Cut-off points for isometric handgrip and low limb explosive strength in relation to indicators of overweight/obesity in people with intellectual disabilities: analysis by age groups.

BACKGROUND: The prevalence of overweight/obesity has been increasing globally and in people with Intellectual Disabilities (IDs), this problem is exacerbated even more, which added to a low physical condition that contributes to the deterioration of functionality and increases the risk of developing chronic diseases in the course of life. Therefore, the aim of this study was to establish cut-off points for levels of isometric handgrip and low limb explosive strength in children, adolescents and adults, which identify overweight/obesity in people with IDs and their respective associations. METHODS: The sample was made up of 131 individuals with IDs, belonging to four special and community educational centres in the city of Santiago, Chile. Body mass index (BMI) and waist-to-height ratio (WHR) were used as indicators of overweight/obesity. Handgrip strength was used as a measure of isometric strength, and countermovement jump was used as a measure of low limb explosive strength. For the comparison of variables by age group, the analysis of Ancova, Kruskal-Wallis and chi-square tests were used. The total area under the receiver operating characteristic curve of isometric handgrip and low limb explosive strength was identified as an indicator of overweight/obesity according to age groups. A logistic regression model was used to quantify the effect that strength categories below the cut-off point have on the risk of overweight and obesity. RESULTS: Significant differences were observed between the age groups for body weight, height, BMI and WHR, as well as in the levels of absolute handgrip strength and vertical jump with countermovement (P ≤ 0.05). Children showed the lowest cut-off points for absolute and relative strength. The adolescent group showed the highest cut-off points for relative strength and countermovement jump and adults showed the highest value for absolute strength as indicators of overweight/obesity. Different associations between cut-off points with BMI and WHR were found. CONCLUSIONS: Adolescents showed the highest cut-off point for relative strength and countermovement jump, and adults showed the highest value for absolute strength, according to overweight/obesity indicators (BMI and WHR). It is suggested to adjust resistance training programmes according to age categories for the prevention of overweight/obesity in people with IDs.

Norovirus infection as a model of chronic or recurrent infection in common variable immunodeficiency.

Common variable immunodeficiency (CVID) is the most frequent symptomatic primary immunodeficiency (PID) in general population. PID are genetic diseases that share a dysfunction in the immune system entailing a greater risk of both chronic and recurrent infections. These patients can also develop chronic gastrointestinal infections caused by norovirus with persistent viral dissemination, which can be detected months after primoinfection. Additionally, a proportion of CVID patients show a typical severe enteropathy presenting with recurrent diarrhoea, intestinal malabsorption, inflammatory lesions, and villous atrophy. Some studies have related this enteropathy with chronic intestinal infection caused by norovirus.

Incidence, outcomes, and associated factors of isolated striatocapsular infarct after mechanical thrombectomy.

OBJECTIVE: To describe baseline and procedural characteristics and clinical outcomes of isolated striatocapsular infarct (iSCI) after mechanical thrombectomy in patients with large-vessel occlusion of the anterior cerebral circulation and its clinical outcome. METHODS: We performed a longitudinal study including all patients treated with mechanical thrombectomy at our centre between 2015 and 2017; patients were divided into 2 groups (iSCI and non-iSCI) according to whether they presented iSCI in a control CT scan at 24 hours. RESULTS: Of the 83 patients identified, 22.9% developed an iSCI. There were no statically significant differences in baseline characteristics or in reperfusion times. Patients presenting iSCI showed better collateral circulation and better reperfusion rates in the bivariate analysis. No significant difference was observed for mortality at discharge or at 3 months, or for functional prognosis at 3 months. CONCLUSIONS: Even if successful reperfusion is achieved, iSCI is a common sequela, independently of reperfusion time, especially in patients with good collateral circulation.

Tomografía computarizada multidetector en la planificación del tratamiento de la fibrilación auricular / Multidetector computed tomography in planning the treatment of atrial fibrillation

OBJETIVOS: Conocer la anatomía de las venas pulmonares (VVPP) mediante tomografía computarizada multidetector (TCMD) en pacientes con fibrilación auricular (FA) antes de la ablación. MATERIAL Y MÉTODOS: Realizamos TCMD a 89 pacientes con FA analizando número, variantes y venas accesorias pulmonares, diámetro y forma ostia, distancia a la primera bifurcación y trombo en la orejuela izquierda. RESULTADOS: El patrón venoso pulmonar más frecuente fue 4 VVPP (dos derechas y dos izquierdas) en 49 pacientes (55,1%). Las VVPP superiores presentaron mayor diámetro ostial que las inferiores [vena pulmonar superior derecha (VPSD)> vena pulmonar inferior derecha (VPID); p = 0,001 y vena pulmonar superior izquierda (VPSI)> vena pulmonar inferior izquierda (VPII); p <0,001]. El diámetro ostial de las VVPP derechas era mayor que el de las izquierdas (VPSD> VPSI; p <0,001 y VPID> VPII; p <0,001). El ostium más circular lo presentó la VPID (ratio: 0,885) respecto a la VPII (p <0,001) y a la VPSI (p <0,001). La distancia a la primera bifurcación ha sido mayor en las venas superiores (VPSD> VPID; p = 0,008 y VPSI> VPII; p = 0,038). La distancia a la primera bifurcación fue mayor en las VVPP izquierdas (VPSI> VPSD; p <0,001 y VPII> VPID; p <0,001). Otros hallazgos fueron: divertículos (30), apéndices auriculares accesorios (5), aneurismas septales (8), bolsas septales (6) y 1 trombo en la orejuela izquierda. CONCLUSIÓN: La TCMD antes de la ablación demuestra la anatomía de la aurícula izquierda (AI) y de las VVPP con diferencias significativas entre los diámetros y morfología de los ostia venosos

OBJECTIVE: To know the anatomy of the pulmonary veins (PVs) by multidetector computed tomography (MDCT) in patients with atrial fibrillation (AF) prior to ablation. MATERIALS AND METHODS: MDCT was performed in 89 patients with AF, analyzing the number of PVs, accessory variants and veins, diameter and ostial shape, distance to the first bifurcation and thrombus in the left atrial appendage. RESULTS: The most frequent venous pattern was 4 PVs (two right and two left) in 49 patients (55.1%). The superior veins had a statistically significant greater mean ostial diameter than the inferior veins (Right Superior Pulmonary Vein (RSPV)> Right Inferior Pulmonary Vein (RIPV); p = 0.001 and Left Superior Pulmonary Vein (LSPV)> Left Inferior Pulmonary Vein (LIPV); p < 0.001). The right pulmonary veins ostial diameters were significantly larger than the left pulmonary veins ostial diameters (RSPV> LSPV; p < 0.001 and RIPV> LIPV; p < 0.001). The most circular ostium was presented by the VPID (ratio: 0.885) compared to the LIPV (p<00.1) and LSPV (p < 0.001). The superior veins had a statistically significant greater mean distance to first bifurcation than the inferior veins (RSPV> RIPV; p = 0.008 and LSPV> LIPV; p = 0.038). Mean distance to first bifurcation has been greater in left PVs respect to the right PVs (LSPV> RSPV; p < 0.001and LIPV> RIPV; p < 0.001). Other findings found in AI: diverticula (30), accessory auricular appendages (5), septal aneurysms (8), septal bags (6) and 1 thrombus in the left atrial appendage. CONCLUSION: MDCT prior to ablation demonstrates the anatomy of the left atrium (LA) and pulmonary veins with significant differences between the diameters and morphology of the venous ostia

Multidetector computed tomography in planning the treatment of atrial fibrillation. / Tomografía computarizada multidetector en la planificación del tratamiento de la fibrilación auricular.

OBJECTIVE: To know the anatomy of the pulmonary veins (PVs) by multidetector computed tomography (MDCT) in patients with atrial fibrillation (AF) prior to ablation. MATERIALS AND METHODS: MDCT was performed in 89 patients with AF, analyzing the number of PVs, accessory variants and veins, diameter and ostial shape, distance to the first bifurcation and thrombus in the left atrial appendage. RESULTS: The most frequent venous pattern was 4 PVs (two right and two. left) in 49 patients (55.1%). The superior veins had a statistically significant greater mean ostial diameter than the inferior veins (Right Superior Pulmonary Vein (RSPV)> Right Inferior Pulmonary Vein (RIPV); p=0.001 and Left Superior Pulmonary Vein (LSPV)> Left Inferior Pulmonary Vein (LIPV); p<0.001). The right pulmonary veins ostial diameters were significantly larger than the left pulmonary veins ostial diameters (RSPV> LSPV; p<0.001 and RIPV> LIPV; p<0.001). The most circular ostium was presented by the VPID (ratio: 0.885) compared to the LIPV (p<00.1) and LSPV (p<0.001). The superior veins had a statistically significant greater mean distance to first bifurcation than the inferior veins (RSPV> RIPV; p=0.008 and LSPV> LIPV; p=0.038). Mean distance to first bifurcation has been greater in left PVs respect to the right PVs (LSPV> RSPV; p<0.001and LIPV> RIPV; p<0.001). Other findings found in AI: diverticula (30), accessory auricular appendages (5), septal aneurysms (8), septal bags (6) and 1 thrombus in the left atrial appendage. CONCLUSION: MDCT prior to ablation demonstrates the anatomy of the left atrium (LA) and pulmonary veins with significant differences between the diameters and morphology of the venous ostia.

Motivación en la práctica del judo en deportistas no profesionales / Motivation of judo practice in non-professional athlete

El presente estudio tiene como objetivo determinar y analizar las relaciones y diferencias existentes entre el clima motivacional, en base al nivel competitivo en judocas no profesionales. Participaron un total de 121 judocas chilenos no profesionales (70 hombres y 51 mujeres) con edades comprendidas entre los 18 y 40 años, provenientes de siete clubes de judo. Completaron una hoja de autoregistro de variables sociodemográficas y un cuestionario de clima motivacional (PMCSQ-2). Los resultados indican que en los judocas aficionados predomina el clima tarea y a medida que se asciende en el nivel, en deportistas amateurs cobra una mayor importancia el clima ego. Como principal conclusión destaca que los judocas amateurs distinguen en mayor proporción la diferencia entre la superación personal y el esfuerzo (clima tarea) y demuestran mayor habilidad física que los demás. Al contrario que sucede en los aficionados, donde la correlación entre ambos es inferior, aunque sigue siendo negativa

The aim of this study is to determine and analyse the relationships and differences in the motivational climate, based on the competitive level in non-professional judokas. A sample of 121 non-professional Chilean judokas (70 men and 51 women) aged between 18 and 40, coming from seven different judo clubs took part. They completed a self-registration sheet of sociodemographic variables and a motivational climate questionnaire (PMCSQ-2). The results indicate that the task goal orientation prevails in non-professional judokas and as the level rises, in amateur athletes the ego goal orientation takes on greater importance. The main deduction is that amateur judokas distinguish in a greater proportion between personal improvement and effort (task goal orientation) and show a greater physical ability than others.This is opposed to what happens with non-professionals, where the correlation between both is lower, although still negative

Incidence, outcomes, and associated factors of isolated striatocapsular infarct after mechanical thrombectomy. / Incidencia, pronóstico y factores asociados al infarto estriatocapsular aislado tras trombectomía mecánica.

OBJECTIVES: To describe baseline and procedural characteristics and clinical outcomes of isolated striatocapsular infarct (iSCI) after mechanical thrombectomy in patients with large-vessel occlusion of the anterior cerebral circulation andits clinical outcome. METHODS: We performed a longitudinal study including all patients treated with mechanical thrombectomy at our centre between 2015 and 2017; patients were divided into 2 groups (iSCI and non-iSCI) according to whether they presented iSCI in a control CT scan at 24h. RESULTS: Of the 83 patients identified, 22.9% developed an iSCI. There were no statically significant differences in baseline characteristics or in reperfusion times. Patients presenting iSCI showed better collateral circulation and better reperfusion rates in the bivariate analysis. No significant difference was observed for mortality at discharge or at 3 months, or for functional prognosis at 3 months. CONCLUSIONS: Even if successful reperfusion is achieved, iSCI is a common sequela, independently of reperfusion time, especially in patients with good collateral circulation.

[Influence of mechanical thrombectomy on the incidence of isolated striatocapsular infarction and a description of its clinical characteristics]. / Influencia de la trombectomia mecanica en la incidencia de infarto estriatocapsular aislado y descripcion de sus caracteristicas clinicas.

INTRODUCTION: The great vulnerability of the striatocapsular region to ischaemia means that mechanical thrombectomy has its limitations in occlusions of large-calibre vessels when it comes to preventing the striatocapsular region from undergoing infarction. AIMS: To analyse the effect of endovascular treatment on the incidence of isolated striatocapsular infarction (iSCI) and to describe its clinical characteristics. PATIENTS AND METHODS: We conducted a retrospective study to analyse the incidence of iSCI following treatment of cerebral reperfusion. The baseline and clinical characteristics of the patients identified with iSCI and the incidence of iSCI is compared between two groups according to the availability of mechanical thrombectomy: one (pre-thrombectomy group) that received intravenous fibrinolysis as the only treatment for cerebral reperfusion available in that moment; and another (post-thrombectomy group) that received a mechanical thrombectomy with or without intravenous fibrinolysis. RESULTS: Of the 390 patients who received reperfusion, 8.2% had iSCI. Of the 135 patients treated with intravenous fibrinolysis, 4.4% (n = 6) developed iSCI (pre-thrombectomy group), and of the 255 patients treated in the post-thrombectomy group, iSCI was observed in 10.2%. The statistical analysis of the incidence of iSCI between the two groups showed significant differences (p = 0.034). A sensory-motor clinical picture was the most frequent among the patients with iSCI (63.33%), with a frequency of cortical symptoms of 55.17%. CONCLUSIONS: According to the data, there has been an increase in the incidence of iSCI in our setting following the establishment of mechanical thrombectomy.

TITLE: Influencia de la trombectomia mecanica en la incidencia de infarto estriatocapsular aislado y descripcion de sus caracteristicas clinicas.Introduccion. La gran vulnerabilidad a la isquemia de la region estriatocapsular hace que la trombectomia mecanica tenga sus limitaciones en las oclusiones de vaso de gran calibre a la hora de evitar que la region estriatocapsular se infarte. Objetivos. Analizar el efecto del tratamiento endovascular en la incidencia de infarto estriatocapsular aislado (IECa) y describir sus caracteristicas clinicas. Pacientes y metodos. Estudio retrospectivo en el que se analiza la incidencia de IECa tras el tratamiento de reperfusion cerebral. Se describen las caracteristicas basales y clinicas de los pacientes identificados con IECa y se compara la incidencia del IECa entre dos grupos segun la disponibilidad de trombectomia mecanica: uno (grupo pretrombectomia) que recibio fibrinolisis intravenosa como unico tratamiento de reperfusion cerebral disponible en ese momento, y otro (grupo postrombectomia) que recibio trombectomia mecanica con o sin fibrinolisis intravenosa. Resultados. Del total de 390 pacientes reperfundidos, un 8,2% tuvo un IECa. De 135 pacientes tratados con fibrinolisis intravenosa, un 4,4% (n = 6) desarrollo un IECa (grupo pretrombectomia), y de 255 pacientes tratados en el grupo postrombectomia, se visualizo IECa en un 10,2%. El analisis estadistico de la incidencia de IECa entre ambos grupos mostro diferencias significativas (p = 0,034). La clinica sensomotora fue la mas frecuente entre los pacientes con IECa (63,33%), con una frecuencia de sintomas corticales de un 55,17%. Conclusiones. Segun los datos, hemos presenciado un aumento en la incidencia de IECa en nuestro medio tras la instauracion de la trombectomia mecanica.

[Signs predicting early growth of intracerebral haemorrhage in computer tomography without enhancement and mortality]. / Signos predictores de crecimiento precoz de la hemorragia intracerebral en la tomografia computarizada sin contraste y mortalidad.

INTRODUCTION: Intracerebral haemorrhage is associated with high morbidity and mortality, and an increase in its volume in the early phases entails a poorer prognosis. The blend sign, the heterogeneous density, the irregular morphology and a fluid level in the haematoma are related to an early growth of the haematoma. AIM: To determine whether these four characteristics are associated with greater mortality at 7, 30 and 90 days of the occurrence of the intracerebral haemorrhage. PATIENTS AND METHODS: A retrospective cohort study that included all the patients attended in our hospital between 2010 and 2015 for spontaneous intracerebral haemorrhage with a computed tomography brain scan performed in the first six hours following the onset of symptoms. RESULTS: Of the 158 patients included in the sample, 23 (14.6%) presented blend sign; 39 (24.7%), heterogeneity; 53 (33.5%), irregularity; and 33 (20.9%), fluid level. In the bivariate analysis, only heterogeneity and irregularity were associated with increased mortality at 7, 30 and 90 days. In the multivariate logistic regression analysis, previous treatment with an antiplatelet drug, a score on the Glasgow Coma Scale below 13 and irregularity were associated with higher mortality in the first seven days. CONCLUSION: The study shows an association between irregularity of the haematoma and mortality in the first seven days. Irregularity would allow identification of patients with a more unfavourable prognosis; in these cases, strict surveillance, especially of factors related to the growth of the haematoma, could improve their prognosis.

TITLE: Signos predictores de crecimiento precoz de la hemorragia intracerebral en la tomografia computarizada sin contraste y mortalidad.Introduccion. La hemorragia intracerebral esta asociada a una elevada morbimortalidad y su aumento de volumen en fases iniciales conlleva un peor pronostico. El signo de la mezcla, la densidad heterogenea, la morfologia irregular y un nivel liquido en el hematoma se relacionan con un crecimiento precoz del hematoma. Objetivo. Determinar si esas cuatro caracteristicas se asocian a una mayor mortalidad a los 7, 30 y 90 dias de ocurrida la hemorragia intracerebral. Pacientes y metodos. Estudio de cohortes retrospectivo que incluyo a todos los pacientes atendidos en nuestro hospital, entre 2010 y 2015, por una hemorragia intracerebral espontanea con tomografia computarizada cerebral realizada en las primeras seis horas tras el inicio de los sintomas. Resultados. De los 158 pacientes incluidos, 23 (14,6%) presentaban signo de la mezcla, 39 (24,7%) heterogeneidad, 53 (33,5%) irregularidad y 33 (20,9%) nivel liquido. En el analisis bivariante, solo la heterogeneidad y la irregularidad se asociaron a mayor mortalidad a los 7, 30 y 90 dias. En el analisis por regresion logistica multivariante, el tratamiento previo con antiagregante plaquetario, una puntuacion en la escala de coma de Glasgow menor de 13 y la irregularidad se asociaron a una mayor mortalidad en los siete primeros dias. Conclusion. El estudio muestra asociacion entre la irregularidad del hematoma y la mortalidad en los siete primeros dias. La irregularidad permitiria identificar a pacientes con peor pronostico, en los que una vigilancia estricta, especialmente de factores relacionados con el crecimiento del hematoma, podria mejorar su pronostico.

Diagnóstico por la imagen en neuroftalmología / Diagnostic imaging in neuro-ophthalmology

La neuroftalmología es la parte de la neurología y la oftalmología que se encarga del estudio de las enfermedades que afectan al sistema visual y a los mecanismos que controlan la motilidad ocular y la función pupilar. Las pruebas de imagen permiten realizar una adecuada valoración anatómica y patológica de las estructuras que conforman la vía visual, los nervios que controlan la motilidad ocular y pupilar, y las propias estructuras orbitarias. Este artículo se divide en tres apartados (recuerdo anatómico, técnicas de imagen apropiadas y valoración patológica en función de la sintomatología clínica) con el propósito de proporcionar herramientas útiles que permitan al radiólogo elegir en cada momento la técnica de imagen más adecuada para el correcto diagnóstico de las enfermedades y un ajustado diagnóstico diferencial

Neuro-ophthalmology is a field combining neurology and ophthalmology that studies diseases that affect the visual system and the mechanisms that control eye movement and pupil function. Imaging tests make it possible to thoroughly assess the relevant anatomy and disease of the structures that make up the visual pathway, the nerves that control eye and pupil movement, and the orbital structures themselves. This article is divided into three sections (review of the anatomy, appropriate imaging techniques, and evaluation of disease according to clinical symptoms), with the aim of providing useful tools that will enable radiologists to choose the best imaging technique for the differential diagnosis of patients’ problems to reach the correct diagnosis of their disease

Correlación de hallazgos preoperatorios en la tomografía axial computarizada con la presencia de vía aérea difícil en pacientes intervenidos mediante cirugía otorrinolaringológica de cabeza y cuello / Correlation of preoperative findings in computed axial tomography with the presence of difficult airway in patients undergoing head and neck otorhinolaryngological surgery

Objetivos: Establecer una correlación entre 4 mediciones realizadas en la tomografía axial computarizada preoperatoria y la presencia de vía aérea difícil, y con la predicción clínica de la misma, en pacientes intervenidos mediante cirugía otorrinolaringológica. Material y métodos: Se realizó un estudio observacional, retrospectivo, usando como fuente de información las historias clínicas de 104 pacientes intervenidos bajo anestesia general e intubación endotraqueal por enfermedad oncológica durante un periodo de 36 meses. Sobre la base de los hallazgos obtenidos en las pruebas de imagen preoperatorias se realiza un análisis de regresión logística multivariante, donde las variables dependientes son grados extremos de visualización de la glotis (Cormack III-IV) o la presencia de predictores de intubación dificultosa (Mallampati III-IV). Se introdujeron en dicho modelo un total de 4 factores tomográficos y clínicos de vía aérea difícil. Resultados: En el grupo Cormack III-IV, en el modelo multivariante los resultados no fueron estadísticamente significativos cuando se comparaban con los predictores tomográficos (p>0,05; IC 95% distancia de la epiglotis a la pared faríngea posterior 0,030-2,31; distancia de la base de la lengua a la pared faríngea posterior 0,018-1,37). En el grupo Mallampati III-IV, en el modelo multivariante únicamente la distancia de las cuerdas vocales a la pared faríngea posterior muestra resultados clínicamente significativos (p<0,05; IC 95% 0,104-8,53). Conclusiones: En el abordaje de la vía aérea actualmente nos podemos apoyar en los predictores correspondientes al examen físico para adelantarnos a situaciones que pongan en riesgo la oxigenación y la ventilación de nuestros pacientes. Aunque aún los datos son insuficientes para recomendar las pruebas de imagen en este ámbito, parece que en un futuro pueden sumarse al examen físico para aumentar el rendimiento diagnóstico

Objectives: To establish a correlation between 4 measurements made on preoperative computed axial tomography and the presence of difficult airway, as well as its clinical prediction in patients undergoing otorhinolaryngological surgery. Material and methods: A retrospective, observational study was carried out using the information gathered from the clinical notes of 104 patients undergoing general anaesthesia and endotracheal intubation for oncological otorhinolaryngological surgery over a period of 36 months. Based on the findings in the preoperative imaging tests, a multivariate logistic regression analysis was performed, where the dependent variable was the presence of extreme grades of visualization of the glottis visualisation (Cormack III-IV) or the presence of predictors of difficult intubation (Mallampati III-IV). This resulted in a total of 4 tomographic and clinical factors of difficult airway being introduced in this model. Results: In the Cormack III-IV group, the results were not statistically significant in the multivariate model when compared to the tomography predictors, distance from epiglottis to posterior pharyngeal wall (95% CI; 0.030 - 2.31, P<.05), and the distance from the base of the tongue to the posterior pharyngeal wall (95% CI; 0.018-1.37, P<.05). In the Mallampati III-IV group, in the multivariate model only the distance from the vocal cords to the posterior pharyngeal wall showed clinically significant results (95% CI; 0.104 - 8.53, P<.05). Conclusions: In the approach to the airway, reliance on predictors is based on physical examination to anticipate situations that put oxygenation and ventilation of the patients at risk. There are still insufficient data to recommend imaging tests in this area, however it seems that in the future they may be added to the diagnostic performance of physical examination as predictors of difficult airway

Correlation of preoperative findings in computed axial tomography with the presence of difficult airway in patients undergoing head and neck otorhinolaryngological surgery. / Correlación de hallazgos preoperatorios en la tomografía axial computarizada con la presencia de vía aérea difícil en pacientes intervenidos mediante cirugía otorrinolaringológica de cabeza y cuello.

OBJECTIVES: To establish a correlation between 4 measurements made on preoperative computed axial tomography and the presence of difficult airway, as well as its clinical prediction in patients undergoing otorhinolaryngological surgery. MATERIAL AND METHODS: A retrospective, observational study was carried out using the information gathered from the clinical notes of 104 patients undergoing general anaesthesia and endotracheal intubation for oncological otorhinolaryngological surgery over a period of 36 months. Based on the findings in the preoperative imaging tests, a multivariate logistic regression analysis was performed, where the dependent variable was the presence of extreme grades of visualization of the glottis visualisation (Cormack III-IV) or the presence of predictors of difficult intubation (Mallampati III-IV). This resulted in a total of 4 tomographic and clinical factors of difficult airway being introduced in this model. RESULTS: In the Cormack III-IV group, the results were not statistically significant in the multivariate model when compared to the tomography predictors, distance from epiglottis to posterior pharyngeal wall (95% CI; 0.030 - 2.31, P<.05), and the distance from the base of the tongue to the posterior pharyngeal wall (95% CI; 0.018-1.37, P<.05). In the Mallampati III-IV group, in the multivariate model only the distance from the vocal cords to the posterior pharyngeal wall showed clinically significant results (95% CI; 0.104 - 8.53, P<.05). CONCLUSIONS: In the approach to the airway, reliance on predictors is based on physical examination to anticipate situations that put oxygenation and ventilation of the patients at risk. There are still insufficient data to recommend imaging tests in this area, however it seems that in the future they may be added to the diagnostic performance of physical examination as predictors of difficult airway.

Diagnostic imaging in neuro-ophthalmology. / Diagnóstico por la imagen en neuroftalmología.

Neuro-ophthalmology is a field combining neurology and ophthalmology that studies diseases that affect the visual system and the mechanisms that control eye movement and pupil function. Imaging tests make it possible to thoroughly assess the relevant anatomy and disease of the structures that make up the visual pathway, the nerves that control eye and pupil movement, and the orbital structures themselves. This article is divided into three sections (review of the anatomy, appropriate imaging techniques, and evaluation of disease according to clinical symptoms), with the aim of providing useful tools that will enable radiologists to choose the best imaging technique for the differential diagnosis of patients' problems to reach the correct diagnosis of their disease.

Migrations, admixture and genetic diversity in Central Argentinian Patagonia: analysis of autosomal Alu polymorphisms / Migraciones, mestizaje y diversidad genética en la Patagonia Central Argentina: análisis de polimorfismos autosómicos Alu

This study aimed to analyze autosomal Alu insertions in three localities from Patagonia Argentina belonging to the Andes region and the coast of the Chubut province. Knowledge of the genetic diversity of these populations, along with the genealogical data, will contribute to better understand historical information, differential migration process and bio-demographic composition of the Central Patagonia region. In order to achieve this objective, 16 autosomal Alu insertion polymorphisms were genotyped: ACE, APO-A1, TPA25, FXIIIB, A25, HS4.32, D1, HS4.69, HS2.43, Sb19.12, Yb8NBC120, Sb19.3, Yb8NBC125, Ya5NBC221, DM, and CD4. Our results showed that the Central Patagonia region presents a complex continental genetic admixture with marked Native American roots (39% ± 1.2), Eurasian (56% ± 1.73) and, to a lesser extent, African (5% ± 1.7). The genetic proximity of the Patagonian samples in relation to groups from Europe and Northern Africa, but with a displacement towards the native communities, constitutes a clear indicator of the differential admixture process that took place in different regions of Argentina. Moreover, genetic differences were observed between Patagonian localities and Bahía Blanca (Central region of Argentina). These observations warned us that population genetic constitution analysis cannot be approached without bearing in mind the regional particularities, which are the result of the different historical, migratory, social-economic and demographic processes that occurs in the country.

Este estudio tiene como objetivo el análisis de las inserciones autosómicas Alu en tres localidades de la Patagonia argentina localizadas en la región andina y costera de la provincia de Chubut. El conocimiento de la diversidad genética de estas poblaciones, junto con los datos genealógicos, contribuirán a una mejor comprensión de la información histórica, los procesos migratorios diferenciales y la composición bio-demográfica de la región central Patagónica. Para alcanzar este objetivo se analizaron 16 polimorfismos autosómicos de inserción Alu: ACE, APO-A1, TPA25, FXIIIB, A25, HS4.32, D1, HS4.69, HS2.43, Sb19.12, Yb8NBC120, Sb19.3, Yb8NBC125, Ya5NBC221, DM y CD4. Nuestros resultados mostraron que la región central Patagónica presenta una mezcla genética continental compleja de marcadas raíces nativo americanas 39% (± 1.2), eurasiáticas 56% (± 1.73) y, en menor medida, africanas 5% (± 1.7). La proximidad genética de las muestras patagónicas a los grupos de Europa y del Norte de África, pero con un mayor desplazamiento hacia las comunidades nativas, constituye un claro indicador del proceso de mezcla diferencial que tuvo lugar en las distintas regiones de la Argentina. Por otra parte, las diferencias genéticas observadas entre las localidades de Patagonia y Bahía Blanca (región central de la Argentina), nos advierten que no puede analizarse la constitución genética de las poblaciones sin tener en cuenta las particularidades regionales, que son el resultado de los diferentes procesos históricos, migratorios, socio-económicos y demográficos que ocurrieron en el interior del país.

Prevalencia de sarcopenia en una unidad de media y larga estancia / Prevalence of sarcopenia in a media and long stay Unit

Antecedentes. La sarcopenia se caracteriza por la pérdida de masa y fuerza muscular esquelética y representa un factor de riesgo de fragilidad, pérdida de independencia y discapacidad física. Este estudio pretende valorar la prevalencia de sarcopenia en una población de pacientes ingresados en una unidad de media-larga estancia. Pacientes y métodos. Estudio descriptivo, longitudinal y observacional que incluyó a 166 pacientes mayores de 18 años ingresados de forma consecutiva durante un año para tratamiento paliativo, convalecencia o rehabilitación. Se registraron datos administrativos y antropométricos. La detección de sarcopenia se realizó mediante la valoración de la fuerza muscular en cintura escapular y pélvica, fuerza prensil en manos, masa muscular y de la capacidad funcional física. Resultados. La prevalencia global de sarcopenia fue del 77,6%. La mayor parte de los pacientes con sarcopenia presentaban sarcopenia severa (91,2%), con los 3 parámetros valorados disminuidos: fuerza muscular (88,2%), masa muscular (85,5%) y rendimiento físico (94,70%). Conclusiones. La prevalencia de sarcopenia en los pacientes ingresados en nuestra unidad de media-larga estancia es muy elevada, superior a la descrita en población no institucionalizada, y con frecuencia tiene un grado importante de severidad (AU)

Background. Sarcopenia is characterized by the loss of skeletal muscle mass and strength and represents a risk factor for frailty, loss of independence and physical disabilities. This study aimed to assess the prevalence of sarcopenia in a population of patients admitted to a media and long-stay unit. Patients and methods. Descriptive, cross-sectional observational study that included 166 patients over 18 years who were admitted consecutively for a year to palliative care, convalescence or rehabilitation. Administrative and anthropometric data were recorded. Sarcopenia detection was performed by assessing the strength in the scapular and pelvic girdle muscles, grip strength in the hands, muscle mass and physical functional capacity. Results. The overall prevalence of sarcopenia was 77.6%. Most patients had severe sarcopenia (91.2%), with reduced levels of the 3 assessed parameters: muscle strength (88.2%), muscle mass (85.5%) and physical performance (94.70%). Conclusion. The prevalence of sarcopenia in patients admitted to our media and long-stay unit is higher than that reported in noninstitutionalized populations, and often has a significant degree of severity (AU)

Prevalence of sarcopenia in a media and long stay Unit. / Prevalencia de sarcopenia en una unidad de media y larga estancia.

BACKGROUND: Sarcopenia is characterized by the loss of skeletal muscle mass and strength and represents a risk factor for frailty, loss of independence and physical disabilities. This study aimed to assess the prevalence of sarcopenia in a population of patients admitted to a media and long-stay unit. PATIENTS AND METHODS: Descriptive, cross-sectional observational study that included 166 patients over 18 years who were admitted consecutively for a year to palliative care, convalescence or rehabilitation. Administrative and anthropometric data were recorded. Sarcopenia detection was performed by assessing the strength in the scapular and pelvic girdle muscles, grip strength in the hands, muscle mass and physical functional capacity. RESULTS: The overall prevalence of sarcopenia was 77.6%. Most patients had severe sarcopenia (91.2%), with reduced levels of the 3 assessed parameters: muscle strength (88.2%), muscle mass (85.5%) and physical performance (94.70%). CONCLUSION: The prevalence of sarcopenia in patients admitted to our media and long-stay unit is higher than that reported in noninstitutionalized populations, and often has a significant degree of severity.

Multimodality management of a locally advanced primary oesophageal melanoma with radical surgery and adjuvant chemoimmunoradiotherapy.

We present the case of a 46-year-old woman diagnosed with a primary oesophageal melanoma (PEM), who was treated with radical surgery followed by combined chemoimmunotherapy (interferon, carboplatin, dacarbazine and external radiotherapy) and who achieved a complete response after this treatment. PEMs are rare malignancies, with less than 300 cases described in the literature. The main differential diagnosis is with metastases of skin or ocular malignant melanomas. They are usually diagnosed at advanced stages and prognosis is typically poor. The main treatment modality should be radical surgery. The role of adjuvant treatment is uncertain, although some long responses have been seen with the use of chemotherapy or immunotherapy alongside surgery.

Multimodality management of a locally advanced primary oesophageal melanoma with radical surgery and adjuvant chemoimmunoradiotherapy

We present the case of a 46-year-old woman diagnosed with a primary oesophageal melanoma (PEM), who was treated with radical surgery followed by combined chemoimmunotherapy (interferon, carboplatin, dacarbazine and external radiotherapy) and who achieved a complete response after this treatment. PEMs are rare malignancies, with less than 300 cases described in the literature. The main differential diagnosis is with metastases of skin or ocular malignant melanomas. They are usually diagnosed at advanced stages and prognosis is typically poor. The main treatment modality should be radical surgery. The role of adjuvant treatment is uncertain, although some long responses have been seen with the use of chemotherapy or immunotherapy alongside surgery (AU)

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