Protocolo de Durán modificado en rehabilitación precoz de lesiones tendinosas flexoras de la mano / Modified Duran protocol in early rehabilitation of flexor tendon injuries of the hand

OBJETIVOS: conocer la efectividad del Protocolo de Durán Modificado en las Lesiones Tendinosas Flexoras de la Mano determinando el grado de discapacidad funcional en pacientes atendidos por el Servicio de Medicina Física y Rehabilitación del Hospital de Clínicas en el periodo agosto ­ diciembre de 2016. MATERIAL Y MÉTODOS: se incluyeron dos grupos paralelos: al primer grupo (9 pacientes) se aplicó el protocolo de Durán Modificado y al segundo (9 pacientes) el tratamiento rehabilitador convencional. La valoración de la funcionalidad fue a través de la fórmula de Strickland, el sistema de Bruck Gramcko y la Distancia Pulpejo-Palma. Se realizó en 36 sesiones de 30 minutos aproximadamente para cada modalidad terapéutica con la correspondiente evaluación al finalizar los 3 meses de terapia. RESULTADOS: los que realizaron el protocolo de Durán Modificado finalizaron el tratamiento con una funcionalidad excelente en 4 casos, bueno en 3 y regular en 2 según la fórmula de Strickland. Según el sistema de Buck Gramcko la funcionalidad fue excelente para 5 pacientes y regular para 4. Y finalmente con la evaluación de la distancia pulpejo - palma se determinó que 4 pacientes obtuvieron un rango excelente, 4 bueno y 1 regular. CONCLUSIONES: la aplicación del protocolo de Durán modificado como rehabilitación precoz en pacientes con lesiones tendinosas flexoras de la mano es de mayor efectividad que el tratamiento rehabilitador convencional siendo una herramienta que puede ser aplicada de manera temprana en pacientes postoperados por esta afección

OBJECTIVES: to determine the effectiveness of the Modified Duran Protocol on flexor tendon injuries of the hand determining the degree of functional disability in patients treated by the Department of Physical Medicine and Rehabilitation at the Hospital de Clinicas during term August - December 2016.MATERIAL AND METHODS: we included two parallel groups: The Duran Modified protocol was applied on the first group (9 patients) and the Conventional Rehabilitation (9 patients) Treatment on the second. The assessment of the functionality was carried out with the formula Stricklan, Bruck Gramcko System and Pulpejo-Palma Distance. It was conducted in 36 sessions of approximately 30 minutes for each treatment modality with the corresponding evaluation at the end of 3 months of therapy. RESULTS: those who carried out the Modified Duran protocol completed treatment with excellent functionality in 4 cases, good in 3 and fair in 2 according to the formula Strickland. According Gramcko Buck system functionality was excellent for 5 patients and Fair for 4. Finally the evaluation of the pulpejo - palm distance showed that four patients had an excellent range, 4 good and 1 fair. CONCLUSIONS: the application the Modified Duran protocol as immediate rehabilitation in patients with flexor tendon injuries of the hand is more effective than conventional rehabilitation treatment being a tool that can be applied early in patients after surgery for this injury

Global stability and H theorem in lattice models with nonconservative interactions.

In kinetic theory, a system is usually described by its one-particle distribution function f(r,v,t), such that f(r,v,t)drdv is the fraction of particles with positions and velocities in the intervals (r,r+dr) and (v,v+dv), respectively. Therein, global stability and the possible existence of an associated Lyapunov function or H theorem are open problems when nonconservative interactions are present, as in granular fluids. Here, we address this issue in the framework of a lattice model for granularlike velocity fields. For a quite general driving mechanism, including both boundary and bulk driving, we show that the steady state reached by the system in the long-time limit is globally stable. This is done by proving analytically that a certain H functional is nonincreasing in the long-time limit. Moreover, for a quite general energy injection mechanism, we are able to demonstrate that the proposed H functional is nonincreasing for all times. Also, we put forward a proof that clearly illustrates why the "classical" Boltzmann functional H_{B}[f]=∫drdvf(r,v,t)lnf(r,v,t) is inadequate for systems with nonconservative interactions. This is done not only for the simplified kinetic description that holds in the lattice models analyzed here but also for a general kinetic equation, like Boltzmann's or Enskog's.

Enseñanza de la Patología General en España: ¿es el residente un convidado de piedra? / General Pathology training in Spain: is the resident a stone guest?

No disponible

Prevalence of metabolic syndrome in urban Colombian adolescents aged 10-16 years using three different pediatric definitions.

The aim of this study was to evaluate the metabolic syndrome (MetS) prevalence in adolescents using three different definitions for this age group. The evaluated sample consisted of 718 male and 743 female adolescents. Definitions by Cook et al., de Ferranti et al. and International Diabetes Federation (IDF) for adolescents were used to estimate the prevalence of MetS. The prevalence of MetS was 8.5, 2.5 and 1.2% by de Ferranti et al., Cook et al. and IDF definitions, respectively. High fasting glucose component had the lower prevalence whereas high triglycerides levels component was the most prevalent. In obese adolescents, the prevalence of MetS was higher. MetS classification in adolescents strongly depends on the definition chosen. Further research is required for the evaluation of the current definitions (multicentric studies), and for addition or design of new and useful criteria.

C-reactive protein, waist circumference, and family history of heart attack are independent predictors of body iron stores in apparently healthy premenopausal women.

Ferritin levels have been associated with metabolic syndrome and insulin resistance. The aim of the present study was to evaluate the prediction of ferritin levels by variables related to cardiometabolic disease risk in a multivariate analysis. For this aim, 123 healthy women (72 premenopausal and 51 posmenopausal) were recruited. Data were collected through procedures of anthropometric measurements, questionnaires for personal/familial antecedents, and dietary intake (24-h recall), and biochemical determinations (ferritin, C reactive protein (CRP), glucose, insulin, and lipid profile) in blood serum samples obtained. Multiple linear regression analysis was used and variables with no normal distribution were log-transformed for this analysis. In premenopausal women, a model to explain log-ferritin levels was found with log-CRP levels, heart attack familial history, and waist circumference as independent predictors. Ferritin behaves as other cardiovascular markers in terms of prediction of its levels by documented predictors of cardiometabolic disease and related disorders. This is the first report of a relationship between heart attack familial history and ferritin levels. Further research is required to evaluate the mechanism to explain the relationship of central body fat and heart attack familial history with body iron stores values.

Longitudinal changes of structural connectivity in traumatic axonal injury.

OBJECTIVES: To identify structural connectivity change occurring during the first 6 months after traumatic brain injury and to evaluate the utility of diffusion tensor tractography for predicting long-term outcome. METHODS: The participants were 28 patients with mild to severe traumatic axonal injury and 20 age- and sex-matched healthy control subjects. Neuroimaging was obtained 0-9 days postinjury for acute scans and 6-14 months postinjury for chronic scans. Long-term outcome was evaluated on the day of the chronic scan. Twenty-eight fiber regions of 9 major white matter structures were reconstructed, and reliable tractography measurements were determined and used. RESULTS: Although most (23 of 28) patients had severe brain injury, their long-term outcome ranged from good recovery (16 patients) to moderately (5 patients) and severely disabled (7 patients). In concordance with the diverse outcome, the white matter change in patients was heterogeneous, ranging from improved structural connectivity, through no change, to deteriorated connectivity. At the group level, all 9 fiber tracts deteriorated significantly with 7 (corpus callosum, cingulum, angular bundle, cerebral peduncular fibers, uncinate fasciculus, and inferior longitudinal and fronto-occipital fasciculi) showing structural damage acutely and 2 (fornix body and left arcuate fasciculus) chronically. Importantly, the amount of change in tractography measurements correlated with patients' long-term outcome. Acute tractography measurements were able to predict patients' learning and memory performance; chronic measurements also determined performance on processing speed and executive function. CONCLUSIONS: Diffusion tensor tractography is a valuable tool for identifying structural connectivity changes occurring between the acute and chronic stages of traumatic brain injury and for predicting patients' long-term outcome.

Celulitis diseminada como presentación inicial de criptococosis sistémica en un paciente con artritis reumatoide / Systemic cryptococcosis presenting as extensive cellulitis in a patient with rheumatoid arthritis

No disponible

No disponible

Detecting differential memory performance among Spanish-speaking patients with temporal lobe epilepsy.

There is relatively little research pertaining to neuropsychological assessment of Spanish-speaking individuals with intractable temporal lobe epilepsy (TLE). The current study examined verbal and visual memory performances in 38 primarily Spanish-speaking patients with TLE (Right = 15, Left = 23) of similar epilepsy duration to determine if lateralizing differences can be found using verbal and nonverbal memory tests. On a test specifically designed to assess auditory learning and memory among Spanish-speaking individuals, the Spanish Verbal Learning Test (SVLT), patients with left TLE performed significantly worse than patients with right TLE. In contrast, no significant differences in story or visual memory were seen using common memory tests translated into Spanish. Similar to what has been found in English speakers, these results show that verbal memory differences can be seen between left and right sided TLE patients who are Spanish-speaking to aid in providing lateralizing information; however, these differences may be best detected using tests developed for and standardized on Spanish-speaking patients.

Relación entre los factores de riesgo de enfermedades crónicas no transmisibles y la sensibilidad a la insulina en adultos jóvenes de 18 a 39 años de la ciudad de Cali-Colombia / Association of risk factors for non transmissible chronic diseases with insuline sensitivity, in young adults in the city of Cali, Colombia

The prevalence of insulin resistance and risk factors for chronic diseases is not known in Colombia. The purpose of the study was of determine the association of insulin resistance and risk of chronic diseases in young, apparently healthy adults. By convenience, 97 subjects, mean age of 24 years were studied. Family and personal history, anthropometrics, lipid profile, and a short insulin tolerance test was done to each subject to identify prevalence o insulin resistance and its association with risk factors. Plasma lipids and anthropometrics were within acceptable range. Insulin sensitivity was categorized as high, border high, border low and low. Out of 97 subjects 47 had altered sensitivity. Most women (68%) were classified as border low, and most men (60%) as low. There was a difference between these two categories in waist circumference and weight. Border low and low cases had not less than 3 risk factors but the total number of factors was not different within the 4 groups. More than 50% of cases had family history of chronic diseases, sedentary life and low C-HDL. There was a negative association between insulin sensitivity and fasting Glycaemia and positive with fasting triglycerides, BMI, Waist hip ratio and weight. Results suggest a surprisingly high prevalence of risk factors in a young group associated with altered insulin sensitivity. It may be possible to identify early indicators of risk and develop appropriate strategies for prevention.

En Colombia se desconoce la prevalencia de resistencia a insulina(RI) y factores de riesgo(FR) para el desarrollo de enfermedades crónicas no transmisibles(ECNT). El objetivo del estudio fue determinar asociación entre FR de ECNT y el grado de sensibilidad a insulina (SI)I en adultos jóvenes aparentemente sanos. Se seleccionaron por conveniencia 97 sujetos (24±4.66 años), de quienes se obtuvo historia familiar y personal, antropometría, perfil lipídico y se practicó Test Corto de Tolerancia a Insulina para determinar prevalencia de RI y factores de riesgo asociados. La media del perfil lipídico y la antropometría estuvieron dentro de límites de referencia. La SI se categorizó en Alta, Media-Alta, Media-Baja y Baja, 51% de mujeres y 41% de hombres se ubicaron en los grupos de menor sensibilidad. Se encontró diferencia entre la circunferencia de cintura y peso entre sujetos con SI Baja y Media-Baja y SI Media Alta y Alta. Los grupos con Media-Baja y Baja presentaron como mínimo tres FR. Mas del 50% de los casos con antecedentes familiares de ECNT, sedentarismo, bajo C-HDL. Asociación negativa entre SI y glucosa en ayunas y positiva de triglicéridos en ayunas con el Índice de masa corporal, relación cintura cadera y peso. Los resultados muestran una presencia elevada de FR para el desarrollo de ECNT en población joven asociada a una prevalencia de disminución de la SI mayor que la reportada, permitirán proponer indicadores tempranos para detectar personas a riesgo y utilizar estrategias de prevención adecuadas.

Occupational asthma due to acrylates in a graphic arts worker.

BACKGROUND: Acrylates are used in a wide variety of products such as solvents, adhesives, paints, printing ink, soft contact lenses, porcelain nails, and methacrylates (used by dentists and orthopedists). Currently there are various types of acrylic compounds: acrylates, cyanoacrylates (such as tissue adhesives and home glues), and methacrylates (prostheses and dental and orthopedic fillings). The sensitization mechanism is unknown, but the allergy is believed to be due to a non-IgE mediated phenomenon, since a late asthmatic response occurs. Various cases of acrylate-induced asthma have been reported, especially in dentists and persons using glues or paints containing this substance. MATERIAL AND METHODS: We present the case of a 52-year-old man who had been working in graphic arts for the previous 7 years. For the previous 2 years he had experienced persistent cough with a sensation of drowning, dyspnea that increased with moderate exertion, and nasal obstruction despite continuous treatment. The symptoms first appeared after an episode of acute respiratory difficulty associated with weight loss, pulmonary infiltrates, and eosinophilia. Peak expiratory flow (PEF) was measured during work and sick leave, and specific bronchial challenge with acrylates was performed in a bronchial chamber. RESULTS: The PEF improved on weekends and sick leave. The challenge test provoked a late asthmatic response and the non-specific bronchial hyperreactivity increased after the test. As well in the sputum samples there was a increase of eosinophil amount.

Occupational asthma due to acrylates in a graphic arts worker / Asma ocupacional por acrilatos en un trabajador de artes gráficas

Background: Acrylates are used in a wide variety of products such as solvents, adhesives, paints, printing ink, soft contact lenses, porcelain nails, and methacrylates (used by dentists and orthopedists). Currently there are various types of acrylic compounds: acrylates, cyanoacrylates (such as tissue adhesives and home glues), and methacrylates (prostheses and dental and orthopedic fillings). The sensitization mechanism is unknown, but the allergy is believed to be due to a non-IgE mediated phenomenon, since a late asthmatic response occurs. Various cases of acrylate-induced asthma have been reported, especially in dentists and persons using glues or paints containing this substance. Material and methods: We present the case of a 52-year-old man who had been working in graphic arts for the previous 7 years. For the previous 2 years he had experienced persistent cough with a sensation of drowning, dyspnea that increased with moderate exertion, and nasal obstruction despite continuous treatment. The symptoms first appeared after an episode of acute respiratory difficulty associated with weight loss, pulmonary infiltrates, and eosinophilia. Peak expiratory flow (PEF) was measured during work and sick leave, and specific bronchial challenge with acrylates was performed in a bronchial chamber. Results: The PEF improved on weekends and sick leave. The challenge test provoked a late astmatic response and the non-specifc bronchial hyperreactivity increased after the test. As well in the sputum samples there was a increase of eosinophil amount

Antecedentes: Los acrilatos se usan en una amplia variedad de productos, como solventes, adhesivos, pinturas, tinta de imprenta, lentes de contacto blandas y uñas de porcelana, mientras que los metacrilatos los usan dentistas y ortopedas. Hay varios tipos de compuestos acrílicos: acrilatos, cianoacrilatos (como adhesivos de tejidos y pegamentos de uso doméstico), así como de metacrilatos usados en prótesis dentales y rellenos ortopédicos. Los mecanismos de sensibilización se desconocen, pero se piensa que la reacción alérgica no está mediada por IgE, ya que la reacción asmática se produce tardíamente. Hay publicados varios casos de asma inducida por acrilato, especialmente en dentistas y personas que usan colas o pinturas que contienen esas sustancias. Material y métodos: Se presenta el caso de un varón de 52 años de edad que había trabajado en artes gráficas en los últimos 7 años. En los dos últimos años había presentado tos persistente con sensación de ahogo, disnea que aumentaba con el ejercicio moderado y obstrucción nasal, a pesar del tratamiento continuado. Los síntomas aparecieron primero tras un episodio agudo de dificultad respiratoria asociada con pérdida de peso, infiltrados pulmonares y eosinofilia. El flujo espiratorio punta (PEF) se midió durante el trabajo y los días de baja laboral. Se llevó a cabo prueba de provocación con acrilatos en cámara bronquial. Resultados: El PEF mejoró en los fines de semana y los días de baja laboral. El test de provocación dio lugar a una crisis de asma tardía. Después de la prueba, aumentó la hiperreactividad bronquial no específica. Al mismo tiempo, en las muestras de esputo se constató un aumento del contenido en eosinófilos

A adesão de pacientes portadores de glomerulopatias ao tratamento da equipe multidisciplinar: uma contribuição da Psicologia / Compliance of glomerulopathies affected patients to the multidisciplinary treatment team: a psychological contribution

O estudo teve como objetivo verificar junto a uma amostra de pacientes portadores de glomerulopatias, quais os possíveis fatores relacionados ao comportamento aderente e não-aderente bem como avaliar se determinadas variáveis de personalidade podem estar significativamente prevalentes em algum grupo(AU)

A adesão de pacientes portadores de glomerulopatias ao tratamento da equipe multidisciplinar: uma contribuição da Psicologia / Compliance of glomerulopathies affected patients to the multidisciplinary treatment team: a psychological contribution

O estudo teve como objetivo verificar junto a uma amostra de pacientes portadores de glomerulopatias, quais os possíveis fatores relacionados ao comportamento aderente e não-aderente bem como avaliar se determinadas variáveis de personalidade podem estar significativamente prevalentes em algum grupo.

[Validation of the SCOFF questionnaire for screening the eating behaviour disorders of adolescents in school]. / Validación del cuestionario SCOFF para el cribado de los trastornos del comportamiento alimentario en adolescentes escolarizadas.

OBJECTIVE: To determine the internal consistency and criteria validity of the SCOFF questionnaire for screening adolescent eating behaviour disorders. DESIGN: Validation study with stochastic sampling. SETTING: Three schools at Bucaramanga, Colombia. PARTICIPANTS: 241 students selected at random from 1595 possible ones. MAIN INTERVENTIONS: SCOFF questionnaire and semi-structured CIDI interview, administered independently. MAIN MEASUREMENTS: Social and personal details, Cronbach's alpha, sensitivity analysis, specificity, forecast values, Cohen mean kappa test, and ROC curve. RESULTS: Sensitivity found was 81.9% (95% CI, 70.7-89.7) and specificity, 78.7% (95% CI, 71.7-84.6). The area under the ROC curve was 0.8596 (95% CI, 0.8108-0.9084); the Cronbach's alpha test, 0.436, and the Cohen mean kappa, 0.554 (95% CI, 0.425-0.683). CONCLUSIONS: The SCOFF questionnaire is an acceptable alternative for screening groups of adolescents because of its simplicity and speed of administration.

Validación del cuestionario SCOFF para el cribado de los trastornos del comportamiento alimentario en adolescentes escolarizadas / Validation of the scoff questionnaire for screening the eating behaviour disorders of adolescents in school

Objetivo. Determinar la consistencia interna y la validez de criterio del cuestionario SCOFF en adolescentes para el cribado de los trastornos de la conducta alimentaria (TCA). Diseño. Estudio de validación con muestreo probabilístico. Emplazamiento. Tres colegios en Bucaramanga, Colombia. Participantes. Un total de 241 estudiantes seleccionadas al azar entre 1.595 elegibles. Intervenciones principales. Cuestionario SCOFF y entrevista semiestructurada CIDI, aplicados de manera independiente. Mediciones principales. Características demográficas, prueba alfa de Cronbach, análisis de sensibilidad, especificidad, valores predictivos, prueba kappa media de Cohen y curva ROC. Resultados. La sensibilidad encontrada fue del 81,9% (intervalo de confianza [IC] del 95%, 70,7-89,7) y la especificidad, del 78,7% (IC del 95%, 71,7-84,6). El área bajo la curva ROC fue de 0,8596 (IC del 95%, 0,8108-0,9084); la prueba alfa de Cronbach fue de 0,436 y la kappa media de Cohen, de 0,554 (IC del 95%, 0,425-0,683). Conclusiones. El cuestionario SCOFF es una alternativa aceptable para el cribado de grupos de población adolescente por su sencillez y rapidez de administración

Objective. To determine the internal consistency and criteria validity of the SCOFF questionnaire for screening adolescent eating behaviour disorders. Design. Validation study with stochastic sampling. Setting. Three schools at Bucaramanga, Colombia. Participants. 241 students selected at random from 1595 possible ones. Main interventions. SCOFF questionnaire and semi-structured CIDI interview, administered independently. Main measurements. Social and personal details, Cronbach’s alpha, sensitivity analysis, specificity, forecast values, Cohen mean kappa test, and ROC curve. Results. Sensitivity found was 81.9% (95% CI, 70.7-89.7) and specificity, 78.7% (95% CI, 71.7-84.6). The area under the ROC curve was 0.8596 (95% CI, 0.8108- 0.9084); the Cronbach’s alpha test, 0.436, and the Cohen mean kappa, 0.554 (95% CI, 0.425-0.683). Conclusions. The SCOFF questionnaire is an acceptable alternative for screening groups of adolescents because of its simplicity and speed of administration

Influencia del origen etnico sobre la sensibilidad a insulina, perfil lipidico en personas entre 18 y 39 años / Influence of ethnic origen on insulin sensivity, lipid profile of persons with 18 and 39 years old

Se observa en ciertos grupos étnicos, un riesgo alto de desarrollar enfermedades crónicas no transmisibles (ECnT) cuando los sujetos son sometidos a dieta de alta densidad calórica y estilo de vida sedentaria. Este hecho se asocia al desarrollo de resistencia a insulina en estas mismas poblaciones. La resistencia a insulina está ligada a enfermedad cardiovascular posiblemente a través de cambios en el metabolismo de lípidos. El objetivo de este estudio fue evaluar la asociación entre el grupo étnico con sensibilidad a insulina, características bioquímicas y antropométricas.A 113 sujetos entre 18-39 años se les realizó encuesta de antecedentes familiares, antropometría, test de tolerancia a insulina, genotipificación ApoE y determinación de glucosa y lípidos. Los resultados fueron sometidos a Análisis de Regresión Múltiple para cada uno de los grupos étnicos. TAG se asocian significantemente con edad, sensibilidad a insulina e IMC en etnia blanca (p=0.016), mestiza (p=0.040) e indígena (p=0.040). Sin relación significante con colesterol total y col-HDL, etnia, IMC, edad y sensibilidad a insulina. Resistentes a insulina 44 por ciento, porcentaje relativamente alto considerando que es un grupo de personas jóvenes. La distribución del genotipo ApoE es: 2/ 3=7 por ciento, 3/3=72 por ciento, 3/4=17 por ciento y 4/4=2 por ciento con alto porcentaje del alelo E4. Los datos sugieren que la sensibilidad a insulina es independiente del grupo étnico, IMC y edad. El análisis estadístico permite concluir: que en la etnia blanca la concentración de TAG está correlacionada con la sensibilidad a insulina, en los mestizos se correlaciona con el IMC y en los indígenas con la edad y sensibilidad a insulina. En el grupo étnico negro ninguna de estas variables está correlacionada con los TAG. En cada etnia existen situaciones de riesgo para perfiles alterados de lípidos que se sabe están asociados al desarrollo temprano de ECNT. Los resultados de este estudio pueden ser utilizados como base para el diseño de estrategias de prevención para mejorar la calidad de vida en el adulto

[Confirmed and suspected digoxin intoxications]. / Intoxicaciones digitálicas sospechadas y corfimadas.

AIMS: To quantify and analyze suspected and actual digoxin intoxications. METHOD: A drug-use study has been carried out of digoxinaemia requests and results in patients treated chronically with digoxin. RESULTS: Digoxin intoxication (presence of symptoms and typical signs) was suspected in 31.3% of the patients. The percentage analytically confirmed intoxications (digoxinaemia >2 ng/mL) was 16.6%. Sex, age, and dosage had no significant effect in the suspicion or confirmation of digoxin intoxication. Hospitalization and the association of hypokalaemic drugs or those increasing digoxinaemia had no effect in the suspicion of digoxin intoxication. In analytically confirmed intoxications, no significant differences were found between suspected and non-suspected cases. CONCLUSIONS: The suspicion of this intoxications is not usually related with digoxin serum levels, and thus, the toxic limit is imprecise.