Musicoterapia en pacientes con la COVID-19

Introducción: La musicoterapia puede ser utilizada para influenciar en el estado físico y emocional de pacientes diagnosticados con la COVID-19. Se realiza una revisión sistemática exploratoria que incluye estudios observacionales y ensayos clínicos; Pubmed y Scopus fueron las bases de datos empleadas para la realización de la búsqueda. Además, se incluyen registros de ensayos clínicos de la Plataforma de Registros Internacionales de Ensayos Clínicos de la Organización Mundial de la Salud. Objetivo: Explorar la literatura médica disponible, sobre el impacto clínico de la musicoterapia en pacientes diagnosticados con la COVID-19. Desarrollo: De 39 documentos encontrados se incluyen 2 artículos: un ensayo clínico y un reporte de caso, con una población total de 41 pacientes. Se encuentra evidencia médica que respalda el impacto clínico favorable sobre la saturación de oxígeno, rehabilitación física y síntomas asociados al estrés en pacientes con diagnóstico de la COVID-19 con y sin requerimiento de soporte ventilatorio. Conclusiones: La musicoterapia es una herramienta útil en el tratamiento y rehabilitación no farmacológica de pacientes con la COVID-19; sin embargo, son necesarios nuevos estudios clínicos con mayor número de poblaciones muestrales y mayor tiempo de seguimiento.

Background: Music therapy can be used to influence the physical and emotional state of patients diagnosed with COVID-19. An exploratory systematic review was carried out including observational studies and clinical trials, Pubmed and Scopus were the databases used to carry out the literature search. In addition, clinical trial registries from the World Health Organization International Clinical Trials Registry Platform are included. Objective: To explore the available medical literature on the clinical impact of music therapy in patients diagnosed with COVID-19. Development: Of 39 documents found in the search, two articles are included: a clinical trial and a case report, with a total population of 41 patients. Medical evidence is found to support the favorable clinical impact on oxygen saturation, physical rehabilitation and symptoms associated with stress in patients diagnosed with COVID-19 with and without the need for ventilatory support. Conclusions: Music therapy is a useful tool in the non-pharmacological treatment and rehabilitation of patients with COVID-19. However, new clinical studies with a larger number of sample populations and follow-up times using music therapy in this disease are necessary.

Defecto óseo de Stafne: hallazgo en radiografía panorámica / Stafne bone defect: findings on panoramic radiography

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Development of a small panel of SNPs to infer ancestry in Chileans that distinguishes Aymara and Mapuche components

BACKGROUND: Current South American populations trace their origins mainly to three continental ancestries, i.e. European, Amerindian and African. Individual variation in relative proportions of each of these ancestries may be confounded with socio-economic factors due to population stratification. Therefore, ancestry is a potential confounder variable that should be considered in epidemiologic studies and in public health plans. However, there are few studies that have assessed the ancestry of the current admixed Chilean population. This is partly due to the high cost of genome-scale technologies commonly used to estimate ancestry. In this study we have designed a small panel of SNPs to accurately assess ancestry in the largest sampling to date of the Chilean mestizo population (n = 3349) from eight cities. Our panel is also able to distinguish between the two main Amerindian components of Chileans: Aymara from the north and Mapuche from the south. RESULTS: A panel of 150 ancestry-informative markers (AIMs) of SNP type was selected to maximize ancestry informativeness and genome coverage. Of these, 147 were successfully genotyped by KASPar assays in 2843 samples, with an average missing rate of 0.012, and a 0.95 concordance with microarray data. The ancestries estimated with the panel of AIMs had relative high correlations (0.88 for European, 0.91 for Amerindian, 0.70 for Aymara, and 0.68 for Mapuche components) with those obtained with AXIOM LAT1 array. The country's average ancestry was 0.53 ± 0.14 European, 0.04 ± 0.04 African, and 0.42 ± 0.14 Amerindian, disaggregated into 0.18 ± 0.15 Aymara and 0.25 ± 0.13 Mapuche. However, Mapuche ancestry was highest in the south (40.03%) and Aymara in the north (35.61%) as expected from the historical location of these ethnic groups. We make our results available through an online app and demonstrate how it can be used to adjust for ancestry when testing association between incidence of a disease and nongenetic risk factors. CONCLUSIONS: We have conducted the most extensive sampling, across many different cities, of current Chilean population. Ancestry varied significantly by latitude and human development. The panel of AIMs is available to the community for estimating ancestry at low cost in Chileans and other populations with similar ancestry.

Caracterización de las potenciales interacciones farmacológicas en pacientes de una unidad de cuidados intensivos en un hospital de tercer nivel de Bogotá / Characterization of potential drug-drug interactions in patients hospitalized in the intensive care unit of a tertiary hospital in Bogotá

Resumen Introducción. Las interacciones farmacológicas ocurren con mayor frecuencia en las unidades de cuidados intensivos que en otros servicios. Sin embargo, en Colombia son pocos los estudios en que se han evaluado en pacientes críticamente enfermos. Objetivos. Caracterizar las potenciales interacciones farmacológicas en las prescripciones de pacientes hospitalizados en una unidad de cuidados intensivos y determinar los factores asociados con su aparición. Materiales y métodos. Se analizó una cohorte retrospectiva de pacientes hospitalizados en una unidad de cuidados intensivos, durante un periodo de siete meses. Las prescripciones diarias se evaluaron en busca de potenciales interacciones farmacológicas mediante el programa Lexicomp™. Se calculó la incidencia de interacciones, se clasificaron según su tipo, gravedad y grado de documentación, y se evaluaron los factores asociados con su aparición mediante regresión logística. Resultados. La proporción de pacientes con por lo menos una interacción fue de 84 %, en tanto que el 87 % presentó más de una interacción; la mediana fue de seis interacciones por paciente. La más frecuente fue entre el fentanilo y el midazolam (23 %). Las interacciones de gravedad y grado de documentación moderados fueron las más frecuentes (77,6 y 52,6 %, respectivamente). El fármaco índice más frecuente fue el midazolam (12 %) y el precipitante más frecuente, el fentanilo (10,6 %). La edad (odds ratio, OR=3,1) y el número de medicamentos (OR=11,8), se asociaron con la aparición de interacciones. Conclusiones. Dada su elevada frecuencia y potencial impacto negativo es importante vigilar sistemáticamente las prescripciones en cuidados intensivos para detectar las interacciones, con el fin de contribuir al uso racional de los medicamentos y a mejorar la calidad de la atención.

Abstract Introduction: Drug-drug interactions occur more frequently in intensive care units than in other services. However, in Colombia, there are few studies on this problem in critically ill patients. Objectives: To characterize potential drug-drug interactions generated from prescriptions during hospitalization in an intensive care unit and to determine factors associated with their onset. Materials and methods: A retrospective cohort was assembled with patients hospitalized in an intensive care unit for a seven-month period. The daily prescription was assessed for potential drugdrug interactions using the Lexicomp® program. We calculated the incidence of interactions, classified them by type, severity, and level of documentation, and evaluated the factors associated with their onset using logistic regression. Results: The proportion of patients with at least one interaction was 84% while 87% had more than one interaction; the median was six interactions per patient. The most frequent was fentanyl and midazolam (23%). Moderate interactions were the most frequent by severity (77.6%) and by documentation (52.6%). The most common index and precipitating drugs were midazolam (12%) and fentanyl (10.6%), respectively. Age (OR=3.1) and the number of drugs (OR=11.8) were associated with the occurrence of interactions. Conclusions: Given their high frequency and potential negative impact, the systematic monitoring of prescriptions in intensive care units to detect interactions is important. Such monitoring contributes to the rational use of medicines and to improve the quality of care.

A review of longnose skates Zearaja chilensis and Dipturus trachyderma (Rajiformes: Rajidae) / Una revisión sobre las rayas de hocico largo Zearaja chilensis y Dipturus trachyderma (Rajiformes: Rajidae) / Urna revisão das raías longnose Zearaja chilensis e Dipturus trachyderma (Rajiformes: Rajidae)

Longnose skates may have a high intrinsic vulnerability among fishes due to their large body size, slow growth rates and relatively low fecundity, and their exploitation as fisheries target-species places their populations under considerable pressure. These skates are found circumglobally in subtropical and temperate coastal waters. Although longnose skates have been recorded for over 150 years in South America, the ability to assess the status of these species is still compromised by critical knowledge gaps. Based on a review of 185 publications, a comparative synthesis of the biology and ecology was conducted on two commercially important elasmobranchs in South American waters, the yellownose skate Zearaja chilensis and the roughskin skate Dipturus trachyderma, in order to examine and compare their taxonomy, distribution, fisheries, feeding habitats, reproduction, growth and longevity. There has been a marked increase in the number of published studies for both species since 2000, and especially after 2005, although some research topics remain poorly understood. Considering the external morphological similarities of longnose skates, especially when juvenile, and the potential niche overlap in both, depth and latitude it is recommended that reproductive seasonality, connectivity and population structure be assessed to ensure their long-term sustainability.

Las rayas de nariz larga tienen una alta vulnerabilidad intrínseca entre los peces, debido a su gran tamaño corporal, bajas tasas de crecimiento y relativamente baja fecundidad; por otra parte, el hecho de ser blanco de explotación pesquera coloca a su población bajo una presión considerable. Las rayas de nariz larga se encuentran alrededor del mundo en aguas costeras subtropicales y templadas. Aunque se han registrado a lo largo de 150 años en Suramérica, los críticos vacíos de información que aún persisten comprometen la capacidad de determinar el estatus de estas especies. Con base en una revisión de 185 publicaciones, se realizó una síntesis comparativa de la biología y ecología de dos de las especies de elasmobranquios comerciales de aguas suramericanas: la raya volantín (Zearaja chilensis) y la raya espinosa (Dipturus trachyderma). Se examinaron y compararon su taxonomía, distribución, hábitos alimenticios, reproducción, crecimiento, longevidad y explotación pesquera. El número de estudios publicados sobre ambas especies se ha incrementado considerablemente desde 2000 y especialmente después de 2005, aunque algunos tópicos de investigación permanecen poco entendidos. Considerando la similitud morfológica externa de las rayas de nariz larga, especialmente en sus estadios juveniles, y que su nicho potencial se superpone tanto en profundidad como en latitud, se recomienda determinar su estacionalidad reproductiva, con el fin de asegurar su sostenibilidad en el largo plazo.

Raias longnose podem ter uma elevada vulnerabilidade intrínseca entre os peixes, devido ao seu grande tamanho de corpo, taxas lentas de crescimento e fecundidade relativamente baixa, e sua exploraclo como especies alvo de pesca coloca suas populacóes sob considerável pressao. Sao encontradas ao redor do mundo em águas costeiras subtropicais e temperadas. Embora raias longnose hajam sido registradas por mais de 150 anos na América do Sul, a capacidade de avaliar o status dessas espécies ainda é comprometida por lacunas críticas de conhecimento. Com base em uma revisao de 185 publicacóes, uma síntese comparativa da biologia e ecologia foi realizada uma síntese comparativa da biología e ecología de duas espécies de elasmobranquios comerciais de águas sul-americanas, a raia nariz-amarelo (Zearaja chilensis) e a raia pele-áspera (Dipturus trachyderma); com vistas a analisar e comparar a sua taxonomía, distribuicao, pescas, habitats de alimentacao, reprodujo, crescimento e longevidade. Houve um aumento acentuado no número de estudos publicados para ambas as espécies desde 2000, e especialmente depois de 2005, embora alguns tópicos de investiga^ão permanecam pouco compreendidos. Considerando as similaridades morfológicas externas das raias longnose, especialmente quando jovens, e a potencial sobreposição de nichos ocupados tanto em relaclo a profundidade quanto a latitude, recomenda-se que a sazonalidade reprodutiva, seja avaliada para assegurar a sua sustentabilidade em longo prazo.

Nivel de satisfacción de estudiantes en el diseño e implementación del laboratorio de simulación virtual en la sección de Farmacología de la Facultad de Medicina de la UNMSM / Satisfaction level of students in the design and implementation of a virtual simulation laboratory in the department of pharmacology, Faculty of Medicine at UNMSM

Diseñar y construir un modelo pedagógico de uso del Laboratorio de Simulación Virtual en la Sección de Farmacología y conocer el nivel de satisfacción de los estudiantes. Material y Métodos: Estudio descriptivo, cualitativo de tipo investigación-acción. Se planificó el diseño e implementación de un laboratorio de simulación virtual, la intervención de mejora y perfección del material didáctico para el desarrollo de prácticas en la sección de Farmacología de la Facultad de Medicina de la UNMSM, utilizando los software Microlab® y Rat CV. Se realizó la técnica de la entrevista, como instrumento se utilizó una encuesta de satisfacción de usuario del laboratorio virtual, utilizando una escala de Likert del mínimo de satisfacción iniciando en 1 al máximo de 10. Tamaño de muestra de 26 alumnos. Resultados: Se implementó un nuevo proceso de enseñanza - aprendizaje de Farmacología Experimental mediante el uso del Laboratorio de simulación virtual. La mayoría de los alumnos encuestados sobre la implementación del laboratorio de aula virtual, mostró un nivel de satisfacción de 9-10/10 en la escala de Likert. Conclusión: El laboratorio de simulación virtual de la Sección de Farmacología implementado estimula el aprendizaje eficiente de los actores de este proceso, con un buen nivel de satisfacción de los estudiantes...

To design and build an educational model using a Virtual Simulation Laboratory Section of Pharmacology and to know the level of student satisfaction. Material and Methods: Descriptive, qualitative study of research-action type. The design and implementation of a virtual simulation laboratory, the intervention of improvement and perfection of teaching materials for the development of the practical section of Pharmacology, Faculty of Medicine at San Marcos was planned, using the software Microlab@ and CV Rat. A survey of user satisfaction in virtual laboratory technique was conducted, using the interview as an instrument, and a Likert scale of minimum satisfaction starting in 1 to maximum of IO. Sample size of 26 students. Results: A new process of Experimental Pharmacology Laboratory teaching - Iearning was implemented, using virtual simulation. Most students in the virtual classroom lab have a satisfaction level 9-10 / IO on the Likert scale. Conclusion: The implemented virtual simulation laboratory in the Section of Pharmacology, efficiently stimulates the Iearning of the actors of this process, with a good level of student satisfaction...

Centro de Referência em Obesidade do Município do Rio de Janeiro ­ O Papel do Educador Físico / Reference Center on Obesity (RCO) in the City of Rio de Janeiro - The Role of Physical Educator

O objetivo deste trabalho é apresentar a estrutura organizacional do Centro de Referência em Obesidade e o papel do educador físico na equipe para tratamento da obesidade. O Centro de Referência em Obesidade é formado por uma equipe multidisciplinar, aonde o educador físico vem a contribuir para a construção de um olhar mais amplo sobre o processo terapêutico através da atividade física. A atuação deste profissional se dá através de uma completa avaliação do paciente e questões associadas à prática do exercício físico. A intervenção é realizada por meio de conscientização, informação e práticas corporais em seu aspecto global. O educador físico no Centro de Referência em Obesidade busca desenvolver estudos e formular metodologias capazes de produzir evidências e comprovar a efetividade de estratégias de atividades físicas na prevenção da obesidade e na promoção da saúde.

The objective of this paper is to present the organizational structure of the Reference Center on Obesity and the function of the physical educator on staff to treat obesity. The Reference Center on Obesity consists of a multidisciplinary team, where the physical educator will contribute to building a broader look on the therapeutic process through physical activity. The work of this professional is through a thorough patient assessment and issues associated with physical exercise. Intervention is accomplished through awareness, information and bodily practices in its global aspect. The physical educator in Reference Center on Obesity seeks to develop studies and formulate methodologies able to produce evidence and prove the effectiveness of strategies for physical activity in prevention of obesity and health promotion.

Suicidal ideation among students enrolled in healthcare training programs: a cross-sectional study / Ideação suicida entre estudantes da área da saúde: um estudo transversal

Objective: We aimed to assess the presence of suicidal ideation, depressive symptoms and symptoms of hopelessness in three healthcare training programs. Method: The study's population comprised all students enrolled at the Medical School of the Fundação do ABC, Brazil, from 2006 to 2007 compared to students enrolled in nursing and pharmacy programs. We applied the Beck Scale for Suicidal Ideation, the Beck Depression Inventory and the Beck Hopeless Scale to assess psychiatric symptomatology. The general response rates of the medical, nursing, and pharmacy students were 56 percent, 56 percent and 61 percent, respectively. Results: There was no difference regarding the presence of suicidal ideation among medical, nursing and pharmacy students. There was also no difference regarding the presence of either depression or hopelessness in medical students in comparison to nursing and pharmacy students. In comparison to nursing and pharmacy students, significantly higher severity rates in terms of hopelessness were observed only among medical students. Conclusion: Although we did not observe significant differences regarding suicidal ideation and depression among the three healthcare programs, our findings suggest that the presence of suicidal ideation is indeed a source of concern. Early identification of these symptoms is crucial in order to offer appropriate support and treatment and prevent deaths by suicide.

Objetivo: Objetivou-se avaliar a presença de ideação suicida, sintomas depressivos e sintomas de desesperança entre três cursos da área da saúde. Método: A população do estudo consistiu de todos os estudantes de medicina matriculados na Faculdade de Medicina da Fundação do ABC, Brasil, durante 2006 e 2007, comparados com os alunos matriculados nos cursos de enfermagem e farmácia. Aplicamos a Escala de Ideação Suicida de Beck, o Inventário de Depressão de Beck e a Escala de Desesperança de Beck para avaliar sintomatologia psiquiátrica. A taxa de resposta entre os estudantes de medicina, enfermagem e farmácia foi de 56 por cento, 56 por cento e 61 por cento, respectivamente. Resultados: Não houve diferença em relação à presença de ideação suicida entre os estudantes de medicina, enfermagem e farmácia. Também não houve diferença em relação à presença de depressão ou desesperança nos estudantes de medicina em comparação com os alunos de enfermagem e farmácia. Taxas de gravidade significativamente mais elevadas foram observadas apenas em desesperança entre os estudantes de medicina em comparação com os alunos de enfermagem e farmácia. Conclusão: Embora não tenhamos observado diferenças significativas entre os três cursos da área da saúde com relação à ideação suicida e depressão, a presença de ideação suicida é um achado preocupante. A identificação precoce destes sintomas é fundamental, de modo a se oferecer apoio e tratamento adequados e prevenir mortes por suicídio.

Seudoquiste óseo hemorrágico o traumático: aporte al diagnóstico diferencial por imagen / Hemorrhagic or traumatic bone pseudocyst: a contribution to the differential diagnostic imaging

Al abordar el estudio de la patología maxilar, existe un capítulo, de difícil diagnóstico preciso. Este corresponde al de las lesiones seudoquísticas intraóseas, denominación sugerida a partir de su análisis histopatológico, el cual demostró que su morfología histológica no respetaba el patrón quístico. Es de naturaleza no odontogénica y se caracteriza por el compromiso de oras piezas óseas. Reportamos un caso con diagnóstico clínico de quiste traumático, confirmado por histopatología. Su hallazgo fue casual por encontrarse el paciente bajo un tratamiento paralelo

¿Es factible monitorear la tensión de las meninges? tonometría de aplanación. Ensayo en un modelo teórico / Is monitoring meningeal tension feasible? applanation tonometry. Test on a theorical model

El monitoreo instrumental de la tensión de las meninges -realizado en forma precoz, en el primer agujero de la craneotomía - permitiría una comprobación objetiva, exacta y comparable de las condiciones de operabilidad en la cirugía endocraneana y facilitaría una elección más ajustada de las herramientas con que cuenta el anestesiólogo pra proveer esas condiciones. Buscando el instrumento adecuado para realizar el monitoreo pretendido, investigamos -en un modelo teórico que evoca a la caja craneana y a las meninges- si es factible practicar la tonometría de aplanación en una membrana elástica. La respuesta afirmativa al interrogante planteado en el título nos faculta para analizar, en un trabajo ulterior, qué correlación existe entre la presión endocraneana y la tensión de las meninges en animales y personas, y, posteriormente, apreciar si el monitoreo de la tensión de las meninges (tonometría de la duramadre) es útil para valorar las condiciones de operabilidad en la cirugía endocraneana.