[Electrodiagnostic support in an atypical form of amyotrophic lateral sclerosis (Vulpian-Bernhardt syndrome)]. / Apoyo del electrodiagnóstico en una forma atípica de esclerosis lateral amiotrófica (síndrome de Vulpian-Bernhardt).

Background: Vulpian-Bernhardt syndrome is an atypical form of the motor neuron disease described since the 19th century. The importance of a timely diagnosis lies in the increased survival present in this variant. Due to the clinical rarity and complex diagnosis we report a clinical case of this disease, which is why we describe the typical clinical presentation, the diagnostic approach, and we make a bibliographic review of this neurodegenerative disorder as well. Clinical case: Latin American man whose clinical case onset was characterized by thoracic asymmetric and increasing limb weakness, showing affection from distal to proximal upper limbs area. Subsequently, symptoms worsened to the point of limiting day-to-day activities and conditioning patient's physical independence. Physical examination was consistent with motor neuron disease. Nerve conduction studies were performed and confirmed findings compatible with motor neuron involvement limited to thoracic limbs. Conclusion: Vulpian-Bernhardt syndrome is an uncommon form of motor neuron disease. Due to the rarity of its presentation, it is frequent to confuse clinical profile even for trained physicians. The importance of electrodiagnosis relies in identifying the neurogenic origin of the disease, as well as the active denervation and reinnervation data. Considering that with this syndrome patients have a longer survival than with the classic form of amyotrophic lateral sclerosis, it is important to have a clear diagnosis approach in order to provide a better quality of life and supportive treatment.

Introducción: el síndrome de Vulpian-Bernhardt es una forma atípica de la enfermedad de la motoneurona descrita desde el siglo XIX. La importancia de un diagnóstico oportuno radica en la mayor supervivencia que presenta esta variante. Debido a la rareza clínica y al diagnóstico complejo presentamos un caso clínico de esta enfermedad, por lo que describimos el cuadro clínico típico, el abordaje diagnóstico y hacemos una revisión bibliográfica de este trastorno neurodegenerativo. Caso clínico: hombre de origen latinoamericano que comenzó su padecimiento con debilidad de miembros torácicos, asimétrica y progresiva de distal a proximal. Los síntomas progresaron hasta limitar sus actividades de la vida diaria y su independencia física. La exploración física fue compatible con enfermedad de motoneurona. Se hicieron estudios de extensión y neuroconducción que confirmaron hallazgos compatibles con afectación en motoneurona limitada a miembros torácicos. Conclusión: el síndrome Vulpian-Bernhardt es una forma clínica poco común. Debido a su rareza, es fácil confundir el cuadro clínico, incluso por parte de experimentados. La importancia del electrodiagnóstico radica en identificar el origen neurogénico de la enfermedad, los datos de denervación activa y reinervación. Al ser una forma en la que se presenta una supervivencia mayor que en la forma clásica, es importante el diagnóstico claro para dar una mejor calidad de vida y tratamiento de soporte.

3D printed ventilation tubes and their effect on biological models.

BACKGROUND: Acute otitis media (AOM) causes inflammation and hearing loss. Ventilation tubes are key in treatment. 3D printing improves prostheses in otorhinolaryngology, offering precision and greater adaptability. MATERIALS AND METHODS: An experimental study was conducted with Wistar rats from July to December 2020. 3D tympanostomy tube models were designed, with technical specifications and tests performed on inexpensive 3D printers. The tympanostomy tube was inserted endoscopically. RESULTS: Procedures were performed on five rats with implants in both ears. Pre-intervention pathologies, such as atical retraction and glue ear, were found. The PLA-printed tympanostomy tube showed improvement after adjustments. Histopathological results revealed significant middle and inner ear damage. CONCLUSION: In our study, the design and 3D printing of implants fulfilled the desired functions when modified, with a height of 5 mm. Complications included PLA degradation and ear damage. There were no adverse events during observation, highlighting the need for further research on 3D-printed implants.

Electroacupuncture efficacy in diabetic polyneuropathy: Study protocol for a double-blinded randomized controlled multicenter clinical trial.

BACKGROUND: Diabetic peripheral neuropathy (DPN) is the most common complication of type 2 diabetes mellitus (T2DM); its diagnosis and treatment are based on symptomatic improvement. However, as pharmacological therapy causes multiple adverse effects, the implementation of acupunctural techniques, such as electroacupuncture (EA) has been suggested as an alternative treatment. Nonetheless, there is a lack of scientific evidence, and its mechanisms are still unclear. We present the design and methodology of a new clinical randomized trial, that investigates the effectiveness of EA for the treatment of DPN. METHODS: This study is a four-armed, randomized, controlled, multicenter clinical trial (20-week intervention period, plus 12 weeks of follow-up after concluding intervention). A total of 48 T2DM patients with clinical signs and symptoms of DPN; and electrophysiological signs in the Nerve Conduction Study (NCS); will be treated by acupuncture specialists in outpatient units in Mexico City. Patients will be randomized in a 1:1 ratio to one of the following four groups: (a) short fibre DPN with EA, (b) short fibre DPN with sham EA, (c) axonal DPN with EA and (d) axonal DPN with sham EA treatment. The intervention will consist of 32 sessions, 20 min each, per patient over two cycles of intervention of 8 weeks each and a mid-term rest period of 4 weeks. The primary outcome will be NCS parameters, and secondary outcomes will include DPN-related symptoms and pain by Michigan Neuropathy Screening Instrument (MNSI), Michigan Diabetic Neuropathy Score (MDNS), Dolour Neuropatique Score (DN-4), Semmes-Westein monofilament, Numerical Rating Scale (NRS) for pain assessment, and the 36-item Short Form Health Survey (SF-36). To measure quality of life and improve oxidative stress, the inflammatory response; and genetic expression; will be analysed at the beginning and at the end of treatment. DISCUSSION: This study will be conducted to compare the efficacy of EA versus sham EA combined with conventional diabetic and neuropathic treatments if needed. EA may improve NCS, neuropathic pain and symptoms, oxidative stress, inflammatory response, and genetic expression, and it could be considered a potential coadjutant treatment for the management of DPN with a possible remyelinating effect. TRIAL REGISTRATION: ClinicalTrials.gov. NCT05521737 Registered on 30 August 2022. International Clinical Trials Registry Platform (ICTRP) ISRCTN97391213 Registered on 26 September 2022 [2b].

Escala de Motivação para Aprendizagem em Universitários: Versão Breve / Learning Motivation in Higher Education Scale: Brief Version / Escala de Motivación para el Aprendizaje en Universitarios: Versión Abreviada

A avaliação da motivação para aprender é um aspecto relevante em contextos educacionais, pois a motivação pode influenciar o engajamento dos estudantes, sua aprendizagem e seu desempenho em tarefas acadêmicas. O objetivo deste estudo foi propor uma versão breve da Escala de Motivação para Aprendizagem em Universitários (EMAPRE-U Breve). A EMAPRE-U é uma escala de 28 itens que avalia três dimensões motivacionais: meta aprender, meta performance-aproximação e meta performance-evitação. Participaram do estudo 525 universitários do primeiro ano de graduação de uma universidade pública. Através de análises fatoriais exploratórias e de conteúdo dos itens chegou-se a uma versão com 15 itens. Análises fatoriais confirmatórias e de correlação com construtos relacionados forneceram evidências de validade para a medida breve, e indicaram um bom ajuste dos dados ao modelo trifatorial. Os resultados sugerem que o instrumento tem o potencial de contribuir para a avaliação da motivação para aprendizagem na educação superior, ainda que aprimoramentos possam ser feitos no futuro.

The assessment of motivation to learn is a relevant aspect in educational contexts as motivation can influence student engagement, learning, and performance in academic tasks. The aim of this study was to propose a brief version of the Motivation Scale for Learning in University Students (EMAPRE-U Brief). The EMAPRE-U is a 28-item scale that assesses three motivational dimensions: the learning goal, the performance-approach goal, and the performance-avoidance goal. The study included 525 first-year undergraduate students at a public university. Through exploratory factor analysis and item content analysis, a 15-item version was developed. Confirmatory factor analysis and correlation with theoretically related constructs provided evidence of validity for the brief measure and indicated a good fit of the data to the three-factor model. The results suggest that the instrument has the potential to contribute to the assessment of motivation for learning in higher education, although improvements could be made in the future.

La evaluación de la motivación para aprender es un aspecto relevante en los contextos educativos, ya que la motivación puede influir en el compromiso, aprendizaje y desempeño del estudiante en las tareas académicas. El objetivo de este estudio fue proponer una versión breve de la Escala de Motivación para el Aprendizaje en Estudiantes Universitarios (EMAPRE-U Brief). La EMAPRE-U es una escala de 28 ítems que evalúa tres dimensiones motivacionales: metas de aprendizaje, metas de aproximación al rendimiento y metas de evitación del rendimiento. El estudio incluyó a 525 estudiantes de primer año de pregrado de una universidad pública. A través del análisis factorial exploratorio y el contenido de los ítems, se llegó a una versión de 15 ítems. Los análisis factoriales confirmatorios y las correlaciones con constructos relacionados proporcionaron evidencia de validez para la versión breve, e indicaron un buen ajuste de los datos al modelo de tres factores. Los resultados sugieren que el instrumento tiene el potencial de contribuir a la evaluación de la motivación para el aprendizaje en la educación superior, aunque podrían realizarse mejoras en el futuro.

Insights into the genetic spatial structure of Nicaraguan weedy rice and control of its seed spread.

BACKGROUND: The genetic backgrounds and occurrence patterns of weedy rice (WR, Oryza sativa) are highly diverse, and so are the challenges facing its control among countries. WR control is difficult because it is similar to cultivated rice and manual removal is one of the few options for control. Understanding the ecology of WR will aid efforts to break its life cycle and establish long-term management strategies under both irrigated and rainfed systems. RESULTS: Nicaraguan WR (NWR) plants were genetically closer to the AUS and Indica pools in terms of to genetic distance. A map of admixture coefficients suggested a pattern of long-distance dispersal and spread of NWR across Nicaragua, which has likely been facilitated by commercial activities and sharing of harvesting equipment between border cities or important trading ports and inland regions. Moreover, the NWR plants from the soil seedbank in irrigated regions showed different habitats and lower grain number per panicle compared with plants spread by seed-mediated contamination. In addition, grain indexes showed that length-to-width ratio was a better indicator than awn length for distinguishing between NWR and Nicaraguan Indica cultivars. CONCLUSION: Analysis of the population structure and habitats of NWR revealed five clusters derived from seed-mediated contamination in rainfed upland regions, plants from the soil seedbank in irrigated double-cropping regions, and pollen-mediated contamination across both regions. Field weed management before harvesting and seed purification based on the length-to-width ratio can be conducted to improve the efficiency of long-term control of WR in Nicaragua. © 2022 Society of Chemical Industry.

Dermatomyositis post vaccine against SARS-COV2.

BACKGROUND: Dermatomyositis belongs to an infrequent group of diseases predominantly found in patients older than 40 years old and is characterized by dermal and muscular findings. This disease presents itself as proximal, ascending and symmetric weakness and typical dermatosis with findings such as elevated muscle enzymes, altered electromyography and typical changes in muscle biopsy; as of today, the etiology of the disease in unknown. The COVID-19 vaccine has been a fundamental tactic to achieve control of the coronavirus (SARS CoV2), and it's clear that the benefits of getting the vaccine overweight the risks that might come along with it. Although rare, all adverse effects should be reported, this could help us to understand the elusive pathophysiology of inflammatory idiopathic myopathy. CASE PRESENTATION: In this text we will describe the case of a patient with dermatomyositis who was vaccinated against SARS CoV2 with BNT162b2 mRNA (Pfizer-BioNTech), showing a temporal relation between the vaccination and the beginning of her symptoms. We realized all the diagnostic approach to the suspected disease including electromyography, muscle biopsy and laboratory findings, corroborating the diagnosis. The patient received standard treatment for this disease (steroid therapy) and have a classic slow improvement. CONCLUSIONS: Although it´s not possible to confirm a direct correlation between the vaccine and the onset of the disease, we considered that there are enough data to suspect that this could be a trigger event and therefore should always be considered a possible cause for a case of inflammatory idiopathic myopathy.

Revolution in modern teaching in dentistry since the appearance of the COVID-19 pandemic: A review.

Dentistry schools have attempted to overcome the challenges imposed by the coronavirus disease 2019 (COVID-19) pandemic through teaching via the Internet with the use of virtual platforms, designed to simulate face-to-face interaction and counteract the social isolation affecting the integral development of students. This review searched the main health databases, including MEDLINE via PubMed, Scopus and LILACS, and selected 31 articles to proceed with the research. During the pandemic, platforms such as Facebook, Instagram, YouTube, Zoom, Google Meet, and other similar tools allowed teachers to develop dynamic slides and dental models to simulate procedures, which played an important role in the course of mainly theoretical classes. In addition, applications such as WhatsApp allowed the rapid acquisition and sharing of useful information on a specific topic. While virtual resources facilitate the learning process through generating interest as well as providing accurate, necessary, valuable, and easily accessible information, which is constantly updated, the disadvantages of remote learning include the lack of instruments, infrastructure and materials, apart from supervision, to promote personal development and progressive evolution to directly treat patients. Another issue with regard to virtual learning is whether within a short period of time students can achieve a comparable level of practical skills as in the case of the conventional learning. In conclusion, the current pandemic has changed not only the use of technology in education, but also educational strategies for the future.

[Optical and mechanical properties of translucent zirconium as an optimal restorative material in fixed prosthesis: A review of the literature]. / Propiedades ópticas y mecánicas del zirconio translúcido como material restaurador óptimo en prótesis fija: Una revisión de la literatura.

Introduction: The main consequence of not treating tooth decay in time is the total or partial loss of the tooth. One of the alternatives to replace the lost tooth and return the functions is through fixed prostheses. Today there are 3 generations of yttrium-stabilized zirconium polycrystals (Y-TZP). Seeing that in the third Generation the yttrium content was increased to approximately 5% in moles (5Y), stabilizing the materials approximately 50% of cubic phase and 50% of tetragonal phase, thus giving a translucent zirconium (5Y) with a high aesthetics and greater naturalness to the dental crown. Objective: To identify the different optical and mechanical properties of translucent zirconium compared to other restorative materials used in fixed prostheses. Materials and methods: This narrative review evaluated 115 scientific articles from the Medline information sources (via PubMed), Science Direct, Scopus, SciELO and LILACS from the last 5 years, published in Spanish, Portuguese and English. We included 51 articles that met the selection criteria which were randomized clinical trials and observational studies, in vitro studies and in vivo studies that evaluated the optical and mechanical properties of translucent zirconium as an optimal restorative material in fixed prostheses. We excluded systematic reviews, case reports and editorials. Results: It was observed that zirconium being a relatively new material and in constant evolution has studies mostly in vitro, among which stand out those that speak both of the mechanical and optical properties that vary depending on the generation to which the material belongs, as well as the adhesiveness of the material which is for now not viable, therefore, it is essential that more studies be carried out on this material. Conclusions: We can mention that zirconium has evolved over time, providing better optical properties, but as a consequence it has been reducing flexural strength and fracture toughness. However, this material provides good biocompatibility with oral structures. On the other hand, translucent zirconium according to studies is a non-recordable material, so new methods are sought to improve its adhesion.

Toxoplasmosis Is More Frequent in Schizophrenia Patients Than in the General Population in Mexico and Is Not Associated with More Severe Course of Schizophrenia Measured with the Brief Psychiatric Rating Scale.

Toxoplasmosis is a disease, which was discovered in 1908, caused by the intracellular parasite Toxoplasma gondii. T. gondii infects neuronal, glial, and muscle cells, and chronic infections are characterized by the presence of cysts, in the brain and muscle cells, formed by bradyzoites. T. gondii is capable of synthesizing L-DOPA, a precursor of dopamine. Dopamine is a neurotransmitter that is key in the etiology of neuropsychological disorders such as schizophrenia. Previous studies have shown high levels of IgG Toxoplasma antibodies in schizophrenia patients. Many published studies show that the prevalence of toxoplasmosis is higher in schizophrenia patients. In this study, we aimed to identify the prevalence of Toxoplasma infection in patients with schizophrenia and the relationships between, sociodemographic factors and the Brief Psychiatric Rating Scale. A total of 27 schizophrenic patients were included and IgG anti-T. gondii was determined in serum samples by ELISA. The Brief Psychiatric Rating Scale, sociodemographic factors were associated with seropositivity. We found that the prevalence of Toxoplasma antibodies was 51.7%. In the Brief Psychiatric Rating Scale, statistical significant association (p = 0.024) was found in Item 13 which is related to motor retardation, however, the association turned non-significant after of correction for multiple tests or after of analyzed with a logistic regression p = 0.059, odds ratio (OR) = 2.316 with a 95% confidence interval [0.970 to 5.532]. Other association was not found between toxoplasmosis and others factors. The prevalence of toxoplasmosis on our population under study was significantly higher than that reported by general population or other group of Mexican schizophrenia patients.

Prevención de riesgo psicosocial en adolescentes: el rol de los Centros de Día de Menores en España / Prevention of psychosocial risk in adolescents: The role of Community Youth Centers in communities in Spain / Prevenção do risco psicossocial em adolescentes: O papel dos Centros de Dia Juvenis em Espanha

Resumen (analítico) El artículo analiza la función de los Centros de Día de Menores (CDM) como recursos especializados en la intervención socioeducativa con adolescentes en riesgo. Se trata de una investigación cualitativa, en la que se han integrado diferentes técnicas con el fin de triangular evidencias objetivas. En el plano metodológico participó una muestra de 30 profesionales, implementando diferentes técnicas: entrevistas y grupos de discusión. Los datos obtenidos se codificaron y categorizaron. Los resultados destacan la especificidad de los CDM como recurso de proximidad en el proceso de socialización y de acompañamiento progresivo, individualizado y flexible de adolescentes en riesgo. Las conclusiones inciden en la especialización del recurso en la atención a adolescentes que atraviesan procesos vitales complejos y en la consolidación del recurso como alternativa socioeducativa a la educación formal, utilizando en el territorio como generador de oportunidades.

Abstract (analytical) The article analyzes the role of Community Youth Centers (CDMs for their initials in Spanish) as a specialized resource for socio-educational interventions with at-risk adolescents. This is a qualitative investigation in which different techniques have been integrated in order to triangulate objective evidence. At the methodological level, 30 staff participated in different data collection processes (two discussion groups as well as semi-structured interviews). The data obtained was codified and categorized. The results highlight the specificity of the CDMs as an available resource for the process of socialization and the provision of gradual, progressive, individualized and flexible accompaniment to at-risk adolescents. The conclusions of the study recommend the specialization of the CDMs to support adolescents who are experiencing complex life processes and the consolidation of these centers as a socio-educational alternative that generates opportunities.

Resumo (analítico) O artigo analisa o papel desenvolvido pelos Centros de Dia de Menores (CDM) na intervenção socioeducativa com adolescentes em risco. Tratase de uma investigação qualitativa, na qual diferentes técnicas foram implementadas para triangular evidências objetivas. Ao nível metodológico, 30 profissionais participaram em grupos de discussão e entrevistas semiestruturadas. Os resultados destacam a especificidade do CDM como um recurso de proximidade no acompanhamento gradual, progressivo, individualizado e flexível de adolescentes em risco. As conclusões incidem sobre a especialização deste recurso na educação de adolescentes nos seus processos de vida complexos e na sua consolidação como alternativa socioeducativa à educação formal.

Infected hepatic echinococcosis. Clinical, therapeutic, and prognostic aspects. A systematic review.

Infected hepatic echinococcosis (IHE), defined as a cystic infection, and the development of a liver abscess may be a complication in the natural history of hepatic echinococcosis. The aim of this study was to review the evidence available related to clinical, therapeutic, and prognostic aspects of IHE. We conducted a systematic review. Trip Database, BIREME-BVS, SciELO, LILACS, IBECS, PAHO-WHO; WoS, EMBASE, SCOPUS and PubMed were consulted. Studies related to IHE in humans, without language restriction, published between 1966 and 2020 were considered. Variables studied were publication year, geographical origin of the samples, number of patients, therapeutic and prognosis aspects, and methodological quality (MQ) for each article. Descriptive statistics was applied. Subsequently, weighted averages (WA) of the MQ of each article were calculated for each variable of interest. 960 related articles were identified; 47 fulfilled selection criteria, including 486 patients with a median age of 48 years, 51.6% being male. The largest proportion of articles were from Spain, India, and Greece (36.1%). Mean cyst diameter was 14.1 cm, and main location was right liver lobe (74.0%). WA for morbidity, mortality, hospital stay, and follow-up were 28.5%, 7.4%, 8.5 days and 14.8 months, respectively. The most common causative microorganisms of superinfection isolated were Enterobacteriaceae. An association with cholangitis was reported in 13.4% of cases. Mean MQ of the 47 articles included was 7.6 points. We can conclude that the information related to IHE is scarce and scattered throughout articles of small casuistry and poor quality, and consequently does not provide strong evidence.

Association between Burnout Syndrome and medical training by specialty in first-year residents / Síndrome de burnout en residentes de primer año: asociación por especialidad

Abstract Introduction Burnout syndrome (BOS) comprises emotional exhaustion, depersonalization, and reduced personal accomplishment in those affected. Instruments such as the Maslach Burnout Inventory (MBI) can help to identify those affected. Physicians in training have been described as an at-risk group for this syndrome. Objective Describe the association between BOS and medical training by specialty in first-year residents. Method This is a cross-sectional analytical study of specialty residents at the Hospital Civil de Guadalajara. Sociodemographic data were obtained and the MBI was administered to identify BOS. Samples were compared, and a comparative analysis performed to identify factors associated with BOS. Results Eighty-eight residents were included, with 21.6% (n = 19) presenting BOS, 53.4% displaying emotional exhaustion (n = 47), 53.7% showing depersonalization (n = 47), and 39.8% reduced personal accomplishment (n = 35). Presenting BOS was not associated with sociodemographic characteristics or type of specialty. Work hours (ro = .229, p = .032), and a higher number of on-call hours/week (ro = .34, p = .001) were associated with higher BOS. Discussion and conclusion The prevalence of BOS was lower than expected. Over half scored for emotional exhaustion and depersonalization, which could be explained by a self-reporting bias. There was no association between the group/type of specialty and BOS. This study creates new knowledge that works as an institutional situational diagnosis, helps to determine the scope of the problem, and encourages to consider the contributing factors to its origin and maintenance.

Resumen Introducción El síndrome de burnout (SBO) comprende el agotamiento emocional, la despersonalización y la reducción de la realización personal en aquellos a quienes afecta. Instrumentos como el Maslach Burnout Inventory (MBI) pueden ayudar a identificar a los afectados. Los médicos en formación se han descrito como un grupo de riesgo para presentar este síndrome. Objetivo Describir la asociación entre el síndrome de burnout y la formación médica por especialidad en residentes de primer año. Método Se trata de un estudio analítico transversal de residentes de especialidad del Hospital Civil de Guadalajara. Se obtuvieron datos sociodemográficos y se administró el MBI para identificar SBO. Se compararon las muestras y se realizó un análisis comparativo para identificar los factores asociados con SBO. Resultados Se incluyeron 88 residentes, con 21.6% (n = 19) presentando SBO; 53.4% mostrando agotamiento emocional (n = 47); 53.7% (n = 47) mostrando despersonalización; y 39.8% (n = 35) reducción de realización personal. La presentación de SBO no se asoció a características sociodemográficas ni al tipo de especialidad. Las horas de trabajo (ro = .229, p = .032) y un mayor número de horas de guardia/semana (ro = .34, p = .001) se asociaron con una mayor BOS. Discusión y conclusión La prevalencia de SBO fue menor de lo esperado. Más de la mitad puntuó por agotamiento emocional y despersonalización, lo que podría explicarse por un sesgo en la autoevaluación. No hubo asociación entre el grupo/tipo de especialidad y SBO. Este estudio genera nuevos conocimientos que funcionan como un diagnóstico situacional institucional, ayuda a determinar el alcance del problema y alienta a considerar los factores que contribuyen a su origen y mantenimiento.

Morphological characteristics of liver abscesses according its etiology / Características morfológicas de los abscesos hepáticos según su etiología

Although infrequent in the diagnostics areas, liver abscesses are of significant relevance, which is related to the high morbidity and mortality figures they can cause if they are not detected and treated in time. Although multiple operational classifications are described, the one most recognized for its usefulness is that related to its causative agent (pyogenic or bacterial infection, hydatid origin or secondary to infected hydatidosis, and amoebic or by invasive amebiasis). The objective of this article was to generate a study report regarding the morphological characteristics of liver abscesses, characterizing them according to their etiology, as well as describing their study and the latest recommended treatments.

Los abscesos hepáticos son entidades nosológicas de baja frecuencia, pero de significativa relevancia, la que se relacionada con las elevadas cifras de morbilidad y mortalidad que pueden causar si no son detectados y tratados a tiempo. Si bien se describen múltiples clasificaciones operacionales, aquella más reconocida por su utilidad es la relacionada a su agente causal (piógenos o bacterianos, hidatídicos o secundarios a hidatidosis infectada, y amebianos o por amebiasis invasora). El objetivo de este artículo fue generar un documento de estudio respecto de las características morfológicas de los abscesos hepáticos, caracterizándolos de acuerdo con su etiología, así como describir su estudio y tratamiento recomendado de acuerdo con el estado del arte.

Adaptation to brazilian portuguese of the O*Net Interests Profiler: Short Form / Adaptação ao português brasileiro do O*Net Interests Profiler: Short Form / Adaptación al portugués brasilero del O*Net Interests Profiler: Short Form

This study aimed to adapt to the Brazilian Portuguese the O*NET Interests Profiler - Short Form. The instrument evaluates vocational interests according to the RIASEC model, which includes six types (Realistic, Investigative, Artistic, Social, Enterprising, and Conventional). Validity evidence was obtained through Principal Components Analysis, Multidimensional Scaling, correlations between secondary concepts from the theoretical model, and contrasts between groups. PCA results, the contrasts between selected occupational groups and correlational results between secondary concepts followed the theoretical expectations. However, the MDS results did not fully confirm the hexagonal structure. Overall results suggest the adapted instrument has acceptable evidence of validity. Further studies are suggested to increase the suitability of the Brazilian version of the instrument.

O objetivo deste estudo foi adaptar o O*NET Interests Profiler - Short Form para o português brasileiro. O instrumento avalia interesses vocacionais de acordo com o modelo RIASEC, que inclui seis dimensões (Realista, Investigativo, Artístico, Social, Empreendedor e Convencional). As evidências de validade foram obtidas por meio da Análise de Componentes Principais, Escalonamento Multidimensional, correlações entre os conceitos secundários do modelo teórico e contrastes entre grupos ocupacionais. Os resultados da ACP, dos contrastes entre os grupos selecionados e dos resultados das correlações entre os conceitos secundários confirmaram as expectativas teóricas. No entanto, os resultados do EMD não confirmaram totalmente a estrutura hexagonal. Em geral, os resultados sugerem que o instrumento adaptado apressenta evidências aceitáveis de validade. Estudos adicionais são sugeridos para aumentar a adequação da versão brasileira do instrumento.

Este estudio tuvo como objetivo adaptar al portugués brasileño el O*NET Interests Profiler - Short Form. El instrumento evalúa los intereses vocacionales de acuerdo con el modelo RIASEC, que incluye seis dimensiones (Realista, Investigativo, Artístico, Social, Emprendedor y Convencional). Las evidencias de validez se obtuvieron mediante Análisis de Componentes Principales, Escalamiento Multidimensional, correlaciones entre los conceptos secundarios del modelo teórico y contrastes entre grupos ocupacionales. Los resultados del PCA, los contrastes entre los grupos seleccionados y los resultados de las correlaciones entre los conceptos secundarios confirmaron las expectativas teóricas. Sin embargo, los resultados del MDS solo confirmaron parcialmente la estructura hexagonal. Los resultados sugieren que el instrumento adaptado tiene evidencias aceptables de validez y confiabilidad. Se sugieren estudios adicionales para aumentar la idoneidad de la versión brasileña del instrumento.

Electroacupuncture and Curcumin Promote Oxidative Balance and Motor Function Recovery in Rats Following Traumatic Spinal Cord Injury.

Spinal cord injury (SCI) is a condition that puts the patient's life at risk in the acute phase and, during the chronic stage, results in permanent deficits in motor, sensory and autonomic functions. Isolated therapeutic strategies have not shown an effect on this condition. Therefore, this study aimed to evaluate the effects of electroacupuncture (EA) and curcumin, alone or combined, on the oxidative balance, motor function recovery and amount of preserved tissue following a traumatic SCI. Long-Evans rats were divided into five groups: SHAM, SCI, SCI + EA, SCI + Curcumin, and SCI + EA + Curcumin. Nitric oxide was significantly decreased in the Curcumin group; the EA, Curcumin and SCI + EA + Curcumin groups had significantly decreased hydroxyl radical and lipid peroxidation levels. Motor function recovery and the amount of preserved spinal cord tissue were significantly greater in the EA, Curcumin and EA + Curcumin groups. The results show that EA and Curcumin treatment alone or in combination decreased oxidative stress, improved functional motor recovery and increased the amount of preserved spinal cord tissue following a traumatic injury.

Synthesis and Characterization of Poly(Vinyl Alcohol)-Chitosan-Hydroxyapatite Scaffolds: A Promising Alternative for Bone Tissue Regeneration.

Scaffolds can be considered as one of the most promising treatments for bone tissue regeneration. Herein, blends of chitosan, poly(vinyl alcohol), and hydroxyapatite in different ratios were used to synthesize scaffolds via freeze-drying. Mechanical tests, FTIR, swelling and solubility degree, DSC, morphology, and cell viability were used as characterization techniques. Statistical significance of the experiments was determined using a two-way analysis of variance (ANOVA) with p < 0.05. Crosslinked and plasticized scaffolds absorbed five times more water than non-crosslinked and plasticized ones, which is an indicator of better hydrophilic features, as well as adequate resistance to water without detriment of the swelling potential. Indeed, the tested mechanical properties were notably higher for samples which were undergone to crosslinking and plasticized process. The presence of chitosan is determinant in pore formation and distribution which is an imperative for cell communication. Uniform pore size with diameters ranging from 142 to 519 µm were obtained, a range that has been described as optimal for bone tissue regeneration. Moreover, cytotoxicity was considered as negligible in the tested conditions, and viability indicates that the material might have potential as a bone regeneration system.

[Implementation of intraoperative neurophysiologic monitoring in children and adults in secondary and tertiary health care facilities]. / Implementación del monitoreo neurofisiológico intraoperatorio en niños y adultos en el segundo y tercer nivel de atención.

INTRODUCTION: Intraoperative neurophysiological monitoring (IONM) is a procedure that uses neurophysiological techniques in order to evaluate the motor and sensitive systems during surgeries that endanger the nervous system. METHOD: The approach, scope, target population, and clinical questions to be answered were defined. A systematic search of the evidence was conducted step by step; during the first stage, clinical practice guidelines were collected, during the second stage systematic reviews were obtained, and during the third stage, clinical trials and observational studies were procured. The MeSH nomenclature and free related terminology were used, with no language restrictions and a 5-10 years frame. The quality of the evidence was graded using the CEPD and SIGN scales. RESULTS: Obtained using the search algorrhythms of 892 documents. Fifty-eight were chosen to be included in the qualitative synthesis. A meta-analysis was not possible due to the heterogeneity of the studies. CONCLUSIONS: Eighteen recommendations were issued and will support the adequate use of the IONM.

INTRODUCCIÓN: El monitoreo neurofisiológico intraoperatorio (MNIO) es un procedimiento que emplea técnicas neurofisiológicas con la finalidad de evaluar los sistemas motor y sensitivo durante cirugías que ponen en riesgo al sistema nervioso. MÉTODO: Se definieron el enfoque, los alcances, la población diana y las preguntas clínicas por resolver. Se realizó una búsqueda sistematizada de la evidencia por etapas. En la primera, se buscaron guías de práctica clínica; en la segunda, revisiones sistemáticas; y en la tercera, ensayos clínicos y estudios observacionales. Se utilizaron los términos MeSH y libres correspondientes, sin restricciones de lenguaje y con una temporalidad de 5 a 10 años. Se graduó la calidad de la evidencia utilizando las escalas CEPD y SIGN. RESULTADOS: Mediante los algoritmos de búsqueda se obtuvieron 892 documentos, y se seleccionaron 58 para la inclusión de la síntesis cualitativa. Debido a la heterogeneidad entre los estudios, no fue posible realizar metaanálisis. CONCLUSIONES: Se emitieron 18 recomendaciones, las cuales servirán como apoyo para la adecuada utilización del MNIO.

Prevalencia de enfermedades infecciosas crónicas en autopsias clínicas / Prevalence of chronic infectious diseases in clinical autopsies

Las enfermedades infecciosas crónicas constituyen un problema de salud pública mundial al ser importante causa de mortalidad. En Guatemala no existen estudios postmortem recientes que aborden dicho tema, por lo que se desconoce su prevalencia en autopsias clínicas del país. El presente estudio se delimita las siguientes enfermedades: tuberculosis, candidiasis, neurocisticercosis, aspergilosis, coccidioidomicosis e histoplasmosis. Objetivo: determinar la prevalencia de las enfermedades infecciosas crónicas en autopsias clínicas. Material y Métodos: investigación descriptiva retrospectiva, basada en los datos de 909 boletas de protocolos completos de autopsias clínicas realizadas del año 2006 al 2015 en el Departamento de patología en el Hospital General San Juan de Dios de Guatemala

Clinical features of Guillain-Barré Syndrome in a tertiary-level hospital in Mexico / Síndrome de Guillain-Barré en el Hospital de Especialidades del Centro Médico Nacional Siglo XXI

Background: Guillain-Barré Syndrome (GBS) is an acute polyneuropathy characterized by symmetrical weakness of the limbs with hyporeflexia or areflexia with a maximum progression within four weeks and can impair respiratory function and implies disability at a long. The aim of this paper was to describe the clinical, epidemiological and neurophysiological features of patients with GBS at the Hospital de Especialidades del Centro Medico Nacional Siglo XXI (HECMNSXXI) Methods: An observational, retrospective cross-sectional study, data were collected form clinical records of adults with GBS hospitalized in HECMNSXXI from March 2012 to March 2016. The recorded variables were demographics, previous infection, clinical presentation, disability scores, prognosis scores and neurophysiological subtypes. Results: Clinical records of 94 patients were analysed with a mean age of 53 years, 61% male, with previous infection in 80%. Albumin cytologic dissociation was present in 50%. Medical Research Council (MRC) sum scores mean was 32, the SGB disability score at admittance with a mean of 3.63. The axonal subtype was in 68%, and demyelinating in 29%, not conclusive in 3%. Conclusions: In this study the demographic and clinical features are similar to other previous reports, we documented a greater proportion of axonal subtype, which are related with important disability and worse prognosis.

Introducción: El síndrome de Guillain-Barré (SGB) es una polirradiculoneuropatía aguda caracterizada por debilidad simétrica progresiva de las extremidades con hipo o arreflexia, que progresa en un máximo de 4 semanas y que puede llevar a la falla respiratoria y a discapacidad a largo plazo. El objetivo de este trabajo fue describir las características clínicas, epidemiológicas y neurofisiológicas de pacientes con SGB del Hospital de Especialidades del Centro Médico Nacional Siglo XXI (HECMNSXXI). Métodos: Se realizó un estudio observacional de tipo transversal retrolectivo. Se obtuvieron datos de expedientes clínicos de adultos con diagnóstico de SGB hospitalizados en el HECMNSXXI en el periodo de marzo de 2012 a marzo de 2016. Se registraron variables demográficas, clínicas y neurofisiológicas. Resultados: Se incluyeron 94 pacientes con un promedio de edad de 53 años, en su mayoría hombres, con infección previa en 80%. La fuerza muscular medida con la escala del Medical Research Council (MRC) fue en promedio de 32, la escala de discapacidad del SGB (Hughes) al ingreso tuvo un promedio de 3.63. La variedad axonal se encontró en 68%, la desmielinizante en 29% y en 3% no concluyente. Conclusiones: Se documentan en esta muestra características demográficas y clínicas similares a lo reportado en la literatura, así como la mayor proporción de variedades axonales, las cuales tienen mayor severidad en la presentación clínica así como mal pronóstico.