16 research outputs found

    Inferior vena cava filters: a review

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    Venous thromboembolism is an entity that ranges from deep vein thrombosis to pulmonary embolism, both are highly prevalent diseases in our environment and potentially fatal. The intention of this review is to compile information regarding the indications, contraindications, complications and comparison of different therapeutic methods in order to create an algorithm. An exhaustive review was performed with the available literature, using the PubMed, ScienceDirect, Scopus and Cochrane databases from 2004 to 2021. The search criteria were formulated to identify reports related to inferior vena cava filters. Venous thrombosis manifested as deep vein thrombosis or pulmonary embolism is a highly prevalent disease in our setting with high morbidity and mortality. Currently, different therapeutic options have been presented to address this pathology, in this review we focus on the developments regarding the use of vena cava filters. Reviewing the indications for the placement of a vena cava filter, we find absolute indications such as a contraindication to anticoagulation and high risk of massive pulmonary embolism. Pulmonary thromboembolism is a disease with high prevalence and mortality, we have highly effective and novel treatments such as the vena cava filter, patients should be selected carefully always taking into account the absolute and relative indications

    Neuroaxial anesthesia caused paraplegia: a case report

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    Patients who undergo; anesthesia, neuraxial analgesia, or some type of neuraxial blockage are exposed to multiple complications. 33-year-old male patient, suffers a femur fracture with a long oblique trace causing pain and functional limitation for movements. Surgical resolution is determined using neuraxial block at L2-L3 level, and intravenous sedation. During his postoperative follow-up, a decrease in strength was confirmed in the lower limbs with 0/5 on the Daniels scale, 100% sensitivity without sphincter control, steroids were prescribed along with magnetic resonance imaging and a neurosurgical evaluation was requested. The MRI shows bulging of the fibrous annulus that obliterates the epidural fat and makes contact with the thecal sac in the L5-S1 intervertebral disc level. The neurosurgery service prescribes rehabilitation sessions at home, electrostimulation and neuropathic medications. Patient was discharged with rehabilitation sessions at home and medical treatment. In his last consultation, an evaluation from the psychiatry department was requested for ideas of disability, hopelessness, fantasies of death without a suicide plan related to limitations and loss of functionality. Patient does not return to external follow-up, cannot be located

    The neurobiology of splitbrain crayfish

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    Background: They crayfish brain is segmented into two symmetrical hemiganglia. Normally both hemiganglia are in direct communication through a series of well-defined neural bridges that cross de midline to form reciprocal cross connections.Methods: An original study was carried out in the Department of Physiology of the Faculty of Medicine, UNAM during the period from August 2019 to August 2020. 13 Crayfish Procambarus clarkii weighing between 1g to 30g were used. Each eyestalk of the animals was tied to a displacement transducer coupled with a polygraph so that optomotor or electrical activity was bilaterally recorded. The separation of the right from the left hemiganglia from the cerebral or supraesophageal ganglion was performed with a sagittal section, splitbrain (SB).Results: The normal photo motor reflex in crayfish eye is measured as a gradual decrease in the ERG amplitude. During tactile stimulation, the visual activation of both eyestalks in normal crayfish leads to a highly regular bilateral activity. The regular activity can only be altered by disturbing the mechanoreceptors located in the shell surrounding the eyestalks.Conclusions: The procedure presented in this article provides unique characteristics for the study of the nervous system such as a detailed response of the bilateral optomotor reflex

    Chronic venous insufficiency: a review

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    Chronic venous insufficiency (CVI) comprises a complete spectrum of morphological and functional abnormalities of the venous system1 including any long-term functional and morphological alteration. CVI accounts for several abnormalities of the venous system. It is a highly prevalent disease that causes serious economic consequences, a decrease in the quality of life and can lead to serious complications. An exhaustive review was performed with the available literature, using the PubMed, ScienceDirect, Scopus and Cochrane databases from 2004 to 2021. The search criteria were formulated to identify reports related to chronic venous insufficiency. The pathophysiology of chronic venous insufficiency begins with chronic venous hypertension and the dilation of the vessel, this leads to a series of pathological changes in the venous wall and surrounding tissues, in advanced stages of CVI, skin lesions are associated with an increased proliferation of skin capillaries and microcirculatory abnormalities that may be the result of an altered level of factors responsible for the angiogenic response, such as vascular endothelial growth factor (VEGF), fibroblast growth factor 2 (FGF2) and angiostatin. In this review, updates on pathophysiology, clinic, diagnosis, classification and treatment of this disease are analyzed, with special emphasis on therapeutic options. Chronic venous insufficiency is a disease that affects the patient at several levels, mainly diminishing his/her quality of life. Currently there are various treatments ranging from habit modifications, pharmacological, to endovenous and surgical treatment.

    How culturally unique are pandemic effects? Evaluating cultural similarities and differences in effects of age, biological sex, and political beliefs on COVID impacts

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    Despite being bio-epidemiological phenomena, the causes and effects of pandemics are culturally influenced in ways that go beyond national boundaries. However, they are often studied in isolated pockets, and this fact makes it difficult to parse the unique influence of specific cultural psychologies. To help fill in this gap, the present study applies existing cultural theories via linear mixed modeling to test the influence of unique cultural factors in a multi-national sample (that moves beyond Western nations) on the effects of age, biological sex, and political beliefs on pandemic outcomes that include adverse financial impacts, adverse resource impacts, adverse psychological impacts, and the health impacts of COVID. Our study spanned 19 nations (participant N = 14,133) and involved translations into 9 languages. Linear mixed models revealed similarities across cultures, with both young persons and women reporting worse outcomes from COVID across the multi-national sample. However, these effects were generally qualified by culture-specific variance, and overall more evidence emerged for effects unique to each culture than effects similar across cultures. Follow-up analyses suggested this cultural variability was consistent with models of pre-existing inequalities and socioecological stressors exacerbating the effects of the pandemic. Collectively, this evidence highlights the importance of developing culturally flexible models for understanding the cross-cultural nature of pandemic psychology beyond typical WEIRD approaches

    A922 Sequential measurement of 1 hour creatinine clearance (1-CRCL) in critically ill patients at risk of acute kidney injury (AKI)

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    Ciencia Odontológica 2.0

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    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

    Precariedad, exclusión social y diversidad funcional (discapacidad): lógicas y efectos subjetivos del sufrimiento social contemporáneo (II). Innovación docente en Filosofía

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    El PIMCD "Precariedad, exclusión social y diversidad funcional (discapacidad): lógicas y efectos subjetivos del sufrimiento social contemporáneo (II). Innovación docente en Filosofía" se ocupa de conceptos generalmente eludidos por la tradición teórica (contando como núcleos aglutinantes los de la precariedad laboral, la exclusión social y diversidad funcional o discapacidad), cuyo análisis propicia nuevas prácticas en la enseñanza universitaria de filosofía, adoptando como meta principal el aprendizaje centrado en el estudiantado, el diseño de nuevas herramientas de enseñanza y el fomento de una universidad inclusiva. El proyecto cuenta con 26 docentes de la UCM y otros 28 docentes de otras 17 universidades españolas (UV, UNED, UGR, UNIZAR, UAH, UC3M, UCA, UNIOVI, ULL, EHU/UPV, UA, UAM, Deusto, IFS/CSIC, UCJC, URJC y Univ. Pontificia de Comillas), que permitirán dotar a las actividades programadas de un alcance idóneo para consolidar la adquisición de competencias argumentativas y dialécticas por parte de lxs estudiantes implicados en el marco de los seminarios previstos. Se integrarán en el PIMCD, aparte de PDI, al menos 26 estudiantes de máster y doctorado de la Facultad de Filosofía, a lxs que acompañarán durante el desarrollo del PIMCD 4 Alumni de la Facultad de Filosofía de la UCM, actualmente investigadores post-doc y profesorxs de IES, cuya experiencia será beneficiosa para su introducción en la investigación. Asimismo, el equipo cuenta con el apoyo de varixs profesorxs asociadxs, que en algunos casos son también profesores de IES. Varixs docentes externos a la UCM participantes en el PIMCD poseen una dilatada experiencia en la coordinación de proyectos de innovación de otras universidades, lo que redundará en beneficio de las actividades a desarrollar. La coordinadora y otrxs miembros del PIMCD pertenecen a la Red de Innovación Docente en Filosofia (RIEF), puesta en marcha desde la Universitat de València (http://rief.blogs.uv.es/encuentros-de-la-rief/), a la que mantendremos informada de las actividades realizadas en el proyecto. Asimismo, lxs 6 miembros del PAS permitirán difundir debidamente las actividades realizadas en el PIMCD entre lxs estudiantes Erasmus IN del curso 2019/20 en la Facultad de Filosofía, de la misma manera que orientar en las tareas de maquetación y edición que puedan ser necesarias de cara a la publicación de lxs resultados del PIMCD y en las tareas de pesquisa bibliográfica necesarias para el desarrollo de los objetivos propuestos. Han manifestado su interés en los resultados derivados del PIMCD editoriales especializadas en la difusión de investigaciones predoctorales como Ápeiron y CTK E-Books

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

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    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

    Conocimiento práctico y teórico de maíz y frijol en la región triqui alta, Oaxaca

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    The objective of the article is to contrast the practical knowledge that women and men possess about the quality and use of corn and beans, with the theoretical knowledge to evaluate the quality of these grains in the laboratory. There were 27 semi-structured interviews and two participatory workshops, in the mother tongue ‛triqui’, in Santo Domingo of the state, region triqui high, Oaxaca. The hectolitre weight (PH) and flotation index (IF) were evaluated in 20 corn collections. In beans, cooking time (TC), water absorption capacity during soaking (CAA) and percentage of solids in the cooking broth (PSC) in 15 accessions were evaluated. The results were analyzed with a completely randomizeddesign, comparison test of tukey means and correlations. The interviewees indicated preference for white corn, with hard grains (IF= 0-12) and intermediate grains (IF= 38-62), followed by blue, pinto, yellow, red was less preferred. All the pigmented maize washard grain (IF= 13-37). The pH was between 74-81 kg hl-1. In beans, the species Phaseolus vulgarisL. (common) and Phaseolus coccineusL. (ayocote) were identified, the one with the longest tradition and preference for consumption was the ‛dry bean’(ayocote) which requires 317 min for cooking. The practical knowledge of men and women of Santo Domingo del Estado on the quality of corn and beans, showed an association with the theoretical trends of quality in corn; in the bean there was an association with the cooking time. Keywords:beans, corn, genus, milpa, traditional knowledge.El objetivo del artículo es contrastar los conocimientos prácticos que poseen mujeres y hombres sobre la calidad y uso de maíz y frijol, con los conocimientos teóricos para evaluar la calidad de estos granos en laboratorio. Se efectuaron 27 entrevistas semiestructuradas y dos talleres participativos, en la lengua materna ‘triqui’, en Santo Domingo del Estado, región ‘triqui alta, Oaxaca. Se evaluó el peso hectolítrico (PH) e índice de flotación (IF) en 20 colectas de maíz. En frijol se evaluó el tiempo de cocción (TC), capacidad de absorción de agua durante el remojo(CAA)y porcentaje de sólidos en el caldo de cocción (PSC) en 15 accesiones. Los resultados se analizaron con un diseño completamente al azar, prueba de comparación de medias tukey y correlaciones. Los(as)entrevistados(as)indicaron preferencia por el maíz blanco, con granos duros (IF= 0-12) e intermedios (IF= 38-62), seguido del azul, pinto, amarillo, el rojo fue de menor preferencia. Todos los maíces pigmentados fueron de grano duro (IF= 13-37). El PH estuvo entre 74-81 kg hl-1. En frijol se identificaron las especies Phaseolusvulgaris L. (común) y Phaseolus coccineus L. (ayocote), el de mayor tradición y preferencia para el consumo fue el ‘ejote seco’ (ayocote) que requiere 317 min para su cocción. El conocimiento práctico de hombres y mujeres de Santo Domingo del Estado sobre la calidad del maíz y frijol, mostró asociación con las tendencias teóricas de calidad en maíz; en el frijol se mostró asociación con el tiempo de cocción. Palabras clave:conocimientos tradicionales,frijol, género,maíz, milp
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