Prevention and treatment of cisplatin-induced ototoxicity in adults: A systematic review.

OBJECTIVES: Ototoxicity is a common disabling side effect of platinum-based chemotherapy. This study aimed to assess the evidence on the management of platinum-induced ototoxicity in adult cancer patients. METHODS: Four databases were searched up to 1 November 2022. Original studies were included if they reported on a pharmacologic or non-pharmacologic intervention to prevent or treat platinum ototoxicity in adults. The articles' quality was assessed via two grading scales. RESULTS: Nineteen randomised controlled trials and five quasi-experimental studies with 1673 patients were analysed. Eleven interventions were identified, nine pharmacological and two non-pharmacological. Six of the interventions (sodium thiosulphate, corticoids, sertraline, statins, multivitamins and D-methionine) showed mild benefits in preventing cisplatin-induced ototoxicity. Only one trial assessed corticoids as a potential treatment. Overall, only six trials were deemed with a low risk of bias. The majority of studies inadequately documented intervention-related adverse effects, thereby limiting safety conclusions. CONCLUSIONS: Current interventions have mild benefits in preventing cisplatin-induced ototoxicity in adult cancer patients. Sodium thiosulphate is the most promising intervention as a preventive strategy. Rigorous, high-quality research is warranted, encompassing an evaluation of all potential symptoms and innovative treatment modalities.

Rural Palliative Care Telemedicine for Advanced Cancer Patients: A Systematic Review.

Context: Telemedicine offers the opportunity to provide remote palliative care for patients to control symptoms and improve quality of life, even for patients with advanced diseases. Objectives: Establish a telemedicine model of rural palliative care for advanced cancer patients with difficulties in accessing standard care. Methods: This review comports with the minimum standards described in the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) and uses the palliative care literature review iterative method (PALETTE) proposed by Zwakman et al in 2018. Results: Three hundred, ninety-two articles were identified in PubMed and EMBASE databases and alternative search engines such as Google Scholar and OpenGrey. A telemedicine delivery model was developed for patients with limited access to standard care, which consists of identifying the candidate population, establishing the most convenient telemedicine modality, agreeing with patients and caregivers on palliative care needs, and evaluating the interventions effectiveness. Conclusion: Telemedicine is a revolutionary tool to provide palliative care to advanced cancer patients whose clinical condition or location prevent them from accessing conventional care.

Malformaciones linfáticas abdominales en una población pediátrica: experiencia en un centro de referencia de Medellín, Colombia / Abdominal lymphatic malformations in a pediatric population: Experience in a referral center in Medellín, Colombia

Introducción. Los linfangiomas son anormalidades benignas del sistema linfático, que corresponden a dilataciones quísticas de estos vasos y se localizan especialmente en el cuello. Solo el 10 % de todas estas malformaciones se encuentran en el abdomen y presentan síntomas variables de acuerdo al tamaño y su ubicación especifica, siendo el dolor abdominal el principal síntoma. Métodos. Se presentan cinco pacientes pediátricos con malformaciones linfáticas abdominales. Se describen su cuadro clínico, localización, tratamiento y la experiencia en el manejo de dicha patología en un hospital de referencia. Resultados. Los métodos más apropiados para hacer una aproximación diagnóstica son la ecografía, la tomografía computarizada y la resonancia nuclear magnética. Dentro de las opciones descritas para el tratamiento están la farmacológica, la escleroterapia y la resección quirúrgica, tanto por vía abierta como por laparoscopia. Conclusión. Existe una variedad de métodos para realizar la resección de los linfangiomas abdominales, pero la cirugía sigue siendo la más efectiva, especialmente cuando se cuenta con la laparoscopia como una herramienta terapéutica.

Introduction. Lymphangiomas are benign abnormalities of the lymphatic system, which correspond to cystic dilations of these vessels and are located especially in the neck. Only 10% of all these malformations are found in the abdomen and present variable symptoms according to size and their specific location, with abdominal pain being the main symptom. Methods. Five pediatric patients with abdominal lymphatic malformations are presented. Their clinical presentation, location, treatment and experience in the management of this pathology in a referral hospital are described. Results. The most appropriate methods to make a diagnostic approach are ultrasound, computed tomography and magnetic resonance imaging. Among the options described for treatment are pharmacological, sclerotherapy and surgical resection, both open and laparoscopic. Conclusion. There are a variety of methods for resecting abdominal lymphangiomas, but surgery remains the most effective, especially when laparoscopy is used as a therapeutic tool.

Calidad de vida relacionada con la salud bucal del adulto mayor rehabilitado con prótesis total / Quality of life related to the oral health of the major adult rehabilitated with total prosthesis

Objetivo Analizar la calidad de vida y la salud bucal de los adultos mayores entre 60 y 90 años rehabilitados con prótesis dental total uni o bimaxilar en consulta odontológica en la E.S.E. Hospital Santa Mónica, Dosquebradas-Risaralda en el 2018-1. Metodología Estudio descriptivo transversal con componente analítico. Muestreo no probabilístico por conveniencia. Se hizo revisión de historias clínicas, encuesta sociodemográfica y escala GOHAI. Se realizó análisis univariado con proporciones e intervalos de confianza, bivariado con prueba χ², multivariado con regresión logística múltiple. Resultados La muestra fue de 34 personas con promedio de 69,53 años y DE+/- 7,07; 100% de los encuestados pertenecían al régimen subsidiado, 76% al estrato socioeconómico 1, 50% presentaron prótesis superior, 38,2% bimaxilar, 22,8 % inferior. La media del GOHAI fue de 43,5 puntos, es decir, calidad de vida buena. En la función física 26,5% refirió que sus prótesis siempre les impidieron hablar bien; función psicosocial 26,5% siempre estuvieron insatisfechos con la apariencia de sus dientes o prótesis; según la prueba χ² hubo significancia estadística con valor de p<0.05 con el nivel de escolaridad, fecha de instalación de la prótesis, quitarse la prótesis para dormir, número de prótesis que ha tenido, sufrir hipertensión arterial, sufrir de enfermedades sistémicas, lesiones en la mucosa oral. Conclusiones Se demuestra que la calidad de vida se ve reducida en aquellos adultos mayores con enfermedad sistémica, barreras de acceso a una rehabilitación oportuna y deficientes prácticas de higiene oral; lo que muestra el predominio de factores sociales susceptibles de ser modificados

Objective To analyze the quality of life and oral health of older adults between 60 and 90 years of age rehabilitated with single or bimaxillary total dental prosthesis in a dental consultation at E.S.E. Santa Monica Hospital, Dosquebradas- Risaralda in 2018-1. Methods A transversal descriptive design was carry out. Non-probabilistic convinience sampling was used. A review of medical records was made, sociodemographic survey and the GOHAI were applied. Statistical analysis was performed, proportions and confidence intervals were calculated, χ² test and multiple logistic regression were used for the bi and multivariate analysis. Results The sample consisted of 34 people with an average age of 69.53 years and SD +/- 7.07; 100% of the sampled belonged to the subsidized regime, 76% to the socioeconomic level 1, 50% presented superior prosthesis, 38.2% bimaxillary, and 22.8% inferior prosthesis. The GOHAI average was 43,5 points, meaning good quality of life. In physical function 26.5% reported that their prosthesis always restrict them speaking well, in psychosocial function 26.5% were always dissatisfied with the appearance of their teeth or prosthesis; according to the χ² test there was statistical significance with p <0.05 value related to the education level, prosthesis' date of installation, number of prostheses the person have had, systemic diseases, lesions in the oral mucosa. Conclusions It is shown that the quality of life is reduced in older adults with systemic diseases, barriers to timely rehabilitation and poor oral hygiene practices; which shows the predominance of social factors that can be modified.

Correlación entre discapacidad y calidad de vida en niños con trastorno por déficit de atención con hiperactividad / Correlation between disability and quality of life in children with attention deficit hyperactivity disorder

Resumen Introducción. El trastorno por déficit de atención con hiperactividad (TDAH) genera limitaciones en las actividades y restricciones en la participación, de allí que deba abordarse desde un modelo biopsicosocial que considere la dimensión calidad de vida (CV). Objetivo. Correlacionar el grado de discapacidad a nivel escolar con la CV en niños con TDAH. Materiales y métodos. Se realizó un estudio correlacional en una muestra no probabilística de 106 niños de 8 a 12 años de Cali, Colombia. Se utilizaron los instrumentos MINIKID, KIDSCREEN-27 versiones padres y niños y el Cuestionario para Limitaciones en Actividad y Restricciones en Participación TDAH Versión Profesores. Se hizo un análisis descriptivo de características sociodemográficas y CV y un análisis correlacional entre grado de discapacidad con CV. Resultados. El promedio de edad de los niños estudiados fue de 9.6±1.19 años, predominó el género masculino y TDAH de tipo combinado. La CV es bien valorada por padres y niños, pero los puntajes bajos se presentan en la dimensión "El colegio". No se encontró correlación entre CV y grado de discapacidad. Conclusión. Los padres y niños con TDAH valoran positivamente la CV, pero hay tendencia a una valoración menor en la dimensión colegio. No existe correlación entre CV y grado de discapacidad a nivel escolar.

Abstract Introduction: Attention deficit hyperactivity disorder (ADHD) generates limitations in activities and restrictions in participation. Consequently, this condition should be addressed based on a biopsychosocial model that considers the quality of life (QL) dimension. Objective: To correlate the degree of disability at school with the QL in children with ADHD. Materials and methods: A correlational study was conducted on a non-probability sample of 106 children aged 8 to 12 in Cali, Colombia. The instruments used were MINIKID, KIDSCREEN-27 for parents and children, and the Activity Limitations and Participation Restrictions of Children with ADHD Questionnaire, teachers version. A descriptive analysis of socio-demographic characteristics and QL, as well as a correlational analysis between degree of disability and QL were carried out. Results: The average age of the children studied was 9.6±1.19 years, with predominance of the male sex and combined ADHD. QL was positively assessed by parents and children, but low scores are observed in the "The School" dimension. No correlation was found between QL and degree of disability. Conclusion: Parents and children with ADHD assess QL positively, but there is a tendency towards a lower score in the school dimension. There is no correlation between QL and degree of disability at school level.

Comparative study of the antioxidant capacity in green tea by extraction at different temperatures of four brands sold in Colombia / Estudio comparativo de la capacidad antioxidante en té verde por extracción a diferentes temperaturas de cuatro marcas vendidas en Colombia

Background: Tea (Camellia sinensis) is the most highly consumed beverage in the world in addition to water. The most common way of preparation is by immersing the tea bag in hot or cold water. In Colombia, it is a recent trend and the market is growing continuously. Objectives: The objective of this study is to compare the antioxidant characteristics of four brands of green tea sold in Colombia at room and hot-temperature in relation to the preparation conditions. Methods: Four commercial brands of green tea (Oriental®, Lipton®, Hindú®, Jaibel®) were used in an aqueous extraction at two temperatures: Cold tea extract (25°C) and hot tea extract (80°C). Total polyphenol concentration (TPC) was determined by Folin-Ciocalteu method; Total flavonoid content (TFC) was determined by spectrophotometric method and the antioxidant capacity was determined by two methods: DPPH radical capture assay, and the oxygen radical absorbance capacity (ORAC) assay. Finally, a method to quantify the catechins of the tea extracts, high performance liquid chromatography (HPLC) was applied. Results: The TPC vary between: 2.53 ­ 14.63 mg GAE/ g sample for cold tea extract and 29.34 - 55.06 mg GAE/g sample for hot tea extract. The TFC vary between: 2.67 ­ 7.08 mg CE/g per sample for the cold tea extract and 5.43­ 8.41 mg CE/ g sample for hot tea extract. A similar profile assays: for cold tea extract: 22.36 ­ 41.29 mg TE /g sample for DPPH and 22.95 ­ 46.25 mg TE/g sample for ORAC. Similarly, for hot tea extract the following ranges were: 38.50 ­ 110.01 mg TE/g sample for DPPH and 23.40- 113.60 mg TE/g sample for ORAC. In general, the values obtained in each assay for each brand were as follows: Oriental®> Lipton®> Hindú®> Jaibel®. The chromatographic profiles showed the presence of ten compounds. Conclusions: These results confirm that the aqueous extraction of green tea at 80°C leads to the formation of infusions made up of compounds with higher antioxidant capacity in comparison with extractions at room temperature.

Antecedentes: El té (Camellia sinensis) es la bebida más consumida en el mundo, además del agua. La forma más común de preparación es sumergiendo la bolsa de té en agua caliente o fría. En Colombia, es una tendencia reciente y el mercado está creciendo. Objetivos: El objetivo de este estudio es comparar las características antioxidantes de cuatro marcas de té verde vendidas en Colombia en relación con las condiciones de preparación. Métodos: Se utilizaron cuatro marcas comerciales de té verde (Oriental®, Lipton®, Hindú®, Jaibel®) mediante extracción acuosa a dos temperaturas: extracto de té frío (25°C) y extracto de té caliente (80°C). La concentración total de polifenoles (TPC) se determinó mediante el método de Folin-Ciocalteu; el contenido total de flavonoides (TFC) se determinó mediante método espectrofotométrico y la capacidad antioxidante se determinó mediante dos métodos: ensayo de captura del radical DPPH y ensayo de capacidad de absorción de radicales de oxígeno (ORAC). Finalmente, para cuantificar las catequínas de los extractos de té se aplicó cromatografía líquida de alta resolución (HPLC). Resultados: Los valores para TPC varían entre 2,53 -14,63 mg GAE/g extracto de té frío y entre 29,34 - 55,06 mg GAE/g extracto de té caliente. Los valores para TFC varían entre 2,67 - 7,08 mg de CE/g extracto de té frío y entre 5,43 - 8,41 mg de CE/g extracto de té caliente. Se observó un perfil similar en la capacidad antioxidante mediante ambos ensayos, extracto de té frío: 22,36 - 41,29 mg TE/g por DPPH y 22,95 - 46,25 mg TE/g por ORAC, extracto de té caliente: 38,50 - 110,01 mg TE/g por DPPH y 23,40- 113,60 mg TE/g por ORAC. En general, los valores obtenidos en cada ensayo respecto a cada marca se comportaron así: Oriental®> Lipton®> Hindú®> Jaibel®. Los perfiles cromatográficos mostraron la presencia de 10 compuestos. Conclusiones: Estos resultados confirman que la extracción acuosa de té verde a 80°C conduce a la formación de infusiones ricas en compuestos con capacidad antioxidante en comparación con extracciones a temperatura ambiente.

[Association between the characteristics of coordination development disorder and symptoms of attention deficit disorder with hyperactivity in children in the city of Manizales]. / Asociación de características de trastorno del desarrollo de la coordinación con síntomas de trastorno por déficit de atención con hiperactividad en niños de la ciudad de Manizales.

INTRODUCTION: Developmental coordination disorder (DCD) in childhood is an important public health problem, which has important implications for different spheres of development: motor, cognitive, psychosocial and emotional. Therefore, the presence of comorbidity is common, along with other disorders in child development. This article presents a study that determines the association between DCD characteristics with attention deficit and hyperactivity disorder (ADHD) symptoms. OBJECTIVE: To determine the association between DCD characteristics and ADHD symptoms in the city of Manizales, Colombia. METHODS: Cross-sectional, descriptive and associative study, in a sample of 140 children aged 6-12, randomised in public and private institutions. A structured interview was conducted, along with the questionnaires MINIKID and Cuestionario para Trastorno del Desarrollo de la Coordinación (CTDC). A descriptive univariate analysis was performed on the the sociodemographic characteristics, as well as association tests with χ(2) test, and dependence level with φ coefficient. RESULTS: A statistically significant association was found between the CTDC characteristics with ADHD symptoms (φ=.452; P=.001). CONCLUSIONS: An association was found in the studied population between the CTDC characteristics and ADHD symptoms, indicating that children with difficulties in motor performance may also have attention difficulties and hyperactivity.

Asociación de características de trastorno del desarrollo de la coordinación con síntomas de trastorno por déficit de atención con hiperactividad en niños de la ciudad de Manizales / Association between the characteristics of coordination development disorder and symptoms of attention deficit disorder with hyperactivity in children in the city of Manizales

Introducción: El trastorno del desarrollo de la coordinación (TDC) en la infancia es un problema importante para la salud pública, ya que tiene repercusiones importantes en las diferentes esferas del desarrollo: motor, cognitivo, psicosocial y emocional; por ello es frecuente la comorbilidad con otros trastornos del desarrollo infantil. Se presenta un estudio que determina la asociación de características de TDC con síntomas del trastorno por déficit de atención con hiperactividad (TDAH). Objetivo: Determinar la asociación de características de TDC con síntomas de TDAH en niños y niñas de la ciudad de Manizales, Colombia. Métodos: Estudio descriptivo y de asociación con una muestra de 140 niñas de 6-12 años de edad, aleatorizados en instituciones educativas públicas y privadas. Se realizó entrevista estructurada y aplicación de los instrumentos MINIKID y Cuestionario para Trastorno del Desarrollo de la Coordinación (CTDC). Se realizaron análisis descriptivo univariable para la caracterización sociodemográfica y pruebas de asociación a través del test de la χ² y grado de dependencia con coeficiente φ. Resultados: Se encontró asociación estadísticamente significativa entre características de TDC y síntomas de TDAH (φ = 0,452; p = 0,001). Conclusiones: En la población estudiada se encontró asociación entre características de TDC y síntomas de TDAH, lo que indica que niños con dificultades en el desempeño motor también pueden sufrir dificultades de atención e hiperactividad.

Introduction: Developmental coordination disorder (DCD) in childhood is an important public health problem, which has important implications for different spheres of development: motor, cognitive, psychosocial and emotional. Therefore, the presence of comorbidity is common, along with other disorders in child development. this article presents a study that determines the association between DCD characteristics with attention deficit and hyperactivity disorder (ADHD) symptoms. Objective: To determine the association between DCD characteristics and ADHD symptoms in the city of Manizales, Colombia. Methods: Cross-sectional, descriptive and associative study, in a sample of 140 children aged 6-12, randomised in public and private institutions. A structured interview was conducted, along with the questionnaires MINIKID and Cuestionario para Trastorno del Desarrollo de la Coordinación (CTDC). A descriptive univariate analysis was performed on the the sociodemographic characteristics, as well as association tests with 2 test, and dependence level with φ coefficient. Results: A statistically significant association was found between the CTDC characteristics with ADHD symptoms (φ=.452; P=.001). Conclusions: An association was found in the studied population between the CTDC characteristics and ADHD symptoms, indicating that children with difficulties in motor performance may also have attention difficulties and hyperactivity.

Endoftalmitis endógena asociada a absceso hepático por Klebsiella pneumoniae. Descripción de tres casos y revisión de la literatura / Endoftalmite endógena associadas com abscesso hepático por Klebsiella Pneumoniae. Descrição de três casos e revisão de literatura / Endogenous endophthalmitis associated with Klebsiella pneumoniae liver abscess. Description of three cases and literature review

Se presentan los casos de tres pacientes con endoftalmitis endógena asociada a absceso hepático por Klebsiella pneumoniae, atendidos en el Hospital Universitario San Vicente Fundación, de Medellín. Esta complicación forma parte del síndrome de absceso hepático criptogénico invasor por K. pneumoniae, entidad descrita hace 25 años y cuya prevalencia parece ir en aumento. Para cada paciente se describen los síntomas y signos, el aislamiento microbiológico, el tratamiento, la evolución y el desenlace visual. Es la primera vez que se informa esta enfermedad en Colombia...

We describe three patients with endogenous endophthalmitis associated with Klebsiella pneumoniae liver abscess, treated at Hospital Universitario San Vicente Fundación (Medellín, Colombia). This complication is part of a syndrome described 25 years ago, whose prevalence seems to be rising: cryptogenic invasive K. pneumoniae liver abscess. Symptoms and signs, microbiological isolates, treatment, evolution and visual outcome are described for each patient.It is the first report of this disease in Colombia...

Apresenta o caso de três pacientes com endoftalmite endógena associadas com abscesso hepático por Klebsiella pneumoniae tratados no Hospital Universitário San Vicente Foundación, de Medellín. Esta complicação faz parte da síndrome, abscesso hepático criptogênica invasora por K. Pneumoniae, entidade descrita há 25 anos e cuja prevalência parece estar aumentando. Para cada paciente descreve os síntomas e sinais, o isolamento microbiológico, o tratamento, a evolução e o resultado visual. Esta é a primeira vez que se informa dessa doença na Colômbia...

Consistencia interna y validez concurrente del cuestionario para evaluación de limitaciones y restricciones en niños con TDAH / Internal Consistency and Concurrent Validity of the Questionnaire for Limitations and Restrictions Assessment in Children with ADHD / Consistência interna e validez concorrente do questionário para avaliação de limitações e restrições em crianças com TDAH

Introducción: El TDAH es uno de los diagnósticos más frecuentes en psiquiatría infantil, su diagnóstico temprano reviste una gran importancia para su intervención familiar, escolar y social. Basándose en la clasificación internacional del funcionamiento, la discapacidad y la salud CIF, se diseñó un cuestionario para la evaluación de limitaciones en la actividad y restricciones en la participación en niños con TDAH, el cuestionario CLARP-TDAH versión padres y profesores. Objetivo: Determinar el grado de consistencia interna de los CLARP-TDAH y su validez concurrente con el cuestionario de capacidades y dificultades SDQ versión padres y maestros. Materiales y métodos: Muestra de 203 niños de 6 a 12 años con TDAH, escolarizados, en cinco ciudades de Colombia. Se aplicaron estos cuestionarios a padres y profesores. El análisis de consistencia interna se realizó por coeficiente de Cronbach, y la validez concurrente mediante coeficiente de correlación de Spearman y con predictores múltiples y únicos a través de modelos de regresión lineal múltiple y simple. Resultados: La consistencia interna fue elevada para los cuestionarios globales y para cada uno de sus dominios. El CLARP-TDAH padres obtuvo consistencia interna de 0,83 y el CLARP-TDAH profesores de 0,93. Se halló validez concurrente entre los CLARPTDAH y el SDQ padres y maestros, existe concurrencia entre el CLARP-TDAH profesores y SDQ maestros, y entre el CLARP-TDAH padres y profesores, esto dado por valores p < 0,001.

Introduction: ADHD is one of the most common diagnoses in child psychiatry, its early diagnosis is of great importance for intervention at family, school and social environment. Based on the International Classification of Functioning, Disability and Health (ICF), a questionnaire was designed to assess activity limitations and participation restrictions in children with ADHD. The questionnaire was called "CLARP-ADHD Parent and Teacher Version". Objective: To determine the degree of internal consistency of the CLARP-ADHD questionnaire, and its concurrent validity with the "Strengths and Difficulties Questionnaire SDQ parent and teacher version". Material and Methods: A sample of 203 children aged 6 to 12 with ADHD, currently attending school in five Colombian cities. The questionnaires were applied to parents and teachers. The internal consistency analysis was performed through Cronbach coefficient and concurrent validity using the Spearman correlation coefficient utilizing multiple and unique predictors through multiple linear regression as well as simple regression models. Results: A high internal consistency was found for global questionnaires for each of its domains. The CLARP-ADHD for parents gave as result an internal consistency of 0.83, and the CLARP-ADHD for teachers one of 0.93. Concurrent validity was found between the CLARP-ADHD and the SDQ Parent and Teacher version; also, concurrence between the CLARPADHD for Teachers and the SDQTeachers was found, as well as between CLARPADHD for Parents and CLARP ADHD Teachers, given by p values of p < 0.001.

Introdução: O TDAH é um dos diagnósticos mais frequentes em psiquiatria infantil, seu diagnóstico precoce reviste uma grande importância para sua intervenção no nível familiar, escola e social. Baseando-se na classificação internacional do funcionamento, a deficiência e a saúde CIF, criou-se um questionário para a avaliação de limitações na atividade e restrições na participação em crianças com TDAH, o questionário CLARP-TDAH Versão Pais e Professores. Objetivo: Determinar o grau de consistência interna dos CLARP TDAH e sua validez concorrente com o questionário de capacidades e dificuldades SDQ versão pais e professores. Materiais e Métodos: Amostra de 203 crianças de 6 e 12 anos com TDAH, escolarizados, em cinco cidades da Colômbia. Aplicaram-se estes questionários a pais e professores. A análise de consistência interna realizou-se por coeficiente de Cronbach, e a validez concorrente mediante coeficiente de correlação de Spearman e com preditores múltiplos e únicos através de modelos de regressão lineal múltipla e simples. Resultados: A consistência interna foi elevada para os questionários globais e para cada um de seus domínios. O questionário CLARP-TDAH dos pais obteve consistência interna de 0,83, e o CLARP-TDAH dos professores de 0,93. Achou-se validez concorrente entre os CLARP TDAH e o SDQ Pais e Professores, existe concorrência entre o CLARP TDAH Professores e SDQ Professores, e entre o CLARP TDAH Pais e CLARP TDAH Professores, isto dado por valores p < 0,001.

Confiabilidad intraevaluador del cuestionario para limitaciones en la actividad y restricciones en la participación de niños con TDAH / Intra-rater Reliability for the Questionnaire on Activity Limitations and Participation Restrictions of Children With ADHD

Introducción: Los cuestionarios para la evaluación de limitaciones en la actividad y restricciones en la participación de niños con TDAH (CLARP-TDAH) se han desarrollado recientemente en Colombia, basados en las sugerencias hechas por la Organización Mundial de la Salud (OMS) desde la Clasificación Internacional del Funcionamiento, la Discapacidad y la Salud (CIF), lo cual permite trascender de la evaluación clínica a una evaluación desde la funcionalidad y el funcionamiento de los niños en su contexto familiar y escolar. En este estudio se determinó el grado de confiabilidad intraevaluador para los cuestionarios CLARP TDAH Padres y Profesores. Métodos: En una muestra no probabilística de 203 niños y niñas colombianos escolarizados y diagnosticados con TDAH, se determinó la confiabilidad intraevaluador a través del índice kappa; los informantes fueron los padres y los profesores. Resultados: Se encontró que la confiabilidad intraevaluador de los dominios del cuestionario CLARP-TDAH para padres obtuvo κ > 0,7, mientras que para los dominios del CLARP-TDAH Profesores resultaron > 0,8. Conclusiones: Los cuestionarios CLARP-TDAH son una herramienta con buen nivel de confiabilidad intraevaluador, lo cual permite realizar una evaluación confiable de las limitaciones en la actividad y las restricciones en la participación para determinar el funcionamiento en los entornos familiar y escolar.

Introduction: Questionnaires for evaluating activity limitations and participation restrictions in children with ADHD (CLARP-TDAH) has recently been developed in Colombia, based on the suggestions made by the WHO from the International Classification of Functioning, Disability and Health (ICF), allowing clinical evaluation beyond an evaluation of the functionality and functioning of children in their family and school environments. Previous research with the questionnaire proved useful in the multidisciplinary approach of Colombian children with ADHD. This study determines the level of intra-rater reliability for questionnaires CLARP-TDAH Parents and Teachers. Methods: The study included a non-random sample of 203 Colombian children attending school and diagnosed with ADHD. Intra-rater reliability and the reproducibility of the results was determined using the Kappa index. The informants were parents and teachers. Results: Kappa values >0.7 were obtained for the intra-rater reliability of the questionnaire domains of CLARP-TDAH Parents, while for CLARP-TDAH Teachers domains these values were >0.8. Conclusions: CLARP-TDAH questionnaires are a tool with a good level of intra-rater reliability, which allows a reliable assessment of activity limitations and participation restrictions in order to determine the level of functioning at home and school.

[Intra-rater Reliability for the Questionnaire on Activity Limitations and Participation Restrictions of Children With ADHD]. / Confiabilidad intraevaluador del cuestionario para limitaciones en la actividad y restricciones en la participación de niños con TDAH.

INTRODUCTION: Questionnaires for evaluating activity limitations and participation restrictions in children with ADHD (CLARP-TDAH) has recently been developed in Colombia, based on the suggestions made by the WHO from the International Classification of Functioning, Disability and Health (ICF), allowing clinical evaluation beyond an evaluation of the functionality and functioning of children in their family and school environments. Previous research with the questionnaire proved useful in the multidisciplinary approach of Colombian children with ADHD. This study determines the level of intra-rater reliability for questionnaires CLARP-TDAH Parents and Teachers. METHODS: The study included a non-random sample of 203 Colombian children attending school and diagnosed with ADHD. Intra-rater reliability and the reproducibility of the results was determined using the Kappa index. The informants were parents and teachers. RESULTS: Kappa values >0.7 were obtained for the intra-rater reliability of the questionnaire domains of CLARP-TDAH Parents, while for CLARP-TDAH Teachers domains these values were >0.8. CONCLUSIONS: CLARP-TDAH questionnaires are a tool with a good level of intra-rater reliability, which allows a reliable assessment of activity limitations and participation restrictions in order to determine the level of functioning at home and school.

Traducción al español del cuestionario para diagnóstico de trastorno del desarrollo de la coordinación / Spanish Translation Questionnaire of the Developmental Coordination Disorder / Tradução espanhola do questionário para o diagnóstico de transtorno do desenvolvimento da coordenação

El trastorno del desarrollo de la coordinación se reconoce por dificultades motoras que afectan el rendimiento en actividades cotidianas y escolares; por tanto, se hace necesario un diagnóstico precoz para iniciar una intervención oportuna. Un cuestionario para diagnosticar es el Developmental coordination disorder questionnaire'07, DCDQ'07. Objetivo: realizar la traducción y adaptación transcultural al español del DCDQ'07. Materiales y métodos: tres traductores independientes tradujeron el cuestionario, clasificando sus ítems como equivalentes, con problemas en algunas palabras y sin equivalencia, y desde su equivalencia experiencial, semántica, conceptual e idiomática. Resultados: el artículo presenta los resultados preliminares de la investigación, la cual culminó su primera fase de traducción de los quince ítems del cuestionario. Ocho de ellos fueron clasificados como equivalentes, seis con problemas en algunas palabras y uno sin equivalencia. Diez ítems correspondieron a traducción por equivalencia experiencial, cuatro se clasificaron como equivalentes semánticos y uno se consideró con doble equivalencia. La autora del cuestionario original valoró positivamente la versión en español. La percepción de los padres frente al cuestionario fue positiva. Conclusiones: la mayoría de los ítems del cuestionario no tuvo dificultad en su traducción, facilitando su adaptación transcultural al español y la continuidad del proceso de validación y confiabilidad.

The developmental coordination disorder can be recognized by motor difficulties that affect the performance in daily and school activities; therefore, it is necessary to get its early diagnosis in order to initiate early intervention. A tool for diagnosis is the Developmental coordination disorder questionnaire'07, DCDQ'07. Objective: the translation and cultural adaptation of the DCDQ'07 into Spanish. Materials and methods: three independent translators translated the questionnaire into Spanish. Its items were classified according to their equivalent or non-equivalent problems in some words, and also according to their experiential, semantic, conceptual or idioms equivalence. Results: 8 items out of 15 questionnaire items were classified as equivalent 8, 6 of them presented problems in a few words and only one was classified as non-equivalent, 10 items correspond to experiential equivalence translation, 4 items were classified as semantic equivalent and only one got two equivalents. The author agreed the Spanish version. Also, the parent's opinions about the questionnaire were positive. Conclusions: most of the items of the questionnaire did not have translation difficulties. It allowed its translation and cultural adaptation into Spanish as well as its validation continuity and reliability process.

Reconhece-se o transtorno do desenvolvimento da coordenação pelas dificuldades motoras que afetam o rendimento em atividades cotidianas e escolares, portanto precisa-se de um diagnóstico precoce para começar uma intervenção oportuna. Um questionário para tal diagnóstico é o Developmental coordination disorder questionnaire'07 (DCDQ'07). Objetivo: a tradução e adaptação transcultural do DCDQ'07 ao espanhol. Materiais e métodos: três tradutores independentes fizeram a tradução do questionário e classificaram seus items como equivalentes, com problemas em algumas palavras e sem equivalência, como também desde a equivalência experiencial, semântica, conceitual e idiomática. Resultados: dos 15 items do questionário, 8 foram classificados como equivalentes, 6 com problemas em algumas palavras e só um foi classificado sem equivalência, 10 items corresponderam à tradução por equivalência experiencial, 4 foram classificados como equivalentes semânticos e só um foi classificado com dupla equivalência. A autora do questionário apreciou positivamente a versão em espanhol. A apreciação dos pais à frente do questionário é positiva. Conclusões: a tradução da maioria dos items do questionário foi fácil. Isto facilitou a adaptação transcultural ao espanhol e a continuidade do processo de validação e confiabilidade.

Serología en hepatitis virales / Serology in viral hepatitis

Las infecciones por los virus de las hepatitis A (VHA), B (VHB), C (VHC), D (VHD) y E (VHE) producen cuadros clínicos y bioquímicos similares, por lo que es necesario recurrir a pruebas de laboratorio diferentes a las de función hepática para identificar con certeza los agentes etiológicos; entre ellas se encuentran: las serológicas, con la que se pueden detectar antígenos virales y los correspondientes anticuerpos, y las moleculares que permiten detectar el genoma viral. Para diagnosticar la existencia de una infección actual por cualquiera de estos virus basta con las pruebas serológicas, excepto en el caso de la infección por VHC para la que es necesario detectar el genoma viral. Las pruebas moleculares son de gran utilidad para el seguimiento y la toma de decisiones terapéuticas en los pacientes con infección crónica por VHB o VHC. El presente artículo es una revisión de las pruebas de laboratorio disponibles para el diagnóstico de cada una de las hepatitis virales.

Infections due to hepatitis viruses A (HAV), B (HBV), C (HCV), D (HDV), and E (HEV) result in similar clinical and biochemical manifestations. Consequently, in order to identify with certainty the etiologic agents of hepatitis, it is necessary to carry out laboratory tests different from those used to assess liver function. Two kinds of tests are available for that purpose, namely: serological and molecular. The former are useful to detect viral antigens and the corresponding antibodies. The latter allow the detection of viral genomes. In order to diagnose current infections with any such viruses, except HCV, serological tests are sufficient. For HCV it is necessary to detect the viral genome. Molecular tests are very useful for follow-up purposes, and to fundament therapeutic decisions in patients with either HBC or HCV chronic infections. This article presents a review of the tests available to diagnose the different agents of viral hepatitis.

[Somatic condition of the clam Polymesoda solida (Veneroidea: Corbiculidae) in the rainy season of the Salamanca Island Natural Park, Colombian Caribbean]. / Condición somática de la almeja Polymesoda solida (Veneroidea: Corbiculidae) durante el periodo lluvioso, en el Parque Natural Isla de Salamanca, Caribe colombiano.

The estuarine clam Polymesoda solida is the main fishery resource in the Salamanca Island Natural Park. I sampled the clam in three interconnected lagoons (Poza Verde, El Torno and Atascosa) during the rainy period (April to November 2004). Sixty individuals were monthly collected by hand on each lagoon; 30 to analyze two condition indexes (relationship between body and shell weight and between soft dry and wet weight), yield (meat percentage) and length-weight relationships. Maturity of female gonad smears was assessed on the remaining individuals. Measures of salinity, temperature, pH, dissolved oxygen, transparency and depth, were also taken at the collection places. Increases of the condition indexes occurred when the Magdalena River showed some decreases in its level, especially at Poza Verde and El Torno. The condition indexes were higher at 27-33 mm, (range where maturity size was reached). Clams from Poza Verde, the lagoon nearest to the Magdalena River, had the highest values in condition indexes, yield, fresh weight and maturity frequency. Yield was directly correlated to the condition indexes and sexual maturity. The condition index (body weight/shell weight) showed a highest multiple regression coefficient with salinity, pH and transparency (R2=74%), indicating the relevance of the hydrological regime in the regulation of the condition of the organisms. P. solida seems to be more adapted to the lowest salinities of the system (0.0-0.4), corresponding to Poza Verde, where the influence of the Magdalena river is more direct and steady. Additionally, differences found between sites in the assessed variables, emphasize the importance of considering spatial heterogeneity of this kind of lagoon estuaries, and should be taken into account for future fisheries management in the rainy period and conservation of P. solida populations.

Condición somática de la almeja Polymesoda solida (Veneroidea: Corbiculidae) durante el periodo lluvioso, enel Parque Natural Isla de Salamanca, Caribe colombiano

Somatic condition of the clam Polymesoda solida (Veneroidea: Corbiculidae) in the rainy season of the Salamanca Island Natural Park, Colombian Caribbean. The estuarine clam Polymesoda solida is the main fishery resource in the Salamanca Island Natural Park. I sampled the clam in three interconnected lagoons (Poza Verde, El Torno and Atascosa) during the rainy period (April to November 2004). Sixty individuals were monthly collected by hand on each lagoon; 30 to analyze two condition indexes (relationship between body and shell weight and between soft dry and wet weight), yield (meat percentage) and length-weight relationships. Maturity of female gonad smears was assessed on the remaining individuals. Measures of salinity, temperature, pH, dissolved oxygen, transparency and depth, were also taken at the collection places. Increases of the condition indexes occurred when the Magdalena River showed some decreases in its level, especially at Poza Verde and El Torno. The condition indexes were higher at 27-33mm, (range where maturity size was reached). Clams from Poza Verde, the lagoon nearest to the Magdalena River, had the highest values in condition indexes, yield, fresh weight and maturity frequency. Yield was directly correlated to the condition indexes and sexual maturity. The condition index (body weight/shell weight) showed a highest multiple regression coefficient with salinity, pH and transparency (R²=74%), indicating the relevance of the hydrological regime in the regulation of the condition of the organisms. P. solida seems to be more adapted to the lowest salinities of the system (0.0-0.4), corresponding to Poza Verde, where the influence of the Magdalena river is more direct and steady. Additionally, differences found between sites in the assessed variables, emphasize the importance of considering spatial heterogeneity of this kind of lagoon estuaries, and should be taken into account for future fisheries management in the rainy period and conservation of P. solida populations. Rev. Biol. Trop. 58 (1): 131-145. Epub 2010 March 01.

Se evaluó la condición somática de la almeja Polymesoda solida en tres lagunas del Parque Isla de Salamanca (abril a noviembre de 2004), durante el periodo lluvioso. En 60 individuos por laguna, se analizaron mensualmente índices de condición, rendimiento, relación talla-peso y madurez gonadal en fresco. También se midió salinidad, temperatura, pH, oxígeno disuelto, transparencia y profundidad del agua. Los mayores índices de condición coincidieron con descensos en el nivel del río Magdalena, especialmente en Poza Verde y El Torno. Estos índices fueron más altos en tallas entre 27mm y 33mm, donde también se ubicó la talla media de madurez sexual. En Poza Verde, laguna con mayor influencia del río, se presentaron los mayores índices de condición, rendimiento, peso húmedo y frecuencia de madurez, revelando una mejor condición de los organismos. El índice de condición (peso cuerpo/ peso concha) presentó mayor coeficiente de regresión múltiple con la salinidad, pH y transparencia, sugiriendo la importancia del régimen hidrológico en su regulación. Las diferencias espaciales en las variables evaluadas, resaltan la necesidad de tener en cuenta la heterogeneidad de este tipo de estuarios para la conservación y manejo adecuado de la pesquería de P. solida.

Tabaquismo entre estudiantes de medicina

Objetivo: Estimar la prevalencia de tabaquismo entre estudiantes de medicina de nuestra universidad y determinar su actitud hacia las acciones contra el tabaquismo. Métodos: Se aplicó un cuestionario de 12 preguntas a todos los estudiantes de los semestres primero a décimo de la Facultad de Medicina de la Pontificia Universidad Javeriana de Bogotá. Resultados: 618 de 625 estudiantes (99 por ciento) contestaron la encuesta. El 19 por ciento del total fueron fumadores, 14 por ciento de las mujeres y el 22 por ciento de los hombres (p<0.01). La prevalencia fue diferente en cada semestre con una tendencia a aumentar en los semestres más altos: 10 por ciento en primer semestre y 32 por ciento en décimo semestre (p<0.01). Entre los fumadores, las mayores razones para no fumar fueron no interés (43 por ciento) y salud (25 por ciento). Los estudiantes estuvieron expuestos al tabaco en cafeterías (96 por ciento), oficinas (69 por ciento), salones de clases (41 por ciento), ascensores (27 por ciento) y pabellones de hospitalización (9 por ciento). Sobre la posibilidad de implementar áreas restringidas para fumar, 94 por ciento estuvieron de acuerdo (79 por ciento fumadores, 98 por ciento, no fumadores) y 67 por ciento (39 por ciento fumadores, 74 por ciento no fumadores) en prohibirlo. El 68 por ciento de los fumadores participarían en un programa de cesación del tabaquismo. Conclusiones: La prevalencia de tabaquismo en esta población de estudiantes de medicina es levemente inferior a la nacional del 21.4 por ciento. Hay una prevalencia mayor en los semestres superiores (p<0.01), lo que podría estar influenciado por la ausencia de programas contra el tabaquismo en nuestra universidad. Es necesaria la implementación de programas de educación y áreas sin tabaco la universidad y en el hospital.