Dependencia al dispositivo móvil e impulsividad en estudiantes universitarios de Riobamba-Ecuador / Mobile device dependence and impulsivity in university students from Riobamba-Ecuador

El uso excesivo de la telefonía celular crea situaciones problemáticas, resaltando la dependencia. Se realizó un estudio con el objetivo de determinar la relación entre los niveles de dependencia al dispositivo móvil y los tipos de impulsividad en universitarios; con enfoque cuantitativo, de tipo no experimental correlacional. La población de estudio estuvo conformada por 2533 estudiantes de 18 a 26 años de la Facultad de Ciencias de la Salud de la Universidad Nacional de Chimborazo, matriculados en el periodo académico agosto 2019 ­ marzo 2020. La recolección de los datos se hizo a través del Test de Dependencia al Móvil y la Escala de Impulsividad (BIS-11). La media de la edad fue de 21,3 años. El 66,5% de la muestra mostró un nivel modera-do de dependencia del dispositivo móvil. El 85,03% tenía impulsividad no planificada, con un puntaje de nivel medio de impulsividad en cada subescala y globalmente. Entre ambas variables fundamentales de estudio se estableció una correlación positiva, maderada y estadísticamente significativa

Excessive use of smartphones creates problematic situations, highlighting dependency. This study was carried out to determine the relationship between the levels of dependence on the mobile device and the types of impulsivity in university students. This research included a quantitative approach, and a non-experimental correlational type. The study population consisted of 2533 students aged 18 to 26 from the Faculty of Health Sciences of the National University of Chimborazo, enrolled in the academic period August 2019 - March 2020. Data collection was done through the Mobile Dependence Test and Impulsivity Scale (BIS-11). The mean age was 21.3 years. 66.5% of the sample showed a moderate level of dependence on the mobile device. 85.03% had unplanned impulsivity, with a score of medium level of impulsivity in each subscale and globally. A positive, lumpy, and statistically significant correlation was established between both fundamental study variables

Informed consent in clinical research at a general hospital in Mexico: opinions of the investigators.

In Mexico informed consent is a legal requirement that ensures that patients who are invited to participate in clinical trials are provided with all the information needed to decide whether to participate, or not, in a research protocol. To improve our understanding of the problems physicians in developing countries encounter, when obtaining informed consent (IC), we examined their opinion on the importance of IC in clinical research, the quantity and quality of the information provided to the participant, and the conditions in which the IC is obtained. Investigators considered that IC was useful to the patients, providing information that helped the patient to make a decision about his/her participation. Nevertheless, they felt that for some aspects of the research, like drug development in general, the use of placebos, and the randomization process, many of the patients were not capable of fully understanding the information provided, referring to the complexity of the information and illiteracy as the main reasons. Many investigators were not acquainted with some of the guidelines established in the Mexican General Law of Health,(1) 36% of them admitting to not having completed their IC letters. Most investigators gave only minutes to the patient to make a decision and 20% of ICs were obtained while the patient was hospitalized. Except for one investigator, all of them considered that specific training in medical ethics would be useful for the daily clinical work.

Speech summer camp for treating articulation disorders in cleft palate patients.

INTRODUCTION: Compensatory articulation disorder (CAD) severely affects speech intelligibility of cleft palate children. CAD must be treated with speech therapy. Children can manage articulation better when they use language in event contexts such as every day routines. OBJECTIVE: The purpose of this paper is to study and compare two modalities of speech intervention in cleft palate children with associated CAD. The first modality is a conventional approach providing speech therapy in 1-h sessions, twice a week. The second modality is a speech summer camp in which children received therapy 4h per day, 5 days a week for a period of 3 weeks. We were aimed to determine if a speech summer camp could significantly enhance articulation in CP children with CAD. MATERIALS AND METHODS: Forty-five children with repaired cleft palates who exhibited CAD were studied. A matched control group of 45 children with repaired cleft palate who also exhibited CAD were identified. The patients included in the first group attended a speech summer camp for 3 weeks. The matched control subjects included in the second group received speech therapy aimed to correct CAD twice per-week in 1-h sessions. RESULTS: At the onset of either the summer camp or the speech therapy period, the severity of CAD was evenly distributed with non-significant differences across both groups of patients (p > 0.05). After the summer camp (3 weeks) or 12 months of speech therapy sessions at a frequency of twice per-week, both groups of patients showed a significant decrease in the severity of their CAD (p < 0.05). However, when the distribution of the severity of CAD was compared at the end of the summer camp or the speech therapy period, non-significant differences were found between both groups of patients (p > 0.05). CONCLUSIONS: A speech summer camp is a valid and efficient method for providing speech therapy in cleft palate children with compensatory articulation disorder.

[Sensitivity and specificity of endoscopy for the detection of velocardiofacial syndrome]. / Sensibilidad y especificidad de la endoscopia para la detección del síndrome velocardiofacial.

INTRODUCTION: Velo-cardio-facial syndrome (VCFS) (also known as DiGeorge sequence, and 22q11.2 deletion syndrome among other labels) is now recognized as the most common syndrome associated with cleft palate and velopharyngeal insufficiency. 22q11.2 deletion syndrome has been associated with medially positioned internal carotid arteries. This anomaly may be associated with posterior pharyngeal pulsations seen on endoscopy. The purpose of this paper is to study the diagnostic efficacy of the endoscopy for the detection of patients with 22q11.2 deletion syndrome, using as gold standard test the fluorescence in situ hybridization (FISH) test. MATERIAL AND METHODS: Twenty nine patients with submucous cleft palate, velopharyngeal insufficiency, and 22q11.2 deletion as demonstrated by FISH were studied. Also, 29 patients with submucous cleft palate, and without abnormalities in the FISH procedure, were studied as controls. All patients from both groups underwent endoscopy. A double-blind procedure was utilized whereby all videonasopharyngoscopies were independently revised by the two examiners. RESULTS: Twenty five patients with VCFS demonstrated posterior pharyngeal pulsations seen on endoscopy (sensitivity of 86%). In contrast, none of the patients from the control group showed posterior pulsations (specificity of 100%). Positive predictive value was 100%, and negative predictive value was 87%. CONCLUSIONS: Endoscopy seems to be a safe and reliable procedure for evaluating patients with 22q11.2 deletion syndrome. The observations of posterior pharyngeal wall pulsations on endoscopy should alert clinicians to the diagnosis of 22q11.2 deletion, and also, can be useful for preventing the risk of damage to the carotid arteries during velopharyngeal surgery. This indicates another important role of endoscopy in the preoperative assessment of children for palatopharyngoplasty.

Epilepsia y embarazo. Riesgos y beneficios del tratamiento anticonvulsivo / Epilepsy and pregnancy: risks and benefits of anticonvulsant treatment

La epilepsia en el trastorno neurológico más frecuente durante la gestación. Una de las principales preocupaciones que enfrenta el médico se relaciona con los potenciales efectos indeseables que los fármacos anticonvulsivos pudieron ejercer sobre el curso del embarazo y el desarrollo fetal. El objetivo del presente trabajo fue investigar las complicaciones maternas y obstétricas en 50 epilépticas embarazadas, así como los posibles efectos teratogénicos de diversos agentes anticonvulsivos sobre los recién nacidos de dichas pacientes atendidas en el Hospital General "Dr. Manuel Gea González" SSA, de 1989 a 1992. Los resultados indican que el 78 por ciento de las pacientes recibieron tratamiento a base de carbamezepina o difenilhidantoína y solamente 10 por ciento requirieron una combinacion de fármacos. La mayor parte de las gestaciones (76 por ciento) se resolvió por vía vaginal, y únicamente en tres neonatos (6 por ciento) se detectaron malformaciones congénitas menores, como hipoplasia de falanges y anomalías estructurales del pabellón auricular. Estos datos sugieren que existe un margen de seguridad aceptable en el empleo de anticonvulsivos en pacientes epilépticas durante el embarazo, especialmente cuando el control de las crisis convulsivas puede lograrse con un sólo fármaco

Tuberculosis. Diagnóstico postmortem y su relación con el diagnóstico clínico / Tuberculosis. Posmortem diagnosis and its relation with clinical diagnosis

Entre 1978 y 1991, el Hospital General ®Dr. Manuel Gea González¼ de la Secretaría de Salud, se realizaron 2,525 autopsias, encontrándose que en 66 casos (2.6 por ciento) se estableció el diagnóstico postmortem de tuberculosis, de los cuales solamente 30 de ellos contaban con diagnóstico clínico de la enfermedad. La proporción de casos diagnosticados postmortem fue mayor en hombres y se incrementó con la edad. Más del 60 por ciento de los casos de tuberculosis diseminada pasaron inadvertidos al diagnóstico clínico. Estos datos indican que la tuberculosis continúa siendo un problema subestimado clínicamente, particularmente en los pacientes de mayor edad y en aquellos con manifestaciones atípicas o extrapulmonares de la enfermedad