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Introduction: The pandemic affected the internship of health sciences students when they attended the hospital. Objective: To determine the factors associated with the perceived impact of the Peruvian hospital internship during COVID-19. Methods: Cross-sectional;descriptive, bivariate analytical and multivariate statistics were obtained based on an exploratory survey conducted as part of a larger investigation, to which variables such as age, sex, type of university, stress, anxiety, depression, and repercussions of the internship were associated. Results: Of 121 respondents, most of them thought that family would have supported if they have gotten a severe disease. Also, they thought that they could have infected their families or friends/acquaintances if they have gone to the hospital. Many of them disagreed on the statement about the hospital or university providing them safety implements. There was an association between thinking that they could have gotten COVID-19 if they have gone to the hospital versus anxiety score (p= 0,030), being a male according to the perception that the university provided materials to take care of themselves (p= 0,029), and having studied in a private university according to perceiving that the hospital would not have supported them if they have gotten seriously ill (p= 0,049). Conclusion: The factors associated with the perception of repercussions of the boarding school are family support, being able to infect their acquaintances, lack of materials provided by universities and hospitals, anxiety, being male, and coming from private universities. © 2023, Editorial Ciencias Medicas. All rights reserved.
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Introduction: Melanoma of the rectum is an extremely rare disease. The median survival rate is 2-5 years. Current treatment for this aggressive cancer is resection if possible and consider adjuvant or neoadjuvant radiotherapy;immunotherapy in nonresectable cases. Given the rapid spread of disease due to its submucosal growth and metastasis pattern, there is low success rates with treatments. Case Description/Methods: An 84-year-old male presented to the emergency department with an acute COVID-19 infection. The patient was also found to have gram-negative septicemia on blood cultures, so a CT abdomen/pelvis was performed (Figure 1a). The CT showed rectal wall thickening. A flexible sigmoidoscopy was planned for a future outpatient visit after recovering from his acute infection. The patient, however, developed an acute onset of dyspnea and had a high probability V/Q scan while in the hospital. He was started on anticoagulation, and shortly after starting therapy the patient developed bright red rectal bleeding. Due to the new onset of rectal bleeding it was decided to expedite the sigmoidoscopy. The sigmoidoscopy was performed in the hospital showing an ulcerated partially black pigmented non- obstructing medium-sized mass that was partially circumferential involving one-third of the lumen (Figure 1b). A biopsy of the lesion was taken using cold-forceps. The pathology stained positive for S100 consistent with melanoma. The diagnosis of anorectal melanoma was made, and colorectal surgery was consulted. The patient was deemed not to be a surgical candidate secondary to age and active COVID-19 infection. Oncology was consulted, and it was decided to start the patient on radiation and immunotherapy with a PD-1 inhibitor. Discussion(s): The symptoms of anorectal melanoma can be subtle and in this case report completely asymptomatic. Symptoms to be aware of are rectal bleeding and tenesmus. Diagnosing melanoma on sigmoidoscopy can be challenging as most tumors are not pigmented. Biopsies should be taken and sent for immunohistochemical staining for S100, if positive the patient should have a PET scan. Treatment choices for the tumor are based on staging. In a resectable tumor sphincter-saving local excision with radiotherapy to the site of the tumor and the pericolic and inguinal lymphatics is recommended. For unresectable tumors or tumors with distant metastasis, immunotherapy with PD-1 inhibitors (nivolumab and ipilimumab) is an emerging treatment choice.
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After the COVID 19 pandemic, universities were forced to interrupt face-to-face training and face the immediacy of a virtual learning environment. Almost two years after this event, it is urgent to rethink the training space and have a hybrid learning in which education makes both face-to-face and virtual training more flexible. Based on this premise, the objective of the article is to provide information on the contributions of scientific research on the use of virtual reality technology in the educational field from 2020 to 2022. This research is a review article. systematic, it is of a qualitative approach, basic-descriptive type. 15 articles have been selected for analysis from the Scopus database. For inclusion and exclusion criteria and search terms, based on the PRISMA protocol, are presented. © 2022, Associacao Iberica de Sistemas e Tecnologias de Informacao. All rights reserved.
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In recent years, technology applied to education has advanced by leaps and bounds;Pressured by the Covid-19 pandemic, it has been necessary to move from face-to-face to virtual, which has required teachers to show the full potential of digital tools, such as visual organizers. The objective of the research was the interpretation of the utility of graphic organizers (GO) for the acquisition of learning in higher education students. The methodology used was qualitative, a type of basic research of hermeneutic design;Through interviews with teachers with expertise in GO, interviews were conducted with teachers with extensive experience in the use of GO, processing the information with AtlasTi. As a result, the relevance of using the GO in higher education teaching was obtained, while emerging categories were obtained that will allow the best interpretation of the study variable. It is concluded that the use of GO has a positive significance in the assimilation of new knowledge to achieve significant learning. © 2022, Associacao Iberica de Sistemas e Tecnologias de Informacao. All rights reserved.
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We analyze the Brazilian production and diffusion of scientific literature on COVID-19 in 2020, to assess what was the protagonism of this country during this event. All documents were obtained from Web of Science and considered under bibliometric and altmetric analysis. We used the production and citation indicators crossed with other variables like author, institutional affiliation, impact factors, funding organizations, research areas, etc. A total of 2,703 articles were found, mostly published in December and in English, having received 10,190 citations, with an average of 3.77 citations per document, a value lower than that found for other countries. Ten journals concentrated publications, being only one of those not Brazilian. Sao Paulo University was the most producing institution. Analyzing the top 100 most cited articles with an altmetric tool, the average Altmetric Attention Score (AAS) was 392.22. From the 40,062 mentions on social media, 94.8% came from Twitter, mainly by general public (78.6%). The top 10 articles with the highest AAS concentrated 79,5% of all attention;eight of them were original investigations. We propose a content analysis to verify which specific topics are attracting greater interest from the general public, but not so much from the scientific community.
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Background: The impact of coronavirus disease 2019 (COVID-19) on individuals with End Stage Kidney Disease (ESKD) receiving maintenance hemodialysis (MHD) is unknown. This study aims to describe clinical characteristics and outcomes in a cohort of patients with ESKD receiving MHD hospitalized with confirmed COVID-19 infection in an urban community hospital during the New York City peak of the global COVID19 pandemic. Methods: Cases with a diagnosis of ESKD and COVID-19 based on positive PCR testing results were identified from retrospective review of electronic health records for patients hospitalized between March 4, 2020 and April 30, 2020. Electronic health records were reviewed in order to obtain demographic data, presenting symptoms, laboratory values, medical management, and outcomes. Results: 29 patients with ESKD on MHD with confirmed COVID-19 infection were identified. 16/29 (55%) were over age 60 years, 20 (69%) were male and 14 (48%) were Hispanic. 18 (62%) had Diabetes and 26 (89%) were overweight or obese (BMI >;25). All had hypertension. 68% were on Statin and 40% on ACE inhibitor or ARB at the time of admission. 25/29 (86%) were dialyzed via arteriovenous fistula or graft. The most common presenting symptoms were dyspnea (85%), cough (60%) and fever (28%). All initial chest radiographs showed abnormalities, with diffuse infiltrates on 21 (72.4%) and focal infiltrates on the remainder. All patients who required renal replacement therapy during hospitalization received conventional HD. 10 patients required mechanical ventilation during hospitalization (34%);all of these patients died. Overall, 13 patients (45%) died and 16 patients (55%) were discharged after a median of 6 and 7 days hospitalization, respectively. Three patients (10%) were readmitted during the period of observation. No significant associations were found between age, sex, race, or diabetes and mortality. Mechanical ventilation was the most consistent predictor of death. Conclusions: 45% mortality was observed in a small cohort of patients with ESKD on MHD with confirmed COVID-19 infection hospitalized during the peak of the global COVID-19 infection. This high mortality rate reinforces the need for social distancing and infection control measures to reduce transmission in this high risk population.
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In the context of the arrival of vaccines against COVID-19 in Peru, it is important to know which sectors are the most willing to be vaccinated. The objective of this study was to determine the socio-labor factors associated with the possibility of vaccination against COVID-19 if required by work. Analytical cross-sectional study, which had as its main question whether they would be vaccinated if it was a job requirement, this was compared according to work category, sex and age group;descriptive and analytical statistics were obtained. Of the 6628 workers surveyed, 34% and 35% would get vaccinated if required to do so by their job, based on whether they had not yet been sick or had already been sick, respectively. In the multivariate analysis, there was a higher frequency of agreement to be vaccinated among those in the mining sector (aPR: 1.33;95%CI: 1.05-1.69;p-value=0.019), those doing domestic work (aPR: 1.14;95%CI: 1.01-1.29;p-value=0.036) and men (aPR: 1.07;95%CI. 1.01-1.14;p-value=0.029);in contrast, those in the younger age range 40-49 years (aPR: 0.82;95%CI: 0.71-0.95;p-value=0.010) were less likely to be vaccinated than those in the younger age range (aPR: 0.82;95%CI: 0.71-0.95;p-value=0.010). There was a low perception of the possibility of getting vaccinated if asked to do so at work, the main factors associated with the possibility of getting vaccinated being not having been previously infected with COVID-19, belonging to the mining sector, performing domestic work and being male. © 2021 Instituto de Altos Estudios de Salud Publica. All rights reserved.