Efficacy and safety of the switch of Triumeq® to generic (abacavir + lamivudine) + Tivicay®: data at 48 weeks.

Introduction: Generic drugs are helpful to enhance the efficiency of the sanitary system. A generic coformulation of abacavir (ABC) and lamivudine (3TC) is available since 2016 in Spain. A report of our experience with its use is exposed. Methods: Patients between February 2017 and June 2017 who were taking Triumeq® were switched to the generic ABC + 3TC plus DTG. Efficacy, safety, reasons for discontinuation and costs savings were evaluated at 48 weeks. Results: Switch was made in 93 patients, with a median age of 47 years and a mean time of 12.33 years with HIV infection. Six patients (6.5%) discontinued the new ART, being toxicity of the central nervous system the most frequent reason. The effective saving derived from the change after 1 year of treatment was 151.127 €. Conclusions: The change from Triumeq® to a generic regimen of ABC + 3TC and another pill of DTG seems to be safe and efficient at 48 weeks.

Experience of Using an App in HIV Patients Older Than 60 Years: Pilot Program.

BACKGROUND: New technologies can promote knowledge of HIV infection among patients suffering from this disease. Older patients with HIV infection represent an increasingly large group that could benefit from the use of specific apps. OBJECTIVE: The aim of the study was to observe the acceptability and use of a mobile app on HIV infection in patients at least 60 years old and offer them the possibility of anonymously establishing contact with their peers. METHODS: A series of clinical and psychosocial parameters were studied in 30 HIV-infected patients of over 60 years. The patients must be at least 60 years old, with a follow-up in the outpatient clinic for at least 1 year and without pathologies that limit his or her life expectancy to less than a year. They must know how to read and write. To be part of the group assigned to the app, they had to have their own smartphone and confirm that they were connected to the internet from that device. Overall, 15 of them were randomized to use an app and 15 were in the control group. All tests were repeated after 6 months. RESULTS: The median age of patients was 66.5 years. Among them, 29 patients had an undetectable viral load at baseline. The median number of comorbid diseases was 2. Overall, 11 of them lived with their partners and 19 lived alone. They spent an average of 5 hours a day sitting down, and 56% (17/30) of them referred high physical activity. They scored 4 out of 5 for general quality of life perception. Moreover, 80% (24/30) presented high adherence to their treatment, and the average number of concomitant medications was 5. In the 6-min walking test, they covered a distance of 400 meters, and 3 of them desaturated during the test. The 15 patients made frequent use of the app, with 2407 sessions and an average of 7 min and 56 seconds time of use with a total of 13,143 screen views. During the 6 months of the trial, 3 non-AIDS events took place. There were no significant modifications to body mass index, blood pressure measurements, lipid profile, or immuno-virology information data. There were no differences in the questionnaire scores for perception of quality of life, confessed physical activity, or antiretroviral treatment (ART) and non-ART treatment adherence. CONCLUSIONS: Significant differences between studied parameters were not objectified in these patients, possibly because this trial has significant limitations, such as a small sample size and only a brief follow-up period. However, patients did use the app frequently, making this a possible intervention to be proposed in future subsequent studies.

Mortalidad materna en Ambato, Ecuador. 2005-2014 / Maternal mortality in Ambato, Ecuador. 2005-2014

Resumen Introducción. La mortalidad materna (MM) es uno de los indicadores sanitarios que evidencia con mayor claridad la inequidad de género para la toma de decisiones y la exclusión social, esto toda vez que demanda una intervención médica urgente encaminada a prevenir una muerte. Objetivo. Exponer la magnitud y la tendencia de la MM en el cantón Ambato entre los años 2005 y 2014. Materiales y métodos. Estudio observacional, descriptivo, retrospectivo y transversal de las muertes maternas ocurridas en Ambato entre los años 2005 y 2014. El universo de estudio estuvo conformado por las 46 muertes maternas ocurridas y 51 947 nacidos vivos. Resultados. Se evidenció un ascenso significativo de la natalidad (r=0.652, p=0.041) y en el número de nacidos vivos con asistencia profesional (r=0.894, p=0.000); la razón de MM acumulada en el periodo fue de 88.6, con una tendencia al descenso no significativa (r=0.12 p=0.743). La enfermedad hipertensiva del embarazo fue la primera causa directa de MM (n=17, 41.5%). Conclusiones. La natalidad ha ido en ascenso y la tendencia de la MM a lo largo de 10 años no ha mostrado cambios significativos. La enfermedad hipertensiva del embarazo ha sido la principal causa de MM.

Abstract Introduction: Maternal mortality (MM) is one of the health indicators that most clearly demonstrates gender inequality in decision-making and social exclusion, since it demands urgent medical intervention aimed at preventing death. Objective: To expose the magnitude and trend of MM in Ambato between 2005 and 2014. Materials and methods: Observational, descriptive, retrospective and cross-sectional study of maternal deaths in Ambato between 2005 and 2014. The study universe consisted of 46 maternal deaths and 51 947 live births. Results: There was a significant increase in the birth rate (r=0.652, p=0.041) and in the number of live births with professional assistance (r=0.894, p=0.000). The cumulative MM ratio in the period was 88.6, with a non-significant downward trend (r=0.12 p=0.743). Hypertensive disease of pregnancy was the first direct cause of MM (n=17, 41.5%). Conclusions: Birth rates have been on the rise and the trend of MM over 10 years has not shown significant changes. Hypertensive disease of pregnancy remains the main cause of MM.

Egresados de la carrera de Enfermería y su perfil profesional / Nursing major graduates and their professional profiles

Introducción: A través de los estudios de seguimiento a graduados se pueden obtener las incompatibilidades e insuficiencias de las competencias disponibles en relación con las competencias necesarias para concretar la estrategia corporativa. Objetivo: Evaluar el perfil profesional y necesidades de formación de los egresados de la Carrera de Enfermería de la Universidad Técnica de Ambato. Métodos: Se realizó un estudio observacional, descriptivo y retrospectivo como parte del seguimiento a graduados de la Carrera de Enfermería. El universo estuvo representado por los 698 graduados de la carrera desde enero del año 2002 hasta diciembre de 2017, no se seleccionó muestra. Resultados: Se evidenció una tendencia ascendente no significativa del número de graduados (r=0,024 IC95 por ciento : 32,81 a 54,94). La mayoría de los graduados se desempeñaron en el área de salud pública (44,4 por ciento) y como empleados públicos (73,7 por ciento). Señalaron como principales asignaturas en su formación la enfermería médico-quirúrgica (35,4 por ciento) y la enfermería gineco-obstétrica (24,6 por ciento), a la vez que demandaron con mayor frecuencia la formación de posgrado en las áreas de emergencias y atención en salud familiar. Conclusiones: A pesar del discreto incremento en el número de graduados, la Carrera de Enfermería de la Universidad Técnica de Ambato ha respondido a su encargo social en cuanto a la formación de talento humano que en mayor medida se ha desempeñado en el sector público(AU)

Introduction: Through follow-up studies of graduates, the incompatibilities and inadequacies of available competences can be obtained in association with the competences necessary to concretize the corporate strategy. Objective: To evaluate the professional profile and the training needs of the Nursing major graduates from Technical University of Ambato. Methods: An observational, descriptive and retrospective study was carried out as part of the follow-up of the Nursing major graduates. The population was represented by the 698 graduates from January 2002 to December 2017. No sample was selected. Results: There was a non-significant trend towards an increase in the number of graduates (r=0.024; 95 percent confidence interval, 32.81 to 54.94). The majority of the graduates worked in the area of public health (44.4 percent) and as public employees (73.7 percent). They mentioned that the main subjects in their training were Medical-Surgical Nursing (35.4 percent) and Gynecological-Obstetric Nursing (24.6 percent), while demanding more frequent postgraduate training in the emergency and family healthcare areas. Conclusions: Despite the discreet increase in the number of graduates, the Nursing major of Technical University of Ambato has responded to its social assignment as to the training of human talent, a personal that has significantly worked in the public sector(AU)

Diagnóstico prenatal de ventriculomegalia e hidrocefalia fetal / Prenatal diagnosis of ventriculomegalia and fetal hydrocephalia

La Ventriculomegalia y la hidrocefalia fetal son enfermedades complejas y multifactoriales. El tamaño del sistema ventricular cambia durante el embarazo excepto el atrio que se mantiene estable entre 6 a 8 mm, desde la 15 a las 40 semanas gestacionales. Cuya incidencia es de hasta 2 por 1000 nacimientos. Puede asociarse con hidrocefalia, pero también puede estar relacionado con disminución del tejido cerebral normal. El desarrollo neurológico puede correlacionarse con la gravedad de la ampliación ventricular, la cual varía según a causa y la presencia de otras malformaciones asociadas. Las causas de ventriculomegalia, son casi las misma de la hidrocefalia, ya que en ambos existe un aumento del perímetro cefálico, pero existe también casos de ventriculomegalia, sin problemas con la cantidad de líquido cefalorraquídeo, como en la atrofia cerebral por infección intracraneana, daño de sustancia blanca y hemorragia focal. Dentro de los criterios prenatales debe destacarse, antecedentes de madre con polihidramnios, hallazgos ultrasonográficos fetales de ventriculomegalia, niveles altos de alfa feto proteína sérica materna o del líquido amniótico. El diagnóstico prenatal se realiza gracias al advenimiento de la ecografía prenatal de alta resolución, logrando observarse la dilatación ventricular de rutina dentro del útero. Ayudado por la resonancia magnética y es confirmado al nacimiento.

Ventriculomegalyand fetal hydrocephalus are complex and multifactorial diseases. The size of the ventricular system changes during pregnancy and the atrium remains between 6 to 8 mm, from 15 to 40 gestational weeks. Whose incidence is up to 2 per 1000 births. It may be associated with hydrocephalus, but it may also be related to the injury of normal brain tissue. Neurological development can be correlated with the severity of ventricular enlargement, which varies according to the cause and the presence of other associatedmalformations. The causes of ventriculomegaly are almost the same as hydrocephalus, and in both cases there is an increase in the cephalic perimeter, but there are also cases of ventriculomegaly, without problems with the amount of cerebrospinal fluid, asin the cerebral atrium due to intracranial infection, damage of white matter and focal hemorrhage. Within the prenatal criteria should be noted, mother's history with polyhydramnios, fetal ultrasound findings of ventriculomegaly, high levels of alpha fetus, maternal serum protein or amniotic fluid. The prenatal diagnosis is made thanks to the advent of high resolution prenatal ultrasound, making it possible to observe routine ventricular dilatation within the uterus. Helped by magnetic resonance and is confirmed at birth.

Efficacy and safety of the switch of Triumeq® to generic (abacavir + lamivudine) + Tivicay®: data at 24 weeks.

BACKGROUND: Generic drugs may help to support antiretroviral treatment. We want to assess the efficacy and safety at 24 weeks of the change of coformulated (abacavir + lamivudine + dolutegravir) to (abacavir + lamivudine) coformulated as a generic pharmaceutical specialty + dolutegravir. METHODS: Between February and June 2017, switch from Triumeq® to a generic pharmaceutical specialty co-formulated tablet (abacavir + lamivudine) plus Tivicay® was made. Demographic, viroimmunological characteristics and the Charlson index were collected. Six months after switching, efficacy and safety were evaluated. RESULTS: Switch was made in 93 patients, with a mean age of 47 years, after six months there were five patients (5.4%) with viral loads between 50 and 400 copies, no patient had viral loads of greater amount. There were 2 interruptions due to toxicity (2.15%), in relation to symptoms of the central nervous system. There were no differences in the amount of years with HAART, nor in the previous months with the STR regimen based on abacavir + lamivudine + dolutegravir, nor in the Charlson index. The effective saving in 2017 derived from the change in these 93 patients was € 125.512. CONCLUSIONS: The change from a regimen of abacavir + lamivudine + dolutegravir seems to be safe and effective at 24 weeks.

Importancia de la inmunización anti virus de Hepatitis B en estudiantes de Enfermería / Importance of immunization against Hepatitis B virus in nursing students

La hepatitis B constituye un problema de salud pública, con alta morbilidad asociada a daño hepático agudo, crónico y cáncer. Esta situación agrava por deficiencias en los programas de vacunación en niños y poblaciones de alto riesgo. Los profesionales y estudiantes de la salud están expuestos a riesgo biológico y la prevalencia de infección puede llegar a 11.1%, siendo hasta tres veces mayor que en la población general. La profesión de enfermería está expuesta a riesgos biológicos, siendo superior durante el proceso de formación por la escasa experiencia, que eleva el peligro de accidentes en sus prácticas y estancias hospitalarias. La vacunación es la forma más eficaz de prevención. En este artículo se analizala necesidad de que los estudiantes de salud, en específico los de enfermería, reciban el esquema de vacunación, tomando en cuenta que aún cumplido, puede no generarse inmunidad al virus y aumentar su exposición y susceptibilidad

Hepatitis B is a public health problem, with high morbidity associated with acute, chronic liver damage and cancer. This situation is aggravated by deficiencies in vaccination programs in children and high-risk populations. Professionals and students of health are exposed to biological risk and the prevalence of infection can reach 11.1%, being up to three times higher than in the general population. The nursing profession is exposed to biological risks, being superior during the training process due to thescarce experience, which increases the risk of accidents in their practices and hospital stays. Vaccination is the most effective form of prevention. This article analyzes the need for health students, specifically nursing students, to receive the vaccination schedule, taking into account that even when it is completed, immunity to the virus cannotbe generated and its exposure and susceptibility increased

Resultados de la evaluación de competencias profesionales a estudiantes de enfermería del Ecuador / Results of the evaluation of professional competencies to nursing students of Ecuador

Contexto: en Ecuador, el sistema educativo nacional se encuentra en procesos de cambio. El Estado a través de su órgano rector, implementa regulaciones, evaluaciones, categorizaciones y procesos de mejoramiento de la calidad de las universidades. Las facultades, escuelas o carreras de enfermería del país deben propiciar la calidad en la formación. En este contexto, se ejecuta la investigación sobre competencias profesionales de enfermería en estudiantes del último año de la Carrera de Enfermería (Internado Rotativo) de las 21 facultades, escuela o carreras de enfermería de las universidades del país en el año 2.014. Objetivo: aplicar un proceso de simulación de la evaluación de competencias dirigido a los estudiantes del último año de la Carrera de Enfermería, que permitan facilitar la comprensión del estudiante tanto del contenido de los reactivos como de la forma de presentación, teniendo en cuanta los lineamientos utilizados por el Consejo de Evaluación, Acreditación y Aseguramiento de la Calidad de la Educación Superior. Diseño: investigación de campo, descriptivo, evaluativo y transversal. Lugar y sujetos: estudio nacional en 21 Unidades Académicas y con un total de 2.167 estudiantes del Internado Rotativo. Mediciones principales: se aplicó en el año 2014, por una sola vez, un cuestionario de evaluación objetiva con 60 reactivos. Resultados: las asignaturas de formación profesional que superan el 70% de logro en los aprendizajes son clínicas-quirúrgicas, salud reproductiva, enfermería del neonato, niño y adolescente, enfermería materna infantil, enfermería comunitaria y salud mental. Por asignaturas, el promedio general de respuestas correctas de todas las facultades, escuelas y carreras de Enfermería de las 21 universidades es de 43.3%. Los estudiantes logran mejores resultados de aprendizaje y competencias en Enfermería Comunitaria, Enfermería en Salud Reproductiva, Enfermería Materno Infantil y menores puntajes en Investigación e Epidemiología, Fundamentos de Enfermería/Enfermería Básica I y II y Administración (36,3%). Conclusión: los resultados globales demuestran puntos fuertes y débiles en las competencias profesionales de los estudiantes por asignaturas. Existen diferencias en los resultados de acuerdo a las unidades académicas y a los contextos donde se ubican. (AU)

Context: in Ecuador, the national education system is in processes of change. The State, through its governing body, is implementing regulations, evaluations categorizations and processes to improve the quality of universities. The faculties, schools or nursing careers of the Country should promote the quality of training.In this context, research is presented like this: What is the result of professional nursing competencies of the senior students of the School of Nursing (Rotating internship) of the 21 faculties, schools or nursing careers of universities in the year 2014? Objective: To apply a simulation procedure of evaluation of competencies aimed at final year students of the School of Nursing, which let evaluate and facilitate student understand-ing of both the content of the reagents and the manner of presentation, taking into account the guidelines used by the Board of Evaluation, Accreditation and Quality Assurance of High-er Education. Design: the research was field with a descriptive, evaluative and transverse level. Place and individuals: the study was national in 21 Academic Units and a total of 2167 stu-dents of the last year or semester in nursing careers (Rotating Internship). Main measurements: it was applied only once in 2014 an objective evaluation question-naire through 60 reagents. Results: vocational subjects exceeding 70% achievement in learning are: Surgical clinical, reproductive health, neonates, child and adolescent, maternal child nursing, community nursing and mental health. By subjects, the overall average of correct answers from all facul-ties, schools and nursing careers of the 21 universities is 43.3%. Students achieve better learning outcomes and competences in Community Nursing, Nursing Reproductive Health, Nursing Mother and Child and lower scores on Research and Epidemiology, Fundamentals of Nursing/ Basic Nursing I and II and administration. Conclusion: the global results show strengths and weaknesses of the professional skills of the students by subjects. There are differences in the results according to academic units and the contexts in which they are located. (AU)

Performance of gymnastics skill benefits from an external focus of attention.

The present study was designed to fill a gap in the literature on attentional focus and sports performance. Specifically, in contrast to most previous studies in which an external focus was directed at an implement, we used a gymnastics skill that did not involve the use of an implement. Furthermore, while most studies used only outcome measures of performance, we also assessed movement quality. Twelve-year-old gymnasts performed a maximum vertical jump with a 180-degree turn while airborne, with their hands crossing in front of their chest during the turn under three different focus conditions. Under the external focus condition, participants were asked to focus on the direction in which a tape marker, which was attached to their chest, was pointing after the turn. Under the internal focus condition, they were asked to focus on the direction in which their hands were pointing after the turn. Under the control condition, no focus instructions were given. The external focus condition resulted in both superior movement form and greater jump height than did the other two conditions, which produced comparable results. The present findings show that, similar to other tasks, the performance of form-based skills can be enhanced relatively easily by appropriate external focus instructions.

Mechanisms of inorganic carbon acquisition in two estuarine Rhodophyceans: Bostrychia scorpioides (Hudson) ex Kützing Montagne and Catenella caespitosa (Withering) L. M. Irvine.

Marine macroalgae possess a range of mechanisms to increase the availability of CO2 for fixation by ribulose-1,5-bisphosphate carboxylase/oxygenase. Of these, possession of a periplasmic or external carbonic anhydrase and the ability to use bicarbonate ions is widely distributed. The mechanisms of carbon acquisition were studied in two estuarine red macroalgae Bostrychia scorpioides and Catenella caespitosa using a range of techniques. pH-drift and CO2-depletion experiments at constant pH suggested that CO2 is the main source of inorganic carbon in both species. Inhibitors indicated that internal and external carbonic anhydrase were present in both species. Inhibitors also suggested that uptake of bicarbonate is unlikely to be present (P < 0.05).

Inteligencia Emocional en el Deporte: Validación española del Schutte Self Report Inventory (SSRI) en deportistas españoles / Emotional Inteligence in Sport: Validation of the Schutte Self Report Inventory (SSRI) in Spanish athletes / Inteligência emocional no esporte: validação espanhola do schutte self report inventory (SSRI) em esportistas espanhois

El propósito del estudio fue validar el Inventario de Inteligencia Emocional (SSRI) de Schutte et al. (1998) en una muestra de deportistas españoles de diferente nivel de pericia. Participaron 2091 deportistas (1519 hombres y 572 mujeres) de edades comprendidas entre los 11 y los 59 años (M= 20.8; DT= 6.14). Los resultados de los AFE y AFC mostraron que el cuestionario presenta una estructura de cuatro dimensiones (percepción emocional, gestión auto-emocional, gestión hetero-emocional y utilización emocional), además de permitir obtener un valor de la escala general denominado Inteligencia Emocional en el Deporte. Las propiedades psicométricas y fiabilidad de la escala permiten presentar un inventario apto para la medición de la inteligencia emocional en el deporte (AU)

In this study we analyzed the validation and reliability of the SSRI Schutte's et al. (1998) Inventory of Emotional Intelligence using EFA and CFA with Spanish athletes of different expertise level. This sample was comprised of 2091 athletes (1519 males and 572 females) with a mean age of 20.8 years (ST: 6.14) and an age range of 11 to 59 years. The results obtained in this study presented a four dimensions structure (Emotional perception, self-emotional management, hetero-emotional management and emotional utilization), and a global score of emotional intelligence in Sport. Psychometric properties and reliability of this instrument permits to offer an inventory apt to be applied in sport contexts (AU)

O propósito desse estudo foi de validar o inventario de Inteligência Emocional (SSRI) de Schutte et al. (1998), em uma mostra de esportista espanhóis de diferentes níveis de habilidades. Participaram 2091 esportistas (1519 homens e 572 mulheres) de idades compreendidas entre 11 e 59 anos de idade (M= 20.8; DT= 6.14). Os resultados dos AFE e AFC mostraram que o questionário apresenta uma estrutura de quatro dimensões (percepção emocional, gestão auto- emocional gestão hetero-emocional e utilização emocional), ademais de permitir obter um valor de escala geral denominada Inteligência Emocional no Esporte. As propriedades psicométricas e fiabilidade da escala permitiram apresentar um inventario apto para medir a inteligência emocional de esportistas (AU)