Epidemiology of suicide mortality in Mexican young people (ages 15-29) from 1990 to 2020 / Epidemiología del suicidio en jóvenes mexicanos (15-29 años) de 1990 a 2020

Abstract Introduction In 2020, suicide was the third leading cause of death in Mexico among young people ages 15 and 29, accounting for 43.0% of all suicides in the country, making it a major public health issue. Objective To explore changes in the geographic distribution of suicide rates by state and to analyze the magnitude, distribution, and pattern of suicide mortality in young Mexicans ages 15 to 29 between 1990 and 2020. Method Descriptive, ecological time-series study, based on official information. Standardized mortality rates were calculated using information on deaths (INEGI) and population estimates (CONAPO). The magnitude, distribution, and patterns of suicide mortality at the national level and by state were analyzed using the Joinpoint segmented regression model. Results From 1990 to 2020, suicide mortality in young people increased by 198% and was higher in women (285%) than men (178%). The states with the highest suicide mortality rates from 2016 to 2020 were Chihuahua (18.5 suicides/100,000 young people ages 15-29), Aguascalientes (16.6), Yucatán (14.4), Guanajuato (14.1), and San Luis Potosí (12.9), accounting for 23.0% of total suicide deaths. Discussion and conclusion The study of mortality trends could contribute to the management of a national suicide prevention strategy in young Mexicans, providing support for public health decision-making, such as the identification of the states and regions that should be prioritized.

Resumen Introducción En 2020, el suicidio fue la tercera causa de muerte en México en los jóvenes de 15 a 29 años y concentró el 43.0% del total de suicidios del país. Por lo tanto, es un problema de salud pública muy relevante. Objetivo Explorar los cambios en la distribución geográfica de las tasas de suicidio por entidad federativa, así como analizar la magnitud, distribución y tendencia de la mortalidad por suicidio, en los jóvenes mexicanos de 15 a 29 años entre 1990 y 2020. Método Estudio ecológico descriptivo de series de tiempo, a partir de la información de fuentes oficiales. Se calcularon las tasas estandarizadas de mortalidad utilizando la información sobre defunciones (INEGI) y las estimaciones de población (CONAPO). Se analizó la magnitud, distribución y tendencias de la mortalidad por suicidio a nivel nacional y por entidad federativa, utilizando el modelo de regresión segmentada Joinpoint. Resultados De 1990 a 2020, la mortalidad por suicidio en jóvenes creció 198%, siendo mayor en las mujeres (285%) que en los hombres (178%). Las entidades con mayor mortalidad por suicidio, de 2016 a 2020, fueron Chihuahua (18.5 suicidios/100 mil jóvenes 15-29 años), Aguascalientes (16.6), Yucatán (14.4), Guanajuato (14.1) y San Luis Potosí (12.9), las cuales concentraron el 23.0% del total de muertes por suicidios. Discusión y conclusión El estudio de las tendencias de la mortalidad podría contribuir a la gestión de una estrategia nacional para la prevención del suicidio en jóvenes mexicanos, proporcionando sustento para la toma de decisiones en salud pública, como la identificación de las entidades federativas y regiones del país que deben recibir la máxima prioridad.

Teaching Competencies in Nursing Professors: Visions of Students and Academics / Competencias docentes en profesores de Enfermería: visión de alumnos y académicos

Objective. This work sought to know the view of Nursing professors and students about the competencies the faculty staff must have to deploy their educational function with maximum quality and efficiency. Methods. Descriptive qualitative study through focus groups conducted with professors, students and recent Nursing career graduates from universities in Spain. Results. The importance of the proposed teaching competencies was delved into, highlighting the importance of professors knowing the context in which they teach, having the ability to self-evaluate their activity, and having adequate interpersonal communication skills, and deploy the teaching-learning process by performing proper planning, using new technologies, and knowing how to engage in teamwork. Moreover, a small discrepancy was detected in relation to disciplinary competence, which students felt was of importance, but which academics indicated is taken for granted in nursing professors; competencies directly related to the act of teaching must be enhanced. Conclusion.Practical unanimity was found between academics and students in affirming that the competencies investigated are important for adequate development of the teaching activity in nursing professors. In all cases, the urgent need was highlighted for nursing professors to have adequate teaching training to provide their students with formation of the highest quality.

Objetivo. Conocer la visión de profesores y alumnos de Enfermería acerca de las competencias que deben presentar los docentes para desplegar su función educativa con la máxima calidad y eficacia. Métodos. Estudio descriptivo cualitativo a través de grupos focales realizados con profesores, alumnos y recién egresados del Grado en Enfermería de universidades de España. Resultados. Se profundizó en la importancia de las competencias docentes propuestas, destacando la relevancia de que los profesores conozcan el contexto en el que desarrollan la docencia, tengan la habilidad de autoevaluar su actividad, dispongan de unas adecuadas habilidades de comunicación interpersonal, y desplieguen el proceso de enseñanza-aprendizaje realizando una correcta planificación, empleando las nuevas tecnologías y sabiendo trabajar en equipo. Por otro lado, se detectó una pequeña discrepancia con relación a la competencia disciplinar, a la que los estudiantes brindaron una gran importancia, pero que los académicos indicaron que se da por supuesta en los profesores enfermeros, debiendo ser potenciadas las competencias directamente relacionadas con el acto docente. Conclusión. Se ha hallado una práctica unanimidad entre académicos y estudiantes en afirmar que las competencias investigadas son importantes para un adecuado desarrollo de la actividad docente en los profesores de Enfermería. En todos los casos, se destacó la imperiosa necesidad de que los profesores de Enfermería dispongan de una adecuada capacitación docente para poder brindar a sus estudiantes una formación de la máxima calidad.

Correlación de la cuantificación de fibrosis hepática por morfometría mediante HepaScan con el análisis de las biopsias hepáticas. Estudio piloto / Correlation of liver fibrosis quantification by morphometry using HepaScan with the analysis of liver biopsies. A pilot study

Resumen Antecedentes: El estándar de oro para determinar el grado de fibrosis hepática (FH) continúa siendo la evaluación de la biopsia. Existen técnicas de morfometría que permiten cuantificar la FH en estudios histopatológicos. Objetivo: Medir la correlación entre la evaluación histológica de FH y la cuantificación por morfometría del porcentaje de fibrosis (PF) mediante HepaScan. Material y métodos: Estudio piloto observacional, analítico, transversal, prospectivo y prolectivo en el que se analizaron cortes histopatológicos de hígado de 29 personas fallecidas por alguna hepatopatía y 22 personas fallecidas por otras causas (controles). El PF se calculó con HepaScan en fotografías digitales de cortes histológicos teñidos con la técnica Masson, comparándolo con el diagnóstico de tres patólogos expertos. Resultados: Fueron analizadas 401 imágenes del grupo con hepatopatía y 250 del grupo de control. La concordancia interobservador tuvo un índice kappa de 0.329. Entre los grupos de clasificación histopatológica existieron diferencias estadísticas en el PF (p = 0.0001). La capacidad predictiva de HepaScan con base en el área bajo la curva característica operativa del receptor fue de 0.983, 0.812 y 0.895 para fibrosis leve, moderada y severa, respectivamente. Conclusiones: HepaScan mostró muy buen desempeño para evaluar el PF en cortes histológicos, por lo que puede coadyuvar al diagnóstico patológico cualitativo.

Abstract Background: The gold standard for determining the degree of liver fibrosis (LF) continues to be biopsy evaluation. There are morphometry techniques that allow LF to be quantified on histopathological studies. Objective: To measure the correlation between LF histological evaluation and fibrosis percentage (FP) morphometric quantification using the HepaScan software. Material and methods: Observational, analytical, cross-sectional, prospective, prolective pilot study in which liver histological sections from 29 people who died from some liver disease and from 22 people who died from other causes (controls) were analyzed. FP was calculated with HepaScan on digital photographs of histological sections stained with the Masson technique, comparing it with the diagnosis established by three expert pathologists. Results: Four-hundred and one images from the group with liver disease and 250 from the control group were analyzed. Inter-observer agreement had a kappa index of 0.329. There were FP statistically significant differences (p = 0.0001) between histopathological classification groups. HepaScan predictive capacity based on the area under the receiver operating characteristic curve was 0.983, 0.812, and 0.895 for mild, moderate, and severe fibrosis, respectively. Conclusions: HepaScan showed very good performance for evaluating FP in histological sections, which is why it can contribute to qualitative pathological diagnosis.

El concepto de etnia en un país pluriétnico y multicultural: una representación desde un grupo de estudiantes de odontología / The concept of ethnicity in a multi-ethnic and multicultural country: a representation from a group of dental students

Objetivo: explorar el concepto de <<etnias>>, en un grupo de estudiantes de Odontología de una universidad privada. Métodos: Se realizó un estudio cualitativo con 11 estudiantes entre 18 y 21 años en una Facultad de Odontología de una Universidad de Bogotá, en el curso de Socio Humanística I. Se efectuó una entrevista semiestructurada a cada estudiante; se obtuvo el consentimiento informado, el estudio fue clasificado como sin riesgo. Se aplicó en una sesión una entrevista semiestructurada, organizada en forma de historia donde el estudiante se involucra al leer el relato y contestar los interrogantes a medida que transcurría la lectura, lo que sirvió como base para el análisis de contenido. Resultados: Se determinaron tres categorías a saber: concepto de etnia, grupos étnicos en Colombia y enfoque diferencial étnico en salud, encontrándose que la etnia para los estudiantes es el reconocimiento de multietnicidad y pluriculturalidad del país, acompañado de diversidad. Conclusión: Con relación al concepto de etnia, se resalta que para algunos de los encuestados hay una confusión con representar los grupos étnicos como: madres cabeza de hogar, desplazados y población LGBTI. Los estudiantes respondieron "Raizales, negritudes, indígenas, Rom, desplazados, adultez, vejez, niñez, LGTBI." Que, aunque tienen relación con el enfoque diferencial, no corresponden al interrogante planteado en la historia.

Objective: to explore the concept of ethnicity in a group of odontology students of a private university. Methods: A qualitative study was carried out with 11 students between 18 and 21 years of age in an odontology faculty of a university in Bogota, in the course of socio-humanistic I. A semi-structured interview was conducted with each student, aninformed consent was obtained, and the study was classified as risk-free. A semi-structured interview was applied in one session, organized in the form of a story where the student was involved by reading the story and answering the questions as the reading progressed, which served as a basis for the content analysis. Results: Three categories were determined: concept of ethnicity, ethnic groups in Colombia and ethnic differential approach in health, finding that ethnicity for students is the recognition of multiethnicity and multiculturalism of the country, accompanied by diversity. Conclusion: In relation to the concept of ethnicity, a highlight is that for some of the participants there is confusion with representing ethnic groups such as: single mothers, displaced people and LGBTI population. The students answered "Raizal, black people, indigenous people, Rom, displaced, adults, elders, children, LGTBI". Although they are related to the differential approach, they do not correspond to the question raised in the story.

Liver transplant for metastatic neuroendocrine tumors: a single-center report / Transplante de fígado para tumores neuroendócrinos metastáticos: série de casos

ABSTRACT BACKGROUND: Neuroendocrine tumors are rare neoplasms of uncertain biological behavior. The liver is one of the most common sites of metastases, occurring in 50% of patients with metastatic disease. AIMS: To analyze a clinical series in liver transplant of patients with neuroendocrine tumors metastases. METHODS: A retrospective descriptive study, based on the review of medical records of patients undergoing liver transplants due to neuroendocrine tumor metastases in a single center in northeast Brazil, over a period of 20 years (January 2001 to December 2021). RESULTS: During the analyzed period, 2,000 liver transplants were performed, of which 11 were indicated for liver metastases caused by neuroendocrine tumors. The mean age at diagnosis was 45.09±14.36 years (26-66 years) and 72.7% of cases were females. The most common primary tumor site was in the gastrointestinal tract in 64% of cases. Even after detailed investigation, three patients had no primary tumor site identified (27%). Overall survival after transplantation at one month was 90%, at one year was 70%, and five year, 45.4%. Disease-free survival rate was 72.7% at one year and 36.3% at five years. CONCLUSIONS: Liver transplantation is a treatment modality with good overall survival and disease-free survival results in selected patients with unresectable liver metastases from neuroendocrine tumors. However, a rigorous selection of patients is necessary to obtain better results and the ideal time for transplant indication is still a controversial topic in the literature.

RESUMO RACIONAL: Os tumores neuroendócrinos são neoplasias raras de comportamento biológico incerto. O fígado é um local comum de metástase, ocorrendo em 50% dos pacientes com doença metastática. OBJETIVOS: Analisar casuística de transplante hepático por metástases de tumores neuroendócrinos. MÉTODOS: Estudo descritivo retrospectivo com revisão de prontuários de pacientes submetidos a transplante hepático por metástases de tumores neuroendócrinos em um único centro no Nordeste do Brasil durante 20 anos (janeiro de 2001 a dezembro de 2021). RESULTADOS: Durante o período analisado, foram realizados 2.000 transplantes hepático, sendo 11 indicados por metástases hepáticas de tumores neuroendócrinos. A média de idade ao diagnóstico foi de 45,09±14,36 anos (26-66 anos) e 72,7% dos casos eram do sexo feminino. O local do tumor primário mais comum foi o trato gastrointestinal (64% dos casos). Após detalhada investigação, três pacientes não tiveram o local do tumor primário identificado (27%). A sobrevida global um mês e após um ano do transplante foi de 90 e 70%, respectivamente. A sobrevida após 5 anos foi de 45,4%. A taxa de sobrevida livre de doença foi de 72,7% no primeiro ano e 36,3% em cinco anos. CONCLUSÕES: O transplante hepático é uma modalidade de tratamento com bons resultados de sobrevida global e sobrevida livre de doença, em pacientes selecionados com metástases hepáticas irressecáveis de tumores neuroendócrinos. No entanto, a seleção rigorosa dos pacientes é necessária para obter melhores resultados e o momento ideal para a indicação do transplante ainda é um tema controverso na literatura.

Assessment of the need for routine intraoperative cell salvage in liver transplantation

Purpose: This study aimed to assess the necessity of routine intraoperative cell salvage in liver transplantations. Methods: A total of 327 liver transplants performed between 2014 and 2016 was included in the analysis. Patient data, including pre-transplant examinations, intraoperative red blood cell transfusions, and procedural information, were collected. Results: The median age of the patients was 54 years old, with 67% (219) being male. The most prevalent ABO blood type was O, accounting for 48% (155) of cases. The leading causes of liver disease were hepatitis C (113 cases, 34.6%) and alcohol-related liver disease (97 cases, 29.7%). Out of the 327 liver transplants, allogeneic red blood cell transfusions were administered in 110 cases (34%) with a median of two units of red blood cells per case. Cell salvage was employed in 237 transplants (73%), and successful blood recovery was achieved in 221 cases (93%). Among the group that recovered more than 200 mL of blood, the median volume of recovered blood was 417 mL, with no transfusion of allogeneic blood required. A total of 90 transplants was performed without utilizing cell salvage, and, among these cases, 19 required blood transfusions, with a median of zero units transfused. Conclusions: This study suggests that routine cell salvage is unnecessary for all liver transplantations. The most suitable indication for its use is in patients presenting with portal vein thrombosis and abnormal creatinine levels.

Vínculos, autonomía y salud mental en adultos jóvenes del proceso de reintegración en Colombia / Bonds, autonomy and mental health in young adults of the reintegration process in Colombia

Este artículo busca explorar la construcción de los vínculos, su relación con el desarrollo de la autonomía y las problemáticas de salud mental de adultos jóvenes excombatientes de grupos armados que hacen parte del proceso de reintegración en Colombia. Se analizaron 3977 registros de la Encuesta Multimodal Psicosocial (EMP) correspondientes a adultos jóvenes entre los 18 y 24 años, que fueron aplicadas en desarrollo del proceso de reincorporación. Se aplicaron dos métodos de análisis estadísticos complementarios: el método de Componentes Principales (ACP) y un método Jerárquico aglomerativo. En el análisis de los procesos vinculares se encontró que en un grupo alrededor de un 80 % de los casos registra haber experimentado rupturas vinculares importantes a causa de la violencia, el abandono temprano y/o vivir en contextos de conflicto y violencia. En cuanto al análisis de los procesos de autonomía, se encontró que un grupo correspondiente al 70 % reporta no contar con las capacidades para garantizar su autonomía y calidad de vida, pasando por condiciones de precarización laboral con riesgo a incurrir en redes de delincuencia. Y un 39 % reporta coincidir alta disposición de riesgo en sus procesos vinculares y de autonomía.

This article seeks to explore the construction of bonds, their relation with the development of autonomy and the mental health problems of young adult ex-combatants of armed groups who are part of the reintegration process in Colombia. A total of 3977 records of the Psychosocial Multimodal Questionnaire (PMS) corresponding to young adults between 18 and 24 years old, which were applied in the development of the reincorporation process, were analyzed. Two complementary statistical analysis methods were applied: The Principal Components Method (PCA) and an agglomerative Hierarchical method. In the analysis of bonding processes, it was found that, in one group, about 80% of the cases recorded having experienced significant bonding ruptures due to violence, early abandonment and/or living in contexts of conflict and violence. Regarding the analysis of the processes of autonomy, a group corresponding to 70% reported not having the capacities to guarantee their autonomy and quality of life, going through conditions of job insecurity with the risk of incurring in criminal networks. And 39% report a high risk disposition in their relationship and autonomy processes.

¿Son los implantes "personalizados" una solución en la cirugía de revisión acetabular? A propósito de un caso / Are customized implants a solution in acetabular revision surgery? A case study

Se presenta a un paciente de 73 años que había sido sometido a dos revisiones de prótesis de cadera debido a una infección crónica por un microorganismo multirresistente. Acude a nuestro centro tras un primer tiempo quirúrgico. En la radiografía simple y la tomografía computarizada, se observan un defecto femoral tipo IV y un defecto acetabular tipo IIIA de Paprosky. Tras un control clínico y análisis de laboratorio, se decide la reconstrucción acetabular mediante un implante "personalizado" y un vástago tumoral. A los 2 años, el paciente evoluciona favorablemente: deambula con bastón y sin dolor. El implante está estable y en posición normal, no hubo recidiva infecciosa. Nivel de Evidencia: IV

We present the case of a 73-year-old patient, previously treated with two hip prosthesis revisions due to a chronic infection caused by a multidrug-resistant microorganism, who consulted after the first surgical procedure. Radiographic and computed tomography studies revealed a Paprosky type IV femoral defect and a type IIIA acetabular defect. Following clinical and laboratory monitoring, it was decided to perform acetabular reconstruction using a custom-made implant and a tumor stem. Two years later, the patient shows a favorable evolution: he is able to walk with a cane and without pain. The implant is stable and properly positioned, with no recurrent infection. Level of Evidence: IV

Peroral endoscopic myotomy for achalasia: safety profile, complications and results of 94 patients / Miotomia endoscópica peroral para acalásia: perfil de segurança, complicações e resultados de 94 pacientes

ABSTRACT BACKGROUND: Achalasia is an esophageal motility disorder, with clinical presentation of dysphagia and regurgitation. This is a chronic condition with no cure. Current treatment options aim to reduce lower esophageal sphincter tone by pharmacological, endoscopic or surgical means, with the aim of improving patients' symptoms. Peroral endoscopic myotomy (POEM) is an alternative endoscopic surgery to Heller cardiomyotomy, in which the procedure is performed orally, by endoscopy, offering efficacy comparable to surgical myotomy, with relative ease and minimal invasion, without external incisions. AIMS: To study the safety of POEM by analyzing its results, adverse events and perioperative complications and the main ways to overcome them, in addition to evaluating the effectiveness of the procedure and the short-term postoperative quality of life. METHODS: A qualitative and quantitative, observational and cross-sectional study that analyzed patients who underwent the POEM in a reference center, from December 2016 to December 2022, maintaining the technical standard of pre-, peri- and postoperative protocol. RESULTS: A total of 94 patients were included in the study, and only three had postoperative complications. The average early postoperative Eckardt score was 0.93 and the late 1.40, with a mean improvement of 7.1 in early results and 6.63 in late results (p<0.05). CONCLUSIONS: POEM can be reproduced with an excellent safety profile, significant relief of symptoms and improvement in esophageal emptying, and in quality of life.

RESUMO RACIONAL: A acalasia é uma desordem da motilidade esofágica, com apresentação clínica de disfagia e regurgitação, uma condição crônica sem cura. As opções de tratamentos atuais visam reduzir o tônus do esfíncter esofagiano inferior (EEI) por meios farmacológicos, endoscópicos ou cirúrgicos, com o objetivo de aliviar os sintomas dos pacientes. A miotomia endoscópica peroral, sigla do inglês (POEM) é uma cirurgia endoscópica alternativa à cardiomiotomia a Heller (CH), em que a miotomia é realizada por via oral, por endoscopia, oferecendo eficácia comparável a miotomia cirúrgica, com relativa facilidade e mínima invasão, sem incisões externas. OBJETIVOS: Analisar a segurança do POEM analisando seus resultados, eventos adversos, complicações perioperatórias e suas principais formas de contorná-los, além de avaliar a eficácia do procedimento e a qualidade de vida pós-operatória, em curto prazo. MÉTODOS: Estudo qualitativo e quantitativo, observacional e transversal avaliando pacientes que realizaram o POEM em um centro de referência, entre dezembro de 2016 até dezembro de 2022, mantendo padrão técnico de preparo pré, peri e pós-operatório. RESULTADOS: Foram incluídos no estudo 94 pacientes e apenas 3 apresentaram complicações pós-operátorias. O escore de Eckardt médio precoce pós-operatório foi de 0,93 e o tardio de 1,40, com melhora média de 7,1 em resultados precoces e de 6,63 em resultados tardios (p<0,05). CONCLUSÕES: O POEM pode ser reproduzido com excelente perfil de segurança, alívio significativo dos sintomas e melhora do esvaziamento do esôfago, oferecendo melhora na qualidade de vida.

Factores de riesgo para mortalidad en mujeres adultas mayores con síndrome de fragilidad

Introducción: La fragilidad es un síndrome geriátrico de gran prevalencia e impacto en la población adulta mayor, que se asocia con diversos desenlaces negativos en la salud, particularmente en el sexo femenino, pues implica una mayor predisposición de morir. Existen diversos factores asociados a la mortalidad en mujeres frágiles, entre los descritos están los factores sociodemográficos, la presencia de comorbilidades y los síndromes geriátricos. Objetivos: Determinar los factores de riesgo asociados a mortalidad en mujeres adultas mayores con síndrome de fragilidad. Métodos: Estudio observacional, analítico, de tipo cohorte retrospectiva, análisis secundario en una base de datos de una investigación realizada en adultos mayores del Centro Médico Naval "Cirujano Mayor Santiago Távara" entre los años 2010 y 2015 con seguimiento de supervivencia hasta junio del 2016. La muestra para el presente análisis se constituyó por datos de 341 adultas mayores frágiles, de acuerdo al fenotipo de Fried. Resultados: El estado civil, ser divorciadas o separadas, la multimorbilidad, el número de fármacos, el riesgo de caídas y el Puntaje de la Escala de Gijón se asociaron significativamente con un mayor riesgo de mortalidad en mujeres frágiles, mientras que la educación, la edad, el Puntaje del Índice de Barthel y el Puntaje de Minimental State Examination no fueron factores asociados. Conclusiones: Las mujeres frágiles divorciadas o separadas, con pobre soporte social, mayor consumo de fármacos y multimorbilidad, y con riesgo de caídas tienen mayor riesgo de mortalidad.

Introduction: Frailty is a geriatric syndrome of great prevalence and impact in the older adult population, associated with various negative health outcomes, particularly in the female sex. Among the various factors associated with mortality in frail women, sociodemographic factors, as well the presence of comorbidities and geriatric syndromes have been described. Objective: To determine the risk factors associated with mortality in older women with frailty syndrome. Methods: An observational and analytical study of retrospective-cohort type was carried out, between the years 2010 and 2015, through the secondary analysis in a database of a research conducted with older adults from Cirujano Mayor Santiago Távara Naval Medical Center, with survival follow-up until June 2016. The sample for the present analysis was made up of 341 frail elderly women, according to Fried's phenotype. Results: Marital status, being divorced or separated, multimorbidity, number of drugs, risk of falls and the score based on Gijon's scale were significantly associated with an increased mortality risk in frail women; while education, age, as well as the scores based on Barthel index and the Mini-mental State Examination were not associated factors. Conclusions: Frail women who are divorced or separated, with poor social support, higher drug use, multimorbidity and at risk for falls are at higher risk for mortality.

La Huamanripa (Senecio tephrosioides Turcz) como alternativa saludable para afecciones respiratorias durante la pandemia COVID-19 / Huamanripa (Senecio tephrosioides Turcz) as a healthy alternative for respiratory conditions during the COVID-19 pandemic / Huamanripa (Senecio tephrosioides Turcz) como alternativa saudável para problemas respiratórios durante a pandemia de COVID-19

Desde tiempo histórico las plantas medicinales se han empleado como ingrediente principal para preparación de diferentes recetas. Motivo que se investigó sobre la Huamanripa como alternativa saludable para afecciones respiratorias durante la pandemia COVID-19 en Barranca. Objetivo. El objetivo fue determinar la eficiencia de la Huamanripa como alternativa saludable para las afecciones respiratorias en la pandemia. Materiales y Método. La metodología se basa en investigación descriptiva con enfoque cuantitativo prospectivo, por lo que se cuestionó sobre la preparación, frecuencia de consumo y para que enfermedades se consumen. Obtenidos los datos se procesaron mediante estadísticas básicas y regresión. Resultados. Se determinó que la Huamanripa lo usan para tratamiento casero medicinal y consume con frecuencia 4 a 5 veces por semana para afecciones respiratorias y COVID-19, consumo de Huamanripa por mes con 23 % de la población, porcentaje de alivio de afecciones respiratorias con 84 %, correlación entre el consumo de Huamanripa y porcentaje de alivio r = 0.99 y en análisis de varianza del consumo de Huamanripa y el porcentaje de alivio no hubo significancia. Conclusiones. Concluye que la Huamanripa es una alternativa eficiente y se puede complementar con otros tratamientos para las afecciones respiratorias y síntomas de COVID-19; ya sea por sus propiedades como aceites especiales y terpenos que tienen efectos antimicrobiana, antiinflamatoria, aliviante, lo cual favorece a la salud.

Since historical times, medicinal plants have been used as the main ingredient for the preparation of different recipes. For this reason, Huamanripa was investigated as a healthy alternative for respiratory diseases during the COVID-19 pandemic in Barranca. Objective. The objective was to determine the efficiency of Huamanripa as a healthy alternative for respiratory diseases during the pandemic. Materials and Method. The methodology is based on descriptive research with a prospective quantitative approach, so that the preparation, frequency of consumption and the diseases for which it is consumed were questioned. Data were obtained and processed by means of basic statistics and regression. Results. It was determined that Huamanripa is used for medicinal home treatment and consumed 4 to 5 times a week for respiratory diseases and COVID-19, consumption of Huamanripa per month with 23% of the population, percentage of relief of respiratory diseases with 84%, correlation between consumption of Huamanripa and percentage of relief r = 0.99 and in variance analysis of Huamanripa consumption and percentage of relief there was no significance. Conclusions. It is concluded that Huamanripa is an efficient alternative and can be complemented with other treatments for respiratory conditions and symptoms of COVID-19; either by its properties such as special oils and terpenes that have antimicrobial, anti-inflammatory, relieving effects, which favors health.

Desde tempos históricos as plantas medicinais têm sido utilizadas como ingrediente principal para a preparação de diferentes receitas. Por esta razão, Huamanripa foi investigado como uma alternativa saudável para doenças respiratórias durante a pandemia da COVID-19 em Barranca. Objetivo. O objetivo era determinar a eficiência de Huamanripa como uma alternativa saudável para as doenças respiratórias durante a pandemia. Materiais e Método. A metodologia é baseada em pesquisa descritiva com uma abordagem quantitativa prospectiva, de modo que foram feitas perguntas sobre a preparação, a freqüência do consumo e para quais doenças é consumida. Os dados foram obtidos e processados utilizando estatísticas básicas e regressão. Resultados. Foi determinado que Huamanripa é usado para tratamento medicinal domiciliar e consumido 4 a 5 vezes por semana para doenças respiratórias e COVID-19, consumo de Huamanripa por mês com 23% da população, porcentagem de alívio de doenças respiratórias com 84%, correlação entre consumo de Huamanripa e porcentagem de alívio r = 0,99 e na análise de variância do consumo de Huamanripa e da porcentagem de alívio não houve significância. Conclusões. Conclui que Huamanripa é uma alternativa eficiente e pode ser complementada com outros tratamentos para condições respiratórias e sintomas da COVID-19; seja por suas propriedades como óleos especiais e terpenos que têm efeitos antimicrobianos, anti-inflamatórios, aliviadores, o que favorece a saúde.

Factores asociados a la percepción de estrés y ciclo académico en estudiantes, EPO - UNA-Perú / Factors associated with the perception of stress and academic cycle in students, EPO - UNA-Peru / Fatores associados à percepção de estresse e ciclo acadêmico em estudantes, EPO - UNA-Peru

Complementariamente, al estrés académico se le define como un proceso sistémico de carácter adaptativo y esencialmente psicológico. Objetivo. Determinar la relación de los factores asociados a la percepción del estrés con el ciclo académico en los estudiantes matriculados en el semestre académico 2020-I, en la Escuela Profesional de Odontología de la Universidad Nacional del Altiplano, Perú. Materiales y métodos. Se consideró el diseño de tipo no experimental de relacional y de corte transversal, con una muestra de 144 estudiantes, seleccionada por muestreo de tipo no probabilístico, donde se aplicó el cuestionario "Dental Environment Stress Questionaire". Resultados. En la dimensión de carga académica, la falta de tiempo entre seminarios y laboratorios o clínicas, falta de tiempo para realizar las tareas asignadas, asistencia y éxito en temas odontológicos, miedo a reprobar un curso o un semestre y falta de autoevaluación y el conocimiento de las propias competencias tienen una correlación positiva moderada con el ciclo académico, el retraso en la recepción de notas con el ciclo académico tiene una correlación positiva muy alta. En la dimensión de prácticas preclínicas y clínicas, la correlación de los factores que explican esta dimensión con el ciclo académico es positiva y baja; en la dimensión de tratamiento de pacientes, la correlación entre sus factores con el ciclo académico es positiva y muy bajo. Conclusiones. En la dimensión de Escuela Profesional y administración, la correlación de los factores considerados con el ciclo académico es positiva muy baja y en la dimensión de relaciones interpersonales, la correlación de competencia por las calificaciones y el ambiente creado por los docentes con el ciclo académico es positiva baja.

In addition, academic stress is defined as a systemic process of an adaptive and essentially psychological nature. Objective. To determine the relationship of the factors associated with the perception of stress with the academic cycle in students enrolled in the academic semester 2020-I, at the Professional School of Dentistry of the Universidad Nacional del Altiplano, Peru. Materials and methods. A non-experimental relational and cross-sectional design was considered, with a sample of 144 students, selected by non-probabilistic sampling, where the questionnaire "Dental Environment Stress Questionnaire" was applied. Results. In the dimension of academic load, lack of time between seminars and laboratories or clinics, lack of time to perform assigned tasks, attendance and success in dental subjects, fear of failing a course or a semester and lack of self-evaluation and knowledge of own competences have a moderate positive correlation with the academic cycle, the delay in receiving grades with the academic cycle has a very high positive correlation. In the dimension of preclinical and clinical practices, the correlation of the factors explaining this dimension with the academic cycle is positive and low; in the dimension of patient treatment, the correlation between its factors with the academic cycle is positive and very low. Conclusions. In the dimension of professional school and administration, the correlation of the factors considered with the academic cycle is positive and very low, and in the dimension of interpersonal relations, the correlation of competence for qualifications and the environment created by teachers with the academic cycle is positive and low.

Além disso, o estresse acadêmico é definido como um processo sistêmico de natureza adaptativa e essencialmente psicológica. Objetivo. Determinar a relação entre os fatores associados à percepção do estresse e o ciclo acadêmico dos alunos matriculados no semestre acadêmico de 2020-I na Faculdade Profissional de Odontologia da Universidade Nacional del Altiplano, Peru. Materiais e métodos. Foi considerado um projeto relacional não experimental e transversal, com uma amostra de 144 estudantes, selecionados por amostragem não-probabilística, onde foi aplicado o questionário "Questionário de Estresse do Ambiente Dental". Resultados. Na dimensão da carga acadêmica, a falta de tempo entre seminários e laboratórios ou clínicas, a falta de tempo para realizar as tarefas designadas, o comparecimento e o sucesso nas disciplinas odontológicas, o medo de falhar um curso ou um semestre e a falta de auto-avaliação e de conhecimento das próprias competências têm uma correlação positiva moderada com o ciclo acadêmico, a demora em receber notas com o ciclo acadêmico tem uma correlação positiva muito alta. Na dimensão da prática pré-clínica e clínica, a correlação dos fatores que explicam esta dimensão com o ciclo acadêmico é positiva e baixa; na dimensão do tratamento do paciente, a correlação entre seus fatores com o ciclo acadêmico é positiva e muito baixa. Conclusões. Na dimensão da escola profissional e da administração, a correlação dos fatores considerados com o ciclo acadêmico é positiva e muito baixa, e na dimensão das relações interpessoais, a correlação da competência para qualificações e do ambiente criada pelos professores com o ciclo acadêmico é positiva e baixa.

Tratamiento trombolítico de rescate en paciente con fístula arteriovenosa para hemodiálisis trombosada / Rescue thrombolytic treatment in patients with arteriovenous fistula for thrombosed hemodialysis

Introducción: La hemodiálisis continúa siendo la modalidad de terapia de reemplazo renal prevalente en el mundo. La disfunción de la fístula arteriovenosa para hemodiálisis tiene efectos negativos en el paciente y su calidad de vida, por lo que el acceso vascular funcional se necesita para un adecuado tratamiento de hemodiálisis en pacientes con enfermedad renal terminal. El mayor inconveniente del acceso vascular resulta su alta incidencia de oclusión trombótica, causada por la estenosis, la cual se inicia por lesiones hiperplásicas de la capa intimal del vaso. Una de las modalidades de tratamiento a nivel internacional es la trombólisis del acceso vascular trombosado de menos de 24 horas de evolución. Objetivo: Exponer los resultados obtenidos con la aplicación de la trombólisis percutánea del acceso vascular para hemodiálisis trombosado en paciente con enfermedad renal terminal. Presentación del caso: Paciente masculino de 52 años, con diagnóstico de trombosis aguda del acceso vascular para hemodiálisis por enfermedad renal terminal, de 5 días de evolución, con deterioro de su estado de salud por encontrarse subdializado y urémico, con agotamiento del acceso vascular global para hemodiálisis. Se utilizó el tratamiento fibrinolítico directo del acceso vascular percutáneo a 100 mil UI/hora de Heberquinasa® en 10 horas, con recuperación del latido, thrill y repermeabilización de la fístula para hemodiálisis. Conclusiones: El tratamiento fibrinolítico con Heberquinasa® permitió la recuperación del paciente con trombosis aguda del acceso vascular para hemodiálisis. Se evitaron complicaciones asociadas a la subdiálisis y/o colocación de catéter central, y se incorporó al paciente a su programa de hemodiálisis, con garantías para su calidad de vida(AU)

Introduction: Hemodialysis continues to be the prevalent renal replacement therapy modality in the world. Arteriovenous fistula dysfunction for hemodialysis has negative effects on the patients and their quality of life, so functional vascular access is needed for adequate hemodialysis treatment in patients with end-stage renal disease. The greatest drawback of vascular access is its high incidence of thrombotic occlusion, caused by stenosis, which is initiated by hyperplastic lesions of the intimate layer of the vessel. One of the treatment modalities at the international level is the thrombolysis of the thrombosed vascular access of less than 24 hours of evolution. Objective: To present the results obtained with the application of percutaneous thrombolysis of vascular access for thrombosed hemodialysis in patients with end-stage renal disease. Case presentation: Male patient of 52 years, with diagnosis of acute thrombosis of vascular access for hemodialysis due to end-stage renal disease, 5 days of evolution, with deterioration of his health state due to being sub-dialized and uremic, with exhaustion of the global vascular access for hemodialysis. Direct fibrinolytic treatment of percutaneous vascular access at 100 thousand IU/hour of Heberkinase® was used in 10 hours, with recovery of the heartbeat, thrill and repermeabilisation of the fistula for hemodialysis. Conclusions: Fibrinolytic treatment with Heberkinase® allowed the recovery of the patient with acute thrombosis from the vascular access for hemodialysis. Complications associated with sub-dialysis and/or central catheter placement were avoided, and the patient was incorporated into their hemodialysis program, with guarantees for their quality of life(AU)

Simulación y optimización de sistemas de vacunación con capacidad finita / Simulation and optimization of systems vaccination with finite capacity

Resumen Objetivo: Caracterizar y optimizar el flujo de pacientes dentro de un centro de vacunación, para los casos donde debe tomarse en cuenta que existe una capacidad finita en las colas frente a las estaciones. Materiales y Métodos: Se asume que los sistemas de vacunación se comportan como una red cerrada de colas con capacidad finita; para caracterizar el flujo de pacientes, se aplica simulación y un diseño experimental Box-Bhenken, donde las variables son las capacidades en las colas (buffer); posteriormente se obtienen los metamodelos del tiempo de ciclo y del número de pacientes vacunados, finalmente se calcula la asignación óptima de los lugares en las colas aplicando programación matemática. Resultados: Las colas de llenado de formatos, entrega de información y vacunación son las de mayor efecto sobre el tiempo de estadía; las colas de vacunación y el Triage son las de mayor efecto sobre la cantidad de pacientes vacunados.Si se maximiza la salida de pacientes, la mayor cantidad de lugares deben asignarse a la estación de vacunación y el resto de los espacios se distribuyen en las demás estaciones; por otra parte, si se minimiza el tiempo de estadía, entonces la mayor parte de los lugares se asignan a la estación Triage y a continuación a la estación de Vacunación, el resto de los espacios se asignarán dependiendo de la capacidad total del sistema. Conclusiones: Los responsables de administrar esta clase de sistemas deben definir el criterio bajo el cual deben cuantificar el desempeño del sistema de vacunación y a partir de este, gestionar y controlar el proceso. Cuando la demanda supera las expectativas y no es viable incrementar la capacidad, entonces la alternativa es optimizar el flujo controlando la cantidad de personas dentro del sistema.

Abstract Objective: Characterize and optimize the flow of patients within a vaccination center, for cases where it must be consider that there is a finite capacity in the queues in front of the stations. Materials and Methods: Vaccination systems are assumed to behave as a closed queue network with finite capacity; To characterize the flow of patients, simulation and a Box-Bhenken experimental design are applied, where the variables are the capacities in the queues (buffer); Subsequently, the metamodels of the cycle time and the number of vaccinated patients are obtained. Finally, the optimal allocation of places in the queues is calculated by applying mathematical programming. Results: The queues for filling out forms, delivery of information and vaccination are the ones with the greatest effect on the length of stay; the vaccination and triage queues have the greatest effect on the number of vaccinated patients. If the output of patients is maximized, the greatest number of places should be assigned to the vaccination station and the rest of the spaces are distributed in the other stations; On the other hand, if the length of stay is minimized, then most of the places are assigned to the Triage station and then to the Vaccination station, the rest of the spaces will be assigned depending on the total capacity of the system. Conclusions: Those responsible for managing this class of systems must define the criteria under which they must quantify the performance of the vaccination system and, based on this, manage and control the process. When demand exceeds expectations and increasing capacity is not feasible, then the alternative is to optimize flow by controlling the number of people within the system.

Transplante hepático em pacientes portadores de HIV: série de casos da região nordeste do Brasil / Liver transplantation in hiv patients: a case series from the northeast region of brazil

ABSTRACT Background: The emergence of potent combined highly active antiretroviral therapy (ART) in 1996 changed the natural history of HIV infection, with a significant reduction in mortality due to opportunistic infections but increased morbidity due to chronic cardiovascular, hepatic, and renal diseases. In May 2016, a reference center for liver transplantation in the Northeast of Brazil performed the first liver transplantations (LT) in HIV patients, with five others until 2021. Methods: The criteria for selection of LT were good adherence and absence of resistance to ART, HIV viral load maximum suppression, T-CD4+ lymphocyte count of more than 100 cells/mm3, and absence of opportunistic infections in the last 6 months. Results: Six liver transplants were performed between May 2016 and May 2021, five men, with a mean age of 53.2 years, and one was a diabetic patient. All patients had access to grafts with short cold ischemia with a mean time of 5 hours and 39 minutes. The 4-month survival rate was 100%, with a range time of follow-up of 4-63 months (mean time of 31 months). The mean pre-transplant T-CD4+ lymphocyte count was 436 cells/mm3. The mean length of hospital stay after transplantation was 16.8 days. One patient presented precocious vena cava thrombosis; another had stenosis of cavocaval anastomosis leading to refractory ascites, renal failure and post-transplant graft dysfunction, and another presented stenosis of choledochal anastomosis. Immunosuppression and prophylaxis were used according to standard protocols, and there were no differences in the profile of infections or rejection after liver transplantation. Conclusion: This case series documents good survival and usual transplant procedures for confirmed HIV cases.

RESUMO Contexto: A emergência da terapia antirretroviral de alta potência, em 1996, mudou a história natural da infecção por HIV, com redução significativa de mortalidade por infecções oportunistas, mas com aumento de morbidade por doenças crônicas cardiovasculares, hepáticas e renais. Em maio de 2016, um centro de referência em transplante hepático no Nordeste do Brasil realizou o primeiro transplante hepático em portadores de HIV, com cinco outros até 2021. Métodos: Os critérios de seleção para o transplante hepático foram: boa aderência e ausência de resistência à terapia antirretroviral, carga viral indetectável, contagem de linfócitos T-CD4+ acima de 100/ mm3 e ausência de infecções oportunistas nos últimos 6 meses. Resultados: Seis transplantes hepáticos foram feitos em portadores de HIV entre maio de 2016 e maio de 2021, cinco homens, com idade média de 53,2 anos, um paciente diabético. Todos os pacientes tiveram acesso a enxertos com tempo de isquemia fria curto com média de 5 horas e 39 minutos. A sobrevida em 4 meses foi de 100%, com tempo de acompanhamento de 4-63 meses (média de 31 meses). A contagem média de linfócitos T-CD4+ pré-transplante foi de 436 células/ mm3. A média de tempo de internação foi de 16,8 dias. Um paciente teve trombose de veia cava proximal; outro teve estenose de anastomose cavo-caval, levando à ascite refratária, falência renal e disfunção de enxerto pós-transplante; e outro teve estenose de anastomose do colédoco. A imunossupressão e a profilaxia foram usadas de acordo com protocolos padrão e não houve diferenças no perfil de infecções ou de rejeição pós-transplante. Conclusão: Esta casuística ilustra que o transplante de fígado em portadores do HIV apresenta complicações usuais e sobrevida satisfatória.

Caracterización de enfermos con cáncer de tiroides operados en el Hospital Clínico Quirúrgico General "Freyre de Andrade" / Characterization of Patients with Thyroid Cancer Operated on in "Freyre de Andrade" General Clinical Surgical Hospital

Introducción: El cáncer de tiroides es el tumor más común de los malignos originados en órganos endocrinos (más del 92 por ciento) y comprende un grupo de tumores que son diferentes clínicamente, epidemiológicamente y en cuanto a pronóstico. Objetivo: Caracterizar a los enfermos con cáncer de tiroides operados en el Hospital Clínico Quirúrgico General "Freyre de Andrade". Métodos: Se realizó un estudio descriptivo, retrospectivo de corte longitudinal en el Hospital Clínico Quirúrgico General "Freyre de Andrade" en el período 2014-2019. El universo estuvo constituido por 32 enfermos operados de cáncer de tiroides. Fueron analizadas variables sociodemográficas, clasificación de Bethesda, diagnóstico histológico, técnica quirúrgica empleada y complicaciones. Resultados: El cáncer de tiroides predominó en mujeres (87,5 por ciento) entre 51 - 60 años (25,0 por ciento). Según la clasificación de Bethesda prevaleció la categoría VI (15,62 por ciento). Predominó el carcinoma papilar (65,62 por ciento). A todos los enfermos se le realizó una tiroidectomía total y las complicaciones fueron el hematoma posoperatorio (6,25 por ciento) y el granuloma (6,25 por ciento). Conclusiones: El cáncer tiroideo predomina en mujeres entre la quinta y sexta década de la vida. La técnica quirúrgica que se utiliza es la tiroidectomía total con baja morbilidad. Predomina la variante histológica del carcinoma papilar(AU)

Introduction: Thyroid cancer is the most common malignant tumor originating in endocrine organs (more than 92 percent) and comprises a group of clinically, epidemiologically and prognostically different tumors. Objective: To characterize patients with thyroid cancer operated on at Freyre de Andrade General Clinical Surgical Hospital. Methods: A descriptive, retrospective and longitudinal study was carried out at Freyre de Andrade General Clinical Surgical Hospital in the period 2014-2019. The universe consisted of 32 patients operated on for thyroid cancer. Sociodemographic variables, Bethesda classification, histological diagnosis, used surgical technique and complications were analyzed. Results: Thyroid cancer predominated in women (87.5 percent) between 51 and 60 years of age (25.0 percent). According to the Bethesda classification, category VI prevailed (15.62 percent). Papillary carcinoma predominated (65.62 percent). All patients underwent total thyroidectomy, while the complications were postoperative hematoma (6.25 percent) and granuloma (6.25 percent. Conclusions: Thyroid cancer predominates in women between the fifth and sixth decades of life. The used surgical technique is total thyroidectomy, reporting low morbidity. The histological variant of papillary carcinoma predominates(AU)

Síndrome de Evans y embarazo: reporte de un caso / Evans syndrome and pregnancy: a case report

Resumen El síndrome de Evans es una enfermedad conformada por la presencia simultánea o secuencial de trombocitopenia inmunitaria y anemia hemolítica autoinmunitaria, que puede ser primaria o secundaria a otra patología. Es una afección poco frecuente, por lo que es necesario tener una alta sospecha, y descartar otras patologías que cursan con dichas alteraciones hematológicas, para hacer el diagnóstico. Su manejo representa un desafío terapéutico dado su curso crónico y recidivante. La presentación durante el embarazo se asocia a morbilidad materna y fetal. A continuación presentamos el caso de una gestante en quien se pesquisó trombocitopenia severa aislada al ingreso al control prenatal, y que en el curso del embarazo desarrolló AHAI conformando un síndrome de Evans, que se consideró secundario a LES incompleto al realizar el estudio reumatológico. Debido a la pobre respuesta al tratamiento médico con corticoides e inmunosupresores, la mayor parte del embarazo se mantuvo hospitalizada para observación, ajuste y cambio de terapia, siendo necesario recurrir a manejo quirúrgico con esplenectomía.

Abstract Evans syndrome is a rare entity formed by the simultaneous or sequential presence of immune thrombocytopenia and autoimmune hemolytic anemia, which can be primary or secondary to another pathology. The presentation of this disease during pregnancy is associated with maternal and fetal morbidity. The syndrome's diagnosis requires a high suspicion and the ruling out of other pathologies that can happen with the same hematological alterations. The management represents a therapeutic challenge because of its chronic and recurrent course. Below we present the case of a pregnant woman in whom isolated severe thrombocytopenia was detected at admission for prenatal control, and who developed AIHA during the pregnancy, forming Evans syndrome, which was considered secondary to incomplete SLE when performing the rheumatological study. Due to the poor response to medical treatment with corticosteroids and immunosuppressants, the patient was hospitalized for most of her pregnancy for observation, adjustment and change of therapy, and even it was necessary resort to surgical management with splenectomy.

Suicide after and during the COVID-19 pandemic in Mexico City

Objectives: Prior research has indicated that no increase in suicides occurred immediately following the declaration of the COVID-19 emergency in Mexico City. Here we examine longer-term overall suicide trends and trends according to basic demographic groups. Methods: We used interrupted time-series analysis to model trends in monthly suicides before COVID-19 (January 1, 2010 to March 31, 2020), comparing the expected number of suicides both overall and according to age and sex with the observed number of suicides for the remainder of 2020 (April 1, 2020 to December 31, 2020). Results: There was an overall increase in suicides during the first 9 months of the pandemic, with a rate ratio of 2.07 (1.86-2.31). The increase began in the early months of the pandemic and remained stable and high after June 2020. Men and women, younger people (< 45) and older people (≥ 45) were affected. The increase was especially high among older women (RR = 3.33; 2.04-5.15). Conclusions: The increase in suicides in Mexico City is worrying and highlights the need to strengthen economic development, mental health, and well-being programs. Suicides among older women should be closely monitored. There is an urgent need to expand primary health care services to include robust suicide prevention and treatment options.

Jejunal perforation secondary to kick during kick-boxing practice: laparoscopic management / Perforación yeyunal secundaria a patada durante práctica de kick-boxing: Manejo laparoscópico

Abstract Small bowel injury in a sports setting is a rare occurrence with a paucity of reported cases. A 30-year old male patient consulted for generalized abdominal pain subsequent to secondary blunt abdominal trauma during kick-boxing practice. A computed tomography scan of the abdomen and pelvis revealed a moderate amount of free fluid in both the parietocolic space and the rectovesical pouch, with perihepatic pneumoperitoneum. Emergency laparoscopy was indicated and a closure of small bowel defect was performed. Diagnosis of small bowel injuries is difficult, resulting in delayed treatment and increased mortality and morbidity.

Resumen La lesión intestinal en un entorno deportivo es infrecuente con pocos casos comunicados. Un varón de 30 años consultó por dolor abdominal generalizado posterior a un traumatismo abdominal cerrado secundario a la práctica de kick-boxing. Una tomografía computarizada de abdomen y pelvis reveló líquido libre tanto en el espacio parietocólico como en la bolsa rectovesical, con neumoperitoneo perihepático. Se indicó laparoscopia exploradora con cirugía de rafia intestinal. El diagnóstico de las lesiones del intestino delgado es difícil, lo que provoca un retraso en el tratamiento y un aumento de la mortalidad y la morbilidad.