Diagnóstico de divertículo de Meckel mediante cápsula endoscópica / Diagnose of Meckel's diverticulum through endoscopic capsule

Meckel's diverticulum can be present in up to 1.2% of the population. It is usually diagnosed as an imaging finding, but it can present with complications such as digestive bleeding, intestinal obstruction, diverticulitis, ulcers, and perforation, more frequently in childhood or infancy. The diagnosis workup for this condition will depend on their clinical manifestation, the most frequent being gastrointestinal bleeding of obscure origin or small intestinal bleeding. In this context, although capsule endoscopy is the preferred technique, its diagnostic yield for the detection of Meckel's diverticulum is not entirely clear and it has not been compared in a controlled studies with other diagnostic methods. Here we report the diagnosis of a Meckel diverticulum and its intestinal complications by means of capsule endoscopy in a patient with iron deficiency anemia and gastrointestinal bleeding

El divertículo de Meckel puede estar presente en el 1,2% de la población general. Usualmente es diagnosticado como un hallazgo, pero puede presentarse con mayor frecuencia en la niñez o infancia por sus complicaciones como hemorragia digestiva, obstrucción intestinal, diverticulitis, úlceras y perforación. El enfrentamiento diagnóstico de esta condición dependerá de la manifestación clínica, siendo lo más frecuente hemorragia digestiva de origen oscuro o de intestino delgado. En este contexto, si bien la cápsula endoscópica es la técnica de elección, su rendimiento diagnóstico para la detección del divertículo de Meckel no es del todo claro y no ha sido comparado de forma controlada con otras técnicas diagnósticas. En el presente caso se reporta el diagnóstico de un divertículo de Meckel y sus complicaciones intestinales mediante cápsula endoscópica en una paciente con anemia ferropriva y hemorragia digestiva.

A method to assess heart rate variability in neonate rats: validation in normotensive and hypertensive animals

Several studies have focused on the heart rate variability (HRV) of murine species, while studies discussing HRV in murine neonates and infants remain scarce, since recording hemodynamic signals through invasive methods in small animals has been found to be quite challenging. Thus, this study aimed at describing and validating a novel method to assess HRV in newborn rats. An electrocardiogram (ECG) system was used to determine RR intervals in awake newborns and evaluate HRV in normotensive (Wistar) and hypertensive (SHR) neonate rats. After birth, ECG was recorded in the awake newborns, and they were allowed to rest on a heated surface, restricted only by the weight of the adhesive ECG electrodes. The electrodes were cut and adapted to provide more comfort to the animal, and gently placed on the newborn's skin. RR intervals were recorded over a 30-min period using an ECG system together with LabChart software (4 KHz). Three sequences of 5 min each from the ECG recording period were analyzed in time and frequency domains, using CardioSeries software. ECG data resulted in a clearly interpretable signal that was used to generate an RR interval sequence through time for the analysis of HRV. SHR neonates presented increased cardiac sympathovagal balance compared to Wistar neonates (low frequency/high frequency: 3.85±0.71 vs 0.90±0.09). In conclusion, the ECG setup here described may be used to record RR intervals to assess HRV in neonate rats, thus detecting early impairment of HRV in hypertensive newborns.

Eventos adversos asociados al uso de inhibidores de bomba de protones: un análisis crítico de la evidencia actual / Adverse events associated with the use of proton-pump inhibitors: a critical analysis of current evidence

Proton pump inhibitors (PPIs) are one of the most widely used types of drugs in clinical practice, designed to treat highly prevalent pathologies in the clinical activity of gastroenterology. Despite having precise and approved indications, reports have described a use beyond the established indications, such as management of various symptoms of the digestive tract or associated with polypharmacy, considering that their indication could be questionable in a significant percentage of individuals on prolonged treatment with PPI. In recent years, several basic, clinical and epidemiological studies have warned of possible adverse events associated with the use of PPIs that have generated concern in physicians and patients, and an impact on the public opinion due to the wide use of these drugs among the population. The purpose of this review is to critically analyze the available evidence regarding adverse events associated with the use of PPIs, in addition to providing some recommendations for clinical practice

Los inhibidores de bomba de protones (IBP) son fármacos ampliamente usados en la práctica clínica, destinados a tratar patologías altamente prevalentes en la actividad clínica de gastroenterología. Pese a contar con indicaciones precisas y aprobadas, reportes han descrito un uso más allá de las indicaciones establecidas, como manejo de diversos síntomas del tracto digestivo o asociado a polifarmacia, considerándose que su indicación podría ser cuestionable en un porcentaje importante de individuos en tratamiento prolongado con IBP. En los últimos años, diversos estudios básicos, clínicos y epidemiológicos han alertado sobre posibles eventos adversos asociados al uso de IBP que han generado preocupación en tratantes y pacientes, además de impactar en la opinión pública por la amplia distribución del uso de estos fármacos en la población. El objetivo de esta revisión es analizar críticamente la evidencia disponible respecto a los eventos adversos asociados al uso de IBP, además de entregar algunas recomendaciones para la práctica clínica.

Learning gain of pharmacy students after introducing guided inquiry learning with computer simulation in a pharmacology class in Fiji / 보건의료교육평가

PURPOSE: Active learning methods such as problem-based learning have been widely adopted in health professions education, although guided inquiry learning has been used only in limited settings. The objective of this study was to determine students' learning gain when guided inquiry learning was combined with computer simulation in a basic pharmacology course. METHODS: The second-year pharmacy students from Fiji National University participated in the study. Following classroom lectures on pharmacokinetics and pharmacodynamics, the students used tutor-prepared practice problems in groups of 3-4 to explore their concepts with Cyber Patient and Virtual Organ Bath software. Pre- and posttest assessments were administered to determine the learning gain from the exercises based on Hake's criteria. RESULTS: Forty-two students participated in the study. The average normalized learning gain from the pharmacokinetics exercises was 0.68. Thirty-seven participants (88.1%) achieved a significant learning gain, while 5 (11.90%) did not. The average normalized learning gain from the pharmacodynamics exercises was 0.76. Forty-one participants (97.6%) achieved a significant learning gain, while one participant (2.4%) did not. CONCLUSION: These results demonstrated that use of guided inquiry learning with computer simulations could produce significant learning gains with improvement in students' understanding of basic pharmacology.

Presencia de síndrome de burnout en Hospital El Pino y su relación con variables epidemiológicas / Presence burnout's syndrome in El Pino Hospital and his relation with epidemiological variables

INTRODUCCIÓN: El Síndrome de Burnout corresponde a la intensificación de la sintomatología del estrés, debido a una relación constante con personas que sufren. OBJETIVO: Establecer la prevalencia del Síndrome de Burnout entre profesionales de salud del Hospital El Pino y su asociación con variables sociodemográficas y laborales. MATERIAL Y MÉTODO: Estudio descriptivo transversal. Muestra de 99 profesionales de salud del Hospital El Pino, se les aplicó el cuestionario Maslach Burnout Inventory y una encuesta de datos elaborada por los autores, durante Septiembre 2009. Se utilizó estadística descriptiva con comparación de porcentajes por prueba Chi Cuadrado. RESULTADOS: Tasa de respuesta del 70,7 por ciento. La presencia del Síndrome de Burnout en profesionales de salud del Hospital El Pino fue del 51,5 por ciento. No hubo asociación estadística entre Síndrome de Burnout y las variables: sexo, edad, áreas de servicios, horas de trabajo, número de turnos noche y estado civil (p<0,05); sí hubo asociación con las variables número de hijos y profesión (p<0,05). DISCUSIÓN: El Síndrome de Burnout tiene una alta y significativa presencia en los profesionales de salud del Hospital El Pino. Es importante aplicar medidas de cuidado y preventivas para proteger al personal de salud frente al Síndrome de Burnout.

INTRODUCTION: Burnout's Syndrome corresponds to the intensification of the own stress’s symptomatology, due to a constant relation with people that suffers. OBJETIVE: To establish the Burnout's Syndrome’s prevalence in the "Health’s Care Professionals of El Pino Hospital" and his association with sociolabor and demographic variables. MATERIAL AND METHOD: Sample of 99 “Health’s Care Professionals of El Pino Hospital”,there was applied the Maslach Burnout Inventory and information survey, during September 2009. Was did descriptive statistics with comparison of percentages by Chi-square test. RESULTS: Rate of response 70.7 percent. Presence of the Burnout's Syndrome 51.5 percent. There was no statistical association between Burnout's Syndrome and the variables: sex, age, areas of services, working hours, number of shifts in the night and marital status (p<0.05). There was a strong association between "number of children" and "profession" with the Burnout's Syndrome (p<0.05). DISCUSSION: Burnout's Syndrome has a high and significant presence in the “Health’s Care Professionals of El Pino Hospital”. It is important to apply care and preventive measures to protect the Health personnel.

Clinical analysis of 1,393 females with mastalgia

To determine the clinical profile of benign and malignant mastalgia in terms of age distribution, geographic location, laterality, pain severity and pattern.METHOD: This is a 3-year (April 1,2001 until March 31, 2004) retrospective chart review of female patients presenting with mastalgia in a hospital-based government breast center at Vicente Sotto Memorial Medical Center, Cebu City. Malignant mastalgia was diagnosed based on histopathologic findings. Pain severity assessment was based on a numeric scale of 0 to 10. Exclusion criteria include patients without mastalgia as chief complaint, no histopathologic confirmation of malignancy and males. All statistical computations were done using Chi square test with a = 0.05.RESULTS: A total of 1237 patients (89 percent) had benign mastalgia with an average age of 29.72 +/- 10.96 years and 156 (11 percent) had malignant mastalgia with an average of 48.92 +/- 11.96 years. Patients less than 60 years of age had a statistically significant probability that their mastalgia is due to benign pathology (p CONCLUSION: Age above 60 years, right-sidedness and non-cyclical pain pattern are the only significant factors for differentiating whether the mastalgia is due to a benign or malignant etiology.

Evaluación de fungicidas para el control de enfermedades a nivel de follaje y fruto del tomate: iycopersicum esculentum mill / Fungicide evaluation for the control of tomatoes desease

Experimento realizado en Alto Lino, Boquete, provincia de Chiriquí, en los meses comprendidos entre agosto de 1986 y principios de marzo de 1987. El diseño utilizado fue de bloque al azar con cuatro réplicas. Los fungicidas utilizados en el estudio fueron: , y . Se incluyó además, una variable al tratamiento 6 y un testigo absoluto. Los parámetros evaluados fueron el porcentaje de afección foliar causada por (Phytophthora infectans), (Alternaria solani), (Xanthomonas versicatoria), así como el rendimiento total por tratamiento. Según el análisis estadístico de Duncan al 5 porciento de significancia para la variable rendimiento total, los mejores tratamientos en orden descendente fueron los fungicidas SDS 64220 a dosis de 5.5 Kg/Ha; SDS 63539 a dosis de 6.0 Lts/Ha; y el SDS 64220 a dosis de 3.5 Kg/Ha. En ninguna de las parcelas tratadas con fungicidas se observó incidencia de tizón tardío y en general, se observó que los fungicidas en su mayoría efectuaron un buen control de fitopatógenos a nivel de fruto