Candida haemulonii Complex and Candida auris: Biology, Virulence Factors, Immune Response, and Multidrug Resistance.

There is worldwide concern about the constant increase in infections caused by Candida species that are multiresistant to antifungal drugs. The most common candidiasis is caused by Candida albicans, however, the species of the Candida haemulonii complex and Candida auris are emerging opportunistic pathogens, which isolation from clinical samples has significantly increased in the past years. The special interest in the study of these species lies in their ability to evade the action of antifungal drugs, such as amphotericin B, azoles, and echinocandins. In addition, the phenotypic changes of these species have given them the ability to easily adapt to environmental changes, including the host milieu and immunity. In this paper, a detailed review of the current literature on the C. haemulonii complex and C. auris is shown, analyzing aspects such as biology, immune response, putative virulence factors, infection, treatment, and the current strategies for diagnosis.

Current Status of Regulatory Non-Coding RNAs Research in the Tritryp.

Trypanosomatids are protozoan parasites that cause devastating vector-borne human diseases. Gene expression regulation of these organisms depends on post-transcriptional control in responding to diverse environments while going through multiple developmental stages of their complex life cycles. In this scenario, non-coding RNAs (ncRNAs) are excellent candidates for a very efficient, quick, and economic strategy to regulate gene expression. The advent of high throughput RNA sequencing technologies show the presence and deregulation of small RNA fragments derived from canonical ncRNAs. This review seeks to depict the ncRNA landscape in trypanosomatids, focusing on the small RNA fragments derived from functional RNA molecules observed in RNA sequencing studies. Small RNA fragments derived from canonical ncRNAs (tsRNAs, snsRNAs, sdRNAs, and sdrRNAs) were identified in trypanosomatids. Some of these RNAs display changes in their levels associated with different environments and developmental stages, demanding further studies to determine their functional characterization and potential roles. Nevertheless, a comprehensive and detailed ncRNA annotation for most trypanosomatid genomes is still needed, allowing better and more extensive comparative and functional studies.

Hsa-miR-183-5p Modulates Cell Adhesion by Repression of ITGB1 Expression in Prostate Cancer.

Prostate cancer is a major health problem worldwide. MiR-183 is an oncomiR and a candidate biomarker in prostate cancer, affecting various pathways responsible for disease initiation and progression. We sought to discover the most relevant processes controlled by miR-183 through an unbiased transcriptomic approach using prostate cell lines and patient tissues to identify miR-183 responsive genes and pathways. Gain of function experiments, reporter gene assays, and transcript and protein measurements were conducted to validate predicted functional effects and protein mediators. A total of 135 candidate miR-183 target genes overrepresenting cell adhesion terms were inferred from the integrated transcriptomic analysis. Cell attachment, spreading assays and focal adhesion quantification of miR-183-overexpressing cells confirmed the predicted reduction in cell adhesion. ITGB1 was validated as a major target of repression by miR-183 as well as a mediator of cell adhesion in response to miR-183. The reporter gene assay and PAR-CLIP read mapping suggest that ITGB1 may be a direct target of miR-183. The negative correlation between miR-183 and ITGB1 expression in prostate cancer cohorts supports their interaction in the clinical set. Overall, cell adhesion was uncovered as a major pathway controlled by miR-183 in prostate cancer, and ITGB1 was identified as a relevant mediator of this effect.

Extensive Translational Regulation through the Proliferative Transition of Trypanosoma cruzi Revealed by Multi-Omics.

Trypanosoma cruzi is the etiological agent for Chagas disease, a neglected parasitic disease in Latin America. Gene transcription control governs the eukaryotic cell replication but is absent in trypanosomatids; thus, it must be replaced by posttranscriptional regulatory events. We investigated the entrance into the T. cruzi replicative cycle using ribosome profiling and proteomics on G1/S epimastigote cultures synchronized with hydroxyurea. We identified 1,784 translationally regulated genes (change > 2, false-discovery rate [FDR] < 0.05) and 653 differentially expressed proteins (change > 1.5, FDR < 0.05), respectively. A major translational remodeling accompanied by an extensive proteome change is found, while the transcriptome remains largely unperturbed at the replicative entrance of the cell cycle. The differentially expressed genes comprise specific cell cycle processes, confirming previous findings while revealing candidate cell cycle regulators that undergo previously unnoticed translational regulation. Clusters of genes showing a coordinated regulation at translation and protein abundance share related biological functions such as cytoskeleton organization and mitochondrial metabolism; thus, they may represent posttranscriptional regulons. The translatome and proteome of the coregulated clusters change in both coupled and uncoupled directions, suggesting that complex cross talk between the two processes is required to achieve adequate protein levels of different regulons. This is the first simultaneous assessment of the transcriptome, translatome, and proteome of trypanosomatids, which represent a paradigm for the absence of transcriptional control. The findings suggest that gene expression chronology along the T. cruzi cell cycle is controlled mainly by translatome and proteome changes coordinated using different mechanisms for specific gene groups. IMPORTANCE Trypanosoma cruzi is an ancient eukaryotic unicellular parasite causing Chagas disease, a potentially life-threatening illness that affects 6 to 7 million people, mostly in Latin America. The antiparasitic treatments for the disease have incomplete efficacy and adverse reactions; thus, improved drugs are needed. We study the mechanisms governing the replication of the parasite, aiming to find differences with the human host, valuable for the development of parasite-specific antiproliferative drugs. Transcriptional regulation is essential for replication in most eukaryotes, but in trypanosomatids, it must be replaced by subsequent gene regulation steps since they lack transcription initiation control. We identified the genome-wide remodeling of mRNA translation and protein abundance during the entrance to the replicative phase of the cell cycle. We found that translation is strongly regulated, causing variation in protein levels of specific cell cycle processes, representing the first simultaneous study of the translatome and proteome in trypanosomatids.

Transcriptome-wide analysis of the Trypanosoma cruzi proliferative cycle identifies the periodically expressed mRNAs and their multiple levels of control.

Trypanosoma cruzi is the protozoan parasite causing American trypanosomiasis or Chagas disease, a neglected parasitosis with important human health impact in Latin America. The efficacy of current therapy is limited, and its toxicity is high. Since parasite proliferation is a fundamental target for rational drug design, we sought to progress into its understanding by applying a genome-wide approach. Treating a TcI linage strain with hydroxyurea, we isolated epimastigotes in late G1, S and G2/M cell cycle stages at 70% purity. The sequencing of each phase identified 305 stage-specific transcripts (1.5-fold change, p≤0.01), coding for conserved cell cycle regulated proteins and numerous proteins whose cell cycle dependence has not been recognized before. Comparisons with the parasite T. brucei and the human host reveal important differences. The meta-analysis of T. cruzi transcriptomic and ribonomic data indicates that cell cycle regulated mRNAs are subject to sub-cellular compartmentalization. Compositional and structural biases of these genes- including CAI, GC content, UTR length, and polycistron position- may contribute to their regulation. To discover nucleotide motifs responsible for the co-regulation of cell cycle regulated genes, we looked for overrepresented motifs at their UTRs and found a variant of the cell cycle sequence motif at the 3' UTR of most of the S and G2 stage genes. We additionally identified hairpin structures at the 5' UTRs of a high proportion of the transcripts, suggesting that periodic gene expression might also rely on translation initiation in T. cruzi. In summary, we report a comprehensive list of T. cruzi cell cycle regulated genes, including many previously unstudied proteins, we show evidence favoring a multi-step control of their expression, and we identify mRNA motifs that may mediate their regulation. Our results provide novel information of the T. cruzi proliferative proteins and the integrated levels of their gene expression control.

Radio-frequency energy harvesting for wearable sensors.

The use of wearable biomedical sensors for the continuous monitoring of physiological signals will facilitate the involvement of the patients in the prevention and management of chronic diseases. The fabrication of small biomedical sensors transmitting physiological data wirelessly is possible as a result of the tremendous advances in ultra-low power electronics and radio communications. However, the widespread adoption of these devices depends very much on their ability to operate for long periods of time without the need to frequently change, recharge or even use batteries. In this context, energy harvesting (EH) is the disruptive technology that can pave the road towards the massive utilisation of wireless wearable sensors for patient self-monitoring and daily healthcare. Radio-frequency (RF) transmissions from commercial telecommunication networks represent reliable ambient energy that can be harvested as they are ubiquitous in urban and suburban areas. The state-of-the-art in RF EH for wearable biomedical sensors specifically targeting the global system of mobile 900/1800 cellular and 700 MHz digital terrestrial television networks as ambient RF energy sources are showcased. Furthermore, guidelines for the choice of the number of stages for the RF energy harvester are presented, depending on the requirements from the embedded system to power supply, which is useful for other researchers that work in the same area. The present authors' recent advances towards the development of an efficient RF energy harvester and storing system are presented and thoroughly discussed too.

Bloqueo aurículo ventricular congénito completo. Reporte de un caso y revisión de la literatura / Full congenital atrioventricular blockage: case report and literature review

Introducción: el bloqueo aurículo ventricular (AV) completo congénito (BCC) es una entidad poco común, siendo una lesión del tejido de conducción cardíaco que surge antes del nacimiento, en la que se produce una alteración de la transmisión de los impulsos auriculares a los ventrículos y puede aparecer de forma aislada o familiar; se debe hacer el diagnóstico diferencial con la coexistencia de una cardiopatía estructural o su asociación a enfermedades autoinmunes clínicas o subclínicas; su diagnóstico se realiza mediante ecografía y ecocardiografía fetal, técnicas que permiten el seguimiento y manejo perinatal óptimo, aconsejándose la finalización de la gestación en casos de sufrimiento fetal o signos de insuficiencia cardíaca; presenta alta morbilidad y mortalidad y requiere alto índice de sospecha para su diagnóstico. La implantación de un marcapasos es el tratamiento definitivo que contribuye a la sobrevida y pronóstico de estos pacientes.

Introduction: congenital complete auricular ventricular Blockage is a rare entity, being a cardiac conduction tissue lesion that develops before birth, which produces an alteration of the transmission of the auricular impulses towards the ventricules, and it could appear isolated or familiar form; the differential diagnosis must be performed with the coexistence of a structural cardiopathy, or its association with clinical or subclinical autoimmune diseases; its diagnosis is done by means of a fetal echography or echocardiography, techniques which allow an optimal perinatal follow up and management, advising the termination of the gestation period in cases of fetal suffering or signs of cardiac insuffciency; there is high morbidity and mortality rates which require high suspicion indication for its diagnosis. The implantation of a pacemaker is the definite treatment of choice which contributes to patient´s life expectancy and prognosis.

Experimental Path Loss Models for In-Body Communications Within 2.36-2.5 GHz.

Biomedical implantable sensors transmitting a variety of physiological signals have been proven very useful in the management of chronic diseases. Currently, the vast majority of these in-body wireless sensors communicate in frequencies below 1 GHz. Although the radio propagation losses through biological tissues may be lower in such frequencies, e.g., the medical implant communication services band of 402 to 405 MHz, the maximal channel bandwidths allowed therein constrain the implantable devices to low data rate transmissions. Novel and more sophisticated wireless in-body sensors and actuators may require higher data rate communication interfaces. Therefore, the radio spectrum above 1 GHz for the use of wearable medical sensing applications should be considered for in-body applications too. Wider channel bandwidths and smaller antenna sizes may be obtained in frequency bands above 1 GHz at the expense of larger propagation losses. Therefore, in this paper, we present a phantom-based radio propagation study for the frequency bands of 2360 to 2400 MHz, which has been set aside for wearable body area network nodes, and the industrial, scientific, medical band of 2400 to 2483.5 MHz. Three different channel scenarios were considered for the propagation measurements: in-body to in-body, in-body to on-body, and in-body to off-body. We provide for the first time path loss formulas for all these cases.

In-Body to On-Body Ultrawideband Propagation Model Derived From Measurements in Living Animals.

Ultrawideband (UWB) radio technology for wireless implants has gained significant attention. UWB enables the fabrication of faster and smaller transceivers with ultralow power consumption, which may be integrated into more sophisticated implantable biomedical sensors and actuators. Nevertheless, the large path loss suffered by UWB signals propagating through inhomogeneous layers of biological tissues is a major hindering factor. For the optimal design of implantable transceivers, the accurate characterization of the UWB radio propagation in living biological tissues is indispensable. Channel measurements in phantoms and numerical simulations with digital anatomical models provide good initial insight into the expected path loss in complex propagation media like the human body, but they often fail to capture the effects of blood circulation, respiration, and temperature gradients of a living subject. Therefore, we performed UWB channel measurements within 1-6 GHz on two living porcine subjects because of the anatomical resemblance with an average human torso. We present for the first time, a path loss model derived from these in vivo measurements, which includes the frequency-dependent attenuation. The use of multiple on-body receiving antennas to combat the high propagation losses in implant radio channels was also investigated.

Experimental UWB frequency analysis for implant communications.

Implantable biomedical sensors with the ability to transmit wirelessly real-time physiological data to an external unit can enable better management of chronic diseases. The IEEE Standard 802.15.6-2012 specifies the implementation of implant communications within 402-405 MHz, which unfortunately allows low data transmission rates only. Ultra wideband (UWB) interfaces within 3.1-10.6 GHz offer a number of advantages at the expense of higher path losses. Efforts to characterize the implant UWB channel have been undertaken via computer simulations, but these may not capture completely the effects on the implant radio channel of multiple physiological functions. To overcome these limitations we provide insight into the frequency-domain behavior of the UWB implant channel within 3.1-8.5 GHz based on propagation measurements in a liquid phantom and a living swine. A thorough comparison of the relative received power in phantom-based and in vivo measurements for the in-body to on-body (IB2OB) and in-body to off-body (IB2OFF) channel scenarios are presented.

5G: The Convergence of Wireless Communications.

As the rollout of 4G mobile communication networks takes place, representatives of industry and academia have started to look into the technological developments toward the next generation (5G). Several research projects involving key international mobile network operators, infrastructure manufacturers, and academic institutions, have been launched recently to set the technological foundations of 5G. However, the architecture of future 5G systems, their performance, and mobile services to be provided have not been clearly defined. In this paper, we put forth the vision for 5G as the convergence of evolved versions of current cellular networks with other complementary radio access technologies. Therefore, 5G may not be a single radio access interface but rather a "network of networks". Evidently, the seamless integration of a variety of air interfaces, protocols, and frequency bands, requires paradigm shifts in the way networks cooperate and complement each other to deliver data rates of several Gigabits per second with end-to-end latency of a few milliseconds. We provide an overview of the key radio technologies that will play a key role in the realization of this vision for the next generation of mobile communication networks. We also introduce some of the research challenges that need to be addressed.

Wireless vital signs from a life-supporting medical device exposed to electromagnetic disturbance.

OBJECTIVES: To evaluate the level of agreement of simulated wired and Wi-Fi vital signs output from an intra-aortic balloon pump during exposure to electromagnetic interference from frequency overlapping ZigBee sensors. MATERIAL AND METHODS: A series of experiments with interference from single and multiple ZigBee sensors were benchmarked with wired and Wi-Fi output. Tests included single ZigBee sensor adjacent and co-channel interference, and multiple ZigBee interferences towards the Wi-Fi receiver and transmitter. RESULTS: Interference-free differences between wired and wireless aortic blood pressure and electrocardiogram were very small, verified by time domain and Bland - Altman plots. Bland - Altman plots comparing level of agreement in wired and wireless aortic blood pressure and ECG output during interference experiments showed a difference from 0.2 to 0.3 mmHg for blood pressure, and from 0.001 to 0.004 mV for electrocardiogram. CONCLUSIONS: Level of agreement in wired and wireless (Wi-Fi) arterial blood pressure and electrocardiogram during single or multiple sensor interference was high. No clinically relevant degradation of Wi-Fi transmission of aortic blood pressure or ECG signals was observed.

Hernia diafragmática no traumática complicada en un anciano / Non traumatic complicated diaphragmatic hernia in an old man

La hernia de Morgagni es una variedad poco frecuente de hernia diafragmática no traumática. En un paciente anciano del sexo masculino se encontró un gran saco herniario que contenía estómago, epiplón mayor y colon transverso, encarcelados a través de un defecto diafragmático retroesternal, lo cual es muy raro en la vejez. El paciente tenía antecedentes de litiasis vesicular, úlcera duodenal y diastasis de los músculos rectos abdominales, e ingresó con dolor torácico, epigastralgia, aerogastria, distensión en la porción superior del abdomen y vómitos. El diagnóstico se obtuvo mediante radiografías posteroanterior y lateral del tórax y del abdomen. Se realizó una laparotomía de urgencia y se encontró una hernia de Morgagni encarcelada sin afectación vascular. Se redujo el contenido, se resecó el saco herniario, se reparó el defecto herniario y se efectuó la colecistectomía. La recuperación posoperatoria fue inmediata y completa. El seguimiento posoperatorio de 6 meses no mostró recidiva herniaria(AU)

Morgagni hernia is an uncommon variety of non-traumatic diaphragmatic hernia, usually located in the right-side anterior diaphragm. A big herniary sac, which contained the greater omentum, the stomach, and the transverse colon incarcerated due to a retrosternal diaphragmatic defect, was found in an old male patient. This is very unusual finding in the elderly. This patient had a history of cholelithiasis, duodenal ulcer and diastasis recti. He was admitted at the hospital with chest pain, epigastralgia, aerogastria, upper abdominal distension, and vomits. He underwent emergency radiological studies. The diagnosis was based on chest posterior-anterior and lateral X-rays of the chest and the abdomen. Emergency laparotomy was performed to find Morgagni hernia without any vascular effect. The content was removed, the hernia sac was excised, the Morgagni foramen was repaired and cholecistectomy was performed. The recovery of the patient was complete and immediate postoperatively. The six-month follow-up showed no hernia recurrence(AU)

Hernia diafragmática no traumática complicada en un anciano / Non traumatic complicated diaphragmatic hernia in an old man

La hernia de Morgagni es una variedad poco frecuente de hernia diafragmática no traumática. En un paciente anciano del sexo masculino se encontró un gran saco herniario que contenía estámago, epiplón mayor y colon transverso, encarcelados a través de un defecto diafragmático retroesternal, lo cual es muy raro en la vejez. El paciente tenía antecedentes de litiasis vesicular, úlcera duodenal y diastasis de los músculos rectos abdominales, e ingresó con dolor torácico, epigastralgia, aerogastria, distensión en la porción superior del abdomen y vómitos. El diagnóstico se obtuvo mediante radiografías posteroanterior y lateral del tórax y del abdomen. Se realizó una laparotomía de urgencia y se encontró una hernia de Morgagni encarcelada sin afectación vascular. Se redujo el contenido, se resecó el saco herniario, se reparó el defecto herniario y se efectuó la colecistectomía. La recuperación posoperatoria fue inmediata y completa. El seguimiento posoperatorio de 6 meses no mostró recidiva herniaria(AU)

Morgagni hernia is an uncommon variety of non-traumatic diaphragmatic hernia, usually located in the right-side anterior diaphragm. A big herniary sac, which contained the greater omentum, the stomach, and the transverse colon incarcerated due to a retrosternal diaphragmatic defect, was found in an old male patient. This is very unusual finding in the elderly. This patient had a history of cholelithiasis, duodenal ulcer and diastasis recti. He was admitted at the hospital with chest pain, epigastralgia, aerogastria, upper abdominal distension, and vomits. He underwent emergency radiological studies. The diagnosis was based on chest posterior-anterior and lateral X-rays of the chest and the abdomen. Emergency laparotomy was performed to find Morgagni hernia without any vascular effect. The content was removed, the hernia sac was excised, the Morgagni foramen was repaired and cholecistectomy was performed. The recovery of the patient was complete and immediate postoperatively. The six-month follow-up showed no hernia recurrence(AU)

Pase de visita docente-asistencial hospitalario en las especialidades quirúrgicas / Teaching ward rounds for surgical specialties

INTRODUCCIÓN: el pase de visita docente-asistencial de pregrado se desarrolla en la actualidad en la atención primaria de salud como pase de vista comunitario, y en la atención secundaria con el hospitalario. La enseñanza de la mayoría de las asignaturas de las especialidades quirúrgicas, se ha realizado con pacientes hospitalizados. Diversos cambios en el diseño curricular y en la organización de los servicios quirúrgicos han incidido en el pase de visita docente-asistencial de pregrado en las asignaturas de especialidades quirúrgicas. OBJETIVO: caracterizar el pase de visita de pregrado en las asignaturas de especialidades quirúrgicas. MÉTODOS: estudio transversal en el campo de la educación médica de pregrado sobre el pase de visita hospitalario de las asignaturas de especialidades quirúrgicas en el Hospital Militar Central "Dr. Carlos J. Finlay" durante el primer semestre del curso 2010-2011. La muestra quedó constituida por 31 profesores y 35 internos. La encuesta dirigida a los educadores incluyó aspectos como: categoría docente, años de experiencia, grado académico y aspectos sobre el pase de visita, y una segunda encuesta dirigida a estudiantes al término de la rotación por Cirugía General del internado, exploró la frecuencia y la calidad de este. RESULTADOS: el 48,4 % de los profesores refirió que en su asignatura el pase de visita docente se realizaba diariamente, el 45,2 % coincidió en que la cantidad de educandos que participaba era adecuada. Los alumnos en general catalogaron como buena la calidad de los pases de visita y la asignatura de Cirugía General fue la más favorecida en sus opiniones (82,8 %). CONCLUSIONES: los profesores, en su mayoría, consideraron el pase de visita de pregrado en las asignaturas de las especialidades quirúrgicas como la actividad principal de educación en el trabajo y la mayoría de los alumnos expresó su satisfacción con la calidad de este.

INTRODUCTION: in primary health care, teaching rounds take the form of community rounds. In secondary health care, they take the form of ward rounds. Most contents in surgical specialties have always been taught through interviews with hospitalized patients. Various changes in curricular design and in the organization of surgical services have had an impact on undergraduate surgical teaching rounds. OBJECTIVE: characterize undergraduate teaching rounds for surgical specialties. METHODS: a cross-sectional study was conducted of undergraduate ward rounds for surgical specialties at Dr. Carlos J. Finlay Central Military Hospital during the first semester of academic year 2010-2011. The sample was composed of 31 teachers and 35 interns. The survey designed for teachers included items such as teaching category, years of experience, academic degree and data on ward rounds. The survey for students, which was applied at the end of the general surgery rotation of their internship, inquired about the frequency and quality of ward rounds. RESULTS: 48.4 % of the teachers stated that ward rounds for their subjects were performed daily, and 45.2 % agreed that the number of participant students was adequate. Most students evaluated the quality of ward rounds as good. Their opinions were specially favorable when they referred to the subject general surgery (82.8 %). CONCLUSIONS: most teachers viewed undergraduate ward rounds for contents from surgical specialties as the main in-service training activity, and most students expressed their satisfaction with their quality.

Pase de visita docente-asistencial hospitalario en las especialidades quirúrgicas / Teaching ward rounds for surgical specialties

Introducción: el pase de visita docente-asistencial de pregrado se desarrolla en la actualidad en la atención primaria de salud como pase de vista comunitario, y en la atención secundaria con el hospitalario. La enseñanza de la mayoría de las asignaturas de las especialidades quirúrgicas, se ha realizado con pacientes hospitalizados. Diversos cambios en el diseño curricular y en la organización de los servicios quirúrgicos han incidido en el pase de visita docente-asistencial de pregrado en las asignaturas de especialidades quirúrgicas. Objetivo: caracterizar el pase de visita de pregrado en las asignaturas de especialidades quirúrgicas. Métodos: estudio transversal en el campo de la educación médica de pregrado sobre el pase de visita hospitalario de las asignaturas de especialidades quirúrgicas en el Hospital Militar Central Dr. Carlos J. Finlay durante el primer semestre del curso 2010-2011. La muestra quedó constituida por 31 profesores y 35 internos. La encuesta dirigida a los educadores incluyó aspectos como: categoría docente, años de experiencia, grado académico y aspectos sobre el pase de visita, y una segunda encuesta dirigida a estudiantes al término de la rotación por Cirugía General del internado, exploró la frecuencia y la calidad de este. Resultados: el 48,4 por ciento de los profesores refirió que en su asignatura el pase de visita docente se realizaba diariamente, el 45,2 por ciento coincidió en que la cantidad de educandos que participaba era adecuada. Los alumnos en general catalogaron como buena la calidad de los pases de visita y la asignatura de Cirugía General fue la más favorecida en sus opiniones (82,8 por ciento). Conclusiones: los profesores, en su mayoría, consideraron el pase de visita de pregrado en las asignaturas de las especialidades quirúrgicas como la actividad principal de educación en el trabajo y la mayoría de los alumnos expresó su satisfacción con la calidad de este(AU)

Introduction: in primary health care, teaching rounds take the form of community rounds. In secondary health care, they take the form of ward rounds. Most contents in surgical specialties have always been taught through interviews with hospitalized patients. Various changes in curricular design and in the organization of surgical services have had an impact on undergraduate surgical teaching rounds. Objective: characterize undergraduate teaching rounds for surgical specialties. Methods: a cross-sectional study was conducted of undergraduate ward rounds for surgical specialties at Dr. Carlos J. Finlay Central Military Hospital during the first semester of academic year 2010-2011. The sample was composed of 31 teachers and 35 interns. The survey designed for teachers included items such as teaching category, years of experience, academic degree and data on ward rounds. The survey for students, which was applied at the end of the general surgery rotation of their internship, inquired about the frequency and quality of ward rounds. Results: 48.4 percent of the teachers stated that ward rounds for their subjects were performed daily, and 45.2 percent agreed that the number of participant students was adequate. Most students evaluated the quality of ward rounds as good. Their opinions were specially favorable when they referred to the subject general surgery (82.8 percent). Conclusions: most teachers viewed undergraduate ward rounds for contents from surgical specialties as the main in-service training activity, and most students expressed their satisfaction with their quality(AU)

Caracterización del cáncer de esófago en pacientes operados. Hospital "Dr. Carlos J. Finlay" / Characterization of the esophagus cancer in operated patients. "Dr. Carlos J. Finlay" Hospital

Introducción: el cáncer de esófago es una de las neoplasias más agresivas del tracto digestivo. La cirugía es el método fundamental de tratamiento, con una alta frecuencia de complicaciones. Objetivo: caracterizar el cáncer de esófago en pacientes intervenidos quirúrgicamente. Método: se realizó un estudio descriptivo, longitudinal y con carácter prospectivo, en el Hospital "Dr. Carlos J. Finlay", entre enero de 2002 y diciembre de 2012. Universo de 62 pacientes. Se incluyeron pacientes con cáncer de esófago sometidos a resección. Las variables cualitativas se describieron estadísticamente mediante cifras frecuenciales y porcentuales. Resultados: el 82.3% perteneció al sexo masculino. El tercio inferior del esófago fue el más afectado en 42.2%. La variedad histológica que predominó fue el adenocarcioma en 59.7%. La mayoría de los pacientes se diagnosticaron en estadio IIb (41.9 %). La técnica quirúrgica más empleada fue la de Ivor Lewis (58.1%) y la sutura que más se realizó fue la mecánica. La estenosis de la anastomosis fue la complicación más frecuente en 12.9% y apareció solo cuando se realizó la sutura manual de la anastomosis. El tipo de sutura más utilizada fue la manual en 17.4%. La sobrevida postoperatoria fue de 17.7% a los 5 años. Conclusiones: predominaron los pacientes mayores de 60 años y pertenecientes al sexo masculino. La localización más frecuente fue en tercio inferior, con predominio del adenocarcinoma. La mayoría fueron diagnosticados en estadio IIb. La estenosis posquirúrgica fue la complicación más frecuente. La sobrevida postoperatoria fue aceptable.

Introduction: the esophagus cancer is one of the most aggressive neoplasias in the digestive tract. The surgery is the fundamental method of treatment, with a high frequency of complications. Objective: to characterize the esophagus cancer in patients intervened surgically. Method: it was done a descriptive, longitudinal study and of prospective character, in the "Dr. Carlos J. Finlay", between January of 2002 and December of 2012. The universe of the study was 62 patients. It was included patients with resection of esophagus cancer and in which the author of this paper participated on the operation. The qualitative variables were described statistically by means of frequencies and percentages. Results: 82.3% belonged to the masculine sex. The inferior third of the esophagus was the more affected in 42.2%. The histological variety that prevailed was the adenocarcioma in 59.7%. Most of the patients were diagnosed in IIb stage (41.9%). The surgical technique more carried out was Ivor Lewis (58.1%) and the type of suture was the mechanical. The stenosis of the anastomosis was the most frequent complication in 12.9% and it was appear only in cases with manual suture of the anastomosis. The type suture more used was the manual in the 17. 4%. The postoperative overlife was 17.7% at five years. Conclusions: most of patients were older than 60 years and men. The most frequent localization was in inferior third, with prevalence of the adenocarcinoma. Most was diagnosed in IIB stage. The postsurgical stenosis was the most frequent complication. The postoperative overlife was acceptable.

Las consultas externas hospitalarias como escenarios docentes alternativos para la enseñanza en la asignatura de Cirugía General / Inpatient external clinic as alternative educational scenarios for the teaching of the subject General Surgery

Introducción: la enseñanza municipalizada de la Cirugía General constituye un nuevo enfoque en la formación de los médicos generales integrales. Sin embargo, es una realidad las dificultades para lograr que los educandos adquieran las habilidades imprescindibles para un adecuado examen físico en la asignatura Cirugía General. Objetivo: valorar el mejor escenario docente para que los educandos adquieran la mayor cantidad posible de conocimientos propuestos en el programa de la asignatura Cirugía General. Material y Métodos: se realizó un estudio prospectivo y longitudinal con una muestra de 43 educandos de dos policlínicos de la Facultad "Finlay-Albarrán", cursos 2008-2009, 2009-2010 y 2010-2011, durante la rotación de Cirugía General en cuarto año de medicina. Entre las formas de educación en el trabajo estuvieron diferentes modalidades de consultas que fueron comparadas en cuanto a pacientes vistos y examinados. Al final de cada rotación se realizaron exámenes prácticos por estaciones. Resultados: con afección del cuello fueron atendidos en las consultas externas hospitalarias el 86.6 %. Con enfermedades de la mama y del tórax, fueron examinados en la consulta externa hospitalaria el 84,7%. Por enfermedades del abdomen, 163 fueron examinados por los educandos, mayoritariamente durante su estancia en la consulta hospitalaria. Enfermedades como tumores de partes blandas, proctológicas y angiológicas, sólo pudieron verse en las consultas externas hospitalarias. El 79.1 % de los 43 alumnos obtuvo calificación de cinco puntos; ocho obtuvieron calificación de cuatro (18,6 %); uno de tres (2,3 %). No hubo calificación de dos. Conclusiones: las consultas externas hospitalarias fueron los escenarios docentes que en mayor medida influyeron en el proceso de enseñanza-aprendizaje en la asignatura Cirugía General.

Introduction: the municipalized teaching of the General Surgery constitutes a new focus in the formation of the integral general doctors. However, it is a reality the difficulties to achieve that the students acquires the indispensable abilities for an appropriate physical exam in the subject General Surgery. Objective: to value about the best educational scenario in which medicine students acquires the more possible quantity of knowledge proposed in the program of the subject General Surgery. Material and Methods: it was done a prospective and longitudinal study that included to the students of fourth year of medicine of two clinics of the Faculty "Finlay-Albarrán ", in the courses 2008-2009, 2009-2010 and 2010-2011, during the rotation of General Surgery. Were excluded those students whose cards didn't gather the necessary conditions for the study, being a final sample of 43 students. Education activities were planned in the work during the stay. At the end of each rotation they do practical exams for stations which included elements of these consultations. Results: of the total of sick with affection of the neck were assisted in the hospital external clinic 86.6%. In relation with the illnesses of the breast and the thorax, were examined in the hospital external consultations, 84, 7% students. Of 260 sick persons assisted by illnesses of the abdomen, 163 were examined by the students, the most part during their stay in the hospital clinic. Other illnesses like tumors of soft parts, proctologics and angiologics entities, only could be seen in the hospital external clinics. 79.1% of the 43 students obtained qualification of five points; eight obtained qualification of four (18, 6%); one of three (2, 3%). there was not qualification of two. Conclusions: the hospital external clinic was the better educational scenarios for the formation of knowledge in medical students.

Caracterización del cáncer de esófago en pacientes operados. Hospital Dr Carlos J. Finlay / Characterization of the esophagus cancer in operated patients. Dr. Carlos J. Finlay Hospital

Introducción: el cáncer de esófago es una de las neoplasias más agresivas del tracto digestivo. La cirugía es el método fundamental de tratamiento, con una alta frecuencia de complicaciones. Objetivo: caracterizar el cáncer de esófago en pacientes intervenidos quirúrgicamente.Método: se realizó un estudio descriptivo, longitudinal y con carácter prospectivo, en el Hospital Dr. Carlos J. Finlay, entre enero de 2002 y diciembre de 2012. Universo de 62 pacientes. Se incluyeron pacientes con cáncer de esófago sometidos a resección. Las variables cualitativas se describieron estadísticamente mediante cifras frecuenciales y porcentuales. Resultados: el 82.3 por ciento perteneció al sexo masculino. El tercio inferior del esófago fue el más afectado en 42.2 por ciento. La variedad histológica que predominó fue el adenocarcioma en 59.7 por ciento. La mayoría de los pacientes se diagnosticaron en estadio IIb (41.9 por ciento). La técnica quirúrgica más empleada fue la de Ivor Lewis (58.1 por ciento) y la sutura que más se realizó fue la mecánica. La estenosis de la anastomosis fue la complicación más frecuente en 12.9 por ciento y apareció solo cuando se realizó la sutura manual de la anastomosis. El tipo de sutura más utilizada fue la manual en 17.4 por ciento. La sobrevida postoperatoria fue de 17.7 por ciento a los 5 años. Conclusiones: predominaron los pacientes mayores de 60 años y pertenecientes al sexo masculino. La localización más frecuente fue en tercio inferior, con predominio del adenocarcinoma. La mayoría fueron diagnosticados en estadio IIb. La estenosis posquirúrgica fue la complicación más frecuente. La sobrevida postoperatoria fue aceptable(AU)

Introduction: the esophagus cancer is one of the most aggressive neoplasias in the digestive tract. The surgery is the fundamental method of treatment, with a high frequency of complications. Objective: to characterize the esophagus cancer in patients intervened surgically. Method: it was done a descriptive, longitudinal study and of prospective character, in the Dr. Carlos J. Finlay, between January of 2002 and December of 2012. The universe of the study was 62 patients. It was included patients with resection of esophagus cancer and in which the author of this paper participated on the operation. The qualitative variables were described statistically by means of frequencies and percentages. Results: 82.3 percent belonged to the masculine sex. The inferior third of the esophagus was the more affected in 42.2 percent. The histological variety that prevailed was the adenocarcioma in 59.7 percent. Most of the patients were diagnosed in IIb stage (41.9 percent). The surgical technique more carried out was Ivor Lewis (58.1 percent) and the type of suture was the mechanical. The stenosis of the anastomosis was the most frequent complication in 12.9 percent and it was appear only in cases with manual suture of the anastomosis. The type suture more used was the manual in the 17. 4 percent. The postoperative overlife was 17.7 percent at five years. Conclusions: most of patients were older than 60 years and men. The most frequent localization was in inferior third, with prevalence of the adenocarcinoma. Most was diagnosed in IIB stage. The postsurgical stenosis was the most frequent complication. The postoperative overlife was acceptable(AU)

Las consultas externas hospitalarias como escenarios docentes alternativos para la enseñanza en la asignatura de Cirugía General / Inpatient external clinic as alternative educational scenarios for the teaching of the subject General Surgery

Introducción: la enseñanza municipalizada de la Cirugía General constituye un nuevo enfoque en la formación de los médicos generales integrales. Sin embargo, es una realidad las dificultades para lograr que los educandos adquieran las habilidades imprescindibles para un adecuado examen físico en la asignatura Cirugía General. Objetivo: valorar el mejor escenario docente para que los educandos adquieran la mayor cantidad posible de conocimientos propuestos en el programa de la asignatura Cirugía General. Material y Métodos: se realizó un estudio prospectivo y longitudinal con una muestra de 43 educandos de dos policlínicos de la Facultad Finlay-Albarrán, cursos 2008-2009, 2009-2010 y 2010-2011, durante la rotación de Cirugía General en cuarto año de medicina. Entre las formas de educación en el trabajo estuvieron diferentes modalidades de consultas que fueron comparadas en cuanto a pacientes vistos y examinados. Al final de cada rotación se realizaron exámenes prácticos por estaciones.Resultados: con afección del cuello fueron atendidos en las consultas externas hospitalarias el 86.6 por ciento. Con enfermedades de la mama y del tórax, fueron examinados en la consulta externa hospitalaria el 84,7 por ciento. Por enfermedades del abdomen, 163 fueron examinados por los educandos, mayoritariamente durante su estancia en la consulta hospitalaria. Enfermedades como tumores de partes blandas, proctológicas y angiológicas, sólo pudieron verse en las consultas externas hospitalarias. El 79.1 por ciento de los 43 alumnos obtuvo calificación de cinco puntos; ocho obtuvieron calificación de cuatro (18,6 por ciento); uno de tres (2,3 por ciento). No hubo calificación de dos.Conclusiones: las consultas externas hospitalarias fueron los escenarios docentes que en mayor medida influyeron en el proceso de enseñanza-aprendizaje en la asignatura Cirugía General(AU)

Introduction: the municipalized teaching of the General Surgery constitutes a new focus in the formation of the integral general doctors. However, it is a reality the difficulties to achieve that the students acquires the indispensable abilities for an appropriate physical exam in the subject General Surgery. Objective: to value about the best educational scenario in which medicine students acquires the more possible quantity of knowledge proposed in the program of the subject General Surgery. Material and Methods: it was done a prospective and longitudinal study that included to the students of fourth year of medicine of two clinics of the Faculty "Finlay-Albarrßn ", in the courses 2008-2009, 2009-2010 and 2010-2011, during the rotation of General Surgery. Were excluded those students whose cards didn't gather the necessary conditions for the study, being a final sample of 43 students. Education activities were planned in the work during the stay. At the end of each rotation they do practical exams for stations which included elements of these consultations. Results: of the total of sick with affection of the neck were assisted in the hospital external clinic 86.6 percent. In relation with the illnesses of the breast and the thorax, were examined in the hospital external consultations, 84, 7 percent students. Of 260 sick persons assisted by illnesses of the abdomen, 163 were examined by the students, the most part during their stay in the hospital clinic. Other illnesses like tumors of soft parts, proctologics and angiologics entities, only could be seen in the hospital external clinics. 79.1 percent of the 43 students obtained qualification of five points; eight obtained qualification of four (18, 6 percent); one of three (2, 3 percent). there was not qualification of two. Conclusions: the hospital external clinic was the better educational scenarios for the formation of knowledge in medical students(AU)