Normative Data in Cross-Cultural Neuropsychological Instruments in Spaniards and Colombians Living in Spain.

BACKGROUND: Cross-Cultural Dementia Screening (CCD), Rowland Universal Dementia Assessment Scale (RUDAS), and European Cross-cultural Neuropsychological Test Battery (CNTB) are three novel neuropsychological instruments developed from a cross-cultural perspective to reduce the impact of culture in cognitive assessment and improve the assessment in diverse populations. OBJECTIVE: We aimed to collect and present normative data on these tests in a majority population sample (Spaniards living in Spain) and in a minority population sample (Colombians living in Spain). METHODS: CCD, RUDAS, and CNTB were administered to a group of 300 cognitively healthy participants (150 Spaniards and 150 Colombians). Linear regression modeling strategy was used to provide adjusted norms for demographic factors and to explore the influence of these factors on test performance. RESULTS: Most of the CCD and CNTB scores were predicted by age and years of education, with some tests only predicted by age or showing a ceiling effect. The comparison of normative data between the two samples confirmed the favorable cross-cultural properties of these instruments, with only some differences in processing speed and executive functioning scores. CONCLUSIONS: Our study finds a comparable influence of demographic factors in both populations on the performance of CCD, RUDAS, and CNTB, confirming their adequate cross-cultural properties. We provide normative data for these tests in Spaniards and Colombians living in Spain.

Definition of self-medication: a scoping review.

Self-medication (SM) is a global and growing phenomenon. It represents a public health problem due to antibiotic resistance, risk of adverse drug reactions, drug-drug interactions, disease masking, and increased morbidity. There is not a consensus on the definition of SM. The definitions found in different studies make it difficult to address this problem from a theoretical perspective and therefore find an adequate solution to this public health problem. The aim of this article is to search the medical literature to characterize the current understanding of SM in the medical community. We conducted a scoping review of definitions of SM by searching on PubMed - Medline, Embase, and LILACS using the following combination of keywords: 'self-prescription' or 'self prescription', 'self-medication' or 'self medication', or 'automedication' and 'definition' or 'explanation'. The search was limited to articles containing the definition of SM, with no limit on language or year. Duplicate studies and those that did not mention the definition of SM were excluded from the final review. A total of 65 studies were included in the final selection. We found a vast heterogeneity in the definition of SM. Most articles based their definition of SM on the process of obtaining the drug, the nonparticipation of a specific health professional, the source of the medication, and the reason for SM. Other interesting concepts such as self-care, nonadherence to a prescription, reuse of stored drugs, and sharing and lending medicines were also considered forms of SM by other authors, however. This study highlights the need to reach a consensus regarding the definition of SM to adequately propose strategies to address this global health problem. This study shows the diverse concepts that need to be included in a future definition of SM. Plain Language Summary: Definition of self-medication: a review with systematic methodology Self-medication (SM) is a global and growing phenomenon that represents a public health problem due to antibiotic resistance, risk of dangerous side effects, interactions between drugs, and disease masking. Currently, there is not a consensus on the definition of SM, which makes it difficult to address this problem and therefore find an adequate solution. Making a standard definition would allow the development of programs focused on addressing drug-related problems associated with self-medication behavior. The purpose of this article is to search the medical literature to define the current understanding of SM in the medical community. We included a total of 65 studies and found a great variance in the definition of SM. Most articles based their definition of SM on the process of obtaining the drug, the nonparticipation of a specific health professional, the source of the medication, and the reason for SM. Other interesting concepts such as self-care, not following a prescription, reuse of stored drugs, and sharing and lending medicines were also considered forms of SM by other authors, however. Furthermore, this study highlights that SM is a wider concept that goes beyond aiming to promote and restore health, as aesthetic and recreational purposes are also reasons for SM that can put individuals at risk and compromise the correct and safe use of medications.

The Lack of Alternative Oxidase 1a Restricts in vivo Respiratory Activity and Stress-Related Metabolism for Leaf Osmoprotection and Redox Balancing Under Sudden Acute Water and Salt Stress in Arabidopsis thaliana.

In plants salt and water stress result in an induction of respiration and accumulation of stress-related metabolites (SRMs) with osmoregulation and osmoprotection functions that benefit photosynthesis. The synthesis of SRMs may depend on an active respiratory metabolism, which can be restricted under stress by the inhibition of the cytochrome oxidase pathway (COP), thus causing an increase in the reduction level of the ubiquinone pool. However, the activity of the alternative oxidase pathway (AOP) is thought to prevent this from occurring while at the same time, dissipates excess of reducing power from the chloroplast and thereby improves photosynthetic performance. The present research is based on the hypothesis that the accumulation of SRMs under osmotic stress will be affected by changes in folial AOP activity. To test this, the oxygen isotope-fractionation technique was used to study the in vivo respiratory activities of COP and AOP in leaves of wild-type Arabidopsis thaliana plants and of aox1a mutants under sudden acute stress conditions induced by mannitol and salt treatments. Levels of leaf primary metabolites and transcripts of respiratory-related proteins were also determined in parallel to photosynthetic analyses. The lack of in vivo AOP response in the aox1a mutants coincided with a lower leaf relative water content and a decreased accumulation of crucial osmoregulators. Additionally, levels of oxidative stress-related metabolites and transcripts encoding alternative respiratory components were increased. Coordinated changes in metabolite levels, respiratory activities and photosynthetic performance highlight the contribution of the AOP in providing flexibility to carbon metabolism for the accumulation of SRMs.

Propuesta de modelo técnico de pateo en fútbol: Una revisión sistemática de variables cinemáticas y cinéticas / Proposal of a Technical Model of Soccer Kicking: A Systematic Review of Kinematic and Kinetic Variables

Resumen Este artículo presenta una visión propositiva de la bibliografía actual en la técnica de pateo en fútbol. Los objetivos de la investigación son: (i) identificar las variables cinéticas y cinemáticas potenciales utilizadas en los análisis de la técnica y (ii) determinar los valores de variables cinéticas y cinemáticas en relación con la técnica de pateo en fútbol. Se revisaron las siguientes bases de datos; PubMed y Taylor and Francis online, para obtener artículos seleccionados desde 2000-2017. Se utilizó la metodología PRISMA®; se incluyeron artículos con participantes adultos o juveniles sobre la mecánica de pateo en fútbol a través de variables biomecánicas. Los artículos incluidos fueron 29, posteriormente se elaboró un modelo técnico compuesto por cuatro fases: preparación, balanceo, impacto y seguimiento. Una perspectiva biomecánica con base en la técnica podría ofrecer una estrategia prometedora para mejorar, a partir del entrenamiento y análisis de la técnica, el rendimiento en fútbol además de proveer antecedentes para la prevención de lesiones.

Abstract This article describes a propositive vision of the current literature on soccer kicking techniques. It aims to identify the potential kinetic and kinematic variables used in the analysis of the techniques, and to determine the values of kinetic and kinematic variables in relation to the kicking techniques in soccer. PubMed and Taylor & Francis online were reviewed to obtain selected articles from 2000 to 2017. PRISMA® methodology was implemented. Twenty-nine papers were selected; they considered kicking techniques in soccer young or adult participants through biomechanical variables. Then, a four-phase technical model was prepared: preparation, roll, impact, and follow-up phases. A technique-based biomechanical perspective can offer a promising strategy to improve, from training and technique analysis, the performance in football, in addition to providing a background for injury prevention.

Resumo Este artigo apresenta uma visão propositiva da bibliografia atual sobre a técnica do chute no futebol. Os objetivos da pesquisa são: (i) identificar as variáveis cinéticas e cinemáticas potenciais utilizadas na análise da técnica e (ii) determinar os valores das variáveis cinéticas e cinemáticas em relação à técnica de pontapés no futebol. As seguintes bases de dados foram revistas; PubMed e Taylor e Francis online, para artigos selecionados de 2000 a 2017. Foi utilizada a metodologia PRISMA®; foram incluídos artigos com participantes adultos ou juvenis sobre mecânica do chute de futebol através de variáveis biomecânicas. Os artigos incluídos foram 29, posteriormente foi desenvolvido um modelo técnico composto por quatro fases: preparação, balanceamento, impacto e acompanhamento. Uma perspectiva biomecânica baseada na técnica poderia oferecer uma estratégia promissora para melhorar, a partir do treinamento e da análise da técnica, o desempenho no futebol, bem como fornecer um pano de fundo para a prevenção de lesões.

The Apoplastic and Symplastic Antioxidant System in Onion: Response to Long-Term Salt Stress.

The response of apoplastic antioxidant systems in root and leaf tissues from two onion genotypes ('Texas 502', salt-sensitive and 'Granex 429', salt-resistant) in response to salinity was studied. Electrolyte leakage data indicated the membrane integrity impairing by the effect of salts, especially in 'Texas 502'. We detected superoxide dismutase (SOD) and peroxidase (POX) activity in the root and leaf apoplastic fractions from onion plants. Salinity increased SOD activity in the root symplast of 'Texas 502' and in 'Granex 429' leaves. In contrast, salinity reduced SOD activity in the leaf and root apoplastic fractions from 'Texas 502'. In 'Granex 429', salt-stress increased leaf apoplastic POX activity and symplastic catalase (CAT) activity of both organs, but a decline in root apoplastic POX from 'Texas 502' took place. Salt-stress increased monodehydroascorbate reductase (MDHAR) in root and leaf symplast and in root glutathione reductase GR, mainly in 'Granex 429', but only in this genotype, leaf dehydroascorbate reductase (DHAR) activity increased. In contrast, a decline in leaf GR was produced only in 'Texas 502'. Salinity increased leaf ASC levels, and no accumulation of dehydroascorbate (DHA) was observed in roots in both cases. These responses increased the redox state of ascorbate, especially in roots. In contrast, salinity declined reduced glutathione (GSH), but oxidised glutathione (GSSG) was accumulated in leaves, decreasing the redox state of glutathione. Salinity slightly increased root GSH concentration in the salt-tolerant genotype and was unchanged in the salt-sensitive genotype, but no accumulation of GSSG was produced, favoring the rise and/or maintenance of the redox state of the glutathione. These results suggest that the lower sensitivity to salt in 'Granex 429' could be related to a better performance of the antioxidant machinery under salinity conditions.

Determinación de la frecuencia de PNUs en una población heterogénea cerrada y su utilidad como marcadores para estudios de asociación genética en casos de labio y paladar hendido no sindrómico / Determination of frequency of SNP's in a population of mixed genetic origin and its use as genetic markers for association studies in cases of not syndromic cleft lip and palate

RESUMEN El labio y paladar hendido es una de las patologías congénitas con mayor prevalencia en el mundo. En el presente trabajo se hace un análisis de 12 PNU localizados en las secuencias genómicas de ABCA4, BMP4, MSX1, SUMO1, VAX1 y IRF6, bajo una perspectiva epidemiológica, de genética molecular, genómica y de genética de poblaciones; todo lo anterior aplicado a una población de Querétaro, México, de origen genético mixto. Material y métodos: Se realizó un estudio observacional, analítico y descriptivo a partir de muestras de 93 tríadas (sujetos de estudio y sus padres). Al seleccionar PNU que puedan ser diferenciados por medio de RFLP esperamos distinguir entre marcadores genéticos que: 1) cumplan con la ecuación de equilibrio de Hardy-Weinberg y 2) validarlos como potenciales marcadores genéticos para ser empleados en estudios de asociación en poblaciones cerradas de origen genético mixto con labio y paladar hendido (Amealco, Querétaro, México). De ser así, posteriormente se plantea probar las frecuencias obtenidas con una población seleccionada genéticamente cerrada de Amealco, Querétaro. Resultados: Después de realizar el análisis RFLP de 12 PNU localizados en la secuencia de genes ABCA4, BMP4, MSX1, SUMO1, VAX1 y IRF6, hallamos el mismo alelo para PNU analizado, el cual se encuentra en el 100% de la población. Conclusión: De los 12 PNU analizados, en este reporte, por primera vez se menciona la frecuencia de cinco de ellos. Los restantes siete presentaron la misma frecuencia reportada en la literatura. Aunque los PNU seleccionados no fueron de utilidad como marcadores genéticos debido a que el mismo alelo está presente en el 100% de la población general. El hecho de haberlos encontrado en el mismo genotipo de todas las muestras indica que la población de la ciudad de Querétaro es genéticamente cerrada y con base en esto extremadamente útil para futuras validaciones de otros PNU como posibles marcadores genéticos.

ABSTRACT The cleft lip and palate is one of the congenital pathologies with greater prevalence in the world. In the present work, there is an analysis of 12 SNP's located in genomic sequences of ABCA4, BMP4, MSX1, SUMO1, VAX1 andIRF6, under an epidemiological perspective, molecular genetics, genomics and population genetics. All of the above applied to a population of Queretaro, Mexico, of mixed genetic origin. Material and methods: A study was conducted of observation, analytic and descriptive study with samples from 93 triads (study subjects and their parents). When you select SNP's that can be differentiated by RFLP (Restriction Fragment Length Polymorphism)we hope to distinguish between genetic markers that: 1)comply with the equation of balance of Hardy-Weiner and 2) Validate them as potential genetic markers to be used in studies of association in closed populations of genetic origin mixed with cleft lip and palate in Amealco, Queretaro, Mexico. If so subsequently raises test the frequencies obtained with a selected population genetically closed in Amealco, Queretaro. Results: After performing the RFLP analysis of 12 SNP's located in the sequence of genes ABCA4, BMP4, MSX1, SUMO1, VAX1 and IRF6, we find the same allele for SNP analyzed which is located in the 100% of the population. Conclusion: Of the 12 SNP's analyzed in this report, for the fi rst time 5 of them are mentioned their frequency. The rest of them had the same frequency reported in the literature. Although the SNP's selected were not useful as a genetic markers due to the same allele is present in 100% of the general population. The fact of having found in the same genotype of all samples indicates that the population of the city of Queretaro is genetically closed and on the basis of this extremely useful for future validations of other SNP's as potential genetic markers.

[Factorial Structure of the Cardiff Anomalous Perceptions Scale (CAPS) in a Colombian Population Sample]. / Estructura factorial de la Cardiff Anomalous Perceptions Scale (CAPS) en una muestra de población colombiana.

BACKGROUND: The continuum hypothesis of psychosis assumes that hallucinations are not exclusive of psychotic disorders. A number of psychometric tests have been developed to assess psychosis using a dimensional model. OBJECTIVES: To determine the factorial structure of the Cardiff Anomalous Perceptions Scale (CAPS) for the Colombian population, and to contrast the fit of two factor models previously reported in the literature by conducting a confirmatory factor analysis (CFA). METHODS: This was a cross-sectional study in which 207 subjects from the general population were assessed using the Cardiff Anomalous Perceptions Scale. RESULTS: A two-factor structure with acceptable ordinal alpha coefficients (α=.88 and α=.87) was found. One factor gathered items related to multimodal perceptual alterations, and a second factor grouped items related with experiences linked to the temporal lobe. The analysis of the first factor indicated that it was dependent on cultural issues for the interpretation of sensations. The second factor appeared almost unchanged on diverse populations, suggesting its transcultural character. When comparing the models proposed by Bell et al. and Jaen-Moreno et al. using the data obtained from the sample, the confirmatory factor analysis conducted indicated inadequate goodness-of-fit indexes (χ(2)). However, some incremental goodness-of-fit indexes (normalized χ(2) [RMSEA]) were acceptable. The Jaén-Moreno et al. model showed the best fit to the data collected from the Colombian sample. CONCLUSIONS: The factorial structure of CAPS for the Colombian population appears to be sensitive to cultural issues, especially when describing anomalous sensorial experiences.

Estructura factorial de la Cardiff Anomalous Perceptions Scale (CAPS) en una muestra de población colombiana / Factorial Structure of the Cardiff Anomalous Perceptions Scale (CAPS) in a Colombian Population Sample

Introducción: La hipótesis del continuo de la psicosis asume que las alucinaciones no son fenómenos exclusivos de los trastornos del espectro psicótico. Se ha desarrollado una serie de pruebas psicométricas abordando la psicosis a partir de un modelo dimensional. Objetivos: Determinar la estructura factorial de la Escala de Percepciones Anómalas de Cardiff (CAPS) en población colombiana y contrastar el ajuste de dos modelos factoriales previamente reportados en la literatura utilizando la técnica de análisis factorial confirmatorio (AFC). Métodos: Estudio instrumental y transversal en el que participaron 207 sujetos de la población general evaluados con la CAPS. Resultados: Se encontró una estructura de dos factores con coeficientes alfa ordinales aceptables (α = 0,88 y α = 0,87). Un primer factor reúne ítems relacionados con alteraciones perceptuales multimodales y un segundo factor agrupa ítems asociados a experiencias relacionadas con el lóbulo temporal. El análisis del primer factor indica que depende de aspectos culturales en la interpretación de las sensaciones. El segundo factor aparece casi inalterable en diversas poblaciones, lo cual hace pensar en su carácter transcultural. Al comparar los modelos de Bell et al. y Jaén-Moreno et al., a partir de los datos obtenidos, los AFC muestran índices de ajuste absolutos (χ²) inadecuados. Sin embargo, algunos índices de ajuste incremental (χ²normalizado [RMSEA]) son aceptables. De los dos modelos, el propuesto por Jaén-Moreno et al. Fue el que mejor se adecuó a los datos de la muestra colombiana. Conclusiones: La estructura factorial del CAPS en población colombiana parece ser sensible a aspectos culturales en la interpretación de experiencias sensoriales anómalas.

Background: The continuum hypothesis of psychosis assumes that hallucinations are not exclusive of psychotic disorders. A number of psychometric tests have been developed to assess psychosis using a dimensional model. Objectives: To determine the factorial structure of the Cardiff Anomalous Perceptions Scale (CAPS) for the Colombian population, and to contrast the fit of two factor models previously reported in the literature by conducting a confirmatory factor analysis (CFA). Methods: This was a cross-sectional study in which 207 subjects from the general population were assessed using the Cardiff Anomalous Perceptions Scale. Results: A two-factor structure with acceptable ordinal alpha coefficients (α=.88 and α=.87) was found. One factor gathered items related to multimodal perceptual alterations, and a second factor grouped items related with experiences linked to the temporal lobe. The analy sis of the first factor indicated that it was dependent on cultural issues for the interpretation of sensations. The second factor appeared almost unchanged on diverse populations, sug gesting its transcultural character. When comparing the models proposed by Bell et al. and Jaen-Moreno et al. using the data obtained from the sample, the confirmatory factor analysis conducted indicated inadequate goodness-of-fit indexes (χ²). However, some incremental goodness-of-fit indexes (normalized χ² [RMSEA]) were acceptable. The Jaén-Moreno et al. model showed the best fit to the data collected from the Colombian sample. Conclusions: The factorial structure of CAPS for the Colombian population appears to be sensitive to cultural issues, especially when describing anomalous sensorial experiences.

Correlación cito-colpo-histológica de lesiones causadas por el virus del papiloma humano (HPV) y la utilidad de la técnica de PCR para determinar la infección por HPV / Correlation of cyto-colpo-histology in human papillomaviruses (HPV) lesions and the use of PCR technique in determining HPV infection

Introducción: El cáncer de cuello uterino es una patología prevalente más aun en países sub-desarrollados y existe una relación causal entre la infección persistente con algún tipo oncogénico de HPV y el desarrollo de dicha neoplasia.Se cuenta con un estudio de screening mundialmente aceptado y que también previene el carcinoma cervical que es el Papanicolaou y colposcopia, y en los últimos años se han incorporado estudios de biología molecular para el estudio del ADN viral.Material y Métodos: Se estudiaron a 60 pacientes. Se tomo como método gold standard a la biopsia de cuello uterino y a 29 pacientes se les realizo PCR para identificar ADN-HPV. La edad promedio de las pacientes fue de 30,95 años con mayor cantidad de pacientes en el rango etareo de 21-25 años. Resultados: El 70% tuvo citología negativa y 48 pacientes tuvieron biopsia positiva, 16 con resultado positivo de PCR. Obtuvimos una alta especificidad el Papanicolaou con respecto a la biopsia (90%), no así en comparación con el test de PCR (S=56% E=50%) debido al número pequeño de pacientes que se sometieron a este estudio. Discusión: Las mujeres menores de 30 años son las que más chances tienen de contraer la infección, no así de desarrollar la enfermedad debido a la historia natural de la misma, por lo que aconsejamos continuar con el screening regular de Papanicolaou/colposcopia e introducir con lapsos de 3 años o más en mujeres mayores a 30 años los estudios de biología molecular.Conclusiones: Se espera poder contar con mayores estrategias que nos permitan usar los beneficios de los test ADN-HPV sin sobre tratar a mujeres que probablemente atraviesan por una infección transitoria. (AU)

Introduction: Cervical cancer is a prevalent pathology, especially in underdeveloped countries, and there is a causal relationship between persistent infection with some type of oncogenic HPVs and the development of said neoplasia. There are two universally-accepted screening studies which also prevent cervical cancer, i.e. Pap smear and colposcopy, and, in the last few years some molecular biology studies have been adopted for the study of viral DNA. Material and methods: 60 patients were studied. Cervical biopsy was the gold standard method used and 29 patients were tested using the PCR technique to identify HPV-DNA. Patients average age was 30.95, most of whom belonged to the 21-25 years old age span. Results: 70% of patients had negative cytology test and 48 patients obtained positive biopsy results, 16 had positive results in the PCR test. The Pap smear specificity was higher as regards the biopsy (90%), unlike the PCR test (S=56% E=50%) due to the small number of patients that underwent this study. Discussion: Women younger than 30 years old have more chances of infection, but no of developing the disease considering its natural history. Therefore, we recommend continuing with the Pap smear/colposcopy regular screening and introducing molecular biology studies in women older than 30 years old, every 3 years or more.Conclusions: We hope to have more strategies available which enable the use of HPV-DNA test benefits, without overtreating patients who are probably suffering from a transitory infection. (AU)

Correlación cito-colpo-histológica de lesiones causadas por el virus del papiloma humano (HPV) y la utilidad de la técnica de PCR para determinar la infección por HPV / Correlation of cyto-colpo-histology in human papillomaviruses (HPV) lesions and the use of PCR technique in determining HPV infection

Introducción: El cáncer de cuello uterino es una patología prevalente más aun en países sub-desarrollados y existe una relación causal entre la infección persistente con algún tipo oncogénico de HPV y el desarrollo de dicha neoplasia.Se cuenta con un estudio de screening mundialmente aceptado y que también previene el carcinoma cervical que es el Papanicolaou y colposcopia, y en los últimos años se han incorporado estudios de biología molecular para el estudio del ADN viral.Material y Métodos: Se estudiaron a 60 pacientes. Se tomo como método gold standard a la biopsia de cuello uterino y a 29 pacientes se les realizo PCR para identificar ADN-HPV. La edad promedio de las pacientes fue de 30,95 años con mayor cantidad de pacientes en el rango etareo de 21-25 años. Resultados: El 70% tuvo citología negativa y 48 pacientes tuvieron biopsia positiva, 16 con resultado positivo de PCR. Obtuvimos una alta especificidad el Papanicolaou con respecto a la biopsia (90%), no así en comparación con el test de PCR (S=56% E=50%) debido al número pequeño de pacientes que se sometieron a este estudio. Discusión: Las mujeres menores de 30 años son las que más chances tienen de contraer la infección, no así de desarrollar la enfermedad debido a la historia natural de la misma, por lo que aconsejamos continuar con el screening regular de Papanicolaou/colposcopia e introducir con lapsos de 3 años o más en mujeres mayores a 30 años los estudios de biología molecular.Conclusiones: Se espera poder contar con mayores estrategias que nos permitan usar los beneficios de los test ADN-HPV sin sobre tratar a mujeres que probablemente atraviesan por una infección transitoria.

Introduction: Cervical cancer is a prevalent pathology, especially in underdeveloped countries, and there is a causal relationship between persistent infection with some type of oncogenic HPVs and the development of said neoplasia. There are two universally-accepted screening studies which also prevent cervical cancer, i.e. Pap smear and colposcopy, and, in the last few years some molecular biology studies have been adopted for the study of viral DNA. Material and methods: 60 patients were studied. Cervical biopsy was the gold standard method used and 29 patients were tested using the PCR technique to identify HPV-DNA. Patients' average age was 30.95, most of whom belonged to the 21-25 years old age span. Results: 70% of patients had negative cytology test and 48 patients obtained positive biopsy results, 16 had positive results in the PCR test. The Pap smear specificity was higher as regards the biopsy (90%), unlike the PCR test (S=56% E=50%) due to the small number of patients that underwent this study. Discussion: Women younger than 30 years old have more chances of infection, but no of developing the disease considering its natural history. Therefore, we recommend continuing with the Pap smear/colposcopy regular screening and introducing molecular biology studies in women older than 30 years old, every 3 years or more.Conclusions: We hope to have more strategies available which enable the use of HPV-DNA test benefits, without overtreating patients who are probably suffering from a transitory infection.

Tratamiento quirúrgico de adenomas adrenales / Surgical treatment of adrenal adenoma

Presentamos nuestra casuística de 60 adrenalectomías por adenoma, desde febrero de 1993 hasta enero de 2010, determinando los aspectos clínicos y patológicos más importantes desde el punto de vista quirúrgico, comparando la técnica laparoscópica respecto a la cirugía abierta. Material y métodos: Estudio retrospectivo observacional valorando características clínicas y hormonales, destacando las variables relacionadas con la cirugía (tamaño y localización del tumor, tipo y duración de la cirugía, tipo de incisión), incidencias intra operatorias, pérdidas hemáticas, datos anatomo patológicos (peso, tamaño y confirmación microscópica), complicaciones pos operatorias. Resultados: De los 60 pacientes, 24 eran hombres y 36 mujeres, con una edad media de 52,5 años (79,3 - 8,1). Todos ellos fueron diagnosticados anatomo patológicamente de adenoma adrenal siendo 50 adenomas funcionantes frente a 10 no funcionantes. De los adenomas funcionantes se establecieron los siguientes diagnósticos: 34 de síndrome de Con (56,6 por ciento), 15 casos de síndrome de Cushing (25 por ciento) y 1 síndrome adrenogenital (1,6 por ciento). La localización predominante fue la izquierda con 38 casos (63,3 por ciento) frente a la derecha con 22 casos (36,6 por ciento).En 39 pacientes se realizó adrenalectomía laparoscópica transperitoneal, mientras que en los 21 pacientes restantes se realizó cirugía abierta. La duración quirúrgica media fue de 147 minutos (230-50). El tamaño medio de la pieza quirúrgica fue de 3,27 cm (8-0,7). La estancia media hospitalaria fue de 6,4 días (20-2). Entre las complicaciones destacaron dos neumotórax, una angina de pecho, una neumonía nosocomial y dos pacientes que precisaron reintervención a las 24 horas de la cirugía por hemorragia y shock hipovolémico. Conclusiones: Debe considerarse la adrenalectomía laparoscópica unilateral como el tratamiento de elección del adenoma adrenal...

We present our series of sixty adrenalectomy for adrenal adenoma, from February 1993until January 2010, determining the most important clinical and pathological aspects from a surgical point of view. We compare the laparoscopic approach with open surgery. Material and methods: Retrospective observational study evaluating clinical and hormonal characteristics. We highlight the surgery-related variables (tumor size and location, type and duration of surgery, type of incision), intraoperative events, blood loss, histological findings (weight, size and microscopic confirmation) and postoperative complications. Results: Total number of 60 patients, 24 were men and 36 women with a mean age of 52.5 years (79.3to 8.1). All of them were histologically diagnosed of adrenal adenoma. 50 were functioning adenomas (10 non-functioning) with the final following diagnoses: 34 Conn’s syndrome (56,6 percent), 15 Cushing’s syndrome (25percent) and 1 adrenogenital syndrome (1,6 percent). The primary side was left with 38 cases(63,3 percent) compared to the right side with 22 cases (36,6 percent).Thirty-nine patients (65 percent) underwent transperitoneal laparoscopic adrenalectomy, while the remaining 21 patients had open surgery. The average operating time was 147 minutes (230-50). The mean sizeof the specimen was 3.27 cm (8-0.7). The average hospital stay was 6.4 days (20 - 2). The most important complications were: two pneumothorax, one angina pectoris, a nosocomial pneumonia and two patients who were reoperated 24 hours after surgery due to hemorrhage and hypovolemic shock. Conclusion: Unilateral laparoscopic adrenalectomy should be considered as the treatment of choice for adrenal adenoma, as it is a safe surgical technique with a low complication rate. It allows a shorter hospital stay and a more rapid incorporation into everyday life...

Evaluación de la técnica de ELISA con antígeno total de cysticercus cellulosae para el diagnóstico de la neurocisticercosis humana en Chile / Evaluation of ELISA technic with total antigen of cysticercus cellulosae in the diagnosis of human neurocysticercosis in Chile

La estandarización del método de ELISA con el empleo de un antígeno total de cysticercus cellulosae, se evaluó en 22 sueros de pacientes con neurocisticercosis comprobada y 106 sueros correspondientes a individuos sanos y pacientes con otras patologías parasitarias y no parasitarias. Los resultados demostraron una sensibilidad de 68,2 por ciento y una especificidad global de 92,5 por ciento. Las reactividades cruzadas se presentaron en sueros de pacientes con hidatidosis, tumor cerebral y factor reumatoide. Se concluye que se debe buscar nuevas alternativas metodológicas que permiten aumentar la sensibilidad y especificidad para el diagnóstico de la cisticercosis humana en Chile