Percepción de los estudiantes que rindieron el Examen Nacional de Enfermería de Chile / Students' perception of the Chilean National Nursing Exam

BACKGROUND: In 2008, the Chilean National Nursing Examination Commission, COENENF, developed a national nursing exam (ENENF). Since 2013, COENENF has implemented a validated opinion survey at the time of the national examination to strengthen the quality of the exam and facilitate its continuous improvement. AIM: To determine the perception of nursing students about general aspects, specific areas, representativeness, mastery and usefulness of the 2018 ENENF. MATERIAL AND METHODS: A descriptive, cross-sectional study, using a self-administered Likert-type survey, was administered in 2018 to 2949 last-year nursing students from 29 nursing schools who took the ENENF. The survey comprised three areas: representativeness of the questions, student mastery of each area, and the usefulness of the exam. RESULTS: Students had a positive perception of the Chilean ENENF and its application. Theoretical knowledge is effectively assessed and close to half of the sample agreed that the ENENF is useful. The results also suggest areas that should be improved. CONCLUSIONS: Nursing students had a positive perception of the ENENF.

[Students' perception of the Chilean National Nursing Exam]. / Percepción de los estudiantes que rindieron el Examen Nacional de Enfermería de Chile.

BACKGROUND: In 2008, the Chilean National Nursing Examination Commission, COENENF, developed a national nursing exam (ENENF). Since 2013, COENENF has implemented a validated opinion survey at the time of the national examination to strengthen the quality of the exam and facilitate its continuous improvement. AIM: To determine the perception of nursing students about general aspects, specific areas, representativeness, mastery and usefulness of the 2018 ENENF. MATERIAL AND METHODS: A descriptive, cross-sectional study, using a self-administered Likert-type survey, was administered in 2018 to 2949 last-year nursing students from 29 nursing schools who took the ENENF. The survey comprised three areas: representativeness of the questions, student mastery of each area, and the usefulness of the exam. RESULTS: Students had a positive perception of the Chilean ENENF and its application. Theoretical knowledge is effectively assessed and close to half of the sample agreed that the ENENF is useful. The results also suggest areas that should be improved. CONCLUSIONS: Nursing students had a positive perception of the ENENF.

Validación de encuesta de percepción Examen Nacional de Enfermería Chileno / Pesquisa de validação da percepção Exame Nacional de Enfermagem do Chile / Validation of perception survey Chilean National Nursing Exam

Investigación descriptivacuantitativa y cualitativa. Objetivo: validarencuesta de percepción de los egresados deEnfermería en Chile, respecto al ExamenNacional de Enfermería. Metodología: locualitativo consideró el método Delphiparticipando expertos en la disciplina deenfermería y del área educación yevaluación. Para lo cuantitativo se utilizó elanálisis de alfa de Cronbach, usando elsistema SPSS. Resultados: El K obtenido porlos expertos estuvo entre el 0,95 a 1 lo quedeterminó que todos tenían un alto grado decompetencia en el tema sobre el cual se lesconsultó. Los expertos vincularon losobjetivos propuestos con cada uno de los 21ítems de la encuesta. En 8 de ellos el 100%de los expertos coincidió con lo plateado porla Comisión del Examen Nacional deEnfermería, en 10 de los ítems un 80%, en 2de los ítems un 50% y en 1 ítem un 33%. Elalpha de Cronbach obtenido fue de 0,97, loque demuestra un alto grado de consistenciainterna del instrumento. Conclusiones: Sevalida la encuesta de opinión, cumpliendo demanera rigurosa y lógica con todas susetapas, demostrando su validez yconfiabilidad.(AU)

Quantitative and qualitativedescriptive research. Objective: to validatethe survey on the perception of nursinggraduates in Chile, regarding the NationalExam taken and applied. Methodology:qualitative, using the Delphi method withexperts in the areas of nursing, education,and evaluation; and quantitative, usingCronbach's alpha analysis with the SPSSsystem. Results: The K was between 0.95 to 1, which suggests that all of the experts hada high degree of competence in the opiniontopic. The objectives proposed in the 21-item survey were linked. In 8 items 100% ofthe experts stated their agreement with theaspects raised by the National Nursing ExamCommission; in 10 items 80%, in 2 items50% and in 1 item 33%. Cronbach's alphamethod estimated the internal consistencyreliability of the instrument to be 0.97,demonstrating a high degree of internalconsistency among the items analyzed.Conclusions: to validate an instrument it isnecessary to rigorously complete each stepwith a sequence that allows one to accountfor validity and reliability.(AU)

Quantitative and qualitativedescriptive research. Objective: to validatethe perception survey of nursing graduates inChile, regarding the National Nursing Exam.Methodology: the Delphi method wasconsidered qualitative, involving experts inthe nursing discipline and in the educationand evaluation area. For the quantitativeanalysis, Cronbach's alpha was used, usingthe SPSS system. Results: The K obtainedby the experts was between 0.95 to 1, whichdetermined that all of them had a high degreeof competence in the subject on which theywere consulted. The experts linked theproposed objectives with each of the 21items in the survey. In 8 of them, 100% ofthe experts agreed with what was stated bythe National Nursing Exam Commission, in10 of the items 80%, in 2 of the items 50%and in 1 item 33%. The Cronbach's alphaobtained was 0.97, which shows a highdegree of internal consistency of theinstrument. Conclusions: The opinion poll isvalidated, rigorously and logicallycomplying with all its stages, demonstratingits validity and reliability.(AU)

Osteotomía percutánea de la falange distal del hallux. Indicaciones y técnica / Percutaneous osteotomy of the distal phalanx of the hallux. Indications and technique

Introducción: Las técnicas para corregir las deformidades del hallux incluyen osteotomías metatarsianas y falángicas. Las osteo-tomías sobre la falange proximal corrigen el DASA y el ángulo interfalángico. Sin embargo, no se han publicado las indicaciones para la osteotomía de la falange distal. El objetivo de este artículo es comunicar la técnica y las indicaciones de la osteotomía percutánea de la falange distal del hallux, y evaluar los resultados de una serie de casos. materiales y métodos: Se analizaron 14 pies en los que se realizó una osteotomía de la falange distal del hallux para corregir una deformidad. Se midieron el DASA, la oblicuidad interfalángica y el ángulo falange distal-interfalángico en las radiografías. La técnica quirúrgica fue percutánea con control fluoroscópico. Los resultados se evaluaron mediante las escalas analógica visual de dolor y AOFAS. Seguimiento medio: 52 meses. Resultados: 13 pies de mujeres y un pie de hombre. Edad promedio: 58 años. Los resultados clínico y estético fueron excelentes, con alivio del dolor. Mejoría de la escala AOFAS: promedio 37 puntos. Análisis comparativo de ángulos preoperatorios y posoperatorios: DASA (p = 0,01), excepto cuando se aisló de la muestra a los pacientes con osteotomía tipo Akin (p = 0,33); ángulos F2-IF y F2-MTF (p <0,00001). Se registraron las complicaciones. Conclusiones: En la deformidad en valgo de la falange distal del hallux sintomática, se debe considerar una osteotomía correctora sola o asociada a osteotomía de la falange proximal. La osteotomía percutánea de la falange distal es un método eficaz, seguro y rápido. Nivel de Evidencia: IV

Introduction. There are many techniques to correct the hallux deformity. Most of them include metatarsal and/or phalanx osteotomies. The Akin osteotomy of the proximal phalanx is used to correct the distal articular set angle (DASA), or the interphalangeal angle. However, indications for the distal phalanx osteotomy remain unpublished. The aim of this study is to communicate the technique of performing and the indications for percutaneous osteotomy of the distal phalanx of the hallux, and evaluate the results of a cases series. Materials and methods. We report 14 cases in which distal phalangeal osteotomy was performed. Radiographic measurements were performed on dorsal-plantar view foot, to analyze distal articular set angle (DASA), interphalangeal obliquity, and F2-IP angle. Surgical technique was performed by minimally incision surgery. The clinical and functional results were evaluate by the visual analogue scale pain, and the AOFAS score. Mean follow-up was 52 months. Results. The clinical result for all the patients was excellent, pain was relieved and deformities corrected. Pre- and post-operative comparative angles: DASA (p: 0.01), except when isolated from the sample for Akin-type osteotomy (p: 0.33). Angle F2-IF and angle F2-MTF (p: <0.00001). The patients where highly satisfied with both the aesthetic and functional results. Complications were registered. Conclusion. In the symptomatic hallux´s distal phalanx deformity a corrective distal phalanx osteotomy should be considered alone, or associated with the osteotomy of the proximal phalanx. Percutaneous distal phalanx osteotomy is an effective, safe, and fast procedure. Level of Evidence: IV

Fractura bilateral de cadera en un paciente con síndrome de Down / Bilateral hip fracture in a patient with Down syndrome

Existen pocos datos publicados de fracturas de cadera bilaterales simultáneas. Presentamos el caso de un varón de 56 años con síndrome de Down y demencia tipo Alzheimer afecto de fractura bilateral de cadera y cuyo tratamiento fue la artroplastia parcial de cadera cementada bilateral. Con ella se intentó evitar el periodo de carga parcial que podría derivarse del tratamiento mediante osteosíntesis, ya que se trataba de un paciente poco cooperador debido a su falta de independencia para las actividades básicas de la vida diaria y a su deterioro mental. Hasta el momento de su fallecimiento, cuatro años después de la cirugía, pudo caminar sin ayuda, con total autonomía. En nuestra experiencia, la cirugía en un solo tiempo, mediante prótesis de cadera bilateral, es segura y proporciona buenos resultados en pacientes con deficiencia mental severa

There are few published data available about simultaneous bilateral hip fractures. We present the case of a 56-year-old man with Down syndrome and Alzheimer-like dementia with simultaneous bilateral hip fracture. A bilateral partial hip cemented arthroplasty was performed on this patient. The aim was to avoid the partial burden that could be caused by ostheosynthesis, due to the patient's lack of cooperation arising from his mental deterioration and his problems realizing everyday activities. He was able to walk unaided with complete autonomy until his death fourth years later. In our experience, one stage surgery for bilateral hip prosthesis is safe and provides good results in patients with severe mental impairment

Piglet colibacillosis diagnosis based on multiplex polymerase chain reaction and immunohistochemistry of paraffin-embedded tissues.

Enterotoxigenic Escherichia coli (ETEC) causes diarrhea in pigs, referred to as colibacillosis. The aim of this study was to optimize multiplex polymerase chain reaction (PCR) and immunohistochemistry (IHC) analyses of paraffin-embedded material to detect pathogenic E. coli strains causing colibacillosis in pigs. Multiplex PCR was optimized for fimbriae (F18, F4, F6, F5, and F41) and toxins (types A and B heat-stable toxins [STaP and STb], heat-labile toxin [LT], and type 2 Shiga toxin [STx2e]), and IHC was optimized for an anti-E. coli polyclonal antibody. Samples (132) from pigs received between 2006 and 2014 with clinical and histopathological diagnoses of colibacillosis were analyzed. E. coli was detected by IHC in 78.7%, and at least one virulence factor gene was detected in 71.2%. Pathogenic strains of ETEC with at least one fimbria and one toxin were detected in 40% of the samples in multiplex PCR. The most frequent virulence types were F18-STaP (7.5%), F18-STaP-STb (5.7%), and F4-STaP (3.8%). A statistically significant association was noted between virulence factors F4, F18, STaP, and STb and positive immunostaining results. Colibacillosis diagnosis through multiplex PCR and IHC of paraffin-embedded tissues is a practical approach, as samples can be fixed and stored for long periods before analysis.

Uso del Brief Pain Inventory (BPI) para la evaluación de las técnicas intervencionistas en el tratamiento de la lumbalgia / Brief Pain Inventory (BPI) for evaluation of interventional techniques in back pain treatment

El inventario breve de valoración del dolor o Brief Pain Inventory (BPI) es una escala desarrollada por The Pain Research Group de la Universidad de Wisconsin para la valoración del dolor oncológico y no oncológico en su intensidad, repercusión emocional y funcional, validada en español. El objetivo de nuestro estudio fue valorar el efecto de los procedimientos intervencionistas sobre el dolor en pacientes con lumbalgia a través del BPI. La evaluación se realizó en la Policlínica de Terapia del Dolor del Departamento de Anestesiología del Hospital de Clínicas, Montevideo, Uruguay, desde octubre de 2013 a septiembre de 2014 a pacientes que recibieron inyecciones epidurales o facetarias de corticoides a nivel lumbar, mediante la aplicación de BPI antes y luego de un mes de realizado el procedimiento. Un total de 60 pacientes que recibieron procedimientos intervencionistas como parte de la terapia multimodal de su lumbalgia fueron evaluados. Más del 50 por ciento de los pacientes estudiados presentaron una respuesta exitosa en cada ítem del BPI al mes de haberse realizado los procedimientos mencionados, entendiendo como tal a una reducción en cada ítem de un 50 por ciento o más, comparado con la evaluación basal. El BPI resultó ser útil en la evaluación de los efectos de los procedimientos intervencionistas sobre distintos aspectos del dolor en pacientes con lumbalgia. Estos efectos fueron aceptables a corto plazo...

The Brief Pain Inventory (BPI) is a scale to evaluated cancer and non-cancer pain developed by The Pain Research Group of the University of Wisconsin, validated in Spanish. It includes evaluation of pain intensity, emotional and functional repercussion of pain. The aim of our study was to evaluate the effect of interventional pain procedures in back pain using the BPI. The study was performed in the Pain Clinic Service of the University Anesthesiolgy Department, Hospital de Clínicas, Montevideo, Uruguay, from October 2013 to March 2014. Sixty patients with back pain received epidural and facet joint steroid injections as part of a multimodal treatment approach. The BPI was performed before and 1 month after receiving the procedures. More than 50 percent of the patients had a successful response to procedures, defined this as a 50 percent improvement in BPI scale items, comparing control measures with baseline ones. The BPI was considered a useful tool to evaluate the effects of interventional procedures in back pain treatment. These effects were considered moderate in a short term follow-up...

Diagnóstico imuno-histoquímico e caracterização anatomopatológica de clamidiose em psitacídeos / Immunohistochemical diagnosis and pathological characterization of chlamydiosis in psittacine

A clamidiose é causada por Chlamydophila psittaci e representa uma das principais zoonoses de origem aviária. Realizou-se um estudo retrospectivo em psitacídeos do período de 1995 a 2012 e exame imuno-histoquímico (IHQ) anti-Chlamydia. Foram avaliados 111 casos, dos quais 12 foram a óbito devido à clamidiose. As aves eram provenientes de apreensão ou cativeiro (zoológicos, criatórios, centros de triagem e domicílios). À necropsia observou-se fígado aumentado (4/12) com áreas branco-amareladas (3/12), baço aumentado (2/12) e rompido (1/12), saco pericárdico com deposição de fibrina (1/12), polisserosite fibrinosa (1/12) e em três casos não havia lesões. Na avaliação histopatológica evidenciou-se hepatite necrótica mononuclear (7/12), hepatite mononuclear (3/12), hiperplasia de ductos biliares (8/12), esplenite necrótica histiocitária (9/12), hemossiderose em fígado (9/12) e baço (9/12), aerossaculite mononuclear (4/12), pericardite fibrino-heterofílica (2/12), necrose (1/12) e rarefação (1/12) linfoide de bursa de Fabricius, pneumonia fibrinosa (1/12), nefrite mononuclear (1/12) e granulomas renais (1/12). Observaram-se inclusões basofílicas intracitoplasmáticas (corpos elementares) em fígado (2/12), baço e rins (1/12). Evidenciou-se imunomarcação anti-Chlamydia em fígado (11/12), baço (7/9), pulmões (3/9), rins (2/8), intestinos (2/3), sacos aéreos (1/4) e bursa de Fabricius (1/2). A IHQ poderá ser utilizada como forma de diagnóstico definitivo post mortem de clamidiose em psitacídeos no Brasil...

Chlamydiosis is caused by Chlamydophila psittaci and is one of the most important avian zoonosis. A retrospective study in psittacines was performed from 1995 to 2012 with immunohistochemistry (IHC) anti-Chlamydia. Hundred eleven cases were evaluated and twelve birds died due to chlamydiosis. The birds were obtained from illegal commerce traffic or captive conditions (zoos, breeding birds, wildlife rehabilitation center and pets). Grossly, there were hepatomegaly (4/12) with yellowish-white areas (3/12), splenomegaly (2/12), splenic rupture (1/12), fibrin deposition in pericardial sac (1/12), fibrinous polyserositis (1/12), and in three cases lesion was not found. Histopathological evaluation revealed mononuclear necrotizing hepatitis (7/12), mononuclear hepatitis (3/12), biliary duct hyperplasia (8/12), histiocytic necrotizing splenitis (9/12), hemosiderosis in liver (9/12) and spleen (9/12), mononuclear aerosaculitis (4/12), fibrin heterophilic pericarditis (2/12), lymphoid necrosis (1/12) and depletion of bursa Fabricius (1/12), fibrinous pneumonia (1/12), mononuclear nephritis (1/12), and renal granulomas (1/12). Basophilic intracytoplasmic inclusions (elementary bodies) were observed in liver (2/12), spleen and kidney (1/12). Positive immunostaining for Chlamydia could be detected in liver (11/12), spleen (7/9), lung (3/9), kidney (2/8), intestines (2/3), air sacs (1/4) and bursa of Fabricius (1/2). It was concluded that IHC can be used as postmortem definitive diagnosis of chlamydiosis in psittacines...

Programa de prevenção e tratamento do tabagismo: uma vivência acadêmica de enfermagem / Program of smoking prevention and treatment: a nursing academic experience in the health area

O presente artigo relata a experiência como acadêmica de enfermagem no mês de julho de 2006, em um Programa de Prevenção e Combate ao Tabagismo da Secretaria Municipal de Saúde no Centro Municipal de Saúdedo Município de Redentora-RS. Destaca-se a importância como acadêmica, de fazer parte deste projeto, o qual foi criado com os objetivos de auxiliar, orientar, tratar, recuperar, promover a saúde e prevenir as doenças, abordando as consequências que o tabaco traz para a vida da pessoa fumante e das que convivem com a mesma. Os resultados demonstraram ser significativos, pois algumas pessoas já deixaram o tabaco, outras diminuíram a quantidade consumida por dia, mas o mais relevante foi constatar que todos continuam o tratamento com o grupo de fumantes e a equipe profissional.

Proposta de implantação dos protocolos de acolhimento do ministério da saúde no PSF Jardim Itamaraty III no município de Poços de Caldas/MG

Introdução: Apesar da existência de um Manual da Atenção Primária para o Acolhimento, do Ministério da Saúde, desde 2013 ele não é utilizado na prática clínica. A realidade vivenciada nas Unidades de Atenção Básica (UBS) do município de Poços de Caldas/MG é a ausência de um protocolo de acolhimento e de preparo de alguns funcionários para realizá-lo.Objetivo: Elaborar um projeto de intervenção que visa implantar os fluxogramas para atendimento a demanda espontânea com classificação de risco como guias de consulta rápida e capacitar as técnicas de enfermagem para utilizá-los no Programa de Saúde da Família (PSF) Jardim Itamaraty III.Metodologia: Revisão de literatura sobre Acolhimento e Planejamento Estratégico Situacional. Conclusão: A utilização dos fluxogramas para o Acolhimento é fundamental para uma padronização, segurança, respaldo nos atendimentos realizados pelas técnicas de enfermagem e enfermeira na unidade do PSF Jardim Itamaraty III. Como produto dessa ação, espera-se uma maior organização do atendimento à demanda espontânea e a redução da sobrecarga por consultas médicas, com bastante resolutividade nas consultas de enfermagem na unidade