Transarterial Embolization for Adhesive Capsulitis of the Shoulder: Midterm Outcomes on Function and Pain Relief.

PURPOSE: To determine the safety and potential effectiveness of transarterial embolization for adhesive capsulitis of the shoulder. MATERIALS AND METHODS: This prospective study analyzed consecutive adult patients with adhesive capsulitis referred for embolization between January 2018 and May 2023 after a poor response to treatment (symptoms and limitation of motion in ≥2 axes; ≤120° flexion, ≤50° external rotation and/or internal rotation with the shoulder abducted 90°) persisting for >3 months after having completed ≥6 weeks of analgesics and physical therapy. Different types of pain and mobility were measured before embolization and 1, 3, and 6 months after embolization. Overall upper limb function (Quick Disabilities of Arm, Shoulder, and Hand) and patient satisfaction were measured before and 6 months after embolization. Long-term follow-up comprised telephone interviews and clinical history reviews. RESULTS: A total of 20 patients (12 [60%] women; median age, 50.7; interquartile ranges [IQR], 45‒55 years) were included; 6 (30%) had diabetes and 15 (75%) were off work. Median duration of symptoms before embolization was 39.4 weeks (IQR, 28‒49 weeks), and median duration of rehabilitation therapy was 12.8 weeks (IQR, 8‒16 weeks). Six months after embolization, significant improvements were observed in nocturnal pain (P = .003), pain on moving (P = .001), external rotation (P < .001), internal rotation (P < .001), active flexion (P < .001), passive flexion (P = .03), active abduction (P < .001), passive abduction (P < .001), and overall function (P < .001). Despite objective improvements, patient satisfaction was nearly unchanged. Only 1 patient experienced a mild adverse event. CONCLUSION: Transarterial embolization is safe and potentially effective in treating adhesive capsulitis of the shoulder refractory to conventional treatment. Clinical improvements were maintained in the mid to long term.

Decreased HDL-C Levels as a Predictor of Organ Failure in Acute Pancreatitis in the Emergency Department.

High-density lipoprotein cholesterol (HDL-C) is reported as a biomarker of systemic inflammation and multi-organ failure (MOF), which has been rarely investigated in acute pancreatitis (AP), a frequent condition in the emergency department (ED). The objective was to study the predictive capacity of the decrease in HDL-C to the progression of MOF in AP in the ED; analyzing 114 patients with AP for one year in a longitudinal and prospective study, AP severity was obtained by the Atlanta classification, in relation to modified Marshall and Bedside Index for Severity in Acute Pancreatitis (BISAP) scores, and clinical and laboratory parameters in a 48 h hospital stay. The area under the receiver operating characteristic (ROC) curve was used to estimate the validity of the predictor and define optimal cut-off points. It was found that AP was classified as severe in 24.5%, mainly for biliary etiology (78.9%) and female sex (73.6%). As a biomarker, HDL-C decreased from 31.6 to 29.5 mg/dL in a 48 h stay (p < 0.001), correlating negatively with the increase in severity index > 2 and the modified Marshall (p < 0.032) and BISAP (p < 0.009) scores, finding an area under the ROC curve with a predictive capacity of 0.756 (95% CI, 0.614-0.898; p < 0.004) and a cut-off point of 28.5 mg/dL (sensitivity: 79%, specificity: 78%), demonstrating that the decrease in HDL-C levels serves as a useful indicator with a predictive capacity for MOF in mild to severe AP, during a 48 h hospital stay in the ED.

A new surgical technique for sutureless partial nephrectomy: renal sutureless device.

BACKGROUND: Several factors impact the preservation of renal function after partial nephrectomy. Warm ischemia time is the main modifiable surgical factor. Renorrhaphy represents the key of hemostasia, but it is associated with increase of warm ischemia time and complications. The aim of this study was to describe our initial surgical experience with a new surgical technique for sutureless partial nephrectomy, based on the application of our own developed renal-sutureless-device-RSD. METHODS: Between 2020-2021, 10 patients diagnosed with renal cell carcinoma stage cT1a-b cN0M0 with an exophytic component were operated using renal-sutureless-device-RSD. Surgical technique of sutureless partial nephrectomy with renal-sutureless-device-RSD is described in a step-by-step fashion. Clinical data was collected in a dedicated database. Presurgical, intraoperative, postoperative variables, pathology and functional results were evaluated. Medians and ranges of values for selected variables were reported as descriptive statistics. RESULTS: Partial nephrectomy was carried out with the use of renal-sutureless-device-RSD without renorrhaphy in all cases (70%cT1a-30%cT1b). Median tumor size was 3.15 cm (IQR: 2.5-4.5). R.E.N.A.L Score had a range between 4a-10. Median surgical time was 97.5 minutes (IQR 75-105). Renal artery clamping was only required in 4 cases, with a median warm ischemia time of 12.5 minutes (IQR 10-15). No blood transfusion, intraoperative and postoperative complications were noted. Free-of-disease margin rate achieved was 90%. Median length of stay was 2 days (IQR 2-2). Laboratory data on hemoglobin and hematocrit levels, as well as renal function tests, remained stable after partial nephrectomy. CONCLUSIONS: Our initial experience suggests that a sutureless PN using the RSD device is feasible and safe. Further investigation is needed to determine the clinical benefit of this technique.

Small rodent monitoring at Birkebeiner Road, Norway.

Background: Northern small mammal populations are renowned for their multi-annual population cycles. Population cycles are multi-faceted and have extensive impacts on the rest of the ecosystem. In 2011, we started a student-based research activity to monitor the variation of small rodent density along an elevation gradient following the Birkebeiner Road, in southeast Norway. Fieldwork was conducted by staff and students at the University campus Evenstad, Inland Norway University of Applied Sciences, which has a long history of researching cyclic population dynamics. The faculty has a strong focus on engaging students in all parts of the research activities, including data collection. Small rodents were monitored using a set of snap trap stations. Trapped animals were measured (e.g. body mass, body length, sex) and dissected to assess their reproductive status. We also characterised the vegetation at trapping sites. New information: We provide a dataset of small rodent observations that show fluctuating population dynamics across an elevation gradient (300 m to 1,100 m a.s.l) and in contrasting habitats. This dataset encompasses three peaks of the typical 3-4-year vole population cycles; the number of small rodents and shrews captured show synchrony and peaked in years 2014, 2017 and 2021. The bank vole Myodesglareolus was by far (87%) the most common species trapped, but also other species were observed (including shrews). We provide digital data collection forms and highlight the importance of long-term data collection.

Characterization of adult patients with systemic sclerosis in a reference center from northwestern Colombia: A descriptive survey / Caracterización de pacientes adultos con esclerosis sistémica en un centro de referencia del noroccidente de Colombia: un estudio descriptivo

ABSTRACT Background: Systemic sclerosis is an autoimmune and multisystemic disease characterized by vascular involvement and fibrosis that mainly affects the skin and internal organs; its morbidity and mortality are the highest of rheumatic diseases. Objective: To determine the sociodemographic, clinical, and paraclinical characteristics of adult patients with systemic sclerosis in a reference center in rheumatology in northwestern Colombia, between 2006 and 2016. Methods: A retrospective descriptive study was conducted. Information on sociodemographic, clinical, and paraclinical variables was collected from the review of medical records. The data were processed with the IBM SPSS 22 statistical package. The qualitative variables were expressed in absolute and relative frequencies and the quantitative variables in mean and standard deviation or median and interquartile range, according to their distribution. Results: 44 patients were included, predominantly women (90.9%), with an average age of 59 years; the most common variety was the limited (61.3%). One hundred percent of the subjects presented Raynaud's phenomenon and the most common compromised systems were: cutaneous (100%), musculoskeletal (59.1%), and gastrointestinal (50%). 95.5% of the patients fulfilled the diagnostic criteria ACR / EULAR 2013. Regarding the immunological profile, 72.7% of the individuals had positive antinuclear antibodies, of which 53.1% had a centromeric pattern. Conclusions: Sociodemographic, clinical and similar characteristics were found in this cohort, according to what was published in the literature. The most frequent extracutaneous systems involved were: musculoskeletal, gastrointestinal, and pulmonary, which cause a large part of the associated morbidity, as well as a decrease in quality of life.

RESUMEN Introducción: La esclerosis sistémica es una enfermedad autoinmune y multisistémica, caracterizada por vasculopatía y fibrosis que afecta principalmente la piel y órganos internos; su morbilidad y mortalidad son las más altas de las enfermedades reumatológicas. Objetivo: Determinar las características sociodemográficas, clínicas y paraclínicas de pacientes adultos con esclerosis sistémica en un centro de referencia en reumatología del noroccidente de Colombia, entre el 2006 y el 2016. Métodos: Estudio descriptivo retrospectivo. La información sobre las variables sociodemográficas, clínicas y paraclínicas se recogió de la revisión de registros médicos. Los datos se procesaron con el paquete estadístico IBM SPSS 22. Las variables cualitativas se expresaron en frecuencias absolutas y relativas y las cuantitativas en media y desviación estándar o mediana y rango intercuartílico, según su distribución. Resultados: Se incluyeron 44 pacientes, predominantemente mujeres (90,9%), con una edad promedio de 59 arios; la variedad más común fue la limitada (61,3%). El 100% de los sujetos presentaron el fenómeno de Raynaud y los sistemas comprometidos con mayor frecuencia fueron: cutáneo (100%), musculoesquelético (59,1%) y gastrointestinal (50%). El 95,5% de los pacientes cumplieron con los criterios diagnósticos ACR/EULAR 2013. Con respecto al perfil inmunológico, el 72,7% de los individuos tenía anticuerpos antinucleares positivos, de los cuales, un 53,1% tenía un patrón centromérico. Conclusiones: Se encontraron características sociodemográficas y clínicas similares en esta cohorte, de acuerdo a lo publicado en la literatura. Los sistemas extracutáneos más frecuentemente involucrados fueron: musculoesquelético, gastrointestinal y pulmonar, que causan una gran parte de la morbilidad asociada, así como una disminución en la calidad de vida.

A brain and a head for a different habitat: Size variation in four morphs of Arctic charr (Salvelinus alpinus (L.)) in a deep oligotrophic lake.

Adaptive radiation is the diversification of species to different ecological niches and has repeatedly occurred in different salmonid fish of postglacial lakes. In Lake Tinnsjøen, one of the largest and deepest lakes in Norway, the salmonid fish, Arctic charr (Salvelinus alpinus (L.)), has likely radiated within 9,700 years after deglaciation into ecologically and genetically segregated Piscivore, Planktivore, Dwarf, and Abyssal morphs in the pelagial, littoral, shallow-moderate profundal, and deep-profundal habitats. We compared trait variation in the size of the head, the eye and olfactory organs, as well as the volumes of five brain regions of these four Arctic charr morphs. We hypothesised that specific habitat characteristics have promoted divergent body, head, and brain sizes related to utilized depth differing in environmental constraints (e.g., light, oxygen, pressure, temperature, and food quality). The most important ecomorphological variables differentiating morphs were eye area, habitat, and number of lamellae. The Abyssal morph living in the deepest areas of the lake had the smallest brain region volumes, head, and eye size. Comparing the olfactory bulb with the optic tectum in size, it was larger in the Abyssal morph than in the Piscivore morph. The Piscivore and Planktivore morphs that use more illuminated habitats have the largest optic tectum volume, followed by the Dwarf. The observed differences in body size and sensory capacities in terms of vision and olfaction in shallow and deepwater morphs likely relates to foraging and mating habitats in Lake Tinnsjøen. Further seasonal and experimental studies of brain volume in polymorphic species are needed to test the role of plasticity and adaptive evolution behind the observed differences.

Systematic Review of Prevalence Studies and Familial Aggregation in Vestibular Migraine.

Background: Vestibular migraine (VM) is complex disorder consisting of episodes of migraine and vertigo with an estimated prevalence of 1-3%. As migraine, it is considered that VM has genetic predisposition; however, evidence to support a genetic contribution has not been critically appraised. Objective: The aim of this systematic review is to assess available evidence in scientific publications to determine the role of inheritance in VM. Methods: After performing the quality assessment of the retrieved records, 31 studies were included (24 epidemiological reports and 7 genetic association studies in families or case-control in candidate genes). We gathered data about prevalence of VM in different populations and in families, and also about the genetic findings reported. In addition, other variables were considered to assess the heritability of VM, such as the ancestry, the age of onset or the familial history of vertigo and migraine. Results: The estimated prevalence of VM was different between black (3.13%), white (2.64%) and Asian (1.07%) ethnicities. The reported prevalence of VM in migraine patients is higher in European countries (21%) than in Asian countries (10%). Moreover, the prevalence of the migraine-vertigo association in families is 4-10 times higher than the prevalence reported in the general population (sibling recurrence risk ratio λs = 4.31-10.42). We also found that the age of onset is lower in patients with simultaneous onset of symptoms and in those who have familial history for migraine and/or vertigo, suggesting anticipation. Although some genetic studies have reported few allelic variants associated to MV, replication studies are needed to validate these results. Conclusions: The available evidence to support heritability in VM is limited. Variability in prevalence depending on ethnicity and geographic location suggests a combined genetic and environmental contribution to VM. However, the familial aggregation observed in VM support genetic and shared familial environmental effects that remarks the necessity of twins and adoptees-based epidemiological studies to estimate its heritability.

"And if you gaze long into an abyss, the abyss gazes also into thee": four morphs of Arctic charr adapting to a depth gradient in Lake Tinnsjøen.

The origin of species is a central topic in biology. Ecological speciation might be a driver in adaptive radiation, providing a framework for understanding mechanisms, level, and rate of diversification. The Arctic charr Salvelinus alpinus L. is a polymorphic species with huge morphological and life-history diversity in Holarctic water systems. We studied adaptive radiation of Arctic charr in the 460-m-deep Lake Tinnsjøen to (a) document eco-morphology and life-history traits of morphs, (b) estimate reproductive isolation of morphs, and (c) illuminate Holarctic phylogeography and lineages colonizing Lake Tinnsjøen. We compared Lake Tinnsjøen with four Norwegian outgroup populations. Four field-assigned morphs were identified in Lake Tinnsjøen: the planktivore morph in all habitats except deep profundal, the dwarf morph in shallow-moderate profundal, the piscivore morph mainly in shallow-moderate profundal, and a new undescribed abyssal morph in the deep profundal. Morphs displayed extensive life-history variation in age and size. A moderate-to-high concordance was observed among morphs and four genetic clusters from microsatellites. mtDNA suggested two minor endemic clades in Lake Tinnsjøen originating from one widespread colonizing clade in the Holarctic. All morphs were genetically differentiated at microsatellites (F ST: 0.12-0.20), associated with different mtDNA clade frequencies. Analyses of outgroup lakes implied colonization from a river below Lake Tinnsjøen. Our findings suggest postglacial adaptive radiation of one colonizing mtDNA lineage with niche specialization along a depth-temperature-productivity-pressure gradient. Concordance between reproductive isolation and habitats of morphs implies ecological speciation as a mechanism. Particularly novel is the extensive morph diversification with depth into the often unexplored deepwater profundal habitat, suggesting we may have systematically underestimated biodiversity in lakes. In a biological conservation framework, it is imperative to protect endemic below-species-level biodiversity, particularly so since within-species variation comprises an extremely important component of the generally low total biodiversity observed in the northern freshwater systems.

Programa educativo ante la violencia intrafamiliar en el adulto mayor / Educational program against domestic violence in the elderly

La familia como red social de apoyo, acrecienta su importancia con el envejecimiento de sus integrantes de más edad, los cuales necesitan del espacio familiar, sin embargo, la práctica de la violencia intrafamiliar emerge como problema social el cual existe en muchas familias y no sale a la luz pública. Se implementó una estrategia educativa preventiva en los familiares que ocasionan maltrato a los adultos mayores de tres consultorios médicos de la Policlínica # 1, Manzanillo, Granma. Enero 2017–Enero 2018. El universo de trabajo quedó conformado por 340 personas, de ellas fueron seleccionados por muestreo aleatorio simple 80, representando a los adultos mayores de 40 y el resto a sus familiares. Se crearon tres grupos de trabajo, se les aplicó una encuesta diseñada para los familiares con participación de los adultos mayores, así como la revisión de la historia clínica de salud familiar, lo cual permitió obtener la información de las variables. Luego de obtenida esta se diseñó el programa educativo para dar salida a los objetivos propuestos. La mayor cantidad de adultos mayores maltratados estaban entre 60 a 74 años, predominó el sexo femenino, las cuales convivían con sus hijos u otro miembro de la familia. Predominó dentro de las formas de maltrato psicológico los insultos no verbales. Como violencia física prevalecieron las agresiones verbales. Predominaron los problemas económicos y/o sociales. Se concluyó que después de la aplicación de programa educativo los ancianos no eran maltratados, se demostró el impacto positivo del mismo en las familias(AU)

The family as a social support network, increases its importance with the aging of its older members, who need family space, however, the practice of domestic violence emerges as a social problem which exists in many families and does not leave in public light. A preventive educational strategy was implemented in family members who cause abuse to older adults in three medical offices of Polyclinic # 1, Manzanillo, Granma. January 2017-January 2018. The work universe was made up of 340 people, of which they were selected by simple random sampling 80, representing older adults 40 and the rest to their families. Three work groups were created, a survey designed for family members with participation of older adults was applied, as well as the review of the family health clinical history, which allowed obtaining information on the variables. After obtaining this, the educational program was designed to meet the proposed objectives. The largest number of abused older adults were between 60 and 74 years old, the female sex prevailed, which coexisted with their children or another family member. Non-verbal insults predominated within the forms of psychological abuse. As physical violence, verbal aggressions prevailed. Economic and /or social problems predominated. It was concluded that after the application of the educational program, the elderly were not mistreated, its positive impact on the families was demonstrated(EU)

Subtitling for d/Deaf and Hard-of-Hearing Children: Current Practices and New Possibilities to Enhance Language Development.

In order to understand and fully comprehend a subtitle, two parameters within the linguistic code of audiovisual texts are key in the processing of the subtitle itself, namely, vocabulary and syntax. Through a descriptive and experimental study, the present article explores the transfer of the linguistic code of audiovisual texts in subtitling for deaf and hard-of-hearing children in three Spanish TV stations. In the first part of the study, we examine current practices in Spanish TV captioning to analyse whether syntax and vocabulary are adapted to satisfy deaf children's needs and expectations regarding subtitle processing. In the second part, we propose some alternative captioning criteria for these two variables based on the needs of d/Deaf and hard-of-hearing (DHH) children, suggesting a more appropriate way of displaying the written linguistic code for deaf children. Although no specific distinction will be made throughout this paper, it is important to refer to these terms as they have been widely used in the literature. Neves (2008) distinguishes between the "Deaf", who belong to a linguistic minority, use sign language as their mother tongue, and usually identify with a Deaf community and culture; the "deaf", who normally have an oral language as their mother tongue and feel part of the hearing community; and the "hard of hearing", who have residual hearing and, therefore, share the world and the sound experience of hearers. In the experimental study, 75 Spanish DHH children aged between 8 and 13 were exposed to two options: the actual broadcast captions on TV, and the alternative captions created by the authors. The data gathered from this exposure were used to analyse the children's comprehension of these two variables in order to draw conclusions about the suitability of the changes proposed in the alternative subtitles.

Risk of Illness with Salmonella due to Consumption of Raw Unwashed Vegetables Irrigated with Water from the Bogotá River.

The Bogotá River receives untreated wastewater from the city of Bogotá and many other towns. Downstream from Bogotá, water from the river is used for irrigation of crops. Concentrations of indicator organisms in the river are high, which is consistent with fecal contamination. To investigate the probability of illness due to exposure to enteric pathogens from the river, specifically Salmonella, we took water samples from the Bogotá River at six sampling locations in an area where untreated water from the river is used for irrigation of lettuce, broccoli, and cabbage. Salmonella concentrations were quantified by direct isolation and qPCR. Concentrations differed, depending on the quantification technique used, ranging between 107.7 and 109.9 number of copies of gene invA per L and 105.3 and 108.4 CFU/L, for qPCR and direct isolation, respectively. A quantitative microbial risk assessment model that estimates the daily risk of illness with Salmonella resulting from consuming raw unwashed vegetables irrigated with water from the Bogotá River was constructed using the Salmonella concentration data. The daily probability of illness from eating raw unwashed vegetables ranged between 0.62 and 0.85, 0.64 and 0.86, and 0.64 and 0.85 based on concentrations estimated by qPCR (0.47-0.85, 0.47-0.86, and 0.41-0.85 based on concentrations estimated by direct isolation) for lettuce, cabbage, and broccoli, respectively, which are all above the commonly propounded benchmark of 10-4 per year. Results obtained in this study highlight the necessity for appropriate wastewater treatment in the region, and emphasize the importance of postharvest practices, such as washing, disinfecting, and cooking.

[Models of care and classification of "Children with special health care needs-CSHCN": Recommendations from the CSHCN Committee, Chilean Paediatric Society]. / Modelo de atención y clasificación de «Niños y adolescentes con necesidades especiales de atención en salud-NANEAS¼: recomendaciones del Comité NANEAS de la Sociedad Chilena de Pediatría.

"Children with special health care needs" (CSHCN) is an emerging and heterogeneous group of paediatric patients, with a wide variety of medical conditions and with different uses of health care services. There is consensus on how to classify and assess these patients according to their needs, but not for their specific diagnosis. Needs are classified into 6 areas: a) specialised medical care; b) use or need of prescription medication; c) special nutrition; d) dependence on technology; e) rehabilitation therapy for functional limitation; and f) special education services. From the evaluation of each area, a classification for CSHCN is proposed according to low, medium, or high complexity health needs, to guide and distribute their care at an appropriate level of the health care system. Low complexity CSHCN should be incorporated into Primary Care services, to improve benefits for patients and families at this level. It is critical to train health care professionals in taking care of CSHCN, promoting a coordinated, dynamic and communicated work between different levels of the health care system. Compliance with these guidelines will achieve a high quality and integrated care for this vulnerable group of children.

Adult-onset Diamond-Blackfan anemia with a novel mutation in the exon 5 of RPL11: too late and too rare.

Diamond-Blackfan anemia (DBA) is a congenital erythroid aplasia usually diagnosed in the early infancy and associated with mutations or large deletions in 11 ribosomal protein (RP) genes. Adult patients with severe, transfusion dependence, aregenerative anemia might have a genetic-in-origin disease with an atypical presentation. Late onset nonclassical DBA should be ruled out and mutations of RP genes studied.

Hijos de pacientes con trastorno afectivo bipolar tipo I de una población paisa: perfil psicopatológico y neuropsicológico / Offspring of Patients with Bipolar Disorder Type I from the ‘Paisa' Population: Psychopathological and Neuropsychological Profile

Objetivo: Caracterizar los principales hallazgos psicopatológicos y los perfiles neuropsicológicos de un grupo de hijos de pacientes adultos con TAB de ascendencia antioqueña. Métodos: 20 sujetos hijos de pacientes con TAB tipo I se evaluaron por medio de la entrevista diagnóstica K-SADS-LP para establecer sus diagnósticos según criterios del DSM-IV-TR. También se les aplicaron varias subpruebas de la Evaluación Neuropsicológica Infantil (ENI) y una versión abreviada de la Escala de Inteligencia para niños WISC III. Los padres bipolares y los copadres biológicos fueron evaluados con la Entrevista Diagnóstica para Estudios Genéticos (DIGS). Resultados: Los trastornos psiquiátricos más frecuentes fueron los de ansiedad de separación (35%), fobia simple (20%), trastorno por déficit de atención con hiperactividad (50%) y trastorno oposicionista y desafiante (20%). Como un hallazgo psicopatológico frecuente, este grupo presentó, además, síntomas subsindromáticos de ansiedad y trastorno por déficit de atención con hiperactividad. Ninguno de los hijos evaluados presentó TAB y solo dos casos presentaron trastorno depresivo mayor; sin embargo, se encontraron síntomas subsindromáticos para manía en una cuarta parte de la muestra. Los hallazgos neuropsicológicos principales en los HPB fueron dificultades de memoria de evocación, memoria diferida y almacenamiento de información. Conclusiones: Este grupo de niños y adolescentes hijos de padres con TAB tipo I del aislado genético antioqueño, presenta diagnósticos según el DSM-IV-TR de trastorno de ansiedad y TDAH y, además, síntomas subsindrómicos de diversos trastornos psiquiátricos, incluido el TAB. Algunas medidas neuropsicológicas muestran un menor rendimiento en pruebas de memoria y atención.

Objective: To characterize the main psycho pathological findings and neuropsychological profiles in a group of offspring of parents with Bipolar Disorder of Antioquia-Colombian ancestry. Methods: 20 children of parents with bipolar disorder type I were assessed using the K-SADS-PL in order to establish their diagnosis according with DSM-IV-TR criteria. Neuropsychological assessment was done by using subtests of the "Evaluación Neuropsicológica Infantil (ENI)" and the abbreviated version of WISC III. Bipolar parents and biological co-parents were evaluated with the Diagnostic Interview for Genetic Studies (DIGS). Results: The most common psychiatric disorders found were separation anxiety disorder (35%), simple phobia (20%), attention deficit hyperactivity disorder (50%), and oppositional defiant disorder (20%). This group of offspring also presented subsyndromal anxiety and ADHD symptoms as a common psychopathological finding. None of the children assessed had bipolar disorder and only two cases presented major depressive disorder. However, subsyndromal symptoms for mania were found in a quarter of the sample. The main neuropsychological findings in the offspring were difficulties in memory evocation, memory recall, and long term memory. Conclusions: This group of children and adolescents of parents with BD type I from paisa population (Colombia) genetic isolate presents DSM-IV-TR diagnoses of anxiety and disruptive disorders and subsyndromal symptoms of several psychiatric disorders including BD. Some neuropsychological measures show low performance in memory and attention tests.

Diseño y fabricación de un nuevo distractor curvo de sínfisis mandibular para transporte óseo / Design and manufacture of a new curve symphyseal distractor for mandibular bone transport

Son activados principalmente por el operador diariamente; teniendo como ventaja estos últimos la ausencia de cicatrices cutáneas permanentes. El objetivo principal de este estudio fue diseñar y fabricar un prototipo de distractor curvo de sínfisis, intraoral para reconstrucción mandibular. Materiales y Métodos: Se realizaron pruebas técnicas: modelo elementos finitos del distractor y cuerpo mandibular, generando una malla formada por 80.000 elementos con restricciones en el condilo mandibular, dos tornillos a cada lado de la placa y cuatro a cada lado del distractor en todos los grados de libertad; se aplicaron fuerzas de 248N a la zona. Finalmente, se realizó la prueba de instalación en cadáver para verificar la técnica quirúrgica y su ergonomía. Resultados: Se observó una distribución uniforme de esfuerzos para todo el sistema mandíbula- distractor, garantizando su resistencia y estabilidad estructural. Conclusiones: El dispositivo es resistente a las fuerzas de masticación, es de facial instalación y activación; permite la reconstrucción de segmentos curvos de amplia longitud.

Introduction and Objective: Currently, there are extra-and intra devices, which are mainly triggered by the operator daily, taking advantage as the latter no permanent scars skin. The main objective of this study was to design and manufacture a prototype of intraoral curve symphyseal distractor for mandibular reconstruction. Materials and Methods: The following technical tests were carried out: finite element model of the distractor and mandibular body creating a net of 80,000 elements with restrictions in the mandibular condyle, two screws on each side of the plate and four on each side of the distractor in every degree of freedom. 248N forces were applied to the zone. Finally, the installation test on a cadaver was done in order to verify the surgical technique and its ergonomy. Results: A uniform distribution of strains was observed for all the mandibular-distractor system, guarantying its resistance and structural stability. Conclusions: The device is resistant to masticatory forces; it is easy to install and to activate and allows the reconstruction of wide range curved segments.

Osteomielitis hematógena de la rama íleo-isquiopubiana: a propósito de un caso / Hematogenous osteomyelitis of the ischiopubic ramus: a propos of a case

Se presenta el caso del paciente Y. P. T., del sexo femenino, raza mestiza, 11 años de edad, quien ingresa en la Sala de Misceláneas por traumatismo en la región glútea, diagnosticado inicialmente como una miositis de los aductores del muslo derecho. Según la evolución clínica, humoral y radiológica, desarrolla signos y síntomas de osteomielitis aguda de la rama íleo-isquiopubiana derecha, comprobada por velocidad de sedimentación globular acelerada y alteraciones radiológicas en esa zona, así como por la presencia de un cuadro febril intermitente. Se aplica tratamiento con penicilinas, quinolonas y betalactámicos. La paciente se encuentra en estos momentos en franca recuperación. Se significa la cooperación entre distintas disciplinas para la solución de los problemas de salud

Osteomielitis hematógena de la rama íleo-isquiopubiana: a propósito de un caso / Hematogenous osteomyelitis of the ischiopubic ramus: a propos of a case

Se presenta el caso del paciente Y. P. T., del sexo femenino, raza mestiza, 11 años de edad, quien ingresa en la Sala de Misceláneas por traumatismo en la región glútea, diagnosticado inicialmente como una miositis de los aductores del muslo derecho. Según la evolución clínica, humoral y radiológica, desarrolla signos y síntomas de osteomielitis aguda de la rama íleo-isquiopubiana derecha, comprobada por velocidad de sedimentación globular acelerada y alteraciones radiológicas en esa zona, así como por la presencia de un cuadro febril intermitente. Se aplica tratamiento con penicilinas, quinolonas y betalactámicos. La paciente se encuentra en estos momentos en franca recuperación. Se significa la cooperación entre distintas disciplinas para la solución de los problemas de salud(AU)

Programa de educación para la salud en el trasplantado de corazón. Ensayo controlado con asignación aleatoria / Health education programme in heart transplant recipients. A randomized controlled trial

Objetivo. Conocer la eficacia de un programa educativo en los pacientes trasplantados de corazón en la adquisición de conocimientos, habilidades de autocuidado y percepción de su salud. Material y método. Ensayo clínico controlado con asignación aleatoria que se aplicó en pacientes trasplantados por primera vez de corazón que fueron asignados para recibir un programa educativo o la práctica informativa habitual. A todos los pacientes del estudio se les pasó un cuestionario con 40 preguntas cerradas cuando ingresaban en el hospital para la primera revisión después del alta. Las respuestas de 20 variables, que abarcaban las áreas de conocimiento, autocuidado y percepción de salud, fueron agrupadas en 5 factores mediante análisis factorial. Resultados. El estudio se realizó con 60 pacientes, 30 en el grupo intervención y 30 en el grupo control. Los 2 grupos fueron comparables en todas las variables iniciales. Los 5 factores explicaron el 60% de la variabilidad total. El grupo intervención presentó una puntuación más alta en el factor 1, relacionado con el conocimiento y el autocuidado de la inmunodepresión, el rechazo, las infecciones, el tratamiento y los signos y síntomas de alerta (medianas de 0,54 y -0,23 para la intervención y el grupo control, respectivamente; p = 0,009). En otros 3 factores, el grupo intervención presentó puntuaciones más altas no significativas respecto al grupo control. Conclusiones. Un programa educativo mejora el nivel de conocimientos de los pacientes con trasplante de corazón con respecto al rechazo, las infecciones y los signos y síntomas de alerta y mejora el nivel de autocuidados en relación con el tratamiento inmunodepresor (AU)

Objective. To assess the effectiveness of an education programme on the acquisition of knowledge, self-care skills and health perception in heart transplant recipients. Material and method. A randomized controlled trial was conducted in patients receiving a heart transplant for the first time who were assigned to undergo an educational programme or the usual information process. All patients filled in a questionnaire with 40 closed items when they were admitted to hospital for the first follow-up visit after discharge. Using factorial analysis, the responses to 20 variables, which covered the fields of knowledge, self-care and health perception, were grouped into 5 factors. Results. Sixty patients were enrolled, 30 in the intervention group and 30 in the control group. The 2 groups were similar in all baseline characteristics. The 5 factors explained 60% of the total variability. The intervention group had higher scores for factor 1, related to knowledge and self-care of immunosuppression, rejection, infections, treatment and warning symptoms and signs (median: 0.54 and -0.23 for the intervention and control groups, respectively; p = 0.009). In 3 other factors, the intervention group had higher scores than the control group but the difference was not significant. Conclusions. The education programme improved heart transplant recipients’ knowledge of rejection, infections, and warning symptoms and signs, as well as self-care related to immunosuppressive treatment (AU)

CA-125 como marcador tumoral en una paciente con linfoma no hodgkiniano / Ca-125 as a tumor marker in a patient with non Hodgkin's lymphoma

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