Objective: to map the instruments for risk assessment of pressure ulcers in adults in critical situation in intensive care units; identify performance indicators of the instrument, and the appreciation of users regarding the instruments’ use/limitations. Method: a scoping review. We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews in the writing of the study. We carried out the searches in the EBSCOhost search tool for 8 databases, resulting in 1846 studies, of which 22 studies compose the sample. Results: we identified two big instrument groups: generalist [Braden, Braden (ALB), Emina, Norton-MI, RAPS, and Waterlow]; and specific (CALCULATE, Cubbin & Jackson, EVARUCI, RAPS-ICU, Song & Choi, Suriaidi and Sanada, and COMHON index). Regarding the predictive value, EVARUCI and CALCULATE presented better results for performance indicators. Concerning appreciation/limitations indicated by users, we highlight the CALCULATE scale, followed by EVARUCI and RAPS-ICU, although they still need future adjustments. Conclusion: the mapping of the literature showed that the evidence is sufficient to indicate one or more instruments for the risk assessment of pressure ulcers for adults in critical situation in intensive care units.

Objetivo: mapear los instrumentos para la evaluación del riesgo de lesiones por presión en adultos en situación crítica en una unidad de terapia intensiva; identificar los indicadores de desempeño de los instrumentos y la apreciación de los usuarios con respecto al uso/limitaciones de los instrumentos. Método: scoping review. Para redactar el estudio se utilizó la extensión Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. La investigación se realizó mediante la herramienta de búsqueda EBSCOhost en 8 bases de datos, resultando 1846 estudios, de los cuales 22 conforman la muestra. Resultados: se identificaron dos grandes grupos de instrumentos: los generalistas [Braden, Braden (ALB), Emina, Norton-MI, RAPS y Waterlow]; y los específicos (CALCULATE, Cubbin & Jackson, EVARUCI, RAPS-ICU, Song & Choi, Suriaidi y Sanada y el índice COMHON). En cuanto al valor predictivo, EVARUCI y CALCULATE mostraron los mejores resultados de indicadores de desempeño. En cuanto a las apreciaciones/limitaciones señaladas por los usuarios, destaca la escala CALCULATE, seguida de la EVARUCI y la RAPS-ICU, aunque aún necesitan ajustes futuros. Conclusión: el mapeo mostró que las evidencias son suficientes para indicar uno o más instrumentos para la evaluación del riesgo de lesiones por presión en adultos críticos en una unidad de cuidados intensivos.

Objetivo: mapear os instrumentos para avaliação do risco de lesões por pressão nos adultos em situação crítica em unidade de cuidados intensivos; identificar os indicadores de desempenho dos instrumentos e a apreciação dos utilizadores quanto ao uso/às limitações dos instrumentos. Método: scoping review. O Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews foi utilizado para a redação do estudo. A pesquisa foi realizada na ferramenta de busca EBSCOhost em oito bases de dados, resultando em 1846 estudos, dos quais 22 compõem a amostra. Resultados: identificaram-se dois grandes grupos de instrumentos: os genéricos [Braden, Braden (ALB), Emina, Norton-MI, RAPS e Waterlow]; e os específicos (CALCULATE, Cubbin & Jackson, EVARUCI, RAPS-ICU, Song & Choi, Suriaidi e Sanada e o índice de COMHON). Quanto ao valor preditivo, a EVARUCI e a CALCULATE apresentaram os melhores resultados de indicadores de desempenho. Em relação à apreciação/às limitações apontadas pelos utilizadores, destacam-se a escala CALCULATE, seguindo-se da EVARUCI e da RAPS-ICU, embora ainda necessitem de ajustes futuros. Conclusão: o mapeamento mostrou que as evidências são suficientes para indicar um ou mais instrumentos para avaliação do risco de lesões por pressão nos adultos em situação crítica em unidade de cuidados intensivos.

Abstract Aiming to translate, culturally adapt, and psychometrically evaluate the Person-centred Practice Inventory - Staff (PCPI-S) for Portuguese healthcare professionals, this methodological study was conducted sequentially in two phases. Phase I followed the 10-steps recommendations from the ISPOR taskforce for translation and cultural adaptation of patient reported outcome measures. Phase II comprised a quantitative cross-sectional virtual survey of the translated PCPI-S with healthcare professionals, who were reached through snowball sampling from both primary and specialized care settings. The psychometric properties of the PCPI-S were determined by assessing reliability and construct validity. A sample of 304 healthcare professionals participated in Phase II. Ceiling effects were found. The overall internal consistency was excellent (> 0.9). The confirmatory factor analysis showed a good model fit after minor modifications, revealing construct validity, and supporting the theoretical framework. In conclusion, the three-factorial model of PCPI-S adjusted to the studied sample is a valid and reliable instrument to assess the perceptions of healthcare professionals on person-centred practice in various Portuguese clinical contexts. Considering the ceiling effects, the effect of social desirability should be explored.

Resumo Com o objetivo de traduzir, adaptar culturalmente e avaliar psicometricamente o Inventário para a Prática Centrada na Pessoa para profissionais de saúde (PCPI-S) em diversos contextos de prestação de cuidados, este estudo metodológico realizou-se em duas fases sequenciais. A Fase I seguiu as recomendações de dez etapas da taskforce da ISPOR para tradução e adaptação cultural de medidas de resultados auto reportados. A Fase II incluiu um estudo cross-sectional do PCPI-S traduzido com profissionais de saúde, que foram alcançados por meio de amostragem snowball em contextos de cuidados primários e diferenciados. A psicometria do PCPI-S foi analisada pela avaliação da confiabilidade e validade de construto. Uma amostra de 304 profissionais de saúde participou da Fase II. Efeitos de teto foram encontrados. A consistência interna geral foi excelente (> 0,9). A análise fatorial confirmatória mostrou um bom ajuste do modelo e validade de construto, refletindo o referencial teórico. Concluindo, o modelo tri-fatorial do PCPI-S ajustado à amostra estudada é um instrumento válido e fiável para avaliar as percepções dos profissionais de saúde sobre a prática centrada na pessoa em vários contextos de cuidados portugueses. Considerando os efeitos teto, a desejabilidade social deve ser explorada.

SUMMARY: We make a review of the first years of the Argentine Association of Anatomy, which was created in the year 2000 and which is currently still in force. Its origins, objectives, first presidents and congresses are described, as well as publications, in addition to its inter-societal relations, among them the Chilean Society of Anatomy stands out.

RESUMEN: Realizamos una reseña de los primeros años de la Asociación Argentina de Anatomía, que se creó en el año 2000 y que actualmente continúa vigente. Se describen sus orígenes, objetivos, primeros presidentes y congresos, así como publicaciones, además de sus relaciones inter-societarias, entre ellas se destaca la Sociedad Chilena de Anatomía.

Resumen Analizando los mitos desde una perspectiva sociológica, desentrañamos algunas peculiaridades que se hallan cimentadas de manera subterránea en la leyenda del Chiru Chiru, uno de los relatos que fortalece el culto a la Virgen del Socavón en Oruro. Realizado el estudio, consideramos que este mito corresponde a una alegoría del retorno de Europa y la posterior muerte del expresidente Belzu a manos de Mariano Melgarejo debido a la filosofía ultramontanista de la época en torno a los presidentes providenciales, en una dimensión sociopolítica según la cual la ciudad de Oruro era belcista en su momento. Entonces, el discurso consolidado refiere al hecho de que el “presidente héroe” del pueblo orureño fue eliminado por uno más del pueblo (el peón caminero reflejado en Melgarejo). De acuerdo al discurso de la leyenda, el Chiru Chiru- Belzu traicionó su pacto con la Virgen y con los que con los que representaba (el pueblo) al atacar a “uno más del pueblo” (quien en este caso, para el discurso de la leyenda, sería Melgarejo); sin embargo, la Virgen lo perdona y lo tran-sustancia para que sea el medio de comunicación entre el pueblo y la Virgen, de esa manera, el ladrón de la historia asume el rol -nuevamente- de ofrenda (capacocha) para fortalecer esta relación y su rol simbólico providencial.

Abstract Analyzing the myths from a sociological perspective, we unravel some peculiarities from within the legend of Chiru Chiru, one of the stories that strengthens the cult of the Virgin of the tunnel in Oruro. After the study, we consider that this corresponds to an allegory of the return of Europe and the subsequent death of former President Belzu at the hands of Mariano Melgarejo due to the ultramontanism philosophy of the time around providential presidents, in a sociopolitical dimension, in which the city of Oruro was a warmonger at the time , then the consolidated discourse refers to the fact that the “hero president” of the Oruro people was eliminated by one more of the people (the road laborer reflected in Melgarejo) according to the legend’s speech, Chiru Chiru-Belzu betrayed his pact with the virgin and obviously with those who represented (the town) when attacking “one more of the town” (which in this case for the speech of the legend would be Melgarejo) however, the Virgin forgives him and transubstantiates him to be the means of communication between the people and the Virgin, in this way, the thief in the story- assumes the role -again- of offering (capacocha) to strengthen this relationship and strengthen its providential symbolic role.

Abstract: Eucalyptus planted forests contribute to maximizing lumber production but problems such as longitudinal growth strain can negatively influence the quality of the products. Knowing dendrometric variables and wood properties can help in the prediction of longitudinal growth strain, mainly with the help of artificial intelligence. Thus, the aim of this research was to evaluate the use of artificial neural networks to predict longitudinal growth strain in Eucalyptus trees based on dendrometric variables, spacing between trees and wood density. The longitudinal growth strain was measured in trees of four Eucalyptus clones planted in three spacings. The diameter and height of each tree were measured. The basic wood density was determined. Artificial neural networks were used to estimate longitudinal growth strain as a function of dendrometric variables, tree spacing and wood density. The results showed that the artificial neural networks presented good results for training and validation, with most of them resulting in high correlation coefficient values. The trained artificial neural networks showed a correlation coefficient above 0,56. Artificial neural networks showed that the variables clone and basic wood density were the ones that most contributed to the prediction of longitudinal growth strain. On the other hand, the spacing between trees, the height of the tree and the diameter at breast height were not relevant to predict growth stresses.

Abstract Aiming to translate, culturally adapt, and psychometrically evaluate the Person-centred Practice Inventory - Staff (PCPI-S) for Portuguese healthcare professionals, this methodological study was conducted sequentially in two phases. Phase I followed the 10-steps recommendations from the ISPOR taskforce for translation and cultural adaptation of patient reported outcome measures. Phase II comprised a quantitative cross-sectional virtual survey of the translated PCPI-S with healthcare professionals, who were reached through snowball sampling from both primary and specialized care settings. The psychometric properties of the PCPI-S were determined by assessing reliability and construct validity. A sample of 304 healthcare professionals participated in Phase II. Ceiling effects were found. The overall internal consistency was excellent (> 0.9). The confirmatory factor analysis showed a good model fit after minor modifications, revealing construct validity, and supporting the theoretical framework. In conclusion, the three-factorial model of PCPI-S adjusted to the studied sample is a valid and reliable instrument to assess the perceptions of healthcare professionals on person-centred practice in various Portuguese clinical contexts. Considering the ceiling effects, the effect of social desirability should be explored.

Resumo Com o objetivo de traduzir, adaptar culturalmente e avaliar psicometricamente o Inventário para a Prática Centrada na Pessoa para profissionais de saúde (PCPI-S) em diversos contextos de prestação de cuidados, este estudo metodológico realizou-se em duas fases sequenciais. A Fase I seguiu as recomendações de dez etapas da taskforce da ISPOR para tradução e adaptação cultural de medidas de resultados auto reportados. A Fase II incluiu um estudo cross-sectional do PCPI-S traduzido com profissionais de saúde, que foram alcançados por meio de amostragem snowball em contextos de cuidados primários e diferenciados. A psicometria do PCPI-S foi analisada pela avaliação da confiabilidade e validade de construto. Uma amostra de 304 profissionais de saúde participou da Fase II. Efeitos de teto foram encontrados. A consistência interna geral foi excelente (> 0,9). A análise fatorial confirmatória mostrou um bom ajuste do modelo e validade de construto, refletindo o referencial teórico. Concluindo, o modelo tri-fatorial do PCPI-S ajustado à amostra estudada é um instrumento válido e fiável para avaliar as percepções dos profissionais de saúde sobre a prática centrada na pessoa em vários contextos de cuidados portugueses. Considerando os efeitos teto, a desejabilidade social deve ser explorada.

SUMMARY: We carry out a historical review of the Rioplatense Society-Association of Anatomy, which was a group of Argentine-Uruguayan anatomists. Its origins and objectives, organizational structure, congresses and publications are considered. Later, with the growth of anatomy in both countries, it was divided into the Argentine Association of Anatomy and the Uruguayan Society of Anatomy.

RESUMEN: Realizamos una reseña histórica de la Sociedad-Asociación Rioplatense de Anatomía, que fue una agrupación de anatomistas argentino-uruguaya. Se consideran sus orígenes y objetivos, estructura organizativa, congresos y publicaciones. Posteriormente con el crecimiento de la anatomía en ambos países se desdobló en la Asociación Argentina de Anatomía y la Sociedad Uruguaya de Anatomía.

Resumo Objetivo: Determinar se existem diferenças entre o acompanhamento por teleconsulta e o acompanhamento habitual nos doentes com patologias crónicas, nos cuidados de saúde primários e secundários, no que concerne à redução da morbilidade e mortalidade. Fontes dos dados: MEDLINE/PubMed, NHS Evidence, The Cochrane Library e Turning Research Into Practice. Métodos: Pesquisa de estudos observacionais, ensaios clínicos e revisões sistemáticas nas línguas portuguesa e inglesa, publicados entre janeiro de 2000 e agosto de 2020, utilizando os termos MeSH Chronic Disease, Telemedicine, Remote Consultation, Primary Health Care e General Practice. Para avaliação dos níveis de evidência e da força de recomendação foi aplicada a escala Strength of Recommendation Taxonomy (SORT), da American Family Physician. Resultados: Obtiveram-se 260 estudos, dos quais apenas oito cumpriram os critérios de inclusão. Cinco dos estudos revelaram benefício significativo na morbimortalidade com o recurso a teleconsulta, face aos cuidados habituais, nomeadamente: melhoria da qualidade de vida e diminuição do número de internamentos em doentes com múltiplas comorbilidades; diminuição de sintomas álgicos e depressão associados a dor músculo-esquelética crónica; diminuição da hospitalização e mortalidade por todas as causas e diminuição de recurso a cuidados de saúde adicionais no caso da insuficiência cardíaca. Dois estudos demonstraram resultados sobreponíveis entre os doentes teleconsultados e os doentes sob cuidados habituais, relativamente ao número de exacerbações e recurso a cuidados de saúde adicionais em doentes asmáticos, número e duração de reinternamento por doença pulmonar obstrutiva crónica ou insuficiência cardíaca e na mortalidade e recursos de cuidados de saúde adicionais nos doentes com múltiplas comorbilidades. Conclusão: Esta revisão demonstrou não haver um consenso claro quanto aos resultados dos indicadores de morbimortalidade em utentes com patologias crónicas, acompanhados por teleconsulta. Ainda assim, a maioria dos estudos demonstrou benefício do uso de teleconsulta nos indicadores de morbimortalidade dos doentes acompanhados por teleconsulta relativamente aos doentes acompanhados por método habitual. Embora não consonantes, os estudos encontrados demonstraram resultados pelo menos sobreponíveis, e não inferiores, na utilização da teleconsulta quando comparada com o acompanhamento habitual dos doentes. E, considerando a qualidade dos estudos encontrados, são necessários mais estudos neste âmbito para aumentar a robustez dos resultados encontrados e permitir a generalização à prática clínica diária.

Abstract Objectives: To establish if there are differences between the use of teleconsultation and the usual care in patients with one or more chronic diseases, followed in primary or secondary healthcare, in association with the reduction of morbidity and mortality. Data sources: MEDLINE/PubMed, NHS Evidence, The Cochrane Library e Turning Research Into Practice. Methods: Search of observational studies, clinical trials, systematic reviews, and meta-analyses in Portuguese and English, published between January 2000 and August 2020 with the MeSH terms ‘Chronic Disease’, ‘Telemedicine’, ‘Remote Consultation’, ‘Primary Health Care’ and ‘General Practice’. To assess the evidence levels and recommendation importance it was used the Strength of Recommendation Taxonomy (SORT) scale of the American Family Physician. Results: Two hundred and sixty articles were obtained, of which only eight met the inclusion criteria. Five of the studies showed significant benefits in morbidity and mortality criteria, with the use of teleconsultation versus the use of usual care, such as: improvement in quality of life and a decrease in the number of hospitalizations of patients with multiple comorbidities; minimization of aching symptoms and depression, associated with chronic musculoskeletal pain; decreasing of hospitalization and mortality from all causes and reduction of the use of additional health care support in case of heart failure. Two studies showed the results between patients with access to teleconsultation and patients with usual care, in relation to the number of exacerbations, the use of additional health care assistance in asthmatic patients; number and duration of re-hospitalization in patients with chronic obstructive pulmonary disease or heart failure and concerning mortality and use of additional health care support by patients with multiple comorbidities. Conclusion: This revision showed that there is no obvious consensus regarding the results of morbidity and mortality indication criteria, in patients with chronic diseases, supported by teleconsultation. Nevertheless, the majority of the studies manifested the benefit of the use of teleconsultation in such criteria, compared to the patients supported by the usual consultation methods. Although not concordant, regarded studies demonstrated results at least overlapping, and not inferior, in the use of telemedicine when compared to the usual follow-up of patients. Even so, regarding the quality of the considered studies, there are needed more studies in this area to increase the viability of the results demonstrated, and allow the consequent generalization to the daily and normalized clinical practice.

ABSTRACT Introduction: The method for expert consultation is commonly applied to scientific research conducted in the Social Sciences to validate scales, approaches, planning, politics, and other matters in decision making; however, its incorrect, indiscriminate, and partial use is confirmed. Objective: To validate the need to apply the method for expert consultation at three levels in order to determine: the competence of experts; the reliability of the instrument used; and the consensus among experts on the topic approached. Material and Methods: Systematization of documents related to the use of the method for expert consultation in scientific research, master´s and doctoral theses, articles, monographs, and other publications. Non-parametric statistical tests were applied. Results: It is confirmed that the application of the method for expert consultation following the appropriate procedures allows for an increase in the methodological rigor and a contribution to scientific research. Conclusions: The method for expert consultation is an effective tool in scientific research provided that it is rigorously applied.

RESUMEN Introducción: En muchas investigaciones científicas de las Ciencias Sociales, es usual la aplicación del método de consulta a expertos con el fin de validar escalas, enfoques, proyecciones, políticas y otros temas para la adopción de decisiones fundamentadas, aunque se constata su empleo parcial, indiscriminado e incorrecto. Objetivo: Fundamentar la necesidad de aplicar el método de consulta a expertos en tres niveles para determinar: la competencia de los expertos; la fiabilidad del instrumento empleado y el consenso entre los expertos sobre el tema abordado. Material y Métodos: Se realizó una sistematización de documentos relacionados con el empleo del método de consulta de expertos en la investigación científica, tesis de doctorado y maestría, artículos, monografías y otras publicaciones. Se aplicaron pruebas estadísticas no paramétricas. Resultados: Se constata que la aplicación del método de consulta a expertos siguiendo los procedimientos adecuados, permite elevar el rigor metodológico y su contribución en la investigación científica. Conclusiones: El método de consulta a expertos constituye una herramienta eficaz en la investigación científica siempre que se aplique con el rigor requerido.

Abstract: This study aimed to evaluate the spatial distribution of the air circulation speed and the final moisture content of pine lumber after kiln drying by using geostatistics. Two kilns acting on boards of 27 mm and 42 mm were evaluated. Air circulation speed and final moisture content were collected in different regions of the kilns. There was no significant difference for air circulation speed and final moisture content between the front and rear regions of the equipment. In the horizontal axis (Y-axis), air circulation speed averages did not differ statistically in both situations, but higher values for this variable were obtained from the spaces between the piles. Final moisture content tended to increase when closer to the door opening. In the vertical axis (Z-axis), the lower part tended to reach higher air circulation speed values. Thus, the spatial behavior influences the air circulation speed and final moisture content during lumber drying. Besides, the variograms presented the same tendency in comparison to the data obtained in a conventional manner, which indicates that geostatistics can be used to represent variables in kilns during the drying process.

Abstract This paper aims to address the export incentive mechanisms through a case study exploring the advantages of the Integrated Drawback system, in a wood flooring company. A study was conducted indicating the inputs entered into the Integrated Drawback system in Suspension mode for the laminate flooring production process. The procedures required to acquire inputs using Drawback were described and the taxes that will be suspended were described. This is an efficient public policy instrument to export incentive. The Drawback regime can be applied by any exporting company, provided that the acquired inputs are used in the manufacturing process. In addition, it shows that tax reform is important measure to increase Brazilian competitiveness in different sectors, including the wood sector.

Abstract Introduction: COVID-19 is mainly a respiratory illness, however, with an incidence in nearly a third of patients of neurological manifestations secondary to affection to the central or peripheral nervous system, used to be more frequent in severe illness, having a wide range of disability and mortality. Clinical case: We present the clinical case of a 39 years old female ,previously healthy, with diagnosis of COVID-19, initiating her illness with encephalitis and status epilepticus, posteriorly longitudinally extensive myelitis and anoxic-ischemic encephalopathy, which, despite of opportune diagnosis and treatment, she had a poor outcome developing persistent vegetative state. Conclusions: COVID--19’s neurological manifestations could lead to a high risk of disability and mortality, needing an opportune detection and treatment, with a high suspicion of encephalitis and status epilepticus in patients with decrease of alertness and focal motor symptoms.

Resumen Introducción: COVID-19 es una enfermedad principalmente respiratoria, sin embargo con una incidencia en poco más del tercio de los pacientes de manifestaciones neurológicas variadas que pueden afectar tanto sistema nervioso central como periférico, las cuales, tienden a ser más frecuentes a mayor severidad de la enfermedad, así como con un riesgo de discapacidad y mortalidad variable. Caso clínico: Se presenta un caso clínico de un paciente femenina de 39 años, previamente sana, con diagnóstico de COVID-19, quien debuta con encefalitis y estado epiléptico. Posteriormente se identifica mielitis longitudinalmente extensa y encefalopatía hipóxico-isquémica, lo cual, a pesar de tener un diagnóstico y manejo oportuno, cursó con evolución desfavorable en cuanto a discapacidad al presentar un estado vegetativo persistente. Conclusiones: Las manifestaciones neurológicas de COVID-19 pueden conllevar un alto riesgo de discapacidad y mortalidad, por lo que se requiere una detección y manejo oportunos, con un alto índice de sospecha de encefalitis y de estado epiléptico en pacientes con disminución del estado de alerta y focalización motora.

Abstract Introduction: Multiple sclerosis is one of the main causes of disability in young people. It has characteristic lesions in magnetic resonance images which are part of diagnosis criteria, and some of them could predict a long-term disability. In mexican population there is no description about multiple sclerosis imaging characteristics. Materials and methods: We performed an observational, descriptive, cross-sectional, and retrolective study at the Neurology Service of Specialties Hospital of Siglo XXI National Medical Center of Mexican Social Security Institute, in Mexico, evaluating magnetic resonance images characteristics of patients with multiple sclerosis diagnosis between January 2017 and January 2020. Results: 75 patients were included, 8% had 1-3 T2-weighted lesions, 18.6% had 4-9 T2-weighted lesions, and 73.3% had 10 or more T2-weighted lesions. 50.6% had infratentorial lesions and 61.3% had spinal cord lesions. Gadolinium enhancing lesions were found in 48%, with a median of lesions 2 (IQR 1,3). Conclusions: Mexican patients with multiple sclerosis have a great incidence of magnetic resonance image poor prognosis factors, which should lead to a closer follow-up and influence treatment options.

Resumen Introducción: La esclerosis múltiple es una de las principales causas de discapacidad en personas jóvenes. Se caracteriza por lesiones en resonancia magnética que forman parte de sus criterios diagnósticos, prediciendo algunas de ellas discapacidad a largo plazo. En la población mexicana no existe descripción de las características por imagen de esclerosis múltiple. Materiales y métodos: Desarrollamos un estudio observacional, descriptivo, retrolectivo de cohorte en el servicio de Neurología del Hospital de Especialidades del Centro Médico Nacional “Siglo XXI” del Instituto Mexicano del Seguro Social, en México, evaluando las características por imagen de resonancia magnética en pacientes con diagnóstico de esclerosis múltiple entre enero de 2017 y enero de 2020. Resultados: 75 pacientes fueron incluidos. En secuencia T2 el 8% tuvo 1-3 lesiones, 18.6% tuvo 4-9 lesiones en secuencia T2 y 73.3% tuvo 10 o más lesiones. El 50.6% tuvieron lesiones infratentoriales y el 61.3% tuvo lesiones en médula espinal. Lesiones captantes de gadolinio se encontraron en el 48%, con una mediana de lesiones de 2 (RIC 1,3). Conclusiones: Los pacientes mexicanos con esclerosis múltiple tienen una gran incidencia de factores de mal pronóstico por resonancia magnética, lo cual debería de guiar a un seguimiento más estrecho e influenciar en las opciones de tratamiento.

Abstract Introduction: status epilepticus is a medical condition which could lead to a great disability and be mortal. Background of epilepsy could prevent a progression to a refractory status epilepticus and predict a good functional prognosis. Nevertheless, in Mexican population there are no studies about that. Materials and methods: an observational, analytic, retrospective, cohort study was performed with patients with status epilepticus in Specialities Hospital of “Siglo XXI” National Medical Center, in Mexico. It was evaluated the probability of presenting refractory status epilepticus and a good functional outcome in patients with a background of epilepsy, performing Pearson Chi-square. Results: 40 patients with status epilepticus were included, 32 with refractory status epilepticus and 14 with a background of epilepsy. The probability of presenting a refractory status epilepticus with a background of epilepsy was OR 1.29 (p 0.53), and for a good functional outcome was OR 3.63 (p 0.10). Conclusions: background of epilepsy is not a protective factor for preventing the progression to a refractory status epilepticus, neither a factor for predicting a good functional outcome in our study with Mexican population. Nevertheless, further studies with a bigger sample are needed in order to prove these results.

Resumen Introducción: el estado epiléptico es una condición que puede ser discapacitante y mortal. El antecedente de epilepsia puede favorecer a que un paciente no progrese a estado epiléptico refractario y a que tenga un buen pronóstico funcional. Sin embargo, en la población mexicana no existen estudios al respecto. Materiales y métodos: se realizó un estudio observacional, analítico, retrospectivo de una cohorte de pacientes atendidos con estado epiléptico en el Hospital de Especialidades del Centro Médico Nacional Siglo XXI, en México. Se evaluó la probabilidad de presentar estado epiléptico refractario y de buen desenlace funcional en pacientes con antecedente de epilepsia, realizándose chi cuadrada de Pearson. Resultados: se atendieron 40 pacientes con estado epiléptico, 32 con estado refractario y 14 con antecedentes de epilepsia. La probabilidad de presentar antecedente de epilepsia con estado epiléptico refractario fue OR 1.29 (p 0.53) y con desenlace funcional favorable de OR 3.63 (p 0.10). Conclusiones: el antecedente de epilepsia no es un factor que previene la progresión a estado epiléptico refractario ni un factor que predice un desenlace funcional favorable en el actual estudio de población mexicana. Sin embargo, se requieren estudios con mayor muestra para corroborarlo.