Prescripciones potencialmente inapropiadas en pacientes geriátricos hospitalizados en el servicio de medicina interna en un hospital de referencia en México / Potentially inappropriate prescriptions in geriatric patients hospitalized in the internal medicine department of a referral hospital in Mexico

Resumen Antecedentes: Una prescripción potencialmente inapropiada (PPI) constituye un riesgo de presentar efectos adversos por un fármaco que superan los beneficios de este, pudiendo considerarse como uso inadecuado de medicamentos. Objetivo: Describir la prevalencia de prescripciones potencialmente inapropiadas en pacientes geriátricos hospitalizados en el servicio de medicina interna de un hospital de referencia en México. Material y métodos: Diseño descriptivo transversal, con asignación simple de expedientes clínicos de pacientes hospitalizados mayores de 65 años, entre enero de 2016 y agosto de 2017. Se aplicaron los criterios STOPP y START para identificar el número de PPI, cantidad de medicamentos prescritos, presencia, cantidad y tipo de comorbilidades, así como días de estancia hospitalaria. Resultados: Se encontró una prevalencia de 73.3 % de PPI y las principales comorbilidades fueron hipertensión arterial y diabetes mellitus tipo 2. Se cuantificaron 1885 medicamentos prescritos; la estancia hospitalaria media fue de 6.3 días. Conclusiones: Se identificó alta prevalencia de PPI en los pacientes geriátricos hospitalizados, de ahí la importancia de aplicar los criterios STOPP y START y del papel del farmacéutico en la validación de la prescripción antes de la administración de medicamentos.

Abstract Background: Potentially inappropriate prescription (PIP) constitutes a risk for the development of adverse effects of a drug that outweigh its benefits, which can be considered inappropriate medication use. Objective: To describe the prevalence of PIP in geriatric patients hospitalized at the internal medicine department of a referral hospital in Mexico. Material and methods: Cross-sectional, descriptive design, with simple allocation of medical records from patients older than 65 years hospitalized between January 2016 and August 2017. The STOPP/START criteria were applied to identify the number of PIPs, the number of prescribed medications, number and type of comorbidities, as well as days of hospital stay. Results: A prevalence of PIP of 73.3% was identified, with main comorbidities being hypertension and type 2 diabetes mellitus. A total of 1,885 prescribed medications were quantified; mean hospital stay was 6.3 days. Conclusions: A high prevalence of PIP was identified in hospitalized geriatric patients, hence the importance of applying the STOPP/START criteria and of the role of the pharmacist for validating the prescription prior to drug administration.

Bovine semen thermoresistance tests and their correlation with pregnancy rates after fixed-time artificial insemination / Testes de termorresistência do sêmen bovino e sua correlação com taxas de prenhez após inseminação artificial em tempo fixo

The objective of the study was to determine whether or not there is a correlation between thermoresistance tests (TT) after semen thawing and pregnancy rate (PR) after fixed-time artificial insemination (FTAI). Four different TT were performed on ten samples used for AI; a rapid test (RTT) (30min / 46°C) and three slow tests (STT): STT1 (60min/38°C), STT2 (180min/38°C), and STT3 (300min/38°C). Two hundred and fifteen multiparous crossbred cows were submitted to FTAI under the following protocol: on day zero (d0) the animals received a P4 device +EB; on d7 PGF2α; on d8 P4 was removed and eCG+EC were administered; IATF was performed on d10. Three gestational diagnoses (G D) were performed on d40, d70 and d120. The mean sperm motility (%) in RTT and STTs were 19.84±6.13, 28.55±10.48, 17.62±5.87 and 8.63±3.46, respectively, and TP in the three DG 61.86%, 57.67%, and 55.81%, respectively. Through Person test a significant negative correlation (P< 0.05) was found between STT2 and PR at 60 days (r= -0.644) and between STT3 and all TPs (r= -0.774, -0.752, 0.748). It was concluded that TT parameters are not able to determine correlation between semen quality and TP.(AU)

O objetivo do presente estudo foi determinar se há ou não correlação entre testes de termorresistência (TT) após descongelamento do sêmen e taxa de prenhez (TP) após inseminação artificial em tempo fixo (IATF). Quatro diferentes TT foram realizados nas 10 amostras utilizadas para a IA; um teste rápido (RTT) (30min/46°C) e três testes lentos (STT): STT1 (60min/38°C), STT2 (180min/38°C) e STT3 (300min/38°C). Duzentas e quinze vacas cruzadas multíparas foram submetidas à IATF sob o seguinte protocolo: no dia zero (d0), os animais receberam um dispositivo de P4+EB; em d7, PGF2α; em d8, retirou-se P4 e eCG+EC administrados; no d10, foi realizada IATF. Três diagnósticos gestacionais (DG) foram feitos, em d40, d70 e d120. As médias de motilidade espermática (%) em RTT e STTs foram 19,84±6,13, 28,55±10,48, 17,62±5,87 e 8,63±3,46, respectivamente, e TP nos três DG 61,86%, 57,67% e 55,81%, respectivamente. Por meio do teste de Person, uma correlação negativa significativa (P<0,05) foi encontrada entre os resultados de STT2 e PR aos 60 dias (r=-0,644) e entre STT3 e todas TPs (r=-0,774, -0,752 e -0,748). Concluiu-se que parâmetros de TT não são capazes de determinar correlação entre qualidade do sêmen e TP.(AU)

Pacientes con fibrilación auricular no valvular tratados con antivitamina K o anticoagulantes directos: perfil de paciente y efectos a largo plazo / Patients with non-valvular atrial fibrillation on vitamin k antagonists or direct-acting oral anticoagulants: patients profile and long-term follow up outcomes

Resumen Introducción: La llegada de los anticoagulantes directos (ACD) ha supuesto un cambio en el tratamiento de la fibrilación auricular no valvular (FANV) en los últimos años. Los objetivos de este estudio son determinar el grado de control de la anticoagulación con antivitamina K (AVK) y su posible implicación en efectos cardiovasculares adversos mayores (ECAM) y evaluar las diferencias entre el grupo en tratamiento con AVK respecto del grupo con ACD. Pacientes y métodos: Estudio de cohorte prospectivo que incluyó a pacientes consecutivos diagnosticados con FANV valorados en el Servicio de Cardiología con un seguimiento de 18 meses. Se analizaron diferencias demográficas, clínicas y analíticas entre grupos, incluido el grado de control de la anticoagulación del grupo AVK y su posible relación con ECAM. Resultados: Se incluyó a 273 pacientes: 46.5% tratados con AVK, 42.5% con ACD y 11% sin tratamiento anticoagulante. El control de la anticoagulación con AVK fue del 62.1%, sin diferencias en ECAM en función de control. El grupo ACD presentó menos ECAM que el grupo de AVK (13.4 vs. 4.3%; HR, 0.90; 0.83-0.98; p = 0.01), con una menor mortalidad cardiovascular (0.0 vs. 5.5%; HR, 0.94; 0.90-0.98; p = 0.01) y total (0.9 vs. 12.6%; HR, 0.88; 0.82-0.94; p menor que 0,01), aunque sin diferencias significativas en eventos hemorrágicos (0.9 vs. 4.7%; p = 0.07) ni isquémicos (2.6 vs. 0.8%; p = 0.27). Discusión: Los pacientes con AVK poseen un perfil clínico diferente en comparación con los que reciben ACD. El control de anticoagulación del grupo de AVK fue inadecuado en casi la mitad de los casos. El grupo de AVK presentó más ECAM que el grupo de ACD.

Abstract Introduction: The arrival of direct-acting oral anticoagulants (DOACs) has led to a change in the management of non-valvular atrial fibrillation (NVAF) in recent years. The objectives of this study are to determine the level of therapeutic control of anticoagulation with vitamin K antagonists (VKA) and its possible involvement in major adverse cardiovascular events (MACE) and to evaluate differences between the group on VKA with respect to the group on DOACs. Patients and methods: Prospective cohort study that included consecutive patients diagnosed with NVAF in Cardiology Consultations with a clinical follow-up of 18 months. Demographic, clinical and analytical differences between groups were analyzed, including the level of therapeutic control of anticoagulation on the VKA group and its association with MACE. Results: Overall, 273 patients were included: 46.5% on VKA, 42.5% on DOACs, 11% without antithrombotic treatment. Patients on VKA spent 62.1% of their time within therapeutic range (TTR by the Rosendaal formule). There were no differences in MACE depending on anticoagulation control. The DOACs group presented lesser MACE rate than the VKA group (13.4 vs. 4.3%; 0.90; HR 0.90; 0.83-0.98 p = 0.01) with lower cardiovascular mortality (0.0 vs. 5.5%; HR, 0.94; 0.90-0.98; p = 0.01) and total mortality (0.9 vs. 12.6%; HR, 0.88; 0.82-0.94; p less 0.01) although without significant differences in hemorrhagic (0.9 vs. 4.7 %; p = 0.07), or ischemic events (2.6 vs. 0.8%, p = 0.27). Conclusions: Patients on VKA have a different clinical profile than those who receive DOACs. Patients on VKA have an inadequate control of the anticoagulation in quite the half of the cases. The VKA group presented more MACE than the DOACs group.

Development of a Mechatronic System for Rehabilitation of Injuries in the Radial Nerve / Desarrollo de un Sistema Mecatrónico para Rehabilitación de Lesiones del Nervio Radial

ABSTRACT This work presents the design, analysis and implementation of a mechatronic System focused on helping to improve Rehabilitation therapies to patients affected by some Radial Nerve Injuries (SYRR-NERI). The device was developed with the aim of finding simple solutions for the different subsystems that form the SYRR-NERI. The mechatronic system basically consists of two coupled four-bar mechanisms with a Proportional-Integral-Derivative (PID) controller in their respective drive motors to regulate the rotational velocity. In addition, each mechanism has touch sensors in order to limit its movement. The implementation of the control algorithm and the logic to perform the synchronized movements is performed by a microcontroller. The result is an affordable and functional prototype which needs to be tested in real situations with the help of physiotherapists and patients to obtain the necessary information to improve its performance.

RESUMEN Este trabajo presenta el diseño, análisis e implementación de un sistema mecatrónico enfocado en ayudar a mejorar las terapias de rehabilitación para pacientes afectados por algunas lesiones del nervio radial. El dispositivo fue desarrollado tratando de proponer soluciones sencillas para los diferentes subsistemas que integran el dispositivo. El sistema mecatrónico consiste básicamente en dos mecanismos acoplados de cuatro barras con un controlador Proporcional-Integral-Derivativo (PID) en sus respectivos motores impulsores para regular la velocidad angular. Además, cada mecanismo tiene sensores táctiles para limitar el movimiento. La implementación del algoritmo de control y de la lógica para realizar los movimientos sincronizados se lleva a cabo mediante un microcontrolador. El resultado es un dispositivo económicamente accesible y funcional que tiene por objetivo ser probado en situaciones reales y, con la ayuda de fisioterapeutas y pacientes, obtener la información necesaria para mejorar su desempeño.

Lexical tonal discrimination in Zapotec children. A study of the theta rhythm / Discriminación tonal léxica en niños zapotecas. Un estudio del ritmo theta

Abstract Background: Zapotec is a language used mainly in the state of Oaxaca in Mexico of tonal characteristic; homophone words with difference in fundamental frequency with different meanings. Our objective was to analyze changes in the electroencephalographic (EEG) theta rhythm during word discrimination of lexical tonal bi-syllabic homophone word samples of Zapotec. Methods: We employed electroencephalography analysis during lexical tonal discrimination in 12 healthy subjects 9-16 years of age. Results: We observed an increase in theta relative power between lexical discrimination and at rest eyes-open state in right temporal site. We also observed several significant intra- and inter-hemispheric correlations in several scalp sites, mainly in left fronto-temporal and right temporal areas when subjects were performing lexical discrimination. Conclusions: Our data suggest more engagement of neural networks of the right hemisphere are involved in Zapotec language discrimination.

Resumen Introducción: El zapoteco es un lenguaje hablado principalmente en el estado de Oaxaca, en México, que tiene la característica de ser tonal; es decir, las palabras homófonas que difieren en la altura del fundamental tienen diferente significado. El objetivo de este trabajo fue analizar los cambios del ritmo theta del electroencefalograma en el curso de la discriminación de palabras bisilábicas homófonas en zapoteco. Método: Se empleó el análisis espectral del electroencefalograma durante la discriminación tonal léxica del lenguaje zapoteco en 12 niños sanos de 9-16 años. Resultados: Se observó una mayor potencia relativa theta en la región temporal derecha durante la discriminación léxica en comparación con el registro de reposo-ojos abiertos. También se observaron varias correlaciones significativas intra e interhemisféricas con predominio entre la región frontotemporal izquierda y temporal derecha mientras se realizaba la discriminación tonal léxica. Conclusión: Estos resultados sugieren que hay un mayor compromiso de las redes neuronales en el hemisferio derecho que participan en la discriminación del lenguaje zapoteco.

Phonological awareness and sinusoidal amplitude modulation in phonological dislexia / Conciencia fonológica y la modulación sinusoidal de la amplitud en la dislexia fonológica

ABSTRACT Objective Dyslexia is the difficulty of children in learning to read and write as results of neurological deficiencies. The objective was to test the Phonological awareness (PA) and Sinusoidal amplitude modulation (SAM) threshold in children with Phonological dyslexia (PD). Methods We performed a case-control, analytic, cross sectional study. We studied 14 children with PD and 14 control children from 7 to 11 years of age, by means of PA measurement and by SAM test. The mean age of dyslexic children was 8.39 years and in the control group was 8.15. Results Children with PD exhibited inadequate skills in PA, and SAM. We found significant correlations between PA and SAM at 4 Hertz frequency, and calculated regression equations that predicts between one-fourth and one-third of variance of measurements. Conclusion Alterations in PA and SAM found can help to explain basis of deficient language processing exhibited by children with PD.

RESUMEN Objetivo La Dislexia es la dificultad en niños de aprender a leer y escribir como resultado de una deficiencia neurológica. Nuestro objetivo fue probar la Conciencia fonológica (CF) y la Modulación sinusoidal de la amplitud (MSA) en niños con Dislexia fonológica (DF). Métodos Realizamos un estudio analítico, transversal, de casos y controles. Estudiamos la CF y la MSA en 14 niños con DF y 14 controles de 7–11 años. La edad media de los niños con DF fue de 8.39 años y de los controles fue 8.15. Resultados Los niños con DF presentaron deficiencias en CF y en MSA. Encontramos correlaciones entre CF y MSA en la frecuencia de 4 Hertzios (Hz), calculamos ecuaciones de regresión que predijeron de un cuarto a un tercio de la varianza de las mediciones. Conclusión Las deficiencias en CF y en MSA pueden ayudar a comprender las alteraciones en el procesamiento del lenguaje presentadas por los niños con DF.

Sound localization and word discrimination in reverberant environment in children with developmental dyslexia / Localización sonora y discriminación de palabras en ambientes reverberantes en niños con dislexia del desarrollo

Objective Compare if localization of sounds and words discrimination in reverberant environment is different between children with dyslexia and controls. Method We studied 30 children with dyslexia and 30 controls. Sound and word localization and discrimination was studied in five angles from left to right auditory fields (-90o, -45o, 0o, +45o, +90o), under reverberant and no-reverberant conditions; correct answers were compared. Results Spatial location of words in no-reverberant test was deficient in children with dyslexia at 0º and +90o. Spatial location for reverberant test was altered in children with dyslexia at all angles, except –-90o. Word discrimination in no-reverberant test in children with dyslexia had a poor performance at left angles. In reverberant test, children with dyslexia exhibited deficiencies at -45o, -90o, and +45o angles. Conclusion Children with dyslexia could had problems when have to locate sound, and discriminate words in extreme locations of the horizontal plane in classrooms with reverberation. .

Objetivo Comparar localización de sonidos y localización-discriminación de palabras bajo reverberación y sin reverberación en niños disléxicos y controles. Método Estudiamos 30 niños disléxicos y 30 controles, pareados por edad. La localización sonora y discriminación a palabras fue estudiada en cinco ángulos horizontales en los campos izquierdo y derecho (-90o, -45o, 0o, +45o, +90o), bajo reverberación y sin reverberación; las respuestas correctas fueron comparadas Resultados: La localización sonora sin reverberación fue deficiente en niños disléxicos a 0º y +90º. La localización bajo reverberación falló en niños disléxicos en todos los ángulos, excepto –-90o. Durante la discriminación a palabras, sin reverberación, los niños disléxicos fallaron en ángulos izquierdos. En la prueba reverberante, los niños disléxicos fallaron a -–45o, -90o y +45o. Conclusion Los niños con dislexia pueden tener problemas cuando tienen que localizar sonidos y discriminar palabras en las localizaciones extremas del plano horizontal en salones de clases típicos con reverberación. .

Caracterização da equideocultura no estado de Minas Gerais / Characterization of equidae breeding in Minas Gerais state

Recently, horse breeding has achieved greater prominence in the Brazilian society and now it started to appear as a part of the Brazilian agribusiness. The state of Minas Gerais stands out as the main producer of equidae in Brazil. The aim of this work was to characterize the breeding of equidae in this State in order to support future researches in this sector. By the evaluation of records from 1990 to 2009 provided by the "Brazilian Institute of Geography and Statistics" (IBGE) and also 967 interviews with breeders of equidae, it was possible to characterize some important points. It was observed that equidae breeding in this State moves over R$1,500,000,000 per year and employs 86,000 people. The main investments of the properties are made in purchasing saddles, accessories and commercial feeds. The main goal of equidae breeders in Minas Gerais has been the work in rural properties (49.49%) complementing many farming activities, especially the work with cows. Although Minas Gerais holds the main herd of equidae in the country, the number of animals has decreased. On the one hand, the equidae breeding sector has demonstrated its social and economic importance in agribusiness; on the other, hand further researches are needed to develop public policies to improve the breeding of equidae in Minas Gerais.

Comparação entre as medidas morfométricas de equinos Mangalarga Marchador de marcha batida e marcha picada / Comparison between the morphometric measures of Mangalarga Marchador horses of batida marcha and picada marcha

The present study aimed to compare the morphometric measurements of Mangalarga Marchador horses of batida and picada marcha. Twenty-two linear and eight angular measurements of 222 males (130 of batida marcha and 92 of picada marcha) and 266 females (168 of batida marcha and 98 picada marcha) were compared in a completely randomized design, consisting of two treatments: horses of batida and picada marcha. The results were submitted to analysis of variance and means were compared by Fisher test (P<0.05). It was concluded that most of the measures of Mangalarga Marchador horses of batida and picada marcha have similar values, however, there are differences between some angles of members...

Hematologia e bioquímica sérica de equinos de concurso completo de equitação em treinamento / Hematology and serum biochemistry of event horses in training

Avaliaram-se a hematologia e a bioquímica sérica em equinos de concurso completo de equitação (CCE) em treinamento durante testes de esforço incremental em esteira ergométrica de alta velocidade. Foram utilizados 16 equinos em delineamento experimental inteiramente ao acaso com quatro tratamentos e quatro repetições em esquema de parcelas subdivididas, utilizando-se como fontes de variação nos tratamentos a idade e o histórico de treinamento em CCE. As parcelas foram constituídas pelos testes incrementais realizados nas fases inicial e final do treinamento. As subparcelas foram representadas pelos tempos de avaliação e coletas. Os equinos do grupo experimental novos iniciantes apresentaram valor médio do hematócrito de 43,24%, sendo inferior ao hematócrito do grupo adultos iniciantes, 45,63%, novos experientes, 46,39%, e competidores, 47,74%. Houve diferença (P<0,05) entre os testes físicos realizados nas fases inicial e final do treinamento, com redução na concentração plasmática de glicose, de 112 para 98,88mg/dL, nas concentrações séricas de creatinina, de 1,41 para 1,29mg/dL, e de proteínas totais, de 6,52 para 6,38g/dL, na contagem de monócitos, de 0,54 para 0,48 10³/mm³, e com aumento na concentração plasmática de lactato, de 3,31 para 3,79mmol/L, na concentração sérica de ácido úrico, de 1,44 para 1,77mg/dL, no hematócrito, de 44,19 para 46,90%, na concentração de hemoglobina, de 14,33 para 15,10g/dL, e na contagem de leucócitos totais, de 9,26 para 9,61 10³/mm³. O treinamento dos equinos de CCE aumentou o condicionamento físico dos equinos, com maior capacidade de metabolização do lactato após o exercício e aumento nos valores basais do hematócrito e da concentração de hemoglobina.

Was evaluated the hematology and serum biochemistry in event horses (CCE) in training during incremental treadmill tests. Sixteen horses were used in a completely randomized design with four treatments and four repetitions in subdivided parcels, using age and previous history of training in events as sources of treatment variation. The parcels constituted of incremental treadmill tests performed at the beginning and end of training. The subparcels were represented by the time of evaluation and collection of samples. The equines of new beginners group had mean hematocrit value of 43.24%, being lower than the hematocrit of adult beginners group, 45.63%, new experienced group, 46.39%, and competitors group, 47.74%. There were differences (P<0.05) between the tests performed at the beginning and end of training, with reduction in glucose plasma concentration, from 112 to 98,88mg/dL, in seric concentration of creatinine, 1.41 to 1.29mg/dL, and total protein, 6.52 to 6.38 g/dL, in monocyte count, 0.54 to 0.48 10³/mm³, and an increase of lactate plasma concentration, from 3.31 to 3.79mmol/L, in seric concentration of uric acid, 44 to 1.77mg/dL, in hematocrit, 44.19 to 46.90%, in hemoglobin concentration, 14.33 to 15.10 g/dL, and blood cell count, 9.26 to 9.61 10³/mm³. The training of event horses improves physical performance of horses, with increased capacity of lactate metabolism after exercise and increased basal hematocrit and hemoglobin concentration.

Incidência da carne PSE (pale, soft, exsudative) em suínos em razão do tempo de descanso pré-abate e sexo / Resting time pre-slaughter and sex on the incidence of PSE (pale, soft, exsudative) meat in pigs

Avaliou-se o efeito do período de descanso pré-abate e do sexo sobre a incidência de carne PSE (pale, soft, exudative) em suínos. Foram realizadas três visitas a abatedouro comercial, nas quais se mensurou o pH das carcaças (n=2128) aos 45 minutos após o abate, de lotes compostos por fêmeas, machos castrados cirurgicamente e machos imunocastrados e de lotes mistos (fêmeas e machos castrados cirurgicamente), submetidos a período de descanso que variou de duas a 16 horas. Carcaças com pH45≤5,8 foram classificadas como PSE, e com pH45>5,8 como normais. Em função do número de animais avaliados dentro de cada categoria, estimou-se a frequência de carne PSE. A incidência total de carne PSE foi de 10,1%, sendo maior nos lotes de animais imunocastrados (13,5%) quando comparados aos lotes de fêmeas (8,6%) ou de machos castrados cirurgicamente (8,5%). Períodos de descanso menores que seis horas e acima de 14 horas aumentaram a incidência de carne PSE. Período de descanso entre seis e oito horas minimizaram a ocorrência de carnes PSE.

Were evaluated the effect of lairage pre-slaughter and sex on the incidence of PSE (pale, soft and exudative) meat in pigs. There were three visits to a commercial slaughterhouse, in which the pH of carcasses (n=2128) was measured at 45 minutes after slaughter of lots consisting exclusively of females, males castrated surgically, males immunologically castrated and mixed lots (females and castrated surgically) underwent a resting time, and time between the shipment and slaughter ranged from two to 16 hours. Carcasses with pH45≤5.8 were classified as PSE and with pH45>5.8 as normal. Depending on the number of animals evaluated in each category we estimated the frequency of PSE. The overall incidence of PSE meat was 10.1%, higher in lots of animals immunocastrated (13.5%) compared to lots of females (8.6%) or castrated males (8.5%). Resting time of less than six hours and up to 14 hours increased the incidence of PSE meat. Resting time between six and eight hours minimized the occurrence of PSE meat.

Frecuencia y caracterización de tabaquismo en pacientes internados con patología respiratoria: estudio multicéntrico en hospitales de Buenos Aires / Frequence and characteristics of smoking patients admitted with respiratory pathology: a multicenter survey in Buenos Aires Hospitals

Introducción: Actualmente en Argentina no hay información sobre la prevalencia de tabaquismo en pacientes internados por enfermedad respiratoria. El objetivo de este estudio es determinar la prevalencia de tabaquismo y evaluar las características de la adicción a la nicotina en pacientes internados por patología respiratoria. Materiales y métodos: Estudio de corte transversal en 9 Hospitales de Buenos Aires. Se encuestaron pacientes cuyo motivo de ingreso fueron enfermedades respiratorias. Las variables estudiadas fueron reporte de consumo de tabaco (fumador actual, ex fumador, nunca fumador), dependencia mediante test de Fagerstrõm (TF), abstinencia mediante Minessota Nicotine Withdrawal Scale (MNWS); y motivación para dejar defumar mediante test de Richmond. Se evaluó la implementación del consejo breve y del tratamiento farmacológico.Resultados: Se encuestaron 376 pacientes, la edad media fue de 53 ± 16 años; el 54.5% eran varones. La prevalencia de fumadores actuales fue 30.3 % (IC:25.8-35.3). Los pacientes fumadores actuales presentaron TF promedio de 4.59 ± 2.9 puntos (dependencia moderada) y MNWS promedio de 1.14 ± 0.85 puntos (abstinencia leve). El 79.7% presentaba motivación moderada a alta para dejar de fumar. El 77% (IC:64.5-86.8%) de los fumadores actuales recibió consejo breve, pero solo 10.2% (IC:3.8-20.8) recibió tratamiento farmacológico.Conclusiones: La prevalencia de tabaquismo es similar a la reportada en la población general de Argentina. Los pacientes fumadores actuales presentan dependencia a la nicotina moderada y síndrome de abstinencia leve; con motivación moderada a alta para dejar de fumar durante la internación. La mayoría recibió consejo breve pero notratamiento farmacológico.

Background: Nowadays Argentina has no data about the prevalence of tobacco smoking about patients hospitalized for respiratory diseases. The objectives of this study are to establish the prevalence of the tobacco smoking habit and to assess the features of nicotine addiction in these patients. Methods: We designed a cross-sectional study with the participation of 9 Buenos Aires Hospitals. We surveyed patients who were hospitalized for respiratory diseases. The survey included the tobacco smoking habit, nicotine dependence with Fagerstrõm test (FT), nicotine abstinence with Minessota Nicotine Withdrawal Scale (MNWS) andmotivation to quit with Richmond´s test. We also assessed the implementation of brief advice and pharmacological treatment for tobacco use cessation. Results: 376 patients were surveyed, the mean age was 53 ±16 years and 54.5% were male. Prevalence ofactive tobacco smokers was 30.3% (IC: 25.8-35.3). The mean FT was 4.59 ± 2.9 points (moderate dependence) and the MNWS mean was 1.14 ± 0.85 points (mild abstinence). The majority (79.7%) had moderate to high motivation to quit smoking. Despite77% (IC: 64.5-86.8%) of active tobacco smokers received a brief advice, only 10.2% (IC: 3.8-20.8) were prescribed pharmacological treatment for tobacco use cessation. Conclusion: The prevalence of tobacco smoking in patients who were hospitalized forrespiratory diseases is similar to the prevalence in the general population of Argentina. Active tobacco smokers who are hospitalized for respiratory diseases have moderate nicotine dependence, mild withdrawal symptoms and moderate to high motivation to quit the smoking habit. Most patients received a brief advice but no pharmacologicaltreatment for tobacco use cessation.

A novel technique leading to complete sensory and motor recovery across a long peripheral nerve gap

Sensory nerve grafts are the [quot ]gold standard[quot ] for inducing neurological recovery in peripheral nerves with a gap. However, the effectiveness of sensory nerve grafts is variable, generally not leading to complete sensory and motor recovery, with good recovery limited to gaps shorter than 2 cm, and the extent of recovery decreasing with increasing graft length. An alternative technique using a conduit filled with pure fibrin to bridge a nerve gap leads to only limited neurological recovery. We tested the effectiveness of a novel nerve repair technique in which a 5-cm long radial nerve gap was repaired using two sural nerve graft surrounded by a collage tube filled with pure fibrin. By 1 1/2 years post surgery, the patient recovered complete sensory and motor function. In conclusion, this study suggests that the combination of pure fibrin surrounding sural nerve grafts is responsible for inducing the extensive neurological recovery induced by either pure fibrin or sural grafts alone. This technique is presently being tested in a clinical trial.

Variables predictoras de embolias en endocarditis infecciosa / Embolism predictors of infective endocarditis

El evento embólico (EE) aumenta la morbi-mortalidad de la endocarditis infecciosa (EI). La prevalencia de EE oscila entre 22% y 50%, pudiendo ocasionar hasta el 25% de las muertes de los pacientes que lo presentan. El EE puede ocurrir previamente al diagnóstico, durante el tratamiento o bien posteriormente al mismo. Nuestro objetivo fue analizar las características demográficas, clínicas, microbiológicas, ecocardiográficas y terapeúticas, de pacientes con EI (con y sin embolias) para tratar de establecer variables predictoras del EE. Se realizó en el Hospital Italiano de La Plata, desde marzo de 1996 hasta diciembre de 2004, un estudio descriptivo observacional de una cohorte de pacientes con diagnóstico de EI. Se analizaron en forma retrospectiva 53 pacientes con EI (35 sin EE y 18 con EE). La presencia de vegetación (en el ecocardiograma transtorácico (ETT) y/o en el transesofágico (ETE) al momento del diagnóstico, el tamaño ³ 10 mm y el compromiso de la válvula mitral nativa, fueron las variables en las que existió una asociación estadísticamente significativa con el EE para ser consideradas como predictoras. El tamaño ³ 10 mm fue la única variable asociada a EE en el análisis de regresión logística. Durante el tratamiento antibiótico electivo hubo una reducción de EE, no observándose a partir de la segunda semana.

The embolic event (EE) increases the morbidity and mortality of infective endocarditis (IE). Prevalence of EE ranges between 22% and 50%, death rates being up to 25% of patients. EE may occur prior to diagnosis, during treatment or afterwards. The objective of this study was to evaluate the demographic, clinical, microbiological, echocardiographic and therapeutic characteristics in patients suffering from IE (with or without emboli) in order to determine predictors for EE. A descriptive study based on observations of patient population diagnosed with IE was conducted at the Hospital Italiano of La Plata during the period March 1996 - December 2004. Fifty-three patients with IE were analyzed (35 without EE and 18 with EE) in retrospect. We found that the presence of vegetations in the transthoracic (TTE) and/or transesophagic (TEE) echocardiographies at the time of diagnosis, the size ³ 10 mm and the compromise of the native mitral valve were the variables that showed significant statistical association with EE to be considered as predictors. The size ³ 10 mm was the only variable associated with EE in the logistic regression analysis. During the elective antibiotic treatment, there was a reduction in EE, without their being present from the second week onwards.