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Academic Stress Assessment Using Virtual Reality as an Educational Tool in Spine Surgery

Open Journal of Modern Neurosurgery 2024年第2期14卷 114-123页

作者： Diana Chávez Lizárraga Jesús Alberto Pérez Contreras Fernando Alvarado Gómez evelyn quintero medina Emmanuel Cantú Chávez Iván Ulises Sámano López Ana Sofía Peña Blesa Department of Neurosurgery ángeles Pedregal Ciudad de México México Department of Traumatology and Orthopedics Hospital Santa Fe Bogotá Colombia

Introduction: The evaluation of academic stress in medical students and residents is a topic of significant interest, given the considerable challenges they face during their learning process with traditional teaching methods. The use of technologies like virtual reality presents an opportunity to enhance their skills through simulations and training. The main objective of this study is to qualitatively assess the stress levels experienced by medical students and residents by integrating virtual reality into their current learning methods, aiming to improve their ability to manage stressors in their practice. Material and Methods: A questionnaire was conducted with 12 medical students and 12 Traumatology and orthopedics residents. The purpose of the questionnaire was to evaluate the levels of academic stress using the SISCO inventory. The stress levels were calculated by transforming average values into percentages, and the following criteria were assigned: 0 to 33% for Mild Stress, 34 to 66% for Moderate Stress, and 67 to 100% for Deep Stress. Then, a virtual reality class focused on spine surgery was provided. Both medical students and residents were trained using the Non Nocere SharpSurgeon software platform and Oculus Quest 2 virtual reality glasses. At the end of the session, a second questionnaire related to the practice with virtual reality was conducted with the same evaluation criteria and a comparative analysis was carried out. Results: 12 undergraduate students from Hospital Angeles Mexico, CDMX and 12 traumatology and orthopedics residents at Hospital Santa Fe, Bogota were evaluated. The students in CDMX reported an average qualitative stress of 28.50% during habitual practices, which decreased to an average of 14.67% after virtual reality practice. Residents in Bogotá experienced an average qualitative stress of 30.50% with their current learning methods but this reduced to an average of 13.92% after using virtual reality. These findings indicate that t

关键词： Virtual Reality Academic Stress Learning Strategies Spine Surgery Training

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Fulminant Hepatitis Associated with Chronic Consumption of 3,4-Methylenedioxy-Methamphetamine;Case Report

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Open Journal of Gastroenterology 2024年第5期14卷 161-166页

作者： Ulises Solis Gomez Gustavo Adolfo Hernández Valdez Juan Antonio Contreras Escamilla Ivan Alejandro medina Jimenez Jorge Morales Rojas Jocelyn Nataly quintero Melendez Marco Antonio González Villar Department of Internal Medicine ISSSTE APP General Hospital of Tepic Tepic Nayarit Mexico

The amphetamine derivative 3,4-methylenedioxymethamphetamine (MDMA), also called ecstasy, is a neurotoxin widely consumed among young people that has increased in recent years because it is a recreational drug, of which immediate effects are known such as a greater sensation of well-being, extroversion, increased sensory perception. However, its long-term effects have been described very little in the medical literature, including damage to the heart, central nervous system, kidney, etc. One of its little-known effects is hepatotoxicity, of which few cases are known associated with fulminant hepatitis, which is a rapidly deteriorating condition that is generally associated with a syndrome of multiple organ dysfunction and death. Therefore, it is very important to know this type of damage in the short and long term. The following case is of a 39-year-old man who came to our service due to jaundice syndrome and the only history of MDMA consumption, who as the days went by met the criteria for fulminant liver failure, with damage to multiple organs (organ dysfunction syndrome).

关键词： Fulminant Hepatitis Acute Liver Failure Methamphetamine Severe Acute Liver Failure in a User of Drugs of Abuse Hepatology

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Uremic Bleeding in 2 Patients with Dieulafoy’s Lesion: Case Report and Literature Review

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Open Journal of Gastroenterology 2024年第5期14卷 167-173页

作者： Gustavo Adolfo Hernández Valdez Diana Estefanía Ibarra García Juan Antonio Contreras Escamilla Janette Alejandra Gamiño Gutierrez Francisco Manuel Tonatiuh Carrillo Beltran Ulises Solis Gomez Jocelyn Nataly quintero Meléndez Ivan Alejandro medina Jimenez Marco Antonio González Villar Jorge Rojas Morales Department of Internal Medicine ISSSTE APP General Hospital of Tepic Tepic Nayarit Mexico Hospital Civil de Guadalajara Fray Antonio Alcalde Guadalajara Jalisco M&#233xico

Dieulafoy’s lesions are rare vascular malformations of the gastrointestinal tract. A Dieulafoy’s lesion is an aberrant vessel that does not reduce in caliber when it extends from the submucosa to the mucosa. Damage to this artery can cause severe and intermittent arterial bleeding from small vascular stumps that are difficult to visualize. Furthermore, these catastrophic bleeding episodes frequently result in hemodynamic instability and the need for transfusion of multiple blood products. Recently, uremic syndrome has been identified as a risk factor for gastric mucosal lesions. We present two clinical cases of acute digestive bleeding due to Dielafoy lesion with chronic kidney disease as the main cause, where two different therapies were performed endoscopically. We concluded with the results of our patients that the best therapy was the application of the hemostatic hemoclip on the injury vs the injection with adrenaline on the wound site. Uremia is identified as a risk factor for upper gastrointestinal bleeding in patients with pre-existing Dieulafoy’s lesion, as well as a higher incidence of new bleeding.

关键词： Dieulafoy’s Lesion Gastrointestinal Bleeding Endoscopy Endoscopy Hemostatic Clips Kidney Disease Adrenaline Thermal Coagulation Dieulafoy

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Ventriculo-atrial shunt with occlusion of the internal jugular vein: operative experience and surgical technique

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中华神经外科杂志(英文) 2024年第2期10卷 1-8页

作者： quintero Silvia Tatiana Ramirez-Velandia Felipe Moreno Andres Felipe Hortua Vera Lina Rugeles Paula Gonzalez Rafael Augusto Azuero Pontificia Universidad Javeriana Clinica Medilaser S.A.S. Clinica Chicamocha Bucaramanga Santander Colombia Neurology and Neurosurgery Research Group Pontificia Universidad Javeriana Bogotá D.C. Colombia Universidad Industrial de Santander Clinica Chicamocha Bucaramanga Colombia Universidad Autónoma de Bucaramanga Clinica Chicamocha Bucaramanga Colombia Clinica Chicamocha Bucaramanga Santander Colombia

Background Ventricular shunts are one of the most frequent techniques used for the management of hydrocephalus. The ventriculoperitoneal shunt (VPS) is the most commonly performed procedure, and the ventriculoatrial shunt (VAS) is the second option in most medical centers. The main objective of this study is to introduce and describe a surgical approach for VAS outlining our experience and comparing it with traditional shunting *** In this retrospective cohort comparison study, we included patients with hydrocephalus treated with a surgical procedure between January 2010 and February 2021 at a single academic institution. We categorized the procedures into two groups: patients with VPS and conventional VAS grouped together into the conventional technique (CT) group, and the second group was patients with whom we performed VAS with complete internal jugular vein occlusion (IJVOT). We compared the surgical time, postoperative complications, and occurrence of shunt failure among the groups by performing univariate analysis using the Fisher exact *** Out of the 106 patients included in the analysis, IJVOT was performed in 66 patients, and CT in 40 patients. The median surgical time was 60 min (IQR 60-90) for IJVOT versus 100 min (IQR 60-120) for CT (p < 0.01). In the follow-up a month after the procedure, 83.3% of patients with IJVOT and 62.5% of patients with CT did not require shunt removal or shunt revision (p < 0.01). Shunt revision rates were 12.5% and 1.5% for CT while 1.5% and 2.5% for IJVOT at 1 and 6 months after the *** Our findings demonstrate that VAS with IJVOT is a safe method that exhibited shorter surgical times and outcomes comparable to CT. However, since the present study represents the first cohort evaluating IJVOT, it is imperative to conduct larger prospective studies, along with clinical trials, to fully explore and establish efficacy, long-term outcomes, and an in-depth comparison among shunting techniques

关键词： Hydrocephalus Ventriculoatrial shunting Internal jugular vein Operative time Complications Shunt removal

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Neuropsychological Profile of a Patient with Acquired Brain Damage Following Vascular Lesion of the Left Anterior Cingulate Cortex

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Neuroscience & Medicine 2024年第1期15卷 66-75页

作者： Jimmy Zúñiga-Márquez Lina Borda-Camargo Diego Buitrago-Mora Lorely Guerra-Valdés Laura González Patricia quintero-Cusgüen Nataly Gutierrez-Ávila Hospital Universitario de la Samaritana Bogotá Colombia Neuropsychological Assessment and Diagnosis Graduate Program School of Psychology Universidad San Buenaventura Bogotá Bogotá Colombia

Stroke is a physiological alteration associated with changes in blood flow that can result in sudden-onset cognitive impairment. It has a heterogenous clinical presentation with varying degrees of severity correlated with specific central nervous system zones or areas, and its prognosis is uncertain. This case study describes a 62-year-old male patient with acquired brain damage of the anterior cingulate cortex as a result of an ischemic event in the territory of the left anterior cerebral artery. Cognitive function was assessed using the neuropsychological executive function and frontal lobe test battery (BANFE-2) as well as other neuropsychological tests. The results show a profile of higher mental functions characterized by the presence of dysexecutive syndrome with marked behavioral alteration and diencephalic amnesia. .

关键词： Ischemic Stroke Anterior Cingulate Cortex Neuropsychology Acquired Brain Damage

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Body Contour in the Post-Bariatric Male Patient

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Modern Plastic Surgery 2024年第2期14卷 15-22页

作者： Erick Zúñiga-Garza Israel Salgado-Adame Claudio D. Rojas-Gutiérrez Laura María Rodríguez-Barrios Guillermo Álvarez-Sánchez Eduardo Camacho-quintero Department of Plastic Surgery National Medical Center &#822020 de Noviembre&#8221 Mexico City Mexico

Background: Obesity is currently considered a public health problem. Bariatric procedures have become an important part of obesity management and, consequently, the number of male patients seeking post-bariatric reconstructive procedures have increased. Therefore, the clinical approach and understanding of the body contour of this population have become more relevant. The goal of post-bariatric reconstruction is to enhance the male silhouette through removal of skin and adipose tissue excess, and abdominal rectus diastasis repair. Material and Methods: We conducted a retrospective study at the Plastic and Reconstructive Surgery Department of the National Medical Center “20 de Noviembre”. All male patients referred to our department to start a post-bariatric reconstruction protocol from January 2018 to December 2022 were included in this study. Results: In total, 15 patients who underwent corporal contouring procedures were included;median age was 49.2 years with minimum of 33 years, and a maximum of 57 years. Median Body mass index was 28.4 kg/m2 with minimum of 22 kg/m2 and maximum of 38 kg/m2. All patients were treated 18 months after their bariatric surgery. All patients underwent an abdominoplasty as a body contouring procedure. 4 (26.7%) patients presented complications related to the surgery. Conclusion: We described a comprehensive and systematic approach to massive weight loss for male patients, suggesting an abdominal marking based on the patient’s clinical features and the expected results avoiding feminization of the abdominal body contour.

关键词： Massive Weight Loss Post-Bariatric Male Abdominoplasty Contouring

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Attenuation of dextran sodium sulphate induced colitis in matrix metalloproteinase-9 deficient mice

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World Journal of Gastroenterology 2006年第40期12卷 6464-6472页

作者： Alfredo Santana Carlos medina Maria Cristina Paz-Cabrera Federico Díaz-Gonzalez Esther Farré Antonio Salas Marek W Radomski Enrique quintero Gastroenterology Department and Research Unit Hospital Universitario de Canarias Tenerife Spain Reumathology Department Hospital Universitario de Canrias Tenerife Spain Pathology Department Hospital Mutua de Terrassa Barcelona Spain Institute of Molecular Medicine University of Texas Houston-Texas United States

AIM: To study whether matrix metalloproteinase-9 (MMP-9) is a key factor in epithelial damage in the dextran sodium sulphate (DSS) model of colitis in ***: MMP-9-deficient and wild-type (wt) mice were given 5% DSS in drinking water for 5 d followed by recovery up to 7 d. On d 5 and 12 after induction of colitis, gelatinases, MMP-2 and MMP-9, were measured in homogenates of colonic tissue by zymography and Western blot, whereas tissue inhibitor of metalloproteinases (TIMPs) were measured by reverse zymography. The gelatinolytic activity was also determined in supernatants of polymorphonuclear leukocytes (PMN) isolated from mice blood. Moreover, intestinal epithelial cells were stimulated with TNF-α to study whether these cells were able to produce MMPs. Finally, colonic mucosal lesions were measured by microscopic examination. RESULTS: On d 5 of colitis, the activity of MMP-9 was increased in homogenates of colonic tissues (0.24 ± 0.1 vs 21.3 ± 6.4, P < 0.05) and PMN from peripheral blood in wt (0.5 ± 0.1 vs 10.4 ± 0.7, P < 0.05), but not in MMP-9-deficient animals. The MMP-9 activity was also up-regulated by TNF-α in epithelial intestinal cells (2.5 ± 0.5 vs 14.7 ± 3.0, P < 0.05). Although colitis also led to increase of TIMP-1 activity, the MMP-9/TIMP-1 balance remained elevated. Finally, in the MMP-9-deficient colitic mice both the extent and severity of intestinal epithelialinjury were significantly attenuated when compared with wt mice. CONCLUSION: We conclude that DSS induced colitis is markedly attenuated in animals lacking MMP-9. This suggests that intestinal injury induced by DSS is modu-lated by MMP-9 and that inhibition of this gelatinase may reduce inflammation.

关键词： Matrix metalloproteinases MMP-9-deficient Dextran sodium sulphate Inflammatory bowel disease Experimental colitis

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Identification of ta-siRNAs and Cis-nat-siRNAs in Cassava and Their Roles in Response to Cassava Bacterial Blight

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Genomics, Proteomics & Bioinformatics 2013年第3期11卷 172-181页

作者： Andrés quintero Alvaro L. Pérez-quintero Camilo López Departamento de Biología Universidad Nacional de Colombia

Trans-acting small interfering RNAs （ta-siRNAs） and natural cis-antisense siRNAs （cisnat-siRNAs） are recently discovered small RNAs （sRNAs） involved in post-transcriptional gene silencing, ta-siRNAs are transcribed from genomic loci and require processing by microRNAs （miRNAs）. cis-nat-siRNAs are derived from antisense RNAs produced by the simultaneous tran- scription of overlapping antisense genes. Their roles in many plant processes, including pathogen response, are mostly unknown. In this work, we employed a bioinformatic approach to identify ta-siRNAs and cis-nat-siRNAs in cassava from two sRNA libraries, one constructed from healthy cassava plants and one from plants inoculated with the bacterium Xanthomonas axonopodis pv. manihotis （Xam）. A total of 54 possible ta-siRNA loci were identified in cassava, including a homo- log of TAS3, the best studied plant ta-siRNA. Fifteen of these loci were induced, while 39 were repressed in response to Xam infection. In addition, 15 possible c/s-natural antisense transcript （cis-NAT） loci producing siRNAs were identified from overlapping antisense regions in the genome, and were found to be differentially expressed upon Xam infection. Roles of sRNAs were predicted by sequence complementarity and our results showed that many sRNAs identified in this work might be directed against various transcription factors. This work represents a significant step toward understanding the roles of sRNAs in the immune response of cassava.

关键词： ta-siRNA nat-siRNA Natural antisense transcriptCassava Xanthomonas

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Light Induced Inhibition of Protein Phosphatase Calcineurin

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Chinese Journal of Chemistry 2014年第10期32卷 1011-1014页

作者： Andres quintero Weilin Lin Sophia Hermann Yixin Zhang BCUBE Center for Molecular Bioengineering Technische Universität DresdenArnoldstrasse 1801307 DresdenGermany

Light-induced switching of drug activity can be used to realize spatio-temporal control of biological activity in cells and in *** our study of light-switchable derivatives of immunosuppressive drug cyclosporin A(CsA)in their inhibition of protein phosphatase calcineurin(CaN),we have discovered that 7-methyl-6-thioguanosine(MESG)inhibits CaN under light irradiation through a photo-crosslinking *** inhibition has shown selectivity over other enzymes such as phosphatase PP2A,protease chymotrypsin,and cyclophilin 18,the receptor protein for *** discovery could pave the way to discover new covalent inhibitors for protein phosphtase,to design immunophilin-independent CaN inhibitors,and to design new light controlled inhibitors to modulate signal transduction.

关键词： inhibitor photo-switching immunosuppression calcineurin phosphatase

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气候紧急状态下遗产地保护数字工作流程的机遇与挑战

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中国文化遗产 2024年第1期119卷 50-55页

作者：郑宇马里奥·桑塔纳·坤泰洛卡尔顿大学卡尔顿沉浸式媒体工作室加拿大渥太华K1S 5B6

本文深入探讨了数字工作流程为遗产地应对日益严重的气候变化影响所带来的机遇和挑战,以及需要采取更多样化的方法来帮助确定适应气候变化的优先事项,将遗产保护视为可持续发展和减缓气候变化的驱动力。特别提出使用数字技术来记录易受... 详细信息

本文深入探讨了数字工作流程为遗产地应对日益严重的气候变化影响所带来的机遇和挑战,以及需要采取更多样化的方法来帮助确定适应气候变化的优先事项,将遗产保护视为可持续发展和减缓气候变化的驱动力。特别提出使用数字技术来记录易受气候变化现象影响的遗产地的必要性,这些遗产地由于缺乏世界范围的重视和传统遗产保护框架的认可而未被研究。

关键词：数字技术遗产记录有计划的保护遗产地保护气候行动气候紧急状态

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