Methodological considerations in cross-sectional studies validating the International Classification of Functioning, Disability and Health (ICF) Core-Sets: a systematic review.

PURPOSE: To describe and analyze the methodological characteristics and quality of cross-sectional studies that have validated an ICF-CS. MATERIALS AND METHODS: A systematic review was conducted to identify empirical studies published in English that validated any ICF-CS using a cross-sectional design. Databases searched included Web of Science, Scopus, CINAHL, PubMed, Embase, and PsycINFO. The search was conducted in November 2022 with an update in October 2023. Two independent reviewers coded studies that met the inclusion criteria and assessed their methodological quality and risk of bias using the AXIS tool. Synthesis was performed by calculating frequencies and percentages. RESULTS: 87 articles validating 24 ICF-CSs were analyzed. Most articles showed strengths in consistency between study objectives and the outcome variables measured. However, a large majority did not report sample size calculation (up to 94.2% in Delphi studies), and few validation studies were conducted in the WHO regions of Africa and the Eastern Mediterranean. CONCLUSIONS: The quality of cross-sectional studies validating ICF-CSs was satisfactory, although several articles did not describe aspects such as sample size calculation. Validity evidence for ICF-CS studies could be improved by conducting more multicenter studies, replicating ICF-CS validation studies in different WHO regions, and through synthesis of existing research.

Cross-sectional validation studies of ICF-CSs have satisfactory quality, supporting the use of the CSs in clinical rehabilitation settings similar to those evaluated here.Additional validation studies are required for ICF-CSs that have not yet been validated or for which validity evidence is limited.The methodological findings of this review constitute a roadmap that could guide the development and improve the quality of future ICF-CS validation studies.Knowing which ICF-CSs are validated through cross-sectional designs is useful for planning and designing interventions and instrument development.

Metabolic effects in patients with celiac disease, patients with nonceliac gluten sensitivity, and asymptomatic controls, after six months of a gluten-free diet. / Efectos de una dieta libre de gluten (DLG) durante 6 meses sobre el metabolismo en pacientes con enfermedad celíaca, sensibilidad al gluten no celíaca y controles asintomáticos.

INTRODUCTION AND OBJECTIVES: It is essential for patients with celiac disease (CD) to be on a gluten-free diet (GFD) but said diet has also been reported to increase the risk for metabolic syndrome. There is no evidence on the metabolic effects of a GFD in patients with nonceliac gluten sensitivity (NCGS) or in asymptomatic subjects. Therefore, the aim of the present study was to evaluate the metabolic effects of a GFD over a 6-month period in patients with CD, patients with NCGS, and in asymptomatic controls (ACs). MATERIALS AND METHODS: A prospective study was conducted that evaluated metabolic syndrome and its components of obesity, high blood pressure, hepatic steatosis, and hyperglycemia at the baseline and at 6 months. RESULTS: A total of 66 subjects (22 CD, 22 NCGS, and 22 AC) were included in the study. At the baseline, 10% of the patients with CD presented with obesity, high blood pressure, hepatic steatosis, and metabolic syndrome. After 6 months, obesity and metabolic syndrome increased by 20% (p=0.125). In the patients with NCGS, obesity increased by 5% after the GFD and 20% of those patients presented with de novo hepatic steatosis. The prevalence of obesity decreased by 10% in the controls after the GFD (30 vs 20%, p=0.5) and none of the other components of metabolic syndrome were affected. CONCLUSIONS: The metabolic benefits and risks of a GFD should be considered when prescribing said diet in the different populations that opt for that type of intervention.

Quantification of physical activity using the QAPACE questionnaire: A two stage cluster sample design survey of children and adolescents attending urban school.

BACKGROUND: Quantification of physical activity as energy expenditure is important since youth for the prevention of chronic non communicable diseases in adulthood. It is necessary to quantify physical activity expressed in daily energy expenditure (DEE) in school children and adolescents between 8-16 years, by age, gender and socioeconomic level (SEL) in Bogotá. METHODS: This is a Two Stage Cluster Survey Sample. From a universe of 4700 schools and 760000 students from three existing socioeconomic levels in Bogotá (low, medium and high). The random sample was 20 schools and 1840 students (904 boys and 936 girls). Foreshadowing desertion of participants and inconsistency in the questionnaire responses, the sample size was increased. Thus, six individuals of each gender for each of the nine age groups were selected, resulting in a total sample of 2160 individuals. Selected students filled the QAPACE questionnaire under supervision. The data was analyzed comparing means with multivariate general linear model. Fixed factors used were: gender (boys and girls), age (8 to 16 years old) and tri-strata SEL (low, medium and high); as independent variables were assessed: height, weight, leisure time, expressed in hours/day and dependent variable: daily energy expenditure DEE (kJ.kg-1.day-1): during leisure time (DEE-LT), during school time (DEE-ST), during vacation time (DEE-VT), and total mean DEE per year (DEEm-TY) RESULTS: Differences in DEE by gender, in boys, LT and all DEE, with the SEL all variables were significant; but age-SEL was only significant in DEE-VT. In girls, with the SEL all variables were significant. The Post-hoc multiple comparisons tests were significant with age using Fisher's Least Significant Difference (LSD) test in all variables. For both genders and for all SELs the values in girls had the higher value except SEL high (5-6) The boys have higher values in DEE-LT, DEE-ST, DEE-VT; except in DEEm-TY in SEL (5-6) In SEL (5-6) all DEEs for both genders are highest. For SEL (3-4) all DEEs are lowest. CONCLUSIONS: Children and adolescents in Bogotá have less DEE than at other latitudes. Girls have more free time but lower energy expenditure in their different activities. The socioeconomic level has influence in DEE.

Milk fatty acid profile from grazing buffaloes fed a blend of soybean and linseed oils / Perfil de ácidos graxos do leite de búfalas a pasto recebendo uma mistura de óleo de soja e linhaça na dieta

The aim of the study was to examine the changes in milk fatty acid (FA) profile of grazing buffaloes fed either low (L, 276g/d) or high (H, 572g/d) doses of a blend (70:30, wt/wt) of soybean and linseed oils. Fourteen multiparous Mediterranean buffaloes grazing on a native pasture were fed 4 kg/day of a commercial concentrate containing no supplemental oil over a pre-experimental period of ten days. The baseline milk production and composition and milk FA profile were measured over the last three days. After this pre-experimental period the animals received the same concentrate added with either the L or H oil doses for 26 additional days. Milk yield (g/animal/day) did not differ at the start (1776 ± 522 and 1662 ± 291 for L and H, respectively, P<0.622) or at the end of the trial (4590 ± 991 and 4847 ± 447 in L and H, respectively, P<0.543). Baseline milk fat content (g/kg) averaged 77.1 (±20.5) in L and 74.3 (±9.9) in H (P<0.10) and was reduced (P<0.031) to 60.7 (±23.6) and 49.4 (±11.2) (P<0.0031) respectively after L and H with no differences between treatments (P<0.277). Baseline milk protein content (L=43.2 ± 3.4 and H= 44.3 ± 6.9g/kg) increased after oil supplementation (P<0.0001) in both L (73.2 ± 6.0g/kg) and H (68.4 ± 4.9g/kg) without differences between oil doses (P<0.123). Milk fat content of 14:0 decreased after oil supplementation only in the H treatment (5.29 to 4.03, P<0.007) whereas that of 16:0 was reduced (P<0.001) at both L (24.49 to 19.75g/100g FA) and H (25.92 to 19.17g/100g FA) doses. The reduction of total content of 12:0 to 16:0 was higher (P<0.052) in H (32.02 to 23.93g/100g FA) than L (30.17 to 25.45g/100g FA). Vaccenic acid content increased (P<0.001) from 5.70 to 13.24g/100g FA in L and from 5.25 to 16.77 in H, with higher results in the in H treatment (P<0.001). Baseline rumenic acid was sharply increased (P<0.001) in L (1.80 to 4.09g/100g FA, +127%) and H (1.60 to 4.61g/100g FA, +187%) with no differences between...

O objetivo do presente estudo foi avaliar as mudanças no perfil de ácidos graxos do leite de búfalas leiteiras recebendo baixas (B, 276g/d) ou altas (A, 572g/d) doses de uma mistura de óleos de soja e linhaça (70:30, peso/peso) na dieta. Quatorze búfalas multíparas da raça Mediterrânea, mantidas em pastagens nativas, receberam 4kg/dia de um concentrado comercial sem adição de óleo (pré-tratamento) ao longo de umperíodopré-experimental de 10 dias. A produção de leiteindividual e amostras de leite foram coletadas individualmente para determinação dos valores basais de composição e perfil de ácidos graxos do leite nos últimos trêsdias. Após este período, os animais receberam o mesmo concentrado adicionado deBou Apor 26 dias. A produção de leite (g/animal/dia) não diferiu no início (1776 ± 522 e 1662 ± 291para B e A, respectivamente (P<0,622) e no final do período experimental(4590 ±991e4847 ± 447 para LeH, respectivamente, P<0,543). O teor de gordura do leite (g/100g) apresentou valores médios de 77,1(±20,5)paraBe74,3 (±9,9)paraA(P<0,10) durante o período pré-tratamento,mas foi reduzido (P<0,03) após o fornecimento das dietas com óleo para 60,7 (± 23,6) e 49,4 (± 11,2), respectivamente para B e A, não havendo diferenças entre tratamentos (P<0,277). Os teores basais de proteína do leite (B=43,2 ± 3,4 e A=44,3 ± 6,9g/kg) aumentaram após a suplementação com óleo (P<0,0001) em ambos B (73,2 ± 6,0g/kg) e A (68,4 ± 4,9g/kg), não ocorrendo diferenças entre tratamentos (P<0,123). O teor médio basal de 14:0 na gordura do leite (4,76g/100g AG) foi reduzido após a suplementação da dieta com óleo somente no tratamento A (5,29 para 4,03, P<0,007). O teor de 16:0 na gordura do leite foi reduzido (P<0,001) nos tratamentos B (24,49 para 19,75g/100g AG) e A (25,92 para 19,17g/100g AG). A redução nos teores de 12:0+14:0+16:0 na gordura do leite foi maior (P<0,052) em A (32,02 para 23,93g/100g AG) do que em B (30,17 para 25,45g/100g AG). O teor de ácido vacênico (AV)...

Eosinophilic esophagitis prevalence in an adult population undergoing upper endoscopy in southeastern Mexico.

Eosinophilic esophagitis (EoE) prevalence fluctuates according to the population studied and varies from 0.4% in an open population to 6.5% in subjects with esophageal symptoms. Even though this entity has been described in North American and European populations, it is still considered an 'unusual' condition in Latin America. The study aimed to determine EoE prevalence in patients undergoing elective endoscopy in a tertiary referral center in southeastern Mexico. Consecutive patients were evaluated that had been referred to the Medical and Biological Research Institute, Veracruz, Mexico, for upper endoscopy due to gastrointestinal symptoms. Demographic variables and symptoms were analyzed in all the cases. Eight mucosal biopsies of the esophagus (four proximal and four distal) were obtained and were reviewed by a blinded pathologist. Histological diagnosis was established when the mean eosinophil count at a large magnification was ≥15. A total of 235 subjects (137 women, 51.16 years) were evaluated, and EoE prevalence was 1.7% (4/235 95% confidence interval 0.2-3.6%). In all four cases, pH test were normal. Among patients with histological diagnosis of EoE, a greater number of patients with a past history of asthma (50% vs. 19.3%, P = 0.04) and a tendency for a greater frequency of dysphagia (50% vs. 25%, P = 0.10). There were no differences in the endoscopic findings (rings, grooves, plaques, or stricture) when compared with the patients presenting with erosive esophagitis. EoE prevalence among patients undergoing upper endoscopy from southeastern Mexico was 1.7%, which can be regarded as intermediate to low.

Esophageal motor disorders in subjects with incidentally discovered Chagas disease: a study using high-resolution manometry and the Chicago classification.

In patients with chronic indeterminate Chagas disease, conventional manometry has shown that 25-48% had esophageal motor disorders. Recently, esophageal high-resolution manometry (HRM) has revolutionized the assessment of esophageal motor function. In this study, we performed esophageal HRM in a group of subjects with incidentally positive serological findings for Trypanosoma cruzi. In this prospective observational study, we evaluated subjects who had positive serological tests for Chagas disease detected during a screening evaluation for blood donation. All subjects underwent symptomatic evaluation and esophageal HRM with a 36 solid-state catheter. Esophageal abnormalities were classified using the Chicago classification. Forty-two healthy subjects (38 males) aged 18-61 years (mean age, 40.7 years) were included. When specific symptoms questionnaire was applied, 14 (33%) subjects had esophageal symptoms. Esophageal high-resolution manometry revealed that 28 (66%) of the subjects had an esophageal motility disorder according to the Chicago classification. Most common findings were hypocontractile disorders in 18 subjects (43%) and esophagogastric junction (EGJ) outflow obstruction in 6 (15%). Esophageal high-resolution manometry reveals that up to two thirds of the subjects with an incidental diagnosis of Chagas disease have esophageal abnormalities. This technology increases the detection and allows a more complete assessment of esophageal motor function in subjects infected with T. cruzi even in the early stages of the disease.

Osteoma gigante en mandíbula. Reporte de Caso / Giant osteoma in Jaw. Case Report

El osteoma es una neoplasia benigna poco común, que se caracteriza por presentar un crecimiento óseo progresivo, el cual está  compuesto por la proliferación bien diferenciada de hueso compacto y/o esponjoso. En el área maxilofacial se presenta con mayor frecuencia en la cara lingual posterior de la mandíbula. Se caracteriza por crecimiento lento y asintomático. El caso describe una paciente de 45 ños con un osteoma gigante mandibular de 4 años de evolución tratado quirúrgicamente.

Osteomas are considered a rare benign neoplasm, characterized by a progressive bone growth, which is composed of a proliferation well differentiated of compact or cancellous bone. In the maxillofacial area when present, commonly found in the posterior lingual surface of the mandible. It is characterized by slow growth and asymptomatic. The case describes a mandibular giant osteoma of 4 year of evolution treated with surgical treatment.

Consensus on treatment of endometrium carcinoma with brachytherapy.

Radiotherapy (RT) is commonly used as adjuvant treatment following hysterectomy and double oophorectomy in endometrial carcinoma. Prophylactic vaginal brachytherapy (BT) is the most common treatment in BT units. The PORTEC and GOG 99 studies have attempted to clarify the indications of BT and postoperative external RT, changing treatment standards. However, prophylactic BT regimens are very varied and there is currently no consensus on how to treat patients in terms of dose per fraction and number of fractions. Moreover, unoperated cases of endometrium are uncommon and there is limited experience in their treatment with BT. The 9th Consensus Meeting of the SEOR and SEFM Brachytherapy Group, held in Malaga on 11 March 2011, was therefore dedicated to "Brachytherapy in Endometrial Carcinoma". This article presents the consensus on treatment of endometrial carcinoma in operated (prophylactic vaginal BT) and unoperated (endouterine BT) patients.

Consensus on treatment of endometrium carcinoma with brachytherapy

Radiotherapy (RT) is commonly used as adjuvant treatment following hysterectomy and double oophorectomy in endometrial carcinoma. Prophylactic vaginal brachytherapy (BT) is the most common treatment in BT units. The PORTEC and GOG 99 studies have attempted to clarify the indications of BT and postoperative external RT, changing treatment standards. However, prophylactic BT regimens are very varied and there is currently no consensus on how to treat patients in terms of dose per fraction and number of fractions. Moreover, unoperated cases of endometrium are uncommon and there is limited experience in their treatment with BT. The 9th Consensus Meeting of the SEOR and SEFM Brachytherapy Group, held in Malaga on 11 March 2011, was therefore dedicated to "Brachytherapy in Endometrial Carcinoma". This article presents the consensus on treatment of endometrial carcinoma in operated (prophylactic vaginal BT) and unoperated (endouterine BT) patients (AU)

Influence of fish oil in the concentration of conjugated linoleic acid and omega 6 and 3 in buffalo milk / Influência do óleo de peixe na concentração de ácido linoléico conjugado e Omega 6 e 3 no leite de búfalas

The aim of this research work was to investigate the influence of fish oil supplementation on the concentration of conjugated linoleic acid (CLA) and omega 6 and 3 in samples of buffalo milk. A total of 24 female buffaloes separated at random into three groups were fed for 49 days with: natural pasture (group I), supplemented with 70mL of fish oil (group II) and 140mL of fish oil (group III). In the experiment the concentration of CLA showed differences (P<0.05) among the three groups, with a maximum of 7.14mg/g fat in group II. No significant differences were found in omega-6 among the three groups. The highest value of 3.82mg/g fat corresponded to group I, whicht had not been supplemented with fish oil. Significant differences were observed in omega 3 (P<0.05) in groups II and III with respect to group I. The highest average value of 2.42mg/g fat was obtained in group III. The closest relationship omega 6/3 (1.37:1) was observed in group III. As a result, the diets of groups II and III, which included fish oil, increased significantly the content of CLA and omega 3 with reductions in levels of omega 6.

Estudou-se a influência da suplementação com óleo de peixe sobre a concentração dos ácidos graxos ômega 6 e 3, mostrado no leite de búfala. Foram utilizadas 24 búfalas aleatoriamente selecionadas e distribuídas em três grupos e alimentados com pastagem natural por 49 dias com: nenhum suplemento (grupo I), suplementado com 70mL de óleo de peixe (grupo II) e com 140mL de óleo de peixe (grupo III). A concentração de CLA diferiu (P<0,05) entre os três grupos, com valores máxima de até 7,14mg/g de gordura no grupo II. Não foram observadas diferenças significativas para os ácidos graxos omega 6, sendo o maior valor de 3,82mg/g de gordura no grupo I. Foi observada diferença significativa quanto aos ácidos graxos ômega 3 (P<0,05) nos grupos II e III em relação ao grupo I. O mais elevado valor, 2,42mg/g de gordura foi observado no grupo III. A relação ômega 6/3 mais estreita, 1,37:1, foi observada no grupo III. Os resultados mostram que os animais dos grupos II e III que receberam suplementação de óleo de peixe aumentou significativamente o teor de CLA e de omega 3, com diminuição de omega 6.

[Comparative analysis between breath test, serological immunoassay and rapid-urease test for detection of Helicobacter pylori infection in Mexican patients with non-investigated dyspepsia]. / Un análisis comparativo entre prueba de aliento, serología y prueba de ureasa rápida para la detección de infección por Helicobacter pylori en pacientes mexicanos con dispepsia no investigada.

INTRODUCTION: There are multiple Helicobacter pylori (Hp) detection tests, some are invasive and other noninvasive. The diagnostic accuracy of these methods varies according to the prevalence of the disease. OBJECTIVE: To determine the diagnostic accuracy of the breath test, serology and rapid urease test, considering gastric biopsy with Giemsa stain as the gold standard in Hp-infected subjects with uninvestigated dyspepsia. METHODS: Eighty four subjects (64 women, mean age 45 years) who were referred for dyspeptic symptoms were evaluated. Also, 20 healthy volunteers (12 men, average age 38 years) were evaluated. All the subjects underwent hystological analysis with Giemsa stain, breath test (Heliprobe®), rapid urease test (CLOtest®) and serological immunoassay (Hexagon®). RESULTS: Overall, Hp infection was diagnosed by histological analysis in 59 subjects (49 patients and 10 healthy subjects). Positivity to breath test, rapid urease test and serology were 56%, 46% and 44% respectively. Agreement with the histological analysis was 0.902 for the breath test, 0.620 for rapid urease test and 0.45 for serology. The area under the curve for the breath test was 0.95, for the rapid urease test was 0.82 and for serological test was 0.74. CONCLUSIONS: In our population, the breath test shown to have a diagnostic accuracy equivalent to histological analysis by Giemsa in subjects with uninvestigated dyspepsia.

[Esophageal motor disorders in asymptomatic subjects with Trypanosoma cruzi infection]. / Alteraciones motoras del esófago en sujetos asintomáticos con infección crónica por Trypanosoma cruzi.

BACKGROUND: The indeterminate chronic or "asymptomatic" phase of Trypanosoma cruzi (Chagas' disease) infection is characterized by the absence of gastrointestinal symptoms, and has an estimated duration of 20 to 30 years. However, the intramural denervation that induces dysfunction of the gastrointestinal tract is progressive. Recently, epidemiological studies have shown that the seroprevalence for this infection in our area ranges between 2% and 3% of the population. OBJECTIVE: To detect the presence of esophageal motor disorders in asymptomatic individuals chronically infected with Trypanosoma cruzi using standard esophageal manometry. METHODS: A cross sectional study in 28 asymptomatic subjects (27 men, age 40.39 ± 10.79) with serological evidence of infection with Trypanosoma cruzi was performed. In all cases demographic characteristics, gastrointestinal symptoms and esophageal motility disorders using conventional manometry were analyzed. RESULTS: In this study 54% (n = 15) of asymptomatic subjects had an esophageal motor disorder: 5 (18%) had nutcracker esophagus, 5 (18%) nonspecific esophageal motor disorders, 3 (11%) hypertensive lower esophageal sphincter (LES), 1 (4%) an incomplete relaxation of the LES and 1 (4%) had chagasic achalasia. CONCLUSIONS: More than half of patients that course with Chagas' disease in the indeterminate phase and that are apparently asymptomatic have impaired esophageal motility. Presence of hypertensive LES raises the possibility that this alteration represents an early stage in the development of chagasic achalasia.

Evaluation of electrical properties of Cr/CrN nano-multilayers for electronic applications.

The electrical properties of Cr/CrN nano-multilayers produced by Unbalanced Magnetron Sputtering have been studied as a function of bilayer period and total thickness. Two groups of multilayers were produced: in the first group the bilayer period varied between 20 nm, 100 nm and 200 nm with total thickness of 1 microm, and in the second group the bilayer period varied between 25 nm, 50 nm and 100 nm and a total thickness of 100 nm. X-ray Diffraction (XRD), Scanning Electron Microscopy (SEM) and Transmission Electron Microscopy (TEM) were used in order to investigate the microstructure characteristics of the multilayers, and the Four Point Probe (FPP) method was used to evaluate in-plane and transverse electrical resistivity. XRD results show (111) and (200) orientations for all the CrN coatings and the presence of a multilayer structure was confirmed through SEM studies. Transverse electrical resistivity results show that this property is strongly dependent on the bilayer period.

[Fructose intolerance in patients with irritable bowel syndrome: a case-control study]. / Intolerancia a la fructosa en pacientes con síndrome de intestino irritable; un estudio de casos y controles.

INTRODUCTION: Recently it has been reported that prevalence of fructose intolerance (FI) in patients with functional gastrointestinal disorders range between 38% -75%. OBJECTIVE: To determine the prevalence of FI in subjects diagnosed with irritable bowel syndrome (IBS). METHODS: We studied 25 subjects (17 women, average age 36 years) with IBS (Rome II) and 25 healthy controls (14 women, mean age 37 years) who underwent a breath test after oral loading with fructose (Gastrolyzer ®, Bedfont Scientific Ltd., UK). The load consisted of 25 grams of fructose dissolved in 250 ml of water (10% solution). Breath test analysis of the particles per million (ppm) of hydrogen exhaled were performed every 15 minutes for 3 hours. The fructose breath test was considered positive when concentrations of hydrogen were higher than at 20 ppm or a raising greater than 5 ppm in 3 consecutive samples was detected. RESULTS: According to the Rome II criteria, 10 patients (40%) had IBS-C, 9 (36%) had IBS-D and 6 (24%) had IBS-M. Thirteen (52%) of IBS patients had IF, while only 4 (16%) of control subjects (p = 0.01). Patients with IBS and fructose intolerante tend to suffering from diarrhea predominant IBS (p = 0.053). CONCLUSIONS: Fructose intolerance may be responsible for gastrointestinal symptoms in at least half of IBS patients, especially in the group of patients with IBS-D.

Entropía. Monitorización, fundamentos y comparación respecto al resto de monitores de profundidad anestésica / Entropy. Bases and monitoring. comparison with other anesthesia depth monitors

El uso de monitores de profundidad anestésica, basados en el electroencefalograma, ha demostrado su utilidad tanto en la disminución de los despertares intraoperatorios como en la titulación de los distintos fármacos anestésicos. Varios aparatos han sido diseñados con la intención de extraer y procesar el registro electroencefalográfico, dando como resultado un valor numérico representativo de un nivel de hipnosis. Distintos estudios analizan la diferencia entre estos monitores y el comportamiento de los mismos con los fármacos anestésicos utilizados en la práctica diaria; recientemente ha aparecido un nuevo módulo para la medición de la hipnosis, entropía, basado en un concepto termodinámico, analiza los datos según su variabilidad; aportando como novedad dos indicadores, entropía de respuesta y entropía de estado, que recogen un rango de frecuencias electroencefalográficas distintas, con la intención de poder distinguir entre electromiograma y electroencefalograma

Anaesthesia depth monitors that are based mainly on the electroencephalogram (EEG) have demonstrated but also titrating the different anaesthetic agents. Several devices have been designed to analyse and process the EEG trace and obtain a single number that represents the hypnpsis level. Different studies analyse this monitors and their response with the anaesthetics agents used on the daily practice. Recently the entropy monitor have appeared, it is based on the thermodynamic concept, analyzes the data variability and innovates to offer two different indexes: response and state entropy; that allow distinguish between electromyogram and electroencephalogram

Valoración del síndrome escrotal agudo en atención primaria

No disponible

[Chromosome 22 (22q.11.2) deletion. Etiology of conotruncal heart abnormalities]. / Deleción en el cromosoma 22 (22q.11.2). Etiología de cardiopatías congénitas troncoconales.

Important advances in the diagnosis and treatment of congenital heart disease (CHD) have been made in the past 50 years. Nowadays echocardiogram plays an important role in the diagnosis. This procedure is able to identify a wide range of malformations. Cardiac catheterization is mainly a therapeutic tool, surgery is now performed much earlier because CHDS are diagnosed sometimes before birth or very early in life. All this advances in the diagnosis and treatment of this group of patients, allows them not only a better quality of life but also the possibility of reaching adulthood and having children. The study of the etiology of CHD is a field that has not evolved as fast as the assessment and treatment. Nowadays we have a larger population of adults with CHD. The discovery of a microdeletion of chromosome 22 q11.2 associated with conotruncal cardiac defects, proves a common etiology for clinical phenotypes and conotruncal malformations. In order to identify, which of these patients share the same etiology and presented with this syndrome, we collected a group that shared not only heart defects of the conotruncal type but also specific phenotypic alterations such as broad nasal bridge, nasal dimple, high palate, and digitalization of the first finger among others. The first two patients studied with FISH technique were positive to monosomy of a locus on chromosome 22. Those patients with CHD of conotruncal type should undergo microdeletion testing so genetic counseling can be offered as well as appropriate treatment in areas such as cardiology and developmental psychology.

[Prevalence of vaginal candidiasis in a low-risk obstetric population in Santander]. / Prevalencia de candidiasis vaginal en una población obstétrica de bajo riesgo en Santander.

OBJECTIVES: To find the prevalence of vaginal candidiasis in pregnant women monitored through primary care and to see whether it is on the increase. DESIGN: Descriptive and retrospective study of pregnant women. SETTING: Cazoña Health District (34,783 inhabitants). SUBJECTS: The entire obstetric population monitored by our health centre between 1992 and 1997 inclusive. MEASUREMENTS AND RESULTS: Retrospective study of clinical histories of all the pregnant women seen at our health centre (878 pregnancies). After discounting those referred to obstetricians, abortions/miscarriages and premature births, 549 normal low-risk pregnancies (62.30% of the total) were monitored to completion in primary care. The women's age range was 16 to 40. The mean prevalence of candidiasis was 18% (CI, 15.0-21.6). Its frequency increased as the number of pregnancies increased and dropped as the age of the pregnant women increased. CONCLUSIONS: Prevalence found in our study was 18% and did not increase as the years passed.

Prevalencia de candidiasis vaginal en una población obstétrica de bajo riesgo en Santander / Prevalence of vaginal candidiasis in a low-risk obstetric population in Santander

Objetivo. Conocer la prevalencia de candidiasis vaginal en embarazadas controladas desde atención primaria y ver si está aumentando con el paso del tiempo. Diseño. Estudio descriptivo, retrospectivo del universo de mujeres embarazadas. Emplazamiento. Zona Básica de Salud Cazoña (34.783 habitantes). Sujetos. Toda la población obstétrica controlada en nuestro centro de salud desde 1992 a 1997, ambos inclusive. Mediciones y resultados. Estudio retrospectivo de las historias clínicas de todas las mujeres embarazadas captadas en nuestro centro de salud (878 embarazos). Descartados los derivados a tocólogo, abortos y partos prematuros, se han valorado 549 embarazos (62,30 por ciento del total) normales, de bajo riesgo, controlados hasta el final por atención primaria, con un rango de edad de 16-40 años. La prevalencia media de candidiasis es de un 18 por ciento (IC, 15,0-21,6). Su frecuencia aumenta a medida que se incrementa el número de gestaciones y disminuye a medida que aumenta la edad de la embarazada.Conclusiones. La prevalencia encontrada en nuestro estudio es de un 18 por ciento, y no está aumentando a medida que pasan los años (AU)