Incidence of spinal cancer in a tertiary care hospital in Mexico / Incidência de câncer da coluna vertebral em um hospital de terceiro nível de atenção no México / Incidencia de cáncer de columna vertebral en un hospital de tercer nivel de atención en México

ABSTRACT Objective To determine the incidence of primary malignant bone tumors of the spine in a High Specialty Orthopedics and Traumatology Medical Unit. Methods Review study. The study included patients receiving benefits from the Mexican Social Security Institute of all ages and both sexes with malignant spinal bone tumors during the period from 2010 to 2017. The descriptive statistics used were central tendency measures and dispersion in the SPSS v. 22 program from IBM. The results are presented in tables and figures. Results There were 107 patients, 56 (52.34%) men, 51 (47.66%) women with a mean age of 59.75 + 10.76 years (minimum 35, maximum 88). There were 46,840 hospital discharges during the period, for an annual average of 5,855 and a monthly average of 487.91. Of the 107 study cases, 78 (72.89%) were in the lumbosacral, 15 (14.01%) in the cervical, and 14 (13.08%) in the thoracic region. The incidence for the period was 1.9/1000 discharges, 1.38in 2010 increasing to 2.32 in 2017. Conclusions The behavior of primary malignant spinal tumors has increased its presentation from 2010 to 2017 . Level of evidence III; Non-analytical, descriptive study.

RESUMO Objetivo Conhecer a incidência de tumores ósseos malignos primários da coluna vertebral em uma unidade médica de alta especialidade médica em Ortopedia e Traumatologia. Métodos Estudo de revisão. O período do estudo incluiu os anos de 2010 a 2017 incluindo pacientes com tumores ósseos malignos da coluna vertebral, de todas as idades e ambos os sexos e usuários do IMSS (Instituto Mexicano de Seguridade Social). Foram utilizadas medidas estatísticas descritivas de tendência central e de dispersão no programa SPSS v. 22 IBM. Os resultados são apresentados em tabelas e gráficos. Resultados O estudo incluiu 107 pacientes, 56 (52,34%) homens e 51 mulheres (47,66%); idade média 59,75 + 10,76 anos (mínima 35, máxima 88). As altas hospitalares durante o período foram 46840, média anual de 5855 e média mensal de 487,91; dos tumores malignos 78 (72,89%) foram na região lombossacra, 15 (14,01%) na região cervical e 14 (13,08%) na região torácica. A incidência do período foi de 1,9/1000 altas, 1,38 em 2010, aumentando para 2,32 em 2017. Conclusões O comportamento dos tumores malignos primários da coluna vertebral tem aumentado desde 2010 a 2017. Nível de evidência III; Estudo analítico-descritivo.

RESUMEN Objetivo Conocer la incidencia de tumores óseos malignos primarios de columna vertebral en una Unidad Médica de Alta Especialidad en Ortopedia y Traumatología. Métodos Estudio de revisión. El período de estudio comprendió los años 2010 a 2017, incluyendo a pacientes con tumores óseos malignos de columna vertebral, de todas las edades y ambos sexos, y usuarios del IMSS (Instituto Mexicano del Seguro Social). Fueron utilizadas medidas estadísticas descriptivas de tendencia central y de dispersión en el programa SPSS v. 22 de IBM. Los resultados son presentados en tablas y gráficos. Resultados El estudio incluyó a 107 pacientes, 56 hombres (52,34%), y 51 mujeres (47,66%); edad promedio 59,75 + 10,76 años (mínima 35, máxima 88). Las altas hospitalarias durante el período fueron 46840, promedio anual de 5855 y promedio mensual de 487,91; de los tumores malignos, 78 (72,89%) casos en la región lumbosacra, 15 (14,01%) en la región cervical y 14 (13,08 %) en la región torácica. La incidencia del período fue 1,9/1000 altas, 1,38 en 2010, aumentando para 2,32 en 2017. Conclusiones El comportamiento de los tumores malignos primarios de columna vertebral ha aumentado desde 2010 a 2017. Nivel de evidencia III; Estudio analítico-descriptivo.

Validez factorial del cuestionario sobre trato digno en enfermería / Review of the effect of uncertainty in adults with type 2 diabetes mellitus

Introducción: Ofrecer un trato digno a los pacientes es un componente central en la calidad de los servicios de salud, por lo que su medición válida resulta altamente relevante. Objetivo: Evaluar la validez de constructo del cuestionario Trato digno en enfermería, desarrollado por la Secretaría de Salud en México. Métodos: Estudio observacional, transversal y analítico. Se seleccionó una muestra por conveniencia, la cual estuvo constituida por 355 pacientes atendidos en el 100% de los 89 centros de salud. Resultados: Hubo en promedio de puntuaciones altas de trato digno (0.84, rango 0-1)), el ajuste del modelo resultó adecuado al considerar diversos índices: NNFI = 0.99; NFI = 0.98; CFI = 0.99; RMSEA = 0.04; PNFI = 0.70 y chi cuadrada normada = 2.37. Un hallazgo notable fue la correlación positiva (p < 0.05) entre las dimensiones de relaciones humanas con la dimensión comunicativa (r = 0.95), relaciones humanas con la dimensión interior de la persona (r = 0.90) y dimensión comunicativa con dimensión interior de la persona (r = 0.90). Conclusión: Se comprobó la validez de constructo del cuestionario Trato digno en enfermería.

Introduction: Providing dignified care to patients is one of the main components in health care quality, which is why measuring it is really important. Objective: To evaluate the construct validity of the Dignified Care questionnaire in nursing, this was developed by the Secretaría de Salud (Mexico's Health Secretary). Methods: Observational, cross-sectional, and analytical study. 355 patients, attended in all the 89 health centers, were selected by convenience sampling. Results: There were on average high punctuations of dignified care (0.84, range 0,1). The adjustment of the model was appropriate, since several indexes were considered: NNFI = 0.99; NFI = 0.98; CFI = 0.99; RMSEA = 0.04; PNFI = 0.70 and normalized chi squared = 2.37. A remarkable finding was the positive correlation between the following dimensions (p < 0.05): human relations with communication (r = 0.95), human relations with the patient's inner dimension (r = 0.90), and communication with the patient's inner dimension (r = 0.90). Conclusions: Construct validity of the Dignified Care questionnaire in nursing was confirmed.

[Bibliometric analysis of scientific output on influenza in Mexico, 2000-2012]. / Análisis bibliométrico de la producción científica sobre la influenza en México, 2000-2012.

BACKGROUND: During the spring of 2009, H1N1 influenza became the first pandemic of the 21st century. There are no bibliometric studies in Mexico that have analyzed this topic in relation to the generation of Mexican knowledge. The aim of this article is to determine the volume and impact of Mexican scientific output published in journals indexed in Science Citation Index (SCI) on influenza from January 1, 2000, to October 1, 2012. METHODS: All the documents within SCI whose topic was influenza were included; in order to do this, we used the describers influenza or swine flu H1N1. The analysis included authorship, international collaboration, journals, document type, citations and address of correspondence. RESULTS: In 2000-2012, 241 articles related to influenza were published. The years with the highest number of articles were 2009 (n = 53) and 2010 (n = 62). The journals with the highest quantity of papers were Salud Pública de México (n = 16), PLOS ONE (n = 13), Archives of Medical Research (n = 13) and Vaccine (n = 10). The most investigated area was infectious diseases (18.9 %), followed by internal medicine (14 %) and immunology (14 %), occupational health (13 %) and experimental medicine (12.3 %). CONCLUSION: The scientific output on influenza supposes near 1 % of the total of the medical-scientific production with a decline posterior to the outbreak of 2009 pandemic influenza.

Introducción: la influenza H1N1 se convirtió en la primera pandemia del siglo XXI en 2009-2010. En México no hay estudios bibliométricos que hayan analizado este tema en relación con la generación del conocimiento mexicano. El objetivo es determinar el volumen e impacto de la producción científica mexicana publicada en revistas del Science Citation Index (SCI) sobre influenza en el periodo 2000-octubre de 2012. Métodos: se incluyeron todos los documentos vertidos en SCI cuyo tema de abordaje fuera influenza; para esto se emplearon los descriptores influenza o swine flu H1N1. El análisis incluyó autoría, patrón de colaboración internacional, revistas, tipo de documento, citaciones y dirección de correspondencia. Resultados: en 2000-2012 se publicaron 241 artículos relacionados con influenza. Los años con el número más alto de artículos publicados fueron 2009 (n = 53) y 2010 (n = 62). Las revistas con más publicaciones fueron Salud Pública de México (n = 16), PLOS ONE (n = 13), Archives of Medical Research (n = 13) y Vaccine (n = 10). El área más investigada fue enfermedades infecciosas (18.9 %), seguida de medicina interna (14 %) e inmunología (14 %), salud ocupacional (13 %) y medicina experimental (12.3 %). Conclusión: la producción científica sobre la influenza supone cerca del 1 % del total de la producción médico-científica con un decremento posterior a la pandemia de influenza en 2009.

Cómo comunicar los resultados de investigación en enfermería / How to communicate results in nursing research

Resumen:

La mayoría del personal de enfermería no escribe para publicar. Los profesionales de enfermería que realizan investigación experimentan la necesidad de comunicar sus resultados de investigación en el foro científico. Esto puede considerarse como una responsabilidad ajena a su formación; sin embargo, no lo es, ya que escribir un artículo científico se considera como una cuestión fundamental para el desarrollo profesional del área de enfermería. Este documento tiene el propósito de mostrar al personal de enfermería la manera como debe prepararse un documento científico que será sometido a una revista académica. Comentamos cuáles son los beneficios obtenidos por escribir un artículo y con ello animamos a los profesionales de enfermería a comunicar sus resultados bajo la estructura de un artículo original.

Abstract:

Most of nursing staff does not write to publish. Nursing professionals conducting research, experience the need to communicate their research results in the scientific forum. This can be regarded as an oblivious responsibility beyond its training formation; however, it is not like that: a scientific paper is considered essential for the professional development of nursing. The aim of this document is to show to the nursing staff how to prepare a scientific document that will be submitted to an academic journal. We discussed about what are the benefits gained by writing an article, and, therefore, we encourage the nursing professionals to communicate their results under the structure of the original article.

Quantifying the mortality caused by the H1N1 influenza virus during the 2009 pandemic in Mexico.

INTRODUCTION: The frequency and mortality of the pandemic caused by influenza A(H1N1)pdm09 might have been underestimated, especially in developing countries. This study was designed to quantify the possible underestimation of pandemic influenza mortality and evaluate the concordance between the data reported for A(H1N1)pdm09 mortality and the causes of death reported during the pandemic period of April 2009 to February 2010. METHODOLOGY: The death certificates of 754 confirmed cases of A(H1N1)pdm09 infection were included in the study. Data was analyzed using the United States Centers for Disease Control and Prevention's statistical model accounts for the variability in the proportion at each step using the Monte Carlo probabilistic model sampled from a uniform probability distribution. RESULTS: A total of 1,969 deaths were estimated, with an estimated lethality of 5.53 per 100,000 (range, 3.5-8.76 per 100,000) in contrast with the 754 deaths and a lethality of 1.98 per 100,000 infected patients officially reported. In 631 of 754 (83.7%) death certificates from A(H1N1)pdm09 influenza-positive patients, influenza was not mentioned as a cause of death. CONCLUSIONS: It is possible that the mortality of the pandemic was three times higher than officially reported in Mexico. One source of error that could explain this underestimation is in the completion of death certificates, because in > 80% of confirmed cases of infection with influenza virus, it was not reported as the cause of death.

[Mechanical ventilation parameters associated to barotrauma in a neonatal intensive care unit]. / Parámetros de ventilación mecánica asociados a barotrauma en una unidad de cuidados intensivos neonatales.

OBJECTIVE: To identify the parameters of mechanical ventilation related to barotrauma and to identify associated diseases. MATERIAL AND METHODS: There was a partial retrospective study which included all the files and/or newborns (NB) who were in the Neonatal Intensive Care Unit during March 2003 to April 2008 met the inclusion criteria. Two groups were conformed, the group A, cases (those with barotrauma) and B controls (that did not show it). Area of significance was considered when p < 0.05. RESULTS: In multivariate analysis was only significant relevance in relation to the ventilatory parameters mean airway pressure (MAP) > 10 cm H20 on the eighth day, and as confronted all variables including one different from the ventilator as arterial blood gases in the multivariate analysis also, the oxygenation index (OI) with a value > 10 showed statistical significance as it preceded to the barotrauma. The pathology associated with barotrauma was patent ductus arteriosus (PDA) hemodynamically significant with p < 0.05. CONCLUSIONS: Based on the foregoing its is concluded that when a NB patient with mechanical ventilatory support after the first days, to improve lung compliance should be going down different ventilatory parameters as soon as possible to avoid reaching a MAP > 10 cm H2O above the eighth day of ventilatory management, but OI > 10 at any time would be announcing the possibility of barotrauma and other side to treat the significant hemodynamically PDA either medically or surgically in the shortest time.

[Predictors factors for the extubation failure in two or more times among preterm newborn]. / Factores predictores para falla en la extubación en dos o más ocasiones en el recién nacido de pretérmino.

INTRODUCTION: With the ventilatory mechanical attendance has been prolonged the life of the preterm newborn (PTNB) critically sick and during that lapse many occasions it is necessary reintubation to PTNB in two or more times with the subsequent damage that makes enter to the patient to a vicious circle with more damage during the same reintubated. The objective of this study was to determine the factors that predict the extubation failure among PTNB from 28 to 36 weeks of gestational age in two or more times. MATERIAL AND METHODS: It was considered extubation failure when in the first 72 hours of being had extubated the patient; there was reintubation necessity, independent of the cause that originated it. For the second extubation or more took the same approach. During the period of September to December of the 2004 were included in retrospective study to all PTNB that were interned in one hospital of third level that fulfilled the inclusion approaches (one study published where we take account the first extubation failure) and in retrolective study to the patients of the same hospital of January to October of the 2006. They were formed two groups, group A of cases (who failed in extubation two or more times) and the B of controls (who failed in extubation for the first time). The descriptive statistic and the inferential through of Student t test or Mann-Whitney U or rank sum test Wilcoxon, in suitable case; Chi-square or Fisher's exact test was used. Odds ratio (OR) and multivariate analysis for to study predictors factors for the extubation failure was employed. Statistical significance was considered at p < 0.05. RESULTS: The group A it was conformed by 21 patients and the group B for 20 patients. In the multivariate analysis it was association like predictive factor for fail of the second extubation to the presence of postextubation atelectasis with an OR 19.2 with IC to 95% of 3.1-117 (P = 0.001) and preextubation oxygenation index (IO2) >2, OR 5.3, IC to 95% of 1.3-21.4 (P = 0.02). In the bronchoscopy study they were some anatomical alterations that they explained the extubation failure in the second time. CONCLUSIONS: We conclude that it is important to plan an extubation in the PTNB, when there has already been a previous failure, and to avoid the well-known predictors factors for extubation failure as much as possible in the extubation in the PTNB, and that according to that found in this study non to extubate with an IO2 >2, and to manage the atelectasis postextubation intensively. Later to the pursuit of those limits and after a second extubation failure, be probably necessary to pass to bronchoscopy if the patient's conditions allow it.