Valoración antropométrica de escolares del área de salud de La Mancha-Centro. Comparación con el Estudio Transversal Español de Crecimiento 2010 / Anthropometric assessment of schoolchildren from the La Mancha-Centro health area. Comparison with the Spanish Cross-Sectional Growth Study 2010

Resumen Objetivos: Determinar peso, talla e índice de masa corporal (IMC) de escolares del área de salud La Mancha-Centro y compararlos con los definidos en el Estudio Transversal Español de Crecimiento 2010 (ETEC-2010). Métodos: Estudio transversal de 954 escolares entre 6 y 12 años. Se obtuvieron media, desviación estándar y distribuciones percentilares de peso, talla e IMC por sexo y edad. Se analizaron las diferencias en cada grupo semestral de edad. Resultados: Existió incremento progresivo del IMC con la edad, significativo en las niñas a partir de los nueve años y en los niños desde los 8.5 años. Desde los 10 años, el IMC promedio resultó 2.3 kg/m2 superior al de edades menores (p < 0.001); la mayor diferencia entre los sexos ocurrió a los 12 años: 2 ± 0.98 kg/m2 más en los varones (p = 0.042). Globalmente no se hallaron diferencias significativas de peso, talla e IMC con el ETEC-2010, aunque el peso medio de los niños manchegos de 8.5 a 11.5 años fue 3.9 kg mayor que el del resto de los niños españoles. Conclusiones: Los parámetros antropométricos de los escolares manchegos no difieren de los estándares nacionales; sin embargo, los varones preadolescentes manchegos pesan casi 4 kg más.

Abstract Objectives: To determine weight, height and body mass index (BMI) of schoolchildren from the La Mancha-Centro health area and compare them with those determined by the Spanish Cross-sectional Growth Study 2010 (SCGS-2010). Methods: Cross-sectional study of 954 schoolchildren aged 6-12 years. Mean, standard deviation, and percentile distributions of weight, height, and BMI by gender and age were obtained. Differences in each 6-month age group were analyzed. Results: There was a progressive increase in BMI with age, which was significant in girls from nine years of age on and in boys from 8.5 years on. From age 10, average BMI was 2.3 kg/m2 higher than at younger ages (p < 0.001). The biggest difference between genders occurred at age 12: 2 ± 0.98 kg/m2 higher in boys (p = 0.042). Overall, no significant differences were found in weight, height and BMI vs. SCGS-2010, although mean weight of male children from La Mancha-Centro aged between 8.5 and 11.5 years was 3.9 kg higher than that of the rest of Spanish male children. Conclusions: Anthropometric parameters of schoolchildren from La Mancha-Centro do not significantly differ from national standards; however, preadolescent males from La Mancha-Centro weigh almost 4 kg more.

The perception and management of emotions in nursing students under clinical training / La percepción y la gestión de las emociones en los estudiantes de enfermería en formación clínica

BACKGROUND: Patient care must be understood holistically and to achieve this goal, nurses must be aware and familiar with the world of emotions. Poor handling of emotions by nursing professionals can affect their health, also leading to lower-quality care. Therefore, it is important to explore the management of their emotions before becoming a nurse. PURPOSE: To evaluate Perceived Emotional Intelligence in 3rd- year nursing students in an academic context and in clinical practicum. METHODOLOGY: Longitudinal and prospective design. The Trait Meta-Mood Scale-24 was used at three different moments, the first two corresponding to the academic context and the third to the clinical practice context, the age variable was also analyzed. RESULTS: 40 students of an average age (24.81±1.164 years old). Perception and Emotional Regulation were found to be different according to the learning context. Students over the age of 25 years old were also found to perceive their emotions better, but to understand them worse. CONCLUSIONS: Nursing students' perception of their own emotions may vary in function of their learning context, with age being a factor that has an influence on the management of emotions. Implications: In the design of the nursing program it's important to include managing emotions and to choose when to do so.

Rehabilitación física en pacientes con artropatía hemofílica: revisión sistemática y metaanálisis sobre dolor / Physical rehabilitation in haemophilic arthropathy: systematic review and pain-related meta-analysis

RESUMEN Introducción: La artropatía hemofílica (AH) cursa con diferentes manifestaciones clínicas importantes, como son las hemorragias articulares, el dolor, la disminución de la amplitud del movimiento y las alteraciones funcionales que pueden causar secuelas en la funciona lidad y movilidad. El ejercicio físico adaptado a los pacientes con hemofilia puede ser una adecuada estrategia terapéutica, que repercuta positivamente sobre la calidad de vida de dichos sujetos. Objetivos: Evaluar la eficacia de la rehabilitación física en el tratamiento de la artropatía hemofílica. Materiales y métodos: Se ha realizado una revisión sistemática y metaánálisis de ensayos clí nicos (seleccionados según criterios de elegibilidad). Para ello, se han utilizado las siguientes bases de datos: PEDro, Pubmed, Scopus y Web of Science. Se empleó la escala «PEDro¼ para evaluar la calidad metodológica de los estudios. Resultados: Tras aplicar los criterios de inclusión y exclusión, en la revisión final fueron incluidos siete artículos, los cuales aportaron resultados favorables sobre la fuerza y el diá metro muscular, el rango de movilidad, el estado articular y la calidad de vida. De ellos, dos estudios aportaron datos para metaanálisis, con resultados favorables sobre la variable dolor [Diferencia de medias estandarizada (DME) = -2,64; IC 95%: (-4,26; 1,03)]. Conclusiones: Se encontró evidencia sobre la eficacia de la rehabilitación física en el trata miento de la artropatía hemofílica. El ejercicio terapéutico (ET) es el principal tratamiento realizado; con este se obtuvieron mejoras significativas en distintas variables físicas.

ABSTRACT Introduction: Haemophilic arthropathy presents with different important clinical disorders, such as joint disease, pain, decreased range of motion, and functional alterations that can produce limitations in functionality and mobility. The physical exercise adapted to patients with haemophilia can be an adequate therapeutic strategy, having a positive impact on the quality of life of these subjects. Objectives: To identify the published clinical trials that evaluate the efficacy of physical rehabilitation in the treatment of haemophilic arthropathy. Materials and methods: A systematic review and meta-analysis of clinical trials was con ducted (using pre-defined eligibility criteria). The literature search was performed in the databases: PEDro, Pubmed, Scopus, and Web of Science. The quality of the methods used in the studies was evaluated using the PEDro scale. Results: After applying the inclusion and exclusion criteria, 7 studies were included in this review, providing favourable results on muscle strength and circumference, range of motion, joint disease, and quality of life. Moreover, 2 articles contributed information to the meta-analysis, showing favourable results on pain [Standardised mean difference (SMD) = -2.64; 95% CI: (-4.26; 1.03)]. Conclusions: This systematic review found evidence on the efficacy of physical rehabilitation in the treatment for haemophilic arthropathy. Therapeutic exercise is the main treatment carried out, obtaining significant improvements in the different physical outcomes.

Prevalencia de bocio y yodo-deficiencia en embarazadas indígenas de cinco áreas no metropolitanas de Colombia 2019 / Prevalence of goiter and iodine deficiency in indigenous pregnant women from five non-metropolitan areas of Colombia 2019

RESUMEN Objetivo: evaluar la prevalencia de yodo deficiencia y de bocio en mujeres indígenas gestantes de cinco áreas no metropolitanas en Colombia. Materiales y métodos: estudio de corte transversal descriptivo. Se incluyeron mujeres embarazadas de cualquier edad gestacional sin condiciones patológicas del embarazo, atendidas en los centros de salud comunitarios o en sus residencias. Se excluyeron aquellas con comorbilidades presentes al momento del embarazo y también a quienes recibían suplementos con yodo. Muestreo aleatorio simple. Se midieron las características sociodemográficas y obstétricas, la concentración de yodo en orina y la presencia de bocio de acuerdo a la metodología de la Organización Mundial de la Salud. Se realizó un análisis descriptivo. Resultados: 189 gestantes indígenas fueron candidatas a ingresar al estudio, de las cuales 2 no aceptaron participar y 62 tenían criterios de exclusión, finalmente se analizaron 125. La concentración urinaria de yodo tuvo una mediana de 184,4 µg/L (min-max: 12,0-390,0). Un total de 42 gestantes (33,6%) tenían yodo deficiencia (< 100 µg/L) y se evidenció bocio (grado 1-2) en 43 (34,4%). No se identificó bocio grados 3 o 4. Conclusiones: embarazadas indígenas residentes en áreas no metropolitanas evidenciaron alta prevalencia de bocio y yodo deficiencia. Se requiere evaluar los efectos materno-perinatales e implementar intervenciones nutricionales.

ABSTRACT Objective: To assess the prevalence of goiter and iodine deficiency in indigenous pregnant women coming from five non-metropolitan areas in Colombia. Materials and methods: Descriptive cross-sectional cohort study that included pregnant women of any gestational age with no pregnancy-related conditions, seen in community health centers or in their homes. Patients with comorbidities at the time of pregnancy and those who were receiving iodine supplementation were excluded. Simple random sampling was used. The sociodemographic and obstetric characteristics, urinary iodine concentration and the presence of goiter were measured in accordance with the World Health Organization methodology. A descriptive analysis was performed. Results: Of 189 indigenous pregnant women who were candidates to enter the study, 2 declined participation, and 62 had exclusion criteria, and 125 were included in the final analysis. The mean urinary iodine concentration was 184.4 µg/L (min-max: 12.0-390.0). A total of 42 women (33.6%) had iodine deficiency (< 100 µg/L), and goiter (grade 1-2) was found in 43 (34.4%). No grade 3 or 4 goiter was identified. Conclusions: A high prevalence of goiter and iodine deficiency was found in indigenous pregnant women living in non-metropolitan areas. There is a need to assess maternal and perinatal effects and to implement nutritional interventions.

Eficacia de una intervención educativa para mejorar el conocimiento de las/os enfermeras/os sobre el sondaje gástrico en pediatría / Effectiveness of an educational intervention to improve nurses' knowledge on pediatric nasogastric intubation

Objetivo. Eficacia de una intervención educativa para mejorar el conocimiento de las/os enfermeras/os sobre el sondaje gástrico en pediatría. Métodos. Estudio multicéntrico cuasi experimental pre- y postest mediante intervención educativa teórica basada en la evidencia bibliográfica y la evaluación de su eficacia a los 4 meses. Resultados. Cuestionarios entregados: 1019. Válidos: 557 (54,66 %) pretest, 246 (24,14 %) postest. Las respuestas pre- y postest fueron que el riesgo implícito que conllevaba siempre el procedimiento había sido percibido por el 53,2 % y aumentó al 70,7 % (p < 0,001). El 4,3 % elegía el tamaño de la sonda gástrica (SG) mediante tablas y se elevó al 24,6 % (p < 0,001). La longitud de la SG por introducir medida mediante el método nariz-oreja-distancia media xifoides-ombligo (nose-ear-mid-umbilicus; NEMU, por sus siglas en inglés) ascendió del 34,2 % al 81,3 % (p < 0,001). La comprobación de la ubicación de la SG previa a su uso pasó del 73,1 % al 86,5 % (p < 0,001). La comprobación de los cinco correctos (paciente, medicamento, dosis, vía y hora) previa a la utilización de la SG aumentó del 85,6 % al 91 %. Como métodos de comprobación, mejoró la percepción de inseguridad de la auscultación del 11,7 % al 31,1 % (p < 0,001), y disminuyó su uso del 95,1 % al 81,6 %. Creció la percepción de seguridad de la medición del pH gástrico del 71,3 % al 91,1 % (p < 0,001), y aumentó su uso del 7,6 % al 54,3 % (p < 0,001). Conclusiones. La intervención educativa resultó eficaz para incrementar el conocimiento de enfermería sobre el sondaje gástrico pediátrico.

Objective. To establish the effectiveness of an educational intervention to improve nurses' knowledge on pediatric nasogastric intubation. Methods. Multicenter, quasi-experimental, pre- and post-test study using a theoretical educational intervention based on bibliographic evidence and assessment of its effectiveness after 4 months. Results. Delivered questionnaires: 1019. Valid questionnaires: 557 (54.66 %) pre-test and 246 (24.14 %) post-test. Pre- and post-test answers indicated that the implied risk always entailed by the procedure had been perceived by 53.2 % and then increased to 70.7 % (p < 0.001). Nasogastric (NG) tube size was chosen using tables by 4.3 % of participants, and increased to 24.6 % (p < 0.001). The length of NG tube to be inserted as measured by the nose-ear-midumbilicus distance (NEMU) method increased from 34.2 % to 81.3 % (p < 0.001). Confirmation of NG tube placement prior to use increased from 73.1 % to 86.5 % (p < 0.001). Confirmation of the five rights (patient, drug, dosage, route, and timing) prior to NG tube use increased from 85.6 % to 91 %. In relation to confirmation methods, the perception that auscultation was unsafe improved from 11.7 % to 31.1 % (p < 0.001), and its use reduced from 95.1 % to 81.6 %. The perception that the measurement of gastric pH was safe increased from 71.3 % to 91.1 % (p < 0.001), and its use rose from 7.6 % to 54.3 % (p < 0.001). Conclusions. The educational intervention was effective to increase nurses' knowledge on pediatric nasogastric intubation.

Hipercalcemia paraneoplásica de carcinoma anaplásico da tireoide / Paraneoplastic hypercalcemia of anaplastic thyroid carcinoma: case report

A hipercalcemia deve ser considerada no diagnóstico diferencial de alterações neuropsiquiátricas agudas. Em 90% dos casos, a etiologia corresponde a hiperparatireoidismo primário ou neoplasias. Valores séricos superiores a 14mg/dL e sintomáticos são frequentemente tradutores de causa maligna. O carcinoma anaplásico da tireoide consiste em um tumor indiferenciado, com progressão rápida e prognóstico reservado, que evolui, em alguns casos, a partir de lesões tireóideas preexistentes, benignas ou malignas (desdiferenciação). Embora a apresentação clínica mais frequente destes tumores consista no desenvolvimento de massa cervical, eles podem ser diagnosticados no esclarecimento etiológico de metástases ou síndromes paraneoplásicos. A hipercalcemia, associada à neoplasia, pode ocorrer em contexto de metástases ósseas, com libertação de citocinas, ou por mecanismo humoral, mediada pela proteína relacionada ao hormônio hormônio paratireóideo (PTHrP). Os autores descrevem o caso de uma mulher de 85 anos, com antecedentes de bócio multinodular benigno, internada para esclarecimento etiológico de hipercalcemia grave, com manifestações neuropsiquiátricas, diagnosticando-se, após avaliação, carcinoma anaplásico da tireoide. O caso foi abordado em reunião multidisciplinar, optando-se por limitação terapêutica a cuidados paliativos. A doente faleceu 3 meses após o diagnóstico.(AU)

Hypercalcaemia should be considered in the differential diagnosis of acute neuropsychiatric disorders. In 90% of the cases, the etiology corresponds to primary hyperparathyroidism or neoplasms. Serum values above 14mg/dL and symptomatic are often indicative of a malignant cause. The anaplastic thyroid carcinoma consists of an undifferentiated tumor, with rapid progression and poor prognosis, which in some cases progresses from pre-existing benign or malignant thyroid diseases (dedifferentiation). Although the most frequent clinical presentation of these tumors consists of the development of a cervical mass, they can be diagnosed in the etiological clarification of metastases or paraneoplastic syndromes. Neoplasm-associated hypercalcaemia may occur in the context of bone metastasis, with release of cytokines, or through a humoral mechanism, mediated by the parathyroid hormone (PTHrP)-related protein. The authors describe the case of an 85-year-old woman with a history of multinodular benign goiter, hospitalized for etiological elucidation of severe hypercalcaemia with neuropsychiatric manifestations, with a final diagnosis of anaplastic thyroid carcinoma, after the diagnostic evaluation. The case was approached in a multidisciplinary meeting, and the therapeutic limitation to palliative care was chosen. The patient died 3 months after the diagnosis.(AU)

Clozapine-induced myocarditis in observational cross-sectional and follow-up evaluations: comparison with other antipsychotics in naturalistic settings / Miocarditis inducida por clozapina durante la evaluación observacional, transversal y longitudinal: comparación con otros antipsicóticos en ambientes naturalísticos

Myocarditis occurs more frequently during clozapine (CLZ) administration than during treatment with other antipsychotic drugs (APs). In this observational study, we transversally screened outpatients for myocarditis by comparing a CLZ group of 132 subjects, with a non-CLZ group taking other APs (n = 371) only, and in 21 CLZ-treated patients and 18 subjects treated with other APs who had been followed for more than one year. The protocol included a) assessment of symptoms such as dyspnea, tachycardia, chest discomfort, fever, cough, and edema, b) blood pressure and heart auscultation; c) a standard electrocardiogram after a 5-minute rest, d) white cell count, and qualitative determination of troponin I, creatine-kinase-MB and myoglobin, and e) a cardiologist evaluation of subjects with suspected myocarditis. Only one case of myocarditis was detected, providing an approximation of the frequency of myocarditis of 1.6% in the first month of treatment. This was a 30-year-old man with schizophrenia who developed symptoms at day 6 after starting a treatment with 200 mg of CLZ a day without titration. Myocarditis was not observed during prolonged CLZ or other AP administration. These results support the proposal of starting CLZ treatment with a low dose and the feasibility of a simple protocol for myocarditis detection in psychiatry primary care.

El desarrollo de miocarditis ocurre con más frecuencia durante el tratamiento con clozapina (CLZ) que durante el uso de otros antipsicóticos (APs). En el presente estudio observacional evaluamos la presencia de miocarditis mediante un protocolo transversal comparando 132 sujetos tratados con CLZ con 371 pacientes tratados con otro AP, y en 21 sujetos tratados con CLZ y 18 pacientes tratados con otro AP en un protocolo longitudinal mayor 1 año de duración. La evaluación incluyó: a) detección de síntomas como disnea, taquicardia, malestar torácico, fiebre, tos y edema; b) presión arterial y auscultación cardiaca; c) electrocardiograma estándar luego de un reposo de 5 minutos; d) contaje de glóbulos blancos y determinación cualitativa de troponina I, creatin-kinasa-MB y mioglobina, y e) evaluación por un cardiólogo en sujetos sospechosos para miocarditis. Detectamos un solo caso de miocarditis, lo que permite una aproximación sobre la frecuencia de miocarditis de 1,6 % durante el primer mes de tratamiento. Se trató de un sujeto masculino con esquizofrenia que desarrolló síntomas durante el día 6 después de haber iniciado el tratamiento con CLZ a la dosis de 200 mg por día sin titulación. No se detectaron sujetos sospechosos de miocarditis durante el tratamiento prolongado con CLZ u otro AP. Estos resultados sustentan la recomendación de comenzar el tratamiento con clozapina a dosis bajas, y la factibilidad de utilizar un protocolo sencillo para detectar miocarditis en la atención psiquiátrica primaria.

Aplasia medular transitória associada a infecção por parvovírus B19 / Transient aplastic crisis caused by Parvovirus B19 infection

O parvovírus B19 é um eritrovírus humano com tropismo para as células progenitoras da medula óssea, sendo responsável por um grande espectro de manifestações clínicas, desde infecções assintomáticas até crises aplásicas graves. Os autores apresentam o caso de uma mulher de 40 anos, com história de anemia ferropênica por menorragias, que desenvolveu quadro clínico com febre, cefaleias, petéquias e, osteriormente, exantema nas pernas, associado à hipoplasia medular com redução transitória da contagem de todas as linhagens celulares hematológicas. A suspeita de infecção aguda por parvovírus B19 foi confirmada pela detecção de anticorpos IgM antiparvovírus B19 no sangue periférico, por meio de teste imunoenzimático (ELISA). Os achados do mielograma no 5o dia após a admissão, apesar de haver ainda tão só recuperação parcial das linhagens celulares hematológicas no sangue periférico, revelaram linhagens celulares medulares normais. A paciente teve recuperação espontânea, apenas com terapêutica de suporte.

Parvovirus B19 is a human erythrovirus with tropism for erythroid progenitor cells. It is responsible for a wide range of clinical manifestations, from asymptomatic infections to severe aplastic crises. The authors present the case of a 40 year-old female patient with history of iron-deficiency anemia from menorrhagia who presented with fever, headache, petechiae,and later,rash on lower limbs, associated with medullary hypoplasia and transient decrease of all hematologic cell lines.The suspicion of acute Parvovirus B19 infection was confirmed by the detection of anti-Parvovirus B19 IgM antibodies through Enzyme-Linked Immunosorbent Assay (ELISA). Although there was only partial recovery of the hematologic cell lineage in peripheral blood, findings on myelogram 5 days after admission showed normal hematopoietic cell lines. The patient had spontaneous recovery only with supportive treatment.

Metabolic syndrome and related variables, insulin resistance, leptin levels, and PPAR-γ2 and leptin gene polymorphisms in a pedigree of subjects with bipolar disorder

Objective: Evidence points to a high prevalence of metabolic dysfunction in bipolar disorder (BD), but few studies have evaluated the relatives of subjects with BD. We conducted a cross-sectional study in an extended family of patients with BD type I. Methods: The available relatives of the same family were interviewed (DSM-IV-R) and assessed in fasting conditions for body mass index, constituent variables of the metabolic syndrome (MS), leptin levels, insulin resistance index, and single nucleotide polymorphisms (SNPs) for the leptin receptor and promoter and PPAR-γ2 genes. The frequency of MS was compared with that recorded in the local general population. Results: Ninety-three relatives of three adults with BD were evaluated (30 aged < 18 years, 63 aged > 18 years). The frequency of MS was similar to that of the general population. Significantly higher frequencies of abnormal glucose, total and low density cholesterol (LDL-c) levels (all p < 0.05), waist circumference (p = 0.057), and leptin and insulin resistance values (in adults only) were observed in the family. Adults with the QQ genotype of the leptin receptor displayed higher LDL-c levels than carriers of the R allele. Conclusions: The associations among BD consanguinity, familial hypercholesterolemia, and leptin receptor SNPs reported herein should be replicated and extended in other pedigrees. .

Predictores de recurrencia de sangrado en pacientes con hemorragia digestiva alta no variceal / Predictors of bleending recurrence in patients with non-varicose upper gastrointestinal bleeding

Introducción: La tasa de resangrado en hemorragia digestiva alta no variceal continúa siendo elevada. Objetivo: identificar los predictores de falla terapéutica endoscópica en adultos con hemorragia digestiva alta recurrente no variceal atendidos en el Hospital Universitario de Maracaibo entre enero, 2006 y diciembre, 2010 que ameritaron una segunda endoscopia. Materiales y Métodos: estudio retrospectivo y transversal. La muestra fue dividida en grupo A (resangró) y B (no resangró). Resultados: del total de 380 casos que recibieron terapia inicial, 271 úlceras (71,3% p<0,0001) representaron el tipo de lesión más frecuente, correspondiendo con los 24 casos que resangraron (6,31%). Las lesiones que resangraron se ubicaron en segunda porción de duodeno (20,8%), fundus gástrico (16,6%) y cara posterior de bulbo duodenal (12,5%). De éstas, 11 fueron úlceras (54,5% duodenales vs 45,4% gástricas), tipo Forrest IA, IB y IIA (p<0,03), con vaso expuesto >2mm (media 5mm, DE±3mm). Conclusión: los predictores de falla terapéutica endoscópica (úlcera ≥2cms, ubicación en cara posterior de bulbo duodenal, Forrest IA, IB y IIA, y terapia endoscópica aplicada durante el primer episodio de sangrado) contribuyen de manera independiente al aumento del riesgo del resangrado.

Introduction: Rebleeding’s rate in non-variceal upper gastrointestinal bleeding remains high. Aim: Identify predictors of endoscopic therapy failure in adult patients with recurrent non-variceal upper gastrointestinal bleeding treated at the Hospital Universitario de Maracaibo between January, 2006 and December, 2010 that required a second endoscopy. Methods: a retrospective and cross sectional study. The sample was divided into Group A (with rebleeding) and Group B (without rebleeding). Results: of the 380 cases who received therapy during the first endoscopy, 271 ulcers (71,3% p <0,0001) represented the most frequent type of injury, being consistent with the 24 cases that rebleed (6,31%). Rebleeding lesions were located in second portion of duodenum (20,8%), gastric fundus (16,6%) and posterior duodenal bulb (12,5%). Meanwhile, the rebleeding ulcers (n=11), were duodenal 54,5% vs gastric 45,4%, classified as Forrest IA, IB and IIA (p <0,03), with exposed vessel >2mm. Conclusions: the predictors of endoscopic therapy failure in our location are similar to those established (ulcer size ≥2cms, placed on posterior duodenal bulb, Forrest IA, IB and IIA, and endoscopic therapy applied during the first episode) and contribute independently to increased risk of rebleeding despite applying the recommended therapeutic.

Profile resistance of pathogens causing urinary tract infection in the pediatric population, and antibiotic treatment response, at a University Hospital 2010-2011 / Perfil de resistencia de los patógenos causantes de infección urinaria en la población pediátrica y respuesta al tratamiento antibiótico, en un hospital universitario 2010-2011

Abstract Background: Urinary tract infection (UTI) is one of the most common bacterial infections in childhood and causes acute and chronic morbidity as hypertension and chronic kidney disease. Objectives: To describe the demographic characteristics, infectious agent, antibiotic resistance patterns and empiric therapy response of UTI in pediatric population. Methods: This is a descriptive, retrospective study. Results: Were included 144 patients, 1:2.06 male to female ratio. The most common symptom was fever (79.9%) and 31.3% had history of previous UTI. 72.0% of the patients had positive urine leukocyte count (>5 per field), urine gram was positive in 85.0% of samples and gram negative bacilli accounted for 77.8% for the total pathogens isolated. The most frequent uropathogens isolated were Escherichia coli and Klebsiella pneumoniae. Our E.coli isolates had a susceptibility rate higher than 90% to most of the antibiotics used, but a resistance rate of 42.6% to TMP SMX and 45.5% to ampicillin sulbactam. 6.3% of E. coli was extended-spectrum beta-lactamases producer strains. The most frequent empirical antibiotic used was amikacin, used in 66.0% of the patients. 17 of 90 patients who undergone voiding cistouretrography (VCUG) had vesicoureteral reflux. Conclusion: This study revealed that E. coli was the most frequent pathogen of community acquired UTI. We found that E. coli and other uropathogens had a high resistance rate against TMP SMX and ampicillin sulbactam. In order to ensure a successful empirical treatment, protocols should be based on local epidemiology and susceptibility rates.

Resumen Antecedentes: La infección del tracto urinario (ITU) es una de las infecciones bacterianas más frecuentes en la infancia, se asocia con alta morbilidad aguda y de enfermedades a largo plazo como hipertensión arterial e insuficiencia renal crónica. Objetivo: Describir las características demográficas, agente etiológico, perfil de sensibilidad y respuesta al tratamiento empírico de una población pediátrica. Métodos: Estudio descriptivo, retrospectivo realizado en el Hospital Pablo Tobón Uribe (HPTU), Medellín (Colombia), entre enero de 2010 y diciembre de 2011. Resultados: Se incluyeron 144 pacientes, con una relación hombre: mujer de 1:2.06. El 79.9% consultó por fiebre objetiva y el 31.3% había tenido un episodio de ITU previa. El 72.0% presentó leucocituria y el gram de gota de orina sin centrifugar fue positivo en el 86.0% (77.8% de bacilos con tinción de gram negativos). Los uropatógenos más frecuentes fueron Escherichia coli y Klebsiella pneumoniae. Escherichia coli tuvo una sensibilidad mayor al 90% para la mayoría de antibióticos, excepto en el de trimetropín sulfametoxazol, con una resistencia del 42.6% y del 45.5% a la ampicilina sulbactam. Se usó la amikacina como tratamiento empírico en el 66.0%. En 17 de 90 pacientes se encontró algún grado de reflujo vesicoureteral (RVU). Conclusión: La elección del tratamiento empírico precoz debe basarse en el conocimiento de la epidemiología y el perfil de sensibilidad y resistencia de cada institución. En este estudio se encontró elevado porcentaje de resistencia de la E. coli y otros uropatógenos a trimetropín sulfametoxazol y ampicilina sulbactam.

Tradução, adaptação e validação do conteúdo da secçãoi da escala: ôassessment of peer relationsõ para o idioma português / Translation, adaptation and content validation of section i of the scale ôassessment of peer relationsõ into the portuguese language

Objetivo: realizar a adaptação e validação do conteúdo da secção I da escala ôAssessment of PeerRelationsõ û Avaliação das Relações com Pares para o idioma Português. Método: a secção I foi traduzidae retro traduzida por tradutores experientes. A versão de consenso resultante desta tradução foi utilizadaem dois estudos piloto que indicaram a necessidade de melhoramentos linguísticos. Realizadas asalterações necessárias, reuniu-se um painel com oito peritos û investigadores na área da intervençãoprecoce e das interações sociais û que procedeu à discussão aprofundada de cada um dos itens secção I.Resultados: todo o processo inerente a este estudo revelou-se de extrema importância para a exploraçãoaprofundada da secção I e para a realização de todas as alterações consideradas necessárias para quea escala possa ser funcional e aplicável na Língua e Cultura Portuguesas. Conclusões: o processo deinvestigação permitiu atingir o objetivo delineado e, assim, foi possível adaptar e validar, para o idiomaportuguês, o conteúdo da secção I da escala Assessment of Peer Relations û Avaliação das Relações comPares.

Migraine life-time prevalence in mental disorders: concurrent comparisons with first-degree relatives and the general population / Prevalencia de migraña en trastornos mentales: comparación concurrente con familiares de primer grado y con la población general

The authors quantified the prevalence of migraine in subjects with mental disorders, first-degree relatives and the adult general population (GP) in Mérida, Venezuela. After validation, a modified, short version of the Lipton’s diagnostic scale was administered to consecutively admitted in- and out-patients (n = 1059), their first-degree relatives (n = 445) and a probabilistic sample of the GP (n = 516). In the GP, the frequency of migraine (percentage and 95% confidence interval) was 14.9 (11.8-17.9). The migraine frequencies were (percentage and odd ratio probability against the GP: bipolar disorder (15.7%, p = 0.5), schizophrenia (8.3%, p = 0.08), depression and dysthimia (24.4%, p = 0.2), anxiety disorders (10.0%, p = 0.02), personality disorders (11.4%, p = 0.15), all other disorders (15.5%, p = 0.4), relatives of bipolar patients (4.4%, p < 0.001), relatives of schizophrenia patients (3.5%, p = 0.003), and relatives of patients with all other mental disorders (12.8%, p = 0.4). Migraine was more common in women (p < 0.001), and the bipolar patients presented the highest female to male ratio (8:1). A high variability was observed in migraine prevalence among the diagnostic categories, but it was particularly high in subjects with affective disorders, mainly in women, who thus deserve special attention from clinicians.

Los autores cuantificaron la prevalencia de migraña en sujetos con trastornos mentales, sus familiares de primer grado y la población general (PG) en Mérida, Venezuela. Se utilizó una versión abreviada de la escala diagnostica de Lipton. Luego de un estudio de validez, tal escala se administró a pacientes ambulatorios u hospitalizados atendidos en forma consecutiva (n = 1.059), a sus familiares de primer grado (n = 445) y a una muestra probabilística de la PG (n = 516). La frecuencia de migraña en la PG (porcentaje e intervalo de confianza de 95%) fue de 14,9 (11,8-17,9). La frecuencia para los diversos trastornos (porcentaje y probabilidad asociada a la razón de momios (odds ratio) con respecto a la PG) fue: trastorno bipolar (15,7%, p = 0,5), esquizofrenia (8,3%, p = 0,08), depresión y distimia (24,4%, p = 0,2), trastornos de ansiedad (10,0%, p = 0,02), trastornos de personalidad (11,4%, p = 0,15), todos los otros trastornos (15,5%, p = 0,4). En los familiares, la frecuencia fue: trastorno bipolar (4,4%, p < 0,001), esquizofrenia (3,5%, p = 0,003), otros trastornos (12,8%, p = 0,4). El diagnóstico de migraña fue más frecuente en mujeres (p < 0,001), y los sujetos con trastorno bipolar presentaron el mayor índice mujer:hombre (8:1). Se observó una alta variabilidad en la prevalencia de migraña en las diversas categorías diagnósticas. Tal frecuencia fue particularmente elevada en sujetos con trastornos afectivos, principalmente en mujeres, las cuales ameritan una atención especial por parte de los médicos tratantes.

Fractura de Chance no identificada por tomografía computada convencional: presentación de un caso / Chance fracture missed by convencional CT: presentation of a clinical curse

Introducción. Las fracturas por flexión-disrupción de la columna lumbar que comprometen el cuerpo vertebral en el eje axial se denominan fractura de Chance y pueden pasar desapercibidas en la tomografía computada (TC) convencional. Caso clínico. Varón de 9 años que sufre colisión frontal cuando viajaba en el asiento trasero de un vehículo, sin silla adaptada ni elevador, sujeto por el cinturón de seguridad. Presentaba lesiones cutáneas a la exploración abdominal compatibles con marca de cinturón. La TC toracoabdominal convencional no detectó la fractura de Chance a nivel de L2 que fue sospechada clínicamente, diagnosticada por radiografía lateral dorso lumbar y confirmada por resonancia magnética (RM). Conclusión. La fractura de Chance aparece en niños menores de 12 años y estatura inferior a 135 cm con lesiones asociadas al cinturón de seguridad por accidente de tráfico. Este tipo de fracturas puede pasar desapercibido en una TC convencional, por lo que, si se sospecha, debería ampliarse el estudio diagnóstico. La RM es el estudio de elección. Este caso enfatiza la importancia del uso de mecanismos elevadores homologados, en menores de 12 años.

O momento da avaliação na intervenção precoce: o envolvimento da família estudo das qualidades psicométricas do ASQ-2 dos 30 aos 60 meses / The moment of assessment in early intervention: study of parental involvement of psychometric properties of ASQ-2 from 30 to 60 months

A relação entre pais e profissionais de saúde e de educação é fundamental para o desenvolvimento da criança. Esta se torna ainda mais essencial em crianças que apresentam risco de desenvolvimento. Essa mesma relação é valorizada numa abordagem centrada na família tendo implicações significativas nas práticas nos diferentes contextos e na sua aplicabilidade, exigindo que os profissionais assumam novos papéis e que aprendam novas competências no trabalho com as famílias. Estas competências concretizam-se nos primeiros contactos com a família desde o momento da avaliação até à efetiva prestação de serviços. A realização deste estudo surgiu da necessidade constatada de envolver os pais desde o primeiro momento do processo em intervenção precoce através de um instrumento formal e de simples aplicação. O ASQ-2 é constituído por 19 questionários divididos por diferentes idades entre os quatro e os 60 meses. Cada questionário é composto por 30 itens divididos pelas áreas de desenvolvimento comunicação, motricidade global, motricidade fina, resolução de problemas e pessoal-social. Este trabalho constitui a análise dos questionários dos 30 aos 60 meses para observar as qualidades psicométricas do ASQ, tendo sido aplicados a uma amostra de conveniência de 127 famílias do distrito de Braga. Foi possível verificar que o ASQ-2 traduzido apresenta resultados atraentes o que significa que poderá vir a ser utilizado pela população portuguesa de pais e profissionais (de saúde e de educação) que pretendam concretizar as suas dúvidas através de um instrumento formal de rastreio e de monitorização do desenvolvimento da criança.

The relationship between parents and health and education professionals is fundamental to the development of the child. This becomes even more important in children who are at risk. This relationship is valued in a family-centered approach and there are significant implications for practice in different contexts, requiring professionals to take on new roles and learn new skills in working with families. These skills come to the foreground during the first contacts with the family beginning at the time of assessment through to the effective provision of services. This study arose due to the perception that parents needed to be involved from the very beginning of the process in Early Intervention, by means of a formal instrument and simple application. The ASQ-2 is composed of 19 different questionnaires organized according to age intervals from 4 to 60 months. Each questionnaire comprises 30 items grouped according to the developmental areas of communication, gross motor, fine motor, problem solving and personal-social. This study presents the analysis of questionnaires from 30 to 60 months to observe the psychometric properties of the ASQ applied to a convenience sample of 127 households in the district of Braga. We concluded that the ASQ-2 presents attractive results suggesting that it could be used by the Portuguese population of parents and professionals (health and education) who wish to answer some questions using a formal screening and monitoring of child development instrument.

Ocorrência de Leishmania spp. em felinos do município de Araçatuba, SP / Occurrence de Leishmania spp. in domestic cats from Araçatuba, SP

Este trabalho teve como objetivo comparar a ocorrência de Leishmania spp. em gatos por dois métodos (citológico e sorológico), bem como associar a ocorrência deste protozoário com as variáveis sexo, idade e raça. Amostras séricas de 283 felinos domésticos foram testadas pela Reação de Imunofluorescência Indireta (RIFI), e o exame parasitológico direto de linfonodos também foi realizado para a verificação da positividade para Leishmania spp. Ocorrência de 0,7 por cento (2/283) foi observada nos felinos examinados, por meio de imprint de linfonodos e nenhum animal apresentou títulos de anticorpos para Leishmania spp. As duas fêmeas positivas eram sem raça definida, sendo uma jovem e outra adulta. Por meio dos resultados obtidos, não foi constatada diferença estatisticamente significante em relação às variáveis sexo, raça e idade nos gatos desta pesquisa (p > 0,05). Ocorrência de Leishmania spp. nos gatos deste estudo foi baixa. Devido a esta baixa incidência sugere-se que estes não assumem importância epidemiológica na área do estudo.

This study had the purpose to compare the occurrence of Leishmania spp. in felines through two methods (cytological and serological), as well as to associate the occurrence of this protozoan with the sex, age and breed variables. Serum samples from 283 domestic felines were processed by means of Indirect Immunofluorescence Reaction (IIR), and the direct parasitological test for linfonodes was also carried out in order to verify positivity for Leishmania spp. Occurrence of 0.7 percent (2/283) was observed in the tested felines by means of linfonode imprinting and no animal showed title of antibodies for Leishmania spp. The two positive females were mongrel, a young female and an adult female feline. From the obtained results, no statistically significant difference was observed as regards the sex, breed and age variables in this research (p > 0.05). Occurrence of Leishmania spp. in the cats of this study was low. Such low incidence suggests that these hosts has no epidemiological relevance in the study area.

Manifestaciones clínicas tempranas de LES / Early clinical manifestations of SLE

El estudio de formas tempranas de presentación del lupus eritematoso sistémico (LES) permite optimizar su diagnóstico y tratamiento. Se revisaron las historias clínicas de pacientes con edad ≥12 años que cumplían con ≥4criterios del Colegio Americano de Reumatología (ACR). El término “presentación temprana del LES” se asignó al primer año de evolución de la enfermedad, comenzando con la fecha cuando el(los) primer(os) criterio(os) fue(ron) reportado(s) en la historia clínica. Los pacientes fueron agrupados si satisfacían cualquier combinación de ≥4, 2-3 ó 1 criterio(s) para la clasificación del LES a través del primer año de la enfermedad. El impacto sobre el diagnóstico temprano del LES fue estimado de acuerdo a la actitud del médico de atención primaria para descartar tempranamente la enfermedad. 115 pacientes fueron admitidos al estudio. Al final del primer año de evolución de la enfermedad, 68 (59,13%) reunieron <4 criterios vs. 47 (40,86%) que reunieron ≥4 criterios del CAR (p=0,05). Los pacientes que reunieron <4 criterios alcanzaron el mínimo número de criterios para LES (≥4) dentro de los siguientes 10 años (promedio 4,9 años). De los 68 pacientes que alcanzaron <4 criterios, 31 (45,58%) reunieron dos o tres criterios y 37 (54,41%) tan sólo un criterio (p=0,46). El más frecuente de los criterios solitarios fue el síndrome inflamatorio poliarticular, 26 (70,20%) comparado con un conjunto de manifestaciones cutáneas, hematológicas, neurológicas, cardiopulmonares, renales y falso VDRL positivo, 11 (29,72%) (p=0,01). Los pacientes con un número insuficiente de criterios para LES son más frecuentes que aquellos con ≥4 criterios positivos al final del primer año de presentación de la enfermedad. La manifestación de un solo criterio (comparado con los que tenían ≥2) se asoció con un retardo en el diagnóstico temprano del LES de por lo menos 1 año

The study of early systemic lupus erythematosus (SLE) presentation can optimize its diagnosis and treatment. The clinical charts of those patients ≥12 years old complied with ≥ 4 criteria for SLE of the American College of Rheumatology (ACR) were reviewed. The term “early presentation of SLE” corresponded to the first year of evolution of the disease, starting with the date when the first(s) criterion/criteria were reported in the chart. The patients were grouped if they complied with a combination of ≥4, 2-3 or 1 ACR criteria for the classification of SLE through the first year of disease. The impact over the early diagnosis of SLE was estimated according to the early performance of the primary care doctor in ruling out the disease. 115 patients were included. At the end of the first year, 68 patients (59.13%) met <4 ACR criteria vs. 47 (40.86%) who met ≥4 (p=0.05). Patients who met <4 criteria fulfilled ≥4 criteria within the next 10 years (mean= 4.9 years). Of the 68 cases with <4 ACR criteria, 31 (45.58%) met two or three criteria and 37 (54.41%) met one solitary criterion (p=0.46). The most frequent early single onset ACR criterion for SLE was the polyarticular inflammatory syndrome, 26 (70.20%) followed by a group of other single criterion that included cutaneous, hematologic, neurologic, cardiopulmonary, renal, and false-positive VDRL, 11 cases (29.72%) (p=0.01). An early solitary criterion-compared with those patients with ≥2- was associated with a lack of documentation in the medical chart- of constitutional symptoms, indication of serum antibodies and referral to specialist. Patients with an insufficient quota of ACR criteria for SLE exceeded those with ≥4 positive criteria at the end of the first year of the disease. Patients with a single criterion of presentation compared with those patients who started with ≥2 early criteria-were associated with a delay in the early diagnosis of SLE by at least one year

Proteína C reactiva como marcador de severidad en pacientes con Pancreatitis Aguda

El objetivo del estudio fue establecer la utilidad de la proteína C reactiva (PCR) como marcador de severidad en pacientes con pancreatitis aguda (PA), evaluados en el Servicio de Gastroenterología del Hospital Universitario de Maracaibo. Durante los meses de Marzo a Diciembre de 2006. Materiales y Métodos: Estudio prospectiva, descriptiva, correlacional, Se analizaron las variables: edad, sexo, formas clínicas, etiología, criterios de Ranson, grados de Baltazar y valores de PCR. La PCR se determinó mediante técnica cuantitativa, utilizando reactivo de látex. Resultados: Se estudiaron 35 pacientes con predomino del sexo femenino 20 (57,14%) y mas frecuente entre la tercera y cuarta década de la vida. En relación a los criterios de Ranson 25 (71,43%) presentaron menos de 3 criterios de Ranson, con valores de PCR entre 8 y 128 mg/dl, 10 (28,57%) obtuvieron º 3 criterios de Ranson y el rango de PCR entre 128 a 256 mg/dl, (p= 0,0011).Se demostró asociación positiva entre las cifras de PCR y criterios de Ranson (r= 0,871, p=0,0001) y no se observó entre PCR y Baltazar. Predominó la PA de etiología biliar en 16 (45,71%) El promedio 146,28μ80,22 de PCR encontrados en pacientes con PA alcohólica fue ligeramente superior al compararlo con las otras causas. Conclusión: La PCR es una prueba de laboratorio útil para determinar la severidad de PA.

The objective of this study was to establish the utility of c- reactive protein (CRP) as a marker of severity in patients with acute pancreatitis (AP), evaluated in the Gastroenterology service at the University Hospital of Maracaibo between March and December of 2006. Methods: This was a Prospective, descriptive and correlational study. The variables analyzed were age, sex, clinical presentation, etiology, Ranson´s criteria, Baltazar score and CRP values. CRP was determined through the quantitative technique, using the latex reagent. Results: We studied 35 patients, predominantly female 20 (57.14%), in the thirth and fourth decade of their lives. Regarding Ranson´s criteria, 25 (71.43%) presented less than 3 items, with CRP values between 8 and 128 mg/dl, 10 (28.57%) had º 3 with a CRP range between 128 and 256 mg/ dl, (p= 0.0011). A strong association between CRP and Ransom´s criteria was demonstrated (r= 0.871, p=0,0001), not observed between CRP and Balthazar score. AP of biliary etiology predominated in 16 (45.71%) The average 146,28μ80,22 CRP found in patients with alcoholic AP was higher when compared to the other etiologies. Conclusion: CRP is an useful laboratory test in order to determine the severity of AP.

Características epidemiológicas, endoscópicas e histológicas de pacientes con enfermedad inflamatoria intestinal

La enfermedad Inflamatoria Intestinal: (Rectocolitis Ulcerosa Idiopática y Enfermedad de Crohn) presenta diferentes características epidemiológicas, endoscópicas e histológicas. Materiales y Métodos: Estudio descriptivo, transversal retrospectivo ? prospectivo, donde se aplicó un formulario desde enero hasta noviembre 2006 para determinar las características epidemiológicas, endoscópicas, e histológicas de los pacientes. Resultados: Se encontró 28 pacientes con Rectocolitis Ulcerosa Idiopatica y 6 pacientes con Enfermedad de Crohn. En RCUI predominó el sexo femenino (53.6%), raza mezclada (92.9%), antecedentes familiares ausentes (78.6%) sin antecedentes personales de importancia (82.1%), con Pancolitis (53.6%) y duración de la enfermedad entre 6 meses y 5 años el (60.8%). En Crohn se presentó similar distribución de sexo, la raza predominante fue la mezclada (83.3%), ningun antecedente familiar, habito tabáquico y localización solo en Colon (50%) y 66.6% tenían menos de 1 año del diagnostico. En Rectocolitis el grupo etáreo mas frecuente (35.7%) de 30 ? 39 años, en Crohn 33.3% en grupos etáreos de 30-39 y 40-49 años. Los síntomas mas frecuentes fueron similares en ambas dolor abdominal y diarrea con o sin sangre. Los hallazgos endoscopicos 53.6% enfermedad moderada con reporte histológico de ulceras, abscesos o distorsión de las criptas 82.4% en rectocolitis y Ulceraciones lineales o serpenginosas en segmentos efectuando recto en 100%, histología de conglomerado de macrófagos (83.3%) y granulomas no caseosos o epiteloides en 66.7% en Crohn. Conclusiones: Los resultados coinciden en su mayoría con los reportados en la literatura internacional y deben servir como base de datos para la realización de estudios prospectivos.

The aim of this study was to determine epidemiologic characteristics, endoscopic and histologic findings of Inflamatory Bowel Disease (IBD): Ulcerative Colitis (UC) and Crohn`s disease (CD) performed in outpatients in the Hospital Universitario de Maracaibo between January and November 2006. Through a descriptive, retrospective-prospective, transversal. study the information was recorded with a cuestionary, 28 pacients had UC and 6 CD, female was most frequent in 53.6%, Hispanic race (92.9%), without any family(78.6%) or personal past history (82.1%). Pancolitis was present in 53.6%. The time of illness was between 6 months to 5 years (60.8%). CD had similar sex distribution, Hispanic race was predominant in 83.3%, no tabaco habit and colon only presentation in 50%. 66.6% had one year or less with the diagnosis. UC was more frequent between 30-39 years of age (35.7%), CD more frequent between 30-39 and 40-49 years of age (33.3%). The most frequent clinical feature was abdominal pain, diarrhea with/ without blood. Endoscopic features were moderate illness 53.6%, with crypt architectural distortion, abscess, and ulcers (82.4%) in UC. CD segmental involment with skip areas, deep linear ulcerations rectum spared 100% and epitheloid granulomas 66.7% and infiltration of macrophages 83.3%. This report was similar in current issue and could be used in prospective studies.

Pólipos de colon: Una revisión de 1 año de experiencia en un centro de referencia

Los pólipos colorectales son lesiones elevadas de origen epitelial. Pueden ser pediculados, subpediculados y sésiles. Se clasifican en lesiones neoplásicas y no neoplásicas. Materiales y métodos: Estudio descriptivo, retrospectivo donde se revisaron los informes de colonoscopia y de anatomía patológica año 2004, teniendo en cuenta datos de identificación, motivo del estudio, características endoscópicas, anatomopatológicas, hallazgos endoscópicos asociados y técnicas de polipectomía empleada. Resultados: se encontraron pólipos colorectales en 49 informes de pacientes de 799 estudios endoscopicos realizados (6,13%) con predominio del sexo femenino (73,5%) y mayor frecuencia desde la quinta década de la vida. El motivo de consulta fue variado: desde dolor abdominal, hemorragia digestiva inferior e indicación de polipectomía. En cuanto a las características endoscópicas los pólipos sésiles fueron los más frecuentes y se localizaron en su mayoría en el recto. El tamaño preponderante fue de 5 a 10mm y su presentación generalmente fue única. El tipo histológico predominante es el hiperplásico con 42,9%, con un 40,8% de adenomatosos. El 100% de los pólipos adenomatosos presentaron algún grado de displasia. Las técnicas de polipectomía empleada fueron de pinza fría y asa de diatermia. Conclusiones: los pólipos no neoplásicos hiperplásicos y adenomatosos son los mas frecuentes por lo que es necesario realizar polipectomía y estudio histológico de todas estas lesiones.

Colorectal polyps are elevated epithelial lesions and can be pediculate, subpediculate or sessile. They are classified in non neoplastic and neoplastic polyps. Methods: Descriptive and retrospective study. Endoscopies reports and pathological anatomies reports from 2004, we reviewed personal data, endoscopic and pathologic characteristics of the polyps, endoscopic associate findings and technique of polipectomies. Results: Colorectales polyps in 49 patients from 799 endoscopies (6.13%) corresponding most prevalence to the female sex (73.5%) with more frequency in the fifth decade of life. The reason of consult varied from abdominal pain to lower gastrointestinal bleeding and polipectomy indication. The polyp endoscopic characteristics showed that sessile were more frequent, located in their majority in the rectum, the preponderant size was from 5 to 10 mm and mostly unique. The histopathology type of the polyps was hyperplasic with a42.9% and adenomatous 40.8%. 100% The adenomatous polyps had some grade of dysplasia. The techniques for endoscopy polipectomy were cold biopsy forced and diathermic snare . Conclusions: hiperplastic and adenomatous polyps are the most common, lesions, these lesions justify endoscopic polypectomy and histological examination.