Funcionalidad de la mano luego de una carpectomía proximal: primer caso en el servicio de kinesiología de la Universidad Nacional de Asunción

The wrist is the anatomical segment that allows the hand to be brought closer to the mouth. Fractures and dislocations of the carpal bones are rare, accounting for between 5-7% of fractures of the wrist and hand, and occur through high-risk trauma. energy thus generating a significant physical and functional disability for the patient. Proximal row carpectomy aims to preserve the mobility of the wrist and reduce its impairment for activities of daily living. We present a 41-year-old male patient with a sawmill profession who was referred to physiotherapy rehabilitation after surgery due to high-energy trauma to the dominant hand through a traffic accident. The evolution was favorable, after 8 weeks of physiotherapy rehabilitation and following an intervention protocol mediated by therapeutic and rehabilitation exercises, the patient was able to perform voluntary activities with the hand related to mobility and grip strength.La muñeca es el segmento anatómico que permite aproximar la mano a la boca, las fracturas luxaciones de los huesos del carpo son poco frecuentes, corresponden entre el 5-7% de las fracturas de la muñeca y la mano, se presentan mediante traumatismos de alta energía generando así una discapacidad física y funcional importante para el paciente. La carpectomía de la hilera proximal tiene como objetivo preservar la movilidad de la muñeca y reducir su deterioro para las actividades de la vida diaria. Se presenta un paciente de sexo masculino de 41 años de edad de profesión aserradero que fue derivado a rehabilitación fisioterapéutica post intervención quirúrgica por traumatismo de alta energía sobre la mano dominante a través un accidente de tránsito. La evolución fue favorable, a las 8 semanas de rehabilitación fisioterapéutica y siguiendo un protocolo de intervención mediado por ejercicios terapéuticos y de rehabilitación, el paciente logró realizar actividades voluntarias con la mano relacionadas a la movilidad y la fuerza de prensión. &nbsp

Epigenética en técnicas de reproducción asistida: razones y evidencias para una reflexión

Los procesos epigenéticos producen cambios covalentes en la cadena de ADN sin alteración en la secuencia de bases nitrogenadas. Una de las modificaciones epigenéticas más relevantes es el proceso de metilación de citosina. Este proceso es de vital importancia para mantener el silenciamiento génico en el desarrollo normal, la impronta genómica y la inactivación del cromosoma X. Así, por ejemplo, cuando se producen alteraciones en la impronta, estos pueden desencadenar enfermedades, especialmente aquellas relacionadas con defectos en el desarrollo embrionario y el proceso neoplásico. En los últimos años se ha visto que mediante el uso de técnicas de reproducción asistida (TRAs), se pueden ver aumentados los desórdenes de este tipo, motivación suficiente por la que creemos que resulta de interés un mayor conocimiento de las modificaciones epigenéticas y su relación con numerosas enfermedades y disfunciones tras el uso de TRAs, con notables consecuencias sobre el manejo, tratamiento y prevención en el futuro de enfermedades en recién nacidos. En este trabajo, se describen los mecanismos de las modificaciones epigenéticas, más concretamente la metilación de citosina, las implicaciones que tiene dicha metilación de ADN sobre disfunciones y desarrollo de enfermedades en recién nacidos, los factores implicados en TRAs causantes y/o transmisión de la metilación de ADN y, finalmente, las metodologías analíticas para la determinación del grado de metilación en ADN.Epigenetic events lead to covalent modifications at the DNA chain without mutagenic alterations in the DNA sequence. One of the most relevant epigenetic modifications corresponds to the methylation process of cytosine. The above process is of outstanding importance to keep the gene silencing of normal development, genomic imprinting and inactivation of chromosome X. Thus, for instance, when the genomic imprinting suffers alterations, it can trigger the appearance of diseases, mainly those related to defects during the embrionary development or in neoplasic processes. Over the last few years, it has been observed that via the use of assisted reproductive techniques (ARTs) a number of the above disorders and dysfunctions can be proliferated, reason enough for which we strongly demand a more profound knowledge about the epigenetic modifications and their relationships with a wide number of diseases and dysfunctions after ARTs, with notable consequences in the management, treatment and prevention of diseases in newborn babies In this work, the authors describe the mechanisms involved in epigenetic modifications -more particularly cytosine methylation-, the implications of cytosine methylation at DNA upon dysfunctions and development of diseases in newborn babies, causal factors implicated in ARTs and/or transmission of DNA methylation and, finally, the analytical methodologies used for the determination of methylation grade in DNA

Group Prenatal Care in Mexico: perspectives and experiences of health personnel

OBJETIVO: Identificar barreras y facilitadores de la implementación del modelo de Atención Prenatal en Grupo en México (APG), desde la perspectiva del personal de salud. MÉTODOS: Estudio cualitativo descriptivo en cuatro clínicas de la Secretaría de Salud en dos estados de México (Morelos e Hidalgo) de junio de 2016 a agosto de 2018. Se realizaron 11 entrevistas semi-estructuradas a prestadores de servicios de salud. Se exploraron sus percepciones y experiencias durante la implementación del modelo de APG. Se identificaron barreras y facilitadores para su adopción en dos dimensiones: a) estructurales (espacio, recursos, personal de salud, volumen de pacientes, comunidad) y b) actitudinales (motivación, liderazgo, aceptabilidad, abordaje de problemas, clima y comunicación). RESULTADOS: Las barreras más relevantes reportadas en el nivel estructural fueron la disponibilidad de espacio físico en las unidades y la sobrecarga de trabajo del personal de salud. Se identificó la dificultad para adoptar una relación menos jerárquica durante la atención a las gestantes en el nivel actitudinal. El principal facilitador a nivel actitudinal fue la aceptabilidad que los prestadores tienen del modelo. Un hallazgo específico para el contexto de la implementación en México fue la resistencia al cambio en la relación médico-paciente; resulta difícil abandonar el modelo jerárquico prevaleciente y cambiar a una relación más horizontal con las gestantes. CONCLUSIONES: El análisis de la implementación del modelo de APG en México, desde la perspectiva del personal de salud, ha evidenciado barreras y facilitadores similares a las experiencias en otros contextos. Esfuerzos futuros para la adopción del modelo deberán enfocarse en la atención oportuna de las barreras identificadas, sobre todo aquellas señaladas en la dimensión actitudinal que pueden ser modificadas a través de capacitaciones continuas al personal de salud.OBJECTIVE: Identify barriers and facilitators to implementing the Group Prenatal Care model in Mexico (GPC) from the health care personnel’s perspective. METHODS: We carried out a qualitative descriptive study in four clinics of the Ministry of Health in two states of Mexico (Morelos and Hidalgo) from June 2016 to August 2018. We conducted 11 semi-structured interviews with health care service providers, and we examined their perceptions and experiences during the implementation of the GPC model. We identified the barriers and facilitators for its adoption in two dimensions: a) structural (space, resources, health personnel, patient volume, community) and b) attitudinal (motivation, leadership, acceptability, address problems, work atmosphere and communication). RESULTS: The most relevant barriers reported at the structural level were the availability of physical space in health units and the work overload of health personnel. We identified the difficulty in adopting a less hierarchical relationship during the pregnant women’s care at the attitudinal level. The main facilitator at the attitudinal level was the acceptability that providers had of the model. One specific finding for Mexico’s implementation context was the resistance to change the doctor-patient relationship; it is difficult to abandon the prevailing hierarchical model and change to a more horizontal relationship with pregnant women. CONCLUSION: Analyzing the GPC model’s implementation in Mexico, from the health care personnel’s perspective, has revealed barriers and facilitators similar to the experiences in other contexts. Future efforts to adopt the model should focus on timely attention to identified barriers, especially those identified in the attitudinal dimension that can be modified by regular health care personnel training

Analysis of four scales for global severity evaluation in Parkinson’s disease

Global evaluations of Parkinson?s disease (PD) severity are available, but their concordance and accuracy have not been previously tested. The present international, cross-sectional study was aimed at determining the agreement level among four global scales for PD (Hoehn and Yahr, HY; Clinical Global Impression of Severity, CGIS; Clinical Impression of Severity Index, CISI-PD; and Patient Global Impression of Severity, PGIS) and identifying which of them better correlates with itemized PD assessments. Assessments included additional scales for evaluation of the movement impairment, disability, affective disorders, and quality of life. Spearman correlation coefficients, weighted and generalized kappa, and Kendall?s concordance coefficient were used. Four hundred thirty three PD patients, 66% in HY stages 2 or 3, mean disease duration 8.8 years, were analyzed. Correlation between the global scales ranged from 0.60 (HY with PGIS) to 0.91 (CGIS with CISI-PD). Kendall?s coefficient of concordance resulted 0.76 (P<0.0001). HY and CISI-PD showed the highest association with age, disease duration, and levodopa-equivalent daily dose, and CISI-PD with measures of PD manifestations, disability, and quality of life. PGIS and CISI-PD correlated similarly with anxiety and depression scores. The lowest agreement in classifying patients as mild, moderate, or severe was observed between PGIS and HY or CISI-PD (58%) and the highest between CGIS and CISI-PD (84.3%). The four PD global severity scales agree moderately to strongly among them; clinician-based ratings estimate PD severity, as established by other measures, better than PGIS; and the CISI-PD showed the highest association with measures of impairment, disability, and quality of life.Fil: Martinez Martin, Pablo. Universidad Carlos III de Madrid. Instituto de Salud; EspañaFil: Rojo Abuin, José Manuel. Consejo Superior de Investigaciones Cientificas. Centro de Ciencias Humanas y Sociales. Instituto de Historia.; EspañaFil: Rodríguez Violante, Mayela. Instituto Nacional de Neurología y Neurocirugía; MéxicoFil: Serrano Dueñas, Marcos. Pontificia Universidad Católica del Ecuador; EcuadorFil: Garreto, Nélida Susana. Universidad de Buenos Aires. Facultad de Medicina. Centro Universitario de Neurologia "dr. Jose Maria Ramos Mejia".; ArgentinaFil: Martínez Castrillo, Juan Carlos. Instituto Ramón y Cajal de Investigación Sanitaria; EspañaFil: Campos Arillo, Víctor. Hospital Xanit International; EspañaFil: Fernández, William. Universidad Nacional de Colombia; ColombiaFil: Chaná Cuevas, Pedro. Universidad de Santiago de Chile. Facultad de Humanidades. Instituto de Ciencias Biomédicas.; ChileFil: Arakaki, Tomoko. Universidad de Buenos Aires. Facultad de Medicina. Centro Universitario de Neurologia "dr. Jose Maria Ramos Mejia".; Argentina. Fundación para la Lucha contra las Enfermedades Neurológicas de la Infancia; ArgentinaFil: Alvarez, Mario Gustavo. Centro Internacional de Restauración Neurológica ; CubaFil: Pedroso Ibañez, Ivonne. Centro Internacional de Restauración Neurológica ; CubaFil: Rodríguez Blázquez , Carmen. Universidad Carlos III de Madrid. Instituto de Salud; EspañaFil: Ray Chaudhuri , Kallol. National Parkinson Foundation International Centre of Excellence; Reino UnidoFil: Merello, Marcelo Jorge. Fundación para la Lucha contra las Enfermedades Neurológicas de la Infancia; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentin

Combination of inclusive top-quark pair production cross-section measurements using ATLAS and CMS data at √s = 7 and 8 TeV

ATLAS-CMS Collaboration: et al.A combination of measurements of the inclusive top-quark pair production cross-section performed by ATLAS and CMS in proton–proton collisions at centre-of-mass energies of 7 and 8 TeV at the LHC is presented. The cross-sections are obtained using topquark pair decays with an opposite-charge electron–muon pair in the final state and with data corresponding to an integrated luminosity of about 5 fb−1 at √s = 7 TeV and about 20 fb−1 at √s = 8 TeV for each experiment. The combined cross-sections are determined to be 178.5 ± 4.7 pb at √s = 7 TeV and 243.3+6.0−5.9 pb at √s = 8 TeV with a correlation of 0.41, using a reference top-quark mass value of 172.5 GeV. The ratio of the combined crosssections is determined to be R8/7 = 1.363 ± 0.032. The combined measured cross-sections and their ratio agree well with theory calculations using several parton distribution function (PDF) sets. The values of the top-quark pole mass (with the strong coupling fixed at 0.118) and the strong coupling (with the top-quark pole mass fixed at 172.5 GeV) are extracted from the combined results by fitting a next-to-next-to-leading-order plus next-to-next-toleading-log QCD prediction to the measurements. Using a version of the NNPDF3.1PDF set containing no top-quark measurements, the results obtained are m pole t = 173.4+1.8−2.0 GeV and αs(mZ) = 0.1170+0.0021−0.0018.Article funded by SCOAP3 .Generalitat Valenciana; MCIN/AEI/10.13039/501100011033, ERDF “a way of making Europe”, and the Programa Estatal de Fomento de la Investigación Científica y Técnica de Excelencia María de Maeztu, grant MDM-2017-0765 and Programa Severo Ochoa del Principado de Asturias (Spain). Individuals have received support from the Marie-Curie programme and the European Research Council and Horizon 2020 Grant, contract Nos. 675440, 724704, 752730, 758316, 765710, 824093, 884104, and COST Action CA16108 (European Union).Peer reviewe

Ser alumno en la nocturna: entre el oficio y la posibilidad / To be a student at evening school: between job and possibility

This article is the result of a research about the life and work of the French educator Philippe Meirieu and it tries to show some discourse aspects of peda­gogy in France and its relationship with the sciences of education. Pudgy is not the science of education as it appears in other conceptual regions or pedagogic traditions (German or English). Science of education in France appears institu­tionalized in 1967 and since that date pedagogy inhabits in its bosom as a con­cept rather than as a disciplinary space. With the aim of understanding the com­plex discourse of pedagogy we have con­sulted magazines, books, papers and some doctoral theses in science of education. Among the most important magazines in our field of reference we can mention The French Magazine of Pedagogy (Revue Francaise de Pédagogie), Magazine of Sci­ence of Education for the New Era (Revue de Sciencies de l’Education Pour la Nou­velle Era), the Pedagogy Notebooks (Ca­hiers de Pédagogie), the Magazine Knowl­edge’s (Revue Savoirs). These magazines appeared on the French university stage some years after the birth of the science of education. As Pedagogy appears as a given concept, it seems that this ques­tion is neither the spring nor the interest of the theorists or practicals or experts; it has each day less place in the science of education debates.El presente trabajo comprende algunos re­sultados preliminares de la investigación en curso: “Las subjetividades juveniles en las escuelas medias nocturnas”. Desde una perspectiva cualitativa, se plan­tea un abordaje que permita rescatar sin­gularidades, sentidos, significados y re­presentaciones puestos en juego en los procesos estudiados hasta el momento. Considerando que los establecimientos educativos comprendidos en la investi­gación poseen características particulares, población escolar proveniente de contex­tos socio-culturales diversos y con biogra­fías de fracaso escolar, éstas parecen incidir en las representaciones que los alumnos construyen acerca de sí mismos, de sus trayectorias escolares y de sus percepcio­nes respecto del ser “buen alumno”. El objetivo es establecer algunas conside­raciones respecto de las representaciones que los jóvenes que asisten a las escuelas medias nocturnas tienen acerca de: ¿Qué es ser buen alumno? ¿Qué percepciones tienen respecto de su oficio de alumno? ¿Qué representaciones poseen de las ca­racterísticas de su trayectoria escolar y del trabajo escolar? 

Optical-turbulence and wind profiles at San Pedro Mártir

Results of monitoring optical-turbulence profiles and velocity of the turbulence layers at San Pedro Mártir, Mexico, are presented. The data were collected during 11 nights in April-May 1997 and 16 nights in May 2000 using the Generalized Scidar of Nice University installed on the 1.5-m and 2.1-m telescopes. The statistical analysis of the 6414 turbulence profiles obtained shows that the seeing produced by the turbulence in the first 1.2 km, not including dome seeing, at the 1.5-m and the 2.1-m telescopes have median values of 0 to z 0. hss'' 63 and 0 to z 0. hss'' 44, respectively. The dome seeing at those telescopes have median values of 0 to z 0. hss'' 64 and 0 to z 0. hss'' 31. The turbulence above 1.2 km and in the whole atmosphere produces seeing with median values of 0 to z 0. hss'' 38 and 0 to z 0. hss'' 71. The temporal correlation of the turbulence strength drops to 5

Association between sociodemographic factors and noncavitated and cavitated caries lesions in 8- to 12-year-old Mexican schoolchildren

The aim of this study was to evaluate the association between sociodemographic factors and noncavitated and cavitated caries lesions in Mexican schoolchildren. This cross-sectional study was conducted in 2020 on 8-to-12-year-old schoolchildren of different socioeconomic status (SES). The caries was evaluated using ICDAS II, SES was evaluated using three categories—a high, middle, or low-income level—of the CONAPO. Multinomial logistic regression analyses were performed in order to ascertain the associations between socioeconomic factors and noncavitated and cavitated caries lesions. The prevalence of noncavitated lesions was 38.0% and cavitated lesions was 43.4% in permanent dentition. In all the samples, 50.6% of schoolchildren had poor oral hygiene. About 52.5% of the mothers and 64.7% of the fathers had less than 9 years of education. Schoolchildren with a low-income level have more cavitated lesions (ICDAS II 4–6) than schoolchildren with high-income level (56.3% vs 15.8%, P=.009). The multinomial logistic regression models showed that mother’s level of education <9 years and low-income level were significantly associated with cavitated caries lesions (ICDAS II 4–6), [odds ratio=1.79 (1.17 – 2.75); P=.007], [OR=2.21 (1.23 – 3.97); P=.008], respectively. The socioeconomic level was not associated with noncavitated caries lesions (ICDAS II 1–3)