ABSTRACT Background: Dengue virus infection is an endemic disease in some regions of Peru. Most of these cases are classified as dengue without warning signs and the reported mortality is less than 1%. However, there are certain conditions associated with the disease that could increase mortality. Case report: We present the case of a 48-year-old female patient from a dengue endemic area with clinical and laboratory compatible with dengue disease with warning signs. During hospitalization, she presents hemoptysis and respiratory insufficiency, leading to death. Conclusion: It is important to recognize diffuse alveolar hemorrhage as part of dengue respiratory manifestations and to differentiate it from other infectious and non-infectious possibilities in order to provide appropriate and early management.

RESUMEN Introducción: La infección por el virus del dengue es una enfermedad endémica en ciertas regiones del Perú. La mayoría de estos casos se clasifican como dengue sin signos de alarma y la mortalidad reportada es menor de 1%. Sin embargo, existen ciertas condiciones asociadas a la enfermedad que podrían incrementar la mortalidad. Reporte de caso: Se presenta el caso de una paciente mujer de 48 años procedente de área endémica de esta infección con cuadro clínico y hallazgos laboratoriales compatibles con enfermedad por dengue con signos de alarma. Durante la hospitalización, cursa con hemoptisis e insuficiencia respiratoria produciendo su posterior fallecimiento. Conclusión : Es importante reconocer la hemorragia alveolar difusa como parte del compromiso respiratorio por dengue y diferenciarlo de otras posibilidades infecciosas y no infecciosas para poder brindar el manejo adecuado de forma temprana.

Abstract Influenza infection is a latent public health problem, affecting millions of people throughout the world, which imposes high morbidity and economic burden on the region. In Argentina, influenza‐associ ated mortality is estimated at 6/100 000 person‐years, and is higher among men ≥ 65 years old. The knowledge of the baseline characteristics and outcomes of hospitalized patients is crucial for public health officials planning interventions to address local outbreaks. Thus, in this retrospective, single-center study, performed in a high-complexity university hospital, we aimed to analyze clinical characteristics, image findings, and laboratory variables of patients with laboratory-confirmed influenza requiring hospitalization in our hospital during 2019. Cases were confirmed by real-time reverse transcription-polymerase chain reaction. One hundred and forty-three patients with influenza were hospitalized during the study period; 141 (98.6%) were infected with influenza virus type A, including 88 (61.5%) with the H1N1 subtype. The median age was 71 years (IQR 60- 82), 111 (77.6%) were older than 70 years, and 126 (88.1%) had at least one coexisting illness; 56 (39.1%) patients required intensive care unit, 16 (11.1%) invasive mechanical ventilation, and 6 (4.1%) died during hospitalization. In this study, in-hospital mortality was similar to that reported in previous series of non-pandemic influenza, even though the majority of the cases in this study were older than 70 years and had at least one coexisting illness.

Resumen La influenza es un problema latente de salud pública que afecta a millones de personas en todo el planeta e impone una alta morbilidad y carga económica para la región. En Argentina, la mortalidad asociada a la influenza se estima en 6/100 000 personas-año y es mayor entre los hombres mayores de 65 años. El conocimiento de las características clínicas y la evolución de los pacientes hospitalizados es fundamental para planificar el abordaje de los brotes locales. En este estudio retrospectivo, realizado en un hospital universitario de alta complejidad, nuestro objetivo fue analizar las características clínicas, los hallazgos de imágenes y las variables de laboratorio en 143 pacientes con influenza confirmada por laboratorio que requirieron hospitalización durante 2019. Los casos fueron confirmados mediante la reacción en cadena de la polimerasa con transcripción inversa en tiempo real. El 98.6% (n: 141) estaban infectados por influenza tipo A y 61.5% (n: 88) correspondía al subtipo H1N1. La mediana de edad fue 71 años (IQR 60-82), el 77.6% (n: 111) tenía más de 70 años y el 88.1% (n: 126) al menos una enfermedad coexistente. El 39.1% (n: 56) requirió internación en unidad de cuidados intensivos, el 11.1% (n: 16) ventilación mecánica invasiva y seis pacientes (4.1%) fallecieron durante la hospitalización. En este estudio, la mortalidad hospitalaria fue similar a la publicada en series previas de influenza no pandémica, aunque la mayoría de los pacientes eran mayores de 70 años y presentaban al menos una enfermedad coexistente.

RESUMO Objetivo: Analisar se as modificações na atenção médica em razão da aplicação dos protocolos para COVID-19 afetaram os desfechos clínicos de pacientes sem a doença durante a pandemia. Métodos: Este foi um estudo observacional de coorte retrospectiva conduzido em uma unidade de terapia intensiva clínica e cirúrgica com 38 leitos, localizada em hospital privado de alta complexidade na cidade de Buenos Aires, Argentina, e envolveu os pacientes com insuficiência respiratória admitidos à unidade de terapia intensiva no período compreendido entre março e abril de 2020 em comparação com o mesmo período no ano de 2019. Compararam-se as intervenções e os desfechos dos pacientes sem COVID-19 tratados durante a pandemia em 2020 e os pacientes admitidos em 2019. As principais variáveis avaliadas foram os cuidados respiratórios na unidade de terapia intensiva, o número de exames de tomografia computadorizada do tórax e lavados broncoalveolares, complicações na unidade de terapia intensiva e condições quando da alta hospitalar. Resultados: Observou-se, em 2020, uma redução significante do uso de cânula nasal de alto fluxo: 14 (42%), em 2019, em comparação com 1 (3%), em 2020. Além disso, em 2020, observou-se aumento significante no número de pacientes sob ventilação mecânica admitidos à unidade de terapia intensiva a partir do pronto-socorro, de 23 (69%) em comparação com 11 (31%) em 2019. Contudo, o número de pacientes com ventilação mecânica 5 dias após a admissão foi semelhante em ambos os anos: 24 (69%), em 2019, e 26 (79%) em 2020. Conclusão: Os protocolos para unidades de terapia intensiva com base em recomendações internacionais para a pandemia de COVID-19 modificaram o manejo de pacientes sem COVID-19. Observamos redução do uso da cânula nasal de alto fluxo e aumento no número de intubações traqueais no pronto-socorro. Entretanto, não se identificaram alterações na percentagem de pacientes intubados na unidade de terapia intensiva, número de dias sob ventilação mecânica ou número de dias na unidade de terapia intensiva.

Abstract Objective: To analyze whether changes in medical care due to the application of COVID-19 protocols affected clinical outcomes in patients without COVID-19 during the pandemic. Methods: This was a retrospective, observational cohort study carried out in a thirty-eight-bed surgical and medical intensive care unit of a high complexity private hospital. Patients with respiratory failure admitted to the intensive care unit during March and April 2020 and the same months in 2019 were selected. We compared interventions and outcomes of patients without COVID-19 during the pandemic with patients admitted in 2019. The main variables analyzed were intensive care unit respiratory management, number of chest tomography scans and bronchoalveolar lavages, intensive care unit complications, and status at hospital discharge. Results: In 2020, a significant reduction in the use of a high-flow nasal cannula was observed: 14 (42%) in 2019 compared to 1 (3%) in 2020. Additionally, in 2020, a significant increase was observed in the number of patients under mechanical ventilation admitted to the intensive care unit from the emergency department, 23 (69%) compared to 11 (31%) in 2019. Nevertheless, the number of patients with mechanical ventilation after 5 days of admission was similar in both years: 24 (69%) in 2019 and 26 (79%) in 2020. Conclusion: Intensive care unit protocols based on international recommendations for the COVID-19 pandemic have produced a change in non-COVID-19 patient management. We observed a reduction in the use of a high-flow nasal cannula and an increased number of tracheal intubations in the emergency department. However, no changes in the percentage of intubated patients in the intensive care unit, the number of mechanical ventilation days or the length of stay in intensive care unit.

Abstract Aim: This study aimed to compare the heart rate (HR) values and technical actions frequencies during small-sided (SSG) and generic (GG) games in women futsal players. Methods: Six futsal players (age: 20.5 ± 7.4 years, height: 163.3 ± 16 cm, body mass: 57.9 ± 22 kg, maximum rate of oxygen consumption (VO2max): 42.0 ± 9 mL.kg.min−1) performed two experimental conditions in two days separated for at least 72h of interval: (1) one set of 10 min of SSG, 3x3 players; and (2) one set of 10 min of GG, 4 (1 joker) x 4 (1 joker) players. During each experimental session, the subject's HR values were monitored every 1 min of play. Pass, shot, dribbling, driving, and disarmament were recorded during the games. Results: There was no difference between SSG and GG for HR average (p = 0.50). The HR values that were recorded at the first minute of GG were higher than SSG (p = 0.02). The HRmax in SSG and GG were equivalent to 91.9% and 90.8% of HRmax of the incremental test, respectively. Total technical actions were higher in SSG (+ 18.4%, p = 0.001) than GG. Pass was higher in the SSG (+16%; p = 0.01) in comparison to GG. Conclusion: Both models were higher than HRmax equivalent to AT velocity. The technical actions of the SSG were higher than GG, suggesting that the SSG model is a suitable technical and physiological stimulus for the development of female futsal players.

Abstract Procalcitonin guidance stimulates a reduction in the duration of antibiotic treatment in critically ill patients with a presumed bacterial infection, but its role in infections caused by multidrug-resistant bacteria has not been sufficiently explored. In this retrospective observational study, we analyzed procalcitonin curves of 32 patients with culture-confirmed ventilation-associated pneumonia (VAP) and catheter-related bloodstream infections (CRBSI) occurred during the period 11/1/2016 to 7/1/2019. Sixteen infections were caused by multidrug-resistant bacteria (10 CRBSI and 6 VAP) and other 16 by sensitive bacteria (10 CRBSI and 6 VAP). CRBSI generated by multidrug-resistant bacteria elicited significantly higher procalcitonin levels than CRBSI infections caused by sensitive bacteria (39 ± 30 μg/l vs. 10.7 ± 11 μg/l, p = 0.02). Patients with VAP caused by sensitive and multidrug-resistant bacteria elicited similar procalcitonin levels. The time to a decrease in procalcitonin level to less than 80% of the peak value or less than 0.5 μg/l upon effective antibiotic treatment was 7.2 ± 2.9 days in multidrug-resistant bacteria vs. 5 ± 1.8 days in sensitive bacteria (p = 0.03). In multidrug-resistant bacteria, the inflammatory response measured by procalcitonin is stronger and longer, even with an effective antibiotic treatment. However, the decline occurs before the conventional antibiotic scheme is completed. The potential application of antibiotic protocols guided by procalcitonin to these groups of patients grants further studies aimed to reduce exposure to antibiotics in critical multidrug-resistant infections.

Resumen La cinética de la procalcitonina es útil para reducir la duración de la antibioticoterapia en pacientes críticos, pero no se analizó su rol en infecciones por gérmenes multirresistentes. Se realizó un estudio observacional retrospectivo, analizando las curvas de procalcitonina de pacientes con neumonías asociadas a ventilación mecánica (NAVM) y bacteriemias asociadas a catéter (BAC) con rescate bacteriano durante el período 1/11/16 a 1/7/19. Se estudiaron 16 pacientes con infección por gérmenes sensibles (10 BAC y 6 NAVM) y 10 por gérmenes multirresistentes (10 BAC y 10 NAVM). Los pacientes con BAC generadas por gérmenes multirresistentes presentaron valores de procalcitonina mayores que los pacientes con BAC por gérmenes sensibles: (39 ± 30 μg/l vs. 10.7 ± 11 μg/l, p = 0.02). Los pacientes con NAVM generada por gérmenes sensibles y multirresistentes presentaron valores de procalcitonina similares. El descenso de procalcitonina a niveles 80% menores al valor máximo o menores a 0.5 μg/l (con tratamiento antibiótico efectivo) fue más veloz en pacientes con infección por gérmenes sensibles (5 ± 1.8 días vs. 7.2 ± 2.9 días, p = 0.03). En las infecciones por gérmenes multirresistentes, la respuesta inflamatoria medida por procalcitonina fue más intensa y prolongada, aun con un tratamiento antibiótico efectivo. Sin embargo, el descenso se produjo antes de que finalizaran los esquemas antibióticos convencionales. Por este motivo, se considera necesario estudiar la potencial utilidad de protocolos antibióticos guiados por procalcitonina en pacientes con infecciones por gérmenes multirresistentes para reducir la exposición a antibióticos.

Resumo O objetivo deste artigo é avaliar efeitos de um protocolo misto de exercícios físicos sobre o risco cardiovascular (RCV), qualidade de vida e presença de sintomas depressivos em idosos hipertensos. Estudo longitudinal, prospectivo e quase-experimental com 48 idosos. Desenvolveu-se um protocolo de exercícios físicos durante 16 semanas, segundo American College Sports of Medicine e foram realizadas avaliações antropométricas (peso, estatura, índice de massa corporal e circunferência da cintura) e bioquímicas (colesterol total, LDL-c, HDL-c; triglicerídeos). A média de idade foi de 66,5±4,8 anos. Os fatores de RCV frequentes foram dislipidemia (58,3%) e sedentarismo (45,8%). Após intervenção houve redução dos valores médios de colesterol total e LDL-colesterol e aumentaram níveis de HDL-colesterol. O RCV e a pontuação do escore de risco global diminuíram significativamente. A frequência de sintomas depressivos reduziu de 25% para 4,2%. Observou-se melhora nos domínios do SF-36: físico, saúde e vitalidade. O protocolo misto de exercícios físicos constituiu-se em alternativa possível, de baixo custo e eficaz na melhora do perfil lipídico e da qualidade de vida relacionada à saúde dos idosos desta pesquisa.

Abstract The scope of this article is to evaluate the effects of a mixed protocol of physical exercises on cardiovascular risk (CVR), quality of life and the presence of depressive symptoms in elderly hypertensive patients. It involved a longitudinal, prospective and quasi-experimental study with 48 elderly individuals. A physical exercise protocol was developed for 16 weeks according to American College of Sports Medicine, and anthropometric variables (weight, height, body mass index and waist circumference), as well as biochemical variables (total cholesterol, LDL-c, HDL-c; triglycerides) were evaluated. The mean age was 66.5±4.8 years. The frequent CVR factors were dyslipidemia (58.3%) and sedentary lifestyle (45.8%). After intervention, there was a reduction in mean values of total and LDL-cholesterol and increased HDL-cholesterol levels. The CVR and global risk score decreased significantly. The frequency of depressive symptoms decreased from 25% to 4.2%. An improvement was observed in SF-36 physical, health and vitality domains. The mixed protocol of physical exercises constituted a possible low cost and effective alternative in the improvement of the lipid profile and the quality of life related to the health of the elderly who participated in this research.

Resumo O objetivo deste artigo é avaliar efeitos de um protocolo misto de exercícios físicos sobre o risco cardiovascular (RCV), qualidade de vida e presença de sintomas depressivos em idosos hipertensos. Estudo longitudinal, prospectivo e quase-experimental com 48 idosos. Desenvolveu-se um protocolo de exercícios físicos durante 16 semanas, segundo American College Sports of Medicine e foram realizadas avaliações antropométricas (peso, estatura, índice de massa corporal e circunferência da cintura) e bioquímicas (colesterol total, LDL-c, HDL-c; triglicerídeos). A média de idade foi de 66,5±4,8 anos. Os fatores de RCV frequentes foram dislipidemia (58,3%) e sedentarismo (45,8%). Após intervenção houve redução dos valores médios de colesterol total e LDL-colesterol e aumentaram níveis de HDL-colesterol. O RCV e a pontuação do escore de risco global diminuíram significativamente. A frequência de sintomas depressivos reduziu de 25% para 4,2%. Observou-se melhora nos domínios do SF-36: físico, saúde e vitalidade. O protocolo misto de exercícios físicos constituiu-se em alternativa possível, de baixo custo e eficaz na melhora do perfil lipídico e da qualidade de vida relacionada à saúde dos idosos desta pesquisa.

Abstract The scope of this article is to evaluate the effects of a mixed protocol of physical exercises on cardiovascular risk (CVR), quality of life and the presence of depressive symptoms in elderly hypertensive patients. It involved a longitudinal, prospective and quasi-experimental study with 48 elderly individuals. A physical exercise protocol was developed for 16 weeks according to American College of Sports Medicine, and anthropometric variables (weight, height, body mass index and waist circumference), as well as biochemical variables (total cholesterol, LDL-c, HDL-c; triglycerides) were evaluated. The mean age was 66.5±4.8 years. The frequent CVR factors were dyslipidemia (58.3%) and sedentary lifestyle (45.8%). After intervention, there was a reduction in mean values of total and LDL-cholesterol and increased HDL-cholesterol levels. The CVR and global risk score decreased significantly. The frequency of depressive symptoms decreased from 25% to 4.2%. An improvement was observed in SF-36 physical, health and vitality domains. The mixed protocol of physical exercises constituted a possible low cost and effective alternative in the improvement of the lipid profile and the quality of life related to the health of the elderly who participated in this research.

Films were deposited from aluminum acetylacetonate (Al(acac)3) using a methodology involving reactive sputtering and low energy ion bombardment. The plasma was generated by the application of radiofrequency power to the powder containing electrode and simultaneously, negative pulses were supplied to the electrode where the substrates were attached. It was investigated the effect of the duty cycle of the pulses (Δ) on the properties of the coatings. Association of ion bombardment to the deposition process increased film thickness, structure reticulation and organic content. Ions from the deposition environment were implanted at the film-air interface or underneath it. Morphology and topography were altered depending on Δ. Considering the enhancement of Δ, it affected the flux of ions reaching the depositing interface and then the deposition rate, H content, crosslinking degree and surface microstructure. Alumina groups were detected in the infrared spectra, whereas the precipitation of amorphous alumina was confirmed by X-ray diffraction.

RESUMO O objetivo desse estudo foi avaliar o impacto da reposição hídrica com água de coco sobre o estado de hidratação e cardiovascular drift durante o exercício. Treze voluntários do sexo masculino realizaram três sessões de exercício em cicloergômetro, submetidos a formas distintas de hidratação: grupo sem água (SA); grupo com água (CA); e grupo água de coco (CAC). O estado de hidratação foi determinado por alterações percentuais na massa corporal (∆ %MC) e urina. A frequência cardíaca (FC) foi registrada para avaliar o cardiovascular drift. Houve um aumento significativo da desidratação no grupo SA (∆ %MC = - 1,43 ± 0,15), comparado aos grupos CA (∆ %MC = - 0,68 ± 0,15) e CAC (∆ % MC = - 0,70 ± 0,19). O grupo SA demonstrou aumentos significativos da FC comparado aos outros grupos. Conclui-se que a água de coco favoreceu a hidratação e a redução da FC, evitando o cardiovascular drift, mas com impacto similar à água.

ABSTRACT The purpose of this study was to evaluate the impact of fluid replacement with coconut water on the hydration status and cardiovascular drift during exercise. Thirteen male volunteers performed three sessions of exercise in bicycle ergometer, submitted to different forms of fluid replacement: no water intake (NW) group; with water intake (WW) group; and with coconut water (WCW) group. Hydration status was determined by percentage body mass changes (∆ % BM) and urine. Heart rate (HR) was recorded to evaluate the cardiovascular drift. There was a significant increase of dehydration in the NW group(∆ % BM = - 1.43 ± 0.15) compared with WW(∆ % BM = - 0.68 ± 0.15) and WCW groups(∆ % BM = - 0.70 ± 0.19). The NW group showed significant increases in HR compared to other groups. It was concluded that coconut water promotes hydration and HR reduction, preventing cardiovascular drift, but similar to water impact.

O objetivo desse estudo foi avaliar o estado de hidratação e desempenho cognitivo-motor em atletas durante uma prova de fast triathlon no calor. Doze triatletas (34 ± 2,7 anos) participaram do trabalho. O estado de hidratação foi mensurado pela perda de massa corporal (MC), coloração e gravidade específica (GE) urinárias. O desempenho cognitivo-motor foi verificado pela coordenação motora (CM) e tempo de reação simples (TRS). Após a prova houve uma diminuição significativa da MC (1,8 %; P < 0,001). Um aumento significativo entre pré e pós-competição foi observado para o índice de coloração da urina (P < 0,001) e GE (P < 0,001), respectivamente. O TRS foi melhor após a prova. Porém, demonstraram dismetria, prejudicando sua CM. Conclui-se que níveis de desidratação foram observados entre os atletas após a prova. Alterações opostas foram encontradas quanto ao desempenho cognitivo-motor. Atletas demonstraram uma maior descoordenação motora, mas melhoraram seu tempo de reação.

The purpose of this study was to evaluate the hydration status and cognitive-motor performance in athletes during a fast triathlon race in the heat. Twelve triathletes (34 ± 2.7 years) participated in the study. Hydration status was measured by body mass (BM) loss, urine color and urine specific gravity (SG). The cognitive-motor performance was determined by motor coordination (MC) and simple reaction time (SRT). There was a significant decrease of BM (1.8 %; P < 0.001). A significant increase from pre race to post race was observed in urine color (P < 0.001) and SG (P < 0.001), respectively. The SRT was faster after race. However, athletes demonstrated dysmetria, impairing MC. It was concluded that dehydration levels were observed among athletes after race. Adverse changes were found on the cognitive-motor performance. Athletes demonstrated greater motor incoordination, but improved the reaction time.

El autor ofrece un ensayo reflexivo sobre su experiencia investigativa en la realización del proyecto Historia de Bugalagrande. Describe la forma en que investigó y escribió la historia local de su terruño natal, un pueblo en el Valle del Cauca, desde el establecimiento de estancias a comienzo del siglo XVII, su transformación en hacienda y luego indivisos, hasta constituirse físicamente en un pueblo con sus calles y plazas a finales del siglo XIX. El texto referencia los apoyos teóricos, metodológicos, manejo de fuentes y la narrativa desarrollada por el autor. Las reflexiones desnudan la influencia de historiadores clásicos del marxismo inglés, la microhistoria italiana, la microhistoria mexicana e historiadores locales del Valle del Cauca. El proyecto y la experiencia se desarrollaron durante el periodo sabático del investigador.

The aim of this study is the characterization of the processes of mobbing among administration and services staff in the University of Galicia. A sample of 321 subjects was surveyed. Results show that a significant percentage of workers perceive themselves as victims of mobbing regardless the gender. The most frequent types of behaviors have to do with both the personal and the professional spheres. The victim’s causal attributions refer to aspects related to the organization and deterioration of the work climate. As main consequences of mobbing, victims point out aspects related to the psychological and emotional health -being the passive strategy (no reaction) the most used to protect themselves from these attacks.

El objetivo de este trabajo es la caracterización de los procesos de acoso psicológico entre el personal de administración y servicios de la universidad pública de Galicia. Para ello, se ha seleccionado una muestra formada por 321 personas, de las cuales un 8,7% manifiestan ser víctimas de mobbing. Los resultados señalan una incidencia semejante entre los hombres y entre las mujeres. Los tipos de comportamientos más frecuentes tienen que ver tanto con la esfera personal como con la profesional, y las atribuciones causales más señaladas por las víctimas se refieren a aspectos relacionados con la organización del centro y el deterioro del clima laboral. Las víctimas señalan como principales consecuencias del mobbing aspectos relacionados con la salud psicológica y emocional, siendo la estrategia más empleada para enfrentarse a estos ataques la pasiva, es decir, no hacer nada.

Resumo Este artigo discute a trajetória acadêmica da Antropologia no Rio Grande do Sul, Brasil, no período que vai de 1940 a 1969, Iniciada pelo padre Balduíno Rambo, botânico, teólogo e líder jesuíta local, a Antropologia no Rio Grande do Sul vai progressivamente transformando-se, de uma ênfase majoritária em arqueologia (inicialmente no molde “hard science”) para o perfil diversificado que a caracteriza a partir dos anos 70.

Abstract The purpose of the present paper is to develop the academic history of Anthropology in Rio Grande do Sul, Brazil, from 1940 to 1969, Started by father Balduíno Rambo, a botanic, theologist and remarkable Jesuit leader, the beginning Anthropology worked only in archeological studies, situation that remained unchanged until the sixties. From 1970, the Anthropology of Rio Grande do Sul will have a new profile, having his major emphasis in simbolic and cultured studies.