Arthrodilation: a treatment algorithm as a conservative management option for adhesive capsulitis / Artrodilatación: un algoritmo de tratamiento como opción de tratamiento conservador de la capsulitis adhesiva

Abstract: Introduction: the management of adhesive capsulitis (AC) remains a topic of debate among orthopedic surgeons, with a wide variation in the literature. Conservative treatment relies as the first-line option as clinical studies report positive outcomes. However, there is variability in the effectiveness of different treatment modalities. Material and methods: this study aimed to analyzed functional and clinical outcomes of patients with AC who underwent the arthrodilation protocol, including three ultrasound-guided injections administered on a weekly basis: two corticosteroid injections and one injection of hyaluronic acid combined with corticosteroids. Additionally, patients received a specific rehabilitation therapy. Visual analogue scale (VAS), the university of California-Los Angeles shoulder score (UCLA) and Constant-Murley score were assessed before treatment and after 3-month follow-up period. Results: 23 patients were included, receiving the same treatment protocol with a mean onset of symptoms of 4.9 ± 1.7 months. Among these patients, there was a clear predominance of females (65.2%). Age distribution ranged from 39 to 74 years (mean = 56) indicating that individuals in their mid-50s were more susceptible to developing this condition. Furthermore, a slight majority (52.2%) exhibited AC in their right shoulder. VAS significantly decreased (-6.09 ± 1.9 [p ≤ 0.05]). Similarly, UCLA score (10.9 ± 2.9 to 31.7 ± 2.2) and Constant-Murley score (22.3 ± 6.1 to 62.0 ± 6.2) improved significantly. Pre-to-post treatment evaluation showed improvement in both UCLA (mean = 20.8 ± 2.9 [p ≤ 0.05]) and Constant-Murley (mean = 39.7 ± 9 [p ≤ 0.05]). Conclusion: arthrodilation protocol demonstrated promising results, with patients achieving good to excellent outcomes and safely resuming their regular daily activities within a short-term follow-up period. These findings provide support for arthrodilation as a viable conservative management option and contribute valuable insights to the ongoing research aimed at identifying optimal treatment approaches for adhesive capsulitis.

Resumen: Introducción: el tratamiento de la capsulitis adhesiva (CA) sigue siendo un tema de debate entre los cirujanos ortopedistas, con una variación amplia en la literatura. El tratamiento conservador se considera la opción de primera línea, ya que los estudios clínicos muestran resultados positivos. Sin embargo, existe variabilidad en la efectividad de las diferentes modalidades de tratamiento. Material y métodos: este estudio tuvo como objetivo analizar los resultados funcionales y clínicos de pacientes con CA que se sometieron al protocolo de artrodilatación, incluyendo tres inyecciones guiadas por ultrasonido administradas semanalmente: dos inyecciones de corticosteroides y una inyección de ácido hialurónico combinado con corticosteroides. Además, los pacientes recibieron una terapia de rehabilitación específica. La escala analógica visual (EVA), la puntuación del hombro de la Universidad de California-Los Ángeles (UCLA) y la puntuación de Constant-Murley se evaluaron antes del tratamiento y después de un período de seguimiento de tres meses. Resultados: se incluyeron 23 pacientes que recibieron el mismo protocolo de tratamiento con un inicio medio de síntomas de 4.9 ± 1.7 meses. Entre estos pacientes hubo un claro predominio del sexo femenino (65.2%). La distribución por edades osciló entre 39 y 74 años (media = 56), lo que indica que las personas de alrededor de 55 años eran más susceptibles a desarrollar esta afección. Además, una ligera mayoría (52.2%) presentaba CA en el hombro derecho. La EVA disminuyó significativamente (-6.09 ± 1.9 [p ≤ 0.05]). De manera similar, la puntuación de UCLA (10.9 ± 2.9 a 31.7 ± 2.2) y la puntuación de Constant-Murley (22.3 ± 6.1 a 62.0 ± 6.2) mejoraron significativamente. La evaluación previa y posterior al tratamiento mostró una mejoría tanto en UCLA (media = 20.8 ± 2.9 [p ≤ 0.05]) como en Constant-Murley (media = 39.7 ± 9 [p ≤ 0.05]). Conclusión: el protocolo de artrodilatación demostró resultados prometedores, los pacientes lograron resultados de buenos a excelentes y reanudaron de manera segura sus actividades diarias regulares dentro de un período de seguimiento a corto plazo. Estos hallazgos respaldan la artrodilatación como una opción de tratamiento conservador viable y aportan conocimientos valiosos a la continua investigación destinada a identificar tratamientos óptimos para la capsulitis adhesiva.

Evidencias de validez, fiabilidad e invarianza factorial de una escala breve de empatía para niños peruanos / Evidence of validity, reliability and factor invariance of a brief scale of empathy for Peruvian children

Resumen La empatía es conceptualizada como la conciencia de las emociones y cogniciones de los demás y resulta importante en el contexto escolar para el favorecimiento de la convivencia y prevención de conductas agresivas. En ese sentido, el presente estudio tiene como objetivo examinar las evidencias de validez, fiabilidad e invarianza factorial de una escala breve de empatía básica (BES) en niños peruanos. Por ende, participaron 838 niños y niñas entre 8 y 12 años de edad (M = 9.95; DE = 1.13) de seis instituciones educativas, algunos colegios fueron utilizados para el análisis exploratorio y otros para confirmar. Se administró la BES que fue adaptada para niños (BES-I). Respecto al análisis de datos, se efectuó un análisis factorial exploratorio (AFE) y confirmatorio (AFC), además del análisis de invarianza factorial, para finalmente examinar la fiabilidad mediante el coeficiente omega (ω). Los resultados del AFE sugieren una medida bidimensional oblicua (cognitivo y afectivo). Del mismo modo, el AFC reafirmó estos resultados por presentar buenas bondades de ajuste (CFI ≥ .97, RMSEA ≤ .04); estos hallazgos son coherentes con los postulados teóricos que sugieren que la empatía es un constructo compuesto por factores específicos y no por un solo factor. La invarianza factorial de acuerdo con el sexo demostró que la BES-I mide lo mismo en niños y niñas y la fiabilidad obtenida mediante el coeficiente ω fue superior a .65, lo cual indica que es aceptable. Se concluye que la BES-I es un instrumento breve que puede resultar valioso en la comprensión de la empatía infantil en futuras investigaciones.

Abstract Childhood is a period where prevention and promotion actions can be carried out; therefore, the study of positive variables such as mindfulness, well-being, resilience and empathy has increased for some years. In this sense, empathy is conceptualized as the awareness of the emotions and cognitions of others in socio-emotional theoretical models; additionally, its study is important in the school context for the promotion of coexistence and prevention of aggressive behavior. Likewise, women are known to present higher empathy prevalence than men. Within the perspectives of this construct related to the cognitive and affective states, it became the most relevant in various studies and measurement instruments; despite this, there is a lack of brief instruments to measure empathy in the Latin American context. In this sense, this study aims to examine the evidence of validity, reliability and factor invariance of a short Basic Empathy Scale (BES) in Peruvian children. For these purposes, 838 children between 8-12 years old (M = 9.95; SD = 1.13) from six schools participated, some of them were used for exploratory analysis and others for confirmation. Likewise, eleven professionals from the clinical field and with experience in children's issues participated and applied the two criteria-based BES: relevance and representativeness. Prior to this, ten children were interviewed to verify the clarity of the items. After this procedure, trained research assistants created a version of the BES for children (BES-I) for children in their respective classrooms; who also requested parental authorization by signing an informed consent. The data was analyzed by R statistical software of free access using packages such as 'psych', 'lavaan', 'MBESS', 'semTools'; two factor analyses were performed; one, exploratory (AFE) and two, confirmatory (AFC), in a third moment a multigroup analysis was performed to evaluate to what extent the factor structure is invariant in the subgroups of males and females; finally, reliability was calculated using the omega coefficient (ω). The results show that the items have the representativeness and relevance in their content according to eleven experts in clinical psychology, whose responses were quantified by V of Aiken reaching values higher than .70. The internal structure in the AFE indicated the presence of two related factors (cognitive and affective) that explain 35 % of the model variance. Similarly, the AFC verified these results by showing optimal goodness of fit (IFC ≥ .97, RMSEA ≤ .04) in the two-factor model; these empirical findings are consistent with theoretical assumptions suggesting that empathy is a construct comprising specific factors rather than a single factor. As for the multi-group analysis according to sex, the invariance of the BES-I was evidenced, when observing that the differences between the base or configuration model and those with restricted thresholds, loads, variance and covariance are minimally recommended; in that way, the BES-I is established to measure the same in boys and girls; finally, regarding the reliability in the two-factor model, the coefficient ω is observed to exceed .65 for both the cognitive factor (ω = .66) and the affective factor (ω = .66). It is concluded that the BES-I is a brief instrument to be interpreted in a two-dimensional oblique way, taking as reference the theoretical cognitive-affective perspective; thus, the validity evidence of the BES-I is valuable for the understanding of child empathy in future Latin American researches.

Three-Dimensional Modeling of the Structural Microenvironment in Post-Traumatic War Wounds

BACKGROUND@#The development of post-traumatic heterotopic ossification (HO) is a common, undesirable sequela in patients with high-energy (war-related) extremity injuries. While inflammatory and osteoinductive signaling pathways are known to be involved in the development and progression of post-traumatic HO, features of the structural microenvironment within which the ectopic bone begins to form remain poorly understood. Thus, increasing our knowledge of molecular and structural changes within the healing wound may help elucidate the pathogenesis of post-traumatic HO and aid in the development of specific treatment and/or prevention strategies. @*METHODS@#In this study, we performed high-resolution microscopy and biochemical analysis of tissues obtained from traumatic war wounds to characterize changes in the structural microenvironment. In addition, using an electrospinning approach, we modeled this microenvironment to reconstitute a three-dimensional type I collagen scaffold with non-woven, randomly oriented nanofibers where we evaluated the performance of primary mesenchymal progenitor cells. @*RESULTS@#We found that traumatic war wounds are characterized by a disorganized, densely fibrotic collagen I matrix that influences progenitor cells adhesion, proliferation and osteogenic differentiation potential. @*CONCLUSION@#Altogether, these results suggest that the structural microenvironment present in traumatic war wounds has the potential to contribute to the development of post-traumatic HO. Our findings may support novel treatment strategies directed towards modifying the structural microenvironment after traumatic injury.

Prefrontal symptomatology in People with Amyotrophic lateral Sclerosis: Clinical Utility and Psychometric Properties of Prefrontal Symptoms Inventory (PSI)

The Amyotrophic Lateral Sclerosis (ALS) is a multisystemic disorder. It is considered a neuromuscular disease but also involves cognitive (executive functions, social cognition, attention, memory and language), emotional or behavior changes in over 50% of the reported cases and to of frontotemporal diagnosis lobar degeneration of behavioral variant in up to 15% of the cases. For this reason, the presence of cognitive and motivational problems was analysed in a Spanish sample of ALS patients through the prefrontal symptoms inventory (PSI) to determine applicability in this disease STI. A sample of 31 patients with a potential ALS or definitive diagnostic criteria according to El Escorial was used. Obtained results ISP were compared with a sample of 31 healthy people in the same proportions of gender, age and education level. Obtained results showed a not significant difference between the two populations in the motivational factor problems, related to the depression symptomatology frequently associated with ALS. A significant positive correlation between age at diagnosis and the scale of the motivational problems was observed, with a not significant trend related to problems in the executive control and in social the behavior control and with the age at diagnosis, in the same sense with age at diagnosis. Therefore, it can be concluded that, despite the results obtained, emotional and behavioral deficits in ALS patients and symptoms related to frontotemporal dementia (among others, anosognosia or lack of consciousness symptoms) could have interfered in patient perception about their symptomatology

FACTORES DE RIESGO ASOCIADOS A LA INFECCIÓN POR Cystoisospora suis EN GRANJAS PORCINAS DE LA REGIÓN CENTRAL DE VENEZUELA / RISK FACTORS ASSOCIATED WITH Cystoisospora suis INFECTION IN SWINE HERDS OF THE CENTRAL REGION OF VENEZUELA

Se condujo una investigación en Venezuela con la finalidad de conocer algunos aspectos epidemiológicos sobre la presencia de Cystoisospora suis en 67 granjas porcinas intensivas. Para la determinación de la carga parasitaria se seleccionaron 572 camadas con signos de diarrea, así como 1.712 muestras fecales de cerdos adultos. Las muestras se cultivaron en dicromato de potasio al 2,5% y posteriormente se procesaron mediante una técnica copro-parasitológica. Además, en cada granja se aplicó una encuesta epidemiológica. El protozoario se encontró en 55 granjas (82,1%) y 210 camadas (36,7%). Al referirlo a camadas, se observaron ooquistes en lechones menores de tres días de edad, lo que podría indicar la existencia de rutas alternativas de la infección. En cerdos adultos se encontró correlación significativa (rho = 0,35; P < 0,05) entre la excreción de ooquistes en lechones y en madres, lo que sugiere que estas podrían actuar como fuentes de infección. Se constató correlación entre el número de partos de la cerda y la prevalencia en camadas y cerdas lactantes (P < 0,05), pues, a mayor número de partos, disminuye la prevalencia. Probablemente estos hallazgos están asociados con mecanismos inmunológicos desconocidos. El tamaño de la granja no afectó la presencia del parásito; sin embargo, las granjas con pisos plásticos mostraron mayor control de la infección. Se concluye que algunos mecanismos inmunológicos, aún sin dilucidar, podrían estar involucrados en la cadena de transmisión del protozoario, los cuales podrían jugar un papel importante en el desarrollo de la cystoisosporosis porcina.

It was carried out an investigation in Venezuela with the aim of studying the epidemiological aspects of Cystoisospora suis in intensive swine herds. Sixty-seven intensive swine herds were included. For parasite determination 572 litters with signs of diarrhea, as well as 1,712 faecal samples from mature pigs were selected. Stool samples were cultured in a 2.5% potassium dichromate solution and later processed by copro-parasitological technique. Epidemiological surveys were applied on each farm. The results indicated that C. suis was observed in 55 herds (82.1%) and 210 litters (36.7%). Regarding to litters, oocysts were observed in piglets less than three days of life, which could indicate the existence of alternative infection way. Regarding to mature pigs, there was a significant correlation (rho = 0.35; P < 0.05) among oocysts excretion in piglets and sows, suggesting that sows may act as infection sources. Sows parity was statistically correlated with the prevalence values in litters as in lactating sows (P < 0.05). This might indicate that as parity increase, prevalence decreases in these groups. Probably, these findings are associated with unknown immunologic mechanisms. The herd size did not affect the presence of the parasite, however, farms with plastic floors showed greater control of the infection. It is concluded that non elucidated immunologic mechanisms might be involved in the protozoa transmission cycle and play an important role in the development of porcine cystoisosporosis.

Fotoperíodo sobre parâmetros fisiológicos relacionados ao estresse em alevinos de tilápia-do-nilo / Photoperiod on physiological parameters related to stress in Nile tilapia fingerlings

Com este trabalho objetivou-se avaliar a influência de diferentes fotoperíodos sobre parâmetros fisiológicos relacionados ao estresse em alevinos de tilápia-do-nilo (Oreochromis niloticus). Foi utilizado um delineamento inteiramente casualizado, com cinco tratamentos (0L; 6L; 12L; 18L; 24L) e quatro repetições, sendo o aquário a unidade experimental. Cento e sessenta alevinos de tilápia, 3,21±0,05g e 4,35±0,07cm, foram distribuídos em 20 aquários de 20 litros, em sistema de recirculação com temperatura controlada em 27oC e densidade de oito peixes por aquário. Por um período de 75 dias, a alimentação foi realizada duas vezes ao dia com ração extrusada contendo 40% de proteína bruta. Ao final do período experimental, os dados de crescimento, sobrevivência, cortisol, glicose e hematócrito foram submetidos à análise de variância e, posteriormente, em caso de significância (P<0,05), foi realizado um teste Tukey a 5% para comparação das médias. A manipulação do fotoperíodo demonstra não alterar a homeostase dos alevinos, uma vez que não há diferença sobre a sobrevivência, glicose sanguínea, hematócrito e cortisol plasmático (P>0,05).

The objective of this study was to evaluate the influence of different photoperiods on physiological parameters related to stress in Nile tilapia fingerlings (Oreochromis niloticus). A completely randomized design with five treatments (0L, 6L, 12L, 18L, 24L) and four replications was used, and the aquarium as the experimental unit. One hundred and sixty tilapia fingerlings, 3.21±0.05g and 4.35±0.07cm were distributed in 20 aquariums of 20L in a recirculation system with temperature controlled at 27 º C and density of eight fish per aquarium. Feeding was performed twice daily with extruded feed containing 40% crude protein, for a period of 75 days. At the end of experimental period, the data of survival, cortisol, glucose and hematocrit were subjected to analysis of variance and, subsequently, in case of significance (P<0.05) a Tukey test 5% was performed to compare means. Manipulation of photoperiod shows no alteration in the homeostasis of juveniles, since there is no difference in survival, blood glucose, hematocrit and plasma cortisol (P>0.05).

CALIDAD DE LA LECHE, DIGESTIBILIDAD IN VITRO DE LA MATERIA SECA Y PRODUCCIÓN EN VACAS ALIMENTADAS CON GRAMÍNEAS SOLAS O ASOCIADAS CON Lotus uliginosus / MILK CHEMICAL COMPOSITION, MATTER DRY IN VITRO DIGESTIBILITY AND PRODUCTION IN COWS FED ALONE GRASSES OR ASSOCIATED Lotus uliginosus

La presente investigación tuvo como objetivo evaluar el uso de la leguminosa Lotus uliginosus como alternativa de inclusión dentro de las praderas en dos ecorregiones estratégicas de la Sabana de Bogotá. En cada finca se evaluaron cuatro tratamientos: 1) kikuyo solo (P. clandestinum), 2) kikuyo asociado con trébol pata de pájaro (P. clandestinum + L. uliginosus), 3) festuca alta sola (F. arundinacea) y 4) Festuca alta asociada con trébol pata de pájaro (F. arundinacea + L. uliginosus). El número de bovinos varió de acuerdo a la capacidad de carga de cada finca. Se utilizaron animales que se encontraban en el segundo tercio de lactancia durante un período experimental de siete días. En cada tratamiento se determinó la producción (L/día) y calidad de leche (% de grasa, proteína y sólidos totales); en la pastura se evaluó la composición química (MS, FDN, FDA) y la digestibilidad in vitro de la materia seca (DIVMS). Se midió el consumo voluntario. En la finca Megaleche la producción de biomasa presentó diferencias significativas (P<0,05) entre los tratamientos destacándose el tratamiento del kikuyo solo; la calidad nutricional de las pasturas también presentó diferencias (P<0,04) destacándose el tratamiento de kikuyo + trébol pata de pájaro, asociación que también se destacó en consumo voluntario (P< 0.05) y producción de leche (P<0,05). En la finca Colega el contenido de proteína del forraje presentó diferencias cuando las gramíneas se asociaron con el trébol pata de pájaro (P<0,001). Se concluyó que la introducción del Lotus en las praderas mejoró la producción de leche y consumo de materia seca en los animales.

The present research aimed to evaluate the use of the legume Lotus uliginosus alternatively inclusion into the meadows on two strategic ecoregions savannah of Bogota. In each farm four treatments: 1) only kikuyu (P. clandestinum), 2) associated kikuyo Birdsfoot trefoil (P. clandestinum + L. uliginosus), 3) single tall fescue (F. arundinacea) and 4) tall fescue associated Birdsfoot trefoil (F. arundinacea + L. uliginosus). The number of cattle varied according the load capacity of each farm. Were used animals that were in the second third of lactation during a trial period of seven days, in each treatment was determined production (L/day) and milk quality (% of fat, protein and total solids). In the pasture it was evaluated chemical composition (DM, NDF, ADF) and in vitro digestibility of matter dry (IVDMD). Voluntary intake was measured. On the farm Megaleche biomass production showed significant differences (P˂0.05) between treatments kikuyu emphasizing treatment alone nutritional quality of pastures also showed significant differences (P˂0.04) emphasizing treating kikuyu + Birdsfoot trefoil an association that was also highlighted in the voluntary intake (P˂0.05) and milk production (P˂0.05). On the farm Colega protein content of forage grasses differed when associated with Birdsfoot trefoil (P˂0.001). It was concluded that the introduction of Lotus grassland improved milk production and dry matter intake in animals.

Is the Murciano-Granadina a single goat breed?: a molecular genetics approach / É a Murciano-Granadina raça única?: um enfoque genético-molecular

The population structure of the Murciano-Granadina breed was determined using 25 microsatellites from 266 goats of seven populations. The results of the genetic differentiation analysis showed that it is possible to differentiate the Murciana and Granadina populations even though a low F ST value (0.0432) had been obtained. Individuals could be assigned to their populations with a success rate of more than 80 percent. Bayesian-based clustering analysis of allele frequencies and multivariate analysis revealed that Murciana and Granadina populations were grouped in different clusters since K=3. The results demonstrate that Murciana and Granadina are still two different genetic groups included into Murciano-Granadina denomination. There is the opportunity to the genetically manage these populations, under a single herd-book but adding the necessary modifications to respect the conservation of the genetic diversity based on the use of multibreed models of genetic evaluation.

Determinou-se a estrutura da raça Murciano-Granadina, usando-se 25 microssatélites e 266 animais de sete populações. Os resultados da diferenciação genética mostram que é possível diferenciar populações de Murciana e Granadina, apesar dos baixos valores de F ST obtidos - 0.0432. Os indivíduos foram designados às suas populações com taxa de sucesso superior a 80 por cento. A análise bayesiana de agrupamento das frequências alélicas e a análise multivariada revelaram que as populações Murciana e Granadina foram agrupadas em diferentes clusters, uma vez que o melhor K obtido foi três. Os resultados demonstraram que Murciana e Granadina ainda são dois grupos genéticos distintos incluídos na denominação Murciano-Granadina. É possível manejar geneticamente essas populações dentro de um único livro de registro, porém adotando-se as modificações necessárias em relação à conservação e à diversidade genética, com base no uso de modelos de avaliação multirracial.

Elaboración de un queso tipo cotija con base en una mezcla de leche y garbanzo (Cicer arietinum L) / Elaboration of cheese

The objetive of this work was to elaborate cotija type cheese prepared with whole milk and chickpea (Cicer arietinum L.), inoculated with S. Thermophilus and to compare its physicochemical, microbiological and sensorial characteristics with a commercial cheese. Two mixture were selected 70:30 and 80:20 (whole milk:chickpea paste). Both mixture were ground, pasteurized and inoculated with. S. Thermophilus, to develop taste and aroma. Two rennet concentrations (1:10,000 and 2:10,000), lactic acid and 50 per cent CaCl2 solution were used in both products. Results showed that cheese made with 70:30 mixture and 1:10,000 rennet concentration gave a weak curde and 12 per cent of total solids were lost; in the same way as 70:30 mixture and 2:10,000 rennet concentration. Nevertheless, cheese made with 80:20 mixture and 10,000 or 2:10,000 rennet concentration showed hard consistency of its curd. Addition of 10 per cent sodium chloride solution to he 80:20 mixture cheese, made better whey drain, and a cotija type cheese with similar sensory characteristics as a whole milk cheese, was obtained. Chemical and physical analysis of the extended cotija type cheese showed 14.3 +/- 0.42 and 15.5 +/- 0.21 g/100 g of protein and lipid content respectively. Microbiologically, the extended cotija type cheese is pathogenic microorganisms free for human consumption. Sensory evaluation of the chickpea extended cheese showed a 80 per cent acceptance while the acceptance of the whole milk commercial cheese was 90 per cent.

Hallazgos laparoscópicos en pacientes con dolor pélvico, dismenorrea y esterilidad / Laparoscopic findings in patients with pelvic, pain dysmenorrhea and esterility

La endometriosis es una patología frecuente en la práctica ginecológica; que se asocia a una gran variedad de síntomas entre los que destacan dismenorrea, dolor pélvico y esterilidad. Se evaluaron 71 pacientes de la práctica privada sometidas a laparoscopia que presentaban cuelquiera de estas tres entidades. Se encontró un porcentaje mayor de endometriosis en cada grupo de estudio comparado con la literatura, pero no se encontró una relación directa entre la intensidad de la endometriosis y los tres grupos de estudio de acuerdo a la clasificación modificada de la Sociedad Americana de Fertilidad. Se encontró que el dolor pélvico se asoció en la mayoría de los casos con patología orgánica. Por otro lado, se estableción la utilidad de la laparoscopia en el diagnóstico, estadificación y tratamiento de la endometriosis

Propuesta de un model de historia clínica ginecológica simplificada

Para el manejo adecuado de la información de un centro hospitalario ginecológico, es necesario tener un documento que registre todo el proceso ginecológico de la mujer. No existe una historia clínica en la que consten los datos más importantes de los pacientes. Se ha demostrado que la historia clínica única no cumple con los requisitos de fácil llenado, que no tenga que escribir textos extensos y subjetivos. El centro Latinoamericano de Perinatología (CLAP, Montevideo), propuso un modelo de historia clínica perinatal simplificada, llegó a presentar un formulario único sencillo de bajo costo y fácil de llenar. Desde 1984, el hospital municipal San José, inicia la utilización de la historia clínica perinatal simplificada del Clap. Preocupados por el registro de datos en él área de ginecología, nuestro equipo de trabajo presenta un modelo de historia clínica ginecologica simplificada, que corresponde a las necesidades cotidianas del hospital.

Mini-colecistectomía sub costal, de 3-4 cms. Seguimiento de 3 años / Subcostal, 3-4 cm, mini-cholecystectomy. A 3-year follow-up

The authors report the results of mini-cholecystectomy performed through a 3 to 4 cm long subcostal incision in 29 patients with the diagnosis of acute or chronic cholecystitis, from February 1991 to November 1922. Some of the patients were obese, diabetics or presented as emergency cases. The patients were operated on in the morning, as in laparoscopic cholecystectomy, began oral intake in the afternoon and were discharged on the day after surgery. Dissection of the gallbladder was facilitated by the use of a modified gynecologic valve and long thin instruments. Duration of surgery varied from 40 to 140 minutes. Patients could return to work on the third day after surgery. Notably, the costs/benefits were on the third more favorable than those of laparoscopic cholecystectomy

Tumores carcinoide: experiencia en un hospital general / Carcinoid Tumors: experience in a general hospital

Presentamos la casuístic de Tumores Carcinoide de un período de 13 años en un hospital. La frecuencia fue de 1.54 casos por año; el 65 por ciento de ellos fue en varones, el grupo etareo más agectado correspondió al comprendido entre los 61-70 años, siendo la mediana los 48 años. Se observó que en el sexo masculino fue más frecuente en los mayores de 40 años, mientras que en el femenino lo fueron en lmenores de esa edad. Las localizaciones primarias más frecuentes fueron: bronquio (25 por ciento);estómago (20 por ciento),apéndice(15 por ciento) y recto(15 por ciento). Los primarios digestivos correspondieron al 50 por ciento de casos, los extradigestivos al 40 por ciento y desconocido en el 10 por ciento. sobre el tipo histológico: en los digestivos fue más frecuente el E, y en los estradigestivos el B. Las manifestaciones clínicas más frecuentes fueron dolor (47 por ciento) y fiebre (26.3 por ciento). El Síndrome Carcinoide se presentó en 3 casos: dos de ellos sin metástasis hepáticas. Nuestra serie se asemeja más a la descrita en la literatura japonesa

Esternosis aórtica y embarazo: presentación de un caso y revisión fisiopatológica / Aortic stenosis and pregnancy: pressentation of casse, and physiopathologic review

Se presenta un caso de una paciente de 31 años de edad con el diagnóstico de estenosis aórtica, prolapso de la válvula mitral, insuficiencia aórtica y embarazo. Se revisa la literatura haciendo un análisis del manejo de este tipo de padecimiento.