Resumen Introducción: La Hidatidosis hepática es una zoonosis endémica en Chile, siendo la región de Aysén la de mayor incidencia. El manejo de la enfermedad quística hepática se basa en la Clasificación de la OMS, que determina la indicación quirúrgica. Materiales y Método: Estudio de serie de casos de pacientes operados de quiste hidatídico hepático mediante quistectomía parcial laparoscópica, entre los años 2005 y 2022, en el Hospital Regional Coyhaique, utilizando una técnica quirúrgica estandarizada. Resultados: 133 pacientes, con un total de 165 quistes operados. El 70% eran lesiones OMS tipo 1 y 2, con diámetro promedio de 9,5 cm. Tiempo operatorio promedio 92 minutos. La tasa de complicaciones intraoperatorias fue de 3,7% y de conversión a cirugía abierta 11%. La morbilidad global fue de 35%, destacando la presencia de la fístula biliar con un 21%. El 83% de las complicaciones fueron Clavien I, II y IIIb. No hubo mortalidad en la serie. Conclusión: La quistectomía parcial laparoscópica es una técnica adecuada y segura para el tratamiento del quiste hidatídico hepático, especialmente, en centros de Cirugía General.

Introduction: Hepatic hydatidosis is an endemic zoonosis in Chile; Aysén region have the highest incidence. Management of cystic liver disease is based on the WHO Classification, which determines the surgical indication. Materials and Method: Case series study of patients operated on for hepatic hydatid cyst by laparoscopic partial cystectomy, between 2005 and 2022, at the Coyhaique Regional Hospital, using a standardized surgical technique. Results: 133 patients, with a total of 165 operated cysts. 70% were WHO type 1 and 2 lesions, with an average diameter of 9.5cm. Average operating time 92 minutes. The intraoperative complication rate was 3.7% and conversion to open surgery was 11%. Global morbidity was 35%, highlighting the presence of biliary fistula with 21%. 83% of the complications were Clavien I, II and IIIb. There was no mortality in the series. Conclusion: Laparoscopic partial cystectomy is an adequate and safe technique for the treatment of hepatic hydatid cyst, especially in General Surgery centers.

Resumo A tripanossomose bovina, causada por Trypanosoma vivax, é uma doença que teve origem na África, e atualmente, afeta bovinos em diversos países da América do Sul, incluindo quase todos os estados brasileiros. Apesar dos relatos de infecção por T. vivax, no sul do Brasil, dados sobre seu status de circulação não estão disponíveis atualmente. Neste estudo, o objetivo foi detectar anticorpos IgG anti-Trypanosoma spp. em bovinos do Rio Grande do Sul e sugerir possíveis áreas de risco de transmissão de T. vivax. Foi analisado um total de 691 amostras de soro de bovinos, das regiões intermediárias do Rio Grande do Sul, usando-se o ensaio de imunofluorescência indireta (IFA). A soroprevalência geral de anticorpos anti-Trypanosoma em bovinos foi de 24,6% (170/691). A taxa de detecção variou de 0 a 37,3%, com uma alta prevalência nas regiões intermediárias de Ijuí (37,3%), Uruguaiana (30,7%) e Passo Fundo (28,9%). Portanto, essas regiões foram sugeridas como possíveis áreas de risco para a tripanossomose bovina, devido à alta soroprevalência. Este é o primeiro estudo sorológico a determinar o status de infecção por Trypanosoma spp., em bovinos do Rio Grande do Sul, fornecendo dados sobre a epidemiologia da tripanossomose no estado. bovina vivax África atualmente brasileiros T Brasil antiTrypanosoma anti spp 69 usandose usando se IFA. IFA . (IFA) 246 24 6 24,6 170/691. 170691 170/691 170 (170/691) 373 37 3 37,3% , (37,3%) 30,7% 307 30 7 (30,7% 28,9%. 289 28,9% 28 9 (28,9%) Portanto estado (IFA 2 24, 17069 170/69 17 (170/691 37,3 (37,3% 30,7 (30,7 28,9 (28,9% 1706 170/6 1 (170/69 37, (37,3 30, (30, 28, (28,9 170/ (170/6 (37, (30 (28, (170/ (37 (3 (28 (170 ( (2 (17 (1

Abstract Bovine trypanosomosis, caused by Trypanosoma vivax, is a disease that originated in Africa and currently affects cattle in several South American countries, including almost all Brazilian states. Despite the reports on T. vivax infection in southern Brazil, data on its circulation status is currently unavailable. In this study, we aimed to detect anti-Trypanosoma spp. IgG antibodies in cattle from Rio Grande do Sul and suggest areas with T. vivax transmission risk. A total of 691 serum samples from cattle in the intermediate regions of Rio Grande do Sul were analyzed using indirect immunofluorescence assay (IFA). The overall seroprevalence of anti-Trypanosoma antibodies in cattle was 24.6% (170/691). The detection rate ranged from 0-37.3%, with a high prevalence in the intermediate regions of Ijuí (37.3%), Uruguaiana (30.7%), and Passo Fundo (28.9%). Thus, these regions were suggested as possible bovine trypanosomosis risk areas due to the high seroprevalence. This is the first serological study to determine Trypanosoma spp. infection status in cattle from Rio Grande do Sul, providing data on the epidemiology of trypanosomosis in the state. countries states T Brazil unavailable antiTrypanosoma anti spp 69 IFA. IFA . (IFA) 246 24 6 24.6 170/691. 170691 170/691 170 (170/691) 037.3%, 0373 0 37.3%, 37 3 0-37.3% 373 37.3% , (37.3%) 30.7%, 307 30.7% 30 7 (30.7%) 28.9%. 289 28.9% 28 9 (28.9%) Thus state (IFA 2 24. 17069 170/69 17 (170/691 037 037.3% 0-37.3 37.3 (37.3% 30.7 (30.7% 28.9 (28.9% 1706 170/6 1 (170/69 03 037.3 0-37. 37. (37.3 30. (30.7 28. (28.9 170/ (170/6 037. 0-37 (37. (30. (28. (170/ 0-3 (37 (30 (28 (170 0- (3 (2 (17 ( (1

Abstract Background Streptococcus pneumoniae bacteremia may result in Infective Endocarditis (IE). In the pre-antibiotic era, it caused 10 %‒15 % of IE, decreasing to < 3 % after penicillin availability. Although infrequent, it causes aggressive disease. Methods Retrospective analysis of endocarditis databases, prospectively implemented in 4 Brazilian institutions, 2005‒2023. Results From the prospective cohorts comprising 2321 adult patients with IE, we identified 11 (0.47%) with pneumococcal IE. Males represented 7/11 and mean age was 54 years (22‒77). All had native valve involvement; perivalvular abscess was present in 6/11. Only one patient had concurrent meningitis. Beta-lactams were the antibiotics used in 10/11. All had surgical indication, but only 6 had it, as the others were seriously ill. Overall, in hospital mortality was 6/11, but only 1/6 of those who underwent surgery died, compared to 5/5 of those who had an indication for surgery and did not have it. Conclusions The high mortality rates and need for surgical intervention emphasize the need to promptly identify and manage pneumococcal endocarditis. Physicians ought to recommend vaccination to all patients at risk for severe pneumococcal disease. IE . (IE) preantibiotic pre antibiotic era 1 15 %‒1 availability infrequent disease databases institutions 20052023 2005 2023 2005‒2023 232 0.47% 047 0 47 (0.47% 711 7 7/1 5 22‒77. 2277 22‒77 22 77 (22‒77) involvement 611 6/11 meningitis Betalactams Beta lactams 1011 10/11 ill Overall 16 1/ died 55 5/ (IE %‒ 2005202 200 202 2005‒202 23 0.47 04 (0.47 71 7/ 227 22‒7 2 (22‒77 61 6/1 101 10/1 200520 20 2005‒20 0.4 (0.4 22‒ (22‒7 6/ 10/ 20052 2005‒2 0. (0. (22‒ 2005‒ (0 (22 ( (2

Abstract This work focused on the development of competencies using information and communication technologies (TIC), and in a particular way on the use of GeoGebra (educational software) as a teaching-learning strategy of mathematics in secondary education students. The research design was quasi-experimental in nature; it allowed inferring the causal relationships between variables, one independent and two dependents. The sample was made up of 60 students from two groups of the seventh grade of the José Miguel de Restrepo y Puerta Educational Institution, in the municipality of Copacabana, Colombia, whose ages ranged between 12 and 15 years, and who took the subject of Mathematics, a course where the GeoGebra software package and other IT tools were implemented for the experimental group. Among the results stands out the value of ICT for teaching geometric concepts and the development of spatial thinking, as well as for students to acquire skills necessary for life.

Resumen El presente trabajo se enfocó en el desarrollo de competencias mediante el uso de las tecnologías de la información y la comunicación (TIC), y de manera particular en el uso de GeoGebra (software educativo) como estrategia de enseñanza-aprendizaje de las matemáticas en alumnos de educación secundaria. El diseño de la investigación fue de carácter cuasiexperimental; permitió inferir las relaciones causales entre variables, una independiente y dos dependientes. La muestra estuvo integrada por 60 estudiantes de dos grupos del grado séptimo del Institución Educativa José Miguel de Restrepo y Puerta, del municipio de Copacabana, Colombia, cuyas edades oscilaban entre los 12 y 15 años, y quienes cursaron la asignatura de Matemáticas, curso donde se implementó, para el grupo experimental, el uso del paquete informático GeoGebra y otras herramientas informáticas. Entre los resultados destaca la valía de las TIC para la enseñanza de conceptos geométricos y el desarrollo del pensamiento espacial, así como para que los estudiantes adquieran competencias necesarias para la vida.

Resumo Este trabalho centrou-se no desenvolvimento de competências através da utilização de tecnologias de informação e comunicação (TIC) e, de forma particular, na utilização do GeoGebra (software educacional) como estratégia de ensino-aprendizagem de matemática no ensino secundário de alunos. O desenho da pesquisa era de natureza quase experimental; permitiu inferir as relações causais entre as variáveis, uma independente e duas dependentes. A amostra foi composta por 60 alunos de duas turmas da sétima série da Instituição de Ensino José Miguel de Restrepo y Puerta, do município de Copacabana, Colômbia, com idades variando entre 12 e 15 anos, e que cursaram a disciplina de Matemática , um curso onde foi implementado o uso do pacote de software GeoGebra e outras ferramentas de TI para o grupo experimental. Entre os resultados destaca-se o valor das TIC para o ensino de conceitos geométricos e o desenvolvimento do pensamento espacial, bem como para que os alunos adquiram competências necessárias à vida.

Resumo Este artigo se concentra no estudo dos processos de formação de professores de educação rural que atuam na região de Tequendama, departamento de Cundinamarca (Colômbia), especificamente em três instituições localizadas no município de San Antonio del Tequendama. Este objeto de análise foi escolhido devido à necessidade de estudar a formação de professores tanto nos aspectos pedagógicos como na utilização de ferramentas tecnológicas, conhecimentos essenciais para melhorar a qualidade da formação nos diversos níveis de ensino. Los participantes, elegidos por conveniencia, fueron 90 maestros y maestras que laboraban en el año lectivo 2019. Para recabar la información se empleó una encuesta constituida por 27 preguntas en las que se relacionaron la formación del docente rural y el conocimiento y uso de las TIC na aula. Os resultados mostram, em termos de TIC, que estes meios tecnológicos são utilizados pelos professores mais para fins particulares e pessoais do que pedagógicos, pelo que não tiveram o impacto esperado nos processos de ensino-aprendizagem. Além disso, deve-se destacar que neste trabalho foi demonstrado que os professores não foram capacitados para atuar no meio rural, ambientes em que existem particularidades e necessidades muito distintas das do meio urbano.

Abstract This paper focuses on the study of the training processes of rural education teachers who work in the Tequendama region, department of Cundinamarca (Colombia), specifically in three institutions located in the municipality of San Antonio del Tequendama. This object of analysis was chosen due to the need to study teacher training both in pedagogical aspects and in the use of technological tools, essential knowledge to improve the quality of training at various educational levels. The participants, chosen for convenience, were 90 teachers who worked in the 2019 school year. To collect the information, a survey consisting of 27 questions was used in which the training of rural teachers and the knowledge and use of ICT were related. in the classroom. The results show, in terms of ICT, that these technological means are used by teachers more for private and personal purposes than pedagogical, so they have not had the expected impact within the teaching-learning processes. In addition, it should be noted that in this work it has been shown that teachers have not been trained for work in rural areas, environments in which there are particularities and needs that are very different from those of urban areas.

Resumen El presente trabajo se enfoca en el estudio de los procesos formativos de docentes de educación rural que laboran en la región del Tequendama, departamento de Cundinamarca (Colombia), específicamente en tres instituciones ubicadas en el municipio de San Antonio del Tequendama. Este objeto de análisis fue elegido debido a la necesidad que existe de estudiar la formación docente tanto en aspectos pedagógicos como en el uso de las herramientas tecnológicas, conocimientos esenciales para mejorar la calidad formativa en los diversos niveles educativos. Los participantes, elegidos por conveniencia, fueron 90 maestros y maestras que laboraban en el año lectivo 2019. Para recabar la información se empleó una encuesta constituida por 27 preguntas en las que se relacionaron la formación del docente rural y el conocimiento y uso de las TIC en el aula. Los resultados demuestran, en cuanto a las TIC, que esos medios tecnológicos son usados por los docentes más para fines particulares y personales que pedagógicos, por lo que no han tenido el impacto esperado dentro de los procesos de enseñanza-aprendizaje. Además, cabe señalar que en el presente trabajo se ha evidenciado que los maestros no han sido formados para el trabajo en zonas rurales, ambientes en los cuales se presentan particularidades y necesidades muy distintas a las de las zonas urbanas.

Resumo O objetivo deste trabalho foi determinar qual foi o impacto da implementação de uma metodologia com enfoque construtivista para promover o desenvolvimento de competências de cidadania em alunos do 11º ano do departamento de Quindío (Colômbia). Para isso, foi realizado um estudo com abordagem quantitativa de escopo exploratório, descritivo e com delineamento quase experimental com delineamento transversal. Especificamente, participaram 83 instituições públicas de ensino médio do departamento de Quindío. Da mesma forma, dois grupos (um piloto e um controle) da décima primeira série foram selecionados durante o período de 2018-2. No grupo piloto, foi desenvolvida a metodologia baseada em abordagens construtivistas de ensino (por exemplo, aprendizagem significativa e colaborativo-cooperativo). O instrumento utilizado foi a entrevista estruturada, que consistiu em uma série de questões sistematizadas, além de questionários aplicados em três áreas: uma dirigida aos diretores, outra aos coordenadores da área Social e a última aos orientadores. Os resultados mostram que há deficiências na apropriação de metodologias construtivistas e modelos pedagógicos utilizados nas instituições em estudo. Da mesma forma, a apropriação de metodologias construtivistas não tem sido adequada no desenvolvimento de competências de cidadania em alunos do 11º ano, o que se reflete em baixo índice de desempenho escolar e comprometimento nas atividades acadêmicas devido a conflitos, intolerância e desigualdade vivida na comunidade educacional.

Abstract The purpose of this work was to determine what the impact has been regarding the implementation of a methodology with a constructivist approach to promote the development of citizenship competencies in eleventh grade students in the department of Quindío (Colombia). For this, a study was carried out with a quantitative approach of exploratory, descriptive scope and with a quasi-experimental design with cross-sectional delineation. Specifically, 83 public educational institutions of secondary education of the department of Quindío participated. Likewise, two groups (one pilot and one control) of the eleventh grade were selected during the 2018-2 period. In the pilot group, the methodology based on constructivist teaching approaches (eg, meaningful learning and collaborative-cooperative) was developed. The instrument used was the structured interview, which consisted of a series of systematic questions, in addition to questionnaires that were applied in three areas: one addressed to the principals, another to the Social area coordinators and the last to the guidance teachers. The results show that there are deficiencies in the appropriation of constructivist methodologies and pedagogical models used in the institutions under study. Likewise, the appropriation of constructivist methodologies has not been adequate in the development of citizenship competences in eleventh grade students, which is reflected in a low score of school performance and commitment in their academic activities due to conflicts, intolerance and inequality that is experienced in the educational community.

Resumen El propósito del presente trabajo fue determinar cuál ha sido el impacto en cuanto a la implementación de una metodología con enfoque constructivista para promover el desarrollo de competencias ciudadanas en estudiantes del grado undécimo en el departamento del Quindío (Colombia). Para ello, se llevó a cabo un estudio con enfoque cuantitativo de alcance exploratorio, descriptivo y con un diseño cuasi experimental con delineación transversal. En concreto, participaron 83 instituciones educativas públicas de educación media del departamento del Quindío. Asimismo, se seleccionaron dos grupos (uno piloto y otro de control) del grado undécimo durante el periodo 2018-2. En el grupo piloto se desarrolló la metodología basada en enfoques de enseñanza constructivistas (p. ej., el aprendizaje significativo y el colaborativo-cooperativo). El instrumento utilizado fue la entrevista estructurada, que consistió en una serie de preguntas sistemáticas, además de cuestionarios que se aplicaron en tres rubros: uno dirigido a los rectores, otro a los coordinadores de área de Sociales y el último a los docentes orientadores. Los resultados demuestran que existen deficiencias en la apropiación de las metodologías constructivistas y los modelos pedagógicos empleados en las instituciones objeto de estudio. Asimismo, la apropiación de metodologías constructivistas no ha sido adecuada en el desarrollo de competencias ciudadanas en los estudiantes de grado undécimo, lo cual se v e reflejado en un puntaje bajo de rendimiento escolar y de compromiso en sus actividades académicas debido a los conflictos, intolerancia y desigualdad que se viven en la comunidad educativa.

Abstract: Synovial sarcoma is a malignant mesenchymal neoplasm. Its typical presentation is a juxtaarticular mass, palpable and painless. We present a 63 years old male, with a tumor in the left inguinal region, an excisional biopsy was performed, resulting in a hydradenocarcinoma with a positive regional ganglion. Immunohistochemistry was performed resulting in poorly differentiated synovial sarcoma. Synovial sarcoma is a rare soft tissue neoplasm affecting young adults. It is located more frequently in the extremities and the presence of metastasis at diagnosis is common. It has a poor prognosis and the treatment is with surgical resection and chemotherapy.

Resumen: El sarcoma sinovial es una neoplasia mesénquima maligna. Su presentación típica es una masa yuxtaarticular, palpable e indolora. Presentamos el caso de un hombre de 63 años con un tumor en la región inguinal izquierda, en quien se realizó una biopsia escisional, con resultado de hidradenocarcinoma con ganglio regional positivo. Se efectuó inmunohistoquímica con resultado de sarcoma sinovial poco diferenciado. El sarcoma sinovial es una neoplasia de tejidos blandos poco frecuente, que afecta a adultos jóvenes. Se localiza con mayor frecuencia en las extremidades y es común la presencia de metástasis al diagnóstico. Tiene mal pronóstico y el tratamiento es con resección quirúrgica y quimioterapia.

Abstract: The sign of Leser-Trélat is a cutaneous paraneoplastic syndrome; it is an explosive dermatosis (seborrheic keratosis) associated with occult malignancy. Male 67, started with dyspepsia, aerophagia and reflux, weight loss. Physical examination with brown keratotic neoformations, in thorax and abdomen. In the endoscopy was found a gastric adenocarcinoma. PET/CT with liver metastases. Esophagogastrectomy was performed with esophagogastric anastomosis. The pathophysiology is presumed by growth factors produced by the tumor. Survival depends on the type and stage of the primary tumor. When this sign is found, the intentional search for occult neoplasia is recommended.

Resumen: El signo de Leser-Trélat es un síndrome paraneoplásico cutáneo, es una dermatosis explosiva (queratosis seborreica) asociada con malignidad oculta. Paciente masculino de 67 años, inició con dispepsia, aerofagia y reflujo, pérdida de peso. La exploración revela neoformaciones queratósicas en tórax y abdomen, pigmentadas café. En la endoscopia se encontró con adenocarcinoma gástrico. PET/CT metástasis hepáticas. Se realizó esofagogastrectomía con anastomosis esófago-gástrica. La fisiopatología se presume por factores de crecimiento producidos por el tumor. La sobrevida depende del tipo y estadio del tumor primario. Ante la aparición de este signo se recomienda la búsqueda intencionada de neoplasia oculta.

ABSTRACT OBJECTIVE To report the design, methodology and initial results of the National Socioeconomic Survey of Access to Health of the EsSalud Insured. RESULTS There were interviews in 25,000 homes, surveying 79,874 people, of which 62,659 were affiliated to EsSalud. The insured people are mainly males (50.6%) with a higher technical education level (39.7%). The insured population has mostly independent (95.0%) and own (68.1%) home. Only 34.5% of the insured practice some sport or physical exercise; 14.0% of the population suffers from a chronic disease; 3.5% have diabetes; and 7.1%, arterial hypertension. In the last three months, 35.4% of the members needed medical attention; of these, only 73.1% received health care and the remaining 10.9% were treated in pharmacies or non-formal health care services. RESULTS The 25,000 homes were interviewed, surveying 79,874 people, of which 62,659 were affiliated to EsSalud. The insured people are mainly males (50.6%) with a higher technical education level (39.7%). The insured population has mostly independent (95.0%) and own (68.1%) home. Only 34.5% of the insured practice some sport or physical exercise; 14.0% of the population suffers from a chronic disease; 3.5% have diabetes; and 7.1%, arterial hypertension. In the last three months, 35.4% of the members needed medical attention; of these, only 73.1% received health care and the remaining 10.9% were treated in pharmacies or non-formal health care services. CONCLUSIONS This survey is the first performed in the population of EsSalud affiliates, applied at the national level, and has socio-economic and demographic data of the insured, their distribution, risk factors of health, prevalence of health problems and the degree of access to health services.

RESUMEN OBJETIVO Reportar el diseño, metodología y resultados iniciales de la Encuesta Nacional Socioeconómica de Acceso a la Salud de los Asegurados de EsSalud. MÉTODOS La Encuesta se ejecutó en los 24 departamentos del país. Los temas investigados fueron: características de la vivienda y miembros del hogar, educación, salud, empleo e ingreso y gastos del hogar. Se realizó un tipo de muestreo bi-etápico: la unidad primaria de muestreo estuvo conformada por conglomerados compuestos por una manzana dentro del ámbito de cobertura del centro asistencial; la unidad secundaria de muestreo fueron viviendas particulares donde habitaba al menos un asegurado a EsSalud. Se analizaron los datos de 62,659 afiliados y se muestran porcentajes ajustados por el factor de expansión. Para las comparaciones, se utilizó la prueba de chi-cuadrado. RESULTADOS Se entrevistaron 25000 viviendas, encuestándose a 79,874 personas, de las cuales 62,659 eran afiliados a EsSalud. Los afiliados son principalmente varones (50.6%) con un nivel de educación técnico superior (39.7%). La población afiliada cuenta mayoritariamente con vivienda independiente (95.0%) y propia (68.1%). Solo el 34.5% de los asegurados practica algún deporte o ejercicio físico. El 14.0% de la población padece de alguna enfermedad crónica; el 3.5% presenta diabetes; y el 7.1%, hipertensión arterial. En los últimos tres meses, el 35.4% de los afiliados necesitaron atención médica; de estos, solo el 73.1% recibieron atención sanitaria y el 10.9% restante se atendieron en farmacias o servicios no formales de atención en salud. CONCLUSIONES Esta encuesta es la primera realizada en la población de afiliados a EsSalud, aplicada a nivel nacional, y cuenta con datos socioeconómicos y demográficos de los asegurados, su distribución, factores de riesgo de la salud, prevalencia de los problemas de salud y el grado de acceso a los servicios de salud.

ABSTRACT OBJECTIVE To report the design, methodology and initial results of the National Socioeconomic Survey of Access to Health of the EsSalud Insured. RESULTS There were interviews in 25,000 homes, surveying 79,874 people, of which 62,659 were affiliated to EsSalud. The insured people are mainly males (50.6%) with a higher technical education level (39.7%). The insured population has mostly independent (95.0%) and own (68.1%) home. Only 34.5% of the insured practice some sport or physical exercise; 14.0% of the population suffers from a chronic disease; 3.5% have diabetes; and 7.1%, arterial hypertension. In the last three months, 35.4% of the members needed medical attention; of these, only 73.1% received health care and the remaining 10.9% were treated in pharmacies or non-formal health care services. RESULTS The 25,000 homes were interviewed, surveying 79,874 people, of which 62,659 were affiliated to EsSalud. The insured people are mainly males (50.6%) with a higher technical education level (39.7%). The insured population has mostly independent (95.0%) and own (68.1%) home. Only 34.5% of the insured practice some sport or physical exercise; 14.0% of the population suffers from a chronic disease; 3.5% have diabetes; and 7.1%, arterial hypertension. In the last three months, 35.4% of the members needed medical attention; of these, only 73.1% received health care and the remaining 10.9% were treated in pharmacies or non-formal health care services. CONCLUSIONS This survey is the first performed in the population of EsSalud affiliates, applied at the national level, and has socio-economic and demographic data of the insured, their distribution, risk factors of health, prevalence of health problems and the degree of access to health services.

RESUMEN OBJETIVO Reportar el diseño, metodología y resultados iniciales de la Encuesta Nacional Socioeconómica de Acceso a la Salud de los Asegurados de EsSalud. MÉTODOS La Encuesta se ejecutó en los 24 departamentos del país. Los temas investigados fueron: características de la vivienda y miembros del hogar, educación, salud, empleo e ingreso y gastos del hogar. Se realizó un tipo de muestreo bi-etápico: la unidad primaria de muestreo estuvo conformada por conglomerados compuestos por una manzana dentro del ámbito de cobertura del centro asistencial; la unidad secundaria de muestreo fueron viviendas particulares donde habitaba al menos un asegurado a EsSalud. Se analizaron los datos de 62,659 afiliados y se muestran porcentajes ajustados por el factor de expansión. Para las comparaciones, se utilizó la prueba de chi-cuadrado. RESULTADOS Se entrevistaron 25000 viviendas, encuestándose a 79,874 personas, de las cuales 62,659 eran afiliados a EsSalud. Los afiliados son principalmente varones (50.6%) con un nivel de educación técnico superior (39.7%). La población afiliada cuenta mayoritariamente con vivienda independiente (95.0%) y propia (68.1%). Solo el 34.5% de los asegurados practica algún deporte o ejercicio físico. El 14.0% de la población padece de alguna enfermedad crónica; el 3.5% presenta diabetes; y el 7.1%, hipertensión arterial. En los últimos tres meses, el 35.4% de los afiliados necesitaron atención médica; de estos, solo el 73.1% recibieron atención sanitaria y el 10.9% restante se atendieron en farmacias o servicios no formales de atención en salud. CONCLUSIONES Esta encuesta es la primera realizada en la población de afiliados a EsSalud, aplicada a nivel nacional, y cuenta con datos socioeconómicos y demográficos de los asegurados, su distribución, factores de riesgo de la salud, prevalencia de los problemas de salud y el grado de acceso a los servicios de salud.

Abstract: Introduction: The Mckittrick-Wheelock syndrome is characterized by hydroelectrolytic depletion, secondary to hypersecretory diarrhea due to a large villous adenoma of the rectum. Its cause is postulated by hypersecretion of prostaglandin E2. The adenoma occurs most frequently in the rectum. Case report: A 60-year-old male with chronic diarrheal, one year of evolution, with multiple tratments, underwent a left hemicolectomy due to the finding of a serrated adenoma of the rectum. Conclusions: The condition is characterized by diarrhea and severe dehydration; treatment with indomenthacin has been tried to decrease the secretion of prostaglandin E2, being the definitive treatment, surgery.

Resumen: Introducción: El síndrome de Mckittrick-Wheelock es un cuadro caracterizado por depleción hidroelectrolítica, secundario a diarrea hipersecretora debido a un adenoma velloso de recto de gran tamaño. Se postula su causa por hipersecreción de prostaglandina E2. El adenoma se presenta con mayor frecuencia en recto. Caso clínico: Masculino de 60 años con cuadro diarreico de un año de evolución multitratada, es sometido a hemicolectomía izquierda, por hallazgo de adenoma aserrado de recto. Conclusiones: La manifestación clínica es con diarrea y deshidratación, se ha probado tratamiento con indometacina para disminuir la secreción de prostaglandina E2, siendo el tratamiento definitivo el quirúrgico.

Este estudo teve como objetivo examinar a perceção de estudantes de Educação Física sobre o valor educativo do Modelo de Educação Esportiva (MEE) pelo confronto entre a vivência do modelo enquanto alunos e como professores estagiários. Participaram no estudo 16 estudantes do Mestrado em Ensino da Educação Física da FADEUP. Aplicou-se uma entrevista semiestruturada e de resposta aberta após a validação de construção e de conteúdo. Os participantes percepcionaram potencial elevado do MEE no desenvolvimento da formação pessoal, social e desportiva de crianças e jovens. Não obstante, as suas elevadas exigências, ao nível da organização e gestão de alunos e atividades, foram reconhecidas pelos participantes na condição de professores estagiários. A investigação futura deve se centrar na análise do modo como os futuros professores aprendem a ensinar o currículo do MEE, fornecendo indicadores para o domínio de prática e contribuindo para a eficácia pedagógica na sua implementação.

This study examined the perceptions of pre-service teachers on the educational value of the Sport Education model (SEM) by contraposition of their experiences as students during the teacher education program and as pre-service teachers. The participants were 16 senior students of the Master in Teaching Physical Educationin FADEUP. After construct and content validation a semi-structured interview containing open-ended questions was applied. The participants grasped the model as an extremely valuable educational experience that holds the potential for the young students' personal, social, and sports development. Notwithstanding, as pre-service teachers, the participants pictured SEM as highly demanding in the managerial organization of class, students and activities. In future, research should examine more thoroughly the manner by which upcoming teachers learn to teach the SEM curriculum in order to provide benchmarks for enhanced practice and pedagogical capability of novice teachers during early implementation of the model.

Introduction: The artificial sphincter (ABS) has been proposed as an option for the treatment for severe refractory fecal incontinence. We have witnessed a great discussion on systematic reviews regarding the short-and long-term results of ABS, assessing its real benefit. Objective: To analyze the surgical outcomes of patients undergoing artificial sphincter implantation and review of surgical technique. Material and Methods: Between 2003 and 2007, the ABS system was introduced in four patients. The mean age was 34 years (13 to 54 years). Two patients were admitted for rectal agenesis, a severe anorectal trauma and abdominoperineal resection for a low rectal cancer. Results: Follow-up time was 12 to 60 months. We performed the explantation of the device for perineal wound infection in one case. All patients had mild incontinence ABS showed a decrease an average of 3.5 points to 12 months of follow-up on the Wexner Scale. Conclusions: The installation of the artificial sphincter is a feasible and safe alternative for anorectal reconstruction in selected patients. The morbidity and explantation of the series is similar to other international reports.

Introducción: El esfínter artificial (siglas en inglés ABS) ha sido propuesto como una opción para el tratamiento de incontinencia fecal severa refractaria. Hemos sido testigos de una gran discusión en revisiones sistemáticas respecto a los resultados a corto y largo plazo del ABS, evaluando su real beneficio. Objetivos: Analizar los resultados quirúrgicos de los pacientes sometidos a implante de esfínter artificial y revisar la técnica quirúrgica. Material y Métodos: Entre los años 2003 y 2007 se implantó el sistema ABS en cuatro pacientes. La edad media fue de 34 años (13 a 54 años). Dos pacientes ingresaron por agenesia rectal, uno por trauma anorrectal severo y otro por resección abdominoperineal de un cáncer de recto bajo.Resultados: El tiempo de seguimiento fue de 12 a 60 meses. Se realizó la explantación del dispositivo por infección de herida perineal en un caso. Todos los pacientes que mantuvieron el ABS presentaron incontinencia leve con un descenso a los 12 meses de seguimiento a una media de 3,5 puntos en la escala de Wexner. Conclusiones: La instalación del esfínter artificial es una alternativa segura y realizable para la reconstrucción anorrectal en pacientes seleccionados. El porcentaje de morbilidad y explantación de la serie es similar a otros reportes internacionales.