La responsabilidad penal en la intervención médica en cirugías estéticas

Introduction: Medical intervention, especially in the field of plastic surgery, is a delicate activity in which health professionals must act with great skill and knowledge. However, concerns arise regarding the possible legal consequences for those doctors who, through negligence or incompetence, and lack of objective duty of care, harm their patients. Objectives: The fundamental objective of the research is to determine the criminal responsibility that falls on the doctor in surgical interventions, especially in plastic surgeries, to ensure a good right to health. An attempt was made to delve deeper into the way incompetence, ignorance, negligence, and lack of objective duty of care are judged and punished in this field. Methodology: To achieve a holistic understanding of the topic, a qualitative approach was adopted, theoretically based on scientific and jurisprudential data extracted from indexed journals. In addition, a comparative analysis of the law in Spain, Colombia and Chile was conducted, with the purpose of discerning the legislation pertinent to the criminal responsibility of health professionals in these countries. Conclusion: After an exhaustive review, it is concluded that failure to act with due sense in medical activities that put human life at risk may have legal consequences. However, criminal liability could not be precisely determined in the specific area of plastic surgeries in Ecuador, despite these being the interventions with the highest number of incidents and fatal outcomes in the country.Introducción: La intervención médica, especialmente en el ámbito de las cirugías plásticas, es una actividad delicada en la que los profesionales de la salud deben actuar con suma pericia y conocimiento. Sin embargo, surgen preocupaciones en cuanto a las posibles consecuencias legales para aquellos médicos que, por negligencia o impericia, y falta de deber objetivo de cuidado dañan a sus pacientes. Objetivos: El objetivo fundamental de la investigación es determinar la responsabilidad penal que recae sobre el médico en las intervenciones quirúrgicas, en especial en cirugías plásticas, con la finalidad de asegurar un buen derecho a la salud. Se buscó profundizar en la manera en que se juzga y se sanciona la impericia, el desconocimiento y la negligencia y la falta de deber objetivo de cuidado en este campo. Metodología: Para lograr una comprensión holística del tema, se adoptó un enfoque cualitativo, fundamentado teóricamente en datos científicos y jurisprudenciales extraídos de revistas indexadas. Además, se realizó un análisis comparativo del derecho en España, Colombia y Chile, con el propósito de discernir las legislaciones pertinentes a la responsabilidad penal de los profesionales de la salud en estos países. Conclusión: Tras una revisión exhaustiva, se concluye que no actuar con la debida sensatez en actividades médicas que ponen en riesgo la vida humana puede tener consecuencias legales. Sin embargo, no se pudo determinar con precisión la responsabilidad penal en el ámbito específico de las cirugías plásticas en Ecuador, a pesar de ser estas las intervenciones con un mayor número de incidencias y fatales desenlaces en el país. Área de estudio general: Derecho. Área de estudio específica: Derecho Procesal

Effects on BMI of a Program to promote healthy habits for adolescents and their parents

[EN] Obesity and overweight represent a public health problem. Its high prevalence and the negative biopsychosocial consequences of overweight in adolescents highlight the need for effective treatment. Intervention through the promotion of healthy habits is a strategy to improve this condition. The aim of this study was to develop a program of healthy habits for adolescents and their parents, looking for changes in the body mass index of adolescents before and after applying the program. Material and Method: A longitudinal, prospective, quasi-experimental and correlational study with non-probabilistic sampling was carried out through a nutritional, psychological, physical and family program involving adolescents between 12 and 15 years of age as well as their parents. Results: A difference was observed in the body mass index of adolescents before and after attending the program. Conclusions: This study showed that taking into account the global aspects of nutrition, psychological, physical and family activity, is an effective solution to this important health problem.[ES] La obesidad y el sobrepeso representan un problema de salud pública. Su alta prevalencia y las consecuencias biopsicosociales negativas del exceso de peso en adolescentes resaltan la necesidad de un tratamiento efectivo. La intervención mediante la promoción de hábitos saludables es una estrategia para mejorar esta condición. El objetivo de este estudio fue desarrollar un programa de hábitos saludables para adolescentes y sus padres, buscando cambios en el índice de masa corporal de los adolescentes antes y después de aplicar el programa.Material y Método: Se realizó un estudio longitudinal, prospectivo, cuasi-experimental y correlacional, con muestreo no probabilístico, mediante un programa nutriológico, psicológico, físico y familiar en el que participaron adolescentes entre 12 y 15 años de edad así como a sus padres.Resultados: Se observó una diferencia en el índice de masa corporal de los adolescentes antes y después de la asistencia al programa.Conclusiones: En este estudio se pudo demostrar que tomar en cuenta los aspectos globales de nutrición, psicológicos, actividad física y familiar, es una solución efectiva para este importante problema de salud.Chávez Montes De Oca, V.; Lerma Partida, S.; Luna Vázquez, F.; Carrasco Ponce, B.; Jiménez Rivera, P. (2018). Efectos sobre el IMC de un programa de promoción de hábitos saludables para adolescentes y sus padres. Revista sobre la infancia y la adolescencia. (15):58-69. doi:10.4995/reinad.2018.7516SWORD586915Abril-Valdez, E., Rascón-Loreto, C., Bonilla-Fernández, P., Hernández-Pérez, H., Cuevas-Bahena, S., Arenas-Monreal, L. (2012). Promoción de hábitos saludables en escolares de Hermosillo, Sonora, México. Revista Cubana de Higiene y Epidemiología, 50(3), 354-364. Recuperado a partir de http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1561-30032012000300010&lng=es&nrm=iso&tlng=esAguilar, C. J., González, J. E., García, G. C., García, L. P., Álvarez, F. J., Padilla, L. C., González, M. J., Ocete, H. E. (2011). Obesidad de una población de escolares de Granada: evaluación de la eficacia de una intervención educativa. Nutrición hospitalaria, 26, 636-641. https://doi.org/10.3305/nh.2011.26.3.5195Balcazar, F., Montero, M., Newbrough, J. (2003). PromociónSalud.pdf. 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C., Mogollón, P. A. (2005). La salud y la promoción de la salud: una aproximación a su desarrollo histórico y social. Revista Ciencias de la Salud, 3(1), 62-7. Recuperado a partir de http://www.scielo.org.co/pdf/recis/v3n1/v3n1a7.pdfCDC. (2014). Centers for Disease Control and Prevention. Recuperado 22 de noviembre de 2015, a partir de http://www.cdc.gov/obesity/data/index.htmlCosta, G. N., A., Leite de Araujo, T., & Cavalcante3, Frota, C. T., Teixeira, L. F., Gimeniz, G. M. (2014). Nursing: promoting the health of overweight children and adolescents in the school context. Rev Esc Enferm USP, 48(1), 153-61. https://doi.org/10.1590/S0080-623420140000100020Díaz, P. A. (2013). Marco legal de las profesiones en México. Alegatos, 85, 1009-1026. Recuperado a partir de http://www.azc.uam.mx/publicaciones/alegatos/pdfs/78/85-13.pdfEddy I. L., Moral P. I., Brotons C. C., Frutos G. E., Calvo T. M., C. A. N. (2012). Hábitos de estilo de vida en adolescentes con sobrepeso y obesidad. Pediatría Atención Primaria, XIV(54), 127-137. Recuperado a partir de http://redalyc.org/pdf/3666/366638737005.pdfElizondo-Montemayor, L., Gutiérrez, N., Moreno, D., Monsiváis, R., & Martínez, U., Nieblas, B., Lamadrid-Zertuche, A. (2014). Intervención para promover hábitos saludables y reducir obesidad en adolescentes de preparatoria. Estudios Sociales, 43, 218-239. Recuperado a partir de http://www.ciad.mx/archivos/revista-eletronica/RES43/Fabiola_Monsivais-11.pdfENSANUT. (2012). Encuesta Nacional de Salud y Nutrición. Recuperado 8 de diciembre de 2014, a partir de http://ensanut.insp.mx/informes/ENSANUT2012ResultadosNacionales.pdfFung, C., Kuhle, S., Lu, C., Purcell, M., Schwartz, M., Storey, K., & Veugelers, P. J. (2012). From "best practice" to "next practice": the effectiveness of school-based health promotion in improving healthy eating and physical activity and preventing childhood obesity. The international journal of behavioral nutrition and physical activity, 9, 27. https://doi.org/10.1186/1479-5868-9-27IMEO. (2014). Instituto Médico Europeo de la Obesidad. Recuperado 22 de noviembre de 2015, a partir de http://stopalaobesidad.com/tag/el-centro-nacional-para-estadisticas-de-salud-de-eeuu-nchs/Maddaleno, M., Morellano, P., Infante-Espínola, F. (2003). Salud y desarrollo de adolescentes y jóvenes en Latinoamérica y El Caribe: desafíos para la próxima década. Salud Pública de México, 45, S132-S139. Recuperado a partir de http://www.scielo.org.mx/pdf/spm/v45s1/15454.pdfMazurek, M. B., Kelly, S., Jacobson, D., Belyea, M., Shaibi, G., Small, L., O'Haver, J., Marsiglia, F. F. (2013). The COPE healthy lifestyles TEEN randomized controlled trial with culturally diverse high school adolescents: baseline characteristics and methods. Contemporary clinical trials, 36(1), 41-53. https://doi.org/10.1016/j.cct.2013.05.013Mazurek, M.B., Leigh, S., Morrison-Beedy, D., Strasser, A., Spath, L. Kreipe, R., Crean, H., Jacobson, D., Stephanie, S., O'Haver, J. (2007). The COPE Healthy Lifestyles TEEN program: feasibility, preliminary efficacy, & lessons learned from an after school group intervention with overweight adolescents. Journal of pediatric health care : official publication of National Association of Pediatric Nurse Associates & Practitioners, 21(5), 315-22. https://doi.org/10.1016/j.pedhc.2007.02.009Morales, G. J. (2010). Obesidad: un enfoque multidisciplinario. (C. al Día, Ed.) (Primera). México. Recuperado a partir de http://www.uaeh.edu.mx/investigacion/productos/4823/libro_de_obesidad.pdfNuño G. B. Madrigal L. (1999). Orientaciones_educativas_para_padres_de_adolescentes.pdf. (Universidad de Guadalajara, Ed.).OMS. (2014). Organización Mundial de la salud| Obesidad y sobrepeso. Recuperado 8 de diciembre de 2014, a partir de http://www.who.int/mediacentre/factsheets/fs311/es/Organización Mundial de la Salud. (2014). Salud para los adolescentes del mundo: Una segunda oportunidad en la segunda década. (OMS, Ed.). Ginebra, Suiza. Recuperado a partir de http://apps.who.int/adolescent/second-decade/files/WHO_FWC_MCA_14.05_spa.pdf?ua=1&ua=1Organización Panamericana de la Salud. (2001). Manual de comunicación social para programas de promoción de la salud de los adolescentes. Washington, DC. Recuperado a partir de http://www.nutricionenmovimiento.org.mx/dif/images/manual_comunicacion_salud_OPS.pdfPapalia, D. Wendkos, O.S., DusKin, F. R. (2004). Psicología del desarrollo de la Infancia a la adolescencia (Undécima). México: Mc Graw Hill.Pascualini, D., Llorens, A. (2010). Salud y Bienestar de Adolescentes y Jóvenes: una mirada integral. (Organización Panamericana de Salud, Ed.). Bueno Aires. Recuperado a partir de http://publicaciones.ops.org.ar/publicaciones/otras pub/SaludBienestarAdolescente.pdfRestrepo, H. M. H. (2002). Promoción de la Salud: Cómo construir una vida saludable (2a ed.). Colombia. Recuperado a partir de http://iris.paho.org/xmlui/bitstream/handle/123456789/789/9589181554.pdf?sequence=1Rocha, S. D., Martín-Matillas, M., Carbonell-Baeza V., Aparicio, V., Delgado-Fernández, M. (2014). del sobrepeso / obesidad infantil y adolescente. Revista Andaluza de Medicina del Deporte, 7(l), 33-43. Recuperado a partir de http://web.b.ebscohost.com/ehost/pdfviewer/pdfviewer?vid=1&sid=ea79ed85-d20c-4900-b10f-0aed97c8f13e@sessionmgr112&hid=101Safdie, M., Cargo, M., Richard, L., & Lévesque, L. (2014). An ecological and theoretical deconstruction of a school-based obesity prevention program in Mexico. The international journal of behavioral nutrition and physical activity, 11(1), 103. https://doi.org/10.1186/s12966-014-0103-2Safdie, M., Jennings-Aburto, N., Lévesque, L., Janssen, I., Campirano-Núñez, F., López-Olmedo, N., Aburto, T., & Rivera, J. (2013). Impact of a school-based intervention program on obesity risk factors in Mexican children. Salud pública de México, 55 Suppl 3(1), 374-87. Recuperado a partir de http://www.ncbi.nlm.nih.gov/pubmed/24643486Sandoval-Montes I., Romero-Velarde, E., Vásquez-Garibay, E., González-Rico, J., Martínez-Ramírez, H., Sánchez-Talamantes, E., Troyo-Sanromán, R. (2010). Obesidad en niños de 6 a 9 años. Factores socioeconómicos, demográficos y disfunción familiar. Recuperado 14 de octubre de 2014, a partir de http://www.medigraphic.com/pdfs/imss/im-2010/im105d.pdfSecretaria de Salud. (2013). Estrataegia Nacional para la Prevención y Control del Sobrepeso, la Obesidad y la Diabetes. Recuperado 8 de diciembre de 2014, a partir de http://promocion.salud.gob.mx/dgps/descargas1/estrategia/Estrategia_con_portada.pdfServicios de Salud de Veracruz. (2011). Servicios de salud de veracruz. Recuperado a partir de http://web.ssaver.gob.mx/saludpublica/files/2011/10/PLAN-ESTATAL-DE-TRABAJO-ADOLESCENCIA-2011.pdfUnited Nations International Children's Emergency Fund. (2006). Convención sobre los derechos del niño. Recuperado 27 de junio de 2017, a partir de http://www.un.org/es/events/childrenday/pdf/derechos.pdfvan Sluijs, E. M. F., McMinn, A. M., & Griffin, S. J. (2007). Effectiveness of interventions to promote physical activity in children and adolescents: systematic review of controlled trials. BMJ (Clinical research ed.), 335(7622), 703. https://doi.org/10.1136/bmj.39320.843947.BEWorld Health Organization. (2007). Development of a WHO growth reference for school-aged children and adolescents. Recuperado 20 de mayo de 2015, a partir de http://www.who.int/growthref/growthref_who_bull/en

Gestión del conocimiento: perspectiva multidisciplinaria. Volumen 11

El libro “Gestión del Conocimiento. Perspectiva Multidisciplinaria”, Volumen 11, de la Colección Unión Global, es resultado de investigaciones. Los capítulos del libro, son resultados de investigaciones desarrolladas por sus autores. El libro cuenta con el apoyo de los grupos de investigación: Universidad Sur del Lago “Jesús María Semprúm” (UNESUR), Zulia – Venezuela; Universidad Politécnica Territorial de Falcón Alonso Gamero (UPTAG), Falcón – Venezuela; Universidad Politécnica Territorial de Mérida Kleber Ramírez (UPTM), Mérida – Venezuela; Universidad Guanajuato (UG) - Campus Celaya - Salvatierra - Cuerpo Académico de Biodesarrollo y Bioeconomía en las Organizaciones y Políticas Públicas (C.A.B.B.O.P.P), Guanajuato – México; Centro de Altos Estudios de Venezuela (CEALEVE), Zulia – Venezuela, Centro Integral de Formación Educativa Especializada del Sur (CIFE - SUR) - Zulia - Venezuela, Centro de Investigaciones Internacionales SAS (CIN), Antioquia - Colombia.y diferentes grupos de investigación del ámbito nacional e internacional que hoy se unen para estrechar vínculos investigativos, para que sus aportes científicos formen parte de los libros que se publiquen en formatos digital e impreso

Diet-Induced Metabolic Syndrome Altered Bladder Urothelium in Adult Female Rats

In recent years, the prevalence of chronic non-communicable diseases has increased. In females, there is a close relationship in the development of these diseases after menopause to estrogenic signaling occurring in various tissues; such is the case for the bladder, compromising its physiology in females. We sought to analyze the effect of diet-induced metabolic syndrome on the bladder epithelium. Eighteen 12-week-old Wistar rats were divided into an intact control group (C, n = 6), a cafeteria diet SMet group (CAF, n = 6), and a high-fat/high-sugar diet SMet group (HF/HS, n = 6). Atrophy and hyperplasia in the bladder epithelium were observed in the case of the CAF diet, while only inflammation was observed in the other schemes

The effects of hydrolysed sorghum on growth performance and meat quality of rabbits

[EN] The effect of sorghum hydrolysed by Trametes maxima CU1 and Pycnoporus sanguineus CS2 was evaluated on growth performance traits and rabbit meat quality. A total of 24 unsexed New Zealand rabbits, weaned at 20 d of age, were allocated to 2 treatments: T1 (diet including 300 g/kg of non-hydrolysed sorghum) and T2 (diet including 300 g/kg of hydrolysed sorghum by Trametes maxima CU1 and Pycnoporus sanguineus CS2). Rabbits of group T2 did not have significantly different (P>0.05) feed intake compared to those in T1. Carcass traits were also not significantly different (P>0.05) between the 2 groups. The pH, water-holding capacity, colour and cooking loss of the longissimus lumborum were not different (P>0.05) between treatments, whereas the pH of the rabbits biceps femoris was higher in T2 (6.21; P<0.05) than in T1 (6.14). Meat hardness and gumminess in T2 were lower (P<0.05) in comparison to meat from T1. Thus, sorghum hydrolysed by Trametes maxima CU1 and Pycnoporus sanguineus CS2 contributed to a better rabbit meat texture. The authors are grateful for the financial support provided by the Programa de Apoyo a la Investigación Cientifica y Tecnológica de la UANL (CT268Q15). This research was supported by Facultad de Agronomía, Universidad Autónoma de Nuevo León, principally providing facilities and diet ingredients. Hernández-Martínez, CA.; Treviño-Cabrera, GF.; Hernández-Luna, CE.; Silva-Vázquez, R.; Hume, ME.; Gutiérrez-Soto, G.; Méndez-Zamora, G. (2018). The effects of hydrolysed sorghum on growth performance and meat quality of rabbits. World Rabbit Science. 26(2):155-163. doi:10.4995/wrs.2018.7822 155 163 26

Pregestational Exposure to T. gondii Produces Maternal Antibodies That Recognize Fetal Brain Mimotopes and Induces Neurochemical and Behavioral Dysfunction in the Offspring

The activation of the maternal immune system by a prenatal infection is considered a risk factor for developing psychiatric disorders in the offspring. Toxoplasma gondii is one of the pathogenic infections associated with schizophrenia. Recent studies have shown an association between high levels of IgG anti-T. gondii from mothers and their neonates, with a higher risk of developing schizophrenia. The absence of the parasite and the levels of IgGs found in the early stages of life suggest a transplacental transfer of the anti-T. gondii IgG antibodies, which could bind fetal brain structures by molecular mimicry and induce alterations in neurodevelopment. This study aimed to determine the maternal pathogenic antibodies formation that led to behavioral impairment on the progeny of rats immunized with T. gondii. Female rats were immunized prior to gestation with T. gondii lysate (3 times/once per week). The anti-T. gondii IgG levels were determined in the serum of pregestational exposed females&rsquo; previous mating. After this, locomotor activity, cognitive and social tests were performed. Cortical neurotransmitter levels for dopamine and glutamate were evaluated at 60 PND in the progeny of rats immunized before gestation (Pregestational group). The maternal pathogenic antibodies were evidenced by their binding to fetal brain mimotopes in the Pregestational group and the reactivity of the serum containing anti-T. gondii IgG was tested in control fetal brains (non-immunized). These results showed that the Pregestational group presented impairment in short and long-term memory, hypoactivity and alteration in social behavior, which was also associated with a decrease in cortical glutamate and dopamine levels. We also found the IgG antibodies bound to brain mimotopes in fetuses from females immunized with T. gondii, as well as observing a strong reactivity of the serum females immunized for fetal brain structures of fetuses from unimmunized mothers. Our results suggest that the exposure to T. gondii before gestation produced maternal pathogenic antibodies that can recognize fetal brain mimotopes and lead to neurochemical and behavioral alterations in the offspring

Can topical epinephrine application to the papilla prevent pancreatitis after endoscopic retrograde cholangiopancreatography? Results from a double blind, multicentre, placebo controlled, randomised clinical trial

Background and study aims Post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) is a complication associated with important morbidity, occasional mortality and high costs. Preventive strategies are suboptimal as PEP continues to affect 4% to 9% of patients. Spraying epinephrine on the papilla may decrease oedema and prevent PEP. This study aimed to compare rectal indomethacin plus epinephrine (EI) versus rectal indomethacin plus sterile water (WI) for the prevention of PEP.Patients and methods This multicentre randomised controlled trial included patients aged &gt;18 years with an indication for ERCP and naive major papilla. All patients received 100 mg of rectal indomethacin and 10 mL of sterile water or a 1:10 000 epinephrine dilution. Patients were asked about PEP symptoms via telephone 24 hours and 7 days after the procedure. The trial was stopped half way through after a new publication reported an increased incidence of PEP among patients receiving epinephrine.Results Of the 3602 patients deemed eligible, 3054 were excluded after screening. The remaining 548 patients were randomised to EI group (n=275) or WI group (n=273). The EI and WI groups had similar baseline characteristics. Patients in the EI group had a similar incidence of PEP to those in the WI group (3.6% (10/275) vs 5.12% (14/273), p=0.41). Pancreatic duct guidewire insertion was identified as a risk factor for PEP (OR 4.38, 95% CI (1.44 to 13.29), p=0.009).Conclusion Spraying epinephrine on the papilla was no more effective than rectal indomethacin alone for the prevention of PEP.Trial registration number This study was registered with ClinicalTrials.gov (NCT02959112)