Dynamic of Glucose Homeostasis in Virtual Patients: A Comparison between Different Behaviors.

This work presents a mathematical model of homeostasis dynamics in healthy individuals, focusing on the generation of conductive data on glucose homeostasis throughout the day under dietary and physical activity factors. Two case studies on glucose dynamics for populations under conditions of physical activity and sedentary lifestyle were developed. For this purpose, two types of virtual populations were generated, the first population was developed according to the data of a total of 89 physical persons between 20 and 75 years old and the second was developed using the Monte Carlo approach, obtaining a total of 200 virtual patients. In both populations, each participant was classified as an active or sedentary person depending on the physical activity performed. The results obtained demonstrate the capacity of virtual populations in the generation of in-silico approximations similar to those obtained from in-vivo studies. Obtaining information that is only achievable through specific in-vivo experiments. Being a tool that generates information for the approach of alternatives in the prevention of the development of type 2 Diabetes.

Efecto protector del Desmodium molliculum EAM (manayupa) en ratas con toxicidad hepática inducida por naproxeno / Protective effect of Desmodium molliculum EAM (manayupa) in rats with naproxen-induced liver toxicity

Objetivo. Verificar el efecto protector del extracto acuoso de hojas y tallos de Desmodium molliculum EAM (manayupa), en la toxicidad hepática inducida por el naproxeno en ratas Ratus novergicus variedad Wistar albino, hembras. Materiales y métodos. Estudio experimental. Se utilizaron 36 ratas hembras de 250 ± 10 g, divididas en seis grupos de seis: A (control -); B (control + naproxeno); patrón C (silimarina 100 mg / kg) y 3 experimental (EAM): D 80 mg/kg; E 160 mg/kg y F 240 mg/kg). Los grupos B, C, D, E, F recibieron por vía oral naproxeno 27,38 mg, los primeros cinco días y durante 14 días. El efecto protector hepático se determinó mediante el análisis bioquímico: GOT, GPT, GGT, proteínas totales, albúmina sérica, fosfatasa alcalina y creatinina. Resultados. Se encontró que el grupo B perdió peso (180,65 ± 6,5 g), bilirrubina total (0,76 ± 0,4) bilirrubina directa (1.7 ± 0,8), TGO (160 ± 10,4) y TGP (412 ± 20,4) alto, comparado con el grupo A, C, D, E y F. Conclusiones. El EAM tiene efecto protector sobre la toxicidad hepática inducida por naproxeno en ratas, evidenciado por los parámetros bioquímicos.

Objective. To verify the protective effect of the aqueous extract of leaves and stems of Desmodium molliculum EAM (manayupa), on the hepatic toxicity induced by Naproxen in rats Ratus novergicus albino Wistar variety, females. Materials and methods. 36 female rats of 250 ± 10 g were used, divided into six groups of six: A (Control -), B (Control + Naproxen), Pattern C (Silymarin 100 mg / kg) and 3 Experimental (EAM): D 80 mg / kg, E 160 mg / kg and F 240 mg / kg). Groups B, C, D, E, F orally received Naproxen 27.38 mg, the first five days and for 14 days. The hepatic protective effect was determined by the biochemical analysis: GOT, GPT, GGT, total proteins, serum albumin, alkaline phosphatase, creatinine. Results. group B was found to lose weight (180.65 ± 6.5 g), total bilirubin (0.76 ± 0.4) direct bilirubin (1.7 ± 0.8), TGO (160 ± 10.4) and TGP (412 ± 20.4) high, compared to group A, C, D, E and F. Conclusion. EAM has a protective effect on hepatic toxicity induced by naproxen in rats, evidenced by biochemical parameters.

The utility of preoperative level of erythrocytosis in the prediction of postoperative blood loss and 30-day mortality in patients with tetralogy of fallot.

BACKGROUND: Postoperative major bleeding is a relatively common complication of patients undergoing corrective surgery of tetralogy of Fallot (TOF). Life-threatening blood losses can lead to aggressive transfusions or reoperation. Little is known about the risk factors associated with a bleeding tendency in TOF patients. This study aimed to establish predictive models for postoperative blood loss and mortality in TOF patients. METHODS: We conducted a retrospective observational study involving patients with TOF who were posted for corrective cardiac surgery in a single hospital between 2010 and 2015. Hospital records including sociodemographic, pre- and intra-operative characteristics were extracted. Postoperative blood loss (within 24 and 48 h) and 30-day mortality were the primary and secondary outcomes, respectively. Multivariate linear and logistic regression models were used to identify determinants of outcomes. RESULTS: A total of 60 patients were included in this study. The median age was 1 year (interquartile range = 0.62-5) and the male to female ratio of 1.7:1. Mean postoperative blood loss within 24 h was 283 ± 212 mL. In multivariate linear regression, preoperative hematocrit (ß = 6.63, P = 0.042) and duration of intraoperative oxygenator with CPB (ß = 5.16, P = 0.025) were significantly correlated with postoperative blood loss within 24 h. After adjusting for sociodemographic, intra- and post-operative characteristics, preoperative hematocrit (odds ratio [OR] = 1.10, 95% confidence interval [CI] = 1.01-1.21), and postoperative red blood cell transfusions (OR = 3.88, 95% CI = 1.16-12.9) showed statistically significant association with 30-day mortality. The area under the receiver operating characteristic curve of the multivariable model was 0.863. CONCLUSIONS: Preoperative levels of erythrocytosis appear to predict postoperative blood loss and short-term mortality in TOF patients undergoing corrective surgery.

Factores influyentes en el rendimiento académico de estudiantes del primer año de medicina / Factors associated with academic performance in first-year medical students

Introducción: El rendimiento académico dentro de la universidad es el producto de la influencia de múltiples factores, los cuales se ponen de manifiesto desde los primeros años de estudio. Objetivos: Identificar los factores que afectarían el rendimiento académico en los estudiantes de medicina del primer año de estudios. Diseño: Estudio observacional longitudinal. El tipo de muestreo utilizado fue no probabilístico por cuotas. Lugar: Facultad de Medicina de San Fernando, Universidad Nacional Mayor de San Marcos (UNMSM), Lima-Perú. Participantes: Estudiantes de medicina durante el primer año de estudios. Intervenciones: Un cuestionario aplicado a los participantes, examen físico, psicológico y análisis de laboratorio. Principales medidas de resultados: Factores que influyen en el rendimiento académico bajo. Resultados: Se evaluó 40 estudiantes de ambos sexos (14 mujeres y 26 varones), con edades comprendidas entre 18 y 30 años. Procedian de colegio estatal 31 (78%) y de colegio privado 9 (23%); en cuanto a hábitos de estudio, 27 (67%) refirieron leer las materias propias de la profesión, por lo menos una vez al día, mientras que 13 (33%) lo hacía de manera semanal. El número de horas de estudio al dìa consistió en 1 a 2 horas al día en 10 (25%), 3 a 4 horas de estudio en 18 (45%), 5 a 6 horas de estudio em 10 (25%) y 2 de ellos (5%) refirieron estudiar solo en fechas de exámenes; 25 alumnos (62%) tuvieron como estrategia de estudio solo el uso de la memoria, 7 (18%) utilizaron la memoria más los apuntes de clase, 4 de ellos (10%), apuntes más esquemas, y 4 (10%), apuntes más esquemas y textos. El carácter predominante de los alumnos fue alegre en 22 (55%) y no alegre en 18 (45%). La autoestima fue considerada alta en 15 de los participantes (37,5%), autoestima moderada en 21 (52,5%).

Introduction: The low academic performance at the university is influenced by multiple factors manifested in the early years of study. Objectives: To determine the factors affecting the low academic performance of medical students during their first year of studies. Design: Observational, longitudinal study. Non-probability sampling was used for assessments. Setting: San Fernando Faculty of Medicine, San Marcos National University, Lima-Peru. Interventions: A questionnaire, physical, psychological and laboratory examinations were applied. Main outcome measures: Factors that influence low academic performance. Results: Forty students (14 females and 26 males), aged between 18 and 30 years, were evaluated; 31 came from state schools (78%) and 9 from private schools (23%). With regards to study habits, 27 (67%) reported reading the subjects of the profession at least once a day, and 13 (33%) did so weekly. Study hours per day were1 to 2 in 10 (25%), 3 to 4 hours in 18 (45%), 5 to 6 hours in 10 (25%) and 2 (5%) reported studying only the day of test; 25 students (62%) presented as a strategy to study only by memory, 7 (18%) used memoryplus class notes, 4 (10%) used diagrams and notes, and 4 (10%) notes and diagrams and texts. The students predominant character was cheerful in 22 (55%) and not happy in 18 (45%). Self-esteem was considered high in 15 participants (37,5%), moderate in 21 (52,5%) and low in 4 (10%). The socio-economic aspect of the participants revealed that in 17 cases(42,5%) family income was equal to or less than S/ 1 500 (one thousand five hundred soles) a month, the house was own in 23 (57,5%) and rented in 17 (42,5%). House location was largely in popular areas in 25 (62,5%), followed by residential area in 10 (25%), and human settlements in 5 (12,5%).

Relajantes musculares en pacientes quemados y su interrelación con niveles de potasio / Neuromuscular relaxants in burned patients and its relation with potasium plasma levels

Se realizó un estudio clínico doble ciego, aleatorio comparando el uso de 3 relajantes musculares (Succinilcolina, Vecuronio, Atracurium) en 38 pacientes quemados de ambos sexos rango de edad entre 1 y 50 años (x=17 años) con quemaduras mayor del 25 por ciento de superficie corporal total y profundidad de II y III grado, para evaluar los niveles de potasio en el período pre y post inducción. La anestesia fue inducida con Fentanyl a dosis de 1-2 microgramos/kg y Tiopental sódico a dosis de 5-7 mgs/kg; Grupo I (n=15) recibieron Succinilcolina a dosis de 2 mg/kg EV, precurarizado con D-Tubocurarina a dosis de 0.01 mg/kg EV; el Grupo II (n=12) recibieron Vecuronio dosis de impregnación 0.06 mg/kg y a los 3 minutos 0.1 mg/kg; el Grupo III (n=11) Atracurium con dosis de impregnación de 0.06 mg/kg EV y a los 3 minutos 0,25 mg/kg EV. El mantenimiento anestésico se hizo con 02-Etrane-Fentanyl. Todos los pacientes fueron monitorizados con método no invasivo para tensión arterial, estetoscopio precordial, pulsioxímetro y ECG continuo (DII). Los niveles de potasio plasmático fueron medidos 5 minutos antes y 5 minutos después de la inducción, por el método de fotometría de llama con litio como patrón interno. Los resultados no mostraron cambios estadísticamente significantes(P>0.05); los niveles de potasio permanecieron invariables. La calidad de la relajación para la intubación fue adecuada en el Grupo I y II. El presente estudio muestra que la Succinilcolina no produce significantes cambios en los niveles de potasio, en los pacientes quemados y las complicaciones asociadas con su administración son iguales a las que se presentan en los pacientes normales