Critérios relacionados à alta hospitalar segura do recém-nascido: Uma revisão integrativa

Objetivo: Identificar os principais critérios evidenciados pela literatura científica envolvidos na alta hospitalar segura do recém-nascido. Método: Trata-se de uma revisão integrativa da literatura, realizada em dezembro de 2021 nas bases de dados Pubmed/ Medline, BVS, Scopus, Lilacs, utilizando-se os descritores "patient discharge summaries" OR "patient discharge" AND "newborn". O estudo foi fundamentado pelos procedimentos metodológicos PRISMA, foram adotados critérios de elegibilidade, critérios de inclusão: artigos disponíveis na íntegra, publicados nos últimos 5 anos, nos idiomas inglês, espanhol e português que versassem sobre cuidados ao recém-nascido, alta hospitalar ou alta do paciente neonatal. E de exclusão: todos os artigos que não atendiam ao objetivo da pesquisa e ou não possuíam relação com o tema em estudo. Resultados: Dos 94 artigos identificados entre 2017 e 2021 foram incluídos 12 estudos, sendo a maioria do Brasil e de abordagem qualitativa. Foram estabelecidas três categorias temáticas de análise: 1) Parâmetros biofisiológicos; 2) Comunicação e orientação aos pais: fragilidades e potencialidades da família; e 3) Cuidados pós alta e seguimento de rede. Conclusão: De acordo com a bibliografia selecionada está concluído que a alta hospitalar segura de recém-nascidos requer atenção aos aspectos fisiológicos, de comunicação com a família e intersetorial para seguimento de rede.

Objetivo: Identificar los principales criterios evidenciados por la literatura científica involucrados en el alta hospitalaria segura del recién nacido. Método: Revisión integrativa de la literatura, realizada en diciembre de 2021 en las bases de datos Pubmed/Medline, BVS, Scopus, Lilacs, utilizando los descriptores "patient high summaries" OR "patient high" AND "newborn". El estudio se basó en los procedimientos metodológicos PRISMA, se adoptaron criterios de elegibilidad y criterios de inclusión: artículos disponibles en su totalidad, publicados en los últimos 5 años, en inglés, español y portugués que versan sobre la atención del recién nacidos, el alta hospitalaria o el alta del paciente neonatal. Se excluyeron todos los artículos que no cumplieran con el objetivo de la investigación y/o no tuvieran relación con el tema en estudio. Resultados: De los 94 artículos identificados entre 2017 y 2021, se incluyeron 12 estudios, la mayoría de Brasil y con abordaje cualitativo. Se establecieron tres categorías temáticas de análisis: 1) Parámetros biofisiológicos 2) Comunicación y orientación a los padres: fragilidades y potencialidades de la familia y 3) Atención posterior al alta y seguimiento en red. Conclusión: Según a la bibliografía seleccionada, se concluye que el alta hospitalaria segura de los recién nacidos requiere atención a aspectos fisiológicos, de comunicación con la familia e intersectoriales para el seguimiento en red.

Objective: To identify the main criteria evidenced by the literature published on newborns' hospital discharge. Method: This is an integrative literature review, carried out in December 2021 in the PubMed/Medline, BVS, Scopus and LILACS databases, using the "patient discharge summaries" OR "patient discharge" AND "newborn" descriptors. The study was based on PRISMA methodological procedures, eligibility criteria were adopted, and the inclusion criteria were as follows: articles available in full, published in the last 5 years in English, Spanish and Portuguese and dealing with newborn care, hospital discharge or neonatal patient discharge. All articles that did not meet the research objective and/or were not related to the topic under study were excluded. Results: Of the 94 articles identified between 2017 and 2021, 12 studies were included, most from Brazil and with a qualitative approach. Three thematic analysis categories were established: 1) Biophysiological parameters; 2) Communication and guidelines for parents: weaknesses and strengths of the family; and 3) Post-discharge care: network follow-up. Conclusion: According to the selected bibliography, it is concluded that newborns' safe hospital discharge requires attention to the physiological, communication with the family and intersectoral aspects for network follow-up.

¿Cuántos Tipos de Revisiones de la Literatura Existen? Enumeración, Descripción y Clasificación. Revisión Cualitativa / How Many Types of Literature Reviews are There? Listings, Description and Classification

La expansión y consolidación de la práctica clínica basada en la evidencia ha llevado entre otras, a la necesidad de realizar una variedad cada vez mayor de tipos de revisión de la literatura científica; lo que permite avanzar en el conocimiento y comprender la amplitud de la investigación sobre un tema de interés, teniendo en cuenta que una de las propiedades del conocimiento es su carácter acumulativo. Sin embargo, la diversidad de la terminología utilizada genera confusión de términos y conceptos. El objetivo de este manuscrito fue proporcionar un listado de los tipos de revisiones de la literatura más frecuentemente utilizados con sus características y algunos ejemplos de ellas. Revisión cualitativa. Se examinaron de forma dirigida las bases de datos PubMed, WoS y Scopus, en búsqueda de términos asociados a tipos de revisiones y síntesis de la literatura científica. Se encontraron 21 tipos de revisión; y 29 variantes y sinonimias asociadas; las que ilustran los procesos de cada una de ellas. Se da una descripción general de las características de cada cual, junto con las fortalezas y debilidades percibidas. No obstante, se verificó que sólo algunos tipos de revisión poseen metodologías propias y explícitas. Este enfoque, proporciona un punto de referencia para quienes realizan o interpretan revisiones en el ámbito sanitario, y sugiere dos tipos de propuestas de clasificación.

SUMMARY: The expansion and consolidation of evidence-based clinical practice has led, among other things, to the need to carry out an increasing variety of types of literature reviews, which allows advancing in knowledge and understanding the breadth of research on a topic of interest. However, the diversity of the terminology used generates confusion of terms and concepts. The aim of this manuscript was to provide a list of the most frequently used review types with their characteristics and some examples. Qualitative review. PubMed, WoS and Scopus databases were examined in a directed way, searching for terms associated with types of reviews and syntheses of the scientific literature. Twenty-one types of review, and 29 variants and associated synonymies were found; those that illustrate the processes of each of them. An overview of the characteristics of each is given, along with perceived strengths and weaknesses. However, it was verified that only some types of review have their own explicit methodologies. This approach, provides a point of reference for those who perform or interpret reviews in the health field and suggests two classification proposals.

Self-care guidelines for patients in the post-hematopoietic stem cell transplantation period: a scoping review / Orientaciones para el autocuidado de pacientes en el post-trasplante de células madre hematopoyéticas: revisión de alcance / Orientações para o autocuidado de pacientes no pós-transplante de células-tronco hematopoéticas: revisão de escopo

ABSTRACT Objective: To map the evidence on self-care guidelines for patients in the post-hematopoietic stem cell transplantation (HSCT) period. Method: Scoping review supported by Joanna Briggs Institute recommendations, with searches conducted between March and April 2022 in national and international databases and repositories of theses and dissertations. Results: Of the 11 studies that composed the final sample, the guidelines had a social and personal aspect, as post-transplant patients need to follow numerous essential recommendations for the prevention of infections and complications for successful treatment and improved quality of life. Conclusion: Knowing the self-care guidelines that must be performed by post-HSCT patients is fundamental for the nursing team to provide the necessary information for care outside the controlled environment of the hospital, in addition to minimizing episodes of infection, death, and increasing the survival and quality of life of transplant recipients.

RESUMEN Objetivo: mapear las evidencias sobre las orientaciones realizadas para el autocuidado de pacientes en el post-trasplante de células madre hematopoyéticas (TCTH). Método: Scoping Review apoyada en las recomendaciones del Instituto Joanna Briggs, con búsquedas entre marzo y abril de 2022 en bases de datos y repositorios de tesis y disertaciones nacionales e internacionales. Resultados: de los 11 estudios que compusieron la muestra final, las orientaciones tenían un carácter social y personal, ya que el paciente en el post-trasplante necesita seguir numerosas recomendaciones imprescindibles para la prevención de infecciones y complicaciones para el éxito del tratamiento y la mejora de la calidad de vida. Conclusión: Conocer las orientaciones para el autocuidado que deben ser realizadas por pacientes en el post-TCTH es fundamental para que el equipo de enfermería proporcione la información necesaria para los cuidados fuera del contexto controlado del ambiente hospitalario, además de minimizar los episodios de infección, muerte y aumentar la sobrevida y calidad de vida de los transplantados.

RESUMO Objetivo: mapear as evidências sobre as orientações realizadas para o autocuidado de pacientes no pós-transplante de células-tronco hematopoéticas (TCTH). Método: Scoping Review apoiada nas recomendações do Joanna Briggs Institute, com buscas entre março e abril de 2022 em bases de dados e repositórios de teses e dissertações nacionais e internacionais. Resultados: dos 11 estudos que compuseram a amostra final, as orientações tinham cunho social e pessoal, visto que o paciente do pós-transplante precisa seguir inúmeras recomendações imprescindíveis para a prevenção de infecções e complicações para o êxito do tratamento e melhoria da qualidade de vida. Conclusão: Conhecer as orientações para o autocuidado que devem ser realizadas por pacientes no pós-TCTH é fundamental para que a equipe de Enfermagem forneça as informações necessárias para os cuidados fora do contexto controlado do ambiente hospitalar, além de minimizar os episódios de infecção, morte e aumentar a sobrevida e qualidade de vida dos transplantados.

Educational technologies used to teach self-management after hematopoietic stem cell transplantation: a scoping review / Tecnologías educativas utilizadas para enseñar el autocuidado después del trasplante de células madre hematopoyéticas: revisión de alcance / Tecnologias educacionais utilizadas para o ensino da autogestão no pós-transplante de células-tronco hematopoéticas: scoping review

ABSTRACT Objective: to map the scientific evidence on the educational technologies used to teach self-management in hematopoietic stem cell post-transplantation. Method: a scoping review, based on JBI recommendations. The searches took place between January and February 2022, in databases and repositories of dissertations and theses. The PCC strategy was used, namely: P (Population) - patients (patient participation); C (Concept) - educational technologies and self-management (instructional technology, self-management); and C (Context) - post hematopoietic stem cell transplantation (bone marrow transplantation). Studies that discussed the educational technologies used to teach self-management after hematopoietic stem cell transplantation, available in full electronically, were included. Editorials, letters to the editor and opinion articles were excluded. Duplicate studies were considered only once. The data are presented in figures and chart format. Results: sixteen studies were selected to compose the final sample, most of which showed that the most used educational technologies in the context of hospital discharge after hematopoietic stem cell transplantation are websites, software, movies, online videos or not, care plans, posters, books and booklets aimed at teaching. Conclusion: the use of educational technologies in teaching and patient health education is a reality present in services at any level of health care. The highlight of the approach to this topic is anchored in how these technologies are used and whether they are properly defined for each patient, according to the results of this study.

RESUMEN Objetivo: mapear la evidencia científica sobre las tecnologías educativas utilizadas para enseñar el automanejo en el postrasplante de células madre hematopoyéticas. Método: revisión de alcance, basado en las recomendaciones del JBI. Las búsquedas se realizaron entre enero y febrero de 2022, en bases de datos y repositorios de disertaciones y tesis. Se utilizó la estrategia PCC, a saber: P (Población) - pacientes (participación de los pacientes); C (Concepto) - tecnologías educativas y autogestión (tecnología instruccional, autogestión); y C (Contexto): postrasplante de células madre hematopoyéticas (trasplante de médula ósea). Se incluyeron estudios que discutieron las tecnologías educativas utilizadas para enseñar el autocuidado después del trasplante de células madre hematopoyéticas, disponibles en su totalidad electrónicamente. Se excluyeron editoriales, cartas al editor y artículos de opinión. Los estudios duplicados se consideraron una sola vez. Los datos se presentan en formato de tablas y figuras. Resultados: se seleccionaron 16 estudios para componer la muestra final, la mayoría de los cuales mostró que las tecnologías educativas más utilizadas en el contexto del alta hospitalaria después del trasplante de células madre hematopoyéticas son sitios web, software, películas, videos en línea o no, planes de atención, carteles, libros y folletos destinados a la enseñanza. Conclusión: el uso de tecnologías educativas en la enseñanza y educación en salud del paciente es una realidad presente en los servicios de cualquier nivel de atención a la salud. Lo más destacado del abordaje de este tema está anclado en cómo se utilizan estas tecnologías y si están bien definidas para cada paciente, según los resultados de este estudio.

RESUMO Objetivo: mapear as evidências científicas sobre as tecnologias educacionais utilizadas para o ensino da autogestão no pós-transplante de células-tronco hematopoéticas. Método: scoping review, apoiada nas recomendações do JBI. As buscas ocorreram entre janeiro e fevereiro de 2022, em bases de dados e repositórios de dissertações e teses. Utilizou-se a estratégia PCC, a saber: P (População) - pacientes (participação do paciente); C (Conceito) - tecnologias educacionais e autogestão (tecnologia instrucional, autogerenciamento); e C (Contexto) - pós-transplante de células-tronco (transplante de medula óssea). Foram incluídos estudos que discutissem sobre as tecnologias educacionais utilizadas para o ensino da autogestão no pós-transplante de células-tronco hematopoéticas, disponíveis na íntegra em meio eletrônico. Foram excluídos editoriais, cartas ao editor e artigos de opinião. Os estudos duplicados foram considerados apenas uma vez. Os dados estão apresentados em formato de figuras e quadro. Resultados: foram selecionados 16 estudos para compor a amostra final, dentre os quais, em sua maioria, evidenciaram que as tecnologias educacionais mais utilizadas no contexto de alta hospitalar no pós-transplante de células tronco-hematopoéticas são websites, softwares, filmes, vídeos online ou não, planos de cuidado, cartazes, livros e cartilhas voltados para o ensino. Conclusão: o uso das tecnologias educacionais no ensino e na educação em saúde dos pacientes é uma realidade presente nos serviços em qualquer um dos níveis de atenção à saúde. O ponto de destaque da abordagem a este tema se ancora em como essas tecnologias são utilizadas e se são definidas de forma adequada para cada paciente, conforme resultados deste estudo.

Presencia de las distintas áreas quirúrgicas en el Congreso Nacional de Cirugía. Análisis de los últimos 12 años

Introducción: Los trabajos científicos permiten divulgar, compartir y contrastar resultados a terceros. Una de las formas de ver la actividad investigativa de cada especialidad es a través de las presentaciones que realizan en reuniones científicas. Objetivo: Describir el número de presentaciones de las distintas especialidades o áreas quirúrgicas en Chile en el principal congreso realizado a nivel nacional y evaluar si el comportamiento fue distinto durante los años de pandemia por coronavirus. Material y Método: Estudio bibliométrico del Congreso Chileno de Cirugía entre los años 2010 y 2021 evaluando el número total de presentaciones por área quirúrgica, año de presentación y período categorizado en 2010 a 2019 y 2020 a 2021. Se realiza estadística descriptiva y análisis de asociación de medias de publicaciones por área y período. Resultados: Se identificaron 4.462 presentaciones, incluyendo resúmenes orales, póster, videos y jornada de residentes. La media total fue 371,8 trabajos anuales. Coloproctología y Cirugía Gastroesofágica aportaron un total de 616 (13,8%) y 598 (13,4%) respectivamente. La media de presentaciones anuales previo a la pandemia por coronavirus fue de 414, en contraste a los 160 trabajos anuales durante ella, existiendo una disminución significativa de medias de presentaciones por área de 27,6 (± 18,8) a 10,7 (± 8,69) (p < 0,001), sin diferencias sus porcentajes de participación respecto del total (p = 0,776). Conclusión: Coloproctología y Cirugía Gastroesofágica son las áreas quirúrgicas más representadas. Si bien en el período contemporáneo a la pandemia por coronavirus significó una disminución en las presentaciones, no se observó una modificación en el porcentaje de participación de algún área en particular.

Introduction: Scientific studies allow the disclosure, sharing and comparison of results with third parties. One of the ways to see the investigative activity of each medical specialty is through the presentations they make at scientific meetings. Aim: To describe the number of presentations of the different surgical specialties or areas in Chile in the main congress held at a national level and to assess whether the behavior was different during the years of the coronavirus pandemic. Material and Method: Bibliometric study of the Chilean Congress of Surgery between 2010 and 2021, evaluating the total number of presentations by surgical area, year of presentation and two categorized periods (2010 to 2019 and 2020 to 2021). Descriptive statistics and association analysis of publication means by area and period are performed. Results: 4,462 presentations were identified, including oral summaries, posters, videos, and residents' sessions, with a mean of 371.8 per year. Coloproctology and Gastroesophageal Surgery contributed a total of 616 (13.8%) and 598 (13.4%) respectively. The mean number of annual presentations prior to the coronavirus pandemic was 414, in contrast to the 160 annual works during it, with a significant decrease in the mean number of presentations per area from 27.6 (± 18.8) to 10.7 (± 8.69) (p < 0.001), without differences in their percentages of participation with respect to the total (p = 0.776). Conclusion: Coloproctology and Gastroesophageal Surgery are the most represented surgical areas. Although the contemporary period of the coronavirus pandemic meant a decrease in presentations, no change was observed in the percentage of participation in any particular area.

As agendas do Global Education Reform Movement (GERM) e as suas relações com a Educação Física / The Global Education Reform Movement (GERM) agenda and its relationship with Physical Education / Las agendas del Movimiento Global de Reforma Educativa (GERM) y su relación con la Educación Física

RESUMO O avanço mundial do conservadorismo provocou a constituição de um movimento articulado denominado Global Education Reform Movement (GERM), que com a sua agenda tenta ditar os ritmos da educação. No Brasil não é diferente: com a permeabilidade do GERM na educação nacional, identificamos que a Educação Física vem sendo tocada com esses traços de modernização que, no nosso entender, esmaecem o significado e as ações do componente curricular. Assim, pela análise de documentos, discutimos como essa agenda global se relaciona com o contexto da Educação Física nacional.

ABSTRACT The worldwide advance of conservatism led to the formation of an articulated movement called the Global Education Reform Movement (GERM), which with its agenda tries to dictate the rhythms of education. In Brazil it is no different: with the permeability of GERM in national education, we identified that Physical Education has been touched with these modernization traits that, in our view, fade the meaning and actions of the curricular component. Thus, through the analysis of documents, we discussed how this global agenda relates to the context of national Physical Education.

El avance mundial del conservadurismo llevó a la formación de un movimiento articulado denominado Movimiento Global de Reforma Educativa (GERM), que con su agenda trata de dictar los ritmos de la educación. En Brasil no es diferente: con la permeabilidad del GERM en la educación nacional, identificamos que la Educación Física ha sido tocada con esos rasgos de modernización que, a nuestro juicio, desdibujan el sentido y las acciones del componente curricular. Así, a través del análisis de documentos, discutimos cómo esta agenda global se relaciona con el contexto de la Educación Física nacional.

Cooperação Ipea-Bireme: interoperabilidade de sistemas para a disseminação de informação em saúde / Ipea-Bireme cooperation: system interoperability for dissemination of health information / Cooperación Ipea-Bireme: interoperabilidad de sistemas para difusión de información de salud

O objetivo deste texto é descrever e discutir a experiência de cooperação entre o Instituto de Pesquisa Econômica Aplicada (Ipea) e o Centro Latino-Americano e do Caribe de Informação em Ciências da Saúde (Bireme) para a interoperabilidade de seus sistemas de informação, com vistas à indexação da produção em saúde do Ipea às bases de dados de literatura científica mantidas pela Bireme, fomentando assim a disseminação do conhecimento produzido pelo instituto nesta área. Conclui-se, a partir da análise desta iniciativa, que o seu sucesso é devido ao comprometimento das equipes, as quais conformaram acordos de cooperação nos níveis técnico, de conteúdo e organizacional, requisitos estes apontados pela literatura científica sobre o assunto como determinantes para seu êxito.

The aim of this paper is to describe and discuss the experience of cooperation between the Institute of Applied Economic Research (Ipea) and the Latin American and Caribbean Center on Health Sciences Information (Bireme) for the interoperability of their information systems, to index the health production of Ipea to the databases of scientific literature maintained by Bireme, thus promoting the dissemination of the knowledge produced by the institute in this area. It is concluded, from the analysis of this initiative, that its success is due to the commitment of the teams, which formed cooperation agreements at the technical, content and organizational levels, requirements that are pointed out by the scientific literature on the subject as determinants for its success.

El objetivo de este documento es describir y discutir la experiencia de cooperación entre el Instituto de Investigación Económica Aplicada (IPEA) y el Centro Latinoamericano y del Caribe de Información en Ciencias de la Salud (Bireme) para la interoperabilidad de sus sistemas de información, con el objetivo de indexar la producción de salud de Ipea a las bases de datos de literatura científica mantenidas por Bireme, promoviendo así la difusión del conocimiento producido por el instituto en esta área. Se concluye, a partir del análisis de esta iniciativa, que su éxito se debe al compromiso de los equipos, que formaron acuerdos de cooperación a nivel técnico, de contenido y organizacional, requisitos que la literatura científica señala sobre el tema como determinantes para su éxito.

Cómo leer y generar publicaciones científicas: la importancia del título y el resumen de un artículo científico / Scientific communication: the importance of the title and abstract of a scientific paper

The abstract of a scientific research paper must be well written and reviewed. Sometimes is the only section of a paper that is read, therefore must have the problem, research question, objective, hypothesis, method, results and conclusions, with the limitation of the study. Editors through the abstract deduce what a paper is about and its scientific relevance. The title condenses the paper's content in a few words, must capture the reader's attention and includes patients and methods. Both, the research summary and title of the paper are used for references databases. The paper gives some tips to write a good research abstract and title.

El resumen de un artículo científico debe ser prolíjamente redactado y revisado ya que muchas veces es lo único que se lee. Debe ser específico y representativo del texto, describiendo el problema, el objetivo, la hipótesis, cómo se hizo la investigación y que resultados se obtuvieron con sus conclusiones, mostrando las limitaciones del estudio. El título debe llamar la atención del lector y describir los pacientes y el método en forma breve. Es en base al resumen que editores evaluan la validez y relevancia del artículo científico. El título y resumen es lo que se incorpora en las bases de datos bibliográficas. En este artículo se describen los pasos para la redacción de un resumen de un buen artículo científico.

Planificación del alta / Discharge planning

El alta hospitalaria constituye una transición clave en salud, cuya importancia frecuentemente queda invisibilizada ante el apremio por hospitalizaciones más abreviadas y procesos que por años se han desarrollado de determinada forma. Un alta planificada y/o ejecutada de manera inadecuada puede significar reingresos y repercutir negativamente a nivel del usuario, sus familias y sistemas de atención. Múltiples intervenciones, con distinto nivel de evidencia buscan optimizar el proceso, enfocándose en los equipos, dispositivos y/o usuarios involucrados. Dado que no existe una única estrategia efectiva, el presente artículo recorre aspectos que la literatura ha identificado como relevantes al momento de trabajar por altas planificadas.

Hospital discharge is a key transition health process, whose relevance is often overshadowed by the urgency of shortened hospitalizations and health institutions routines that have been settled for many years. An unplanned and inappropriate discharge can lead to readmissions and negative implications for patients, caregivers and hospitals. Therefore, multiple interventions exist, with different levels of evidence that seek to improve the discharge process by focusing on health teams, institutions and patients. Given there is no single effective strategy, this article covers aspects that several authors have identified as relevant when working on discharge planning.

Resumen estructurado de Revisiones Sistemáticas (FRISBEE) / Summary of the Body of Evidence (FRISBEE)

RESUMEN: Las revisiones sistemáticas corresponden al máximo nivel de evidencia y son la principal herramienta para resolver incertidumbres clínicas(1). Sin embargo, dado sus características, presentan desventajas para su aplicación rápida y sencilla(2). Dado lo anterior es que se han creado nuevos formatos dentro de los que se incluyen los resúmenes estructurados de revisiones sistemáticas, dentro de los que se incluyen los Friendly Summary Of The Body Of Evidence (FRISBEE) (4). El proceso de elaboración de un FRISBEE comienza, como toda búsqueda de evidencia, con el planteamiento de una pregunta clínica estructurada y específica con la cual se desarrollará una búsqueda en la base de datos Epistemonikos que arrojará todas las revisiones sistemáticas atingentes. De ellas, se deben seleccionar las que respondan la pregunta clínica planteada y, a partir de ellas, se analizarán los estudios primarios de manera tal que se pueda obtener un resultado global de la evidencia, el grado de certeza de la misma, una conclusión y mensajes claves al respecto. El resultado final es un resumen de la evidencia en relación a una pregunta determinada que contempla la información contenida en todas las revisiones sistemáticas publicadas. Su utilidad e importancia está determinada debido a que facilitan la aplicabilidad clínica de la evidencia disminuyendo la complejidad de lectura e incorporando aspectos prácticos tanto para el clínico como el paciente.

ABSTRACT: Systematic reviews are the highest level of evidence and the main tool for resolving clinical uncertainties(1). However, due to their characteristics, their quick and easy application(2) presents disadvantages. That is why new formats have been created, comprising the structured summaries of systematic reviews, including the Friendly Summary Of The Body Of Evidence (FRISBEE) (4). The process of elaboration of a FRISBEE begins, like any search of evidence, with the approach of a structured and specific clinical question and the development of a search in the Epistemonikos database that will yield all the pertinent systematic reviews. Of these, those that answer the clinical question should be selected and, based on them, the primary studies will be analyzed to get a global result of the evidence, its degree of certainty, conclusions and key messages in this regard. The final result is a summary of the evidence related to a specific question that includes the information contained in all published systematic reviews. Its usefulness and importance is determined because it facilitates the clinical applicability of the evidence, decreasing the reading complexity and incorporating practical aspects for both the clinician and the patient.

Síntesis y regulación de compuestos del aroma y el sabor derivados de la levadura en la cerveza: ásteres / Synthesis and regulation of flavor compounds derived from brewing yeast: Esters

Las levaduras, durante el proceso de elaboración de cerveza, producen más de 500 compuestos químicos; estos pueden impactar tanto negativa como positivamente en las características organolépticas de la cerveza. En los últimos años, y en particular gracias al avance de la biología molecular y la genómica, se han logrado progresos notables en el conocimiento de las bases moleculares y celulares de la síntesis y regulación de muchos de estos compuestos que inciden en lo que se denomina flavor (aroma y sabor) de la cerveza. Este artículo está enfocado en los ésteres responsables del aroma y el sabor floral y frutado de la cerveza. La formación de estos ésteres depende de diversas enzimas y de factores como la concentración de nutrientes presente en el mosto, la cantidad de oxígeno y dióxido de carbono disuelto, la temperatura de fermentación y, principalmente, la genética de la levadura utilizada. En esta revisión se brinda información de cómo se originan los ésteres y cómo los diferentes parámetros fermentativos impactan en las concentraciones finales de estos compuestos y en la calidad del producto terminado.

During brewing process yeast produce more than 500 chemical compounds that can negatively and positively impact beer at the organoleptic level. In recent years, and particularly thanks to the advancement of molecular biology and genomics, there has been considerable progress in our understanding about the molecular and cellular basis of the synthesis and regulation of many of these flavor compounds. This article focuses on esters, responsible for the floral and fruity beer flavor. Its formation depends on various enzymes and factors such as the concentration of wort nutrients, the amount of dissolved oxygen and carbon dioxide, fermentation temperature and mainly the genetics of the yeast used. We provide information about how the esters originate and how is the impact of different fermentative parameters on the final concentrations of these compounds and the quality of the end product.

Telemedicine network Program for reperfusion of Myocardial infarction / Programa en red para la reperfusión del infarto con telemedicina

background: Early management of myocardial infarction in the area of public health requires the integration of specific programs for the coordination of healthcare services. Objective: The aim of this study was to evaluate the impact on delay times and reperfusion rate of a comprehensive program for the reperfusion of myocardial infarction in a hospital network of the Southern Greater Buenos Aires. Methods: The network consists of six low-mid-complexity hospitals and a third-level referral center with 24-hour cath-lab. Stage 1 of the program (2009-2010) evaluated the existing barriers to reperfusion; Stage 2 (2011-2013) implemented the progressive incorpora-tion of improvements and Stage 3 assessed the program (2013-2014) complemented with fellows in each hospital. Program impact was evaluated by the proportion of patients reperfused and time to its implementation. results: A total of 432 patients referred from the network were hospitalized with diagnosis of ST-segment elevation myocardial infarction. Mean age was 56±9 years and 83.3% were men. The proportion of reperfused patients progressively increased: S1 60.7%, S2 69% and S3 78%, p for trend=0.01. Time to reperfusion decreased significantly between S1 and S3, from 120 minutes (IQR 55-240) to 90 minutes (IQR 35-150), p=0.04, with a median reduction of 30 minutes in the door-to-balloon and door-to-needle times. Conclusions: The application of a program for myocardial reperfusion based on the diagnosis of barriers was associated with 28.5% increase in reperfusion, and a significant reduction in the implementation times. This public network model built on algorithms adapted to local barriers may contribute to improve the care of myocardial infarction in our country.

Impact of a Meditation Program on Pulse-Wave Velocity, C-reactive Protein and Quality of life / Impacto de un programa de meditación sobre la velocidad de onda de pulso, la proteína C-reactiva y la calidad de vida

background: Although various studies refer to the effect of meditation on blood pressure (BP), its impact on other cardiovascular clinical variables is unknown. Objective: The aim of this study was to evaluate the effects of a meditation program on pulse wave velocity (PWV), quality of life and ultrasensitive C-reactive protein (us-CRP) in patients with ischemic heart disease or chronic heart failure. Methods: This was a randomized study with two groups of patients: a meditation group (M) and an active control group (AC) with cardiovascular health education, evaluating the difference between initial and final values at 12 weeks of B P, PWV, quality of life (assessed by the SF-36 questionnaire) and us-CRP. results: Thirty-five patients were included in the M group and 35 in the AC group; mean age was 61 years and 80% were men. Both groups had similar baseline characteristics, except for higher number of smokers and triglyceride levels in the M group. At 12 weeks, no significant differences were found for ∆PWV: +0.51 (±1.40) in AC and +0.19 (±1.53) in M (p=0.37). Conversely, ∆SF-36 was +0.79 (±7.58) in AC vs. +5.40 (±9.69) (p=0.03) in M, and ∆us-PCR was +1.17 (±2.9) in AC vs. -0.69 (±0.89) in M (p=0.02). Conclusions: A meditation program did not significantly modify PWV at 12 weeks. However, patients allocated to this intervention improved their quality of life and us-PCR was significantly reduced. Larger studies are required to confirm these findings and explore the mechanisms involved in this improvement.

Diagnostic ability of Physical Examination in aortic Valve stenosis / La capacidad diagnóstica del examen físico en la estenosis valvular aórtica

background: Physical examination is essential to detect aortic stenosis but there is scarce information currently available. Objectives: The goal of this study is to evaluate the diagnostic yield of physical examination, the interobserver agreement of clinical signs, and to establish a score to identify severe aortic stenosis. Methods: One-hundred patients were included in the study. Before echocardiographic evaluation, two cardiologists independently evaluated the clinical signs of the physical examination in aortic stenosis. Sensitivity, specificity, and inter-observer agreement were calculated, and the area under the curve was analyzed to develop a score for predicting severe aortic stenosis. results: The decreased intensity of the first heart sound and the crescendo-decrescendo shape of the murmur had sensitivity >90% and specificity <70%. The specificities of an absent second sound, a murmur that peaks later in systole and the presence of a parvus et tardus pulse were >95%, but the sensitivities were <50%. Inter-observer agreement was good for most criteria, except for murmur shape and intensity. The best area under the curve was achieved by the score composed of heart sounds of decreased or absent intensity, duration of the holosystolic murmur, parvus et tardus carotid pulse and a grade 3-4 systolic murmur. Conclusions: Physical examination findings have low sensitivity but good specificity. Inter-observer agreement of clinical signs of severity was moderately good. Correct identification of patients with severe aortic stenosis can be achieved using a simple score.

Clinical and Functional Outcome of Percutaneous alcohol septal ablation in Obstructive Hypertrophic Cardiomyopathy / Resultados clínicos y funcionales de la ablación septal percutánea con alcohol en la miocardiopatía hipertrófica obstructiva

background: Percutaneous septal ablation is a therapeutic option for patients with obstructive hypertrophic cardiomyopathy refrac-tory to optimal medical therapy. However, results of initial persistence and long-term safety are still controversial. Objectives: The aim of this study was to report percutaneous alcohol septal ablation technique, clinical and functional outcome, cardiovascular events and its impact on long-term follow-up. Methods: A total of 23 patients were included in the study. Functional class (FC), left ventricular outflow tract gradient before and after the procedure and long-term cardiovascular events were evaluated. results: Median follow-up was 52 months (IR 33-72). All patients were in FC III or IV prior to the procedure, under maximum tolerated medical therapy. The procedure was successful in 91% of cases, with 85% of patients currently in FC I and 15% in FC II. Baseline left ventricular outflow tract gradient decreased from 75 mmHg (95% CI 51-89) to 25 mmHg (95% CI 10-37) (p <0.003) and with Valsalva maneuver from 118 mmHg (95% CI 88-152) to 38 mmHg (95% CI 16-69) (p <0.0002), persisting in the long-term follow-up. During hospitalization, two patients presented with complete atrioventricular block requiring permanent pacemaker implantation. No cardiovascular deaths occurred during follow up. Conclusions: Alcohol septal ablation is a promising option for the treatment of a selected population with hypertrophic obstructive cardiomyopathy, generating sustained clinical and functional improvement with low incidence of events in the long-term follow up.

Estudio TAMARA II. Tabaquismo en médicos de la República Argentina II / The tamara ii trial. smoking among physicians in argentina

background: Smoking is the leading cause of preventable morbidity and death. It is important to know the characteristics of smoking habits among physicians and their attitude toward patients who smoke. Objective: The aim of this study is to investigate the prevalence of smoking among physicians in Argentina, the factors associated with tobacco consumption and their attitude toward their patients who smoke. Methods: An observational cross- sectional study was performed between June and December 2013 in Argentine physicians of dif-ferent specialties. Using a structured survey, the following variables were analyzed: associated cardiovascular risk factors, charac-teristics of tobacco consumption, smoking cessation training and the attitude toward the patient who smokes. results: 3,033 physicians were surveyed, ; 57% were men, and mean age was 41.3±12 years; 19.7% were current smokers and 21.7% were former smokers. The probability of being a smoker was higher among surgeons (OR 1.29) or physicians working at the emergency room (OR 1.41). Undergraduate and postgraduate tobacco cessation training was achieved by 36.6% and 40.8% of physicians, respectively. Young physicians, clinical specialties or private practice were associated with higher level of training. Tobacco cessation counseling was more frequent in physicians with higher level of training than physicians who smoked or surgeons. Former smokers presented higher prevalence of risk factors and cardiovascular events. Family history of smoking habit was more common in former smokers and current smokers. Conclusions: The prevalence of smoking among Argentine physicians is high. Different factors are involved in the probability of smoking, tobacco cessation training or the possibility of medical counseling. Higher level of training in smoking cessation must be provided.

Software educativo para la ayuda del procesamiento analítico sintético de la información en la red de bibliotecas médicas de Villa Clara / Educational software to support the analytical-synthetic processing of information in the network of medical libraries of Villa Clara

El procesamiento analítico sintético es una de las etapas del ciclo de vida de la información que con la llegada de las nuevas tecnologías ha sufrido cambios. Después de realizar el diagnóstico de las necesidades de los bibliotecarios de la red de bibliotecas médicas, que en su mayoría son graduados de cultura y educación y no poseen suficientes conocimientos referentes al Sistema de Información de Ciencias Médicas, se ha constatado que el nivel de preparación para el procesamiento analítico sintético no es el más adecuado. Teniendo en consideración que los recursos humanos de la red tienen que estar preparados para garantizar la calidad del servicio, se propone elaborar un software para contribuir a la preparación de los bibliotecarios en el procesamiento analítico sintético de la información en la red de bibliotecas médicas de Villa Clara. Para el diagnóstico se aplicaron métodos y técnicas con enfoque cualitativo sin dejar de emplear algunos recursos con enfoque cuantitativo que posibilitaron conocer la situación actual en la red de bibliotecas médicas y determinar los contenidos a incluir en el software. Está estructurada en cinco temas con una interfaz amigable, donde el usuario puede navegar fácilmente por los temas de su interés en el tiempo que requiera. Con la puesta en práctica del software los bibliotecarios tienen a su disposición una fuente de información que brinda conocimientos y técnicas necesarias para el adecuado procesamiento analítico sintético de la información y una herramienta de consulta y apoyo para las actividades de superación e investigación

The introduction of new technologies has brought about changes in analytical-synthetic processing, one of the stages in the life cycle of information. Most librarians in the network of medical libraries are graduates in cultural and educational studies, and are not sufficiently familiar with the Medical Sciences Information System. A diagnosis of their needs showed that their training in analytical-synthetic processing is not adequate. Bearing in mind that personnel from the network should be ready to ensure the quality of services, we propose to develop a software supporting the training of librarians in analytical-synthetic processing of information in the network of medical libraries of Villa Clara. The diagnosis was based on qualitative methods and techniques as well as some quantitative resources making it possible to understand the current status of the network of medical libraries and determine the contents to be included. The software is structured into five topics, and a friendly interface enables users to easily move about their areas of interest at any moment. Implementation of the software will provide librarians with a source of information related to the knowledge and techniques required for the appropriate analytical-synthetic processing of information, as well as a tool for consultation and support to professional development and research activities

Publicaciones seriadas de la terapia ocupacional en latinoamerica / Publicações periódicas da terapia ocupacional na América Latina / Serial publications in occupational therapy in Latin America

Este artículo presenta el panorama bibliográfico de las revistas de Terapia Ocupacional en cuatro países: Argentina, Chile, Colombia y Venezuela. Desde los inicios de la Terapia Ocupacional en los países de la región latinoamericana, fueron creados distintos programas de formación a nivel técnico, posteriormente, a mediados de los ochenta, la mayoría de programas se reconfi guraron a nivel profesional, al incorporar trabajosinvestigativos como requisito de grado. En los primeros años el soporte bibliográfi co se importaba de construía con base a contextos angloparlantes. La mayor parte del revistas específico latinoamericana da área comenzó a finales de los noventa. Su desarrollo es desigual en el tiempo, el mantenimiento de una mayor tradición de la publicación de Libros. El presente trabajo discute discute los inicios, el desarrollo, la decadencia y el resurgimiento de las publicaciones seriadas en el contexto latinoamericano. Resulta que todos los esfuerzos se requieren parareactivar la publicación en revistas propias de terapia ocupacional y usar los recursos digitales para lograrlo, son pasos hacia la apropiación social del conocimiento y la consolidación de la Terapia Ocupacional como profesión

Este artigo apresenta o panorama bibliográfico de revistas de Terapia Ocupacional de quatro países: Argentina, Chile, Colômbia e Venezuela. Desde o início da Terapia Ocupacional nos países da região latino-americana, foram criados vários programas de formação em nível técnico. Posteriormente, em meados dos anos oitenta, a maioria dos cursos se reconfigurou no nível profissional, ao incorporar trabalhos de pesquisa como requisito para obtenção do diploma. Nos primeiros anos, o apoio bibliográfico se construiu com base na produção anglo-saxônica. A maior parte das revistas específicas latino-americanas da área começou ao final dos anos noventa. Seu desenvolvimento é desigual no tempo, mantendo uma maior tradição de publicação em livros. O presente trabalho discute o início, o desenvolvimento, a queda e ressurgimento das publicações periódicas em Terapia Ocupacional no contexto latino-americano. Conclui-se que são necessários todos os esforços para reativar a publicação em revistas próprias da área de Terapia Ocupacional e usar os recursos digitais para desenvolvê-la, visando à apropriação social do conhecimento e à consolidação da Terapia Ocupacional como profissão

This article presents a bibliographic overview on Occupational Therapy journals in four countries: Argentina, Chile, Colombia and Venezuela. Since the beginning of occupational therapy in Latin American countries, several training programs at the technical level were created. In the mid 1980s, most courses were reconfigured at the professional level, incorporating researches as a requirement for obtaining the degree. In the early years, the literature was built on the supporting basis of the North American production. Most of the specific Latin American journals in the area began in the late nineties. It has developed unevenly through time, maintaining the greater tradition of publishing books. This paper discusses the beginning, development, decline and resurgence of Occupational Therapy periodicals in Latin American. It was possible to conclude that all efforts are needed to revive the publication of journals specific to the area of occupational therapy and use digital resources to develop them, aiming at the social appropriation of knowledge and consolidation of occupational therapy as a profession

Los lenguajes de indización en e-Salud: su aplicación a los documentos sobre trastornos de la conducta alimentaria / Indexing languages in e-Health: applications for documents about eating disorders

La presencia cada vez mayor de las bases de datos especializadas y su uso generalizado, así como las posibilidades de difusión que las nuevas tecnologías ofrecen, obliga a un análisis pertinente de los documentos. Los lenguajes de indización nacen a raíz del crecimiento de la información generado por la revolución científica, como una forma rápida y normalizada de procesar, almacenar y recuperar los contenidos documentales. Este trabajo examina las características y ventajas de los lenguajes documentales en la era digital describiendo ejemplos de tesauros, y sus correspondientes relaciones jerárquicas, aplicados a los trastornos de la conducta alimentaria.

The increased presence and widespread use of specialized databases, as well as the possibilities for distribution offered by new technologies, require a pertinent method for analyzing documents. Indexing languages emerge from the information growth generated by the scientific revolution as a quick, standardized way to process, store and retrieve document contents. This paper examines the characteristics and advantages of documentary languages in the digital age, describing examples of thesauri and their corresponding hierarchical relationships as applied to eating disorders.

Caracterización nutricional y de la cinética de degradación ruminal dealgunos de los recursos forrajeros con potencial para la suplementaciónde rumiantes en el trópico alto de Colombia / Nutritional characterization and ruminal degradation kinetics of someforages with potential for ruminants supplementation in the highland tropics of Colombia / Caracterização nutricional e cinética de degradação ruminal de algunsdos recursos forrageiros com potencial para o suplementação de gadona nas regiões tropicais de altitude da Colômbia

El objetivo de este estudio fue caracterizar la calidad nutricional de nueve recursos forrajeros: Consuelda(Symphytum peregrinum), Morera (Morus alba), San Joaquín (Malvaviscus penduliflorus), Nacedero (Trichantheragigantea), Botón de oro (Tithonia diversifolia Hemsl. Gray), Ramio (Boehmeria nivea L. Gaud, Arboloco (Montanoa quadrangularis Bipontinus Schultz), Chachafruto (Erythrina edulis Triana ex Michelle) y Aliso (Alnus acuminata Kunth), con potencial para su inclusión en los programas de suplementación estratégica en el trópico de altura en Colombia. Los forrajes que mostraron los mayores niveles de Proteína Cruda (PC) fueron Confrey (28,42), Chachafruto (26,52%), Arboloco (26,35%) y lo que mostraron los más bajos fueron San Joaquín (15,92%) y Aliso(16,88%). Los contenidos más bajos de Fibra en Detergente Neutro (FDN) los presentaron Morera (33,55%) y Aliso(35,79%), mientras que los más altas se observaron para Chachafruto (49,64%) y Ramio (48,54%). Los contenidosde nutrientes de los forrajes evaluados pueden incluirse en planes de suplementación ya que mejoran la densidad energética de la dieta y podrían incrementar el consumo de materia seca.

The aim of this study was to characterize the nutritional quality of nine forage resources: Comfrey (Symphytum peregrinum), White Mulberry (Morus alba), Sleeping Hibiscus (Malvaviscus penduliflorus), Nacedero (Trichantheragigantea), tree marigold (Tithonia diversifolia Hemsl.) Gray, Ramie (Boehmeria nivea L.) Gaud, Arboloco (Montanoaquadrangularis Bipontinus Schultz), Chachafruto (Erythrina edulis Triana ex Michelle) and Andean Alder (Alnusacuminata Kunth), with potential for inclusion in strategic supplementation programs in the highland tropics ofColombia. The forages that showed the highest levels of PC were Comfrey (28,42%), Chachafruto (26,52%), Arboloco(26,35%) and those that showed the lowest were the Sleeping Hibiscus (15,92%) and Andean Alder (16,88%). The lowest NDF contents were presented by White Mulberry (33,55%) and Andean Alder (35,79%) while the highest wereobserved for Chachafruto (49,64%) and Ramie (48,54%). The nutrient content of forages evaluated can be included insupplementation programs, due to they can enhance the energy density of the diet and may increase dry matter intake.

O objetivo deste estudo foi caracterizar a qualidade nutricional de nove recursos forrageiros: Confrei (Symphytumperegrinum), amoreira (Morus alba), San Joaquín (Malvaviscus penduliflorus), Nacedero (Trichanthera gigantea),Botón de oro (Tithonia diversifolia Hemsl. Gray), rami (Boehmeria nivea L. Gaud), Arboloco (Montanoaquadrangularis Bipontinus Schultz), chachafruto (Erythrina edulis Triana ex Michelle) e Amieiros (Alnus acuminataKunth), com potencial para sua inclusão em programas de suplementação estratégica nas regiões tropicais de altitudeda Colômbia. As forrageiras que apresentaram os maiores níveis de PC foram Confrei (28,42%), Chachafruto(26,52%), Arboloco (26,35%) e as que mostraram os menores níveis foram a San Joaquín (15,92%) e Amieiros(16,88%). Os menores teores de FDN estavam na Amoreira (33,55%) e Amieiros (35,79%), enquanto os mais altosforam observados para Chachafruto (49,64%) e Rami (48,54%). Os conteúdos de nutrientes das forrageiras avaliadasforam incluídos nos planos de suplementação já que aumentam a densidade energética da dieta e podem aumentar aingestão de matéria seca.