Trastornos somatomorfos y rasgos de personalidad en pacientes hospitalizados por lumbalgia crónica en El Salvador / Somatoform Disorders and Personality Traits in Hospitalized Patients with Chronic Back Pain in El Salvador

Introducción. El trastorno somatomorfo se caracteriza por la presentación de múltiples síntomas físicos que no pueden ser atribuidos a otra enfermedad física, mental o al uso de sustancias, teniendo como comorbilidad más prevalente a los trastornos de personalidad. Objetivo. Determinar la frecuencia de trastorno somatomorfo, sus características principales y diferentes rasgos de personalidad entre pacientes con lumbalgia crónica. Metodología. Estudio descriptivo transversal realizado con pacientes ingresados en el servicio de neurocirugía del Hospital General del Instituto Salvadoreño del Seguro Social. La recolección de datos se realizó a través de la escala Screening for Somatoform Symptoms 2 y la escala InternationalPersonality Disorder Examination. Las variables cualitativas fueron analizadas a través de frecuencias absolutas. Las variables cuantitativas fueron analizadas a través de medidas de tendencia central y de dispersión. Los análisis estadísticos fueron realizados en el programa Statistical Package for the Social Sicience, versión 26. Resultados. Se incluyeron 60 pacientes, 40 de ellos mujeres, 31 entre los 41 y 60 años. Veintiocho pacientes presentaron ocho o más síntomas, excluyéndose dolor lumbar. Cuarenta y cinco pacientes reportaron sintomatología por más de un año. Cincuenta y tres pacientes presentaron trastorno somatomorfo. Los trastornos de personalidad más frecuentes fueron obsesivo-compulsivos (31), límites (21) y paranoides (21). Conclusión. Los pacientes con dolor lumbar crónico que requieren ingreso hospitalario presentan una alta frecuencia de trastornos somatomorfos, con dolor en piernas o brazos como síntoma principal; además, estos pacientes se caracterizan por presentar en su mayoría rasgos de personalidad obsesivo-compulsivos.

Introduction. The somatoform symptoms disorder is characterized by multiple psychical symptoms that can't be attributed to another physical or mental health diagnosis or drug abuse, having personality disorders as the most common comorbidity. Objective. To determine the frequency of somatoform disorders, it's most important characteristics and different personality traits among patients with chronic back pain. Methodology. Cross-sectional descriptive study carried out with patients admitted to the neurosurgery department of the General Hospital of the Salvadoran Social Security Institute. Data collection was carried out using the Screening for Somatoform Symptoms 2 scale and the International Personality Disorder Examination scale. The qualitative variables were analyzed through absolute frequencies. The quantitative variables were analyzed through measures of central tendency and dispersion. The statistical analyzes were carried out using the Statistical Package for the Social Sciences version 26. Results. The study included 60 patients, 40 of them women, 31 between 41 and 60 years old. Twenty-eight patients presented eight or more symptoms, excluding low back pain. Forty-five patients reported symptoms for more than one year. Fifty-three patients presented somatoform disorder. The most frequent personality disorders were obsessive-compulsive (31), borderline (21) and paranoid (21). Conclusion. Patients with chronic lower back pain who require hospital admission have a high frequency of somatoform disorders, with the main symptom being pain in the legs or arms; furthermore, these patients are characterized by mostly presenting obsessive-compulsive personality traits

Weak and fragmented regulatory frameworks on the accuracy of blood pressure-measuring devices pose a major impediment for the implementation of HEARTS in the Americas.

Global HEARTS is a WHO initiative for cardiovascular disease prevention and control. Accurate blood pressure (BP) measurement is an essential component of the initiative. This study aimed to determine the regulatory frameworks governing the accuracy of BPMDs in countries of the Americas participating in the HEARTS initiative. Quantitative and qualitative analysis of the laws and regulations relevant to ensuring the accuracy of BPMDs were determined from the Ministries of Health/Regulatory Agencies among 13 countries in Latin America and the Caribbean. Analysis included characterizing the scope of regulations (ie, pre-market approval, sales and promotion, labeling, cuff sizes, and procurement), information systems for monitoring the models of BPMDs used in primary health care (PHC), and systems to enforce compliance with regulations. Ten of the 13 countries had medical device laws, but regulations that specifically address BPMDs only existed in three countries. Only one country (Brazil) had regulations for mandatory accuracy validation testing and only two countries regulated internet sales of BPMDs. Labeling and cuff size regulations existed in four and two countries, respectively. Less than half the countries reported having a data repository on the BPMD models being used in PHC facilities (four countries) or sold (five countries). Weak and fragmented regulatory frameworks on the accuracy of BPMDs exist among countries of the Americas. This will adversely affect the accuracy of blood pressure assessment and hence poses a major impediment for successful implementation of HEARTS initiative.

PIAS-like protein Zimp7 is required for the restriction of the zebrafish organizer and mesoderm development.

The Zmiz2 (Zimp7) protein and its homolog Zmiz1 (Zimp10) were initially identified in humans as androgen receptor co-activators. Sequence analysis revealed the presence of an SP-RING/Miz domain, which is highly conserved in members of the PIAS family and confers SUMO-conjugating activity. Zimp7 has been shown to interact with components of the Wnt/ß-Catenin signaling pathway and with Brg1 and BAF57, components of the ATP-dependent mammalian SWI/SNF-like BAF chromatin-remodeling complexes. In this work, we analyze the role of zygotic Zimp7 in zebrafish development. We describe evidence indicating that Zimp7 is required for mesoderm development and dorsoventral patterning. Morpholino-mediated reduction of zygotic Zimp7 produced axial mesodermal defects that were preceded by up-regulation of organizer genes such as bozozok, goosecoid and floating head at the onset of gastrulation and by down-regulation of the ventral markers vox, vent and eve1 indicating loss of the ventrolateral mesoderm. Consistently, embryos overexpressing zimp7 RNA exhibited midline defects such as loss of forebrain and cyclopia accompanied by transcriptional changes directly opposite of those found in the morphants. In addition, the patterning of ventralized embryos produced by the overexpression of vox and vent was restored by a reduction of Zimp7 activity. Altogether, our findings indicate that Zimp7 is involved in transcriptional regulation of factors that are essential for patterning in the dorsoventral axis.

[The frequency of risk factors associated with obesity and being overweight in university students from Colima, Mexico]. / Frecuencia y factores de riesgo asociados a sobrepeso y obesidad en universitarios de Colima, México.

OBJECTIVE: Determining risk factor frequency regarding obesity and being overweight in university students. METHODS: A cross-sectional analytic study was carried out on 821 students from the University of Colima. Some variables analysed were age, gender, alcoholism, smoking and weight-control drug use. RESULTS: 821 students were included (380 male, 441 female), 20.9±2.5 average age. 27.8 % of males were overweight and 14.7 % suffered from obesity; this was 17 % and 5.2 % in females, respectively. Smoking (2.1 OR; 1.4-3.8 95 % CI; p=0.01) and alcoholism (2.1 OR; 1.2-3.6 95 % CI; p=0.003) were associated with being overweight and being obese. Weight-control drug use was a protective factor in both genders (0.4 OR; 0.2-0.8 95 % CI; p=0.01); diet control was only a protective factor in women (2.2. OR; 1.1-3.4 95 % CI; p=0.01). CONCLUSIONS: 31.6 % of university students were overweight and suffered from obesity. Smoking and alcoholism in males were associated with being overweight and suffering from obesity. Weight-control and diet-control drug use were protective factors.

Frecuencia y factores de riesgo asociados a sobrepeso y obesidad en universitarios de Colima, México / The frequency of risk factors associated with obesity and being overweight in university students from Colima, Mexico

Objetivo Determinar la frecuencia y factores de riesgo para sobrepeso y obesidad en jóvenes universitarios. Métodos Se realizó un estudio transversal analítico en 821 alumnos inscritos de la Universidad de Colima. Entre las variables analizadas se encuentran: edad, género, alcoholismo, tabaquismo y utilización de medicamentos o sustancias para control de peso. Resultados Se estudiaron 821 alumnos (380 hombres y 441 mujeres) con una edad promedio de 20,9±2,5 años. Las frecuencias de sobrepeso y obesidad en hombres fueron de 27,8 por ciento y 14,7 por ciento y en mujeres de 17 por ciento y 5,2 por ciento. En hombres el tabaquismo (OR 2,1, IC 95 por ciento 1,4-3,8;p=0,01) y etilismo (OR 2,1, IC 95 por ciento 1,2-3,6;p=0,003), estuvieron asociados a sobrepeso y obesidad. Fueron factores protectores en ambos géneros el uso de sustancias para control de peso (OR 0,4, IC 95 por ciento 0,2-0,8;p=0,01); mientras que el control dietético fue un factor protector sólo en las mujeres (OR 2,2, IC 95 por ciento 1,1- 3,4;p=0,01). Conclusiones En estudiantes universitarios, el 31,6 por ciento presentó sobrepeso y obesidad. En hombres, el tabaquismo y etilismo se asociaron a sobrepeso y obesidad. El uso de sustancias para bajar de peso y control dietético fueron factores protectores.

Objective Determining risk factor frequency regarding obesity and being overweight in university students. Methods A cross-sectional analytic study was carried out on 821 students from the University of Colima. Some variables analysed were age, gender, alcoholism, smoking and weight-control drug use. Results 821 students were included (380 male, 441 female), 20.9±2.5 average age. 27.8 percent of males were overweight and 14.7 percent suffered from obesity; this was 17 percent and 5.2 percent in females, respectively. Smoking (2.1 OR; 1.4-3.8 95 percent CI; p=0.01) and alcoholism (2.1 OR; 1.2-3.6 95 percent CI; p=0.003) were associated with being overweight and being obese. Weight-control drug use was a protective factor in both genders (0.4 OR; 0.2-0.8 95 percent CI; p=0.01); diet control was only a protective factor in women (2.2. OR; 1.1-3.4 95 percent CI; p=0.01). Conclusions 31.6 percent of university students were overweight and suffered from obesity. Smoking and alcoholism in males were associated with being overweight and suffering from obesity. Weight-control and diet-control drug use were protective factors.

A proposed approach for the selection of the proper surgical therapy to obtain an adequate margin of resection in locally advanced ultra-low rectal cancer after modern preoperative CRX management.

OBJECTIVE: We performed a retrospective review to identify objective factors that could facilitate the surgeon's decision regarding the feasibility of an adequate resection with a margin of< 2 cm from the dentate line. We could not find clear guidelines for clinicians regarding the use of close margins for sphincter saving surgery following chemoradiation (CRX). We proposed what state of the art imaging tools are potentially useful to identify tumor downstage following preoperative CRX and aid in the development of guidelines. METHODS: Reviewed of the literature on the subject and performance of current diagnostic imaging studies useful in identifying rectal tumor downstaging after preoperative CRX. RESULTS: Without safe margins of resection an abdominoperineal resection (APR) is the operation of choice. All sphincter saving rectal cancer operations results for ultra-low tumors need to be as good as results from an APR. Performing frozen section for the ultralow rectal cancer margins is recommended. The Endorectal Ultrasonography (ERUS) data appear encouraging and suggest that we should evaluate TRUS earlier after CRX, before the desmoplastic reaction and scar tissue appears. It could turn out to be an objective and accurate method of evaluating tumor downstaging. Color Doppler evaluation has shown higher specificity than that of grey scale ultrasound in staging and differentiating scar from anal cancers. Similarly, PET scanning performed earlier and with modern PET-CT equipment is worth exploring. CONCLUSION: At this point with the information available from the literature, we suggest that patients with clinically advanced rectal cancer can have a distal margin resection of less than 2 cm if: 1- the tumor is not mucin producing, 2- the tumor is not high-grade, and 3- the response to preop CRX is adequate, however there exist no clear guidelines available to judge what is an excellent versus a moderate or poor response.

Estudio retrospevtivo: colecistectomías abierta en los últimos 5 años en el Hospital Militar Regional de Monterrey, NL / Retrospective study for open cholecystectomy through the five last year in the Military Regional Hospital of Monterrey, NL

Las colecistectomías abiertas ocupan uno de los primeros lugares de los procedimientos quirúrgicos en los hospitales de segundo y tercer nivel, sólo rebasadas por las cirugías ginecológicas, pequeñas cirugías de piel y las apendicectomías, conviertiéndolo entonces en un método seguro e ideal para resolver la patología vesicular de forma quirúrgica cuando así se requiere. El presente estudio fue realizado en un hospital de segundo nivel en un total de 142 pacientes, en los cuales no se inclyeron patrones de exclusión como lo son: sexo, edad, patologías crónicas degenerativas entre otras. A todo el grupo estudiado fue posible darles seguimiento a corto y mediano plazo, observando que el rango de edades se encontraba entre los 14 a 92 años. La realización de la técnica quirúrgica en su mayoría fue por incisiones tranversas y un bajo número por inciciones medias supraumbilicales, con resultados similares, utilizando para ambos tipos de incisiones la repación con tipos similares de suturas. Todos, excepto uno del universo de pacientes fue manejado con antibióticos convencionales, el estudio realizado con los criterios referidos reportó que la mortlidad fue del 0 por ciento y la morbilidad del 1.3 por ciento, menor estancia hospitalaria y una disminución importante en la frecuencia de complicaciones transoperatorias y postoperatorias por lo cual se satisfacen ampliamente los objetivo trazados de todo paciente quirúrgico y observando que los resultados correponden ampliamente a lo reportado en la literatura mundial