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Background/Aims: Vascular access (VA) is the highest risk factor for blood infections, hospitalization, and mortality of patients undergoing hemodialysis (HD). The risk of mortality while using a catheter is greater than that while using grafts. The objective of this article is to know the survival rate in relation to the type of VA. Methods: A retrospective cohort of HD patients was studied. The data gathered included age, gender, first VA at the surrogate site, days between the first and second access, number of accesses, and anatomical site of VA placement. Mean differences were estimated using χ2 or Student's t test. Survival was calculated using the Kaplan-Meier curves and included in tables. Statistical significance was established as p < 0.05. The statistical computer software package SPSSw v25 was used for the analysis. Results: A total of 896 patients were included with a mean age of 47.88 years (SD ± 16.52), the duration of the first VA was 398.81 days (±565.79), the mean number of VAs used was 2.26 (±1.15), and the median time undergoing HD was 728.73 days. The duration of catheter placement was 330.42 days, and 728.60 days for fistula use (p = 0.001). The mean number of days of renal replacement was 611.59 days for catheter and 1,495.25 days for internal arteriovenous fistula (IAVF) patients (p = 0.001). Conclusions: The survival of the initial VA is greater for the IAVF, followed by the tunneled catheters and the lowest by the non-tunneled catheters, which continue to be frequently used in our setting. [ABSTRACT FROM AUTHOR]

Copyright of Revista Medica del IMSS is the property of Direccion de Prestaciones Medicas - IMSS and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Colombiana de Ciencias Sociales is the property of Fondo Editorial Fundacion Universitaria Luis Amigo and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: One of the causes of dissatisfaction among residents is related to burnout syndrome, stress and depression. The aim of this study is to describe the prevalence of depression, anxiety and suicide risk symptoms and its correlation with mental disorders among medical residents over an academic year. Methods: 108 medical residents registered to second year of medical residence answered the Beck Depression Inventory, the State-Trait Anxiety Inventory and the Suicide Risk Scale of Plutchik: at the entry, six months later and at the end of the academic year. Results: Residents reported low depressive symptoms (3.7 %), low anxiety symptoms (38 %) and 1.9 % of suicide risk at the beginning of the academic year, which increased in second measurement to 22.2 % for depression, 56.5 % for anxiety and 7.4 % for suicide risk. The statistical analysis showed significant differences between the three measurements (p < 0.001). The prevalence of depressive disorder was 4.6 % and no anxiety disorder was diagnosed. Almost all of the residents with depressive disorder had personal history of depression. None reported the work or academic environment as a trigger of the disorder. There was no association by specialty, sex or civil status. Conclusions: The residents that are susceptible to depression must be detected in order to receive timely attention if they develop depressive disorder. [ABSTRACT FROM AUTHOR]

Copyright of Revista Medica del IMSS is the property of Direccion de Prestaciones Medicas - IMSS and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Boletín del Colegio Mexicano de Urología is the property of Colegio Mexicano de Urologia A.C. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Medica del IMSS is the property of Direccion de Prestaciones Medicas - IMSS and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: adenocarcinoid tumor is a rare malignancy that combines clinical and histological features of epithelial origin (adenocarcinoma) and neuroendocrine (carcinoid), occupies less than 1 % of all colorectal cancer histology, occurring mainly in the appendix and its presence in the colon is rare. Clinical case: we present a case of a 41-year-old female with sigmoid colon tumor, who underwent an extended left hemicolectomy and anastomosis; having a good postoperative evolution, with hospital stay of seventh days. The final histopathological study reported was adenocarcinoid colon tumor with free margins of injuries and four positive nodes of adenocarcinoma. Conclusions: adenocarcinoid tumors are present in the appendix in 85 to 95 % of all cases and only 6 % are located in the colon (13 % in sigmoid). Early diagnosis is certainly the most important determinant of good prognosis, in these cases the five-year survival is 80 to 84 %, and 15 years of 60 %. [ABSTRACT FROM AUTHOR]

Copyright of Cirugía y Cirujanos is the property of Publicidad Permanyer SLU and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Probiotics have been used in the adjuvant treatment of Ulcerative Colitis (UC)., Objective: To evaluate the role of a combination of probiotics on the clinical, histological changes and feeding tolerance in patients with UC., Methods: An open UC patients with mild to moderate activity and clinical trial was conducted. Patients were randomized to receive or a combination of 6 strains of probiotics for 3 months while continuing their drug treatment established. UC activity was assessed by Truelove and Witts scale and histological findings by Gupta index. Descriptive statistics, Chi square test and Student t test for comparison of the two groups was performed., Results: In each group 17 patients were included. An improvement was found in the disease activity (52.9% vs. 23.5%, p = 0.07) and in histologic index (82.3% vs. 41.1%, p = 0.03) in patients treated with probiotics compared to the control group. Improved food tolerance was also observed in patients treated with probiotics., Conclusion: The study shows a beneficial short-term effect on symptoms, histological findings and feeding tolerance with the administration of a combination of 6 strains of probiotics in patients with UC.

Background: Teaching strategies have been defined as procedures, means or resources that teachers used to promote meaningful learning., Aim: Identify teaching strategies and evaluation used by the professor with residents in tertiary hospitals health care., Methods: This is a cross-sectional study conducted with full, associate and assistant professors of various medical specialties. A questionnaire was applied to evaluate the strategies used by professors to teach and evaluate students., Results: We included a sample of 90 professors in 35 medical specialties. The most frequent teaching activities were: organizing students to develop presentations on specific subjects, followed by asking questions on previously reviewed subjects, In terms of the strategies employed, the most frequent "always" option was applied to case analyses. The most frequent methods used for the evaluation of theoretical knowledge were: participation in class, topic presentation and exams., Conclusions: Teaching activities were primarily based on the presentation of specific topics by the residents. The most commonly used educational strategies were clinical case analyses followed by problem-based learning and the use of illustrations. Evaluation of the residents' performance in theory knowledge, hinged on class participation, presentation of assigned topics and exams., (Copyright: © 2017 SecretarÍa de Salud)

Introduction: Toxic megacolon (MT) is a potentially lethal complication of inflammatory, ischemic and infectious colitis. Usually it is related to ulcerative nonspecific colitis or Crohn disease. Recently it has been observed an increased in pseudomembranous colitis as cause of TM. The aim of this study is to describe the frequency, clinical evolution and prognosis of patients with TM., Methods: Retrospective study, from January 2009 to January 2014 1500 patients were hospitalized in the Department of Coloproctology. We included 13 of 1500 patients with diagnosis of TM according to Jalan criteria and surgically corroborated. To determine the averages descriptive statistics was used., Results: We studied 13 patients with TM (79.9% male and 20.1% female), the average age was 47.69±18.3 years. The most frequently associated diseases were: nonspecific ulcerative colitis (30.8%), pseudomembranous colitis (30.8%), neutropenic colitis (23.1%), Crohn Disease (7.7%) and ischemic colitis (7.7%). Subtotal colectomy plus terminal ileostomy was done in 84.6%, extended right hemicolectomy with ileostomy plus mucous fistula in 7.7% and extended right hemicolectomy with ileostomy plus Hartmann pouch in 7.7%. The mortality was 61.5%. The prevalence in the 5 years was 13 of 1500 (0.86%) patients., Conclusions: The prevalence of TM is low with a high mortality. A prompt diagnosis and treatment can improve the poor prognosis in these patients.

Background: One of the causes of dissatisfaction among residents is related to burnout syndrome, stress and depression. The aim of this study is to describe the prevalence of depression, anxiety and suicide risk symptoms and its correlation with mental disorders among medical residents over an academic year., Methods: 108 medical residents registered to second year of medical residence answered the Beck Depression Inventory, the State-Trait Anxiety Inventory and the Suicide Risk Scale of Plutchik: at the entry, six months later and at the end of the academic year., Results: Residents reported low depressive symptoms (3.7 %), low anxiety symptoms (38 %) and 1.9 % of suicide risk at the beginning of the academic year, which increased in second measurement to 22.2 % for depression, 56.5 % for anxiety and 7.4 % for suicide risk. The statistical analysis showed significant differences between the three measurements (p < 0.001). The prevalence of depressive disorder was 4.6 % and no anxiety disorder was diagnosed. Almost all of the residents with depressive disorder had personal history of depression. None reported the work or academic environment as a trigger of the disorder. There was no association by specialty, sex or civil status., Conclusions: The residents that are susceptible to depression must be detected in order to receive timely attention if they develop depressive disorder.

Background: the morbidity and mortality in surgery of gallbladder and biliary tract (SGBT) in the geriatric patient define the prognostic. The aim was to describe the perioperative and immediate post-operative complications of the geriatric patient undergoing SGBT., Methods: A cross-sectional study with control group in patients older than 60 years was done. The patients were divided into two groups by age (I: 60-69 years and II: > 70 years). The variables analyzed were morbidity, anesthetic risk, type of surgery, perioperative and post-operative complications, conversion rate and length of hospital stay., Results: a total of 236 patients were included: 65.2 % were females with a mean age 68.5 years. Chronic cholelithiasis accounted for 83 % and laparoscopic cholecystectomy was the procedure most commonly performed (72.8 %). Surgery was scheduled in 92 % cases and urgently in 8 %. In both groups, ASA rank was I-II in 76.2 % vs. 70.1 %; the conversion rate was 2.5 %. Complications were 13.5 %, of which 9.3 % were postoperative and 4.2 % of perioperative. Complications were higher in emergency surgery than elective surgery (36.8 % vs. 11.8 %). The average hospital stay was 4.2 days and there was no mortality., Conclusions: the age does not represent an increase in complications. The laparoscopic cholecystectomy is safe and applicable in elderly. Complications presented were related to the urgent nature of the surgery.

Background: adenocarcinoid tumor is a rare malignancy that combines clinical and histological features of epithelial origin (adenocarcinoma) and neuroendocrine (carcinoid), occupies less than 1 % of all colorectal cancer histology, occurring mainly in the appendix and its presence in the colon is rare., Clinical Case: we present a case of a 41-year-old female with sigmoid colon tumor, who underwent an extended left hemicolectomy and anastomosis; having a good postoperative evolution, with hospital stay of seventh days. The final histopathological study reported was adenocarcinoid colon tumor with free margins of injuries and four positive nodes of adenocarcinoma., Conclusions: adenocarcinoid tumors are present in the appendix in 85 to 95 % of all cases and only 6 % are located in the colon (13 % in sigmoid). Early diagnosis is certainly the most important determinant of good prognosis, in these cases the five-year survival is 80 to 84 %, and 15 years of 60 %.

Objective: To determine the maxillofacial trauma profile, concomitant results and treatment of those persons injured in bicycle accidents. Several variables were identified such as age, sex, mechanism, place, month, injury patterns and symptomatology, time for receiving medical care, and treatments., Material and Methods: This was an exploratory, descriptive, analytic, and retrospective study. All patients with maxillofacial trauma injury as a result of bicycle accidents were admitted to the emergency service in 2002 in the traumatology hospital Victorio de la Fuente Narváez, Mexican Institute of Social Security that covers the entire Federal District zone and some suburbs, without any distinction made as to injury specialty., Results: Patients (127) with maxillofacial trauma from bicycle accidents were identified. Children aged 6 to 10 years were the most affected. There was more injury in soft tissue in the midfacial area, such as contusions, injuries dermabrasion and some fractures resulting in nose trauma. Most of the accidents happened in the streets by falling from the bicycles. Forty six persons had more than two maxillofacial injuries. Head trauma with cervically projected sprain was demonstrated as associated trauma. More than 50% of the patients received immediate treatment under local anesthesia by maxillofacial surgery or orthopedics and traumatology during the afternoon and night., Conclusions: Prevention programs for parents and children in homes, schools and medical care facilities should be established to encourage traffic education and the use of protective headgear.

Objective: To determine clinical correlation of reports of computed tomographic angiography renal (CT-AR) and surgical findings of the kidney donor patient., Material and Methods: Patients were submitted nephrectomy in the related live donor renal transplant program between January and December 2002 as paut of life to which he is made as he CT-AR study protocol. Statistical analysis was carried out by descriptive statistics., Results: Anatomical characteristics of 35 kidneys of the same number of live donors (AD) submitted CT-AR were evaluated and comparison with report of surgical technique was made. Incidence of accessory renal arteries was 23%. As reported by CT-AR, the were 39 renal arteries (91%) compared with 43 arteries found during surgery. CT-AR identified four supernumerary renal arteries (50%) of eight identified during surgical technique; 36 hiliar arteries (90%) and three polar arteries were identified by CT-AR (100%). Only one a case report of early bifurcation of renal artery (20%) by CT-AR was recorded. Anatomical characteristics of veins were described in their totality. CT-AR is a useful instrument to identify alterations in anatomical structure of the renal vasculature, with results similar to other studies for description of renal arteries and veins. We propose ATR as the initial study for evaluation of the renal architecture of the live kidney (LKD).

Objective: Our objective was to determine the relationship between reflux of duodenogastric contents with different degrees of esophagitis, and its levels and activity, with regard to the severity of esophagitis-induced duodenogastroesophageal reflux disease (DGERD)., Material and Methods: Our study design was prospective, transversal, descriptive, observational, and open. We took samples of gastric and esophageal juices from patients with a diagnosis of gastroesophageal reflux disease (GERD) and esophagitis during the period from March to August 2002. Sample material was placed in black rubber-covered assay tubes to prevent bilirubin degradation. In our Unit's central laboratory, these samples were centrifuged for 30 min, the dissolved material separated, and a reactive strip was introduced to measure the amount of bile pigment. Endoscopic study reports were provided by this Department on terminating the procedure. Univariate analysis was used to obtain results., Results: In 60% of cases, the esophageal liquid was positive for total bilirubin; 40% presented stage II esophagitis, 27% chronic esophagitis, and 27%, stage I esophagitis. Specific quantifications of total bilirubin at different stages of esophagitis demonstrated in stage II 50% with levels of 0.1-1, 33% with a level of 2-3, in cases of chronic esophagitis 75% with levels of 0.1-1, and with stage I esophagitis, 25% with levels of 2-3 mg/dl. Measurement of gastric pH showed 18 (69%) <3 and esophageal pH of 20 (67%) > 4, with 10 (33%) referring occasional or asymptomatic dyspepsia. We determined presence of duodenal elements in esophagus by means of quantification of total bilirubin in 60% of patients, observing greatest frequency of stage II esophagitis. Low but continuous levels of duodenal, principally biliary, elements continued in patients with DGERD, producing greatest damage in esophageal mucosa.