Trastorno por Déficit de Atención e Hiperactividad (TDHA) y trastornos del estado del ánimo en estudiantes de medicina humana peruanos: una prueba piloto a nivel nacional / Attention Deficit Hyperactivity Disorder (ADHD) and mood disorders in Peruvian human medicine students: a nationwide pilot test

Introducción: el Trastorno por Déficit de Atención con Hiperactividad, también conocido por sus siglas TDAH, es considerado como un trastorno del neurodesarrollo. Diversos estudios reportan que la persistencia de los síntomas durante la adultez se da en el 50-70% de niños con TDAH. Respecto del área académica, la literatura menciona que esta patología en la población universitaria oscila entre un 10 a 25% de estudiantes, en particular los de Medicina Humana. Materiales y métodos: estudio piloto con diseño Cross-sectional, para explorar las variables mencionadas en los estudiantes de todo el territorio peruano se agruparon los departamentos en cinco macro regiones, se utilizaron los cuestionarios ASRS V1.1 y DASS-21. Resultados: se contó muestra total de 250 participantes para la prueba piloto (50 por cada macro región), respecto del TDAH, 33,6% presentó resultados sugestivos. La prevalencia de trastornos del estado anímico fue del 81,6%, dentro de ellos la ansiedad fue más prevalente (70,4%), seguido por la depresión (62,8%) y el estrés (57,6%). Se encontró asociación entre el TDAH y los siguientes: trastorno anímico (PR=1,3 IC(95%) ), depresión (PR=1,51 IC(95%) ), ansiedad (PR=1,47 IC(95%) ) y estrés (PR=1,87 IC(95%) ). Conclusiones: el presente estudio piloto nos ha permitido probar satisfactoriamente el desempeño del instrumento y la técnica propuesta por el diseño metodológico en el estudio primario, confirmado con la obtención de cifras estimadas coherentes con lo descrito por la literatura, y confirmando la asociación entre las variables de interés.

Introduction: Attention Deficit Hyperactivity Disorder, also known by its acronym ADHD, is considered a neurodevelopmental disorder. Several studies report that the persistence of symptoms during adulthood occurs in 50-70% of children with ADHD. Regarding the academic area, the literature mentions that this pathology in the university population ranges from 10 to 25% of students, in particular those of human medicine. Materials and methods: pilot study with Cross-sectional design, to explore the variables mentioned in students from all over the Peruvian territory, the departments were grouped into 5 macro regions, the ASRS V1.1 and DASS-21 questionnaires were used. Results: a total sample of 250 participants was counted for the pilot test (50 for each macro region), regarding ADHD, 33.6% presented suggestive results. The prevalence of mood disorders was 81.6%, among them, anxiety was more prevalent (70.4%), followed by depression (62.8%) and stress (57.6%). An association was found between ADHD and the following: Mood disorder (PR=1.3 CI (95%) ). Depression (PR=1.51 CI (95%) ). Anxiety (PR=1.47 CI (95%) ). and Stress (PR=1.87 CI (95%) ). Conclusions: the present pilot study has allowed us to satisfactorily test the performance of the instrument and the technique proposed by the methodological design in the primary study, confirmed by obtaining estimated figures consistent with what is described in the literature, and confirming the association between the variables of interest.

Manifestaciones cutáneas de enfermedades gastrointestinales / Cutaneous manifestations of gastrointestinal diseases

The gastrointestinal system is closely related to the skin. Multiple disorders of the gastrointestinal tract that manifest clinically on the skin surface are recognized, which can even occur before establishing the definitive diagnosis of the disease. For this reason, it is necessary that the dermatologist is internalized regarding the wide variety of clinical signs that can guide the etiological study, which requires in most cases, a multidisciplinary management. (AU)

Conocimientos y actitud de los odontólogos en la atención de personas con discapacidad intelectual / Knowledge and attitude of dentists in care of persons with disability

El objetivo de este artículo es hacer una revisión sobre el estado del arte de la actitud y conocimientos de los odontólogos, en la atención de personas con discapacidad intelectual. La literatura científica es coincidente en mostrar que las personas con discapacidad intelectual, presentan alta prevalencia en caries dental, enfermedad periodontal, pérdida de dientes, mala higiene oral y en ocasiones no cuentan con el apoyo familiar o de cuidadores, para mejorar su salud bucal e implementar tratamientos preventivos y de rehabilitación. Se considera vulnerable a este grupo de población y necesita atención odontológica integral. Se realizó la búsqueda en las bases de datos MEDLINE, Scielo, Redalyc, sobre estudios relacionados con esta temática. En conclusión, los estudios evidencian que existe falta de conocimientos y/o entrenamiento de los profesionales para la atención odontológica de pacientes con discapacidad intelectual, además actitud negativa hacia este grupo de personas y se observa con mayor frecuencia en los odontólogos de mediana edad, sin embargo en cuanto mayor experiencia tiene el profesional, más efectividad en la implementación de tratamientos.

The objective of this article is to carry out a state of the art review of the attitude and knowledge of dentists regarding the attention of people with intellectual disability. Scientific literature is coincidental in showing that intellectually disabled people exhibit high prevalence in tooth decay, periodontal disease, loss of teeth, bad oral hygiene and sometimes they do not have the familiar support or minders to improve the conditions of oral health and to implement preventive treatments and of rehabilitation. This population group is considered to be vulnerable and in need of integral dental attention. The research was done using the MEDLINE, Redalyc, Scielo databases on studies related to this subject. In conclusion, the studies reveal that in the dental attention of patients with intellectual disability, there is a lack of knowledge and/or training of the professionals, additionally; negative attitude appears more frequently in middle age dentists. Nevertheless, the more work experience the dentist has, the more effectiveness there is in the treatment implementation.

Rhinocladiella aquaspersa, proven agent of verrucous skin infection and a novel type of chromoblastomycosis.

We report a case of chromoblastomycosis which resembled sporotrichosis due to the presence of warty nodules and lymphatic distribution on the forearm in a 56-year-old male. Mycological and histopathological investigation of exudates and biopsy tissue samples revealed a granulomatous lesion with muriform cells, the hallmark of chromoblastomycosis. The infection showed only localized expansion with verrucous plaques suggesting a new clinical type of the disease. The causative agent was identified as Rhinocladiella aquaspersa. This case prompted a study of the clinical spectrum of R. aquaspersa, through which we identified a second case caused by this fungus in a 62-year-old Brazilian female. The case was unusual in that R. aquaspersa exhibited hyphae rather than muriform cells in tissue. Given the difficulties treating chromoblastomycosis and other infections caused by melanized fungi, we evaluated the in vitro activities of extended-spectrum triazoles, amphotericin B, and echinocandins against these clinical isolates of R. aquaspersa. Itraconazole (MIC; 0.063 mg/l) and posaconazole (MIC; 0.125 mg/l) had the highest in vitro activities, while voriconazole and isavuconazole had somewhat lower activities (MICs; 2 mg/l) against the isolates. Amphotericin B and anidulafungin each had an MIC of 1 mg/l, whereas the MIC of caspofungin was 8 mg/l.

Trastornos de la conducta alimentaria en estudiantes de la carrera de nutrición y dietética / Eating disorders symptoms among female nutrition and dietetic university students

Background: Several studies report eating disorder symptoms among nutrition and dietetic students and among dieticians. Objective: To estimate the presence of eating disorder symptoms among female nutrition and dietetic students at the University of Valparaíso. Material and Methods: The Eating Disorders Inventory (EDI) and the Eating Attitudes Test (EAT-40) were administered to 123 freshman, sophomore, junior and senior nutrition and dietetic students. Their mean age was 20 year 9 months old. Results: Nutrition and dietetic students had the same risk (15%) as others students of suffering an eating disorder behavior and the nutritional status was not associated to the risk of developing eating disorder symptoms. Body dissatisfaction (p=0.01), drive for thinness (p=0.01), maturity fears and perfectionism (p=0.05) were the most prevalent symptoms measured by EDI. A greater tendency towards the development of an anorexic more than a bulimic symptomatology was detected. Conclusion: The results contribute to the knowledge of eating disorders, considered as emerging pathologies, especially within vulnerable groups.

Antecedentes: Numerosos estudios señalan la presencia de síntomas compatibles con trastornos de la conducta alimentaria en estudiantes de nutrición y nutricionistas. Objetivo: Estimar la presencia de sintomatología relacionada con desórdenes alimentarios en estudiantes de sexo femenino de la carrera de Nutrición y Dietética de la Universidad de Valparaíso. Material y Métodos: La muestra constó de 123 estudiantes que cursaban entre primer y cuarto año de la carrera, con una media de edad de 20 años 9 meses a las que se les aplicó el Inventario de Trastornos Alimentarios (EDI) y el Test de Actitudes Alimentarias (EAT-40). Resultados: Las estudiantes de Nutrición y Dietética tuvieron un riesgo similar (15%) de padecer patologías alimentarias que otros universitarios y el estado nutricional no se asoció al riesgo de desarrollarlas. Las sintomatologías más prevalentes en el grupo de riesgo según el EDI fueron insatisfacción corporal (p=0,01), motivación por la delgadez (p=0,01) y perfeccionismo (p=0,05). Se detectó una mayor tendencia hacia la presencia de sintomatología anoréctica en relación a la bulímica. Conclusión: Los hallazgos obtenidos contribuyen al conocimiento sobre los cuadros alimentarios, patologías que actualmente se encuentran en alza, y en grupos que la literatura designa como vulnerables.

Long-term follow-up of tension-free Lichtenstein hernioplasty: application of a qualitative-and-quantitative measurement instrument.

Real outcomes for the inguinal tension-free Lichtenstein hernioplasty are not reflected by the usual parameters by which they are measured and habitually reported. It is possible to measure these outcomes from the point of view of the surgeon, as well as from the patient's, using an instrument specifically designed for that purpose. The aim of this study was to analyze the outcomes of the tension-free hernioplasty in 236 patients. Based upon the concept of quality-of-life, we designed a structured questionnaire in the form of a qualitative-and-quantitative measurement instrument. The study had two phases. First, we analyzed retrospectively the clinical records. Second, we interviewed the patients applying the instrument. The score demonstrated that 83% of the patients feel that the outcomes of their surgery are excellent, 9.7% feel that they are very good, and 3.8% feel that they are bad or very bad. Outcomes of the Lichtenstein hernioplasty should not only reflect the technological progress of hernia surgery but also the more intimate aspects of the patient's experience. It is possible to measure the outcomes of this common surgical procedure in a more complete way using a simple measurement instrument.

Inferencia de parametros estadisticos de los grupos sanguineos O A B y el factor Rh en el departamento de Cochabamba / Statistical parameters of blood groups O, A, B and factor Rh in Cochabamba

Se determinaron los grupos sanguineos O, A, B y el FactorRh en 20.611 personas del departamento de Cochabamba. Se tomaron muestras dirigidas de diversas areas geograficas habitadas por grupos poblacionales de distinta influencia racial y de areas autoctonas. Se hicieron comparaciones e inferencias de los datos obtenidos entre la poblacion de la ciudad de Cochabamba,las provincias, las poblaciones autoctonas (tribus de los Yuracares) y los datos proporcionados por el Autor A. Guyton en el libro Fisiologia Medica y el autor B., Houssay en el libro Fisiologia Humana. La distribucion de los datos finales es: Grupos sanguineos ( por ciento ): O:74.6; A:19.3; B:5,2; AB:0,9. Factor Rh: Positivo 98,9; Negativos: 1,1

[Hemoglobin variants and hematologic and serologic parameters of the population of El Limón (Aragua State, Venezuela)]. / Variantes hemoglobínicas y parámetros hematológicos y serológicos de población de El Limón (Estado Aragua, Venezuela).

Nine hundred and fifty seven individuals from El Limon (Aragua State, Venezuela) were studied, in order to get information on their hematologic, immunologic and biochemical characteristics. The majority of surnames were of Spanish origin although there were also from other European nationalities. No surname from Venezuelan Indians was found. The pathologic hemoglobin variants (Hb S, Hb C and Hb D-Punjab) have a frequency of 4.3%. Eight albumin variants were detected. The hematologic values suggest a high frequency of iron deficiency. Positivity for hepatitis virus B was found in 0.9% of the population. The carriers and patients for hemoglobin variants per generation was calculated for the whole municipality (5062 and 26, respectively). The African component of the population was estimated in around 18%.

Trace measurements of the antineoplastic agent methotrexate by adsorptive stripping voltammetry.

An extremely sensitive voltammetric method is presented for trace measurement of the cancer chemotherapy drug methotrexate. The method is based on controlled adsorptive preconcentration of methotrexate on the hanging mercury-drop electrode, followed by voltammetric determination of the surface species. Cyclic voltammetry was used to explore the interfacial behaviour. The adsorptive stripping response was evaluated with respect to preconcentration time and potential, pH, concentration dependence, stripping mode, possible interferences, and other variables. The detection limit found was 2 x 10(-9)M (5-min preconcentration), the response was linear, and the relative standard deviation (at the 1.6 x 10(-7)M level) 2.2%. Sensitive adsorptive stripping measurements were also obtained by use of a carbon-paste disk electrode. Applicability to urine analysis is illustrated.

Fabrica de cajas de cambio

El presente estudio de implementacion de una fabrica de cajas de velocidad comprende un analisis de la situacion actual y principalmente de las perspectivas futuras de la demanda de este componente en el mercado nacional para vehiculos que han sido asignados a Bolivia dentro de la programacion automotriz subregional. Dentro de esta perpectiva, bolivia a travez de la empresa Nacional Automotriz a instalado ya plantas terminales ensambladoras de vehiculos automotores, los cuales constituiran el mercado de sustentacion para industrias de componentes automotrices. en el contexo de la propuesta 45 de la programacion sectorial automotriz del acuerdo de Cartagena, Bolivia a recibido pre-asignaciones, para la fabricacion en el pais de ciertos componentes y subconjuntos que se incluiran en el vehiculo que se produciran en el pais para que este sea considerado de origen subregional, dentro de estos componentes se encuentra la caja de velocidades.