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High-flow nasal cannula and non-invasive mechanical ventilation in pediatric asthma exacerbation: two-year prospective observational study in intensive care
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Delgado, Carolina S.

; García-Salido, Alberto

; García-Teresa, María Á.

; Martínez de Azagra-Garde, Amelia

; Leoz-Gordillo, Inés

; Lama Caro-Patón, Gema de

; Nieto-Moro, Montserrat

Boletín médico del Hospital Infantil de México

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Dez 2023, Volume 80 Nº 6 Páginas 355 - 360

Resumo: Es En | Texto: Es En | PDF: Es | PDF: En

Resumen Introducción: El asma es una causa frecuente de ingreso en la unidad de cuidados intensivos pediátricos (UCIP). En este, cuadro el uso de cánula nasal de alto flujo (CNAF) se ha visto extendido. En este trabajo se describe el tratamiento global en la UCIP ante el ingreso por asma en un hospital monográfico pediátrico y se evalúa la respuesta al uso de la CNAF, comparando la evolución de los pacientes con aquellos que recibieron ventilación no invasiva (VNI). Métodos: Se llevó a cabo un estudio observacional prospectivo (de octubre del 2017 a octubre del 2019). Se describieron epidemiología, clínica, tratamiento y soporte respiratorio. Para la comparación se crearon tres grupos de pacientes: 1) solo CNAF; 2) CNAF y VNI; y 3) solo VNI. Resultados: Se incluyeron 76 pacientes. La mediana de edad fue de dos años y un mes; la mediana de índice pulmonar fue 5. La mediana de ingreso en UCIP fue de tres días y de ingreso hospitalario, seis días. Los niños con solo CNAF (56/76) mostraron menos días de UCIP (p = 0.025) y no requirieron VNI (6/76). También mostraron mayor SatO2/FiO2 (saturación de oxígeno/fracción de oxígeno inspirado) (p = 0.025) y menor nivel de PCO2 (presión parcial de CO2) (p = 0.032). La VNI se utilizó primero siempre en el grupo que recibió ambas modalidades (14/76). No se encontraron diferencias epidemiológicas o clínicas entre grupos. Conclusiones: En nuestra serie, el uso de CNAF no aumentó los días de ingreso en la UCIP ni de hospital. Tampoco requirió cambio a VNI. Al ingreso, una gasometría normal y bajo requerimiento de oxígeno permitieron seleccionar a los pacientes respondedores. Se necesitan más ensayos multicéntricos clínicos aleatorizados para verificar estos datos.

Abstract Background: Asthma is a common cause of admission to the pediatric intensive care unit (PICU). We described and analyzed the therapies applied to children admitted to a tertiary PICU because of asthma. Later, we evaluated high-flow nasal cannula (HFNC) use in these patients and compared their evolution and complications with those who received non-invasive ventilation. Methods: We conducted a prospective observational study (October 2017-October 2019). Collected data: epidemiological, clinical, respiratory support therapy needed, complementary tests, and PICU and hospital stay. Patients were divided into three groups: (1) only HFNC; (2) HFNC and non-invasive mechanical ventilation (NIMV); and (3) only NIMV. Results: Seventy-six patients were included (39 female). The median age was 2 years and 1 month. The median pulmonary score was 5. The median PICU stay was 3 days, and the hospital stay was 6 days. Children with HNFC only (56/76) had fewer PICU days (p = 0.025) and did not require NIMV (6/76). Children with HFNC had a higher oxygen saturation/fraction of inspired oxygen ratio ratio (p = 0.025) and lower PCO2 (p = 0.032). In the group receiving both therapies (14/76), NIMV was used first in all cases. No epidemiologic or clinical differences were found among groups. Conclusion: HFNC was a safe approach that did not increase the number of PICU or hospital days. On admission, normal initial blood gases and the absence of high oxygen requirements were useful in selecting responders to HFNC. Further randomized and multicenter clinical trials are needed to verify these data.

https://doi.org/10.24875/bmhim.23000070

Implementación de una jornada virtual de telesalud y capacitación masiva para personas mayores chilenas y estudiantes de la salud. Impacto en la cobertura
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Gutiérrez, Myriam

; Mauro, Jorge

; Asecio, Javiera

; Acevedo, Fabrizio

; Herrada, Javiera

; Torres, Constanza

; Delgado, Carolina

; Fasce, Gerardo

Revista médica de Chile

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Fev 2023, Volume 151 Nº 1 Páginas 61 - 71

Resumo: En Es | Texto: En Es | PDF: En | PDF: Es

Background: Aging increases the vulnerability to diseases and environmental changes such as the COVID-19 pandemic. Telehealth and tele-education are vital to prevent the deleterious effects of prolonged confinement, and to train the community, and constantly rotating medical students and health professionals. Aim: To assess the perception and impact of an online course about healthy aging aimed at the community and health care professionals. Material and Methods: An open online one-day course to promote healthy aging was carried out. A cross-sectional online survey about the course was answered by 386 attendants and a knowledge test was applied to 114 people. Results: Seventy-five percent of respondents attended the course synchronously. Of these, 79% were women, 20% were older people and 53% were caregivers of an older person. All respondents acquired new knowledge and were willing to participate again. The frequency of interest about self-care is three times greater than about caring for another person, In an older person, the interest is 101 more times about self-care than caring for another person. Ninety five percent of respondents felt more active and 84% felt more accompanied. Conclusions: The course facilitated access to information on the promotion of active and healthy aging in the community with a favorable perception and a positive impact. The coverage for older people with a digital gap should be improved.

https://doi.org/10.4067/s0034-98872023000100061

Leucemia promielocítica aguda durante el embarazo: reporte de 17 casos de un país en desarrollo
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Cabrera-García, Álvaro

; Balderas-Delgado, Carolina

; Ramírez-Lozada, Tito

; Valencia-Rocha, Ubaldo Rafael

; Madera-Maldonado, Elizabeth

; Camargo-Romero, Etsel

; Pérez-Samano, Daniela

; Gallardo-Rodríguez, Adán Germán

; Olarte-Carrillo, Irma

; Ramos-Peñafiel, Christian

Ginecología y obstetricia de México

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2023, Volume 91 Nº 4 Páginas 241 - 248

Resumo: Es En | Texto: Es En | PDF: Es | PDF: En

Resumen OBJETIVO: Recopilar casos atendidos en centros oncológicos de México y reportar los tratamientos exitosos, con respuestas completas y las complicaciones del embarazo. MATERIALES Y MÉTODOS: Estudio retrospectivo de serie de casos que incluyó a pacientes con leucemia promielocítica aguda asociada con el embarazo atendidas en diferentes hospitales de la zona metropolitana de la Ciudad de México entre 1999 y 2021. RESULTADOS: Se identificaron 17 pacientes con leucemia promielocítica aguda asociada con el embarazo, con mediana de edad de 23 años (14-40 años); 7 correspondieron a madres menores de 20 años. En relación con su entorno social 9 tenían baja escolaridad, 12 se dedicaban al hogar y 13 tenían una pareja al momento de la concepción. Por último, 11 eran originarias de una zona urbana. Las pacientes atendidas entre 1999-2010 se trataron con interferón plus citarabina (7 de 17) o mediante soporte transfusional y esteroide (2 de 17), en 8 de los 17 casos el tratamiento se inició con tretinoína en combinación con quimioterapia (daunorrubicina) como tratamiento de inducción. CONCLUSIONES: El tratamiento de pacientes embarazadas y con leucemia promielocítica aguda representa un reto debido al riesgo trombótico y hemorrágico. Si bien la adición de tretinoína ha modificado el pronóstico de las pacientes con esta leucemia, su indicación a las embarazadas sigue siendo motivo de controversia, sobre todo por el riesgo de teratogenicidad.

Abstract OBJECTIVE: To collect cases attended in oncology centers in Mexico and to report successful treatments, with complete responses and complications around gestation. MATERIALS AND METHODS: Retrospective case series study including patients with pregnancy-associated acute promyelocytic leukemia attended in different hospitals in the metropolitan area of Mexico City between 1999 and 2021. RESULTS: Seventeen patients with pregnancy-associated acute promyelocytic leukemia were identified, with a median age of 23 years (14-40 years); 7 corresponded to mothers younger than 20 years. In relation to their social environment, 9 had low schooling, 12 were homebased and 13 had a partner at the time of conception. Finally, 11 were originally from an urban area. Patients seen between 1999-2010 were treated with interferon plus cytarabine (7 of 17) or by transfusion support and steroid (2 of 17), in 8 of the 17 cases treatment was initiated with tretinoin in combination with chemotherapy (daunorubicin) as induction therapy. CONCLUSIONS: Treatment of pregnant patients and patients with acute promyelocytic leukemia represents a challenge due to thrombotic and hemorrhagic risk. Although the addition of tretinoin has modified the prognosis of patients with this leukemia, its indication in pregnant women remains controversial, especially because of the risk of teratogenicity.

https://doi.org/10.24245/gom.v91i4.8485

Evaluación de motivación y satisfacción en la intervención educativa “Diseño de Casos Clínico Patológicos”: estudio piloto en estudiantes de medicina
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Delgado, Carolina

; Fasce, Eduardo

; Ortiz, Liliana

; Torres, Constanza

; Neira, Camila

; Inostroza, Nadia

Revista médica de Chile

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Out 2022, Volume 150 Nº 10 Páginas 1386 - 1395

Resumo: Es En | Texto: Es En | PDF: Es | PDF: En

Background: Undergraduate Pathology training in medicine is based on modalities centered on the teacher and associated with controlled motivation, with low satisfaction with the educational process. According to the Self-determination Theory, an early participation with responsibilities in clinical practice and an educational environment that promotes autonomy and basic psychological needs satisfaction (BPNS), would generate intrinsic motivation. Aim: To develop an educational intervention based on the pathologists' workplace model, which supports a learning environment intended to the satisfaction of BPNS in medical students. To evaluate the results of the intervention on the levels of motivation and satisfaction. Material and Methods: In the first phase of the study, an educational modality focused on the student was planned, consisting of the design of a pathological clinical case (DPC), performing the specialist's steps under minimal supervision and a contextualized environment. In the second phase, the level of satisfaction (Scale of student experience) and intrinsic motivation in 3rd year medical students was evaluated. Results: After the intervention, 99 students showed high levels of satisfaction (94% of agreement) and intrinsic motivation (6.7 of 7 points), including all sub-scales. They considered that their competences had increased and assessed the intervention as useful. Conclusions: DPC is an innovative, feasible and attractive methodology for Pathology learning, with a high degree of satisfaction and intrinsic motivation. This experience can be extended to similar disciplines.

Organic Waste Bio-Based Materials for 3D Extrusion: Eggshells, Shells Sand and Coffee grains with Sodium Alginate
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Delgado, Carolina Vasco Costa

; Breuer, Rebecca Louise

; Forman, Gabriela Santos

Convergências - Revista de Investigação e Ensino das Artes

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Mai 2022, Volume 15 Nº 29 Páginas 77 - 88

Resumo: En Pt | Texto: En Pt | PDF: En | PDF: Pt

Abstract This study explores bioplastics fabrication based on alginate polymer with added glycerine as a plasticizer, creating flexibility, and organic waste was used as a filler avoiding shrinkage. Exploratory, observational and experimental, Literature Review, amongst other methods, were used within a Qualitative and Quantitative Methodology by Design through practice. The research material was documented through an open-source FabLab platform and shared with a community of researchers and future designers who want to design innovative and environmentally friendly materials to replace synthetic plastics. Fifteen different bio-based materials resulted from this experiment, applicable for varied applications. Results show that different fillers added to sodium alginate and glycerine present ample opportunities for sustainable bio-ceramics, bio-composites and bio-plastics.

Resumo Este estudo explora a fabricação de bioplásticos à base de polímero de alginato com adição de glicerina como plastificante, criando flexibilidade. Resíduos orgânicos foram usados como enchimento e reduzir o encolhimento. Foram utilizados métodos Qualitativos e Quantitativos para Design através da prática, tais como: Exploração, Observação e Experimentação, e Revisão de Literatura, entre outros. O material de pesquisa foi documentado por meio de uma plataforma FabLab de código aberto e compartilhado com uma comunidade de pesquisadores e futuros designers que desejam projetar materiais inovadores e ecológicos capazes de substituir os plásticos sintéticos. Resultaram desta experiência quinze materiais de base biológica, aplicáveis a diversas funções. Os resultados mostram que diferentes enchimentos adicionadas ao alginato de sódio e glicerina apresentam amplas oportunidades para biocerâmicas, biocompósitos e bioplásticos sustentáveis.

https://doi.org/10.53681/c1514225187514391s.29.133 27 downloads

Standardization and diagnostic utility of the Frontal Assessment Battery for healthy people and patients with dementia in the Chilean population
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Grandi, Fabrissio

; Martínez-Pernía, David

; Parra, Mario

; Olavarria, Loreto

; Huepe, David

; Alegria, Patricia

; Aliaga, Álvaro

; Lillo, Patricia

; Delgado, Carolina

; Tenorio, Marcela

; Rosas, Ricardo

; López, Oscar

; Becker, James

; Slachevsky, Andrea

Dementia & Neuropsychologia

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Mar 2022, Volume 16 Nº 1 Páginas 69 - 78

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

RESUMO. A Bateria de Avaliação Frontal (FAB) é um teste de rastreio que mede as funções executivas. Embora esse instrumento tenha sido validado em vários países, sua utilidade diagnóstica em uma população chilena ainda não foi estudada. Objetivos: (1) Adaptar a FAB para uma população chilena; (2) estudar as propriedades psicométricas da FAB em uma população chilena; (3) avaliar a influência sociodemográfica no desempenho da FAB em uma amostra de controles saudáveis; e (4) desenvolver dados normativos para este último grupo. Métodos: Um grupo controle saudável (n=344) e um grupo de pacientes com demência (n=156) foram avaliados com a versão chilena da FAB. Resultados: A FAB apresentou boa consistência interna (alfa de Cronbach=0,79) e validade aceitável com base na relação com outras variáveis. A análise fatorial mostrou a unidimensionalidade do instrumento. Diferenças significativas foram encontradas no valor total da FAB entre os grupos controle saudável e demência. Com a amostra pareada, o ponto de corte estabelecido foi de 13,5, que apresentou sensibilidade de 80,8% e especificidade de 90,4%. A análise de regressão mostrou que a escolaridade e a idade predisseram significativamente o desempenho da FAB no grupo saudável. Finalmente, os dados normativos são fornecidos. Conclusões: O presente estudo mostrou que a FAB é uma ferramenta útil para discriminar entre pessoas saudáveis e aquelas com demência. No entanto, mais estudos são necessários para explorar a capacidade do instrumento para caracterizar a síndrome disexecutiva em pessoas com demência na população chilena.

ABSTRACT. The Frontal Assessment Battery (FAB) is a screening test that measures executive functions. Although this instrument has been validated in several countries, its diagnostic utility in a Chilean population has not been studied yet. Objectives: This study aimed to (1) adapt FAB in a Chilean population; (2) study the psychometric properties of the FAB in a Chilean population; (3) assess the sociodemographic influence in the performance of the FAB in a sample of healthy controls (HC); and (4) develop normative data for this healthy group. Methods: A HC (n=344) and a group of patients with dementia (n=156) were assessed with the Chilean version of FAB. Results: FAB showed good internal consistency (Cronbach's alpha=0.79) and acceptable validity based on the relationship with other variables. Factor analysis showed the unidimensionality of the instrument. Significant differences were found in the total FAB value between the HC and dementia groups. With the matched sample, the established cutoff point was 13.5, showing a sensitivity of 80.8% and a specificity of 90.4%. Regression analysis showed that education and age significantly predicted FAB performance in the healthy group. Finally, normative data are provided. Conclusions: This study shows that FAB is a useful tool to discriminate between healthy people and people with dementia. However, further studies are needed to explore the capacity of the instrument to characterize the dysexecutive syndrome in people with dementia in the Chilean population.

https://doi.org/10.1590/1980-5764-dn-2021-0059

Consenso de leucemia mieloide aguda en México
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Arana-Luna, Luara L.

; Alvarado-Ibarra, Martha

; Silva-Michel, Luis G.

; Morales-Maravilla, Adrián

; González-Rubio, María del C.

; Chávez-Aguilar, Lénica A.

; Tena-Iturralde, María Fernanda

; Mojica-Balceras, Liliana

; Zapata-Canto, Nidia

; Galindo-Delgado, Patricia

; Miranda-Madrazo, María Raquel

; Morales-Hernández, Alba E.

; Silva-Vera, Karina

; Grimaldo-Gómez, Flavio A.

; Hernández-Caballero, Álvaro

; Bates-Martin, Ramón A.

; Álvarez-Vera, José L.

; Tepepa-Flores, Fredy

; Teomitzi-Sánchez, Óscar

; Fermín-Caminero, Denisse J.

; Peña-Celaya, José A. de la

; Salazar-Ramírez, Óscar

; Flores-Villegas, Luz V.

; Guerra-Alarcón, Lidia V.

; Leyto-Cruz, Faustino

; Inclán-Alarcón, Sergio I.

; Milán-Salvatierra, Andrea I.

; Ventura-Enríquez, Yanet

; Pérez-Lozano, Uendy

; Báez-Islas, Pamela E.

; Tapia-Enríquez, Ana L.

; Palma-Moreno, Orlando G.

; Aguilar-Luévano, Jocelyn

; Espinosa-Partida, Arturo

; Pérez-Jacobo, Luis F.

; Rojas-Castillejos, Flavio

; Ruiz-Contreras, Josué I.

; Loera-Fragoso, Sergio J.

; Medina-Coral, Jesús E.

; Acosta-Maldonado, Brenda L.

; Soriano-Mercedes, Emely J.

; Saucedo-Montes, Erick E.

; Valero-Saldana, Luis M.

; González-Prieto, Susana G.

; Nava-Villegas, Lorena

; Hernández-Colin, Ana K.

; Hernández-Alcántara, Areli E.

; Zárate-Rodríguez, Pedro A.

; Ignacio-Ibarra, Gregorio

; Meillón-García, Luis A.

; Espinosa-Bautista, Karla A.

; Ledesma de la Cruz, Cindy

; Barbosa-Loría, Diego M.

; García-Castillo, Carolina

; Balderas-Delgado, Carolina

; Cabrera-García, Álvaro

; Pérez-Zúñiga, Juan M.

; Hernández-Ruiz, Eleazar

; Villela-Peña, Atenas

; Gómez Cortés, Sue Cynthia

; Romero-Rodelo, Hilda

; Garzón-Velásquez, Katheryn B.

; Serrano-Hernández, Cristina

; Martínez-Ríos, Annel

; Pedraza-Solís, María Luisa

; Martínez-Coronel, Jorge A.

; Narváez-Davalos, Iris M.

; García-Camacho, Alinka S.

; Merino-Pasaye, Laura E.

; Aguilar-Andrade, Carolina

; Aguirre-Domínguez, Juan A.

; Guzmán-Mera, Pedro G.

; Delgado-de la Rosa, Elizabeth

; Flores López, Perla E.

; González-Aguirre, Lilia L.

; Ramírez-Alfaro, Edgar M.

; Vera-Calderón, Heidi

; Meza-Dávalos, María Lizeth

; Murillo-Cruz, Juan

; Pichardo-Cepín, Yayra M.

; Ramírez-Romero, Eva F.

Gaceta médica de México

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2022, Volume 158 Nº spe3 Páginas M1 - M51

Resumo: En Es | Texto: En Es | PDF: En | PDF: Es

Abstract Acute myeloid leukemia (AML) comprises a heterogeneous group of hematopoietic cell neoplasms of myeloid lineage that arise from the clonal expansion of their precursors in the bone marrow, interfering with cell differentiation, leading to a syndrome of bone marrow failure. AML is a consequence of genetic and epigenetic changes (point mutations, gene rearrangements, deletions, amplifications, and arrangements in epigenetic changes that influence gene expression) in hematopoietic precursor cells, which create a clone of abnormal cells that are capable of proliferating but cannot differentiate into mature hematopoietic cells or undergo programmed cell death. The diagnosis requires more than 20% myeloid blasts in the bone marrow and certain cytogenic abnormalities. Treatment will depend on age, comorbidities, and cytogenetic risk among the most frequent.

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https://doi.org/10.24875/gmm.m21000597 895 downloads

Diagnósticos frecuentes de consulta externa de medicina general de la Universidad Santo Tomás (USTA), Bucaramanga, 2015-2017
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Muñoz-Pérez, Paola A.

; Forero-Peñaranda, Estefanía

; Ortiz-Delgado, Carolina

; García-González, Daniel E.

Revista de Salud Pública

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Ago 2021, Volume 23 Nº 4 Páginas 1 -

Resumo: Es En | Texto: Es En | PDF: Es | PDF: En

RESUMEN Objetivo Determinar los diagnósticos más frecuentes de los pacientes atendidos en el servicio de consulta externa de medicina general de la Universidad Santo Tomás (USTA), seccional Bucaramanga, entre 2015 y 2017. Método Estudio descriptivo retrospectivo de los registros diarios de pacientes atendidos en el servicio médico con un N=13 892 pacientes -estudiantes, administrativos, docentes, egresados y División de Educación Abierta y a Distancia (DUAD)-. Se excluyeron 5 907 registros para un n=7 985 datos de exploración, correspondientes a pacientes que hicieron uso exclusivamente del servicio de consulta médica. Resultados 5 808 (73%) de las consultas fueron realizadas por mujeres y 2 177 (27%) hombres; jóvenes entre 19 y 26 años (60,9%), estudiantes de pregrado (71,8%), de odontología (29,6%) y derecho (26,5%), atendidos por enfermedades del aparato respiratorio (16,4%), con afectaciones más frecuentes a adolescentes (15,4%) y jóvenes (17,2%). La rinofaringitis aguda fue el principal diagnóstico CIE-10. Los jóvenes consultaron por diarrea y gastroenteritis de presunto origen infeccioso (6,7%); los adultos (5,7%) y docentes (6,1%), por cervicalgia, y el personal administrativo, por infección viral no especificada (5,7%). Conclusiones La población atendida en consulta médica de la USTA entre 2015 y 2017 fueron principalmente mujeres y jóvenes entre 19 a 26 años. Las enfermedades transmisibles como las enfermedades del aparato respiratorio fueron más frecuentes que las enfermedades crónicas no transmisibles, principalmente la rinofaringitis aguda, enfermedad de alta transmisibilidad en comunidad. Las mujeres, adolescentes y estudiantes de pregrado, fueron atendidos en consulta por consejo y asesoramiento sobre la anticoncepción, lo que coincide con la Encuesta Nacional De Demografía y Salud.

ABSTRACT Objective To determine the most frequent diagnoses of the patients treated in primary medical care services of the Santo Tomás University (USTA, by its initials in Spanish), Bucaramanga section, between 2015 and 2017. Method A retrospective descriptive study of the daily records of patients treated in primary medical care services with an N=13 892 patients -students, administrative workers, professors, graduates, and Open and at Distance Education Division (DUAD, by its initials in Spanish)-. 5 907 records were excluded for a n=7 985 scan data corresponding to patients who used the medical consultation service exclusively. Results 5 808 (73%) of the consultations were conducted by women and 2 177 (27%) by men; young people between 19 and 26 years (60.9%), undergraduate students (71.8%), in dentistry (29.6%) and law (26.5%), people treated for respiratory diseases (16.4%), affected adolescents (15.4%) and young people (17.2%) more frequently. Acute rhinopharyngitis was the main diagnosis ICD-10. Young people consulted for diarrhea and gastroenteritis of suspected infectious origin (6.7%); adults (5.7%) and professors (6.1%), for neck pain, and administrative workers, for unspecified viral infection (5.7%). Conclusions The population who attended medical consultation of the Santo Tomás University in Bucaramanga throughout 2015-2017 were mainly women and young people between 19 and 26 years. Communicable diseases such as respiratory diseases were more frequent than chronic noncommunicable diseases, mainly acute rhinopharyngitis, a disease of high transmissibility in the community. Women, adolescents, and undergraduate students were treated in consultation for contraceptive counseling, which coincides with the National Demography and Health Survey.

https://doi.org/10.15446/rsap.v23n4.87943

Embarazo y COVID-19. Consideraciones en la práctica de la hematología
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Balderas-Delgado, Carolina

; Cabrera-García, Álvaro

; Baptista-González, Héctor A.

Gaceta médica de México

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2021, Volume 157 Supl. 3 Páginas S112 - S119

Resumo: En Es | Texto: En Es | PDF: En | PDF: Es

Abstract Coronavirus disease 2019 (COVID-19) in a vulnerable population, such as the pregnant woman, fetus, and newborn, requires an establishment of effective and safe strategies focused on the safety of the mother-child binomial. The objective of this report is to present the results of the review of secondary information sources (meta-analysis and systematic review), of the state of the art in the advancement of knowledge of the disease due to COVID-19 during pregnancy. Different reports have insisted that maternal mortality from COVID-19 is low. However, the maternal mortality ratio (MMR) increased from 30.9 to 45.5 deaths per 100,000 births, that is, it showed an increase of 36.32% compared to the same week of 2019. Due to its unprecedented condition and the particular behavior of the COVID-19 disease during the perinatal period, the generation of new data, its integration into accessible information and its epidemiological clinical analysis will inevitably provide new evidence that must be integrated into clinical management and practice. But the issue is not limited to COVID-19, the increase in MMR is 24% for maternal obstetric hemorrhage, 20% for hypertensive disease, and 28.5% for puerperal sepsis. There is no characteristic hematological behavior and the appearance of thrombotic or hemorrhagic complications in the patient with COVID-19, without clinical characteristics similar to those seen in her non-pregnant peers. The global increase in all causes of maternal mortality are not exclusive to COVID-19, which exposes the deficiencies of the health system in terms of primary health care, prenatal surveillance, family planning, among other programs; additional to the impact of COVID-19. The redesign of public policies in terms of primary health care for the entire population is an urgent need, particularly for pregnant women.

Resumen La enfermedad por coronavirus 2019 (COVID-19) en una población vulnerable, como es el caso de la mujer embarazada, feto y recién nacido, obliga a establecer estrategias efectivas y seguras centradas en la seguridad del binomio madre-hijo. El objetivo del presente reporte es presentar los resultados de la revisión de las fuentes de información secundaria (metaanálisis y revisión sistemática) del estado del arte en el avance del conocimiento de la COVID-19 durante el embarazo. En diferentes reportes se ha insistido en que la mortalidad materna por COVID-19 es baja. Sin embargo, la razón de mortalidad materna (RMM) aumentó de 30.9 a 45.5 defunciones por cada 100,000 nacimientos, es decir, mostró un incremento del 36.32% respecto a la misma semana del 2019. Pero el tema no se limita a la COVID-19, el aumento en la RMM es del 24.% para hemorragia materna, del 20% para la enfermedad hipertensiva y del 28.5% para sepsis puerperal. Sin embargo, por su naturaleza de condición inédita y el comportamiento particular de la COVID-19 durante el periodo perinatal, la generación de nuevos datos, su integración a información accesible y su análisis clínico epidemiológico inevitablemente proporcionarán nuevas evidencias que deberán integrarse a la gestión y práctica clínica. No existe un comportamiento hematológico característico o de las complicaciones trombóticas o hemorrágicas de la paciente con COVID-19, son características clínicas similares a las que se presenta en sus pares sin embarazo. El aumento global en todas las causas de mortalidad materna no son exclusivas de la COVID-19, lo que expone las deficiencias del sistema de salud en términos de atención primaria de la salud, vigilancia prenatal y planificación familiar, entre otros programas más; adicional al impacto de la COVID-19. Es una necesidad imperiosa el rediseño de las políticas públicas en términos de atención primaria para la salud a toda la población, en particular para las mujeres embarazadas.

https://doi.org/10.24875/gmm.m21000486 55 downloads

10.

El sonido salsero del Grupo Niche: un proyecto musical translocal
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Ochoa, Juan Sebastián

; Zapata, Carlos Andrés

; Santamaría-Delgado, Carolina

Revista musical chilena

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Dez 2020, Volume 74 Nº 234 Páginas 175 - 197

Resumo: En Es | Texto: En Es | PDF: En | PDF: Es

Grupo Niche is undoubtedly the Colombian salsa band with greater national and international recognition. It was founded in Bogotá in 1979 by chocoan composer Jairo Varela (1949-2012), who throughout his life was its director and the composer of almost all their work. In 1982 the band moved to Cali, and in the surroundings of the Cali salsa movement the band grew and consolidated, generating an association between them and the city. Despite the relevance of Afro populations and their musical practices in the Cali society, until now little has been done to analyze in depth the musical proposal of groups such as Grupo Niche. The present text seeks to fill this gap through the description and rigorous analysis of the musical elements that are present in their work and making questions about the processes and contexts of its creation. The question that guides the analysis refers to the relationship between the musical proposal of the Niche Group and the traditional music of the Colombian Pacific, and what this tells us about the aesthetic and politics of the group.

El Grupo Niche es sin duda la agrupación de salsa colombiana con mayor reconocimiento a nivel nacional e internacional. Fue fundado en Bogotá en 1979 por el compositor chocoano Jairo Varela (1949-2012), quien durante toda su vida fue su director y el compositor de casi toda su obra. En 1982 la orquesta se trasladó a Cali, y en el entorno del movimiento salsero caleño la agrupación creció y se consolidó, generando una asociación entre la orquesta y la ciudad. A pesar de la relevancia de las poblaciones afro y de sus prácticas musicales en la sociedad caleña, hasta ahora se ha hecho poco por analizar en profundidad la propuesta musical de agrupaciones como el Grupo Niche. El presente texto busca subsanar este vacío mediante la descripción y el análisis riguroso de los elementos musicales que componen la obra y realizando preguntas en torno a los procesos y contextos de su creación. La cuestión que orienta el análisis se refiere a la relación entre la propuesta musical del Grupo Niche y las músicas tradicionales del Pacífico colombiano, y lo que nos dice acerca de la apuesta estética y política de la agrupación.

658 downloads

11.

Hipoacusia como factor de riesgo para demencia
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Wimmer del Solar, Jonathan

; Delgado, Carolina

; Torrente, Mariela C.

; Délano, Paul H.

Revista médica de Chile

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Ago 2020, Volume 148 Nº 8 Páginas 1128 - 1138

Resumo: En Es | Texto: En Es | PDF: En | PDF: Es

In the last decades, there has been an increase in life expectancy in the world, with the consequent modification in the proportion of adults over 60 years. This is accompanied by an increase in pathologies for which aging is the main risk factor, such as dementia and hearing loss, which profoundly affect the quality of life of individuals and their family and impact health system costs. Given the lack of disease-modifying treatments for dementia, the study of mechanisms to prevent its occurrence has become a world priority. In the year 2017, the Lancet “Commission for dementia prevention, intervention, and care” proposed a model, in which hearing loss emerged as a new modifiable risk factor for the development of dementia. This result undoubtedly has important consequences for the understanding the multifactorial nature of dementia, our daily clinical practice and public policies aimed at its prevention and treatment. In this article, we review the current evidence supporting the association between dementia and hearing loss, discussing the available strategies for prevention, detection and treatment of hearing loss and its possible impact on the natural course of dementia. A flow chart for the clinical management of different subgroups of patients is proposed.

1345 downloads

12.

El Kairós griego: cómo y cuándo decirle al paciente o a los padres lo que sospechamos
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Solé Delgado, Carolina

; Fabra GarridoCelia, Celia

; Bonet de Luna, Concepcióna

Pediatría Atención Primaria

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Set 2018, Volume 20 Nº 79 Páginas 261 - 267

Resumo: En Es | Texto: En Es | PDF: En | PDF: Es

Abstract Delivering bad news is increasingly relevant for the medical community. In our clinical practice we confront patients and their parents with diagnoses, processes and treatments, without realizing that they can be facing radical changes in their lives. This article aims to answer how and when communicate to our patients or their parents that we suspect that something is not right. To accomplish this goal we will work with two clinical cases. We will explore their circumstances. We will investigate the stages of communication and the factors involved in the process (Buckman stages). We will analyze why we do it wrong and how to do it better. We´ll conclude with a decalogue that will serve as a quick guide in these situations.

Resumen La comunicación de malas noticias es un tema importante para la comunidad médica. En nuestra práctica clínica diaria estamos informando a nuestros pacientes y sus padres sobre diagnósticos, procesos y tratamientos, sin darnos cuenta de que pueden suponer un cambio radical en sus vidas. En este artículo se pretende contestar a cómo y cuándo decirle al paciente o a los padres que sospechamos que algo no está bien. Para ello, trabajamos con dos casos clínicos reales. Exploramos sus circunstancias, investigamos las etapas de la comunicación y los factores que influyen en ella (etapas de Buckman). Analizamos por qué lo hacemos mal y cómo deberíamos hacerlo mejor. Concluimos con un decálogo resumen que nos sirva de guía rápida en estas situaciones.

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13.

Utility of the Neuropsychiatric Inventory Questionnaire (NPI-Q) in the assessment of a sample of patients with Alzheimer's disease in Chile
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Musa, Gada

; Henríquez, Fernando

; Muñoz-Neira, Carlos

; Delgado, Carolina

; Lillo, Patricia

; Slachevsky, Andrea

Dementia & Neuropsychologia

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Jun 2017, Volume 11 Nº 2 Páginas 129 - 136

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

RESUMO O Questionário de Inventário Neuropsiquiátrico (NPI-Q) é um instrumento baseado em informantes que mede a presença e a gravidade de 12 Sintomas Neuropsiquiátricos (NPS) em pacientes com demência, bem como o sofrimento do informante. Objetivo: Avaliar as propriedades psicométricas do NPI-Q e a prevalência de NPS em pacientes com doença de Alzheimer (DA). Métodos: Foram avaliados 53 pacientes com DA. Eles foram divididos em dois grupos diferentes: AD leve (n=26) e AD moderado (n=27). A validade convergente foi estimada correlacionando os resultados do NPI-Q com os escores do Inventário Neuropsiquiátrico (NPI) e um teste de eficiência cognitiva global (Addenbrooke's Cognitive Examination - Revised - ACE-R). A confiabilidade do NPI-Q foi analisada pelo cálculo da sua consistência interna. A prevalência de NPS foi estimada com NPI e NPI-Q. Resultados: Foram observadas correlações positivas e significativas entre NPI-Q, NPI e ACE-R (r=0,730; p<0,01 e 0>315; p<0>05). O instrumento apresentou um nível adequado de confiabilidade (alfa de Cronbach=0J83). Os NPS mais prevalentes foram apatia/indiferença (62,3%) e disforia/depressão (58,5%). Conclusão: O NPI-Q apresenta indicadores de validade e confiabilidade aceitáveis em pacientes com DA, o que indica que é um instrumento adequado para a avaliação rotineira de NPS na prática clínica.

ABSTRACT The Neuropsychiatric Inventory Questionnaire (NPI-Q) is an informant-based instrument that measures the presence and severity of 12 Neuropsychiatric Symptoms (NPS) in patients with dementia, as well as informant distress. Objective: To measure the psychometric properties of the NPI-Q and the prevalence of NPS in patients with Alzheimer's disease (AD) in Chile. Methods: 53 patients with AD were assessed. Subjects were divided into two different groups: mild AD (n=26) and moderate AD (n=27). Convergent validity was estimated by correlating the outcomes of the NPI-Q with Neuropsychiatric Inventory (NPI) scores and with a global cognitive efficiency test (Addenbrooke's Cognitive Examination - Revised - ACE-R). Reliability of the NPI-Q was analysed by calculating its internal consistency. Prevalence of NPS was estimated with both the NPI and NPI-Q. Results: Positive and significant correlations were observed between the NPI-Q, the NPI, and the ACE-R (r=0.730; p<0.01 and 0.315; p<0.05 respectively). The instrument displayed an adequate level of reliability (Cronbach's alpha=0.783). The most prevalent NPS were apathy/indifference (62.3%) and dysphoria/depression (58.5%). Conclusion: The NPI-Q exhibited acceptable validity and reliability indicators for patients with AD in Chile, indicating that it is a suitable instrument for the routine assessment of NPS in clinical practice.

https://doi.org/10.1590/1980-57642016dn11-020005 4146 downloads

14.

Adherencia al Tratamiento en Rehabilitación Cardíaca: Diseño y Validación de un Programa de Intervención Biopsicosocial
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ROCHA-NIETO, LILIA MERCEDES

; HERRERA-DELGADO, CAROLINA

; VARGAS-OLANO, MARCO ORLANDO

Revista Colombiana de Psicología

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Jun 2017, Volume 26 Nº 1 Páginas 61 - 81

Resumo: Es En Pt | Texto: Es En Pt | PDF: Es | PDF: En | PDF: Pt

Resumen El estudio pretendió el diseño y validación de contenido de un programa de intervención biopsicosocial para mejorar la adherencia al tratamiento (AT) en pacientes en rehabilitación cardiaca (RC) durante la fase no supervisada por profesionales de la salud. El diseño incluyó la revisión de literatura científica y la información de tres grupos focales: expertos (5), pacientes (6) y familiares y/o cuidadores (5). El programa está sustentado en el concepto de autorregulación y basado en el modelo HAPA (Health Action Process Approach); la estructura contiene sesiones educativas y psicológicas, así como ejercicios transversales y actividades de seguimiento. La validación se realizó con seis jueces expertos, quienes calificaron los componentes: objetivos, actividades, metodología y recursos. Esta evaluación reveló índices de validación de contenido (IVC) excelentes (1) y buenos (0,83), según parámetros de Lynn (1986). Se concluyó que es una intervención clara, pertinente, suficiente y coherente, útil para el psicólogo que integra los equipos interdisciplinarios sanitarios, lo cual mejora el beneficio para los pacientes.

Abstract The study aimed to validate the design and content of a biopsychosocial intervention program to improve adherence to treatment (AT) by patients in cardiac rehabilitation (CR) when they are not supervised by health professionals. A review of scientific literature was performed and information from three focus groups: experts (5), patients (6) and family and / or caregivers (5). The program is based on the concept of self-regulation and based on the HAPA model (Health Action Process Approach); the structure included educational and psychological sessions, as well as cross exercises and monitoring activities. Validation was performed by six expert judges, who qualified the following components: objectives, activities, methodology and resources. This assessment revealed excellent (1) and good (0.83) content validation indexes (CVI) in accordance with Lynn parameters (1986). It was concluded that the program is clear, relevant, adequate and coherent. Besides, it is useful for health psychologists who work to interdisciplinary teams, and enhances the benefits for patients.

Resumo Este estudo pretendeu desenhar e validar o conteúdo de um programa de intervenção biopsicossocial para melhorar a aderência ao tratamento em pacientes em reabilitação cardíaca durante a fase não supervisionada por profissionais da saúde. O desenho incluiu a revisão de literatura científica e a informação de três grupos focais: especialistas (5), pacientes (6) e familiares e/ou cuidadores (5). O programa está apoiado no conceito de autorregulação e baseado no modelo Health Action Process Approach (hapa); a estrutura contém sessões educativas e psicológicas bem como exercícios transversais e atividades de seguimento. A validação foi realizada com seis juízes especializados, os quais qualificaram os componentes: objetivos, atividades, metodologia e recursos. Essa avaliação revelou índices de validação de conteúdo excelentes (1) e bons (.83), segundo parâmetros de Lynn (1986). Concluiu-se que é uma intervenção clara, pertinente, suficiente e coerente, útil para o psicólogo que integra as equipes interdisciplinares sanitárias, o que melhora o benefício para os pacientes.

https://doi.org/10.15446/rcp.v26n1.53610 2040 downloads

15.

Neoplasia de células dendríticas plasmocitoides blásticas con respuesta inicial a quimioterapia y recaída en sistema nervioso central: Caso clínico
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Contreras, Loreto

; Mercado, Loreto

; Delgado, Carolina

; Cabezas, Claudia

; Starke, Laksmi

; Romero, Mónica

; Ibieta, Fernando

; Henríquez, Mauricio

; Chandia, Mauricio

Revista médica de Chile

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Jan 2017, Volume 145 Nº 1 Páginas 115 - 120

Resumo: En Es | Texto: En Es | PDF: En | PDF: Es

Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare, clinically aggressive hematologic malignancy that most commonly manifests as cutaneous lesions with or without bone marrow involvement and leukemic dissemination. The demonstration of tumor cells with the characteristic immunophenotype with expression of CD56, generally CD4 and dendritic cell antigens (CD123, cyTCL-1, HLA-DR), in the absence of myeloid or lymphoid lineage markers is required for the diagnosis. Responses to chemotherapy are initially satisfactory, with frequent systemic and central nervous system relapses. We report a 24 year-old male with BPDCN, initially diagnosed and treated as non-Hodgkin CD4+ T-cell lymphoma, with initial complete remission who evolved with early central nervous system relapse. A second attempt of chemotherapy failed and the patient died two months later.

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