Simulación clínica para la docencia de los principios básicos para la exploración clínica en ginecología para estudiantes de Medicina

Los participantes podrán ser todos los estudiantes de Medicina que pertenezcan a la Unidad Docente de Obstetricia y Ginecología y tendrá lugar en el Servicio de Obstetricia y Ginecología del HGUGM. Se fundamenta en los conocimientos de la anatomía genitourinaria y pélvica, así como de los conocimientos teóricos de exploración ginecológica (historia clínica dirigida, valoración de los genitales externos, tacto bimanual.especuloscopia, realización de citología cervico-vaginal). En taller consiste en llevar estos conocimientos a la práctica, efectuándolos de forma simulada sobre un entrenador tipo CFPT Mk 3, que es una representación anatómicamente precisa y táctil de la pelvis femenina

Latin American study of hereditary breast and ovarian cancer LACAM : a genomic epidemiology approach

Q2Q1Artículo original1-13Purpose: Hereditary Breast and Ovarian Cancer (HBOC) syndrome is responsible for ~5–10% of all diagnosed breast and ovarian cancers. Breast cancer is the most common malignancy and the leading cause of cancer-related mortality among women in Latin America (LA). The main objective of this study was to develop a comprehensive understanding of the genomic epidemiology of HBOC throughout the establishment of The Latin American consortium for HBOC-LACAM, consisting of specialists from 5 countries in LA and the description of the genomic results from the first phase of the study. Methods: We have recruited 403 individuals that fulfilled the criteria for HBOC from 11 health institutions of Argentina, Colombia, Guatemala, Mexico and Peru. A pilot cohort of 222 individuals was analyzed by NGS gene panels. One hundred forty-three genes were selected on the basis of their putative role in susceptibility to different hereditary cancers. Libraries were sequenced in MiSeq (Illumina, Inc.) and PGM (Ion Torrent-Thermo Fisher Scientific) platforms. Results: The overall prevalence of pathogenic variants was 17% (38/222); the distribution spanned 14 genes and varied by country. The highest relative prevalence of pathogenic variants was found in patients from Argentina (25%, 14/57), followed by Mexico (18%, 12/68), Guatemala (16%, 3/19), and Colombia (13%, 10/78). Pathogenic variants were found in BRCA1 (20%) and BRCA2 (29%) genes. Pathogenic variants were found in other 12 genes, including high and moderate risk genes such as MSH2, MSH6, MUTYH, and PALB2. Additional pathogenic variants were found in HBOC unrelated genes such as DCLRE1C, WRN, PDE11A, and PDGFB. Conclusion: In this first phase of the project, we recruited 403 individuals and evaluated the germline genetic alterations in an initial cohort of 222 patients among 4 countries. Our data show for the first time in LA the distribution of pathogenic variants in a broad set of cancer susceptibility genes in HBOC. Even though we used extended gene panels, there was still a high proportion of patients without any detectable pathogenic variant, which emphasizes the larger, unexplored genetic nature of the disease in these populations

Percepção da qualidade de vida de cuidadores de pacientes participantes de um programa de crônicos, Villavicencio (Colômbia)

Objective: Identify perceptions about the quality of life of informal caregivers of chronically ill adults who are attending a program for the chronically ill sponsored by a state-run social welfare agency in Villavicencio, Colombia. Materials and Methods: This is a descriptive, cross-sectional study with a qualitative approach. The focus is on informal caregivers (n = 180) of chronically ill adults who are involved in the Chronic Illness Awareness and Prevention Program. The Quality of Life (QOL) Instrument – Family Version developed by Ferrell and Grant was used with the caregivers, and the Granger adapted version of the Pluses profile was used to assess the functionality of chronically ill patients. The score ranges and measures of central tendency and dispersion for the domains of well-being and quality of life are determined. Results: In most of the caregivers, there was evidence that the domains of physical and social well-being are not affected. The dimensions of psychological and spiritual well-being are at the middle level, as is quality of life. Conclusions: The results can be used by nursing to guide training processes aimed at strengthening the skills caregivers have to promote health and wellbeing, prevent quality of life from deteriorating, and provide timely care and in better conditions for a family member who is suffering from a chronic illness.Objetivo: determinar la percepción de la calidad de vida de cuidadores informales de adultos que padecen enfermedad crónica, que asisten al Programa de Crónicos de la Empresa Social del Estado de Villavicencio, Colombia. Materiales y métodos: estudio descriptivo, de abordaje cuantitativo y de corte transversal en cuidadores informales (n = 180) de adultos crónico usuarios del Programa de Promoción y Prevención de Crónicos. Con los cuidadores se utilizó el instrumento Calidad de Vida (QOL) versión familiar de Ferrell y Grant, y para valorar la funcionalidad de los pacientes crónicos, se usó el perfil Pulses adaptado por Granger. Se determinan rangos de puntaje, medidas de tendencia central y dispersión para los dominios de bienestar y calidad de vida. Resultados: en la mayoría de los cuidadores se evidenció que los dominios de bienestar físico y social no se encuentran afectados, y las dimensiones de bienestar psicológico y espiritual están en nivel medio, al igual que la calidad de vida. Conclusiones: para la enfermería, los resultados pueden orientar procesos de capacitación a fin de fortalecer habilidades de cuidado en cuidadores que permitan promover la salud y el bienestar, evitar el deterioro de la calidad de vida y cuidar oportunamente y en mejores condiciones al familiar que padece enfermedad crónica.Doi:10.5294/aqui.2016.16.1.11Objetivo: determinar a percepção da qualidade de vida de cuidadores informais de idosos que padecem doença crônica, que participam do Programa de Crônicos da Empresa Social do Estado de Villavicencio (Colômbia). Materiais e métodos: estudo descritivo, de abordagem quantitativa e de corte transversal em cuidadores informais (n = 180) de idosos crônicos usuários do Programa de Promoção e Prevenção de Crônicos. Com os cuidadores, utilizou-se o instrumento Qualidade de Vida (QoL, por sua sigla em inglês) versão familiar de Ferrell e Grant, e para avaliar funcionalidade dos pacientes crônicos, usou-se o perfil Pulses, adaptado por Granger. Determinaramse faixas de pontuação, medidas de tendência central e dispersão para os domínios de bem-estar e qualidade de vida. Resultados: na maioria dos cuidadores, evidenciou-se que os domínios de bem-estar físico e social estão em nível médio, assim como a qualidade de vida. Conclusões: para a enfermagem, os resultados podem orientar processos de capacitação a fim de fortalecer habilidades de cuidado em cuidadores que permitam promover a saúde e o bem-estar, evitar a deterioração da qualidade de vida e cuidar oportunamente e em melhores condições do familiar que padece doença crônica

Percepción de la calidad de vida de cuidadores de pacientes asistentes a un programa de crónicos, Villavicencio, Colombia

Objetivo: determinar la percepción de la calidad de vida de cuidadores informales de adultos que padecen enfermedad crónica, que asisten al Programa de Crónicos de la Empresa Social del Estado de Villavicencio, Colombia. Materiales y métodos: estudio descriptivo, de abordaje cuantitativo y de corte transversal en cuidadores informales (n = 180) de adultos crónico usuarios del Programa de Promoción y Prevención de Crónicos. Con los cuidadores se utilizó el instrumento Calidad de Vida (QOL) versión familiar de Ferrell y Grant, y para valorar la funcionalidad de los pacientes crónicos, se usó el perfil Pulses adaptado por Granger. Se determinan rangos de puntaje, medidas de tendencia central y dispersión para los dominios de bienestar y calidad de vida. Resultados: en la mayoría de los cuidadores se evidenció que los dominios de bienestar físico y social no se encuentran afectados, y las dimensiones de bienestar psicológico y espiritual están en nivel medio, al igual que la calidad de vida. Conclusiones: para la enfermería, los resultados pueden orientar procesos de capacitación a fin de fortalecer habilidades de cuidado en cuidadores que permitan promover la salud y el bienestar, evitar el deterioro de la calidad de vida y cuidar oportunamente y en mejores condiciones al familiar que padece enfermedad crónica. Doi:10.5294/aqui.2016.16.1.1

Percepção da qualidade de vida de cuidadores de pacientes participantes de um programa de crónicos, Villavicencio (Colômbia)

12 páginasObjetivo: determinar la percepción de la calidad de vida de cuidadores informales de adultos que padecen enfermedad crónica, que asisten al Programa de Crónicos de la Empresa Social del Estado de Villavicencio, Colombia. Materiales y métodos: estudio descriptivo, de abordaje cuantitativo y de corte transversal en cuidadores informales (n = 180) de adultos crónico usuarios del Programa de Promoción y Prevención de Crónicos. Con los cuidadores se utilizó el instrumento Calidad de Vida (QOL) versión familiar de Ferrell y Grant, y para valorar la funcionalidad de los pacientes crónicos, se usó el perfil Pulses adaptado por Granger. Se determinan rangos de puntaje, medidas de tendencia central y dispersión para los dominios de bienestar y calidad de vida. Resultados: en la mayoría de los cuidadores se evidenció que los dominios de bienestar físico y social no se encuentran afectados, y las dimensiones de bienestar psicológico y espiritual están en nivel medio, al igual que la calidad de vida. Conclusiones: para la enfermería, los resultados pueden orientar procesos de capacitación a fin de fortalecer habilidades de cuidado en cuidadores que permitan promover la salud y el bienestar, evitar el deterioro de la calidad de vida y cuidar oportunamente y en mejores condiciones al familiar que padece enfermedad crónica.Objective: Identify perceptions about the quality of life of informal caregivers of chronically ill adults who are attending a program for the chronically ill sponsored by a state-run social welfare agency in Villavicencio, Colombia. Materials and Methods: This is a descriptive, cross-sectional study with a qualitative approach. The focus is on informal caregivers (n = 180) of chronically ill adults who are involved in the Chronic Illness Awareness and Prevention Program. The Quality of Life (QOL) Instrument - Family Version developed by Ferrell and Grant was used with the caregivers, and the Granger adapted version of the Pluses profile was used to assess the functionality of chronically ill patients. The score ranges and measures of central tendency and dispersion for the domains of well-being and quality of life are determined. Results: In most of the caregivers, there was evidence that the domains of physical and social well-being are not affected. The dimensions of psychological and spiritual well-being are at the middle level, as is quality of life. Conclusions: The results can be used by nursing to guide training processes aimed at strengthening the skills caregivers have to promote health and wellbeing, prevent quality of life from deteriorating, and provide timely care and in better conditions for a family member who is suffering from a chronic illness.Objetivo: determinar a percepção da qualidade de vida de cuidadores informais de idosos que padecem doença crónica, que participam do Programa de Crônicos da Empresa Social do Estado de Villavicencio (Colômbia). Materiais e métodos: estudo descritivo, de abordagem quantitativa e de corte transversal em cuidadores informais (n = 180) de idosos crônicos usuários do Programa de Promoção e Prevenção de Crônicos. Com os cuidadores, utilizou-se o instrumento Qualidade de Vida (QoL, por sua sigla em inglês) versão familiar de Ferrell e Grant, e para avaliar funcionalidade dos pacientes crônicos, usou-se o perfil Pulses, adaptado por Granger. Determinaram-se faixas de pontuação, medidas de tendência central e dispersão para os domínios de bem-estar e qualidade de vida. Resultados: na maioria dos cuidadores, evidenciou-se que os domínios de bem-estar físico e social estão em nível médio, assim como a qualidade de vida. Conclusões: para a enfermagem, os resultados podem orientar processos de capacitação a fim de fortalecer habilidades de cuidado em cuidadores que permitam promover a saúde e o bem-estar, evitar a deterioração da qualidade de vida e cuidar oportunamente e em melhores condições do familiar que padece doença crônica.Universidad de La Saban

Clinical characterization of behavioral characteristics related to neurodevelopment in preschool-age patients born preterm in the Central Military Hospital.

Describir características comportamentales relacionadas con neurodesarrollo en pacientes prescolares con antecedentes de prematurez. Lugar: Consulta ambulatoria de Neuropediatría Psiquiatría Infantil del Hospital Militar Central, Bogotá – Colombia. Población: Niños con antecedente de prematuridad nacidos entre el 2008 y 2012 en el Hospital Militar Central de Bogotá - Colombia. Metodología: Revisión de historias clínicas de una muestra aleatoria de pacientes preescolares con antecedente de prematurez. Se citaron con sus padres para realizar una valoración comportamental y del Neurodesarrollo, por medio de la escalas Child Behavior Check List y Escala Abreviada del Desarrollo (EAD-1), previa firma del consentimiento informado. Diseño: Estudio transversal de una cohorte histórica de prematuros. Medición: Se realizó una medición de variables sociodemográficas, clínicas, comportamentales y del neurodesarrollo, a través de entrevista a padres, revisión de la historia clínica y valoracion de las escalas descritas. Análisis: Se realizó un análisis estadístico de cada una de las variables escritas. Se realizó además un cruce de variables según la pertinencia, utilizando las medidas de correlación de Spearman y Pearson según correspodía, para obtener la significancia. Resultados: la escala de desarrollo tuvo una buena correlación con el CBCL. El peso al nacer es una de las variables mas relacionadas con el desarrollo y aspectos comportamentales, asi como también el bienestar mental materno. La subescalas internalizantes prevaleció sobre los síntomas externalizantes, llamando la atención el resultado de somatización y ansiedad. Conclusiones: Los resultados se equiparan a los referidos en la literatura, los prematuros de muy bajo peso al nacer tienen mayores desenlaces en alteración en la escala de comportamientos que se hacen evidentes en la edad preescolar.No aplicaDescribe behavioral characteristics related to neurodevelopment in preschool-age patients born preterm. Location: Neuropediatrics and Child Psychiatry Outpatient Consultation – Hospital Militar Central, Bogota – Colombia. Population: Children with preterm birth history, born between 2008 and 2012 in Hospital Militar Central, Bogota – Colombia. Methods: Clinical history revision on a random sample of preschool-age patients with preterm birth history. Parents were met and after informed consent forms had been signed, proceeded to complete a behavioral and neurodevelopmental valuation using the Child Behavior Check-List and the Abbreviated Scale of Development (EAD-1). Design: Cross-sectional study of a historical cohort of preterm birth children. Measurements: Interviews with parents, clinical history revision and assesment of described scales were used to measure social, demographic, clinical, behavioral, and neurodevelopmental variables. Analysis: A statistical analysis was performed on each described variable. Additionally, relationship between variables of interest was studied using Spearman or Pearson correlation statistics to obtain the significance. Results: The development scale and the CBCL present a good correlation. Birth weight is highly related to development and behavioral aspects; maternal mental health also being related. The internalizing subscale prevailed over externalizing symptoms; in which somatization and anxiety results stand out. Conclusions: Results are comparable to those found in literature. Preterm children born very low weight tend to present outcomes with higher alteration in the behavioral scale, which become evident at preschool age

New Regenerative Vascular Grafts for Hemodialysis Access: Evaluation of a Preclinical Animal Model

The purpose of this study was to evaluate a suitable animal model for the in vivo evaluation of patency and vascular tissue regeneration in small intestinal submucosa (SIS) vascular grafts for hemodialysis access. First, a 4-mm U-shaped SIS vascular graft was implanted between the internal carotid artery (CA) and the external jugular vein (JV) in five sheep and six swine. The U-shape grafts remained functional for 53 ± 4 days in sheep and 32 ± 2 days in swine. The sheep model presented exaggerated inflammation, so the swine model was selected for the in vivo study. Based on these initial results, a 4-mm C-shape SIS vascular graft with SIS circumferential reinforcement was developed to mechanically improve the vascular graft and manage complications identified during surgery in both sheep and swine. The C-shape vascular graft was implanted in a swine model (n = 3) between the CA and JV. GORE-TEX® vascular grafts were used as controls in the contralateral side of the neck. C-shape grafts remained patent for 47 ± 4 days, whereas the GORE-TEX® grafts were patent for 30 ± 15 days. The C-shape vascular graft was easier to handle during surgery, and its circumferential reinforcement improved in vivo patency, avoiding kinks in the graft after implantation. Histological results showed neovascularization and some regeneration with the alignment of endothelial cells in the vascular wall of the grafts. The model developed may be helpful in other research involving in vivo studies of vascular grafts for hemodialysis access