RESUMEN

Gastric cancer (GC) is the fourth leading cause of cancer-related death, associated with late diagnosis and treatment resistance. Currently, screening tests for GC are not cost-effective or have low accuracy. Previously, we described an extended phenotype of gastric cancer stem cells (GCSCs; CD24+CD44+CD54+EpCAM+) that is associated with metastasis and tumor stage in GC patients. The goal of the current research is to evaluate the presence of these GCSCs in the peripheral blood of GC patients and healthy volunteers. A total of 73 blood samples were collected from 32 GC patients and 41 healthy volunteers. After peripheral blood mononuclear cell (PBMC) extraction, multiparametric flow cytometry was performed looking for GCSCs. Using clustering data through artificial intelligence (AI), we defined high/low levels of circulating GCSCs (cGCSCs) and proceeded to evaluate its association with clinical and prognostic variables. Finally, a diagnostic test analysis was performed evaluating patients and healthy volunteers. We found that cGCSCs are present in most GC patients with a mean concentration of 0.48%. The AI clustering showed two groups with different cGCSC levels and clinical characteristics. Through statistical analysis, we confirmed the association between cGCSC levels and lymph node metastasis, distant metastasis, and overall survival. The diagnostic test analysis showed sensibility, specificity, and area under the curve (AUC) of 83%, 95%, and 0.911, respectively. Our results suggest that the assessment of cGCSCs CD24+CD44+CD54+EpCAM+ could be a potential noninvasive test, with prognostic value, as well as highly sensitive and specific for screening or diagnosis of GC; however, a larger scale study will be necessary to confirm this.

RESUMEN

This work presents Chameleon, a cloud computing (CC) Industry 4.0 (I4) neutron spectrum unfolding code. The code was designed under the Python programming language, using Streamlit framework®, and it is executed on the cloud, as I4 CC technology through internet, by using mobile devices with internet connectivity and a web navigator. In its first version, as a proof of concept, the SPUNIT algorithm was implemented. The main functionalities and the preliminary tests performed to validate the code are presented. Chameleon solves the neutron spectrum unfolding problem and it is easy, friendly and intuitive. It can be applied with success in various workplaces. More validation tests are in progress. Future implementations will include improving the graphical user interface, inserting other algorithms, such as GRAVEL, MAXED and neural networks, and implementing an algorithm to estimate uncertainties in the calculated integral quantities.

Asunto(s)

Algoritmos , Nube Computacional , Redes Neurales de la Computación , Internet , Neutrones

RESUMEN

Abstract Background Early mobilization after surgery is a cornerstone of the Enhanced Recovery After Surgery (ERAS) programs in total hip arthroplasty (THA) or total knee arthroplasty (TKA). Our goal was to determine the time to mobilization after this surgery and the factors associated with early mobilization. Methods This was a predefined substudy of the POWER.2 study, a prospective cohort study conducted in patients undergoing THA and TKA at 131 Spanish hospitals. The primary outcome was the time until mobilization after surgery as well as determining those perioperative factors associated with early mobilization after surgery. Results A total of 6093 patients were included. The median time to achieve mobilization after the end of the surgery was 24 hours [16-30]. 4,222 (69.3%) patients moved in ≤ 24 hours after surgery. Local anesthesia [OR = 0.80 (95% confidence interval [CI]: 0.72-0.90); p= 0.001], surgery performed in a self-declared ERAS center [OR = 0.57 (95% CI: 0.55-0.60); p< 0.001], mean adherence to ERAS items [OR = 0.93 (95% CI: 0.92-0.93); p< 0.001], and preoperative hemoglobin [OR = 0.97 (95% CI: 0.96-0.98); p< 0.001] were associated with shorter time to mobilization. Conclusions Most THA and TKA patients mobilize in the first postoperative day, early time to mobilization was associated with the compliance with ERAS protocols, preoperative hemoglobin, and local anesthesia, and with the absence of a urinary catheter, surgical drains, epidural analgesia, and postoperative complications. The perioperative elements that are associated with early mobilization are mostly modifiable, so there is room for improvement.

Asunto(s)

Humanos , Artroplastia de Reemplazo de Cadera , Artroplastia de Reemplazo de Rodilla , Ambulación Precoz , Complicaciones Posoperatorias/etiología , Hemoglobinas , Estudios Prospectivos , Tiempo de Internación

RESUMEN

The aim of this work is to obtain new inequalities for the variable symmetric division deg index $ SDD_\alpha(G) = \sum_{uv \in E(G)} (d_u^\alpha/d_v^\alpha+d_v^\alpha/d_u^\alpha) $, and to characterize graphs extremal with respect to them. Here, by $ uv $ we mean the edge of a graph $ G $ joining the vertices $ u $ and $ v $, and $ d_u $ denotes the degree of $ u $, and $ \alpha \in \mathbb{R} $. Some of these inequalities generalize and improve previous results for the symmetric division deg index. In addition, we computationally apply the $ SDD_\alpha(G) $ index on random graphs and we demonstrate that the ratio $ \langle SDD_\alpha(G) \rangle/n $ ($ n $ is the order of the graph) depends only on the average degree $ \langle d \rangle $.

RESUMEN

We perform a detailed computational study of the recently introduced Sombor indices on random networks. Specifically, we apply Sombor indices on three models of random networks: Erdös-Rényi networks, random geometric graphs, and bipartite random networks. Within a statistical random matrix theory approach, we show that the average values of Sombor indices, normalized to the order of the network, scale with the average degree. Moreover, we discuss the application of average Sombor indices as complexity measures of random networks and, as a consequence, we show that selected normalized Sombor indices are highly correlated with the Shannon entropy of the eigenvectors of the adjacency matrix.

Asunto(s)

Síndrome Coronario Agudo/diagnóstico por imagen , Anomalías de los Vasos Coronarios/diagnóstico por imagen , Enfermedades Vasculares/congénito , Síndrome Coronario Agudo/terapia , Adulto , Angiografía Coronaria , Puente de Arteria Coronaria , Anomalías de los Vasos Coronarios/terapia , Femenino , Humanos , Persona de Mediana Edad , Intervención Coronaria Percutánea , Enfermedades Vasculares/diagnóstico por imagen , Enfermedades Vasculares/terapia

RESUMEN

ANTECEDENTES: La colitis actínica es una endarteritis obliterante ocasionada por exposición a radiación ionizante. Se manifiesta de manera aguda (primeras semanas) o crónica (hasta 30 años después). CASO CLÍNICO: Paciente tratado por neoplasia rectal mediante quimiorradioterapia y amputación abdominoperineal. En su estudio por cuadros oclusivos se objetiva una estenosis colónica desde la colostomía hasta el ángulo hepático. Se lleva a cabo cirugía resectiva, con resultado favorable. CONCLUSIONES: En los próximos años es previsible un aumento en la incidencia de esta patología. Resultará fundamental establecer un nivel de sospecha que nos permita detectar los casos, así como establecer medidas que prevengan su aparición. BACKGROUND: Radiation colitis is a obliterans endarteritis caused by exposure to ionizing radiation. It manifests early or late in time. CASE REPORT: We present a case of rectal cancer treated with chemoradiotherapy and abdominoperineal resection ten years before. Patient suffered occlusive periods and colonoscopy showed stenotic colon extending from the colostomy up hepatic flexure. Colonic resection surgery was performed. CONCLUSIONS: It will be essential to establish a high level of suspicion that allows us to detect cases and it also will be essential to establish measures to prevent its occurrence.

Asunto(s)

Enteritis , Neoplasias del Recto , Colonoscopía , Colostomía , Constricción Patológica/etiología , Enteritis/etiología , Humanos , Neoplasias del Recto/cirugía

RESUMEN

INTRODUCCIÓN: El número de cesáreas en todo el mundo se ha incrementado de forma importante y nuestro país no es la excepción. En algunos lugares se supera el 60% de cesáreas en relación al parto vaginal. No existe una clasificación adecuada para el análisis de este incremento. La clasificación de los 10 grupos de Robson se basa en cuatro pilares: a) antecedentes obstétricos; b) progreso del parto; c) categoría del embarazo; y d) edad gestacional. Sugerimos utilizar la clasificación de Robson para determinar qué grupo de mujeres embarazadas contribuyen más al total de cesáreas en nuestra institución. MÉTODO: Estudio retrospectivo, descriptivo, transversal, observacional, de 2014 al 2016, incluyendo a todas las embarazadas con más de 27 semanas de gestación. Se resolvió el embarazo a 706 mujeres con un porcentaje de cesárea del 65.29%. El promedio de edad fue de 31 ± 4.2 años, y el de la edad gestacional fue de 38.5 ± 6.7 semanas. Eran primigestas el 47%. La indicación materna más frecuente de cirugía fue por cesárea iterativa, y la fetal por distocia de presentación. En cuanto a la ubicación del mayor número de pacientes dentro de la clasificación de Robson, fue el grupo 5 con un 21.24%, seguido del grupo 2 con un 13.88% y del grupo 1 con un 9.6%. CONCLUSIÓN: La existencia de cicatriz uterina previa fue el factor determinante en la mayor parte de las cesáreas. Sugerimos incidir sobre la indicación de la primera cesárea y así disminuir cicatrices uterinas. INTRODUCTION: The increase of cesarean sections worldwide has increased significantly, our country is no exception, in some places it exceeds 60% of cesarean sections in relation to vaginal delivery, there is no adequate classification for the analysis of this increase. The classification of the 10 groups of Robson is based on four pillars: a) obstetric history; b) progress of labor; c) category of pregnancy; and d) gestational age. We suggest using Robson's classification to determine which group of pregnant women contribute most to the total number of cesareans in our institution. METHOD: This retrospective, descriptive, cross-sectional, observational study was conducted from 2014 to 2016, all pregnant women with more than 27 weeks' gestation were included. Pregnancy was resolved in 706 women with a caesarean section of 65.29%, mean age was 31 ± 4.2 years, and gestational age 38.5 ± 6.7 weeks. 46.74% were primiparous. The most frequent maternal indication for surgery was by iterative cesarean section and the fetal one was due to presentation dystocia, as for the location of the patients within the Robson classification was group 5 with 21.24%, group 2 with 13.88% and the 1 with 9.6%. CONCLUSION: The previous uterine scarring was the determining factor in most of the cesarean sections, we suggest to influence the indication of the first cesarean section and thus to avoid uterine scars.

Asunto(s)

Cesárea/clasificación , Cesárea/estadística & datos numéricos , Adulto , Estudios Transversales , Femenino , Ginecología , Departamentos de Hospitales , Hospitales , Humanos , México , Obstetricia , Embarazo , Estudios Retrospectivos

RESUMEN

BACKGROUND: Preeclampsia, a pregnancy disorder characterized by hypertension and proteinuria, represents the leading cause of fetal and maternal morbidity and mortality in developing countries. The identification of novel and accurate biomarkers that are predictive of preeclampsia is necessary to improve the prognosis of patients with preeclampsia. OBJECTIVE: To evaluate the preeclampsia predictive value of 34 angiogenic-related proteins. METHODS: We performed a nested cohort case-control study of pregnant women. The profile of the 34 proteins was evaluated at 12, 16, and 20 gestational weeks (GWs), using urine/plasma from 16 women who developed preeclampsia and 20 normotensive pregnant controls by Bio-Plex ProTM Human Cancer Biomarker Panels 1 and 2. RESULTS: The urine concentration of soluble epidermal growth factor receptor (sEGFR), hepatocyte growth factor (HGF), angiopoietin-2 (ANG-2), endoglin (ENG), soluble fas ligand (sFASL), interleukin 6 (IL-6), placental growth factor (PLGF), and vascular endothelial growth factor A (VEGF-A) at 12 GW, prolactin (PRL), ANG-2, transforming growth factor alpha (TGF-α), and VEGF-A at 16 GW, and soluble IL-6 receptor alpha (sIL-6Rα), ANG-2 and sFASL at 20 GW, were different between groups (p < 0.05). The concentration cut-off values calculated in this study for the mentioned proteins, predicted an increased risk to developing preeclampsia in a range of 3.8-29.8 times in the study population. CONCLUSION: The proteins sEGFR, HGF, ANG-2, sFASL, IL-6, PLGF, VEGF-A, PRL, TGF-α FGF-b, sHER2/Neu sIL-6Rα, ENG, uPA, and insulin-like growth factor binding protein 1 (IGFBP-1), were predictive of the development of preeclampsia and their use as markers for this disease should be considered.

Asunto(s)

Biomarcadores/orina , Preeclampsia/diagnóstico , Adolescente , Adulto , Angiopoyetina 2/orina , Estudios de Casos y Controles , Endoglina/metabolismo , Receptores ErbB/metabolismo , Proteína Ligando Fas/orina , Femenino , Factor de Crecimiento de Hepatocito/orina , Humanos , Interleucina-6/orina , Factor de Crecimiento Placentario/orina , Preeclampsia/orina , Embarazo , Primer Trimestre del Embarazo/orina , Segundo Trimestre del Embarazo/orina , Pronóstico , Prolactina/orina , Factor de Crecimiento Transformador alfa/orina , Factor A de Crecimiento Endotelial Vascular/orina , Adulto Joven

RESUMEN

PURPOSE: To perform serum microRNA expression profiling to identify members of chromosome 19 miRNA cluster involved in preeclampsia development. METHODS: Serum chromosome 19 miRNA cluster microRNA expression profiling was evaluated at 12, 16, and 20 gestational weeks and at the time of preeclampsia diagnosis, in women who developed preeclampsia (WWD-PE; n = 16) and controls (n = 18) using TaqMan low density array plates. RESULTS: A total of 51 chromosome 19 microRNA cluster members were evaluated. The circulating hsa-miRs 512-3p, 518f-3p, 520c-3p, and 520d-3p, were differentially expressed between groups (P < 0.05). Compared with controls, serum levels of hsa-miR-518f-3p at 20 GW were useful for identifying WWD-Mild-PE (P = 0.035) and WWD-Severe-PE (P = 0.007). CONCLUSIONS: Serum hsa-miRs 512-3p, 518f-3p, 520c-3p, and 520d-3p, are differentially expressed between WWD-PE and controls and their role in the development of preeclampsia should be investigated further.

Asunto(s)

Cromosomas Humanos Par 19 , Perfilación de la Expresión Génica , MicroARNs/genética , MicroARNs/metabolismo , Placenta/metabolismo , Preeclampsia/sangre , Estudios de Casos y Controles , Femenino , Regulación del Desarrollo de la Expresión Génica , Humanos , Preeclampsia/genética , Preeclampsia/metabolismo , Embarazo

RESUMEN

BACKGROUND: Preeclampsia, a pregnancy disorder characterized by hypertension and proteinuria, represents the leading cause of fetal and maternal morbidity and mortality in developing countries. The identification of novel and accurate biomarkers that are predictive of preeclampsia is necessary to improve the prognosis of patients with preeclampsia. OBJECTIVE: The objective of this study is to evaluate the usefulness of nine urinary metalloproteinases to predict the risk of preeclampsia development. METHODS: MMP-1, MMP-2, MMP-3, MMP-7, MMP-8, MMP-9, MMP-10, MMP-12 and MMP-13 were analyzed in urine (early-pregnancy) from 17 women predicted to develop preeclampsia and 48 controls using the Bio-Plex Pro-Human MMP panel (Bio-Rad, Hercules, CA). RESULTS: Urinary MMP-2 showed differences between groups which allowed us to calculate an increased risk for PE development of up to 20 times among the study population. CONCLUSION: Increased urinary concentration of MMP-2 at 12 and 16 weeks of gestation predicted an increased risk of developing preeclampsia in the study population.

Asunto(s)

Biomarcadores/orina , Metaloproteinasa 2 de la Matriz/orina , Preeclampsia/diagnóstico , Preeclampsia/orina , Adolescente , Adulto , Femenino , Edad Gestacional , Humanos , Metaloproteinasas de la Matriz/orina , Valor Predictivo de las Pruebas , Embarazo , Pronóstico , Factores de Riesgo , Adulto Joven

RESUMEN

OBJECTIVE: This study sought to determine whether the angiotensin-converting enzyme insertion/deletion (ACE I/D) polymorphism, obesity and oxidative damage are risk factors for the development of preeclampsia in Mexican women. STUDY DESIGN: A total of 66 women with preeclampsia (PE) and 37 women with normal pregnancies (NP) were included in the study. DNA was extracted from whole blood, and the ACE I/D polymorphism was evaluated by polymerase chain reaction. ACE activity and oxidative damage were assessed in plasma. The intergroup comparisons were analyzed by an analysis of variance (ANOVA) with post hoc tests. Hardy-Weinberg equilibrium (HWE) was tested by x2 analysis, odds ratios (OR) were calculated as a measure of the degree of relative risk of preeclampsia, and for correlations, we used Spearman's correlation coefficient. RESULTS: The frequency of the DD genotype was higher in PE (34.84%) than NP (10.82%). The OR of the DD genotype and D allele were associated with a 4.4-fold (CI=95% 2.24-14) and 3-fold (CI=95% 1.69-5.62) increased risk of developing PE, respectively. Major ACE activity in the DD genotype and obesity were features of the PE group; oxidative damage to proteins and a reduction in the activity of the antioxidant system showed a correlation with BMI (p<0.01). CONCLUSION: Our results suggest that ACE I/D polymorphism, high ACE activity, body mass index and oxidative damage may play key roles in the pathogenesis of PE in the Mexican population. Furthermore, these findings could be used as predictive factors of PE.

Asunto(s)

Predisposición Genética a la Enfermedad , Peptidil-Dipeptidasa A/genética , Preeclampsia/genética , Adulto , Estudios de Casos y Controles , Femenino , Hispánicos o Latinos/genética , Humanos , México , Obesidad/complicaciones , Estrés Oxidativo , Polimorfismo Genético , Preeclampsia/etiología , Embarazo , Factores de Riesgo , Adulto Joven

RESUMEN

OBJECTIVE: To demonstrate that among patients with acute respiratory distress syndrome (ARDS), the presence of diffuse alveolar damage (DAD) at histological examination, as compared to its absence, defines a specific subphenotype. METHODS: We studied 149 patients who died in our ICU with the clinical diagnosis of ARDS according to the Berlin Definition (BD) and who had autopsy examination. We compared the change over time of different clinical variables in patients with (n = 49) and without (n = 100) DAD. A predictive model for the presence of DAD was developed and validated in an independent cohort of 57 patients with ARDS and postmortem examination (21 of them with DAD). RESULTS: Patients with DAD, as compared to patients without DAD, had a lower PaO2/FiO2 ratio and dynamic respiratory system compliance, and a higher SOFA score and INR, and were more likely to die of hypoxemia and less likely to die of shock. In multivariate analysis, variables associated with DAD [odds ratio, 95% confidence interval (CI)] were PaO2/FiO2 ratio [0.988 (0.981-0.995)], dynamic respiratory system compliance [0.937 (0.892-0.984)] and age [0.972 (0.946-0.999)]. Areas under the ROC curve (95 % CI) for the classification of DAD using the regression model or the BD were, respectively, 0.74 (0.65-0.82) and 0.64 (0.55-0.72) (p = 0.03). In the validation cohort, the areas under the ROC curve for the diagnosis of DAD were 0.73 (0.56-0.90) and 0.67 (0.54-0.81) for the regression model and the BD, respectively. CONCLUSIONS: The presence of DAD appears to define a specific subphenotype in patients with ARDS. Targeting patients with DAD within the population of patients with the clinical diagnosis of ARDS might be appropriate to find effective therapies for this condition.

Asunto(s)

Alveolos Pulmonares/patología , Síndrome de Dificultad Respiratoria/patología , Autopsia , Brasil , Colombia , Humanos , Estudios Multicéntricos como Asunto , Análisis Multivariante , Fenotipo , Síndrome de Dificultad Respiratoria/clasificación , Estudios Retrospectivos

RESUMEN

Alzheimer's disease (AD) is a progressive disorder of the brain that leads to memory loss, dementia, and death. Several lines of evidence suggest that the accumulation of amyloid-ß (Aß) peptides may trigger the dysfunction and degeneration observed in the AD brain. The basal forebrain, including the septal region, which regulates the excitability of the hippocampus and neocortex, is affected early in AD because its neurons are vulnerable to Aß peptides. In addition, connections between lateral and medial septal regions (medial septum and diagonal band of Broca) have been demonstrated in previous studies. To demonstrate the involvement of excitotoxicity in Aß-induced septal damage, we compared rats injected with Aß1-40 into the lateral septal region structure with rats treated with memantine (a noncompetitive NMDA receptor antagonist), before, during, and after Aß1-40 injection. Medial septal cholinergic neurons were immunochemically identified and their numbers were estimated using Image J cell count. Our results show that Aß1-40-treated animals have a significantly low number of medial septum and diagonal band of Broca cholinergic neurons compared with the Aß/memantine-treated group.

Asunto(s)

Péptidos beta-Amiloides/toxicidad , Neuronas Colinérgicas/efectos de los fármacos , Memantina/administración & dosificación , Fármacos Neuroprotectores/administración & dosificación , Fragmentos de Péptidos/toxicidad , Núcleos Septales/efectos de los fármacos , Animales , Recuento de Células , Neuronas Colinérgicas/citología , Masculino , Ratas , Ratas Sprague-Dawley , Núcleos Septales/citología

RESUMEN

BACKGROUND: A population-based cross-sectional design was used to compare the prevalence of respiratory and general symptoms and of respiratory and heart diseases in two communities of Juana Díaz, Puerto Rico: Guayabal, exposed to particulate matter from quarries and diesel exhaust; and Río Cañas Abajo, which has no such exposure. METHODS: A probabilistic sampling design was used to obtain a representative sample of households and 288 residents of the selected households were interviewed. Adjusted PORs were estimated to assess the relationship between diseases/symptoms and place of residence using logistic regression models. To estimate the parameters of this model, a multilevel approach was used in order to control for potential correlation among residents of the same block. RESULTS: A higher prevalence of general and respiratory symptoms and of respiratory diseases was observed for residents of Guayabal when compared to Río Cañas Abajo (p < 0.05). Residents of Guayabal were more likely to have bronchitis (adjusted POR = 5.5; p-value < 0.05), nasal allergies (adjusted POR = 4.2; p-value = 0.01), nasal congestion (adjusted POR = 2.9; p-value = 0.02), and nausea and vomiting (adjusted POR = 8.7; p-value < 0.01). CONCLUSIONS: The perception of the community of Guayabal of a higher prevalence of symptoms and health conditions was supported by the present findings. This study provides statistical evidence for the design of an analytical epidemiologic study aimed at evaluating the potential effect of quarrying on adverse health outcomes in the community of Guayabal.

Asunto(s)

Exposición a Riesgos Ambientales , Material Particulado/efectos adversos , Enfermedades Respiratorias/epidemiología , Emisiones de Vehículos , Adolescente , Adulto , Anciano , Enfermedades Cardiovasculares/epidemiología , Niño , Análisis por Conglomerados , Estudios Transversales , Polvo , Femenino , Humanos , Masculino , Persona de Mediana Edad , Minerales , Náusea/epidemiología , Neoplasias/epidemiología , Puerto Rico/epidemiología , Muestreo , Vómitos/epidemiología , Adulto Joven

RESUMEN

BACKGROUND: Information from recent multiple trials on the pathophysiology and outcome of ST-segment elevation myocardial infarction (STEMI) has changed its clinical perspective and strategic management, leading to a revision of the 1999 ACC/AHA practice guidelines for that condition. OBJECTIVE: Analyze the clinical characteristics, management strategies, the timing of therapeutic interventions and outcome of patients with STEMI referred to the Cardiovascular Center of Puerto Rico (CVCPR). METHODS: Retrospective review of medical records of all patients admitted to the CVCPR with a diagnosis of STEMI from January 1, 2003 to December 31, 2003. RESULTS: A total of 184 medical records were reviewed. Seventy-six percent of patients were men, mean age was 62.1 +/- 11.8 years. A high prevalence of coronary risk factors was present: systemic hypertension (64%), diabetes mellitus (40%), dyslipidemia (35%), smoking (33%) and previous CAD (32%). Less than 1/4 of referral forms contained data indicative of whether patients had received antiplatelet therapy, beta-blockers, ACE inhibitors or statins. Fifty percent of patients arrived to the CVCPR more than 48 hours after diagnosis. Only forty-two patients (23%) arrived within 12 hours. Thrombolytic therapy had been used in 27% of them. 179 (97%) patients underwent coronary angiography, 69.2% of which had multivessel disease. 114 (62%) patients underwent percutaneous coronary interventions (PCI) with stenting. Patients submitted to PCI and stenting of the culprit lesion had a better outcome and survival than the ones not exposed to those procedures (p = 0.02). Approximately two-third of patients received secondary prevention medications upon discharge. CONCLUSIONS: Relevant findings of this review were that in spite of high prevalence of CAD major risk factors, the use of medications of proven benefit for prevention and treatment of CAD at referral centers was less than that recommended by current guidelines, a significant delay in the transfer of patients to the tertiary care facility (in most cases that period exceeded more than 48 hours after diagnosis) and a reduced utilization of thrombolytic therapy. Intensification of the education of physicians throughout the island regarding these matters is to be encouraged. Additional measures should include, development of written protocols at referral centers to assure a more expedite clinical assessment of patients, an enhancement of their capability for utilizing fibrinolytic agents in suitable candidates and the timely transfer to PCI-capable facilities of patients that may still benefit from catheter reperfusion.

Asunto(s)

Infarto del Miocardio/terapia , Adulto , Anciano , Anciano de 80 o más Años , Angioplastia Coronaria con Balón/efectos adversos , Fármacos Cardiovasculares/uso terapéutico , Angiografía Coronaria , Electrocardiografía , Femenino , Fibrinolíticos/uso terapéutico , Hospitales Universitarios/estadística & datos numéricos , Humanos , Masculino , Persona de Mediana Edad , Infarto del Miocardio/diagnóstico , Infarto del Miocardio/epidemiología , Puerto Rico/epidemiología , Estudios Retrospectivos , Factores de Riesgo , Terapia Trombolítica/efectos adversos , Resultado del Tratamiento

RESUMEN

Se realizó un estudio durante el primer semestre del curso 1987-1988 en el Departamento de Pediatría de la Facultad de Medicina del Instituto Superior de Ciencias Médicas de Villa Clara, con el próposito de conocer en qué medida se cumplen los objetivos educativos de la labor pedagógica de nuestra asignatura. Se seleccionó un grupo de actividades docentes, en las que se valororaron aspectos tales como: vinculación del contenido con la práctica, aspecto ideológico en los temas impartidos, así como disciplina de los estudiantes y cumplimiento de los postulados de la educación formal. Se demostró que el 68,4%de las actividades evaluadas existió vinculación de la teoría con la práctica pero en mostrar la posibilidad de conocimiento del mundo por el hombre hubo dificultades, pues sólo se logró en un 42,0%. Sólo en el 10,5%se estimuló la emulación entre los grupos por parte del personal docente y la puntualidad a las actividades se cumplió en el 47,3%de las valoraciones realizadas, lo que se considera significativo

Asunto(s)

Educación Médica , Enseñanza , Pediatría

Asunto(s)

Oxalatos/orina , Citratos/orina , Concentración de Iones de Hidrógeno , Electroforesis

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Citratos/orina , Concentración de Iones de Hidrógeno , Oxalatos/orina , Electroforesis