Estadística práctica con Stat Graphics

Estas prácticas de Estadística hacen uso del programa Statgraphics Plus® versión 7.1. Su objetivo principal es el aprendizaje de la Estadística, pero dada la importancia del ordenador en los estudios estadísticos prácticos, se ha procurado tratar preferentemente los temas en que este es particularmente útil, por no decir imprescindible

Artrodesis de rodilla por fracaso de la artroplatsia total

Veintiuna artrodesis de rodilla fueron realizadas en nuestro Servicio en los últimos 20 años. Se realiza un estudio retrospectivo con un seguimiento medio de 10 años. Las razones para la artrodesis fueron en 12 ocasiones (57%) infección de la artroplastia total, y en los 9 casos restantes (43%) aflojamiento aséptico. La artrodesis se realizó mediante fijación externa en un solo plano en 11 casos (52%), en biplano se colocó en 7 (33%), 2 casos con placas a compresión (9,5%) y el caso restante mediante un clavo intramedular (5%). La fusión después del procedimiento inicial se obtuvo solamente en 12 pacientes (57%) y añadiendo procedimientos adicionales totalizamos 19 rodillas fusionadas (90%). Las complicaciones encontradas fueron: 9 pseudoartrosis, 2 infecciones en el trayecto de las fichas, 2 roturas del material de fijación, una infección persistente que llevó a la amputación, y una parálisis del nervio ciático poplíteo externo.A total of 21 knee arthrodesis performed in the last 20 years was reviewed with an average follow-up of 10 years. Arthrodesis was performed following deep infection in 12 cases (57%) and aseptic loosening of the prostheses in the remaining 9 cases. TH artrodesis were performed using one-plane external fixation in 11 cases, two-planes external fixation in 7, compression plates in 2, intramedular nailing in only 12 patients. Using additional procedures we obtained 19 fused knees (90 %). The complications in this series were: Psuedarthrosis (9 cases), infection of the fixator pins (2 cases), infection of the fixator pins (2 cases), and broken osteosybrtesis components (2 cases), severe deep infection with final amputation of the limb (1 case), and CPE injury (1 case)

Importancia de la acreditacion internacional de facultades de medicina

As of 2024, medical school graduates who wish to pursue graduate studies in the U.S. or in Canada, they must have graduated from medical schools with quality educational programs endorsed by recognized agencies, capable of granting international accreditation.   The World Federation for Medical Education (WFME) is one of these agencies.  The WFME accepted the new accreditation policy of the Educational Committee for Foreign Medical Education (ECFMG) whereby physicians applying for ECFMG certification from 2024 onwards, must have graduated from a university medical center accredited by a quality assurance agency that is recognized by the WFME. The COMAEM (Mexican Council for the Accreditation of Medical Education) is endorsed by the WFME and other international organizations that ensure the quality of higher education. The accreditation granted by COMAEM is a recognition that the medical program meets the criteria, indicators and quality parameters established by this organization. Starting in 2024, graduates of an accredited program will be able to apply for ECFMG certification through the United States Medical Licensing Examination (USMLE) and thus be able to do a specialty residency or work in the U.S.  In Peru, only the Alberto Hurtado School of Medicine of the Cayetano Heredia Peruvian University has completed the international accreditation process through COMAEM and has received such accreditation.A partir de 2024, egresados de facultades de medicina que deseen hacer estudios de postgrado en los EE.UU o el Canadá, deberán graduarse en escuelas de medicina con programas educativos de calidad avalados por agencias reconocidas capaces de otorgar una acreditación internacional. La World Federation for Medical Education (WFME) es una de estas agencias. La WFME aceptó la nueva política de acreditación del Educational Committee for Foreign Medical Education (ECFMG) por la que médicos que postulen para la certificación del ECFMG del 2024 en adelante, tendrán que haberse graduado en un centro universitario de medicina acreditado por una agencia de aseguramiento de calidad que se encuentre reconocida por la WFME. El COMAEM (Consejo Mexicano para la Acreditación de la Educación Médica) está avalado por la WFME y otros organismos internacionales que aseguran la calidad de la educación superior. La acreditación que concede el COMAEM es un reconocimiento que el programa de medicina cumple con los criterios, indicadores y parámetros de calidad establecidos por este organismo. A partir de 2024, los egresados de un programa acreditado podrán postular para la certificación del ECFMG a través del examen de licencia médica de los Estados Unidos o USMLE (United States Medical Licensing Examination) y así poder hacer una residencia de especialización o trabajar en EE. UU.  En el Perú, solo la Facultad de Medicina Alberto Hurtado de la Universidad Peruana Cayetano Heredia ha completado el proceso de acreditación internacional a través de COMAEM y ha recibido dicha acreditación

Low-intensity continuous ultrasound to inhibit cancer cell migration

In recent years, it has been verified that collective cell migration is a fundamental step in tumor spreading and metastatic processes. In this paper, we demonstrate for the first time how low-intensity ultrasound produces long-term inhibition of collective migration of epithelial cancer cells in wound healing processes. In particular, we show how pancreatic tumor cells, PANC-1, grown as monolayers in vitro respond to these waves at frequencies close to 1 MHz and low intensities (< 100 mW cm(-2)) for 48-72 h of culture after some minutes of a single ultrasound irradiation. This new strategy opens a new line of action to block the spread of malignant cells in cancer processes. Despite relevant spatial variations of the acoustic pressure amplitude induced in the assay, the cells behave as a whole, showing a collective dynamic response to acoustic performance. Experiments carried out with samples without previous starving showed remarkable effects of the LICUs from the first hours of culture, more prominent than those with experiments with monolayers subjected to fasting prior to the experiments. This new strategy to control cell migration demonstrating the effectiveness of LICUS on not starved cells opens a new line of action to study effects of in vivo ultrasonic actuation on tumor tissues with malignant cells. This is a proof-of-concept study to demonstrate the physical effects of ultrasound stimulation on tumor cell migration. An in-depth biological study of the effects of ultrasounds and underlying biological mechanisms is on-going but out of the scope of this article.This work is financed by the Spanish National Plan projects PID 2021-128985OB-I00: "New Non-invasive technology to inhibit growth of solid tumors by low intensity ultrasounds", DPI 2017-90147-R and intramural research project IRYCIS (2018/0240)

Epistasis between intracellular cholesterol trafficking-related genes (NPC1 and ABCA1) and Alzheimer's disease risk

Aberrant cholesterol metabolism has been implicated in Alzheimer´s disease (AD). Recent findings have suggested an interaction of Niemann-Pick C1 (NPC1) and ATP-binding cassette transporter A1 (ABCA1) proteins in intracellular cholesterol transport and in maintaining cell cholesterol balance. Underexpression of NPC1 in concert with underexpression of ABCA1 would result in increased cholesterol accumulation and increased AD risk. We examined a functional polymorphism in the ABCA1 promoter region (−477, rs2422493), and four NPC1 polymorphisms in exon 6 (rs18050810), intron 20 (rs4800488), intron 22 (rs2236707), and intron 24 (rs2510344) capturing 85% of genetic variability in Hap Map CEU population, in a group of 631 Spanish AD patients and 731 controls. Subjects carrying both the ABCA1 (−477) TT genotype and the NPC1 (exon 6) GG genotype (OR = 1.89; 95% CI 1.04-3.41), NPC1 (intron 20) AA genotype (OR = 2.05; 95% CI 1.26-3.33), NPC1 (intron 22) AA genotype (OR = 2.05; 95% CI 1.18-3.58), or NPC1 (intron 24) GG genotype (OR = 1.89; 95% CI 1.16-3.07) had a higher risk of developing AD than subjects without these risk genotypes. Testing for epistatic interaction between genes in the pathway of cholesterol metabolism might be useful for predicting AD risk

Genetic variation in the tau kinases pathway may contribute to the risk of Alzheimer´s disease

Tau abnormal hyperphosphorylation and the formation of neurofibrillary tangles in Alzheimer´s disease (AD) brain is the result of upregulation of tau kinases. In a group of 729 Spanish late-onset AD patients and 670 healthy controls, we examined variations into a set of 20 candidate genes of kinases involved in tau phosphorylation at AD-related sites (PRKACB; CAMK2A; MARK1, 2, 3 and 4; CSNK1D; CDC2; RPS6KB1 and 2; p38α and β; IB1; JNK1, 2 and 3; MEK1 and 2; ERK1 and 2), to address hypotheses of genetic variation that might influence AD risk. There was an increased frequency of RPS6KB2 (intron 2, rs917570) minor allele in patients (50%) versus controls (39%) (OR = 1.52; 95% CI 1.30-1.77; p = 1.24×10−5 Bonferroni corrected), and the CDC2 AGC haplotype derived from SNPs in introns 3 (rs2448347), 5 (rs2456772), and 7 (rs1871447) showed a protective effect against AD in APOE ε4 allele noncarriers (permutation p = 1.0×10-4) with a frequency of 9% in cases and 15% in controls. Common genetic variation in the tau kinases pathway does underlie individual differences in susceptibility to AD

Caracterización de la enfermedad trofoblástica gestacional en Camagüey

Introducción: Enfermedad trofoblástica gestacional (ETG) es el conjunto de procesos benignos y malignos derivados de una proliferación anormal del trofoblasto.Objetivo: Caracterizar los principales aspectos clínicos y anatomopatológicos de la ETG en Camagüey durante el período de enero de 2011 a diciembre de 2012.Diseño Metodológico: Se realizó un estudio observacional descriptivo transversal en 26 gestantes.Resultados: En 16 pacientes estudiadas, el signo que motivó el ingreso fue el sangrado vaginal, mientras que el 92,3 % del universo tenía como variedad anatomopatológica a la mola hidatiforme.Conclusiones: La ETG constituye un problema de salud en el Hospital Universitario Ginecobstétrico Provincial Ana Betancourt de Mora, Camagüey ABSTRACTIntroduction: Gestational trophoblastic disease (GTD) is the set of benign and malignant processes resulting from abnormal proliferation of trofoblasto.Objetive: To describe the main clinical and pathological aspects of the GTD in Camaguey during the period January 2011 to December 2012.Methodological Design: A cross-sectional observational study was performed in 26 pregnant women.Results: In 16 patients sign leading to admission was vaginal bleeding, while 92.3% of the universe was like the hydatidiform mole pathological variety.Conclusions: The ETG is a health problem in Ana Betancourt de Mora`s Hospital, Camagüey.

Feasibility assessment of the interactive use of a Monte Carlo algorithm in treatment planning for intraoperative electron radiation therapy

This work analysed the feasibility of using a fast, customized Monte Carlo (MC) method to perform accurate computation of dose distributions during pre- and intraplanning of intraoperative electron radiation therapy (IOERT) procedures. The MC method that was implemented, which has been integrated into a specific innovative simulation and planning tool, is able to simulate the fate of thousands of particles per second, and it was the aim of this work to determine the level of interactivity that could be achieved. The planning workflow enabled calibration of the imaging and treatment equipment, as well as manipulation of the surgical frame and insertion of the protection shields around the organs at risk and other beam modifiers. In this way, the multidisciplinary team involved in IOERT has all the tools necessary to perform complex MC dosage simulations adapted to their equipment in an efficient and transparent way. To assess the accuracy and reliability of this MC technique, dose distributions for a monoenergetic source were compared with those obtained using a general-purpose software package used widely in medical physics applications. Once accuracy of the underlying simulator was confirmed, a clinical accelerator was modelled and experimental measurements in water were conducted. A comparison was made with the output from the simulator to identify the conditions under which accurate dose estimations could be obtained in less than 3 min, which is the threshold imposed to allow for interactive use of the tool in treatment planning. Finally, a clinically relevant scenario, namely early-stage breast cancer treatment, was simulated with pre- and intraoperative volumes to verify that it was feasible to use the MC tool intraoperatively and to adjust dose delivery based on the simulation output, without compromising accuracy. The workflow provided a satisfactory model of the treatment head and the imaging system, enabling proper configuration of the treatment planning system and providing good accuracy in the dosage simulation

El impacto de la pandemia del COVID-19 en la educación médica: adaptabilidad y experiencia con enseñanza a distancia de la Sociedad Médica Peruano Americana

The COVID-19 pandemic had a significant impact on medical care and medical education in Peru.&nbsp; In response, the Peruvian American Medical Society (PAMS), a charitable medical organization based in the USA, pursued its medical and educational missions in Peru by adopting virtual learning technology. We developed closer collaborative relationships with several medical schools and the Peruvian Association of Medical Schools (ASPEFAM) while offering a faculty panel of twenty-four members to provide lectures and multidisciplinary webinars in Spanish. We conducted 19 webinars including COVID -19 and non-COVID-19 related topics that over the last two years attracted 14,489 participants from 23 countries. They were the foundation for twenty publications in Peruvian medical journals. Our clinical investigations competition was positively received as was our pilot project on research mentorship. The COVID -19 pandemic had a positive effect on the educational mission of PAMS in Peru.La pandemia del COVID-19 tuvo un impacto significativo en el cuidado y la educación médicos en el Perú. En respuesta, la Sociedad Médica Peruano Americana (PAMS), una organización médica benéfica con sede en los EE. UU., adoptó sus misiones médicas y educativas en Perú usando estrategias virtuales. Desarrollamos colaboración con varias facultades de medicina y la Asociación Peruana de Facultades de Medicina (ASPEFAM) y ofrecimos un panel de veinte y cuatro miembros para brindar conferencias y seminarios multidisciplinarios en español. Hicimos 19 seminarios, incluyendo temas relacionados y no relacionados al COVID-19, que en los últimos dos años atrajo a 14 489 participantes de 23 países. Ellas fueron la base de 20 publicaciones en revistas médicas peruanas. Nuestro concurso de investigaciones clínicas y nuestro proyecto piloto de mentoría de investigación fueron recibidos positivamente. La pandemia del COVID-19 tuvo un efecto positivo en la misión educativa de PAMS en Perú

Mediating role of inclusive leadership in innovative teaching behavior

Purpose: The prime purpose of current research is to investigate the mediating role of inclusive leadership between teaching policy, teachingresources,and innovativeteaching behavior. Design/methodology/approach: This research has collected data on a Likert scale questionnaire and the structural equation modeling technique is applied in data analysis.The population of this research are teachers in Peru. Findings: The findings of this research highlighted that the mediating role of inclusive leadership is significant between teaching policy, teachingresources,and innovative teaching behavior.Furthermore, the research highlighted that the direct impact of teaching policy, teachingresources, and inclusiveleadership are significant in innovative teaching behavior.Research limitations/implications: This research has theoretical implications as it has enhanced the model of innovative teaching with mediating role of inclusive leadership. Furthermore, the practical implications of this research can improve teaching behavior innovatively by adopting new policies for teaching and utilizing appropriate resources for it. Originality/value: This research is designed on the original idea to improve the model of innovative teaching behavior with inclusive leadership to provide remarkable implications in the knowledge and practice.Campus Chimbot