Vocal Problems and Burnout Syndrome in Nonuniversity Teachers in Galicia, Spain.

INTRODUCTION: Voice disorders and burnout syndrome are common among teachers. This study aimed to explore the relationship among vocal problems, burnout syndrome, and some personal work factors. METHODS: This cross-sectional descriptive study enrolled 90 nonuniversity teachers who completed the Multidimensional Vocal Scale for Teachers (EVM-D) to evaluate vocal problems and an adapted Spanish version of the Maslach Burnout Inventory-Educators Survey (MBI-ES) to detect burnout syndrome. RESULTS: Overall, 16% of teachers expressed symptoms compatible with burnout, and 60% of them were in the interval above the 75th percentile of the EVM-D, i.e., they had a high risk of vocal problems. An association between burnout and more vocal problems was established among teachers, particularly between the vocal symptoms and vocal abuse dimensions with the emotional exhaustion subscale of the MBI-ES. A history of anxiety/depression and fewer years of professional experience were associated with more vocal problems. The burnout group perceived more "loss of vocal power," "vocal fatigue," "vocal effort," and "hoarseness." Vocal abuse items received the highest scores of EVM-D. However, only "shouting" in the classroom was significantly different between the groups with and without burnout. CONCLUSION: Emotional exhaustion of burnout syndrome, history of anxiety/depression, and a shorter professional experience were associated with vocal problems, which could limit the performance of teachers. Reducing classroom noise, establishing strategies to avoid shouting, or strengthening personal accomplishments in teachers could be useful in breaking the cycle of vocal problems and emotional exhaustion, particularly at the beginning of their professional experience.

Relación del nivel socioeconómico con el rendimiento académico de estudiantes durante la pandemia por COVID-19 / Relationship of socioeconomic level with the academic performance of students during the COVID-19 pandemic

Introducción: el nivel socioeconómico (NSE) de las familias tiene un papel fundamentan en el desempeño académico de los estudiantes. Durante la pandemia, las familias con NSE bajo tuvieron menores oportunidades y se acrecentaron las desigualdades por limitaciones económicas y técnicas, lo cual pudo haber influido en las calificaciones y rendimiento académico de los alumnos. Objetivo: identificar la relación entre el NSE y el rendimiento académico de un grupo de estudiantes de licenciatura en enfermería durante la pandemia COVID-19. Metodología: estudio transversal, cuantitativo, analítico, con alumnos que tuvieron educación a distancia, se utilizó el instrumento denominado Nivel Socioeconómico (NSE) de la Asociación Mexicana de Agencias de Inteligencia de Mercado y Opinión Pública (AMAI), así como los promedios del semestre cursado en línea Resultados: participaron 167 alumnos, entre las variables de rendimiento académico y nivel socioeconómico se obtuvo un valor de p = 0.961, para las variables de sexo y estado civil se encontró asociación con un valor de p < 0.05. Conclusiones: no se identificó ninguna relación entre las variables del rendimiento académico y el nivel socioeconómico; sin embargo, otras variables como estado civil y sexo dieron significancia estadística, por lo que se sugiere ahondar en estas variables, así como su relación con el rendimiento académico.

Introduction: The socioeconomic level (SES) of families has a fundamental role in the academic performance of students, during the pandemic families with a low SES had fewer opportunities and increased inequalities due to economic and technical limitations, which could influence grades and academic performance. of the students Objective: To identify th e relationship between the SES and aca demic performance of nursing undergraduate students during COVID-19. Methodology: Cross-sectional, quantitative, analytical study with students who had distance education, the instrument called Socioeconomic Level (NSE) of the Mexican Association of Market Intelligence Agencies and Public Opinion (AMAI) was used. and the averages of the semester completed online. Results: 167 students participated, between the variables of academic performance and socioeconomic level a value of p = 0.961 was obtained, for the variables of sex, marital status an association was found with a p value less than 0.05. Conclusions: No relationship was identified between the variables of academic performance and socioeconomic level, however, other variables such as marital status and sex gave statistical significance, so it is suggested to delve into these variables as well as their relationship with academic performance.

Hidratación combinada y efectos en la salud vocal en estudiantes de logopedia / Combined hydration and effects on the vocal health in speech language pathology students

Objetivo: Evaluar si la hidratación combinada (sistémico y superficial) disminuye síntomas vocales y mejora la eficiencia glótica en una muestra de estudiantes de Logopedia. Material y Métodos: Estudio cuasi-experimental con grupo Hidratación (N=20) y grupo Control (N=19) con valoración pre y post-hidratación (ingesta de agua 1.500 ml/día e inhalaciones dos veces/día durante una semana). Se analizaron factores deshidratantes relacionados con la voz (uso vocal, tabaco, alcohol, café, respiración bucal), síntomas vocales y eficiencia glótica a través del Tiempo Máximo Fonación, Fo, Jitter % y Shimmer %, usando Multi-Dimensional Voice Program (MDVP). Resultados: Grupo Hidratación disminuyó significativamente sequedad (p = 0,013), carraspeo (p = 0,005), fatiga vocal (p = 0,015), dolor faríngeo (p = 0,009), Shimmer % (p = 0,048) frente al grupo Control que sólo disminuyó el carraspeo (p = 0,02). Conclusiones: La hidratación combinada puede ser una medida útil para mejorar la salud vocal de los futuros logopedas. (AU

Objective: To evaluate if a combined hydration (systemic and superficial) decreases the vocal symptoms and improves the glottic efficiency in a sample of university students of Speech therapist. Material and Methods: Quasi-experimental study with Hydration group (N=20) and Control group (N=19) with pre and post-hydration assessment (water intake 1.500 ml/day and steam twice/day for a week). Voice-related dehydrating factors (vocal use, tobacco, alcohol, coffee, oral breathing), vocal symptoms and glottic efficiency through Maximum Phonation Time, Fo, Jitter % and Shimmer %, using Multi-Dimensional Voice Program (MDVP) were analyzed. Results: Hydration group significantly decreased dryness (p = .013=, throat clearing (p = .005), vocal fatigue (p = .015), pain throat (p = .009) and Shimmer % (p = .048) compared to the Control group, which only decreased throat clearing (p = .02). Discussion: The combined hydration may be a useful measure to improve vocal health for future speech-language-pathologists. (AU)

The Application of 3D Anatomy for Teaching Veterinary Clinical Neurology.

Neuroanatomy is always a challenging topic for veterinary students. It is widely accepted that understanding the anatomy of the central nervous system (CNS) is essential to explain many of the pathological processes that affect the brain. Although its study has varied over time to achieve this goal, in human and veterinary medicine it is difficult to find a teaching method that associates normal anatomy with pathological alterations of the brain. For the first time, we have created an educational tool that combines neuroanatomy and neuropathology, using different magnetic resonance (MR) images as a basis and EspINA software as analyzer, to obtain segmented structures and 3D reconstructions of the dog brain. We demonstrate that this combination is an optimal tool to help anatomists to understand the encephalon, and additionally to help clinicians to recognize illness including a multitude of neurological problems. In addition, we have tried to see whether photogrammetry, which is a common technique in other sciences, for example geology, could be useful to teach veterinary neuroanatomy. Although we still need further investigations, we have been able to generate 3D reconstructions of the whole brain, with very promising results to date.

Anestesia total intravenosa en pacientes con síndrome oclusivo intestinal / Total Intravenous anesthesia in patients with intestinal occlusive syndrome

Introducción: La anestesia total intravenosa es una técnica de anestesia general en la que se administran los fármacos exclusivamente por vía endovenosa, en ausencia de agentes inhalatorios. Objetivo: Describir los resultados que se observaron en el empleo de la anestesia total intravenosa en los pacientes con diagnóstico de síndrome oclusivo para tratamiento quirúrgico. Métodos: Se desarrolló una investigación observacional descriptiva, longitudinal en el Hospital General Docente "Abel Santamaría Cuadrado", de enero de 2014 a enero de 2017. De un universo de 417 pacientes, se seleccionó una muestra de 205 casos que cumplieron con los criterios de inclusión y exclusión. Las variables fueron presión arterial media, frecuencia cardíaca, saturación de oxígeno, complicaciones, tiempo de recuperación, nivel de sedación y respuesta analgésica. Resultados: El 95,61 por ciento de los casos se mantuvieron normotensos y el 96,10 por ciento con frecuencia cardíaca normal. Se constataron signos clínicos de superficialidad anestésica en el 1,46 por ciento de los individuos. La mayoría de los casos se recuperaron entre 10 y 20 min para un 92,19 por ciento. Se observó un nivel de sedación insuficiente en 189 pacientes (92,19 por ciento). No se evidenciaron complicaciones posoperatorias en el 96,58 por ciento. La respuesta analgésica fue adecuada en el 95,12 por ciento de los casos. Conclusiones: La aplicación de la anestesia total intravenosa para cirugía por oclusión intestinal demostró resultados satisfactorios como método anestésico(AU)

Introduction: Total intravenous anesthesia is a general anesthesia technique in which drugs are administered exclusively intravenously, in the absence of inhalation agents. Objective: To describe the outcomes observed in the use of total intravenous anesthesia in patients diagnosed with occlusive syndrome for surgical treatment. Methods: A descriptive, longitudinal and observational research was carried out in Abel Santamaría Cuadrado General Teaching Hospital of Pinar del Río, Cuba, from January 2014 to January 2017. From a universe of 417 patients, a sample of 205 cases that met the inclusion and exclusion criteria was selected. The variables were mean arterial pressure, heart rate, oxygen saturation, complications, recovery time, level of sedation, and analgesic response. Results: 95.61 percent of the cases remained normotensive and 96.10 percent kept a normal heart rate. Clinical signs of sedation were found in 1.46 percent of the individuals. Most of the cases recovered between 10 and 20 minutes, accounting for 92.19 percent. Insufficient sedation was observed in 189 patients (92.19 percent). No postoperative complications were observed in 96.58 %. Analgesic response was adequate in 95.12 percent of cases. Conclusions: The application of total intravenous anesthesia for intestinal occlusion surgery showed satisfactory outcomes as an anesthetic method(AU)

Anestesia total intravenosa en la cirugía oncológica de mama / Total intravenous anesthesia in oncologist breast surgery

Introducción: El cáncer es la principal causa de muerte. Cada año se diagnostican millones de mujeres con cáncer de mama que necesitan tratamiento quirúrgico, para lo cual la anestesia total intravenosa parece ser una excelente opción. Objetivo: Describir los resultados de la aplicación de la anestesia total intravenosa en las pacientes a las que se les efectuó cirugía oncológica de mama. Métodos: Se realizó un estudio observacional, descriptivo, longitudinal, prospectivo, en el Servicio de Anestesiología del Hospital General Docente "Abel Santamaría Cuadrado" en el período comprendido entre enero de 2013 y enero de 2015. Se estudió una población accesible de 111 pacientes seleccionados mediante criterios de inclusión y exclusión. Para el análisis estadístico se utilizaron distribuciones de frecuencias, cálculo de medidas de tendencia central y de dispersión. Algunas de las variables fueron tensión arterial, frecuencia cardíaca, saturación de oxígeno, complicaciones, tiempo de recuperación, nivel de sedación, respuesta analgésica. Resultados: Se logró gran estabilidad hemodinámica en más del 95 por ciento de las pacientes. Se detectó superficialidad anestésica en 1,80 por ciento de los casos. El 92,80 por ciento de los casos se recuperaron entre 10 y 20 min. Se presentó sedación adecuada en 106 pacientes. Las principales complicaciones fueron las náuseas y los vómitos en 9,01 por ciento. Existió una adecuada respuesta analgésica en 93,69 por ciento de los casos. Conclusiones: La aplicación de la anestesia total intravenosa para cirugía oncológica de mama arrojó resultados muy satisfactorios como método anestésico(AU)

Introduction: Cancer is the leading cause of death worldwide. Every year millions of women are diagnosed with breast cancer and they need surgical treatment, for which total intravenous anesthesia seems to be an excellent option. Objective: Describe the results of the application of total intravenous anesthesia in patients undergoing oncological breast surgery. Methods: An observational, descriptive, longitudinal, prospective study was conducted in the Anesthesiology Service of "Abel Santamaría Cuadrado" Hospital in the period between January 2013 and January 2015. An accessible population of 111 patients selected using inclusion and exclusion criteria was studied. For the statistical analysis, frequency distributions, calculation of measures of central tendency and dispersion were used. Some of the variables were blood pressure, heart rate, oxygen saturation, complications, recovery time, level of sedation, analgesic response. Results: High hemodynamic stability was achieved in more than 95 percent of the patients. Anesthetic superficiality was detected in 1.80 percent of cases. 92.80 percent of the cases recovered after 10 to 20 minutes. Adequate sedation was present in 106 patients. The main complications were nausea and vomiting in 9.01 percent There was an adequate analgesic response in 93.69 percent of the cases. Conclusions: The application of total intravenous anesthesia for oncological breast surgery yielded very satisfactory results as an anesthetic method(AU)

Urethro-venous intravasation during retrograde urethrography in a dog.

A 9-year-old 6-kg male castrated mixed-breed dog was admitted to the hospital as a second opinion for left-sided nephrectomy. Plain radiographs, ultrasound, excretory urography and retrograde urethrography revealed left-sided hydronephrosis and calculi in the bladder and urethra. The urethral calculi were hydropropulsed into the bladder and nephrectomy and cystotomy were performed. Three days after surgery, the patient showed preputial inflammation, pain and pollakiuria. Retrograde urethrography was repeated and extra-urethral leakage of contrast medium into the penile tissue was identified, followed by filling of the draining veins, reaching the caudal vena cava, with subsequent opacification of the right renal pelvis and ureter and opacification of a lymph node. The dog improved during hospitalisation and a retrograde urography performed 6 months after the initial surgery confirmed full recovery.

Propofol como agente inductor anestésico en la cesárea electiva / Propofol as an anesthetic inducing agent in elective caesarean section

Introducción: La decisión de realizar la inducción anestésica con propofol o tiopental en la paciente obstétrica para operación cesárea es un tema controvertido, con resultados contradictorios entre las investigaciones. Objetivo: Presentar los resultados que se publicaron en la literatura nacional e internacional sobre el uso del propofol como agente anestésico en la inducción de la anestesia general en la operación cesárea electiva. Métodos: Se realizó una revisión no sistemática de la bibliografía basada en artículos que se publicaron en bases de datos indexadas en Infomed como Hinari, Ebsco, Scielo, Pubmed, Cubmed, Cocrhane; en idioma español e inglés, durante los últimos diez años, utilizando palabras clave como: (inducción anestésica OR anestesia general OR) AND (propofol OR) AND (operación cesárea OR cesárea OR). Desarrollo: Se destacaron artículos donde se comparan los resultados del uso del propofol contra el tiopental y otros barbitúricos durante la inducción anestésica en cuanto a variables hemodinámicas, efectos adversos, calidad anestésica y desenlaces neonatales como el estado físico, capacidad de adaptación neurológica y gases arteriales. Conclusiones: El propofol es el agente más común para la inducción anestésica en la paciente obstétrica que necesita cesárea electiva. Este presenta resultados adecuados maternos y fetales, y menor incidencia de efectos adversos(AU)

Introduction: The decision to perform anesthetic induction with propofol or thiopental in obstetric patients for cesarean section is a controversial issue, with contradictory oncomes among investigations. Objective: To present the results published in the national and international literature about the use of propofol as an anesthetic agent in the induction of general anesthesia in elective cesarean section. Methods: A nonsystematic review of the bibliography was carried out, with a focus on articles in Spanish and English published, during the last ten years, in databases indexed in Infomed, such as Hinari, Ebsco, Scielo, Pubmed, Cubmed, Cocrhane, using keywords such as (inducción anestésica [anesthetic induction] OR anestesia general [general anesthesia] OR) AND (propofol OR) AND (operación cesárea [cesarean section] OR cesárea [cesarean] OR). Development: Articles were highlighted if they compared the results of propofol usage against thiopental and other barbiturates during anesthetic induction in terms of hemodynamic variables, adverse effects, anesthetic quality and neonatal outcomes such as physical state, neurological adaptation capacity and arterial gases. Conclusions: Propofol is the commonest agent for anesthetic induction in obstetric patients requiring elective caesarean section. This presents adequate maternal and fetal outcomes, as well as a lower incidence of adverse effects(AU)

Plasma rico en plaqueta en el tratamiento de la enfermedad degenerativa discal / Platelet-rich plasma in the treatment of degenerative disc disease

Introducción: La enfermedad degenerativa discal es una entidad frecuente y uno de los principales motivos de consulta. Genera altas tasas de discapacidad, años útiles perdidos, así como altos costos económicos por asistencia médica y grandes pérdidas monetarias. Su tratamiento es generalmente conservador, aunque en la actualidad se incluyen terapias biológicas novedosas. Objetivo: Describir las principales propiedades biológicas que hacen del plasma rico en plaquetas una terapéutica efectiva para la enfermedad degenerativa discal. Métodos: Se realizó una revisión no sistemática de la bibliografía basada en artículos que se publicaron en bases de datos indexadas en Infomed como Hinari, Ebsco, Scielo, Pubmed, Cubmed, Cocrhane, Scopus, LILACS; en idioma español, inglés y portugués, durante los últimos diez años. Desarrollo: Se expusieron características clínico epidemiológicas de la enfermedad degenerativa discal, así como las propiedades biológicas que le permiten al plasma rico en plaqueta tener una función activa en la regeneración del disco intervertebral o el retraso de la cascada de degradación de este. Se resaltan los principales estudios de acuerdo a la vía de administración del plasma rico en plaquetas y sus resultados. Conclusiones: De acuerdo con lo publicado por los autores, el plasma rico en plaquetas es una alternativa efectiva en el tratamiento de la enfermedad degenerativa discal por la producción de factores derivados de las plaquetas, que intervienen en la degeneración del disco intervertebral, siendo la vía intradiscal la que más se emplea(AU)

Introduction: Degenerative disc disease is a frequent condition and one of the main reasons to attend the consultation. It generates high rates of disability, useful years lost, as well as high economic costs for medical assistance and large monetary losses. Its treatment is generally conservative, although novel biological therapies are currently included. Objective: To describe the main biological properties that make platelet-rich plasma an effective therapy against degenerative disc disease. Methods: A nonsystematic review of the bibliography was carried out based on articles published, during the last ten years, in databases indexed in Infomed, such as Hinari, Ebsco, Scielo, Pubmed, Cubmed, Cocrhane, Scopus, and LILACS, in Spanish, English and Portuguese. Development: Clinical-epidemiological characteristics of degenerative disc disease were presented, as well as the biological properties that allow platelet-rich plasma to have an active function in the regeneration of the intervertebral disc or the delay of its degradation cascade. The main studies are highlighted, according to the route of administration of platelet-rich plasma and their results. Conclusions: According to what has been published by authors, platelet-rich plasma is an effective alternative in the treatment of degenerative disc disease, due to the production of factors derived from platelets, which intervene in the degeneration of the intervertebral disc, being the intradiscal pathway the most used(AU)

[Relationship among sleep quality, sleep habits and school adjustment in adolescents from an urban district of Galicia.] / Interrelacion entre calidad, hábitos de sueño y ajuste escolar en adolescentes de un distrito urbano de Galicia.

OBJECTIVE: The duration and the sleep quality are related to the emotional status and the academic performance in adolescents. The objective of this study was to evaluate the quality of sleep in a group of adolescents, and to explore its relationship with school adjustment and performance. METHODS: A cross-sectional descriptive study was made with 56 adolescents aged 13-17 years from a high school institute in an urban district of La Coruña city was performed during the scholar´s year 2016-2017. The participants completed the Pittsburgh Sleep Quality Index (ICSP) and the Brief School Adjustment Scale, and a brief questionnaire about their sleep habits and school scores. Descriptive analysis and different comparative parametric or not parametric statistical tests were applied according to type of variable; statistical significant value was considerate for p<0.10. RESULTS: The 35.7% of sample was poor sleepers and sleepiness was the most altered variable in ICSP. The female participants tended to sleep less than the male participants, and all of them went to sleep 100 minutes later on the weekend. Being a good or bad sleeper did not affect academic performance. Globally the school adjustment was satisfactory. Diurnal dysfunction was related to a worse adolescent-teacher and adolescent-classmate relationship. Diurnal dysfunction was also related to a poor motivation to perform academic tasks. CONCLUSIONS: Sleepiness is the most relevant problem in poor sleepers. Sleepiness has a negative influence on school adjustment and motivation for school activities of all adolescents; it is frequent and underestimated in most of the cases.

OBJETIVO: La duración y calidad del sueño están relacionadas en los adolescentes con su estado emocional y rendimiento académico. El objetivo del estudio fue evaluar la calidad del sueño en un grupo de jóvenes y explorar su relación con el ajuste y rendimiento escolar. METODOS: Se realizó un estudio descriptivo-transversal, con 56 adolescentes entre 13 y 17 años de un instituto de educación secundaria de un distrito de La Coruña, durante el curso 2016-2017. Los participantes cumplimentaron el Índice de Calidad del Sueño de Pittsburgh (ICSP), la Escala Breve de Ajuste Escolar y un breve cuestionario sobre hábitos de sueño y calificaciones académicas. Realizamos el análisis descriptivo y diferentes pruebas comparativas o de asociación estadística por métodos paramétricos o no paramétricos según cada variable, considerándose significativos valores de p<0,10. RESULTADOS: El 35,7% de la muestra se clasificó como mala durmiente y la somnolencia fue la variable más alterada del ICSP. Las mujeres dormían significativamente menos que los varones, aunque ambos retrasaban 100 minutos el sueño durante el fin de semana. Ser buen o mal durmiente no afectó al rendimiento académico. El ajuste escolar fue satisfactorio globalmente. Las variables que expresaron desajuste en la interacción con los profesores y compañeros de clase, así como la realización de tareas escolares, se relacionaron con la disfunción diurna. CONCLUSIONES: La somnolencia es el problema más relevante en el grupo de malos durmientes. Esta puede influir negativamente en el ajuste escolar y en la motivación para las actividades escolares de todos los adolescentes, siendo frecuente y subestimada en la mayoría de los casos.

Sex Determination in Two Species of Anuran Amphibians by Magnetic Resonance Imaging and Ultrasound Techniques.

The objective of the present study was to evaluate whether gender determination in two amphibian species (Kaloula pulchra and Xenopus laevis) can be reliably carried out by means of magnetic resonance imaging (benchtop magnetic resonance imaging; BT-MRI) or ultrasound (high-resolution ultrasound; HR-US) techniques. Two species of healthy, sexually mature anurans have been used in the present study. Eight Kaloula (blind study) and six Xenopus were used as controls. Magnetic resonance imaging experiments were carried out on a low-field (1 Tesla) benchtop-MRI (BT-MRI) system. HR-US examination was performed with high-resolution equipment. Low-field BT-MRI images provided a clear and quantifiable identification of all the sexual organs present in both genders and species. The HR-US also allowed the identification of testes and ovaries in both species. Results indicate that BT-MRI allowed a very precise sex identification in both anuran species, although its use is limited by the cost of the equipment and the need for anesthesia. HR-US allowed an accurate identification of ovaries of both species whereas a precise identification of testes is limited by the ultrasonographer experience. The main advantages of this technique are the possibility of performing it without anesthesia and the higher availability of equipment in veterinary and zoo institutions.

Forensic cases of suspected dog and cat abuse in the Community of Madrid (Spain), 2014-2019.

Companion animal abuse is an issue that concerns not only veterinarians and law enforcement agencies but also society in general. Animals that die under suspicious or violent circumstances should be submitted to reference laboratories for a postmortem examination by veterinary forensic pathologists trained to recognize animal abuse. Nevertheless, the low notification rate of such cases in Spain may explain the country's lag in the development of veterinary forensics and the limited information available on animal abuse epidemiology in comparison with other countries. By sharing information among the entities involved in recognizing animal abuse, we can better address these issues, thus improving veterinary forensics in Spain (and elsewhere). In this study, we analysed the cause and manner of death of 96 dog and cat carcasses suspected of animal abuse. These cases were submitted to our diagnostic laboratory for forensic postmortem examination by public agencies and animal protection centres. To our knowledge, this is the first study to focus on the postmortem analysis of forensic cases of suspected dog and cat abuse in Spain. On the basis of gross and histopathological findings, we distinguished between natural and non-natural abuse-related deaths, classifying the latter. We confirmed that most of the dog deaths were related with abuse, though the suspected abuse and the cause of death did not always coincide. In contrast, cause of death was determined to be natural in many of the cat suspected abuse cases. The most frequent non-natural abuse-related cause of death in dogs was blunt force trauma (n=24, 43.64%), followed by firearm injuries (n=10, 18.18%), asphyxia (n=5, 9.09%), heatstroke (n=3, 5.45%), starvation (n=2, 3.64%), bite injury (n=1, 1.82%), and sharp force trauma (n=1, 1.82%). In cats, the most common cause of death was blunt force trauma (n=9, 21.95%), followed by firearm injuries (n=3, 7.32%) and bite injury (n=2, 4.88%). The main goal of our study is to share our results with the scientific community to advance the field of veterinary forensics in Spain, which will lead to more successful prosecutions by law enforcement agencies. Finally, we highlight that veterinarians who can accurately recognize signs of animal abuse may be able to better respond to cases of companion animal cruelty, which in turn, may prevent possible escalation to interpersonal violence.

La psicología militar en la prevención de salud mental durante la pandemia por SARS-Cov-2 / Military psychology in mental health prevention in Spain during the SARS-Cov-2 Pandemic

La literatura científica señala que las situaciones de emergencias y desastres tienen un impacto más elevado para la salud mental que para la salud física. No había razones para pensar que la pandemia por COVID-19 y la situación de estado de alarma fueran a impactar menos que epidemias anteriores. Por ello, la psicología militar debía aportar algunas de sus capacidades para reducir el impacto de la emergencia en la salud mental de una parte de la población. MÉTODO: Se realizaron búsquedas bibliográficas en PubMed, PsycINFO y EBSCOhost de cara a analizar el impacto de la pandemia por COVID-19 en la salud mental. Además, se describen algunas de las diferentes actuaciones que ha llevado a cabo la psicología militar en todo el territorio nacional, durante la mencionada crisis sanitaria. RESULTADOS: Se observa un impacto psicológico negativo del COVID-19 en países como China, Argelia, Irán, India, Italia, España, Reino Unido o Alemania. La psicología militar realizó al menos 15000 actuaciones, aunque no todas se concretaron en intervenciones psicológicas y solo unas 8000 se pudieron contabilizar formalmente. El 40% de las personas atendidas recibieron al menos una intervención psicológica (13% en formato individual y 27% en sesión grupal para intervinientes). De las actuaciones individuales contabilizadas, aproximadamente el 18% derivó en intervención psicológica. En las intervenciones individuales se observaron síntomas de salud mental negativos, así como patrones de resiliencia para gestionar el estrés. Las actuaciones se llevaron a cabo con: Trabajadores y usuarios de residencias de mayores y centros de personas vulnerables; hospitalizados y familiares de hospitalizados y fallecidos por COVID-19; militares intervinientes en la emergencia; familiares de militares; trabajadores civiles del Ministerio de Defensa; militares en situación de retiro; y viudas de militares. CONCLUSIONES: Según la literatura científica, la emergencia sanitaria ha tenido un impacto negativo en la salud mental. Sin embargo, pese a los síntomas negativos, los individuos también demuestran patrones de resiliencia bien establecidos

Scientific community indicates that emergency and disaster situations have a higher impact on mental health than on physical health. There was no reason to believe that outbreak COVID-19 and state of alarm were going to impact less than previous epidemics. For this reason, military psychology needed to contribute with some of its capabilities to reduce the impact of the emergency on the mental health of part of the population. METHOD: Bibliographic searches in PubMed, PsycINFO and EBSCOhost were performed for analyze the impact of the COVID-19 pandemic on mental health. In addition, some of the actions that military psychology has carried out throughout the Nation are described. RESULTS: A negative psychological impact of COVID-19 was observed in countries such as China, Algeria, Iran, India, Italy, Spain, United Kingdom or Germany. Military psychology carried out at least 15,000 actions, although not all of them resulted in psychological interventions and about half of them were formally accounted. Approximately 40% of the people received at least one psychological intervention (13% in individual format and 27% in group session for participants). Of the individual actions recorded, about 18% needed psychological first aid. Negative symptoms but also positive resilience patterns were observed in people. Actions were done in different contexts: Workers and users of nursing homes and centers for vulnerable people; hospitalized and hospitalized's relatives and deceased by COVID-19; military personnel as first workers; military relatives; civil workers from the Ministry of Defense; retired military personnel; and military widows. CONCLUSIONS: According to the scientific literature, this outbreak has had a negative impact on mental health. However, despite negative symptoms, people also presented resilience patterns

[Essential aspects during the resuscitation of intravascular volume in polytraumatized patients]. / Aspectos esenciales durante la reanimación del volumen intravascular en pacientes politraumatizados.

Trauma is the leading cause of death in the first four decades of life, responsible for 3.5 million deaths a year and carrying a high economic and social impact. Hemorrhagic shock is the consequence of injuries in these patients. Despite extensive knowledge about its pathophysiology and many replacement drugs and therapies, resuscitation of the intravascular volume sometimes is insufficient and ineffective. Hemorrhagic shock, resulting in macro and microvascular changes that favor the development of anaerobic metabolism, is associated with multiple complications that can lead to the demise of the patient. The purpose of this article is to describe the essential aspects that should be taken into account during the resuscitation of the intravascular volume of multiple trauma patients. We conducted a search and review of the available literature on the resuscitation of trauma patients. Reference searches were conducted in the MEDLINE/PubMed, Cumed, SciELO, EBSCO, Hinari, Cochrane databases. We reviewed the historical evolution of volume replacement in the polytrauma patient, endothelial glycocalyx, changes in the Starling law paradigm, goal-guided resuscitation, the different fluids used during resuscitation, monitoring, and the concepts of damage control resuscitation and damage control surgery.

El trauma es la principal causa de muerte en las primeras cuatro décadas de la vida, responsable de 3,5 millones de muertes al año con un alto impacto económico y social. El estado de shock hemorrágico es la consecuencia de las lesiones en estos pacientes, donde a pesar de un amplio conocimiento de su fisiopatología e innumerables fármacos y terapias de reemplazo, a menudo es insuficiente e ineficaz para resucitar su volumen intravascular. Esta entidad produce alteraciones macro y microvasculares, que favorecen el desarrollo del metabolismo anaerobio. Se encuentra asociado a múltiples complicaciones que pueden derivar en la muerte del paciente. El objetivo de este trabajo es describir aspectos esenciales para tener en cuenta durante la reanimación del volumen intravascular de pacientes politraumatizados. Se realizó una búsqueda y revisión de la literatura disponible sobre reanimación del paciente politraumatizado. Se efectuaron búsquedas de referencias en las bases de datos MEDLINE/PubMed, Cumed, SciELO, EBSCO, Hinari, Cochrane. Se revisaron aspectos como la evolución histórica del reemplazo de volumen en el paciente politraumatizado, el glicocalix endotelial, los cambios en el paradigma de las leyes de Starling, la reanimación guiada por objetivos, los diferentes líquidos que se utilizan durante la reanimación, el monitoreo de estos y los conceptos de reanimación y cirugía de control de daños.

Interrelacion entre calidad, hábitos de sueño y ajuste escolar en adolescentes de un distrito urbano de Galicia / Relationship among sleep quality, sleep habits and school adjustment in adolescents from an urban district of Galicia

FUNDAMENTOS: La duración y calidad del sueño están relacionadas en los adolescentes con su estado emocional y rendimiento académico. El objetivo del estudio fue evaluar la calidad del sueño en un grupo de jóvenes y explorar su relación con el ajuste y rendimiento escolar. MÉTODOS: Se realizó un estudio descriptivotransversal, con 56 adolescentes entre 13 y 17 años de un instituto de educación secundaria de un distrito de La Coruña, durante el curso 2016-2017. Los participantes cumplimentaron el Índice de Calidad del Sueño de Pittsburgh (ICSP), la Escala Breve de Ajuste Escolar y un breve cuestionario sobre hábitos de sueño y calificaciones académicas. Realizamos el análisis descriptivo y diferentes pruebas comparativas o de asociación estadística por métodos paramétricos o no paramétricos según cada variable, considerándose significativos valores de p < 0,10. RESULTADOS: El 35,7% de la muestra se clasificó como mala durmiente y la somnolencia fue la variable más alterada del ICSP. Las mujeres dormían significativamente menos que los varones, aunque ambos retrasaban 100 minutos el sueño durante el fin de semana. Ser buen o mal durmiente no afectó al rendimiento académico. El ajuste escolar fue satisfactorio globalmente. Las variables que expresaron desajuste en la interacción con los profesores y compañeros de clase, así como la realización de tareas escolares, se relacionaron con la disfunción diurna. CONCLUSIONES: La somnolencia es el problema más relevante en el grupo de malos durmientes. Esta puede influir negativamente en el ajuste escolar y en la motivación para las actividades escolares de todos los adolescentes, siendo frecuente y subestimada en la mayoría de los casos

BACKGROUND: The duration and the sleep quality are related to the emotional status and the academic performance in adolescents. The objective of this study was to evaluate the quality of sleep in a group of adolescents, and to explore its relationship with school adjustment and performance. METHODS: A cross-sectional descriptive study was made with 56 adolescents aged 13-17 years from a high school institute in an urban district of La Coruña city was performed during the scholar's year 2016-2017. The participants completed the Pittsburgh Sleep Quality Index (ICSP) and the Brief School Adjustment Scale, and a brief questionnaire about their sleep habits and school scores. Descriptive analysis and different comparative parametric or not parametric statistical tests were applied according to type of variable; statistical significant value was considerate for p < 0.10. RESULTS: The 35.7% of sample was poor sleepers and sleepiness was the most altered variable in ICSP. The female participants tended to sleep less than the male participants, and all of them went to sleep 100 minutes later on the weekend. Being a good or bad sleeper did not affect academic performance. Globally the school adjustment was satisfactory. Diurnal dysfunction was related to a worse adolescent-teacher and adolescent-classmate relationship. Diurnal dysfunction was also related to a poor motivation to perform academic tasks. CONCLUSIONS: Sleepiness is the most relevant problem in poor sleepers. Sleepiness has a negative influence on school adjustment and motivation for school activities of all adolescents; it is frequent and underestimated in most of the cases

Analgesia subaracnoidea en el trabajo de parto: bupivacaína/fentanilo vs. petidina / Subarachnoid analgesia in labor: bupivacaine/fentanyl vs pethidine

Introducción: La analgesia subaracnoidea es una alternativa para el trabajo de parto por su seguridad y adecuada relación riesgo/beneficio. Objetivo: Evaluar la efectividad de la analgesia durante el trabajo de parto con la comparación de dos métodos analgésicos. Método: Se realizó un estudio cuasiexperimental, longitudinal y prospectivo en 92 gestantes que se atendieron en el Hospital General Docente Abel Santamaría Cuadrado durante el período entre enero de 2014 y enero de 2017. Las pacientes se dividieron en dos grupos de 46 cada uno, al azar, por orden de llegada a la unidad quirúrgica. El grupo A, bupivacaína al 0,5 por ciento, en dosis de 2 mg y fentanilo en dosis de 25 mcg; y grupo B en el que se utilizó petidina en dosis de 25 mg, en todos los casos por vía intratecal. Las variables analizadas fueron: tensión arterial media, frecuencia cardíaca media, saturación parcial de oxígeno, tiempo de inicio de la analgesia, calidad analgésica, efectos adversos y nivel de satisfacción de las pacientes. Se empleó el análisis descriptivo y la diferencia de proporciones. Resultados: El grupo A mantuvo una TAM entre 84 y 88 mmHg, (Z= 6,0 significativa); FC media entre 80 y 88 lat/min, (Z= 1,94 no significativa); SpO2 con una media de 99,2 por ciento. En 46,74 por ciento (43 casos) el tiempo de inicio de la analgesia fue corto (Z= 8,47), siendo Buena en 100 por ciento de los casos (Z= 6,89 significativa), con recién nacido vigoroso en 100 por ciento (Z= 10,25 significativa). La evolución fue satisfactoria en 48,19 por ciento de las pacientes. Presentaron prurito 8,69 por ciento. En el grupo B hubo hipertensión arterial en 2,17 por ciento de los casos, con menos estabilidad de la FC, tiempos mayores de inicio de trabajo de parto en 12,96 por ciento y fue Buena en 40,22 por ciento. Estas pacientes mostraron menos satisfacción (41,30 por ciento). Conclusiones: La administración subaracnoidea de fentanilo/bupivacaína fue más efectiva que la petidina para la analgesia durante el trabajo de parto(AU)

Introduction: Subarachnoid analgesia is an alternative for labor due to its safety and suitable risk-benefit relationship. Objective: To evaluate the effectiveness of analgesia during labor with the comparison of two analgesic methods. Method: A quasiexperimental, longitudinal and prospective study was carried out in 92 pregnant women who attended Abel Santamaría Cuadrado General Teaching Hospital during the period between January 2014 and January 2017. The patients were divided into two groups of 46 each, randomly assigned, in order of arrival to the surgical unit. Group A was treated with intrathecal administration of bupivacaine 0.5 percent, in a dose of 2 mg, and fentanyl in a dose of 25 mcg; and group B was treated with intrathecal administration of pethidine, in a dose of 25 mg. The variables analyzed were mean arterial blood pressure, mean heart rate, partial oxygen saturation, time of onset of analgesia, analgesic quality, adverse effects and level of patient satisfaction. The descriptive analysis and the difference in proportions were used. Results: Group A maintained a mean arterial blood pressure between 84 and 88 mmHg, (Z=6.0 significant); heart rate averages between 80 and 88 beats per minute, (Z=1.94 not significant); partial oxygen saturation with an average of 99.2 percent. In 46.74 percent (43 cases) the time of onset of analgesia was short (Z=8.47), being good in 100 percent of the cases (Z=6.89 significant), with vigorous newborn in 100 percent (Z=10.25 significant). The evolution was satisfactory in 48.19 percent of the patients. They presented pruritus 8.69 percent. In group B, there was arterial hypertension in 2.17 percent of the cases, with less stability of the heart rate, greater times of labor beginning in 12.96 percent and it was good in 40.22 percent. These patients showed less satisfaction (41.30 percent). Conclusions: Subarachnoid administration of fentanyl/bupivacaine was more effective than pethidine for analgesia during labor(AU)

Conducta perioperatoria de la terapia antitrombótica / Perioperative behavior of antithrombotic therapy

Introducción: El envejecimiento poblacional en Cuba ha incrementado la presencia de enfermos que requieren tratamiento con anticoagulantes y antiagregantes plaquetarios que necesitan una intervención quirúrgica. Objetivo: Exponer los aspectos fundamentales de la conducta perioperatoria en pacientes con terapia antitrombótica, tratamiento puente y anticoagulación ante diversos procederes e intervenciones quirúrgicas electivas y de urgencias, al aplicar la variabilidad interindividual en cada tratamiento. Desarrollo: Los anestesiólogos desempeñan una función protagónica en el tratamiento anestésico de estos pacientes. Son los máximos responsables de los cambios a efectuar en la conducta farmacológica, así como confeccionar estrategias de tratamiento con vista a establecer un equilibrio entre el riesgo trombótico y hemorrágico. Conclusiones: Los anestesiólogos deben cumplir los protocolos de tromboprofilaxis en el perioperatorio, para evitar la ocurrencia de enfermedades tromboembólicas, al realizar una evaluación individualizada, al tener en cuenta las propiedades farmacológicas de los anticoagulantes y de los antiagregantes plaquetarios en cirugía electiva y de urgencia(AU)

Introduction: Population aging in Cuba has increased the presence of patients who require surgical interventions and treatment with anticoagulants and antiplatelet agents. Objective: To present the fundamental aspects of perioperative behavior in patients with antithrombotic therapy, bridging and anticoagulation therapy in response to various procedures and elective and emergency surgeries, when applying interindividual variability in each treatment. Development: Anesthesiologists play a leading role in the anesthetic treatment of these patients. They are the main responsible for the changes to be made in the pharmacological behavior, as well as to formulate treatment strategies with a view to establishing a balance between thrombotic and hemorrhagic risks. Conclusions: Anesthesiologists must comply with the protocols of thromboprophylaxis in the perioperative period to avoid the occurrence of thromboembolic diseases when performing an individualized evaluation. They must also take into account the pharmacological properties of anticoagulants and antiplatelet agents in elective and emergency surgeries(AU)

Analgesia peridural torácica para el alivio del dolor posoperatorio en la cirugía torácica / Thoracic epidural analgesia for the relief of postoperative pain in thoracic surgery

Introducción: El dolor posoperatorio es un fenómeno observado con elevada frecuencia y constituye uno de los retos más importantes en el ámbito quirúrgico. Objetivo: Describir los resultados clínicos y hemodinámicos obtenidos con la utilización de anestesia peridural torácica alta como técnica analgésica durante el período posoperatorio en los pacientes intervenidos de tórax. Método: Se realizó un estudio descriptivo, longitudinal, prospectivo en el Hospital Abel Santamaría Cuadrado, entre enero de 2014 y enero de 2017. La muestra estuvo conformada por 37 pacientes que cumplieron con los criterios de inclusión y exclusión. Resultados: Predominaron los valores normales en los que no presentaron dolor posoperatorio, con 33 ± 5,23 y 33 ± 7,86 respectivamente. Se calculó una media de saturación de oxígeno de 99,48 por ciento y frecuencia respiratoria de 16 res/min. Se evidenció que 31 pacientes (83,78 por ciento) no presentaron complicaciones posoperatorias secundarias a la técnica analgésica. En la mayoría no fue necesaria la analgesia de rescate, elemento que representó el 89,19 por ciento. Resultó significativo que 32 pacientes (86,49 por ciento), manifestaron encontrarse satisfechos con el proceder y los resultados alcanzados. Conclusiones: La aplicación de la peridural con morfina para cirugía de tórax arrojó resultados muy efectivos como método analgésico con adecuada estabilidad, mínimas complicaciones requerimientos de rescate analgésico, lo que propició satisfacción por los pacientes(AU)

Introduction: Postoperative pain is a phenomenon that appears frequently and constitutes one of the most important challenges in the surgical field. Objective: To describe the clinical and hemodynamic results obtained with the use of high thoracic epidural as analgesic technique during the postoperative period in patients undergoing thoracic surgery. Method: A descriptive, longitudinal, prospective study was carried out in Abel Santamaría Cuadrado Hospital, during the period between January 2014 and January 2017. The sample consisted of 37 patients who met the inclusion and exclusion criteria. Results: In blood pressure and heart rate according to analgesic response, normal values prevailed in those without postoperative pain, with 33 ± 5.23 and 33 ± 7.86 respectively. A mean of oxygen saturation of 99.48 percent and respiratory rate of 16 res/min were calculated. It was evidenced that 31 patients (83.78 percent) did not present postoperative complications after the analgesic technique. In the majority, rescue analgesia was not necessary, an element that represented 89.19 percent. It was significant that 32 patients (86.49 percent) said they were satisfied with the procedure and the results achieved. Conclusions: The application of peridural with morphine for thoracic surgery yielded very effective results as an analgesic method with adequate stability, minimal complications and analgesic rescue requirements, which led to patient satisfaction(AU)

First Radiological Study of a Complete Dental Ontogeny Sequence of an Extinct Equid: Implications for Equidae Life History and Taphonomy.

The sequence of cheek teeth mineralization, eruption, and replacement of an extinct horse species is here documented with radiological techniques for the first time thanks to the exceptional preservation of Hipparion sp. mandibles from Cerro de los Batallones (Madrid Basin, Spain). The sequence of dental ontogeny in mammals provides valuable insights about life history traits, such as the pace of growth, and about the mode of formation of fossiliferous assemblages. We have determined that the order of permanent cheek teeth mineralization and eruption of hipparionine horses is m1, m2, (p2, p3), p4, m3. Cheek teeth mineralization timing of hipparionine horses coincides with the one observed in modern equids. In turn, there are differences in the eruption timing of the p4 and m3 between horses belonging to the Anchitheriinae and Hipparionini compared to equids of the Equus genus that might be related to the shorter durability of the deciduous tooth dp4 in anchitheriine and hipparionine horses and, more broadly, to an increased durability of equid teeth through their evolutionary history. Based on the dental eruption sequence, hipparionine horses are slow-growing, long-living mammals. The Hipparion sp. assemblage from Batallones-10 conforms to an attritional model, as individuals more vulnerable to natural mortality predominate.

Conducción anestésica de un paciente con bloqueo de rama izquierda agudo / Anesthetic approach of a patient with acute left-branch block

Introducción: El bloqueo de rama izquierda del haz de His dependiente de la frecuencia cardíaca no es una entidad común en la práctica clínica del anestesiólogo, sino que se presenta como consecuencia de enfermedades cardiacas o no que ocurren por lentitud de la frecuencia ventricular sobre todo, con enfermedad de las arterias coronarias planteadas solo como diagnóstico después de haberlas descartado. Objetivo: Describir el manejo clínico-anestésico de una paciente que presentó bloqueo de rama izquierda del haz de His para cirugía torácica electiva por tumor de mediastino. Desarrollo: Se presenta un caso clínico de una paciente con bloqueo de rama izquierda dependiente de la frecuencia cardiaca que se anunció para cirugía del tórax, sin historia previa de coronariopatía. La cirugía trascurrió sin complicaciones y con buenos resultados. Conclusiones: el bloque de rama izquierda dependiente de la frecuencia cardiaca es una entidad rara y un diagnóstico excluyente de otras entidades cardiovasculares o no como la isquemia miocárdica. Un adecuado manejo intraoperatorio del paciente proporciona excelentes resultados sin traducción clínica ni complicaciones(AU)

Introduction: Rate-dependent left bundle branch block is not a rare entity for the clinical practice in anesthesiology, but appears as a consequence of heart diseases or not always due to slowness in atrial frequency above all, with coronary artery diseases diagnosed only after their being ruled out. Objective: To describe the clinical-anesthetic management of a patient who presented left bundle branch block for elective thoracic surgery due to mediastinal tumor. Findings: We present a clinical case of a female patient with rate-dependent left bundle branch block who was announced for thoracic surgery, without a previous history of coronary artery disease. The surgery proceeded without complications and with positive outcome. Conclusions: Rate-dependent left-branch block is a rare entity and a diagnosis ruling out other cardiovascular entities or not, such as myocardial ischemia. An adequate intraoperative management of the patient provides excellent outcome without clinical translation or complications(AU)