Objetivo: Ejemplificar la valoración del estrés, distrés, y coping percebidos por pacientes con heridas de difícil cicatrización (HDC), atendidos en un servicio de Terapia Enterostomal: heridas, ostomias e incontinencias. Método: Estudio secundario, observacional y prospectivo de 10 pacientes adultos con HDC, atendidos entre dos a seis consultas. Fueron aplicados el Formulário de datos sociodemográficos y clínicos; el Inventario Breve del Dor (sensibilidad - BPIS e interferencia - BPII); el Instrumento de Valoración de la Herida de Bates Jensen – BWAT; y la Escala de Estrés Percebido - PSS, la cual incluye coping e distrés. Los datos fueron expresados en promedios. Resultados: Los pacientes tenían HDC principalmente en los membros inferiores, con duración de 21,2 meses; BWAT 23,7; BPIS 4; BPII 3,2. El estrés fue caracterizado por un PSS total de 28,5 puntos, con coping 16 y distrés de 16,4 puntos. En la última consulta fue identificada la diminuición de 4,3 pontos en la BWAT; 0,8 en la BPIS; 7,6 puntos en la PSS con 5,3 en el distrés. La BPII aumentó 0,7 y el coping 2,2. Conclusión: La herida parece interferir en el nivel de estrés percibido, es decir, en la dimensión biopsicosocial del paciente. El coping destaca como factor determinante en la percepción del estrés y es esencial un enfoque multidisciplinar para su gestión y para evaluar el distrés.

Objetivo: Exemplificar a avaliação do estresse, distresse e coping percebidos por pacientes com feridas de difícil cicatrização (FDC), atendidos em ambulatório de Estomaterapia. Método: Estudo secundário, observacional e prospectivo de 10 pacientes adultos com FDC, acompanhados durante duas a seis consultas. Foram utilizados Formulário de dados sociodemográficos e clínicos; Inventário Breve de Dor (sensibilidade - BPIS e interferência - BPII); Instrumento de Avaliação da Ferida da Bates Jensen – BWAT e Escala de Estresse Percebido - PSS, incluindo coping e distresse, com dados expressos em médias. Resultados: Os pacientes tinham FDC principalmente em membro inferior, com duração de 21,2 meses; BWAT 23,7; BPIS 4; BPII 3,2. O estresse foi caracterizado por PSS total de 28,5 pontos, distresse de 16,4 e coping 16. Na última consulta foi observada diminuição de 4,3 pontos na BWAT; 0,8 na BPIS; 7,6 pontos na PSS com 5,3 no distresse. A BPII aumentou 0,7 e o coping 2,2. Conclusão: A ferida parece interferir no nível de estresse percebido, ou seja, na dimensão biopsicossocial do paciente. O coping se destaca como um fator determinante na percepção do estresse e uma abordagem multidisciplinar é essencial para o seu manejo e para a avaliação do distresse.

Objective: To exemplify the stress, distress, and coping assessment perceived by patients with hard-to-heal wounds (HHW) receiving treatment in a Stomatherapy outpatient clinic. Methods: Observational, prospective secondary study involved 10 adult patients with HHW, who were followed over two to six consultations. The following tools were used: sociodemographic and clinical data form; Brief Pain Inventory (sensitivity - BPI-S and interference - BPI-I); Bates-Jensen Wound Assessment Tool (BWAT); Perceived Stress Scale (PSS), which included measures of coping and distress with data expressed as means. Results: Patients primarily had HHW located on the lower extremities, with a duration of 21.2 months; BWAT score was 23.7; BPI-S was 4; and BPI-I was 3.2. Stress was characterized by a total PSS score of 28.5 points, with a distress score of 16.4 and a coping score of 16. In the final consultation, there was a decrease of 4.3 points in BWAT; 0.8 points in BPI-S; and 7.6 points in PSS, with a 5.3 point reduction in distress. The BPI-I increased by 0.7, and coping improved by 2.2. Conclusion: The wound seems to interfere with the level of perceived stress, i.e. the patient's biopsychosocial dimension. Coping stands out as a determining factor in the perception of stress, and a multidisciplinary approach is essential for its management and assessment of distress.

ABSTRACT: The clinical case of a 50-year-old patient is presented, who comes to the consultation due to moderately intense painful symptoms of 2 days' duration located in the right posterior mandibular area, accompanied by mild swelling of the mandibular angle and lymphadenopathy in the ipsilateral area. Intraoral examination revealed a partially erupted tooth 4.8 with erythema and presence of purulent discharge on the distal mucosa. Additionally, tooth 3.8 with similar clinical characteristics was identified. Imaging analysis showed osteolysis and root resorption of teeth 4.8 and 3.8, as well as lingual cortical perforation in both teeth and vestibular cortical involvement related to tooth 3.8. The initial diagnosis was chronic suppurative osteomyelitis, which was treated by excision of both lesions and associated teeth along with one week of antibiotic therapy. Histopathological analysis indicated the presence of Actinomyces clusters, thus confirming the definitive diagnosis of Actinomyces osteomyelitis. Consequently, the therapeutic approach with antibiotic therapy was extended for 1 month.

RESUMEN: Se presenta el caso clínico de un paciente de 50 años de edad el cual acude a la consulta debido a sintomatología dolorosa de intensidad moderada de 2 días de evolución ubicada en zona mandibular posterior derecha, acompañado de edema discreto de ángulo mandibular y linfadenopatía en zona ipsilateral. Al examen intraoral se observó diente 4.8 semierupcionado con eritema y presencia de exudado purulento en mucosa distal, además, se pesquisó diente 3.8 con características clínicas similares. Al análisis imagenológico, se observa osteolisis y rizálisis de diente 4.8 y 3.8, además de perforación de cortical lingual en ambos dientes y cortical vestibular en relación al diente 3.8. El diagnóstico inicial fue de osteomielitis crónica supurativa, el cual fue tratado mediante exéresis de ambas lesiones y dientes asociados en conjunto de antibioterapia durante 1 semana. El análisis histopatológico indicó la presencia de conglomerados de Actinomyces, por lo tanto, el diagnóstico definitivo fue de osteomielitis por Actinomyces. En consecuencia, la conducta terapéutica con antibioterapia fue prolongada durante 1 mes.

Resumo: Introdução: As quedas são uma preocupação importante entre os idosos hipertensos, pois podem causar lesões graves e reduzir a qualidade de vida. Compreender o impacto do uso de medicamentos anti-hipertensivos no risco de queda e no medo de cair é fundamental para melhorar o cuidado ao paciente e as estratégias de prevenção de quedas. Objetivo: Analisar os fatores associados ao risco e medo de cair em idosos hipertensos em tratamento medicamentoso. Métodos: Estudo quantitativo e transversal, realizado com 70 idosos hipertensos de um centro de especialidades médicas do município de Sapezal, Brasil. Foram aplicados o teste Timed Up and Go e a Escala de Eficácia de Quedas. Os dados foram analisados pelo teste qui-quadrado, regressão logística binária e teste de Hosmer-Lemeshow. Um nível de significância de p < 0,05 foi considerado. Resultados: Idosos que utilizam dois ou mais medicamentos anti-hipertensivos apresentam chances significativamente maiores de risco de queda (48,167 vezes) e medo de cair (15,007 vezes) em comparação com aqueles que utilizam apenas um medicamento. Além disso, aqueles que fazem uso de medicamentos por um a quatro anos e por mais de quatro anos têm 6,679 e 13,444 vezes mais chances de experimentar medo de cair com quedas recorrentes, em comparação com aqueles que os utilizam por menos de um ano. Conclusão: Há uma associação entre a quantidade e a duração do uso de medicamentos com maior risco e medo de cair em idosos hipertensos

Abstract: Introduction: Falls are a major concern among hypertensive older adults, as they can lead to severe injuries and reduced quality of life. Understanding the impact of antihypertensive medication use on fall risk and fear of falling is essential for improving patient care and fall prevention strategies. Objective: To investigate the associations between antihypertensive medication use and the risk and fear of falling in hypertensive older adults. Methods: A quantitative and cross-sectional study was conducted with 70 hypertensive older adults from a medical specialty center in the municipality of Sapezal, Brazil. The Timed Up and Go test and the Falls Efficacy Scale were applied. Data were analyzed using the Chi-square test, binary logistic regression, and the Hosmer-Lemeshow test. A significance level of p < 0.05 was considered. Results: Older adults using two or more antihypertensive medications have significantly higher chances of fall risk (48.167 times) and fear of falling (15.007 times) compared to those using only one medication. Additionally, those taking medications for one to four years and over four years have 6.679 and 13.444 times greater chances of experiencing fear of falling with recurrent falls compared to those using them for less than one year. Conclusion: There is an association between the quantity and duration of medication use with a higher risk and fear of falling in hypertensive older adults.

Resumen: Introducción: Las caídas son una preocupación importante entre los adultos mayores hipertensos, ya que pueden provocar lesiones graves y una reducción en la calidad de vida. Comprender el impacto del uso de medicamentos antihipertensivos en el riesgo de caída y el miedo a caer es fundamental para mejorar la atención al paciente y las estrategias de prevención de caídas. Objetivo: Investigar las asociaciones entre el uso de medicamentos antihipertensivos y el riesgo y miedo a caer en adultos mayores hipertensos. Métodos: Estudio cuantitativo y transversal, realizado con 70 personas mayores hipertensas de un centro de especialidades médicas del municipio de Sapezal, Brasil. Se aplicaron la prueba Timed Up and Go y la Escala de Eficacia de Caídas. Los datos se analizaron mediante la prueba de chi-cuadrado, regresión logística binaria y la prueba de Hosmer-Lemeshow. Se consideró un nivel de significancia de p < 0.05. Resultados: Las personas mayores que utilizan dos o más medicamentos antihipertensivos tienen significativamente mayores probabilidades de riesgo de caída (48,167 veces) y miedo de caer (15,007 veces) en comparación con aquellas que utilizan solo un medicamento. Además, aquellas que usan medicamentos durante uno a cuatro años y más de cuatro años tienen 6,679 y 13,444 veces más probabilidades de experimentar miedo de caer con caídas recurrentes, en comparación con aquellas que los usan por menos de un año. Conclusión: Existe una asociación entre la cantidad y la duración del uso de medicamentos con un mayor riesgo y miedo de caer en personas mayores hipertensas

BACKGROUND: Orthotic management of trigger finger refers to the use of splints to immobilise affected joints. The prevalence of trigger finger and the assessment and treatment practices utilised by occupational therapists for this affliction in South Africa, are not yet documented. AIM: To explore occupational therapists' orthotic management for clients with trigger finger in KwaZulu-Natal, and the factors influencing the therapists' decision when prescribing orthoses. METHODS: A quantitative cross-sectional study design was implemented with a sample size of 102 via a stratified random sampling approach. A survey questionnaire was administered. Data were coded using frequencies and then descriptively analysed using SPSS. RESULTS: Findings indicated that trigger finger is common in clinical settings and the majority (99%) of the occupational therapists use splints when managing trigger finger and as a first line of treatment (69.9%). The joint-blocking splint is preferred by 96.6% of the participants with the MCP joint-blocking splint being favoured by 55.0%. The most considered factors when deciding on the splint type are clinical presentation (99.1%), and the client's occupation (92.4%), and the most preferred measures of the effectiveness of treatment are pain (97.1%) and range of motion (97%). CONCLUSION: The study has demonstrated that the inconsistencies noted in global research also apply in KwaZulu-Natal. Therefore, further investigations on the effectiveness of splinting and a guide on deciding on splint type as well as appropriate outcome measures are necessary to ensure that clients receive optimal care through evidence-informed practice. IMPLICATIONS FOR OCCUPATIONAL THERAPY PRACTICE • This study informs further understanding of the current assessment prior to splinting and treatment practices that occupational therapists in the South African context provide for their clients with trigger finger. • The study demonstrates that irrespective of the participant's level of experience and their clinical settings, the considerations when deciding on splint types remain the same. • The results are consistent with available literature particularly with which splint type to issue. However, the development for a guide regarding the orthotic management of trigger finger covering aspects like the splint regime and the recommendations of exercises is vital as discrepancies emerged largely from these areas. The type of exercises, stages at which they may be introduced, duration and frequency should be considered for deeper engagement. • The development of this protocol will ensure consistency of treatment and evidence-informed practice.

BACKGROUND: COVID-19 infection has a variable clinical presentation, with a small subgroup of patients developing severe disease, requiring intensive care with mechanical ventilation, with an increased mortality rate. South Africa (SA) has experienced multiple waves of this pandemic, spanning the pre-vaccine and vaccine periods. The method and initiation of treatment is a debated topic, changing according to evolving research and the literature. The present study investigated the use of high-dose intravenous immunoglobulin (IVIg) as a salvage therapy after initial medical treatment failure OBJECTIVES: To compare disease progression among critically ill COVID-19 pneumonia patients receiving IVIg therapy with that in patients receiving standard of care (SoC), in respect of inflammation, organ dysfunction and oxygenation METHODS: This was a single-centre, retrospective study of patients admitted to the intensive care unit (ICU) at Chris Hani Baragwanath Academic Hospital, Johannesburg, SA, during the pre-vaccine COVID-19 pandemic. Demographics, inflammatory markers (C-reactive protein (CRP)), organ function (Sequential Organ Failure Assessment (SOFA) score), oxygenation (ratio of partial pressure of oxygen in arterial blood to fraction of inspiratory oxygen (P/F ratio)), overall mortality and complications (nosocomial infections and thromboembolism) were recorded and compared RESULTS: We included 113 eligible patients in the study. The IVIg cohort had a significantly lower initial P/F ratio than the SoC cohort (p=0.01), but the change in P/F ratio was similar (p=0.54). Initial CRP and changes in CRP were similar in the two groups (p=0.38 and p=0.75, respectively), as were initial SOFA score and changes in SOFA score (p=0.18 and p=0.08, respectively) and vasopressor dose on day 0 and day 5 (p=0.97 and p=0.93, respectively). Duration of mechanical ventilation did not differ significantly between the IVIg group and the SoC group (p=0.13). There were no significant differences in measured complications between the two groups. On univariate analysis, the relative risk of death was 1.6 times higher (95% confidence interval (CI) 1.1 - 2.3) in the IVIg group; however, a logistical regression model demonstrated that only a higher P/F ratio (odds ratio (OR) 0.991; 95% CI 0.983 - 0.997) and higher mean airway pressure (OR 1.283; 95% CI 1.026 - 1.604) were significantly associated with ICU mortality CONCLUSION: Use of IVIg in our study was directed at an older population, with significantly worse oxygenation. We found no evidence of adverse effects of immunoglobulin therapy; however, we found no benefit either. Only the P/F ratio and mean airway pressure independently predicted ICU mortality

Resumen Introducción: El ataque cerebrovascular (ACV) o ictus es una emergencia médica que requiere de una atención inmediata para mejorar el pronóstico del paciente. Además, necesita una adecuada identificación de las manifestaciones clínicas y disminución de los tiempos de atención y manejo para reducir las discapacidades que trae consigo. Material y métodos: Estudio observacional, y retrospectivo que usó los datos de un hospital de Colombia, del registro RES-Q y también los de la iniciativa Angels de los años 2021 y 2022. Resultados: Se registraron 287 casos, el promedio de edad fue de 67,85 años, el 51,92 % eran hombres y el 48,08 % mujeres; los factores de riesgo predominantes fueron: hipertensión arterial en un 58,88 %, diabetes en un 57,49 %, hiperlipidemia en un 5,22 % y tabaquismo en el 3,48 % de los casos; el 83,48 % eran de origen isquémico y el 16,52 % hemorrágico; las medias del tiempo fueron: inicio de síntomas y llegada al servicio 304,95 minutos, tiempo puerta-imagen 53,02 minutos y tiempo puerta-aguja 66,50 minutos. Al 20,70 % de los eventos isquémicos les realizaron trombólisis; un 69,30 % de los isquémicos ingresaron fuera del periodo de ventana y un 10 % no cumplieron con los otros criterios. Finalmente, el 8,25 % de los pacientes fallecieron. Discusión: Los avances en el tratamiento del ACV, donde el tiempo es cerebro, continúan vigentes, pues el tiempo sigue siendo una variable determinante en el resultado. En los análisis recientes, se ha determinado que el tiempo puerta-aguja debe ser inferior a 30 minutos. La escala de NIHSS ayuda a direccionar el diagnóstico y a decidir el manejo. Conclusiones: Se evidencia que los tiempos de atención están por fuera de las metas, sin embargo, se apunta a mejorar las acciones y ajustar el proceso para disminuir el tiempo en el cual se realiza la atención y el manejo indicado, según el tipo de ACV y así prevenir discapacidades futuras y secuelas que disminuyan la calidad de vida de los pacientes.

Abstract Introduction: An acute stroke is a medical emergency that requires immediate attention to improve the patient's prognosis. We need to adequately identify the clinical manifestations, reduce care and management times, and lessen the associated disabilities. Materials and methods: An observational, retrospective study using data from a hospital in Colombia from the RES-Q registry and the Angels initiative for the years 2021 and 2022. Results: We registered 287 cases, with an average age of 67.85 years. The gender distribution was 51,92 % male and 48,08 % female. The predominant risk factors. The prevalence of arterial hypertension is 58,88 %, followed by diabetes at 57,49 %, hyperlipidemia at 5,22 %, and smoking at 3,48 %. Of these, 83.48 % have an ischemic origin, while 16.52% are hemorrhagic. The average time from the onset of symptoms to arrival at the service is 304.95 minutes, while the time from door-to-image is 53.02 minutes, and the time from door-to-needle is 66.50 minutes. We performed thrombolysis on 20.70 % of the ischemic events. We admitted 69.30 % of ischemic patients outside the window period, and 10 % did not meet the other criteria. 8.25 % of patients died. Discussion: Advances in the treatment of stroke, where time is of the essence, continue to be in force, as time continues to be a determining variable in the outcome. Recent analyses have determined that door-to-needle time should be less than 30 minutes. The NIHSS scale helps to guide the diagnosis and decide on management. Conclusions: It's clear that the care times fall short of the objectives; however, the goal is to enhance the actions and modify the process to shorten the duration of care, tailor the management according to the type of stroke, and avert future disabilities and sequelae that lower patients' quality of life.

Resumen Introducción: La fractura de cadera es la causa más común de hospitalización en personas de edad avanzada, frágiles, debido a la osteoporosis y las caídas recurrentes. El 18% de las mujeres y el 6% de los hombres sufren este tipo de fractura. Se espera que el número global de estas fracturas aumente a 4,5 millones en 2050. La cirugía sigue siendo el tratamiento de elección predominante, y las guías de práctica clínica recomiendan iniciar la rehabilitación de forma precoz. Sin embargo, en muchas ocasiones, los pacientes tienen problemas para asistir a las clínicas de fisioterapia. Objetivo: Evaluar la eficacia de los programas de telerrehabilitación para pacientes operados de fractura de cadera. Materiales y Métodos: Se realizó una revisión siguiendo la normativa PRISMA. Se consultaron las bases de datos de PubMed, CINAHL, PsycINFO, SPORTDiscus, Academic Search Complete, LILACS, IBECS, CENTRAL, SciELO y WOS. Se utilizó la herramienta Cochrane para valorar el riesgo de sesgo. Resultados: Se obtuvieron 59 artículos. Tras aplicar los criterios de inclusión, quedaron 5 ensayos clínicos. La muestra total estaba formada por 282 pacientes operados de fractura de cadera. La duración total de la telerrehabilitación osciló entre 3 y 12 semanas. En todos los estudios, se comunicó la seguridad y la buena tolerabilidad. Conclusiones: La telerrehabilitación es eficaz en pacientes operados de fractura de cadera. Este método mejora la movilidad, la calidad de vida, el nivel de miedo a caerse, la ansiedad, la depresión, y favorece la recuperación del nivel de estado físico anterior a la fractura.

Abstract Introduction: Hip fracture is the leading cause of hospitalization in frail geriatric patients, due to osteoporosis and frequent falls. They affect 18% of women and 6% of men. The global number of hip fractures is expected to increase to 4.5 million by 2050. Surgery remains the predominant treatment of choice, and clinical practice guidelines recommend starting rehabilitation early. However, patients often have difficulty attending physical therapy clinics. Objective: To evaluate the effectiveness of telerehabilitation programs for patients undergoing hip fracture surgery. Materials and Methods: A review was carried out following the PRISMA guidelines. The databases of PubMed, Cinahl, PsycINFO, SPORTDiscus, Academic Search Complete, Lilacs, IBECS, CENTRAL, SciELO, and WOS were consulted. The Cochrane tool was used to assess the risk of bias. Results: 59 articles were retrieved from all databases. After applying the inclusion criteria, 5 clinical studies remained. The total sample was 282 patients operated on for hip fractures. The total duration of telerehabilitation ranged from 3 to 12 weeks. All studies showed safety and good tolerability. Conclusions: Telerehabilitation is effective in patients undergoing hip fracture surgery. This method improves mobility, quality of life, effectiveness of falls, anxiety, depression, and supports physical recovery to prefracture levels.

Resumen Introducción : Los retrasos en el tratamiento anti microbiano adecuado de las bacteriemias prolongan la estadía hospitalaria, aumentan la mortalidad e in crementan los costos. Aún hoy en día se requiere un tiempo considerable para obtener la identificación y antibiograma de los microorganismos en los hemocul tivos positivos. El objetivo fue evaluar el impacto de la implementa ción del panel BCID2 de FilmArray® (FA) sobre el tiempo de inicio de tratamientos antimicrobianos adecuados y sobre los costos potenciales de los mismos. Métodos : Estudio observacional retrospectivo de los hemocultivos positivos de pacientes hospitalizados, procesados por FA y por metodología tradicional. Se evaluaron los cambios de antimicrobianos en base a los resultados del FA. Se calcularon los días de reducción de tratamiento antimicrobiano y el ahorro potencial en el uso de los mismos, teniendo en cuenta también los costos del FA. Resultados : Se analizaron 87 episodios de bacte riemia. En 42 (48.3%) de ellos se desescaló el trata miento a antimicrobianos de menor espectro, en 7 (8%) se escaló a antimicrobianos de mayor espectro, en 8 (9.2%) se cambió el antimicrobiano sin variar el espectro y en 30 (34.5%) no se realizaron cambios con los resultados del FA. Los cambios de antimicrobianos se realizaron en promedio 2.3 días más rápido que con los métodos convencionales. Se calculó un ahorro potencial de US$ 7408. Conclusión : La implementación del panel BCID2 de FilmArray ® permitió adecuar los tratamientos antimi crobianos más rápidamente acortando la duración de los tratamientos empíricos de amplio espectro, lo cual resultó costo-efectivo.

Abstract Introduction : Delay in initiating appropriate anti microbial therapy prolongs hospitalization, increases in-hospital mortality, and raises economic costs. Cur rently, the identification and susceptibility testing of bacteria in positive blood cultures require a considerable amount of time. The objective of this study was to assess the impact of the BCID2 FilmArray® (FA) panel on the timing of appropriate antimicrobial therapy and potential anti microbial costs. Methods : This is a retrospective observational study focused on positive blood cultures in hospitalized pa tients. FA processing was conducted concurrently with routine sample processing. Changes in antibiotic treat ments based on FA results were evaluated, and the re duction in antimicrobial therapy duration and associated cost savings were calculated. Results : Eighty-seven bacteremia episodes were ana lysed. In 42 (48%) of them antimicrobial therapy was de-escalated to narrower spectrum agents, while in 7 (8%) therapy was escalated to broader spectrum anti microbials. Additionally, in 8 (9%) antimicrobials were switched without changing spectrum and in 30 (34%) no changes were made based on FA results. Antimicrobial changes were made 2.3 days faster than with routine sample processing resulting in calculated potential sav ings of US$ 7408. Conclusion : The implementation of FA facilitated a faster administration of appropriate antimicrobial therapy, leading to a reduction in the duration of broad-spectrum empirical antimicrobial therapy and subse quent economic savings.

Abstract: Observational studies have described an increase in the duration of oxygen therapy, bronchopulmonary dysplasia (BPD), and retinopathy of prematurity (ROP) in relation to the use of high-flow nasal cannula (HFNC, 2013-2016). Objective: to analyze changes in the evolution of very preterm newborns with the use of HFNC. Patients and Method: The incidence of neonatal pathologies between 2013 and 2021 was analyzed with a statistical process control. An analysis of cases (with HFNC, 2017-2021) and controls (without HFNC, 2013-2016) was performed, 1:2, matched by weight and gestational age, comparing the main neonatal morbidities and respiratory support. Univariate analysis and logistic regression were performed with the variables associated with BPD and ROP. Results: 59 cases and 116 controls. The statistical process control revealed an increase in BPD and ROP over time, which coincides with the incorporation of the HFNC and with the increase in days of oxygen therapy. The case-control analysis showed an increase in respiratory support and oxygen therapy measures and greater severity at birth, according to the Apgar and Neocosur score, in the group with HFNC. Logistic regression showed a significant association between the use of the HFNC and the risk of BPD and ROP. In addition, a longer duration of mechanical ventilation, lower birth weight, and more late sepsis were associated with BPD, and lower weight and gestational age at birth and longer duration of mechanical ventilation were associated with ROP. Conclusions: These findings require a quality improvement program to reduce BPD and ROP, seeking an adequate use of HFNC.

Resumen: Estudios observacionales han descrito aumento de duración de oxigenoterapia, displasia broncopulmonar (DBP) y retinopatía del prematuro (RDP) en relación al uso de cánula de alto flujo (CNAF). Objetivo: analizar los cambios presentados en la evolución de recién nacidos muy prematuros con el uso de CNAF. Pacientes y Método: Con control estadístico de procesos se analizó la incidencia de patologías neonatales entre el 2013 y 2021. Se realizó un análisis de casos (CNAF, 2017-2021) y controles (sin cánula, 2013-2016), 1:2, pareados por peso y edad gestacional, comparando las principales morbilidades neonatales y el soporte respiratorio. Se realizó análisis univariado y regresión logística con las variables asociadas a DBP y RDP. Resultados: 59 casos y 116 controles. El control estadístico de procesos reveló un aumento de DBP y RDP en el tiempo, que coincide con la incorporación de la CNAF y con el aumento de los días de oxigenoterapia. El análisis de casos y controles describió aumento de medidas de soporte respiratorio y oxigenoterapia y mayor gravedad al nacer, según Apgar y score Neocosur, en el grupo con CNAF. En regresión logística se encontró asociación significativa del uso de la CNAF con el riesgo de DBP y RDP. Además se asoció mayor duración de ventilación mecánica, menor peso de nacimiento y más sepsis tardía para DBP; menor peso y edad gestacional al nacer y mayor duración de ventilación mecánica para RDP. Conclusiones: Estos hallazgos requieren un programa de mejoría de calidad para disminuir la DBP y RDP, procurando un uso adecuado de CNAF.

Abstract Background The treatment for atopic dermatitis (AD) has been the focus of clinical research, and behavioral intervention is considered an indispensable treatment method. To our knowledge, no relevant meta-analysis has evaluated the effects of behavioral interventions on atopic dermatitis. Objectives To evaluate the effects of behavioral interventions on atopic dermatitis. Methods The authors searched PubMed, EMBASE, and Cochrane CENTRAL to retrieve relevant RCTs (up to Feb 2022). The search strategy involved a combination of related keywords. The Cochrane Q and I2 statistics were used to assess heterogeneity. Results Six RCTs involving seven reports with 246 patients were included. The results suggested that behavioral interventions could relieve eczema severity (correlation coefficient [r = −0.39]; p < 0.001) and scratching severity significantly (r = −0.19; p = 0.017), while not affect itching intensity (r = −0.02; p = 0.840). A sensitivity analysis confirmed the robustness of the results. Study limitations An important limitation of this study was the insufficient number of RCTs and the limited sample size. In addition, the study lacked a control group receiving a type of intervention other than the experimental protocol. Another limitation was the short duration of follow-up. Conclusions This study suggests that behavioral interventions could be effective in treating atopic dermatitis by reducing eczema and scratching severity. Additionally, habit-reversal behavioral therapy may be more effective for treating atopic dermatitis. AD (AD research method knowledge metaanalysis meta PubMed EMBASE up 2022. 2022 . 2022) keywords I heterogeneity 24 included correlation r −0.39 039 0 39 −0.39] 0.001 0001 001 −0.19 019 19 0.017, 0017 0.017 , 017 0.017) −0.02 002 02 0.840. 0840 0.840 840 0.840) size addition protocol followup. followup follow up. follow-up Additionally habitreversal habit reversal 202 2 −0.3 03 3 0.00 000 00 −0.1 01 1 0.01 −0.0 084 0.84 84 20 −0. 0.0 08 0.8 8 −0 0. −

Resumen La evaluación de los resultados del tratamiento ortodóntico ha sido estudiada en los últimos años por clínicos e investigadores a través del examen intraoral o el uso de índices, como el Grading System for Dental Casts and Panoramic Radiographs System (CRE). Se realizó una búsqueda de la literatura en diferentes bases de datos como Pubmed (MEDLINE), Embase, Lilacs, Cochrane y otras fuentes, con el uso de palabras claves y operadores booleanos. Las referencias que cumplieron los criterios de búsqueda y el examen de los investigadores fueron obtenidas en texto completo, clasificados y analizados para recopilar información de las 4 temáticas planteadas: 1. CRE (ABO/OGS) en la evaluación de la calidad de resultados, 2. CRE (ABO/OGS) y otros índices en la evaluación, 3. Implementación digital CRE (ABO/OGS), 4. Implementación regional CRE (ABO/OGS). Fueron encontrados 103 artículos, de los cuales 52 fueron seleccionados, a partir de estos se observó el uso del CRE a nivel mundial, mostrando ser una herramienta versátil en múltiples campos, como el análisis del manejo terapéutico, tipo de aparatología utilizada, medición de estabilidad, desempeño de servicios universitarios y privados, entre otras temáticas, orientadas a conocer el resultado del tratamiento ortodóntico; su uso conjunto con otros índices parece ser un complemento que permitiría analizar variables dentales, esqueléticas y faciales no contempladas. La implementación digital del CRE (ABO/OGS), OGS muestra ser una herramienta prometedora que tras ajustes puede traer ventajas en el análisis de resultados. Así mismo, se ha encontrado que el uso del CRE(ABO/OGS) dentro de las universidades ha generado la mejoría de los resultados de los tratamientos al compararse en el tiempo.

ABSTRACT In the last years, clinicians and researchers have evaluated orthodontic treatment outcomes through intraoral examination or the use of indices. One of the most frequently used indices is the Grading System for Dental Casts and Panoramic Radiographs System (CRE). A literature search was carried out in different databases such as PubMed, Embase, Lilacs, Cochrane, and other sources, through a structured strategy using keywords and Boolean operators. The references that met the search criteria and the researchers' examination were obtained in full text, classified, and analyzed to collect information on the 4 set out topics: 1. CRE (ABO/OGS) in the evaluation of the quality of results, 2. CRE (ABO/OGS) and other indices, 3. CRE (ABO/OGS) digital implementation, 4. CRE (ABO/OGS) regional implementation. 103 articles were found, of which 52 were selected. The use of CRE worldwide was observed, showing that it is a versatile tool in multiple fields, such as analysis of therapeutic management, type of equipment used, measurement stability, performance of university and private services, among other topics aimed at knowing the result of orthodontic treatment. From other part, its use along with other indices seems to be a complement that would allow analysis of dental, skeletal, and facial variables not contemplated. The digital implementation of the CRE (ABO/OGS) shows to be a promising tool that after adjustments can bring advantages in the analysis of results. Likewise, it has been found that the use of CRE (ABO/OGS) within universities has generated improvement in treatment results when compared over time.

ABSTRACT: Pemphigus vulgaris (PV) and mucous membrane pemphigoid (MMP) are bullous autoimmune diseases that reach the oral mucosa and have common clinical features. The objective of the study was to present and compare the clinical manifestations of PV and MMP and the results of applied treatments. A case series of a stomatology service from 1985 to 2018. Data collection included epidemiological data, comorbidities, medications in use, duration of symptoms before the first visit, previous treatment, symptomatology, clinical description of lesions, presumptive diagnosis, histopathological description, extraoral manifestations, final diagnosis, treatment and follow-up. The medical records of 25 patients were analysed, 19 of whom were diagnosed with MMP and 6 with PV. The female gender was prevalent in MMP (84 %) and the male gender in PV (67 %). More than 60 % of patients complained of pain at their first visit. Patients with MMP took on average 6 months to seek professional help and patients with PV, about 2 months. Desquamative gingivitis was the most common lesion (63 %) in MMP and non-gingival ulcers (67 %) in PV. Minimal therapy was effective in all cases of MMP, and in PV one individual required minimal adjuvant therapy due to worsening of the case. Patients with PV have more intense signs and oral symptoms and may need more intensive treatment than patients with MMP. The use of topical and/or systemic corticosteroids was sufficient for most cases in both diseases.

RESUMEN: Pénfigo vulgar (PV) y Penfigoide de la Membrana Mucosa (PMM) son enfermadades autoinmunes ampollosas que llegan a la mucosa oral y tienen características clínicas comunes. El objetivo de este estudio fue presentar y comparar las manifestaciones clínicas de PV y PMM y los resultados de los tratamientos aplicados. En el análisis se incluyó una serie de casos de un servicio de estomatología de 1985 a 2018. La recolección de información incluyó datos epidemiológicos, comorbilidades, medicamentos en uso, duración de los síntomas antes de la primera visita, tratamientos previos, sintomatología, descripción clínica de las lesiones, diagnóstico presuntivo, descripción histopatológica, manifestaciones extraorales, diagnóstico final, tratamiento y seguimiento. Se analizaron las historias clínicas de 25 pacientes, 19 de los cuales fueron diagnosticados de PMM y 6 de PV. El sexo feminino fue prevalente en PMM (84 %) y el sexo masculino en PV (67 %). Más del 60 % de los pacientes se quejaron de dolor durante la primera consulta. Los pacientes con PMM tardaron en promedio 6 meses en buscar ayuda profesional y los pacientes con PV, alrededor de 2 meses. La gingivitis descamativa fue la lesion más común (63 %) en PMM y las úlceras non gengivales (67 %) en PV. La terapia mínima fue efectiva en todos los casos de PMM, y en PV un individuo requirió terapia adyuvante mínima debido al empeoramiento del caso. Los pacientes con PV tienen signos y síntomas orales más intensos y pueden necesitar un tratamiento más intensivo que los pacientes con PMM. El uso de corticosteroides tópicos y/o sistémicos fue suficiente para la mayoría de los casos en ambas enfermedades.

Resumo A gastroenterite aguda (GEA) continua a ser uma das patologias mais frequentes em idade pediátrica, sendo que a rehidratação oral permanece a pedra angular do seu tratamento. O racecadotril é um fármaco antidiarreico utilizado no tratamento da diarreia aguda em crianças, dado que reduz a secreção de água e eletrólitos pelo aparelho digestivo. Apesar de poder ser considerado no tratamento da GEA, não é claro se é realmente eficaz. O objetivo deste trabalho é, através de uma revisão bibliográfica, avaliar se existe evidência que suporte o seu uso no tratamento da diarreia aguda em idade pediátrica. Foi realizada uma pesquisa de artigos publicados nos últimos 10 anos, na língua portuguesa ou inglesa, nas bases de dados MEDLINE; NICE; Cochrane Library; BMJ; CPG Infobase - Clinical Practice Guidelines; Bandolier. As palavras-chave utilizadas foram “Racecadotril”, “Child”, “Child, Preschool”, “Diarrhea” e “Gastroenteritis”. A seleção dos artigos foi feita em duplicado pelas autoras que, perante dúvidas, discutiram conjuntamente a sua inclusão/exclusão. Para a atribuição dos níveis de evidência e forças de recomendação, foi usada a escala Strenght of Recommendation Taxonomy. Obtiveram-se um total de 443 artigos, tendo, no final, sido incluídos oito artigos: três meta-análises, duas revisões, duas guidelines e uma opinião de peritos. Os estudos incluídos nesta revisão demonstraram uma redução no número e volume de dejeções, na duração da diarreia e no tempo de cura. Conclui-se que o racecadotril parece ser eficaz no tratamento da diarreia aguda e pode ser considerado em conjunto com a solução de rehidratação oral (SORT B).

Abstract Acute gastroenteritis (AGE) remains one of the most frequent diseases in pediatric age with oral rehydration being the cornerstone of its treatment. Racecadotril is an antidiarrheal drug used for the treatment of acute diarrhea in children, as it reduces the secretion of water and electrolytes by the digestive tract. Although it could be considered in the treatment of AGE, it is not clear whether racecadotril is really effective. The objective of this study is to assess whether there is evidence to support its use in the treatment of AGE in pediatrics, through a literature review. A search of articles published in the last 10 years, in Portuguese or English, was carried out in the MEDLINE databases; NICE; Cochrane Library; BMJ; CPG Infobase - Clinical Practice Guidelines; Bandolier. The keywords used were “Racecadotril”, “Child”, “Child, Preschool”, “Diarrhea” and “Gastroenteritis”. The selection of articles was made in duplicate by the authors who, when in doubt, jointly discussed its inclusion/exclusion. The Strength of Recommendation Taxonomy scale was used to assign levels of evidence and strengths of recommendation. A total of 443 articles were obtained, and in the end, eight articles were included: three meta-analyses, two reviews, two guidelines and one expert opinion. The studies included in this review demonstrated a reduction in the number and volume of stools, in duration of diarrhea, and in healing time. It is concluded that racecadotril seems to be effective in the treatment of acute diarrhea and can be considered in conjunction with the oral rehydration solution (SORT B).

RESUMEN Introducción: La creciente ocupación de la unidad de cuidados intensivos (UCI) y los avances en la medicina de cuidados críticos han dado como resultado una población de sobrevivientes en constante expansión. La discapacidad experimentada puede retrasar el regreso a las actividades laborales y modificar la dinámica familiar habitual, lo que conlleva importantes consecuencias financieras y sociales. Presentación: Trece pacientes ingresaron a la UCI de nuestro centro con requerimiento de ventilación mecánica invasiva, recibieron seguimiento en la sala de internación general hasta su externación y continuaron con un seguimiento telefónico a los tres, seis y doce meses del alta. Los datos corresponden a un subanálisis sobre calidad de vida y capacidad funcional en 101 pacientes pos-UCI (Clinical trials: NCT05149430). Conclusión: En un año, solo 4 de 10 pacientes regresaron a una situación laboral activa. La literatura reporta que el tiempo durante el cual sostienen sus nuevos trabajos es breve, y se estima que vuelvan a quedar desempleados en pocos meses. En cuanto al grupo familiar, no hemos encontrado reportes similares; sin embargo, observamos que 4 pacientes requirieron un cuidador o centro de rehabilitación a los seis meses.

ABSTRACT Introduction: The increasing admission to the intensive care unit (ICU) and advancements in critical care have resulted in an ever-expanding population of survivors. Disability can delay the return to work and change the usual family dynamics, leading to important financial and social consequences. Case presentation: Thirteen patients were admitted to the ICU of our center with a requirement for invasive mechanical ventilation, received follow-up in the general ward until discharge, and continued with telephone follow-up at three, six, and twelve months after discharge. The data pertain to a sub-analysis of quality of life and functional capacity in 101 post-ICU patients (Clinical trials: NCT05149430). Conclusion: Within one year, only 4 out of 10 patients returned to an active work situation. The literature reports that the duration for which they hold their new jobs is brief, and it is estimated that they will become unemployed again in a few months. Regarding the family group, we have not found similar reports; however, we observed that 4 patients required a caregiver or rehabilitation center at six months.

RESUMEN Objetivo: Describir las características clínicas y demográficas de sujetos con esclerosis múltiple (EM) que asisten a un instituto de rehabilitación en la Ciudad Autónoma de Buenos Aires. Materiales y métodos: Estudio observacional, descriptivo y transversal. Se incluyeron sujetos mayores de 18 años con diagnóstico de EM. Las variables demográficas fueron el sexo, la edad al momento del diagnóstico, la edad al ingreso y la posesión del Certificado Único de Discapacidad. Las variables clínicas y demográficas abarcaron los tiempos de evolución e ingreso a los servicios, así como aquellas variables clínicas consideradas de mayor impacto en la rehabilitación. Resultados: De un total de 39 sujetos, 21 (53,8 %) eran de sexo masculino. La media de edad fue de 45,5 años (DE 9,9). La mediana del tiempo de evolución de la enfermedad fue de 9 años (mín.-máx. 4-17). Además, el 67,6 % de los sujetos realizaban marcha, y la mayoría necesitaban algún dispositivo de ayuda para esta actividad. Conclusión: Se describieron algunas de las características clínicas y demográficas de los sujetos con EM que asistieron a un instituto de rehabilitación en la Ciudad Autónoma de Buenos Aires.

ABSTRACT Objective: To describe the clinical and demographic characteristics of subjects with multiple sclerosis (MS) who attend a rehabilitation center in the Autonomous City of Buenos Aires. Materials and methods: An observational, descriptive, and cross-sectional study was conducted. Subjects aged over 18 years and diagnosed with MS were included. The demographic variables were sex, age at diagnosis, age at admission, and possession of the Unique Disability Certificate. The clinical and demographic variables included the duration of the disease and admission to the services, as well as clinical variables considered to have the greatest impact on rehabilitation. Results: Out of a total of 39 subjects, 21 (53.8 %) were male. The mean age was 45.5 years (SD 9.9). The median duration of the disease was 9 years (min.-max. 4-17). Additionally, 67.6 % of the subjects were able to walk, and most required some form of assistance device for this activity. Conclusion: Some of the clinical and demographic characteristics of subjects with MS who attended a rehabilitation center in the Autonomous City of Buenos Aires were described.