Tratamiento alternativo de la obesidad exógena

Introduction: obesity is a multifactorial-origin disorder that is characterized by the excessive accumulation of fat and general hypertrophy of adipose tissue in the body; a risk factor known as multiple diseases with esthetic and social repercussion. Objective: to achieve the ideal weight in obese patients by means of combining the diet, homeopathy and implantation of catgut suture in acupuncture points, trying to balance the energy and changing lifestyles. Material and method: a descriptive, longitudinal and prospective study was conducted in the service of Natural and Traditional Medicine at “Abel Santamaria Cuadrado” Pinar del Rio, during 2011. The target group and the sample coincided, both were comprised of 80 patients, a clinical history was made to each patient and body mass index was calculated. Patients were monthly assessed and treated using diet and homeopathy (group I), as well as diet, homeopathy and catgut applied on the acupuncture points (group II). Results: degree II of obesity prevailed in female sex from 27 to 37 years old. The alternatives of treatment used to treat obesity were effective in 93,8% of patients and the majority reached the ideal weight between the 4th and 6th months of treatment. Conclusions: the association of diet, homeopathy and implantation of catgut in acupuncture points to the treatment of exogenous obesity was more effective than the purely use of diet and homeopathy.Introducción: la obesidad es una de origen multifactorial caracterizada por acumulación excesiva de grasa o hipertrofia general del tejido adiposo en el cuerpo; factor de riesgo conocido para múltiples enfermedades, con repercusión estética y social.Objetivo: obtener el peso ideal en pacientes obesos mediante la combinación de dieta, homeopatía e implantación de catgut en puntos de acupuntura, tratando de equilibrar la energía y cambiar estilos de vida.Material y método: se realizó un estudio descriptivo, longitudinal, y prospectivo en el servicio de Medicina Tradicional y Natural del Hospital General Docente Abel Santamaría Cuadrado de Pinar del Río en el año 2011. El universo y la muestra coinciden estando constituidas por 80 pacientes, a todos los pacientes se les realizó en la primera consulta historia clínica y se les calculó el índice de masa corporal. Los pacientes se valoraron mensualmente y tratados con dieta y homeopatía (grupo I) y dieta, homeopatía y siembra de catgut en puntos de acupuntura (grupo II).Resultados: se obtuvo un predominio de la obesidad grado II, en el sexo femenino entre 27 y 37 años. Las alternativas de tratamiento utilizadas para la obesidad fueron efectivas en un 93,8 % de los pacientes y la mayoría de los que alcanzaron el peso ideal lo hicieron entre el cuarto y sexto mes de tratamiento.Conclusiones: la asociación de dieta, homeopatía e implantación de catgut en puntos de acupuntura para el tratamiento de la obesidad exógena fue más efectiva que la utilización solo de dieta y homeopatía

Varicocele e infertilidad con implantación de catgut

Introduction: one the medical and psychosocial problems that in major extend damages the population in reproductive ages is infertility. According to the American Society of Reproductive Medicine, it affects 6,1 millions of people in United States approximately, which is equivalent up to 10% of the population in reproductive age. It has been estimated that infertility is present in 15% of the couples. About 35%, the third part of the cases is associated with male factors, varicocele is the most frequent. Case report: a 31-year-old-male patient, operated when he was 12 years old, because he suffered from a non-treated right testicular atrophy (cryptorchidism) attended at “Abel Santamaria Cuadrado” University Hospital, to the infertility clinic service to be studied. Clinical examination verified a compensator left testis with varicocele of degree III. Complementary examinations showed normal limit rates, except the spermogram. Conclusions: surgical treatment was performed (section and ligation of spermatic cord) and the use of antioxidants, without achieving the fecundity. It was reached with the implantation of chromate catgut on the chosen acupuncture points.Introducción: la infertilidad es uno de los problemas médicos y psicosociales que en mayor cuantía está perjudicando a la población en edad reproductiva. De acuerdo con la Sociedad Americana de Medicina Reproductiva, afecta alrededor de 6,1 millones de personas en Estados Unidos, lo que equivale al 10 % de la población en edad reproductiva.Se ha estimado que la infertilidad está presente en el 15 % de las parejas. Aproximadamente el 35 %, la tercera parte de los casos, se deben a un factor masculino, siendo el varicocele la causa más frecuente. Presentación del caso: se trata de un paciente de 31 años de edad operado a los 12 años de atrofia testicular derecha no tratada por criptorquidea, que acude a la consulta de infertilidad del Hospital General Docente Abel Santamaría Cuadrado de Pinar del Río para estudio. Al examen físico se constata un testículo izquierdo compensador con varicocele grado III. Se realizan exámenes complementarios con valores dentro de límites normales, excepto el espermograma. Conclusiones: se procedió al tratamiento quirúrgico (sección y ligadura del cordón espermático) y al uso de antioxidantes, sin lograr la fecundidad. Esta sucedió después de alcanzar valores normales en el espermograma con la implantación de catgut cromado en los puntos de acupuntura seleccionados

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

Tratamiento alternativo de la obesidad exógena An alternative treatment of exogenous obesity

Introducción: la obesidad es una de origen multifactorial caracterizada por acumulación excesiva de grasa o hipertrofia general del tejido adiposo en el cuerpo; factor de riesgo conocido para múltiples enfermedades, con repercusión estética y social. Objetivo: obtener el peso ideal en pacientes obesos mediante la combinación de dieta, homeopatía e implantación de catgut en puntos de acupuntura, tratando de equilibrar la energía y cambiar estilos de vida. Material y método: se realizó un estudio descriptivo, longitudinal, y prospectivo en el servicio de Medicina Tradicional y Natural del Hospital General Docente Abel Santamaría Cuadrado de Pinar del Río en el año 2011. El universo y la muestra coinciden estando constituidas por 80 pacientes, a todos los pacientes se les realizó en la primera consulta historia clínica y se les calculó el índice de masa corporal. Los pacientes se valoraron mensualmente y tratados con dieta y homeopatía (grupo I) y dieta, homeopatía y siembra de catgut en puntos de acupuntura (grupo II). Resultados: se obtuvo un predominio de la obesidad grado II, en el sexo femenino entre 27 y 37 años. Las alternativas de tratamiento utilizadas para la obesidad fueron efectivas en un 93,8 % de los pacientes y la mayoría de los que alcanzaron el peso ideal lo hicieron entre el cuarto y sexto mes de tratamiento. Conclusiones: la asociación de dieta, homeopatía e implantación de catgut en puntos de acupuntura para el tratamiento de la obesidad exógena fue más efectiva que la utilización solo de dieta y homeopatía.Introduction: obesity is a multifactorial-origin disorder that is characterized by the excessive accumulation of fat and general hypertrophy of adipose tissue in the body; a risk factor known as multiple diseases with esthetic and social repercussion. Objective: to achieve the ideal weight in obese patients by means of combining the diet, homeopathy and implantation of catgut suture in acupuncture points, trying to balance the energy and changing lifestyles. Material and method: a descriptive, longitudinal and prospective study was conducted in the service of Natural and Traditional Medicine at "Abel Santamaria Cuadrado" Pinar del Rio, during 2011. The target group and the sample coincided, both were comprised of 80 patients, a clinical history was made to each patient and body mass index was calculated. Patients were monthly assessed and treated using diet and homeopathy (group I), as well as diet, homeopathy and catgut applied on the acupuncture points (group II). Results: degree II of obesity prevailed in female sex from 27 to 37 years old. The alternatives of treatment used to treat obesity were effective in 93,8% of patients and the majority reached the ideal weight between the 4th and 6th months of treatment. Conclusions: the association of diet, homeopathy and implantation of catgut in acupuncture points to the treatment of exogenous obesity was more effective than the purely use of diet and homeopathy

Varicocele e infertilidad con implantación de catgut

Introducción: la infertilidad es uno de los problemas médicos y psicosociales que en mayor cuantía está perjudicando a la población en edad reproductiva. De acuerdo con la Sociedad Americana de Medicina Reproductiva, afecta alrededor de 6,1 millones de personas en Estados Unidos, lo que equivale al 10 % de la población en edad reproductiva. Se ha estimado que la infertilidad está presente en el 15 % de las parejas. Aproximadamente el 35 %, la tercera parte de los casos, se deben a un factor masculino, siendo el varicocele la causa más frecuente. Presentación del caso: se trata de un paciente de 31 años de edad operado a los 12 años de atrofia testicular derecha no tratada por criptorquidea, que acude a la consulta de infertilidad del Hospital General Docente Abel Santamaría Cuadrado de Pinar del Río para estudio. Al examen físico se constata un testículo izquierdo compensador con varicocele grado III. Se realizan exámenes complementarios con valores dentro de límites normales, excepto el espermograma. Conclusiones: se procedió al tratamiento quirúrgico (sección y ligadura del cordón espermático) y al uso de antioxidantes, sin lograr la fecundidad. Esta sucedió después de alcanzar valores normales en el espermograma con la implantación de catgut cromado en los puntos de acupuntura seleccionados

Diminishing benefits of urban living for children and adolescents’ growth and development

Optimal growth and development in childhood and adolescence is crucial for lifelong health and well-being1–6. Here we used data from 2,325 population-based studies, with measurements of height and weight from 71 million participants, to report the height and body-mass index (BMI) of children and adolescents aged 5–19 years on the basis of rural and urban place of residence in 200 countries and territories from 1990 to 2020. In 1990, children and adolescents residing in cities were taller than their rural counterparts in all but a few high-income countries. By 2020, the urban height advantage became smaller in most countries, and in many high-income western countries it reversed into a small urban-based disadvantage. The exception was for boys in most countries in sub-Saharan Africa and in some countries in Oceania, south Asia and the region of central Asia, Middle East and north Africa. In these countries, successive cohorts of boys from rural places either did not gain height or possibly became shorter, and hence fell further behind their urban peers. The difference between the age-standardized mean BMI of children in urban and rural areas was <1.1 kg m–2 in the vast majority of countries. Within this small range, BMI increased slightly more in cities than in rural areas, except in south Asia, sub-Saharan Africa and some countries in central and eastern Europe. Our results show that in much of the world, the growth and developmental advantages of living in cities have diminished in the twenty-first century, whereas in much of sub-Saharan Africa they have amplified

International Nosocomial Infection Control Consortiu (INICC) report, data summary of 43 countries for 2007-2012. Device-associated module

We report the results of an International Nosocomial Infection Control Consortium (INICC) surveillance study from January 2007-December 2012 in 503 intensive care units (ICUs) in Latin America, Asia, Africa, and Europe. During the 6-year study using the Centers for Disease Control and Prevention's (CDC) U.S. National Healthcare Safety Network (NHSN) definitions for device-associated health care–associated infection (DA-HAI), we collected prospective data from 605,310 patients hospitalized in the INICC's ICUs for an aggregate of 3,338,396 days. Although device utilization in the INICC's ICUs was similar to that reported from ICUs in the U.S. in the CDC's NHSN, rates of device-associated nosocomial infection were higher in the ICUs of the INICC hospitals: the pooled rate of central line–associated bloodstream infection in the INICC's ICUs, 4.9 per 1,000 central line days, is nearly 5-fold higher than the 0.9 per 1,000 central line days reported from comparable U.S. ICUs. The overall rate of ventilator-associated pneumonia was also higher (16.8 vs 1.1 per 1,000 ventilator days) as was the rate of catheter-associated urinary tract infection (5.5 vs 1.3 per 1,000 catheter days). Frequencies of resistance of Pseudomonas isolates to amikacin (42.8% vs 10%) and imipenem (42.4% vs 26.1%) and Klebsiella pneumoniae isolates to ceftazidime (71.2% vs 28.8%) and imipenem (19.6% vs 12.8%) were also higher in the INICC's ICUs compared with the ICUs of the CDC's NHSN