Discapacidad militar: revisión de recursos psicosociales en los ejércitos de nuestro entorno / Military disability: review of psychosocial resources in the armies of our environment

El avance legislativo y social respecto a los derechos e igualdad de oportunidades de las personas con discapacidad, no excluye a los contextos militares. Estados Unidos, Francia, Reino Unido o España, han desarrollado instrumentos para garantizar la protección legal, administrativa y económica de los militares con discapacidad, pero los proyectos y programas de recuperación social parecen insuficientes, por lo que este trabajo se centra en el objetivo de revisar los recursos psicosociales disponibles en los ejércitos de nuestro entorno.Los resultados muestran que la mayor parte de los estudios revisados se centran en la recuperación de militares con trastorno de estrés postraumático (TEPT), aunque también se recogen trabajos con lesionados medulares o con daño cerebral. Las temáticas abordadas, con relación al apoyo psicosocial y los recursos disponibles, se enfocan a la empleabilidad, las compensaciones económicas, los tratamientos y los factores que favorecen la integración social. Destacan los estudios sobre: (1) los beneficios aportados por los programas de empleo con apoyo para la salud, la integración social y la autoestima, (2) el uso de perros de servicio, que mejoran la calidad de vida y la producción laboral, y (3) los programas de deporte, que mejoran la autoestima y la calidad de vida, y favorecen el crecimiento postraumático.Como conclusión, se apunta la necesidad de establecer programas de recuperación integral, no solamente sanitaria, sino también psicosocial. Los militares y veteranos con discapacidad deben ser informados y asesorados acerca de los recursos que tienen a su disposición, pero también acompañados en la transición a la vida civil, iniciando proyectos laborales, sociales, deportivos y de ocio, que favorezcan su calidad de vida, su autoestima y su recuperación. (AU)

The legislative and social progress regarding the rights and equal opportunities of people with disabilities does not exclude military contexts. The United States, France, the United Kingdom and Spain have developed instruments to guarantee legal, administrative, and economic protection for military personnel with disabilities, although social recovery projects and programs seem insufficient. Therefore, this bibliographic review focuses on the objective of reviewing the psychosocial resources available in the Armies of our environment.The results show that most of the studies reviewed focus on the recovery of military personnel with post-traumatic stress disorder (PTSD), although there are also studies on spinal cord injury or brain damage. The topics addressed, in relation to psychosocial support and available resources, focus on employability, economic compensation, treatments and factors that favour social integration. Of note are studies on: (1) the benefits brought by supported employment programs, for health, social integration, and self-esteem, (2) the use of service dogs, that improve quality of life and work production, and (3) sports programs, which improve self-esteem and quality of life, and favour post traumatic growth.In conclusion, the need to establish comprehensive recovery programs, not only health, but also psychosocial, is pointed out. Military personnel and veterans with disabilities should be informed and advised about the resources available to them, and accompanied in the transition to civilian life, initiating work, social, sports and leisure projects that favour their quality of life, self-esteem, and recovery. (AU)

DNA aneuploidy by flow cytometry is an independent prognostic factor in gastric cancer.

In the present study the prognostic value of both DNA ploidy and the proliferative activity of tumour cells were studied in a series of 76 consecutive patients suffering from gastric tumours. DNA ploidy and the proliferative index (as measured by the percentage of S-phase cells) were determined by flow cytometry using fresh tumour specimens. The presence of DNA aneuploid clones by flow cytometry was detected in 62% of the cases (mean DNA index of 1.63 +/- 0.46; range 1.08-2.92), the mean proportion of S-phase cells being of 18.4 +/- 11.5%. In comparison with diploid cases, aneuploid tumours showed a higher proliferative activity (cases with more than 15% S-phase cells: 18.4% versus 6.1%, p = 0.0001) as well as a higher incidence of node involvement (95% versus 68%, p = 0.001). By contrast, no significant differences were detected with respect to sex, age, histologic grade and type, clinical stage, tumour size and the incidence of extranodal involvement. Upon grouping the patients according to the proportion of S-phase cells no significant differences were observed for the clinical and biological parameters explored except for an association between a high percentage of S-phase cells and the presence of DNA aneuploidy (40% versus 96%, p = 0.0001). Regarding survival the presence of DNA aneuploidy was significantly associated with poor outcome as compared to the diploid cases (median of 15 versus 26 months, p = 0.005). By contrast, the proportion of S-phase cells did not predict patients's outcome. Multivariate analysis of prognostic factors showed that the presence of DNA aneuploidy (p = 0.003) together with the histologic type (p = 0.03) and the existence of extranodal metastases (p = 0.05) were the best combination of prognostic factors for survival prediction.

Healing of colonic ischemic anastomoses in the rat: role of superoxide radicals.

PURPOSE: The aim of this study was to evaluate the role of superoxide radicals in the healing of ischemic colonic anastomoses in the rat. METHODS: Adult male Wistar rats were used in a factorial design with two factors (normal or ischemic colonic anastomoses) each having two levels (treatment with saline or allopurinol). Colonic anastomoses were performed either in normal or previously devascularized colons (ischemic anastomoses) at identical locations, using the same technique. On the fourth postoperative day, animals were killed, and specimens were taken for determinations. RESULTS: Ischemic anastomoses displayed significant increases in superoxide radical (assayed as superoxide anion), superoxide dismutase, and glutathione peroxidase concentrations. Bursting strength and hydroxyproline levels were also significantly lower in these anastomoses. Allopurinol administration elicited a significant decrease in superoxide anions and raised both bursting strength and hydroxyproline levels only in ischemic anastomoses. CONCLUSIONS: Superoxide radicals are involved in the delay in healing of ischemic anastomoses. Allopurinol lowers superoxide anion production and has beneficial effects on the cicatrization of ischemic anastomoses.

[Detection and characterization of pre-core mutants of hepatitis B virus (HBV) in chronically infected patients]. / Detección y caracterización de mutantes pre-core del virus de la hepatitis B (HBV) en pacientes crónicamente infectados.

Hepatitis B virus infection is responsible of an important number of world morbimortality. This is associated to severe liver outcome such as cirrhosis and hepatocellular carcinoma. Diverse factors influence the severity of liver injury produced by Hepatitis B Virus (HBV): the emergence of HBV mutants unable to secrete "e" antigen (pre-core mutants), the virus and host genetic heterogenicity and immune system competence. Particularly, the presence of pre-core mutants in chronic carriers is associated a low response to interferon therapy. We present paper is to present evidence as to the presence of these mutants in chronically infected, HBeAg negative patients (HBsAg positive) in Argentina. Viral DNAs were extracted from sera of nine patients, amplified by PCR and characterized by restriction enzyme assay. All of them appear to be pre-core mutants according with serological markers and a very low level of viral DNA detected in serum. Further genetic characterization of one of them by nucleotide sequence analysis of the pre-core region let allowed us to show modifications at codon 15 and 28 both of them previously described for pre-core mutants.

Superoxide dismutase (SOD) and neutrophil infiltration in intestinal ischaemia-revascularization.

SOD is the main detoxifying enzyme of OFRs which have been mainly purported to participate in ischaemia revascularization lesions. A study was made of the behaviour of SOD during ischaemia and the response to pharmacological doses of SOD in Wistar rats in which ischaemia was induced by 90 min of clamping and followed by revascularization. SOD levels were determined in the intestinal wall, evaluating the degree of infiltration of neutrophils, leucocytes and monocytes by immunohistochemical methods. Ischaemia led to a significant decrease in intestinal wall SOD levels (p = 0.003). The administration of pharmacological doses of SOD was observed to improve survival of the animals (p = 0.001) and significantly decreased the infiltration of leucocytes only during revascularization measured by MPO and LCA. Beneficial effects of SOD could be explained by its effect as scavenger of OFRs and by its action on the neutrophil infiltration.

Detección y caracterización de mutantes pre-core del virus de la hepatitis B (HBV) en pacientes crónicamente infectados. / [Detection and characterization of pre-core mutants of hepatitis B virus (HBV) in chronically infected patients]

Hepatitis B virus infection is responsible of an important number of world morbimortality. This is associated to severe liver outcome such as cirrhosis and hepatocellular carcinoma. Diverse factors influence the severity of liver injury produced by Hepatitis B Virus (HBV): the emergence of HBV mutants unable to secrete [quot ]e[quot ] antigen (pre-core mutants), the virus and host genetic heterogenicity and immune system competence. Particularly, the presence of pre-core mutants in chronic carriers is associated a low response to interferon therapy. We present paper is to present evidence as to the presence of these mutants in chronically infected, HBeAg negative patients (HBsAg positive) in Argentina. Viral DNAs were extracted from sera of nine patients, amplified by PCR and characterized by restriction enzyme assay. All of them appear to be pre-core mutants according with serological markers and a very low level of viral DNA detected in serum. Further genetic characterization of one of them by nucleotide sequence analysis of the pre-core region let allowed us to show modifications at codon 15 and 28 both of them previously described for pre-core mutants.

Ultrasonic blood flow measurements in arteriovenous fistulas: an experimental study.

Femoral arteriovenous fistulas (AVF) were constructed in dogs. Fistulas blood flow was measured simultaneously with standard Doppler equipment, with electromagnetic flow probes and by direct timed blood collection. A good correlation was observed between Doppler and direct timed blood collection (r = 0.822, p less than 0.001) and also between Doppler and electromagnetic determinations (r = 0.747, p less than 0.001). These results lead us to suggest that transcutaneous measurement of AVF flow is possible with standard Doppler equipment and we recommend this technique for the management of AVF constructed in uremic patients.

Concentrations of cefmetazole in plasma and tissue resulting from peri-incisional administration before appendectomy.

The levels of cefmetazole in plasma and tissue were determined after injection of a dose of 30 mg/kg into the zone of the wound of each of 15 patients undergoing appendectomy. The mean plasma levels of cefmetazole at the start and end of surgery (8.9 +/- 2.4 and 31.7 +/- 6.4 min after dosage) were 21.1 and 59.0 micrograms/ml, respectively; concentrations of the drug were 14.6 and 4,486.9 micrograms/g in skin, 9,165.0 and 1,756.4 micrograms/g in subcutaneous tissue, and 8,669.6 and 2,022.9 micrograms/g in muscle.