Prevalencia del consumo de bebidas energizantes y efectos adversos en estudiantes de medicina / Prevalence of energy drinks consumption and adverse effects among medical students

Introducción: las bebidas energizantes son preparados estimulantes e hidratos de carbono. Objetivo: determinar la prevalencia, características del consumo y los efectos adversos en estudiantes de un programa de medicina Metodología: estudio observacional, descriptivo, de corte transversal y retrospectivo, que incluyó estudiantes de medicina de una institución de educación superior, excluyendo a aquellos que no cursaban la carga académica completa para su semestre, quienes diligenciaron de manera inadecuada la encuesta o que no aceptaron la participación en el estudio. Resultados y discusión: participaron 241 estudiantes, de los cuales 72,20% eran mujeres. Solo 55 manifestaron trastornos patológicos de tipo insomnio (13,69%) y cefalea o migraña (8,30%) y 49,38% informaron sobre el consumo de bebidas energizantes. Existe la probabilidad de una mezcla con sustancias alcohólicas dada la elevada frecuencia de consumo (51,26%), lo que no ocurrió con el hábito de fumar. Los eventos adversos informados fueron insomnio (21,58%), taquicardia (17,43%), cefalea (14,52%), enrojecimiento facial (13,28%) y en menor medida temblor, ansiedad o trastornos gastrointestinales (17,42%). Conclusiones: el consumo de bebidas energizantes es alta durante la adolescencia y en especial en los universitarios, pero estas sustancias a largo plazo pueden generar efectos adversos cuyas principales complicaciones son cardíacas, por lo que es importante vigilar la comercialización de las mismas.

Introduction: energy drinks (ED) are stimulant and carbohydrate preparations. Objective: to determine the prevalence, characteristics of ED usage and adverse effects among students of a medical program Methodology: an observational, descriptive, cross-sectional, retrospective study, which included medical students of a higher education institution. Those who were not completing the full academic load for their semester, those who responded the survey inadequately or did not agree to participate in the study, were excluded. Results and discussion: 241 students participated, of which 72,20% were females. Only 55 reported symptoms such as insomnia (13.69%) and headache or migraine (8.30%) and 49.38% reported on ED consumption. To combine energy drinks with alcohol is probable, given the high alcohol consumption rate (51.26%), while it was not associated with smoking. Adverse events reported were insomnia (21.58%), tachycardia (17.43%), headache (14.52%), facial flushing (13.28%) and tremor; and to a lesser extent, anxiety, and gastrointestinal disorders (17.42%). Conclusions: energy drinks consumption is high at adolescence, especially among university students. These preparations can produce long-term adverse effects mainly cardiovascular complications. Thus, monitoring ED marketing is important.

Risk factors associated with severe COVID-19 outcomes in Jamaica: a cross-sectional study of national surveillance data / Factores de riesgo asociados a la COVID-19 grave en Jamaica: estudio transversal de datos nacionales de vigilancia / Fatores de risco associados a desfechos graves da COVID-19 na Jamaica: estudo transversal de dados de vigilância nacional

ABSTRACT Objectives. To describe the characteristics and outcomes of COVID-19 cases in Jamaica and to explore the risk factors associated with severe COVID-19 from 9 March to 31 December 2020. Methods. A cross-sectional analysis of national surveillance data was conducted using confirmed COVID-19 cases in Jamaica. Definitions of a confirmed case, disease severity, and death were based on World Health Organization guidelines. Chi-square and Fisher exact tests were used to determine association with outcomes. Logistic regression models were used to determine predictors of severe COVID-19. Results. This analysis included 12 169 cases of COVID-19 (median age, 36 years; 6 744 females [ 55.4%]) of which 512 cases (4.2%) presented with severe disease, and of those, 318 patients (62.1%) died (median age at death, 71.5 years). Severe disease was associated with being male (OR 1.4; 95% CI, 1.2-1.7) and 40 years or older (OR, 6.5; 95% CI, 5.1-8.2). COVID-19 death was also associated with being male (OR, 1.4; 95% CI, 1.1-1.7), age 40 years or older (OR, 17.9; 95% CI, 11.6-27.7), and in the Western versus South East Health Region (OR 1.7; 95% CI, 1.2-2.3). Conclusions. The findings of this cross-sectional analysis indicate that confirmed cases of COVID-19 in Jamaica were more likely to be female and younger individuals, whereas COVID-19 deaths occurred more frequently in males and older individuals. There is increased risk of poor COVID-19 outcomes beginning at age 40, with males disproportionately affected. COVID-19 death also varied by geographic region. This evidence could be useful to other countries with similar settings and to policymakers charged with managing outbreaks and health.

RESUMEN Objetivos. Describir las características y los resultados de los casos de COVID-19 en Jamaica y explorar los factores de riesgo asociados a la COVID-19 grave desde el 9 de marzo hasta el 31 de diciembre del 2020. Métodos. Se realizó un análisis transversal de datos nacionales de vigilancia a partir de los casos confirmados de COVID-19 en Jamaica. Las definiciones de caso confirmado, gravedad de la enfermedad y muerte se basaron en las directrices de la Organización Mundial de la Salud. Para determinar la asociación con los criterios de valoración se utilizó la prueba de χ2 y la prueba exacta de Fisher. Se usaron modelos de regresión logística para determinar los factores predictivos de la COVID-19 grave. Resultados. Se incluyeron en el análisis 12 169 casos de COVID-19 (mediana de edad, 36 años; 6 744 mujeres [55,4%]), de los que 512 (4,2%) fueron de enfermedad grave. De estos pacientes, 318 (62,1%) fallecieron (mediana de edad al morir, 71,5 años). Se observó una asociación de la enfermedad grave con el sexo masculino (OR de 1,4; IC del 95 %, 1,2-1,7) y con la edad igual o superior a 40 años (OR de 6,5; IC del 95 %, 5,1-8,2). La muerte por COVID-19 también mostró una asociación con el sexo masculino (OR de 1,4; IC del 95%, 1,1-1,7), con la edad igual o superior a 40 años (OR de 17,9; IC del 95%, 11,6-27,7) y con la Región de Atención de Salud Occidental en comparación con la Sudoriental (OR de 1,7; IC del 95%, 1,2-2,3). Conclusiones. Los resultados de este análisis transversal indican que los casos confirmados de COVID-19 en Jamaica correspondieron una mayor probabilidad a mujeres y personas más jóvenes, mientras que las muertes por COVID-19 fueron más frecuentes en varones y personas de mayor edad. Hay un mayor riesgo de evolución desfavorable de la COVID-19 a partir de los 40 años, que afecta de manera desproporcionada a los varones. Las muertes por COVID-19 también variaron según la región geográfica. Esta evidencia podría ser de utilidad para otros países con entornos similares y para los responsables de la formulación de políticas en materia de gestión de brotes y salud.

RESUMO Objetivos. Descrever as características e os desfechos dos casos de COVID-19 na Jamaica e explorar os fatores de risco associados à COVID-19 grave de 9 de março a 31 de dezembro de 2020. Métodos. Análise transversal de dados de vigilância nacional usando casos confirmados de COVID-19 na Jamaica. As definições de caso confirmado, gravidade da doença e morte foram baseadas nas recomendações da Organização Mundial da Saúde. Foram usados testes de qui-quadrado e exato de Fisher para determinar a associação com os desfechos. Modelos de regressão logística foram usados para determinar os preditores de COVID-19 grave. Resultados. Esta análise incluiu 12.169 casos de COVID-19 (idade mediana: 36 anos; 6 744 do sexo feminino [55,4%]), dos quais 512 casos (4,2%) apresentaram doença grave; desses, 318 pacientes (62,1%) morreram (idade mediana ao morrer: 71,5 anos). A doença grave estava associada a ser do sexo masculino (razão de chances [RC]: 1,4; intervalo de confiança de 95% [IC 95%]: 1,2-1,7) e ter 40 anos ou mais de idade (RC: 6,5; IC 95%: 5,1-8,2). A morte por COVID-19 também estava associada a ser sexo masculino (RC: 1,4; IC 95%: 1,1-1,7), ter 40 anos ou mais (RC: 17,9; IC 95%: 11,6-27,7) e estar na Região Sanitária Oeste em comparação com a Região Sanitária Sudeste (RC: 1,7; IC 95%: 1,2-2,3). Conclusões. Os achados desta análise transversal indicam que a probabilidade de casos confirmados de COVID-19 na Jamaica era maior em indivíduos do sexo feminino e mais jovens, ao passo que as mortes por COVID-19 ocorreram com mais frequência em indivíduos do sexo masculino e mais velhos. Há um risco maior de resultados desfavoráveis em relação à COVID-19 a partir dos 40 anos, e indivíduos do sexo masculino são desproporcionalmente mais afetados. A morte por COVID-19 também variou de acordo com a região geográfica. Essas evidências podem ser úteis para outros países com cenários semelhantes e para os formuladores de políticas encarregados de manejar surtos e gerenciar a saúde.

Exposición a ceniza volcánica producida por el volcán Turrialba y enfermedades respiratorias, Costa Rica, 2016 / Exposure to volcanic ash produced by the Turrialba volcano and respiratory diseases, Costa Rica, 2016

Resumen Objetivo: Describir el comportamiento espacial de la contaminación por cenizas volcánicas y el efecto sobre la incidencia de enfermedades respiratorias agudas y crónicas, en las comunidades expuestas a la ceniza producida por la actividad del Volcán Turrialba, durante el año 2016. Materiales y métodos: Se realizó un estudio ecológico, observacional retrospectivo, transversal y correlacional, en donde se categorizaron 36 cantones a 50 km a la redonda del volcán Turrialba, según su nivel de contaminación. Resultados: Se constata un comportamiento diferenciado en el espacio geográfico de afectación de la pluma de ceniza volcánica, todos los territorios incluidos en el estudio resultaron con algún nivel de contaminación, sin embargo, se distinguen tres zonas, alta, media y baja contaminación. Un 46.6% de los eventos epidemiológicos estudiados poseen un mayor riesgo de presentarse en cantones con alta contaminación, sobre los cantones con media y baja contaminación. Conclusiones: Es posible que la afectación por contaminación debido a la ceniza volcánica haya incrementado el riesgo de exacerbación de enfermedades respiratorias crónicas, en la zona bajo la influencia directa de la pluma de cenizas volcánicas.

Abstract Objective: Describe the spatial behavior of contamination by volcanic ash and the effect on the incidence of acute and chronic respiratory diseases in communities exposed to the ash produced by the activity of the Turrialba Volcano during the year 2016. Materials and methods: An ecological, observational, retrospective, cross-sectional and correlational study was carried out, where 36 cantons within 50 km of the Turrialba volcano were categorized, according to their level of contamination. Results: A differentiated behavior is verified in the geographical space affected by the volcanic ash plume, all the territories included in the study resulted in some level of contamination, however three zones are distinguished, high, medium and low contamination. 46.6% of the epidemiological events studied have a higher risk of occurring in cantons with high contamination, over cantons with medium and low contamination. Conclusions: It is possible that the contamination due to volcanic ash has increased the risk of exacerbation of chronic respiratory diseases in the area under the direct influence of the volcanic ash plume.

Estratégias utilizadas por enfermeiros da atenção primária na prevenção do câncer de colo do útero: revisão integrativa / Strategies used by primary care nurses in the prevention of cervical cancer: integrative review

Objetivo: identificar, na literatura científica, as estratégias utilizadas por enfermeiros da Atenção Primária para a prevenção do câncer de colo do útero. Métodos: revisão integrativa nas bases de dados EMBASE, LILACS (BVS), SCOPUS e Web of Science, entre março e abril de 2023. Após a busca, seguiu-se com leitura na íntegra dos artigos selecionados e extração dos dados para análise. A amostra final foi constituída por 5 estudos. Resultados: as principais estratégias utilizadas foram intervenções educativas, com predominância de palestras e posterior convite ou coleta de material para a realização do exame preventivo. Também foram utilizadas rodas de conversa (círculo de cultura), orientações por contato telefônico e oferta de ficha clínica auto preenchível na consulta de enfermagem. Conclusões: os estudos possibilitaram identificar estratégias positivas na prevenção do câncer de colo do útero, podendo direcionar enfermeiros a investir cada vez mais em metodologias voltadas a uma maior autonomia das mulheres

Objective: to identify, in the scientific literature, the strategies used by primary care nurses to prevent cervical cancer. Methods: An integrative review of the EMBASE, LILACS (BVS), SCOPUS, and Web of Science databases between March and April 2023. After the search, the selected articles were read in full, and the data were extracted for analysis. The final sample consisted of 5 studies. Results: the main strategies used were educational interventions, with a predominance of lectures and subsequent invitations or collection of material to carry out the preventive exam. Conversation circles (culture circles), telephone guidance, and the provision of a self-completed clinical form during the nursing consultation were also used. Conclusions: the studies made it possible to identify positive strategies for preventing cervical cancer, which could direct nurses to increasingly invest in methodologies aimed at increasing women's autonomy

Manejo del paciente con Hipertiroidismo en consulta externa de la Unidad Técnica de Endocrinología del Hospital Carlos Andrade Marín / Management of the patient with hyperthyroidism in the outpatient clinic of the Technical Unit of Endocrinology of the Endocrinology Technical Unit of the Carlos Andrade Marín Hospital

El hipertiroidismo es un trastorno caracterizado por el exceso de hormonas tiroideas. El déficit de yodo es un factor clave en dicha patología y en lugares con suficiencia del mismo se asocian a au-toinmunidad tiroidea. La prevalencia de hipertiroidismo mani-fiesto varía del 0,2% al 1,3% en áreas con suficiencia de yodo, sin embargo, esto puede variar en cada país por diferencias en umbrales de diagnóstico, sensibilidad de ensayo y población se-leccionada. Un reporte de The Third National Health and Nutri-tion Examination Survey (NHANES III) mostró que el hiperti-roidismo manifiesto se presenta en 0,7% de la población general e hipertiroidismo subclínico en el 1,7%1,2.En incidencia, la patología se asocia con la suplementación de yodo, con la mayor frecuencia en áreas de deficiencias, por au-mento de nódulos tiroideos en la población anciana, teniendo a regiones de áreas montañosas como América del Sur, África Central y suroeste de Asia dentro de este grupo. Un meta aná-lisis de estudios europeos mostró una incidencia general de 50 casos por 100000 personas/años1. En Ecuador, según los datos del Instituto Nacional de Estadísticas y Censos (INEC) del 2017, se reportaron 157 casos de hipertiroidismo, de los cuales la En-fermedad de Graves (EG) fue la causa más común, seguida por el bocio multinodular tóxico (BMNT) y finalmente el adenoma tóxico (AT) con una incidencia de 61 %, 24 % y 14 % respecti-vamente3.Los pacientes con esta patología tienen aumento de riesgo com-plicaciones cardiovasculares y mortalidad por todas las causas, siendo falla cardíaca uno de sus principales desenlaces, así el diagnóstico precoz evita estos eventos, principalmente en pobla-ción de edad avanzada.El presente protocolo se ha realizado para un correcto trata-miento de esta patología en el Hospital de Especialidades Carlos Andrade Marín (HECAM).

Hyperthyroidism is a disorder characterized by an excess of thyroid hormones. Iodine deficiency is a key factor in this pa-thology and in places with iodine deficiency it is associated with thyroid autoimmunity. The prevalence of overt hyperthyroidism varies from 0,2% to 1,3% in iodine-sufficient areas; however, this may vary from country to country due to differences in diag-nostic thresholds, assay sensitivity, and selected population. A report from The Third National Health and Nutrition Examina-tion Survey (NHANES III) showed that overt hyperthyroidism occurs in 0,7% of the general population and subclinical hyper-thyroidism in 1,7%1,2.In incidence, the pathology is associated with iodine supplemen-tation, with the highest frequency in areas of deficiencies, due to increased thyroid nodules in the elderly population, having regions of mountainous areas such as South America, Central Africa and Southwest Asia within this group. A meta-analysis of European studies showed an overall incidence of 50 cases per 100000 person/years1. In Ecuador, according to data from the National Institute of Statistics and Census (INEC) in 2017, 157 cases of hyperthyroidism were reported, of which, Graves' di-sease (GD) was the most common cause, followed by toxic mul-tinodular goiter (BMNT) and finally toxic adenoma (TA) with an incidence of 61 %, 24 % and 14 % respectively3.Patients with this pathology have an increased risk of cardiovas-cular complications and all-cause mortality, with heart failure being one of the main outcomes, so early diagnosis avoids these events, mainly in the elderly population.The present protocol has been carried out for the correct treat-ment of this pathology at the Carlos Andrade Marín Specialties Hospital (HECAM).

Frecuencia de eventos cardiovasculares en pacientes con lupus eritematoso sistémico / Frequency of cardiovascular events in patients with systemic lupus erythematosus

Resumen Introducción: el progreso en los tratamientos para el lupus eritematoso sistémico (LES) resultó en una disminución de la mortalidad; sin embargo, la enfermedad cardiovascular y las complicaciones infecciosas aún son las principales causas de muerte. La evidencia apoya la participación del sistema inmunológico en la generación de la placa aterosclerótica, así como su conexión con las enfermedades autoinmunes. Objetivos: describir la frecuencia de eventos cardiovasculares (ECV) en el Registro de Lupus Eritematoso Sistémico de la Sociedad Argentina de Reumatología (RELESSAR) transversal, así como sus principales factores de riesgo asociados. Materiales y métodos: estudio descriptivo y transversal para el cual se tomaron los pacientes ingresados en el registro RELESSAR transversal. Se describieron las variables sociodemográficas y clínicas, las comorbilidades, score de actividad y daño. ECV se definió como la presencia de al menos una de las siguientes patologías: enfermedad arterial periférica, cardiopatía isquémica o accidente cerebrovascular. El evento clasificado para el análisis fue aquel posterior al diagnóstico del LES. Se conformaron dos grupos macheados por edad y sexo 1:2. Resultados: 1515 pacientes mayores de 18 años participaron del registro. Se describieron 80 pacientes con ECV (5,3%). En este análisis se incluyeron 240 pacientes conformando dos grupos. La edad media fue de 47,8 (14,4) y 47,6 (14,2) en el grupo con y sin ECV respectivamente. Los pacientes con ECV tuvieron mayor duración del LES en meses, mayor índice de Charlson, mayor SLICC (Systemic Lupus International Collaborating Clinics/American College of Rheumatology), mayor frecuencia de manifestaciones neurológicas, síndrome antifosfolípido, hospitalizaciones y uso de ciclofosfamida. Las únicas variables asociadas en el análisis multivariado fueron el índice de Charlson (p=0,004) y el SLICC (p<0,001). Conclusiones: los ECV influyen significativamente en nuestros pacientes, y se asocian a mayor posibilidad de daño irreversible y comorbilidades.

Abstract Introduction: progress in treatments for systemic lupus erythematosus (SLE) has resulted in a decrease in mortality; however, cardiovascular and infectious diseases remain the leading causes of death. Evidence supports the involvement of the immune system in the generation of atherosclerotic plaque, as well as its connection to autoimmune diseases. Objectives: to describe the frequency of cardiovascular disease (CVD) in the cross-sectional RELESSAR registry, as well as its associated variables. Materials and methods: a descriptive and cross-sectional study was performed using patients admitted to the cross-sectional RELESSAR registry. Sociodemographic variables, clinical variables, comorbidities, activity and damage scores were described. CVD was defined as at least one of the following: peripheral arterial disease, ischemic heart disease, or cerebrovascular accident. All patients with at least one CVD were included in our analysis (heart attack, central nervous system vascular disease, and peripheral arteries atherosclerotic disease). The event classified for the analysis was that after the diagnosis of SLE. SLE diagnosis was previous to CVD. Two groups matched by age and sex, 1:2 were formed. Results: a total of 1515 patients older than 18 years participated in the registry. Eighty patients with CVD (5.3%) were described in the registry. Two-hundred and forty patients were included, according to two groups. The mean age was 47.8 (SD 14.4) and 47.6 (SD 14.2) in patients with and without CVD, respectively. Patients with CVD had a longer duration of SLE in months, a higher Charlson index, a higher SLICC, increased frequency of neurological manifestations, antiphospholipid syndrome, hospitalizations, and use of cyclophosphamide. The associated variables in the multivariate were the Charlson Index (p=0.004) and the SLICC (p<0.001). Conclusions: CVDs have a significant influence on our patients, being associated with a greater possibility of damage and comorbidities.

Evaluation of the attitude and behavior on COVID-19 vaccination among medical students of Texila American university-college of medicine

Background: Among the frontline healthcare workers who may encounter COVID-19 patients are medical students. It is critical to quickly reach high COVID-19 vaccination coverage rates in this population. They will be tasked with making vaccine recommendations and offering advice to people who are vaccine-resistant as future health-care providers. Aim and Objective: The present study was created to evaluate medical students’ attitudes and behaviors about the COVID-19 immunization. Materials and Methods: Following Institutional Review Board permission, the study was carried out at Texila American University’s College of Medicine. A 15-item survey was completed by about 110 medical students to gauge their beliefs and actions on the COVID-19 vaccination. On statistical product and service solutions 16, descriptive analysis was used to analyze the data. Results: The majority of participants had favorable opinions toward vaccinations and believed that the COVID-19 immunization is crucial, but only 53% said that they would take part in a trial of the COVID-19 vaccine, and 65% said that they would not take the flu vaccine this flu season. The majority of students expressed the opinion that vaccinations are essential for maintaining health and that family members should also obtain them. Students who were ready to receive the vaccination right away were more inclined to believe in public health professionals, worry about side effects, and support vaccination laws. Conclusion: The study assessed medical students’ attitudes and behaviors about receiving the COVID-19 vaccine and emphasizes the necessity for an educational curriculum regarding the vaccine’s safety and efficacy to encourage uptake.

Clinical and Safety Outcomes of Endovascular Therapy 6 to 24 Hours After Large Vessel Occlusion Ischemic Stroke With Tandem Lesions / 대한뇌졸중학회지

Background@#and Purpose Effect of endovascular therapy (EVT) in acute large vessel occlusion (LVO) patients with tandem lesions (TLs) within 6–24 hours after last known well (LKW) remains unclear. We evaluated the clinical and safety outcomes among TL-LVO patients treated within 6–24 hours. @*Methods@#This multicenter cohort was divided into two groups, based on LKW to puncture time: early window (<6 hours), and late window (6–24 hours). Primary clinical and safety outcomes were 90-day functional independence measured by the modified Rankin Scale (mRS: 0–2) and symptomatic intracranial hemorrhage (sICH). Secondary outcomes were successful reperfusion (modified Thrombolysis in Cerebral Infarction score ≥2b), first-pass effect, early neurological improvement, ordinal mRS, and in-hospital and 90-day mortality. @*Results@#Of 579 patients (median age 68, 32.1% females), 268 (46.3%) were treated in the late window and 311 (53.7%) in the early window. Late window group had lower median National Institutes of Health Stroke Scale score at admission, Alberta Stroke Program Early Computed Tomography Score, rates of intravenous thrombolysis, and higher rates for perfusion imaging. After adjusting for confounders, the odds of 90-day mRS 0–2 (47.7% vs. 45.0%, adjusted odds ratio [aOR] 0.71, 95% confidence interval [CI] 0.49–1.02), favorable shift in mRS (aOR 0.88, 95% CI 0.44–1.76), and sICH (3.7% vs. 5.2%, aOR 0.56, 95% CI 0.20–1.56) were similar in both groups. There was no difference in secondary outcomes. Increased time from LKW to puncture did not predicted the probability of 90-day mRS 0–2 (aOR 0.99, 95% CI 0.96–1.01, for each hour delay) among patients presenting <24 hours. @*Conclusion@#EVT for acute TL-LVO treated within 6–24 hours after LKW was associated with similar rates of clinical and safety outcomes, compared to patients treated within 6 hours.

Oral parasitic protozoan Entamoeba gingivalis in periodontal disease patients, northeastern Thailand

@#Entamoeba gingivalis is present in the oral cavity of humans and is associated with periodontal disease. Consequently, this study aimed to comprehensively investigate the E. gingivalis infection and the associated risk factors among individuals suffering from periodontal conditions. A cross-sectional descriptive study was carried out within a cohort of periodontal patients. Dental plaque specimens were meticulously collected and subsequently subjected to thorough examination using the polymerase chain reaction (PCR)-based technique targeting the small subunit ribosomal RNA (SrRNA) gene of the organism. The occurrence of risk factors for E. gingivalis infection was analyzed by the chi-square test and binary logistic regression. Out of the 230 participants, 60 were clinically diagnosed with periodontitis, while 170 were afflicted with gingivitis. Out of the 230 patients, 25 (10.9%) tested positive for E. gingivalis infections. An in-depth analysis unveiled that a significant majority of infections were recorded within subgroups characterized by a marital status (15.45%), manifestation of periodontitis (25.00%), and concomitant presence of underlying disease (20.83%). Furthermore, the high risk factor associated with E. gingivalis infection was the female (ORadj = 13.65, 95% CI = 1.08-173.21), followed by periodontitis (ORadj = 3.30, 95% CI = 1.21-9.00), respectively. The study employs a molecular diagnostic approach to screen for E. gingivalis enrichment within a subset of periodontal patients with advancing disease. The findings emphasize the necessity for further research to elucidate the pathogenesis of E. gingivalis and advocate for vigilant surveillance within a substantial population of periodontal patients.

Efficacy of Curcumin on Cognitive Function Scores in Women with Premenstrual Syndrome and Dysmenorrhea: A Triple-Blind, Placebo-Controlled Clinical Trial / 中国结合医学杂志

OBJECTIVE@#To assess the efficacy of a curcumin supplementation on cognitive abilities in women suffering from premenstrual syndrome (PMS) and dysmenorrhea.@*METHODS@#A randomized, triple-blind, placebo-controlled trial was conducted from December 2019 to March 2020. A total of 124 women who had both PMS and dysmenorrhea were enrolled, and were equally and randomly assigned to the curcumin group or placebo group, 62 cases in each. Each subject received either a capsule containing 500 mg of curcuminoid, or a placebo daily, for 10 days (7 days before and until 3 days after the onset of menstrual bleeding) over 3 menstrual cycles. The cognitive abilities questionnaire was used to measures cognitive functions in 7 specific areas. Adverse reactions were monitored during and after the trial in both groups.@*RESULTS@#Administration of curcumin was associated with a significant increase in memory score (P=0.002), inhibitory control and selective attention (P=0.020), and total cognitive ability task (P=0.024). In addition, significant increments were found in scores of memory (3.5±3.1 vs. 0.4±3.8 in the curcumin and placebo groups, respectively; P=0.035), inhibitory control and selective attention (3.0±3.7 vs. 0.4±3.7; P=0.027) and total cognitive abilities (8.3±12.3 vs. 2.2±12.4; P=0.025) in the curcumin group versus placebo groups. Curcumin was safe and well-tolerable in current clinical trial.@*CONCLUSION@#Curcumin has a beneficial efficacy on cognitive function scores in women with PMS and dysmenorrhea, with improvements in memory, inhibitory control and selective attention. (Registration No. IRCT20191112045424N1, available at: https://www.irct.ir ).

Aplicación de la Teoría del Cuidado Cultural a la investigación: prácticas de cuidado preventivas de hantavirus / Applying Cultural Care Theory to research: hantavirus preventive care practices

INTRODUCCIÓN: La investigación en enfermería surge de las necesidades y experiencias en la práctica y debe contribuir a generar, redefinir y actualizar el conocimiento de enfermería a través de comprobación o generación de nuevas teorías de enfermería. El conocimiento nuevo generado o actualizado debe retornar y mejorar la práctica del cuidado de enfermería dirigido las personas, familia y comunidad. Sin embargo en ocasiones la interrelación investigación y teoría no es clara, afectando de esta manera la relevancia de la aplicación de las teorías de enfermería en la práctica del cuidado de enfermería. OBJETIVO: La presente reflexión responde al objetivo de ejemplificar cómo se aplicó la Teoría del Cuidado Cultural Universalidad y Diversidad de Leininger al estudio del fenómeno de las prácticas de cuidado preventivas de hantavirus. DESARROLLO: Sistematización crítica de la experiencia investigativa a través de una propuesta metodológica, que describe cómo la Teoría del Cuidado Cultural Universalidad y Diversidad de Leininger guio el proceso de investigación sobre las prácticas de cuidado preventivas de hantavirus, factores personales, sociales, modos de vida y creencias culturales. CONCLUSIONES: Un elemento fundamental en toda investigación de enfermería es mostrar de manera clara y explícita cómo la teoría se interconecta con todas las fases de la investigación y en consecuencia genera conocimiento de enfermería para la práctica del cuidado.

INTRODUCTION: Nursing research arises from needs and experiences in practice and should contribute to generate, redefine and update nursing knowledge by testing or developing new nursing theories. Such new or updated knowledge should lead to improvements in the practice of nursing care applied to persons, family, and community. However, sometimes the interrelationship between research and theory is unclear, affecting the relevance of such theories to nursing care practice. OBJECTIVE: The present reflection aims to exemplify how Leininger's Theory of Cultural Care Universality and Diversity was applied to the study of hantavirus preventive care practices. DEVELOPMENT: Critical systematization of the research experience through a proposed methodology that describes how Leininger's Theory of Cultural Care Universality and Diversity guided research related to hantavirus preventive practices, personal and social factors, lifestyles, and cultural beliefs. CONCLUSIONS: A fundamental element in all nursing research is to clearly and explicitly show how theory interfaces with all phases of research and consequently generates nursing knowledge for caring practice.

A retrospective multicenter study of oral and maxillofacial lesions in older people

Abstract Few studies on the distribution of oral diseases in older people are available in the literature. This study aimed to investigate the prevalence and demographic characteristics of oral and maxillofacial lesions in geriatric patients (age ≥ 60 years). A retrospective descriptive cross-sectional study was performed. Biopsy records were obtained from archives of three Brazilian oral pathology centers over a 20-year period. Data on sex, age, anatomical site, skin color, and histopathological diagnosis were collected and analyzed. Pearson's chi-square test was used to evaluate differences in the frequency of the different oral and maxillofacial lesion groups. A total of 7,476 biopsy records of older patients were analyzed. Most cases were diagnosed in patients aged 60 to 69 years (n = 4,487; 60.0%). Females were more affected (n = 4,403; 58.9%) with a female-to-male ratio of 1:0.7 (p < 0.001). The tongue (n = 1,196; 16.4%), lower lip (n = 1,005; 13.8%), and buccal mucosa (n = 997; 13.7%) were the most common anatomical sites. Reactive and inflammatory lesions (n = 3,840; 51.3%) were the most prevalent non-neoplastic pathologies (p < 0.001), followed by cysts (n = 475; 6.4%). Malignant neoplasms were more frequent (n = 1,353; 18.1%) than benign neoplasms (n = 512; 6.8%). Fibrous/fibroepithelial hyperplasia (n = 2,042; 53.2%) (p < 0.001) and squamous cell carcinoma (n = 1,191; 88.03%) (p < 0.001) were the most common oral lesions in older adults. Biopsy data allow the accurate characterization of the prevalence of oral and maxillofacial lesions, supporting the development of public health policies that can enable the prevention, early diagnosis, and appropriate treatment of these lesions. Also, they bring valuable information that helps dentists and geriatricians diagnose these diseases.

Certainty of evidence, why? / Certeza das evidências, por quê?

ABSTRACT Optimal clinical decision-making requires understanding of evidence regarding benefits, harms, and burdens of alternative management options. Rigorously conducted systematic reviews and meta-analyses offer accurate summaries of the evidence. However, such summaries may review only low-certainty evidence, in the process highlighting that no single decision is likely to be best for all patients. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach offers a systematic and transparent method for rating certainty of evidence in systematic reviews. In this paper, we will address the importance of assessing the certainty associated with bodies of evidence; explain how the GRADE system rates the certainty of evidence from systematic reviews; and present the GRADE evidence to decision framework for moving from evidence to strong or weak recommendations in clinical practice guidelines.

RESUMO Para tomar a melhor decisão clínica, é preciso compreender as evidências a respeito dos benefícios, malefícios e ônus das alternativas de manejo. Revisões sistemáticas e meta-análises que sejam realizadas com rigor oferecem resumos precisos das evidências. No entanto, é possível que esses resumos avaliem apenas as evidências cujo grau de certeza é baixo e, ao fazê-lo, ressaltem que provavelmente não existe uma decisão única que será a melhor para todos os pacientes. O Grading of Recommendations Assessment, Development, and Evaluation (GRADE) é um método sistemático e transparente para avaliar o grau de certeza das evidências em revisões sistemáticas. Neste artigo, abordaremos a importância de avaliar o grau de certeza das evidências; explicaremos como o sistema GRADE classifica o grau de certeza das evidências provenientes de revisões sistemáticas e apresentaremos o evidence to decision framework (quadro para a avaliação de evidências) do GRADE para decidir se as evidências se traduzem em recomendações fortes ou fracas nas diretrizes de prática clínica.

Impact of telemedicine on metabolic control and hospitalization of peritoneal dialysis patients during the COVID-19 pandemic: a national multicentric cohort study / Impacto da telemedicina no controle metabólico e hospitalização de pacientes em diálise peritoneal durante a pandemia de COVID-19: um estudo de coorte multicêntrico nacional

Abstract Introduction: The coronavirus-19 pandemic threatens the lives of all people, but results in higher mortality rates for patients with end-stage kidney disease (ESKD) including those on peritoneal dialysis (PD). Telemedicine was the main alternative to reduce exposure to the virus, but it was introduced in the Brazil without proper training. Objective: To investigate the impact of telemedicine on metabolic control, peritonitis rates, and hospitalization in PD patients during the pandemic. Methods: This was a retrospective multicenter cohort study. We included all adult patients on chronic PD from 9 clinics selected by convenience during the pandemic. The outcomes of interest were measured and compared between before and after switching to telemedicine using repeated measure analysis and multilevel Poisson regression. Results: The study included 747 patients with a mean age of 59.7±16.6 years, of whom 53.7% were male and 40.8% had diabetes. Biochemical parameters including hemoglobin, potassium, phosphate, calcium, and urea serum levels did not change significantly after transition to telemedicine. There was no association between telemedicine and peritonitis rates. In contrast, hospitalization rates increased significantly in the telemedicine period. The incidence rate ratio (IRR) for hospitalization in the telemedicine period was 1.54 (95%CI 1.10-2.17; p 0.012) and 1.57 (95%CI 1.12-2.21; p 0.009) in the mixed-effects Poisson regression before and after adjustment for the presence of confounders. Admissions for hypervolemia and infections not related to PD doubled after transition to telemedicine. Conclusion: The implementation of telemedicine without proper training may lead to an increase in adverse events in PD patients.

Resumo Introdução: A pandemia do coronavírus-19 ameaça a vida de todas as pessoas, mas resulta em uma alta taxa de mortalidade em pacientes com doença renal em estágio terminal (DRET), incluindo aqueles em diálise peritoneal (DP). A telemedicina foi a principal alternativa para reduzir a exposição ao vírus, mas foi introduzida no Brasil sem treinamento adequado. Objetivo: Investigar o impacto da telemedicina no controle metabólico, taxas de peritonite e hospitalização em pacientes em DP na pandemia. Métodos: Estudo de coorte multicêntrico retrospectivo. Incluímos todos os pacientes adultos em DP crônica de 9 clínicas selecionadas por conveniência durante a pandemia. Desfechos de interesse foram medidos e comparados entre antes e depois da mudança para telemedicina usando análise de medidas repetidas e regressão multinível de Poisson. Resultados: Incluiu-se 747 pacientes com idade média de 59,7±16,6 anos, sendo 53,7% homens e 40,8% diabéticos. Parâmetros bioquímicos, incluindo níveis séricos de hemoglobina, potássio, fosfato, cálcio e ureia não mudaram significativamente após transição para telemedicina. Não houve associação entre telemedicina e taxas de peritonite. Em contraste, taxas de hospitalização aumentaram significativamente no período de telemedicina. A razão de taxas de incidência (RTI) para internação no período de telemedicina foi 1,54 (IC95% 1,10-2,17; p 0,012) e 1,57 (IC95% 1,12-2,21; p 0,009) na regressão multinível de Poisson antes e após ajuste para presença de fatores de confusão. As internações por hipervolemia e infecções não relacionadas à DP dobraram após transição para telemedicina. Conclusão: A implementação da telemedicina sem treinamento adequado pode levar ao aumento de eventos adversos em pacientes em DP.

Revisión sistemática del concepto: envejecimiento saludable / Systematic review of the concept: healthy aging / Revisão sistemática do conceito: envelhecimento saudável

El siguiente estudio, dará a conocer los resultados de la revisión sistemática en la literatura, en torno al concepto envejecimiento saludable, considerando que la forma de envejecer de muchos adultos es preocupante, por las repercusiones en la salud conforme se envejece. Para esto, se realizó una búsqueda en algunas bases de datos como, Pubmed.ncbi, ScienceDirect, Medline, BIREME - Portal Regional de la BVS, e-Libro de la Universidad de Panamá, Scholarly Journals, Google académico, páginas oficiales de organismos internacionales como la OPS, OMS y CEPAL, artículos en scielo.org, Revistas Especializadas de Geriatría, Gerontología y Salud Pública. Seguidamente se seleccionaron estudios empíricos y teóricos relacionados al envejecimiento y así, analizar el concepto. Se concluye que la Década del Envejecimiento Saludable 2021-2030, es una propuesta centrada en cuatro esferas de acciones fundamentales, para proteger la salud, el bienestar y están fuertemente conectadas entre sí, que persiguen mejorar la vida de las personas mayores, sus familias y comunidades. Y desde la investigación, constituye un reto para la disciplina y la profesión de Enfermería, al generar cuidados a partir de teorías, que a su vez faciliten el entendimiento y abordaje del fenómeno. Igualmente, en la cooperación técnica a nivel nacional e internacional, en la salud de la población envejecida y las políticas globales. Esta revisión sistemática nos permitió identificar las dimensiones esenciales del concepto envejecimiento saludable, las cuales se resumen en tres dimensiones: 1. Capacidad funcional, física y mental, que le permite a la persona adulta ser y hacer lo que prefiere, 2. Actitud que no enfatice la edad cronológica como un impedimento para lograr metas, 3. Práctica sistemática de promoción de estilos de vida saludables, y de prevención de enfermedades crónicas no transmisibles.

Abstract The following study will present the results of the systematic review of the literature around the concept of healthy aging, considering that the way many adults age is a concern due to the repercussions on health as they age. As a result, a search was carried out in some databases such as Pubmed.ncbi, ScienceDirect, Medline, BIREME - Regional Portal of the VHL, e-Book of the University of Panama, Scholarly Journals, academic Google, official pages of international organizations such as PAHO, WHO, and ECLAC, articles in scielo.org, Specialized Journals of Geriatrics, Gerontology and Public Health. Next, empirical and theoretical studies related to aging were selected to analyze the concept. It is concluded that the Decade of Healthy Aging 2021-2030 is a proposal focused on four spheres of fundamental actions to protect the health and well-being which are strongly connected to each other, which seek to improve the lives of older people, their families, and communities. And from research, the proposal constitutes a challenge for the discipline and the Nursing profession by generating care based on theories that facilitate the understanding and approach to the phenomenon. Likewise, in technical cooperation at the national and international level, in the health of the elderly population and global policies. This systematic review allows us to identify the essential dimensions of the healthy aging concept, which are summarized in three dimensions. 1. Functional, physical, and mental capacity, which allows the adult to be and do what they prefer, 2. An attitude that does not emphasize chronological age as an impediment to achieving goals, 3. The systematic practice of promoting healthy lifestyles and preventing chronic non-communicable diseases.

Resumo O estudo a seguir apresentará os resultados da revisão sistemática na literatura, em torno do conceito de envelhecimento saudável, considerando que a forma de envelhecer de muitos adultos é preocupante, devido às repercussões na saúde à medida que envelhecem. Para isso, foi realizada uma pesquisa em algumas bases de dados como Pubmed.ncbi, ScienceDirect, Medline, BIREME - Portal Regional do VHL, e-Book da Universidade de Panamá, Revistas Académicas, Académicos do Google, páginas oficiais de organizações internacionais como a OPAS, a OMS e a ECLAC, artigos em scielo.org, Revistas Especializadas de Geriatria, Gerontologia e Saúde Pública. Em seguida, foram selecionados estudos empíricos e teóricos relacionados com o envelhecimento e, assim, o conceito foi analisado. Conclui-se que a Década do Envelhecimento Saudável 2021-2030, é uma proposta focada em quatro áreas fundamentais de ações para proteger a saúde, o bem-estar e estão fortemente ligadas entre si, e procuram melhorar a vida dos idosos, das suas famílias e suas comunidades. E a partir da pesquisa, constitui um desafio para a disciplina e a profissão de Enfermagem, gerando cuidados a partir de teorias, que por sua vez facilitam a compreensão e abordagem do fenómeno. Da mesma forma, na cooperação técnica a nível nacional e internacional, na saúde da população envelhecida e nas políticas globais. Essa revisão sistemática permitiu identificar as dimensões essenciais do conceito de envelhecimento saudável, que são resumidas em três dimensões: 1. Capacidade funcional, física e mental, que permite que a pessoa adulta seja e faça o que preferir, 2. Atitude que não enfatiza a idade cronológica como impedimento para atingir objetivos, 3. Prática sistemática de promoção de estilos de vida saudáveis, e prevenção de doenças crónicas não transmissíveis

Associação do Genótipo e Fenótipo da Paraoxonase-1 com Angiografia Positiva para Doença Arterial Coronariana / Association of Paraoxonase-1 Genotype and Phenotype with Angiogram Positive Coronary Artery Disease

Resumo Fundamento Tem sido demonstrado que um aumento dos níveis séricos de PON1 é protetor contra vários distúrbios. Foi relatado que vários polimorfismos de nucleotídeo único (SNPs, single nucleotide polymorphisms ) do gene PON1 estão associados a níveis e atividade de proteínas enzimáticas séricas. Objetivos Investigar a associação de SNPs do PON1 e atividade da paraoxonase sérica com a doença arterial coronariana (DAC). Métodos Foram estudados 601 pacientes não relacionados submetidos à angiografia coronária, incluindo aqueles com estenose >50% (N=266) e aqueles com estenose <30% (N=335). Os SNPs rs662 e rs840560 do gene da paraoxonase foram determinados utilizando o método ARMS-PCR e o SNP rs705379 foi genotipado utilizando análise de PCR-RFLP. A atividade da paraoxonase sérica foi medida utilizando paraoxon como substrato. O valor de p<0,05 foi considerado significante. Resultados A atividade da paraoxonase sérica não foi significativamente diferente entre os grupos de estudo. Após ajuste para idade, sexo, hipertensão, diabetes mellitus e dislipidemia, o genótipo GG e o modelo codominante de rs662 foram positivamente associados a uma angiografia positiva (respectivamente, OR = 2,424, IC 95% [1,123-5,233], p <0,05, OR = 1,663, IC 95% [1,086-2,547]). A atividade da paraoxonase sérica foi significativamente maior no alelo G e variante GG do polimorfismo rs662, alelo A e variante AA de rs854560 e alelo C e variante CC de rs705379. A análise de haplótipos mostrou que o haplótipo ATC foi significativamente mais prevalente no grupo com angiografia negativa. A análise entre os grupos indicou que o alelo A de rs662 foi significativamente associado à menor atividade da paraoxonase no grupo com angiografia positiva (p=0,019). Conclusões A presença do alelo G do polimorfismo de nucleotídeo único rs662 está independentemente associada ao aumento do risco de DAC.

Abstract Background It has been shown that increased serum PON1 levels are protective against several disorders. Several single nucleotide polymorphisms (SNPs) of the PON1 gene have been reported to be associated with serum enzyme protein levels and activity. Objective To investigate the association of SNPs of PON1 and serum paraoxonase activity with coronary artery disease (CAD). Methods A total of 601 unrelated patients who underwent coronary angiography including those who had >50% stenosis (N=266) and those with <30% stenosis (N=335) were studied. The Paraoxonase gene rs662 and rs840560 SNPs were determined using the ARMS-PCR method and the rs705379 SNP was genotyped using PCR-RFLP analysis. Serum paraoxonase activity was measured using paraoxon as a substrate. A p value of p<0.05 was considered as significant. Results Serum paraoxonase activity was not significantly different between the study groups. After adjustment for age, sex, hypertension, diabetes mellitus and dyslipidemia, the GG genotype and co-dominant model of rs662 was positively associated with a positive angiogram (respectively, OR=2.424, 95%CI [1.123-5.233], p<0.05, OR=1.663, 95%CI [1.086-2.547]). Serum paraoxonase activity was significantly higher in the G allele and GG variant of rs662, A allele and AA variant of rs854560 and C allele and CC variant of rs705379. The haplotype analysis has shown that the ATC haplotype was significantly more prevalent among the angiogram negative group. The analysis between groups indicated that the A allele of rs662 was significantly associated with lower paraoxonase activity in the positive angiogram group (p=0.019). Conclusions The presence of the G allele of the rs662 single nucleotide polymorphism is independently associated to increased risk of CAD.

Más allá de los límites de la disciplina con niños prematuros: una reflexión holística / Beyond the Limits of Discipline with Premature Children: A Holistic Reflection / Além dos limites da disciplina com bebés prematuros: uma reflexão holística

Introducción. En este artículo se presenta una reflexión sobre la necesidad de tener una visión holística en la problemática de la prematurez, para que los equipos del área de salud puedan tener una comprensión de la multiplicidad de factores presentes en el parto prematuro, y sus consecuencias para el menor, la madre, los familiares y el personal de salud involucrado. Tema de reflexión. El tema se sustenta en dos investigaciones realizadas con las madres, los padres y los niños beneficiarios del Programa Madre Canguro en un hospital del Estado, en dos momentos, 2012 y 2014, con algunos de los autores del presente artículo. Conclusiones. Además de la revisión de la literatura científica relacionada con el tema y la problemática, se concluye que, bajo una mirada holística, se comprende de manera integral la problemática y se propicia una mejor comunicación con los padres; con el equipo de la atención en salud, se logra un manejo transdisciplinario, superando los objetos de estudios aislados. Se da así un abordaje integrador y significativo en la cotidianidad de cada actor, desde la piel, con el Programa Madre Canguro, hasta la racionalidad de la ciencia.

Introduction. This article presents a reflection on the need for a holistic view of the problem of premature births, so that healthcare teams can understand the multiplicity of factors present in premature births, and its consequences for the minor, the mother, the family members, and the healthcare staff involved. Topic of reflection. The topic is based on two investigations carried out with mothers, fathers, and children's beneficiaries of the Mother Kangaroo Program in a State hospital, at two moments, 2012 and 2014, with some of the authors of this article. Conclusions. In addition to the review of the scientific literature related to the topic and the problem, it is concluded that, under a holistic view, the problem is understood in a comprehensive way and better communication with the parents is encouraged. With the healthcare team, cross-disciplinary handling is achieved, overcoming the objects of isolated studies. As such, there is an integrative and significant approach in the daily life of each actor, from the skin, with the Mother Kangaroo Program, to the rationality of science.

Introdução. Este artigo apresenta uma reflexão sobre a necessidade de se ter uma visão holística da problemática da prematuridade, para que as equipes da área da saúde possam ter uma compreensão da multiplicidade de fatores presentes no parto prematuro, e suas consequências para a criança, a mãe, os familiares e o pessoal de saúde envolvido. Tópico de reflexão. O tema é baseado em duas pesquisas realizadas com mães, pais e filhos beneficiários do Programa Mãe Canguru em um hospital estadual, em dois momentos, 2012 e 2014, com alguns dos autores deste artigo. Conclusões. Além da revisão da literatura científica relacionada ao tópico e ao problema, conclui-se que, sob uma visão holística, o problema é plenamente compreendido e incentiva-se uma melhor comunicação com os pais; com a equipe de saúde, consegue-se uma gestão transdisciplinar, superando os objetos de estudos isolados. Isto proporciona uma abordagem integradora e significativa no cotidiano de cada ator, desde a pele, com o Programa Mãe Canguru, até a racionalidade da ciência.

Beneficios del cuidado de enfermería con congruencia cultural en el bienestar y satisfacción del paciente / Benefits of Culturally Congruent Nursing Cure as Part of Patient Well-Being and Satisfaction

Introducción: En el contexto de una sociedad global y diversa, los cuidados de enfermería con congruencia cultural son una necesidad apremiante. Los acelerados procesos migratorios, los cambios en la economía global y el reconocimiento universal de los derechos humanos son evidencias inequívocas de esta necesidad. Objetivo: Identificar las evidencias sobre los beneficios del cuidado de enfermería con congruencia cultural, en el bienestar y satisfacción del paciente. Métodos: Revisión sistemática integrativa de estudios originales publicados del 2000-2019, en español e inglés. Se utilizaron siete bases de datos: SciELO, Lilacs, EBSCO Host, Dialnet, DOAJ, Redalyc y Pubmed, con la estrategia de búsqueda: "cuidado cultural" AND "enfermería", "cultural congruent care" AND "nursing" OR "cultural care" AND "nursing", cuidado cultural. Se seleccionaron 14 artículos a los que se realizó análisis de contenido. Conclusiones: Los artículos seleccionados permitieron identificar los beneficios de los cuidados de enfermería con congruencia cultural observados en diferentes grupos como adultos, adultos mayores y sus cuidadores, madres lactantes, escolares y adolescentes. Los beneficios del cuidado cultural se evidenciaron al abordar fenómenos como la funcionalidad familiar, la sobrecarga del cuidador, la promoción de la lactancia materna, el manejo del estrés, la ansiedad, la depresión y la calidad de vida de las sobrevivientes de cáncer de mama. Los cuidados de enfermería con congruencia cultural evidenciaron el desarrollo de una mejor relación enfermera-paciente y una mayor satisfacción de los pacientes y sus familias(AU)

Introduction: In the context of a global and diverse society, culturally congruent nursing care is an urgent need. Accelerated migration processes, changes in the global economy and universal recognition of human rights unequivocally evidence this need. Objective: To identify evidence on the benefits of culturally congruent nursing care as part of patient well-being and satisfaction. Methods: Integrative systematic review of original studies published from 2000 to 2019 in Spanish and English. Seven databases were used: SciELO, Lilacs, EBSCO Host, Dialnet, DOAJ, Redalyc and Pubmed. The following search strategy was designed: "cuidado cultural" AND "enfermería", "cultural congruent care" AND "nursing" OR "cultural care" AND "nursing", cuidado cultural [cultural care]. Fourteen articles were selected and processed through content analysis. Conclusions: The selected articles permitted to identify the benefits of culturally congruent nursing care observed in different groups such as adults, aged adults and their caregivers, breastfeeding mothers, school children and adolescents. The benefits of cultural care were evidenced by addressing phenomenons such as family functionality, caregiver overload, promotion of breastfeeding, coping with stress, anxiety and depression, as well as quality of life in breast cancer survivors. Culturally congruent nursing care evidenced the development of a better nurse-patient relationship, as well as greater patient and family satisfaction(AU)

A five-year review of perinatal and maternal outcomes and their predisposing socio-demographic factors in a tertiary hospital in South-South Nigeria

Background: With a 慥ery High� maternal mortality ratio (MMR) of 814 per 100,000 live births, Nigeria contributes the largest proportion of 19% to the global burden of maternal mortality. The causes of maternal and perinatal mortality in Nigeria are linked to the three levels of delay in accessing maternal healthcare. The objective of the study was to identify the sociodemographic contributors to adverse maternal and perinatal outcomes and mortalities in the facility and make appropriate recommendations that would improve maternal and perinatal outcomes/mortalities.Methods: This research was a retrospective study. It was conducted between January, 2016 and December, 2020. Relevant data was retrieved, entered into a pre-designed proforma, and analysed using Statistical Product and Service Solutions for windows� version 25, SPSS Inc.; Chicago, USA.Results: Age of the women (X2=12.94; p-0.005), marital status (X2=66.86; p-0.001), level of education (X2=8.77; p-0.033) and occupation of participants (X2=26.30; p-0.001) were sociodemographic characteristics that are significantly associated with the outcome of pregnancies in this centre. perinatal mortality was also associated with age of the women (X2=15.52; p-0.001), their marital status (X2=105.48; p-0.001), level of education (X2=223.15; p-0.005) and occupation (X2=229.6; p-0.001).Conclusions: Our study revealed that socio-demographic factors of the patients to a large extent contributes to maternal and perinatal morbidity and mortality, and not just the three delays.

Diseño y validación de un cuestionario para medir prácticas preventivas de hantavirus en una comunidad endémica / Design and validation of a questionnaire to measure hantavirus preventive practices in an endemic community

RESUMEN Objetivo. Diseñar y analizar las evidencias de validez de contenido, estructura interna y fiabilidad de un cuestionario de prácticas preventivas de hantavirus en una comunidad endémica en el contexto panameño. Materiales y métodos. Estudio cuantitativo de diseño instrumental. Esta investigación se desarrolló en cuatro etapas: revisión de literatura, validez de contenido a través de juicio de expertos con el método de agregados individuales y el cálculo de la V de Aiken; prueba piloto y validación psicométrica, a través del análisis factorial exploratorio (AFE) y análisis de fiabilidad de las puntuaciones del instrumento con el alfa ordinal. Resultados. Se evidenció validez de contenido y se reportó valores de V de Aiken superiores a 0,70 en el límite inferior del intervalo de confianza al 95%. En la estructura interna se identificó que los 8 ítems subyacen a un solo factor que explica el 60,70% de la varianza total de la prueba y con cargas factoriales superiores a 0,40; en el análisis de fiabilidad se obtuvo un valor de alfa ordinal de 0,84, valor considerado como bueno. Conclusiones. El cuestionario de práctica preventivas de hantavirus es un instrumento breve que muestra propiedades psicométricas aceptables para medir las actividades o conductas que realizan las personas para prevenir el hantavirus.

ABSTRACT Objective. To design and analyze the evidence of content validity, internal structure, and reliability of a questionnaire of preventive practices for hantavirus in an endemic community in the Panamanian context. Material and methods. Quantitative study of instrumental design. This research was conducted in four phases: Literature review, content validity through expert judgment with the individual aggregate method and the calculation of the V Aiken, pilot test and psychometric validation, through exploratory factor analysis (EFA) and reliability analysis of instrument scores with ordinal alpha. Results. Content validity was evidenced and V Aiken values higher than 0.70 were reported in the lower limit of 95% CI. In the internal structure we identified that the 8 items underlie a single factor that explains 60.70% of the total variance of the test and with factor loadings greater than 0.40; during the reliability analysis, we obtained an ordinal alpha value of 0.84, which is considered good. Conclusions. The Hantavirus preventive practical questionnaire is a brief instrument that shows acceptable psychometric properties to measure the activities or behaviors that people carry out to prevent hantavirus.