Diseño y validación mediante el método Delphi de un cuestionario para conocer los criterios del jugador de baloncesto cuando penetra hacia la canasta / Desenho e validação através do método Delphi de um questionário para conhecer os critérios do jogador de basquete quando ele penetra em direção ao cesto / Design and validation by Delphi method of a questionnaire to determine the criteria of a basketball player when he drives

Uno de los elementos que más determinan el rendimiento en el jugador de baloncesto es su capacidad de toma de decisiones. Por ello, es necesario ampliar los estudios que permitan entender esta capacidad. El objetivo de esta investigación fue construir y validar un cuestionario que permitiese conocer los Criterios del Jugador de Baloncesto cuando Penetra hacia la Canasta (CJB-PEC). Después de llevar a cabo una revisión de la literatura por parte de los investigadores y de sostener una mesa de discusión, se procedió a la creación de tres dimensiones y 24 ítems para el cuestionario. Posteriormente, se seleccionó a un grupo de 10 diez expertos en el objeto de estudio de esta investigación, los cuales colaboraron vía remota por correo electrónico en la evaluación cuantitativa y cualitativa del instrumento. Con el método Delphi en la primera versión tras obtener los valores medios de 10 expertos en univocidad, pertinencia e importancia a través del coeficiente de V de Aiken (0.75), con intervalos de confianza (IC) al 90% y nivel crítico al 0.70, se encontró que: la pregunta 20 no alcanzó el valor mínimo en la V de Aiken. Las preguntas 4,5,12,13,16, 20 en univocidad, la 12,18,19,20,21,24 en pertinencia, la 7,12,16, 18,19,20,21,24en importancia y la 12,18,19,20,24 en valor total no alcanzaron el nivel crítico. Con los resultados y observaciones de los expertos se modificó y construyó la segunda versión del cuestionario. Ésta tuvo 24 ítems, eliminándose las preguntas 4 y 20, reformulándose las preguntas por debajo del nivel crítico al 0.70 y agregándose 2 preguntas. Esta versión pasó a una segunda ronda con los expertos y consiguió valores superiores a 0.75 en la V de Aiken en todas las preguntas, con IC al 90%. Ninguna preguntaestuvo por debajo del nivel crítico al 0.70...(AU)

One of the elements that most determines the performance of a basketball player is their decision-making ability. Therefore, it is necessary to expand the studies that allow us to understand this capacity. The objective of this research was to construct and validate a questionnaire that would allow us to understand the Criteria of the Basketball Player when Penetrating to the Basket (CJB-PEC). After conducting a literature review by the researchers and holding a discussion, we proceeded to create three dimensions and 24 items for the questionnaire. Subsequently, a group of 10 experts in the subject of this research was selected, and they collaborated remotely via email in the quantitative and qualitative evaluation of the instrument. Using the Delphi method in the first version, after obtaining the mean values from 10 experts in clarity, relevance, and importance through the Aiken's V coefficient (0.75), with confidence intervals (CI) at90% and a critical level at 0.70, itwas found that: question 20 did notreach the minimum value in Aiken's V. Questions 4, 5, 12, 13, 16, 20 in clarity, questions 12, 18, 19, 20, 21, 24 in relevance, questions 7, 12, 16, 18, 19, 20, 21, 24 in importance, and questions 12, 18, 19, 20, 24 in the total value did not reach the critical level. Based on the results and expert observations, the second version of the questionnaire was modified and constructed. This version had 24 items, with questions 4 and 20 removed, questions reformulated below the critical level of 0.70, and 2 newquestions added. This versionwent through a second round with the experts and achieved values above 0.75 in Aiken's V for all questions, with a 90% CI. No question was below the critical level of 0.70...(AU)

Um dos elementos que mais determina o desempenho de um jogador de basquetebol é a sua capacidade de tomar decisões. Assim, torna-se necessário expandir os estudos que nos permitam compreender essa capacidade. Desta forma, o objetivo deste estudo foi construir e validar um questionário para avaliar os Critérios do Jogador de Basquetebol ao Penetrar na Cesto (CJB-PEC). Após a realização de uma revisão da literatura pelos investigadores e uma discussão, procedemos à criação de três dimensões e 24 itens para o questionário. Posteriormente, foi selecionado um grupo de 10 especialistas no assunto desta pesquisa, que colaboraram remotamente por e-mail na avaliação quantitativa e qualitativa do instrumento. Usando o método Delphi na primeira versão, após obter os valores médios de 10 especialistas em clareza, relevância e importância por meio do coeficiente V de Aiken (0.75), com intervalos de confiança (IC) a 90% e um nível crítico de 0.70, constatou-se que: a pergunta 20 não atingiu o valor mínimo no V de Aiken. Asperguntas 4, 5, 12, 13, 16, 20 em clareza, as perguntas 12, 18, 19, 20, 21, 24 em relevância, as perguntas 7, 12, 16, 18, 19, 20, 21, 24 em importância e as perguntas 12, 18, 19, 20, 24 no valor total não atingiram o nível crítico. Com base nos resultados e observações dos especialistas, o questionário passou por uma modificação e construção da sua segunda versão. Essa versão continha 24 itens, com as perguntas 4 e 20 removidas, as perguntas reformuladas abaixo do nível crítico de 0.70 e 2 novas perguntas adicionadas. Esta versão passou por uma segunda rodada com os especialistas e alcançou valores acima de 0.75 no V de Aiken para todas as perguntas, com um IC de 90%. Nenhuma pergunta ficou abaixo do nível crítico de 0.70...(AU)

Calidad de atención en el manejo de enfermedad cerebrovascular isquémica aguda posterior a la iniciativa angels / Acute ischemic cerebrovascular disease management quality of care following the adoption of the angels initiative

Introducción: el ataque cerebrovascular (ACV) es común a nivel mundial, una de cada cuatro personas puede presentarlo a lo largo de la vida. Constituye la segunda causa de muerte y la tercera principal de discapacidad. Es importante la atención integral para lograr un impacto en la calidad de vida. Objetivo: determinar la calidad de atención en el manejo del ACV isquémico agudo de los pacientes que consultaron al servicio de neurología en los Hospitales de San José e Infantil Universitario de San José, Bogotá DC, entre enero 1/2019 y enero 1/2020. Metodología: estudio descriptivo de corte transversal. El criterio de inclusión fue pacientes mayores de 18 años con diagnóstico de ACV isquémico. La información se recolectó de las historias clínicas, se empleó estadística descriptiva para analizar los datos. Resultados: se incluyeron 411 pacientes, 88,8% sin alteración del estado de conciencia, 26,4% ingresaron antes de las 4,5 horas de ventana para trombólisis, se realizaron procedimientos de recanalización endovenosa a 11,4%. El tiempo puerta aguja tuvo una mediana de 37,2 minutos comparado con la mediana nacional de tiempo que fue 56,5 min según lo registrado en la plataforma ResQ. El 72% recibió terapia antiagregante y estatina 88.8%. Discusión y conclusiones: al identificar los síntomas es importante ser estrictos en el tiempo de atención y la implementación de plataformas para óptimos planes de atención. Se requieren campañas masivas de educación, así como que planes de mejora institucionales.

Introduction: cerebrovascular attack (CVA) is common worldwide. One in four people may have a stroke during their lifetime. It is the second leading cause of death and the third leading cause of disability. Thus, it is important to provide integrated care to achieve an impact on quality of life. Objective: to determine ischemic CVA management quality of care among patients seen at the neurology service of the San José and Infantil Universitario de San José hospitals in Bogotá DC, between January 1/2019 and January 1/2020. Methodology: a descriptive, cross-sectional study. The inclusion criteria included patients over 18 years of age diagnosed with ischemic CVA. Information was collected from clinical records. Data was analyzed using descriptive statistics. Results: 411 patients were included; 88.8% had an altered state of consciousness, 26.4% were admitted within the 4.5-hour window for thrombolysis; 11.4% underwent intravenous reperfusion procedures. Door-to-needle time: median was 37.2 minutes versus the national media of 56.5 min according to the ResQ records platform; 72% received anti-platelet therapy and 88.8% received statins. Discussion and conclusions: the establishment of a strict time to care and the implementation of platforms to improve care plans, is essential. Massive education campaigns are required, as well as, institutional improvement plans.

Evaluación de parámetros inflamatorios, trombóticos y variantes genéticas en pacientes con ataque cerebrovascular isquémico que se asisten en un hospital de Uruguay

Introducción: El ataque cerebrovascular es la segunda causa de muerte en adultos en el mundo occidental y una de las principales causas de discapacidad permanente, aumentando su frecuencia con la edad, el 85 % es de tipo isquémico. Objetivos: Analizar parámetros trombofílicos, hipofibrinolíticos y genéticos en pacientes con ataque cerebrovascular isquémico y evaluar la posible asociación de estos con factores de riesgo cardiovascular. Metodología: Se utilizó un cuestionario para evaluar la presencia de factores de riesgo cardiovascular en 114 pacientes incluidos en el estudio con diagnóstico de ataque cerebrovascular isquémico. Proteína C y antitrombina fueron determinados mediante métodos cromogénicos, resistencia a la proteína C activada e inhibidor lúpico mediante métodos coagulométricos y proteína S libre, inhibidor del activador del plasminógeno-1, homocisteína y lipoproteína (a) por métodos inmunoquímicos. Fibrinógeno fue determinado por coagulometría y proteína C reactiva por inmunoturbidimetría, ambos contra un grupo control. Las variantes genéticas factor V Leiden, protrombina G20210A, rs1205 (gen PCR), rs1800779 (gen NOS3) y rs2257073 (gen ASB10) fueron analizadas mediante real-time PCR, comparando los últimos tres con una población de referencia. La alteración de las frecuencias de las variables fue determinada por análisis estadístico chi-cuadrado. Resultados: Tres de los cuatro pacientes jóvenes estudiados presentaron indicadores de trombofilia. El resto de los parámetros alterados fueron homocisteína 30.1% (22.4-39.1), lipoproteína (a) 32.1% (24.1-41.4), inhibidor del activador del plasminógeno-1 36.0% (27.8-45.1), fibrinógeno 12.3% (7.5-19.6) y proteína C reactiva 78.1% (69.6-84.7). Se encontró asociación (p < 0.05) entre ciertos factores de riesgo cardiovascular y los parámetros evaluados como hipertensión/proteína C reactiva, dislipemia/lipoproteína (a), arritmia/lipoproteína (a) y arritmia/fibrinógeno. Para pacientes con ataque cerebrovascular isquémico solo la variante rs1205 mostró una frecuencia más alta del alelo T. Conclusiones: Este estudio revela la importancia de analizar la trombofilia en pacientes jóvenes, especialmente en aquellos sin factores de riesgo cardiovascular, así como el rol de la hipofibrinolisis, inflamación y algunas variantes genéticas en el desarrollo de ataque cerebro vascular isquémico.

Introduction: Stroke is the second cause of death in adults in the Western world and one of the main causes of permanent disability, increasing in frequency with age; 85% are ischemic. Objectives: To analyze thrombophilic, hypofibrinolytic, inflammatory, and genetic parameters in patients with ischemic stroke and evaluate possible associations with vascular risk factors. Methodology: Questionnaires were used to evaluate vascular risk factors in 114 patients included in the study with ischemic stroke diagnosis. Protein C and Antithrombin were determined by chromogenic assays, Activated Protein C Resistance and Lupus Anticoagulant were determined with by coagulometry and Free Protein S, Plasminogen activator inhibitor-1, Homocysteine and Lipoprotein (a) by immunochemistry. Fibrinogen was assayed by coagulometry and C-reactive protein by immunoturbidimetry, both against a control group. Factor V Leiden, Prothrombin G20210A, rs1205 (CRP gene), rs1800779 (NOS3 gene) and rs2257073 (ASB10 gene) genetic variants were analyzed by Real-Time PCR, comparing the last three with a reference population. Alteration frequencies of the variables were determined by chi-square statistical analysis. Results: Three out of four of the young patients studied presented indicators of thrombophilia. The rest of the altered parameters were Homocysteine 30.1% (22.4-39.1), Lipoprotein (a) 32.1% (24.1-41.4), Plasminogen activator inhibitor-1 36.0% (27.8-45.1), Fibrinogen 12.3% (7.5-19.6) and C-reactive protein 78.1% (69.6-84.7). Associations were found (p<0.05) between certain vascular risk factors and parameters evaluated, namely hypertension/C-reactive protein, dyslipidemia/lipoprotein (a), arrhythmia/lipoprotein (a) and arrhythmia/fibrinogen. For ischemic stroke patients only the genetic variant rs1205 showed higher frequency of the T allele. Conclusions: This study reveals the importance of analyzing thrombophilia in young patients, especially those without vascular risk factors, as well as the role of hypofibrinolysis, inflammation and some genetic variants in the development of ischemic stroke.

Introdução: O AVC é a segunda causa de morte em adultos no mundo ocidental e uma das principais causas de incapacidade permanente, aumentando de frequência com a idade; 85% são isquémicos. Metas: Analisar os parâmetros trombofílicos, hipofibrinolíticos e genéticos em pacientes com acidente vascular cerebral isquêmico e avaliar a possível associação com fatores de risco cardiovascular. Metodologia: Um questionário foi utilizado para avaliar a presença de fatores de risco cardiovascular em 114 pacientes incluídos no estudo com diagnóstico de acidente vascular cerebral isquêmico. Proteína C e antitrombina foram determinadas por métodos cromogênicos, resistência à proteína C ativada e inibidor de lúpus por métodos coagulométricos e proteína S livre, inibidor do ativador do plasminogênio-1, homocisteína e lipoproteína (a) por métodos imunoquímicos. O fibrinogênio foi determinado por coagulometria e a proteína C-reativa por imunoturbidimetria, ambos contra um grupo controle. As variantes genéticas fator V Leiden, protrombina G20210A, rs1205 (gene PCR), rs1800779 (gene NOS3) e rs2257073 (gene ASB10) foram analisadas por PCR em tempo real, comparando as três últimas com uma população de referência. As frequências de alteração das variáveis ​​foram determinadas pela análise estatística qui-quadrado. Resultados: Três dos quatro pacientes jovens estudados apresentaram indicadores de trombofilia. O resto dos parâmetros alterados foram homocisteína 30,1% (22,4-39,1), lipoproteína (a) 32,1% (24,1-41,4), inibidor do ativador de plasminogênio-1 36,0% (27,8-45,1), fibrinogênio 12,3% (7,5-19,6) e proteína C reativa 78,1% (69,6-84,7). Foi encontrada associação (p<0,05) entre alguns fatores de risco cardiovascular e os parâmetros avaliados como hipertensão/proteína C reativa, dislipidemia/lipoproteína (a), arritmia/lipoproteína (a) e arritmia/fibrinogênio. Para pacientes com acidente vascular cerebral isquêmico apenas a variante rs1205 apresentou maior frequência do alelo T. Conclusões: Este estudo revela a importância de analisar a trombofilia em pacientes jovens, especialmente aqueles sem fatores de risco cardiovascular, bem como o papel da hipofibrinólise, inflamação e algumas variantes genéticas no desenvolvimento do acidente vascular cerebral isquêmico.

Examining MEmory Training for Recovery-Adolescent among Afghan adolescent boys: a pilot randomised controlled trial.

Objective: To conduct a pilot randomised controlled trial examining the feasibility, acceptability and efficacy of MEmory Training for Recovery-Adolescent (METRA) in improving psychological symptoms among Afghan adolescent boys following a terrorist attack.Method: A pilot randomised controlled trial compared METRA to a Control Group, with a three-month follow-up. The study occurred in Kabul (June-November 2022). Fifty-eight boys aged 14-19 years (Mage = 16.70, SD = 1.26) with heightened posttraumatic stress disorder (PTSD) symptoms were recruited through a local school that had recently experienced a terrorist attack. Participants were randomised 1:1 to receive METRA (n = 28) (10 session group-intervention) or Control (n = 30) (10 group-sessions of study skills). Primary outcomes were self-reported PTSD symptoms at post-intervention. Secondary outcomes included self-reported anxiety, depression, Afghan-cultural distress symptoms and psychiatric difficulties.Results: There were challenges in youth participation related to security and competing education demands. For those who did complete METRA, METRA was deemed feasible and acceptable. Following the intent-to-treat principle, linear mixed effects models found at posttreatment the METRA group had a 20.89-point (95%CI -30.66, -11.11) decrease in PTSD symptoms, while the Control Group had a 1.42-point (95%CI -8.11, 5.27) decrease, with the group over time interaction being significant (p < .001). METRA participants had significantly greater reductions in depression, anxiety, Afghan-cultural distress symptoms and psychiatric difficulties than did Controls. All gains were maintained at three-month follow-up.Conclusions: With some modifications, METRA appears a feasible intervention for adolescent boys in humanitarian contexts in the aftermath of a terrorist attack.

Very few adolescents in Afghanistan receive evidence-based psychological interventions.MEmory Training for Recovery-Adolescents was associated with significant reductions in psychological symptoms.With some modifications, MEmory Training for Recovery-Adolescents appears a feasible intervention for adolescent boys in humanitarian contexts in the aftermath of a terrorist attack.

ACV isquémico en población joven: ¿existe un enfoque diferencial del riesgo? / Ischemic stroke in a young population: is there a differential approach to risk factors?

Introducción: El ataque cerebrovascular isquémico en el adulto joven se define como aquel que ocurre en la población entre los 18 y los 55 años, y representa el 15-18 % de todos los ACV isquémicos. Los factores de riesgo en jóvenes son comunes a los encontrados en adultos mayores. El objetivo de este trabajo es describir las características clínicas y los factores de riesgo de una población menor de 55 años con ACV isquémico atendida en un centro de referencia hospitalario en Colombia. Materiales y métodos: Estudio descriptivo, retrospectivo de corte transversal en pacientes entre los 18 y los 55 años; se incluyeron 100 pacientes sobrevivientes a un primer ACV isquémico agudo confirmado por neuroimagen, atendidos entre enero de del 2019 y noviembre del 2021. Resultados: De 1023 pacientes con diagnóstico de ACV isquémico agudo, el 9,8 % fueron adultos jóvenes. La media de edad fue de 45 ± 8,7 años, y el 59 % de estos pacientes fueron hombres. Discusión: Los factores de riesgo "tradicionales" se presentan en la mayoría de los jóvenes con ACV isquémico. La hipertensión arterial se mantiene como el antecedente más frecuente. Las mujeres presentan eventos de mayor severidad y peor desenlace funcional. Conclusión: Los pacientes mayores de 45 años tienen un perfil de factores de riesgo similar a lo observado en adultos mayores con ACV, mientras que en los menores de 45 años se encuentra un perfil de factores de riesgo diferente que plantea un diagnóstico etiológico particular de esta población.

Introduction: Ischemic stroke in young adults is defined as occurring in individuals between the ages of 18 and 55, representing 15-18 % of all ischemic strokes. Risk factors in young adults are similar to those found in older adults. The objective of this study is to describe the clinical characteristics and risk factors of a population under 55 years of age with ischemic stroke treated at a hospital reference center in Colombia. Materials and methods: Descriptive, retrospective cross-sectional study in patients between 18 and 55 years old. A total of 100 patients between 18 and 55 years old who survived a first confirmed acute ischemic stroke, as confirmed by neuroimaging, were included. The study period was from January 2019 to November 2021. Results: Out of 1023 patients diagnosed with acute ischemic stroke, 9.8 % occurred in young adults. The mean age was 45 ± 8.7 years, of which 59 % were male. Discussion: "Traditional" risk factors are present in the majority of young adults with ischemic stroke. Hypertension remains the most common antecedent. Women experience more severe events and worse functional outcomes. Conclusion: Patients over 45 years old have a risk factor profile similar to what is observed in older adults with stroke, while in those under 45, a different risk factor profile is found, which poses a particular etio-logical diagnosis for this population.

Posttraumatic stress disorder and depression after the 2018 Strasbourg Christmas Market terrorist attack: a comparison of exposed and non-exposed police personnel.

Background: Police personnel are among the first responders exposed to terrorist attacks, raising in number in the late decades. Due to their profession, they are also exposed to repetitive violence, increasing their vulnerability to PTSD and depression.Objective: Our study aims at comparing the prevalence of PTSD and depression, and the risk factors associated with these conditions among directly and indirectly exposed versus non-exposed police personnel during the Strasbourg Christmas Market terrorist attack.Method: Three months after the attack, participants completed a survey assessing their sociodemographic characteristics, occupational data, degree of exposure, sleep debt around the event, event centrality (CES), and three mental health conditions: PTSD (PCL-5), depression (PHQ-9), and suicide risk (yes/no questions).Results: A total of 475 police personnel responded to the questionnaire: 263 were exposed to the attack (182 of them directly) and 212 were non-exposed. Among directly exposed participants, the prevalences of partial and complete PTSD were 12.6 and 6.6%, and the prevalence of moderate-to-severe depression was 11.5%. Multivariate analysis revealed that direct exposure was associated with a higher risk of PTSD (OR = 2.98 [1.10-8.12], p = .03). Direct exposure was not associated with a higher risk of depression (OR = 0.40 [0.10-1.10], p = .08). A significant sleep debt after the event was not associated with a higher risk of later PTSD (OR = 2.18 [0.81-5.91], p = .13) but was associated with depression (OR = 7.92 [2.40-26.5], p < .001). A higher event centrality was associated with both PTSD and depression (p < .001).Conclusions: Police personnel directly exposed to the Strasbourg Christmas Market terrorist attack were at higher risk of PTSD but not depression. Efforts to prevent and treat PTSD should focus on directly exposed police personnel. However, general mental health should be monitored for every personnel member.

Direct exposure to the terrorist attack and gender (female) were significantly associated with a higher risk of PTSD among police personnel.Sleep debt after the attack was significantly associated with depression but not with PTSD.No occupational factor was associated with either PTSD or depression.Both PTSD and depression were significantly associated with a higher suicide risk.A higher event centrality was significantly associated with direct exposure and a higher risk of both PTSD and depression.

Papel de la neuropatía diabética en la aparición y desarrollo del síndrome del pie diabético / Role of Diabetic Neuropathy in the Onset and Development of Diabetic Foot Syndrome

Introducción: La neuropatía diabética es la complicación más frecuente de la diabetes mellitus y una de sus posibles consecuencias es el síndrome del pie diabético. Los médicos del primer nivel de atención deben conocer el comportamiento clínico de la neuropatía diabética y, sobre todo, como influye en la aparición y desarrollo del síndrome del pie diabético. Objetivo: Describir el papel de la neuropatía diabética en la aparición y desarrollo del síndrome del pie diabético. Métodos: Para la obtención de la información se utilizaron como motores de búsqueda de información científica los correspondientes a Scielo, Pubmed, y Google Académico. Se usaron como palabras clave: diabetes mellitus; neuropatía diabética; pie diabético; síndrome de pie diabético; úlcera de pie diabético; ataque de pie diabético. Se evaluaron diferentes trabajos de revisión, investigación y páginas web, y se excluyeron los artículos que tuvieran más de 10 años de publicados, en idiomas diferentes al español, portugués e inglés y que no se refirieran al tema de estudio a través del título. Esto permitió la cita de 45 referencias bibliográficas. Conclusiones: La neuropatía diabética constituye el principal factor de riesgo en la aparición y desarrollo del síndrome del pie diabético, sobre todo cuando se asocia a artropatía (defectos podálicos), enfermedad vascular periférica y/o sepsis. El control de la glucemia, la detección temprana del pie de riesgo y el cuidado preventivo de los miembros inferiores, repercutirá favorablemente en la salud y bienestar del paciente(AU)

Introduction: Diabetic neuropathy is the most frequent complication of diabetes mellitus and one of its possible consequences is diabetic foot syndrome. First level of care physicians should know the clinical behavior of diabetic neuropathy and, above all, how it influences the appearance and development of diabetic foot syndrome. Objective: To describe the role of diabetic neuropathy in the appearance and development of diabetic foot syndrome. Methods: To obtain the information, SciELO, PubMed and Google Scholar were used as search engines for scientific information. The keywords used were: diabetes mellitus; diabetic neuropathy; diabetic foot; diabetic foot syndrome; diabetic foot ulcer; diabetic foot attack. Different review papers, research papers and web pages were evaluated and articles that were more than 10 years old and published in languages other than Spanish, Portuguese and English and that did not refer to the subject of the study through the title were excluded. This allowed the citation of 45 bibliographic references. Conclusions: Diabetic neuropathy constitutes the main risk factor in the appearance and development of diabetic foot syndrome, especially when associated with arthropathy (foot defects), peripheral vascular disease and/or sepsis. Glycemic control, early detection of the foot at risk and preventive care of the lower limbs will have a favorable impact on the patient's health and well-being(AU)

Blumenau, April 5, 2023: The point of view of psychiatry / Blumenau, 5 de abril de 2023: O ponto de vista da psiquiatria

ABSTRACT The goal of this editorial is to analyse a recent case of mass murder under the psychiatric perspective.

RESUMO O objetivo do presente editorial é o de analisar, sob a perspectiva da psiquiatria, um caso recente de homicídio em massa.

Violencia intrafamiliar en Colombia en los últimos doce años

La presente investigación consiste en evaluar y comparar estadísticamente el número de casos de violencia intrafamiliar en Colombia entre los años 2010-2021, con base en los reportes de la Policía Nacional. La base de datos está compuesta por 896.017 casos de violencia denunciados. Se empleó distribución de frecuencias, análisis comparativo por el método GLM y proyección Biplot. Cundinamarca diverge estadísticamente respecto a las demás regiones evaluadas, donde las mujeres presentan el mayor porcentaje de violencia intrafamiliar. Factores como las restricciones de movilidad, la incertidumbre, el estrés entre otros componentes, son la raíz de situaciones complejas familiares.

The present research consists of evaluating and statistically comparing the number of cases of intrafamily violence in Colombia between the years 2010-2021, based on the reports of the National Police. The database is made up of 896,017 reported cases of violence. Frequency distribution, comparative analysis by the GLM method and Biplot projection were used. Cundinamarca differs statically with respect to the other regions evaluated, where women present the highest percentage of domestic violence. Factors, such as mobility restrictions, uncertainty, stress, among other components, are at the root of complex family situations.

Ataque de nervios: The impact of sociodemographic, health history, and psychological dimensions on Puerto Rican adults.

Introduction: Ataque de nervios (ADN) is a cultural syndrome prevalent in Puerto Ricans characterized as an episode of intense emotional upset due to overwhelming stress. Methods: The Ataque de Nervios Questionnaire, developed at the Center for the Study and Treatment for Fear and Anxiety (CETMA), served as the diagnostic tool for this retrospective secondary data analysis. We evaluated three models regarding ADN's function as a marker of (1) sociodemographic vulnerability, (2) health history risk, and (3) psychological vulnerability. This last model was subdivided to assess the scores of screening tests regarding anxiety (Anxiety Sensitivity Inventory, Beck Anxiety Inventory, and State-Trait Anxiety Inventory), affect (Beck Depression Inventory, Emotional Dysregulation Scale, Positive and Negative Affective Schedule), personality (NEO Five-Factor Inventory), and trauma (considering the responses to the Childhood Trauma Questionnaire and the Life Event Checklist). Results: Our study sample had a total of 121 Puerto Rican adult patients from CETMA out of which 75% had ADN. We differentiated subjects according to their ADN status with t-tests and Mann-Whitney U tests and evaluated our models using logistic regressions. People with ADN showed more anxiety, depressive symptoms, emotional dysregulation, and negative affect than those without ADN. They also revealed lower positive affect and agreeableness. Highly extraverted but minimally agreeable personalities related to ADN. Living with a partner and being employed were risk factors for ADN. Having higher educational levels showed the strongest effect size: it greatly reduced the odds of an ataque. Discussion: These characteristics suggest a distinct profile of ADN seen in employed, educated, adult Puerto Ricans living on the Island experiencing anxiety. Our study provides clinical tools to comprehend our patients' ADN experience, enriching our practice as culturally competent health providers.

Survival rate and stability of surface-treated and non-surface-treated orthodontic mini-implants: a randomized clinical trial

ABSTRACT Objectives: This clinical trial was conducted to evaluate the stability and failure rate of surface-treated orthodontic mini-implants and determine whether they differ from those of non-surface-treated orthodontic mini-implants. Trial Design: Randomized clinical trial with a split-mouth study design. Setting: Department of Orthodontics, SRM Dental College, Chennai. Participants: Patients who required orthodontic mini-implants for anterior retraction in both arches. Methods: Self-drilling, tapered, titanium orthodontic mini-implants with and without surface treatment were placed in each patient following a split-mouth design. The maximum insertion and removal torques were measured for each implant using a digital torque driver. The failure rates were calculated for each type of mini-implant. Results: The mean maximum insertion torque was 17.9 ± 5.6 Ncm for surface-treated mini-implants and 16.4 ± 9.0 Ncm for non-surface-treated mini-implants. The mean maximum removal torque was 8.1 ± 2.9 Ncm for surface-treated mini-implants and 3.3 ± 1.9 Ncm for non-surface-treated mini-implants. Among the failed implants, 71.4% were non-surface-treated mini-implants and 28.6% were surface-treated mini-implants. Conclusion: The insertion torque and failure rate did not differ significantly between the groups, whereas the removal torque was significantly higher in the surface-treated group. Thus, surface treatment using sandblasting and acid etching may improve the secondary stability of self-drilling orthodontic mini-implants. Trial registration: The trial was registered in the Clinical Trials Registry, India (ICMR NIMS). Registration number: CTRI/2019/10/021718

RESUMO Objetivos: Este ensaio clínico foi conduzido para avaliar a estabilidade e a taxa de falha de mini-implantes ortodônticos com superfície tratada, e determinar se elas diferem das dos mini-implantes ortodônticos sem superfície tratada. Desenho do estudo: Ensaio clínico randomizado com desenho de boca dividida. Instituição: Department of Orthodontics, SRM Dental College, Chennai/India. Participantes: Pacientes que necessitavam de mini-implantes ortodônticos para retração anterior em ambas as arcadas. Métodos: Mini-implantes ortodônticos autoperfurantes, cônicos, de titânio com ou sem tratamento de superfície, foram colocados em cada paciente, seguindo um desenho de boca dividida. Os torques máximos de inserção e de remoção foram medidos para cada mini-implante, usando um torquímetro digital. As taxas de falha foram calculadas para cada tipo de mini-implante. Resultados: O valor médio do torque máximo de inserção foi de 17,9 ± 5,6 Ncm para mini-implantes com superfície tratada e 16,4 ± 9,0 Ncm para mini-implantes sem superfície tratada. O valor médio do torque máximo de remoção foi de 8,1 ± 2,9 Ncm para mini-implantes com superfície tratada e 3,3 ± 1,9 Ncm para mini-implantes sem superfície tratada. Entre os implantes que falharam, 71,4% eram mini-implantes sem superfície tratada e 28,6% eram mini-implantes com superfície tratada. Conclusão: O torque de inserção e a taxa de falha não diferiram significativamente entre os grupos; porém, o torque de remoção foi significativamente maior no grupo com superfície tratada. Assim, o tratamento de superfície com jateamento e condicionamento ácido pode melhorar a estabilidade secundária dos mini-implantes ortodônticos autoperfurantes. Registro do estudo: Esse estudo foi registrado no Clinical Trials Registry, Índia (ICMR NIMS). Número de registro: CTRI/2019/10/021718

Three first records of stick insects attacking plants (Inseect: Phasmida) in Tibet / Três primeiros registros de insetos-pau atacando plantas (Inseect: Phasmida) no Tibet

Except for a few stick insects that are economically valuable, most species be considered to be forest pests, so it is extremely important to obtain plant host-use information of more stick insects. In this paper, the plant hosts of three species of stick insects were recorded for the first time. We also discovered these stick insects can feed upon the flowers or leaves of plants. Lopaphus unidentatus (Chen & He, 1995) (Phasmida: Lonchodidae) attacked Hypericum choisianum Wall. ex N. Robson, 1973 (Hypericaceae), Leurophasma dolichocercum Bi, 1995 (Phasmida: Aschiphasmatidae) attacked Antenoron filiforme (Thunb.) Roberty & Vautier, 1964 (Polygonaceae) and Megalophasma granulatum Bi, 1995 (Phasmida: Lonchodidae) attacked Debregeasia orientalis C. J. Chen, 1991 (Urticaceae). Finally, we were lucky enough to also obtain photographs of them mating and feeding.

Exceto por alguns insetos-pau que são economicamente valiosos, a maioria das espécies pode ser considerada praga florestal, por isso é extremamente importante obter informações sobre o uso de hospedeiros de plantas de mais insetos-pau. Neste artigo, as plantas hospedeiras de três espécies de bicho-pau foram registradas pela primeira vez. Também descobrimos que esses bichos-pau podem se alimentar de flores ou folhas de plantas. Lopaphus unidentatus (Chen & He, 1995) (Phasmida: Lonchodidae) atacou a parede de Hypericum choisianum. ex N. Robson, 1973 (Hypericaceae), Leurophasma dolichocercum Bi, 1995 (Phasmida: Aschiphasmatidae) atacou Antenoron filiforme (Thunb.) Roberty & Vautier, 1964 (Polygonaceae) e Megalophasma granulatum Bi, 1995 (Phasmida: Lonchodidae orientaled) atacou Chen, 1991 (Urticaceae). Finalmente, tivemos a sorte de também obter fotos deles se acasalando e se alimentando.

Three first records of stick insects attacking plants (Inseect: Phasmida) in Tibet

Abstract Except for a few stick insects that are economically valuable, most species be considered to be forest pests, so it is extremely important to obtain plant host-use information of more stick insects. In this paper, the plant hosts of three species of stick insects were recorded for the first time. We also discovered these stick insects can feed upon the flowers or leaves of plants. Lopaphus unidentatus (Chen & He, 1995) (Phasmida: Lonchodidae) attacked Hypericum choisianum Wall. ex N. Robson, 1973 (Hypericaceae), Leurophasma dolichocercum Bi, 1995 (Phasmida: Aschiphasmatidae) attacked Antenoron filiforme (Thunb.) Roberty & Vautier, 1964 (Polygonaceae) and Megalophasma granulatum Bi, 1995 (Phasmida: Lonchodidae) attacked Debregeasia orientalis C. J. Chen, 1991 (Urticaceae). Finally, we were lucky enough to also obtain photographs of them mating and feeding.

Resumo Exceto por alguns insetos-pau que são economicamente valiosos, a maioria das espécies pode ser considerada praga florestal, por isso é extremamente importante obter informações sobre o uso de hospedeiros de plantas de mais insetos-pau. Neste artigo, as plantas hospedeiras de três espécies de bicho-pau foram registradas pela primeira vez. Também descobrimos que esses bichos-pau podem se alimentar de flores ou folhas de plantas. Lopaphus unidentatus (Chen & He, 1995) (Phasmida: Lonchodidae) atacou a parede de Hypericum choisianum. ex N. Robson, 1973 (Hypericaceae), Leurophasma dolichocercum Bi, 1995 (Phasmida: Aschiphasmatidae) atacou Antenoron filiforme (Thunb.) Roberty & Vautier, 1964 (Polygonaceae) e Megalophasma granulatum Bi, 1995 (Phasmida: Lonchodidae orientaled) atacou Chen, 1991 (Urticaceae). Finalmente, tivemos a sorte de também obter fotos deles se acasalando e se alimentando.

Three first records of stick insects attacking plants (Inseect: Phasmida) in Tibet / Três primeiros registros de insetos-pau atacando plantas (Inseect: Phasmida) no Tibet

Abstract Except for a few stick insects that are economically valuable, most species be considered to be forest pests, so it is extremely important to obtain plant host-use information of more stick insects. In this paper, the plant hosts of three species of stick insects were recorded for the first time. We also discovered these stick insects can feed upon the flowers or leaves of plants. Lopaphus unidentatus (Chen & He, 1995) (Phasmida: Lonchodidae) attacked Hypericum choisianum Wall. ex N. Robson, 1973 (Hypericaceae), Leurophasma dolichocercum Bi, 1995 (Phasmida: Aschiphasmatidae) attacked Antenoron filiforme (Thunb.) Roberty & Vautier, 1964 (Polygonaceae) and Megalophasma granulatum Bi, 1995 (Phasmida: Lonchodidae) attacked Debregeasia orientalis C. J. Chen, 1991 (Urticaceae). Finally, we were lucky enough to also obtain photographs of them mating and feeding.

Resumo Exceto por alguns insetos-pau que são economicamente valiosos, a maioria das espécies pode ser considerada praga florestal, por isso é extremamente importante obter informações sobre o uso de hospedeiros de plantas de mais insetos-pau. Neste artigo, as plantas hospedeiras de três espécies de bicho-pau foram registradas pela primeira vez. Também descobrimos que esses bichos-pau podem se alimentar de flores ou folhas de plantas. Lopaphus unidentatus (Chen & He, 1995) (Phasmida: Lonchodidae) atacou a parede de Hypericum choisianum. ex N. Robson, 1973 (Hypericaceae), Leurophasma dolichocercum Bi, 1995 (Phasmida: Aschiphasmatidae) atacou Antenoron filiforme (Thunb.) Roberty & Vautier, 1964 (Polygonaceae) e Megalophasma granulatum Bi, 1995 (Phasmida: Lonchodidae orientaled) atacou Chen, 1991 (Urticaceae). Finalmente, tivemos a sorte de também obter fotos deles se acasalando e se alimentando.

Neuromuscular Alterations Associated with COVID-19. A Scientific Literature Review

Introduction: The COVID-19 pandemic has brought short, medium, and long-term consequences on the quality of life of those affected. Among the complications are those related to the involvement of the nervous system and the structures involved in body movement, with sequelae that may be transitory and/or definitive, and require rehabilitation. Objective: Identify the neuromuscular alterations that affect body movement, associated with COVID-19. Material and methods: A search was made for observational works published in the SCOPUS, PubMed, EBSCO, and Nature databases between January 2020 and June 2022 under the PRISMA methodology, to answer the PICO question: what are the neuromuscular alterations that can potentially affect movement, associated with COVID-19? The established filters were type of study, language, age, availability, publication dates. The MeSH terms were SARS-Cov-2, COVID-19, Long Covid, Motor Activity Neuromuscular Diseases, Neurological Disorders, Guillain-Barré Syndrome, Myelitis Transverse, Stroke, Patient, Peripheral Nervous System Diseases. The methodological quality was evaluated according to STROBE and the level of evidence was established according to CEBM. Results: In the first search, 645 articles were identified. 637 were discarded by filters, titles, duplicate abstracts, methodological quality, and level of evidence. There were 8 articles selected for the present review in which neuromuscular alterations of central and peripheral origin were identified, such as myalgias, fatigue, polyneuroradiculopathies, CNS inflammation, among others, with clinical manifestations that affect movement. Conclusion: COVID-19 is a multisystemic disease that can affect the nervous system with symptoms of neuromuscular alterations that compromise body movement.

Introducción: La pandemia por la COVID-19 ha traído consecuencias a corto, mediano y largo plazo sobre la calidad de vida de los afectados. Entre las complicaciones se encuentran aquellas relacionadas con la afectación del sistema nervioso y las estructuras involucradas en el movimiento corporal, con secuelas que pueden ser transitorias y/o definitivas, y requieren rehabilitación Objetivo: Identificar las alteraciones neuromusculares que afectan el movimiento corporal, asociadas a la COVID-19. Material y métodos: Se hizo una búsqueda de trabajos observacionales publicados en las bases de datos SCOPUS, PubMed, EBSCO y Nature entre enero de 2020 y junio de 2022 bajo metodología PRISMA, para dar respuesta a la pregunta PICO: ¿cuáles son las alteraciones neuromusculares que potencialmente pueden afectar el movimiento, asociadas a la COVID-19? Los filtros establecidos fueron tipo de estudio, idioma, edad, disponibilidad y fechas de publicación. Los términos MesH fueron SARS-Cov-2, COVID-19, Long Covid, Motor Activity Neuromuscular Diseases, Neurological Disorders, Guillain-Barré Syndrome, Myelitis Transverse, Stroke, Patient, Peripheral Nervous System Diseases. La calidad metodológica se evaluó según STROBE y el nivel de evidencia se estableció según CEBM. Resultados: En la primera búsqueda se identificaron 645 artículos. Posteriormente se descartaron 637 por filtros, títulos, resúmenes duplicados, calidad metodológica y nivel de evidencia. Así, quedaron seleccionados 8 para la presente revisión, en los cuales se identificaron alteraciones neuromusculares de origen central y periférico, como mialgias, fatiga, polineuroradiculopatías, inflamación del SNC, entre otras, con manifestaciones clínicas que afectan el movimiento. Conclusión: La COVID-19 es una enfermedad multisistémica que puede afectar el sistema nervioso con síntomas de alteraciones neuromusculares que comprometen el movimiento corporal.

Offensive Difference Styles and Technical Situational Variables Between European and South American Elite Football Leagues / Diferencias de estilos ofensivos y variables situacionales técnicas entre las ligas de fútbol de élite europeas y sudamericanas

Abstract We aimed to compare teams' attack styles in Europe and South America elite football in the two most valued domestic leagues in both continents (Spanish La Liga & English Premier League in Europe, and Argentinian Superliga & Brazilian Série A in South America). For this purpose, we used a sample of 84 teams and 3,780 cases in 1,214 games. Using an observational tool, we analyzed performance indicators (goals, shots, dribbles, and passes) and attack situations. Effect size (ES) and non-clinical magnitude-based inference (MBI) were used to evaluate uncertainty. Results revealed that European teams scored more goals per game related to fast (ES = 0.35; likely MBI) and positional attack (ES = 0.36; likely MBI). In addition, teams from the European leagues spent more time playing in the opposition third zone of the pitch, performed a higher number of assists (ES = 0.38; likely MBI) and through-ball assists (ES = 0.46; likely MBI) than South American ones. Finally, South American teams made higher numbers of shots out of the box (ES = 1.52, almost certain MBI) and off-target shots (ES = 1.08; almost certain MBI), and they also spent more time playing in the middle third zone (ES = 1.65; almost certain MBI). No differences were identified in set-pieces goals, length passing, and aerial duels. These findings may provide information regarding attack style profiles from each continent league. Also, it could be highly beneficial for coaches to be able to continuously design the specific training situations of the offensive process.

Resumen El objetivo fue comparar estilos de ataque de los equipos en el fútbol de élite de Europa y Sudamérica en las dos ligas nacionales más valoradas de ambos continentes (Europa: Liga española y Premier League inglesa; Sudamérica: Superliga argentina y Serie A brasileña). Para ello, se empleó una muestra de 84 equipos y 3780 casos en 1214 partidos. Mediante una herramienta de observación, se analizaron indicadores de rendimiento (goles, tiros, regates y pases) y situaciones posicionales de ataque. Para evaluar la incertidumbre, se calculó el tamaño del efecto (ES) y la inferencia basada en la magnitud no clínica (MBI). Los resultados revelaron que los equipos europeos lograron más goles por partido mediante transición rápida (ES = 0,35; ''probable'' MBI) y ataque posicional (ES = 0,36; ''probable'' MBI). Además, los europeos pasaron más tiempo jugando en el último tercio del campo rival, realizaron más asistencias (ES = 0,38; ''probable'' MBI) y asistencias con pase entre defensores rivales (ES = 0,46; ''probable'' MBI) que los sudamericanos. Finalmente, los equipos sudamericanos realizaron más tiros desde fuera del área (ES = 1,52; ''casi seguro'' MBI) y tiros fuera de la portería (ES = 1,08; ''casi seguro'' MBI), y también pasaron más tiempo jugando en el tercio medio del campo (ES = 1,65; ''casi seguro'' MBI). No se identificaron diferencias en goles mediante jugadas a balón parado, pases largos y duelos aéreos. Estos hallazgos informan sobre estilos de ataque de cada liga continental y podrían ayudar a diseñar situaciones de entrenamiento del proceso ofensivo.

Resumo O objetivo era comparar os estilos de ataque das equipes de futebol de elite europeu e sul-americano nas duas ligas nacionais mais valorizadas de ambos os continentes (Europa: Liga espanhola e Premier League inglesa; América do Sul: Superliga argentina e Serie A Brasileira). Para este fim, foi utilizada uma amostra de 84 equipes e 3780 casos em 1214 jogos. Usando uma ferramenta de observação, foram analisados indicadores de desempenho (metas, tiros, dribles e passes) e situações de ataque posicional. Para avaliar a incerteza, foram calculados o tamanho do efeito (ES) e a inferência baseada em magnitude não-clínica (MBI). Os resultados revelaram que os times europeus marcaram mais gols por jogo através de uma transição rápida (ES = 0,35; MBI "provável") e ataque posicional (ES = 0,36; MBI "provável"). Além disso, os europeus passaram mais tempo jogando no último terço do campo rival, fizeram mais assistências (ES = 0,38; MBI 'provável') e assistência com um passe entre os defensores adversários (ES = 0,46; MBI 'provável') do que os sul-americanos. Finalmente, as equipes sul-americanas chutaram mais fora da área (ES = 1,52; 'quase certamente' MBI) e chutes fora do gol (ES = 108; 'quase certamente' MBI), e passaram mais tempo jogando no meio terço do campo (ES = 1,65; 'quase certamente' MBI). Não foram identificadas diferenças nos gols por meio de jogos com a bola parada, nos passes longos e nos passes aéreos. Estas descobertas informam os estilos de ataque de cada liga continental e poderiam ajudar a projetar situações de treinamento para o processo de ataque.

Nivel de información sobre factores de riesgo de Infarto agudo de miocardio en pacientes ambulatorios, Corrientes año 2021 / Level of information on risk factors for acute myocardial infarction in outpatients, Corrientes year 2021

Determinar el nivel de información sobre factores de riesgo de Infarto agudo de miocardio en los pacientes ambulatorios que asisten a una institución de salud de la provincia de Corrientes año 2021. Metodología: Estudio cuantitativo descriptivo, transversal y observacional. Muestra obtenida mediante muestreo probabilístico aleatorio simple compuesta por 108 pacientes que asistieron a los consultorios de Diabetes, Presurometría y Hospital de Día. Se aplicó un cuestionario validado mediante una prueba piloto. Variables: edad, sexo, nivel de instrucción, Nivel de información sobre alimentación, hábitos nocivos, actividad física y preguntas generales. Los resultados fueron volcados a una matriz diseñada en programa Excel. Resultados: La población en estudio presento una mediana de edad de 43, moda 39 y predomino del sexo masculino 56%, sobre el femenino 44%, en el nivel de instrucción prevaleció el secundario completo 19% seguido de primario incompleto 15%. Abordando los niveles de información sobre factores de riesgo de Infarto agudo de miocardio predominaron los niveles altos en todas las variables trabajadas, obteniendo un nivel general de información alto del 82%, se apreció en la alimentación 65%, hábitos nocivos 70%, aspectos generales un 86% y actividad física 48%. Conclusión: Esta investigación remarca la importancia de la educación permanente y en etapas tempranas sobre los factores de riesgo de Infarto Agudo de Miocardio. La población en estudio presento un nivel alto de información. No obstante, la educación debe fomentarse para llegar al 37% restante que obtuvo niveles inferiores[AU]

To determine the level of information on risk factors for acute myocardial infarction in outpatients attending a health institution in the province of Corrientes in 2021. Methodology: Quantitative descriptive, cross-sectional and observational study. Sample obtained by simple random probabilistic sampling made up of 108 patients who attended the Diabetes, Blood Pressure and Day Hospital clinics. A validated questionnaire was applied by means of a pilot test. Variables: age, sex, level of education, level of information on food, harmful habits, physical activity and general questions. Te results were dumped into a matrix designed in Excel program. Results: Te population under study presented a median age of 43, mode 39 and a predominance of males 56%, over females 44%, on the level of education the complete secondary prevailed 19% followed by incomplete primary 15%. Addressing the levels of information on risk factors for acute myocardial infarction, high levels predominated in all the variables worked on, obtaining a high general level of information of 82%, disaggregating 65%, harmful habits 70%, aspects general 86% and physical activity 48%. Conclusion: Tis research highlights the importance of permanent education and in early stages about the risk factors of Acute Myocardial Infarction. Te study population presented a high level of information. However, education should be encouraged to reach the remaining 37% who obtained lower levels[AU]

: Determinar o nível de informação sobre fatores de risco para infarto agudo do miocárdio em pacientes ambulatoriais atendidos em uma instituição de saúde na província de Corrientes em 2021. Metodologia: Estudo quantitativo descritivo, transversal e observacional. Amostra obtida por amostragem probabilística aleatória simples composta por 108 pacientes atendidos nas clínicas de Diabetes, Pressão Arterial e Hospital Dia. Foi aplicado um questionário validado por meio de teste piloto. Variáveis: idade, sexo, escolaridade, nível de informação sobre alimentação, hábitos nocivos, atividade física e questões gerais. Os resultados foram despejados em uma matriz projetada no programa Excel. Resultados: A população em estudo apresentou mediana de idade de 43 anos, moda 39 e predominância do sexo masculino 56%, sobre o feminino 44%, no nível de escolaridade o ensino médio completo prevaleceu 19% seguido do ensino fundamental incompleto 15%. Abordando os níveis de informação sobre fatores de risco para infarto agudo do miocárdio, predominaram níveis elevados em todas as variáveis trabalhadas, obtendo um nível geral de informação elevado de 82%, desagregando 65%, hábitos nocivos 70%, aspectos gerais 86% e atividade física 48%. Conclusão: Esta pesquisa destaca a importância da educação permanente e precoce sobre os fatores de risco do Infarto Agudo do Miocárdio. A população do estudo apresentou um alto nível de informação. No entanto, a educação deve ser incentivada para atingir os 37% restantes que obtiveram níveis mais baixos[AU]

Tratamiento posterior a un ataque cerebrovascular con estatinas y metas de colesterol de baja densidad / Statin treatment and low density cholesterol targets in patients post stroke

RESUMEN INTRODUCCIÓN: El ACV es uno de los eventos cardiovasculares más prevalentes en el mundo, en Colombia es la segunda causa de muerte y la primera de discapacidad. Uno de los factores de riesgo más importantes para tener en cuenta es el control del colesterol, la reducción de los niveles de C-LDL, principalmente por medio del tratamiento con estatinas y otros fármacos hipolipemiantes. MATERIALES Y MÉTODOS: En esta revisión narrativa de la literatura se ha recogido la información más relevante sobre el uso y los beneficios de este tratamiento y algunas consideraciones adicionales. CONCLUSIÓN: Los hallazgos de esta revisión demuestran el efecto protector de esta terapia cuando se consiguen reducir los niveles de C-LDL y colesterol, además, las otras terapias como ezetimiba o inhibidores de PSCK9. Por otro lado, los estudios mencionan posibles efectos beneficiosos en el contexto de ACV pero se requieren más ensayos clínicos.

ABSTRACT INTRODUCTION: Stroke is one of the most prevalent cardiovascular events in the world, in Colombia it is the second cause of death and first in disability. One of the most important risk factors to consider is cholesterol control, the reduction of LDL-C and cholesterol levels, mainly through treatment with statins and other lipid-lowering drugs. MATERIALS AND METHODS: The most relevant information on the use and benefits of this treatment and some additional considerations have been collected in this narrative review of the literature. CONCLUSION: The results of this narrative review show the protective effect of this therapy when it is possible to reduce LDL-C and cholesterol levels, in addition to other therapies such as ezetimibe or PSCK9 inhibitors. On the other hand, studies mention possible beneficial effects in the context of stroke but more clinical trials are required.

Rehabilitación neuromotora en unidades de tratamiento del ataque cerebrovascular / Neuromotor rehabilitation in stroke treatment units

RESUMEN: Introducción: El Ataque Cerebro Vascular (ACV) es la segunda causa de muerte a nivel mundial y primera causa de discapacidad en el adulto. Su complejidad requiere de una atención integral a través de un equipo multiprofesional, implementado en las denominadas Unidades de Tratamiento del Ataque Cerebrovascular (UTAC). Considerando su relevancia e impacto en el pronóstico, es fundamental conocer las acciones desarrolladas en el ámbito de la rehabilitación neuromotora en estas unidades, información que actualmente es limitada. Método: Estudio descriptivo de corte transversal, la muestra fue por conveniencia, participaron 5 kinesiólogos de establecimientos públicos de salud. La recolección de información se realizó con una encuesta en línea enfocada a las acciones que se realiza en la UTAC. El análisis de datos se realizó con STATA 15 y ATLAS TI 8.0. Resultados: El inicio y frecuencia de la rehabilitación neuromotora es variable, ocurre entre las 24 y 48 horas posterior al diagnóstico. Diariamente se realizan entre una a tres sesiones por usuario, su duración varía desde 25 a 90 minutos. Las acciones neuromotoras son de carácter integral y multiprofesional, el abordaje incluye el componente neuromotor, respiratorio y estado cognitivo. Las acciones neuromotoras incorporan técnicas de facilitación de la postura más alta lograda por el usuario y estimulación sensorial, entre otras. Conclusiones: La rehabilitación neuromotora en las UTAC de Chile muestra realidades diferentes en cuanto a la identificación, funcionamiento y la intervención neuromotora.

ABSTRACT Background: Stroke is the second leading cause of death in the world and the first cause of disability in adults. Its complexity requires comprehensive care provided by a multiprofessional team, implemented in the so-called Stroke Treatment Units (STUs). In view of their relevance and impact on the prognosis, identifying activities developed in the framework of neuromotor rehabilitation is of fundamental importance, information which, at present, is not readily available. Methods: Cross-sectional descriptive study, convenience sampling with the participation of 5 kinesiologists from public health centers in Chile. Information was collected by means of an online survey focused on the work being carried out in the STUs. Data analysis was performed using STATA 15 and ATLAS TI 8.0 software. Results: Initiation and frequency of neuromotor rehabilitation is variable and occurs between 24 and 48 hours after diagnosis. Between one and three daily sessions per user are performed and their duration varies from 25 to 90 minutes. Neuromotor activities are integral and multiprofessional; the approach includes neuromotor, respiratory and cognitive components. Neuromotor activities incorporate facilitation techniques for the most advanced user posture achieved and sensory stimulation, among others. Conclusions: Neuromotor rehabilitation in Chile´s STUs shows different realities in terms of identification, functioning and neurokinetic intervention.