Cardiac arrest in the setting of probable catastrophic antiphospholipid syndrome in young patient with a history of COVID infection and polyglandular disorder-Case report.

Antiphospholipid syndrome is an autoimmune disorder characterized by arterial and venous thrombosis and recurrent spontaneous abortions due to the persistent presence of antiphospholipid antibodies. Probable Catastrophic antiphospholipid (Catastrophic antiphospholipid-like syndrome) is a life-threatening presentation of antiphospholipid syndrome which manifests as intravascular thrombosis, leading to rapid onset of symptoms and involvement of multiple organ systems. We present a case of a 28-year-old woman with a history of polyglandular autoimmune syndrome, systemic lupus erythematosus, provoked bilateral deep vein thrombosis in the setting of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection 2 years prior, and hypothyroidism who presents with a cardiac arrest in the setting of an acute ST-elevation myocardial infarction with thromboembolic occlusion of two coronary arteries simultaneously in the setting of noncompliance with anticoagulation for the past 1 week. Her presentation was further complicated by acute hypoxic respiratory failure due to diffuse alveolar hemorrhage during the hospital course with progressive multiorgan failure and eventual death. Catastrophic antiphospholipid is associated with high morbidity and mortality, thus a timely diagnosis and multidisciplinary approach to management is needed for evaluation and management.

Duplication of 12q24.21q24.33 in a Girl with Epilepsy, Expanding the Phenotype.

Introduction: Duplication of 12q is characterized by craniofacial dysmorphia, growth failure, occasional brain malformations, abnormalities of the extremities, skeletal and thoracic malformations, cardiovascular defects, anogenital abnormalities like cryptorchidism, psychomotor delay, and intellectual disability. Case presentation: We describe a female patient with typical manifestations of duplication 12q and epilepsy. She had a normal 46,XX karyotype. The microarray assay exhibited a 19.35-Mb gain at 12q24.21q24.33 due to ins(21;12)(p11.2;q24.21q24.33)mat. Discussion and Conclusion: The duplicated region in the patient encompasses 219 genes, 24 considered as pathological. No relation between epilepsy and the genes reported as pathological has been reported.

Transvaginal evisceration of the small bowel a rare and potentially lethal event, a case report.

INTRODUCTION AND IMPORTANCE: Evisceration of the small bowel through the vagina is an extremely rare condition and a life-threatening surgical emergency. Complications associated with this condition include bowel ischemia, abdominal sepsis, and deep vein thrombosis. Therefore, prompt surgical consultation and treatment are crucial as delay in treatment can lead to a grim outcome. CASE PRESENTATION: We report the case of a 50-year-old female obese patient with a past medical history of uterine surgery. During a cough episode, she experienced sudden transvaginal evisceration that required emergent surgery. Thankfully she fully recovered and is doing well. DISCUSSION AND CONCLUSIONS: Transvaginal evisceration is a life-threatening and extremely rare pathology; it requires urgent diagnosis and surgical intervention since bowel viability can be compromised. During these rare events, interdisciplinary surgical cooperation is vital to obtain the best possible outcome for patients.

Usefulness of two-channel amplitude-integrated EEG recording in a neonatal setting.

INTRODUCTION: The development of two-channel aEEG monitors in recent years has allowed for the detection of unilateral brain lesions, and for guided decision-making in real time for infants admitted to the neonatal unit. OBJECTIVE AND METHODS: To highlight some of the main clinical situations in NICU where two-channel amplitude-integrated electroencephalography may provide important additional information to one-channel monitoring. aEEG recordings were obtained from Olympic Brainz® Monitor, which records a two-channel aEEG as well as a raw EEG from two electrodes over each hemisphere. RESULTS: This article describes the advantages of the use of the two-channel aEEG in different clinical scenarios of the newborn infant: infarct, brain malformation, subdural hygroma, subgaleal bleeding, and preterm brain damage. CONCLUSIONS: Two-channel monitoring allows the detection of asymmetries in aEEG trends and/or epileptic activity that may reflect unilateral brain pathology, and it conditions diagnostic and therapeutic approaches in clinical practice.

[Psychological factors predictive of healthy lifestyles]. / Factores psicológicos predictores de estilos de vida saludable.

OBJECTIVE: To present a robust statistical model that considers some psychological factors as predictors of healthy lifestyle. MATERIALS AND METHODS: A battery composed of validated instruments was applied to evaluate beliefs, healthy practices, coping styles, positive mental health and perceived self-efficacy in a sample of 570 university students from Bogotá, Colombia. Based on the information obtained, descriptive, variance and correlation analyzes were developed, as well as a structural equations model. RESULTS: High scores were obtained in the categories 'optimal psychological factors', 'beliefs and healthy practices', except for the 'physical activity practice' and 'less adaptive coping factors' categories. Likewise, significant differences were found in most of the variables measured, as well as important correlations between adaptive psychological factors and healthy practices and beliefs. Finally, the structural equations model that showed the greatest adjustment predicts by 89% the variance of positive mental health based on the interaction between the variables 'coping directed to the problem', 'general satisfaction', 'pro social attitude', 'social skills' and 'self-efficacy'. In turn, the presence of positive mental health, when interacting with healthy beliefs, predicts the occurrence of healthy lifestyles by 63%. CONCLUSION: Even when the model is not conclusive, it can provide empirical support to possible health interventions to be implemented in higher education institutions, based on the strengthening of psychological predictive factors.

OBJETIVO: Presentar un modelo estadístico robusto que considere algunos factores psicológicos como predictores del estilo de vida saludable. MATERIALES Y MÉTODOS: Se aplicó una batería compuesta por instrumentos validados para evaluar creencias y prácticas saludables, estilos de afrontamiento, salud mental positiva y autoeficacia percibida en una muestra de 570 estudiantes universitarios de Bogotá, Colombia. Con la información obtenida se desarrollaron análisis descriptivos, de varianza y correlacionales, así como un modelo de ecuaciones estructurales. RESULTADOS: Se identificaron altos puntajes en los factores psicológicos óptimos, en las creencias y en las prácticas saludables en la muestra, excepto para el ítem de práctica de actividad física, y en los factores de afrontamiento menos adaptativos. Así mismo, se encontraron diferencias significativas en la mayoría de las variables medidas, y correlaciones importantes entre los factores psicológicos adaptativos con las prácticas y creencias saludables indagadas. Por último, el modelo de ecuaciones estructurales que mostró mayor ajuste predice en un 89% la varianza de la salud mental positiva a partir de la interacción entre las variables afrontamiento dirigido al problema, satisfacción general, actitud pro social, habilidades sociales y autoeficacia; a su vez, la presencia de salud mental positiva, en interacción con las creencias saludables predice con un 63% la ocurrencia de estilos de vida saludables. CONCLUSIÓN: Aun cuando el modelo no es concluyente, puede brindar soporte empírico a las posibles intervenciones en salud a implementar en las instituciones de educación superior, basadas en el fortalecimiento de los factores psicológicos predictores.

Improved Patient Outcomes by Normalizing Sympathovagal Balance: Differentiating Syncope-Precise Subtype Differentiation Leads to Improved Outcomes.

Syncope is difficult to definitively diagnose, even with tilt-table testing and beat-to-beat blood pressure measurements, the gold-standard. Both are qualitative, subjective assessments. There are subtypes of syncope associated with autonomic conditions for which tilt-table testing is not useful. Heart rate variability analyses also include too much ambiguity. Three subtypes of syncope are differentiated: vasovagal syncope (VVS) due to parasympathetic excess (VVS-PE), VVS with abnormal heart rate response (VVS-HR), and VVS without PE (VVS-PN). P&S monitoring (ANSAR, Inc., Philadelphia, PA) differentiates subtypes in 2727 cardiology patients (50.5% female; average age: 57 years; age range: 12-100 years), serially tested over four years (3.3 tests per patient, average). P&S monitoring noninvasively, independently, and simultaneously measures parasympathetic and sympathetic (P&S) activity, including the normal P-decrease followed by an S-increase with head-up postural change (standing). Syncope, as an S-excess (SE) with stand, is differentiated from orthostatic dysfunction (e.g., POTS) as S-withdrawal with stand. Upon standing, VVS-PE is further differentiated as SE with PE, VVS-HR as SE with abnormal HR, and VVS-PN as SE with normal P- and HR-responses. Improved understanding of the underlying pathophysiology by more accurate subtyping leads to more precise therapy and improved outcomes.

Factores psicológicos predictores de estilos de vida saludable / Psychological factors predictive of healthy lifestyles

RESUMEN Objetivo Presentar un modelo estadístico robusto que considere algunos factores psicológicos como predictores del estilo de vida saludable. Materiales y Métodos Se aplicó una batería compuesta por instrumentos validados para evaluar creencias y prácticas saludables, estilos de afrontamiento, salud mental positiva y autoeficacia percibida en una muestra de 570 estudiantes universitarios de Bogotá, Colombia. Con la información obtenida se desarrollaron análisis descriptivos, de varianza y correlacionales, así como un modelo de ecuaciones estructurales. Resultados Se identificaron altos puntajes en los factores psicológicos óptimos, en las creencias y en las prácticas saludables en la muestra, excepto para el ítem de práctica de actividad física, y en los factores de afrontamiento menos adaptativos. Así mismo, se encontraron diferencias significativas en la mayoría de las variables medidas, y correlaciones importantes entre los factores psicológicos adaptativos con las prácticas y creencias saludables indagadas. Por último, el modelo de ecuaciones estructurales que mostró mayor ajuste predice en un 89% la varianza de la salud mental positiva a partir de la interacción entre las variables afrontamiento dirigido al problema, satisfacción general, actitud pro social, habilidades sociales y autoeficacia; a su vez, la presencia de salud mental positiva, en interacción con las creencias saludables predice con un 63% la ocurrencia de estilos de vida saludables. Conclusión Aun cuando el modelo no es concluyente, puede brindar soporte empírico a las posibles intervenciones en salud a implementar en las instituciones de educación superior, basadas en el fortalecimiento de los factores psicológicos predictores.(AU)

ABSTRACT Objective To present a robust statistical model that considers some psychological factors as predictors of healthy lifestyle. Materials and Methods A battery composed of validated instruments was applied to evaluate beliefs, healthy practices, coping styles, positive mental health and perceived self-efficacy in a sample of 570 university students from Bogotá, Colombia. Based on the information obtained, descriptive, variance and correlation analyzes were developed, as well as a structural equations model. Results High scores were obtained in the categories 'optimal psychological factors', 'beliefs and healthy practices', except for the 'physical activity practice' and 'less adaptive coping factors' categories. Likewise, significant differences were found in most of the variables measured, as well as important correlations between adaptive psychological factors and healthy practices and beliefs. Finally, the structural equations model that showed the greatest adjustment predicts by 89% the variance of positive mental health based on the interaction between the variables 'coping directed to the problem', 'general satisfaction', 'pro social attitude', 'social skills' and 'self-efficacy'. In turn, the presence of positive mental health, when interacting with healthy beliefs, predicts the occurrence of healthy lifestyles by 63%. Conclusion Even when the model is not conclusive, it can provide empirical support to possible health interventions to be implemented in higher education institutions, based on the strengthening of psychological predictive factors.(AU)

El síndrome de ovario poliquístico: aspectos psicológicos / Polycystic ovary syndrome: psychological aspects

ANTECEDENTES: La gran mayoría de la literatura científica sobre el síndrome de ovario poliquístico (SOP) ha utilizado un enfoque bio-médico para analizar esta enfermedad. En América Latina, y específicamente en idioma español, hay escasa información sobre las relaciones del SOP con factores psicológicos. OBJETIVO: Analizar este trastorno ginecológico de origen endocrino y su asociación con diferentes factores psicológicos, así como su abordaje integral. MÉTODO: Se realizó una búsqueda en bases de datos en los últimos años con los términos "SOP", "calidad de vida", "ansiedad", "depresión", "imagen corporal" y "disfunción sexual". RESULTADOS: El SOP es una enfermedad multifactorial que se ha vinculado a la depresión, la ansiedad, el estrés, la insatisfacción de la imagen corporal, trastornos sexuales y de la alimentación, el funcionamiento cognitivo, calidad de vida y el bienestar psicológico; la co-ocurrencia de este tipo de situaciones psicológicas alimenta la condición somática en mención. CONCLUSION: El abordaje psicológico puede complementar las acciones preventivas y terapéuticas que influyen en la efectividad del tratamiento y el bienestar subjetivo informado por los pacientes.

BACKGROUND: The vast majority of the scientific literature on polycystic ovary syndrome (PCOS) have used a bio-medical approach to analyzing this disease. In Latin America, specifically in Spanish, little is known about the relationship of PCOS with psychological factors. AIM: To analyze this gynecological disorder of endocrine origin and their association with different psychological factors and their comprehensive approach. METHOD: A search was performed in databases in recent years with the terms "PCOS", "quality of life", "anxiety", "depression", "body image" and "sexual dysfunction." RESULTS: PCOS is a multifactorial disease that has been linked to depression, anxiety, stress, dissatisfaction with body image, sexual and eating disorders, cognitive functioning, quality of life and psychological well-being; the co-occurrence of such psychological situations feed the somatic condition analyzed. CONCLUSION: The psychological approach can complement the preventive and therapeutic actions that influence the effectiveness of treatment and subjective well-being reported by patients.

Eficacia de los imanes permanentes multipolares en el tratamiento del dolor crónico en pacientes con osteoartrosis generalizada / Effectiveness of the multipolar permanent magnets in the treatment of chronic pain in patients with generalized osteoarthrosis

Se efectuó un estudio longitudinal y controlado de 100 pacientes con osteoartrosis generalizada, atendidos en el Servicio de Medicina Natural y Tradicional del Hospital Provincial Docente Clinicoquirúrgico Saturnino Lora Torres de Santiago de Cuba, desde enero hasta diciembre del 2010, a fin de evaluar la eficacia de los imanes permanentes multipolares en el tratamiento del dolor crónico en los afectados. Estos imanes se ubicaron y fijaron en diferentes puntos de acupunturas para aliviar la dolencia. Los niveles de dolor se cuantificaron mediante la Escala Visual Análoga, por sexo y rango de edades; se evaluaron a los 0, 30, 60 y 90 días durante la terapia. Se demostró la factibilidad del uso de los imanes permanentes multipolares en el alivio del dolor de los pacientes con osteoartrosis generalizada por ser simples, seguros, eficaces y no inducir efectos adversos en el organismo(AU)

A longitudinal and controlled study of 100 patients with generalized osteoarthrosis, assisted in the Service of Natural and Traditional Medicine of Saturnino Lora Torres Clinical Surgical Teaching Provincial Hospital in Santiago de Cuba was carried out from January to December, 2010, in order to evaluate the effectiveness of the multipolar permanent magnets in the treatment of the chronic pain in those affected. These magnets were placed and fixed in different acupuncture points to reduce pain. The pain levels were quantified by means of the Analogue Visual Scale, by sex and age range; they were evaluated at the 0, 30, 60 and 90 days during the therapy. The feasibility of the use of the multipolar permanent magnets was demonstrated in the relief of pain of the patients with generalized osteoarthrosis as they are simple, sure, effective and induce no adverse effects in the organism(AU)

Eficacia de los imanes permanentes multipolares en el tratamiento del dolor crónico en pacientes con osteoartrosis generalizada / Effectiveness of the multipolar permanent magnets in the treatment of chronic pain in patients with generalized osteoarthrosis

Se efectuó un estudio longitudinal y controlado de 100 pacientes con osteoartrosis generalizada, atendidos en el Servicio de Medicina Natural y Tradicional del Hospital Provincial Docente Clinicoquirúrgico "Saturnino Lora Torres" de Santiago de Cuba, desde enero hasta diciembre del 2010, a fin de evaluar la eficacia de los imanes permanentes multipolares en el tratamiento del dolor crónico en los afectados. Estos imanes se ubicaron y fijaron en diferentes puntos de acupunturas para aliviar la dolencia. Los niveles de dolor se cuantificaron mediante la Escala Visual Análoga, por sexo y rango de edades; se evaluaron a los 0, 30, 60 y 90 días durante la terapia. Se demostró la factibilidad del uso de los imanes permanentes multipolares en el alivio del dolor de los pacientes con osteoartrosis generalizada por ser simples, seguros, eficaces y no inducir efectos adversos en el organismo.

A longitudinal and controlled study of 100 patients with generalized osteoarthrosis, assisted in the Service of Natural and Traditional Medicine of "Saturnino Lora Torres" Clinical Surgical Teaching Provincial Hospital in Santiago de Cuba was carried out from January to December, 2010, in order to evaluate the effectiveness of the multipolar permanent magnets in the treatment of the chronic pain in those affected. These magnets were placed and fixed in different acupuncture points to reduce pain. The pain levels were quantified by means of the Analogue Visual Scale, by sex and age range; they were evaluated at the 0, 30, 60 and 90 days during the therapy. The feasibility of the use of the multipolar permanent magnets was demonstrated in the relief of pain of the patients with generalized osteoarthrosis as they are simple, sure, effective and induce no adverse effects in the organism.

Luxatio erecta bilateral: um relato de caso / Bilateral luxatio erecta, a case report

O deslocamento inferior do ombro (luxatio erecta) é uma lesão rara, acometendo aproximadamente 0,5% dos deslocamentos dessa articulação. A grande maioria desses casos ocorre unilateralmente. Em setembro de 2004, um homem de 43 anos chegou ao pronto-socorro do Hospital Universitário de Santa Maria (HUSM) com queixa de dor bilateral no ombro e incapacidade de abaixar os braços, em consequência de uma queda com os braços abduzidos, enquanto desempenhava sua atividade laboral. Após o exame físico e radiológico constatou- se que o indivíduo apresentava uma luxação inferior bilateral dos ombros. O paciente foi então encaminhado ao bloco cirúrgico onde foi realizada redução incruenta das luxações sob anestesia através da técnica de tração e contra-tração. No dia seguinte recebeu alta com imobilização tipo Velpeau mantendo os ombros totalmente aduzidos e rotados internamente, com orientação de manter a imobilização por três semanas. Foi orientado também a realizar fisioterapia.

Inferior shoulder dislocation (luxactio erecta) is a rare lesion affecting approximately 0.5% of dislocations of this joint. The vast majority of these cases occur unilaterally. In September 2004, a 43 year old man was brought to the emergency room of the University Hospital of Santa Maria (HUSM) complaining of bilateral shoulder pain and inability to lower the arms, as a result of a fall with the arms abducted, while carrying out work activities. After physical examination and radiological exams, it was found that the patient had a bilateral inferior shoulder dislocation. He was referred to the surgical ward and after intravenous sedation, both shoulders were reduced by closed reduction using the traction-countertraction maneuver. The patient was discharged the day after the reduction. Both arms were immobilized with a velpeau sling in total adduction and intrarotation, with instructions to maintain immobilization for three weeks. The patient was also advised to receive physiotherapy.

BILATERAL LUXATIO ERECTA, A CASE REPORT.

Inferior shoulder dislocation (luxactio erecta) is a rare lesion affecting approximately 0.5% of dislocations of this joint. The vast majority of these cases occur unilaterally. In September 2004, a 43 year old man was brought to the emergency room of the University Hospital of Santa Maria (HUSM) complaining of bilateral shoulder pain and inability to lower the arms, as a result of a fall with the arms abducted, while carrying out work activities. After physical examination and radiological exams, it was found that the patient had a bilateral inferior shoulder dislocation. He was referred to the surgical ward and after intravenous sedation, both shoulders were reduced by closed reduction using the traction-countertraction maneuver. The patient was discharged the day after the reduction. Both arms were immobilized with a velpeau sling in total adduction and intrarotation, with instructions to maintain immobilization for three weeks. The patient was also advised to receive physiotherapy.

Efectos de la bromocriptina sobre la apetencia cocaínica bajo un modelo de doble alternativa de elección en animales / Efects of the bromocriptine on appetite cocaine

Empleando un modelo de doble alternativa de elección: droga VS. alimento en perros sometidos a un cocainismo experimental, se encuentra que los animales tienden a elegir la droga a pesar de la administración de bromocriptina. Los resultados obtenidos viabilizan la propuesta de una prevalencia del condicionamiento clásico de señales en la instauración de la adicción cocaínica, al cual estaría asociado un condicionamiento operante de señales para el mantenimiento del comportamiento adictivo

Determinación de bacterias patógenas en el área quirúrgica de gineco-obstetricia del Centro Materno-Infantil San Lorenzo de los Mina, mayo-junio 1989 / Determination of pathogen bacterias in surgical area of gyneco-obstetrics of the Centro Materno-Infantil San Lorenzo de los Mina, May-June 1989

Se realizó un estudio observacional, analítico y transversal, durante los meses de mayo y junio 1989, para la determinación de la presencia de bacterias patógenas en el área quirúrgica de gineco-obstetricia en el Centro Materno Infantil San Lorenzo, de Los Mina, Distrito Nacional, R. D. Se cultivaron muestras que fueron tomadas del personal médico, paramedico y del área quirúrgica (equipos hospitalarios, instrumental quirúrgico y ambiente del quirófano), de donde se tomaron 25 cultivos, 10 en el personal mencionado y 15 en el área quirúrgica. En total hubo crecimiento en 8 cultivos para un 32 por ciento , todos ellos bacilos gram negativos

Sulfato de magnesio versus diazepam en el manejo de la pre-eclampsia severa

Con el objetivo de investigar cuál fármaco es más efectivo y con menores efectos secundarios en el manejo de la pre-eclampsia, se realizó un estudio prospectivo con 44 pacientes que asistieron al Centro Materno Infantil San Lorenzo en el período enero-marzo de 1990 con el diagnóstico de pre-eclampsia severa. De los 44 pacientes, 22 fueron manejadas con sulfato de magnesio y 22 con diazepam, mostrando ambos fármacos efectividad en el manejo de las pacientes. En ambos grupos se presentaron signos de intoxicación en las madres y disminución en al Apgar de los recién nacidos, aunque no hubo diferencias significativas entre los dos grupos. Por el menor precio del Sulfato de Magnesio recomendamos su uso en nuestros hospitales públicos para el manejo de los casos de pre-eclampsia severa