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Análisis de las Variaciones Anatómicas y Dimensionales del Canal Nasopalatino Mediante Tomografía Computarizada de Haz Cónico
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Godoy, Iván E

; Valenzuela, Kimberly A

; Arce, Cecilia P

; Arqueros, Marcelo R

; Rodríguez, Macarena C

; Niklander, Sven E

; Meléndez, Patricio A

International Journal of Morphology

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jun 2023, Volume 41 N. 3 Pages 881 - 888

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

SUMMARY: Anatomical knowledge of the nasopalatine canal (PNC) is essential for performing surgeries in the anterior sector of the maxilla and thus anticipating possible complications. The objective of this work is to evaluate and determine the anatomical and dimensional variations of the CNP according to sex, age and dental status. This cross-sectional study analyzed a total of 251 CBCT images obtained from the database of the Oral and Maxillofacial Imaging Service of the Faculty of Dentistry of the Andrés Bello University, Viña del Mar, Chile. To evaluate the statistical association between CNP variations with sex, age and dental status, the Student's T test, chi-square and ANOVA (p<0.5) were performed. The CNP showed variability in terms of morphology and dimensions. The most predominant shape of the PNC was cylindrical (65.33 %) and the most frequent shape of the canal curvature in the sagittal plane was straight inclined (54.98 %). The mean length was 10.92 ± 2.82 mm, being greater in men (p<0.01). The most frequent anatomical variation in the coronal plane was the single channel type (57.76 %). The effect of sex on the distance between the anterior wall of the PNC and the buccal crest of the maxilla was not significant (p>0.05). In addition, a significant difference was detected between the dental state and the dimension of the vestibular table in relation to the CNP (p<0.01). CNP variations should be considered to avoid potential complications during surgical procedures.

RESUMEN: El conocimiento anatómico del canal nasopalatino (CNP) es fundamental para la realización de cirugías en el sector anterior del maxilar y así prever posibles complicaciones. El objetivo de este trabajo es evaluar y determinar las variaciones anatómicas y dimensionales del CNP según sexo, edad y estado dental. Este estudio transversal analizó un total de 251 imágenes de TCHC obtenidas de la base de datos del Servicio de Imagenología Oral y Maxilofacial de la Facultad de Odontología de la Universidad Andrés Bello, Viña del Mar, Chile. Para evaluar la asociación estadística entre variaciones del CNP con sexo, edad y estado dentario se realizó la prueba T de Student, chi-cuadrado y ANOVA (p<0,5). El CNP mostró variabilidad en cuanto a morfología y dimensiones. La forma más predominante del CNP fue cilíndrica (65,33 %) y la forma más frecuente de la curvatura del canal en el plano sagital fue recto inclinado (54,98 %). La longitud media fue de 10,92 ± 2,82 mm, siendo mayor en hombres (p<0,01). La variación anatómica más frecuente en el plano coronal fue el tipo canal único (57,76 %). El efecto del sexo sobre la distancia entre la pared anterior del CNP y la cresta vestibular del maxilar no fue significativo (p>0,05). Además, se detectó diferencia significativa entre el estado dentario y la dimensión de la tabla vestibular en relación con el CNP (p<0,01). Se deben considerar las variaciones de CNP para evitar posibles complicaciones durante los procedimientos quirúrgicos.

COVID-19 outcomes in people living with HIV: Peering through the waves
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Sales, Thaís Lorenna Souza

; Souza-Silva, Maíra Viana Rego

; Delfino-Pereira, Polianna

; Neves, João Victor Baroni

; Sacioto, Manuela Furtado

; Assis, Vivian Costa Morais de

; Duani, Helena

; Oliveira, Neimy Ramos de

; Sampaio, Natália da Cunha Severino

; Ramos, Lucas Emanuel Ferreira

; Schwarzbold, Alexandre Vargas

; Jorge, Alzira de Oliveira

; Scotton, Ana Luiza Bahia Alves

; Castro, Bruno Mateus de

; Silva, Carla Thais Cândida Alves da

; Ramos, Carolina Marques

; Anschau, Fernando

; Botoni, Fernando Antonio

; Grizende, Genna Maira Santos

; Nascimento, Guilherme Fagundes

; Ruschel, Karen Brasil

; Menezes, Luanna Silva Monteiro

; Castro, Luís César de

; Nasi, Luiz Antônio

; Carneiro, Marcelo

; Godoy, Mariana Frizzo de

; Nogueira, Matheus Carvalho Alves

; Guimarães Júnior, Milton Henriques

; Ziegelmann, Patricia Klarmann

; Almeida, Rafaela Charão de

; Francisco, Saionara Cristina

; Silveira Neto, Sidney Teodoro

; Araújo, Silvia Ferreira

; Avelino-Silva, Thiago Junqueira

; Aliberti, Márlon Juliano Romero

; Pires, Magda Carvalho

; Silva, Eduardo Sérgio da

; Marcolino, Milena Soriano

Clinics

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2023, Volume 78 elocation 100223

Abstract: En | Text: En | PDF: En

Abstract Objective To evaluate clinical characteristics and outcomes of COVID-19 patients infected with HIV, and to compare with a paired sample without HIV infection. Methods This is a substudy of a Brazilian multicentric cohort that comprised two periods (2020 and 2021). Data was obtained through the retrospective review of medical records. Primary outcomes were admission to the intensive care unit, invasive mechanical ventilation, and death. Patients with HIV and controls were matched for age, sex, number of comorbidities, and hospital of origin using the technique of propensity score matching (up to 4:1). They were compared using the Chi-Square or Fisher's Exact tests for categorical variables and the Wilcoxon for numerical variables. Results Throughout the study, 17,101 COVID-19 patients were hospitalized, and 130 (0.76%) of those were infected with HIV. The median age was 54 (IQR: 43.0;64.0) years in 2020 and 53 (IQR: 46.0;63.5) years in 2021, with a predominance of females in both periods. People Living with HIV (PLHIV) and their controls showed similar prevalence for admission to the ICU and invasive mechanical ventilation requirement in the two periods, with no significant differences. In 2020, in-hospital mortality was higher in the PLHIV compared to the controls (27.9% vs. 17.7%; p = 0.049), but there was no difference in mortality between groups in 2021 (25.0% vs. 25.1%; p > 0.999). Conclusions Our results reiterate that PLHIV were at higher risk of COVID-19 mortality in the early stages of the pandemic, however, this finding did not sustain in 2021, when the mortality rate is similar to the control group.

https://doi.org/10.1016/j.clinsp.2023.100223

Vigilancia de la resistencia del Mycobacterium tuberculosis a los fármacos en Paraguay, 2014 a 2017
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Estigarribia, Gladys

; Aguirre, Sarita

; Sequera, Guillermo

; Méndez, Julieta

; Aguilar, Gloria

; Sosa, Natalia

; Céspedes, Cynthia

; Ferreira, Patricia

; Ortiz, Analia

; Rios, Patricia

; Martinez, Rossana

; Silguero, Zulema

; Weiler, Natalie

; Orrego, Veronica

; Godoy, Margarita

Anales de la Facultad de Ciencias Médicas (Asunción)

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dec 2022, Volume 55 N. 3 Pages 27 - 34

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

ABSTRACT The objective of the study was to identify the resistance of Mycobacterium tuberculosis to drugs in Paraguay, 2014 to 2017. A retrospective observational study was carried out. The data from the National Tuberculosis Program of Paraguay between the years 2014 to 2017 were used. All patients with a diagnosis of Tuberculosis who underwent a resistance test were included. Data were extracted in Excel and analyzed with Stata 17.0. 3429 tuberculosis patients who had a result of at least one sensitivity test were included. Resistance was found in 2.1% of patients. Resistance to Rifampicin was present in 0.3% of cases while to Izionazide in 0.6% of cases. The prevalence of resistance was higher in men 3.4 (95% CI 2.2 - 4.8) p = 0.003, who resided in the Chaco 6.0 (95% CI 3.4 - 9.7) p = 0.000, previously treated 2.7 (95% CI 1.1 - 5.1) p = 0.010. In the model, it was observed that a previously treated patient has a greater chance of having resistance OR 2.62 (95% CI 1.1 - 6.24). The prevalence of resistance of Mycobacterium tuberculosis to drugs was related to having been previously treated.

RESUMEN El objetivo del estudio fue identificar la resistencia del Mycobacterium tuberculosis a los fármacos en Paraguay, 2014 a 2017. Se realizó un estudio observacional retrospectivo. Se utilizaron los datos del Programa Nacional de Tuberculosis del Paraguay comprendidos entre los años 2014 a 2017. Se incluyeron todos los pacientes con diagnóstico de Tuberculosis que se realizaron un test de resistencia. Se extrajeron los datos en Excel y fueron analizados con Stata 17.0. Se incluyeron 3429 pacientes con tuberculosis que contaban con resultado de al menos una prueba de sensibilidad. La resistencia se encontró en 2.1% de los pacientes. La resistencia a la Rifampicina estuvo presente en el 0.3% de los casos mientras que a la Izionazida en el 0.6% de los casos. La prevalencia de resistencia fue más alta en hombres 3.4 (IC 95% 2.2 - 4.8) p=0.003, que residían en el chaco 6.0 (IC 95% 3.4 - 9.7) p=0.000, previamente tratados 2.7 (IC 95% 1.1 - 5.1) p=0.010. En el modelo se pudo observar que un paciente previamente tratado tiene mayores posibilidades de tener resistencia OR 2.62 (IC 95% 1.1 - 6.24). La prevalencia de resistencia del Mycobacterium tuberculosis a fármacos estuvo relacionada con haber sido previamente tratado.

https://doi.org/10.18004/anales/2022.055.03.27

Evaluación de la Mineralización en Mandíbula y Diente de Trucha Arcoíris (Oncorhynchus mykiss) Mediante Microscopía Electrónica de Barrido de Presión Variable Acoplada a Detector de Espectroscopía de Rayos X de Energía Dispersiva
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Godoy, Karina

; Sandoval, Cristian

; Manterola-Barroso, Carlos

; Salinas, Paulo

; Salazar, Luis A

; Rojas, Mariana

International Journal of Morphology

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2022, Volume 40 N. 2 Pages 530 - 539

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

SUMMARY: In salmon farming systems, X-ray images are used to evaluate the spine and fins, but these do not allow quantifying the minerals that make up the bone, for different techniques that are destructive are used. Variable Pressure Scanning Electron Microscopy (VP SEM) coupled to an Energy Dispersive X-ray spectroscopy detector (EDX), allows us to analyze the microstructure and at the same time determine chemical elements, percentages, and distribution present at specific points in a sample. Five control and five jaw deformity trout, from freshwater and in the smolt stage were used. The structure and mineralization of the bone were analyzed, an average six quantification points were chosen per region of interest (ROI) and then they were analyzed by Scanning Electron Microscopy (VP SEM-EDX). The data obtained have shown the average mass percentage of calcium in trout joint bone was 8.07 % and 14.48 % in jaw deformity and control trout, respectively; and the average mass percentage of phosphorus is 4.07 % and 7.60 %, in jaw deformity and control trout, respectively. Other elements present in the sample were also identified, such as magnesium, sodium, carbon, oxygen, nitrogen, sulphur, fluorine, zinc, aluminium, and iron, with special interest the increase of carbon in the analyzed samples with mandibular deformity and the presence of aluminum in all samples. The VP SEM-EDX Technique allows direct evaluation, without destruction of the sample and with minimal sample preparation. In bone, the most frequent application of SEM-EDX is the measurement of the content of calcium (Ca) and phosphorus (P) and the relationship that exists between these elements, calcium/phosphorus (Ca/P), in the sample. At the same time, the technique allows us to detect other microelements from water or food that can eventually cause alterations in fish, confirming the hypothesis that elemental microanalysis is useful for salmon farming.

RESUMEN: En salmonicultura se utilizan imágenes de rayos X, para evaluar la columna vertebral y las aletas, pero estas no permiten cuantificar los minerales que constituyen el hueso, para esto se utilizan otras técnicas que son destructivas. La Microscopía Electrónica de Barrido de presión variable (VP SEM) acoplada al detector espectroscopia de rayos X de energía dispersiva (EDX) acoplado, nos permite analizar la microestructura y a la vez determinar elementos químicos, porcentaje y distribución presentes en puntos específicos en una muestra. Se utilizaron 5 truchas control y 5 con deformidad mandibular, de agua dulce en etapa de smolt, se analizó la estructura y mineralización del hueso, se eligieron en promedio 6 puntos de cuantificación por región de interés y se analizaron mediante Microscopía Electrónica de Barrido (VP SEM-EDX). Los datos obtenidos muestran porcentaje en masa de Ca promedio en hueso articular de truchas fueron de 8.07 % y de 14.48 % en truchas con deformidad mandibular y control respectivamente y el porcentaje en masa promedio de P es de 4.07 % y 7.60 %, en truchas con deformidad mandibular y control respectivamente. Se identificó además otros elementos presentes en la muestra como Mg, Na, C, O, N, S, F, Zn, Al y Fe, con especial interés en el aumento de carbono en las muestras analizadas con deformidad mandibular y la presencia de aluminio en todas las muestras. La Técnica de VP SEM-EDX, permite evaluar de forma directa, sin destrucción de la muestra y con una preparación mínima de la muestra. En el hueso, la aplicación más frecuente de SEM-EDX es la medición del contenido de Ca y P y la relación que existe entre estos elementos Ca/P, en la muestra. Paralelamente la técnica nos permite la detección de otros microelementos provenientes del agua o de la alimentación y que eventualmente pueden provocar alteraciones en los peces, confirmando la hipótesis que el microanálisis elemental tiene utilidad para la salmonicultura.

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MORPHOLOGICAL ASPECT OF PYOGENIC SPINAL EPIDURAL ABSCESSES. PART I
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Bazán, Pedro Luis

; Adaro, José Carlos Soria

; Ciccioli, Nicolás Maximiliano

; Adaro, Alfredo Osvaldo Godoy

; Gonzalez, Richard Alejandro Avero

Coluna/Columna

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2022, Volume 21 N. 1 elocation e260738

Abstract: Pt En Es | Text: Pt En Es | PDF: Pt | PDF: En | PDF: Es

RESUMO Introdução: O abscesso peridural piogênico da coluna (PSEA) é de difícil diagnóstico e pode ter consequências devastadoras. A ressonância magnética (RM) tem alta sensibilidade e especificidade, que são aumentadas ainda mais com contraste. Existem várias classificações dos processos infecciosos vertebrais, com ênfase em espondilodiscite. Objetivo: Analisar os parâmetros morfológicos e sua reprodutibilidade; e analisar as diferentes sequências de imagens de ressonância. Métodos: A partir de um banco de imagens, foi planejada uma classificação morfológica do PSEA, com cinco parâmetros: Região (R) que indica os limites superior e inferior do abscesso; Localização (U), indicando se o abscesso é anterior ou posterior dentro do canal; Comprometimento (C), meníngeo ou de conteúdo das estruturas; Associação (A), discite, osteomielite ou ambas e Perivertebral (P), abscesso extravertebral anterior, lateral ou posterior. Os três primeiros parâmetros dão uma ideia do volume da PSEA, enquanto os dois últimos mostram os focos infecciosos relacionados. Trinta e cinco casos foram analisados usando o coeficiente de Kappa. Resultados: A reprodutibilidade global intra e interobservador foi Kappa 0,81. Os resultados para cada parâmetro foram os seguintes: R = 0,95, U = 0,92, C = 0,66, A = 0,70 e P = 0,80. Os três primeiros dão uma noção de volume e os dois últimos se relacionam com a presença de focos infecciosos vertebrais fora do canal. A RM ponderada em T2 com contraste foi considerada a sequência de imagens mais eficaz. Conclusões: A classificação morfológica é simples de usar e tem excelente reprodutibilidade. Os parâmetros com maior reprodutibilidade foram região e localização com valores > 0,92. A adição do contraste de gadolínio aumentou a sensibilidade do diagnóstico; o uso de imagens sagitais e axiais em RM T2 foi a sequência de imagens mais sensível. Nível de Evidência III; Original.

ABSTRACT Background: Pyogenic Spinal Epidural Abscess (PSEA) is difficult to diagnose and can have devastating consequences. Magnetic Resonance Imaging (MRI) has high sensitivity and specificity, which are further increased with the use of contrast. There are several classifications of vertebral infectious processes, with emphasis on spondylodiscitis. Objective: To analyze the morphological parameters and their reproducibility; and to analyze different resonance imaging sequences. Methods: Using an image database, a morphological classification of PSEA was planned, with five parameters: Region (R), indicating the upper and lower limits of the abscess; Location (U), indicating whether the abscess is anterior or posterior within the canal; Compromise (C), meningeal or content of the structures; Association (A), discitis, osteomyelitis or both; and Perivertebral (P), anterior, lateral or posterior extravertebral abscess. The first three parameters give an idea of the volume of the PSEA, while the last two give the related infectious foci. Thirty-five cases were analyzed using Kappa’s coefficient. Results: The global intra- and interobserver reproducibility was Kappa 0.81. The results for each parameter were as follows: R=0.95, U=0.92, C=0.66, A=0.70 and P=0.80. The first three give a notion of volume and the last two relate to the presence of vertebral infectious foci outside the canal. T2 weighted MRI with contrast was found to be the most effective imaging sequence. Conclusion: The morphological classification is simple to use, with excellent reproducibility. The parameters with the highest reproducibility were region and location, with values >0.92. The addition of gadolinium contrast increased the sensitivity of the diagnosis; the use of sagittal and axial images in T2-MRI was the most sensitive imaging sequence. Evidence Level III; Original.

RESUMEN Introducción: El absceso epidural espinal piógeno (PSEA) es difícil de diagnosticar y puede tener consecuencias devastadoras. La resonancia magnética (RM) tiene una alta sensibilidad y especificidad, que aumentan aún más con el contraste. Existen varias clasificaciones de los procesos infecciosos vertebrales, con énfasis en la espondilodiscitis. Objetivo: Analizar los parámetros morfológicos y su reproducibilidad; y analizar las diferentes secuencias de imágenes de resonancia. Métodos: Utilizando un banco de imágenes, se planificó una clasificación morfológica del PSEA, con 5 parámetros: Región (R), que indica los límites superior e inferior del absceso; Ubicación (U), que indica si el absceso es anterior o posterior dentro del canal; Compromiso (C), meníngeo o contenido de las estructuras; Asociación (A), discitis, osteomielitis o ambas; y absceso perivertebral (P), anterior, lateral o posterior extravertebral. Los tres primeros parámetros dan una idea del volumen del PSEA y los dos últimos los focos infecciosos relacionados. Se analizaron 35 casos mediante el coeficiente Kappa. Resultados: La reproducibilidad general intra e interobservador fue Kappa 0,81. Los resultados de cada parámetro fueron los siguientes:: R=0,95, U=0,92, C=0,66, A=0,70 y P=0,80. Los tres primeros dan una noción de volumen y los dos últimos se relacionan con la presencia de focos infecciosos vertebrales fuera del canal. La resonancia magnética ponderada en T2 con contraste se consideró la secuencia de imágenes más eficaz. Conclusiones: La clasificación morfológica es sencilla de utilizar y tiene una excelente reproductividad. Los parámetros con mayor reproducibilidad fueron la región y ubicación con valores > 0,92. La adición de contraste de gadolinio aumentó la sensibilidad del diagnóstico; el uso de imágenes sagitales y axiales en RM T2 fue la secuencia de imágenes más sensible. Nivel de Evidencia III; Original.

https://doi.org/10.1590/s1808-185120222101260738

Plasma lathosterol measures rates of cholesterol synthesis and efficiency of dietary phytosterols in reducing the plasma cholesterol concentration
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Nunes, Valéria Sutti

; Ilha, Angela de Oliveira Godoy

; Ferreira, Guilherme da Silva

; Bombo, Renata de Paula Assis

; Afonso, Milessa Silva

; Lavrador, Maria Silvia Ferrari

; Machado, Roberta Marcondes

; Nakandakare, Edna Regina

; Quintão, Eder Carlos Rocha

; Lottenberg, Ana Maria

Clinics

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2022, Volume 77 elocation 100028

Abstract: En | Text: En | PDF: En

Abstract Objectives Because the plasma campesterol/cholesterol ratio does not differ between groups that absorb different amounts of cholesterol, the authors investigated whether the plasma Phytosterols (PS) relate to the body's cholesterol synthesis rate measured as non-cholesterol sterol precursors (lathosterol). Method The authors studied 38 non-obese volunteers (58±12 years; Low-Density Lipoprotein Cholesterol ‒ LDL-C ≥ 130 mg/dL) randomly assigned to consume 400 mL/day of soy milk (Control phase) or soy milk + PS (1.6 g/day) for four weeks in a double-blind, cross-over study. PS and lathosterol were measured in plasma by gas chromatography coupled to mass spectrophotometry. Results PS treatment reduced plasma total cholesterol concentration (-5.5%, p < 0.001), LDL-C (-7.6%, p < 0.001), triglycerides (-13.6%, p < 0.0085), and apolipoprotein B (apo B) (-6.3%, p < 0.008), without changing high density lipoprotein cholesterol (HDL-C concentration), but plasma lathosterol, campesterol and sitosterol expressed per plasma cholesterol increased. Conclusions The lathosterol-to-cholesterol plasma ratio predicted the plasma cholesterol response to PS feeding. The highest plasma lathosterol concentration during the control phase was associated with a lack of response of plasma cholesterol during the PS treatment period. Consequently, cholesterol synthesis in non-responders to dietary PS being elevated in the control phase indicates these cases resist to further synthesis rise, whereas responders to dietary PS, having in the control phase synthesis values lower than non-responders, expand synthesis on alimentary PS. Responders absorb more PS than non-responders, likely resulting from responders delivering into the intestinal lumen less endogenous cholesterol than non-responders do, thus facilitating greater intestinal absorption of PS shown as increased plasma PS concentration.

https://doi.org/10.1016/j.clinsp.2022.100028

Team emergency assessment measure (TEAM) of non-technical skills: The Brazilian Portuguese version of the TEAM tool
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Giugni, Fernando Rabioglio

; Dias, Roger Daglius

; Rodrigues, Caio Godoy

; Pinesi, Henrique Trombini

; Scalabrini-Neto, Augusto

Clinics

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2022, Volume 77 elocation 100043

Abstract: En | Text: En | PDF: En

Abstract Objectives The aim of this study was to conduct the translation and cross-cultural adaptation of the original Team Emergency Assessment Measure (TEAM) tool into the Brazilian Portuguese language and investigate the internal consistency, inter-rater reliability, and concurrent validity of this new version (bp-TEAM). Methods Independent medical translators performed forward and backward translations of the TEAM tool between English and Portuguese, creating the bp-TEAM. The authors selected 23 videos from final-year medical students during in-situ emergency simulations. Three independent raters assessed all the videos using the bp-TEAM and provided a score for each of the 12 items of the tool. The authors assessed the internal consistency and the inter-rater reliability of the tool. Results Raters assessed all 23 videos. Internal consistency was assessed among the 11 items of the bp-TEAM from one rater, yielding a Cronbach's alpha of 0.89. inter-item correlation analysis yielded a mean correlation coefficient rho of 0.46. Inter-rater reliability analysis among the three raters yielded an intraclass correlation coefficient of 0.86 (95% CI 0.83‒0.89), p < 0.001. Conclusion The Brazilian Portuguese version of the TEAM tool presented acceptable psychometric properties, similar to the original English version.

https://doi.org/10.1016/j.clinsp.2022.100043

HETEROTOPIC OSSIFICATION IN ACETABULAR FRACTURES: SYSTEMATIC REVIEW AND META-ANALYSIS OF PROPHYLAXIS
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BUENO, THIAGO SANCHEZ PIRES

; GODOY, GABRIEL PARIS DE

; FURUKAVA, REBECA BARROS

; GAGGIOLI, NICOLE TAKAKURA

; TAMAOKI, MARCEL JUN SUGAWARA

; MATSUNAGA, FABIO TERUO

; BELLOTI, JOÃO CARLOS

Acta Ortopédica Brasileira

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dec 2021, Volume 29 N. 6 Pages 331 - 340

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO Objetivo: A profilaxia e o tratamento da ossificação heterotópica ainda são controversos. O objetivo desta pesquisa foi avaliar a efetividade das intervenções para prevenir o desenvolvimento da ossificação heterotópica após a fixação cirúrgica das fraturas do acetábulo. Métodos: Foi realizada uma revisão sistemática com pesquisa nas bases de dados PubMed/MEDLINE, Embase, LILACS e Cochrane até 4 de agosto de 2020, sem restrições quanto ao idioma e ano de publicação. Foram incluídos apenas ensaios clínicos randomizados realizados em humanos sem restrições com base na dosagem dos tratamentos, no uso e na duração da profilaxia. Cálculos de metanálise foram realizados utilizando o software Review Manager desenvolvido pela Cochrane. Resultados: Dois estudos compararam o uso de radioterapia e indometacina e três compararam o uso de indometacina com um grupo placebo ou não indometacina. Os cálculos de metanálise não indicaram diferenças estatísticas entre radioterapia versus indometacina (RR 1.45, IC de 95% 0.97 a 2.17, p = 0,55) e indometacina versus placebo ou não indometacina (RR 0.85, IC de 95% 0.68 a 1.06, p = 0,59). Conclusão: Não há evidências suficientes para afirmar que a utilização da radioterapia ou da indometacina é efetiva para prevenir a formação da ossificação heterotópica após cirurgias por fraturas do acetábulo. Além disso, o número de complicações foi maior no grupo indometacina quando comparado ao placebo ou à não intervenção. Nível de Evidência I, Revisão Sistemática.

ABSTRACT Objective: Heterotopic ossification is defined as the formation of trabecular bone in soft tissues. It is a common complication after surgical treatment of acetabular fractures. However, its prophylaxis and treatment are still controversial. The objective of this research is to evaluate the effectiveness of actions to prevent the development of heterotopic ossification after surgical correction of acetabular fractures. Methods: A systematic review was carried out with research in the databases PubMed/MEDLINE, Embase, LILACS and Cochrane until August 4, 2020, without restrictions on language and year of publication. Only randomized clinical studies carried out in humans without restrictions based on the dosage of treatments, use and duration of prophylaxis were included in this review. Results: Two studies compared the use of radiotherapy and indomethacin and three compared the use of indomethacin with a placebo or non-indomethacin group. The meta-analysis calculations did not indicate statistical differences between radiotherapy versus indomethacin (RR 1.45, IC 95% 0.97 to 2.17, p = 0,55) and indomethacin versus placebo or not indomethacin (RR 0.85, IC 95% 0.68 to 1.06, p = 0,59). Conclusion: There is insufficient evidence to affirm that the use of radiotherapy or indomethacin are effective to prevent the formation of heterotopic ossification after surgery for fractures of the acetabulum. In addition, the number of complications was higher in the indomethacin group when compared to placebo or no intervention. Level of Evidence I, Systematic Review.

https://doi.org/10.1590/1413-785220212906244689 3 downloads

Segurança do Agente de Contraste SF6 (SonoVueⓇ) no Ecocardiograma sob Estresse Farmacológico
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Furtado, Rogerio Gomes

; Rassi, Daniela do Carmo

; Melato, Luciano Henrique

; Oliveira, Ana Caroline Reinaldo de

; Nunes, Paula Meneses

; Baccelli, Priscila Elias

; Santos, Sara Camila de Oliveira

; Santos, Victor Emanuel

; Rassi Junior, Luiz

; Nunes, Colandy Godoy

Arquivos Brasileiros de Cardiologia

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dec 2021, Volume 117 N. 6 Pages 1170 - 1178

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo Fundamento Em 2007, a Food and Drug Administration (FDA) determinou revisões sobre segurança dos agentes de contraste ecocardiográfico (ACE) disponíveis no mercado após relatos de mortes. Ao longo desses anos, diversos estudos comprovaram a segurança dos ACE, porém com poucos estudos relacionados ao SonoVue®. Objetivos Avaliar a segurança do SonoVue® durante o ecocardiograma sob estresse farmacológico (EEF) por meio da análise da incidência de reações alérgicas e da comparação entre os grupos quanto ao surgimento de arritmia, efeitos colaterais menores e eventos adversos. Métodos Estudo observacional, prospectivo, no qual 2.346 pacientes foram submetidos ao EEF e divididos em dois grupos: grupo 1 com ACE (n=1.099) e grupo 2 sem ACE (n=1.247). Os pacientes foram avaliados durante o EEF – 24 horas e 30 dias. Foi definido p significativo quando <0,05. Resultados O grupo 1 apresentou efeitos colaterais mais leves, como cefaleia (5/0,5% vs. 19/1,5%, p=0,012) e hipertensão reativa (3/0,3% vs . 19/1,5%, p=0,002), menos arritmias como extrassístoles ventriculares (180/16,4% vs . 247/19,8%, p=0,032) e taquicardia paroxística supraventricular (2/0,2% vs . 15/1,2%, p=0,003), assim como nenhum evento adverso como infarto agudo do miocárdio (IAM) e óbito. No grupo 2, um paciente apresentou IAM <24h (1/01%) e dois óbitos <30 dias (2/0,1%). Urticária relacionada ao SonoVue® foi observada em 3 (0,3%) pacientes sem reação anafilática. Conclusão SonoVue® demonstrou segurança durante o EEF, não sendo observados morte, IAM ou reação anafilática. Observou-se menor incidência de efeitos colaterais mais leves e arritmias no grupo que utilizou o ACE, assim como baixa incidência de reações alérgicas leves.

Abstract Background In 2007, the United States Food and Drug Administration mandated safety reviews of commercially available echocardiographic contrast agents (ECA), following reports of death. During the past years, different studies have proven the safety of ECA, but there have been few studies on SonoVue®. Objectives To evaluate the safety of SonoVue® during pharmacological stress echocardiography (PSE), by analyzing the incidence of allergic reactions and comparing groups regarding the appearance of arrhythmia, minor side effects and adverse events. Methods In this observational, prospective study, 2346 patients underwent PSE, and they were divided into the following 2 groups: group 1 with ECA (n = 1099) and group 2 without ECA (n = 1247). Patients were evaluated during PSE, at 24 hours, and at 30 days. Statistical significance was defined as p < 0.05. Results Group 1 had fewer minor side effects, such as headache (5/0.5% versus 19/1.5%, p = 0.012) and less reactive hypertension (3/0.3% versus 19/1.5%, p = 0.002); fewer arrhythmias, such as ventricular extrasystoles (180/16.4% versus 247/19.8%, p = 0.032) and paroxysmal supraventricular tachycardia (2/0.2% versus 15/1.2%, p = 0.003); and no adverse events, such as acute myocardial infarction (AMI) or death. In group 2, 1 patient had AMI in < 24 hours (1/01%), and there were 2 deaths in < 30 days (2/0.1%). SonoVue®-related urticaria was seen in 3 (0.3%) patients, without anaphylactic reaction. Conclusion SonoVue® demonstrated safety during PSE. No cases of death, AMI, or anaphylactic reaction were observed. There was a lower incidence of minor side effects and arrhythmias in the group that received ECA, as well as a low incidence of mild allergic reactions.

https://doi.org/10.36660/abc.20200475 2 downloads

10.

Impacto psicofísico de la COVID-19 en trabajadores de la salud: subanálisis temporal
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BELLIA, SEBASTIÁN

; BATTIONI, LUCIANO

; SCATULARO, CRISTHIAN E

; GODOY ARMANDO, CASANDRA

; GIORGINI, JULIO C

; LESCANO, ADRIÁN

; PEREIRO, STELLA M

Revista argentina de cardiología

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dec 2021, Volume 89 N. 6 Pages 507 - 512

Abstract: Es En | Text: Es En | PDF: Es | PDF: En

RESUMEN Introducción: La pandemia por el Coronavirus-2 ha generado efectos psicológicos negativos claros en el personal de salud. Nuestro objetivo fue describir la tendencia temporal de estos efectos. Material y métodos: se compararon los resultados de la encuesta ImPaCTS-SAC.20, que evaluó ansiedad, depresión, burnout, alteraciones de los estilos de vida y las relaciones personales, en los períodos de junio-julio y agosto-septiembre de 2020 en la Ciudad Autónoma de Buenos Aires y la Provincia de Buenos Aires. Se analizaron las respuestas de 862 trabajadores de la salud del Área Metropolitana de Buenos Aires (AMBA). Resultados: hubo proporcionalmente más casos de depresión leve y moderada en agosto/septiembre que en junio/julio, sin embargo, esta diferencia no fue estadísticamente significativa (p = 0,151). La proporción de encuestados que presentaron ansiedad se mantuvo estable: 41% vs 41% (p = 0,941). Al progresar la pandemia disminuyó la proporción de no fumadores (85,1% vs 77,4%, p = 0,036) y se observó un incremento significativo de los profesionales que recurrieron a la psicoterapia (15% vs 24,6%, p = 0,001), sin diferencias significativas en otros métodos para manejar el estrés. Conclusiones: Las consecuencias psicofísicas provocadas por la pandemia no presentaron diferencias entre los meses de junio y septiembre, por lo que podrían ser duraderos y requerir asistencia psicológica profesional.

ABSTRACT Background: The Coronavirus-2 pandemic has generated clear negative psychological effects on health workers. Our objective was to describe the temporal evolution of these effects. Methods: The results of the ImPaCTS-SAC.20 survey which evaluated anxiety, depression, burnout, lifestyle alterations and personal relationships, in the Autonomous City of Buenos Aires and Buenos Aires Province were compared in the periods of June-July and August-September, 2020. The responses of 862 health workers from the Metropolitan Area of Buenos Aires (AMBA) were analyzed. Results: There were proportionally more cases of mild and moderate depression in august/september than in june/july, however, this difference was not statistically significant (p=0.151). The rate of respondents who presented anxiety remained stable: 41% vs. 41% (p=0.941). As the pandemic progressed, the rate of non-smokers decreased (85.1% vs. 77.4%, p=0.036) and a significant increase was observed in professionals who resorted to psychotherapy (15% vs. 24.6%, p=0.001), with no significant differences in other methods to manage stress. Conclusions: The psychophysical consequences caused by the pandemic did not differ between the months of june and september, so they could be long-lasting and require professional psychological assistance.

https://doi.org/10.7775/rac.es.v89.i6.20452 40 downloads

11.

Bronquiolitis por rinovirus en menores de 1 año y riesgo de sibilancias recurrentes y asma
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Godoy Sanchez, Laura Evangelina

; Wentzel, Gabriele

; Mesquita Ramirez, Mirta Noemi

Pediatría (Asunción)

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aug 2021, Volume 48 N. 2 Pages 113 - 119

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

ABSTRACT Introduction: Bronchiolitis has been associated with recurrent wheezing. Objective: to analyze the incidence of recurrent wheezing, hospitalizations and atopy / asthma in patients with a history of hospitalization for rhinovirus (RV) bronchiolitis before 12 months of age. Materials and Methods: this was a retrospective cohort study. We included patients aged 2 to 4 years with recurrent wheezing and a history of hospitalization for bronchiolitis before 12 months of age, with a positive viral testing by molecular study. Demographic data, hospitalizations, personal and family history of atopy, asthma and exposure to smoke were studied. The data were analyzed in SPSS using descriptive and inferential statistics. The results were expressed in RR with 95% CI. The protocol was approved by the institutional ethics committee. Results: 120 patients were included. There were no differences in the incidence of recurrent wheezing in the exposed and control groups, 50.9% vs 49%, respectively, p = 0.85. Hospitalizations for wheezing and the presence of atopy were more frequent in the Rhinovirus group, RR = 1.7 (95% CI 1.2 -2.9) p = 0.03 and RR 1.6 (95% CI 1, 2 -2.2) p = 0.005 respectively. Conclusions: the incidence of recurrent wheezing was similar in both cohorts. Hospitalizations for wheezing and atopy / asthma were higher in the Rhinovirus group.

RESUMEN Introducción: La Bronquiolitis se ha asociado a sibilancias recurrentes. Objetivo: analizar la incidencia de sibilancias recurrentes, hospitalizaciones y atopia/asma en pacientes con antecedentes de hospitalización por bronquiolitis por RV antes de los 12 meses de edad. Materiales y Métodos: estudio de cohorte retrospectiva. Ingresaron pacientes de 2 a 4 años con sibilancias recurrentes y antecedentes de hospitalización por bronquiolitis antes de los 12 meses de edad, con retorno viral positivo por estudio molecular. Fueron estudiados los datos demográficos, hospitalizaciones, atopia personal y familiar, asma y exposición al humo. Los datos fueron analizados en SPSS utilizando estadísticas descriptivas e inferenciales. Los resultados se expresaron en RR con IC 95%. El protocolo fue aprobado por el comité de ética institucional. Resultados: Ingresaron 120 pacientes. No hubo diferencias en la incidencia de sibilancias recurrentes en el grupo expuesto y el control50,9% vs 49% respectivamente p=0,85. Las hospitalizaciones por sibilancias y la presencia de atopia fueron más frecuentes en el grupo Rinovirus, RR=1,7 (IC 95% 1,2 -2,9) p=0,03 y RR 1,6 (IC 95% 1,2 -2,2) p= 0,005 respectivamente. Conclusiones: la incidencia de sibilancias recurrentes fue similar en ambas cohortes. Las hospitalizaciones por sibilancias y la atopia/asma fue mayor en el grupo Rinovirus.

https://doi.org/10.31698/ped.48022021005 310 downloads

12.

Correlación del grosor de la pared vesical con síndrome de vejiga hiperactiva y hallazgos urodinámicos
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Carrillo-Núñez, Carolina

; Velázquez-Castellanos, Patricia Inés

; Godoy-Rodríguez, Nancy

; Macías-Vera, Norah Nalleli

Revista mexicana de urología

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aug 2021, Volume 81 N. 4 elocation e03

Abstract: Es En | Text: Es En | PDF: Es | PDF: En

Resumen Objetivo: Correlacionar el grosor de la pared vesical por ultrasonido transabdominal en las pacientes con síndrome de vejiga hiperactiva y hallazgos urodinámicos. Materiales y métodos: Se realizó un estudio prospectivo, analítico y descriptivo que incluyó 30 pacientes con diagnóstico de síndrome de vejiga hiperactiva, a quienes se les realizó estudio de urodinamia y medición del grosor de la pared vesical por ultrasonido transabdominal, de la Unidad de Urología Ginecológica del Hospital Civil "Fray Antonio Alcalde" de Guadalajara, Jalisco, México, desde enero a diciembre del 2018. Se realizó estadística descriptiva. Para las variables cuantitativas se realizaron pruebas de comparación de media, por medio de la t de student. Se realizaron modelos logísticos para predicción de sintomatología y curvas ROC con J de Youden para determinar un punto de corte a la medida del grosor vesical con relación a la sintomatología. Así como correlación de variables con prueba de Pearson. Resultados: Se obtuvieron 30 pacientes con síndrome de vejiga hiperactiva y diagnóstico urodinámico de detrusor hiperactivo. Se realizaron 2 subgrupos clasificando según la presencia o no de incontinencia urinaria. La edad promedio fue de 58.68±13.61. Se observó que la complianza es mayor, aunque no significativamente, en pacientes sin incontinencia. Existen tendencias hacia un mayor volumen residual y presión vesical entre pacientes con incontinencia, al mismo tiempo que se observa una correlación negativa moderada entre incontinencia y grosor vesical (R2= -444, p<0.05). A partir de esto se determinó por medio de las coordenadas se obtuvo la J de Youden que establece el punto de corte para el incremento de presentar incontinencia por encima de 2.95 mm (AUROC 0.696, SENS 53.6%, ESP 88.9%) de grosor vesical y al realizar las comparaciones de datos urodinámicos, se encontró que las pacientes con más de 2.96 mm tienen una menor complianza (AUROC 0.760, SENS 73.3%, ESP 80%). Conclusiones: La medida del grosor de la pared vesical por ultrasonido transabdominal puede ser una herramienta útil para la valoración integral de pacientes con síndrome de vejiga hiperactiva, para predecir la probabilidad de la enfermedad así como el pronóstico para respuesta al tratamiento.

Abstract Objective: To correlate the bladder wall thickness by transabdominal ultrasound in patients with overactive bladder syndrome and urodynamic findings. Materials and methods: A prospective, analytical and descriptive study was done that included 30 patients with overactive bladder syndrome diagnosis, who underwent to urodynamic study and measurement of the bladder wall thickness by transabdominal ultrasound, from the Urogynecological Unit of the Hospital Civil Fray Antonio Alcalde from January to December 2018. Descriptive statistics was done. For the quantitative variables, mean comparison tests were performed, using Student's t test. Logistic models were used to predict symptoms and ROC curves with Youden's J to determine a cut-off point for the measurement of bladder thickness in relation to symptoms. As well as correlation of variables using Pearson's test. Results: Thirty patients with overactive bladder syndrome and urodynamic diagnosis of overactive detrusor were obtained. We made two subgroups, classifying according to the presence or absence of urinary incontinence. The mean age was 58.68 ± 13.61. Compliance was found to be higher, although not significantly, in patients without incontinence. There are trends towards a higher residual volume and bladder pressure among patients with incontinence, at the same time that a moderate negative correlation is observed between incontinence and bladder thickness (R2 = -.444, p <0.05). From this, it was determined by means of the coordinates, the Youden J was obtained, which establishes the cut-off point for the increase of presenting incontinence above 2.95 mm (AUROC 0.696, SENS 53.6%, ESP 88.9%) of bladder thickness and When making the comparisons of urodynamic data, it was found that patients with more than 2.96 mm have a lower compliance (AUROC 0.760, SENS 73.3%, ESP 80%). Conclusions: The measurement of the bladder wall thickness by transabdominal ultrasound can be a useful tool for the comprehensive evaluation of patients with overactive bladder syndrome, to predict the probability of the disease as well as the prognosis for response to treatment.

https://doi.org/10.48193/rmu.v81i4.598

13.

FOOT ALIGNMENT IN SYMPTOMATIC NATIONAL FOOTBALL LEAGUE (NFL) ATHLETES: A WEIGHTBEARING CT ANALYSIS
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BERNASCONI, ALESSIO

; CESAR NETTO, CESAR DE

; ROBERTS, LAUREN

; LINTZ, FRANÇOIS

; GODOY-SANTOS, ALEXANDRE LEME

; O’MALLEY, MARTIN JOSEPH

Acta Ortopédica Brasileira

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aug 2021, Volume 29 N. 3 Pages 118 - 123

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO Objetivo: Descrever o alinhamento do pé em jogadores da National Football League (NFL) com diferentes patologias sintomáticas do pé e tornozelo usando a tomografia computadorizada de feixe cônico com suporte de peso (weightbearing cone-beam computed tomography - WBCBCT), e comparar as medidas a grupo controle de voluntários com pés de alinhamento normal. Métodos: Quarenta pés (36 jogadores ativos da NFL) foram avaliados usando WBCBCT e comparados com 20 controles da população normal. As medidas incluíram: Offset do pé e tornozelo(FAO); Calcâneo Offset (CO); ângulo de alinhamento do retropé (HAA); ângulo entre as facetas inferior e superior do tálus (Inftal-Suptal); ângulo entre a faceta inferior do tálus e o solo (Inftal-Hor); ângulo do arco do antepé (FAA); distância navicular/solo e cuneiforme medial/solo. Resultados: Atletas da NFL mostraram retropé com alinhamento neutro quando comparados aos controles (FAO: 1% vs. 0,5%; CO:2,3mm vs. 0,8 mm; HAA: 2,9° vs. 0,8°, com todos p > 0,05) e morfologia normal da articulação subtalar (sem diferença nos ângulos Inftal-Suptal e Inftal-Hor). Por outro lado, observamos nos atletas profissionais um arco longitudinal medial diminuído (FAA: 15° vs. 18,3°,p=0,03) com distâncias médias do navicular/solo (38,2 mm vs. 42,2 mm, p = 0,03) e do cuneiforme medial/solo (27 mm vs. 31,3 mm, p = 0,01) menores quando comparados ao grupo controle. Conclusão: Em nossa série, os jogadores da NFL apresentaram um arco longitudinal medial diminuído em relação aos controles, mas um retropé neutro. WBCBCT pode ajudar a esclarecer os fatores de risco anatômicos para lesões em jogadores profissionais de elite. Nível de Evidência III, Estudo retrospectivo comparativo.

ABSTRACT Objective: Our aim was to describe the foot alignment in National Football League (NFL) players with different symptomatic foot and ankle pathologies using weightbearing cone-beam computed tomography (WBCBCT), comparing them to normally aligned feet as control group. Methods: 41 feet (36 active NFL players) were assessed using WBCBCT and compared to 20 normally aligned controls from a normal population. Measurements included: Foot and Ankle Offset (FAO); Calcaneal Offset (CO); Hindfoot Alignment Angle (HAA); angle between inferior and superior facets of the talus (Inftal-Suptal); angle between inferior facet of the talus and the horizontal/floor (Inftal-Hor); Forefoot Arch Angle (FAA); navicular- and medial cuneiform-to-floor distance. Results: NFL athletes showed a neutrally aligned hindfoot when compared to controls (FAO: 1% vs 0.5%; CO: 2.3 mm vs 0.8 mm; HAA: 2.9° vs 0.8° in two groups, with all p > 0.05) and a normal morphology of the subtalar joint (no difference in Inftal-Suptal and Inftal-Hor angles). Conversely, in athletes we found a decreased medial longitudinal arch (FAA: 15° vs 18.3°, p = 0.03) with smaller navicular (38.2 mm vs 42.2 mm, p = 0.03) and medial cuneiform (27 mm vs 31.3 mm, p = 0.01) mean distances to the floor when compared to controls. Conclusion: In our series, NFL players presented a lower medial longitudinal arch than controls but a neutrally aligned hindfoot. WBCBCT may help shed light on anatomical risk factors for injuries in professional players. Level of Evidence III, Retrospective comparative study.

https://doi.org/10.1590/1413-785220212903236709 177 downloads

14.

Guidelines on controlling latent tuberculosis infection to support tuberculosis elimination
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Godoy, P

Revista Española de Sanidad Penitenciaria

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apr 2021, Volume 23 N. 1 Pages 28 - 36

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

Abstract Objectives Latent TB infection (LTBI) affects 25% of the world's population. As long as this reservoir exists, the elimination of TB will not be feasible. The Assembly of the World Health Organization adopted the “Global End TB” strategy for the elimination of TB in 2014. The objective of this review is to present strategies for risk groups that are candidates for the detection and treatment of LTBI. Material and method There is sufficient evidence of screening in: immunocompromised people (HIV-infected, biological therapies, alternative renal therapy, organ transplantation), recent immigrants, inmates in prison, people injecting drugs and homeless people, and workers from at-risk settings. Tests to diagnose LTBI include tuberculin skin test (TST) and gamma release assay interferon (IGRA). There is no reference test and the choice of one or the other will depend on logistical considerations, such as avoiding injection (TST) or not needing a second visit (IGRA). Treatment of LTBI is based on the use of isoniazide and rifampicin in short period of 3 or 4 months, using associations of rifampicin and isoniazide or rifampicin alone. Discussion Given the estimated high prevalence of LTBI, renewed efforts are required to reduce the number of people with LTBI that includes a registration and monitoring system to observer progress, increased testing, and the use of short treatment guidelines.

Resumen Objetivos La infección tuberculosa latente (ITL) afecta al 25% de la población mundial. Mientras exista este reservorio, la eliminación de la tuberculosis (TB) no será factible. La asamblea de la Organización Mundial de la Salud (OMS) adoptó en el año 2014 la estrategia mundial para la eliminación de la tuberculosis (Global End TB). El objetivo de esta revisión es presentar las estrategias para los grupos de riesgo que son candidatos a la detección y el tratamiento de la ITL. Material y método Existe suficiente evidencia de la rentabilidad del cribado en: personas inmunodeprimidas (infectadas por el virus de la inmunodeficiencia humana, terapias biológicas, terapia renal sustitutiva, trasplante de órganos), inmigrantes recientes, internos en prisión, personas que se inyectan drogas y personas sin techo, y trabajadores de entornos de riesgo. Las pruebas para diagnosticar la ITL incluyen la prueba de la tuberculina (PT) y el interferón gamma release assay (IGRA). No existe una prueba de referencia y la elección de una u otra técnica dependerá de consideraciones de tipo logístico, como evitar la venopunción (PT) o el hecho de no necesitar una segunda visita (IGRA). El tratamiento de ITL se basa en el uso de isoniacida y rifampicina en pautas cortas de 3-4 meses, con rifampicina e isoniacida o rifampicina sola. Discusión Dada la alta prevalencia estimada de ITL, se requieren renovar esfuerzos para reducir el número de personas con dicha enfermedad que incluya un sistema de registro y vigilancia para supervisar los progresos, el aumento de las pruebas y el uso de directrices de tratamiento cortos.

https://doi.org/10.18176/resp.00028

15.

Implementación de una actividad física en residentes de pediatría y síndrome de Burnout
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Chamorro Caballero, Zaida Eliane

; Godoy Sánchez, Laura Evangelina

; Martínez, Gloria De Jesús

; Mesquita Ramirez, Mirta N

Pediatría (Asunción)

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apr 2021, Volume 48 N. 1 Pages 31 - 36

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

ABSTRACT Introduction: Residency is a period in the training of the doctor very different from what was learned at the university level. Objective: evaluate the effect of physical activity in pediatric residents regarding Burnout Syndrome. Materials and Methods: This was a non-randomized controlled intervention study. Pediatric residents were assigned to receive Zumba classes 2 hours per week for 10 weeks (study group) or no intervention (control group). Burnout Syndrome was measured using the Maslach Burnout Inventory questionnaire pre and post intervention in both groups. Other variables studied were: age, gender, physical and social activity, family structure and years of residence. The data were analyzed with SPSS. An alpha error of less than 5% was considered. The protocol was approved by the ethics committee of the hospital, with participants’ consent. Results: 47 residents participated, 23 in the study group and 24 in the control group. Pre-intervention Burnout Syndrome was 52.2% and 37.5% in the study group and the control group, respectively, p = 0.31. After the intervention it was 17.4% and 45.8% in the study and control group respectively. OR: 0.25 (95% CI 0.65 -0.9) p = 0.03. The absolute benefit was 35% and the number needed to treat 2.8. Conclusions: Physical exercise for 2 hours a week alleviated burnout syndrome in Pediatric residents, with an absolute benefit of 35%.

RESUMEN Introducción: La residencia es un periodo en la formación del médico muy diferente a lo aprendido en la universidad. Objetivo: evaluar el efecto de la actividad física en residentes de pediatría, sobre el Síndrome de Burnout. Materiales y Métodos: Estudio de intervención no aleatorizado controlado. Los residentes de Pediatría fueron asignados a recibir clases de Zumba 2 horas semanales por 10 semanas (grupo estudio) o ninguna intervención (grupo control). Se midió el Síndrome de Burnout utilizando el cuestionario Maslach Burnout Inventory pre y post intervención en ambos grupos. Otras variables estudiadas fueron: edad, género, actividad física y social, estructura familiar y años de residencia. Los datos fueron analizados con SPSS. Se consideró un error alfa inferior al 5%. El protocolo fue aprobado por el comité de ética del hospital, con consentimiento de los participantes. Resultados: Participaron 47 residentes, 23 en el grupo estudio y 24 en el grupo control. El Síndrome de Burnout pre- intervención fue 52,2 % y 37,5 % en el grupo estudio y el grupo control respectivamente p=0,31. Después de la intervención fue de 17,4 % y 45,8% en el grupo estudio y control respectivamente. OR: 0,25 (IC95% 0,65 -0,9) p=0,03. El beneficio absoluto fue del 35% y el número necesario para tratar 2,8. Conclusiones: El ejercicio físico 2 horas semanales mitigó el síndrome de burnout en residentes de Pediatría, con un beneficio absoluto del 35%.

https://doi.org/10.31698/ped.48012021006 302 downloads

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