Beneficios de la ludoterapia en niños con síndrome down que asisten a la Escuela de Educación Especial, San Miguel, año 2017

El Síndrome Down es una de las alteraciones congénitas más común en El Salvador, ligada a la trisomía 21 y sus variantes; translocación y mosaicismo, relacionada directamente con el retraso mental y diversas afectaciones del desarrollo psicomotriz, teniendo esto en cuenta se decidió realizar un trabajo de investigación, aplicando las técnicas de ludoterapia en la escuela de educación especial de San Miguel, que en su inicio estuvo formada por una muestra de 9 alumnos con este síndrome, entre las edades de 5 a 10 años. Obteniendo resultados positivos en el 100% de estudiantes que formo parte de la muestra tanto en los aspectos cognitivos y motrices, ésta investigación se realizó con el objetivo de aumentar y mejorar los procesos de atención, concentración, motricidad fina y gruesa, equilibrio y coordinación motriz a través de la terapia del juego adaptada a las principales deficiencias que presento la muestra de estudio con el objetivo de mejorar los aspectos antes mencionados, durante el proceso de ejecución se llevó a cabo una investigación cuantitativa, la cual nos permitió registrar y analizar los datos obtenidos de una evaluación inicial y compararlos con una evaluación final pudiendo concluir que la ludoterapia es efectiva en el tratamiento

Aceptación tecnológica del uso de la realidad aumentada por estudiantes del nivel secundario: una mirada a una clase de Química

The teaching of Chemistry often becomes automatic and not very dynamic. Chemical concepts require scientific thought processes, being abstract for students (men and women). Therefore, it is important to apply educational resources that promote motivation and interaction with them for meaningful learning. The main objective of this study is to analyze the degree of students' acceptance towards augmented reality technology. The sample was intentional non-probabilistic (N = 100), composed of students of the fifth grade of the pre-university secondary level, in the subject of Chemistry, from the cities of Santiago and Santo Domingo in the Dominican Republic. The instrument applied was the technology acceptance model (TAM), created by Davis in 1989. The results obtained reflect a high degree of acceptance of the augmented reality technology by the participating students to learn about the electronic distribution of the elements of the periodic table. Likewise, the students consider that it is useful and very user-friendly. In summary, augmented reality technology enhances the understanding of chemistry concepts, helps to make classes more dynamic and facilitates the teaching of abstract concepts in a chemistry class, through the enjoyment of interacting with the enriched object in augmented reality format.La enseñanza de la Química, muchas veces, se torna automática y poco dinámica. Los conceptos químicos necesitan de procesos de pensamiento científico y pueden resultar abstractos para los estudiantes (hombres y mujeres). Por esto, es importante aplicar recursos educativos que promuevan la motivación e interacción con los mismos para los aprendizajes significativos. El objetivo principal de este estudio es analizar el grado de aceptación que se produce en los estudiantes hacia la tecnología de realidad aumentada. La muestra fue no probabilística intencional (N = 100) y estuvo compuesta por estudiantes de quinto grado del nivel secundario preuniversitario de la asignatura de Química en las ciudades de Santiago y Santo Domingo de la República Dominicana. El instrumento aplicado fue el modelo de aceptación de la tecnología (technology acceptance model [TAM]), creado por Davis en 1989. Los resultados obtenidos reflejan un elevado grado de aceptación de la tecnología de realidad aumentada por parte de los estudiantes participantes para conocer la distribución electrónica de los elementos de la tabla periódica. Asimismo, los estudiantes consideran que su uso es útil y muy divertido. En síntesis, la tecnología de realidad aumentada potencia la comprensión de conceptos de Química, ayuda a dinamizar las clases y facilita la enseñanza de temas abstractos a través del disfrute en la interacción con el objeto enriquecido en formato realidad aumentada

A Low-Cost Visible Light Positioning System for Indoor Positioning

Currently, a high percentage of the world’s population lives in urban areas, and this proportion will increase in the coming decades. In this context, indoor positioning systems (IPSs) have been a topic of great interest for researchers. On the other hand, Visible Light Communication (VLC) systems have advantages over RF technologies; for instance, they do not need satellite signals or the absence of electromagnetic interference to achieve positioning. Nowadays, in the context of Indoor Positioning (IPS), Visible Light Positioning (VLP) systems have become a strong alternative to RF-based systems, allowing the reduction in costs and time to market. This paper shows a low cost VLP solution for indoor systems. This includes multiple programmable beacons and a receiver which can be plugged to a smartphone running a specific app. The position information will be quickly and securely available through the interchange between the receiver and any configurable LED-beacon which is strategically disposed in an area. The implementation is simple, inexpensive, and no direct communication with any data server is required.This research was funded by INDRA-Adecco Foundation Chair on Accessible Technology, Comunidad de Madrid and the FSE/FEDER Program under grant SINFOTON2-CM (S2018/NMT-4326) and the UNIVERSIDAD CARLOS III DE MADRID under grant 2020/00038/001

Sporadic cloud-based mobile augmentation on the top of a virtualization layer: a case study of collaborative downloads in VANETs

Current approaches to Cloud-based Mobile Augmentation (CMA) leverage (cloud-based) resources to meet the requirements of rich mobile applications, so that a terminal (the so-called application node or AppN) can borrow resources lent by a set of collaborator nodes (CNs). In the most sophisticated approaches proposed for vehicular scenarios, the collaborators are nearby vehicles that must remain together near the application node because the augmentation service is interrupted when they move apart. This leads to disruption in the execution of the applications and consequently impoverishes the mobile users’ experience. This paper describes a CMA approach that is able to restore the augmentation service transparently when AppNs and CNs separate. The functioning is illustrated by a NaaS model where the AppNs access web contents that are collaboratively downloaded by a set of CNs, exploiting both roadside units and opportunistic networking. The performance of the resulting approach has been evaluated via simulations, achieving promising results in terms of number of downloads, average download times, and network overheadMinisterio de Educación y Ciencia | Ref. TIN2017-87604-

Resistencia antibiótica de bacterias aisladas en hemocultivos y urocultivos en niños hospitalizados. Hospital Nacional Almanzor Aguinaga Asenjo 2017 – 2018

Introduction: Antimicrobial resistance increases morbidity and mortality and is a serious problem in the world. Objective: to describe the antibiotic resistance of bacteria isolated in blood and urine cultures in hospitalized children under 15 years of age. Material and Methods: Descriptive - retrospective study. Bacterial identification was made with VITEK XL, antibiotic susceptibility with CLSI. Results: Blood cultures: Staphylococcus hominis 12.5% ​​resistant to Vancomycin. Staphylococcus epidermidis had 100% resistance to Oxacillin and 0% resistance to Vancomycin. Urine cultures: Klebsiella pneumoniae 0% resistance to Amikacin, Gentamicin and Nitrofurantoin. Escherichia Coli, had resistance to Amikacin 1.96%, Nitrofurantoin 3.92%. Conclusions: E, Coli, resistance less than 6.25% for Amikacin and Nitrofurantoin. Klebsiella pneumoniae, 0% resistance for Amikacin and Gentamicin. Blood cultures: Staphylococcus epidermidis, zero resistance to Vancomycin. Staphylococcus hominis, resistance less than 12% for Vancomycin and Rifampicin.Introducción. La resistencia antimicrobiana incrementa la morbimortalidad y es un problema serio en el mundo. Objetivo: Describir la resistencia antibiótica de bacterias aisladas en hemocultivos y Urocultivos en niños hospitalizados menores de 15 años. Material y Métodos: Estudio descriptivo – retrospectivo. La identificación bacteriana se hizo con VITEK XL, la susceptibilidad antibiótica con el CLSI. Resultados: Hemocultivos: Staphylococcus hominis 12,5% resistente a la Vancomicina. El Staphylococcus epidermidis, tuvo 100% de resistencia a Oxacilina y 0% resistencia a Vancomicina. Urocultivos: Klebsiella pneumoniae 0% resistencia a Amikacina, Gentamicina y Nitrofurantoina. La Escherichia Coli, tuvo resistencia para Amikacina 1,96%, Nitrofurantoina 3,92%. Conclusiones: E, Coli, resistencia menor de 6,25% para Amikacina y Nitrofurantoina. La Klebsiella pneumoniae, 0% de resistencia para Amikacina y Gentamicina. Hemocultivos: Estafilococo epidermidis, cero resistencia a Vancomicina. El Staphylococcus hominis, resistencia menor de 12% para Vancomicina y Rifampicina

Use of rivaroxaban and acetylsalicylic acid as a combined treatment for peripheral arterial disease in Central Military Hospital

Background: The objective of this research was to evaluate the behavior of 3 risk indicators for peripheral arterial disease in patients under oral treatment with rivaroxaban 2.5 mg every 12 hours plus, acetylsalicylic acid 100 mg every 24 hours. It was hypothesized that the oral combination of rivaroxaban and acetylsalicylic acid presents a therapeutic advantage over other treatments.Methods: A prospective longitudinal and non-randomized study of a single center was performed. 59 patients with peripheral arterial disease were included and treated with acetylsalicylic acid + rivaroxaban. Peak systolic velocity, ankle-brachial index and C reactive protein index were evaluated.Results: Significant changes were found at month 1 and 3 of follow-up in maximum systolic velocity, ankle-arm index and C-reactive protein index. The baseline peak systolic velocity (PSV) in the anterior tibial artery had significant differences after one month of treatment (p=0.001) and after 3 months (p=0.001). The baseline PSV in the posterior tibial artery had significant differences compared to the values found at the month of treatment (p=0.001) and 3 months (p=0.001). In the ankle-brachial index a baseline median of 0.790 was found, one month after the treatment of 0.795 (p=0.147) and 3 months after 0.800 (p=0.019). The mean baseline C-reactive protein obtained was 73.142 mg/l, at one month 87.233 mg/l (p=0.001) and at 3 months at 79.009 mg/l (p=0.294) with a standard deviation of 67.18, 74.78 and 69.69 respectively.Conclusions: The combined use of acetylsalicylic acid and rivaroxaban allows a clinical improvement in patients with peripheral arterial disease

The deep inferior epigastric artery perforator flap: a review

Breast cancer is recognized worldwide as a major health problem among women due to its high incidence and high mortality and morbidity rates. Breast reconstruction is an approach of great value for those patients who underwent mastectomy, impacting their quality of life and psychological stress. The deep inferior epigastric artery perforator (DIEP) flap was described as the preferred graft for breast reconstruction with an autologous flap by surgeons because it represented a decrease in complications for the time and obtained better results. DIEP flap reconstruction requires microsurgical skills as well as continuous monitoring of the patient to identify and resolve possible associated complications.

Therapeutic alternatives for the prevention of intra peritoneal adhesions

Intestinal adhesions are bands of fibrous tissue created by the intimate contact of two injured surface tissues; these appear in 93% of the patient undergoing intra-abdominal or gastrointestinal surgery. The comorbidities associated with the formation of adhesions have an impact on quality care offered to patients, leading to an increase in healthcare. Goals of this study was to perform a review that includes different therapeutic alternatives in basic and clinical research to prevent the formation of postoperative abdominal peritoneal adhesions. A bibliographic search was conducted in different databases including Pub med, Medline, Cochrane, science direct, from the years 2000 to 2018 using the keywords: gastrointestinal adhesions, small bowel obstruction, prophylaxis, treatment. Only experimental and clinical articles were selected. The development of peritoneal adhesions in most of the experimental studies occurred with cecal abrasion, studying the effect of biodegradable materials, drugs and gels such as mXG Hydrogel. Nanofiber membranes, agents created with recombinant technology such as periostin antisense oligonucleotide and aerosol applications such as polysaccharide 4DryField PH, are positioned to replace in the future the actual limited mechanical barriers application commonly used in abdominal surgery such as seprafilm and interceed. There are several anti-adhesion agents in experimental phase with different mechanism of action that could be used in the short term to prevent the formation of post-surgical intestinal adhesions. The inclusion of gastrointestinal surgeons in basic research is increasing and necessary with multidisciplinary collaboration. It is expected in short term the study and development of a greater number of materials to minimize tissue trauma and decrease the formation of post-surgical adhesions

Management of a ruptured epidural catheter, an anesthesiologist's dilemma: a case report

Epidural anesthesia is a widely used anesthetic technique in lower extremity surgeries although it is a relatively safe procedure, it can have complications, such as rupture of the epidural catheter. This is a 69-year-old male patient with a diagnosis of Wagner IV diabetic foot is presented, which was scheduled for left supracondylar amputation in which after epidural block, retention of the catheter tip in the epidural space at level L2-L3 was seen, so hemi laminectomy was performed in a second surgical stage in L2 and removal of the epidural catheter. Ideally a broken needle should be removed as soon as possible

Angiosome study of the first digital feet space, for reconstruction of the digital tip

Background: The concept of angiosome explains the anatomical variations that exist between the vessels of different regions of the body and helps to understand the contributions of arterial blood supply to the skin and adjacent structures, dividing the human body into three-dimensional vascular blocks.Methods: This was an observational and descriptive study. In both lower extremities of 5 corpses with adequate tissue preservation in the operating room attached to the teaching area of the National Institute of Forensic Sciences in Mexico City. Angiosome study of the medial neurocutaneous flap of the second toe of both feet was performed.Results: The average, in centimeters, of the surface of the flaps was 1.57 cm x 2.47 cm, the average diameter of the inter-metatarsal digital artery was 1.1 millimeters and the average diameter of the veins draining the angiosome was 1.4 millimeters. The most constant anatomy was that of the nerve, which was present in all cases, with the digital nerve forming the neurosome of the flap.Conclusions: To obtain optimal results in microsurgery transfers, it is necessary to have a technique that is quick for harvesting the flap and with adequate systematization so as not to injure the neurovascular bundle, this is achieved through complete anatomical knowledge, without forgetting the main variants