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RESUMO Introdução: As demandas atuais enfrentadas por uma organização esportiva levam a questionar a qualidade com que são gerenciados os processos substantivos que nela ocorrem, com o objetivo de buscar a eficiência nos resultados esperados e a eficácia na consecução dos objetivos que a sociedade exige dela. Objetivo: determinar a necessidade de mudança estratégica na gestão dos processos organizacionais da Escola Nacional de Voleibol de Cuba. Materiais e métodos: foram utilizados técnicas e métodos científicos, tais como: análise de fontes documentais, entrevista, pesquisa, brainstorming, matriz SWOT, diagrama de Ishikawa, matriz de impacto cruzado, MIC-MAC, triangulação estatístico-matemática e metodológica. Resultados: sintetiza-se na verificação das inadequações existentes na referida gestão, como premissa que evidencia o estado de necessidade percebido, pois a variável em estudo para sua transformação constitui o principal fator-chave de sucesso no desenvolvimento dessa organização esportiva. Conclusões: a variável em estudo para sua transformação constitui o principal fator-chave de sucesso no desenvolvimento da organização, o que documenta a necessidade de mudança estratégica em sua gestão.

RESUMEN Introducción: las exigencias actuales que enfrenta una organización deportiva llevan a cuestionar la calidad con que se gestionan los procesos sustantivos que en ella se desarrollan, en aras de buscar la eficiencia en los resultados que se esperan y la eficacia en la consecución de los fines que la sociedad le demanda. Objetivo: determinar la necesidad de un cambio estratégico en la gestión de los procesos organizacionales de la Escuela Nacional de Voleibol de Cuba. Materiales y métodos: se emplearon técnicas y métodos científicos tales como: análisis de fuentes documentales, entrevista, encuesta, tormenta de ideas (Brainstorming), matriz DAFO, diagrama de Ishikawa, matriz de impactos cruzados, MIC-MAC, estadísticos-matemáticos y triangulación metodológica. Resultados: se sintetiza en la comprobación de las insuficiencias existentes de la reseñada gestión, como premisa que evidencia el estado de necesidad advertido, pues la variable en estudio para su transformación constituye el principal factor clave del éxito en el desarrollo de esta organización deportiva. Conclusiones: la variable en estudio para su transformación constituye el principal factor clave del éxito en el desarrollo de la organización, todo lo cual documenta la necesidad del cambio estratégico de su gestión

ABSTRACT Introduction: The current demands of a sports organization do not always match the reality of significant process management aimed to produce the efficient outcomes expected and to meet the social goals. Aim: To determine the need for a strategic change in organizational process management at the Cuban National School of Volleyball. Materials and methods: Scientific techniques and methods were used, such as documentary review, interview, survey, brainstorming, SWOT matrix, Ishikawa diagram, MIC-MAC cross-impact matrix, statistical-mathematical methods, and methodological triangulation. Results: The shortcomings found were summarized as a premise evidencing the state of adverted need since the study variable constitutes the main key factor of success in the development of a sports organization. Conclusions: The study variable is the main key factor of success in organizational development, which proves the need for a strategic change in management.

https://doi.org/10.34982/2223.1773.2024.v9.no1.013

Resistencia transmitida de VIH-1 en pacientes sin exposición a tratamiento antirretroviral. Guatemala
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Navas Castillo, Jessenia Sabrina

; Quintana Galindo, Maria Cristina

; Orózco Morán, Nydia Anaidé

; Méndez Andrade, Aura Marina

; Medrano Chiquitó, Claudia Ninette

; Celada, Eduardo

; Samayoa Bran, Ana Johanna

Anales de la Facultad de Medicina

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2024, Volume 11 Nº 1 elocation e202

Resumo: Pt En Es | Texto: Pt En Es | PDF: Pt | PDF: En | PDF: Es

Resumo O objetivo deste estudo foi descrever os níveis de resistência transmitida ao HIV-1 em adultos tratados em Unidades de Cuidados Integrais na Guatemala. O estudo incluiu prontuários de 185 pacientes adultos HIV-1 positivos, recentemente diagnosticados sem histórico de uso de TARV, no período de novembro de 2019 a novembro de 2020. A análise foi realizada no software DeepChek® v2.0, para classificação da resistência, O algoritmo Stanford HIVdb (v9.4 - 07/12/2022) foi seguido. Foi encontrada 18.4% (IC 95% 13.1 - 24.7%) de resistência geral a alguma família de ARVs. Houve evidência de 15.1% (IC 95% 10.3 - 21.1%) de resistência individual à família de NNRTI, afetando principalmente NVP e EFV; 2.2% (IC 95% 0.6 - 5.4%) resistência ao INTR, principalmente ao FTC/3TC; e 2.7% (IC 95% 0.9 - 6.2%) de resistência intermediária e baixa ao IP NFV e LPV/r. Três casos apresentaram resistência múltipla a NRTIs + NNRTIs. As mutações mais frequentemente encontradas foram K103N (41.2%), M184V/I (8.8%) e M46I (5.9%). A elevada resistência transmitida do HIV-1 em pacientes atendidos em diferentes Unidades de Cuidados Integrados ao HIV demonstra a importância de analisar periodicamente a tendência de resistência em pessoas que não foram expostas aos ARVs, o que por sua vez é um marcador indireto da presença de ARVs adquiridos. resistência no país, dados que demonstram a necessidade de ações e intervenções rápidas e eficazes dado o seu impacto na saúde pública.

Abstract The objective of this study was to describe the levels of transmitted HIV-1 resistance in patients with a recent HIV diagnosis before starting ART, treated in Comprehensive Care Units in Guatemala during the years 2019 and 2020. The study included records of 185 HIV-positive adult patients, recently diagnosed with HIV without a history of ART use. The analysis was carried out in the DeepChek® v2.0 software, the Stanford HIVdb algorithm (v9.4 - 07/12/2022) was followed to classify resistance. 18.4% (95% CI 13.1 - 24.7%) of general resistance to some family of ARVs was found. There was evidence of 15.1% (95% CI 10.3 - 21.1%) of individual resistance to the NNRTI family, mainly affecting NVP and EFV; 2.2% (95% CI 0.6 - 5.4%) resistance to INTR, mostly to FTC/3TC; and 2.7% (95% CI 0.9 - 6.2%) of intermediate and low resistance IP NFV and LPV/r. Three cases presented multiple resistance to NRTIs + NNRTIs. The most frequently found mutations were K103N (41.2%), M184V/I (8.8%) and M46I (5.9%). The high transmitted resistance of HIV-1 in patients treated in different Comprehensive HIV Care Units demonstrates the importance of periodically analyzing the trend of resistance in people who have not been exposed to ARVs, which in turn is an indirect marker. of the presence of acquired resistance in the country, data that demonstrate the need for prompt and effective actions and interventions given its impact on public health.

Resumen El objetivo del estudio fue describir los niveles de resistencia transmitida de VIH-1 en adultos atendidos en Unidades de Atención Integral de Guatemala. El estudio incluyó registros de 185 pacientes adultos VIH-1 positivo, de reciente diagnóstico sin antecedente de uso de TAR, de noviembre del 2019 a noviembre del 2020. El análisis se realizó en el software DeepChek® v2.0, para la clasificación de la resistencia se siguió el algoritmo de Stanford HIVdb (v9.4 - 07/12/2022). Se encontró 18.4% (IC 95% 13.1 - 24.7%) de resistencia general a alguna familia de ARVs. Se evidenció 15.1% (IC 95% 10.3 - 21.1%) de resistencia individual a la familia de INNTR afectando principalmente a NVP y EFV; 2.2% (IC 95% 0.6 - 5.4%) de resistencia a INTR, mayormente a FTC/3TC; y 2.7% (IC 95% 0.9 - 6.2%) de resistencia intermedia y baja los IP NFV y LPV/r. Tres casos presentaron resistencia múltiple a los INTR + INNTR. Las mutaciones más frecuentemente encontradas fueron K103N (41.2%), M184V/I (8.8%) y M46I (5.9%). La elevada resistencia transmitida del VIH-1 en pacientes atendidos en distintas Unidades de Atención Integral del VIH, demuestra la importancia de analizar periódicamente la tendencia de la resistencia en personas que no han estado expuestas a ARVs, lo cual a su vez es un marcador indirecto de presencia de resistencia adquirida en el país, datos que evidencian la necesidad de acciones e intervenciones prontas y efectivas dado su impacto en la salud pública.

https://doi.org/10.25184/anfamed2024v11n1a3

Revisores 2023
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Molas de la Quintana, Adriana Beatriz

; Jimenez Genchi, Alejandro

; Carrizales, Alexia

; Gotti, Amanda

; Martinez Ortiz, Ana

; Rocío Martínez Yacelga, Ana del

; Camilo Ciantelli, Ana Paula

; Jimenez Figueroa, Andres

; Neumann, Angélica Paula

; Parodi Svartman, Bernardo

; Vazquez Rodriguez, Carolina

; Da Silva, Cecilia

; Baroni, Cecilia

; Lanza Perez, Cintia Beatriz

; Mola, Débora

; Alarcón Rubio, David

; Perales Mejia, Felipe de Jesús

; Sarachu, Gerardo

; Gelpi, Gonzalo

; Sosa, Gustavo

; Viana Batista, Helder

; Moizéis, Heloísa Bárbara Cunha

; Carrasco, Jimena

; Ungaretti, Joaquín

; Moreira, Karen

; Tomatis, Karina

; Oros, Laura Beatriz

; Mazaro, Lisabelle Manente

; Chiavone, Luciana

; Perilla Toro, Lyria Esperanza

; Campagnoli, Mabel Alicia

; Ruiz Barbot, Mabela

; Brenlla, María Elena

; Folle Chavannes, María Ana

; Freytes Frey, Marcela

; Rossal, Marcelo

; Ortiz, Maria Victoria

; Nabergoi, Mariela

; Montenegro, Marisela

; Lladó, Mónica

; Freitas De León, Paribanú

; Solís García, Patricia

; Ruiz Santos, Paul

; Fiorati, Regina Célia

; Martins, Rita de Cássia Andrade

; Dominguez-Lara, Sergio Alexis

; Herranz, Silvana Melisa

; Yoma, Solana María

; Gondim, Sonia Maria Guedes

; Rostagnol, Susana

; Wittke, Tommy

; Ballesteros, Virginia

; Tamayo, William

Psicología, Conocimiento y Sociedad

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Dez 2023, Volume 13 Nº 3 Páginas 116 - 118

Resumo: Es | Texto: Es | PDF: Es

https://doi.org/10.26864/pcs.v13.n3.rev

Frecuencia de eventos cardiovasculares en pacientes con lupus eritematoso sistémico.
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García, Lucila

; Gobbi, Carla

; Quintana, Rosana

; Alba, Paula

; Roverano, Susana

; Álvarez, Analía

; Graf, César

; 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

; Maldonado Aguila, Rodrigo

; Gordon, Sergio

; Micelli, Marina

; Nieto, Romina

; Rausch, Gretel

; Gongora, Vanina

; Damico, Agustina

; 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, Marcela

; Caputo, Víctor

; Larroude, María Silvia

; Domínguez, Nadia

; Gómez, Graciela

; Rodríguez, Graciela

; Marín, Josefina

; Collado, Victoria

; Jorfen, Marisa

; Bedran, Zaida

; Curti, Ana

; Gazzoni, María Victoria

; Sarano, Judith

; Finucci Curi, Pablo

; Rojas Tessel, Romina

; Arias Saavedra, Maira

; Sattler, María Emilia

; Machado Escobar, Maximiliano

; Astesana, Pablo

; París, Úrsula

; Vandale, Juan Manuel

; Santa Cruz, María Julia

; Pons-Estel, Bernardo

; García, Mercedes

Revista argentina de reumatología

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Out 2023, Volume 34 Nº 2 Páginas 43 - 50

Resumo: Es En | Texto: Es En | PDF: Es | PDF: En

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

Seroprevalence of Toxoplasmosis in Puerperal Women Treated at a Tertiary Referral Hospital
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Medeiros, Juliana Fernandes

; Silva, Ana Cláudia Rabelo e

; Rocha, Natália Domene Franco da

; Georg, Alexia Viegas

; Melli, Patricia Pereira dos Santos

; Quintana, Silvana Maria

; Duarte, Geraldo

Revista Brasileira de Ginecologia e Obstetrícia

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Fev 2023, Volume 45 Nº 2 Páginas 59 - 64

Resumo: En Pt | Texto: En Pt | PDF: En | PDF: Pt

Abstract Objective To evaluate the seroprevalence of toxoplasmosis among puerperal women cared for at a tertiary university hospital and the level of understanding of these puerperal women about toxoplasmosis, vertical transmission, and its prophylaxis. Methods For this cross-sectional study, we evaluated 225 patients using presential interviews, prenatal documentation, and electronic medical records. Data were stored using Research Electronic Data Capture (REDCap) software. Prevalence rates were estimated by the presence of reactive IgG antibodies against Toxoplasma gondii. Data analysis was performed using the chi-square test and calculation of the odds ratio (OR). Seroreactivity to T. gondii and exposure variables (age, educational level, and parity) were analyzed using a confidence interval (95%CI) and a significance level of 5% (p < 0.05). Results The seropositivity rate for T. gondii was 40%. There was no association between seroprevalence and age. Primiparity was a protective factor against seropositivity and low education was a risk factor. Conclusion Knowledge of T. gondii infection and its transmission forms was significantly limited, presenting a risk for acute maternal toxoplasmosis and vertical transmission of this protozoan. Increasing the education level regarding the risk of toxoplasmosis during pregnancy could reduce the rates of infection and vertical transmission of this parasite.

Resumo Objetivo Avaliar a soroprevalência de toxoplasmose entre puérperas atendidas em um hospital universitário terciário e o nível de compreensão dessas puérperas sobre toxoplasmose, transmissão vertical e sua profilaxia. Métodos Para esse estudo transversal, foram avaliadas 225 pacientes utilizando entrevistas presenciais, documentação de pré-natal e prontuário eletrônico. Os dados foram armazenados usando o software Research Electronic Data Capture (REDCap). As taxas de prevalência foram estimadas pela presença de anticorpos IgG reativos contra o Toxoplasma gondii. A análise dos dados foi realizada por meio do teste do qui-quadrado e cálculo do odds ratio (OR). A sororreatividade ao T. gondii e as variáveis de exposição (idade, escolaridade e paridade) foram analisadas, utilizando-se intervalo de confiança (IC95%) e nível de significância de 5% (p < 0,05). Resultados A taxa de soropositividade para T. gondii foi de 40%. Não houve associação entre soroprevalência e idade. A primiparidade foi fator de proteção contra a soropositividade e a baixa escolaridade foi fator de risco. Conclusão O conhecimento da infecção por T. gondii e suas formas de transmissão foi significativamente limitado, apresentando risco para toxoplasmose materna aguda e transmissão vertical desse protozoário. Aumentar o nível de escolaridade quanto ao risco de toxoplasmose durante a gravidez pode reduzir as taxas de infecção e transmissão vertical desse parasita.

https://doi.org/10.1055/s-0043-1764495

Initial oral microbiota and the impact of delivery mode and feeding practices in 0 to 2 month-old infants
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GARCÍA-QUINTANA, Alejandra

; FRATTAROLI-PERICCHI, Annabella

; FELDMAN, Sonia

; LUENGO, Jesus

; ACEVEDO, Ana María

Brazilian Oral Research

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2023, Volume 37 elocation e078

Resumo: En | Texto: En | PDF: En

Abstract The aim of this study was to describe the initial oral microbiota and how delivery mode and feeding practices impact its diversity in 0-2-month-old infants. This was a cross-sectional study that consisted of one collection of saliva samples from 0-2-month infants at baseline. Ten pairs of mothers and infants were selected. Medical health history, pregnancy, birth, feeding practices (breastfeeding or milk formula), and infant health status was obtained. Pooled microbial samples were obtained from the oral surfaces using a sterile cotton swab. Infants did not receive any breast milk before sampling. After collection, each swab was analyzed through microbiological culture-based procedures, using selective mediums. Cultures were analyzed for the presence of Streptococci, Lactobacillus, Staphylococcus, Enterobacterium , and Candida albicans . Twenty percent of the samples were serially diluted (10-2) to assess the number of bacteria expressed as CFU. Bacillota was the leading phylogenetic group in the infant’s pooled microbial sample. The most prevalent genera were Streptococcus, Lactobacillus , and Staphylococcus . Two participants had a positive growth of Candida albicans . The association between genus group, type of delivery, and feeding practices was not statistically significant (p > 0.05). Lactobacillus genus was frequently present in the cesarean delivery group but with slightly higher counts in a vaginal delivery study subject. Exclusively breastfed infants showed presence of Streptococcus, Lactobacillus, Staphylococcus . The oral microbiome in infants (0-2 month-old) is highly heterogeneous and dynamic. Microbiota composition seems to be impacted by mode of delivery, with slight differences among groups. Breastmilk appears as an essential factor in maintaining the oral microbiome’s stability and diversity.

https://doi.org/10.1590/1807-3107bor-2023.vol37.0078

Estudio de la influencia del uso del suelo en las relaciones entre variables físico-químicas a través de análisis de redes
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Martín-Sanz, Juan Pedro

; Valverde-Asenjo, Inmaculada

; Santiago-Martín, Ana de

; Quintana-Nieto, José Ramón

; González-Huecas, Concepción

; López-Lafuente, Antonio

Revista de Ciências Agrárias

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Dez 2022, Volume 45 Nº 4 Páginas 51 - 60

Resumo: Es En | Texto: Es En | PDF: Es | PDF: En

Resumen El ser humano al emplear el suelo modifica paulatinamente sus propiedades lo que puede producir la pérdida o reducción de la salud del suelo. El objetivo de este trabajo fue analizar si diferentes usos del suelo producen diferencias en las relaciones de un set de 24 variables físico-químicas. La zona de estudio se situó al sureste de Madrid (España) en la que se muestrearon 10 puntos en los que los tres usos principales del suelo (cereal, olivar y natural) se encontraban colindantes. Las relaciones entre las variables físico-químicas para cada uso se determinaron por las correlaciones bivariadas de Spearman (P<0,05). El estudio de estas relaciones se llevó a cabo mediante técnicas de análisis de redes. El uso del suelo influyó en las relaciones entre las variables analizadas. Los suelos agrícolas, especialmente los de cereal, tuvieron una menor y peor cantidad de correlaciones. Los suelos agrícolas tuvieron una mayor tendencia a formar módulos independientes entre sí, lo que indicaría una menor resiliencia de estos suelos. Las variables físico-químicas más importantes cambiaron entre usos: relacionadas con la materia orgánica en la red del uso natural y relacionadas con distintos coloides inorgánicos en los usos agrícolas.

Abstract The human being when using the soil gradually modifies its properties which can cause the loss or reduction of the health of the soil. The objective of this work was to analyse whether different land uses produce differences in the relationships of a set of 24 physical-chemical variables. The study area was located southeast of Madrid (Spain) in which 10 points were sampled where the three main soil uses (cereal, olive grove and natural) were adjacent. The relationships between the physical-chemical variables for each use were determined by Spearman's bivariate correlations (P<0.05). The study of these relationships was carried out using network analysis techniques. Soil use influenced the relationships between the variables analysed. Agricultural soils, especially cereal soils, had fewer and worse number of correlations. Agricultural soils had a greater tendency to form modules independent of each other, which would indicate a lower resilience of these soils. The most important physical-chemical variables changed between uses: related to organic matter in the network of natural use and related to different inorganic colloids in agricultural uses.

https://doi.org/10.19084/rca.28376

Características clínicas y evolución de la infección por SARS-CoV-2 en pacientes con lupus eritematoso sistémico en Argentina: datos del registro nacional SAR-COVID
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Isnardi, Carolina Ayelén

; Roberts, Karen

; Tissera, Yohana

; Petkovic, Ingrid

; Berbotto, Guillermo

; Gobbi, Carla

; Tanten, Romina

; Cogo, Karina

; Asnal, Cecilia

; Baños, Andrea

; Vivero, Florencia

; Schmid, María Marcela

; Lázaro, María Alicia

; German, Noelia

; Takashima, Lorena

; Scafati, Julia

; Werner, Marina Laura

; Casalla, Luciana

; Matellan, Carla

; Castrillon, Diana M

; Rodríguez, Florencia

; Moyano, Sebastián

; Martín, María Luz

; Cosentino, Vanesa

; Herscovich, Natalia

; Tralice, Elda R

; Barbich, Tatiana

; Vásquez, Dora L

; Buschiazzo, Emilio

; Maid, Pablo

; Ledesma, Ana C

; Yohena, Víctor

; Gómez, Gimena

; Quintana, Rosana

; Pons-Estel, Guillermo J

Revista argentina de reumatología

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Out 2022, Volume 33 Nº 4 Páginas 188 - 198

Resumo: Es En | Texto: Es En | PDF: Es | PDF: En

Resumen Introducción: el lupus eritematoso sistémico (LES) es una enfermedad sistémica que se ha asociado a mayor severidad con la infección por SARS-CoV-2. Particularmente la alta actividad de la enfermedad y algunos inmunosupresores se han vinculado a peores desenlaces. Objetivos: describir las características por SARS-CoV-2 en pacientes con LES en Argentina del registro SAR-COVID y establecer los factores asociados a peor desenlace de la misma. Materiales y métodos: estudio observacional. Se incluyeron pacientes con diagnóstico de LES con infección confirmada por SARS-CoV-2 (RT-PCR y/o serología positiva) del registro SAR-COVID. Los datos se recolectaron desde agosto de 2020 hasta marzo de 2022. El desenlace de la infección se midió mediante la escala ordinal de la Organización Mundial de la Salud (EO-OMS). Se definió COVID-19 severo con un valor EO-OMS ≥5. Análisis descriptivo, test T de Student, test de Mann Whitney U, ANOVA, chi2 y Fisher. Regresión logística múltiple. Resultados: se incluyeron 399 pacientes, el 93% de sexo femenino, con una edad media de 40,9 años (DE 12,2). El 39,6% tenía al menos una comorbilidad. Al momento de la infección, el 54,9% recibía glucocorticoides, el 30,8% inmunosupresores y el 3,3% agentes biológicos. La infección por SARS-CoV-2 fue leve en la mayoría de los casos, mientras que un 4,6% tuvo curso severo y/o falleció. Estos últimos presentaban comorbilidades, usaban glucocorticoides y tenían síndrome antifosfolipídico (SAF) con mayor frecuencia y mayor actividad de la enfermedad al momento de la infección. En el análisis multivariado, la hipertensión arterial, el diagnóstico de SAF y el uso de glucocorticoides se asociaron a hospitalización severa y/o muerte por COVID-19 (EO-OMS ≥5). Conclusiones: en esta cohorte de pacientes con LES con infección por SARS-CoV-2 confirmada, la mayoría cursó de manera sintomática, un 22,1% fue hospitalizado y un 5% requirió ventilación mecánica. La mortalidad fue cercana al 3%. El diagnóstico de SAF, tener hipertensión arterial y el uso de glucocorticoides se asociaron significativamente con COVID-19 severo.

Abstract Introduction: systemic lupus erythematosus (SLE) is a systemic disease that has been associated with greater severity with SARS-CoV-2 infection. Particularly high disease activity and some immunosuppressants have been linked to worse outcomes. Objectives: to describe the characteristics due to SARS-CoV-2 in patients with SLE in Argentina from the SAR-COVID registry and to establish the factors associated with a worse outcome of the same. Materials and methods: observational study. Patients diagnosed with SLE with confirmed SARS-CoV-2 infection (RT-PCR and/or positive serology) from the SAR-COVID registry were included. Data was collected from August 2020 to March 2022. The outcome of the infection was measured using the World Health Organization - ordinal scale (WHO-OS). Severe COVID-19 was defined as an WHO-OS value ≥5. Descriptive analysis, Student's T test, Mann Whitney U, ANOVA, chi2 and Fisher. Multiple logistic regression. Results: a total of 399 patients were included, 93% female, with a mean age of 40.9 years (SD 12.2), 39.6% had at least one comorbidity. At the time of infection, 54.9% were receiving glucocorticoids, 30.8% immunosuppressants, and 3.3% biological agents. SARS-CoV-2 infection was mild in most cases, while 4.6% had a severe course and/or died. The latter had comorbidities, used glucocorticoids and had antiphospholipid syndrome (APS) more frequently and higher disease activity at the time of infection. In the multivariate analysis, high blood pressure, the diagnosis of APS, and the use of glucocorticoids were associated with severe hospitalization and/or death from COVID-19 (WHO-EO ≥5). Conclusions: in this cohort of SLE patients with confirmed SARS-CoV-2 infection, most had a symptomatic course, 22.1% were hospitalized, and 5% required mechanical ventilation. Mortality was close to 3%. The diagnosis of APS, having high blood pressure, and the use of glucocorticoids were significantly associated with severe COVID-19.

https://doi.org/10.47196/rar.v33i4.704

Impact and risk factors related to the spread of SARS-CoV-2 (Covid-19) in older adults
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Hernández-Solís, Alejandro

; Quintana-Martínez, Andrea

; Quintanar-Ramírez, María I.

; Solis-Zuñiga, Ana K.

; Reding-Bernal, Arturo

Revista médica del Hospital General de México

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Jun 2022, Volume 85 Nº 2 Páginas 62 - 67

Resumo: En | Texto: En | PDF: En

Abstract Objective: To identify and describe the risk factors that increase susceptibility in older adults to infection by SARS-CoV-2 (Covid-19). Material and methods: Descriptive, cross-sectional study in adults over 60 years, patients with a positive result (RT-PCR) were analysed to detect SARS-CoV-2. The study was carried out from May 17 to July 21, 2020. A multiple logistic regression model was used to analyse the risk factors of the study population. Results: 102 older adults were included with a mean age of 82.5 ± 8.8 years, 55 (54%) were positive and 47 (46%) were negative. When analysing the risk factors related to higher mortality coupled with Covid-19 infection, the statistically significant variable was frailty, with an OR of 11.6 in frail adults compared to robust individuals (p-value = 0.024.) Conclusion: In the vulnerable population, risk factors must be identified and treated, but above all, such factors must be prevented in advance; early detection, isolation, effective treatment must be carried out as well as follow-up of contacts and prevention of the spread of the new virus to reduce mortality in vulnerable groups.

https://doi.org/10.24875/hgmx.21000086 6 downloads

10.

Validación por expertos del contenido del diagnóstico enfermero de NANDA-I Fatiga (00093)
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Oter-Quintana, Cristina

; Cid-Expósito, María Gema

; Martín-García, Ángel

; Brito-Brito, Pedro Ruymán

; Parro-Moreno, Ana Isabel

; Martínez-Martín, María Luisa

; Alcolea-Cosín, María Teresa

; Alameda-Cuesta, Almudena

Revista Cubana de Enfermería

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Mar 2022, Volume 38 Nº 1 elocation e4427

Resumo: En Es | Texto: En Es | PDF: En | PDF: Es

ABSTRACT Introduction: Fatigue is an important health concern that requiring appropriate assessment, diagnosis and nursing care planning focused on those who suffer from it. Objective: To validate the content of NANDA-I nursing diagnosis of fatigue (00093) in the version included in a clinical database. Methods: Descriptive and exploratory study of diagnostic content validation by experts following Fehring's proposal. The setting of the study was Spain. Data collection was carried out between June 2019 and March 2020. The participating experts had experience and training in the use of standardized nursing languages. Results: Of the thirteen characteristics that define the diagnosis included in the database, seven were validated as major, five as minor and one was not validated. All sixteen related factors of the diagnosis were validated. The content validity index of the diagnosis was 0.81. Conclusions: The diagnosis obtained a high content validity index. The components of the NANDA-I diagnosis of fatigue (00093) in the clinical database version correspond with those present in the NANDA-I diagnosis of fatigue (00093) in the NANDA-I Classification 2018-2020. The current research is considered to contribute with an increase in diagnostic accuracy by identifying key defining characteristics for the diagnosis. At the same time, it validates related factors that have an influence on the diagnosis but are not incorporated among the components of the NANDA-I diagnosis of fatigue (00093) in the 2018-2020 edition of the NANDA-I Classification.

RESUMEN Introducción: La fatiga constituye un importante problema de salud que precisa de una adecuada valoración, diagnóstico y planificación de cuidados enfermeros centrados en quienes la sufren. Objetivo: Validar el contenido del diagnóstico enfermero NANDA-I Fatiga (00093) en la versión incluida en una base de datos clínica. Métodos: Estudio descriptivo y exploratorio de validación de contenido diagnóstico mediante expertos siguiendo la propuesta de Fehring. El ámbito de estudio fue España. La recogida de datos se realizó entre los meses de junio 2019-marzo 2020. Los expertos participantes disponían de experiencia y formación en el uso de lenguajes estandarizados enfermeros. Resultados: De las 13 Características Definitorias con las que cuenta el diagnóstico incluido en la base de datos, siete fueron validadas como mayores, cinco como menores y una no fue validada. Los 16 Factores Relacionados del diagnóstico fueron validados. El Índice de Validez de Contenido del diagnóstico fue de 0,81. Conclusiones: El diagnóstico obtuvo un Índice de Validez de Contenido elevado. Los componentes del diagnóstico NANDA-I Fatiga (00093) en la versión de la base de datos clínica guardan correspondencia con los presentes en el diagnóstico NANDA-I Fatiga (00093) en la Clasificación NANDA-I 2018-2020. Se considera que la investigación actual contribuye a incrementar la precisión diagnóstica al identificar Características Definitorias claves de la presencia del diagnóstico. Al tiempo valida Factores Relacionados influyentes en el diagnóstico no incorporados en los componentes del diagnóstico NANDA-I Fatiga (00093) en la edición de la Clasificación NANDA-I 2018-2020.

11.

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 Nº 1 Páginas 14 - 25

Resumo: Es En | Texto: 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

12.

Recuperación de poblaciones de tortuga verde y sus interacciones con la duna costera como línea base para una restauración ecológica integral
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Guzmán-Hernández, Vicente

; Monte-Luna, Pablo del

; López-Castro, Melania

; Uribe-Martínez, Abigail

; Huerta-Rodríguez, Patricia

; Gallegos-Fernández, Sandra A.

; Azanza-Ricardo, Julia

; Martínez-Portugal, Rosa C.

; Barragán-Zepeda, Ana K.

; Quintana Pali, Guadalupe P.

; Martín-Viaña, Yanet F.

; Gómez-Ruíz, Pilar A.

; Acosta-Sánchez, Héctor H.

; López-Hernández, Martha

; Castañeda-Ramírez, D. Gerardo

; Ortíz, Antonio

; Cuevas, Eduardo

Acta botánica mexicana

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2022, Nº 129 elocation e1954

Resumo: Es En | Texto: Es En | PDF: Es | PDF: En

Resumen: Antecedentes y Objetivos: La restauración ecológica se ha centrado en los componentes físicos y vegetales de los ecosistemas, y ha dejado de lado a la fauna silvestre y sus interacciones. Chelonia mydas es un macroherbívoro en peligro de extinción que anida en playas de México y Cuba, e influye en la vegetación costera con aportaciones de materia orgánica. Los objetivos de este estudio fueron analizar su recuperación poblacional, un índice del verdor de la vegetación de duna, así como la cantidad de materia orgánica estimada de sus nidadas antes y después de la implementación de una Norma Oficial Mexicana. Métodos: Se analizaron datos de entre dos y tres décadas de monitoreo biológico en 16 playas de anidación de Chelonia mydas; a partir de ellos se realizaron tres niveles de análisis de indicadores demográficos, la aportación de materia orgánica de las tortugas en la playa y el vigor vegetal a partir de sensores remotos, además de aplicar los estadísticos pertinentes. Resultados clave: Hubo un crecimiento exponencial del número de anidaciones de tortuga verde (entre 12 y 14% anual), asociado con pulsos de reclutamiento poblacional en los años 2000 y 2008. El aporte de materia orgánica a la playa fue significativamente mayor después de un cambio en la estrategia para manejo de las nidadas en México, y se detectó un incremento en el verdor de la vegetación de duna en zonas de anidación alta de Chelonia mydas. Conclusiones: El incremento de las poblaciones de tortuga verde lleva a reflexionar acerca de las implicaciones que tiene la recuperación de especies de fauna sobre otras comunidades en los ecosistemas que habitan, lo que demanda el análisis de los paradigmas actuales y la adaptación de estrategias que atiendan sus necesidades de manejo, procurando las condiciones de integridad ecológica de sus hábitats.

Abstract: Background and Aims: Ecological restoration has focused on the physical and vegetation components of ecosystems, leaving aside studies on wild fauna and their interactions. Chelonia mydas is an endangered macroherbivore that nests on sandy beaches of Mexico and Cuba, and influences the coastal vegetation with organic matter contributions. The objectives of this study were to analyze its population recovery, a greenness index for dune vegetation, and the amount of organic matter estimated from its clutches before and after the implementation of an official Mexican norm. Methods: Biological data obtained from two and three decades of monitoring 16 Chelonia mydas nesting beaches were analyzed; based on these, three levels of demographic indexes were carried out, the contribution of organic matter by marine turtles to the beach and the vegetal vigor using remote sensing, besides implementing the pertinent statistical analysis. Key results: There was an exponential increase of the green turtle nests (between 12 and 14% per year), associated with population recruitment pulses in 2000 and 2008. The contribution of organic matter to the beach was significantly higher after a change in clutches management in Mexico, and an increase in the dune vegetation greenness was detected in high Chelonia mydas nesting zones. Conclusions: The increase of the green turtle populations invites to reflex about the implications of the recovery of species of fauna have on other communities in the ecosystems they inhabit, demanding the analysis of the actual paradigms and the adaptation strategies that attend their management needs, procuring the ecological integrity conditions of their habitats.

https://doi.org/10.21829/abm129.2022.1954

13.

Caries experience and associated risk factors in Venezuelan 6-12-year-old schoolchildren
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García-Quintana, Alejandra

; Díaz, Stephanie

; Cova, Oriana

; Fernandes, Sara

; Aguirre, Maria Angélica

; Acevedo, Ana María

Brazilian Oral Research

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2022, Volume 36 elocation e026

Resumo: En | Texto: En | PDF: En

Abstract: This research aims to provide updated information on caries experience and associated risk factors in children 6-12 years old. A cross-sectional and descriptive study design was carried out with a non-probabilistic, convenient sample of 209 children male and female. Clinical examinations were performed by calibrated dental students following WHO detection criteria. Caries indices dmft and DMFT were calculated. Caries Risk Assessment data was collected using an adapted CAMBRA instrument; following the International Caries Care guidelines. Descriptive statistics were performed to analyze the results and Chi-square test, Contingency Coefficient (C) and Corrected Typified Residues were calculated to determine the association between variables. 58% of the total population had dental caries lesions in its more severe stages (cavitation) and 42% were apparently healthy (AHS) without any cavitated lesions. The mean dmft index was 1.34 ± 1.93, and the mean DMFT index was 0.63 ± 1.22. Lesion severity remained between 1-2 teeth affected on both dentitions. A statistically significant association (p = 0.035) between the health condition and toothbrushing was stablished with a degree of dependence of C = 0.144. A positive standardized residual of 2.1 was evident for schoolchildren that experience caries lesion that never brush their teeth and AHS that brushed their teeth more than once. No association (p = 0.081) was found between health condition and intake of sugary snacks and beverages. A severe dental caries experience with a statistically significant association between the health condition and toothbrushing with fluoridated toothpaste 1450 ppm > 1 a day and a positive correlation in schoolchildren that experience caries lesion that never brush their teeth.

https://doi.org/10.1590/1807-3107bor-2022.vol36.0026

14.

Evaluation of an educational intervention (edworkcases) involving clinical cases and Nursing students: a cross-sectional observational study
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Guzmán-Almagro, María Isabel

; Oter-Quintana, Cristina

; Martín-Salinas, Carmen Clara

; Cid-Galán, María Luisa

; Carrillo-Camacho, Elena

; Navarta-Sánchez, María Victoria

; Castedo-Martínez, Oscar

; Alcolea-Cosín, María Teresa

; Fonseca, Luciana Mara Monti

; Parro-Moreno, Ana Isabel

Revista Latino-Americana de Enfermagem

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2022, Volume 30 elocation e3723

Resumo: Pt En Es | Texto: Pt En Es | PDF: Pt | PDF: En | PDF: Es

Resumo Objetivo: avaliar o impacto da intervenção educacional (edworkcases) nos resultados da avaliação dos alunos em suas práticas clínicas, suas atitudes em relação aos diagnósticos de Enfermagem e sua satisfação. Método: estudo observacional transversal, realizado com 69 estudantes do terceiro ano de Enfermagem de uma universidade pública de Madri, Espanha. Os dados analisados foram obtidos das notas dos alunos em suas práticas clínicas, bem como, os escores pré- e pós-intervenção na Escala de Posições frente ao Diagnóstico de Enfermagem e uma pesquisa de satisfação. A comparação de médias por participação no projeto (sim/não) foi realizada por meio do teste t de Student. A comparação de médias por professor foi realizada por meio de testes de Kruskal-Wallis. Resultados: taxa de participação: 72,4%; 92% dos participantes eram mulheres; mediana de idade de 21 anos. Foram encontradas diferenças estatisticamente significativas entre participantes e não participantes em termos de pontuação média na Avaliação Geral e na Avaliação do Estudo de Caso, com maiores pontuações encontradas entre o grupo de participantes. A pontuação média das atitudes em relação aos diagnósticos de Enfermagem foi de 99,9 (DP=2,8) antes da intervenção e 111,1 (DP=2,9) após a intervenção [IC 95%: 3,3-19,2]. Conclusão: a utilização de edworkcases como parte do treinamento prático foi considerada satisfatória, permitindo a articulação teoria e prática e melhorando as atitudes dos alunos em relação aos diagnósticos de Enfermagem.

Abstract Objective: to evaluate the impact of the (edworkcases) educational intervention on students’ evaluation outcomes in their clinical practices, their attitudes towards Nursing diagnoses, and their satisfaction. Method: this study used a cross-sectional observational design. The participants were 69 third-year Nursing students from a public university in Madrid, Spain. The data analysed in the study were the grades obtained by students for their clinical practices, as well as pre-post intervention scores on the Positions on Nursing Diagnosis Scale and a satisfaction survey. A means comparison by participation in the project (yes/no) was carried out using Student’s t-test. A means comparison by professor was conducted using Kruskal-Wallis tests. Results: participation rate: 72.4%; 92% of the participants were women; median age = 21 years old. Statistically significant differences were found between participants and non-participants in terms of mean score in the Overall Evaluation and in the Case Study Evaluation, with higher scores found among the group of participants. The mean score for attitudes towards Nursing diagnoses was 99.9 (SD=2.8) before the intervention and 111.1 (SD=2.9) after the intervention [95% CI: 3.3-19.2]. Conclusion: the use of (edworkcases) as part of the practical training was considered satisfactory, enabling theory and practice to be combined and improving students’ attitudes towards Nursing diagnoses.

Resumen Objetivo: evaluar el efecto de la intervención educativa (edworkcases) sobre los resultados de la evaluación de los estudiantes en sus prácticas clínicas, sus actitudes hacia los diagnósticos de Enfermería y su nivel de satisfacción. Método: en este estudio se empleó un diseño transversal y observacional. Los participantes fueron 68 estudiantes de tercer año de la carrera de Enfermería de una universidad pública de Madrid, España. Los datos que se analizaron en el estudio fueron las calificaciones obtenidas por los estudiantes en sus prácticas clínicas, al igual que las puntuaciones antes y después de la intervención en la Escala de Posicionamiento ante el Diagnóstico de Enfermería y en una encuesta de satisfacción. Se utilizó la prueba t de Student para realizar una comparación de valores medios por participación en el proyecto (sí/no). La comparación de valores medios por profesor se llevó a cabo por medio de pruebas Kruskal-Wallis. Resultados: índice de participación: 72,4%; el 92% de los participantes eran mujeres, con una mediana de edad de 21 años. Se encontraron diferencias estadísticamente significativas entre participantes y no participantes en cuanto a la puntuación media en la Evaluación General y en la Evaluación de Estudios de Caso, con puntuaciones más elevadas en el grupo de participantes. Las puntuaciones medias correspondientes a las actitudes con respecto a los diagnósticos de Enfermería fueron 99,9 (SD=2,8) y 111.1 (SD=2.9) antes y después de la intervención, respectivamente [IC 95%: 3,3-19,2]. Conclusión: se consideró satisfactorio utilizar edworkcases como parte te la capacitación práctica, lo que permitió combinar teoría y práctica y mejorar las actitudes de los estudiantes con respecto a los diagnósticos de Enfermería.

https://doi.org/10.1590/1518-8345.6190.3723

15.

Manifestaciones Autoinmunes en pacientes con COVID-19
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Jarolin, Dora Montiel

; Quintana, Auda

; Jarolin, Magalí

; Riveros, César

; Ibáñez, Elvis

; Torres, Estela

; Caballero, Marlene

; Taboada, Verónica

; Nuñez, Pedro

; Ferreira, Leticia

; Morel, Zoilo

Revista Paraguaya de Reumatología

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Dez 2021, Volume 7 Nº 2 Páginas 34 - 40

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Abstract: Introduction: Several autoimmune manifestations concurrent with or following COVID-19 infection have been reported. The purpose of this work is to present a case series of COVID-19 patients with autoimmune or autoinflammatory features. Methods: Case series of adult patients with a history of COVID-19 and autoinmune or autoinflammatory manifestations presenting during or after the acute infection, admitted to the “Hospital Nacional” of Paraguay, between September 2020 and August 2021. Results: We present ten patients with a history of COVID-19 infection and autoimmune manifestations, with an average of 20 days between the onset of COVID-19 symptoms and autoimmune manifestations (range: 8-30 days). 40% of the patients had underlying pathologies, such as arterial hypertension, obesity, chronic kidney disease, diabetes, smoking, and illicit drug use (cocaine). No patient had a history of rheumatic disease. The most frequent autoimmune complication was Guillain-Barré Syndrome (GBS) (40%), followed by vasculitis. SARS-CoV-2 PCR in nasopharyngeal or oropharyngeal swabs was positive in 80% of cases. Antibodies to SARS-CoV-2 were detectable in 4 cases. Cytopenias (severe anemia and thrombocytopenia) were found in patients with Systemic Lupus Erythematosus (SLE), Thrombotic Thrombocytopenic Purpura (TTP), and Immune Thrombocytopenic Purpura (ITP). Two patients had autoantibodies: one patient with SLE (ANA) and one patient with Granulomatosis with Polyangiitis (c-ANCA). Eight patients had favorable outcomes with immunosuppressive treatment (systemic corticosteroids, IVIG, cyclophosphamide, and Mycophenolate mofetil). The remaining two patients died. Conclusion: GBS, cytopenias, and vasculitis were the most frequent autoinmune manifestations associated with SARS-CoV-2 infection. Most patients had a favorable outcome with immunosuppressive treatment.

Resumen: Introducción: Se han reportado varias manifestaciones autoinmunes en pacientes con COVID -19 agudo o posterior al mismo. El objetivo de este trabajo fue presentar una serie de casos de pacientes con COVID-19 y manifestaciones autoinmunes y autoinflamatorias. Método: Serie de casos de pacientes adultos con COVID-19 agudo o antecedente del mismo, y manifestaciones autoinmunes y autoinflamatorias, internados en el Hospital Nacional de Paraguay, durante el periodo comprendido entre septiembre 2020 y agosto 2021. Resultados: Se presentan diez pacientes con COVID-19 o antecedente cercano del mismo, y manifestaciones autoinmunes, con un promedio de 20 días después de iniciados los síntomas de COVID-19 (rango: 8-30 días). El 40% de los pacientes tenían patologías de base, como hipertensión arterial, obesidad, insuficiencia renal, diabetes, tabaquismo, y uso de drogas ilícitas como cocaína. Ningún paciente tenía antecedentes de enfermedad reumática. La complicación autoinmune más frecuente fue Síndrome de Guillain-Barré (SGB) (40%), seguida por vasculitis. La PCR del SARS-CoV-2 en hisopo nasofaríngeo y orofaríngeo fue positiva en el 80% de los casos, con presencia de Anticuerpos para Sars-Cov-2 en 4 casos. Se encontraron datos de citopenias (anemia severa y plaquetopenia) en aquellos pacientes con lupus eritematoso sistémico (LES), púrpura trombocitopénica trombótica (PTT) y púpura trombocitopenica inmune (PTI). En cuanto a la presencia de anticuerpos, solo fueron positivos: ANA en el paciente con LES y ANCA-c en el paciente con Granulomatosis con Poliangeitis. Tras el tratamiento inmunosupresor con corticoides sistémicos, IGIV, o incluso ciclofosfamida y Micofenolato mofetil según el caso, hubo mejoría clínica, excepto en dos pacientes que fallecieron. Conclusión: El SGB, las manifestaciones autoinmunes hematológicas y las vasculitis fueron las manifestaciones más frecuentes, en relación a la infección por Sars-Cov 2. La mayoría de los pacientes presentó una buena evolución con el tratamiento inmunosupresor.

https://doi.org/10.18004/rpr/2021.07.02.34 117 downloads

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