Autopercepción corporal y su impacto en la función sexual orgásmica en estudiantes mujeres de educación superior / Body self-perception and its impact on orgasmic sexual function in female higher education students, Chillán, 2021

Objetivo: Analizar la percepción de la imagen corporal y su impacto en la función sexual orgásmica en mujeres estudiantes de la educación superior de Chillán, 2021. Métodos: Estudio cuantitativo, analítico, de corte transversal. Se evaluaron cuatro variables: datos demográficos, imagen corporal, orgasmo y función sexual. Se utilizó un Google Formulario a mujeres estudiantes entre 18 y 44 años de edad, de la educación superior en la ciudad de Chillán. Posterior a ello, los datos obtenidos se recopilaron y tabularon en el programa estadísticos SPSS 23. Resultados: Las dimensiones del índice de función sexual femenino alteradas con mayor frecuencia fueron: satisfacción (80,6 %), excitación (73,8 %) y orgasmo (51,5 %). El 99,0 % de las encuestadas presentaron disfunción sexual. Con respecto a la relación entre la dimensión de excitación y la pobre imagen corporal producida por el propio cuerpo (p = 0,019 r = -0,223) presentó correlación estadísticamente significativa, no así entre los puntajes totales de ambos instrumentos (p = 0,34; r = 0,09). Finalmente, las correlaciones entre la dimensión de dolor al momento de tener relaciones sexuales y la autodesvalorización por la apariencia física correlacionaron positivamente (p = 0,049; r = 0,196). Conclusión: Se observó alterado el orgasmo por la percepción de cómo se sienten con su propio cuerpo las encuestadas, lo que crearía una imagen corporal negativa llevando a una insatisfacción corporal(AU)

Objective: Analyze the perception of body image and its impact on orgasmic sexual function in female higher education students in Chillán, 2021. Methods: Quantitative, analytical, cross-sectional study. Four variables were evaluated: demographic data, body image, orgasm and sexual function. A Google Form was used for female students between 18 and 44 years of age, from higher education in the city of Chillán. Subsequently, the data obtained were compiled and tabulated in the statistical program SPSS 23. Results: The most frequently altered dimensions of the female sexual function index were: satisfaction (80.6%), arousal (73.8%), and orgasm (51.5%). 99.0% of the respondents had sexual dysfunction. Regarding the relationship between the arousal dimension and the poor body image produced by one's own body (p = 0.019; r = -0.223), there was a statistically significant correlation, but not between the total scores of both instruments (p = 0.34; r = 0.09). Finally, the correlations between the dimension of pain at the time of sexual intercourse and self-depreciation due to physical appearance were positively correlated (p = 0.049; r = 0.196). Conclusion: The orgasm was observed to be altered by the perception of how the respondents felt about their own body, which would create a negative body image leading to body dissatisfaction(AU)

Descriptive analysis of histological types in women undergoing post mastectomy breast reconstruction

Background: Breast cancer is a pathological entity that widely compromises the life and quality of life of affected women; in addition to the great affectation to the current health services. Therefore, maintaining an accurate and complete cancer registry program is one of the most important factors in implementing national cancer control programs and evaluating the results of screening, diagnosis, and treatment. Among the current limitations in the studies, there is a gap in the study of the population undergoing breast reconstruction. Methods: A retrospective study was carried out at hospital general de México “Dr. Eduardo Licéaga” with the information from the clinical records of the period 2019-2020. Patients undergoing breast reconstruction after mastectomy with histological report were included. Through non-probabilistic sampling, a population of 138 women was formed. For data analysis, frequencies and percentages were calculated for the qualitative variables; while for the quantitative variables, mean and standard deviation were calculated. Results: 138 women who underwent breast reconstruction were included, the mean age was 49.9±10.85 years, the mean BMI was 26.80±4.62 kg/m2, the secondary educational level predominated (34.8%), radiotherapy was applied to 34.1%, reconstruction was late in 75.4%, the most frequent reconstruction technique was TRAM flap (44.2%), the histological type of invasive ductal carcinoma predominated (68.1%). Conclusions: In women undergoing post-mastectomy breast reconstruction, the histological type of invasive ductal carcinoma predominates.

Epidemiological aspects of facial trauma in a third level hospital in Mexico

Background: Facial trauma is common in early adulthood and may require complex surgery and even high mortality. Methods: Retrospective, cross-sectional study at the Hospital General de México during the period from January 2018 to December 2021. Patients with a diagnosis of fracture of the facial region, who had a complete clinical record, of any age, were included. Patients who did not comply with the treatment in the hospital unit, with incomplete clinical records, were excluded. Through non-probability sampling, a sample of 156 patients was formed. The descriptive data analysis was carried out by calculating frequencies and percentages for the qualitative variables. For the quantitative variables, measures of central tendency and dispersion were calculated according to the distribution of the variables (mean and standard deviation). for variables with normal distribution and median with interquartile range for variables with non-normal distribution). Results: 156 patients were included, the male sex predominated (89.7%), the age group from 21 to 30 years (35.3%), the injury mechanism of aggression by a third party (54.5%). Facial fractures occurred in the following descending order: orbit (64.7%), zygoma (41.7% n=65), mandibular (23.1% n=36), nasal (22.4% n=35), maxilla (21.8% n=34), NOE (4.5% n=7), Le Fort (3.8% n=6), and palate (3.8% n=6). Within orbital fractures, the most frequently affected region was the orbital floor (42.3%). The patients with orbital fracture were mostly men (88.1% versus 11.9%). The highest frequency of these fractures was between the ages of 21 and 30 (38.6%). Surgical treatment of fractures in general was established in 44.9%, performing open reduction and internal fixation of fractures in 41.0%. Conclusions: The most frequent facial fractures are: orbit, zygoma, and mandibular; they mainly affect the male sex in the second decade of life, they are produced mainly by aggressions to third parties. The management of facial fractures is predominantly surgical, through open reduction and internal fixation.

Incidence of complications in breast reconstruction with autologous tissue in a third level hospital

Background: The objective of this study is to analyze the incidence of complications after breast reconstruction with pedicled or free flaps at the hospital general de Mexico "Dr. Eduardo Liceaga”. Methods: A retrospective, single-center study, including 44 female patients, who underwent immediate or delayed breast reconstruction after breast cancer, between 2019 and 2020, and had at least a 2-year follow up, evaluating the association between patient risk factors (age, history of radiotherapy, presence of overweight or obesity and immediate or delayed reconstruction) with the presence of complications such as seroma, hematoma, wound infection or wound dehiscence. We analyzed data with SPSS software, v23.0. Results: There was no statistically significant difference for the presence of complications associated with risk factors studied. Conclusions: We need more prospective, multicenter studies, including larger sample and strict follow up of patients.

Osteoporosis bilateral del yunque, hallazgos otopatológicos / Case report: Bilateral incus osteoporosis, otopathological findings / Relato de caso: Osteoporose bilateral da bigorna, achados otopatológicos

La osteoporosis es una enfermedad sistémica esquelética, cuyas manifestaciones más comunes son las fracturas vertebrales y de cadera. En relación con el oído, se han realizado algunos estudios controversiales que sugieren el aumento de riesgo de pérdida auditiva en pacientes con osteoporosis, mientras otros indican que no hay relación alguna con esta enfermedad. Se realizó un reporte de caso donde se describen los hallazgos en el oído medio y oído interno, tras la valoración bajo microscopía de luz, en un espécimen de hueso temporal con antecedente de osteoporosis. Se evidencia desmineralización, porosidad y disminución cualitativa del tejido óseo, así como disminución del espacio incudomaleolar.

Osteoporosis is a skeletal systemic disease, commonly known for its affection on hips and spine. In relation to the ear, several controversial studies have documented an increased risk for hearing loss in patients with osteoporosis, while others do not find any association with these disorders. A case report was carried out which describes the findings in the middle ear and inner ear, after evaluation under light microscopy, in a temporary bone specimen with a history of osteoporosis. Demineralization, porosity and qualitative diminished bone tissue are found, as well as a decrease in the incudomallear joint.

A osteoporose é uma doença esquelética sistêmica, cujas manifestações mais comuns são as fraturas vertebrais e de quadril. Em relação ao ouvido, foram realizados alguns estudos controversos que sugerem um risco aumentado de perda auditiva em pacientes com osteoporose, enquanto outros indicam que não há relação com essa doença. Foi feito um relato de caso descrevendo os achados em ouvido médio e ouvido interno, após avaliação sob microscopia de luz, em espécime de osso temporal com histórico de osteoporose. Há evidências de desmineralização, porosidade e diminuição qualitativa do tecido ósseo, bem como diminuição do espaço incudomaleolar.

Phytochemical profile of methanolic extracts from Chilca (Baccharis glutinosa) roots and its activity against Aspergillus ochraceus and Fusarium moniliforme

Aim: The present study aimed to identify the phytochemicals of methanolic extract from Baccharis glutinosa (chilca) roots (MEBg) and to evaluate its antifungal activity on two major fungal pathogens of agricultural importance. Methodology: The antifungal activity was evaluated by inhibition halo, minimum inhibitory concentration (MIC), minimum fungicidal concentration (MFC) and % sporulation against A. ochraceus and F. moniliforme. As a preliminary test, inhibition halo was tested using 1, 10, 100 and 270 mg ml-1 of MEBg. Different concentrations of MEBg were applied for MIC and MFC tests. Ketoconazole was used as positive control. The treatments were applied in triplicate. The phytochemical compounds of MEBg were determined by GC-MS analysis. Results: The MEBg produced an inhibition zone of 2 to 4 mm in the inhibition halo test, with concentrations of 100 and 270 mg ml-1 for A. ochraceus and F. moniliforme, respectively. Reduction in % sporulation above 50 was shown in concentrations over 8 mg ml-1. MEBg were reported to exhibit antifungal activities against A. ochraceus and F. moniliforme with the MIC values ranging from 2 to 5.6 mg∙ml-1 and the MFC from 12 to 15 mg ml-1. GC-MS analysis of Chilca extracts revealed that the most abundant metabolites were furfural compounds and organic acids. The most abundant furfural compounds were 5-(hydroxymethyl) furan-2-carbaldehyde (38.59%), furan-2-carbaldehyde (4.103%) and 5-methylfuran-2-carbaldehyde (2.1%). Interpretation: The MEBg revealed efficient antifungal activity, likely due to the presence of bioactive compounds, which could be used as an alternative for biological control of pathogenic fungi in maize and coffee crops.

Atención de Enfermería durante el postoperatorio a paciente sometido a clipaje de aneurisma por ruptura / Postsurgical Nursing Attention on a patient who underwent aneurysm clipping / Assistência de enfermagem no pós-operatório ao paciente submetido a ruptura de aneurisma

Introducción Es reconocido que el personal de enfermería es quien tiene mayor interacción con el paciente, por lo que se ve obligado a contar con conocimientos y experiencia suficiente que permita identificar y atender las necesidades de individuos que sufren de enfermedad cerebrovascular. Esta condición de salud puede ser secundaria a la ruptura de un aneurisma, lo que conduce al paciente a un estado crítico; además, puede traducirse en riesgo para el equilibrio financiero de la familia y el Sistema Sanitario. Métodos: Se desarrollaron las etapas del proceso de cuidado de enfermería centradas en una situación real de la práctica clínica durante el periodo postoperatorio de una paciente sometida a clipaje de aneurisma. Se utilizó el modelo de patrones funcionales de Marjory Gordon para la recolección de los datos; además de la taxonomía NANDA-NIC-NOC. Resultados: Se presentan los planes de cuidado en los que se centró la intervención de enfermería en la paciente valorada. Así como la evaluación del proceso en las dimensiones de estructura, proceso y resultado. Discusión/conclusiones: El EVC secundario a ruptura de aneurisma cerebral es una situación grave y devastadora para la familia y el sistema sanitario. Por tanto, una adecuada atención de enfermería a este problema es de la mayor importancia.

Introduction: It is well acknowledged that nursing staff have the greatest interaction with patients and thus, nurses need to have sufficient knowledge and experience to identify the diverse needs, for example of those patients suffering from cerebrovascular disease. This condition can be a consequence of a ruptured aneurysm, which can in turn lead the patient to a critical status jeopardizing the financial equilibrium of his/her family and the health system. Methods: The nursing process stages were developed during the postsurgical period of a patient who underwent an aneurysm clipping. The Gordon's functional health patterns model was used to collect data, in addition to the NANDA/NIC/NOC taxonomy. Results: Care plans derived from the nursing intervention were presented, as well as the related assessment in terms of the structure, process, and results dimensions. Discussion/Conclusion: The CVE secondary to the rupture of an aneurysm is a serious and devastating situation for the patient, his/her family, and the health system, therefore, an adequate related nursing attention becomes of the most importance.

Introdução: Reconhece-se que os enfermeiros têm maior interação com o paciente, sendo obrigados a ter conhecimento e experiência suficientes para identificar e atender às necessidades dos indivíduos portadores de doença cerebrovascular. Essa condição de saúde pode ser secundária à ruptura de um aneurisma, que leva o paciente a um estado crítico; além disso, pode ser traduzido em risco para o equilíbrio financeiro da família e do Sistema de Saúde. Métodos: Desenvolveram-se as etapas do processo de cuidar em enfermagem, enfocando uma situação real da prática clínica no pós-operatório de um paciente submetido a clipagem de aneurisma. O modelo de padrões funcionais de Marjory Gordon foi utilizado para coleta de dados; além da taxonomia NANDA-NIC-NOC. Resultados: São apresentados planos de cuidados em que a intervenção de enfermagem foi focada no paciente valorizado. Assim como a avaliação do processo nas dimensões de estrutura, processo e resultado. Discussão / conclusões: A EVC secundária a um aneurisma cerebral roto é uma situação grave e devastadora para a família e o sistema de saúde. Portanto, cuidados de enfermagem adequados para este problema são de extrema importância.

Producción de biofilm y presencia de genes icaABCD en cepas de Staphylococcus aureus aisladas de leche cruda / Biofilm production and presence of genes icaABCD in Staphylococcus aureus strains isolated from raw milk

En la patogénesis de la mastitis estafilocócica, el biofilm se considera un marcador de virulencia que permite la adherencia del microorganismo al epitelio mamario. Con la finalidad de determinar la producción de biofilm y detectar la presencia de genes icaABCD, se analizaron 30 cepas de S. aureus aisladas de leche cruda obtenida de vacas con mastitis subclínica. El biofilm se determinó por el método cuantitativo sobre microplacas de cultivo celular y los genes icaABCD por reacción en cadena de la polimerasa. En 96,67% de las cepas de S. aureus se observó producción de biofilm. De éstas 43,34% fueron fuertes productoras, 30,00% moderadas productoras, 23,33% débiles productoras y 3,33% no productoras de biofilm. La totalidad de los genes icaADCD se obtuvo en 6,66% de los aislamientos. Todas las cepas, excepto una, presentaron icaA o icaD. En 56,66% de los aislamientos se identificaron genes icaA/icaD. En todas las cepas productoras de biofilm se identificaron genes del operón icaABCD, lo cual evidencia que poseen un factor de virulencia que facilita su persistencia en el tejido mamario. Además, el biofilm constituye una fuente de contaminación microbiana que puede conducir a fallas en los procesos de producción que generen problemas de inocuidad de los alimentos.

In the pathogenesis of staphylococcal mastitis the biofilm is considered a marker of virulence that allows the adhesion of the microorganism to the mammary epithelium. In order to determine the production of biofilm and the presence of icaABCD gene, 30 S. aureus strains isolated from raw milk obtained from cows with subclinical mastitis were analyzed. Biofilm production was determined by the quantitative method on microplates for cell culture and the presence of genes icaABCD by polymerase chain reaction. Biofilm production was observed in 96.67% of strains of S. aureus. These 43.34% were strong producers, 30.00% producing moderate, 23.33% weak producers and 3.33% non producing biofilm. All of the icaABCD genes was obtained at 6.66% of the isolates. All strains, except one, presented icaA or icaD. 56,66% of isolates identified genes icaA/icaD. The icaABCD operon genes were identified in all biofilm-producing strains, which demonstrates that they possess a virulence factor that facilitates its persistence in the breast tissue. In addition, the biofilm is a source of microbial contamination which can lead to failures in production processes that generate problems of food safety.

Factores pronósticos de complicaciones postquirúrgicas en pacientes con infecciones óseas y seudoartrosis / Prognostic factors for post surgical complications in bone infection and pseudarthrosis

Resumen: La infección ósea y la seudoartrosis son las principales complicaciones ortopédicas en cuyo tratamiento intervienen múltiples factores en la tasa de falla al tratar de corregirlas. Conocer estos factores fue el problema que originó la investigación a través de un estudio longitudinal y prospectivo de una cohorte histórica de 83 pacientes de 43.3 ± 16.1 años de edad tratados por seudoartrosis asépticas y sépticas, osteomielitis, osteítis, consolidación viciosa o prótesis infectadas, el desenlace se relacionó con los factores pronósticos sistémicos y locales tomados del modelo de Cierny-Mader como factores que afectan la vigilancia inmunológica, el metabolismo y la vascularización local. Para el análisis bivariado se aplicó χ2 o el test exacto de Fisher; para el análisis multivariado se aplicó el modelo de regresión logística binaria no condicional con método de Wald hacia atrás para seleccionar los factores pronósticos significativos. El error alfa se fijó ≤ 0.05. Las complicaciones se presentaron en 51.8% de los casos. Los factores locales (linfedema, arteritis, insuficiencia venosa y pérdida de piel) con una OR de 5.0 (IC 95% 1.0-24.9, p = 0.03), las seudoartrosis sépticas con OR de 5.0 (IC 95% 1.9-13.0, p = 0.001) y fracturas segmentarias con OR de 3.2 (IC 95% 0.8-13.0, p = 0.07) fueron los factores pronósticos identificados en el análisis bivariado; sin embargo, la regresión logística sólo seleccionó como factor significativo a las seudoartrosis sépticas. Es necesario detectar y en su caso controlar o eliminar dichos factores que pueden incidir directamente en malos resultados postquirúrgicos.

Abstract: Bone infection and nonunion are the main orthopedic and traumatic complications whose treatment remains a challenge because multiple factors are involved in the rate of failures when you try to correct them. Knowing these factors were the problem that caused the research through a prospective longitudinal study of 83 patients of 43.3 ± 16.1 years old. They were treated for aseptic and septic nonunion, osteomyelitis, osteitis, malunion or infected joint replacement. The cases were classified with or without postoperative complications and outcome related to systemic and local factors taken prognostic model Cierny-Mader as factors affecting immune surveillance, metabolism and local vascularization. For bivariate analysis of data χ2 it was applied or where appropriate Fisher's exact test; for multivariate analysis model not conditional binary logistic regression method was applied Wald backward to select the significant prognostic factors. The alpha error was set ≤ 0.05. General complications occurred in 51.8% of cases. Local factors (lymphedema, arteritis, venous insufficiency, loss of skin) with an OR of 5.0 (95% CI 1.0-24.9, p = 0.03), septic nonunion with OR of 5.0 (95% CI 1.9-13.0, p = 0.001) and segmental fractures with an OR of 3.2 (95% CI 0.8-13.0, p = 0.07) were the prognostic factors identified in the bivariate analysis; however, the logistic regression only selected as the septic pseudoarthrosis as a significant factor. It is necessary to detect and if necessary control or eliminate those factors that can directly affect poor postoperative results.

Síndrome de hipoplasia femoral y facies inusual: reporte de un caso / Femoral hypoplasia-unusual facies syndrome: A case report

Introducción: El síndrome de hipoplasia femoral y facies inusual es una enfermedad rara con expresividad hereditaria variable, aunque se han reportado casos con un patrón autosómico dominante. Afecta particularmente las estructuras de la cara asociado a hipoplasia de fémur. Si bien su etiología no ha sido bien identificada, se ha asociado con diabetes materna, exposición a drogas, infecciones virales, radiaciones y oligohidramnios. Objetivo: Presentar el caso de una recién nacida con este síndrome. Caso clínico: Recién nacida de 41 semanas de gestación con nariz pequeña, labio superior delgado, micrognatia, filtrum largo, implantación baja de orejas, epicanto, cadera displásica con flexión y aducción de miembro inferior derecho y acortamiento del mismo a expensas del muslo. En la imagen radiográfica se encontró hipoplasia de fémur derecho con techo acetabular ipsilateral displásico. Se realizó una evaluación completa por distintos especialistas que descartaron otras malformaciones asociadas. Se programó el alargamiento quirúrgico de miembros inferiores a la edad de 5 meses con la finalidad de que deambule con sus propios pies; paralelamente se inició apoyo con kinesiterapia. Conclusiones: El síndrome de hipoplasia femoral y facies inusual es un padecimiento poco frecuente, que implica la participación de un equipo médico multidisciplinario para su manejo.

Introduction: Femoral hypoplasia-unusual facies syndrome is a rare disease with variable expressivity, although cases have been reported with an autosomal dominant pattern. It particularly affects the structures of the face associated with hypoplasia of the femur. Its aetiology is relatively unknown. However, this syndrome has been associated with maternal diabetes, drug exposure, viral infections, radiation, and oligohydramnios. Objective: The case of a newborn with this syndrome is presented. Clinical case: Newborn of 41 weeks gestation with small nose, thin upper lip, micrognathia, long philtrum, low set ears, epicanthal folds, dysplastic hips showing flexion, and adduction of the right leg, and shortening at the expense of the thigh. X-ray images revealed femoral hypoplasia and dysplastic acetabular roof. Different physicians from other specialties who excluded other associated malformations performed a complete evaluation. Surgical bone lengthening of lower limb is scheduled at 5 months of age, with the purpose that she walks with her own feet; at the same time she began management with kinesiotherapy. Conclusions: Femoral hypoplasia-unusual facies syndrome is a rare condition. A multidisciplinary health care team must treat individuals with femoral hypoplasia-unusual facies syndrome.

Sarcoma de Kaposi clásico en un paciente joven e inmunocompetente: reporte de un caso / Classic Kaposi's sarcoma in a young, immunocompetent patient: a case report

El sarcoma de Kaposi (SK) es un cáncer que se desarrolla a partir de las células de los vasos sanguíneos o linfáticos. Fue descrito, en 1872, por Moriz Kaposi, y por muchos años se consideró una neoplasia de curso poco agresivo, lo cual cambió con la epidemia del sida. Se han descrito clásicamente cuatro grupos de SK: clásico, endémico, iatrogénico y epidémico. El SK clásico, aparece con mayor frecuencia en pacientes de 60 a 70 años y de origen mediterráneo. Se presenta el caso de un paciente joven de 27 años, inmunocompetente que desarrolla un SK clásico con inicio inusual.

Kaposi's sarcoma is a type of cancer that develops from blood cells or lymphatic vessels. It was described in 1872 by Moriz Kaposi, and for many years was considered an aggressive neoplasm, which changed with the AlDS epidemic. lt has been classically described into four groups of Kaposi's sarcoma: classic, endemic, iatrogenic and epidemic. The classic Kaposi sarcoma occurs more frequent in patients from 60 to 70 years old and Mediterranean origin. We report the case of a young patient of 27 years old, immunocompetent who developed classic Kaposi sarcoma with an un usual start.

Gestión de garantía de calidad en un policlínico de terapia de anticoagulación oral, Hospital de Carabineros de Chile, Santiago, Chile: satisfacción del cliente como índice de calidad en un hospital público / Gestion of quality control in an outpatient anticoagulant clinic, Hospital de Carabineros de Chile: client satisfaction as an index of quality in a public hospital

El presente estudio prospectivo tiene como objetivo desarrollar instrumentos metodológicos que permitan evaluar y garantizar la calidad de los servicios médicos que se otorgan en la nueva policlínica de control de la anticoagulación oral (TACO) mediante la investigación de la satisfacción del paciente. Las perspectivas del estudio son: infraestructura, procesos, resultados de la atención integral y cuestionamiento del elemento de satisfacción del cliente. Sujetos, materiales y método: Una muestra de 82 de 127 (65 por ciento) pacientes atendidos durante el mes de Marzo de 2010, fueron estudiados utilizando una encuesta estándar, formulada en base a los resultados de un estudio piloto previo. Pacientes que por su enfermedad no tenían capacidad para completar la encuesta fueron excluidos, como aquellos quienes no quisieron participar y los que tuvieron su control por vía telefónica. Resultados: En general la Policlínica tuvo una evaluación de excelente en 48 por ciento de los pacientes, con un promedio sobre 17 puntos (rango 0 a 20). El equipo logró cumplir con las expectativas de 95 por ciento de los pacientes. Hubo diferencias en las evaluaciones entre el equipo profesional y no profesional, pero ambos obtuvieron un promedio sobre 4 (1 a 5). Hubo una diferencia significativa en la evaluación obtenida entre el estudio piloto y el definitivo, respecto al cumplimiento de las expectativas del paciente. Conclusiones: En la encuesta de control de calidad, la Unidad en general obtuvo una calificación buena, pero identificó áreas para mejorar el servicio y atención. Demostró que la calidad de gestión es dependiente del equipo total y el resultado final depende de la participación de todos. Es un proceso largo y no exento de dificultades, la encuesta es parte de la iniciación con la toma de consciencia del problema. Modificaciones a la encuesta son necesarios para el seguimiento y forma parte de la estrategia institucional.

The present prospective study had as its objective the development of instruments which permitted the evaluation of the quality of medical services provided by the outpatient anticoagulant clinic, using client satisfaction as an index of quality. The form of the study included the elements of infrastructure, processes, results of the clinical attention and addressing the element of patient satisfaction. Materials, Methods and Patients: A sample of 82 of the 127 patients attended during March 2010 was studied using a standard questionnaire, based on the results of an earlier pilot study. Patients, who for their illness, were not capable of completing the questionnaire, were excluded from the study, as well as those who did not wish to participate or had their anticoagulation controlled by phone. Results: In general, the outpatient clinic had an excellent evaluation in 48 percent of cases, with an average score of 17 points (range 0-20). The team achieved a 95 percent rate of fulfilling the patients expectations. Although there were differences between the evaluation of the professional and non-professional teams, both obtained an average score of over 4 (range 1-5). The evaluation of the patients improved in the definitive study in comparison with the original pilot study. Conclusions: The survey of quality control showed that the outpatients clinic obtained a qualification classed as good, but identified areas which needed to ve improved. It shows that the quality of care is dependent on the performance of the whole team and the results depend on the participation of all. Implementing quality control is a long process and not extent of problems. Modifications to the questionnaire are necessary for follow up work and form part of the Hospitals Quality Control.

Factores de riesgo de depresión posparto en puérperas venezolanas valoradas por medio de la escala de Edimburgo / Risk factors of postpartum depression in Venezuelan women measured by Edinburgh postnatal depression scale

Antecedentes: La depresión posparto (DPP) es un importante trastorno de la salud mental en la mujer, al cual se le han atribuido variados factores de riesgo para su presentación. Objetivo: Se propuso determinar los factores de riesgos para DPP en puérperas atendidas en la Maternidad "Dr. Armando Castillo Plaza" del Hospital Universitario de Maracaibo, Venezuela. Método: Se realizó una investigación descriptiva con diseño no experimental, mediante una muestra de 100 puérperas, evaluadas por la Escala de Depresión Postparto de Edimburgo (EDPS). Resultados: Hubo una prevalencia del test positivo del 91 por ciento, con una prevalência de DPP confirmada mediante el DSM-IV del 22 por ciento. De las características evaluadas solo los trastornos médicos durante el embarazo, la enfermedad del neonato, no contar con el apoyo de su pareja, presentar antecedentes de depresión o melancolía o tener un nivel educativo primario o inferior, mostraron una asociación significativa con el desarrollo de DPP. El nacimiento mediante cesárea y no contar con el apoyo familiar presentaron una asociación significativa con el riesgo de DPP; mientras que el parto vaginal o haber alcanzado un nivel educativo superior a la primaria mostraron tener un efecto protector. Conclusión: Existe una alta prevalencia de DPP, con diversos factores de riesgo que permitirían tomar acciones para un diagnóstico oportuno de esta enfermedad.

Background: Postpartum depression (PPD) is a major mental health disorder in women, which have been attributed to various risk factors for it presentation. Objective: To determine the PPD's risk factors present in the postpartum patients taken care of Maternity "Dr Armando Castillo Plaza" at the University Hospital of Maracaibo, Venezuela. Method: A descriptive study was conducted with non-experimental design, which included a sample of 100 postpartum women, as measured by the scale of the Edinburgh Postpartum Depression (EDPS). Results: The results demonstrated a prevalence of the positive test in 91 percent of the sample, with a confirmed prevalence of postpartum depression by the DSM-IV of 22 percent, determined that the characteristics assessed only medical disorders during pregnancy, the disease of the newborn, not having the support from your partner, have a history of depression or melancholy, or have a primary or lower education level, showed a significant association with the development of PPD. For its part, the birth by caesarean section and not having family support showed a significant association with the risk of PPD, while vaginal delivery or have reached a level higher than primary education showed a protective effect with this condition. Conclusion: There is a high prevalence of postpartum depression, with several risk factors that would take action for a timely diagnosis of disease.

Prevalencia de depresión posparto en primigestas y multíparas valoradas por la escala de Edimburgo / Prevalence of postpartum depression in nulliparous and multiparous women evaluated by Edinburgh postnatal depression scale

Antecedentes: Los trastornos depresivos representan un importante problema de salud pública, siendo más frecuente en las mujeres y con mayor riesgo durante el embarazo y puerperio. Objetivo: Comparar la prevalencia de depresión posparto en primigestas y multíparas atendidas en la División de Obstetricia y Ginecología del Servicio Autónomo Hospital Universitario de Maracaibo, Venezuela. Método: Se realizó una investigación comparativa con diseño no experimental, que incluyó una muestra de 100 mujeres en puerperio tardío, divididas en dos grupos pares de 50 sujetos según paridad, evaluadas mediante la Escala de Depresión Posparto de Edimburgo. Resultados: Los resultados demostraron una prevalencia del test positivo en el 91 por ciento de la muestra, con una prevalencia de depresión posparto confirmada por medio del DSM-IV del 22 por ciento, presentando mayor frecuencia de ideación suicida las multíparas (p<0,05). No hubo una asociación estadísticamente significativa entre paridad y depresión posparto. Conclusión: La población estudiada presenta una alta prevalencia de depresión postparto, sin diferencias en cuanto a su paridad.

Background: Today the depressive upheavals represent an important public health's problem, being more frequent in the women and with greater risk during the pregnancy and puerperium. Objective: To compare the prevalence of postpartum depression in nulliparous and multiparous women taken care of Maternity "Dr. Armando Castillo Plaza" at the University Hospital of Maracaibo, Venezuela. Method: A comparative investigation with non experimental design was realized, it which included a sample of 100 women in later puerperium, divided in two even groups of 50 subjects according to her parity, evaluated by Edinburgh Postnatal Depression Scale. The results demonstrated a prevalence of the positive test in 91 percent of the sample, with a confirmed prevalence of postpartum depression by the DSM-IV of 22 percent, presenting a highly frequency of suicidal ideas in the multiparous group (p<0.05) also, don't found statistically significant association between parity and postpartum depression. Conclusion: The studied population show a highly prevalence of postpartum depression, without majors differences according to the parity.

Efecto antioxidante de frutas y hortalizas de la zona central de Chile / Antioxidant effect of fruits and vegetables of central region of Chile

Las especies reactivas del oxígeno (ERO) causan daño celular que se puede expresar como patología, tales como las enfermedades cardiovasculares (ECV) y otras enfermedades crónicas no transmisibles. El organismo humano cuenta con sistemas antioxidantes; algunos provienen de la dieta, especialmente de frutas y hortalizas, otros los genera el mismo organismo de manera endógena. El objetivo de este estudio fue conocer la capacidad antioxidante in vitro de algunas frutas y hortalizas que se consumen en la Región del Maule de Chile. Las once especies de frutas y 16 de hortalizas empleadas en el estudio fueron adquiridas en el Centro Regional de Abastecimiento de Talca, en época de cosecha; a partir de ellas se obtuvo extractos acuosos y metanólicos. La actividad antioxidante se determinó mediante decoloración del radical violeta 2,2-difenil-I-picril hidrazilo hidratado (DPPH). En general la actividad antioxidante, en extractos metanólicos, fue mayor en frutas (70,3 por ciento; 87,7-54,3 por ciento de decoloración) que en hortalizas (54,7 por ciento; 44,3-79,7 por ciento) (p < 0.003) y dependiente de la concentración del extracto evaluado. En los ensayos a 1000 f < g/m, la mayoría de las frutas mostraron un porcentaje de decoloración superior al 60 por ciento y las que presentaron mayor actividad antioxidante fueron frambuesa, frutilla y kiwi. Entre las hortalizas, las que presentaron mayor actividad antioxidante, fueron los tomates seguidos por pepino dulce, betarraga, melón tuna, pimentón y sandía. La actividad antioxidante observada en la mayoría de las frutas y hortalizas evaluadas podría ser un argumento científico a dar a conocer en las campañas de promoción del consumo interno y en la exportación de productos hortofrutícolas.

The reactive oxygen species (ERO) cause cell damage that can be expressed as a disease, including cardiovascular disease (CVD) and other non transmissible chronic diseases. The human body has antioxidant systems, some come from the diet, especially fruits and vegetables, and others are generated by the same organism as an endogenous way. The aim of this study was to determine the in vitro antioxidant capacity of some fruits and vegetables that are consumed in the Maule Region, Chile. Eleven species of fruits and 16 of vegetables used in the study were obtained at the Regional Center of Fruits and Vegetables of Talca during the harvest season, and different aqueous and methanol extract were obtained. The antioxidant activity was determined by purple discoloration of the radical 2,2-diphenyl-1-picryl hidrazilo hydrated (DPPH). In general the antioxidant activity was slightly higher in fruits (70,3 percent; 87,7-54,3 percent) than in vegetables (54,7 percent; 44,3-79,7 percent) (p < 0.003) and it was dependent on the concentration of the extract. In the tests at 1000 ug/m, most fruits showed a higher percentage of discoloration over to 60 percent; those that showed higher antioxidant activity were raspberry, strawberry and kiwi. Among vegetables, those showing higher antioxidant activity were tomato, followed by melon pear, red beet, melon (type tuna), sweet pepper and watermelon. The antioxidant activity observed in most fruits and vegetables could be assessed as a scientific argument to make known in promotional campaigns in national consumption and the horticultural products exports.

Epifisiolisis en un paciente con osteopetrosis: reporte de un caso clínico y revisión de la literatura / Slipped capital femoral epiphysis in a patient with osteopetrosis: case report and literature review

A case report of an 8 years old patient with Osteopetrosis and a Slipped Capital Femoral Epiphysis is presented. Along with a literature review (where there are only two reports of this pathology) the diagnosis methods and treatment are displayed. Clinical results, x-rays and MRI are exhibited.

Se presenta un caso de Epifisiolisis en un paciente de 8 años con el diagnóstico de Osteopetrosis. Junto con una revisión de la literatura, en que solamente se encuentran dos publicaciones con casos similares, se exhiben los métodos diagnósticos y el tratamiento realizado, así como sus resultados clínicos e imagenológicos.

AIDS stigma combinations in a sample of Puerto Rican health professionals: qualitative and quantitative evidence

The HIV/AIDS epidemic continues to impact Puerto Rico and the Caribbean region with growing numbers of cases each year. The stigma that surrounds the epidemic has harmful implications on the health of people living with the disease and public health in general, fostering health deterioration and new infections. When this stigma emanates from health professionals it can severely hinder access to health services, which are crucial for those living with the virus. Still, AIDS stigma has been previously explored among this population as a separate phenomenon from other pre-existing stigmas. This has yielded a limited perspective on the complexity of how AIDS stigma is manifested. In light of this limitation, the main objectives of this study were: 1) to document AIDS stigma among a sample of Puerto Rican health professionals and health professionals in training and 2) to explore the combination of other stigmas (sexism, homophobia, and negative attitudes towards drug users) with that associated to HIV/AIDS. Through an exploratory design, using a mixed method approach (qualitative in-depth interviews and quantitative questionnaires), we explored the objectives in a sample of 501 health professionals and health professionals in training. The results evidenced the combinations of other stigmas with that of HIV/AIDS. Homophobia yielded the strongest correlation and was the best predictor of AIDS stigma. These results evidence the need to develop interventions to reduce AIDS stigma and its combinations among this population.

Prosthetic valve endocarditis

Prosthetic valve infective endocarditis represents a defined pathological entity which follows an epidemiological and nosological pattern in accordance to an arbitrary classification. Chronologically it is divided into the entities of early and late prosthetic valve endocarditis, each with its own unique characteristics. The clinical features, complications and diagnosis do not vary much from native valve endocarditis. There are clear and precise indications to aid in the diagnosis and treatment of this entity which differ from native valve endocarditis

Reacción inflamatoria abdominal postquirúrgica: experimento aleatorio, ciego y controlado en modelo animal,Departamento de cirugia y Patología Hospital Roosevelt, Laboratorio de Cirugía Experimental Facultad de Medicina Universidad Francisco Marroquín, Guatemala / Post-surgical abdominal inflammatory reaction Randomized, blind controlled experiment in an animal model Surgical Departament and Pathology Section, Roosevelt Hospital in Guatemala City, Experimental Surgery Laboratory of the Medical School of Francisco Marroquín University

Introducción: la reacción inflamatoria (RI) es una secuencia compleja de acontecimientos que ocurren en los tejidos de los seres vivos luego de lesión celular. Se puede manifestar objetivamente para el cirujano mediante la presencia de hallazgos macroscópicos abdominales observados durante la cirugía (1,2,3). El objetivo del presente estudio fue evidenciar la reacción inflamatoria en el abdomen de la rata expuesta a: bilis, clips de titanio y fragmentos de gasa. Material y métodos: se realizó un modelo experimental en el Laboratorio de Cirugía de la Universidad Francisco Marroquín. Se utilizaron 100 ratas de la especie Wistar a las cuales les fueron asignadas en forma aleatoria cifras numéricas para clacificarlas así...

Evaluación de una maniobra nutricional tendiente a reducir los niveles de colesterol en pacientes portadores de enfermedad coronaria en el sistema público de salud chileno / Evaluation of a nutritional intervention to reduce cholesterol levels in patients with coronary artery disease

Background: The mainstay of cholesterol reduction therapy is the diet. But the lack of compliance and prescription problems limit its usefulness. Aim: To compare the effectiveness of a nutritional intervention given by a nutritionist with the usual recommendations given by a physician to reduce the LDL cholesterol levels in patients with coronary artery disease, treated at the Regional public hospital in Temuco. Material and Methods: One hundred and forty patients with coronary heart disease (last acute episode at least three months before), without nutritional interventions nor cholesterol-lowering drugs, who gave informed consent, were randomized to receive either instructions by their physician or to take part in a nutritional program. The nutritional intervention consisted in five educational sessions, adapted from the NCEP and from a program of the Nutrition Department of the Catholic University of Chile. Patients randomized to the medical intervention received the standard written recommendations about diet. Lipid profile was measured before the intervention and after a three and twelve months follow up. Results: After one year the group on the nutritional program reduced LDL cholesterol by 11.1% (p=0.03). There were no changes in the medical group. However, only 10% patients on the nutritional intervention group and 8% of those with medical recommendations achieved LDL cholesterol levels less than 100 mg/dl. There were no changes in triglycerides, weight or body mass index during the period. Conclusions: Although this nutritional intervention proved to be more effective than usual medical instructions, most patients on secondary prevention did not achieve acceptable LDL cholesterol levels (Rev Méd Chile 2004; 132: 1457-65).