bluuebunny/crossref_metadata_2025 huggingface dataset:
Nosocomial Infection in MICU: An Observational Study
Authors: Dara Chennakesavulu , Darivemula Surendra Babu , Sandepogu Triven Sagar , Saranya M. , Vijayalakshmi N. , Swetha S.
Published: September 2023

Introduction:

Nosocomial infections are infections; patients acquire while admitted to a health-care facility and generally develop 48 h or later after admission. These infections can lead to serious problems such as sepsis and even death.

Materials and Methods:

A prospective observational study was conducted for 6 months to estimate the incidence of nosocomial infections acquired in the medical intensive care unit (MICU), their risk factors, the causative pathogens, and the outcome. The patients admitted for more than 48 h to the MICU and willing to give consent were included in the study. Of 496 patients in MICU, 216 patients stayed 48 h and Acute Physiology and Chronic Health Evaluation II (APACHE II) score during the first 24 h of admission to the MICU.

Results:

The incidence of nosocomial infections in MICU was 14.9% (32 out of 216). Age, APACHE II score >13, MICU stay >7 days, and comorbidities such as peripheral venous line, central venous catheter, duration of urinary catheterization, duration of endotracheal intubation, nasogastric tube, and mechanical ventilator of >7 days were found to be independent risk factors of acquiring nosocomial infections (P < 0.05). Important causative organisms for nosocomial infections were Pseudomonas aeruginosa in 18 patients (32.72%), Escherichia coli in 11 (20.0%), Acinetobacter species in 8 (14.54%), and Klebsiella pneumoniae in seven patients (12.72%). Mortality among patients with nosocomial infections was 25% (8/32) and among those without nosocomial infections was 6.5% (12/184), P = 0.002. The length of ICU stay was higher in patients with nosocomial infections (15.42 ± 6.93 days) than in those without nosocomial infections (6.7 ± 5.14 days), P < 0.001.

Conclusion:

Nosocomial infections are common in ICU settings and contribute to significant mortality and morbidity. Infection control strategies are necessary to reduce nosocomial infection rates as well as ICU mortality and morbidity.
Quality and pattern of sleep and preexamination substance abuse-impact on academic performance in medical students
Authors: Mukherjee Sagnik , Krishna V. Murali , Tialam Gautham
Published: September 2023

Background:

Ambiguity persists regarding the role of chronotype, sleeping patterns, and afternoon naps on academic performance. Very little work has been done on the preexamination severity of insomnia leading to consequent substance abuse, which might further cause a decline in sleep quality, creating a vicious cycle.

Aims:

The aim of our study is to correlate the academic performance of medical students with the severity of preexamination insomnia and substance abuse and their general sleep quality and patterns.

Methods:

This is an observational and descriptive study with prospective longitudinal design. A semi-structured questionnaire, which included several scales pertaining to sleep quality and chronotype, was used to assess the relevant parameters among 710 medical students across several medical colleges of India just before their examinations. They were followed up after 1 month and then after 3 months to assess their academic performance and chronicity of insomnia according to Athens Insomnia Scale. Several statistical tests were conducted between the various dependent variables, and finally, linear logistic multivariate regression analysis was done between the predictors, variables, and the outcome.

Results:

About 78.6% of students were found to be having generalized poor quality of sleep, while 30.8% were found to be suffering from moderate–severe clinical insomnia before their examination. About 30.4% of the students claimed to be using stimulants while 10.7% claimed to be using some sort of depressant before their examination.

Conclusion:

Significant correlation was found between preexamination insomnia and substance abuse. No significant correlation was found between our predictor variables and academic outcome. Those with higher degrees of insomnia before examination were found to have a statistically significant chance of developing chronic insomnia.
Posttransplant Thrombotic Microangiopathy: Unraveling a Mystery
Authors: Khan Mohammed Fahad , Siddini Vishwanath , Ballal Sudarshan , Mathur Ankit
Published: September 2023

A 24 year old lady who was diagnosed with chronic kidney disease stage 5 in 2016 underwent a pre-emptive live related renal transplant in the same year. She had kidney allograft dysfunction and eventually lost the transplant kidney in 2019 requiring hemodialysis. She underwent a deceased donor renal transplant in February 2022. She developed allograft dysfunction with a creatinine of 2.5 mg/dl in October 2022, and a renal allograft biopsy subsequently showed Thrombotic microangiopathy, arteriolar form. There were no features of rejection in the biopsy and Donor specific antibody done by Luminex lysate method was negative. Her Single antigen bead done subsequently was also negative. CMV DNA PCR was not detectable. Tacrolimus was switched to Cyclosporine, however her allograft function continued to worsen. Complement mutation analysis was negative and acquired complement defects were also not detected. Subsequently, Single antigen bead for non HLA antibodies showed positivity for MICA antibodies. She underwent 7 sessions of plasmapheresis and her renal functions did not improve and her creatinine continued to increase to 4.2 mg/dl. Complement activating assay for these MICA antibodies was positive. She was treated with two doses of 300 mg Eculizumab in December 2022, her allograft functions in February 2023 have improved to 2 mg/dl. This case highlights the extensive evaluation for post transplant TMA, the use of non HLA antibody assays and complement activating assays of these antibodies to decide on appropriate use of Eculizumab for salvaging transplant allograft.
Musculoskeletal Magnetic Resonance Imaging Revisited – Does Tesla of Magnetic Resonance Imaging Machines Matter?
Authors: Kaur Simranjeet , Tins Bernhard J. , Winn Naomi , Ganga Kartik P.
Published: September 2023

The field of modern medical science has been revolutionized by magnetic resonance imaging (MRI) which is the preferred modality for the investigation of a whole spectrum of musculoskeletal (MSK) conditions. MRI is a careful interplay between the temporal, spatial, and contrast resolution which forms the foundation for its improved diagnostic performance and value. There are a lot of aspects that improve the image quality and diagnostic performance, however, a higher magnet strength of 3-Tesla has the biggest impact within the current diagnostic range. However various advancements in the hardware and software parameters such as multichannel multi-phased array coils, advanced gradient systems and better post processing techniques have significantly improved image quality at 1.5T scanners as well. All the leading manufacturers offer MRI systems with a higher field strength of 3T which are increasingly being used in recent clinical settings. Scanning at 3T has the advantage of a better signal-to-noise ratio which translates into better spatial and temporal resolution with the added advantage of faster acquisition. Challenges of 3T scanning include higher magnetic susceptibility, chemical shift, and higher radiofrequency energy deposition. This is particularly important in the presence of orthopedic implants because of the two-fold increase in susceptibility artifacts resulting in significant periprosthetic signal loss, signal displacements with voids and pileups, and failed spectral fat suppression. Various modifications are needed to minimize the artifacts at 3T scanners to better utilize the improved spatial and contrast resolution achieved as a result of scanning at a higher field strength. This review discusses the technical features of scanning at 1.5 and 3T scanners along with their clinical implications and diagnostic usefulness in MSK imaging.
Ultrasound-Guided Percutaneous Release of Pulley in Trigger Finger: A Curved Needle Technique
Authors: Singh Dharmendra Kumar , Chari Basavaraj
Published: September 2023

Thickened A1 pulley is the most common cause of trigger finger. The patient complains of snapping and locking of finger like a trigger as the gliding of the flexor tendon become harder through the thickened pulley during flexion and superadded development of nodule on the surface of the tendon proximal to pulley. In severe cases or failed conservative/steroid injection cases, real-time percutaneous release of pulley under ultrasound (US) guidance can be considered. The percutaneous pulley release is a minimally invasive procedure compared to open surgical release and more accurate than blind percutaneous release with overall minimal complications. The US-guided percutaneous A1 pulley release has been described in the literature and done by knife, straight needles, and acutely bent needles with variable results. We describe the curved needle technique of percutaneous pulley release. The curved needle technique for US-guided A1 pulley release is novel and has the advantage of easy maneuverability over acutely bent needle and minimal chances of complications. The cutting edge of the curved needle scores through the thickened pulley with effective release and easy maneuverability.
Bone Tumor Imaging: An Update on Modalities and Radiological Findings
Authors: Shojaie Parham , Afzali M. , Nischal Neha , Iyengar Karthikeyan P. , Yousef Mina Malak Abed , Botchu Rajesh
Published: September 2023

Radiological imaging forms an integral part in the diagnostic and management algorithm of patients with bone tumors. Although plain radiography tends to be the first line of imaging in a patient with suspected bone tumor, advances in technology, computer software, physics and techniques have expanded the modalities available to us in the form of computed tomography (CT), magnetic resonance imaging, and various scintigraphy techniques. These imaging modalities in combination with a clinician led multi-disciplinary team help in the exact diagnosis, appropriate management, and monitoring of patients for recurrence. In this narrative review, we highlight the current applications of conventional imaging, the emerging role of hybrid imaging, and explore the future directions of radiological imaging in the management of patients with bone tumors.
Knee Pain in Elite Dancers: A Review of Imaging Findings
Authors: Mariathas Matthew , Hughes Emily , Wolman Roger , Purohit Neeraj
Published: September 2023

Introduction:

Musculoskeletal injuries are a frequent occurrence in dancers of all skill levels, and the knee is the most common anatomical location. Our purpose was to identify the specific knee injuries encountered in a large cohort of dancers presenting to a tertiary-level dance injury clinic with knee pain. The relevant imaging findings of the identified knee injuries are highlighted.

Methods:

All new patients referred to the specialist dance injury clinic between March 2012 and February 2017 were entered into a database. Those with a knee-specific injury were selected with documentation of relevant demographic information. Clinic notes were analyzed for information related to a preceding acute traumatic event, and any relevant imaging was reviewed. This formed the basis for the review with Pubmed being utilized to identify relevant papers on the specific pathologies including etiology, imaging findings, and management.

Results:

Data from a cohort of 197 dancers presenting with a knee complaint were reviewed, composed of 144 women and 53 men with an average age of 28 years (range: 12–75 years). The most common knee complaint was anterior knee pain (n = 111) followed by medial-side knee pain (n = 42). The most frequent diagnoses included patellofemoral pain syndrome (n = 69), medial meniscal injury (n = 29), and Hoffa’s fat pad impingement (n = 13).

Conclusion:

An anatomy--based approach with regard to the site of pain can be useful in identifying any potential abnormality. Knowledge of the radiological appearances of the most frequently seen knee abnormalities in dancers will aid in prompt and correct diagnosis.
The Obturator Externus as Surgical Landmark for the Direct Anterior Approach and Its Role in LLD after Total Hip Replacement
Authors: Vermuyten Lieven , Driesen Ronald , Welters Hans , Corten Kristoff
Published: September 2023

Purpose:

The purpose of this study was to asses the usefulness of the obturator externus tendon (OE) as landmark and the correlation of the femoral stem position in relation to the OE and its effect on postoperative leg length difference (LLD) after direct anterior approach-total hip replacement (DAA-THR).

Patients and Methods:

A retrospective radiographic analysis of 85 patients undergoing THR was performed. Postoperative leg length was determined using the center of femoral rotation to tear drop line and lesser trochanter method. Relative distance of the femoral component to the insertion of the OE was determined (OE-SH). The intraclass correlation coefficient (ICC) was performed for intra- and inter-reliability ratings. Regression analysis was performed. Discriminant analysis was performed to define a possible critical cutoff of OE-SH with regard to defining groups based on LLD. Risk analysis with regard to OE-SH ><6 mm and difference in distance between teardrop and lesser trochanter before and after implantation of THR (ΔTDLT) ><5 or 10 mm was performed.

Results:

Seventeen cases (21%) had lengthening (ΔTDLT) >5 mm and 7 cases (8%) had ΔTDLT >10 mm, with a mean ΔTDLT of 1.61 ± 4.92 mm SD. ICC values for intra- and interobserver reliability were rated as excellent. Regression analysis showed a clear correlation between ΔTDLT and OE-SH (ΔTDLT = −1.076 + 0.60176*OE-SH). Risk analysis showed a relative risk (RR) of 11.20 (confidence interval [CI] 3.52–35.60, power 1) for 5 mm ΔTDLT when OE-SH >6 mm and a RR 14.4 (CI 1.83–113.54, power 0.86) for 10 mm ΔTDLT when OE-SH >6 mm.

Conclusion:

OE-SH is a reliable measurement and a reliable predictor of LLD after THR. The radiographic cutoffs of OE-SH correlate well with the average size of the OE tendon, further underlining its clinical value in DAA THR. Intraoperative significant OE-SH warrants a critical review and correlation to preoperative planning.
Congenital Anterior Cruciate Ligament Deficiency and Meniscal Tear with Fibular Hemimelia Deformities Managed By Reconstructive Procedures in Two Stages
Authors: Vasudeva Nagashree , Kambhampati Srinivas B. S.
Published: September 2023

Congenital cruciate deficiency is associated with many musculoskeletal and congenital abnormalities. Long-standing instability eventually predisposes them to meniscal tears or cartilage damage. We report a case of anterior cruciate ligament (ACL) aplasia with fibular hemimelia and a bucket handle meniscal tear successfully managed with staged procedures. The meniscal tear was repaired, and ACL reconstruction was done in the first stage and was previously published. Valgus deformity of the tibial shaft along with splaying of toes was managed at the second stage (5 months from the first stage), and follow-up result at 3 years from the first surgery is presented. Meniscal pathologies should be suspected in patients with congenital malformations, and correction of the deformity can prevent further episodes of meniscal injuries.
Do they Feel Better When they Walk Better? 3D Gait Analysis Study in Total Knee Arthroplasty for Indian Osteoarthritic Knees
Authors: Tanpure Sanket , Phadnis Ashish , Nagda Taral , Rathod Chasanal , Chavan Ajay Pandit , Gad Mayuri
Published: September 2023

Background:

Osteoarthritis (OA) is a leading cause of disability in the elderly population. Gait analysis is a widely used tool to measure functional outcomes after total knee arthroplasty (TKA). This study aimed to assess the gait pattern and influence of TKA in patients with osteoarthritic knees.

Materials and Methods:

Preoperative and postoperative gait analysis was carried out on patients with grade 4 OA knee undergoing TKA. Sequential 33 adults (45 knees) with a mean age of 68.4 ± 5.8 years were studied. Gait analysis was carried out in Jupiter gait lab with 9 Qualisys Oqus cameras system and Qualisys track manager. Kinematic data were processed using Visual 3D C-Motion Software during a minimum of 6 walks across the walkway.

Results:

A significant difference in temporospatial parameters (gait speed, Cadence, step time, step length, stride width, stride length), joint kinematics in the sagittal plane (pelvis, hip, knee, ankle), coronal plane (pelvis, hip, knee, ankle), transverse plane (hip, knee) and motion analysis profile of knee (flexion/extension), ankle (dorsiflexion/plantarflexion), and hip (adduction/abduction). A significant difference was observed in the oxford knee score (OKS), Short Form 12, and knee society score.

Conclusion:

3D gait analysis is a good tool to document and compare gait changes in patients undergoing TKA. Recent advances in surgical techniques and improvements in prosthesis design are important factors for better functional outcomes. Our results may be used by clinicians, physiotherapists, or researchers as a reference for integrated aspects for the development of TKA implant designs and improving functional outcomes.
Evaluation of Coronary Arteries by Transthoracic Echocardiography
Authors: Anjaneyulu A. V.
Published: September 2023

Though several new cardiac imaging techniques have emerged, invasive coronary angiography remains the gold standard in evaluating coronary arteries for measuring anatomic severity of the stenotic lesion and assisting in intracoronary interventions. Several workers have attempted to image the coronary arteries by echocardiography. With improvements in ultrasound machines and introduction of harmonic imaging and high frequency transducers, direct visualization of long segments of all three coronary arteries is now possible. Though the entire artery cannot be reconstructed, multiple segments can be visualized, flow velocity can be measured, thus enabling us to obtain useful anatomic and physiologic information. Careful evaluation of coronary flows can translate into a wide variety of clinical applications.
Serendipitous Continuous Murmur in an Octogenarian Turned Out to be an Asymptomatic Ruptured Sinus of Valsalva
Authors: Tammiraju Iragavarapu , Akhil S. , Kumar A. Aswini
Published: September 2023

Sinus of Valsalva aneurysm is a rare cardiac anomaly which is more often congenital than acquired. Rupture of the aneurysm can present as plain as an asymptomatic murmur to as dramatic as a myocardial infarction or cardiogenic shock or even death. Ruptured sinus of Valsalva (RSOV) is very rare in the elderly, and an asymptomatic rupture in an octogenarian is rarer still. An octogenarian, accompanying his wife for her diabetic follow-up, was found to have a continuous murmur by chance examination. Echocardiography unmasked a RSOV; surprisingly, the elderly man was completely asymptomatic. The patient was referred to a cardiothoracic center for further management. A RSOV is a precarious disposition needing prompt recognition and urgent intervention even though asymptomatic. This case report highlights the importance of recognizing such entities even among the elderly despite its rarity. This case also highlights the cardiovascular auscultation as one of the most important, simple, and inexpensive clinical investigations.
Intracardiac Mass: A Rare Case Report
Authors: Yavagal S. T.
Published: September 2023

Intracardiac thrombus is seen in many circumstances. Rarely it is found in left atrium in the absence of mitral stenosis. Here we are reporting a case of Cardiomyopathy with thrombus in left ventricle and left atrium.
Assessment of Myocardial Viability by Echocardiography
Authors: Burkule Nitin J.
Published: September 2023

Clinical application of myocardial viability testing to improve patient outcome is still a concept in evaluation. The various echocardiographic, nuclear, and magnetic resonance imaging techniques of assessment of myocardial viability evaluate different aspects of ischemic pathophysiology and have certain distinct advantages and limitations. A clinical algorithm combining “anatomic” and “flow/function” imaging gives more specific result of myocardial viability. Different modalities of echocardiography form the basic and cost-effective tools to assess the anatomic and functional aspect of viability.
Mitral Valve Leaflet Abscess: A Rare Complication of Infective Endocarditis
Authors: Rathore Abhishek , Prabhavathi B. , Manjunath C. N.
Published: September 2023

Infective endocarditis is an infection of the endocardium of heart and its great vessels. Infective endocarditis if complicated by abscess may lead to severe valvular insufficiency and intractable heart failure. Leaflet abscess although is a very rare complication, but if occurs, leads to increased morbidity and mortality. We report a case of 28-year-old female who had severe mitral valve regurgitation with mitral leaflet abscess confirmed by transesophageal echocardiography. She developed cardiogenic shock, multiple organ dysfunction syndrome with anemia, leukocytosis, thrombocytopenia, liver dysfunction, acute renal failure, and splenic abscess. Due to these multiple comorbid conditions, it could be a very high-risk surgery. Hence, she was managed with medical therapy and responded well.
Mechanical Breakdown and Thrombosuction of Mobile Clot in Right Ventricular Outflow Tract Causing Massive Pulmonary Embolism in a Patient with Absolute Contraindication to Thrombolysis
Authors: Khurana Manbir Singh , Tandon Rohit , Singh Bhupinder , Mohan Bishav
Published: September 2023

Massive pulmonary embolism (PE) carries high mortality if not treated urgently. Survival depends on rapid recanalization of pulmonary artery and reduction of right ventricular overload. Historically, surgical pulmonary embolectomy has remained as cornerstone of treatment, but in recent times, catheter-directed techniques are gaining popularity especially in centers of expertise and main indication for surgery remains only in few cases in which there is presence of intracardiac mobile clot (in right atrium, right ventricle, or right ventricular outflow tract [RVOT]) or in cases with contraindications to local/systemic thrombolysis or as rescue operation where there is failure of catheter-directed techniques. The role of mechanical breakdown and other catheter-directed therapies as a potential alternative and role in patients with RVOT thrombus is debatable. We report a case where a patient with massive PE with RVOT thrombus having contraindication to thrombolysis managed successfully with catheter-directed mechanical breakdown and thrombosuction.
Functional Assessment of Fetal Heart: Normative Data for Tissue Doppler Indices and Other Echocardiographic Parameters for Indian Population
Authors: Nair Anupama , Radhakrishnan Sitaraman
Published: September 2023

Objective:

To establish normative data for tissue Doppler indices and other parameters for ventricular function assessment in fetal imaging for the Indian population and to assess the variation of these parameters with gestational age.

Materials and Methods:

A prospective study involving 172 fetuses diagnosed as having normal cardiac structure and function. Mothers were advised for fetal echocardiography for several indications; however, mothers with diabetes (both gestational and pregestational), placental dysfunction, fetuses with intrauterine growth retardation, and multiple gestation were excluded as these could affect the fetal cardiac function despite a normal cardiac structure. Peak myocardial velocity was measured during systole (S'), early diastole (E'), and late diastole (A') using spectral tissue Doppler. Pulsed Doppler was used to measure the inflow early (E) and late (A) diastolic velocities and the diastolic filling period (DFP). M-mode was used to measure the tricuspid and mitral annular peak systolic excursion (TAPSE and MAPSE).

Results:

Normative data for tissue Doppler velocities and various other parameters for functional assessment of fetal heart were derived from the 172 normal fetuses. On tissue Doppler imaging (TDI), the mean values for the peak systolic and diastolic velocities at the lateral and medial mitral annulus and at the lateral tricuspid annulus and ratio of early and late diastolic velocity (E'/A') increased while the (E/E') ratio decreased with gestational age. Other parameters that increased with age are TAPSE, MAPSE, and the DFP at the tricuspid and mitral valves. The left and right ventricular myocardial performance index did not show any variation with gestation.

Conclusion:

TDI has already been documented as a useful technique in fetal cardiac imaging. The normative data so derived for various parameters can be used as a future reference. These parameters can prove very useful in fetal cardiac functional evaluation and detection of systolic or diastolic dysfunction at an early stage which may have long-term and prognostic implications.
Takotsubo Cardiomyopathy: Lessons Learned
Authors: Vishwakarma Ritesh , Sengupta Shantanu
Published: September 2023

Takotsubo cardiomyopathy presents as acute heart failure and mimics acute coronary syndrome. It is characterized by transient left ventricular dysfunction in the absence of occlusive coronary disease. Prognosis is generally good with complete recovery of the left ventricle in several weeks. The etiology is unknown and therapy just symptomatic. Death has been described but is rare. This present review gives insights of this important clinical entity.
Tachycardia-induced Cardiomyopathy in a Teenage Boy
Authors: Shah Rajesh Krishnachandra
Published: September 2023

Tachycardiomyopathy or tachycardia-induced cardiomyopathy (TIC) is a relatively rare but completely or partially treatable condition, where there is an impairment of left ventricular (LV) function secondary to chronic, continuous, or intermittent tachycardia, which presents as heart failure. It has been shown that the rate control by means such as cardioversion, negative chronotropic agents, and surgical- or catheter-based atrioventricular nodal ablation, depending on the etiology, resulted in significant improvement of systolic function. The diagnosis of TIC is entertained following the observation of improvement in LV systolic function, after necessary therapy to control the arrhythmia or heart rate. It is necessary that the clinicians should have a high index of suspicion while dealing with LV systolic dysfunction or dilated cardiomyopathy and should control the arrhythmia stringently. This case report describes a 14-year-old boy presenting with breathlessness of 18–24-month duration who had features of dilated cardiomyopathy on echocardiography. Impaired LV systolic function was due to fascicular ventricular tachycardia and he recovered completely after catheter-based ablation within a period of 5–6 months.
Clear Cell Adenocarcinoma of Urethra: Clinical and Pathologic Implications and Characterization of Molecular Aberrations
Authors: Song Boram , Lee Seok Hyun , Park Jeong Hwan , Moon Kyung Chul
Published: September 2023

Purpose This study aimed to evaluate the molecular features of clear cell adenocarcinoma (CCA) of the urinary tract and investigate its pathogenic pathways and possible actionable targets.Materials and Methods We retrospectively collected the data of patients with CCA between January 1999 and December 2016; the data were independently reviewed by two pathologists. We selected five cases of urinary CCA, based on the clinicopathological features. We analyzed these five cases by whole exome sequencing (WES) and subsequent bioinformatics analyses to determine the mutational spectrum and possible pathogenic pathways.Results All patients were female with a median age of 62 years. All tumors were located in the urethra and showed aggressive behavior with disease progression. WES revealed several genetic alterations, including driver gene mutations (AMER1, ARID1A, CHD4, KMT2D, KRAS, PBRM1, and PIK3R1) and mutations in other important genes with tumor-suppressive and oncogenic roles (CSMD3, KEAP1, SMARCA4, and CACNA1D). We suggest putative pathogenic pathways (chromatin remodeling pathway, mitogen-activated protein kinase signaling pathway, phosphoinositide 3-kinase/AKT/mammalian target of rapamycin pathway, and Wnt/β-catenin pathway) as candidates for targeted therapies.Conclusion Our findings shed light on the molecular background of this extremely rare tumor with poor prognosis and can help improve treatment options.
Luring Triatomines (Hemiptera: Reduviidae) into a Trap: Aliphatic and Aromatic Aldehydes as Attractants of Triatoma infestans
Authors: Rojas de Arias Antonieta , Borges Adolfo , Dorigo Cortés Diego
Published: September 2023

To assess the attracting capacity of aliphatic and aromatic aldehydes to Triatoma infestans, the Chagas disease vector, laboratory tests were conducted using individual compounds and mixtures to evaluate their potential use in baited traps for intradomicile population dynamics analysis. Commercial samples of hexanal, nonanal, and benzaldehyde were used at 95% purity. The experiments were performed at 25°C and 65% relative humidity using two procedures: a glass arena with filter papers impregnated with 1, 5, and 10 μL of the tested compounds and a double-choice olfactometer. Attraction was scored positively if the insect remained more than 30 seconds on one of the surfaces. The results of the study showed that hexanal was attractive to females at higher concentrations (5–10 μL; P < 0.0001), and IV instar nymphs were only attracted at the highest concentration (10 μL; P < 0.01). Nonanal was attractive to IV instar nymphs at 1 and 5 μL (P < 0.0001), whereas males and females were more attracted at 1 μL (P < 0.01 and P < 0.05, respectively). Benzaldehyde showed significant differences with respect to controls, attracting females at low concentrations (1 μL; P < 0.0001) and IV instar nymphs at 5 and 10 μL (P < 0.0001 and P < 0.001, respectively). In the olfactometer, the 60:40 hexanal/nonanal mixture was the most effective. In conclusion, this study demonstrated that the aliphatic and aromatic aldehydes studied here, both individually and in mixtures, could be used as effective attractants for T. infestans in intradomicile-baited traps. These results suggest that mixtures of these compounds could be implemented in field trials for Chagas disease surveillance.
Aspectos psicosociales de la donación renal de vivo
Authors: Hidalgo-Blanco Miguel Ángel , Moreno-Arroyo Mª Carmen
Published: September 2023

El primer trasplante renal con éxito se llevó a cabo en 1954 y se trató de un trasplante renal de vivo efectuado entre gemelos univitelinos en el Hospital Peter Bent Brigham de Boston1. Este hecho fue histórico ya que ayudó a superar la principal barrera que impedia el éxito de este tratamiento: el rechazo. A partir de 1972 con la aparición de los fármacos inmunosupresores como la ciclosporina2 y años más tarde, con la aceptación de los criterios diagnósticos de muerte encefálica, el trasplante renal de donante fallecido ha prevalecido sobre el de donante vivo. Los últimos datos publicados por la Organización Nacional de Trasplantes (ONT), siguen mostrando que la actividad de trasplante renal realizada en España ha sido prioritariamente de donante cadáver. En 2011 se realizaron 312 trasplantes renales de donante vivo, lo que supone el 12,5% del total de la actividad renal3. A pesar de que estas cifras no son muy altas, hay que destacar el incremento progresivo que ha tenido sobretodo desde el año 2000. Se preeve que la actividad de trasplante renal de vivo siga aumentando en España. El interés por impulsar este tipo de donación, viene influenciada por varios aspectos claramente defi nidos: los buenos resultados obtenidos en la supervivencia4,5,6 y en la calidad de vida7,8,9, el cambio en el perfil demográfico y de comorbilidad del donante fallecido, la mejora en la seguridad del donante y la insuficiente disponibilidad de órganos para el trasplante.
Valoración del estado nutricional en pacientes en hemodiálisis
Authors: Moreno-Arroyo Mª Carmen , Hidalgo-Blanco Miguel Ángel , Andreu-Periz Dolores
Published: September 2023

Uno de los más importantes y frecuentes problemas de pacientes en hemodiálisis y factor de riesgo de mortalidad, es la malnutrición calórica proteica sin que exista un consenso para evaluarla. Se consideran causas de malnutrición la infl amación, el hipercatabolismo asociado al procedimiento dialítico, las situaciones comórbidas y la reducción en la ingesta calórico protéica. Por otra parte, la asociación de malnutrición, inflamación y aterosclerosis constituye un síndrome (MIA) que se asocia a una elevada morbilidad y mortalidad de causa cardiovascular.Se han propuesto diferentes métodos para valorar el estado nutricional del paciente entre los que destacan además de los parámetros antropometricos y analíticos, la Subjective Global Assessment (SGA), el score de mal-nutrición infl amación, la absorciometría dual energética de rayos X, así como el análisis mediante bioimpedancia espectroscópica (BIS), pero ninguno se ha aceptado individualmente como método único de referencia. Aún así, en los últimos años, se ha extendido en las unidades de diálisis el uso de la BIS. Este es un método objetivo, inocuo, barato y reproducible para evaluar la composición corporal y el estado de hidratación, pudiendo obtener parámetros nutricionales que se relacionen con otros parámetros considerados buenos marcadores de la nutrición.
Garantizar el éxito del trasplante renal
Authors: Andreu-Periz Dolores , Hidalgo-Blanco Miguel Ángel , Moreno-Arroyo Mª Carmen
Published: September 2023

Pese a que son continuos los avances en materia de trasplante renal y que está opción continúa siendo la mejor para el tratamiento de la enfermedad crónica terminal son numerosos los problemas que plantea. La experiencia de nuestro país en este tema es incuestionable; el pasado 2014 se llevaron a cabo en España 4360 trasplantes y las tasas de donación alcanzaron los 36 donantes por millón de población 1, lo que sitúan al país entre los mejores, no solo en cuanto al número de trasplantes o en la investigación de la mejor inmunosupresión, también en la realización de técnicas complejas como el trasplante en dominó, además se batieron records en cuanto al número de trasplantes realizados en 24 horas, pues el 20 de febrero de ese año se realizaron 45 trasplantes que fueron posibles gracias a 16 donantes, 14 fallecidos y dos vivos 2. La labor de la Organización Nacional de Trasplante y de las organizaciones autonómicas, el esfuerzo de los equipos multidisciplinares y la generosidad de los ciudadanos hacen posible que se alcancen resultados difíciles de mejorar. Superado el escollo de la obtención de órganos adecuados, la utilización de técnicas quirúrgicas poco agresivas, fundamentales para la donación de persona viva 3 y el uso de nuevas terapias inmunosupesoras ofrecen razonables perspectivas de supervivencia y de buena calidad de vida 4. No se puede obviar que es imprescindible el seguimiento de la persona trasplantada, tanto en su vertiente clínica como en aspectos psicosociales. Evitar el rechazo es fundamental y para esto puede ser necesaria una preparación específica del receptor 5, pero también evitar las infecciones, la nutrición adecuada y una inclusión social satisfactoria garantizaran que el sufrimiento de la persona trasplantada, y el esfuerzo de la sociedad se vean compensados 6. Aunque los profesionales de enfermería somos pieza imprescindible en el engranaje son pocas las publicaciones que llegan a esta Revista sobre el tema, por lo que es necesario que los profesionales que trabajan en cualquier vertiente de ese campo hagan llegar sus experiencias al mundo apasionante de la enfermería nefrología.
COVID-19 Pandemisini Durdurmaya Yönelik Tedbirlerin Çocuk Sağlığına Etkileri: Tüm Yönleriyle
Authors: AKÖZLÜ Zeynep , MUTLU Birsen
Published: September 2023

COVID-19 pandemisi sürecinde virüse maruz kalma ve bunun sonucunda ortaya çıkan enfeksiyonu önlemek, yeterli tıbbi bakımı sağlamak, salgının ilerlemesini yavaşlatmak, ve sağlık sistemlerinin sürdürülebilirliğini sağlamak amacıyla çeşitli tedbirler alınmıştır. Bu evrensel kriz, her yaştan ve her ülkeden çocuğu etkilemiştir. Alınan tedbirler kapsamında uygulanan sokağa çıkma kısıtlamaları çocukların genel sağlığı, esenlikleri ve gelişimleri üzerinde olumsuz etkiler yaratmıştır. Pediatri hemşireleri, COVID-19 krizinin çocuklar üzerindeki etkilerinin farkında olmak ve pandemi koşulları altında bile çocuğun sağlıklı büyüme ve gelişmesini desteklemek açısından oldukça kritik konumdadır. Dünyada ve Türkiye’de çocuk sağlığına yönelik kazanımların sürdürülmesi için başta pediatri hemşireleri olmak üzere tüm hemşirelerin COVID-19 pandemisinin çocuk refahı üzerindeki etkileri hakkında bilgi sahibi olması önemlidir. Bu derlemede COVID-19 pandemisi yönetimine ilişkin önlemlerin çocuk sağlığı üzerindeki etkilerinin incelenmesi amaçlanmıştır. Yapılan literatür incelemesi sonucunda COVID-19 pandemisinin çocuk sağlığı üzerindeki etkilerinin beslenme bozuklukları, ekran süresinin artışı, fiziksel aktivitede azalma, uyku düzeninde bozulmalar, kazalar/yaralanmalar ve zehirlenmeler, sağlık hizmetlerine erişememe, eğitimin kesintiye uğraması, okul temelli sağlık hizmetlerine erişimde güçlükler, yoksulluk, ihmal/istismar, çocuk işçiliğinde ve evliliklerinde artış ve tüm bunların getirdiği psikososyal sorunlar olmak üzere oldukça geniş boyutlu olduğu görülmüştür.
Migración y medios de comunicación. Notas periodísticas del fenómeno migratorio hacia Estados Unidos
Authors: Rocha Romero David , Vera Martínez Martín Cutberto
Published: September 2023

El presente artículo tiene como objetivo analizar cómo algunos periódicos nacionales y extranjeros presentan la migración internacional que atraviesa México para llegar al norte, de 2016 a 2019. Para tal efecto se tomó una muestra de 196 notas periodísticas. Se analiza cómo los periódicos que retratan la realidad, de manera subjetiva, ya sea por criterios editoriales, ideología política o intereses particulares, ven este fenómeno migratorio. Se clasificaron las notas periodísticas como neutras, positivas o negativas y así tener una visión más clara y panorámica de la postura de los medios frente a la migración internacional. De 96 notas periodísticas, el 56% se consideró como neutras, el 26% como positivas y el 17% negativas. Entre las nacionales el 64% son neutras y 14% positivas y entre las extranjeras 51% son neutras y 32% positivas. Las fuentes extranjeras tienen el doble de porcentaje de notas consideradas positivas.
Factores asociados a la fatiga laboral de conductores de mixer de una planta de hormigón
Authors: Chuñir García Henrry Marcelo , Manzano Merchán Fredy Omar
Published: September 2023

La presente investigación analiza los factores asociados a la fatiga laboral de los conductores de mixer de una planta de hormigón de la ciudad de Cuenca – Ecuador. El diseño de la investigación es exploratorio, descriptivo y no experimental; el instrumento de fatiga laboral de H. Yoshitake y el instrumento complementario sociodemográfico, laboral, accidentes e incidentes se ejecutó en la empresa, donde fue resuelto individualmente por los 40 conductores al terminar de conducir por varias horas durante toda la jornada laboral. Se divide en dos partes, mediante el análisis estadístico descriptivo se evidenció que los factores que predominan en la correlación de: sociodemográfico y laboral con la fatiga es el estado civil, nivel de instrucción, lugar de residencia y tiempo de recorrido vivienda – trabajo; y la segunda entre accidentes e incidentes laborales con la fatiga, en quienes sí presenciaron estos factores en conjunto. Los hallazgos indican un alto índice de fatiga que presentan los conductores, por ello se debe implementar medidas de corrección y la organización de las actividades laborales. También, se debe evaluar la salud de los conductores para prevenir enfermedades preexistentes que se relacionan con la aparición de la fatiga laboral.
Trastornos músculo esqueléticos en el personal de enfermería de un hospital en Cuenca, Ecuador
Authors: Moscoso Moscoso Paola Carolina , Matovelle Bustos Daniela Lorena
Published: September 2023

Las enfermedades músculo esqueléticas son evidentes en el personal de enfermería, pues son el grupo laboral con mayor incidencia de dolor de espalda, de esfuerzo y sintomatología neurológica, producto del manejo manual, la condición clínica de los pacientes y los principios biomecánicos aplicables. Los Trastornos Músculo Esqueléticos son un grupo de alteraciones, los cuales afectan a diversas partes del cuerpo y se manifiestan con síntomas dolorosos. El objetivo de este trabajo fue evaluar las alteraciones músculo esqueléticos asociadas a la movilización manual de pacientes, en el personal de enfermería de un hospital de la ciudad de Cuenca, Ecuador. El enfoque del estudio fue de tipo cualitativo y cuantitativo de alcance descriptivo y transversal aplicado a una población de 13 enfermeras/os. La información se obtuvo mediante el cuestionario Nórdico de Kuorinka, el cual determinó que las zonas corporales afectadas en el último año fueron: lumbar 77%, tobillos y pies 69%, cuello 46%, dorsal 38%, rodillas 31%, hombro 23%, muñeca 8%; el método MAPO estableció un índice de riesgo de 5,8 necesitando intervenciones a corto plazo. Se concluye que el índice MAPO es Alto teniendo 5,6 veces más riesgo de desarrollar problemas músculo esqueléticos que el resto de la población.
Hubungan Perilaku Ibu dalam Pemilihan Makanan Balita Dengan Statu Gizi Kurang di Wilayah Kerja Puskesmas Wajo
Authors: Isna Putri Syarif Syastriani , Asriadi  , Anita
Published: September 2023

The role of mothers in protecting children's nutritional conditions is by increasing their knowledge, attitudes and actions of mothers regarding toddler nutrition. Nutritional disorders can be caused by a lack of knowledge, attitudes, and actions in an effort to apply information in everyday life.The research method used is descriptive analytical method which means survey research that tries to explore how and why health phenomena occur using 46 samples and 46 populations and found mothers who have good knowledge as much as 11 (23.9%) and less knowledge 35 (76, 1%). while those with good attitudes were 2 (4.3%) and less attitudes were 44 (95.7%) and there were also 17 (37.0%) good and 29 (63.0%) good mothers.So the conclusion of this study is that there is a significant relationship between maternal behavior concerning the knowledge, attitudes and actions of mothers in the dietary selection of children under five under five in the working area of Baubau City Wajo Health Center in 2018, with the hypothesis that HA is treated Hₐ is acceptedSuggestions in this study are to further improve the knowledge of mothers of children under five through the implementation of Posyandu activities and balit weight weighing periodically and continuously and also to improve services through counseling on mothers' knowledge, attitudes, and actions and the selection of food for mothers.
Teori Receptie, dan Teori Receptie a Contrario dalam Pusaran Muslim Minoritas dan Muslim Mayoritas di Indonesia
Authors: Omega Hasan Lucky
Published: September 2023

This research investigates the application of the Reception Theory and Reception Theory A Contrario in the context of minority and majority Muslim communities in Indonesia. Through literature studies, case analyses, interviews, and contrastive analysis, this research aims to understand the impact of using both of these theories on the social reality in regions with different characteristics. The research results indicate that, although they hold academic value, the Reception Theory and Reception Theory A Contrario are not in line with the factual conditions of society in Indonesia, particularly in Aceh and Bali. The application of these theories has the potential to create conflicts between the majority and minority Muslim communities. Therefore, the author concludes that the Reception Theory and Reception Theory A Contrario should not be used as the main theories or references in regulating the application of Islamic law in Indonesia. Instead, a more inclusive approach is needed that can accommodate the cultural and religious diversity in Indonesia. This research provides a new contribution to the discussion on the relevance of Islamic law theories in the multicultural social context of Indonesia.
Постать Лонгина Цегельського в розвитку міжнародних відносин і дипломатії Західноукраїнської Народної Республіки
Authors: Полич М.І.
Published: September 2023

У статті простежено фopмyвання світогляду та особистості Лонгина Цeгельcькoго. Розглянуто його особистість як політика і громадського діяч в останній період існування Авcтрo-Угоpcької імперії. Oxaрактеризовано його участь у cтyдентськомy русі та перші кроки у політичній кар’єрі. Підкреслено, що посольська діяльність Л. Цeгeльcького розпочалася в період, коли заxідноyкраїнське суспільство перебувало у правовому полі Aвстpо-Угopської монархії. Завдяки чіткій позиції та ораторським здібностям він викривав антинародну політику цісарського правління, критикував і засуджував галицьке москвофільство, захищав інтереси і права українських селян. Окрім того, проаналізовано політичну діяльність Л. Цегельського у роки Першої світової війни.

Проаналізовано державотворчу та міжнародну діяльність Л. Цeгeльcького у роки національно-визвольних змагань 1918–1921 рр. Зазначено, що серед галицького політикуму Л. Цeгeльcький виокремлювався теоретичною та політичною підготовкою, далекоглядністю та переконливою позицією. З початку визвольних змагань політик виступав за повне забезпечення автономії і політичної рівноправності національних меншин, peaлізацію яких можна було б здійснити насамперед мирними, лeгiтимно-пpaвовими методами.

Зазначено, що особливої уваги заслуговує період життя Л. Цегельського, пов’язаний із його дepжавотворчою діяльністю у період Західноукраїнської Народної Республіки. Л. Цегельський виступав ініціатором різного роду державно-політичних акцій, виявляв чималу активність у різних зустрічах, зібраннях, маніфестаціях і нарадах. Проаналізовано його роботу після проголошення злуки українських земель коли він став одночасно заступником міністра закордонних справ Української Народної Республіки в Києві.
Українсько-німецькі відносини в контексті Брест-Литовської конференції 1918 р.
Authors: Дацків І.Б.
Published: September 2023

У даній статті йдеться про міжнародні зв’язки України в добу національно-визвольних змагань 1917-1918 рр. З’ясовуються передумови українсько-німецького зближення наприкінці Першої світової війни. У роботі проаналізовано особливості відносин між Німеччиною та урядом Української Центральної Ради, розкривається вплив політики Німеччини на становлення та розвиток української державності. Охарактеризовано участь української делегації на Брест-Литовських переговорах, та укладення мирного договору з Центральними державами. В науковому дослідженні розглядаються економічні аспекти, зокрема в системі українсько-німецьких відносин, які суттєво впливали на зовнішньополітичну орієнтацію Києва та Берліна, були важливим чинником під час переговорів та укладання міжнародних угод. Висвітлюється діяльність українських дипломатичних представництв та економічно-торгівельних місій за кордоном, спрямованої на забезпечення розвитку української економіки та потреб війни за незалежність. Показано залежність відносин між Німеччиною та Україною від розстановки сил на міжнародній арені. Показано, що найважливішим досягненням України, здобутим завдяки економічним угодам, було збереження державної незалежності та вихід на міжнародну арену і на цій основі можливість продовжувати національно-визвольні змагання у майбутньому. Загалом проведення такого дослідження є доцільним не тільки в контексті історії Німеччини та України, а й у контексті всесвітньої історії, оскільки еволюція українсько-німецьких відносин у цей період значною мірою залежала від розвитку подій на міжнародній арені.