Objective: To evaluate changes in RSV seasonality in the last 25 years and their correlation with the mean annual temperature.
Methods: Cross-sectional study, based on RSV and temperature data from the City of Buenos Aires (1995-2019). For each year, we describe the beginning, end, and duration of the RSV season and the correlation with the mean annual temperature.
Results: We identified 10,183 RSV infections. The duration of the RSV season decreased significantly (1995: 29 weeks vs. 2019: 18 weeks; R: 0.6 (p< 0.001)), due to an earlier ending (1995: week 45 vs. 2019: week 34; 0.6 (p<0.001)). No correlation was observed between mean annual temperature and the duration, start, or end of the RSV season.
Conclusion: In the last 25 years, the duration of the RSV season has been significantly shortened due to an earlier ending, without correlation with temperature.
Introduction: Trigeminal neuropathic pain (TNP) is a syndrome of severe, disabling, constant facial pain arising from the trigeminal nerve or ganglion. Arteriovenous malformations (AVM) are a rare cause of TNP. The limited choices of intervention of TNP include peripheral nerve stimulation, trigeminal nucleotomy and motor cortex stimulation.
Case report: We present a 56-year-old man who suffered from trigeminal neuropathic pain secondary to nerve compression due to a giant posterior fossa AVM. The pain was refractory to drug treatment. From all the therapeutic options available we declined the microvascular decompression of the trigeminal nerve due to the presence of the giant AVM, or stereotactic radiosurgery because of the AVM´s diffuse nidus. After a multidisciplinary discussion we proposed a minimally invasive, safe and reversible treatment: Motor Cortical Stimulation (MCS). We placed a 16-pole epidural electrode on the right precentral gyrus. The patient had satisfactory pain control with some supplemental medication. No complications or side effects such as seizures, sensory disturbances or infections were presented.
Discussion: The limited choices of intervention of TNP include peripheral nerve stimulation, trigeminal nucleotomy and MCS. Henssen et al performed a systematic review where they investigated the effectiveness of MCS and discovered that this is significantly different among different chronic neuropathic orofacial pain disorders. A visual analogue scale (VAS) measured median pain relief of 66.5% was found.
Conclusion: MCS should be one more tool to consider in highly selected cases, when other treatments are unfeasible.
Introduction: There are a set of conditions that directly affect the quality of life of older adults, causing marginalization and discrimination of this age group.
Objective: Determining the factors that affect the perception of discrimination and quality of life of older adults in the province of El Oro, Ecuador.
Methods: Observational, descriptive, qualitative-phenomenological, cross-sectional, cross-sectional study in older adults aged 65 years, between September 2019 and November 2020. The sample consisted of 399 older adults. The questionnaire "Biopsychosocial assessment of older adults from a bioethical approach" was used. The following variables were measured: discrimination and self-perception of quality of life. Multiple correspondence analysis was used to examine the association between discrimination, quality of life and the variables under study.
Results: 61.7% of the respondents considered that discrimination exists, with ageism predominating. The variable most related to the perception of discrimination of the MAs was the treatment in health care, and the family environment. The quality of life in a significant percentage was unsatisfactory due to: their family environment, poor social integration and dissatisfaction with their health.
Conclusions: The quality of life of older adults was unsatisfactory in almost half of the respondents, influenced by the relationship with the family, social integration, and health status. The older adults reported that there is discrimination and ageism in the treatment perceived in the health services and the family environment, in violation of the principles of bioethics.
Purpose: The purpose of this study is to perform a systematic review of the scientific literature to compare single and double row techniques for rotator cuff tears in terms of functional, pain improvement and structural healing of the tendon.
Methods: In order to carry out the research, a systematic selection of scientific articles has been made by consulting PubMed and The Cochrane Library databases. The articles included in the present study compare the single-row and double-row techniques, with publication date between 2016 and 2021.
Results: Diverse results are observed in the UCLA, SST, Constant and ASES assessment scales and in the range of mobility, therefore, the superiority of one technique in terms of functional results is not established. The double row technique may show superiority in the strength variable, although there is a methodological variability in its measurement. The double-row technique may be related to more intense postoperative pain, while the single-row technique to residual shoulder pain. However, the variables strength and pain show non-homogeneous or coincident data. The superiority of the double row repair in the structural healing of the tendon and a lower re-tear rate than the single row technique is established with statistically significant results, being the most homogeneous and coincident studies.
The organization in hospital medicine services is characterized by its hierarchy, where the difference in knowledge and status between medical directors, heads of service, specialist doctors and residents implicitly entail a power dynamic that generates abuse. According to Bourdieu's symbolic theory, the framework that underlies abuse is formed by symbolic violence that materializes in complex relationships in which each person knows their hierarchical position and does not question it. But this symbolic violence is experienced unconsciously, where abuse is perceived as an attitude that is part of an established order where the abuser and the abused act without questioning the abuse and perpetuating the historically inherited model. To eradicate abuse of residents, it is necessary to become aware of the symbolic foundation of abuse that legitimizes and perpetuates it to unmask the relationship between the abuser and the abused, proposing a new relational framework based on respect and dialogue.
Desmoid-type fibromatosis (DF) is a rare monoclonal, fibroblastic proliferation characterized by an unpredictable and variable clinical course. We present the case of a 56-year-old woman who underwent total thyroidectomy for papillary thyroid carcinoma in 2012 and who developed a cervical mass at the left laterocervical level during follow-up, raising the diagnosis of tumor recurrence. Computed tomography of the neck showed solid formations with heterogeneous contrast uptake in the right lateral region of the neck. At the level of the thoracic operculum, a second 26-mm formation was observed that medially contacted the left lateral wall of the trachea. Lateral lymphadenectomy was performed, which was incomplete. Histology showed findings consistent with desmoid-type fibromatosis. DF are slowly proliferating, non-metastatic tumors with a highly invasive capacity that are usually present in familial adenomatous polyposis (FAP)-Gardner syndrome. Our case had a history of massive colonic polyposis and first-degree relatives of colorectal cancer.
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