Unusual Upper Gastrointestinal Bleeding Due to a Neuroendocrine Tumor Arising in Meckel Diverticulum.

Meckel diverticulum is the most common congenital variation of the gastrointestinal tract arising from incomplete obliteration of the vitelline duct during gestation. In most cases, individuals are asymptomatic. This is a case of a 38-year-old patient with hematochezia in whom Meckel diverticulum was diagnosed. A mass was identified within the diverticulum. Histopathological and immunohistochemical studies revealed a well-differentiated neuroendocrine tumor. The development of tumors in Meckel diverticulum is rare, and when identified, only 0.5%-3.2% of these tumors are found to be malignant. Furthermore, gastrointestinal bleeding is an infrequent clinical feature of neuroendocrine tumors. A unique aspect of this case was that numerous imaging studies and endoscopic procedures were unable to definitively identify the presence of Meckle diverticulum and underlying neuroendocrine tumor. Through a high clinical suspicion and collaboration with surgical colleagues, an exploratory laparotomy was performed, which ultimately led to the identification and diagnosis of the underlying pathology.

Estrés Percibido y Consumo de Alcohol en Indígenas / Perceived Stress and Alcohol Consumption in Indigenous

Introducción: En Latinoamérica el consumo de bebidas alcohólicas es causante de problemas relacionados con la salud física, mental y social. La Comisión Nacional para el Desarrollo de los Pueblos Indígenas señala que las poblaciones indígenas son vulnerables a presentar problemas con el consumo de alcohol derivado de algunas características como pobreza extrema y rezago educativo, nuestro objetivo fue conocer el efecto del estrés percibido sobre el consumo de alcohol en una población indígena. Material y método: El diseño del estudio fue descriptivo, correlacional, predictivo. Resultados: El estrés percibido se relacionó positiva y significativamente con el número de copas consumidas en un día típico (rs = .211, p‹.01), y con el consumo de alcohol AUDIT (rs= .328, p ‹ .01), sin embargo, se relacionó negativa y significativamente con la edad (rs = -.135, p ‹.05). El Modelo final presentó un efecto significativo en la totalidad del modelo (F (1,110) = 20.126, p = .001), explica el 39.3% de la varianza del consumo de alcohol. Se encontró que el estrés percibido tuvo un efecto positivo y significativo sobre el consumo de alcohol (B =.229, p ‹ .001). Conclusiones: El estrés percibido es un factor que influye en el consumo excesivo de alcohol en las poblaciones indígenas, se considera que el consumo de drogas es una estrategia de afrontamiento para hacer frente a problemas estresantes en la vida diaria. La población presento problemas con el consumo de alcohol excesivo episódico, prevalencias altas en consumo en el último año y consumo dañino (AU)

Introduction: In Latin America, alcoholic beverages consumption is a main reason of problems related to physical, mental and social health. The National Commission for the Development of Indigenous Peoples states that indigenous populations are vulnerable problems related to alcohol consumption because a set of characteristics such as extreme poverty and educational backwardness. Our objective was to determine the effect of perceived stress on alcohol consumption in an indigenous population.Method: Study design was descriptive, correlational, and predictive.Results: Perceived stress was positively and significantly related to the number of drinks consumed in a typical day (rs = .211, p‹.01), it’s also related with alcohol consumption (AUDIT) (rs= .328, p ‹ .01), however, it was negatively and significantly related to age (rs = -.135, p ‹.05). The final Model presented a significant effect in the whole model (F (1,110) = 20.126, p = .001), explaining 39.3% of the variance of alcohol consumption. Perceived stress was found to have a positive and significant effect on alcohol consumption (B =.229, p ‹ .001).Conclusions: Perceived stress is a factor influencing excessive alcohol consumption in indigenous populations, drug use is considered a coping strategy to deal with stressful problems in daily life. The population presented problems with heavy episodic drinking, past year drinking with high prevalence and harmful drinking (AU)

Perceived discrimination and alcohol consumption in an indigenous population / Discriminación percibida y consumo de alcohol en una población indígena

Abstract Introduction Indigenous populations are considered a vulnerable minority and have characteristics such as poverty, difficulties to access food, housing, and educational backwardness; these conditions make them prone to alcohol consumption problems. Dependence on alcohol consumption probably arises as a symbol of protest, challenge, and response to social anguish, which has in turn repercussions in marginal population sectors that have conditions of fragility due to exploitation and discrimination, such as indigenous people. Objective To know the effect of perceived discrimination on alcohol consumption in Mexican indigenous population. Method Research design was descriptive, correlational check-model, with a sample of 362 adults from two indigenous communities. Results A simple linear regression model was performed, which shows a significant effect in the entire model (F[248] = 78.312, p = .001), which explains 49% of the variance of alcohol consumption. A significant positive influence was also found from the perceived discrimination variable (β = .626, p < .001) on alcohol consumption. Discussion and conclusion The studied indigenous communities had characteristics that the literature highlights as risk factors for developing addictive behaviors of alcohol consumption. These results coincide with those of the National Commission for the Development of Indigenous Peoples. Indigenous population present discrimination problems that are associated with alcohol consumption problems.

Resumen Introducción Las poblaciones indígenas se consideran minoritarias y vulnerables, y se caracterizan por su pobreza, dificultad para acceder a la alimentación, la vivienda y el rezago educativo. Estas condiciones los vuelven propensos a presentar problemas de consumo de alcohol. La dependencia al consumo de alcohol surge probablemente como símbolo de protesta, reto y respuesta a la angustia social, lo cual repercute en los sectores poblacionales marginales que poseen condiciones de fragilidad por la explotación y discriminación como los pueblos indígenas. Objetivo Conocer el efecto de la discriminación percibida en el consumo de alcohol en poblaciones indígenas mexicanas. Método El diseño del estudio fue descriptivo, correlacional de comprobación de modelo, con una muestra de 362 adultos de dos comunidades indígenas. Resultados Se realizó el modelo de regresión lineal simple el cual muestra efecto significativo en la totalidad del modelo (F[248] = 78.312, p = .001), explica el 49% de la varianza del consumo de alcohol, además se encontró influencia positiva significativa de la variable discriminación percibida (β = .626, p < .001) sobre el consumo de alcohol. Discusión y conclusión Las comunidades indígenas estudiadas poseen características que la literatura destaca como factores de riesgo para desarrollar conductas adictivas de consumo de alcohol, estos resultados coinciden con lo expuesto por la Comisión Nacional para el Desarrollo de los Pueblos Indígenas. Las poblaciones indígenas presentan problemas de discriminación que se asocian con los problemas de consumo de alcohol.

El sentido de la vida como mediador entre la autoestima y la adicción al internet en adolescentes / The meaning of life as a mediator between self-esteem and Internet addiction in adolescents

Introducción: La adicción al Internet se ha relacionado con la autoestima, y el sentido de la vida con ambas variables, porque se debe explorar su rol mediador. Objetivo: Analizar la relación entre la adicción al Internet y la autoestima en adolescentes mexicanos. Metodología: Se efectuó un estudio descriptivo y correlacional con una muestra de 238 estudiantes seleccionados por muestreo no probabilístico por conveniencia. Se utilizaron una cédula de datos personales, la escala de autoestima de Rossemberg, el test de adicción al Internet y el test de sentido de la vida. Se apegó a lo dispuesto en el Reglamento de la Ley General de Salud en Materia de Investigación para la Salud en Seres Humanos en México y a la declaración de Helsinki. Resultados: La adicción al Internet se relacionó negativa y significativamente con el sentido de la vida (rs=-.359, p= <.001) y con la autoestima (rs=-.426, p=<.001). El sentido de la vida mostró un efecto mediador entre la autoestima y la adicción al Internet (B= -.188, SE= .066, 95% IC [-.320, -.056]). El sexo tuvo un efecto moderador entre la autoestima y la adicción al Internet siendo significativo en ambos sexos. Conclusión: La autoestima y el sentido de la vida pueden predecir una disminución de la adicción al Internet. Así mismo, el rol de género puede presentar variaciones con respecto a los puntos de vista y forma de pensar y moderan la relación entre la autoestima y la adicción al Internet. (AU)

Mechanical Circulatory Support in Women.

A number of devices can now provide mechanical circulatory support (MCS) to patients with acute cardiogenic shock (CS) and chronic end-stage heart failure (HF). Women differ from men in pathophysiology and natural history of CS and HF, and are usually sicker at admission. Current evidence suggests that women benefit as much as men, if not more, from both temporary and durable MCS for appropriate indications. Yet, women have been under-represented in clinical trials of MCS devices. Limited evidence suggests that women benefit more from temporary MCS in CS associated with acute myocardial infarction. However, in patients with durable left ventricular assist devices (LVADs), women are more likely to experience thromboembolic events and right HF. This review aims to study available evidence and determine areas for further research on gender differences in (a) use of temporary MCS for CS and (b) use of durable LVADs. Use of MCS in conditions specific to, or more common in women (pregnancy, takotsubo cardiomyopathy, peripartum cardiomyopathy, and spontaneous coronary artery dissection) is also discussed.

Short-Term Pediatric Acclimatization to Adaptive Hearing Aid Technology.

Purpose This exploratory study assessed the perceptual, cognitive, and academic learning effects of an adaptive, integrated, directionality, and noise reduction hearing aid program in pediatric users. Method Fifteen pediatric hearing aid users (6-12 years old) received new bilateral, individually fitted Oticon Opn hearing aids programmed with OpenSound Navigator (OSN) processing. Word recognition in noise, sentence repetition in quiet, nonword repetition, vocabulary learning, selective attention, executive function, memory, and reading and mathematical abilities were measured within 1 week of the initial hearing aid fitting and 2 months post fit. Caregivers completed questionnaires assessing their child's listening and communication abilities prior to study enrollment and after 2 months of using the study hearing aids. Results Caregiver reporting indicated significant improvements in speech and sound perception, spatial sound awareness, and the ability to participate in conversations. However, there was no positive change in performance in any of the measured skills. Mathematical scores significantly declined after 2 months. Conclusions OSN provided a perceived improvement in functional benefit, compared to their previous hearing aids, as reported by caregivers. However, there was no positive change in listening skills, cognition, and academic success after 2 months of using OSN. Findings may have been impacted by reporter bias, limited sample size, and a relatively short trial period. This study took place during the summer when participants were out of school, which may have influenced the decline in mathematical scores. The results support further exploration with age- and audiogram-matched controls, larger sample sizes, and longer test-retest intervals that correspond to the academic school year.

Auditory cognition and perception of action video game players.

A training method to improve speech hearing in noise has proven elusive, with most methods failing to transfer to untrained tasks. One common approach to identify potentially viable training paradigms is to make use of cross-sectional designs. For instance, the consistent finding that people who chose to avidly engage with action video games as part of their normal life also show enhanced performance on non-game visual tasks has been used as a foundation to test the causal impact of such game play via true experiments (e.g., in more translational designs). However, little work has examined the association between action video game play and untrained auditory tasks, which would speak to the possible utility of using such games to improve speech hearing in noise. To examine this possibility, 80 participants with mixed action video game experience were tested on a visual reaction time task that has reliably shown superior performance in action video game players (AVGPs) compared to non-players (≤ 5 h/week across game categories) and multi-genre video game players (> 5 h/week across game categories). Auditory cognition and perception were tested using auditory reaction time and two speech-in-noise tasks. Performance of AVGPs on the visual task replicated previous positive findings. However, no significant benefit of action video game play was found on the auditory tasks. We suggest that, while AVGPs interact meaningfully with a rich visual environment during play, they may not interact with the games' auditory environment. These results suggest that far transfer learning during action video game play is modality-specific and that an acoustically relevant auditory environment may be needed to improve auditory probabilistic thinking.

Percepción de riesgo ante el consumo de alcohol y tabaco en estudiantes de ciencias de la salud de Saltillo / Risk Perception for alcohol and tobacco consumption in Saltillo's Health Sciences students

Introducción: Los problemas de salud pública causados por el consumo de sustancias psicoactivas han alcanzado proporciones alarmantes y constituyen a escala mundial una carga sanitaria y social importante y en gran medida prevenible. Objetivo: Identificar la relación entre la percepción de riesgo y consumo de alcohol y tabaco en estudiantes universitarios de ciencias de la salud de una institución pública educativa de Saltillo, Coahuila, México. Metodología: El diseño del estudio es de tipo descriptivo y correlacional, con una muestra de 609 estudiantes seleccionados por el muestreo probabilístico estratificado. Se utilizó una cédula de datos personales y de prevalencia de consumo de alcohol y tabaco, el cuestionario de percepción de riesgo hacia el Consumo de Drogas Lícitas y la Prueba de Identificación de Desórdenes por Uso de Alcohol. El presente estudio se apegó a lo dispuesto en el Reglamento de la Ley General de Salud en Materia de Investigación para la Salud en Seres Humanos en México. Resultados: La cantidad de cigarrillos consumidos y la edad de los participantes presentaron una relación estadísticamente significativa (rs=0.156, p= .026) al igual que la percepción de riesgo y la cantidad de bebidas Alcohólicas consumidas, tuvo una relación significativa negativa (rs=-0.102, p=.026 Conclusión: El estudio aporta información veraz y oportuna en cuanto al perfil del consumo de alcohol y tabaco en estudiantes de ciencias de la salud

Introduction: Public health problems caused by the consumption of psychoactive substances have reached alarming proportions and constitute an important and largely prevenTable health and social burden on a global scale. Objective: To identify the relationship between risk perception and alcohol and tobacco consumption in health sciences university students of a public educational institution of Saltillo, Coahuila, Mexico. Methodology: The study design is descriptive and correlational, with a sample of 609 students selected by stratified probabilistic sampling. A personal data card and the prevalence of alcohol and tobacco consumption, the risk perception questionnaire for the consumption of licit drugs and the test for the identification of disorders due to alcohol use were used. The present study is under the provisions of the Regulation of the General Health Law on Research for Health in Human Beings in Mexico. Results: The amount of cigarettes consumed and the age of the participants presented a statistically significant relationship (rs=0.156, p= .026) as well as the perception of risk and the amount of alcoholic beverages consumed, had a significant negative relationship (rs=-0.102, p=.026). Conclusion: The study provides accurate and timely information regarding the profile of alcohol and tobacco consumption in health science students

Role of Bisphosphonates in Vascular calcification and Bone Metabolism: A Clinical Summary.

BACKGROUND: Vascular calcification is known to be a strong risk factor for cardiovascular adverse events and mortality. Atherosclerosis, diabetes, aging, abnormal bone mineral homeostasis and high uremic milieu such as chronic kidney disease are major factors that contribute to the progression of vascular calcification. Several mechanisms such as the osteoblastic transition of vascular smooth muscle cells in response to oxidative stress have shed light on the active nature of vascular calcification, which was once thought to be a passive process. The fine interplay of regulatory factors such as PTH, vitamin D3, FGF 23 and klotho reflect the delicate balance between vascular calcification and bone mineralization. Any disturbance affecting this equilibrium of the bonemineral- vascular axis results in accelerated vascular calcification. Bisphosphonates share similar mechanism of action as statins, and hence several studies were undertaken in humans to verify if the benefits proven to be obtained in animal models extended to human models too. This yielded conflicting outcomes which are outlined in this review. This was attributed mainly to inadequate sample size and flaws in the study design. Therefore, this benefit can only be ascertained if studies addressing this are undertaken. CONCLUSION: This review seeks to highlight the pathophysiologic phenomena implicated in vascular and valvular calcification and summarize the literature available regarding the use of bisphosphonates in animal and human models. We also discuss novel treatment approaches for vascular calcification, with emphasis on chronic kidney disease and calciphylaxis.

Evaluation of marking efficiency of different alizarin red S concentrations on body fish structures in Oreochromis niloticus (Perciformes: Cichlidae) juveniles.

The use of alizarin red S (ARS) marked tilapias could provide valuable fisheries management information to evaluate fish stocking events and may facilitate aquaculture management practices. As a new technique in fishes, the aim of this study was to compare and evaluate the chemical marks produced in tilapia juveniles by ARS through two treatments: 1) 12 hours of immersion and 2) immersion after osmotic induction. This was analyzed at three concentrations: 50, 75 and 100mg/l, and in three structures: otoliths, fish scales and caudal fin rays of Oreochromis niloticus juveniles. After three culture months 80% of specimens were analyzed and significant differences (p<0.05) in mark intensity were detected between treatments for otoliths and fin rays, but not for fish scales. Significant differences between concentrations were found for the 12h immersion treatment, while no significant differences were detected with osmotic induction. Our results showed that marks appeared at all concentrations, and none of the concentrations produced weak marks. Osmotic induction had a greater mortality than the 12h immersion procedure. After eight culture months the rest of the specimens were analyzed and the mark permanence was observed in all cases. According to the present results we recommend the marking process of 12h immersion treatment at 100mg/L concentration.

Evaluation of marking efficiency of different alizarin red S concentrations on body fish structures in Oreochromis niloticus (Perciformes: Cichlidae) juveniles

The use of alizarin red S (ARS) marked tilapias could provide valuable fisheries management information to evaluate fish stocking events and may facilitate aquaculture management practices. As a new technique in fishes, the aim of this study was to compare and evaluate the chemical marks produced in tilapia juveniles by ARS through two treatments: 1) 12 hours of immersion and 2) immersion after osmotic induction. This was analyzed at three concentrations: 50, 75 and 100mg/l, and in three structures: otoliths, fish scales and caudal fin rays of Oreochromis niloticus juveniles. After three culture months 80% of specimens were analyzed and significant differences (p<0.05) in mark intensity were detected between treatments for otoliths and fin rays, but not for fish scales. Significant differences between concentrations were found for the 12h immersion treatment, while no significant differences were detected with osmotic induction. Our results showed that marks appeared at all concentrations, and none of the concentrations produced weak marks. Osmotic induction had a greater mortality than the 12h immersion procedure. After eight culture months the rest of the specimens were analyzed and the mark permanence was observed in all cases. According to the present results we recommend the marking process of 12h immersion treatment at 100mg/L concentration.

El uso de alizarina roja S (ARS) para marcar tilapias podría proporcionar información valiosa para el manejo de su pesquería. Para evaluar pesquerías acuaculturales manejadas con siembras o repoblamientos de peces se comparó y evaluó la marca producida por la alizarina roja S, empleando dos tratamientos: 1) Inmersión en ARS durante 12h; e 2) Inmersión en ARS después de un choque osmótico. El análisis se realizó a tres concentraciones: 50, 75 y 100mg/l y en tres estructuras: otolitos, escamas y radios de la aleta caudal de Oreochromis niloticus. Ochenta por ciento de los ejemplares fueron cultivados durante tres meses y analizados posteriormente. Los resultados mostraron diferencias entre las concentraciones de la marca para el tratamiento de 12h de inmersión mientras que no hubo diferencias entre las concentraciones para el tratamiento con inducción osmótica. Se encontraron diferencias en la intensidad de la marca entre los tratamientos para otolitos y radios de las aletas pero para las escamas no hubo diferencias significativas. Todas las concentraciones produjeron marcas (desde débiles a intensas), sin embargo la concentración de 100mg/l no produjo marcas débiles. El tratamiento por inducción osmótica presentó mayores niveles de mortalidad. Después de ocho meses de cultivo el resto de los ejemplares fueron analizados y se observó la permanencia de las marcas en todos los casos. En vista de lo anterior, para los propósitos de marcaje se recomienda el uso del tratamiento de inmersión por 12h y una concentración de 100mg/l.