Diagnóstico del proceso de reafirmación profesional, en la carrera de Cultura Física, en Granma

La formación de profesionales, con elevada calidad, es tarea esencial de la Educación Superior, por lo que de manera permanente se demanda de graduados comprometidos con los procesos de desarrollo, donde quedan evidenciados los conocimientos, habilidades y valores en los que se han formado. El diagnóstico tuvo como objetivo caracterizar la situación de la orientación y reafirmación profesional (consolidación de los motivos e intenciones profesionales) en el proceso de estudio de la carrera Licenciatura en Cultura Física, en Granma; a partir de tres dimensiones: pedagógica, psicológica y sociológica. Se aplicaron métodos teóricos y empíricos que mostraron insuficiencias en las acciones planificadas en las estrategias educativas y en el plan de trabajo metodológico de las diferentes disciplinas, un limitado aprovechamiento de las potencialidades del contenido y las actividades extensionistas y bajos niveles de satisfacción por el estudio de la Carrera; lo que se manifestó en la no selección de una esfera de actuación para el futuro desempeño profesional, y en los elevados niveles de deserción de los estudiantes, en los dos primeros años de formación.

A formação de profissionais, com elevada qualidade, é uma tarefa essencial do Ensino Superior, razão pela qual existe uma procura permanente de licenciados comprometidos com processos de desenvolvimento, onde se evidenciam os conhecimentos, competências e valores em que foram formados. O objetivo do diagnóstico foi caracterizar a situação de orientação e reafirmação profissional (consolidação de motivos e intenções profissionais) no processo de estudo do Bacharelado em Cultura Física, no Granma; a partir de três dimensões: pedagógica, psicológica e sociológica. a corrida; o que se manifestou na não seleção de uma esfera de atuação para futura atuação profissional, e nos elevados índices de evasão estudantil, nos dois primeiros anos de formação.

The training of professionals, with high quality, is an essential task of Higher Education, which is why there is a permanent demand for graduates committed to development processes, where the knowledge, skills and values in which they have been trained are evidenced. The objective of the diagnosis was to characterize the situation of professional guidance and reaffirmation (consolidation of professional motives and intentions) in the process of studying the Bachelor's degree in Physical Culture, in Granma; from three dimensions: pedagogical, psychological and sociological. Theoretical and empirical methods were applied that showed insufficiencies in the planned actions in the educational strategies and in the methodological work plan of the different disciplines, a limited use of the potential of the content and extension activities and low levels of satisfaction with the study of the career; which was manifested in the non-selection of a sphere of action for future professional performance, and in the high levels of student dropout, in the first two years of training.

Breathing mode influence on craniofacial development and head posture / Influência do modo de respiração sobre o desenvolvimento craniofacial e a postura da cabeça

Abstract Objective The incidence of abnormal breathing and its consequences on craniofacial development is increasing, and is not limited to children with adenoid faces. The objective of this study was to evaluate the cephalometric differences in craniofacial structures and head posture between nasal breathing and oral breathing children and teenagers with a normal facial growth pattern. Method Ninety-eight 7-16 year-old patients with a normal facial growth pattern were clinically and radiographically evaluated. They were classified as either nasal breathing or oral breathing patients according to the predominant mode of breathing through clinical and historical evaluation, and breathing respiratory rate predomination as quantified by an airflow sensor. They were divided in two age groups (G1: 7-9) (G2: 10-16) to account for normal age-related facial growth. Results Oral breathing children (8.0 ± 0.7 years) showed less nasopharyngeal cross-sectional dimension (MPP) (p = 0.030), whereas other structures were similar to their nasal breathing counterparts (7.6 ± 0.9 years). However, oral breathing teenagers (12.3 ± 2.0 years) exhibited a greater palate length (ANS-PNS) (p = 0.049), a higher vertical dimension in the lower anterior face (Xi-ANS-Pm) (p = 0.015), and a lower position of the hyoid bone with respect to the mandibular plane (H-MP) (p = 0.017) than their nasal breathing counterparts (12.5 ± 1.9 years). No statistically significant differences were found in head posture. Conclusion Even in individuals with a normal facial growth pattern, when compared with nasal breathing individuals, oral breathing children present differences in airway dimensions. Among adolescents, these dissimilarities include structures in the facial development and hyoid bone position.

Resumo Objetivo A incidência da respiração anormal e de suas consequências no desenvolvimento craniofacial aumenta e não é limitada a crianças com fácies adenoideanas. O objetivo deste estudo foi avaliar as diferenças cefalométricas nas estruturas craniofaciais e na postura da cabeça entre crianças e adolescentes com respiração nasal e respiração bucal com padrão de crescimento facial normal. Método 98 pacientes com idades entre 7-16 anos com padrão de crescimento facial normal foram avaliados de forma clínica e radiológica. Eles foram classificados como pacientes com respiração nasal ou respiração bucal de acordo com a predominância do modo de respiração por meio da avaliação clínica e histórica e da predominância da frequência respiratória conforme qualificado por um sensor de fluxo de ar. Os pacientes foram divididos em duas faixas etárias (G1: 7 a 9) (G2: 10 a 16) para contabilizar o crescimento normal facial relacionado à idade. Resultados As crianças com respiração bucal (8,0 ± 0,7 anos) mostraram menor dimensão transversal nasofaríngea (MPP) (p = 0,030), ao passo que outras estruturas foram semelhantes a seus pares com respiração nasal (7,6 ± 0,9 anos). Contudo, os adolescentes com respiração bucal (12,3 ± 2,0 anos) mostraram maior comprimento do palato (espinha nasal anterior-espinha nasal posterior [ENA-ENP]) (p = 0,049), maior dimensão vertical na menor face anterior (Xi-ENA-Pm) (p = 0,015) e menor posição do osso hioide a respeito do plano mandibular (H-PM) (p = 0,017) do que seus pares com respiração nasal (12,5 ± 1,9 anos). Não foram constatadas diferenças estatisticamente significativas na postura da cabeça. Conclusão Mesmo em indivíduos com padrão de crescimento facial normal, em comparação com indivíduos com respiração nasal, as crianças com respiração bucal apresentam diferenças nas dimensões das vias aéreas. Entre os adolescentes, essas dissimilaridades incluem estruturas no desenvolvimento facial e na posição do osso hioide.

Cronología eruptiva de dientes permanentes en una población indígena del Perú

Objetivo: El objetivo del presente estudio fue determinar la cronología eruptiva de la dentición permanente en una población indígena del Perú. Metodología: Se trata de un estudio transversal, con una muestra de 1644 niños en edades comprendidas entre 5 y 16 años (804 niñas y 840 niños), a los cuales realizó un examen bucal para determinar la fase de erupción en la que se encontraban las piezas dentales. Para realizar la estadística, se utilizó el programa spss versión 21. Las pruebas estadísticas utilizadas fueron t Student para muestras independientes, dependiendo de las pruebas de supuesto de normalidad y homocedasticidad. Resultados: Un análisis descriptivo da como resultado que el primer molar superior izquierdo y el inferior derecho erupcionaron a los 6,98 años y 6,99 años respectivamente, y la última pieza dental que erupcionó fue el segundo molar superior derecho a los 11,91 años. Conclusiones: El primer diente en erupcionar fue el primer molar (superior e inferior), mientras que el ultimo diente en erupcionar fue el segundo molar superior. Los dientes erupcionan antes en las niñas. Los dientes erupcionan simultanemente tanto en el lado derecho e izquierdo. Los dientes erupcionan antes en la mandibbula que en la maxila.

Obesidad pregestacional como factor de riesgo asociado a preeclampsia / Pre-gestational obesity as a risk factor for preeclampsia

OBJETIVO: Evaluar la obesidad como factor de riesgo de preeclampsia. DISEÑO: Estudio caso control realizado en el Hospital Dos de Mayo, Lima, Perú. MATERIAL Y MÉTODOS: Después de excluir 35 pacientes, se comparó 107 mujeres preeclámpticas con 107 gestantes normotensas, pareadas para edad gestacional (ñ1 semana). Se correlacionó peso pregestacional con la presencia de preeclampsia usando chi-cuadrado; se empleó t de student para comparar promedios y se controló variables confusoras usando la regresión logística. RESULTADOS: La preeclampsia estuvo asociada con una edad de 35 años o más (OR 3,0; IC 95 por ciento 1,2 a 7,9), historia de preeclampsia en el embarazo previo (OR 5,4; IC 95 por ciento 1,6 a 17,9) y obesidad (OR 6,5; 6,2 a 2,8), considerada como el tercil más alto de los parámetros índice de masa corporal (IMC), pliegue tricipital y circunferencia braquial media en el grupo control. Existió significativa tendencia linear de riesgo de preeclampsia con estos parámetros (p< 0,001).

Ambulatory patient contolled epidural analgesia (PCEA) for labor using ropivacaine: a comparative study of three different concentrations: a randomized double-blind controlled trial

Objective: This study determined the efficacy and safety of three different concentrations of ropivacaine hydrochloride via patient controlled epidural analgesia (PCEA) for ambulatory pain. Specifically, labor analgesic efficacy, manifestation of motor block, frequency of demand dosing, adverse side effects, incidence of spontaneous, instruments, and surgical deliveries, parturient and obstetrician satisfaction of the pain regimen, and neonatal outcome were assessed. Design: A randomized, double-blind controlled trial. Setting: University of Santo Tomas Hospital, a tertiary teaching hospital. Populations: Fifty-eight parturients of mixed parity, 18-40 years of age. ASA Physical Status I and II, for vaginal delivery were randomly divided into 3 parallel treatment groups. Methods: Group I (21 patients) received PCEA Ropivacaine 0.1 percent. Group II (18 patients) PCEA Ropivacaine 0.05 percent. and Group III (19 patients) PCEA Ropivacaine 0.025 percent. After placement of lumbar epidural catheter, PVEA was started: continuous infusion at 8ml/hour, demand bolus of 4 ml, with lockout period of 15 minutes, and an hourly limit of 12 ml were set. After labor relief was achieved (VAS score 0-3), with a block height of at least T10; ambulation under close supervision was allowed if patient has normal motor assessment using straight leg raising test and Bromage scale, intact joint proprioception and vibration sense, and negative orthostatic hypotension. Results: Uterine contraction pain score using the Visual Analogue Scale showed significant difference between the VAS scores before and after the study drug was started (p=0.01). the degree of pain relief was comparable between the three groups (p+0.09). But time-to-onset pain relief was faster in Group I with a mean of 15.5 minutes and slowest in Group III with a mean of 24.68 minutes. Group one had the least mean demands for more analgesic of 13.55 and accepted boluses 2.89 compared to Group III (mean demands 33.21; accepted boluses 8.42). seven percent of the population who require supplemental IV analgesics all belonged to Group III. No motor block and adverse materno-fetal side effects were noted in all three groups. Eighty-eight percent of the patients delivered spontaneously, 10 percent required instrumental deliveries, and one underwent cesarean delivery, with good neonatal outcomes. Conclusions: PCEA Ropivacaine is effective and safe for ambulatory labor pain. Ropivacaine 0.1 percent and 0.05 percent were comparable in their analgesic efficacy, onset of pain relief, patient analgesic demands, with high patient and obstetrician satisfaction. (Author)

The crown: a severe cephalo- truncal disproportion in a 2 year old infant with patent ductus arterious (PDA) undergoing a V-P shunting

This is a case of 2 year old girl, that diagnosed in a case of congenital hydrocephalus secondary to aqueductal- stenosis, referred for the anesthesia for ventriculo- peritoneal shunting.

The plight of kasabach-merritt syndrome in a 7 month old infant with obstructive facio-cervico-mediastinal cystic hygroma and hemangioma

The objective of this case are: 1. to present the pathophysiology and clinical manifestations of Kasabach- Merrit syndrome; 2. to present the anesthetic implications of a patient with a huge facio-cervico-mediastinal cystic hygroma with hemangioma on the floor of the mouth; 3. and to present alternative technique for positioning the head of this patient for direct laryngoscopy and endotracheal intubation.