Déficit de atención con y sin hiperactividad y su relación con lesiones traumatológicas en niños entre 6 y 12 años en la clínica El Prado de la ciudad de Santa Marta

ResumenEl trastorno por déficit de atención con o sin Hiperactividad (TDAH) se define como un trastorno crónico sintomáticamente evolutivo, esta alteración del neurodesarrollo en el niño suele caracterizarse por la presencia de problemas para concentrarse y dedicarse a una tarea asignada o al cumplimiento de reglas impartidas; permaneciendo en constante movimiento. Por tanto, estos niños son propensos a presentar accidentes con un alto riesgo de lesionarse, fracturarse o sufrir algún tipo de trauma físico de grados variables, a diferencia de los niños que miden sus actos y no presentan déficit de atención. Este estudio se llevó a cabo, en el marco de la investigación descriptivo – correlacional, con el objetivo de describir la relación existente entre el trastorno por déficit de atención con y/o sin hiperactividad (TDHA) y las presencia de lesiones y/o traumas ortopédicos en Niños entre 6 y 12 Años en la Clínica El Prado de la Ciudad de Santa Marta. Pacientes y Métodos: se conformó un grupo de 31 niños con su respectiva autorización de padres, tutores o representantes legales, 21 de ellos eran hombres (67,7%) y 10 mujeres (32,3%) los cuales asistían por lesiones ortopédicas al servicio de urgencias de la Clínica El Prado y fueran diagnosticados con déficit de atención con y sin hiperactividad, pudiendo así obtenerse una muestra del 15,5% en relación a la población total. Para el diagnostico del TDHA se utilizaron los Criterios diagnósticos del DSM IV, DSM IV Checklist o lista de síntomas, y la escala Multidimensional del Comportamiento BASC para Padres y Docentes. Resultados: De acuerdo con los datos estadísticos se puede observar que aunque un gran número de niños que conforman la muestra presentan características propias del diagnóstico de déficit de atención y sus subtipo (60%), no existe evidencia estadísticamente significativa que demuestre la relación entre ésta y la presencia de lesiones y traumatismo ortopédico, por el contrario la prueba de asociación de variables demuestra que estas son completamente independientes. El restante de participantes de la muestra (40%) no cumple con los criterios de clasificación. (Duazary 2009-II 124-133)AbstractThe disruption of attention deficit disorder with or without hyperactivity (TDAH) is defined as an evolutionary symptomatic chronic disruption. The alteration of this neuro development in a child is usually characterized by the presence of problems to concentrate and dedicate in an assignment duty or failure to comply with given rules; remaining in constant movement. Therefore, these children are prone to present accidents with high risk of injuring themselves, fracturing or undergoing some type of physical trauma of variable degrees, unlike the children who measure their acts and they do not present/display attention deficit. This studio, We are carried out within the framework descriptive-correlative investigation, with the objective to describes the existing relation between the upheaval by and/or deficit of attention with without hyperactivity (TDHA) and the presence of injuries and/or orthopedics traumas in children between 6 and 12 years in the Clinic the Prado of Santa Marta City. Patients and methods: Conform a group of 31 children with respective authorization of their parents, legal tutors or representatives, 21 of them was men (67.7%) and 10 women (32.3%) who assisted by orthopedics injuries to the service of urgency of the Clinic the Prado and was diagnosed with deficit of attention with and without hyperactivity, thus being able to obtain a sample of 15.5% in relation to the total population. For diagnostic of the TDHA the criteria were used diagnoses of DSM IV, DSM IV Checklist or list of symptoms, and the Multidimensional scale of Behavior BASC for parents and docents. Results: According to the statistical data it is possible to be observer that although a great number of children who conform the sample present/display own characteristics of diagnostic of attention deficit and their subtypes (60%), does not exist statistically significant evidence that it shows the relation between this and the presence of lesions and orthopedic traumatism; on the contrary the test of association of variables demonstrates that these are completely independent. The rest of participants of the sample (40%) do not fulfill the classification criteria.Key words: Deficit of attention; Upheavals; Hyperactivity; Trauma; Fracture; Neurodevelopment

Contraction amplitude is a relevant predictor of bolus transit during sitting viscous solution swallows in healthy individuals : preliminary results of a multicenter study using high resolution impedance manometry (HRIM)

Q1Q1https://orcid.org/0000-0002-9219-4548https://orcid.org/0000-0003-1222-0636https://orcid.org/0000-0002-4523-7947Revista Internacional - Indexad

Anxiety can significantly explain bolus perception in the context of hypotensive esophageal motility: Results of a large multicenter study in asymptomatic individuals

This article may be used for non-commercial purposes in accordance With Wiley Terms and Conditions for self-archiving'. © 2017 John Wiley & Sons, Inc. All rights reserved. This author accepted manuscript is made available following 12 month embargo from date of publication (May 2017) in accordance with the publisher’s archiving policyBackground Previous studies have not been able to correlate manometry findings with bolus perception. The aim of this study was to evaluate correlation of different variables, including traditional manometric variables (at diagnostic and extreme thresholds), esophageal shortening, bolus transit, automated impedance manometry (AIM) metrics and mood with bolus passage perception in a large cohort of asymptomatic individuals. Methods High resolution manometry (HRM) was performed in healthy individuals from nine centers. Perception was evaluated using a 5‐point Likert scale. Anxiety was evaluated using Hospitalized Anxiety and Depression scale (HAD). Subgroup analysis was also performed classifying studies into normal, hypotensive, vigorous, and obstructive patterns. Key Results One hundred fifteen studies were analyzed (69 using HRM and 46 using high resolution impedance manometry (HRIM); 3.5% swallows in 9.6% of volunteers were perceived. There was no correlation of any of the traditional HRM variables, esophageal shortening, AIM metrics nor bolus transit with perception scores. There was no HRM variable showing difference in perception when comparing normal vs extreme values (percentile 1 or 99). Anxiety but not depression was correlated with perception. Among hypotensive pattern, anxiety was a strong predictor of variance in perception (R2 up to .70). Conclusion and Inferences Bolus perception is less common than abnormal motility among healthy individuals. Neither esophageal motor function nor bolus dynamics evaluated with several techniques seems to explain differences in bolus perception. Different mechanisms seem to be relevant in different manometric patterns. Anxiety is a significant predictor of bolus perception in the context of hypotensive motility

Atrasentan and renal events in patients with type 2 diabetes and chronic kidney disease (SONAR): a double-blind, randomised, placebo-controlled trial

Background: Short-term treatment for people with type 2 diabetes using a low dose of the selective endothelin A receptor antagonist atrasentan reduces albuminuria without causing significant sodium retention. We report the long-term effects of treatment with atrasentan on major renal outcomes. Methods: We did this double-blind, randomised, placebo-controlled trial at 689 sites in 41 countries. We enrolled adults aged 18–85 years with type 2 diabetes, estimated glomerular filtration rate (eGFR)25–75 mL/min per 1·73 m 2 of body surface area, and a urine albumin-to-creatinine ratio (UACR)of 300–5000 mg/g who had received maximum labelled or tolerated renin–angiotensin system inhibition for at least 4 weeks. Participants were given atrasentan 0·75 mg orally daily during an enrichment period before random group assignment. Those with a UACR decrease of at least 30% with no substantial fluid retention during the enrichment period (responders)were included in the double-blind treatment period. Responders were randomly assigned to receive either atrasentan 0·75 mg orally daily or placebo. All patients and investigators were masked to treatment assignment. The primary endpoint was a composite of doubling of serum creatinine (sustained for ≥30 days)or end-stage kidney disease (eGFR <15 mL/min per 1·73 m 2 sustained for ≥90 days, chronic dialysis for ≥90 days, kidney transplantation, or death from kidney failure)in the intention-to-treat population of all responders. Safety was assessed in all patients who received at least one dose of their assigned study treatment. The study is registered with ClinicalTrials.gov, number NCT01858532. Findings: Between May 17, 2013, and July 13, 2017, 11 087 patients were screened; 5117 entered the enrichment period, and 4711 completed the enrichment period. Of these, 2648 patients were responders and were randomly assigned to the atrasentan group (n=1325)or placebo group (n=1323). Median follow-up was 2·2 years (IQR 1·4–2·9). 79 (6·0%)of 1325 patients in the atrasentan group and 105 (7·9%)of 1323 in the placebo group had a primary composite renal endpoint event (hazard ratio [HR]0·65 [95% CI 0·49–0·88]; p=0·0047). Fluid retention and anaemia adverse events, which have been previously attributed to endothelin receptor antagonists, were more frequent in the atrasentan group than in the placebo group. Hospital admission for heart failure occurred in 47 (3·5%)of 1325 patients in the atrasentan group and 34 (2·6%)of 1323 patients in the placebo group (HR 1·33 [95% CI 0·85–2·07]; p=0·208). 58 (4·4%)patients in the atrasentan group and 52 (3·9%)in the placebo group died (HR 1·09 [95% CI 0·75–1·59]; p=0·65). Interpretation: Atrasentan reduced the risk of renal events in patients with diabetes and chronic kidney disease who were selected to optimise efficacy and safety. These data support a potential role for selective endothelin receptor antagonists in protecting renal function in patients with type 2 diabetes at high risk of developing end-stage kidney disease. Funding: AbbVie

An exploration of service providers’ experiences with Latinos convicted of a sex offense

Despite the growing Latino presence in the U.S. criminal justice system and among those who have committed sex offenses specifically, little is known about the barriers and challenges faced by this population when accessing treatment services. This study sought to gather more information about responsivity factors that may be specific to Latinos who have committed sexual offenses. Service providers who worked with Latinos convicted of sexual offenses completed an online survey and answered questions regarding perceived challenges and barriers they encountered when working with Latino clients and were asked to provide recommendations concerning services and treatment provision. Service providers frequently reported issues related to a lack of culturally sensitive services, bilingual professionals, and clients’ limited knowledge about the U.S. legal system. Among service providers with experience working with undocumented Latino immigrants, some indicated specific challenges such as stressors related to their immigration status and a lack of resources. Professionals’ recommendations were consistent with the challenges reported and findings are discussed as they pertain to responsivity issues in the provision of treatment services to Latino individuals who have committed sexual offenses

Déficit de atención con y sin hiperactividad y su relación con lesiones traumatológicas en niños entre 6 y 12 años en la clínica El Prado de la ciudad de Santa Marta

ResumenEl trastorno por déficit de atención con o sin Hiperactividad (TDAH) se define como un trastorno crónico sintomáticamente evolutivo, esta alteración del neurodesarrollo en el niño suele caracterizarse por la presencia de problemas para concentrarse y dedicarse a una tarea asignada o al cumplimiento de reglas impartidas; permaneciendo en constante movimiento. Por tanto, estos niños son propensos a presentar accidentes con un alto riesgo de lesionarse, fracturarse o sufrir algún tipo de trauma físico de grados variables, a diferencia de los niños que miden sus actos y no presentan déficit de atención. Este estudio se llevó a cabo, en el marco de la investigación descriptivo – correlacional, con el objetivo de describir la relación existente entre el trastorno por déficit de atención con y/o sin hiperactividad (TDHA) y las presencia de lesiones y/o traumas ortopédicos en Niños entre 6 y 12 Años en la Clínica El Prado de la Ciudad de Santa Marta. Pacientes y Métodos: se conformó un grupo de 31 niños con su respectiva autorización de padres, tutores o representantes legales, 21 de ellos eran hombres (67,7%) y 10 mujeres (32,3%) los cuales asistían por lesiones ortopédicas al servicio de urgencias de la Clínica El Prado y fueran diagnosticados con déficit de atención con y sin hiperactividad, pudiendo así obtenerse una muestra del 15,5% en relación a la población total. Para el diagnostico del TDHA se utilizaron los Criterios diagnósticos del DSM IV, DSM IV Checklist o lista de síntomas, y la escala Multidimensional del Comportamiento BASC para Padres y Docentes. Resultados: De acuerdo con los datos estadísticos se puede observar que aunque un gran número de niños que conforman la muestra presentan características propias del diagnóstico de déficit de atención y sus subtipo (60%), no existe evidencia estadísticamente significativa que demuestre la relación entre ésta y la presencia de lesiones y traumatismo ortopédico, por el contrario la prueba de asociación de variables demuestra que estas son completamente independientes. El restante de participantes de la muestra (40%) no cumple con los criterios de clasificación. (Duazary 2009-II 124-133)AbstractThe disruption of attention deficit disorder with or without hyperactivity (TDAH) is defined as an evolutionary symptomatic chronic disruption. The alteration of this neuro development in a child is usually characterized by the presence of problems to concentrate and dedicate in an assignment duty or failure to comply with given rules; remaining in constant movement. Therefore, these children are prone to present accidents with high risk of injuring themselves, fracturing or undergoing some type of physical trauma of variable degrees, unlike the children who measure their acts and they do not present/display attention deficit. This studio, We are carried out within the framework descriptive-correlative investigation, with the objective to describes the existing relation between the upheaval by and/or deficit of attention with without hyperactivity (TDHA) and the presence of injuries and/or orthopedics traumas in children between 6 and 12 years in the Clinic the Prado of Santa Marta City. Patients and methods: Conform a group of 31 children with respective authorization of their parents, legal tutors or representatives, 21 of them was men (67.7%) and 10 women (32.3%) who assisted by orthopedics injuries to the service of urgency of the Clinic the Prado and was diagnosed with deficit of attention with and without hyperactivity, thus being able to obtain a sample of 15.5% in relation to the total population. For diagnostic of the TDHA the criteria were used diagnoses of DSM IV, DSM IV Checklist or list of symptoms, and the Multidimensional scale of Behavior BASC for parents and docents. Results: According to the statistical data it is possible to be observer that although a great number of children who conform the sample present/display own characteristics of diagnostic of attention deficit and their subtypes (60%), does not exist statistically significant evidence that it shows the relation between this and the presence of lesions and orthopedic traumatism; on the contrary the test of association of variables demonstrates that these are completely independent. The rest of participants of the sample (40%) do not fulfill the classification criteria.Key words: Deficit of attention; Upheavals; Hyperactivity; Trauma; Fracture; Neurodevelopment.</p

Déficit de atención con y sin hiperactividad y su relación con lesiones traumatológicas en niños entre 6 y 12 años en la clínica El Prado de la ciudad de Santa Marta

El trastorno por déficit de atención con o sin Hiperactividad (TDAH) se define como un trastorno crónico sintomáticamente evolutivo, esta alteración del neurodesarrollo en el niño suele caracterizarse por la presencia de problemas para concentrarse y dedicarse a una tarea asignada o al cumplimiento de reglas impartidas; permaneciendo en constante movimiento. Por tanto, estos niños son propensos a presentar accidentes con un alto riesgo de lesionarse, fracturarse o sufrir algún tipo de trauma físico de grados variables, a diferencia de los niños que miden sus actos y no presentan déficit de atención. Este estudio se llevó a cabo, en el marco de la investigación descriptivo – correlacional, con el objetivo de describir la relación existente entre el trastorno por déficit de atención con y/o sin hiperactividad (TDHA) y las presencia de lesiones y/o traumas ortopédicos en Niños entre 6 y 12 Años en la Clínica El Prado de la Ciudad de Santa Marta. Pacientes y Métodos: se conformó un grupo de 31 niños con su respectiva autorización de padres, tutores o representantes legales, 21 de ellos eran hombres (67,7%) y 10 mujeres (32,3%) los cuales asistían por lesiones ortopédicas al servicio de urgencias de la Clínica El Prado y fueran diagnosticados con déficit de atención con y sin hiperactividad, pudiendo así obtenerse una muestra del 15,5% en relación a la población total. Para el diagnostico del TDHA se utilizaron los Criterios diagnósticos del DSM IV, DSM IV Checklist o lista de síntomas, y la escala Multidimensional del Comportamiento BASC para Padres y Docentes. Resultados: De acuerdo con los datos estadísticos se puede observar que aunque un gran número de niños que conforman la muestra presentan características propias del diagnóstico de déficit de atención y sus subtipo (60%), no existe evidencia estadísticamente significativa que demuestre la relación entre ésta y la presencia de lesiones y traumatismo ortopédico, por el contrario la prueba de asociación de variables demuestra que estas son completamente independientes. El restante de participantes de la muestra (40%) no cumple con los criterios de clasificación. (Duazary 2009-II 124-133)

Are Latinos who commit sexual offenses different? A closer examination of characteristics and offense patterns

Research examining ethnic and cultural differences among individuals who commit sex offenses remains limited. Specifically, literature focusing on sex offenses committed by Latinos is scarce. Using archival data from a large sample of individuals who committed sex offenses, this study explored differences between Latino, White, and African American individuals related to their characteristics, the offenses, and the victims. Latinos in the sample were more likely to have a lower educational level, and to be living with the victim, than either their White or African American counterparts. To further understand the influence of cultural background, the study also examined differences within the Latino group based on their country of origin. Within the Latino sample, differences emerged in their educational level, criminal background, and psychiatric history. These findings are discussed as they pertain to future research and current practices related to the management and treatment of Latinos who commit sexual offenses

Clinical practice guideline for disease caused by gastroesophageal reflux

Objetivo: brindar una guía de práctica clínica basada en la evidencia más reciente para el diagnóstico y tratamiento del reflujo gastroesofágico teniendo en cuenta la efectividad y seguridad de las intervenciones dirigidas a pacientes, personal asistencial, administrativo y entes gubernamentales de cualquier servicio de atención en Colombia. Materiales y métodos: esta guía fue desarrollada por un equipo multidisciplinario con apoyo de la Asociación Colombiana de Gastroenterología, el Grupo Cochrane ITS y el Instituto de Investigaciones Clínicas de la Universidad Nacional de Colombia. Se desarrollaron preguntas clínicas relevantes y se realizó la búsqueda de guías nacionales e internacionales en bases de datos especializadas. Las guías existentes fueron evaluadas en términos de calidad y aplicabilidad; 1 guía cumplió los criterios de adaptación, por lo que se decidió adaptar 3 preguntas clínicas. El Grupo Cochrane realizó la búsqueda sistemática de la literatura. Las tablas de evidencia y recomendaciones fueron realizadas con base en la metodología GRADE. Las recomendaciones de la guía fueron socializadas en una reunión de expertos con entes gubernamentales y pacientes. Resultados: se desarrolló una guía de práctica clínica basada en la evidencia para el diagnóstico y tratamiento de pacientes con reflujo gastroesofágico en Colombia. Conclusiones: el diagnóstico y manejo oportuno de los pacientes con ERGE contribuirá a disminuir la carga de la enfermedad en Colombia, así como de las enfermedades asociadas.Objective: To provide a clinical practice guideline with the latest evidence for diagnosis and treatment of gastroesophageal reflux for patients, caregivers, administrative and government bodies at all levels of care in Colombia. Materials and Methods: This guide was developed by a multidisciplinary team with the support of the Colombian Association of Gastroenterology, Cochrane STI Group and Clinical Research Institute of the Universidad Nacional de Colombia. Relevant clinical questions were developed and the search for national and international guidelines in databases was performed. Existing guidelines were evaluated quality and applicability. One guideline met the criteria for adaptation, so the group decided to adapt 3 clinical questions. Systematic literature searches were conducted by the Cochrane Group. The tables of evidence and recommendations were made based on the GRADE methodology. The recommendations of the guide were socialized in a meeting of experts with government agencies and patients. Results: An evidence-based Clinical Practice Guidelines for the diagnosis and treatment of gastroesophageal reflux was developed for the Colombian context. Conclusions: The opportune detection and appropriate management of gastroesophageal reflux would contribute to the burden of the disease in Colombia and its associated diseases