Telemedicina en tiempos de covid-19 ¡más que un medio, una oportunidad! / Telemedicine in times of covid-19. More than a means, an opportunity!

La telemedicina se implementó en muchos países en tiempo de pandemia por el nuevo Coronavirus, los beneficios que brinda y cómo podemos mejorar los servicios de atención en el sistema nacional de salud en el Ecuador. Objetivo: describir el proceso en telemedicinas en tiempos de COVID-19. Materiales y métodos: El presente artículo fue realizado bajo la perspectiva de una revisión bibliográfica de nivel descriptivo, monográfico. La técnica aplicada fue el fichaje bibliográfico y el análisis sistemático de los documentos encontrados en la web. Conclusión: Se describen brevemente los logros en los países como China, España, América latina y la implementación en el sistema nacional de salud ecuatoriano como estrategia para cubrir la demanda de atención que se presentaron en los meses con más altos de contagios por Covid-19, además de recomendaciones desde la medicina familiar para continuar implementando la Telemedicina en el primer nivel de atención en tiempos de pandemia(AU)

Telemedicine was implemented in many countries in times of the new Coronavirus pandemic, the benefits it provides and how we can improve care services in the national health system in Ecuador. Objective: to describe the telemedicine process in times of COVID-19. Materials and methods: This article was carried out from the perspective of a descriptive, monographic level bibliographic review. The applied technique was the bibliographic record and the systematic analysis of the documents found on the web. Conclusion: Theachievements in countries such as China, Spain, Latin America and the implementation in the Ecuadorian national health system as a strategy to cover the demand for care that occurred in the months with the highest number of infections by Covid-19 are briefly described. , in addition to recommendations from family medicine to continue implementing Telemedicine at the first level of care in times of pandemic(AU)

Influencia del marketing social en el consumo de alcohol y tabaco en los estudiantes universitarios / The influence of social marketing in alcohol and tobacco consumption in university students

Introducción: El consumo de alcohol y tabaco en las regiones de América Latina es el más alto en comparación con el resto del mundo. Los adolescentes y adultos varones se identifican como uno de los grupos de mayor vulnerabilidad. El marketing social constituye una herramienta que influye en el comportamiento de las personas, por lo que se pueden fomentar estilos de vida más saludables, e implementarse estrategias para que los individuos y las comunidades tomen conciencia con respecto a su salud, a través del cambio en sus rutinas, conductas y pensamientos. Objetivo: Evaluar la influencia del marketing social en la reducción del consumo de alcohol y tabaco en los estudiantes de la Universidad de las Fuerzas Armadas ESPE. Métodos: La investigación fue de tipo descriptiva-correlacional. Se emplearon métodos teóricos y empíricos, y se utilizó la técnica de observación científica a través de datos primarios obtenidos de una encuesta aplicada a los estudiantes de los niveles desde sexto hasta noveno semestres de la carrera Ingeniera Comercial de la Universidad de las Fuerzas Armadas ESPE. El procesamiento de datos se realizó mediante SPSS. Resultados: El tipo de consumo más recurrente fue el alcohol en jóvenes universitarios de la Universidad de las Fuerzas Armadas ESPE. Los resultados coincidieron en que el consumo de alcohol y tabaco estuvo relacionado con la influencia de las amistades y el lugar más recurrente de uso de estas sustancias resultó la Universidad. Se determinó que el marketing social podría influenciar medianamente en el comportamiento de los estudiantes, con el apoyo de las redes sociales, a través de campañas de acción, desmotivación de vicios, y mensajes de salud y vida. Conclusiones: Los resultados indicaron la necesidad de elevar la efectividad de los programas y las actividades de marketing social dirigidos a la reducción del consumo de alcohol y tabaco en la comunidad universitaria, ya que existe un gran porcentaje de consumo de dichas sustancias(AU)

Introduction: Alcohol and tobacco consumption in the regions of Latin America is the highest compared to the rest of the world. Teenagers and adult males identify themselves as one of the most vulnerable groups. Social marketing is a tool that influences people's behavior, so you can promote healthier lifestyles, and implement strategies so that individuals and communities become aware of their health, through the change in their routines, behaviors and thoughts. Objective: To evaluate the influence of social marketing in reducing alcohol and tobacco consumption in the students from the University of the Armed Forces ESPE in Ecuador. Methods: The research was descriptive-correlational. Theoretical and empirical methods were used, and the technique of scientific observation was used through primary data obtained from a survey applied to students from the sixth to ninth semesters of the Commercial Engineering career of the University of the Armed Forces ESPE. Data processing was performed with SPSS. Results: The most recurrent type of consumption was alcohol in university students of the University of the Armed Forces ESPE. The results agreed that the consumption of alcohol and tobacco was related to the influence of friendships and the most recurrent place of use of these substances was the University. It was determined that social marketing could moderately influence student behavior, with the support of social networks through action campaigns, demotivation of vices, and health and life messages. Conclusions: The results indicated the need to increase the effectiveness of social marketing programs and activities aimed at reducing alcohol and tobacco consumption in the university community, since there is a high percentage of consumption of these substances(AU)

Biomarcadores de reação inflamatória crônica em pacientes com queimaduras radiológicas (síndrome cutânea da radiação) / Biomarkers of chronic inflammatory reaction in patients with radiological burns (cutaneous radiation syndrome)

Introdução: Os efeitos tardios da radiação geralmente são irreversíveis e podem ter efeitos devastadores sobre a qualidade de vida de pessoas expostas acidentalmente ou durante os tratamentos de radiação terapêutica. Apesar de diversas etiologias terem sido sugeridas em relação a essa toxicidade tardia, parâmetros inflamatórios envolvidos durante a fase tardia são menos conhecidos. Objetivo: O objetivo deste estudo foi analisar a resposta do sistema imunológico nas reações inflamatórias em pacientes com lesões de pele tardias após radioterapia ou procedimentos de fluoroscopia intervencionista. Métodos: O acompanhamento de 25 pacientes, dos 160 atendidos no Hospital de Queimados a partir de 1997, que demonstrou reações cutâneas tardias classificadas de acordo como sistema de RTOG/EORTC é relatado aqui. A expressão de moléculas de adesão ICAM1e 1-integrina em granulócitos e linfócitos, bem como alterações nas subpopulações dos linfócitos T, foram avaliadas por citometria de fluxo e o nível de proteína C-reativa, um marcador inflamatório bem estudado, foi quantificado por um ensaio imunoturbidimétrico. Resultados: Aanálise da expressão de moléculas de adesão revelou maior expressão de integrina 1em linfócitos de pacientes Grau IV em comparação a controles não-expostos. Observou-se, também, diminuição dos valores de sua expressão no acompanhamento de pacientes com boa resposta ao tratamento terapêutico. Isto foi acompanhado por uma tendência a diminuição na proporção T (CD4 +)/ T(CD8+) de pacientes com má evolução do G4 em comparação aos doentes do G4 com boa evolução. O nível de proteína C reativa (PCR) apresentou valores mais elevados em pacientes em fase aguda e pacientes com toxicidade tardia, mas em crise exacerbação.

Introduction: Late effects of radiation are generally irreversible and can have devastating effects on quality of life of people exposed either accidentally or during therapeutic radiation treatments. Although many etiologies have been suggested regarding these late toxicities, inflammatory parameters involved during the late phase are less known. Objective: The aim of this study was to analyze the response of the immune system in the inflammatory reactions in patients with late skin injuries after radiotherapy or interventional fluoroscopy procedures. Methods: The follow up of twenty five patients, out of 160 referred to Burn Hospital from 1997, that showed late cutaneous reactions graded according to the RTOG / EORTC system is reported here.The expression of adhesion molecules ICAM1 and 1-integrin on granulocytes and lymphocytes, as well as changes in subpopulations of T lymphocytes were evaluated by flow cytometry and the level of C-reactive protein, a well-studied inflammatory marker was quantified by an immunoturbidimetric assay. Results: The analysis of adhesion molecules expression revealed a higher expression of 1 Integrin on lymphocytes of Grade IV patients compared to non-exposed controls. It was also noted a decrease in its expression values in the follow up of patients with good response to therapeutic treatment. This was paralleled by a tendency to a decrease in the T(CD4+) / T(CD8+) ratio of G4 patients with bad evolution compared to G4 patients with good evolution.The level of C Reactive Protein (CRP) showed higher values in patients in acute phase and patients with late toxicity but in exacerbation crisis. Conclusions: The parameters analyzed, which require confirmation in a larger study, in combination with other inflammatory indicators, could be used as potential follow-up markers of the chronic radio-induced inflammation process just as its response to therapeutic treatments.