Traducción y adaptación transcultural de la escala AS-20 para medir la calidad de vida en adultos con estrabismo en Colombia, prueba piloto / Translation and transcultural adaptation of the AS-20 scale to measure quality of life in adults with strabismus in Colombia, a pilot study

Antecedentes El estrabismo genera un impacto psicosocial negativo en los pacientes adultos, afectando aspectos como la autopercepción y la calidad de vida. No existe en Colombia una escala que permita medir dicho impacto. Objetivo Realizar la traducción y adaptación transcultural del instrumento AS-20 al español colombiano, para medición de la calidad de vida en pacientes adultos con estrabismo en Colombia. Materiales y métodos Prueba piloto de un estudio de corte transversal de traducción, traducción inversa y adaptación del instrumento de medición tipo escala de calidad de vida AS-20 de su idioma original en pacientes adultos con estrabismo en Bogotá, Colombia. Resultados Dieciséis pacientes fueron evaluados. El rango de edad fue entre 18 y 68 años, con un promedio de 41 años. La escala fue respondida en una media de tiempo de 10,62min. Se reportó dificultad en 3 individuos para la comprensión de 2 ítems (preguntas 8 y 14), los cuales se ajustaron, resolviendo la dificultad. Conclusión Se realizó la traducción y prueba piloto de la escala AS-20 a español colombiano identificando y corrigiendo los problemas de traducción en la prueba. Este es el primer paso del proceso de adaptación transcultural. Con base en los resultados, la validación y adaptación transcultural se puede finalizar en un próximo estudio (AU)

Background Strabismus generates a negative psychosocial impact on adult patients, affecting aspects such as self-perception and quality of life. There is no scale in Colombian Spanish that measures these impacts. Objective To carry out the translation and cross-cultural adaptation of the AS-20 instrument into Colombian Spanish, for measuring the quality of life in adult patients with strabismus in Colombia. Materials and methods Pilot test of a cross-sectional study for the translation, reverse translation, and cross-cultural adaptation of the AS-20 instrument from its original language, English, to Colombian Spanish, in adult patients with strabismus in Bogotá, Colombia. Results Sixteen patients were assessed. The age range was between 18 and 68 years with a mean age of 41 years. The scale was answered in an average time of 10.62min. Difficulty was reported in 3 individuals for understanding 2 items (questions 8 and 14), which were resolved. Conclusion The translation and pilot test of AS-20 scale into Colombian Spanish was carried out, identifying and solving translational difficulties. It is the first step in the cross-cultural adaptation process. Based on the results, the validation and cross-cultural adaptation can be completed in a future study (AU)

Bioremoval of copper by filamentous fungi isolated from contaminated soils of Puchuncaví-Ventanas Central Chile.

Pollution represents a high risk to plants, animals, and human beings, causing an imbalance and affecting the environment. Soil is considered a universal sink, containing the highest load of environmental pollution. Puchuncaví-Ventanas sector, decreed as a saturated contamination zone in 1993, is considered one of the most affected areas by industrial pollution and belongs to one of the 5 sacrifice zones of Chile. The localities of Puchuncaví and Ventanas have heavy metal pollution levels that exceed up to 99% of the limits allowed by Canadian standards. The objective of this study was to characterize heavy metal tolerance and removal potential of filamentous fungi isolated from polluted soils for their use in decontamination systems and in situ soil improvement. Six fungal strains were selected based on their tolerance and a high capability to accumulate heavy metals, achieving copper bioaccumulation of 84% (Mortierella sp. strain LG01), 49% (Clonostachys sp. strain CQ23) and 48-77.5% (Trichoderma sp. strain LM01A). Trichoderma sp. strain LM01A was able to remove 41% of copper from contaminated soil under ex situ conditions. Some fungal strains belong to beneficial fungal genera, which are used as bioproducts in agriculture. The results of this study highlighted the use of Trichoderma sp. in soils contaminated, which may be of special interest in agriculture due to the large amounts of copper sulfate still applied as a pesticide in Chile and the world.

Translation and transcultural adaptation of the AS-20 scale to measure quality of life in adults with strabismus in Colombia, a pilot study.

BACKGROUND: Strabismus generates a negative psychosocial impact on adult patients, affecting aspects such as self-perception and quality of life. There is no scale in Colombian Spanish that measures these impacts. OBJECTIVE: To carry out the translation and cross-cultural adaptation of the AS-20 instrument into Colombian Spanish. MATERIALS AND METHODS: Pilot test of a cross-sectional Study for the translation, reverse translation, and cross-cultural the AS-20 instrument from its original language, English, to Colombian Spanish, in adult patients with strabismus in Bogotá, Colombia. RESULTS: 16 patients were assessed. The age range was between 18 and 68 years with a mean age of 41 years. The scale was answered in an average time of 10.62min. Difficulty was reported in three individuals for understanding two items (questions 8 and 14), which were resolved. CONCLUSION: The translation and pilot test of AS-20 scale into Colombian Spanish was carried out, identifying and solving translational difficulties. Is the first step in the cross-cultural adaptation process. Based on the results, the validation and cross-cultural adaptation can be completed in a future study.

Efectos de un programa de rehabilitación remota en atención primaria en salud, posterior al alta hospitalaria por COVID-19: estudio observacional / Effects of a remote rehabilitation program in primary health care, after hospital discharge due to COVID-19: observational study

Se ha reportado un importante daño sistémico de los pacientes afectados por COVID-19, y aún existen interrogantes sobre las secuelas a largo plazo. Surge ante esto la necesidad de plantear programas de rehabilitación de los sistemas primarios de atención, que respondan a estas necesidades. Se realizó un programa de 6 semanas de rehabilitación remota, con seguimiento y progreso semanal, posterior al alta hospitalaria por COVID-19 a 114 usuarios de 4 centros de atención primaria de la comuna de El Bosque, Santiago, R. Metropolitana. Se incluyó a pacientes de edades entre 21 y 93 años, combinando los principios del ejercicio terapéutico individualizado, una evaluación presencial previo y posterior a las 6 semanas de trabajo. Los indicadores evaluados fueron: Minimental Abreviado, 1 Minute Sit to Stand Test (1min STST), Timed Up and Go (TUG), índice de Barthel y FRAIL. Se hicieron análisis inferenciales y descriptivos y se encontraron mejoras favorables en los indicadores de condición física (TUG y 1'STST), Índice de Barthel y el Simple "FRAIL" Questionnaire Screening Tool (FRAIL). En conclusión, si bien la mayoría de los indicadores tuvieron resultados favorables, es necesario seguir estudiando herramientas de evaluación más sensibles e intervenciones específicas que se adapten a las necesidades de las personas.

Significant systemic damage has been reported in patients affected by COVID-19, and questions remain about long-term sequelae. Therefore, the need arises to propose rehabilitation programs for primary care systems that respond to these needs. A 6-week program of remote rehabilitation, with weekly follow-up and progress, after hospital discharge for COVID-19 was carried out on 114 users from 4 primary care centers in the commune of El Bosque, Santiago, Chile. The program included patients from 21 to 93 years-old, combining the principles of individualized therapeutic exercise, a face-to-face evaluation before and after 6 weeks of work. The indicators evaluated were: Abbreviated Minimental, 1 minute Sit to Stand Test (1 min STST), Timed Up and Go (TUG), Barthel index and the Simple "FRAIL" Questionnaire Screening Tool (FRAIL). Inferential and descriptive analyses were carried out and favorable improvements were found in the indicators of physical condition (TUG and 1min STST), Barthel Index and FRAIL. In conclusion, while most of the indicators had favorable results, it is required to further explore more sensitive assessment tools and targeted interventions that are tailored to people's needs.

Efectos de un programa de tele-rehabilitación en la capacidad física y disnea en atención primaria en salud, posterior al alta hospitalaria por COVID-19: estudio observacional / Effects of a tele-rehabilitation program on physical capacity and dyspnea in primary health care, after hospital discharge for covid-19: observational study

Resumen En marzo del año 2020, se declaró una pandemia de características mundiales, por un virus, que genera deterioro importante a nivel sistémico, SARS -CoV-2, con la enfermedad COVID-19. El deterioro funcional de quienes sufren secuelas post COVID-19 ha llevado a los profesionales de la rehabilitación a buscar formas eficientes de intervenir. Este estudio, descriptivo y retrospectivo, evaluó los efectos de un programa de rehabilitación remoto de 6 semanas, en 39 pacientes dados de alta de COVID-19, de un Centro de Salud Familiar (CESFAM) de la Comuna de El Bosque, Santiago, Chile, entre julio y diciembre del año 2020, analizando la capacidad física con el test 1 minuto sentado-de pie y disnea con escala de Borg modificada. Los resultados mostraron cambios estadísticamente significativos en la capacidad física y disnea de los pacientes intervenidos. Es necesario estudiar los beneficios de intervenciones específicas para esta población, y su impacto a largo plazo, entendiendo que convivimos con una nueva enfermedad, un COVID-19 prolongado, que incluso en cuadros leves está dejando secuelas funcionales importantes.

In March 2020, a pandemic of global characteristics was declared, due to a virus, which generates significant deterioration at the systemic level, SARS -CoV-2, with the COVID-19 disease. The functional deterioration of those suffering from post-COVID-19 sequelae has led rehabilitation professionals to look for efficient ways to intervene. This study, descriptive and retrospective, evaluated the effects of a 6-week remote rehabilitation program, in 39 patients discharged from COVID-19, from a Family Health Center in the Commune of El Bosque, Santiago, Chile, between July and December 2020, analyzing physical capacity with the 1 minute sitting-standing test and dyspnea with modified Borg's scale. The results showed statistically significant changes in the physical capacity and dyspnea of the operated patients. It is necessary to study the benefits of specific interventions for this population, and their long-term impact, understanding that we live with a new disease, a prolonged COVID, which even in mild cases is leaving important functional sequelae.

Determinantes socioeconómicos y sociodemográficos asociados al consumo de frutas y verduras de las madres de familia y los hogares de escolares de Jalisco / Socioeconomic and sociodemographic determinants associated with fruit and vegetable consumption among mothers and homes of schoolchildren in Jalisco

Introducción: incrementar el consumo de frutas y verduras es una prioridad, objetivo fundamental en las políticas públicas a nivel mundial. Dado que dicho consumo en los escolares de Jalisco (México) se encuentra por debajo de las recomendaciones alimentarias, es esencial identificar los determinantes que influyen en su consumo de frutas y verduras, para promover el desarrollo de acciones que contribuyan a mejorarlo. Objetivo: identificar los determinantes socioeconómicos y sociodemográficos del consumo de frutas y verduras en las madres de familia y los hogares de escolares de Jalisco, México. Método: estudio transversal analítico, realizado durante el primer trimestre del año 2020 utilizando una frecuencia de consumo de alimentos validada y un cuestionario sobre factores sociodemográficos y socioeconómicos. Resultados: el bajo nivel educativo de las madres de los escolares se asoció con un menor consumo de verduras y el bajo nivel de ingresos en el hogar se asoció con un menor consumo de frutas por los escolares. Conclusiones: el bajo nivel educativo de las madres y el bajo nivel de ingresos de los hogares fueron determinantes asociados al consumo de frutas y verduras de los escolares. Sin embargo, se presentaron diferencias en cuanto a los determinantes para las frutas y para las verduras. Estos factores y sus diferencias deben de tenerse en cuenta para la planificación de acciones que contribuyan a mejorar la ingesta de frutas y verduras en la población escolar (AU)

Introduction: increasing fruit and vegetable consumption is a priority. It has been prioritized as a fundamental objective of public policies worldwide. Given that such consumption in schoolchildren in Jalisco (Mexico) is below the dietary recommendations it is crucial to identify the determinants that influence this consumption to promote the development of contextualized actions that improve it. Objective: to identify the socioeconomic and sociodemographic determinants of fruit and vegetable consumption among mothers and households of schoolchildren in Jalisco, Mexico. Method: an analytical, cross-sectional study carried out during the first quarter of 2020. A validated food consumption frequency and a questionnaire on sociodemographic and socioeconomic factors were used for its development. Results: a lower educational level of the mothers of schoolchildren was associated with a lower consumption of vegetables by schoolchildren. In turn, a lower household income level was associated with a lower consumption of fruits in schoolchildren. Conclusions: a low educational level of mothers and a low household income were determinants associated with fruit and vegetable consumption in schoolchildren. However, there were differences in the determinants for fruits and vegetables. It is essential to consider these factors and their differences in order to plan actions that contribute to improving fruit and vegetable intake in the school population (AU)

Hipertensión maligna y feocromocitoma: reporte de un caso / Malignant hypertension and pheochromocytoma: a case report

La hipertensión arterial maligna se define por cifras extremadamente altas de presión arterial asociadas a daño orgánico. Constituye una causa de emergencia hipertensiva donde coexisten cifras elevadas de presión arterial, con hemorragia y exudados bilaterales retinianas (retinopatía hipertensiva grado III), con o sin papiledema (retinopatía hipertensiva grado IV), asociada usualmente a lesión renal o cardíaca. En un 1% de los casos es secundaria a causas endocrinológicas, entre ellas, la más frecuente: el feocromocitoma, que clásicamente se ha caracterizado por la tríada cefalea, sudoración y palpitaciones. Sin embargo, no existe un hallazgo clínico único que tenga un valor significativo en su diagnóstico. A continuación, presentamos el caso de una paciente de 23 años con emergencia hipertensiva y masa suprarrenal asociado a retinopatía hipertensiva grado IV. (AU)

Malignant arterial hypertension is defined by extremely high levels of pressure associated with organ damage. It is a cause of hypertensive emergency and is defined by the coexistence of high blood pressure and bilateral retinal haemorrhage or exudates (grade III hypertensive retinopathy), with or without papilloedema (grade IV hypertensive retinopathy) currently associated with organ damage such as renal or cardiac failure. Around 1% of malignant arterial hypertension is secondary to endocrinological causes, including the most common: pheochromocytoma, which is classically characterized by the triad: headache, sweating and palpitations. However, there is no single clinical finding that is of significant value in its diagnosis. We now present the case of a 23-year-old patient with a hypertensive emergency, an adrenal mass associated with grade IV hypertensive retinopathy. (AU)

Nuevas formas de inicio al tabaquismo en adolescentes / New forms of the initiation of smoking in adolescents

Objetivos: Estimar la prevalencia del consumo de tabaco y las formas de inicio al mismo entre adolescentes de la ciudad de Ibiza, con el fin de implantar estrategias de intervención que permitan a los adolescentes aumentar sus conocimientos sobre el tabaquismo y las nuevas formas de consumo de tabaco. Sujetos y métodos: Estudio transversal realizado en estudiantes de 12 a 18 años. Se envió acceso a un cuestionario digital anónimo a dos institutos de la isla. La muestra definitiva fue de 344 alumnos. Además del consumo de tabaco y de cannabis se analizaron otras variables sociodemográficas y familiares.Resultados: Participaron 344 adolescentes de entre 12 y 18 años, de los cuales un 50,2 % eran mujeres. La edad media de inicio del consumo se sitúa en los 13 años, lo que coincide con los últimos estudios realizados a nivel nacional. El vapeador es el producto más consumido entre los encuestados, lo que parece deberse al fácil acceso que tiene y a la aceptación social. El cannabis tiene un porcentaje de consumo similar al cigarrillo, lo que indica que su consumo está normalizado entre los adolescentes y que el acceder a ellos no es difícil. Dentro de los motivos para el inicio del consumo, un 48,2 % lo hace porque en su entorno fuman, igualmente un 37,5 % contesta que se inicia en el consumo de tabaco por diversión, lo que lleva implícito el contexto social (grupo de amigos), reforzando la idea de que en el inicio al tabaquismo hay, mayoritariamente, un componente social. Conclusiones: Está claramente demostrada la necesidad de intervención en el ámbito educativo con actividades y programas de prevención, ya entre los niños de educación primaria, incluyendo en dichos programas información sobre las nuevas formas de consumo de nicotina que están irrumpiendo con fuerza entre los jóvenes.(AU)

Objectives: To estimate the prevalence of smoking consumption and forms of its initiation among adolescents in the city of Ibiza, in order to implement intervention strategies that allow for adolescents to increase their knowledge on smoking and the new smoking consumption forms. Subjects and methods: Cross-sectional study in students of 12 to 18 years. Access to an anonymous digital questionnaire was sent to two institutes of the island. The final sample included 344 students. In addition to the consumption of tobacco and of cannabis, other sociodemographic and familial variables were analyzed. Results: A total of 344 adolescents, aged 12 to 18 years, 50.2 % of whom were women, participated. The mean age of initiation of smoking was 13 years, which coincides with the recent studies conducted on a national level. The electronic cigarette is the product that is used most among those surveyed, which seems to be due to the easy access it has and its social acceptance. The use of cannabis has a similar percentage to that of the cigarette, which indicates that its use is normalized among adolescents and that it is not difficult to access it. Within the reasons for the initiation of its use, 48.2 % did so because people smoked in their setting. A total of 37.5 % answered that they began to smoke for fun, which implies the social context (group of friends), reinforcing the idea that mainly there is a social component involved in the beginning of smoking habit. Conclusions: The need for intervention in the educational setting with prevention programs and activities is clearly demonstrated, beginning among children in primary education. Information should be included in these programs on the new ways that the nicotine consumption is entering with force among the young persons.(AU)

[Malignant hypertension and pheochromocytoma: a case report]. / Hipertensión maligna y feocromocitoma: reporte de un caso.

Malignant arterial hypertension is defined by extremely high levels of pressure associated with organ damage. It is a cause of hypertensive emergency and is defined by the coexistence of high blood pressure and bilateral retinal haemorrhage or exudates (grade III hypertensive retinopathy), with or without papilloedema (grade IV hypertensive retinopathy) currently associated with organ damage such as renal or cardiac failure. Around 1% of malignant arterial hypertension is secondary to endocrinological causes, including the most common: pheochromocytoma, which is classically characterized by the triad: headache, sweating and palpitations. However, there is no single clinical finding that is of significant value in its diagnosis. We now present the case of a 23-year-old patient with a hypertensive emergency, an adrenal mass associated with grade IV hypertensive retinopathy.

[The renin-angiotensin system and the brain]. / El rol del sistema renina angiotensina a nivel cerebral.

The renin-angiotensin-aldosterone (RAAS) system and its effects on blood pressure and the regulation of water and electrolyte balance have been studied focusing on the cardiovascular and renal system. The activation of RAAS in other organs has local and systemic repercussions by modeling the macro- and microvasculture of peripheral organs. The brain RAAS influence on systemic blood pressure through the sympathetic nervous system. The angiotensin converting enzyme/angiotensin II/angiotensin 1 receptor axis (ACE/AngII/AT1), classical pathway, and angiotensin converting enzyme type 2/angiotensin (1-7)/Mas receptor (ACE2/Ang (1-7)/MasR), non-classical pathway, are involved in the modulation of the sympathetic response. The imbalance of these two axes with subsequently Ang II accumulation promote neurogenic hypertension and other vascular pathologies. The aminopeptidase/angiotensin IV/angiotensin 4 receptor (AMN/Ang IV/AT4) axis, which is exclusive of the brain, acts on cerebral microvasculature and participates in cognition, memory, and learning. The aim of this review is to decipher the major central RAAS mechanisms involved in blood pressure regulation. In addition, paracrine functions of brain RAAS and its role in neuroprotection and cognition are also described in this review.

Manejo de pacientes de Ortopedia y Traumatología en el contexto de la contingencia por covid-19: revisión de conceptos actuales revisión de la literatura / Management of Orthopedics and Traumatology patients in the context of covid-19 contingency: current concepts review

El objetivo del presente estudio es presentar una revisión de la literatura disponible, que permita abordar de forma ordenada la evidencia actual con respecto a la organización de un servicio de cirugía ortopédica y traumatología durante la pandemia por covid-19, el manejo de los pacientes y las medidas de protección para el personal de salud involucrado. Se realizó una búsqueda de literatura en bases de datos (PUBMED y Scielo), instituciones gubernamentales de salud y sociedades científicas. Los autores seleccionaron los artículos que consideraron pertinentes para la presente revisión. Se plantean recomendaciones para los distintos escenarios de la práctica ortopédica: consulta externa, hospitalización, cirugía (electiva y de urgencias) y urgencias; así como recomendaciones específicas para algunas subespecialidades (cirugía de columna, cirugía de mano y ortopedia pediátrica).

In this study, we review current evidence on how to organize an orthopaedic's department during the covid-19 pandemic, how to manage patients and how to protect health personnel. We executed these search in PUBMED, Scielo, government health agencies and scientific associations databases. We selected articles based on relevance. We made recommendations for different scenarios of orthopedic practice: outpatient clinic, inpatient care, surgery (elective and emergency) and emergency department. We also made recommendatios for some orthopaedic subspecialties, including spinal surgery, hand surgery and pediatric orthopaedics.

Recomendaciones para el manejo de pacientes con enfermedad Inflamatoria Intestinal (EII) y COVID-19 / Recommendations for the management of patients with Inflammatory Bowel Disease (IBS) and COVID-19

The new Coronavirus (SARS-CoV-2) appeared in China in December 2019. Since then and until April 2020 it spread worldwide affecting more than three million people. Its exponential rise is still growing all over the world, taking thousands of lives. SARS-CoV-2 is very contagious, person to person, by droplets which can generate a respiratory infection known as COVID-19. Some patients are at higher risk: Older people, those with cardiovascular disease, diabetes and hypertension are the most prone to an unfavorable outcome. Our Inflammatory Bowel Disease (IBD) patients are a special cluster, with many of them taking immunosuppressive treatment for long periods, which could pose an important risk. Scientifics societies all over the world have joined efforts to generate data, share experiences and make recommendations for good clinical management. This is a review of the available evidence, expert opinion, and proposed ways of working during the pandemic

El nuevo coronavirus (SARS-CoV-2) apareció en China en diciembre de 2019. Desde su inicio hasta abril de 2020 se ha expandido por todo el mundo, afectando a más de tres millones de personas. Su ascenso exponencial sigue creciendo, generando miles de muertes. Su contagiosidad es persona a persona por gotitas, pudiendo llegar a generar un cuadro clínico de infección respiratoria conocido como COVID-19. Algunos pacientes tienen más riesgos de tener un curso desfavorable; adultos mayores, pacientes con enfermedad cardiovascular, hipertensos y diabéticos. Nuestros pacientes con enfermedad inflamatoria intestinal son un grupo de pacientes con características particulares, muchos de ellos reciben tratamiento inmunosupresor por largos períodos, lo que pudiese suponer un riesgo específico. Las sociedades científicas de Europa y Norteamérica han realizado un esfuerzo conjunto para generar datos, compartir experiencias y dictar recomendaciones de buen manejo clínico. Esta es una revisión de la evidencia disponible, opiniones de expertos y formas de trabajo propuestos durante la pandemia.

Efectividad de la suplementación de ácidos grasos omega-3 en pacientes con enfermedad de Alzheimer: revisión sistemática con metaanálisis / Effectiveness of omega-3 fatty acid supplementation in patients with Alzheimer disease: A systematic review and meta-analysis

INTRODUCCIÓN: La enfermedad de Alzheimer (EA) es una patología neurodegenerativa caracterizada por demencia de carácter progresivo asociada a una perdida global de funciones cognitivas. MÉTODOS: Se realizó una síntesis de evidencia a través de una revisión sistemática con metaanálisis de ensayos clínicos que hayan evaluado la suplementación de omega-3 en pacientes con EA. OBJETIVO: Determinar si existe evidencia científica que avale la efectividad de la suplementación omega-3 en la mejoría de la función cognitiva de pacientes con EA. Estrategia de búsqueda: La estrategia de búsqueda incluyó solo ensayos clínicos aleatorizados (ECA). Las bases de datos usadas fueron: Medline, Cochrane Central, Cinahl y Lilacs. Además, se realizó una búsqueda electrónica en Google Scholar. Selección de estudios: Se obtuvieron 6 artículos que cumplían con nuestros criterios de elegibilidad. Se evaluó el riesgo de sesgo según el método Cochrane. CONCLUSIÓN: No hay evidencia consistente que avale la suplementación de omega-3 versus placebo en la mejoría de la función cognitiva de pacientes con EA a corto y mediano plazo

INTRODUCTION: Alzheimer disease (AD) is a neurodegenerative disease characterised by progressive dementia associated with global cognitive dysfunction. METHODS: We conducted a systematic review and meta-analysis of clinical trials evaluating omega-3 supplementation in patients with AD. OBJECTIVE: To determine if there is scientific evidence of the effectiveness of omega-3 supplementation in improving cognitive function in patients with AD. Search strategy: We included only randomised controlled trials (RCTs) from the following databases: Medline, Cochrane Central, Cinahl, and LILACS. An electronic search was also conducted using Google Scholar. Study selection: Six articles met the eligibility criteria. The risk of bias was assessed following the Cochrane method. CONCLUSION: There is no consistent evidence to support the effectiveness of omega-3 supplementation in improving cognitive function in AD patients in the short and medium term

A comparative study between real-time PCR and loop-mediated isothermal amplification to detect carbapenemase and/or ESBL genes in Enterobacteriaceae directly from bronchoalveolar lavage fluid samples.

OBJECTIVES: To evaluate and compare the efficacy of real-time PCR (Xpert Carba-R) and loop-mediated isothermal amplification (Eazyplex® SuperBug CRE) for detecting carbapenemase carriage in Enterobacteriaceae directly from bronchoalveolar lavage (BAL). METHODS: Negative BAL samples were spiked with 21 well-characterized carbapenemase-producing Enterobacteriaceae strains to a final concentration of 102-104 cfu/mL. Xpert Carba-R (Cepheid, Sunnyvale, CA, USA), which detects five targets (blaKPC, blaNDM, blaVIM, blaOXA-48 and blaIMP-1), and the Eazyplex® SuperBug CRE system (Amplex-Diagnostics GmbH, Germany), which detects seven genes (blaKPC, blaNDM, blaVIM, blaOXA-48, blaOXA-181, blaCTXM-1 and blaCTXM-9), were evaluated for the detection of these genes directly from BAL samples. RESULTS: Xpert Carba-R showed 100% agreement with carbapenemase characterization by PCR and sequencing for all final bacteria concentrations. Eazyplex® SuperBug CRE showed 100%, 80% and 27% agreement with PCR and sequencing when testing 104, 103 and 102 cfu/mL, respectively. False negative results for Eazyplex® SuperBug CRE matched the highest cycle threshold values for Xpert Carba-R. Hands-on time for both assays was about 15 min, but Eazyplex® SuperBug CRE results were available within 30 min, whereas Xpert Carba-R took around 50 min. CONCLUSIONS: We here describe the successful use of two commercial diagnostic tests, Xpert Carba-R and Eazyplex® SuperBug CRE, to detect bacterial carbapenem resistance genes directly in lower respiratory tract samples. Our results could be used as proof-of-concept data for validation of these tests for this indication.

Effectiveness of omega-3 fatty acid supplementation in patients with Alzheimer disease: A systematic review and meta-analysis. / Efectividad de la suplementación de ácidos grasos omega-3 en pacientes con enfermedad de Alzheimer: revisión sistemática con metaanálisis.

INTRODUCTION: Alzheimer disease (AD) is a neurodegenerative disease characterised by progressive dementia associated with global cognitive dysfunction. METHODS: We conducted a systematic review and meta-analysis of clinical trials evaluating omega-3 supplementation in patients with AD. OBJECTIVE: To determine if there is scientific evidence of the effectiveness of omega-3 supplementation in improving cognitive function in patients with AD. SEARCH STRATEGY: We included only randomised controlled trials (RCTs) from the following databases: Medline, Cochrane Central, Cinahl, and LILACS. An electronic search was also conducted using Google Scholar. STUDY SELECTION: Six articles met the eligibility criteria. The risk of bias was assessed following the Cochrane method. CONCLUSION: There is no consistent evidence to support the effectiveness of omega-3 supplementation in improving cognitive function in AD patients in the short and medium term.

Cytomegalovirus infection in HIV-infected patients in the era of combination antiretroviral therapy.

BACKGROUND: Cytomegalovirus infection dramatically decreased with the introduction of antiretroviral therapy. Whether incidence, clinical characteristics and prognosis of cytomegalovirus in HIV infected patients, has changed over time is. scarcely known. METHODS: Retrospective single-center study. Patients included in this study were all HIV infected patients that went to our center for any disease, and were diagnosed with cytomegalovirus, during the period 2004-2015. epidemiological, clinical and laboratory patients variables were collected in a clinical database. Clinical characteristics, incidence of cytomegalovirus and predictors of mortality during the study were assessed. Results were considered statistically significant when p < 0.05. All statistical analyses were calculated by SPSS version 20.0 (Chicago, IL,USA). RESULTS: Fifty-six cases of cytomegalovirus infection, in HIV infected patients were identified during the study period (incidence rate-1.7 cases per 1000 persons/year). The most frequent presentation was systemic illness in 43% of cases. Of note,no patients presented with ophthalmic manifestations. The 30-days mortality was 18%. Predictors of mortality were, in the univariate analysis, admission to the intensive care unit OR 32.4 (3.65-287.06) p = 0.0001, and mechanic ventilation 84 OR (8.27-853.12) p = 0.0001, and ART OR 4.1 (0.97-17.31) p = 0.044. These variables were assessed by multivariate analysis, and only mechanical ventilation was statistically significant (p < 0.05) CONCLUSION: Incidence of cytomegalovirus infection was higher than described in the antiretroviral therapy era. Clinical presentation has changed. Mechanic ventilation predicted mortality.

Insuficiencia cardiaca izquierda como causa de hemoptisis / Left heart failure as a cause of hemoptysis

La hemoptisis puede ser la primera manifestación de un gran número de enfermedades cuyo pronóstico y tratamiento son muy diversos. Por ello, en la práctica clínica es muy importante plantear un buen diagnóstico diferencial y realizar un correcto diagnóstico etiológico. Presentamos el caso de un varón de 26 años con hemoptisis secundaria a insuficiencia cardiaca izquierda

Hemoptysis may be the first manifestation of a large number of diseases whose prognosis and treatment are very diverse. Therefore, in clinical practice it is very important to propose a good differential diagnosis and make a correct etiological diagnosis. We present the case of a 26-year-old man with hemoptysis secondary to left heart failure

Hepatectomía en 2 tiempos con técnica de ALPPS (Asociación de bipartición hepática con ligadura portal para hepatectomía en 2 tiempos): experiencia y resultados iniciales del Hospital Regional de Talca / 2 stage hepatectomy with ALPPS technique (Liver splitting association) with ligature portal for hepatectomy in 2 times): experience and initial results of the Regional Hospital of Talca

Resumen Introducción: La insuficiencia hepática posoperatoria (IHP) es una causa importante de morbimortalidad posoperatoria en cirugía hepática. Un remanente hepático futuro (RHF) insuficiente es una de las principales causas IHP La asociación de bipartición hepática con ligadura portal para hepatectomía en 2 tiempos (ALPPS) es una técnica relativamente nueva que induce una rápida hipertrofia parenquimatosa reduciendo el tiempo de espera para lograr un volumen hepático adecuado. Nuestro objetivo es comunicar la experiencia y los resultados iniciales de la hepatectomía en 2 tiempos utilizando la técnica de ALLPS. Material y Método: Se incluyeron todos los pacientes en los que se ha realizado una hepatectomía en 2 tiempos utilizando la técnica de ALPPS entre el 1 de junio de 2014 y el 31 de julio de 2016 en la Unidad de Cirugía Digestiva del Hospital Regional de Talca. Resutados: Durante el periodo de estudio, se realizaron 47 hepatectomías en el Hospital Regional de Talca. En 3 casos (6.3%), se realizó una hepatectomía en 2 tiempos utilizando la técnica de ALPPS, en todos ellos se logró una hipertrofia del remanente hepático futuro (RHF) que permitió completar el segundo tiempo sin IHP clínicamente significativa. Conclusión: En nuestra experiencia inicial, la técnica de ALPPS logró aumentar el RHF permitiendo resecar pacientes que inicialmente tenían un RHF insuficiente para ser sometidos a una hepatectomía mayor.

Introduction: Postoperative liver failure (POLF) is a relevant cause of morbimortality after liver surgery. An insufficient future liver remnant (FLR) is one of the main causes of POLF. The association of hepatic bipartition with portal ligation for 2-stage hepatectomy (ALPPS) is a relatively new technique that induces rapid parenchymal hypertrophy reducing the waiting time to achieve adequate FLR. Our aim is to communicate the experience and the initial results of the hepatectomy in 2-stages using the ALLPS technique. Material and Method: All patients in whom a 2-stage hepatectomy using ALPPS technique between June 1, 2014 and July 31, 2016 in the Digestive Surgery Unit of the Hospital Regional of Talca were included. Results: There were 47 hepatectomies performed at the Hospital Regional of Talca. In 3 cases (6.3%), a 2-stage hepatectomy was performed using the ALPPS technique, in all of which a hypertrophy of the future hepatic remnant (RHF) was achieved, which allowed completing the second stage without POLF clinically significant. Conclusion: In our initial experience, the ALPPS technique successfully allowed increase FLR in patients who initially had insufficient FLR to be submitted a major liver resection.

Foros virtuales y construcción de conocimiento en profesionales de la salud / Virtual forums and knowledge building among health professionals / Foros virtuais e construção de conhecimento em professionais da saúde

La modalidad e-learning se ha convertido en un método que ha permitido a los profesionales de la salud actualizar sus conocimientos. Esta forma de enseñanza facilita la construcción de aprendizaje colaborativo entre quienes participan en foros de discusión. Objetivo: Describir la construcción de conocimiento colaborativo de profesionales de la salud de las comunidades virtuales de aprendizaje que participan en cursos del Programa de Educación Continua de la Escuela de Enfermería de la Universidad Católica de Chile en 2014. Método: Estudio mixto cuantitativo descriptivo y cualitativo con análisis de contenido según Earl Babbie y basado en el modelo de Gunawardena. Resultados: La construcción de conocimiento se realiza, predominantemente, en las fases I y II del modelo de Gunawardena. Conclusión: Si bien los foros permiten la construcción de conocimiento colaborativo, en áreas específicas del saber, al igual que algunos otros estudios reportados en la literatura, el conocimiento alcanza solo las primeras etapas del modelo de Gunawardena, que implicaría que comparten información y establecen desacuerdos entre los argumentos, pero no se lograría un mayor aprendizaje, es decir, generan una propuesta con las ideas del grupo, contrastan lo discutido con la experiencia personal o información existente, sin embargo no aplican los nuevos conocimientos construidos.

E-learning modality has become a method which has allowed health professionals to update their knowledge. It is a teaching strategy which facilitates the collaborative knowledge building among those participating in the discussion forums. Objective: To describe collaborative knowledge building among health professionals in learning virtual communities who participate in courses of the Continuous Education Program of the Nursing School of the Catholic University of Chile in 2014. Method: This is a quantitative, descriptive, and qualitative study with content analysis following the guidelines of Earl Babbie and based on the Gunawardena model. Results: Knowledge building takes place, mainly, in stages II and II of the Gunawardena model. Conclusion: While these forums allow the building of collaborative knowledge in some specifiareas, as it was reported in other studies, this knowledge only reaches the first stages of the Gunawardena model, which means that there is information sharing, and arguments are agreed or disagreed, but there is no further learning; in other words, the proposed group's ideas contrast the discussions around personal experiences or existing knowledge, however, the new built knowledge is not applied.

Resumo: A modalidade e-learning tornou-se em um método que permitiu aos profissionais da saúde atualizar seus conhecimentos. Esta forma de ensino facilita a construção de aprendizagem colaborativa entre quem participa em foros de discussão. Objetivo: Descrever a construção de conhecimento colaborativo de profissionais da saúde das comunidades virtuais de aprendizagem que participam em cursos do Programa de Educação Continuada da Escola de Enfermagem da Universidade Católica do Chile em 2014. Método: Estudo misto quantitativo descritivo e qualitativo com análise de conteúdo segundo Earl Babbie e baseado no modelo de Gunawardena. Resultados: A construção de conhecimento realiza-se, predominantemente, nas fase I e II modelo de Gunawardena. Conclusão: Se bem os foros permitem a construção de conhecimento colaborativo, em áreas específicas do saber, ao igual que alguns outros estudos reportados na literatura, o conhecimento só atinge as primeiras etapas do modelo de Gunawardena, que implicaria que compartilham informação e estabelecem desacordos entre os argumentos, mas não se consegue uma maior aprendizagem, quer dizer, geram uma proposta com as ideias do grupo, contrastam o discutido com a experiência pessoal ou informação existente, no entanto, não aplicam os novos conhecimentos construídos.