Antibody persistence 7 years after hepatitis-A vaccine in children with human immunodeficiency virus infection.

BACKGROUND: HIV-infected children have a higher risk of presenting infections, including the hepatitis A virus (HAV). The inactivated HAV vaccine is immunogenic in immunocompetent hosts; however, there are insufficient studies on the duration of seroprotection in HIV-infected children. METHODS: An analytical cohort study was conducted. HIV-1-infected children who received the inactivated HAV vaccine (2 doses) were included. Blood samples were taken for antibody measurement, the first one 28 days after the second dose and another 7 years after the vaccination schedule. Information on viral load, immunological category, weight, height, and response to antiretroviral treatment from diagnosis to the last assessment was obtained. RESULTS: 19 patients were included, with a mean age of 12.6 years (SD ± 2.29). 58% were male. 80% of the patients presented protective immunoglobulin G antibodies against HAV 7-year post-vaccination. The antibody concentration was found to be between 13 and 80 mIU/mL (median of 80 mIU/mL). 52% showed some degree of immunosuppression. There was no statistically significant relationship between the presence of seroprotection and viral load, treatment failure, immunological category, and malnutrition. Twelve patients presented with antiretroviral treatment failure, and in 33% of them, the antibodies did not offer satisfactory seroprotection. CONCLUSION: 7-year post-vaccination, 80% of HIV-infected children maintain seroprotection titers against HAV.

INTRODUCCIÓN: Los niños infectados por el virus de la inmunodeficiencia humana (VIH) tienen mayor riesgo de presentar infecciones, incluyendo hepatitis por virus A (VHA). La vacuna inactivada contra el VHA es inmunógena en el huésped inmunocompetente. No hay estudios suficientes sobre el tiempo de seroprotección en niños infectados por el VIH. MÉTODO: Estudio de cohorte, analítico. Se incluyeron niños con infección por VIH-1 que recibieron la vacuna inactivada contra el VHA (dos dosis). Se les tomaron muestras sanguíneas para medición de anticuerpos, una 28 días después de la segunda dosis y otra 7 años después del esquema de vacunación. Se obtuvo información de carga viral, categoría inmunológica, peso y talla, y respuesta al tratamiento antirretroviral desde el diagnóstico hasta la última valoración. RESULTADOS: Se incluyeron 19 pacientes con una edad media de 12.6 años (± 2.29). El 58% fueron del sexo masculino. El 80% de los pacientes presentaron anticuerpos immunoglobulin G (IgG) contra el VHA protectores a los 7 años de la vacunación. La concentración de anticuerpos se encontró entre 13 y 80 mUI/ml (mediana: 80 mUI/ml). El 52% mostraron algún grado de inmunosupresión. No existe relación estadísticamente significativa entre la presencia de seroprotección y la carga viral, la falla al tratamiento, la categoría inmunológica ni la desnutrición. Doce pacientes presentaron falla al tratamiento antirretroviral; en el 33% de ellos los anticuerpos no ofrecían seroprotección satisfactoria. CONCLUSIONES: A 7 años posvacunación, el 80% de los niños con VIH mantienen títulos de seroprotección frente al VHA.

Prevalence and Predictors of Somatization in Peruvian Undergraduate Students during the COVID-19 Pandemic.

The COVID-19 pandemic had a strong impact on mental health. Multiple studies report the alarming prevalence of depression, anxiety, and stress-related conditions due to the lockdown measures. Nevertheless, somatization has been an overlooked topic in current literature despite its strong relationship with most mental health conditions. The aim of this study was to describe the prevalence of somatic symptoms and their associated factors in a sample of 3218 undergraduate students from Lima, Peru. A cross-sectional design was carried out. The prevalence of somatic symptoms was measured with the PHQ-15. As predictors of somatic symptom severity, we included psychopathological (depression, anxiety, and stress), psychological (perceived social support, resilience, satisfaction with life, and academic self-efficacy), and sociodemographic (e.g., age, sex, employment status, relationship status, daily hours of sleep) variables. A generalized linear model from a binomial family and a logit link function were applied based on a Factor Score Regression approach, with half of the sample presenting moderate-to-severe somatic symptoms. Anxiety was the strongest predictor of somatic symptom severity, followed by academic self-efficacy. Significant differences were found regarding sex, relationship status, daily hours of sleep and COVID-19 risk-related variables. In conclusion, interventions on reducing anxiety and promoting academic self-efficacy may have a stronger impact on somatic symptom severity and should focus on more vulnerable specific demographic groups such as females.

Clinical presentation of pediatric patients with symptomatic SARS-CoV-2 infection during the first months of the COVID-19 pandemic in a single center in Mexico City.

Background: The clinical spectrum of COVID-19 is broad, from asymptomatic to severe cases and death. The objective of this study is to analyze the clinical course of patients attended during the first months of the SARS-CoV-2 pandemic in a third-level pediatric hospital. Methods: Design: prospective cohort study. Patients with viral respiratory disease or suspected cases of COVID-19 were evaluated at the Pediatric Hospital, National Medical Center XXI Century, Mexico City, from 21 March 2020 to 13 January 2021. Statistical analysis: Chi-square test and Fisher's exact test were used for comparisons; a logistic regression model was constructed to identify clinical or laboratory characteristics associated with critical disease. A p-value < 0.05 was considered statistically significant. Results: A total of 697 patients met the operational definition of viral respiratory disease or suspected cases of COVID-19 and underwent real-time reverse transcription polymerase chain reaction (rRT-PCR) SARS-CoV-2 testing. Patients with a positive result were included. Of the 181 patients (26%), 121 (66.8%) had mild disease and were treated as outpatients and 60 (33.1%) were hospitalized. A total of six patients met the criteria for multisystem inflammatory syndrome in children (MIS-C). Of the 60 inpatients, 65% were males, and 82% had one or more comorbidities. The main comorbidities were cancer (42%) and overweight (15%). The median hospital stay was 9 days. The inpatients had a higher frequency of fever, general malaise, dyspnea, chills, polypnea, and cyanosis than the outpatients (p < 0.05). Only 21.4% of the outpatients had one or more comorbidities, which were lower than in the hospitalized patients (p < 0.001). Laboratory data at admission were similar between critically ill and those with moderate and severe disease. The patients who developed pneumonia were at higher risk of critical disease, while older age was associated with a better prognosis. A total of 13 of the 60 inpatients died (mortality 7.1%). All but one had one or more comorbidities: four had cancer, four congenital heart disease, one chronic kidney disease and epilepsy, one Epstein-Barr virus-induced hemophagocytic lymphohistiocytosis, one obesity, and one diabetes mellitus. Conclusion: Hospital mortality is high, especially in children with comorbidities. Despite 2 years having passed since the beginning of the COVID-19 pandemic, the epidemiological and clinical data on children are still helpful to improve their prognosis.

A Poverty Simulation's Impact on Nursing and Social Work Students' Attitudes Towards Poverty and Health.

BACKGROUND: Currently, about 40 million people in the United States live in poverty, one of the most significant social determinants of health. Nurses and social workers must understand the effect of living in poverty on their clients' health and quality of life. PURPOSE: Nurses and social workers will encounter persons living in poverty. Therefore, beginning in their undergraduate education, health professions students must be aware of their attitudes towards poverty and how poverty affects health. METHODS: The Community Action Poverty Simulation was conducted with nursing and social work students at a small liberal arts institution. The Attitudes toward Poverty-Short Form (ATP-SF) and Beliefs Related to Poverty and Health (BRPH) tools were used pre- and postsimulation to assess students' attitudes about poverty and beliefs about the relationship between poverty and health. An emotional response plan was created to address participants' emotional responses by providing a separate space on-site and information about future resources. RESULTS: The ATP-SF showed a significant overall difference (p < .001) between pre- and postsimulation surveys, indicating a shift toward a structural explanation of poverty; the BRPH showed that participants believed poverty is the result of illness and inability to work (p < .01). CONCLUSION: This study supports poverty simulation use to promote awareness of attitudes towards those living in poverty and how poverty impacts health. Recommendations include using more community resource volunteers with first-hand poverty experience, allowing students to role-play adults or older teens in the simulation, and including other health professions students.

Guide to Implementing a Student- and Faculty-Led Interprofessional Poverty Simulation.

Abundant evidence supports the benefits of simulated learning. Simulations enhance students' communication and teamwork skills and expose students to situations they may not experience in clinical rotations. More specifically, research has confirmed the benefit of conducting poverty simulations with nursing and social work students from financially privileged backgrounds; these students demonstrated an enhanced structural understanding of poverty over a behavioral understanding, following simulated experiences (Noone, Sideras, Gubrud-Howe, Voss, & Mathews, 2012). This article describes the process of planning and implementing a poverty simulation.

Implementation of the TeamSTEPPS Curriculum With Baccalaureate Nursing and Social Work Students Utilizing Student Trainers: A Qualitative and Quantitative Study.

Nursing and social work education programs are seeking innovative ways to prepare students to function as collaborative members of interprofessional teams upon graduation. Communication is a key linked to a decrease in medical errors, which compromise patient safety. In response to nursing students' concerns about clinical experiences in which they had witnessed poor communication with the potential to jeopardize patient care, faculty members identified a communication skills training program designed to improve team performance. Senior nursing and social work students at the beginning of their last semester of school were trained in selected modules of the Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) training program and subsequently trained their student colleagues. The goal was to emphasize communication skills and strategies in a sustainable student trainer model. Qualitative and quantitative data about participant experiences revealed significant improvement in teamwork attitudes and communication skills following the training.

Depresión y ansiedad durante el aislamiento obligatorio por el COVID-19 en Lima Metropolitana / Depression and anxiety during the mandatory isolation period due to COVID-19 in Lima Metropolitan Area

Resumen Antecedentes la implementación de medidas de salud pública como la cuarentena o el aislamiento son estrategias útiles para el control de una enfermedad; no obstante, también traen consecuencias sobre la salud mental. Objetivos: describir la prevalencia de síntomas de ansiedad y depresión en adultos de Lima Metropolitana, durante el periodo de aislamiento social en respuesta a la pandemia del COVID-19. Método: se utilizaron ítems de la Escala de Ansiedad de Lima (EAL-20) y de la Escala de Psicopatología Depresiva (EPD-6) en una muestra de 565 adultos que residen en Lima Metropolitana durante el Estado de Emergencia Sanitaria. Resultados: se identificó la prevalencia de síntomas relacionados a la ansiedad y depresión. Además, se encontraron diferencias en función del sexo, edad, nivel educativo, y la modalidad del trabajo o estudio. Conclusiones: el aislamiento obligatorio implica la prevalencia de síntomas de ansiedad y depresión en adultos de Lima Metropolitana, los cuales se manifiestan de diferentes formas al considerar variables sociodemográficas. Esto es congruente con estudios a nivel internacional, por lo que deberían considerarse al tomar decisiones ligadas a políticas públicas de salud.

Abstract Background :the implementation of public health measures such as quarantines and isolation is a useful strategy for disease control; nonetheless, said measures may also have consequences on mental health. Objectives: to describe the prevalence of depression and anxiety symptoms in adults living in Lima Metropolitan Area during the social isolation period due to the COVID-19 pandemic. Method: items from the Lima Anxiety Scale (EAL-20) and the Depressive Psychopathology Scale (EPD-6) were used in a sample of 565 adults living in Lima Metropolitan Area during the health emergency. Results: prevalence of anxiety and depression symptoms were identified. Also, differences regarding sex, age, education level, and modality of work or study were found. Conclusions: the mandatory isolation period involves the prevalence of anxiety and depression symptoms in adults living in Lima Metropolitan Area. Such phenomena might occur in different ways according to the different sociodemographic variables. These findings are consistent with those from international studies; thus, they should be considered when making decisions related to public health policies.

Clinical management of COVID-19 paediatric cases. / Manejo clínico de casos pediátricos de COVID-19.

Coronaviruses are a family of viruses present in different species of animals, which can infect humans, causing epidemics and pandemics. On January 9th, 2020, a new virus was announced as the cause of an outbreak of severe pneumonia in Wuhan, China. On March 11th, WHO declared the SARS-CoV-2 pandemic, the disease was called COVID-19. The virus is transmitted by droplets, contact and airborne during aerosol-generating procedures. In almost all pediatric cases a household contact was the source of infection. Unlike adults, the disease in children has a mild course, even in those under one year of age. The main symptoms are fever, dry or productive cough, headache, general discomfort, and shortness of breath, which is a sign of severity. The incubation period is 1-12.5 days (media 5-6 days). The most affected age group are school children. The disease may present as a mild acute upper airway infection, or as pneumonia. Very few cases progress to severe pneumonia and other complications such as acute respiratory distress syndrome, shock and multiorgan failure. There is not yet a specific antiviral treatment approved for use in children. This document aims to guide the management of suspected or confirmed pediatric patients of COVID-19.

El 9 de enero de 2020 fue anunciado un nuevo virus como la causa de un brote de neumonía grave en Wuhan, China. El 11 de marzo, la Organización Mundial de la Salud declaró la pandemia por SARS-CoV-2, virus causante de la enfermedad COVID-19. El virus se transmite por gotas, contacto y por vía aérea en procedimientos que generan aerosoles. En el caso de los niños, la fuente de contagio casi siempre es un contacto intradomiciliario. En los pacientes pediátricos, la enfermedad tiene un curso leve, incluso en los menores de un año. Los principales síntomas son: fiebre, tos seca o productiva, cefalea, malestar general y dificultad respiratoria, que es un signo de gravedad. El período de incubación es de 1 a 12.5 días (media 5-6). El grupo de edad más afectado son los escolares. La enfermedad puede presentarse como un cuadro leve de infección aguda de vías aéreas superiores o como neumonía. Muy pocos casos progresan a neumonía grave y a complicaciones como síndrome de distrés respiratorio agudo, choque y falla multiorgánica. Aún no hay tratamiento antiviral específico aprobado para su uso en niños. El presente documento tiene como objetivo guiar el manejo de los pacientes pediátricos sospechosos o confirmados de COVID-19.

Competencies of the nurse in educational institutions: a look from educational managers. / Competencias de la enfermera en instituciones educativas: una mirada desde los gestores educativos.

OBJECTIVE: Describe and analyze the attributes of the nurse competencies in caring of students since the manager look of educational institutions. METHOD: Qualitative descriptive-exploratory study. Seven principals of educational institutions of Trujillo (Peru) participates in a non-structured interview during the first semester of 2016 and the analysis of oral discourse was used. RESULTS: Empirical categories: The nurse in the promotion of educational community health; The nurse in the prevention of the educational community illness; The student nurse articulating health - education in the everyday life of students. FINAL CONSIDERATIONS: This study contributes to the conceptual support of the competencies of the student nurse for the intersectoral health - education action and the setting-up of health with students in the educational institutions.

Principios de cuidado al adulto mayor en familias peruanas y mexicanas / Principles of caring to the elderly in Peruvian and Mexican families: comparative study

Resumen Objetivo: Caracterizar la dinámica familiar en el cuidado al adulto mayor según los principios de identidad, solidaridad, conversación y del amor en familias peruanas y mexicanas. El referencial teórico central estuvo dado por los principios de cuidado de la familia de Bustamante. Material y métodos: Estudio descriptivo-cualitativo, exploratorio comparado Perú-México en la perspectiva comparada Perú-México. Participaron en el estudio 10 familias seleccionadas de cada país, donde hay un adulto mayor como uno de sus miembros, cuyos núcleos pertenecen a estratos bajos en ambos casos. De sus representantes se tomaron los discursos orales, que para el análisis de datos fueron utilizados bajo la perspectiva comparada de Bereday. Resultados: La identidad es vista como una expresión de: autorresponsabilidad, visibilidad y reconocimiento social, territorialidad de las redes de convivencia con el adulto mayor, autorreconocimiento, autoimperativo de cuidado y protección entre sus miembros. Conclusiones: La solidaridad y expresión de amor son los principios de la familia y que el adulto mayor es valorado por su experiencia vivida. Se recomienda incluir los indicadores de principios de cuidado en las investigaciones, docencia y asistencia de atención al adulto mayor con enfoque familiar.

Abstract Objective: To characterize the family dynamics in the care of the elderly according to the principles of identity, solidarity, conversation and love in Peruvian and Mexican families. The central theoretical referential was given by the principles of family caring of Bustamante. Material and methods: Exploratory descriptive-qualitative study in the comparative perspective between Peru and Mexico. The study involved 10 families from each country that has an older adult as a family member belonging to the middle strata of both countries. Oral discourses of representatives of the selected families of the two countries were used. For the analysis of data, the analysis of oral discourse in the comparative perspective of Bereday was used. Results: The most important findings highlight that identity is seen as an expression of: self-responsibility, visibility and social recognition, territoriality of networks of coexistence with the elderly, self-recognition, self-imperative care and protection among their members. Conclusions: We obtained indicators of solidarity and expression of love in the family of the elderly. It is recommended to include the indicators of care principles in research, education and care assistance to the elderly with a family focus.

Competencias de la enfermera en instituciones educativas: una mirada desde los gestores educativos / Competências da enfermeira nas instituições educacionais: uma visão dos gestores da educação / Competencies of the nurse in educational institutions: a look from educational managers

Resumen OBJETIVO Describir y analizar los atributos de las competencias de la enfermera en el cuidado de los escolares vista por los gestores de instituciones educativas. MÉTODO Estudio cualitativo descriptivo-exploratorio. Siete directores de instituciones educativas de Trujillo (Perú) participaron en una entrevista no estructurada, durante el primer semestre del año 2016 y se utilizó el análisis de discurso oral. RESULTADOS Categorías empíricas: La enfermera en la promoción de la salud de la comunidad educativa; La enfermera en la prevención de la enfermedad en la comunidad educativa; La enfermera escolar articulando salud-educación en el cotidiano de vida de los escolares. CONSIDERACIONES FINALES El estudio contribuye al sustento conceptual de las competencias de la enfermera escolar para la acción intersectorial salud-educación y el establecimiento de políticas de promoción de salud de los escolares dentro las instituciones educativas.

Resumo OBJETIVO Descrever e analisar os atributos das competências da enfermeira escolar no cuidado escolares a partir da perspectiva dos gestores de instituições de ensino. MÉTODO Estudo qualitativo descritivo-exploratório: Sete diretores de instituições de ensino em Trujillo (Peru), participaram em uma entrevista no estruturada e se utilizou a análise de depoimentos orais. RESULTADOS Os resultados reportam as categorias empíricas: a enfermeira na promoção da saúde da comunidade educativa; a enfermeira na prevenção de doenças da comunidade educativa; A enfermeira escolar articulando a saúde e a educação no cotidiano do escolar. CONSIDERAÇÕES FINAIS O estudo contribui ao marco conceitual das competências da enfermeira escolar para a ação inter setorial em saúde-educação e para o estabelecimento de políticas na promoção da saúde dos escolares no interior das instituições educativas.

Abstract OBJECTIVE Describe and analyze the attributes of the nurse competencies in caring of students since the manager look of educational institutions. METHOD Qualitative descriptive-exploratory study. Seven principals of educational institutions of Trujillo (Peru) participates in a non-structured interview during the first semester of 2016 and the analysis of oral discourse was used. RESULTS Empirical categories: The nurse in the promotion of educational community health; The nurse in the prevention of the educational community illness; The student nurse articulating health - education in the everyday life of students. FINAL CONSIDERATIONS This study contributes to the conceptual support of the competencies of the student nurse for the intersectoral health - education action and the setting-up of health with students in the educational institutions.

Caracterización del estado de salud de los adultos mayores en la región La Libertad (Perú) / Characterization of the health status of the elderly in the region La Libertad (Peru)

Resumen Objetivo: Caracterizar el estado de salud de los adultos mayores en la región La Libertad (Perú). Materiales y métodos: Estudio cuantitativo, descriptivo, exploratorio, transversal. Se utilizaron las escalas de valoración Minimental State Examination (MMSE), The Mini Nutritional Assessment (MNA-SF), Geriatric Oral Health Assessment, Index (GOHAI), Functional Assessment Stages (Fast), Escala de Depresión de Yesavage Y Sheikh, Test de Morisky Green, Índice de Katz y Escala de Lawton para actividades de la vida diaria. Se aplicó en las 12 provincias de la región La Libertad. Muestra de 1110 adultos mayores. Resultados: Este artículo presenta solo una parte de los resultados obtenidos en la investigación realizada con los adultos mayores en la región la Libertad - Perú. El 93,6 % presentó cognición normal. La mayoría percibió su salud como regular. Actividad física adecuada 18,3-27,7 %. Estado nutricional normal 61,1%. Necesitan atención oral 39,7 %. Satisfecho sexualmente 41,9 %. Sus valores más importantes son amor y respeto y 73,3 % está preparado para morir. Vacunados contra influenza 50,5 %. No realizan mamografía ni Papanicolaou 76 % y 70,9 % y un 65 % de varones no realizó examen de próstata. Presentan enfermedad 67,6 %, siendo las principales hipertensión arterial, artritis y diabetes mellitus. Sufrieron caídas 30,5 %. Incontinencia urinaria en mujeres 36,3 %-45,6 % y varones 30%-49%. Depresión 28,9 %. Polifarmacia 35 %. Independientes en actividades básicas e instrumentales de la vida diaria 83,4 % y 60 %, respectivamente. No tienen seguro de salud 20,7 %. Conclusiones: Los problemas más importantes se evidencian en inadecuada actividad física, riesgo/malanutrición, escasa cobertura de vacunas y detección de cáncer de mama, cuello uterino y próstata. La hipertensión arterial, artritis y diabetes mellitus poco controladas con significativa presencia de polifarmacia y la no tenencia de seguro de salud.

Abstract Objective: to characterize the health status of older adults in the La Libertad (Peru) region. Materials and methods: Quantitative, descriptive, exploratory, cross-sectional study. Valuation scales were used: Minimental State Examination (MMSE), The Mini Nutritional Assessment (MNA-SF) (GOHAI), Functional Assessment Stages (Fast), Yesavage and Sheikh Depression Scale, Morisky Green Test, Katz Index, and Lawton Scale for activities of daily living. It was applied in the 12 provinces of the region La Libertad. Sample of 1110. Results: This article presents only a part of the results obtained in the research carried out with older adults in the La Libertad - Peru region.93.6 % presented normal cognition. Most perceived their health as regular. Adequate physical activity 18.3-27.7 %. Normal nutritional status 61.1 %. They need oral attention 39.7 %. Satisfied sexually 41.9 %. Their most important values are love and respect and 73.3 % are prepared to die. Vaccinated against influenza 50.5 %. They did not perform mammography or Papanicolaou 76 % and 70.9 % and 65 % of men did not perform prostate examination. They present disease 67.6 % being the main hypertension, arthritis and diabetes mellitus. They suffered falls 30.5 %. Urinary incontinence in women 36.3 % -45.6 % and men 30 % -49 %. Depression 28.9 %. Polypharmacy 35%. Independent in basic and instrumental activities of daily life 83.4 % and 60 % respectively. They do not have health insurance 20.7 %. Conclusions: The most important problems are evidenced by inadequate physical activity, risk / malanutrition, poor coverage of vaccines and detection of breast, cervical, and prostate cancer. Arterial hypertension, arthritis and diabetes mellitus poorly controlled with significant presence of polypharmacy and non-possession of health insurance.

Correlación entre diagnóstico ecográfico e histopatológico de poliposis vesicular en la Clínica Good Hope 2008-2014 / Correlation between sonographic diagnosis and histopathological results of gallbladder poliposis in Good Hope Clinic 2008-2014

Objetivo: determinar la correlación entre el diagnóstico ecográfico y el resultado histopatológico de poliposis vesicularen los pacientes y encontrar el valor predictivo positivo de la ecografía en el diagnóstico de esta patología.Material y Métodos: Es una investigación no experimental, transversal, descriptiva y correlacional, realizada en unamuestra de 128 pacientes operados con diagnóstico de poliposis vesicular en la clínica Good Hope entre 2008 y 2014. Serevisaron los informes ecográficos e histopatológicos de estos pacientes y se buscó la relación mediante el coeficiente decorrelación de Spearman.Resultados: El 67,2% de la muestra correspondió al sexo femenino y el 32,8% al sexo masculino; la edad promedio fue de43,4 años. El 74,2% de los 128 casos presentó pólipos según el examen histopatológico, de los cuales el 94,7% fueronpseudopólipos y 84% fueron pólipos de colesterol; solo el 5,3% de los pólipos fueron verdaderos (adenomas) y ninguno deellos fue maligno, el pólipo más grande midió 13 mm. El valor predictivo positivo de la ecografía en el diagnóstico depoliposis vesicular fue 74.21%. La correlación entre el número de pólipos por ecografía e histopatología según elcoeficiente de Spearman fue muy baja, directa y significativa (Rho=0,189, p=0,032).Conclusión: Existe una correlación directa entre el diagnóstico ecográfico y el resultado histopatológico de poliposisvesicular; la ecografía puede considerarse como un método confiable para el diagnóstico de esta patología.

Objective: To determine the correlation between sonographic diagnosis and histopathological results of gallbladderpolyposis and find the positive predictive value of ultrasound in the diagnosis of this pathology.Material and Methods: It is a non experimental, transversal, descriptive and correlational study with a sample composedof all patients operated with a diagnosis of gallbladder polyps in the Good Hope Clinic between the years 2008 and 2014. Atotal of 128 patients were observed. Histopathological and sonographic reports of these patients were reviewed and thestatistical correlation of both studies was sought by the test of Spearman.Results: Reveals that 67,2% were females and 32,8% were males; the average age was 43,4 years; 74,2% presented polypsby histopathological examination, of which 94,7% were pseudopolyps, with 82 % cases of cholesterolpolyps, only 5,3% weretrue polyps (adenomas) and none of them were malignant. The positive predictive value of ultrasound in the diagnosis ofgallbladder polyposis was 74,21%. According to the Spearman coefficient the correlation between the number of polyps byultrasonography and histopathology was low, direct and significant (Rho = 0,189; p = 0,032).Conclusions: We conclude that there is a correlation between the ultrasound diagnosis and histopathological result ofgallbladder polyps and ultrasound can be considered a reliable method for the diagnosis of gallbladder polyps.

Espacios vividos de la práctica en el currículum del licenciado en enfermería de la Escuela Nacional de Enfermería y Obstetricia-Universidad Nacional Autónoma de México, México / Practice lived spaces in the nursing undergraduate program of the Escuela Nacional de Enfermería y Obstetricia-Universidad Nacional Autónoma de México, Mexico

Introducción: El currículo formal manifestado en planes de estudio se encuentra en tensión con la perspectiva del currículo como conjunto de experiencias, denominado currículo vivido o currículo como práctica. Objetivo: Realizar un acercamiento a las vivencias cotidianas en cada uno de los espacios en que ocurre el proceso formativo de los estudiantes que cursan el último semestre de la Licenciatura en Enfermería. Métodos: Estudio cualitativo descriptivo basado en entrevistas colectivas de 2 grupos focales con un total de 16 estudiantes de la Licenciatura en Enfermería del 8º Semestre de la carrera. Las entrevistas se realizaron con una guía semiestructurada previo consentimiento informado. Se efectuó análisis de contenido siguiendo la técnica de Strauss, Corbin y De Souza; se generaron 3 categorías principales, de las cuales en este manuscrito solo se presenta una. Resultados: Del análisis se seleccionó la categoría denominada "espacios vividos de la práctica", con las subcategorías a) Viviendo la enfermería en el aula; b) Viviendo la enfermería en el hospital, y c) Viviendo la enfermería más allá del hospital. Discusión y conclusiones: El cotidiano del estudiante se conforma tanto por las actividades académicas como por las experiencias del día a día, del vivir en un aula, laboratorio, hospital o más allá del hospital; estos son espacios de desarrollo, vivencias y emociones que les hacen fortalecerse día a día. Así, el aprendizaje del cuidado se da a través de la experiencia, que es a su vez una vivencia espacial y entramada en relaciones complejas que le alimentan. La cultura escolar contribuye a interiorizar representaciones, creencias, gustos, ideologías, que en su conjunto se constituyen en el saber cultural expresado en el currículo real o vivido.

Introduction: The formal curriculum presented in the study plans is in tension with the perspective of the curriculum as a group of experiences, called lived curriculum or curriculum as practice. Objective: To present an approach to the daily experiences that occur in each of the spaces of the formative process of the students in the last semester of the nursing undergraduate program. Methods: Qualitative descriptive study based on collective interviews of 2 focus groups with a total of 16 students in their 8th semester of the nursing undergraduate program. The interviews were performed with a semi-structured guide, and with informed consent. A content analysis was performed following the Strauss, Corbin, and De Souza technique. Three principal categories were generated, and this study will show one of them. Results: From the analysis, the category named "lived spaces of the practice" was selected, including its sub-categories a) Living the nursing in the classroom; b) Living the nursing in the hospital; and c) Living the nursing beyond the hospital. Discussion and conclusions: The regular experiences of the student are made up of academic activities as well as the everyday ones, as regards living in a classroom, laboratory, hospital, or beyond. These are spaces of development, experiences and emotions which strengthen the students day by day. Thus, care learning is achieved through experience, which at the same time is a special living and links complex relationships which feed it. The scholastic culture helps interiorize representations, beliefs, preferences, ideologies, which all together form the knowledge culture expressed in the real or lived curriculum.

El cuidado de Enfermería en el cuerpo de la persona con cáncer / Nursing care in the body of the person with cancer

Introducción: El cáncer es una de las enfermedades que más muertes ocasiona en la población a nivel mundial. Esta enfermedad afecta no sólo al cuerpo (sujeto-objeto que cuidamos los profesionales de Enfermería y que poco hemos reflexionado sobre él), sino también afecta lo psicológico y espiritual de la persona. Objetivo: Iniciar una reflexión filosófica del cuerpo de la persona con cáncer. Desarrollo: Es necesario introducirnos en los diferentes conceptos del cuerpo para que se comprenda desde el punto de vista filosófico que el cuerpo es un sujeto que requiere de acompañamiento durante el cuidado, de la comprensión del funcionamiento de ese cuerpo diferente, resultado de los tratamientos empleados para su curación, porque no es fácil acompañar a un cuerpo mutilado por un tratamiento quirúrgico, comprender que fue un tratamiento para salvar la vida, pero que afecta el hacer de las actividades diarias que son el motor de la vida del ser humano. Conclusión: La enfermería es una piedra angular durante el tratamiento de las personas con cáncer, ya que este proceso da lugar al surgimiento de una persona diferente pero dispuesta a seguir existiendo, independientemente de las transformaciones de su cuerpo y de su relación con el medio ambiente.

Introduction: Cancer is one of the illnesses which provoke more deaths in the population in a world level. This illness it affects not only the body, subject-object which we the nursing professionals care and which low is what we have reflected on, but also the psychology and spirit of the person. Objective: To initiate a philosophical reflection on the body of the person with cancer. Development: It is necessary to engage into the different concepts of the body so that it is comprehended from the philosophical point of view that the body is a subject which requires company during its care, from the comprehension of the functioning of that different body, result of the treatments used for its healing, because it is not easy to accompany a mutilated body due to a surgical treatment, to understand that it was a treatment to save its life, but it affects the daily activities which are the engine of the human being. Conclusion: Nursing is a corner Stone during the treatment of the persons with cancer, because this process gives to the emergence of a different person but willing to continue existing, independently of the transformations of the body and its relation to the environment.

Satisfacción laboral y calidad de vida profesional de las enfermeras del Hospital Regional Docente de Trujillo, 2009 / Labour satisfaction and life quality of nurses of the Regional Teaching Hospital of Trujillo, 2009

La presente investigación se realizó con el objetivo de determinar la relación del nivel de satisfacción laboral y nivel de calidad de vida profesional de las enfermeras del hospital Regional Docente de Trujillo, con enfoque teórico conductista, basado en Herzberg, Maslow. El diseño de investigación fue descriptivo correlacional; el universo muestral estuvo constituido por 84 enfermeras, a quienes se aplicó dos instrumentos: la escala de satisfacción laboral de Nuñez y calidad de vida profesional CVP 35 Sánchez. El análisis de los datos se realizó con el paquete estadístico SPSS versión 18.0 y la prueba estadística χ². Las dimensiones con un nivel alto de satisfacción laboral son las relacionadas con al competencia profesional y la propia satisfacción del trabajo; y con un nivel bajo, las de promoción profesional, presión en el trabajo. Las dimensiones con un nivel bueno de calidad de vida profesional son la motivación intrínseca y la capacidad de realizar el trabajo y la de bajo nivel, la carga de trabajo percibido. Existe una relación significativa entre la satisfacción laboral y la calidad de vida profesional.

This non-experimental research of descriptive correlational design aimed to establish the relationship between level of labour satisfaction and quality of profesional life in nurses of the Regional Teaching Hospital of Trujillo (Peru), with the behavioral theoretical approach, based on Herzberg-Maslow. The sample consisted of 84 nurses. The instruments used were the labour satisfaction and professional quality of life scale (CVP). The data was statistically analyzed by the Statistical Package for Social Science (SPSS) and the means of the Chi square test. The study came to the following conclusions: The dimesnsions with a high level of labour satisfaction is the one related to the profesional competence and job satisfaction and the low levels are related to the career development, work pressure. The dimensions with a good level of working life quality are intrinsic motivation and the ability to perform the work: the one of low level of satisfaction is the perceived workload. there is a significant relationship between labour satisfaction and quality of professional life.

Trastocamiento de la salud en la cotidianidad de las mujeres embarazadas con pre-eclampsia / Health Disruption in everyday life of pregnant women with preeclampsia

El presente estudio cualitativo, descriptivo, exploratorio, tiene el objetivo de describir y analizar la cotidianidad de las mujeres que presentan pre-eclampsia de una comunidad semiurbana del Municipio de Chimalhuacán del Estado de México. Esta enfermedad es un problema de salud pública en México, ha ocupado el primer lugar en muertes maternas por más de dos décadas¹ y se presenta del 5 al 10 % de todos los embarazos.² Maffesoli, Morín, Maturana, Varela, Figuereido y Boff son los autores que dieron el soporte teórico. Se realizaron entrevistas a profundidad a dieciséis mujeres usuarias del Hospital General Chimalhuacán durante el embarazo. El análisis de los datos se realizó considerando los principios de Orlandi.³ Del análisis del discurso surgieron dos categorías: Auto-eco-socio-organización de la cotidianidad y Creando Vida en la cotidianidad. La primera categoría con 3 subcategorías: Tiempo, espacio y movimiento, identidad y, solidaridad. La segunda categoría, con dos subcategorías: Corporalidad-Subjetividad y trastrocamiento de la salud. En las consideraciones finales se enfatiza que la cotidianidad de las mujeres que presentan pre-eclampsia durante el embarazo se caracteriza por ser un fenómeno complejo, autónomo: auto-organizador, auto-productor, auto-determinado, relacional, irreductible, dialógico, recursivo, hologramático, dinámico, cambiante (neguentrópico), homeostático, sinérgico; se trastoca, se vive con identidades múltiples y solidarias frente a las adversidades. Con estos hallazgos se presentan algunos indicativos importantes para construir modelos singulares, sensibles y culturalmente específicos para el cuidado de estas mujeres.

This qualitative, descriptive and exploratory study has the objective of describing and analyzing the everyday life of women with pre-eclampsia in a semi-urban community in the municipality of Chimalhuacán, state of Mexico. Pre-eclampsia is a public health problem in Mexico which has occupied the first place in maternal deaths over two decades, 1 and which occurs in 5 to 10% of all pregnancies. 2 Maffesoli Morin, Maturana,, Varela,, Figueiredo and Boff works provide theoretical foundations for this study. Depth interviews were conducted to sixteen women attending the Chimalhuacán General Hospital during their pregnancies. The data analysis was performed considering the principles of Orlandi. 3 From the discourse analysis, two categories emerged; Auto-eco-socio-organization of the daily life, and creating life in the everyday. The first category included three subcategories; time, space and movement, and identity and solidarity. The second category included two subcategories; corporeality-subjectivity, and health disruption. The final considerations of the everyday emphasizes women's pre-eclampsia as complex, autonomous, self-organizing, self-produced, self-determined, relational, irreducible, dialogic, recursive, hologramatic, dynamic, changing(negentropy), homeostatic, synergistic, and as living with multiple identities and endurance against adversity. The study findings can help design indicative singular, sensitive and culturally especific models for these women.

Relación entre el nivel de conocimientos sobre las medidas de bioseguridad y su aplicación por los profesionales de enfermería que laboran en los Servicios de Centro Quirúrgico y Hospitalización del Instituto Regional de Enfermedades Neoplásicas IREN Norte. Trujillo 2009 / Relationship between the level of knowledge about biosecurity measures and their implementation by nurses who work in services and Hospital Surgery Center of the Regional Institute of Neoplastic Diseases. Trujillo 2009

Objetivos: Determinar la relación entre el nivel de conocimientos sobre medidas de bioseguridad y su aplicación por los profesionales de enfermería que laboran en los servicios de Centro Quirúrgico y Hospitalización del Instituto Regional de Enfermedades Neoplásicas. Material y Método: El estudio fue de nivel aplicativo, tipo cuantitativo, método descriptivo, de corte transversal. La población estuvo conformada por 16. La técnica fue la observación y la entrevista; los instrumentos fueron un cuestionario y una lista de cotejo. Resultados: Del 100 por ciento (16), el 87.5 por ciento (14) tienen un Nivel de conocimientos medio y 12.5 por ciento (2) alto. En relación a la Aplicación, el 87.5 por ciento (14) aplican y 12.5 por ciento (2) no aplican. Para establecer la relación entre el nivel de conocimientos y su aplicación, se aplicó la prueba t de student para comparar grupos, obteniéndose que no existe relación estadística entre las variables de estudio. Conclusiones: La mayoría de los profesionales de Enfermería tienen conocimiento medio y aplican las medidas de bioseguridad y un mínimo porcentaje significativo tienen conocimiento alto y no aplican las medidas de bioseguridad. Al establecer relación mediante la prueba t de student, se comprobó la hipótesis de que no existe relación significativa entre las variables en estudio

Objectives: To determine the relationship between the level of knowledge about biosecurity measures and their implementation by nurses who work in services and Hospital Surgery Center of the Regional Institute of Neoplastic Diseases. Material and methods: The study was level application, quantitative, descriptive method, cross-sectional. The population consisted of 16. The technique was the observation and interview, the instruments were a questionnaire and a checklist. Results: 100 per cent (16), 87.5 per cent (14) have a medium knowledge level of 1.5 per cent (2) high. In relation to the application, 87.5 per cent (14) applied and 12.5 per cent (2) do not apply. To establish the relationship between the level of knowledge and its application, we applied the Student t test to compare groups, obtaining that there is no statistical relationship between the study variables. Conclusions: Most nursing professionals have average knowledge and implement biosecurity measures and a minimum significant percentage have high knowledge and do not apply biosecurity measures. By establishing relationship by Student's t test, we checked the hypothesis that there is no significant relationship between the variables under study

El timerosal y las enfermedades del neurodesarrollo infantil / Thimerosal and children's neurodevelopmental disorders

Se evalúa la relación causal entre el timerosal (etilmercurio), como preservante en las vacunas pediátricas, y el incremento de casos de enfermedades del neurodesarrollo infantil, como consecuencia de la ampliación de los esquemas de inmunización. Se revisó la información científica, relacionando el timerosal y las evidencias que permitan evaluar una posible asociación causal, con estudios epidemiológicos, ecológicos, biomoleculares y toxicológicos, de bioseguridad, toxicológicos fetales y sobre salud reproductiva. Se encontró múltiples asociaciones entre la exposición a timerosal y las enfermedades del neurodesarrollo infantil. Tal neurotoxicidad ocurre en los infantes y fetos de gestantes vacunadas por dosis acumulativa de mercurio. Las diversas evidencias implican al timerosal como el agente causante, agravante o disparador de las enfermedades del neurodesarrollo infantil. La toxicidad del mercurio obligó al retiro progresivo del timerosal de los medicamentos. Lamentablemente, en las vacunas, ha habido una sustancial demora en la demostración de su impacto negativo. Actualmente, existen vacunas sin timerosal, cuyo uso está ocasionando la disminución de la incidencia de las enfermedades del neurodesarrollo infantil.

The causal relation of thimerosal (ethylmercury), preservative in pediatric vaccines, and the increase of childrenÆs neurodevelopmental disorders as a result of the increase in immunization schemes is determined. The scientific information on thimerosal and its influence on the childÆs neurodevelopmental disorders is reviewed. Evidences found in epidemiological, ecological, biomolecular, toxicology, biosecurity, fetal toxicology and reproductive health studies signal the possible causal association of thimerosal exposition and neurodevelopmental disorders of the child. Such neurotoxicity occurs in infants and fetuses of vaccinated pregnant women, due to mercury cumulative doses. The various evidences imply thimerosal as the causal agent, aggravating or triggering neurodevelopmental disorders of the child. The mercury toxicity forced progressive thimerosal withdrawal. Unfortunately, there was a delay in demonstrating thimerosal negative impact Currently vaccines without thimerosal are causing less incidence of childrenÆs neurodevelopmental disorders.