Pre-operative factors associated with short- and long-term outcomes in the patient with inguinal hernia: What does the current evidence say?

Hernia repair is one of the most frequent interventions in surgery worldwide. The approach to abdominal wall and inguinal hernias remains a challenge due to emerging evidence on aspects such as timely diagnosis, use of innovative techniques or post-surgical care. However, pre-operative preparation is also a factor that substantially affects the absolute success rate of this type of condition. Time management between diagnosis and intervention, control of diseases that increase intra-abdominal pressure, weight and nutritional status, are some of the many elements to be considered in this type of patients before surgery. Considering that this condition carries high health care costs, especially in case of recurrence, has a risk of complications and affects the individual's functional capacity, the objective of this review is to synthesize evidence on the role of these factors on the short- and long-term outcome of inguinal hernia management, and to make suggestions on the general approach to this type of patients.

Synthesis of 1-Azaspiro[4.4]nonane Derivatives Enabled by Domino Radical Bicyclization Involving Formation and Capture of Alkoxyaminyl Radicals.

The application of a domino radical bicyclization for the synthesis of compounds containing the 1-azaspiro[4.4]nonane skeleton in 11-67% yields as a mixture of diastereomers is described (trans configuration preference). This process involved formation and capture of alkoxyaminyl radicals. For this purpose, O-benzyl oxime ethers with a brominated or iodinated aromatic ring or a terminal alkynyl group and an alkenyl moiety were employed as starting materials. The bicyclization was initiated by 2,2'-azobisisobutyronitrile or triethylborane and promoted by Bu3SnH. The best results were obtained with O-benzyl oxime ethers containing an alkenyl moiety tethered to electron withdrawing groups or aryl substituents, whereas oxime radical precursor attached to methyl-substituted olefin precluded the capture of alkoxyaminyl radical, giving rise mainly to monocyclized product.

Experimental characterization of the complete life cycle of Haemoproteus columbae, with a description of a natural host-parasite system used to study this infection.

Characterization of complete life cycles of haemoparasites requires the maintenance of suitable susceptible vertebrate hosts and vectors for long periods in captivity, in order to follow the complete parasitic cycle in definitive and intermediate hosts. Currently, there are few host-parasite models established in avian haemosporidian research, and those have been developed mainly for species of Passeriformes and their parasites. This study aimed to develop an experimental methodology to access the complete life cycle of Haemoproteus columbae (cytb lineage HAECOL1), which parasitizes the Rock Pigeon (Columba livia) and louse fly (Pseudolynchia canariensis). A colony of louse flies, which are the natural vectors of this parasite, was established. Thirty newly emerged insects were exposed to H. columbae infection and used to infect naïve Rock Pigeons. The peak of parasitaemia (acute stage) was seen between 27 and 32 days p.i. when up to 70.8% of red blood cells were infected. The crisis occurred approximately 1 week after the peak, and the long-lasting chronic parasitaemia stage followed. Exo-erythrocytic meronts were seen mainly in the lungs where extensive tissue damage was reported, but also in the kidneys and spleen. In the vector, the sporogonic cycle of H. columbae was completed between 13 and 16 days p.i., at an average temperature ranging between 12 and 15 °C. This host-parasite model is tractable for maintenance in captivity. It is recommended for use in studies aiming for detailed characterization of host-parasite relationships in areas such as physiology, pathology, immunobiology, genetics, as well as for evaluative treatments and to follow the infection in any stage of parasite development both in the vertebrate or invertebrate host.

Effects of Resisted Sprints With Changes of Direction Through Several Relative Loads on Physical Performance in Soccer Players.

PURPOSE: To compare the effects of resisted change-of-direction (COD) movements, using several relative loads, on soccer players' physical performance. METHODS: Fifty-four male soccer players were randomly assigned to 1 of the following 3 groups, which differed only in the magnitude of the external load used during the COD training: COD training without external load (COD-0; n = 16), COD training with a 12.5% body-mass external load (COD-12.5; n = 19), and COD training with a 50% body-mass external load (COD-50; n = 19). Participants performed the specific COD training twice per week for 6 wk. Before and after the training period, a battery of tests was completed: countermovement jump, 30-m running sprint (time in 10 m [T10], 20 m [T20], and 30 m [T30]), L-run test, and V-cut test. RESULTS: Within-group comparisons showed substantial improvements in countermovement jump and T10 (likely) in COD-0, whereas countermovement jump, T10, and T20 were substantially enhanced (possibly to likely) in COD-50. COD-12.5 induced substantial improvements in all analyzed variables (likely to most likely). Between-groups comparisons showed better effects on all analyzed variables for COD-12.5 than for COD-0 (possibly to very likely), whereas COD-50 only showed possibly better effects than COD-0 on T10. In addition, COD-12.5 induced a better effect on L-run and V-cut tests than COD-50 (possibly to likely). CONCLUSIONS: These results indicate that COD training, especially moderate load (12.5% body mass) resisted COD training, may have a positive effect on COD skills, running sprint performance, and jumping ability in young soccer players.

Influencia de la musicoterapia en el Trastorno de espectro autista Grado 1 / Influence of music therapy in Autism Spectrum Disorder Grade 1

El desarrollo de lenguaje es un pilar fundamental en el desarrollo infantil y necesario para el desarrollo para habilidades sociales. Investigaciones a lo largo de décadas se han dedicado a entender la conexión entre la música y nuestros procesos cognitivos cómo aprendizaje, lenguaje y entendimiento simbólico. Que han demostrado que esta terapia facilita el desarrollo del discurso en pacientes con un trastorno del espectro autista. Existen dos tipos de musicoterapia: activa y pasiva. Donde en la terapia activa el sujeto interpreta un instrumento, canta o danza; por otro lado la terapia pasiva se propone a inducir al paciente a un estado que permita llevar un proceso integro para la persona mediante sesiones de escucha de 20 a 30 minutos donde la vibración y las ondas de la música ayudan a regular las frecuencias cerebrales. Estudios comparativos muestran un efecto positivo con los pacientes en tratamiento en el desarrollo del lenguaje, estructuras cognitivas, reconocimiento de patrones e inteligencia verbal. Conclusiones: Estas influencias de la terapia conforman las bases y soporte que posteriormente ayudan en el sostenimiento de relaciones y habilidades social. (AU)

Factores asociados a infección por VIH-1 en hijos de madres con infección VIH-1 del Hospital Daniel A. Carrión entre Enero del 2005 y Diciembre del 2009 / Factors associated with HIV-1 infection in children of mothers with HIV-1 infection at the Hospital Daniel A. Carrion between January 2005 and December 2009

INTRODUCCION: La transmisión vertical del virus de la inmunodeficiencia humana sigue siendo un problema de salud pública en nuestro país, a pesar de que en los últimos 15 años la tasa de transmisión vertical del VIH se ha reducido significativamente tras la aplicación de distintas medidas profilácticas como el uso de antirretrovirales, la cesárea electiva y la lactancia artificial exclusiva. El seguimiento y tratamiento de estos niños afectados es todo un reto tanto como para el especialista como para el pediatra en la práctica clínica habitual. Por lo que esta investigación tiene como objetivo: determinar los factores asociados a infección por VIH-l en hijos de madres con infección por VIH-1 del Hospital Daniel A. Carrión entre enero del 2005 y diciembre del 2009. MATERIAL Y METODOS: Se revisaron retrospectivamente las historias clínicas de los pacientes pediátricos nacidos en el Hospital Daniel A. Carrión, Callao entre enero del 2005 a diciembre del 2009, con el antecedente de ser hijos de madres con infección por VIH-1, de acuerdo a los criterios de inclusión y exclusión, llenándose una ficha de recolección de datos, y luego se procedió al análisis de los datos, mediante el programa SPSS 18.0. RESULTADOS: Se obtuvo una población de 41 pacientes, de los cuales el porcentaje de niños que desarrollaron infección VIH fue del 12.2 por ciento. El porcentaje de niños con antecedente de ser hijos de madres con infección por VIH, que recibieron tratamiento profiláctico con Zidovudina, luego del nacimiento fue del 100 por ciento. La edad gestacional promedio de niños que desarrollaron la enfermedad fue de 37.8 semanas, mientras que la de los niños que no desarrollaron la enfermedad fue de 38.47 semanas. Los hijos de madres que recibieron TARGA durante el embarazo no desarrollaron la infección, mientras que el 26.3 por ciento de los niños de madres que no recibieron TARGA durante el embarazo desarrollo la infección. El peso promedio del neonato infectado fue menor...

INTRODUCTION: Vertical transmission of human immunodeficiency virus remains a public health problem in our country, even though in the past 15 years the rate of HIV transmission has been significantly reduced after the application of different prophylactic measures such as the use antiretrovirals, elective caesarean section and bottle feeding exclusively. Monitoring and treatment of these affected children is a challenge both to the specialist and to the pediatrician in routine clinical practice. Therefore, this research aims: to determine the factors associated with HIV-1 infection in children of mothers with HIV-1 infection in the Hospital Daniel A. Carrion between January 2005 and December 2009. MATERIALS AND METHODS: We retrospectively reviewed the medical records of pediatric patients born in the Hospital Daniel A. Carrion, Callao, from January 2005 to December 2009, with a history of being born to mothers with HIV-l, according to the inclusion and exclusion criteria, filling a form of data collection, and then proceeded to data analysis, using SPSS 17.0. RESULTS: The study included 41 patients, of which the percentage of children who developed HIV infection was 12.2 per cent. The percentage of children with a history of being children of HIV-infected mothers who received prophylactic zidovudine after birth was 100 per cent. The average gestational age of children who developed the disease was 37.8 weeks, while the children who did not develop the disease was 38.47 weeks. Children of mothers who received HAART during pregnancy did not develop infection, while 26.3 per cent of children of mothers who did not receive HAAR T during pregnancy infection development. The average weight of infected newborns was lower than the average weight of the baby is not infected. The 3.0 per cent of children born by cesarean delivery, HIV-infected mothers, developed HIV infection, while in children born by vaginal delivery this percentage was 50.0 per cent. CONCLUSIONS...

The decline of verbal and visuospatial working memory across the adult life span.

It has been well established that working memory abilities decrease with advancing age; however, the specific time point in the adult life span at which this deficit begins and the rate at which it advances are still controversial. There is no agreement on whether working memory declines equally for visuospatial and verbal information, and the literature disagrees on how task difficulty may influence this decay. We addressed these questions in a lifespan sample of 1,500 participants between 21 and 80 years old. The n-back task was used, with letters and circles presented at different positions around an imaginary circle, to evaluate working memory in the verbal and visuospatial domains, respectively. The participants' task was to judge whether the current stimulus matched a stimulus that was shown n trials prior. Both domains were evaluated in two levels of difficulty: 1-back and 2-back. The comparison across decades showed that discrimination in the visuospatial and 1-back tasks started to decline earlier in women than in men; however, discrimination was equal between the sexes in the verbal and 2-back tasks. Performance on tasks in the visuospatial domain exhibited more pronounced decline than in those in the verbal domain. The rate of decline in working memory accuracy was superior in 2-back tasks than in 1-back tasks, independent of the domain. These results revealed that the effects of aging on working memory are less dependent on the type of information and more reliant on the resources demanded by the task.

The rate of source memory decline across the adult life span.

Previous studies have suggested that the ability to remember contextual information related to specific episodic experiences declines with advancing age; however, the exact moment in the adult life span when this deficit begins is still controversial. Source memory for spatial information was tested in a life span sample of 1,500 adults between the ages of 21 and 80. Initially, images of common objects were randomly presented on one quadrant of a screen while the participants judged whether they were natural or artificial. During the retrieval phase, these same images were mixed with new ones, and all images were displayed in the center of the screen. The participants were asked to judge whether each image was new or old, and whether it was old, to indicate in which quadrant of the screen it had originally been presented. Source accuracy decreased linearly with advancing age at a rate of 0.6% per year across all decades even after controlling for educational level; this decline was unaffected by sex. These results reveal that either spatial information becomes less efficiently bound to episodic representations over time or that the ability to retrieve this information decreases gradually throughout the adult life span.

Tumores avanzados de testículo: experiencia con quimioterapia / Advanced testicular tumors: experience with drug theraphy

21 pacientes con tumores de testículo avanzados han sido tratados con quimioterapia en el Instituto Oncológico Luis Razetti e Instituto Médico. La Floresta desde 1984. 19 pacientes han sido evaluables para respuesta. 15 pacientes presentaron por lo menos uno de los siguientes factores de mal pronóstico: Masa abdominal mayor de 10 cms, lesión mediastinal, heliar o pulmonar con diámetro mayor de 2 cms. Enfermedad visceral (excluyendo los pulmones) en hígado, tracto gastrointestinal, huesos y Sistema Nervioso Central. Tumores Extragonadales. 4 pacientes no presentaron factores de mal pronóstico. Los pacientes con factores de mal pronóstico fueron tratados con los regímenes VBD-VP-16 (vimblastina, bleomicina, cisplatino en alta dosis y VP-16) y desde Septiempre de 1986 con el régimen BEP (bleomicina, etoposido, cisplatina a dosis convencionales). Dos pacientes con seminoma fueron tratados con la combinación VAB-6. De 19 pacientes evaluables, 10(52.6) obtuvieron una respuesta completa: cuatro (21%) con quimioterapia y seis (31.5%) con quimioterapia y resección de las masas residuales. Seis pacientes presentaron respuesta imcompleta y uno de los pacientes no respondió al tratamiento. La toxicidad hematológica fue severa con dos muertes toxicas relacionadas al régimen VBD-VP-16. Después de un seguimiento medio de 20 meses (9 a 45 meses) once pacientes (58.7%) se encuentran libres de enfermedad. El tratamiento con quimioterapia desde 1984 ha mejorado las perspectivas en nuestros pacientes con tumores de testículo comparado a nuestras series recientemente revisadas