Diagnostic utility of transcranial magnetic stimulation for neurodegenerative disease: a critical review / Utilidade diagnóstica da estimulação magnética transcraniana para doenças neurodegenerativas: uma revisão crítica

ABSTRACT. Neurodegenerative diseases pose significant challenges due to their impact on brain structure, function, and cognition. As life expectancy rises, the prevalence of these disorders is rapidly increasing, resulting in substantial personal, familial, and societal burdens. Efforts have been made to optimize the diagnostic and therapeutic processes, primarily focusing on clinical, cognitive, and imaging characterization. However, the emergence of non-invasive brain stimulation techniques, specifically transcranial magnetic stimulation (TMS), offers unique functional insights and diagnostic potential. TMS allows direct evaluation of brain function, providing valuable information inaccessible through other methods. This review aims to summarize the current and potential diagnostic utility of TMS in investigating neurodegenerative diseases, highlighting its relevance to the field of cognitive neuroscience. The findings presented herein contribute to the growing body of research focused on improving our understanding and management of these debilitating conditions, particularly in regions with limited resources and a pressing need for innovative approaches.

RESUMO. As doenças neurodegenerativas representam desafio significativo por seu impacto na estrutura cerebral, função e cognição. À medida que a expectativa de vida aumenta, a prevalência dessas doenças cresce rapidamente, resultando em substanciais encargos pessoais, familiares e sociais. Esforços têm sido feitos para otimizar os processos diagnósticos e terapêuticos, com foco principal na caracterização clínica, cognitiva e de imagem. No entanto, o surgimento de técnicas de estimulação cerebral não invasivas, especificamente a estimulação magnética transcraniana (EMT), oferece compreensão funcional e potencial diagnóstico únicos. A TMS permite a avaliação direta da função cerebral, fornecendo informações valiosas inacessíveis por outros métodos. Esta revisão teve como objetivo resumir a utilidade diagnóstica atual e potencial da EMT na investigação de doenças neurodegenerativas, destacando sua relevância para o campo da neurociência cognitiva. As conclusões aqui apresentadas contribuem para o crescente corpo de investigação centrado na melhoria da nossa compreensão e gestão dessas condições debilitantes, particularmente em regiões com recursos limitados e necessidade premente de abordagens inovadoras.

Hipercolesterolemia familiar descripción de un caso en una familia de Armenia - Quindío (Colombia)

Introducción: La Hipercolesterolemia familiar (HF) es una enfermedad genética de carácter autosómico dominante, poco frecuente, generada por la mutación en el cromosoma 19. Es la primera causa de enfermedad cardiovascular prematura. Las mutaciones patogénicas que generan la HF se relacionan con el receptor de LDL (LDLr), la apolipoproteina B-100 (Apo- B100) y la proteína convertasa subtilisina / kexina tipo 9 (PCSK9), que produce elevación del colesterol y alteración de la vía del LDLr en el 80 % de los casos diagnosticados de HF (5). Presentamos un reporte de caso de cuatro pacientes que pertenecen a la misma familia, quienes presentan mutaciones patogénicas de diferente compromiso a nivel cardiovascular y sistémico que ha afectado de manera negativa su cotidianidad. El objetivo de este trabajo es realizar una correlación del hipercolesterolemia familiar de tipo genético a partir de la literatura, con respecto a la serie de casos presentada, y evaluar el impacto que este genera en los servicios de salud, en la vida del paciente y su familia. Discusión: El reporte de caso que presentamos se fundamenta en la sospecha de HF según los criterios de Holanda. En estos pacientes se reconoce mutación del gen LDLr que se relaciona con HF. Sin embargo, no ha sido ampliamente estudiada. Chmara realizó en Polonia por primera vez un estudio en el que reportó la variante ac 11G>T. En Colombia, el estudio de López encontró tres mutaciones, identificadas como variante a c.11G > A, n c.416A > G y c.1187G > A (8). Conclusión: La HF en nuestro medio es poco frecuente y con gran impacto social, en la mayoría de los casos genera síntomas clínicos y aumento del riesgo cardiovascular desde una edad temprana. Es importante resaltar el diagnóstico oportuno y el conocimiento por parte del personal de salud para generar una calidad de vida adecuada a los pacientes y evitar que aumente el riesgo cardiovascular.

Introduction: Familial hypercholesterolemia (FH) is a rare autosomal dominant genetic disease caused by a chromosome 19 mutation. It is the main cause of premature cardiovascular disease. Pathogenic mutations which cause FH are related to the LDL receptor (LDLr), B-100 apolipoprotein (Apo-B100) and type 9 subtilisin/kexin convertase protein (PCSK9), causing blood cholesterol increase and impairment of the LDLr pathway in up to 80% of patients diagnosed with FH. We present the case of 4 patients belonging to the same family and who present pathogenic mutations leading to diverse kinds of cardiovascular and systemic disease. Discussion: The case report we are presenting is based on the suspicion of FH according to the dutch criteria. These patients had the LDLr gene mutation related to FH. However, this mutation has not been thoroughly studied. The ac 11G>T variant was reported for the first time in Poland by Chmara. In Colombia, Lopez found 3 mutations identified as variant a c.11G > A, variant n c.416A > G and variant c.1187G > A. Conclusion: FH is rare in Colombia. Early diagnosis and healthcare worker awareness must be highlighted to improve the quality of life and decrease the cardiovascular risk of patients.

Bazo estrellado. A propósito de un caso / Stellate spleen. A case report

Las lesiones esplénicas pueden pasar desapercibidas en los estudios imagenológicos solicitados con otros fines. Las calcificaciones esplénicas representan un amplio espectro de lesiones que pueden originarse secundarias a diversos procesos patológicos subyacentes. La autoesplenectomía es una entidad extremadamente rara con algunos casos descritos en la literatura asociados a enfermedades autoinmunes. Se presenta el caso de una paciente de 46 años de edad con lupus eritematoso sistémico (LES) en quien se encuentra el bazo calcificado y atrófico como hallazgo incidental en una tomografía axial computarizada (TAC) de tórax.

Splenic lesions may go unnoticed in imaging studies requested for other purposes. Splenic calcifications represent a wide spectrum of lesions that can arise secondary to various underlying pathological processes. Autosplenectomy is an extremely rare entity with some cases described in the literature associated to autoimmune diseases. The case of a 46-year-old patient with Systemic Lupus Erythematosus (SLE) is presented, in whom the calcified and atrophic spleen is found as an incidental finding in a Chest tomography.

Cisticercosis hepática: a propósito de un caso y revisión de la literatura / Hepatic cysticercosis: a case report and review of the literature

Resumen La cisticercosis hepática es una enfermedad parasitaria bastante rara que consiste en el compromiso hepático por el cisticerco, con pocos casos reportados en la literatura, ninguno antes reportado en Colombia. Esta infección es producida por Cysticercus cellulosae, la forma larvaria del helminto Taenia solium. Es adquirida al consumir los huevos de la Tenia spp que se encuentran en la comida poco cocinada o el agua. En los casos reportados de cisticercosis hepática, el tratamiento se basa principalmente en el uso de antihelmínticos y en ocasiones quirúrgico. Se presenta el caso de un paciente mayor, indígena, quien consultó por melenas y dolor abdominal. En el examen físico se encontró hepatomegalia. Las imágenes diagnósticas plantean diagnóstico diferencial entre quiste hidatídico vs cistoadenoma/ cistoadenocarcinoma. El examen histopatológico sugiere compromiso por cisticercosis. Se reporta el caso de una cisticercosis hepática, con histología altamente sugestiva y hallazgos imagenológicos bastante inusuales a los previamente descritos en literatura. MÉD.UIS. 2020;33(2):101-108.

Abstract Hepatic cysticercosis is a quite rare parasitic disease consisting of hepatic involvement by the cysticercus, with few cases reported in the literature, none previously reported in Colombia. This infection is caused by Cysticercus cellulosae, the larval form of the Taenia solium helminth. It is acquired by consuming the Tenia sppeggs found in undercooked food or water. In reported cases of hepatic cysticercosis, treatment is based primarily on the use of anthelmintics and occasionally surgery. We present the case of an older, indigenous patient who consulted for melena and abdominal pain. Hepatomegaly is found on physical examination. Diagnostic images suggested a differential diagnosis between hydatid cyst vs. cystadenoma / cystadenocarcinoma. Histopathological examination suggested compromise due to cysticercosis. The case of hepatic cysticercosis is reported, with highly suggestive histology and imaging findings quite unusual to those previously described in the literature. MÉD.UIS. 2020;33(2):101-108.

Indicadores de carga física de trabajo en exposición intermitente crónica a gran altura / Indicators of physical work load in chronic intermittent exposure at high altitude

Se han establecido regulaciones para la exposición ocupacional a cargas físicas del trabajo, y a hipoxia intermitente crónica (HIC). También se ha indicado incorporar los riesgos asociados a HIC a un sistema de gestión de seguridad y salud en el trabajo. Dado que las cargas físicas de trabajo (CFT) en HIC pueden condicionar riesgos de trabajo pesado y fatiga física, se considera oportuno revisar el efecto de la CFT a gran altitud, entre 3000 y 5500 m de altura, sobre el riesgo de trabajo pesado, por lo cual se procede a recopilar estudios de campo de la capacidad aeróbica, mediciones de los signos que permiten evaluar el % de Carga Cardiovascular (%CCV) ocupado a gran altura. El %CCV se calcula mediante las frecuencias cardíacas (FC) de reposo, la máxima y la de trabajo. El monitoreo continuo de la FC y mediciones directas de la capacidad aeróbica máxima muestran que en HIC se modifican las tres FC de %CCV, también se muestra que cuando la FC de trabajo en altitud está por sobre 110 latidos/minuto hay mayor riesgo de fatiga y trabajo pesado. Adicionalmente se encontró que la capacidad aeróbica, VO2máx, medido a nivel del mar se reduce en trabajadores aclimatados a HIC con una reducción del 7% de la FC máxima. Este efecto, entendido como frenación fisiológica protectora, se puede perder durante una desaclimatación a nivel de mar por más de 10 días. En vista de una mayor probabilidad de trabajo pesado en HIC se proponen intervenciones para prevenir, controlar y mitigar riesgos de fatiga, cansancio y trabajo pesado que afecten la salud, conducta segura y productividad. En conclusión, en faenas a gran altitud, la CFT se puede evaluar mediante medición del %CCV basada en registros de la FC de reposo, máxima y de trabajo, en cada cota donde se ejecuta la actividad laboral, porque la hipoxia hipobárica modifica los tres componentes de esa ecuación.

Regulations have been established for the occupational exposition to physical loads from work, and chronic intermittent hypoxia (HIC). Also, it has been indicated to include the associated HIC risks to a security and health management system at work. Since physical workload (CFT) in HIC can condition risks of hard work and physical fatigue, it is considered appropriate to review the CFT effect at high altitude, between 3000 and 5500m of altitude, over the risks of hard work, which is why is proceeding to compile field studies about the aerobic capacity, measures of signs that allows assessing the % of Cardiovascular load (%CCV) used at great altitudes. The % CCV is estimated by cardiac frequencies (FC) at rest, maximum, and from work. The FC continuous monitoring and direct measures of the maximum aerobic capacity displays that the three FC of %CCV are modified in HIC is also displayed that when the work FC in altitude is over 110 heartbeats/minute there is major fatigue and hard work risk. Moreover, it was determined that aerobic capacity, VO2 max, measured at sea level is reduced in acclimated workers to HIC with a 7% reduction of maximum FC. This effect, known as physiological protective restrain, can be lost during a deacclimation at sea level for more than 10 days. At the sight of a greater probability of hard work in HIC, interventions are proposed to prevent, control, and reduce fatigue risks, tiredness, and hard work that affects health, safe-conduct, and productivity. In conclusion, in chores at high altitudes, CFT can be assessed by measuring the %CCV based on date from the FC in rest, maximum and from work, in each height where work activities are performed, because the hypobaric hypoxia modifies the three components of that equation.

Micropropagación y aclimatación de Maguey Pitzometl (Agave marmorata Roezl) en la Mixteca Poblana / Micropropagation and acclimatization of Maguey Pitzometl (Agave marmorata Roezl) in the poblana Mixteca

RESUMEN Agave marmorata R. es una planta que se adapta a terrenos someros y fertilidad baja, también sirve para la retención y conservación de agua de lluvia reduciendo la erosión del suelo. Actualmente se encuentra de forma silvestre y escasa en la Mixteca Poblana (México) donde es intensamente aprovechada en gastronomía y como planta medicinal. Por ello, se propuso la propagación in vitro como estrategia de rescate y conservación a partir de brotes in vitro de Agave marmorata en un medio de cultivo básico de Murashige y Skoog (1962) 100 %, suplementado con azúcar de caña 3 %, myoinositol 100 mg-L-1, agar 0.7 % y 0.40 mg-L-1 de tiamina-HCl, donde se agregaron por separado diferentes concentraciones de 6-Bencil-adenina (BA) y ácido indol-3-acético (AIA) mediante un arreglo factorial 5x5. Se evaluó el número y longitud de brotes y de raíces obtenidos in vitro. Para [as plantas en aclimatación sólo se evaluó el porcentaje de sobrevivencia en diferentes sustratos. Los datos de las variables se sometieron a un análisis de varianza y a una prueba de medias de Tukey (p=0.05). La mejor respuesta para longitud de brotes, número y longitud de raíces fue en el medio MS 100 % adicionando 10 mg-L-1 de AIA y la proliferación de nuevos brotes fue promovida con la adición de BA y AIA en igual concentración. Finalmente, se obtuvo el 100 % de sobrevivencia de las plántulas en los sustratos de peat moss más agrolita y peat moss más arena de río.

ABSTRACT Agave marmorata R. is a plant that adapts to shallow lands and low fertility, it also serves for the retention and conservation of rainwater reducing soil erosion. It is currently found in a wild and scarce form in the Mixteca Poblana (Mexico) where it is intensively used in gastronomy and as a medicinal plant. For this reason, in vitro propagation was proposed as a rescue and conservation strategy from in vitro shoots of Agave marmorata in a basic culture medium of Murashige and Skoog (1 962) 100 %, supplemented with 3 % sugar cane, myo- inositol 100 mg-L-1, agar 0.7 % and 0.40 mg-L-1 thiamine-HCl, where different concentrations of 6-Benzyl-adenine (BA) and indole-3-acetic acid (IAA) were added separately by a 5x5 factorial arrangement. The number and length of shoots and roots obtained in vitro were evaluated. For the plants in acclimation only the percentage of survival in different substrates was evaluated. Los datos de las variables se sometieron a un análisis de varianza y a una prueba de medias de Tukey (p=0.05). The best response for shoot length, number and length of roots was in the MS 100 % medium adding 10 mg-L-1 of IAA and the proliferation of new shoots was promoted with the addition of BA and IAA in the same concentration. Finally, 100 % survival of the seedlings was obtained in the substrates of peat moss plus agrolita and peat moss plus river sand.

Expresión de O6-metilguanina-ADN-metiltransferasa (MGMT) en pacientes chilenos con glioblastoma multiforme / O6-methylguanine-DNA-methyltransferase (MGMT) expression in patients with glioblastoma multiforme

Background: Patients with Glioblastoma multiforme (GBM) have a five years survival of less than 5%, but the response to chemotherapy with alkylating agents can vary depending on the methylation status of O6-methylguanine-DNA-methyltransferase (MGMT). Genetic testing has limitations for routine use, while immunohistochemistry (IHC) offers a fast and affordable technique but with heterogeneous results in the literature. Aim: To evaluate MGMT expression by IHC in tumor tissue of Chilean patients with GBM. Material and Methods: Tumor samples of 29 patients with a pathological diagnosis of GBM were studied. We performed IHC staining and manual analysis of positive and negative cells for MGMT expression. A cut-off of at least 10% of cells expressing MGMT was used. Demographic and clinical features of patients were obtained from clinical records. Results: The median number of cells counted per case was 692 (interquartile range [IQR] 492-928). Fifteen cases (52%) were positive for MGMT expression. Median overall survival was 5.3 months (IQR 3.4-12-8). The effect of MGMT expression on the therapeutic response was not studied since only 3 patients received chemotherapy. Conclusions: Our results are similar to international reports, but we were not able to determine the association between MGMT expression and therapeutic response.

Evaluación del minimental abreviado de la evaluación funcional del adulto mayor (EFAM) como screening para la detección de demencia en la atención primaria / Performance of an abbreviated mini mental examination to detect dementia in older people

Background: The usefulness of the abbreviated Mini-Mental State Examination included in the Chilean Functional assessment of elderly people (MM-SE-EFAM) to detect Dementia has not been determined. Aim: To assess the performance of the MMSE-EFAM to detect dementia. Material and Methods: We studied a non-probabilistic sample of subjects older than 65 years who had been assessed by the MMSE-EFAM in a Chilean primary care center during a period of 6 months. Patients underwent clinical evaluation by a neurologist blinded to MMSE-EFAM score, to establish the diagnosis of dementia using DSM-IV-TR criteria. Besides, the full Mini-Mental State Examination (MMSE) was applied. Results: The clinical diagnosis of Dementia was established in 13 of the 54 peoples evaluated. MMSE-EFAM had a sensitivity of 30.8% (95% confidence intervals (CI); 9-61.4) and a specificity of 90.2% (95% CI; 76.9%-97.3%), while MMSE had a sensitivity of 84.6% (95% CI; 54.6-98.1) and a specificity of 58.5% (95% CI; 42.1-73.7). In a receiver operating characteristic (ROC) curve analysis, the areas under the curve (AUC) were 0.77 (95% CI; 0.61-0.93) and 0.82 (95% CI; 0.70-0.95) for MMSE-EFAM and MMSE, respectively. Socio-demographic variables did not influence test performance in both cases. Conclusions: MMSE-EFAM has a low sensitivity to detect patients with Dementia and it is not an effective screening tool. These results are in agreement with the evidence and international guidelines that do not support the use of cognitive screening tools to detect dementia in the older general population.

Tumor de frantz: el tumor de las mujeres jovenes. correlacion radiologico-patologica de dos casos en tomografia revision de la literatura / Frantz's tumor: the tumor of young women. pathological-radiological correlation of two cases on tomography review of the literature / Tumor de frantz: o tumor das mulheres jovens. correlação patológica-radiológica de dois casos na tomografia revisão da literatura

El tumor de Frantz o tumor sólido pseudopapilar del páncreas, es un tumor raro único de bajo potencial maligno que afecta principalmente a mujeres jóvenes con un promedio de edad de 21,97 años. Las pacientes son generalmente asintomáticas y es descubierto de manera incidental mediante examen físico y la realización de imágenes por otras razones. La tasa de curación con la resección total del tumor es mayor al 95%. Por lo tanto, el análisis realizado por las imágenes en resonancia magnética o en tomografía y la posterior confirmación patológica, demuestra con precisión las características de este tumor para su mayor comprensión y poder realizar un rápido diagnóstico y tratamiento oportuno.

Frantz's tumor or solid pseudopapillary tumor of the pancreas is a rare unique tumor of low potential for malignancy that mainly affects young women with a mean age of 21.97 years. Patients are generally asymptomatic and the tumor might be discovered at physical examination and the performance or abdominal imaging for other reasons. More than 95% of patients are cured by complete resection. Therefore, the analysis done by magnetic resonance imaging and tomography and the pathological confirmation shows with accuracy the main characteristics of this tumor for its better understanding and make a prompt diagnosis and pertinent treatment.

O tumor de Frantz ou o tumor pseudopapilar sólido do pâncreas é um tumor único e raro de baixo potencial de malignidade que afeta principalmente mulheres jovens com idade média de 21,97 anos. Os pacientes geralmente são assintomáticos e o tumor pode ser descoberto no exame físico e no desempenho ou imagem abdominal por outros motivos. Mais de 95% dos pacientes são urados por ressecção completa. Assim sendo, a análise feita por ressonância magnética e tomografia e a confirmação patológica mostram com precisão as principais características deste tumor para melhor compreensão e um diagnóstico imediato e tratamento pertinente.

Lipomas: de la cabeza a los pies / Lipomas: From Head to Toe

Introducción: En la práctica diaria, y la mayoría de veces de manera incidental, es frecuente encontrar lesiones lipomatosas de diferente origen que requieren una caracterización adecuada. Objetivo: Revisar y describir las lesiones lipomatosas benignas más frecuentes; analizar su origen, sus características en los diferentes métodos de imagen ­como ultrasonido (US), tomografía computarizada (TC) y resonancia magnética (RM)­ y su implicación en procesos de enfermedad. Métodos: Revisión bibliográfica de las lesiones lipomatosas de la cabeza a los pies con una revisión retrospectiva de casos de nuestra institución. Resultados: Los lipomas son tumores benignos usualmente diagnosticados de manera incidental. Es importante conocer sus características en imágenes para acercarse al diagnóstico apropiado.

Introduction: In daily practice, and in most cases incidentally, we often find lipomatous lesions of different origin which require proper characterization. Objective: Our goal is to review and describe the most frequently found benign lipomatous lesions, describing their origin and their characteristics in different imaging techniques such as ultrasound (US), Computed tomography (CT) and Magnetic resonance (MR), and their involvement in disease. Methods: We perform a bibliographic research in lipomatous lesions from head to toe and a retrospective review of cases from our institution. Results: Lipomatous lesions are benign tumors usually diagnosed incidentally. It is important to know its features in the different imaging methods for an accurate diagnosis.

Disección espontánea de la arteria coronaria diagnosticada por angioTAC: Presentación de un caso / Spontaneous Coronary Artery Dissection Diagnosed By Ct Angiography: A Case Report

La disección espontánea de las arterias coronarias es una rara causa de síndrome coronario agudo, su presentación clínica varía desde un síndrome coronario agudo hasta la muerte súbita, dependiendo de la extensión de la disección. En las publicaciones se evidencia que la mayoría aparecen en mujeres de edad media. A continuación presentamos un caso de disección espontánea de la arteria coronaria izquierda con extensión a la rama descendente anterior y circunfleja, en una mujer de 31 años de edad.

Spontaneous coronary artery dissection is a rare cause of acute coronary syndrome. Clinical presentation is variable, from acute coronary syndrome to sudden death, depending on the extent of the dissection; case reports and case series shows evidence that most cases present in middle-aged women. We present a case of spontaneous dissection of the left coronary artery extending to the left anterior and circumflex descending branch in a 31 years old woman

Estadificación del cáncer colorrectal mediante resonancia magnética / MRI Staging of Colorectal Cancer

El cáncer colorrectal es la cuarta causa de muerte a nivel mundial y la quinta causa de muerte por cáncer en Colombia. La resonancia magnética es la modalidad ideal para la valoración del cáncer colorrectal, ya que permite la estadificación mediante la determinación de la invasión más allá de la muscular propia, la extensión hacia órganos adyacentes, la identificación de pacientes candidatos a quimioterapia o radioterapia prequirúrgica y la planeación del procedimiento quirúrgico. El punto clave se basa en la diferenciación entre los estadios T2 y T3 mediante el uso de secuencias con información T2 de alta resolución. Además de esto, permite la valoración del tamaño y la morfología de los ganglios linfáticos, y aumenta considerablemente la especificidad para la detección de compromiso ganglionar. La resonancia magnética es una técnica con una alta especificidad y una alta reproducibilidad

Colorectal cancer is the fourth leading cause of death worldwide and the fifth leading cause of cancer death in Colombia. MRIs are ideal for evaluating colorectal cancer, especially for screening, because they allow staging by determining the extent of any invasion beyond the muscularis and into adjacent organs. This is key for identifying candidates for chemotherapy and/or preoperative radiation therapy and for planning surgical procedures. The key is differentiation between stages T2 and T3 by using T2 sequences with high resolution information. In addition, MRIs allow assessment of the size and morphology of the lymph nodes and greatly increases the specificity of detection of nodal involvement. Magnetic resonance imaging has high specificity and reproducibility

Studying the links between organizational culture, innovation, and performance in Spanish companies / Estudiando el vínculo entre cultura organizacional, innovación y desempeño en empresas españolas

Innovation is considered to be one of the key factors that influence the long-term success of a company in the competitive markets of today. As a result, there is a growing interest in the further study of the determining factors of innovation. Today, the focus is on these factors related to people and behavior, emphasizing the role of organizational culture, as a factor that can both stimulate or restrain innovation, and therefore affect company performance. However, there is little empirical research linking these variables, particularly in the Spanish context. The purpose of this paper is to study these links by using a sample of industrial companies. The results show that culture can foster innovation, as well as company performance, or it could also be an obstacle for both of them, depending on the values promoted by the culture. It has been found specifically, that an adhocratic culture is the best innovation and performance predictor. Based on these results, it can be concluded that, innovation mediates the relationship between certain types of organizational cultures and performance.

La innovación se considera como uno de los factores clave del éxito a largo plazo de una empresa en los mercados competitivos actuales. Como resultado, existe un creciente interés por profundizar en los determinantes de la innovación. En la actualidad la atención se centra en los determinantes relacionados con las personas y el comportamiento, y hace hincapié en el papel de la cultura organizacional como un factor que puede estimular o frenar la innovación y por lo tanto afectar el desempeño de las empresas. Sin embargo, existe poca investigación empírica que vincule estas variables, en particular en el contexto español. El propósito de este trabajo es estudiar estos vínculos en una muestra de empresas industriales. Los resultados muestran que la cultura puede fomentar la innovación y el desempeño de la empresa o puede actuar como una barrera para ambos, dependiendo de los valores que fomenta la cultura. En particular, se encuentra que la cultura adhocrática es el mejor predictor de innovación y desempeño. Además, sobre la base de los resultados, se concluye que la innovación media la relación entre cultura y desempeño.

Distrofia muscular facioescapulohumeral en Chile: presentación de serie en hospital de referencia terciario / Facioscapulohumeral muscular dystrophy: Report of seven patients

Background: Facioscapulohumeral muscular dystrophy is the third most common muscular dystrophy with an estimated prevalence of 1 per 20.000 and a normal life expectancy in the majority of patients. However, approximately 15% of patients become wheelchair bound in the course of their life. It is a hereditary autosomal dominant disease with high (95%) penetrance by the age of 20, but with variable degree of phenotypic expression even in the same family group. Symptoms frequently start in the second decade of life, with facial and scapular weakness. Aim: To report the clinical features of seven patients with the disease, seen at a public hospital. Material and Methods: Analysis of seven patients with genetic study seen in a public Hospital in Santiago. Results: The age of patients fluctuated from 18 to 61 years and four were females. The mean age at onset of symptoms was 29 years and four had a family history of the disease. The usual presenting complaint was arm or shoulder asymmetric weakness. Four patients had bone pain. Facial involvement was present in four. A genetic study was done in five patients, the other two patients were relatives, confirming the contraction or lower number of repetitions in D4Z4 region. After 12 years of follow up only 2 patients older than 60 years cannot work and one female patients is in a semi dependent state at the age of 30. Conclusions: The clinical workup in the diagnosis and the timely indication of genetic studies are highlighted, to avoid unnecessary and invasive procedures. The variability in the phenotypic expression in a similar genetic defect is discussed and the genetic or epigenetic mechanisms of this muscular dystrophy are described.

Enfermedad de mondor reporte de caso: a case report / Mondor's disease: um estudo de caso / Doença de mondor

Se presenta un caso de la enfermedad de Mondor, una tromboflebitis de las venas superficiales de la mama. Su diagnóstico se establece clínicamente y se confirma con mamografía y ultrasonido. Es una entidad poco conocida de la cual existe escasa literatura. Se pretende revisar su etiología, fisiopatología y la importancia de la correlación clínico-radiológica de esta entidad ya que para el radiólogo es de vital importancia conocer el diagnóstico diferencial y realizar diagnóstico mediante correlación clínico- imagenológica.

A case of Mondor's disease is presented, a thrombophlebitis of the superficial veins of the breast. Its diagnosis is established clinically and confirmed by ultrasonography and mammography. This is a rarely known entity with a few data in the literature. A review of the etiology, physiopathology, and the importance of the clinic and radiologic correlation of this entity is pretended, since knowing the differential diagnosis and making the diagnosis through the clinic and imaging correlation is of vital importance for the radiologist.

Presenta-se um caso da doença de Mondor, uma tromboflebites das veias superficiais da mama. Seu diagnóstico define-se clinicamente e confirma-se com mamografia e ultra sonido. É uma entidade pouco conhecida da que existe escassa literatura. Pretende-se revisar sua etiologia, fisiopatologia e a importância da correlação clínico-radiológica de esta entidade, pois é muito importante para o radiologista conhecer o diagnóstico diferencial e fazer diagnóstico mediante correlação clínicoprojeção de imagem.

Microorganisms associated to tomato seedlings growing in saline culture act as osmoprotectant

Less than 0.5% of total water in the world is available for human consumption and agriculture. The major part of the world's water is saline and salinity in soils interferes in germination of seeds and the posterior development of the plant. In order to increase the osmotolerance of tomato, seedlings were associated with Azospirillum brasilense Cd, Azospirillum brasilense Cd transformed bacteria with a plasmid harboring a trehalose biosynthesis gene-fusion or Chlorella vulgaris. Two plant culture media: Hydroponic and Murashige and Skoog were tested. In the first set of studies seedlings were associated to single free cells meanwhile in a second set single and combined free cells were studied. A positive interaction between transformed Azospirillum and Chlorella vulagris and tomato plants was observed. Seedlings showed a salt concentration tolerance, as sodium chloride, up to 200 mM. According to our results, the association of plants with A. brasilense Cd-BIF and C. vulgaris is a viable approach to increase their salt tolerance and biomass, as consequence the possible use of sea water to irrigate horticultural plants.

Enfermedad de Müller-Weiss: un diagnóstico ignorado / Müller-Weiss Disease: An Ignored Diagnosis

La enfermedad de Müller-Weiss es una displasia del escafoides tarsiano producida en la infancia, pero sin síntomas hasta la edad adulta. No se considera una osteonecrosis del escafoides del adulto. Característicamente, el astrágalo está en varo y lateralizado, lo que genera una compresión en sentido anteroposterior de la porción externa del escafoides tarsiano. El compromiso suele ser bilateral. Las dos condiciones necesarias para el desarrollo de la enfermedad de Müller-Weiss son: retraso en la osificación del escafoides tarsiano y transferencia lateral de carga, en ocasiones favorecida por un primer metatarsiano corto. El varo del retropié y la morfología del escafoides son las características más frecuentes encontradas en los hallazgos radiológicos.

The Müller-Weiss disease is a tarsal navicular dysplasia developed in childhood which presents no symptoms until adulthood. Is not considered an adult osteonecrosis of the scaphoid. Characteristically, the talus is in varus and lateralized, generating anteroposterior compression of the outer portion of the tarsal navicular. There is often bilateral affection. The two necessary conditions for the development of Müller-Weiss' disease are: a delay in the ossification of the tarsal navicular and the lateral load transfer, which are favored by a short first metatarsal. The varus deviation of the hind foot and the tarsal navicular morphology are the two most commonly found radiological findings.

Acclimatization to chronic intermittent hypoxia in mine workers: a challenge to mountain medicine in Chile

In the past two decades, Chile has developed intense mining activity in the Andes mountain range, whose altitude is over 4,000 meters above sea level. It is estimated that a workforce population of over 55,000 is exposed to high altitude hypobaric hypoxia. The miners work under shift systems which vary from 4 to 20 days at the worksite followed by rest days at sea level, in a cycle repeated for several years. This Chronic Intermittent Hypoxia (CIH) constitutes an unusual condition for workers involving a series of changes at the physiological, cellular and molecular levels attempting to compensate for the decrease in the environmental partial pressure of oxygen (PO2). The mine worker must become acclimatized to CIH, and consequently undergoes an acute acclimatization process when he reaches the worksite and an acute reverse process when he reaches sea level. We have observed that after a period of 3 to 8 years of CIH exposure workers acclimatize well, and evidence from our studies and those of others indicates that CIH induces acute and chronic multisystem adjustments which are effective in offsetting the reduced availability of oxygen at high altitudes. The aims of this review are to summarize findings of the physiological responses to CIH exposure, highlighting outstanding issues in the field.