Paletilla vs descuaje: una representación de los lazos interculturales en la medicina tradicional / Paletilla vs descuaje: a representation of intercultural bounds in traditional medicine

En la Estrategia de la OMS sobre medicina tradicional (2014-2023), se define esta como “la suma total de los conocimientos, capacidades y prácticas basados en las teorías, creencias y experiencias propias de diferentes culturas, bien sean explicables o no, utilizadas para mantener la salud y prevenir, diagnosticar, mejorar o tratar enfermedades físicas y mentales” [Fragmento de texto] (AU)

Comment on "Global distribution of earthworm diversity".

Phillips et al (Reports, 25 October 2019, p. 480) incorrectly conclude that tropical earthworm communities are less diverse and abundant than temperate communities. This result is an artifact generated by some low-quality datasets, lower sampling intensity in the tropics, different patterns in richness-area relationships, the occurrence of invasive species in managed soils, and a focus on local rather than regional richness.

Recomendaciones prácticas para el manejo perioperatorio del paciente con sospecha o infección grave por coronavirus SARS-CoV-2 / Practical recommendations for the perioperative management of the patient with suspection or serious infection by coronavirus SARS-CoV

En diciembre del 2019, la Comisión Municipal de Salud y Sanidad de Wuhan (provincia de Hubei, China) informó de una serie de casos de neumonía de etiología desconocida. El 7 de enero del 2020, las autoridades chinas identificaron como agente causante del brote un nuevo tipo de virus de la familia Coronaviridae, denominado SARS-CoV-2. Desde entonces, se han notificado miles de casos con una diseminación global. Las infecciones en humanos provocan un amplio espectro clínico que va desde infección leve del tracto respiratorio superior, hasta síndrome de distrés respiratorio agudo grave y sepsis. No existe un tratamiento específico para SARS-CoV-2, motivo por lo que los aspectos fundamentales son establecer medidas adecuadas de prevención y el tratamiento de soporte y manejo de las complicaciones

In December 2019, the Wuhan Municipal Health and health Commission (Hubei Province, China) reported a series of cases of pneumonia of unknown etiology. On January 7, 2020, the Chinese authorities identified as a causative agent of the outbreak a new type of virus of the Coronaviridiae family, called SARS-CoV-2. Since then, thounsands of cases have been reported with global dissemination. Infections in humans cause a broad clinical spectrum ranging from mild upper respiratory tract infection, to severe acute respiratory distress syndrome and sepsis. There is not specific treatment for SARS-CoV-2, which is why the fundamental aspects are to establish adequate prevention measures and support treatment and management of complications

Practical recommendations for the perioperative management of the patient with suspection or serious infection by coronavirus SARS-CoV. / Recomendaciones prácticas para el manejo perioperatorio del paciente con sospecha o infección grave por coronavirus SARS-CoV-2.

In December 2019, the Wuhan Municipal Health and health Commission (Hubei Province, China) reported a series of cases of pneumonia of unknown etiology. On January 7, 2020, the Chinese authorities identified as a causative agent of the outbreak a new type of virus of the Coronaviridiae family, called SARS-CoV-2. Since then, thounsands of cases have been reported with global dissemination. Infections in humans cause a broad clinical spectrum ranging from mild upper respiratory tract infection, to severe acute respiratory distress syndrome and sepsis. There is not specific treatment for SARS-CoV-2, which is why the fundamental aspects are to establish adequate prevention measures and support treatment and management of complications.

Estudio piloto de seguridad y eficacia descongestiva del ácido hialurónico al 0.2% / Pilot study of safety and decongestant efficacy of 0.2% hyaluronic acid

Introducción: Los síntomas de congestión nasal tienen una influencia negativa en la calidad de vida de los pacientes. Los tratamientos disponibles son parcialmente eficaces, por lo que es deseable el desarrollo de productos que ayuden a aliviar estos síntomas. El objetivo de este estudio fue investigar la efectividad y la tolerabilidad de un inhalador con ácido hialurónico en niños. Material y métodos: Se llevó a cabo un estudio piloto, prospectivo, multicéntrico, no comparativo, con un inhalador con ácido hialurónico al 0,2%, en niños de 2-11 años de edad que presentaban congestión nasal. El inhalador se administró durante 7 días, con dos visitas, una de inicio (día 0) y otra final (día 7), y un registro domiciliario diario de los síntomas. Se evaluaron la efectividad, la tolerabilidad, la facilidad de uso y la satisfacción de los usuarios. Resultados: El estudio se realizó en 99 pacientes. Se observaron mejoras estadísticamente significativas (p <0,001) entre la visita inicial y la final, así como en las valoraciones al tercer y sexto días, en cuanto a congestión nasal, dificultad para respirar por la nariz, moqueo, respiración bucal de día y de noche y dificultad para dormir, comer y realizar una actividad física. La satisfacción de los usuarios e investigadores fue mayor del 80%. Conclusiones: El inhalador con ácido hialurónico tuvo gran efectividad y buena tolerabilidad en niños con síntomas de congestión nasal, y fue valorado muy positivamente por parte de los investigadores, los padres y los niños mayores de 8 años

Background: Persistent congestive nasal symptoms have a negative influence on patients' quality of life, daily activities and sleep. The current available treatments are partly effective, and it would be desirable to develop products which help to relieve these symptoms. The purpose of this study was to research into the effectiveness and safety of a nasal spray with hyaluronic acid in children. Methods: This was a pilot, prospective, multicentric, uncontrolled study with a 0.2% hyaluronic acid nasal spray, tested in children aged from 2 to 11 with nasal congestion. The spray was used for 7 days, with two visits, basal (day 0) and final (day 7), and a daily record of symptoms by parents. Effectiveness, safety, ease of use and users’ satisfaction were assessed. Results: 99 patients were included. Statistically significant improvements (p <0.001) were observed in the parameters studied between basal and final visits, and at the third and sixth day: nasal congestion, difficulty in breathing through the nose, runny nose, breathing through the mouth during the day and during the night, and difficulty in sleeping, eating and performing physical activities. Satisfaction of users and researchers was greater than 80%. Conclusions: The nasal spray with hyaluronic acid had high effectiveness and safety in children with nasal congestion symptoms, and was evaluated very positively by researchers, parents and children older than 8

O desespero humano em Kierkegaard: contribuição para a Psicologia / Human despair in Kiekergaard and contributions to Psychology

O artigo apresenta uma das obras do filósofo Sõren Kierkegaard assinada pelo personagem Anti-Climacus. Inicia com uma crítica à especulação dos saberes afastados da realidade concreta e semimplicação com a vida. Descreve, em seguida, a doença que dá título à obra e suas personificações. Aopsicólogo, segundo Anti-Climacus, caberia detectar o desespero, assim como o médico detecta a presençada doença orgânica no paciente que afirma estar bem. Encontram-se descritos na obra 'modos desubjetivação', seja na consciência ou inconsciência de se ter um eu, no aprisionamento ao temporal emdetrimento do eterno, no esquecimento dos necessários em favor dos possíveis ou vice-versa. Pretende-semostrar a atualidade do estudo da obra para o psicólogo

O desespero humano em Kierkegaard: contribuição para a Psicologia / Human despair in Kiekergaard and contributions to Psychology

O artigo apresenta uma das obras do filósofo Sören Kierkegaard assinada pelo personagem Anti-Climacus. Inicia com uma crítica à especulação dos saberes afastados da realidade concreta e semimplicação com a vida. Descreve, em seguida, a doença que dá título à obra e suas personificações. Aopsicólogo, segundo Anti-Climacus, caberia detectar o desespero, assim como o médico detecta a presençada doença orgânica no paciente que afirma estar bem. Encontram-se descritos na obra ‘modos desubjetivação’, seja na consciência ou inconsciência de se ter um eu, no aprisionamento ao temporal emdetrimento do eterno, no esquecimento dos necessários em favor dos possíveis ou vice-versa. Pretende-semostrar a atualidade do estudo da obra para o psicólogo(AU)

[A case-control study of the influence of the smoking behaviour in multiple sclerosis]. / Estudio de casos y controles sobre la influencia del hábito tabáquico en la esclerosis múltiple.

INTRODUCTION: Several epidemiological studies have demonstrated that there is a genetic factor of susceptibility in Multiple Sclerosis (MS) and that the environmental factors play an important important role in their development. Smoking is among the environment factors studied. In fact, several studies have established a relationship between smoking and multiple sclerosis, although most of them did not find significant results or found that these were contradictory. OBJECTIVE: To evaluate the influence of the smoking habit on the risk of suffering MS. METHODS: This was a case-control matched study with 138 patients diagnosed of MS according to the McDonald criteria who were paired with the same number of controls of the same gender, residents in the same city and having the same age +/-2 years. Demographic data, smoking status (never, always smokers, ex-smokers), Kurtzke disability status scale (EDSS) and type of MS were collected. RESULTS: Out of a total of 138 MS patients (93 women, 43 men), 110 had relapsing-remitting MS, 20 secondary progressive MS and 7 primary progressive MS. Most of the patients were smokers and ex-smokers (63%). In the control group, only the 41,3% were smokers/ex-smokers. Moreover, the age of onset for smoking was earlier in the case group. CONCLUSION: Being a smoker/ex-smoker implies a 27% greater risk of developing MS compared to those who have never smoked. This risk is statistically significant for women but not for men due to the low number of them in the sample.

Estudio de casos y controlessobre la influencia del hábito tabáquicoen la esclerosis múltiple / A case-control study of the influence of the smoling behaviour in multiple sclerosis

Introducción. Diversos estudios epidemiológicos demuestranque en la esclerosis múltiple (EM) existe un factor genético de susceptibilidad,así como que los factores ambientales juegan un papelprominente en el desarrollo de la misma. Entre los factores ambientalesestudiados se encuentra el tabaco. De hecho, varios estudiosestablecen relación entre fumar y EM, pero la mayoría de ellos nohallaron resultados significativos o éstos fueron contradictorios.Objetivo. Evaluar la influencia del hábito tabáquico en el riesgode padecer EM.Material y métodos: Estudio caso-control pareado con 138 pacientesdiagnosticados de EM según los criterios de McDonald y el mismonúmero de controles del mismo sexo, residentes en el mismo municipioy la misma edad ±2 años. Se recogieron los datos demográficos, statusde fumar, escala de discapacidad de Kurtzke (EDSS) y tipo de EM.Resultados. De los 138 pacientes (93 mujeres, 43 hombres), 110presentaban EM remitente recurrente, 20 EM secundariamente progresivay 7 EM primariamente progresiva. La mayoría de los pacientesresultaron ser fumadores y exfumadores (63%) frente al (41,3%)de los controles. Asimismo, la edad de inicio en el hábito de fumar fuemás precoz en los casos que en los controles.Conclusión. Ser fumador/exfumador implica un 27% más deriesgo de desarrollar EM frente a los nunca fumadores. Este riesgo esestadísticamente significativo en mujeres y no en varones, probablementedebido al bajo número de los mismos en el total de la muestra (AU)

Introduction. Several epidemiological studies have demonstratedthat there is a genetic factor of susceptibility in MultipleSclerosis (MS) and that the environmental factors play an importantrole in their development. Smoking is among the environmentfactors studied. In fact, several studies have established arelationship between smoking and multiple sclerosis, althoughmost of them did not find significant results or found that thesewere contradictory.Objective. To evaluate the influence of the smoking habit onthe risk of suffering MS.Methods. This was a case-control matched study with 138patients diagnosed of MS according to the McDonald criteria whowere paired with the same number of controls of the same gender,residents in the same city and having the same age ±2 years.Demographic data, smoking status (never, always smokers, exsmokers),Kurtzke disability status scale (EDSS) and type of MSwere collected.Results. Out of a total of 138 MS patients (93 women, 43 men),110 had relapsing-remitting MS, 20 secondary progressive MS and7 primary progressive MS. Most of the patients were smokersand ex-smokers (63%). In the control group, only the 41,3% weresmokers/ex-smokers. Moreover, the age of onset for smoking wasearlier in the case group.Conclusion. Being a smoker/ex-smoker implies a 27% greaterrisk of developing MS compared to those who have neversmoked. This risk is statistically significant for women but not formen due to the low number of them in the sample (AU)

Edema pulmonar fatal en paciente con meningitis por enterovirus / No disponible

No disponible

Fibrinolisis prehospitalaria enUVI móvil / No disponible

Objetivos: Evaluar la seguridad y la eficacia del tratamientofibrinolítico administrado por las UVI móvil 061-Galicia en pacientes con síndrome coronario agudo con elevaciónde ST (SCACEST).Métod o s: Estudio descriptivo y prospectivo de 30pacientes atendidos por las UVI móvil 061- Galicia entreenero de 2002 y marzo de 2006 con los siguientes criteriosde inclusión: SCACEST y administración prehospitalaria detratamiento fibrinolítico. Se excluyen aquellos pacientes concontraindicaciones para el mismo o con disponibilidad deangioplastia coronaria transluminal percutánea (ACTP) primariaen menos de 90 minutos.Resultados: La edad media fue de 59,84 años, con unclaro predominio del sexo masculino (93%). La localizaciónmás frecuente del SCACEST fue la arteria coronaria derecha(53%). La media de los tiempos de solicitud de asistencia,asistencia y llegada al hospital tras la administración delfibrinolítico fueron 40, 66 y 116 minutos, respectivamente.No se produjeron complicaciones derivadas del tratamientoadministrado. La tasa de reinfarto al año fue de un 3% yla supervivencia al año del 90%.Conclusiones: La fibrinolisis prehospitalaria realizadapor las UVI móvil en nuestra comunidad representa unaopción de tratamiento segura y eficaz en pacientes conSCACEST sin contraindicaciones para lamisma y sin disponibilidadde ACTP primaria en menos de 90 minutos (AU)

Objectives: To assess the safety and the effectiveness offibrinolytic therapy administered to ST-elevation myocardialinfarction (STEMI) patients at emergency mobile units(EMU) 061- Galicia.Methods: Descriptive and prospective study that englobe30 patients treated by EMU 061- Galicia between january2002 and march 2006 with the following selection criteria:STEMI and prehospital fibrinolytic treatment. Patients whohad contraindications to fibrinolytic therapy or availabilityof primary pecutaneous coronary intervention (PCI) before90 minutes were excluded.Results: The average age was 59.84 years, with a clearpredominance of masculine sex (93%). The most frequentlyaffected vessel was right coronary artery. The average of thetimes of attendance request, attendance and arrival to thehospital after the administration of fibrinolytic therapywere 40, 66 and 116 minutes, respectively. Complicationsderived from the fibrinolytic treatment did not take place.After 1 year, the recurrent myocardial infarction rate was3% and the survival rate was 90%.Conclusions: Prehospital fibrinolisis made at EMU inour community represents and option of safe and effectivetreatment in STEMI patients without contraindications tofibrinolytic therapy and without availability of primary PCIbefore 90 minutes (AU)

Impaired placentation in fetal alcohol syndrome.

Intrauterine growth restriction (IUGR) is one of the key features of fetal alcohol syndrome (FAS), and IUGR can be mediated by impaired placentation. Insulin-like growth factors (IGF) regulate placentation due to stimulatory effects on extravillous trophoblasts, which are highly motile and invasive. Previous studies demonstrated that extravillous trophoblasts express high levels of aspartyl-(asparaginyl) beta-hydroxylase (AAH), a gene that is regulated by IGF and has a critical role in cell motility and invasion. The present study examines the hypothesis that ethanol impaired placentation is associated with inhibition of AAH expression in trophoblasts. Pregnant Long Evans rats were fed isocaloric liquid diets containing 0% or 37% ethanol by caloric content. Placentas harvested on gestation day 16 were used for histopathological, mRNA, and protein studies to examine AAH expression in relation to the integrity of placentation and ethanol exposure. Chronic ethanol feeding prevented or impaired the physiological conversion of uterine vessels required for expansion of maternal circulation into placenta, a crucial process for adequate placentation. Real-time quantitative RT-PCR analysis demonstrated significant reductions in IRS-1, IRS-2, and significant increases in IGF-II and IGF-II receptor mRNA levels in ethanol-exposed placentas. These abnormalities were associated with significantly reduced levels of AAH expression in trophoblastic cells, particularly within the mesometrial triangle (deep placental bed) as demonstrated by real time quantitative RT-PCR, Western blot analysis, ELISA, and immunohistochemical staining. Ethanol-impaired placentation is associated with inhibition of AAH expression in trophoblasts. This effect of chronic gestational exposure to ethanol may contribute to IUGR in FAS.

Calidad del registro de quimioterapia en los servicios de farmacia hospitalaria de Andalucía / Chemotherapy registry quality in Andalusian hospital pharmacy departments

Objetivo: Analizar la calidad de los registros de las unidadescentralizadas de citostáticos de los hospitales de Andalucía y la disponibilidadde datos para analizar la utilización de estos fármacos.Método: Se elaboró un cuestionario ad hoc, usando variablesrelativas a la cobertura de información sobre pacientes y tratamientos,grado de informatización y organización. Los cuestionarios secumplimentaron en septiembre de 2005 mediante encuesta al responsablede los tratamientos quimioterápicos de los 19 servicios defarmacia de los hospitales que tratan pacientes oncológicos enAndalucía.Resultados: La tasa de respuesta fue del 100%, aunque un serviciono contaba con unidad centralizada de citostáticos. La coberturade preparación centralizada fue del 89% para hospital de día, el84% para pacientes ingresados, el 79% para pacientes hematológicosy el 69% para pacientes pediátricos. El registro está informatizadosólo en 13 hospitales (68%), con una gran variabilidad en losprogramas usados. La dispensación de temozolamida y de capecitabinacuenta con registro propio en el 68 y 42% de los casos. El nombredel paciente y el nombre y la dosis del citostático son los únicosdatos que se registran en todos, mientras que el nombre del protocolosólo se registra en el 47%, el diagnóstico, estadiaje y clasificaciónTNM en el 58, 31 y 16% respectivamente.Conclusiones: Existe una gran variabilidad en los sistemas deinformación para la gestión de uso de citostáticos, y carenciasimportantes en la disponibilidad de datos del paciente para realizarestudios de utilización y adecuación de la prescripción

Objective: To analyze registry quality in centralized cytostatictherapy units in Andalusian hospitals, and the availability of datato analyze the use of these drugs.Method: An ad hoc questionnaire was designed using variablesrelated to information coverage on patients and their treatments,data processing extent, and organization. Questionnaireswere completed in September 2005 by surveying people responsiblefor chemotherapy in all 19 pharmacy departments inAndalusian hospitals that treat oncologic patients.Results: Response rate was 100%, but one department hadno centralized cytostatic therapy unit. Centralized preparationcoverage was 89% for the day hospital, 84% for inpatients, 79%for hematologic patients, and 69% for pediatric patients. Registriesare computerized in only 13 hospitals (68%) with a varietyof software programs. Temozolamide and capecitabine dispensationhas a separate registry in 68% and 42% of cases, respectively.Patient name, and cytostatic name and dosage are the onlydata recorded in all instances, while protocol name is only recordedin 47%, and diagnosis, staging, and TNM categorization in58%, 31%, and 16% of cases, respectively.Conclusions: There is great variability regarding informationsystems for cytostatic use management, and a relevant shortage ofpatient data available for prescription use and adaptation studies

[Chemotherapy registry quality in Andalusian hospital pharmacy departments]. / Original breve Calidad del registro de quimioterapia en los servicios de farmacia hospitalaria de Andalucía.

OBJECTIVE: To analyze registry quality in centralized cytostatic therapy units in Andalusian hospitals, and the availability of data to analyze the use of these drugs. METHOD: An ad hoc questionnaire was designed using variables related to information coverage on patients and their treatments, data processing extent, and organization. Questionnaires were completed in September 2005 by surveying people responsible for chemotherapy in all 19 pharmacy departments in Andalusian hospitals that treat oncologic patients. RESULTS: Response rate was 100%, but one department had no centralized cytostatic therapy unit. Centralized preparation coverage was 89% for the day hospital, 84% for inpatients, 79% for hematologic patients, and 69% for pediatric patients. Registries are computerized in only 13 hospitals (68%) with a variety of software programs. Temozolamide and capecitabine dispensation has a separate registry in 68% and 42% of cases, respectively. Patient name, and cytostatic name and dosage are the only data recorded in all instances, while protocol name is only recorded in 47%, and diagnosis, staging, and TNM categorization in 58%, 31%, and 16% of cases, respectively. CONCLUSIONS: There is great variability regarding information systems for cytostatic use management, and a relevant shortage of patient data available for prescription use and adaptation studies.

Bronchiolitis obliterans with organizing pneumonia associated with acute Coxiella burnetii infection.

We report the case of a 62-year-old man who developed bronchiolitis obliterans with organizing pneumonia (BOOP) associated with acute Coxiella burnetii infection. The diagnosis of BOOP was made by fiber-optic transbronchial biopsy. Treatment with corticosteroids resulted in rapid clinical improvement and complete resolution of airspace opacities. To the best of our knowledge, this is the first well-documented case of BOOP associated with C. burnetii infection. This case suggests that this infection might trigger the development of BOOP.

Family planning services at school-based health centers: findings from a national survey.

Although nearly 1000 school-based health centers (SBHCs) operate in the United States, little is known about SBHCs' sexual and reproductive health services. This study investigated reproductive and sexual health services delivery in SBHCs, specifically the types of services available in SBHCs. A 16-page, self-administered questionnaire asked center staff to identify the reproductive health services provided on site as well as which services were restricted and by whom. The results suggest that whereas most SBHCs provided at least one reproductive health service, most centers were restricted from providing contraceptive services, usually by school district policy.

[Breast feeding: knowledge, attitudes and sociocultural ambiguity]. / Lactancia materna: conocimientos, actitudes y ambigüedad sociocultural.

OBJECTIVES: Found sociocultural attitude with regard to breast-feeding (BF) between the sanitary (SP) and no sanitary personnel (NSP) of health centers. DESIGN: Descriptive, cross-sectional study. SETTING: 4 health centres and 3 hospitals of Valencia. PARTICIPANTS: 442 workers of these centres. INTERVENTION: Structured questionnaire. MAIN RESULTS: 88% of SP and 76% of NSP (p < 0.05) believed that BF has many advantages comparing with artificial-feeding in a developed country. SP said more advantages of BF than NSP (p < 0.0001). Most renowned advantages were immunological, affective relationship and comfort. Main inconveniences were dependence, work reasons, aesthetic nature and insecurity in the ingested amount. 56% of SP and 86% of NSP (p < 0.0001) believed milk's analysis necessary. 56% women and 38% men (p < 0.001) didn't see correct give BF in public. Men were more concerned than women (p < 0.05) for local problems of chest, aesthetic results, milk's quality and transmission of illnesses. CONCLUSIONS: It's necessary to support knowledge and re-evaluating the trust in the nutritious capacity of maternal milk between the personnel of health centers and hospitals. Generic ambiguity toward functions of feminine breast exists and public'BF isn't acceptable. It's necessary recover socioculturally the image of BF and keep in mind the existent ambiguity upon designing campaigns of promotion.

[Pyogenic liver abscess: changes in etiology, diagnosis and treatment over 18 years]. / Absceso hepático piógeno: cambios en la etiología, diagnóstico y tratamiento a lo largo de 18 años.

BACKGROUND: There are no detailed studies in our country on the impact of modern imaging techniques on diagnosis, treatment and prognosis of pyogenic liver abscesses. MATERIAL AND METHODS: All patients with the diagnosis of PLA from 1981 to 1998 were included in the study. The study was divided in two periods: 1981 to 1989 and 1990 to 1998. RESULTS: Compared with the first time period, the following was observed from 1990 to 1998: the mean age was higher (52 versus 65 years, p = 0.006), infections with identified source increased (33% versus 74%, p = 0.003), diagnosis was earlier (13 versus 3 days, p = 0.0002), modern imaging techniques were used more frequently (17% versus 96%, p = 0.002), the proportion of recovered microorganisms increased (53% versus 88%, p = 0.002), as well as use of percutaneous drainage (0% versus 37%, p = 0.002) and the prognosis was better (mortality rate 40% versus 10%, p = 0.01). CONCLUSIONS: Relevant changes were observed among patients in our hospital in the nineties regarding epidemiology, management and prognosis of PLAs. Part of these changes are due to a higher use of new imaging techniques.