Percepción de la calidad de vida en para-deportistas y no deportistas chilenos con lesión cerebral / Perception of quality of life in chilean para-athletes and non-athletes with brain injury

Cornejo, M. I., Henríquez, M., Herrera, F., Muñoz, F., Bernardes, N., Auricchio, J. R., y Castelli-Correia de Campos, L. F. (2022). Percepción de la calidad de vida en para- deportistas y no deportistas chilenos con lesión cerebral. PENSAR EN MOVIMIENTO: Revista de Ciencias del Ejercicio y la Salud, 20 (2), 1-18. La calidad de vida (CV) y la actividad física son aspectos relevantes en la salud de la población, y esta última con un impacto positivo en las personas con discapacidad. Debido a esto, los objetivos de este estudio fueron comparar las características e identificar la asociación entre los dominios de la percepción de la CV entre un grupo de personas con lesión cerebral que practican fútbol, para-deportistas (PD) y personas con lesión cerebral no para-deportistas (NPD), además determinar si existen diferencias en la percepción de la CV según las diferentes clases deportivas (FT1, FT2 y FT3). El estudio se desarrolló en Chile, donde se aplicó el cuestionario WHOQOL-BREF para determinar la CV de los participantes. Los resultados identificaron una relación positiva y significativa entre los distintos dominios de la CV (p < .001, r = .44 - .67). Además, se observó una mejor percepción de la CV en los PD (p < .001, TE = 1.18, grande) en comparación con lo reportado por el grupo NPD. Por otro lado, no se obtuvieron diferencias significativas entre los dominios para las diferentes clases deportivas en el grupo PD. Estos datos refuerzan la idea de que la práctica deportiva influye en la participación social y en la percepción de la CV en PD con lesión cerebral. El desarrollo conjunto de los factores asociados entre la salud y el bienestar socioemocional podrían colaborar con la consolidación de la práctica deportiva y de actividad física, los cuales, a su vez son beneficiosos para las personas con discapacidad tal como lo plantean los objetivos del desarrollo sostenible en su agenda de trabajo provista al año 2030.

Cornejo, M. I., Henríquez, M., Herrera, F., Muñoz, F., Bernardes, N., Auricchio, J. R., y Castelli-Correia de Campos, L. F. (2022). Perception of quality of life in chilean para-athletes and non-athletes with brain injury. PENSAR EN MOVIMIENTO: Revista de Ciencias del Ejercicio y la Salud, 20 (2), 1-16. Quality of life (QOL) and physical activity are relevant aspects in the health of the population, and the latter has a positive impact on people with disabilities. For this reason, the objectives of this study were to compare the characteristics and identify the association between the domains of QOL perception between a group of people with brain injury who practice soccer, para-athletes (PD) and non-para-athletes with brain injury (NPD), as well as to determine if there are differences in the perception of QOL according to the different sports classes (FT1, FT2 and FT3). The study was carried out in Chile, where the WHOQOL-BREF questionnaire was applied to determine the QOL of participants. The results identified a positive and significant relationship between the different domains of QOL (p < .001, r = .44 - .67). In addition, a better perception of QoL was observed in the PDs (p < .001, TE = 1.18, large) compared to that reported by the NPD group. On the other hand, no significant differences between domains were obtained for the different sport classes in the PD group. These data reinforce the idea that sport practice influences social participation and perception of QoL in PD with brain injury. The joint development of the factors associated between health and socioemotional well-being could collaborate in the consolidation of sports practice and physical activity, which, in turn, are beneficial for people with disabilities, as proposed by the Sustainable Development Goals in their work agenda foreseen for the year 2030.

Cornejo, M. I., Henríquez, M., Herrera, F., Muñoz, F., Bernardes, N., Auricchio, J. R., y Castelli-Correia de Campos, L. F. (2022). Percepção da qualidade de vida em paratletas e não-atletas chilenos com lesões cerebrais. PENSAR EN MOVIMIENTO: Revista de Ciencias del Ejercicio y la Salud, 20 (2), 1-16. Qualidade de vida (QV) e atividade física são aspectos relevantes da saúde da população, tendo esta última um impacto positivo sobre as pessoas com deficiências. Portanto, os objetivos deste estudo foram comparar as características e identificar a associação entre os domínios da percepção de QV entre um grupo de pessoas com lesões cerebrais que praticam futebol, paratletas (P) e pessoas com lesões cerebrais não paratletas (NP), e determinar se existem diferenças na percepção de QV de acordo com as diferentes classes esportivas (FT1, FT2 e FT3). O estudo foi realizado no Chile, onde o questionário WHOQOL-BREF foi utilizado para determinar o QV dos participantes. Os resultados identificaram uma relação positiva e significativa entre os diferentes domínios da QV (p < 0,001, r = 0,44 - 0,67). Além disso, uma melhor percepção de QV foi observada nos Ps (p < 0,001, TE = 1,18, grande) em comparação com a relatada pelo grupo NP. Por outro lado, não foram obtidas diferenças significativas entre os domínios para as diferentes classes esportivas do grupo P. Estes dados reforçam a ideia de que a prática esportiva influencia a participação social e a percepção da QV nos P com lesão cerebral. O desenvolvimento conjunto de fatores associados à saúde e ao bem-estar socioemocional poderia contribuir para a consolidação da prática do esporte e da atividade física, que, por sua vez, são benéficos para as pessoas com deficiência, conforme estabelecido nas Metas de Desenvolvimento Sustentável em sua agenda para 2030.

Manejo de las lesiones anexiales en el embarazo y actualización del abordaje laparoscópico / Management of adnexal masses in pregnancy and an update of the laparoscopic approach

Resumen El manejo del tumor anexial en embarazadas sigue siendo un desafío. El objetivo del siguiente trabajo es realizar una revisión bibliográfica, en la que se abordarán las diferentes alternativas en cuanto a diagnóstico y manejo del tumor anexial en embarazadas, así como también indicaciones de abordaje quirúrgico y recomendaciones para una cirugía segura. Los tumores anexiales en embarazadas son poco frecuentes, y la mayoría son benignos y tipo funcionales. La ecografía ha sido fundamental para lograr diferenciar su carácter benigno o maligno. El manejo puede ser expectante o quirúrgico. El manejo quirúrgico se reserva para ciertas características de las lesiones anexiales. En cuanto a la vía operatoria, la literatura apoya la laparoscopia mostrando que existen múltiples beneficios al compararla con la laparotomía. Para el abordaje quirúrgico existen opciones en cuanto a la técnica, siendo estas anexectomía o quistectomía. Resulta fundamental tener consideraciones especiales en la técnica debido a los cambios fisiológicos de las embarazadas, como por ejemplo la altura uterina y el tamaño del tumor anexial. A modo de conclusión, el manejo de los tumores anexiales en el embarazo sigue siendo controversial y se extrapola principalmente basándose en la literatura de pacientes no gestantes u otros procedimientos quirúrgicos en embarazadas.

Abstract Nowadays the management of the adnexal tumors in pregnant women is still a challenge. The purpose of this article is to perform a bibliographic review and present the differential diagnosis, management, and surgical approaches for the women in this condition. Adnexal tumors in pregnant women are rare, most of them are benign corresponding to functional cysts. In order to differentiate benign from malignant tumors, Ultrasonography has been one of the most important imaging advances. The management can be either expectant or surgical. Surgical management is referred for tumors with certain specific characteristics. In relation to surgical management, the literature supports laparoscopy, showing greater benefits in comparison to laparotomy. There are different options for this kind of approach. Its mandatory to have special considerations in the technique due to the physiological changes in pregnant women, some examples are the uterine and the tumor size. The management of the adnexal tumors in pregnancy is still controversial, its based on studies of non-pregnant patients or other kinds of surgeries in pregnant women.

Factores demográficos y comorbilidades asociadas a severidad de COVID-19 en un hospital chileno: el rol clave del nivel socioeconómico / Comorbidities and demographic factors associated with severe COVID-19 outcomes in a Chilean hospital

Background: Several risk factors are associated with COVID-19 severity and death, such as advanced age, male sex, and the presence of comorbidities. Aim: To study the effect of these risk factors and socioeconomic variables on the outcome of Chilean patients admitted with COVID-19 to a Chilean public hospital. Material and Methods: Review of medical records of patients admitted to a Chilean public hospital with a positive PCR test for COVID-19, Chile from March to June 2020. The outcome variable was severity (ICU admission or death). The exposure variables were age, sex, socioeconomic level, and comorbidities. A multivariable logistic regression analysis was performed. Results: Of 1,141 confirmed cases, 266 cases had a severe evolution (23.3%), including 147 deaths (fatality 12.9%). Advanced age and low socioeconomic status were the variables most strongly associated with severity. An age of 80 years or over had an odds ratio (OR) = 11.1 [95% confidence intervals (CI) 5.22-23.53]. The OR [95% CI] for a low socioeconomic level was 3.1 [1.1-8.5]. The figure for male sex was 2.13 [1.5-3.0], for chronic kidney disease was 2.65 [1.49-4.73], for obesity was 2.36 [1.65-3.39], and for diabetes 1.78 [1.22-2.61]. No significant association with severity was found for high blood pressure, chronic pulmonary disease, cardiovascular disease, or smoking. Conclusions: Following age, a low socioeconomic level was the factor with the higher association with a poor outcome or severe evolution of COVID-19.

Design of a nursing objective structured clinical examination of a first-year clinical practice program / Projeto de um exame clínico estruturado objetivo de enfermagem de um programa de prática clínica do primeiro ano / Diseño de una prueba de evaluación clínica objetiva estructurada de cuidados de enfermería del primer curso de prácticas clínicas

ABSTRACT Objective: The aim of the present study was to design a content-valid nursing objective structured clinical examination attending a first-year clinical nursing practice program. Method: The examination was designed following a procedure based on the consensus of experts which was comprised of three phases: selection of the activities in which students should be competent according to the learning outcomes of the course, clinical case design, and integration of the clinical cases designed into the stations of the test. Results: Of the 44 surveys submitted for the design of the stations, 37 were answered, of which 31 respondents met the inclusion criteria of the panel of experts. The activities on which the experts reached the highest degrees of consensus were: basic physical assessment and monitoring of vital signs, assessment of hygiene and skin status, ability to develop care plans, management of safety principles in administration of medication and administration of oral medication. Based on the selected activities, the experts developed 20 clinical cases, from which a four-station nursing objective structured clinical examination was designed. Conclusion: The structured methodology based on the design of experts enabled the design of a content-valid objective structured clinical examination appropriate for the evaluation of the learning outcomes achieved by the students attending a clinical practice program.

RESUMO Objetivo: O objetivo do presente estudo foi elaborar um exame clínico estruturado de objetivos de enfermagem com conteúdo válido, participando de um programa de prática clínica de enfermagem do primeiro ano. Método: O exame foi elaborado seguindo um procedimento baseado no consenso de especialistas que compreendeu três fases: seleção das atividades nas quais os alunos deveriam ser competentes de acordo com os resultados de aprendizagem do curso, desenho do caso clínico e integração do quadro clínico casos projetados para as estações do teste. Resultados: Das 44 pesquisas submetidas para a concepção das estações, 37 foram respondidas, das quais 31 respondentes atenderam aos critérios de inclusão do painel de especialistas. As atividades nas quais os especialistas alcançaram maior grau de consenso foram: avaliação física básica e monitoramento dos sinais vitais, avaliação da higiene e do estado da pele, capacidade de desenvolver planos de cuidados, gestão dos princípios de segurança na administração de medicamentos e administração de medicamentos orais. Com base nas atividades selecionadas, os especialistas desenvolveram 20 casos clínicos, a partir dos quais foi elaborado um exame clínico estruturado objetivo de enfermagem em quatro estações. Conclusão: A metodologia estruturada baseada na concepção de especialistas permitiu a concepção de um exame clínico estruturado objetivo válido e de conteúdo adequado para a avaliação dos resultados de aprendizagem alcançados pelos alunos que frequentam um programa de prática clínica.

RESUMEN Objetivo: El objetivo de este estudio fue diseñar una Evaluación Clínica Objetiva Estructurada con validez de contenido para evaluar el nivel de competencias de estudiantes de primer curso de formación practico-clínica enfermera. Método: Se diseñó la prueba siguiendo un procedimiento basado en consenso de expertos con tres fases: selección de las actividades en la que los alumnos debían ser competentes en base a los resultados de aprendizaje de la asignatura, diseño de casos clínicos, e integración de los casos clínicos diseñados en las estaciones de la prueba. Resultados: Las actividades que alcanzaron mayor consenso por parte de los expertos fueron: valoración física básica y monitorización de signos vitales, valoración de la higiene y estado de la piel, capacidad para elaborar planes de cuidados, manejo de los principios de seguridad en la administración de medicación y administración de medicación oral. En base a las actividades seleccionadas, los expertos elaboraron 20 casos clínicos, a partir de los cuales se diseñó una evaluación clínica objetiva estructurada de cuidados de enfermería formada por cuatro estaciones. Conclusión: La metodología estructurada basada en el diseño de expertos permitió el diseño de una evaluación clínica objetiva estructurada adecuada para evaluar los resultados de aprendizaje alcanzados por los estudiantes de primer curso de formación práctico-clínica.

Educational Interventions in Adolescents, for the Management of Obesity: A Review of the Literature

Introduction: Overweight and obesity is a serious global health problem in minors related to multiple chronic degenerative or fatal diseases.Aim: To analyze the results of available scientific studies of educational interventions in the management of overweight or obesity in adolescents.Methodology: Those studies found in a database between 2014-2019 that performed intervention or management of overweight or obesity in a population between 6 and 18 yearsof age were included.Results and Discussion: Fourteen studies met the inclusion criteria of which only three performed a probabilistic sampling being these more significant. Different types of interventions were identified from educational, cognitive-behavioral and physicalactivity promotion. The variables with the greatest significant difference were body composition and waist circumference, the Body Mass Index still has no significant difference.Conclusion: Educational interventions achieve an important role in the management of overweight or obesity having significant changes in the short, medium and long term

Relationship of Calories Intake and Physical Activity in Adolescents in Colima, Mexico: A Cross-sectional Study

Aims: To identify the relationship between calories intake, physical activity and body mass index in adolescents in Colima Mexico.Study Design: A cross-sectional study analytic, observational.Place and Duration of the Study: Colima and Tecoman, Mexico.Methodology: Itwas designed in adolescents, of both genders, with a BMI in 85thpercentile or greater, where the average daily calorie intake was quantified with the SNUT survey and the level of physicalactivity with the International Physical Activity Questionnaire. Anthropometry to obtain the BMI. The stage of change of the trans-theoretical model was identified. Statistical analysis was Pearson's r between calories and BMI and between physical activity and BMI, systolic and diastolicblood pressure with BMI, and the stages of change

Comparación de los valores de alpha ratio entre hombres y mujeres fumadores y no fumadores entre 18 y 26 años / Comparison of alpha ratio values between men and women smokers and non-smokers between 18 and 26 years

El hábito de fumar puede causar daños a la voz, incluso en etapas tempranas. El valor alpha ratio permitiría detectar cambios en el timbre de voz debido a dicho hábito, pudiendo ser un indicador preventivo de futuras patologías vocales. El objetivo de esta investigación fue determinar si existen diferencias significativas entre los valores de alpha ratio de hombres y mujeres, fumadores y no fumadores, sin patología vocal previa, de manera de respaldar su uso a nivel preventivo. Se midieron los valores Leq 0-1000 Hz y Leq 1000-5000 Hz, que componen alpha ratio, en 194 sujetos entre 18 y 26 años que no hacen uso profesional de la voz. El grupo se dividió en 32 hombres fumadores y 21 no fumadores, 61 mujeres fumadoras y 80 no fumadoras. Se grabaron sus voces en una cámara silente, utilizando los programas Audacity y PRAAT. Los valores alpha ratio en fumadores tanto en hombres como mujeres, presentaron valores promedio mayores que los no fumadores. No se encontraron diferencias significativas entre los valores de alpha ratio entre hombre fumadores y no fumadores (p = .2799) solo entre mujeres fumadoras y no fumadoras (p = .0111). Se compararon los valores Leq 0-1000 Hz y Leq 1000-5000 Hz entre mujeres fumadoras y no fumadoras encontrándose solo diferencias significativas en los valores Leq 1000-5000 Hz (p = .0095). Se puede concluir que el valor alpha ratio podría ser un buen indicador temprano de predisposición para el desarrollo de alteraciones que afecten el timbre de voz, en especial en el caso de las mujeres.

Smoking habit can cause damage to the voice, even in the early stages, which can hinder the communication process. Early identification of alterations in vocal parameters allows preventive measures to be taken prior to the generation of irreversible damage. The alpha ratio value is a vocal parameter obtained through an acoustic analysis that would allow detecting changes in the voice timbre, being able to be a preventive indicator of vocal pathologies. The objective of this investigation was to determine if there are significant differences between the alpha ratio values of men and women, smokers and non-smokers, without previous vocal pathology. The values Leq 0-1000 [Hz] and Leq 1000-5000 [Hz], which make up the alpha ratio value, were measured in 194 subjects between 18 and 26 years of age who did not use professional voice. The group was divided into 32 male smokers and 21 non-smokers, 61 females mokers and 80 non-smokers. The information gathering process was carried out in two stages: in the first one the subject was asked to inhale deeply and to emit a / a / sustained for a time of 5 seconds, for calibration and verification of parameters. In the second stage, a text of 101 words was requested: For the recording, a microphone was used 10 cm away from the face, with a 45° angle to it. Study subjects were standing at all times. The Audacity and PRAAT programs were used for recording and acoustic analysis, respectively, and for the statistical analysis the STATA version 14 program was used. Alpha ratio values in smokers (men and women) presented higher values than non-smokers. Male smokers average alpha ratio: .5181709; male non-smokers average alpha ratio value: .4972945. Female smokers, average alpha ratio: .5321025; Non-smoking women, average alpha ratio value: .5036634. However, no significant differences were found between the values of alpha ratio between male smokers and non-smokers (p = .2799) only among females mokers and non-smokers (p = .0111). When there were statistically significant differences between the alpha ratio values of smoking and non-smoking women, the values of Leq 0-1000Hz and Leq 1000-5000 Hz were analyzed independently. The mean value Leq 0-1000 Hz of female smokers was 36.80148; The mean value Leq 0-1000 Hz in non-smoking women was 35.8655. There is no significant difference between these values (p = .171). The mean value Leq 1000-5000 Hz of female smokers was 19.58016; the mean value Leq 1000-5000 Hz in non-smoking women was 18.15138; there is a significant difference between these values (p =.0095). These results are consistent with previous research since the alterations of the voice, due to tobacco damage, are manifested in frequencies above 1000 Hz, although it would have been expected that the values of smokers were lower than the non-smokers, and not higher as in this case. This could be due to the fact that the subjects in this study were healthy, with no diagnosed pathology, and are likely to be at an early stage of vocal damage and as a compensatory form their system is making an over exertion that manifests itself in more values high. From the results obtained it can be concluded that the alpha ratio value could be a good early indicator of predisposition for the development of alterations affecting voice timbre especially in the case of women. It is necessary in order to provide a correct preventive diagnosis, to establish reference values of normality that allow to identify alterations and to study how the value of alpha ratio was affected in a population of smokers with greater number of years of smoking habit.

Costo de la atención materno infantil en un sistema de salud institucionalizado / Costo of materno-infantile case in an institutionalized health system

El objetivo fue calcular el costo parcial y total de la atención materno infantil. El estudio se realizó en una Unidad de Medicina Familiar (UMF) y Hospital General de Zona (HGZ) pertenecientes a un sistema de salud institucionalizado. Se definieron los servicios utilizados, el tipo de acciones realizadas y la intensidad de la utilización en la atención materno infantil. El cálculo de los costos se efectuó de manera independiente en la UMF y el HGZ. Para la estimación de los costos fijos se requirió de departamentalización, determinación de insumos y costos, construcción de ponderadores, definición de gastos de servicios básicos; esta información se relacionó con la depreciación, el tiempo laborado y la productividad. Se definieron los supuestos adoptados para el cálculo de los costos fijos. Para el cálculo de los costos variables los insumos fueron determinados por un grupo de expertos y el costo correspondió al registrado en las notas de compra. La suma del costo fijo y variable por tipo de acción determinó el costo unitario, este se multiplicó por la intensidad de la utilización y la suma total permitió conocer el costo de la atención prenatal, del parto y postnatal; la suma de esta tres estableció el costo de la atención perinatal. El costo de la atención prenatal fue de $ 1,205.33, el de la atención del parto $ 3,314.98, el de la etapa postnatal $ 559.91 y el costo total de la atención perinatal $ 5,079.22. Esta es una información valiosa para el médico ya que puede ser utilizada en las actividades de planeación