionales para el análisis de datos masivos y se dan ejemplos de su uso en estudios y experiencias previas. Seguidamente, se exponen los conceptos (nodo/arista) y las principales variables de centralidad que se estudian en el análisis de red en procesos de difusión de innovaciones en salud; y, finalmente, se explica cómo ejecutar el procedimiento de análisis de sentimientos supervisado para estudiar contenidos de salud a gran escala.

Abstract The two main methodological approaches for research with big data in health communication are presented: network analysis and the analysis of feelings. Firstly, the paradigm change that the communication field in health is experiencing, thanks to the computational methods for the analysis of massive data, and examples of its use in previous studies and experiences are explained. Next, the concepts (node / edge) and the main centrality variables that are studied in the network analysis in health innovation dissemination processes are exposed; and, finally, it is explained how to execute the supervised feelings analysis procedure to study large-scale health content

Lesión simultánea de ambos ligamentos colaterales de la articulación metacarpofalángica del pulgar. Reporte de caso / Simultaneous injury of both ligaments at the metacarpophalangeal joint of the thumb. Case report

Presentamos un caso de fractura simultánea por avulsión de ambos ligamentos colaterales de la articulación metacarpofalángica del pulgar. Se analizan el mecanismo de la lesión y el tratamiento utilizado. Nivel de evidencia clínica. Nivel IV.

We report a case of simultaneous avulsion fracture of both collateral ligaments of the metacarpophalangeal joint of the thumb. The mechanism of injury and treatment used are analyzed. Evidence level. IV

Luxación de tobillo sin fractura asociada: caso clínico y nueva clasificación / Luxation de cheville sans fracture associée: cas clinique, nouvelle classification / Ankle dislocation with no associated fracture: a case and new classification

La luxación cerrada sin fractura asociada de tobillo es una entidad extremadamente rara. Se presenta el caso de un hombre de 35 años que se lesionó mientras jugaba fútbol. El tratamiento consistió en reducción cerrada seguido de inmovilización con una botina de yeso durante 6 semanas y descarga de la extremidad las primeras 10 semanas. A los 12 meses de seguimiento, el paciente había retomado la práctica deportiva con un rango de movimiento completo. Se revisó la bibliografía existente y se propone una nueva clasificación(AU)

Closed dislocation of ankle with no associated fracture is an extremely rare entity. A case of 35 year-old man who was injured while playing soccer is presented. The treatment consists of closed reduction followed by immobilization with a walking cast for 6 weeks and unloading of the injured extremity the first 10 weeks. At 12 months follow-up, the patient had reinitiated sport at full range of motion. The literature was reviewed and a new classification is proposed(AU)

La luxation fermée de cheville sans fracture associée est une affection très rare. Le cas d’un homme (35 ans) lésé en jouant au football est présenté. Le traitement a consisté en réduction fermée, suivie d’immobilisation par botte plâtrée pendant 6 semaines, et mise en décharge du membre inférieur les dix premières semaines. Douze mois après, le patient a repris la pratique sportive en un rang de mouvement complet. On a fait une revue de la littérature, et on propose une nouvelle classification(AU)

Luxación traumática de cadera en un niño / Luxation traumatique de hanche chez l'enfant / Traumatic hip dislocation in a child

Introducción: la luxación traumática de cadera en un paciente pediátrico es una lesión muy infrecuente. No existe consenso sobre su manejo óptimo en urgencias y el seguimiento posterior. Reporte de caso: se reporta el caso de un niño de 4 años que sufrió una luxación traumática de cadera derecha mientras esquiaba. Recibió tratamiento conservador que consistió en reducción cerrada y sin inmovilización posterior. Se realizó una revisión de la literatura sobre esta lesión traumática, su tratamiento y seguimiento. Se mencionan las características diferenciales de la entidad en la población adulta. Resultados: en el presente caso, los resultados fueron muy satisfactorios, pues el paciente tuvo una recuperación funcional completa con un nivel de vida equiparable al que tenía antes de la luxación. Conclusión: la luxación traumática de cadera en la población pediátrica es infrecuente. Sin embargo, dada la importancia de su reducción a la mayor brevedad posible con el objetivo de evitar complicaciones posteriores como la osteonecrosis avascular, es preciso diagnosticarla y tratarla lo más precozmente posible. No existe consenso, sin embargo, en cuanto al tratamiento y seguimiento óptimo de esta afección una vez resuelto el episodio agudo(AU)

Introduction: traumatic hip dislocation in a pediatric patient is a rare injury. There is no consensus on the optimal management in its emergency and follow-up. Case report: the case of a 4 year-old boy who suffered a traumatic dislocation of the right hip while skiing is reported. He received conservative treatment consisting of closed reduction and with no further immobilization. A review of the literature on this traumatic injury, treatment and follow-up was performed. The differential characteristics of the above entity in the adult population are mentioned. Results: in the present case, the results were very satisfactory, since the patient had complete functional recovery with same level of life that he had before the dislocation. Conclusion: traumatic hip dislocation in pediatric population is rare. However, given the importance of its reduction as soon as possible in order to avoid further complications such as avascular osteonecrosis, diagnosis and treatment is necessary as early as possible. There is no consensus, however, as to the optimal treatment and monitoring of the condition after an acute episode is solved(AU)

Introduction: la luxation traumatique de hanche est une lésion peu fréquente chez l'enfant. Il n'existe pas de consensus sur sa prise en charge en urgences et son suivi subséquent. Rapport de cas: le cas d'un enfant âgé de 4 ans ayant souffert une luxation traumatique de la hanche droite lors du ski est rapporté. Il a eu un traitement conservateur consistant en réduction fermée sans immobilisation ultérieur. On a fait une revue de la littérature de cette lésion traumatique, son traitement et son suivi. Les caractéristiques de différentiation de cette affection dans une population adulte sont mentionnées. Résultats: dans ce cas, les résultats ont été satisfaisants, car le patient a eu une complète récupération fonctionnelle lui permettant un niveau de vie comparable à celui qu'il menait avant la luxation. Conclusions: la luxation traumatique de hanche est peu fréquente chez l'enfant. Il est pourtant nécessaire de la diagnostiquer et la traiter précocement pour éviter des complications telles que l'ostéonécrose avasculaire. Mais, il n'existe pas encore de consensus sur un traitement et un suivi appropriés(AU)

Metástasis hepáticas de origen colorrectal sincrónicas: ¿intervención simultánea o secuencial? / Simultaneous or sequential treatment of liver metastases of colon cancer?: experience in 76 patients

Background: Synchronous liver metastases of colon cancer can be managed with sequential or simultaneous surgical management of the primary tumor and the metastases. Aim: To compare the evolution of patients whose liver metastases were treated sequentially or simultaneously. Material and Methods: Retrospective analysis of 76 patients aged 63 +/- 11 years (67 percent males). In 25, metastases were managed simultaneously and in 51 there were treated sequentially after a period of chemotherapy. All interventions were performed by the same surgeon. Results: Patients treated sequentially had a higher number of metastases andmore lymph nodes involved than their counterparts treated simultaneously. The overall resectability index was 78 percent. Eighteen major and 28 minor hepatic resections were carried out. Significantly more major resections were carried out in the sequential treatment group. Mean hospital stay was 11 days and 20 percent of patients had complications, with no differences between groups. Survival at one, three and five years was 75, 45 and 36 percent in the simultaneous treatment and 76, 49 and 29 percent in the sequential treatment group (with no significant differences between groups). Conclusions: In this group of patients no differences in complications or survival were observed when liver metastases were treated simultaneously or sequentially. However groups were not homogeneous.

Introducción: Existen distintas estrategias para el tratamiento de las metástasis hepáticas de origen colorrectal sincrónicas (MHCRS): cirugía secuencial, según respuesta a quimioterapia, intervención simultá-nea del tumor y las metástasis o cirugía hepática previa al tumor primario; el uso de una u otra estrategia es aún controvertido. Objetivo: Comparar la morbimortalidad y supervivencia en dos grupos de pacientes con MHCRS intervenidos de forma simultánea versus secuencial. Pacientes y Métodos: Definimos las MHCRS como aquellas que se diagnostican antes o durante la intervención del tumor primario. Se comparan dos grupos de pacientes con MHCRS, 25 sometidos a intervención simultánea (grupo 1) y 51 tras quimioterapia (intervención secuencial: grupo 2). La cirugía hepática la realizó el mismo cirujano. Revisamos datos del paciente, del tumor primario, intervención quirúrgica, transfusión perioperatoria, morbimortalidad y supervivencia. Resultados: 76 pacientes, con edad media de 62,79 +/- 11,3 años. El número de metástasis y la invasión ganglionar del tumor primario fueron mayores en el grupo 2 de forma estadísticamente significativa. Índice de resecabilidad: 77,6 por ciento: 18 resecciones hepáticas mayores y 28 menores, con diferencias significativas entre ambos grupos (p = 0,05). La estancia media (10,89 días), Índice de morbilidad (19,7 por ciento) y supervivencia actuarial a 1,3 y 5 años fueron similares (75 por ciento, 45 por ciento y 36 por ciento en el grupo 1 y de 76 por ciento, 49 por ciento y 29 por ciento en el grupo 2). Mortalidad: 1,6 por ciento. Conclusiones: Las MHCRS pueden ser intervenidas de forma simultánea al tumor primario en pacientes seleccionados siempre que el equipo sea especializado. La morbimortalidad y la supervivencia son similares tanto en la intervención simultánea como en la secuencial.

El empalamiento inguinal como reto diagnóstico y terapéutico para el médico y cirujano de urgencias / Inguinal impalement; diagnostic and therapeutic challenge for emergency medical and surgeon

Introducción: el objetivo de este trabajo es presentar un caso de empalamiento a través de la región inguinal. Las heridas por empalamiento son infrecuentes y, en ocasiones, de extrema gravedad, necesitan de una actuación rápida del personal médico de urgencias y del cirujano. Caso clínico: se presenta el caso de un varón de 40 años que sufrió un accidente laboral con empalamiento de un hierro de ferralla a través de la región inguinal derecha, el cuerpo extraño penetró en la cavidad abdominal. Se expone ampliamente el caso clínico, así como los procedimientos realizados en el diagnóstico y el tratamiento de este tipo de lesiones. Conclusiones: las heridas por empalamiento son infrecuentes y suponen un reto para el personal médico que atiende al afectado desde el primer momento, tanto por lo complejas que pueden ser, como por la necesidad de una actuación rápida, sin poder conocer a priori, en muchas de las situaciones, la extensión verdadera de las lesiones, que se evidenciará durante el posible acto operatorio(AU)

Introduction: the objective of this paper was to present a case of impalement through the inguinal region. The impalement injuries are infrequent and sometimes extremely serious. These injuries require prompt action of the emergency medical personnel and surgeon. Clinical case: a forty-year old man, who had an occupational accident resulting in impalement of an iron rebar through the right inguinal region and penetrating abdominal cavity. The clinical case and the procedures performed in the diagnosis and treatment of these injuries were presented in detail. Conclusions: The impalement injuries are rare and represent a challenge to the medical staff that treat the patient from the very beginning, because they can be very complex and require fast action and treatment. In many cases, the real dimension and severity of lesions at first is unknown and can only be assessed during surgery(AU)

[Rupture of splenic artery pseudoaneurysm: an unusual cause of upper gastrointetinal bleeding]. / Ruptura de pseudoaneurisma de la arteria esplénica: una causa poco frecuente de hemorragia digestiva alta.

BACKGROUND: Bleeding from a pancreatic pseudocyst is a severe complication after pancreatitis that can lead to a massive gastrointestinal blood loss. Pseudocyst rupture into the stomach is an unusual complication. CLINICAL CASE: We report the case of a 34-year-old woman with a history of alcoholism and a pancreatic pseudocyst. One year after follow-up of her pseudocyst, she arrived at the emergency room with an episode of upper gastrointestinal bleeding. An upper digestive endoscopy showed active bleeding in the subcardial fundus, which could not be endoscopically controlled. Abdominal angio-CT confirmed the diagnosis of a splenic artery pseudoaneurysm in close contact with the back wall of the stomach, as well as a likely fistulization of it. The patient was urgently operated and a distal splenopancreatectomy and fistulorrhaphy was performed. CONCLUSION: The rupture of a splenic artery pseudoaneurysm may rarely present as upper gastrointestinal bleeding. This may be lethal if not urgently treated.

Antecedentes: tras una pancreatitis, el sangrado de un pseudoquiste pancreático es una complicación grave que puede conducir a una hemorragia digestiva masiva. La ruptura de ese pseudoquiste en el estómago es rara. Caso clínico: se comunica el caso de una paciente femenina de 34 años de edad, con antecedentes de alcoholismo y un pseudoquiste pancreático. Después de abandonar el estudio y seguimiento del pseudoquiste pancreático un año más tarde reingresó de urgencia debido a un cuadro de hemorragia digestiva alta. En una endoscopia del tubo digestivo alto se encontró sangrado activo en la región del fundus gástrico, que no pudo controlarse. La angio-tomografía axial computada abdominal confirmó el diagnóstico de pseudoaneurisma de la arteria esplénica, en íntimo contacto con la pared posterior del estómago y quizá fistulizado al mismo. La paciente se intervino con carácter urgente realizándose esplenopancreatectomía distal y fistulorrafia. Conclusión: en raras ocasiones la ruptura de un pseudoaneurisma de la arteria esplénica puede iniciarse como una hemorragia digestiva alta, que puede ser letal si no es tratada con urgencia.

A cell junction pathology of neural stem cells leads to abnormal neurogenesis and hydrocephalus.

Most cells of the developing mammalian brain derive from the ventricular (VZ) and the subventricular (SVZ) zones. The VZ is formed by the multipotent radial glia/neural stem cells (NSCs) while the SVZ harbors the rapidly proliferative neural precursor cells (NPCs). Evidence from human and animal models indicates that the common history of hydrocephalus and brain maldevelopment starts early in embryonic life with disruption of the VZ and SVZ. We propose that a "cell junction pathology" involving adherent and gap junctions is a final common outcome of a wide range of gene mutations resulting in proteins abnormally expressed by the VZ cells undergoing disruption. Disruption of the VZ during fetal development implies the loss of NSCs whereas VZ disruption during the perinatal period implies the loss of ependyma. The process of disruption occurs in specific regions of the ventricular system and at specific stages of brain development. This explains why only certain brain structures have an abnormal development, which in turn results in a specific neurological impairment of the newborn. Disruption of the VZ of the Sylvian aqueduct (SA) leads to aqueductal stenosis and hydrocephalus, while disruption of the VZ of telencephalon impairs neurogenesis. We are currently investigating whether grafting of NSCs/neurospheres from normal rats into the CSF of hydrocephalic mutants helps to diminish/repair the outcomes of VZ disruption.

A cell junction pathology of neural stem cells leads to abnormal neurogenesis and hydrocephalus

Most cells of the developing mammalian brain derive from the ventricular (VZ) and the subventricular (SVZ) zones. The VZ is formed by the multipotent radial glia/neural stem cells (NSCs) while the SVZ harbors the rapidly proliferative neural precursor cells (NPCs). Evidence from human and animal models indicates that the common history of hydrocephalus and brain maldevelopment starts early in embryonic life with disruption of the VZ and SVZ. We propose that a "cell junction pathology" involving adherent and gap junctions is a final common outcome of a wide range of gene mutations resulting in proteins abnormally expressed by the VZ cells undergoing disruption. Disruption of the VZ during fetal development implies the loss of NSCs whereas VZ disruption during the perinatal period implies the loss of ependyma. The process of disruption occurs in specific regions of the ventricular system and at specific stages of brain development. This explains why only certain brain structures have an abnormal development, which in turn results in a specific neurological impairment of the newborn. Disruption of the VZ of the Sylvian aqueduct (SA) leads to aqueductal stenosis and hydrocephalus, while disruption of the VZ of telencephalon impairs neurogenesis. We are currently investigating whether grafting of NSCs/neurospheres from normal rats into the CSF of hydrocephalic mutants helps to diminish/repair the outcomes of VZ disruption.

New ependymal cells are born postnatally in two discrete regions of the mouse brain and support ventricular enlargement in hydrocephalus.

A heterogeneous population of ependymal cells lines the brain ventricles. The evidence about the origin and birth dates of these cell populations is scarce. Furthermore, the possibility that mature ependymal cells are born (ependymogenesis) or self-renewed (ependymal proliferation) postnatally is controversial. The present study was designed to investigate both phenomena in wild-type (wt) and hydrocephalic α-SNAP mutant (hyh) mice at different postnatal stages. In wt mice, proliferating cells in the ventricular zone (VZ) were only found in two distinct regions: the dorsal walls of the third ventricle and Sylvian aqueduct (SA). Most proliferating cells were monociliated and nestin+, likely corresponding to radial glial cells. Postnatal cumulative BrdU-labeling showed that most daughter cells remained in the VZ of both regions and they lost nestin-immunoreactivity. Furthermore, some labeled cells became multiciliated and GLUT-1+, indicating they were ependymal cells born postnatally. Postnatal pulse BrdU-labeling and Ki-67 immunostaining further demonstrated the presence of cycling multiciliated ependymal cells. In hydrocephalic mutants, the dorsal walls of the third ventricle and SA expanded enormously and showed neither ependymal disruption nor ventriculostomies. This phenomenon was sustained by an increased ependymogenesis. Consequently, in addition to the physical and geometrical mechanisms traditionally explaining ventricular enlargement in fetal-onset hydrocephalus, we propose that postnatal ependymogenesis could also play a role. Furthermore, as generation of new ependymal cells during postnatal stages was observed in distinct regions of the ventricular walls, such as the roof of the third ventricle, it may be a key mechanism involved in the development of human type 1 interhemispheric cysts.

A simple PCR-based genotyping method for M105I mutation of alpha-SNAP enhances the study of early pathological changes in hyh phenotype.

alpha-SNAP is an essential component of the protein machinery responsible for membrane fusion events in different cell types. The hyh (hydrocephalus with hop gait) mouse carries a missense mutation in Napa gene that results in a point mutation (M105I) in alpha-SNAP protein. Homozygous animals for the mutant allele have been identified by the clinical and/or neuropathological phenotype, or by direct sequencing of PCR products. The aims of the present study were (i) to develop a high-throughput technique to genotype hyh mice, (ii) to correlate genotype-phenotype, and (iii) to analyze the earliest pathological changes of hyh mutant mice. As no restriction sites are affected by the hyh mutation, we resolved this problem by creating a BspHI restriction site with a modified (mismatch) polymerase chain reaction (PCR) primer in wild-type allele. This artificially created restriction site (ACRS)-PCR technique is a simple, rapid and reliable method to genotype hyh mice in a day-work procedure. Biochemical and histological analysis of genotyped hyh embryos at different developmental stages allowed us to identify and characterize the earliest brain pathological changes of the hyh phenotype, including the first signs of neuroepithelial disruption and neuronal ectopia. In addition, genotype-phenotype analysis of 327 animals confirmed that (i) hyh is a single-gene autosomal recessive disorder, and (ii) the disorder has 100% penetrance (i.e., the mutation was only present in affected mice). The genotyping method described here enhances the potentiality of hyh mouse as a unique in vivo model to study the role of membrane trafficking in different developmental and physiological processes.

Isolation, characterization and long term preservation of mutant strains of Xanthophyllomyces dendrorhous.

The yeast Xanthophyllomyces dendrorhous is biotechnologically important due to its ability to produce the pigment astaxanthin, but is poorly understood at the genetic level. This is mainly because its preservation is difficult and many of the mutants obtained are unstable. The objectives of the present work were (i) the mutagenesis X. dendrorhous and, (ii) isolation of mutants with auxotrophic markers suitable for genetic studies of the carotenogenesis pathway and sexual cycle. Additionally, two kinds of preservation methods at the laboratory level were tested for the storage of strains. A collection of X. dendrorhous mutants affected in the production of carotenoid pigments or development of sexual structures and auxotrophic requirements were isolated by treatment with N-methyl-N'-nitro-N-nitrosoguanidine and the antibiotic nystatin. From a detailed analysis about the requirements of auxotrophic mutants the ARG7, ARG3 and PRO3 loci can be defined in this yeast. Among the methods assayed for the long-term preservation of X. dendrorhous strains, the dehydrated gelatin drop method showed the highest recovery of viable yeast after storage for 65 months. No changes in auxotrophic properties and in macro or micro morphology were observed after applying the latter method.

Reproductive health surveillance in the US-Mexico border region, 2003-2006: the Brownsville-Matamoros Sister City Project for Women's Health.

INTRODUCTION: High birth and immigration rates in the US-Mexico border region have led to large population increases in recent decades. Two national, 10 state, and more than 100 local government entities deliver reproductive health services to the region's 14 million residents. Limited standardized information about health risks in this population hampers capacity to address local needs and assess effectiveness of public health programs. METHODS: We worked with binational partners to develop a system for reproductive health surveillance in the sister communities of Matamoros, Tamaulipas, Mexico, and Cameron County, Texas, as a model for a broader regional approach. We used a stratified, systematic cluster-sampling design to sample women giving birth in hospitals in each community during an 81-day period (August 21-November 9) in 2005. We conducted in-hospital computer-assisted personal interviews that addressed prenatal, behavioral, and lifestyle factors. We evaluated survey response rates, data quality, and other attributes of effective surveillance systems. We estimated population coverage using vital records data. RESULTS: Among the 999 women sampled, 947 (95%) completed interviews, and the item nonresponse rate was low. The study sample included 92.7% of live births in Matamoros and 98.3% in Cameron County. Differences between percentage distributions of birth certificate characteristics in the study and target populations did not exceed 2.0. Study population coverage among hospitals ranged from 92.9% to 100.0%, averaging 97.3% in Matamoros and 97.4% in Cameron County. CONCLUSION: Results indicate that hospital-based sampling and postpartum interviewing constitute an effective approach to reproductive health surveillance. Such a system can yield valuable information for public health programs serving the growing US-Mexico border population.