Experiences of grief and moral sentiments in survivors of the armed conflict in Medellín, Colombia.

The objective of the study is to understand the experience of grief and moral sentiments in survivors of the armed conflict in the city of Medellín, Colombia, through qualitative research. In total, 32 people affected by different victimising acts in the context of the armed conflict participated. There is a direct relationship between moral sentiments and the processes of handling and processing loss. Moral sentiments frame the experience of emotions in the victim, after the events have occurred, which influence the way in which the pain experienced is processed. These sentiments permeate the processes of dealing with the incident in survivors, the ways in which they perceive themselves and the perpetrators, and the social stances they adopt to face life. We conclude that moral factors play a role in the emotional recovery of victims and are indicative the possibility or difficulty of processing the events that occurred.

Acute Intrathoracic Tuberculosis in Children and Adolescents with Community-Acquired Pneumonia in an Area with an Intermediate Disease Burden.

Tuberculosis (TB) in the pediatric population is a major challenge. Our objective was to describe the clinical and microbiological characteristics, radiological patterns, and treatment outcomes of children and adolescents (from 1 month to 17 years) with community-acquired pneumonia (CAP) caused by TB. We performed a prospective cohort study of a pediatric population between 1 month and 17 years of age and hospitalized in Medellín, Colombia, with the diagnosis of radiologically confirmed CAP that had ≤ 15 days of symptoms. The mycobacterial culture of induced sputum was used for the bacteriological confirmation; the history of TB contact, a tuberculin skin test, and clinical improvement with treatment were used to identify microbiologically negative TB cases. Among 499 children with CAP, TB was diagnosed in 12 (2.4%), of which 10 had less than 8 days of a cough, 10 had alveolar opacities, 9 were younger than 5 years old, and 2 had close contact with a TB patient. Among the TB cases, 50% (6) had microbiological confirmation, 8 had viral and/or bacterial confirmation, one patient had multidrug-resistant TB, and 10/12 had non-severe pneumonia. In countries with an intermediate TB burden, Mycobacterium tuberculosis should be included in the etiological differential diagnosis (as a cause or coinfection) of both pneumonia and severe CAP in the pediatric population.

Induced sputum as an adequate clinical specimen for the etiological diagnosis of community-acquired pneumonia (CAP) in children and adolescents.

OBJECTIVES: This study aimed to evaluate the utility of induced sputum (IS) for the diagnosis of community-acquired pneumonia (CAP) in pediatric population. METHODS: This cross-sectional study included pediatric population aged between 1 month and 17 years who were hospitalized with a diagnosis of CAP in 13 hospitals in Colombia, in whom an IS sample was obtained. Gram staining, aerobic bacterial and mycobacterial culture tests, and polymerase chain reaction (PCR) for 6 atypical bacteria and 15 respiratory viruses were performed. We evaluated the quality of IS samples. RESULTS: IS samples were collected in 516 of 525 children included in this study. The median age was 32 months, 38.6% were younger than 2 years, and 40.9% were between 2 and 5 years. Two patients had transient hypoxemia during the procedure. The quality of the IS obtained was good in 48.4% and intermediate in 24.5%. Identification of a respiratory pathogen was achieved with an IS sample (with Gram staining, culture test, and PCR) in 372 of 516 children with CAP. CONCLUSION: Our study shows that IS is an adequate sample for the diagnosis of CAP in pediatric population that required hospitalization. The procedure was safe, well tolerated, and with better diagnostic yields compared with the rest of the samples obtained.

Experiences of Grief and Moral Sentiments in Survivors of the Armed Conflict in Medellín, Colombia. / Experiencias de duelo y sentimientos morales en sobrevivientes del conflicto armado en Medellín, Colombia.

The objective of the study is to understand the experience of grief and moral sentiments in survivors of the armed conflict in the city of Medellín, Colombia, through qualitative research. In total, 32 people affected by different victimising acts in the context of the armed conflict participated. There is a direct relationship between moral sentiments and the processes of handling and processing loss. Moral sentiments frame the experience of emotions in the victim, after the events have occurred, which influence the way in which the pain experienced is processed. These sentiments permeate the processes of dealing with the incident in survivors, the ways in which they perceive themselves and the perpetrators, and the social stances they adopt to face life. We conclude that moral factors play a role in the emotional recovery of victims and are indicative the possibility or difficulty of processing the events that occurred.

Trastornos emocionales y rendimiento académico en estudiantes de odontología / Emotional disorders and their relationship to academic achievement in dental students

Introducción: Los trastornos emocionales pueden tener influencia en el rendimiento académico de los estudiantes, sin embargo, los factores, tanto académicos como familiares y sociales, pueden modificar dicha relación. Objetivo: Describir los trastornos emocionales y su relación con el rendimiento académico en los estudiantes de la Facultad de Odontología de la Universidad Cooperativa de Colombia, sede Medellín, Envigado. Materiales y métodos: Se realizó un estudio transversal, en 140 estudiantes seleccionados aleatoriamente, a quienes se les realizó una encuesta con información sociodemográfica, de rendimiento académico y se les aplico un instrumento validado para medición de los trastornos emocionales. Se realizó un análisis univariado y bivariado. Resultados: participaron 140 estudiantes, la edad promedio fue 22,5 años, la mayoría mujeres 55,7%. En general el promedio de los estudiantes fue de 3,79 con una desviación estándar de 0,33 una mínima de 3,0 y una máxima de 4,5. Principalmente se encontró un mayor porcentaje del trastorno depresivo en un 18,6% y de ansiedad en 13,6% y no se encontró asociación con significación estadística entre los trastornos emocionales y el rendimiento académico, según la prueba chi-cuadrado (p≥0,05, chi-cuadrado). Conclusión: Los trastornos emocionales más frecuentes en los estudiantes de odontología fueron depresión y ansiedad. La depresión se presentó más en los estudiantes con rendimiento académico promedio (bueno).

Introduction: Emotional disorders can influence the academic performance of students, however, the factors, academic, family and social, can modify this relationship. Aim: To describe the emotional disorders and their relationship with academic performance in the students of the Faculty of Dentistry of the Cooperativa de Colombia University, Medellin, Envigado. Materials and methods: A cross-sectional study was conducted in 140 randomly selected students, who were surveyed with sociodemographic information, academic performance and applied a validated instrument for measuring emotional disorders. A univariate and bivariate analysis was performed. Results: 140 students participated, the average age was 22,5 years, most women 55,7%. In general the average of the students was of 3.79 with a standard deviation of 0.33 a minimum of 3,0 and a maximum of 4,5. Mainly, a greater percentage of the depressive disorder was found in 18,6% and of anxiety in 13,6% and there was no association with statistical significance between the emotional disorders and the academic performance, according to the chi-square test (p≥0.05, chi-square). Conclusion: The most frequent emotional disorders in dental students were depression and anxiety. Depression occurred more in students with average (good) academic performance.

Tailoring a compact and stable Langmuir bi-dimensional PbX-based layered perovskite film at the air-water interface and on solid support.

The present work studies the stability of Langmuir organic-inorganic superlattice materials thin films consisting of layered perovskite-based films with controlled 2D framework as well as to design experimental conditions for increasing the efficiency of the organic-inorganic perovskite motif by mechanical stimulus. Therefore, a whole covering of the air/water interface by a compact and stable lead-based layered perovskite structure is pursued. A 2D layered perovskite-type hybrid structure of the form [(CH3(CH2)19NH3)2(PbX4)], X=Cl, and Br, in which, two-dimensional sheets stabilized by a inner bilayer of organic monoammonium cation matrix, is mechanically tailored by successive compression-expansion cycles. The formation of 2D molecular patterns has been characterized by ΔR, BAM, XRD and XPS.

[Neurosurgical position causes peripheral nerve injuries?] / ¿La posición neuroquirúrgica ocasiona lesión de nervio periférico?

BACKGROUND: Positioning during neurosurgical procedures is a challenge for surgical teams even if precautions are taken, the mechanisms underlying peripheral nerve injury (elongation, compression or ischaemia) are latent and it is important to know the frequency of occurrence in our environment. OBJECTIVE: To analyze the frequency of peripheral nerve injury secondary to surgical positioning. MATERIALS AND METHODS: Prospective study including 163 patients scheduled for neurosurgical procedures. Four groups: supine, lateral, ventral and park bench were analyzed by neurological exploration in order to detect injury and relate with risk factors already described. RESULTS: In this study 112 patients were included, two patients who were under park bench position experienced paresthesias in ulnar region of less than 24 hours' duration; statistically significant correlation with body weight greater than 85kg. CONCLUSION: The incidence of peripheral nerve injury is low, understanding the mechanisms that may originate it helps towards prevention and early detection of complications.

Renal hydatid cyst: medical treatment.

INTRODUCTION: Hydatid disease is a zoonosis caused by the parasite Echinococcus granulosus. It has a worldwide distribution, being endemic in Portugal. Hydatid disease of the urinary tract is rare, occurring in less than 2% of all cases. CASE REPORT: 14-year-old male with hydatid disease of the kidney. The diagnosis was established by imaging studies and specific serologic testing. Treatment consisted of four 4-week cycles of albendazol and resulted in a progressive reduction of the cyst as well as in a negative specific serology. DISCUSSION: Even though the recommended treatment is surgical excision, studies have demonstrated that medical treatment may be an alternative allowing for organ preservation.

Cisto hidático do rim: tratamento médico / Renal hydatid cyst: medical treatment

Resumo Introdução: A infecção por Echinococcus ou hidatidose constitui-se em uma zoonose causada pelo parasita Echinococcus granulosus. Apresenta distribuição mundial, sendo Portugal considerado endêmico. A doença hidática do rim é rara, ocorrendo em apenas 2% dos casos. Caso Clínico: Adolescente de 14 anos, do sexo masculino, com doença hidática do rim. O diagnóstico foi efetuado por exames de imagem e por teste sorológico específico. Foi instituída terapêutica com albendazol durante quatro ciclos de quatro semanas cada, tendo-se verificado diminuição significativa do tamanho do cisto e negatividade dos anticorpos específicos. Discussão: Embora a terapêutica recomendada seja a excisão cirúrgica, estudos demonstram que a terapêutica médica pode ser uma alternativa a considerar, permitindo a preservação do órgão.

Abstract Introduction: Hydatid disease is a zoonosis caused by the parasite Echinococcus granulosus. It has a worldwide distribution, being endemic in Portugal. Hydatid disease of the urinary tract is rare, occurring in less than 2% of all cases. Case report: 14-year-old male with hydatid disease of the kidney. The diagnosis was established by imaging studies and specific serologic testing. Treatment consisted of four 4-week cycles of albendazol and resulted in a progressive reduction of the cyst as well as in a negative specific serology. Discussion: Even though the recommended treatment is surgical excision, studies have demonstrated that medical treatment may be an alternative allowing for organ preservation.

Direct observation by using Brewster angle microscopy of the diacetylene polimerization in mixed Langmuir film.

Mixed Langmuir monolayers of 10,12-Pentacosadiynoic acid (DA) and amphiphilic hemicyanine (HSP) have been fabricated at the air-water interface. The mixed monolayer has been proved to be completely homogeneous. The DA molecules are arranged in a single monolayer within the mixed Langmuir monolayer, as opposed to the typical trilayer architecture for the pure DA film. Brewster angle microscopy has been used to reveal the mesoscopic structure of the mixed Langmuir monolayer. Flower shape domains with internal anisotropy due the ordered alignment of hemicyanine groups have been observed. Given the absorption features of the hemicyanine groups at the wavelength used in the BAM experiments, the enhancement of reflection provoked by the absorption process leads to the observed anisotropy. The ordering of such groups is promoted by their strong self-aggregation tendency. Under UV irradiation at the air-water interface, polydiacetylene (PDA) has been fabricated. In spite a significant increase in the domains reflectivity has been observed owing to the modification in the mentioned enhanced reflection, the texture of the domains remains equal. The PDA polymer chain therefore grows in the same direction in which the HSP molecules are aligned. This study is expected to enrich the understanding and design of fabrication of PDA at interfaces.

Diacetylene mixed Langmuir monolayers for interfacial polymerization.

Polydiacetylene (PDA) and its derivatives are promising materials for applications in a vast number of fields, from organic electronics to biosensing. PDA is obtained through polymerization of diacetylene (DA) monomers, typically using UV irradiation. DA polymerization is a 1-4 addition reaction with both initiation and growth steps with topochemical control, leading to the "blue" polymer form as primary reaction product in bulk and at interfaces. Herein, the diacetylene monomer 10,12-pentacosadiynoic acid (DA) and the amphiphilic cationic N,N'-dioctadecylthiapentacarbocyanine (OTCC) have been used to build a mixed Langmuir monolayer. The presence of OTCC imposes a monolayer supramolecular structure instead of the typical trilayer of pure DA. Surface pressure, Brewster angle microscopy, and UV-vis reflection spectroscopy measurements, as well as computer simulations, have been used to assess in detail the supramolecular structure of the DA:OTCC Langmuir monolayer. Our experimental results indicate that the DA and OTCC molecules are sequentially arranged, with the two OTCC alkyl chains acting as spacing diacetylene units. Despite this configuration is expected to prevent photopolymerization of DA, the polymerization takes place without phase segregation, thus exclusively leading to the red polydiacetylene form. We propose a simple model for the initial formation of the "blue" or "red" PDA forms as a function of the relative orientation of the DA units. The structural insights and the proposed model concerning the supramolecular structure of the "blue" and "red" forms of the PDA are aimed at the understanding of the relation between the molecular and macroscopical features of PDAs.

[Care plan for patients with locked-in syndrome]. / Plan de cuidados en el síndrome de cautiverio.

We present a case and a Care Plan of a patient with Locked-in Syndrome. This is a disease of vascular origin, s characterised by a severe paralysis of the whole body, but not of the mind, as the intellectual faculties remain intact. We emphasise the importance of the development on the part of the professionals who take care of these patients and their communicative abilities, as they are essential in their treatment, for the satisfaction of the patients, their families and the professionals themselves. Communicating with these patients is a major challenge for professionals, who have to make use of their creative and communicative skills, which are essential for treatment to the satisfaction of patients themselves, their families and the professionals. We must also take into account the family involvement in the patient care. The union between the family and the patient is of vital importance in establishing a trusting relationship. During the development of our nursing duties, we must not forget the training the main caregiver must acquire to satisfy the main needs of the relative in the hospital, and at home in the future. Working together with the family is very important at all times, identifying the primary caregiver--although the support received by all is beneficial--and setting a series of common objectives to evaluate the progress of the case. It is about partnership: patient, family and professionals, must all establish a communication system adapted to each case by paying attention to the signals that the patient sends, and making use of an appropriate scale to interpret them suitably.