Psychometric properties and measurement invariance of the Work-Related Acceptance and Action Questionnaire (WAAQ) in a Colombian sample

The Work-Related Acceptance and Action Questionnaire (WAAQ) is a self-report instrument that measures psychological flexibility at work. Although this scale has been validated in some languages, its psychometric properties in Colombia are unknown, making it challenging to assess work-related psychological flexibility in this country. The present study analyzed the psychometric properties and factor structure of the WAAQ in a sample of 985 Colombian workers. The internal consistency of the WAAQ measured through coefficient alpha was .88. The one-factor model with correlated error terms between items 4 and 7 showed a very good fit to the data (RMSEA= 0.033, CFI= .998, NNFI= .997, SRMR= 0.018). The WAAQ showed metric and scalar invariance across gender, age group, socioeconomic stratum, and hierarchical level. Furthermore, it correlated negatively with psychological inflexibility, psychological distress, emotional exhaustion, and cynicism and positively with professional efficacy, work engagement, and job satisfaction. In conclusion, the WAAQ seems to be a valid self-report of work-related psychological flexibility in Colombian samples (AU)

Psychometric Properties and Measurement Invariance of the Maslach Burnout Inventory-General Survey in Colombia.

The Maslach Burnout Inventory-General Survey (MBI-GS) is a widely used scale that measures burnout in the general professions. Debate persists regarding the factor structure of the MBI-GS, and there is scarce empirical evidence about the reliability, validity, and measurement invariance of the MBI-GS in Spanish-speaking samples. Moreover, the psychometric properties of the MBI-GS have not been analyzed in Colombia. This study aimed to analyze the internal consistency, factor structure, measurement invariance, and convergent validity of the MBI-GS in a large sample of Colombian workers. The MBI-GS was administered to a total sample of 978 workers from three private companies in Bogotá (66.9% males, 32.7% females, 0.4% other). All subscales showed adequate internal consistency (alphas ranging from 0.72 to 0.86). The three-factor model demonstrated a very good fit to the data (root mean square error of approximation - RMSEA = 0.05, comparative fit index - CFI = 0.99, non-normed fit index - NNFI = 0.98, and standardized root mean square residual - SRMR = 0.06). The measurement invariance both at a metric and scalar level was supported across gender, age group, and socioeconomic status. The MBI-GS subscales showed the expected correlations with job satisfaction, work engagement, psychological distress, and psychological inflexibility. In conclusion, the Spanish version of the MBI-GS demonstrated good psychometric properties in a Colombian sample.

Clinical Characteristics and Outcomes of a Cohort of Pediatric Oncohematologic Patients With COVID-19 Infection in the City of Bogotá, Colombia.

BACKGROUND: In children, the complications of severe acute respiratory syndrome coronavirus 2 infection occur less frequently than in adults but the characteristics of this disease in oncology patients are not well characterized. METHODS: This was a retrospective study in patients younger than 18 years of age with coronavirus disease 2019 (COVID-19) and cancer diagnoses between April and September 2020. Demographic variables, laboratory, and radiologic findings and complications of each case were identified. A descriptive analysis was performed. RESULTS: A total of 33 patients were identified; the median age was 10 years. Fifteen patients (42%) were in chemotherapy at the time of the infection diagnosis, in two patients the chemotherapy protocol was permanently suspended. The most common symptom was fever in 20 patients (60%). Seven patients (21.2%) showed mild pneumonia, four patients (12.1%) severe pneumonia, and three cases (9.0%) were classified as critical. In the evaluated cohort, five patients (15.1%) died, and in two of those, death was caused by COVID-19 infection. CONCLUSIONS: Children with an oncologic disease, the search for COVID cases should be oriented to patients with fever, including febrile neutropenia, the presence of respiratory symptoms, and the search for epidemiologic contact. A higher frequency of complications and mortality attributed to COVID-19, two in pediatric oncohematologic patients was found. Institutional strategies to detect the infection early and lower institutional infection are indicated.

Natalizumab in patients with multiple sclerosis in Colombia: a case series / Natalizumab en pacientes con esclerosis múltiple en Colombia: una serie de casos

SUMMARY INTRODUCTION: Natalizumab is a humanized monoclonal antibody prescribed in the treatment of multiple sclerosis, the most prevalent chronic and inflammatory disease of the central nervous system (CNS). NEDA (no evidence of disease activity) status is the goal of multiple sclerosis treatment. METHODOLOGY: The clinical records of 22 patients with multiple sclerosis, followed for a mean of 9.2 years (range: 1.9 -18.3 years) between 2000 and 2018 were analyzed. These patients received treatment with natalizumab in a high-complexity neurological outpatient clinic in Bogotá, Colombia. RESULTS: Eighteen patients (82%) reached NEDA status within a median time of six months. Seven patients (32%) tested positive for anti-JC virus antibodies. However, none of them developed progressive multifocal leukoencephalopathy. During the evaluation period, five patients (23%) presented new lesions and 17 patients (77%) had relapses before reaching NEDA status. CONCLUSIONS: This study gave an exploratory analysis of the characteristics of a series of patients with MS in the Colombian context. In the retrospective analysis, it was observed that more than 80% of the studied sample that received treatment with natalizumab, reached NEDA status. Despite the methodological limitations inherent to this type of study and sample size, it suggests that natalizumab could be an appropriate medication for the management of multiple sclerosis in Colombia.

RESUMEN INTRODUCCIÓN: Natalizumab es un anticuerpo monoclonal humanizado empleado en el tratamiento de esclerosis múltiple, la enfermedad crónica e inflamatoria más prevalente del sistema nervioso central. El estado de NEDA (sin evidencia de actividad de la enfermedad) es el objetivo del tratamiento de la esclerosis múltiple. METODOLOGÍA: Se analizaron las historias clínicas de 22 pacientes con esclerosis múltiple que fueron seguidos durante una media de 9,2 años (rango: 1,9-18,3 años) entre 2000 y 2018. Estos pacientes recibieron tratamiento con natalizumab en una clínica ambulatoria neurológica de alta complejidad en Bogotá, Colombia. RESULTADOS: Dieciocho pacientes (82)% alcanzaron el estado NEDA en un tiempo medio de seis meses. Siete pacientes (32%) dieron positivo para anticuerpos anti-virus JC. Sin embargo, ninguno desarrolló leucoencefalopatía multifocal progresiva. Durante el periodo de seguimiento cinco pacientes (23%) presentaron nuevas lesiones y 17 pacientes (77%) tuvieron recaídas antes de alcanzar el estado NEDA. CONCLUSIONES: Este estudio provee un análisis exploratorio de las características de una serie de pacientes colombianos con esclerosis múltiple.. En el análisis retrospectivo, se observó que más de 80% de ellos alcanzó el estado NEDA. A pesar de las limitaciones metodológicas inherentes al tipo de estudio y el tamaño de la muestra, este estudio sugiere que natalizumab podría ser un medicamento apropiado para el tratamiento de la esclerosis múltiple. en Colombia.

Efficacy and safety of dabrafenib-trametinib in the treatment of unresectable or metastatic melanoma with BRAF V600 mutation: A systematic review and network meta-analysis.

The current systematic review aimed to evaluate the efficacy and safety of dabrafenib plus trametinib (dabrafenib-trametinib) with those of other therapeutic alternatives in the treatment of patients with BRAF V600 mutation unresectable or metastatic melanoma. The search was carried out on four databases up to July-2018. Two separate network meta-analyses (NMA) were performed using the frequentist method (random effects): one with an exclusive population with BRAF V600 mutation (NMA-pBRAFV600) and another with a mixed population (with or without the mutation: NMA-pMixed). An evidence profile was included using the GRADE method for NMA. The validity of the final estimator in the NMA-pMixed was assessed via sensitivity analysis. Five clinical trials were included in the NMA-pBRAFV600. In the NMA-pBRAFV600 population, dabrafenib-trametinib had a favorable effect on overall survival (OS) and progression-free survival (PFS) compared with dabrafenib, vemurafenib, and dacarbazine, and on partial response rate (PRR) and overall response rate (ORR) compared with dacarbazine and vemurafenib. In the NMA-pMixed population, dabrafenib-trametinib had a positive effect on OS vs ipilimumab 3 mg/kg and on PFS and PRR vs ipilimumab (3 and 10 mg/kg), nivolumab, and pembrolizumab. However, dabrafenib-trametinib, and vemurafenib-cobimetinib were comparable in terms of clinical efficacy. In addition, dabrafenib-trametinib was associated with less grades 3 and 4 adverse events.

Efficacy and safety of dabrafenib-trametinib in the treatment of unresectable advanced/metastatic melanoma with BRAF-V600 mutation: A systematic review and network meta-analysis.

The current systematic review aimed to evaluate and compare the efficacy and safety of dabrafenib-trametinib with those of other therapeutic alternatives in the treatment of patients with unresectable advanced/metastatic melanoma with BRAF-V600 mutation. The search was carried out on four databases up to July 2018. Two separate network meta-analyses (NMA) were performed using the frequentist method (random effects): one with an exclusive population with BRAF-V600 mutation (NMA-pBRAFV600) and another with mixed population (with or without the mutation: NMA-pMixed). An evidence profile was included using the GRADE method for NMA. The validity of the final estimator in the NMA-pMixed was assessed via a sensitivity analysis. Nine clinical trials were included in the NMA-pBRAFV600. Dabrafenib-trametinib was found to have a favorable effect on overall survival (OS) and progression-free survival (PFS) compared with dabrafenib, vemurafenib, and dacarbazine and on partial response rate (PRR) and overall response rate compared with dacarbazine and vemurafenib. In the NMA-pMixed, dabrafenib-trametinib was found to have a positive effect on OS versus ipilimumab 3 mg/kg and on PFS and PRR versus ipilimumab, nivolumab, and pembrolizumab. However, dabrafenib-trametinib and vemurafenib-cobimetinib significantly differed in terms of efficacy. In addition, dabrafenib-trametinib has a favorable effect on Grades 3 and 4 adverse events.

Urban concentration, non-renewable energy consumption, and output: do levels of economic development matter?

The accelerated urbanization process generates a significant increase in energy, whose sources are mainly polluting. The harmful effects of both processes are reflected in climate change. This article examines the equilibrium and causality relationship among urban concentration, non-renewable energy consumption, and the real per capita output in 110 countries during 1971-2017. Using data from the World Bank's World Development Indicators (2018), we classify countries into four groups according to their level of development. Our evidence suggests that urban concentration has a negative effect on real per capita output in high-income countries, while non-renewable energy consumption has a positive effect on all groups of countries. The cointegration tests show that there is short- and long-term equilibrium in all groups of countries. The results of the DOLS and PDOLS models indicate that the strength of the cointegration vector is weak in most of the countries and groups analyzed. The Granger-type causality tests show that there is bidirectional causality from the real per capita output to the urban concentration in high and middle-low-income countries. There is unidirectional causality from the population concentration towards the real per capita output in the low-income countries; from the non-renewable energy consumption to the real per capita output in high-income countries; from the real per capita output to the non-renewable energy consumption in the countries of medium-high and medium-low income; and from urban concentration to non-renewable energy consumption in high- and medium-high-income countries. Our results highlight the importance of promoting policies of urban planning and generation and consumption of renewable energy without limiting the expansion of the output.

Shaping the adult brain with exercise during development: Emerging evidence and knowledge gaps.

Exercise is known to produce a myriad of positive effects on the brain, including increased glia, neurons, blood vessels, white matter and dendritic complexity. Such effects are associated with enhanced cognition and stress resilience in humans and animal models. As such, exercise represents a positive experience with tremendous potential to influence brain development and shape an adult brain capable of responding to life's challenges. Although substantial evidence attests to the benefits of exercise for cognition in children and adolescents, the vast majority of existing studies examine acute effects. Nonetheless, there is emerging evidence indicating that exercise during development has positive cognitive and neural effects that last to adulthood. There is, therefore, a compelling need for studies designed to determine the extent to which plasticity driven by developmental exercise translates into enhanced brain health and function in adulthood and the underlying mechanisms. Such studies are particularly important given that modern Western society is increasingly characterized by sedentary behavior, and we know little about how this impacts the brain's developmental trajectory. This review synthesizes current literature and outlines significant knowledge gaps that must be filled in order to elucidate what exercise (or lack of exercise) during development contributes to the health and function of the adult brain.

Valoración del cuidado de enfermería por parte de adolescentes gestantes antes de una intervención en atención prenatal y después de esta / Evaluation of Nursing by Pregnant Adolescents before and after an Intervention in Prenatal Care / Avaliação de enfermagem por adolescentes grávidas antes e após uma intervenção no pré-natal

Introducción: Investigaciones sobre gestación en mujeres adolescentes han detectado ciertas necesidades, como sentirse escuchadas o apoyadas y recibir trato humanizado. Objetivo: Determinar cómo adolescentes gestantes valoraron el cuidado proporcionado por el servicio de enfermería antes de una intervención y después de esta, en una institución de salud de Bucaramanga, en 2015. Método: Estudio cuasi experimental pretest y postest en 39 adolescentes asistentes a atención prenatal. Para la valoración del cuidado se utilizó la Escala Profesional de Cuidado, organizada en las subescalas: sanador compasivo y competente. La valoración pretest se realizó después del control prenatal convencional, por enfermería, y la postest, después de la intervención de cuidado, fundamentada en la teoría de Swanson. Resultados: Aunque las valoraciones del cuidado fueron excelentes antes de la intervención, mejoraron posteriormente, lo que muestra un aumento de puntajes mínimos de 48 antes, a 57 después de la intervención, y en disminución de las desviaciones estándar 2,6704 y 0,6863, respectivamente. Estos cambios son notorios en el sanador compasivo referido a la relación afectuosa y de confianza que establece el enfermero(a) en la interacción de cuidado. Conclusiones: La teoría de Swanson permitió abordar a la adolescente en la atención prenatal, supliendo necesidades de escucha, trato humanizado y apoyo. Ello se evidencia en la valoración posterior.

Introduction: Research on pregnancy in adolescent women has detected certain needs, such as feeling heard or supported and receiving humane treatment. Objective: To determine how pregnant adolescents evaluated the care provided by the nursing service before and after an intervention at a health institution in Bucaramanga in 2015. Method: Quasi-experimental pretest and posttest study in 39 adolescents attending antenatal care. For the assessment of care, the Professional Care Scale was used, organized in the subscales: compassionate and competent healer. The pretest evaluation was carried out after the conventional prenatal control, by nursing, and the posttest, after the care intervention, based on Swanson's theory. Results: Although the values of the care were excellent before the intervention, they improved later, which shows an increase of minimum scores of 48 before, to 57 after the intervention, and in decrease of the standard deviations 2.6704 and 0.6863, respectively. These changes are notorious in the compassionate healer referred to the affectionate and trusting relationship established by the nurse in the care interaction. Conclusions: Swanson's theory allowed to approach the adolescent in prenatal care, supplying listening needs, humanized treatment and support. This is evidenced in the subsequent assessment.

Introdução: Pesquisas sobre gravidez em adolescentes detectaram certas necessidades, como sentir-se ouvido ou apoiado e receber tratamento humanizado. Objetivo: Determinar como adolescentes grávidas apreciado o atendimento prestado pelo serviço de enfermagem antes da cirurgia e depois disso, em uma instituição de saúde de Bucaramanga, em 2015. Método: Pré-teste quasi-experimental e estudo pós-teste em 39 adolescentes freqüentando pré-natal. Para a avaliação do atendimento, utilizou-se a Escala de Cuidados Profissionais, organizada nas subescalas: curador compassivo e competente. A avaliação do pré-teste foi realizada após o controle pré-natal convencional, pela enfermagem, e o pós-teste, após a intervenção assistencial, com base na teoria de Swanson. Resultados: Embora as avaliações foram excelente cuidado antes de cirurgia, posteriormente melhorados, que mostra um aumento na pontuação mínima de 48 antes de 57 após a intervenção, e diminuíram os desvios padrão e 0,6863 e 2,6704, respectivamente. Essas mudanças são notórias no curandeiro compassivo referente à relação afetiva e de confiança estabelecida pelo enfermeiro na interação do cuidado. Conclusões: A teoria de Swanson permitiu abordar o adolescente no pré-natal, suprindo necessidades de escuta, tratamento humanizado e apoio. Isto é evidenciado na avaliação subsequente.

Caso Clínico: Neumomediastino Anterior, Secundario a Procedimiento Dental / Case Report: Anterior Pneumomediastinum, Secondary to Dental Procedure

INTRODUCCIÓN: El neumomediastino es la presencia de aire en el mediastino, tiene incidencia variable que oscila entre 1/80 000 y 1/42 000 a nivel mundial, genera una diversidad de características clínicas, puede ser secundario a entidades torácicas o extra torácicas; dentro de las causas extratorácicas, podemos asociarlo a procedimientos dentales siendo de vital importancia considerar la posibilidad y la asociación a dichos procedimientos para su diagnóstico y tratamiento adecuado. CASO CLÍNICO: Paciente de sexo femenino de 23 años, que 24 horas previas a su ingreso, se realizó procedimiento dental tipo exodoncia del tercer molar inferior izquierdo, en el que se usó instrumental manual y neumático, que debió ser suspendido; la paciente presentó dolor intenso más dificultad respiratoria, posterior a ello dolor torácico opresivo, mandibular y en cuello de lado izquierdo, acompañado de enfisema subcutáneo en hemicara izquierda, cuello bilateralmente y subclavicular izquierdo. EVOLUCIÓN: Paciente es ingresada con diagnóstico de neumomediastino secundario a procedimiento dental para tratamiento antibiótico de amplio espectro y vigilancia, durante su hospitalización por tres días permanece estable, afebril con mejoría clínica general. CONCLUSIÓN: El neumomediastino es una complicación poco frecuente tras intervenciones odontológicas, se debe sospechar por el uso de instrumental neumático que disecan los tejidos blandos faciales, del cuello y tórax; la paciente tuvo una evolución favorable en base al diagnóstico y tratamient

BACKGROUND: Neumomediastinum is defined as the presence of air in the mediastinum, It has variable incidence that oscillates between 1/80000 and 1/420000, generates a diversity of clinical characteristics. It can be secondary to thoracic or extra thoracic entities, within extrathoracic causes; it can be associated with dental procedures, being of vital importance consider the possibility and the association to this procedure to get to an adequate diagnosis and treatment. CASE REPORT: A 23-year-old female patient who, 24 hours prior to admission, underwent a dental procedure such as a third-molar left third molar extraction, in which manual instruments and pneumatics dental lathe were used, which had to be suspended; the patient presented severe pain plus respiratory difficulty, after that she presented oppressive chest pain, mandibular and left side neck, accompanied by subcutaneous emphysema in the left side of the face, neck bilaterally and left subclavicular EVOLUTION: The patient was hospitalize with a diagnosis of neumomediastinum secondary to dental procedure to receive treatment with broad spectrum antibiotic and surveillance, during her hospitalization for three days she remains stable, afebrile with general clinical improvement. CONCLUSIONS: The neumomediastinum is a rare complication after odontological interventions. It should be suspected when pneumatic instrument lathe are used that dissect facial, neck and thorax soft tissues; the patient had a favorable evolution based on the diagnosis and early treatment proposed by the doctors according to the patients symptoms.

Estudio Experimental: Prevención de Parasitosis en Escolares en Zona Rural. Azuay, Ecuador. 2013­ 2014 / Experimental Research: Prevention of Parasitosis in Schoolchildren in a Rural Area. Azuay, Ecuador. 2013 - 2014

INTRODUCCIÓN: El parasitismo intestinal representa un problema médico-social con alta prevalencia en los niños de los países en desarrollo. Uno de los factores influyentes es la precaria condición sanitaria en determinadas zonas. El objetivo de este estudio fue determinar el impacto de la aplicación de un programa educativo en conocimientos, actitudes y prácticas que permita disminuir la prevalencia de parasitismo intestinal. MÉTODO: Se realizó un estudio descriptivo experimental en una zona rural de Azuay - Ecuador, durante los años 2013 y 2014. El universo fue 190 niños y 145 padres de familia que fueron seleccionados al azar en dos grupos: estudio y control. Se comparó los conocimientos, actitudes, prácticas y prevalencia de parasitismo entre los dos grupos con la aplicación de un cuestionario y un examen coproparasitario antes y después de la intervención. RESULTADOS: La intervención educativa mostró un impacto positivo, dado que en los escolares del grupo estudio los conocimientos mejoraron de 39.6 % a 97.2 % (p: <0.05). Las actitudes aumentaron de 48.1 % a 97.2 % (p: <0.05). Por último, las prácticas de 66.6 % a 69 % (p: 0.741). En los escolares del grupo control no se evidenciaron cambios significativos. Los padres de familia del grupo estudio incrementaron sus conocimientos de 92.85 % a 98.57 % (p: 0.095). Las actitudes de 87.14 % a 94.28 % (p: 0.145). Las prácticas se perfeccionaron del 88.57 % al 100 % (p: <0.05). En el grupo de control no se evidenciaron cambios positivos que fueran significativos para el estudio. En el grupo estudio previo a la intervención la prevalencia de parasitismo fue 46.22 %, la cual disminuyó a 35.83 % luego de la misma. En contraposición con el grupo control, cuya prevalencia inicial fue de 29.8 % y luego aumentó a 56 % (p: <0.05). El riesgo relativo fue de 0.690311 con un IC 95% (0.5241- 0.9091). CONCLUSIONES: La intervención educativa es un factor protector para la prevención de parasitismo(au)

BACKGROUND: Intestinal parasitism represents a medical-social problem with high prevalence in children in developing countries. One of the influential factors is the precarious state of health in certain areas. The aim of this study was to determine the impact of the application of an educational program on knowledge, attitudes and practices that would reduce the prevalence of intestinal parasitism. METHOD: A descriptive experimental study was carried out in a rural area of Azuay - Ecuador during the years 2013 and 2014. The universe was 190 children and 145 parents who were randomly selected in two groups: study and control. The knowledge, attitudes, practices and prevalence of parasitism between the two groups were compared with the application of a questionnaire and a coproparasitary examination before and after the intervention. RESULTS: The educational intervention showed a positive impact, since in the students of the study group the knowledge improved from 39.6 % to 97.2 % (p: <0.05). Attitudes increased from 48.1 % to 97.2 % (p: <0.05). Finally, the practices from 66.6 % to 69 % (p: 0.741). There were no significant changes in the students in the control group. The parents of the study group increased their knowledge from 92.85 % to 98.57 % (p: 0.095). The attitudes of 87.14 % to 94.28 % (p: 0.145). Practices were improved from 88.57 % to 100 % (p: <0.05). There were no positive changes in the control group that were significant for the study. In the pre-intervention study group the prevalence of parasitism was 46.22 %, which decreased to 35.83 % after the same. In contrast to the control group, whose initial prevalence was 29.8 % and then increased to 56 % (p: <0.05). The relative risk was 0.690311 with a 95 % CI (0.5241-0.9091). CONCLUSION: Educational intervention is a protective factor against parasitism(au)

Prevalence and Extrinsic Risk Factors for Dental Erosion in Adolescents.

OBJECTIVE: This manuscript examined the prevalence and extrinsic risk factors for dental erosion (DE) in early and middle adolescents in Pasto, Colombia. STUDY DESIGN: Dental erosion was evaluated in a random sample of 384 individuals aged 10-15 years attending three primary and high schools in this cross-sectional study. Clinical dental assessment for DE was done using O'Sullivan index. Data on general sociodemographic variables and extrinsic risks factors were obtained. Descriptive and univariate binary logistic regression analyses were performed. RESULTS: Dental erosion was observed in 57.3% of individuals. The univariate binary logistic regression analysis showed that frequency of drinking natural fruit juices (OR 2.670, 95% CI 1.346 - 5.295, P=0.004) and their pH (OR 2.303, 95% CI 1.292 - 4.107, P=0.004) were more associated with the odd of DE in early adolescence. However, a high SES (OR 10.360, 95% CI 3.700 - 29.010, P<0.001) and frequency of snacks with artificial lemon taste (OR 3.659, 95% CI 1.506 - 8.891, P=0.003) were highly associated with the risk of DE in middle adolescence. CONCLUSIONS: The results suggest that DE is a prevalent condition in adolescents living in a city in southern Colombia. The transition from early to middle adolescence implies new bio-psychosocial changes, which increase the risk for DE.

A comprehensive analysis and immunobiology of autoimmune neurological syndromes during the Zika virus outbreak in Cúcuta, Colombia.

We have focused on the epidemiology and immunobiology of Zika virus (ZIKV) infection and factors associated with the development of Guillain-Barré syndrome (GBS) and other neurological syndromes in Cúcuta, the capital of North Santander department, Colombia. Data of patients with ZIKV disease reported to the national population-based surveillance system were used to calculate the basic reproduction number (R0) and the attack rates (ARs) as well as to develop epidemiological maps. Patients with neurological syndromes were contacted and their diagnoses were confirmed. A case-control study in which 29 patients with GBS associated with ZIKV compared with 74-matched control patients with ZIKV infection alone was undertaken. Antibodies against arboviruses and other infections that may trigger GBS were evaluated. The estimated value of R0 ranged between 2.68 (95% CI 2.54-2.67) to 4.57 (95% CI 4.18-5.01). The sex-specific ARs were 1306 per 100,000 females, and 552 per 100,000 males. A non-linear interaction between age and gender on the ARs was observed. The incidence of GBS in Cúcuta increased 4.41 times secondary to ZIKV infection. The lag time between ZIKV infection and neurological symptoms was 7 days (interquartile range 2-14.5). Patients with GBS appeared to represent a lower socioeconomic status and were living near to environmentally contaminated areas. All GBS patients were positive for IgG antibodies against both ZIKV and Dengue virus, and 69% were positive for Chikungunya virus. Noteworthy, GBS was associated with a previous infection with M. pneumoniae (OR: 3.95; 95% CI 1.44-13.01; p = 0.006). No differences in antibody levels against C. jejuni, Epstein-Barr virus and cytomegalovirus were observed. High rates of cranial nerves involvement and dysautonomia were present in 82% and 75.9%, respectively. Intensive care unit (ICU) admission was necessary in 69% of the GBS patients. Most of the patients disclosed a high disability condition (Hughes grade 4). Dysautonomia was the main risk factor of poor GBS prognosis (i.e., ICU admission and disability). Thirteen patients were diagnosed with other neurological syndromes different to GBS (6 with transverse myelitis, 3 with encephalitis, 3 with peripheral facial palsy and one with thoraco-lumbosacral myelopathy). Our data confirm an increased transmission of ZIKV in Cúcuta, and provide support to the view that severe neurological syndromes are related to ZIKV disease. The complex ways by which previous infections and socioeconomic status interact to increase the risk of GBS in people infected by ZIKV should be further investigated.

Valoración del cuidado profesional de enfermería que realizan las adolescentes gestantes antes y después de una intervención de cuidado / Assessment of professional nursing care made by pregnant adolescents before and after care intervention

La gestación en la adolescencia es un asunto de interés en la salud pública, debido a su incremento y al impacto que este tiene en la salud de la madre, del hijo por nacer y de la sociedad en general. Dentro de la revisión de la literatura se encontró tres necesidades de la adolescente gestante en cuanto a la atención prenatal se refiere: sentirse apoyadas, escuchadas y recibir trato humanizado. A partir de este contexto, surge la necesidad que el profesional de enfermería realice intervenciones de cuidado con la adolescente gestante de tal manera que ella pueda valorar este cuidado profesional como útil para su bienestar, en este caso desde la perspectiva teórica de cuidado profesional como la de Kristen Swanson. Objetivo: Determinar la valoración del cuidado profesional de enfermería que realizan las gestantes adolescentes atendidas, antes y después de una intervención de cuidado en una institución de primer nivel de atención de Bucaramanga. Diseño: Estudio pre-experimental pre-test y post-test en 39 adolescentes gestantes que asistieron a atención prenatal por enfermería a la E.S.E. Instituto de Salud de Bucaramanga a las cuales se les aplicó La Escala Profesional de Cuidado de Kristen Swanson en su versión colombiana (Vesga Gualdrón), para determinar la valoración del cuidado ofrecido por la enfermera en la atención prenatal convencional antes y después a la intervención de cuidado diseñada y propuesta en la presente investigación, con base en la teoría de Kristen Swanson. Resultados: La etapa de la adolescencia que predominó fue la tardía (66,7%), la media de la edad gestacional al ingreso del estudio fue de 21,974 semanas; el 82,1% de las adolescentes cursaban con su primera gestación y sólo 10,3% de ellas asistieron al menos una vez al curso de preparación para la maternidad y paternidad. Estadísticamente se comprobó que el efecto de la intervención para la valoración del cuidado de enfermería es relevante, y este cambio se atribuye especialmente a la dimensión del sanador compasivo. No obstante, tanto en la valoración general del cuidado como en la valoración por dimensiones la puntuación siempre estuvo en el rango excelente tanto en el antes como en el después de la intervención de cuidado. Conclusiones: se destaca en los resultados de la investigación que la valoración de cuidado de enfermería siempre fue excelente. Ya en el análisis específico por ítems de la dimensión sanador compasivo, se encontró la necesidad de fortalecer el cuidado de enfermería en los aspectos relacionados con mostrar actitud positiva de escucha y de atención con las adolescentes para permitirles expresar sus sentimientos, dentro de la atención prenatal convencional realizada por la enfermera.

The teenage pregnancy is a matter of concern for public health because of its increase and the impact it has on the health of the mother, the unborn child and of society in general. Within the literature review three needs of pregnant adolescent in terms of prenatal care refers found: you feel supported, listened to and receive humane treatment. From this context, the need to perform professional nursing care interventions with pregnant adolescent in such a manner that it can assess this professional and helpful care for their welfare, in this case from the theoretical perspective of professional care as Kristen Swanson. Objective: Determine the assessment of professional nursing care by pregnant teenagers before and after an intervention care in an institution of primary care of Bucaramanga. Design: study pre-experimental pretest and post-test in 39 pregnant teenagers who attended prenatal care nursing in ESE Health Institute of Bucaramanga to which we applied the Caring Professional Scale´s Kristen Swanson in its Colombian version (Vesga Gualdrón) to determine the value of care provided by the nurse in conventional prenatal care before and after the an intervention of care designed and proposed in this research, based on the theory of Kristen Swanson. Results: The adolescence that prevailed was late (66.7%), the mean gestational age at study entry was 21,974; 82.1% of girls were enrolled in their first pregnancy and only 10.3% of them attended at least once a preparation for parenthood. Statistically it was found that the effect of the intervention for the evaluation of nursing care is relevant, and this change is mainly attributable to the dimension of the compassionate healer. However, in the overall assessment of care and assessment by dimensions score was always excellent range in both the before and the after the intervention care. Conclusions stands out in the results of research the valuation of nursing care was always excellent. Already in the specific analysis items of the compassionate healer dimension, was found the need to strengthen the nursing care aspects show positive attitude of listening and attention to girls and allow them to express their feelings, in prenatal care was found by conventional nurse.