Diffusion of Technology in the Teaching of Neuroanatomy in Times of Pandemic: A Medical and Academic Perspective on Learning.

The Covid-19 pandemic has caused major changes in many sectors of society worldwide. The issue of medical education stands out since it had to adapt to the rules of social isolation, ensuing discussions about the computerization of teaching methodology, particularly in neuroanatomy. In particular, the latter showed satisfactory adaptability to new technologies and highly promising learning results. During this review, we aim to evaluate the current state of neuroanatomy teaching and evaluate the possibilities of incorporating technology into teaching-learning of human anatomy in a post-pandemic world.

Psychological Resilience and Suicide Attempt in Patients With Bipolar Disorder: An Exploratory Study.

BACKGROUND: Patients with bipolar affective disorder (BPAD) have a suicide risk of up to 30 times higher than the general population. There is increasing interest in analyzing the effects of resilience in psychiatric diseases and its relationship to other factors such as suicide risk. AIM: The main objective of this study was to analyze the relationship between psychological resilience and suicide attempts, along with other relevant clinical and sociodemographic variables in euthymic patients with BPAD. METHODS: Eighty six outpatients, more than 18 years old, mostly men (60.5%) with BPAD type 1, 2, mixed, and unspecified, in euthymic phase receiving antidepressant and/or euthimizing treatment, participated in the study. Sociodemographic and clinical variables were assessed by means of a questionnaire and psychological resilience by means of Connor-Davidson's 10-item Resilience Scale. RESULTS: Patients with previous autolytic attempts scored significantly lower in resilience than those who had not attempted suicide (T = 3.30; p ≤ .001; 20.61 ± 6.58 vs. 26.52 ± 7.29). Patients diagnosed with BPAD scored significantly lower than other samples of university participants, workers, and the unemployed. The number of depressive episodes experienced was negatively and significantly associated with resilience scores (r = -.28; p < .01). CONCLUSIONS: Patients diagnosed with BPAD who had made autolytic attempts had lower resilience scores than those who had not made them and lower scores than other general nonpsychiatric samples. The promotion of resilience in patients diagnosed with BPAD would facilitate a more adaptive and positive coping with the disease and their recovery process.

The effect of Gestational Diabetes Mellitus on the fetal compartment.

In indicated preterm births such a Gestational Diabetes Mellitus (GDM), little is known about the role of the amnion membranes. Investigating the role of amnion membrane inflammation in response GDM may suggest novel pathophysiologic mechanisms. We hypothesize that increased GDM inflammatory mediators may weaken the amnion membrane predisposing them to infection. Maternal and fetal serum and amnion membrane biopsies were collected from 20 GDM and 38 normoglycemic subjects (control) who underwent elective cesarean sections. Cytokines and adipokines were evaluated in serum and amnion culture supernatant samples. Amnion membrane biopsies from GDM and control subjects were studied: fresh frozen for RNA analysis for Toll-like receptor expression; cultured with LPS to test membrane permeability, and inflammation LPS + anti-TLR4 for testing mechanism. GDM was associated with higher fetal serum leptin (p = 0.004) and IL-10 (p = 0.04) compared to controls. Amnion membrane explants from GDM had higher levels of IL-6 (p = 0.019), and lower expression of Claudin-4 (p = 0.007) and increased permeability (p = 0.046) compared to controls. GDM membranes treated with LPS showed an increased expression of IL-10 (p = 0.013); IL-6 (p = 0.004) and TNF-α (p = 0.0005) but did not affect membrane permeability. LPS and anti-TLR4 antibody treatment reduced the production of TNF-α in controls (p = 0.03) and GDM (p = 0.007) compared to LPS alone. Fetal inflammatory response seems more balanced in GDM and does not impact membrane permeability function even with an infectious stimulus. Light fetal membrane inflammatory response may explain lack of preterm labor in GDM. Concluding, benign inflammation in the membranes may not be harmful for pregnancy maintenance.

[Osteosynthesis with 2-octylcyanoacrylate and sodium bicarbonate in zygomatic arch fractures: animal model results]. / 2-octilcianoacrilato y bicarbonato de sodio para osteosíntesis de arco cigomático. Un modelo animal.

BACKGROUND: 2-octylcyanoacrylate (2OCA) is a liquid monomer that polymerizes on contact with a surface by an exothermic reaction creating a strong and flexible film. The addition of sodium bicarbonate accelerates the polymerization. The aim was to use the combination of 2OCA and sodium bicarbonate in the treatment of zygomatic arch fractures in an animal model and to evaluate the biocompatibility and bone healing. METHODS: twenty animals were subjected to bilateral zygomatic arch fracture under surgical sedation, and using 2OCA fixation and sodium bicarbonate for the experimental side and without fixation for the control side. Observation was over a period from two to four weeks, assessing biocompatibility, stability and consolidation. RESULTS: at the end of two and four weeks the twenty animals showed the presence of osseous callus and continuity of marrow channel measured by macroscopic and radiography examinations. CONCLUSIONS: the use of 2-octylcyanoacrylate and sodium bicarbonate led to the stabilization and reduction of bilateral zygomatic arch fractures in an animal model without adverse reactions.

[Küttner's tumour (chronic sclerosing sialadenitis). Clinical, pathological, and immunohistochemical study in 8 cases of a little-known entity]. / Tumor de Küttner (sialoadenitis crónica esclerosante). Estudio clinicopatológico e inmunohistoquímico de 8 casos de una entidad poco reconocida.

OBJECTIVE: To present the clinical-pathological characteristics of Küttner's tumour (KT) or chronic sclerosing sialadenitis. MATERIAL AND METHOD: We studied 8 cases of KT that were graduated histologically according to the Seifert grading system. An immunohistochemistry panel including CD20, CD3, and keratin AE1-3 was performed. RESULTS: All cases involved the sub-maxillary gland. Microscopically the cases were in stages 2, 3, and 4. There was a chronic inflammatory infiltrate, marked fibrosis, variable degrees of parenchymal atrophy, PAS+ intraluminal material, and microliths. The infiltrate was polymorphic and polyclonal, without lymphoepithelial lesions. CONCLUSIONS: Although it has a typical clinical and pathological presentation and was described more than a century ago, KT remains under-diagnosed and often reported as non-specific inflammatory infiltrate or as "low grade lymphoma". In this latter diagnosis lies the greatest importance for recognizing KT, as confusion with lymphoma would result in a different therapeutic approach.

Tumor de Küttner (sialoadenitis crónica esclerosante). Estudio clinicopatológico e inmunohistoquímico de 8 casos de una entidad poco reconocida / Küttner's Tumour (Chronic Sclerosing Sialadenitis). Clinical, pathological, and immunohistochemical study in 8 cases of a little-known entity

Objetivo: Presentar las características clinicopatológicas del tumor de Küttner (TK) o sialoadenitis crónica esclerosante. Material y método: Se estudiaron 8 casos de TK. Se graduaron los casos histológicamente de acuerdo con la clasificación de Seifert. Se realizó una batería de anticuerpos contra CD20, CD3 y queratina AE1-3. Resultados: Todos los casos afectaron a la glándula submaxilar. Microscópicamente se encontraban en estadios 2, 3 y 4. Había inflamación crónica folicular y fibrosis acentuada, con atrofia parenquimatosa variable, material PAS+ intraluminal y microcalcificaciones. El infiltrado inflamatorio fue polimorfo, policlonal y sin lesiones linfoepiteliales. Conclusiones: A pesar de su descripción hace más de un siglo y su presentación clínica e histopatológica característica, el TK es poco diagnosticado y a menudo se informa como proceso inflamatorio inespecífico o como linfoma de bajo grado. En este último diagnóstico radica la mayor importancia del reconocimiento del TK, ya que resultaría en un manejo terapéutico diferente

Objective: To present the clinical-pathological characteristics of Küttner's tumour (KT) or chronic sclerosing sialadenitis. Material and method: We studied 8 cases of KT that were graduated histologically according to the Seifert grading system. An immunohistochemistry panel including CD20, CD3, and keratin AE1-3 was performed. Results: All cases involved the sub-maxillary gland. Microscopically the cases were in stages 2, 3, and 4. There was a chronic inflammatory infiltrate, marked fibrosis, variable degrees of parenchymal atrophy, PAS+ intraluminal material, and microliths. The infiltrate was polymorphic and polyclonal, without lymphoepithelial lesions. Conclusions: Although it has a typical clinical and pathological presentation and was described more than a century ago, KT remains under-diagnosed and often reported as non-specific inflammatory infiltrate or as "low grade lymphoma". In this latter diagnosis lies the greatest importance for recognizing KT, as confusion with lymphoma would result in a different therapeutic approach

[Appendiceal mucocele and gangrenous cholecystitis]. / Mucocele apendicular y colecistitis aguda gangrenada.

OBJECTIVE: We present a case report of appendiceal mucocele and gangrenous cholecystitis. SETTING: Hospital de Especialidades, Centro Médico Nacional Siglo XXI, México, D.F. CLINICAL CASE: An 80-year-old man was admitted to the hospital with diagnosis of acute cholecystitis and abdominal tumor under study, with complaints of abdominal pain for 10 days located in the right upper quadrant, without fever or significant weight loss. Laboratory analyses revealed moderate leucocytosis. CT of the abdomen revealed thickening of the gallbladder wall and acute local inflammation, as well as the presence of abdominal tumor in the right lower quadrant. The patient was surgically explored with the following findings: gangrenous cholecystitis and appendiceal tumor of 20 cm length. Cholecystectomy and appendectomy was performed. The postoperative period was normal. The final histological report was appendiceal mucocele and the patient was discharged after 5 days. The patient is currently without complaints at 5 months postoperatively.

Mucocele apendicular y colecistitis aguda gangrenada / Appendiceal mucocele and gangrenous cholecystitis

Objetivo: descripción de un caso de mucocele apendicular y colecistitis aguda gangrenada, atendido en el Hospital de Especialidades, Centro Médico Nacional Siglo XXI, IMSS. Caso clínico: hombre de 80 años de edad que ingresó al hospital con diagnóstico de colecistitis aguda y tumor abdominal de etiología desconocida, dolor abdominal de 10 días de evolución localizado en hipocondrio derecho, sin fiebre ni pérdida importante de peso. Los exámenes de laboratorio mostraron únicamente leucocitosis moderada. La tomografía computarizada abdominal mostró vesícula biliar con paredes engrosadas y datos de agudización, así como tumor abdominal en fosa iliaca derecha. Se exploró quirúrgicamente con los siguientes hallazgos: colecistitis aguda supurada y tumoración apendicular de 20 cm de longitud, sin datos de malignidad. Se realizó colecistectomía y apendicectomía. El periodo posoperatorio transcurrió sin incidentes. El diagnóstico histopatológico fue de mucocele apendicular no roto. El paciente fue dado de alta a los cinco días. Pasados cinco meses de la intervención, se encontraba asintomático.

OBJECTIVE: We present a case report of appendiceal mucocele and gangrenous cholecystitis. SETTING: Hospital de Especialidades, Centro Médico Nacional Siglo XXI, México, D.F. CLINICAL CASE: An 80-year-old man was admitted to the hospital with diagnosis of acute cholecystitis and abdominal tumor under study, with complaints of abdominal pain for 10 days located in the right upper quadrant, without fever or significant weight loss. Laboratory analyses revealed moderate leucocytosis. CT of the abdomen revealed thickening of the gallbladder wall and acute local inflammation, as well as the presence of abdominal tumor in the right lower quadrant. The patient was surgically explored with the following findings: gangrenous cholecystitis and appendiceal tumor of 20 cm length. Cholecystectomy and appendectomy was performed. The postoperative period was normal. The final histological report was appendiceal mucocele and the patient was discharged after 5 days. The patient is currently without complaints at 5 months postoperatively.

La habilidad de cuidado de los cuidadores familiares de personas con enfermedad crónica. un estudio comparativo de tres unidades académicas de enfermería / Caring ability of family caregivers of chronically diseased people

Objetivo: Describir y comparar la habilidad en el cuidado de los cuidadores familiares de personas con enfermedad crónica, en aquellos que se encuentran vinculados a programas docente-asistenciales de tres unidades académicas de enfermería que pertenecen a la red de trabajo en cuidado al paciente crónico y su familia. Materiales y métodos: Su metodología responde a una comparación de estudios descriptivos, cuantitativos, de corte transversal, con una muestra de 45 cuidadores de la Universidad de la Sabana, 90 de Unillanos y 90 de la Universidad Nacional de Colombia. El instrumento para la recolección de la información fue el Inventario de habilidad de cuidado, CAI®, de Ngozi Nkongho. Resultados: Al finalizar el estudio se evidenció un comportamiento similar en la habilidad de cuidado de los cuidadores en las tres instituciones. Estos resultados confirman los hallazgos de la literatura. Conclusiones: Es clara la necesidad de incluir en las políticas de salud pública y en la academia procesos que preparen a los profesionales de enfermería en el cuidado de los cuidadores de enfermos crónicos discapacitados...

Comparación entre la habilidad de cuidado de cuidadores de personas en situación de enfermedad crónica en Villavicencio, Meta / Comparlson between cure taker's abilities among chronic illness caretakers in the city of Villavicencio, in the province of Meta

El presente trabajo mide y compara la habilidad de cuidado de un grupo de cuidadores informales de pacientes en situación de enfermedad crónica discapacitante. El instrumento utilizado fue el Inventario de Habilidad de Cuidado (CAI) de Ngozi Nkongo, el cual mide la habilidad que tienen las personas para cuidar cuando están en una relación con otros, a partir del desarrollo de tres componentes: conocimiento, paciencia y valor. El análisis se basó en la determinación de cada una de estas categorías en dos grupos de cuidadores -de pacientes de consulta externa y del servicio de hospitalización-. En cada uno de los grupos se analizaron 37 afirmaciones de los cuidadores con respecto a su forma de pensar, sentir y actuar dentro de su experiencia de cuidado. Los hallazgos permitieron la comprensión y el conocimiento real de la situación de cuidado de personas que, sin tener la orientación adecuada y el apoyo efectivo, adelantan acciones de cuidado a personas con altas demandas de cuidado como son los adultos mayores con enfermedad crónica discapacitante. Finalmente, se presentan algunas sugerencias que fortalecen la experiencia de cuidado, particularmente en cuidadores informales para ser abordadas desde la asistencia, la docencia y la investigación en enfermería.

This work measures and compares the abilities of a group of temporary caretakers that have critically disabling illness patients. The tool that was used for this study was Ngozi Nkongo's CAI, which measures the ability to care for another with whom one has a relation, by developing three components: knowledge, patience, and courage. The analysis was based on the determination of each of theses categories in two groups of caretakers – out patients, and in patients-. In each one of the groups, 37 affirmations of the caretakers were analysed regarding the way they think, feel, and act considering their care taking experience. The findings enable one to understand and to acquire real knowledge of the delicate...

Pancreatoduodenectomía en hemorragia de tubo digestivo. Reporte de un caso / Pancreaticoduodenectomy in digestive tract hemorrhage. Report of a case

Objetivo: describir la presentación clínica y el tratamiento de un paciente con neoplasia pancreática neuroendocrina y hemorragia de tubo digestivo. Antecedentes: los tumores neuroendocrinos del páncreas son neoplasias relativamente raras; cuando no son funcionantes el cuadro clínico es inespecífico y se manifiestan hasta que la neoplasia ha adquirido grandes dimensiones. La hemorragia masiva de tubo digestivo alto es una manifestación clínica poco frecuente de este tipo de tumores. Método: se presenta un caso en el cual se requiere tratar una hemorragia masiva de tubo digestivo alto con pancreatoduodenectomía de urgencia por una neoplasia ulcerada de la cabeza del páncreas. Conclusión: la pancreatoduodenectomía es sin duda el procedimiento de elección para control de la hemorragia masiva duodenal en presencia de una neoplasia neuroendocrina del páncreas ulcerada.