178ª Reunión de Patólogos de la Zona Norte. 24 de marzo de 2023

Como profesoras responsables y colaborador docente de la asignatura Procedimientos Diagnósticos y Terapéuticos Anatomopatológicos en el tercer curso del grado de Medicina, hemos liderado esta reunión científica y nos proponemos la publicación de este libro de resúmenes de los casos presentados para acercar y visibilizar nuestro trabajo a la comunidad universitaria, en especial a los estudiantes de Medicina. La especialidad médica de Anatomía Patológica es una desconocida por la mayoría de los estudiantes pese a haberse cursado la materia en el 5º semestre del grado, lo que hace difícil su elección en las plazas MIR. Para impulsar y dar publicidad a nuestra especialidad dentro de la comunidad universitaria, sirva de ejemplo y de transmisión de conocimiento a nuestros alumnos la publicación de este libro de casos

Role of age and sex in the diagnosis of early-stage malignant melanoma: A cross-sectional study

Age and sex have been identified as predictors of outcome in malignant melanoma (MM). The aim of this multicentre, cross-sectional study was to analyse the role of age and sex as explanatory variables for the diagnosis of thin MM. A total of 2,430 patients with MM were recruited. Cases of in situ (Tis) and T1 MM were more frequent than T2–T4 MM (56.26% vs. 43.74%). Breslow thickness increased throughout decades of life (analysis of variance (ANOVA) p < 0.001), with a weak correlation between Breslow thickness and patient's age (r = 0.202, p < 0.001). Breslow thickness was significantly less in women (1.79 vs. 2.38 mm, p = 0.0001). Binary logistic regression showed a significant (p < 0.001) odds ratio for age 0–29 years (1.18), and 30–59 years (1.16), and for women (1.09). Age and sex explained 3.64% of the variation observed in Tis–T1 frequency (R2 = 0.0364). Age and sex appear to explain a low percentage of the variation in the early detection of MM

Nursing assistance in family planning

Objetivo: Determinar la calidad del cuidado brindado por el personal de enfermería a las usuarias y la satisfacción en la atención.&amp;nbsp;Método: Estudio de carácter cuantitativo de alcance descriptivo, tipo corte transversal; con 345 usuarias mayores de 14 años de edad; realizado entre octubre de 2013 a junio de 2014, en una institución de primer nivel de atención en salud, en la ciudad de Bucaramanga.&amp;nbsp;Resultados: Edad mínima 14 años; el 63,19% (n=218) vive en unión libre; edad mínima de inicio de relaciones sexuales 12 años y máxima 25 años. En el 25,8% (n=89) no se garantizaba la privacidad; el 87,54% (n=302) de los consultorios no contaban con baño para usuarias. No saludan, ni se refieren al usuario por su nombre, en el 3,77% (n=13) y el 14,78% (n=51) respectivamente. En el 11,59% (n=40) no se explicó el procedimiento antes de ejecutarlo y más del 90% no brindó asesoría en derechos sexuales y reproductivos. El 50,43% (n=174) de los usuarios consideró bueno el trato recibido; un 99,66% (n=344) calificó de buena a excelente la asesoría; el 52,46% (n=181) califica como buena la atención; el 97,97% (n=338) y el 99,13% (n=342) recomendarían y volverían a la institución.&amp;nbsp;Conclusión: los usuarios en general refieren la calidad como buena en la atención brindada. Se hace necesario promover los derechos sexuales y reproductivos durante la consulta del programa.Objective: To determine the quality of care provided to patients by the nursing staff to users and their satisfaction with the assistance.&amp;nbsp;Method:&amp;nbsp;quantitative study with descriptive scope&amp;nbsp;and transversal design with 345 users above the age of 14 conducted from October 2013 to June 2014 in a first level health care institution in the city of Bucaramanga.&amp;nbsp;Results: Minimum age 14 years old; 63.19% (n=218) of participants live in cohabitation; age of first sexual intercourse 12 years old and maximum age 25 years old. In the 25.8% (n = 89) of cases privacy was not guaranteed; the 87.54% (n = 302) of the doctor's offices did not have restrooms for the patients to use. The patients were not greeted nor referred to by their names, in 3.77% (n = 13) and in 14.78% (n = 51) of the cases respectively. In the 11.59% (n = 40) of the cases the procedure was not explained before it was carried out and in more than 90% of the cases there was no advice on sexual and reproductive rights provided to the patient. A 50.43% (n = 174) of the users felt well treated; a 99.66% (n = 344) rated the advice provided from good to excellent; a 52.46% (n = 181) of the users qualified the care received as good; 97.97% (n = 338) of the patients would recommend the institution to others and 99.13% (n = 342) would return to the institution.&amp;nbsp;Conclusion: users generally refer good quality to the care provided. It is necessary to promote sexual and reproductive rights during the medical consultation of the program

Marcadores tisulares relacionados con el proceso de carcinogénesis y proliferación celular y su implicación en la evolución del hepatocarcinoma tras el trasplante hepático.

El hepatocarcinoma es la neoplasia primaria de hígado más frecuente. Por ello, actualmente hay un gran interés en conocer la implicación de diferentes marcadores biológicos que podrían tener relación con el pronóstico y la recidiva tumoral tras el trasplante hepático. Uno de los marcadores estudiados en este trabajo, relacionado con la inflamación y la carcinogénesis, es la COX2. El interés en su estudio, ha derivado de su implicación en la progresión del cáncer de colon, esófago y estómago, pero no se conoce con exactitud cuál es su papel pronóstico en el hepatocarcinoma. Otro marcador que hemos estudiado, relacionado con la proliferación celular, es el Ki67. Su elevada expresión se ha asociado con un mal pronóstico del tumor. El estudio de COX2 y Ki67 podría identificar a un subgrupo de pacientes de riesgo y realizar un tratamiento más específico en el futuro

Enfermedades psiquiátricas y trabajo. Revisión bibliográfica y jurisprudencial (Trastornos esquizofrénicos, trastorno bipolar y trastornos ansioso-depresivos)

Las enfermedades psiquiátricas en su conjunto y, algunas de ellas de forma específica, constituyen un problema de salud pública en todos los países y conllevan un coste económico asociado, tanto directo como indirecto. Pero además, cuando la persona enferma ejerce su derecho al trabajo ello comporta, en ocasiones, más allá de su diagnóstico y su tratamiento, la necesidad de tomar unas acciones en las empresas, limitantes adaptativas o restrictivas, para el trabajador afectado y la adopción de medidas socio-laborales con repercusión posterior administrativa y jurídica. Se revisarán en este trabajo las publicaciones médicas recogidas en la base de datos de referencia (Pub-Med) relativa a estas patologías, su diferenciación en cuanto a los aspectos clínico asistenciales y su comparativa con los socio-laborales. De igual forma se realiza en este trabajo una revisión del impacto de estas patologías en la base de datos jurídica (Westlaw Insignis) y su diferenciación según cada patología y área del derecho correspondiente. Sirvan los resultados para, a través del conocimiento actual de la situación, basada en estos datos, elaborar posibles estrategias preventivas de futuro ante conflictos médico legales y de nuevos enfoques más coordinados entre todos los agentes implicados.Psychiatric disorders as a whole and some of them in a specific way constitute a public health problem in all countries and entail an economic cost associated, both directly and indirectly. In addition, some issues are to be considered when the sick person exercises his right to work, beyond diagnosis and treatment of his/her disease. Companies need to take some actions whether adaptive or restrictive for the affected employee, and the adoption of socio-labor measures which will have administrative and legal impact. The medical publications listed in the reference database (Pub-Med) concerning these pathologies will be reviewed in this article with emphasis in those clinical aspects that correlate health care with socio-labor implications. Paralelly, this work reviews the impact of these diseases in the legal databases (Westlaw Insignis) and their differentiation according to each disorder and its corresponding area of the law.The conclusions of this work, through the current knowledge of the situation, will serve to develop possible preventive strategies to address future medico-legal conflicts as well as to develop more coordinated approaches among all the stakeholders

Sistema de visión sinérgico para detección de movimiento

La detección de movimiento en sistemas de vigilancia y monitoreo se ve favorecida por la combinación sinérgica de diferentes tipos de cámaras y su óptima distribución sobre el área de interés. Se propone un modelo de optimización para un sistema de visión sinérgico basado en programación lineal entera. Los objetivos son encontrar la posición y orientación óptima de cada una de las cámaras direccionales y omnidireccionales con el fin de maximizar la cobertura del espacio de trabajo y detectar los objetos en movimiento presentes. Para detectar eficientemente el movimiento, incluso ante cambios de luminosidad globales, se utiliza un algoritmo de substracción de fondo que usa la información espacial de la textura. El método propuesto se evalúa en un conjunto representativo de escenarios reales utilizando una red de cámaras. Los resultados muestran que nuestro algoritmo es capaz de determinar el número mínimo de cámaras necesario para cubrir un área determinada

Growth, Photosynthesis, and Physiological Responses of Ornamental Plants to Complementation with Monochromic or Mixed Red-Blue LEDs for Use in Indoor Environments

Inch (Tradescantia zebrina) and spider (Chlorophytum comosum) plants were grown in a growth chamber for two months in plastic containers to evaluate the effects of different light treatments (TO Tube luminescent Dunn (TLD) lamps or control), TB (TLD lamps + blue light emitting diodes (LEDs)), TR (TLD lamps + red LEDs), and TBR (TLD lamps + blue and red LEDs) on biomass, photosynthesis, and physiological parameters. Total dry weight and water content were evaluated at the end of the experimental period. After two months, pigment concentrations and the photosynthetic rate were assessed in both species. The total soluble sugar, starch, and proline concentrations in the leaf as physiological parameters were studied at the end of the experiment. Both species had increased root, shoot, and total dry weight under blue LEDs conditions. The chlorophyll concentration showed a specific response in each species under monochromic or mixed red-blue LEDs. The highest photosynthetic rate was measured under the addition of mixed red-blue LEDs with TLD lamps. At the physiological level, each species triggered different responses with respect to total soluble sugars and the proline concentration in leaves under monochromic or mixed red-blue LEDs. Our study demonstrated that the addition of blue LEDs is advisable for the production of these ornamental foliage species

The body, the creative arts, and inclusion: A certified program experience “Find your own voice”

The exploration and construction of creative spaces are essential for human beings, and allow for flexible individual and collective encounters in which the value of an individual‘s experience is not predetermined. The experiences and modes of expression of the participants are appraised in an environment in which the borders and paradigms of what one "should" do or how one "should" act are open. The creation of spaces where difference is valued and validated becomes a privileged pretext for the goal of inclusion, through which all of the participants can find, develop, and express themselves. This process has been conceived as a certificate program with the purpose of developing spaces of inclusion and encounter by placing the creative, sensitive exploration of the body at the centre. The creative arts allow us to be open to living experience and to the joy of the diversity. There have been two cohorts in the program, with a total of fifteen students, women, with ages between 20 and 35 years, from different backgrounds such as anthropology, preschool and special education, psychology, social and political studies, and the arts. We use methods such as DanceAbility, Biodanza, dance improvisation, music improvisation with the body, and voice and musical instruments, as well as storytelling and photography. The participants draw on their learning processes as a different way of understanding inclusion. They become better able to recognize their own creative nature and to apply their experience in their everyday work

Agroclimatic Requirements of Traditional European Pear (Pyrus communis L.) Cultivars from Australia, Europe, and North America

Flowering in temperate fruit trees depends on the temperatures during the previous months; chill is required to overcome endodormancy, and then heat exposure is needed. These agroclimatic requirements are cultivar-specific and determine their adaptability to the growing area and their response to climate change. We aim to estimate the agroclimatic requirements of 16 traditional cultivars of European pears grown in Zaragoza (Spain). We used Partial Least Squares regression analysis to relate 20-year records of flowering dates to the temperatures of the 8 previous months. This approach allowed us to establish the chilling and forcing periods, through which we quantified temperatures with three models for chill accumulation (Chilling Hours, Utah model, and Dynamic model) and one model for heat accumulation (Growing Degree Hours). The results indicated very little difference in the chilling and forcing periods. Chill requirements ranged from 43.9 to 49.2 Chill Portions; from 1027 to 1163 Chilling Units; and from 719 to 774 Chilling Hours. Heat requirements ranged from 6514 to 7509 Growing Degree Hours. Flowering dates were mainly determined by the temperatures during the chilling period. This means that reductions in winter chill caused by global warming in many regions could cause flowering delays or even failures in the fulfillment of chill requirements.Publishe