Epidemiología de la faringitis estreptocócica. Período enero de 2018 - diciembre de 2021 / Epidemiology of streptococcal pharyngitis. January 2018 - December 21

La faringoamigdalitis es uno de los motivos más frecuentes de consulta en pediatría. Aproximadamente un 70-80% de las faringoamigdalitis son de etiología viral. El 20-30% restante son de origen bacteriano. El agente causal más frecuente es Streptococcus pyogenes (estreptococo ß-hemolítico del grupo A). El rol de Streptococcus dysgalactiae subsp. equisimilis, (estreptococos ß-hemolíticos grupos C y G) fue claramente establecido como agente etiológico en la faringitis bacteriana, tanto en niños como en adultos. Se realizó un análisis descriptivo y retrospectivo entre enero 2018 y diciembre de 2021. Se evaluó la prevalencia de faringitis estreptocócica, la edad, el período estacional, los agentes etiológicos y la resistencia a macrólidos durante los períodos pre-COVID-19 (2018-2019) y COVID-19 (2020-2021). Se analizaron 11 396 muestras de exudados de fauces de pacientes con sospecha de faringitis bacteriana; las mismas se procesaron mediante el uso de técnicas microbiológicas convencionales. En el período estudiado el porcentaje de positividad de los cultivos de exudados de fauces se mantuvo constante. Al comparar los períodos pre-COVID-19 (2018-2019) y COVID-19 (2020-2021) se observó una disminución en el número de aislados de S. pyogenes con un aumento de S. dysgalactiae subsp. equisimilis, mientras que la resistencia a macrólidos encontrada fue superior en S. pyogenes y para S. dysgalactiae subsp. equisimilis se mantuvo constante. Es importante realizar el cultivo para la identificación del agente etiológico y determinar la sensibilidad antibióticapara continuar con la vigilancia epidemiológica de la resistencia a los macrólidos, porque representan una opción en pacientes alérgicos a ß-lactámicos (AU)

Pharyngotonsillitis is one of the most frequent reasons for consultation in children. Approximately 70-80% of pharyngotonsillitis are of viral etiology. The remaining 20-30% are bacterial in origin. The most frequent causative agent is Streptococcus pyogenes (group A ß-hemolytic streptococcus). Streptococcus dysgalactiae subsp. equisimilis (ß-hemolytic streptococcus groups C and G) was clearly established as an etiologic agent in bacterial pharyngitis in both children and adults. A descriptive and retrospective analysis was conducted between January 2018 and December 2021. The prevalence of streptococcal pharyngitis, age, seasonal period, etiologic agents, and macrolide resistance during the pre-COVID-19 (2018-2019) and COVID-19 (2020-2021) periods were evaluated. We analyzed 11 396 specimens of swabs from patients with suspected bacterial pharyngitis. Conventional microbiological techniques were used. In the study period, the percentage of positivity of swab cultures remained constant. When comparing the preCOVID-19 (2018-2019) and COVID-19 (2020-2021) periods, a decrease in the number of S. pyogenes isolates was observed with an increase in S. dysgalactiae subsp. equisimilis, while the resistance to macrolides found was higher for S. pyogenes and remained constant for S. dysgalactiae subsp. equisimilis. The identification of the etiologic agent and determination of antibiotic sensitivity are important for epidemiological surveillance of macrolide resistance, as they are a treatment option in patients who are allergic to ß-lactams (AU)

Effects of an early rehabilitation program for adult cystic fibrosis patients during hospitalization: a randomized clinical trial

There is little information on pulmonary rehabilitation in patients with cystic fibrosis (CF) with pulmonary exacerbation. This study aimed to evaluate the effects of an early rehabilitation program on lung function, muscle strength, inflammatory markers, and quality of life in adults with CF hospitalized for pulmonary exacerbation. In this randomized controlled trial, 19 patients were included in the intervention group and 15 in the control group. The intervention group underwent an early rehabilitation program for 14 days after admission. All patients underwent spirometry, one-repetition maximum tests (1RM), and the 6-min walk test, and answered the Revised Cystic Fibrosis Questionnaire (CFQ-R) for quality of life and the International Physical Activity Questionnaire. Serum levels of interleukin and tumor necrosis factor alpha (TNF-α) were measured. In the intervention group, there were increases in 1RM biceps (P=0.009), triceps (P=0.005), shoulder abductors (P=0.002), shoulder flexors (P=0.004), hamstrings (P<0.001), and quadriceps values (P<0.001). In addition, there were improvements in CFQ-R-emotion (P=0.002), treatment burden (P=0.002), vitality (P=0.011), and physical scores (P=0.026), and a reduction in the Borg resting fatigue score (P=0.037). The interleukins levels did not change after the intervention. In adult CF patients with pulmonary exacerbation, early hospital rehabilitation had a significant impact on improving resting fatigue, muscle strength, and quality of life.

Control del dolor con infiltración local transquirúrgica en postoperados de reemplazo total de rodilla / Pain control with local infiltration transsurgical in postoperative total knee replacement

Resumen: Introducción: De 15-20% de los pacientes sometidos a una artroplastía total de rodilla no quedaron satisfechos y las causas más comunes fueron dolor residual y función limitada. De manera tradicional se ha utilizado analgesia epidural o bloqueos nerviosos periféricos como analgesia. Objetivo: Evaluar la eficacia de la infiltración con solución de epinefrina, ketorolaco, morfina y ropivacaína en pacientes postoperados de reemplazo total de rodilla. Material y métodos: Estudio de cohorte observacional, transversal, retrospectivo y analítico. Se incluyeron pacientes con gonartrosis de 18 a 100 años de edad programados para cirugía de reemplazo total de rodilla de Mayo de 2018 a Agosto de 2021, con documentación de sus datos clínicos, demográficos, basales, prequirúrgicos y dolor postoperatorio a las 24 horas. Se compararon pacientes infiltrados con los que recibieron analgesia intravenosa. Resultados: Se incluyeron un total de 66 pacientes con una media de edad de 69.1; 65.2% fueron mujeres. Cuarenta y tres punto nueve por ciento tuvieron afectación del lado izquierdo, 50% tuvieron una clasificación de Kellgren-Lawrence III y 31.8% tuvieron un grado IV. Treinta y seis pacientes (54.5%) formaron el grupo control, mientras que 30 (45.5%) recibieron la intervención con el cóctel analgésico. Con respecto al dolor, se encontró una menor mediana del dolor por escala visual análoga en pacientes con la intervención (2 vs 8 puntos, p < 0.001); la mayoría con el cóctel se encontraron sin dolor (66.7%) o dolor leve (23.3%) y ningún paciente del grupo control lo alcanzó (p < 0.001). Todos los pacientes del grupo control requirieron analgesia de rescate, mientras que sólo en 30% del grupo de intervención se utilizó (p < 0.001). Conclusión: El uso de infiltración local transquirúrgica disminuye el dolor postoperatorio y el requerimiento de analgésicos y analgesia de rescate durante las primeras 24 horas.

Abstract: Introduction: 15-20% of patients undergoing total knee arthroplasty were not satisfied and the most common causes were residual pain and limited function. Epidural analgesia or peripheral nerve blocks have traditionally been used as analgesia. Objective: To evaluate the efficacy of infiltration with epinephrine, ketorolac, morphine and ropivacaine solution in postoperative total knee replacement patients. Material and methods: Observational, cross-sectional, retrospective and analytical cohort study. We included patients with gonarthrosis aged 18 to 100 years scheduled for total knee replacement surgery from May 2018 to August 2021; with documentation of their clinical, demographic, baseline, pre-surgical and postoperative pain data at 24 hours. Infiltrated patients were compared with those receiving intravenous analgesia. Results: A total of 66 patients with a mean age of 69.1 were included;65.2% were women. Forty-three point nine percent had left-sided involvement, 50% had a classification of Kellgren-Lawrence III and 31.8% had a grade IV. Thirty-six patients (54.5%) formed the control group, while 30 (45.5%)received the intervention with the analgesic cocktail. With regard to pain,a lower median pain was found by visual analog scale in patients with the intervention (2 vs 8 points, p < 0.001); most with the cocktail they found no pain (66.7%) or mild pain (23.3%) and no patient in the control group reached it (p < 0.001). All patients of the control group required rescue analgesia, while only 30% of the intervention group used it (p < 0.001). Conclusion: The use of trans-surgical local infiltration decreases postoperative pain and the requirement of analgesics and rescue analgesia during the first 24 hours.

Radiculopatía asociada a tumor intrarraquídeo extradural en adolescente / Adolescent radiculopathy associated with extradural intraspinal tumor

Resumen: Introducción: Los procesos expansivos intrarraquídeos suelen tener una evolución insidiosa que dificultan su diagnóstico precoz. Los tumores intrarraquídeos son clasificados de acuerdo con su localización en el conducto raquídeo: extradural e intradural, y éstos se clasifican en extramedular e intramedular. Al comienzo, pueden provocar cuadros de dolor poco específicos y, a veces, dolores de tipo radicular. El paciente podrá tener síntomas como: pérdida de fuerza, pérdida de equilibrio, pérdida de sensibilidad y disturbios esfinterianos. Las neoplasias intrarraquídeas, cuando son diagnosticadas, tienen indicación de tratamiento quirúrgico. Material y métodos: Se describe el caso clínico de adolescente masculino de 14 años, dolor en región lumbar desde hace cuatro años, de inicio insidioso, intermitente, progresivo, que se exacerba hace seis meses, con irradiación a extremidades inferiores, que se acompaña de parestesias y paresias progresivas de predominio en extremidad inferior derecha. Resultados: Se realiza laminotomía L4 y L5 bilateral, exploración y resección de tumoración y liberación de raíces nerviosas. Se obtiene tumor de características similares a tejido adiposo en donde se observa amplia red vascular en su interior, con tamaño aproximado de 14 × 10 × 4 mm de forma ovoide, aplanada con superficie lisa y brillante. Conclusión: Los tumores raquimedulares son tumores relativamente raros; sin embargo, de estos tumores, la localización intrarraquídea extradural corresponde a la mitad de los casos. En nuestro paciente, se integró el diagnóstico de lipoma del filum terminale, el cual corresponde a menos de 1% de todos los tumores de la columna vertebral.

Abstract: Introduction: Expansive intra-spinal processes usually have an insidious course that makes their early diagnosis difficult. Intra-spinal tumors are classified according to their location in the spinal canal: extradural and intradural, and these are classified as extramedullary and intramedullary. At the beginning, they can cause non-specific pain conditions and, sometimes, root-type pain. The patient may have symptoms such as: loss of strength, loss of balance, loss of sensation, sphincter disorders. Intra-spinal neoplasms, when diagnosed, have an indication for surgical treatment. Material and methods: The clinical case of a 14-year-old male adolescent is described, pain in the lumbar region for four years, of insidious onset, intermittent, progressive, exacerbated six months ago, with radiation to the lower extremities, which is accompanied by progressive paresthesia and paresis predominantly in the lower right limb. Results: Bilateral L4 and L5 laminotomy is performed, exploration and resection of the tumor and release of nerve roots. Tumor with characteristics similar to adipose tissue is obtained, where a wide vascular network is observed inside, with an approximate size of 14 × 10 × 4 mm, ovoid in shape, flattened with a smooth and shiny surface. Conclusion: Spinal tumors are relatively rare tumors, however, of these tumors, the extradural intraspinal location accounts for half of the cases. In our patient, the diagnosis of lipoma of the filum terminale was integrated, which corresponds to less than 1% of all tumors of the spine.

Feature Extraction from Distributions of Phase Synchronization Values of EEG Recordings

ABSTRACT Epilepsy is the most common neurological pathology. Despite treatments available to patients, only 58% to 73% will be free of seizures. This uncertainty in treatment outcomes can lead to other psychiatric affectations in cases where treatment success may be in doubt. Seizure prediction models (SPMs) emerged as a measure to help determine when patients may be susceptible to an imminent crisis. These models are based on the continuous monitoring of patient's EEG signals and subsequent continuous analysis to identify features that differentiate ictal from interictal states. This is an ongoing field of research whose aim is to establish a robust set of features to feed the SPM and obtain a high degree of certainty regarding when the next seizure will occur. In this work we propose the analysis of phase differences of EEG as a method to extract features capable of discriminating ictal and preictal states in patients; specifically, the numeric distance between Q1 and Q3 of the distribution of phase differences. We compared this values to other phase synchronization methods and tested our hypothesis getting a p < 0.0009 with our proposed method.

Metaplasia sinovial capsular mamaria: a propósito de un caso / Mammary capsular synovial metaplasia: a case report

La metaplasia sinovial capsular mamaria es una patología poco frecuente, de origen desconocido, que se presenta generalmente con aumento de volumen mamario (colección líquida) en un período breve y frecuentemente unilateral el posoperatorio (3 meses o más). Su diagnóstico se realiza por punción con aguja fina guiada por ecografía y estudios histomorfológico y de inmunohistoquímica. Debe diferenciarse del linfoma anaplásico de células grandes asociado a implantes mamarios. El tratamiento consiste en extracción por punción de la colección líquida, reposo del brazo del lado afectado y en caso de recidivas cambio de implante e instilación de corticoides en bolsillo capsular. Presentación a propósito de un caso.

Breast capsular Synovial Metaplasia is a rare pathology of unknown origin, which usually occurs with increased breast volume (liquid collection) in a short and often unilateral postoperatively (3 months or more). Diagnosis is made with fine needle puncture guided by ultrasound and histomorphological and immunohistochemistry studies. It should differ from anaplastic large cell lymphoma associated with breast implants. Treatment consists of puncture extraction of the liquid collection, rest of the arm of the affected side and in case of relapses implant change and installation of Corticoids in capsular pocket. Filing on a case

Corrección del componente rotacional prequirúrgico y postquirúrgico del primer metatarsiano secundario a osteotomía de Chevron modificado / Correction of the pre- and post-surgical rotational component of the first metatarsal secondary to modified Chevron osteotomy

Resumen: Introducción: Hallux valgus (HV) es una patología compleja del antepié, recientemente se ha mostrado interés en el componente rotacional (CR) distal del primer metatarsiano por su relación con recidivas postquirúrgicas de la deformidad. La selección de la técnica quirúrgica es controversial con escasa literatura acerca de la corrección de rotación con osteotomías comunes. Nuestro objetivo es evaluar características radiológicas prequirúrgicas y postquirúrgicas respecto a CR del primer metatarsiano en la cirugía de corrección de HV moderado a severo usando osteotomía de Chevron largo. Material y métodos: Estudio observacional, prospectivo y comparativo en el que se evaluó el CR del primer metatarsiano en nueve pies pertenecientes a seis pacientes con una edad media de 45 años. El CR fue evaluado con base en la metáfisis proximal del primer metatarsiano en fluoroscopías axiales sin carga y AP de pie. Las mediciones se realizaron por un residente de ortopedia y traumatología y un subespecialista en cirugía de pie y Tobillo. Resultados: Se documentaron diferencias significativas (p = 0.05) en el ángulo de pronación prequirúrgico y postquirúrgico al utilizar osteotomía de Chevron largo. El resultado funcional de los pacientes evaluados fue excelente a 11 meses de seguimiento. Conclusiones: Radiológicamente, la corrección rotacional es variable y previamente no se ha reportado en la literatura con esta osteotomía. Se establecen bases morfológicas para la realización de estudios posteriores en la evaluación de rotación de cabeza del primer metatarsiano con diferentes osteotomías.

Abstract: Introduction. Hallux valgus (HV) is a complex forefoot pathology, in which interest has recently been shown in the distal rotational component (CR) of the first metatarsal due to its relationship with postsurgical relapses of the deformity. The selection of surgical technique is controversial with little current literature on the correction of rotation with common osteotomies. The aim of this study is to evaluate preoperative and postoperative radiological characteristics regarding CR of the first metatarsal using long Chevron osteotomy for moderate to severe HV. Material and methods: An observational, prospective and comparative study was carried out in which the CR of the first metatarsal was evaluated in nine feet belonging to six patients with a mean age of 45 years. The RC was evaluated based on the proximal metaphysis of the first metatarsal in axial fluoroscopies of unloaded metatarsals and standing AP. Measurements were performed by an Orthopedic and Traumatology resident and a Foot and Ankle Surgery subspecialist. Results: Significant differences (p = 0.05) were documented in the preoperative and postoperative pronation angle when using long Chevron osteotomy. The functional result of the evaluated patients was excellent at 11 months of follow-up. Conclusions: Radiologically, the rotational correction is variable and has not previously been reported in the literature with this osteotomy. We establishes the morphological bases for the performance of subsequent studies in the evaluation of head rotation of the 1st metatarsal with different osteotomies.

Encuesta de Percepción en Capacidad Instalada para la Formación de Médicos Residentes en Ortopedia (Traumatología) y Necesidades de la Atención en Patología Musculoesquelética Aguda y Crónica en México. Primera Parte / Installed Capacity Perception Survey for the Training of Resident's Program in Orthopedics and Care Needs in Acute and Chronic Musculoskeletal Pathology in Mexico

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Abstract: Introduction: It is essential that orthopaedic resident physicians be highly proficient in all aspects, considering the balance between supply, demand, need and context. Fundamental to identify the capacity and quality installed for their training in Mexico. Material and methods: Observational Study, transverse, non-probabilistic sampling-conglomerates, in two phases. The instrument has 8 domains, 57 variables and 4,867 items. 60 graduate professors of 20 states, 50 hospital sites, 22 university programs. Results: 1,038 years of experience (collective intelligence), 17 years of experience/teacher (01 to 50 years). Identified: acute pathology 30 (2 to 90%), chronic pathology 30 (5 to 96%), patients ˂ 15 years, 10 (3 to 30%), patients between 15 and 65 years, 47 (2 to 78%), patients ˃ 65 years, 20 (2 to 60%), number of beds/seat 20 (2 to 510), number of clinics 3 (1 to 48), number of surgical procedures/headquarters per year at the national level, was 960 (50 to 24,650). The national average per resident doctor is 362 surgeries/year with 1,450 surgical times/year. Conclusions: The needs and resources for the training of physicians specializing in orthopedics/traumatology are highly heterogeneous, so it should be adapted to the epidemiological needs of the region of influence, in an area of epidemiological transition. 62.2% expressed not having or have bad academic and scientific infrastructure at its headquarters, more than 50% without rotation overseas and ˃ 90% without regular scientific production.

Sublethal effect of Abamectin in the functional response of the predator Phytoseiulus persimilis (Athias-Henriot) on Tetranychus urticae (Koch) (Acari: Phytoseiidae, Tetranychidae) / Efeito subletal da Abamectina na resposta funcional do predador Phytoseiulus persimilis (Athias-Henriot) em Tetranychus urticae (Koch) (Acari: Phytoseiidae, Tetranychidae)

Abstract The biological control used for the control of Tetranychus urticae (Koch) is the predator mite Phytoseiulus persimilis (Athias-Henriot). It is important to the know the effects of acaricides on the biological behavior the Abamectin on the functional response of P. persimilis. The functional response of the predator was of type II exposed to concentration of Abamectin, the functional response parameters: successful attack rate (a'), handling time (Th), search efficiency and the maximum predation theory (T/Th) were affected by the acaricide. The predator spends more time in persecute, dominate, consume and prepair it self to the next searching comparing with the proof subject an the predation ability was affected.

Resumo O controle biológico utilizado para o controle de Tetranychus urticae (Koch) é o acaro predador Phytoseiulus persimilis (Athias-Henriot). É importante conhecer os efeitos dos acaricidas sobre o comportamento biológico do predador. Foi avaliado o efeito tóxico de a Abamectina na resposta funcional de P. persimilis. A resposta funcional do predador foi tipo II exposta a concentrações subletais de Abacmetina, os parâmetros da resposta funcional: taxa de ataque (a'), tempo de manipulação (Th), a eficiência na procura e predação teórica máxima (T/Th) foram afetados pelo acaricida. O predador passa mais tempo na procura, dominar, consumir e se preparar para a próxima procura em comparação com a testemunha e sua capacidade de predação foi afetada.

Síndrome de schimmelpennig. a propósito de un caso / Schimmelpennig syndrome. report of a case

RESUMEN El síndrome de Schimmelpenning es un desorden neurocutáneo sistémico raro caracterizado por nevo sebáceo extendido, de ubicación primordialmente craneofacial, y compromiso de diferentes órganos neuroectodérmicos. Los principales desórdenes del sistema nervioso central (SNC) comprenden retraso mental, convulsiones y hemimegalencefalia. Otras anomalías asociadas incluyen oculares, osteoesqueléticas, cardiovasculares y genitourinarias. Reportamos el caso de una paciente femenina de 4 meses de edad con lesiones cutáneas y sistémicas compatibles con Syndrome de Schimmelpenning - Feuerstein - Mims y RMN que muestra compromiso del SNC.

SUMMARY Schimmelpenning syndrome is a rare congenital neurocutaneous disorder characterized by extensive nevus sebaceous, mainly craniofacial, and abnormalities in different neuroectodermal organ systems. The most common central nervous system disorders are intellectual disability, seizures and hemimegalencephaly. Other associated anomalies include ocular, skeletal, cardiovascular and genitourinary. We report a four month old female patient with cutaneous and systemic lesions compatible with Schimmelpenning - Feuerstein - Mims syndrome and MRI showing central nervous system compromise. system compromise include seizures, mental retardation and anatomic alterations that include cranial asymmetry, hemimegalencephaly with asymmetric and dilated ventricles, and calcium deposit. We report the case of a four month old female patient with skin and systemic lesions compatible with Schimmelpenning syndrome and MRI showing its central nervous system compromise.

Comparación de lípidos sanguíneos entre pollos de engorde y gallinas ponedoras / Blood lipid comparison between broilers and laying hens

RESUMEN El objetivo del presente estudio fue comparar los niveles séricos del colesterol total, triglicéridos, colesterol de la lipoproteína de alta densidad y colesterol de la lipoproteína de baja densidad entre pollos de engorde y gallinas ponedoras. Se recolectó sangre después de ayuno de 30 pollos de engorde de la línea Cobb 500 de 35 días de edad y de 40 gallinas ponedoras de la línea Hy-Line W-36 de 26 semanas. Se midieron los niveles séricos de triglicéridos y colesterol total mediante métodos enzimáticos colorimétricos, mientras que para determinar el colesterol de las lipoproteínas de alta y de baja densidad se usó el método directo [detergente + N,Nbis(4-sulfobutil)-m-toluidina]. Los datos se analizaron medieante ANOVA simple usando el paquete estadístico Statgraphics® Plus 5.1. Se presentaron diferencias significativas (P < 0.05) entre los pollos de engorde y las gallinas ponedoras en los niveles séricos de los triglicéridos (21.4 vs. 759.6 mg/dL, respectivamente) y en los niveles de colesterol de la lipoproteína de alta densidad (93.1 vs. 64.6 mg/dL, respectivamente). No se encontraron diferencias significativas (P > 0,05) para el colesterol total (125.1 and 137.0 mg/dL, respectivamente) ni para los niveles de colesterol de la lipoproteína de baja densidad (52.2 and 48.2 mg/dL, respectivamente). Los resultados del presente estudio muestran que aunque hubo diferencias de sexo, edad, madurez sexual y sistemas de producción, no se encontraron diferencias en los niveles séricos de colesterol total o en los niveles de colesterol de la lipoproteína de baja densidad entre pollos de engorde y gallinas ponedoras. La diferencia en la concentración de triglicéridos, es debida al transporte de lípidos hacia el ovario en las gallinas ponedoras.

ABSTRACT The aim of the present study was to compare total cholesterol, triglycerides, low-density lipoprotein cholesterol and high-density lipoprotein cholesterol serum levels between broiler chickens and laying hens. Whole blood was collected after fasting from 30, 35-day-old broiler chickens (Cobb 500 line) and 40, 26-week-old laying hens (Hy-Line line W-36). The serum triglyceride and total cholesterol levels were measured by enzymatic colorimetric methods, while a direct method [detergent + N,N-Bis(4- sulfobutyl)-m-toluidine] was used to determine the low density lipoprotein cholesterol and high density lipoprotein cholesterol levels. Data were analyzed by simple ANOVA using the statistics package Statgraphics® Plus 5.1. Significant differences (P < 0.05) were found between broiler chickens and laying hens in serum triglycerides (21.4 vs. 759.6 mg/dL, respectively) and high-density lipoprotein cholesterol levels (93.1 vs.64.6 mg/dL, respectively). No significant differences were found for total cholesterol (125.1 and 137.0 mg/dL, respectively) or low-density liprotein cholesterol levels (52.2 and 48.2 mg/dL, respectively). The results of the present study show that even though there are differences in gender, age, sexual maturity and production systems, there are no differences in serum total cholesterol or low-density lipoprotein cholesterol levels between broiler chickens and laying hens. The 35-fold difference in serum triglycerides is related to the transport of lipids to the ovary in a laying hen.

Experiencia en el tratamiento quirúrgico del angiofibroma nasal juvenil en Hospital de Especialidades No 2 Lic. Luis Donaldo Colosio Murrieta. Instituto Mexicano del Seguro Social de Ciudad Obregón, Sonora / Experience in the surgical treatment of juvenile nasopharyngeal angiofibroma at the Hospital de Especialidades No. 2 "Lic. Luis Donaldo Colosio Murrieta", Mexican Social Security Institute, Ciudad Obregón, Sonora

Objetivo: Exponer nuestra experiencia y evaluar la recurrencia en el manejo quirúrgico del angiofibroma nasal juvenil, abordaje abierto contra endoscópico, en el servicio de otorrinolaringología del noroeste del país. Materiales y métodos: Estudio observacional, retrospectivo, analítico. Se revisaron los expedientes clínicos de los pacientes con diagnóstico de angiofibroma nasal juvenil de 2014 a 2017, atendidos en el Servicio de Otorrinolaringología y Cirugía de Cabeza y Cuello de esta institución. Resultados: Un total de 19 pacientes con diagnóstico de angiofibroma nasal juvenil, fueron sometidos a un procedimiento quirúrgico, 14 abiertos y 5 endoscópicos, la recurrencia fue de 50 % y 40 % respectivamente, lo cual no fue estadísticamente significativo (p=0.88). No obstante, se contrastaron otras variables, como la necesidad de la Unidad de Cuidados Intensivos (UCI) para ambos grupos, 71 % en abordaje abierto y 20 % para el endoscópico, en lo cual si encontramos diferencia significativa (p=0.04). Conclusiones: El estudio no muestra una ventaja estadísticamente significativa del abordaje endoscópico frente al abordaje abierto, pero sí una menor necesidad de hospitalización en UCI, lo que reduciría los costos de atención.

Objective: To present our experience and assess the recurrence of juvenile nasopharyngeal angiofibroma after a surgical treatment (open versus endoscopic approach) in the country's northwestern Department of Otorhinolaryngology. Materials and methods: An observational, retrospective, analytical study. The medical records of patients diagnosed with juvenile nasopharyngeal angiofibroma, who were treated at the Department of Otorhinolaryngology - Head and Neck Surgery of this institution from 2014 to 2017, were reviewed. Results: A total of 19 patients diagnosed with juvenile nasopharyngeal angiofibroma underwent a surgical procedure, out of which 14 had an open surgery and 5 an endoscopic one. Recurrence accounted for 50 % and 40 %, respectively, which was not statistically significant (p = 0.88). However, other variables were compared, such as the need for admission to the Intensive Care Unit (ICU), which was represented by 71 % in the case of the open approach and 20 % for the endoscopic approach, where a significant difference was found (p = 0.04). Conclusions: The study shows no statistically significant advantage of the endoscopic approach versus the open approach, but demonstrates less need for ICU admissions, which would reduce healthcare costs.

Beetle diversity in fragmented thornscrub and isolated trees / Diversidade de coleópteros em um fragmento do bioma thornscrub e árvores isoladas

Abstract Due to land use change mainly for induced agriculture, Tamaulipan thornscrubin northeast Mexico has been cleared and transformed into small patches of vegetation as small as isolated trees surrounded by agricultural fields. In this study, we explored how tree isolation or growing inside a fragment of remnant vegetation influence diversity of coleopterans in two plant species (Prosopis laevigata (Humb. &Bonpl.exWilld.) M.C. Johnst. (mesquite) and Ebenopsis ebano (Berl.) Barneby (Texas ebony). We found 72 coleopteran morphospecies; fifteen occurred mainly in remnant fragments and ten mainly in isolated trees. There were more insects under isolated mesquites than under those immersed in remnant fragments, while in Texas ebony the highest beetle density for isolated trees coincided with periods of bean and maize in surrounding agriculture.

Resumo Devido a mudança de uso da terra para induzir principalmente a agricultura, o bioma thornscrub no nordeste México tem sido transformado em fragmentos pequenos como árvores isoladas rodeadas por campos agrícolas. Neste estudo exploramos como o isolamento das árvores influi na diversidade de coleópteros em duas espécies de plantas (Prosopis laevigata (Humb. & Bonpl.ex Willd) M.C. Johnst. (mesquite) e Ebenopsis ebano (Berl.) Barneby (Texas ebony). Encontramos 72 morfospecies do coleópteros; quinze ocorreram principalmente em fragmentos remanescentes e dez em árvores isoladas. No estudo houve mais insetos nas “mesquite” isoladas do que nos fragmentos remanescentes do bioma thornscrub, enquanto que em “Texas ebony” a densidade alta de coleópteros para árvores isoladas coincidiu com períodos de produção de feijão e milho na agricultura ao redor.

Evaluación in vitro de la actividad antimicrobiana de un gel para manos con nanomoléculas de cobre / In vitro evaluation of the antimicrobial activity of a hand gel with copper nanomolecules

Introducción: en los últimos años el uso del cobre se ha propuesto como una alternativa para la disminución de IAAS. Objetivos: evaluar la actividad antimicrobiana in vitro de un gel para manos, con nanomoléculas de cobre en cepas de: Candida albicans, C. parapsilosis, Staphylococcus aureus, Enteroccus faecalis, Escherichia coli y Pseudomona aeruginosa. Materiales y Método: estudio experimental in vitro. Se sembraron cepas de referencia (ATCC) en medios de cultivos y se colocaron cuatro discos de gasas estériles con gel de cobre, clorhexidina, alcohol gel y de agua destilada. Se midieron los halos a las 24, 48 hs y 7 días. Se utilizó la prueba de Anova y test HSD Tukey para análisis estadístico. Resultados: para C. albicans y C. parapsilosis el gel de cobre presentó un halo de inhibición a las 24, 48 hs y 7 días, siendo mayor al de clorhexidina (p< 0,001) en el caso de la C. albicans. Para S. aureus, E. coli y P. aeruginosa presentó un halo menor (p< 0,001) que el de clorhexidina a las 24 hs, sin embargo, no hubo inhibición a las 48 hs ni a los 7 días. En E. faecalis no hubo halo de inhibición a ningún tiempo. Conclusiones: el gel de cobre presentó actividad in vitro tanto para C. albicans como para C. parapsilosis, hasta los 7 días. Presentó actividad sobre S. aureus, E. coli y P. aeruginosa hasta las 24 hs. No presentó actividad antimicrobiana sobre E. faecalis.

Introduction: in the last few years the use of copper has been proposed as an alternative for reducing HAIs. Objective: to assess in vitro antimicrobial activity of a gel with copper nanomolecules on strains of Candida albicans , C. parapsilosis, Staphylococcus aureus, Enteroccus faecalis , Escherichia coli and Pseudomona aeruginosa. Materials and Methods: in vitro experimental study. Reference strains (ATCC) were seeded in growth medium and then four disks of sterile gauze impregnated with gel copper, chlorhexidine, gel alcohol and distilled water were placed in the culture. Halos were measured at 24, 48 hours and 7 days. Anova test and Tukey HSD test were used to statistical analysis. Results: for C. albicans and C. parapsilosis copper gel provided an inhibition at 24, 48 hours and 7 days, being higher than chlorhexidine (p <0.001) in the case of C. albicans. For S. aureus, E. coli and P. aeruginosa copper gel showed a lower halo (p <0.001) than chlorhexidine at 16 and 24 hours, however there was no inhibition at 48 hrs or 7 days. In E. faecalis no inhibition halo was found at any time. Conclusions: the copper gel showed in vitro activity for C. albicans and C. parapsilosis up to 7 days. Presented activity on S. aureus, E. coli and P. aeruginosa up to 24 hrs. It did not show antimicrobial activity against E. faecalis.

Sublethal effect of Abamectin in the functional response of the predator Phytoseiulus persimilis (Athias-Henriot) on Tetranychus urticae (Koch) (Acari: Phytoseiidae, Tetranychidae)

Abstract The biological control used for the control of Tetranychus urticae (Koch) is the predator mite Phytoseiulus persimilis (Athias-Henriot). It is important to the know the effects of acaricides on the biological behavior the Abamectin on the functional response of P. persimilis. The functional response of the predator was of type II exposed to concentration of Abamectin, the functional response parameters: successful attack rate (a), handling time (Th), search efficiency and the maximum predation theory (T/Th) were affected by the acaricide. The predator spends more time in persecute, dominate, consume and prepair it self to the next searching comparing with the proof subject an the predation ability was affected.

Resumo O controle biológico utilizado para o controle de Tetranychus urticae (Koch) é o acaro predador Phytoseiulus persimilis (Athias-Henriot). É importante conhecer os efeitos dos acaricidas sobre o comportamento biológico do predador. Foi avaliado o efeito tóxico de a Abamectina na resposta funcional de P. persimilis. A resposta funcional do predador foi tipo II exposta a concentrações subletais de Abacmetina, os parâmetros da resposta funcional: taxa de ataque (a'), tempo de manipulação (Th), a eficiência na procura e predação teórica máxima (T/Th) foram afetados pelo acaricida. O predador passa mais tempo na procura, dominar, consumir e se preparar para a próxima procura em comparação com a testemunha e sua capacidade de predação foi afetada.

Validación de un instrumento para evaluar la satisfacción de los usuarios atendidos en el consultorio externo de psiquiatría de un hospital público (Lima, Perú) / Validation of an instrument to assess the user satisfaction of the out-patient psychiatric services in a public hospital.

Objetivo: Validar un instrumento para evaluar la satisfacción de los usuarios de la consulta externa de psiquiatría. Método: A partir del contenido de otros instrumentos para evaluar la satisfacción de los pacientes con su atención, de la opinión de un grupo de psiquiatras y de la información que se obtuvo al aplicar una primera versión de la escala a 40 usuarios de consultorio de psiquiatría, se construyó una segunda versión autoadministrable, la cual fue evaluada en cuanto a claridad y relevancia de los ítems, consistencia interna, análisis de componentes principales para variables categóricas (CATPCA) y convergencia con la misma segunda versión pero administrada por entrevista. Resultados: La opinión sobre las preguntas del cuestionario por parte de usuarios y médicos fue en general favorable. El alfa de Cronbach fue 0,828. El CATPCA permitió identificar 3 factores relacionados con: 1) el acto médico, 2) la organización y 3) la comodidad y espera; siendo el primero el más importante. La correlación del puntaje total de la versión autoadministrable y la versión por entrevista fue 0,876 (p<0,0001). Conclusiones: Este estudio inicial realizado en consultorio de psiquiatría, muestra que esta nueva escala para evaluar satisfacción del usuario tiene características psicométricas adecuadas.

Objective: To validate an instrument to assess the user satisfaction of the out-patient psychiatric services. Method: Based on other instruments for assessment of patient satisfaction with their care, the opinion of a group of psychiatrists, and the information obtained by applying a first version of the scale to 40 users of psychiatric clinic, a second self-rating version of the scale was constructed. Then it was evaluated for clarity and relevance of the items, internal consistency, principal component analysis for categorical variables (CATPCA) and convergence with the same second version but administered by interview. Results: The opinion of the questionnaire by users and physicians was generally favorable. Cronbach’s alpha was 0.828.The CATPCA allowed to identify three factors related to:1) the medical act, 2) the organization, and 3) comfort and waiting time; the first being the most important. The correlation of the total score of the self-administered version and version by interview was 0.876 (p <0.0001). Conclusions: This initial study in psychiatric out-patient services shows that this new scale for assessment of user satisfaction has good psychometric features.

Clasificación mediante análisis de conglomerados: un método relevante para la psiquiatría / Classification by cluster analysis: a relevant method for psychiatry

El objetivo de este artículo es describir el método de análisis por conglomerados y sus aplicaciones especialmente en la investigación psiquiátrica. El análisis de conglomerados es un método que permite clasificar individuos u objetos en grupos homogéneos (conglomerados o clusters). Dentro de cada conglomerado los objetos tienen características similares entre ellos pero diferentes a las de los objetos de otros conglomerados. El análisis por conglomerados tiene aplicaciones en diversas áreas que van desde la biología hasta los negocios, particularmente es muy importante para la psiquiatría donde la clasificación de los trastornos mentales ha sido motivo de controversia.

The objective of this paper is to describe the cluster analysis method and its applications especially in psychiatric research. Cluster analysis is a method for classifying individuals or objects into homogeneous groups (clusters). Within each cluster, objects have similar features among them but different from those of objects of other clusters. Cluster analysis has applications in diverse fields ranging from biology to business, it is particularly important for psychiatry where the classification of mental disorders has been controversial.

"Estilos de vida en adolescentes de nivel medio superior de una comunidad semiurbana" / "Lifestyles in teen top-middle level of a semi-urban comunity"

Se propuso identificar los estilos de vida en adolescentes de una comunidad semiurbana, buscando respuesta a la pregunta: ¿Cuáles son los factores que se identifican en el instrumento Fantastic, en los estudiantes de la comunidad de Ixtlahuaca? Se trabajó con la variable de estilos de vida, ocupando el instrumento FANTASTIC. La muestra la conforman 1088 estudiantes, 603 hombres y 485 mujeres. La religión de mayor prevalencia es la católica con 844. Del instrumento se obtuvo una fiabilidad de .79, con 6 factores identificados: sentimientos negativos y estrés, satisfacción y pensamiento positivo, alimentación dañina, relajación y sueño, alcohol y tabaco, cafeína. Se concluye que se requiere manejo de hábitos saludables, prevención de adicciones y alimentación.

The proposal was to identify lifestyles among adolescents in a semi-urban community, seeking answers to the question: What are the factors that are identified in the Fantastic instrument in students Ixtlahuaca community? We worked with the lifestyle variable, holding the instrument FANTASTIC. The sample is formed by 1088 students, 603 men and 485 women. The most prevalent religion is Catholic with 844. The instrument yielded a reliability of .79, with 6 factors identified: negative feelings and stress, satisfaction and positive thinking, harmful food, relaxation and sleep, alcohol and snuff, caffeine. It is concluded that it is required management of healthy habits, addictions and alimentation prevention.

Consumo de macronutrientes en niños preescolares venezolanos con diagnóstico de caries severa en la infancia temprana / Macronutrients consumption by venezuelan preschool children diagnosed with severe early childhood caries

El propósito de este estudio fue determinar el consumo de macronutrientes y calorías en niños preescolares venezolanos con Caries Severa de la Infancia Temprana (CSIT). Para ello, se examinaron 32 niños entre 4 y 5 años de edad con diagnóstico de CSIT, quienes asistieron al Postgrado de Odontología Infantil de la Facultad de Odontología de la Universidad Central de Venezuela. Se consideró un niño con CSIT aquel que presentaba lesiones cariosas, comprometiendo casi todos los dientes, incluyendo los incisivos inferiores, afectando toda la superficie dentaria. Para determinar el consumo de macronutrientes se utilizó una encuesta, en la cual se registró el tipo y cantidad de alimento ingerido durante 24h por tres días. A partir de estos datos se calculó el consumo de proteínas, grasas, hidratos de carbono totales, tipo de hidrato de carbono, así como las calorías provenientes de dichos macronutrientes. Igualmente, se realizó un cuestionario para determinar su condición socioeconómica. Los resultados indicaron que el 100% de los niños evaluados pertenecían a un estrato socioeconómico bajo con un consumo promedio de hidratos de carbono, proteínas, grasas y calorías totales de 151,2± 44,3; 31,5± 9,6; 28,8±10,9 g/día y 962.6±274,4 kcal/día, respectivamente. Al evaluar el tipo de hidrato de carbono los resultados indicaron que los niños consumían dulces retentivos en un 67,7%, dulces sólidos pegajosos en un 20,6% y azúcar en solución en un 11,8%. No se encontraron diferencias significativas en cuanto al consumo de macronutrientes y energía, de acuerdo a la edad y género. Los resultados de este estudio indican que los niños con CSIT evaluados presentaron una baja ingesta de proteínas y un consumo promedio de calorías por debajo de los valores recomendados

The purpose of this study was to determine the intake of macronutrients and the amount of calories consumed by a group of Venezuelan children with severe early childhood caries (in spanish CSIT). For this study, 32 children, 4 and 5 years of age, with severe early childhood caries coming from families with a low social-economical status, were selected. A child with severe early childhood caries was considered when almost all the teeth were affected including the lower incisors. The severe condition indicated that the majority of the surfaces were affected by the diseased. Protein, fat, carbohydrates, type of carbohydrate and total calories consumption of each child were determined over three days using a 24 hours recall method. At the same time a questionnaire to determine the social-economical conditions was implemented. The results showed that 100% of the children came from low social-economical status with an average carbohydrates, proteins, fats and calories consumption of 151.2± 44.3; 31.5± 9.6, 28.8± 10.9 g/day and 962.6± 274.4 Kcal/day, respectively. When the type of carbohydrate was analyzed the result showed that 67.7% children ingested retentive sweet, 20.6% solid sticky sweet and 11.8% sugar in solution. When the macronutrients and calories consumption were evaluated according to age and gender, no differences were observed. The results of this study indicate that the evaluated children presented a low daily intake of proteins and a mean consumption of calorie below the recommended values