matias gonzalez

Resumen: Presentamos un caso de midriasis congénita bilateral (MCB) asociada a otras alteraciones oculares en una lactante de 4 meses de edad, sin retraso en el desarrollo psicomotor ni enfermedades sistémicas. Comparamos nuestro caso con los 13 ya ...

ABSTRACT Las Tecnologías de la Información y las Comunicaciones (TICs) y la WWW deben ser una fuente de oportunidades para la integración, el aprendizaje, el empleo y no un conjunto de nuevas barreras que aumente la exclusión y la discriminación. Aplicando herramientas de evaluación es posible identificar y revertir estas barreras en productos existentes, propiciando el acceso y la interacción a las personas, independientemente de sus capacidades diferentes y/o especiales. Pero el desafío real es aportar a un escenario más proactivo, que tenga en cuenta estas barreras al momento de concebir y desarrollar nuevos sitios y aplicaciones. Enfocados en personas con discapacidad motora y/o cognitiva y considerando estándares nacionales e internacionales vigentes, en este trabajo se realiza un análisis de los problemas que enfrenta este grupo crítico de usuarios de interés para comunicarse con los demás y el mundo que los rodea, y cómo pueden contribuir a esta comunicación la tecnología y la Web. La identificación de barreras se utiliza para proponer el diseño de sistemas Web personalizados de comunicación aumentativo y alternativo, que puedan enriquecerse dentro de una comunidad, compartiendo pictogramas descriptivos en un entorno de interacción usable y accesible.

The incidence of intestinal endometriosis is reported between 5.3 and 12% of cases and of these, between 70 and 93% are located in the rectum and sigmoid. We report the case of a 32-year-old with constipation and bloating and cramping pain during the last 2 years. The pain increased in frequency during the past 6 months. From the data obtained from physical examination and imaging studies may be suspected pelvic endometriosis with infiltration of anterior rectal wall. Resection of the low anterior rectum with colo-rectal anastomosis was performed, with adequate surgical outcome and resolution of symptoms. In patients of childbearing age with abdominal or pelvic pain, constipation of recent onset or occlusive bowel, which may or may not be related to the menstrual cycle should be considered transmural infiltration by endometrial tissue.

Persistence of depressive symptoms after myocardial infarction (MI) is associated with an adverse outcome. The relationship between depression and Invasive Revascularization Therapy (IRT) is not yet fully understood. To compare the frequency of depressive symptoms and other psychosocial variables among patients with MI, undergoing or not undergoing IRT. Prospective evaluation of 45 patients aged 58 +/- 11 years (87% males) with a diagnosis of MI (Killip I and II). On admission to hospital and at follow up 3 months after discharge, all patients completed the Beck Depression Inventory (BDI), the Zung Anxiety Inventory (ASI), and the Medical Outcomes Study (MOS) social support survey. Depressive symptoms were considered to be present if the BDI score was over 10. Thirty seven percent were hypertensive, 15% diabetic and 44% smokers. Sixty four percent of patients underwent IRT (11.1% revascularization surgery and 53.3% coronary angioplasty). Forty four percent of patients scored over 10 in the BDI at baseline assessment and 26.5% at 3 months follow-up (p < 0.01). At baseline BDI score was 10.2 +/- 5.1 and 9.1 +/- 4.4 among patients subjected or not subjected to IRT, respectively (NS). The figures at 3 months of follow up were 9.9 +/- 5.6 and 4.1 +/- 2.5, respectively (p < 0.01). At baseline and three months BDI, anxiety and perceived social support were significantly correlated. Depressive symptoms were frequent after MI in this group of patients, and decreased at follow up only among patients not subjected to IRT.

... Palabras clave Delirium. Geriatría. Pronóstico. González, Matías a ; Carrasco, Marcela b. a Departamento de Psiquiatría. Facultad de Medicina. Pontificia Universidad Católica de Chile. Santiago de Chile. Chile. b Departamento de Geriatría. Facultad de Medicina. ...

ABSTRACT INTRODUCTION AND OBJECTIVES: The bladder augmentation is used in the treatment of both structural and functional lower urinary tract disorders, creating a reservoir that allows a low pressure filling of the bladder. The purpose of this paper is to describe an augmentation enterocistoplasty with continent ileal conduit surgical technique and its outcomes. METHODS: Between May 2008 and May 2012, 16 patients underwent augmentation enterocystoplasties with continent illeal conduit. All patients had at least 1 year follow-up. Among the diseases causing bladder dysfunction: 6 (37.5%) were neurogenic bladders due to spinal cord injury, 4 (25%) microbladders due to myelomeningocele, 4 (25%) microbladders secondary to radiotherapy, 1 (6.25%) tuberculous microbladder and 1 (6.25%) idiopathic bladder. All patients mentioned urinary incontinence (UI) and urinary tract infection as the reason for consultation, 5 (31.25%) of them also had renal failure with aggregate uronephrosis and 4 (25%) used indwelling urinary catheter. Surgical technique: Section of 45 cm of vascularized ileum, 15 cm from the ileocecal valve, detubularizing 30 cm of the proximal portion and respecting 15 cm of distal ileum that will form the ileal conduit. The open intestinal portion is folded in a "U" shape, joining the adjacent edges. Refinement and intussusception of the ileal conduit, forming an anti-reflux valve. The bladder is opened in the sagittal plane, the intestinal patch and bladder edges are sutured together. Umbilical resection and umbilical duct externalization. RESULTS: The mean follow-up was 30.18 months (13-48). Mean age was 37 years old (23-71). Intermittent catheterization was performed from postoperative day 21. Immediate complications occurred, 1 (6.25%) urinary fistula, paralytic ileus in 2 (12.5%) patients, urosepsis in 2 (12.5%) patients. Late complications were urinary tract infection in 4 patients (25%), urinary incontinence in 4 (25%), bladder stones in 2 patients (12.5%), and 1 patient (6.25%) decided to continue with permanent bladder catheter in the ileal conduit. The mean preoperative and post-operative bladder pressures was 87 cm of H2O and 17 cm of H2O respectively. The average preoperative and post-operative bladder capacity after one year was 112.5 cc (40-230 cc) and 426.25 cc (250-660 cc) respectively. CONCLUSIONS: The surgical technique for augmentation enterocistoplasty with continent ileal conduit is a feasible and safe approach for the management of urinary incontinence and renal failure in patients with neurogenic bladder and/or microbladder refractory to other treatments. Source of Funding: none