Uso de fuentes de información y tecnologías de la información y comunicación (TIC) según el tipo de universidsad en siete países de América Latina

Objetivos: Identificar el uso de fuentes de información, así como, tecnologías de la información y comunicación (TIC) según el tipo de universidad en siete países de América Latina.Métodos:Estudio transversal en estudiantes de medicina de siete países de América Latina. Se midió el uso de fuentes y tecnologías de información y comunicación con el autoreporte sobre el uso de buscadores científicos (SciELO, PubMed, Google Scholar) y TIC (laptop, smartphone, wifi). Las variables secundarias fueron el país y el tipo de universidad de procedencia (pública/privada) de los estudiantes de medicina. Resultados: De 4463 encuestados, SciELO fue usado por el 83.3% y el 55.0% en una universidad pública y privada, respectivamente. Mientras que PubMed fue reportado por el 79.9% y 59.2% de estudiantes de universidad pública y privada, respectivamente. Las universidades privadas tuvieron mayor uso de TIC en Panamá y Bolivia, en contraste con aquellas de tipo públicas fueron Paraguay, México, Colombia y Argentina. La mayoría de los estudiantes usaban smartphone en más del 60%. Conclusiones: Se identificó que el smartphone fue utilizado por la mayoría de los estudiantes. El uso de Internet fue mayor en estudiantes de universidades privadas, además, no se encontraron grandes porcentajes del uso de PubMed y SciELO, en universidades públicas y privadas. Se deben reforzar las estrategias educativas en el campo de la educación médica, debido a pobre cultura de manejo de información basada en evidencias

Polimorfismo del gen de la banda 3 eritrocítica en grupos étnicos de Costa Rica

Banda 3 (AE1) es una de las proteínas más abundantes de la membrana del eritrocito humano. Ésta funciona como un intercambiador aniónico cloruro / bicarbonato y es el punto de anclaje de varias proteínas del citoesqueleto del eritrocito. Se han descrito varias mutaciones y muchas variantes polimórficas se han asociado a esferocitosis hereditaria. La identificación de un marcador genético en el extremo 5’ del gene AE1 podría asociarse a varios defectos moleculares del eritrocito. Este marcador genético es un fragmento de restricción de longitud polimórfica "RFLP" producido por la endonucleasa de restricción Pst I. Se analizaron para este polimorfismo un total de 216 individuos de siete poblaciones: una hispanomestiza (Valle Central), dos afrodescendientes (Limón y Guanacaste) y cuatro amerindias (bribri, cabecar, maleku y guaymí). El alelo más frecuente en la población hispanomestiza fue el 2, mientras en los grupos afrodescendientes y amerindios se encontró el 1. No se observaron diferencias significativas con respecto al equilibrio de Hardy-Weinberg en seis de las poblaciones, sin embargo, el grupo Guaymí si presenta diferencias significativas con respecto al equilibrio de Hardy-Weinberg.<br>Polymorphism of the erythrocyte band 3 gene (EPB3) in ethnic groups of Costa Rica. Band 3 (AE1) is one of the most abundant proteins in the membrane of the human erythrocyte. This protein works as an anionic CI - and HCO3- exchanger and it also functions as an anchor for several proteins of the erythrocyte's cytoesqueleton. Several mutations have been described and many polymorphic variants have been associated to hereditary spherocytosis. The identification of a genetic marker at position 5' of the AE1 gene could be associated to several molecular defects of the erythrocyte. This genetic marker is a restriction fragment length polymorphism (RFLP) produced by restriction enzime Pst I. For this polymorphism a total of 216 individuals belonging to seven different populations were analyzed: one from the Central Valley, two African descendants (Limón and Guanacaste) and four Amerindians (Bribri, Cabecar, Maleku and Guaymi). The most frequent allele in the Amerindian population was no 1. No significant differences were found with respect to the Hardy-Weinberg equilibrium in six of the populations, although the Guaymi group does present significative differences. Rev. Biol. Trop. 52(3): 659-663. Epub 2004 Dic 15

Caudal epidural block instead of general anesthesia in an adult with Duchenne muscular dystrophy

Shabana Z Shafy,1 Mohammed Hakim,1 Mauricio Arce Villalobos,1 Gregory D Pearson,2,3 Giorgio Veneziano,1 Joseph D Tobias1,4 1Department of Anesthesiology and Pain Medicine, Nationwide Children&rsquo;s Hospital, Columbus, OH, USA; 2Department of Plastic Surgery, Nationwide Children&rsquo;s Hospital, Columbus, OH, USA; 3Department of Plastic Surgery, The Ohio State University, Columbus, Ohio, USA; 4Department of Anesthesiology &amp; Pain Medicine, The Ohio State University, Columbus, Ohio, USA Abstract: Duchenne muscular dystrophy (DMD), first described in 1834, is an X-linked dystrophinopathy, leading to early onset skeletal muscle weakness. Life expectancy is reduced to early adulthood as a result of involvement of voluntary skeletal muscles with respiratory failure, orthopedic deformities, and associated cardiomyopathy. Given its multisystem involvement, surgical intervention may be required to address the sequelae of the disease process. We present a 36-year-old adult with DMD, who required anesthetic care during surgical debridement of an ischial pressure sore. Given his significant respiratory muscle involvement, ultrasound-guided caudal epidural anesthesia was used instead of general during the surgical procedure. The technique and its applications are discussed, with particular emphasis on the feasibility and safety of using regional anesthetic techniques in patients with DMD. Keywords: Duchenne&rsquo;s muscular dystrophy, caudal epidural, regional anesthesi

Restauráción del paisaje en Hojancha, Costa Rica

15 ilus. 9 tab. 47 ref. 51 pág.El objetivo de este trabajo fue evaluar las condiciones, procesos y resultados de la restauración del paisaje en el cantón de Hojancha, Guanacaste, Costa Rica. La metodología constó de la construcción de un éstandar (marco jerárquico de principios, criterios e indicadores) y la sistematización de la experiencia desde el punto de vista de la institucionalidad. Los resultados muestran que las políticas, intervención externa y mecanismos de compensación crearon condiciones favorables. Los procesos desarrollados fueron la capacidad de gestión y coordinación y la convergencia de las acciones de las organizaciones locales. Los resultados se dieron en la estructura y composición del paisaje y en los bienes y servicios que el mismo genera. The objective was to evaluate the conditons, processes, and results of landscape restoration in Hojancha, Guanacaste, Costa Rica. A standard (hierarchical framework of principles, criteria, and indicators) was built and the experience was systematized from the institutional point of view. The results showed that favorables conditions were created by the political framework, external intervention, and compensation mechanisMON. The processes developed were the managing and coordinating capacities, and convergence of actions among local institutions. Results were evident in the structure and composition of the landscape as well as in the goods and services generated by the landscape

Evaluaci?n de la restauraci?n del paisaje en el cant?n de Hojancha, Costa Rica

Ilus. 1 tab.El objetivo de este trabajo fue evaluar las condiciones, procesos y resultados de la restauraci?n del paisaje en el cant?n de Hojancha, Guanacaste, Costa Rica. Para ello se construy? un est?ndar (marco jer?rquico de principios, criterios e indicadores -PC&I) y se sistematiz? la experiencia desde el punto de vista de institucionalidad. Los resultados muestran que las condiciones se dieron en el ?mbito de pol?ticas, intervenci?n externa y mecanismos de compensaci?n. Los procesos desarrollados fueron la capacidad de gesti?n y la coordinaci?n y convergencia de las acciones de las instituciones locales. Los resultados se dieron en la estructura y composici?n del paisaje y en los bienes y servicios que el mismo genera. The objective of the study was to evaluate the conditions, processes, and results of landscape restoration in Hojancha, Guanacaste, Costa Rica. The methodology was developed by constructing a standard (hierarchical framework of principles, criteria, and indicators [PC&I]) and with the systemization of the experience from the institutional point of view. The results showed that the conditions were observed in the political framework, external intervention, and compensation mechanisms. The processes developed were the managing capacity, coordination, and action convergence of local institutions. The results were observed in the structure and composition of the landscape as well as in the goods and services generated by the landscape

La tala ilegal en Costa Rica: un an?lisis para la discusi?n

6 ilus. 6 tab. 27 ref. Tambi?n como: Serie Econom?a, Pol?tica y Gobernanza del Ordenamiento de Recursos Naturales. no.

Evaluation of postoperative analgesia in pediatric patients after hip surgery: lumbar plexus versus caudal epidural analgesia

Mauricio Arce Villalobos,1 Giorgio Veneziano,1,2 Rebecca Miller,1 Ralph J Beltran,1,2 Senthil Krishna,1,2 Dmitry Tumin,1,3 Kevin Klingele,1,2 Joseph D Tobias1&ndash;31Department of Anesthesiology &amp; Pain Medicine, Nationwide Children&rsquo;s Hospital, Columbus, OH, USA; 2Department of Anesthesiology &amp; Pain Medicine, The Ohio State University College of Medicine, Columbus, OH, USA; 3Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USABackground:There continues to be focus on the value of regional and neuraxial anesthetic techniques when combined with general anesthesia to improve postoperative analgesia. The reported advantages include decreased postoperative opioid requirements, decreased medication-related adverse effects, decreased hospital length of stay, and increased patient satisfaction. Orthopedic procedures of the hip may be amenable to such techniques as there is significant postoperative pain with the requirement for hospital admission and the administration of parenteral opioids. Given the surgical site, various regional anesthetic techniques may be used to provide analgesia including caudal epidural anesthesia (CEA) or lumbar plexus blockade (LPB).Purpose: The objective of this study was to assess the effectiveness of LPB versus CEA as an analgesic thechnique for patients undergoing elective hip surgery from the opioid consumption and pain scores perspective.Patients and methods: The current study retrospectively reviews our experience with CEA and LPB for postoperative analgesia after hip surgery in the pediatric population.&nbsp;Regional anesthesia technique was reviewed as well as opioid requirements and pain scores.Results: The study cohort included 61 patients, 29 who received an LPB and 32 who received CEA. No difference was noted in the demographics between the two groups. Intraoperative opioid use was 0.7 (IQR: 0.5, 1.1) mg/kg of oral morphine equivalents (MEs) in the LPB group compared to 0.6 (IQR: 0.5, 0.9) in the CEA group (p=0.479). Postoperative opioid use over the first 48 hrs was 4 (IQR: 1, 6) mg/kg of oral ME in the LPB group, compared to 2 (interquartile range [IQR]: 1, 3) in the CEA group (p=0.103). Over the first 24 hrs after surgery, the median pain score in the LPB group was 5 (IQR: 1&ndash;6), compared to 3 (IQR: 0, 5) in the CEA group (p=0.014).Conclusion: These retrospective data suggest a modest postoperative benefit of CEA when compared to LPB following hip surgery in the pediatric population. Postoperative pain scores were lower in patients receiving CEA; however, no difference in the intraoperative or postoperative opioid requirements was noted between the two groups.Keywords: lumbar plexus block, caudal epidural anesthesi