Hospital Español

The present study aims to provide a thorough analysis of the graffiti identified within and in the surroundings of the church of the monastic complex of Saint Kyriakos at Oxyrhynchus, Egypt. A heterogeneous corpus of epigraphic evidence is examined, counting lists of personal names and commemorative texts. These texts provide valuable insights into writing and cultic practices within this religious institution in the Byzantine phase. Particular attention is devoted to the analysis of writing techniques and the tools selected for the production of these graffiti, as well as to the identification of their potential authors, suggesting the active participation of members of the monastic community as well as devotees visiting the religious complex. In addition, the study examines some examples of multigraphic graffiti, in which textual and figurative elements are combined, among which are Christian religious markers and motifs recurrent in the Egyptian iconographic tradition.

<title>Resumen</title> El divertículo de Meckel se presenta en el 2% de la población, y aunque en la mayoría de los casos son clínicamente silentes, los que se hacen sintomáticos suelen hacerlo antes de los 2 años de edad. Es el más frecuente de los divertículos que se encuentran en el intestino delgado, es asintomático y su diagnóstico es transoperatorio. Una complicación infrecuente de esta enfermedad es la perforación. Presentamos a una mujer de 57 años con dolor localizado en el cuadrante inferior derecho, progresivo. Se solicitó una TC de abdomen con contraste intravenoso, que mostró lo que parecía ser un cuerpo extraño en el íleon con perforación ileal. La paciente fue llevada a cirugía para diagnóstico laparoscópico, donde se le realizó resección y anastomosis de la proyección ileal perforada, observándose un divertículo con espina de pescado en su interior y ulceración del mismo, confirmado posteriormente por anatomía patológica. <bold>Palabras Clave:</bold> dolor agudo, cuerpo extraño, perforación intestinal, Divertículo de Meckel, resección de intestino delgado.

This research aims to diagnose and demonstrate how the application of the Lourenço Filho Maturity Test for Learning Literacy contributes to determining the necessary aptitudes to achieve effective reading and writing maturity in children aged 5 to 6 years. The study was conducted with 291 second-grade students from central schools in the city of Tulcán (180 girls and 111 boys). The results indicate that, at the individual level, the projection of learning to read and write is in chronological-academic balance (6 months to 1 academic year); however, the group-level results show that reading comprehension requires reinforcement due to the lack of adequate support in the development of activities that foster the maturation of skills involved in reading and writing. These findings were obtained through the in situ application of the test and its subsequent analysis using descriptive statistics based on median and standard deviation formulas. The study encourages first- and second-grade teachers to use the test as a pedagogical tool in early teaching and learning of language arts.

Uno de los problemas fundamentales que enfrenta el estudio del arte callejero en Chile es la ausencia de una historiografía que pueda reconstruir su trayectoria dentro del campo de las artes visuales, lo que ha derivado en aproximaciones fragmentarias, preponderantemente de enfoque sociológico, y con un acceso limitado a fuentes que permitan estudiar su desarrollo como parte de un proceso histórico de largo aliento. A diferencia de las artes visuales tradicionales en Chile, las prácticas callejeras no han logrado consolidar una tradición que articule sus orígenes, transformaciones y disputas, en parte debido a la dificultad de incorporar manifestaciones que excedan los marcos ya canonizados. Ante este vacío, este artículo propone un diagnóstico en doble sentido: subrayar la urgencia de avanzar hacia una historiografía que reconozca el arte callejero desde su dimensión artística y no solo como fenómeno sociopolítico, y examinar la multiplicidad de términos —graffiti, muralismo, arte urbano, arte público o arte callejero, entre otros— utilizados para referirse a estas prácticas, evaluando sus alcances y limitaciones con el fin de justificar el uso del concepto “arte callejero” como categoría amplia para su análisis, valoración y futura inscripción en una tradición histórica propia

Introduction In chronic granulomatous disease (CGD), Aspergillus is the most common cause of invasive fungal infections and accounts for a high percentage of mortality. Methods The current study included 45 patients with a genetic diagnosis of CGD recruited between 2005 and 2024 from seven public hospitals in four Mexican cities. Results We recruited 45 patients of CGD with invasive aspergillosis (IA) events. The median age between the first CGD manifestation and first aspergillosis event was 65 months. Mortality rate was 57.7% for proven aspergillosis events, 23.1% for probable events, and 19.2% for possible events (p = 0.038). Aspergillus fumigatus was the most common species. Of the 45 patients, 26 (58%) had one IA event, nine (20%) had two, five (11%) had three, and five (11%) had four IA events. The median time between the first and second events was 35 months (15–65), between the second and third events was 26 months (17.5–32.5), and between the third and fourth events was 22 months (15.5–43.5). Of the 78 IA events, 43 (55%) were treated with monotherapy, 16 (20.5%) with dual therapy, 15 (19.2%) with triple therapy, three (3.8%) with quadruple therapy, and one (1.5%) with quintuple therapy. Twenty-six (58%) of the 45 patients died, out of which 18 (69%) had IA. The median age at death was 107.5 months (44.7–196). Overall survival of the 45 patients was 80.8% at 64 months. Conclusions The high mortality rate of IA in CGD patients could be reduced by early suspicion, initiating correct antifungal treatment over a long period, and considering the performance of hematopoietic stem cell transplantation.

El objeto principal del artículo es&nbsp;el "micelio de las comunidades", una metáfora que compara la red subterránea de micelio en la naturaleza (conexiones vitales entre plantas, hongos y bacterias para la supervivencia) con las redes invisibles de saberes, sentires y colaboraciones en comunidades indígenas o locales, invisibles al "ojo colonizador" cartesiano, pero reveladas mediante la&nbsp;Investigación Acción Participativa (IAP), que hace emerger estas hifas de "sentipensar" para fortalecer la vida comunitaria.

Implanted or anchored telemetry devices are valuable tools in cetacean research, especially for species whose habitats and ranging patterns limit the collection of movement and behavioural data by less invasive methods. In this study, 130 Low‐Impact Minimally Percutaneous External Transmitter (LIMPET) tags were deployed on Cuvier’s beaked whales and fin whales. LIMPET tags are small Type A (anchored) tags which are remotely deployed and secured on or near the dorsal fin using medical‐grade titanium darts. They transmitted data via satellite for weeks to months (mean = 34 days, range 1–239 days). Most of these tagged whales (n = 123) were photo‐identified at deployment. Sixty‐one were photographed after tag loss, with the proportion of the resighted tagged whales meeting or exceeding the inter‐annual resighting rates of their populations. Thirty‐seven resighted whales (16 fin and 21 beaked) had adequate quality photos of the attachment site for visual assessment of healing on at least one day, over periods from 1–4,779 days (13.1 years) after the end of tag transmission. Most tag sites had resolved as one or two small (&lt; 2 cm) marks or shallow depressions within 2–3 years. LIMPET tags placed outside the dorsal fin (n = 34) had significantly shorter transmission durations but were not associated with larger residual marks. Swelling, a notable concern in other tag follow‐up studies, was observed in five whales, three of which were sighted with retained darts that had separated from the external tag package. It took 2–4 years to shed these retained darts. In two cases, the darts appear to have migrated through the fin and exited on the contralateral side. Retention petals from LIMPET tag darts may be left behind; if so, results suggest they are likely encapsulated or ejected without leaving a visible mark. These findings suggest that LIMPET tags are generally a safe and effective option for collecting extended movement and behavioural data from these and similar species.

Introduction: Extranodal NK/T cell lymphoma (ENKTL) is a rare subtype of non-Hodgkin lymphoma Epstein-Barr virus associated. The pathogenesis of these lesions is not completely known. Objectives: To present an atypical case of nasal extranodal NK T-cell lymphoma. Materials and methods: We present the case of a 37-year-old patient with a diagnosis of extranodal nasal NK/T cell lymphoma with clinical symptoms and radiological images, which looks like a vascular tumor. Pre-surgical embolization was performed due to the high vascularity found on the tomography. The lesion was completely resected endoscopically, the patient received chemotherapy and radiotherapy, currently in remission with a two-year follow-up. Discussion: NK/T cell lymphomas are rare sinonasal tumors. Radiologically, they are locally invasive with extension to adjacent structures; they do not usually present as hypervascularized lesions. Conclusions: The detection of these tumors represents a challenge. Early diagnosis confers a better prognosis and response to treatment.

ABSTRACTIntroductionCancer is one of the most expensive global health challenges and surgery is needed in most cases. This study aimed to describe out‐of‐pocket payments for cancer surgery across country income groups.MethodsThis was a preplanned secondary analysis from an international prospective cohort study of consecutive patients undergoing cancer surgery in October 2020. Out‐of‐pocket payments (OOPP) to cover most of the cost of cancer surgery were compared across country income groups. Other funding sources were also described as follows: public funds, insurance, or others. A logistic regression model was used to identify variables independently associated with OOPP in low‐ and middle‐income countries.ResultsThere were 24,498 patients included from 1332 hospitals from 108 countries. Overall, 6.4% (1571/24,498) had OOPP to cover most of the cost of their cancer surgery. OOPP rates varied across country income groups: 0.5% (89/16,680) in HICs, 5.7% (272/4784) in UMICs, 38.6% (1008/2614) in LMICs, and 48.1% (202/429) in LICs. Besides the country income, male sex (OR 1.16, 95% CI 1.02–1.32, and p = 0.024) and elective surgery (OR 1.31, 1.04–1.67, and p = 0.022) were associated with OOPP for cancer surgery.DiscussionPatients accessing cancer surgery in LMICs are at an increased risk of catastrophic expenditure. Governments should prevent this by developing health insurance plans that cover elective cancer surgery, possibly involving diverse stakeholders. The interpretation of gender‐related risks demands deeper understanding of the ability to pay out‐of‐pocket and access care.

Effective postoperative pain management is essential to optimize outcomes in total hip arthroplasty (THA). While the fascia iliaca (FI) block has been commonly used, the pericapsular nerve group (PENG) block has emerged as a potentially more targeted alternative. This study aimed to compare the analgesic efficacy and safety of the PENG block versus the FI block in patients undergoing elective THA. In this retrospective observational study, 30 patients scheduled for primary elective THA were divided into two groups: one receiving an FI block (40 mL of 0.25% ropivacaine + 4 mg dexamethasone) and the other a PENG block (20 mL of 0.25% ropivacaine + 4 mg dexamethasone), both performed under ultrasound guidance. Pain scores were assessed using the Numeric Rating Scale (NRS) at 0, 6, 12, 18, and 24 hours postoperatively. Additional outcomes included opioid consumption, time to ambulation, and adverse events. The PENG group reported significantly lower NRS scores at all time points (p&lt;0.05), with the most pronounced difference observed immediately postoperatively and at 24 hours. Time to ambulation was significantly shorter in the PENG group (9.2±2.1 hours vs. 11.6±2.8 hours; p=0.01). Opioid consumption and incidence of adverse events were similar between groups. The PENG block provided superior early postoperative analgesia and facilitated earlier mobilization compared to the FI block in patients undergoing elective THA, without increasing opioid use or complications. These findings support its integration into multimodal analgesic protocols for hip surgery.