bluuebunny/crossref_metadata_2025 huggingface dataset:
The health economic benefits of perioperative patient warming for prevention of blood loss and transfusion requirements as a consequence of inadvertent perioperative hypothermia
Authors: Ingram Andy , Harper Mark
Published: June 2018

Active warming of patients is recommended by The National Institute for Health and Care Excellence (NICE) to prevent inadvertent perioperative hypothermia (IPH). This paper examines the cost effectiveness of one consequence of IPH, an increase in blood loss and the resulting transfusion risk. We quantified the risk and modelled two patient pathways, one with and one without warming, across two different surgery types. We were able to demonstrate the cost effectiveness of active warming based on one consequence even allowing for uncertainties in the model.
Left Atrial Appendage Aneurysm Characterized by Multimodal Imaging
Authors: Brenneman David J. , Pitkin Andrew D. , Gupta Dipankar , Bleiweis Mark S. , Reyes Karl M. , Chandran Arun
Published: June 2018

We present a four-year-old female with an incidental finding of a congenital left atrial appendage aneurysm who underwent surgical resection with excellent results. This case highlights the importance of multimodal imaging in the diagnosis and characterization of this rare condition.
The Racial Position of European Immigrants 1883–1941: Evidence from Lynching in the Midwest
Authors: Rigby David , Seguin Charles
Published: June 2018

The racial position of European immigrants in the nineteenth and early twentieth centuries vis-à-vis blacks and whites is debated. Some argue that many European immigrant groups were initially considered nonwhite, while others argue that they were almost always considered white, if sometimes still from a distinct intrawhite racial category. Using a new dataset of all lynchings in the American Midwest from 1883 to 1941, we explore differences in collective violence enacted upon three groups: native-born whites, blacks, and European immigrants. We find that European immigrants were lynched in ways, and at rates, much more similar to that of native whites than to those of blacks. Blacks in the Midwest were lynched at roughly 30 times the rate of native-born whites and European immigrants, and were sometimes ritually burned in massive “spectacle lynchings” while native whites and European immigrants were never burned. We find suggestive evidence that European immigrants were perceived to have posed threats to the political order. Our results suggest that, in the American Midwest, despite nativist othering, European immigrants were fully on the white side of the color line, and were protected from collective violence by their white status.
The “Cold Open” as a Method for Launching a Course
Authors: O’Brien James
Published: June 2018

The “cold open” is a literary technique that can be usefully adapted for management education, particularly as an opening exercise on the first day of class. Specifically, this approach includes presenting a carefully chosen problem to the class without preamble, providing students an opportunity to work on the problem, and perhaps most important, conducting a debrief that is focused on schema construction for the course and that identifies and builds on the current level of understanding on the part of the students. The “cold open” allows the instructor to begin to surface concepts that support the construction of schema, which is in turn linked to transfer of learning and the emergence of expertise. This article includes a worked example of “cold open,” including debriefing questions, and additional sample problems for instructors who wish to incorporate this technique into their teaching repertoires.
UNICEF’s Urban Basic Services Programme in Illegal Settlements in Guatemala City
Authors: Espinosa Lair , Rivera Oscar A. López
Published: June 2018

This article describes the Urban Basic Services Programme that UNICEF’s Guatemala Office developed in Guatemala City between 1984 and 1993. Working initially with other NGOs and subsequently with government agencies, the programme developed a variety of community based, community directed initiatives for water, sanitation and drainage, housing improvement, health promotion, health care and child development in the illegal or informal settlements in which close to half of Guatemala City’s population live. The programme included an innovative network of health promoters elected from their own community and new models of community based day care.
The endothelial tumor suppressor p53 is essential for venous thrombus formation in aged mice
Authors: Bochenek Magdalena L. , Bauer Tobias , Gogiraju Rajinikanth , Nadir Yona , Mann Amrit , Schönfelder Tanja , Hünig Leonie , Brenner Benjamin , Münzel Thomas , Wenzel Philip , Konstantinides Stavros , Schäfer Katrin
Published: June 2018

Key Points

Deletion of p53 in endothelial cells prevents venous thrombosis in aged, but not in adult, mice. Neutralization of heparanase in aged mice using TFPI2 peptides restores the thrombotic phenotype of adult mice.
Full-waveform inversion in acoustic orthorhombic media and application to a North Sea data set
Authors: Masmoudi Nabil , Alkhalifah Tariq
Published: June 2018

Full-waveform inversion (FWI) in anisotropic media is challenging, mainly because of the large computational cost, especially in 3D, and the potential trade-offs between the model parameters needed to describe such media. By analyzing the trade-offs and understanding the resolution limits of the inversion, we can constrain FWI to focus on the main parameters the data are sensitive to and push the inversion toward more reliable models of the subsurface. Orthorhombic anisotropy is one of the most practical approximations of the earth subsurface that takes into account the natural horizontal layering and the vertical fracture network. We investigate the feasibility of a multiparameter FWI for an acoustic orthorhombic model described by six parameters. We rely on a suitable parameterization based on the horizontal velocity and five dimensionless anisotropy parameters. This particular parameterization allows a multistage model inversion strategy in which the isotropic, then, the vertical transverse isotropic, and finally the orthorhombic model can be successively updated. We applied our acoustic orthorhombic inversion on the SEG-EAGE overthrust synthetic model. The observed data used in the inversion are obtained from an elastic variable density version of the model. The quality of the inverted model suggests that we may recover only four parameters, with different resolution scales depending on the scattering potential of these parameters. Therefore, these results give useful insights on the expected resolution of the inverted parameters and the potential constraints that could be applied to an orthorhombic model inversion. We determine the efficiency of the inversion approach on real data from the North Sea. The inverted model is in agreement with the geologic structures and well-log information.
Exploring viable geologic interpretations of gravity models using distance-based global sensitivity analysis and kernel methods
Authors: Phelps Geoff , Scheidt Celine , Caers Jef
Published: June 2018

ABSTRACT

We have explored ways to integrate alternative geologic interpretations into the modeling of gravity data. These methods are applied to the Vaca Fault east of Fairfield, California, USA, where the structure across the fault is in question, and the Vaca Fault is used as a case study to demonstrate the method. The Vaca Fault is modeled using gravity data collected along a 10 km line perpendicular to the strike of the fault. Of particular interest is how the gravity data might inform on the dip of the Vaca Fault and thickness of the nonmarine section and whether spatial autocorrelation of density internal to the geologic units significantly influences the resulting gravity anomaly. We approach these questions by creating a suite of structural geologic models, which we then populate with geostatistically generated densities and from which the respective synthetic gravity anomalies are calculated. We perform distance-based generalized sensitivity analysis to identify which model inputs most leverage the calculated gravity anomaly. We then use multidimensional scaling to transform the gravity anomalies into a metric space and estimate the posterior probabilities of each structural geologic model using a Bayesian approach. We find that the gravity anomalies are particularly sensitive to zones of autocorrelated density values generated from geostatistical modeling. The structural geologic models most likely to produce gravity anomalies that match the observed data are the moderately dipping normal faults, 45° and 60°, although the probability that the fault dips more steeply, including in a strike slip or reverse fault orientation, is approximately 30%. The probability of a thicker nonmarine unit is 67%, more probable than a thinner nonmarine unit. This suggests that the Vaca Fault dips moderately to the east and truncates a thicker nonmarine unit, but that any further process modeling should include alternatives of the geologic structures.
Sleep disorders in psychiatry
Authors: Selsick Hugh , O'Regan David
Published: June 2018

Sleep medicine is a truly multidisciplinary field that covers psychiatric, neurological and respiratory conditions. As the field has developed it has become increasingly clear that there is a great deal of overlap between sleep and psychiatric disorders and it is therefore essential for psychiatrists to have some knowledge of sleep medicine. Even those disorders, such as obstructive sleep apnoea, that may seem to be outside the remit of psychiatry can have complex and important interactions with psychiatric conditions. In this article we give a brief overview of the range of sleep disorders a psychiatrist might encounter, how they are recognised, investigated and treated, and how they relate to psychiatric conditions.

LEARNING OBJECTIVES

•

Be aware of the range of sleep disorders that might be encountered in psychiatric practice

•

Understand how these sleep disorders affect mental health

•

Have a broad understanding of how these disorders are investigated and treated

DECLARATION OF INTEREST

H.S. has accepted speaker fees from Janssen Pharmaceuticals.
Integrative Therapies During and After Breast Cancer Treatment: ASCO Endorsement of the SIO Clinical Practice Guideline
Authors: Lyman Gary H. , Greenlee Heather , Bohlke Kari , Bao Ting , DeMichele Angela M. , Deng Gary E. , Fouladbakhsh Judith M. , Gil Brigitte , Hershman Dawn L. , Mansfield Sami , Mussallem Dawn M. , Mustian Karen M. , Price Erin , Rafte Susan , Cohen Lorenzo
Published: June 2018

Purpose

The Society for Integrative Oncology (SIO) produced an evidence-based guideline on use of integrative therapies during and after breast cancer treatment that was determined to be relevant to the American Society of Clinical Oncology (ASCO) membership. ASCO considered the guideline for endorsement.

Methods

The SIO guideline addressed the use of integrative therapies for the management of symptoms and adverse effects, such as anxiety and stress, mood disorders, fatigue, quality of life, chemotherapy-induced nausea and vomiting, lymphedema, chemotherapy-induced peripheral neuropathy, pain, and sleep disturbance. Interventions of interest included mind and body practices, natural products, and lifestyle modifications. SIO systematic reviews focused on randomized controlled trials that were published from 1990 through 2015. The SIO guideline was reviewed by ASCO content experts for clinical accuracy and by ASCO methodologists for developmental rigor. On favorable review, an ASCO Expert Panel was convened to review the guideline contents and recommendations.

Results

The ASCO Expert Panel determined that the recommendations in the SIO guideline—published in 2017—are clear, thorough, and based on the most relevant scientific evidence. ASCO endorsed the guideline with a few added discussion points.

Recommendations

Key recommendations include the following: Music therapy, meditation, stress management, and yoga are recommended for anxiety/stress reduction. Meditation, relaxation, yoga, massage, and music therapy are recommended for depression/mood disorders. Meditation and yoga are recommended to improve quality of life. Acupressure and acupuncture are recommended for reducing chemotherapy-induced nausea and vomiting. Acetyl-l-carnitine is not recommended to prevent chemotherapy-induced peripheral neuropathy because of a possibility of harm. No strong evidence supports the use of ingested dietary supplements to manage breast cancer treatment–related adverse effects. Additional information is available at: www.asco.org/supportive-care-guidelines .
Radiation biology and oncology in the genomic era
Authors: Kerns Sarah L. , Chuang Kuang-Hsiang , Hall William , Werner Zachary , Chen Yuhchyau , Ostrer Harry , West Catharine , Rosenstein Barry
Published: June 2018

Radiobiology research is building the foundation for applying genomics in precision radiation oncology. Advances in high-throughput approaches will underpin increased understanding of radiosensitivity and the development of future predictive assays for clinical application. There is an established contribution of genetics as a risk factor for radiotherapy side effects. An individual’s radiosensitivity is an inherited polygenic trait with an architecture that includes rare mutations in a few genes that confer large effects and common variants in many genes with small effects. Current thinking is that some will be tissue specific, and future tests will be tailored to the normal tissues at risk. The relationship between normal and tumor cell radiosensitivity is poorly understood. Data are emerging suggesting interplay between germline genetic variation and epigenetic modification with growing evidence that changes in DNA methylation regulate the radiosensitivity of cancer cells and histone acetyltransferase inhibitors have radiosensitizing effects. Changes in histone methylation can also impair DNA damage response signaling and alter radiosensitivity. An important effort to advance radiobiology in the genomic era was establishment of the Radiogenomics Consortium to enable the creation of the large radiotherapy cohorts required to exploit advances in genomics. To address challenges in harmonizing data from multiple cohorts, the consortium established the REQUITE project to collect standardized data and genotyping for ~5,000 patients. The collection of detailed dosimetric data is important to produce validated multivariable models. Continued efforts will identify new genes that impact on radiosensitivity to generate new knowledge on toxicity pathogenesis and tests to incorporate into the clinical decision-making process.
Contracts for Healthcare Referral Services: Coordination via Outcome-Based Penalty Contracts
Authors: Adida Elodie , Bravo Fernanda
Published: June 2018

This work focuses on the business-to-business interaction between a service requester and a service provider in a healthcare environment. The requester is the primary caregiver responsible for managing the health of a population of patients. When a patient requires advanced care outside of the requester’s expertise, the requester refers the patient to a provider and pays for the referral services. Treatment may succeed or fail, and in the case of failure, the requester incurs further follow-up costs. The requester may exert preventive effort to reduce the volume of referrals. The provider may exert nonreimbursable effort to reduce the chance of treatment failure. We analyze payment contracts between the two firms. We find that fee-for-service (FFS) induces neither system nor social optimum effort outcomes. However, a penalty contract can generally coordinate the effort decisions with either the system optimum or the social optimum. Furthermore, we find that patients may benefit from having a coordinating contract replace FFS. However, the types of procedures that make a coordinating contract most advantageous for the requester and provider are not necessarily the same as those that make the patients better off than under FFS. Yet, in most cases, the coordinating contract improves social welfare, as compared to FFS, and brings it close to the social optimum. Hence, the requester–provider coordinating contract can be considered as an improvement over FFS for the entire system.

The online appendix is available at https://doi.org/10.1287/mnsc.2017.3000 .

This paper was accepted by Serguei Netessine, operations management.
Does Transparency Stifle or Facilitate Innovation?
Authors: Brown James R. , Martinsson Gustav
Published: June 2018

Corporate transparency reduces information asymmetries between firms and capital markets but increases the costs associated with information leakage to competitors. We explore how a country’s information environment affects innovation, an activity characterized by high information asymmetries and potentially severe proprietary costs. Studying both long-run cross-country differences in the availability of firm-specific information to corporate outsiders, as well as quasi-experimental shocks to the information environment following transparency-enhancing security market reforms, we document significantly higher rates of R&D and patenting in richer information environments. The effects of transparency are strongest in industries that rely on external equity rather than bank debt, indicating that transparency facilitates innovation by reducing the information costs associated with arm’s-length financing. In contrast, transparency has no impact on physical capital accumulation, consistent with fewer information asymmetries in tangible assets. An economy’s information environment has important but heterogeneous effects on the nature and extent of real economic activity.

This paper was accepted by Shiva Rajgopal, accounting.
Power-assisted exercise for people with complex neurological impairment: a feasibility study
Authors: Young Rachel Elizabeth , Richards Emma , Darji Neha , Velpula Suchitra , Goddard Sara , Smith Christine , Broom David
Published: June 2018

Background/Aims:

Participation in physical activity and exercise presents a challenge for adults with complex neurological impairment. Power-assisted exercise facilitates combined limb and trunk movement and may be an option for people with movement impairment. The aim of this study was to determine whether power-assisted exercise is a feasible activity option for people with complex neurological impairment.

Methods:

Seven adults with complex neurological impairment were recruited to take part in a 4-week programme of twice weekly power-assisted exercise. Programme attendance and completion was recorded and adverse events or effects documented. Mobility was monitored using the Timed Up and Go test (TUG). Upon completion of the programme, participants were interviewed regarding their experience of using the equipment.

Findings:

All seven participants completed the programme and the overall attendance was 96%. No adverse events occurred; two participants reported minor adverse effects, which were temporary. The TUG scores improved and participants enjoyed the programme, reporting perceived benefits in physical function and wellbeing.

Conclusions:

The findings of this study demonstrate that people with complex neurological impairment can participate in a programme of power-assisted exercise. Reported improvements in physical mobility suggest that further research in this area is indicated.
Training healthy persons and individuals with Parkinson's disease to use Xbox Kinect games: a preliminary study
Authors: Dantas Isabela Viana , Leal Josevan Cerqueira , Hilgert Luiza Saboya , Allegretti Ana Luiza Caltabiano , Dos Santos Mendes Felipe Augusto
Published: June 2018

Background/Aims:

Individuals with Parkinson's disease, besides the motor and cognitive symptoms may even present deficits in the motor learning. A recent therapeutic approach involves virtual reality that offers elements that can minimize the difficulties in the learning process. Recently, the therapeutic potential of Nintendo Wii® gaming device for rehabilitation of patients with Parkinson's disease has been showing positive results, but studies related to the use of the Kinect for XboxTM are still scarce. The present study aimed to investigate the effects of motor and cognitive demands of six Kinect for Xbox 360TM games on the learning of patients with Parkinson's disease, comparing it with healthy individuals.

Methods:

A total of 19 adults, 8 with idiopathic Parkinson's disease and 11 healthy adults participated in a program which included 10 training sessions and had their scores registered three times.

Findings:

The results showed that in four of those games, patients with Parkinson's disease showed an ability to improve and keep their performance, but not in the other two games, similar to healthy adults.

Conclusions:

It was concluded that motor and cognitive abilities affected by Parkinson's disease may be improved with the use of virtual training proposed in this study. Some of the games and gaming devices features can influence the learning process, even in healthy adults.
‘Pinball kids’ at higher risk of exclusion, gangs and grooming
Authors: Henshaw Pete
Published: June 2018

Warning about the children in care who are ‘pinging’ around the system with frequent changes to home, school and social workers
Do you dread Shakespeare lessons?
Authors: Bumford Danielle
Published: June 2018

Danielle Bumford describes education's love-hate relationship with teaching Shakespeare and how she has overcome this using the Playing Shakespeare project
Preliminary list of Coleoptera heritage species of the Talassemtane National Park, Morocco
Authors: Benyahia Yousra , Brustel Hervé , El Antry Salwa , Courtin Olivier , Maatouf Noureddin , Valladares Lionel , Rohi Latifa
Published: June 2018

A faunistic survey on beetles was conducted within the Talassemtane National Park (Western Rif, District of Chefchaouen), in order to improve knowledge of their local diversity, to assess species and provide the first list of heritage species. This is an inventory that took place for 3 consecutive years (2013-2015). Out of 550 species identified so far, 137 are processed in this document, which lists heritage species: 67 endemic to Morocco, 20 rare saproxylic and 48 species new to Morocco, including two new to science.
Planeamento de alta hospitalar: perspetivas e reflexões acerca dos protelamentos sociais em Portugal
Authors: Santo Ines Espirito , Ferreira Fatima Marisol
Published: June 2018

Introdução: O objetivo deste artigo é compreender e analisar o fenómeno dos protelamentos sociais em Portugal e em particular do Centro Hospitalar Lisboa Central. Material e Métodos: Mediante uma análise descritiva e interpretativa pretende-se analisar analogamente os resultados ao nível nacional e em particular dos protelamentos sociais no período de janeiro a dezembro de 2016. Para a análise dos protelamentos do CHLC foi criada uma folha de registo específica para recolha dos seguintes parâmetros: o perfil do utente, as causas do protelamento e o destino no após alta. Resultados: Os dados demonstram que a realidade dos protelamentos sociais do CHLC em muito se assemelha ao quadro nacional dos restantes hospitais do país. No ano de 2016, foram registados 171 doentes com alta protelada por razões sociais, representando 4,2% dos doentes que originaram episódio social de internamento. No total, permaneceram nesta situação durante 4080 dias perfazendo uma média de 23,8 dias. Discussão: Embora a intervenção atempada, organizada e eficaz do assistente social seja determinante para a efetivação da alta hospitalar, existem um conjunto de causas internas e externas que poderão impedir que a alta clinica seja coincidente com a alta social e consequentemente evitar os protelamentos sociais.
Tapas de publicidad. Introducción y fundamentos
Authors: Rom-Rodríguez Josep-A.
Published: June 2018

Tapas de publicidad. Este libro es una introducción al mundo de la publicidad. Se dirige especialmente a quien se inicia en los estudios o en la profesión. Su estructura, inspirada en un menú gastronómico, incluye: Aperitivos (preguntas frecuentes y estereotipos), Entrantes (conceptos, marketing, técnicas, historia y actualidad), Platos principales (el proceso de trabajo al completo), Postres (marco ético-legal y tendencias) y Cafés y copas (la opinión de la profesión). Un contenido completo, explicado en tono ameno, con una atractiva dirección de arte y salpicado de campañas. Y de propina secciones como Agencias, El pinche cocina (propuestas de ejercicios) y BRANDadA (recomendaciones de libros, blogs y webs). ¿No te ha entrado hambre de saber más?
Cross-National Understandings of the Purpose of Professional-Child Relationships: Towards a Social Pedagogical Approach
Authors: Cameron Claire
Published: June 2018

A reassertion of the value of relationships in UK practice with children in care is underway after a period when outcome focused work obscured their importance. But little is specified in the training requirements for foster carers or residential care workers about how to construct and maintain high quality relationships. This paper presents evidence from a study of understandings of professional-child relationships in three continental European countries that are informed by social pedagogy and from social pedagogues working in England. Four purposes of relationships are identified that hinge on questions of whether the relationship is about facilitating another objective such as building children’s skills, participation in society, taking action on their behalf, or about being together in an ethical encounter. The paper then discusses the role of trust in relationships and the deployment of the self. It concludes by identifying four practical indicators for social pedagogic professional-child relationships. They should be: present and future orientated; founded on practical actions; they require awareness of how the worker uses their ‘self’; and a supportive organisational environment.
Neural Correlates of Odor Learning in the Presynaptic Microglomerular Circuitry in the Honeybee Mushroom Body Calyx
Authors: Haenicke Joachim , Yamagata Nobuhiro , Zwaka Hanna , Nawrot Martin , Menzel Randolf
Published: June 2018

The mushroom body (MB) in insects is known as a major center for associative learning and memory, although exact locations for the correlating memory traces remain to be elucidated. Here, we asked whether presynaptic boutons of olfactory projection neurons (PNs) in the main input site of the MB undergo neuronal plasticity during classical odor-reward conditioning and correlate with the conditioned behavior. We simultaneously measured Ca2+responses in the boutons and conditioned behavioral responses to learned odors in honeybees. We found that the absolute amount of the neural change for the rewarded but not for the unrewarded odor was correlated with the behavioral learning rate across individuals. The temporal profile of the induced changes matched with odor response dynamics of the MB-associated inhibitory neurons, suggestive of activity modulation of boutons by this neural class. We hypothesize the circuit-specific neural plasticity relates to the learned value of the stimulus and underlies the conditioned behavior of the bees.
Calidad del registro del certificado de defunción en un hospital pediátrico de Lima, Perú
Authors: Zeta-Ruiz Nieves , Soncco Carlos
Published: June 2018

Introducción. Los certificados de defunción son documentos legales que cuentan con datos epidemiológicos y estadísticos necesarios para la toma de decisiones a nivel hospitalario, siendo de vital importancia el correcto llenado de este documento. Objetivo. Determinar la calidad del registro del Certificado de Defunción en el Hospital de Emergencias Pediátricas durante el periodo 2010–2014. Diseño. Estudio descriptivo y transversal. Lugar. Hospital de Emergencias Pediátricas, Lima - Perú. Materiales. Se incluyeron 60 certificados de defunción emitidos durante los años 2010 a 2014. Intervenciones. Se utilizó una ficha siguiendo los criterios utilizados en un estudio peruano anterior. Principales medidas de resultados. Se evaluó la calidad de los certificados empleando una escala ordinal de cuatro categorías; buena, regular, mala y pésima calidad. Resultados. De los 60 certificados de defunción evaluados, más del 50% fue de mala y pésima calidad, alcanzando solo el 47% de regular calidad. Conclusiones. El mayor porcentaje de certificados de defunción presentan mala y pésima calidad, siendo necesario capacitar a los profesionales médicos en el correcto llenado de este documento. Además sería importante implementar el uso del certificado de defunción electrónico, a fin que los decisores en salud puedan contar oportunamente con los correspondientes datos epidemiológicos y estadísticos.
Detección de la mutación E8SJM en el gen LIPA, por PCR en tiempo real, para la investigación de la enfermedad por almacenamiento de ésteres de colesterol
Authors: Rojas Málaga Diana , Matte Ursula , Schmidt Cerski Carlos Thadeu , Giugliani Roberto
Published: June 2018

Introducción: La enfermedad por Almacenamiento de Ésteres de Colesterol (CESD; Cholesteryl Ester Storage Disease) es una enfermedad de depósito lisosomal, su presentación es bastante variable y su diagnóstico constituye un desafío. Además, existe un número de anomalías observadas en los pacientes con CESD que se sobreponen a diagnósticos más comunes, siendo probable que sea subdiagnosticada. La mayoría de pacientes relatados hasta el momento son portadores de la mutación E8SJM en el gen LIPA. En este sentido, el auxilio en el diagnóstico es fundamental pues existen opciones de terapia en desarrollo. Diseño: Estudio observacional. Objetivo: Estandarizar la técnica de PCR en tiempo real para la detección de la mutación más frecuente, E8SJM, en muestras de sangre periférica y de biopsia hepática para el auxilio diagnóstico de CESD y futuros estudios de prevalencia de la mutación. Institución: Centro de Terapia Génica del Hospital de Clínicas de Porto Alegre (HCPA), Brasil. Material biológico: Muestras de ADN extraídas de sangre periférica y tejido hepático parafinado. Principales medidas de resultados: Presencia/Ausencia de la mutación E8SJM. Resultados: Se estandarizó la reacción de PCR en tiempo real, la mutación fue detectada correctamente y posteriormente validada por secuenciación de Sanger. La mutación fue analizada en 137 muestras y encontrada en apenas una paciente que ingresó al Servicio de Genética Médica del HCPA con diagnóstico clínico y bioquímico de CESD/Wolman. Conclusiones: La técnica de PCR en tiempo real es ideal para la detección rápida y en gran escala de la mutación frecuente asociada a CESD.
Habilidades teóricas y prácticas para flebotomía entre alumnos de primer semestre de medicina en el Centro de Simulación Montagne, Mérida - México
Authors: Cetina-Sauri Gregorio , Puga-Matú Herbert , Chávez-Medina Jaidy , Cambranis-Romero Joeana , Aguilar-Vargas Esteban , Méndez-Domínguez Nina
Published: June 2018

Introducción. El uso de simuladores de pacientes humanos es una estrategia eficaz en la enseñanza de procedimientos clínicos. Sin embargo, existe poca información para ayudar a los profesores a mejorar sus estrategias docentes permitiéndoles mejorar las experiencias de aprendizaje de acuerdo a la edad o el sexo de los alumnos que emplean este tipo de simulación. Objetivos. Identificar si existen diferencias por sexo o edad en asociación a las habilidades de los alumnos del primer semestre de medicina para la flebotomía. Diseño. Cuasiexperimental. Lugar. Centro de Simulación Médica Montagne de la Universidad Marista de Mérida. Participantes. Estudiantes de primer semestre de la licenciatura en medicina. Intervenciones. Intervención educativa del proceso de flebotomía con toma de muestra, empleando simuladores de alta fidelidad. Para el análisis, se evaluó la asociación de las variables de edad y sexo con el desempeño de los alumnos. Principales medidas de los resultados. Se analizaron las evaluaciones prácticas y teóricas. Para la evaluación práctica se aplicó una rúbrica de 20 ítems y se promediaron las puntuaciones de las esferas teóricas y prácticas de los alumnos. Resultados. Se identificó que las mujeres desempeñaron mejor sus habilidades prácticas (p<0,03) aún en el modelo de regresión lineal ajustado por edad y grupo. Discusión. El mejor desempeño en la práctica de flebotomía entre las alumnas de medicina difícilmente sea un hallazgo aislado, pues puede derivarse de las habilidades para la comunicación interpersonal, misma que también puede ser reforzada en los alumnos del sexo masculino.
Conocimientos sobre salud sexual y su relación con el comportamiento sexual en estudiantes universitarios
Authors: Ordoñez Sánchez Joe , Real Cotto Jhony , Gallardo León Jefferson , Alvarado Franco Hugo , Roby Arias Aurora
Published: June 2018

Introducción. La salud sexual y reproductiva es de gran importancia y se define como un proceso ligado al desarrollo humano; es decir, comienza desde el nacimiento y se desarrolla durante toda la vida. Objetivo: Establecer el conocimiento sobre salud sexual y su relación con el comportamiento sexual de los estudiantes en las edades de 18 a 25 años de la Facultad de Ciencias de la Salud de la Universidad Técnica de Babahoyo, año 2014. Diseño: no experimental, transversal, de tipo descriptivo comparativo. Lugar: Facultad de Ciencias de la Salud de la Universidad Técnica de Babahoyo de la Provincia de Los Ríos, Ecuador. Participantes: Estuvo conformada por 140 estudiantes de las escuelas de obstetricia y enfermería. Intervenciones: Se utilizó entrevista directa cara a cara, utilizando un cuestionario validado del Proyecto Integrado: “La salud sexual y la salud reproductiva de la población estudiantil de la Universidad Nacional de Costa Rica”. Medidas de resultados: Para el análisis se empleó los indicadores descriptivos y analíticos entre las variables. Resultados: La mayoría de los estudiantes (92%) se declara como persona sexualmente activa, mientras que el 76% ha practicado sexo oral. En cuanto a la actitud el 50% de los estudiantes está en desacuerdo en que los hombres que se arreglan más sean afeminados mientras que el 81% desaprueba que las mujeres que no se preocupan por su apariencia sean marimachos. Conclusiones: Los estudiantes en su mayoría se declaran sexualmente activos y tres de cada cuatro estudiantes practican el sexo oral, presentando un nivel medio en conocimientos y comportamiento.
Embarazo en cicatriz de cesárea previa: ¿Es siempre quirúrgico? Reporte de un caso
Authors: Cassana Alessandra , Yanque Omar
Published: June 2018

El embarazo en cicatriz de cesárea previa (CSP) es un tipo raro de embarazo ectópico que debe ser diagnosticado tempranamente para poder encontrar la mejor opción terapéutica. Presentamos un caso de CSP, inicialmente mal diagnosticado como una gestación no evolutiva que fue sometida a legrado uterino. La paciente fue referida a nuestra institución, donde el manejo médico conservador con metotrexato falló, y la única opción fue la resección quirúrgica del CSP. El CSP debe de ser sospechado y diagnosticado lo más temprano posible. En países en vías de desarrollo, se debe priorizar la prevención de hemorragia masiva así como de morbilidad materna compleja. El abordaje mínimamente invasivo debe de ser planificado como el tratamiento de primera línea sobre el manejo médico.
Enfermedad de Kawasaki en lactante de dos meses
Authors: Flores Chávez Ana María del Pilar
Published: June 2018

Se presenta el caso de un lactante de 2 meses con Enfermedad de Kawasaki (KD), que tuvo criterios clínicos incompletos al inicio de la enfermedad, evidenciándose como complicación final dilatación de las arterias coronarias. Se realiza una revisión actualizada de la literatura sobre dicha patología. A pesar de que esta enfermedad es poco frecuente en este grupo etario, es de suma importancia pensar en esta patología ya que el tratamiento precoz disminuye la incidencia de complicaciones cardíacas. En conclusión, el diagnóstico diferencial de todo lactante febril menor de 6 meses sin foco aparente debe incluir la Enfermedad de Kawasaki, así no cumpla los criterios necesarios.
Efectos del reposo prolongado en adultos mayores hospitalizados
Authors: Ibarra Cornejo José Luis , Fernández Lara María José , Aguas Alveal Elena Viviana , Pozo Castro Alex Felipe , Antillanca Hernández Bárbara , Quidequeo Reffers Diego Galvarino
Published: June 2018

Introducción: El reposo prolongado en cama y la disminución de la actividad física en los adultos mayores representan un factor predisponente al desarrollo o al agravamiento de ciertas condiciones patológicas relacionadas en mayor medida con los sistemas cardiovascular, respiratorio y musculoesquelético, en donde hasta el 33% de los adultos mayores hospitalizados presentarán deterioro funcional en al menos una de las actividades de la vida diaria y se incrementa a acerca del 50% cuando superan los 80 años de edad. Objetivo: Describir los principales efectos del reposo en cama sobre los principales sistemas que pudiesen generar un decline funcional en el adulto mayor hospitalizado. Metodología: Se realizó una revisión bibliográfica en las bases de datos Pubmed, Scielo y Pedro. Resultados: La información obtenida se organizó de acuerdo a los sistemas corporales principalmente involucrados en el reposo prolongado. Se encontró que la falta de movilidad en adultos mayores provoca un desacondicionamiento físico, además de un agravamiento de la enfermedad que lo llevo a la residencias hospitalarias conllevando a un aumento de los días de hospitalización. Conclusiones: el reposo en cama puede ser minimizado tanto como sea posible y puede ser prescrita una recuperación ambulatoria y actividad física para limitar los efectos de desacondicionamiento del reposo en cama.
Diagnóstico de tuberculosis en el marco de la evaluación periódica ocupacional: observaciones a la actual normativa peruana
Authors: Jhonston Erik J. , Alarcon-Ruiz Christoper A. , Miñan-Tapia Armando , Taype-Rondan Alvaro
Published: June 2018

Sr Editor, en Perú la Ley de Seguridad y Salud en el Trabajo vigente establece que el empleador es responsable de proteger la salud de sus trabajadores mediante actividades como los exámenes médico ocupacionales (EMO), que según la Resolución Ministerial (RM) 312-2011 del Ministerio de Salud (MINSA) son obligatorios para cada actividad económica (1). Si bien esta RM ha implicado un avance en la salud ocupacional peruana, presenta ciertas falencias con respecto al tamizaje de tuberculosis, que podrían estar impidiendo un diagnóstico certero en la población vulnerable.
Hermilio Valdizán y Anales de la Facultad, una apuesta inconclusa por un proyecto de medicina peruana
Authors: Murillo Peña Juan Pablo
Published: June 2018

Hermilio Valdizán es sin duda uno de los personajes más importantes de la medicina peruana de todo los tiempos. Este médico San Fernandino de origen provinciano en un tiempo muy corto logro construir el edificio cultural sobre el cual se construiría la medicina peruana del siglo XX. Sostenemos que este proyecto fue el de la construcción de un nuevo marco de modernización social y cultural peruano desde la medicina, lo cual se explica a través de los diversos hitos en la vida de académica y pública de Valdizán y se expresa en la revista que fundó, los Anales de la Facultad.
Infarto cerebral limítrofe secundario a enfermedad inflamatoria orbitaria idiopática
Authors: Ramírez-Quiñones Jorge A. , Barrientos-Imán Danny M. , Rivas-Franchini Diana , Valencia-Chávez Ana M. , Abanto-Argomedo Carlos
Published: June 2018

Los infartos limítrofes son aquellos ubicados en regiones entre dos territorios vasculares contiguos y la enfermedad inflamatoria orbitaria idiopática es un proceso inflamatorio orbitario inespecífico. Presentamos el caso de un varón de 60 años con exoftalmos, ptosis palpebral, disminución de agudeza visual derecha y afección de los nervios oculomotores derechos. Los estudios de imágenes mostraron una masa retro ocular derecha con invasión de los senos cavernosos y esfenoidal. Durante la hospitalización, el paciente sufrió un infarto cerebral limítrofe por compresión de la arteria carótida interna derecha en su segmento intracavernoso. La exéresis y la anatomía patológica de la lesión orbitaria fueron compatibles con la enfermedad inflamatoria orbitaria idiopática. Nuestro caso muestra a la enfermedad inflamatoria orbitaria idiopática como una causa inhabitual de infarto cerebral limítrofe.
Genotipificación molecular de las cepas del virus sarampión en el Perú, 2018
Authors: Condori-Yujra Fredy J. , Jimenez-Vasquez Víctor , Enríquez-Alva Giancarlo W. , Gordillo-Vilchez Sara M. , Cabezudo-Pillpe Néstor E.
Published: June 2018

Sr. Editor, en el año 2017, cuatro países de la región de las Américas notificaron casos confirmados de sarampión, a saber: Argentina (3 casos), Canadá (45 casos), los Estados Unidos de América (120 casos) y la República Bolivariana de Venezuela (727 casos). En los primeros meses de 2018, los siguientes 9 países han notificado casos confirmados: Antigua y Barbuda (1 caso), Brasil (14 casos), Canadá (4 casos), Colombia (1), Estados Unidos de América (13 casos), Guatemala (1 caso), México (4 casos), Perú (2 casos) y Venezuela (159 casos)(1).
Conocimientos y percepciones de los internos de medicina sobre Atención Primaria de Salud con enfoque en salud familiar y comunitaria
Authors: Rosales Anca Angielina E.
Published: June 2018

Sr. Editor, el presente estudio tiene como referente los documentos de la Organización Panamericana de la Salud, referidos a la atención primaria de salud (APS) en las américas (1,2,3). Entre las experiencias y aportes de las escuelas de medicina en la APS, Cuba y Brasil son los países de América Latina que han demostrado tener una iniciativa y un alto compromiso gubernamental en el desarrollo de ella, enfatizando la formación de pregrado (3,4,5). Sin embargo, en la mayor parte de las escuelas médicas de las américas, los hospitales continúan siendo el único escenario para el entrenamiento práctico de los estudiantes, dejando de lado el enfoque familiar y comunitario (6).
Evaluation of an educational handout on knowledge about toxoplasmosis
Authors: Dabritz Haydee A. , Conrad Patricia A.
Published: June 2018

AIMS: The study sought to determine the factors associated with prior knowledge about toxoplasmosis, and to assess what participants learned after reading an educational handout. METHODS: Participants were recruited at two sites in California: a public meeting about water quality in Morro Bay; and at the Women Infants and Children’s Nutrition Program office or La Leche League meetings in Yolo County. Demographic differences between sites were compared using Fisher’s exact test, and change in knowledge before and after reading the handout using Mantel-Haenszel methodology. RESULTS: Non-Hispanic white participants were more likely than those of Hispanic ethnicity (62% vs. 20%, respectively) to have prior knowledge about toxoplasmosis. The most common source of information was newspapers (36%). Only 16% had obtained information from medical professionals. After reading the handout, 85% of participants identified Toxoplasma gondii as a parasite and 98% identified cats as the source of oocysts. Ninety-eight percent of participants who read the handout were aware they could acquire infection from cat faeces, 94% from meat, 78% from soil or in utero, and 69% from unwashed vegetables. Fewer (59%) recognized all sources. CONCLUSIONS: Knowledge about toxoplasmosis increased in all areas evaluated, but gaps remained, particularly with regard to environmental sources of Toxoplasma gondii infection and clinical manifestations of disease. In addition to care in handling cat faeces/litter and avoidance of undercooked meat, healthcare providers counseling pregnant women should emphasize the importance of wearing gloves when gardening, hand washing after handling soil or meat, and rinsing fresh vegetables thoroughly before consumption.
Análise da marcha de crianças com paralisia cerebral com e sem uso de órteses de tornozelo e pé
Authors: Bridi Daiane , Cavião Ingrid Corso , Schmitt Vinícius Mazzochi , Saccani Raquel , Bonetti Leandro Viçosa , Cechetti Fernanda , Zatta Patrícia Regina Righês P.
Published: June 2018

AIMS: To analyze the linear parameters of the gait of children with spastic hemiparetic cerebral palsy, users of articulated ankle and foot orthoses.METHODS: A three-dimensional analysis of the gait of eight children with spastic hemiparetic cerebral palsy, aged 5 to 10 years, classified in levels I and II of the Gross Motor Function Classification System, was made with and without the use of ankle and foot orthoses. A kinematic system with seven integrated cameras captured the three-dimensional trajectory of markers in the participants' body during gait, with data being collected at a sampling rate of 100 Hz. For the comparisons, the paired t-test and the t-test for a sample were used.RESULTS: Considering the gait’s spatiotemporal variables of these children with cerebral palsy compared to normal values, only velocity (with the orthosis and without the orthoses) presented a statistically significant difference. The mean normal gait velocity is 1.25 m/s, while in the non-orthoses participants the mean velocity was 0.98±0.10 m/s (p=0.0001) and with the use of orthoses the mean velocity was 0.96±0.21 m/s (p=0.0001). In the comparison between children using or not the ankle and foot orthoses, velocity, cadence and pitch length were respectively 0.98±0.10 m/s, 131±16.15 steps/min and 0.44±0.08 m in the children without the orthoses; and 0.96±0.21 m/s, 128.37±22.9 steps/min and 0.48±0.05 m in the children with the orthoses. The differences were not statistically significant.CONCLUSIONS: Comparison between the same group with and without the use of ankle and foot orthoses suggests that their use in children with cerebral palsy may promote an increase in step length and a decrease in velocity and cadence in relation to condition without orthosis, favouring a better distribution of weight in the paretic member and providing a better symmetry in gait. However, the differences were not statistically significant. Thus, it is expected that the results obtained in this study can serve as a pilot for future research, with larger samples.