Lumbalgia y derivación al especialista de columna: situación y recursos en hospitales públicos de la Ciudad Autónoma de Buenos Aires / Low back pain and referral to the spine specialist: situ ation and resources in Buenos Aires public hospitals

Resumen Introducción: El 90% de las lumbalgias agudas son de causa inespecífica. Existen guías internacionales que permiten identificar a aquellos pacientes que requieren atención especializada. En nuestro país la orientación a la atención primaria de la salud es escasa, centrada prin cipalmente en la atención en los hospitales. El objetivo del presente estudio fue describir los recursos de salud, diagnósticos y terapéuticos, utilizados en la atención inicial de pacientes con dolor lumbar que acuden a la consulta del médico especialista Métodos: Estudio descriptivo y transversal, con re colección prospectiva de los datos a través de un cues tionario destinado a pacientes con dolor lumbar que acuden por primera vez a la consulta especializada. Resultados: Se incluyeron 44 pacientes, edad media 53 años; 50% concurrió por dolor crónico. La derivación informal se asoció con: especialidad de derivación (no traumatólogo), pacientes con mayor número de consul tas a guardia y mayor demora en obtener la consulta. El 52% concurrió con al menos un estudio complementario. Conclusión: La mayor parte de las derivaciones fueron correctas, sin embargo, predominó la derivación infor mal. Solo 1/5 de los pacientes fue examinado y menos del 30% de los pacientes con banderas rojas acudió con estudios complementarios adecuados. La mediana del tiempo de espera para la consulta fue 24 días.

Abstract Introduction: 90% of cases of acute low back pain have no specific underlying cause. International guide lines are available to help identify those individuals who require specialized care. However, in our country, there is a limited emphasis on primary healthcare, with the primary focus on hospital-based care. The aim of this study is to provide an overview of the diagnostic and therapeutic resources utilized in the initial care of patients experiencing low back pain at their first con sultation with a specialist physician. Methods: Descriptive and cross-sectional study, with prospective data collection through a questionnaire administered to patients experiencing low back pain during their first visit to a specialist's office. Results: A total of 44 patients were included, with an average age of 53 years; 50% sought medical atten tion for chronic pain. Informal referrals were associated with the referring physician's specialty (non-orthopedic), patients with a higher number of emergency depart ment visits, and longer waiting times to obtain the consultation; 52% of patients arrived with at least one complementary study. Conclusion: Most of the referrals were appropriate; however, informal referrals were more common. Only 1/5 of the patients underwent an physical examination, and less than 30% of those with red flag symptoms presented with suitable complementary studies. The median wait ing time for the consultation was 24 days.

Stemness and Cell Cycle Regulators and Their Modulation by Retinoic Acid in Ewing Sarcoma.

Retinoic acid (RA) regulates stemness and differentiation in human embryonic stem cells (ESCs). Ewing sarcoma (ES) is a pediatric tumor that may arise from the abnormal development of ESCs. Here we show that RA impairs the viability of SK-ES-1 ES cells and affects the cell cycle. Cells treated with RA showed increased levels of p21 and its encoding gene, CDKN1A. RA reduced mRNA and protein levels of SRY-box transcription factor 2 (SOX2) as well as mRNA levels of beta III Tubulin (TUBB3), whereas the levels of CD99 increased. Exposure to RA reduced the capability of SK-ES-1 to form tumorspheres with high expression of SOX2 and Nestin. Gene expression of CD99 and CDKN1A was reduced in ES tumors compared to non-tumoral tissue, whereas transcript levels of SOX2 were significantly higher in tumors. For NES and TUBB3, differences between tumors and control tissue did not reach statistical significance. Low expression of CD99 and NES, and high expression of SOX2, were significantly associated with a poorer patient prognosis indicated by shorter overall survival (OS). Our results indicate that RA may display rather complex modulatory effects on multiple target genes associated with the maintenance of stem cell's features versus their differentiation, cell cycle regulation, and patient prognosis in ES.

Effect of immune checkpoint inhibitors at different treatment time periods on prognosis of patients with extensive-stage small-cell lung cancer.

BACKGROUND: The application of immune checkpoint inhibitors (ICIs) in treating patients with extensive-stage small-cell lung cancer (ES-SCLC) has brought us new hope, but the real-world outcome is relatively lacking. Our aim was to investigate the clinical use, efficacy, and survival benefit of ICIs in ES-SCLC from real-world data analysis. METHODS: A retrospective analysis of ES-SCLC patients was conducted between 2012 and 2022. Progression-free survival (PFS) and overall survival (OS) were assessed between groups to evaluate the value of ICIs at different lines of treatment. PFS1 was defined as the duration from initial therapy to disease progression or death. PFS2 was defined as the duration from the first disease progression to the second disease progression or death. RESULTS: One hundred and eighty patients with ES-SCLC were included. We performed landmark analysis, which showed that compared to the second-line and subsequent-lines ICIs-combined therapy group (2SL-ICIs) and non-ICIs group, the first-line ICIs-combined therapy group (1L-ICIs) prolonged OS and PFS1. There was a trend toward prolonged OS in the 2SL-ICIs group than in the non-ICIs group, but the significance threshold was not met (median OS 11.94 months vs. 11.10 months, P = 0.14). A longer PFS2 was present in the 2SL-ICIs group than in the non-ICIs group (median PFS2 4.13 months vs. 2.60 months, P < 0.001). CONCLUSION: First-line ICIs plus chemotherapy should be applied in clinical practice. If patients did not use ICIs plus chemotherapy in first-line therapy, the use of ICIs in the second line or subsequent lines of treatment could prolong PFS2.

Characterization and Association of Rips Repertoire to Host Range of Novel Ralstonia solanacearum Strains by In Silico Approaches.

Ralstonia solanacearum species complex (RSSC) cause several phytobacteriosis in many economically important crops around the globe, especially in the tropics. In Brazil, phylotypes I and II cause bacterial wilt (BW) and are indistinguishable by classical microbiological and phytopathological methods, while Moko disease is caused only by phylotype II strains. Type III effectors of RSSC (Rips) are key molecular actors regarding pathogenesis and are associated with specificity to some hosts. In this study, we sequenced and characterized 14 newly RSSC isolates from Brazil's Northern and Northeastern regions, including BW and Moko ecotypes. Virulence and resistance sequences were annotated, and the Rips repertoire was predicted. Confirming previous studies, RSSC pangenome is open as α≅0.77. Genomic information regarding these isolates matches those for R. solanacearum in NCBI. All of them fit in phylotype II with a similarity above 96%, with five isolates in phylotype IIB and nine in phylotype IIA. Almost all R. solanacearum genomes in NCBI are actually from other species in RSSC. Rips repertoire of Moko IIB was more homogeneous, except for isolate B4, which presented ten non-shared Rips. Rips repertoire of phylotype IIA was more diverse in both Moko and BW, with 43 common shared Rips among all 14 isolates. New BW isolates shared more Rips with Moko IIA and Moko IIB than with other public BW genome isolates from Brazil. Rips not shared with other isolates might contribute to individual virulence, but commonly shared Rips are good avirulence candidates. The high number of Rips shared by new Moko and BW isolates suggests they are actually Moko isolates infecting solanaceous hosts. Finally, infection assays and Rips expression on different hosts are needed to better elucidate the association between Rips repertoire and host specificities.

Multicriteria spatial model to prioritize degraded areas for landscape restoration through agroforestry.

Reconciling the restoration of ecosystem services within agricultural landscapes is an effort that has been advancing within degraded areas restoration through agroforestry systems. However, to contribute to the effectiveness of these initiatives, it is essential to integrate landscape vulnerability and local demands to better highlight in which areas the implementation of agroforestry systems should be prioritized. Thus, we developed a spatial hierarchization methodology as a decision support tool as an active strategy for agroecosystem restoration. The proposed method constitutes a spatial indicator of priority areas to guide agroforestry interventions, including resource allocation and public policies for payment for environmental services. The methodology consists of Multicriteria Decision Analysis implemented in GIS software by combining input datasets based on biophysical conditions, environmental and socioeconomic aspects, that integrated promotes an assessment of the environment fragility, the pressures and responses to land use dynamic; a strategy for landscape restoration and conservation of the natural habitats, and multiple specific scenarios for decision making regarding the agricultural and the local actors demands. The output of the model provides the spatial distribution of areas suitable for the implementation of agroforestry systems, sorted into four priority levels (Low, Medium, High, and Extreme priority). The method is a promising tool proposal for territorial management and governance and subsidizes future research on the flows of ecosystem services.•Assessment of the environment fragility and the pressures and responses to land use dynamic.•Strategy for landscape restoration and conservation of remaining natural habitats.•Multiple specific scenarios for decision making regarding the agricultural and the local actors demands.

Exercise volume load in women with breast cancer: Study protocol for the ABRACE randomized clinical trial.

Background: An increased number of breast cancer patients are challenged by acute and persistent treatment side effects. Oncology guidelines have been establishing physical exercise to counteract several treatment-related toxicities throughout cancer care. However, evidence regarding the optimal dose-response, feasibility, and the minimal resistance exercise volume and/or intensity remains unclear. The ABRACE Study will assess the impact of different resistance training volumes (i.e., single or multiple sets) combined with aerobic exercise on physical and psychological outcomes of breast cancer patients undergoing primary treatment. Methods: This study is a randomized, controlled, three-armed parallel trial. A total of 84 participants, aged ≥18 years, with breast cancer stages I-III, initiating adjuvant or neoadjuvant chemotherapy (≤50% of sessions completed) will be randomized to multiple sets resistance training plus aerobic training group, single set resistance training plus aerobic training group or control group. Neuromuscular and cancer-related fatigue (primary outcomes), muscle strength, muscle thickness, muscle quality by echo intensity, body composition, cardiorespiratory capacity, functional performance, upper-body endurance and quality of life will be measured before and after the 12-week intervention. Our analysis will follow the intention-to-treat approach and per-protocol criteria, with additional sub-group analysis. Discussion: Findings support prescribing exercise during chemotherapy for breast cancer and elucidate the potential role of different resistance training volumes as a management strategy for physical and psychological impairments in women with early-stage breast cancer. Our main hypothesis is for superiority in physical and psychological outcomes for both training groups compared to the control group, with no difference between single or multiple sets groups. Trial registration: Clinical trials NCT03314168.

Desarrollo y validación de una tarea experimental de Memoria Episódica verbal en español / Development and validation of an experimental verbal Episodic Memory task in Spanish

RESUMEN Propósito Elaborar y validar una tarea experimental de memoria episódica verbal en español. Método Se elaboraron seis bloques de codificación: tres profundos y tres superficiales, cado uno con distintas demandas de esfuerzo cognitivo. Los bloques fueron revisados por cuatro jueces expertos y examinados en una aplicación piloto. Se evaluó la concordancia respecto a si la tarea permitía manipular combinadamente el nivel de procesamiento y el esfuerzo cognitivo durante la codificación incidental de palabras, así como la claridad de las instrucciones, ejemplos y dinámica de trabajo. Resultados Variables como la disponibilidad léxica, metría y fuerza de asociación fueron útiles para diferenciar el esfuerzo cognitivo entre cada bloque. Los jueces concordaron que los bloques de procesamiento admiten una manipulación combinada del nivel de procesamiento y esfuerzo cognitivo y que las instrucciones son precisas. Luego del pilotaje, los participantes concordaron que las instrucciones, ejemplos y forma de trabajo eran fácil de comprender y realizar. Conclusión Los resultados proporcionan evidencia de validez relacionada con el contenido para la tarea experimental propuesta, transformándose con ello en una alternativa viable de considerar en investigaciones orientadas a identificar factores ambientales que contribuyan a compensar los defectos que muestra la memoria episódica con la edad.

ABSTRACT Purpose To develop and validate an experimental verbal episodic memory task in Spanish. Methods Six encoding blocks were elaborated, three deep and three superficial, each one with different demands of cognitive effort. The blocks were reviewed by four expert judges and tested in a pilot application. The agreement was assessed on whether the task allowed combined processing level and cognitive effort to be manipulated during incidental encoding of words, as well as clarity of instructions, examples, and workflow. Results Variables such as lexical availability, metrics, and strength of association were useful to differentiate the cognitive effort between each block. The judges agreed that the processing blocks allowed a combined manipulation of the level of processing and cognitive effort and that the instructions are precise. After the pilot, the participants agreed that the instructions, examples, and way of working were easy to understand and perform. Conclusion The results provide evidence of validity related to the content for the proposed experimental task, thus becoming a viable alternative to consider in research aimed at identifying environmental factors that contribute to compensating the defects shown by episodic memory with age.

Validez de contenido para una entrevista autobiográfica para adultos mayores / Content validity for an autobiographical interview for older adults

RESUMEN Objetivo Validar una propuesta de Entrevista Autobiográfica orientada al adulto mayor típico. Método Se diseñaron preguntas para una entrevista de memoria autobiográfica semiestructurada y se desarrolló un protocolo para la aplicación de esta. Se utilizaron 28 jueces; 14 fonoaudiólogos y 14 adultos mayores. Adicionalmente, se pilotaron 2 entrevistas. Posteriormente, la validez de contenido se obtuvo mediante el procedimiento clásico de Lawshe, utilizando complementariamente una evaluación para la comprensibilidad y extensión de la entrevista, así como un procedimiento de triangulación de datos con los jueces y participantes de la experiencia piloto. Resultados De los 22 ítems evaluados, solo 4 estuvieron por sobre el valor crítico de referencia (0.49). Conclusión Se discute sobre la necesidad de incorporar esta medida de análisis en el contexto del respeto, la identidad y la agencia de los adultos mayores, como parte de un cambio de paradigma bajo la mirada de las atenciones centradas en la persona y un modelo de competencia comunicativa. Así como la necesidad de incorporar paradigmas culturales diferentes y el uso de tecnologías digitales.

ABSTRACT Purpose To validate a proposal for an autobiographical interview oriented to the typical older adult. Methods Questions for a semi-structured autobiographical memory interview were designed and a protocol for its application was developed. Fourteen Speech and Language Pathologists judges and 14 older adults were used. Additionally, 2 interviews were conducted. Subsequently, content validity was obtained by means of Lawshe's classic procedure. Also, using a complementary evaluation for comprehensibility and length of the interview, as well as a data triangulation procedure with the judges and participants of the pilot experience. Results Of the 22 items evaluated, only 4 were above the critical reference value (0.49). Conclusion The need to incorporate this measure of analysis in the context of respect, identity and agency of older adults is discussed as part of a change in thinking under the gaze of person-centered care and a communicative competence model. As well as the need to incorporate different cultural paradigms and the use of digital technologies.

¿Basta con el habla? Evaluación del desarrollo del lenguaje en niños sordos prelocutivos durante los primeros seis años de vida. Una revisión sistemática / Is speech enough? Language development evaluation in the first 6 years of prelingually deaf children. A systematic review

RESUMEN Objetivo Sintetizar la información científica relevante sobre la evaluación del desarrollo del lenguaje en niños sordos prelocutivos durante los primeros seis años de vida, con el fin de determinar si es suficientes para confirmar la presencia de algún desarrollo de lenguaje en esta población, o si se requiere un enfoque más integral. Estrategia de investigación Se realizó una revisión estructurada de la literatura científica en las siguientes bases de datos: PubMed, Lilacs, Ibecs, Trip DataBase, Cochrane library, Clinical Trial y Nice. Criterios de selección revisiones sistemáticas, evaluaciones de tecnologías sanitarias, ensayos clínicos aleatorizados, estudios observacionales de cohorte y casos - controles; incluyendo publicaciones sobre evaluación de cualquier aspecto del desarrollo de lenguaje, cualquier intervención y en cualquier idioma, se excluyeron si únicamente evalúan audición o habla, sordera central, súbita, transitoria, sordoceguera, con otras discapacidades o con trastornos del espectro autista. Análisis de datos se usó la metodología GRADE para analizar la calidad de la evidencia. Resultados es factible realizar evaluaciones del desarrollo de lenguaje a niños sordos prelocutivos. Se obtiene una calidad de la evidencia moderada que sugiere cierta confianza en los resultados de las evaluaciones, siempre y cuando vengan acompañadas de una apreciación integral de otros elementos lingüísticos. Conclusión los resultados de las evaluaciones de lenguaje deben sostenerse, en mayor medida, en datos sobre el lenguaje receptivo y expresivo, y que cuyas evidencias pueden enriquecerse al adjuntar evaluaciones de elementos lingüísticos formales tanto de la modalidad oral como gestual, y de los componentes pragmáticos de los procesos comunicacionales.

ABSTRACT Purpose To synthesize the relevant scientific information regarding the assessment of language development in prelingually deaf children during their first six years of life, in order to determine whether it is sufficient to confirm the presence of some language development in this population, or if a more integrated approach would be more appropriate. Research strategies A structured review of the relevant scientific literature was carried out in the following databases: PubMed, Lilacs, Ibecs, Trip DataBase, Cochrane library, Clinical Trial and Nice. Selection criteria Systematic reviews, health technology assessments, randomized clinical trials, observational cohorts and case-control studies; including publications of assessments concerning any aspect of language development or any intervention in any language. Evaluations related exclusively to hearing and speech, to central, sudden or transient deafness, to deaf-blindness, to further disabilities or to autism spectrum disorders, were excluded. Data analysis GRADE methodology was used to analyze evidence quality. Results It is possible to evaluate the language development of prelingually deaf children. A moderate quality of evidence was obtained, suggesting that the evaluations' results are fairly trustworthy, provided that the assessments are conducted within an integrated approach of other linguistic elements. Conclusion The results of the language evaluations must be supported mostly by receptive and expressive language data, and the found evidence can be improved by combining the assessments of the formal linguistic elements of both oral and gestural modalities with the pragmatic components of the communication process.

Invenções tecnológicas de cuidadores familiares na perspectiva de profissionais da atenção domiciliar / Invenciones tecnológicas de los cuidadores familiares desde la perspectiva de los profesionales del cuidado domiciliario / Technological inventions of family caregivers from the perspective of home care professionals

Resumo Objetivo descrever as invenções tecnológicas desenvolvidas por cuidadores familiares na perspectiva de profissionais da atenção domiciliar, discutindo-as a luz das necessidades de cuidado no domicílio. Método pesquisa qualitativa, multicêntrica, apoiada no modelo teórico das Necessidades Humanas Básicas, de Wanda Horta. Os dados foram obtidos a partir de entrevistas com 52 profissionais de equipes de Atenção Domiciliar de quatro municípios de Minas Gerais, submetidas à Análise de Conteúdo. Resultados foram identificadas 27 invenções criadas por cuidadores com materiais/recursos existentes no domicílio. A maior parte das invenções foi motivada pelas necessidades psicobiológicas de movimentação, posicionamento, proteção e conforto, alimentação, eliminações fisiológicas, higiene e terapêutica medicamentosa. Outras invenções foram motivadas pelas necessidades psicossociais e psicoespirituais para melhorar a comunicação entre o cuidador e o familiar, proporcionar lazer, distração e conforto espiritual. Conclusões/Implicações para a prática os processos de invenção de cuidadores explicitam consciência reflexiva ao articularem, assistemática e intuitivamente, recursos e objetos existentes no domicílio, gerando estratégias ou produtos semelhantes a tecnologias existentes. Estas invenções podem ser avaliadas, estimuladas, orientadas ou refutadas pelos profissionais de saúde cotidianamente envolvidos no cuidado domiciliar.

Resumen Objetivo describir las invenciones tecnológicas desarrolladas por los cuidadores familiares desde la perspectiva de los profesionales de la atención domiciliaria, discutiéndolas a la luz de las necesidades de atención en el hogar. Método investigación cualitativa, sustentada en el modelo teórico de las Necesidades Humanas Básicas. Los datos fueron obtenidos a partir de entrevistas con 52 profesionales de equipos de Atención Domiciliaria de cuatro municipios de Minas Gerais, sometidos al Análisis de Contenido. Resultados se identificaron 27 inventos creados por cuidadores con materiales disponibles en casa. La mayoría de los inventos fueron motivados por las necesidades psicobiológicas de movimiento, posicionamiento, protección y comodidad, alimentación, eliminaciones, higiene y farmacoterapia. Otros inventos fueron motivados por las necesidades psicosociales y psicoespirituales de mejorar la comunicación entre el cuidador y el familiar, proporcionando entretenimiento, distracción y consuelo espiritual. Conclusiones/Implicaciones para la práctica las invenciones de los cuidadores muestran una conciencia reflexiva al articular, de manera asistemática e intuitiva, los recursos y objetos existentes en el hogar, generando estrategias o productos similares a las tecnologías existentes. Estas invenciones pueden ser evaluadas, estimuladas, guiadas o refutadas por profesionales de la salud.

Abstract Objective To describe the technological inventions developed by family caregivers from the perspective of home care professionals, discussing them in the light of the care needs at home. Method qualitative, multicenter research, supported by the theoretical model of the Basic Human Needs of Wanda Horta. The data were obtained from interviews with 52 professionals from Home Care teams in four municipalities of Minas Gerais, which were submitted to Content Analysis. Results were identified 27 inventions created by caregivers with materials/resources existing at home. Most of the inventions were motivated by the psychobiological needs of movement, positioning, protection and comfort, feeding, physiological eliminations, hygiene and drug therapy. Other inventions were motivated by psychosocial and psychospiritual needs to improve communication between caregiver and family member, provide leisure, distraction, and spiritual comfort. Conclusions/Implications for practice the processes of invention of caregivers show reflective awareness by articulating, unsystematically and intuitively, existing resources and objects at home, generating strategies or products similar to existing technologies. These inventions can be evaluated, stimulated, guided or refuted by health professionals involved in home care on a daily basis.

Avaliação da gravidade (pim ii), funcionalidade (fss) e de desconforto respiratório (bsa) nos impactos e desfechos da internação hospitalar em utip / Assessment of severity (pim ii), functionality (fss) and of respiratory distress (bsa) in the impacts and outcomes of hospital admission in utip / Valoración de la gravedad (pim ii), funcionalidad (fss) y de la dificultad respiratoria (bsa) en los impactos y resultados del ingreso hospitalario en utip

Objetivo: identificar o perfil de admissões e o impacto nos desfechos de crianças internadas em uma terapia intensiva pediátrica e comparar os escores de gravidade, funcionalidade e de desconforto respiratório avaliados respectivamente pelas escalas (PIM II, FSS e BSA). Métodos: Estudo de caráter descritivo, retrospectivo, quantitativo de amostragem censitária. Ferramentas de avaliação: Pediatric Index of Mortality - PIM II, Functional Status Scoret -FSS, Boletim de Silverman-Andersen -BSA e avaliação de prontuários médicos e assistenciais. Resultados: 257 crianças menores de 12 anos foram incluídas no estudo durante todo o ano de 2019. A maioria 56% (n 143) eram menores de um ano e masculino 64 % (n 164) por causas respiratórias 60,05 % (n 155). A mortalidade foi de 9,8% (n 25), e a quantidade média de dias de ventilação mecânica foi de 4,57 dias ± 1,31. A idade não influenciou na quantidade de dias de ventilação mecânica (p<0.05), e o BSA avaliado isoladamente, não se associou a necessidade imediata de intubação (p<0.05), os pacientes do desfecho óbito ficaram em média 8,88 e ±13,04 dias internados, e no desfecho alta 4,73 ±6,63 dias. O PIM II pode ser utilizado para o risco de óbito (p <0,05) e valores maiores ou iguais a 21,58 % foram associados a óbitos e menores ou iguais a 6,65 % foram associados à alta. A FSS dos 257 pacientes na admissão foram: normal (147), disfunção leve (37), moderada (47) e grave (26); na alta hospitalar a FSS foi: normal (178), leve (21), moderada (25) e grave (8) mostrando que grau de funcionalidade normal e leve na admissão esta significativamente associado com a alta hospitalar (p< 0,001). Conclusão: O escore de gravidade PIM II foram compatíveis com os desfechos óbito ou alta, as variações no escore BSA para necessidade de ventilação mecânica não estão associados com a idade e com grau do escore. A funcionalidade mais adequada na admissão está associada ao desfecho alta, e os pacientes em sua maioria saem funcionais.

Objective: To identify the profile of admissions and the impact on outcomes of children admitted to a pediatric intensive care unit and to compare severity, functionality and respiratory distress scores assessed respectively by the scales (PIM II, FSS and BSA). Methods: This was a descriptive, retrospective, quantitative study with census sampling. Assessment tools: Pediatric Index of Mortality - PIM II, Functional Status Scoret -FSS, Silverman-Andersen Bulletin -BSA and assessment of medical and health care records. Results: 257 children under the age of 12 years were included in the study throughout 2019. The majority 56% (n 143) were under one year and male 64 % (n 164) from respiratory causes 60.05 % (n 155). Mortality was 9.8% (n 25), and the average amount of days on mechanical ventilation was 4.57 days ± 1.31. Age had no influence on the number of days of mechanical ventilation (p<0.05), and the BSA assessed alone was not associated with the immediate need for intubation (p<0.05), the patients in the outcome death were hospitalized for an average of 8.88 ±13.04 days, and in the discharge outcome 4.73 ±6.63 days. The PIM II can be used for the risk of death (p <0.05) and values greater than or equal to 21.58 % were associated with death and less than or equal to 6.65 % were associated with discharge. The FSS of the 257 patients at admission were: normal (147), mild (37), moderate (47) and severe (26) dysfunction; at hospital discharge the FSS was: normal (178), mild (21), moderate (25) and severe (8) showing that the degree of normal and mild functionality at admission was significantly associated with hospital discharge (p < 0.001). Conclusion: The PIM II severity scores were compatible with the outcomes death or discharge, the variations in BSA score for mechanical ventilation need were not associated with age and score level. The most adequate functionality at admission is associated with the outcome discharge, and most patients leave the hospital functional.

Objetivo: Identificar el perfil de ingreso y el impacto en los resultados de los niños ingresados en una unidad de cuidados intensivos pediátricos y comparar las puntuaciones de gravedad, funcionalidad y distrés respiratorio evaluadas respectivamente por las escalas (PIM II, FSS y BSA). Métodos: Se trató de un estudio descriptivo, retros- pectivo y cuantitativo con muestreo censal. Instrumentos de evaluación: Índice de Mor- talidad Pediátrica - PIM II, Functional Status Scoret -FSS, Boletín de Silverman-Ander- sen -BSA y evaluación de historias clínicas y asistenciales. Resultados: 257 niños meno- res de 12 años fueron incluidos en el estudio a lo largo de 2019. La mayoría 56% (n 143) eran menores de un año y varones 64% (n 164) de causas respiratorias 60,05% (n 155). La mortalidad fue del 9,8% (n 25) y la media de días con ventilación mecánica fue de 4,57 días ± 1,31. La edad no influyó en el número de días de ventilación mecánica (p<0,05), y el BSA evaluado por sí solo no se asoció con la necesidad inmediata de intu- bación (p<0,05), los pacientes en el resultado muerte estuvieron hospitalizados una media de 8,88 ±13,04 días, y en el resultado alta 4,73 ±6,63 días. El PIM II se puede utilizar para el riesgo de muerte (p <0,05) y los valores mayores o iguales a 21,58 % se asociaron con la muerte y menores o iguales a 6,65 % se asociaron con el alta. La SFS de los 257 pacientes al ingreso fue: normal (147), disfunción leve (37), moderada (47) y grave (26); al alta hospitalaria la SFS fue: normal (178), leve (21), moderada (25) y grave (8) mos- trando que el grado de funcionalidad normal y leve al ingreso se asoció significativamente con el alta hospitalaria (p < 0,001). Conclusiones: Las puntuaciones de gravedad del PIM II fueron compatibles con los resultados muerte o alta hospitalaria, las variaciones en la puntuación del BSA para la necesidad de ventilación mecánica no se asociaron con la edad y el nivel de puntuación. La funcionalidad más adecuada al ingreso se asocia con el resultado alta, y la mayoría de los pacientes salen del hospital funcionales.

Instrumento de evaluación de la percepción de los contrastes mínimos en Lengua de Señas Chilena - evidencias de confiabilidad / Instrument to evaluate the perception of minimal contrasts in Chilean Sign Language - reliability evidence

RESUMEN Objetivo Obtener evidencias de confiabilidad de la prueba para evaluar la percepción de los contrastes mínimos en Lengua de Señas Chilena (LSCh). Método Participaron 10 niños y adolescentes Sordos con edades entre los 7 y 14 años, que fueron evaluados con la prueba de percepción de los contrastes mínimos en LSCh. En un primer momento se les aplicó la prueba, y entre 11 y 14 días después se les reaplicó nuevamente (confiabilidad test - retest). Para analizar los datos, fue realizada la correlación Rho de Spearman. Durante la primera aplicación se solicitó autorización a los padres de los niños y adolescentes para grabar las respuestas de los participantes para que otro evaluador pudiese repuntuar los protocolos, con el fin de obtener la confiabilidad interevaluador. Para el análisis de los datos se utilizó el cálculo estadístico first-order agreement coefficient (AC1) de Gwet. Resultados En la confiabilidad test - retest se obtuvo una correlación fuerte y significativa (Rho= 0,741; p=0,014). En la confiabilidad interevaluador, los valores de concordancia obtenidos varían entre 0,962 a 1 (p<0,001), indicando que la prueba presenta concordancia casi perfecta. Conclusión La prueba de percepción de pares de mínimos en LSCh presenta confiabilidad test - retest e interevaluador satisfactoria.

ABSTRACT Purpose Obtain evidence of the test reliability to evaluate the perception of minimum contrasts in Chilean Sign Language (LSCh). Methods Ten deaf children and adolescents aged between 7 and 14 years participated in this study. They were evaluated with the test of perception of minimal contrasts in LSCh. The test was reapplied 11 and 14 days after the first application (test-retest reliability). Spearman's Rho correlation was performed. During the first application, authorization was requested from the parents of the children and adolescents to record the responses of the participants so that another evaluator could re-score the protocols, in order to obtain inter-rater reliability. First-order agreement coefficient (AC1) Gwet's was used for data analysis. Results Test-retest obtained a strong and significant correlation (Rho= 0.741; p=0.014). The concordance values obtained inter-rater vary between 0.962 and 1 (p<0.001), indicating that the test presents almost perfect concordance. Conclusion The minimum pairs perception test in LSCh presents satisfactory test-retest and inter-rater reliability.

Cultural adaptation and validation of the SPICT-ES™ instrument to identify palliative care needs in Chilean older adults.

INTRODUCTION: Chile presents a context of an aging population and increased life expectancy, leading to many older adults (OA) needing palliative care (PC) during the course of their illness. The SPICT-ES™ is an instrument used to clinically evaluate patients with advanced chronic illness (ACI) to detect PC needs. Validating this instrument in Chile will allow for early detection of OA at risk of clinical deterioration who require this care. OBJECTIVE: Adapt and validate the SPICT-ES™ instrument to identify PC needs among OA in Chile. METHODOLOGY: Study following quantitative design - cross-sectional, descriptive, and developed in three stages: cultural adaptation by expert judgment; preliminary test of the SPICT-ESCH instrument to evaluate reliability and application of the SPICT-ESCH in 292 patients, to determine internal consistency and stability of the instrument. This study was done between January 2019 and July 2021. Participants in the study were nurses and OA from 5 health centers in Santiago, Chile. This study was approved by the Ethics Committee of Universidad de los Andes. RESULTS: In the cultural adaptation with content validity, following expert judgment, all items were kept. Semantic modifications were made on only three of them. A Lawshe coefficient of 84% which determined SPICT-ESCH as an acceptable instrument for the following stages of validation and reliability. The pilot for the new version in Chile, SPICT-ESCH, determined stability and consistency over time, with a Pearson correlation coefficient (ρ) of 0.9167 (p < 0.0001). In the final application of the instrument, to fortify the psychometric evaluation (n = 292) we identified 53.4% positive SPICT-ESCH. The logistical model via OR (< 0.001) showed that the items predicted the positivity of the instrument. The internal consistency obtained was 0.8662, confirming a correlation and intercorrelation between items. 100% of nurses evaluated the SPICT-ESCH as a useful and feasible instrument. CONCLUSION: SPICT-ESCH includes all the relevant indicators for adequate clinical identification of PC needs among the Chilean OA population, who could Benefit from the early introduction of palliative support contributing to their quality of life.

Identidade(s) em movimento: ações coletivas e multiplicidade nas trajetórias juvenis / Identity(s) in movement: collective actions and multiplicity in youth / Identidad(es) en movimiento: acciones colectivas y multiplicidad en trayectorias jóvenes

Este texto trata de um ensaio teórico que busca discutir questões relativas ao conceito de identidade ou identidade(s), na perspectiva de alguns autores da Sociologia e da Psicologia Social Crítica, direcionando às ações coletivas e trajetórias juvenis. As elaborações sobre identidade têm como contribuição principal essencial a obra de Alberto Melucci (2006), compondo um esquadrinhamento teórico referencial no estudo realizado. Ao refletirmos sobre a identidade em movimento e a multiplicidade nas trajetórias juvenis percebemos por meio da literatura especializada e analisada que não podemos negar os contextos múltiplos que lançam mão os jovens para tomar as suas decisões e estratégias escolares e laborais. As trajetórias juvenis se apresentam oscilantes, não-lineares, caracterizadas por rupturas, uma série de transformações e rearranjos vividos, assim como a própria constituição das identidades(s). Os jovens vivem situações de experimentação em suas trajetórias pessoais e profissionais num movimento que se apresenta circulante, fluído e incerto.

This text is a theoretical essay that aims to discuss issues related to the concept of identity or identity( ies), from the perspective of some authors of Sociology and Critical Social Psychology, directing to collective actions and youth trajectories. The elaborations on identity have as their main essential contribution the work of Alberto Melucci (2006), composing a theoretical scrutiny of reference in the study carried out. When we reflect on identity in motion and the multiplicity of youth trajectories, we realize through the specialized and analyzed literature that we cannot deny the multiple contexts that young people use to make their school and work decisions and strategies. Youth trajectories are oscillating, non-linear, characterized by ruptures, a series of lived transformations and rearrangements, as well as the very constitution of identity(ies). Young people experience situations of experimentation in their personal and professional trajectories in a movement that is circulating, fluid and uncertain.

Este texto es un ensayo teórico que busca discutir cuestiones relacionadas con el concepto de identidad o identidad(es), desde la perspectiva de algunos autores de la Sociología y la Psicología Social Crítica, dirigiéndose a acciones colectivas y trayectorias juveniles. Las elaboraciones sobre identidad tienen como principal aporte esencial el trabajo de Alberto Melucci (2006), componiendo un escrutinio teórico de referencia en el estudio realizado. Cuando reflexionamos sobre la identidad en movimiento y la multiplicidad de trayectorias juveniles, percibimos a través de la literatura especializada y analizada que no podemos negar los múltiples contextos que utilizan los jóvenes para tomar sus decisiones y estrategias escolares y laborales. Las trayectorias juveniles son oscilantes, no lineales, caracterizadas por rupturas, una serie de transformaciones y reordenamientos vividos, así como la constitución misma de (s) identidad(es). Los jóvenes viven situaciones de experimentación en sus trayectorias personales y profesionales en un movimiento circulante, fluido e incierto.

Telogen Effluvium and COVID-19: a case and a brief review of literature / Eflúvio Telógeno e COVID-19: um caso e uma breve revisão de literatura

COVID-19 is a new disease that has brought a great impact on global morbidity and mortality. There have been increasingly frequent reports of persistent symptoms and/or clinical manifestations attributed to COVID-19 after the acute phase of the disease. In this article, we present a case of post-COVID-19 telogen effluvium in a 39-year-old hypertensive and obese patient who looked for medical attention due to massive hair loss. Previous history of moderate COVID-19 4 months ago. After investigation and exclusion of other possible causes of telogen effluvium well established in the literature, the condition was attributed to the previous episode of COVID-19. Persistent fever, the cytokine storm, and the entire immunological cascade of COVID-19 can lead to apoptosis of the keratinocytes of the hair follicles, initiating the catagen phase early followed by the telogen phase with a consequent capillary release. Late symptoms possibly secondary to COVID-19 should receive attention and interest from the medical and scientific community. As it is a new disease, whose late consequences are not yet fully known/elucidated, careful observation and careful clinical follow-up of these patients are recommended (AU)

A COVID-19 é uma doença nova que vem provocando grande impacto na morbimortalidade mundial. Relatos de persistência de sintomas e/ou manifestações clínicas atribuídas à COVID-19 após a fase aguda da doença tem sido cada vez mais frequentes. Neste artigo, apresentamos um caso de eflúvio telógeno pós COVID-19 em um paciente de 39 anos, hipertenso e obeso, que procurou atendimento médico devido à queda volumosa de cabelos. Histórico prévio de COVID-19 moderada há 4 meses. Após investigação e exclusão de outras possíveis causas de eflúvio telógeno bem estabelecidas na literatura o quadro foi atribuído ao episódio prévio de COVID-19. É possível que a febre persistente, a tempestade de citocinas e toda a cascata imunológica da COVID-19 possam levar à apoptose dos queratinócitos dos folículos capilares, iniciando, assim, precocemente a fase catágena seguida pela fase telógena com consequente liberação capilar. Sintomas tardios possivelmente secundários à COVID-19 devem ser alvo de atenção e interesse da comunidade médica e científica. Por se tratar de uma doença nova, cujas consequências tardias ainda não se encontram completamente conhecidas/ elucidadas, recomenda-se a observação atenta e o seguimento clínico criterioso desses pacientes (AU)

Clinical, Epidemiological, and Epizootic Features of Sporothrix brasiliensis in Espírito Santo, Brazil.

We verified the clinical-epidemiological, microbiological, and molecular aspects of feline sporotrichosis in Espírito Santo, Brazil, as well as demonstrated the degree of reliability of the cytopathological examination in diagnosis, when compared to fungal culture. From March 2019 to April 2020, 154 suspicious cats were evaluated by collecting data and biological samples. The Cohen's kappa coefficient and the Chi-square independence defined the degree of agreement and the accuracy parameters, respectively. The interobserver agreement was high (Kappa coefficient = 0.96). Sensitivity, specificity, predictive (positive and negative), and accuracy values were 95.0, 97.0, 99.1, 84.2, and 95.5%, respectively. All isolates evaluated were identified as Sporothrix brasiliensis by species-specific PCR. A digital image bank (Padlet) was created with different types of clinical forms and positive slide profiles. We concluded that the cytopathological technique used demonstrated a high degree of reliability. We report an overwhelming occurrence of S. brasiliensis during epizooties in ES.

Temporal trends in the epidemiology of inflammatory bowel diseases in the public healthcare system in Brazil: A large population-based study.

Background: Population-based data on epidemiology of Inflammatory Bowel Diseases (IBD) in Brazil are scarce. This study aims to define temporal trends of incidence and prevalence rates of Crohn's disease (CD) and ulcerative colitis (UC) in Brazil. Methods: All IBD patients from the public healthcare national system were included from January 2012 to December 2020. Average Annual Percent Change (AAPC) and 95% confidence intervals (CI) were calculated using log-linear regression for incidence and binomial regression for prevalence. Moran's I autocorrelation index was used to analyse clustering of cities by level of prevalence. Findings: A total of 212,026 IBD patients were included. Incidence of IBD rose from 9.4 in 2012 to 9.6 per 100,000 in 2020 (AAPC=0.8%; 95% CI -0.37, 1.99); for UC, incidence increased from 5.7 to 6.9 per 100,000 (AAPC=3.0%; 95% CI 1.51, 4.58) and for CD incidence decreased from 3.7 to 2.7 per 100,000 (AAPC=-3.2%; 95% CI -4.45, -2.02). Prevalence of IBD increased from 30.0 in 2012 to 100.1 per 100,000 in 2020 (AAPC=14.8%; CI 14.78-14.95); for UC, from 15.7 to 56.5 per 100,000 (AAPC=16.0%; CI 15.94, 16.17); for CD from 12.6 to 33.7 per 100,000 (AAPC=12.1% CI 11.95, 12.02). A south-north gradient was observed in 2020 prevalence rates of IBD [I=0.40 (p<0.0001)], CD [I=0.22 (p<0.0001)] and UC [I=0.42 (p<0.0001)]. Interpretation: Incidence of CD is decreasing whereas of UC is increasing, leading to stabilization in the incidence of IBD from 2012 to 2020 in Brazil. Prevalence of IBD has been climbing with 0.1% of Brazilians living with IBD in 2020. Funding: None.

Fatores correlacionados à fragilidade de idosos em atenção ambulatorial: diferença entre grupos etários / Factores correlacionados con la fragilidad de los ancianos en la atención ambulatoria: diferencia entre grupos de edad / Factors correlated with the frailty of elderly in outpatient care: difference between age groups

RESUMO Objetivo correlacionar variáveis sociodemográficas e de saúde de idosos de diferentes grupos etários com a fragilidade. Método estudo quantitativo, transversal, realizado com 50 idosos atendidos em um Ambulatório de Gerontologia no interior de São Paulo. Foram coletados dados sociodemográficos e de saúde, sendo: fragilidade; desempenho cognitivo; dependência em Atividades Básicas e Instrumentais de Vida Diária e sintomas depressivos. Para a análise dos dados, foi utilizado o teste de correlação de Spearman. Resultados houve o predomínio de mulheres, com média de 79,4 (±9,4) anos de idade e baixa escolaridade. Foram considerados frágeis 58,3% dos idosos entre 60 e 79 anos e 84,6% daqueles acima de 80 anos. No primeiro grupo, houve correlação entre a fragilidade e o maior número de medicamentos, pior desempenho cognitivo, dependência em Atividades Básicas e Instrumentais de Vida Diária. Nos mais longevos, a fragilidade correlacionou-se ao maior número de morbidades, pior desempenho cognitivo e dependência em Atividades Básicas e Instrumentais de Vida Diária. Conclusão e implicações para a prática: as correlações encontradas permitem o estabelecimento de medidas para aperfeiçoar o planejamento de ações voltadas à assistência ambulatorial, possibilitando organizar prioridades de prevenção e intervenção.

RESUMEN Objetivo correlacionar variables sociodemográficas y de salud de ancianos de diferentes grupos de edad con fragilidad. Método estudio cuantitativo, transversal, realizado con 50 ancianos atendidos en un Ambulatorio de Gerontología del interior de São Paulo. Se recogieron datos sociodemográficos y de salud, así: fragilidad; rendimiento cognitivo; dependencia de las Actividades Básicas e Instrumentales de la Vida Diaria y síntomas depresivos. Para el análisis de los datos se utilizó la prueba de correlación de Spearman. Resultados hubo predominio del sexo femenino, con media de 79,4 (±9,4) años de edad y baja escolaridad. El 58,3% de los ancianos entre 60 y 79 años y el 84,6% de los mayores de 80 años fueron considerados frágiles. En el primer grupo, hubo correlación entre la fragilidad y el mayor número de medicamentos, peor desempeño cognitivo, dependencia de las Actividades Básicas e Instrumentales de la Vida Diaria. En los mayores, la fragilidad se correlacionó con mayor número de morbilidades, peor desempeño cognitivo y dependencia de las Actividades Básicas e Instrumentales de la Vida Diaria. Conclusión e implicaciones para la práctica: las correlaciones encontradas permiten establecer medidas para mejorar la planificación de acciones dirigidas a la atención ambulatoria, posibilitando la organización de prioridades de prevención e intervención.

Abstract Objective to correlate socio-demographic and health variables of elderly people of different age groups with frailty. Method this is a quantitative, cross-sectional study conducted with 50 elderly individuals seen at a Gerontology Outpatient Clinic in the interior of São Paulo. Socio-demographic and health data were collected, including: frailty, cognitive performance, dependence on Basic and Instrumental Activities of Daily Living, and depressive symptoms. For data analysis, the Spearman correlation test was used. Results there was a predominance of women, with a mean age of 79.4 (±9.4) years and low education. A total of 58.3% of the elderly aged between 60 and 79 years and 84.6% of those above 80 years were considered frail. In the first group, there was a correlation between frailty and a higher number of medications, worse cognitive performance, and dependence on Basic and Instrumental Activities of Daily Living. In the oldest old, frailty correlated with a greater number of morbidities, worse cognitive performance, and dependence on Basic and Instrumental Activities of Daily Living. Conclusion and implications for practice the correlations found allow the establishment of measures to improve the planning of actions aimed at outpatient care, enabling the organization of prevention and intervention priorities.

Normative nasalance scores in Chilean adults / Valores normativos de nasalancia en adultos chilenos

ABSTRACT Purpose The present study is aimed towards determining and comparing normative nasalance scores in Chilean Spanish-speaking adult men and women. Methods 40 women (age range 18 to 35, X = 25.79, SD = 5.83) and 36 men (age range 18 to 35, X = 26.45, SD = 4.08) were invited to participate, all of them without any previous speech therapy, neurological pathologies, intellectual deficits, hearing loss, syndromes, or other diagnosed pathologies that could impact speech production. A study of proper velopharyngeal function was performed, using a perceptual resonance evaluation. Nasalance was determined using a model 6450 Nasometer, during the reading of three standardized speech samples in Spanish: a nasal passage (NP), an oronasal passage (ONP), and an oral passage (OP). Also, the nasalance distance was calculated. Genders were compared using Wilcoxon tests for independent samples. Results The NP presented the highest percentage of nasalance, with 52.13% (± 4.73), followed by the ONP with 25.38% (± 3.7), and finally the OP, which presented the lowest value of 14.15% (± 5.03). Meanwhile, nasalance distance was 37.98% (± 5.32). Finally, no significant differences were observed when comparing the nasalance between genders (p >0.05). Conclusion The nasalance values obtained were similar to those observed for other Spanish speakers. Also, male and women showed similar scores. The results of this study are a contribution to the indirect assessment of velopharyngeal function in Chilean adults.

RESUMEN Objetivo El presente estudio tiene como objetivo determinar y comparar puntajes normativos de nasalancia en hombres y mujeres chilenos de habla hispana. Método Participaron 40 mujeres (rango de edad de 18 a 35, X = 25.79, DE = 5.83) y 36 hombres (rango de edad de 18 a 35, X = 26.45, DE = 4.08), todos sin ningún antecedente de tratamiento fonoaudiológico, patologías neurológicas, déficit intelectual, hipoacusia, síndromes u otras patologías diagnosticadas que podrían afectar la producción del habla. La adecuada función velofaríngea fue determinada en vivo a través de una evaluación perceptual de la resonancia. La nasalancia se determinó utilizando un Nasometer modelo 6450, durante la lectura de tres muestras de habla estandarizadas en español: un párrafo nasal (PN), un párrafo oronasal (PON) y un párrafo oral (PO). Además, se calculó la distancia de nasalancia. La comparación entre ambos sexos fue realizada con el test de Wilcoxon para muestras independientes. Resultados El PN presentó el mayor porcentaje de nasalancia con 52.13% (± 4.73), seguido del PON con 25.38% (± 3.7), y finalmente el PO, que presentó el valor más bajo de 14.15% (± 5.03). En tanto, la distancia de nasalancia fue del 37.98% (± 5.32). Por último, no se observaron diferencias significativas al comparar entre ambos sexos (p> 0.05). Conclusión Los valores de nasalancia obtenidos fueron similares a los observados para otros hispanohablantes. Además, hombres y mujeres mostraron puntuaciones similares. Los resultados de este estudio son una contribución a la evaluación indirecta de la función velofaríngea en adultos chilenos.

Síntomas de hipoacusia y exposición al ruido recreativo en jóvenes universitarios, Barranquilla, Colombia / Hearing loss symptoms and leisure noise exposure in university students in Barranquilla, Colombia

RESUMEN Objetivo Investigar la participación de estudiantes universitarios en actividades de ocio productoras de ruido y la relación entre los niveles de exposición semanal al ruido recreativo y síntomas de hipoacusia auto reportados, en la ciudad de Barranquilla, Colombia. Método Se realizó un estudio transversal mediante encuesta virtual, basada en el Cuestionario de Exposición al Ruido, más 11 preguntas de síntomas auditivos, a una muestra aleatoria de 730 sujetos. El nivel de exposición semanal al ruido recreativo se estimó a partir del tiempo dedicado al total de actividades recreativas reportadas por los participantes y su evaluación subjetiva de la intensidad de ruido producida por cada actividad, transformada en niveles de ruido continuo equivalente. La asociación entre la exposición al ruido recreativo y la presencia de síntomas de hipoacusia se analizó mediante la prueba de Chi-cuadrado. Resultados El 93% de los participantes manifestó al menos un síntoma de hipoacusia y la mitad reportó cuatro o más. El síntoma más frecuente de hipoacusia asociada al ruido fue el tinnitus (72%). El 55% tenía una exposición semanal de ruido por encima de 85 dBA y en éstos la prevalencia de síntomas de hipoacusia fue mayor (p < 0.05). Conclusión Se sugiere la presencia de deterioro auditivo en gran parte la población universitaria, asociado con altas dosis de exposición semanal al ruido recreativo. Es necesario fortalecer los programas de promoción de la salud auditiva en la academia, y desde los servicios de salud, la valoración objetiva y periódica de la audición.

ABSTRACT Purpose The aim of this study was to investigate the total weekly exposure to leisure noise among university students and to assess its association with self-reported symptoms of hypoacusis. Methods This is a cross-sectional survey. An online questionnaire based on the "Noise Exposure Questionnaire", plus 11 questions regarding hearing loss were sent to 730 randomly selected students. Participants self-reported time spent on different leisure noise activities and their subjective evaluation of the loudness of these activities, converted into equivalent noise levels, were used to estimate weekly noise exposure levels that were compared to occupational noise limits (> 85 dBA = hazardous). Inference statistics was applied to relate hearing symptoms and "likely or having some degree of hearing loss" with hazardous weekly leisure noise exposure levels. Results Ninety-three percent of the participants reported at least one hypoacusis symptom. The most frequent sound-related ear symptom was tinnitus (72%). Fifty-five percent of the individuals presented weekly exposure to noise >85 dBA. Symptoms of hearing loss were more prevalent in those exposed to weekly noise levels >85 dBA. Conclusion This study suggests that there may be hearing loss caused by exposure to high levels of leisure noise in a large part of the study population. Health promotion of hearing conservation should be emphasized at university level. Objective repeated measurement of hearing acuity should be part of integral health services for the youth population.