O uso de Tecnologias de Informação e Comunicação em Saúde na Atenção Primária à Saúde no Brasil, de 2014 a 2018 / The use of Information and Communication Technologies in Primary Health Care in Brazil - the period of 2014 to 2018

Resumo As Tecnologias da Informação e Comunicação em Saúde permitem o armazenamento e processamento de dados digitais, acesso a informações e comunicações à distância. O objetivo deste artigo foi descrever a utilização destas tecnologias para o apoio à prática clínica e educação permanente pelas equipes de saúde da atenção primária à saúde do Brasil no período de 2014 a 2018, no âmbito do Programa de Melhoria do Acesso e da Qualidade na Atenção Básica, segundo características do contexto geopolítico. É um estudo transversal que analisou os dados coletados junto às equipes das Unidades Básicas de Saúde. Foi observada uma crescente utilização pelas equipes dos recursos da Telessaúde, Rede Universitária de Telemedicina e Universidade Aberta do Sistema Único de Saúde para auxílio à prática clínica e educação permanente em saúde. Nas regiões Norte e Nordeste o uso destas tecnologias dobrou, do ciclo II ao ciclo III. A necessidade de investimentos em infraestrutura, recursos humanos na Atenção Primária à Saúde, qualificação e formação profissional é um caminho para o fortalecimento do Sistema Único de Saúde e sua Rede de Atenção em Saúde, contribuindo para um fluxo de atendimento contínuo, com qualidade e acesso universal.

Abstract Information and Communication Technologies in Health allow the storage and processing of digital data, access to information and remote communications. The objective of this article was to describe the use of these Technologies to support clinical practice and continuing education by primary health care teams in Brazil the period of 2014 to 2018, within the scope of the Access and Quality Improvement Program Basic, according to characteristics of the geopolitical context. It's a cross-sectional study that analyzed the data collected from the teams of the Basic Health Units. A growing use by the teams of Telehealth resources, the Telemedicine University Network and the Open University of the Unified Health System was observed to aid clinical practice and permanent health education. In the North and Northeast regions, the use of these Technologies doubled, from cycle II to cycle III. The need for investments in infrastructure, human resources in Primary Health Care, qualification and professional training is a way to strengthen the Unified Health System and its Health Care Network, contributing to a continuous flow of care, with quality and access universal.

Comportamiento Mecánico de un Premolar Humano Sano Sometido a Fuerzas Funcionales y Disfuncionales en un MEF / Mechanical Behavior of a Healthy Human Premolar Subjected to Functional and Dysfunctional Forces in a FEM

El propósito de este estudio fue analizar el comportamiento mecánico de la estructura dental sana de un primer premolar inferior humano sometido a fuerzas funcionales y disfuncionales en diferentes direcciones. Se buscó comprender, bajo las variables contempladas, las zonas de concentración de esfuerzos que conllevan al daño estructural de sus constituyentes y tejidos adyacentes. Se realizó el modelo 3D de la reconstrucción de un archivo TAC de un primer premolar inferior, que incluyó esmalte, dentina, ligamento periodontal y hueso alveolar considerando tres variables: dirección, magnitud y área de la fuerza aplicada. La dirección fue dirigida en tres vectores (vertical, tangencial y horizontal) bajo cuatro magnitudes, una funcional de 35 N y tres disfuncionales de 170, 310 y 445 N, aplicadas sobre un área de la cara oclusal y/o vestibular del premolar que involucró tres contactos estabilizadores (A, B y C) y dos paradores de cierre. Los resultados obtenidos explican el fenómeno de combinar tres vectores, cuatro magnitudes y un área de aplicación de la fuerza, donde los valores de esfuerzo efectivo equivalente Von Mises muestran valores máximos a partir de los 60 MPa. Los valores de tensión máximos se localizan, bajo la carga horizontal a 170 N y en el proceso masticatorio en la zona cervical, cuando la fuerza pasa del 60 %. Sobre la base de los hallazgos de este estudio, se puede concluir que la reacción de los tejidos a fuerzas funcionales y disfuncionales varía de acuerdo con la magnitud, dirección y área de aplicación de la fuerza. Los valores de tensión resultan ser más altos bajo la aplicación de fuerzas disfuncionales tanto en magnitud como en dirección, produciendo esfuerzos tensiles significativos para la estructura dental y periodontal cervical, mientras que, bajo las cargas funcionales aplicadas en cualquier dirección, no se generan esfuerzos lesivos. Esto supone el reconocimiento del poder de detrimento estructural del diente y periodonto frente al bruxismo céntrico y excéntrico.

SUMMARY: The purpose of this study was to analyze the mechanical behavior of the healthy dental structure of a human mandibular first premolar subjected to functional and dysfunctional forces in different directions. It was sought to understand, under the contemplated variables, the areas of stress concentration that lead to structural damage of its constituents and adjacent tissues. The 3D model of the reconstruction of a CT file of a lower first premolar was made, which included enamel, dentin, periodontal ligament and alveolar bone considering three variables: direction, magnitude and area of the applied force. The direction was directed in three vectors (vertical, tangential and horizontal) under four magnitudes, one functional of 35 N and three dysfunctional of 170, 310 and 445 N, applied to an area of the occlusal and/or buccal face of the premolar that involved three stabilizing contacts (A, B and C) and two closing stops. The results obtained explain the phenomenon of combining three vectors, four magnitudes and an area of force application, where the values of effective equivalent Von Mises stress show maximum values from 60 MPa. The maximum tension values are located under the horizontal load at 170 N and in the masticatory process in the cervical area, when the force exceeds 60%. Based on the findings of this study, it can be concluded that the reaction of tissues to functional and dysfunctional forces varies according to the magnitude, direction, and area of application of the force. The stress values turn out to be higher under the application of dysfunctional forces both in magnitude and in direction, producing significant tensile stresses for the dental and cervical periodontal structure, while under functional loads applied in any direction, no damaging stresses are generated. This supposes the recognition of the power of structural detriment of the tooth and periodontium against centric and eccentric bruxism.

Consenso colombiano de la enfermedad inflamatoria intestinal pediátrica

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Introduction: Pediatric ulcerative colitis (CUP), pediatric Crohn's disease (PCD), and pediatric inflammatory bowel disease not classifiable (PIDNCID) have clinical and psychosocial particularities that differentiate them from those of adults and may condition different therapeutic approaches due to possible nutritional, growth and developmental repercussions, representing a challenge for the pediatrician and gastroenterologist. Objective: Develop expert consensus evidence-based recommendations for the timely and safe diagnosis and treatment of Pediatric Inflammatory Bowel Disease (PID) in children under 18 years of age for professionals caring for these patients and healthcare payers. Methodology: Through a panel of experts from the Colombian College of Pediatric Gastroenterology, Hepatology and Nutrition (COLGAHNP) and a multidisciplinary group, 35 questions were asked regarding the clinical picture, diagnosis, and treatment of PID. Through a critical review and analysis of the literature with particular emphasis on the main clinical practice guidelines (CPGs), randomized clinical trials (RCTs), and meta-analyses of the last ten years, from which the experts made 77 recommendations that responded to each of the research questions with their respective practical points. Subsequently, each of the statements was voted on within the developer group, including the statements that achieved > 80%. Results: All statements scored > 80%. PID has greater extension, severity, and evolution towards stenosis, perianal disease, extraintestinal manifestations, and growth retardation compared to adult patients, so its management should be performed by multidisciplinary groups led by pediatric gastroenterologists and prepare them for a transition to adulthood. Porto's criteria allow a practical classification of PID. In CPE, we should use the Paris classification and perform ileocolonoscopy and esophagogastroduodenoscopy, since 50% have upper involvement, using the SES-CD (UCEIS/Mayo in CUP) and taking multiple biopsies. Initial labs should include inflammatory markers and fecal calprotectin and rule out intestinal infections. Treatment, induction, and maintenance of PID should be individualized and decided according to risk stratification. Follow-up should use PCDAI and PUCAI for the last 48 hours. Immunologists and geneticists should evaluate patients with early and infantile PID. Conclusion: A consensus guideline is provided with evidence-based recommendations on timely and safe diagnosis and treatments in patients with ILD.

Hematuria macroscópica como signo inicial del cáncer primario de uretra. Reporte de caso / Macroscopic hematuria as an initial sign of primary urethral cancer. Case report

Fundamento: El cáncer primario de uretra se define como el tumor cuya primera lesión se localiza en la uretra; es infrecuente, el mismo representa menos del 1 % de los tumores malignos y el 5 % de los tumores malignos del sistema urinario. La extensión de este proceso a la glándula prostática genera sintomatología urinaria obstructiva e irritativa y cuadros agudos como la hematuria macroscópica. Objetivo: Presentar el caso de un paciente con cáncer primario de uretra en su variedad urotelial con hematuria macroscópica como forma clínica de presentación. Presentación del caso: Caso clínico de un paciente masculino de 75 años de edad, con hematuria macroscópica como forma clínica de presentación de cáncer primario de uretra en su variedad urotelial, el cual se diagnosticó anatomopatológicamente durante el estudio de la hematuria. Conclusiones: El caso que se presenta permite alertar a la comunidad científica que en pacientes que presentan hematuria macroscópica, sin manifestaciones urológicas obstructivas ni irritativas, también debe tenerse en cuenta el diagnóstico de cáncer uretral primario, aunque sea un signo infrecuente como forma clínica de presentación de esa enfermedad.

Background: Primary urethral cancer is defined as a tumor whose first lesion is located in the urethra; is very uncommon, represents less than 1% of malignant tumors and 5% of malignant tumors of the urinary system. The extension of this process to the prostate gland creates obstructive and irritative urinary symptoms and acute conditions such as macroscopic hematuria. Objective: To present the case of a patient with primary urethral carcinoma in its urothelial variety with macroscopic hematuria as clinical presentation. Case presentation: Clinical case of a 75-year-old male patient, with macroscopic hematuria as a clinical presentation of primary cancer of the urethra in its urothelial variety, diagnosed anatomopathologically during the hematuria study. Conclusions: The case presented alerts the scientific community that the diagnosis of primary urethral cancer should be considered in patients with macroscopic hematuria in the absence of obstructive or irritative urologic manifestations, although it is a rare sign as clinical presentation of this disease.

Características de los pacientes pediátricos hospitalizados con COVID-19 durante la tercera ola (variante ómicron) en un hospital de referencia del Perú / Characteristics of pediatric patients hospitalized with COVID-19 during the third wave (omicron variant) at a referral hospital in Peru

RESUMEN El objetivo del presente estudio fue describir las características de los pacientes pediátricos (entre 28 días y 14 años) hospitalizados con COVID-19 durante la tercera ola (variante ómicron) en el Hospital Nacional Edgardo Rebagliati Martins (HNERM) (Lima, Perú). En esta cohorte retrospectiva, se revisaron las historias clínicas de 122 pacientes pediátricos que fueron atendidos en el HNERM entre enero e inicios de abril del 2022 (55% varones, mediana de edad de 5 años), 77,9% durante el primer mes, y la mitad presentaron alguna comorbilidad. Se hospitalizaron principalmente por dificultad respiratoria, comorbilidad descompensada y deshidratación. El 6,6% ingresaron a cuidados intensivos, 4,9% a ventilación mecánica invasiva, 5,7% requirieron algún vasoactivo y 1,6% fallecieron. Los fármacos más usados fueron antibióticos (43,4%) y corticoides (27,1%). En conclusión, se encontró un incremento rápido de hospitalizaciones en comparación con las olas anteriores, la mayoría con evolución favorable, y con un amplio uso empírico de antibióticos.

ABSTRACT This study aimed to describe the characteristics of pediatric patients (28 days to 14 years of age) hospitalized with COVID-19 during the third wave of the pandemic (omicron variant) at the Hospital Nacional Edgardo Rebagliati Martins (HNERM) (Lima, Peru). In this retrospective cohort, we reviewed the medical records of 122 pediatric patients who attended HNERM between January and early April 2022 (55% male, median age: 5 years); 77.9% attended HNERM during the first month, and half of them had some comorbidity. Participants were hospitalized mainly for respiratory distress, decompensated comorbidity, and dehydration. Of the participants, 6.6% were admitted to intensive care, 4.9% to invasive mechanical ventilation, 5.7% required some vasoactive agent and 1.6% died. The most commonly used drugs were antibiotics (43.4%) and corticosteroids (27.1%). In conclusion, hospitalizations rapidly increased during the third wave, when compared to previous waves, most of them with favorable progression and with a wide empirical use of antibiotics.

Abordaje de la enfermedad de Behçet vulvar: comunicación de caso

La enfermedad de Behçet (EB) es un trastorno inflamatorio, multisistémico, recidivante y remitente de etiología desconocida. Una característica clave de la enfermedad es la ulceración orogenital que provoca una morbilidad considerable con gran impacto en la calidad de vida de los pacientes. Su manejo médico consiste en un esquema con colchicina, esteroides o inmunomoduladores. Comunicamos el caso de una paciente con lesiones genitales quien consultó en múltiples ocasiones, recibiendo manejo antibiótico e incluso quirúrgico, con respuesta refractaria a estas intervenciones. Posteriormente, por las características de las lesiones y el comportamiento clínico se sospechó enfermedad de Behçet y se instauró manejo médico con esteroides orales y curaciones con fitoestimulina. Hubo resolución de las úlceras genitales y posteriormente la paciente fue llevada a cirugía para corrección de las sinequias vulvares.

Behçet's disease (BD) is an inflammatory, multisystemic, relapsing-remitting disorder of unknown etiology. A key feature of the disease is orogenital ulceration that causes considerable morbidity with great impact on patient's quality of life. Its medical management consists of a scheme with colchicine, steroids or immunomodulators. We report the case of a patient with genital lesions who consulted on multiple occasions, receiving antibiotics and even surgical management, with refractory response to these interventions. Subsequently, due to the characteristics of the lesion and clinical behavior, Behçet's disease was suspected and medical management with oral steroids and cures with phytostimulin was initiated. The genital ulcers were resolved, and the patient was subsequently taken to surgery for correction of the vulvar synechiae.

Depression, suicide ideation, and irrational beliefs: Explanatory models in psychology students / Depresión, ideación suicida y creencias irracionales: modelos explicativos en estudiantes de psicología

Abstract Introduction In rational emotive behavioral therapy, irrational beliefs are significant in mental health since their presence leads to conditions such as depression and suicidal ideation. Since these conditions have been increasing worldwide, it is essential to explore the factors that contribute to their understanding. Objective To design explanatory models for depression and suicidal ideation based on irrational beliefs in psychology students. Method Quantitative, non-experimental, cross-sectional study with multivariate analysis. Results Two explanatory models were designed: one for depression and the other for suicidal ideation. Thirty-nine per cent of depressive symptomatology can be explained by the presence of irrational beliefs concerning perfectionism, avoidance of responsibilities, concern over the future, and the determinism of the past. At the same time, 54% of suicidal ideation can be explained by the presence of beliefs centering on perfectionism, avoidance of responsibilities, external locus of control, and the determinism of the past. Discussion and conclusion Depression and suicidal ideation in psychology students can partly be explained by irrational beliefs concerning perfectionism, external locus of control, concern over the future, avoidance of responsibilities, and the determinism of the past. Clinical care approaches can modify these beliefs to reduce symptoms and promote mental health.

Resumen Introducción Para la terapia racional emotiva conductual las creencias irracionales tienen un gran peso en la salud mental, ya que la presencia de estas genera padecimientos como depresión e ideación suicida. Se sabe que en el mundo estos padecimientos han ido en aumento, por ello, es importante explorar factores que faciliten su explicación. Objetivo Generar modelos explicativos para la depresión y la ideación suicida desde las creencias irracionales en estudiantes de psicología. Método Estudio cuantitativo, no experimental, transversal con análisis multivariado. Resultados Se realizaron modelos explicativos; uno para la depresión y otro para ideación suicida. La sintomatología depresiva se explica en 39% con la presencia de creencias irracionales de perfeccionismo, evitación de responsabilidades, preocupación por el futuro y determinismo del pasado. Por otro lado, la ideación suicida se explica en 54% con la presencia de las creencias de perfeccionismo, evitación de responsabilidades, locus de control externo y determinismo del pasado. Discusión y conclusión La depresión e ideación suicida en estudiantes de psicología se puede explicar en parte por creencias irracionales de perfeccionismo, locus de control externo, preocupación por el futuro, evitación de responsabilidades y determinismo del pasado. A través de enfoques de atención clínica es factible modificar dichas creencias con el objetivo de disminuir sintomatología y promover la salud mental.

Mastócitos e síndrome de ativação mastocitária: o que há de novo? / Mast cells and mast cell activation syndrome: what's new?

Os mastócitos são as principais células efetoras da resposta alérgica aguda, desempenhando também um papel importante na angiogênese, tolerância imunológica, regulação da fibrinólise, regeneração neuronal e osteoclastogênese. Localizam-se maioritariamente na pele e nas mucosas do intestino e pulmões, onde exercem uma função "sentinela". As síndromes de ativação mastocitária são caracterizadas pela ocorrência de episódios recorrentes de manifestações clínicas resultantes da libertação de mediadores mastocitários. Esta constitui-se como entidade complexa com um espectro de sintomas associados, representando um desafio diagnóstico e terapêutico. Nesta revisão, os autores pretendem apresentar uma visão geral sobre a estrutura e função dos mastócitos e sobre os critérios diagnósticos e abordagem terapêutica da síndrome de ativação mastocitária.

Mast cells are the main effector cells of acute allergic response, also playing an important role in angiogenesis, immune tolerance, regulation of fibrinolysis, neuronal regeneration, and osteoclastogenesis. They are generally located in the skin and mucous membranes of the intestines and lungs, where they perform a "sentinel" function. Mast cell activation syndrome is characterized by recurrent clinical manifestations resulting from the release of mast cell mediators. This complex entity, which involves a spectrum of associated symptoms, is a diagnostic and therapeutic challenge. In this article we overview of the structure and function of mast cells, in addition to the diagnostic criteria and therapeutic approaches to mast cell activation syndrome.

Influencia del pie como receptor en la postura corporal, la simetría facial y cráneo-mandibular / The influence of foot as a receptor on body posture and on facial, mandibular and cranial symmetries

Introducción: Un apoyo plantar incorrecto puede considerarse un factor etiológico de asimetrías faciales y cráneo-mandibulares pues modifica, de forma instantánea, la relación entre el maxilar y la mandíbula. Por tanto, resulta vital identificar la etiología de estas asimetrías para establecer diagnósticos y tratamientos certeros. Objetivo: Determinar la influencia del apoyo plantar en la postura corporal, la simetría facial y cráneo-mandibular en adolescentes. Métodos: Se realizó un estudio descriptivo y transversal de enero a septiembre de 2019 con 180 adolescentes que asistieron al servicio de Ortodoncia de la Clínica Docente de Especialidades «Victoria de Santa Clara», los cuales cumplían con criterios de selección de la investigación. Se analizaron variables faciales, posturales y cefalométricas. Se determinó: la simetría facial mediante el análisis de líneas faciales, el apoyo plantar al calcular el índice cavitario, la postura corporal, según la prueba de Di Rocca, y la simetría mandibular con el método modificado de Kurt y Uysal. Se siguieron las normas éticas y fueron aplicadas la prueba de Fisher, la de McNemar, y la técnica de conglomerado. Resultados: Predominaron los adolescentes con apoyo plantar asimétrico y los pies varo. Del total de casos con asimetría facial, 72,53 % presentó apoyo plantar asimétrico, y 39,44 % planos biilíaco y biclavicular desequilibrados y divergentes. La asimetría mandibular se observó en el 56,11%, la mayoría con apoyo plantar asimétrico. Conclusiones: Se pudo constatar la influencia del apoyo plantar en la postura corporal, la simetría facial y cráneo-mandibular, pues se observó un alto grado de relación entre las variables estudiadas.

Introduction: an incorrect plantar support can be considered an etiological factor of facial, mandibular and cranial asymmetries since it instantly modifies the relationship between the maxilla and mandible. Therefore, it is vital to identify the etiology of these asymmetries to establish accurate diagnoses and treatments. Objective: to determine the influence of plantar support on body posture and on facial, mandibular and cranial symmetries in adolescents. Methods: a descriptive and cross-sectional study was carried out from January to September 2019 with 180 adolescents who were seen in the Orthodontics service at "Victoria de Santa Clara" Specialty Teaching Dental Clinic, who met the research selection criteria. Facial, postural and cephalometric variables were analyzed. Facial symmetry was determined through the analysis of facial lines, plantar support by means of cavity index, body posture according to the Di Rocca test, and mandibular symmetry with the modified method of Kurt and Uysal. Ethical standards were followed and Fisher's and McNemar's tests as well as clustering technique were applied. Results: adolescents with asymmetric plantar support and varus feet predominated. The 72.53% had asymmetric plantar support from the total cases with facial asymmetry, and 39.44% had unbalanced and divergent biiliac and biclavicular planes. Mandibular asymmetry was observed in 56.11%, mostly with asymmetric plantar support. Conclusions: the influence of plantar support on body posture and on facial, mandibular and cranial symmetries was posible to verify since a high degree of relationship was observed among the variables studied.

Hearing Thresholds at High Frequencies: Age as a Predictor of Values

Abstract Introduction The audiological evaluation has the main objective of determining the integrity of the auditory system. Pure tone audiometry is a standardized behavioral procedure that aims to investigate auditory thresholds to describe auditory sensitivity. Despite being recognized since the mid-1960s, high frequency audiometry is still little used and explored in clinical practice, and its use is more considered as an audiological monitoring tool or as a research tool. Objective To analyze the audiological thresholds of high frequency audiometry in normal hearing individuals, and to verify the predictive capacity of age in the auditory thresholds of high frequency audiometry. Methods This is a retrospective, cross-sectional, and quantitative study that was approved by the Research Ethics Committee under number 5.039.583/21. The procedures were: clinical evaluation, pure tone audiometry, acoustic immittance measurements, and high frequency audiometry. All data collected from the exams were tabulated in an Excel spreadsheet and analyzed using appropriate statistical tests in the Statistical Package Social Sciences software. Results A total of 980 medical records were analyzed. The right and left ears presented similar tonal hearing thresholds for the frequencies of 12 kHz and 16 kHz. The threshold variance of 29.8% in the 12 kHz frequency can be explained by the variance of age, while, for the frequency of 16 kHz, this percentage is of 46.4%. Conclusion For 12 kHz hearing thresholds, an increase of 1 year leads to a 0.66 dBHL increase in hearing threshold. For 16 kHz hearing thresholds, an increase of 1 year leads to a 1.02 dBHL increase in hearing threshold.

Idades de referência dos atletas medalhados nos campeonatos de portugal de atletismo: estudo de 30 anos (1990-2019) / Reference ages of medallists at the portuguese athletics championships: a 30-year study (1990-2019)

RESUMO Segundo a literatura, um inventário preciso da distribuição das idades de melhor desempenho nas diferentes disciplinas do atletismo pode proporcionar uma informação ímpar na altura de se produzirem planos e programas de treino de longo prazo para eventos ao mais alto nível. O presente estudo tem como objetivo identificar a idade de melhor desempenho dos atletas participantes nos campeonatos de Portugal de atletismo, com referência às disciplinas e setores que caracterizam a competição. Foram consideradas todas as participações medalhadas (pista coberta - PC, n = 2310; ar livre - AL, n = 3161). Os intervalos de confiança para a idade média dos atletas medalhados foram obtidos com recurso ao método de Equações de Estimação Generalizadas. Os resultados indicaram a média de idades, (i) PC, mais baixa no salto com vara feminino (21.60 anos) e no salto em comprimento masculino (24.42 anos), e mais elevada nos 3000 m marcha feminino (25.18 anos) e nos 5000 m marcha masculino (29.70 anos); (ii) AL, mais baixa no salto em comprimento feminino (22.90 anos) e nos 200 m masculino (23.46 anos), e mais elevada nos 5000 m feminino (27.55 anos) e 10000 m marcha masculino (32.23 anos). Os resultados sugerem que as idades de melhor desempenho ocorrem (i) PC, entre os 23 e os 24 anos nas atletas femininas, e os 24 e os 25 nos atletas masculinos; (ii) AL, entre os 23 e os 25 anos nas atletas femininas, e os 24 e 26 anos nos atletas masculinos. O conhecimento objetivo das idades de melhor desempenho nos campeonatos de Portugal de atletismo, por sexo e disciplina, poderá ser uma informação útil para uma gestão eficiente de talentos e das carreiras desportivas.

ABSTRACT According to the literature, a precise inventory of the distribution of the best-performing ages in the different athletics disciplines can provide unique information when producing long-term training plans and programs for events at the highest level. This study aims to identify the age at which athletes participating in the Portuguese athletics championships performed best, with reference to the disciplines and sectors that characterize the competition. All medal-winning participations were considered (indoor track and field, n = 2310; outdoor track and field, n = 3161). Confidence intervals for the average age of medal-winning athletes were obtained using the Generalized Estimating Equations method. The results indicated that the average ages were (i) Indoor track and field - lower in the women's pole vault (21.60 years) and men's long jump (24.42 years), and higher in the women's 3000 m run (25.18 years) and men's 5000 m race walk (29.70 years); (ii) Outdoor track and field - lower in the women's long jump (22.90 years) and men's 200m (23.46 years), and higher in the women's 5000 m (27.55 years) and men's 10000 m race walk (32.23 years). The results suggest that the best-performing ages are (i) Indoor track and field - between 23 and 24 years old in female athletes and 24 and 25 years old in male athletes; (ii) Outdoor track and field - between 23 and 25 years old in female athletes, and 24 and 26 years old in male athletes. Objective knowledge of the best-performing ages in the Portuguese athletics championships by gender and discipline could be useful information for efficient talent and career management.

Características clínico-epidemiológicas de COVID-19 en pacientes de la comunidad y del Hospital Regional Lambayeque, Perú

Introducción: Desde el inicio del brote de COVID-19 se han descrito diferencias entre las características clínicas, la evolución y el pronóstico de los pacientes de distintas localidades del Perú y del mundo. Objetivo: Determinar las características clínicas y epidemiológicas de la COVID-19 en pacientes de la comunidad y del Hospital Regional Lambayeque. Métodos: Se realizó un estudio de enfoque cuantitativo, nivel relacional y diseño observacional con datos secundarios. Se empleó la técnica de la documentación, se verificaron los datos recolectados en la ficha estandarizada de investigación clínica epidemiológica de COVID-19 del Ministerio de Salud del Perú. Resultados: De 4 463 pacientes analizados en el 36,4 % se detectó la presencia de SARS-CoV-2 y de éstos la mediana de edad fue de 40 años, siendo el sexo femenino el más frecuente (53,4 %). Del total de participantes, 23,7 % no registraron síntomas, sin embargo, los pacientes que declararon tos, dolor de garganta, malestar, fiebre/escalofrío, disnea, anosmia, ageusia y exudado faríngeo tenían más probabilidades de resultar infectados. De los positivos a la COVID-19, 40,2 % presentaban alguna comorbilidad. Las ocupaciones de policía/militar, ama de casa, estudiante y obrero de construcción civil tenían más probabilidades de dar positivo, mientras que, el personal sanitario tuvo 33 % menos probabilidad de infección. Conclusiones: Casi cuatro de cada 10 participantes tuvieron infección por SARS-CoV-2, existió predominio en los varones y personas en edad económicamente activa. La cuarta parte fueron asintomáticos. La tos, dolor de garganta, malestar y fiebre fueron los síntomas más frecuentes; menos frecuentes fueron la dificultad respiratoria, la anosmia, ageusia y exudado faríngeo, pero representaron mayor probabilidad de infección. Casi dos de cada 10 pacientes presentaron comorbilidad como problemas cardiovasculares, diabetes, asma y obesidad. En cuanto a las ocupaciones, el personal sanitario, policial y ama de casa fueron los grupos más afectados.

Introduction: Since the beginning of the outbreak, differences have been described between the clinical characteristics, evolution and prognosis of patients from different locations in Peru and the world. Objective: To determine the clinical and epidemiological characteristics of COVID-19 in patients from the community and the Lambayeque Regional Hospital. Methods: A study of quantitative approach, relational level and observational design with secondary data was carried out. The documentation technique was used, the data collected in the standardized COVID-19 clinical epidemiological investigation form of the Ministry of Health of Peru was verified. Results: Of 4,463 patients analyzed, 36.4 % had the presence of SARS-CoV-2, and of these the average age was 40 years, with the female sex being the most frequent (53.4 %). Of the total participants, 23.7 % had no symptoms, however, patients who reported cough, sore throat, malaise, fever/chills, dyspnea, anosmia, ageusia, and pharyngeal exudate were more likely to be infected with SARS- CoV-2. Of the positive patients for COVID-19, 40.2 % had some comorbidity. Likewise, the occupations of police/military, housewife, student and civil construction worker were more likely to test positive for COVID-19, while health personnel had a 33 % lower probability of SARS-CoV-2 infection. Conclusions: It is concluded that almost four out of 10 participants had SARS-CoV-2 infection, of which there was a predominance in men and people of economically active age. A quarter were asymptomatic. Cough, sore throat, malaise, and fever were the most frequent symptoms; likewise, respiratory distress, anosmia, ageusia, and pharyngeal exudate were less frequent, but represented a higher probability of infection. Almost two out of 10 patients had comorbidities such as cardiovascular problems, diabetes, asthma, and obesity. Regarding occupations, health personnel, police and housewives were the most affected groups.

Implementation and methodology of a pilot, localized video library of cataract surgeries for residency training in a tertiary Philippine Eye Institute

Objectives@#Video-based learning of surgical skills is a useful complement in training programs. This is more evident where direct patient exposure is limited due to multiple factors. In ophthalmic surgery, access to high quality ocular surgery videos such as for cataract operations, can provide significant learning points for trainees in an institutional program. Creation therefore of a local, curated, and indexed library of cataract surgery would support alternative means to maximize training of new ophthalmic surgeons. The objective of the project was to develop a local library of cataract surgery videos as an adjunct teaching tool for resident trainees in a Philippine tertiary eye care center. @*Methods@#A collection of cataract surgery videos from 2013-2020 were compiled into a single workstation. Videos were reviewed and catalogued using set keywords for easy searchability and labelling. @*Results@#256 videos of cataract surgeries were compiled into the library. 6 main headings for the keywords, with 159 total subheadings were established to provide robust tagging and search options to index the video.@*Conclusion@#Particularly in Ophthalmic surgery, refinement of surgical technique is essential in ensuring better postoperative visual outcomes. This is achieved through repetition and careful dissection of operative technique. The use of a library with multiple videos of a similar procedure allows trainees more exposure to certain cases. This ultimately affords trainees, better experience and confidence in their own surgeries.

Contenidos de carbono y nitrógeno del suelo en un agroecosistema altoandino del Valle del Cauca, Colombia

Los ecosistemas altoandinos o de alta-montaña, se caracterizan por prestar servicios ecosistémicos esenciales, muchos de ellos, relacionados con el suelo; sin embargo, se conoce que las actividades agrícolas y pecuarias han llevado a cambios progresivos en los parámetros físicos, químicos y agotamiento del carbono orgánico y nitrógeno del suelo, contribuyendo a la pérdida de calidad edáfica e incrementando las emisiones de gases de efecto invernadero. Este estudio evaluó la influencia de tres coberturas vegetales: bosque nativo, pastizal naturalizado de Pennisetum clandestinum y monocultivo de Allium fistulosum, sobre algunas propiedades del suelo, en un ecosistema altoandino del Valle del Cauca (Colombia). Se midieron propiedades edáficas, como densidad aparente, materia orgánica, contenidos y almacenamiento de C y N. Se encontró que las prácticas agrícolas asociadas al monocultivo influyeron significativamente en las propiedades edáficas evaluadas, generando cambios a nivel físico y químico, lo que podría aumentar la vulnerabilidad del suelo a la degradación. Se observó que los pastizales de P. clandestinus (C4), con un manejo del pastoreo de tipo extensivo, baja carga animal, presentaron mayor potencial para acumular C, reciclar N y mitigar el efecto del pisoteo, siempre y cuando, se garantice una gestión óptima del pastoreo, en términos de una carga animal, ambientalmente sostenible. El tipo de cobertura vegetal y las prácticas de manejo asociadas promovieron cambios físicos y químicos, en los primeros centímetros del suelo, afectando la capacidad del suelo para almacenar C y N, lo que podría incidir en la provisión de Servicios Ecosistémicos.

High Andean or high-mountain ecosystems are characterized by providing essential ecosystem services, many of them related to the soil. However, it is known that agricultural and livestock activities have led to progressive changes in the physical and chemical parameters of the soil and depletion of organic carbon and nitrogen, contributing to the loss of edaphic quality and increasing greenhouse gas emissions. This study evaluated the influence of three kinds of plant covers: native forest, Pennisetum clandestinum naturalized grassland, and Allium fistulosum monoculture, on some soil properties in a high Andean ecosystem of Valle del Cauca (Colombia). The edaphic properties measured were: bulk density, soil organic matter, C and N contents, and storage. It was found that the agricultural practices associated with monoculture significantly influenced the evaluated edaphic properties, generating changes at a physical and chemical level, which could increase the vulnerability of the soil to degradation. It was observed that the grasslands of P. clandestinus (C4), with extensive grazing management, and a low stocking rate, presented the greater potential to accumulate C, recycle N and mitigate the trampling effect, as long as optimal management is guaranteed in terms of environmentally sustainable stocking load. The kind of vegetation cover and the associated management practices, promoted physical and chemical changes, in the first centimeters of the soil, affecting the soil's capacity to store C and N, which could affect the provision of Ecosystem Services.

Rendimiento diagnóstico de la prueba rápida para la detección del antígeno NS1 y anticuerpos IgM e IgG contra el virus del dengue / Diagnostic performance of the rapid test for the detection of NS1 antigen and IgM and IgG anti-antibodies against dengue virus

Objetivos. Determinar el rendimiento diagnóstico de la prueba rápida SD dengue DUO (Inyecta) para la detección de NS1, IgM e IgG en comparación con la prueba de ELISA. Materiales y métodos. Es una evaluación de prueba diagnóstica que incluyó 286 muestras de suero de pacientes con sintomatología atribuible a dengue de zonas endémicas del Perú. Las muestras se analizaron por ELISA y la prueba rápida SD dengue DUO (Inyecta) para IgM, NS1 e IgG en el Instituto de Investigación Nutricional en Lima. Resultados. La sensibilidad de la prueba rápida fue de 68% para NS1 e IgM, y 86% para IgG, mejorando este parámetro a 75% y 81% para NS1 e IgM, respectivamente, en los tres primeros días. La especificidad para los tres analitos fue mayor a 87%. La concordancia de los resultados obtenidos medidos por el coeficiente Kappa para los tres analitos fue buena y no se encontró reacción cruzada con otros arbovirus. Conclusiones. La prueba rápida SD Dengue DUO permite detectar con una adecuada sensibilidad y especificidad NS1, IgM e IgG. La sensibilidad para IgM y NS1 aumenta cuando se detecta en los tres primeros días de síntomas, por lo que se recomienda su implementación en los centros de primer nivel de atención para un diagnóstico temprano y oportuno.

Objectives . To assess the diagnostic performance of the SD dengue DUO rapid test (Inyecta) for the detection of NS1, IgM and IgG in comparison to the ELISA test. Materials and methods . This is a diagnostic test evaluation that included 286 serum samples from patients with symptomatology attributable to dengue from endemic areas of Peru. The samples were analyzed by ELISA and the SD dengue DUO rapid test (Inyecta) for IgM, NS1 and IgG at the Instituto de Investigación Nutricional in Lima. Results . The sensitivity of the rapid test was 68.0% for NS1 and IgM, and 86.0% for IgG, improving to 75.0% and 81.0% for NS1 and IgM, respectively, during the first three days. The specificity for all three analytes was greater than 87.0%. The concordance of the results, measured by the Kappa coefficient for the three analytes, was good and no cross-reaction with other arboviruses was found. Conclusions . The SD dengue DUO rapid test allows detection of NS1, IgM and IgG with adequate sensitivity and specificity. Sensitivity for IgM and NS1 increases when detected during the first three days of symptoms. Therefore, we recommend its implementation in primary care centers for early and timely diagnosis.

Rendimiento académico en estudiantes de enfermería de una universidad pública / Academic performance in nursing students from a public university

Introducción: la globalización ha impactado el ámbito educativo, por lo que las instituciones de educación superior tienen la responsabilidad de generar en los alumnos destrezas, habilidades y conocimientos que faciliten el proceso de aprendizaje para mejorar y mantener un rendimiento académico eficiente. Objetivo: describir el rendimiento académico desde la perspectiva de los estudiantes de noveno semestre de la Licenciatura en Enfermería de una institución pública del estado de Oaxaca, México. Metodología: el diseño del estudio fue descriptivo transversal. La muestra fue de 159 estudiantes, con un nivel de confianza de 95% y un margen de error del 5%. El muestreo fue probabilístico aleatorio simple. Para la medición del rendimiento académico se aplicó la Escala MEDMAR. La ética del estudio consideró la declaración de Helsinki. El análisis de los datos se procesó a través del programa SPSS, versión 22, y Microsoft Excel Office 10. Para el análisis de los datos se utilizó la estadística descriptiva. La confiabilidad del instrumento reportó un alfa de Cronbach de 0.9. Resultados: los estudiantes percibieron el rendimiento académico como bueno (12.6%) y muy bueno (87.4%). En las variables contextuales se observó en un 74.4% como muy bueno. Para las variables propias del estudiante se percibió un 85.5% en calidad de muy bueno. Conclusión: las evidencias encontradas apuntan a que los estudiantes perciben el rendimiento académico de manera positiva.

Introduction: Globalization has had an impact on the educational field, which is why higher education institutions have the responsibility of generating skills, abilities and knowledge in students that facilitate the learning process to improve and maintain an efficient academic performance. Objective: To describe the academic performance from the perspective of the students of the ninth semester of the Bachelor of Science in Nursing of a public institution of the state of Oaxaca. Methodology: The study design was descriptive, cross-sectional. The sample consisted of 159 students, with a confidence level of 95% and a margin of error of 5%. The sampling was simple random. To measure academic performance, the MEDMAR Scale was applied. The ethics of the study considered the Declaration of Helsinki. The data analysis was processed through the Statistical Package for Social Sciences, version 22, and Microsoft Excel Office 10. Descriptive statistics were used for data analysis. The reliability of the instrument reported a Cronbach's alpha of 0.9 Results: Students perceived the academic performance as good (12.6%) and very good (87.4%). In contextual variables, it was observed in 74.4% as very good. For the student's own variables, 85.5% were perceived as very good. Conclusion: The evidence found indicates that students perceive academic performance in a positive way.

Integrative Dimensional Personality Inventory for ICD-11: Development and Evaluation in the Peruvian Correctional Setting / Inventario Integrativo de la Personalidad Dimensional para la CIE-11: desarrollo y evaluación en el sistema penitenciario peruano

Abstract Background: Personality disorder (PD) is an important predictor of the commission of crimes; however, there is a lack of clinical instruments adjusted to the characteristics of Peruvian convicts. Objective: To develop a reliable and valid comprehensive personality measurement instrument, the Integrative Dimensional Personality Inventory, ICD-11 version (IDPI-11), according to the standards of the International Classification of Diseases (ICD-11). Method: A stratified simple of prisoners from the Huancayo Penitentiary (HP) was selected (n study 1 = 60; n study 2 = 1095). Results: High reliability indices(McDonald's _ _ .73) and adequate levels of content validity(CVI-S ≥ .87), construct validity, and criterion validity of the scales were found. This could explain the probability (a) of belonging to the group of inmates with instrumental or impulsive crimes (R2 N ≥ .52, OR ≥ 1.02, p ≤ .021), and (b) that recidivism, designated by the prison security level imposed, increases (R2≥ .53, β ≥ 1.16, p ≤ .008). Conclusions: The instrument is a valid and reliable measure that allows a dimensional and integrative assessment of the personality of convicts of the HP, according to ICD-11 standards

Resumen Antecedentes: el trastorno de la personalidad (TP) es un predictor importante en la comisión de delitos; sin embargo, existe una ausencia de instrumentos clínicos para las características del convicto peruano. Objetivo: desarrollar un instrumento de medición integral de la personalidad confiable y válido, el Inventario Integrativo de Personalidad Dimensional versión CIE-11 (IDPI-11), según los estándares de la Clasificación Internacional de Enfermedades (CIE-11). Método: se utilizó una muestra estratificada de reclusos del Establecimiento Penitenciario de Huancayo (EPH) (n estudio 1 = 60; n estudio 2 = 1095). Resultados: se encontraron altos índices de confiabilidad (ω de McDonald ≥ .73) y niveles adecuados de validez de contenido (CVI-S ≥ .87), constructo y criterio de sus escalas, pudiendo explicar la probabilidad de: (a) pertenecer al grupo de internos con delitos instrumentales o impulsivos (R2≥ .52, OR ≥ 1.02, p ≤ .021);y(b) que la tendencia a reincidir, designada por el grado de seguridad penitenciaria impuesto, aumente (R2 ≥ .53, β ≥ 1,16, p ≤ .008). Conclusiones: el instrumento construido es una medida válida y confiable que permite una evaluación dimensional e integrada de la personalidad del convicto de la EP de Huancayo, de acuerdo con los estándares de la CIE-11.

Caracterización inmunogenética de donantes cadavéricos cubanos en el año 2019 / Immunogenetic characterization of Cuban cadaveric donors in 2019

Introducción: El trasplante es la opción terapéutica más favorable para las personas con insuficiencia renal crónica. El donante puede ser cadavérico o donante vivo, emparentado o no. Los resultados del trasplante están en relación con varios factores inmunológicos y no inmunológicos. Objetivo: Caracterizar inmunogenéticamente a los donantes cadavéricos cubanos para trasplante renal. Métodos: Se realizó un estudio transversal y descriptivo de los donantes cadavéricos durante el año 2019. Se analizó la región de procedencia, sexo, color de la piel y rangos de edades de los donantes, así como, grupo sanguíneos ABO y Rhesus Rh; serología para VIH, Virus de hepatitis B(VHB) y Virus de hepatitis C (VHC); y hábitos tóxicos. Resultados: Se estudió un total de 95 donantes cadavéricos, 62 provenientes del occidente y 33 del centro del país. El 63,2 por ciento fueron masculinos y 36,8 por ciento femenino. El grupo de edad de mayor frecuencia fue 40 - 60 años y la edad media de 49,45 años. El 58,95 por ciento de los pacientes fueron de grupo sanguíneo O; 30,53 por ciento grupo A y los grupos B y AB tuvieron 5,26 por ciento de prevalencia; y solo 8 fueron Rh negativos. Todos tuvieron serología para VIH, VHB y VHC negativas. Las enfermedades asociadas más frecuentes fueron la hipertensión arterial y la diabetes mellitus. Conclusiones: Los donantes cadavéricos durante el año 2019 mostraron características similares a las reportadas por otros estudios. El aumento de las edades de los donantes incide en la aparición de enfermedades asociadas y esto pudiera repercutir en el resultado del trasplante(AU)

Introduction: Transplantation is the most favorable therapeutic option for people with chronic renal failure. The donor can be a cadaveric or living donor, related or not. Transplant outcomes are related to various immunological and non-immunological factors. Objective: To characterize Cuban cadaveric donors for renal transplantation Materials and methods: A cross-sectional and descriptive study of cadaveric donors was carried out during the year 2019. The region of origin, sex, skin color and age ranges of the donors were analyzed, as well as ABO and Rhesus Rh blood groups; serology for HIV, Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV), and toxic habits. Results: A total of 95 cadaveric donors were studied, 62 from the West and 33 from the Center of the country. 63.2 percent were male and 36.8 percent female due to the most frequent age group being 40-60 years and the mean age of 49.45 years. 58.95 percent of the patients were of blood group O, 30.53 percent group A and groups B and AB had 5.26 percent prevalence; and only 8 were Rh negative. All had negative serology for HIV, HBV and HCV. The most frequent associated diseases were arterial hypertension and diabetes mellitus. Conclusions: The cadaveric donors during the year 2019 showed characteristics similar to those reported by other studies. The increase in the age of the donors affects the appearance of associated diseases and this could affect the result of the transplant(AU)

Tipo de familia e inteligencia emocional en enfermeros de un hospital público de Perú

Resumen: Introducción: La familia, la más añeja de las instituciones sociales humanas, marca al individuo en sus diferentes etapas de vida y se constituye en un ambiente propicio para el perfeccionamiento de su identidad. Objetivo: Determinar el tipo de familia e inteligencia emocional (IE) en los enfermeros de un hospital público de Perú en la atención de la pandemia. Método: El estudio es transversal con una muestra censal de 80 enfermeros que trabajaron en hospitalización de COVID-19 de un hospital público durante el mes de mayo de 2020 y que contaban con al menos 3 meses de antigüedad. Previo consentimiento informado, se les aplicó una encuesta con el instrumento escala Trait Meta-Mood Scale (TMMS-24) en su versión adaptada y validada al contexto peruano, su fiabilidad alcanzó un coeficiente de alfa de Cronbach mayor a 0,8. Resultados: El tipo de familia que predomina en los enfermeros es nuclear (56,3 %) y la IE es predominantemente baja (36,3%); se destaca el nivel bajo de la dimensión percepción emocional (43,8 %), mientras que las dimensiones de comprensión y regulación de emociones presentan un predominio de nivel excelente (36,3 %) y adecuada (41,3 %) respectivamente. Conclusiones: La IE debería considerarse al momento de diseñar políticas sanitarias de gestión del talento humano y a la hora de la capacitación en servicios de salud.

Resumo: Introdução: A família, a mais antiga das instituições sociais humanas, marca o indivíduo nas diferentes etapas da vida e constitui um ambiente propício para a melhoria de sua identidade. Objetivo: Determinar o tipo de inteligência familiar e emocional (EI) dos enfermeiros em um hospital público no Peru durante o tratamento de uma pandemia. Método: O estudo foi um estudo transversal com uma amostra de 80 enfermeiros que trabalharam na hospitalização da COVID-19 em um hospital público durante o mês de maio de 2020 e que tinham pelo menos 3 meses de antiguidade. Após o consentimento informado, foi realizada uma pesquisa utilizando o instrumento Trait Meta-Mood Scale (TMMS-24) em sua versão adaptada e validada para o contexto peruano, com uma confiabilidade de mais de 0,8 coeficiente alfa do Cronbach. Resultados: O tipo predominante de família entre os enfermeiros é nuclear (56,3 %) e EI é predominantemente baixo (36,3 %); destaca-se o baixo nível da dimensão da percepção emocional (43,8 %), enquanto as dimensões de compreensão e regulação das emoções mostram uma predominância de níveis excelentes (36,3 %) e adequados (41,3 %), respectivamente. Conclusões: A EI deve ser considerado na elaboração de políticas de saúde para a gestão de talentos humanos e no treinamento em serviços de saúde.

Abstract: Introduction: The family, the oldest of human social institutions, marks the individual in his or her different stages of life and constitutes an environment favorable for the improvement of his or her identity. Objective: To determine the type of family and emotional intelligence (EI) in nurses of a public hospital in Peru during pandemic care. Method: The study is a cross-sectional study with a census sample of 80 nurses who worked in COVID-19 hospitalization of a public hospital during the month of May 2020 and who had at least 3 months of seniority. After informed consent, a survey was administered with the Trait Meta-Mood Scale (TMMS-24) in its version adapted and validated to the Peruvian context. Its reliability reached a Cronbach's alpha coefficient greater than 0.8. Results: The predominant type of family among nurses is nuclear (56.3 %) and EI is predominantly low (36.3 %); the low level of the emotional perception dimension (43.8 %) stands out, while the dimensions of understanding and regulation of emotions present a predominance of excellent (36.3 %) and adequate (41.3 %) levels, respectively. Conclusions: EI should be considered when designing health policies for human talent management and when training in health services.