Use of audiovisual devices in transnasal endoscopy without sedation to improve tolerance. A prospective clinical trial.

INTRODUCTION AND AIM: Transnasal endoscopy (TNE) has proven its diagnostic utility, but it has not been widely accepted given that it is performed without sedation. There are no previous studies on the use of methods to improve its tolerability. Our aim was to evaluate the tolerability of TNE, when simultaneously performed with an audiovisual device as a distractor. METHODS: We evaluated 50 patients, 10 of whom did not agree to participate. The performance of the procedure was explained, using an audiovisual device. Before randomization, we applied anxiety and depression scores. Patients were divided into 2 groups: Group I (using an audiovisual device during the procedure) and Group II (without a device). Anxiety and numeric pain rating scales were used, and vital signs were monitored and recorded before, during, and after the endoscopy. An overall procedure satisfaction score was applied at the end of the study and 24 h later. RESULTS: Mean age was 41.6 years and 35 of the patients were women (87.5%). The most frequent indication for TNE was refractory gastroesophageal reflux disease. There were no severe comorbidities, and none of the patients had a significant anxiety or depression score. One patient in Group II did not tolerate TNE due to nasal pain. There was no statistically significant difference between groups, regarding anxiety, pain, vital signs, and satisfaction scale. CONCLUSION: Our study showed that TNE was well tolerated and had a high acceptance rate in our patients. The use of distracting audiovisual devices did not increase tolerance to the endoscopic procedure.

The Spatial-Numerical Association of Response Codes (SNARC) effect in highly math-anxious individuals: An ERP study.

The Spatial-Numerical Association of Response Codes (SNARC) effect was examined in highly (HMA) and low math-anxious (LMA) individuals performing a number comparison in an ERP study. The SNARC effect consists of faster latencies when the response side is congruent with number location in the mental number line (MNL). Despite the stronger SNARC effect in the HMA group, their responses in incongruent trials were slower than in congruent trials only for the largest numerical magnitudes. Moreover, HMAs showed a less positive centroparietal P3b component in incongruent trials than in congruent ones, but only for the largest magnitudes. Since the SNARC effect arises during response selection and P3b positivity decreases with the difficulty of decision, this result suggests that HMA individuals might find it more difficult than LMAs to control the conflict between the automatically activated location of numbers in the MNL and the response side, especially in more cognitively demanding trials.

Piomiositis de localización inusual / Pyomyositis of unusual location

Presentamos el caso de una niña de nueve años que presenta una tumoración del músculo esternocleidomastoideo en el contexto de un traumatismo con diagnóstico definitivo de piomiositis. El texto repasa la sintomatología, las pruebas complementarias y el tratamiento, así como los principales diagnósticos diferenciales (AU)

We report the case of a nine-year-old girl who presents a post-traumatic sternocleidomastoid tumoration with final diagnosis of pyomyositis. Symptomatology, diagnostic tests, treatment and main differential diagnosis are reviewed (AU)

Respuesta psicofisiológica en un salto táctico paracaidista HAHO. Caso de Estudio / Psychophysiological response in a HAHO tactical parachute jump. A case study

Esta investigación tiene por objeto analizar la respuesta psicofisiológica de un paracaidista en un salto HAHO. Se analizó a un saltador experimentado de la Brigada Paracaidista del Ejército de Tierra Español en un salto HAHO, salto a 18000 pies y apertura a 16000 pies. Antes y después del salto se evaluaron parámetros de fuerza muscular, activación cortical, creatinfosfokinasa y glucosa, percepción subjetiva de esfuerzo y habilidades motrices finas específicas. Durante el salto se evaluó la frecuencia cardiaca, la modulación autonómica y la acelerometría. Los datos muestran como un salto HAHO provocó un aumento de la modulación simpática, alcanzando valores de frecuencia cardiaca máxima de 175 pulsaciones, una disminución de la activación cortical y de la fuerza muscular, un aumento de la creatinfosfokinasa, un mantenimiento de la glucosa, una percepción subjetiva de esfuerzo inferior a la respuesta orgánica evaluada y ningún efecto sobre la habilidad motriz fina especifica del combatiente

This research aimed to study the psychophysiological response in a HAHO parachute jump. A HAHO jump, jump at 18,000 feet and opening at 16,000 feet, was evaluated in one warfighter of the Paratrooper Brigade of the Spanish Army. Before and after the HAHO jump parameters of muscle strength, cortical arousal, blood levels of creatinekinase and glucose, rated of perceived exertion and specific fine motor skills were assessed. During the jump heart rate, autonomic modulation and accelerometry were evaluated. The data shows as a HAHO jump caused an increased sympathetic modulation, reaching values of maximum heart rate of 175 beats per minute, a decreased in cortical arousal and muscle strength, an increased blood levels of creatinekinase, a maintenance of blood glucose, a rated of perceived exertion lower than the assessed organic response and no effect on specific fine motor skills of the warfighter

Morphometric analysis of nodules in human onchocerciasis collected in communities of the southern Chiapas focus, México.

Human onchocerciasis is a disease that remains as an important public health problem. The morphometric and physical characteristics of 363 Onchocerca volvulus nodules collected in the major endemic focus of onchocerciasis in Southern Chiapas (Soconusco), was assessed. In the present work we found that treatment the morphometry of 363 onchocercal nodules preserved in a 67% glycerol solution was determined by measuring the length, width and thick of each nodule with a Vernier caliper. The mass was determined with an analytical balance and the volume by measuring the water displacement, while the specific gravity was calculated by dividing mass over the volume. Statistical analysis was calculated for each parameter. The results showed that the nodules were rather longer than wider or thicker. Morphometric characteristics were 9.87 +/-3.70 (mean +/- standard deviation), 7.52 +/- 2.81, and 4.62 +/-+/- 2.06 mm for length, width and thick respectively. In regard to the shape, 62.81% of the nodules showed a lenticular shape, while 18.18% were spherical and 19.01% were ovoid. Based on the distribution of frequencies of the length, the nodules were classified in three groups: the "small" (5.77 +/- 0.73 mm; n = 104, 28.65%), the "medium" group (9.86 +/- 2.05 mm; n = 203 nodules, 55.92%), and the group of the "big" ones (16.03 +/- 1.91 mm; n = 56, 15.43%). Moreover, the physical characteristics were: for the mass 0.33 +/- 0.24 g, the volume of displaced water was 0.28 +/- 0.26 ml, and the specific gravity was 1.10 +/- 0.55 g/ml. The results indicated that most of the Mexican Onchocerca nodules have a lenticular shape with average size of 10x7x5 mm, which is useful in the knowledge of the genus biodiversity and can be taken as a parameter in clinical or epidemiological trials, where onchocerciasis remains as a public health problem.