Molecular characterization of Passiflora edulis f. flavicarpa Degener with ISSRs markers.

Passiflora edulis it is a specie widely distributed and cultivated in Colombia, with economic potential. Although there is a wide genetic and phenotypic variability, it has not yet been explored through the use of molecular techniques. This study aimed to characterize the structure and genetic diversity of P. edulis cultivars using ISSR markers. The study was carried out using leaf samples from 21 cultivars of P. edulis collected within a productive system in the department of Boyacá, Colombia, using seven ISSR primers. Genetic similarity was used to cluster by the UPGMA method, polymorphic information content (PIC), expected heterozygosity (He), Shannon index (I), gene flow (Nm), and coefficient of genetic differentiation (Gst) were estimated using POPGENE and TFPGA software. The Bayesian model and analysis of molecular variance (AMOVA) were used to assess the genetic structure. Cultivars of P. edulis showed high polymorphism rates. Seven ISSR produced 138 loci. The cluster analysis formed two groups according to the genetic similarity and phenotypic characteristics associated mainly with the fruit. The average value of expected heterozygosity was 0.29 for the total population and 0.27 and 0.22 for groups I and II, respectively. AMOVA indicates higher diversity within groups, but not between groups showing levels of hierarchy different from those considered in this study. Moderate genetic differentiation (Gst=0.12) and high gene flow (Nm=3.91) are observed.

Tarsal tunnel ganglion cyst: intraneural or extraneural site?

Intraneural ganglion cysts are very uncommon lesions, whose diagnosis has increased since the articular theory and the description of the MRI findings were established. We present a case report of a 59-year-old man with symptoms of tarsal tunnel syndrome. Foot and ankle MRI demonstrated the presence of an intraneural cystic lesion in the posterior tibial neve and its connection with the subtalar joint through an articular branch. The identification of the specific radiological signs like the «signet ring sign¼ allowed establishing an adequate preoperative diagnosis, differentiating it from an extraneural lesion and facilitating the articular disconnection of the nerve branch during surgery.

Characterization of yellow pitahaya (Selenicereus megalanthus Haw.) genotypes under two productive systems in Colombia.

Selenicereus megalanthus Haw. It is an exotic fruit tree, with productive and nutritional potential. In Colombia, there is a great phenotypic and genotypic diversity, but its genetic studies are scarce. The objective was to characterize morphologically 15 selected yellow pitahaya genotypes, under two productive systems in the open field and under cover, in the municipalities of Miraflores and Zetaquira, in Boyacá, Colombia. Quantitative characters were evaluated: plant height (PH), number of vegetative sprouts (NVS), sub-sprouts (SS), longest sprouts length (LSL), distance between areoles (DBA), width of the ribs in the apical region (WRA), width of the ribs in the middle region (WRM), width of the ribs in the basal region (WRB), height of undulations between successive areoles in a rib (HUA), number of spines per areole (NSA) and longest spine length (LSP). The results showed under the two productive systems and the evaluated localities that the variables with the highest coefficient of variation (greater than 90%) were the number of sub-sprouts, height of the undulations between successive areoles (HUA) and the longest spine length (LSP). High positive correlations were obtained between the distances areoles, the width of the ribs and the length of the spines (r>0.7). The conglomerate showed that the characteristics that define the groupings are height of the plant, the texture of the cladodes, the width of the ribs and the height of the undulations. Characters associated with the shoots and cladodes were identified, which directly influence the vegetative propagation and therefore the yield of the yellow pitahaya.

Manejo anestésico del déficit de glucosa 6-fosfato deshidrogenasa / Anesthetic management of glucose 6-phosphate dehydrogenase deficiency

El déficit de glucosa 6-fosfato deshidrogenasa es la enzimopatía más frecuente de los glóbulos rojos, contando con una prevalencia de 400 millones de personas en el mundo y una herencia ligada al cromosoma X, afectando sobre todo a varones. La glucosa 6-fosfato-deshidrogenasa participa en la vía de las pentosas-fosfato, encargada del metabolismo celular, y produciendo antioxidantes. Un déficit de esta enzima altera su capacidad de proteger a los hematíes del estrés oxidativo que producen ciertos medicamentos, condiciones metabólicas, infecciones y alimentos. Se requieren consideraciones anestésicas específicas para disminuir la morbimortalidad asociada a intervenciones médico-quirúrgicas en pacientes con esta enfermedad. En este artículo se expone el caso de un varón de 45 años con este déficit enzimático sometido a anestesia general combinada para resección anterior baja de recto programada.(AU)

Glucose 6-phosphate dehydrogenase deficiency is the most common enzyme disease of red blood cells, with around 400 million people suffering from it throughout the world and linked to the X chromosome inheritance, thus it predominantly affects men. Glucose 6-phosphate-dehydrogenase participates in the pentose-phosphate pathway, being responsible for cellular metabolism and the production of antioxidants. A deficiency of this enzyme alters its ability to protect red blood cells from oxidative stress caused by certain drugs, metabolic conditions, infections and food. Specific anesthetic considerations are required to reduce the morbidity and mortality associated with medical-surgical interventions in patients with this disease. This article presents the case of a 45-year-old man with Glucose 6-Phosphate Dehydrogenase deficiency who underwent combined general anesthesia for programmed low anterior resection of the rectum.(AU)

Anesthetic management of glucose 6-phosphate dehydrogenase deficiency.

Glucose 6-phosphate dehydrogenase deficiency is the most common enzyme disease of red blood cells, with around 400 million people suffering from it throughout the world and linked to the X chromosome inheritance, thus it predominantly affects men. Glucose 6-phosphate-dehydrogenase participates in the pentose-phosphate pathway, being responsible for cellular metabolism and the production of antioxidants. A deficiency of this enzyme alters its ability to protect red blood cells from oxidative stress caused by certain drugs, metabolic conditions, infections and food. Specific anesthetic considerations are required to reduce the morbidity and mortality associated with medical-surgical interventions in patients with this disease. This article presents the case of a 45-year-old man with glucose 6-phosphate dehydrogenase deficiency who underwent combined general anaesthesia for programmed low anterior resection of the rectum.

Afrosymetric method for quantifying saponins in Chenopodium Quinoa Willd. from Colombia.

Quinoa (Chenopodium quinoa Willd.) is a pseudocereal that, in addition to presenting good nutritional characteristics in the grain, has secondary metabolites in the episperm of the seeds and, within them, saponins. Saponins are characterized by being emulsifying, foaming and generating a bitter taste. This metabolite has not been completely studied in quinoa materials from Colombia. For this reason, the objective of this research was to quantify the content of saponins present in quinoa materials from the department of Boyacá using three afrosimetric methods. For this, a completely randomized design (CRD) was implemented with a factorial arrangement of 3 (afrosimetric methods) x 5 (quinoa materials). From the quantification of saponins, it was determined that the Amarilla de maranganí genotype, was the one that presented the highest content in all the evaluated methods; the standard afrosimetric method being the most efficient. Finally, the conglomerate analysis allowed to discriminate the materials in sweet quinoas such as Tunkahuan and Blanca de Jericó with saponin contents lower than 0.06%, and in bitter quinoas (Negra de la Colorada, Dorada and Amarilla de Maranganí) with contents higher than 0.11%. The biochemical characterization of the germplasm will allow a selection of genotypes suitable for consumption and for the industry, given the potential use that saponins currently have.

Detección de la interacción ácido acetilsalicílico – metamizol en pacientes de farmacia comunitaria / Screening for acetylsalicylic acid - metamizole interaction in community pharmacy patients

JUSTIFICACIÓN Y OBJETIVOS: Metamizol puede reducir el efecto del ácido acetilsalicílico (AAS) sobre la agregación plaquetaria cuando se administran concomitantemente. Por lo tanto, esta combinación se debe utilizar con precaución en pacientes que toman dosis bajas de AAS aspirina para cardioprotección. La elevada utilización de metamizol puede suponer una situación que favorezca la aparición de interacción farmacológica con AAS, fármaco ampliamente prescrito por su acción antiagregante plaquetaria. El objetivo de este estudio es describir los pacientes de farmacia comunitaria que pueden estar expuestos a la interacción AAS-metamizol e identificar aquellas situaciones en las que sería necesario intervenir de forma prioritaria.MÉTODOS: estudio observacional realizado en dos farmacias comunitarias de Málaga con los pacientes que acuden a por metamizol y/o AAS durante 3 meses (septiembre-octubre 2021). Se han registrado las interacciones farmacológicas (IF) con la ayuda de un programa informático que utiliza la base de datos del Consejo General de Colegios Oficiales de Farmacéuticos (CGCOF) y que es capaz de emitir una señal de alerta al farmacéutico ante asociaciones de medicamentos capaces de producir IF en el momento de la dispensación.RESULTADOS: se ha detectado esta IF en 34 pacientes, de los que un 29,4 % corresponde a hombres y un 70,6 % a mujeres. La media de edad ha sido de 69,9 (DE: 13,2), con un consumo medio de medicamentos de 9,3 (DE: 3,04). Todos los pacientes o cuidadores fueron informados de la existencia de la interacción, pero no se consiguió informar a los médicos de atención primaria. (AU)

Analysis of the genetic diversity of Dragon fruit based on ISSR markers in Colombia.

Selenicereus megalanthus H. is a tropical fruit belonging to the family Cactaceae, is rich in essential nutrients, antioxidants and bioactive components. It presents wide variability in different characteristics and a great demand in the market; however, genetic studies in Colombia are scarce. The main of this study was to characterize the genetic diversity of 76 yellow pitahaya genotypes with eight ISSR markers. Genetic parameters expected average heterozygosity (He), percentage of polymorphic loci, genetic distances and Fst were estimated with TFPGA. The analysis of the population genetic structure was carried out with the STRUCTURE 2.3.4. As a result, 225 alleles were generated and the number of polymorphic loci ranged 85 (CT, AG) to 90 (GT). High genetic diversity was found, with an average value of heterozygosity was 0.34 with a genetic differentiation coefficient (Fst) of 0.26, indicating that there was a great genetic diversity, similar values than those reported in other studies of pitahaya genetic diversity in Colombia. The 76 genotypes were grouped into K=3 according to geographic location, however, in some groups a mixture of individuals from different origins was observed. The analysis of molecular variance (AMOVA) showed higher variation (75%) within groups than among groups (25%). These results provide information that can be used to develop conservation strategies for dragon fruit and breeding programs to obtain more productive pitahaya genotypes with superior quality, high yield and with resistance to biotic and abiotic factors.

Analysis of the genetic diversity of Dragon fruit based on ISSR markers in Colombia

Abstract Selenicereus megalanthus H. is a tropical fruit belonging to the family Cactaceae, is rich in essential nutrients, antioxidants and bioactive components. It presents wide variability in different characteristics and a great demand in the market; however, genetic studies in Colombia are scarce. The main of this study was to characterize the genetic diversity of 76 yellow pitahaya genotypes with eight ISSR markers. Genetic parameters expected average heterozygosity (He), percentage of polymorphic loci, genetic distances and Fst were estimated with TFPGA. The analysis of the population genetic structure was carried out with the STRUCTURE 2.3.4. As a result, 225 alleles were generated and the number of polymorphic loci ranged 85 (CT, AG) to 90 (GT). High genetic diversity was found, with an average value of heterozygosity was 0.34 with a genetic differentiation coefficient (Fst) of 0.26, indicating that there was a great genetic diversity, similar values than those reported in other studies of pitahaya genetic diversity in Colombia. The 76 genotypes were grouped into K=3 according to geographic location, however, in some groups a mixture of individuals from different origins was observed. The analysis of molecular variance (AMOVA) showed higher variation (75%) within groups than among groups (25%). These results provide information that can be used to develop conservation strategies for dragon fruit and breeding programs to obtain more productive pitahaya genotypes with superior quality, high yield and with resistance to biotic and abiotic factors.

Resumo Selenicereus megalanthus H. é uma fruta tropical pertencente à família Cactaceae, rica em nutrientes essenciais, antioxidantes e componentes bioativos. Apresenta grande variabilidade em diferentes características e uma grande demanda no mercado; no entanto, os estudos genéticos na Colômbia são escassos. O principal deste estudo foi caracterizar a diversidade genética de 76 genótipos de pitahaya amarela com oito marcadores ISSR. Parâmetros genéticos esperados de heterozigosidade média (He), porcentagem de locos polimórficos, distâncias genéticas e Fst foram estimados com TFPGA. A análise da estrutura genética da população foi realizada com a ESTRUTURA 2.3.4. Como resultado, 225 alelos foram gerados e o número de loci polimórficos variou de 85 (CT, AG) a 90 (GT). Foi encontrada alta diversidade genética, com um valor médio de heterozigosidade de 0,34 com coeficiente de diferenciação genética (Fst) de 0,26, indicando que havia uma grande diversidade genética, valores semelhantes aos relatados em outros estudos de diversidade genética de pitahaya na Colômbia. Os 76 genótipos foram agrupados em K = 3 de acordo com a localização geográfica, porém, em alguns grupos foi observada uma mistura de indivíduos de diferentes origens. A análise de variância molecular (AMOVA) mostrou maior variação (75%) dentro dos grupos do que entre os grupos (25%). Esses resultados fornecem informações que podem ser utilizadas para desenvolver estratégias de conservação da fruta do dragão e programas de melhoramento para a obtenção de genótipos de pitahaya mais produtivos, com qualidade superior, alto rendimento e com resistência a fatores bióticos e abióticos.

Analysis of the genetic diversity of Dragon fruit based on ISSR markers in Colombia / Análise da diversidade genética da fruta do dragão com base em marcadores ISSR na Colômbia

Selenicereus megalanthus H. is a tropical fruit belonging to the family Cactaceae, is rich in essential nutrients, antioxidants and bioactive components. It presents wide variability in different characteristics and a great demand in the market; however, genetic studies in Colombia are scarce. The main of this study was to characterize the genetic diversity of 76 yellow pitahaya genotypes with eight ISSR markers. Genetic parameters expected average heterozygosity (He), percentage of polymorphic loci, genetic distances and Fst were estimated with TFPGA. The analysis of the population genetic structure was carried out with the STRUCTURE 2.3.4. As a result, 225 alleles were generated and the number of polymorphic loci ranged 85 (CT, AG) to 90 (GT). High genetic diversity was found, with an average value of heterozygosity was 0.34 with a genetic differentiation coefficient (Fst) of 0.26, indicating that there was a great genetic diversity, similar values than those reported in other studies of pitahaya genetic diversity in Colombia. The 76 genotypes were grouped into K=3 according to geographic location, however, in some groups a mixture of individuals from different origins was observed. The analysis of molecular variance (AMOVA) showed higher variation (75%) within groups than among groups (25%). These results provide information that can be used to develop conservation strategies for dragon fruit and breeding programs to obtain more productive pitahaya genotypes with superior quality, high yield and with resistance to biotic and abiotic factors.

Selenicereus megalanthus H. é uma fruta tropical pertencente à família Cactaceae, rica em nutrientes essenciais, antioxidantes e componentes bioativos. Apresenta grande variabilidade em diferentes características e uma grande demanda no mercado; no entanto, os estudos genéticos na Colômbia são escassos. O principal deste estudo foi caracterizar a diversidade genética de 76 genótipos de pitahaya amarela com oito marcadores ISSR. Parâmetros genéticos esperados de heterozigosidade média (He), porcentagem de locos polimórficos, distâncias genéticas e Fst foram estimados com TFPGA. A análise da estrutura genética da população foi realizada com a ESTRUTURA 2.3.4. Como resultado, 225 alelos foram gerados e o número de loci polimórficos variou de 85 (CT, AG) a 90 (GT). Foi encontrada alta diversidade genética, com um valor médio de heterozigosidade de 0,34 com coeficiente de diferenciação genética (Fst) de 0,26, indicando que havia uma grande diversidade genética, valores semelhantes aos relatados em outros estudos de diversidade genética de pitahaya na Colômbia. Os 76 genótipos foram agrupados em K = 3 de acordo com a localização geográfica, porém, em alguns grupos foi observada uma mistura de indivíduos de diferentes origens. A análise de variância molecular (AMOVA) mostrou maior variação (75%) dentro dos grupos do que entre os grupos (25%). Esses resultados fornecem informações que podem ser utilizadas para desenvolver estratégias de conservação da fruta do dragão e programas de melhoramento para a obtenção de genótipos de pitahaya mais produtivos, com qualidade superior, alto rendimento e com resistência a fatores bióticos e abióticos.

¿Qué hemos aprendido de la notificación de incidentes de seguridad en el Bloque Quirúrgico?: estudio descriptivo transversal de 2 años de actividad de un grupo analizador multidisciplinar / What have we learned from reporting safety incidents in the Surgical Block?: Cross-sectional descriptive study of two-years of activity of a multidisciplinary analytical group

Antecedentes y objetivos: Los sistemas de notificación de incidentes (SNI) se consideran una herramienta que facilita el aprendizaje y la cultura de seguridad. Utilizando la experiencia adquirida con SENSAR, evaluamos la viabilidad y la actividad de un grupo multidisciplinar analizador de incidentes en el paciente quirúrgico notificados a un sistema general comunitario, el del Observatorio para la Seguridad del Paciente (OSP). Material y método: Estudio observacional descriptivo transversal planificado a 2 años. Previa formación en el análisis, se crea un grupo multidisciplinar en cuanto a especialidades y categorías profesionales, que analizarían los incidentes en el paciente quirúrgico notificados al OSP. Se clasifican los incidentes y se analizan sus circunstancias. Resultados: Entre los meses de marzo de 2015 y 2017 se notificaron 95 incidentes (4 por no profesionales). Los facultativos notificaron más que la enfermería, 54 (56,8%) vs. 37 (38,9%). La unidad que más notificó fue Anestesia con 46 (48,4%) (p=0,025). Los tipos de incidentes se relacionaron principalmente con el procedimiento asistencial (30,5%); el momento, con el preoperatorio (42,1%) y el lugar, con el área quirúrgica (48,4%), detectándose diferencias significativas en función de la filiación del notificante (p=0,03). No daño, o morbilidad menor, presentaron el 88% de los incidentes. Se identificaron errores en el 79%. El análisis de los incidentes dirigió las medidas a tomar. Conclusiones: La actividad que mantuvo el grupo multidisciplinar de análisis durante el periodo de estudio propició el conocimiento del sistema entre los profesionales y permitió identificar elementos de mejora en el Bloque Quirúrgico a diferentes niveles

Background and objectives: Incident Reporting Systems (IRS) are considered a tool that facilitates learning and safety culture. Using the experience gained with SENSAR, we evaluated the feasibility and the activity of a multidisciplinary group analyzing incidents in the surgical patient notified to a general community system, that of the Observatory for Patient Safety (OPS). Material and method: Cross-sectional observational study planned for two years. After training in the analysis, a multidisciplinary group was created in terms of specialties and professional categories, which would analyze the incidents in the surgical patient notified to the OPS. Incidents are classified and their circumstances analyzed. Results: Between March 2015 and 2017, 95 incidents were reported (4 by non-professionals). Doctors reported more than nurses, at 54 (56.84%) vs. 37 (38.94%). The anaesthesia unit reported most at 46 (48.42%) (P=.025). The types of incidents mainly related to the care procedure (30.52%); to the preoperative period (42.10%); and to the place, the surgical area (48.42%). Significant differences were detected according to the origin of the notifier (P=.03). No harm, or minor morbidity, constituted 88% of the incidents. Errors were identified in 79%. The analysis of the incidents directed the measures to be taken. Conclusions: The activity undertaken by the multidisciplinary analytical group during the period of study facilitated knowledge of the system among the professionals and enabled the identification of areas for improvement in the Surgical Block at different levels

What have we learned from reporting safety incidents in the Surgical Block?: Cross-sectional descriptive study of two-years of activity of a multidisciplinary analytical group. / ¿Qué hemos aprendido de la notificación de incidentes de seguridad en el Bloque Quirúrgico?: estudio descriptivo transversal de 2 años de actividad de un grupo analizador multidisciplinar.

BACKGROUND AND OBJECTIVES: Incident Reporting Systems (IRS) are considered a tool that facilitates learning and safety culture. Using the experience gained with SENSAR, we evaluated the feasibility and the activity of a multidisciplinary group analyzing incidents in the surgical patient notified to a general community system, that of the Observatory for Patient Safety (OPS). MATERIAL AND METHOD: Cross-sectional observational study planned for two years. After training in the analysis, a multidisciplinary group was created in terms of specialties and professional categories, which would analyze the incidents in the surgical patient notified to the OPS. Incidents are classified and their circumstances analyzed. RESULTS: Between March 2015 and 2017, 95 incidents were reported (4 by non-professionals). Doctors reported more than nurses, at 54 (56.84%) vs. 37 (38.94%). The anaesthesia unit reported most at 46 (48.42%) (P=.025). The types of incidents mainly related to the care procedure (30.52%); to the preoperative period (42.10%); and to the place, the surgical area (48.42%). Significant differences were detected according to the origin of the notifier (P=.03). No harm, or minor morbidity, constituted 88% of the incidents. Errors were identified in 79%. The analysis of the incidents directed the measures to be taken. CONCLUSIONS: The activity undertaken by the multidisciplinary analytical group during the period of study facilitated knowledge of the system among the professionals and enabled the identification of areas for improvement in the Surgical Block at different levels.

Sangrado posmenopáusico como estrategia de detección temprana de cáncer de endometrio / Postmenopausal bleeding as an early cancer detection strategy endometrium

Esta revisión sistemática y metanálisis evaluó los estudios observacionales que informan la prevalencia de la hemorragia posmenopáusica (HPM) en mujeres con cáncer de endometrio, así como el riesgo de cáncer de endometrio en mujeres con HPM en poblaciones no seleccionadas. El objetivo del estudio fue evaluar la prevalencia de HPM en mujeres con cáncer de endometrio y el riesgo de cáncer de endometrio en mujeres con HPM.

This systematic review and meta-analysis evaluated observational studies that report the prevalence of postmenopausal hemorrhage (MPH) in women with endometrial cancer, as well as the risk of endometrial cancer in women with MMP in unselected populations. The aim of the study was to assess the prevalence of MPH in women with endometrial cancer and the risk of endometrial cancer in women with HPM.

Resección de radios de la mano en pacientes pediátricos / Ray resection in paediatric population

Objetivo. Valoración de los resultados clínicos y funcionales de la resección completa de los radios de la mano en población pediátrica y descripción de los aspectos técnicos más relevantes de la cirugía. Material y método. Estudio retrospectivo observacional de pacientes intervenidos en el periodo comprendido entre 2010-2015. Criterios de inclusión: resección de uno o más radios de la mano y seguimiento mínimo de un año. Evaluación de las características clínicas, resultados funcionales y estéticos, complicaciones, necesidad de apoyo psicológico y grado de satisfacción. Resultados. Cuatro pacientes cumplieron criterios de inclusión. La edad media fue de 5 años (rango 1-14 años). Las causas fueron: hamartoma lipofibromatoso, amputación traumática, deficiencia radial y sindactilia compleja. El segundo radio fue resecado en tres pacientes y el tercer y cuarto radio en un paciente. No se realizó transferencia de radios adyacentes. No existieron complicaciones postoperatorias ni durante el seguimiento. Ningún paciente precisó ayuda psicológica. Todos presentaron excelentes resultados estéticos, funcionales y con un alto grado de satisfacción. Discusión. La resección completa de uno o más radios de la mano se utiliza como técnica de rescate en pacientes con lesiones vasculares, tumores, traumatismos, infecciones o malformaciones congénitas. Las publicaciones existentes son pequeñas series en pacientes adultos o casos clínicos aislados, no existiendo apenas referencias en población pediátrica. Conclusión. La resección de radios de la mano es una técnica útil y segura en la población pediátrica que proporciona excelentes resultados estéticos y funcionales en aquellos casos en los que es imposible la preservación de uno o varios dedos (AU)

Aim. Evaluation of clinical and functional outcome of ray resection in paediatric population and description of key aspects of surgical technique. Material and methods. We performed a retrospective review of all patients undergoing surgery between 2010-2015. Inclusion criteria: one or more ray resections of the hand and a minimum of one year follow-up. Evaluation of clinical characteristics, functional and cosmetic results, complications, need for psychological support and patient or family satisfaction. Results. Four patients met the inclusion criteria. The mean age at surgery was 5 years (range, 1-14 years). Aetiology was: fibrolipomatous hamartoma, traumatic amputation, radial deficiency and complex syndactyly. Second ray was resected in three patients and third and fourth ray in one. No finger transfer was performed. No immediate post-operative complications were found at the final evaluation. None of them needed psychological support. All the patients showed excellent clinical and functional results with a high grade of satisfaction. Discussion. Ray resection of the hand has been used as salvage procedure in patients with vascular lesions, tumours, trauma, infections or congenital malformations. There are only a few published studies including small samples in adults or case reports, with no references in the paediatric population. Conclusion. Ray resection of the hand is a useful and safe technique in paediatric population, obtaining excellent cosmetic and functional results in those cases in which it is impossible to preserve one or more fingers (AU)

Ray resection in paediatric population. / Resección de radios de la mano en pacientes pediátricos.

AIM: Evaluation of clinical and functional outcome of ray resection in paediatric population and description of key aspects of surgical technique. MATERIAL AND METHODS: We performed a retrospective review of all patients undergoing surgery between 2010-2015. INCLUSION CRITERIA: one or more ray resections of the hand and a minimum of one year follow-up. Evaluation of clinical characteristics, functional and cosmetic results, complications, need for psychological support and patient or family satisfaction. RESULTS: Four patients met the inclusion criteria. The mean age at surgery was 5 years (range, 1-14 years). Aetiology was: fibrolipomatous hamartoma, traumatic amputation, radial deficiency and complex syndactyly. Second ray was resected in three patients and third and fourth ray in one. No finger transfer was performed. No immediate post-operative complications were found at the final evaluation. None of them needed psychological support. All the patients showed excellent clinical and functional results with a high grade of satisfaction. DISCUSSION: Ray resection of the hand has been used as salvage procedure in patients with vascular lesions, tumours, trauma, infections or congenital malformations. There are only a few published studies including small samples in adults or case reports, with no references in the paediatric population. CONCLUSION: Ray resection of the hand is a useful and safe technique in paediatric population, obtaining excellent cosmetic and functional results in those cases in which it is impossible to preserve one or more fingers.

Cambios en resonancia magnética funcional en estudiantes de medicina con y sin restricción moderada de sueño / Changes in functional magnetic resonance imaging in medical students with and without moderate sleep deprivation

OBJETIVO: Describir los efectos de la restricción moderada del sueño en las regiones cerebrales involucradas en los procesos de inhibición cognitiva, función motora y fluidez fonológica, utilizando imágenes por resonancia magnética funcional (RMf). Materiales y métodos: Se estableció una condición de sueño habitual y otra de restricción moderada en 12 estudiantes diestros de pre y posgrado de Medicina, de entre 20 y 40 años. En ambos estados se utilizó la prueba psicológica de atención d2 e imágenes de RMf con paradigmas de función motora, fluencia fonológica y atención del tipo inhibición de la función ejecutiva Stroop. La restricción moderada de sueño fue de al menos el 63% con respecto al sueño habitual. Resultados: Se encontraron diferencias significativas en la activación cerebral con RMf para la función motora (p<0,05) entre el ciclo de sueño regular y el de restricción moderada. La actividad cerebral en RMf con los paradigmas de atención Stroop y fluidez fonológica no mostró diferencias significativas, así como tampoco la prueba psicológica de atención d2. Discusión: Se encontró interferencia en las activaciones cerebrales de representación motora con la restricción moderada de sueño, pero no se hallaron diferencias significativas en las activaciones de atención tipo Stroop, ni en la tarea de fluencia fonológica o las pruebas de atención d2. Esto podría deberse a una insuficiente restricción del sueño o a eficientes mecanismos de compensación en los sujetos de este estudio. Conclusión: Existen diferencias en las activaciones cerebrales de representación motora en la restricción moderada del sueño medidas con RMf

OBJECTIVE: To describe the effects of moderate sleep deprivation in brain regions involved in cognitive inhibition processes, motor function, and phonological fluency using functional Magnetic Resonance Imaging (fMRI). Materials and methods: A sample of 12 under-graduate and post-graduate medical students, between 20 and 40 years, were subjected to a follow-up of the number of hours of regular sleep in order compare to a moderate sleep deprivation after a nightshift. The d2 attention test and fMRI studies were used in both groups in order to evaluate motor function, verbal fluency and cognitive inhibition, or Stroop paradigms. The moderate sleep deprivation was at least 63% with respect to the regular sleep pattern during the previous week. Results: Significant differences in brain activity were found in fMRI to measure motor function (P<0.05) comparing regular sleep cycle and moderate sleep deprivation. The brain activity with fMRI Stroop paradigms and phonological fluency showed no significant differences between the two conditions, likewise with the psychological attention test d2. Discussion: The fMRI showed interference on motor representation activations in moderate sleep deprivation. No significant differences in fMRI were found in the processes of cognitive inhibition or Stroop paradigms, in phonological fluency, or in the psychological attention test d2. These could be attributed to inadequate sleep deprivation or efficient compensation mechanisms in the subjects of this study. Conclusión: There is a difference showed in fMRI on motor representation activations in moderate sleep deprivation

Universal prophylaxis or preemptive strategy for cytomegalovirus disease after liver transplantation: a systematic review and meta-analysis.

We systematically reviewed and meta-analyze the efficacy of universal prophylaxis (UP) and preemptive (PE) strategies (using ganciclovir or valganciclovir) in preventing cytomegalovirus (CMV) disease (CMD) among liver transplant recipients (LTRs). We performed an electronic search of MEDLINE, EMBASE and the Cochrane Database till December 2013. Studies that assessed UP or PE for preventing CMD in LTRs were included. The risk of bias was assessed using the Newcastle-Ottawa scale. The primary outcome was CMD, secondary outcomes being acute cellular rejection (ACR), graft loss (GL) and mortality. Due to the heterogeneity of comparative studies, an indirect comparison was performed. Pooled incidence rates with 95% confidence interval (CI) are calculated for each outcome using a random-effects model. Thirty-two studies involving 2456 LTRs were included. The majority of the studies were of low risk of bias. Irrespective of donor/recipient CMV sero-status, CMD was 10% with UP (95% CI: 6-14; I(2) = 87%; 16 studies, n = 1581) and 7% with PE (95% CI: 3-10; I(2) = 84%; 16 studies, n = 875) (mean difference 2.6; 95% CI: -3.25 to 8.45, p = 0.34). Likewise, ACR and mortality were similar with the two strategies. However, GL was significantly lower in the UP group, regardless of donor/recipient sero-status. In indirect comparison, the incidence of CMD, ACR and mortality in LTRs were similar with two strategies. Trials comparing the two strategies directly are needed.

Influencia de la oxitocina administrada durante el parto en el mantenimiento de la lactancia materna. Estudio preliminar / Influence of oxytocin administered during labor in maintaining. breastfeeding. Preliminary study

Introducción: El uso de la oxitocina (Oxt) durante el parto está tan generalizado que hay una tendencia a asumir que sus efectos son bien conocidos. El objetivo del presente estudio es determinar si la Oxt administrada durante el parto posee alguna influencia sobre el mantenimiento de la lactancia materna exclusiva (LME). Pacientes y métodos: Este trabajo forma parte de un estudio cuyo objetivo principal es valorar la influencia de la Oxt administrada durante el parto en los reflejos neonatales primitivos. Se trata de un estudio descriptivo observacional realizado en 20 díadas madre-hijo. Se incluyeron madres primigestas que no habían presentado complicaciones durante el embarazo y habían tenido un recién nacido a término sano fruto de un parto vaginal inducido o estimulado con Oxt. Se realizó una llamada telefónica a los 3 meses. Resultados: Las dosis de Oxt que recibieron durante el parto las madres que no mantenían LME al cabo de 1 y 3 meses fueron superiores a las que mantenían LME (p <0,05). Conclusión: La Oxt administrada durante el parto puede influir de forma negativa en el mantenimiento de la LME(AU)

Introduction: Synthetic oxytocin (Oxt) is the most commonly used drug to induce or augment labour contractions. The objective of the study is to evaluate the effect of Oxt used during labour on exclusive breastfeeding. Patients and methods: This job is part of an observational descriptive study which primary objective is to investigate the effect of intrapartum oxytocin administration on primitive neonatal reflexes. Twenty women with their first term pregnancies were studied. Inclusion criteria were: healthy primiparae with a single gestation at term and vaginal delivery induced or augmented with Oxt. Three months following the birth all mothers were contacted by telephone to assess feeding. Results: Women breastfeeding exclusively had received a significantly lower average dose of Oxt than those women who were not exclusively breastfeeding at 1 and 3 months postpartum (p<0.05). Conclusion: Synthetic Oxt used during labour may have negative influence on breastfeeding(AU)

I Conferencia Nacional de Consenso sobre el Injerto Óseo del Seno Maxilar / 1st National Consensus Conference on maxillar sinus bone grafts

Objetivo: El objetivo de la I Conferencia Española de Consenso sobre el Injerto Óseo Sinusal era intentar llegar a puntos de acuerdo sobre las principales controversias de esta técnica, aplicada de forma muy variada y con el empleo de materiales muy diversos, y conseguir plasmar los mismos en un documento resumen consensuado por todos los autores. Material y método: Durante los días 17 y 18 de octubre de 2008 se celebró en Oviedo la citada conferencia, auspiciada por la Sociedad Española de Cirugía Oral y Maxilofacial. En ella se dieron cita un total de 50 ponentes de reconocido prestigio nacional e internacional que repasaron en 6 mesas de trabajo las principales controversias sobre los injertos óseos sinusales. Tras las conferencias de los ponentes, los moderadores establecían las principales conclusiones de cada mesa y se abría un turno de debate donde participaban todos los asistentes. Resultado: Este documento y sus conclusiones emanan de las presentaciones realizadas por los ponentes y de las deliberaciones y acuerdos de cada mesa de trabajo. Ambos han sido aprobados tras varias correcciones por todos los autores antes de ser enviados para su publicación. Además, han obtenido el reconocimiento científico oficial de la Sociedad Española de Cirugía Oral y Maxilofacial y deben servir como base para futuros estudios y reuniones científicas. Conclusiones: El objetivo fundamental cuando se realiza un injerto óseo sinusal es la formación de hueso vital en el seno maxilar, para conseguir la supervivencia a largo plazo de los implantes tras su carga protésica. Para ello, la técnica y la secuencia de tratamiento deben orientarse a conseguir resultados predecibles y estables en el tiempo, aunque esto suponga un mayor tiempo de espera hasta la colocación de la prótesis. La estabilidad inicial del implante es el factor clave para la osteointegración y debe ser el principal criterio para indicar implantes simultáneos o diferidos en el seno maxilar(AU)

Objective: The objectives of the first Spanish Consensus Conference on Sinus Bone Graft were trying to reach agreements points on the major controversies of this technique, and translate them in a summary document. Material and method: During the 17th and 18th of October of 2008 took place in Oviedo (Spain) the Conference, sponsored by the Spanish Society of Oral and Maxillofacial Surgery. There, 50 national and international speakers reviewed in 6 workshops the major controversies of sinus bone grafts. Following the conferences, the moderators proposed the main conclusions of each workshop and opened a round of discussion where all attendees participated. Results: This document and its conclusions emanate from the presentations made by the speakers and the discussions and agreements of each workshop. Both have been approved after several corrections by all authors before being submitted for publication. They have also obtained the official scientific recognition of the Spanish Society of Oral and Maxillofacial Surgery and should serve as a basis for future scientific studies and meetings. Conclusions: The main objective when we perform a sinus bone graft is vital bone formation in the maxillary sinus, to achieve long-term survival of the implants after prosthetic loading. To do this, the technique and sequence of treatment should aim to achieve predictable and stable results over time, although this involves a longer waiting time. The initial implant stability is the key factor for osseointegration and should be the main criterion to indicate simultaneous or delayed implants in the maxillary sinus(AU)