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INTRODUCTION: In the last decades sports practice in children has increased, thus increasing the number of musculoskeletal injuries. There are no validated scales in Spanish for the functional evaluation of knee aspects in children. The validation and cross-cultural adaptation of the Pedi-IKDC scale to Spanish, used for this purpose, was carried out. METHODOLOGY: The scale was applied to 50 patients that suffered traumatic knee injuries between 2016 and 2021 and underwent surgical interventions. The validation process of the scale was carried out after a pilot test, cross-cultural adaptation of words into Spanish, translation-retranslation, statistical, determination of internal consistency of the instrument, intraclass correlation, test-retest and evaluation of data dispersion. RESULTS: The internal consistency of the evaluated instrument is good according to the Gregory scale with a Cronbach's alpha of 0.82 The intraclass correlation was considered substantial (0.624) and the test-retest correlation, showed a coefficient of 0.91. The Bland-Altman graph showed a low dispersion among the data. CONCLUSION: The Pedi-IKDC scale can be a useful tool to assess functionality in children who have undergone knee surgery, it is considered valid, with adequate reliability and with the advantage of easy application.
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INTRODUCTION: In the last decades sports practice in children has increased, thus increasing the number of musculoskeletal injuries. There are no validated scales in Spanish for the functional evaluation of knee aspects in children. The validation and cross-cultural adaptation of the Pedi-IKDC scale to Spanish, used for this purpose, was carried out. METHODOLOGY: The scale was applied to 50 patients that suffered traumatic knee injuries between 2016 and 2021 and underwent surgical interventions. The validation process of the scale was carried out after a pilot test, cross-cultural adaptation of words into Spanish, translation-retranslation, statistical, determination of internal consistency of the instrument, intraclass correlation, test-retest and evaluation of data dispersion. RESULTS: The internal consistency of the evaluated instrument is good according to the Gregory scale with a Cronbach's alpha of 0.82 The intraclass correlation was considered substantial (0.624) and the test-retest correlation, showed a coefficient of 0.91. The Bland-Altman graph showed a low dispersion among the data. CONCLUSION: The Pedi-IKDC scale can be a useful tool to assess functionality in children who have undergone knee surgery, it is considered valid, with adequate reliability and with the advantage of easy application.
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BACKGROUND: Variants of 8q24 locus have been associated with prostate cancer (PCa) susceptibility. This study aims to analyze the genetic basis of PCa susceptibility in Mexican men by analyzing SNPs in the 8q24 locus for the first time. METHODS: A case-control study was performed in 875 men recruited from the Mexican Social Security Institute, 326 patients with PCa, and 549 non-PCa patients (88 with benign prostatic hyperplasia BPH and 461 healthy controls). The 8q24 locus SNPs: rs16901979, rs16983267, rs1447295, and rs7837328 were genotyped by allelic discrimination assays using TaqMan probes. Statistical analysis was performed using Epi Info statistical 7.0 and SNPstats softwares. RESULTS: All genotype frequencies were in Hardy-Weinberg Equilibrium. No differences were observed in genotype distribution between PCa and non-PCa patients for rs6983267. Under different inheritance models, the rs16901979, rs1447295, and rs7837328 SNPs were associated with PCa (OR = 2.8, 1.8, and 1.72, respectively; Pc < 0.001) when comparing PCa patients against controls. This association remains between PCa and BPH patients under different models (OR = 8.5, 2.2, and 1.9, respectively; Pc < 0.001). There were no significant differences in allele and genotype distribution among BPH patients and controls. The combined effect of the alleles CGAA for the SNPs rs16901979, rs6983267, rs1447295, and rs7837328 showed significant differences between PCa patients and controls (OR = 2.9, 95% CI = 1.48-5.83, Pc = 0.008). Four 8q24 variants were not associated with D'Amico score, age at diagnosis, and bone metastases. CONCLUSIONS: Our study provides the first confirmation that variants rs16901979, rs1447295, and 7837328 at 8q24 locus are associated with PCa susceptibility in Mexican men.
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Hiperplasia Prostática , Neoplasias de la Próstata , Estudios de Casos y Controles , Cromosomas Humanos Par 8/genética , Predisposición Genética a la Enfermedad , Genotipo , Humanos , Masculino , Polimorfismo de Nucleótido Simple , Hiperplasia Prostática/genética , Neoplasias de la Próstata/epidemiología , Neoplasias de la Próstata/genética , Neoplasias de la Próstata/patologíaRESUMEN
Resumen Los tumores cerebrales son una causa importante de las epilepsias de difícil manejo, corresponden a un 20-30 % de los casos de cirugía de epilepsia refractaria. En este grupo de pacientes los tumores neuroepiteliales de bajo grado asociados a epilepsia (LEAT) son la principal causa, siendo los más frecuentes los tumores neuroepiteliales disembrioplásticos (DNT) y ganglioglioma (GG). En el presente artículo revisamos los cambios en la definición de epilepsia refractaria, avances en el diagnóstico por imágenes y el diagnóstico histopatológico con los nuevos marcadores moleculares, que han permitido un diagnóstico cada vez más precoz y certero. Se revisa también la cirugía resectiva que permite en estos casos una libertad de crisis cercana un 70-90% de los pacientes. Los mejores resultados en términos de control de crisis, se pueden alcanzar cuando la cirugía es precoz.
Brain tumors are an important cause of epilepsy that is difficult to manage, accounting for 20-30% of cases of refractory epilepsy surgery. In this group of patients, low-grade epilepsy-associated neuroepithelial tumors (LEAT) are the main cause and the most frequent being dysembryoplastic neuroepithelial tumors (DNT) and ganglioglioma (GG). In this article, we review the changes in the definition of refractory epilepsy, advances in diagnostic imaging, and histopathological diagnosis with new molecular markers, which have allowed for an increasingly early and accurate diagnosis. Resective surgery is also reviewed, allowing in these cases a seizure freedom close to 70-90% of patients. The best outcome in terms of seizure control can be achieved when early surgery is performed.
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Humanos , Neoplasias Neuroepiteliales/complicaciones , Epilepsia/cirugíaRESUMEN
Resumen: Introducción: La evaluación SANE (Single Assessment Numeric Evaluation) es un tipo de desenlace reportado por el paciente, corto y fácil de administrar que se correlaciona con otras evaluaciones funcionales del hombro más extensas. Hasta la fecha no se encuentra validada en nuestra lengua. Objetivo: Traducir, validar y adaptar la evaluación SANE al idioma español. Material y métodos: Se realizó la traducción y contra-traducción por dos evaluadores expertos bilingües y un traductor oficial. Se determinó la validez de constructo con un grupo de expertos en cirugía de hombro, la validez de criterio con la escala de American Shoulder and Elbow Surgeons (ASES) previamente validada en español y la reproducibilidad de la prueba. Resultados: Se evaluaron 113 pacientes con un promedio de edad de 53.6 años, siendo 56% mujeres. El diagnóstico más frecuente fue síndrome de manguito rotador en un 78.6% seguido por artrosis glenohumeral y acromioclavicular, hombro congelado e inestabilidad del hombro. El índice de correlación de Pearson entre el SANE y el ASES fue de 0.699. La reproducibilidad de la prueba fue alta con un coeficiente de correlación intraclase de 0.86. Conclusiones: La evaluación SANE es una medida de desenlace centrada en el paciente fiable y válida, que tiene una buena correlación con puntajes funcionales previamente validados al español más extensos. Se presenta la versión traducida y adaptada al español, que puede ser utilizada como medida de desenlace para intervenciones quirúrgicas o no quirúrgicas en patologías de hombro.
Abstract: Introduction: The Single Assessment Numeric Evaluation (SANE) score is a brief method of evaluating patients' perception of the shoulder joint and has proven high correlation with other outcome measures that are more lengthy and time-consuming in daily practice. The SANE score to date has not been validated in Spanish. Objective: To translate, adapt, and validate the SANE score in Spanish. Material and methods: An initial translation and counter-translation was conducted by two bilingual evaluators and an official translator. Content validity was evaluated by a group of experts in shoulder surgery. The criteria validity was determined by determining correlation with the previously translated and validated ASES score. Reliability of the test was determined. Results: 113 patients were evaluated, with an average age of 53.6 being 56% female. The most frequent diagnosis was rotator cuff syndrome in 78.6% followed by frozen shoulder, glenohumeral and acromioclavicular osteoarthritis and shoulder instability and acromioclavicular dislocation. Correlation between the SANE and ASES results was 0.699. The test was highly reliable with an intraclass correlation coefficient of 0.86. Conclusion: The SANE score is a valid and reliable patient centered outcome measure that has a good correlation with other previously validated scores in Spanish that are less practical. We present a translated valid version of the SANE score in Spanish that can be used as a patient reported outcome measure for shoulder pathologies.
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INTRODUCTION: The Single Assessment Numeric Evaluation (SANE) score is a brief method of evaluating patients' perception of the shoulder joint and has proven high correlation with other outcome measures that are more lengthy and time-consuming in daily practice. The SANE score to date has not been validated in Spanish. OBJECTIVE: To translate, adapt, and validate the SANE score in Spanish. MATERIAL AND METHODS: An initial translation and counter-translation was conducted by two bilingual evaluators and an official translator. Content validity was evaluated by a group of experts in shoulder surgery. The criteria validity was determined by determining correlation with the previously translated and validated ASES score. Reliability of the test was determined. RESULTS: 113 patients were evaluated, with an average age of 53.6 being 56% female. The most frequent diagnosis was rotator cuff syndrome in 78.6% followed by frozen shoulder, glenohumeral and acromioclavicular osteoarthritis and shoulder instability and acromioclavicular dislocation. Correlation between the SANE and ASES results was 0.699. The test was highly reliable with an intraclass correlation coefficient of 0.86. CONCLUSION: The SANE score is a valid and reliable patient centered outcome measure that has a good correlation with other previously validated scores in Spanish that are less practical. We present a translated valid version of the SANE score in Spanish that can be used as a patient reported outcome measure for shoulder pathologies.
INTRODUCCIÓN: La evaluación SANE (Single Assessment Numeric Evaluation) es un tipo de desenlace reportado por el paciente, corto y fácil de administrar que se correlaciona con otras evaluaciones funcionales del hombro más extensas. Hasta la fecha no se encuentra validada en nuestra lengua. OBJETIVO: Traducir, validar y adaptar la evaluación SANE al idioma español. MATERIAL Y MÉTODOS: Se realizó la traducción y contra-traducción por dos evaluadores expertos bilingües y un traductor oficial. Se determinó la validez de constructo con un grupo de expertos en cirugía de hombro, la validez de criterio con la escala de American Shoulder and Elbow Surgeons (ASES) previamente validada en español y la reproducibilidad de la prueba. RESULTADOS: Se evaluaron 113 pacientes con un promedio de edad de 53.6 años, siendo 56% mujeres. El diagnóstico más frecuente fue síndrome de manguito rotador en un 78.6% seguido por artrosis glenohumeral y acromioclavicular, hombro congelado e inestabilidad del hombro. El índice de correlación de Pearson entre el SANE y el ASES fue de 0.699. La reproducibilidad de la prueba fue alta con un coeficiente de correlación intraclase de 0.86. CONCLUSIONES: La evaluación SANE es una medida de desenlace centrada en el paciente fiable y válida, que tiene una buena correlación con puntajes funcionales previamente validados al español más extensos. Se presenta la versión traducida y adaptada al español, que puede ser utilizada como medida de desenlace para intervenciones quirúrgicas o no quirúrgicas en patologías de hombro.
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Inestabilidad de la Articulación , Lesiones del Manguito de los Rotadores , Articulación del Hombro , Femenino , Humanos , Masculino , Persona de Mediana Edad , Reproducibilidad de los Resultados , Lesiones del Manguito de los Rotadores/cirugía , Hombro , Resultado del TratamientoRESUMEN
PURPOSE: In this paper, we reported three distinct cases of tinea, including tenia ungulum, tenia pedis, and tenia cruris caused by the infection of Nannizzia nana in the immunocompetent patients who were also the residents of Guatemala. Dermatophytes were identified phenotypically and genotypically. Thereafter, DNA was extracted from the fungal isolates and a fragment of the ITS1-5.8S-ITS2 region was amplified and sequenced. The direct visual examination revealed the presence of fungal hyphae and arthroconidia. These characteristic morphological features resembled with the general features of the species, Nannizzia nana. Furthermore, nucleotide sequences that were amplified from the fungal isolates, confirmed the species identification. Thereafter, all the patients were treated with Terbinafine (250mg) through oral route for two weeks, except the patient with onychomycosis, who received the same treatment but for an extended period of three months. All the patients showed complete recovery from dermatophytosis. This study contributes to a better understanding of the epidemiology of human infections that are caused by dermatophytes, often misdiagnosed. Dermatophytes are currently less known but are now being more frequently identified due to the improvements in the diagnostic techniques.
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Arthrodermataceae/genética , Dermatomicosis/diagnóstico , Adulto , Antifúngicos/uso terapéutico , Arthrodermataceae/patogenicidad , ADN de Hongos/genética , Dermatomicosis/tratamiento farmacológico , Dermatomicosis/microbiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Técnicas de Diagnóstico Molecular , Terbinafina/uso terapéuticoRESUMEN
Milk is a liquid food that possesses an important quantity of highly bioavailable macronutrients. In addition, it is readily accessible, as well as relatively inexpensive. Given that the knowledge of physicians about nutrition and food composition is deficient, in general, many of the dietary interventions recommended in diverse clinical settings lack a scientific basis. The aim of the present review was to produce a technical opinion that serves as a frame of reference to best sustain recommendations for consuming milk and dairy products as daily nutrition in the adult and older adult. The effects of milk and dairy products during the pediatric stage are not addressed in the present work. The Asociación Mexicana de Gastroenterología and the Asociación Mexicana de Gerontología y Geriatría jointly discussed and analyzed topics dealing with the legal designation of milk, the classification and nutritional profile of cow's milk, its nutritional characteristics, its consumption in the adult, intolerance to cow's milk, and associations of milk consumption with digestive tract alterations and other conditions. Finally, certain aspects of milk consumption in the older adult and its relation to overall health are briefly discussed.
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Productos Lácteos , Leche , Factores de Edad , Anciano , Anciano de 80 o más Años , Animales , Bovinos , Consenso , Fenómenos Fisiológicos del Sistema Digestivo , Salud , Humanos , México , Hipersensibilidad a la Leche , Estado NutricionalRESUMEN
The disease caused by the influenza virus is a global public health problem due to its high rates of morbidity and mortality. Thus, analysis of the information generated by epidemiological surveillance systems has vital importance for health decision making. A retrospective analysis was performed using data generated by the four molecular diagnostic laboratories of the Mexican Social Security Institute between 2010 and 2016. Demographics, influenza positivity, seasonality, treatment choices and vaccination status analyses were performed for the vaccine according to its composition for each season. In all cases, both the different influenza subtypes and different age groups were considered separately. The circulation of A/H1N1pdm09 (48.7%), influenza A/H3N2 (21.1%), influenza B (12.6%), influenza A not subtyped (11%) and influenza A/H1N1 (6.6%) exhibited well-defined annual seasonality between November and March, and there were significant increases in the number of cases every 2 years. An inadequate use of oseltamivir was determined in 38% of cases, and the vaccination status in general varied between 12.1 and 18.5% depending on the season. Our results provide current information about influenza in Mexico and demonstrate the need to update both operational case definitions and medical practice guidelines to reduce the inappropriate use of antibiotics and antivirals.
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Virus de la Influenza A/fisiología , Gripe Humana/epidemiología , Laboratorios/estadística & datos numéricos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Femenino , Humanos , Incidencia , Lactante , Recién Nacido , Gripe Humana/virología , Masculino , México/epidemiología , Persona de Mediana Edad , Prevalencia , Estudios Retrospectivos , Estaciones del Año , Adulto JovenRESUMEN
OBJECTIVE: Aspergillus section Nigri comprises a group of related species that include Aspergillus niger, A. welwitschiae, A. carbonarius, A. brasiliensis and A. tubingensis. Some of these species are morphologically very similar to A. niger but exhibit different patterns of susceptibility to antifungal agents; such is the case for A. tubingensis. Therefore, when diagnosing aspergillosis, it is important to identify the pathogen at the species level. This study aimed to identify the species of an Aspergillus spp. isolate (MM-82) obtained from a patient with a dermatosis localized to the right leg. MATERIALS AND METHODS: The MM-82 isolate was examined for macro- and microscopic morphology, conidia size and thermotolerance, and a phylogenetic analysis of a benA gene segment was performed for molecular identification. Susceptibility to antifungals was determined using antifungal microdilution according to the methodology of European Society of Clinical Microbiology and Infectious Diseases (EUCAST). RESULTS: Based on its phenotypic characteristics and the phylogenetic analysis of the sequence of a benA gene segment, the MM-82 isolate was identified as A. tubingensis. This fungus did not show resistance to antifungal agents commonly used for treatment. CONCLUSION: This study demonstrated that A. tubingensis can cause skin infection; this constitutes the first report of a case of aspergillosis caused by A. tubingensis in Mexico.
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Antifúngicos/uso terapéutico , Aspergilosis/diagnóstico , Aspergillus/aislamiento & purificación , Enfermedades de la Piel/diagnóstico , Aspergilosis/tratamiento farmacológico , Aspergillus/clasificación , Aspergillus/efectos de los fármacos , Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/microbiología , Femenino , Genes Fúngicos , Humanos , Pierna/microbiología , México , Pruebas de Sensibilidad Microbiana , Persona de Mediana Edad , Filogenia , Enfermedades de la Piel/tratamiento farmacológico , Enfermedades de la Piel/microbiología , Esporas Fúngicas/efectos de los fármacos , Esporas Fúngicas/aislamiento & purificaciónRESUMEN
Mycobacterium tuberculosis has developed resistance to anti-tuberculosis first-line drugs. Multidrug-resistant strains complicate the control of tuberculosis and have converted it into a worldwide public health problem. Mutational studies of target genes have tried to envisage the resistance in clinical isolates; however, detection of these mutations in some cases is not sufficient to identify drug resistance, suggesting that other mechanisms are involved. Therefore, the identification of new markers of susceptibility or resistance to first-line drugs could contribute (1) to specifically diagnose the type of M. tuberculosis strain and prescribe an appropriate therapy, and (2) to elucidate the mechanisms of resistance in multidrug-resistant strains. In order to identify specific genes related to resistance in M. tuberculosis, we compared the gene expression profiles between the pansensitive H37Rv strain and a clinical CIBIN:UMF:15:99 multidrug-resistant isolate using microarray analysis. Quantitative real-time PCR confirmed that in the clinical multidrug-resistant isolate, the esxG, esxH, rpsA, esxI, and rpmI genes were upregulated, while the lipF, groES, and narG genes were downregulated. The modified genes could be involved in the mechanisms of resistance to first-line drugs in M. tuberculosis and could contribute to increased efficiency in molecular diagnosis approaches of infections with drug-resistant strains.
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Farmacorresistencia Bacteriana Múltiple , Mycobacterium tuberculosis/efectos de los fármacos , Mycobacterium tuberculosis/genética , Transcriptoma , Genes Bacterianos , Reacción en Cadena en Tiempo Real de la PolimerasaRESUMEN
Adult aseptic necrosis of the femoral head progresses from its reversible phase, stages I-II-III (Ficat-ARCO), to stages IV-V coxarthrosis, and this represents a health problem. An observational, descriptive, prospective, case-series type of study was conducted to prove the hypothesis that the boring decompression of the femoral neck-head cancellous layer, together with the local implantation of multipotent adult autologous stem cells processed according to Ficoll at approximate amounts of 16.1 x 10(6) cells/ml, is the treatment of choice for stages I-II-III of aseptic necrosis of the femoral head. These cells create the necessary tissue conditions to preserve the structure of the femoral head thus avoiding or delaying its degeneration and the resulting prosthetic arthroplasty. A total of 16 patients with a diagnosis of stages I-II-III aseptic necrosis of the hip, ages 40-70, all of whom were at the reversible stage and accepted the above mentioned procedure, were included. The evaluation was conducted in June 2011 applying Harris' pain-function scale. Its score was used to determine the mean, the standard deviation and the median. Pain relief and functional recovery without surgical or immune complications were proven. According to Harris' score, 3 stage-III patients were under the median. One stage-III patient required prosthetic arthroplasty, so 93.7% of the patients retained their femoral head more than 2 years after the surgery. We conclude that the proposed procedure is the procedure of choice for stages I-II and it makes us be more selective in the case of stage III necrosis.
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Necrosis de la Cabeza Femoral/cirugía , Trasplante de Células Madre , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios ProspectivosRESUMEN
Forty-two year-old woman, with no relevant medical history, presented with 3-year burning epigastric pain radiating to right upper quadrant, accompanied by nausea and vomiting, food intolerance and estheatorrea. She was treated by 2 years with H2 blockers. Cholelithiasis was found and laparoscopic cholecystectomy was performed without changes in clinical picture. She presented upper gastrointestinal bleeding secondary to severe esophagitis and gastritis. Proton pump inhibitors at high doses were added to the treatment with partial improvement. Abdominal ultrasound showed tumor in pancreatic head but it was not confirmed by computed tomography. High levels of serum gastrin (17,251 µg/L) were detected. Patient underwent laparotomy and with the aid of ultrasound the mass in the head of the pancreas was localized and resected. Recovery was uneventful. The pathology report was a gastrinoma. At one year follow up, patient remains asymptomatic.
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Síndrome de Zollinger-Ellison/diagnóstico , Adulto , Femenino , HumanosRESUMEN
We have purified Gal/GalNAc lectin from Entamoeba histolytica by electroelution. The purified protein was used to immunize rabbits and obtain polyclonal IgG's anti-lectin. These antibodies were used as tools to analyze the expression and localization of the amoebic lectin in both virulent (vEh) and non-virulent (nvEh) variants of axenically cultured HM1:IMSS strain. vEh is able to induce liver abscesses in hamsters, whereas nvEh has lost this ability. In vitro, amoebic trophozoites from both variants equally express this protein as shown by densitometric analysis of the corresponding band in Western blots from lysates. In both types of trophozoites, the pattern of distribution of the lectin was mainly on the surface. We have also compared by immunohistochemistry the presence and distribution of lectin in the in vivo liver lesions produced in hamsters. In order to prolong the survival of nvEh to analyze both variants in an in vivo model, hamsters inoculated with nvEh were treated with methyl prednisolone. Our results suggest that the Gal/GalNAc lectin is equally expressed in both nvEh and vEh.
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Antígenos de Carbohidratos Asociados a Tumores/metabolismo , Entamoeba histolytica/metabolismo , Entamoeba histolytica/patogenicidad , Lectinas/metabolismo , Animales , Anticuerpos Antiprotozoarios/inmunología , Especificidad de Anticuerpos , Antígenos de Carbohidratos Asociados a Tumores/inmunología , Antígenos de Carbohidratos Asociados a Tumores/aislamiento & purificación , Western Blotting , Cricetinae , Densitometría , Electroforesis en Gel de Poliacrilamida , Entamoeba histolytica/inmunología , Inmunohistoquímica , Lectinas/inmunología , Lectinas/aislamiento & purificación , Absceso Hepático Amebiano/inmunología , Absceso Hepático Amebiano/parasitología , Masculino , Conejos , Trofozoítos/inmunología , Trofozoítos/metabolismo , VirulenciaRESUMEN
This paper documents an exploratory meeting organized by the Pan American Health Organization, that gathered nurses from countries of Latin America, who identified the shortage and migration tendencies as an emerging area in need of investigation. The exploratory meeting was conducted under the direction of the Regional Advisor on Nursing and Allied Health Personnel at the Pan American Health Organization in collaboration with the nursing leadership of Latin America. Fifteen of the 19 Latin American Countries participated in the meeting including: Argentina, Bolivia, Brazil, Chile, Colombia, Dominican Republic, El Salvador, Ecuador, Guatemala, Honduras, Mexico, Panama, Peru, Uruguay, and Venezuela. All agreed that documentation was needed concerning the shortage and migration of nurses including its causes and effects, the distribution of professional nurses, and available public policies to support the needs of professional nurses in Latin America (AU).
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Humanos , Enfermería , Migración Humana/tendencias , Administración de Personal/métodos , Desarrollo de Personal/organización & administración , América Latina , Asistentes de Enfermería/provisión & distribuciónRESUMEN
A partir del análisis realizado en el presente artículo, se establece que los desafíos en educación, salud, infraestructura, seguridad ciudadana e innovación son básicos de superar por Guatemala, si desea ubicar en mejores condiciones de competitividad a nivel global. La base de la afirmación anterior se encontró analizando los Índices de Desarrollo Humano y el Índice de Competitividad Global de los últimos seis años. En el IDH Guatemala se ubica en la posición 118 de 131 países evaluados que lo ubica en un nivel medio. Está en la última posición de América Latina, bajando una en el último año. Entre las variables que destacan: la esperanza de vida al nacer (EVN)es de 69.7 años, el producto interno bruto (PIB) por habitante suma US$ 4 mil 568 y la tasa de alfabetización de adultos (TAA) es de 69.1...
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Producto Interno Bruto , Desarrollo Humano , Indicadores y ReactivosRESUMEN
While the 2005 progress report of the United Nations Millennium Development Goals stresses out the need of a dramatic increase in investment to meet the sanitation target in the third world, it is important to anticipate about some parallel negative impacts that may have this optimistic programme (extension of sewer networks without sufficient treatment works). Research was initiated on Lerma River (Mexico), subjected to many rejects disposal, to design a monitoring network and evaluate the impact of wastewaters on its water quality. The discharges was inventorized, geo-positioned with a GPS and mapped, while the physico-chemical characteristics of the river water, its tributaries and main rejects were evaluated. Microtox system was used as an additional screening tool. Along the 60 km of the High Course of Lerma River (HCLR), 51 discharges, with a diameter or width larger than 0.3 m (including 7 small tributaries) were identified. Based on the inventory, a monitoring network of 21 sampling stations in the river and 13 in the important discharges (>2 m) was proposed. A great similitude was found between the average characteristics of the discharges and the river itself, in both the wet and dry seasons. Oxygen was found exhausted (<0.5 mg/L) almost all along the high course of the river, with COD and TDS average levels of 390 and 1980 mg/L in the dry season, against 150 and 400 mg/L in the wet season. In the dry season, almost all the sites along the river revealed some toxicity to the bacteria test species (2.9 to 150 TU, with an average of 27 TU). Same septic conditions and toxicity levels were observed in many of the discharges. Four of the six evaluated tributaries, as well as the lagoon (origin of the river), were relatively in better conditions (2 to 8 mg/L D.O., TU<1) than for the Lerma, acting as diluents and renewal of the HCLR flow rate. The river was shown to be quite a main sewer collector. The high surface water contamination by untreated wastewaters that is depicted in this research should be taken into account in the Millennium Goals strategies, by promoting treatment plan works simultaneously, when sewer networks in the third world would extend.
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Ríos , Aguas del Alcantarillado/efectos adversos , Contaminantes del Agua/análisis , Contaminantes del Agua/toxicidad , Aliivibrio fischeri/efectos de los fármacos , Monitoreo del Ambiente , Concentración de Iones de Hidrógeno , México , Nefelometría y Turbidimetría , Oxígeno/análisis , Temperatura , Contaminación del Agua/efectos adversos , Contaminación del Agua/análisisAsunto(s)
Humanos , Masculino , Femenino , Ejercicio Físico , Actividad Motora , Universidades , MéxicoRESUMEN
Los trastornos de la audición presentan una alta prevalencia en la población infantil con graves consecuencias para la comunicación, y para el desarrollo cognitivo y emocional del niño. En los últimos años se han generado importantes avances en las tecnologías disponibles para la detección temprana de las pérdidas auditivas, lo cual ha permitido la creación de programas de cribado auditivo en numerosos países según sus propias características organizativas y tecnológicas. Objetivo. Se describe y fundamenta el modelo adoptado por el programa cubano de cribado auditivo, con múltiples grupos de riesgo, en funcionamiento desde 1983. Desarrollo. Se presentan datos acerca de la prevalencia de los trastornos auditivos, edad media de detección, cobertura del cribado, programas de estimulación temprana utilizados y sus efectos sobre el desarrollo cognitivo y progreso escolar del niño. Finalmente, se discuten los resultados de la introducción de una nueva tecnología diagnóstica para la evaluación objetiva de la audición en toda la gama de frecuencias audibles, basada en el registro de potenciales evocados auditivos de estado estable (PEAee) mediante el sistema cubano AUDIX. Conclusiones. El modelo cubano de cribado auditivo puede considerarse una alternativa válida para la detección temprana de trastornos auditivos en condiciones de limitados recursos. Durante su período de funcionamiento óptimo logró reducir a 10 meses la edad media de detección. El grupo de niños identificados e intervenidos tempranamente logró un mejor desarrollo cognitivo, afectivo y lingüístico. El uso de los PEAee a múltiples frecuencias en un protocolo de cribado auditivo puede aportar valiosa información audiométrica(AU)
Asunto(s)
Humanos , Recién Nacido , Lactante , Preescolar , Pérdida Auditiva/terapia , Pruebas Auditivas , Tamizaje Masivo , Tamizaje NeonatalRESUMEN
INTRODUCTION: Infant hearing loss is a highly prevalent disorder which untreated can severely disrupt normal brain development. As a result there is a significant delay in language acquisition as well as many cognitive and emotional problems in the child. Over the last decades important advances have occurred in the available technology for early detection and assessment of hearing impairment. Therefore many countries worldwide have become aware of the need for hearing screening programs. The optimal protocols depending on the local conditions of health care as well as the availability of technological and human resources. AIM: To summarize the results obtained over the last 20 years by an ongoing hearing screening protocol. DEVELOPMENT: Data on the coverage program, sensitivity and specificity, age of identification of hearing losses, diagnostic and intervention stages will be summarized and discussed. Also the long terms effects of early detection on the child cognitive and language development are analyzed. Finally, the possible role of a new technique based on the recording of multiple auditory steady state potentials with Cuban equipment (AUDIX system) was evaluated within this context. CONCLUSIONS: The Cuban targeting multiple high risk hearing screening program is a useful alternative to early detection of hearing losses. The average detection age of hearing loss was 10 months during the period of optimal functioning. Cognitive, emotional and linguistic development are improved by early detection and intervention. The multiple auditory steady state responses can provide valuable audiometric information within a screening context.