Abstract Jalisco is one of the main honey bee producing states in Mexico. However, information on the parasitoses that affect the productivity of honey bee (Apis mellifera) colonies in the state is limited and addresses only a few regions. The objective of this study was to determine the prevalence and intensity of two parasitic diseases of Apis mellifera -varroosis (Varroa destructor) and nosemosis (Vairimorpha spp.)- in six regions of Jalisco. Bees from 365 colonies collected during the spring were analyzed. Varroosis was the most frequent parasitosis (90 %), and nosemosis was the least frequent (15 %). The infestation or infection levels of these parasitoses were generally low: <5 % (mites per 100 bees) for varroosis, and <310,000 spores/bee for nosemosis. The regions with the highest prevalence and intensity of V. destructor were the Highlands, the Center, and the South, while infections by Vairimorpha ceranae -the only species of the fungus found- were significantly higher in the Southeastern and Southern regions. It is advisable to carry out epidemiological studies at other times of the year in order to detect possible seasonal effects of parasitoses for the purpose of designing strategies for their control.

Resumen Jalisco es uno de los principales estados productores de miel de abejas en México. Sin embargo, la información sobre parasitosis que afectan la productividad de las colonias de abejas melíferas (Apis mellifera) en el estado es limitada y de pocas regiones. El objetivo de este estudio fue determinar la prevalencia e intensidad de dos enfermedades parasitarias de Apis mellifera, varroosis (Varroa destructor) y nosemosis (Vairimorpha spp.), en seis regiones de Jalisco. Se analizaron abejas de 365 colonias colectadas durante la primavera. La varroosis fue la parasitosis más frecuente (90 %) y la nosemosis la menos frecuente (15 %). Los niveles de infestación o infección de las parasitosis fueron en general bajos. Para varroosis, <5 % (ácaros en 100 abejas) y para nosemosis, <310,000 esporas/abeja. Las regiones con mayor prevalencia e intensidad de V. destructor fueron Altos, Centro y Sur, mientras que las infecciones por Vairimorpha ceranae, la única especie del hongo encontrada, fueron significativamente más altas en las regiones Sureste y Sur. Se recomienda realizar estudios epidemiologicos en otras épocas del año para detectar posibles efectos estacionales de las parasitosis para diseñar estrategias para su control.

Resumen Este artículo se deriva de la investigación «La Formación y el Perfil Profesional del Editor en Iberoamérica» y pretende estimular la reflexión sobre las lógicas de la formación en edición de publicaciones académicas mediante el análisis de algunos de los principales aspectos curriculares de los programas en esta categoría. Es un estudio cualitativo y descriptivo que consultó a 84 líderes editoriales y a 21 egresados de un programa de especialización; también analizó una muestra de 16 programas de diversos países. Los hallazgos confirman 1) el predominio de programas enfocados en la formación técnica especializada, adscritos, principalmente, a las ciencias sociales y humanas y, en particular, a disciplinas como la comunicación social y el diseño; y 2) los enfoques curriculares se orientan a la coordinación y ejecución de los procesos editoriales, así como a la gestión administrativa de los proyectos y empresas del sector, con una fuerte intención de generar productos editoriales digitales que complementen la oferta de formatos análogos.

Abstract This article is derived from the research «The Training and Professional Profile of the Editor in Ibero-America» and aims to stimulate reflection on the logic of training in publication editing by analyzing some of the main curricular aspects of academic programs. It is a qualitative and descriptive study that consulted 84 editorial leaders and 21 graduates of a specialization program; also analyzed a sample of 16 programs from various countries. The findings confirm 1) the predominance of programs focused on specialized technical training, attached mainly to the social and human sciences and, in particular, to disciplines such as social communication and design; and 2) the curricular approaches are oriented towards the coordination and execution of editorial processes, as well as the administrative management of projects and companies in the sector, with a strong intention of generating digital editorial products that complement the offer of analog formats.

ABSTRACT Objective: To evaluate the cumulative incidence, risk factors, and outcomes of COVID-19 in patients with Cushing's disease (CD). Subjects and methods: In all, 60 patients with CD following up in our outpatient clinic answered via phone interview a questionnaire about the occurrence of COVID-19 infection documented by RT-PCR (including the diagnosis date and clinical outcome) and vaccination status. Clinical and biochemical data on disease activity (hypercortisolism) and comorbidities (obesity, diabetes mellitus, and hypertension) were obtained from the patients' electronic medical records. Risk ratios (RRs) of risk factors were obtained using univariate and multivariate analyses. Results: The cumulative incidence of COVID-19 in patients with CD during the observation period was 31.7%, which was higher than that in the general reference population (9.5%). The cumulative incidence of COVID-19 was significantly higher in patients with hypercortisolism (57% versus 17% in those without hypercortisolism, p = 0.012) and obesity (54% versus 9% in those without obesity, p < 0.001) but not in patients with hypertension or diabetes mellitus. On multivariate analysis, hypercortisolism and obesity were each independent risk factors for COVID-19 (RR 2.18, 95% CI 1.06-4.46, p = 0.033 and RR 5.19, 95% CI 1.61-16.74, p = 0.006, respectively). Conclusion: The incidence of COVID-19 in patients with CD was associated with hypercortisolism, as expected, and obesity, a novel and unexpected finding. Thus, correction of hypercortisolism and obesity should be implemented in patients with CD during the current and future COVID-19 outbreaks. Objective COVID19 COVID 19 COVID-1 Cushings Cushing s CD. . (CD) methods all 6 RTPCR RT PCR including outcome status (hypercortisolism (obesity mellitus records RRs (RRs analyses Results 317 31 7 31.7% 9.5%. 95 9.5% 9 5 (9.5%) 57% 57 (57 17 0.012 0012 0 012 54% 54 (54 0.001 0001 001 analysis 218 2 18 2.18 1.064.46, 106446 1.06 4.46, 1 06 4 46 1.06-4.46 0033 033 0.03 519 5.19 1.6116.74, 1611674 1.61 16.74, 61 16 74 1.61-16.74 0006 006 0.006 respectively. respectively respectively) Conclusion expected finding Thus outbreaks COVID1 COVID- (CD 3 31.7 9.5 (9.5% (5 0.01 01 0.00 000 00 21 2.1 064 1.064.46 10644 106 1.0 446 4.46 1.06-4.4 003 03 0.0 51 5.1 6116 1.6116.74 161167 161 1.6 1674 16.74 1.61-16.7 31. 9. (9.5 ( 2. 1.064.4 1064 10 1. 44 4.4 1.06-4. 0. 5. 611 1.6116.7 16116 167 16.7 1.61-16. (9. 1.064. 4. 1.06-4 1.6116. 1611 16. 1.61-16 (9 1.064 1.06- 1.6116 1.61-1 1.611 1.61-

RESUMEN Objetivos: contribuir para el cambio de comprensiones y saberes del sistema popular de mujeres ribereñas sobre el autocuidado íntimo femenino, antes y detrás la aplicación de una dinámica educativa. Métodos: estudio cualitativo-participativo apoyándose en el Sunrise Model. Participaron 20 mujeres, registradas en Unidad Básica de Salud de la isla de Combu, estado de Pará, Brasil, en el segundo semestre de 2022. Ocurrieron entrevistas semiestructuradas antes y detrás la dinámica educativa; y posterior análisis inductiva reflexiva. Resultados: señálese un mecanismo femenino de educación generacional; acto cultural del baño como sinónimo de autocuidado íntimo y prevención de enfermedades; aseos íntimos con hierbas medicinales; falta de abordaje del tema por el sistema profesional; temor del uso del “agua turbia”; y falta de recursos financieros para compra de productos específicos vueltos a cuidados genitourinarios. Consideraciones Finales: factores de compañerismo y sociales mueven el autocuidado íntimo, pero tabús, desconocimiento y pobreza han vividos por ribereñas. Objetivos educativa Métodos cualitativoparticipativo cualitativo participativo Model 2 Combu Pará Brasil 2022 reflexiva Resultados generacional enfermedades medicinales profesional agua turbia turbia” genitourinarios Finales tabús 202

RESUMO Objetivos: contribuir para a mudança de compreensões e saberes do sistema popular de mulheres ribeirinhas sobre o autocuidado íntimo feminino, antes e depois da aplicação de uma dinâmica educativa. Métodos: estudo qualitativo-participativo apoiando-se no Sunrise Model. Participaram 20 mulheres, cadastradas em Unidade Básica de Saúde da ilha do Combu, estado do Pará, Brasil, no segundo semestre de 2022. Ocorreram entrevistas semiestruturadas antes e depois da dinâmica educativa; e posterior análise indutiva reflexiva. Resultados: aponta-se um mecanismo feminino de educação geracional; o ato cultural do banho como sinônimo de autocuidado íntimo e da prevenção de doenças; asseios íntimos com ervas medicinais; falta de abordagem do tema pelo sistema profissional; temor do uso da “água barrenta”; e falta de recursos financeiros para compra de produtos específicos voltados aos cuidados genitourinários. Considerações Finais: fatores de companheirismo e sociais movem o autocuidado íntimo, contudo tabus, desconhecimento e pobreza são vivenciados pelas ribeirinhas. Objetivos educativa Métodos qualitativoparticipativo qualitativo participativo apoiandose apoiando se Model 2 Combu Pará Brasil 2022 reflexiva Resultados apontase aponta geracional doenças medicinais profissional água barrenta barrenta” genitourinários Finais tabus 202

ABSTRACT Objectives: to contribute to the change in understandings and knowledge of the popular system among riverine women about female intimate self-care before and after the application of an educational dynamic. Methods: a qualitative-participative study based on the Sunrise Model. Twenty women registered at a Basic Health Unit on the Combu island, state of Pará, Brazil, participated in the second half of 2022. Semi-structured interviews were conducted before and after the educational dynamic; followed by reflective inductive analysis. Results: these are pointed out: a female mechanism of generational education; the cultural act of bathing as synonymous with intimate self care and disease prevention; intimate care with medicinal herbs; lack of professional system approach to the topic; fear of using “muddy water”; and lack of financial resources to purchase specific products for genitourinary care. Final Considerations: companionship and social factors drive intimate self-care; however, riverine women experience taboos, ignorance, and poverty. Objectives selfcare dynamic Methods qualitativeparticipative qualitative participative Model island Pará Brazil 2022 Semistructured Semi structured analysis Results out education prevention herbs topic muddy water water” Considerations however taboos ignorance poverty 202 20 2

Resumo: Introdução: nos últimos anos, tem havido um aumento na identificação de bactérias multirresistentes (BMDR) em pediatria, tanto de colonização como de infecção, o que tem impactado na morbimortalidade. Uma vigilância rigorosa é realizada no hospital para orientar medidas de prevenção e evitar propagação e contágio intra-hospitalar. Objetivos: descrever a incidência, características epidemiológicas e clínicas de crianças e adolescentes hospitalizados nos quais a BMDR foi identificada por meio de vigilância de infecções associadas à assistência de saúde. Material e métodos: estudo observacional, descritivo e retrospectivo. Foram incluídas crianças e adolescentes internados em hospital de referência nos quais foi identificada MRMO. Variáveis: epidemiológicas, clínicas, microbiológicas e evolutivas. Análise estatística: medidas sumárias. Os padrões éticos de pesquisa foram garantidos. A colonização pelo BMDR foi estudada em crianças com internação superior a 10 dias provenientes de áreas fechadas fora do Hospital de Referência Pediátrica, a amostra foi coletada retal. Foram aplicadas técnicas de detecção e cultura de ácidos nucleicos. Resultados: foram identificados 59 pacientes, 56 colonizações e 3 infecções, a primeira foi uma colonização por KPC em 2016. A partir daí aumentaram para 18 em 2022 e para 14 em julho de 2023. A idade média foi de 9,1 meses (variação de 15 dias a 7 anos). 32 meninas e 27 meninos. Os pacientes vieram de todo o país, com predomínio da região metropolitana (15 Montevidéu e 14 Canelones). 35 pacientes apresentavam comorbidades: 12 prematuros, 2 transplantados, 8 cardiopatias congênitas, 5 com desnutrição grave com nutrição parenteral total, 2 em tratamento com imunossupressores e 1 hemato-oncológico. 37 pacientes receberam antibioticoterapia antes da detecção do BMDR (média de 9 dias). Em relação aos dispositivos médicos, 14 tiveram intubação orotraqueal, 6 receberam acesso venoso central, 3 tiveram traqueostomia, 3 drenagem torácica, 1 drenagem biliar e 1 teve um dispositivo venoso implantável permanente. O diagnóstico na alta foi infecção respiratória em 45, sendo a bronquiolite a mais comum em 29. 56 foram internados em cuidados intensivos, média de 11,6 dias (variação de 1 a 90). Quanto à identificação do agente, as amostras foram swab retal 57, secreções respiratórias 2 e sangue 1. Para swab retal o método de detecção foi o PCR em 39 e cultura em 18. Nos casos de infecções: hemocultura 1 e cultura de secreções respiratórias 2. Porém, o mecanismo de resistência foi identificado por testes imunocromatográficos. As bactérias mais frequentemente identificadas foram Klebsiella pneumoniae 9 e Pseudomonas aeruginosa 6. A distribuição de acordo com o mecanismo de resistência foi NDM 33, KPC 10, OXA-48 9, OXA-51 6, VIM 6, IMP 1, GES 1. Em 3 casos identificados 2 carbapenemases. 6 pacientes morreram (2 infectados e 4 colonizados). 41 pacientes receberam alta hospitalar. Conclusões: através da vigilância, observou-se um aumento na identificação de BMDR, especialmente no último ano. A presença de infecção por BMDR contribuiu para o aumento da mortalidade. A identificação oportuna é essencial para evitar a disseminação e orientar medidas de prevenção.

resumen está disponible en el texto completo

Summary: Introduction: in recent years, there has been an increase in the identification of Multidrug Resistant Bacteria (MDRB) in pediatrics, regarding both colonization and infection, which has led to morbidity and mortality. Strict surveillance is carried out in the hospital to guide prevention measures and prevent the spread and intra-hospital contagion. Objectives: to describe the incidence, epidemiological and clinical characteristics of hospitalized children and adolescents to whom MDRB was identified through surveillance of infections associated with health care. Material and methods: observational, descriptive, retrospective study. We included children and adolescents admitted to a pediatric reference hospital to whom BMDR had been prescribed. Variables: epidemiological, clinical, microbiological and evolutionary. Statistical analysis: summary measures. Ethical research standards were guaranteed and colonization by BMDR was studied in children with stays of more than 10 days who came from closed areas outside the Pediatric Reference Hospital, the sample was swabbed rectal. Techniques for nucleic acid detection and culture were applied. Results: 59 patients were identified, 56 colonizations and 3 infections, the first was a colonization by KPC in 2016. Since then, they increased to 18 in 2022 and 14 in July 2023. The average age was 9.1 months (range 15 days to 7 years). 32 female and 27 male. The patients came from all over the country, predominantly from the metropolitan area (15 Montevideo and 14 Canelones). 35 patients had comorbidities: 12 preterm, 2 transplanted, 8 congenital heart disease, 5 severe malnutrition with total parenteral nutrition, 2 under treatment with immunosuppressants and 1 hemato oncological. 37 patients received antibiotic therapy prior to MDRB detection (average 9 days). Regarding medical devices, 14 had orotracheal intubation, 6 had a central venous line, 3 had a tracheostomy, 3 had chest drainage, 1 had biliary drainage and 1 had a permanent implantable venous device. The diagnosis at discharge was respiratory infection in 45 cases, bronchiolitis was the most common in 29. 56 were admitted to intensive care, mean 11.6 days (range 1 to 90). Regarding agent identification, 57 samples were rectal swabs, 2 respiratory secretions and blood sample. We used PCR for rectal swab detection in 39 patients and culture in 18. For cases of infections: 1 blood culture and 2 cultures of respiratory secretions, then the resistance mechanism was identified by immunochromatographic tests. The most frequently identified bacteria were Klebsiella pneumoniae 9 and Pseudomonas aeruginosa 6. The distribution according to resistance mechanism was NDM 33, KPC 10, OXA-48 9, OXA-51 6, VIM 6, IMP 1, GES 1. In 3 cases we identified 2 carbapenemase. 6 patients died (2 infected and 4 colonized). 41 patients were discharged. Conclusions: through surveillance, an increase in the identification of MDRB was observed, especially in the past year. The presence of MDRB infection contributed to increased mortality. Timely identification is essential to prevent dissemination and to implement guideline prevention measures.

Abstract Mexico is one of the world’s foremost producers and exporters of bees’ honey (Apis mellifera L.), and the state of Jalisco is one of the top three honey producers in Mexico. However, the Mexican beekeeping industry is affected by the high defensive behavior and lower honey production of Africanized honey bees compared to European bees. The objective of this study was to determine the African or European ancestry of honey bee colonies in six regions of temperate and subtropical climates in the state of Jalisco, Mexico, using morphometric and mitochondrial DNA analyses. More than 50% of the colonies in Jalisco had African mitotype and morphotype (59.0% and 62.5%, respectively). The frequency of africanization of the studied colonies was significantly higher (p < 0.05) in regions of low altitude and in subtropical climates, such as the Southeast and Southwest regions, than in regions of higher elevation and in temperate climates, such as Los Altos. There was a significant correlation between the forewing length of the bees and the altitude at which their colonies were located (r = 0.51, p< 0.01), indicating that the lower the altitude, the higher the degree of africanization of the bees. Future studies are warranted to determine if the degree of africanization of honey bee colonies increases or remains in equilibrium. These studies will make it posible to design mitigation strategies against the negative effects of the africanization of honey bees.

Resumen México es de los principales productores y exportadores de miel de abejas (Apis mellifera L.) a nivel mundial y el estado de Jalisco se encuentra entre los tres primeros productores a nivel nacional. Sin embargo, la apicultura mexicana es afectada por el alto comportamiento defensivo y menor productividad de las abejas africanizadas en comparación con abejas europeas. El objetivo de este estudio fue determinar la ancestría africana o europea de colonias de abejas melíferas en seis regiones de clima templado y subtropical en el estado de Jalisco, México, mediante análisis morfométricos y de ADN mitocondrial. Más del 50% de las colonias de abejas de Jalisco tuvieron mitotipo y morfotipo africano (59.0 y 62.5%, respectivamente). La frecuencia de africanización de las colonias fue significativamente mayor (p < 0.05) en regiones de baja altitud y climas subtropicales (regiones Sureste y Suroeste), que en regiones de mayor elevación y en climas templados (región de los Altos). Hubo correlación significativa entre la longitud del ala de las abejas y la altitud a la que se encontraban las colonias (r = 0.51, p < 0.01); esto indica que a menor altitud hay un mayor grado de africanización de las abejas. Se recomiendan realizar estudios para determinar si el grado de africanización de las colonias de abejas aumenta o se mantiene en equilibrio, lo que permitirá diseñar estrategias de amortiguamiento de los efectos negativos de la africanización de las abejas melíferas.

Abstract The Pantanal is the largest seasonal freshwater wetland on Earth, characterized by the seasonal flooding and complex mosaic vegetation, which determines its biodiversity. Among this biodiversity, dung beetles (Coleoptera: Scarabaeidae: Scarabaeinae) are a group of insects that perform important ecological functions, such as: nutrient cycling, seed dispersion and parasite control. In order to mitigate the lack of information on dung beetle fauna of the Brazilian Pantanal, we conducted a bibliographic search of virtually all literature published until november-2020 on dung beetles sampled in the Pantanal. In addition, we had accessed to the records the largest collection of the dung beetle species from Brazilian Pantanal. We recorded 68 dung beetle species of 30 genera. The genera Canthon Holffmanseg 1847 is the most diverse with 13 species recorded. Although our knowledge about the dung beetle fauna in this ecosystem is still incipient, our results demonstrated a high richness of dung beetles in the Brazilian Pantanal. In addition, our study provides first list of dung beetle species and an illustrated dichotomy key to identify genera and some species occurring in the Brazilian Pantanal. Thus, the use of this guide for identification of dung beetle species and a list of species can be important tools to help researchers and provide incentive for new inventories on dung beetle fauna in the Brazilian Pantanal. Earth vegetation biodiversity Coleoptera (Coleoptera Scarabaeidae Scarabaeinae functions as cycling control november2020 november 2020 november-202 addition 6 3 184 1 incipient Thus november202 202 november-20 18 november20 20 november-2 november2 2 november-

Resumo O Pantanal é a maior área úmida sazonal de água doce Neotropical da Terra, caracterizada pelas inundações sazonais e pela complexa vegetação em mosaico, que determina sua biodiversidade. Dentre essa biodiversidade, os besouros rola-bosta (Coleoptera: Scarabaeidae: Scarabaeinae) são um grupo de insetos que desempenham importantes funções ecológicas, tais como: ciclagem de nutrientes, dispersão de sementes e controle de parasitas. A fim de mitigar a falta de informações sobre a fauna de besouros rola-bosta do Pantanal brasileiro, realizamos uma pesquisa bibliográfica de praticamente toda a literatura publicada até novembro de 2020 sobre besouros rola-bosta amostrados no Pantanal. Além disso, acessamos os registros da maior coleção da espécie de rola-bosta do Pantanal brasileiro. Registramos 68 espécies de besouros rola-bosta de 30 gêneros. O gênero Canthon Holffmanseg 1847 é o mais diverso com 13 espécies registradas. Embora nosso conhecimento sobre a fauna de rola-bostas neste ecossistema ainda seja incipiente, nossos resultados demonstraram uma alta riqueza de besouros rola-bosta no Pantanal brasileiro. Além disso, nosso estudo fornece a primeira lista de espécies de besouros rola-bosta e uma chave de dicotomia ilustrada para identificar gêneros e algumas espécies encontrados no Pantanal brasileiro. Assim, a utilização deste guia para identificação das espécies de besouros rola-bostas e uma lista de espécies podem ser ferramentas importantes para auxiliar pesquisadores e incentivar novos inventários sobre a fauna de besouros rola-bostas no Pantanal brasileiro. Terra mosaico biodiversidade rolabosta rola bosta Coleoptera (Coleoptera Scarabaeidae Scarabaeinae ecológicas como nutrientes parasitas brasileiro 202 disso 6 3 184 1 registradas rolabostas bostas incipiente Assim 20 18 2

Resumo Enquadramento: Knowledge Translation (KT) permite a aplicabilidade eficaz e dinâmica de evidências científicas na prática clínica. Objetivo: Analisar o efeito de uma intervenção multifacetada baseada na KT para capacitação de profissionais de saúde na gestão da dor na vacinação em crianças. Metodologia: Estudo quase-experimental realizado entre agosto e dezembro de 2017, com nove profissionais de enfermagem atuantes em salas de vacinação de duas Unidades Básicas de Saúde do Distrito Federal. Realizou-se as fases Preparação e Implementação da estratégia multifacetada Evidence-based Practice for Improving Quality (EPIQ), na perspectiva da KT. Resultados: As fases da EPIQ permitiram a identificação de barreiras e facilitadores na vacinação em crianças, além do estabelecimento de metas e estratégias e mudança no conhecimento dos profissionais. Houve um acréscimo de 13,9% no percentual médio de respostas corretas no pós-teste (p = 0,036), sendo a temática “gestão da dor” a que apresentou maior efetividade (92,8%). Conclusão: A utilização da estratégia multifacetada EPIQ, baseada na KT, melhorou a aquisição de conhecimentos relacionados à gestão da dor na vacinação em crianças.

Abstract Background: Knowledge Translation (KT) allows the efficient and dynamic use of scientific evidence in clinical practice. Objective: To analyze the impact of a multifaceted KT intervention to train health care professionals in pain management in childhood vaccination. Methodology: This quasi-experimental study was conducted between August and December 2017, with nine nursing professionals working in the vaccination rooms of two Unidades Básicas de Saúde (UBSs - Basic Health Units) of the Brazilian Federal District. The “Preparation” and “Implementation” phases of the multifaceted KT intervention Evidence-based Practice for Improving Quality (EPIQ) were conducted. Results: The EPIQ phases allowed identifying the barriers to and facilitators of vaccination in children, establishing objectives and strategies, and improving health professionals’ knowledge. There was a 13.9% increase in the mean percentage of correct answers in the posttest (p = 0.036), with the topic “Pain management” presenting the highest score of correct answers (92.8%). Conclusion: Implementing the multifaceted KT intervention EPIQ improved the knowledge of pain management in childhood vaccination.

Resumen Marco contextual: Knowledge Translation (KT) permite la aplicación efectiva y dinámica de la evidencia científica en la práctica clínica. Objetivo: Analizar el efecto de una intervención multifacética basada en la KT para capacitar a los trabajadores de la salud en el manejo del dolor para la vacunación infantil. Metodología: Estudio cuasi experimental realizado entre agosto y diciembre de 2017, con nueve profesionales de enfermería que trabajan en salas de vacunación de dos Unidades Básicas de Salud del Distrito Federal. Se llevaron a cabo las fases de preparación e implementación de la estrategia multifacética Evidence-based Practice for Improving Quality (EPIQ), desde la perspectiva de la KT. Resultados: Las fases de la EPIQ permitieron identificar las dificultades y los facilitadores de la vacunación infantil, además de establecer objetivos, estrategias y cambios en los conocimientos de los profesionales. Hubo un aumento del 13,9% en el porcentaje medio de respuestas correctas en la prueba posterior (p = 0,036), y el tema “tratamiento del dolor” fue el que mostró una mayor eficacia (92,8%). Conclusión: El uso de la estrategia multifacética EPIQ, basada en la KT, mejoró la adquisición de conocimientos relacionados con el manejo del dolor en la vacunación infantil.

ABSTRACT: Sjögren syndrome is the second most common chronic autoimmune disease, environmental and hereditary mechanisms causes an autoimmune epithelitis that affect the exocrine glandular tissue mainly, but also other organs; because this broad spectrum of clinical characteristics, the diagnostic and treatment become a challenge. Studies has shown that 0.1-0.6 % of the population is affected, with predominance of females over males (9:1). In Colombia there are few descriptive epidemiological studies and characterization of the affected population. Clinical and epidemiological characterization of Sjögren syndrome patients. A descriptive cross-sectional observational study was conducted, 409 clinical histories of patients with the syndrome at San Ignacio University Hospital from 2012 to 2019 were analized. The data collected were subjected to a descriptive statistic. The average age of diagnosis was 59 years, the ratio female: male 9:1 (91.7 % and 8.3 % respectively), the highest frequency of the syndrome was found in the 51 to 60 years old group (131) followed by the 61 to 70 years old group (114). The most common clinical manifestation was xerostomia (90 %), minor salivary gland biopsy was the most frequent test requested (65 %). The osseoarticular involvement was the most frecuent concomitant disease. Although the etiology of Sjögren syndrome is little known, its characterization, as well as the identification of the diagnostic and therapeutic means used, is of great help in understanding the disease; this information will allow the development of increasingly effective and specific treatments. More studies are required, in different locations, which will highlight the differences between populations.

RESUMEN: El síndrome de Sjögren es la segunda enfermedad autoinmune crónica más prevalente; factores hereditarios y medioambientales interactúan provocando una “epitelitis autoinmune” que daña el tejido glandular exocrino principalmente, pero también a otros órganos; debido a esta heterogeneidad clínica, el diagnóstico y tratamiento constituyen un desafío. Estudios demuestran que afecta al 0,1-0,6 % de la población, con predilección por el sexo femenino (9:1). En Colombia existen pocos estudios epidemiológicos descriptivos y de caracterización en este síndrome. Caracterizar los parámetros clínicos y epidemiológicos de pacientes con síndrome de Sjögren. Se realizó un estudio observacional descriptivo de corte transversal, se revisaron historias clínicas de 409 pacientes con el síndrome que asistieron al Hospital Universitario San Ignacio entre 2012 y 2019. Los datos se analizaron usando estadística descriptiva. La edad promedio de diagnóstico fue 59 años, la relación mujer: hombre 9:1, (91,7 % y 8,3 % respectivamente). Hubo mayor prevalencia en pacientes de 51 a 60 años (131) seguido por los de 61-70 años (114). La manifestación clínica más común fue la xerostomía (90 %); la biopsia de glándula salival menor fue el examen complementario más solicitado (65 %). El compromiso óseo-articular, fue la enfermedad concomitante más asociada. La etiología de la enfermedad es poco conocida, sin embargo, su caracterización, así como la identificación de medios diagnósticos y terapéuticos ayuda en la comprensión de la clínica; dicha información permitirá el desarrollo de tratamientos cada vez más efectivos y específicos.

Abstract Background: Loud sound has a negative impact on the health of the neonate in the short and long term. Its reduction is a problem in the newborn intensive care unit (NICU). Objective: To determine the decibel levels inside and outside the incubator before and after speaking in the NICU of a tertiary care hospital. Material and methods: An experimental, analytical, prospective, cross-sectional study was carried out, accepted by the ethics committee. Decibels were measured before and after speaking inside and outside the incubator, and decibel levels were compared between shifts. Results: When comparing the average decibels inside the incubator before speaking, we found an average of 60 ± 3.8 and after speaking 65 ± 4 being statistically significant (< 0.001). The total average of decibels outside the incubator before speaking was 64.1 ± 3.7 and after speaking 69.1 ± 3.9 being statistically significant (< 0.001). Conclusions: After talking and comparing the decibels inside vs. outside, we found that outside the incubator is 4 decibels higher than inside (p < 0.001). When comparing the shifts, the evening shift was the noisiest and the night shift the least.

Resumen Antecedentes: El sonido elevado conlleva un impacto negativo en la salud del neonato a corto y largo plazo. La reducción de este es un problema en la unidad de cuidados intensivos neonatales (UCIN). Objetivo: Determinar los niveles de decibelios dentro y fuera de la incubadora antes y después de hablar en la UCIN de un hospital de tercer nivel. Material y métodos: Se realizó un estudio experimental, analítico, prospectivo, transversal, aceptado por el comité de ética. Se midieron los decibelios antes y después de hablar dentro y fuera de la incubadora y se compararon los niveles de decibelios entre turnos. Resultados: Al comparar el promedio de decibelios dentro de la incubadora antes de hablar encontramos un promedio de 60 ± 3.8 y después de hablar 65 ± 4, siendo la diferencia estadísticamente significativa (p < 0.001). El promedio total de decibelios fuera de la incubadora antes de hablar fue de 64.1 ± 3.7 y después de hablar 69.1 ± 3.9, siendo la diferencia estadísticamente significativa (p < 0.001). Conclusiones: Después de hablar y comparar los decibelios dentro vs. fuera encontramos que fuera de la incubadora tiene 4 decibelios más que dentro (p < 0.001). Al comparar las jornadas, el turno vespertino fue el más ruidoso y el nocturno el menos.

Abstract: Introduction: teratomas are the most common extragonadal germ cell neoplasm in neonates, but they can have different locations. We describe the diagnostic-therapeutic process of three newborns with this type of tumor. Cases presentation: these are three neonates in whom, before birth, a tumor was detected by echocardiography in different locations: orbit, oropharynx, and sacrococcygeal. All three underwent surgical resection in the perinatal stage. By histopathology, the report was a mature teratoma. Alpha-fetoprotein and human chorionic gonadotropin levels confirmed the diagnosis. At the age of six months, the postoperative course has been satisfactory. Conclusions: identification of teratomas during gestation is important for management planning at birth. Complete surgical resection is the treatment of choice, and serum levels of tumor markers should be part of long-term surveillance.

Resumen: Introducción: los teratomas constituyen la neoplasia germinal extragonadal más común en neonatos, pero pueden tener diferentes localizaciones. Presentamos tres recién nacidos con este tipo de tumores, a fin de dar a conocer el proceso diagnóstico-terapéutico. Presentación de los casos: se trata de tres RN en quienes, antes del nacimiento, se detectó la presencia de una tumoración por ecocardiografía en localizaciones diferentes: órbita, orofaringe y sacrococcígeo. En los tres se realizó resección quirúrgica en la etapa perinatal; por histopatología el reporte fue de teratoma maduro. Los niveles de alfafetoproteína y de la gonadotropina coriónica humana confirmaron el diagnóstico. A la edad de seis meses, la evolución postoperatoria ha sido satisfactoria. Conclusiones: la identificación de teratomas durante la gestación es importante para la planeación del manejo al nacimiento. La resección completa es el tratamiento de elección, y los niveles séricos de marcadores tumorales deben formar parte de la vigilancia a largo plazo.

Objective: To describe the methodological and operational aspects of the Cancer Surveillance Project and its associated factors: population-based and hospital-based registry (VIGICAN), in Mato Grosso (MT). Methods: VIGICAN was divided into two projects: an extension one, which updated the data from the Population-Based Cancer Registry (RCBP) of MT in the period 2008 to 2016; and one of research, which collected primary data, through individual interviews and analysis of medical records of people with a diagnosis of cancer, aged 18 years or over, treated at reference hospitals for oncology. To analyze the factors associated with cancer, the following variables were collected: socioeconomic and demographic, social support, status and health behavior, and environmental exposure. Results: In the períod from 2008 to 2016, approximately one hundred thousand cases of cancer (incident and prevalent) were reported in the RCBP Cuiabá and Interior. After validation procedures, fifty thousand incident cases were chosen. The survey interviewed 1,012 patients, 38.2% living in the municipalities of Cuiabá and Várzea Grande, 60.4% in the interior of the state and 1.4% in other states. Preliminary data revealed that the majority were female (55.0%) and younger than 60 years (54.3%). Among those interviewed, 7.2% reported smoking tobacco, 15.5% consumed alcoholic beverages (15.5%) and 32.7% lived close to crops. Conclusion: The development of these projects allowed the integration of education with health services and will enable the recognition of specificities and different exposure scenarios and factors associated with cancer in the Mato Grosso territory.

Objetivo: Descrever os aspectos metodológicos e operacionais do Projeto Vigilância do Câncer e seus fatores associados: registro de base populacional e hospitalar (VIGICAN), em Mato Grosso (MT). Métodos: O VIGICAN se desdobrou em dois projetos: um de extensão, que atualizou os dados dos Registros de Câncer de Base Populacional (RCBP) de MT no período de 2008 a 2016; e um de pesquisa, que coletou dados primários, por meio de entrevistas individuais e análise de prontuários de pessoas com diagnóstico de câncer, com 18 anos ou mais, atendidas em hospitais de referência para oncologia. Para analisar os fatores associados ao câncer, foram coletadas as seguintes variáveis: socioeconômicas e demográficas, suporte social, situação e comportamentos de saúde e exposição ambiental. Resultados: No período de 2008 a 2016, foram notificados nos RCBP Cuiabá e Interior, aproximadamente, 100 mil casos de câncer (incidentes e prevalentes). Após procedimentos de validação, foram eleitos 50 mil casos incidentes. A pesquisa entrevistou 1.012 pacientes, sendo 38,2% residentes nos municípios de Cuiabá e Várzea Grande, 60,4% no interior do estado e 1,4% em outros estados. Os dados preliminares revelaram que a maioria era do sexo feminino (55,0%) e tinha menos de 60 anos (54,3%). Entre os entrevistados, 7,2% relataram fumar tabaco, 15,5% consumiam bebidas alcoólicas (15,5%) e 32,7% moravam próximos a lavouras. Conclusão: O desenvolvimento desses projetos permitiu a integração do ensino com os serviços de saúde e possibilitará o reconhecimento das especificidades e diferentes cenários de exposição e fatores associados ao câncer do território mato-grossense.

RESUMEN: Los viveros forestales que producen seedlings de especies nativas deben poner a disposición una alta diversidad forestal para satisfacer las demandas de los proyectos de recuperación. De esta forma, comprender el comportamiento de las diferentes especies y mejorar la tecnología de producción califica el manejo y reduce las pérdidas. Por lo tanto, se estudió el efecto de la adición de polímero hidroretenedor al sustrato sobre el desempeño de tres especies nativas cultivadas en condiciones de vivero. El diseño experimental fue completamente al azar con un esquema factorial. Se investigaron rasgos de supervivencia, morfológicos y fisiológicos en plántulas. En general, se observó que las especies estudiadas resultaron aptas para la técnica de trasplante con alta supervivencia a pesar de la influencia negativa del hidrogel sobre esta variable en las plántulas. Por otro lado, el uso de polímero hidroretenedor mejoró el crecimiento en altura, diámetro del tallo y la calidad de estas plántulas, demostrando ser una estrategia viable en la producción de seedlings nativas en un vivero.

SUMMARY: Forest nurseries that produce native species seedlings need to make heigh forestry diversity available to supply the demands of forest ecosystem recovery projects. In this way, understanding the behavior of different species and improving production technology improve management and reduce losses. We here studied the effect of the water-retaining polymer addition to the substrate on the performance of three native species grown under nursery conditions. The experimental design was completely randomized with a factorial scheme. Survival, morphological and physiological attributes of seedlings were investigated. In general, it was observed that studied species proved to be suitable for the subculturing technique, with high survival despite of hydrogel negative influence on this variable in seedlings. On the other hand, the use of water-retaining polymer improved growth in height, stem diameter and seedlings quality, demonstrating to be a viable strategy in native seedlings production in a nursery.

Resumen El agente causal de la enfermedad por coronavirus (COVID-19), asociado a síndrome respiratorio agudo grave (SARS-CoV-2), genera un espectro de síntomas que afectan fundamentalmente el sistema respiratorio, el sistema nervioso central (SNC), la regulación hemostásica y el sistema inmune. La parálisis bilateral de cuerdas vocales (PBCV) es una entidad cuya incidencia en infectados se desconoce, bien porque no se presentan durante el tiempo suficiente o por la dificultad de establecer una causalidad directa con el virus. La infección vírica, como causa de PBCV, está descrita en la literatura y se sospecha que una parte de los casos idiopáticos corresponden a infecciones víricas no diagnosticadas. Aunque los mecanismos neurotrópicos no están completamente aclarados para el SARS-CoV-2, existen indicios sólidos para asegurar su potencial neuroinvasivo. Las causas traumáticas, neoplásicas y neurológicas son las etiologías más comunes de PBCV, sin que se pueda descartar el origen vírico. Es plausible una causalidad entre el COVID-19 y la PBCV, que requerirá mayores estudios a corto y largo plazo. Presentamos una serie de casos que sostienen y discuten la hipótesis en consideración.

Abstract The agent that causes the coronavirus disease (COVID-19), associated with the severe acute respiratory syndrome (SARS-CoV-2), produces a spectrum of symptoms that mainly affect the respiratory system, the central nervous system (CNS), the regulation of hemostasis and the immune system. Bilateral vocal fold paralysis (BVFP) is a condition of unknown incidence among infected patients, either because it is short-lived or because of the difficulty in establishing a direct cause to the virus. Viral infection has been described in the literature as a cause of BVFP and there is the suspicion that a proportion of the idiopathic cases are due to undiagnosed viral infections. Although the neurotropic mechanisms for SARS-CoV-2 remain unclear, there is strong evidence to ensure its neuroinvasive potential. The most frequent etiologies of BVFP are trauma, neoplasm, and neurological, but a viral origin should not be ruled out. Causality between COVID-19 and BVFP is plausible and will require further study in the short and long term. We present a case series that support and discuss the hypothesis under consideration.