Conflito com a lei e sexismo: percepções de adolescentes de Sergipe (Brasil) / Conflicto con la ley y sexismo: percepciones de adolescentes de Sergipe (Brasil) / Conflict with the law and sexism: perceptions of adolescents in Sergipe (Brazil)

Resumo O objetivo deste estudo é investigar como adolescentes do gênero feminino, em privação de liberdade, percebem a situação de conflito com a lei e o sexismo. Participaram quatro adolescentes que cumpriam medida socioeducativa de privação de liberdade em Sergipe (Brasil). Foram realizadas entrevistas semiestruturadas, interpretadas por meio da análise temática de conteúdo. Emergiram duas categorias: «Diferenças de gênero no ato infracional: a transgressão como característica masculina¼ e «Diferenças de gênero na medida socio-educativa: a obediência como característica feminina¼, indicando o impacto do gênero na percepção dessas adolescentes. Em conjunto, os resultados evidenciam que atentar ao recorte de gênero e às relações entre conflito com a lei e o sexismo são aspectos fundamentais para alcançar o ideário da legislação brasileira, o atendimento às especificidades das adolescentes numa proteção integral e igualitária.

Resumen El objetivo de este estudio es investigar cómo adolescentes, privadas de libertad, perciben la situación de conflicto con la ley y el sexismo. Participaron cuatro adolescentes que cumplían medida so-cioeducativa de privación de libertad en Sergipe (Brasil). Se realizaron entrevistas semiestructuradas, interpretadas mediante análisis de contenido temático. Surgieron dos categorías: «diferencias de género en la infracción: la transgresión como característica masculina¼ y «diferencias de género en la medida socioeducativa: la obediencia como característica femenina¼, indicando el impacto del género en la percepción de estas adolescentes. En conjunto, los resultados muestran que la atención al género y la relación entre conflicto con la ley y sexismo son aspectos fundamentales para lograr los ideales de la legislación brasileña, que es respetar las especificidades de las adolescentes en una protección integral e igualitaria.

Abstract This study aims to research how female adolescents who are deprived of their liberty perceive the relationship between their conflict with the law and sexism. The participants were four adolescents who were detained in a correctional facility in Sergipe (Brazil). Semi-structured interviews were conducted and these were interpreted using thematic content analysis. Two categories emerged: «Gender differences in infractions: transgression as a male characteristic¼ and «Gender differences in so-cioeducational scenarios: obedience as a female characteristic¼, highlighting the impact of gender on the perceptions of these adolescents. The results obtained through this research indicate that concentrating gender and the relationship between conflict with the law and sexism are fundamental aspects for achieving ideal legislation that respects the specific situations experienced by adolescents and provides them with integrated and equal protection.

Calidad de vida en demencia Alzheimer: un nuevo desafío / Quality of life in Alzheimer's dementia: a new challenge

Resumen El progresivo envejecimiento de la población mundial se encuentra directamente asociado al aumento de las patologías neurodegenerativas. Dentro de estas, la Enfermedad de Alzheimer es el tipo de demencia de mayor prevalencia a nivel mundial y se asocia a un mayor deterioro de la calidad de vida, no solo en los pacientes, sino que también en sus cuidadores y entorno familiar. Frente a este escenario, durante los últimos años ha adquirido especial importancia el evaluar la calidad de vida en pacientes con demencia Alzheimer, siendo un aspecto de creciente interés en el ámbito clínico y de la salud pública al ser considerado como un indicador en la medición de la efectividad de los distintos tipos de intervenciones, farmacológicas y no farmacológicas, sobre la enfermedad y su evolución. El conocer el concepto calidad de vida por parte de los equipos de salud y la evaluación clínica de esta en pacientes con demencia Alzheimer se ha vuelto un pilar fundamental tanto en el manejo, como en el uso de la información para la toma de decisiones en relación a políticas públicas relacionadas a pacientes con demencia. En este trabajo se abordará la temática desde tres ámbitos, la importancia de la enfermedad de Alzheimer, la calidad de vida a lo largo de los años, y como ésta puede ser utilizada en el manejo de patologías neurodegenerativas como la demencia.

The progressive aging of the world population is directly associated with the increase in neurodegenerative pathologies. Among these, Alzheimer's disease is the most prevalent type of dementia worldwide which is associated with a greater deterioration in the quality of life, not only in patients but also in their caregivers and family environment. In this context, during the last years has become important to evaluate the quality of life in patients with Alzheimer's dementia to be an area of growing interest in clinical and public health because it is considered as an indicator in effectiveness measurement of the different types of interventions, pharmacological and non-pharmacological, on the disease and its evolution. Heath teams know the concept of quality of life and its clinical evaluation in patients with Alzheimer's dementia and it has become fundamental support for both management and the use of information for decision-making in the field of public policies related to patients with dementia. In this viewpoint the theme will be addressed from three areas, the importance of Alzheimer's disease, quality of life throughout history, and how it can be used in the management of neurodegenerative diseases such as dementia.

Necrólisis epidérmica tóxica en una adolescente diagnosticada de trastorno bipolar II y tratada con lamotrigina / Toxic epidermal necrolysis in an adolescent with Bipolar Disorder II and treated with Lamotrigine

Resumen La necrólisis epidérmica tóxica es una enfermedad cutánea severa, la mayoría de las veces desencadenada como reacción adversa a medicamentos, con alta morbilidad y mortalidad. La lamotrigina, junto a otros medicamentos estabilizadores del ánimo, constituye la causa medicamentosa más frecuente de esta complicación, consistente en necrosis y esfacelo de la epidermis y mucosas en más del 30 % de la superficie corporal, con la consecuente pérdida de líquidos y electrolitos, respuesta inflamatoria sistémica, susceptibilidad a infecciones y hasta sepsis, además de posibles secuelas ominosas. En la actualidad, el diagnóstico de trastorno bipolar se hace con mayor frecuencia, incluyendo al grupo etario de niños y adolescentes, pero tal proceso diagnóstico se caracteriza por dificultades y controversias en mayor cuantía que otros diagnósticos psiquiátricos. Ello obliga a una meticulosa elucubración diagnóstica y selección farmacológica, con pleno conocimiento de las moléculas del arsenal medicamentoso para, en caso de prescripción de lamotrigina, establecer una escrupulosa psicoeducación al paciente y sus familiares además de un seguimiento estricto y cercano. A propósito del caso de una adolescente diagnosticada de trastorno bipolar II, que recibió lamotrigina durante un episodio depresivo pero con un esquema posológico inadecuado, y desarrolló necrólisis epidérmica tóxica, revisamos y comentamos la literatura correspondiente. Concluimos en que es preciso extremar las precauciones al decidir el uso de lamotrigina para minimizar el riesgo de este severo efecto adverso.

Toxic epidermal necrolysis is a severe skin disease, most often triggered as an adverse drug reaction, with high morbidity and mortality. Lamotrigine, together with other mood stabilizer drugs, constitutes the most frequent drug that causes this complication, which consists of necrosis and detachment of the epidermis and mucosa in more than 30% of the body surface, with the consequent loss of water and electrolytes, systemic inflammatory response, susceptibility to infections and even sepsis, in addition to other possible ominous sequelae. Currently, the diagnosis of bipolar disorder is made more frequently, including the age group of children and adolescents, but such a diagnostic process is characterized by difficulties and controversies to a greater extent than other psychiatric diagnoses. This requires meticulous diagnostic process and pharmacological selection, with full knowledge of the molecules in the drug arsenal so, in case of lamotrigine prescription, it should be established scrupulous psychoeducation to the patient and their family members, as well as strict and close follow-up. A propos of the case of an adolescent girl diagnosed with bipolar II disorder, who received lamotrigine during a depressive episode but with an inappropriate posology, and developed toxic epidermal necrolysis, we reviewed and commented on the corresponding literature. We conclude that extreme caution is necessary when deciding the use of lamotrigine to minimize the risk of this severe adverse effect.

Conocimiento de la anticoncepción de emergencia en mujeres adolescentes de enseñanza media de la comuna de Hualqui, Chile / Emergency contraception knowledge in female adolescent secondary education students from Hualqui commune, Chile

INTRODUCCIÓN Dado que el conocimiento sobre la anticoncepción de emergencia puede ser de gran utilidad en la promoción de la salud sexual y salud reproductiva, especialmente en los adolescentes, la deficiencia del mismo podría disminuir su prescripción y uso. OBJETIVO Describir el conocimiento sobre los métodos anticonceptivos de emergencia de un grupo de mujeres adolescentes estudiantes de enseñanza media de la comuna de Hualqui, Chile. MATERIAL Y MÉTODO Se realizó un estudio descriptivo de corte transversal. Se encuestó a 115 mujeres adolescentes estudiantes de primer a cuarto año de enseñanza media del liceo San Juan Bautista de Hualqui, Octava Región de Chile. Se exploraron antecedentes generales de salud sexual y salud reproductiva, y conocimientos sobre la anticoncepción de emergencia, su uso y formas de adquisición. RESULTADOS La edad promedio fue de 16,1 años. El 39% de las estudiantes eran sexualmente activas, y en promedio iniciaron su vida sexual a los 15,3 años y tuvieron 2,1 parejas sexuales. El método anticonceptivo que más utilizaban fue el anticonceptivo hormonal inyectable (31,1%), seguido de la anticoncepción oral combinada (20,0%). Con respecto a la anticoncepción de emergencia, el 80,9% declaró saber de su entrega liberada, mientras que el 11,1% declaró haberlos usado alguna vez. El 91,3% de las encuestadas consideró necesario tener mayor información. CONCLUSIÓN Las adolescentes participantes del estudio mostraron algún grado de conocimiento respecto a la anticoncepción de emergencia, pese a no utilizarla habitualmente. No obstante, la mayoría expresó la necesidad de tener mayor acceso a información relacionada al tema.

BACKGROUND Given that knowledge about emergency contraception can be very useful in promoting sexual health and reproductive health, especially in adolescents, its deficiency could decrease its prescription and use. AIM To describe the knowledge about emergency contraceptive methods of a group of female adolescent secondary education students from the Hualqui commune, Chile. METHOD A descriptive cross-sectional study was carried out. 115 adolescent women students from first to fourth year of high school at San Juan Bautista high school in Hualqui, Eighth Region of Chile, were surveyed. General sexual health and reproductive health backgrounds, and knowledge of emergency contraception, its use, and forms of acquisition were explored. RESULTS The average age was 16,1 years. 39% of the students were sexually active, and on average started their sex life at 15,3 years and had 2,1 sexual partners. The most widely used contraceptive method was injectable hormonal contraception (31,1%), followed by combined oral contraception (20,0%). Regarding the emergency contraception, 80,9% stated that they knew of their free delivery, while 11,1% stated that they had ever used them. 91,3% of respondents considered it necessary to have more information. CONCLUSIONS The adolescents participating in the study showed some degree of knowledge regarding emergency contraception, despite not using it regularly. However, the majority expressed the need for greater access to information related to the topic.

«Aconchego do Lar¼: Discutindo o Serviço de Acolhimento Familiar / "Warmth of Home": Discussing the Foster Care Service / «Acogida del hogar¼: discutiendo el Servicio de Acogimiento Familiar

Resumo (analítico) O Serviço de Acolhimento Familiar (SAF) se encontra inserido num processo de reformulação da política de proteção dos direitos do público infantojuvenil. Assim, discute-se a implantação do SAF em um município do Nordeste brasileiro, sob a perspectiva dos profissionais do SAF, famílias (acolhedora e de origem), criança acolhida, Conselho Tutelar, Promotor de Justiça e Juiz. A partir de entrevistas semiestruturadas, realizou-se a análise das concepções sobre o SAF, como uma alternativa de cuidados à população infantojuvenil. O estudo mostra que o SAF é considerado uma alternativa de atendimento às crianças e adolescentes, sendo ressaltada a atenção individualizada e a afetividade no contexto do acolhimento. Todavia, existem desafios a serem vencidos, como a maior divulgação do SAF, demonstrando, assim, que ele ainda não se consolidou na rede de atendimento.

Abstract (analytical) The Foster Care Service (FCS) is part of a reformulation of the protection policy for children and adolescents' rights. The implementation of the FCS in a Brazilian north-eastern municipality is discussed based on the perspectives of professionals, families (foster and biological), foster children, members of the Guardianship Council, Justice Promoters and Judges. Using semi-structured interviews, an analysis of the concepts of FCS was carried out as a care alternative for children and youth populations. The study reveals that FCS is regarded as a care alternative for children and young people, emphasizing individualized assistance and affective relationships in foster care. However, there are challenges that need to be overcome, such as an increase in the coverage of FCS, demonstrating as it has not yet been consolidated in service networks.

Resumen (analítico) El Servicio de Acogimiento Familiar (SAF) se encuentra inserto en un proceso de reformulación de la política de protección de los derechos del público infantojuvenil. En este artículo se estudia la implantación del SAF en un municipio del nordeste brasileño, bajo la perspectiva de los profesionales del SAF, familias (acogedora y de origen), niño acogido, Consejo Tutelar, promotor de justicia y juez. A partir de entrevistas semiestructuradas, se realizó el análisis de las concepciones sobre el SAF, como una alternativa de cuidados a la población infantojuvenil. El estudio muestra que el SAF es considerado una alternativa de atención a los niños y adolescentes, siendo resaltada la atención individualizada y la afectividad en el contexto del acogimiento. Sin embargo, existen desafíos a ser superados, como la mayor divulgación del SAF, demostrando así que todavía no se ha consolidado en la red de atención.

Significados do mundo do crime para adolescentes em medida socioeducativa de internação, Brasil / Meanings of the 'world of crime' for adolescents at treatment facilities, Brazil / Significados del «mundo del crimen¼ para adolescentes en unidades socioeducativas, Brasil

Resumo (analítico) O objetivo deste estudo é investigar significados atribuídos ao mund do crime por adolescentes em medida socioeducativa de internação. Os participantes do estudo foram 25 adolescentes (15 a 19 anos) do sexo masculino internados em quatro unidades socioeducativas nos Estados do Rio Grande do Sul e Espírito Santo, Brasil. Foram realizados dois grupos focais em cada Estado, interpretados por Análise Temática. Os significados expressos pelos participantes revelaram que a vinculação ao mundo do crime atende a necessidades de segurança econômica, fortalecimento da identidade pessoal, reconhecimento social, senso de pertencimento e proteção física, consistindo em um processo de resiliência oculta. A compreensão das perspectivas dos adolescentes sobre o mundo do crime pode informar práticas de atendimento capazes de atender necessidades materiais e simbólicas e prevenir riscos.

Abstract (analytical) This study aims to comprehend meanings of the world of crime among adolescents at treatment facilities. The participants of this study were 25 male adolescents (15 to 19 years) at four treatment facilities in the states of Espírito Santo and Rio Grande do Sul, Brazil. Two focal groups in each state were held, interpreted using the Thematic Analysis technique. The meanings expressed by participants revealed that their affiliation with the world of crime meets their needs of economic security, strengthening of personal identity, social recognition, sense of belonging, and physical protection. Their involvement in the world of crime consists of a hidden resilience process. The comprehension of adolescents' perspectives of the world of crime can inform services so that they are able to meet their material and symbolic needs and prevent risks.

Resumen (analítico) El objetivo de este estudio es comprender significados del mundo del crimen para adolescentes internados en unidades socioeducativas. Los participantes del estudio fueron 25 adolescentes (15 a 19 años) del sexo masculino internados en cuatro unidades en los Estados del Rio Grande do Sul y Espírito Santo, Brasil. Fueron realizados dos grupos focales en cada Estado, interpretados por Análisis Temático. Los significados expresados por los participantes han revelado que la afiliación al mundo del crimen atiende a necesidades de seguridad económica, fortalecimiento de la identidad personal, reconocimiento social, sentido de pertenencia y protección física, lo que consiste un proceso de resiliencia oculta. La comprensión de las perspectivas de los adolescentes sobre el mundo del crimen puede generar prácticas de tratamiento capaces de satisfacer necesidades materiales y simbólicas y prevenir riesgos.

Efectividad de intervenciones basadas en Mindfulness para mejorar el control de la Diabetes Mellitus tipo 2: una revisión sistemática e integración metanalitica preliminar / Effectiveness of Mindfulness-based interventions to improve control of type 2 diabetes mellitus: a systematic review and preliminary meta-analytic integration

Resumen El propósito de este trabajo fue estudiar la efectividad de intervenciones basadas en Mindfulness sobre el nivel de hemoglobina glicada —HbA1c— en pacientes con diabetes mellitus tipo 2 —DM2—. Se realizó una revisión sistemática e integración metanalítica preliminar. La búsqueda de los estudios se realizó en las siguientes bases: PubMed, Bireme, Web of Science, SciELO, Embase, EBSCOhost, SCOPUS, Psychology Database. Se identificaron 10 artículos: cuatro fueron llevados a cabo en Estados Unidos, dos en Irán, uno en Alemania, uno en Australia, uno en Tailandia y uno en Inglaterra. Se observó una reducción en los niveles de la HbA1c utilizando Mindfulness en comparación a los grupos controles (p < 0,02). Además, se observó un efecto diferenciado al analizar según número de participantes, sexo y tiempo de seguimiento. Se concluyó que el uso de intervenciones basadas en Mindfulness tendría un efecto indirecto sobre la reducción de la hemoglobina glicada.

Abstract The purpose of this paper was to study the effectiveness of Mindfulness-based interventions on the level of glycated hemoglobin —HbA1c— in patients with type 2 diabetes mellitus —DM2—. A systematic review and preliminary meta-analytic integration was performed. The search of the studies was carried out in the following bases: PubMed, Bireme, Web of Science, SciELO, Embase, EBSCOhost, SCOPUS, Psychology Database. Ten articles were identified: four were published in the United States, two in Iran, one in Germany, one in Australia, one in Thailand and one in England. A reduction in HbA1c levels was observed using Mindfulness compared to control groups (p <0,02). In addition, according to the number of participants, sex and time of follow-up a differentiated effect was found. It was concluded that the use of interventions based on Mindfulness would have an indirect effect on the reduction of glycated hemoglobin (HbA1c).

Optical Coherence Tomography and Stent Boost Imaging Guided Bioresorbable Vascular Scaffold Overlapping for Coronary Chronic Total Occlusion Lesion

We report herein the optical coherence tomography (OCT) and stent boost imaging guided bioresorbable vascular scaffold (BVS) implantation for right coronary artery (RCA) chronic total occlusion (CTO) lesion. The gold standard for evaluating BVS expansion after percutaneous coronary intervention is OCT. However, stent boost imaging is a new technique that improves fluoroscopy-based assessments of stent overlapping, and the present case shows clinical usefulness of OCT and stent boost imaging guided ‘overlapping’ BVS implantation via antegrade approach for a typical RCA CTO lesion.

Control de la infección por tuberculosis en instituciones de salud

Introducción. La tuberculosis es una problemática de salud pública y laboral que afecta especialmente algunos grupos vulnerables como los trabajadores de la salud. Objetivo. Describir la implementación de las medidas de control de la infección por tuberculosis en 51 instituciones de salud. Métodos. Estudio de tipo cuantitativo, alcance descriptivo y corte transversal. La herramienta de recolección de datos se sometió a revisión de expertos. Se realizó un análisis estadístico descriptivo y de tipo univariado. Resultados. Se identificó en relación a la implementación de las medidas de control administrativas que N= 37 (68.6%) de las instituciones de salud contaban con un plan de control de infecciones específico para tuberculosis. Sobre las medidas de control ambientales solo N=8 (16.3%) de las instituciones de salud tenían ventilación natural y/o mecánica. Sobre las medidas de protección personal N=43 (84.3%) de las instituciones de salud tenían respiradores N-95 disponibles para el personal de salud. Conclusión. Es necesario fortalecer el establecimiento de las medidas de control administrativas, ambientales y de protección respiratoria en las instituciones de salud, de manera que se disminuya el riesgo de transmisión de tuberculosis en los trabajadores del sector.

Introduction. Tuberculosis is both a public and occupational health problem highly prevalent in susceptible groups, such as health workers. Objective. To describe the tuberculosis infection control strategies implemented among 51 health institutions. Methods. Cross-sectional study. The instruments used for data collection were validated by experts. A statistical analysis included the descriptive analysis and the univariate analysis of the data were conducted. Results. In regards with the implementation of administrative strategies, 68,6% (N=37) of the health facilities had plans for tuberculosis infection control. Concerning the environmental strategies, 16,3% (N=8) had natural y/o mechanic ventilation. Among the strategies for personal protection, 84,3% (N=43) provided N-95 respirators to their workers. Conclusion. It is advisable to improve the organization of administrative, environmental and personal strategies to control the tuberculosis infection. This will allow reducing the prevalence of tuberculosis infection among health workers.

Introdução. A tuberculose é uma problemática de saúde pública e laboral que atinge especialmente alguns grupos vulneráveis como trabalhadores da saúde. Objetivo. Descrever a implementação de medidas de controle da infeção por tuberculose em 51 instituições de saúde. Metodologia: Estudo de tipo quantitativo, alcance descritivo e corte transversal. A ferramenta de recolecção de dados passou pela revisão de expertos. Realizou-se análise estadística descritiva e univariada. Resultados. Em relação à implementação das medidas de controle administrativo encontrou-se que N = 37 (68,6%) das instituições de saúde tinham um plano de controle de infecções específico para tuberculose. Enquanto às medidas de controle ambientais apenas N = 8 (16,3%) das instituições de saúde referiram ter ventilação natural e / ou mecânica. No que diz as medidas de proteção pessoal, N = 43 (84,3%) das instituições de saúde manifestaram ter aparelhos de ventilação N-95 disponíveis para o pessoal de saúde. Conclusão. É necessário fortalecer o estabelecimento das medidas de controle administrativo, ambientais e de proteção respiratória nas instituições de saúde, de forma que se possa reduzir o risco de transmissão de tuberculose nos trabalhadores do setor.

Evaluación de la disfunción vaginal en mujeres embarazadas sintomáticas y asintomáticas mediante la utilización de los estados vaginales básicos (EVB) y su comparación con el estudio microbiológico convencional / Evaluation of vaginal dysfunction in symptomatic and asymptomatic pregnant women by using the analysis of basic vaginal states (BVS) and its comparison with the conventional microbiological study

Durante el embarazo se producen frecuentemente infecciones del tracto genital inferior asociadas a complicaciones maternas y perinatológicas. El objetivo del trabajo fue evaluar la disfunción vaginal mediante el análisis de los estados vaginales básicos (EVB) por la metodología del balance del contenido vaginal (BACOVA) y compararlo con el estudio microbiológico convencional en el diagnóstico de candidiasis, tricomonosis y vaginosis bacteriana (VB). Entre 2010 y 2012 se estudiaron 1238 pacientes embarazadas; 1046 eran asintomáticas (A) y 192 sintomáticas (S). La prevalencia del EVB I fue del 59,5 % y 26 %, respectivamente. El EVB II se observó en 19,7 % de las mujeres A y en 17,2 % de las S. El EVB III se detectó solamente en las A, en 0,4 %. El EVB IV se observó en 14,4 % de las A y en 38 % de las S. El EVB V se detectó en 6 % de las A y en 18,8 % de las S. En las mujeres A, las levaduras se asociaron a los EVB I y II en el 55,5 % y 23,2 % de los casos, respectivamente; entre las S, alcanzaron el 32,4 % y 31 % de los casos, en igual orden. Las tricomonas se asociaron al EVB I en el 50 % de las A, al EVB IV en el 44,4 % de las S y al EVB V en el 33,3 % de las S. La sensibilidad del BACOVA para detectar levaduras fue 80,4 % en las A y 85,5 % en las S; para detectar tricomonas, del 40 % y 75 %, y para detectar VB, del 100 % en los dos grupos. La especificidad del BACOVA fue 100 % para todos los patógenos en las A y en las S. El estudio de los EVB resultó útil para orientar el diagnóstico a la disfunción vaginal, independientemente de la sintomatología, por lo que se sugiere este estudio como parte del control prenatal. Durante el embarazo se producen frecuentemente infecciones del tracto genital inferior asociadas a complicaciones maternas y perinatológicas. El objetivo del trabajo fue evaluar la disfunción vaginal mediante el análisis de los estados vaginales básicos (EVB) por la metodología del balance del contenido vaginal (BACOVA) y compararlo con el estudio microbiológico convencional en el diagnóstico de candidiasis, tricomonosis y vaginosis bacteriana (VB). Entre 2010 y 2012 se estudiaron 1238 pacientes embarazadas; 1046 eran asintomáticas (A) y 192 sintomáticas (S). La prevalencia del EVB I fue del 59,5 % y 26 %, respectivamente. El EVB II se observó en 19,7 % de las mujeres A y en 17,2 % de las S. El EVB III se detectó solamente en las A, en 0,4 %. El EVB IV se observó en 14,4 % de las A y en 38 % de las S. El EVB V se detectó en 6 % de las A y en 18,8 % de las S. En las mujeres A, las levaduras se asociaron a los EVB I y II en el 55,5 % y 23,2 % de los casos, respectivamente; entre las S, alcanzaron el 32,4 % y 31 % de los casos, en igual orden. Las tricomonas se asociaron al EVB I en el 50 % de las A, al EVB IV en el 44,4 % de las S y al EVB V en el 33,3 % de las S. La sensibilidad del BACOVA para detectar levaduras fue 80,4 % en las A y 85,5 % en las S; para detectar tricomonas, del 40 % y 75 %, y para detectar VB, del 100 % en los dos grupos. La especificidad del BACOVA fue 100 % para todos los patógenos en las A y en las S. El estudio de los EVB resultó útil para orientar el diagnóstico a la disfunción vaginal, independientemente de la sintomatología, por lo que se sugiere este estudio como parte del control prenatal.

Infections of the lower genital tract associated to maternal and perinatal complications frequently occur during pregnancy. The aim of this study was to evaluate vaginal dysfunction through the analysis of basic vaginal states (BVS) using the methodology of balance of the vaginal content (BAVACO) and to compare it with the microbiological study of candidiasis, trichomoniasis and bacterial vaginosis (BV). Pregnant patients (1238) were examined from 2010 to 2012. In asymptomatic (A) (n: 1046) and symptomatic pregnant women (S) (n: 192) BVS I was 59.5% and 26% of the patients, respectively. BVS II was observed in 19.7% of A and in 17.2% of S. BVS III was only detected in A in 0.4%. BVS IV was observed in 14.4% of A and in 38% of S. BVS V was detected in 6% of A and in 18.8% of S. Yeasts were associated to BVS I and II in 55.5% and 23.2% of A, respectively; and in 32.4% and 31% of S, respectively. Trichomonas were associated to BVS I in 50% of A, to IV in 44.4% of S and to V in 33.3% of S. BAVACO susceptibility to detect yeasts was 80.4% and 85.5% in A and S, respectively; 40% and 75% in A and S, respectively, to detect trichomonas and 100% in A and S to detect BV. BAVACO specificity was 100% for all pathogens in A and S. The study of BVS proved useful as a guide to evaluate vaginal dysfunction, regardless of symptomatology. Therefore, this study is recommended as prenatal control. Infections of the lower genital tract associated to maternal and perinatal complications frequently occur during pregnancy. The aim of this study was to evaluate vaginal dysfunction through the analysis of basic vaginal states (BVS) using the methodology of balance of the vaginal content (BAVACO) and to compare it with the microbiological study of candidiasis, trichomoniasis and bacterial vaginosis (BV). Pregnant patients (1238) were examined from 2010 to 2012. In asymptomatic (A) (n: 1046) and symptomatic pregnant women (S) (n: 192) BVS I was 59.5% and 26% of the patients, respectively. BVS II was observed in 19.7% of A and in 17.2% of S. BVS III was only detected in A in 0.4%. BVS IV was observed in 14.4% of A and in 38% of S. BVS V was detected in 6% of A and in 18.8% of S. Yeasts were associated to BVS I and II in 55.5% and 23.2% of A, respectively; and in 32.4% and 31% of S, respectively. Trichomonas were associated to BVS I in 50% of A, to IV in 44.4% of S and to V in 33.3% of S. BAVACO susceptibility to detect yeasts was 80.4% and 85.5% in A and S, respectively; 40% and 75% in A and S, respectively, to detect trichomonas and 100% in A and S to detect BV. BAVACO specificity was 100% for all pathogens in A and S. The study of BVS proved useful as a guide to evaluate vaginal dysfunction, regardless of symptomatology. Therefore, this study is recommended as prenatal control.

O tema desastre na área da saúde: perfil da produção técnico-científica na base de dados especializada em desastres da Biblioteca Virtual em Saúde (BVS) / The theme of disaster in health care: profile of technical and scientific production in the specialized database on disasters of the Virtual Health Library - VHL

Dentre as bases especializadas da Biblioteca Virtual em Saúde (BVS), a sobre "Desastres" indica a importância do tema para a área da saúde. O objetivo deste artigo foi identificar o perfil das publicações técnico-científicas desta base especializada. A partir de buscas sistemáticas e da análise dos resultados foi possível determinar: o tipo de publicação, os principais assuntos abordados, os tipos de desastres mais frequentes nas publicações, os países e as regiões como assunto, período histórico com mais publicações e a tendência atual das publicações. Ao explorar detalhadamente a base especializada, percebe-se que o número de assuntos principais é elevado, característica que dificulta buscas específicas dentro dela. Por outro lado, é positivo o fato de o tema desastre ser tratado de forma ampla e diversificada, associado a diferentes assuntos das ciências naturais e das ciências sociais. O tema desastre exige produção de conhecimento interdisciplinar para reduzir os impactos dos desastres e para gestão dos riscos. Deste modo, a saúde, por se tratar de uma área interdisciplinar, pode contribuir para tal produção.

In the specialized database of the Virtual Health Library (VHL), the DISASTER database highlights the importance of the theme for the health sector. The scope of this article is to identify the profiles of technical and scientific publications in the specialized database. Based on systematic searches and the analysis of results it is possible to determine: the type of publication; the main topics addressed; the most common type of disasters mentioned in published materials, countries and regions as subjects, historic periods with the most publications and the current trend of publications. When examining the specialized data in detail, it soon becomes clear that the number of major topics is very high, making a specific search process in this database a challenging exercise. On the other hand, it is encouraging that the disaster topic is discussed and assessed in a broad and diversified manner, associated with different aspects of the natural and social sciences. The disaster issue requires the production of interdisciplinary knowledge development to reduce the impacts of disasters and for risk management. In this way, since the health sector is a interdisciplinary area, it can contribute to knowledge production.

Bioabsorbable Vascular Scaffolds Eluting with Everolimus: for Percutaneous Coronary Intervention of Patients with de-novo Coronary Artery Lesion: Our Experiences at a Tertiary Hospital.

Background: Aim of the study was to evaluate the primary procedural success of percutaneous coronary intervention (PCI) of de-novo coronary artery lesion by using Bioabsorbable Vascular Scaffold (BVS) ABSORB stents eluting Everolimus. Methods: Total 16 patients were enrolled in this very preliminary study of BVS absorb. Among them, Male: 11 and Female: 5. Total 20 stents were deployed. Mean age were for Male: 56 yrs, for Female: 60 yrs. Associated coronary artery disease (CAD) risk factors were Dyslipidemia, High Blood pressure, Diabetes Mellitus, Positive family history (FH) for CAD and Smoking. Patients were followed up clinically. Results: Among the study group; 13 (81%) were Dyslipidemic, 10(62.5%) were hypertensive; 6 (37.5%) patients were Diabetic, FH 3(18.75%), and 2(18%) were all male smoker. Female patients were more obese [Body Mass Index (BMI) M 25: F 27] and developed CAD in advance age. A common stented territory was for left anterior descending artery (LAD): 6 (37.5%), left circumflex artery (LCX) 5 (25%), right coronary artery (RCA) 6(37.5%). One patient had both LCX and LAD stenting. Total 3 patients had double/overlapping stent in RCA lesion. Territory wise distributions of BVS ABSORB stent were for LAD 6(30%), RCA 9 (45%), and LCX 5 (25%). There was no periprocedural or postprocedural complication. Conclusion: BVS ABSORB Everolimus eluting vascular scaffold showed favorable clinical outcome without any major cardiac events (acute or late stent thrombosis, MI or death) over a period of 9 month. Thus, BVS ABSORB would be favorable alternative to other available drug eluting metallic stents.

Fuerza de presinn manual y correlación con indiadores antropométricos y condicción física en estudiantes universitaroos / Manual pessure fforce and correlation wih anthropometric and physical ccondition in college suudents

Introducción: La fuerza de prensión manual (FPM) ha sido ampliamente utilizada como un test para evaluar la función muscular desde finales del siglo XIX. A partir de la década de los 80 se empezó a estudiar su relación con el estado nutricional, especialmente en el medio hospitalario. Actualmente el test se considera un marcador sensible del estado nutricional en este ámbito. El objetivo de este estudio es examinar la correlación entre la FPM y algunas variables antropométricas y de la condición física, para determinar su utilidad como herramienta complementaria en la valoración y diagnóstico nutricional a nivel ambulatorio. Materiales y Métodos: Se evaluaron 92 estudiantes beneficiarios de un subsidio de alimentación (46 hombres y 46 mujeres) en edades entre los 17 y los 34 años, a los cuales se les determinó el peso, estatura, 4 pliegues de grasa subcutánea, circunferencia de la cintura, test de banco de Harvard y FPM. Resultados y Discusión: Se encontró una correlación positiva entre la FPM y el índice de masa corporal alterado (r = 0,84) y con el porcentaje de grasa elevado (r = 1,0) en los hombres. En las mujeres las correlaciones no fueron concluyentes (r = 0,07, -0,4). No se encontró correlación estadística al analizar la FPM versus la condición física por género. Conclusiones: La FPM podría ser indicador útil en estudios de valoración nutricional en hombres jóvenes, sin embargo se requieren más estudios para evaluar su utilidad en mujeres.

Introduction: Handgrip strength testing (HGS) has been widely used as a test to evaluate muscle function since the XIX century. From the 80's, researchers began to study its relationship with nutritional status, especially in the clinical setting. Nowadays, the test is considered as a sensible marker of nutritional status in hospitals. The aim of this study is to examine the correlation between handgrip strength and some anthropometric and physical status variables to determine its usefulness as a complementary tool in the outpatient assessment nutritional diagnosis. Materials and Methods: Ninety-two (92) students beneficiary of a food subsidy (46 men - 46 women), aged 17-37 years underwent a nutritional assessment by measuring weight, height, subcutaneous skin folds, waist circumference, Harvard bench step test, and HGS. Results and Discussion: A positive correlation was found between HGS and altered body mass index (r = 0.84) and with high fat mass percentage (r = 1.0) in men. In women these correlations were not significant (r = 0.07, -0.4). When analyzing the correlation between HGS and physical status by gender, the results were not conclusive. Conclusions: HGS could be a useful marker in nutritional assessment studies in young men, however, more studies are required to evaluate its usefulness in women.

A Recovery Case of Severe Heart Failure after Emergency Coronary Artery Bypass Grafting Supported by a Left Ventricular Assist System / 日本心臓血管外科学会雑誌

In general strategy for postcardiotomy heart failure includes inotropic support followed by the use of an intra-aortic balloon pump and percutaneous cardiopulmonary bypass support (POPS). The insertion of a ventricular assist system (VAS) may become necessary when these procedures fail to restore hemodynamic stability. The ABIOMED BVS 5000 left ventricular assist support system (LVAS) has been approved for clinical use in Japan since 1998. Here we describe our experience with the recovery of a 52-year-old man from postcardiotomy heart failure after using an ABIOMED BVS 5000 LVAS. The patient was admitted to our institution with dyspnea. Heart failure with severe left ventricular dysfunction was diagnosed, and recent myocardial infarction was suspected from his history and electrocardiogram. Two days after admission, ventricular fibrillation occured and the arrythmia was hard to control. PCPS was connected and emergency coronary angiography showed triple vessel disease. We performed emergency coronary artery bypass grafting with the heart beating under PCPS and immediately implanted an ABIOMED BVS 5000 device to achieve myocardial recovery after stopping PCPS. He was weaned from the LVAS at 6 days after surgery. His postoperative course was relatively uneventful and he was discharged after recovery.