Estudio piloto sobre la afectación de los servicios de las residencias medicalizadas de ancianos por efecto de la Covid-19 / Pilot study on the impact of COVID-19 on the services provided in nursing homes for the elderly

Objetivo: la COVID-19 ha azotado con virulencia a las residencias de ancianos en España. Los numerosos contagios y fallecimientos, la afectación sobre la salud física y mental de los profesionales o las medidas sanitarias de protección y prevención, han afectado a ciertos servicios fundamentales para los usuarios, empeorando su salud y calidad de vida. El presente estudio pretende identificar los servicios afectados por la pandemia, determinar el grado de afectación de los mismos y establecer posibles diferencias de opinión en función de los datos sociodemográficos y laborales de los profesionales respondientes. Método: muestreo intencional, 49 profesionales de dos residencias medicalizadas en Morón de la Frontera (Sevilla), metodología de encuesta, diseño cuasiexperimental y transversal, análisis descriptivos e inferenciales (contrastes de medias) con el programa SPSS. Resultados: muchos servicios se han visto afectados, aunque en distinto grado. En grado alto, las relaciones sociales y terapias ocupacionales; en grado medio, la salud física y mental, ABVD y educación social. En menor grado, AIVD y recursos sociales. Así mismo, no se hallaron diferencias significativas en las respuestas debidas al sexo, edad, formación, profesión o residencia (p-valor ≥.05 en todos los casos), mostrando así un alto grado de acuerdo en las opiniones de los profesionales. Conclusiones: numerosos servicios y rutinas, fundamentales para la calidad de vida de los usuarios, resultaron multi-afectados por efecto de la pandemia en ambos centros residenciales para personas mayores. (AU)

Objective: COVID-19 has hit nursing homes in Spain with virulence. The numerous infections and deaths, the impact on the physical and mental health of the professionals and the health protection and prevention measures have affected certain essential services for users, worsening their health and quality of life. The present study aims to identify the services affected by the pandemic, to determine the degree to which they have been affected and to establish possible differences of opinion according to the sociodemographic and occupational data of the responding professionals. Method: purposive sampling, 49 professionals from two medical residences in Morón de la Frontera (Seville), survey methodology, quasi-experimental and cross-sectional design, descriptive and inferential analysis (mean contrasts) with the SPSS program. Results: many services have been affected, albeit to varying degrees. To a high degree, social relations and occupational therapies; to a medium degree, physical and mental health, BADL and social education. To a lesser degree, IADL and social resources. Likewise, no significant differences were found in the responses due to sex, age, training, profession or residence (p-value ≥.05 in all cases), thus showing a high degree of agreement in the opinions of the professionals. Conclusions: numerous services and routines, fundamental to the quality of life of users, were multiply affected by the pandemic in both residential centers for the elderly. (AU)

The cognitive and psychiatric subacute impairment in severe Covid-19.

Neurologic impairment persisting months after acute severe SARS-CoV-2 infection has been described because of several pathogenic mechanisms, including persistent systemic inflammation. The objective of this study is to analyze the selective involvement of the different cognitive domains and the existence of related biomarkers. Cross-sectional multicentric study of patients who survived severe infection with SARS-CoV-2 consecutively recruited between 90 and 120 days after hospital discharge. All patients underwent an exhaustive study of cognitive functions as well as plasma determination of pro-inflammatory, neurotrophic factors and light-chain neurofilaments. A principal component analysis extracted the main independent characteristics of the syndrome. 152 patients were recruited. The results of our study preferential involvement of episodic and working memory, executive functions, and attention and relatively less affectation of other cortical functions. In addition, anxiety and depression pictures are constant in our cohort. Several plasma chemokines concentrations were elevated compared with both, a non-SARS-Cov2 infected cohort of neurological outpatients or a control healthy general population. Severe Covid-19 patients can develop an amnesic and dysexecutive syndrome with neuropsychiatric manifestations. We do not know if the deficits detected can persist in the long term and if this can trigger or accelerate the onset of neurodegenerative diseases.

Corrección de hernia de Amyand con malla y apendicetomía: reporte de caso / Amyand's hernia repair with surgical mesh and appendectomy: a case report

RESUMEN La hernia de Amyand se define como la presencia de un apéndice vermiforme dentro de un saco herniario inguinal. Menos del 1 % de las publicaciones médicas sobre hernias en el mundo corresponde a este padecimiento, y los reportes en Latinoamérica y el Caribe son escasos. Este artículo describe el caso de un varón de 78 años con un cuadro clínico de cinco meses de evolución aproximadamente. El paciente refiere que sentía una masa en la región inguinal derecha de crecimiento progresivo. Luego se asoció un dolor (de escala 8/10) durante los dos días previos al ingreso en el departamento de urgencias. Durante la operación en la región inguinal derecha, se abre el saco herniario que muestra partes del colon derecho, el ciego y el apéndice (edematosos), por lo que se decide realizar una apendicectomía y la reconstrucción con una malla de polipropileno.

ABSTRACT Amyand's hernia is defined as the presence of the vermiform appendix within an inguinal hernial sac. Less than 1 % of the world medical publications on hernias address this disease, out of which very few come from Latin America and the Caribbean. This is the case of a 78-year-old male patient who experienced signs and symptoms for approximately five months. He felt a lump in the right inguinal region which progressively increased in size. Two days prior to admission to the intensive care unit, he said his pain level was 8/10. During the right inguinal approach, the hernial sac was opened, revealing parts of the right colon, cecum and appendix with edematous changes. Therefore, the patient underwent an appendectomy and repair with polypropylene mesh.

Broken beer bottle as a cause of sigmoid perforation: A summary of causes and predictors in the management of traumatic and non-traumatic colorectal perforation.

INTRODUCTION AND IMPORTANCE: The presence of foreign bodies at the colorectal level and associated complications is a problem that has become increasingly common in emergency departments. This condition carries high health costs, in addition to having high morbidity and mortality rates, due to the large number of complications such as perforation. CASE PRESENTATION: 46-year-old male patient, who came to the emergency department of a low-level hospital with a clinical picture of approximately one day of evolution consisting of the violent introduction of a foreign body (bottle) at the anorectal level secondary to aggression in a fight, with subsequent endoluminal rupture. CLINICAL DISCUSSION: The most recent evidence indicates that the incidence of perforation as a complication of colorectal foreign body introduction is low. However, the presence of profuse bleeding, advanced age, presence of comorbidities and sepsis are predictors of poor prognosis in these cases. In general, perforation secondary to non-traumatic causes is more frequent, being predominantly due to colorectal cancer, ischemia, diverticulitis, inflammatory bowel disease, inadequate use of enema, iatrogenic endoscopy or anorectal manometry or fecal impaction. The presence of unfavorable factors prolongs hospital stay, the risk of reoperation, perianal infection, peritonitis, sepsis and wound infection, generating mortality rates of up to 38%. CONCLUSION: Colorectal perforation is more frequent in non-traumatic situations and carries health costs and risk of mortality. Its management depends on hospital aspects, clinical context of the patient and training of health personnel. However, most of the outcomes are favorable.

Pigment epithelium-derived factor (PEDF) and PEDF-receptor in the adult mouse brain: Differential spatial/temporal localization pattern.

Pigment epithelium-derived factor (PEDF) is a multifunctional protein which was initially described in the retina, although it is also present in other tissues. It functions as an antioxidant agent promoting neuronal survival. Recently, a PEDF receptor has shown an elevated binding affinity for PEDF. There are no relevant data regarding the distribution of both proteins in the brain, therefore the main goal of this work was to investigate the spatiotemporal presence of PEDF and PEDFR in the adult mouse brain, and to determine the PEDF blood level in mouse and human. The localization of both proteins was analyzed by different experimental methods such as immunohistochemistry, western-blotting, and also by enzyme-linked immunosorbent assay. Differential expression was found in some telencephalic structures and positive signals for both proteins were detected in the cerebellum. The magnitude of the PEDFR labeling pattern was higher than PEDF and included some cortical and subventricular areas. Age-dependent changes in intensity of both protein immunoreactions were found in the cortical and hippocampal areas with greater reactivity between 4 and 8 months of age, whilst others, like the subventricular zones, these differences were more evident for PEDFR. Although ubiquitous presence was not found in the brain for these two proteins, their relevant functions must not be underestimated. It has been described that PEDF plays an important role in neuroprotection and data provided in the present work represents the first extensive study to understand the relevance of these two proteins in specific brain areas.

Hallazgo incidental de hernia vesical en estudio gammagráfico de extensión ósea / Incidental bladder hernia on bone scintigraphy

No disponible

Metabolic endotoxemia promotes adipose dysfunction and inflammation in human obesity.

Impaired adipose tissue (AT) lipid handling and inflammation is associated with obesity-related metabolic diseases. Circulating lipopolysaccharides (LPSs) from gut microbiota (metabolic endotoxemia), proposed as a triggering factor for the low-grade inflammation in obesity, might also be responsible for AT dysfunction. Nevertheless, this hypothesis has not been explored in human obesity. To analyze the relationship between metabolic endotoxemia and AT markers for lipogenesis, lipid handling, and inflammation in human obesity, 33 patients with obesity scheduled for surgery were recruited and classified according to their LPS levels. Visceral and subcutaneous AT gene and protein expression were analyzed and adipocyte and AT in vitro assays performed. Subjects with obesity with a high degree of metabolic endotoxemia had lower expression of key genes for AT function and lipogenesis ( SREBP1, FABP4, FASN, and LEP) but higher expression of inflammatory genes in visceral and subcutaneous AT than subjects with low LPS levels. In vitro experiments corroborated that LPS are responsible for adipocyte and AT inflammation and downregulation of PPARG, SCD, FABP4, and LEP expression and LEP secretion. Thus, metabolic endotoxemia influences AT physiology in human obesity by decreasing the expression of factors involved in AT lipid handling and function as well as by increasing inflammation.

Estrategia para la preparación profesional del tecnólogo en Rehabilitación en Salud / Estratégia para a preparação profissional do Tecnólogo em Reabilitação em Saúde / Strategy for Professional training for technologist health Rehabilitation

Introducción: el tecnólogo en Rehabilitación en Salud requiere superarse en aras de incrementar sus conocimientos en lo docente e investigativo para mejorar el desempeño profesional. Objetivo: elaborar una estrategia dirigida a incrementar la participación de tecnólogos en Rehabilitación en Salud en acciones dirigidas a su superación profesional. Método: se realizó un estudio descriptivo de corte transversal con 25 Tecnólogos en Rehabilitación en Salud de la Universidad de Ciencias Médicas de Guantánamo en el período 2016- 2017. Resultados: el 100,0 por ciento de los tecnólogos manifestó necesidades de superación respecto a contenidos de Metodología de la Investigación y el 92,0 por ciento respecto a contenidos de Pedagogía. Se diseñó e implementó una estrategia para dar solución a estas necesidades que posibilitó que el 92,0 por ciento recibiera preparación pedagógica y el 96,0 por ciento recibiera preparación sobre Metodología de la Investigación. Conclusiones: se concluye que la estrategia que se diseñó e implementó posibilita incrementar la participación de tecnólogos en Rehabilitación en Salud en acciones dirigidas a su superación profesional, lo que significa una contribución a una transformación cualitativamente superior en su desempeño profesional en las funciones docentes e investigativas(AU)

Introdução: o tecnólogo em Reabilitação em Saúde precisa aprimorarse para aumentar seus conhecimentos em ensino e pesquisa para melhorar o desempenho profissional. Objetivo: desenvolver uma estratégia que vise aumentar a participação de tecnólogos em Reabilitação em Saúde em ações voltadas ao seu desenvolvimento profissional. Método: foi realizado um estudo transversal descritivo com 25 tecnólogos em Reabilitação em Saúde da Universidade de Ciências Médicas de Guantánamo no período 2016-2017. Resultados: 100,0 por cento dos tecnólogos manifestaram necessidade de aprimoramento em relação ao conteúdo da Metodologia da Pesquisa e 92,0 por cento em relação ao conteúdo da Pedagogia. Foi elaborada e implementada uma estratégia para atender a essas necessidades, permitindo que 92,0 por cento recebessem preparação pedagógica e 96,0 por cento recebessem preparação sobre a Metodologia da Pesquisa. Conclusões: conclui-se que a estratégia elaborada e implementada possibilita aumentar a participação de técnicos em Reabilitação em Saúde em ações voltadas ao seu desenvolvimento profissional, o que significa uma contribuição para uma transformação qualitativamente superior em seu desempenho profissional nas funções de ensino e pesquisa(AU)

Introduction: the technologist in Health Rehabilitation needs to improve himself in order to increase his knowledge in teaching and research to improve professional performance. Objective: to develop a strategy aimed at increasing the participation of technologists in Health Rehabilitation in actions aimed at their professional development. Method: a descriptive cross-sectional study was carried out with 25 Technologists in Health Rehabilitation of the University of Medical Sciences of Guantanamo in the period 2016-2017. Results: 100.0 per cent of the technologists expressed needs for improvement regarding the contents of Research Methodology and 92.0per cent regarding the contents of Pedagogy. A strategy was designed and implemented to solve these needs that allowed 92.0per cent to receive pedagogical preparation and 96.0per cent to receive preparation on Research Methodology. Conclusions: it is concluded that the strategy that was designed and implemented makes it possible to increase the participation of technicians in Health Rehabilitation in actions aimed at their professional development, which means a contribution to a qualitatively superior transformation in their professional performance in teaching and research functions(AU)

[Standardization of gastric emptying scintigraphy with egg white labeled with 99mTc-sulfur colloid]. / Estandarización de la gammagrafía de vaciamiento gástrico con albúmina de huevo marcada con 99mTc sulfuro coloidal.

BACKGROUND: Gastric emptying scintigraphy has become the gold standard, by excellence, in gastric emptying studies. This method must be standardized for the correct interpretation of results. The ideal protocol must be performed with an egg sandwich or egg white poder, both labeled with 99mTc sulphur colloid. The aim of this study was to standardize and determine the protocol with99m Tc sulphur colloid incorporated in egg white and compare it with a hamburger labeled with 99mTc sulphur colloid as well. METHODS: We studied 30 patients who underwent gastric emptying scintigraphy with the two aforementioned meals. RESULTS: Emptying percentages and retention with both meals were similar within an hour and two; however, statistical significance arose until the third hour with a p value of 0.26 by using Student's t for independent samples. CONCLUSIONS: Gastric emptying studies in both protocols where similar with normal ranges. The egg white ingested must be consistent for reproducible results in gastric motility disease, like organoleptic and volume characteristics.

Introducción: la gammagrafía de vaciamiento gástrico (VG) es el estándar de oro para determinar el porcentaje de VG. La estandarización del método permite la obtención de resultados reproducibles. La dieta estandarizada se compone de un sándwich de albúmina de huevo en polvo reconstituida y marcada con 99mTc sulfuro coloidal (SC). El objetivo fue estandarizar y determinar el porcentaje de vaciamiento gástrico tras la ingesta del sándwich de albúmina de huevo y compararlo con el porcentaje de ingesta de una hamburguesa, ambos marcados con 99mTc sulfuro coloidal. Método: se incluyeron 30 pacientes a los que se les realizó estudio de gammagrafía de vaciamiento gástrico con las dos dietas propuestas. Resultados: los porcentajes de vaciamiento y retención con ambos tipos de alimentos fueron similares a la hora y a las dos horas; sin embargo, hubo diferencias significativas a las tres horas con un valor de p = 0.26, calculado mediante t de Student para muestras independientes. Conclusiones: los tiempos de vaciamiento gástrico con ambas dietas estuvieron dentro de rangos normales. La dieta estandarizada con albúmina de huevo reconstituida aporta ventajas en cuanto al estudio de las posibles alteraciones de la motilidad gástrica, como sus características organolépticas y de volumen.

Entorno virtual de desarrollo socio-humanístico para profesionales de la salud en Guantánamo / Virtual environment and socio-humanistic development for health professionals in Guantánamo

Este trabajo es resultado parcial de la investigación realizada dentro del Proyecto Investigativo Institucional para el desarrollo del capital intelectual de la Universidad de Ciencias Médicas Guantánamo entre los años 2012 y 2014. La población la constituyó una selección de 150 profesionales de la salud de las diversas sedes en la UCMG; la muestra la constituyen 129 cursistas que vencieron los 5 cursos de postgrado desarrollados durante la investigación. La metodología seguida en esta investigación se corresponde con la de una investigación cualitativa en tanto diseña una propuesta metodológica que emerge como línea rectora en el proceso de desarrollo postgraduado en las disciplinas de ciencias sociales, políticas y humanísticas de los profesionales de la Salud. El problema detectado fue la ineficiencia en el desarrollo socio-humanístico de profesionales de la salud que incide negativamente en la calidad del servicio que prestan. El objetivo que se cumplió fue el de elaborar un software informático con actividades docentes de postgrado que permitan, mediante la autogestión de conocimientos, lograr la eficiente superación postgraduada en Ciencias Sociales, Políticas y Humanísticas de los profesionales de la Salud. En la investigación tuvimos como resultados fundamentales la respuesta a necesidades muy concretas del desarrollo de los profesionales de la Salud en ciencias sociales, políticas y humanísticas, en particular el aumento de la calidad en la preparación académica y docente, política y ética de los estudiantes(AU)

This work is partially a result of research conducted within the Institutional Investigative Project to develop the intellectual capital of the University of Medical Sciences Guantánamo between 2012 and 2014. The population was a selection of 150 health professionals of the various locations in UCMG; The sample population was 129 investigators whom finished 5 postgraduate courses developed during the investigation. The methodology used in this study corresponds to a qualitative research design as a methodology emerges as a guiding line in the development process and postgraduate degree in the disciplines of social, political and humanistic professionals Health sciences. The problem was detected, inefficiency in the socio-humanistic development of health professionals that adversely affects the quality of their service. The objective was accomplished in the develop a computer software with postgraduate teaching activities, through self-management skills, achieving efficient, postgraduate in Social, Political and Humanities in Health Sciences professionals. In the research had obtained the results as key and responses to very specific needs of the development of health professionals in social sciences, political and humanistic, including quality in academic and teacher education, politics and ethics of students(AU)

¿Influye el medio de preservación del injerto en los resultados y costos del trasplante hepático de donante fallecido?: Comparación de dos soluciones de preservación / Outcomes using two preservation solutions (UW/HTK) in liver transplantation from brain death donors

Background: Preservation solutions are critical for organ transplantation. In liver transplant (LT), the solution developed by the University Of Wisconsin (UW) is the gold-standard to perfuse deceased brain death donor (DBD) grafts. Histidine-Tryptophan-Ketoglutarate (HTK), formerly a cardioplegic infusion, has been also used in solid organ transplantation. Aim: To compare the outcomes of LT in our center using either HTK or UW solution. Patients and Methods: Retrospective study including 93 LT DBD liver grafts in 89 patients transplanted between March 1994 and July 2010. Forty-eight grafts were preserved with UW and 45 with HTK. Donor and recipient demographics, total infused volume, cold ischemia time, post-reperfusion biopsy, liver function tests, incidence of biliary complications, acute rejection and 12-month graft and patient survival were assessed. Preservation solution costs per liver graft were also recorded. Results: Donor and recipient demographics were similar. When comparing UW and HTK, no differences were observed in cold ischemia time (9.6 ± 3 and 8.7 ± 2 h respectively, p = 0.23), biliary complications, the incidence of acute rejection, primary or delayed graft dysfunction. Histology on post-reperfusion biopsies revealed no differences between groups. The infused volume was significantly higher with HTK than with UW (9 (5-16) and 6 (3-11) l, p < 0.001). The cost per procurement was remarkably lower using HTK. Conclusions: Perfusion of DBD liver grafts with HTK is clinically equivalent to UW, with a significant cost reduction.

A polymorphic enhancer near GREM1 influences bowel cancer risk through differential CDX2 and TCF7L2 binding.

A rare germline duplication upstream of the bone morphogenetic protein antagonist GREM1 causes a Mendelian-dominant predisposition to colorectal cancer (CRC). The underlying disease mechanism is strong, ectopic GREM1 overexpression in the intestinal epithelium. Here, we confirm that a common GREM1 polymorphism, rs16969681, is also associated with CRC susceptibility, conferring ∼20% differential risk in the general population. We hypothesized the underlying cause to be moderate differences in GREM1 expression. We showed that rs16969681 lies in a region of active chromatin with allele- and tissue-specific enhancer activity. The CRC high-risk allele was associated with stronger gene expression, and higher Grem1 mRNA levels increased the intestinal tumor burden in Apc(Min) mice. The intestine-specific transcription factor CDX2 and Wnt effector TCF7L2 bound near rs16969681, with significantly higher affinity for the risk allele, and CDX2 overexpression in CDX2/GREM1-negative cells caused re-expression of GREM1. rs16969681 influences CRC risk through effects on Wnt-driven GREM1 expression in colorectal tumors.

[Chromosomal abnormalities in patients from Obstetrics and Gynaecology hospital]. / Anormalidades cromosómicas en pacientes de un hospital de ginecoobstetricia.

BACKGROUND: Chromosomal abnormalities are present in 2-4 % of all newborns, and they cause 20 % of deaths in the first year of life. The estimated prevalence of chromosomal abnormalities is one for each 500-1000 newborns. These abnormalities can be numerical or structural, and they can affect autosomal or sexual chromosomes. They affect from 1 to 3 % of general population, and from 6 to 7 % of individuals with congenital anomalies. METHODS: Descriptive study, which included all the registries of cytogenetic analysis (of adults and newborns) made in a genetic laboratory in a period of 14 years. The prevalence of polymorphisms and chromosomal abnormalities in the patients from the Hospital de Ginecoobstetricia 23, Instituto Mexicano del Seguro Social (Monterrey, Nuevo León) was assessed. RESULTS: Of 4006 cytogenetic studies, 253 (6.3 %) did not show in vitro growth, 2667 (66.5 %) were normal, and 1175 (29.3 %) were abnormal. Of these, 614 (52.2 %) had polymorphisms, and 561 (47.7 %) structural or numerical chromosomal abnormalities. In regards to these chromosomopathies (561), trisomy 21 was observed in 429 (36.5 %); Turner's syndrome, in 84 (7.1 %); trisomy 18, in 57 (4.8 %); and trisomy 13, in 32 (2.7 %). With G-band technique, we found 93 % of in vitro cell growth. CONCLUSIONS: Of these studies, 55 % was performed due to non-numerical abnormalities; 14.4 %, due to structural abnormalities; and the rest, due to polymorphisms.

INTRODUCCIÓN: las anormalidades cromosómicas se presentan en 2 a 4 % de los recién nacidos y causan 20 % de las muertes en el primer año de vida. Su prevalencia es de uno por cada 500 a 1000 recién nacidos vivos. Pueden ser numéricas o estructurales y afectar a los cromosomas autosómicos o sexuales. Se presentan en 1 a 3 % de la población general y en 6 a 7 % de los individuos con anomalías congénitas. MÉTODOS: estudio descriptivo en el que se incluyeron todos los resultados citogenéticos de cariotipos tomados de sangre periférica de adultos y neonatos. Se evaluó la prevalencia de polimorfismos y alteraciones cromosómicas en derechohabientes del Hospital de Ginecoobstetricia 23 del Instituto Mexicano del Seguro Social, en Monterrey, Nuevo León. RESULTADOS: de 4006 estudios citogenéticos, en 253 no se obtuvo crecimiento de linfocitos (6.3 %), 2667 fueron normales (66.5 %) y 1175, anormales (29.3 %); de estos últimos, en 614 (52.2 %) se identificaron polimorfismos cromosómicos y en 561 (47.7 %), aberraciones cromosómicas estructurales o numéricas. De las cromosomopatías (561, 47.7 %), la trisomía 21 se observó en 429 (36.5 %), el síndrome de Turner en 84 (7.1 %), la trisomía 18 en 57 (4.8 %) y la trisomía 13 en 32 (2.7 %). Con la técnica de bandeo G se obtuvo un crecimiento celular in vitro de 93 %. CONCLUSIONES: 55 % de los estudios se realizó por anormalidades diferentes a las numéricas, 14.4 % por alteraciones estructurales y el resto se debió a polimorfismos.

[Outcomes using two preservation solutions (UW/HTK) in liver transplantation from brain death donors]. / ¿Influye el medio de preservación del injerto en los resultados y costos del trasplante hepático de donante fallecido?: Comparación de dos soluciones de preservación.

BACKGROUND: Preservation solutions are critical for organ transplantation. In liver transplant (LT), the solution developed by the University Of Wisconsin (UW) is the gold-standard to perfuse deceased brain death donor (DBD) grafts. Histidine-Tryptophan-Ketoglutarate (HTK), formerly a cardioplegic infusion, has been also used in solid organ transplantation. AIM: To compare the outcomes of LT in our center using either HTK or UW solution. PATIENTS AND METHODS: Retrospective study including 93 LT DBD liver grafts in 89 patients transplanted between March 1994 and July 2010. Forty-eight grafts were preserved with UW and 45 with HTK. Donor and recipient demographics, total infused volume, cold ischemia time, post-reperfusion biopsy, liver function tests, incidence of biliary complications, acute rejection and 12-month graft and patient survival were assessed. Preservation solution costs per liver graft were also recorded. RESULTS: Donor and recipient demographics were similar. When comparing UW and HTK, no differences were observed in cold ischemia time (9.6 ± 3 and 8.7 ± 2 h respectively, p = 0.23), biliary complications, the incidence of acute rejection, primary or delayed graft dysfunction. Histology on post-reperfusion biopsies revealed no differences between groups. The infused volume was significantly higher with HTK than with UW (9 (5-16) and 6 (3-11) l, p < 0.001). The cost per procurement was remarkably lower using HTK. CONCLUSIONS: Perfusion of DBD liver grafts with HTK is clinically equivalent to UW, with a significant cost reduction.

Variantes metodológicas para el trabajo independiente con enfoque interdisciplinario en Estadísticas Sanitarias / Methodological variants for independent work with an interdisciplinary focus on Health Statistics

En el presente artículo, el colectivo de profesores de la asignatura Metodología de la Investigación y Estadística reflexiona sobre el trabajo metodológico y su papel de dirección en función de garantizar la calidad del proceso docente-educativo mediante actividades de superación como la que se expone, donde se analizan variantes metodológicas para el trabajo independiente con enfoque interdisciplinario en el tema de Estadísticas Sanitarias en respuesta a dificultades detectadas y con la finalidad de contribuir de manera más efectiva al desarrollo de la actividad cognoscitiva de los estudiantes, propiciando un mayor nivel de profundización científica y de integración de los contenidos que tributen al desarrollo de habilidades profesionales(AU)

In this article, the group of teachers of the subject Methodology Course for Research and Statistics reflects on the methodological work and its leading role in terms of ensuring the quality of the educational process through activities where methodological variants for independent work with an interdisciplinary approach are discussed in the topic of health statistics in response to detect and in order to contribute more effectively to the development of the cognitive activity of students so difficult, leading to a higher level of scientific depth and integration of content that ascribe to the development of professional skills