Exploring the Theory of Employee Planned Behavior: Job Satisfaction as a Key to Organizational Performance.

This article introduces a significant advancement with the "Theory of Employee Planned Behavior" (TEPB), a novel extension of the well-established Theory of Planned Behavior (TPB). The TEPB uniquely positions job satisfaction as a central determinant in driving organizational performance. Using data from county-level government institutions in the United States, this research offers a nuanced exploration into how employee satisfaction influences organizational commitment and citizenship behaviors, which, in turn, substantially impact organizational performance. Our approach utilizes a significant dataset involving 372 dyads across hierarchical levels in government institutions. Through the application of Structural Equation Modeling (SEM), we rigorously validate the TEPB model. The results highlight a significant relationship where enhanced job satisfaction leads to stronger organizational commitment. This heightened commitment further fosters organizational citizenship behaviors, crucial in achieving superior organizational performance. This work notably extends the TPB model by integrating organizational performance as a consequential outcome. It also provides empirical evidence of the direct relationship between job satisfaction and organizational performance, specifically in the context of government institutions. Such findings are invaluable for organizational executives and policymakers in recognizing the paramount importance of employee satisfaction for organizational success. Overall, the TEPB model presented in this study offers a holistic and practical framework for organizations seeking to understand and effectively manage employee behavior. By focusing on job satisfaction, organizations can foster a more committed and proactive workforce, significantly improving performance and efficiency.

Psychosocial risk factors identification in Mexican workers and RGIII validation.

BACKGROUND: Since 2018, NOM-035-STPS-2018 has been applied in Mexico, focused on measuring psychosocial risk factors (PRFs) in workers and the Reference Guide III (RGIII) has been presented, however, research focused on its validation has been scarce, in very specific sectors and with small samples. OBJECTIVE: Determine the levels of PRFs of five work centers and reliability and validity aspects of RGIII. METHOD: The RGIII was applied to 1458 workers (806 women and 652 men) from five workplace in the industrial sector of Ensenada (Mexico), and the level of risk of the PRFs was analyzed, as well as their reliability and validity through Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA). RESULTS: The PRFs with medium, high and very high-risk levels are Workload, Lack of control over work and Workday. The RGIII presents adequate reliability with Cronbach's α, Alpha ordinal RHO and Omega of 0.93, 0.95 and 0.95, respectively. The EFA shows all five subscales maintain factor loadings greater than 0.43, although Leadership and relationships at work has better saturation values, and Work environment ended with only three items. The CFA indicates Leadership and work relationships with a Root Mean Square Error of Approximation (RMSEA) goodness of fit index of 0.072. CONCLUSION: The RGIII allows the identification and evaluation of the level of risk of PRFs. It complies with sufficient internal consistency. It does not have a clear factorial structure, because it does not meet the minimum values of goodness-of-fit indexes that would allow confirming the structure proposed in RGIII.

Influence of Resilience on Burnout Syndrome of Faculty Professors.

This research aims to describe the relationship between resilience and burnout facing COVID-19 pandemics. The sample was n = 831 lecturers and professors of a Mexican public university. This study is a quantitative, non-experimental, cross-sectional, explanatory, and ex post facto research using Structural Equations Modeling with latent variables under the partial least square's method technique. We used the CD-RISC-25 and SBI questionnaires to measure resilience and burnout, respectively. Structural Equations Modeling (SEM-PLS) allowed the visualization of the exogenous variable (resilience) in endogenous variables (dimensions of SBI burnout: E9 guilt, E7 emotional exhaustion, E8 indolence, and E6 work illusion). To this day, there are very few previous studies that jointly analyze in Mexico the characteristics of resilience and burnout in the face of the COVID-19 pandemic. Findings show that resources availability has the strongest correlation with accomplishment in teaching, followed by cynicism and emotional exhaustion. These results have important professional implications.

Influence of COVID-19 Pandemic Uncertainty in Negative Emotional States and Resilience as Mediators against Suicide Ideation, Drug Addiction and Alcoholism.

This research uses structural equation modeling to determine the influence of uncertainty due to the COVID-19 pandemic as an independent variable in the negative emotional states and resilience (as mediating variables) vs. drug addiction, alcoholism, and suicide ideation as dependent variables in 5557 students from a public state university in Northern Mexico. The five variables are related through eight hypotheses and tested using partial least squares. We used an adapted questionnaire sent by email in May 2020. Findings show that uncertainty facing the COVID-19 pandemic had a direct and significant influence on negative emotional states and a significant inverse effect on resilience; in the trajectory, drug addiction and alcoholism, and suicide ideation are explained.

Infrared thermal imaging monitoring on hands when performing repetitive tasks: An experimental study.

The monitoring of infrared thermal images is reported to analyze changes in skin temperature in the hand fingers when repetitive work is performed to know which finger has a greater risk of injury, besides, the recovery time is analyzed regarding the initial temperature and its relationship with age, sex, weight, height if practice sports, and Body Mass Index (BMI) per individual. For the above, an experimental test was carried out for 10 minutes on a repetitive operation that takes place in the telecommunications industry and 39 subjects participated in which an infrared thermal image of the dorsal and palmar part of both hands was taken in periods of 5 minutes after the 10-minute test has elapsed. The results show that none of the participants recovered their initial temperature after 10 minutes of the experimental test. In addition, it was found that there is a relationship between skin temperature and sex, and that age influences the recovery of temperature. On the other hand, the thumb, index, and middle fingers have a higher risk of injury in the analyzed task. It is concluded that performing repetitive work with all the fingers of the hand does not show that all they have the same risk of injury, besides that, not all the variables studied affect the recovery of temperature and its behavior.

Quantitative Models for Prediction of Cumulative Trauma Disorders Applied to the Maquiladora Industry.

Temperature gradient changes on the surface of the skin or in the middle of the body are signs of a disease. The aim of this study is to develop quantitative models for the prediction of cumulative trauma disorders (CTDs) arising from highly repetitive activities, considering risk factors, such as age, gender, body mass index (BMI), blood pressure (BP), respiratory rate (RR), and heart rate, to prevent injuries in manufacturing factory operators. This research involved 19 individuals from the area of sanding and 14 individuals from the area of tolex in manufacturing factories who had their vital signs and somatometry taken, as well as thermal images of their hands in the dorsal and palmar areas; an evaluation by the OCRA method was also applied. Factors such as BP and heart rate were determined to significantly influence the injuries, but no strong association with BMI was found. Quadratic regression models were developed, the estimates of which were adequately adjusted to the variable (R2 and R2 adjusted > 0.70). When integrating the factors of the OCRA method to the generated models, a better fit was obtained (R2 and adjusted R2 > 0.80). In conclusion, the participants who present levels out of the normal range in at least one of the factors have high probabilities of developing injuries in their wrists.

Successful use of problem-solving methodology to reduce pharmacy chemotherapy processing time.

OBJECTIVES: The primary objectives of this study were to (1) reduce pharmacy turnaround time (TAT) without compromising safety and quality and (2) reduce compounding order overload during peak hours (8:00 AM-5:00 PM). The secondary objective was to decrease patient wait time pertinent to pharmacy services. SETTING: The setting was a hospital-based pharmacy. PRACTICE DESCRIPTION: Pharmacy dispensing more than 1800 doses daily, 30% of which goes to outpatient cancer treatment. Patients usually receive multiple compounded medications; thus, compounding numbers are several folds higher than patient number. High compounded chemotherapy order volume overloaded pharmacy staff during peak hours and was a major contributor to patient wait time. PRACTICE INNOVATION: Using Define Measure Analyze Improve Control Six Sigma and intelligent risk-taking strategies, a dedicated team identified root causes of problems and designed long-lasting solutions that would not compromise quality. EVALUATION: The most effective initiative was the advanced preparation of chemotherapy for select patients (Concierge), which addressed pharmacy TAT, patient wait time, and chemotherapy order overload, all without affecting safety or quality of dispensed medications. RESULTS: Pharmacy TAT decreased by 77% for Concierge patients and 31% for standard patients. Comparable decreases were observed for patient wait time: 67% for Concierge and 27% for standard patients. Safety and quality were maintained for all dispensations during and after implementation of Concierge. A concurrent 8% increase in patient number was observed despite no changes in physical capacity. CONCLUSION: The implementation of Concierge initiatives: markedly reduced pharmacy TAT without compromising safety checks performed by pharmacists; decreased chemotherapy order overload during peak hours; improved distribution of assignments for pharmacy staffand statistically significant decreased wait time for all patients, especially those selected for Concierge. Effective selection of Concierge patients minimized additional costs associated with wasted premixed chemotherapy. Improving workflow for a subset of patients affected a greater patient population, allowing additional patients to be treated daily.

Burnout Syndrome in Police Officers and Its Relationship with Physical and Leisure Activities.

No previous studies in Mexico have been found that jointly analyze physical and leisure activities as variables related to mental health in police officers. This paper presents research on burnout in Mexican Police officers. The question it answers is: is there any association of burnout with physical and leisure activities and personal profile? A total of 276 police officers (87% men and 13% women) participated. To obtain information, the Spanish Burnout Inventory and the Operational Police Stress questionnaires were used. A cross sectional study design was utilized with tests of validity and reliability, goodness of fit, analysis of variance (ANOVA), and analysis of k-means clusters. Results showed that a high number of policemen had high prevalence of burnout and a high level of mental exhaustion, and that exercise was positively and significantly related to lower burnout risk. Men showed higher risk than women. Results should be considered to improve interventions and occupational health practices in the police force. This paper improves understanding of burnout among policemen and the importance of exercise and leisure activities to alleviate burnout.

The resource-based reflective risk assessment model for understanding the quality of work life of nurses.

BACKGROUND: There is a need to examine the psychological traits that impact the "personal quality of life" and "personal well-being" of caregivers in the workplace. PURPOSE: This research proposes the resource-based reflective risk assessment model using a "at risk" framework to integrate mental health traits, producing a "portrait" of nursing quality of life and well-being. METHODS: Cross-sectional surveys on the quality of work life of nurses in Australia and Mexico were used to collect data. FINDINGS: Significant differences based on the ProQOL "at-risk" categories were found in all the 10 constructs with a similar pattern between the 2 countries. The proposed model was shown to be a useful framework for integrating mental health constructs that have a "draining" and "gaining" effect on nurses' well-being. DISCUSSION: The proposed model provides framework for understanding nursing well-being as well an integrating structure to add additional constructs to construct a comprehensive portrait of nurses' quality work life and personal well-being.

Liderazgo y su relación con variables de resultado: un modelo estructural comparativo entre liderazgo transformacional y transaccional en una empresa de entretenimiento en México / Leadership and its Relationship with Outcome Variables: a Structural Model Comparing Transformational and Transactional Leadership in an Entertainment Company in Mexico

El objetivo de la investigación fue determinar la influencia de factores de liderazgo transformacional y transaccional en variables de resultado con personal directivo de nivel medio de una Empresa de Entretenimiento en México, D.F, con el Modelo de de liderazgo transformacional de Bass y Avolio. Se aplicó el "Cuestionario sobre Datos Sociodemográficos y Organizacionales del Trabajador" y la "Adaptación al Multifactor Leadership Questionnaire" (MLQ), a una muestra de n = 100 directivos de nivel medio. Los Modelos de Ecuaciones Estructurales determinaron que en el perfil de liderazgo de los directivos investigados destacan en primer lugar sub-escalas transformacionales como son: Estimulación intelectual, Influencia idealizada (Conducta), Influencia idealizada (Atributo) y Consideración individual. La variable de resultados más importante para ellos es el Esfuerzo extra. Lo anterior implica que los directivos estén interesados en desarrollar la capacidad de resolución de problemas y la actualización de su personal. Se reafirmaron los hallazgos teóricos y empíricos de estudios previos, como son las correlaciones directas significativas entre las variables de liderazgo (liderazgo transformacional, transaccional y variables de resultado), e inversas todas ellas con el no liderazgo. Se obtuvieron niveles de confiabilidad Alpha de Cronbach superiores a .70 en la evaluación de dichas variables, a partir de los instrumentos.

The purpose of this article was to determine the influence of transformational and transactional leadership behavior in the outcome variables of a sample of 100 managers within an entertainment provider organization in Mexico. Structural equation modeling showed that the leadership behavior factors of the participating managers highlighted in first place transformational subscales such as intelectual stimulation, idealized influence (behavior), idealized influence (atribute) and individual consideration. The most important outcome variable for them was extra effort. This result means that managers are interested in developing their followers skillness to resolve problems and update their staff. The theoretical and empirical findings of previous studies of the Model of Bass and Avolio were reaffirmed such as direct and significant correlations between the leadership behaviors and outcome variables and inverse correlations with laissez faire leadership behavior. Alpha Cronbach reliability values were above .70 in such variables.

Estados afectivos emocionales(depresión, ansiedad y estrés) en personal de enfermería del sector salud pública de México / Emotional affective states (depression, anxiety and stress) of nursing in a mexican public health sector

Este trabajo es una investigación de tipo descriptivo-correlacional, transversal con diseño no experimental sobre el estado afectivo emocional de los trabajadores de la Salud. Su objetivo es identificar la existencia de diferencias significativas entre el género y estados afectivos emocionales (depresión, ansiedad y estrés) de los trabajadores de una institución del sector salud pública ubicada en la ciudad de Ensenada perteneciente al estado de Baja California situado al noroeste de México. Se trabajó con una muestra por conveniencia la cual integra a 130 empleados; en la recolección de los datos se utilizó la escala DASS-21. Los resultados identificaron los estados afectivos emocionales dentro de un rango normal y que no existen diferencias estadísticamente significativas en cuanto al género; además, se encontraron correlaciones fuertes, positivas y significativas entre las subescalas del DASS-21.

This study is a descriptive correlational cross-sectional approach with a non-experimental design about emotional affective states related dissorders in Mexican public health workers. It´s goal was to identify the existence of significant differences between gender and emotional affective state (depression, anxiety and stress) for workers in a hospital located in Ensenada, Baja California in north-western Mexico. The work covers a sample of 130 employees. To collection of data used a DASS-21 scale. The results identified an emotional affective state within a normal range. No statistically differences in gender were identified. Positive and significant correlations between subscales of the DASS-21 were found.

Experience of a pediatric HIV clinic in Guatemala City.

OBJECTIVES: To describe the clinical experience of a Guatemalan pediatric HIV clinic and referral center, and fill the gap in literature available on pediatric HIV in Guatemala, a country facing a growing HIV epidemic. METHODS: Analyses were performed on data available from the clinical databases maintained by the Clínica Familiar Luis Angel García within the Hospital General San Juan de Dios in Guatemala City, Guatemala. RESULTS: From January 1997-June 2006, a total of 536 children (individuals under 13 years of age) were registered at the clinic, 54% of them female. At the initial visit, 241 were known to be HIV infected, while 295 were known to have been exposed to HIV, but were of undetermined infection status. Of the 295 with undetermined status, serostatus was determined in 173, and 57 (33%) were HIV positive. The patients came from all 24 departments of Guatemala, but the majority (64%) was from Guatemala City. Most had perinatal exposure; three patients had been sexually exposed to HIV (all male); and the mode of infection could not be determined for six children. In the cohort of children whose infection status was initially undetermined, the provision of antiretroviral (ARV) medication (both pre- and neonatal), in addition to Cesarean section, was associated with an odds ratio of 0.06 for HIV infection (P < 0.001) when compared to children who had no interventions. Highly active antiretroviral therapy (HAART) was administered to 167 HIV-infected children. There were 44 known deaths in this cohort; no deaths occurred among the children who were not infected. CONCLUSIONS: Pediatric HIV/AIDS is present in all parts of Guatemala. Programs to prevent mother to child transmission and to provide appropriate treatment to families living with HIV/AIDS must be a public health priority.

Development and evaluation of an enzyme-linked immunosorbent assay to detect Histoplasma capsulatum antigenuria in immunocompromised patients.

Histoplasma capsulatum infection causes significant morbidity and mortality in human immunodeficiency virus-infected individuals, particularly those in countries with limited access to rapid diagnostics or antiretroviral therapies. The fungus easily disseminates in persons with AIDS, resulting in progressive disseminated histoplasmosis (PDH), which can progress rapidly to death if undiagnosed. The availability of a simple, rapid method to detect H. capsulatum infection in less developed countries where the infection is endemic would dramatically decrease the time to diagnosis and treatment of PDH. We have developed an antigen-capture enzyme-linked immunosorbent assay (ELISA) to detect PDH antigenuria in infected patients. The assay uses polyclonal antibodies against H. capsulatum as both capture and detection reagents, and a standard reference curve is included to quantify antigenuria and ensure reproducibility. We evaluated this assay using specimens collected from patients with AIDS and culture-proven histoplasmosis in a Guatemalan clinic (n = 48), from healthy persons (n = 83), and from patients with other, nonhistoplasmosis diseases (n = 114). The ELISA demonstrated a sensitivity of 81% and a specificity of 95% in detecting H. capsulatum antigen in urine. This assay relies on simple technology that can be performed in institutions with limited resources. Use of this test will facilitate rapid diagnosis of PDH in countries where mortality is high, expediting treatment and likely reducing PDH-related mortality.

Experience of a pediatric HIV clinic in Guatemala City / Experiencia de una clínica pediátrica para el VIH en la Ciudad de Guatemala

OBJECTIVES: To describe the clinical experience of a Guatemalan pediatric HIV clinic and referral center, and fill the gap in literature available on pediatric HIV in Guatemala, a country facing a growing HIV epidemic. METHODS: Analyses were performed on data available from the clinical databases maintained by the Clínica Familiar Luis ángel García within the Hospital General San Juan de Dios in Guatemala City, Guatemala. RESULTS: From January 1997-June 2006, a total of 536 children (individuals under 13 years of age) were registered at the clinic, 54 percent of them female. At the initial visit, 241 were known to be HIV infected, while 295 were known to have been exposed to HIV, but were of undetermined infection status. Of the 295 with undetermined status, serostatus was determined in 173, and 57 (33 percent) were HIV positive. The patients came from all 24 departments of Guate mala, but the majority (64 percent) was from Guatemala City. Most had perinatal exposure; three patients had been sexually exposed to HIV (all male); and the mode of infection could not be determined for six children. In the cohort of children whose infection status was initially undetermined, the provision of antiretroviral (ARV) medication (both pre- and neonatal), in addition to Cesarean section, was associated with an odds ratio of 0.06 for HIV infection (P < 0.001) when compared to children who had no interventions. Highly active antiretroviral therapy (HAART) was administered to 167 HIV-infected children. There were 44 known deaths in this cohort; no deaths occurred among the children who were not infected. CONCLUSIONS: Pediatric HIV/AIDS is present in all parts of Guatemala. Programs to prevent mother to child transmission and to provide appropriate treatment to families living with HIV/AIDS must be a public health priority.

OBJETIVOS: Describir la experiencia de una clínica y centro de referencia pediátrico para el VIH en Guatemala y llenar el vacío existente en la literatura científica sobre la infección pediátrica por el VIH en ese país, donde se enfrenta una creciente epidemia por el VIH. MÉTODOS: SE analizaron los datos disponibles en la base de datos clínicos de la Clínica Familiar Luis Ángel García del Hospital General San Juan de Dios, Ciudad de Guatemala, Guatemala. RESULTADOS: Entre enero de 1997 y junio de 2006 en la clínica se registraron 536 menores de 13 años; 54 por ciento de los cuales eran niñas. En la visita inicial se sabía que 241 estaban infectados por el VIH y que 295 habían estado expuestos a ese virus aunque su diagnóstico era indeterminado. De estos, se determinó el estatus serológico de 173, de los cuales 57 (33 por ciento) resultaron positivos al VIH. Los pacientes procedían de los 24 departamentos de Guatemala, pero la mayoría (64 por ciento) era de la Ciudad de Guatemala. La mayoría de los pacientes había estado expuestos al VIH por la vía perinatal; tres pacientes (todos varones), por la vía sexual y no se pudo determinar la vía de infección de seis niños. En la cohorte de niños con diagnóstico inicial indeterminado, el tratamiento antirretroviral (tanto pre como posnatal) junto con el nacimiento por cesárea se asociaron con una razón de posibilidades (odds ratio) de tener la infección por el VIH de 0,06 (P < 0,001) en comparación con los niños sin estas intervenciones. El tratamiento antirretroviral de gran actividad (HAART) se administró a 167 niños infectados por el VIH. Se registraron 44 muertes en esta cohorte, ninguna en los niños sin infección. CONCLUSIONES: La infección pediátrica por VIH/sida está presente en todos los departamentos de Guatemala. Los programas para evitar la transmisión de madre a hijo y brindar el tratamiento adecuado a las familias que viven con VIH/sida son una prioridad de salud pública.

Variables psicológicas como predictores de conductas de prevención relacionadas con la infección por VIH / Psychological variables as predictors of preventive behaviors related to HIV

Objetivo: Estudio transversal que tuvo como su objetivo identificar si variables que incluían a los conocimientos, creencias y motivos se constituían en predictores de dos conductas de prevención relacionadas con la infección por VIH: ½Evitar una relación sexual con penetración¼ e Intención de uso de preservativo en el futuro¼. Métodos: De una muestra original de 648 estudiantes pertenecientes a dos instituciones educativas que se localizan en Hermosillo, México, se trabajó con una submuestra de 328 estudiantes que en el momento del estudio informaron no tener experiencia sexual. Para el analisis de los datos se utilizaron estadísticas descriptivas, el x2 de Pearson y un analisis multivariado de regresión logística. Resultados: El anßlisis con el x2 de Pearson arrojó diferencias significativas en ambas conductas: para los que habían tenido oportunidad de comprometerse en una relación sexual con penetración y la habían evitado (x2 [2]=45.378; p=0.000), así como entre quienes respondieron a una baja o una alta probabilidad de usar preservativo en el futuro (x2 [2]=235.622; p=0.000). El analisis de regresión logística reveló que la variable motivos predijo la conducta evitar una relación sexual con penetración (x22 [9]=33.805; p=0.000), mientras que también la variable motivos predijo la conducta intención de uso de preservativo en el futuro (x2 [8]=18.069; p=0.021).Conclusiones: Se discute la importancia que reviste la variable motivos en el contexto de los programas dirigidos a prevenir la infección por VIH en ese sector de la población.

Fundament: A cross-sectional study was carried out with the main objective to identify if psychological variables including knowledge, belief, and motivation predicted two prevention behaviors related to HIV infection: ½To postpone a sexual intercourse¼ and ½Condom use intention¼. Method: From an original sample of 648 students of two institutions located in Hermosillo, Mexico, we worked with a subsample of 328 students whom reported no sexual experience. For data analysis descriptive statistics, the PearsonÆs x2 and a logistic regression analysis were used. Results: The PearsonÆs x2 showed significant differences in both behaviors: those who have the opportunity to involve in a sexual relationship and they avoid it (x2 [2]=45.378; p=0.000), as well as those who have condom use intention (x2 [2]=235.622; p=0.000). The logistic regression analysis revealed that one type of motivation predicted the behavior to avoid a sexual relationship with penetration (x2 [9]=33.805; p=0.000), if well another type of motivation predicted the behavior condom use intention (x2 [8]=18.069; p=0.021). Conclusions: The role of the variable motivation in the prevention of HIV infection programs is discussed.

Psicología de la salud: algunas reflexiones críticas sobre su qué y su para qué / Health psychology: some critical reflections on its what and its why

No obstante el crecimiento experimentado por la Psicología de la Salud en todo el orbe, todavía se observa la carencia de propuestas tipo interfase que permitan vincular a la psicología como disciplina profesional con el campo de la salud. Se revisan algunos de los problemas más acusados que enfrenta el citado campo de actuación, tanto en lo que hace a sus múltiples definiciones como a la pobre delimitación de lo propiamente psicológico. Se presenta una línea de argumentos en la que se justifica su qué y su para qué a partir de un modelo psicológico de salud biológica y la necesidad de contar con una metodología para la evaluación de las variables psicológicas que son pertinentes para el cuidado, mantenimiento o recuperación de la salud.

Efusión pleural maligna: estudio citopatológico de 75 casos consecutivo con correlación clínica e histológica / Malignant pleural effusion: cytopathological study in 75 consecutive cases with clinical and histological correlation

Con el propósito de evaluar la calidad del diagnóstico citopatológico en casos de efusión pleural maligna, se estudiaron 75 pacientes afectados por tal patología (50 mujeres y 25 hombres con edad promedio de 56 años). Las historias clínicas y material histológico disponible permitieron la localización del tumor primario en 88 por ciento de los casos. En mujeres los tumores primarios más frecuentes fueron carcinomas de mama (34 por ciento), pulmón (30 por ciento), neoplasias de origen desconocido (12 por ciento) y linfomas/leucemias (10 por ciento), mientras que en hombres comprendieron carcinomas de pulmón (72 por ciento), neoplasias de origen desconocido (12 por ciento) y linfomas/leucemias (8 por ciento). El adenocarcinoma representó el tipo histológico predominante. El porcentaje de positividad de las citologías pleurales fue superior al obtenido en el material de biopsia (87,63 por ciento vs 64,44 por ciento; P= 0,0004) y aportó el primer diagnóstico morfológico de cáncer en 57,33 por ciento de los casos. Un diagnóstico concluyente de malignidad fue obtenido con la primera muestra del líquido pleural en 90,67 por ciento de los pacientes y con dos muestras en el 100 por ciento, mientras que para las biopsias el porcentaje de positividad no alcanzó el 70 por ciento con una tercera muestra. Los valores de sensibilidad y especificidad del método citológico fueron 100 por ciento y 42,86 por ciento, respectivamente. Se concluye que la citología del líquido pleural es un método de gran valor para el estudio de los pacientes con efusión pleural maligna

Carcinoma mucoepidermoide bronquial en la infancia: reporte de un caso y revisión de la literatura / Carcinoma

Se presenta el caso de una niña de 10 años de edad con antecedente de cuatro hospitalizaciones por neumonías basales derechas a repetición. La radiografía de tórax evidenció infiltrado con tendencia a la condensación, broncograma aéreo e imagen radiolúcida redondeada en base pulmonar derecha. la tomografía computarizada reveló un tumor heterogéneo en el segmento posterolateral derecho. En la fibrobroncoscopia se observó protusión de tumor polipoide en bronquio basal derecho. Se realizó lobectomía inferior derecha. histológicamente el tumor mostró características de un carcinoma mucoepidemoide de bajo grado. hasta 1997, solo habían sido reportados treinta y tres casos de carcinomas mucoepidermoides broncogénicos en la infancia. Clinicamente se manifiestan como neumonías recurrentes o de lenta resolución. Los niños con estas manifestaciones clinicas deben ser evaluados exhaustivamente incluyendo estudios tomográficos y endoscópicos. Actualmente, la resección quirúrgica del lóbulo pulmonar afectado por el tumor, con los respectivos ganglios linfáticos hiliares labores, es el tratamiento más aceptado

Problemas diagnosticos en un caso de granulomatosis de weneger de presentación inusual / Diagnostic problems in an case of granulomatosis of weneger of unusual presentation

La granulomatosis de Wegener (GW) de presentación atípica suele ofrecer gran dificultad diagnóstica, debido a la inespecificidad de los síntomas y signos iniciales, a la gran cantidad y que muchas veces son difíciles de separar, y a la ausencia de la tríada histopalógica clásica y diagnóstica de la enfermedad en un gran porcentaje de las biopsias extrapulmonares. se presenta el caso clínico de un paciente que inició la enfermedad bajo la forma de un psudotumor inflamatorio retroorbitario izquierdo, con posterior afectación sistemática de múltiples órganos y en quien el diagnóstico de GW sólo pudo ser establecido en el estudio postmortem. La experiencia clínica obtenida en este caso resalta la importancia diagnóstica que en la GW tienen la exhaustiva correlación entre los datos clínicos e histológicos, la aplicación del test de ANCA en los casos sospechosos y la comparación de la biopsias orbitarias con las extraculares, tomando en cuenta que la sobrevida de los pacientes afectados por esta enfermedad depende exclusivamente del diagnóstico oportuno y del tratamiento temprano con un régimen de corticoesteroides y de agentes citostáticos