Asociación entre síndrome de cirugía lumbar fallida y el índice de masa corporal

"El síndrome de cirugía lumbar fallida es una entidad que va en aumento a medida que se han desarrollado nuevos procedimientos quirúrgicos que demandan una mayor especialización y requerimiento de insumos técnicos para el tratamiento de la patología de la columna lumbar. Cada vez son mayores los pacientes diagnosticados con este síndrome, sin embargo la poca comprensión de los múltiples factores que la predisponen condiciona el aumento en la prevalencia de este padecimiento, generando pérdidas económicas por días de incapacidad, la falta de reintegración a las actividades laborales y cotidianas y el gasto que supone para los servicios de salud por el número de consultas, intervenciones quirúrgicas y los insumos médicos necesarios para el tratamiento de este Síndrome. Se ha intentado correlacionar los múltiples factores predisponentes a esta patología; sin embargo, no existe evidencia suficiente en la bibliografía disponible en la cual se correlacione la influencia de un alto índice de masa corporal que condicione la aparición o prevalencia del dolor persistente o síntomas radiculares posterior a una o más cirugías lumbares. El objetivo de esta tesis es Demostrar la asociación entre el Síndrome de cirugía lumbar fallida con el IMC"

CALIDAD DE VIDA Y NECESIDAD PRÓTESIS BUCAL DE LOS TRABAJADORES DE LA EMPRESA SIDERÚRGICA ALTOS HORNOS DE MÉXICO

México se encuentra entre los países de alto rango de frecuencia en enfermedades bucales, dentro de ellas, la caries dental y la enfermedad periodontal.  Esta situación, se presenta en gran cantidad de  mexicanos que pierdan sus piezas dentales y se encuentren parcialmente o totalmente desdentados lo que puede limitar la capacidad de comunicarse, comer o  afectar la dimensión psicosocial del individuo. Esta investigación, se desarrolla bajo la premisa de que la calidad de vida medida a través del Índice de GOHAI está asociada a la necesidad de prótesis bucal. Menos de la mitad de la muestra necesita de prótesis nuevas o de reparación de las mismas. El grupo de edad que más necesitó prótesis, fue el de 50 a 65 años. En el presente estudio se encontró que pacientes parcialmente dentados, sin prótesis ó con prótesis insatisfactoria, presentaban índice de calidad de vida inferior a los pacientes que no necesitaban de prótesis. AbstractMexico is among the countries with a high frequency range of oral diseases, within them, dental caries and periodontal disease. This situation presents a great number of Mexicans who lose their teeth and are partially or fully edentulous which may limit the ability to communicate, eat or affect the psychosocial dimension of the individual. This research was developed under the premise that the quality of life measured by the Index GOHAI is associated with the need for oral prosthesis. Less than half of the sample prosthesis need new or repair them. The age group that most needed prosthesis was 50 to 65 years. In the present study we found that partially dentate patients without prostheses or prosthetic unsatisfactory index had lower quality of life for patients who did not need oral prosthesis. Palabras claves: protésis oral, calidad de vida, trabajadore

Global Retinoblastoma Presentation and Analysis by National Income Level.

Importance: Early diagnosis of retinoblastoma, the most common intraocular cancer, can save both a child's life and vision. However, anecdotal evidence suggests that many children across the world are diagnosed late. To our knowledge, the clinical presentation of retinoblastoma has never been assessed on a global scale. Objectives: To report the retinoblastoma stage at diagnosis in patients across the world during a single year, to investigate associations between clinical variables and national income level, and to investigate risk factors for advanced disease at diagnosis. Design, Setting, and Participants: A total of 278 retinoblastoma treatment centers were recruited from June 2017 through December 2018 to participate in a cross-sectional analysis of treatment-naive patients with retinoblastoma who were diagnosed in 2017. Main Outcomes and Measures: Age at presentation, proportion of familial history of retinoblastoma, and tumor stage and metastasis. Results: The cohort included 4351 new patients from 153 countries; the median age at diagnosis was 30.5 (interquartile range, 18.3-45.9) months, and 1976 patients (45.4%) were female. Most patients (n = 3685 [84.7%]) were from low- and middle-income countries (LMICs). Globally, the most common indication for referral was leukocoria (n = 2638 [62.8%]), followed by strabismus (n = 429 [10.2%]) and proptosis (n = 309 [7.4%]). Patients from high-income countries (HICs) were diagnosed at a median age of 14.1 months, with 656 of 666 (98.5%) patients having intraocular retinoblastoma and 2 (0.3%) having metastasis. Patients from low-income countries were diagnosed at a median age of 30.5 months, with 256 of 521 (49.1%) having extraocular retinoblastoma and 94 of 498 (18.9%) having metastasis. Lower national income level was associated with older presentation age, higher proportion of locally advanced disease and distant metastasis, and smaller proportion of familial history of retinoblastoma. Advanced disease at diagnosis was more common in LMICs even after adjusting for age (odds ratio for low-income countries vs upper-middle-income countries and HICs, 17.92 [95% CI, 12.94-24.80], and for lower-middle-income countries vs upper-middle-income countries and HICs, 5.74 [95% CI, 4.30-7.68]). Conclusions and Relevance: This study is estimated to have included more than half of all new retinoblastoma cases worldwide in 2017. Children from LMICs, where the main global retinoblastoma burden lies, presented at an older age with more advanced disease and demonstrated a smaller proportion of familial history of retinoblastoma, likely because many do not reach a childbearing age. Given that retinoblastoma is curable, these data are concerning and mandate intervention at national and international levels. Further studies are needed to investigate factors, other than age at presentation, that may be associated with advanced disease in LMICs

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Heterogeneous contributions of change in population distribution of body mass index to change in obesity and underweight NCD Risk Factor Collaboration (NCD-RisC)

From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in different regions using data from 2896 population-based studies with 187 million participants. Changes in the prevalence of underweight and total obesity, and to a lesser extent severe obesity, are largely driven by shifts in the distribution of BMI, with smaller contributions from changes in the shape of the distribution. In East and Southeast Asia and sub-Saharan Africa, the underweight tail of the BMI distribution was left behind as the distribution shifted. There is a need for policies that address all forms of malnutrition by making healthy foods accessible and affordable, while restricting unhealthy foods through fiscal and regulatory restrictions

Knowledge and practices for the prevention of anemia in pregnant women cared for at the Chacarilla de Otero Health Center, San Juan de Lurigancho, march-may, 2023

Objetivo: determinar la relación entre los conocimientos y prácticas de la anemia en gestantes atendidas en el Centro de Salud Chacarilla de Otero, San Juan de Lurigancho, marzo-mayo, 2023. Material y método: el enfoque es cuantitativo, el diseño no experimental, correlacional y transversal, en una muestra de 66 mujeres gestantes. La técnica de recolección de datos fue la encuesta y los instrumentos de recolección de datos, el cuestionario de conocimientos sobre anemia y el cuestionario de prácticas preventivas sobre anemia. Resultados: en los datos demográficos, la mayoría de gestantes tienen 25 años o menos (28,8%), son convivientes (72,7%), con estudios de secundaria (30,3%), su peso pregestacional es de 61 a 65 kg (47,0%) y presentan anemia gestacional leve (56,0%). Se evidenció que no existe relación entre los conocimientos y las prácticas sobre la anemia en gestantes (p>0,05); asimismo, en su mayoría presentan un nivel de conocimiento medio sobre prevención de la anemia (68,2%), igual que en la dimensión de conceptos básicos sobre anemia (53,0%) y prevención de la anemia (72,7%); en las prácticas, la mayor parte de gestantes tiene prácticas adecuadas sobre la prevención de la anemia (81,8%), igual que en la dimensión de alimentación rica en hierro (72,7%) y administración de micronutrientes (63,6%). Conclusiones: no existe relación entre los conocimientos y prácticas sobre la prevención de la anemia en gestantes, asimismo, presentan un nivel de conocimiento medio sobre la prevención de la anemia y prácticas adecuadas sobre la prevención de la anemia

Focos sépticos bucales en pacientes con uveítis Oral sepsis in patients with uveitis

Se realizó un estudio descriptivo y transversal de 26 pacientes con uveítis, atendidos en el Servicio de Estomatología del Hospital General Docente "Juan Bruno Zayas Alfonso" de Santiago de Cuba, desde mayo hasta diciembre del 2011, con vistas a describir las infecciones bucales frecuentemente asociadas a dicha afección y la importancia del tratamiento estomatológico en estos enfermos. La información se obtuvo de las entrevistas y las historias clínicas; además, se realizó examen físico intrabucal y estudio radiográfico para diagnosticar y tratar la presencia de caries, procesos periapicales, procesos pulpares y enfermedades periodontales. Se empleó el programa SPSS versión 10.0 y como medidas de resumen, los índices y los porcentajes. Todos los afectados presentaron algún tipo de infección bucal, con mayor frecuencia de las periodontitis y los procesos periapicales en dientes posteriores del maxilar superior. La agudeza visual tuvo gran mejoría debido al tratamiento conjunto oftalmológico y estomatológico.A descriptive and cross-sectional study was carried out in 26 patients with uveitis, treated at the Stomatology Department of "Juan Bruno Zayas Alfonso" Teaching General Hospital in Santiago de Cuba from May to December 2011, in order to describe oral infections often associated with this condition and the importance of dental treatment in these patients. Data were obtained from interviews and medical records. Moreover, oral examination and radiographic study were performed to diagnose and treat dental caries, periapical and pulpal conditions and periodontal diseases. The software SPSS version 10.0 and rates and percentages as summary measure were used. All patients had some type of oral infection with increased frequency of periodontitis and periapical conditions in posterior maxillary teeth. Visual acuity greatly improved due to combined dental and ophthalmological treatment

Cervical disc arthroplasty, challenges and indications: case report

Degenerative changes in the intervertebral discs can cause a significant impact on the biomechanics of the spine this can result in compression of the nerve roots or the spinal cord [1].&nbsp