Surgeons vs ChatGPT: Assessment and Feedback Performance Based on Real Surgical Scenarios.

INTRODUCTION: Artificial intelligence tools are being progressively integrated into medicine and surgical education. Large language models, such as ChatGPT, could provide relevant feedback aimed at improving surgical skills. The purpose of this study is to assess ChatGPT´s ability to provide feedback based on surgical scenarios. METHODS: Surgical situations were transformed into texts using a neutral narrative. Texts were evaluated by ChatGPT 4.0 and 3 surgeons (A, B, C) after a brief instruction was delivered: identify errors and provide feedback accordingly. Surgical residents were provided with each of the situations and feedback obtained during the first stage, as written by each surgeon and ChatGPT, and were asked to assess the utility of feedback (FCUR) and its quality (FQ). As control measurement, an Education-Expert (EE) and a Clinical-Expert (CE) were asked to assess FCUR and FQ. RESULTS: Regarding residents' evaluations, 96.43% of times, outputs provided by ChatGPT were considered useful, comparable to what surgeons' B and C obtained. Assessing FQ, ChatGPT and all surgeons received similar scores. Regarding EE's assessment, ChatGPT obtained a significantly higher FQ score when compared to surgeons A and B (p = 0.019; p = 0.033) with a median score of 8 vs. 7 and 7.5, respectively; and no difference respect surgeon C (score of 8; p = 0.2). Regarding CE´s assessment, surgeon B obtained the highest FQ score while ChatGPT received scores comparable to that of surgeons A and C. When participants were asked to identify the source of the feedback, residents, CE, and EE perceived ChatGPT's outputs as human-provided in 33.9%, 28.5%, and 14.3% of cases, respectively. CONCLUSION: When given brief written surgical situations, ChatGPT was able to identify errors with a detection rate comparable to that of experienced surgeons and to generate feedback that was considered useful for skill improvement in a surgical context performing as well as surgical instructors across assessments made by general surgery residents, an experienced surgeon, and a nonsurgeon feedback expert.

Speech and language therapy students' perception of learning through the incorporation of clinical simulation workshops: a mixed-methods study

ABSTRACT Purpose: this study had two aims: (1) Analyse students' perceptions of achieved learning in the simulation workshops implemented in multiple areas in a Speech and Language Therapy curricula, and (2) Establish the effect of incorporating simulation workshops in the students' comprehensive evaluation of the course. Methods: a survey on perceived learning was validated, including quantitative and qualitative sections, and applied to students that participated in the simulation workshops (n=241). Additionally, quantitative information from a survey of systematic application on the comprehensive perception of the courses that implemented workshops was analysed (n=277). Results: the quantitative section showed a positive perception of learning through the simulation workshop and coincided with the qualitative section's positive opinions. Additionally, the courses that implemented simulation workshops showed a positive evaluation in methodology, feedback, and organization. Conclusion: the students had a positive perception of the incorporation of clinical simulation workshops. The survey's sections provided complementary information regarding learning through clinical simulation.

Implementación de un modelo de atención kinesiológico, temprano y prospectivo, en personas con cáncer de mama / Implementation of an early and prospective physical therapy model care in people with breast cancer

Resumen El cáncer de mama es un problema de salud pública en Chile y el mundo por su alta incidencia. La cirugía es un pilar fundamental en el tratamiento del cáncer de mama. Hasta un 60% de las personas tratadas por cáncer de mama presentan alteraciones funcionales en el miembro superior. Existen modelos sanitarios para la rehabilitación de las alteraciones funcionales, sin embargo, en Chile no es un estándar en la atención de salud. Este artículo describe: 1) las alteraciones del miembro superior secundarias a la cirugía por cáncer de mama y 2) un modelo de atención kinesiológico, temprano y prospectivo, para personas tratadas por cáncer de mama.

Breast cancer is a public health problem in Chile and the world due to high incidence. Surgery is the mainstay in the breast cancer treatment. Up to 60% of people receiving this management have functional morbidity in the upper limb. There are rehabilitation health models care for the functional morbidity, however, in Chile is not a standard in the health care. This article describes: 1) upper limb morbidity secondary to breast cancer surgery, and 2) early and prospective physical Therapy model care for people with breast cancer.

Diseño, implementación y evaluación de la metodología aprendizaje servicio en la carrera de fonoaudiología / Design, implementation and evaluation of the learning methodology Phonoaudiology career service

Introducción: el perfil de egreso de la carrera de Fonoaudiología de la Pontificia Universidad Católica de Chile (UC) compromete que los estudiantes desarrollen habilidades transversales esenciales para entregar un servicio de excelencia. Para este desarrollo, uno de los elementos claves es que los cursos utilicen metodologías activas con desafíos progresivos y monitoreados. Una de estas metodologías es Aprendizaje Servicio (A+S). El objetivo de este estudio es describir el diseño, implementación y evaluación de la metodología A+S en el plan de estudios de la carrera de Fonoaudiología. Método: en base al modelo UC de institucionalización de A+S y un proyecto de docencia institucional adjudicado, se definen habilidades transversales a desarrollar en los cursos. Se inicia el proceso de incorporación de la metodología a través de un piloto y se aplican encuestas institucionales para evaluar los resultados de la implementación. Resultados: se seleccionan cinco cursos para trabajar las habilidades transversales de compromiso social, trabajo en equipo, habilidades comunicativas, pensamiento crítico y resolución de problemas en 3 niveles de desempeño según la progresión curricular del estudiante. Los alumnos manifiestan una alta contribución de la metodología al proceso de enseñanza-aprendizaje, superando el 85 por ciento de aprobación en todos los cursos. El 100 por ciento de los profesores considera importante su incorporación en la malla curricular. Discusión: se logra adaptar e implementar un modelo de incorporación de la metodología A+S en la carrera de Fonoaudiología, lo que permite que los estudiantes tengan oportunidades de desarrollo de las habilidades transversales declaradas en el perfil de egreso, de manera organizada, monitoreada, y progresiva a lo largo del plan de estudios.(AU)

Background: the graduate profile of the Speech and Language Pathology program at the Pontificia Universidad Católica de Chile (UC)describes that students will develop essential transversal skills that will allow them to deliver excellent care as health professionals. Thisrequires the use of active learning methodologies in its courses, one of which is Service Learning (S+L). This study aims to describe the design, implementation and evaluation of S+L in the curriculum of Speech and Language Pathology program. Method: based on the UC model of implementation of S+L and an institutional teaching project grant, the transversal skills to be developed in each of the courses were defined. The process of incorporating the methodology began with a pilot. Institutional surveys were applied to evaluate the results of the implementation. Results: five courses were selected to work on the transversal skills of social commitment, teamwork,communication skills, critical thinking and problem-solving in 3 levels of performance according to the student's curricular progression. The students saw a high contribution of the methodology to the research process, surpassing the 85 percent approval in all the courses. 100 percent of teachers consider important to incorporate S + L into the curriculum. Discussion: it was possible to adapt and implement a model of incorporation of the S + L methodology in the Speech and Language Pathology career, which allows students to develop the transversal skills declared in the graduation profile, in an organized, monitored, and progressive way throughout the curriculum.(AU)

Percepción de los estudiantes de kinesiología sobre la incorporación de la metodología b-learning y uso de dispositivos móviles en el curso de análisis del movimiento / Kinesiology students' perception of the incorporation of the b-learning methodology and the use of mobile devices in the course of movement analysis

Introducción: el aumento del número de estudiantes en carreras de la salud hace necesario incluir nuevas metodologías de enseñanza-aprendizaje. La literatura avala el uso de las tecnologías de la información y comunicación (TICs) y el b-learning como recursos para abordar esta problemática. El propósito fue evaluar la percepción de los estudiantes universitarios de la carrera de kinesiología sobre la incorporación de TICs y b-learning en el curso Análisis del Movimiento. Material y Método: se aplicó un cuestionario a 94 estudiantes. Se determinó evidencia de validez de constructo a través de análisis confirmatorio de factores y confiabilidad mediante Alpha de Cronbach. Se estimó la mediana (Q1-Q3) de cada dimensión, determinando posibles diferencias mediante la prueba de Kruskal-Wallis. Resultados: se definió una encuesta con 5 dimensiones y 27 ítems. Los enunciados cargaron en las 5 dimensiones. El coeficiente de Alpha de Cronbach fue de α=0,83. Los resultados según la Mediana (Q1-Q3) por dimensión fueron: Percepción General de la Metodología 4,83 (4,67-5), Percepción de los materiales utilizados 4,75 (4,5-5), Percepción del Autoaprendizaje 4,09 (3,82-4,27), Interacción con los docentes y compañeros 4,75 (4,25-5), Evaluación 5 (4,67-5) y la nota global fue de 6 (6-7). Discusión: el cuestionario posee adecuada evidencia de validez y confiabilidad, hubo diferencias estadísticamente significativas entre dimensiones, especialmente en Percepción del Autoaprendizaje. Los estudiantes valoran positivamente la organización en los procesos de innovación en metodologías de enseñanza y evaluación, el uso de sistemas digitales como facilitadores de su aprendizaje y la oportunidad de aprendizaje autónomo.(AU)

Introduction: physiotherapy has systematically increased its students, being necessary to include new teaching and learning methodologies. The literature supports the use of information and communication technologies (ICT) and b-learning as resources to address this problem. The aim was to evaluate the perception of Physiotherapy students about the incorporation of ICTs and b-learning in the course of Movement Analysis. Methods: experts designed an instrument that applied to 94 students. The construct validity determined through a factor confirmatory analysis and reliability by Cronbach's Alpha. The median (Q1-Q3) of each dimension was estimated, determining the existence of possible differences through the Kruskal-Wallis test. Results: a survey with five categories and 27 items was defined and loaded in the five dimensions. The coefficient of Cronbach's alpha was α = 0.83. The results according to the Median (Q1-Q3) for the measure were: General Perception of the Methodology 4.83 (4.67-5), Perception of the materials used 4.75 (4.5-5), Perception of Self-Learning 4.09 (3.82-4.27), Interaction with teachers and classmates 4.75 (4.25-5), Evaluation 5 (4.67-5) and overall score was 6 (6-7). Discussion: the questionnaire has validity and reliability, statistical differences between measures were found, especially in the Perception of Self-Learning. The students valued positively the organization in the processes of innovation in teaching and evaluation methodologies, the use of digital systems as facilitators of their learning and the opportunity for autonomous learning.(AU)

Updates in the correlation of electroneuromyographic findings in diabetic polyneuropathy / Actualidades en la correlación de hallazgos electroneuromiográficos en polineuropatía diabética

Background: The diabetic neuropathy is the most common microvascular complication of diabetes mellitus. The reported prevalence ranges from 10-90%. Electrophysiological alterations can be demonstrated in nearly 100% of diabetics. Objective: To know the current profile of the patient with diabetic polyneuropathy. Methods: Retrospective and descriptive study from 2015 to 2016. Reports of electroneuromyography with diabetic polyneuropathy result were analyzed, evaluating neuroconduction parameters of motor and sensory nerves, late F responses and myography. Descriptive statistics, Student's t-test and Pearson's correlation coefficient were used. Results: The sample included 72 men (65.5%) and 38 women (34.5%), mean age 61.2 years, mean duration of diabetes of 9.9 years. The most affected nerve was superficial peroneus, absent in 70% of the population.A positive correlation was found (p < 0.001) for the affection of all the nerves symmetrically and predominantly in neuroconduction velocities of the lower and upper limbs. Conclusion: The most frequent electrophysiological finding in diabetic polyneuropathy was sensory affection, being more severe in lower limbs. A finding in patients with recent diagnosis is the prolongation of proximal latencies in the lower extremities.

Introducción: la neuropatía diabética es la complicación microvascular más frecuente de la diabetes mellitus. Las prevalencias reportadas oscilan del 10 al 90%. Se pueden demostrar alteraciones electrofisiológicas en casi el 100% de los diabéticos. Objetivo: conocer el perfil actual del paciente con polineuropatía diabética. Métodos: estudio retrospectivo y descriptivo del año 2015 a 2016. Se analizaron reportes de electroneuromiografía con resultado de polineuropatía diabética, evaluando parámetros de neuroconducción de nervios motores y sensoriales, respuestas tardías F y miografía. Se utilizó estadística descriptiva, la prueba de t de Student y el coeficiente de correlación de Pearson. Resultados: la muestra incluyó a 72 hombres (65.5%) y 38 mujeres (34.5%), con edad media de 61.2 años, todos con diagnóstico de diabetes mellitus tipo 2, con duración media de la diabetes de 9.9 años. El nervio más afectado fue el peroneo superficial, ausente en el 70% de la población. Se encontró una correlación positiva(p < 0.001) para la afección de todos los nervios de forma simétrica y de predominio en velocidades de neuroconducción de miembros inferiores y superiores. Conclusión: el hallazgo electrofisiológico más frecuente en polineuropatía diabética fue la afección sensorial, siendo más severa en miembros inferiores. Un hallazgo en pacientes con reciente diagnóstico es la prolongación de latencias proximales en extremidades inferiores.

Screening for Depressive Mood During Acute Chikungunya Infection in Primary Healthcare Settings.

Background: We aimed to screen for depressive mood experienced during acute chikungunya (CHIKV) infection, and to evaluate the association of several exposures with the risk of depressive symptoms. Methods: A cross-sectional analysis of a multicenter cohort study took place and data from 354 adult individuals with confirmed CHIKV infection were analyzed. Participants were recruited in primary health care settings and the Patient Health Questionnaire-2 (PHQ-2) was used. Prevalence odds ratios (OR) and 95% confidence intervals (CIs) estimated by means of logistic models were used. Results: Depressive mood (PHQ-2 score 3 or higher) was reported by 44.1% of individuals. Subjects with articular effusion (OR = 3.37, 95% CI 1.77⁻8.11), gastrointestinal manifestations (diarrhea, vomiting or abdominal pain, OR = 1.97, 95 CI 1.21⁻3.19), and higher length of severe arthralgia (reference ≤ 14 days: 15⁻30 days, OR = 3.38, 95% CI 1.78⁻6.41; ≥ 30 days, OR = 1.69, 95% CI 0.95⁻3.01) were more likely to self-report depressive mood. Increasing age (≥ 40 years old, OR = 0.55, 95% CI 0.31⁻0.95) and rash (OR = 0.54, 95% CI 0.30⁻0.98) were associated with a decreased risk of depressive mood. Conclusions: Depressive mood seemed to be a frequent event among analyzed individuals, and markers associated with its risk were identified.

Razonamiento clínico inductivo o deductivo: una propuesta cualitativa en kinesiología / nductive or deductive clinical reasoning: a proposal qualitative in kinesiology

Introducción: a través del proceso de razonamiento clínico, los profesionales de la salud evalúan críticamente sus intervenciones, siendo esta habilidad necesaria para reconocer qué factores son relevantes para el usuario, a fin de realizar juicios clínicos apropiados que contribuyan a la condición de salud óptima del paciente. La literatura indica que el proceso en un estudiante puede no ser lineal, siendo necesario retroceder y buscar nuevas soluciones y patrones para determinar una elección terapéutica. Objetivo: describir el proceso de razonamiento clínico realizado en estudiantes de ciclo intermedio de Kinesiología en la Universidad de Concepción. Método: investigación cualitativa y descriptiva. 7 estudiantes de tercer y cuarto año de la Universidad de Concepción participaron en la recolección de datos, siguiendo un proceso de consentimiento informado. Se aplicó un cuestionario sociodemográfico y se analizaron los problemas kinesiológicos de un caso clínico mediante asociación libre. Los registros se obtuvieron con una grabadora y luego se realizó un análisis de contenido utilizando CAQDAS Atlas-ti 7.5.2. Resultados: a partir de la lectura de los documentos grabados, surgieron 335 unidades asociadas al razonamiento clínico de los estudiantes de Kinesiología. Estas unidades se agruparon en 58 códigos y estos a su vez, en 2 categorías: razonamiento deductivo y razonamiento inductivo. Discusión: el análisis del proceso es esencial para identificar qué estrategias buscan los estudiantes para resolver en un caso clínico, qué diferencias y particularidades existen entre los estudiantes, y qué metodologías de enseñanza son las más adecuadas para guiar apropiadamente las decisiones terapéuticas que enfrentarán los profesionales de la salud en forma diaria.(AU)

Introduction: Through the clinical reasoning process, health professionals critically evaluate their interventions, being these skills required to recognize which factors are relevant to the user, in order to make appropriate clinical judgments that contribute to the optimal health condition of the user. The literature shows that the student´s process may not be linear, needing to go back and look for new solutions and patterns to determine a therapeutic choice. Objective: Describe the process of clinical reasoning carried out in Physiotherapy students who study in the intermediate cycle at the University of Concepción. Method: Qualitative and descriptive research. 7 students from third and fourth year at the Universidad de Concepción started the sample collection, following an informed consent process. A socio-demographic questionnaire was applied, and kinesthetic problems of a clinical case were analyzed by free association. Records were obtained with a tape recorder and then a content analysis was performed using CAQDAS Atlas-ti 7.5.2. Results: From the listening of the recorded documents, 335 units emerged associated with the clinical reasoning of the Physiotherapy students. These units were grouped into 58 codes and these in turn, in 2 categories: deductive reasoning and inductive reasoning. Discussion: Analysis of the process is essential to identify which strategies students seek to resolve a case, what differences and particularities exist among students, and which teaching strategies are best suited to adequately guide the therapeutic decisions they will face as health professionals on a daily basis.(AU)

[Definitive contraception with Essure device: Single institutional experience on 517 procedures]. / Anticoncepción definitiva con Essure: experiencia unicéntrica de 517 procedimientos.

OBJECTIVES: To analyse the outcomes of patients undergoing Essure sterilization in a single institution, interns of complications and technique failure. PATIENTS AND METHODS: Retrospective descriptive study of 517 patients underwent definitive contraception with Essure device in outpatient hysteroscopy office without anesthesia and controlled at 3 months with abdominal radiography, ultrasonography and hysterosalpingography in selected cases. RESULTS: The success rates of the insertion of Essure was 96.8%, similar to data reported in the literature with 3.7% of vagal reactions, as most prevalent complication. 7 (1.35%) unintended pregnancies were observed. CONCLUSIONS: Essure is a permanent birth control device, with high rate of successful insertion and a low rate of complications. Unintended pregnancies in our study are high and we must change the protocols of placement and monitoring, considering hysterosalpingography as a routine control test.

Mallas en la cirugía del prolapso genital / Meshes for genital prolapse surgery

El objetivo de esta revisión es analizar la información científica disponible sobre la utilización de las mallas en la cirugía del prolapso genital, evaluando eficacia, efectos adversos y complicaciones. La utilización de mallas en la reparación del compartimento anterior se asocia con mejores resultados anatómicos que las técnicas clásicas, mientras que no hay datos suficientes que avalen su utilización en el compartimento posterior. En el compartimento apical, la colposacropexia abdominal ha demostrado tener tasas de recurrencia menores que los procedimientos por vía vaginal, ya sea mediante técnicas clásicas o mediante el uso de mallas. Las mallas se asocian con efectos adversos a corto y a largo plazo, que pueden implicar la necesidad de nuevos procedimientos quirúrgicos. (AU)

Mallas en la cirugía del prolapso genital / Meshes for genital prolapse surgery

El objetivo de esta revisión es analizar la información científica disponible sobre la utilización de las mallas en la cirugía del prolapso genital, evaluando eficacia, efectos adversos y complicaciones. La utilización de mallas en la reparación del compartimento anterior se asocia con mejores resultados anatómicos que las técnicas clásicas, mientras que no hay datos suficientes que avalen su utilización en el compartimento posterior. En el compartimento apical, la colposacropexia abdominal ha demostrado tener tasas de recurrencia menores que los procedimientos por vía vaginal, ya sea mediante técnicas clásicas o mediante el uso de mallas. Las mallas se asocian con efectos adversos a corto y a largo plazo, que pueden implicar la necesidad de nuevos procedimientos quirúrgicos.

[Node status in 454 ductal breast cancers cases according to the association with in situ component]. / Afectación ganglionar en 454 casos con carcinoma ductal infiltrante de mama según el hallazgo de componente intraductal asociado.

BACKGROUND: Studies have shown that breast infiltrating ductal carcinoma develops from precursor lesions or pre-invasive. It is accepted that the risk of invasive ductal carcinoma increased slightly in hyperplasia, but especially in cases of atypical hyperplasia and intraductal carcinoma. OBJECTIVES: To evaluate and compare the nodal status between ductal breast cancer with in situ component (group 1) or without it (group 2). MATERIAL AND METHOD: Descriptive and retrospective study that included 454 ductal breast cancers. Data concerning clinical and pathological variables was collected. All data was compared between both groups. RESULTS: Among all cases, 176 (38.8%) showed positive lymph nodes, 136 patients (39.5%) from group 1 and 40 cases (36.4%) from group 2. Among group 1 cases, high-grade subgroup showed higher positive lymph node rate (82 cases, 55.4%) than the extensive in situ carcinomas subgroup (84 cases, 49.7%). Both of them had a significant higher rate than group 2 cases (p = 0.003 y p = 0.028, respectively). Moreover, the low-grade in situ carcinomas without cellular necrosi had positive lymph nodes just in 30 cases (24%), significantly lower (p = 0.034) than group 2. CONCLUSIONS: We did not find overall statistical differences between groups depending on in situ associated component. But when we analyzed in situ subgroups, we found differences with higher positive lymph node rate in high grade carcinomas and extensive in situ carcinomas subgroups, while lower affectation rates were observed in low grade carcinomas (without cellular necrosis), compared to the group of breast cancers without in situ component associated.

[Sonographic ovarian vascularization and volume in women with polycystic ovary syndrome treated with clomiphene citrate and metformin]. / Vascularización y volumen ovárico ecográfico en mujeres con síndrome de ovario poliquístico tratadas con citrato de clomifeno y metformina.

OBJECTIVE: To measure the vascularization and ovarian volume with three-dimensional sonography in patients diagnosed of polycystic ovary syndrome with stimulated ovulation treatment, and to analyse the differences between the patients treated with clomiphen citrate versus clomiphen citrate and metformin. MATERIAL AND METHOD: Therty patients were studied. Twenty ovulation cycles were obtained with clomiphen citrate and 17 with clomiphen citrate plus merformin (added in case of obesity or hyperglucemy/hyperinsulinemia). Ovarian volumes and vascular indexes were studied with 3D-sonography and results were analysed by treatment. RESULTS: There were no statistical differences of ovarian volume by treatment along the cycles, although bigger volume were found in ovulatory cycles compared to non-ovulatory ones (20,36 versus 13,89 ml, p = 0,026). No statistical differences were also found concerning vascular indexes, neither by treatment nor by the obtention of ovulation in the cycle. CONCLUSIONS: Ovarian volume and vascular indexes measured with three-dimensional sonography in patients diagnosed of polycystic ovary syndrome do not show differents values in patients treated with clomiphen citrate alone versus clomiphen citrate plus metformin.

[Reproducibility of the fetal nasal bone measurement by means of bidimensional and three-dimensional ecography during the second trimester of the pregnancy]. / Reproducibilidad de la medición del hueso nasal fetal mediante ecografía bidimensional y tridimensional durante el segundo trimestre del embarazo.

AIMS: The utility of the valuation-measurement of the nasal bone in the prognosis of chromosomopaties during the second trimester of the pregnancy is demonstrated. OBJECTIVE: To evaluate the repeatability of nasal bone measurement during second trimester with bidimensional and three-dimensional sonography. MATERIAL AND METHOD: Nasal bone was measured in 50 single pregnancies. First observer carried out two measures of nasal bone with bidimensional sonography, and 1 measure with three-dimensional sonography. Second observer carried out just one measure with bidimensional sonography (2D) and just another one with three-dimensional sonography (3D). We studied the intraobserver variability with 2D sonography, and the interobserver variability with 2D and 3D sonography. RESULTS: 2D-sonography: nasal bone measurement showed excellent intraobserver correlation with a correlation coefficient of 0,87 (CI 95%: 0,78-0,93) and a little means difference of 0,18 (SD: 0,74). Indeed, there was a good interobserver correlation with a correlation coefficient of 0,92 (CI 95%: 0,85-0,95), and a means difference of 0,14 (SD: 0,56). 3D-sonography: there was a acceptable interobserver correlation with correlation coefficient of 0,70 (CI 95%: 0,52-0,82). CONCLUSION: Nasal bone measurement is highly reproducible by means of bidimensional sonography while using three-dimensional sonography, the results are just acceptable.

[Urogenital prolapse repair using polypropylene mesh]. / Reparación del prolapso urogenital con malla de polipropileno.

BACKGROUND: Urogenital prolapse is a condition that affects 1 to 43% of post-hysterectomized patients. Since several years some synthetic meshes have been used to repair pelvic floor, and apparently they have advantages over them predecessors. OBJECTIVE: To evaluate the efficacy and security of polypropylene meshes in the repair of urogenital prolapse. MATERIAL AND METHOD: Retrospective and non-randomized study in 106 patients that had different kinds of urogenital prolapse repaired using polypropylene meshes. The follow-up was carried out by two visits to the hospital, 2 and 6 months after surgery. The variables analyzed were age, parity, menopause presence, kind of surgical technique, surgical time, time at hospital and complications. Afterwards, the information was analyzed descriptively. RESULTS: Average age was 64.4 years. The rate of multiparity and menopause women was 91.51% and 92.45% respectively. The most used surgical technique was the anterior mesh with tension-free band (34,90%) to repair the associated urinary incontinence. The rate of intraoperatory complications was 2.8%, immediate complications was 37.7% and late complications was 21.6%. The success rate after 6 months was 80 to 100%, depending on the technique. CONCLUSIONS: There is a low rate of intraoperatory and medium-term complications in the reconstructive surgery of pelvic floor for the urogenital prolapses using polypropylene meshes, which makes this technique a secure and effective option for the treatment of this problem.

[Fetal chylothorax. Is prenatal treatment beneficial?]. / Quilotórax fetal: es benéfico su tratamiento prenatal?

We report a case of fetal chylothorax handled with intrauterine treatment, which finally died. Diagnosis, treatment and evolution are reviewed. Characteristics of the disease are described and treatment options are discussed.

Agendas innovadoras de investigación / Innovative agenda on research

La ciencia, la tecnología y la innovación constituyen un factor cada vez mas determinantes en la constitución de la sociedad moderna, de allí la ôsociedad del conocimientoö como un termino utilizado para definirla. Al mismo tiempo hay una visión mucho mas critica y cuidadosa acerca de ella y de su relación con la sociedad. Hay mas exigencias desde el punto de vista ético, político, económico y ambiental, al punto de que, desde hace algún tiempo, se viene pregonando la necesidad de establecer un nuevo ôcontrato socialö que regule sus vinculaciones con la sociedad, en términos de una mayor responsabilidad y de una mayor evaluación de su desempeño. Todo esto conforma un panorama radicalmente diferente del característico de los no tan lejanos tiempos de la ôrepublica de la cienciaö, en los que la ciencia era, para casi todos sus efectos, un asunto que casi exclusivamente concernía a los científicos, fuente incuestionable, ademàs, de progreso y bienestar. Este nuevo contrato se encuentra vincukado a un modo de producción de conocimientos que implica regirse por los cánones del desarrollo sustentable. En tal sentido es un modo que supone la adopción del enfoque sistémico, es decir, una manera de pensar en términos de interconexión, relaciones y contexto, dentro de la cual los criterios éticos, sociales y ecológicos gravitan con mucha fuerza. Señalado lo anterior, la definición de las agendas de investigación, es decir de los temas que se van a abordar se vuelve asunto muy complejo con respecto, no solo a la escogencia de esos temas, sino a la de los actores sociales que van a participar en la definición y desarrollo de la agenda, de los esquemas de evaluación que se tienen que adoptar (los cuales trascienden abiertamente el mero ôjuicio de los paresö), de los orígenes, formas y condiciones del financiamiento, de las formulas convenidas para la apropiación de los resultados y del patrón de difusión de los mismos...

Research in the social sciences

Meeting of the Advisory Committee on Health Research, 31. Pan American Health Organization; Jul. 15-17, 1996

La investigacion en el campo de las ciencias sociales / Research in the social sciences

Reunión del Comité Asesor de Investigaciones en Salud, 31. Organizacion Panamericana de la Salud; Jul. 15-17, 1996