Aprendizajes de estudiantes del área de la salud en tiempos de Covid-19: una revisión integrativa / Learning Process of Health Care Student in Times of Covid-19: An Integrative Review / Aprendizagem do discente na área da saúde em tempo de Covid-19: uma revisão integrativa

Objetivo: caracterizar la producción científica relacionada con los aprendizajes de los estudiantes de salud en tiempos de pandemia por COVID-19. Metodología: revisión integrativa por medio de la búsqueda y análisis de literatura en nueve bases de datos científicas de acceso libre. Se incluyeron cuarenta artículos de investigación teniendo en cuenta los Descriptores en Ciencias de la Salud (DeCs) para su búsqueda, no se limitó el periodo de publicación al tratarse de un tema emergente. La investigación se realizó entre diciembre de 2020 y marzo de 2021. Resultados: se identifica la tendencia a estudiar el tema en el nivel de pregrado y específicamente, en la profesión de medicina. El abordaje metodológico con enfoque cuantitativo se presentó más en Asia. Las tendencias temáticas fueron: 1) percepción de los estudiantes en relación con el entorno de aprendizaje en línea y 2) factores para un entorno de aprendizaje. Conclusión: parece haber un acuerdo en la necesidad de un aprendizaje significativo en la educación virtual, sin embargo, todavía se discute cómo y para qué hacerlo.

Objective: to characterize the scientific production related to health students' learning in times of COVID-19 pandemic. Methodology: integrative review by means of literature search and analysis in nine open access scientific databases. Forty research articles were included taking into account the Descriptors in Health Sciences (DeCs) for their search, the period of publication was not limited as it was an emerging topic. The research was conducted between December 2020 and March 2021. Results: the tendency to study the topic at the undergraduate level and specifically in the medical profession is identified. The methodological approach with a quantitative focus was more present in Asia. The thematic trends were: 1) students' perception of the online learning environment and 2) factors for a learning environment. Conclusion: there seems to be an agreement on the need for meaningful learning in virtual education, however, how and for what to do it is still discussed.

Objetivo: caracterizar a produção científica relacionada à aprendizagem dos discentes da área da saúde em tempo de pandemia por COVID-19. Metodologia: revisão integrativa por meio da busca e análise da literatura em nove bases de dados científicas de acesso livre. Incluíram-se quarenta artigos de pesquisa considerando Descritores em Ciências da Saúde (DeCs) para sua busca, não se limitou o período de publicação por se tratar de um tema emergente. A pesquisa foi realizada entre dezembro de 2020 e março de 2021. Resultados: Foi identificada a tendência a estudar o tema no nível de graduação e especificamente na profissão de medicina. A abordagem metodológica com enfoque quantitativa apresentou-se mais na Ásia. As tendências temáticas foram: 1) percepção dos alunos em relação ao ambiente de aprendizagem online e 2) fatores para um ambiente de aprendizagem. Conclusão: parece haver consenso sobre a necessidade de uma aprendizagem significativa na educação virtual, porém, como e por que fazê-lo ainda está sendo discutido.

CO2 biocapture by Scenedesmus sp. grown in industrial wastewater.

Greenhouse gases (GHG) emissions are widely related to climate change, triggering several environmental problems of global concern and producing environmental, social, and economic negative impacts. Therefore, global research seeks to mitigate greenhouse gas emissions. On the other hand, the use of wastes under a circular economy scheme generates subproducts from the range of high to medium-value, representing a way to help sustainable development. Therefore, the use of wastewater as a culture medium to grow microalgae strains that biocapture environmental CO2, is a proposal with high potential to reduce the GHG presence in the environment. In this work, Scenedesmus sp. was cultivated using BG-11 medium and industrial wastewater (IWW) as a culture medium with three different CO2 concentrations, 0.03%, 10%, and 20% to determine their CO2 biocapture potential. Furthermore, the concomitant removal of COD, nitrates, and total phosphorus in wastewater was evaluated. Scenedesmus sp. achieves a biomass concentration of 1.9 g L-1 when is grown in BG-11 medium, 0.69 g L-1 when is grown in a combination of BG-11 medium and 25% of industrial wastewater; both cases with 20% CO2 supplied. The maximum CO2 removal efficiency (8.4%, 446 ± 150 mg CO2 L-1 day-1) was obtained with 10% CO2 supplied and using a combination of BG-11 medium and 50% IWW (T2). Also, the highest removal of COD was reached with a combination of BG-11 medium and T2 with a supply of 20% CO2 (82% of COD removal). Besides, the highest nitrates removal was achieved with a combination of BG-11 medium and 75% IWW (T3) with a supply of 10% CO2 (42% of nitrates removal) and the maximum TP removal was performed with the combination of BG-11 medium and 25% IWW (T1) with a supply of 10% CO2 (67% of TP removal). These results indicate that industrial wastewater can be used as a culture media for microalgae growth and CO2 biocapture can be performed as concomitant processes.

Utilidad de la historia médico-psicológica en estudiantes que inician ciclos clínicos en la carrera de medicina como instrumento para la comprensión integral del paciente y facilitador de la alianza terapéutica / The utility of medical-psychological history in medical students who start rotations as a way to comprehend the patient and as a facilitator for the therapeutic alliance

Introducción: La formación del estudiante de medicina busca la adquisición de conocimientos teóricos y prácticos, actitudes ético-morales, habilidades y destrezas en la comunicación interpersonal. Tener una formación integral permitirá establecer una relación médico-paciente adecuada para ofrecer una mejor atención desde el primer contacto que tienen con él. Sujetos y métodos: Se implementó y evaluó una experiencia vivencial en la que los estudiantes realizaron historias clínicas de tipo médico-psicológico a pacientes del hospital donde llevan a cabo sus rotaciones, sin que se encontraran presentes los profesores, agregando un comentario que reflejaba lo que experimentaron en el encuentro. Se utilizó una metodología cualitativa de tipo investigación-acción participativa. Posteriormente se analizaron los comentarios de cada estudiante y se compararon con lo encontrado en la bibliografía. Resultados: Ante esta experiencia, la mayoría de los estudiantes se sintieron ansiosos o incómodos al indagar en temas personales como la sexualidad. Así mismo, sintieron empatía ante la enfermedad o la historia personal de cada paciente, lo que les hizo entender mejor su manera de ser, su situación y su manera de afrontarla, y comprender cómo la relación médico-paciente influye en el paciente y en su enfermedad. Conclusión: La realización de este tipo de historia clínica por parte de los estudiantes al inicio de su formación clínica es una experiencia vivencial que deja un aprendizaje con un importante impacto emocional, pues le permite el contacto directo con el ser humano enfermo y no solamente con la enfermedad, fortaleciendo la relación médico-paciente

Introduction: Medical students' formation needs the acquisition of theoretical and practical knowledge, ethical-moral attitudes, and interpersonal communication skills. Having a comprehensive education will establish an adequate doctorpatient relationship to offer better care since the first contact they have with them. Subjects and methods: A qualitative methodology of participatory research-action type was used. Medical students who were beginning their clinical practice applied medical-psychological histories to patients of the hospital where they carry out their clerkships, without the teachers being present, adding a comment that reflects what they experienced after having the encounter. Subsequently, the comments of each student were analyzed and compared with what was found in the literature. Results: Most of the students felt anxious or uncomfortable when they inquired about personal topics such as sexuality. They also felt empathy for the illness and/or personal history of each patient, which helped them understand their way of being, their situation, as well as their way of dealing with it and comprehend how the doctor-patient relationship influences the patient and in their illness. Conclusion: Carrying out this type of medical history by the students who start their clinical training is an experience that impacts importantly on an emotional level, because it allows direct contact with the sick human being and not only with the disease, strengthening the doctor-patient relationship

[High-density lipoproteins (HDL) size and composition are modified in the rat by a diet supplemented with "Hass" avocado (Persea americana Miller)]. / El tamaño y la composición de las lipoproteínas de alta densidad (HDL) se modifican en la rata por una dieta suplementada con aguacate "Hass" (Persea americana Miller).

PURPOSE: To determine the effects of dietary avocado on HDL structure and their associated enzyme, paraoxonase 1 (PON1). METHODS: Fifteen Wistar male rats received avocado as part of their daily meal (5 g by 17.5 g chow diet), keeping the caloric intake similar to the control group (n=15) that received their usual chow diet. After 5 weeks, HDL were isolated by sequential ultracentrifugation and their size and chemical composition were analyzed. PON1 was determined in serum spectrophotometrically using phenylacetate as substrate. RESULTS: Rats that received avocado had about 27% lower triglycerides plasma levels whereas their HDL-cholesterol was 17% higher as compared to control group. The mean HDL Stokes diameter was significantly lower in avocado group (11.71 +/- 0.8 vs. 12.27 +/- 0.26 nm, in control group, p < 0.05). The HDL size decrease was associated to a lower content of protein, particularly of apo Al, with a concomitant higher proportion of phospholipids in HDL isolated from avocado group. HDL structural modifications induced by avocado were not related to modifications of LCAT and PLTP activities, but occurred in parallel with higher serum levels of PON1 activity when compared to the controls (57.4 +/- 8.9 vs. 43.0 +/- 5.6 micromol/min/mL serum, p < 0.05). CONCLUSIONS: The inclusion of avocado in the diet decreased plasma triglycerides, increased HDL-cholesterol plasma levels and modified HDL structure. The latter effect may enhance the antiatherogenic properties of HDL since PON1 activity also increased as a consequence of avocado.

Life and death decisions in the extremely preterm infant: What happens in a level III perinatal centre?

OBJECTIVE: To describe resuscitation decisions and withdrawal of treatment practices in live-born infants at the extremes of prematurity at St Joseph's Health Care (London, Ontario). STUDY DESIGN: A retrospective chart review was conducted on all neonatal deaths between 22 weeks, zero days' and 25 weeks, six days' gestational age over an eight-year period. Documentation concerning end-of-life discussions was subjected to thematic review to limit or withhold resuscitation or withdraw treatment. RESULTS: Three hundred eighteen infants were delivered between 22 weeks, zero days' and 25 weeks, six days' gestational age. Of these, 21% of infants (67 of 318) were stillborn, 38% (121 of 318) were alive on discharge from hospital and 41% (130 of 318) died in the neonatal period. Of the live-born infants who did not survive to discharge, 34% (44 of 130) had no initial attempts at resuscitation. Withdrawal of life-sustaining treatment was the immediate cause of death in 84% of cases (61 of 73) in which the infant survived initial resuscitation. Documented parental rationale for withdrawal of treatment included "preventing pain and suffering", "not wanting (their baby) to die on a ventilator" and "poor quality of life". Families in which the mother identified as Catholic were more likely to withhold resuscitation and to withdraw life-sustaining treatment because death was imminent despite ongoing treatment. Non-Catholic families were more likely to withdraw life-sustaining treatment based on prediction of a poor long-term prognosis. CONCLUSIONS: Decisions not to initiate resuscitation remain fairly common practice at the extremes of prematurity. The majority of deaths in those who survive initial resuscitative measures are secondary to withdrawal of treatment decisions made in the neonatal intensive care unit.

Systemic microcirculation after complete high and low thoracic spinal cord section in rats.

Spinal cord injury (SCI) produces multiple systemic and metabolic alterations. Although some systemic alterations could be associated with ischemic organ damage, little is known about microvascular blood flow (MVBF) in organs other than the spinal cord after acute SCI. We used laser Doppler flowmetry in anesthetized rats to assess MVBF in several tissues before and after complete T-2 and T-9 SCI at 1 h and on days 1, 3, and 7 post-SCI. Mean arterial blood pressure (MAP), heart rate and hematologic variables also were recorded. MAP changes after T-2 injury were not significant, while MAP decreased significantly 1 h after T-9 injury. Statistically significant bradycardia occurred after T-2 injury at 7 days; statistically significant tachycardia occurred after T-9 injury at 1, 3, and 7 days. Hematocrit significantly increased at day 1 and decreased at days 3 and 7 after T-2 injury. SCI was associated with significant decreases in MVBF in liver, spleen, muscle and fore footpad skin. Changes in MVBF in hind footpad skin and kidney were not significant. Changes were more pronounced at 1 h and 1 day post-SCI. Significant differences between MVBF after T-2 and T-9 SCI occurred only in liver. MVBF significantly correlated with regional peripheral vascular resistances (assessed using the MAP/MVBF ratio), but not with MAP. In conclusion, organ-specific changes in systemic MVBF that are influenced by the level of SCI, could contribute to organ dysfunction.

Dermatitis microbiana numular / Nummular microbial dermatitis

Introducción. La dermatitis microbiana numular (DMN) se ha reportado en México con una frecuencia de 0.5 a 6 por ciento de la consulta dermatológica. Se realizó este estudio con el objeto de conocer el comportamiento de la DMN en nuestra población. Material y métodos. Se estudiaron retrospectivamente 33 casos, de enero de 1996 a enero de 1997, en el Hospital Infantil de México Federico Gómez. Resultados. La DMN representa el 2.78 por ciento de la consulta de dermatología de primera vez. Predomina en hombres con 63 por ciento de los casos. La edad media fue de 4 años y 10.8 meses con una desviación estándar (DE) de 7.4 meses. La forma diseminada fue la más común, afectando con mayor frecuencia extremidades inferiores. El tiempo de evolución el diagnóstico fue de 8.8 meses con DE de 2.3 meses. Se evidenció foco infeccioso en 79 por ciento de los casos, siendo rinosinusitis y parasitosis los más comunes. La biometría hemática reportó eosinofilia en más de la mitad de los pacientes. Sólo se encontró asociación a dermatitis atópica y atopia en 5 casos. La primavera fue la estación con mayor prevalencia. El tratamiento fue con antibióticos y antiparasitarios sistémicos en 27 pacientes y antihistamínicos en 9. Sólo un paciente requirió esteroide tópico. Más del 70 por ciento evolucionaron satisfactoriamente. Conclusiones. Los hallazgos de este estudio son similares a los referidos en la literatura mundial respecto a epidemiología, cuadro clínico y asociación con enfermedades infecciosas