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The Digital Sovereignty Trap. Avoiding the Return of Silos and a Divided World
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Morales Sánchez, Gustavo Alfonso

Relaciones internacionales

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dec 2023, Volume 32 N. 65 Pages 326 - 328

Abstract: Es | Text: Es | PDF: Es

Effectiveness of pancreatic stent placement in pediatric patients with acute recurrent and chronic pancreatitis
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Blanco-Rodríguez, Gerardo

; Ledezma-Cifuentes, Mallerli N.

; García-Cárdenas, Eustorgio S.

; Blanco-Velasco, Gerardo

; Peña-García, Mario

; Penchyna-Grub, Jaime

; Teyssier-Morales, Gustavo

; Zurita Cruz, Jessie N.

Boletín médico del Hospital Infantil de México

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oct 2023, Volume 80 N. 5 Pages 296 - 301

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

Resumen Introducción: El uso de prótesis pancreáticas en niños con pancreatitis aguda recurrente (PAR) y crónica (PC) ha evolucionado. La principal indicación establecida es el tratamiento del dolor abdominal persistente. El objetivo de este estudio fue evaluar la eficacia del uso prótesis pancreática para el dolor abdominal refractario en pacientes pediátricos con PAR y PC, sin respuesta a manejo conservador. Métodos: Se llevó a cabo un estudio retrospectivo de serie de casos. Se incluyeron pacientes menores de 16 años con diagnóstico de PAR y PC. Se realizó una colangio pancreatografía retrograda endoscópica (CPRE) para introducir inicialmente una y posteriormente dos prótesis pancreáticas. Se evaluaron síntomas abdominales antes y después del tratamiento, número de recambios, duración del tratamiento y complicaciones con seguimiento a 24 meses y posterior a su retiro. Resultados: Se incluyeron 9 pacientes con PAR y PC: seis de etiología no determinada y tres con páncreas divisum. La edad promedio fue de 12.4 años. La colocación de prótesis alivió el dolor abdominal en el 100%, con 3.2 sesiones de recambio cada 6.2 meses en 27.4 meses, y complicaciones leves (15.7%). Un paciente presentó dolor al retirar las prótesis y requirió cirugía derivativa. Conclusiones: El uso de prótesis pancreática en pacientes con dolor abdominal refractario con PAR y PC demostró ser eficaz y seguro al aliviar los síntomas a mediano plazo con mínimas complicaciones.

Abstract Background: The use of pancreatic prostheses in children with acute recurrent pancreatitis (ARP) and chronic pancreatitis (CP) has evolved. The main established indication is the treatment of persistent abdominal pain. This study aimed to evaluate the efficacy of pancreatic stenting for refractory abdominal pain in pediatric patients with ARP and CP. Methods: We conducted a retrospective case series study. We included patients under 16 years of age diagnosed with ARP and CP in the study. Endoscopic retrograde cholangiopancreatography (ERCP) was performed with the insertion of one and later two pancreatic stents. We evaluated abdominal symptoms before and after treatment, number of changes, duration of treatment, and complications with follow-up at 24 months and after withdrawal. Results: Nine patients with ARP and CP were included in the study: six with undetermined etiology and three with pancreas divisum. The mean age was 12.4 years. Prosthesis placement relieved abdominal pain in 100% of cases, with 3.2 replacement sessions every 6.2 months for 27.4 months, and mild complications (15.7%). One patient experienced pain on removal of the prosthesis and required bypass surgery. Conclusion: Pancreatic stent placement in patients with refractory abdominal pain with ARP and CP proved to be effective and safe, providing medium-term symptom relief and minimal complications.

https://doi.org/10.24875/bmhim.23000044

The poverty of Critical Theory in International Relations
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Morales Sánchez, Gustavo Alfonso

Relaciones internacionales

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jun 2023, Volume 32 N. 64 Pages 210 - 213

Abstract: Es | Text: Es | PDF: Es

The impact of the COVID-19 pandemic on the diagnosis and treatment of ocular cancer
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Fontes Junior, Vicente Conrado

; Fernandes, Arthur Gustavo

; Morales, Melina Correa

; Belfort Neto, Rubens

Arquivos Brasileiros de Oftalmologia

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apr 2023, Volume 86 N. 2 Pages 127 - 130

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

ABSTRACT Purpose: To evaluate the impact of social isolation due to the COVID-19 pandemic on the number of new cases and therapeutic approaches at the Ocular Oncology division from the Universidade Federal de São Paulo (UNIFESP). Methods: A retrospective study was conducted by medical records review of new patients treated before the pandemic from March 2019 to September 2019 (pre-pandemic group) and during the pandemic from March 2020 to September 2020 (pandemic group). Data regarding age, sex, ethnicity, place of origin, clinical diagnosis, time since referral, and proposed therapy were analyzed. Results: We analyzed 186 new cases, 122 from the pre-pandemic group and 64 from the pandemic group, representing a decrease of 47.54% in new cases. There was no statistically significant change in sex, race, state of origin, history of cancer, age, or time with suspected cancer (p>0.05). A higher frequency of malignancies was observed in the pandemic group (68%) when compared to the pre-pandemic group (48.48%). Benign tumors were the most common diagnosis in the pre-pandemic group (41.80%), while conjunctival squamous cell carcinoma was the modal diagnosis in the pandemic group (31.25%). There was a decreasing trend (p=0.097) in the number of surgeries (-7.63%) and an increase in topical treatment (+10.68%). There was also a tendency to perform fewer surgeries in benign tumors and decreased follow-up visits. Conclusion: Our findings showed a significant decrease in the number of new cases referred to the Ocular Oncology service. Moreover, the pandemic led to a switch in the therapeutic approach with preference to non-invasive treatments that would demand operating rooms. A drastic increase of cases perhaps in advanced stages might be expected because of the decrease observed in the first six months of quarantine.

RESUMO Objetivo: Avaliar o impacto do isolamento social devido à pandemia COVID-19 sobre o número de casos novos e abordagens terapêuticas. Métodos: Estudo retrospectivo por revisões de prontuários de novos pacientes tratados antes da pandemia, de março de 2019 a setembro de 2019 (grupo pré-pandemia), e durante a pandemia, de março de 2020 a setembro de 2020 (grupo pandemia). Dados analisados incluíram idade, sexo, etnia, local de origem, diagnóstico clínico, tempo desde o encaminhamento e terapia proposta. Resultados: Um total de 186 novos casos foram analisados, sendo 122 do grupo pré-Pandemia e 64 do grupo Pandemia, representando uma redução de 47,54%. Não houve alteração estatisticamente signi ficativa quanto a sexo, raça, estado de origem, história do câncer, idade ou tempo de encaminhamento (p>0,05). Observou-se maior frequência de malignidades no grupo pandemia (68%) quando comparado com o grupo pré-pandemia (48,48%). Os tumores benignos foram os casos mais diagnosticados no grupo pré-pandemia (41,80%), enquanto no grupo pandemia o diagnóstico mais frequente foi o carcinoma de células escamosas de conjuntiva (31,25%). Houve tendência (p=0,097) de diminuição no número de cirurgias (-7,63%) e de aumento no tratamento tópico (+10,68%). Houve também uma tendência a diminuição de indicação cirúrgica em tumores benignos e diminuição dos retornos imediatos. Conclusão: Nossos achados mostram uma diminuição significativa no número de novos casos encaminhados ao setor de Oncologia Ocular. Além disso, a pandemia levou a uma mudança na abordagem terapêutica com preferência a tratamentos não invasivos, a fim de evitar o uso de salas de cirurgia. Um aumento drástico de casos, talvez em estágios avançados, pode ser esperado como resultado da diminuição observada nos primeiros 6 meses de quarentena.

https://doi.org/10.5935/0004-2749.20230023

Seguridad de las drogas biológicas y sintéticas dirigidas utilizadas en pacientes con enfermedades reumáticas inmunomediadas.
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Isnardi, Carolina A

; Roberts, Karen

; Exeni, Ida

; De La Sota, Mercedes

; Soriano, Enrique

; Dubinsky, Diana

; Medina, Gustavo

; Berbotto, Guillermo A

; Velozo, Edson J

; Papasidero, Silvia

; Gamba, Julieta

; Saurit, Verónica

; Citera, Gustavo

; Díaz, Mónica

; Catay, Erika

; Gómez, Graciela

; Sacnun, Mónica

; Larroude, María S

; Cavillon, Emilia

; Secco, Anastasia

; Aste, Nora

; Pons-Estel, Bernardo

; García, Mercedes A

; Pisoni, Cecilia

; Bovea, Gladys

; Morales, Liliana

; Granel, Amelia

; Gobbi, Carla

; Savio, Verónica

; Álvarez, Analia P

; Casado, Gustavo

; Soares Souza, Sidney

; Petkovic, Ingrid

; Castro, Cecilia

; Kerzberg, Osvaldo

; Gallardo, María de los Ángeles

; Brigante, Alejandro

; Haye Salinas, María

; Alfaro, María Agustina

; Pons-Estel, Guillermo J

; de la Vega, María Celina

Revista argentina de reumatología

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jan 2023, Volume 34 N. 1 Pages 3 - 15

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

Resumen Introducción: conocer la seguridad de las drogas actualmente disponibles para el tratamiento de las enfermedades reumáticas es muy importante al momento de tomar decisiones terapéuticas objetivas e individualizadas en la consulta médica diaria. Asimismo, datos de la vida real amplían el conocimiento revelado por los ensayos clínicos. Objetivos: describir los eventos adversos (EA) reportados, estimar su frecuencia e identificar los factores relacionados con su desarrollo. Materiales y métodos: se utilizaron datos BIOBADASAR, un registro voluntario y prospectivo de seguimiento de EA de tratamientos biológicos y sintéticos dirigidos en pacientes con enfermedades reumáticas inmunomediadas. Los pacientes son seguidos hasta la muerte, pérdida de seguimiento o retiro del consentimiento informado. Para este análisis se extrajeron datos recopilados hasta el 31 de enero de 2023. Resultados: se incluyó un total de 6253 pacientes, los cuales aportaron 9533 ciclos de tratamiento, incluyendo 3647 (38,3%) ciclos sin drogas modificadoras de la enfermedad biológicas y sintéticas dirigidas (DME-b/sd) y 5886 (61,7%) con DME-b/sd. Dentro de estos últimos, los más utilizados fueron los inhibidores de TNF y abatacept. Se reportaron 5890 EA en un total de 2701 tratamientos (844 y 1857 sin y con DME-b/sd, respectivamente), con una incidencia de 53,9 eventos cada 1000 pacientes/año (IC 95% 51,9-55,9). La misma fue mayor en los ciclos con DME-b/sd (71,1 eventos cada 1000 pacientes/año, IC 95% 70,7-77,5 versus 33,7, IC 95% 31,5-36,1; p<0,001). Las infecciones, particularmente las de la vía aérea superior, fueron los EA más frecuentes en ambos grupos. El 10,9% fue serio y el 1,1% provocó la muerte del paciente. El 18,7% de los ciclos con DME-b/sd fue discontinuado a causa de un EA significativamente mayor a lo reportado en el otro grupo (11,5%; p<0,001). En el análisis ajustado, las DME-b/sd se asociaron a mayor riesgo de presentar al menos un EA (HR 1,82, IC 95% 1,64-1,96). De igual manera, la mayor edad, el mayor tiempo de evolución, el antecedente de enfermedad pulmonar obstructiva crónica, el diagnóstico de lupus eritematoso sistémico y el uso de corticoides se asociaron a mayor riesgo de EA. Conclusiones: la incidencia de EA fue significativamente superior durante los ciclos de tratamientos que incluían DME-b/sd.

Abstract Introduction: knowing the efficacy and safety of the drugs currently available for the treatment of rheumatic diseases is very important when making objective and individualized therapeutic decisions in daily medical consultation. Likewise, real-life data extends the knowledge revealed by clinical trials. Objectives: to describe the reported adverse events (AEs), estimate their frequency and identify factors associated to them. Materials and methods: BIOBADASAR data were used, which is a voluntary, prospective follow-up registry of AEs of biological and synthetic treatments in patients with immune-mediated rheumatic diseases. Patients are followed until death, loss of followup, or withdrawal of informed consent. To carry out this analysis, the data collected up to January 31, 2023 was extracted. Results: a total of 6253 patients were included, who contributed with 9533 treatment periods, including 3647 (38.3%) periods without b/ts-DMARDs and 5886 (61.7%) with b/ts-DMARDs. Among the latter, the most used were TNF inhibitors and abatacept. A total of 5890 AEs were reported in a total of 2701 treatments (844 and 1857 without and with b/ts-DMARDs, respectively), with an incidence of 53.9 events per 1000 patients/ year (95% CI 51.9-55.9). It was higher during the periods with b/ts-DMARDs (71.1 events per 1000 patients/year, 95% CI 70.7-77.5 vs 33.7, 95% CI 31.5-36.1, p<0.001). Infections, particularly those of the upper respiratory tract, were the most frequent AEs in both groups. 10.9% were severe and 1.1% were associated with the death of the patient. 18.7% of the periods with b/ts-DMARDs were discontinued due to an AE, significantly higher than that reported in the other group (11.5%; p<0.001). In the adjusted analysis, b/ts-DMARDs were associated with a higher risk of presenting at least one AE (HR 1.82, 95% CI 1.64-1.96). Similarly, older age, longer evolution time, history of chronic obstructive pulmonary disease, diagnosis of systemic lupus erythematosus, and use of corticosteroids were associated with a higher risk of AE. Conclusions: the incidence of AEs was significantly higher during those treatment periods that included DME-b/sd.

https://doi.org/10.47196/rar.v34i1.726

Valor cultural de la flora medicinal de las etnias Mochó y Kakchikel del estado de Chiapas, México
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Trigueros-Vázquez, Imna Yolanda

; Ruíz-Rosado, Octavio

; Gallardo-López, Felipe

; Solís-Guzmán, Blanca Flor

; Morales-Trejo, Fredy

; López-Romero, Gustavo

Polibotánica

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2023, N. 55 Pages 179 - 195

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

Abstract Medicinal plants have had worldwide cultural importance because of their use and preservation in rural communities and urban areas. The aim of this research was to determine the cultural significance that Kakchikel and Mochó ethnic groups, inhabitants of the Sierra Mariscal estate of Chiapas, give to their medicinal plants. A qualitative and quantitative approach was used with direct interviews and a questionnaire. The data provided by the respondents was used to build up a Microsoft Excel® database for descriptive statistics to estimate the number of plants used per illness, grouped according to the International Statistical Classification of Diseases and Related Health Problems of the WHO. Similarity of illnesses amongst ethnic groups was determined adopting the Jaccard index, and the Significant Use Level (TRAMIL) or cultural value per plant species was evaluated as well. Both ethnic groups are registered for some official or private medical services, but they prefer using medicinal plants, regardless of their literacy level. The Mochó ethnic group reported 93 illnesses and the Kakchikel 74, classified into 13 diseases groups according to the WHO, having a 28.5% of similarity index. Ten out of 167 illnesses were reported as the most common ailments, such as: coughing, headache, diarrhea, fever, flu, stomachache, diabetes, kidneys ailments, gastritis and wounds. From 209 as total of medicinal plants, the Mochó reported using 123 and the Kakchikel 86, from which 16 and 14 species had cultural significance respectively. Most used medicinal plants are Fennel (Foeniculum vulgare Mill.), common rue (Ruta graveolens L.) and verbain (Verbena litoralis Kunth.).

Resumen Las plantas medicinales han tenido importancia global y local en cuanto a su uso y conservación en las comunidades rurales y zonas urbanas. El objetivo de esta investigación fue determinar el Valor Cultural que las etnias Mochó y Kakchikel dan a la flora medicinal de su territorio en la Sierra Mariscal, Chiapas. En esta investigación se utilizó un enfoque mixto (cualitativo y cuantitativo), con el apoyo de entrevistas dirigidas y aplicación de un cuestionario. La información proporcionada por los entrevistados se integró en una base de datos de Microsoft Excel® para determinar el número de plantas usadas por las etnias para atender sus padecimientos, de acuerdo con la Clasificación Internacional de Enfermedades y Problemas Relacionados con la Salud (CIE-10) de la Organización Mundial de la Salud. Se determinó el índice de similitud de enfermedades entre etnias adaptando el índice de Jaccard, y se obtuvo el Valor Cultural TRAMIL de las plantas medicinales para atender sus padecimientos. Aunque los integrantes de ambas etnias se encuentran afiliados en algún servicio médico oficial o acuden al médico particular, los entrevistados indicaron preferir el uso de plantas medicinales independientemente de su escolaridad. La etnia Mochó reportó 93 padecimientos y la Kakchikel 74, distribuidos en 13 grupos de enfermedades, teniendo un índice de similitud de 28.5%. Del total de los padecimientos, diez fueron comunes en ambas etnias: tos, dolor de cabeza, diarrea, fiebre, gripe, dolor de estómago, diabetes, riñones, gastritis y heridas. De las 209 plantas reportadas, 123 corresponden a la etnia Mochó y 86 a la etnia Kakchikel, de las cuales 16 y 14 respectivamente tuvieron un Valor Cultural; y las plantas medicinales más usadas son Hinojo (Foeniculum vulgare Mill.), Ruda (Ruta graveolens L.) y Verbena (Verbena litoralis Kunth.).

https://doi.org/10.18387/polibotanica.55.12

IMPLEMENTACIÓN DE TRES GUÍAS DE BUENAS PRÁCTICAS CLÍNICAS EN LA ESCUELA DE ENFERMERÍA DE LA UNIVERSIDAD DE TALCA, CHILE
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Domíngüez-Araya, Gustavo Adolfo

; Morales-Herrera, Edith

; Suazo-Díaz, Nancy Loreto

; Bustamante-Muñoz, Wanda

; Amigo-Rojas, Claudia

; Pino-Monsalve, Ingrid

Ciencia y enfermería

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2023, Volume 29 elocation 15

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

ABSTRACT This article describes the implementation process of three guidelines developed by the Registered Nurses' Association of Ontario (RNAO) in the adult nursing module at the School of Nursing of the University of Talca. This process is part of the agreement reached between the University of Talca and this association, through the Department of Nursing of the University of Chile, Host Leader of the RNAO's Best Clinical Practice Guidelines Program. This implementation has been carried out through various teaching-learning methodologies that have allowed students to integrate and apply Evidence-Based Nursing in clinical practice and also to establish an alliance between the academic institution and health care centers.

RESUMEN El presente artículo describe el proceso de implementación de tres guías elaboradas por la Registered Nurses' Association of Ontario (RNAO) de Canadá, en el módulo enfermería en el adulto en la Escuela de Enfermería de la Universidad de Talca, proceso que se enmarca en el convenio establecido entre la Universidad de Talca y esta asociación, a través del Departamento de Enfermería de la Universidad de Chile, host leader del Programa de Guías de Buenas Prácticas Clínicas de la RNAO. Esta implementación se llevó a cabo a través de diversas metodologías de enseñanza-aprendizaje que han permitido a los estudiantes integrar y aplicar la Enfermería Basada en Evidencia en la práctica clínica y también, establecer una alianza entre la institución académica y los centros de asistencia sanitaria.

RESUMO Este artigo descreve o processo de implementação de três diretrizes desenvolvidas pela Associação de Enfermeiros Registrados de Ontario (RNAO, sigla em inglês) do Canadá no módulo de enfermagem para adultos da Escola de Enfermagem da Universidade de Talca. Esse processo faz parte do acordo estabelecido entre a Universidade de Talca e esta associação, por meio do Departamento de Enfermagem da Universidade do Chile, host leader do Programa de Boas Práticas Clínicas da RNAO. Essa implementação foi realizada por meio de várias metodologias de ensino-apredizagem que permitiram aos estudantes integrarem a Enfermagem Baseada em Evidências à prática clínica, e também estabelecer uma aliança entre a instituição académica e os centros de saúde.

https://doi.org/10.29393/ce29-15itgi60015

Exploración de facilitadores y barreras para implementar los roles ampliados de enfermería en México
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Casales-Hernández, María Guadalupe

; Reyes-Morales, Hortensia

; Nigenda, Gustavo

; García-Saisó, Sebastián

Revista Panamericana de Salud Pública

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2023, Volume 47 elocation e142

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

RESUMEN Objetivo. Explorar la percepción de los profesionales de enfermería respecto a los facilitadores y las barreras para la implementación de funciones ampliadas de enfermería en una entidad federativa de México. Métodos. Estudio cualitativo de tipo descriptivo con enfoque fenomenológico. Durante el 2022 se realizaron 18 entrevistas semiestructuradas a tres tipos de informantes: a) jefaturas estatales de enfermería, b) jefaturas jurisdiccionales de enfermería, y c) jefaturas de unidad de salud y personal de enfermería operativo (atención directa a pacientes). Resultados. Se identificaron los siguientes facilitadores: disposición de adopción de la estrategia (postura favorable de directivos y aceptabilidad del personal de enfermería), reorganización de funciones (simplificación de procesos y análisis de la situación de unidades de salud) y acceso a la capacitación y características del personal de enfermería (profesionalización, experiencia laboral y actitud favorable). Entre las barreras se encontraron: contexto del primer nivel de atención (falta de personal, exceso de actividades administrativas, falta de espacio físico, carencia de material, insumos y consumibles), resistencia al cambio (celo profesional por otras disciplinas y duplicidad de tareas), salarios del personal, falta de actualización, poca confianza para el incremento de funciones y actitud de los pacientes (resistencia a la atención por enfermería). Conclusiones. Comprender la percepción de los profesionales de enfermería permite identificar elementos clave para la ampliación exitosa de las funciones de enfermería a partir de la expansión de competencias laborales del personal operativo; será necesaria una reorganización y una gestión adecuada en los diferentes niveles de toma de decisiones.

ABSTRACT Objective. To explore the perceptions of nursing professionals regarding facilitators and barriers to the implementation of expanded nursing functions in a state in central Mexico. Methods. Qualitative descriptive phenomenological study. During 2022, 18 semi-structured interviews were conducted with three types of informants: a) head nurses at state-level facilities; b) head nurses at local-level facilities; and c) heads of health units and operational nursing staff who have direct contact with patients. Results. The following facilitators were identified: willingness to adopt the strategy (seen as favorable by managers and acceptable by nursing staff); reorganization of functions (simplification of processes and analysis of the situation of health units); access to training; and characteristics of nursing staff (professionalization, work experience, and favorable attitude). Barriers included: conditions at the first level of care (personnel shortages, too many administrative activities, lack of physical space, materials, supplies, and consumables), resistance to change (professional jealousy of other disciplines and duplication of tasks), staff salaries, lack of training, not trusted with expanded duties, and attitude of patients (resistance to nursing care). Conclusions. By understanding the perceptions of nursing professionals, we can identify key elements for the successful expansion of nursing functions through expansion of the competencies of operational staff. Reorganization and proper management at different levels of decision-making will be necessary.

RESUMO Objetivo. Explorar as percepções dos profissionais de enfermagem sobre os facilitadores e as barreiras à implementação de funções ampliadas de enfermagem em um estado do México. Métodos. Estudo qualitativo descritivo com abordagem fenomenológica. Em 2022, foram realizadas 18 entrevistas semiestruturadas com três tipos de informantes: a) chefes estaduais de enfermagem; b) chefes jurisdicionais de enfermagem; e c) chefes de unidades de saúde e profissionais de enfermagem que fazem atendimento direto aos pacientes. Resultados. Os seguintes facilitadores foram identificados: disposição para adotar a estratégia (atitude favorável dos gerentes e aceitação da equipe de enfermagem), reorganização das funções (simplificação dos processos e análise da situação das unidades de saúde) e acesso a capacitação e características da equipe de enfermagem (profissionalização, experiência de trabalho e atitude favorável). As barreiras encontradas incluem: contexto do primeiro nível de atenção (falta de pessoal, excesso de atividades administrativas, falta de espaço físico, falta de materiais, insumos e consumíveis), resistência à mudança (zelo profissional de outras disciplinas e duplicação de tarefas), salários do pessoal, falta de atualização, pouca confiança na expansão das funções e atitude dos pacientes (resistência ao atendimento por profissionais de enfermagem). Conclusões. Entender as percepções dos profissionais de enfermagem permite a identificação de elementos-chave para a expansão bem-sucedida das funções de enfermagem por meio da expansão das competências de trabalho dos profissionais que atendem pacientes; serão necessários reorganização e gerenciamento adequado nos diferentes níveis de tomada de decisão.

https://doi.org/10.26633/rpsp.2023.142

Dysarthria in hereditary spastic paraplegia type 4
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Jacinto-Scudeiro, Lais Alves

; Rothe-Neves, Rui

; Santos, Vanessa Brzoskowski dos

; Machado, Gustavo Dariva

; Burguêz, Daniela

; Padovani, Marina Martins Pereira

; Ayres, Annelise

; Rech, Rafaela Soares

; González-Salazar, Carelis

; França Junior, Marcondes Cavalcante

; Saute, Jonas Alex Morales

; Olchik, Maira Rozenfeld

Clinics

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2023, Volume 78 elocation 100128

Abstract: En | Text: En | PDF: En

Abstract Objective: To describe the speech pattern of patients with hereditary Spastic Paraplegia type 4 (SPG4) and correlated it with their clinical data. Methods: Cross-sectional study was carried out in two university hospitals in Brazil. Two groups participated in the study: the case group (n = 28) with a confirmed genetic diagnosis for SPG4 and a control group (n = 17) matched for sex and age. The speech assessment of both groups included: speech task recording, acoustic analysis, and auditory-perceptual analysis. In addition, disease severity was assessed with the Spastic Paraplegia Rating Scale (SPRS). Results: In the auditory-perceptual analysis, 53.5% (n = 15) of individuals with SPG4 were dysarthric, with mild to moderate changes in the subsystems of phonation and articulation. On acoustic analysis, SPG4 subjects’ performances were worse in measurements related to breathing (maximum phonation time) and articulation (speech rate, articulation rate). The articulation variables (speech rate, articulation rate) are related to the age of onset of the first motor symptom. Conclusion: Dysarthria in SPG4 is frequent and mild, and it did not evolve in conjunction with more advanced motor diseases. This data suggest that diagnosed patients should be screened and referred for speech therapy evaluation and those pathophysiological mechanisms of speech involvement may differ from the length-dependent degeneration of the corticospinal tract.

https://doi.org/10.1016/j.clinsp.2022.100128

10.

Scleral communication between Glaucoma drainage device capsule and the suprachoroidal space simulating amelanotic choroidal melanoma
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Queiroz, Diego

; Lustosa, Gustavo Porto

; Mascato, Diego

; Morales, Melina Correia

; Fernandes, Arthur Gustavo

; Fernandes, Rodrigo Antonio Brant

Arquivos Brasileiros de Oftalmologia

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2023, Volume 86 N. 6 elocation e20230073

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

ABSTRACT This is a case report involving a 56-year-old male patient with a history of pars plana vitrectomy due to a rhegmatogenous retinal detachment in the right eye that resulted in the implantation of a drainage device after the patient developed secondary glaucoma. Two years after the device’s implantation, the patient was referred to our care as his visual acuity had decreased to 20/200 (1.00 LogMAR). At the fundus evaluation, a choroidal amelanotic elevation was observed at the upper temporal equator, and a potential diagnosis was made of amelanotic choroidal melanoma. The ultrasound exam visualized the patient’s implanted superotemporal justabulbar drainage device, which revealed a transscleral communication from the plate fibrocapsular’s draining space to the suprachoroidal space (fistula). The ultrasound also revealed a focal pocket of choroidal detachment in the patient’s superotemporal region, simulating an amelanotic choroidal melanoma. A new pars plana vitrectomy was performed to remove the internal limiting membrane without repercussions at the fistula site. The patient’s recovery progressed well, and he regained a visual acuity of 20/70 (0.55 LogMAR). To the best of our knowledge, this is the first case report of this condition.

RESUMO Relato de caso de paciente 56 anos, sexo masculino, com histórico de vitrectomia via pars plana por descolamento de retina em olho direito e posterior implante de dispositivo de drenagem por glaucoma secundário. Dois anos após o procedimento foi encaminhado ao serviço por baixa de acuidade visual (AV) de 20/200 (1.00 LogMAR). À fundoscopia, observou-se uma elevação amelanótica temporal no equador com hipótese diagnóstica de melanoma de coroide amelanótico. O exame de ultrassom mostrou implante de dispositivo de drenagem justabulbar temporal superior com comunicação transescleral para espaço subcoroidal (fístula), sugerindo bolsão focal de descolamento de coroide em equador temporal superior simulando melanoma de coroide amelanótico. O paciente foi abordado cirurgicamente devido membrana epirretiniana com nova vitrectomia via pars plana para peeling de membrana limitante interna, sem repercussões no local da fístula, evoluindo bem com acuidade visual de 20/70 (0.55 LogMAR). Ao nosso conhecimento, este é o primeiro caso relatado nessa condição.

https://doi.org/10.5935/0004-2749.20230073

11.

The SISBIOTA-Diptera Brazilian Network: A long-term survey of Diptera from unexplored Brazilian Western Arc of Amazon, Cerrado, and Pantanal
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Lamas, Carlos José Einicker

; Fachin, Diego Aguilar

; Falaschi, Rafaela Lopes

; Alcantara, Daniel Máximo Correa de

; Ale-Rocha, Rosaly

; Amorim, Dalton de Souza

; Araújo, Maíra Xavier

; Ascendino, Sharlene

; Baldassio, Letícia

; Bellodi, Carolina Ferraz

; Bravo, Freddy

; Calhau, Julia

; Capellari, Renato Soares

; Carmo-Neto, Antonio Marcelino do

; Cegolin, Bianca Melo

; Couri, Márcia Souto

; Carvalho, Claudio José Barros de

; Dios, Rodrigo de Vilhena Perez

; Falcon, Aida Vanessa Gomez

; Fusari, Livia Maria

; Garcia, Carolina de Almeida

; Gil-Azevedo, Leonardo Henrique

; Gomes, Marina Morim

; Graciolli, Gustavo

; Gudin, Filipe Macedo

; Henriques, Augusto Loureiro

; Krolow, Tiago Kütter

; Mendes, Luanna Layla

; Limeira-de-Oliveira, Francisco

; Maia, Valéria Cid

; Marinoni, Luciane

; Mello, Ramon Luciano

; Mello-Patiu, Cátia Antunes de

; Morales, Mírian Nunes

; Oliveira, Sarah Siqueira

; Patiu, Claudemir

; Proença, Barbara

; Pujol-Luz, Cristiane Vieira de Assis

; Pujol-Luz, José Roberto

; Rafael, José Albertino

; Riccardi, Paula Raile

; Rodrigues, João Paulo Vinicios

; Roque, Fabio de Oliveira

; Sallum, Maria Anice Mureb

; Santis, Marcelo Domingos de

; Santos, Charles Morphy Dias dos

; Santos, Josenilson Rodrigues dos

; Savaris, Marcoandre

; Shimabukuro, Paloma Helena Fernandes

; Silva, Vera Cristina

; Schelesky-Prado, Daniel de Castro

; Silva-Neto, Alberto Moreira da

; Camargo, Alexssandro

; Sousa, Viviane Rodrigues de

; Urso-Guimarães, Maria Virginia

; Wiedenbrug, Sofia

; Yamaguchi, Carolina

; Nihei, Silvio Shigueo

Revista Brasileira de Entomologia

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2023, Volume 67 N. 4 elocation e20230051

Abstract: En | Text: En | PDF: En

ABSTRACT The SISBIOTA-BRASIL was a three-year multimillion-dollar research program of the Brazilian government to document plants and animals in endangered/understudied areas and biomes in Brazil. Distributional patterns and the historical events that generated them are extensively unknown regarding Brazilian fauna and flora. This deficiency hinders the development of conservation policies and the understanding of evolutionary processes. Conservation decisions depend on precise knowledge of the taxonomy and geographic distribution of species. Given such a premise, we proposed to research the diversity of Diptera of the Brazilian western arc of Amazon, Cerrado, and Pantanal in the states of Mato Grosso, Mato Grosso do Sul, and Rondônia. Three important biomes of the South American continent characterize these Brazilian states: Amazon forest, Cerrado (Brazilian Savannah), and Pantanal. Besides their ecological relevance, these biomes historically lack intensive entomological surveys. Therefore, they are much underrepresented in the Brazilian natural history collections and in the scientific literature, which is further aggravated by the fact that these areas are being exponentially and rapidly converted to commercial lands. Our project involved over 90 collaborators from 24 different Brazilian institutions and one from Colombia among researchers, postdocs, graduate and undergraduate students, and technicians. We processed and analyzed nearly 300,000 specimens from ~60 families of Diptera collected with a large variety of methods in the sampled areas. Here, we provide a detailed overview of the genera and species diversity of 41 families treated. Our results point to a total of 2,130 species and 514 genera compiled and identified for the three states altogether, with an increase of 41% and 29% in the numbers of species and genera known for the three states combined, respectively. Overall, the 10 most species-rich families were Tachinidae, Cecidomyiidae, Tabanidae, Psychodidae, Sarcophagidae, Stratiomyidae, Bombyliidae, Syrphidae, Tephritidae, and Asilidae. The 10 most diverse in the number of genera were Tachinidae, Stratiomyidae, Asilidae, Mycetophilidae, Syrphidae, Tabanidae, Muscidae, Dolichopodidae, Sarcophagidae, and Chloropidae. So far, 111 scientific papers were published regarding taxonomic, phylogenetic, and biogeographical aspects of the studied families, with the description of 101 new species and three new genera. We expect that additional publications will result from this investigation because several specimens are now curated and being researched by specialists.

https://doi.org/10.1590/1806-9665-rbent-2023-0051

12.

Sustainability assessment based on stakeholders’ perception of tourism activities in Loreto Bay National Park, Mexico
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Castillo Velasco-Martínez, Iris del

; Beltrán-Morales, Luis Felipe

; Ortega-Rubio, Alfredo

; Avilés-Polanco, Gerzaín

; Arnaud-Franco, Gustavo

; Herrera-Ulloa, Ángel

Estudios sociales. Revista de alimentación contemporánea y desarrollo regional

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dec 2022, Volume 32 N. 60 elocation e221265

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

Resumen Objetivo: Valuar el nivel de sustentabilidad, con base en las percepciones turísticas de las partes interesadas del Parque Nacional Bahía de Loreto (PNLB) en México. Metodología: Se seleccionaron indicadores y se organizaron en tres componentes: (1) gestión de destinos; (2) impacto social, económico y cultural; (3) impacto ambiental; y dos dimensiones: social y ambiental. Se aplicaron encuestas a empresas turísticas, residentes y visitantes. Se utilizaron tablas de contingencia para identificar la dependencia significativa entre indicadores. Resultados: Un nivel de sustentabilidad aceptable. Los indicadores con menor valor fueron el conocimiento de los residentes sobre las AP, el beneficio que obtienen del turismo, así como su participación en actividades ambientales. Limitaciones: Algunos de los indicadores empleados son específicos para el PNBL, por lo que deben adecuarse a cada AP. Conclusiones: Las aportaciones del método y una serie de recomendaciones para incrementar el beneficio económico de los residentes y su participación en la gestión de las AP.

Abstract Objective: To assess the level of sustainability, based on stakeholders’ tourism perceptions of Loreto Bay National Park (LBNP) in Mexico. Methodology: Indicators were selected and organized in three components: (1) destination management; (2) social, economic, and cultural impact; (3) environmental impact; and two dimensions: social and environmental. Surveys were applied to tourist companies, residents, and visitors. Contingency tables were used to identify significant dependence between indicators. Results: The results showed an acceptable sustainability level. Indicators with lower value were residents’ knowledge about PA, the benefit they obtain from tourism, as well as their participation in environmental activities. Limitations: Some of the indicators used are specific to LBNP, therefore they should be adequate for each PA. Conclusions: The study concludes with the contributions of the method and a series of recommendations to increases residents’ economic benefit and their involvement in PA management.

https://doi.org/10.24836/es.v32i60.1265

13.

Primary spontaneous intracerebral hemorrhage in COVID-19 patients: differences among presentation patterns – A systematic review
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Parra-Romero, Gustavo

; Navarro-Olvera, José L.

; Beltrán-Mendoza, Jesús Q.

; Ruiz-Sandoval, José L.

; Mar-Álvarez, Ariatne

; Aguado-Carrillo, Gustavo

; Teyes-Calva, Nicolas

; Rodríguez-Morales, Jahir

; Martínez-Luna, Ariam A.

; Hernández-Valencia, Aldo F.

; Carrillo-Ruiz, José D.

Cirugía y cirujanos

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dec 2022, Volume 90 N. 6 Pages 734 - 741

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

Abstract Objective: The objective of this study was to determine if there are differences between the presentation patterns of hemorrhagic stroke (HS) associated to COVID-19. Methods: It was performed a systematic search based on PRISMA guidelines of the cases reported in PUBMED of HS associated to SARS-CoV-2 infection and we added to this sample cases from our own hospital cohort. Patients in the database were separated by groups according to presentation symptoms: if they debuted with neurological symptoms or debuted with pulmonary symptoms. Results: Seventy cases were included in the study. Patients that debuted with pulmonary symptoms accounted for 68.6% of the cases with an interval between the development of symptoms and the presentation of HS of 15.6 days. We found that the use of anticoagulants during hospitalization, multifocal image pattern, and the elevation of D-dimer, Ferritin, and lactate dehydrogenase levels were significantly associated with the group of pulmonary presentation, whereas the presence of hypertension during hospitalization, and a lower hemoglobin level was associated with the group of neurologic symptoms. Conclusion: Although HS associated with COVID-19 is a clinical entity with increasing evidence, it is necessary to establish that there are two forms of presentation with their own characteristics.

Resumen Objetivo: determinar si existen diferencias entre los patrones de presentación de hemorragia intracraneal asociada a COVID-19. Pacientes y métodos: Se realizó una búsqueda sistemática basada en la guía PRISMA de los casos reportados en PUBMED de hemorragia intracraneal asociados a infección por SARS-CoV-2 y se agregaron a esta muestra casos de nuestra propia cohorte hospitalaria. Resultados: se incluyeron 70 casos. Los pacientes que debutaron con síntomas pulmonares representaron el 68.6% de los casos con un intervalo entre el desarrollo de los síntomas y la presentación de la hemorragia intracraneal de 15.6 días. Encontramos que el uso de anticoagulantes durante la hospitalización, el patrón de imagen multifocal y la elevación de los niveles de dímero D, ferritina y deshidrogenasa láctica se asociaron significativamente con el grupo de presentación pulmonar, mientras que la presencia de hipertensión durante la hospitalización, y un nivel de hemoglobina más bajo se asoció con el grupo que debutó con síntomas neurológicos. Conclusión: si bien la hemorragia intracraneal asociada a COVID-19 es una entidad clínica con evidencia creciente, es necesario establecer que existen dos formas de presentación con características propias.

https://doi.org/10.24875/ciru.21000813

14.

Consensus Statement of the Mexican College of Interventional Cardiology and Endovascular Therapy on percutaneous coronary treatment with drug-coated balloon. The COMECITE DCB consensus statement+
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Moguel-Ancheita, Rafael

; Olvera-Ruiz, Rafael

; Moreno-Buenrostro, Javier

; Ramos-Cházaro, Enrique

; Lozoya-Morales, José Juan

; Bautista-López, Germán Ramón

; Bayardo-Solórzano, Héctor Vicente

; Castillo-Gutiérrez, Mauricio Adolfo

; Picos-Bovio, Eva María

; Beltrán-Nevárez, Octavio

; Muñoz-Beltrán, Leocadio Gerardo

; Cabrera-Arroyo, Carlos Gustavo

Cardiovascular and metabolic science

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dec 2022, Volume 33 N. 4 Pages 196 - 209

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

Resumen: La intervención coronaria percutánea (ICP) es actualmente el método de revascularización prevalente durante los últimos 40 años debido a su eficacia, baja tasa de complicaciones y mínima invasión, con el inconveniente de la restenosis. La estrategia dominante para mejorar la ICP para obtener beneficios a largo plazo es la utilización de stents liberadores de fármacos, aunque la tasa actual de restenosis intrastent es ≈10%, aparte de otros inconvenientes como la inserción de cuerpo extraño, riesgo de trombosis, hemorragia en pacientes de alto riesgo, potencial de atrapamiento de ramas y posibilidad de múltiples capas de metal después del tratamiento de la restenosis intrastent. El balón recubierto de fármaco puede reducir la restenosis sin dejar un cuerpo extraño ni agregar capas de metal, su uso está respaldado por declaraciones de consenso de grupos de expertos y actualizaciones de publicaciones de informes durante casi una década. El presente artículo es de la declaración del Colegio Mexicano de Cardiología Intervencionista y Terapia Endovascular (COMECITE) con respecto a la utilización actual del balón medicado coronario y recomendaciones en restenosis intrastent, vasos pequeños, bifurcaciones, descendente anterior izquierda/coronaria principal izquierda e infarto agudo de miocardio.

Abstract: Percutaneous coronary intervention (PCI) is currently the prevalent revascularization method for the last forty years due to its efficacy, low complication rate, and minimal invasion with still pending restenosis solution. The dominant strategy to improve PCI for long-lasting benefits is the utilization of drug-eluting stents (DES), even though the current in-stent restenosis (ISR) rate is ≈10%, plus the inconvenience of foreing body insertion, thrombosis risk, bleeding in high-risk patients, jailing branches potential and possible multiple metal layers after ISR treatment. Drug coated-balloon (DCB) may reduce restenosis without leaving a foreign body and adding metal layers. Several expert group consensus statements and updating report publications, support their utilization for almost a decade. The present paper is from the Mexican College of Interventional Cardiology and Endovascular Therapy (COMECITE) statement regarding current DCB utilization and recommendations in ISR, small vessels, bifurcations, left anterior descendent/left main coronary and acute myocardial infarction.

https://doi.org/10.35366/109247

15.

Sistema de radiocirugía robótica estereotáctica CyberKnife en estadios avanzados de melanoma uveal ciliocoroideo. Resultados preliminares en México
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Ortiz-Morales, Gustavo

; Domínguez-Varela, Irving

; Gómez-Elizondo, Daniela E.

; Pérez-Ramos, Erik

; González-Godínez, Sara

; Aguilar-y-Méndez, Dione

; Estrada-Hernández, Christian

; Corral, Ramiro

; Zamorano-Gómez, Octavio

; Shields, Carol L.

; Dalvin, Lauren A.

; González-Monroy, Efrén

; Ancona-Lezama, David

Revista mexicana de oftalmología

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oct 2022, Volume 96 N. 5 Pages 205 - 212

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

Resumen Objetivo: Reportar los resultados iniciales de la cirugía estereotáctica con CyberKnife® (CK®) para etapas avanzadas de melanoma de cuerpo ciliar y coroides (MCC-C) en pacientes mexicanos. Método: Revisión retrospectiva de expedientes clínicos. Se analizaron los resultados de los pacientes a quienes se trató con CK® (Accuray Inc, Sunnyvale, CA, Estados Unidos). Resultados: Cuatro pacientes con MCC-C fueron tratados bajo este protocolo. La media de edad fue de 53.2 ± 5.3 años (rango: 47-60). La mediana de seguimiento fue de 9.5 ± 3.1 meses (rango: 5-12). El diámetro promedio del tumor fue de 13.49 mm, el grosor promedio fue de 11.74 mm y el volumen tumoral promedio fue de 1251.97 mm3. Los tumores tuvieron una configuración de domo (50%) y de seta (50%), de tamaño mediano a grande. Tres pacientes tuvieron un tumor T3b y uno tuvo un tumor T4d en fase inicial según el American Joint Committee on Cancer (AJCC). Se prescribió una dosis promedio de radiación de 2763 ± 181,3 cGy al 90% de la línea de isodosis. Todos los pacientes lograron el control local del tumor después de una sesión de radiocirugía en la última visita de seguimiento. Un paciente presentó datos de toxicidad aguda (desprendimiento seroso de retina) y fue tratado con éxito. Ninguno de los pacientes precisó enucleación secundaria. Conclusiones: El abordaje multidisciplinario con CK® es una terapia efectiva en el manejo del MCC-C de tamaño mediano a grande. Es necesario mayor tiempo de seguimiento para confirmar estos hallazgos y evaluar la morbilidad a largo plazo.

Abstract Objective: To report the early results of CyberKnife® (CK®) stereotactic radiosurgery in advanced stages of ciliochoroidal (CBCh) melanoma in Mexican patients. Method: A retrospective review of charts was performed to analyze the outcomes of patients who underwent CK® (Accuray Inc, Sunnyvale, CA, USA). Results: Four patients with CBCh melanoma were treated under this protocol. The mean age was 53.2 ± 5.3 years (range: 47-60). Median of follow-up was 9.5 ± 3.1 months (range: 5-12). Mean tumor diameter was 13.49 mm, mean thickness, 11.74 mm, and mean gross tumor volume, 1251.97 mm3. Tumors were dome- (50%) and mushroom-spahed (50%), in medium-to-large sizes. Three patients had T3b tumors, and 1 had a T4d tumor at the early tumor staging according to the American Joint Committee on Cancer (AJCC). A mean dose of 2763 ± 181.3 cGy was prescribed to the 90% isodose line. All patients achieved local tumor control after a single radiosurgical session at the latest follow-up. One patient presented with acute toxicity (extensive serous retinal detachment associated with radiation induced tumor vasculopathy) that was promptly managed. None of the patients required secondary enucleation. Conclusions: CK® appears to be an effective therapy for the management of medium-to-large sized CBCh melanoma. A prospective comparative study with longer follow-up is needed to confirm these findings and assess long-term morbidity.

https://doi.org/10.24875/rmo.m22000236

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You can enrich your search in a very simple way. Use the search indexes combined with the connectors (AND or OR) and specify more your search.

For example, if you want to search for articles about
cases of dengue in Brasil in 2015, use:
ti:dengue and publication_year:2015 and aff_country:Brasil

See below the complete list of search indexes that can be used:

Index code	Element
ti	article title
au	author
kw	article keywords
subject	subject (title words, abstract and keywords)
ab	abstract
ta	journal short title (e.g. Cad. Saúde Pública)
journal_title	journal full title (e.g. Cadernos de Saúde Pública)
la	publication language code (e.g. pt - Portuguese, es - Spanish)
type	document type
pid	publication identifier
publication_year	publication year of publication
sponsor	sponsor
aff_country	country code of the author's affiliation
aff_institution	author affiliation institution
volume	article volume
issue	article issue
elocation	elocation
doi	DOI number
issn	journal ISSN
in	SciELO colection code (e.g. scl - Brasil, col - Colômbia)
use_license	article usage license code

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