Resumen Objetivo: Describir la atención aguda de pacientes con infartos bilaterales del tálamo en centros de atención primaria y avanzada de ataque cerebrovascular en diferentes regiones de Colombia. Métodos: Estudio descriptivo retrospectivo multicéntrico de serie de casos de pacientes con diagnóstico por imágenes de infarto talámico bilateral, en Colombia. Participaron 14 hospitales ubicados en siete ciudades del país. Resultados: Se registraron 28 casos, la edad promedio fue de 66.8 años con un 53.6% genero masculino; el 96.3% tenía un mRs previo favorable (0-2). La escala NIHSS al ingreso promedio de 14 puntos; la presentación clínica más frecuente fue el estado mental alterado en un 82.1%. La estructura más comprometida fue la región anterior bilateral del tálamo en 12 pacientes (42.85%). La etiología más común fue de causa indeterminada (39.3%). Un paciente recibió terapia de reperfusión con trombólisis intravenosa (3.6%). Estancia hospitalaria promedio de 19 días. Conclusiones: Los infartos talámicos bilaterales representan un desafío diagnóstico en el departamento de emergencias, debido a su baja incidencia reportada y la variabilidad en las presentaciones clínicas. Se debe fortalecer la capacidad de los centros de atención de ataques cerebrovasculares e investigación, para contribuir a los resultados clínicos.

Abstract Objective: To describe the acute care of patients with bilateral thalamic infarctions in primary and advanced stroke centers in different regions of Colombia. Methods: Multicenter retrospective descriptive study of a series of cases of patients with an imaging diagnosis of bilateral thalamic infarction, in Colombia. 14 hospitals located in seven cities of the country participated. Results: 28 cases were registered, the mean age was 66.8 years with 53.6% men and 96.3% had a favorable previous mRs (0-2). Mean NIHSS at admission was 14 points, the most frequent clinical presentation was altered mental status in 82.1%. The most compromised structure was the bilateral anterior region of the thalamus in 12 patients (42.85%). The most common etiology was undetermined cause (39.3%). 1 patient underwent reperfusion therapy with intravenous thrombolysis (3.6%). Mean hospital stay was 19 days. Conclusions: Bilateral thalamic infarcts are a diagnostic challenge in the emergency department, due to their low reported incidence and the variable clinical presentations, stroke and research centers should be strengthened to contribute to clinical outcomes.

SUMMARY OBJECTIVE: The objective of this study was to assess the clinical and uterine cervix characteristics of patients displaying vaginal discharge with positive results for Mycoplasma sp. and/or Ureaplasma spp. METHODS: An analytical cross-sectional study involving women aged 18–45 years was conducted. Microbiological assessments included Ureaplasma and Mycoplasma cultures, as well as human papillomavirus hybrid capture using ecto and endocervix swabs. All tests were two-tailed, and significance was set at p<0.05. RESULTS: Among 324 women, Ureaplasma prevalence was 17.9%, and Mycoplasma prevalence was 3.1%. The Ureaplasma-positive group exhibited a higher frequency of urinary tract infections (39.1 vs. 19%, p=0.002) and human papillomavirus (39.7 vs. 12.8%, p≤0.001) compared with controls. The Mycoplasma-positive group showed a higher frequency of non-contraceptive use compared with controls (66.2 vs. 30.0%, p=0.036). Abnormal colposcopic findings were more prevalent in the Mycoplasma/Ureaplasma-positive group than in controls (positive: 65% vs. control: 35%, p=0.001). Pap smear findings did not differ between the groups. CONCLUSION: Ureaplasma spp. was associated with urinary tract infections and human papillomavirus, while the presence of Mycoplasma sp. was linked to reduced contraceptive use. When analyzing both pathogens together, a higher frequency of abnormal colposcopic findings was observed, with no difference in cytological findings in the positive group. OBJECTIVE sp andor or spp METHODS crosssectional cross sectional 1845 18 45 18–4 conducted cultures swabs twotailed, twotailed two tailed, tailed two-tailed p005 p 0 05 p<0.05 RESULTS 32 179 17 9 17.9% 31 3 1 3.1% Ureaplasmapositive 39.1 391 39 (39. vs 19 19% p=0.002 p0002 002 39.7 397 7 128 12 8 12.8% p≤0.001 p0001 001 Mycoplasmapositive noncontraceptive non 66.2 662 66 2 (66. 300 30 30.0% p=0.036. p0036 p=0.036 . 036 p=0.036) Mycoplasma/Ureaplasmapositive MycoplasmaUreaplasmapositive Mycoplasma/Ureaplasma (positive 65 control 35 35% p=0.001. p=0.001 p=0.001) groups CONCLUSION together observed 184 4 18– p00 p<0.0 17.9 3.1 39. (39 p=0.00 p000 00 12.8 p≤0.00 66. 6 (66 30.0 p003 p=0.03 03 MycoplasmaUreaplasma p0 p<0. 17. 3. (3 p=0.0 12. p≤0.0 (6 30. p<0 ( p=0. p≤0. p< p=0 p≤0 p= p≤

Abstract Objective To assess the efficacy, safety, and acceptability of misoprostol in the treatment of incomplete miscarriage. Data sources The PubMed, Scopus, Embase, Web of Science, Cochrane Library, and Clinical Trials databases (clinicaltrials.gov) were searched for the relevant articles, and search strategies were developed using a combination of thematic Medical Subject Headings terms and text words. The last search was conducted on July 4, 2022. No language restrictions were applied. Selection of studies Randomized clinical trials with patients of gestational age up to 6/7 weeks with a diagnosis of incomplete abortion and who were managed with at least 1 of the 3 types of treatment studied were included. A total of 8,087 studies were screened. Data collection Data were synthesized using the statistical package Review Manager V.5.1 (The Cochrane Collaboration, Oxford, United Kingdom). For dichotomous outcomes, the odds ratio (OR) and 95% confidence interval (CI) were derived for each study. Heterogeneity between the trial results was evaluated using the standard test, I2 statistic. Data synthesis When comparing misoprostol with medical vacuum aspiration (MVA), the rate of complete abortion was higher in the MVA group (OR = 0.16; 95%CI = 0.07–0.36). Hemorrhage or heavy bleeding was more common in the misoprostol group (OR = 3.00; 95%CI = 1.96–4.59), but pain after treatment was more common in patients treated with MVA (OR = 0.65; 95%CI = 0.52–0.80). No statistically significant differences were observed in the general acceptability of the treatments. Conclusion Misoprostol has been determined as a safe option with good acceptance by patients. efficacy safety miscarriage PubMed Scopus Embase Science Library clinicaltrials.gov clinicaltrialsgov clinicaltrials gov (clinicaltrials.gov articles words 4 2022 applied 67 6 7 6/ included 8087 8 087 8,08 screened V51 V 5 V.5. Collaboration Oxford Kingdom. Kingdom . Kingdom) outcomes OR 95 CI (CI study test I statistic MVA, , (MVA) 0.16 016 0 16 95CI 0.07–0.36. 007036 0.07–0.36 07 36 0.07–0.36) 3.00 300 00 1.96–4.59, 196459 1.96–4.59 96 59 1.96–4.59) 0.65 065 65 0.52–0.80. 052080 0.52–0.80 52 80 0.52–0.80) treatments 202 808 08 8,0 V5 V.5 9 (MVA 0.1 01 00703 0.07–0.3 3.0 30 19645 1.96–4.5 0.6 06 05208 0.52–0.8 20 8, V. 0. 0070 0.07–0. 3. 1964 1.96–4. 0520 0.52–0. 2 007 0.07–0 196 1.96–4 052 0.52–0 0.07– 19 1.96– 05 0.52– 0.07 1.96 0.52 0.0 1.9 0.5 1.

Resumo Objetivo Avaliar a eficácia, segurança e aceitabilidade do misoprostol no tratamento do aborto incompleto. Fontes de dados Os bancos de dados PubMed, Scopus, Embase, Web of Science, Cochrane Library e bancos de dados de Ensaios Clínicos (clinicaltrials.gov) foram pesquisados para os artigos relevantes, e estratégias de busca foram desenvolvidas usando uma combinação de termos temáticos de Medical Subject Headings e palavras de texto. A última pesquisa foi realizada em 4 de julho de 2022. Nenhuma restrição de idioma foi aplicada. Seleção dos estudos Foram incluídos ensaios clínicos randomizados com pacientes com idade gestacional até 6/7 semanas com diagnóstico de aborto incompleto e que foram manejadas com pelo menos um dos três tipos de tratamento estudados. Um total de 8.087 estudos foram selecionados. Coleta de dados Os dados foram sintetizados usando o pacote estatístico Review Manager V.5.1 (The Cochrane Collaboration, Oxford, United Kingdom). Para resultados dicotômicos, o odds ratio (OR, na sigla em inglês) e o intervalo de confiança (IC) de 95% foram derivados para cada estudo. A heterogeneidade entre os resultados do ensaio foi avaliada usando o teste padrão, estatística I2. Síntese dos dados Ao comparar misoprostol com aspiração a vácuo médico (MVA, na sigla em inglês), a taxa de aborto completo foi maior no grupo MVA (OR = 0,16; IC95% = 0,07–0,36). Hemorragia ou sangramento intenso foi mais comum no grupo do misoprostol (OR = 3,00; 95%CI = 1,96–4,59), mas a dor após o tratamento foi mais comum em pacientes tratados com MVA (OR = 0,65; 95%CI = 0,52–0,80). Não foram observadas diferenças estatisticamente significativas na aceitabilidade geral dos tratamentos. Conclusão O misoprostol tem se mostrado uma opção segura e com boa aceitação pelos pacientes. eficácia PubMed Scopus Embase Science clinicaltrials.gov clinicaltrialsgov clinicaltrials gov (clinicaltrials.gov relevantes texto 2022 aplicada 67 6 7 6/ estudados 8087 8 087 8.08 selecionados V51 V 5 1 V.5. The Collaboration Oxford Kingdom. Kingdom . Kingdom) dicotômicos OR, OR inglês IC (IC 95 estudo padrão I2 I MVA, (MVA inglês, , 0,16 016 0 16 IC95 0,07–0,36. 007036 0,07–0,36 07 36 0,07–0,36) 3,00 300 3 00 95CI CI 1,96–4,59, 196459 1,96–4,59 96 59 1,96–4,59) 0,65 065 65 0,52–0,80. 052080 0,52–0,80 52 80 0,52–0,80) tratamentos 202 808 08 8.0 V5 V.5 9 0,1 01 IC9 00703 0,07–0,3 3,0 30 19645 1,96–4,5 0,6 06 05208 0,52–0,8 20 8. V. 0, 0070 0,07–0, 3, 1964 1,96–4, 0520 0,52–0, 2 007 0,07–0 196 1,96–4 052 0,52–0 0,07– 19 1,96– 05 0,52– 0,07 1,96 0,52 0,0 1,9 0,5 1,

Introduction: Various studies have linked lifestyle and metabolic diseases to hearing loss. Research on metabolic syndrome has reported a higher prevalence of hearing loss in individuals with it than those without it. Objectives: To conduct a systematic review and meta-analysis summarizing the risk of hearing loss in people diagnosed with metabolic syndrome or diseases versus those without metabolic syndrome. Methods. Following the PRISMA recommendations for systematic review and meta-analysis, searches were conducted in PubMed, Web of Science, and SciELO. Only cross-sectional studies associate hearing loss with obesity, hypertension, Diabetes, Dyslipidemia, Cholesterol, metabolic syndrome, and Hyperglycemia. The odds ratios (OR) with their 95% confidence intervals (CI) of the studies were pooled in a random effects model using the Mantel-Haenszel method. Using Rev Manager 5.1, OR heterogeneity was assessed using the I2 and Q statistics. Results. Twenty-eight observational studies were included in the quantitative analysis. The OR for prevalent hearing loss was 1.27 (95% CI 1.07, 1.51) in obesity, 1.97 (95% CI 1.51, 2.57) in diabetes, 1.53 (95% CI 1.31, 1.79) in hypertension, and 4.22 (95% CI 1.74, 10.20) for metabolic syndrome. Conclusions. The findings suggest that both metabolic syndrome and some diseases, such as obesity, diabetes, and hypertension, could be associated with the risk of hearing loss, and control of these diseases could reduce this risk.

RESUMEN Objetivo: Realizar una revisión sistemática y metaanálisis que resuma el riesgo de hipoacusia de personas con diagnóstico de síndrome o enfermedades metabólicas versus aquellas sin síndrome metabólico. Material y Métodos: Siguiendo las recomendaciones PRISMA para revisión sistemática y metaanálisis, se realizaron búsquedas en 3 indexadores (PubMed, Web of Science y SciELO). Se incluyeron sólo estudios transversales que reportan asociaciones de hipoacusia con obesidad, Hipertensión; Diabetes, Dislipidemia, Colesterol, síndrome metabólico e Hiperglicemia. Las odds ratios (OR) con sus intervalos de confianza (IC) del 95% de los estudios se agruparon en un modelo de efectos aleatorios por el método de Mantel Haenszel. Con Rev Manager 5.1, se evaluó la heterogeneidad OR mediante las estadísticas I2 y Q. Resultados: 28 estudios observacionales fueron incluidos en el análisis cuantitativo. Las OR para hipoacusia prevalente fue de 1.27 (95% IC 1.07, 1.51) en obesidad, 1.97 (95% IC 1.51, 2.57) en diabetes, 1.53 (95% IC 1.31, 1.79) en hipertensión y 4.22 (95% IC 1.74, 10.20) para síndrome metabólico. Conclusiones: Los hallazgos sugieren que tanto el síndrome metabólico como algunas enfermedades como obesidad, diabetes e hipertensión podrían asociarse con el riesgo de hipoacusia, pudiendo el control de estas enfermedades atenuar este riesgo.

Resumen En el actual escenario sociosanitario enfrentado a raíz de la pandemia por SARS-CoV-2, múltiples actividades se han visto mermadas, e incluso, suspendidas por los largos periodos de aislamiento social y las medidas de cuidado para evitar contagios. En este sentido, muchas personas han dejado de recibir con la misma regularidad, o bajo las mismas circunstancias, sus tratamientos, incluyendo a niños con Trastornos del Neurodesarrollo (TND). Es así como surgen las intervenciones Parentales. Estas son programas donde los padres o cuidadores primarios son entrenados para llevar a cabo acciones terapéuticas con el niño y cuyo objetivo puede estar orientado a promover múltiples habilidades. El objetivo de la presente revisión sistemática fue determinar el efecto de estas intervenciones para promover el lenguaje y la comunicación en niños con diagnóstico de TND de entre 2 y 5 años. Se realizó una búsqueda sistemática en las bases de datos ERIC, MEDLINE y PubMed, considerando publicaciones de entre enero del 2010 y marzo de 2022. De las 9885 referencias iniciales, y posterior a las etapas de tamizaje y elegibilidad, 5 fuentes primarias cumplieron con los criterios de selección. Los resultados indican que las intervenciones parentales para habilidades de comunicación serían efectivas e incluso se mantendrían los efectos en medidas de seguimiento. En cuanto a las habilidades de lenguaje, los resultados a través de los estudios son contradictorios. Por otra parte, ninguno de los estudios reporta efectos adversos para los niños. En cuanto a efectos beneficios o adversos para padres o cuidadores primarios, ninguno de los estudios incluidos reporta medidas asociadas.

Abstract In the current socio-sanitary scenario that we are facing as a result of the SARS-CoV-2 Pandemic, there have been many activities that have been reduced and even suspended due to long periods of social isolation and care measures to avoid contagion. In this sense, many people have stopped receiving their treatments with the same regularity or under the same circumstances, including children with Neurodevelopmental Disorders. This is how parental interventions correspond to programs where parents or primary caregivers are trained to carry out therapeutic actions with the child and whose objective may be aimed at promoting multiple skills. The objective of this systematic review was to determine the effect of these interventions to promote language and communication in children diagnosed with Neurodevelopmental Disorders between 2 and 5 years of age. A systematic search was carried out in the ERIC, MEDLINE and PubMed databases including publications between January 2010 and March 2022. Of the 9885 initial references, and after the screening and eligibility stages, 5 primary sources met the selection criteria. The results indicate that parental interventions for communication skills would be effective, and the effects would even be maintained in follow-up measures. Regarding language skills, the results across studies are contradictory. On the other hand, none of the studies reported adverse effects for children. Regarding beneficial or adverse effects for parents or primary caregivers, none of the included studies reported associated measures.

Resumen: En Chile la malnutrición por exceso continúa en aumento, afectando especialmente a la población infantil. Solucionar esta problemática de salud pública requiere desarrollar estrategias de promoción y prevención que consideren las propuestas de las comunidades, especialmente la de los propios niños y niñas. Objetivo: Conocer las opiniones y sugerencias de niños y niñas de tercero y cuarto básico de escuelas de la zona sur de Santiago de Chile, respecto de sus prácticas alimentarias y de actividad física, en el marco del proyecto FONDEF IT 1810016. Sujetos y Método: Se desarrollaron siete parlamentos escolares en siete escuelas mediante una metodología cualitativa participativa, recogiendo las opiniones de 176 niños y niñas acerca de sus hábitos y preferencias tanto de alimentos como de actividad física. Resultados: Los alimentos más consumidos y preferidos son aquellos fáciles de preparar y de alta disponibilidad, como pan, tallarines y leche. Los alimentos que requieren preparación, como pescado, legumbres, frutas, verduras y preparaciones caseras, son menos consumidos y tienen menos preferencia. En las actividades físicas recreativas destacan los videojuegos y el fútbol. Los estudiantes proponen aumentar las horas de educación física, los recreos y mejorar la disponibilidad y acceso a alimentos saludables en los entornos escolares como estrategia de solución al problema de la malnutrición por exceso. Conclusiones: Los Parlamentos Escolares como estrategia participativa aportan en la generación conjunta de conocimiento. La necesidad de incluir a las comunidades como partes interesadas en las iniciativas de salud, reconoce a través de su participación, a los niños y las niñas como actores sujetos de derechos.

Abstract: In Chile, overnutrition continues to increase, especially affecting children. Solving this public health problem requires the development of promotion and prevention strategies that consider the suggestions of the communities, especially those of the children themselves. Objective: To know the opinions and suggestions of third and fourth-grade children from schools in the southern area of Santiago, Chile, regarding their eating practices and physical activity, as part of the FONDEF IT 1810016 project. Subjects and Method: Seven School Meetings were held in seven schools using a participatory qualitative methodology, collecting the opinions of 176 children regarding both their food and physical activity habits and preferences. Results: The most consumed and preferred foods are those easy to prepare and highly available, such as bread, pasta, and milk. Foods that require preparation or are less available, such as fish, legumes, fruits, vegetables, and homemade preparations, are less consumed and have less preference. Regarding physical activities, video games and soccer stand out. Students propose increasing the hours of physical education and recesses and improving the availability and access to healthy foods in school environments as a solution strategy. Conclusions: School Meetings as a participatory strategy contribute to the joint generation of knowledge. The need to include communities as participants in health initiatives recognizes, through their role, children as subjects of rights.

Resumen: En Chile la malnutrición por exceso continúa en aumento, afectando especialmente a la población infantil. Solucionar esta problemática de salud pública requiere desarrollar estrategias de promoción y prevención que consideren las propuestas de las comunidades, especialmente la de los propios niños y niñas. Objetivo: Conocer las opiniones y sugerencias de niños y niñas de tercero y cuarto básico de escuelas de la zona sur de Santiago de Chile, respecto de sus prácticas alimentarias y de actividad física, en el marco del proyecto FONDEF IT 1810016. Sujetos y Método: Se desarrollaron siete parlamentos escolares en siete escuelas mediante una metodología cualitativa participativa, recogiendo las opiniones de 176 niños y niñas acerca de sus hábitos y preferencias tanto de alimentos como de actividad física. Resultados: Los alimentos más consumidos y preferidos son aquellos fáciles de preparar y de alta disponibilidad, como pan, tallarines y leche. Los alimentos que requieren preparación, como pescado, legumbres, frutas, verduras y preparaciones caseras, son menos consumidos y tienen menos preferencia. En las actividades físicas recreativas destacan los videojuegos y el fútbol. Los estudiantes proponen aumentar las horas de educación física, los recreos y mejorar la disponibilidad y acceso a alimentos saludables en los entornos escolares como estrategia de solución al problema de la malnutrición por exceso. Conclusiones: Los Parlamentos Escolares como estrategia participativa aportan en la generación conjunta de conocimiento. La necesidad de incluir a las comunidades como partes interesadas en las iniciativas de salud, reconoce a través de su participación, a los niños y las niñas como actores sujetos de derechos.

Abstract: In Chile, overnutrition continues to increase, especially affecting children. Solving this public health problem requires the development of promotion and prevention strategies that consider the suggestions of the communities, especially those of the children themselves. Objective: To know the opinions and suggestions of third and fourth-grade children from schools in the southern area of Santiago, Chile, regarding their eating practices and physical activity, as part of the FONDEF IT 1810016 project. Subjects and Method: Seven School Meetings were held in seven schools using a participatory qualitative methodology, collecting the opinions of 176 children regarding both their food and physical activity habits and preferences. Results: The most consumed and preferred foods are those easy to prepare and highly available, such as bread, pasta, and milk. Foods that require preparation or are less available, such as fish, legumes, fruits, vegetables, and homemade preparations, are less consumed and have less preference. Regarding physical activities, video games and soccer stand out. Students propose increasing the hours of physical education and recesses and improving the availability and access to healthy foods in school environments as a solution strategy. Conclusions: School Meetings as a participatory strategy contribute to the joint generation of knowledge. The need to include communities as participants in health initiatives recognizes, through their role, children as subjects of rights.

SUMMARY OBJECTIVE: The aim of this study was to evaluate and compare Maternal Near Miss prevalence and outcomes before and during the coronavirus disease 2019 pandemic. METHODS: This retrospective study was carried out in a university maternity hospital of high complexity. The population was divided into two groups: G1, 1 year before the coronavirus disease 2019 pandemic period (August 2018–July 2019) and G2, 1 year during the pandemic period (August 2020–July 2021). All pregnant/postpartum women hospitalized up to 42 days after the end of pregnancy/childbirth were included, and pregnant women who were admitted with coronavirus disease 2019/flu symptoms were excluded. The association of variables with “Maternal Near Miss” was estimated using logistic regression. RESULTS: A total of 568 women from G1 and 349 women from G2 fulfilled the Maternal Near Miss criteria. The prevalence of Maternal Near Miss in pre-pandemic was 144.1/1,000 live births and during the pandemic was 78.5/1,000 live births. In the analysis adjusted for G1, the factors of days of hospitalization (PR: 1.02, CI: 1.0–1.0, p<0.05), pre-eclampsia (PR: 0.41, CI: 1.4–2.2, p<0.05), and sepsis/severe systemic infection (PR: 1.79, CI: 0.3–0.4, p<0.05) were crucial for women with the Maternal Near Miss condition to have a greater chance of being admitted to the intensive care unit. In G2, low education (PR: 0.45, CI: 0.2–0.9, p<0.05), eclampsia (PR: 5.28, CI: 3.6–7.6, p<0.05), and use of blood products (PR: 6.48, CI: 4.7–8.8, p<0.05) increased the risk of admission to the intensive care unit. CONCLUSION: During the pandemic, there was a lower prevalence of Maternal Near Miss in high-risk pregnancies, fewer hospitalizations, and more deaths compared to the non-pandemic period. OBJECTIVE 201 METHODS complexity groups G August 2018July July 2018 2020July 2020 2021. 2021 . 2021) pregnantpostpartum postpartum 4 pregnancychildbirth pregnancy childbirth included 2019flu flu excluded regression RESULTS 56 34 criteria prepandemic pre 14411000 144 000 144.1/1,00 7851000 78 5 78.5/1,00 PR (PR 102 02 1.02 CI 1010 0 1.0–1.0 p<0.05, p005 p p<0.05 , 05 preeclampsia 041 41 0.41 1422 2 1.4–2.2 sepsissevere sepsis severe 179 79 1.79 0304 3 0.3–0.4 unit 045 45 0.45 0209 9 0.2–0.9 528 28 5.28 3676 6 7 3.6–7.6 648 48 6.48 4788 8 4.7–8.8 CONCLUSION highrisk pregnancies hospitalizations nonpandemic non 20 202 1441100 14 00 144.1/1,0 785100 78.5/1,0 10 1.0 101 1.0–1. p00 p<0.0 04 0.4 142 1.4–2. 17 1.7 030 0.3–0. 020 0.2–0. 52 5.2 367 3.6–7. 64 6.4 478 4.7–8. 144110 144.1/1, 78510 78.5/1, 1. 1.0–1 p0 p<0. 0. 1.4–2 03 0.3–0 0.2–0 5. 36 3.6–7 6. 47 4.7–8 14411 144.1/1 7851 78.5/1 1.0– p<0 1.4– 0.3– 0.2– 3.6– 4.7– 1441 144.1/ 785 78.5/ p< 1.4 0.3 0.2 3.6 4.7 144.1 78.5 3. 4. 144. 78.

ABSTRACT Purpose To estimate the reliability of scripts designed for undergraduate Speech-Language Therapy students. Methods A descriptive cross-sectional study was carried out. Qualitative variables were summarized by frequency or proportion and quantitative through means (CI 95%). Reliability was estimated through Cronbach's α coefficient, and inter-rater agreement was determined using Fleiss’s Kappa index. The analytical tests considered a significance level of p<0.05. Results 80 scripts organized in four areas of speech-language therapy were validated by 41 speech-language pathologists. The average experience of the professionals was 17.1 years. The reliability of the corpus was α: 0.67 (min= 0.34; max: 0.84), and the inter-rater agreement κ: 0.29 (min: 0.07; max: 0.45). Conclusion The corpus's reliability scores were similar to those reported by previous studies in different health professions. Having validated strategies aimed at developing proficiency and supporting classic training actions in undergraduate courses will contribute to increasing the quality of future health professionals. SpeechLanguage Speech Language students crosssectional cross sectional out CI 95%. 95 95% . 95%) Cronbachs Cronbach s coefficient interrater inter rater Fleisss Fleiss index p005 p 0 05 p<0.05 8 speechlanguage speech language 4 pathologists 171 17 1 17. years 067 67 0.6 min= min (min 0.34 034 34 max 0.84, 084 0.84 , 84 0.84) κ 029 29 0.2 0.07 007 07 0.45. 045 0.45 45 0.45) corpuss professions 9 p00 p<0.0 06 6 0. 0.3 03 3 08 0.8 02 2 0.0 00 04 0.4 p0 p<0. p<0 p<

RESUMEN Objetivo Estimar la confiabilidad y reproducibilidad de un corpus de scripts diseñado para el pregrado de fonoaudiología. Método Estudio observacional de tipo descriptivo y temporalidad transversal. Se estimó la validez de constructo a partir del coeficiente α de Cronbach y la reproducibilidad con el índice Kappa de Fleiss. Las pruebas analíticas consideraron un nivel de significancia p<0.05. Resultados Se creó un corpus de 80 scripts organizados en 4 áreas de la fonoaudiología el que fue validado por 41 fonoaudiólogos. La experiencia promedio de los profesionales fue de 17.1 años (Std. Err: 2.4; IC 95%: 11.7-22.6). La confiabilidad del corpus fue α: 0.67 y el acuerdo interevaluador, κ: 0.29. Conclusión Los puntajes de confiabilidad y reproducibilidad del corpus creado fueron similares a los reportados por estudios previos en otras profesiones de la salud. Contar con estrategias validadas que se orienten al desarrollo de competencias y complementen las acciones formativas, contribuirá a incrementar la calidad en la formación de futuros profesionales de la salud. transversal Fleiss p005 p 0 05 p<0.05 8 fonoaudiólogos 171 17 1 17. Std. Std (Std Err 2.4 24 2 95% 95 11.722.6. 117226 11.7 22.6 . 11 7 22 6 11.7-22.6) 067 67 0.6 interevaluador κ 029 29 0.29 salud formativas p00 p<0.0 2. 9 722 11.722.6 11722 117 11. 226 22. 11.7-22.6 06 0. 02 0.2 p0 p<0. 72 11.722. 1172 11.7-22. p<0 11.722 11.7-22 p< 11.72 11.7-2 11.7-

Resumen La enfermedad de Newcastle es una de las afecciones víricas con un elevado grado de patogenia. El objetivo de este estudio fue determinar la prevalencia de la enfermedad de Newcastle en aves de traspatio de los cantones Latacunga y Salcedo, en Cotopaxi - Ecuador. Fueron muestreadas 180 aves de traspatio de diferente sexo y edades. Se efectuó una encuesta epidemiológica mediante un muestreo probabilístico, sobre categoría de las aves; rango de edad; finalidad de la crianza y enfermedades previas. Se empleó la prueba de ELISA-i para detectar casos positivos a la enfermedad. La prevalencia de la enfermedad de Newcastle fue del 13.89 % asociada a la no vacunación contra la enfermedad, siendo más afectadas las aves hembras y los animales adultos entre las semanas 12 - 24 o superior. Con casos donde las aves cursaban el pico de la enfermedad vírica o el virus en su parte de replicación y transmisión.

Abstract Newcastle disease is one of the viral conditions with a high degree of pathogenesis. The objective of this study was to determine the prevalence of Newcastle disease in backyard poultry of the cantons of Latacunga and Salcedo, in Cotopaxi - Ecuador. 180 backyard poultry of different sex and ages were sampled. An epidemiological survey was carried out through a probabilistic sampling, on the category of birds; age range; purpose of rearing and previous illnesses. The ELISA-i test was used to detect cases positive for the disease. The prevalence of Newcastle disease was 13.89% associated with non-vaccination against the disease, with female birds and adult animals between 12-24 weeks or higher being more affected. With cases where the birds were at the peak of the viral disease or the virus in its part of replication and transmission.

Abstract Colombia has experienced a non-international armed conflict which has lasted for more than 60 years. On September 4, 2012, during the presidential term of Juan Manuel Santos, peace negotiations began between the Colombian State and the Revolutionary Armed Forces of Colombia -People's Army (FARC-EP) - with the aim of ending the armed conflict between both actors. The agreements culminated on September 26, 2016. Regarding the foregoing, questions arose on the criminal liability of the State agent. The question on their liability has resounded in the competent international bodies, such as the International Criminal Court and the Inter-American Court of Human Rights. The recently created Special Jurisdiction for Peace (JEP) is now to decide the possible activation of the principle of complementarity to avoid delays in processes involving high-ranking State officials and properly comply with the provisions of Article 120, Statute of Rome.

Resumen Colombia ha vivido un conflicto armado de carácter no internacional que ha durado más de 60 años. El 4 de septiembre de 2012, durante el periodo presidencial de Juan Manuel Santos, se iniciaron las negociaciones de paz entre el Estado colombiano y las Fuerzas Armadas Revolucionarias de Colombia -Ejército del Pueblo (FARC-EP)-, con el objetivo de terminar el conflicto armado entre ambos actores. Los acuerdos culminaron el 26 de septiembre de 2016. Con ello surgieron cuestionamientos en los que se reclama la responsabilidad de los agentes del Estado. La cuestión en torno a dicha responsabilidad ha retumbado en las instancias internacionales competentes, como la Corte Penal Internacional y la Corte Interamericana de Derechos Humanos. La recientemente creada Jurisdicción Especial para la Paz (JEP) es ahora la encargada de dirimir la posible activación del principio de complementariedad para evitar dilaciones en los procesos que involucren altos mandos del Estado y, así, cumplir lo dispuesto en el artículo 120 del Estatuto de Roma.

Resumo Objetivo O objetivo do presente estudo foi comparar prospectivamente os retalhos sural e propeller para cobertura de partes moles da extremidade inferior. Foram avaliadas as seguintes variáveis: incidência de perda total ou parcial do retalho e morbidade da área doadora (fechamento primário versus enxerto de pele). Métodos Análise prospectiva e randomizada de dados coletados de todos os pacientes apresentando defeitos em tecidos moles da extremidade distal da perna e do retropé submetidos aos retalhos em questão. Resultados Foram avaliados 24 pacientes com idades entre 4 e 60 anos, entre 2011 e 2017. Cobertura completa foi obtida em 22 dos 24 pacientes (91,6%) e observamos falha em 2 retalhos (8,4%). O retalho sural, sendo a opção mais popular, continua a representar uma alternativa segura e versátil para defeitos cutâneos do terço distal da perna e da região do calcanhar. O retalho propeller, da mesma maneira, mostrou-se uma opção comparável para o tratamento destas lesões desafiadoras. Conclusão Os retalhos sural e propeller são boas opções para a cobertura de partes moles da extremidade inferior, demostrando baixas taxas de complicações como perda parcial ou total do retalho.

Abstract Objective The objective of the present study was to prospectively compare the sural and propeller flaps for soft-tissues coverage of the lower extremity. The following variables were evaluated: incidence of complete or partial flap loss and donor area morbidity (primary closure versus skin graft). Methods Prospective and randomized analysis of data collected from all patients presenting with soft tissue defects of the lower third of the leg and heel treated with reverse sural or propeller flaps. Results Twenty-four patients aged between 4 and 60 years old were evaluated between 2011 and 2017. Complete coverage was obtained in 22 of the 24 patients (91.6%). Two flaps failed (8.4%). The sural flap, being the most popular option, continues to represent a safe and versatile alternative for skin defects of the lower third of the leg and heel region. Likewise, the propeller flap was a comparable option to treat these challenging defects. Conclusion Sural and propeller flaps are good options for soft tissues coverage of the lower extremity, with low complication rates (partial or total flap loss).

RESUMO JUSTIFICATIVA E OBJETIVOS A mamografia é um exame de imagens das mamas, obtidas por meio de radiografia com realização da compressão do tecido mamário. A dor é um fator constantemente relatado pelas pacientes submetidas ao procedimento e, por esse motivo, evidencia-se a necessidade de estabelecer estratégias alternativas não farmacológicas que reduzam a sensação dolorosa. O objetivo deste estudo foi realizar uma revisão integrativa sobre os métodos não farmacológicos utilizados para o alívio da dor durante o exame mamográfico. CONTEÚDO A busca foi realizada no mês de abril de 2021 em quatro bases de dados (Pubmed, Medline, Scopus e CINAHL) utilizando os descritores “dor”, “manejo da dor”, “mamografia”, “musicoterapia” e “terapias complementares”. Após a leitura e análise final, quatro artigos atenderam aos critérios preestabelecidos, abordando o manejo não farmacológico da dor durante a mamografia. Os estudos evidenciaram diferentes métodos para redução da dor, como a utilização de almofada e a alteração no protocolo de compressão, bem como a intervenção com música. CONCLUSÃO Evidências sobre o manejo não farmacológico da dor relacionada à mamografia ainda são escassas. Entre as estratégias encontradas, o protocolo personalizado de compressão e o uso de almofadas compressíveis apresentaram eficácia analgésica, enquanto o uso da música não resultou em redução significativa da dor procedimental. No entanto, por se tratar de uma revisão integrativa, destaca-se a necessidade da realização de sínteses de evidências com maior rigor metodológico para estimar o tamanho do efeito analgésico dessas intervenções.

ABSTRACT BACKGROUND AND OBJECTIVES Mammography is an examination of images of the breasts, obtained through radiography with compression of the breast tissue. Pain is a factor constantly reported by patients undergoing the procedure and, for this reason, there is a need to establish alternative non-pharmacological strategies that reduce the sensation of pain. The aim of this study was to carry out an integrative review on non-pharmacological methods used for pain relief during mammography examination. CONTENTS The search was carried out in April 2021 in four databases (Pubmed, Medline, Scopus and CINAHL) using the descriptors “pain”, “pain management”, “mammography”, “music therapy” and “complementary therapies “. After reading and final analysis, four articles met the pre-established criteria, addressing the non-pharmacological management of pain during mammography. The studies showed different methods to reduce pain, such as the use of pads and changes in the compression protocol, as well as the intervention with music. CONCLUSION Evidence on the non-pharmacological management of mammography-related pain is still scarce. Among the strategies found, the customized compression protocol and the use of compressible pads showed analgesic efficacy, while the use of music did not result in a significant reduction in procedural pain. However, as this is an integrative review, there is a need to carry out evidence syntheses with greater methodological rigor to estimate the size of the analgesic effect of these interventions.

Abstract: Objective: To determine the exposure to aflatoxin B1 (AFB1) in southern Mexico and the presence of the aflatoxin signature mutation in hepatocellular carcinoma (HCC) tissue from patients from a cancer referral center. Materials and methods: We estimated the prevalence and distribution of AFB1 in a representative sample of 100 women and men from Chiapas using the National Health and Nutrition Survey 2018-19. We also examined the presence of the aflatoxin signature mutation in codon 249 (R249S), and other relevant mutations of the TP53 gene in HCC tissue blocks from 24 women and 26 men treated in a national cancer referral center. Results: The prevalence of AFB1 in serum samples was 85.5% (95%CI 72.1-93.1) and the median AFB1 was 0.117 pg/µL (IQR, 0.050-0.350). We detected TP53 R249S in three of the 50 HCCs (6.0%) and observed four other G>T transversions potentially induced by AFB1. Conclusion: Our analysis provides evidence that AFB1 may have a relevant role on HCC etiology in Mexico.

Resumen: Objetivo: Determinar la exposición a aflatoxina_B1 (AFB1) en el sur de México y la presencia de la mutación característica de AFB1 en tejido de carcinoma hepatocelular (CHC) de pacientes de un centro oncológico. Material y métodos: Se estimó la prevalencia y distribución de AFB1 en una muestra representativa de 100 mujeres y hombres de Chiapas a partir de la Encuesta Nacional de Salud y Nutrición 2018-19. También se observó la presencia de la mutación característica de AFB1 en el codón 249 (R249S), y otras mutaciones relevantes del gen TP53 en bloques de tejido de CHC de 24 mujeres y 26 hombres estudiados en un centro de referencia nacional de oncología. Resultados: La prevalencia de AFB1 en las muestras de suero fue de 85.5% (IC95% 72.1-93.1) y la mediana de la concentración 0.117 pg/µL (IQR, 0.050-0.350). Se detectó TP53 R249S en tres de 50 casos de CHC (6.0%) y se observaron cuatro transversiones G>T potencialmente inducidas por AFB1. Conclusión: El presente análisis proporciona evidencia de que la AFB1 puede tener un papel relevante en la etiología del CHC en México.

RESUMEN Objetivo: Conocer el tiempo de diferimiento y recaída posterior a quimioterapia de inducción en niños con leucemia linfoblástica aguda (LLA) en un hospital nacional de Lambayeque. El estudio: Estudio observacional analítico, cohorte retrospectiva. Se revisaron las historias clínicas de pacientes de 2 y 15 años de edad con diagnóstico de LLA que alcanzaron remisión completa al término de la inducción, atendidos en un hospital nacional de Lambayeque. Hallazgos: Los pacientes presentaron una mediana de edad de 5 años. Aunque la mayoría respondió al término de la inducción IA, 43/75 niños con LLA recayeron. Los niños con recaída tuvieron un diferimiento de 6 días [RIC: 0-25] entre fin de la inducción y el inicio de la fase de consolidación. Conclusión: El diferimiento ≥ 7 días en los esquemas de quimioterapia afecta a la sostenibilidad de la remisión.

ABSTRACT Objective: To know the deferral and relapse time after induction chemotherapy in children with acute lymphoblastic leukemia (ALL) in a national hospital in Lambayeque The study: Analytical observational study of a retrospective cohort. The medical records of patients aged 2 and 15 years, with diagnosis of ALL, who achieved complete remission at the end of induction, treated in a national hospital in Lambayeque were reviewed. Findings: The patients studied had a median age of 5 years. Although the majority responded at the end of IA induction, still 43/75 children with ALL relapsed. Children with relapse had a deferral time of 6 days [IQR: 0-25] between the end of induction and the beginning of the consolidation phase. Conclusion: Deferral time ≥7 days in chemotherapy regimens affects the sustainability of remission.