Experimental study of an asymmetric valveless pump to elucidate insights into strategies for pediatric extravascular flow augmentation.

Asymmetric pumping is a sub-category of valveless pumping in which a flexible tube is rhythmically compressed in the transverse symmetry plane. Due to the resulting asymmetry between the suction and discharge pipes, a net pumping head is achieved. Asymmetric pumping is regarded as one of the main mechanisms responsible for the Liebau effect in addition to impedance pumping. However, there remains a paucity of research surrounding the governing parameters of asymmetric pumping. Here, we conducted an experimental study of the performance of an asymmetric pump, with an aim to assess its potential for extravascular flow augmentation. A custom flexible latex tube and experimental platform were developed for this purpose. We tested various tube thicknesses and pinching frequencies. Our results demonstrate that the performance is within the range of physiological requirements for pediatric circulatory devices (~ 1 L/min and < 30 mmHg). We conclude that due to the absence of reverse flow and its mechanical simplicity, pure asymmetric pumping is promising for selected cardiovascular applications with less complexity than other valveless techniques.

Adaptación transcultural del cuestionario motion sickness susceptibility questionnaire form short (MSSQ-SHORT) para la población adulta chilena / Cross-cultural adaptation of the motion sickness susceptibility questionnaire form short (MSSQ-SHORT) for the chilean adult population

Resumen Introducción: La cinetosis se relaciona con la presencia de una serie de síntomas que comúnmente son inducidos por situaciones cotidianas de viajes en medios de transporte. Una forma utilizada por décadas para determinar el grado de susceptibilidad a la cinetosis ha sido con la aplicación del cuestionario en su versión acortada Motion Sickness Suscep-tibility-short (MSSQ-short). Objetivo: Adaptar lingüística y transculturalmente al español el cuestionario MSSQ-short. Material y Método: Se llevaron a cabo cuatro etapas: Traducción directa, traducción inversa (retrotraducción), consolidación por un comité de expertos y pretest (aplicabilidad/viabilidad). En la etapa de pre-test 51 personas respondieron el cuestionario. Resultados: La discrepancias encontradas en las primeras etapas fueron resueltas por un tercer traductor, el cual concluyó en un documento final en español que fue analizado y revisado por el comité de expertos. Se determinaron los percentiles del 0 al 100, percentil 50 con 9,0 puntos, percentil 25 con 2,13 puntos y el percentil 75 con 17,4 puntos. La consistencia interna del cuestionario fue de 0,889. Conclusión: La traducción y adaptación transcultural fue aceptada por un comité de expertos y participantes con distintas características demográficas y educacionales. El cuestionario obtuvo buena consistencia interna y resultados concordantes con la versión original.

Abstract Introduction: Motion sickness is related to the presence of a series of symptoms that are typically induced by everyday situations of travel in means of transport. A way used for decades to determine the degree of susceptibility to motion sickness has been with the application of the questionnaire in its shortened version Motion Sickness Susceptibility-short (MSSQ-short). Aim: Linguistically and cross-culturally adapt the MSSQ-short questionnaire to Spanish. Material and Method: Four stages were carried out: direct translation, reverse translation (back translation), consolidation by a committee of experts, and pretest (applicability/feasibility). In the pre-test stage, 51 people answered the questionnaire. Results: The discrepancies found in the early stages were resolved by a third translator, which concluded in a final document in Spanish that was analyzed and reviewed by the expert committee. The percentiles from 0 to 100 were determined, 50th percentile with 9.0 points, 25th percentile with 2.13 points, and 75th percentile with 17.4 points. The internal consistency of the questionnaire was 0.889. Conclusion: The cross-cultural translation and adaptation were accepted by a committee of experts and participants with different demographic and educational characteristics. The questionnaire obtained good internal consistency and results consistent with the original version.

Hombro doloroso: hemangioma en el músculo subescapular / Painful shoulder: hemangioma of the subscapularis muscle

Presentamos una tumoración vascular benigna, un hemangioma, situado en el músculo subescapular como causa de hombro doloroso en una mujer joven, caso poco frecuente en la literatura. Mujer de 30 años remitida a nuestra consulta por omalgia izquierda de 3 años de evolución, con radiografía y resonancia magnética cervical y de hombro izquierdo sin hallazgos significativos. Presenta dolor en la región escapular medial izquierda sin masa palpable. La resonancia magnética de la escápula informa de una tumoración vascular intramuscular, ovalada, bien definida, compatible con hemangioma subescapular. Tras la exéresis de la tumoración y el tratamiento rehabilitador posterior la paciente se encuentra asintomática. Los hemagiomas son tumores vasculares benignos que pueden manifestarse con dolor tras una actividad prolongada por la derivación del flujo sanguíneo que se produce desde el tejido circundante al hemangioma. Suelen tener buen pronóstico (AU)

We present a case of a benign vascular tumour, a haemangioma located in the subscapularis muscle as a cause of painful shoulder in a young woman. Such cases have rarely been reported in the literature. A 30-year-old woman was referred to our clinic for a 3-year history of shoulder pain and no significant findings on X-ray and magnetic resonance imaging of the cervical spine and left shoulder. The patient had pain in the left medial scapular area with no palpable mass. Magnetic resonance imaging of the scapula revealed an oval, well-defined, intramuscular vascular tumour compatible with haemangioma of the subscapularis muscle. After excision of the tumour and subsequent rehabilitation treatment, the patient is asymptomatic. Haemangiomas are benign vascular tumours that can cause pain due to swelling in the area of the tumour after prolonged activity. Prognosis is generally favourable (AU)

[Boceprevir and telaprevir safety in routine clinical practice]. / Seguridad de boceprevir y telaprevir en la práctica clínica habitual.

PURPOSE: To compare the safety profile of telaprevir (TLV) and boceprevir (BOC) with each other and with those described in clinical trials (CT). MATERIAL AND METHODS: Retrospective multicenter observational study. Variables collected: age, sex, type of patient (naive, nonresponder or recurrent), fibroscan, Hb nadir, neutrophil and platelet count, presence of rash, anorectal discomfort, number of patients treated with erythropoiesis stimulating factors (EPO) and colony stimulating factors granulocyte (G-CSF). RESULTS: BOC vs CT: anemia (56.5% vs. 49%.), Thrombocytopenia (56.5% vs 32%, p = 0.023). neutropenia (17.4% vs. 29.5%). Use of EPO (13% vs 43%;. p = 0.008), pruritus (13% vs. 21.1%), rash (16.1% vs. 8.7%), anorectal discomfort (4.3% vs. 0%, p = 0.0001), dysgeusia (47.8% vs. 37%). TLV vs. CT: anemia (51.2% vs. 32%, p = 0.014), neutropenia (2.3 vs 3.6%), thrombocytopenia (41.9% vs. 27.4%, p = 0.05), pruritus (39.5% vs 47), rash (16.3% vs 55%, P <0.001), anorectal discomfort (39.5% vs 26%), dysgeusia (14% vs. 9.5%). BOC vs TLV: anemia (56.5% vs 51.2%), neutropenia (17.4% vs 2.3%), thrombocytopenia (56.5% vs 41.9%), rash (8.7% vs 16.3%), pruritus (39.5% vs 13%) and anorectal discomfort (4.3% vs 39.5%, P = 0.006), dysgeusia (14% vs 47.8%, P = 0.007), EPO (13% vs. 25.6%). GCSF was used for a patient treated with TLV. CONCLUSIONS: 1. BOC and TLV have shown a worse safety profile for anemia, thrombocytopenia and anorectal discomfort than those described in CT. 2. As in CT, anemia, neutropenia and thrombocytopenia were more common with BOC. Patients treated with TLV experienced more pruritus, rash and anorectal discomfort.

Seguridad de boceprevir y telaprevir en la práctica clínica habitual / Boceprevir and telaprevir safety in routine clinical practice

Objetivo: Comparar el perfil de seguridad telaprevir (TLV) y boceprevir (BOC) entre sí y con lo descrito en ensayos clínicos (EECC).Material y método: Estudio multicéntrico observacional retrospectivo. Variables recogidas: edad, sexo, tipo de paciente (naïve, no respondedor o recidivantes), fibroscan, Hb nadir, recuento de neutrófilos y plaquetas, presencia de exantema, malestar anorrectal, número de pacientes tratados con estimuladores de la eritropoyesis (EPO) y factores estimuladores de colonias de granulocitos (G-CSF).Resultados: BOC vs EECC: anemia (56,5% vs. 49%), trombocitopenia (56,5% vs. 32%; p = 0,023). Neutropenia (17,4% vs. 29,5%).Utilización de EPO (13% vs. 43%; p = 0,008), prurito (13% vs.21,1%), exantema (8,7% vs. 16,1%); molestias anorrectales (4,3%vs. 0%; p = 0,0001), disgeusia (47,8% vs. 37%). TLV vs. EECC: anemia (51,2% vs. 32%; p = 0,014), neutropenia (2,3 vs. 3,6%), trombocitopenia (41,9% vs. 27,4%; p = 0,05), prurito (39,5 vs. 47%),exantema (16,3% vs. 55%; p < 0,001), molestias anorrectales(39,5% vs. 26%). Disgeusia (14% vs. 9,5%). BOC vs. TLV: anemia (56,5% vs. 51,2%), neutropenia (17,4% vs. 2,3%), trombocitopenia (56,5% vs. 41,9%), exantema (8,7% vs. 16,3%), prurito (39,5% vs. 13%) y molestias anorrectales (4,3% vs. 39,5%; p = 0,006), disgeusia (47,8% vs. 14%; p = 0,007) EPO (13% vs.25,6%). G-CSF se utilizó para un paciente tratado con TLV.Conclusiones:1. BOC y TLV han mostrado un perfil de seguridad peor que en los EECC en cuanto a anemia, trombocitopenia y malestar ano-rrectal.2. Al igual que en EECC, anemia, neutropenia y trombocitopenia fueron más frecuentes con BOC. Por otro lado los pacientes tratados con TLV presentaron más prurito, exantema y malestar anorrectal

Purpose: To compare the safety profile of telaprevir (TLV) and boceprevir (BOC) with each other and with those described in clinical trials (CT).Material and methods: Retrospective multicenter observational study. Variables collected: age, sex, type of patient (naive, non responder or recurrent), fibroscan, Hb nadir, neutrophil and platelet count, presence of rash, anorectal discomfort, number of patients treated with erythropoiesis stimulating factors (EPO) and colony stimulating factors granulocyte (G-CSF).Results: BOC vs CT: anemia (56.5% vs. 49%.), Thrombocytopenia(56.5% vs 32%, p = 0.023). neutropenia (17.4% vs. 29.5%). Use of EPO (13% vs 43%;. p = 0.008), pruritus (13% vs. 21.1%), rash(16.1% vs. 8.7%), anorectal discomfort (4.3% vs. 0%, p =0.0001), dysgeusia (47.8% vs. 37%). TLV vs. CT: anemia (51.2%vs. 32%, p = 0.014), neutropenia (2.3 vs 3.6%), thrombocytopenia (41.9% vs. 27.4%, p = 0.05), pruritus (39.5% vs 47), rash(16.3% vs 55%, P <0.001), anorectal discomfort (39.5% vs26%), dysgeusia (14% vs. 9.5%). BOC vs TLV: anemia (56.5% vs51.2%), neutropenia (17.4% vs 2.3%), thrombocytopenia(56.5% vs 41.9%), rash (8.7% vs 16.3%), pruritus (39.5% vs 13%) and anorectal discomfort (4.3% vs 39.5%, P = 0.006), dysgeusia (14% vs 47.8%, P = 0.007), EPO (13% vs. 25.6%). G-CSF was used for a patient treated with TLV.Conclusions:1. BOC and TLV have shown a worse safety profile for anemia, thrombocytopenia and anorectal discomfort than those described in CT.2. As in CT, anemia, neutropenia and thrombocytopenia were more common with BOC. Patients treated with TLV experienced more pruritus, rash and anorectal discomfort

Distribution pattern of muscle fibre types in soft palate of the dog (Canis familiaris, L.).

Distribution pattern of fibre types was studied in the muscles of the soft palate (palatinus, levator veli palatini and tensor veli palatini muscles) in the dog. The fibrillar classification was based on using histochemistry and immunohistochemistry methods: myofibrillar adenosine thriphosphatase (mATPase) to different pH of pre-incubation; nicotine adenine dinucleotide (reduced) tetrazolium reductase (NADH-TR) and finally, application of specific monoclonal antibodies against myosin heavy chain isoforms I, IIa and IIx. In the palatinus and levator veli palatini muscles, pure type I fibres and the hybrid type IIax and IIc were shown, with a checkerboard distribution in the first and a clear predominance of hybrid fibre types (about 98% of the total population) in levator veli palatini muscle. On the other hand, in the tensor veli palatini muscle, type IIx and IIm fibres were identified (fast-twitch fibres related to fast-moving muscles and the powerful jaw muscles of carnivores). The tensor veli palatini muscle had a different distribution and fibrillar composition with predominantly type IIm fibres in its central zone, whilst the peripheral zone was primarily type I and IIx fibres.

Mejoras en las consultas de pacientes externos tras la implantación de un robot automático de dispensación / Improvement of the outpatient clinics after the implementation of an automated robot for delivery

Objetivos: Describir mejoras en logística, gestión y satisfacción de los pacientes tras la implantación de un robot de dispensación (RAD) en las consultas externas de Farmacia. Material y métodos: Diseño pre-post intervención: implantación de un RAD. El estudio se llevó a cabo en un hospital de tercer nivel. Debido a un cambio de ubicación de las consultas externas, se planificó un nuevo circuito de medicamentos. Se implementaron modificaciones en los programas de farmacia para la integración con el RAD. Se midió el stock inmovilizado, diferencia ente las existencias reales-virtuales para medicamentos antirretrovirales; medidos en porcentaje respecto al total y el índice de rotación de stock. Se compararon encuestas de satisfacción de 2007-2011 tras la realización de distintos cambios en las consultas. Resultados: El circuito de medicamentos así como los cambios informáticos realizados resultaron eficaces para el mantenimiento de existencias de medicamentos. El stock inmovilizado descendió en el periodo de estudio 2.209.935,77€. El índice de rotación descendió de 1,87 a 0,79. El robot ha reducido la espera a menos de 10 minutos en un 90% respecto a las encuestas anteriores. Discusión: La incorporación del RAD a las consultas ha significado mejoras en la logística, en la gestión y en la satisfacción de los pacientes (AU)

Objectives: To discover the improvements in logistics, management and satisfaction of the patients after the implantation of a robot of dispensation (RAD) in the external consultations of Pharmacy. Material and Methods: Pre-post design: implantation of RAD. The study was conducted on a third level hospital. A new circuit of drugs was designed due to a change of location of the external consultations. Modifications on the pharmacy pro grams were implemented for the integration with RAD. The immobilized stock was measured, difference among the real-virtual existences for anti-retroviral drugs; measured as a percentage of the total and the index of rotation of the stock. Satisfaction surveys of 2007-2011 were compared after the realization of the different changes in the consultations. Results: The circuit of drugs as well as the computer changes made were efficient for the maintenance of the stock of drugs. The immobilized stock decreased 2.209.935,77€ during the pe riod of the study. The index of rotation decreased from 1.87 to 0.79. The robot has reduced the waiting to less than 10 minutes in 90% with regard to the previous surveys. Discussion: The incorporation of RAD in the consultations has meant improvements in the logistic, in the management and in (AU)

La indicación de la traqueotomía condiciona las variables predictoras del tiempo hasta la decanulación en pacientes críticos / The indication of tracheotomy conditions the predictors of time to decannulation in critical patients

Objetivos: No se han podido desarrollar modelos predictores de tiempo de decanulación de pacientes traqueotomizados. El objetivo del estudio fue desarrollar variables asociadas al tiempo empleado en decanular a los pacientes, mediante la clasificación de los pacientes según la indicación de la traqueotomía (TRQ). Diseño: Estudio de cohortes prospectivo observacional. Ámbito: Dos UCI médico-quirúrgicas. Pacientes: Se incluyeron todos los pacientes traqueotomizados en UCI, excluyendo aquellos con órdenes de no resucitación, TRQ crónicas, enfermos neuromusculares o con daño cerebral. Fueron clasificados en 2 grupos: traqueotomizados por ventilación mecánica o destete prolongado (Grupo 1) y pacientes traqueotomizados por disminución del nivel de conciencia o incapacidad para manejar las secreciones respiratorias (Grupo 2). Intervenciones: Se empleó un protocolo de destete y decanulación. Variables de interés principales: Se recogieron entre otras las siguientes variables: tiempo hasta decanulación, capacidad vital y flujo espiratorio máximo, necesidades de aspiración, Glasgow (..) (AU)

Objective: Variables predicting optimal timing for tracheostomy decannulation remain unknown. We aimed to determine whether classifying patients into two groups according to their indications for tracheostomy could identify variables associated with time to decannulation. Design: A prospective, observational cohort study was carried out. Location: Two medical-surgical ICUs. Patients: We included all patients tracheostomized during ICU stay, excluding patients with do-not-resuscitate orders, tracheostomies for long-term airway control, neuromuscular disease, or neurological damage. Patients were classified into two groups: patients tracheostomized due to prolonged weaning and/or prolonged mechanical ventilation (Group 1), and patients tracheostomized due to low level of consciousness or inability to manage secretions (Group 2). Interventions: Patients were weaned and decannulated according to established protocols. Main variables: We recorded the following variables: time to tracheostomy, forced vital capacity, peak flow, suctioning requirements, Glasgow Coma Score (GCS), characteristics of respiratory secretions, and swallowing function. Statistical analyses included (..) (AU)

The indication of tracheotomy conditions the predictors of time to decannulation in critical patients.

OBJECTIVE: Variables predicting optimal timing for tracheostomy decannulation remain unknown. We aimed to determine whether classifying patients into two groups according to their indications for tracheostomy could identify variables associated with time to decannulation. DESIGN: A prospective, observational cohort study was carried out. LOCATION: Two medical-surgical ICUs. PATIENTS: We included all patients tracheostomized during ICU stay, excluding patients with do-not-resuscitate orders, tracheostomies for long-term airway control, neuromuscular disease, or neurological damage. Patients were classified into two groups: patients tracheostomized due to prolonged weaning and/or prolonged mechanical ventilation (Group 1), and patients tracheostomized due to low level of consciousness or inability to manage secretions (Group 2). INTERVENTIONS: Patients were weaned and decannulated according to established protocols. MAIN VARIABLES: We recorded the following variables: time to tracheostomy, forced vital capacity, peak flow, suctioning requirements, Glasgow Coma Score (GCS), characteristics of respiratory secretions, and swallowing function. Statistical analyses included Cox-proportional multivariate analysis with time to decannulation as the dependent variable. RESULTS: A total of 227 patients were tracheostomized in the ICUs; of these, 151 were finally included in the study. In the multivariate analysis, time to decannulation in Group 1 was associated with the male gender (HR 1.74 (1.04-2.89), p= 0.03), age>60 years (HR 0.58 (0.36-0.91), p= 0.02), high suctioning frequency (HR 0.81 (0.67-0.97), p= 0.02), low forced vital capacity (HR 0.48 (0.28-0.82), p<0.01), and low peak flow (HR 0.25 (0.14-0.46), p<0.01). In Group 2 time to decannulation was associated to GCS >13 (HR 2.73 (1.51-4.91), p<0.01), high suctioning frequency (HR 0.7 (0.54-0.91), p<0.01), and inadequate swallowing (HR 1.97 (1.11-3.52), p=0.02). CONCLUSION: Variables associated with longer time to decannulation in ICU-tracheostomized patients differ with the indications for tracheostomy.

[Improvement of the outpatient clinics after the implementation of an automated robot for delivery]. / Mejoras en las consultas de pacientes externos tras la implantación de un robot automático de dispensación.

OBJECTIVES: To discover the improvements in logistics, management and satisfaction of the patients after the implantation of a robot of dispensation (RAD) in the external consultations of Pharmacy. MATERIAL AND METHODS: Pre-post design: implantation of RAD. The study was conducted on a third level hospital. A new circuit of drugs was designed due to a change of location of the external consultations. Modifications on the pharmacy pro grams were implemented for the integration with RAD. The immobilized stock was measured, difference among the real-virtual existences for anti-retroviral drugs; measured as a per centage of the total and the index of rotation of the stock. Satisfaction surveys of 2007-2011 were compared after the realization of the different changes in the consultations. RESULTS: The circuit of drugs as well as the computer changes made were efficient for the maintenance of the stock of drugs. The immobilized stock decreased 2.209.935,77€ during the pe riod of the study. The index of rotation decreased from 1.87 to 0.79. The robot has reduced the waiting to less than 10 minutes in 90% with regard to the previous surveys. DISCUSSION: The incorporation of RAD in the consultations has meant improvements in the logistic, in the management and in.

Deleterious versus neuroprotective effect of metabolic inhibition after traumatic spinal cord injury.

STUDY DESIGN: This work is an experimental and prospective study in adult, female, Long-Evans rats. OBJECTIVES: The aim of this study was to probe the effect of metabolic inhibition after an acute traumatic spinal cord injury (TSCI) using a standardized contusion model (NYU impactor) to know whether the metabolic inhibition is a 'secondary mechanism of injury' or a mechanism of protection. SETTING: All experimental procedures were carried out in the Mexico City. METHODS: Animals were divided into five groups: one sham and four with TSCI, including no treatment, rotenone (inhibitor of mitochondrial complex I), sodium azide (inhibitor of mitochondrial complex IV) and pyrophosphate of thiamine or non-degradable cocarboxylase as a metabolic reactivator. RESULTS: After TSCI, the metabolic inhibition with sodium azide treatment diminished the lipid peroxidation process (malondialdehyde levels by spectrophotometric procedures) and the damage to the spinal cord tissue (morphometric analysis), and increased the activity of creatine kinase and lactate dehydrogenase enzymes (P<0.05) (measured by spectrophotometric procedures 24 h after TSCI as well as after the functional recovery of the hind limb (evaluated weekly for 2 months by the BBB (Basso, Beattie and Bresnahan) scale)) when compared with the TSCI group without treatment. CONCLUSION: The results show that the partial and transitory inhibition of the aerobic metabolism after an acute TSCI could be a self-protection mechanism instead of being a 'secondary mechanism of injury'.

Anatomía veterinaria: Experiencia metodológica en el marco del espacio europeo de educación superior / Veterinary Anatomy: methodology experience within the European Space of Higher Education

Se expone la metodología docente aplicada en Anatomía Veterinaria, de la licenciatura de Veterinaria de la Universidad de Murcia, desde el curso 2005 2006 hasta la actualidad. Durante este periodo la Unidad Docente de Anatomía y Embriología Veterinarias ha desarrollado proyectos de innovación educativa dirigidos a realizar experiencias ECTS (Sistema Europeo de Transferencia y acumulación de Créditos). En estos proyectos hemos incrementado el enfoque práctico de la asignatura, con el fin de que el alumno potencie competencias tales como: autoaprendizaje, trabajo en equipo, destrezas, etc., lo que permite una mayor adaptación al perfil profesional que demanda el mercado de trabajo. Para ello, además de las prácticas convencionales, hemos introducido una nueva modalidad práctica denominada: trabajos prácticos dirigidos. Esta modalidad es también presencial y consiste en la realización de actividades prácticas –diferentes a las prácticas convencionales– que los alumnos han de desarrollar durante cada sesión, en grupos de 4-5 alumnos. Estos trabajos varían en función de la materia. Así, en “Osteología” se realizan diversas actividades en el Museo Anatómico Veterinario, tales como la interpretación de imágenes óseas anatómicas, radiografías, etc., mientras que en “Sistemas Neuromusculares” y “Sistemas Viscerales” se realiza la disección de los diferentes planos musculares y viscerales en el perro, así como la interpretación de secciones anatómicas transversales (anatomía seccional). Con el fin de fomentar el estudio de los alumnos, se introduce un sistema de evaluación continua a lo largo del curso, en las diferentes materias. Los resultados han mostrado una mejora en la motivación y en la participación activa de los alumnos, así como unos mejores resultados académicos en la materia práctica (AU)

This work describes the teaching methodology applied in Veterinary Anatomy since 2005 to 2008. This subject is taught in the Veterinary degree of the University of Murcia. During this period the Department of Veterinary Anatomy has carried out some educative innovation projects, in order to apply ECTS methodology (European credit transfer and accumulation system). These projects increase the practical approach to the subject in order to improve some competences (self-learning, job in small groups, skills, etc.) and to allow a better adaptation to the professional profile of the job market. The methodology includes conventional practices and a new practical model: guided practical jobs. This latter is carried out in groups of 4-5 students whose undertake some practical activities that vary according to the particular subject. On “Osteology”, these activities consisted in the interpretation of some anatomical osseus images, radiographies, etc. in the Anatomical Veterinary Museum. On “neuromuscular and visceral systems” the students dissected different muscle and visceral planes of dog cadavers and interpreted some transversal anatomical sections. In order to improve the study methodology, we have introduced a continuous evaluation throughout the course. Results show a increasing of the motivation and participation, as well as better punctuations in the practical exams (AU)

[Achondroplasia, judgement about the upper airway approach]. / Acondroplasia, juicio crítico sobre el manejo de la vía aérea alta.

Achondroplasia is an hereditary disorder which belongs to the group of illnesses called condristrophic or anomalies in the ossification of the cartilages. Its main characteristic is a series of irregularities in the skeleton, but the most outstanding characteristic is the short height. The diagnosis of achondroplasia is achieved by means of a combination of clinical and radiological characteristics. The 99% of the cases is diagnosticated by the genetic study. Because of its multiple deformities not only in the skull and cervical but also thoracic, usually in adults, it means a challenge for the use of upper airway when it's requiered. To choose the fibreoptics or orotraqueal intubation or the tracheotomy are very complex processes in these cases. We do a revision about the ENT aspects to be considered in the patients of achondroplasia

Acondroplasia, juicio crítico sobre el manejo de la vía aérea alta / Achondroplasia, judgement about the use in the upper airway

La acondroplasia es un desorden hereditario que pertenece al grupo de enfermedades denominado condrodistrofias o anomalías en la osificación de los cartílagos. Se caracteriza por una serie de alteraciones en el esqueleto, pero lo más característico es la baja talla. El diagnóstico de la acondroplasia se consigue mediante una combinación de características clínicas y radiológicas. El estudio genético diagnostica el 99% de los casos. Por las múltiples deformidades tanto cráneo facial, cervical y torácicas usualmente presentes en el adulto, supone un reto el manejo de la vía aérea superior cuando así lo precise. Elegir la intubación fibroóptica, la intubación orotraqueal o la traqueotomía son procedimientos de gran complejidad en estos casos. Hacemos una revisión en lo referente a los aspectos ORL a considerar en el paciente acondroplásico

Acondroplasia is an hereditary disorder which belongs to the group of illnesses called condristrophic or anomalies in the ossification of the cartilages. Its main characteristic is a series of irregularities in the skelton, but the most outstanding characteristic is the short beight. The diagnosis of achondroplasia is achieved by means of a combination of clinical and radiological characteristics. The 99% of the cases is diagnosticated by the genetic study. Because of its multiple deformities not only in the skull and cervical but also thoracic, usually in adults, it means a challenge for the use of upper airway when it´s required. To choose the fibreoptics or orotraqueal intubation or the tracheotomy are very complex processes in these cases. We do a revision about the ENT aspects to be considered in the patients of achondroplasia

Anticoncepción de emergencia: perfil de las usuarias y características de la demanda / Emergency contraceptive: profile of the users and demand characteristics

OBJETIVOS. Describir el perfil de las usuarias de la anticoncepción de emergencia así como las características de la demanda de dicho medicamento. MATERIAL Y MÉTODOS. Estudio descriptivo, transversal, realizado en el ámbito de las urgencias de Atención Primaria en un medio urbano. Las participantes fueron las pacientes que solicitaron la píldora del día después en dichas urgencias. RESULTADOS. Características generales: 132 mujeres, cuya media de edad fue 22,9 años (rango 14-46 años); referido a sus características sociales, un 85,6% estaban solteras, un 12,1% casadas y el 2,3% separadas. En cuanto a su nivel de estudios, un 45,8% eran estudiantes, tenían estudios primarios un 18,2%, secundarios un 66,7% y superiores un 15,2%. Las razones de la demanda en un 75,8% se debió a un fallo en el método de barrera o preservativo, el 17,7% no usó ningún método anticonceptivo y un 6,5% lo atribuyó a otras razones. Los meses de mayor demanda fueron agosto, septiembre y diciembre; los sábados y domingos los días en que más se solicitó. La media de horas transcurridas desde el coito sin protección hasta la solicitud de este medicamento fueron 14,5. Hasta un 24,4% de las mujeres ya habían utilizado previamente la anticoncepción de emergencia. CONCLUSIÓN. El perfil de las usuarias de la anticoncepción de emergencia se ajusta al descrito en otros estudios. Existe un uso abusivo o mal uso de la píldora del día después y un bajo uso de los métodos de barrera

OBJECTIVE. Describe user profile of emergency contraceptions and the characteristics of demand for this drug. MATERIAL AND METHODS. Descriptive, cross-sectional study conducted in primary care emergency setting in urban area. Participants were patients who requested the day after pill in such emergencies. RESULTS. General characteristics: 132 women, whose mean age was 22.9 years (range 14-46 years). Social characteristics: 85.6% were single, 12.1% married and 2.3% separated. Regarding study level, 45.8% were students, 18.2% had primary studies, 66.7% secondary and 15.2% upper education. Reasons for the demand were due to failure of barrier method or condom in 75.8%, 17.7% did not use any contraceptive method and 6.5% attributed it to other reasons. The months of greatest demand were August, September and December. Saturday and Sunday were the days on which it was requested most. Mean hours since the intercourse without protection until request of the medication was 14.5. Up to 24.4% of the women had already previously used the emergency contraception. CONCLUSION. The user profile of emergency contraceptives adjusts to its description in other studies. There is an abusive or bad use of the day after pill and low use of barrier methods

Determinación de la expresión de cicloxigenasa-2 en el colon de la rata / Determination of cyclooxigenase-2 expression on rat's colon

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Cyclooxygenase-2 inhibition in colon experimental carcinogenesis.

BACKGROUND: An overexpression of cyclooxygenase-2 (COX-2) has been seen in colon tumors; therefore, COX-2 specific inhibitors may be used as preventive agents. The aim of this study was to investigate the effect of both selective and non-selective COX-2 inhibitors on the incidence of colonic tumors in a model of chemical carcinogenesis in the rat. DESIGN: Experimental study with 65 male Sprague-Dawley rats randomly assigned to one of four groups: (a) control (n = 20), with chemical carcinogenesis using 1-2 dimethylhydrazine (1-2 DMH); (b) acetylsalicylic acid (ASA) (n = 15), with chemical carcinogenesis and the addition of ASA at 30 mg/kg; (c) low-dose rofecoxib (n = 15), with chemical carcinogenesis and the addition of rofecoxib at a dose of 1.2 mg/kg; (d) high-dose rofecoxib (n = 15), with carcinogenesis and the addition of rofecoxib at 3 mg/kg. Carcinogenic induction was performed with 1-2 DMH at a weekly dose of 25 mg/kg for 18 weeks. The main parameter evaluated was percentage of neoplastic colonic tissue, which relates tumor surface area to colon surface area. RESULTS: Rofecoxib at a dose of 3 mg/kg significantly reduced chemical colon carcinogenesis in rats (p < 0.01). Rofecoxib in lower doses had the same effect on adenomas (p < 0.05) with no effect on adenocarcinomas. Rofecoxib reduced COX-2 expression in tumoral tissue from adenomas and adenocarcinomas (p < 0.01). CONCLUSIONS: Rofecoxib prevents chemical colon carcinogenesis in the rat, with a reduction of tumoral colonic percentage in adenocarcinomas and tumoral COX-2 expression.

Inhibición de la ciclooxigenasa-2 en la carcinogénesis cólica experimental / Cyclooxygenase-2 inhibition in colon experimental carcinogenesis

Introducción: se ha comprobado a nivel clínico y experimentalla existencia de sobreexpresión de la ciclooxigenasa-2 (COX-2)en los tumores de colon, por lo que los inhibidores de dicha enzimapodrían tener un efecto preventivo. El objetivo del estudio esinvestigar el efecto de la inhibición de la ciclooxigenasa en un modelode carcinogénesis cólica farmacológica en la rata.Material y métodos: estudio experimental en 65 ratas Sprague-Dawley macho, asignadas a uno de los grupos: control (n =20), con carcinogénesis farmacológica con 1-2 dimetilhidrazina;grupo ácido acetilsalicílico (n = 15), con carcinogénesis y adiciónde AAS, grupo Inhibidores COX-2 a bajas dosis (n = 15), con carcinogénesisy adición de rofecoxib a dosis de 1,2 mg/kg, y grupoInhibidores COX-2 a altas dosis (n = 15), con carcinogénesis y rofecoxiba dosis de 3 mg/kg. El principal parámetro evaluado es elporcentaje de tejido cólico neoplásico y la expresión de COX-2 enel colon normal y neoplásico.Resultados: el rofecoxib a dosis altas reduce el porcentaje decolon ocupado por adenocarcinomas inducidos (p < 0,01). El rofecoxiba dosis bajas presentó el mismo efecto sobre los adenomas(p < 0,05), sin efecto sobre los adenocarcinomas. La expresiónCOX-2 es superior en los adenocarcinomas frente a losadenomas. El rofecoxib redujo la expresión COX-2 respecto alcontrol y AAS (p < 0,01), tanto en los adenomas como en losadenocarcinomas, no mostrando este efecto sobre el colon normal.Conclusiones: el rofecoxib redujo la carcinogénesis cólica inducidaen ratas, reduciendo la expresión COX-2 en los tumores ydisminuyendo el porcentaje de colon neoplásico

Background: an overexpression of cyclooxygenase-2 (COX-2) has been seen in colon tumors; therefore, COX-2 specific inhibitorsmay be used as preventive agents. The aim of this studywas to investigate the effect of both selective and non-selectiveCOX-2 inhibitors on the incidence of colonic tumors in a model ofchemical carcinogenesis in the rat.Design: experimental study with 65 male Sprague-Dawleyrats randomly assigned to one of four groups: (a) control (n = 20),with chemical carcinogenesis using 1-2 dimethylhydrazine (1-2DMH); (b) acetylsalicylic acid (ASA) (n = 15), with chemical carcinogenesisand the addition of ASA at 30 mg/kg; (c) low-dose rofecoxib(n = 15), with chemical carcinogenesis and the addition ofrofecoxib at a dose of 1.2 mg/kg; (d) high-dose rofecoxib (n = 15),with carcinogenesis and the addition of rofecoxib at 3 mg/kg.Carcinogenic induction was performed with 1-2 DMH at a weeklydose of 25 mg/kg for 18 weeks. The main parameter evaluatedwas percentage of neoplastic colonic tissue, which relates tumorsurface area to colon surface area.Results: rofecoxib at a dose of 3 mg/kg significantly reducedchemical colon carcinogenesis in rats (p < 0.01). Rofecoxibin lower doses had the same effect on adenomas (p < 0.05)with no effect on adenocarcinomas. Rofecoxib reduced COX-2expression in tumoral tissue from adenomas and adenocarcinomas(p < 0.01).Conclusions: rofecoxib prevents chemical colon carcinogenesisin the rat, with a reduction of tumoral colonic percentage inadenocarcinomas and tumoral COX-2 expression

Effect of rofecoxib on colon chemical carcinogenesis at colonic anastomotic area in the rat.

AIM: To investigate the effect of the selective cyclooxygenase-2 (COX-2) inhibitor rofecoxib on the incidence of perianastomotic colonic tumors in a model of chemical carcinogenesis in the rat. EXPERIMENTAL DESIGN: Experimental study with 45 male Sprague-Dawley rats randomly assigned to one of three groups: control (n = 15) with colocolic anastomosis and chemical carcinogenesis with 1-2 dimethylhydrazine (1-2 DMH); rofecoxib 0.0027% (n = 15) with colonic anastomosis, chemical carcinogenesis and the addition of dietary rofecoxib at doses of 27 parts per million (ppm), and rofecoxib 0.0058% (n = 15) with colonic anastomosis, chemical carcinogenesis and the addition of dietary rofecoxib at doses of 58 ppm. Carcinogenic induction was performed with 1-2 DMH at a weekly dose of 25 mg/kg of weight for 18 weeks, and colonic tumors induced were analyzed in postoperative week 20. The main parameter evaluated was the percentage of colonic neoplastic tissue, which relates tumor surface area to the colon's surface area. RESULTS: Rofecoxib at doses of 2.5 mg/kg or 0.0058 ppm significantly reduced chemical colon carcinogenesis in rats, both in the perianastomotic area and the rest of the colon (p < 0.01). In the extra-anastomotic area, rofecoxib at doses of 2.5 mg/kg has significantly greater inhibitory effect than rofecoxib in doses of 1.2 mg/kg or 0.0027 ppm (p < 0.005). CONCLUSIONS: Rofecoxib causes a reduction in chemical colon carcinogenesis in rats. This effect is sustained in the perianastomotic area, and the investigation of its role in operated colorectal cancer with risk of locoregional recurrence may therefore be of interest.