Estudio piloto: contacto padre-hijo(a) y oxitocina en varones preparados especialmente para el nacimiento / Pilot study: father-child contact and oxytocin in males with a special education for childbirth

INTRODUCCÍON: Los padres se han involucrado cada vez más en el embarazo y el nacimiento de sus hijos, pero aún se requieren intervenciones paternas que permitan reubicar al padre en su rol de corresponsabilidad en la crianza. OBJETIVO: Observar el comportamiento-actitud paterna hacia el/la hijo(a) y la cantidad de oxitocina (OT) secretada en el nacimiento, en padres preparados de un modo especial para el parto. Método: Estudio piloto de 8 meses, parte de una investigación mayor cuali-cuantitativa de dos fases. La fase cualitativa inicial desarrolló una intervención preparatoria de padres para el nacimiento, con énfasis en la vinculación padre-hijo(a). La fase cuantitativa correspondió al piloto de la intervención paterna antenatal. RESULTADOS: Los padres presenciaron activamente el momento del expulsivo y el encuentro madre-hijo(a). Posteriormente, todos optaron por el contacto físico piel-piel con su hijo(a). La OT paterna experimentó un aumento (no significativo) durante el contacto padre-hijo(a) en comparación con la OT basal (momento inmediato al nacimiento). CONCLUSIONES: Padres preparados, sensibilizados y vinculados con su hijo(a) desde el embarazo experimentarían variaciones de la cantidad de OT cuando realizan contacto piel-piel con su hijo(a) en el nacimiento. Se requiere investigación experimental con una muestra mayor de participantes para concluir de manera categórica.

INTRODUCTION: Fathers have been increasingly involved in the pregnancy and birth of their children, but paternal interventions are still required to relocate the father in his role of co-responsibility in parenting. OBJECTIVE: To observe the paternal behavior-attitude towards the child and the amount of oxytocin (OT) secreted at birth in parents prepared (in a special way) for childbirth. METHOD: Pilot study of 8 months, part of a larger qualitative-quantitative research of two phases. The initial qualitative phase developed a male preparatory intervention for the birth, with emphasis on the father-child bonding. The quantitative phase corresponded to the pilot of the antenatal paternal intervention. RESULTS: Fathers actively witnessed the moment of delivery and the mother-child attachment. Subsequently, all of them opted for physical skin-to-skin contact with their child. Paternal OT experienced a (non-significant) increase during father-child contact, compared to baseline OT (immediately after birth). CONCLUSIONS: Males prepared, sensitized and involved with their child since pregnancy would experience variations in the amount of OT when they make father-child skin-to-skin contact at childbirth. Experimental research with a larger sample of participants is required to categorically reach a conclusion.

Split unilateral del nervio femoral a nivel del músculo psoas mayor: reporte de caso / Unilateral femoral nerve split at the psoas major muscle: case report

RESUMEN: El nervio femoral (NF) es el mayor o ramo del plexo lumbar. Normalmente se origina de las divisiones posteriores del segundo al cuarto ramo anterior del plexo lumbar (L2-L4). El músculo psoas mayor tiene su origen a nivel de las vértebras T12 a L5, se fusiona con el músculo ilíaco para luego insertarse en el trocánter menor del fémur. Normalmente, a nivel de la pelvis menor el NF se encuentra entre los músculos ilíaco y psoas mayor. En este trabajo presentamos un caso donde el músculo psoas mayor se relaciona con divisiones o split del NF, esta es una rara variación en la división y curso del NF con relación al músculo psoas mayor. Se observó que el NF se dividía en dos ramos por sobre el plano del ligamento inguinal después de su origen en el plexo lumbar. El NF del lado izquierdo se formó por las ramas ventrales de L2 a L4, a nivel de L5 el nervio es perforado por fascículos del músculo psoas mayor. La división inferior del NF pasaba profundamente a las fibras del músculo iliopsoas y la división superior pasaba superficialmente al músculo psoas mayor y profundo a la fascia ilíaca. Después de un trayecto de 60,21 mm ambas divisiones se unieron, después de atrapar fibras músculo iliopsoas justo inmediatamente proximal al ligamento inguinal para formar el tronco del NF. Si bien las causas embriológicas de las variaciones de los nervios periféricos se remontan a la quinta y sexta semana de vida intrauterina, la expresión clínica de disfunciones neuromusculares aparecerá varios decenios después. De modo que los médicos de las áreas de la traumatología y neurología deben estar al tanto de tales variantes anatómicas para entender mejor el dolor y los síndromes asociados a la compresión nerviosa y durante las maniobras quirúrgicas en esta región.

SUMMARY: AbstractThe femoral nerve (NF) is the major branch (or ramus) of the lumbar plexus. It normally originates from the posterior divisions of the second to fourth anterior branches of the lumbar plexus (L2-L4). The psoas major muscle originates at the level of the T12 to L5 vertebrae, fuses with the iliacus muscle and then inserts into the lesser trochanter of the femur. Normally, at the level of the lesser pelvis, the NF is found between the iliacus and psoas major muscles. In this paper we present a case where the psoas major muscle is related to divisions or splitting of the NF, this is a rare variation in the division and course of the NF in relation to the psoas major muscle. The NF was observed to divide into two branches above the plane of the inguinal ligament after its origin in the lumbar plexus. The NF on the left side was formed by ventral branches from L2 to L4, at the level of L5 the nerve is perforated by fascicles of the psoas major muscle. The lower division of the NF passed deep to the fibers of the iliopsoas muscle and the upper division passed superficial to the psoas major muscle and deep to the iliac fascia. After a path of 60.21 mm both divisions joined, after trapping iliopsoas muscle fibers just immediately proximal to the inguinal ligament to form the NF trunk. While the embryological causes of peripheral nerve variations date back to the fifth and sixth week of intrauterine life, the clinical expression of neuromuscular dysfunctions will appear several decades later. Thus, physicians in the areas of traumatology and neurology should be aware of such anatomical variants to better understand pain and syndromes associated with nerve compression and during surgical maneuvers in this region.

Repensando el proceso de enseñanza-aprendizaje de la morfología en el mundo post-pandemia / Rethinking the teaching-learning process of morphology in the post-pandemic world

Las ciencias morfológicas incluyen el estudio de tres disciplinas que analizan el cuerpo humano: la anatomía macroscópica, la histología y la embriología, las cuales forman parte central del ciclo básico en todas las carreras de la salud. El aprendizaje morfológico ocurre en el laboratorio y se basa en el estudio de disecciones cadavéricas, preparaciones histológicas o muestras del desarrollo embrionario, con el propósito de lograr una adecuada compresión de las características morfoestructurales del cuerpo humano. Sin embargo, la pandemia por SARS-CoV-2 significó un cambio profundo en la forma de enseñar, incorporando métodos de enseñanza-aprendizaje utilizados du-rante la pandemia que incluyen estrategias como los microscopios virtuales, atlas interactivos o videos de disecciones, lo que ha llevado a algunos a cuestionar la necesidad de utilizar los laboratorios de morfología. La educación virtual ha aparecido como una alternativa factible de mantener post-pandemia, sin embargo, el paso por el laboratorio es irreemplazable en la formación de profesionales de la salud, permitiendo el desarrollo de otras competencias más allá de la aplicación del conocimiento. La morfología seguirá siendo la piedra angular en la formación de profesionales de la salud. El desafío es como a través de la innovación y la creatividad incorporamos las nuevas tecnologías digitales, agregando un nuevo valor al estudio de esta disciplina.

Morphological sciences include the study of three disciplines that analyze the human body: macroscopic anatomy, histology, and embr-yology, which are a central part of the basic cycle in all health careers. Morphological learning occurs in the laboratory, it is based on the study of cadaveric dissections, histological preparations, or samples of embryonic development to achieve an adequate compression of the morphological structure of the human body. The SARS-CoV-2 pandemic meant a profound change in the way of teaching. These, teaching-learning methods that have been implemented during the pandemic include virtual microscopes, interactive atlases, or videos of dissections, which has led some teachers to question the usefulness of morphology laboratories. Virtual education has appeared as a feasible alternative to maintaining in post-pandemic; however, going through the laboratory is irreplaceable in the training of health professionals, allowing the development of other skills beyond the application of knowledge. The morphology will continue to be the cornerstone in the education of health professionals. The challenge is how through innovation and creativity, we incorporate new digital technologies, adding a new value to the study of this discipline

Burnout syndrome in athletes and their association with body image dissatisfaction at a private university.

BACKGROUND: Burnout syndrome, from the sporting point of view, is the integration of both physical and emotional signs, caused by the high demands in competition. According to several studies, the prevalence of burnout syndrome is influenced by several factors that would lead to athlete's body image dissatisfaction. METHODS: The study design is cross-sectional analysis. The study sample was 352 athletes selected from the Universidad Peruana de Ciencias Aplicadas (UPC). The main variables of this study are the burnout syndrome; which was measured by Athlete Burnout Questionnaire (ABQ) and body image dissatisfaction, through thirteen Scale drawings contour figure Gardner. To find the association between body image dissatisfaction and burnout syndrome Poisson regression was used. RESULTS: Athletes with burnout syndrome have 1.08 times more likely having body image dissatisfaction with a value P=0.011 (95% CI: 1.02-1.15). It was also found that a sport collectively practiced is a protective factor for Burnout Syndrome with P=0.015 (95% CI: 0.4-0.9). CONCLUSIONS: Relation between burnout syndrome and body image dissatisfaction in athletes was found. In addition, a relationship between practicing an individual sport and burnout syndrome was also found. More studies are necessary to confirm these relationships.

Arteria subclavia derecha retroesofágica: reporte de caso / Right retroesophageal subclavian artery: case report

RESUMEN: Durante el desarrollo embrionario suelen ocurrir anomalías a nivel del arco aórtico primordial. Una de estas es la arteria subclavia retroesofágica derecha (ASDR) la cual es un defecto frecuente de los arcos aórticos embriológicos y se debe a la interrupción del cuarto arco aórtico (AO) derecho entre las depresiones para la arteria carótida común y la arteria subclavia. Las variaciones anatómicas y morfológicas del AO y sus ramas son significativas para los procedimientos diagnósticos y quirúrgicos en el tórax y el cuello. Reportar una ASDR encontrada durante disección, correlacionando esta con sus implicancias clínicas. De un cadáver de sexo femenino, de edad y causa de muerte desconocida, fijado con formaldehído al 10 % y aguada destilada. Se realizó disección del corazón y los grandes vasos, en especial el AO, desarrollado según la técnica convencional, para remover el órgano luego de disecar el pericardio y disecar la arteria aorta ascendente y el AO, preservando plenamente su configuración externa y sus ramas colaterales, donde se encontró la ASDR. La ASDR presentó un diámetro en su origen de 12,13 mm. La longitud existente entre la ASDR y la Arteria carótida común Derecha (ACCD) fue de 43,84 mm. El diámetro del esófago a nivel cefálico y caudal de la ASDR alcanzó valores de 17,59 mm y 13,82 mm respectivamente. Por su parte los diámetros de la tráquea a nivel cefálico y caudal a la ASDR, fueron respectivamente 22,12 mm y 13,30 mm. El conocimiento de esta variante anatómica resulta de gran interés a la hora de interpretar y orientar el diagnóstico de las posibles causas de una disfagia asociada a una arteria subclavia retroesofágica y fundamenta aún más la importancia del estudio mediante disección.

SUMMARY: During embryonic development, anomalies usually occur at the primordial aortic arch (AA) level. One of these is the right retroesophageal subclavian artery (RSA). The anatomical and morphological variations of AA and its branches are significant for diagnostic and surgical procedures in the thorax and neck. The objective of the study was to report an RSA found during the dissection, correlating this with the corresponding clinical implications. A human female cadaver of unknown age and cause of death was used and conserved in 10 % formaldehyde and distilled wash. The dissection of the heart and large vessels was performed. There was particular emphasis one the AA, and development according to conventional techniques, removing the organ after dissecting the pericardium and dissecting the ascending aorta and the AA. External function and its collateral branches were fully preserved, where the RSA was located. The RSA presented a diameter at its origin of 12.13 mm. The length between the RSA and the common right carotid artery (CRCA) was 43.84 mm. The diameter of the esophagus at the cephalic and caudal level of the RSA has values of 17.59 mm and 13.82 mm respectively. Furthermore, the diameters of the trachea at cephalic and caudal level to the RSA, respectively, were 22.12 mm and 13.30 mm. Knowledge of this anatomical variant is of great interest when interpreting and guiding the diagnosis of potential causes of a dysphagia associated with a retroesophageal subclavian artery, and is even more important during dissection studies.

Morphological and biometric characteristics of the pectinate muscles and the taenia sagittalis of the right atrium in the human heart

The crista terminalis (CT) is a well-defined fibromuscular crest formed by the union of the venous sinus and the primitive right auricle, which extends along the posterolateral face of the right atrial wall. The pectinate muscles (PM) are muscular crests which extend anterolaterally from the CT to the auricle and may present in a series of variable shapes and sizes. The biggest and most prominent PM is called the taenia sagittalis (TS). PM with highly trabeculated muscle fibres predispose patients to the occurrence of arrhythmias. The present article is a descriptive study of the anatomical and biometric characteristics of the right atrium. We studied 30 hearts of adult Chilean individuals, aged between 18 and 84 years, of both sexes, with no apparent cardiac pathology, belonging to the Normal Human Anatomy Unit of the Basic Sciences Department of Universidad de La Frontera. The samples were washed with distilled water and immediately placed in formalin at 10%. The atria were first separated from the ventricles, then opened perpendicularly through the intercaval zone to give access to the interior. The distribution of pectinate muscles found, according to the classification of Loukas et al. (2008) and Siddiqui et al. (2013), was as follows: Type I, 20%; Type II, 23.3%; Type III, 23.3%; Type IV, 6.7%; Type V, 6.7%; Type VI, 20%. TS was found to be present in 46.6% of the hearts examined, two or more TS in 29.8% and no TS in 23.6%. The length of the pectinate muscles is variable; the shortest are located on the medial wall. Six types of pectinate muscle patterns were observed

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[Burnout Syndrome, Family and Work Related Variables on General Practitioners in Bogota. A Strategy of Work Quality]. / Síndrome por quemarse en el trabajo y variables familiares y laborales de los médicos generales de Bogotá. Una estrategia de calidad laboral.

BACKGROUND: The burnout syndrome is a set of work-related symptoms related to weariness and exhaustion, in response to the emotional stress at work and its consequences. The aim of the study was to measure the frequency of burnout in General Practitioners (GPs) from 3 private institutions in Bogotá, Colombia and to determine the associated factors according to the variables taken into account. METHODS: It is a descriptive cross-sectional study which was used to analyse the Questionnaire for Burnout Syndrome (CESQT). The population was 106 GPs. RESULTS: The level of burnout was at a critical level in 6.6% of the GP population. The variables showed that having a stable partner and children are a protective factor. By contrast, work in emergency rooms is a risk factor.

Síndrome por quemarse en el trabajo y variables familiares y laborales de los médicos generales de Bogotá. Una estrategia de calidad laboral / Burnout Syndrome, Family and Work Related Variables on General Practitioners in Bogota. A Strategy of Work Quality

Introducción: El síndrome por quemarse en el trabajo (SQT) es un conjunto de síntomas relacionados con desgaste laboral y agotamiento en respuesta al estrés emocional en el trabajo y sus respectivas consecuencias. El objetivo del estudio es medir la frecuencia del SQT entre los médicos generales de tres instituciones privadas de Bogotá y determinar los factores asociados según las variables consideradas. Métodos: Es un estudio de corte transversal descriptivo, para el que se utilizó el cuestionario para la evaluación del síndrome de quemarse por el trabajo (CESQT). Constituyeron la población 106 médicos generales. Resultados: Se encontró que el 6,6% de la población presenta un nivel crítico. Las variables muestran que tener pareja estable e hijos es un factor protector y, por lo contrario, trabajar en urgencias es un factor de riesgo.

Background: The burnout syndrome is a set of work-related symptoms related to weariness and exhaustion, in response to the emotional stress at work and its consequences. The aim of the study was to measure the frequency of burnout in General Practitioners (GPs) from 3 private institutions in Bogotá, Colombia and to determine the associated factors according to the variables taken into account. Methods: It is a descriptive cross-sectional study which was used to analyse the Questionnaire for Burnout Syndrome (CESQT). The population was 106 GPs. Results: The level of burnout was at a critical level in 6.6% of the GP population. The variables showed that having a stable partner and children are a protective factor. By contrast, work in emergency rooms is a risk factor.