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Quiste esplénico epidérmico infectado. Reporte de caso
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Luraschi-Centurión, Víctor

; Riquelme, Silvia Rebeca

; Molinas-Argüello, Joel

; Benítez, Jorge Oscar

Revista del Instituto de Medicina Tropical

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dec 2023, Volume 18 N. 2 Pages 66 - 69

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

RESUMEN Los quistes esplénicos son infrecuentes y presentan una baja incidencia (0.07%). Las etiologías son varias, pero en su mayoría se deben a parasitarios y no parasitarios. Entre los primeros se encuentran los quistes hidatídicos por equinococosis que son más comunes sobre todo en zonas endémicas. En el siguiente trabajo se presenta el caso de una paciente de sexo femenino de 17 años de edad que consulta por un cuadro de 6 días de evolución que inicia con dolor, tipo puntada de moderada intensidad, localizado en hipocondrio izquierdo, acompañado de fiebre graduada en 38 grados con escalofríos.

ABSTRACT Splenic cysts are uncommon and have a low incidence rate (0.07%). The etiologies are diverse, but mostly attributed to both parasitic and non-parasitic origins. Among the former, hydatid cysts due to echinococcosis are more prevalent, especially in endemic areas. This report describes the case of a 17-year-old female patient who presented with a 6-day history of pain, of moderate intensity and stabbing type, localized in the left hypochondrium. The pain was accompanied by a fever reaching 38 degrees Celsius and chills.

https://doi.org/10.18004/imt/2023.18.2.10

Core curriculum in cariology for dentistry degrees in the Republic of Argentina
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Carletto-Kórber, Fabiana PM

; Sorazabal, Ana

; Medici, Silvia

; Ali, Sofía

; Barrionuevo, Alejandra

; Cardozo, Juana

; Cucchi, Analía

; D'Eramo, Luciana

; Escandriolo, Jorge

; Fontanetti, Pablo

; García, Shirley

; Lombardo, Adriana

; Mardenlli, Alejandra

; Masoli, Carla

; Mulbany, Patricia

; Pereira, Lía

; Pérez, Silvia

; Preliasco, Mariana

; Rossi, Glenda

; Squassi, Aldo

; Ulloque, Jorgelina

; Vaculik, Patricia

; Ventrera, Verónica

; Bordoni, Noemí

; Giacaman, Rodrigo A

Acta Odontológica Latinoamericana

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dec 2023, Volume 36 N. 3 Pages 183 - 190

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

ABSTRACT Aim To prepare a consensus document of the cariology contents and competences included in the curriculum for the dentistry degree at Argentine dental faculties/schools Materials and Method Planning the process in stages: Stage 1- Diagnosis of the situation (Google Form) and invitation to participate extended to the 20 academic units (AU) that offer dentistry degrees. Stage 2- Assessment process of Content (C) and Competences (I) agreements in the five domains: D1 Basic Sciences, D2 Risk and diagnosis of dental caries, D3 Decision-making for non-invasive treatments, D4 Decision-making for invasive treatment, and D5 Evidence-based cariology at community level. Stage 3- Consensus. Stages 2 and 3 were held in Workshop format in virtual mode (W) Results Stage 1- Of the total 20 Google forms sent to the AU, 13 responses were received: 7 from National Universities and 6 from Private Universities. All participants agreed to be part of the consensus. Stage 2- W: 20 representatives from 10 AU participated. It began with a contextualizing conference, after which the representatives were divided into 5 groups to assess the agreements of each D. Stage 3- The Cariology Curriculum document was organized into 5 Domains, and 23 C and 31 I of clinical application were defined for teaching cariology. The contents and competences for each domain were agreed upon. The final document was sent to all W participants for their approval and dissemination in each AU involved Conclusion Cariology contents were defined for dentistry students at Universities in the Argentine Republic.

RESUMEN Objetivo Elaborar un documento de consenso de los contenidos y competencias de cariología en el currículo para las facultades/escuelas de odontología argentinas, a nivel del grado Materiales y Método El proceso de creación se efectuó en etapas: 1- Diagnóstico de situación (Formulario electrónico) e invitación a participar a las 20 unidades académicas (UA) donde se imparte la carrera de odontología. 2- Proceso de valoración de acuerdos de Contenidos (C) y Competencias (I) en los cinco dominios (D): D1: Ciencias Básicas; D2: Riesgo y diagnóstico de caries dental; D3: Toma de decisiones tratamientos no invasivos; D4: Toma de decisiones para el tratamiento invasivo y D5: Cariología basada en la evidencia a nivel comunitario. 3- Etapa de consenso. Las etapas 2 y 3 se efectuaron en formato de Workshop en modalidad virtual (W) Resultados Etapa 1: Del total de 20 formularios enviados a las UA se recibieron 13 respuestas (65%), 7 (53,8%) de Universidades Nacionales y 6 (46,1%) de gestión Privada. El 100% de los participantes estuvieron de acuerdo en formar parte del consenso. Etapa 2: W: Participaron 20 representantes de 10 UA. El proceso se inició con una conferencia contextualizadora, posteriormente los representantes fueron divididos en 5 grupos para la valoración de acuerdos de cada D. Etapa 3: El documento de658. 658.l Currículo en Cariología se organizó en 5 Dominios. Se definieron 23 C y 31 I de aplicación clínica para la enseñanza de la Cariología. Se consensuaron los contenidos y las competencias para cada uno de los dominios. El documento final fue enviado a todos los participantes del W para su aprobación y difusión en cada una de las UA involucradas Conclusión En base al trabajo realizado se determinó un consenso de competencias y contenidos en cariología para estudiantes de grado de Odontología, de las Universidades de la República Argentina.

https://doi.org/10.54589/aol.36/3/183

Cidades e comunidades sustentáveis? Problemas práticos de implementação local da Agenda 2030 à luz do processo de reabilitação das ilhas do Porto
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Varea Oro, Aitor

; Jorge, Sílvia

CIDADES, Comunidades e Territórios

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oct 2023, N. au23 Pages 69 - 86

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

Resumo O presente artigo problematiza as dificuldades de operacionalização da Agenda 2030 das Nações Unidas, comprometida com a redução das desigualdades e a promoção de um desenvolvimento sustentável. Partindo do conceito de vulnerabilidade urbana, recorre-se a um caso de estudo concreto - o processo de reabilitação das ilhas do Porto -, representativo das dificuldades e desafios a ultrapassar, mas também das ferramentas a mobilizar na concretização das metas assumidas. A análise das causas históricas da vulnerabilidade nas ilhas permite identificar as implicações que hoje têm na exclusão e nas iniquidades em saúde de quem aí reside, os principais fatores de risco, as ferramentas concretas adotadas e os resultados atingidos. Conclui-se que a intervenção sobre o meio físico pode, nestes territórios, ser uma forma eficaz de combater a vulnerabilidade urbana, mas também que a implementação do Objetivo do Desenvolvimento Sustentável 11 - cidades e comunidades sustentáveis - está dependente da capacidade de articular uma nebulosa de ações e intervenientes. O grande desafio das políticas públicas passa assim por criar uma agenda para que os procedimentos, a nível local, orientem a ação do poder público e dos intervenientes privados no alcance da mudança preconizada.

Abstract This article discusses the difficulties in implementing of the United Nations' 2030 Agenda, committed to reducing inequalities and promoting sustainable development. Starting from the concept of urban vulnerability, a specific case study is used - the rehabilitation process of the ilhas of Porto - which is representative of the challenges to be overcome, as well as the tools to be mobilized in achieving the set goals. Analysing the historical causes of vulnerability on the ilhas allows us to identify the implications for the exclusion and health inequities of its residents are identified, as well as the main risk factors, the concrete tools adopted, and the results achieved. It is concluded that intervention in the physical environment can be, in these territories, an effective way to combat urban vulnerability, and that the implementation of Sustainable Development Goal 11 - sustainable cities and communities - depends on the ability to articulate a network of actions and stakeholders. The major challenge for public policies is therefore to create an agenda for procedures that, at the local level, guide the action of public and private stakeholders in achieving the desired change.

https://doi.org/10.15847/cct.29239

O acesso a uma habitação condigna em Portugal: Um olhar sobre os grupos mais vulneráveis
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Jorge, Sílvia

; Melo, Vanessa

CIDADES, Comunidades e Territórios

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oct 2023, N. au23 Pages 1 - 3

Abstract: Pt | Text: Pt | PDF: Pt

https://doi.org/10.15847/cct.32820

‘Não resolvi o problema da habitação, mas aprendi umas coisas pelo caminho.’ Entrevista com Helena Roseta
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Jorge, Sílvia

; Melo, Vanessa

CIDADES, Comunidades e Territórios

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oct 2023, N. au23 Pages 123 - 133

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

Resumo Helena Roseta é uma cidadã e arquiteta preocupada e ocupada, desde sempre, em garantir o direito à habitação. Desempenhou vários cargos políticos ao longo do tempo, tais como o de Presidente da Câmara Municipal de Cascais (1983-1986), de vereadora pelo Partido Socialista (2009-2013) e pelos “Cidadãos por Lisboa” na Câmara Municipal de Lisboa (2007-2009) e de Presidente da Assembleia Municipal de Lisboa (2013-2019). Fundou a Plataforma Artigo 65, em 2006, e é apelidada de mãe da Lei de Bases da Habitação, publicada em 2019 (Assembleia da República, 2019). Aos 71 anos reformou-se dos cargos políticos, mas não das suas causas. Nesta entrevista, Helena Roseta partilha a sua experiência e visão sobre a habitação em Portugal, sublinhando as dificuldades sentidas por diferentes grupos vulneráveis ao longo do tempo. A conversa parte de uma breve contextualização histórica do acesso à habitação no país, tendo o 25 de Abril como momento charneira, e chega à Nova Geração de Políticas de Habitação e à publicação da Lei de Bases da Habitação, que enquadram a atual conjuntura. A lente sobre a habitação, indissociável de um habitat condigno, abre-se ainda ao programa público Bairros Saudáveis, focado também na melhoria das condições de saúde, bem-estar e qualidade de vida dos residentes de territórios vulneráveis, a partir de pequenas intervenções com uma dotação máxima de 50 000 euros.

Abstract Helena Roseta is a citizen and architect who has always been concerned and busy with ensuring the right to housing. She held several political positions over time, such as Mayor of Cascais City Council (1983-1986), city councilor for Socialist Party (2009-2013) and for “Citizens for Lisbon” at Lisbon City Council (2007-2009) and President of the Lisbon Municipal Assembly (2013-2019). She founded Plataforma Artigo 65, in 2006, and is called the ‘mother’ of the Basic Housing Law, published in 2019. At the age of 71, she is retired from political positions, but not from her causes. In this interview, Helena Roseta shares her experience and vision about housing in Portugal, highlighting the difficulties experienced by different vulnerable groups over time. The conversation starts with a brief historical contextualization of access to housing in the country, with 25th of April as a pivotal moment, and goes on to discuss the New Generation of Housing Policies and the publication of the Basic Housing Law, which frame the current situation. The lens on housing, inseparable from a decent habitat, also opens up to the Healthy Neighborhoods public programme, also focused on improving the health conditions, well-being and quality of life of residents of vulnerable territories, based on small interventions with a maximum allocation of 50,000 euros.

https://doi.org/10.15847/cct.32865

Papel del acceso transeptal en TAVI en un paciente con estenosis aórtica sobre válvula bicúspide incruzable
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Martínez-Sole, Julia

; Lozano-Edo, Sílvia

; Ten-Morro, Francisco

; Andrés-Lalaguna, Luis

; Sanz-Sánchez, Jorge

; Díez-Gil, José Luis

REC: Interventional Cardiology

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sep 2023, Volume 5 N. 3 Pages 227 - 228

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

https://doi.org/10.24875/recic.m22000306

Papel del acceso transeptal en TAVI en un paciente con estenosis aórtica sobre válvula bicúspide incruzable. Resolución
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Martínez-Sole, Julia

; Lozano-Edo, Sílvia

; Ten-Morro, Francisco

; Andrés-Lalaguna, Luis

; Sanz-Sánchez, Jorge

; Díez-Gil, José Luis

REC: Interventional Cardiology

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sep 2023, Volume 5 N. 3 Pages 230 - 231

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

https://doi.org/10.24875/recic.m22000308

Manejo endoscópico de fístulas del seno piriforme. Reporte de dos casos
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Sánchez-Paredes, Vicente

; Madriñán-Rivas, Jorge Eduardo

; Gutiérrez-Lucatero, Silvia

; Simonín-Ruiz, Oscar David

; Pacheco-Y Orozco, Farid Adán

Revista de sanidad militar

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jun 2023, Volume 77 N. 2 elocation e02

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

Resumen Caso 1: Femenino de cuatro años de edad con absceso cervical izquierdo recurrente por fístula del seno piriforme izquierdo tratada finalmente con electrocoagulación endoscópica sin recidivas en más de siete meses. Caso 2: Masculino de seis años de edad con absceso cervical izquierdo recurrente por fístula del seno piriforme izquierdo tratado con electrocoagulación endoscópica sin recidivas en más de 6 meses. Discusión: Las fistulas del seno piriforme son poco comunes, resueltas en forma quirúrgica con amplias disecciones cervicales y en ocasiones con hemitiroidectomías. No suelen sospecharse sino hasta la recurrencia del cuadro. Aunque no todos los abscesos cervicales son por fístulas del seno piriforme, recomendamos descartarla en casos de recidiva sobre todo en el lado izquierdo del cuello; acompañando el drenaje con exploración endoscópica. De confirmarse el diagnóstico se ofrece tratamiento por electrocoagulación en la misma intervención con mejores resultados al evitar los riesgos que implica la resección extensa del tratamiento convencional. En nuestros casos usamos endoscopía flexible y electrocoagulación con resultados superiores en relación con el tratamiento quirúrgico convencional. Limitaciones: Solo se trata de dos casos, pero corresponden a una entidad poco frecuente. Valor: Se muestra como alternativa el tratamiento endoscópico con electrocoagulación con mejores resultados en relación con el manejo tradicional para los casos de fístula del seno piriforme en niños.

Abstract Case 1: A 4-year-old female with a recurrent left cervical abscess due to a left piriform sinus fistula finally treated with endoscopic electrocoagulation without recurrences for more than 7 months. Case 2: 6-year-old male with recurrent left cervical abscess due to left piriform sinus fistula treated with endoscopic electrocoagulation without recurrences for more than 6 months. Discussion: Piriform sinus fistulas are rare and are surgically corrected with extensive cervical dissections and occasionally hemithyroidectomies. They are not usually noticed as such until the recurrence. Although not all cervical abscesses are due to piriform sinus fistulas, we recommend ruling out in cases of recurrence, especially on the left side of the neck, accompanying by drainage with endoscopic exploration. If the suspicion is confirmed, electrocoagulation treatment is offered in the same intervention with better results by avoiding the risks involved in an extensive resection with conventional treatment. In our cases we use flexible endoscopy and electrocoagulation with better results compared to conventional surgical treatment. Limitations: These are only two cases, but they are rare. Value: Endoscopic treatment with electrocoagulation is shown as an alternative with better results in relation to traditional management for cases of piriform sinus fistula in children.

https://doi.org/10.56443/rsm.v77i2.365

Diferencias en la duración del reflejo rectoanal inhibitorio O en pacientes con constipación funcional refractaria y mielomeningocele
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Fernández, Julián

; Messere, Gabriela

; Ortiz, Gonzalo

; Oviedo, Adriana

; Vidal, Jorge

; Morise, Silvia

; Nurko, Samuel

; Bigliardi, Román

Archivos argentinos de pediatría

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apr 2023, Volume 121 N. 2 Pages 6 - 6

Abstract: Es | Text: Es | PDF: Es

RESUMEN Introducción. Habitualmente, durante la manometría anorrectal, en lo correspondiente al reflejo rectoanal inhibitorio (RRAI) solo se pesquisa su presencia o ausencia. Estudios han reportado que su análisis detallado puede brindar datos de interés. Nuestra hipótesis es que la medición del RRAI puede dar información para reconocer causas orgánicas (médula anclada, lipoma, etc.) en pacientes en los que previamente se consideró como de causa funcional. Objetivos. Comparar la duración del reflejo rectoanal inhibitorio en la manometría anorrectal de pacientes con constipación funcional refractaria (CFR) y mielomeningocele (MMC). Población y métodos. Estudio observacional, transversal, analítico (2004-2019). Pacientes constipados crónicos con incontinencia fecal funcional y orgánica (mielomeningocele). Se les realizó manometría anorrectal con sistema de perfusión de agua y se midió la duración del RRAI con diferentes volúmenes (20, 40 y 60 cc). Grupo 1 (G1): 81 CFR. Grupo 2 (G2): 54 MMC. Se excluyeron pacientes con retraso madurativo, esfínter anal complaciente, agenesia sacra y aquellos no colaboradores. Resultados. Se incluyeron 135 sujetos (62 varones). La mediana de edad fue G1:9,57 años; G2: 9,63 años. Duración promedio G1 vs. G2 con 20 cc: 8,89 vs. 15,21 segundos; con 40 cc: 11.41 vs. 21,12 segundos; con 60 cc: 14,15 vs. 26,02 segundos. La diferencia de duración del RRAI entre ambos grupos con diferentes volúmenes fue estadísticamente significativa (p = 0,0001). Conclusión. La duración del RRAI aumenta a mayor volumen de insuflación del balón en ambas poblaciones. Pacientes con MMC tuvieron mayor duración del RRAI que aquellos con CFR. En los pacientes con RRAI prolongado, debe descartarse lesión medular.

https://doi.org/10.5546/aap.2022-02598

10.

COVID-19: presentación clínica inicial y su correlación con la gravedad de la enfermedad
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Freire-Chávez, Jorge L

; Cordovilla-Zamora, Mónica J

; Solís-Aramayo, Marco A

; Quadrelli, Silvia

Revista americana de medicina respiratoria

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mar 2023, Volume 23 N. 1 Pages 25 - 31

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

RESUMEN Los pacientes con COVID-19 tienen un amplio espectro de presentación clínica y las tasas de mortalidad en los casos graves son relativamente altas. La identificación tem prana de los factores de riesgo que se relacionan con la gravedad de la enfermedad es de vital importancia. Con el objetivo de correlacionar los síntomas iniciales de COVID-19 con la gravedad de la enfermedad, se realizó el presente estudio de cohorte transversal retrospectivo y observacional de 413 pacientes con diagnóstico de COVID-19 entre enero y marzo 2021. De todos los síntomas iniciales estudiados, la disnea (p < 001), fiebre (p 0,001), tos (p 0,002), odinofagia (p 0,01), cefalea (p 0,01) y síntomas gastrointestinales (p 0,03), se asociaron con el desarrollo de una enfermedad grave. Las comorbilidades que se asociaron con peor pronóstico fueron: hipertensión arterial (p < 0,001), obesidad (p < 0,001), EPOC (p < 0,001), extabaquismo (p < 0,001), diabetes (p 0,01), enfermedad cardiovascular previa (p 0,03), y enfermedad oncológica activa (p 0,04). En conclusión, los pacientes con diagnóstico de COVID-19, cuya manifestación inicial es disnea, fiebre, tos, odinofagia, cefalea y síntomas gastrointestinales, deben ser monitoreados de cerca para prevenir el deterioro de la enfermedad.

ABSTRACT Patients with COVID-19 have a broad spectrum of clinical presentations, and mortal ity rates are relatively high in severe cases. Early identification of risk factors that are related to the severity of the disease is of vital importance. In order to correlate the initial symptoms of COVID-19 with disease severity, the present retrospective, cross-sectional, observational cohort study was conducted, including 413 patients diagnosed with COVID-19 between January and March, 2021. Of all the initial symptoms that were studied, dyspnea (p < 001), fever (p 0.001), cough (p 0.002), odynophagia (p 0.01), headache (p 0.01), and gastrointestinal symptoms (p 0.03) were associated with the development of severe illness. The comorbidities that were associated with the worst prognoses were: arterial hypertension (p < 0.001), obesity (p < 0.001), COPD (chronic obstructive pulmonary disease) (p < 0.001), former smoking (p < 0.001), diabetes (p 0.01), previous cardiovascular disease (p 0.03), and active oncological disease (p 0.04). In conclusion, patients diagnosed with COVID-19 whose initial manifestations include dyspnea, fever, cough, odynophagia, headache, and gastrointestinal symptoms should be closely monitored to prevent disease deterioration.

https://doi.org/10.56538/ramr.dsvu8304

11.

COVID-19: initial clinical presentation and its correlation with the severity of the disease
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Freire-Chávez, Jorge L

; Cordovilla-Zamora, Mónica J

; Solís-Aramayo, Marco A

; Quadrelli, Silvia

Revista americana de medicina respiratoria

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mar 2023, Volume 23 N. 1 Pages 94 - 100

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

RESUMEN Los pacientes con COVID-19 tienen un amplio espectro de presentación clínica y las tasas de mortalidad en los casos graves son relativamente altas. La identificación tem prana de los factores de riesgo que se relacionan con la gravedad de la enfermedad es de vital importancia. Con el objetivo de correlacionar los síntomas iniciales de COVID-19 con la gravedad de la enfermedad, se realizó el presente estudio de cohorte transversal retrospectivo y observacional de 413 pacientes con diagnóstico de COVID-19 entre enero y marzo 2021. De todos los síntomas iniciales estudiados, la disnea (p < 001), fiebre (p 0.001), tos (p 0.002), odinofagia (p 0.01), cefalea (p 0.01) y síntomas gastrointestinales (p 0.03), se asociaron con el desarrollo de una enfermedad grave. Las comorbilidades que se asociaron con peor pronóstico fueron: hipertensión arterial (p < 0.001), obesidad (p <0.001), EPOC (p < 0.001), ex tabaquismo (p < 0.001), diabetes (p 0.01), enfermedad cardiovascular previa (p 0.03), y enfermedad oncológica activa (p 0.04). En conclusión, los pacientes con diagnóstico de COVID-19, cuya manifestación inicial es disnea, fiebre, tos, odinofagia, cefalea y síntomas gastrointestinales, deben ser monitoreados de cerca para prevenir el deterioro de la enfermedad.

ABSTRACT Patients with COVID-19 have a broad spectrum of clinical presentations, and mortal ity rates are relatively high in severe cases. Early identification of risk factors that are related to the severity of the disease is of vital importance. In order to correlate the initial symptoms of COVID-19 with disease severity, the pres ent retrospective, cross-sectional, observational cohort study was conducted, including 413 patients diagnosed with COVID-19 between January and March, 2021. Of all the initial symptoms that were studied, dyspnea (p < 001), fever (p 0.001), cough (p 0.002), odynophagia (p 0.01), headache (p 0.01), and gastrointestinal symptoms (p 0.03) were associated with the development of severe illness. The comorbidities that were associated with the worst prognoses were: arterial hypertension (p < 0.001), obesity (p < 0.001), COPD (chronic obstructive pulmonary disease) (p < 0.001), former smok ing (p < 0.001), diabetes (p 0.01), previous cardiovascular disease (p 0.03), and active oncological disease (p 0.04). In conclusion, patients diagnosed with COVID-19 whose initial manifestations include dyspnea, fever, cough, odynophagia, headache, and gastrointestinal symptoms should be closely monitored to prevent disease deterioration.

https://doi.org/10.56538/ramr.uxjv9747

12.

Influenza vaccination for primary and secondary prevention of cardiovascular risk: Call to action of Cardiology Societies of Mexico
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Guerra, Arturo

; Cossío, Jorge

; Enciso, José Manuel

; Alcocer, Alejandro

; Gómez-Álvarez, Enrique

; Meaney, Eduardo

; Palomo, Silvia

; Alcocer, Luis

Cardiovascular and metabolic science

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mar 2023, Volume 34 N. 1 Pages 25 - 28

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

Resumen: La influenza aumenta sustancialmente el riesgo de desencadenar síndromes coronarios agudos e insuficiencia cardiaca. La vacunación contra la influenza disminuye estos riesgos y disminuye la aparición de complicaciones. Se recomienda la vacunación de toda la población, especialmente las personas con riesgo o con enfermedad cardiovascular establecida.

Abstract: Influenza substantially increases the risk of triggering acute coronary syndromes and heart failure. Vaccination against influenza decreases these risks and diminishes the occurrence of complications. Vaccination of the entire population is recommended, especially for people at risk or with established cardiovascular disease.

https://doi.org/10.35366/110250

13.

Avaliação da implantação da Rede de Cuidados à Pessoa com Deficiência no Sistema Único de Saúde: um estudo de casos múltiplos
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Ribeiro, Kátia Suely Queiroz Silva

; Saldanha, Jorge Henrique Santos

; Zanela, Ângela Kemel

; Ferrari, Fernando Pierette

; Freitas, Grace Kelly Filgueiras

; Barroso, Ralf Braga

; Silva, Silvia Lanziotti Azevedo da

; Chaves, Sônia Cristina Lima

; Aquino, Victor da Silva

; Schmitt, Ana Carolina Basso

; Fernandes, Tiótrefis Gomes

Cadernos de Saúde Pública

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2023, Volume 39 N. 5 elocation e00186122

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

Resumo: A Rede de Cuidados à Pessoa com Deficiência (RCPCD) foi implantada em 2012 como desdobramento das ações do Plano Viver sem Limite, sendo objeto de pesquisas recentes, entretanto, não foram encontrados estudos de avaliação do grau de implantação dessa rede. O objetivo deste artigo foi avaliar o grau de implantação da RCPCD em oito estados nas cinco regiões geográficas brasileiras. Realizou-se estudo de casos múltiplos mediante pesquisa avaliativa do grau de implantação da RCPCD nos estados/casos: Amazonas, Bahia, Espírito Santo, Mato Grosso do Sul, Minas Gerais, Paraíba, Rio Grande do Sul e São Paulo. Para tanto, desenvolveu-se um modelo lógico da política e uma matriz de medidas. O grau de implantação de sete estados foi classificado como moderado, somente o Amazonas obteve grau de implantação incipiente. Foram identificadas diferenças importantes na avaliação de cada fase desse processo, as fases de diagnóstico regional e adesão à rede obtiveram grau de implantação de moderado a avançado na maioria dos estados. Na fase da contratualização dos serviços, nenhum estado alcançou o grau avançado de implantação e a fase de acompanhamento e monitoramento da RCPCD basicamente não ocorreu em todos os estados. A matriz de medidas permite avaliar o grau de implantação da RCPCD. Ainda, o reconhecimento dos resultados do grau de implantação pelos grupos condutores e áreas técnicas estaduais referendou o uso desse instrumento. Salienta-se a necessidade de ações para o aprimoramento dessa implantação, tais como: fortalecer a regionalização, instituir grupos condutores regionais, garantir mecanismos de contratualização e definir critérios para certificação dos pontos de atenção.

Resumen: La Red de Atención a Personas con Discapacidad (RCPCD) se implementó en 2012 en el Sistema Único de Salud como resultado de las acciones del Plan Vivir sin Límite, y es objeto de una investigación reciente; sin embargo, no hay estudios de evaluación del grado de implementación de esta red. El objetivo de este estudio fue evaluar el grado de implementación de la RCPCD en ocho estados de las cinco regiones geográficas brasileñas. Se realizó un estudio de caso múltiple mediante una investigación evaluativa sobre el grado de implementación de la RCPCD en los estados/casos: Amazonas, Bahia, Espírito Santo, Mato Grosso do Sul, Minas Gerais, Paraíba, Rio Grande do Sul y São Paulo. Para ello, se elaboraron un modelo lógico de la política y una matriz de medidas. El grado de implementación de siete estados se clasificó como moderado, solamente Amazonas obtuvo un grado de implementación incipiente. Se identificaron diferencias importantes en la evaluación de cada fase de este proceso, las fases de diagnóstico regional y adhesión a la red lograron un grado de implementación de moderado a avanzado en la mayoría de los estados. En la fase de contratación de los servicios, ningún estado alcanzó el nivel avanzado de implementación, y la fase de seguimiento y monitoreo de la RCPCD básicamente no se realizó en todos los estados. La matriz de medidas permite evaluar el grado de implementación de la RCPCD, y el reconocimiento de los resultados del grado de implementación por parte de los grupos de dirección y el área técnica de los estados avaló su uso. Son necesarias más acciones para mejorar esta implementación, tales como: fortalecer la regionalización, establecer grupos de dirección regional, garantizar mecanismos de contratación y definir criterios para la certificación de puntos de atención.

Abstract: The Care Network for People with Disabilities (RCPCD) was implemented in 2012 as a consequence of the actions of the Viver sem Limite (Living without Limits) plan and has been the research object of recent studies. However, no published studies address the degree of implementation of this network. This study aimed to evaluate the degree of implementation of the RCPCD in eight states in the five regions of Brazil. This multiple case study performed evaluative research of the degree of implementation of the RCPCD in the states of Amazonas, Bahia, Espírito Santo, Mato Grosso do Sul, Minas Gerais, Paraíba, Rio Grande do Sul, and São Paulo. A logical model of the policy and a measurement matrix were developed. The degree of implementation of seven states was moderate, but Amazonas had an incipient degree of implementation. The evaluation of each stage of the process showed important differences, as the regional diagnosis and network adhesion stages presented moderate to advanced degrees of implementation in most states. In the service contracting stage, no state had an advanced degree of implementation, and the stage of follow-up and monitoring of the RCPCD was not even reached. The measurement matrix helps evaluate the degree of implementation of the RCPCD, and, by recognizing its results, the state steering groups and technical area recommend its use. Actions to improve this implementation, such as strengthening regionalization, establishing regional steering groups, ensuring contracting mechanisms, and defining criteria for certification of the care points, are necessary.

https://doi.org/10.1590/0102-311xpt186122

14.

Pharmacokinetics and therapeutic target attainment of vancomycin in pediatric post-liver transplant patients
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Morales Junior, Ronaldo

; Juodinis, Vanessa D'Amaro

; Souza, Daniela Carla de

; Santos, Silvia Regina Cavani Jorge

Brazilian Journal of Infectious Diseases

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2023, Volume 27 N. 6 elocation 103688

Abstract: En | Text: En | PDF: En

Abstract Introduction Vancomycin is widely prescribed to treat or prevent Gram-positive infections in pediatric liver transplant recipients. The objective of this prospective cohort study is to describe vancomycin pharmacokinetics and to evaluate the therapeutic target attainment after initial dose regimen. Materials and methods Patients with previous renal injury were excluded. Vancomycin therapy started with 40‒60 mg/kg/day. The pharmacokinetic parameters were assessed using two steady-state blood samples and the first-order kinetic equations. Therapeutic target was defined as vancomycin 24-hour Area Under the Curve/Minimum Inhibitory Concentration (AUC/MIC) ≥ 400 and < 600. Results Sixteen patients were included. The found vancomycin clearance, half-life, and volume of distribution were, respectively: 2.1 (1.3‒2.8) mL/kg/min, 3.3 (2.7‒4.4) hours, and 0.7 (0.5‒0.9) L/kg. With the initial dose, only 6 (37 %) patients reached the therapeutic target against Gram-positive pathogens with MIC 1 mg/L. After individual dose adjustments, all patients reached the target. The correlation between trough levels and AUC was low (R2= 0.5). Conclusions Pediatric patients with preserved renal function after liver transplantation have an increased volume of distribution for vancomycin, and most patients present subtherapeutic levels after the standard initial dosing regimen. With the vancomycin AUC-guided monitoring and dosing, it is possible to improve therapeutic target attainment.

https://doi.org/10.1016/j.bjid.2023.103688

15.

Avaliação da implantação da Rede de Cuidados à Pessoa com Deficiência no Sistema Único de Saúde: um estudo de casos múltiplos
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Ribeiro, Kátia Suely Queiroz Silva

; Saldanha, Jorge Henrique Santos

; Zanela, Ângela Kemel

; Ferrari, Fernando Pierette

; Freitas, Grace Kelly Filgueiras

; Barroso, Ralf Braga

; Silva, Silvia Lanziotti Azevedo da

; Chaves, Sônia Cristina Lima

; Aquino, Victor da Silva

; Schmitt, Ana Carolina Basso

; Fernandes, Tiótrefis Gomes

Cadernos de Saúde Pública

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2023, Volume 39 N. 5 elocation e00186122

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

https://doi.org/10.1590/0102-311xpt186122

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