Raríssimo caso de pericardite constritiva: sangramento pericárdico pós-traumático por causa inusitada / Very rare case of constrictive pericarditis: post-traumatic pericardial bleeding due to an unusual cause

APRESENTAÇÃO DO CASO: Paciente do sexo masculino, 69 anos, fumante, sem outras comorbidades, agricultor, consulta por dispnéia. Ao exame físico na admissão apresenta sinais de insuficiência cardíaca direita. Foi realizado ecocardiograma com evidência de massa adjacente ao ventrículo direito (VD), causando compressão com diminuição a distensibilidade do VD, com áreas de intensa calcificação pericárdica de distribuição desigual e padrão hemodinâmico de constrição. Nega antecedentes de tuberculose, radioterapia de tórax ou cirurgia cardíaca prévia. Realizada TC de tórax com contraste, evidenciando calcificações pericárdicas, com imagem de "pseudotumor" adjacente a VD de contorno irregular, calcificação intensa e conteúdo heterogêneo. O paciente foi submetido a pericardectomia e ressecção do tumor, com achado de intensa calcificação e coágulos remanescentes em seu interior. Interrogado especificamente sobre antecedente de trauma torácico, ao que o paciente respondeu ter sofrido uma pancada por cabeça de bovino, 10 anos antes do início dos sintomas. Descartou-se contato com Mycobacterium tuberculosis, tireoidopatias e neoplasias. Em ausência de outra explicação que justificasse os achados, foi assumida como etiologia pericardite constritiva secundária a hemopericárdico por contusão cardíaca. DISCUSSÃO: As causas mais comuns de pericardite constritiva incluem tuberculose, colagenoses, uremia, febre reumática, radioterapia, neoplasias. Existem pouquíssimos relatos na literatura relacionando pericardite constritiva a trauma torácico fechado, a maioria das associações são com o trauma da pericardiectomia durante uma cirurgia cardíaca. Chama a atenção a intensa calcificação pericárdica com efeito de massa compressiva adjacente ao VD e a localização heterogênea das calcificações nas paredes de VE, podendo corresponder com a distribuição pós-traumática do sangramento. Apesar de ser relatado na literatura que a tuberculose está entre as causas que mais apresentam calcificação visível ao exame radiológico, não há evidências que ligam a alteração a uma etiologia específica. COMENTÁRIOS FINAIS: Pelo perfil da população que atendemos no SUS, devemos abrir o espectro de possibilidades para não nos surpreendermos com motivos inusitados de consulta na população. Não há casos publicados de pericardite pós-traumática, secundária a hemopericárdio pós pancada de bovino. Com a grande quantidade de trabalhadores rurais no Brasil, sua incidência poderia estar sendo subestimada.

A Collaborative Platform for Advancing Automatic Interpretation in ECG Signals.

Numerous papers report the efficiency of the automatic interpretation capabilities of commercial algorithms. Unfortunately, these algorithms are proprietary, and academia has no means of directly contributing to these results. In fact, nothing at the same stage of development exists in academia. Despite the extensive research in ECG signal processing, from signal conditioning to expert systems, a cohesive single application for clinical use is not ready yet. This is due to a serious lack of coordination in the academic efforts, which involve not only algorithms for signal processing, but also the signal acquisition equipment itself. For instance, the different sampling rates and the different noise levels frequently found in the available signal databases can cause severe incompatibility problems when the integration of different algorithms is desired. Therefore, this work aims to solve this incompatibility problem by providing the academic community with a diagnostic-grade electrocardiograph. The intention is to create a new standardized ECG signals database in order to address the automatic interpretation problem and create an electrocardiography system that can fully assist clinical practitioners, as the proprietary systems do. Achieving this objective is expected through an open and coordinated collaboration platform for which a webpage has already been created.

Rol de trampas extracelulares de neutrófilos en el pronóstico de las infecciones del sistema respiratorio / Role of neutrophil extracellular traps in the prognosis of respiratory tract infections

Las trampas extracelulares de neutrófilos (NET, por sus siglas en inglés) han surgido recientemente como un vínculo potencial entre la inmunidad y la inflamación, que podría cumplir un papel clave en la patogénesis de las infecciones de vías respiratorias. El objetivo de esta revisión es determinar su rol como marcador pronóstico en enfermedades infecciosas de vías respiratorias. Para la elaboración de este artículo de revisión narrativa se consultaron las publicaciones disponibles a través de una búsqueda automatizada en las bases de datos de PubMed, Scopus y Embase. Las concentraciones elevadas de trampas extracelulares de neutrófilos (cfADN, complejos de mieloperoxidasas-ADN) en pacientes con cuadro clínico grave por infecciones de vías respiratorias, se relacionan con una estancia hospitalaria más larga, periodo prolongado de administración de antibióticos, aumento del riesgo de ingreso a la UCI, necesidad de ventilación mecánica, disfunción orgánica e incluso la muerte (p ≤ 0,05). A pesar de no contar con un parámetro de medición estandarizado, el exceso de trampas extracelulares de neutrófilos se corresponde con la gravedad del daño tisular observado en pacientes con infecciones de vías respiratorias, esto revela el importante rol pronóstico de la respuesta de los neutrófilos y del proceso de la NETosis en las enfermedades infecciosas pulmonares

Neutrophil extracellular traps (NET) have recently emerged as a potential link between immunity and inflammation, which could play a key role in the pathogenesis of respiratory tract infections. This review aims to determine the role of neutrophil extracellular traps as prognostic markers in respiratoria tract infectious diseases. For this article a literature review was undertaken, consulting available publications through an automated search in PubMed, Scopus, and Embase databases. High concentrations of neutrophil extracellular traps (cfDNA, Myeloperoxidase-DNA complexes) in patients with severe clinical presentation due to respiratory tract infections are related to a longer length of hospital stay, prolonged period of antibiotic administration and increased risk of admission to the ICU, need for mechanical ventilation, organ dysfunction and even death (p ≤ 0.05). Despite not having a standardized measurement parameter, the excess of neutrophil extracellular traps corresponds to the severity of tissue damage observed in patients with respiratory tract infections, revealing the important prognostic role of the neutrophil response and NETosis process in pulmonary infectious diseases

EOG Signal Classification with Wavelet and Supervised Learning Algorithms KNN, SVM and DT.

The work carried out in this paper consists of the classification of the physiological signal generated by eye movement called Electrooculography (EOG). The human eye performs simultaneous movements, when focusing on an object, generating a potential change in origin between the retinal epithelium and the cornea and modeling the eyeball as a dipole with a positive and negative hemisphere. Supervised learning algorithms were implemented to classify five eye movements; left, right, down, up and blink. Wavelet Transform was used to obtain information in the frequency domain characterizing the EOG signal with a bandwidth of 0.5 to 50 Hz; training results were obtained with the implementation of K-Nearest Neighbor (KNN) 69.4%, a Support Vector Machine (SVM) of 76.9% and Decision Tree (DT) 60.5%, checking the accuracy through the Jaccard index and other metrics such as the confusion matrix and ROC (Receiver Operating Characteristic) curve. As a result, the best classifier for this application was the SVM with Jaccard Index.

Human-Machine Interface: Multiclass Classification by Machine Learning on 1D EOG Signals for the Control of an Omnidirectional Robot.

People with severe disabilities require assistance to perform their routine activities; a Human-Machine Interface (HMI) will allow them to activate devices that respond according to their needs. In this work, an HMI based on electrooculography (EOG) is presented, the instrumentation is placed on portable glasses that have the task of acquiring both horizontal and vertical EOG signals. The registration of each eye movement is identified by a class and categorized using the one hot encoding technique to test precision and sensitivity of different machine learning classification algorithms capable of identifying new data from the eye registration; the algorithm allows to discriminate blinks in order not to disturb the acquisition of the eyeball position commands. The implementation of the classifier consists of the control of a three-wheeled omnidirectional robot to validate the response of the interface. This work proposes the classification of signals in real time and the customization of the interface, minimizing the user's learning curve. Preliminary results showed that it is possible to generate trajectories to control an omnidirectional robot to implement in the future assistance system to control position through gaze orientation.

Impacto de la pandemia en la práctica de los profesionistas de la salud oral en México / Impact of the COVID-19 pandemic in the oral health professionals' practice in Mexico

partir de la pandemia, los odontólogos han presentado una serie de complicaciones en su práctica diaria, la naturaleza misma de la profesión representa un alto riesgo de contagio y la posibilidad de generar una infección cruzada por el virus SARS-CoV-2, por lo que han tenido que limitar su labor a la atención de urgencias, adquiriendo insumos relacionados a incrementar los cuidados de su grupo de trabajo y del paciente. Objetivo: Conocer el impacto de esta plaga en la práctica de los profesionistas de la salud oral en México. Material y métodos: Se realizó un estudio descriptivo y transversal mediante la aplicación de una encuesta a través de redes sociales a odontólogos, los resultados se expresaron con tablas de frecuencias y porcentajes. Resultados: Se recibieron respuestas de 200 cirujanos dentistas con clínica privada, 71% comentó haber cerrado su consultorio al inicio de esta calamidad, en contraste, el 53.5% de profesionales afirmaron tener actualmente una consulta no restringida, refiriendo que se ha visto reducida entre 50 y 75%, la mayoría reconoce que han tenido que reforzar el uso de EPP y algunos protocolos de protección, 16.5% ha padecido COVID-19. Conclusiones: La pandemia ha generado un impacto económico importante en la práctica de los odontólogos, al combinarse la disminución del número de pacientes con el aumento de gastos. Se debe considerar a la odontología como una profesión de alto riesgo, por lo que este gremio debe ser tomado en cuenta para el plan de vacunación como parte importante del sector salud (AU)

Given the nature of their profession, the COVID-19 pandemic has brought complications in their daily practice to odontologists, who are at a high risk of contracting the disease, and the possibility of creating a cross infection by the SARS-CoV-2 virus. That is why odontologists have had to restrain their practice to attend to emergencies only and acquire consumables and equipment related to improve their patients' care and the safety of their work team. Objective: To know the COVID-19 pandemic impact in the oral health professionals' practice in Mexico. Material and methods: A transversal, descriptive study was conducted by using a survey through social networks to gather information from odontologists practicing in Mexico. Results were presented in frequency and percentage tables. Result: Responses of 200 dental surgeons in private practice were received. 71% said that they closed their office at the beginning of the pandemic. On the other hand, 53.5% of them currently have a non-restricted practice but it is reduced between 50 and 75%. Most of them recognized that they had to improve the use of PPE and add some protection protocols, 16.5% have suffered from COVID-19. Conclusions: This pandemic has generated an important economic impact in the odontological practice, combining the decrease in the number of patients with the increase in their office expenses. Odontology must be considered a high-risk profession and an important part of the health sector, consequently, these professionals must be included in the vaccination plan on a priority basis (AU)

Modificaciones en el patrón geométrico y la función cardiaca asociadas a malnutrición por excesoª / Modifications in the Geometric Pattern and Cardiac Function Associated with Excess Malnutritionª

Introducción: Hace años, Cuba, en su Anuario Estadístico de Salud, viene presentando las enfermedades del corazón como la primera causa de muerte. Asociados a la morbimortalidad cardiovascular se encuentran el sobrepeso y la obesidad, también identificados por la American Heart Association como uno de los mayores e independientes factores de riesgo cardiovascular. Desde entonces, varios estudios han relacionado el aumento de peso con modificación de la morfofunción del corazón. Objetivo: Describir las modificaciones del patrón geométrico del ventrículo izquierdo y de la función cardiaca asociadas a malnutrición por exceso en sujetos de la provincia La Habana. Métodos: Se estudiaron 72 sujetos de ambos sexos, aparentemente sanos, que acudieron al Hospital Calixto García a chequearse. A todos se les realizó anamnesis, examen físico, se midió el porcentaje de grasa corporal utilizando un equipo de bioimpedancia; esto permitió clasificar a los sujetos en tres grupos: grupos N (normal), A (alto) y MA (muy alto) y un ecocardiograma. Se procedió a comparar los grupos entre sí mediante análisis estadístico. Resultados: En 23 sujetos con porcentaje de grasa corporal superior al normal, predominó el remodelado concéntrico del ventrículo izquierdo. A mayor composición de grasa corporal aumentó la frecuencia de relajación prolongada, comprometiendo la función diastólica y decreció ligeramente la fracción de eyección del ventrículo izquierdo. Conclusiones: En asociación con el aumento en el porcentaje de grasa corporal hubo cambios morfológicos del corazón, destacando la remodelación concéntrica y el deterioro de la función diastólica(AU)

Introduction: For years, Cuba, in its Statistical Health Yearbook, has presented heart disease as the leading cause of death. Associated with cardiovascular morbidity and mortality are overweight and obesity, also identified by the American Heart Association as one of the largest and independent cardiovascular risk factors. Since then, several studies have linked weight gain with modification of the morphofunction of the heart. Objective: To describe the modifications of the geometric pattern of the left ventricle and of the cardiac function associated with malnutrition due to excess in subjects from the province of Havana. Methods: Seventy-two apparently healthy subjects of both sexes who came to the Calixto García Hospital for a check-up were studied. All underwent anamnesis, physical examination, the percentage of body fat was measured using a bioimpedance equipment; This allowed the subjects to be classified into three groups: N (normal), A (high) and MA (very high) groups and an echocardiogram. The groups were compared with each other through statistical analysis. Results: In 23 subjects with a percentage of body fat higher than normal, concentric remodeling of the left ventricle predominated. A higher body fat composition increased the frequency of prolonged relaxation, compromising diastolic function, and the left ventricular ejection fraction decreased slightly. Conclusions: In association with the increase in the percentage of body fat, there were morphological changes of the heart, highlighting the concentric remodeling and the deterioration of the diastolic function(AU)

Incidencia de la insatisfacción laboral en la eficiencia de la gestión. Caso Clínica Estomatológica / Incidence of the occupational dissatisfaction in the efficiency of management. Case Dental Clinic

Introducción: la calidad en la gestión de los servicios asistenciales, es una exigencia que produce beneficios tanto para la población como para las instituciones de salud, máxime en Cuba, donde "Los servicios de salud son gratuitos, pero cuestan". Los costos de calidad son indicadores de eficiencia, particularmente en las partidas asociadas a fallos que evalúan los recursos malgastados por una deficiente gestión y sobre lo cual deberán enfocarse las acciones para la mejora. Objetivo: identificar los costos por fallos, en estrecha relación con el análisis de sus causas y la satisfacción de los trabajadores. Materiales y métodos: se realizó un estudio descriptivo. La metódica radicó en la investigación de campo en base a encuestas aplicadas a los trabajadores, revisión de documentos, evaluación de partidas de costos por extensión del sistema contable o estimación, según el caso, así como el análisis causal desarrollado por un grupo de expertos de la organización, con representación de las diferentes áreas de la clínica objeto de estudio. Resultados: se evalúan monetariamente fallos incurridos durante el año 2014, ascendiendo a $ 12260,49, los mayores montos estuvieron asociados a reelaboraciones y desperdicios. El análisis causal mostró una fuerte incidencia de los trabajadores en la ocurrencia de dichas ineficiencias, predominando las negligencias. La insatisfacción de los trabajadores, fue de una media general de 2,94 (por debajo de 3), lo que se puede interpretar como que estos reciben menos de lo que esperan, esencialmente, en cuanto a salario, condiciones laborales y participación en la toma de decisiones. Conclusiones: se establecen los montos de los costos asociados a fallos en la gestión de los servicios de la Clínica Estomatológica III Congreso del PCC, en línea con el análisis de la satisfacción de los trabajadores como elemento causal fundamental que incide en la calidad de los servicios en dicha organización, la cual debe establecer plan de mejoras en su gestión (AU).

Introduction: the quality of management in health care services is an exigency producing benefits both for the population and for health institutions, especially in Cuba, where "health services are free, but they cost." The quality costs are indicators of efficiency, particularly in the items associated to failures assessing resources misspent for a deficient management, and on which the actions should be focused for getting improvement. Objective: to identify the costs by failures, in tight relation with the analysis of their causes and workers´ satisfaction. Materials and methods: a descriptive study was carried out. Methodologically, it was a field research on the bases of surveys applied to workers, documental reviewing, and evaluation of cost items by extension of the accounting system or estimation, according to the case, and also the causal analyses performed by an expert group of the organization, with representatives of the different areas of the clinic being studied. Results: the failures that occurred during 2014 are monetarily evaluated, coming to $ 12 260.49. The highest amounts were associated to re-elaborations and wastes. The causal analysis showed a strong incidence of the workers in the occurrence of those inefficiencies, predominating negligence. The workers´ dissatisfaction was in general average 2.94 (under 3), what may be interpreted like if they receive less than they expect, essentially as for salary, working conditions and participation in decision-making. Conclusions: the amount of the cost associated to failures in the management of the services in the Dental Clinic "III Congreso del PCC" is established, aligned with the analysis of the workers´ satisfaction as main causal element striking in the quality of the services in that institution; they should elaborate and carried out a plan for the improvement of their management (AU).

Incidencia de la insatisfacción laboral en la eficiencia de la gestión. Caso Clínica Estomatológica / Incidence of the occupational dissatisfaction in the efficiency of management. Case Dental Clinic

Introducción: la calidad en la gestión de los servicios asistenciales, es una exigencia que produce beneficios tanto para la población como para las instituciones de salud, máxime en Cuba, donde "Los servicios de salud son gratuitos, pero cuestan". Los costos de calidad son indicadores de eficiencia, particularmente en las partidas asociadas a fallos que evalúan los recursos malgastados por una deficiente gestión y sobre lo cual deberán enfocarse las acciones para la mejora. Objetivo: identificar los costos por fallos, en estrecha relación con el análisis de sus causas y la satisfacción de los trabajadores. Materiales y métodos: se realizó un estudio descriptivo. La metódica radicó en la investigación de campo en base a encuestas aplicadas a los trabajadores, revisión de documentos, evaluación de partidas de costos por extensión del sistema contable o estimación, según el caso, así como el análisis causal desarrollado por un grupo de expertos de la organización, con representación de las diferentes áreas de la clínica objeto de estudio. Resultados: se evalúan monetariamente fallos incurridos durante el año 2014, ascendiendo a $ 12260,49, los mayores montos estuvieron asociados a reelaboraciones y desperdicios. El análisis causal mostró una fuerte incidencia de los trabajadores en la ocurrencia de dichas ineficiencias, predominando las negligencias. La insatisfacción de los trabajadores, fue de una media general de 2,94 (por debajo de 3), lo que se puede interpretar como que estos reciben menos de lo que esperan, esencialmente, en cuanto a salario, condiciones laborales y participación en la toma de decisiones. Conclusiones: se establecen los montos de los costos asociados a fallos en la gestión de los servicios de la Clínica Estomatológica III Congreso del PCC, en línea con el análisis de la satisfacción de los trabajadores como elemento causal fundamental que incide en la calidad de los servicios en dicha organización, la cual debe establecer plan de mejoras en su gestión (AU).

Introduction: the quality of management in health care services is an exigency producing benefits both for the population and for health institutions, especially in Cuba, where "health services are free, but they cost." The quality costs are indicators of efficiency, particularly in the items associated to failures assessing resources misspent for a deficient management, and on which the actions should be focused for getting improvement. Objective: to identify the costs by failures, in tight relation with the analysis of their causes and workers´ satisfaction. Materials and methods: a descriptive study was carried out. Methodologically, it was a field research on the bases of surveys applied to workers, documental reviewing, and evaluation of cost items by extension of the accounting system or estimation, according to the case, and also the causal analyses performed by an expert group of the organization, with representatives of the different areas of the clinic being studied. Results: the failures that occurred during 2014 are monetarily evaluated, coming to $ 12 260.49. The highest amounts were associated to re-elaborations and wastes. The causal analysis showed a strong incidence of the workers in the occurrence of those inefficiencies, predominating negligence. The workers´ dissatisfaction was in general average 2.94 (under 3), what may be interpreted like if they receive less than they expect, essentially as for salary, working conditions and participation in decision-making. Conclusions: the amount of the cost associated to failures in the management of the services in the Dental Clinic "III Congreso del PCC" is established, aligned with the analysis of the workers´ satisfaction as main causal element striking in the quality of the services in that institution; they should elaborate and carried out a plan for the improvement of their management (AU).

Consumo de alcohol en la adolescencia: Consideraciones médicas y orientaciones educativas / Alcohol consumption during adolescence: Medical considerations and educational counseling

El consumo de alcohol por parte de los adolescentes supera en España el consumo de otras sustancias psicoactivas. Los daños que el cerebro humano sufre a causa del etanol, especialmente en la etapa de la adolescencia, son objeto de muchos estudios y se centran principalmente en cómo se afecta la neurotransmisión. Además, la vulnerabilidad del cerebro de los adolescentes a la influencia del alcohol ofrece rasgos peculiares por cuanto se encuentra en una etapa de intensa actividad de remodelación sináptica. Es necesario unir fuerzas, conocimientos y recursos dirigidos a un mejor conocimiento, tanto de los efectos biológicos del alcohol en el individuo adolescente como de los derivados del consumo en los ámbitos emocional, social y familiar, para diseñar actuaciones educativas que faciliten la modificación o erradicación de hábitos no saludables relacionados con la ingesta de alcohol. La evaluación previa se dirige a promover la calidad de vida en la Educación Secundaria, una etapa crucial en el desarrollo global del ser humano.

Alcohol is the most commonly consumed psychoactive drug among Spanish adolescents. The effects of alcohol on human brain, specifically on neurotransmission, are broadly studied. The adolescent brain is especially vulnerable to the effects of alcohol due to the intense and active processes of synapses restructuring ocurring during this period. To achieve and establish educational interventions directed to facilitate and eradicate harmful habits related to alcohol consumption during adolescence, it is necessary to join resources, knowledge and forces focused on a better understanding of the biological effects of alcohol and the harm produced in the emotional, social and familiar realms. Here, we discuss that intervention needs previous evaluation and should focus on Secondary Education, a crucial period in human development.

Teorías y modelos de enfermería. Una aproximación a la lectura crítica / Nursing theories and models. An approach to critical reading

Resumen

Introducción: la educación en enfermería a través del tiempo ha sido rutinaria y pasiva lo que requiere desarrollar aptitudes de tipo reflexivo, que reflejen una actuación profesional de calidad para la atención del paciente, para ello demanda tener habilidades como la lectura crítica que al desarrollarla permite el florecimiento de una actitud crítica la cual lleva implícito el desarrollo de la autocrítica.

Objetivo: comparar el nivel de desarrollo para la habilidad de lectura crítica de textos de teorías y modelos de enfermería alcanzada mediante dos estrategias educativas diferenciadas.

Metodología: estudio cuasiexperimental, con un grupo experimental (GE) integrado por 12 alumnos del 7° semestre de Licenciatura de Enfermería y un grupo control (GC) conformado por 11 alumnos del mismo semestre. Para estimar el grado de desarrollo de habilidad para la lectura crítica de textos teóricos se utilizó un instrumento cuyo índice de confiabilidad fue de 0.96. El GE fue sometido a una estrategia que promueve ambientes propicios para la reflexión y crítica, el grupo control fue continuo con la enseñanza habitual.

Resultados: en la medición basal no se encontraron diferencias significativas entre ambos grupos. Al comparar los grupos posterior a la intervención, encontramos diferencia estadísticamente significativa para el GE.

Conclusiones: un ambiente propicio para confrontar la experiencia con la literatura científica y someterla a la crítica en este caso sobre teorías y modelos de enfermería favorece el desarrollo de la aptitud para la lectura crítica de textos teórico.

Summary

Introduction: through the years nursing education has been monotonous and passive so it requires to develop reflexive skills that reflect a professional performance and quality patient care, thus it is necessary to apply abilities such as critical reading that allows the development of a critical attitude which implies the evolution to self-criticism.

Objective: in order to compare the level of skill development for critical reading of texts, in nursing theories and models, achieved by two different educational strategies.

Methodology: a quasi-experimental study was conducted with an experimental group (GE) composed of 12 students of 7th semester of Bachelor in Nursing and a control group (GC) composed of 11 students in the same semester. To estimate the degree of skill development for critical reading of theoretical texts an instrument of which reliability index was 0.96 was used. The GE was subjected to a strategy that fosters reflective and critical environments, the GC kept regular education.

Results: in the baseline measurement there were no significant differences between groups. When comparing post-intervention groups, we found statistically significant difference for the GE.

Conclusions: a conducive environment to confront the experience with scientific literature and to subject it to criticism, in this case on nursing theories and models, favors the development of skills for critical reading of theoretical texts.

[Development of critical reading on theoretical papers. Criticism of the teaching performance]. / Desarrollo de lectura crítica de textos teóricos. Crítica a la actuación docente.

BACKGROUND: The critical reading development requires the reader get involved with author idea, systematizing, arguing and debating the information sources. Our objective was to evaluate the development of the skill to critical reading of theoretical text in education with an educational strategies aimed to promote active participation. METHODS: A study of intervention, comparative, multicentre and prospective with five groups of students was designed An instrument was refined and validated to measure the critical reading ability of theoretical text before and after the educational strategies, that had in common the aim to favor development critical reading from the participative approach of the education. RESULTS: Before the educational intervention the D group and E group had higher median score showing statistical difference (p = 0.02) than the other control groups. After educational intervention the skill for critical reading was similar (p = 0.20). CONCLUSIONS: Teaching performance during the development of educational strategy promotes the participation that favors in a similar way the critical reading of theoretical texts.

Aproximación a la lectura crítica de textos teóricos de enfermería. Elaboración y validación de un instrumento / Approaching to critical reading of theoretical nursing texts. Elaboration and validation of an instrument

Introducción: Desarrollar aptitudes que faciliten el camino para el aprendizaje y la elaboración del conocimiento a los alumnos de la licenciatura de enfermería es básico para su formación, entre ellas la lectura crítica de textos teóricos. Considerar estos atributos en el proceso educativo requiere de poner énfasis a la forma en que se construyen instrumentos que se aproximen a la realidad objetiva de la evaluación. Objetivo: Construir y validar un instrumento que permita identificar la forma en que los alumnos de licenciatura de enfermería se aproximan a las fuentes de información de textos teóricos durante su proceso formativo. Metodología: Se construyó y validó un instrumento de lectura crítica de textos teóricos en enfermería, posterior a la revisión y análisis por un grupo de expertos en lectura crítica, el instrumento quedó conformado por 86 items y se aplicó a un grupo piloto (estudiantes del 7º semestre de la licenciatura en enfermería). Resultados: La consistencia interna se determinó mediante la prueba de Kuder-Richardson No. 21, resultando un índice de 0.96. Discusión: El proceso de construcción y validación de un instrumento requiere de una vigilancia epistemológica del desarrollo y fortalecimiento de una postura que dé coherencia, pertinencia y congruencia a la educación como parte del acto educativo.

Introduction: Developing aptitudes to facilitate the pathway toward the learning process and the elaboration of knowledge in students of baccalaureate in nursing is basic for their formation, among those, the critical reading of theoretical texts. In order to consider these attributes in the learning process, a special emphasis on the way in which the instruments of evaluation are built is required. These instruments need to be close to the objective reality of the evaluation. Objetive: To construct and validate an instrument that allows identifying the way how baccalaureates in nursing students approach to theoretical sources of information during their formation process. Methodology: An instrument of critical reading of theoretical texts was constructed and validated, after a reviewing and analysis by a group of experts in critical reading. The instrument was integrated by 86 items and was applied to a pilot group (students in the level of the seventh semester of baccalaureate in nursing). Results: The internal consistency was determined through the Kuder-Richardson test, number 21, and coming out score of 0.96. Discussion: Construction and validity process for an instrument need to be survillace on its epistemology development and reinforcement in order to get a posture with coherence, pertinence and congruence as a part of evaluation on the educative process.

Registro de pegadas de quatis (Nasua nasua) para monitoramento e educação ambiental utilizando diferentes substratos / Registration of footprints of coatis (Nasua nasua) for surveying and environmental education using different substrata

O Nasua nasua é um procionídeo que distribui da Venezuela ao norte da Argentina, sendo encontrada em todos os ecossistemas brasileiros. A identificação de animais por meio de pegadas é comumente utilizada para várias espécies. Dessa forma, o presente estudo teve como objetivo registrar e descrever as pegadas de quatis (Nasua nasua) utilizando diferentes substratos: areia úmida, argila e alginato, sendo este último até então não descrito para esta finalidade. O registro de pegadas mostrou-se ser um método barato, rápido e de fácil observação. Areia úmida, argila e alginato mostraram ser excelentes substratos com diferentes vantagens e desvantagens. Dessa forma, pode-se concluir que os substratos prestam-se bem ao registro de pegadas de quatis.

Nasua nasua is a procyonide that is distributed from Venezuela to the north of Argentina, being found in all the Brazilian ecosystems. The identification of animals through footprints is used commonly for several species. In that way, the present study had as objective to register and to describe the coatis (Nasua nasua) footprints using different substrata: humid sand, clay and alginate, the last one being not so far described for this purpose. The registration of footprints was shown to be a method cheap, fast and of easy observation. Humid sand, clay and alginate showed to be excellent substrata with advantages and disadvantages. In that way, it can be concluded that the substrata are useful to the registration of coatis footprints.

Tumor venéreo transmissível canino com localização intra-ocular e metástase no baço / Canine transmissible veneral tumor with intra-ocular localization and spleen metastasis

O tumor venéreo transmissível (TVT), também denominado de Linfossarcoma de Sticker, é uma neoplasia de células redondas de origem mesenquimatosa, contagiosa, localizada principalmente na membrana mucosa da genitália externa de cães de ambos os sexos. O TVT pode existir como massa solitária ou lesões múltiplas, em formato de couve-flor, ou como formas pendulares, nodulares, papilares ou multilobulares. A avaliação citológica das lesões é uma ferramenta extremamente útil que pode ser realizada com rapidez e facilidade, baixo custo e com risco mínimo ao paciente. O presente trabalho relata o caso de um animal da espécie canina, sem raça definida, macho, de 4 anos de idade, com 13 quilos, atendido no Hospital Veterinário da Universidade Federal Rural do Semi-Árido (UFERSA), onde foi constatado durante o exame clínico TVT com localização no prepucio, além de cegueira total em decorrência da localização intra-ocular de uma massa avermelhada que se projetava para fora do globo ocular direito e esquerdo. O animal foi então encaminhado ao Laboratório de Patologia Animal da UFERSA para realização do exame anatomopatológico. Através das características microscópicas, permitiu-se a conclusão de TVT como lesão primária no prepucio com acometimento intra-ocular e metástase no baço.

The transmissible venereal tumor (TVT), also called Sticker's Lymphosarcoma, is a round-cells mesenquimatous contagious neoplasia, mainly located in the mucous membrane of both sex dog's external genitalia. The TVT may exist as a solitary mass or multiple injuries, in cauliflower format, or as pendular forms, nodular, papillary or multilobar ones. This work reports the case of a canine animal species, without defined race, male, 4 years old, 13 kilos, taken care of in the Veterinarian Hospital of the Universidade Federal Rural do Semi-Árido (UFERSA), where TVT, located in the prepuces, was evidenced during clinical examination, beyond total blindness in result of an intra-ocular colored mass that projected itself for out of the right and left ocular globe. Then the animal was directed to the Animal Pathology Laboratory of the UFERSA for accomplishment of the anatomopathological examination. Through the microscopical characteristics, TVT conclusion was allowed. It was a primary injury in the prepuces, with intra-ocular injuries and spleen metastasis.

Fatores de risco para a transmissão da anemia infecciosa eqüina, leptospirose, tétano e raiva em criatórios equëstres e parques de vaquejada no município de Mossoró, RN / Risk factors for the transmission of the equine infectious anemia, leptospirosis, tetanus and rabies in horse breeding farms and vaquejada parks in the municipal district of Mossoró, RN

O crescimento da prática de vaquejada no município de Mossoró requer um manejo sanitário adequado visando à prevenção de doenças tanto nos criatórios como nos parques. Dessa forma, este trabalho objetivou avaliar a qualidade do manejo sanitário realizado e a notificação sobre a fiscalização sanitária interestadual e em parques de vaquejada do município. Os dados foram obtidos por meio de um inquérito epidemiológico mediante questionário aplicado a 40 proprietários e tratadores, através do qual foi possível observar que o manejo sanitário dessa espécie é bastante deficitário. Tal fato é agravado pela falha fiscalização interestadual e pela ausência de controle sanitário nos locais dos eventos.

The growth of the vaquejada practice in the municipal district of Mossoró requests an appropriate sanitary handling seeking to the prevention of diseases in the horse breeding farms and in the parks. In that way, this work aimed to evaluate the quality of the accomplished sanitary handling and the notification about the sanitary interstate inspection and in vaquejada parks of the municipal district. The data were obtained through an epidemic inquiry by doing a questionnaire to 40 proprietors and employees responsible for the animals, through which was possible to observe that the sanitary handling of that species is quite deficient. Such fact is worsened by the flaw interstate inspection and for the absence of sanitary control in the places of the events.