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Resumen Introducción: el progreso en los tratamientos para el lupus eritematoso sistémico (LES) resultó en una disminución de la mortalidad; sin embargo, la enfermedad cardiovascular y las complicaciones infecciosas aún son las principales causas de muerte. La evidencia apoya la participación del sistema inmunológico en la generación de la placa aterosclerótica, así como su conexión con las enfermedades autoinmunes. Objetivos: describir la frecuencia de eventos cardiovasculares (ECV) en el Registro de Lupus Eritematoso Sistémico de la Sociedad Argentina de Reumatología (RELESSAR) transversal, así como sus principales factores de riesgo asociados. Materiales y métodos: estudio descriptivo y transversal para el cual se tomaron los pacientes ingresados en el registro RELESSAR transversal. Se describieron las variables sociodemográficas y clínicas, las comorbilidades, score de actividad y daño. ECV se definió como la presencia de al menos una de las siguientes patologías: enfermedad arterial periférica, cardiopatía isquémica o accidente cerebrovascular. El evento clasificado para el análisis fue aquel posterior al diagnóstico del LES. Se conformaron dos grupos macheados por edad y sexo 1:2. Resultados: 1515 pacientes mayores de 18 años participaron del registro. Se describieron 80 pacientes con ECV (5,3%). En este análisis se incluyeron 240 pacientes conformando dos grupos. La edad media fue de 47,8 (14,4) y 47,6 (14,2) en el grupo con y sin ECV respectivamente. Los pacientes con ECV tuvieron mayor duración del LES en meses, mayor índice de Charlson, mayor SLICC (Systemic Lupus International Collaborating Clinics/American College of Rheumatology), mayor frecuencia de manifestaciones neurológicas, síndrome antifosfolípido, hospitalizaciones y uso de ciclofosfamida. Las únicas variables asociadas en el análisis multivariado fueron el índice de Charlson (p=0,004) y el SLICC (p<0,001). Conclusiones: los ECV influyen significativamente en nuestros pacientes, y se asocian a mayor posibilidad de daño irreversible y comorbilidades.

Abstract Introduction: progress in treatments for systemic lupus erythematosus (SLE) has resulted in a decrease in mortality; however, cardiovascular and infectious diseases remain the leading causes of death. Evidence supports the involvement of the immune system in the generation of atherosclerotic plaque, as well as its connection to autoimmune diseases. Objectives: to describe the frequency of cardiovascular disease (CVD) in the cross-sectional RELESSAR registry, as well as its associated variables. Materials and methods: a descriptive and cross-sectional study was performed using patients admitted to the cross-sectional RELESSAR registry. Sociodemographic variables, clinical variables, comorbidities, activity and damage scores were described. CVD was defined as at least one of the following: peripheral arterial disease, ischemic heart disease, or cerebrovascular accident. All patients with at least one CVD were included in our analysis (heart attack, central nervous system vascular disease, and peripheral arteries atherosclerotic disease). The event classified for the analysis was that after the diagnosis of SLE. SLE diagnosis was previous to CVD. Two groups matched by age and sex, 1:2 were formed. Results: a total of 1515 patients older than 18 years participated in the registry. Eighty patients with CVD (5.3%) were described in the registry. Two-hundred and forty patients were included, according to two groups. The mean age was 47.8 (SD 14.4) and 47.6 (SD 14.2) in patients with and without CVD, respectively. Patients with CVD had a longer duration of SLE in months, a higher Charlson index, a higher SLICC, increased frequency of neurological manifestations, antiphospholipid syndrome, hospitalizations, and use of cyclophosphamide. The associated variables in the multivariate were the Charlson Index (p=0.004) and the SLICC (p<0.001). Conclusions: CVDs have a significant influence on our patients, being associated with a greater possibility of damage and comorbidities.

https://doi.org/10.47196/rar.v34i2.747

Seguridad de las drogas biológicas y sintéticas dirigidas utilizadas en pacientes con enfermedades reumáticas inmunomediadas.
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Isnardi, Carolina A

; Roberts, Karen

; Exeni, Ida

; De La Sota, Mercedes

; Soriano, Enrique

; Dubinsky, Diana

; Medina, Gustavo

; Berbotto, Guillermo A

; Velozo, Edson J

; Papasidero, Silvia

; Gamba, Julieta

; Saurit, Verónica

; Citera, Gustavo

; Díaz, Mónica

; Catay, Erika

; Gómez, Graciela

; Sacnun, Mónica

; Larroude, María S

; Cavillon, Emilia

; Secco, Anastasia

; Aste, Nora

; Pons-Estel, Bernardo

; García, Mercedes A

; Pisoni, Cecilia

; Bovea, Gladys

; Morales, Liliana

; Granel, Amelia

; Gobbi, Carla

; Savio, Verónica

; Álvarez, Analia P

; Casado, Gustavo

; Soares Souza, Sidney

; Petkovic, Ingrid

; Castro, Cecilia

; Kerzberg, Osvaldo

; Gallardo, María de los Ángeles

; Brigante, Alejandro

; Haye Salinas, María

; Alfaro, María Agustina

; Pons-Estel, Guillermo J

; de la Vega, María Celina

Revista argentina de reumatología

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jan 2023, Volume 34 N. 1 Pages 3 - 15

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

Resumen Introducción: conocer la seguridad de las drogas actualmente disponibles para el tratamiento de las enfermedades reumáticas es muy importante al momento de tomar decisiones terapéuticas objetivas e individualizadas en la consulta médica diaria. Asimismo, datos de la vida real amplían el conocimiento revelado por los ensayos clínicos. Objetivos: describir los eventos adversos (EA) reportados, estimar su frecuencia e identificar los factores relacionados con su desarrollo. Materiales y métodos: se utilizaron datos BIOBADASAR, un registro voluntario y prospectivo de seguimiento de EA de tratamientos biológicos y sintéticos dirigidos en pacientes con enfermedades reumáticas inmunomediadas. Los pacientes son seguidos hasta la muerte, pérdida de seguimiento o retiro del consentimiento informado. Para este análisis se extrajeron datos recopilados hasta el 31 de enero de 2023. Resultados: se incluyó un total de 6253 pacientes, los cuales aportaron 9533 ciclos de tratamiento, incluyendo 3647 (38,3%) ciclos sin drogas modificadoras de la enfermedad biológicas y sintéticas dirigidas (DME-b/sd) y 5886 (61,7%) con DME-b/sd. Dentro de estos últimos, los más utilizados fueron los inhibidores de TNF y abatacept. Se reportaron 5890 EA en un total de 2701 tratamientos (844 y 1857 sin y con DME-b/sd, respectivamente), con una incidencia de 53,9 eventos cada 1000 pacientes/año (IC 95% 51,9-55,9). La misma fue mayor en los ciclos con DME-b/sd (71,1 eventos cada 1000 pacientes/año, IC 95% 70,7-77,5 versus 33,7, IC 95% 31,5-36,1; p<0,001). Las infecciones, particularmente las de la vía aérea superior, fueron los EA más frecuentes en ambos grupos. El 10,9% fue serio y el 1,1% provocó la muerte del paciente. El 18,7% de los ciclos con DME-b/sd fue discontinuado a causa de un EA significativamente mayor a lo reportado en el otro grupo (11,5%; p<0,001). En el análisis ajustado, las DME-b/sd se asociaron a mayor riesgo de presentar al menos un EA (HR 1,82, IC 95% 1,64-1,96). De igual manera, la mayor edad, el mayor tiempo de evolución, el antecedente de enfermedad pulmonar obstructiva crónica, el diagnóstico de lupus eritematoso sistémico y el uso de corticoides se asociaron a mayor riesgo de EA. Conclusiones: la incidencia de EA fue significativamente superior durante los ciclos de tratamientos que incluían DME-b/sd.

Abstract Introduction: knowing the efficacy and safety of the drugs currently available for the treatment of rheumatic diseases is very important when making objective and individualized therapeutic decisions in daily medical consultation. Likewise, real-life data extends the knowledge revealed by clinical trials. Objectives: to describe the reported adverse events (AEs), estimate their frequency and identify factors associated to them. Materials and methods: BIOBADASAR data were used, which is a voluntary, prospective follow-up registry of AEs of biological and synthetic treatments in patients with immune-mediated rheumatic diseases. Patients are followed until death, loss of followup, or withdrawal of informed consent. To carry out this analysis, the data collected up to January 31, 2023 was extracted. Results: a total of 6253 patients were included, who contributed with 9533 treatment periods, including 3647 (38.3%) periods without b/ts-DMARDs and 5886 (61.7%) with b/ts-DMARDs. Among the latter, the most used were TNF inhibitors and abatacept. A total of 5890 AEs were reported in a total of 2701 treatments (844 and 1857 without and with b/ts-DMARDs, respectively), with an incidence of 53.9 events per 1000 patients/ year (95% CI 51.9-55.9). It was higher during the periods with b/ts-DMARDs (71.1 events per 1000 patients/year, 95% CI 70.7-77.5 vs 33.7, 95% CI 31.5-36.1, p<0.001). Infections, particularly those of the upper respiratory tract, were the most frequent AEs in both groups. 10.9% were severe and 1.1% were associated with the death of the patient. 18.7% of the periods with b/ts-DMARDs were discontinued due to an AE, significantly higher than that reported in the other group (11.5%; p<0.001). In the adjusted analysis, b/ts-DMARDs were associated with a higher risk of presenting at least one AE (HR 1.82, 95% CI 1.64-1.96). Similarly, older age, longer evolution time, history of chronic obstructive pulmonary disease, diagnosis of systemic lupus erythematosus, and use of corticosteroids were associated with a higher risk of AE. Conclusions: the incidence of AEs was significantly higher during those treatment periods that included DME-b/sd.

https://doi.org/10.47196/rar.v34i1.726

Intervención de enfermería en tamiz metabólico neonatal: Revisión integrativa
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Salmón Vega, Silvia Guadalupe

Sanus

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dec 2022, Volume 7 elocation e309

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

Abstrato Introdução: A triagem metabólica neonatal refere-se a um grupo de procedimentos e testes realizados a fim de separar entre recém-nascidos aparentemente saudáveis, aqueles com suspeita de erros congênitos de metabolismo. Portanto, permite detectar a doença antes que ela apareça e iniciar o tratamento a tempo, a fim de evitar complicações, incapacidade e morte. Atualmente, a triagem metabólica neonatal é decisiva para resultados confiáveis. Objetivo: Realizar uma revisão integrativa da literatura sobre intervenção de enfermagem na triagem metabólica neonatal. Metodologia: Pesquisa integrativa nas bases de dados Web of Science, Scielo, Scopus, Pubmed, Sciencedirect, Dialnet, OVID e EBSCO, utilizando os descritores triagem neonatal, cuidados de enfermagem, erros inatos de metabolismo, neonatologia e analgesia; com os operadores booleanos e, ou não, com os operadores booleanos. Dos 116 documentos obtidos, 36 preenchiam os critérios de elegibilidade e representavam o material de estudo. Resultados: A coleta de amostras de sangue para triagem foi realizada entre o terceiro e quinto dia de vida, essencialmente por punção capilar do calcanhar. As medidas analgésicas não-farmacológicas são a amamentação, método canguru e contenção. A amostra deve ser protegida de contaminação, e sua estabilidade depende da temperatura de armazenamento até que a análise seja realizada. Conclusões: A literatura científica revisada capacita o profissional de enfermagem a fornecer cuidados abrangentes e seguros ao recém-nascido que participa do programa.

Abstract Introduction: Neonatal metabolic screening refers to a group of procedures and tests performed in order to separate among apparently healthy newborns, those with suspected inborn errors of metabolism. Therefore, it allows detecting the disease before it appears and initiating the treatment in time in order to prevent complications, disability and death. Currently, the neonatal metabolic screening is decisive for reliable results. Objective: Conduct an integrative literature review of nursing intervention in neonatal metabolic screening. Methodology: Integrative research in the databases Web of Science, Scielo, Scopus, Pubmed, Sciencedirect, Dialnet, OVID and EBSCO, using the descriptors neonatal screening, nursing care, inborn errors of metabolism, neonatology and analgesia; with the Boolean operators and, or and not. Of 116 documents obtained, 36 met eligibility criteria and represent the study material. Results: Blood sample collection for screening was performed between the third and fifth day of life, essentially by capillary puncture of the heel. Non-pharmacological analgesic measures are breastfeeding, kangaroo method and containment. The sample shall be protected from contamination, and its stability depends on the storage temperature until analysis is performed. Conclusions: The scientific literature reviewed empowers the nursing professional to provide comprehensive and safe care to the newborn who participates in the program.

Resumen Introducción: El tamiz metabólico neonatal es el conjunto de procedimientos y pruebas que se realizan para separar entre recién nacidos aparentemente sanos, aquellos con sospecha de errores innatos del metabolismo. Por tanto, permite detectar la enfermedad antes que se manifieste e iniciar tratamiento oportuno para evitar complicaciones, discapacidad y muerte. Actualmente, es un programa neonatal prioritario para la salud infantil. En la etapa operativa, la estandarización de criterios es determinante para resultados confiables. Objetivo: Realizar revisión bibliográfica integrativa de la intervención de enfermería en tamiz metabólico neonatal. Metodología: Investigación integrativa en las bases de datos Web of Science, Scielo, Scopus, Pubmed, Sciencedirect, Dialnet, OVID y EBSCO, utilizando los descriptores tamizaje neonatal, atención de enfermería, errores innatos del metabolismo, neonatología y analgesia; con los operadores booleanos and, or y not. De 116 documentos obtenidos, 36 cumplen criterios de elegibilidad y representan el material de estudio. Resultados: La recolección de muestra de sangre para tamiz se realiza entre el tercer y quinto día de vida, esencialmente mediante punción capilar del talón. Las medidas analgésicas no farmacológicas son lactancia materna, método canguro y contención. La muestra debe protegerse de contaminación, y su estabilidad depende de la temperatura de conservación hasta su análisis. Conclusiones: La literatura científica revisada, faculta al profesional de enfermería para proporcionar atención integral y segura al recién nacido que participa en el programa.

https://doi.org/10.36789/revsanus.vi1.309

Lupus en Argentina. .
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Quintana, Rosana

; García, Lucila

; Gobbi, Carla

; Alba, Paula

; Roverano, Susana

; Álvarez, Analia Patricia

; Graf, César Enrique

; Pisoni, Cecilia

; Spindler, Alberto

; Gómez, Catalina

; Figueredo, Heber Matías

; Papasidero, Silvia

; Paniego, Raúl

; de la Vega, María Celina

; Civit, Emma

; González Lucero, Luciana

; Martire, María Victoria

; Aguila Maldonado, Rodrigo

; Gordon, Sergio

; Micelli, Marina

; Nieto, Romina

; Rausch, Gretel

; Gongora, Vanina

; Damico, Agustina

; Rodríguez Gil, Gustavo

; Dubinsky, Diana

; Orden, Alberto

; Zacariaz, Johana

; Romero, Julia

; Pera, Mariana

; Goñi, Mario

; Rillo, Oscar

; Báez, Roberto

; Arturi, Valeria

; González, Andrea

; Vivero, Florencia

; Bedoya, María Eugenia

; Shmid, María Marcela

; Caputo, Víctor

; Larroude, Maria Silvia

; Domínguez, Nadia

; Gómez, Graciela Noemí

; Rodríguez, Graciela Nora

; Marín, Josefina

; Collado, Victoria

; Jorfen, Marisa

; Bedran, Zaida

; Curti, Ana

; Gazzoni, María Victoria

; Sarano, Judith

; Zelaya, Marcos

; Sacnun, Mónica

; Finucci Curi, Pablo

; Rojas Tessel, Romina

; Arias Saavedra, Maira

; Sattler, María Emilia

; Machado Escobar, Maximiliano Augusto

; Astesana, Pablo

; Paris, Úrsula

; Virasoro, Belén María

; Santa Cruz, María Julia

; Allievi, Alberto

; Vandale, Juan Manuel

; Hojberg, Noelia Giselle

; Pons-Estel, Bernardo

; Pons-Estel, Guillermo

; García, Mercedes Argentina

Revista argentina de reumatología

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mar 2022, Volume 33 N. 1 Pages 14 - 25

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

resumen está disponible en el texto completo

Abstract Introduction: lupus is a complex disease and often difficult to approach. Achieving remission is one of the objectives, incorporating therapeutic options. Objectives: to describe the characteristics of the patients and the use of belimumab, according to the status of the disease. Materials and methods: cross-sectional study. Patients of the RELESSAR registry. Stratification: Remission: SLEDAI=0 and without corticosteroids. Low disease activity SLEDAI> 0 and ≤4 and without corticosteroids and non-optimal control: SLEDAI> 4 and any dose of corticosteroids. Results: a total of 1,277 patients were included, 23.4% in remission, 12.6% in low disease activity and 63.8% in non-optimal control. The last group was younger and had a shorter duration of the disease. They had higher activity and chronicity indices and greater use of immunosuppressants. Only 22.3% of the patients with potential criteria for the use of belimumab (activity disease despite standard treatment) were receiving it. The variables associated with hospitalizations were: corticosteroids, cyclophosphamide and higher SLICC. Those associated with severe infection: mycophenolate mofetil, azathioprine, corticosteroids, and higher SLICC. Conclusions: the complexity of the management of these patients is reflected, visualizing structural aspects such as inequality. The use of belimumab could be beneficial in selected patients.

https://doi.org/10.47196/rar.v33i1.602 101 downloads

Mental health problems among healthcare workers involved with the COVID-19 outbreak
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Robles, Rebeca

; Rodríguez, Evelyn

; Vega-Ramírez, Hamid

; Álvarez-Icaza, Dení

; Madrigal, Eduardo

; Durand, Sol

; Morales-Chainé, Silvia

; Astudillo, Claudia

; Real-Ramírez, Janet

; Medina-Mora, María-Elena

; Becerra, Claudia

; Escamilla, Raúl

; Alcocer-Castillejos, Natasha

; Ascencio, Leticia

; Díaz, Dulce

; González, Hugo

; Barrón-Velázquez, Evalinda

; Fresán, Ana

; Rodríguez-Bores, Lorena

; Quijada-Gaytán, Juan-Manuel

; Zabicky, Gady

; Tejadilla-Orozco, Diana

; González-Olvera, Jorge-Julio

; Reyes-Terán, Gustavo

Brazilian Journal of Psychiatry

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oct 2021, Volume 43 N. 5 Pages 494 - 503

Abstract: En | Text: En | PDF: En

Objective: The mental health problems and perceived needs of healthcare workers involved with coronavirus disease (COVID-19) may vary due to individual and contextual characteristics. The objective of this study was to evaluate healthcare workers’ mental health problems during the common COVID-19 exposure scenario in Mexico, comparing those on the frontline with other healthcare workers according to gender and profession, determining the main risk factors for the most frequent mental health problems. Methods: A cross-sectional online study was conducted with a non-probabilistic sample of 5,938 Mexican healthcare workers who completed brief screening measures of mental health problems and ad hoc questions about sociodemographic professional characteristics, conditions related to increased risk of COVID-19 infection, life stressors during the COVID-19 emergency, and perceived need to cope with COVID-19. Results: The identified mental health problems were insomnia, depression, and posttraumatic stress disorder (PTSD), all of which were more frequent in frontline healthcare workers (52.1, 37.7, and 37.5%, respectively) and women (47.1, 33.0 %, and 16.3%, respectively). A lack of rest time was the main risk factor for insomnia (OR = 3.1, 95%CI 2.6-3.7, p ≤ 0.0001). Mourning the death of friends or loved ones due to COVID-19 was the main risk factor for depression (OR = 2.2, 95%CI 1.8-2.7, p ≤ 0.0001), and personal COVID-19 status was the main risk factor for PTSD (OR = 2.2, 95%CI 1.7-2.9, p ≤ 0.0001). Conclusion: The most frequent mental health problems during the common exposure scenario for COVID-19 in Mexico included the short-term psychological consequences of intense adversity. A comprehensive strategy for preventing mental health problems should focus on individuals with cumulative vulnerability and specific risk factors.

https://doi.org/10.1590/1516-4446-2020-1346 885 downloads

Heliconias with pendent inflorescences as cut flowers
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Gonçalves, Charleston

; Tavares, Armando Reis

; Vega, Silvia Moreira Rojo

; Merida, Daniela

; Castro, Carlos Eduardo Ferreira de

Ornamental Horticulture

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jun 2021, Volume 27 N. 2 Pages 137 - 154

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

Resumo As espécies de Heliconia com inflorescências pendentes e brácteas coloridas são uma boa opção para o mercado de flores de corte, mas apenas algumas espécies de Heliconia, por exemplo. H. rostrata, H. rauliniana e H. chartacea, são comercialmente produzidas no Brasil. Este estudo foi realizado para caracterizar 36 acessos de diferentes espécies, com inflorescências pendentes para serem utilizadas como flor de corte, visando a aumentar o conhecimento e a utilização destas plantas excepcionais pelos consumidores e entusiastas das flores tropicais. As avaliações foram realizadas em plantas da Coleção de Germoplasma do Instituto Agronômico (IAC) Ubatuba, São Paulo, Brasil, crescendo em condição de sombra, sombra parcial ou pleno sol. Foram analisadas características qualitativas e quantitativas relacionadas ao crescimento da touceira e características da haste floral. Um sistema de pontuação foi usado para determinar as espécies mais adequadas para a utilização de flores de corte. Todos os genótipos avaliados foram adequados para serem usados como flores de corte, mesmo as de inflorescências grandes e brácteas dispostas em vários planos, fatos que afetam ou dificultam o manuseio, embalamento e transporte. H. mariae, H. fernandezii, H. platystachys, H. rauliniana, H. rostrata, H. standley, H. necrobracteata e H. laxa foram considerados excelentes. Esta caracterização e sistema de pontuação foram importantes para facilitar a seleção de genótipos de helicônias como flores de corte.

Abstract The Heliconia species with pendent inflorescences and colorful bracts are a good option as a cut flower for floriculture market, but only a few species of this type of Heliconia eg. H. rostrata, H. rauliniana and H. chartacea are commercially produced in Brazil. This study was carried out to characterize 36 Heliconia accessions, with pendent inflorescences, to be used as cut flower, intending to increase knowledge and use of these exceptional plants among tropical flower enthusiasts and consumers. The evaluations were performed on plants of the Germplasm Collection of the Instituto Agronômico (IAC) growing in shade, partial shade or full sun conditions. Qualitative and quantitative characteristics, related to clump growth and flower stem aspects were analyzed. A point scoring system was used to determine the species most suitable for cut flower utilization. All evaluated genotypes reached enough points to be considered suitable for use as cut flowers, even those with large inflorescences and bracts arranged in different planes, facts that affect and limit handling, packaging and transportation. H. mariae, H. fernandezii, H. platystachys, H. rauliniana, H. rostrata, H. standley, H. necrobracteata and H. laxa were considered outstanding. This characterization and scoring system were important to facilitate the selection of heliconia genotypes for use as cut flowers.

https://doi.org/10.1590/2447-536x.v27i2.2265 348 downloads

Características clínicas y epidemiológicas de casos de enfermedad de Chagas aguda en la cuenca amazónica peruana, 2009-2016
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Vega, Silvia

; Cabrera, Rufino

; Álvarez, Carlos A.

; Uribe-Vilca, Irene

; Guerrero-Quincho, Silvia

; Ancca-Juárez, Jenny

; Cabrera-Campos, Bryan

; Celis-Trujillo, Adela

; Zuñiga-Saca, Margarita

; Bernal-Fiestas, Miguel

; Oriundo-Palomino, Richard

Revista Peruana de Medicina Experimental y Salud Pública

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mar 2021, Volume 38 N. 1 Pages 70 - 76

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

ABSTRACT Acute Chagas disease (ACD) cases are reported sporadically in Peru. In this report we describe the clinical and epidemiological characteristics of eight new ACD cases detected by the surveillance system in the Amazon basin, between 2009 and 2016. The average age was 12,7 ±13.7 years, range between 1 to 44 years and 4/8 cases were men. One case was associated with acute diarrheal disease, another with Leptospirosis, and two with urinary tract infection. The global case fatality-rate was 12.5% (1/8). Late detection is a frequent characteristic related with low diagnostic suspicion in patients with a history of fever. The TcI and TcIV lineage was identified as the etiological agent of Chagas disease. Eight new cases of ACDs are reported, of which seven were children.

RESUMEN Los casos de la enfermedad de Chagas aguda (ECA) se reportan en forma esporádica en el Perú. En este artículo se describe las características clínicas y epidemiológicas de ocho nuevos casos de ECA detectados por el sistema de vigilancia en la cuenca amazónica, entre 2009 y 2016. La media de la edad fue 12,7 ± 13,7 años, rango de 1 a 44 años y 4/8 casos fueron varones. Un caso se asoció a enfermedad diarreica aguda, otro a leptospirosis y dos a infección del tracto urinario. La tasa de letalidad global fue 12,5% (1/8). La detección tardía es una característica frecuente relacionada a una escasa sospecha diagnóstica en pacientes con historial de fiebre. Se identificó el linaje TcI y TcIV del agente etiológico de la enfermedad de Chagas. Se reporta ocho nuevos casos de ECA, de los cuales siete fueron menores de edad.

https://doi.org/10.17843/rpmesp.2021.381.6286

Características clínicas y epidemiológicas de casos de enfermedad de Chagas aguda en la cuenca amazónica peruana, 2009-2016
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Vega, Silvia

; Cabrera, Rufino

; Álvarez, Carlos A.

; Uribe-Vilca, Irene

; Guerrero-Quincho, Silvia

; Ancca-Juárez, Jenny

; Cabrera-Campos, Bryan

; Celis-Trujillo, Adela

; Zuñiga-Saca, Margarita

; Bernal-Fiestas, Miguel

; Oriundo-Palomino, Richard

Revista Peruana de Medicina Experimental y Salud Publica

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jan 2021, Volume 38 N. 1 Pages 70 - 76

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

https://doi.org/10.17843/rpmesp.2021.381.6286

Competencias docentes, una innovación en ambientes virtuales de aprendizaje en educación superior
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Vega Lebrún, Carlos Arturo

; Sánchez Cuevas, Mariano

; Rosano Ortega, Genoveva

; Amador Pérez, Silvia Elena

Apertura (Guadalajara, Jal.)

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2021, Volume 13 N. 2 Pages 6 - 21

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

Abstract The emergency closure of educational institutions, in the face of the health contingency due to Covid-19, has prompted the rethinking of the models of teaching competencies to adapt to virtual learning environments (VLE). The objective of this study is to design and validate a model of teaching competencies in VLE, with the support of virtual laboratories, to ensure the quality of higher education during the covid-19 pandemic. A quantitative and correlational methodology was used in a case study. The research is divided into two methodological moments: the design of the model and its validation. The instruments used were a comparative analysis matrix and a Likert-type scale. 5 650 students and 41 teachers participated in the validation cap. The results highlight the need for teacher development, mainly in digital and research skills. One weakness of the study is the lack of weighting of the quality indicators. The proposed model represents an innovation in the definition of indicators, in the form of competencies, for the assurance of educational quality in VLE. It is concluded that the proposed model is pertinent for the assurance of educational quality in VLE.

RESUMEN El cierre de emergencia de las instituciones educativas ante la contingencia sanitaria por la covid-19 ha apremiado el replanteamiento de los modelos de competencias docentes para adaptarse a los ambientes virtuales de aprendizaje (AVA). El objetivo de este estudio fue diseñar y validar un modelo de competencias docentes en AVA, con el soporte de laboratorios virtuales, a fin de asegurar la calidad de la educación superior en este contexto. Se empleó una metodología cuantitativa y correlacional en un estudio de caso. La investigación se dividió en dos momentos metodológicos: el diseño del modelo y su validación. Los instrumentos utilizados fueron una matriz de análisis comparativo y una escala tipo Likert. En la etapa de validación participaron 5 650 estudiantes y 41 profesores. Los resultados destacan la necesidad del desarrollo docente, principalmente en las competencias digitales y de investigación. Una debilidad del estudio es la falta de ponderación de los indicadores de calidad. El modelo propuesto representa una innovación en la definición de indicadores, en forma de competencias, para el aseguramiento de la calidad educativa en los AVA. Se concluye que el modelo propuesto es pertinente para el aseguramiento de la calidad educativa en AVA.

https://doi.org/10.32870/ap.v13n2.2061 132 downloads

10.

¿Es posible ofrecer un algoritmo de decisión clínica en la enfermedad COVID-19 en Atención Primaria?
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Ortega Páez, Eduardo

; Callejas Pozo, José Emilio

; Almazán Fernández de Bobadilla, Mª Vega

; Garach Gómez, Ana

; Santos Pérez, Juan Luis

; Jordano Moreno, Belén

; Sevilla Pérez, Belén

; Martínez Diz, Silvia

Pediatría Atención Primaria

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dec 2020, Volume 22 N. 88 Pages 423 - 433

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

Abstract So far, the data collected in the cases of clinical processes caused by the SARS-CoV-2 (COVID-19) coronavirus in children suggest that they are mild compared to infections in adult patients; However, serious cases such as multisystemic inflammatory syndrome (SIM) have been reported, which requires assessment and emergency action. In the context of the of the Primary Care pediatrician consultation and coinciding with the beginning of the school year, at a time when the incidence of influenza, RSV infection and other respiratory conditions usually increases, consultations for symptoms that can lead to suspect these infections. Therefore, it is important to reach a diagnosis that allows the most appropriate management of the patient and decreasing the community transmission by taking pertinent measures. Given that there are no valid scales that offer a score to assess which is the most appropriate action in the event of a suspected COVID-19 infection, we propose the benefits of a clinical decision algorithm that takes into account epidemiological connotations, based on clinical severity to offer the most appropriate clinical care to patients.

Resumen Hasta ahora, los datos recogidos en los casos de procesos clínicos provocados por el coronavirus SARS-CoV-2 (COVID-19) en niños sugieren que son cuadros leves en comparación con las infecciones en pacientes adultos; no obstante, se ha informado de casos graves, como el síndrome inflamatorio multisistémico (SIM), que precisa de valoración y actuación de emergencia. En el contexto de la consulta del pediatra de Atención Primaria y coincidiendo con el inicio del curso escolar, en una época en la que habitualmente aumenta la incidencia de procesos como la gripe, infección por el virus respiratorio sincitial (VRS) y otros cuadros respiratorios, es habitual la demanda por síntomas que pueden hacer sospechar cualquiera de estas infecciones. En este sentido, es importante llegar a un diagnóstico que permita el manejo más adecuado del paciente. Epidemiológicamente, de manera que se pueda disminuir la transmisión comunitaria tomando las medidas adecuadas y clínicamente para así poder ponderar el nivel de gravedad y poner en marcha las actuaciones más adecuadas. Dado que no existen escalas válidas que ofrezcan un puntaje para valorar cuál es la actuación más adecuada ante la sospecha de una infección COVID-19, planteamos los beneficios de un algoritmo de decisión clínica que tiene en cuenta las connotaciones epidemiológicas, basado en la gravedad clínica, para ofrecer la atención clínica más adecuada a los pacientes.

11.

Caracterización de la fisiología restrictiva del ventrículo derecho mediante flujo 4D
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Vega, Julián

; Lorenzatti, Daniel

; Montserrat, Silvia

; Ortiz-Pérez, José Tomas

; Doltra, Adelina

; Perea, Rosario J

; Caralt, Teresa M. de

; Sotes, Santiago

; Prat-González, Susana

Revista chilena de cardiología

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aug 2020, Volume 39 N. 2 Pages 165 - 167

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

Abstract: Right ventricular restrictive physiology (RVRP) occurs in diverse clinical scenarios, most frequently after repair of Tetralogy of Fallot (TOF). Cardiac magnetic resonance (CMR) can comprehensively evaluate RVRP using 4D flow along with anatomical and fibrosis characterization. Also, RVRP is associated with less pulmonary regurgitation and fewer right ventricle enlargement; its long term protective role is debated. RVRP is a challenging and relevant diagnosis, which hallmark is the presence of antegrade pulmonary arterial Flow in late diastole throughout the respiratory cycle. Also, other hemodynamic findings could aid such us flow in; caval veins, suprahepatic, coronary sinus and tricuspid valve. Obtaining all these flow curves is virtually impossible by echocardiography. CMR with 4DF is a unique and powerful technique enabling this comprehensive hemodynamic evaluation as depicted in this case.

375 downloads

12.

Infusion of Convalescent Plasma is Associated with Clinical Improvement in Critically Ill Patients with COVID-19: A Pilot Study
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Olivares-Gazca, Juan C.

; Priesca-Marín, Jose M.

; Ojeda-Laguna, Martín

; Garces-Eisele, Javier

; Soto-Olvera, Silvia

; Palacios-Alonso, Abraham

; Izquierdo-Vega, Judith

; Chacon-Cano, Rómulo

; Arizpe-Bravo, Daniel

; López-Trujillo, Miguel A.

; Cantero-Fortiz, Yahveth

; Fernandez-Lara, Danitza

; Ruiz-Delgado, Guillermo J.

; Ruiz-Argüelles, Guillermo J.

Revista de investigación clínica

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jun 2020, Volume 72 N. 3 Pages 159 - 164

Abstract: En | Text: En | PDF: En

ABSTRACT Background: The ideal treatment of coronavirus disease (COVID)-19 has yet to be defined, but convalescent plasma (CoPla) has been successfully employed. Objective: The objective of the study was to study the safety and outcomes of the administration of CoPla to individuals with severe COVID-19 in an academic medical center. Methods: Ten patients were prospectively treated with plasma from COVID-19 convalescent donors. Results: Over 8 days, the sequential organ failure assessment score dropped significantly in all patients, from 3 to 1.5 (p = 0.014); the Kirby index (PaO2/FiO2) score increased from 124 to 255, (p < 0.0001), body temperature decreased significantly from 38.1 to 36.9°C (p = 0.0058), and ferritin levels also dropped significantly from 1736.6 to 1061.8 ng/ml (p = 0.0001). Chest X-rays improved in 7/10 cases and in 6/10, computerized tomography scans also revealed improvement of the lung injury. Decreases in C-reactive protein and D-dimer levels were also observed. Three of five patients on mechanical ventilation support could be extubated, nine were transferred to conventional hospital floors, and six were sent home; two patients died. The administration of CoPla had no side effects and the 24-day overall survival was 77%. Conclusions: Although other treatments were also administered to the patients and as a result data are difficult to interpret, it seems that the addition of CoPla improved pulmonary function.

https://doi.org/10.24875/ric.20000237 150 downloads

13.

Relación entre índice de masa corporal y trastorno por déficit de atención con hiperactividad en niños
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Vega Falcón, Vladimir

; Villacrés Gavilanes, Silvia Carolina

; Sánchez Martínez, Belkis

Revista Cubana de Pediatría

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jun 2020, Volume 92 N. 2 elocation e793

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

ABSTRACT Introduction: The body mass index is an indicator of body density, determined by the relationship between body weight and height. Attention deficit hyperactivity disorder is a syndrome with three symptoms: inattention, hyperactivity and impulsivity. Objective: To analyze the relationship between the body mass index and the attention deficit hyperactivity disorder in students. Methods: Observational, cross-sectional, bivariate and ambispective analytical research, carried out in a population of 111 girls and 125 boys, from 10 to 12 years of the Hispanic American Education Unit of the city of Ambato, Ecuador, in the period September 2017 - February 2018. Processing data in Microsoft Excel for body mass index and for the attention deficit hyperactivity disorder, and with Minitab® 18.1 software for the calculation of coefficients of Pearson and Spearman correlation, as well as the normality tests and analysis of outliers with the Grubbs test. Results: The average for body mass index was 20.15 in boys and 20.63 in girls, considered normal. Normal results were obtained in the attention deficit hyperactivity disorder in 93.7% of girls and 90.4% of boys, there being a slight predisposition for this disorder. The correlation between both variables was slightly positive: girls 0.202 and boys 0.457. Conclusions: Both, body mass index and the attention deficit hyperactivity disorder have normal parameters in girls and boys, with a weak positive correlation between them. It was proposed to establish educational strategies for the reduction of obesity and child malnutrition.

RESUMEN Introducción: El índice de masa corporal es un indicador de la densidad corporal. El trastorno por déficit de atención con hiperactividad es un síndrome que presenta tres síntomas: inatención, hiperactividad e impulsividad. Objetivo: Analizar la relación entre el índice de masa corporal y el trastorno por déficit de atención con hiperactividad en niños. Métodos: Investigación observacional, transversal, analítica bivariada y ambispectiva, desarrollada en 111 niñas y 125 niños, de 10 a 12 años de edad estudiantes de la Unidad Educativa Hispano América de la ciudad de Ambato, Ecuador, en el período septiembre 2017- febrero 2018. Los datos del índice de masa corporal y el trastorno por déficit de atención se procesaron en Microsoft Excel, el software Minitab® 18.1 para el cálculo de los coeficientes de correlación de Pearson y Spearman, y prueba de Grubbs para comprobar normalidad y análisis de valores atípicos. Resultados: La media del índice de masa corporal fue de 20,15 en niños y 20,63 en niñas, lo que se consideró normal. El trastorno por déficit de atención: 93,7 % de niñas y 90,4 % de niños, también fue normal. En estos últimos, existió una ligera predisposición por este trastorno. La correlación entre ambas variables fue ligeramente positiva: niñas 0,02 y niños 0,457. Conclusiones: El índice de masa corporal y el trastorno por déficit de atención con hiperactividad tienen parámetros normales en niñas y niños y existe entre ambos una correlación positiva débil. Es necesario establecer estrategias educativas para la disminución de la obesidad y malnutrición infantil.

14.

Medición de óxido nítrico nasal: recomendaciones y procedimiento
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Guzmán-Valderrábano, Carlos

; Madrid-Mejía, Wilmer

; Troncoso-Huitrón, Prysila

; Silva-Cerón, Mónica

; Cid-Juárez, Silvia

; Hernández-Morales, Víctor

; Torre-Bouscoulet, Luis

; Vega-Morales, Lissa De la

; Gochicoa-Rangel, Laura

Neumología y cirugía de tórax

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mar 2020, Volume 79 N. 1 Pages 53 - 58

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

Abstract: The measurement of nasal nitric oxide (nNO) has been a very useful tool for the diagnosis of primary ciliary dyskinesia (PCD). Compared with healthy subjects or affected by others respiratory diseases, PCD patients show low concentrations of nNO. nNO is a simple test that requires minimal cooperation from the subject. The aim of this document is to review technical aspects for calibration, preparation and measurement of nNO.

Resumen: La medición del óxido nítrico nasal es una herramienta de gran utilidad para el diagnóstico de discinesia ciliar primaria. En comparación con sujetos sanos o con otras enfermedades respiratorias, los pacientes con discinesia ciliar primaria presentan bajas concentraciones de óxido nítrico nasal. La medición de óxido nítrico nasal es sencilla y requiere cooperación mínima de quien la realiza. El propósito de este documento es describir el procedimiento de medición de óxido nítrico nasal, así como revisar aspectos técnicos para la calibración y preparación del equipo.

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15.

Métodos de diagnóstico en el estudio de las Miopatías Inflamatorias Autoinmunes: Datos del Registro Argentino de Miopatías Inflamatorias de la Sociedad Argentina de Reumatología
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Gómez, Graciela

; Gargiulo, María de los Ángeles

; Granel, Amelia

; Marcos, Ana

; Gómez, Ramiro Adrián

; Braillard Poccard, Andrea

; Costi, Carolina

; García, Mercedes

; Lojo, María Nieves

; Wernicke, Verónica

; Barrios, Belén

; Papasidero, Silvia

; Benítez, Alejandro

; Viola, Malena

; de La Vega, María Celina

; Aciar, Mariana

; Crespo Espíndola, Maria Elena

; Capelusnik, Dafne

; Schneerberger, Emilce

; Cosatti, Micaela

; Pisoni, Cecilia

; Ponce Delgado, Yessica

; Rillo, Oscar

; Pineda, Susana

; Duartes Noé, Damián

; Rivero, Mariano

; Girard Bosch, Paula

; García Salinas, Rodrigo

; Kisluk, Boris

; Berbotto, Guillermo

; Movia, Roberto

; Visentini, Susana

; Herrera, Gladys

; Lázaro, María Alicia

Revista argentina de reumatología

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mar 2020, Volume 31 N. 1 Pages 3 - 7

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

The Idiopathic Inflammatory Myopathies (IIM) comprise a heterogeneous group of acquired muscle diseases classified as polymyositis (PM), dermatomyositis (DM), Inclusion Body Myositis (IBM), Immuno Mediated Necrotizing Myopathies (IMNM), Overlap Myositis (OM), juvenile myositis, Antisynthethase Syndrome (ASS) and cancer related myositis (CAM). The presence of myositis specific antibodies in the serum and autoantibodies against target antigens and inflammatory infiltrates in muscle tissue suggests the autoimmune condition of the disease. The diagnosis of inflammatory myopathies is often a challenge and the disposal of diagnostic tools are not always available in daily practice. Information on the accessibility of these methods was obtained from the Argentine Register of Myopathies. The study of muscle enzymes, ANA, anti-Jo-1 antibodies and chest tomography were easy to get to most patients while muscle MRI, lung diffusion capacity for carbon monoxide (DLco) and muscle biopsy were performed in less than 50% of cases. Other myositis specific antibodies, necessary for disease diagnosis and prognosis, were mostly done through a subsidy from the Argentine Rheumatology Society.

Las Miopatías Inflamatorias Autoinmunes (MI) comprenden un grupo de enfermedades heterogéneas con presentación y características clínicas variables. Se distinguen subtipos clínicos como Polimiositis (PM), Dermatomiositis (DM), Miositis por cuerpos de Inclusión (MCI), Miopatía Necrotizante Inmunomediada (MNIM), Miositis de los Síndromes de Superposición, formas juveniles de MI (DMJ), Síndrome Antisintetasa (SAS) y Miopatía Asociada a Cáncer (MAC). La presencia de anticuerpos séricos y el infiltrado inflamatorio en la biopsia de músculo sugiere que se trata de una condición autoinmune. Realizar el diagnóstico de las MI suele ser un desafío y las herramientas diagnósticas no siempre están disponibles en la práctica diaria. Se obtuvo información sobre la disponibilidad de estos métodos del Registro Argentino de Miopatías Inflamatorias. El estudio de enzimas musculares, Anticuerpos Antinucleares (ANA), anticuerpo anti-Jo-1 y la tomografía computada de tórax, estuvieron disponibles para la mayoría de los pacientes mientras que la Resonancia Magnética de musculo (RM), el estudio de difusión de monóxido de carbono (DLco) y la biopsia muscular se realizaron en menos del 50% de los casos. La determinación de otros anticuerpos específicos de miositis, de importancia en el diagnóstico y pronóstico de la enfermedad se realizó, en mayor parte, a través de un subsidio de la SAR.

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