[Excessive daytime sleepiness in older adults of a municipal physical activity program] / Somnolencia diurna excesiva en adultos mayores de un programa municipal de actividad física.

Introduction: Physical exercise has been shown to have a favorable impact on the health of the individual. Its combination with other healthy lifestyles can positively impact various areas, including sleep quality. Objective: To determine the frequency of excessive daytime sleepiness in older adults of a municipal physical activity program in Santiago de Cali, Colombia. Methodology: Cross-sectional study that included 605 older adults from a community program of the Secretary of Recreation and Sports of the City of Cali, Colombia, during October 2018 and June 2019. To determine the presence of excessive daytime sleepiness, the Epworth Sleepiness Scale was used. Results: 81.5% of the population was female with a mean age of 73±8 years. The prevalence of excessive daytime sleepiness was 10.5%. Significant differences were only found in the frequency of excessive daytime sleepiness by socioeconomic stratum, being more common in the low socioeconomic stratum (13% vs 4% P=0.03). Conclusion: Excessive daytime sleepiness is a phenomenon that affects older adults; however, its frequency may be lower in those who are physically active.

Introducción: El ejercicio físico ha demostrado tener un impacto favorable en la salud del individuo. Su combinación con otros estilos de vida saludable, puede impactar de forma positiva diversas áreas entre las que se encuentra la calidad del sueño. Objetivo: Determinar la frecuencia de somnolencia diurna excesiva en adultos mayores de un programa municipal de actividad física de Santiago de Cali, Colombia. Metodología: Estudio de corte trasversal que incluyó 605 adultos mayores de un programa comunitario de la Secretaría de Recreación y Deporte de la Ciudad de Cali, Colombia, durante octubre de 2018 y junio de 2019. Para determinar la presencia de somnolencia diurna excesiva se usó la escala de somnolencia Epworth. Resultados: El 81,5% de la población era de sexo femenino con una edad promedio de 73±8 años. La prevalencia de somnolencia diurna excesiva fue del 10,5%.  Sólo se encontró diferencias significativas en la frecuencia de somnolencia diurna excesiva por estrato socioeconómico, siendo más habitual en el bajo (13% vs 4% P=0,03). Conclusión: La somnolencia diurna excesiva es un fenómeno que afecta los adultos mayores, sin embargo, su frecuencia puede ser menor en aquellos que realizan actividad física.

Usability of a mobile application for the clinical follow-up of patients with chronic obstructive pulmonary disease and home oxygen therapy.

BACKGROUND: Technological health tools (e-Health) may potentially facilitate the treatment of patients with chronic diseases through development of self-management and -care skills in patients and caregivers. However, these tools are usually marketed without prior analysis and without providing any context to final users, which frequently results in low adherence to their use. PURPOSE: To determine the usability of and satisfaction toward a mobile app for the clinical monitoring of patients with chronic obstructive pulmonary disease (COPD) receiving oxygen therapy at home. METHODS: This was a participative-qualitative study focused on final users-with direct intervention by patients and professionals-consisting of three phases as follows: (i) medium-fidelity mockups design, (ii) development of a usability test for each user profile, and (iii) assessment of the satisfaction level regarding the usability of the mobile app. A sample was established and selected through non-probability convenience sampling and was divided into two groups as follows: healthcare professionals (n = 13) and patients (n = 7). Each participant received a smartphone with mockup designs. The "think-aloud" method was applied in the usability test. Participants were audio recorded and the anonymous transcriptions were analyzed, highlighting fragments about mockups characteristics and the usability test. The difficulty level of the tasks was assessed with a scale from 1 (very easy) to 5 (too difficult), and task non-completion was considered a critical mistake. The satisfaction level related to test usability was assessed with a 4-score Likert scale ranging from 4 (totally agree) to 1 (totally disagree). RESULTS: Regarding the difficulty level, >60% of professionals described most tasks as "very easy" and 70% of patients as "easy." No participant made critical mistakes and both groups reported a high satisfaction level regarding the usability variables. The patient and professionals group required 18 and 11 min to complete all tasks, respectively. CONCLUSIONS: Participants described the app as intuitive and easy to use. The usability satisfaction results show a high level of satisfaction for both groups. This positive assessment and performance in user tests showed that the mobile application was able to be apprehended and used by participants in the circumstances of use in the usability tests. Usability evaluation through satisfaction surveys and qualitative data analysis allows for greater insight into the use of mobile applications in healthcare.

Conocimientos sobre asistencia respiratoria en cuidadores domiciliarios dos años después de una intervención educativa / Knowledge of respiratory assistance in home caregivers two years after an educational intervention

Introducción: Los cuidadores tienen un papel fundamental en el abordaje de pacientes con enfermedad respiratoria y hospitalización domiciliaria, por lo anterior, la educación de estos es esencial dado que permite la adquisición o actualización de conocimiento capaz de perfeccionar su quehacer y mejorar la calidad de la atención. Método: Estudio longitudinal, en 33 cuidadores de pacientes domiciliarios con formación técnica en enfermería a los que se les aplicó dos cuestionarios sobre tópicos de succión endotraqueal e inhaloterapia dos años después de una intervención educativa. Resultados: El 97% de los cuidadores eran de sexo femenino, el 43% contaba con experiencia laboral superior a 36 meses y un 86% dedicaban hasta 12 horas en el cuidado de pacientes. Aunque no se encontraron diferencias en el porcentaje de aprobación de las pruebas de succión endotraqueal e inhaloterapia a dos años, en la última se evidenció un incremento en el puntaje global (22 ± 1,8 versus 28 ± 1,5 p = 0,001). Conclusiones: La estrategia educativa en el programa de hospitalización domiciliaria resultó efectiva dado que los conocimientos perduraron en un periodo de tiempo de dos años.(AU)

Introduction: Caregivers have a fundamental role in the approach of patients with respiratory disease and home hospitalization, therefore, their education is essential since it allows the acquisition or updating of knowledge capable of perfecting their work and improving the quality of care attention. Method: Longitudinal study, in 33 caregivers of home patients with technical nursing training, who were administered two questionnaires about endotracheal suction and inhalation therapy two years after an educational intervention. Results: 97% of the caregivers were female, 43% had work experience of more than 36 months and 86% spent up to 12 hours caring for patients. Although no differences were found in the percentage of approval of the endotracheal suction and inhalation therapy tests at two years, in the latter there was an increase in the global score (22 ± 1.8 versus 28 ± 1.5 p = 0.001). Conclusions: The educational strategy in the home hospitalization program was effective since the knowledge lasted for a period of two years.(AU)

Specific Focus on Antifungal Peptides against Azole Resistant Aspergillus fumigatus: Current Status, Challenges, and Future Perspectives.

The prevalence of fungal infections is increasing worldwide, especially that of aspergillosis, which previously only affected people with immunosuppression. Aspergillus fumigatus can cause allergic bronchopulmonary aspergillosis and endangers public health due to resistance to azole-type antimycotics such as fluconazole. Antifungal peptides are viable alternatives that combat infection by forming pores in membranes through electrostatic interactions with the phospholipids as well as cell death to peptides that inhibit protein synthesis and inhibit cell replication. Engineering antifungal peptides with nanotechnology can enhance the efficacy of these therapeutics at lower doses and reduce immune responses. This manuscript explains how antifungal peptides combat antifungal-resistant aspergillosis and also how rational peptide design with nanotechnology and artificial intelligence can engineer peptides to be a feasible antifungal alternative.

Herramientas tecnológicas para el control y seguimiento de pacientes con enfermedades respiratorias y soporte de oxígeno / Technological tools for the control and follow-up of patients with respiratory diseases and oxygen support

El uso de las herramientas tecnológicas en salud permite llegar a puntos geográficos donde la medicina tradicional traza una brecha entre las instituciones de salud y los pacientes. Estas tecnologías pueden llegar a reducir las tasas de inasistencia médica, aumentar la adherencia al tratamiento y ayudar a garantizar la frecuencia apropiada de las visitas médicas. El presente trabajo se propuso realizar una revisión de la literatura sobre el control y seguimiento de pacientes con enfermedades respiratorias y soporte de oxígeno, a través de herramientas tecnológicas. Se realizó una búsqueda en las bases de datos Pubmed, Cochrane, Medline, Lilacs, Biomed, National Library, Science, con descriptores tipo Medical Subject Headings (MeSH) y Descriptores en Ciencias de la Salud (DeCS). El análisis de la literatura se realizó por medio de los elementos Strobe, Amstar. A partir de los estudios incluidos en el análisis final se puede evidenciar que la tecnología móvil en salud se ha convertido en una herramienta de gran importancia en el seguimiento y control de pacientes con enfermedades respiratorias, lo cual proporciona en tiempo real datos que pueden ser usados para minimizar complicaciones y ampliar la oportunidad de atención con calidad en pacientes con problemas respiratorios. No obstante, es necesaria la realización de ensayos clínicos que determinen los beneficios clínicos, al utilizar las herramientas tecnológicas en esta área(AU)

The use of technological tools in health allows reaching geographical points where traditional medicine draws a gap between health institutions and patients. These technologies can reduce medical absence rates, increase adherence to treatment, and help ensure the appropriate frequency of medical visits. In the present work it was proposed to carry out a review of the literature on the control and follow-up in patients with oxygen and respiratory diseases through technological tools. A search was carried out in the databases Pubmed, Cochrane, Medline, Lilacs, Biomed, National Library, Science, with descriptors such as Medical Subject Headings (MeSH) and Descriptors in Health Sciences (DeCS). The analysis of the literature was carried out using the elements Strobe, Amstar. From the studies included in the final analysis, it can be evidenced that mobile health technology has become a very important tool in the monitoring and control of patients with respiratory diseases, which provides data in real time that They can be used to minimize complications and expand the opportunity for quality care in patients with respiratory problems, however, it is necessary to carry out clinical trials to determine the clinical benefits, when using technological tools in this area(SU)

Mobile application for monitoring patients under home oxygen therapy: a protocol for a randomized controlled trial.

BACKGROUND: Mobile technologies have become capable of changing the paradigm of healthcare services. A clear example is that, nowadays, these technologies are an important instrument for data collection processes, epidemiologic surveillance, health promotion and disease prevention. Therefore, technological tools should be exploited to optimize the monitoring of patients with chronic diseases, including patients who require home oxygen therapy. PURPOSE: The purpose of this study is to determine the efficacy of a mobile application in the clinical monitoring of patients under home oxygen therapy. METHODS: This is a randomized controlled trial includes subjects of 18 years or older diagnosed with Chronic Obstructive Pulmonary Disease (COPD) who are under home oxygen therapy. Subjects will be divided into two arms: the intervention group will include patients who will be monitored with a mobile application, and the control group will include patients monitored by conventional follow-up methods (periodic visits of a respiratory therapist). The following outcome variables will be considered to measure the effect of the intervention: identification of dyspnea self-management, number of acute exacerbations associated with oxygen therapy, and the occurrence of oxygen supply underuse. DISCUSSION: This study is expected to assess the efficacy of a mobile application in the follow up of patients under home oxygen therapy. It will also determine whether the monitoring of a six-month intervention by a team comprising a physician, a nurse and respiratory therapists can decrease acute exacerbations, determine the most appropriate oxygen dose, and identify the underuse of oxygen systems and supplies. TRIAL REGISTRATION: The study has been registered at ClinicalTrials.gov ( NCT04820790 ; date of registration: March 29, 2021).

[School absenteeism in asthmatic students of an academic institution in Cali]. / Ausentismo escolar en estudiantes asmáticos de una institución educativa de la ciudad de Cali.

Introduction: Asthma as a chronic inflammatory disease of the airways that is characterized by wheezing, respiratory distress, chest tightness and cough, which occurs mainly at night or in the early hours of the morning. In spite of the diagnostic and therapeutic advances, the prevalence of this pathology worldwide continues to increase, affecting mainly the child and adolescent population, in which it generates limitations in daily physical activity, interference in sleep, absence from school days and low academic performance. The objective of this study was to determine the frequency of school absenteeism in asthmatic students of an educational institution in the city of Cali. Methodology: A total of 385 students from 5 to 14 years were included in the study, to which they were supplied with the ISAAC questionnaire, which were completed by the caregivers. From the data obtained, the statistical analysis was performed in the SPSS package version 20 Results: The prevalence of asthma found was 27%, in relation to the absenteeism in this group of students it was evidenced that in total 776 days of classes had been lost during the year, with an average of 7.5 days (DE +/- 7) per student. 45% missed 1-5 times and 6% more than 20 times Conclusions: Based on the findings, it is concluded that asthma is a disease that can have clear repercussions at school level.

Introducción: El asma como una enfermedad crónica inflamatoria de las vías aéreas que se caracteriza por sibilancias, dificultad respiratoria, opresión torácica y tos, la cual se da principalmente en la noche o en las primeras horas de la mañana. A pesar de los avances diagnósticos y terapéuticos, la prevalencia de esta patología a nivel mundial sigue en aumento, afectando principalmente la población infantil y adolescente, en las que genera limitaciones en la actividad física diaria, interferencias en el sueño, ausencias a las jornadas escolares y bajo rendimiento académico. El objetivo del presente estudio fue determinar la frecuencia de ausentismo escolar en estudiantes asmáticos de una institución educativa de la ciudad de Cali. Metodología: Un total de 385 estudiantes de 5 a 14 años fueron incluidos en el estudio, a los cuales se les suministro el cuestionario ISAAC, los cuales fueron diligenciados por los cuidadores. A partir de los datos obtenidos se realizó el análisis estadístico en el paquete SPSS versión 20. Resultados: La prevalencia de asma encontrada fue del 27%, con relación el ausentismo en este grupo de estudiantes se evidenció que en total 776 días de clases se habían perdido durante el año, con un promedio de 7.5 días (DE +/- 7) por estudiante. El 45% faltó de 1-5 veces y un 6% más de 20 veces. Conclusiones: A partir de los hallazgos se concluye que el asma una enfermedad que puede traer claras repercusiones a nivel escolar.

Prevalence and Potential Factors Associated with Tobacco Consumption in Schooled Adolescents / Prevalencia y posibles factores asociados al consumo tabáquico en adolescentes escolarizados / Prevalência e possíveis fatores associados ao consumo de tabaco em adolescentes escolarizados

ABSTRACT Objective: This study estimates the prevalence in tobacco consumption and the associated factors in adolescents at official educational institutions in the municipality of Palmira. Methods: This was a cross-sectional analysis with an analytical component, including 205 high school students from six official schools. The analysis was performed through the SPSS statistics software version 24. Qualitative variables were expressed as ratios with their corresponding 95 % confidence intervals (CI). Quantitative variables were expressed as central tendency and dispersion measures, depending on the distribution of the variable. Finally, an odds ratio was calculated for the associated factors with a 95 % CI and the binary logistic regression model statistical model was used to adjust the variables. Results: The tobacco consumption's overall prevalence was 38.5%, CI 95 % (31.6-45.4 %); e-cigarette, 20 %, 95 % CI (14.2-25.7 %); cigarette, 18.5 %, 95 % CI (12.9-24.1 %) and hookah, 17.9 %, 95 % CI (12.1-23 %), with a greater incidence in women than men. The resulting associated factors were age (OR 3.17, CI 95 % [1.48-6.79]), a partner who smokes (OR 2.51, 95 % CI (1.36-4.63 %), friends who smoke (OR 7.0, 95 % CI [3.4-14.5]), and the possibility of buying individual cigarettes instead of a pack (OR 2.60, 95 % CI (1.26-5.3). Conclusions: Smoking habit's overall prevalence is higher than the one reported in adolescents. Female subjects reported greater and more frequent consumption of e-cigarettes.

RESUMEN Objetivo: estimar la prevalencia del consumo de tabaco y los factores asociados a esta práctica en adolecentes de instituciones educativas oficiales del municipio de Palmira. Métodos: estudio transversal con un componente analítico, que incluyó 205 estudiantes de bachillerato de seis colegios oficiales. El análisis se realizó con el programa estadístico SPSS versión 24. Las variables cualitativas se expresaron como proporciones, con sus respectivos intervalos de confianza (IC) al 95 %; y las variables cuantitativas como medidas de tendencia central y dispersión, según la distribución de la variable. Para los factores asociados, se calcularon Odds ratio con su IC al 95 %, y el ajuste de variables se realizó a través de regresión logística binaria. Resultados: la prevalencia global del consumo tabáquico fue del 38.5 %, IC 95 % (31.6-45.4 %); cigarrillo electrónico, del 20 %, IC 95 % (14.2-25.7 %); cigarrillo, del 18.5 %, IC 95 % (12.9-24.1 %); y narguile, del 17.9 %, IC 95 % (12.1-23 %), con más frecuencia en mujeres que en hombres. Los factores asociados fueron la edad (OR 3.17, IC 95 % [1.48-6.79]), tener novio que consuma tabaco (OR 2.51, IC 95 % (1.36-4.63 %), estar rodeado de amigos que fumen (OR 7.0, IC 95 % [3.4 -14.5]) y comprar cigarrillos sueltos (OR 2.60, IC 95 % (1.26-5.3). Conclusión: la prevalencia global del hábito tabáquico es superior a la reportada en adolescentes, mayor en el sexo femenino, con mayor frecuencia de consumo de cigarrillos electrónicos. Los factores asociados fueron la edad, tener novio o amigos que consuman tabaco y la posibilidad de comprar cigarrillos sueltos.

RESUMO Objetivo: estimar a prevalência do consumo de tabaco e os fatores associados a esse hábito em adolescentes de instituições educativas oficiais do município de Palmira, Colômbia. Métodos: estudo transversal com um componente analítico, que incluiu 205 estudantes do ensino médio de seis colégios oficiais. A análise foi realizada com o programa estadístico SPSS versão 24. As variáveis qualitativas foram expressas como proporções, com seus respectivos intervalos de confiança (IC) a 95 %; as variáveis quantitativas como medidas de tendência central e dispersão, segundo a distribuição da variável. Para os fatores associados, foram calculados Odds ratio com seu IC a 95 %, e o ajuste de variáveis foi realizado por meio de regressão logística binária. Resultados: a prevalência global do consumo de tabaco foi de 38,5 %, IC 95 % (31,6-45,4 %); cigarro eletrônico, de 20 %, IC 95 % (14,2-25,7 %); cigarro, de 18,5 %, IC 95 % (12,9-24,1 %); narguilé, de 17,9 %, IC 95 % (12,1-23 %), com mais frequência em mulheres do que em homens. Os fatores associados foram a idade (OR 3,17, IC 95 % [1,48-6,79]), ter parceiro(a) que consuma tabaco (OR 2,51, IC 95 % (1,36-4,63 %), estar rodeado(a) de amigos que fumam (OR 7,0, IC 95 % [3,4 -14,5]) e comprar cigarro solto (OR 2,60, IC 95 % (1.26-5.3). Conclusões: a prevalência global do hábito tabágico é superior à relatada em adolescentes, maior no sexo feminino, com mais frequência de consumo de cigarros eletrônicos. Os fatores associados foram a idade, ter parceiro(a) ou amigos que consumam tabaco e a possibilidade de comprar cigarros soltos.

Efectos de un programa educativo para cuidadores de pacientes con afecciones respiratorias en el domicilio / Effects of an educational program in caregivers of patients with respiratory diseases in the home

Introducción: La educación en salud en el ámbito domiciliario, es determinante para fortalecer las competencias del equipo de salud. Objetivo: Identificar los efectos de un programa educativo en cuidadores con formación técnica en enfermería de un programa de atención domiciliaria. Métodos: Estudio cuasi experimental. Se tomó la población total de cuidadores con formación técnica en enfermería de una institución, correspondientes a 55 sujetos pertenecientes a las sedes de la ciudad de Cali y al municipio de Palmira, en 2017. El programa educativo consistió en capacitar en temas del cuidado respiratorio en casa, las estrategias de comunicación se enmarcaron en talleres, folletos y videos. Se creó una base de datos ajustada al propósito de los objetivos planteados, la cual fue analizada en el formato SPSS versión 20, y sometida a procesos de revisión y consistencia de datos. Los instrumentos de medición fueron cuestionarios autoadministrados, realizados por las autoras y validados en una prueba piloto aplicada a 33 auxiliares de enfermería externos a la institución, con las mismas características de la población de estudio. Resultados: Tras la ejecución de la intervención educativa se evidenciaron cambios en el puntaje global de los test de succión de la vía aérea (diferencia media pretest vs postest 2,034 p = 0,0001) e inhaloterapia (diferencia media pretest vs postest 1,355 p = 0,043). Conclusiones: La educación en salud en el contexto domiciliario se convierte en una estrategia importante para garantizar intervenciones oportunas dentro de los planes de atención(AU)

Introduction: Health education in the home environment is crucial to strengthen the competences of the health team. Objective: To identify the effects of an educational program in caregivers with technical training in nursing of a home care program, 2017. Methodology: Type of quasi-experimental study, the total population of caregivers with technical training in nursing of an institution was taken, corresponding 55 subjects belonging to the headquarters of the city of Cali and the municipality of Palmira. The educational program consisted of training in topics of respiratory care at home, communication strategies were framed in workshops, brochures and videos. A database adjusted to the purpose of the proposed objectives was created, which was analyzed in the SPSS version 20 format, and subjected to data review and consistency processes. The measurement instrument was a self-administered questionnaire, carried out by the authors and validated in a pilot test applied to 33 nursing auxiliaries external to the institution, with the same characteristics of the study population. Results: It was found that there is a significant difference after providing education regarding airway suction technique, with an average difference of 2.03 P value of 0.000. Conclusions: health education in the home context becomes an important strategy to ensure timely interventions within the care plans(AU)

ADHERENCE TO THE HELPING BABIES BREATHE STRATEGY AT DELIVERY ROOM OF AN INSTITUTION LEVEL II OF CALI (COLOMBIA), YEAR 2017: CROSS SECTIONAL STUDY.

OBJECTIVE: To determine adherence, overall and by components, to the Helping Babies Breathe strategy by physicians caring for neonates in an intermediate complexity institution. METHODS: Cross-sectional study that included live neonates born by spontaneous vaginal delivery and who received care from pediatricians, gynecologists or interns in the delivery room of a university hospital in the city of Cali, Colombia, in 2017. Fetuses with major congenital malformations, twins, and neonates with less than 34 weeks of gestational age were excluded. Sampling was systematic and the sample size was of 150 neonates. Baseline neonatal and maternal characteristics were assessed, as well as adherence to the Helping Babies Breathe strategy by physicians and its components. A descriptive analysis was performed. RESULTS: Adherence to the Helping Babies Breathe was 65.6% (95% CI 53.8-78.4) for pediatricians, 33.33% (95% CI: 4.3-77.7) for obstetricians and gynecologists, and 75.3% (95% CI: 64.8-85.1) for interns. The lowest frequency was found for cap placement on the neonate's head (64.90%; 95% CI: 56.7- 72.4) and placement of the baby in contact with the mother's skin, (65%; 95% CI: 55.9-74.4); the highest frequency was found for covering the baby with warm blankets (98.6%: 95% CI: 95.3-99.8), and positive pressure ventilation in cases of absent response to initial stimulation (100%; 95% CI 30-100). CONCLUSIONS: Results pertaining to the degree of adherence on the part of the practitioners suggest the need to implement continuous education and evaluation processes focused on the application of this proven strategy in institutions offering child-birth care.

TITULO: ADHERENCIA A LA ESTRATEGIA MINUTO DE ORO EN SALA DE PARTOS DE UNA INSTITUCIÓN DE SEGUNDO NIVEL, DE CALI (COLOMBIA), JUNIO-AGOSTO DE 2017: ESTUDIO DE CORTE TRANSVERSAL. OBJETIVO: determinar la adherencia global y por componentes a la estrategia minuto de oro en médicos que atienden recién nacidos en una entidad de mediano nivel de complejidad. METODOS: estudio de corte transversal; se incluyeron recién nacidos vivos de partos vaginales espontáneos atendidos por médicos pediatras, ginecólogos o internos en sala de partos de un hospital universitario de la ciudad de Cali, Colombia, en el 2017. Se excluyeron fetos con malformaciones congénitas mayores, gemelares y con menos de 34 semanas de edad gestacional. Muestreo sistemático. Tamaño muestral: 150 recién nacidos. Se evaluaron las características basales de los recién nacidos y sus madres, y la adherencia a la estrategia minuto de oro y sus componentes. Se hizo análisis descriptivo. RESULTADOS: la adherencia al minuto de oro en médicos pediatras fue del 65,6 % (IC 95 %: 53,8-78,4), en ginecobstetras, de 33,33 % (IC 95 %: 4,3-77,7), y en médicos internos, de 75,3 % (IC 95 %: 64,8-85,1). La menor frecuencia se dio en la colocación del gorro al recién nacido, 64,90 % (IC 95 %: 56,7-72,4), y poner al bebé piel a piel sobre la madre, 65 % (IC 95 %: 55,9-74,4); la mayor frecuencia se presentó en cubrir al recién nacido con paños calientes, 98,6 % (IC 95 %: 95,3-99,8), y la ventilación con presión positiva en los casos en los que no había respuesta a la estimulación inicial, 100 % (IC 95 %: 30-100). CONCLUSIONES: los resultados obtenidos sobre el grado de adherencia de los profesionales sugieren la necesidad de realizar procesos continuos de educación y evaluación sobre la aplicación de esta estrategia de reconocida efectividad en las instituciones que ofrecen el servicio de atención de partos.

Adherencia a la estrategia minuto de oro en sala de partos de una institución de segundo nivel, de cali (colombia), junio-agosto de 2017: estudio de corte transversal / Adherence to the helping babies breathe strategy at delivery room of an institution level ii of cali (colombia), year 2017: cross sectional study

RESUMEN Objetivo: determinar la adherencia global y por componentes a la estrategia minuto de oro en médicos que atienden recién nacidos en una entidad de mediano nivel de complejidad. Materiales y métodos: estudio de corte transversal; se incluyeron recién nacidos vivos de partos vaginales espontáneos atendidos por médicos pediatras, ginecólogos o internos en sala de partos de un hospital universitario de la ciudad de Cali, Colombia, en el 2017. Se excluyeron fetos con mal- formaciones congénitas mayores, gemelares y con menos de 34 semanas de edad gestacional. Muestreo sistemático. Tamaño muestral: 150 recién nacidos. Se evaluaron las características basales de los recién nacidos y sus madres, y la adherencia a la estrategia minuto de oro y sus componentes. Se hizo análisis descriptivo. Resultados: la adherencia al minuto de oro en médicos pediatras fue del 65,6 % (IC 95 %: 53,8-78,4), en ginecobstetras, de 33,33 % (IC 95 %: 4,3-77,7), y en médicos internos, de 75,3 % (IC 95 %: 64,8- 85,1). La menor frecuencia se dio en la colocación del gorro al recién nacido, 64,90 % (IC 95 %: 56,7- 72,4), y poner al bebé piel a piel sobre la madre, 65 % (IC 95 %: 55,9-74,4); la mayor frecuencia se presentó en cubrir al recién nacido con paños calientes, 98,6 % (IC 95 %: 95,3-99,8), y la ventilación con presión positiva en los casos en los que no había respuesta a la estimulación inicial, 100 % (IC 95 %: 30-100). Conclusiones: los resultados obtenidos sobre el grado de adherencia de los profesionales sugieren la necesidad de realizar procesos continuos de educación y evaluación sobre la aplicación de esta estrategia de reconocida efectividad en las institu- ciones que ofrecen el servicio de atención de partos.

ABSTRACT Objective: To determine adherence, overall and by components, to the Helping Babies Breathe strategy by physicians caring for neonates in an intermediate complexity institution. Materials and Methods: Cross-sectional study that included live neonates born by spontaneous vaginal delivery and who received care from pediatricians, gynecologists or interns in the delivery room of a university hospital in the city of Cali, Colombia, in 2017. Fetuses with major congenital malformations, twins, and neonates with less than 34 weeks of gestational age were excluded. Sampling was systematic and the sample size was of 150 neonates. Baseline neonatal and maternal characteristics were assessed, as well as adherence to the Helping Babies Breathe strategy and its components. A descriptive analysis was performed. Results: Adherence to the Helping Babies Breathe was 65.6% (95% CI 53.8-78.4) for pediatricians, 33.33% (95% CI: 4,3-77,7) for obstetricians and gynecologists, and 75.3% (95% CI: 64,8-85,1) for interns. The lowest frequency was found for cap placement on the neonate's head, 64.90% (95% CI: 56.7-72.4), and placement of the baby in contact with the mother's skin, 65% (95% CI: 55.9-74.4); the highest frequency was found for covering the baby with warm blankets, 98,6% (95% CI: 95.3-99.8), and positive pressure ventilation in those cases of absent response to initial stimulation, 100% (95% CI 30-100). Conclusions: Results pertaining to the degree of adherence on the part of the practitioners suggest the need to implement continuous education and evaluation processes focused on the application of this strategy which has been shown to be effective in institutions offering childbirth care.

Entrenamiento muscular respiratorio en un paciente neurocrítico con ventilación mecánica prolongada / Muscle respiratory training in neurocritical patient with prolonged mechanical ventilation

La ventilación mecánica se instaura con frecuencia en los pacientes que ingresan a unidades de cuidados intensivos. A pesar de que su uso en la mayoría de los casos es transitorio, del 32% al 41% de los pacientes neurocríticos la requieren por periodos prologandos debido a diversas condiciones que dificultan el destete. En circunstancias en las que la causa de su prolongación es la debilidad muscular, tiene importancia el entrenamiento muscular inspiratorio, el cual puede contribuir al incremento de la fuerza muscular y facilitar el destete. El objetivo del presente reporte es describir el caso de un paciente de 65 años con hemorragia subaracnoidea Fisher III, ventilación mecánica prolongada, y dificultad para el destete en quien se implementó una estrategia de entrenamiento muscular respiratorio.

Mechanical ventilation is frequently established in patients admitted to intensive care units. Although its use in most cases is transient, from 32% to 41% of neurocritical patients require it for prolonged periods due to various conditions that make it difficult to wean. In circumstances in which the cause of its prolongation is muscle weakness, inspiratory muscle training is important, which can contribute to the increase of muscular strength and facilitate weaning. The objective of this report is to describe the case of a 65-year-old patient with Fisher III subarachnoid hemorrhage, prolonged mechanical ventilation and difficulty in weaning in whom a respiratory muscle training strategy was implemented.