Antecedentes de la formación archivística en Costa Rica / Antecedents of the archivistic formation in Costa Rica

Resumen El artículo tiene como objetivo centrar su atención en el análisis, para darlo a conocer a la comunidad archivística costarricense, de los principales antecedentes que dieron origen a la formación archivística universitaria en Costa Rica; es decir, se investigó sobre la antesala de lo que 1978 dio origen al Diplomado en Archivo Administrativo en la entonces Escuela de Historia y Geografía de Facultad de Ciencias Sociales de Universidad de Costa Rica. Por lo tanto, el trabajo corresponde a una investigación histórica y exploratoria; en el primer caso porque se analiza e interpreta un proceso en perspectiva histórica y el segundo porque es un tema poco estudiado por la historiografía archivística costarricense. La metodología para la realización del trabajo fue el análisis documental, a partir de fuentes de información bibliográficas y documentos de archivos, que quedan reflejados en apartado de referencias bibliográficas. Así las cosas, el artículo presenta un recorrido por el origen de la Archivística en Costa Rica y los diferentes acontecimientos que antecedieron a la creación del Diplomado en Archivo Administrativo. Se concluye, entre otras cosas, que el Proyecto Piloto de la Unesco sentó las bases para el desarrollo archivístico costarricense, la modernización de los archivos y el origen de la formación archivística reglada en el país.

Abstract The article has the objective to center your attention in the analysis, to be known by the Costa Rican archivistic community, of the main antecedents that gave birth to the university archivistic formation in Costa Rica; meaning that an investigation was developed in the anteroom of 1978 with origin of the diploma in administrative archive in the old School of Geography and History of the Faculty of Social Science of the Costa Rican University. The work belongs to an historical and exploratory investigation, cause analyses one process in an historical perspective, and the second one, because it has been little studied by the Costa Rican archivistic historiography. The methodology applied for the work was the documentary analysis based on bibliographical information, and documents from archives that are reflected in the bibliographical references. The article shows a travel around the origins of the archive studies in Costa Rica, and the different events before the creation of the degree in Administrative Archive. To conclude this, the pilot project of the UNESCO, has created the bases for the archivistic development in Costa Rica, the modernization of the archives and the origins of the current archive formation rules in the country.

Corneal backscatter in insulin-dependent and non-insulin-dependent diabetes mellitus patients: a pilot study / Retroespalhamento luminoso das córneas de pacientes com diabete melito dependente e não dependente de insulina: estudo piloto

ABSTRACT Purpose: To compare central corneal backscatter obtained from Scheimpflug images between patients with insulin-dependent and non-insulin-dependent diabetes mellitus (IDDM and NIDDM, respectively) and healthy controls. Methods: Seven patients with IDDM (7 eyes), eleven patients with NIDDM (11 eyes), and sixteen healthy subjects (16 eyes) were included in this pilot study. Scheimpflug imaging system (Pentacam, Oculus Inc., Germany) was used to obtain optical sections of the cornea. Seven meridians were analyzed for each eye, oriented from 70° to 110°. Optical density values for the central 3-mm and 5-mm zones of the cornea were obtained by image analysis using external software. Results: Corneal backscatter was significantly higher in the diabetic patients than in the controls for the central 3-mm (p=0.016) and 5-mm (p=0.014) zones. No significant differences in corneal backscatter were found between the IDDM and NIDDM groups for either zone (both p>0.05). In the NIDDM group, significant correlations were observed for both central zones between corneal backscatter and age (3 mm: r=0.604, p=0.025; 5 mm: r=0.614, p=0.022) and central corneal thickness (3 mm: r=0.641, p=0.017; 5 mm: r=0.671, p=0.012); this was not found in the IDDM group (p>0.05). The presence of diabetes showed a significant effect on central corneal backscatter (Kruskal-Wallis test, p<0.001). Conclusions: Diabetic patients showed higher values of corneal light backscatter than healthy subjects. Corneal optical density analysis may be a useful tool for monitoring and assessing the ocular changes caused by diabetes.

RESUMO Objetivo: Determinar os valores de retroespalhamento luminoso central da córnea em pacientes diabéticos dependentes (IDDM) e não dependentes (NIDDM) de insulina, comparados com controles saudáveis, a partir de imagens de Scheimpflug. Métodos: Foram incluídos neste estudo piloto sete pacientes com IDDM (7 olhos), onze pacientes com NIDDM (11 olhos) e dezesseis indivíduos saudáveis (16 olhos). O sistema de Scheimpflug (Pentacam, Oculus Inc. Germany) foi utilizado para obter secções ópticas da córnea. Foram analisados sete meridianos para cada olho, orientados de 70º a 110º. A análise de imagem por meio de software externo permitiu a obtenção de valores da densidade óptica para os 3 e 5 mm centrais da córnea. Resultados: O retroespalhamento luminoso corneano foi significativamente maior em pacientes diabéticos para os 3 mm centrais (p=0,016) e para os 5 mm centrais (p=0,014) em relação ao grupo controle. Não foram encontradas diferenças significativas entre os grupos IDDM e NIDDM para cada zona analisada (p>0,05 em ambos os casos). No grupo NIDDM, observaram-se correlações significativas para as zonas centrais de 3 mm e 5 mm, entre retroespalhamento luminoso corneano e idade (r=0,604 p=0,025 e r=0,614 p=0,022, respectivamente) e espessura central corneana (r=0,641 p=0,017; r=0,671 p=0,012, respectivamente), o que não foi encontrado no grupo IDDM (p>0,05). O teste de Kruskall-Wallis indicou que a presença de diabete tem um efeito significativo sobre a retroespalhamento central da córnea (p<0,001). Conclusões: Pacientes diabéticos apresentaram valores mais elevados de retroespalhamento luminoso corneano do que indivíduos saudáveis. A análise da densidade óptica corneana pode ser uma ferramenta útil para monitorar e avaliar as alterações oculares causadas pela diabete.

Comunidades ampliadas de pesquisa e ação no Movimento Antimanicomial / Enlarged Communities of Research and Action in the Anti-Asylum Movement

O objetivo deste artigo é investigar a construção de um 'coletivo inteligente', capaz de ações diretas e auto-organização, usando a metodologia da Comunidade Ampliada de Pesquisa e Ação (CAPA), como projeto-piloto, dentro do Núcleo de Luta do Movimento Antimanicomial do Rio de Janeiro, entre agosto e outubro de 2008. Apresentamos o resultado de três reuniões seguindo esse padrão. Concluímos que o projeto-piloto foi bem sucedido, pois os objetivos propostos foram atingidos parcialmente, mas seriam necessárias mais reuniões para atingi-los plenamente. Os participantes foram capazes de uma ação direta no encaminhamento das reuniões devido a uma organização tácita entre eles: o 'coletivo inteligente' se mostrou possível.

The aim of this paper is to investigate the construction of an "intelligent collective", capable of direct action and self-organization, using the methodology of the Enlarged Community of Research and Action as a pilot project, within the Center for Fighting within the Anti-Asylum Movement of Rio de Janeiro, between August and October 2008. Here is the result of three meetings following this pattern. We conclude that the pilot project was successful since the goals were partially achieved, but more meetings would be needed to achieve them thoroughly. The participants were able of direct action in forwarding of the meetings due to a tacit organization among them: the "intelligent collective" proved possible.

Eficácia da mensuração do quinto sinal vital no controle da dor pós-operatória: um ensaio clínico randomizado. projeto piloto / Efficacy of fifth vital sign measurement to control postoperative pain: a randomized clinical trial. pilot project

JUSTIFICATIVA E OBJETIVOS: Em 1996 foi reconhecida a necessidade de considerar a dor como o quinto sinal vital. Desde então muito se discute sobre a melhor forma de tratá-lo. O estudo é um projeto piloto de um ensaio clínico randomizado para adequação metodológica de uma pesquisa que avaliará a eficácia da mensuração da dor pós-operatória através da escala numérica verbal. A metodologia poderá posteriormente ser estendida a diferentes instituições, ainda que o perfil dos pacientes ou procedimentos seja diferente.MÉTODO: Ensaio clínico randomizado aberto realizado entre 2009 e 2010. Quarenta e dois pacientes foram randomizados em dois grupos. A dor foi aferida duas vezes ao dia em cada um deles, porém apenas no grupo com intervenção o resultado da aferição era disponibilizado no prontuário. Desta forma, apenas esse grupo esteve sujeito às adequações analgésicas à dor referida. O restante dos participantes da pesquisa foi submetido à rotina de cuidados da instituição. Os grupos foram comparados por intenção de tratar através do teste de Mann-Whitney, sendo considerado significativo quando p < 0,05. RESULTADOS: O procedimento cirúrgico predominante foi a cesariana (75%). A mediana da dor foi maior no grupo com intervenção, tanto na medida basal quanto no seguimento (4,5), no entanto sem significância estatística.CONCLUSÃO: Como a aferição álgica se trata da mensuração quantitativa de um evento subjetivo, realizou-se este estudo para certificação do instrumento de pesquisa. Os resultados demonstrados objetivam definir a validade do método usado para comparação da aferição da dor no pós-operatório como quinto sinal vital.

BACKGROUND AND OBJECTIVES: The need to consider pain as the fifth vital sign was recognized in 1996. Since then, a lot has been discussed about the best way to do it. This study is a pilot project of a randomized clinical trial for methodological adaptation of a research to evaluate the efficacy of measuring postoperative pain through verbal numerical scale. The methodology shall be afterwards expanded to different institutions, although patients or procedures profile may be different.METHOD: Open randomized clinical trial carried out between 2009 and 2010. Forty-two patients were randomized in two groups. Pain was measured twice a day in all of them, however only in the group with intervention measurement results were made available in their medical records. This way, only this group was subject to analgesic adaptations to referred pain. Other participants were submitted to routine care of the institution. Groups were compared by intention to treat with Mann-Whitney's test, considering significant p < 0.05. RESULTS: Predominant surgical procedure was Cesarean section (75%). Pain median was higher in the group with intervention both in baseline and follow-up measurements (4.5), however without statistical significance.CONCLUSION: Since pain measurement is a quantitative measurement of a subjective event, this study was carried out to certify the research tool. Results aimed at defining the validity of the method used to compare postoperative pain measurement as the fifth vital sign.

Multimodal therapy for painful bladder syndrome / interstitial cystitis: pilot study combining behavioral, pharmacologic, and endoscopic therapies

Purpose: We evaluated the effectiveness of combining behavioral therapy, pharmacologic therapy and endoscopic hydrodistension for treating painful bladder syndrome / interstitial cystitis (PBS/IC). Materials and Methods: Twenty-five patients with PBS/IC were prospectively enrolled in a pilot multimodal behavioral, pharmacologic and endoscopic treatment protocol. Behavioral modification included diet recommendations, fluid restriction to 64 oz. /day, progressive timed voiding and Kegel exercises. Oral pharmacologic therapy consisted of daily doses of macrodantin 100 mg, hydroxyzine 10-20 mg and urised 4 tablets. Patients underwent endoscopic bladder hydrodistention under anesthesia at least 2 weeks after protocol enrollment. Behavioral and pharmacological treatments were continued after the hydrodistention. O'Leary-Sant questionnaire scores were recorded before starting the protocol, after pharmacologic/behavioral therapy, 2 months post-hydrodistension, and at scheduled follow-up. Results: Eighteen patients (72 percent) completed the pilot multimodal treatment protocol and were followed for a mean of 10.2 months. All patients were female with a median age of 36.3 years and had mean bladder capacity under anesthesia of 836 milliliters. Mean O'Leary-Sant symptom index scores for baseline symptoms, after behavioral/pharmacologic treatment, post-hydrodistension and during follow up were 12.5, 8.6, 7.0, and 6.7 (p < 0.05). Mean O'Leary-Sant problem index scores for baseline, after behavioral/pharmacologic treatment, post-hydrodistention and during follow up were 12.7, 8.9, 6.7, and 7.7 (p < 0.05). Conclusion: Our pilot multimodal protocol of behavioral modification, pharmacologic therapy and endoscopic hydrodistention demonstrated a significant progressive improvement in PBS/IC quality of life scores, compared to a pre-treatment baseline. These results should be validated in a larger, placebo controlled trial.