Evaluation of the Level of Psychological Distress in Construction Workers during the COVID-19 Pandemic in Southern Spain.

The COVID-19 pandemic posed a major challenge for construction companies, which were confronted with the need to prevent the enormous negative socio-psychological impact of the pandemic on their employees. The aim of this study was to evaluate the level of psychological distress among construction workers in an advanced phase of the COVID-19 pandemic in Andalusia, southern Spain. For this, a cross-sectional descriptive study was conducted using online questionnaires with data on sociodemographic variables and employment situation, COVID-19 pandemic-related data, and Goldberg's General Health Questionnaire (GHQ-12). A total of 860 questionnaires from all provinces of Andalusia, Spain, were collected between March and May 2022. Descriptive statistical analyses and non-parametric Mann-Whitney U and Chi-squared tests were performed, followed by logistic regression analysis. The incidence of psychological distress was higher among women, individuals under 43 years of age, those with a family income below EUR 1200, participants whose working conditions had been affected by the pandemic, those who had not received adequate means or specific training to protect themselves from infection, those who had experienced symptoms, those who had suffered side effects after vaccination, and those who had been hospitalised. The logistic regression analysis predicted the occurrence of psychological distress in this study by the effect of the pandemic on mental/emotional well-being, the working conditions affected during the pandemic, health-related variables, and the age of the worker. The correctly classified percentage was 75.1%. Assessing psychological distress in construction sectors may allow for the identification of vulnerable groups or even help to reduce the number of errors in daily practice and potential risks of occupational injury or illness.

A Practical Guide to Train the Side-to-side Anastomosis: Tips, Tricks and Technical Nuances.

BACKGROUND: Microanastomosis presents a challenge in neurosurgical procedures, requiring specialized skills. Regular practice outside the operating room is crucial. This study aims to provide a detailed description of the side-to-side anastomosis technique and analyze its advantages in preventing failures compared with other variations. METHODS: We examined the technique, characteristics, and outcomes of side-to-side bypass procedures for complex aneurysms in the anterior cerebral artery territory at our institution over the past decade. We compared our technique with those described in the literature by other groups. RESULTS: The Far East Neurosurgical Institute (FENI) technique was used in 15 patients, with 17 side-to-side anastomoses performed. The average anastomosis time was 27.5 minutes, with 100% patency in follow-up. Our technique demonstrated safety and effectiveness in treating intracranial aneurysms, yielding satisfactory short- and long-term functionality outcomes. We highlight the importance of maintaining a curvilinear arteriotomy shape, at least 3 times the diameter of the artery, and utilizing an interrupted suturing technique on the anterior wall. CONCLUSIONS: This paper presents the first comprehensive description of the side-to-side anastomosis technique, supported with images and videos for training and replicability. Our technique enhances flow dynamics and reduces the risk of acute thrombus formation. Training in simulators and microsurgery practice centers outside the operating room is essential for acquiring and refining microsurgical skills.

Psychological distress among Brazilian workers during the initial stage of the COVID-19 pandemic: a descriptive study.

Background: COVID-19 pandemic imposed drastic and abrupt changes to working environment and organization and that might have caused additional negative effects on mental health. Thus, this study aimed to quantify and assess the severity of psychological distress experienced by Brazilian essential and nonessential workers during the first months of the COVID-19 pandemic. Methods: This descriptive study included 2,903 participants who answered an online questionnaire between April and May 2020. The research questionnaire was translated and culturally adapted to the Brazilian population from a questionnaire developed and validated for the Spanish population. Variables were analyzed using simple and cumulative percentage distributions and measures of central tendency and dispersion. The Wilson score interval was used to calculate confidence interval (CI) for the main outcome, psychological distress. Results: It was observed a high prevalence (72.6%) of psychological distress among the study's participants. They also presented a median risk perception score of 60 (out of a maximum of 90), and their greatest concern was transmitting the virus to family members, close contacts or patients. Furthermore, it was found a lower sense of coherence and work engagement among the participants than those observed in previous studies conducted in other countries. Conclusion: Almost three quarters of the study's participants were classified as presenting psychological distress. Thus, it is imperative to provide mental health remotely delivered interventions to workers during public health events that require prolonged social distancing measures.

Case Report of Ruptured Large Fusiform Distal Anterior Cerebral Artery Aneurysm Treated With A3-A3 In Situ Bypass, Reimplantation, and Trapping With Aneurysmectomy: 2-Dimensional Operative Video.

Large fusiform aneurysms in the distal anterior cerebral territory are infrequent and pose considerable treatment challenges, as they necessitate comprehensive aneurysm resolution without compromising physiological flow dynamics.1-3 We present the case of a 52-year-old man with a ruptured distal anterior cerebral artery fusiform aneurysm. The patient consented to the procedure; this complex condition was successfully managed through an A3-A3 in situ bypass, branch reconstruction, and trapping accompanied by aneurysmectomy. The multifaceted nature of fusiform lesions precludes the feasibility of endovascular interventions as a sole remedy. In addition, reconstructive and deconstructive approaches exhibit elevated mortality rates in patients experiencing high-grade subarachnoid hemorrhage.1,4 Given the intricacies intrinsic to this clinical context and the exigent nature of fusiform aneurysms, the surgical therapeutic arsenal embraces a diverse array of surgical methodologies, each offering a bespoke spectrum of techniques meticulously tailored to attain predefined objectives.3,5-7 These approaches are attuned to promptly abrogate imminent threats, while concurrently mitigating latent complications linked to subarachnoid hemorrhage ensuing from aneurysmal rupture, encompassing the specters of rebleeding, ischemic stroke, and edematous sequelae.8,9 Crucially, the selection of the most appropriate surgical approach hinges on a comprehensive understanding of available options, patient-specific anatomic considerations, and the preferences of the neurosurgeon. Such a nuanced decision-making process ensures an individualized treatment strategy tailored to optimize patient outcomes.3,6.

Risk Factors and Environmental Preventive Actions for Aspergillosis in Patients with Hematological Malignancies.

(1) Background: Aspergillus spp. is a widely distributed filamentous fungus in the environment due to its high sporulation capacity. Currently, invasive aspergillosis (IA) is the most common invasive fungal infection in patients with hematologic malignancies, with high rates of mortality and morbidity. The multifactorial nature of the disease requires appropriate risk stratification to enable the most appropriate preventive measures to be adapted and implemented according to the characteristics of the patient. In this sense, the present research aims to identify recent risk factors and environmental control measures against invasive aspergillosis to establish preventive actions to reduce the incidence of invasive aspergillosis in hospitals. (2) Methods: We conducted a qualitative systematic review of the scientific literature on environmental risk factors and preventive measures for invasive aspergillosis in patients with hematologic malignancies. The Medline, Cochrane, and Scopus databases were consulted, following the PRISMA and STROBE guidelines. (3) Results: Adequate implementation of environmental control measures is presented as the most efficient intervention in terms of prevention to decrease the incidence of invasive aspergillosis in hospitals. Neutropenia, fungal contamination, insufficient environmental control measures in hospital and home settings, length of hospital stay, and anemia, are identified as independent risk factors. We show that HEPA, LAF, and Plasmair® systems are suitable methods to reduce the concentration of airborne fungal spores. Antifungal prophylaxis did not significantly influence IA reduction in our study. (4) Conclusions: Proper professional training and environmental control measures in hospitals are essential for the prevention of invasive aspergillosis. We should optimize risk stratification for patients with hematologic malignancies. Antifungal prophylaxis should be complementary to environmental control measures and should never be substituted for the latter. Studies should also be undertaken to evaluate the efficiency of environmental control measures against IA at patients' homes.

Risk perception of healthcare workers in the first wave of the COVID-19 pandemic in Brazil.

Objectives: To validate the items of the Emotional Impact Questionnaire coronavirus disease-2019 (COVID-19) related to risk perception, estimating its degree, among healthcare workers in the first wave of COVID-19 pandemic, identifying possible associated factors.Methods: cross-sectional study in 1872 healthcare workers of Brazil. The population was characterized by sociodemographic and occupational information, knowledge about COVID-19, quality of information received, risk perception and preventive measures about the disease, and sense of coherence. Results: Being divorced, having a chronic disease, spending more than 1 h per day getting informed about COVID-19, and always or almost always wearing a mask regardless of symptoms, as well as self-perception of health were associated with high-risk perception. An inverse association was found between risk perception, sense of coherence and not knowing if one has had occasional contact with confirmed COVID-19 cases. Conclusion: Risk perception is influenced by emotions, experiences, and knowledge. Sense of coherence and resilience have a role in reducing risk perception. Understanding risk perception is crucial for developing effective strategies to mitigate the impact of the COVID-19 pandemic and other similar scenarios.

Stress, fear, and anxiety among construction workers: a systematic review.

Objectives: The aim of this review was to assess the possible risk factors arising from working conditions, that could have an impact on the stress, fear, and anxiety of construction workers. Methods: A systematic review was conducted following the PRISMA format in the Pubmed, Cochrane, Web of Science, Scopus, and PsycInfo electronic databases on February 3, 2023, using the following key words: anxiety, stress, fear, and construction workers. Methodological quality was assessed using the critical appraisal tools of the Joanna Briggs Institute. Results: A total of 35 studies were included. The results showed a number of conditioning factors for stress, anxiety, and fear among construction workers such as age, inappropriate safety equipment, safety culture, high workload and long working hours, physical pain, low social support from direct supervisor or co-workers, lack of organizational justice and lack of reward, financial situation, maladaptive coping strategies, and characteristics of the pandemic. Conclusions: There are a number of risk factors related to working conditions, organizations, and individuals that can affect the levels of stress, anxiety, and fear among construction workers, such as age, work hardship, safety culture and, especially, the long hours that construction professionals work. This may lead to an increase in the number of occupational accidents and higher associated fatality rates. Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022367724, identifier: CRD42022367724.

[Sources used to obtain information on COVID-19 and its impact on mental health.] / Fuentes utilizadas para obtener información sobre la COVID-19 y su impacto en la salud mental.

With the rise of COVID-19, the society has had the need to search for information about the pandemic and the sources used to obtain information have been very diverse, with a greater predominance of social media, traditional media and consultation with loved ones. In addition, an excess of information has been observed in the media that made access and understanding difficult, as well as a constant concern and anxiety about health that caused a need to search excessively or repeatedly for information on health and disease. This information was not always endorsed by the scientific community and during the pandemic there has been the spread of misinformation, fake news and conspiracy theories about COVID-19 disseminated, mainly through social media. In this sense, both the knowledge and the beliefs apprehended have been able to impact the mental health of the population.

Con la aparición de la COVID-19, la sociedad ha tenido la necesidad de buscar información sobre la pandemia y las fuentes de información usadas para ello han sido muy diversas, con un mayor predominio de las redes sociales, los medios tradicionales y la consulta a las personas allegadas. Además, se ha observado un exceso de información en los medios de comunicación que dificultaba el acceso y el entendimiento, así como una constante preocupación y ansiedad por la salud, lo cual provocaba una necesidad de búsqueda de información excesiva o repetida sobre la salud y la enfermedad. Esta información no siempre estaba avalada por la comunidad científica y durante la pandemia se han sucedido la difusión de información errónea, de las llamadas fake news y de las teorías de conspiración sobre la COVID-19 difundidas, principalmente, a través de las redes sociales. En este sentido, tanto los conocimientos como las creencias aprehendidas han podido impactar en la salud mental de la población.

Fuentes utilizadas para obtener información sobre la COVID-19 y su impacto en la salud mental / ources used to obtain information on COVID-19 and its impact on mental health

Con la aparición de la COVID-19, la sociedad ha tenido la necesidad de buscar información sobre la pandemia y las fuentes de informa-ción usadas para ello han sido muy diversas, con un mayor predominio de las redes sociales, los medios tradicionales y la consulta alas personas allegadas. Además, se ha observado un exceso de información en los medios de comunicación que dificultaba el accesoy el entendimiento, así como una constante preocupación y ansiedad por la salud, lo cual provocaba una necesidad de búsquedade información excesiva o repetida sobre la salud y la enfermedad. Esta información no siempre estaba avalada por la comunidadcientífica y durante la pandemia se han sucedido la difusión de información errónea, de las llamadasfake news y de las teorías deconspiración sobre la COVID-19 difundidas, principalmente, a través de las redes sociales. En este sentido, tanto los conocimientoscomo las creencias aprehendidas han podido impactar en la salud mental de la población.(AU)

With the rise of COVID-19, the society has had the need to search for information about the pandemic and the sources used to obtaininformation have been very diverse, with a greater predominance of social media, traditional media and consultation with lovedones. In addition, an excess of information has been observed in the media that made access and understanding difficult, as well asa constant concern and anxiety about health that caused a need to search excessively or repeatedly for information on health anddisease. This information was not always endorsed by the scientific community and during the pandemic there has been the spreadof misinformation, fake news and conspiracy theories about COVID-19 disseminated, mainly through social media. In this sense, boththe knowledge and the beliefs apprehended have been able to impact the mental health of the population.(AU)

Risk Factors for Working Pregnant Women and Potential Adverse Consequences of Exposure: A Systematic Review.

Objective: To assess the risk factors perceived as stressors by pregnant women in the work environment and the possible adverse consequences of such exposure for the normal development of pregnancy. Methods: Systematic review, guided by the PRISMA guidelines, and using Pubmed, Web of Science, Dialnet, SciELO, and REDIB databases. Methodological quality was assessed using the critical appraisal tools for non-randomised studies of the Joanna Briggs Institute. Results: A total of 38 studies were included. The main risk factors found in the work environment of pregnant women were chemical, psychosocial, physical-ergonomic-mechanical factors, and other work-related factors. The main adverse consequences of exposure to these factors include low birth weight, preterm birth, miscarriage, hypertension and pre-eclampsia, as well as various obstetric complications. Conclusion: During pregnancy, working conditions that are considered acceptable in normal situations may not be so during this stage due to the major changes that occur during pregnancy. Many obstetric effects may have an important impact in the mother's psychological status; therefore, it is important to optimise working conditions during this stage and to reduce or eliminate possible risks.

Desarrollo de técnicas microquirúrgicas usando tinción vascular con y sin silicona en placenta humana con modelos craneales 3D / Development of microsurgical techniques using vascular staining with and without silicone in human placenta with 3D cranial models

En las ultimas décadas, ha habido un cambio en la formación en las especialidades quirúrgicas, lo cual ha llevado a plantearse la necesidad de adquisición de habilidades por fuera del quirófano por medio de la simulación. El objetivo de este trabajo es demostrar que el uso de placentas humanas con modelo craneal tridimensional (3D), es un método de alta fidelidad y retroalimentación para el desarrollo de técnicas microquirúrgicas. Se realizó un estudio de evaluación técnica en el Laboratorio de Microcirugía Dr. Evandro de Oliveira del Hospital de la Beneficiencia de Portugal de São Paulo, utilizando 15 placentas con técnicas de coloración y preservación vascular con silicona para moldes; realizando ejercicio de anastomosis vasculares, ejercicios de disección parenquimatosa placentaria que remedan la disección aracnoidea y del valle silviano, además de simulación de resección de tumores. Cualitativamente la placenta humana es un método con alta fidelidad y retroalimentación, además, es de acceso universal para la adquisición de habilidades microquirúrgicas, que asociada a un modelo craneal 3D permite el perfeccionamiento de craneotomías, coordinación visomotriz, propiocepción y relación de profundidad que se requieren para abordajes neuroquirúrgicos.

In the last decades, there has been a change in training in surgical specialties, which has led to the need to acquire skills outside the operating room through simulation. The aim of this work is to demonstrate that the use of human placentas with a three-dimensional (3D) cranial model is a high fidelity and feedback method for the development of microsurgical techniques. A technical evaluation study was carried out in the Dr. Evandro de Oliveira Microsurgery Laboratory of the Hospital de la Beneficiencia de Portugal in São Paulo, using 15 placentas with coloration techniques and vascular preservation with silicone for molds; performing vascular anastomosis, placental parenchymal dissection exercises that mimic arachnoid and sylvian fissure dissection, in addition to simulating tumor resection. Qualitatively, the human placenta is a method with high fidelity and feedback, and it is also universally accessible for the acquisition of microsurgical skills, which, associated with a 3D cranial model, allows the refinement of the craniotomies, visomotor coordination, proprioception, and depth relationship required for neurosurgical approaches.

Prevalencia y diagnóstico de disfunción temporomandibular en la práctica médica - Hospital General María Auxiliadora / Prevalence and diagnosis of temporomandibular dysfunction in outpatient adults clinical practice at General Hospital Maria Auxiliadora

RESUMEN El objetivo de la investigación fue determinar el diagnóstico y la prevalencia de la Disfunción Temporomandibular (DTM), en el Hospital General María Auxiliadora, Lima, 2019. Material y métodos. Trabajo descriptivo, prospectivo, longitudinal y al azar. La muestra se constituyó con 76 pacientes, aplicándose los Criterios de Investigación para Diagnóstico de Desórdenes Témporo-Mandibulares(RDC/TDM). Resultados. Encontramos, que 73.7% fue del sexo femenino, especialmente en el grupo etario de 30-39 años (35.6%). La etiología de la DTM, es multifactorial y está relacionada a factores estructurales, funcionales y psicológicos. En el diagnóstico de DTM, la cefalea (38.1%) fue el principal síntoma y el dolor a la palpación de la articulación témporomandibular (51.4%), fue el signo destacado en el examen clínico, especialmente, en el sexo femenino (38.2%). El trastorno mixto de Ansiedad-Depresión, fue el cuadro clínico, de alteración del estado de salud mental más frecuente (50.0%), asociado a DTM, predominando en el sexo femenino (38.2%). La combinación de exámenes clínico-otorrinolaringológico, permitió el diagnóstico de DTM, en 77.6% de pacientes. Conclusión. Los pacientes con cuadros clínicos de DTM, que cursan con cefalea y concomitantemente con Ansiedad-Depresión, requieren un manejo terapéutico integral y precoz, para restituirlos a su ambiente de trabajo y mejorar su productividad laboral; la DTM, debería ser considerada, como una causa frecuente de cefalea.

ABSTRACT The objective of this study was to determine the diagnosis and prevalence of temporomandibular joint dysfunction (TMJD) in Maria Auxiliadora General Hospital in Lima, Peru, during 2019. Material and Methods: This is a prospective randomized longitudinal descriptive study. The sample included 76 patients, and Research Criteria for Diagnosing Temporomandibular Joint Disorders were used. Results: We found that 73.7% patients were female, particularly belonging to the 30-39 years age group (35.6%). TMJD etiology is multifactorial and it is related to structural, functional, and psychological factors. When diagnosing TMJD, headache was the main symptom (38.1%), and pain on palpation (51.4%) was the most prominent sign on clinical examination, particularly in females (38.2%). Mixed anxiety-depressive disorder, was the most frequent mental status alteration associated with TMJD found on clinical examination (50.0%), and it also was more frequently found in females (38.2%). A combination of general clinical and ear, nose, and throat examination allowed reaching a diagnosis in 77.6% of all subjects. Conclusion: Patients with TMJD who present with headache and concomitantly with anxiety-depression, require integrative and early therapy management, so they may be reinstalled to their working environment and improve their productivity. TMJD should be considered as a frequent cause of headache.

Articulación facetaria lumbar: correlación anatómica, clínica e imagenológica / Lumbar facet joint: anatomical, clinical and imaging correlation

El dolor facetario lumbar es una de las principales causas de dolor lumbar; representa alrededor del 15-56%. La articulación facetaria estabiliza la columna vertebral, tiene un rol fundamental en el soporte, distribución del peso y regulación de los movimientos rotacionales de la columna. Por ello, el conocimiento de la anatomía y de la biomecánica de esta articulación ayuda a tener una mejor comprensión de su participación en la fisiopatología del dolor lumbar y, por ende, mejora su abordaje diagnóstico y terapéutico. Nosotros revisamos aquí los conceptos actuales de embriología, anatomía, biomecánica y la correlación clínica/imagenológica de los cambios asociados a la enfermedad degenerativa facetaria de la columna lumbar.

Low back pain is a very common reason for emergency room consultation, it is found in approximately 60% of adults, and, within it, facet lumbar pain is one of the main causes, accounting for about 15-56% of low back pain cases. The facet joint stabilizes the spine, helps to distribute loads and has a fundamental role in support, weight distribution, and rotational movements regulation of the spine. Consequently, knowledge of the anatomy and biomechanics of this joint is helpful to have a better understanding of their contribution to the low back pain pathophysiology and, therefore, improving diagnostic and therapeutic approaches. This paper aims to review the current concepts of embryology, anatomy, biomechanics, and clinical/imaging correlation of the changes associated with lumbar degenerative facet disease

Escala de diagnóstico clínico para dolor lumbar de origen facetario: revisión sistemática de la literatura y estudio piloto / Clinical diagnosis scale for pain lumbar of facet origin: systematic review of literature and pilot study

Introducción: El dolor lumbar afecta entre el 60 y 90% de la población y es una causa frecuente de incapacidad en adultos. Puede ser generado por diferentes estructuras anatómicas, entre las cuales se encuentra la faceta articular. Actualmente, el diagnóstico de dolor lumbar de origen facetario depende de la realización de un procedimiento invasivo (bloqueo selectivo) y no puede hacerse exclusivamente con los hallazgos clínicos. Por lo cual, nuestro objetivo es desarrollar una escala de diagnóstico clínico para el dolor lumbar de origen facetario. Materiales y métodos: El estudio fue realizado por medio de 6 fases de la siguiente manera: Fase 1, se realizó una revisión sistemática de la literatura respecto al diagnóstico clínico del dolor lumbar de origen facetario basado en la lista de chequeo PRISMA. Fase 2, se realizó una lista de los signos y síntomas propuestos para diagnóstico de dolor lumbar de origen facetario. Fase 3, se sometió la lista de signos y síntomas encontrados a un comité de expertos para discriminar aquellos que son más significativos para los mismos, estos fueron unidos a variables generales sociodemográficas para desarrollar un cuestionario de evaluación. Fase 4, se aplicó el cuestionario de evaluación que incluía aquellos signos y síntomas seleccionados a un grupo de pacientes con diagnóstico clínico de dolor lumbar secundario a enfermedad facetaria y que fueron sometidos a un bloqueo facetario selectivo. Fase 5, bajo técnica estándar se realizó bloqueo facetario selectivo y posterior control clínico postoperatorio a un mes. Fase 6, se relacionaron los resultados pre- y posquirúrgicos con los signos positivos y se propone una escala clínica de evaluación diagnóstica. Resultados: Se encontraron un total de 36 signos y síntomas para el diagnóstico de síndrome facetario lumbar que fueron sometidos al grupo de expertos, donde fueron incluidos para la encuesta final un total de 12 (8 síntomas y 4 signos). Treinta y un pacientes fueron sometidos a bloqueo facetario lumbar selectivo, en su mayoría mujeres, con un promedio de 60±11,5 años, escala visual análoga del dolor prequirúrgica (EVAD) de 8/10, posquirúrgica de 1,7/10, los signos y síntomas más frecuentemente encontrados incluidos en una escala diagnóstica fueron: 3 síntomas, 1) dolor lumbar axial unilateral o bilateral, 2) mejoría con el reposo, 3) ausencia de patrón radicular, puede tener patrón pseudorradicular, sin embargo, el dolor es mayor el lumbar que dolor en la pierna. Y 3 signos clínicos, 1) signo Kemp, 2) dolor inducido en apófisis articular o transversa, 3) signo de estrés facetario o signo de Acevedo. Conclusión: El diagnóstico clínico del dolor facetario lumbar no es aún claro. Pocas escalas diagnosticas han sido postuladas, con poca o baja validez externa, por lo cual, el presente estudio propone una escala diagnóstica conformada por 3 síntomas y 3 signos clínicos

Introduction: Lumbar pain affects between 60-90% of people. It is a frequent cause of disability in adults. Pain may be generated by different anatomical structures such as the facet joint. However, nowadays pain produced by the facet joint has no clinical diagnosis. Therefore, the purpose of this article is to propose a clinical diagnostic scale for lumbar facet syndrome. Materials and methods: The study was conducted by means of 6 phases as follows, Phase 1, a systematic review of the literature was performed regarding the clinical diagnosis of facet-based lumbar pain based on the PRISMA checklist; Phase 2, a list of signs and symptoms proposed for diagnosis lumbar pain of facet origin was made. Phase 3, the list of signs and symptoms found was submitted to a committee of experts to discriminate the most significant signs and symptoms, these were linked to general sociodemographic variables to develop an evaluation questionnaire; Phase 4, the evaluation questionnaire was applied, including those selected signs and symptoms to a group of patients with clinical diagnosis of facet disease lumbar pain and who underwent a selective facet block. Phase 5, under standard technique selective facet block and subsequent postoperative clinical control at 1 month. Phase 6, given pre and postsurgical results associated with signs present in the patients we propose a clinical scale of diagnosis scale. Descriptive statistics and Stata 12.0 were used as statistical software. Results: A total of 36 signs and symptoms were found for the diagnosis of lumbar facet syndrome that were submitted to the group of experts, where a total of 12 (8 symptoms and 4 signs) were included for the final survey. 31 patients underwent selective lumbar facet blockade, mostly women, with an average of 60±11.5 years, analogous visual scale of preoperative pain of 8/10, postoperative of 1.7/10, the signs and symptoms most frequently found included in a diagnostic scale were: 3 symptoms 1) axial or bilateral axial lumbar pain, 2) improvement with rest, 3) absence of root pattern, may have pseudoradicular pattern, however, the pain is greater lumbar than pain in the leg and 3 clinical signs 1) Kemp sign, 2) pain induced in joint or transverse process, 3) facet stress sign or Acevedo sign. Conclusion: The clinical diagnosis of lumbar facet pain is still debated. Few diagnostic scales have been postulated, with little or no external validity, so the present study proposes a diagnostic scale consisting of 3 symptoms and 3 clinical signs

Clinical diagnosis scale for pain lumbar of facet origin: systematic review of literature and pilot study. / Escala de diagnóstico clínico para dolor lumbar de origen facetario: revisión sistemática de la literatura y estudio piloto.

INTRODUCTION: Lumbar pain affects between 60-90% of people. It is a frequent cause of disability in adults. Pain may be generated by different anatomical structures such as the facet joint. However, nowadays pain produced by the facet joint has no clinical diagnosis. Therefore, the purpose of this article is to propose a clinical diagnostic scale for lumbar facet syndrome. MATERIALS AND METHODS: The study was conducted by means of 6 phases as follows, Phase 1, a systematic review of the literature was performed regarding the clinical diagnosis of facet-based lumbar pain based on the PRISMA checklist; Phase 2, a list of signs and symptoms proposed for diagnosis lumbar pain of facet origin was made. Phase 3, the list of signs and symptoms found was submitted to a committee of experts to discriminate the most significant signs and symptoms, these were linked to general sociodemographic variables to develop an evaluation questionnaire; Phase 4, the evaluation questionnaire was applied, including those selected signs and symptoms to a group of patients with clinical diagnosis of facet disease lumbar pain and who underwent a selective facet block. Phase 5, under standard technique selective facet block and subsequent postoperative clinical control at 1 month. Phase 6, given pre and postsurgical results associated with signs present in the patients we propose a clinical scale of diagnosis scale. Descriptive statistics and Stata 12.0 were used as statistical software. RESULTS: A total of 36 signs and symptoms were found for the diagnosis of lumbar facet syndrome that were submitted to the group of experts, where a total of 12 (8 symptoms and 4 signs) were included for the final survey. 31 patients underwent selective lumbar facet blockade, mostly women, with an average of 60±11.5 years, analogous visual scale of preoperative pain of 8/10, postoperative of 1.7/10, the signs and symptoms most frequently found included in a diagnostic scale were: 3 symptoms 1) axial or bilateral axial lumbar pain, 2) improvement with rest, 3) absence of root pattern, may have pseudoradicular pattern, however, the pain is greater lumbar than pain in the leg and 3 clinical signs 1) Kemp sign, 2) pain induced in joint or transverse process, 3) facet stress sign or Acevedo sign. CONCLUSION: The clinical diagnosis of lumbar facet pain is still debated. Few diagnostic scales have been postulated, with little or no external validity, so the present study proposes a diagnostic scale consisting of 3 symptoms and 3 clinical signs.

Epidemiología y caracterización general de los tumores cerebrales primarios en el adulto / Epidemiology and General Characterization of Primary Brain Tumors in Adults

Los tumores primarios del sistema nervioso representaron aproximadamente el 1,4% de los nuevos diagnósticos de cáncer en 2015 y causan el 2,6% de las muertes por cáncer. Estos tienen una mayor implicación clínica en la población infantil y en adultos jóvenes; y su incidencia disminuye con la edad. Los tumores más frecuentes en los adultos incluyen meningiomas, gliomas y tumores pituitarios. En este artículo se hace una revisión actualizada sobre la epidemiología de los tumores primarios del sistema nervioso, así como las principales características y actualizaciones en el manejo de los tumores más prevalentes en la población adulta.

Primará' nervous system tumors represented approximately 1,4% of new cáncer diagnoses in 2015 and cause 2,6% of deaths secondary' to cáncer. Their major clinical impact is seen in pediatric population and young adults; and their incidence decreases with age. The most frequent tumors in adults inelude meningiomas, gliomas and pituitary tumors. In this arricie, an updated review is made on the epidemiology of primar? tumors of the nervous system, as well as the main features and updates in the management of most prevalent tumors in the adult population.

Derivación exocrina al duodeno en trasplante simultáneo de riñón y páncreas, experiencia en la Fundación Valle de Lili, Cali, Colombia / Exocrine bypass to the duodenum in simultaneous kidney and pancreas transplant, experience at Fundación Valle de Lili, Cali, Colombia

Introducción: El trasplante simultáneo de riñón y páncreas es reconocido como un tratamiento eficaz para el manejo de pacientes con diabetes mellitus, principalmente de tipo I, e insuficiencia renal crónica. Sin embargo, hoy en día aún existe dificultad para el seguimiento del injerto pancreático, ya que no existe un marcador serológico definitivo que lo permita y persiste la dificultad para la toma de biopsias. Se ha descrito una modificación en la técnica quirúrgica que permitiría el acceso endoscópico mediante una duodeno-duodenostomía. Material y métodos. Se seleccionaron los pacientes que recibieron un trasplante simultáneo de riñón y páncreas con derivación exocrina al duodeno, evaluando la seguridad del procedimiento, la evolución y las complicaciones médico-quirúrgicas. Resultados. Nueve pacientes fueron sometidos a trasplante simultáneo de riñón y páncreas con derivación exocrina al duodeno. La mediana de la edad fue de 36 años y la mayoría era del sexo masculino. El tiempo de isquemia en frío fue de 10 horas para el injerto pancreático y de 11 horas para el renal. El tiempo total de hospitalización fue de 21 días. Se presentó una pérdida del injerto pancreático y una pérdida del injerto renal. Hubo una sola muerte, causada por aspergilosis pulmonar. Conclusiones. La derivación exocrina duodenal permite y facilita la evaluación y el seguimiento endoscópico del injerto pancreático. No supone una mayor exigencia técnica en el trasplante simultáneo de riñón y páncreas, ni un incremento en el número de complicaciones en relación directa con la modificación del procedimiento quirúrgico.

Introduction: Despite its recognition as an effective therapy for the management of patients with Type I diabetes mellitus and chronic renal failure, simultaneous kidney and pancreas transplant encounters difficulties in monitoring the pancreatic graft, and there is no strong serologic marker coupled with the difficulties in taking biopsies. We describe a modification of a surgical technique that allows endoscopic access through a duodenostomy. Material and methods. Patients who received simultaneous kidney-pancreas transplantation with exocrine bypass to the duodenum were selected to evaluate the safety of the procedure, the clinical postoperative course, and the medical and surgical complications. Results: Nine patients were submitted to simultaneous kidney-pancreas transplantation with exocrine bypass to the duodenum. Median age was 36, most patients where male. Cold ischemia time was 10 hours for the pancreatic graft and 11 hours for the kidney graft. Total hospital stay was 21 days. There was one death caused by pulmonary aspergillosis. Conclusion: The duodenal exocrine derivation permits and facilitates the evaluation and endoscopy follow-up of the pancreatic graft. It neither imposes greater technical demands in simultaneous kidney-pancreas transplantation, nor an increase in the number of complications directly related to the modification of the surgical procedure.

Trasplante renal con HLA idéntico de donante vivo y cadavérico: experiencia de la Fundación Valle de Lili, Cali, Colombia / Renal transplant with identical HLA with living and cadaver donor: Experience at Fundación Valle de Lili, Cali, Colombia

Introducción: En el trasplante renal con HLA idéntico los episodios de rechazo agudo son menores y tienen mejores tasas de supervivencia del injerto, comparado con los receptores con HLA no idéntico; a pesar de esto, persiste el dilema en cuanto al retiro o la disminución de la dosis de inmunosupresión. El objetivo de este trabajo es describir la experiencia de los trasplantes renales con HLA idéntico de donante vivo y cadavérico que se han realizado en la Fundación Valle del Lili desde 1995 hasta 2014. Material y métodos. De los 1.462 trasplantes renales realizados se incluyeron aquellos con HLA idéntico. Se hizo un análisis estadístico descriptivo para todas las variables consideradas y, para subgrupos seleccionados, el análisis de supervivencia y de rechazo agudo se hizo con el método de Kaplan-Meier. Para el análisis se usó Stata 12.0®. Resultados. Se practicaron 29 trasplantes renales con HLA idénticos. La mayoría fueron en hombres de raza mestiza y lo más frecuente fue una etiología desconocida de la enfermedad renal terminal. Dos pacientes presentaron rechazo agudo, y la supervivencia de los injertos a 1, 5, 10 y 15 años, fue de 100%, 93,7 %, 75 % y 75 %, respectivamente; la supervivencia de los pacientes a los 1, 5, 10 y 15 años, fue de 100%, 93,7 %, 84,3 % y 84,3 %, respectivamente. Conclusiones. Los receptores HLA idénticos poseen una supervivencia prolongada del injerto con menos tasas de rechazo agudo.

Introduction: Kidney transplantation is the treatment of choice for patients with end-stage renal disease (ESRD). Graft rejection is much lower in terms of acute rejection and improved graft survival in renal transplantation with HLA-identical compared to non-identical HLA receptors. The aim of this work is to describe the experience of HLA identical kidney transplantation from live and deceased donors that have been performed at Valle de Lili Foundation since 1995 to 2014. Material and methods. From the 1,462 kidney transplants performed those with HLA-identical were identified, a descriptive statistical analysis was performed for all variables considered in the analysis and for selected subgroups, the analysis of survival and acute rejection was made with the Kaplan-Meier method. Stata 12.0 was used for the analysis. Results: A total of 29 HLA-identical kidney transplants were performed. Most were men of mixed race; the main etiology of ESRD was unknown. Two patients had acute rejection and graft survival at five, ten and fifteen years was 93.7%, 75% and 75% respectively, patient survival at five, ten and fifteen years was 93.7%, 84.3% and 84.3% respectively. Conclusion: HLA-identical receptors have a prolonged survival of the graft with less acute rejection rates.

Medical ozone increases methotrexate clinical response and improves cellular redox balance in patients with rheumatoid arthritis.

Medical ozone reduced inflammation, IL-1ß, TNF-α mRNA levels and oxidative stress in PG/PS-induced arthritis in rats. The aim of this study was to investigate the medical ozone effects in patients with rheumatoid arthritis treated with methotrexate and methotrexate+ozone, and to compare between them. A randomized clinical study with 60 patients was performed, who were divided into two groups: one (n=30) treated with methotrexate (MTX), folic acid and Ibuprophen (MTX group) and the second group (n=30) received the same as the MTX group+medical ozone by rectal insufflation of the gas (MTX+ozone group). The clinical response of the patients was evaluated by comparing Disease Activity Score 28 (DAS28), Health Assessment Questionnaire Disability Index (HAQ-DI), Anti-Cyclic Citrullinated (Anti-CCP) levels, reactants of acute phase and biochemical markers of oxidative stress before and after 20 days of treatment. MTX+ozone reduced the activity of the disease while MTX merely showed a tendency to decrease the variables. Reactants of acute phase displayed a similar picture. MTX+ozone reduced Anti-CCP levels as well as increased antioxidant system, and decreased oxidative damage whereas MTX did not change. Glutathione correlated with all clinical variables just after MTX+ozone. MTX+ozone increased the MTX clinical response in patients with rheumatoid arthritis. No side effects were observed. These results suggest that ozone can increase the efficacy of MTX probably because both share common therapeutic targets. Medical ozone treatment is capable of being a complementary therapy in the treatment of rheumatoid arthritis.

Mammalian cells exposed to ionizing radiation: Structural and biochemical aspects.

Acute or chronic exposure to ionizing radiation is a factor that may be hazardous to health. It has been reported that exposure to low doses of radiation (less than 50 mSv/year) and subsequently exposure to high doses produces greater effects in people. It has been reported that people who have been exposed to low doses of radiation (less than 50 mSv/year) and subsequently are exposed to high doses, have greater effects. However, at a molecular and biochemical level, it is an unknown alteration. This study, analyzes the susceptibility of a biological system (HeLa ATCC CCL-2 human cervix cancer cell line) to ionizing radiation (6 and 60 mSv/90 s). Our research considers multiple variables such as: total protein profile, mitochondrial metabolic activity (XTT assay), cell viability (Trypan blue exclusion assay), cytoskeleton (actin microfilaments), nuclei (DAPI), and genomic DNA. The results indicate, that cells exposed to ionizing radiation show structural alterations in nuclear phenotype and aneuploidy, further disruption in the tight junctions and consequently on the distribution of actin microfilaments. Similar alterations were observed in cells treated with a genotoxic agent (200 µM H2O2/1h). In conclusion, this multi-criteria assessment enables precise comparisons of the effects of radiation between various line cells. However, it is necessary to determine stress markers for integration of the effects of ionizing radiation.