[Transculturation and validation of a Questionnaire Factors Influencing Organ Donation]

Background

There are validated questionnaires in Spanish that evaluate the factors that influence organ donation, but they are not designed for the open population or do not delve into various aspects such as the one proposed.

Objective

Validate an instrument to evaluate the factors that influence organ donation in Mexico.

Material and methods

Phase 1: Development of the instrument. Translation into Spanish of the questionnaire "Factors Inffluencing Organ Donation in Qatar", adapted by experts in donation and clinimetry. Simultaneously, the definitive version of the questionnaire "Factors that Influence Organ Donation" (FIDO) and the questionnaire "International Donor Collaborative Project" were applied to patients, relatives and staff of a tertiary hospital in Puebla, Mexico. Mind a week after 200 respondents. Cronbach's Alpha (AC) (internal consistency), Intraclass Correlation Coefficient (ICC) (external consistency), and Phi (Phi) and Chi square Coefficient (concurrent validity in intention to donate) were obtained.

Results

AC and ICC by domain: Knowledge 0.625 and 0.372; Attitudes 0.776 and 0.761; Beliefs 0.649 and 0.633; Intentions 0.126 and 0.123; Phi: 0.976, Chi square: 2.358 (p = 0.125).

Conclusions

The FIDO questionnaire is valid and consistent to assess knowledge, attitudes, beliefs and intentions in organ donation in the general Mexican population.

[Clinical and histopathological characteristics of malignant colon tumors by location]

Background

The colon has two different embryological origins, which is why it can be divided into right and left with different characteristics each one; therefore, neoplastic lesions have a different clinical picture and are also associated with different pathologies.

Objective

To describe the clinical and histopathological characteristics of malignant colon tumors acording to their location.

Material and methods

Descriptive, retrospective study with 94 patients diagnosed with colon cancer. Descriptive statistics were performed with the calculation of frequencies and percentages, and chi-squared tests were calculated.

Results

Mean age was 61.3 years, 49 (52.1%) were women; 53 (56.4%) were left-sided and 41 (43.6%) right-sided. The main symptom was hematochezia in 32 (60.4%), in patients with left cancer; and diarrhea in 20 (48.8%), in patients with right-sided colon cancer. The presentation of stage I tumors and polyps, p = 0.044 and p = 0.043, respectively, was more frequent on the right side compared to the left side; in the left, hematochezia (p = 0.001), narrow stools(p = 0.05), and a history of type 2 diabetes mellitus (T2DM) (p= 0.036) were more frequent compared to the opposite site.

Conclusions

Stage I and the presence of polyps were more frequent in right-sided cancer compared to left-sided cancer; T2DM, as well as hematochezia and narrow stools were more associated with the left side compared to the right side.

[Pain after panretinal photocoagulation: 50-millisecond pulse versus conventional pulse]

Background

Diabetic retinopathy is a progressive disfunction of blood vessels of the retina secondary to chronic hyperglycemia. There are several treatments, out of which panretinal photocoagulation (PRP) stands out.

Objective

To compare the level of pain in patients undergoing PRP with different impulse.

Material and methods

Comparative, cross-sectional study that compared the level of pain in patients undergoing PRP with a 50-millisecond pulse (group A) versus conventional 200 milliseconds pulse (group B). Mann-Whitney U test was used.

Results

There were 26 patients, 12 (46.16%) female and 14 (53.84%) males. The median age was 58.73 ± 7.31 (40-75) years. 40 eyes were studied, 18 (45%) right and 22 (55%) left. The mean level of glycated hemoglobin was 8.15 ± 1.08 (6.5-12) %. The mean laser power was 297 ± 53.61 (200-380) and 214.5 ± 41.73 (170-320) milliwatts; the mean fluence was 18.85 ± 5.28 (12-28) J/cm2 and 65.9 ± 12.87 (52-98) J/cm2; the mean level of pain was 3.1 ± 1.33 (1-5) and 7.5 ± 1.23 (6-10) points for group A and B, respectively, and there was statistically significant difference (p ˂ 0.001) in the level of pain. There were no complications in any group.

Conclusion

The application of retinal 50-millisecond pulse PRP causes less pain and side effects than 200-millisecond pulse PRP.

[Comparison of protective colostomy vs. ileostomy in rectal cancer surgery]

Background

Rectal cancer (RC) is the 3rd most frequent one in Mexico. Protective stoma in resection and anastomosis is controversial.

Objective

To compare quality of life (QoL), functional capacity (FC) and complications in rectal cancer (RC) patients with low and ultralow anterior resection (LAR and ULAR) with loop transverse colostomy (LTC) versus protective ileostomy (IP).

Material and methods

Comparative, observational study in patients with RC and LTC (Group 1) or IP (Group 2) from 2018-2021. FC pre and postoperative, complications, hospital readmission (HR) and assessment by other specialty (AS) were assessed; QoL was assessed with EQ-5D by telephone. Student-t test, Chi-squared test, Mann-Whitney-U test were used.

Results

Group 1: 12 patients: mean preoperative FC: ECOG 0.83, Karnofsky 91.66%; postoperative: ECOG 1, Karnofsky 89.17%. Mean postoperative QoL: index value 0.76 and health status 82.5%; HR: 25%; AS: 42%. Group 2: 10 patients: mean preoperative FC: ECOG 0.80, Karnofsky 90%; postoperative: ECOG 1.5, Karnofsky 84%. Mean postoperative QoL: index value 0.68 and health status 74%; HR: 50%; AS: 80%. Complications: 100% of sample.

Conclusion

The differences in QoL, FC and complications between LTC and IP in RC patients operated with LAR/ULAR were not significant.

[Cognition in medical residents with and without anxiety in a specialist training hospital]

Background

The resident doctor plays an important role in people's health care.

Objective

To compare the cognition of medical residents with/without anxiety in a specialist training hospital.

Material and methods

Comparative, prospective, cross-sectional study. Medical residents of any grade and specialty were included, who signed informed consent. Those with a diagnosis of cognitive impairment were excluded, and who did not complete the tests were eliminated. AMAS-A test was applied to assess anxiety and NEUROPSI: Attention and memory test for cognitive characteristics. Mann-Whitney's U and Spearman's rho were used, p≤0.05 was considered significant.

Results

155 residents were evaluated, 55.5% men, mean age 32.4 years. Internal Medicine was the predominant specialty (25.2%). AMAS-A identified 94.19% residents with anxiety. NEUROPSI reported Attention and memory domain (38.7%) in normal classification, Memory (34.2%) in high normal, and Attention and executive functions (32.3%) in severe alteration as predominant assessments. Only Memory showed a significant difference between residents with and without anxiety (p=0.015). Attention and executive functions-Physiological anxiety (r=-0.21, p=0.009) and Attention and memory-Social concern (r=-0.268, p=0.001) correlations were significant.

Conclusions

The percentage of anxiety and cognitive alterations in residents physicians is high. Anxiety decisively affects memory capacity in these medical doctors.

[Security protocols adapted to COVID-19 in elective surgery thru 2021]

BACKGROUND

Medical personnel are among the populations with the most infections and morbidity and mortality during the COVID-19 pandemic worldwide.

OBJECTIVE

To evaluate patient and health personnel safety in anesthetic procedures of elective surgeries during COVID-19 pandemic in a 3rd level care Hospital in Puebla, Mexico.

MATERIAL AND METHODS

Descriptive, prospective, analytical study in a 3rd level care unit of the Mexican Social Security Institute in Puebla, Mexico. Elective surgeries from all shifts and any specialty, whose staff signed informed consent, were included. The modified surgical safety checklist for COVID 19, from the World Federation of Societies of Anesthesiologists, was applied.

RESULTS

170 surgeries were evaluated, the predominant specialties were oncosurgery (39.41%), urology (25.29%) and general surgery (14.71%). The most used anesthetic technique was general anesthesia (47.05%); 10.12% accomplished safe intubation/extubation protocols, presence of essential personnel in 6.34%. The use of personal protective equipment decreased during the stages of the pandemic, the use of face masks by medical personnel/patients is the most frequent (100%).

CONCLUSIONS

Security measures have decreased. Adequate security protocols must be continued to avoid new infections. Basic protection measures, the use of personal protective equipment and other protection strategies must persist.

Temporal Trends in Mortality in Patients with Systemic Sclerosis in Public Hospitals Across Mexico from 1998-2017

OBJECTIVE

To investigate national temporal trends over time in mortality rates in patients with systemic sclerosis (SSc) in Mexico between 1998 and 2017.

METHODS

Deaths between 1998 and 2017 were extracted from General Board of Health Information (DGIS) Open Access datasets. 2We identified all persons aged ≥15 years with a diagnosis of SSc (ICD-10 code M34). We calculated the age-standardized mortality rate (ASMR) for SSc and non-SSc (information provided by the National Institute of Statistics, Geography, and Informatics). A Joinpoint regression model was used to determine mortality trends by sex and geographic regions. Annual percentage change (APC) and average APC (AAPC) were calculated using Joinpoint analysis.

RESULTS

From 1998 to 2017, the overall ASMR of SSc increased (AAPC = 2.5%), whereas the ASMR for non-SSc remained stable. By subpopulations, females, and males with SSc had a significant uptrend in the ASMR (APC = 4.6 and 4.4%, respectively), between 1998 and 2008 for the former and between 1998 and 2010 for the later. Females had a non-significant ASMR uptrend between 2008 and 2017 and males a non-significant ASMR decline between 2010 and 2017. Women had a higher SSc-ASMR to non-SSc-ASMR ratio than males. The relative cumulative change between 1998 and 2017 differed between females (78.1%) and males (50.8%), and residents of the Southern region had the largest cumulative change (147.8%).

CONCLUSIONS

SSc mortality rate increased in Mexico between 1998 to 2017, with SSc mortality higher than non-SSc mortality. However, the SSc mortality rate steeply increased in the first ten years but has plateaued in the last 10 years of the study period. Variations by sex and geographic regions were also identified.

[Training about breastfeeding in pregnant women: Effect six months after birth]

BACKGROUND

Inadequate breastfeeding is associated to more comorbidities in children under 5 years old. One reason is deficient information in mothers.

OBJECTIVE

To asses immediate effect of an educational intervention about breastfeeding in pregnant women, and 6 months after child birth, and compare them with other mothers without educational intervention.

MATERIAL AND METHODS

Quasi-experimental, analytical, longitudinal study, carried out in a first level of care in Puebla with 100 pregnant patients between 36 and 40 weeks of gestation. Two groups 50 patients each were recruited. Group 1 received an educational theorical-practical intervention about breastfeeding. Group 2 preferred not receiving educational intervention. Knowledge, attitudes and practices about breastfeeding were assessed before and after training, and 6 months after child birth (Group 1), and before and 6 months after child birth (Group 2). Patients and children were attended by consulting Family Doctors. Descriptive data and Mann Whitney U test were used, p ≤ 0.05 value was considered significant.

RESULTS

Knowledge, attitudes and practices about breast feeding before training between groups were not different. Differences before and after training and 6 months after child birth in Group 1, and 6 months after child birth between groups were significant improvement (p ≤ 0.05).

CONCLUSIONS

An educational theorical-practical intervention in mothers at the end of pregnancy improves breastfeeding practice during 6 months after child birth.

[Dioptric power of intraocular lens and dilatation in patients with cataract]

BACKGROUND

Cataract surgery with intraocular lens implant is, nowadays, the most frequent surgical procedure in all the world. Its success depends on a lot of factors, one of the most important is the calculation of the exact dioptric power of intraocular lens.

OBJECTIVE

To compare the calculation of dioptric power of intraocular lens with and without dilatation in patients with cataract.

MATERIAL AND METHODS

Longitudinal study, the calculation of the dioptric power of the intraocular lens was determined in patients without and with pupillary dilation. The variables were age, gender, eye to study, keratometry, axial length, anterior chamber depth and dioptric power of the intraocular lens. Descriptive statistics and Student t test were performed.

RESULTS

There were 37 patients, 23 females and 14 males. The average age was 68 + 7.87 years. Sixty-four eyes were studied, 30 were right and 34 left. Statistically, there was only significant difference in K2 of the ocular biometry between patients without and with pupillary dilation when obtaining a value of p < 0.05.

CONCLUSION

There are no changes in the calculation of the dioptric power of the Intraocular lens without and with pupillary dilation.

Twenty-year trends in all-cause mortality of patients with systemic lupus erythematosus in Mexico: Results from a nationwide health registry

Objective

Regional variations in systemic lupus erythematosus (SLE) mortality may be due to different spectra of local environmental factors. The aim of this study was to assess mortality trends in adults with SLE using a nationwide health registry.

Methods

Data came from the Dynamic Cubes of the General Direction of Health Information for 1998–2017 for mortality. In patients aged ≥15 years, SLE as the principal cause of death was defined according to ICD-10 code M32 and was classified by sex and age. Joinpoint trend analyses of annual age-standardized mortality rates (ASMR) for SLE patients and non-SLE people were made.

Results

We identified 11 449 SLE deaths and 9,989,874 non-SLE deaths. The SLE ASMR increased more than the non-SLE ASMR, with a 98.2% cumulative increase in the ratio of SLE to non-SLE deaths. Whereas the non-SLE ASMR remained relatively stable throughout the study period (overall and by sex), the SLE ASMR significantly increased between 1998 and 2009, non-significantly decreased between 2009 and 2013 and non-significantly increased thereafter. Both women and men had a large cumulative increase in the SLE ASMR/non-SLE ASMR ratio (73.9 and 191.3%, respectively). The Southeast region had the largest cumulative increases in the ratio of SLE to non-SLE ASMR (108.8%). Of the 11,449 deaths, 445 (3.8%) were in geographical areas where ≥40% of the population is indigenous.

Conclusion

SLE mortality rates have increased since 1998 and remain high compared with non-SLE mortality: significant sex and regional disparities persist.

[Validation of a fast scale patient´s satisfaction in emergencies]

BACKGROUND

Quality of attention is assessed through patient´s satisfaction about attention received. A validated fast scale to asses it in emergency medical services is necessary.

OBJECTIVE

To design and validate the Patient Satisfaction at Emergency Services Scale (ERSAPUR).

MATERIAL AND METHODS

Longitudinal, process study to assess the new satisfaction scale at Emergency room in a second level attention unit. PHASE I: ERSAPUR was designed by 10 quality and emergencies attention experts; redaction was approved by 20 patients consecutively. PHASE II: After written consent, ERSAPUR and Encuesta de Satisfacción del Servicio de Urgencias del Hospital Universitari de Bellvitge de Barcelona scales were applied to patients attended at emergency room, more than18 years-old. Those patients with psychiatric disease, mental handicap or non-spanish parlor were excluded. ERSAPUR was reapplied by phone 7-10 days later. Cronbach´s alfa was used for internal fiability, Spearman´s rho for convergent validity, and Intraclass correlational coefficient (CCI) for test-retest; p ≤ 0.05 was considered significant.

RESULTS

260 patients answered both scales. Medical and nurses cares produced the highest satisfaction. Clean and waiting time produced the highest dissatisfaction. Cronbach´s Alpha = 0.873, Spearman´s rho = 0.654, CCI = 0.75 (p ≤ 0.01).

CONCLUSIONS

ERSAPUR is a valid and fiable scale, and it´s a useful instrument to assess the quality of attention in Emergency room services.

[Quality of life and disease activity assessment in juvenile idiopathic arthritis]

BACKGROUND

Juvenile idiopathic arthritis (JIA) is the most common chronic rheumatological disease in children. It is a multisystemic, dynamic pathophysiology of unknown cause and genetically heterogeneous.

OBJECTIVE

To compare the quality of life and illness' activity in patients with juvenile idiopathic arthritis, from urban, suburban and rural areas.

MATERIAL AND METHODS

Comparative, observational, and cross-sectional study in pediatric patients treated in a second-level medical care hospital, during the period from August to October 2015. The following questionnaires were applied: The Childhood Health Assessment Questionnaire for Quality of Life and The Disease Activity Score-28, in addition to the facial pain and verbal numerical scales for disease activity, both for patients and parents. The Kruskal-Wallis test was used for data analysis.

RESULTS

42 patients of three geostatistical areas were included: urban, suburban and rural; the middle age was 12.7 years, with predominance of the feminine sex (3:1). The polyarticulate type is more prevalent in the rural area. The pain is similar in the three regions. The population of the areas did not find significant difference for activity of the illness and quality of life between geostatistical areas (p ≤ 0.05).

CONCLUSIONS

The patients with juvenile idiopathic arthritis are usually older of eight years. The quality of life is better in the patients of the urban area, compared to those of other areas.

Validity and consistency of an outpatient department user satisfaction rapid scale

Background

User satisfaction is key to define and assess the quality of care; however, there is no patient satisfaction rapid scale in Mexico. Our objective was to determine the validity and consistency of an outpatient department user satisfaction rapid scale (ERSaPaCE).

Method

Comparative, observational, cross-sectional, prolective study. In phase 1, a rapid scale model was developed, which was submitted to experts in medical care for assessment; the instrument was pilot-tested in 10-patient groups, using as many rounds as required until it obtained 20 approvals. In phase 2, the resulting questionnaire and the Outpatient Service User Satisfaction (SUCE) scale were applied to outpatient department users. ERSaPaCE was reapplied by telephone 10 days later. Descriptive statistics, Cronbach's a, Spearman's correlation and intra-class correlation coefficient (ICC) were used.

Results

Two-hundred patients were recruited, out of which 53 % were aged 31-60 years; 51.5 % were women and 48.5 % men, all of them users of the outpatient services from 13 specialties. Cronbach's a for ERSaPaCE was 0.608, whereas ICC was 0.98 (p = 0.000). Convergent validity was 0.681 (p = 0.000) using Spearman's rho.

Conclusion

ERSaPaCE was a valid and consistent instrument for the assessment of outpatient department user satisfaction.

Prevalence of esophageal inlet patch and clinical characteristics of the patients

INTRODUCTION AND AIMS

An inlet patch (IP) is the presence of gastric columnar epithelium outside of the stomach. No studies have been conducted in Mexico on that pathology. The aim of the present study was to determine the prevalence of esophageal IP and the clinical characteristics of the patients that present it.

MATERIALS AND METHODS

A cross-sectional study was conducted that included consecutive patients referred for endoscopy within the time frame of September 2015 to May 2016. The patients answered a questionnaire, and high-definition endoscopy with digital chromoendoscopy was performed. The prevalence of IP was identified. The chi-square test was used to compare the clinical characteristics between patients that presented with esophageal IP and those without it.

RESULTS

A total of 239 patients were included in the study. Their mean age was 53 years, and 130 (54.4%) were women. IP was found in 26 patients (10.9%), 15 of whom were men (57.7%). The main reason for referral to endoscopy was gastroesophageal reflux disease, present in 69.2% of the patients with IP and in 55.9% without IP (p=.19). The most common symptoms were heartburn and regurgitation. The former was present in 69.2% of the patients with IP and in 59.1% without IP (p=.32), and the latter was present in 65.4% of the patients with IP and 69.1% without IP (p=.7). Extraesophageal manifestation distribution was: cough in 46.2% of the patients with IP and 38% without IP (p=.45) and dysphonia in 54% with IP and 47% without IP (p=.53). Twenty-three percent of the patients with IP had Barrett's esophagus, as did 23% without IP (p=.99).

CONCLUSIONS

The prevalence of IP was high. The primary referral diagnosis was gastroesophageal reflux disease. No differences were found in relation to symptoms or the presence of Barrett's esophagus between the patients with and without IP.

[Fifty years of services of biomedical information in health documentation centers in Puebla, Mexico]

Librarian and information services focused on supporting research, teaching, and health care are vital for the generation of new knowledge and its application in health care, both by staff and students, helps to improve the quality of medical care. Therefore, in this article we expose an historical and social tour of 50 years of the Instituto Mexicano del Seguro Social's library services in Puebla. From 1964 to 2014 occurred many events in the development of these services in our area, from the creation of a small space in the basement, to the implementation of spaces created deliberately to provide dignified service to all users, which is why this historical sketch is here as an acknowledgement to the first librarians who contributed to the training of specialists in Mexico.

Evaluación del plan de estudios para la formación de bibliotecarios en Ciencias de la Salud, una nueva propuesta

La evaluación curricular es la comprensión y explicación hermenéutica de un programa educativo. En países como Chile algunas instituciones de educación superior han rediseñado sus planes de estudios en Bibliotecología bajo el enfoque de competencias.El objetivo de este trabajo es analizar el plan de estudios del curso de Asistente de Bibliotecario para unidades de segundo y tercer nivel de Atención Médica en México.Con un estudio descriptivo se analizó el objetivo general, perfil de ingreso, prácticas, servicio social y mapa curricular del plan de estudios de Asistente de Bibliotecario para unidades de segundo y tercer nivel de Atención Médica. Se revisaron el plan curricular del curso Asistente de Bibliotecario y la distribución de asignaturas en cada módulo con referencia a los contenidos temáticos y la estructura del plan de estudios vigente.Se identificó en el objetivo que la direccionalidad del asistente de bibliotecario esté enfocada hacia el área biomédica y no hacia a la formación bibliotecológica ni a las actitudes y responsabilidades de los candidatos para asistentes; en los módulos también fue posible reconocer que hay duplicidad en algunos contenidos temáticos.A diferencia de otros planes de estudio que hacen referencia a la formación de bibliotecarios, nuestro actual plan no lo considera por lo que sugerimos un rediseño curricular apoyado en especialistas en el área tanto pedagógica como bibliotecológica.

[Quality of life in patients with psoriasis]

INTRODUCTION

Psoriasis is a chronic inflammatory skin disease, in which an autoimmune mechanism participates, triggering an accelerated keratopoiesis. Its etiology is unknown; environmental factors, trauma, and infections are involved. The aim of this paper is to present the correlation between the index of severity of psoriasis and quality of life in patients with psoriasis.

METHODS

This was a cross-sectional study in 72 patients with psoriasis, older than 15 years old, who agreed to participate in the study. We applied the Dermatology Life Quality Index and the Psoriasis Severity Index; descriptive statistics, measures of central tendency, dispersion, and correlation measures were used.

RESULTS

Patients (n = 72), were 43% male, 57% female, with a mean age 51.22 (15-77) ± 14.05 years. Education: bachelor's degree 23.6%, housework occupation 26.4%, duration of the disease 12.25 (1-50) ± 10.58 years. Psoriasis plaques occurred in 88.9%, the Psoriasis Severity Index was mild in 70.8%. The result of the impact on quality of life was moderate in effect in 33.3%, the difference between the degree of involvement of the disease and the impact on quality of life was p = 0.104, and correlation between the quality of life and degree of psoriasis was p = 0.463.

CONCLUSION

Quality of life is independent of the degree of disease in patients with psoriasis.

[Spinal tuberculosis: experience in a third level medical facility in Puebla, Mexico]

BACKGROUND

Pott's disease or spinal tuberculosis (STB) is a serious infectious disease, caused by the migration of the bacterium Mycobacterium tuberculosis to the spine. Knowing this disease is a priority for all the physicians. The objective was to show the experience in patients with STB treated in a third level hospital in Puebla, Mexico.

METHODS

Descriptive study. From January to December, 2014, we collected information of patients with STB. The variables were age, gender, length of hospital stay, affected segment of the spine, associated diseases, symptoms, diagnostic methods, type of treatment and complication. We used descriptive statistics, as well as measures of central tendency and dispersion.

RESULTS

We studied 14 patients, 71.4 % male; mean age was 60.29 ± 16.54 years (33-93); the average hospital stay was 18.93 ± 9.32 days (4-34). The affected segment was thoracic in six patients (42.85%) and lumbar in eight (57.15%). Nine patients had associated diseases (64.28%) and five did not (35.7%). All patients received medical treatment and 11 surgical procedures were performed in a total of five patients (35.7%). Complications occurred in two patients (14.3%).

CONCLUSIONS

STB must be managed early to avoid complications. Coordination with the first level of medical care is very important, as well as the adherence to national and international guidelines.

[Five-year survival analysis in patients with penile cancer]

BACKGROUND

Short-term survival of penile cancer is poor. The objective was to describe the 5-years penile cancer survival.

METHODS

Retrospective cohort study. We included patients with penile cancer managed surgically from 2010 to 2014. Descriptive statistics were used for socio-demographic variables and the Kaplan-Meier estimator for survival function.

RESULTS

We studied 22 patients with a mean age of 64.95 years and a time of evolution of 25 months after the diagnosis. 68.2% of patients smoked or had human papillomavirus (HPV); they all presented phimosis; 72.7% had pain in the penis and the groin area; 81.8% had palpable lymph nodes and 45.5% lesions ≥ 3 cm; 86.3% were diagnosed in clinical stage IIIa. 59.1% underwent partial penectomy and 86.4% had squamous cell variety. 40.9% of patients died six months after the surgery. 66% of the smokers presented metastasis; all of the patients that smoked and had HPV infection had neurovascular invasion and died; 83.3% of the patients (n = 6) who underwent partial penectomy and positive lymph node dissection due to metastases died. The 5-years mortality of patients with penile cancer was 40.9%.

CONCLUSION

Tobacco use and HPV increase morbidity and mortality in patients with penile cancer; lesions greater than 5 cm are more common in smokers. The size of the lesion increases with the delay in treatment.

Detection of beta-tubulin in the cytoplasm of the interphasic Entamoeba histolytica trophozoites

It is known that the microtubules (MT) of Entamoeba histolytica trophozoites form an intranuclear mitotic spindle. However, electron microscopy studies and the employment of anti-beta-tubulin (β-tubulin) antibodies have not exhibited these cytoskeletal structures in the cytoplasm of these parasites. The purpose of this work was to detect β-tubulin in the cytoplasm of interphasic E. histolytica trophozoites. Activated or non-activated HMI-IMSS-strain E. histolytica trophozoites were used and cultured for 72 h at 37 °C in TYI-S-33 medium, and then these were incubated with the anti-β-tubulin antibody of E. histolytica. The anti-β-tubulin antibody reacted with the intranuclear mitotic spindle of E. histolytica-activated trophozoites as control. In contrast, in non-activated interphasic parasites, anti-β-tubulin antibody reacted with diverse puntiform structures in the cytoplasm and with ring-shaped structures localized in the cytoplasm, cellular membrane and endocytic stomas. In this work, for the first time, the presence of β-tubulin is shown in the cytoplasm of E. histolytica trophozoites.

[Functional and radiological evaluation of patients with midshaft clavicle fracture surgically treated]

BACKGROUND

Functional and radiographic evaluation at midshaft clavicle fractures is better with surgical than conservative management. The aim of this paper is to describe the functional and radiological evaluation of patients with midshaft clavicle fracture surgery at the Hospital de Traumatología y Ortopedia of the Instituto Mexicano del Seguro Social.

METHODS

Descriptive studies, conducted during the period June 2014 to June 2015, patients undergoing surgical treatment for midshaft clavicle fracture were included. Constant-Murley and Montoya Scales were used to evaluate the functionality and radiological consolidation 6 months after the treatment.

RESULTS

There were 90 patients, average age was 33.63 years, 78.9% were men, left side affected in 53.3% patients. At 6 months after surgery, functional results were excellent in 87.8% of patients, in 91% there was disappearance of fracture line regardless callus. The group of patients aged 18 and 40 years present better functional and radiographic results compared to the other groups (p <0.05).

CONCLUSIONS

The management of patients with diaphyseal clavicle fracture should be surgical, ages between 18 to 40 years and between 61 to 76 years have better functional outcomes with greater consolidation of fracture line regardless of the callus.

[Evaluation of patients with humeral midshaft fractures treated with DCP plate vs. intramedullary nail UHN]

BACKGROUND

Humeral midshaft fractures should be surgically managed, so the knowledge of functionality, bone healing and pain of these treatments is required to obtain the expected results. The aim of this paper is to compare the results of patients with humeral midshaft fracture operated with intramedullary nails UHN vs. DCP plate.

METHODS

Comparative study, conducted during the period of June 2014 to June 2015, in patients with humeral midshaft fracture, incidents, operated with intramedullary nails UHN vs. DCP plate. Pain, functional and radiographic assessment were conducted by Andersen, UCLA and simple X ray test, respectively.

RESULTS

There were 40 patients, 57.5% with DCP plate, 67.5% male, mean age was 42.38 years, mean operative time was 73.3 minutes, side affected 50% right, 87% had complete consolidation with DCP plate against 70.6% of the patients treated with intramedullary nails UHN. Radiographic consolidation was good for both treatments, functionality and pain patients had presented no statistically significant differences in both groups (p ≥ 0.05). Complications are in the range described worldwide for both treatments.

CONCLUSIONS

Both treatments are effective for humeral diaphyseal lesions, however should be cautious and try to avoid the complications that can be serious is recommended.

[Validity and consistency of a new scale (Faces Pain Scale) and of the Spanish version of the CHEOPS scale to evaluate postoperative pain in children]

BACKGROUND

one of the most used scales for the evaluation of children's pain is the CHEOPS. This is complex, reliable but not commonly used in spanish. We decided to create a new Pain Facial Scale to be considered to be used in spanish.

OBJECTIVE

to compare the validity and consistency of two different scales for the evaluation of post-operative pain in children.

METHODS

process, comparative, longitudinal, homodemic, and prolective study. It was elaborated a simple and easy scale, to evaluate the post-operative pain in children. 5 experts evaluated their appearance and content. The original version of CHEOPS was translated to the Spanish by an expert; later this version was corrected and re-translated by a native Anglo-Saxon speaker, the result submitted for evaluation by 5 experts. The validity and consistency of both scales were evaluated by two investigators in a blind way. We used Cronbach's α for the internal consistency of CHEOPS, coefficient of intraclass correlation for the external consistency (inter observer's variability), effect size for sensitivity to the change of category, change of status for internal validity and Spearman's correlation for the convergent analysis.

RESULTS

there was great external consistency, and a good and high internal validity, for the Spanish version of the CHEOPS scale, and an excellent internal validity for the Facial Pain Scale, as well as an excellent internal validity for both scales.

CONCLUSIONS

two scales can be used to evaluate the post-operative pain in children between 4 and 8 years old.