Empatía en médicos con experiencia en Medicina Alternativa. Universidad Nacional de Colombia – Bogotá 2012 – 2013

El presente estudio de carácter epidemiológico cuantitativo descriptivo correlacional tuvo como objetivo caracterizar el nivel de empatía de los médicos con experiencia en medicina alternativa en sus distintas áreas de énfasis (Homeopatía, Medicina Tradicional China y Acupuntura, Terapia Neural y Osteopatía) en el periodo comprendido entre Julio y Diciembre de 2012. Se realizó mediante el diligenciamiento de un instrumento de recolección de información basado en la Escala de Empatía Médica de Jefferson (JSPE) y la categorización y posterior correlación de los puntajes obtenidos con variables sociodemográficas propias de los sujetos, quienes voluntariamente decidieron participar en el mismo. El puntaje general de empatía encontrado en los médicos participantes fue en promedio de 124,81, con un rango de puntaje entre 94-140, una mediana de 127 y una DS de 9,93, observándose una mayor frecuencia de individuos de género femenino, pero sin mostrar una diferencia estadísticamente significativa con respecto a la población de género masculino. Al analizar los datos recolectados se evidencian niveles de empatía semejantes en médicos con formación en medicina alternativa y en quienes son especialistas médicos en áreas como psiquiatría, medicina familiar, medicina interna y pediatría, reportados en la literatura científica con puntajes favorables de empatía.Abstract. This quantitative descriptive correlational epidemiological study aimed to characterize the level of empathy of doctors with experience in alternative medicine in its areas of emphasis (Homeopathy, Traditional Chinese Medicine and Acupuncture, Neural Therapy and Osteopathy) between July and December 2012, through the diligence of a data collection instrument based on the Scale of Physician Empathy Jefferson (JSPE) and subsequent categorization and correlation of the scores with demographic variables of the subjects themselves who voluntarily chose to participate in the study. The physicians overall score of empathy was an averaged of 124.81 with a score range between 94-140, a median of 127 and a SD of 9.93, with a greater frequency of female individuals, but without showing a statistically significant difference compared to the male population. The data collected show similar levels of empathy with training doctors in alternative medicine and doctors who are specialists in areas such as psychiatry, familiar medicine, internal medicine and pediatrics, reported in the scientific literature with favorable scores of empathy.Maestrí

A fully-automatic caudate nucleus segmentation of brain MRI: Application in volumetric analysis of pediatric attention-deficit/hyperactivity disorder

Background Accurate automatic segmentation of the caudate nucleus in magnetic resonance images (MRI) of the brain is of great interest in the analysis of developmental disorders. Segmentation methods based on a single atlas or on multiple atlases have been shown to suitably localize caudate structure. However, the atlas prior information may not represent the structure of interest correctly. It may therefore be useful to introduce a more flexible technique for accurate segmentations. Method We present Cau-dateCut: a new fully-automatic method of segmenting the caudate nucleus in MRI. CaudateCut combines an atlas-based segmentation strategy with the Graph Cut energy-minimization framework. We adapt the Graph Cut model to make it suitable for segmenting small, low-contrast structures, such as the caudate nucleus, by defining new energy function data and boundary potentials. In particular, we exploit information concerning the intensity and geometry, and we add supervised energies based on contextual brain structures. Furthermore, we reinforce boundary detection using a new multi-scale edgeness measure. Results We apply the novel CaudateCut method to the segmentation of the caudate nucleus to a new set of 39 pediatric attention-deficit/hyperactivity disorder (ADHD) patients and 40 control children, as well as to a public database of 18 subjects. We evaluate the quality of the segmentation using several volumetric and voxel by voxel measures. Our results show improved performance in terms of segmentation compared to state-of-the-art approaches, obtaining a mean overlap of 80.75%. Moreover, we present a quantitative volumetric analysis of caudate abnormalities in pediatric ADHD, the results of which show strong correlation with expert manual analysis. Conclusion CaudateCut generates segmentation results that are comparable to gold-standard segmentations and which are reliable in the analysis of differentiating neuroanatomical abnormalities between healthy controls and pediatric ADHD

Efectividad de 5-fluoruracilo y vinorelbina en pacientes multitratadas por cáncer de mama metastásico

Objetivo. Evaluar la actividad y toxicidad de fluoruracilo en infusión continua y vinorelbina en segunda o tercera línea de tratamiento del cáncer de mama metastásico (CMM). Método y pacientes. En este estudio fase II se incluyeron 24 pacientes que habían recibido doxorrubicina y/o paclitaxel. Se administró 5-fluoruracilo a 1g/m2/día en infusión continua por 3 días y vinorelbina a 30 mg/m2 D1 cada 21 días por 6 ciclos. Resultados. Las respuestas globales observadas fueron del 37,5% (12,5% respuestas completas). El período libre de enfermedad se calculó una media de 6,33 ± 8,12 meses (IC 95% de 3,43 meses). Se observó toxicidad en el 12,5% de las pacientes y no se registró toxicidad grave ni muertes relacionadas a tratamiento. Conclusión. El 5-fluoruracilo/vinorelbina a las dosis administradas es un esquema efectivo en pacientes con CMM multitratadas, con un bajo perfil de toxicidad y costo

Biomedicina (Biología, Patobiología Bioclínica y Fármaco-Terapéutica) de la Familia de las Proteínas S100 en la Especie Humana

RESUMEN Las proteínasS100 hacen parte de una familia compuesta por 25 miembros que comparten una estructura común, definida en general por la unión de calcio. Estas son expresadas en forma diferencial en células y tejidos específicos, donde realizan funciones intracelulares o extracelulares, o ambas. Las proteínas S100 están implicadas en la regulación de la fisiología hemato-inmune y neural, la proliferación y division celular, la supervivencia celular y apoptosis, dinámica celular, actividad enzimática y homeostasis del calcio. Su rol en la génesis neoplásica se deduce a partir de estas actividades y de observaciones realizadas cuyo resultado demuestra que las proteínas S100 tienen niveles de expresión alterados en diferentes estadíos y tipos de cáncer. Esta revisión presenta dichos hallazgos y sus implicaciones biomédicas.  Palabras clave: Angiogénesis, Aterosclerosis, Calcio, Cáncer, Calgranulina, Calprotectina, Cobre, Diabetes, Inmunidad, Metástasis, Neoplasia, Neurodegeneración, Psoriasis, Radicales Libres, Zinc.  ABSTRACT The S100 is a protein family up to this date composed of 25 members that share a common structure, defined in general by the calcium binding. These are expressed in a discriminate fashion in specific cells and tissues, have either an intracellular or extracellular function, or both. S100 proteins are implicated in the hemato-immune physiology, neuro-physiology, proliferation and division cellular, cell survival and cell apoptosis, cytoskeleton dynamics, enzyme activity and calcium homeostasis. A role for S100 proteins in neoplasia stems from these activities and from the observation that several S100 proteins have altered levels of expression in different stages and types of cancer. This review summarizes these findings and their biomedic implications.  Key words: Angiogenesis, Atherosclerosis, Calcium, Cancer, Calgranulin, Calprotectin, Copper, Diabetes, Free Radicals, Inmunity, Metastasis, Neoplasie, Neurodegeneration, Psoriasis, Zinc

Biomedicina (Biología, Patobiología Bioclínica y Fármaco-Terapéutica) de la Familia de las Proteínas S100 en la Especie Humana

RESUMEN Las proteínasS100 hacen parte de una familia compuesta por 25 miembros que comparten una estructura común, definida en general por la unión de calcio. Estas son expresadas en forma diferencial en células y tejidos específicos, donde realizan funciones intracelulares o extracelulares, o ambas. Las proteínas S100 están implicadas en la regulación de la fisiología hemato-inmune y neural, la proliferación y division celular, la supervivencia celular y apoptosis, dinámica celular, actividad enzimática y homeostasis del calcio. Su rol en la génesis neoplásica se deduce a partir de estas actividades y de observaciones realizadas cuyo resultado demuestra que las proteínas S100 tienen niveles de expresión alterados en diferentes estadíos y tipos de cáncer. Esta revisión presenta dichos hallazgos y sus implicaciones biomédicas.  Palabras clave: Angiogénesis, Aterosclerosis, Calcio, Cáncer, Calgranulina, Calprotectina, Cobre, Diabetes, Inmunidad, Metástasis, Neoplasia, Neurodegeneración, Psoriasis, Radicales Libres, Zinc.  ABSTRACT The S100 is a protein family up to this date composed of 25 members that share a common structure, defined in general by the calcium binding. These are expressed in a discriminate fashion in specific cells and tissues, have either an intracellular or extracellular function, or both. S100 proteins are implicated in the hemato-immune physiology, neuro-physiology, proliferation and division cellular, cell survival and cell apoptosis, cytoskeleton dynamics, enzyme activity and calcium homeostasis. A role for S100 proteins in neoplasia stems from these activities and from the observation that several S100 proteins have altered levels of expression in different stages and types of cancer. This review summarizes these findings and their biomedic implications.  Key words: Angiogenesis, Atherosclerosis, Calcium, Cancer, Calgranulin, Calprotectin, Copper, Diabetes, Free Radicals, Inmunity, Metastasis, Neoplasie, Neurodegeneration, Psoriasis, Zinc

A Gesture Recognition System for Detecting Behavioral Patterns of ADHD

We present an application of gesture recognition using an extension of dynamic time warping (DTW) to recognize behavioral patterns of attention deficit hyperactivity disorder (ADHD). We propose an extension of DTW using one-class classifiers in order to be able to encode the variability of a gesture category, and thus, perform an alignment between a gesture sample and a gesture class. We model the set of gesture samples of a certain gesture category using either Gaussian mixture models or an approximation of convex hulls. Thus, we add a theoretical contribution to classical warping path in DTW by including local modeling of intraclass gesture variability. This methodology is applied in a clinical context, detecting a group of ADHD behavioral patterns defined by experts in psychology/psychiatry, to provide support to clinicians in the diagnose procedure. The proposed methodology is tested on a novel multimodal dataset (RGB plus depth) of ADHD children recordings with behavioral patterns. We obtain satisfying results when compared to standard state-of-the-art approaches in the DTW context

Probability-based Dynamic Time Warping and Bag-of-Visual-and-Depth-Words for Human Gesture Recognition in RGB-D

We present a methodology to address the problem of human gesture segmentation and recognition in video and depth image sequences. A Bag-of-Visual-and-Depth-Words (BoVDW) model is introduced as an extension of the Bag-of-Visual-Words (BoVW) model. State-of-the-art RGB and depth features, including a newly proposed depth descriptor, are analysed and combined in a late fusion form. The method is integrated in a Human Gesture Recognition pipeline, together with a novel probability-based Dynamic Time Warping (PDTW) algorithm which is used to perform prior segmentation of idle gestures. The proposed DTW variant uses samples of the same gesture category to build a Gaussian Mixture Model driven probabilistic model of that gesture class. Results of the whole Human Gesture Recognition pipeline in a public data set show better performance in comparison to both standard BoVW model and DTW approach

Clinical rating scale for pantothenate kinase-associated neurodegeneration: A pilot study

Pantothenate kinase-associated neurodegeneration is a progressive neurological disorder occurring in both childhood and adulthood. The objective of this study was to design and pilot-test a disease-specific clinical rating scale for the assessment of patients with pantothenate kinase-associated neurodegeneration.info:eu-repo/semantics/publishedVersio

Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAM-COVID-19)

Objectives: The objective of this study was to estimate the association between tocilizumab or corticosteroids and the risk of intubation or death in patients with coronavirus disease 19 (COVID-19) with a hyperinflammatory state according to clinical and laboratory parameters. Methods: A cohort study was performed in 60 Spanish hospitals including 778 patients with COVID-19 and clinical and laboratory data indicative of a hyperinflammatory state. Treatment was mainly with tocilizumab, an intermediate-high dose of corticosteroids (IHDC), a pulse dose of corticosteroids (PDC), combination therapy, or no treatment. Primary outcome was intubation or death; follow-up was 21 days. Propensity score-adjusted estimations using Cox regression (logistic regression if needed) were calculated. Propensity scores were used as confounders, matching variables and for the inverse probability of treatment weights (IPTWs). Results: In all, 88, 117, 78 and 151 patients treated with tocilizumab, IHDC, PDC, and combination therapy, respectively, were compared with 344 untreated patients. The primary endpoint occurred in 10 (11.4%), 27 (23.1%), 12 (15.4%), 40 (25.6%) and 69 (21.1%), respectively. The IPTW-based hazard ratios (odds ratio for combination therapy) for the primary endpoint were 0.32 (95%CI 0.22-0.47; p < 0.001) for tocilizumab, 0.82 (0.71-1.30; p 0.82) for IHDC, 0.61 (0.43-0.86; p 0.006) for PDC, and 1.17 (0.86-1.58; p 0.30) for combination therapy. Other applications of the propensity score provided similar results, but were not significant for PDC. Tocilizumab was also associated with lower hazard of death alone in IPTW analysis (0.07; 0.02-0.17; p < 0.001). Conclusions: Tocilizumab might be useful in COVID-19 patients with a hyperinflammatory state and should be prioritized for randomized trials in this situatio