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Rev. colomb. psicol ; 32(1): 31-40, Jan.-June 2023. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1394971


Abstract New media creates opportunities to directly measure how adolescents respond to aggressive situations. In this study, we report on SIMA, a simulator of digital chats, created to mimic online aggressive interactions within a conflict situation. Adolescents were invited to be part of a digital chat where all interactions were pre-programmed, except for the participants' interventions, to discuss controversial topics (e.g., animal maltreatment). Two chat members engaged in a conflict programmed to escalate quickly through aggressive insults. Sixth and seventh-grade students (mostly aged 12 to 14; n = 287) from one public school (low SES) and one private school (high SES) participated in the study. Responses to open questions after finishing the chat suggest that the great majority considered that they were taking part in a real online interaction. Aggressive offenses towards other members of the chat were very common. SIMA opens many options for further research about bystander behavior in aggressive online interactions.

Resumen Los nuevos medios de comunicación han creado oportunidades para medir directamente cómo los adolescentes responden a situaciones de agresión. Presentamos a SIMA, un simulador de chats digitales creado para imitar interacciones agresivas en línea en una situación de conflicto. Los adolescentes son invitados a ser parte de un chat digital para discutir temas controversiales (p. ej., maltrato animal). En realidad, las interacciones están todas preprogramadas a excepción de las intervenciones de quienes participan. Dos supuestos miembros del chat tienen un conflicto programado para escalar de forma rápida con insultos agresivos. Participaron estudiantes de sexto y séptimo grado (principalmente de 12 a 14 años; n = 287) de un colegio público (NSE bajo) y uno privado (NSE alto). Las respuestas a preguntas abiertas sugieren que la gran mayoría consideró que estaban participando en una interacción en línea real. Las ofensas agresivas hacia otros miembros del chat fueron muy comunes. SIMA abre muchas opciones para futuras investigaciones sobre el comportamiento de espectadores en interacciones agresivas en línea.

Rev. bras. cir. cardiovasc ; 37(4): 472-480, Jul.-Aug. 2022. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1394723


ABSTRACT Introduction: The objective of this study is to explore the impacts of Omaha System-based continuing care on medication compliance, quality of life (QOL), and prognosis of coronary heart disease (CHD) patients after percutaneous coronary intervention (PCI). Methods: A total of 100 CHD patients who were hospitalized and received PCI were selected and divided into the control group and the observation group, 50 patients per group, according to a random number table method. The control group was given routine care, while the observation group was applied Omaha System-based continuing care on the basis of the control group. Results: Follow-up demonstrated that the Morisky-Green score of the observation group was significantly higher than that of the control group (P<0.001), indicating that the medication compliance of the observation group was significantly better than that of the control group (P<0.001). The short form-36 (SF-36) scores were notably higher after nursing compared with on admission; SF-36 scores of the observation group were significantly increased than those of the control group (P<0.001). The incidence of major adverse cardiac event (MACE) in the observation group was significantly lower than in the control group (P<0.001). The nursing satisfaction of the observation group was considerably higher than that of the control group (P<0.01). Conclusion: Omaha System-based continuing care could improve the medication compliance and QOL, reduce the incidence of MACE, and benefit the prognosis of CHD patients after PCI.

Rev. bras. cir. cardiovasc ; 37(4): 546-553, Jul.-Aug. 2022. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1394725


Abstract Objective: To review the evidence behind the role and relevance of redo coronary artery bypass grafting (CABG) in the current practice of percutaneous coronary intervention (PCI). Methods: A comprehensive electronic literature search was performed to identify articles that discuss the practice of PCI and redo CABG in patients that require coronary revascularization. All relevant studies are summarized in narrative manner to reflect current indications and preference. Results: The advancement in utilization of PCI has reduced the rate of redo CABG in patients with previous CABG that requires revascularization of an already treated coronary disease or a new onset of coronary artery stenosis. Redo CABG is associated with satisfactory perioperative outcomes but higher mortality at immediate postoperative period when compared to PCI. Conclusion: Redo CABG patients are less likely to develop comorbidities associated with revascularisation, but the operative mortality is higher and long-term survival rates are similar in comparison to PCI. There is a need for further research into the role of redo CABG in the current advanced practice of PCI.

Rev. bras. cir. cardiovasc ; 37(4): 430-438, Jul.-Aug. 2022. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1394740


ABSTRACT Objective: To compare health-related quality of life (HRQoL) of patients primarily treated with a no-touch saphenous vein graft with that of patients who received a conventional graft. Methods: The study included all individuals treated with a percutaneous coronary intervention (PCI) on a saphenous vein graft (SVG) between January 2006 and June 2020. The RAND-36 health survey was used to assess HRQoL. The Mann-Whitney U test was used to test differences in HRQoL between the two groups. Effect size was estimated via Cohen's d. The average treatment effect between the groups was tested by propensity score matching (PSM). Results: Of the 346 patients treated with a PCI in a stenosed or occluded SVG, 165 responded to RAND-36 (no-touch: n=48; conventional: n=117). Patients with a no-touch graft reported better mean values on seven of the eight health survey domains. Statistically significant differences were observed for four of the domains, all in favour of the no-touch group. The effect size estimates indicated a small difference for five domains, with the highest values (>0.40) seen for the general health and energy/fatigue domains. PSM confirmed a statistically significant difference for the physical functioning and general health domains. Conclusion: At a mean follow-up of 5.4 years, patients who received a PCI in no-touch vein grafts showed significantly better HRQoL than those who received a PCI in conventional vein grafts.

Ciênc. Saúde Colet ; 27(8): 3053-3061, ago. 2022.
Article in English | LILACS-Express | LILACS | ID: biblio-1384466


Abstract COVID-19 has challenged health professionals in widely divergent areas, including innovation of practice, communication, multidisciplinary activities, broader use of technology, and adaptability. The role of the dietitian and other health professionals in dealing with the evolving crisis might be considered essential in treating patients. Given the limited access to various food options, nutrition screening and assessment deserves a high priority to complete a comprehensive nutrition evaluation, identify nutrition risks, prioritize care, and provide early nutrition intervention and support to all patients with or who have had, COVID-19 and are experiencing ongoing symptoms. Such an intervention would benefit the patients and the health system by reducing the length of hospital stay, ameliorating further complications, limiting hospital readmission, enhancing recovery, and assisting in the management of comorbidities and their metabolic alterations. This brief overview outlines the essential role of nutrition intervention and support as part of an integrated, multidisciplinary treatment program for the care of COVID-19 patients during the pandemic. Restrictive movements have changed consultative approaches, and the importance of Telenutrition for the effective communication of health status and recommendations.

Resumo A COVID-19 desafiou profissionais de saúde em diversas áreas, incluindo inovação da prática, comunicação, atividades multidisciplinares, uso amplo de tecnologia e adaptabilidade. O papel do nutricionista e de outros profissionais de saúde para lidar com a crise em expansão pode ser considerado essencial no tratamento de pacientes. Devido ao acesso limitado a várias opções de alimentos, a triagem e a avaliação nutricional devem ser priorizadas para a obtenção de uma avaliação nutricional abrangente, a fim de identificar riscos nutricionais, priorizar atendimento e possibilitar a intervenção nutricional precoce e o apoio a todos os pacientes com, ou que tiveram, COVID-19 e apresentem sintomas contínuos. Tal intervenção traria grande benefício aos pacientes e ao sistema de saúde, ao reduzir o tempo de internação, amenizar complicações posteriores, limitar a readmissão hospitalar, potencializar a recuperação e auxiliar no manejo das comorbidades e suas alterações metabólicas. Esta breve descrição elucida o papel essencial da intervenção nutricional e do apoio como parte de um programa de tratamento multidisciplinar para o cuidado de pacientes com COVID-19 durante a pandemia. Movimentos restritivos mudaram as abordagens consultivas e a importância da telenutrição para a comunicação eficaz do estado de saúde e das recomendações.

Rev. SPAGESP ; 23(1): 103-116, jan.-jun. 2022. tab
Article in Portuguese | LILACS, INDEXPSI | ID: biblio-1356773


RESUMO O uso das mídias digitais por bebês é um fenômeno recente. Algumas evidências apontam para associações do uso de telas na primeira infância e desfechos adversos no desenvolvimento. O objetivo deste estudo é apresentar o processo de construção, implementação e avaliação do estudo-piloto de uma intervenção educativa para pais, profissionais da saúde e educadores sobre uso de mídias digitais na primeira infância. A intervenção segue o modelo de educação continuada, consistiu em quatro encontros presenciais no formato expositivo seguido de discussão em grupo e foi avaliada em termos da aprendizagem dos participantes e satisfação com o curso. Participaram 16 pessoas, majoritariamente profissionais de saúde e educação. Os resultados indicaram melhora significativa nos conhecimentos do tema e satisfação com a intervenção, sendo discutidos de forma a subsidiar o desenvolvimento de novas intervenções sobre a temática.

ABSTRACT The use of digital media by babies is a recent phenomenon. Some evidence highlights associations between the use of screens in early childhood and adverse developmental outcomes. This study aims to report the development, implementation, and evaluation processes of an educational intervention for parents, health professionals, and educators on the use of digital media in early childhood. The intervention follows the model of continuing education, with four face-to-face meetings and presentations followed by group discussions. It was evaluated by participants' learning and satisfaction with the course. Sixteen people participated, mostly health and education professionals. The results indicate a significant improvement in participants’ knowledge and high satisfaction rates. Findings are discussed to support the development of new interventions on the subject.

RESUMEN El uso de medios digitales por parte de los bebés es un fenómeno reciente. Algunas evidencias apuntan asociaciones entre el uso de pantallas en la primera infancia y los resultados adversos del desarrollo. El objetivo del presente estudio es presentar el proceso de construcción, implementación y evaluación del estudio piloto de una intervención educativa para padres, profesionales de la salud y educadores sobre el uso de medios digitales en la primera infancia. La intervención sigue el modelo de educación continua y consistió en cuatro reuniones presenciales en formato expositivo, seguidas de discusión grupal y aún fue evaluada en términos del aprendizaje y satisfacción de los participantes con el curso. Participaron 16 personas, en su mayoría identificadas como profesionales de la salud y de la educación. Los resultados indicaron una mejora significativa en el conocimiento del tema y satisfacción con la intervención, siendo discutida con el fin de apoyar el desarrollo de nuevas intervenciones sobre el tema.

Humans , Infant , Child, Preschool , Parents , Child Development , Growth and Development , Video-Audio Media , Learning
Hacia promoc. salud ; 27(1): 176-187, ene.-jun. 2022. tab
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1375581


Resumen Objetivo: evaluar una intervención educativa en escolares y manipuladores de expendios para incrementar conocimientos y hábitos saludables en alimentación, así como en normativa, con el propósito de mejorar la disponibilidad alimentaria. Materiales y Métodos: estudio de caso, analítico y longitudinal. Se llevó a cabo una intervención educativa participativa en una escuela primaria de la ciudad de Zacatecas, México. Se intervinieron a dos grupos de estudio; escolares y manipuladores de alimentos de los diferentes expendios de la escuela de enero a julio de 2018. Se utilizaron encuestas de elaboración propia para las etapas de diagnóstico y evaluación. Para la intervención de ambos grupos se desarrollaron diferentes cursos-taller de 30-40 minutos. Con base en las pruebas t de student y Wilcoxon se determinaron las diferencias significativas con α=5%. Resultados: la intervención fue positiva en los escolares al incrementarse sus conocimientos y el consumo de alimentos frescos, tanto en el desayuno como en el lonche, en cambio, los resultados entre los manipuladores no derivaron inmediatamente hacia una mejor disponibilidad alimentaria dentro de la escuela, sino hasta que las autoridades de la institución condicionaron la oferta de productos en el expendio. Conclusiones: mediante la educación para la salud y la suma de esfuerzos entre los actores implicados en la intervención educativa, se contribuyó a crear un entorno alimentario escolar saludable. Es necesario dar seguimiento a estas acciones y hacer valer la normativa para reforzar los procesos de cambio hacia mejores prácticas alimentarias entre los escolares y manipuladores del expendio.

Abstract Objective: To evaluate an educational intervention in school children and dispenser handlers to increase knowledge and healthy nutritional habits as well as in regulations with the purpose of improving food availability. Materials and Methods: Analytical and longitudinal case study. A participatory educational intervention was carried out in a primary school in the city of Zacatecas, Mexico. Two study groups were intervened: school children and dispenser handlers from the different school cafeterias from January to July 2018. Self-made surveys were used for the diagnosis and evaluation stages. Different 30-40-minute study-workshops were developed for the intervention of both groups. Based on the Student and Wilcoxon t tests, the significant differences were determined with α = 5%. Results: The intervention was positive in the school children as their knowledge and consumption of fresh food increased both at breakfast and lunch. On the other hand, the results among the dispenser handlers did not immediately led to better food availability within the school but until the authorities of the institution conditioned the offer of products in the cafeterias. Conclusions: Through health education and the sum of efforts between the actors involved in the educational intervention, it was possible to contribute to the creation of a healthy school nutritional environment. It is necessary to monitor these actions and enforce the regulations to reinforce the processes of change towards better food practices among school children and dispenser handlers.

Resumo Objetivo: avaliar uma intervenção educativa em escolares e manipuladores de lanchonetes para incrementar conhecimentos e hábitos saudáveis na alimentação, assim como em normativa, com o propósito de melhorar à disponibilidade alimentar. Materiais e Métodos: estudo de caso, analítico e longitudinal. Realizou-se uma intervenção educativa participativa em uma escola básica da cidade de Zacatecas, México. Afetaram-se a dois grupos de estudo; escolares e manipuladores de alimentos das diferentes lanchonetes da escola de janeiro a julho de 2018. Utilizaram-se enquetes de elaboração própria para as etapas de diagnóstico e avaliação. Para a intervenção de ambos grupos se desenvolveram diferentes cursos-oficinas de 30-40 minutos. Com base nas provas t de student e Wilcoxon se determinaram as diferenças significativas com α=5%. Resultados: a intervenção foi positiva nos escolares ao incrementar-se seus conhecimentos e o consumo de alimentos frescos, tanto no café da manhã como no lanche, em cambio, os resultados entre os manipuladores não derivaram imediatamente para uma melhor disponibilidade alimentaria dentro da escola, senão até que as autoridades da instituição condicionaram a oferta de produtos na lanchonete. Conclusões: através da educação para a saúde e a soma de esforços entre os atores envolvidos na intervenção educativa, contribuiu-se a criar um entorno alimentar escolar saudável. É preciso dar seguimento a estas ações e fazer valer a normativa para reforçar os processos de cambio para melhores práticas alimentares entre os escolares e manipuladores da lanchonete.

Rev. Assoc. Med. Bras. (1992) ; 68(6): 802-807, June 2022. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1387160


SUMMARY OBJECTIVE: A decrease in the left ventricular ejection fraction (≤40%) in the setting of ST-segment elevation myocardial infarction is a significant predictor of mortality in the young ST-segment elevation myocardial infarction population. In this study, we aimed to investigate the predictors of left ventricular ejection fraction reduction and evaluate the long-term mortality rates in young ST-segment elevation myocardial infarction patients with or without decreased left ventricular ejection fraction. METHODS: We enrolled retrospectively 411 consecutive ST-segment elevation myocardial infarction patients aged 45 years or below who underwent primary percutaneous coronary intervention. Young ST-segment elevation myocardial infarction patients were divided into two groups according to their left ventricular ejection fraction (≤40%, n=72 and >40%, n=339), which were compared with each other. RESULTS: Statin use, white blood cell count, C-reactive protein, peak creatine kinase-MB, prolonged ischemia time, left anterior descending artery-related infarction, proximally/ostial located lesion, and no-reflow were independently associated with low left ventricular ejection fraction. Additionally, long-term mortality was considerably higher in the left ventricular ejection fraction ≤40% group than those in the left ventricular ejection fraction>40% group (18.1% versus 2.4%; p<0.001). CONCLUSIONS: In young ST-segment elevation myocardial infarction patients, lesion properties (left anterior descending lesion, proximally located lesion), no-reflow, and prolonged ischemia time appeared to be important determinants for the left ventricular ejection fraction decline, rather than coronary disease severity or demographic and hematological parameters. Statin use may be preventive in the development of left ventricular ejection fraction decline in young ST-segment elevation myocardial infarction patients.

Rev. chil. nutr ; 49(3)jun. 2022.
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1388611


RESUMEN Introducción: La desnutrición hospitalaria es un proceso multicausal y de alta prevalencia. La intervención nutricional temprana mejora el pronóstico de los pacientes afectados y reduce los costos sanitarios. Objetivo: Estimar la diferencia de costo efectividad de la atención de rutina comparado con la intervención nutricional temprana, en pacientes en riesgo nutricional, en un Hospital Universitario de alta complejidad entre marzo y octubre de 2012. Materiales y métodos: Estudio de evaluación económica en 165 pacientes adultos hospitalizados de especialidades médicas y quirúrgicas. Se tomó como referencia la información de un estudio de intervención cuasi experimental realizado en el año 2012. Se estratificaran los pacientes de acuerdo a días de estancia hospitalaria, complicaciones y estado nutricional según grupo de intervención y se obtuvieron los costos sanitarios. Resultados: La mediana en el costo por paciente con complicaciones fue de US$ 3.950 en el grupo de intervención nutricional temprana comparado con US$ 5.301 por la atención de rutina; para la estancia hospitalaria fue de US$ 2.462 vs US$ 4.201 y para los recursos derivados de optimización del peso fue de US$ 3.627 vs US$ 5.132 respectivamente. Conclusión: La intervención nutricional temprana en los pacientes en riesgo nutricional, disminuyó los costos derivados de complicaciones, estancia hospitalaria y optimización del estado nutricional.

ABSTRACT Introduction: Hospital malnutrition is a highly prevalent process with multiple causes. Early nutritional intervention improves the prognosis of affected patients and reduces health costs. Objective: To estimate the cost-effectiveness of routine care compared with early nutritional intervention, in patients at nutritional risk, in a high complexity university hospital between March and October 2012. Materials and methods: Economic evaluation study in 165 adult hospitalized medical and surgical specialty patients. The information from a quasi-experimental intervention study conducted in 2012 was taken as a reference. Patients were stratified by intervention group according to days of hospital stay, complications and nutritional status; health costs were also obtained. Results: For the early nutritional intervention group compared to routine care, the median cost per patient with complications was US$ 3,950 vs US$ 5,301; US$ 2,462 vs US$ 4,201 for hospital stay and US$ 3,627 vs US$ 5,132 for resources derived from weight optimization, respectively. Conclusion: The early nutritional intervention in patients at nutritional risk, decreased the costs derived from complications, hospital stay, and optimization of nutritional status.

Rev. chil. nutr ; 49(3)jun. 2022.
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1388619


RESUMEN La educación alimentaria nutricional es la combinación de estrategias educativas, acompañadas de apoyos ambientales, diseñadas para facilitar la adopción voluntaria de elecciones alimentarias que conducen a un estado óptimo de salud y bienestar. La educación alimentaria nutricional tiene tres componentes: 1) motivación, 2) acción y 3) ambiente. Para elegir la técnica de educación adecuada para cada persona, se deben considerar las características psicoemocionales individuales, especialmente las motivaciones para el cambio y el tipo de personalidad, ya que ambos han mostrado ser buenos predictores de la conducta alimentaria. Dentro de los recursos educativos posibles de utilizar para realizar la educación en alimentación nutricional se encuentran indicaciones verbales, material escrito, uso de internet, dispositivos portátiles, aplicaciones de teléfonos inteligentes, e incluso la clase de cocina. La evidencia demuestra que la educación alimentaria nutricional impacta favorablemente la adherencia a las intervenciones nutricionales, lo cual a la vez se ve reflejado en efectos positivos en la salud.

ABSTRACT Food and nutrition education is the combination of educational strategies, accompanied by environmental supports designed to facilitate voluntary adoption of food choices conducive of health and well-being. It has a motivational phase, an action phase, and an environmental component. To choose the right educational technique for each patient, their individual psychoemotional characteristics must be considered; especially what their motivations for change are, as well as their personality type, because both are good predictors of food behavior. Among the resources that can be used to perform nutrition education are verbal indications, written material, the internet, mobile devices, smartphone applications, and even the kitchen as a place for education. Evidence shows that nutrition education has a favorable impact on diet adherence in different conditions that have an important nutritional component, such as celiac disease, inflammatory bowel disease, diabetes and obesity, which at the same time produces positive health outcomes.

Rev. bras. cir. cardiovasc ; 37(2): 200-206, Apr. 2022. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1376527


Abstract Introduction: Drug-eluting stents (DES) coated with rapamycin or paclitaxel as antiproliferative substances significantly reduced the incidence of clinical restenosis and had fewer side effects after percutaneous coronary intervention. However, DES coated with rapamycin or paclitaxel still cause restenosis due to abnormal tissue growth which remained a therapeutic problem, particularly in certain subgroups, possibly due to drug concentrations. This study examined the impact of different concentrations of rapamycin and paclitaxel on cytokine, cell viability and proliferation in human aortic smooth muscle cells (HASMC)-derived foam cells. Methods: The foam cell model was established in vitro by incubating HASMC with 20 µg/mL oxidized low-density lipoprotein (ox-LDL) for 48 hours. Subsequently, foam cells were treated with different concentrations (0.01 µg/mL, 0.1 µg/mL, 0.5 µg/mL, 1 µg/mL, 5 µg/mL and 10 µg/mL) of rapamycin or paclitaxel for 48 hours, to measure cytokine, cell viability and proliferation by ELISA and MTT, respectively. Finally, viability and proliferation were measured by MTT after the foam cells were treated with 1 µg/mL rapamycin or paclitaxel combined with cytokine antibody for 48 hours. Results: After incubation of HASMC with ox-LDL, the ratios of cholesterol ester and total cholesterol increased significantly (55.29%) (P<0.01). Lipid staining with Oil Red O showed many lipid vacuoles and red dye particles in the cells. Meanwhile, cell viability and proliferation significantly increased compared with the control. This indicated that HASMC had been transformed into foam cells (P<0.01) while rapamycin or paclitaxel concentrations ≥0.1 µg/mL can significantly decrease the foam cell proliferation (P<0.05 or P<0.01), and 1 µg/mL of rapamycin or paclitaxel appeared the most effective concentration. As for cytokines, rapamycin or paclitaxel concentrations ≥1 ug/mL could significantly increase the level of inflammatory cytokines IL-6 (P<0.05 or P<0.01), which was enhanced with the increase of drug concentration. However, rapamycin or paclitaxel concentrations ≥1 µg/mL could significantly reduce the levels of anti-inflammatory cytokines IL-35 and transforming growth factor beta (TGF-β) (P<0.05 or P<0.01), which decreased with the increase of drug concentration. In addition, rapamycin or paclitaxel combined with anti-IL-1β, anti-IL-6, anti- TNF-α or anti-IL-35 had no significant effect on foam cell proliferation compared to the drug alone. However, rapamycin or paclitaxel combined with anti-IL-10 or anti-TGF-β can significantly enhance foam cell proliferation (P<0.01). In addition, there was no difference in the effects of the same concentrations of rapamycin and paclitaxel on foam cells. Conclusion: Although rapamycin or paclitaxel can reduce foam cell proliferation, too high or too low concentrations could decrease effectiveness. In particular, a high dose can induce foam cells to increase inflammatory cytokines secretion, reduce anti-inflammatory cytokines secretion, and thus affect the inhibiting proliferation. For rapamycin- and paclitaxel-eluting stents, this conclusion may explain the clinical observation of in-stent restenosis after percutaneous coronary intervention. DES coated with an appropriate concentration of rapamycin or paclitaxel may, at least to some extent, contribute significantly to reducing incidence of late in-stent restenosis.

Rev. enferm. Inst. Mex. Seguro Soc ; 30(1): 6-13, 04-abr-2022.
Article in Spanish | LILACS | ID: biblio-1378890


Introducción: el personal de enfermería tiene una participación fundamental en el manejo de los residuos peligrosos biológico-infecciosos (RPBI) durante la atención en salud, situación que hace indispensable el conocimiento respecto a la peligrosidad y riesgo en el manejo de estos residuos. Objetivo: evaluar el impacto de una intervención educativa acerca del conocimiento y manejo de RPBI, en el personal de enfermería de un hospital general regional. Metodología: estudio cuasi experimental, pretest/postest, prospectivo y longitudinal. Se realizó una intervención educativa, y antes y después de esta se aplicó un cuestionario para evaluar conocimientos relacionados con RPBI y una lista de cotejo del Modelo Institucional para la Prevención de Infecciones Nosocomiales (MIPRIN) para evaluar el manejo de RPBI. Resultados: la intervención educativa demostró un efecto positivo en los conocimientos del personal de enfermería en relación con el manejo de RPBI. En la evaluación pretest se obtuvo un porcentaje de conocimientos de 65.2% y en la postest fue de 78.3% (p < 0.001). Respecto al cumplimiento en el manejo de RPBI, hubo un incremento; sin embargo, no se puede atribuir a la intervención, puesto que se evaluó por servicio y no de manera directa con los participantes. Conclusión: la intervención educativa mostró cambios significativos en los conocimientos y el manejo de RPBI del personal de enfermería.

Introduction: Nursing staff represent an important percentage in the management of biological hazardous waste (BHW) during health care, a situation that makes this knowledge essential regarding the danger and risk in handling these wastes. Objective: To evaluate the impact of an educational intervention about the knowledge and management of BHW in the nursing staff of a regional general hospital. Methods: quasi-experimental, pre-test/post-test, prospective and longitudinal study. An educational intervention was carried out; before and after this intervention, a questionnaire was administered to evaluate knowledge related to BHW and a checklist of the Institutional Model for the Prevention of Nosocomial Infections (MIPRIN, according to its initials in Spanish) to evaluate the management of BHW. Results: The educational intervention showed a positive effect in the nursing staff's knowledge in relation to BHW. In the pre-test evaluation a knowledge percentage of 65.2% was obtained and in the post-test evaluation it was 78.3% (p < 0.001). Regarding compliance in the management of BHW there was an increase; however, it cannot be attributed to the intervention, since it was evaluated by service and not directly with the participants.

Humans , Male , Female , Biological Products/administration & dosage , Hazardous Waste/prevention & control , Waste Management/statistics & numerical data , Nursing Staff/education , Surveys and Questionnaires , Longitudinal Studies
Rev. colomb. cardiol ; 29(2): 185-198, ene.-abr. 2022. tab, graf
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1376877


Resumen Objetivo: Realizar un metaanálisis de la frecuencia de hiperreactividad plaquetaria (HPR) para aspirina y clopidogrel con diferentes agregómetros, en pacientes con diabetes mellitus (DM) e hipertensión (HTA) sometidos a intervención coronaria percutánea (ICP). Método: Revisión sistemática con metaanálisis a partir de 40 búsquedas en tres bases de datos multidisciplinarias (PubMed, ScienceDirect y SciELO), siguiendo las fases de la guía PRISMA entre los años 2005 y 2021. Se garantizaron la reproducibilidad y la calidad metodológica por parte de dos investigadores que usaron la guía STROBE. Los análisis se basaron en frecuencias y metaanálisis de razón de disparidad, para lo cual se empleó el software Epidat con un intervalo de confianza del 95%. Resultados: Se incluyeron 22 estudios. La frecuencia de hiperreactividad plaquetaria para la aspirina fue desde el 18.8% hasta el 81.8% y para el clopidogrel desde el 18.2% hasta el 71.3%, lo que denota una importante heterogeneidad. Se observó que la frecuencia de hiperreactividad plaquetaria en pacientes diabéticos varió del 21% al 78.7%, mientras que en los pacientes hipertensos fue del 17.6% al 76.8%, y finalmente, la hiperreactividad plaquetaria fue 1,38 veces mayor en los pacientes diabéticos que en aquellos que no lo eran y 1,23 veces mayor en los pacientes hipertensos que en aquellos que no lo eran. Conclusiones: La diabetes mellitus y la hipertensión arterial, como enfermedades de base en pacientes sometidos a intervención coronaria percutánea, están asociadas a hiperreactividad plaquetaria, y esta, a su vez, como demostraron estudios previos, al desarrollo de eventos vasculares a largo plazo. De ahí que una valoración posterior al procedimiento con pruebas de agregometría plaquetaria resultaría potencialmente útil en el marco de la terapia personalizada.

Abstract Objective: To perform a metaanalyze of the frequency of platelet hyperreactivity for aspirin and clopidogrel with different aggregometers, in patients with diabetes mellitus and hypertension undergoing percutaneous coronary intervention. Method: Systematic review with metaanalysis using 40 searches in three multidisciplinary databases (PubMed, ScienceDirect and SciELO), following the phases of the PRISMA guide between the years 2005 and 2021. Reproducibility and methodological quality were guaranteed by two researchers using the STROBE guide. The analyzes were based on frequencies and odds ratio metaanalysis, using Epidat software with a 95% confidence interval. Results: 22 studies were included, the frequency of platelet hyperreactivity was from 18.8% to 81.8% in the case of aspirin, and in the case of clopidogrel from 18.2% to 71.3%, which denotes an important heterogeneity. It was observed that the frequency of platelet hyperreactivity in diabetic patients ranged from 21% to 78.7% and in hypertensive patients from 17.6% to 76.8%, and finally it was observed that the platelet hyperreactivity was 1.38 times higher in diabetic patients than in those who were not and 1.23 times higher in hypertensive patients than in those who were not. Conclusions: Diabetes mellitus and hypertension as underlying pathologies in patients undergoing percutaneous coronary intervention are associated with the presence of platelet hyperreactivity, and this in turn -as shown by previous studies-, with the development of long-term vascular events, therefore a subsequent assessment. The procedure with platelet aggregometry tests would be potentially useful in the context of personalized therapy.

Arq. bras. cardiol ; 119(1): 25-34, abr. 2022. tab, graf
Article in Portuguese | LILACS-Express | LILACS | ID: biblio-1383723


Resumo Fundamento: O desconhecimento do paciente sobre o infarto agudo do miocárdio, suas complicações e os benefícios da revascularização precoce é um ponto crucial na determinação dos desfechos. Além disso, a relação entre fatores socioeconômicos e apresentação do paciente à intervenção coronária percutânea primária (ICPP) não foi totalmente estudada. Objetivos: Nosso objetivo foi investigar se o desconhecimento do paciente e outros fatores socioeconômicos impactam na apresentação do paciente à ICPP. Métodos: O estudo compreendeu 570 pacientes com infarto agudo do miocárdio com supradesnivelamento do segmento ST (IAMCSST) revascularizados por ICPP. Os pacientes foram classificados em dois grupos de acordo com o tempo total de isquemia (tempo desde o início dos sintomas do IAMCSST até a dilatação com balão); grupo I: Pacientes com apresentação precoce (1-12 horas). Grupo II: Pacientes com apresentação tardia (>12-24 horas). Fatores socioeconômicos, desfechos clínicos incluindo mortalidade e eventos cardíacos adversos maiores (ECAM) foram avaliados em cada grupo. O valor de p < 0,05 foi considerado estatisticamente significante. Resultados: Existem diferentes fatores socioeconômicos que afetam a apresentação do paciente à ICPP. A análise de regressão multivariada identificou os preditores socioeconômicos independentes da seguinte forma: baixa escolaridade - OR 4,357 (IC95% 1,087-17,47, p=0,038), isolamento social - OR 4,390 (IC95% 1,158-16,64, p=0,030) e desconhecimento sobre os benefícios da revascularização precoce - OR 4,396 (IC95% 1,652-11,69, p =0,003). A mortalidade e ECAM foram mais altas no grupo II. Conclusão: O desconhecimento do paciente e o baixo nível socioeconômico foram associados à apresentação tardia para a ICPP, com desfechos mais adversos.

Abstract Background: Patient unawareness about acute myocardial infarction, its complications and the benefits of early revascularization is a crucial point that determines the outcomes. Moreover, the relationship between socioeconomic factors and patient presentation to primary percutaneous coronary intervention (PPCI) has not been fully studied. Objectives: Our objective was to investigate whether or not patient unawareness and other socioeconomic factors impact patient presentation to PPCI. Methods: The study comprised 570 patients with ST-segment elevation myocardial infarction (STEMI) revascularized by PPCI. The patients were classified into two groups according to the total ischemia time (the time from STEMI symptom onset to balloon dilatation); group I: Patients with early presentation (1-12 hours). Group II: Patients with late presentation (>12-24 hours). Socioeconomic factors, clinical outcomes including mortality and major adverse cardiac events (MACE) were evaluated in each group. A p-value < 0.05 was considered statistically significant. Results: There are different socioeconomic factors affecting patient presentation to PPCI. Multivariate regression analysis identified the independent socioeconomic predictors as following: low educational level - OR 4.357 (CI95% 1.087-17.47, p=0.038), social isolation - OR 4.390 (CI95% 1.158-16.64, p=0.030) and unawareness about the benefits of early revascularization - OR 4.396 (CI95% 1.652-11.69, p=0.003). Mortality and MACE were higher in group II. Conclusion: Patient unawareness and low socioeconomic status were associated with late presentation to PPCI with more adverse outcomes.

Article in Spanish | LILACS-Express | LILACS | ID: biblio-1386332


RESUMEN La disfunción del nódulo sinusal (DNS) es generalmente secundaria a la senescencia del nodo sinusal y del miocardio auricular circundante. Estamos presentando un paciente de 59 años de edad, hipertenso sin tratamiento y con antecedente de síncope en dos oportunidades en los últimos 4 meses. Ingresa debido a un flutter auricular con conducción auriculoventricular 1:1 con una frecuencia cardiaca de 280 lat/min que cede con goteo de amiodarona. Un Holter de 24 horas demostró un ritmo sinusal predominante, episodios paroxísticos de fibrilación auricular con respuesta ventricular alta, bradicardia sinusal de 47 lat/min. Se realizó el diagnóstico de disfunción del nódulo sinusal, Rubenstein tipo III (Síndrome Bradicardia-Taquicardia). Una coronariografía constató una estenosis del 80% en segmento proximal de la arteria coronaria derecha con componente espástico. La arteria del nódulo sinusal emerge del segmento proximal de la coronaria derecha. Se realizó una angioplastia exitosa con stent medicado. Otro estudio Holter de 24 horas de control pos-angioplastia registró nuevamente episodios paroxísticos de fibrilación auricular con respuesta ventricular alta y episodios de pausas de hasta 3.100 milisegundos por lo que se implantó un marcapasos bicameral. A pesar del restablecimiento de un flujo sanguíneo adecuado a la arteria del nódulo sinusal con la angioplastia de la coronaria derecha no se obtuvo una mejoría de la disfunción del nódulo sinusal.

ABSTRACT Sinus node dysfunction (SND) is generally secondary to senescence of the sinus node and the surrounding atrial myocardium. We are presenting a 59-year-old patient, hypertensive without treatment and with a history of syncope on two occasions in the last 4 months. He was admitted due to a 1: 1 atrioventricular conduction atrial flutter with a heart rate of 280 beats/min that subsides with an amiodarone drip. A 24-hour Holter monitor showed predominant sinus rhythm, paroxysmal episodes of atrial fibrillation with high ventricular response, sinus bradycardia of 47 beats/min. The diagnosis of sinus node dysfunction, Rubenstein type III (Bradycardia-Tachycardia Syndrome) was made. A coronary angiography confirmed an 80% stenosis in the proximal segment of the right coronary artery with a spastic component. The sinus node artery emerges from the proximal segment of the right coronary artery. A successful angioplasty was performed with a medicated stent. Another 24-hour Holter study of post-angioplasty control again recorded paroxysmal atrial fibrillation with high ventricular response episodes and pause episodes of up to 3,100 milliseconds, for which a dual-chamber pacemaker was implanted. Despite the restoration of adequate blood flow to the sinus node artery with right coronary angioplasty, no improvement in sinus node dysfunction was obtained.

Psicol. Caribe ; 39(1): e206, ene.-abr. 2022. tab, graf
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1386971


Abstract. This review provides a qualitative comparative analysis of theoretical and methodological aspects of 27 studies in which the results of the implementation of programs involved in child maltreatment are presented with an attachment perspective. The studies were examined following the Scottish Intercollegiate Guidelines Network. It was found that the programs promote the development of maternal sensitivity, mentalization or reflective functioning and empathy, however, the underlying mechanisms are not differentiated according to the type of abuse to intervene. Likewise, it was found that despite the recognition of the mother's violent childhood experiences as one of the main predisposing factors for child abuse, it is a variable that is scarcely considered in the programs examined. These findings indicate the importance of developing intervention programs that consider a cumulative ecological risk perspective.

Ter. psicol ; 40(1)abr. 2022.
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1390478


Resumen Antecedentes Durante los últimos años ha proliferado el uso de las Tecnologías de la Información y la Comunicación (TIC) para mejorar la efectividad y eficiencia de la intervención psicológica, incluyéndose en este grupo el uso de apps para dispositivos móviles. Objetivo Examinar la disponibilidad de apps puestas a pruebas empíricamente para el tratamiento psicológico de los trastornos emocionales. Método Se realizó una búsqueda bibliográfica de trabajos publicados desde 2016 en las bases de datos Scopus , Web of Science y PubMed . Se seleccionaron aquellos artículos que estudiaban el funcionamiento de una app en población adulta para la intervención psicológica en trastornos emocionales (trastornos de ansiedad, depresivos, límite de la personalidad, somatoformes y disociativos). La selección de los estudios incluidos se llevó a cabo por dos revisores, que resolvieron las discrepancias mediante consenso. Resultados De 485 artículos identificados, se seleccionaron 14 para la revisión sistemática. Los resultados se presentan en función del trastorno emocional al que va dirigido la app . Conclusiones: la disponibilidad de apps empíricamente validadas para la intervención en trastornos emocionales, si bien ha aumentado durante los últimos años, es todavía limitada. Sin embargo, existen resultados prometedores que apuntan hacia la importancia de seguir desarrollando y estudiando la eficacia y efectividad del uso de apps para potenciar la calidad y eficiencia de la atención psicológica.

Abstract Background In recent years, the use of ICTs to improve the effectiveness and efficiency of psychological intervention has proliferated, including the use of apps for mobile devices. Objective To examine the availability of empirically tested apps for the psychological treatment of emotional disorders. Method a literature search of papers published since 2016 in the Scopus, Web of Science and PubMed databases was conducted. It was selected those articles that studied the functioning of an app in the adult population for psychological intervention in emotional disorders (anxiety disorders, depressive disorders, borderline personality disorder, somatoform and dissociative disorders). The selection of included studies was carried out by two reviewers, who resolved discrepancies by consensus. Results Of 485 articles identified, 14 were selected for systematic review. Results are presented according to the emotional disorder targeted by the app. Conclusions The availability of empirically validated apps for intervention in emotional disorders, although increasing in recent years, is still limited. However, there are promising results that point to the importance of continuing to develop and study the efficacy and effectiveness of the use of apps to enhance the quality and efficiency of psychological care.

Arq. gastroenterol ; 59(1): 22-28, Jan.-Mar. 2022. tab
Article in English | LILACS-Express | LILACS | ID: biblio-1374430


ABSTRACT Background Malnutrition is common in liver cirrhosis patients that is correlated with early complications, morbidity and mortality. Objective The purpose of the study was to assess nutritional status, impact of nutritional screening and intervention in liver cirrhosis patients by evaluating their actual energy and protein intake during hospital stay. Methods A cross sectional study was conducted wherein all patients' nutritional status was defined by Subjective Global Assessment tool. Adequate energy and protein supply were planned and executed by using individualized nutritional plan for patients with dietitian's collaboration. Anthropometric measurements included height, weight, body mass index, mid upper arm circumference, hand grip strength and triceps skin-fold thickness. Biochemical tests included haemoglobin, mean corpuscular haemoglobin, volume and concentration, albumin and liver function tests. To record the daily food intake, a 24-hour dietary recall was used. Results Overall 83 patients (mean age 55) were included, among them 46% of patients were moderately malnourished, 12% were normal, while 42% of cirrhotic patients were severely depleted according to Subjective Global Assessment. The mean intake of calories and protein was improved during stay in hospital after nutritional intervention and critical monitoring (P<0.05). Anthropometric measurements at baseline and discharge showed significant differences (P <0.05) in weight, body mass index, triceps skin fold thickness and mid upper arm circumference values, but not in hand grip strength that was associated with malnourishment among patients. Conclusion Providing individualized nutritional intervention and its monitoring by qualified dietitians during hospital stay helps to improve intake in patients that prevent further risk of malnutrition and related complications.

RESUMO Contexto A desnutrição é comum em pacientes com cirrose hepática e está correlacionada com complicações precoces, morbidade e mortalidade. Objetivo O objetivo do estudo foi avaliar o estado nutricional, o impacto da triagem nutricional e a intervenção em pacientes com cirrose hepática, avaliando sua ingestão real de energia e proteína durante a internação hospitalar. Métodos Foi realizado um estudo transversal em que o estado nutricional de todos os pacientes foi definido pela ferramenta de Avaliação Global Subjetiva. O fornecimento adequado de energia e proteína foi planejado e executado por meio de plano nutricional individualizado para pacientes com colaboração de nutricionista. As medidas antropométricas incluíram: altura, peso, índice de massa corporal, circunferência do braço médio, força de aderência da mão e espessura da dobra da pele tríceps. Os testes bioquímicos incluíram: hemoglobina, volume e concentração da hemoglobina corpuscular média, albumina e testes de função hepática. Para registrar a ingestão diária de alimentos, foi utilizado um recall dietético de 24 horas. Resultados Ao todo foram incluídos 83 pacientes (média de 55 anos), entre eles 46% dos pacientes estavam moderadamente desnutridos, 12% estavam normais, enquanto 42% dos pacientes cirróticos estavam severamente depletados de acordo com a Avaliação Global Subjetiva. A ingestão média de calorias e proteínas foi melhorada durante a internação hospitalar após intervenção nutricional e monitoramento crítico (P<0,05). As medidas antropométricas na linha de base e descarga apresentaram diferenças significativas (P< 0,05) em peso, índice de massa corporal, espessura da dobra da pele do tríceps e valores médios de circunferência do braço, mas não na força de aderência da mão que estava associada à desnutrição entre os pacientes. Conclusão Proporcionar intervenção nutricional individualizada e seu acompanhamento por nutricionistas qualificados durante a internação hospitalar ajuda a melhorar a ingestão em pacientes que previnem maior risco de desnutrição e complicações relacionadas.