Ratio of Women with POP Using Pessary, Improvement in Urination and Quality of Life

Introduction: Pelvic organ prolapse (POP) has a general incidence of > 10% in the female population of the Western world. The pessary is a silicone device, it is inserted into the vagina to provide support to the pelvic organs. It is used as a conservative treatment to improve prolapse symptoms. Objective: To evaluate urination among women with a pessary and women without a pessary and to evaluate the effectiveness of pessary treatment in pelvic organ prolapse with voiding difficulties. Material and Methods: A prospective and quasi-experimental observational study of an analytical nature was conducted. It will consist of analyzing the results of treatment with vaginal pessaries in women with POP. A total of 60 women were chosen as a sample of the study, 50% were placed with the pessary. PGI test and uroflujometry were used. Results: The placement of pessary shows how there is a significant correlation between the quality of life of women and urination Conclusions: There is a relationship between the improvement of the quality of life and the improvement of the mycological dynamics of women in pessary treatment. However, the improvement in the quality of life cannot be attributed solely to the improvement of urinary flow, but also to the well-being caused by the reduction of POP (AU)

Introducción: El prolapso de órganos pélvicos (POP)presenta una incidencia general de > 10% en la poblaciónfemenina del mundo occidental. El pesario es un dispositivo de silicona, se introduce en la vagina para proveer soporte a los órganos pélvicos. Se utiliza como tratamientoconservador para mejorar los síntomas del prolapso.Objetivo: Evaluar las micciones entre las mujeres conpesario y las mujeres sin pesario y evaluar la efectividad deltratamiento del pesario en los prolapsos de órganos pélvicosque tienen dificultad miccionalMaterial y Métodos: Se llevó a cabo un estudioobservacional prospectivo y cuasi experimental, de carácter analítico. Consistirá en analizar los resultados detratamiento mediante pesarios vaginales en mujeres conPOP. Un total de 60 mujeres fueron elegidas como muestradel estudio, al 50% se les colocó el pesario. Se utilizó eltest PGI y la uroflujometría.Resultados: La colocación del pesario muestra comoexiste una correlación significativa entre la calidad de vidade las mujeres con POP y las micciones.Conclusiones: Existe relación entre la mejora de lacalidad de vida y la mejora de las dinámicas miccionalesde las mujeres en tratamiento con pesario. Sin embargo,la mejora de la calidad de vida no se puede atribuir únicamente a la mejora del flujo urinario, sino también al bienestar provocado por la reducción del POP (AU)

Diagnostic concordance of pathological methods and reports of hematopathologists compared to local nonspecialized pathologists in the diagnosis of lymphoma in Mexico.

OBJECTIVES: To assess the concordance between lymphoma diagnoses made via tissue biopsy by local pathologists and also to assess the after review of these specimens by more specialized hematopathologists. METHODS: A prospective, non-interventional and multicenter study was conducted at seven sites in Mexico from January 2017 to October 2017. Eligible biopsies were sampled from patients with a previous diagnosis of lymphoma on lymph node biopsy or a diagnosis of extranodal lymphoma, with adequate amount and tissue preservation for the review analysis. The biopsy tissues reviewed by local pathologists were also reviewed by hematopathologists participating in the study. The concordance in diagnosis results was classified into three categories: diagnostic agreement, minor discrepancy and major discrepancy. RESULTS: Out of 111 samples received, 105 samples met the eligibility criteria and were included for full analysis. The median patient age (range) was 54 (16-94) years. A diagnostic agreement was observed in 23 (21.9%) biopsies, minor discrepancies were observed in 32 (30.5%) biopsies and major discrepancies were observed in 50 (47.6%) biopsies. Diagnostic concordance varied across the seven study sites; the rate of major discrepancies ranged from 0% to 100% and the rate of diagnostic agreement ranged from 0% to 81.8%. Out of the 105 reviewed biopsies, a total of 89 cases were diagnosed as lymphoma by hematopathologists. CONCLUSIONS: This study showed that major discrepancies were observed following the review by hematopathologists compared with that of the local pathologist's initial diagnosis in nearly one-half cases. In addition, there was a wide variation in the percentage of diagnostic agreements and discrepancies among different study sites.

Influencia de los pesarios en la calidad de vida de las mujeres con prolapso de órganos pélvicos / No disponible

El prolapso de órganos pélvicos es una condición patológica que impacta negativamente en la calidad de vida de la mujer. Ocurre cuando los músculos, los ligamentos y las fascias del suelo pélvico se estiran y se debilitan, dejando de proporcionar un sostén adecuado, pudiendo descender y salir al exterior (1). La prevalencia está estimada de un 43% a un 76% de la población femenina general, siendo la etiología compleja y multifactorial (2). El pesario es un dispositivo que se instala en la vagina para proveer soporte a los órganos pélvicos. La importancia de su utilización reside en mejorar significativamente la calidad de vida de la paciente y evitar una intervención quirúrgica. El tratamiento es mínimamente invasivo, de bajo coste, seguro y efectivo. Se recomienda cuando la cirugía representa un riesgo mayor a los beneficios (3)

Pelvic organ prolapse is a pathological condition that negatively affects women's quality life. It occurs when the muscles ligaments and tissues supporting the pelvic organs become weak or loose. Then, the pelvic organs can droop down and bulge out of the vagina. The prevalence in women is estimated to be between 43 and 76%, etiology is complex and multifactorial. A pessary is a device inserted into the vagina to support areas that are affected by pelvic organ prolapse. The potential benefit that derives form pessary use is the significant improvement in the patient's quality of life. Thus, pessary treatment allows surgery to be avoided. It is minimally invasive, inexpensive, safe and effective treatment. It is therefore recommended when surgery may pose greater risk than benefit

Luxación de codo / Elbow dislocation

La luxación de codo es la luxación más frecuente en extremidad superior tras la luxación glenohumeral. La reducción cerrada en aquellas luxaciones en que no hay lesión ósea asociada es un procedimiento realizable en el ámbito extrahospitalario, por lo que presentamos un repaso de las diferentes técnicas posibles (AU)

Elbow dislocation is the most frequent dislocation in the upper limb after shoulder dislocation. Closed reduction is feasible in outpatient care when there is no associated fracture. A review is presented of the different reduction procedures (AU)

[Elbow dislocation]. / Luxación de codo.

Elbow dislocation is the most frequent dislocation in the upper limb after shoulder dislocation. Closed reduction is feasible in outpatient care when there is no associated fracture. A review is presented of the different reduction procedures.

La fractura concomitante de clavícula y escápula / Floating shoulder

La fractura concomitante de clavícula y escápula es una entidad poco frecuente que puede ser una de las causas de afectación del complejo suspensorio del hombro también denominado hombro flotante (floating shoulder). Se relaciona frecuentemente con traumatismos de alta energía. Presentamos un caso de esta patología en un paciente varón de 28 años que consultó por caída en bicicleta con contusión sobre hombro izquierdo. Se describen las diferentes opciones terapéuticas planteadas, las imágenes radiológicas y una revisión de la literatura (AU)

The floating shoulder (clavicular and scapular concomitant fracture) is an infrequent condition, mostly related with high energy injuries. We report a 28 year-old man who consulted in our hospital after bicycle fall and contusion over left shoulder. The different therapeutic options and radiological images are described and the literature review is discussed (AU)

Síndrome compartimental agudo / Acute compartmental syndrome

No disponible

Predicción de unión de péptidos de Plasmodium falciparum al HLA clase II. Probabilidad, combinatoria y entropía aplicadas a las proteínas MSP-5 y MSP-6 / Plasmodium falciparum binding peptides prediction to HLA class II. Probability, combinatory and entropy applied to MSP-5 and MSP-6 proteins

Las proteínas de superficie del merozoíto (MSP) son de importancia en la invasión parasitaria al glóbulo rojo. La proteína MSP-5, encontrada en merozoítos libres, tiene un papel en la inmunización de ratones al P. falciparum y P. yoelii, pese a lo cual algunos estudios cuestionan su rol en la invasión. La proteína MSP-6 forma junto con MSP-1 y MSP-7 un complejo en la superficie del merozoíto, liberado del parásito cerca del momento de la invasión al glóbulo rojo. Con el fin de predecir el fenómeno de unión de péptidos de las proteínas de superficie MSP-5 y MSP-6, se aplicó una teoría de unión al HLA clase II, a la totalidad de secuencias de 20 aminoácidos de tales moléculas. Se calcularon los valores de probabilidad, combinatoria y entropía de 168 secuencias nonámeras sobrelapadas de la proteína MSP-5 y 228 de MSP-6. Por último se aplicó la teoría de unión a todos los péptidos nonámeros de tres proteínas construidas computacionalmente, cada una con una longitud de 500 aminoácidos. Para la proteína MSP-5 se predijo un total de 31 secuencias asociadas al macroestado de unión y 137 al de no unión, mientras que se predijo la existencia de 35 secuencias asociadas al macroestado de unión para MSP-6 y 193 al de no unión. Se encontraron respectivamente 100, 111 y 91 secuencias predichas de unión para las tres proteínas teóricas construidas. La predicción teórica de unión de péptidos es útil para facilitar el desarrollo de vacunas, al evidenciar el orden físico-matemático subyacente al fenómeno.(AU)

Mediastinal parathyroid adenoma and brown tumors.

In this report, we describe a rare case of brown tumor and mediastinal parathyroid adenoma. This report emphasizes the value of radionuclide scintigraphy in the setting of persistent disease following parathyroid surgery.

Encefalitis límbica de origen no paraneoplásico / Non-paraneoplastic limbic encephalitis

La encefalitis límbica se caracteriza por el inicio subagudo de alteraciones cognitivas, crisis epilépticas temporales y sintomatología psiquiátrica (1,3) . Las causas más frecuentes de este desorden poco usual son desórdenes y enfermedades de tipo autoinmune, dentro de las cuales se incluyen los síndromes paraneoplásicos (2,4) . La gran mayoría de las veces, la sintomatología neurológica se manifiesta previo a la detección de una neoplasia, sin embargo, ésta no se detecta en la totalidad de los casos (3,4) . Se presentan las imágenes con 18 F-FDG PET/CT de un paciente con sintomatología neurológica típica de encefalitis límbica que se traduce desde el punto de vista de la imagenología molecular, en alteraciones metabólicas a nivel del hipocampo.

Limbic encephalitis is characterized by sub acute onset of cognitive functions, temporal lobe epilepsy and psychiatric symptoms. Most common causes of this rare disorder include autoimmune diseases, and rarely, as a manifestation of a paraneoplastic syndromes. Most of the times, neurological symptoms precede the detection of a primary tumor, however, a neoplasm is not often identified. In this article we describe F-18 FDG PET/CT images of a male patient with typical neurological symptoms that suggested limbic encephalitis, which, from a molecular point of view, translates into metabolic changes at the level of the hippocampal region.

Linfoma no Hodgkin testicular con compromiso de tejidos blandos / Testicular lymphoma with soft tissue involvement

El compromiso testicular por linfoma es una manifestación extranodal de la enfermedad, manifestación inicial de una enfermedad nodal oculta o manifestación tardía de linfoma nodal diseminado. Corresponde al 5 por ciento de todos los tumores testiculares y es la neoplasia mas común del testículo en los pacientes mayores de 50 anos., sin embargo el linfoma primario de testículo es extremadamente raro. corresponde al 1 por ciento de los LNH. La mayoría de los linfomas testiculares son LNH B difuso de célula grande con tendencia a presentar metástasis extra ganglionares, incluyendo piel, SNC, anillo de Waldeyer, testículo contra lateral, pulmones, siendo extremadamente inusual a músculo. Se presentan las imágenes con 18 F-FDG PET/CT de un paciente con LNH B difuso de célula grande de alta agresividad con metástasis a músculos de las pantorrillas.

Testicular involvement by lymphoma may be a manifestation of primary extra nodal disease, initial manifestation of clinically occult nodal disease or a later manifestation of disseminated nodal lymphoma . Occur in 5 percent of all testis tumors and it is the most common testis cancer in patients older of 50 years. However the primary testis lymphoma is very uncommon. Correspond to1 percent of LNH. Most testicular lymphomas are diffuse large B-cell lymphomas with tendency of widespread to extra nodal places, including skin, SNC, Waldeyer,s ring, contra lateral testis, lungs, and is very unusual to find muscle’s metastases. In this article we describe F-18 FDG PET/CT images of metastases to the muscles in a case of diffuse large B-cell lymphoma of high agressivity.

Concentracion sérica de cobre ®libre¼ y ceruloplasmina en niños con desnutricion aguda grave antes de iniciar la terapia nutricional y al momento de recuperar el apetito en turbo, antioquia, colombia / Serum concentrations of free copper and ceruloplasmin in children with severe acute malnutrition before nutritional therapy and after children have recovered the apetite in turbo, antioquia, colombia

Introduction: copper supplementation therapy has been used in children with acute and severe malnutrition. Scientific evidence has shown that malnourished children with edema have free copper in plasma which could produce oxidative stress. Objective: To compared plasma concentrations of free copper between children with acute and severe malnutrition and a control group. Methodology: Cross sectional study where 66 normal and malnourished children were studied. A longitudinal study (before and after type) design was used including 40 children with severe and acute malnutrition; free copper was merasured by high-resolution capillary electrophoresis; ceruloplasmin and PCR by nephelometry. Results: In the cross sectional study children with marasmus had higher free copper serum concentrations than children with oedematous malnutrition, but the difference was not significant. In the control group this metal was not found. Children with oedema showed significant lower ceruloplasmin concentrations than children with marasmus (p=0.00) while the difference in PCR was also no significant for both groups. When the relationship between free copper serum concentrations and the presence of infection was analyzed no significant differences were obtained. However, serum albumin concentration was significantly lower for children with oedematous malnutrition than the marasmic group (p=0.016). After children recovered the appetite in the longitudinal study, serum free copper concentration decreased for both groups and ceruloplasmin concentration increased but no significant differences were observed. Conclusion: Copper supplementation could be considered as nutritional therapy for undernourished children since the beginning of the nutritional treatment, as it is recommended by WHO.

Introducción: La recuperación de los niños con desnutrición aguda grave incluye suplementación con cobre desde el inicio de la terapia; existen evidencias que niños edematosos pueden tener cobre libre en plasma el cual podría generar estrés oxidativo. Objetivo: Comparar concentraciones séricas de cobre libre y ceruloplasmina en un grupo de desnutridos agudos graves y un grupo control Metodología: estudio transversal al ingreso entre niños con y sin desnutrición en una muestra de 66 sujetos y longitudinal de tipo antes y después en 40 niños desnutridos. Se determinó cobre libre por electroforesis capilar de alta resolución; ceruloplasmina y PCR por nefelometría, además de variables clínicas Resultados: En el transversal, los marasmáticos presentaron niveles de cobre libre mayores que los edematosos sin diferencia significativa; en el grupo control este metal no se detectó. En los edematosos la concentración de ceruloplasmina fue significativamente menor con relación a los marasmáticos (p=0.00) y la PCR no presentó diferencia significativa entre ellos. No se encontraron diferencias significativas entre los niveles de cobre libre y presencia o no de infección. La albúmina se encontró más baja en los edematosos con diferencia significativa respecto a los marasmáticos (p=0.016). En el longitudinal, al recuperar el apetito el cobre libre disminuyó y la ceruloplasmina aumentó en los dos grupos sin diferencia significativa Conclusión: el suplemento de cobre como componente de la terapia nutricional puede ser suministrado a los desnutridos desde el inicio como lo propone el protocolo de la OMS.

Atlas: a java-based tool for managing genotypes.

With the exponential increase in genotyping capability, it is fundamental to check data consistency and improve genotype management. Atlas is a Java-based application for managing genotypes that also provides a series of tools useful in traceability, parentage testing, and identification, as well as pedigree and marker visualization.

Varón joven con osteoporosis asociada a fenilcetonuria / Young male with phenylcetonuria associated osteoporosis

Se presenta el caso de un varón joven con osteoporosis asociada a fenilcetonuria.El diagnóstico y tratamiento precoz con el ajuste de la ingesta diaria de fenilalaninade la dieta ha mejorado la supervivencia de estos pacientes. Por ello, ladescripción de este caso clínico tiene como objetivo resaltar una de las principalescomplicaciones de esta entidad durante la juventud o en la edad adulta

We report a case of a young male with osteoporosis associated with phenylketonuria.The early diagnosis and treatment with phenylalanine restriction inthe diet has increased the survival of patients with this disease. The objectiveof this report is to increase the awareness of one of the main complications duringyouth or adult life

Psychosocial morbidity: the economic burden in a pediatric health maintenance organization sample.

OBJECTIVES: To evaluate psychosocial morbidity in pediatric primary care and to determine displaced health care utilization. DESIGN AND SETTING: A cross-sectional sample of parent-child dyads was screened using the Pediatric Symptom Checklist (PSC) at 6 pediatric sites of a health maintenance organization (HMO). Cost and utilization data were retrieved from regional databases for this sample. PARTICIPANTS: Parent-child dyads from an HMO in northern California (N = 1840). The children ranged in age from 2 to 18 years. RESULTS: In all, 13.0% of children exhibited psychosocial dysfunction. The rate of children's chronic illness was 18.4%. Multiple regression analyses measured utilization and cost of health and psychiatric care for the selected population for the previous year; the average log cost of health care per child was $393. The average health care cost for children with anxious, depressed symptoms was $805. Chronically ill children were the highest utilizers of health care, with an average log cost of $1138. When psychosocial dysfunction was present, regression models showed that health care spending was highest for young children. CONCLUSIONS: Health care utilization was higher for children with psychosocial morbidity, was higher among younger children, and decreased with age as psychiatric costs progressively increased.

Being a mother and a por día domestic worker. Companionship and deprivation.

This article presents qualitative findings concerning women's maternal roles, based on interviews conducted in a study on role integration and health, in a Colombian sample of 60 women who are "por día" domestic workers. The results describe the women's worldview as they discuss the stresses and the satisfactions of their mothering roles. The results also include the coping strategies used to deal with the stresses inherent in the maternal role. Women describe how the companionship of their children, watching their children grow, and the nurturing they give their children provides them with pride and deep satisfaction. These satisfying aspects of their role are burdened by the stress related to worry about children's bad behavior, their illness, and a pervasive generalized sense of constant worry. Being single parents adds more stress to these women's lives. Participants coped emotionally through distraction and through talking with friends. Other coping strategies included calming self, problem solving, talking with children, and substance use. The authors conclude with a discussion of the relationship between poverty and work situation as contexts for understanding maternal roles.

Self care actions of Colombian por día domestic workers: on prevention and care.

This is a report of a phenomenological study of Colombia's "por día" domestic workers that examined their actions in promoting their health, in preventing illnesses, and in caring for themselves. A cross sectional sample of 60 per diem female domestic workers in one large city in Colombia were interviewed using open-ended interview questions about their health, self-care actions, health care resources, and patterns of utilization. We argue that knowledge of women's experiences with the health care system, their knowledge of their bodies, and the daily demands on their time and life are vital in defining and planning health care services that women need. We demonstrated that the structural conditions in and for health care services and the lack of knowledge of their bodies act as barriers to women's utilization of health care services and to maintaining their health. Our findings support the need for considering women's health from a development perspective and for offering more integrated and cohesive health care services for women.

Veiled, voluminous, and devalued: narrative stories about low-income women from Brazil, Egypt, and Colombia.

The first purpose of this article is to argue the significance of using international and culturally diverse exemplars in developing nursing knowledge. The second is to identify some urgent priorities in the development of nursing knowledge, particularly as related to women's health. The lived experiences of three women from Brazil, Egypt, and Colombia who are in low-income, devalued, but important jobs are presented through their voices. These storied accounts highlight nursing's mission in dealing with the marginalized client as a human being whose context is historical and sociocultural. The implications for knowledge development as driven by international exemplars, diverse experiences, and narration of stories are discussed.