Automatic gauze tracking in laparoscopic surgery using image texture analysis.

BACKGROUND AND OBJECTIVE: Inadvertent retained surgical gauzes are an infrequent medical error but can have devastating consequences in the patient health and in the surgeon professional reputation. This problem seems easily preventable implementing standardized protocols for counting but due to human errors it still persists in surgery. The omnipresence of gauzes, their small size, and their similar appearance with tissues when they are soaked in blood make this error eradication really complex. In order to reduce the risk of accidental retention of surgical sponges in laparoscopy operations, in this paper we present an image processing system that tracks the gauzes on the video captured by the endoscope. METHODS: The proposed image processing application detects the presence of gauzes in the video images using texture analysis techniques. The process starts dividing the video frames into square blocks and each of these blocks is analyzed to determine whether it is similar to the gauze pattern. The video processing algorithm has been tested in a laparoscopic simulator under different conditions: with clean, slightly stained and soaked in blood gauzes as well as against different biological background tissues. Several methods, including different Local Binary Patterns (LBP) techniques and a convolutional neural network (CNN), have been analyzed in order to achieve a reliable detection in real time. RESULTS: The proposed LBP algorithm classifies the individual blocks in the image with 98% precision and 94% sensitivity which is sufficient to make a robust detection of any gauze that appears in the endoscopic video even if it is stained or soaked in blood. The results provided by the CNN are superior with 100% precision and 97% sensitivity, but due to the high computational demand, real-time video processing is not attainable in this case with standard hardware. CONCLUSIONS: The algorithm presented in this paper is a valuable tool to avoid the retention of surgical gauzes not only because of its reliability but also because it processes the video transparently and unattended, without the need for additional manipulation of special equipment in the operating room.

First inter-laboratory comparison of Echinococcus granulosus sensu lato diagnosis in Latin America

[ABSTRACT]. Objective. To compare the performance of polymerase chain reaction (PCR) and enzyme-linked immunosorbent assay (ELISA) tests for diagnosing Echinococcus granulosus in dog feces among national reference laboratories in Argentina, Chile, Peru, and Uruguay. Methods. National laboratories affiliated with the Ministry of Health/Agriculture of each country exchanged panels of 10 positive/negative samples obtained from their regular national surveillance programs in November 2015 – November 2016. All laboratories applied PCR; two also applied ELISA techniques. Sensitivity and specificity were determined for each laboratory and concordance of results among the laboratories was evaluated by Cohen Kappa coefficient. Results. Poor concordance (3 of 10 paired comparisons had values of Kappa > 0.4), low sensitivity and specificity across all laboratories, and poor performance of both techniques in detecting E. granulosus in canine feces was demonstrated in this study. An ex-post comparison of the laboratories’ test protocols showed substantial heterogeneity that could partially explain poor concordance of results. Conclusion. The results underscore the heterogeneity of canine echinococcosis diagnosis across the region and indicate possible sources of variability. Efforts to standardize canine echinococcosis testing must be included in the plan of action for the Regional Initiative for the Control of Cystic Echinococcosis. Future comparisons with fecal samples of known parasite load are needed.

[RESUMEN]. Objetivo. Comparar el rendimiento de los ensayos de la reacción en cadena de la polimerasa y el enzimoinmunoanálisis de adsorción en fase sólida (o ELISA, por su sigla en inglés) para diagnosticar Echinococcus granulosus en heces caninas en los laboratorios de referencia nacionales de Argentina, Chile, Perú y Uruguay. Métodos. Los laboratorios nacionales, afiliados a los ministerios de salud y agricultura y ganadería de cada país, intercambiaron paneles de diez muestras positivas y negativas obtenidas de sus respectivos programas nacionales de vigilancia desde el mes de noviembre del año 2015 hasta el mismo mes del año siguiente. Todos los laboratorios emplearon la reacción en cadena de la polimerasa y dos emplearon también técnicas de ensayo inmunoenzimático (ELISA). Se determinó la sensibilidad y la especificidad de cada laboratorio y se evaluó la concordancia entre los resultados de los laboratorios mediante el coeficiente kappa de Cohen. Resultados. Este estudio descubrió una escasa concordancia (3 de 10 comparaciones de pares obtuvieron valores de kappa > 0,4), una sensibilidad y especificidad bajas en todos los laboratorios y un rendimiento deficiente de ambas técnicas de diagnóstico de Echinococcus granulosus en heces caninas. La comparación ex post de los protocolos de ensayo de los laboratorios mostró una heterogeneidad sustancial que podría explicar parcialmente la escasa concordancia de los resultados. Conclusiones. Los resultados subrayan la heterogeneidad del diagnóstico de equinococosis canina en toda la región e indican posibles fuentes de esta variabilidad. Deben incluirse medidas para estandarizar la prueba de equinococosis canina en el plan de acción de la Iniciativa Sudamericana para el Control de la Equinococosis Quística. En el futuro serán necesarias comparaciones adicionales con muestras fecales con una carga de parásitos conocida.

[RESUMO]. Objetivo. Comparar o desempenho dos métodos de reação em cadeia da polimerase (PCR) e ensaio imunoenzimático (ELISA) no diagnóstico de infecção pelo Echinococcus granulosus em fezes de cães entre laboratórios de referência nacional na Argentina, Chile, Peru e Uruguai. Métodos. Laboratórios nacionais conveniados ao Ministério da Saúde/Agricultura de cada país participante intercambiaram grupos de 10 amostras positivas/negativas coletadas rotineiramente pelos programas nacionais de vigilância no período de novembro de 2015 a novembro de 2016. Todos os laboratórios empregaram o método de PCR e dois empregaram também o método de ELISA. A sensibilidade e a especificidade dos métodos foram determinadas em cada laboratório, e a concordância dos resultados entre os laboratórios participantes foi avaliada com o coeficiente kappa de Cohen. Resultados. Observou-se fraca concordância (3 de 10 comparações pareadas com kappa >0,4), baixa sensibilidade e especificidade e fraco desempenho de ambos os métodos na identificação do E. granulosus em amostras fecais de cães nos laboratórios participantes do estudo. Uma comparação retroativa revelou considerável heterogeneidade dos protocolos de análise laboratorial, o que poderia em parte explicar a fraca concordância entre os resultados. Conclusões. Os resultados deste estudo apontam para a falta de uniformidade no diagnóstico de equinococose canina em toda a Região e indicam possíveis causas para variabilidade. A padronização da análise laboratorial da equinococose canina deve constar do plano de ação para a Iniciativa Regional para Controle da Hidatidose. Outras comparações de amostras fecais de parasitas conhecidos devem ser realizadas.

Controlled trial of balance training using a video game console in community-dwelling older adults.

BACKGROUND: gamification is a potentially attractive option for improving balance and reducing falls. OBJECTIVES: to assess the effect of balance training using the NintendoTM Wii game console on balance (primary outcome), falls and fear of falling. DESIGN: quasi-randomised, open-label, controlled clinical trial in parallel groups, carried out on community-dwelling patients over 70 years, able to walk independently. Participants were assigned 1:1 to the intervention or control group. Balance training was conducted using the Nintendo WiiFitTM twice a week for 3 months. Balance was assessed using the Tinetti balance test (primary outcome), the unipedal stance and the Wii balance tests at baseline, 3 months and 1 year. Falls were recorded and Fear of falling was assessed by the Falls Efficacy Scale (Short-FES-I). RESULTS: 1,016 subjects were recruited (508 in both the intervention and the control group; of whom 274 and 356 respectively completed the 3-month assessment). There was no between-group difference in the Tinetti balance test score, with a baseline mean of 14.7 (SD 1.8) in both groups, and 15.2 (1.3) at 3 months in the intervention group compared to 15.3 (1.7) in controls; the between-group difference was 0.06 (95% CI 0.30-0.41). No differences were seen in any of the other balance tests, or in incident falls. There was a reduction in the fear of falling at 3 months, but no effect at 1 year. CONCLUSIONS: the study found no effect of balance training using the NintendoTM Wii on balance or falls in older community-dwelling patients.The study protocol is available at clinicaltrials.gov under the code NCT02570178.

First inter-laboratory comparison of Echinococcus granulosus sensu lato diagnosis in Latin America.

OBJECTIVE: To compare the performance of polymerase chain reaction (PCR) and enzyme-linked immunosorbent assay (ELISA) tests for diagnosing Echinococcus granulosus in dog feces among national reference laboratories in Argentina, Chile, Peru, and Uruguay. METHODS: National laboratories affiliated with the Ministry of Health/Agriculture of each country exchanged panels of 10 positive/negative samples obtained from their regular national surveillance programs in November 2015 - November 2016. All laboratories applied PCR; two also applied ELISA techniques. Sensitivity and specificity were determined for each laboratory and concordance of results among the laboratories was evaluated by Cohen Kappa coefficient. RESULTS: Poor concordance (3 of 10 paired comparisons had values of Kappa > 0.4), low sensitivity and specificity across all laboratories, and poor performance of both techniques in detecting E. granulosus in canine feces was demonstrated in this study. An ex-post comparison of the laboratories' test protocols showed substantial heterogeneity that could partially explain poor concordance of results. CONCLUSION: The results underscore the heterogeneity of canine echinococcosis diagnosis across the region and indicate possible sources of variability. Efforts to standardize canine echinococcosis testing must be included in the plan of action for the Regional Initiative for the Control of Cystic Echinococcosis. Future comparisons with fecal samples of known parasite load are needed.

Human T-lymphotropic virus type 1 infection and disease in Spain.

: Human T-lymphotropic virus type 1 (HTLV-1) infection is a neglected disease despite roughly 15 million people are chronically infected worldwide. Lifelong less than 10% of carriers develop life-threatening diseases, mostly a subacute myelopathy known as tropical spastic paraparesis (TSP) and a lymphoproliferative disorder named adult T-cell leukemia (ATL). HTLV-1 is efficiently transmitted perinatally (breastfeeding), sexually (more from men to women) and parenterally (transfusions, injection drug user (IDU), and transplants). To date there is neither prophylactic vaccine nor effective antiviral therapy. A total of 327 cases of HTLV-1 infection had been reported at the HTLV-1 Spanish registry until December 2016, of whom 34 had been diagnosed with TSP and 25 with ATL. Overall 62% were Latin American immigrants and 13% were persons of African origin. The incidence of HTLV-1 in Spain has remained stable for nearly a decade with 20-25 new cases yearly. Of the 21 newly diagnosed HTLV-1 cases during year 2016, one was a native Spaniard pregnant woman, and four presented with symptomatic disease, including three with ATL and one with TSP. Underdiagnosis of HTLV-1 in Spain must be high (iceberg model), which may account for the disproportionate high rate of symptomatic cases (almost 20%) and the late recognition of preventable HTLV-1 transmissions in special populations, such as newborns and transplant recipients. Our current estimate is of 10 000 persons living with HTLV-1 infection in Spain. Given the large flux of immigrants and visitors from HTLV-1 endemic regions to Spain, the expansion of HTLV-1 screening policies is warranted. At this time, it seems worth recommending HTLV testing to all donor/recipient organ transplants and pregnant women regardless place of birth. Although current leukoreduction procedures largely prevent HTLV-1 transmission by blood transfusions, HTLV testing of all first-time donors should be cost-effective contributing to unveil asymptomatic unaware HTLV-1 carriers.

Study protocol of a randomized clinical trial evaluating the effectiveness of a primary care intervention using the Nintendo™ Wii console to improve balance and decrease falls in the elderly.

BACKGROUND: Balance alteration is a risk factor for falls in elderly individuals that has physical, psychological and economic consequences. The objectives of this study are to evaluate the usefulness of an intervention utilizing the Nintendo™ Wii console in order to improve balance, thereby decreasing both the fear of falling as well as the number of falls, and to evaluate the correlation between balance as determined by the console and the value obtained in the Tinetti tests and the one foot stationary test. METHODS/DESIGN: This is a controlled, randomized clinical trial of individual assignment, carried out on patients over 70 years in age, from five primary care centers in the city of Mataró (Barcelona). 380 patients were necessary for the intervention group that carried out the balance board exercises in 2 sessions per week for a 3 month period, and 380 patients in the control group who carried out their usual habits. Balance was evaluated using the Tinetti test, the one foot stationary test and with the console, at the start of the study, at the end of the intervention (3 months) and one year later. Quarterly telephone follow-up was also conducted to keep track of falls and their consequences. DISCUSSION: The study aimed to connect the community with a technology that may be an easy and fun way to assist the elderly in improving their balance without the need to leave home or join rehabilitation groups, offering greater comfort for this population and decreasing healthcare costs since there is no need for specialized personnel. TRIAL REGISTRATION: Current Control Trial NCT02570178.

Comportamiento de la depresión en el adulto mayor del policlínico "Cristóbal Labra" / Behaviour of depression in the elderly at \"Cristobal Labra\" Polyclinic

Introducción: la depresión en el anciano constituye un problema de salud. Los cambios biológicos, psicológicos, económicos y sociales que se observan en el proceso de envejecimiento, asociados a las numerosas patologías que aparecen en esta etapa de la vida, conllevan a pensar que irremediablemente los ancianos tengan todas las condiciones creadas para deprimirse.Objetivo: caracterizar la depresión en los adultos mayores y los tratamientos empleados para la misma, en la consulta de psicogeriatría y demencia de un policlínico.Métodos: se realizó un estudio descriptivo, retrospectivo de corte transversal a 112 ancianos, remitidos por los médicos de familia a la consulta de Psicogeriatría y Demencia del Policlínico "Cristóbal Labra", durante el período de julio a diciembre de 2011. Los datos se recogieron de las historias clínicas. Para el diagnóstico de la patología se aplicó el test de Yesavage y el Mini mental de Folstein.Resultados: la depresión se diagnosticó al 25 por ciento de los ancianos remitidos a consulta; la misma se incrementó con la edad, el bajo nivel educacional y la presencia de enfermedades como osteoartritis y alteraciones sensoriales. Los síntomas principales fueron los trastornos del sueño en el hombre y la tristeza y llanto en la mujer. Se usó la Medicina Natural Tradicional con éxito en un 42,9 por ciento de los ancianos.Conclusiones: la depresión es una entidad frecuente y poco diagnosticada, el uso de la Medicina Natural y Tradicional constituye una alternativa de tratamiento para la misma

Background: depression in the elderly is a health problem. The biological, psychological, economic and social changes seen in the aging process, associated to some pathologies appearing in this stage of life, inevitably lead to think that the elderly have created all the conditions to be depressed.Objective: to characterize depression in the elderly and the treatments followed for this condition in the Psychogeriatric and Dementia consultation at a polyclinic.Methods: a retrospective descriptive cross-sectional study was performed in 112 elderly who were referred by their family doctors to the Psychogeriatric and Dementia consultation of "Cristobal Labra" Polyclinic from July to December 2011. The data were collected from medical records. For the diagnosis of the pathology, the Yesavage and the Folstein Mini Mental tests were applied.Results: depression was diagnosed in a 25 per cent of the elderly who were referred to the consultation. This condition increased with age, low educational levels and the presence of diseases such as osteoarthritis and sensory changes. The principal symptoms were sleep disturbances in men and sadness and crying in women. Traditional Herbal Medicine was used which reported good results in a 42.9 per cent of the patients.Conclusions: depression is a frequent entity which is sometimes misdiagnosed. The use of Traditional Herbal Medicine constitutes an alternative treatment for it

Prevalencia del síndrome demencial y la enfermedad de Alzheimer en pacientes del policlínico Pedro Fonseca / Prevalence of the dementia syndrome and Alzheimer's disease in patients from Pedro Fonseca polyclinic

Introducción: las demencias y enfermedad de Alzheimer constituyen un importante problema de salud con repercusión humana, social y económica en países con alta expectativa de vida. Objetivo: determinar la prevalencia del síndrome demencial y la enfermedad de Alzheimer en ancianos. Métodos: estudio descriptivo de corte transversal en ancianos pertenecientes al policlínico Pedro Fonseca, municipio La Lisa entre el 3 de enero y el 30 de diciembre de 2011. El universo de estudio estuvo constituido por 1 739 ancianos y se seleccionaron 312 que tenían 65 años o más y pertenecían al consultorio No. 6 del citado policlínico. Se excluyeron aquellos con historia de esquizofrenia, retraso mental, afasia, con terapia electroconvulsivante y otras enfermedades psiquiátricas. El diagnóstico de enfermedad de Alzheimer se realizó fundamentalmente mediante los Criterios de la Sociedad Psiquiátrica Americana. Todos los ancianos que conformaron la muestra o sus cuidadores manifestaron su disposición para participar en la investigación. Resultados: el síndrome demencial estuvo presente en 34 de los 312 ancianos, para una prevalencia de 10,8 porciento. Hubo un incremento de la prevalencia con la edad. Dentro del síndrome demencial, la mayor frecuencia correspondió a la demencia tipo Alzheimer probable, en 22 (64,7 porciento) pacientes. Conclusiones: la prevalencia del síndrome demencial y la enfermedad de Alzheimer es notable en los adultos mayores, lo que demuestra que estas enfermedades constituyen un importante problema de salud(AU)

Introduction: dementia and Alzheimer's disease constitute an important health problem with human, social and economic repercussion in countries with high life expectancies. Objectives: to determine the prevalence of the dementia syndrome and Alzheimer's disease in the elderly. Methods: a cross-sectional and descriptive study was conducted in the elderly population belonging to Pedro Fonseca polyclinic in Lisa municipality from January 3rd to December 30th, 2011. The universe of study was 1 739 old people, from whom 312 aged 65 years or more, cared for by the physician's office no. 6 of this polyclinic, were selected. Those old people with history of schizophrenia, mental retardation, other psychiatric diseases and under electroconvulsing therapy were excluded. Alzheimer's disease was diagnosed on the basis of the American Psychiatric Society criteria. All the aged people who made up this sample or their caregivers gave their consent to take part in this study. Results: dementia syndrome was present in 34 out of 312 participants for a prevalence rate of 10.8 percent. Prevalence increased with the age. The highest prevalence rate was observed in probable Alzheimer-type dementia found in 22 (64.7 percent) patients. Conclusions: the prevalence of dementia syndrome and Alzheimer's disease was significant in the older people, which demonstrated that these diseases pose an important health problem in the study area(AU)

Prevalencia del síndrome demencial y la enfermedad de Alzheimer en pacientes del policlínico Pedro Fonseca / Prevalence of the dementia syndrome and Alzheimer's disease in patients from Pedro Fonseca polyclinic

Introducción: las demencias y enfermedad de Alzheimer constituyen un importante problema de salud con repercusión humana, social y económica en países con alta expectativa de vida. Objetivo: determinar la prevalencia del síndrome demencial y la enfermedad de Alzheimer en ancianos. Métodos: estudio descriptivo de corte transversal en ancianos pertenecientes al policlínico Pedro Fonseca, municipio La Lisa entre el 3 de enero y el 30 de diciembre de 2011. El universo de estudio estuvo constituido por 1 739 ancianos y se seleccionaron 312 que tenían 65 años o más y pertenecían al consultorio No. 6 del citado policlínico. Se excluyeron aquellos con historia de esquizofrenia, retraso mental, afasia, con terapia electroconvulsivante y otras enfermedades psiquiátricas. El diagnóstico de enfermedad de Alzheimer se realizó fundamentalmente mediante los Criterios de la Sociedad Psiquiátrica Americana. Todos los ancianos que conformaron la muestra o sus cuidadores manifestaron su disposición para participar en la investigación. Resultados: el síndrome demencial estuvo presente en 34 de los 312 ancianos, para una prevalencia de 10,8 porciento. Hubo un incremento de la prevalencia con la edad. Dentro del síndrome demencial, la mayor frecuencia correspondió a la demencia tipo Alzheimer probable, en 22 (64,7 porciento) pacientes. Conclusiones: la prevalencia del síndrome demencial y la enfermedad de Alzheimer es notable en los adultos mayores, lo que demuestra que estas enfermedades constituyen un importante problema de salud

Introduction: dementia and Alzheimer's disease constitute an important health problem with human, social and economic repercussion in countries with high life expectancies. Objectives: to determine the prevalence of the dementia syndrome and Alzheimer's disease in the elderly. Methods: a cross-sectional and descriptive study was conducted in the elderly population belonging to Pedro Fonseca polyclinic in Lisa municipality from January 3rd to December 30th, 2011. The universe of study was 1 739 old people, from whom 312 aged 65 years or more, cared for by the physician's office no. 6 of this polyclinic, were selected. Those old people with history of schizophrenia, mental retardation, other psychiatric diseases and under electroconvulsing therapy were excluded. Alzheimer's disease was diagnosed on the basis of the American Psychiatric Society criteria. All the aged people who made up this sample or their caregivers gave their consent to take part in this study. Results: dementia syndrome was present in 34 out of 312 participants for a prevalence rate of 10.8 percent. Prevalence increased with the age. The highest prevalence rate was observed in probable Alzheimer-type dementia found in 22 (64.7 percent) patients. Conclusions: the prevalence of dementia syndrome and Alzheimer's disease was significant in the older people, which demonstrated that these diseases pose an important health problem in the study area

Caracterización clínica del hipotiroidismo en pacientes geriátricos Policlínico Pedro Fonseca. La Lisa, 2011 / A clinical characterization of hypothyroidism in geriatric patients Pedro Fonseca Polyclinic. La Lisa Municipality, 2011

Antecedentes: En los últimos decenios ha existido un aumento sostenido de la esperanza de vida en nuestro país con lo que las enfermedades crónicas no transmisibles han experimentado un incremento en su frecuencia en edades geriátricas. Objetivo: Identificar las principales manifestaciones clínicas y enfermedades crónicas asociadas en una cohorte de pacientes geriátricos hipotiroideos asistentes a la consulta de Medicina Interna del Policlínico Docente Pedro Fonseca durante el año 2011.Métodos: Se hizo un estudio descriptivo, retrospectivo y transversal de los pacientes que asistieron a la consulta de Medicina Interna desde enero hasta diciembre 2011, la información fue obtenida de las hojas de cargo, en planillas previamente diseñadas. Universo de estudio 972 gerontes. Se estudiaron las siguientes variables: edad, sexo, así como las manifestaciones clínicas más frecuentes y las enfermedades crónicas asociadas: Diabetes mellitus, hipertensión arterial, cardiopatía isquémica, dislipidemia, obesidad, EPOC y osteoartrosis. A partir de una hoja de cálculo Excel 2007, se establece la frecuencia por sexos de las variables estudiadas. Resultados: Existe una disminución del hipotiroidismo asociado al factor edad predominando el sexo femenino, así como síntomas de mayor referencia fueron: decaimiento, trastornos del sueño, dolores articulares y la depresión como síntomas comunes. Las dislipidemia y la osteoartrosis fueron las enfermedades crónicas que con mayor frecuencia se asocian al hipotiroidismo en nuestra cohorte de estudio. Conclusiones: La dislipidemia y la osteoartrosis son las enfermedades crónicas que más se asocian al hipotiroidismo y la astenia y los trastornos del sueño como manifestaciones clínicas más relevantes en la cohorte estudiada(AU)

Antecedents: There has been an increasing rate of the life hope in our country so no transmissible chronic diseases have been increasing their frequency in geriatric ages. Objectives: Identify the main clinical manifestations and chronic diseases associated in a cohort of hypothyroidism geriatric patients who attended the internal medicine outpatient consulting room at "Pedro Fonseca" polyclinic during 2011. Patients and methods: It was made a descriptive, retrospective and transversal study in geriatric patients who attended the internal medicine outpatient consulting room since January to December, 2011. Data of the patients were taken from the outpatient attendance daily register and tranferred to a previous designed model. The sample included 972 geriatric patients and the following variables were studied: Age, gender, main clinic manifestations and associated chronic diseases such as Diabetes Mellitus, hypertension, heart diseases, lipid disorders, obesity, chronic obstruction lung diseases and osteoarthritis. The frequency by gender (expressed in percents) of all variables was calculated by using an excel program. Results: There is a reducing rate of hypothyroidism associated to age and female sex as well as weakness, sleeping disorders, joins pain and depress like main symptoms. Lipid disorder and osteoarthritis were the most common chronic diseases associated to hypothyroidism in our studied cohort. Conclusions: Lipid disorders and osteoarthritis were the chronic diseases more associated to hypothyroidism. Weakness and sleeping disorders were the most relevant manifestations in the sample studied(AU)

Caracterización clínica del hipotiroidismo en pacientes geriátricos Policlínico Pedro Fonseca. La Lisa, 2011 / A clinical characterization of hypothyroidism in geriatric patients Pedro Fonseca Polyclinic. La Lisa Municipality, 2011

Antecedentes: En los últimos decenios ha existido un aumento sostenido de la esperanza de vida en nuestro país con lo que las enfermedades crónicas no transmisibles han experimentado un incremento en su frecuencia en edades geriátricas. Objetivo: Identificar las principales manifestaciones clínicas y enfermedades crónicas asociadas en una cohorte de pacientes geriátricos hipotiroideos asistentes a la consulta de Medicina Interna del Policlínico Docente Pedro Fonseca durante el año 2011. Métodos: Se hizo un estudio descriptivo, retrospectivo y transversal de los pacientes que asistieron a la consulta de Medicina Interna desde enero hasta diciembre 2011, la información fue obtenida de las hojas de cargo, en planillas previamente diseñadas. Universo de estudio 972 gerontes. Se estudiaron las siguientes variables: edad, sexo, así como las manifestaciones clínicas más frecuentes y las enfermedades crónicas asociadas: Diabetes mellitus, hipertensión arterial, cardiopatía isquémica, dislipidemia, obesidad, EPOC y osteoartrosis. A partir de una hoja de cálculo Excel 2007, se establece la frecuencia por sexos de las variables estudiadas. Resultados: Existe una disminución del hipotiroidismo asociado al factor edad predominando el sexo femenino, así como síntomas de mayor referencia fueron: decaimiento, trastornos del sueño, dolores articulares y la depresión como síntomas comunes. Las dislipidemia y la osteoartrosis fueron las enfermedades crónicas que con mayor frecuencia se asocian al hipotiroidismo en nuestra cohorte de estudio. Conclusiones: La dislipidemia y la osteoartrosis son las enfermedades crónicas que más se asocian al hipotiroidismo y la astenia y los trastornos del sueño como manifestaciones clínicas más relevantes en la cohorte estudiada.

Antecedents: There has been an increasing rate of the life hope in our country so no transmissible chronic diseases have been increasing their frequency in geriatric ages. Objectives: Identify the main clinical manifestations and chronic diseases associated in a cohort of hypothyroidism geriatric patients who attended the internal medicine outpatient consulting room at "Pedro Fonseca" polyclinic during 2011. Patients and methods: It was made a descriptive, retrospective and transversal study in geriatric patients who attended the internal medicine outpatient consulting room since January to December, 2011. Data of the patients were taken from the outpatient attendance daily register and tranferred to a previous designed model. The sample included 972 geriatric patients and the following variables were studied: Age, gender, main clinic manifestations and associated chronic diseases such as Diabetes Mellitus, hypertension, heart diseases, lipid disorders, obesity, chronic obstruction lung diseases and osteoarthritis. The frequency by gender (expressed in percents) of all variables was calculated by using an excel program. Results: There is a reducing rate of hypothyroidism associated to age and female sex as well as weakness, sleeping disorders, joins pain and depress like main symptoms. Lipid disorder and osteoarthritis were the most common chronic diseases associated to hypothyroidism in our studied cohort. Conclusions: Lipid disorders and osteoarthritis were the chronic diseases more associated to hypothyroidism. Weakness and sleeping disorders were the most relevant manifestations in the sample studied.

Violencia sobre personas de la tercera edad con demencia Policlínico Cristóbal Labra Lisa. 2010 / Violence on old persons with dementia Policlínico Cristóbal Labra Lisa. 2010

Introducción: las demencias son enfermedades degenerativas que afectan a 35.6 millones de personas en el mundo y a más de 100 000 en Cuba; constituyen un acontecimiento vital estresante y hacen al anciano muy dependiente de otros y, por tanto, presa fácil de violencia. Objetivo: caracterizar los pacientes con demencia, según grupos de edades, sexo y nivel educacional, manifestaciones clínicas e identificar las conductas violentas, ejercidas sobre ellos, en la consulta de demencia y de terreno durante marzo a agosto de 2010. Material y Método: se realizó un estudio descriptivo desde el 1ero de marzo al 31 de agosto de 2010, en la consulta de demencia y/o en terreno pertenecientes al Policlínico Cristóbal Labra. La información se obtuvo mediante la aplicación de los siguientes instrumentos: Miniexamen del estado mental del anciano, criterios del DSM-IV, la escala de Zarit, Yasavage y la aplicación de una encuesta creada por la autora. Se utilizaron variables cuantitativas y cualitativas; los datos se recogieron en una planilla previamente diseñada y se procesaron de forma automatizada. Los resultados se mostraron en tablas y/o gráficos, y se calcularon medidas de resumen (frecuencias absolutas y porcentajes).Resultados: la demencia se relacionó con aumento de la edad, sexo femenino y menor grado de escolaridad. Los principales síntomas que generaron violencia fueron la pérdida de memoria e insomnio, predominó la Violencia Psicológica; las hijas fueron las principales maltratadoras. Conclusión: la demencia en adultos mayores constituyó un factor estresante generador de violencia en los cuidadores(AU)

Introduction: the violence against the older persons is not a recent, it has been producing since many time ago, it real number is unknow. The dementia is a neurodegenerative disorders, already 35.6 millones of persons in the world and more of 100 000 en Cuba are afected by this pathology. The dementias are an important cause of violence because it produced a big uncapacity physical and intellectual. Objetives: caractherize pacient with dementia, by age, educacional level and sex, know mainly symptoms that produce violence in their mainly parent, diferents types of violences, principle clinical symptoms of psicologycal violence, persons responsible of injuries. Material and Methods: we made a descriptive estudies, since march 1er to agust 31, 2010 about the behavior of the violence on this kind of pacients and it relation with their parent. We used Minimental de Folstein, DSM-IV, Zarit, Yasavage test. Also we used the National Aging Resource Center of violence and the test made for the author. Results: dementias be increased in old patients, women were more afected, it incressed in patient with low educational level, symptoms more frequently found were: memory loss e insomny. The psychological violence was the principal type of violence found, the daughters had more violence behavior. Conclusion: the dementia on old persons produce a lot stress in persons that take care them(AU)

Violencia sobre personas de la tercera edad con demencia Policlínico Cristóbal Labra Lisa. 2010 / Violence on old persons with dementia Policlínico Cristóbal Labra Lisa. 2010

Introducción: las demencias son enfermedades degenerativas que afectan a 35.6 millones de personas en el mundo y a más de 100 000 en Cuba; constituyen un acontecimiento vital estresante y hacen al anciano muy dependiente de otros y, por tanto, presa fácil de violencia. Objetivo: caracterizar los pacientes con demencia, según grupos de edades, sexo y nivel educacional, manifestaciones clínicas e identificar las conductas violentas, ejercidas sobre ellos, en la consulta de demencia y de terreno durante marzo a agosto de 2010. Material y Método: se realizó un estudio descriptivo desde el 1ero de marzo al 31 de agosto de 2010, en la consulta de demencia y/o en terreno pertenecientes al Policlínico Cristóbal Labra. La información se obtuvo mediante la aplicación de los siguientes instrumentos: Miniexamen del estado mental del anciano, criterios del DSM-IV, la escala de Zarit, Yasavage y la aplicación de una encuesta creada por la autora. Se utilizaron variables cuantitativas y cualitativas; los datos se recogieron en una planilla previamente diseñada y se procesaron de forma automatizada. Los resultados se mostraron en tablas y/o gráficos, y se calcularon medidas de resumen (frecuencias absolutas y porcentajes). Resultados: la demencia se relacionó con aumento de la edad, sexo femenino y menor grado de escolaridad. Los principales síntomas que generaron violencia fueron la pérdida de memoria e insomnio, predominó la Violencia Psicológica; las hijas fueron las principales maltratadoras. Conclusión: la demencia en adultos mayores constituyó un factor estresante generador de violencia en los cuidadores.

Introduction: the violence against the older persons is not a recent, it has been producing since many time ago, it real number is unknow. The dementia is a neurodegenerative disorders, already 35.6 millones of persons in the world and more of 100 000 en Cuba are afected by this pathology. The dementias are an important cause of violence because it produced a big uncapacity physical and intellectual. Objetives: caractherize pacient with dementia, by age, educacional level and sex, know mainly symptoms that produce violence in their mainly parent, diferents types of violences, principle clinical symptoms of psicologycal violence, persons responsible of injuries. Material and Methods: we made a descriptive estudies, since march 1er to agust 31, 2010 about the behavior of the violence on this kind of pacients and it relation with their parent. We used Minimental de Folstein, DSM-IV, Zarit, Yasavage test. Also we used the National Aging Resource Center of violence and the test made for the author. Results: dementias be increased in old patients, women were more afected, it incressed in patient with low educational level, symptoms more frequently found were: memory loss e insomny. The psychological violence was the principal type of violence found, the daughters had more violence behavior. Conclusion: the dementia on old persons produce a lot stress in persons that take care them.

Comportamiento de la incapacidad parcial permanente dictaminada por la comisión de peritaje médico laboral de La Lisa en el período 2009-2010 / Behavior of permanent partial disability audited by the medical and occupational expert commission of La Lisa. 2009-2010

Nuestro gobierno revolucionario, desde su triunfo en 1959, ha estado formulado leyes que tienen como fin proteger al trabajador, o sea, no dejarlo desamparado bajo ninguna circunstancia ni a él ni a su familia en caso de que el mismo pudiera enfermarse. Se realiza un estudio descriptivo y retrospectivo de los casos de incapacidad parcial permanente dictaminados en el periodo de 2009-2010 por la comisión de peritaje médico laboral del municipio La Lisa ; el universo fue de 196 casos. La información fue obtenida de los modelos oficiales de dictámenes de peritaje médico laboral, los cuales se recogieron en planillas previamente diseñadas. Se seleccionaron las variables sexo y grupos de edad. Se hallaron porcentajes. El objetivo de nuestro trabajo fue conocer el comportamiento de la invalidez parcial permanente, siendo los principales resultados que la incapacidad parcial permanente ocupó más del 50 por ciento de los 103 tramitados; el sexo femenino fue el que más casos reportó; el grupo de edad más afectado fue el de 50-59 años; y las especialidades que más aportaron casos fueron la de medicina interna y ortopedia. Dentro de la especialidad de medicina interna, las afecciones más frecuentes fueron la cardiopatía isquémica, la hipertensión arterial y la diabetes Mellitus, y dentro de ortopedia, las fracturas, seguidas de la espondiloartrosis(AU)

Development of a rapid immunochromatographic test for simultaneous serodiagnosis of bovine babesioses caused by Babesia bovis and Babesia bigemina.

With the objective of developing a simpler diagnostic alternative, a rapid immunochromatographic test (BoiICT) was constructed for the simultaneous detection of Babesia bovis- and Babesia bigemina-specific antibodies using B. bovis recombinant merozoite surface antigen-2c and B. bigemina recombinant rhoptry-associated protein-1. The BoiICT selectively detected specific antibodies to B. bovis and B. bigemina. All sera from cattle infected with other protozoan parasites (i.e., Cryptosporidium parvum, Neospora caninum, and Theileria orientalis) showed negative results in the BoiICT. The relative sensitivity and specificity for detecting antibody to B. bovis were 96.7% (29 of 30) and 91.3% (73 of 80), respectively. The relative sensitivity and specificity for detecting antibody to B. bigemina were 96.7% (29 of 30) and 92.5% (74 of 80), respectively. These findings indicate that the BoiICT is useful for fast field diagnostic assessment of bovine babesioses without any laboratory equipment.

Diagnostic real-time PCR assay for the quantitative detection of Theileria equi from equine blood samples.

We developed a TaqMan real-time polymerase chain reaction (PCR) assay for the quantitative detection of Theileria equi from the in vitro-cultured parasite and field blood samples collected from horses living in Ghana and Brazil. The detection limit for the assay was determined to be 1.5 parasites/microl per sample, and the quantitative capacity was demonstrated using the in vitro-cultured parasite. For field applications, the real-time PCR assay was compared to a previously established nested PCR assay used as the gold standard for the real-time PCR assay. Of 65 field blood samples, 46 samples were T. equi-positive in the nested PCR assay, while the real-time PCR assay also detected the parasite in all 46 of the nested PCR-positive samples but did not detect T. equi in the remaining 19 negative blood samples. This quantitative real-time PCR assay provides a valuable tool for fast laboratory diagnostic assessment of T. equi infection in horses.

Daños que produce el alcohol etílico en pacientes con dependencia alcohólica / Injuries caused by ethylic alcohol on patients who suffer from alcoholic dependence

Se realizó un estudio descriptivo y de no intervención a los pacientes que acudieron al Centro Comunitario de Salud Mental del municipio Güira de Melena durante 2007, con el objetivo de identificar los daños orgánicos (esteatosis hepática, hepatitis alcohólica, cirrosis hepática, miocardiopatía y arritmias) y psicológicos (depresión, ideas suicidas, violencia, ansiedad, trastornos del sueño y psicosis), que el alcohol etílico produce en la dependencia alcohólica. La muestra quedó conformada por 89 pacientes, 61 hombres y 28 mujeres mayores de 20 años de edad; los criterios de inclusión fueron: cumplir con el Glosario Cubano- 3 para el diagnóstico de dependencia alcohólica y tener antecedentes de salud física y mental. La dependencia alcohólica predominó en el sexo masculino, en las edades de 44 y 49 y en el estado civil soltero. El daño hepático y la depresión fueron los principales daños detectados en los 2 sexos, el tiempo de exposición al alcohol etílico en las edades de 22 a 27 años fue el más significativo(AU)

The study was descriptive and of non intervention in the patients that went to the Guira Community Center of Mental Health, Havana province during the whole year 2007, with the objective of identifying those organic damages (Esteatosis Liverwort, Alcoholic Hepatitis, Hepatic Cirrhosis Miocardiopatia and Arrhythmias) and Psychological (Depression, Suicidal Ideas, Violence, Anxiety, Dysfunctions of the Dream and Psychosis) that the ethylic alcohol produced in the Dependence Alcohólica.The total of patients was 89, 61 man and 28 women bigger than 20 years of age and the inclusion approaches were to fulfil the Cuban Glossary - 3 for the diagnosis of Alcoholic Dependence and antecedents of physical and mental health. The Alcoholic Dependence prevailed in the masculine sex, in the ages between 44-49 and in the single state. The hepatic damage and the depression were the main ones damages detected in both sexes, the time of exhibition to the ethylic alcohol of 22-27 years it was the most significant(AU)