Producción de proteína unicelular de Saccharomyces cerevisiae con granza de arroz e inclusión en cerdos / Production of single cell protein of Saccharomyces cerevisiae with broken rice and inclusion in pigs / Produção de proteína unicelular de Saccharomyces cerevisiae com quirera de arroz e inclusão em suínos

Resumen El contenido proteico de harinas de cereales se incrementa con proteínas microbianas mediante procesos de fermentación utilizando levaduras. El objetivo de esta investigación fue evaluar la inclusión de granza de arroz sometida a fermentación liquida con Saccharomyces cerevisiae por fermentación anaeróbica como fuente de proteína unicelular (PUC) para cerdos en crecimiento. Se realizó prueba piloto en laboratorio para producción de PUC de S. cerevisiae con granza de arroz para estandarizar y encontrar las mejores condiciones en el proceso, para su posterior producción en fermentador de 600 l. Se evalúo la granza obtenida por fermentación con S. cerevisiae por un tiempo de 30 días, en 24 cerdos de 21.72 ± 3.31 kg, distribuidos en un diseño en bloques completos al azar con cuatro tratamientos, tres bloques y seis animales por tratamiento. El ensayo consistió en cuatro niveles de inclusión: T1: 0%, T2: 10%, T3: 20% y T4: 25%, de granza de arroz post-fermentada con S. cerevisiae. Las variables evaluadas fueron peso final (kg), ganancia de peso (g/día), consumo final (kg), conversión alimenticia. El alimento pasó de 8.23% a 13.97% de PC. Se presentaron diferencias (p<0.05) en ganancia diaria de peso T1: 625.81 y T2: 618.77 respecto T3: 526.38 y T4: 542.77 g/día, y en la conversión alimenticia entre T1: 2.20 y T2: 2.16 respecto a los tratamientos T3: 2.54 y T4: 2.45. No hubo diferencias (p>0.05) para el peso final ni el consumo final. El costo de las dietas fue menor para T2, T3 y T4. En conclusión, con la fermentación anaerobia de la granza se mejoró el nivel proteico del alimento por crecimiento de la levadura S. cerevisiae y puede ser incluido en dietas para cerdos en crecimiento, presentándose buena palatabilidad y hasta un nivel de inclusión del 10% obtener buen rendimiento, con una dieta de menor costo.

Abstract Cereal flour protein content can be increased by microbial protein action through yeast-driven fermentation. This research was aimed at evaluating the anaerobic fermentation of liquid rice bran with Saccharomyces cerevisiae as a single cell protein (SCP) source for raising pigs. A pilot test for S. cerevisiae SCP production was carried out in the laboratory using rice bran to standardise and find the best process conditions regarding SCP production in a 600 L fermenter tank. The rice bran obtained by fermentation with S. cerevisiae was evaluated for 30 days using twenty-four 21.72±3.31 kg pigs; a randomised complete block design (RCBD) was used, involving four treatments, three blocks and six animals per treatment. The trial had four rice bran post-fermented with S. cerevisiae inclusion levels: T1 0% bran inclusion, T2 10%, T3 20% and T4 25%. Final weight (kg), average daily gain (g/day), final consumption (kg) and feed conversion ratio (FCR) were the variables evaluated here. SCP inclusion in food rose from 8.23% to 13.97%. There were significant statistical differences (p<0.05) regarding average daily gain for T1 (625.81 g/day) and T2 (618.77) compared to T3 (526.38) and T4 (542.77) and FCR for T1 (2.20) and T2 (2.16) compared to T3 (2.54) and T4 (2.45). There were no differences (p>0.05) regarding final weight or final consumption. Diet costs were lower for T2, T3 and T4. The anaerobic fermentation of rice bran improved feed protein content through S. cerevisiae growth and can be included in diets for raising pigs; it has good palatability and up to 10% SCP inclusion level, obtaining good yield and a lower cost diet.

Resumo O conteúdo protéico das farinhas de cereais é aumentado com proteínas microbianas através de processos de fermentação utilizando leveduras. O objectivo desta pesquisa foi avaliar a inclusão de quirera de arroz submetido a fermentação líquida com Saccharomyces cerevisiae por fermentação anaeróbia como fonte de proteína unicelular (PUC) para porcos em crescimento. Teste-piloto foi realizado no laboratório para a produção PUC de S. cerevisiae com quirera de arroz, a fim de padronizar e encontrar as melhores condições do processo para a produção subsequente fermentador de 600 l. Foram avaliadas a quirera de arroz obtido por fermentação com S. cerevisiae foi avaliado por um período de 30 dias, em 24 porcos 21.72 ± 3.31 kg, distribuídos em blocos casualizados com quatro tratamentos, três blocos e seis animais por tratamento. O julgamento consistiu em quatro níveis de inclusão: T1: 0%, T2: 10%, T3: 20% e T4: 25%, de quirera de arroz pós-fermentado com S. cerevisiae. As variáveis ​​estudadas foram o ganho diário de peso (g/dia), peso final (kg), consumo final (kg) e conversão de feed. A comida passou de 8.23% para 13.97% de PC. Houve diferenças (p<0,05) no ganho de peso diário T1: 625.81 e T2: 618.77 em relação a T3: 526.38 e T4: 542.77 g/dia, e na conversão alimentar entre T1: 2.20 e T2: 2.16 com relação aos tratamentos T3: 2.54 e T4: 2.45. Não houve diferenças (p>0.05) para o peso final ou consumo final. O custo das dietas foi menor para T2, T3 e T4. Em conclusão, com a fermentação anaeróbia do quirera de arroz, o nível protéico da ração foi melhorado pelo crescimento da levedura S. cerevisiae e pode ser incluído em rações para suínos em crescimento, apresentando boa palatabilidade e até um nível de inclusão de 10% obtendo boa desempenho, com uma dieta de menor custo.

Sarcopenia in hemodialysis patients from Buenos Aires, Argentina

Objectives@#Sarcopenia is the loss of skeletal muscle mass and function that occurs with aging that can lead to greater morbidity and mortality. Chronic kidney disease and hemodialysis (HD) favors the development of sarcopenia. We studied the prevalence of sarcopenia and its components using European Working Group on Sarcopenia in Elderly People 2 proposed criteria and risk factors for its development in HD patients. @*Methods@#In 100 adult HD patients, we evaluated: hand grip strength (HGS), muscle mass by dual energy X-ray absorptiometry and physical performance (gait-speed and sit-stand test). @*Results@#Sixty patients were male and 40 were female; mean age 55.6 years. Prevalence of sarcopenia was 16% (11.1% in males and 25% in females; P ¼ 0.05); 7% had severe sarcopenia. Prevalence of low HGS was 33% in males and 28% in females; low muscle mass was 30% in males but 70% in females and low physical performance 23% in males and 45% in females. Falls were reported by 23 patients. Patients with lower HGS had a higher prevalence of falls in the last year (40% two or more falls; P ¼ 0.03). Only females with sarcopenia had lower bone mineral content. Neither age, body mass index, time on dialysis, or prevalence of diabetes predicted sarcopenia. @*Conclusions@#A significant proportion of dialysis patients had sarcopenia, more frequent in females. Low HGS was associated with a higher prevalence of falls. Only females with sarcopenia had lower bone mineral content.

Adaptación transcultural al Español y Validación de la Escala de Lysholm para evaluar la funcionalidad de la rodilla / Cross-cultural adaptation to Spanish and Validation of Lysholm knee Score

Introducción La escala de Lysholm fue desarrollada en 1982 y modificada en 1985 con el fin de evaluar la funcionalidad de los pacientes con lesiones ligamentarias; desde entonces ha sido ampliamente utilizada para evaluar subjetivamente a los pacientes en relación con su capacidad funcional. El propósito de este estudio fue realizar su traducción y adaptación transcultural al español colombiano y desarrollar la validación psicométrica a través de la evaluación de la consistencia interna y fiabilidad test-retest. Materiales y métodos Previa identificación de la escala original de interés, se realizó traducción (inglés-español), adaptación cultural y re-traducción (español-inglés) por expertos lingüistas nativos, quienes valoraron la similitud del contenido de ambos productos (original y retraducido). Asimismo, dicha última versión fue valorada por 40 pacientes con enfermedad de rodilla (lesión meniscal, ruptura de ligamento cruzado anterior, condromalacia y gonartrosis), quienes confirmaron comprender el texto. Posteriormente fue evaluada la consistencia interna mediante la prueba de alfa de Cronbach para todos los ítems, y el coeficiente correlación intraclase­puntaje total del sub-constructo a través de una muestra aleatoria (n=93), la cual validó la estructura factorial de la escala. Resultados El alfa de Cronbach fue de 0,737 y el coeficiente de correlación interclase fue de 0,844, asociado a una concordancia inter-observador alta (Gamma=0,752). El gráfico de Bland-Altman no demostró diferencias sistemáticas entre las mediciones Discusión La presente versión al español (colombiano) de la escala Lysholm es una herramienta válida para medir la funcionalidad en pacientes con lesiones meniscales del ligamento cruzado anterior, condromalacia patelofemoral y gonartrosis en países de habla hispana (preferentemente en Colombia).

Background The Lysholm scale was developed in 1982 and modified in 1985 in order to assess the functionality of patients with knee ligament injuries; since then it has been widely used to subjectively evaluate patients in relation to their functional capacity. The purpose of the study was to carry out its translation and cross-cultural adaptation to Colombian Spanish and to develop psychometric validation through the evaluation of internal consistency and test-retest reliability. Methods After identifying the original scale of interest, translation (English-Spanish), cultural adaptation and re-translation (Spanish-English) were carried out by native linguist experts, who assessed the similarity of the content of both products (original and retranslated). Likewise, this latest version was evaluated by 40 patients with knee disease (meniscal injury, anterior cruciate ligament rupture, chondromalacia and gonarthrosis), who confirmed that they understood the text. Subsequently, the internal consistency was evaluated using Cronbach's alpha test for all items, and the intraclass correlation coefficient ­ ??total score of the sub-construct through a random sample (n=93), which validated the factorial structure of the scale. Results Cronbach's alpha was 0.737 and the interclass correlation coefficient was 0.844, associated with a high inter-observer agreement (Gamma=0.752). The Bland-Altman plot did not show systematic differences between the measurements Discussion This Spanish (Colombian) version of the Lysholm scale is a valid tool to measure functionality in patients with meniscal lesions of the anterior cruciate ligament, patellofemoral chondromalacia and gonarthrosis in Spanish-speaking countries (preferably in Colombia).

Sarcopenia in hemodialysis patients from Buenos Aires, Argentina

Objectives@#Sarcopenia is the loss of skeletal muscle mass and function that occurs with aging that can lead to greater morbidity and mortality. Chronic kidney disease and hemodialysis (HD) favors the development of sarcopenia. We studied the prevalence of sarcopenia and its components using European Working Group on Sarcopenia in Elderly People 2 proposed criteria and risk factors for its development in HD patients. @*Methods@#In 100 adult HD patients, we evaluated: hand grip strength (HGS), muscle mass by dual energy X-ray absorptiometry and physical performance (gait-speed and sit-stand test). @*Results@#Sixty patients were male and 40 were female; mean age 55.6 years. Prevalence of sarcopenia was 16% (11.1% in males and 25% in females; P ¼ 0.05); 7% had severe sarcopenia. Prevalence of low HGS was 33% in males and 28% in females; low muscle mass was 30% in males but 70% in females and low physical performance 23% in males and 45% in females. Falls were reported by 23 patients. Patients with lower HGS had a higher prevalence of falls in the last year (40% two or more falls; P ¼ 0.03). Only females with sarcopenia had lower bone mineral content. Neither age, body mass index, time on dialysis, or prevalence of diabetes predicted sarcopenia. @*Conclusions@#A significant proportion of dialysis patients had sarcopenia, more frequent in females. Low HGS was associated with a higher prevalence of falls. Only females with sarcopenia had lower bone mineral content.

Supervivencia de pacientes con metástasis cervical de primario desconocido en el Instituto Nacional de Oncología y Radiobiología. 2007-2012

Resumen Introducción: Las metástasis cervicales con primario oculto representan el 5% de los tumores de cabeza y cuello. Su diagnóstico y tratamiento han sufrido modificaciones con los años según las diferentes investigaciones, con vistas a mayores tasas de supervivencia. Objetivo: Determinar la supervivencia global y según diferentes variables. Material y Método: Investigación retrospectiva, descriptiva y longitudinal de 96 pacientes diagnosticados en el Instituto Nacional de Oncología y Radiobiología (INOR) en el periodo 2007-2012, manteniéndose el seguimiento hasta el 31 de diciembre de 2017. Resultados: De los pacientes estudiados, 65 eran hombres (67,7%) y 31 mujeres (32,3%), para una razón de 2,1:1, con una media de edad de 61,4 años. El tabaquismo estuvo presente en el 64,6% de la población. El nivel ganglionar más afectado fue el II y 41 pacientes (42,7%) presentaron una enfermedad N1 al diagnóstico. En 42 pacientes (43,8%) estuvo presente el grado histológico poco diferenciado. Al 70,9% se les practicó cirugía con adyuvancia o sin ella y el 86,5% tuvo respuesta completa. El tumor primario apareció en el 13,5% de los casos, más frecuente en amígdala. La supervivencia global a los 5 años fue del 74% y resultaron variables determinantes de supervivencia el estado ganglionar y la extensión extraganglionar. Los resultados coinciden con la literatura revisada. Conclusión: La supervivencia global a los 5 años de los pacientes con metástasis cervical de primario oculto es elevada, tiene tendencia a mejorar con el paso de los años y está determinada por el estado ganglionar y la extensión extracapsular de forma inversamente proporcional.

Abstract Introduction: Cervical metastases with occult primary represent 5% of head and neck tumors. Its diagnosis and treatment have been modified over the years according to different investigations, with a view to higher survival rates. Aim: To determine the overall survival and according to different variables. Material and Method: A retrospective, descriptive and longitudinal investigation of 96 patients diagnosed at INOR in the period 2007-2012 was carried out, with follow-up until December 31, 2017. Results: Of the patients studied, 65 were men (67.7%) and 31 women (32.3%), for a ratio of 2.1: 1, with a mean age of 61.4 years. Smoking was present in the 64.6% of the population. The most affected lymph node level was level II and 42 patients (43.8%) presented N1 disease at diagnosis. Poorly differentiated histological grade was present in 42 patients (43.8%). 70.9% underwent surgery with or without adjuvant surgery and 86.5% had a complete response. The primary tumor appeared in 13.5% of cases, more frequent in the amygdala. Overall survival at 5 years was 74%, and survival variables were lymph node status and extranodal extension. The results coincide with the reviewed literature. Conclusion: The overall 5-year survival of patients with occult primary cervical metastasis is high, tends to improve over the years, and is determined by lymph node status and extracapsular extension in an inversely proportional manner.

Rodilla Flotante: modificación de la clasificación de Fraser y factores asociados con los resultados funcionales / Floating knee: modification on the Fraser classification and factors associated with functional results

Introducción Los casos de rodilla flotante son secundarios a traumas de alta energía, lo que conlleva altas tasas de complicaciones y múltiples patrones de fractura. Este estudio introduce una modificación de la Clasificación de Fraser e identifica factores relacionados con los resultados funcionales. Métodos Se realizó un estudio de cohorte ambidireccional con pacientes diagnosticados con rodilla flotante manejados entre los años 2008 al 2012 en un hospital de referencia. Se recolectaron variables demográficas, presencia de lesión vascular, infección y fracturas abiertas. Se utilizó una modificación de la Clasificación de Fraser para clasificar las fracturas óseas. La Clasificación de Fraser Modificada (CFM) abarcó la siguiente distribución: Tipo I, Tipo II A, Tipo II B y Tipo II C, además de adicionar los Tipos III A, III B y III C. Se evaluó la correlación entre la funcionalidad y la CFM. Se utilizaron los criterios de Karlstrom y Olerud para evaluar la funcionalidad. Resultados Se incluyeron 34 pacientes en el estudio, 30 (88%) hombres y 4 (12%) mujeres con un promedio de edad de 32 años±10,3. Según la CFM las fracturas Tipo II A con 15 (44%) casos y la Tipo I con 13 (38%) casos fueron las fracturas más comunes. 17 (50%) pacientes presentaron un resultado excelente, 3 (9%) bueno, 5 (15%) aceptable y 9 (26%) pobre. Se encontró una correlación moderada entre un resultado pobre y la Clasificación de Fraser Modificada (rho=0.42, p=0.046). La edad ≥ 40 años (OR 6.7 IC 95% 1.1 ­ 41, p=0.03) y la infección en la extremidad inferior afectada (OR 7.2 IC 95% 1.5 ­ 33, p=0.01), se asociaron con un resultado funcional aceptable/pobre. Discusión La Clasificación de Fraser Modificada incluye más patrones de fractura en comparación con la clasificación de Fraser original, permitiendo una mejor caracterización radiológica de las fracturas, con una correlación moderada con los resultados funcionales. La edad ≥ 40 años y la infección en la extremidad comprometida, se asociaron con un resultado funcional aceptable/pobre.

Background Floating Knee is due to high energy trauma, with high rates of complications and multiple patterns of fractures. A modification of the Fraser Classification is introduced, and identifies factors associated with functional outcomes. Methods An ambidirectional cohort study was conducted in a referral teaching hospital during 2008 and 2012. Demographic variables, vascular lesion, infection, and open fractures were recorded. A modification of the Fraser Classification was used to classify the fractures. The Modified Fraser Classification (MFC) encompasses the following distribution: Type I, Type II A, Type II B, and Type II C, and Type III A, Type III B, and Type III C, was added. The correlation between functionality and the MFC was assessed. The Karlstrom and Olerud criteria were used to determine the functional outcome. Results A total of 34 patients were included, of whom 30 (80%) were males and 4 (12%) females. The mean age was 32 years±10.3. According to the MFC, the Type II A (n=15 - 44%) and Type I (n=13 - 38%) were the most common. The functionality outcomes of the patients were Excellent in 50% (17), Good in 9% (3), Acceptable in 15% (5), and Poor in 26% (9). There was a moderate correlation between poor outcomes and the Modified Fraser Classification (rho=0.42, P=0.046). Age ≥ 40 years (OR 6.7, 95% CI; 1.1 ­ 41, P=0.03) and infection (OR 7.2, 95% CI; 1.5 ­ 33, P=0.01) were associated with acceptable/poor results. Discussion The Modified Fraser Classification includes more patterns of fractures in comparison with the original Fraser Classification, allowing for a better characterisation of the patients, with moderate correlation with functional outcomes. Age ≥ 40 years and infection were associated with an acceptable/poor result.

Relación entre score de incontinencia fecal y hallazgos ecográficos en pacientes con antecedente de trauma obstétrico / Relationship between faecal incontinence score and ultrasound findings in patients with a history of obstetric trauma

Introducción: La incontinencia anal es una compleja y devastadora patología que altera la calidad de vida de los pacientes, cuya etiología más común es la lesión esfintérica postparto vaginal. A la hora de clasificar la incontinencia, el score descripto por Jorge y Wexner es el más utilizado en nuestro medio. La ecografía endoanal ha sido definida como el gold standard para evaluar los defectos del esfínter anal. Objetivo: Determinar la correlación entre los hallazgos clínicos y ecográficos en pacientes con incontinencia fecal de causa obstétrica. Material y Métodos: Población: pacientes que consultaron en el Centro Privado de Cirugía y Coloproctología entre enero de 2015 y diciembre de 2017 por incontinencia fecal con antecedentes de trauma obstétrico y a las que se les realizó una ecografía endoanal 360° y score de Jorge y Wexner. Resultados: Se evaluaron 24 pacientes. La media de edad fue de 56 años. El número de partos en promedio fue 2,3 y el Score de Wexner en promedio fue 9.7 (±5.2). La ecografía endoanal confirmó alteración esfintérica por afinamiento o interrupción en el 100% de los pacientes. Se observó una tendencia a una asociación negativa entre el Score de Wexner y la ecografía endoanal (r=-0.328, p=0.067). Las pacientes con menor grado de lesión esfinteriana por ecografía tenían mayor severidad en el Score de Wexner que las pacientes con mayor grado de lesión. Las pacientes con evidencia ecográfica de lesiones leves refirieron un mayor Score de Wexner que aquellas con lesiones severas. Conclusión: En este trabajo no existió correlación entre los hallazgos ecográficos y el score de incontinencia. Si bien la ecografía esfintérica es el gold standard para evaluar daño muscular, la terapéutica no debe ser determinada solamente por la ecografía. Tipo de estudio: Retrospectivo, transversal y descriptivo.

Introduction: Anal incontinence is a complex and devastating pathology that alters the patient's quality of life, whose most common etiology is vaginal postpartum sphincter injury. To classify incontinence, the score described by Jorge and Wexner is the most used in our environment. Endoanal ultrasound has been defined as the gold standard for evaluating anal sphincter defects. Objective: To determine the correlation between clinical and ultrasound findings in patients with fecal incontinence due to obstetric cause. Material and Methods: Population: patients who consulted at the Private Center of Surgery and Coloproctology between January 2015 and December 2017 due to fecal incontinence with a history of obstetric trauma and who underwent a 360º endoanal ultrasound and a Jorge and Wexner score. Results: Twenty-four patients were evaluated. The average age was 56 years. The number of births on average was 2.3 and the Wexner Score on average was 9.7 (± 5.2). Endoanal ultrasound confirmed sphincter alteration by refining or interruption in 100% of patients. A tendency to a negative association was observed between the Wexner Score and the endoanal ultrasound (r = -0.328, p = 0.067). Patients with a lower degree of sphincter injury by ultrasound had greater severity in the Wexner Score than patients with a higher degree of injury. Patients with ultrasound evidence of mild lesions reported a higher Wexner Score than those with severe lesions. Conclusion: In this work, there was no correlation between the sonographic findings and the incontinence score. Although sphincter ultrasonography is the gold standard for assessing muscle damage, therapy should not be determined only by ultrasound. Type of study: Retrospective, cross-sectional and descriptive.

EFFECTIVENESS OF VISION SCREENING TRAINING MODULE IN IMPROVING THE LEVEL OF KNOWLEDGE ON VISION SCREENING AMONG PRE-SCHOOL TEACHERS IN KLANG VALLEY MALAYSIA

@#Empowering lay screeners, such as pre-school teachers, on vision screening is a cost-effective way to ensure larger populations of children can be screened. Although the validity of lay screeners in conducting vision screening were reported in several studies, none showed data concerning improvement of the level of knowledge among lay screeners after completing vision screening training, which could indicate the effectiveness of the training program. This study aimed to determine the level of knowledge of pre-school teachers before and after attending a training program. Sixty pre-school teachers from Tabika and Taska KEMAS were randomly selected. The Study Group (n = 30) was given theory and practical training on vision screening, whereas the Control Group (n = 30) was only given brief verbal instructions on how to conduct the screening. A theory test containing 15 questions related to the training modules were administered to both groups, before and after their training/briefing respectively. The findings showed that the level of knowledge among pre-school teachers in the Study Group (73.24 ± 11.73%) was significantly higher than the Control Group (56.22 ± 13.11%) (p < 0.01). There was also a significant improvement in the level of knowledge among pre-school teachers in the Study Group after the training (p<0.001), whereas no improvement was noted among pre-school teachers in the Control Group (p = 0.636). This study shows the importance of conducting training for pre-school teachers prior to their involvement in conducting vision screening in order to deliver an effective vision screening program to the preschoolers

Use of the united theory of acceptance and use of technology model to study information communication technology- adoption in five Saudi Arabian private hospitals

We conducted a multi-institutional case study to identify the issues associated with the adoption of information and communication technology (ICT) in five private care hospitals in the Kingdom of Saudi Arabia. We conducted interviews with 37 respondents primarily comprising IT professionals. We found that there were three determinants of behavioural intentions in this case study: organisation objectives, facilitating conditions and social influence where there are no effects of performance expectancy or effort expectancy. In all five cases, none of the moderators (age, gender, experience and voluntariness) in the original united theory of acceptance and use of technology model were considered critically important by IT professionals. In the present paper, all qualitative elements such as themes, patterns and overarching in the data were analysed to reach a conclusion. In addition, the various perspectives of using ICT are discussed.

Técnicas didácticas: método de caso clínico con la utilización de video como herramienta de apoyo en la enseñanza de la medicina / Teaching techniques: clinical case approach to the use of video as a tool to support

La enseñanza de las ciencias biomédicas o denominadas también básicas, en los programas de medicina de las Universidades de Colombia, es la base fundamental para el desarrollo continuo del razonamiento científico y clínico en los futuros profesionales facultativos para la evolución social y científica del país. La evaluación autónoma de la calidad interna, por parte de las instituciones educativas, se hace imprescindible para lograr, no sólo, la adquisición de conocimientos fácticos en forma significativa, sino también, la formación ética, estética y humanística de los estudiantes. La enseñanza y el aprendizaje de las ciencias Biomédicas implican aspectos teóricos, metodológicos e investigativos, así como una reflexión constante sobre el quehacer pedagógico, lo que implica la interdisciplinaridad, la integración básico-clínica y, por extensión, la didáctica y la aplicación de tecnologías de la información y la comunicación (TIC). En este escrito, se expone una experiencia pedagógica de tipo cualitativo fundamentada en Método de Caso Clínico (MdC), la cual se llevó a cabo dentro de la sección de Bioclínica de la Universidad El Bosque, se estructuró con el uso de TIC y se basó en un problema de impacto de morbilidad de Salud Pública para Colombia.

The teaching of biomedical sciences or also called basic medical programs at the Universities of Colombia, is the fundamental basis for the continued development of scientific reasoning and clinical professionals in future physicians, and therefore to the social and scientific the country. Therefore, the independent evaluation of internal quality by educational institutions is essential to achieve not only the acquisition of factual knowledge significantly, but also the ethical, aesthetic and humanistic students. Teaching and learning science involves Biomedical theoretical, methodological and research and a constant reflection on the pedagogical practice, which involves interdisciplinary, basic clinical integration, and by extension the teaching and application of new Information and Communication Technology (ICT). In this paper, presents a qualitative learning experience based on Clinical Case Method (MdC), which was held in the section Bioclinic of the University El Bosque, and was structured with the use of TICS and which was based on a problem of impact of disease of public health for Colombia.

[ effect of diclofenac sodium injection on stomach of male rats]

Diclofenac sodium is a non-steroidal anti-inflammatory drug [NSAID]. It is widely used because of its analgesic, anti-inflammatory and antipyretic effects. The aim of this experimental study is to investigate the effects of intramuscular injection of diclofenac sodium in therapeutic and high doses for different periods on the stomach of rats. Forty young adult male albino rats ranging from 180-220 g body weight were used. They were divided into 5 groups of 8 animals for each. Group A and B were the control groups, they received intramuscular injection of normal saline for 7 and 14 weeks respectively. Group C received intramuscular injection of therapeutic doses of diclofenac sodium [2.2 mg/kg/day] for 7 weeks. Group D received therapeutic doses of diclofenac sodium intramuscularly for 14 weeks, while group E was administered intramuscular injection of high doses of diclofenac sodium [11 mg/kg/day] for 7 weeks. At the end of the experiment, the animals were sacrificed and the stomachs were obtained from all groups for light microscopic examinations. No changes were observed in stomachs of groups A, B and C, while in group D there were destruction of glandular architecture, damage of surface epithelium and submucosal blood vessels congestion. Group E reveals destruction and shedding of surface epithelium, necrosis in the gastric mucosa with mononuclear inflammatory cells infiltration, in addition to submucosal blood vessels congestion, edema and hemorrhage. Diclofenac sodium is safe and cause no gastric damage when administered intramuscularly as a single daily therapeutic dose in young adult rats for 7 weeks or less, but it causes gastric damage when the period of administration or the dose of the drug increase [i.e gastric damage depends on the period of exposure and the dose of the drug]

Propuesta de reglas de decisión en las evaluaciones económicas de tecnologías sanitarias para el contexto cubano / Proposals of decision rules in economic assessment of health technologies for the Cuban context

INTRODUCCIÓN: Aunque las evaluaciones económicas en el sector sanitario cubano han crecido en número y en calidad, con poca periodicidad son utilizadas en la toma de decisiones, ni se solicitan con frecuencia. Una de las posibles causas para no emplearlas es que casi ninguna muestra las reglas de decisión aplicadas por los investigadores para la alternativa que proponen, lo que incrementa la incertidumbre de los encargados de tomar decisiones. OBJETIVO: Presentar un grupo de reglas de decisión en evaluaciones económicas que forman parte de la literatura. RESULTADOS: Se presentan criterios de decisión para evaluaciones económicas de tipo costo efectividad (plano costo efectividad); costo utilidad (considerada una variante de la técnica costo efectividad) emplea como criterio de decisión el plano costo efectividad también; costo beneficio utiliza el valor actual neto, la razón costo beneficio bruta y la tasa interna de rendimiento. CONCLUSIÓN: La aplicación de reglas de decisión en las evaluaciones económicas contribuye a la reducción de la incertidumbre en el momento de decidir entre alternativas

INTRODUCTION: Although the economic assessments in the Cuban health sector have increased in number and in quality, they are neither used frequently used in the decision-making nor are frequently requested. One of the potential causes of this non-use is that almost any shows of decision rules applied by researchers for the own alternative increasing the uncertainty of those charged of decisions-making. OBJECTIVE: To present a series of decision rules in economic assessments to be part of the literature. RESULTS: Some decision criteria are presented for economic assessment of cost-effectiveness ( cost-effectiveness plan); cost-usefulness (a variant of cost-effectiveness technique) which uses as decision criterion also the cost-effectiveness plan; cost-benefit uses the net current value, the gross cost-benefit ratio and the performance internal rate. CONCLUSION: The researches related to economic evaluations must to be enclosed by the decision rules on the proposed alternatives, thus it allow to decision-maker to make the choice

Riesgo cardiovascular según tablas de la OMS, el estudio Framingham y la razón apolipoproteína B/apolipoproteína A1 / Cardiovascular risk according the OMS tables, the Framingham study and the B apolipoprotein/A1 apolipoprotein reason

Se realizó una revisión de la bibliografía actual relacionada con el tema de las lipoproteínas y los factores de riesgo cardiovasculares con el objetivo de ofrecer una aproximación a la comprensión de los factores de riesgo relacionados con las enfermedades cardiovasculares. El perfil de riesgo cardiovascular se ha calculado, principalmente, por la Organización Mundial de la Salud, el estudio Framingham y a través de la razón ApoB/ApoA1. La Organización Mundial de la Salud ha elaborado una guía que integra los factores de riesgo para predecir un evento cardiovascular en los 10 años siguientes a la evaluación del enfermo. El estudio Framingham permitió identificar factores de riesgo mayores (hábito de fumar, hipertensión arterial, niveles elevados de colesterol total, bajos niveles de HDL colesterol, aumento de lipoproteína de baja densidad, diabetes mellitus y edad avanzada) y factores de riesgo no mayores (obesidad, sedentarismo, antecedentes familiares de enfermedad coronaria prematura, hipertrigliceridemia y aumento de la lipoproteína A). La razón ApoB/ApoA1 es un marcador predictivo de eventos mortales por enfermedad cardiovascular. Se concluye que los factores de riesgo no inducidos en las tablas de la Organización Mundial de la Salud y en el estudio Framingham pudieran modificar, incrementándolo, el índice de riesgo de enfermedad cardiovascular

A review of current bibliography was carried out related to the subject of lipoproteins and the cardiovascular risk factors. To offer a approximation to the understanding of the risk factors related to cardiovascular diseases. The cardiovascular risk profile has been estimated, mainly by WHO, the Framingham study and through ApoB/Apo1 reason. The WHO has designed a guideline that includes the risk factor to predict a cardiovascular event in the following ten years to ill person assessment. The Farmingham study allowed identifying the greater risk factors (smoking, arterial high blood pressure, high levels of total cholesterol, low levels of HDL cholesterol, increase of low density lipoprotein (LDL), diabetes mellitus and old age) and no greater risk factors (obesity, sedentary state, family backgrounds of a premature coronary disease, hypertriglyceridemia and increase of A lipoprotein). The ApoB/ApoA1 reason is a predictive marker of mortal events from cardiovascular disease. We conclude that the risk factors not included in the tables of the WHO and the Framingham study may to modify increasing it, the cardiovascular disease risk rate

Hepatectomy experience in Baghdad teaching hospital

Hepatectomy is usually performed because it is the most effective way of removing liver tumour [s]. Cryosurgery, Radiofrequency, Laser, Microwave and Chemo-therapies are less effective alternatives. To review the experience of hepatectomy in Baghdad Teaching Hospital - Medical city Iraq with a review of the obstacles and needs for promotion and development. During the period from March 1999 to September 2005, Out of 27 patients admitted to the second surgical unit in Baghdad Teaching Hospital - Medical City with liver tumours, 15 had hepatectomy done by the same surgical team. The remaining 12 cases were beyond resection. The age of patients ranged from 2 to 65 years old with mean age of 34.4 years. Only one [6.7%] patient underwent left lobectomy, 2 [13.3%] left segmentectomy, while the rest 12 patients [80%] underwent right partial or total lobectomy, divided equally between anatomical and non-anatomical resection. Two main techniques were used in transection of liver parenchyma: CUSA Dissector which is used in 9 patients [60%] and clamp-crushing or finger fracture technique was used in the remainder. In addition to CUSA knife, argon beam was used in 5 cases [33.3%]. Postoperative mortality rate was 26.7% [4patients]. The histopathological examination of resected segments of the liver revealed 11 [73.3%] cases of hepatocellular carcinoma, 2 [13.3%] of hepatoblastoma, 1 [6.7%] case metastatic colorectal carcinoma, and 1 [6.7%] case of benign cells [haemangioma]. Hepatectomy for liver tumours can be performed with acceptable safety and efficacy in a suitably staffed and equipped center. The outcome will improve with time and experience

Transcatheter closure of patent ductus arteriosus in infantile form of scimitar syndrome with a type II amplatzer ductal occluder

We report a unique case of infantile form of Scimitar syndrome with a patent ductus arteriosus and pulmonary hypertension. The PDA was closed percutaneously using the new Amplatzer Ductal Occluder device type II

Development of a new high performance liquid chromatography method for measurement of coenzyme Q10 in healthy blood plasma

To improve a new high performance liquid chromatography [HPLC] method for coenzyme Q10 [CoQ10] measurement in human plasma. We conducted this study in the Chemistry and Biochemistry Department, College of Medicine, Al-Nahrain University, Baghdad, Iraq from September 2004 to July 2005. Sixty healthy volunteers aged 28. 51 +/- 7. 30 years were participated in this study. All participants were non-smokers and under no any treatment for the last 3 days and fast for 12 hours before analysis. Coenzyme Q10 levels were measured by improved isocratic reversed phase HPLC technique after one-step ice-cold 1-propanol extraction step. The ultra violet [UV] detection, developed HPLC method gives a good linearity range between 0.1-4.0 mg/L. The coefficients of variations [CVs%] of within-day precision for CoQ10 in human plasma were 0.2-3.90%. Analytical recoveries were 95.5-101.30%, whereas the average CV% of CoQ10 reproducibility was 0.959%. A new improved rapid, precise, and sensitive HPLC method for the quantitation of CoQ10 is suitable for analysis of blood plasma samples

Outcome of Norwood and Damus-Kaye-Stansel procedures for univentricular congenital heart anomalies

To review the experience with Norwood and Damus-Kaye-Stansel [DKS] staged repair in the management of hypoplastic left heart syndrome [HLHS], or functional single ventricle [FSV] with systemic outflow tract obstruction [SOTO]. A retrospective study was conducted from a single center from January 2001 to September 2007 at the Cardiac Sciences Department, King Abdulaziz Cardiac Center, National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia. The cardiac departmental database was reviewed, together with the echocardiographic findings. Demographic data representing age and weight at operation, gender, cardiac anatomy, non-cardiac abnormalities, and operative details were collected. Twenty-eight patients with a diagnosis of HLHS were included in the study. The mean +/- SD for weight was 3.4 +/- 0.85kg and 32 +/- 37 days for age. All infants at our institution who underwent a Norwood or DKS surgery for HLHS, or other forms of FSV with SOTO were included. All included patients underwent first stage palliation consisting of either a classical Norwood procedure in 6/23 [21%] patients, or a modified Norwood with right ventricle to pulmonary artery [RV-PA] conduit in 22/28 [79%] patients. After first stage palliation, 23 patients [82%] survived, and all but one underwent second stage palliation with bidirectional cavopulmonary anastomosis [BCPA]. The survival rate after second stage repair was 91%. Subsequently, 4 patients completed a third stage Fontan with 100% survival. All deceased patients had HLHS. The Norwood procedure is applied to a heterogeneous group of patients with variable outcomes in certain subgroups. Patients with HLHS palliated with the Norwood procedure are at a greater risk for morbidity and mortality compared to those with other forms of FSV with SOTO

Inmunoterapia con bcg en carcinoma papilar de vejiga / Immunotherapy with bcg in papillary bladder carcinoma

Se presenta el caso de un paciente de sexo masculino de 58 anos de edad, con el diagnóstico de Carcinoma papilar superficial de vejiga en quien se realizo inmunoterapia con BCG como tratamiento. El paciente presentó una cistitis granulomatosa como complicación de la inmunoterapia; recibiendo tratamiento específico y suspendiendo la inmunoterapia durante cinco meses. Posteriormente se retoma el tratamiento logrando la erradicación tumoral.

This is a case of a 58 years old male patient with the diagnostic of papilar carcinoma in bladder. It was done an immunotherapy with BCG as treatment. A short term complication of inmunotherapy was a granulomatous cystitis, that the patient presented , He received specific treatment and the inmunotherapy was suspended for five months; furthermore. we continue with the treatment achieving the tumoral erradication.