LEARNING STRATEGIES, AN ADDITIONAL PINCH TO LEARNING A Study of the use of learning strategies by high school students in Mexico

This research presents an analysis of the learning strategies employed by students during confinement due to Covid-19 in the year 2021. The study sample consisted of 200 students from the Licenciado Benito Juárez García high school of the morning shift of the Benemérita Universidad Autónoma de Puebla. A survey was applied to measure the degree of satisfaction in relation to their use and impact on the acquisition of knowledge, allowing them to be more self-taught. The results show that the hypothesis was partially fulfilled, since practice and organization are the learning strategies that most supported them in learning. © GKA Ediciones, authors. Creative Commons Reconocimiento-NoComercial-SinObraDerivada.

Partial Nephrogenic Diabetes Insipidus Secondary to Lithium Use

Introduction: Nephrogenic diabetes insipidus (NDI) is caused by reduced renal response to vasopressin. NDI affects up to 40% of patients on lithium. We present a case of partial NDI secondary to lithium use. Case Description: A 66 year old male with bipolar disorder on lithium presented with shortness of breath, chest tightness and cough. On exam he was cachectic, lethargic, tremulous with decreased skin turgor and dry mucous membranes found to have COVID-19 with initial unremarkable blood work. Received treatment for COVID and subsequently developed worsening encephalopathy, follow up blood work revealed elevated serum sodium of 168 mg/dl, with urine osmolality of 382 and lithium level was elevated at 1.6 mEq/L. He received adequate IV fluid hydration with hypotonic fluids and free water. Serum sodium remained elevated with polyuria. Follow up labs showed urine osmolality decrease to 94 mosml/L therefore nephrogenic diabetes insipidus was suspected. A desmopressin stimulation test was performed and hourly urine osmolality was obtained [Table 1] confirming the diagnosis of nephrogenic diabetes insipidus with a partial response to desmopressin compatible with lithium-induced partial diabetes insipidus. Treatment was started initially with chlorthalidone with inappropriate response, then dose increased to 100mg daily with further addition of amiloride 10mg twice daily with subsequent response and decrease of sodium level from 167 to 147 mEq/L. Discussion(s): Lithium-induced NDI is explained by downregulation of aquaporin 2 channel expression in the principal cells due to accumulation of toxic concentrations of lithium and reduction of the kidneys' ability to preserve water in response to vasopressin. NDI usually presents with polyuria, polydipsia, severe dehydration, and electrolyte imbalance. A less than 50% increase in urine osmolality following desmopressin administration proves NDI. Treatment options include high doses of desmopressin, low sodium diet, thiazide diuretics, amiloride, and NSAIDs. (Table Presented).

Emergency Law, Constitution and covid-19. Lights and shadows of the alarm state in the current context

The CE 78 in its art. 116.1 contemplates the possibility of declaration by the Government of the state of alarm and Organic Law 4/1981 expressly includes the opportunity of declaration of this extraordinary regime in case of health crises such as epidemics. From a purely legislative perspective, the Spanish State, like its European neighbours, certainly has other laws that would make it possible to adopt measures similar to those that enable the state of alarm without the need to centralize decision-making in the executive. The question is whether only the declaration of a state of alarm protects the possibility of limiting the movement of people through the national territory, how and why. For its part, art. 55 EC 78 prescribes the state of exception for the suspension of rights, but says nothing about the state of alarm. In this paper we will analyze how to fit in this apparent conflict of norms and we will address the advisability of opting for one or the other, focusing on the necessary balances with the Autonomous Communities.

Mikros, an Android Application for the Microbiology and Parasitology Subject in the University of Medical Sciences of Camagüey

Introduction: Mobile learning (m-learning) consists in the inclusion of mobile devices into learning activities. In the teaching of medical parasitology and microbiology, such devices offer a high power of illustration and contribute to medical students’ learning of the subject;in addition, they serve as support to other profiles such as health technology. Objective: To present the update, by means of an android application, of the Microbiology and Parasitology course at the University of Medical Sciences of Camagüey. Methods: An optimized application for android 4.4 or higher was created with the Java programming language. This research was carried out at Carlos J. Finlay University of Medical Sciences and applied to medical students in the 2018-2019 and 2019-2020 academic years. The study universe was made up of 1446 students from the academic years from 2016 to 2020. A survey validated by experts was carried out, in the period between November and December 2020, with a probabilistic sample of 88 students from the University of Medical Sciences of Camagüey. Kendall's coefficient of general concordance (W) was calculated for the answers to the questions. Results: Mikros was a teaching support tool, the result of a collaborative project between the Center of Immunology and Biological Products at the University of Medical Sciences and the School of Computer Engineering at Ignacio Agramonte University, in Camagüey, which allowed to present the professor in a teaching modality much in tune with the current times. Conclusions: The Mikros application included basic concepts and a high update level. It also contributed to raising the student’s academic index and satisfaction with learning. It turned out to be a practical consultation tool for students of higher academic years of the major who are rotating through the clinical area, as well as a useful tool for distance learning in COVID-19 times. © 2022, Editorial Ciencias Medicas. All rights reserved.

The impact of sars-cov2 infection in children with liver disease: An international observational registry study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) on children with underlying liver disease (LD) is unknown. We aim to report outcomes for pediatric patients with LD from the joint North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN) and the Society of Pediatric Liver Transplantation (SPLIT) SARS-CoV2 registry Methods: We collected data from patients younger than 21 years with LD from 6 countries and laboratory-confirmed SARS-CoV2 infection reported to a multicenter observational cohort study between April 2020 and May 2021. Results: Seventy-three (59% male,55% white, 23% Hispanic) children with a median age of 9 years were reported in the registry. The most common causes of LD were biliary atresia (22%) followed by autoimmune hepatitis (16%) and non-alcoholic fatty liver disease (16%). Five patients (7%) presented in acute liver failure (ALF);all recovered without the need for a liver transplant. Four patients presented with multisystem inflammatory syndrome in children (2 with ALF, 2 without ALF) with one death reported. The most common presenting symptoms were constitutional (49%) including fever and fatigue followed by respiratory symptoms (47%). Twenty two percent (n=16) of patients were asymptomatic at the time of diagnosis. Twentythree percent had radiologic evidence of pneumonia and 14% reported co-infections. Median peak INR was 1.4, peak total bilirubin 2.9 (mg/dl), peak ALT 129 (IU/l) and nadir albumin 3.1 (g/dl). Sixty-four percent of patients required hospitalization;40% (n=19) in the ICU and 60% (n=28) non-ICU for a median of 6 and 7 days, respectively. Twenty-two percent of patients required respiratory support including mechanical ventilation (n=6), high-frequency oscillatory ventilation (n=3), highflow nasal cannula (n=5) and regular nasal cannula (n=2) for a median of 6 days. Nine patients required vasoactive agents, 3 required renal replacement therapy and 2 patients required ECMO. Sixty-six percent did not receive any SARSCoV2 directed treatment. Twelve (16%) patients developed new liver-related complications including ascites (n=9), GI bleeding (n=2), encephalopathy (n=3), progression of endstage liver disease (n=2) and infection (n=1). There were a total of 3 (4.1%) deaths (20yr, 17yr and 6month of age at time of death) reported secondary to acute on chronic liver failure with respiratory failure and multiorgan failure Conclusion: Contrary to healthy children, almost 2/3rd pediatric patients with LD testing positive for SARS-CoV2 required hospitalization with death reported in 4% of cases. Acute liver failure is rare with SARS-CoV2 infection with recovery reported without the need for liver transplantation. Close monitoring is needed due to an increased risk of underlying liver disease complications and death, particularly in children with end-stage liver disease awaiting transplantation.

[Analysis of the demand for detection of SARSCoV-2 in a health area of Spain]. / Análisis de la demanda de detección de SARS-CoV-2 en un área de salud de España.

OBJECTIVE: Since the discovery of the SARS-CoV-2 virus, the polymerase chain reaction technique (RT-PCR) has become the fundamental method for diagnosing the disease in its acute phase. The objective is to describe the demand-based series of RT-PCR determinations received at a Microbiology Service at a third-level reference hospital for a health area for three months spanning from the onset of the epidemic by SARS-CoV-2. METHODS: A retrospective analysis of the total of the RT-PCR requested in the Microbiology Service analyzed from 02/25/2020 to 05/26/2020 (90 days) has been carried out. They have been grouped by epidemiological weeks and by the petitioner service. A descriptive analysis was carried out by age, gender and number of requests for each patient. In the tests carried out, a confidence level of 95% (p <0.05) was considered significant. RESULTS: A total of 27,106 requests was received corresponding to 22,037 patients. Median age 53.7 (RIC 40.9-71.7) years, women: 61.3%. Proportion of patients with any positive RT-PCR: 14%. Of the total requests for RT-PCR, positive 3,710. Week 13 had the highest diagnosis performance (39.0%). The primary care has been the service thar has made the most requests (15,953). Patients with 3 or more RT-PCR: 565, of them, 19 patients had a positive result after previously having a negative one. CONCLUSIONS: Requests have been increasing depending on the evolution of the epidemic. The RT-PCR has a high diagnostic performance in the phases of highest contagiousness and / or transmissibility of the virus.

Proposal of the Andalusian Center for Sports Medicine to carry out stress tests with gas analysis on elite athletes during the SARS-CoV-2 pandemic

The current pandemic situation, produced by SARS-CoV-2, forces exercise physiology laboratories to take a series of additional measures for the safe performance of stress tests, both diagnostic and performance. The objective of this report is to present preventive measures to be taken to avoid contagion by SARS-CoV-2 during exercise tests on athletes, proposed by the professionals of the Andalusian Center for Sports Medicine, based on scientific evidence available, and oriented towards its application in the laboratory itself, to athletes and to all professionals who participate in its evaluation. © 2020 Centro Andaluz de Medicina del Deporte. All rights reserved.

SARS-CoV-2 and masks: their effectiveness, reuse and use in athletes

Since May 20, the mandatory use of a mask in closed or open public places where the distance of two meters cannot be maintained, has been in force in Spain. With the arrival of SARS-CoV-2 months ago, there has been a discussion about which type of mask is most appropriate for the general and/or health population. To this, doubts about its use in the sports population are added after reincorporation into their training after the confinement caused by the pandemic. Attempts have been made to respond from different official, journalistic and/or different types of investigations. Seeking to shed some light on these issues, we propose this review of what has been published with scientific value to date in PUBMED, with the following objectives: (1) to compare the efficacy of homemade, surgical and FFP2 masks and/or indications according to the target population;(2) possibility for reuse;(3) indication or not for athletes.

The protocol of the Andalusian Center for Sports Medicine, for the screening of SARS-CoV-2 infection in athletes

Objective: To publicize the protocol designed by the Andalusian Center for Sports Medicine, for the screening of SARS-CoV-2 infection in athletes. Method: Consensus of the professionals of the Andalusian Center for Sports Medicine after reviewing the existing protocols for screening the clinical situation COVID-19. Results: A protocol for the screening of SARS-CoV-2 infection in athletes has been developed, which consists of an action plan, a screening questionnaire, a database that includes the entire monitoring of athletes and a system to issue a fitness report to the athlete. Conclusion: A complete protocol for the screening of COVID-19 is proposed, specifically designed for its application in the field of sport, to promote safe sports practice. © 2020 Centro Andaluz de Medicina del Deporte. All rights reserved.