Extensor Medii Proprius: A Cadaveric Case Report.

During routine dissection of 11 cadavers that originated with the Body Donor Program at Philadelphia College of Osteopathic Medicine (PCOM) Georgia, a 69-year-old African American male with bilateral extensor anomalies in the dorsal forearm compartment was encountered. The distinct muscle belly, identified as the extensor medii proprius (EMP), originated from the distal ulna and was inserted near the dorsal aponeurosis of the third digit. Manual traction of the right EMP tendon resulted in the extension of the third digit, suggesting the functional significance of the anomalous muscle. This case study analyzes the EMP found during dissection, as well as the anomalous muscle's prevalence, embryologic origin, and clinical relevance. The presence of the EMP muscle and tendon can be considered when assessing pain in the dorsum of the hand and when preparing for surgical repair or tendon transfer.

El entrenamiento como forma de actualización docente en la Licenciatura en Imaginología y Radiofísica Médica

El desarrollo alcanzado en los servicios de salud demanda la mejora en la superación profesional de los docentes de la Licenciatura en Imaginología y Radiofísica Médica. Esta exigencia requiere la profesionalización en los modos de actuación de la profesión. Su actualización en los contenidos acerca de los principios físicos, anatomía humana, semiología radiológica, en esencia, así como sus habilidades prácticas durante la educación en el trabajo, son imprescindibles. Este trabajo tiene como propósito presentar la concepción del entrenamiento como una forma de profesionalización docente para la actualización de los contenidos. Se presenta la estructura del entrenamiento para la profesionalización del docente en la Licenciatura en Imaginología y Radiofísica Médica y la concepción pedagógica sobre el entrenamiento para su organización y aplicación en los docentes de esta carrera en la Universidad de Ciencias Médicas de Cienfuegos.

The development achieved in the health services demands the teachers Degree in Medical Imaging and Radiophysics' professional improvement. This demand requires professionalization in the action modes. Its updating in physical principles, human anatomy, radiological semiology, as well as its practical skills during education at work, are essential. The purpose of this paper is to present the conception of training as a form of teacher professionalization for content updating. The training structure for the teacher's professionalization in the Medical Imaging and Radiophysics Degree and the training pedagogical conception for its organization and application in this career's teachers at the Cienfuegos Medical Sciences University are presented.

Cost-effectiveness analysis of the daily HIV pre-exposure prophylaxis in men who have sex with men in Barcelona.

INTRODUCTION: Pre-Exposure Prophylaxis (PrEP) for HIV prevention has been implemented in several countries. Previous literature has shown that its cost-effectiveness (and, under some specifications, cost-saving character) is dependent on the reduction in price due to generics, the time-horizon and its effectiveness. The intervention has never been studied in Catalonia after the approval of the PrEP, a territory with extensive implementation. METHODS: Economic evaluation of the implementation of HIV pre-exposition prophylaxis using administrative data from Men who have Sex with Men (MSM) who receive the treatment (at the generic price) compared with non-implementation. A deterministic compartmental model and a social perspective with a micro-costing approach over the time horizon 2022-2062 are used. A baseline 86% effectiveness of PrEP is assumed. RESULTS: Daily oral PrEP is found to be cost-saving: discounted savings in costs are attained after 16 years, and after 40 years they reach 81 million euros. In terms of health indicators, 10,322 additional discounted QALYs are generated by the intervention. Results are sensitive to sexual behavioral patterns among MSM, the price of PrEP (reduced if offered on-demand), its effectiveness and the discount rate. CONCLUSIONS: The use and promotion of PrEP in Catalonia is predicted to result in substantial health and monetary benefits because of reductions in HIV infections. Short-term investments in the promotion of PrEP will result in important cost-savings in the long term.

Safety, immunogenicity and effect on viral rebound of HTI vaccines in early treated HIV-1 infection: a randomized, placebo-controlled phase 1 trial.

HIVACAT T-cell immunogen (HTI) is a novel human immunodeficiency virus (HIV) vaccine immunogen designed to elicit cellular immune responses to HIV targets associated with viral control in humans. The AELIX-002 trial was a randomized, placebo-controlled trial to evaluate as a primary objective the safety of a combination of DNA.HTI (D), MVA.HTI (M) and ChAdOx1.HTI (C) vaccines in 45 early-antiretroviral (ART)-treated individuals (44 men, 1 woman; NCT03204617). Secondary objectives included T-cell immunogenicity, the effect on viral rebound and the safety of an antiretroviral treatment interruption (ATI). Adverse events were mostly mild and transient. No related serious adverse events were observed. We show here that HTI vaccines were able to induce strong, polyfunctional and broad CD4 and CD8 T-cell responses. All participants experienced detectable viral rebound during ATI, and resumed ART when plasma HIV-1 viral load reached either >100,000 copies ml-1, >10,000 copies ml-1 for eight consecutive weeks, or after 24 weeks of ATI. In post-hoc analyses, HTI vaccines were associated with a prolonged time off ART in vaccinees without beneficial HLA (human leukocyte antigen) class I alleles. Plasma viral load at the end of ATI and time off ART positively correlated with vaccine-induced HTI-specific T-cell responses at ART cessation. Despite limited efficacy of the vaccines in preventing viral rebound, their ability to elicit robust T-cell responses towards HTI may be beneficial in combination cure strategies, which are currently being tested in clinical trials.

Dummy regression to predict dry fiber in Agave lechuguilla Torr. in two large-scale bioclimatic regions in Mexico.

Agave lechuguilla Torr., of the family Agavaceae, is distributed from southwestern United States to southern Mexico and is one of the most representative species of arid and semiarid regions. Its fiber is extracted for multiple purposes. The objective of this study was to generate a robust model to predict dry fiber yield (Dfw) rapidly, simply, and inexpensively. We used a power model in its linear form and bioclimatic areas as dummy variables. Training, generation (80%) and validation (20%) of the model was performed using machine learning with the package 'caret' of R. Using canonical correlation analysis (CCA), we evaluated the relationship of Dwf to bioclimatic variables. The principal components analysis (PCA) generated two bioclimatic zones, each with different A. lechuguilla productivities. We evaluated 499 individuals in four states of Mexico. The crown diameter (Cd) of this species adequately predicts its fiber dry weight (R2 = 0.6327; p < 0.05). The intercept (ß0), slope [lnCd (ß1)], zone [(ß2)] and interaction [lnCd:Zona (ß3)] of the dummy model was statistically significant (p < 0.05), giving origin to an equation for each bioclimatic zone. The CCA indicates a positive correlation between minimum temperature of the coldest month (Bio 6) and Dwf (r = 0.84 and p < 0.05). In conclusion, because of the decrease in Bio 6 of more than 0.5°C by 2050, the species could be vulnerable to climate change, and A. lechuguilla fiber production could be affected gradually in the coming years.

Efectividad del tratamiento con acupuntura en la urgencia hipertensiva / Effectiveness of acupuncture treatment in hypertensive emergency

Introducción: La hipertensión arterial constituye un problema de salud, tanto a nivel mundial como en Cuba, por las complicaciones e implicaciones que tiene en la morbilidad de la población mayor de 15 años. Una mayor y mejor asistencia sanitaria no consiste tan solo en la práctica de costosos tratamientos, sino ante todo en educar, sanitariamente, a la población en la utilización de los recursos de la naturaleza, así como en el empleo de técnicas y la búsqueda de terapias menos invasivas y sin efectos secundarios. Objetivo: Evaluar la efectividad del tratamiento acupuntural en la urgencia hipertensiva. Métodos: Se realizó un estudio cuasi-experimental en el Policlínico Fray Benito, municipio Rafael Freyre, en el período comprendido enero de 2019 y mayo de 2020. El universo lo conformaron todos los pacientes que acudieron al cuerpo de guardia de dicho policlínico, remitidos del consultorio médico de familia con diagnóstico de urgencia hipertensiva. La muestra de estudio se escogió de forma aleatoria y quedó constituida por aquellos pacientes con diagnóstico de urgencia hipertensiva, que cumplieron con los criterios de inclusión y los criterios de exclusión. Las principales variables utilizadas fueron edad, sexo, resultados del tratamiento, presencia de reacciones adversas o no. Conclusiones: Se demostró la efectividad del tratamiento acupuntural en la urgencia hipertensiva en el Policlínico Fray Benito(AU)

Introduction: Hypertension constitutes a health problem, both worldwide and in Cuba, due to the complications and implications it has on the morbidity of the population over 15 years of age. More and better health care does not consist only in the practice of expensive treatments, but above all in educating the population in health, in the use of natural resources, as well as in the use of techniques and the search for less invasive therapies and without side effects. Objectives: To evaluate the effectiveness of acupuncture treatment in hypertensive emergency. Methods: A quasi-experimental study was carried out at Fray Benito Community Clinic, Rafael Freyre municipality, from January 2019 to May 2020. The universe was made up of all the patients who attended the emergency room of said polyclinic, referred from their family doctor's office with emergency hypertensive diagnosis. The study sample was chosen randomly with those patients with a hypertensive emergency diagnosis, who met the inclusion and exclusion criteria. The main variables used were age, sex, treatment results, presence of adverse reactions or not. Conclusions: The effectiveness of acupuncture treatment in hypertensive emergencies was demonstrated at Fray Benito Community Clinic(AU)

Use of fourth-generation rapid combined antigen and antibody diagnostic tests for the detection of acute HIV infection in a community centre for men who have sex with men, between 2016 and 2019.

OBJECTIVE: To assess the use of fourth-generation rapid diagnostic tests in identifying acute infection of Human Immunodeficiency Virus (HIV). METHODS: BCN Checkpoint promotes sexual health among men who have sex with men (MSM), with a focus on diagnosing HIV early, initiating combined antiretroviral treatment (cART) promptly, and recommending regular repeat testing for those who have tested negative. This cross-sectional study included all test results obtained at the centre between 25 March 2016 and 24 March 2019. The Alere™ HIV Combo (now rebranded to Determine™ HIV Ultra, from Abbott) was used to detect p24 antigen (p24 Ag) and/or immunoglobulin M (IgM) and G (IgG) antibodies to HIV-1/HIV-2 (HIV Ab). Rapid polymerase chain reaction (PCR) confirmatory testing and Western blot (WB) were performed for clients with a positive rapid test result. Confirmed HIV cases were promptly referred to the HIV unit for care and cART prescription. RESULTS: A total of 12,961 clients attended BCN Checkpoint during the study and 27,298 rapid tests were performed. 450 tests were found to be reactive, of which 430 confirmed as HIV-positive, representing a prevalence of 3.32%. Four confirmed cases (0.93%) were detected as "p24 Ag only", nine (2.09%) as "both p24 and HIV Ab" and 417 (96.98%) as "HIV Ab only". The "p24 Ag only" group had a 1-log higher viral load than the other groups and initiated treatment on the following working day. Overall, there were 20 false-positive results (0.07% and 4.44% of total and reactive tests, respectively), of which 10 positive for "p24 Ag only" and 10 for "HIV Ab only". CONCLUSIONS: Four Acute HIV Infections (AHI), with very high viral loads, have been detected with the "p24 Ag only" while the HIV Ab were still absent. Referral to the HIV unit and initiation of cART on the following working day contributed to improving persons' health and to reduce HIV transmission chain.

Falling HIV incidence in a community clinic cohort of men who have sex with men and transgender women in Barcelona, Spain.

In Barcelona, Spain prior to 2006, HIV testing was mostly limited to formal healthcare facilities with no incidence data reported. A community-based organization (BCN Checkpoint) was established to increase HIV testing in a peer-led community location to generate incidence data in men who have sex with men and transgender women. Three community engagement interventions were conducted between 2009 and 2017 as follows: 2009-2011 (peer-led point-of-care testing for HIV), 2012-2014 (12-monthly HIV testing with an emphasis on testing in partnerships), 2015-2017 (three-monthly HIV testing with rapid referral for antiretroviral initiation). Between 2009 and 2017 a predominantly cisgender male (99.4%) and Spanish national (62.4%) population with mean age of 34.8 years had 49,630 visits. Mean visit number increased from 1.69 in the first to 2.07 in the last three-year period. HIV incidence fell from 4.17 (95% confidence interval [CI]: 3.53-4.93) per 100 person-years in 2009-2011 to 1.57 (95% CI: 1.30-1.89) per 100 person-years in 2015-2017. This represents a 62% reduction (incidence rate ratio: 0.38, 95% CI: 0.29-0.48) between the first and third study period (p < 0.001). These early interventions may have contributed to the reduction seen in HIV incidence in this cohort.

Long-term stability of microbiome diversity and composition in fecal samples stored in eNAT medium.

Fecal samples collected for microbiome analyses are typically frozen to avoid postcollection changes in microbial composition. eNAT is a guanidine thiocyanate-based medium that stabilizes microbial DNA and allows safe specimen handling and shipping by inactivating microorganisms. We collected fecal samples (n = 50) from children undergoing hematopoietic stem cell transplantation. We divided samples into three aliquots: (a) stored in RNAlater and immediately transferred to -80°C; (b) stored in eNAT medium and immediately transferred to -80°C; and (c) stored in eNAT medium at ambient temperature (~20°C) for 30 days prior to transfer to -80°C. Mean (standard deviation) Shannon diversity and Chao1 indices in sample aliquots were 2.05 (0.62) and 23.8 (16.6), respectively. Comparing samples frozen immediately in RNAlater to samples frozen immediately in eNAT, there were no differences in Shannon diversity (p = .51), Chao1 richness (p = .66), and overall microbiome composition (p = .99). Comparing eNAT samples frozen immediately to samples stored at ambient temperature, we identified no differences in Shannon diversity (p = .65), Chao1 richness (p = .87), and overall microbiome composition (p = .99). Storage of fecal samples in eNAT at ambient temperature for 30 days did not alter microbiome richness, diversity, or composition. eNAT may be a useful medium for fecal microbiome studies, particularly when cold chain storage is unavailable.

Síndrome de encefalopatía reversible posterior. Presentación de un caso y revisión de la literatura / Posterior reversible encephalopathy syndrome. Case report and literature review

RESUMEN El síndrome de encefalopatía reversible posterior constituye una entidad clínica y radiológica transitoria, con múltiples factores de riesgo en los cuales la lesión endotelial y el compromiso en la perfusión cerebral son el común denominador. La resonancia magnética cerebral es el método de elección para el diagnóstico. Se presenta el caso de una puérpera de 26 años con antecedentes patológicos personales de aparente salud, que luego de un parto eutócico sufrió choque hipovolémico, producto de hemorragia postparto por atonía uterina con resultado de histerectomía obstétrica subtotal, ventilación mecánica con triple apoyo vasoactivo; después de una evolución favorable comenzó con cefalea intensa y trastornos visuales, cifras elevadas de tensión arterial y presentódos episodios de convulsiones tónico-clónicas generalizadas.Se le realizó tomografía computarizada de cráneo y se solicitó además estudio de resonancia magnética.Se presenta el caso por lo inusual de este tipo de entidad en la práctica médica cotidiana.

ABSTRACT Posterior reversible encephalopathy syndrome constitutes a transient clinical andradiological entity, with multiple risk factors in which endothelial injury and compromise incerebral perfusion are the common characteristics. Brain magnetic resonance is the method of choice for diagnosis.This is the case of a 26-year-old woman with a personal history of apparent health, who after an eutocic delivery suffered hypovolemic shock, product of postpartum hemorrhage due to uterine atony resulting in subtotal obstetric hysterectomy, mechanical ventilation with triple vasoactive support; after a favorable progress, she began with severe headache and visual disorders, high blood pressure and presented two episodes of generalized tonic-clonic seizures. A skull/brain CT scan of was performed and brain magnetic resonance study was also requested. The case is presented because of the unusual nature of this type of entity in everyday medical practice.

Fetal exposure to the maternal microbiota in humans and mice.

Previous studies have demonstrated the presence of microbial DNA in the fetal environment. However, it remains unclear whether this DNA represents viable bacteria and how it relates to the maternal microbiota across body sites. We studied the microbiota of human and mouse dyads to understand these relationships, localize bacteria in the fetus, and demonstrate bacterial viability. In human preterm and full-term mother-infant dyads at the time of cesarean delivery, the oral cavity and meconium of newborn infants born as early as 24 weeks of gestation contained a microbiota that was predicted to originate from in utero sources, including the placenta. Using operative deliveries of pregnant mice under highly controlled, sterile conditions in the laboratory, composition, visualization, and viability of bacteria in the in utero compartment and fetal intestine were demonstrated by 16S rRNA gene sequencing, fluorescence in situ hybridization, and bacterial culture. The composition and predicted source of the fetal gut microbiota shifted between mid- and late gestation. Cultivatable bacteria in the fetal intestine were found during mid-gestation but not late gestation. Our results demonstrate a dynamic, viable mammalian fetal microbiota during in utero development.

Early-life skin microbiota in hospitalized preterm and full-term infants.

BACKGROUND: The infant skin microbiota may serve as a reservoir of bacteria that contribute to neonatal infections and stimulate local and systemic immune development. The objectives of our study were to characterize the skin microbiota of preterm and full-term infants during their birth hospitalization and describe its relationship to the microbiota of other body sites and the hospital environment. RESULTS: We conducted a cross-sectional study of 129 infants, including 40 preterm and 89 full-term infants. Samples were collected from five sites: the forehead and posterior auricular scalp (skin upper body); the periumbilical region, inguinal folds, and upper thighs (skin lower body); the oral cavity; the infant's immediate environment; and stool. Staphylococcus, Streptococcus, Enterococcus, and enteric Gram-negative bacteria including Escherichia and Enterobacter dominated the skin microbiota. The preterm infant microbiota at multiple sites had lower alpha diversity and greater enrichment with Staphylococcus and Escherichia than the microbiota of comparable sites in full-term infants. The community structure was highly variable among individuals but differed significantly by body site, postnatal age, and gestational age. Source tracking indicated that each body site both contributed to and received microbiota from other body sites and the hospital environment. CONCLUSION: The skin microbiota of preterm and full-term infants varied across individuals, by body site, and by the infant's developmental stage. The skin harbored many organisms that are common pathogens in hospitalized infants. Bacterial source tracking suggests that microbiota are commonly exchanged across body sites and the hospital environment as microbial communities mature in infancy.

Calidad de vida en adultos mayores con enfermedad renal crónica en el nivel primario de salud / Life quality in elder people with chronic renal disease in the primary health care level

Introducción: la mayoría de los estudios sobre calidad de vida relacionada a la salud se han dirigido a pacientes en terapias de sustitución renal o transplante renal. Objetivo: valorar la calidad de vida relacionada con la salud en pacientes adultos mayores enfermos renales crónicos desde el nivel primario de salud. Materiales y Métodos: se realizó un estudio observacional, descriptivo en el Consejo Popular Entronque de Pilotos, de mayo del 2014 a mayo del 2015, sobre el comportamiento de la calidad de vida en adultos mayores, con enfermedad renal crónica con estadios 1, 2 y 3 de la enfermedad. El universo fueron los 109 pacientes portadores de la enfermedad a los cuales se aplicó la "Escala MGH de calidad de vida en el adulto mayor". Se utilizaron técnicas de estadística descriptiva y se solicitó el consentimiento informado a los pacientes. Resultados: al inicio del estudio la percepción de calidad de vida de los adultos mayores era muy baja, con pocos pacientes con calidad de vida buena lo que fue modificado favorablemente al año de seguimiento. Conclusiones: se logró que los pacientes adultos mayores con enfermedad renal crónica en los estadios 1,2 y 3 del Consejo Popular Entronque de Pilotos, modificaran favorablemente su percepción de la calidad de vida relacionada con la salud, al año del diagnóstico y seguimiento de la enfermedad (AU).

Introduction: most of the studies on health-related life quality have taken into account patients in therapies of renal replacement or transplantation. Objective: to appraise health-related life quality in elder people suffering chronic renal disease from the primary health care level. Material and Methods: an observational, descriptive study in the Popular Council Entronque de Pilotos, from May 2014 to May 2015, on the behavior of the life quality of elder people with stage 1, 2 and 3 chronic renal disease. The universe was the 109 disease-carrier patients; they applied the "MGH scale of life quality in elder people". Descriptive statistic techniques were used and patients were asked their informed consent. Results: at the beginning of the study, the elder people' life quality perception was very low, having few patients with good life quality; that was favorably modified after a year follow-up. Conclusions: it was achieved the favorable modification of the health-related life quality perception of elder patients with 1, 2, and 3 stage chronic renal disease, living in the Popular Council Entronque de Pilotos, after a year of diagnosis and follow-up (AU).

Diagnóstico de mielomeningocele en un feto mediante resonancia magnética de bajo campo. Presentación de un caso / Diagnosis of mielomeningocele in a fetus through low field magnetic resonance. Case Presentation

La malformación del tubo neural (mielomeningocele) es una enfermedad genética caracterizada por defecto del cierre posterior de las vértebras. El diagnóstico prenatal suele realizarse por ecografía. Se presenta el caso de una embarazada de 35 años de edad, con 26 semanas de gestación, resultado positivo en prueba de alfa feto proteína y dudas en ultrasonido diagnóstico que valoraba la posibilidad de una malformación del tubo neural, por lo que se sugirió realizar resonancia magnética. Al no contar en Cienfuegos con resonancia magnética de alto campo, se aplicaron parámetros de estos equipos a uno de bajo campo (0,35 tesla), con lo que se confirmó el diagnóstico. Las malformaciones del tubo neural, al no ser frecuentes, deben tomarse en cuenta por su costo familiar, personal, social y económico. Es importante diagnosticarlas de manera oportuna a fin de administrar el tratamiento específico, de ahí la importancia de la presentación de este caso, además de lograr la certeza del diagnóstico con un equipo de bajo campo.

The malformation in the neural canal (mielomeningocele) is a genetic disease characterized by a defect in the posterior wedge vertebral closing. Prenatal diagnosis is done by echography. A case of a 35 year old pregnant woman with 26 weeks of gestation is presented with a possitive result of alphafeto protein test and doubts in diagnostic ultrasound evaluating the possibility of a neural canal malformation. For these reasons it was suggested to perform a high field magnetic resonance. As high field resonance is not available, the parameters of low field were applied to this equipment (0.35 Tesla), which confimed the diagnosis. Neural canal malformations are not frequent therefore familial, personal, social and economical costs should be taken into consideration. It is important to diagnose them timely in order to administer the especific treatment. This is the foundation the case presentation importance, added to having achieved a certain diagnosis with a low field equipment.

Calidad de vida en adultos mayores con enfermedad renal crónica en el nivel primario de salud / Life quality in elder people with chronic renal disease in the primary health care level

Introducción: la mayoría de los estudios sobre calidad de vida relacionada a la saludse han dirigido a pacientes en terapias de sustitución renal o transplante renal.Objetivo: valorar la calidad de vida relacionada con la salud en pacientes adultosmayores enfermos renales crónicos desde el nivel primario de salud.Materiales y Métodos: se realizó un estudio observacional, descriptivo en el ConsejoPopular Entronque de Pilotos, de mayo del 2014 a mayo del 2015, sobre elcomportamiento de la calidad de vida en adultos mayores, con enfermedad renalcrónica con estadios 1, 2 y 3 de la enfermedad. El universo fueron los 109 pacientesportadores de la enfermedad a los cuales se aplicó la "Escala MGH de calidad de vidaen el adulto mayor". Se utilizaron técnicas de estadística descriptiva y se solicitó elconsentimiento informado a los pacientes.Resultados: al inicio del estudio la percepción de calidad de vida de los adultosmayores era muy baja, con pocos pacientes con calidad de vida buena lo que fuemodificado favorablemente al año de seguimiento.Conclusiones: se logró que los pacientes adultos mayores con enfermedad renalcrónica en los estadios 1,2 y 3 del Consejo Popular Entronque de Pilotos, modificaranfavorablemente su percepción de la calidad de vida relacionada con la salud, al año deldiagnóstico y seguimiento de la enfermedad (AU).

Introduction: most of the studies on health-related life quality have taken intoaccount patients in therapies of renal replacement or transplantation.Objective: to appraise health-related life quality in elder people suffering chronic renaldisease from the primary health care level.Material and Methods: an observational, descriptive study in the Popular CouncilEntronque de Pilotos, from May 2014 to May 2015, on the behavior of the life quality ofelder people with stage 1, 2 and 3 chronic renal disease. The universe was the 109disease-carrier patients; they applied the “MGH scale of life quality in elder people”.Descriptive statistic techniques were used and patients were asked their informedconsent.Results: at the beginning of the study, the elder people life quality perception wasvery low, having few patients with good life quality; that was favorably modified after ayear follow-up.Conclusions: it was achieved the favorable modification of the health-related lifequality perception of elder patients with 1, 2, and 3 stage chronic renal disease, livingin the Popular Council Entronque de Pilotos, after a year of diagnosis and follow-up (AU).

Osteocondromatosis sinovial: a propósito de un caso / Synovial Osteo-chondromatosis: in Regards with a Case

La condromatosis sinovial es una lesión benigna, poco frecuente y de localización generalmente monoarticular de la membrana sinovial. Afecta a uno de cada 100.000 habitantes. Es 2 veces más frecuente en hombres, y daña fundamentalmente a grandes articulaciones: rodilla (70 %), cadera (20 %) y hombro (19 %). Los estudios imagenológicos son imprescindibles para poder realizar su diagnóstico. Se presenta el caso de un paciente de 20 años, que luego de realizar ejercicios físicos sistemáticos comenzó con aumento de volumen y limitación de movimientos a nivel del hombro izquierdo, acudió al ortopédico y se le impuso tratamiento luego de examen físico y de realizar estudios imagenológicos. Se presenta el caso porque constituye una entidad rara, en la que los estudios por imágenes juegan un rol importante para el diagnóstico y su ulterior tratamiento.

Synovial chondromatosis is a benign, infrequent lesion with a generally synovial membrane mono-articular location. It affects one in every 100,000 inhabitants. It is 2 times more frequent in men, and mainly affects large joints: knee (70 %), hip (20 %) and shoulder (19 %). Imaging studies are essential for diagnosis. A case of 20 year old patient is presented who after performing systematic physical exercises began with left shoulder volume increased and limited movement; he consulted the orthopedic and was prescribed treatment after physical examination and imaging studies. The case is presented because it is an infrequent medical entity in which imaging studies have a vital role for the diagnosis and posterior treatment.

Programa de educación comunitaria sobre salud nefrológica en adultos mayores con factores de riesgo / Community education program about kidney-related health in senior adult with risk factors

Introducción: la enfermedad renal crónica puede ser prevenible y siempre tratable. Las acciones de promoción y educación para la salud influyen en la incidencia y prevalencia de la misma, son el eje del paso del concepto negativo de la salud a una visión positiva. Objetivo: diseñar un programa de educación comunitaria sobre salud nefrológica en adultos mayores. Métodos: se realizó un estudio de desarrollo tecnológico a través de la utilización de técnicas participativas en el periodo de enero de 2015 a enero de 2016. Resultados: la propuesta se sustentó en metas establecidas para su cumplimiento y posterior evaluación de impacto, diseñando un grupo de actividades a realizar previas a la implementación del programa de educación comunitaria que incluyeron capacitación de facilitadores, organización y coordinación de los grupos; así se estructuraron las sesiones de trabajo, dividiendo de forma didáctica el programa en etapas, que incluyeron: diagnóstico comunitario, unificación intersectorial y organización vinculada, utilizando la metodología, investigación -acción- participación, monitoreo y evaluación. Conclusiones: se diseñó un programa de educación comunitaria sobre salud nefrológica dirigido a adultos mayores que podrá ser una herramienta que potencialice la actividad de educación para la salud en este grupo poblacional y logre una mejor calidad de vida de los mismos(AU)

Introduction: Chronic kidney disease can be preventable and always treatable. Health promotion and education actions influence its incidence and prevalence, as well as the axis of the shift from the negative concept of health to a positive vision. Objective: To design a community education program on kidney-related health in senior adults. Methods: A study of technological development was carried out from January 2015 to January 2016. The program proposed was based on the use of participatory techniques. Results: The proposal was based on established goals for its fulfilment and subsequent impact assessment, designing a group of activities to carry out the implementation of the community education program that includes the training of facilitators, and the organization and coordination of the groups. Thus, the work sessions were structured, dividing the program in a didactic way in the stages that included: the community diagnosis, the cross-sector unification, and the related organization, using the methodology research-action-participation, monitoring, and assessment. Conclusions: A community education program on kidney-related health was designed for the senior adults, which could be a tool that would enhance health education activity in this population group and achieve a better quality of life for them(AU)

Programa de educación comunitaria sobre salud nefrológica en adultos mayores con factores de riesgo / Community education program about kidney-related health in senior adult with risk factors

Introducción: la enfermedad renal crónica puede ser prevenible y siempre tratable. Las acciones de promoción y educación para la salud influyen en la incidencia y prevalencia de la misma, son el eje del paso del concepto negativo de la salud a una visión positiva. Objetivo: diseñar un programa de educación comunitaria sobre salud nefrológica en adultos mayores. Métodos: se realizó un estudio de desarrollo tecnológico a través de la utilización de técnicas participativas en el periodo de enero de 2015 a enero de 2016. Resultados: la propuesta se sustentó en metas establecidas para su cumplimiento y posterior evaluación de impacto, diseñando un grupo de actividades a realizar previas a la implementación del programa de educación comunitaria que incluyeron capacitación de facilitadores, organización y coordinación de los grupos; así se estructuraron las sesiones de trabajo, dividiendo de forma didáctica el programa en etapas, que incluyeron: diagnóstico comunitario, unificación intersectorial y organización vinculada, utilizando la metodología, investigación -acción- participación, monitoreo y evaluación. Conclusiones: se diseñó un programa de educación comunitaria sobre salud nefrológica dirigido a adultos mayores que podrá ser una herramienta que potencialice la actividad de educación para la salud en este grupo poblacional y logre una mejor calidad de vida de los mismos(AU)

Introduction: Chronic kidney disease can be preventable and always treatable. Health promotion and education actions influence its incidence and prevalence, as well as the axis of the shift from the negative concept of health to a positive vision. Objective: To design a community education program on kidney-related health in senior adults. Methods: A study of technological development was carried out from January 2015 to January 2016. The program proposed was based on the use of participatory techniques. Results: The proposal was based on established goals for its fulfilment and subsequent impact assessment, designing a group of activities to carry out the implementation of the community education program that includes the training of facilitators, and the organization and coordination of the groups. Thus, the work sessions were structured, dividing the program in a didactic way in the stages that included: the community diagnosis, the cross-sector unification, and the related organization, using the methodology research-action-participation, monitoring, and assessment. Conclusions: A community education program on kidney-related health was designed for the senior adults, which could be a tool that would enhance health education activity in this population group and achieve a better quality of life for them(AU)

Ruthenium-Catalyzed Transfer Hydrogenation for C-C Bond Formation: Hydrohydroxyalkylation and Hydroaminoalkylation via Reactant Redox Pairs.

Merging the chemistry of transfer hydrogenation and carbonyl or imine addition, a broad new family of redox-neutral or reductive hydrohydroxyalkylations and hydroaminomethylations have been developed. In these processes, hydrogen redistribution between alcohols and π-unsaturated reactants is accompanied by C-C bond formation, enabling direct conversion of lower alcohols to higher alcohols. Similarly, hydrogen redistribution between amines to π-unsaturated reactants results in direct conversion of lower amines to higher amines. Alternatively, equivalent products of hydrohydroxyalkylation and hydroaminomethylation may be generated through the reaction of carbonyl compounds or imines with π-unsaturated reactants under the conditions of 2-propanol-mediated reductive coupling. Finally, using vicinally dioxygenated reactants, that is, diol, ketols, or diones, successive transfer hydrogenative coupling occurs to generate 2 C-C bonds, resulting in products of formal [4+2] cycloaddition.