Mexican and Spanish university students' Internet addiction and academic procrastination: Correlation and potential factors.

The 21st-century problem of Internet addiction is increasing globally, but especially among university students. Not surprisingly, then, problematic Internet use is associated with university students' academic procrastination. Because studies are scarce in Mexico and Spain has one of the highest rates of Internet addiction in Europe, this paper (i) analyzed the presence and degree of Internet addiction among university students in Mexico and Spain, (ii) determined potential sociodemographic factors influencing Internet addiction, and (iii) established the type of correlation between Internet addiction and academic procrastination. The cross-sectional study design used an online questionnaire to measure problematic Internet use and academic procrastination through convenience sampling at one university in Mexico and one in Spain. The questionnaire contained three sections: participants' sociodemographic data, the Internet Addiction Test, and the Academic Procrastination Scale. The final sample comprised 758 university students, 387 from Mexico, and 371 from Spain, aged from 18 to 35 (M = 20.08, SD = 3.16). Results revealed similar prevalence rates of problematic and daily Internet use for leisure, potentially influencing Internet addiction in all three models (i.e., Mexico, Spain, and Total). Additionally, significant positive correlation was revealed between problematic Internet use and academic procrastination (p < .001). Finally, findings showed relevant data on Internet addiction's prevalence in Mexican and Spanish university contexts, along with its influential sociodemographic factors.

HPV-based cervical cancer screening in Nicaragua: from testing to treatment.

BACKGROUND: In Nicaragua, cervical cancer is the leading cause of cancer death among women. Human papillomavirus (HPV) testing, primarily using self-sampling, was introduced between 2014 and 2018 in three provinces. We analyzed data from the HPV screening program with the goal of describing key characteristics including reach, HPV prevalence, triage and treatment, and factors associated with follow-up completion. METHODS: We analyzed individual-level data from routinely collected forms for women attending HPV-based cervical cancer screening. HPV-positive women were triaged with Pap or visual inspection with acetic acid (VIA) prior to treatment. Logistic regression was used to identify factors associated with receiving triage and treatment; analyses were adjusted for province, age, and self- vs. provider-collected sampling. RESULTS: Forty-four thousand six hundred thirty-five women were screened with HPV testing; 96.6% of women used self-sampling. Six thousand seven hundred seventy-six women were HPV positive (15.2%), 54.0% of screen-positive women received triage, and 53.1% of triage-positive women were treated, primarily with cryotherapy. If women lost at triage are included, the overall treatment percentage was 27.8%. Province and provider sampling were significantly associated with completing triage. Province and triage type were significantly associated with receiving treatment. The odds of receiving treatment after Pap triage as compared to VIA was significantly lower (aOR: 0.05, 95% CI: 0.04-0.08, p < 0.001), and the relative proportion of women receiving treatment after Pap triage versus VIA was 0.29. CONCLUSIONS: Introduction of HPV testing resulted in a substantial number of women screened, and acceptance of self-sampling was high. Management of screen-positive women remained a challenge, particularly with Pap triage. Our results can inform other developing countries as they work to reach World Health Organization (WHO) elimination targets.

Análisis cientimétrico de las publicaciones indexadas en journal citation reports sobre educación física / Análise cientométrica de publicações indexadas no journal citation reports sobre educação física / Scientometric analysis of publications indexed in journal citation reports on physical education

En los últimos años, la Educación Física se ha consolidado como una disciplina de estudio que acapara gran interés. Como consecuencia, la producción científica ha ido en aumento, reflejándose en la cantidad de artículos que se publican sobre el tema. El objetivo de este trabajo ha sido analizar la producción científica sobre Educación Física, indexada en Web of Science, desde sus inicios hasta el año 2017. Para ello, se ha realizado un estudio bibliométrico, recogiendo los indicadores de producción, dispersión e impacto de la producción científica en la Educación Física. Entre los resultados, se constata que la literatura se encuentra en una etapa de crecimiento exponencial. Además, desde los inicios de la producción científica, en 1902, sobre este tópico se han configurado determinadas revistas, instituciones, países y autores como referentes en la temática. Finalmente, el estudio ofrece una visión general del avance de las publicaciones de impacto sobre Educación Física

Nos últimos anos, a Educação Física se estabeleceu como um campo de estudo de grande interesse. Como consequência, a produção científica tem vindo a aumentar, o que se reflete na quantidade de artigos publicados sobre o assunto. O objetivo deste trabalho foi analisar a produção científica em Educação Física, indexada em Web of Science, desde o seu início até 2017. Para isso, foi realizado um estudo bibliométrico, reunindo os indicadores de produção, dispersão e impacto da produção científica na Educação Física. Dentre os resultados, observa-se que a literatura está em fase de crescimento exponencial. Além disso, desde o início da produção científica sobre esse tema, em 1902, alguns periódicos, instituições, países e autores foram configurados como referências no tema. Finalmente, o estudo fornece uma visão geral do progresso das publicações de impacto sobre Educação Física

In recent years, Physical Education has established itself as a field of study of great interest. Consequently, scientific production has been on the rise, reflected in the number of publications on the topic. This article analyzed scientific production on Physical Education indexed in Web of Science, from its beginnings until 2017. For this, a bibliometric study collected the indicators of production, dispersion and impact of the scientific production on Physical Education. Among the results, it found that the literature is in a stage of exponential growth. Furthermore, since scientific production on the topic began in 1902, certain journals, institutions, countries and authors have been established as benchmarks on the topic. Finally, the study reflects a general overview on the progress of impact publications on Physical Education

Alfabetización digital del profesorado de ciencias ambientales: un análisis de su competencia tecnológica / Digital literacy of environmental science teachers: an analysis of their technological competence

Introducción. En la actualidad el uso de los recursos tecnológicos en la educación es una práctica habitual e incluso de obligado cumplimiento. En la educación secundaria española la competencia digital es una de las habilidades clave que tienen que desarrollar los estudiantes. Este hecho se incrementa si tenemos en consideración que en el ámbito de las Ciencias Ambientales es primordial el uso sostenible de las TIC como factor para reducir el impacto medioambiental. Objetivo. Este trabajo tiene por objetivo analizar la competencia digital con base en el área de información y alfabetización informacional de los docentes de Ciencias Ambientales. Metodología. El estudio se centró en la provincia de Granada (España), contando con una muestra final de 106 profesores. La metodología empleada ha sido cuantitativa, utilizando como instrumento de recogida de datos el cuestionario. Resultados. Entre los resultados, se resalta el nivel satisfactorio en las diferentes subescalas competenciales del área de competencia digital analizada, estableciendo que el profesorado presenta un grado adecuado de formación tecnológica. Además, el modelo de ecuaciones estructurales verifica la correlación positiva entre las subescalas. Conclusión. Finalmente, el estudio sobre la competencia digital docente del profesorado de Ciencias Ambientales muestra una panorámica optimista en el desarrollo de competencias digitales en los estudiantes.

Introduction: Currently, the use of technological resources in education is a common and even mandatory practice. Digital competence is one of the key skills students have to develop in secondary education in Spain. Bearing in mind that in the field of Environmental Sciences the sustainable use of ICTs is essential as a factor in reducing environmental impact, this fact increases. Objective: This work aims to analyze digital competence based on the area of information and informational literacy of Environmental Science teachers. Methodology: This study focused on the province of Granada (Spain) with a final sample of 106 teachers. The methodology used was quantitative, using the questionnaire as a data collection instrument. Results: The satisfactory level in the different competence subscales of the area of digital competence analyzed is highlighted among the results, establishing that the teaching staff presents an adequate degree of technological training. In addition, the structural equation model verifies the positive correlation between the subscales. Conclusion: Finally, the study on the digital teaching competence of Environmental Science teachers shows an optimistic view on the development of digital competences in students.

Pacientes con morbilidad obstétrica grave de acuerdo con la Organización Mundial de la Salud, atendidas en un hospital de alta especialidad (2010-2016) / Patients with severe obstetric morbidity, according to the World Health Organization, atended at the high specialty hospital (2010 to 2016)

Resumen OBJETIVO: Estimar la morbilidad obstétrica grave y mortalidad materna en el Hospital Juárez de México. MATERIALES Y MÉTODOS: Estudio retrospectivo y transversal efectuado para evaluar los registros de pacientes con morbilidad obstétrica grave y la mortalidad materna, de acuerdo con los criterios de la OMS, atendidas en el Hospital Juárez de México de 2010-2016. Se analizaron las variables relacionadas con el diagnóstico, insuficiencia o disfunción orgánica y las intervenciones asociadas con el tratamiento. Se calculó la tasa de morbilidad materna extrema y obstétrica grave (Near Miss/total de embarazadas). Se utilizaron medidas de tendencia central y de dispersión. RESULTADOS: Se registraron 137 casos de morbilidad obstétrica grave y 26 de muerte materna. La mortalidad promedio fue de 5.78% y el índice de mortalidad de 0.415. Las principales causas de morbilidad materna grave y mortalidad fueron: hemorragia obstétrica, hipertensión asociada con el embarazo y sepsis. Se observó un incremento en los casos de morbilidad materna grave y disminución de la mortalidad materna en el periodo estudiado. CONCLUSIÓN: Se sugiere establecer un comité de evaluación y análisis de pacientes con morbilidad obstétrica grave para mejorar la calidad de atención y tratamiento, y disminuir la tasa de mortalidad materna.

Abstract OBJECTIVE: To determine how many cases of severe obstetric morbidity and maternal mortality were presented in 2010-2016, at the Hospital Juárez de México. MATERIALS AND METHODS: A retrospective, cross-sectional, observational study was carried out in cases of severe obstetric morbidity and maternal death were included according, to WHO criteria, attended in the Hospital Juárez de México from 2010-2016,. We included variables related to the diagnosis, with the organic failure or dysfunction and the interventions related to the management. The extreme maternal morbidity rate was calculated; obstetric (Near miss / Total pregnant). Measures of central tendency and dispersion were used. RESULTS: A total of 137 cases of severe obstetric morbidity and 26 of maternal deaths were registered. The mortality rate on average was 5.78% and death rate .415. The main causes of severe maternal morbidity and mortality were obstetric haemorrhage, hypertension associated with pregnancy and sepsis. There was an increase in cases of severe maternal morbidity and decrease in maternal death in the period studied. CONCLUSION: We suggest the establishment of a committee to evaluate and analyze cases of severe obstetric morbidity to improve the quality of care and treatment for this group of pregnant women, to reduce maternal death.

Estudio bibliométrico sobre la realidad virtual aplicada a la neurorrehabilitación y su influencia en la literatura científica / Bibliometric study about virtual reality applied to neurorehabilitation and its presence in scientific literature

Desde los años 90 la realidad virtual se ha aplicado en el ámbito de la salud para tratar fobias y trastornos mentales. Actualmente se utiliza para la neurorrehabilitación, ya que es capaz de engañar al cerebro y extrapolar al usuario a un mundo virtual. Dado el interés creciente por la temática, este trabajo tiene como objetivo analizar la producción científica en la Web of Science y Scopus sobre la realidad virtual aplicada a la neurorrehabilitación durante los últimos 10 años. Para esto, se ha empleado una metodología propia de los estudios bibliométricos a partir del establecimiento de una serie de palabras clave comprobadas en bases de datos y utilizadas por distintos autores en sus publicaciones. Se analizaron 8 variables siguiendo la línea de estudios previos: número total de documentos, producción por años, tipología de los archivos, títulos de las fuentes, instituciones, países, autores y artículos más citados. Entre los resultados se destaca el creciente interés de la temática a partir del año 2013 y el auge de la producción en el año 2016, así como la implicación de las principales potencias mundiales en la investigación y publicación sobre la realidad virtual para la rehabilitación. El análisis de los metadatos muestra un panorama incipiente en las publicaciones sobre la realidad virtual en el ámbito de la salud, donde Estados Unidos se destaca como el país con mayor producción científica(AU)

Ever since the 1990s virtual reality has been applied in healthcare to treat phobias and mental disorders, and is currently used for neurorehabilitation, as it is able to deceive the brain and extrapolate the user to a virtual world. Given the growing interest in the topic, this study aims to analyze the high-impact scientific production about virtual reality applied to neurorehabilitation included in the Web of Science and Scopus in the last 10 years. To achieve this end, a bibliometric methodology was used based on a number of keywords checked in databases and used by different authors in their publications. Eight variables were analyzed, in line with previous studies: total number of documents, production per year, document type, source title, affiliation, countries, authors and most cited articles. Among the results is the growing interest in the topic as of the year 2013 and the boom in production in 2016, as well as the involvement of the main world powers in research and publication about the use of virtual reality for rehabilitation. Finally, analysis of the metadata shows an incipient panorama in publications about virtual reality in healthcare, with the United States as the country with the greatest scientific production(AU)

Embarazo ectópico abdominal, presentación de un caso y revisión de la literatura / Abdominal ectopic pregnancy: case report and literature review

ANECEDENTES El embarazo ectópico abdominal es raro; con baja incidencia y ausencia de sintomatología especifica que dificulta el diagnóstico y no existan criterios para el diagnóstico y tratamiento. OBJETIVO se presenta un caso de embarazo intra-ligamentario de 16 semanas de gestación y se hacer una revisión de la literatura sobre el manejo y comparación de los resultados. CASO CLÍNICO Mujer de 32 años de edad, gestas 3 partos 2; desconoce fecha de ultima menstruación; y control de la fertilidad con condón; acude por presentar dolor abdominal, sin datos de irritación peritoneal; se le realiza ultrasonido y se diagnostica embarazo de 16 semanas con muerte fetal; con sospecha embarazo abdominal; se realiza laparotomía exploradora para extracción fetal, dejando la placenta in situ, y manejo con metotrexate dejando la placenta in situ y egresado al tercer día sin complicaciones. CONCLUSIÓN el embarazo abdominal es raro, de difícil diagnostico; que requiere la extracción quirúrgica y dejar la placenta in situ y manejo adyuvante con metrotexate; reportándose buenos resultados; pero, existe escasa información sobre la fertilidad futura.

BACKGROUND The abdominal ectopic pregnancy is rare; with low incidence and absence of specific symptomatology diagnosis difficult and there are no criteria for the diagnosis and treatment. OBJECTIVE a case of intra-ligament 16 weeks of gestation pregnancy occurs and a review of literature on the handling and comparison of results is done. CASE REPORT Female 32 years old, deeds 3 births 2; known last menstrual period; and fertility control with a condom; comes because of abdominal pain without peritoneal irritation; Ultrasound was performed 16 weeks pregnant and diagnosed with fetal death; abdominal suspected pregnancy; laparotomy for fetal extraction is performed, leaving the placenta in situ, and leaving management methotrexate placental site and discharged on the third day uncomplicated. CONCLUSION abdominal pregnancy is rare, difficult to diagnose; requiring surgical removal and leave the spot and adjuvant use with methotrexate placenta; good results being reported; but there is little information on future fertility.

[Profile dipper/non-dipper in patient with severe preeclampsia, eclampsia and HELLP syndrome during pregnancy and puerperium]. / Perfil dipper-no dipper en pacientes con preeclampsia severa, eclampsia y síndrome de Hellp durante el embarazo y puerperio.

BACKGROUND: Blood pressure (BP) has a circadian rhythm, decreases at night and increases in the morning (dipper), have been observed in patients with impaired in this profile, increased at night and lower in the morning (no dipper) have increased cardiovascular risk. Preeclampsia-eclampsia complicates about 7% of pregnancies, preeclampsia is known to reverse the normal circadian cycle of the BP. OBJECTIVE: To determine the profile dipper/non-dipper in patients with severe preeclampsia, eclampsia and HELLP syndrome patients in Intensive Care and Obstetrics Hospital Juárez of México. MATERIAL AND METHODS: 15 patients were reviewed, 10 with severe preeclampsia, 4 with HELLP syndrome and 1 eclampsia, systolic, diastolic, mean and pulse PA were analyzed during the day/night and pregnancy/postpartum. Using ratios pregnancy day/night pregnancy, puerperium day/night postpartum dipper/non-dipper profile is determined RESULTS: Maternal age 30 ± 6.34 years, 7 primiparous (46%) 8 multiparous (54%), pregnancy was 31.67 ± 4.59 weeks. In all but two results in the ratio of pulse pressure during pregnancy was not the result dipper raiser and did not change during the postpartum period. CONCLUSION: in all patients during pregnancy profile was observed no dipper no change during the postpartum period. The established treatment did not modify this result. So it is appropriate to establish strategies to change this behavior and try to get the patient to regain normal circadian BP rhythm.

[Primary cervical cancer screening]. / Detección primaria del cáncer cervicouterino.

Cervico-uterine cancer screening with cytology decrease incidence by more than 50%. The cause of this cancer is the human papilloma virus high risk, and requires a sensitive test to provide sufficient sensitivity and specificity for early detection and greater interval period when the results are negative. The test of the human papilloma virus high risk, is effective and safe because of its excellent sensitivity, negative predictive value and optimal reproducibility, especially when combined with liquid-based cytology or biomarkers with viral load, with higher sensitivity and specificity, by reducing false positives for the detection of cervical intraepithelial neoplasia grade 2 or greater injury, with excellent clinical benefits to cervical cancer screening and related infection of human papilloma virus diseases, is currently the best test for early detection infection of human papillomavirus and the risk of carcinogenesis.

[Serum hormones that regulate the reproductive axis in men with testicular germ cell cancer and its impact on fertility]. / Hormonas séricas que regulan el eje reproductor en el varón con cáncer germinal de testículo y su repercusión en la fertilidad.

BACKGROUND: Epidemiological studies treat testicular germ cancer as a single disease, the behavior of the two histological types of cancer; seminoma and nonseminoma have differences in reproductive hormone secretion and impair fertility differently. OBJECTIVE: To demonstrate that the serum concentration of pituitary hormones involved in fertility and spermatogenesis in the affected male is different in the two histological types. METHODS: Were determined by radioimmunoassay or inmunoradiometric assay, luteinizing hormone, follicle stimulating hormone, total testosterone, prolactin, estradiol, human chorionic gonadotropin and alpha fetoprotein in 37 patients with germ cell cancer (15 seminoma and 22 nonseminoma) and 35 controls. We analyzed the semen of patients, and were questioned about paternity before the cancer diagnosis. RESULTS: Age was higher in patients with seminoma cancer, showed decreased luteinizing hormone, follicle stimulating hormone, and testosterone and increased estradiol and prolactin in nonseminoma compared with seminoma. In patients with nonseminoma they had 9 children, 5 were oligozoospermic, 3 azoospermic and 6 normal concentration, 8 did not provide sample, seminoma group they had eight children, only one azoospermic, nine normal concentration, and 5 did not provide sample . CONCLUSIONS: The hormonal behavior is different in men with nonseminoma compared with seminoma, so that the negative impact on the reproductive axis and fertility is higher in cases of non-seminoma.

Antecedentes: los estudios epidemiológicos tratan al cáncer germinal de testículo como una sola patología, el comportamiento de los dos tipos histológicos: el seminoma y no seminoma tienen diferencias en la secreción de hormonas reproductivas y alteran la fertilidad de forma diferente. Objetivo: demostrar que la concentración sérica de las hormonas hipofisarias que intervienen en la fertilidad y espermatogénesis en el varón afectado es diferente en los dos tipos histológicos. Material y métodos: estudio clínico, prospectivo, transversal, comparativo de tres grupos de pacientes. Por medio de radioinmunoensayo o ensayo inmunorradiométrico se determinaron las concentraciones de: hormona luteinizante, hormona folículo estimulante, testosterona total, prolactina, estradiol, gonadotropina coriónica humana y alfa feto proteína en suero de 37 pacientes (15 seminoma, y 22 no seminoma) y 35 controles. Se analizó el semen de los pacientes y se les interrogó acerca de su satisfacción de paternidad antes del diagnóstico de cáncer. Resultados: los pacientes con cáncer tipo seminoma fueron de mayor edad, se encontró disminución de: hormona luteinizante, hormona folículo estimulante y testosterona; aumento de: estradiol y prolactina en cáncer no seminoma, en comparación con seminoma. En los pacientes con no seminoma 9 ya tenían hijos, 5 eran oligozoospérmicos, 3 azoospérmicos y 6 con concentración normal 8 no proporcionaron muestra; en el grupo de seminona, 8 ya tenían hijos, sólo 1 azoospérmico; 9 concentración normal, y 5 no proporcionaron muestra. Conclusiones: el comportamiento hormonal es diferente en los hombres con cáncer no seminoma en comparación con los de seminoma, por lo que la repercusión negativa en el eje reproductor y fertilidad es mayor en los casos de no seminoma.

[Giant cystic lymphangioma breast. Report of a case with 20-year follow-up and review of the literature]. / Linfangioma quístico gigante de mama. Reporte de un caso con seguimiento de 20 años y revisión de la bibliografía.

BACKGROUND: Lymphangiomas are congenital malformations or acquired (secondary to trauma, infection or neoplasia) in the mammary gland, are extremely rare. These lesions tend to infiltrate surrounding tissues and malignant degeneration is extremely rare. Clinically manifests as benign masses, slow growing; diagnosed clinically and by imaging studies. Suegery with removal of the mass is performed for aesthetic reasons and to make differential diagnosis with other common injuries. CLINICAL CASE: Women 45 years of age with progressive increase in size of the left breast, breast trauma concerns and has no other symptoms.The histologic diagnosis was cystic lymphangioma giant left mammary gland. DISCUSSION: Lymphangiomas are uncommon lesions and extremely rare in the mammary gland, locally aggresive behavior and are benign, where abnormal lymphatic tissue has some ability to proliferate and accumulate large amounts of liquid, representing cystic appearance, as presented in our case. Local surgical excision is the treatment. CONCLUSION: In this first case of giant breast cystic lymphangioma reported in Mexico, which corroborates the benignity of the lesion.

Antecedentes: los linfangiomas son malformaciones congénitas o adquiridas (secundarias a traumatismos, infecciones o neoplasias) de la glándula mamaria sumamente raras. Estas lesiones tienden a infiltrar los tejidos circundantes y la degeneración maligna es excepcional. Su manifestación clínica es en tumores benignos y de crecimiento lento. Se diagnostica clínicamente y por estudios de imagen. El tumor se extirpa por razones estéticas y para establecer el diagnóstico diferencial con otras lesiones más comunes. Caso clínico: paciente femenina de 45 años de edad, con incremento progresivo del tamaño de la mama izquierda, quizá originado por un traumatismo y no tiene otros sintomas. El diagnóstico histológico definitivo fue: linfangioma quístico gigante de la glándula mamaria izquierda. Discusión: los linfangiomas son lesiones extremadamente raras en la glándula mamaria, de comportamiento agresivo local y benignas. El tejido linfático anormal posee cierta capacidad de proliferar y de acumular grandes cantidades de líquido, lo que representa su apariencia quística, como sucedió en el caso aquí reportado. La extirpación quirúrgica local es el tratamiento indicado. Conclusión: este primer caso de linfangioma quístico gigante de mama reportado en México permite corroborar la benignidad de la lesión.

Increased serum levels of inflammatory mediators and low frequency of regulatory T cells in the peripheral blood of preeclamptic Mexican women.

Regulatory T cells (T(regs); CD4+CD25(high)Foxp3+) are critical in maintaining immune tolerance during pregnancy and uterine vascularization. In this study, we show that, in Mexican women with different preeclamptic severity levels, the number of T(regs) and the subset of CD4+CD25(high)Foxp3+ are decreased compared with those of normotensive pregnant women (NP). Moreover, a systemic inflammatory state is a pivotal feature in the pathogenesis of this disorder and could be related to hypertension and endothelial dysfunction. Likewise, we observed elevated levels of IL-6, TNF-α, and IL-8 in the serum of severe preeclamptic patients (SPE); no differences were found in the IL-1ß and IL-10 levels compared with those of NP patients. An analysis of chemokines in the preeclamptic serum samples showed high levels of CXCL10, CCL2, and CXCL9. Our findings suggest that the preeclamptic state is linked with systemic inflammation and reduced numbers of T(regs).

[The religious aspects of maternal mortality at the time of the Aztecs. Cihuateteo: dead women at first birth]. / Aspectos religiosos de la mortalidad materna en la época de los aztecas. Cihuateteo: las mujeres muertas en el primer parto.

Women who die during pregnancy or childbirth, the Aztec goddess regarded with the same value that was given to the warriors who died on the battlefield, accompanied the sun during its journey through the land, but were also feared and regarded as witches who could fly and cause damage and disease to children, could occupy bodies and produce paralysis, at the funeral the relatives of the Cihuateteo should take care of the woman's body because there was a possibility that parts of soldiers stealing him to gain courage in battle. The governing Cihuateteo magical occupations of women.

[Clinic characteristics of patients with trophoblastic gestational disease complicate with hypertension]. / Características clínicas de pacientes con enfermedad trofoblástica gestacional complicada con enfermedad hipertensiva.

BACKGROUND: The molar pregnancy is complicated with hypertension before 20 weeks, divided into complete mole and partial mole, and in diploid and triploid hydatidiform mola depending on the fetal chromosomes. OBJECTIVE: To determine clinical and laboratory characteristics of patients with hydatidiform mole with and without hypertension, and choriocarcinoma, correlate serum chorionic gonadotropin (hCG) and hypertension. MATERIAL AND METHODS: We reviewed 55 cases with histopathologically proven mole, separately analyzed clinical, laboratory and hCG. RESULTS: The prevalence of mole with hypertension was 1:7; with the choriocarcinoma is 1:11. The age and sexual initiation of mole with hypertension was higher (p = .004 and .002 respectively), liver transaminase AST (p =. 004) and lactate dehydrogenase are higher in the group with hypertension (p =. 000). Positive correlation was obtained r = .246 p =. 044 statistically significant between mean arterial pressure and hCG. We reviewed 31 cases of 28 national and international articles, in patients with diploid hydatidiform the product is allowed to live normal and high blood pressure is showing mild preeclampsia, while partial moles are triploid, malformed products, incompatible with life and with hypertension severe like severe pre-eclampsia. CONCLUSIONS: The molar pregnancy is partially diagnosed with hypertension in our environment, is not properly analyzed and that most of the products of curettage were not performed genetic testing. The hCG probably participate in the hypertensive disorders of pregnancy.

[Amputation level after frostbite: role of bone scan. A case report]. / Nivel de amputación tras lesiones por congelación: papel de la gammagrafía ósea. Reporte de un caso.

BACKGROUND: frostbite is defined as the damage sustained by tissues while subject to temperatures below their freezing point. The severity of tissue damage is variable, but frequently can result in amputation. Early surgical debridement is contraindicated in almost all patients because it can take weeks for definitive demarcation of non-viable tissues to occur. Bone scan is indicted in the evaluation of frostbite injuries and helps to establish the prognosis early. CLINICAL CASE: a 42 year old man suffered frostbite injury in the fingers and toes after more than 24 hours at 8,000 meters of altitude. The patient was treated with anticoagulant therapy and topical cures for six weeks. During this period, we performed two consecutive bone scan studies showing no changes in the level of vascularization. However, clinical improvement was important, devitalized tissues delimited to the level marked by the bone scan study, so amputation was performed. CONCLUSION: Because the bone scan remained invariable, we believe that could help us to determine the amputation level early without delaying surgery.

Antecedentes: la congelación es el daño sufrido por los tejidos cuando se someten a temperaturas inferiores a su punto de congelación. La gravedad de las lesiones es variable, pero con frecuencia termina en amputación. El desbridamiento quirúrgico temprano está contraindicado en la mayoría de los casos porque la demarcación de los tejidos viables tarda en producirse. La gammagrafía ósea está indicada para la evaluación de las lesiones por congelación y ayuda a establecer el pronóstico temprano. Caso clínico: paciente varón de 42 años, con lesiones por congelación en los dedos de las manos y los pies, tras permanecer más de 24 horas a 8,000 metros de altitud. Durante seis semanas se administró tratamiento anticoagulante y se realizaron curas tópicas. En este periodo se practicaron dos estudios gammagráficos consecutivos, sin apreciarse cambios en la vascularización. Sin embargo, la mejoría clínica fue importante, delimitándose el tejido desvitalizado hasta el nivel marcado por el estudio gammagráfico, por lo que se realizó la amputación. Conclusión: puesto que la gammagrafía ósea permaneció invariable, consideramos que puede ayudar a determinar de forma temprana el nivel de amputación, sin tener que demorar la cirugía.

[Fertility and testicular function in a patient with germ cell extragonadal tumor. A report of a case]. / Fertilidad y función testicular en un paciente con tumor extragonadal de células germinales. Comunicación de un caso.

Males are affected from primary extragonadal germ cell tumors with a frequency of 2 to 5%. There is a high incidence of infertility of more than 60% and most of the cases have azoospermia due to testicular damage. The hormonal profile of these patients shows normal luteinizing hormone, normal follicle stimulating hormone and normal testosterone and estradiol. We communicate the case of a male who had a primary retroperitoneal germ cell tumor with a low title of chorionic gonadotropin, elevated estradiol and normal testosterone, prolactin and seminogram. Before beginning treatment with chemotherapy, his wife became pregnant delivering twins, both males. The patient was treated with chemo and radiotherapy after which he became azoospermic with an increase in both luteinizing hormone and follicle stimulating, decreased levels of estradiol and without alteration in prolactin and testosterone. The pituitary testicle axis was affected by the tumor, but the microenvironment of the testicles did not seem to be damaged only after initiating treatment.

[Epidemiological analysis of infertility in a Mexican population]. / Análisis epidemiológico de la infertilidad en una población mexicana.

BACKGROUND: Infertility is defined as the failure to conceive after a year of sexual life without a method of birth control. Most studies indicate that 15% of all couples will experience primary or secondary infertility in some moment of their reproductive life. OBJECTIVE: To gain knowledge of general characteristics from patients with infertility in our environment (social, clinical, diagnostic and therapeutic) that attended the Reproductive Biology Department of Hospital Juárez de Mexico. PATIENTS AND METHODS: A descriptive, observational, situational, and retrospective indagatory study was performed on 116 infertile patients, seen in the outpatient clinic, from January through December 1999. All had entered our protocol of infertility and selected treatment. RESULTS: The altered ovarian endocrine factor was the most frequent (82.7%), followed by cervical factor (80%), masculine factor (38%) and tuboperitoneal factor (29%). In most cases the cause was multifactorial. The percentage of successful pregnancies (31.88%) was similar to that reported in the literature. CONCLUSIONS: The most common factors that influence infertility resembled those exhibited by specialized clinics of affluent countries with similar pregnancy rates.

[Heterosexual precocious puberty due to arrhenoblastoma. Postsurgical spontaneous pregnancy]. / Pubertad precoz heterosexual por arrenoblastoma: embarazo espontáneo postescisión.

It is presented the case of a female with heterosexual precocious puberty associated to hyperandrogenism and virilization due to arrhenoblastoma, who became pregnant after surgery. Clinical study: a 14-year-old female initiated at age 6 years with premature pubarche and telarche. By age 11, the patient only had one menstrual period along with virilization. Physical exam disclosed: facial acne, cricoid enlargement, breast Tanner II, pubic hair Tanner III, clitoromegaly of 4.5 cm and hypotrophy of labia majora. Ferriman and Gallwey: 12. Basal quantitation of circulating testosterone: 1.25 ng/mL (normal: 0.2 to 0.8 ng/mL), androstenedione 13.9 ng/mL (normal: 0.5 to 2.4 ng/mL). A pelvic ultrasonographic study showed: uterus of 66 x 25 x 30 mm, right ovary of 50 x 50 mm, hyperechoic with echolucid and nodular areas (vol. 65.3 cc). Left ovary was of 30 x 30 mm with echolucid areas of 2.0 mm (vol. 5.1 cc). Cariotype: 46XX. Surgical right oophorectomy was performed containing an ovoid tumor of 4 x 3 x 3 cm. Histologic analysis revealed a Sertoli Leydig (Type II, Mayoer) cell tumor. The patient resumed menses and became pregnant at age 20 (22 week obitus). In the last assessment, performed 6 years after surgery, the patient resumed normal menses, Ferriman and Gallwey 5, Tanner V and regression of clitoromegaly to 3.0 cm. In this case, surgery provided remission of hyperandrogenism, normal menstrual cycles and fertility restoration.

[Craniopharyngioma and its impact upon human reproduction: analysis of 15 cases at the Hospital Juarez de Mexico]. / Craneofaringioma y sus repercusiones en la reproducción humana: análisis de 15 casos en el Hospital Juárez de México.

BACKGROUND: Craniopharyngiomas are intracranial tumors of non-glial origin derived from cellular remnants of the Rathke's pouch. Their frequency is 1-3% of intracranial tumors and 13% of suprasellar neoplasms. Histologically, it is a benign lesion, albeit clinically severe with a high index of relapse and sequelae upon the reproductive function. OBJECTIVE: To identify the clinical characteristics of patients with craniopharyngiomas before and after treatment. MATERIAL AND METHODS: We reviewed our experience of 15 cases with craniopharyngioma seen at the Hospital Juarez de Mexico from 1995 throughout 2002. RESULTS: Prevalence was higher in males (ratio 2:1) with ages between 6-45 years old (X 17.9 +/- 6.45 years). The most common symptoms were cephalalgia (100%) and visual disorders (93%); the average levels of hormonal determination were in females: FSH 1.0 mIU/mL, LH 0.5 mIU/mL, estradiol 11.0 pg/mL, PRL 80 mg/mL. In males: FSH 1.7 mIU/mL, LH 2.6 mIU/mL, testosterone 0.6 mg/dL and PRL 29 mg/mL. All patients had hypogonadotropic hypogonadism. Tumoral relapse was mostly seen in patients who underwent only surgery (n = 7, 46.6%). The ones with surgery and radiotherapy (n = 8, 53.3%) did not disclose symptoms that required another surgery. CONCLUSIONS: The main repercussion of craniopharyngioma, due to its proximity to hypothalamus and hypophysis, is on the endocrine and reproductive areas of human being.

Enfermedad facetaria lumbar. Análisis clínico de una serie de 37 pacientes con dolor lumbar tratados con bloqueo facetario lumbar / Lumbar facet disease. Clinical analysis of a series of 37 patients with low back pain treated with lumbar facet block

Objetivo: El dolor lumbar es una patología común cuyo origen multifactorial hace participar las estructuras articulares que son sometidas al proceso degenerativo desencadenado por el alto esfuerzo biomecánico de esta zona. El objetivo de este trabajo es presentar el síndrome facetario lumbar como una causa de dolor lumbar que puede ser diagnosticada y tratada con bloqueos articulares selectivos. Materiales y metodos: Fueron 37 pacientes que consultaron por dolor lumbar, sin radiculopatia y con características clínicas y gamagráficas sugestivas de un Síndrome Facetario Lumbar. Se realizaron un total de 63 bloqueos selectivos de una o varias articulaciones facetarias. El procedimiento fue realizado por el mismo observador (JCA) quien utilizó la técnica bajo visión fluoroscopia o bajo TAC, dirigido al espacio inter-articular o al ramo interno de la raíz dorsal. El análisis incluyo una evaluación clínica a los 8 días y a las 4 semanas del último procedimiento. Resultados: El análisis demostró como 83.7% de los pacientes tuvieron una mejoría en al menos 5 puntos de la escala visual análoga en el último control con respecto a la valoración inicial. Entre ellos, 15 (40.1 %) tuvieron una mejoría superior o igual a 8 puntos de la escala visual análoga. Conclusiones: Las articulaciones facetarias son una estructura anatómica con características particulares que la hacen un elemento generador de dolor. Su diagnóstico clínico y gamagráfico acompañado de bloqueo selectivo bajo visión radiológica permite obtener resultados clínicos interesantes.