ABSTRACT Introduction: Overweight and obesity are public health problems worldwide. Alcoholic beverages could increase total energy intake causing an increase in body weight. However, few authors have pointed out the association between this habit and excess weight in this population. The objective of this study was to determine the association between alcohol consumption and excess weight in university students from 10 Latin American countries during the COVID-19 pandemic. Methodology: A cross-sectional and multicenter study was carried out with 4,539 university students enrolled in ten Latin American countries. To assess alcohol consumption, the question Do you consume alcoholic beverages? (1 portion 1 glass of 200 ml). Body mass index (BMI) kg/m2 was determined from self-reported weight and height. To determine if excess weight was associated with alcohol consumption, a logistic regression analysis was used, adjusted for age, sex, year of study, socioeconomic level, physical activity, and smoking. Results: Among students with normal nutritional status, 59.6% did not consume alcohol, while among those with a BMI ≥25 kg/m2 it was 55.1%. Students who consumed 2 or more servings of alcohol per day had a 2.18 times greater risk of being overweight (OR: 2.18 [95% CI: 1.26 to 3.77]), compared with those who did not consume alcohol. Conclusion: It was observed that those students who consumed more alcohol were more likely to be overweight.

RESUMEN Introducción: El sobrepeso y la obesidad son problemas de salud pública de nivel mundial. Si bien existe información respecto al consumo de alcohol en estudiantes universitarios durante la pandemia, pocos autores han señalado la asociación entre este hábito y el exceso de peso en esta población. El objetivo fue determinar la asociación entre el consumo de alcohol y el exceso de peso en estudiantes universitarios de 10 países de Latinoamérica durante la pandemia por COVID-19. Metodología: Se realizó un estudio transversal y multicéntrico con 4.539 estudiantes universitarios matriculados en diez países de América Latina. Para la valoración del consumo de alcohol se utilizó la pregunta ¿Consumes bebidas alcohólicas? (1 porción 1 vaso de 200 ml). El índice de masa corporal (IMC) se determinó a partir del peso y la altura auto informado. Para determinar si el exceso de peso (IMC ≥25 kg/m2) estaba asociado con el consumo de alcohol, se utilizó un análisis de regresión logística, ajustado por edad, sexo, año de estudio, nivel socioeconómico, actividad física y tabaquismo. Resultados: Entre los estudiantes con estado nutricional normal, un 59,6% no consumía alcohol, mientras entre los que presentaban un exceso de peso era un 55,1%. Los estudiantes que consumían 2 o más porciones de alcohol al día tenían 2,18 veces más riesgo de tener exceso de peso (OR: 2.18 [95% IC: 1,26 a 3,77]), comparado con aquellos que no consumían alcohol. Conclusión: Se observó que aquellos estudiantes que consumieron más alcohol tuvieron más probabilidades de tener exceso de peso.

Abstract In the district of Luján (Buenos Aires Province, Argentina), the lichen community is almost unknown. Even more unknown is its relationship with the different land uses. The objec tives of the present work are: (1) to identify the species of lichenized fungi associated with the different land uses within the territory belonging to this district and (2) to extend the knowledge about the lichenized fungi com munity of the district. Corticolous lichenized fungi have been surveyed in areas with different land uses (urban, residential, and agricultural) and the association between the recorded species has been statistically explored, as well as the identity of indicator species for each type of land use. A total of 41 species were recorded. All indicator species recorded here are considered toxitolerant. The Urban zone can be clearly separated from the other zones by the presence of the species that inhabit it. The Agricultural and Residential zones cannot be clearly separated. The Residential zone is surrounded by large areas of agricultural and livestock use. This situation is common in the town of Luján, where the transition from residential to agricultural areas is abrupt and this would explain the difficulty in separating the agricultural and residential areas through their lichenized fungi community. In the present work, we are able to determine which are the indicator species of each zone according to their land use and for the first time we list corticolous lichenized fungi species belonging to the Luján district.

Resumen En el partido de Luján (provincia de Buenos Aires, Argentina) la comunidad de líquenes es casi desconocida. Aún más desconocida es su relación con los diferentes usos del suelo. Los objetivos del presente trabajo son: (1) identificar las especies de hongos liquenizados asociados a los diferentes usos del suelo dentro del territorio perteneciente a este partido y (2) ampliar el conocimiento sobre dicha comunidad. Se relevaron los hongos liquenizados cortícolas en zonas con diferente uso del suelo (Casco Urbano, Residencial y Agropecuario) y se exploró estadísticamente la asociación entre las especies registradas, así como la identidad de aquellas es pecies indicadoras para cada tipo de uso del suelo. Un total de 41 especies fueron registradas. Todas las especies indicadores registradas aquí son consideradas toxitolerantes. La zona Casco Fundacional puede ser claramente separada del resto de zonas por la presencia de las especies que la habitan. La zona Agropecuaria y Residencial no pueden ser separadas claramente. La zona Residencial está rodeada de superficies de uso Agropecuario amplias. Esta situación es común en la localidad de Luján, donde el paso de zonas residenciales a agropecuarias es abrupto, y esto explicaría, la dificultad de separar las zonas agropecuarias de las residenciales a través de su comunidad de hongos liquenizados. En el presente trabajo, se logró determinar cuáles son las especies indicadoras de cada zona según su uso del suelo y se lista por primera vez especies de hongo liquenizados cortícolas pertenecientes al partido de Luján.

Resumen: Introducción: la sarcopenia puede presentarse en las enfermedades de larga evolución como la insuficiencia renal crónica. Su detección permite aplicar medidas terapéuticas específicas para evitar complicaciones. Objetivo: describir la frecuencia de sarcopenia en pacientes adultos con insuficiencia renal crónica del Hospital Nacional y Hospital Militar en 2021. Metodología: se aplicó un diseño estudio observacional, descriptivo, transversal. Se incluyeron a varones y mujeres, mayores de edad, portadores de insuficiencia renal crónica de los hospitales mencionados. La presencia de sarcopenia se evaluó con medidas antropométricas, la fuerza de presión palmar y la funcionalidad determinada con el cuestionario EuroQol-5D. Se midieron también variables demográficas y clínicas. Se reclutó un grupo control de sujetos jóvenes sanos para obtener parámetros antropométricos comparativos. La investigación fue aprobada por el Comité de Ética de la Universidad Privada del Este, Paraguay. Resultados: se incluyeron 119 pacientes con insuficiencia renal crónica, siendo 62 varones con edad media 56 ± 15 años y 57 mujeres con edad media 61 ± 16 años. Se recluta- ron 150 sujetos sanos, siendo 51 varones con edad media 26 ± 5 años y 99 mujeres con edad media 25 ± 5 años. La etiología predominante de la insuficiencia renal crónica fue la combinación de hipertensión arterial y diabetes mellitus (45,4%). Al medir las medidas antropométricas, la fuerza de presión palmar y la funcionalidad se confirmó sarcopenia en 38,66% de los pacientes. Comparando variables demográficas y clínicas entre los diferentes grados de sarcopenia, sólo la edad resultó mayor en los sujetos con sarcopenia severa. Conclusión: en pacientes con insuficiencia renal crónica la sarcopenia se confirmó en 38,66%.

Abstract: Introduction: Sarcopenia can present in longstanding diseases such as chronic kidney failure (CKD). Its detection enables the initiation of specific therapeutic measures to avoid complications. Objective: To describe the frequency of sarcopenia in adult patients with CKD at the Hospital Nacional and Hospital Militar in 2021. Methodology: We conducted an observational, descriptive, cross-sectional study design. The presence of sarcopenia was evaluated with anthropometric measurements. The hand grip strength and functionality was determined with the EuroQol5D questionnaire. Demographic and clinical variables were also measured. A control group of healthy young subjects was recruited to obtain comparative anthropometric parameters. The research was approved by the Ethics Committee of the Universidad Privada del Este, Paraguay. Results: 119 patients with CKD were included, 62 men with a mean age of 56 ± 15 years and 57 women with a mean age of 61 ± 16 years. 150 healthy subjects were recruited, 51 men with a mean age 26 ± 5 years and 99 women with a mean age 25 ± 5 years. The predominant etiology of CKD was the combination of arterial hypertension and diabetes mellitus (45.4%). Sarcopenia was confirmed in 38.66% of the patients using anthropometric measurements, hand grip strength and functionality. Comparing demographic and clinical variables between the groups with different stages of sarcopenia, only age was higher in the subjects with severe sarcopenia. Conclusion: Sarcopenia was confirmed in 38.66% of patients with CKD%.

RESUMO Objetivo analisar o conceito Cuidados de Transição no contexto da gestão da alta hospitalar. Método reflexão analítica utilizando-se a análise conceitual de Walker e Avant: seleção do conceito; definição do objetivo, identificação do uso do conceito (busca na literatura e dicionários entre setembro-dezembro/2019 nas bases de dados: PubMed, Biblioteca Virtual em Saúde e SCOPUS. Consideraram-se 77 artigos que contemplaram conceito e outros termos que corroboraram o estudo; para fins metodológicos, 12 estudos possibilitaram a análise); definição dos atributos; descrição de caso modelo; descrição de casos adicionais; definição de antecedentes e consequentes; definição de indicadores empíricos. Resultados os antecedentes cuidados fragmentados e reinternação são comuns ao conceito. Identificaram-se atributos cuidado integrado, colaboração profissional, coordenação, planejamento da alta, comunicação, integração profissional e gerenciamento de casos. Conclusão e implicações para a prática foi oportuno analisar o conceito em conjunto com termos relacionados ao contexto da alta hospitalar. Cuidados de Transição são práticas coordenadas e eficazes para a Continuidade dos Cuidados na transferência do usuário na alta hospitalar; nesse contexto, as Enfermeiras de Ligação são potenciais protagonistas para estar à frente nesse processo de Integração. As especificidades do conceito poderão favorecer a sua compreensão e a construção de conhecimentos que repercutam no cuidado coordenado e contínuo.

ABSTRACT Objective to analyze the concept of Transitional Care in the context of hospital discharge management. Method analytical reflection using the Walker and Avant's conceptual analysis: concept selection; definition of the objective, identification of the use of the concept (literature search and dictionaries between September-December/2019 in the databases: PubMed, Virtual Health Library and SCOPUS. A total of 77 articles that contemplated the concept and other terms that corroborated the study were considered; for methodological purposes, 12 studies enabled the analysis); definition of attributes; description of model case; description of additional cases; definition of antecedents and consequents; definition of empirical indicators. Results the fragmented care and readmission antecedents are common to the concept. The attributes integrated care, professional collaboration, coordination, discharge planning, communication, professional integration, and case management were identified. Conclusion and Implications for practice it was opportune to analyze the concept together with terms related to the context of hospital discharge. Transitional Care is coordinated and effective practices for the Continuity of Care in the transference of the user at hospital discharge; in this context, Liaison Nurses are potential protagonists to be ahead in this Integration process. The specificities of the concept may favor its understanding and the construction of knowledge that has repercussions on coordinated and continuous care.

RESUMEN Objetivo analizar el concepto de Atención Transicional en el contexto de la gestión del alta hospitalaria. Método reflexión analítica utilizando el análisis conceptual de Walker y Avant: selección de conceptos; definición del objetivo, identificación del uso del concepto (búsqueda en la literatura y diccionarios entre septiembre-diciembre / 2019 en las bases de datos: PubMed, Virtual Health Library y SCOPUS. Se consideraron 77 artículos que contemplaban el concepto y otros términos que corroboraban el estudio; a efectos metodológicos, 12 estudios permitieron el análisis); definición de atributos; descripción del caso modelo; descripción de casos adicionales; definición de antecedentes y consecuencias; definición de indicadores empíricos. Resultados la atención fragmentada y los antecedentes de readmisión son comunes al concepto. Se identificaron los atributos atención integral, colaboración profesional, coordinación, planificación del alta, comunicación, integración profesional y manejo de casos. Conclusión e implicaciones para la práctica fue apropiado analizar el concepto junto con términos relacionados con el contexto del alta hospitalaria. Transition Care son prácticas coordinadas y efectivas para la Continuidad de la Atención en el traslado del usuario al alta hospitalaria; en este contexto, las Enfermeras de Enlace son potenciales protagonistas para estar a la vanguardia de este proceso de integración. La especificidad del concepto puede favorecer su comprensión y la construcción de conocimientos que inciden en la atención coordinada y continuada.

Resumen Introducción: Una evaluación completa de citometría en el paciente enfermo crítico muestra modificaciones en las líneas celulares que estiman la gravedad y la mortalidad en la sepsis. El objetivo de este estudio es determinar la utilidad de diferentes parámetros e índices citométricos como predictores de la mortalidad en pacientes sépticos. Materiales y métodos: Estudio retrospectivo de cohortes de adultos con sepsis (Criterio 3 de la SEPSIS) hospitalizados en una Unidad de Cuidados Intensivos (Quito,Ecuador). Se excluyeron los pacientes con neoplasias o estados de inmunodeficiencia. Se evaluaron diferentes parámetros citométricos y se utilizaron modelos de regresión logística para establecer el rango predictivo de la mortalidad para cada parámetro y las áreas bajo la curva (AUC) para el análisis de sensibilidad. Resultados: En más de 159 pacientes, la mortalidad fue del 25%. En los no supervivientes, la mediana del APACHE II fue de 25,20 puntos, y la mediana del SOFA fue de 11,18, 10,44 y 10,15 puntos en el momento del ingreso, 48 y 72 horas respectivamente. En cuanto al análisis de sensibilidad para la mortalidad, el punto de corte del EDW fue 14,5% (AUC 0,708), y presentó un OR ajustado de 5,25 (IC 95%: 1,64-16,76, p: 0,005). El punto de corte de MPV fue de 8,45 fL (AUC 0,666), y presentó un OR ajustado de 5,28 (95%CI: 1,72-16,21, p 0,004). Conclusiones. EDW y MPV son predictores independientes de mortalidad, y deben ser utilizados con escalas o biomarcadores para optimizar el manejo y la terapia de los pacientes con sepsis. Serían una alternativa en los centros donde sólo se dispone de citometría de sangre como prueba analítica.

Abstract Introduction: A comprehensive cytometry assessment in the critical ill patient shows modifications in cell lines that estimate severity and mortality in sepsis. The objective of this study is to determine the utility of different cytometric parameters and indices as predictors of mortality in septic patients. Materials and Methods: Retrospective cohort study of adults with sepsis (SEPSIS Criteria 3) hospitalized in an Intensive Unit Care (Quito, Ecuador). Patients with neoplasms or immunodeficiency states were excluded. Different cytometric parameters have been assessed and logistic regression models were used to stablish the predictive range of mortality for each parameter and areas under the curve (AUC) for sensitivity analysis. Results: Over 159 patients, the mortality was 25%. In non-survivors, the median of the APACHE II was 25.20 points, and the median of the SOFA was 11.18, 10.44, 10.15 points at the time of admission, 48, and 72 hours respectively. About the sensitivity analysis for mortality, the cut-off point of EDW was 14.5% (AUC 0.708), and it presented an adjusted OR of 5.25 (95%CI: 1.64-16.76, p: 0.005). The cut-off point of MPV was 8.45 fL (AUC 0.666), and it had an adjusted OR of 5.28 (95%CI: 1.72-16.21, p 0.004). Conclusions: EDW and MPV are independent predictors of mortality, and they must be used with scales or biomarkers to optimize the management and therapy of patients with sepsis. They would be an alternative in centers where only blood cytometry is available as an analytical test.

Resumo: A administração do Sistema Único de Saúde (SUS) no Brasil reside na capacidade de gestão, a qual exige um acervo de competências essenciais para gerir serviços nos variados níveis de atenção à saúde. Habilidades, conhecimentos e atitudes dos gestores exercem influência direta na eficiência e qualidade, especialmente nos serviços de saúde pública. Objetivo: Identificar as evidências científicas das competências essenciais requeridas para gestores que atuam na saúde pública/coletiva. Método: Scoping Review, consoante método de revisão Joanna Briggs Institute e apoio da ferramenta PRISMA-ScR. O levantamento bibliográfico foi realizado entre março e maio de 2019, em bases de dados nacionais e internacionais, com publicações até abril de 2019. Resultados: identificaram-se 756 estudos e, ao final das fases propostas, restaram oito publicações. A competência mais citada foi a liderança. Conclusão: As publicações foram unânimes em mencionar lacunas nas competências essenciais, sugerindo ações e apoio do poder público; atividades formais de aprendizagem; aperfeiçoamento e educação permanente para fortalecimento e desenvolvimento das competências gerenciais.

Abstract: The administration of the Unified Health System (SUS) in Brazil resides in management capacity, which requires a collection of elementary skills to manage services at varying levels of health care. The skills, knowledge and attitudes of managers will directly impact efficiency and quality, especially in public health services. Objective: To identify the scientific evidence of the essential competencies required for managers working in public / collective health. Method: Scoping Review, according to the Joanna Briggs Institute review method. A table with different phases of the study was used, according to a checklist adapted from the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes. The bibliographic survey was carried out from March to May 2019, in national and international databases, with publications until April 2019. Results: 756 studies were found, and, at the end of the proposed phases, eight publications remained. The competence most frequently identified in the texts was leadership. Conclusion: The publications were unanimous in mentioning gaps in essential competences, suggesting actions and support from the public authorities; formal learning activities; improvement and training (permanent education) to strengthen and develop managerial skills.

Resumen Introducción: El formol, una sustancia de uso común en laboratorios de morfología de la mayoría de universidades, donde se preparan soluciones sin tomar en cuenta las normas estandarizadas y principios básicos en salud y educación. El contacto causa toxicidad local originando manifestaciones principalmente respiratorias y cutáneas, como alergias. El objetivo fue identificar la sintomatología que los estudiantes perciben durante la exposición y las medidas de protección personal que utilizan como bioseguridad. Metodología: La investigación fue cuantitativo, descriptivo, transversal y retrospectivo. El muestreo fue no probabilístico, la población conformada por 684 estudiantes de diferentes universidades de Cochabamba de marzo a junio del 2019. La técnica de recolección de datos fue, una encuesta online. Resultados: Durante la semana los estudiantes concurren a los laboratorios como promedio 10 horas. El 53,9% no recibió información sobre los efectos adversos que ocasiona. No saben la composición 50,7% y no tiene conocimiento de los efectos adversos el 61,3%. La sintomatología que presentaron fue; cambios de humor 9.9%, fatiga general 19.7%, irritación garganta 28.8%, rinorrea 29.5%, fatiga ocular 30.2%, lagrimeo 76.9%, dolor ocular 46.3% e irritación de piel 14.4%. Discusión: Se han descrito tres formas de protección cuando se emplea el formaldehido en laboratorios; protección personal, diseño adecuado de los laboratorios y suficiente y eficaz ventilación. Hay que destacar la falta de conocimiento sobre los efectos adversos y el insuficiente control de las universidades con el equipo de bioseguridad empleado por los estudiantes. Es preciso poner en práctica acciones preventivas que incluyen control y educación sobre bioseguridad en ambientes que emplean este químico.

Resumo Introdução: Formalina, substância comumente usada em laboratórios de morfologia na maioria das universidades, onde as soluções são preparadas sem levar em con-sideração as normas padronizadas e os princípios básicos em saúde e educação. O contato causa toxicidade local causando principalmente manifestações respiratórias e cutâneas, como alergias. O objetivo foi identificar os sintomas que os alunos per-cebem durante a exposição e as medidas de proteção individual que utilizam como biossegurança. Metodologia: A pesquisa foi quantitativa, descritiva, transversal e retrospectiva. A amostragem de tipo não probabilística. População composta de 684 estudantes de diferentes universidades de Cochabamba no periodo de março a junho de 2019. A técnica de coleta de dados foi uma pesquisa on-line. Resultados: Durante a semana os alunos frequentam os laboratórios em média 10 horas; 53,9%, não re-ceberam informações sobre os efeitos adversos que causa; 50,7%, desconhecem a composição e 61,3%, desconhecem os efeitos adversos. Os sintomas que eles apre-sentaram foram: alterações de humor 9,9%, fadiga geral 19,7%, irritação na garganta 28,8%, coriza 29,5%, fadiga ocular 30,2%, lacrimejamento 76,9%, dor ocular 46,3% e irritação cutânea 14,4%. Discussão: Três formas de proteção foram descritas quan-do o formaldeído é usado em laboratórios: 1. proteção pessoal, 2. projeto laboratorial adequado e 3. ventilação suficiente e eficaz. Vale destacar o desconhecimento dos efeitos adversos e o controle insuficiente das universidades com a equipe de bios-segurança utilizada pelos estudantes. Ações preventivas devem ser implementadas, incluindo controle e educação sobre biossegurança em ambientes que utilizam esse produto químico

Summary Introduction: Formaldehyde, a substance commonly used in morphology laboratories in the most universities, where solu-tions are prepared without taking into account the standardized norms and basic principles in health and education. Contact with it causes local toxicity, causing mainly respiratory and skin manifestations, such as allergies. The objective was to identify the symptoms that the students perceive du-ring its exposure and the personal protection measures that they use as biosecurity. Methodology: The research was quantitative, descriptive, cross-sectional and retros-pective. The sampling was non-probability, the population was made up by 684 students from different universities in Cochabamba since March to June 2019. The data collection technique was an online survey. Results: During the week students attend the laboratories on an average of 10 hours. A 53.9% did not receive information about the adverse effects it causes. A 50.7% do not know its composition and a 61.3% do not have knowledge about its adverse effects. The symptoms they presented were; mood swings a 9.9%, general fatigue a 19.7%, throat irritation a 28.8%, runny nose a 29.5%, eye fatigue a 30.2%, tearing a 76.9%, eye pain a 46.3% and skin irritation a 14.4%. Discussion: Three protection forms have been described when formaldehyde is used in laboratories; personal protection, adequate laboratory design and its enough and effective ventilation. It must be stand out there is a lack of knowledge about the adverse effects and the insufficient control in the universities with the biosecurity team used by the students. Preventive actions must be put in practice, including the biosafety control and education in environments where this chemical is used

Introduction: Attention deficit hyperactivity disorder (ADHD) has a worldwide prevalence of 5%, and most of medical consultations to children with the diagnosis take place in Primary Care settings. It would be necessary for physicians of the Rural and Urban-Marginal Health Service (SERUM) in Peru to have sufficient knowledge about the diagnosis and management of this disorder for its timely referral to the specialist. Objectives: To determine the knowledge level that SERUM primary care physicians have regarding diagnosis, management and prognosis of ADHD. Material and Methods: This is a descriptive, observational and transversal study, based on the application of a survey instrument, specifically designed for the study of ADHD, and revised by the Peruvian Association of Professionals. Results: From a total of 550 surveys applied, 63.5% (349) met the inclusion criteria. It was found that 80.5% of these probands had a high level of general knowledge about ADHD, but only a 16.9% has a similar knowledge level regarding diagnosis, and 73.1%, an intermediate level. Regarding treatment, 56.2% of the sample had a high and 39.8%, an average knowledge level.Conclusions: SERUM-associatedprimary care physicians in Lima have a high knowledge level about general aspects of ADHD as they consider a combined treatment as the management of choice, and give importance to the prognosis of the non-treated patient. However, most of them do not base their diagnosis on DSM-5 or ICD-10 criteria, and do not identify first-line pharmacological agents for the management of the disorder. The need to improve this aspects is emphasized.

Introducción: El trastorno por déficit de atención con hiperactividad (TDAH), exhibe una prevalencia mundial del 5% y la mayoría de las consultas médicas tienen lugar en clínicas de Atención Primaria. En tal contexto, se plantea la necesidad de que los médicos del Servicio Rural y Urbano Marginal de Salud (SERUM) conozcan suficientemente aspectos del diagnóstico y manejo de este trastorno, para su oportuna derivación al especialista. Objetivos: Determinar el nivel de conocimiento que tienen los médicos serumistas en relación al diagnóstico, manejo y pronóstico del TDAH. Material y Métodos: Estudio descriptivo, observacional y transversal basado en la aplicación de una encuesta a médicos serumistas, revisada por la Asociación de Profesionales Peruanos para el estudio del Trastorno por Déficit de Atención e Hiperactividad. Resultados. De un total de 550 encuestas, 63,5% (349) cumplieron los criterios de inclusión. Se encontró que el 80,5 % de estos probandos tenían un alto nivel de conocimiento general sobre el TDAH. Sin embargo, sólo el 16,9% mostró un nivel similar en relación al diagnóstico y el 73,1% alcanzó un nivel de conocimiento medio. En relación al tratamiento, 56,2 % de la muestra tuvo un nivel alto y 39,8 %, un nivel medio de conocimiento. Conclusiones: Los médicos serumistas encuestados en Lima muestran un alto nivel de conocimiento global en relación al TDAH, consideran apropiadamente el tratamiento mixto de elección y dan importancia al pronóstico del paciente no tratado. La mayoría, sin embargo, no basa su diagnóstico en los criterios del DSM5 o CIE 10 y no identifican fármacos de primera línea para el manejo del trastorno. Se postula la necesidad de mejorar estos aspectos

Objective: Bibliographic analysis of the constraints and technical difficulties in the total testosterone (TT) assay. Methods: Review of articles published in various databases from 2003 to 2014. (PubMed, Health Library, Cochrane). Evaluation and comparison of serum TT assays using the different methods available in our country, validated or not validated by LC-MS/MS. Results: Development of a monograph in which technical problems are evaluated in current TT assays.

Objetivo: Análisis bibliográfico de las limitaciones y dificultades técnicas en el dosaje de testosterona total (TT). Materiales y métodos: Revisión de trabajos publicados en diferentes bases de datos desde 2003 hasta el 2014 (PubMed, Biblioteca Virtual de Salud, Cochrane). Evaluación y comparación del dosaje de TT sérica utilizando métodos disponibles en nuestro país, validados por LC-MS/MS y no validados por LC-MS/MS. Resultados: Elaboración de una monografía en la que se evalúan los problemas técnicos en el dosaje de TT en la actualidad.

OBJECTIVES: The aims of the current study were 1) to evaluate the reliability and validity of the Brazilian version of the 15-item Myasthenia Gravis Quality of Life Scale and 2) to investigate the quality of life of Brazilian patients with myasthenia gravis and its determinants. METHODS: This cross-sectional study included 69 patients with myasthenia gravis who underwent neurological evaluation and completed questionnaires regarding quality of life (the 36-item Short Form of the Medical Outcomes Study and the 15-item Myasthenia Gravis Quality of Life Scale), anxiety and depressive symptoms. RESULTS: The Brazilian version of the 15-item Myasthenia Gravis Quality of Life Scale showed high internal consistency and good concurrent validity with the 36-item Short Form of the Medical Outcomes Study and its subscales. Determinants of quality of life in Brazilian patients with myasthenia gravis included the current status of myasthenia gravis as assessed by the Myasthenia Gravis Composite, the current prednisone dose and the levels of anxiety and depression. CONCLUSION: The Brazilian version of the 15-item Myasthenia Gravis Quality of Life Scale is a valid instrument. Symptom severity, prednisone dosage and anxiety and depression levels impact the quality of life of patients with myasthenia gravis.

Objetivo: determinar o perfil clínico dos pacientes com miastenia gravis (MG) atendidos na Clínica de Doenças Neuromusculares do Serviço de Neurologia do Hospital das Clínicas da Universidade Federal de Minas Gerais, e comparar com outras séries de casos brasileiras. Métodos: foram coletados dados clínicos e sociodemográficos dos pacientes, e realizada revisão sistemática de literatura, focando em estudos nacionais sobre o perfil clínico de pacientes com MG. Resultados: sessenta e nove pacientes participaram do estudo, sendo 55 (91%) do sexo feminino, e a média de idade (desvio-padrão) de 37,6 (±11,4) anos. O tempo médio de doença foi de 14,1 anos. Em relação ao tratamento, o uso isolado de prednisona foi a estratégia mais adotada (64%), seguida do uso de azatioprina (43,3%). Não houve diferença entre os pacientes timectomizados (47) e não timectomizados (22) no que diz respeito à gravidade da doença e ao tratamento. Conclusão: as características clínicas e sociodemográficas da presente amostra de pacientes com MG de um serviço universitário assemelham-se às características de outras séries brasileiras e da literatura internacional.

Summary Objective: to determine the clinical profile of patients with myasthenia gravis (MG); followed at the Neuromuscular Diseases Clinic of the University Hospital, Federal University of Minas Gerais, Brazil, and to compare it with other Brazilian case series. Methods: sociodemographic and clinical data were collected from patients, and a systematic literature review performed, focusing on national studies on the clinical profile of MG patients. Results: sixty nine patients were enrolled in the study. Fifty five (91%) subjects were female and the mean age (SD) was 37.6 (±11.4) years. The mean disease duration was 14.1 years. Regarding treatment, prednisone was the most used strategy (64%), followed by the use of azathioprine (43%). There was no difference between thymectomized (42) and non-thymectomized (27) patients regarding disease severity and medication use. Conclusion: clinical and socio-demographic features of this MG sample from a University-based clinic resemble those reported in other Brazilian series and in the international literature.

Este trabalho descreve aspectos das condições de trabalho e emprego e suas relações com a saúde, no contexto brasileiro, enfatizando as desigualdades sociais relacionadas com a inserção no mercado de trabalho, tendo sido desenvolvido como contribuição ao documento da rede "Employment Conditions and Health Inequalities Knowledge Network (EMCONET) - WHO Commission on Social Determinants of Health". A pesquisa bibliográfica foi realizada no SciELO, LILACS, Google, Google Scholar, MEDLINE e no banco de teses da CAPES. No Brasil, o número de trabalhadores inseridos no setor informal supera o daqueles no setor formal. As informações sobre adoecimento e morte relacionados ao trabalho não estão disponíveis para o conjunto da população economicamente ativa. As condições de trabalho e saúde são ruins em ambos os grupos e, apesar do complexo arcabouço legal referente à proteção dos trabalhadores e de avanços setoriais, as políticas públicas permanecem fragmentadas, apresentam baixa cobertura e pouca eficácia. O crescente envolvimento do movimento social e de sindicatos de trabalhadores na elaboração e gestão de políticas e programas de saúde sinaliza um processo promissor em curso no país.

This paper was prepared for the Employment Conditions and Health Inequalities Knowledge Network (EMCONET), part of the WHO Commission on the Social Determinants of Health. We describe the Brazilian context of employment conditions, labor conditions and health, their characteristics and causal relationships. The social, political and economic factors that influence these relationships are also presented with an emphasis on social inequalities, and how they are reproduced within the labor market and thereby affect the health and wellbeing of workers. A literature review was conducted in SciELO, LILACS, Google and Google Scholar, MEDLINE and the CAPES Brazilian thesis database. We observed that there are more workers operating in the informal sector than in the formal sector and these former have no social insurance or any other social benefits. Work conditions and health are poor in both informal and formal enterprises since health and safety labor norms are not effective. The involvement of social movements and labor unions in the elaboration and management of workers' health polices and programs with universal coverage, is a promising initiative that is underway nationwide.

Este trabalho descreve aspectos das condições de trabalho e emprego e suas relações com a saúde, no contexto brasileiro, enfatizando as desigualdades sociais relacionadas com a inserção no mercado de trabalho, tendo sido desenvolvido como contribuição ao documento da rede "Employment Conditions and Health Inequalities Knowledge Network (EMCONET) - WHO Commission on Social Determinants of Health". A pesquisa bibliográfica foi realizada no SciELO, LILACS, Google, Google Scholar, MEDLINE e no banco de teses da CAPES. No Brasil, o número de trabalhadores inseridos no setor informal supera o daqueles no setor formal. As informações sobre adoecimento e morte relacionados ao trabalho não estão disponíveis para o conjunto da população economicamente ativa. As condições de trabalho e saúde são ruins em ambos os grupos e, apesar do complexo arcabouço legal referente à proteção dos trabalhadores e de avanços setoriais, as políticas públicas permanecem fragmentadas, apresentam baixa cobertura e pouca eficácia. O crescente envolvimento do movimento social e de sindicatos de trabalhadores na elaboração e gestão de políticas e programas de saúde sinaliza um processo promissor em curso no país.

This paper was prepared for the Employment Conditions and Health Inequalities Knowledge Network (EMCONET), part of the WHO Commission on the Social Determinants of Health. We describe the Brazilian context of employment conditions, labor conditions and health, their characteristics and causal relationships. The social, political and economic factors that influence these relationships are also presented with an emphasis on social inequalities, and how they are reproduced within the labor market and thereby affect the health and wellbeing of workers. A literature review was conducted in SciELO, LILACS, Google and Google Scholar, MEDLINE and the CAPES Brazilian thesis database. We observed that there are more workers operating in the informal sector than in the formal sector and these former have no social insurance or any other social benefits. Work conditions and health are poor in both informal and formal enterprises since health and safety labor norms are not effective. The involvement of social movements and labor unions in the elaboration and management of workers' health polices and programs with universal coverage, is a promising initiative that is underway nationwide.

OBJETIVO: Investigar a prevalência de transtornos psiquiátricos em pacientes com miastenia gravis (MG). MÉTODO: Quarenta e um pacientes com MG responderam a uma entrevista psiquiátrica estruturada (MINI-Plus). RESULTADOS: Onze (26,1%) pacientes foram diagnosticados com transtorno depressivo e 19 (46,3%) foram diagnosticados com um transtorno de ansiedade. Pacientes com distimia eram mais velhos (p=0,029) e tinham maior tempo de doença (p=0,006). Os pacientes com fobia social também tiveram maior tempo de doença (p=0,039). CONCLUSÃO: Transtornos psiquiátricos na MG são bastante comuns, principalmente transtornos depressivos e de ansiedade.

OBJECTIVE: To investigate the prevalence of psychiatric disorders in patients with myasthenia gravis (MG). METHOD: Forty-one patients with MG answered to a structured psychiatric interview (MINI-Plus). RESULTS: Eleven (26.1%) patients were diagnosed with a depressive disorder and 19 (46.3%) were diagnosed with an anxiety disorder. Patients with dysthymia were older (p=0.029) and had longer disease duration (p=0.006). Patients with social phobia also had longer disease duration (p=0.039). CONCLUSION: Psychiatric disorders in MG are common, especially depressive and anxiety disorders.

Este estudo teve como objetivo compreender como as mulheres com hipertensão arterial vivenciam o impacto deste diagnóstico. Participaram dez mulheres com hipertensão arterial de um programa de exercício em um município do Estado do México, no período de março a outubro de 2007. Para obtenção dos dados utilizou-se entrevista semiestruturada, de forma individual. As entrevistas foram analisadas segundo o referencial de análise de conteúdo de Bardin. Da análise, originaram-se três categorias 1) Da alegria à angústia; 2) No momento da notificação da doença; 3) tentando adaptar-se à nova vida cotidiana. A vivencia com a hipertensão arterial é algo que enfrenta, desde o momento da notificação até o convívio com a doença, fatos desencadeadores de sentimentos de angústia e medo. É um processo de difícil adaptação.

The objective of the present study was to understand how women with hypertension were affected by the diagnosis of the disease. Ten women with hypertension, members of an exercise program in a municipality of the State of Mexico participated in this study, which took place from March to October of 2007. To obtain the data, a semi-structured interview was conducted, applied on an individual basis. The interviews were analyzed using the theoretical content analysis of L. Bardin. From the analysis of the data, three stages were observed: 1) The initial response, fear or anguish 2) The moment the illness is diagnosed. 3) The adaptation to the new life style. Hypertension is something that these women must cope with from the moment they are diagnosed with the illness and even as they deal with it on a daily basis. These factors generate different types of feelings, such as anguish and fear. These women are forced to handle this difficult process.

Este estudio tuvo como objetivo comprender cómo las mujeres con hipertensión arterial viven el impacto del diagnóstico de esta enfermedad. Participaron diez mujeres con hipertensión arterial, de un programa de ejercicio, en un municipio del Estado de México, en el período de marzo a octubre de 2007. Para obtener los datos, se utilizó una entrevista semi-estructurada, de forma individual. Las entrevistas fueron analizadas según el referencial de análisis de contenido. A partir del análisis se originaron tres categorías: 1) De la alegría a la angustia 2) El momento en que la enfermedad es diagnósticada 3) Intentando adaptarse a una nueva vida cotidiana. Convivir con hipertensión arterial es algo que enfrentan estas mujeres, desde el momento que son diagnósticadas hasta tener que convivir diariamente con la enfermedad, situación que desencadena sentimientos de angustia y miedo. Este es un proceso de difícil adaptación.