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Vulnerabilidade e Vulneração de Crianças no Contexto da Pandemia do Covid-19: Análise de Mídia
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Queiroz, Isabella Regina Gomez de

; Lisboa, Milena Silva

; Farias, Yasmen Guanaes

; Andrade, Pedro Ian

; Lantyer, Vitor Mateus

New Trends in Qualitative Research

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mar 2024, Volume 19 elocation e916

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo Durante a pandemia do COVID-19, mudanças ocorreram em diversos campos, fazendo-se importante conhecer os contextos de risco social e psíquico que marcam condições de vulnerabilidade e vulneração, vividas por crianças e bebês, a despeito de crianças: refugiadas, residentes em favela e crianças vítimas de violência intrafamiliar. Objetivo: Conhecer possíveis riscos à saúde mental de crianças, em situação de vulnerabilidade, no período da pandemia de Covid-19, na realidade brasileira. Método: Estudo de mídia, com vistas à análise do contexto sociopolítico, favorecendo a visão crítica de leituras de mundo distintas, fundamental para compreensão do objeto pretendido. Resultado: A partir dos dados levantados, estruturou-se categorias específicas à cada grupo estudado, a saber: 1) crianças refugiadas: precariedade do abrigo; dimensão legal; perdas e lutos; e xenofobia. 2) crianças residentes periféricas: perdas e lutos; violência à criança; acesso à saúde; e fome. 3) violência intrafamiliar: direitos da criança em situação de violência; violência doméstica na pandemia e meios extradomiciliares que amparam a criança. Os resultados obtidos em cada um dos objetivos específicos, denunciam especificidades de cada um dos grupos: as crianças refugiadas, além de perderem direitos vivenciam perda da sua origem, dificultando o endereçamento do seu sofrimento a um “outro”. As crianças residentes em periferias, além de serem afetadas pela pandemia, sofreram efeitos da necropolitica, advinda da herança colonial. Crianças vítimas de violência intrafamiliar enfrentaram agravos decorrentes do isolamento social e adoecimnto psíquico dos cuidadores. Considera-se, por fim que sem a denúncia necessária, os riscos de esquecimento de tão grave problemática pode se fazer efetivar e os recursos necessários ao cuidado não se fazerem urgentes. A análise da mídia favoreceu lidar com uma lacuna no campo científico, possibilitando a criação de reflexões da condição de vulneração de populações invisibilizadas.

Abstract During the COVID-19 pandemic, changes occurred in several fields, making it important to know the contexts of social and psychic risk that mark conditions of vulnerability and vulnerability, experienced by children and babies, despite children: refugees, residents in favelas and children’s victims of domestic violence. Objective: To know possible risks to the mental health of children, in a situation of vulnerability, in the period of the Covid-19 pandemic, in the Brazilian reality. Method: Media study, with a view to analyzing the sociopolitical context, favoring a critical view of different world readings, fundamental for understanding the intended object. Result: From the collected data, specific categories were structured for each group studied, namely: 1) refugee children: precariousness of the shelter; legal dimension; losses and mourning; and xenophobia. 2) children living in peripheral areas: losses and bereavements; child violence; access to health; and hunger. 3) domestic violence: rights of children in situations of violence; domestic violence in the pandemic and extra-domiciliary means that support the child. The results obtained in each of the specific objectives, denounce specificities of each of the groups: refugee children, in addition to losing rights, experience the loss of their origin, making it difficult to address their suffering to an “other”. Children residing in peripheries, in addition to being affected by the pandemic, suffered the effects of necropolitics, arising from the colonial heritage. Children victims of intrafamily violence faced injuries resulting from social isolation and mental illness of caregivers. Finally, it is considered that without the necessary denouncement, the risks of forgetting such a serious problem can become effective and the resources necessary for care do not become urgent. Media analysis favored dealing with a gap in the scientific field, enabling the creation of reflections on the vulnerable condition of invisible populations.

https://doi.org/10.36367/ntqr.19.2023.e916

Correlation between tomographic scales and vasospasm and delayed cerebral ischemia in aneurysmal subarachnoid hemorrhage
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Haedo, Milagros Gomez

; Grille, Pedro

; Burghi, Gastón

; Barbato, Marcelo

Critical Care Science

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sep 2023, Volume 35 N. 3 Pages 311 - 319

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

ABSTRACT Objective: To determine the prevalence of sonographic vasospasm and delayed ischemic deficit in patients with aneurysmal subarachnoid hemorrhage, to evaluate the correlation between different tomographic scales and these complications, and to study prognostic factors in this group of patients. Methods: This was a prospective study of patients admitted to the intensive care unit with a diagnosis of aneurysmal subarachnoid hemorrhage. The prevalence of sonographic vasospasm and radiological delayed cerebral ischemia was analyzed, as was the correlation between different tomographic scales and these complications. Results: A total of 57 patients were studied. Sixty percent of the patients developed sonographic vasospasm, which was significantly associated with delayed cerebral ischemia and mortality. The Claassen and Hijdra scales were better correlated with the development of cerebral vasospasm (areas under the curve of 0.78 and 0.68) than was Fisher’s scale (0.62). Thirty-two patients (56.1%) developed cerebral infarction on CT; the significantly associated factors were poor clinical grade at admission (p = 0.04), sonographic vasospasm (p = 0.008) and severity of vasospasm (p = 0.015). Only the semiquantitative Hijdra scale was significantly correlated with the development of radiological delayed cerebral ischemia (p = 0.009). The patients who presented cerebral infarction had worse neurological evolution and higher mortality. Conclusion: This is the first study in our environment on the subject. The Claassen and Hijdra tomographic scales showed better prognostic performance than the Fisher scale for the development of cerebral vasospasm. The finding of sonographic vasospasm could be a noninvasive criterion for the early detection of delayed cerebral ischemia and neurological deterioration in patients with aneurysmal subarachnoid hemorrhage.

RESUMO Objetivo: Determinar la prevalencia de vasoespasmo sonográfico y déficit isquémico diferido en pacientes con hemorragia subaracnoidea aneurismática, evaluar la correlación entre las diferentes escalas tomográficas con dichas complicaciones, así como estudiar los factores pronósticos en este grupo de pacientes. Métodos: Estudio prospectivo de pacientes ingresados a la unidad de cuidados intensivos con diagnóstico de hemorragia subaracnoidea aneurismática. Se analizó la prevalencia de vasoespasmo sonográfico e isquemia cerebral diferida radiológica, así como la correlación entre diferentes escalas tomográficas con dichas complicaciones. Resultados: Se estudiaron 57 pacientes. El 60% de los pacientes desarrollaron vasoespasmo sonográfico, el cual se asoció significativamente con isquemia cerebral diferida y mortalidad. Las escalas de Claassen y de Hijdra tuvieron una mejor correlación con el desarrollo de vasoespasmo cerebral (área bajo la curva de 0,78 y 0,68) que la de Fisher (0,62). Treinta y dos pacientes (56,1%) desarrollaron infarto cerebral en la TC, siendo los factores que se asociaron en forma estadísticamente significativa al mismo: pobre grado clínico al ingreso (p = 0,04), vasoespasmo sonográfico (p = 0,008) y severidad del vasoespasmo (p = 0,015). Solamente la escala semicuantitativa de Hijdra se correlacionó significativamente con el desarrollo de isquemia cerebral diferida radiológica (p = 0,009). Los pacientes que presentaron infarto cerebral tuvieron peor evolución neurológica y mayor mortalidad. Conclusion: Se presenta el primer estudio en nuestro medio sobre el tema. Las escalas tomográficas de Claassen y Hijdra presentaron un mejor rendimiento pronóstico que la de Fisher para desarrollo de vasoespasmo cerebral. El hallazgo de vasoespasmo sonográfico podría ser un criterio no invasivo de detección temprana de isquemia cerebral diferida y peoría neurológica en los pacientes con hemorragia subaracnoidea aneurismática.

https://doi.org/10.5935/2965-2774.20230119-en

Noncommunicable diseases in the Americas: a review of the Pan American Health Organization’s 25-year program of work
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Luciani, Silvana

; Nederveen, Leendert

; Martinez, Ramon

; Caixeta, Roberta

; Chavez, Carolina

; Sandoval, Rosa C.

; Severini, Luciana

; Cerón, Diana

; Gomes, Adriana B.

; Malik, Sehr

; Gomez, Fabio

; Ordunez, Pedro

; Maza, Mauricio

; Monteiro, Maristela

; Hennis, Anselm

Revista Panamericana de Salud Pública

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2023, Volume 47 elocation e13

Abstract: En Pt Es | Text: En Pt Es | PDF: En | PDF: Pt | PDF: Es

ABSTRACT This article describes progress in tackling noncommunicable diseases (NCDs) in the Americas since the Pan American Health Organization (PAHO) started its NCD program 25 years ago. Changes in the epidemiology of NCDs, NCD policies, health service capacity, and surveillance are discussed. PAHO’s NCD program is guided by regional plans of action on specific NCDs and risk factors, as well as a comprehensive NCD plan. Its work involves implementing evidence-based World Health Organization technical packages on NCDs and their risk factors with the aim of achieving the Sustainable Development Goal target of a one third reduction in premature mortality caused by NCDs by 2030. Important advances have been made in the past 25 years in implementation of: policies on NCD risk factors; interventions to improve NCD diagnosis and treatment; and NCD surveillance. Premature mortality from NCDs decreased by 1.7% a year between 2000 and 2011 and 0.77% a year between 2011 and 2019. However, policies on risk factor prevention and health promotion need to be strengthened to ensure more countries are on track to achieving the NCD-related health goals of the Sustainable Development Goals by 2030. Actions are recommended for governments to raise the priority of NCDs by: making NCDs a core pillar of primary care services, using revenues from health taxes to invest more in NCD prevention and control; and implementing policies, laws, and regulations to reduce the demand for and availability of tobacco, alcohol, and ultra-processed food products.

RESUMO Este artigo descreve o progresso no combate às doenças não transmissíveis (DNTs) nas Américas desde que a Organização Pan-Americana da Saúde (OPAS) iniciou seu programa para essas doenças há 25 anos. Discute-se como evoluíram a epidemiologia das DNTs, as políticas contra essas doenças, a capacidade dos serviços de saúde e a vigilância. O programa da OPAS para as DNTs é orientado por planos de ação regionais sobre DNTs específicas e fatores de risco, bem como por um plano integral contra essas doenças. O trabalho envolve a implementação de pacotes técnicos da Organização Mundial da Saúde baseados em evidências sobre as DNTs e seus fatores de risco, no intuito de alcançar a meta do Objetivo de Desenvolvimento Sustentável de reduzir em um terço a mortalidade prematura causada pelas DNTs até 2030. Avanços importantes foram obtidos nos últimos 25 anos na implementação de políticas sobre fatores de risco das DNTs, intervenções para melhorar o diagnóstico e o tratamento das DNTs, e vigilância das DNTs. A mortalidade prematura causada pelas DNTs diminuiu 1,7% ao ano entre 2000 e 2011 e 0,77% ao ano entre 2011 e 2019. Contudo, as políticas sobre a prevenção dos fatores de risco e a promoção da saúde precisam ser fortalecidas para que mais países estejam no rumo certo para alcançar as metas de saúde relacionadas a essas doenças, no âmbito dos Objetivos de Desenvolvimento Sustentável até 2030. São recomendadas medidas para que os governos elevem a prioridade das DNTs ao torná-las um pilar central dos serviços de atenção primária, usando a receita dos tributos saudáveis para investir mais na prevenção e no controle das DNTs, e ao implementar políticas, leis e regulamentos para reduzir a demanda e a disponibilidade de álcool, tabaco e produtos alimentícios ultraprocessados.

RESUMEN En este artículo se describe el progreso en la lucha contra las enfermedades no transmisibles (ENT) en la Región de las Américas desde que la Organización Panamericana de la Salud (OPS) iniciara su programa contra las ENT hace 25 años. Se abordan los cambios en las características epidemiológicas, las políticas, la capacidad de los servicios de salud y la vigilancia de estas enfermedades. Este programa de la OPS se rige por planes regionales de acción sobre enfermedades y factores de riesgo específicos, así como por un plan integral de ENT. Su labor consiste en poner en práctica paquetes técnicos de la Organización Mundial de la Salud basados en la evidencia sobre las ENT y sus factores de riesgo con el objetivo de alcanzar la meta de los Objetivos de Desarrollo Sostenible (ODS) de reducir en un tercio la mortalidad prematura causada por las ENT para el 2030. En los últimos 25 años se han logrado importantes avances en la ejecución de políticas sobre los factores de riesgo de estas enfermedades, en las intervenciones para mejorar su diagnóstico y tratamiento, y en la vigilancia. La mortalidad prematura por ENT disminuyó 1,7% anual entre el 2000 y el 2011 y 0,77% anual entre los años 2011 y 2019. Sin embargo, es necesario fortalecer las políticas de prevención de factores de riesgo y promoción de la salud para garantizar que más países estén bien encaminados para lograr las metas de salud de los ODS relacionadas con las ENT para el 2030. Se recomiendan medidas para que los gobiernos prioricen más las ENT y las conviertan en un pilar central de los servicios de atención primaria, al usar los ingresos generados por los impuestos en el sector de la salud para incrementar las inversiones en la prevención y control de las ENT, y ejecutar políticas, leyes y regulaciones para reducir la demanda y la disponibilidad de tabaco, alcohol y alimentos ultraprocesados.

https://doi.org/10.26633/rpsp.2023.13

Análisis del desempeño energético en una refinería de azúcar crudo
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Hernández Touset, Juan Pedro

; Sosa Gomez, Eliani

Tecnología Química

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dec 2022, Volume 42 N. 3 Pages 590 - 606

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

ABSTRACT Process Integration combine several processes to reduce consumption of resources and harmful emissions, becoming an important asset in ensuring the sustainability of industrial processes. This paper aims to set energy performance indicators of a cane sugar refinery. A procedure that includes the energy analysis and Pinch Analysis methodologies is applied, with the use of HENSAD. Targets and energy performance indicators, currently not reported for this refinery, contribute to the definition of an energy baseline and the systematic measurement of efficiency. There is an excess in thermal power duty of 32,5 MW with respect to the minimum heating duty, which determines the research into retrofit designs of the heat exchanger network. Annual savings of 1 010 571 USD estimated in energy analysis and heat integration make the evaluation of investment projects in the energy area feasible.

RESUMEN La integración de procesos combina varios procesos para reducir el consumo de recursos y las emisiones nocivas, convirtiéndose en un activo importante para garantizar la sostenibilidad de los procesos industriales. Este artículo tiene el objetivo de establecer los indicadores de desempeño energético de una refinería de azúcar de caña. Se aplica un procedimiento que incluye las metodologías de análisis de la energía y del Análisis del Pellizco, con el uso de HENSAD. Los objetivos e indicadores de desempeño energético, actualmente no reportados para esta refinería contribuyen a la definición de una línea base energética y la medición sistemática de la eficiencia. Existe un exceso en la demanda de potencia térmica de 32,5 MW con respecto a la demanda mínima de calentamiento, lo que condiciona la investigación en diseños de modificación de la red de intercambiadores de calor. Los ahorros anuales de 1 010 571 USD, estimados en el análisis energético y la integración de calor hacen factible la evaluación de proyectos de inversión en el área de la energía.

Recomendaciones en el abordaje del hematoma intracerebral espontáneo durante la internación
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Pigretti, Santiago G.

; Mirofsky, Matías

; García, Darío E.

; Issac, Cristian

; Valdez, Pascual

; Persi, Gabriel G.

; Mamani, Carlos E.

; Guyon, Jorgelina

; Álvarez, Héctor

; Montes, Mariana

; Daza Aramayo, José M.

; Iturrieta, Pablo

; Chaves, Hernán

; Sarmiento, Verónica

; Tumino, Leandro

; Domeniconi, Gustavo

; Castagna, Rosa

; Sabio, Rodrigo

; Videtta, Walter

; Ciarrocchi, Nicolás

; Lerman, Damián

; Dossi, Daiana E.

; Balian, Natalia R.

; Velasquez, Mariela A.

; Rufino Saravia, Gonzalo

; Alet, Matías J.

; Rodríguez Lucci, Federico

; Ciardi, Celina

; Pujol Lereis, Virginia

; Claverie, Santiago

; Casanova, Matías

; González, Leonardo

; Mónaco, Juan Manuel

; Cárdenas, Rolando E.

; Cirio, Juan José

; Arturi, Jessica

; Requejo, Flavio

; Plou, Pedro L.

; Orzuza, Gabriela

; Bonardo, Pablo

; Díaz, María Fernanda

; Payaslian, Silvio

; Andrade, María Gabriela

; Gomez Schneider, Maia M.

; Romano, Marina

; Colla Machado, Pedro

; Arroyo, José

; Arcondo, María Florencia

; Svampa, Silvana

; Armenteros, Cristhian

; Tejada Jacob, Virginia

; Zurrú, María Cristina

Medicina (Buenos Aires)

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nov 2022, Volume 82 Suppl. 4 Pages 1 - 56

Abstract: Es En | Text: Es En | PDF: Es | PDF: En

Resumen El accidente cerebrovascular (ACV) constituye la principal causa de discapacidad de origen neuro- lógico en los adultos mayores a 40 años y la cuarta causa de muerte en Argentina. En los últimos diez años las publicaciones indexadas relacionadas al tratamiento del ACV isquémico fueron más numerosas que las de ACV hemorrágico. El objetivo de este material es proporcionar recomendaciones locales y actualiza- das del abordaje de pacientes con hematoma intraparenquimatoso espontáneo durante la internación. Para la redacción de este manuscrito se convocó a especialistas en esta enfermedad que conformaron grupos de trabajo. Se plantearon 10 tópicos centrales expresados como epidemiologia, atención inicial, imágenes, tratamiento de la presión arterial, reversión de antitrombóticos, indicación de cirugía, profilaxis anticonvulsivante, pronóstico, prevención de complicaciones y reinicio de antitrombóticos. De cada tópico se plantearon mediante preguntas PICO los interrogantes más frecuentes de la práctica diaria. Luego de una revisión sistemática de la literatura, se generaron recomendaciones evaluadas mediante sistema GRADE y consensuadas entre autores y pacientes.

Abstract Stroke is the leading cause of neurological disability in people over 40 years of age and the fourth leading cause of death in Argentina. In the last ten years, the indexed publications related to the treatment of ischemic stroke were more numerous than those of hemorrhagic stroke. The objective of this material is to provide local and updated recommendations for the management of patients with spontaneous intracere- bral hemorrhage during hospitalization. For the writing of this manuscript, diferent specialists were convened to form working groups. Ten central topics expressed as epidemiology, initial care, imaging, blood pressure treatment, reversal of antithrombotics, indication for surgery, seizure prophylaxis, prognosis, prevention of complications and resumption of antithrombotics were raised. For each topic, the most frequent questions of daily practice were raised through PICO questions. After a systematic review of the literature, recommendations were generated, evaluated using the GRADE system and agreed between authors and patients.

Análisis del ejercicio físico en la Insuficiencia Cardíaca
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Romero-Gómez, Juan Ramón

; Tárraga-Marcos, Loreto

; Romero-Gomez, Beatriz

; Tárraga-López, Pedro J

Journal of Negative and No Positive Results

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mar 2022, Volume 7 N. 1 Pages 64 - 97

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

Abstract Cardiac rehabilitation (CR) has proven to be an effective and safe intervention to improve the prognosis of patients with heart failure (HF). However, there are doubts as to which is the best training method in these patients. Currently, the most recommended is the continuous moderate intensity aerobic training (MICT). In this work, this type of training is compared with high intensity interval training (HIIT). The study variable The main one is physical capacity, measured with the Vo2max. In addition, heart function and health-related quality of life are also assessed. A slight improvement is obtained with HIIT, but both methods are effective and valid, so the most important thing will be individualization based on the characteristics, context and preferences of each patient. On the other hand, training based on MICT alone is also compared with concurrent training, that is, the combination of MICT and resistance training (PE), obtaining favorable conclusions for the second group. In this way, PE is not a substitute for aerobic training, but it is essential to complement it since the adaptations are different and the increase in strength and muscle mass in patients with HF is highly beneficial.

Resumen La rehabilitación cardiaca (RC) ha demostrado ser una intervención eficaz y segura para mejorar el pronóstico de los pacientes con insuficiencia cardiaca (IC). Sin embargo, existen dudas sobre cuál es el mejor método de entrenamiento en estos pacientes. Actualmente, el más recomendado es el entrenamiento aeróbico continuo de intensidad moderada (MICT). En este trabajo se compara este tipo de entrenamiento con el entrenamiento de alta intensidad basado en intervalos (HIIT). La variable de estudio principal es la capacidad física, medida con el Vo2max. Además, también se valoran la función cardiaca y la calidad de vida relacionada con la salud. Se obtiene una ligera mejoría con HIIT, pero ambos métodos son eficaces y válidos, por lo que lo más importante será la individualización en función de las características, contexto y preferencias de cada paciente. Por otro lado, también se compara el entrenamiento basado en MICT en solitario con el entrenamiento concurrente, es decir, la combinación de MICT y entrenamiento de fuerza (EF), obteniendo conclusiones favorables para el segundo grupo. De esta manera, el EF no sustituye al entrenamiento aeróbico, pero si es fundamental para complementarlo ya que las adaptaciones son diferentes y el aumento de la fuerza y masa muscular en pacientes con IC es altamente beneficioso.

https://doi.org/10.19230/jonnpr.4442

Situación actual de las revistas científicas oncológicas de Latinoamérica
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Paucar-Gomez, Medally

; Guerra-Canchari, Pedro

Revista Cubana de Información en Ciencias de la Salud

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sep 2021, Volume 32 N. 3 elocation e1765

Abstract: Es | Text: Es | PDF: Es

Análisis de las Propiedades Psicométricas de la Escala de Comer Emocional (Emotional Eating Scale [EES-C]) en Adolescentes Mexicanos
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Trujillo-Hernández, Pedro Enrique

; Flores-Peña, Yolanda

; Gomez-Melasio, Dafne Astrid

; Angel-García, Julieta

; Lara-Reyes, Braulio Josue

Revista Española de Nutrición Humana y Dietética

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mar 2021, Volume 25 N. 1 Pages 58 - 68

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

Abstract Introduction: Emotional eating is a form of disordered eating and is defined as the act of consuming food in response to negative emotions such as sadness, depressive symptoms, stress, anxiety and irritability. The Emotional Eating Scale for Children and Adolescents (EES-C) allows to identify the emotions that originate or appear in the CE. Objective: To evaluate the psychometric properties of the EES-C in adolescents residing in Northeast Mexico. And to analyze the relationships of the CE according to the sex, age and nutritional status of the participants. Material and Methods: Confirmatory factor analysis (CFA), reliability (internal consistency) and convergent validity of the EES-C in Spanish was performed. Participated 631 adolescents enrolled in the 7th to 9th grade of basic education residing in Northeast Mexico participated. Weight and height measurements were made and the nutritional status of the participants was obtained. Results: The goodness of fit indexes of the proposed model were acceptable: (CFI=0.921; GFI=0.907; AGFI=0.876; SRMS=0.055 and RMSEA=0.068). The internal consistency was acceptable (α=0.92). The average age of the participants was 13.74 years (SD=0.90), the weight ranged between 30.9 and 130.4kg (SD=13.20). Conclusions: The confirmatory factor analysis of the proposed model has a high internal consistency, and five-factor factor structure has an adequate fit. It can be used to measure emotional eating in Mexican adolescents. It is recommended to contrast this model in similar populations.

Resumen Introducción: Comer emocional (CE) es una forma de alimentación desordenada y se define como el acto de consumir alimentos en respuesta a emociones negativas tales como tristeza, síntomas depresivos, estrés, ansiedad e irritabilidad. La Escala de Comer Emocional para Niños y Adolescentes (Emotional Eating Scale [EES-C]) permite identificar las emociones que originan o se presentan en el CE. Objetivo: Evaluar las propiedades psicométricas de la EES-C en adolescentes residentes en el Noreste de México; y analizar la relación del CE de acuerdo a sexo, edad y estado nutricional de los participantes. Material y Métodos: Se realizó análisis factorial confirmatorio (AFC), se analizó la fiabilidad (consistencia interna) y validez convergente de la EES-C. Participaron 631 adolescentes que cursaban entre el 7º y 9º grado de educación básica residentes en el Noreste de México. Se realizaron mediciones de peso y estatura y se obtuvo el estado nutricional de los participantes. Resultados: Los índices de bondad de ajuste del modelo propuesto fueron aceptables: (CFI=0,921; GFI=0,907; AGFI=0,876; SRMS=0,055 y RMSEA=0,068), así como la consistencia interna (α=0,92). La edad promedio de los participantes fue 13,74 años (DE=0,90), el peso osciló entre 30,9 y 130,4kg (DE=13,20). Conclusiones: El AFC del modelo propuesto tiene una consistencia interna alta y estructura factorial de cinco factores con un ajuste adecuado. Puede ser utilizada para medir el CE en adolescentes mexicanos. Se recomienda contrastar este modelo en poblaciones similares.

https://doi.org/10.14306/renhyd.25.1.1071

Residual neuromuscular blockade and late neuromuscular blockade at the post-anesthetic recovery unit: prospective cohort study
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Gonçalves, Pedro Marcos Silva e

; Vieira, Alexandra de Vasconcelos

; Silva, Claudia Helena Ribeiro da

; Gomez, Renato Santiago

Brazilian Journal of Anesthesiology

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feb 2021, Volume 71 N. 1 Pages 38 - 43

Abstract: En | Text: En | PDF: En

Abstract Introduction and objectives: The use of neuromuscular blockers during surgery represented a landmark for anesthesiology. However, their use can prompt residual Neuromuscular Blockade (RNMB) and objective monitoring of neuromuscular function is crucial to warrant the recovery of muscle strength. The present study aimed to estimate the incidence of RNMB and late Neuromuscular Blockade (LNMB) at the Post-Anesthetic Recovery Unit (PACU). Method: The study included 85 patients, 43 of which received cisatracurium and 42 of which, rocuronium. The depth of the Neuromuscular Blockade (NMB) was assessed by Train Of Four (TOF). NMB reversal was performed with the administration of neostigmine and atropine.RNMB was defined when a patient presented TOF below 90% at the PACU. Results: RNMB at the PACU was diagnosed in 39.5% and 40.5% of the patients receiving cisatracurium and rocuronium, respectively (p= 1.0). LNMB at the PACU was found in 32.6% and 16.7% of the patients receiving cisatracurium and rocuronium, respectively (p= 0.131). Conclusions: The incidence ofRNMB remains significant despite the use of intermediate-acting neuromuscular blockers and reversal agents. There was no statistically significant difference in the incidence of RNMB or LNMB in patients receiving cisatracurium or rocuronium. The use of objective NMB monitoring is effective for the diagnosis of RNMB, as well as for treatment management.

https://doi.org/10.1016/j.bjane.2020.12.009 172 downloads

10.

Dental caries prevalence, prospects, and challenges for Latin America and Caribbean countries: a summary and final recommendations from a Regional Consensus
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SAMPAIO, Fabio Correia

; BÖNECKER, Marcelo

; PAIVA, Saul Martins

; MARTIGNON, Stefania

; RICOMINI FILHO, Antonio Pedro

; POZOS-GUILLEN, Amaury

; OLIVEIRA, Branca Heloisa

; BULLEN, Miriam

; NAIDU, Rahul

; GUARNIZO-HERREÑO, Carol

; GOMEZ, Juliana

; MALHEIROS, Zilson

; STEWART, Bernal

; RYAN, Maria

; PITTS, Nigel

Brazilian Oral Research

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2021, Volume 35 Suppl. 1 elocation e056

Abstract: En | Text: En | PDF: En

Abstract Dental caries can be effectively managed and prevented from developing into cavitated lesions while preserving tooth structure at all levels. However, the strong correlation between caries and socioeconomic factors may compromise the efficacy of preventive strategies. The high prevalence of persistent inequalities in dental caries in Latin American and Caribbean countries (LACC) is a matter of concern. The estimates of the burden of disease in some countries in this region are outdated or absent. This paper aims to summarize and present the final recommendations of a regional Consensus for Dental Caries Prevalence, Prospects, and Challenges for LACC. This consensus is based on four articles that were written by a team of Latin American experts, reviewed by dental associations, and presented and discussed in two consensus events. The following domains were explored: epidemiology, risk factors, prevention strategies, and management of dental caries with a focus on restorative procedures. Dental caries can manifest throughout the lifespan of an individual, making it a matter of concern for infants, children, adults, and older people alike. The prevalence rates of untreated caries in deciduous and permanent teeth are high in many parts of the world, including LACCs. Previous evidence suggests that the prevalence of dental caries in 12-year-olds is moderate to high in most Latin American countries. Moreover, the prevalence of treatment needs and dental caries in the adult and elderly population can also be regarded as high in this region. The risk/protective factors (e.g., sugar consumption, exposure to fluoride, and oral hygiene) probably operate similarly in all LACCs, although variations in the interplay of these factors in some countries and within the same country cannot be ruled out. Although salt and water fluoridation programs are implemented in many countries, there is a need for implementation of a surveillance policy. There is also room for improvement with regard to the introduction of minimal intervention techniques in practice and public health programs. Dental caries is a marker of social disadvantage, and oral health promotion programs and interventions aimed at reducing the burden of dental caries in LACCs must consider the complexity of the socioeconomic dynamics in this region. There is an urgent need to promote engagement of stakeholders, policymakers, medical personnel, universities, dental associations, community members, and industries to develop regional plans that enhance the oral health agenda for LACCs. A list of recommendations has been presented to underpin strategies aimed at reducing the prevalence and severity of dental caries and improving the quality of life of the impacted LACC population in the near future.

https://doi.org/10.1590/1807-3107bor-2021.vol35.0056 834 downloads

11.

REFLEXIONES EN TORNO A LA INVESTIGACIÓN CON MÉTODOS MIXTOS
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Sánchez-Gomez, María Cruz

; Martín-Cilleros, María Victoria

; Sá, Patrícia

; Costa, António Pedro

Revista Baiana de Enfermagem

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2020, Volume 34 elocation e31851

Abstract: En Es Pt | Text: En Es Pt | PDF: En | PDF: Es | PDF: Pt

Objective this study presents a theoretical reflection based on the experience of the authors as researchers and professors of curricular units of research methodologies. Method theoretical-philosophical reflection. Results the dichotomy between qualitative and quantitative approaches originated the discussion on the need to think about the possibility of combining these methods aiming to answer the new and complex research problems currently facing us. This discussion was transformed into a dispute that some authors nicknamed "Science War", due to the methodological and epistemological challenges of this combination, which, in its turn, originated the Mixed Methods. The proposed reflection focuses on some of the main issues that arise in the scope of the current discussions between researchers and reflecting/translating some of their concerns.

Objetivo Se presenta una reflexión teórica basada en la experiencia de los autores como investigadores y docentes de unidades curriculares de Metodologías de Investigación. Método reflexión teórica-filosófica. Resultados la dicotomía entre los enfoques cualitativos y cuantitativos dio lugar a la discusión sobre la necesidad de pensar en la posibilidad de combinar estos métodos con el objetivo de responder a los nuevos y complejos problemas de investigación con los que actualmente nos enfrentamos. Esta discusión se transformó en una disputa que algunos autores apodaron "Science War", debido a los desafíos metodológicos y epistemológicos de esta combinación que, por su vez, dio origen a los Métodos Mixtos (Mixed Methods). La reflexión que se propone se centra en algunas de las principales cuestiones que surgen en el ámbito de las actuales discusiones entre investigadores y reflejan/traducen algunas de las inquietudes de los mismos.

Objetivo se presenta una reflexión teórica basada en la experiencia de los autores como investigadores y docentes de unidades curriculares de Metodologías de Investigación. Método reflexión teórica-filosófica. Resultados la dicotomía entre los enfoques cualitativos y cuantitativos dio lugar a la discusión sobre la necesidad de pensar en la posibilidad de combinar estos métodos con el objetivo de responder a los nuevos y complejos problemas de investigación con los que actualmente nos enfrentamos. Esta discusión se transformó en una disputa que algunos autores apodaron "Science War", debido a los desafíos metodológicos y epistemológicos de esta combinación que, por su vez, dio origen a los Métodos Mixtos (Mixed Methods). La reflexión que se propone se centra en algunas de las principales cuestiones que surgen en el ámbito de las actuales discusiones entre investigadores y reflejan/traducen algunas de las inquietudes de los mismos.

https://doi.org/10.18471/rbe.v34.31851 28 downloads

12.

Incidencia de la exposición a los rayos X en cirugías de columna
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Bazán, Pedro L

; Muscia, Roberto

; Gomez Cano, Joaquin

; Corrales Pinto, Jossy

; Borri, Álvaro E

; Medina, Martín

; Ciccioli, Nicolás M

Revista de la Asociación Argentina de Ortopedia y Traumatología

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jun 2019, Volume 84 N. 3 Pages 208 - 216

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

Background: Intraoperative radiographic control (IRC) is an increasingly common practice, but it causes certain adverse events for healthcare providers. Objectives: To measure the use of fluoroscopy in spinal surgery, recognize control measures, evaluate assimilation of protection elements by surgeons, and analyze adverse events for spinal surgeons. Materials and Methods: A survey of 17 multiple-choice questions was e-mailed to spinal surgeons. Results: 55 surveys were answered. More than 60% of surgeons were spinal surgeons. The C-arm is the most widely used machine for final control by pulsating X-rays. Real-time controls are carried out in 31% of cases. One-piece leaded aprons are the most commonly used method, but it is unknown when they should be replaced. Half of the respondents uses more than one protection element. There were seven cases of vision changes, 5 of thyroid disorders, 3 of dermatitis, and 2 of infertility. Three surgeons required surgery for thyroid nodules, cataracts or neoplasm. Conclusions: IRC is a common practice in spinal surgery. One-piece leaded aprons are the most commonly used method and they are often combined with other elements, but it is not known when aprons must be replaced. One in 3 surgeons suffered from the studied conditions, and there were 3 related surgeries. Lack of adequate protection and control is a reality for specialist surgeons, together with a lack of protocols, making this an unregulated issue.

Introducción: El control radioscópico intraoperatorio es una práctica cada vez más frecuente, que no está libre de eventos adversos para el personal de la salud. Objetivos: Conocer la tasa de uso de radioscopia en la cirugía vertebral, reconocer las medidas de control, evaluar la asimilación del cirujano a los elementos de protección y analizar los eventos adversos en estos profesionales. Materiales y Métodos: Se envió, por correo electrónico, a cirujanos espinales, una encuesta de 17 preguntas de opciones múltiples. Resultados: Se recibieron 55 encuestas. El 87% se dedicaba a la columna, en más del 60% de sus prácticas. El arco en C es el método más utilizado para el control final, en forma pulsátil. Solo el 31% controla el tiempo real. El delantal plomado de una pieza es el método más utilizado, pero se desconoce cuándo se debe reemplazar. La mitad utiliza más de un elemento. Siete casos de trastornos visuales, 5 patologías tiroideas, 3 dermatitis y 2 casos de infertilidad. Tres cirujanos fueron operados por nódulos tiroideos, cataratas o neoplasia. Conclusiones: El control radioscópico intraoperatorio es una práctica frecuente en la cirugía espinal. El delantal plomado de una pieza es el método más utilizado y, muchas veces, se lo combina, pero se desconoce cuándo se deben renovar los plomados. Uno de cada tres cirujanos presentaron las patologías evaluadas y 3, cirugías relacionadas. Así queda en evidencia la protección y el control escasos que existen en los cirujanos especialistas, acompañados de una falta de protocolización que deja a la deriva este control.

320 downloads

13.

Pregnancy of unknown location
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Pereira, Pedro Paulo

; Cabar, Fábio Roberto

; Gomez, Úrsula Trovato

; Francisco, Rossana Pulcineli Vieira

Clinics

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2019, Volume 74 elocation e1111

Abstract: En | Text: En | PDF: En

Pregnancy of unknown location is a situation in which a positive pregnancy test occurs, but a transvaginal ultrasound does not show intrauterine or ectopic gestation. One great concern of pregnancy of unknown location is that they are cases of ectopic pregnancy whose diagnosis might be postponed. Transvaginal ultrasound is able to identify an ectopic pregnancy with a sensitivity ranging from 87% to 94% and a specificity ranging from 94% to 99%. A patient with pregnancy of unknown location should be followed up until an outcome is obtained. The only valid biomarkers with clinical application and validation are serum levels of the beta fraction of hCG and progesterone. A single serum dosage of hCG is used only to determine whether the value obtained is above or below the discriminatory zone, that means the value of serum hCG above which an intrauterine gestational sac should be visible on ultrasound. Serum progesterone levels are a satisfactory marker of pregnancy viability, but they are unable to predict the location of a pregnancy of unknown location: levels below 5 ng/mL are associated with nonviable gestations, whereas levels above 20 ng/mL are correlated with viable intrauterine pregnancies. Most cases are low risk and can be monitored by expectant management with transvaginal ultrasound and serial serum hCG levels, in addition to the serum progesterone levels. To minimize diagnostic error and intervene during progressive intrauterine gestation, protocol indicates active treatment only in situations when progressive intrauterine pregnancy is excluded and a high possibility of ectopic pregnancy exists.

https://doi.org/10.6061/clinics/2019/e1111 4922 downloads

14.

Live fetus inside the urinary bladder: a case report
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Gomez, Úrsula Trovato

; Pereira, Pedro Paulo

; Cabar, Fábio Roberto

; Mesquita, José Luiz Borges de

; Francisco, Rossana Pulcineli Vieira

einstein (São Paulo)

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2019, Volume 17 N. 3 elocation eRC4570

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO A fístula vesicouterina é uma condição rara. Sua incidência, no entanto, vem aumentando, devido à maior incidência de cesáreas. A presença de feto vivo dentro da bexiga por meio de uma fístula vesicouterina constutui situação extremamente rara. Relatamos o caso de uma mulher com duas cesarianas anteriores encaminhada para o hospital devido à dor pélvica leve e sangramento genital. Na hospitalização, o exame físico estava normal. A ultrassonografia revelou saco gestacional inserido na parede anterior do útero com feto vivo de aproximadamente 13 semanas, com movimento corporal ativo e frequência cardíaca normal. O abdômen fetal, ao redor da cintura, estava preso na abertura de uma fístula vesicouterina de modo que a cabeça e o tronco fetais estavam totalmente dentro da cavidade da bexiga, enquanto os membros inferiores permaneciam na cavidade uterina. A laparotomia foi realizada, o trajeto fistuloso foi excisado, o feto (que estava sem batimento cardíaco) foi removido ao abrir a bexiga, sendo a cavidade uterina esvaziada. Além disso, foram reparados os defeitos na bexiga e no útero. O pós-operatório transcorreu sem intercorrências. Feto vivo dentro da bexiga é uma condição rara, e a continuidade da gravidez é improvável, sendo que a correção vesicouterina pode ser feita no momento da intervenção cirúrgica.

ABSTRACT Vesicouterine fistula is a rare condition. Its incidence, however, has been increasing due to the higher incidence of cesarean sections. The presence of a live fetus inside the bladder who passed through a vesicouterine fistula is an extremely rare situation. We report a case of woman who underwent two previous cesarean sections, was referred to a hospital due to mild pelvic pain and genital bleeding. At the moment, physical examination was normal. Ultrasound scan revealed a gestational sac inserted into the anterior wall of the uterus, with a living fetus of approximately 13 weeks, with active body movement and normal heart rate inside it. The fetal abdomen, around the waist, was stuck at the opening of a vesicouterine fistula, so that the fetal head and trunk were entirely into the bladder cavity, while lower limbs remained at the uterine cavity. Laparotomy was performed, the fistulous tract was excised, the fetus (without heart beating) was removed on opening the bladder, and the uterine cavity was emptied. The defects in the bladder and uterus were repaired. The postoperative period was uneventful. A live fetus inside the urinary bladder is a rare condition the continuation of pregnancy is unlikely and the vesicouterine correction can be made by the time of surgical intervention.

https://doi.org/10.31744/einstein_journal/2019rc4570 2453 downloads

15.

O papel da automonitorização da glicemia nos doentes com diabetes tipo 2 não insulinotratada
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Namora, Pedro

; Gomez, Salete

Revista Portuguesa de Medicina Geral e Familiar

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aug 2018, Volume 34 N. 4 Pages 255 - 257

Abstract: Pt | Text: Pt | PDF: Pt

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