Reliability, usability, and efficiency of video versus print instructions to teach parents a procedural task: A cross-sectional study.

OBJECTIVE: To compare the reliability, usability, and efficiency of video versus print instructions to teach parents a procedural measurement task. We hypothesized that videos would outperform print in all outcomes. STUDY DESIGN: This cross-sectional study included parents/caregivers of children aged 0-18 years with deep vein thrombosis attending the Thrombosis Clinic at The Hospital for Sick Children for post-thrombotic syndrome (PTS) assessment. Participants were randomly assigned to three instruction types: (i) video, which followed the technique used by clinicians; (ii) long pamphlet, which also followed the clinicians' technique; and (iii) short pamphlet, which explained a simplified technique. After measuring their children's arms or legs using the randomly assigned material, participants completed a usability questionnaire. The reliability of the instructions was estimated by comparing parents/caregivers versus clinicians' measurements using the intraclass correlation coefficient (ICC). Reliability, usability, and efficiency (time to task completion) were compared among the three instruction types. RESULTS: In total, 92 participants were randomized to video (n = 31), long pamphlet (n = 31), and short pamphlet (n = 30). While the video had the highest usability, the short pamphlet was the most reliable and efficient. ICCs were .17 (95% confidence interval [CI]: .00-.39) for the video, .53 (95% CI: .30-.72) for the long pamphlet, and .70 (95% CI: .50-.81) for the short pamphlet. CONCLUSION: Although the video had higher usability, the short/simplified print instruction was more reliable and efficient. However, the reliability of the short pamphlet was only moderate/good, suggesting that whenever possible, measurements should still be obtained by trained clinicians.

Lysophosphatidic Acid Receptor 3 (LPA3): Signaling and Phosphorylation Sites.

LPA3 receptors were expressed in TREx HEK 293 cells, and their signaling and phosphorylation were studied. The agonist, lysophosphatidic acid (LPA), increased intracellular calcium and ERK phosphorylation through pertussis toxin-insensitive processes. Phorbol myristate acetate, but not LPA, desensitizes LPA3-mediated calcium signaling, the agonists, and the phorbol ester-induced LPA3 internalization. Pitstop 2 (clathrin heavy chain inhibitor) markedly reduced LPA-induced receptor internalization; in contrast, phorbol ester-induced internalization was only delayed. LPA induced rapid ß-arrestin-LPA3 receptor association. The agonist and the phorbol ester-induced marked LPA3 receptor phosphorylation, and phosphorylation sites were detected using mass spectrometry. Phosphorylated residues were detected in the intracellular loop 3 (S221, T224, S225, and S229) and in the carboxyl terminus (S321, S325, S331, T333, S335, Y337, and S343). Interestingly, phosphorylation sites are within sequences predicted to constitute ß-arrestin binding sites. These data provide insight into LPA3 receptor signaling and regulation.

LPA3 Receptor Phosphorylation Sites: Roles in Signaling and Internalization.

Lysophosphatidic acid (LPA) type 3 (LPA3) receptor mutants were generated in which the sites detected phosphorylated were substituted by non-phosphorylatable amino acids. Substitutions were made in the intracellular loop 3 (IL3 mutant), the carboxyl terminus (Ctail), and both domains (IL3/Ctail). The wild-type (WT) receptor and the mutants were expressed in T-REx HEK293 cells, and the consequences of the substitutions were analyzed employing different functional parameters. Agonist- and LPA-mediated receptor phosphorylation was diminished in the IL3 and Ctail mutants and essentially abolished in the IL3/Ctail mutant, confirming that the main phosphorylation sites are present in both domains and their role in receptor phosphorylation eliminated by substitution and distributed in both domains. The WT and mutant receptors increased intracellular calcium and ERK 1/2 phosphorylation in response to LPA and PMA. The agonist, Ki16425, diminished baseline intracellular calcium, which suggests some receptor endogenous activity. Similarly, baseline ERK1/2 phosphorylation was diminished by Ki16425. An increase in baseline ERK phosphorylation was detected in the IL3/Ctail mutant. LPA and PMA-induced receptor interaction with ß-arrestin 2 and LPA3 internalization were severely diminished in cells expressing the mutants. Mutant-expressing cells also exhibit increased baseline proliferation and response to different stimuli, which were inhibited by the antagonist Ki16425, suggesting a role of LPA receptors in this process. Migration in response to different attractants was markedly increased in the Ctail mutant, which the Ki16425 antagonist also attenuated. Our data experimentally show that receptor phosphorylation in the distinct domains is relevant for LPA3 receptor function.

Long-term outcomes of pulmonary embolism in children and adolescents.

ABSTRACT: Knowledge regarding the long-term consequences of pulmonary embolism (PE) in children is limited. This cohort study describes the long-term outcomes of PE in children who were followed-up at a single-center institution using a local protocol that included clinical evaluation, chest imaging, echocardiography, pulmonary function tests, and cardiopulmonary exercise tests at follow-up, starting 3 to 6 months after acute PE. Children objectively diagnosed with PE at age 0 to 18 years, who had ≥6 months of follow-up were included. Study outcomes consisted of PE resolution, PE recurrence, death, and functional outcomes (dyspnea, impaired pulmonary or cardiac function, impaired aerobic capacity, and post-PE syndrome). The frequency of outcomes was compared between patients with/without underlying conditions. In total, 150 patients were included; median age at PE was 16 years (25th-75th percentile, 14-17 years); 61% had underlying conditions. PE did not resolve in 29%, recurrence happened in 9%, and death in 5%. One-third of patients had at least 1 documented abnormal functional finding at follow-up (ventilatory impairments, 31%; impaired aerobic capacity, 31%; dyspnea, 26%; and abnormal diffusing capacity of the lungs to carbon monoxide, 22%). Most abnormalities were transient. When alternative explanations for the impairments were considered, the frequency of post-PE syndrome was lower, ranging between 0.7% and 8.5%. Patients with underlying conditions had significantly higher recurrence, more pulmonary function and ventilatory impairments, and poorer exercise capacity. Exercise intolerance was, in turn, most frequently because of deconditioning than to respiratory or cardiac limitation, highlighting the importance of physical activity promotion in children with PE.

The Mexican consensus on fecal incontinence.

Fecal incontinence is the involuntary passage or the incapacity to control the release of fecal matter through the anus. It is a condition that significantly impairs quality of life in those that suffer from it, given that it affects body image, self-esteem, and interferes with everyday activities, in turn, favoring social isolation. There are no guidelines or consensus in Mexico on the topic, and so the Asociación Mexicana de Gastroenterología brought together a multidisciplinary group (gastroenterologists, neurogastroenterologists, and surgeons) to carry out the «Mexican consensus on fecal incontinence¼ and establish useful recommendations for the medical community. The present document presents the formulated recommendations in 35 statements. Fecal incontinence is known to be a frequent entity whose incidence increases as individuals age, but one that is under-recognized. The pathophysiology of incontinence is complex and multifactorial, and in most cases, there is more than one associated risk factor. Even though there is no diagnostic gold standard, the combination of tests that evaluate structure (endoanal ultrasound) and function (anorectal manometry) should be recommended in all cases. Treatment should also be multidisciplinary and general measures and drugs (lidamidine, loperamide) are recommended, as well as non-pharmacologic interventions, such as biofeedback therapy, in selected cases. Likewise, surgical treatment should be offered to selected patients and performed by experts.

Advantages and Short-Term Outcomes of Laparoscopic-Assisted Renal Surgery in Elderly Patients

Objective: To compare the perioperative results of adult and elderly patients undergoing laparoscopic renal surgery. Methodology: Retrospective, analytical study. 448 who underwent kidney surgery for benign or malignant pathologies between 2011-2019 were included in the General Hospital of Mexico “Dr. Eduardo Liceaga”. They were categorized into two groups: Group 1 <60 years and Group 2 >60 years. Descriptive statistics and bivariate analysis were performed, the calculations were performed with 95% reliability and a value of p (<0.05). Results: In the group over 60 years of age, the following was found: Age: 67.1 years (60-83). IMC 28.3 kg/m2 (19-48.7). Intra and postsurgical outcomes: intraoperative bleeding = 184.4cc (5-1700). Surgical Time = 112.6min (30-240). Days of hospital stay = 2 (1-7). Complications in 2.6% (Clavien-Dindo: I = 2; II = 1), no conversion was required in any patient. There were no statistically significant differences with group 1, an exception for intraoperative bleeding. Conclusions: Our study is a pioneer in Latin America in the evaluation of the geriatric population and outcomes with laparoscopic surgery and we recommend that renal procedures with a laparoscopic approach should be considered as the best strategy in the management of benign or malignant renal pathology in geriatric patients (AU)

Objetivo: Comparar los resultados perioperatorios depacientes adultos y adultos mayores sometidos a cirugía renal laparoscópica.Material y Métodos: Estudio retrospectivo,analítico. Se incluyeron 448 sometidos a cirugías renalespor patologías benignas o malignas entre 2011-2019 en elHospital General de México “Dr. Eduardo Liceaga”. Secategorizaron en dos grupos: Grupo 1 <60 años y Grupo2 >60 años. Se realizó estadística descriptiva y análisisbivariado, los cálculos se realizaron con confiabilidad del95% y un valor de p (< 0.05).Resultados: En el grupo de mayores de 60 años, seencontró lo siguiente: Edad promedio: 67.1 años (60-83).IMC 28.3 kg/m2(19-48.7). Desenlaces trans y postquirúrgicos: sangrado transoperatorio (STO) = 184.4cc (5-1700).Tiempo Quirúrgico = 112.6 min (30-240). Días de estanciaintrahospitalaria = 2 (1-7). Complicaciones en el 2.6%(Clavien-Dindo: I = 2; II = 1), no se requirió conversiónen ningún paciente. No existieron diferencias estadísticamente significativas con el grupo 1, a excepción del STO.Conclusiones: Nuestro estudio es pionero enIberoamérica en la evaluación de la población geriátricay desenlaces con cirugía laparoscópica y recomendamosque los procedimientos renales con abordaje laparoscópicodeben considerarse como la mejor estrategia en el manejode patología renal benigna o maligna en los pacientes geriátricos (AU)

Ácido úrico herramienta de tamización para preeclampsia. Una revisión sistemática de la literatura / Uric acid screening tool for preeclampsia a systematic review

Introducción: El ácido úrico se ha descrito como un posible marcador de riesgo para la aparición de preeclampsia; sin embargo, hasta el momento no hay evidencia sólida que lo soporte. El objetivo de este estudio es sintetizar la literatura disponible que permita conocer la utilidad del ácido úrico como una herramienta de tamización para preeclampsia. Metodología: Revisión sistemática de la literatura de estudios primarios que analicen los niveles séricos de ácido úrico en el primer y segundo trimestre de gestación con el desarrollo de preeclampsia. Búsqueda en Pubmed (n: 639). Resultados: Se incluyeron 2 estudios de cohorte con un total de 9.746 gestantes y 398 casos de preeclampsia. En los estudios se encontraron mayores niveles séricos de ácido úrico en las gestantes que desarrollaron preeclampsia (OR 1,8 a 2,0). Conclusiones: El ácido úrico se relaciona con la aparición de preeclampsia y su fisiopatología. Se invita a la comunidad científica a seguir investigando acerca de la utilidad del ácido úrico para su implementación como herramienta de tamización en el primer y el segundo trimestre de embarazo.(AU)

Introduction: Uric acid has been described as a possible risk marker for the appearance of pre-eclampsia. However, so far there is no solid evidence to support it. The objective of this study is to synthesize the available literature to determine the usefulness of uric acid as a screening tool for pre-eclampsia. Methodology: Systematic review of the literature of primary studies that analyse serum uric acid levels in the first and second trimesters of gestation with the development of pre-eclampsia. Search in PubMed (n: 639). Results: Two studies (2 cohort studies) were included with a total of 9,746 pregnant women and 398 cases of pre-eclampsia. In the studies, higher serum uric acid levels were found in pregnant women who developed preeclampsia (OR 1.8 to 2.0). Conclusions: Uric acid is related to the presence of preeclampsia and its pathophysiology. The scientific community is invited to continue investigating the applicability of uric acid for its implementation as a screening tool in the first and second trimester of pregnancy.(AU)

Síndrome axillary web tras cirugía de cáncer de mama. Variante rara con nódulos subcutáneos / Axillary web syndrome following breast cancer surgery. Rare variant with subcutaneous nodules

Se presenta el caso de una mujer de 49 años, tratada e intervenida por cáncer de mama, quien, a las 3semanas de presentar síndrome de axillary web (SAW), desarrolló nódulos subcutáneos, blandos e indoloros a lo largo de su recorrido y cerca de la flexura del codo. Las pruebas complementarias (ecografía Doppler y de partes blandas) descartaron etiología dérmica/subcutánea o neoplásica, y se evidenció trombosis venosa cefálica y cubital. Se pautó tratamiento con anticoagulante y a las 3-4 semanas el SAW mejoró y los nódulos desaparecieron. Con la clínica, evolución y las pruebas complementarias realizadas, junto con la evidencia científica publicada, se diagnosticó de SAW con nódulos subcutáneos. El SAW es una complicación posquirúrgica precoz del cáncer de mama conocida entre los profesionales y cuyo diagnóstico es clínico. La asociación del SAW con nódulos subcutáneos es una de las variantes poco frecuente, en las que es preciso ampliar el estudio. Se cree que los nódulos, al igual que el SAW, son debidos a procesos trombóticos linfovenosos (AU)

We describe the case of a 49-year-old woman who, after surgical treatment of breast cancer, developed axillary web syndrome (AWS) followed, 3 weeks later, by the appearance of soft and painless subcutaneous nodules along the cords and close to the flexure of the elbow. After tests (soft tissue and Doppler ultrasound), a dermal/subcutaneous or neoplastic cause was ruled out, although a cephalic and ulnar venous thrombosis was revealed. Anticoagulant medication was prescribed, with disappearance of the nodules 3-4 weeks later and improvement of AWS. The symptoms, clinical course, diagnostic tests, as well as the published evidence, helped to establish a diagnosis of AWS with subcutaneous nodules. AWS is an early complication after axillary surgery, which is well known among breast cancer professionals and whose diagnosis is based on clinical presentation. Its association with subcutaneous nodules is one of its rare variants and requires compulsory complementary studies to exclude other causes. Like AWS, nodules are believed to be due to lymphatic vessel thrombosis (AU)

Síndrome de Hamman como complicación inusual de COVID-19 / Hamman syndrome as an unusual complication of covid-19

La enfermedad por SARS-CoV-2 ha sido bien conocida por su capacidad de infección y afectación multiórgano con cierta preferencia y gravedad a los pulmones incluyendo lesiones parenquimatosas, alveolares e intersticiales. En esta oportunidad se presenta un caso infrecuente como lo es el síndrome de Hamman en un paciente masculino de 35 años con neumonía viral por COVID-19, Entidad que podría ser un indicador potencial de progresión y agravante de la enfermedad como de los síntomas asociados al patrón usual de la infección. Su tratamiento lo definirá la estabilidad clínica y el tamaño del neumomediastino (AU)

SARS-CoV-2 disease has been well known for its capacity for infection and multi-organ involvement with some preference and severity to the lungs including parenchymal, alveolar and interstitial lesions. On this occasion, an infrequent case such as Hamman syndrome is presented in a 35-year-old male patient with viral pneumonia due to COVID-19. Entity that could be a potential indicator of progression and aggravation of the disease as well as the symptoms associated with the pattern usual infection. His treatment will define the clinical stability and size of the pneumomediastinum (AU)

Identificación de estructuras de infección de Phytophthora palmivora en hojas de clones de palma de aceite Elaeis guinennsis Jacq / Identification of infection structures of Phytophthora palmivora in leaves of oil palm clones Elaeis guineensis Jacq

Este trabajo investigó el modelo de interacción planta-patógeno mediante discos de hojas de clones de palma de aceite inoculados en condiciones ex situ con un aislamiento de Phytophthora palmivora. Las inoculaciones se realizaron en condiciones controladas en cámara de crecimiento. En total, seis diferentes ortets fueron evaluados en seis tiempos de infección (2, 4, 6, 12, 24 y 48 horas postinfección, o hpi). Se determinó la presencia de estructuras de patogenicidad de P. palmivora como quiste, apresorio y tubos germinativos. Los quistes fueron identificados principalmente a las 2, 4 y 6 hpi. A partir de las 48 hpi no hubo presencia de zoosporas enquistadas para ningún ortet evaluado. En cuanto a los apresorios, estos se empezaron a desarrollar a las 4 horas de realizada la inoculación (siendo las 12 y 24 hpi los tiempos de mayor registro de estas estructuras). 121 Identificación de estructuras de infección de Phytophthora palmivora en hojas de clones de palma de aceite (Elaeis guineensis Jacq.) Méndez, K. et al. Introducción La Pudrición del cogollo (pc) es una de las principales enfermedades que afecta al cultivo de palma de aceite, destruyendo plantaciones desde 1964. En Colombia la enfermedad se presenta en las cuatro zonas palmeras y ha alcanzado proporciones epidémicas (Sarria et al., 2013a, 2016). A finales de 2004 en la Zona Suroccidental se registró un incremento en el número de casos, con un crecimiento exponencial de esta enfermedad, y a partir de 2007 se vieron afectadas más de 30.000 ha de cultivos de palma de aceite. En la Zona Central un comportamiento similar de la enfermedad fue registrado para la región de Puerto Wilches (Norte de Santander) entre 2009 y 2013, periodo en el cual se perdieron más de 40.000 ha como consecuencia de una epidemia de pc (Sanz, 2016). Por su parte, los productores de la Zona Norte actualmente hacen frente a la amenaza de una expansión epidémica de la pc con síntoma de hoja clorótica, la cual da cuenta de un estado avanzado de la enfermedad. Una amplia revisión del impacto de esta enfermedad desde sus inicios se encuentra en Benítez & García (2015), Sundram & Intan-Nur (2017) y Torres et al. (2016). La enfermedad de la Pudrición del cogollo es causada por el oomiceto hemibiótrofo P. palmivora (Sarria et al., 2008, 2013). Desde su identificación como agente causal de la pc en 2008, el Centro de Investigación en Palma de Aceite (Cenipalma) ha liderado diferentes investigaciones que han dado como resultado el desarrollo de estrategias de manejo integrado del cultivo de palma, así como la descripción del patógeno por medio de inoculación en condiciones in vitro en foliolos inmaduros de palma (Martínez et al., 2013, 2014a), entre otras. En cuanto a la presencia de esta enfermedad en otros cultivos, Mohamed-Azni et al. (2017) emplearon la técnica de foliolo inmaduro, logrando infectar foliolos de palma de aceite con P. palmivora aislada proveniente de cultivos de cacao y durián. Teniendo en cuenta que actualmente no se conocen fuentes probadas de resistencia de cultivares de Elaeis guineensis a la pc, y que un ciclo de mejoramiento genético de palma puede durar más de 25 años Por su parte, los tubos germinativos se encontraron a partir de las 48 hpi únicamente. Finalmente, se pudo establecer que el patógeno logra colonizar tejidos de foliolo no lignificados de clones de palma. Además, se encontró una relación entre el número de estructuras del patógeno con el comportamiento del cultivar de la palma donor (ramet)

Plant-pathogen model interaction was studied using leaf disks of oil palm clones inoculated ex situ with a Phytophthora palmivora isolate. The inoculation process was performed under growth chamber conditions. Six ortets were evaluated at six post-inoculation times (2, 4, 6, 12, 24 y 48 hours post infection, or hpi). Pathogen's infection structures as cyst, apressorium and germinative tubes were found. Cysts were identified mainly at 2, 4 and 6 hpi. After 48 hpi there were not any cysts for the evaluated ortets. The apresoria started to develop at 4 hpi, with the highest presence of these structures at 12 and 24 hpi. Germinative tubes were found only after 48 hpi. Therefore, it was established that the pathogen can colonize no-lignified tissue of oil palm clones. Finally, we found a relation between the pathogen's structures number and the response of the ortet related to its susceptibility and resistance response. Thus, it was found that the susceptible cultivar showed the highest number of germinative tubes

Sistema de Apoyo para la Cuantificación Semiautomática de Fibrosis Pulmonar en Imágenes de TAC / Support System for Semiautomatic Quantification of Pulmonary Fibrosis in CT Images

Resumen: En este trabajo se presenta un método para calcular los niveles de fibrosis pulmonar en imágenes de tomografía axial computarizada. Se utilizó un algoritmo de segmentación semiautomática basado en el método de Chan-Vese. El método mostró similitudes de forma cualitativa en la región de la fibrosis con respecto al experto clínico. Sin embargo es necesario validar los resultados con una base de datos mayor. El método propuesto aproxima un porcentaje de fibrosis de forma fácil para apoyar su implementación en la práctica clínica minimizando la subjetividad del experto médico y generando una estimación cuantitativa de la región de fibrosis.

Abstract: A method to estimate the pulmonary fibrosis in computed tomography (CT) imaging is presented. A semi-automatic segmentation algorithm based on the Chan-Vese method was used. The proposed method shows a similar fibrosis región with respect to clinical expert. However, the results need to be validated in a bigger data base. The proposed method approximates a fibrosis percentage that allows to achieve this procedure easily in order to support its implementation in the clinical practice minimizing the clinical expert subjectivity and generating a quantitative estimation of fibrosis region.

Ptosis palpebral unilateral como debut de mieloma múltiple / Unilateral ptosis as the initial sign of multiple myeloma

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Variante anatómica supernumeraria del músculo pectoral mayor (tercer pectoral) / Supernumerary anatomical variant of pectoralis major muscle (third pectoral)

INTRODUCCIÓN: existen estudios que describen variantes anatómicas definidas y frecuentes en el poblador Andino Boliviano, en el aparato locomotor pedio y la constancia del Músculo tercer abductor, entre otros. ¿Por qué no en cualquier otro segmento? Las variaciones del Músculo pectoral mayor no suelen ser encontradas con frecuencia en la literatura. MATERIAL Y MÉTODO: se estudiaron 2 cadáveres adultos varones de características; raza mestiza del altiplano Boliviano, edades aparentes entre 30 y 70 años, conservados con solución de Formaldehido al 15% en el Pabellón Florentino Mejía del Departamento de Ciencias Morfológicas de la Facultad de Medicina de la Universidad Mayor San Andrés. El estudio se llevó a cabo en dos gestiones consecutivas. Se realizó la técnica de disección convencional topográfica regional, de las regiones pectoral, axilar y braquial. RESULTADOS: dos preparaciones presentaron la misma variante en la región axilar izquierda. En ambos casos, la estructura muscular bien diferenciada, debajo del pectoral mayor, se originaba en la unión condrocostal de la 6ta y 7ma costilla, tomando un trayecto supero lateral, paralelamente al borde lateral del pectoral Mayor y se insertaba en el borde medial del tabique medial del brazo. CONCLUSIÓN: se trata de una variante del Músculo Pectoralis Tertius o Tercero, que se considera así a todo aquel fascículo supernumerario del músculo pectoral Mayor, con un origen e inserción independiente de él. Empero la descripción del hallazgo no corresponde cabalmente a ninguna mencionada en la literatura revisada. Corresponde a un fascículo supernumerario o músculo no descrito hasta la fecha.

INTRODUCTION: studies describing frequent anatomical variants defined in the Bolivian Andean settler in the locomotion pedal and constancy third abductor muscle, among others. Why not in any other segment? The muscle Pectoralis major's variations usually not often found in the literature. MATERIAL AND METHOD: 2 male adult cadavers were studied characteristics; half blood from Bolivian altiplano apparent ages between 30 and 70 years, preserved with formaldehyde solution 15% in Block Florentino Mejia Morphological Sciences Department of the Faculty of Medicine of the Universidad Mayor San Andrés. The study was conducted in two consecutive steps. The conventional technique of regional topographical dissection of the chest, axillary and brachial regions was performed. RESULTS: two preparations had the same variant in the left axillary region. In both cases, the distinct muscular structure beneath the pectoralis major, originated in the costochondral junction of the 6th and 7th rib, taking a trip surpassed side, parallel to the lateral edge of the pectoralis major and was inserted into the medial edge of the partition medial arm. CONCLUSION: this is a variant of the Pectoralis Tertius Muscle or third, so that everyone sees the pectoral muscle bundle temporary Mayor, with a separate origin and insertion of it. But the description of the find does not correspond fully to any mentioned in the literature reviewed. It corresponds to a temporary issue or muscle not described to date.

In vivo biocompatibility of nanostructured Chitosan/Peo membranes / Biocompatibilidade in vivo de membranas nanoestruturadas de Quitosana/Peo

Electrospinning is a technique that allows the preparation of nanofibers from various materials. Chitosan is a natural and abundant easily obtained polymer, which, in addition to those features, proved to be biocompatible. This work used nanostructured chitosan and polyoxyethylene membranes as subcutaneous implants in Wistar rats to evaluate the biocompatibility of the material. Samples of the material and tissues adjacent to the implant were collected 7, 15, 30, 45 and 60 days post-implantation. Macroscopic integration of the material to the tissues was observed in the samples and slides for histopathological examination that were prepared. It was noticed that the material does not stimulate the formation of adherences to the surrounding tissues and that there is initial predominance of neutrophilia and lymphocytosis, with a declining trend according to the increase of time, featuring a non-persistent acute inflammatory process. However, the material showed fast degradation, impairing the macroscopic observation after fifteen days of implantation. It was concluded that the material is biocompatible and that new studies should be conducted, modifying the time of degradation by changes in obtaining methods and verifying the biocompatibility in specific tissues for biomedical applications.

A eletrofiação é uma técnica que permite a preparação de nanofibras mediante o uso de diversos materiais. A quitosana é um polímero natural, abundante e de fácil obtenção, que, além dessas características, demonstrou ser biocompatível. Este trabalho utilizou membranas nanoestruturadas de quitosana e polióxido de etileno como implantes subcutâneos em ratos Wistar para avaliar a biocompatibilidade do biomaterial. As amostras do material e de tecidos adjacentes ao implante foram retiradas sete, 15, 30, 45 e 60 dias pós-implantação para a observação da integração macroscópica do material aos tecidos e para a preparação de lâminas para exame histopatológico. Verificou-se que o material não estimula a formação de aderências com os tecidos circunvizinhos e que há predominância inicial de neutrofilia e linfocitose, que tendem a decrescer em razão do aumento do tempo, caracterizando um processo inflamatório agudo não persistente. No entanto, o material apresentou degradação rápida, não sendo possível observá-lo macroscopicamente após 15 dias de implantação. Concluiu-se que o material é biocompatível, o que indica que novos estudos devem ser conduzidos, com modificação do tempo de degradação por alterações nos métodos de obtenção e verificação da biocompatibilidade em tecidos específicos para aplicações biomédicas.

Prevalencia de Dolor Miofascial en Músculos de la Masticación y Cervicales en un Centro Especializado en Trastornos Temporomandibulares y Dolor Orofacial / Prevalence of Myofascial Pain in Masticatory and Neck Muscles in a Specialized Center of Temporomandibular Disorders and Orofacial Pain

El dolor miofascial es una patología muscular regional no inflamatoria que en el territorio craneocervical se encuentra clasificada dentro de los Trastornos Temporomandibulares. Afecta al 95% de las personas con trastornos de dolor crónico y es un hallazgo común en pacientes en tratamiento en centros de dolor. Se revisaron 121 fichas de pacientes atendidos en el policlínico de Trastornos Temporomandibulares y Dolor Orofacial de la Universidad de La Frontera, Temuco-Chile, identificando la prevalencia de dolor miofascial y su asociación con la edad y sexo de los pacientes. El 80,99% de los pacientes presentó dolor miofascial, el músculo masetero fue el más afectado, seguido por los músculos temporal y trapecio superior, siendo frecuente la afectación bilateral y simultánea de diferentes músculos. La presencia de dolor miofascial no se asocia a la edad de los pacientes pero si al sexo de estos, donde las mujeres presentan más frecuentemente esta patología. Es importante realizar un correcto diagnóstico de dolor miofascial en pacientes que acuden por dolor en este territorio y más aún es trascendental tomar conciencia de su elevada prevalencia.

Myofascial pain is a noninflammatory regional muscle pathology, in craniocervical territory it is classified as temporomandibular disorder. Myofascial pain affects 95% of people with chronic pain disorders and is a common finding in pain centers. One hundred twenty-one charts of patients seen at the clinic of Temporomandibular Disorders and Orofacial Pain at the Universidad de La Frontera Temuco-Chile, were reviewed, identifying the prevalence of myofascial pain and its association with age and sex of the patients. In 80.99% of patients myofascial pain was present, the masseter muscle was the most affected, followed by the temporal and upper trapezius muscles, with frequent bilateral and simultaneous involvement of different muscles. The presence of myofascial pain is not associated with patient age but it is associated with the sex of these, where women have this condition more often. It is important to make a correct diagnosis of myofascial pain in patients presenting with pain in this area and it is even more crucial to be aware of its high prevalence.

Factores biopsicosociales asociados a la disfunción sexual femenina en una población mexicana / Biopsychosocial factors associated with female sexual dysfunction in a mexican population

Objetivo: Determinar los factores biopsicosociales asociados a la disfunción sexual femenina en una población mexicana. Métodos: Estudio comparativo en mujeres que acudieron como acompañantes a una Unidad de Medicina Familiar de Querétaro, México. Se aplicaron las encuestas de Laumman, Chávez y Velazco, Faces III, y Grajales para valorar sexualidad, funcionalidad conyugal, funcionalidad familiar y estado de la autoestima. Los resultados fueron analizados con Odds Ratios, Chi cuadrado y t de Student. Resultados: De 110 mujeres entrevistadas, 65 (59 por ciento) refirieron alguna disfunción sexual y 45 (41 por ciento) lo negaron. Se formaron aleatoriamente dos grupos de 44 mujeres: con y sin disfunción sexual. Los factores que se asociaron significativamente a las alteraciones sexuales fueron: edad mayor a 40 años, laborar fuera del hogar, presencia de obesidad y/o sobrepeso, hipertensión arterial, diabetes mellitus, histerectomía previa, maternidad, disfuncionalidad conyugal, autoestima alta, depresión leve a severa, familia disfuncional, estrato socioeconómico bajo. Las alteraciones sexuales más frecuentes fueron: disminución en el deseo sexual (34,1 por ciento), disfunción eréctil de la pareja (22,7 por ciento), dispareunia y falta de excitación (20,5 por ciento), sexo referido como desagradable e incapacidad para llegar al orgasmo (13,6 por ciento), ansiedad por el desempeño sexual (6,8 por ciento) y eyaculación precoz (4,5 por ciento). Conclusiones: Es importante identificar los factores que afectan la sexualidad femenina para ofrecer un manejo multidisciplinario y prevenir implicaciones a nivel del entorno familiar y conyugal.

Objective: To determine the biopsychosocial factors associated with female sexual dysfunction in a Mexican population. Methods: A comparative study in women who were attended at a Family Medicine Unit of Queretaro, Mexico. Surveys of Laumman, Chavez and Velazco, Faces III, and Grajales, were applied to assess sexuality, marital functionality, familiar functionality and state self-esteem. The results were analyzed with Odds Ratios, chi-square and Student t test. Results: Of 110 women interviewed, 65 (59 percent) reported sexual dysfunction and 45 (41 percent) denied. They formed two groups randomly from 44 women with and without sexual dysfunction. Factors that were significantly associated with sexual disorders were: age greater than 40 years, labor outside the home, presence of obesity and/or overweight, hypertension, diabetes mellitus, prior hysterectomy, maternity, marital dysfunction, high self-esteem, mild to severe depression, dysfunctional family, low socioeconomic status. The most common sexual dysfunction were: decrease in sexual desire (34.1 percent), erectile dysfunction couples (22.7 percent), dyspareunia and lack of arousal (20.5 percent), referred to as unpleasant sex and inability to reach orgasm 13.6 percent) sexual performance anxiety (6.8 percent) and premature ejaculation (4.5 percent). Conclusions: It is important to identify the factors affecting female sexuality to offer multidisciplinary management and prevention implications at the level of family and marital environment.

Conocimientos y capacitación autopercibida para la reanimación cardiopulmonar / Cardiopulmonary resusitation knowledge and self-perceived degree of readiness

Objetivo: valorar el nivel de conocimientos de los enfermeros sobre el protocolo de reanimación cardiopulmonar (RCP) e identificar el grado de capacitación subjetiva y necesidad de formación autopercibida de los mismos. Método: estudio descriptivo transversal en tres ámbitos de actuación enfermera: atención primaria (A) (áreas 6 y 7), hospitalización general (B) y Unida desde Cuidados Intensivos (C) (Hospital Universitario 12 de Octubre),durante el mes de marzo de 2012, en la Comunidad de Madrid. Para la recogida de datos se utilizó un cuestionario sobre conocimientos, capacitación subjetiva y necesidad de formación en RCP, elaborado según las recomendaciones de 2010 del European Resuscitation Council (ERC) y la American Heart Association (AHA).Resultados: la muestra estuvo compuesta por 105 enfermeros, 35 de cada uno de los tres ámbitos del estudio. Los enfermeros de AP contestaron correctamente al 51,7% de las preguntas, los de planta al 58.9% y los de UCI al69,1%. El 26% de los profesionales enfermeros con más experiencia (> 25años) y el 11% de los que tenían menos experiencia (≤ 5 años) contestaron menos de 4 preguntas correctamente. Los enfermeros con una experiencia profesional de entre 5 y 15 años fueron los que reflejaron mejores conocimientos, contestando más de 6 preguntas bien el 62% de los mismos. El 62,9%de AP, el 54,3% de planta y el 25,7% de UCI se consideró poco preparado para reanimar. Estimaron muy importante la formación continuada el 71,4%,el 94,3% y el 91,4% de los profesionales de cada ámbito respectivamente. Conclusiones: los enfermeros no tienen los conocimientos suficientes y se sienten poco preparados para reanimar, existiendo diferencias según la unidad de trabajo. Se considera necesario mejorar la formación pre y postgrado de Enfermería en RCP (AU)

Purpose: Evaluate the degree of knowledge nursing professionals possess regarding the CPR protocol and identify the subjective degree of readiness and self-perceived need for training thereof. Method: Descriptive, cross-sectional study in three areas of nursing practice: primary care (A) (Districts 6 & 7), general hospitalization (B) and intensive care units (C) (“12 de Octubre" University Hospital) in March 2012 in the Autonomous Community of Madrid. For data collection, a questionnaire on knowledge , subjective degree of readiness and need for training in CPR was used, having been prepared according to the 2010 recommendations of the European Resuscitation Council (ERC) and the American Heart Association (AHA).Results: The sample was comprised of 105 nursing professionals, 35 from each one of the three fields of the study. The PC nursing personnel answered51.7% of the questions correctly, the hospital nurses, 58.9% and the ICU nurses, 69.1%. A total of 26% of the most experienced nursing professionals(> 25 years) and 11% of those who were less experienced (< 5 years) answered less than 4 questions correctly. The nursing personal possessing 5-15 years of professional experience were those showing the greatest degree of knowledge , 62% thereof having answered more than 6 questions correctly. A total of 62.9% of PC nurses, 54.3% of hospital nurses and 25.7% of ICU nurses considered themselves not very well prepared to perform CPR. A total of 71.4% of the PC nurses, 94.3% of the hospital nurses and 91.4% of the ICU nurses considered continuing training to be highly important. Conclusions: Nurses do not possess sufficient knowledge and do not consider themselves to ill-prepared for performing CPR, differences existing depending on the unit where these nursing professionals work. An improvement in undergraduate and graduate nursing training in CPR is considered necessary (AU)

Eficacia y seguridad del tratamiento antibiótico domiciliario endovenoso en pacientes con patología infecciosa procedentes del servicio de urgencias / Safety and efficacy of home intravenous antibiotic therapy for patients referred by the hospital emergency department

Objetivo: Analizar la eficacia y seguridad del tratamiento antibiótico domiciliario endovenoso (TADE) en infecciones de pacientes procedentes del servicio de urgencias. Método: Estudio prospectivo de los pacientes ingresados para TADE en la unidad de hospitalización a domicilio (HaD) del Hospital de Sabadell entre enero del 2008 a junio del 2011. Se comparan dos grupos: pacientes derivados desde urgencias frente a pacientes procedentes de otros dispositivos asistenciales. Las variables analizadas fueron edad, sexo, estancia media, índice de Barthel, vía y forma de administración del antibiótico, tipo de infección, microorganismo aislado, antibiótico utilizado, índices de reingreso precoz y tardío y complicaciones médicas y asociadas al acceso venoso. El TAD Ese autoadministró por parte del cuidador y/o el paciente mediante dispositivos de infusión elastoméricos. Resultados: Se reclutaron 409 pacientes que generaron 492 episodios de TADE, 92 (..) (AU)

Objective: To analyze the safety and efficacy of home intravenous antibiotic therapy (HIVAT) for patients with infections discharged from the emergency department and referred to the home hospital program. Methods: Prospective study of patients referred to the home hospital program of Hospital de Sabadell for HIVAT between January 2008 and June 2011. We compared 2 groups: patients referred by the emergency department and patients referred by any other department or service. Variables analyzed included age, sex, mean stay in the program, Barthel index, route and method for administering the antibiotic, type of infection, microorganism isolated, antibiotic prescribed, early and late readmission rates, and complications (medical and those associated with venous access). HIVAT was self-administered by the patient (or home caregiver) through an elastomeric infusion device. Results: We studied 409 patients and 492 courses of HIVAT; 92 patients were referred by the emergency department and400 came from other care units. Emergency patients were older, had greater functional impairment, a shorter stay in the (..) (AU)