Comportamiento epidemiológico de los factores de riesgo asociados a enfermedades crónicas no transmisibles en estudiantes universitarios

Describir el comportamiento epidemiológico de los factores de riesgo relacionados a enfermedades crónicas no transmisibles asociados a hipertrigliceridemia presentes en los estudiantes del primer año de la carrera de Médico y Cirujano de la Universidad de San Carlos de Guatemala. Estudio descriptivo transversal realizado en 1097 estudiantes, en los cuales se aplicó el cuestionario del método paso a paso para la vigilancia de factores de riesgo de enfermedades crónicas (STEPS) modificado. Se encontró 610 (56%) estudiantes sexo femenino, la media de edad fue de 19 años (±1.56); en relación a los factores de riesgo modificables: 219 (20%) consumen cigarrillo, 274 (25%) consumen alcohol nocivamente, 838 (76%) se alimentan de forma inadecuada, 887 (81%) no practica actividad física significativa; se identificó que 405 (37%) presentaron un índice cintura – cadera considerado de riesgo. En cuanto a los factores asociados a la presencia de hipertrigliceridemia: obesidad se identificó en 147 (13%) estudiantes (X2 de 104.98 y OR de 7), obesidad central en 204 (19%) (X2 de 55.74 y OR de 3), el sobrepeso en 330 (30%) (X2 de 53.4727 y OR de 3), presión arterial alta en 397 (36%) (X2 de 18.63 y OR de 2), y glucemia alterada en ayunas alta en 198 (18%) (X2 de 8.3 y OR de 2). La hipertrigliceridemia se presentó en 411 estudiantes (37%), siendo la edad más afectada la de 19 años. La mayoría de estudiantes estudiados es de sexo femenino. Existe una alta prevalencia de factores de riesgo modificables asociados a enfermedades crónicas no transmisibles, de estos se identificó que factores como obesidad, obesidad central, sobrepeso, presión arterial alta y glucemia alterada en ayunas alta tienen una significativa asociación al desarrollo de hipertrigliceridemia, con un aumento del riesgo de 7, 3, 3, 2 y 2, respectivamente

Ciencia Odontológica 2.0

Libro que muestra avances de la Investigación Odontológica en MéxicoEs para los integrantes de la Red de Investigación en Estomatología (RIE) una enorme alegría presentar el segundo de una serie de 6 libros sobre casos clínicos, revisiones de la literatura e investigaciones. La RIE está integrada por cuerpos académicos de la UAEH, UAEM, UAC y UdeG

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

Medios de comunicación y poder político: Bolivia, Ecuador, Perú y Venezuela

La vigilancia de la función pública y/o la defensa de intereses propios porparte de los medios de comunicación y la búsqueda de legitimidad a sus proyectos políticos por parte de los gobiernos de los países andinos, genera una recurrente tensión en la convivencia de estos dos actores, ya sea en un marco de regímenes autoritarios o democráticos. El presente artículo busca revisar dicha situación entre los gobiernos de Evo Morales (Bolivia), Rafael Correa (Ecuador), Alan García (Perú) y Hugo Chávez (Venezuela) y los medios de comunicación propios de cada país, así como exponer las estrategias utilizadas por estos gobiernos de origen democrático en aras de ganar control sobre los medios de comunicación

Rendú Osler Weber Syndrome; case report

Hereditary hemorrhagic telangiectasia (HHT), or Rendu-Osler-Weber disease, is a dominant autosomal disease characterized by the presence of multiple telangiectasia in skin and mucus, associated with arteriovenous malformations (AVM) of various organs, including the lungs, gastrointestinal system and brain. HHT is presented most frequently as recurrent, spontaneous epistaxis. Patients may also present digestive, pulmonary and intracranial hemorrhage, as well as secondary anemia.This article reports the case of a female patient, 62 years old, with multiple episodes of epistaxis and vaginal bleeding, with diagnosis of complex HHT, which was managed with multiple embolizations, which improved symptoms and survival. In this kind of patient, it is possible, with timely diagnosis and treatment, to obtain a greater quality and expectation of life. Due to the fact that the severity and alterations in each patient are so variable, management should be individualized

Primary Peritoneal Serous Cancer: A Case Report of a Tumor in the Rectovaginal Septum

Peritoneal cancer is the invasion by malignant cells of serous membrane that lines the abdominal cavity, the viscera, and the coelom of the amniotes. Histologically, it is indistinguishable from ovarian counterpart, although in the former, it commonly involves the ovary only superficially, or it may totally lack an ovarian component, but with extensive involvement of the peritoneum, calcified perihepatic peritoneal nodules, or involvement of the omentum, in most cases. The current study describes the case of a 54-year-old female patient referring a history of colitis and dairy intolerance. A transvaginal ultrasound and a computed tomography (CT) scan revealed a tumor measuring 70×61×63 mm. CA-125 serum levels were 880 U/ml. Laparotomy surgery was indicated, and tumor was found at the level of the rectovaginal septum without evidence of metastasis. Tumor dissection and protective colostomy with loop sigmoid colon were performed. A pathological study gave a diagnosis of a high-grade peritoneal serous carcinoma with a micropapillary pattern. The present study describes the case of papillary serous peritoneal cancer presented as a single tumor mass without extensive involvement of the peritoneum. Additionally, the need for routine tests for its diagnosis and documenting hormonal alterations as the cause of its origin are suggested

Guía para el Diagnóstico, Manejo y Tratamiento de Enfermedad de Chagas en fase Aguda a nivel de los Establecimientos de Salud

xvi, 538 hal. : il. ; 21 cm