Aphasia improvement without logotherapy during motor neurorehabilitation of post-stroke hemiparesis using virtual reality or modified constraint-induced movement therapy: A retrospective cohort.

BACKGROUND: Some research suggests that post-stroke aphasia can recover "on its own", however, there is evidence of a common neural substrate for motor and language systems. We hypothesize, that motor neurorehabilitation of hemiparesis could be related to simultaneous improvement in aphasia. OBJECTIVE: To measure changes in post-stroke aphasia and its relation with hemiparesis treated with different therapies. METHODS: Database information (n = 32) on post-stroke hemiparesis (Fugl-Meyer Scale evaluated) managed with virtual reality (VR) versus modified constraint-induced movement therapy (mCIMT) or regular therapy (rPT/OT) was analyzed. None received logotherapy (LT) by appointment at four months. INCLUSION CRITERIA: < 3 months after the stroke, aphasia severe (Boston Aphasia Intensity Scale), and all three evaluations. RESULTS: Twenty-one patient records met inclusion criteria (71,4% women and mean age 66,67±3,13 years) who received VR, mCIMT, or rPT/OT (n = 6, 8, and 7, respectively). There was continuous intra-groups improvement in aphasia (p < 0.05), but inter-groups the greater aphasia recovery (p = 0.05) and hemiparesis (p = 0.02) were in VR, with a high correlation in evolution between them (r = 0.73; p = 0.047). CONCLUSION: High clinical correlation between aphasia, without LT, and hemiparesis evolution during motor neurorehabilitation would support common neural connections stimulation. We will conduct a clinical trial, with a larger sample size to contrast our hypothesis.

Breast cancer detection in Mexico City during 2017. / Detección del cáncer de mama en la Ciudad de México durante 2017.

BACKGROUND: Breast cancer is the leading cause of death of women in Mexico; its detection is among the priorities of Mexico City's (CDMX) Southern Local Office from the Instituto Mexicano del Seguro Social (IMSS: Mexican Institute for Social Security). OBJECTIVE: To describe the incidence and mortality related to breast cancer detection in the CDMX's Southern Local Office units from IMSS in 2017. MATERIAL AND METHODS: Databases from the Coordination of Prevention and Health Care (CPAS), Information and Strategic Analysis (CIAE) and the Breast Clinic (UDDC Mama) were analyzed. Among data, it was included age, study (mastography, ultrasound and biopsy), and histological type, incidence and mortality. For statistical analysis it was used Student's t, and Spearman correlation (p < 0.05). RESULTS: In a population of 589,683 women (40-69 years), 97,779 mastographs were performed. Out of these, there were 94,883 normal (BI-RADS 1) and 1933 suspicious (BIRADS 3-5). In 436 biopsies, infiltrating ductal carcinoma was the most frequent. The incidence rate was 39.3/100,000 and the mortality rate was 3.54/100,000 inhabitants (in 2015 and 2016 it was 6.84 and 7.02/100,000, respectively). CONCLUSIONS: An increase in the incidence and a decrease in breast cancer mortality has been observed, which is related to improvements in screening programs in 2017. It is important to maintain and optimize screening programs.

INTRODUCCIÓN: El cáncer de mama es la principal causa de muerte de mujeres en México; su detección se ubica entre las prioridades de la Delegación Sur de la Ciudad de México del Instituto Mexicano del Seguro Social (IMSS). OBJETIVO: Describir la incidencia y la mortalidad relacionadas con la detección del cáncer de mama en las unidades de la Delegación Sur de la Ciudad de México del IMSS en 2017. MATERIAL Y MÉTODOS: Se analizaron las bases de datos de las Coordinaciones de Prevención y Atención a la Salud (CPAS), de Información y Análisis Estratégico (CIAE) y de la Clínica de Mama (UDDC Mama). Entre los datos se incluyó edad, estudio (mastografía, ultrasonido y biopsia) y tipo histológico, incidencia y mortalidad. Para el análisis estadístico se empleó t de Student y correlación de Spearman (p ≤ 0.05). RESULTADOS: En una población de 589 683 mujeres (40-69 años), se realizaron 97 779 mastografías. De estas hubo 94 883 normales (BIRADS 1) y 1933 sospechosas (BIRADS 3-5). En 436 biopsias, el carcinoma ductal infiltrante fue el más frecuente. La tasa de incidencia fue 39.3/100 000 y de mortalidad de 3.54/100 000 habitantes (en 2015 y 2016 fue de 6.84 y 7.02/100 000, respectivamente). CONCLUSIONES: Se ha observado un incremento en la incidencia y disminución de mortalidad por cáncer de mama, el cual está relacionado con mejoras en programas de detección en 2017. Es importante mantener y optimizar los programas de detección.

Triglycerides and waist to height ratio are more accurate than visceral adiposity and body adiposity index to predict impaired fasting glucose.

AIMS: To evaluate the clinical accuracy of novel indices visceral adiposity index (VAI) and body adiposity index (BAI) to identify patients with impaired fasting glucose (IFG) and compare with its individual components and other obesity indicators. METHODS: A cross-sectional study was conducted in Mexican population. Body mass index (BMI), waist circumference, hip circumference, triglycerides (TG), High density lipoprotein cholesterol (HDL-C), VAI, BAI, waist to hip ratio (WHR) and waist to height ratio (WHtR) were determined. We plotted a receiver operating characteristic curves to assess the abilities to discriminate subjects with IFG from those with normal glucose tolerance (NGT) of the measurements. A binary logistic regression analysis was performed to determine the strength of association with IFG. RESULTS: A total of 280 individuals were included, from which 144 (51.3%) have IFG; the mean age was 47.14 years and 164 (55.5%) were females. Compared with NGT subjects, the participants with IFG had significantly higher levels of BMI, WHtR, VAI, BAI and TG. The measurements with highest area under the curve were TG, (0.631, 95% confidence interval [CI] 0.566-0.697) VAI (0.628, 95% CI 0.563-0.693) and WHtR (0.622, 95% CI 0.557-0.688) and in the adjusted binary logistic regression model, were found to be independently associated with IFG, Odds Ratio of 2.665, (95% CI 1.567-4.533) 2.567 (95% CI 1.527-4.317) and 2.171 (95% CI 1.102-4.276) respectively. CONCLUSIONS: Our data provide evidence that TG, VAI and WHtR could be considered potential tools for the risk assessment of type 2 diabetes mellitus (T2DM) in this population.

La inteligencia emocional y la competencia gerencial del profesional de enfermería / Emotional intelligence and managerial competence of the nurse

Resumen:

El concepto de inteligencia emocional (IE) está relacionado con el rol que juegan las emociones en nuestro diario vivir. El reto para toda persona y quizá aún más para las personas que desempeñan puestos directivos y que tienen a su cargo a un grupo de personas, es el ejercicio cotidiano de una buena práctica de las competencias y aptitudes personales y sociales de la IE. En el ámbito profesional de enfermería, la IE permite a las enfermeras desarrollar relaciones terapéuticas efectivas y facilita la interacción con otros profesionales de la salud; asimismo, posibilita la gestión y la gerencia de los servicios mediante el uso de capacidades intelectuales, humanas y técnicas enfocadas a la organización. Lo fundamental según Goleman es "el dominio de uno mismo", el inicio de todo lo que se produce en nuestras relaciones con el entorno en que nos movemos. Este enfoque de ocuparse primero de "uno mismo" significa tener la capacidad de identificar nuestras debilidades y dotarnos de comportamientos que nos ayuden a superarlas.

Abstract:

The concept of emotional intelligence (El) is related to the role that emotions play in our daily lives. The challenge for everyone and perhaps even more for people in leadership positions that are responsible for a group of people, is the daily good practice of the personal and social skills of emotional intelligence. In the professional field of nursing, El allows nurses to develop effective therapeutic relationships and facilitates interaction with other health professionals; also it benefits the management of services, using intellectual, human and technical capacities geared to the organization. According to Goleman the fundamental is a "mastery of self", the beginning of everything that occurs in our relations with the environment in which we operate. This approach of dealing first with "oneself" means having the ability to identify our own weaknesses and the behaviors that help us to overcome them.

Conocimiento del personal de enfermería sobre los cuidados a la mujer postoperada de mastectomía / Nurse’s knowledge concerning care of post-op mastectomized women

Resumen:

Introducción: a nivel mundial, el cáncer de mama ocupa el primer lugar de muerte por neoplasia maligna. Para el 2030, representará aproximadamente 850 000 muertes de mujeres en edad productiva y más del 85 % estará en un rango de 29 a 69 años de edad. Para las mujeres con cáncer de mama sometidas a mastectomía y que pasaron por quimioterapia y/o radioterapia, el cuidado que la enfermera debe ofrecer es imprescindible.

Objetivo: describir el conocimiento del personal de enfermería sobre los cuidados postoperatorios a la mujer con mastectomía.

Metodología: estudio transversal descriptivo con 200 enfermeras y enfermeros de oncología; se diseñó un instrumento estructurado con ocho apartados y 29 reactivos; la prueba piloto se realizó en 10 % de la muestra y se determinó la confiabilidad del instrumento mediante alfa de cronbach. El análisis fue descriptivo.

Resultados: el nivel de conocimiento sobre los cuidados de la paciente postoperada de mastectomía fue excelente (34 %) y bueno (50.5 %). Sin embargo, en los rubros de alimentación (47 %), vestido (37.5 %) y autoexploración de mama (56 %) no fue satisfactorio.

Conclusiones: El seguimiento del personal de enfermería en el cuidado de la mujer postoperada de mastectomía es fundamental para la recuperación, por ello es relevante que la orientación sea sistematizada en rubros específicos de alimentación, vestido y autoexploración de mama.

Abstract:

Introduction: Worldwide, breast cancer is the leading cause of death from maligrant neoplasms. In 2030, it will represent approximately 850 000 deaths of women in working age, and 85 % of those patients will be aged between 29 and 69 years. For women with breast cancer undergoing a mastectomy and those who went through chemotherapy and/or radiotherapy, the care that the nurse must provide is essential.

Objective: To describe the knowledge of nurses on postoperative care to women with mastectomy. Methodology: A descriptive cross-sectional study of 200 oncology nurses was carried out; a structured instrument with eight points and 29 test items was designed; the pilot test was performed in 10 % of the sample, and the reliability of the instrument was stablished by using cronbach's alpha. Results: The level of knowledge about post-op patient care was: excellent (34 %) and good (50.5 %). However, in the areas of food (47 %), clothing (37.5 %) and breast self-examination (56 %), the knowledge was not satisfactory.

Conclusions: Monitoring of nurses during the care of post-op mastectomized women is essential for recovery; thereby, it is important to systematize the training in specific items of food, clothing and breast self-examination.