Evaluation of the Renal Angina Index to Predict the Development of Acute Kidney Injury in Children With Sepsis Who Live in Middle-Income Countries.

OBJECTIVE: The renal angina index (RAI) provides a clinically feasible and applicable tool to identify critically ill children at risk of severe acute kidney injury (AKI) in high-income countries. Our objective was to evaluate the performance of the RAI as a predictor of the development of AKI in children with sepsis in a middle-income country and its association with unfavorable outcomes. METHODS: This is a retrospective cohort study in children with sepsis hospitalized in the pediatric intensive care unit (PICU) between January 2016 and January 2020. The RAI was calculated 12 hours after admission to predict the development of AKI and at 72 hours to explore its association with mortality, the need for renal support therapy, and PICU stay. RESULTS: We included 209 PICU patients with sepsis with a median age of 23 months (interquartile range, 7-60). We found that 41.1% of the cases (86/209) developed de novo AKI on the third day of admission (KDIGO 1, 24.9%; KDIGO 2, 12.9%; and KDIGO 3, 3.3%).Overall mortality was 8.1% (17/209), higher in patients with AKI (7.7% vs 0.5%, P < 0.01). The RAI on admission was able to predict the presence of AKI on day 3 (area under the curve (AUC), 0.87; sensitivity, 94.2%; specificity, 100%; P < 0.01), with a negative predictive value greater than 95%. An RAI greater than 8 at 72 hours was associated with a greater risk of mortality (adjusted odds ratio [aOR], 2.6; 95% confidence interval [CI], 2.0-3.2; P < 0.01), a need for renal support therapy (aOR, 2.9; 95% CI, 2.3-3.6; P < 0.01), and a PICU stay of more than 10 days (aOR, 1.54; 95% CI, 1.1-2.1; P < 0.01). CONCLUSIONS: The RAI on the day of admission is a reliable and accurate tool for predicting the risk of developing AKI on day 3, in critically ill children with sepsis in a limited resource context. A score greater than eight 72 hours after admission is associated with a higher risk of death, the need for renal support therapy, and PICU stay.

MiSight Assessment Study Spain: A Comparison of Vision-Related Quality-of-Life Measures Between MiSight Contact Lenses and Single-Vision Spectacles.

OBJECTIVES: Recent research has shown that concentric contact lenses (CLs) can be a way to control the progression of myopia. The purpose of the current study was to compare vision-related quality-of-life measures in children wearing distance single-vision (SV) spectacles versus MiSight CLs, a specific concentric design for myopia control. METHODS: Subjects aged 8 to 12 with myopia from -0.75 to -4.00 diopters (D) of sphere and astigmatism less than 1.00 D of cylinder were allocated to the lenses study group (MiSight) or control group (SV). A Pediatric Refractive Error Profile (PREP) questionnaire was administered at 12- and 24-month intervals to evaluate children's perceptions in overall vision, near vision, far distance vision, symptoms, appearance, satisfaction, activities, academic performance, handling, and peer perceptions. The mean score of all items was calculated as the overall score. RESULTS: In total, 74 children completed the study: n=41 in the MiSight group and n=33 in the SV group. In the MiSight group, the ratings at 12 and 24 months for appearance, satisfaction, effect on activities, handling, and peer perceptions were significantly better than those given by children in the SV group (P<0.001), as was the overall score. However, near vision was significantly better in the SV group at both 12 and 24 months (P<0.001). CONCLUSIONS: MiSight CL wear for controlling myopia improves vision-related quality of life in children when compared with spectacle wear.

Analgesia controlada por el paciente (PCA) en cirugía cardiotorácica. Experiencia de 13 años de la Fundación Cardiovascular del Oriente Colombiano / Patient-controlled analgesia (PCA) in cardiothoracic surgery

Este estudio relata la experiencia en el manejo del dolor agudo posterior a cirugía cardiotorácia de la Clínica de Dolor de la Fundación Cardiovascular del Oriente Colombiano, específicamente en el uso de bombas para analgesia controlada por el paciente (PCA). En él se muestra como la variabilidad en las dosis requeridas de analgésicos opioides tipo morfina es extremadamente grande y difícil de predecir, por lo que se necesita un método de administración oportuno, eficaz y flexible para lograr el adecuado control del dolor postoperatorio. Así mismo, demuestra como la utilización de bombas de PCA proporciona una buena calidad de analgesia con una incidencia mínima de efectos adversos o secundarios y sin reportar ningún efecto adverso grave tal como depresión respiratoria

Desempeno real de las egresadas de la Fundacion Escuela de Ciencias de la Salud Facultad de Enfermeria en relacion con el perfil profesional / Real performance of graduated students from Fundacion Escuela de Ciencias de la Salud Facultad de Enfermeria related with professional profile

La importancia del tema escogido, sienta sus bases en el aporte practico para reconsiderar la eficacia y la funcionalidad teorico-practica del curriculum a seguir por la facultad para formacion de enfermeras profesionales ya que las metas propuestas por la institucion dirigen su enfoque educativo hacia la atencion en el cuidado directo al paciente hospitalizado. El seguimiento de las egresadas constituye uno de los medios indicados para establecer en que medida el desempeno real responde al perfil profesional. El proceso de informacion de enfermeras que hoy cuenta con 172 egresadas de las cuales 160 aproximadamente se encuentran ejerciendo como profesionales en distintas instituciones del pais. Se concluye que el tiempo que la egresada lleve ejerciendo su profesion no influye para nada en la realizacion de mayor o menor numero de las funciones planteadas en perfil profesional, es decir que el numero de funciones realizadas es independiente del tiempo que lleve en el ejercicio de su profesion. Tambien el mayor numero de egresadas ejercen en el area asistencial