Efectividad de la hipnosis en cantidad y calidad del sueño en pacientes con depresión post-COVID / Effectiveness of hypnotherapy on sleep quality and quantity in patients with post-COVID depression

Introducción: Se conocen diversos tratamientos para tratar y curar la depresión. Entre los más utilizados se encuentran la psicoterapia y la medicación. La hipnosis clínica utiliza un discurso basado en la sugestión y en los reflejos condicionados del sueño, para lograr la estabilidad en la desregulación del ciclo sueño / vigilia, lo cual es un factor esencial en el tratamiento de las personas deprimidas por la COVID-19. Objetivo: Comparar la evolución en la calidad y cantidad de sueño en pacientes con depresión post-COVID que fueron tratados con medicación e hipnosis. Métodos: Se realizó un estudio explicativo-comparativo, y un diseño cuasi-experimental. La muestra fue de 40 pacientes que fueron ingresados en el Hospital Universitario Clínico Quirúrgico «Cmdte. Manuel Fajardo Rivero», de Santa Clara, entre enero y marzo de 2021, con COVID-19. En un grupo de pacientes se empleó el inventario de depresión de Beck y un cuestionario para evaluar la cantidad y calidad del sueño antes y después de la intervención con medicación; en el otro grupo se empleó la hipnosis. Se utilizó la estadística descriptiva. Resultados: En ambos grupos la terapia empleada fue efectiva, redujo los niveles de depresión y eliminó las alteraciones del sueño. Conclusiones: Ambas formas de tratamiento se pueden emplear para tratar la depresión y los desórdenes propios del sueño. El método sugestivo de despertar de sueño hipnótico a sueño natural fue tan efectivo como los psicofármacos empleados.

Introduction: various treatments are known to treat and cure depression. Psychotherapy and medication are among the most used. Clinical hypnosis uses a discourse based on suggestions and conditioned sleep reflexes to achieve stability in sleep-wake cycle dysregulation, which is an essential factor in the treatment of people depressed by COVID-19. Objective: to compare the evolution in sleep quality and quantity in patients with post-COVID depression who were treated with medication and hypnotherapy. Methods: an explanatory comparative study with a quasi-experimental design was carried out. The sample consisted of 40 patients who were admitted due to COVID-19 at "Cmdte. Manuel Fajardo Rivero" Clinical and Surgical University Hospital from Santa Clara between January and March 2021. Beck Depression Inventory and a questionnaire were used in a group of patients to assess the sleep quality and quantity before and after the intervention with medication; hypnosis was used in the other group. Descriptive statistics was also used. Results: the used therapy was effective in both groups, reduced levels of depression and eliminated sleep disturbances. Conclusions: both forms of treatment can be used to treat depression and sleep disorders. The suggestive method of awakening from hypnotic sleep to natural sleep was as effective as the psychoactive drugs used.

Relaciones Intrafamiliares y Riesgo de Suicidio de Estudiantes Mexicanos de Bachillerato / Intra-Family Relationships and Suicide Risk in Mexican Highschool Students

Resumen La cantidad de muertes por suicidio en México aumenta en promedio 2.35% cada año y se concentra en los grupos de edad de 15 a 24 años. Aunque se sabe que múltiples factores familiares intervienen en el comportamiento suicida de los adolescentes, las formas de evaluarlos han sido heterogéneos. El objetivo fue identificar la relación entre las relaciones intrafamiliares y el riesgo de suicidio en estudiantes de un bachillerato de Aguascalientes. Se implementó un diseño correlacional con muestra tipo censo mediante el uso de las escalas de Plutchik de riesgo suicida y Relaciones Intrafamiliares, cuyas subescalas evalúan unión y apoyo, expresión y dificultades. La información se analizó mediante estadísticas descriptivas, de correlación y regresión lineal. De los 946 participantes se encontró riesgo suicida en casi 20%, predominando las mujeres. Se encontró una relación significativa entre el riesgo suicida y las tres subescalas de relaciones intrafamiliares, aunque sólo Expresión y Dificultades mantuvieron esa correlación en el modelo de regresión lineal. Se concluye que la dinámica familiar en que se desarrollan los jóvenes influye en el riesgo suicida, aunque no constituya causa suficiente. Se sugiere considerar variables psicosociales y usar instrumentos adaptados a cada población en el estudio del suicidio adolescente.

Abstract The number of deaths by suicide in Mexico increases an average of 2.35% each year, concentrating mainly on the age groups of 15 to 24 years. Although multiple family factors are known to play a role in adolescent suicidal behavior, the ways in which they are assessed have been heterogeneous. The objective was to identify the relationship between the components of intrafamily relationships and the risk of suicide in high school students in Aguascalientes. A correlational investigation was implemented, with a census-type sample design using scales: Plutchik's suicide risk and Intrafamily Relationships conformed bay expression, union and difficulties subscales. The information was analyzed with the SPSS program using descriptive statistics, correlation and linear regression. Of the 946 participants, suicidal risk was found in almost 20%, predominantly women. A moderate but significant relationship was found between suicide risk and the three subscales of intrafamily relationships, although only two of them, Expression and Difficulties, maintained this correlation when incorporated together with the other variables to a linear regression model. It is concluded that the family dynamics in which young people develop influences suicide risk. It´s suggest to consider psychosocial variables and adapted scales in the adolescent suicide studies.

Feline iridal melanoma: a case report / Melanoma iridal felino: un reporte de caso / Melanoma felino iridal: um relato de caso

Abstract Feline diffuse iris melanoma is a statistically atypical pathology that compromises the eye, with the possibility of affecting other organs if a metastatic process occurs. Enucleation is usually a therapeutic alternative to reduce the risk of this process; however, this decision requires an adequate clinical examination. The diagnosis of this disease needs to be confirmed by histopathology and its follow-up must be continuous, through chest radiography, abdominal ultrasound and complete ophthalmological examination. This article presents the analysis and discussion of a feline diffuse iridal melanoma case in a domestic short hair cat, its clinical findings, the use of diagnostic aids and its therapeutic approach.

Resumen El melanoma difuso de iris felino es una patología estadísticamente atípica que compromete el globo ocular, con posibilidades de afectar otros órganos del paciente si llega a existir un proceso metastásico. La enucleación suele ser una alternativa terapéutica para reducir el riesgo de dicho proceso; sin embargo, la decisión requiere de un examen clínico adecuado. El diagnóstico de esta enfermedad requiere ser confirmado por medio de histopatología y su seguimiento debe ser continuo, mediante radiografía torácica, ecografía abdominal y examen oftalmológico completo. Este artículo presenta el análisis y discusión de un caso de melanoma iridal difuso felino en un doméstico de pelo corto, sus hallazgos clínicos, uso de ayudas diagnósticas y su enfoque terapéutico.

Resumo O melanoma difuso de íris em felinos é uma patologia estatisticamente atípica que compromete o globo ocular, com possibilidades de afetar outros órgãos do paciente se existir um processo metastático. A enucleação é geralmente uma alternativa terapêutica para reduzir o risco desse processo; entretanto, a decisão requer um exame clínico adequado. Para o diagnóstico desta doença é necessário a análise histoa histopatológica e seu acompanhamento deve ser contínuo, através de radiografia de tórax, ultra-sonografia abdominal e exame oftalmológico completo. Este artigo apresenta a análise e discussão de um caso de melanoma difuso de iris em um gato domestic short hair, seus achados clínicos, o uso de auxiliares de diagnóstico e sua abordagem terapêutica.

Development and validity evidence of the multidimensional scale of sexual selfconcept in a Spanish-speaking context

Abstract Background/objective: STIs and HIV/AIDS are an important public health problem, transmitted by risky sex behaviours. In this context, it is necessary to identify protective factors, of those behaviours, as sexual self-concept. Sexual self-concept is a multidimensional trait (i.e. sexual self-esteem; sexual self-efficacy; and sexual assertiveness), but, in an extensive review, we did not find any measure to assess this multidimensional construct in a Spanish-speaking context. The objective of this research is development a scale to assess sexual self-concept in young people and adults. Method: Time-space sampling with a total size of 792 participants, coming from the two Chilean cities (i.e. Arica and Iquique) with the highest HIV rates, aged between 17 and 53 years old (ME = 23.42; SD = 6.33), with 66.2% women (N = 500), 33.6% men (N = 258). Results: Final scale has 16 items and 4 dimensions: sexual self-esteem, sexual self-efficacy, assertive sexual communication, and assertive sexual behaviour. The identified structure provides satisfactory levels of reliability (ω > .8) and presents robust evidence of validity, based on the internal structure of the test, using ESEM (RMSEA = .060; CFI = .99; TLI = .98), evidence of validity based on relationship to other variables (i.e. risky sexual behaviour) and measurement invariance between men and women. Conclusions: The multidimensional scale of sexual self-concept has adequate psychometric properties to assess sexual selfconcept in equivalent samples.

Actitud de psicólogos asistenciales del municipio Santa Clara en relación con la hipnosis como recurso terapéutico / Attitude of care psychologists of Santa Clara municipality in relation to hypnosis as a therapeutic resource

Introducción: En los últimos 50 años el estudio y la práctica de la hipnosis como recurso terapéutico han ganado mayor espacio dentro del campo de la salud. No obstante el desconocimiento de esta técnica y la existencia de creencias falsas sobre ella perjudican su óptimo empleo. Objetivo: Describir la actitud que tienen los psicólogos asistenciales del municipio Santa Clara en relación con la hipnosis. Métodos: La investigación posee un alcance descriptivo, a partir de un estudio transversal con enfoque cuantitativo, realizado de septiembre a noviembre del 2016. La muestra quedó conformada por 38 psicólogos asistenciales. Se utilizó una encuesta de 16 ítems, donde se abordaron los saberes vinculados a la hipnosis, las creencias atribuidas ella, el valor terapéutico asignado a la hipnosis y la experiencia en su empleo. Resultados: Se apreció un bajo nivel de conocimientos sobre la hipnosis. La principal vía de obtención de conocimiento resultó ser la autopreparación. La mayor parte de los encuestados no emplea la técnica, sin embargo, le otorgan un gran valor terapéutico. No prevalecen las creencias irracionales sobre la hipnosis. Conclusiones: Los psicólogos asistenciales del municipio de Santa Clara, Villa Clara, demandan mayor conocimiento y preparación a través de instituciones académicas sobre el empleo de la hipnosis como recurso terapéutico. No predominan las creencias relacionadas con las condiciones especiales del terapeuta y de pérdida de control de la conducta en los pacientes. Hay reconocimiento del valor terapéutico de la hipnosis, a pesar de no ser empleada por muchos de los profesionales encuestados(AU)

Introduction: In the last 50 years, the study and practice of hypnosis as a therapeutic resource has gained more relevance within the field of health. Despite of this, the ignorance of this technique and the existence of false beliefs about it prejudice its optimal use. Objective: To describe the attitude of care psychologists in Santa Clara municipality in relation to hypnosis. Methods: The research has a descriptive scope, based on a cross-sectional study, with a quantitative approach carried out from September to November 2016. The sample consisted of 38 health psychologists. A 16-item questionnaire was used to discuss the hypnosis knowledge, the beliefs attributed to hypnosis, the therapeutic value assigned to it and the experience in its use. Results: A low level of knowledge about hypnosis was noticed. The main way of obtaining knowledge resulted to be self-preparation. Most of those polled do not use the technique, however they grant to it a great therapeutic value. Irrational beliefs about hypnosis do not prevail. Conclusions: Care psychologists of Santa Clara municipality in Villa Clara province demand greater knowledge and preparation through academic institutions on the use of hypnosis as a therapeutic resource. Beliefs related to the therapist's special conditions and loss of behavioral control in patients are not predominant. There is recognition of the therapeutic value of hypnosis, despite not being used by many of the professionals surveyed(AU)

Bacteriophages in the control of pathogenic vibrios

Vibrios are common inhabitants of marine and estuarine environments. Some of them can be pathogenic to humans and/or marine animals using a broad repertory of virulence factors. Lately, several reports have indicated that the incidence of Vibrio infections in humans is rising and also in animals constitute a continuing threat for aquaculture. Moreover, the continuous use of antibiotics has been accompanied by an emergence of antibiotic resistance in Vibrio species, implying a necessity for efficient treatments. One promising alternative that emerges is the use of lytic bacteriophages; however, there are some drawbacks that should be overcome to make phage therapy a widely accepted method. In this work, we discuss about the major pathogenic Vibrio species and the progress, benefits and disadvantages that have been detected during the experimental use of bacteriophages to their control.

Influencia del volumen de entrenamiento pliométrico en la carga percibida diferenciada de futbolistas de alto nivel / Influence of Plyometric training volume on differentiated perceived exertion load of High-level soccer players / Influência do volume de treinamento pliométrico no esforço percebido diferenciado de jogadores de futebol de alto nível

Resumen Leceaga, J., Los Arcos, A., Castillo, D, y Yanci, J. (2017). Influencia del volumen de entrenamiento pliométrico en la carga percibida diferenciada de futbolistas de alto nivel. PENSAR EN MOVIMIENTO: Revista de Ciencias del Ejercicio y la Salud, 15(2), 1-17. Los objetivos del estudio fueron describir la carga percibida diferenciada (dRPE CE) en un equipo de fútbol durante seis semanas de entrenamiento, analizar si existen diferencias en la dRPE CE entre grupos que realizan dos entrenamientos de pliometría con distinto volumen y analizar la evolución a lo largo de las semanas de la dRPE en ambos grupos. Se registró la carga percibida mediante la percepción subjetiva del esfuerzo respiratorio (RPEres) y muscular (RPEmus) de catorce jugadores de fútbol de un equipo de 2.ª División B de la Liga de Fútbol Española, durante seis semanas. Los jugadores fueron divididos en dos grupos, realizando diferentes volúmenes de entrenamiento de fuerza. El primer grupo (G1FX, 24,42 ± 4,35 años, 1,80 ± 0,05 m, 77,32 ± 6,40 kg, 23,81 ± 1,49 kg/m2) realizó un entrenamiento de pliometría en el eje horizontal, y el segundo grupo (G2FX2, 22,43 ± 2,82 años, 1,82 ± 0,07 m, 76,65 ± 7,56 kg, 22,99 ± 1,13 kg/m2) realizó el mismo entrenamiento de fuerza pero con el doble de volumen. Los resultados obtenidos en el presente estudio no mostraron diferencias significativas entre ambos grupos en la dRPE CE en ninguna de las seis semanas registradas y tampoco se obtuvieron diferencias en ninguno de los dos grupos en dicho periodo, ni en el RPEres CE ni en el RPEmus CE. Realizar mayor volumen de entrenamiento de pliometría no implica que los jugadores que más volumen han realizado perciban un mayor RPEres CE ni RPEmus CE.

Abstract Leceaga, J., Los Arcos, A., Castillo, D, y Yanci, J. (2017). Influence of plyometric training volume on differentiated perceived exertion load of high-level soccer players. PENSAR EN MOVIMIENTO: Revista de Ciencias del Ejercicio y la Salud, 15(2), 1-17. The purpose of this study was to describe the differentiated perceived exertion load rate (dRPE) in a soccer team during six training weeks analyzing the differences in dRPE between groups having two-plyometric training with different volume and analyze the evolution in both groups. During six weeks, perceived load was registered by the subjective rating of perceived exertion (RPE re) and muscular (RPE mu) in 14 soccer players from the 2° División B de la Liga de Fútbol Española [2° B Division of the Soccer Spanish League]. Participants were divided into two groups to work different strength training. The first group (G1FX, 24,42 ± 4,35 years, 1,80 ± 0,05 m, 77,32 ± 6,40 kg, 23,81 ± 1,49 kg/m2) practiced a plyometric training in horizontal axis and the second one (G2FX2, 22,43 ± 2,82 years, 1,82 ± 0,07 m, 76,65 ± 7,56 kg, 22,99 ± 1,13 kg/m2) did the same training, but having double strength volume. Along the six weeks, the results did not show either significant differences between the groups in dRPE nor RPE es CE or RPE mus. Performing higher plyometric training does not mean that those who have practiced more volume would perceive higher RPE es or RPE mus.

Resumo Leceaga, J., Los Arcos, A., Castillo, D, y Yanci, J. (2017). Influência do volume de treinamento pliométrico no esforço percebido diferenciado de jogadores de futebol de alto nível. PENSAR EN MOVIMIENTO: Revista de Ciencias del Ejercicio y la Salud, 15(2), 1-17. Os objetivos do estudo foram descrever o esforço percebido diferenciado (dRPE CE) em uma equipe de futebol durante seis semanas de treinamento, analisar se existem diferenças na dRPE CE entre grupos que realizam dois treinamentos de pliometria com volume distinto e analisar a evolução ao longo das semanas da dRPE em ambos os grupos. Foram registrados o esforço percebido através da percepção subjetiva do esforço respiratório (RPEres) e muscular (RPEmus) de catorze jogadores de futebol de uma equipe de 2.ª Divisão B da Liga de Futebol Espanhola, durante seis semanas. Os jogadores foram divididos em dois grupos, realizando diferentes volumes de treinamento de força. O primeiro grupo (G1FX, 24,42 ± 4,35 anos, 1,80 ± 0,05 m, 77,32 ± 6,40 kg, 23,81 ± 1,49 kg/m2) realizou um treinamento de pliometria no eixo horizontal, e o segundo grupo (G2FX2, 22,43 ± 2,82 anos, 1,82 ± 0,07 m, 76,65 ± 7,56 kg, 22,99 ± 1,13 kg/m2) realizou o mesmo treinamento de força, porém com o dobro do volume. Os resultados obtidos no presente estudo não mostraram diferenças significativas entre ambos os grupos na dRPE CE em nenhuma das seis semanas registradas e também não foram obtidas diferenças em nenhum dos dois grupos no período indicado, nem no RPEres CE e nem no RPEmus CE. Aumentar o volume de treinamento de pliometria não significa que os jogadores que realizaram maior volume percebam consequentemente um maior RPEres CE ou RPEmus CE.

Perfil de autoanticuerpos y asociación con patrones inmuno-electroforéticos en pacientes con esclerosis sistémica / Profile of autoantibodies and association with immunoelectrophoretic patterns in patients with systemic sclerosis

Contexto: la esclerodermia es una enfermedad autoinmune, sistémica y mediada por factores genéticos y ambientales; uno de sus marcadores es la presencia de autoanticuerpos con valor clínico, diagnóstico y pronóstico. Métodos: estudio descriptivo, observacional y relacional efectuado en pacientes con diagnóstico de esclerosis sistémica, atendidos en Unidad de Reumatología del Hospital Carlos Andrade Marín entre junio 2014 a mayo 2015. Los datos fueron procesados mediante análisis de correspondencia y cálculo de Chi cuadrado en el paquete estadístico SPSS 22. Resultados: de 80 pacientes estudiados se detectaron anticuerpos anti-topoisomerasa en 18 individuos (22,5%), anti centrómero (n=38, 47,5%), antinucleares (n=13, 16,3%), anti-ribonucleoproteína (n=7, 8,8%) y sin anticuerpos en 4 individuos (5%). Respecto a los patrones inmunoelectroforéticos se determinó el patrón centromérico en 23 sujetos (28,8%), moteado fino y grueso (n=17, 21,3% cada uno), homogéneo (n=8, 10%), nucleolar (n=7, 8,8%) y citoplasmático (n=1, 1,3%); fueron negativos 7 pacientes (8,8%). Mediante la prueba de chi cuadrado se obtuvo un valor de 116,3 de la relación auto-anticuerpos-patrones inmunofluorescencia, con un valor de p= 0,0000. El análisis de correspondencia demostró las siguientes asociaciones: a) anticuerpos antinucleares y patrón nucleolar (p=0,0021), anticuerpos antinucleares y patrón moteado grueso (p= 0,0123), anticuerpos anticentrómero y patrón centromérico (p= 0,0000), anticuerpos anticentrómero y patrón moteado fino (p= 0,0031), anticuerpos anti-topoisomerasa I y patrón homogéneo (p= 0,0001) y anticuerpos anti-ribonucleoproteína y patrón moteado grueso (p= 0,0000). Conclusiones: el perfil de autoanticuerpos en pacientes con esclerosis sistémica tiene una distribución similar a las publicaciones mundiales y relación es estadísticamente significativa con sus patrones inmunoelectroforéticos. (AU)

Introduction: Scleroderma is an autoimmune disease, systemic and mediated by genetic and environmental factors. One of its markers is the presence of autoantibodies with clinical value, diagnosis and prognosis. Subjects and methods: a descriptive, observational and relational study carried out in patients diagnosed with systemic sclerosis who were treated at the Rheumatology Unit of the Hospital Carlos Andrade Marín from June 2014 to May 2015. The data were processed by correspondence analysis and Chi square calculation in the package Statistic SPSS 22 version. Results: anti-topoisomerase antibodies were detected in 18 individuals (22.5%), anti-centromere (n=38, 47.5%), antinuclear antibodies (n=13, 16.3%), anti-ribonucleoprotein (n = 7, 8.8%) and without antibodies in 4 individuals (5%). As regards immune-electrophoretic patterns, the centromeric pattern was determined in 23 subjects (28.8%), fine and thick mottled (n = 17, 21.3% each), homogeneous (n = 8, 10%), nucleolar = 7, 8.8%) and cytoplasmic (n = 1, 1.3%); 7 patients (8.8%) were negative. The chi-square test yielded a value of 116.3 of the autoantibodies-immunofluorescence ratio, with a value of p=0.0000. Correspondence analysis showed the following associations: a) antinuclear antibodies and nucleolar pattern (p= 0.0021), antinuclear antibodies and thick speckle pattern (p=0.0123), anticentromere antibodies and centromeric pattern (p=0.0000) (p=0.0031), anti-topoisomerase I antibodies and homogeneous pattern (p=0.0001) and anti-ribonucleoprotein antibodies and thick speckle pattern (p=0.0000). Conclusion: The profile of autoantibodies in patients with systemic sclerosis has a similar distribution to global publications, and is statistically significant with his immune-electrophoretic patterns. (AU)

Esclerosis Sistémica en el Hospital Carlos Andrade Marín / Systemical sclerosis in Carlos Andrade Marin Hospital

Introducción: La esclerosis sistémica es una enfermedad crónica multisistémica, caracterizada por alteraciones vasculares, activación inmune y fibrosis de tejidos y órganos. Materiales y métodos: Estudio descriptivo. Pacientes con diagnóstico de Esclerosis Sistémica que cumplieron los criterios de clasificación ACR-EULAR 2013, atendidos en la Unidad de Reumatología del Hospital Carlos Andrade Marín durante el año 2015. Resultados: De 80 pacientes, 18 presentaron esclerosis sistémica en su forma CREST; 32 como CREST incompleto; 14 en la forma difusa; uno con esclerosis sistémica sin esclerosis cutánea; 13 con síndrome de superposición; y, 2 con EMTC. Discusión: Las características clínicas y epidemiológicas de nuestros pacientes coincidieron con las descritas a nivel internacional.

Introduction: Systemic sclerosis is a chronic multisystemic disease characterized by vascular disorders, immune activation, organ and tissue fibrosis. Methods: Descriptive study. Patients diagnosed with systemic sclerosis who met the criteria ACR- EULAR classification 2013, that receive medical care at Carlos Andrade Marín hospital. Results: Prevalence: From 80 patients,18 had systemic sclerosis, full CREST form; 32 had incomplete CREST form; 14 had a diffuse form; one had systemic sclerosis without cutaneous impairment; 13 had overlaping syndrome and two EMTC. Discusion: Clinical and epidemiological characteristics of our patients were consistent with those described in the medical literature.

Síndrome de Reynolds en Hospital Carlos Andrade Marín, serie de casos y revisión / Reynolds Syndrome in Carlos Andrade Marin Hospital: a series of cases and review

Introducción: El Síndrome de Reynolds es la asociación de esclerosis sistémica (SSC) con cirrosis biliar primaria (CBP). Descrito en 1934 por Milbradt y Reynolds en 1976 describió seis casos. Caso: Presentamos tres casos de mujeres atendidas en el Servicio de Reumatologìa del Hospital Carlos Andrade Marín, con patología hepática autoinmune y signos de esclerosis sistémica. El diagnóstico fue confirmado mediante biopsia hepática en dos de ellas y la prueba de fibromax en la restante. Discusión: Reconocer el Síndrome de Reynolds permite el diagnóstico temprano de cirrosis biliar primaria en pacientes con esclerosis sistémica y sospechar esta entidad en quienes padecen enfermedad hepática colestásica autoinmune que, muchas veces, coexisten en forma silenciosa. El diagnóstico oportuno permite intervenciones terapéuticas precoces que podrían mejorar el pronóstico de esta asociación.

Introduction: The Reynolds' syndrome is the combination of systemic sclerosis (SSC) and primary biliary cirrhosis (PBC). It was first described in 1934 by Milbradt. Reynolds in 1976 presented six cases in two of them and fibromax-test in another. Case report: We present three cases of three women treated in the Rheumatology department at Carlos Andrade Marin hosppital who had autoinmune liver disease confirmed by biopsy. Discusion: Recognizing Reynolds' Syndrome allow us to make earlier diagnosis. This autoimmune cholestatic liver disease often remains silent, so that their identification is a valuable diagnostic tool leading to therapeutic interventions.

Growth Inhibition of Some Phytopathogenic Bacteria by Cell-Free Extracts from Enterococcus sp.

Aims: To inhibit of bacterial growth of three important phyto-pathogenic bacteria: Erwinia carotovora, Clavibacter michiganensis sp. michiganensis and Xanthomonas axonopodis by cell-free extracts from submerged cultures of two strains of Enterococcus sp. was tested. Study Design: A complete randomized experimental design with factorial fix was used to evaluate the efficiency of growth inhibition against the phytopathogenic bacteria. Place and Duration of Study: Laboratory of Bioprocesses, Department of Food Science and Technology, School of Chemistry, Universidad Autonoma de Coahuila, Mexico, between December 2011 and July 2012. Methodology: Enterococci strains were isolated from goat milk, buttermilk and whey by typical microbiological procedures and primarily identified based on biochemical tests. Strains were subsequently activated in MRS broth and cells were separated by centrifugation and filtration. Cell-free extracts were tested against plant pathogenic bacteria to determine their growth inhibition potential. Results: Strains of Enterococcus MII-1 and MIV-2 were able to inhibit the growth of three pathogenic bacteria, demonstrating to be an attractive alternative for biological control assays. Conclusion: The cell-free extracts of Enterococcus spp. show inhibition potential to inhibit phytopathogenic bacteria that cause diseases in horticultural crops. Further studies are needed to completely evidence the high potential of use of cell-free extracts from Enterococcus MII-1 and MIV-2.

Efectos sobre factores ocupacionales y en el medio ambiente originados por el proceso de descarne a partir del curtido / Effects on occupational factors and environment as a result from rawhide process of the tanning

La ciudad de León cuenta con 500 empresas de curtiduría y 9 dedicadas al procesamiento del sebo cuyos subproductos (descarne) son desechos que se vierten al medio ambiente en grandes cantidades, ya que no representan un interés para su procesamiento y comercialización, lo que ha causado diversos problemas de contaminación en las zonas habitacionales circundantes por el vertido de aguas residuales, residuos sólidos y emisiones atmosféricas. El impacto al medio se puede considerar como adverso, directo y temporal; reversible, pero con un alto costo económico, lo que implica la necesidad de establecer medidas preventivas de control y mitigación. En el presente estudio se describen las etapas delproceso, las buenas y malas prácticas, los procedimientos estándares de operación y los impactos al medio ambiente originados por el inadecuado manejo de los residuos de las industrias sebaderas. Los resultados muestran que el 80 por ciento de las empresas procesadoras carece de sistemas de almacenamiento adecuado y no poseen sistemas de control ambiental. De igual manera, la mayoría de los operarios no cuenta con equipos de protección personal y no existe un adecuado manejo de sustancias utilizadas en los procesos, lo que incrementa el riesgo de accidentes laborales.

The city of León has 500 tannery companies and nine work in fat processing, whose by-product waste (rawhide) is dumped to the environment in tons because there is no interest in processing and commercializing this substance. This situation has caused several contamination problems in surrounding residential areas because ofthe discharge of wastewater, solid waste, and atmospheric emissions. Impact on environment can be considered as adverse, direct and temporal, as well reversible, but excessively expensive, which involvesthe need of established preventive measures of control and mitigation.The present study describes the different stages of the process, goodand bad practices, standard operational procedures, and environmentalimpacts due to the inadequate handling of waste by these companies. Results show that 80 percent of the processing companies lack appropriate storage systems and do not have an environmental control system. Additionally, most of the operators do not have personal protective equipment and there is not a proper handling of the substances used in processes; this increases the risk of work-related accidents.

El autoconcepto de mujeres sometidas a histerectomía / The women's selfconcept submitted to hysterectomy

Objetivo: el propósito del presente estudio fue comparar los puntajes del autoconcepto obtenidos por un grupo de mujeres antes y un año después de que fueron sometidas a histerectomía. Material y métodos: estudio prospectivo en el que participaron 44 mujeres de 30 a 60 años. Ninguna tenía antecedentes de trastornos psiquiátricos o de uso de fármacos antipsicóticos y/o antidepresivos. El autoconcepto de las mujeres se evaluó con la escala de Tennesse, que incluye una evaluación global y nueve sub-escalas específicas, y que ha sido previamente validado en población mexicana. Para analizar la información se elaboró un programa de computadora y los datos se analizaron con la prueba T para muestras dependientes. Resultados: la edad y escolaridad promedio y desviación estandar (X ± DE) de las participantes fue de 44,5 ± 6,9 y 5,8 ± 3,6 años respectivamente; 39 mujeres de las 44 completaron su evaluación un año después. La calificación global del autoconcepto disminuyó significativamente un año después de que se les practicó la histerectomía (642,3 ± 73,7 vs. 592,1 ± 34; p< 0,001). Ocho de las nueve subescalas también disminuyeron significativamente (p< 0,01). Conclusión: el autoconcepto y ocho sub-escalas de éste disminuyeron significativamente en este grupo de mujeres sometidas a histerectomía. El efecto que pudieran tener la ansiedad que produce la cirugía y el duelo provocado por la esterilidad se evitaron en este estudio al evaluar a las mujeres un año después del procedimiento. El efecto psicosocial de este tipo de cirugías debe considerarse en la preparación de las pacientes y de sus parejas.

Objective: the aim of this study was to compare the self-concept scores before and one year after hysterectomy, of a group of Mexican women. Methods: trought a prospective study, 44 female subjects from 30 to 60 years were evaluated using the Tennesse self-concept scale. Subjects were included if they did not have psychiatric diseases neither use antipsychotic / antidepressive drugs. A software was designed to analyze the information, and the scores of total and the nine individual profiles of self-concept were compared pre and post hysterectomy, using a dependent Student's T test. Results: the mean age and the schooling level of the volunteers were: 44.5 ± 6.9 years and 5.8 ± 3.6 (mean ± SD), respectively. From the 44 women evaluated in the pre-test, 39 complete the evaluation after one year of following. The mean values of the global self-concept scale decreased significantly (p< 0.001) from the beginning (642.3 ± 73.7) to one year after the hysterectomy (592.1 ± 34). The mean values of 8 from the 9 profiles, also decreased significantly (p< 0.01). Conclusion: hysterectomy decreases eight of the nine profiles of the self-concept of the women evaluated. The evaluation of the subjects self-concept one year after the hysterectomy, avoid the influence of grief by sterility or anxiety by the surgery itself. The decreases in the self-concept of a women submitted to hysterectomy should be considered in the clinical practice to prevent psychological effects.

Frecuencia de asma en preescolares con historia de maltrato y su relación con el tipo de maltrato experimentado / Frequency of asthma in preschool children with history of mistreatment and its relation with the type of mistreatment experienced

Introducción. La relación entre asma y maltrato infantil no está del todo clara. Objetivo: reconocer la presencia de asma en grupos de niños que padecieron formas diferentes de maltrato infantil. Métodos. Estudio de tipo retrospectivo que se basó en la revisión de expedientes de menores albergados en una casa cuna del estado de Guanajuato. Se utilizó la chi cuadrada y razón de momios para determinar la fuerza de la relación entre ambas variables y el aumento del riesgo de desarrollar asma después de haber padecido alguno de los tipos de maltrato. Resultados. Quienes experimentaron abandono ingresaron a más temprana edad al albergue (en su mayoría del género femenino), que posteriormente tuvieron mayor riesgo de ser diagnosticados con asma que los menores que padecieron otras formas de maltrato (razón de momios de 2.092 contra 0.549, respectivamente). Conclusiones. Los niños que fueron víctima de abandono tuvieron mayor probabilidad de desarrollar asma a diferencia de los que padecieron otros tipos de maltrato.

Introduction. The relation between asthma and child mistreatment is not absolutely clear. The objective was recognizing asthma in preschool children that suffered diverse forms of mistreatment. Methods. Retrospective study based on medical files revision of children sheltered in a foster house in Guanajuato. Chi square and odds ratio were used to assess the force of the association between both variables and the increase in the risk of developing asthma after suffering some type of mistreatment. Results. Those who experience abandonment were the youngest at his entrance to the foster house (mainly of the feminine gender), that later had a high risk being diagnosed with asthma compared with children who suffered other types of mistreatment (odds ratio 2.092 vs 0.549, respectively). Conclusions. Children that were victims of abandonment had a higher probability to develop asthma than other type of mistreatment victims.

Maltrato y suicidio infantil en el Estado de Guanajuato

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SUMMARY The understanding of child suicide has achieved more and more specific notions since it started to be studied from the theory of adult suicide. Now, the implication of certain factors such as the evolution of death conceptualization, the desire of joining an absent significant person, the premeditation of the suicidal act, the involvement of family environment as a contributing or protective factor, or a previous mistreatment experience, has become clearly recognized. Suicides which occur during the childhood period have been associated to previous sexual-nature abuse experiences. In adult suicides, the presence of some kind of mistreatment during their childhood period has also been found. Both phenomena, mistreatment and child suicide, are usually under-registered because of the variability of their defining approaches or because of some cultural influences such as violence occurring naturally or negation of child suicide or premeditation. It is postulated that the mechanics of child mistreatment traps the abuser into a dynamics based on the inequality of physical, intellectual and/or moral conditions; this reality plus the defenseless nature of children, impedes the termination of that situation unless it finishes by means of another violent act such, as a suicide. Furthermore, the consequences suffered by a child victim of mistreatment can become contributing factors for a suicidal behavior consummation. Consequently, dysfunctions or disturbances on cognitive, psychological, identity, belonging or hopelessness state of the victim, as well as the emotional pain caused by the mistreatment may favor a suicide behavior. Therefore, the purpose of this study is to determine the presence of any given type of child mistreatment in children (since eight to 14 years old) that incurred in a suicide in the State of Guanajuato between 1995 and 2001. The methodology used for this descriptive, observational, retrospective and transversal study, was ex-post-facto (after the event), since the technique for data gathering was carried out by psychological autopsy. This technique facilitates an access into the families and to the understanding of their dynamics, and also to recognizing the circumstances prior to the decease. This technique included one or several interviews with people close to deceased child, besides a detailed analysis of the suicidal event and of all the deceased child's residual belongings (suicide notes in this case). This study searched some direct and indirect indicators of a possible child mistreatment suffered by suicidal children. The psychological autopsy was conformed by a Questionnaire of Psychosocial data, a Suicidal Act Evaluation Questionnaire and by an Informant's Reliability Scale. Because of the lack of specific backgrounds for the cases of child suicide, the Psychological Questionnaire was specifically developed for this study. Studied cases were those belonging to child suicides, up to 14-year-old children, who consummated their death in the State of Guanajuato in the 1995 to 2001 period. The files were obtained by the General Attorney Department. With the information extracted from such files, we proceeded to establish phone and mail contact with relatives of the deceased children. Later on, some interviews were carried out with one or more people close to each child; these interviews were held by psychologists qualified in Psychological Autopsy and Emotional Contention Techniques. The examined data came basically from the Psycho-Social Questionnaire and from the Content Analysis of suicide notes. The analysis method for first data, of quantitative nature, was by frequency distribution and correlation, computed by SPSS statistical software. Qualitative data resulting from the analysis of suicide notes content were verified by a technical jury integrated by three participating clinical psychologists. Results: Twenty nine suicide cases were analyzed, representing 69% of child suicides up to 14-year-old children in the State of Guanajuato within the aforementioned period. The rest of the files were not included in this research because the impossibility for locating the victim's relatives due to changes of residence, and in a lower percentage because they refused to participate in the study due to the emotional pain of talking about the suicide event, or because they ignored the minor child's data regarding the circumstances and causes of his death. Of all the examined cases, 19 (65.5%) were men and 10 (34.5%) were women. The range of child suicides' age was from eight to 14 years old, with a 12.55 year-old average and a 1.62 year-old standard deviation. Five suicide notes were analyzed, which belonged to 4 children: 3 girls (one of them left two notes) and one boy. With respect to 72.4% of the cases, the interviewed persons were first-degree relatives and regarding the remaining percentage, they were cousins, uncles or grandparents who reported having had a close relationship with the deceased child. The average age of the interviewees was 43 years, with a standard deviation age of 17.19 years. In almost half of the suicides (51.7%) some kind of violence was suffered. According to the interviewees' statements, 31% of the children who committed suicide had suffered some kind of psychological mistreatment, 41.1% of them had received some of kind of physical mistreatment, 3.4% were victims of sexual abuse and 10.34% were neglected. Almost a quarter of all the children had suffered two or three kinds of mistreatment. Additionally, 41.4% of suicidal children had seen physical violence at home. Four of the suicide notes included explicit declarations of mistreatment experiences. Other variables that were found were the presence of previous suicide attempts in 20.7% of the cases; and a 26.3% of cases where a relative also had a previous suicide attempt. Family alcohol consumption was detected in 65.5% and drug consumption in 24% of the cases. Further analysis show a correlation between child previous suicide attempts and psychological mistreatment (p= 0.004) or any other kind of violence exposure (p= 0.015). It is concluded that an important percentage of children who incurred in a suicide were indeed victims of some kind of child mistreatment, of which physical one was particularly evident. However, neither physical nor sexual abuse can be separated from their implicit component: the emotional mistreatment. Studies of pure qualitative nature could contribute with more information about the dynamics that associates both phenomena. It is deemed that child mistreatment prevention would directly impact both suicide occurrence for the same group of age, and probably also within adult populations thus reducing its prevalence.

Diagnóstico y manejo de las complicaciones de la cirrosis hepática / Diagnosis and management of hepatic cirrhosis complications

La cirrosis hepática es una patología frecuentemente que reconoce varias etiologías, siendo la más frecuente el consumo de alcohol. Independiente de su casa, su presentación clínica y sus complicaciones son similares y responsables de varios cuadros clínicos que provocan un deterioro de la calidad de vida del paciente, motivando su hospitalización y disminuyendo su sobrevida. El diagnóstico y manejo de las principales complicaciones de la cirrosis hepática ha progresado bastante, mejorando las perspectivas de vida los pacientes que las sufren. En el presente trabajo se presenta una revisión bibliográfica de los avances en el diagnóstico y manejo de las complicaciones de la cirrosis; el diagnóstico y tratamiento según la evidencia disponible.

Displasia neuronal intestinal como causa de constipación crónica pertinaz en adultos / Neuronal intestinal dysplasia causing severe constipation. Report of two cases

Las disganglionosis son anomalías de la inervación del tubo digestivo, identificables con técnicas de inmunohistoquímica (IHQ), distintas de la enfermedad de Hirschsprung. En un estudio prospectivo de pacientes adultos portadores de una constipación crónica pertinaz (CCP), se diagnosticaron dos casos de displasia neuronal (DNI) o hiperganglionosis, motivo de esta presentación. Se complementó el estudio inicial de hematoxilina-eosina con técnicas de IHQ, utilizando anticuerpos contra la proteina S-100 y la enolasa neuronal específica. Se trata de 2 mujeres jóvenes con una constipación refractaria con un enema baritado de doble contraste y manometría anorrectal normales. El tiempo de tránsito colónico mostró un patrón de inercia colónica en ambos casos. Una paciente fue sometida a una esfinteromiectomía anorrectal y la otra a una colectomía total más esfinteromiectomía anorrectal. El control alejado de ambos casos muestra resultados funcionales satisfactorios con un hábito defecatorio normal sin disturbios de la continencia. El estudio de los casos con técnicas de IHQ permitieron re-clasificar el primer caso como una DNI tipo B y al segundo como una Disganglionosis no clasificable. Los criterios histopatológicos diagnósticos de la DNI tipo B no son aceptados universalmente y su correlación con los síntomas es débil. Los estudios en población pediátrica con CCP muestran una prevalencia muy variable y no es seguro que esta información pueda extrapolarse a pacientes adultos. Se concluye que el diagnóstico de DNI tipo B en adultos es complejo y no existe información suficiente para establecer su relevancia en la práctica clínica y, por tanto, el rol de la cirugía en el manejo de esta condición.

Neuronal intestinal dysplasia is an abnormality of intestinal innervation, different from Hirschprung disease, that can be recognized with immunohistochemical techniques. We report two female patients with this disease, aged both 31 years, that had a severe constipation. Barium enema and anorectal manometry were normal. Colonic transit time showed a pattern of colonic inertia in both. One patient was subjected to an anorectal sphincter myomectomy and the other, to a colectomy plus anorectal sphincter myomectomy. Long term follow up showed satisfactory results with normal intestinal habit and without incontinence. Immunohistochemical study of the surgical piece classified the first patient as a type B neuronal intestinal dysplasia and the second patient as a non classifiable neuronal intestinal dysplasia. The pathological criteria for the diagnosis of type B neuronal intestinal dysplasia are not universally accepted and the correlation with symptoms is weak. Therefore the diagnosis of this type of dysplasia is complex and the role of surgical treatment is not completely clear.

Movilización comunitaria para la salud: diálogo multidisciplinario / Community movilization for health: multidisciplinary dialogue

Los autores aportan innovadoras y provocativas conceptualizaciones sobre la salud, la comunidad, la cultura y los derechos humanos. También lo hacen sobre la perspectiva de género, el impacto de la globalización en la acción para el desarrollo y el papel de la comunicación educativa en la movilización comunitaria para la salud

La escuela en tiempos de guerra: una mirada a la educación desde la crisis y la violencia / School in times of war: a look to education from crisis and violence

Diagnostica las deficiencias de la escuela peruana acrecentadas por la violencia y propone al magisterio nacional y a la sociedad civil soluciones democráticas, participativas, opuestas al autoritarismo ideológico, al centralismo esterilizante y a todo intento a vender adoctrinamiento por educación. Propone recobrar no sólo el espacio educativo sino usarlo para el desarrollo humano

Tratamiento de fracturas tardías conminutas del tercio proximal del fémur en pacientes con artroplastía total de cadera / Late comminute fractures of the proximal end of the femur after total hip arthroplasty

Se revisa la literatura referente al aflojamiento de prótesis cementadas, lo cual es el primer paso para que suceda una fractura del fémur alrededor del vástago de la prótesis, y especfíficamente el tratamiento de dichas fracturas, dentro del cual se incluyen a las prótesis no cementadas, y de ellas, la llamada isoelástica que permite la fijación interfragmentaria de la fractura, a través del vástago de la prótesis. Se presentan dos casos tratados de esta manera, estudiados dos años despúes de la operación reconstructiva. Ambas fracturas conminutas, helicoidales alrededor del vástago de la prótesis. Uno de los enfermos ya había sido revisado por aflojamiento del componente femoral, ocho años antes de la fractura. El otro había sido intervenido nueve años antes, por proceso degenerativo. En ambos casos el fenómeno que ocasionó la fractura fue un esfuerzo pequeño. El tercer caso corresponde a una fractura ocasionada por impacto importante durante un accidente automovilístico, tratado con prótesis cementada de vástago largo, y con un periodo de 10 años de evolución. Se discute el fenómeno de resorción ósea con las prótesis cementadas y sus complicaciones, así como el comportamiento de las prótesis no cementadas, haciendo una revisión de la literatura para ambos procedimientos.