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Head and neck squamous cell carcinoma (HNSCC) is well known as a serious health problem worldwide, especially in low-income countries or those with limited resources, such as most countries in Latin America. International guidelines cannot always be applied to a population from a large region with specific conditions. This study established a Latin American guideline for care of patients with head and neck cancer and presented evidence of HNSCC management considering availability and oncologic benefit. A panel composed of 41 head and neck cancer experts systematically worked according to a modified Delphi process on (1) document compilation of evidence-based answers to different questions contextualized by resource availability and oncologic benefit regarding Latin America (region of limited resources and/or without access to all necessary health care system infrastructure), (2) revision of the answers and the classification of levels of evidence and degrees of recommendations of all recommendations, (3) validation of the consensus through two rounds of online surveys, and (4) manuscript composition. The consensus consists of 12 sections: Head and neck cancer staging, Histopathologic evaluation of head and neck cancer, Head and neck surgery-oral cavity, Clinical oncology-oral cavity, Head and neck surgery-oropharynx, Clinical oncology-oropharynx, Head and neck surgery-larynx, Head and neck surgery-larynx/hypopharynx, Clinical oncology-larynx/hypopharynx, Clinical oncology-recurrent and metastatic head and neck cancer, Head and neck surgery-reconstruction and rehabilitation, and Radiation therapy. The present consensus established 48 recommendations on HNSCC patient care considering the availability of resources and focusing on oncologic benefit. These recommendations could also be used to formulate strategies in other regions like Latin America countries.

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Resumen El análisis sobre la técnica de los movimientos deportivos desde el estudio de la variabilidad del movimiento es un nuevo acercamiento a la evaluación, diagnóstico y control de las técnicas deportivas. Se conoció de la existencia de diversas investigaciones sobre la técnica del lanzamiento del disco, sin embargo, estas no han enfocado sus análisis desde la variabilidad, ni han ofrecido procedimientos para hacer el análisis desde esta perspectiva. El objetivo de esta investigación es establecer un procedimiento para el estudio de la variabilidad de la técnica en el Lanzamiento de Disco. El estudio se centró en un caso del sexo masculino que cuenta con 15 años y que entrena lanzamiento del disco en la Escuela de Iniciación Deportiva Escolar (Eide) de Villa Clara. Cuba. En la investigación se utilizaron métodos del nivel teórico y empírico tales como el estudio de casos, el estudio biomecánico y el análisis estadístico-matemático. Se logra comprobar que solo dos parámetros mostraron alta variabilidad en los nueve lanzamientos efectuados, mientras que el resto si logra una desviación estándar menor y por tanto poca variabilidad en los movimientos, además, existió una alta satisfacción de los usuarios con el procedimiento utilizado. El índice obtenido al aplicar la técnica IADOV indica que existe satisfacción de los usuarios introductores con los indicadores determinados.

Resumo A análise da técnica dos movimentos esportivos a partir do estudo da variabilidade do movimento é uma nova abordagem para a avaliação, diagnóstico e controle das técnicas esportivas. Sabia-se da existência de várias investigações sobre a técnica do lançamento de disco, porém, estas não focalizaram sua análise a partir da variabilidade, nem ofereceram procedimentos para fazer a análise nesta perspectiva. O objetivo desta pesquisa é estabelecer um procedimento para o estudo da variabilidade da técnica de Lançamento de Disco. O estudo teve como foco um jovem de 15 anos que treina lançamento de disco na Escola de Iniciação ao Esporte Escolar (Eide), em Villa Clara. Cuba. A pesquisa utilizou métodos de nível teórico e empírico como o estudo de caso, o estudo biomecânico e a análise estatística-matemática. É possível verificar que apenas dois parâmetros apresentaram alta variabilidade nos 9 arremessos realizados, enquanto os demais obtiveram menor desvio padrão e, portanto, pouca variabilidade nos movimentos, além disso, houve alta satisfação dos usuários com o procedimento utilizado. O índice obtido pela aplicação da técnica IADOV indica que há satisfação dos usuários introdutores com os indicadores determinados.

Abstract The analysis on the technique of the sport movements from the study of the variability of the movement is a new approach to the evaluation, diagnosis and control of the sport techniques. It was known of the existence of diverse investigations on the technique of the Launching of the Disk, however these they have not focused their analyses from the variability; neither they have offered procedures to make the analysis from this perspective. The objective of this paper is: to establish a procedure for the study of the variability of the technique in the Launching of Disk. The study was centered in a case of the masculine sex that has 15 years and that it trains Launching of the Disk in the School of Initiation Sport Scholar of Villa Clara. Cuba. As the research methods of the theoretical and empiric level were used as the study of cases, the study of the Biomechanics and the statistical-mathematical analysis. it is possible to verify that single two parameters showed high variability in the 9 made launchings, while the rest if it achieves a deviation standard smaller and therefore little variability in the movements, also, a high satisfaction of the users existed with the used procedure. The index obtained when applying the technical IADOV indicates that the introductory users' satisfaction exists with the certain indicators.

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Two dimensions of the ecological niche (diet and habitat) of a snake assemblage from an endemic rich area in east-central Argentina, the Sierras de Ventania mountain chain, were analyzed. Field data collection was performed in 15-week study periods between 2010 and 2014. Snakes were hand-captured using transect surveys. Field observations on diet were analyzed together with stomach content data from museum specimens. Our results supported the partitioning of the snake assemblage by both habitat use and diet into at least three functional groups: species restricted to microhabitats under rocks and with a diet composed exclusively of ants (Epictia australis); species found mostly in stream microhabitats and feeding mainly upon anurans (Erythrolamprus poecilogyrus and Lygophis elegantissimus); and species found mostly in grassland microhabitats, with specialized diets of terrestrial prey items (Philodryas patagoniensis and Bothrops alternatus). Consistent with previous work, diet was more important than habitat in explaining ecological niche partitioning of this snake assemblage. Our results showed that high overlap values of microhabitat use were compensated by low overlap values of the trophic niche dimension, thus matching the traditional complementary niches hypothesis.

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El procedimiento de histerectomía abdominal total electiva representa una de las intervenciones quirúrgicas más frecuentes en ginecología a nivel mundial siendo sus principales indicaciones la fibromatosis, la endometriosis y el prolapso de órganos pélvicos, las cuales son responsables del 80% de las histerectomías realizadas alrededor del mundo. Dicho procedimiento es realizado con mayor frecuencia en las mujeres entre 40-60 años. Como en todo procedimiento quirúrgico pueden ocurrir ciertas complicaciones, tales como: la infección del sitio quirúrgico, la hemorragia severa, la lesión de órganos vecinos, entre otras (Carpio Luis, 2009). El presente trabajo de investigación describió el perfil clínico epidemiológico de las pacientes sometidas a histerectomía abdominal total electiva por técnica abierta en el Hospital Nacional de la Mujer "Dra. María Isabel Rodríguez", así como sus principales indicaciones y complicaciones asociadas. Dicho estudio fue de tipo descriptivo y se realizó en el centro nosocomial antes mencionado durante el período de julio 2017 a junio 2018.

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We report the case of a 37-year-old woman with no relevant medical history. She was admitted to the hospital for epigastric pain related with food intake for 4 days; the pain did not improve with symptomatic management. A laparoscopic cholecystectomy due to acute lithiasic cholecystitis was performed. However, after 4 days, postoperative painless jaundice was evident; thus, endoscopic retrograde cholangiopancreatography was performed, which revealed an amputation of intrapancreatic common bile duct, as well as secondary intra- and extrahepatic bile duct dilatation. Brushing of the distal portion of the common bile duct revealed a well-differentiated adenocarcinoma. Therefore, a Whipple procedure with pylorus preservation was performed. Pathologic diagnosis of a papillary in situ adenocarcinoma with two microscopic foci of microinvasion was established. The pathologic Tumor-Node-Metastasis (TNM) stage was pT1, pN0, pM0, R0. The patient is asymptomatic and disease-free 24 months after surgery. In general, adenocarcinomas of the extrahepatic bile ducts are uncommon and have a poor prognosis. However, symptomatic patients with early disease stages are even rarer and can be cured surgically.

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Abstract Introduction: Most of the studies that have examined cognitive and executive functions in conduct disorders (CD) have been conducted on institutionalized male adolescents. In this research the cognitive and executive functions of non-institutionalized Colombian school children with CD were compared with normal school children, all between 6 and 12 years-old. Materials and methods: We used a case-control design. The cases were participants who met the diagnostic criteria for CD (n=39) and controls who did not meet these criteria (n=39), according to reports of a professional of the participants' institution, and a structured interview for childhood psychiatric syndromes. The two groups were selected from educational institutions, and there were no differences in age, school grade, or socioeconomic level. The IQ was reviewed, as well as the presence of other mental disorders, serious physical illnesses, and more serious neurological signs.The cognitive and executive functions were evaluated using a child neuropsychological test battery. Results: We found that participants with CD had significantly lower scores in construction abilities, perceptual abilities (tactile, visual and auditory), differed in verbal memory, differed in visual memory, language (repetition, expression and understanding), meta-linguistic abilities, spatial abilities, visual and auditory attention, conceptual abilities, verbal and graphic fluency, and cognitive flexibility. The same differences were found between males, except in repetition, whereas girls showed fewer differences, thus the cognitive and executive performance was poorer in males with CD than in females, especially in verbal and linguistic-related functions. Conclusions: Children with CD could show generalized cognitive and executive deficits. These deficits seem to be more frequent in boys than in girls with CD.

Resumen Introducción: La mayoría de los estudios que han examinado las funciones cognitivas y ejecutivas en el trastorno disocial (TD) se han llevado a cabo con adolescentes varones institucionalizados. En esta investigación, se compararon las funciones cognitivas y ejecutivas de escolares colombianos no institucionalizados con TD con las de escolares normales, todos entre 6 y 12 años de edad. Materiales y métodos: Se utilizó un diseño de casos y controles, en el que los casos eran los participantes que cumplían los criterios diagnósticos de TD (n = 39) y los controles, aquellos que no cumplían estos criterios (n = 39), de acuerdo con el reporte de un profesional de la institución de los participantes y una entrevista estructurada de síndromes psiquiátricos infantiles. Los dos grupos fueron seleccionados de instituciones educativas y no diferían en edad, grado escolar y nivel socioeconómico. El CI fue controlado, así como la presencia de otros trastornos mentales, enfermedades físicas graves y signos neurológicos mayores. Las funciones cognitivas y ejecutivas fueron evaluadas a través de una batería neuropsicológica infantil. Resultados: Los participantes con TD presentaron puntuaciones significativamente más bajas en habilidades construccionales, habilidades perceptuales (táctiles, visuales y auditivas), memoria verbal diferida, memoria visual diferida, lenguaje (repetición, expresión y comprensión), habilidades metalingüísticas, habilidades espaciales, atención visual y auditiva, habilidades conceptuales, fluidez verbal y gráfica y flexibilidad cognitiva. Estas mismas diferencias se encontraron entre los varones entre sí, excepto en repetición, mientras que las niñas presentaron menos diferencias entre sí, de manera que el desem peño cognitivo y ejecutivo fue más bajo entre los varones que entre las niñas con TD, especialmente en funciones verbales y relacionadas con el lenguaje en general. Conclusiones: Los niños con TD podrían presentar déficits cognitivos y ejecutivos generalizados, que parecen ser mayores entre los niños que entre las niñas con dicho trastorno.

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INTRODUCTION: Most of the studies that have examined cognitive and executive functions in conduct disorders (CD) have been conducted on institutionalized male adolescents. In this research the cognitive and executive functions of non-institutionalized Colombian school children with CD were compared with normal school children, all between 6 and 12 years-old. MATERIALS AND METHODS: We used a case-control design. The cases were participants who met the diagnostic criteria for CD (n=39) and controls who did not meet these criteria (n=39), according to reports of a professional of the participants' institution, and a structured interview for childhood psychiatric syndromes. The two groups were selected from educational institutions, and there were no differences in age, school grade, or socioeconomic level. The IQ was reviewed, as well as the presence of other mental disorders, serious physical illnesses, and more serious neurological signs. The cognitive and executive functions were evaluated using a child neuropsychological test battery. RESULTS: We found that participants with CD had significantly lower scores in construction abilities, perceptual abilities (tactile, visual and auditory), differed in verbal memory, differed in visual memory, language (repetition, expression and understanding), meta-linguistic abilities, spatial abilities, visual and auditory attention, conceptual abilities, verbal and graphic fluency, and cognitive flexibility. The same differences were found between males, except in repetition, whereas girls showed fewer differences, thus the cognitive and executive performance was poorer in males with CD than in females, especially in verbal and linguistic-related functions. CONCLUSIONS: Children with CD could show generalized cognitive and executive deficits. These deficits seem to be more frequent in boys than in girls with CD.

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