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Factors associated with perception of the current silhouette and body image dissatisfaction in adults with obesity
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Streb, Anne Ribeiro

; Vieira, Carolina Graef

; Silva, Caroline Soares da

; Bertuol, Cecília

; Vargas, Patrine

; Del Duca, Giovani Firpo

Revista de Nutrição

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2023, Volume 36 elocation e220116

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

RESUMO Objetivo Verificar os fatores associados à percepção da silhueta atual e à insatisfação com a imagem corporal em adultos com obesidade. Métodos Estudo transversal derivado da linha de base de um ensaio clínico randomizado. A percepção de silhueta atual e a insatisfação com a imagem corporal, definida pela diferença entre a percepção da silhueta atual e da ideal, foram obtidas a partir de uma escala variando de um (menor silhueta) a nove pontos (maior silhueta). As variáveis independentes investigadas como fatores associados (regressão linear bruta e ajustada) foram: sexo, idade, cor da pele, índice de massa corporal (kg/m2), percentual de gordura corporal, nível de atividade física e ingestão alimentar. Resultados Foram investigados 69 obesos (índice de massa corporal ≥30kg/m2), sendo 42 do sexo feminino e com os seguintes valores médios: 34,7 (±7,2) anos; 33,5 (±2,8) kg/m2 e silhueta atual de 6,6 (±0,9). Todos estavam insatisfeitos pelo excesso de peso corporal. As categorias que se associaram à percepção da silhueta atual foram o sexo masculino, a cor de pele branca e maiores valores de índice de massa corporal quando comparados os dados referentes ao sexo feminino, a pessoas de cor da pele não branca e a menores valores de índice de massa corporal, respectivamente. Quanto à insatisfação com a imagem corporal, pessoas consideradas brancas tiveram escores mais baixos que aquelas com outras cores de pele. Conclusão Ser do sexo masculino, ter cor da pele branca e ter maior índice de massa corporal foram fatores de risco para a percepção de silhuetas corporais maiores, enquanto apenas a cor da pele não branca esteve associada à insatisfação com a imagem corporal.

ABSTRACT Objective To verify the factors associated with the perception of current silhouette and body image dissatisfaction in adults with obesity. Methods Cross-sectional study derived from the baseline of a randomized clinical trial. The perception of current silhouette and dissatisfaction with body image, defined by the difference between the perception of current and ideal silhouette, were obtained from a scale that ranged from one (smallest silhouette) to nine (largest silhouette). The independent variables investigated as associated factors (crude and adjusted linear regression) were: sex, age, skin color, body mass index (kg/m2), percentage of body fat, level of physical activity, and food intake. Results Sixty-nine obese individuals (body mass index ≥30kg/m2) were studied, 42 of whom were female and with the following mean values: 34.7 (±7.2) years; 33.5 (±2.8) kg/m2, and current silhouette of 6.6 (±0.9). All were dissatisfied with their excess body weight. The categories associated with a perception that matched the current silhouettes were male sex, white skin color, and higher body mass index values when compared to female sex, non-white, and lower body mass index values, respectively. Regarding body image dissatisfaction, white people had lower scores than those with other skin colors. Conclusion Being male, having white skin color, and having a higher body mass index were risk factors for the perception of larger body silhouettes, while only non-white skin color was associated with dissatisfaction with body image.

https://doi.org/10.1590/1678-9865202336e220116

PAAF vs. BAG en nódulos tiroideos, la experiencia en el Hospital Regional de Antofagasta
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Kratc, Renata

; Vargas, Bryan C.

; Aracena, Joaquín

; Piquimil, Lorena

; Carrasco, Cecilia

Revista chilena de radiología

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dec 2022, Volume 28 N. 4 Pages 128 - 134

Abstract: En | Text: En | PDF: En

Resumen Introducción: La punción aspirativa con aguja fina (PAAF) tiene un papel importante en la evaluación del nódulo tiroideo, siendo un método barato, rápido y poco invasivo, sin embargo su alta tasa de resultados inconclusos o insuficientes hacen que la técnica de biopsia con aguja gruesa (BAG) sea una alternativa atractiva. Objetivo: El objetivo de este estudio es evaluar la precisión diagnóstica de la PAAF vs. la BAG en lesiones tiroideas, contrastando sus resultados con los hallazgos histopatológicos de la pieza quirúrgica. Materiales y métodos: Se realizó un análisis retrospectivo del registro clínico del Hospital Regional de Antofagasta, analizando los estudios de PAAF y BAG entre enero del 2017 y diciembre del 2020. Se incluyeron 293 casos. Se determinó sensibilidad, especificidad, valor predictivo positivo (VPP), valor predictivo negativo (VPN) y precisión diagnóstica (PD). Resultados: La correlación histopatológica mostró una sensibilidad para la PAAF del 67.9%, especificidad del 88.9%, VPP del 86.3%, VPN del 72.7% y PD del 78.2%. Para la BAG la sensibilidad fue 93.3%, especificidad 100%, VPP 100% y VPN 93.8%, con PD del 96.6%. Conclusión: La BAG es una prueba sensible y específica, que disminuye la tasa de resultados no diagnósticos. Los datos obtenidos son comparables con la literatura.

https://doi.org/10.24875/rchrad.22000031

Factores asociados al conocimiento y medidas preventivas de mordedura de Loxosceles laeta en la población de la Encuesta Nacional de Programas Presupuestales (ENAPRES) en el Perú 2017-2019
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Borjas-Aguilar, Samir André

; Esteban-Manrique, Paola Cecilia

; Luna-Muñoz, Consuelo del Rocío

; Chanduvi-Puicón, Willer David

; Cruz-Vargas, Jhony A. De La

Revista chilena de infectología

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oct 2022, Volume 39 N. 5 Pages 565 - 572

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

Abstract Background: Metaxenic and zoonotic diseases are one of the ten national priorities for health research in Peru 2019-2023. Of these, the cases reported by loxoscelism have been increasing progressively. Aim: To determine the factors associated with the knowledge and preventive measures of Loxosceles laeta bite in the population of the ENAPRES in Peru 2017-2019. Methods: Observational, cross-sectional, analytical and retrospective study, based on information from ENAPRES. Results: A total sample of 285,354 people was analyzed. Of these, those aged 60 or over (PRa=1,48; 95%CI: 1,45-1,51), those from the coast (PRa=1,37; 95%CI: 1,33-1,40), women (PRa=1,12; 95%CI: 1,11-1,13), with primary or secondary education (PRa=1,12; 95%CI: 1,09-1,15), with inadequate housing [ceiling (PRa=1,07; 95%CI: 1,05-1,10), floor (PRa=1,02; 95%CI: 1,00-1,04)], were associated with higher possibility ofhaving more knowledge about L. laeta bite. On the other hand, those aged 60 or over (PRa=1,49; 95%CI: 1,46-1,52), those from the coast (PRa=1,39; 95%CI: 1,35-1,43), with non-university higher education (PRa=1,19; 95%CI: 1,15-1,22), women (PR a=1,13; 95%CI: 1,12-1,14) and with inadequate housing ceilings (PRa=1,07; 95%CI 1,05-1,10) were associated with a greater possibility of taking adequate preventive measures. In both, an association was found between disposing of organic waste on the street or on public roads (RPa=0.97; 95%CI: 0.96-0.99) Conclusions: It were found factors associated with knowledge and preventive for L. laeta bite.

Resumen Introducción: Las enfermedades metaxénicas y zoonóticas, son consideradas prioridades nacionales de investigación en salud en Perú 2019-2023. De estas, los casos reportados por loxoscelismo han ido aumentando progresivamente. Objetivo: Determinar los factores asociados al conocimiento y medidas preventivas de mordedura de Loxosceles laeta en la población de la ENAPRES en el Perú 2017-2019. Métodos: Estudio de tipo observacional, transversal, analítico y retrospectivo, basado en la información de la ENAPRES. Resultados: Se analizó una muestra total de 285.354 personas. De estas, aquellos con 60 a más años (RPa=1,48; IC95%: 1,45-1,51), los costeños (RPa=1,37; IC95%: 1,33-1,40), las mujeres (RPa=1,12; IC95%: 1,11-1,13), con primaria o secundaria (RPa=1,12; IC95%: 1,09-1,15), con viviendas inadecuadas [techo (RPa=1,07; IC95%: 1,05-1,10), piso (RPa=1,02; IC95%: 1,00-1,04)], se asociaron con mayor posibilidad de tener más conocimiento sobre mordedura de L. laeta. Por otra parte, los encuestados de 60 a más años (RPa=1,49; IC95%: 1,46-1,52), los costeños (RPa=1,39; IC95%: 1,35-1,43), con estudios superiores no universitarios (RPa=1,19; IC95%: 1,15-1,22), las mujeres (RPa=1,13; IC95%: 1,12-1,14) y con viviendas con techos inadecuados (RPa=1,07; IC95%: 1,05-1,10) se asociaron con mayor posibilidad de realizar adecuadas medidas preventivas. En ambas, se halló asociación con el desechar los residuos orgánicos en calle o vía pública (RPa=0,97; IC95%: 0,96-0,99). Conclusiones: Se encontró aquellos factores asociados a conocimientos y a las medidas preventivas de mordedura de L. laeta.

Consenso mexicano para el diagnóstico y tratamiento de la trombastenia de Glanzmann
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García-Chávez, Jaime

; Hernández-Juárez, Jesús

; Sánchez-Jara, Berenice

; García-Lee, María Teresa

; Rodríguez-Castillejos, Cecilia

; Montiel-Cervantes, Laura

; Moreno-Hernández, Manuel

; Ramos-Blas, Gustavo J.

; Soto-Padilla, Janet M.

; Flores-Villegas, Luz V.

; Pérez-Zúñiga, Juan M.

; López-Arroyo, José L.

; Villarreal-Martínez, Laura

; Madera-Maldonado, Cristina E.

; Herrejón-Carmona, Misael

; Lozano-Garcidueñas, Mónica

; Vargas-Ruiz, Ángel G.

; Hernández-Hernández, Darinel

; Peña-Díaz, Aurora de la

; Aquino-Fernández, Efraín

; Majluf-Cruz, Abraham

Gaceta médica de México

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2022, Volume 158 N. spe4 Pages 1 - 17

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

Resumen Las plaquetas tienen un papel central en diferentes escenarios fisiológicos, incluyendo la hemostasia; se unen unas con otras en la agregación plaquetaria, lo cual permite formar un coágulo plaquetario. Para que la agregación sea apropiada se requiere del complejo glicoproteico IIb/IIIa (GPIIb/IIIa) en la superficie plaquetaria. Toda alteración funcional plaquetaria, hereditaria o adquirida, impide la formación adecuada del coágulo y se manifiesta como hemorragia. Las enfermedades plaquetarias hereditarias son raras y, hasta recientemente, fueron ignoradas. Una de las más reconocidas y estudiadas es la trombastenia de Glanzmann (TG), entidad en la cual el número de plaquetas puede ser normal pero la función está alterada. Es un padecimiento autosómico y recesivo que causa hemorragia de diferente intensidad toda la vida y en la cual el problema radica en precisamente en la GPIIb/IIIa. Las hemorragias son típicamente mucocutáneas: equimosis, púrpura, epistaxis, gingivorragia; menos frecuentes son la hemorragia gastrointestinal, hemartrosis o en sistema nervioso central. La hiperpolimenorrea es común en las mujeres y llega a ser tan importante que amerita transfusiones en la menarca. La TG afecta a todos los grupos étnicos y su prevalencia varía entre 1/40,000 y 1/400,000. A pesar de esta información acerca de la TG en el mundo, hay pocas guías o recomendaciones basadas en la opinión de expertos y experiencias unicéntricas. En México la TG es rara y no se cuenta con una recomendación general para su diagnóstico y tratamiento. El objetivo de este documento fue establecer un consenso y hacer sugerencias generales para su diagnóstico y tratamiento.

Abstract Platelets have a central role in several physiological scenarios including hemostasis. Platelets bind each other during platelet aggregation allowing the proper formation of the clot; to be appropriate, platelet aggregation requires the glycoproteic complex IIb/IIIa (GPIIb/IIIa). Every platelet function abnormality both, congenital or acquired, impedes clot formation and favors bleeding episodes. Hereditary platelet abnormalities are rare and, until recently, they were almost ignored. Among these disorders, Glanzmann Thrombasthenia (GT) is a widely recognized abnormality in which platelet counts may be normal, but their function is affected. GT is an autosomal, recessive disease that causes life-long bleeding of different intensity. Main biochemical abnormality resides in GPIIb/IIIa. Bleeding is typically mucocutaneous: easy bruising, purpura, and nose and gum bleeds; less frequently are gastrointestinal bleeds, hemarthrosis, or intracranial. Menorrhagia and hyperpolymenorrhea are common findings in in women and may be the cause of anemia requiring blood transfusions at fertile age. GT affects all ethnic groups and its prevalence ranges between 1/40,000 to 1/400,000. Despite this worldwide information regarding GT, only a few guidelines and recommendations have been published, most of them based on expert opinions. In Mexico, GT is rare and there is not a general recommendation regarding its diagnosis and treatment. The aim of this document was to establish a consensus to suggest a general guideline for the diagnosis and treatment of GT in Mexico.

https://doi.org/10.24875/gmm.m22000691

MORBIDITY AND SURVIVAL AFTER PERIOPERATIVE CHEMOTHERAPY IN GASTRIC CANCER: A STUDY USING THE BECKER’S CLASSIFICATION AND REGRESSION
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MACHADO, Maria Cecília de Aguiar

; BARBOSA, José Pedro Coimbra de Vargas Lobarinhas

; OLIVEIRA, Filipa Ferreira de

; BARBOSA, José Adelino Lobarinhas

ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo)

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2022, Volume 35 elocation e1704

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

RESUMO RACIONAL: O cancer gástrico é uma neoplasia com mau prognóstico. A abordagem multimodal com quimioterapia-perioperatória é o tratamento recomendado para os pacientes com cancer gástrico localmente avançando. Este tratamento induz uma resposta histopatológica manifestado pelo grau de regressão do tumor primário, dos gânglios linfáticos e do estadiamento ypTNM. Apesar de suas vantagens, ainda há dúvidas quanto aos efeitos da quimioterapia na morbimortalidade pós-operatória. OBJETIVOS: Avaliar o impacto da quimioterapia perioperatória e o seu efeito nos resultados anatomopatológicos, na morbidade pós-operatória e na sobrevida. MÉTODOS: Estudo observacional-retrospetivo com 134 doentes com cancer gástrico avançado, que se submeteram a quimioterapia perioperatória e cirurgia radical curativa. O grau de regressão histológico do tumor primário foi avaliado de acordo com os critérios de Becker. A proporção de gânglios regredidos foi determinada e as complicações pós-operatórias foram avaliadas com a classificação de Clavien-Dindo. Os tempos de sobrevida foram comparados entre os grupos por meio das curvas de Kaplan-Meier e do teste Mantel-Cox Log Rank. RESULTADOS: 22,3% dos doentes foram classificados como bons-respondedores e 75,9% como maus-respondedores. Esta variável e a morbidade pós-operatória não estavam relacionadas. 64,2% dos doentes apresentaram invasão ganglionar e 46,3% tinham regressão ganglionar, 49,4% não tinham invasão linfática e 61,9% não tinham sinais de invasão venosa. As complicações pós-operatórias ocorreram em 30,6% dos pacientes. O grupo dos bons respondedores apresentou uma sobrevida mediana de 56,0 meses e o grupo dos maus respondedores 34,0 meses. CONCLUSÕES: A quimioterapia perioperatória induz a regressão quer do tumor primário e dos gânglios-linfáticos. Os resultados da morbidade pós-operatória foram semelhantes aos descritos na literatura. Apesar do grupo dos bons-respondedores apresentar melhor sobrevida, este valor não foi significativo. Assim, são necessários mais estudos que avaliem a importância do grau de regressão ganglionar e o seu impacto na sobrevida.

ABSTRACT BACKGROUND: Gastric cancer is an aggressive neoplasm with a poor prognosis. The multimodal approach with perioperative chemotherapy is currently the recommended treatment for patients with locally advanced gastric cancer. This treatment induces a histopathological response expressed either through the degree of regression of the primary tumor or of the lymph nodes or through yTNM staging. Despite its advantages, there are still doubts regarding the effects of chemotherapy on postoperative morbidity and mortality. AIMS: This study aims to evaluate the impact of perioperative chemotherapy and its effect on anatomopathological results and postoperative morbidity and on patient survival. METHODS: This is an observational retrospective study on 134 patients with advanced gastric cancer who underwent perioperative chemotherapy and curative radical surgery. The degree of histological regression of the primary tumor was evaluated according to Becker’s criteria; the proportion of regressed lymph nodes was determined, and postoperative complications were evaluated according to the Clavien-Dindo classification. Survival times were compared between the groups using Kaplan-Meier curves and the Mantel-Cox log-rank test. RESULTS: In all, 22.3% of the patients were classified as good responders and 75.9% as poor responders. This variable was not correlated with operative morbidity (p=1.68); 64.2% of patients had invaded lymph nodes and 46.3% had regressed lymph nodes; and 49.4% had no lymphatic invasion and 61.9% had no signs of venous invasion. Postoperative complications occurred in 30.6% of the patients. The group of good responders had an average survival of 56.0 months and the group of poor responders had 34.0 months (p=0.17). CONCLUSION: Perioperative chemotherapy induces regression in both the primary tumor and lymph nodes. The results of the operative morbidity were similar to those described in the literature. However, although the group of good responders showed better survival, this value was not significant. Therefore, further studies are needed to evaluate the importance of the degree of lymph node regression and its impact on the survival of these patients.

https://doi.org/10.1590/0102-672020220002e1704

Cemetery Relocations in Hidroituango: An Interdisciplinary Study
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VARGAS, TIMISAY M.

; URIBE, CECILIA L.

; BEDOYA, SANTIAGO V.

; ZAPATA, MARY LUZ Q.

; CARDONA-GALLO, SANTIAGO A.

Anais da Academia Brasileira de Ciências

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2022, Volume 94 N. 1 elocation e20201098

Abstract: En | Text: En | PDF: En

Abstract This study realized the exhumation and transfer of human remains buried in the cemeteries at Orobajo, Barbacoas and La Fortuna (Municipality of Sabanalarga, Peque and Buriticá respectively) within the framework of “Social Management” of the Ituango Hydroelectric Project and the program Integral Restitution of Living Conditions for communities. Methods and techniques from bioanthropology, forensic sciences, archeology and Soil Sciences were used. Cemeteries were characterized by unconventional burials; moreover, documentation of tombs and burial practices were not generalized, nor did they show patterns. In the field assessment, 2,883 pit tests and soil probes using a penetrometer were carried out over a total area of 2,288 square meters. A total of 349 skeletonized human remains were exhumed, almost double of what was expected; of these, 180 were from Orabajo, 151 from Barbacoas, and 18 from La Fortuna. Though the remains showed a great deal of deterioration, age at death was determined for 59% of cases, and sex identified in 49%. Personal artifacts and clothing items were recovered along with the bones in many cases. Remains from Barbacoas and La Fortuna were given over to communities, and final dispositions were made in sites previously agreed upon (cemeteries in Peque, Buriticá and Sabanalarga respectively).

https://doi.org/10.1590/0001-3765202220201098

Consenso chileno de diagnóstico y manejo de neoplasias quísticas pancreáticas. Club de páncreas Chile-SCHGE
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Espino, Alberto

; Vargas, José Ignacio

; Mancilla, Carla

; Muñoz, Pablo

; Martínez, Waldo

; Menéndez, Alejandra

; Jara, Daniela

; Mansilla, Rodrigo

; Schiappacasse, Giancarlo

; Santamarina, Mario

; Huete, Álvaro

; Candia, Roberto

; Silva, Felipe

; Castillo, Cecilia

; Richter, Hugo

; Mejía, Ricardo

; Vial, Paula

; Robles, Ignacio

; Martínez, Jorge

; Jarufe, Nicolás

; Briceño, Eduardo

; Lembach, Hanns

; Zoroquiain, Pablo

; Roa, Juan Carlos

; Walker, Kenneth

; Torres, Javiera

; Carreño, Laura

; Castiblanco, Adriana

; Fernández, Wanda

; Ríos, Álvaro

; Chandia, Javiera

; Ayala, María José

; Rojas, Tamara

; Verdugo, Jorge

; Berger, Zoltán

Revista médica de Chile

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dec 2021, Volume 149 N. 12 Pages 1773 - 1786

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

Pancreatic cystic neoplasms (PCN) are frequently detected on abdominal images performed for non-pancreatic indications. Their prevalence in asymptomatic population ranges from 2.7 to 24.8%, and increases with age. There are several types of pancreatic cysts. Some may contain cancer or have malignant potential, such as mucinous cystic neoplasms, including mucinous cystadenoma (MCN) and intraductal papillary mucinous neoplasms (IPMN). In contrast, others are benign, such as serous cystadenoma (SCA). However, even those cysts with malignant potential rarely progress to cancer. Currently, the only treatment for pancreatic cysts is surgery, which is associated with high morbidity and occasional mortality. The Board of the Chilean Pancreas Club of the Chilean Gastroenterology Society developed the first Chilean multidisciplinary consensus for diagnosis, management, and surveillance of PCN. Thirty experts were invited and answered 21 statements with five possible alternatives: 1) fully agree; 2) partially agree; 3) undecided; 4) disagree and 5) strongly disagree. A consensus was adopted when at least 80% of the sum of the answers “fully agree” and “partially agree” was reached. The consensus was approved by the Board of Directors of the Chilean Pancreas Club for publication.

https://doi.org/10.4067/s0034-98872021001201773

Guía de práctica clínica para el manejo de cáncer de cuello uterino estadios tempranos
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Malca-Tocas, Mirtha Magaly

; Ugarte-Gil, César

; Matos-Miranda, Claudia Patricia

; Becerra-Chauca, Naysha

; Ceballos-Pacheco, Carlos

; Broncano-Huasasquiche, Oswaldo

; Fernández-Butrón, Ana Cecilia

; Livano-Yberico, Teófilo

; Vargas-Caycho, Yan

; Huaringa-Marcelo, Jorge

; Salvador-Salvador, Stefany

; Timaná-Ruiz, Raúl

; Carrera-Acosta, Lourdes

Revista del Cuerpo Médico Hospital Nacional Almanzor Aguinaga Asenjo

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dec 2021, Volume 14 N. 4 Pages 535 - 545

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

ABSTRACT Introduction: This article summarizes the clinical practice guideline (CPG) for the management of early-stage cervical cancer (IA1, IA2, IB1, IB2 o IIA1) in the Social Security of Peru (EsSalud). Objective: To provide clinical recommendations based on evidence for the management of early-stage cervical cancer in EsSalud. Materials and methods: A CPG for the management of early-stage cervical cancer in EsSalud was developed. To this end, a guideline development group (local GDG) was established, including medical specialists and methodologists. The local GDG formulated 8 clinical questions to be answered by this CPG. Systematic searches of systematic reviews and -when it was considered pertinent- primary studies were conducted in Pubmed, Embase y CENTRAL during 2017 - 2018. The evidence to answer each of the posed clinical questions was selected. The quality of the evidence was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology. In periodic work meetings, the local GDG used the GRADE methodology to review the evidence and formulate the recommendations, points of good clinical practice, and the flowchart of management. Finally, the CPG was approved with Resolution No. N 27-IETSI-ESSALUD-2020. Results: This CPG addressed 8 clinical questions on the management of early-stage cervical cancer (IA1, IA2, IB1, IB2 o IIA1). Based on these questions, 10 recommendations (2 strong recommendations and 8 weak recommendations), 7 points of good clinical practice, and 4 flowcharts were formulated. Conclusion: This article summarizes the methodology and evidence-based conclusions from the CPG for the management of early-stage cervical cancer in EsSalud.

RESUMEN Introducción: Este artículo resume la guía de práctica clínica (GPC) para el manejo de cáncer de cuello uterino estadios tempranos (IA1, IA2, IB1, IB2 o IIA1) en el Seguro Social del Perú (EsSalud). Objetivo: Proveer recomendaciones clínicas basadas en evidencia para el manejo de cáncer de cuello uterino estadios tempranos en EsSalud. Materiales y métodos: Se conformó un grupo elaborador de la guía (GEG) que incluyó médicos especialistas y metodólogos. El GEG formuló 8 preguntas clínicas a ser respondidas por la presente GPC. Se realizó búsquedas sistemáticas de revisiones sistemáticas y -cuando fue considerado pertinente- estudios primarios en Pubmed, Embase y CENTRAL durante el 2017 - 2018. Se seleccionó la evidencia para responder cada una de las preguntas clínicas planteadas. La certeza de la evidencia fue evaluada usando la metodología Grading of Recommendations Assessment, Development, and Evaluation (GRADE). En reuniones de trabajo periódicas, el GEG usó la metodología GRADE para revisar la evidencia y formular las recomendaciones, los puntos de buenas prácticas clínicas y los flujogramas de manejo. Finalmente, la GPC fue aprobada con Resolución N 27-IETSI-ESSALUD-2020. Resultados: La presente GPC abordó 8 preguntas clínicas abordando el manejo del cáncer de cuello uterino en estadios tempranos. En base a dichas preguntas se formularon 10 recomendaciones (2 recomendaciones fuertes y 8 recomendaciones condicionales), 7 puntos de buena práctica clínica, y 4 flujogramas. Conclusión: El presente artículo resume la metodología y las conclusiones basadas en evidencias de la GPC para el manejo del cáncer de cuello uterino en estadios tempranos en EsSalud.

https://doi.org/10.35434/rcmhnaaa.2021.144.1462

La estructura discursiva de la defensa doctoral en dos corpus orales
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Ainciburu, María Cecilia

; Agray Vargas, Nancy

Andamios

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dec 2021, Volume 18 N. 47 Pages 113 - 145

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

Resumen La defensa de una tesis doctoral constituye un acto público de relevancia mayor en la vida académica. Cada sede universitaria y país tiene sus convenciones, sin embargo, en todas persiste la estructura de contrapunto propia de la disputatio medieval. Siendo la parte pública de la Defensa un texto oral, no siempre hay la oportunidad de analizar las posiciones argumentativas del candidato y de los miembros del jurado. Esta investigación compara dos corpus orales de defensas doctorales (transcripciones) en inglés y en español, de Estados Unidos y de España (corpus MiCaSe y Nebrija de Comunicación Académica CONCA). El análisis muestra cómo los elementos pragmáticos que caracterizan la situación comunicativa marcan el discurso de sus actores y el nivel de formalidad del discurso.

Abstract The defense of a doctoral thesis is a public act of major importance in academic life. Each university and country have its own conventions, but the counterpoint structure of the medieval disputatio persists in all of them. Since the public part of the Defense is an oral text, there is not always an opportunity to analyze the argumentative positions of the candidate and the members of the jury. This research compares two corpora of doctoral thesis defenses (transcripts) in English and Spanish. They are from different oral traditions, from the United States and Spain. The analysis shows how the pragmatic elements that characterize the communicative situation mark the discourse of its actors and the level of formality of the discourse.

https://doi.org/10.29092/uacm.v18i47.868 25 downloads

10.

Prevalencia de factores de riesgo en pacientes mayores de 50 años con fracturas clásicas de fragilidad atendidos en un hospital de tercer nivel de complejidad en Boyacá
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Sankó Posada, Andrey Alexandrovich

; González Castañeda, Adriana Patricia

; Vargas Rodríguez, Ledmar Jovanny

; Gordillo Nava, Gladys Cecilia

Revista Colombiana de Reumatología

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jun 2021, Volume 28 N. 2 Pages 104 - 110

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

RESUMEN Introducción: Las fracturas por fragilidad son una complicación frecuente de la osteoporosis y generan alto impacto en la calidad de vida del adulto mayor. Las fracturas de cuello femoral, radio distal, húmero proximal y vértebras toracolumbares, en el contexto de un traumatismo menor, se consideran fracturas por fragilidad. Objetivo: Identificar la prevalencia de factores de riesgo en personas mayores de 50 arios con fracturas por fragilidad atendidas en un hospital del departamento de Boyacá. Metodología: Estudio observacional, descriptivo y de corte transversal. Se incluyeron 242 pacientes que presentaron fracturas por fragilidad con diagnóstico confirmado por estudio imagenológico. Resultados: El 62,8% de la población fue femenina. La edad condiciona un aumento del número de fracturas de fémur. El 10,7% de la población tenía un antecedente de fractura, con un aumento de la prevalencia a mayor edad. La fractura de radio distal fue la más frecuente en el 36,8% de la población. Cerca del 40% de los pacientes eran hipertensos y el 7,9% tenía diabetes, en tanto que el 9,7% eran consumidores crónicos de inhibidores de la bomba de protones. El 2,4% consumía glucocorticoides previamente al evento. Conclusiones: El comportamiento poblacional de las fracturas por fragilidad en nuestra ins titución es similar al de otros lugares, tanto a escala nacional como internacional. Por tanto, es importante empezar a crear conciencia sobre la prevención secundaria de la osteoporo sis, con el fin de disminuir las complicaciones, mejorar los desenlaces y disminuir los gastos que consigo trae.

ABSTRACT Introduction: Fragility fractures are a frequent complication of osteoporosis and lead to increased morbidity and mortality, as well as decreasing quality of life of the elderly popu lation, and represents high costs for health care systems. After minor trauma, fractures of the femoral neck, distal radius, proximal humerus, and thoraco-lumbar vertebrae are associated with osteoporosis, and are considered fragility fractures. Objective: To identify the prevalence of risk factors in people over 50 years of age with fragility fractures treated at a third level hospital in the department of Boyacá, Colombia. Methodology: Observational, descriptive, retrospective cross-sectional study. An evaluation was made on 242 patients between 50 and 100 years of age with any of the previously mentioned 4 fragility fractures. Fracture diagnosis had to be confirmed by plain radiography or computed tomography. Results: The majority (62.8%) of the study population was female. Age was associated with an increase in the number of femur fractures. A history of previous fractures was observed in 10.7% of the cases, with prevalence increasing with age. Distal radius fracture was the most frequent in 36.8% of the population. About 40% of the patients had hypertension and 7.9% were diabetic. Chronic use of proton pump inhibitors was observed in 9.7%, and 2.4% consumed glucocorticoids prior to the event. Conclusions: The behaviour of fragility fractures of the population in our institution is simi lar to that of other places, both nationally and internationally. It is therefore important to start raising awareness about secondary prevention of osteoporosis, in order to reduce complications, improve outcomes, and reduce associated costs.

https://doi.org/10.1016/j.rcreu.2020.07.008 80 downloads

11.

Glomeruloesclerosis focal segmentaria de variante colapsante asociada a VIH. Reporte de caso.
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Amador Canals, Annia Cristina

; Agresott Mancera, Ella Cecilia

; Caicedo Mesa, Alberto

; Aborashed Amador, Nahala Fahed

; Vargas Rodríguez, Ledmar Jovanny

; Andrade Pérez, Rafael Enrique

Revista Colombiana de Nefrología

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jun 2021, Volume 8 N. 1 elocation e403

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

Resumen La afectación del virus de la inmunodeficiencia humana (VIH) ha cambiado tras el inicio del tratamiento antirretroviral de gran actividad, ya que este ha generado una mayor supervivencia y un menor número de comorbilidades en los pacientes. Es común que en las personas con VIH el fracaso renal agudo esté asociado a sepsis, toxicidad por fármacos o afección directa por el propio virus. La nefropatía en pacientes con VIH es variada y puede estar asociada al uso de medicamentos o directamente al efecto del virus. La prevalencia de esta patología en este tipo de pacientes es <10% y se caracteriza por un colapso glomerular. Las células del parénquima renal expresan los receptores de quimiocinas CCR5 y CXCR4, que son esenciales para la entrada de cepas de VIH-1 en las células. El presente caso es particularmente interesante ya que la insuficiencia renal aguda en el marco de un síndrome nefrótico fue la primera manifestación en un paciente con VIH/sida.

Abstract : Human immunodeficiency virus infection has changed after the start of highly active antiretroviral treatment, generating greater survival and fewer patient comorbidities. In these patients, the finding of acute renal failure is common, which may be associated with sepsis, drug toxicity, or direct involvement by the virus itself. Nephropathy in patients with HIV infection is varied, where it can be associated with the use of medications or directly due to the effect of the virus (HIVAN). The prevalence is less than 10 % and is characterized by glomerular collapse. Renal parenchyma cells express the chemokine receptors CCR5 and CXCR4 that are essential for the entry of HIV-1 strains into cells. The present case is interesting, since acute renal failure in the framework of a nephrotic syndrome was the first manifestation of a patient with HIV / AIDS.

https://doi.org/10.22265/acnef.8.1.514 125 downloads

12.

Thrombolysis in ischemic cerebrovascular accidents. The experience in Boyacá
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ZARAMA-VALENZUELA, ÁLVARO

; BUSTOS-SÁNCHEZ, JOSÉ LUIS

; GORDILLO-NAVAS, GLADYS CECILIA

; VARGAS-RODRÍGUEZ, LEDMAR JOVANNY

Acta Medica Colombiana

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mar 2021, Volume 46 N. 1 Pages 14 - 19

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

Resumen Introducción: se describe la experiencia de un programa de trombólisis para ataque cerebro-vascular isquémico en un hospital público colombiano de tercer nivel. Objetivos: caracterizar los pacientes que recibieron trombólisis intravenosa por ataque cerebro-vascular isquémico en la institución hospitalaria entre enero de 2014 y junio de 2019. Material y métodos: estudio observacional retrospectivo, a partir de la revisión de historias clínicas. Resultados: se incluyeron 156 pacientes. La edad promedio fue de 66.1 años y 50.6% fueron mujeres. Sólo 28.8% provenían de Tunja. La hipertensión arterial fue el factor de riesgo más prevalente. El tiempo promedio de estancia fue de ocho días (DE 7.7) y el tiempo promedio de ventana fue de 2.8 horas (DE 1.29). El puntaje NIHSS promedio de ingreso fue 12.4 (DE 5) y el de egreso de 4.8 (DE 4.48). La tasa de mortalidad intrahospitalaria fue 14.7% y la tasa de transformación hemorrágica de 10.9%. El tiempo puerta-aguja promedio fue de 62.8 minutos (DE 42.95) y el tiempo puerta-imagen promedio de 23.5 minutos (DE 27.42). Conclusiones: los resultados obtenidos contribuyen a robustecer los datos epidemiológicos sobre los programas de trombólisis en el ataque cerebrovascular isquémico en Colombia y Latinoamérica. La distribución geográfica de la población de este estudio realza la importancia de la construcción de redes de trombólisis y la utilización de herramientas como la telemedicina.

Abstract Introduction: the experience of a thrombolysis program for ischemic cerebrovascular accidents in a Colombian public tertiary care hospital is described. Objectives: to characterize patients who received intravenous thrombolysis due to an ischemic cerebrovascular accident in this hospital between January 2014 and June 2019. Materials and methods: a retrospective observational study based on a chart review Results: 156 patients were included. The average age was 66.1 years, and 50.6% were women. Only 28.8% were from Tunja. Arterial hypertension was the most prevalent risk factor. The average length of stay was eight days (SD 7.7), and the average window period was 2.8 hours (SD 1.29). The average NIHSS score on admission was 12.4 (SD 5) and at discharge was 4.8 (SD 4.48). The inpatient mortality rate was 14.7%, and the rate of hemorrhagic transformation was 10.9%. The average door-to-needle time was 62.8 minutes (SD 42.95), and the average door-to-imaging time was 23.5 minutes (SD 27.42). Conclusions: The results obtained contribute to strengthening the epidemiological data on thrombolysis programs for ischemic cerebrovascular accidents in Colombia and Latin America. The geographical distribution of the study population highlights the importance of constructing thrombolysis networks and using tools like telemedicine. (Acta Med Colomb 2021; 46. DOI: https://doi.org/10.36104/amc.2021.1862

https://doi.org/10.36104/amc.2021.1862 114 downloads

13.

Aspectos bioéticos en la decisión terapéutica del neonato prematuro extremo
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Barría-Pailaquilén, Mauricio

; Burgos-Saelzer, Cecilia B.

; Triviño-Vargas, Patricia

Revista de Salud Pública

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feb 2021, Volume 23 N. 1 Pages 1 -

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

ABSTRACT The article raises the issue of therapeutic decision-making in the face of extreme premature infants, particularly under 25 weeks of gestation, undergoing advanced life support technology. For this, their prognosis and possible sequelae were considered. It exposes the way in which decisions can be made and the actors involved. The ethical perspective of therapeutic acts analyzes the arguments of quality of life and best interests for the patient. Additionally, it attempts to analyze the repercussions for public health, focusing particularly on the allocation and distribution of resources. It is concluded that decision-making cannot be done in isolation by the health team but requires the participation of parents. The dis-proportionate use of diagnostic and therapeutic technology would lead girls, boys and their parents to significant burdens of suffering, individual and state expenses. The quality of life must be weighted and adopted as a criterion analyzing the best interest for the child, his parents and society, in defense of the common benefit and equity.

RESUMEN El artículo plantea la problemática en la toma de decisiones terapéuticas frente al niño prematuro extremo, en particular, aquel de menos de 25 semanas de gestación, sometido a tecnología de soporte vital avanzado. Para ello, se tuvieron en cuenta tanto su pronóstico como las posibles secuelas. Expone la forma en que las decisiones pueden ser tomadas y la manera en que los actores se pueden involucrar. La perspectiva ética de los actos terapéuticos analiza los argumentos de calidad de vida y mejores intereses para el paciente. Adicionalmente, intenta analizar las repercusiones para la salud pública, centrándose particularmente en la asignación y distribución de recursos. Se concluye que la toma de decisiones no puede ser realizada aisladamente por el equipo de salud, sino que requiere de la participación de los padres. El uso desproporcionado de tecnología diagnóstica y terapéutica conllevaría para las niñas, niños y sus padres importantes cargas de sufrimiento y gastos tanto individuales como para el Estado. La calidad de vida debe ser ponderada y adoptada como criterio analizando el mejor interés para el niño, sus padres y la sociedad, en defensa del bien común y equidad.

https://doi.org/10.15446/rsap.v23n1.89122

14.

ARQUEOLOGÍA Y EDUCACIÓN FORMAL EN LA COSTA DE TALTAL-PAPOSO: REFLEXIONES SOBRE “ARQUEOLOGÍA PÚBLICA”
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Salazar, Diego

; Urrea-Navarrete, Josefina

; Escobar, Manuel

; Andrade, Pedro

; Muñoz, Mónica

; Maldonado, Cecilia

; Torres, Romina

; Vargas, Karina

Chungará (Arica)

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dec 2020, Volume 52 N. 4 Pages 651 - 669

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

Abstract: In this paper, we summarize the scope of a project that we have developed in order to make a contribution to the training of local critical agents within the frame of the current educational system of Taltal, in northern Chile. The goal of the project is to connect the academic knowledge on the territory and its (pre)history, which we have produced through three successive research projects, with local non-academic knowledge, educational strategies, and teaching-learning methodologies, which meet the objectives of Ministry of Education’s official curricular programs, but from a local context. We also reflect on the possibilities of strengthening the ties between archaeology and formal education within the frame of a critical public archaeology.

Resumen: Con el objeto de contribuir a la formación de sujetos históricos en el marco del actual sistema educativo formal de la Comuna de Taltal, hemos desarrollado un proyecto que vincula los conocimientos académicos que hemos generado sobre el territorio y su (pre)historia en el marco de tres proyectos Fondecyt sucesivos, con saberes locales no académicos y con estrategias pedagógicas y didáctica de enseñanza-aprendizaje que responden a los objetivos de los planes curriculares del Ministerio de Educación, contextualizándolos a la realidad local. El presente trabajo sintetiza los alcances del proyecto y discute las posibilidades de profundizar los vínculos entre arqueología y educación formal en el marco de una arqueología pública crítica.

90 downloads

15.

Diagnóstico de las necesidades de capacitación de docentes de biología, química, física y matemática, en áreas disciplinares, pedagógicas, y uso de las tecnologías para la promoción de habilidades de pensamiento científico
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Zúñiga-Meléndez, Adriana

; Durán-Apuy, Alejandro

; Chavarría-Vásquez, Jesennia

; Gamboa-Araya, Ronny

; Carballo-Arce, Ana Francis

; Vargas-González, Xinia

; Campos-Quesada, Nelson

; Sevilla-Solano, Cecilia

; Torres-Salas, Isabel

Revista Electrónica Educare

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dec 2020, Volume 24 N. 3 Pages 469 - 497

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

Resumen Este estudio tiene como objetivo conocer las necesidades de capacitación del personal docente de ciencias naturales (biología, química y física) y de ciencias exactas (matemática), de colegios públicos académicos diurnos de la Dirección Regional de Educación de Heredia, para el desarrollo de habilidades científicas. Se trabajó con 72 docentes de matemática y 88 de ciencias naturales. La investigación se realizó desde el paradigma naturalista, con un enfoque cualitativo dominante y con un diseño del tipo de estudio fenomenológico. Se utilizó un instrumento tipo cuestionario, que tenía 12 preguntas dirigidas a indagar las necesidades de capacitación sobre los saberes pedagógicos y el uso de las tecnologías, y se hizo una exploración acerca del grado de interés que tiene el personal docente por recibir capacitación en saberes disciplinares. Las categorías utilizadas para el análisis son las siguientes: aspectos generales del personal docente en ejercicio; intereses de capacitación en el campo disciplinar, pedagógico y uso de las tecnologías; así como retos manifestados. Entre los principales hallazgos se evidenció el interés del cuerpo docente para participar en procesos de actualización en temas como la planificación, mediación y evaluación; además, en el uso de las tecnologías de la información y la comunicación. Además, se determinó que la capacitación en áreas disciplinarias debe estar enfocada al diseño de estrategias de mediación que permitan abarcar los temas de los programas de forma interdisciplinaria y contextualizada, así como en el diseño de procesos evaluativos que permitan evidenciar, en el estudiantado, el grado de apropiación de las habilidades de pensamiento científico y matemático.

Resumo O objetivo deste estudo foi conhecer as necessidades de treinamento que tem os docentes nos termos do desenvolvimento das habilidades científicas na área das ciências naturais (Biologia, Química e Física) e ciências exatas (Matemática), nas escolas diurnas da Direção Regional da província de Heredia segundo o sistema de edução pública da Costa Rica. O estudo foi desenvolvido no âmbito do paradigma naturalista, com abordagem qualitativo dominante e com delineamento do tipo de estudo fenomenológico. No desenvolvimento da pesquisa foi utilizado um instrumento tipo questionário, com 12 perguntas para validar o conhecimento atual e detetar necessidades de treinamento no uso das tecnologias, além de explorar o grau de interesse que têm os docentes para receber treinamento neste campo disciplinar. Para tal fim, foram consideradas as seguintes categorias de análise: aspetos gerais do docente, interesse do docente tanto no campo disciplinar como no contexto pedagógico e no uso das tecnologias; finalmente foram considerados os desafios inerentes que poderia representar este processo para eles. Na aplicação do questionário foram escolhidos 72 professores de matemática e 88 professores das ciências naturais. A partir dos resultadados obtidos encontrou-se uma evidente disposição do corpo docente para participar em processos de atualização dirigidos ao fortalecimento em temas de planejamento, mediação e avaliação das aulas no uso de tecnologias da informação e comunicação. Além disso, determinou-se que o treinamento em áreas disciplinares deveria focar-se no desenho de estratégias de mediação que permitiam abordar os tópicos dos programas de estudo num processo interdisciplinar e melhor contextualizado, bem como validar adequadamente os processos de avaliação que permitissem medir o grau de apropriação de habilidades de pensamento científico e matemático.

Abstract This study aims to better understand training secondary and high school teachers require to develop scientific thinking skills in the areas of natural science (Biology, Chemistry, and Physics) and Mathematics. The study focuses on teachers of these disciplinary areas from public schools with an academic curriculum of the Heredia District of Education in Costa Rica. The study worked with 72 teachers of Mathematics and 88 teachers of natural sciences. The research used a naturalistic paradigm. The experimental design used a dominant qualitative approach, combined with a phenomenological study type. The study developed a questionnaire-type instrument to gather the information needed. This instrument consisted of a total of 12 questions in the following areas: pedagogical knowledge and use of technologies, and exploration of the degree of interest that teaching staff has in receiving training in disciplinary knowledge. The five categories used to analyze the teachers’ answers to the instrument were the following: general aspects of the practicing teacher, training interests in the disciplinary and pedagogical field, use of technologies, and challenges expressed by the teaching staff. Among the main findings of the study, the interest of the teaching staff to participate in updating processes in topics such as planning, mediation, and evaluation was evident, as well as training in the use of information and communication technologies. Also, it was determined that training in disciplinary areas should focus on the design of mediation strategies that allow the contents of the programs to be covered in an interdisciplinary and contextualized way. The teachers also showed interest in receiving training related to the design of evaluative processes that allow giving appropriate feedback to students, in terms of the degree of appropriation of scientific and mathematical thinking skills.

https://doi.org/10.15359/ree.24-3.23

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