Search

Mathematical resilience is a student's ability to survive and be positive when facing difficulties and anxiety in learning mathematics as indicated by the ability to work collaboratively with groups, and have language skills to communicate mathematical understanding. Learning mathematics online caused various negative conditions for students; reduced learning interactions, internet disturbances, material that was not optimally explained, even low support for studying at home. This study aims to find out about students’ mathematical resilience when taking online mathematics lessons during the Covid 19 Pandemic. A qualitative phenomenological design was used, in which 20 high school students in Medan, participated. Data was collected through an open online questionnaire and interview, due to the implementation of social restrictions in Medan. Thematic analysis was used to interpret the data. The results are summed up: (1) Implementation and use of mathematics learning platforms during the Covid 19 Pandemic; (2) Adaptation of students learning mathematics; (3) Students' belief in learning mathematics; (4) students' communication skills during mathematics learning; (5) The Support for learning mathematics. This study recommends several suggestions to strengthen students' mathematical resilience in order to overcome mathematical difficulties and problem when taking online mathematics learning.

Objective: To establish a method for evaluating, in a systematic and periodic way, the degree of compliance with the protocols currently being used in the hospital., Materials and Method: Experts from the hospital designed 6 protocols which were later approved by consensus by several committees and agreed by Medical Direction. The doctors were informed of the new protocols by means of info-sessions and printed materials. In order to evaluate to what extent the protocols were complied with, we carried out a number of longitudinal and cross-sectional studies depending on how often the protocols are used., Results: The study involved 2,190 patients. Cross-sectional studies. Surgical antimicrobial prophylaxis protocol: compliance with the application forms was 83.3% and for surgical interventions it was 64.3%. It should be noted that adherence improved with time. Sliding-scale insulin therapy: compliance improved during the observation period from 54 to 71.1%. Prevention of NSAID induced gastropathy: after 6 months a significant improvement was observed in relation to the previous phase. Pain treatment: of the 117 analgesics prescribed on-demand in the previous phase, 27.3% were administered, as well as 68.4% of a total of 95 fixed prescriptions. In the phases previous to setting up these protocols, adherence ranged from 0 to 68.4%. One year later, adhesion has improved significantly for all the evaluated protocols. Longitudinal studies. Community acquired pneumonia: adhesion was 60.8%, while non significant differences were observed according to severity. Transitory ischemic accident: compliance evaluation showed an adherence value of 81.8%., Conclusions: When the degree of compliance is high, follow-up studies may be spaced out in time. If not, the reasons for this low compliance must be identified and measures must be taken. Follow-up studies must be carried out more often when protocols have just been set up and less frequently as adherence improves.

Background: The prevalence of gallstones is increased in patients with cirrhosis. However the presence of cirrhosis has been generally considered a relative contraindication to cholecystectomy., Aim: To investigate the complications and the outcomes of laparoscopic and open cholecystectomy in patients with cirrhosis., Patients and Methods: Sixty seven patients with gallstones with well-documented cirrhosis undergoing cholecystectomy (laparoscopic cholecystectomy (LC) in 35 and open cholecystectomy (OC) in 32), were studied. The mean age was 57.7 + 10.3 years for LC and 58.9 + 11.6 years for OC. In the LC group, 26 were classified as Child-Pugh class A, 8 as Child's B class and 1 as Child's class C. In the OC group, 12 were classified as Child's class A, 15 as Child's B and 5 as Child's C., Results: Complications occurred in 4 of 35 (12.3%) LC patients (1 patients was Child A and 3 were B). In the OC group 14 of 32 patients had complications (4 Child A, 7 B and 3 C, 43.7% p < 0.05 as compared with LC group). Three patients in the OC group died (9.4%). Mean hospital stay was 2.8 + 1.9 and 13 + 12 days in LC and OC patients, respectively (p < 0.05)., Conclusions: LC has a lower rate of complications than OC and is a reasonable option for Child's class A and B patients with cirrhosis and gallstones.

Background: Esophageal carcinoma has a dismal prognosis. Several authors have reported a very low survival in Chile., Aim: To report the survival of patients with esophageal carcinoma, subjected to esophageal resection., Material and Methods: Analysis of 108 patients subjected to thoracic esophageal resection between 1985 and 1996. Patients were classified according to the location of the tumor and its staging., Results: Eleven patients died in the immediate postoperative period and 90 patients were followed. In 53 the exact cause of death was determined. Global five years survival was 29% and median survival was 18 months. Survival was 100% in stage I tumors. Adjuvant therapy resulted in a better survival of stage III tumors. Survival of stage IV tumors was worst than stage I to III tumors. There was no survival difference between squamous carcinoma or adenocarcinoma. Tumors located in the superior third of the esophagus had a worst prognosis. Causes of death were mediastinic metastases, local recidivism, pleural or pulmonary metastases and less frequently, brain, bronchial or bone metastases., Conclusions: The survival of these, patients with esophageal carcinoma did not differ from the figures reported abroad.

Background Cerebral venous thrombosis is an inusual disease in neonatal age. Increasing reports of this disorder had described since magnetic resonance angiography is used. Case report Newborn of apropriate seze for gestational age was delivered at 35 weeks of gestation. Refered a severe hipoxic-isquemic disease with multisistemic afectation. The second day of life presented disseminated intravascular coagulation with pulmonary bleeding. The third day, the infant developed seizures that required treatment with diazepam in continuous perfussion. MR angiography visualized superior sagital and transvers sinus thrombosis. Coagulation study detected factor V Leiden. Comments Frecuently venous cerebral thrombosis is presenting with lethargy and seizures. The most common vessels involved are sagital and transvers sinus. It is described in association with exogenous risk factors that increasing blood hyperviscosity and additional inhered coagulation dissorders such as defects on antihrombina III, protein C and S and activate protein C resistance. The last defect has a hight prevalence in subjects with trombosis events.

Hungry bone syndrome is a unusual complication of the postoperative period of primary hyperparathyroidism. This syndrome is characterized by hypocalcemia, hypophosphatemia and hypomagnesemia, due to an excessive bone remineralization. We report the clinical features, laboratory and therapy in four females (aged 39 to 73 years old) with a long standing hyperparathyroidism, elevated alkaline phosphatases and decreased bone mineralization in two. The mean size of the adenoma was 2.9 +/- 1.1 cm. Hypocalcemia appeared between days 1 and 6 of the postoperative period. All were treated with calcium, calcitriol and magnesium at different timing and dosages. The mean hospitalization period was 19.8 +/- 2.1 days. As reported previously, low bone mineralization and a large adenoma are risk factors for the syndrome. Serial monitoring of serum calcium and magnesium and an early supplementation of these minerals could prevent hypocalcemia and decrease the hospitalization time.

Background: Laparoscopic adrenal approach was introduced in 1992 and is becoming the surgical method of choice for several adrenal diseases., Aim: To report the initial Chilean experience in laparoscopic adrenalectomy., Material and Methods: A retrospective review of 17 patients subjected to the surgical procedure by the authors., Results: The preoperative diagnosis were adenomas (8 patients), pheochromocytoma (3), cystic lesions (2), adrenal metastases (2), hyperaldosteronism (1) and a pituitary Cushing (1). The average lesion size was 5.4 cm, the operative time 2.5 hours and the hospital stay 2.5 days. Eight patients were discharged in less than 48 hours. Pain was managed with non steroidal antiinflammatory drugs in 14 patients. One subject required conversion to open surgery. Transfusions were required in complex cases with a diaphragmatic hamartoma, Cushing disease and in a combined adrenal and renal resection. One patient had to be re admitted due to a pancreatic pseudo cyst that was drained percutaneously. There have been no recurrences after a mean follow up of 2 years., Conclusions: This early experience with laparoscopic adrenalectomy shows good results. A good patient selection and experience with advanced laparoscopic surgery are requisites for a successful use of this surgical technique.

The case of a 49 yr old alcoholic women with clinical and laboratory findings that suggested a Cushing syndrome is presented. The functional tests showed cortisol suppression greater than 50% of the basal value with 8 mg of dexamethasone and no response in the combined dexamethasone/desmopressin test. Pituitary Nuclear Magnetic Resonance (NMR) was negative, Abdominal Computed Axial Tomography suggested hyperplastic adrenal glands; adrenal nodules were not found in the NMR. Pituitary or hipothalamic Cushing with secondary autonomous micronodular adrenal hyperplasia was suspected. Norcholesterol-I131 SPECT scintigraphy under dexamethasone suppression demonstrated a functional adrenal hyperplasia which was hystologically confirmed.

Objective: To describe case of primary renal lymphoma., Methods/results: A 76-year-old female patient with a diagnosis of a left renal mass was referred to our service. The patient underwent a radical nephrectomy. Histological analysis of the surgical specimen revealed a non-Hodgkin lymphoma. She received combination chemotherapy with CHOP., Conclusions: Primary renal lymphoma is a rare clinical entity whose existence has been questioned very often. Its clinical presentation is not unlike that of any other renal tumor and its diagnosis is by histology. Although it is a rare tumor type, it must be taken into account when making the differential diagnosis of any renal mass. Surgical resection in combination with chemotherapy with or without radiotherapy continues to be the widely utilized treatment for primary renal lymphoma.

A study is made on 131 patients with presumptive diagnosis of viral hepatitis showing that 25% of patients had acute liver failure as an epiphenomenon of a liver disorder excluding viral hepatitis. These results were obtained through a systematic study of all patients in their various clinical, humoral, and anatomotissular aspects; the latter was achieved through laparoscopy and liver biopsy in the state of the disease.

Authors present miocardiac perforation in two children 41 and 20 days old respectively, in whom a central venous catheter by phlebotomy for administration of fluids and parenteral nutrition was introduced: the end of the catheter was left at the level of right auricule. In the first case the perforation presented two hours after introducing the catheter, and in the second case, perforation was later. In neither case were there clinical signs of cardiac tamponade, and an unexpected heart respiratory arrest occurred which was reanimated by a pericardial punction. In the second case perforation was discovered by means of necroscopic study.