Nutritional Interventions in Older Persons with Type 2 Diabetes and Frailty: A Scoping Systematic Review.

In the elderly, the coexistence of type 2 diabetes mellitus (T2DM) and frailty is frequent. Much has been described about pharmacological management and glycemic control goals. However, there is a knowledge gap in terms of the objectives and characteristics of interventions, especially nutritional ones, for this population. A scoping review was performed to document the objectives, characteristics, and results of nutritional interventions in older people with T2DM and frailty. The five-stage framework of Arksey and O'Malley was used, as was the PRISMA extension for scoping reviews. The results stand out for three trends, as follows: (1) experimental studies with multicomponent intervention physical exercise programs and nutritional programs based on educational processes or behavioral intervention; (2) observational studies with an association of the kind of diet assessed by scales and their relation to stages of frailty; (3) a review that updates recommendations on pharmacological and non-pharmacological, diet, exercise, management, as well as glucose control goals for diabetes in frail older persons. Finally, the evidence shows that management of T2DM in older adults with frailty requires goals and interventions tailored to their functional capacity and health condition. The exercise, diet, and education programs reviewed have demonstrated their effectiveness in improving physical performance, reducing the risk of frailty or progression to more advanced stages, and achieving better glycemic control.

Factors Associated with the Deterioration of Intrinsic Capacity among Older Adults in Mexico and Colombia.

BACKGROUND: Intrinsic capacity (IC) is defined as "all the physical and mental attributes possessed by the older person." This concept has gained momentum in recent years because it provides insights into the changes in the functional capacity of individuals during their life. This study examined common factors associated with IC decline among older adults in Mexico and Colombia. METHODS: This cross-sectional, correlational study included 348 community-dwelling older adults. Sociodemographic, clinical, and family conditions were assessed as possible associated factors, and IC was analyzed across five domains: cognitive, locomotor, psychological, vitality (malnutrition through deficiency and excess), and sensory (visual and auditory). Parametric and non-parametric statistical analyses were performed. RESULTS: The common factors associated with impairment according to domain were family dysfunctionality (cognitive domain); myocardial infarction, family dysfunctionality, age >80 years, home occupation, and not having a partner (locomotor domain); dysfunctional family and risk of falls (psychological domain); age >80 years and not having a partner (malnutrition by deficiency domain); age 60-79 years, walking <7,500 steps/day, and peripheral vascular disease (malnutrition by excess domain); risk of falling and being female (visual sensory domain); risk of falling (auditory sensory domain); and dysfunctional family and risk of falling (total intrinsic capacity). CONCLUSION: Both populations had common sociodemographic, clinical, and familial factors that directly affected total IC stocks and their domains.

Factores que afectan el estado nutricional en personas mayores mexicanas: Enasem, 2018.

OBJETIVO: Analizar los factores que afectan el estado nutricional en personas mayores mexicanas del Estudio Nacional de Salud y Envejecimiento en México 2018 (Enasem 2018). Material y métodos. Análisis transversal secundario de determinantes sociales, factores relativos a la salud y eventos estresantes de la vida con dos problemas nutricionales relevantes en personas mayores: 1) desnutrición y 2) exceso de peso considerando sobrepeso y obesidad, mediante regresión logística múltiple. RESULTADOS: 4 587 participantes. La prevalencia de desnutrición fue 16.1% y está relacionada con edad ≥80 años, sin pareja, sin escolaridad, sobrestimación de índice de masa corporal (IMC), dificultad motriz, dependencia funcional instrumental, hospitalización en año previo y caídas en los últimos dos años, autorreporte de fuerza prensil débil, reporte de desastre que afectó vivienda o accidente que afectó la salud. La prevalencia de exceso de peso fue 43.6%, relacionada con ser mujer, tener 60 a 79 años, percibirse sin sobrepeso u obesidad y subestimarlo contra IMC, tener ≥3 enfermedades, síntomas somáticos e inactividad física. CONCLUSIONES: Los factores que afectan el estado nutricional hacia desnutrición o exceso de peso en las personas mayores requieren considerarse como áreas de intervención importante en el envejecimiento.

Explanatory and pragmatic clinical trials Methodological differences / Ensayos clínicos explicativos y pragmáticos Diferencias metodológicas

Abstract Introduction: Clinical trials are experimental studies whose results can lead to the best level of evidence expected for healthcare practice; however, their designs have multiple methodological variants needed to ensure their objectives are met. Objective: To describe the methodological aspects to be considered in designing explanatory and pragmatic clinical trials. Materials and methods: A review of the literature including articles published from 2016-2020: original or review articles describing the methodological aspects of clinical trials. The search and selection were performed on Google Scholar, Scopus and PubMed, obtaining a total of 47 articles for the analysis. Results: Six relevant methodological aspects show differences in clinical trial design with regard to: the purpose and objective; participant recruitment; participant assignment; masking and/ or blinding; data analysis; and internal and external validity. Conclusion: Both types of clinical trials currently have benefits and barriers to overcome for their performance in the clinical setting; health researchers must have a detailed understanding of their methodological requirements to enable them to carry out these types of studies more accurately. (Acta Med Colomb 2022; 48. DOI:https://doi.org/10.36104/amc.2023.2614).

Resumen Introducción: Los ensayos clínicos son estudios experimentales cuyo resultado puede conducir al mejor nivel de evidencia esperado para la práctica en salud; sin embargo, sus diseños presentan numerosas variantes metodológicas necesarias para garantizar el cumplimiento de sus objetivos. Objetivo: Describir los aspectos metodológicos a tener en cuenta en el diseño de los ensayos clínicos explicativos y pragmáticos. Material y métodos: Revisión de literatura que incluyó manuscritos publicados entre los años 2016-2020, artículos originales o de revisión que describieran aspectos metodológicos de los ensayos clínicos. La búsqueda y selección se realizó en Google Scholar, Scopus y Pubmed, obteniendo un total de 47 manuscritos para el análisis. Resultados: Seis aspectos metodológicos relevantes muestran diferencias en el diseño de los ensayos clínicos en cuanto a: el propósito y objetivo, reclutamiento de los participantes, asignación de participantes, enmascaramiento y/o cegamiento, análisis de los datos obtenidos, validez interna y externa. Conclusión: ambas formas de ensayos clínicos muestran actualmente beneficios y barreras por sortear para su desarrollo en el ámbito clínico; es indispensable que los investigadores en salud, conozcan en detalle sus requerimientos metodológicos, con el objetivo de poder realizar de una manera más acertada este tipo de estudios. (Acta Med Colomb 2022; 48. DOI:https://doi.org/10.36104/amc.2023.2614).

Effects of Socio-educational Interventions on the Quality of Life of People with a Digestive Ostomy.

Introduction: The creation of digestive stomata is associated with a change in people's lives. Causing a strong impact that influences all dimensions of life. This paper reports on the effects of socio-educational interventions on the quality of life (QOL) of people with a digestive ostomy. Objective: To describe the effect of a nursing intervention on the QOL of people with a digestive ostomy. Methods: A quasiexperimental study was conducted whose sample consisted of 12 people who were ostomized in a public hospital in Colombia. Participants were selected through convenience sampling and randomly assigned to the intervention group and the control group. For the control group, an educational process was carried out through a theoretical session with virtual mediation (educational video). The QOL was evaluated before and after the interventions through the Montreux questionnaire. Results: The average age was 57(+7) years. No statistical differences were found between the groups in the QOL index or for any of the dimensions that make up QOL. Pretest and post-test analysis for each intervention separately showed improvement in two dimensions of QOL for each group; in the intervention group body image dimension (p = .017) and the positive coping dimension (p = .027). In the control group, the physical well-being dimension (p = .037) and social concerns dimension (p = .034). Conclusions: The personalized educational intervention or carried out through virtual pedagogical mediation, generated a clinically significant increase in the dimensions of QOL, without statistical differences. The study adds knowledge about the impact that digestive stomata have on the QOL, which is why it is necessary to establish specialized interdisciplinary teams to care for the person's new condition at home during the following months.

Cáncer de pulmón, tendencias desde la perspectiva del cuidado / Lung cancer, trends from a care perspective / Cancro do pulmão, tendências de uma perspectiva de cuidados

Objetivo: identificar las tendencias de investigación sobre el cáncer de pulmón durante los últimos cinco años, desde la perspectiva del cuidado de enfermería. Método: revisión bibliométrica y exploratoria realizada a partir de la base de datos de web of science. Se utilizaron los descriptores, lung neoplasm and nursing care con aplicación de filtros, obteniendo un total de 62 artículos publicados entre los años 2017-2021. El análisis bibliométrico fue realizado mediante bibliometrix con el total de los documentos obtenidos; para el análisis exploratorio se utilizaron 30 artículos que describen las principales tendencias temáticas identificadas en la estructura conceptual. Resultados: los indicadores bibliométricos muestran un promedio de publicación de 12 artículos por año, predominaron las publicaciones con enfoque cuantitativo (66,7 %) y de nivel de evidencia baja (56,7 %). El mayor número de artículos publicados por fuente y autor fue de 4. Los resultados exploratorios muestran cinco temáticas relevantes relacionadas con: el diagnóstico del cáncer de pulmón, síntomas, cuidado paliativo, calidad de vida y práctica avanzada de enfermería. Conclusión: se logra identificar publicaciones que enfatizan las temáticas mencionadas, con un nivel de evidencia bajo y con escasas intervenciones realizadas por parte de enfermería. Los estudios se enfocan en el control de síntomas y cuidados en el fin de vida.

Objective: identify trends in lung cancer research over the past five years from a nursing care perspective. Method: bibliometric and exploratory review based on the web of science database. The descriptors, lung neoplasm and nursing care were used with application of filters, obtaining a total of 62 articles published between the years 2017-2021. The bibliometric analysis was performed using bibliometrix with the total number of documents obtained; 30 articles describing the main thematic trends identified in the conceptual structure were used for the exploratory analysis. Results: bibliometric indicators show an average publication rate of 12 articles per year, with a predominance of publications with a quantitative approach (66.7 %) and a low level of evidence (56.7 %). The highest number of articles published per source and author was 4. The exploratory results show five relevant topics related to: lung cancer diagnosis, symptoms, palliative care, quality of life and advanced nursing practice. Conclusion: it is possible to identify publications that emphasize the aforementioned topics, with a low level of evidence and with few interventions carried out by nurses. The studies focus on symptom control and end-of-life care.

Objectivo: identificar tendências na investigação do cancro do pulmão ao longo dos últimos cinco anos, numa perspectiva de cuidados de enfermagem. Método: revisão bibliométrica e exploratória realizada utilizando a teia de dados científicos. Os descritores, neoplasma pulmonar e cuidados de enfermagem foram utilizados com a aplicação de filtros, obtendo um total de 62 artigos publicados entre 2017-2021. A análise bibliométrica foi realizada utilizando a bibliometria com o número total de documentos obtidos; 30 artigos descrevendo as principais tendências temáticas identificadas na estrutura conceptual foram utilizados para a análise exploratória. Resultados: os indicadores bibliométricos mostram uma taxa média de publicação de 12 artigos por ano, com uma predominância de publicações com uma abordagem quantitativa (66,7 %) e um baixo nível de evidência (56,7 %). O maior número de artigos publicados por fonte e autor foi de 4. Os resultados exploratórios mostram cinco tópicos relevantes relacionados com: diagnóstico do cancro do pulmão, sintomas, cuidados paliativos, qualidade de vida e prática avançada de enfermagem. Conclusão: conseguimos identificar publicações que enfatizam os tópicos acima mencionados, com um baixo nível de evidência e com poucas intervenções realizadas por enfermeiros. Os estudos centram-se no controlo dos sintomas e nos cuidados de fim de vida.

Fear of Falling and Environmental Factors: A Scoping Review.

Fear of falling is a geriatric condition that must be understood from both a clinical perspective and from the environment in which older adults live. This review aimed to describe the scientific evidence reported in the last 5 years regarding the fear of falling in older adults and its relationship with environmental factors. The relationships between fear of falling and environmental factors are mainly evidenced in the built environment. Older adults with a fear of falling are described as perceiving the built environment as dangerous when they do not meet the requirements of safety, accessibility, and comfort; they also report the importance of living in communities with controlled crime levels and available social support for older adults to improve their insecurity and feelings of vulnerability.

Barreras para el ejercicio físico en estudiantes universitarios de Manizales, Colombia: diferencias por programa académico / Barriers to physical exercise in university students in Manizales, Colombia: differences by academic program / Barreiras para o exercício físico em estudantes universitários de Manizales, Colômbia: diferenças por programa acadêmico

Resumen Objetivo: analizar las barreras que impiden la práctica de ejercicio físico en estudiantes universitarios pertenecientes a programas académicos de pregrado de la ciudad de Manizales. Materiales y métodos: estudio con enfoque cuantitativo de tipo correlacional, cuya muestra corresponde a 2.576 estudiantes de pregrado presencial pertenecientes a cuatro universidades de la ciudad de Manizales. Para la recolección de datos se utilizó la escala de beneficios y barreras que tiene el ejercicio (EEBS) de Nola Pender. Resultados: las barreras mayormente reportadas se relacionan con el cansancio (67,7 %), la fatiga (60,24 %) y la falta de tiempo para realizar ejercicio físico (48,91 %). Se encontraron 13 barreras asociadas a los programas académicos, siendo los estudiantes de Bellas Artes, quienes se asociaron a un mayor número de barreras. Conclusión: el área de estudio de Bellas Artes se asoció a una mayor percepción de barreras, mientras que los estudiantes de Educación y Agronomía no consideraron barreras para la práctica del ejercicio físico. Los planes de estudios deben incluir espacios académicos y/o lúdicos que permitan una mayor motivación intrínseca y extrínseca para la práctica deportiva acorde a los intereses del área de conocimiento.

Abstract Objective: To analyze the barriers that prevent the practice of physical exercise in university students belonging to undergraduate academic programs in the city of Manizales. Materials and methods: Study with a correlational quantitative approach with a sample of 2,576 undergraduate students from four universities in the city of Manizales. The Nola Pender exercise benefits and barriers scale (EBBS) was used for data collection. Results: The most reported barriers were related to tiredness (67.7%), fatigue (60.24%) and lack of time to perform physical exercise (48.91%). Thirteen barriers associated with academic programs were found, being the Fine Arts students those who were associated with a greater number of barriers. Conclusion: The Fine Arts area of study was associated with a greater perception of barriers while the Education and Agronomy students did not consider barriers to the practice of physical exercise. The study plans must include academic and/or recreational spaces that allow greater intrinsic and extrinsic motivation for the practice of sports according to the interests of the area of knowledge.

Resumo Objetivo: analisar as barreiras que impedem a prática de exercício físico em estudantes universitários pertencentes a programas académicos de formatura da cidade de Manizales. Materiais e métodos: estudo com enfoque quantitativo de tipo correlacional, cuja amostra corresponde a 2.576 estudantes de formatura presencial pertencentes a quatro universidades da cidade de Manizales. Para a coleita de dados se fez a escada de benefícios e barreiras que têm o exercício (EEBS) de Nola Pender. Resultados: as barreiras maiormente reportadas se relacionam com o cansaço (67,7 %), a fatiga (60,24 %) e a falta de tempo para fazer exercício físico (48,91 %). Acharam-se 13 barreiras associadas aos programas acadêmicos, sendo os estudantes de Belas Artes, quem se associaram a um maior número de barreiras. Conclusão: a área de estudo de Belas Artes se associou a uma maior percepção de barreiras, enquanto que os estudantes de Educação e Agronomia não consideraram barreiras para a prática do exercício físico. As diretrizes de estudos devem incluir espaços acadêmicos e/ou lúdicos que permitam uma maior motivação intrínseca e extrínseca para a prática esportiva acorde aos interesses da área de conhecimento.

Calidad de vida en personas portadoras de ostomías digestivas / Quality of life in people with digestive ostomies

INTRODUCCIÓN: La realización de una ostomía digestiva ha de ocasionar en las personas alteraciones en las dimensiones del ser como físicas, mentales, sociales y culturales lo que genera compromisos en la calidad de vida. OBJETIVO: Evaluar el impacto que se presenta en la calidad de vida de la persona en condición de ostomizadas en la ciudad de Manizales. METODOLOGÍA: estudio desarrollado a través de una fase cuantitativa con diseño observacional descriptivo utilizando el cuestionario Montreaux para la valoración de la calidad de vida y una fase cualitativa, fenomenológica realizada por medio de entrevistas semiestructruadas en el que participaron 16 personas en condicion de ostomizados. RESULTADOS: Promedio de edad 56 años, El 75% de ellos pertenecia a estrato socioeconómico bajo, el 50% tenia con estudios de primaria y el 50% con estudios de secundaria. El 75% pertenecía al régimen de salud contributivo. Los resultados cuantitativos mostraron un índice de calidad de vida del 44,5%; el aspecto con porcentaje mas alto en la calidad de vida fue el hecho de no tener preocupaciones sociales 73%, por el contrario, el porcentaje más bajo se obtuvo en el aspecto relacionado con la actividad sexual 25%. Se identificó un porcentaje de autosuficiencia del 80%, pero una adaptación negativa en el 50% de los casos. Los resultados cualitativos, evidenciaron siete categorías que describen los aspectos que alteran la calidad de vida y el autocuidado: sentimiento de discapacidad, pérdida laboral, alteración de la imagen corporal, afrontamiento según duración y posición de la ostomía, proyección del futuro, aislamiento social y alteración de la sexualidad. CONCLUSIÓN: el índice de calidad de vida fue bajo y las categorías encontradas confirman los aspectos de la vida diaria de las personas en condición de ostomizados y la necesidad de brindar un cuidado integral donde el rol de enfermería este visible ampliamente.

INTRODUCTION. The performance of a digestive ostomy must cause alterations in the dimensions of the being such as physical, mental, social and cultural, which generates compromisesin the quality of life. OBJECTIVE. To evaluate the impact on the quality of life of the person with an ostomy condition in the city of Manizales. METHODOLOGY. Study developed through a quantitative phase with a descriptive observational design using the Montreaux questionnaire for the assessment of quality of life and a qualitative, phenomenological phase carried out through semi-structured interviews in which 16 people with ostomized conditions participated. RESULTS. Average age 56 years, 75% of them belonged to low socioeconomic status, 50% had primary education and 50% had secondary education. 75% belonged to the contributory health scheme. The quantitative results showed a quality of life index of 44.5%; The aspect with the highest percentage in quality of life was the fact of not having social concerns, 73%, on the contrary, the lowest percentage was obtained in the aspect related to sexual activity, 25%. A self-sufficiency percentage of 80% was identified, but a negative adaptation in 50% of the cases. The qualitative results showed seven categories that describe the aspects that alter the quality of life and self-care: feeling of disability, job loss, alteration of body image, coping according to duration and position of the ostomy, projection of the future, social isolation and alteration of sexuality. CONCLUSIONS. The quality of life index was low and the categories found confirm the aspects of daily life of people with an ostomy condition and the need to provide comprehensive care where the role of nursing is widely visible.

Endometritis supurativa en una tití gris (Saguinus leucopus) en cautiverio: / Suppurative endometritis in a captive white-footed tamarin (Saguinus leucopus):

Resumen La endometritis es la inflamación del revestimiento interno del útero producida por distintos agentes infecciosos. Puede presentarse de forma clínica o subclínica, y tener curso agudo o crónico. Este documento describe el caso de una hembra de tití gris (Saguinus leucopus) en proceso de rehabilitación en la Unidad de Rescate y Rehabilitación de Animales Silvestres (URRAS), que manifestó enfermedad uterina, y cuyos hallazgos fueron compatibles con endometritis supurativa. No se conocen otros reportes de la patología en calitrícidos. Por tal motivo, se propone adelantar investigaciones que determinen los factores de riesgo en la presentación de estas enfermedades reproductivas, y para estandarizar pruebas paraclínicas que mejoren su diagnóstico en pequeños primates, teniendo en cuenta la escasa información disponible para la especie afectada y las repercusiones en su conservación.

Abstract Endometritis is inflammation of the intern uterus lining caused by different infectious microorganisms, and it can be clinical or subclinical and have an acute or chronic path. This paper describes the case of a female white-footed tamarin (Saguinus leucopus) in rehabilitation from the Unidad de Rescate y Rehabilitacion de Animales Silvestres (URRAS), that presented a uterus disease and the pathological findings were compatible with suppurative endometritis. There are no reports of endometritis in Callitrichidae, suggesting that more studies need to be done to determine the risk factors in the presentation of these reproductive diseases and to standardize paraclinical tests that improve their diagnosis in small primates, taking into account the limited information available for the affected species and the implications for its conservation.

High Rates of Exposures to Waterborne Pathogens in Indigenous Communities in the Amazon Region of Ecuador.

Waterborne pathogens, associated with poverty and poor sanitary conditions, are a major cause of morbidity and mortality worldwide. There are limited data on the epidemiology of waterborne pathogens in indigenous populations living in the Amazon region. We did a cross-sectional survey in two indigenous Shuar communities in the Amazon region of Ecuador in which we documented the presence of pathogens representing different sources of environmental contamination of water. We detected protozoa and soil-transmitted helminths by microscopy of fecal samples and the presence of IgG antibodies to hepatitis A and Leptospira spp. in blood samples from individuals older than 2 years and collected data by questionnaire on sociodemographic factors and knowledge of infectious diseases. Seroprevalence for hepatitis A and Leptospira spp. were 98.1% (95% CI: 97.0-99.8) and 50.0% (95% CI: 43.3-56.6), respectively, whereas 62.6% (95% CI: 55.8-69.4) had enteric parasites in stool samples. In participants older than 6 years, eight of 10 had evidence of infection with or exposure to at least one of the pathogens studied. Although prevalence of pathogens varied by age, it did not vary significantly by gender, temporal migration, illiteracy, perceived morbidity, receipt of conditional cash transfers, water boiling practices, poor housing conditions, and anthropometric status. These findings indicate a high level of contamination of drinking water by human pathogens in these indigenous communities and the need for interventions to improve access to and use of clean drinking water in these marginalized communities.

Calidad de vida en personas portadoras de una ostomía digestiva / Quality of life in people carrying a digestive ostomy / Qualidade de vida nas pessoas portadoras de estomas digestivas

Introducción: Las personas ostomizadas experimentan problemáticas clínicas, per-sonales, familiares y sociales que repercuten en su calidad de vida. Objetivo: Rea-lizar una revisión bibliométrica y exploratoria relacionada con la calidad de vida en personas portadoras de ostomías digestivas. Metodología: Se realizó búsqueda en Scopus, utilizando los descriptores: "Quality of life" y "Surgical stomas". Se selec-cionaron artículos publicados a partir del año 2014, en cualquier idioma, derivados de investigación y revisiones, escritos por enfermería exclusivamente o en cooperación con otras áreas de salud; se excluyeron las publicaciones de ostomías urológicas y respiratorias. Resultados: La muestra total fue de 39 manuscritos. El año de mayor publicación fue 2016; el 66,7 % de las investigaciones correspondía a nivel de eviden-cia baja y el 56,4 % correspondía a investigaciones descriptivas. A nivel exploratorio, el 31,4 % de los estudios utilizó cuestionarios relacionados con la calidad de vida, en el 14,2 % se indagó la calidad de vida a través de estudios cualitativos y en el 54,2 % se evaluaron otras temáticas que interfieren en la calidad de vida. Conclusión: La bibliometría muestra publicaciones con nivel de evidencia baja. Los resultados ex-ploratorios muestran alteración del bienestar en la dimensión física primordialmente, generando situaciones de afrontamiento que afectan la calidad de vida

Introduction: Ostomate patients experiment clinical, personal, social, and family issues which have an impact in their quality of life. Objective: To perform a bi-bliometric and exploratory review related to the quality of life in people carrying digestive ostomies. Methodology: The descriptors "Quality of life" and "Surgical stomas" were used to perform a search in Scopus. Published papers from the year 2014, derived from research and reviews written by nurses exclusively or in collaboration with other areas of health and published in different languages were chosen. The publications of urological and respiratory ostomies were excluded. Results: There was a total sample of 39 manuscripts. The year of highest publications was 2016; the 66.7 % of the research corresponded to a level of low evidence and the 56.4 % corresponded to descriptive research. An exploratory level of 31.4 % of the studies used questionnaires related to the quality of life; in the 14.2 % the quality of life was inquired through qualitative studies, and in the 54.2 % other topics that interfere in the quality of life, were evaluated. Conclusion: The Bibliometrics shows publications with a low level of evidence. The ex-ploratory results show mainly, an alteration of the well-being in the physical dimension, generating coping situations that affect the quality of life.

Introdução: As pessoas com estomas experimentam problemáticas clinicas, pessoais, familiares e sociais que repercutem na sua qualidade de vida Objetivo: Realizar uma revisão bibliográfica exploratória relacionada com a qualidade de vida de pessoas portadoras de estomas digestivas. Mé-todos: Realizou-se a pesquisa no Scopus, utilizando os descritores: "Quality of life" e "Surgical sto-mas". Selecionaram-se artigos publicados desde 2014 em qualquer língua, derivados de pesquisas e revisões, escritos por enfermagem exclusivamente ou em cooperação com outras áreas da saúde, excluíram-se artigos de estomas urológicas e respiratórias. Resultados: Obtiveram-se 39 artigos. O ano de maior publicação foi 2016, o 66,7% dos estudos tinha nível de evidência baixoe o 56,4% correspondeu a estudos descritivos. No nível exploratório, o 31,4% dos estudos empregou escalas relacionadas com qualidade de vida, o 14,2% indagou a qualidade de vida desenvolvendo pesquisas qualitativase o 54,2% avaliaram outras temáticas que interferem na qualidade de vida. Conclusão: A literatura científica mostrou resultados com nível de evidencia baixo. Os resultados exploratórios evidenciaram alteração do bem-estar na dimensão física primordialmente, gerando situações de afrontamento que afetam a qualidade de vida.

Intervenciones no farmacológicas realizadas por enfermería para promover la cesación del tabaco / Non-pharmacological interventions performed by nursing to promote tobacco cessation

OBJETIVO: describir las intervenciones no farmacológicas realizadas por enfermería que han sido reportadas en la literatura actual para promover el cese del consumo de tabaco. MÉTODO: revisión integradora de literatura mediante búsqueda en bases de datos Google Académico, Scopusc, Cochrane y Pubmed. Se tomaron los artículos publicados entre los años 2014 a 2018. Los principales descriptores de búsqueda fueron: "tobacco use cessation" y "nursing care". Se incluyeron un total de 11 manuscritos que fueron analizados por nivel de evidencia, tipo de intervención y principales resultados. RESULTADOS: el 54,5% de los manuscritos correspondía a publicaciones de evidencia media, 36,4% estudios de evidencia alta y el 9,1% evidencia baja, según criterios de Jover y Navarro-Rubio. Las intervenciones mayormente realizadas por enfermería se relacionan con la asesoría breve e intensiva cara a cara y el asesoramiento telefónico. CONCLUSIÓN: la mayor parte de los estudios analizados se ubican en evidencia media y alta. Enfermería logra demostrar con sus intervenciones el aumento de las tasas de abstinencia puntual en todos los estudios; a pesar de esto, la evidencia muestra que se requiere de una mayor preparación desde el proceso enfermero para poder intervenir y promover el cese del tabaco.

OBJECTIVE: to describe the non-pharmacological interventions carried out by nursing that have been reported in the current literature to promote cessation of tobacco use. METHOD: integrative review of literature through Google Scholar, Scopusc, Cochrane and Pubmed databases. The articles published between 2014 and 2018 were taken. The main search descriptors were: "tobacco use cessation" and "nursing care". A total of 11 manuscripts were included that were analyzed by level of evidence, type of interventionand main results. RESULTS: 54.5% of the manuscripts corresponded to publications of medium evidence, 36.4% studies of high evidence and 9.1% low evidence, according to criteria of Jover and Navarro-Rubio. Interventions mainly carried out by nursing are related to brief and intensive face-to-face counseling and telephone counseling. CONCLUSION: most of the studies analyzed are located in medium and high evidence. Nursing is able to demonstrate with its interventions the increase of the rates of punctual abstinence in all the studies; In spite of this, the evidence shows that a greater preparation is required from the nursing process in order to intervene and promote tobacco cessation.

Soil transmitted helminthiasis in indigenous groups. A community cross sectional study in the Amazonian southern border region of Ecuador.

BACKGROUND: Rural communities in the Amazonian southern border of Ecuador have benefited from governmental social programmes over the past 9 years, which have addressed, among other things, diseases associated with poverty, such as soil transmitted helminth infections. The aim of this study was to explore the prevalence of geohelminth infection and several factors associated with it in these communities. METHODS: This was a cross sectional study in two indigenous communities of the Amazonian southern border of Ecuador. The data were analysed at both the household and individual levels. RESULTS: At the individual level, the prevalence of geohelminth infection reached 46.9% (95% CI 39.5% to 54.2%), with no differences in terms of gender, age, temporary migration movements or previous chemoprophylaxis. In 72.9% of households, one or more members were infected. Receiving subsidies and overcrowding were associated with the presence of helminths. CONCLUSIONS: The prevalence of geohelminth infection was high. Our study suggests that it is necessary to conduct studies focusing on communities, and not simply on captive groups, such as schoolchildren, with the object of proposing more suitable and effective strategies to control this problem.

Intususcepción ileal generada por Prosthenorchis sp. en un tití gris (Saguinus leucopus) mantenido en un centro de recepción de fauna en Colombia / Ileal Intussusception Caused by Prosthenorchis sp. in a Gray Marmoset (Saguinus leucopus) Held in a Wildlife Reception Center in Colombia / Intussuscepção ileal gerada por Prosthenorchis sp. em um macaco titi cinza (Saguinus leucopus) mantido em um centro de recepção de fauna na Colômbia

Prosthenorchis sp. es un acantocéfalo común en primates del género Saguinus, que produce lesiones gastrointestinales asociadas con diarrea crónica y baja condición corporal. El diagnóstico es incidental y como tratamiento es necesaria la remoción quirúrgica del parásito. El objetivo de este estudio es describir el cuadro clínico, el manejo diagnóstico y terapéutico de un Saguinus leucopus con nodulaciones e intususcepción ileal causadas por Prosthenorchis sp. En el examen clínico el paciente se encontró deprimido, postrado, hipotérmico y con baja condición corporal, con descamación cutánea generalizada, alopecia del tercio distal de la cola y recorte de todos los caninos. En la palpación abdominal se encontraron nodulaciones en la región distal del abdomen. El cuadro hemático presentó leucopenia, linfopenia y neutropenia; hemoglobina baja; hipocromía y leve policromatofilia, y en el coprológico se encontraron huevos de Prostenorchis sp. y estrongílidos. El paciente ingresó a cirugía, mediante la cual se detectó una intususcepción ileal, por lo que se realizó una enterotomía con posterior enteroanastomosis término lateral del íleon al borde antimesentérico del ciego. Pese al tratamiento antibiótico y analgésico, no hubo evolución favorable del paciente, entró en paro cardiorres-piratorio y murió. El diagnóstico histopatológico fue peritonitis fibrinosa. Este fue un cuadro clínico típico de Prosthenorchis sp., en el que el pronóstico del paciente era reservado a malo y su evolución no fue favorable, tanto por el parasitismo como por las deficiencias nutricionales presentadas. El tratamiento quirúrgico es el manejo de elección; sin embargo, es necesario tener en cuenta que los pacientes con sintomatología clínica avanzada tienen mal pronóstico.

Prosthenorchis sp. is a common acanthocephalan in primates of the genus Saguinus, which produces gastrointestinal lesions associated with chronic diarrhea and low body condition. The diagnosis is incidental and surgical removal of the parasite is necessary as a treatment. The aim of this study was to describe the clinical presentation, diagnosis and therapeutic management of a Saguinus leucopus with nodules and ileal intussusception caused by Prosthenorchis sp. During the clinical examination, the patient was depressed, prostrate, hypothermic, and presenting low body condition, with generalized skin desquamation, alopecia in the distal third of the tail, and chipped canine teeth. Abdominal palpation evidenced nodules in groins. The blood count presented leukopenia, lymphopenia, and neutropenia; low hemoglobin; hypochromia and mild polychromatophilia. Prostenorchis sp. eggs and strongyles were found in stool. The patient was admitted to surgery, through which ileal intussusception was detected; for this reason, an enterotomy was performed followed by end-to-side enteroenterostomy of the ileum to the antimesenteric border of the caecum. Despite the antibiotic and analgesic treatment, the patient did not improve, it went into cardiac arrest and died. The histopathologic diagnosis was fibrinous peritonitis. This was a typical clinical history of Prosthenorchis sp., in which the patient's prognosis was bad and the outcome was not favorable, due both to parasitism and nutritional deficiencies present. Surgery is the treatment of choice; however, it is necessary to consider that patients with advanced clinical symptoms have a poor prognosis.

Prosthenorchis sp. é um acantocéfalo comum em primatas do gênero Saguinus, que produz lesões gastrointestinais associadas com diarreia crônica e baixa condição corporal. O diagnóstico é incidental e como tratamento é necessária a remoção cirúrgica do parasita. O objetivo deste estudo é descrever o quadro clínico, o manejo diagnóstico e terapêutico de um Saguinus leucopus com nodulações e intussuscepção ileal causadas por Prosthenorchis sp. No exame clínico o paciente estava deprimido, prostrado, hipotérmico e com baixa condição corporal, com descamação cutânea generalizada, alopecia do tercio distal da cauda e recorte de todos os caninos. Na palpação abdominal se encontraram nodulações nas virilhas. O hemograma apresentou leucopenia, linfopenia e neutropenia; hemoglobina baixa; hipocromia e leve policromatofilia, e no exame de fezes se encontraram ovos de Prostenorchis sp. e estrongilídeos. O paciente foi levado à cirurgia, através da qual se detectou uma intussuscepção ileal, razão pela qual se realizou uma enterotomia com posterior enteroanastomose término lateral do íleo ao borde antimesentérico do cego. Apesar do tratamento antibiótico e analgésico, não houve evolução favorável do paciente, entrou em parada cardiorrespiratória e morreu. O diagnóstico histopatológico foi peritonite fibrinosa. Este foi um quadro clínico típico de Prosthenorchis sp., no qual o prognóstico do paciente era reservado a malo e sua evolução não foi favorável, tanto pelo parasitismo quanto pelas deficiências nutricionais apresentadas. O tratamento cirúrgico é o escolhido; no entanto, é necessário ter em conta que os pacientes com sintomatologia clínica avançada têm um mau prognóstico.

Conformance contrast testing between rates of pulmonary tuberculosis in Ecuadorian border areas.

OBJECTIVE: To estimate rates of cases of respiratory symptomatic subjects and the incidence rate of pulmonary tuberculosis in two border areas of Ecuador, and contrast them with official figures. MATERIALS AND METHODS: Cross-sectional survey in the southeastern (SEBA), and the Andean southern Ecuadorian border areas (ASBA), which were conducted, respectively, in 1 598 and 2 419 persons aged over 15 years recruited over periods of three weeks. In identified respiratory symptomatic cases, a sputum sample was taken for smear testing. The results (odds ratios and their respective 95% confidence intervals), were compared with local and national official figures using maximum likelihood contrasts. RESULTS: The rates of respiratory symptomatic subjects (7.7% and 5.9% in the SEBA, and ASBA, respectively) and of pulmonary tuberculosis (cumulative incidence rates of 125 and 140 per 100 000 inhabitants, in the same order) were significantly greater than the official figures (of 0.98 and 0.99% for respiratory symptomatic subjects in the SEBA and ASBA, respectively; and of 38.23 per 100 000 inhabitants for pulmonary tuberculosis in Ecuador as a whole) (p<0.001). CONCLUSION: It is necessary to reinforce both active case finding for respiratory symptomatic subject cases, and epidemiological surveillance of pulmonary tuberculosis in Ecuadorian border regions.

Factores de riesgo cardiovascula rmodificables y agencia de autocuidado en funcionarios de una institución universitaria de la ciudad de Manizales, Colombia, 2014 / Modifiable Cardiovascular Risk factors and the Selfcare Capacity Agency Presented by Some Employees at a University of Manizales city (Colombia), 2014

Describir los factores de riesgo cardiovascular modificable y la capacidad de agencia de autocuidado que presentaban los funcionarios de una institución universitaria de Manizales. Materiales y métodos: estudio cuantitativo, de corte transversal con una muestra no probabilística de 51 funcionarios universitarios ingresados a un programa de acondicionamiento físico que presentaban dos o más factores de riesgo cardiovascular modificable. Se identificaron los factores de riesgo cardiovascular por medio de valoración clínica, toma de medidas antropométricas y datos del perfil lipídico. Para la medición del nivel de agencia de autocuidado, se aplicó la escala de Valoración de Agencia de Autocuidado versión Colombiana. Resultados: se encontraron el sedentarismo (92,1%), la obesidad abdominal (92,1%) y las dislipidemias(74,5%) como los factores de riesgo cardiovascular más prevalentes. En cuanto a la agencia de autocuidado se encontró que la mayoría de los individuos percibe tener una alta capacidad para cuidarse. En el análisis multivariado, se observa que hay una mayor discriminación de la agencia de autocuidado alta, con las variables del riesgo relacionadas con el sedentarismo, la obesidad abdominal y la obesidad clase I. Conclusión: a pesar de que los funcionarios presentan factores de riesgo cardiovascular no controlados, perciben tener una alta capacidad de autocuidado y desconocimientode la presencia y de la forma en que podrían controlar de sus factores de riesgo; estefenómeno invita a que enfermería contribuya desde el proceso del cuidado con intervenciones que garanticen la autogestión de la salud en compañía de otras disciplinas, con el fin de lograr un verdadero cambio en los estilos de vida...

Electrocardiographic parameters in captive, clinically healthy, Amazona ochrocephala / Parámetros electrocardiográficos en Amazona ochrocephala clínicamente sanas en cautiverio

Objective. To stablish the electrocardiographic parameters of individuals of the species Amazona ochrocephala, from the Unidad de Rescate y Rehabilitacion de Animales Silvestres at the Universidad Nacional de Colombia. Materials and methods. The electrocardiographic examination was performed under inhaled anesthesia with isoflurane. Leads I, II, III, aVL, aVR and aVF were measured. Results. Electrocardiographic parameters obtained in Lead II. P wave Duration: 0.015-0.044 s, P wave amplitude: 0.031 to 0.6 mv, R wave duration: 0.015-0.022 s, amplitude R: 0.034-0.038 mv, S wave Duration: 0.019- 0.042 s, amplitude S: 0.194-0.815 mv, T wave Duration: 0.025-0.064 s, T-wave amplitude: 0.010 to 0.5 mv, PQ Duration: 0.021-0.076 s, QRS Duration: 0.036-0.068 s, QT Duration: 0.070-0.015 s, RR Duration: 0.104-0.324 s, EEM: -111° to -80°, FC: 240-600 ppm. Conclusions. The results showed different values for amplitude and duration of the P, R and T waves in comparison to those obtained in other studies. However, they were similar for heart rate, MEA and duration of the PQ/R, QT and QRS segments.

Objetivo. Establecer los parámetros electrocardiográficos en individuos de la especie Amazona ochrocephala, de la Unidad de Rescate y Rehabilitación de Animales Silvestres de la Universidad Nacional de Colombia sede Bogotá. Materiales y Métodos. El examen electrocardiográfico se realizó bajo anestesia inhalada con Isoflurano. Se tomaron derivadas I, II, III, aVL, aVR y aVF y posterior medición de ondas e intervalos usando magnificación con lupa. Resultados. Parámetros electrocardiográficos de la segunda derivada. Duración onda P: 0.015-0.044 s, amplitud onda P: 0.031-0.6 mv, duración onda R: 0.015-0.022 s, amplitud R: 0.034-0.038 mv, Duración onda S: 0.019- 0.042 s, Amplitud S: 0.194-0.815 mv, Duración onda T: 0.025-0.064 s, Amplitud onda T: 0.010-0.5 mv, Duración PQ: 0.021-0.076 s, Duración QRS: 0.036-0.068 s, Duración QT: 0.070-0.015 s, Duración R-R: 0.104-0.324 s, EEM: -111° a -80°, FC: 240-600 ppm. Conclusiones. Los resultados mostraron valores diferentes para los rangos de amplitud y duración de las deflexiones P, R y T en comparación a los obtenidos en otros estudios pero similares en cuanto al rango de frecuencia cardiaca, EEM y a la duración de los segmentos PQ/R, QT y QRS.

Conformance contrast testing between rates of pulmonary tuberculosis in Ecuadorian border areas / Pruebas de contraste de conformidad en tasas de tuberculosis pulmonar en zonas fronterizas de Ecuador

Objective. To estimate rates of cases of respiratory symptomatic subjects and the incidence rate of pulmonary tuberculosis in two border areas of Ecuador, and contrast them with official figures. Materials and methods. Cross-sectional survey in the southeastern (SEBA), and the Andean southern Ecuadorian border areas (ASBA), which were conducted, respectively, in 1 598 and 2 419 persons aged over 15 years recruited over periods of three weeks. In identified respiratory symptomatic cases, a sputum sample was taken for smear testing. The results (odds ratios and their respective 95% confidence intervals), were compared with local and national official figures using maximum likelihood contrasts. Results. The rates of respiratory symptomatic subjects (7.7% and 5.9% in the SEBA, and ASBA, respectively) and of pulmonary tuberculosis (cumulative incidence rates of 125 and 140 per 100 000 inhabitants, in the same order) were significantly greater than the official figures (of 0.98 and 0.99% for respiratory symptomatic subjects in the SEBA and ASBA, respectively; and of 38.23 per 100 000 inhabitants for pulmonary tuberculosis in Ecuador as a whole) (p<0.001). Conclusion. It is necessary to reinforce both active case finding for respiratory symptomatic subject cases, and epidemiological surveillance of pulmonary tuberculosis in Ecuadorian border regions.

Objetivo. Determinar las tasas de sintomáticos respiratorios y de incidencia de tuberculosis pulmonar en dos zonas fronterizas de Ecuador, y contrastarlas con cifras oficiales. Material y métodos. Encuesta transversal aplicada en comunidades fronterizas Sur Oriental (FSO) y Sur Andina (FSA) a 1 598 y 2 419 mayores de 15 años, respectivamente. A los sintomáticos respiratorios se les realizó una baciloscopía en esputo. Las tasas y razón de momios se compararon frente a cifras oficiales mediante contraste de verosimilitudes. Resultados. Las tasas de sintomáticos respiratorios (7.7 y 5.9% en FSO y FSA, respectivamente) y de tuberculosis pulmonar (incidencia acumulada 125 y 140 por 100 000 habitantes, respectivamente) discrepan de las cifras oficiales (0.98 y 0.99% de sintomáticos respiratorios, respectivamente; y, 38.23 por 10(5) habitantes para tuberculosis pulmonar en Ecuador) (p<0.001). Conclusión. Fortalecer la búsqueda de sintomáticos respiratorios y la vigilancia epidemiológica de la tuberculosis pulmonar en áreas fronterizas.

Modelación de l estructura jerárquica de macronvertebrados bentónicos a travéés de redes neuronales artificiales / Modeling of the Hierarchical Structure of Freshwater Macroinvertebrates Using Artificial Neural Networks

El estudio de la estructura jerárquica de comunidades ecológicas, se ha sintetizado de manera regular a través de técnicas multivariadas de ordenación o clasificación. Sin embargo, al contarse actualmente con herramientas analíticas de computación bioinspirada provenientes de la inteligencia artificial, existe la oportunidad de establecer modelos ecológicos, con características deseables como flexibilidad, exactitud, robustez y confiabilidad. En este contexto, esta investigación utilizó dos métodos computacionales de utilidad en ecoinformática, referidos a redes neuronales artificiales (RNARs) para la modelación de la estructura jerárquica de una comunidad de macroinvertebrados bentónicos en términos de auto-organización y predicción. El primer método de modelación consistió en un mapa de auto-organización (MAU), una herramienta de aprendizaje no supervisado que clasificó las especies de macroinvertebrados; este MAU tomó en la capa de entrada la abundancia de cada taxa, y en la de salida proyectó su clasificación en 15 unidades y cuatro agrupamientos jerárquicos. La segunda RNA, correspondió a un Perceptrón multicapa de alimentación adelantada con algoritmo de retropropagación, que modeló separadamente la riqueza y la abundancia de Ephemeroptera, Coleoptera y Trichoptera (ECT), en función de nueve variables fisicoquímicas; la arquitectura del perceptrón correspondió a una constitución de nueve, siete, y una neurona en las capas de entrada, intermedia y salida, respectivamente. Los resultados sugieren que las RNARs utilizadas evidenciaron tanto los patrones jerárquicos, como los de riqueza y abundancia de ECT de manera adecuada, al tiempo que facilitaron el análisis de los datos y el entendimiento de la dinámica de la comunidad de macroinvertebrados, objeto de estudio.

The study of hierarchical structures of ecological communities has been synthesized in an ordinary way by means of multivariated techniques of ordination or clustering. Currently, analytical tools of bio-inspired computation belonging to the area of artificial intelligence are available to achieve ecological models with desirable characteristics, such as; flexibility, accuracy, robustness and reliability. In this context, this study employed two computational methods useful in ecoinformatics referring to artificial neural networks (RNAR) for the modeling of the hierarchical structure of a benthic macroinvertebrate community in self-organization and prediction terms. The first ANN modeling method consisted of a Kohonen self-organization map (SOM), a non-supervised learning tool that classify the species of macroinvertebrates; this SOM in the input layer of gets the abundance of each ‘taxa’ from the data matrix, while in the output layer was visualized the computational results. Thus, in the output layer the species are organized in fifteen units and four hierarchical clusters. The second ANN method applied consisted of a multilayer feed-forward perceptron net with back-propagation algorithm to predict the three major insect orders; this means, Ephemeroptera, Coleoptera and Trichoptera (ECT) richness and abundance using a set of nine physical-chemical variables. This ANN architecture included a neuron for each environmental variable, a hidden layer with seven neurons and a neuron in the output layer for ECT prediction. The results suggest that both types of ANN used, SOM and perceptron, were correspondingly related to the hierarchical patterns and with the richness and abundance patterns’ predictions, and gave the data analysis and understanding of the dynamic of the macroinvertebrates community, in a correct way.