Resumen La Sociedad Argentina de Periodoncia ha formulado un Comentario, analizando los condicionantes del contexto nacional, para determinar si las recomendaciones generadas en la Guía de Práctica Clínica de nivel S3 de la Federación Europea de Periodoncia para el tratamiento de la periodontitis en estadios I-III, podrían ser aplicadas para dar respuesta a la demanda de la población, en lo referido a la salud periodontal.

Abstract The Argentine Society of Periodontics has formulated a Commentary, analyzing the determining factors of the national context, to determine if the recommendations generated in the Level S3 Clinical Practice Guideline of the European Federation of Periodontics for the treatment of periodontitis in stages I-III could be applied to respond to the demand of the population, regarding periodontal health.

RESUMEN Objetivo. Evaluar los cambios en la resistencia a los antibióticos de ocho de las combinaciones de fármacos y agentes patógenos incluidos en la lista prioritaria de la Organización Mundial de la Salud y el consumo de seis antibióticos (ceftriaxona, cefepima, piperacilina/tazobactam, meropenem, ciprofloxacina, vancomicina) antes de la pandemia de COVID-19 (de marzo del 2018 a julio del 2019) y durante la pandemia (de marzo del 2020 a julio del 2021) en 31 hospitales del Valle del Cauca (Colombia). Métodos. En este estudio se analiza el antes y el después empleando datos recopilados de forma rutinaria. Para el consumo de antibióticos, se compararon las dosis diarias definidas (DDD) por 100 días-cama. Resultados. Hubo 23 405 cepas bacterianas aisladas prioritarias con datos sobre la resistencia a los antibióticos. El número total de cepas aisladas aumentó de 9 774 antes de la pandemia a 13 631 durante la pandemia. Si bien la resistencia disminuyó significativamente en las cuatro combinaciones seleccionadas de agentes patógenos y fármacos (Klebsiella pneumoniae, productora de betalactamasa de espectro extendido [BLEE], de 32% a 24%; K. pneumoniae, resistente a los carbapenémicos, de 4% a 2%; Pseudomonas aeruginosa, resistente a los carbapenémicos, de 12% a 8%; Acinetobacter baumannii, resistente a los carbapenémicos, de 23% a 9%), el nivel de resistencia de Enterococcus faecium a la vancomicina aumentó significativamente (de 42% a 57%). No hubo cambios en la resistencia en las tres combinaciones restantes (Staphylococcus aureus, resistente a la meticilina; Escherichia coli, productora de BLEE; E. coli, resistente a los carbapenémicos). El consumo de todos los antibióticos aumentó. Sin embargo, el consumo de meropenem disminuyó en los entornos de las unidades de cuidados intensivos (de 8,2 a 7,1 DDD por 100 días-cama). Conclusiones. Aunque el consumo de antibióticos aumentó, se observó una disminución en la resistencia a los antibióticos de cuatro combinaciones de agentes patógenos y medicamentos durante la pandemia, que posiblemente se debió a un aumento en las infecciones adquiridas en la comunidad. Es necesario vigilar el aumento de la resistencia de E. faecium a la vancomicina. Los resultados de este estudio son esenciales para que sirvan de orientación en los programas de optimización del uso de los antibióticos en los entornos hospitalarios de Colombia y en contextos similares en otros lugares.

RESUMO Objetivo. Avaliar as mudanças na resistência a antibióticos em oito das combinações microrganismo/antimicrobiano prioritárias da Organização Mundial da Saúde e o consumo de seis antibióticos (ceftriaxona, cefepima, piperacilina/tazobactam, meropeném, ciprofloxacino, vancomicina) antes (março de 2018 a julho de 2019) e durante (março de 2020 a julho de 2021) a pandemia de COVID-19 em 31 hospitais em Valle del Cauca, Colômbia. Métodos. Este foi um estudo antes/depois utilizando dados coletados rotineiramente. Para avaliar o consumo de antibióticos, foram comparadas doses diárias definidas (DDD) por 100 leitos-dias. Resultados. Havia dados sobre resistência a antibióticos para 23.405 isolados bacterianos prioritários. O número total de isolados aumentou de 9.774 para 13.631 antes e durante a pandemia, respectivamente. Embora a resistência tenha diminuído significativamente para quatro das combinações microrganismo/antimicrobiano selecionadas (Klebsiella pneumoniae, produtora de betalactamase de espectro estendido [ESBL], 32% a 24%; K. pneumoniae, resistente a carbapenêmicos, 4% a 2%; Pseudomonas aeruginosa, resistente a carbapenêmicos, 12% a 8%; Acinetobacter baumannii, resistente a carbapenêmicos, 23% a 9%), o nível de resistência de Enterococcus faecium a vancomicina aumentou significativamente (42% a 57%). Não houve mudança na resistência para as três combinações restantes (Staphylococcus aureus, resistente a meticilina; Escherichia coli, produtora de ESBL; E. coli, resistente a carbapenêmicos). O consumo de todos os antibióticos aumentou. Entretanto, o consumo de meropeném nas unidades de terapia intensiva diminuiu (de 8,2 para 7,1 DDD por 100 leitos-dias). Conclusões. Embora o consumo de antibióticos tenha aumentado, observou-se uma diminuição na resistência a antibióticos de quatro combinações microrganismo/antimicrobiano durante a pandemia. Isso ocorreu possivelmente devido a um aumento nas infecções adquiridas na comunidade. O aumento da resistência de E. faecium à vancomicina deve ser monitorado. Os achados deste estudo são essenciais para guiar os programas de gerenciamento de antimicrobianos em ambientes hospitalares da Colômbia e em outros contextos similares.

ABSTRACT Objective. To assess changes in antibiotic resistance of eight of the World Health Organization priority bug-drug combinations and consumption of six antibiotics (ceftriaxone, cefepime, piperacillin/tazobactam, meropenem, ciprofloxacin, vancomycin) before (March 2018 to July 2019) and during (March 2020 to July 2021) the COVID-19 pandemic in 31 hospitals in Valle del Cauca, Colombia. Methods. This was a before/after study using routinely collected data. For antibiotic consumption, daily defined doses (DDD) per 100 bed-days were compared. Results. There were 23 405 priority bacterial isolates with data on antibiotic resistance. The total number of isolates increased from 9 774 to 13 631 in the periods before and during the pandemic, respectively. While resistance significantly decreased for four selected bug-drug combinations (Klebsiella pneumoniae, extended spectrum beta lactamase [ESBL]-producing, 32% to 24%; K. pneumoniae, carbapenem-resistant, 4% to 2%; Pseudomonas aeruginosa, carbapenem-resistant, 12% to 8%; Acinetobacter baumannii, carbapenem-resistant, 23% to 9%), the level of resistance for Enterococcus faecium to vancomycin significantly increased (42% to 57%). There was no change in resistance for the remaining three combinations (Staphylococcus aureus, methicillin-resistant; Escherichia coli, ESBL-producing; E. coli, carbapenem-resistant). Consumption of all antibiotics increased. However, meropenem consumption decreased in intensive care unit settings (8.2 to 7.1 DDD per 100 bed-days). Conclusions. While the consumption of antibiotics increased, a decrease in antibiotic resistance of four bug-drug combinations was observed during the pandemic. This was possibly due to an increase in community-acquired infections. Increasing resistance of E. faecium to vancomycin must be monitored. The findings of this study are essential to inform stewardship programs in hospital settings of Colombia and similar contexts elsewhere.

Resumen Antecedentes: Los déficits en el procesamiento de la información, la atención sostenida y la cognición social tienen implicaciones importantes para el funcionamiento diario de las personas con esquizofrenia. El presente estudio analizó la relación entre velocidad de procesamiento, atención sostenida, cognición social y funcionamiento en personas clínicamente estables con esquizofrenia. Método: Noventa personas con esquizofrenia y 100 controles sanos completaron una batería de pruebas para evaluar síntomas clínicos, velocidad de procesamiento, atención sostenida, cognición social y funcionamiento. Se utilizaron GLMM y SEM para evaluar las relaciones entre variables. Resultados: Las personas con esquizofrenia tuvieron un peor rendimiento en todos los resultados cognitivos. La velocidad de procesamiento y la atención sostenida, juntas en una variable latente, tuvieron un fuerte efecto sobre el funcionamiento (Beta = 0,32; p < 0,05). La cognición social también tuvo un fuerte efecto sobre el funcionamiento (Beta = 0,29; p < 0,001) en el modelo de mediación, que mostró mejores índices de ajuste que el modelo que incluía solo neurocognición (e.g. RMSEAbasic = 0.131 y RMSEAmediator = 0.054). Conclusiones: El efecto mediador de la cognición social sobre la relación entre la velocidad de procesamiento, la atención sostenida y el funcionamiento sugiere la importancia de incluir ambos dominios junto con la cognición social como objetivos de tratamiento en las intervenciones de rehabilitación.

Abstract Background: Deficits in information processing, sustained attention and social cognition have important implications for the daily functioning of people with schizophrenia. The present study analyzed the relationship between processing speed, sustained attention, social cognition, and functioning in clinically stable people with schizophrenia. Method: Ninety people with schizophrenia and 100 healthy controls completed a battery of measures to assess clinical symptoms, processing speed, sustained attention, social cognition, and functioning. GLMMs and SEM were used to assess the relationships between these variables. Results: People with schizophrenia had impaired performance in all cognitive outcomes compared to healthy controls. Processing speed and sustained attention, together in a latent variable, had a strong effect on functioning (Beta = 0.32; p < .05). However, social cognition had also a strong effect on functioning (Beta = 0.29; p <.001) in the mediation model, which exhibited better indices of fit than the model including neurocognition alone (e.g. RMSEAbasic = 0.131 and RMSEAmediator = 0.054). Conclusions: The mediating effect of social cognition on the relationship between processing speed, sustained attention, and functioning in people with schizophrenia suggests the importance of including both domains of neurocognition along with social cognition as treatment targets in rehabilitation interventions to optimize improvements in functioning in schizophrenia.

This paper aims to explore the production of porous Nb2O5 pellets by pressing and adding anaerobic biomass (sludge) in order to evaluate the microstructure porosity. The thermal treatment temperature of the pellets varied between 300 ºC and 900 ºC. Their structural, morphological, and physical properties were measured, and the adsorption potential of Mn2+ and their reuse were evaluated. All samples had a monoclinic phase. Density average values of samples pressed using sludge ranged between 2.45 and 2.52 g.cm-3, while the one obtained without sludge pressing achieved higher values of around 2.72 g.cm-3. All samples presented high porosity values after the heat treatment (above 40%), which confirms the efficiency of sludge as a means to enhance porosity. These pellets were used for Mn2+ ions adsorption in aqueous medium. The Langmuir isotherm model was the one that achieved the best goodness-of-fit. In kinetic studies, the adsorption reaction was in accordance with second-order kinetics. Adsorbents in the form of pellets are environmentally friendly on account of their significant reuse and recycling potential. However, the particulate matter might become an environmental liability and incur high treatment costs. The samples proved to be reusable, promoting the adsorption of 67% of the Mn2+ after the fifth reuse cycle.

Abstract The aim of this study was to investigate uterine involution using ultrasonography techniques during postpartum. Postpartum ultrasonography evaluation (B-mode, color Doppler and Acoustic Radiation Force Impulse elastography) of the uterus was performed by transabdominal approach at immediate after birth and sequentially every 48 hours, during 30 days. The uterine echotexture did not present significant variations (P >0.05) being homogeneous in most evaluations; echogenicity of the uterus increased along the evaluation period (P =0.0452). Progressive and remarkable decrease of the total uterine diameter (UD) were observed (P <0.0001), especially during the first days postpartum. The thickness of uterine wall gradually decreased, as well the endometrial, myometrium and lumen diameters (P <0.0001). Uterine blood flow was assessed by Doppler and decreased during postpartum period, being significantly lower (P=0.0225) on the 30th day of postpartum. Uterine parenchyma presented as homogeneous dark areas (not deformable) on qualitative ultrasound elastography and the means shear velocity values of the uterine wall on quantitative elastography did not differ. This is the first study that evaluate the stiffness of uterine wall in healthy ewes, providing baseline data about quantitative and qualitative stiffness of the normal uterus, and it may be a useful tool for early diagnosis of uterine alterations during the postpartum period, using the reference parameter established for the assessment of uterine integrity during postpartum period.

Abstract Objective To adapt and validate The Humpty Dumpty Scale for Brazilian culture. Methods Methodological study that followed the steps of translation, synthesis, back-translation, evaluation by specialists, pre-test and evaluation by the author of the original instrument for the cross-cultural adaptation. A total of 103 children/adolescents admitted to a public hospital in the countryside of the state of Sao Paulo were selected. We used a characterization form, The Humpty Dumpty Scale and the Pediatric Patient Classification Instrument, which was used to assess construct validity, with Spearman’s correlation coefficient. Interobserver reliability was assessed using the Intraclass Correlation Coefficient and the Kappa coefficient. Results The committee of 12 experts evaluated the equivalence, clarity and relevance of the items and after three rounds, the percentage of 100% agreement was reached. The reformulations made the items more understandable and, after the author’s evaluation, the final version of the instrument was obtained. Positive and significant correlations were found between The Humpty Dumpty Scale and the Patient (r=0.5184; p<0.0001) and Therapeutic Procedures (r=0.2143; p<0.0332) domains of the patient classification instrument. With the Family domain (r=0.0676; p=0.5060), no significant relationships were achieved. Satisfactory evidence of reliability (Intraclass Correlation Coefficient of 0.93 and Kappa coefficient of 0.80) was observed. Conclusion The Humpty Dumpty Scale was cross-culturally adapted and is now called (in Portuguese) the Ferramenta de Avaliação de Risco de Quedas - Escala Humpty Dumpty. It demonstrated satisfactory evidence of validity and reliability to assess the risk of falling in children and adolescents in the Brazilian context.

Resumen Objetivo Adaptar y validar The Humpty Dumpty Falls Scale para la cultura brasileña. Métodos Estudio metodológico, en el que se realizaron las siguientes etapas para la adaptación transcultural: traducción, síntesis, retrotraducción, evaluación por especialistas, prueba piloto y evaluación por la autora del instrumento original. Se seleccionaron 103 infantes/adolescentes internados en un hospital público del interior del estado de São Paulo. Se utilizó la ficha de caracterización, The Humpty Dumpty Falls Scale y el Instrumento de Clasificación de Pacientes Pediátricos, que se usó para evaluar la validad del constructo, con el coeficiente de correlación de Spearman. La fiabilidad interobservador fue evaluada por el coeficiente de correlación intraclase y por el coeficiente Kappa. Resultados El comité de 12 especialistas evaluó las equivalencias, la claridad y la relevancia de los ítems y, después de tres rondas, se llegó al 100 % de concordancia. Con las reformulaciones los ítems quedaron más comprensibles y, luego de la evaluación de la autora, se obtuvo la versión final de instrumento. Se observaron correlaciones positivas y significativas entre la Escala Humpty Dumpty y los dominios Paciente (r=0,5184; p<0,0001) y Procedimientos terapéuticos (r=0,2143; p<0,0332) del instrumento de clasificación de pacientes. En el dominio Familia (r=0,0676; p=0,5060) no se encontraron relaciones significativas. Se observaron evidencias satisfactorias de fiabilidad (coeficiente de correlación intraclase de 0,93 y coeficiente Kappa de 0,80). Conclusión The Humpty Dumpty Falls Scale fue adaptada transculturalmente y se la denominó Herramienta de Evaluación de Riesgo de Caída – Escala Humpty Dumpty. Demostró evidencias satisfactorias de validez y de fiabilidad para evaluar el riesgo de caída en infantes y adolescentes, en el contexto brasileño.

Resumo Objetivo Adaptar e validar a The Humpty Dumpty Falls Scale para a cultura brasileira. Métodos Estudo metodológico, que seguiu, para a adaptação transcultural, os estágios de tradução, síntese, retrotradução, avaliação por especialistas, pré-teste e avaliação pela autora do instrumento original. Foram selecionadas 103 crianças/adolescentes internados em um hospital público do interior do estado de São Paulo. Foram utilizados ficha de caracterização, The Humpty Dumpty Falls Scale e o Instrumento de Classificação de Pacientes Pediátricos, o qual foi utilizado para avaliar a validade de construto, com o coeficiente de correlação de Spearman. A confiabilidade interobservador foi avaliada pelo Coeficiente de Correlação Intraclasse e pelo coeficiente Kappa. Resultados O comitê de 12 especialistas avaliou as equivalências, a clareza e a relevância dos itens e, após três rodadas, foi alcançado o percentual de 100% de concordância. As reformulações tornaram os itens mais compreensíveis e, após avaliação da autora, foi obtida a versão final do instrumento. Correlações positivas e significantes foram encontradas entre a Escala Humpty Dumpty e os domínios Paciente (r=0,5184; p<0,0001) e Procedimentos terapêuticos (r=0,2143; p<0,0332) do instrumento de classificação de pacientes. Com o domínio Família (r=0,0676; p=0,5060), não foram alcançadas relações significantes. Evidências satisfatórias de confiabilidade (Coeficiente de Correlação Intraclasse de 0,93 e coeficiente Kappa de 0,80) foram observadas. Conclusão The Humpty Dumpty Falls Scale foi adaptada transculturalmente, sendo denominada Ferramenta de Avaliação de Risco de Queda – Escala Humpty Dumpty. Demonstrou evidências satisfatórias de validade e confiabilidade para avaliar o risco de queda em crianças e adolescentes, no cenário brasileiro.

Resumen: Objetivo: Evaluar el efecto de la ingesta de un extracto fibroso de tallos de Stevia rebaudiana Bertoni sobre los niveles de glicemia postprandial en sujetos sanos. Materiales y Métodos: Investigación transversal, experimental, realizada con condiciones éticas de consentimiento y confiabilidad, en el laboratorio de Evaluación del Estado Nutricional de la Universidad Autónoma del Carmen. Para la valoración clínica y antropométrica de los participantes se utilizó una historia clínica y escáner de composición corporal, respectivamente. La población de estudio fue conformada por 16 mujeres sanas con índices de masa corporal normales (20-25 kg/m2). Instrumentos: a) Expediente clínico-dietético y b) Datos bioquímicos obtenidos de la toma sanguínea obtenidos en los diferentes tiempos. Se realizó el análisis de los datos con estadística descriptiva. Resultados: Los resultados mostrados en el grupo de participantes en este estudio, se observó que el valor medio del área bajo la curva (AUC) de la glucosa fue de 709.18 ± 23.60, mientras que el del extracto fibroso de tallos de stevia fue de 556.59 ± 50.47. Conclusiones: Los tallos de Stevia rebaudiana Bertoni. por su contenido en fibra dietética, pueden ser una alternativa para el uso y revalorización de residuos sostenidos en la economía circular en el desarrollo de productos funcionales, otorgándole un valor agregado que contribuye de alguna manera a reducir el sobrepeso y la obesidad, con efecto hipoglucemiante en pacientes con diabetes mellitus (DM) tipo 2.

Abstract: Objective: To evaluate the effect of the ingestion of a fibrous extract of Stevia rebaudiana Bertoni stems on postprandial glycemia levels in healthy subjects. Materials and Methods: Cross-sectional, experimental research, carried out with ethical conditions of consent and reliability, in the Laboratory for the Evaluation of Nutritional Status of the Autonomous University of Carmen. For the clinical and anthropometric assessment of the participants, a medical history and body composition scan were used, respectively. The study population consisted of 16 healthy women with normal body mass indices (20-25 kg/m2). Instruments: a) Clinical-dietetic record and b) Biochemical data obtained from blood sampling obtained at different times. The data analysis was carried out with descriptive statistics. Results: The results shown in the group of participants in this study, it was observed that the mean value of the area under the curve (AUC) of glucose was 709.18 ± 23.60, while that of the fibrous extract of stevia stems was 556.59 ± 50.47. Conclusions: Stevia rebaudiana stems, due to their dietary fiber content, can be an alternative for the use and revaluation of sustained waste in the circular economy in the development of functional products, giving it an added value that contributes in some way to reducing overweight and obesity, with a hypoglycemic effect in patients with type 2 diabetes mellitus (DM).

Resumo A surdez é compreendida a partir de dois discursos - o clínico-terapêutico e o socioantropológico. O artigo objetiva realizar uma análise genealógica da surdez, ou seja, das práticas de saber e poder, na política de saúde brasileira. É uma pesquisa qualitativa, documental, que se baseia em pressupostos teóricos de Michel Foucault. Foram selecionados 13 documentos normativos e 10 informativos, assim como realizadas oito entrevistas semiestruturadas, com amostra não probabilística, utilizando-se a técnica bola de neve. A análise mostrou que as políticas de saúde voltadas às pessoas com deficiência auditiva são efeito das relações de poder e saber existentes no campo da surdez, no qual o discurso médico-patológico, que concebe a surdez como uma deficiência a ser corrigida, é tido como o discurso verdadeiro. O discurso socioantropológico, que reconhece o surdo pelo olhar da diferença e pelo uso da língua de sinais, é um discurso sujeitado, que não tem encontrado espaços na política de saúde. Foram colocados em evidência os contrassensos entre as conquistas ligadas ao acesso às tecnologias e as proposições do setor saúde, cuja política direciona suas ações exclusivamente para o alcance de uma norma ouvinte, desconsiderando a multiplicidade dos sujeitos surdos.

Abstract Deafness can be understood from the clinical-therapeutic and the socio-anthropological perspectives. The study aims to perform a genealogical analysis of deafness; that is, an analysis of the practices of knowledge and power in Brazilian health policy. This is a qualitative, documentary study based on the theoretical assumptions of Foucault. Researchers selected 23 documents and conducted eight semi-structured interviews, which were also considered documents, with a non-probabilistic sample using the snowball technique. The genealogical analysis showed that health policies aimed at people with hearing impairment result from the power and knowledge relationships in the field of deafness, in which the medical-pathological discourse is seen as the real perspective, understanding deafness as a disability to be corrected. The socio-anthropological approach, which recognizes the deaf through the perspective of difference and the use of sign language, is a subject discourse that has not found space in health policy. The study highlighted the contradictions between the achievements related to the access to technologies and the propositions of the health sector, whose policy directs its actions exclusively to reach a listening standard, disregarding the multiplicity of deaf individuals.

Resumo A surdez é compreendida a partir de dois discursos - o clínico-terapêutico e o socioantropológico. O artigo objetiva realizar uma análise genealógica da surdez, ou seja, das práticas de saber e poder, na política de saúde brasileira. É uma pesquisa qualitativa, documental, que se baseia em pressupostos teóricos de Michel Foucault. Foram selecionados 13 documentos normativos e 10 informativos, assim como realizadas oito entrevistas semiestruturadas, com amostra não probabilística, utilizando-se a técnica bola de neve. A análise mostrou que as políticas de saúde voltadas às pessoas com deficiência auditiva são efeito das relações de poder e saber existentes no campo da surdez, no qual o discurso médico-patológico, que concebe a surdez como uma deficiência a ser corrigida, é tido como o discurso verdadeiro. O discurso socioantropológico, que reconhece o surdo pelo olhar da diferença e pelo uso da língua de sinais, é um discurso sujeitado, que não tem encontrado espaços na política de saúde. Foram colocados em evidência os contrassensos entre as conquistas ligadas ao acesso às tecnologias e as proposições do setor saúde, cuja política direciona suas ações exclusivamente para o alcance de uma norma ouvinte, desconsiderando a multiplicidade dos sujeitos surdos.

Abstract Deafness can be understood from the clinical-therapeutic and the socio-anthropological perspectives. The study aims to perform a genealogical analysis of deafness; that is, an analysis of the practices of knowledge and power in Brazilian health policy. This is a qualitative, documentary study based on the theoretical assumptions of Foucault. Researchers selected 23 documents and conducted eight semi-structured interviews, which were also considered documents, with a non-probabilistic sample using the snowball technique. The genealogical analysis showed that health policies aimed at people with hearing impairment result from the power and knowledge relationships in the field of deafness, in which the medical-pathological discourse is seen as the real perspective, understanding deafness as a disability to be corrected. The socio-anthropological approach, which recognizes the deaf through the perspective of difference and the use of sign language, is a subject discourse that has not found space in health policy. The study highlighted the contradictions between the achievements related to the access to technologies and the propositions of the health sector, whose policy directs its actions exclusively to reach a listening standard, disregarding the multiplicity of deaf individuals.

ABSTRACT BACKGROUND: The intensity of the thromboprophylaxis needed as a potential factor for preventing inpatient mortality due to coronavirus disease-19 (COVID-19) remains unclear. OBJECTIVE: To explore the association between anticoagulation intensity and COVID-19 survival. DESIGN AND SETTING: Retrospective observational study in a tertiary-level hospital in Spain. METHODS: Low-molecular-weight heparin (LMWH) status was ascertained based on prescription at admission. To control for immortal time bias, anticoagulant use was analyzed as a time-dependent variable. RESULTS: 690 patients were included (median age, 72 years). LMWH was administered to 615 patients, starting from hospital admission (89.1%). 410 (66.7%) received prophylactic-dose LMWH; 120 (19.5%), therapeutic-dose LMWH; and another 85 (13.8%) who presented respiratory failure, high D-dimer levels (> 3 mg/l) and non-worsening of inflammation markers received prophylaxis of intermediate-dose LMWH. The overall inpatient-mortality rate was 38.5%. The anticoagulant nonuser group presented higher mortality risk than each of the following groups: any LMWH users (HR 2.1; 95% CI: 1.40-3.15); the prophylactic-dose heparin group (HR 2.39; 95% CI, 1.57-3.64); and the users of heparin dose according to biomarkers (HR 6.52; 95% CI, 2.95-14.41). 3.4% of the patients experienced major hemorrhage. 2.8% of the patients developed an episode of thromboembolism. CONCLUSIONS: This observational study showed that LMWH administered at the time of admission was associated with lower mortality among unselected adult COVID-19 inpatients. The magnitude of the benefit may have been greatest for the intermediate-dose subgroup. Randomized controlled trials to assess the benefit of heparin within different therapeutic regimes for COVID-19 patients are required.

Resumen El exantema intertriginoso y flexural simétrico por fármacos (SDRIFE) es una toxicodermia que se presenta con exantema limitado a pliegues, sobretodo en región glútea y genital, y representa una reacción a la exposición sistémica a un medicamento sin sensibilización previa. Presentamos el caso de una paciente mujer adulta previamente sana, que consulta por este tipo de reacción medicamentosa asociada al uso de piroxicam intramuscular, manejada de forma exitosa con antihistamínicos, esteroides tópicos y sistémicos.

Abstract Symmetrical drug related intertriginous and flexural exanthema is a cutaneous drug eruption that is characterized by exanthema limited to creases, buttocks and the upper inner thighs. It represents a reaction to systemic exposure to a drug, without previous sensitization. We present the case of a woman, previously healthy, who consulted due to this drug reaction after being injected with piroxicam, who was successfully treated with antihistamines, topical and systemic corticosteroids.

Abstract Innovation involves both an activity and its outcome (OCDE & Eurostat, 2018) and it is related to innovation capabilities, considered as a special asset for the development and commercialisation of new technologies, the introduction of new products, and the adoption of new processes, especially in contexts of rapid technological change. Innovation capabilities, in turn, are decisive not only in terms of innovation outcomes, but also of competitiveness. This article aims to determine the innovation capabilities variables that are studied in Latin America, compared to the innovation capabilities variables that are analysed in the 2019 Global Competitiveness Report by the World Economic Forum or “WEF” (Schwab, 2019). The research is developed through a systematic review using the PRISMA methodology. Results are obtained for the countries that study innovation capabilities, the variables that are analysed in the studies on innovation capabilities in Latin America, in comparison with the variables analysed by the WEF. The results show a partial articulation between the variables analysed in the studies on innovation capabilities in Latin America and the variables that make up the WEF.

Resumen La innovación involucra tanto una actividad como el resultado de esta (OCDE y Eurostat, 2018) y está relacionada con las capacidades de innovación, consideradas como un activo especial para el desarrollo y comercialización de nuevas tecnologías, la introducción de nuevos productos y la adopción de nuevos procesos, especialmente en contextos de rápido cambio tecnológico. Las capacidades de innovación a su vez son determinantes no solo en los resultados de innovación, sino también en la competitividad. Este artículo tiene como objetivo determinar las variables de capacidades de innovación estudiadas en América Latina, en comparación con las variables de capacidades de innovación que son analizadas en el Informe de Competitividad Mundial- WEF (Schwab, 2019). La investigación se desarrolla mediante una revisión sistemática usando la metodología PRISMA. Se obtienen resultados sobre los países que estudian capacidades de innovación y las variables que se analizan en los estudios sobre capacidades de innovación en América Latina, y se comparan con las variables que analiza WEF. Los resultados evidencian que hay una articulación parcial entre las variables analizadas en los estudios sobre capacidades de innovación en América Latina y las variables que conforman el WEF.

RESUMO Objetivo O objetivo deste estudo foi avaliar o efeito do sistema CROS em fenômenos como efeito sombra da cabeça em usuários de implante coclear unilateral. Método Estudo transversal prospectivo, aprovado pelo conselho de ética sob protocolo 2.128.869. Onze adultos com surdez de instalação pós-lingual usuários de IC Advanced Bionics unilateral foram selecionados. O reconhecimento de fala foi avaliado com palavras gravadas apresentadas a 65dBA a 0o azimute e a (90o no lado contralateral ao IC), com ruído a 55dBA, usando somente o IC e IC+sistema CROS. Os resultados foram analisados usando teste t pareado com alfa de 0,05. Resultados Os escores médios de reconhecimento de fala foram significativamente melhores com IC + CROS em relação à condição apenas IC (p <0,05, p <0,005 e p <0,005 respectivamente). Na apresentação à frente não foram encontradas diferenças significantes. Conclusão Os usuários de IC unilateral sem resíduo útil para uso de prótese auditiva ou impossibilitados de submeter-se à cirurgia bilateral podem se beneficiar do dispositivo CROS para o reconhecimento de fala, sobretudo quando a fala for apresentada ao lado contralateral ao IC.

ABSTRACT Purpose The aim of this study was to evaluate the contribution of the CROS system on the head shadow effect in unilateral implant users. Methods Prospective cross-sectional study, approved by the ethics committee under protocol 2.128.869. Eleven adults with post-lingual deafness users of unilateral Advanced Bionics CI were selected. Speech recognition was evaluated with recorded words presented at 65dBA at 0o azimuth and at 90o on the side contralateral to the CI, with noise at 55dBA, using CI alone and CI + CROS system. The results were analyzed using paired t-test with a 0.05 alpha. Results The mean speech recognition scores were significantly better with CI + CROS in relation to the condition of CI alone (p <0.05, p <0.005 and p <0.005 respectively). In the presentation at 0o azimuth, no significant differences were found. Conclusion Users of unilateral CI without useful residual hearing for the use of hearing aids or unable to undergo bilateral surgery can benefit from the CROS device for speech recognition, especially when the speech is presented on the side contralateral to the CI.

RESUMO: Objetivou-se avaliar níveis de inclusão da casca de banana sobre as variáveis fisiológicas de vacas F1 Holandesas × Zebu em lactação. Foram utilizadas 10 vacas distribuídas em dois quadrados latinos 5×5. Sendo cinco dietas experimentais: silagem de sorgo (grupo controle); e a inserção de 15, 30, 45 e 60% da casca de banana em substituição a silagem de sorgo. O experimento teve duração de 80 dias. Mensuraram-se as variáveis ambientais e fisiológicas dos animais. O índice de temperatura de globo negro e umidade encontrada no turno matutino apresentou uma situação de alerta e no turno vespertino uma situação perigosa. A frequência respiratória foi influenciada pelos níveis de inclusão de casca de banana no turno vespertino. A temperatura retal não foi influenciada pelos níveis de inclusão de casca de banana na dieta. Sob as condições ambientais estudadas, o nível de até 60% de casca de banana, em substituição a silagem de sorgo, não alterou as variáveis fisiológicas de termorregulação em vacas F1 Holandesas × Zebu.

ABSTRACT: The objective was to evaluate the effects of different levels of banana peel inclusion on the physiological variables of lactating F1 Holstein × Zebu cows. Ten cows distributed in two 5 × 5 Latin squares were used. Five experimental diets were tested: sorghum silage (control group); and the addition of 15%, 30%, 45%, and 60% of banana peel to replace sorghum silage. The experiment lasted 80 days. The environmental and physiological variables of the animals were measured. The Black Globe-Humidity Index presented an alert situation in the morning shift and a dangerous situation in the afternoon shift. The respiratory rate was not influenced by the levels of banana peel inclusion (P > 0.05) in the morning shift. However, it was influenced (P < 0.05) in the afternoon shift. The levels of banana peel inclusion in the diet did not affect the rectal temperature. Under the study environmental conditions, the level of up to 60% of banana peel replacing sorghum silage did not alter the physiological variables of thermoregulation in F1 Holstein × Zebu cows.

Abstract The objective was to evaluate the blood flow of the uterine artery (UA) and umbilical artery (UMB) in the physiological pregnancy of goats by means of Doppler throughout the gestational period. Twenty-five Saanen goats weighing 55 ± 10 kg and aged between 2 and 5 were evaluated weekly, from the 21st until the 143rd day of gestation, and daily from that period until parturition. Values for peak systolic velocity (PSV), end diastolic velocity (EDV) and resistance (RI) and pulsatility (PI) indices of the uterine and umbilical arteries were determined. The values obtained were correlated with gestational age by Spearman's test, tested for adjustment to regression models and compared with the number of fetuses by ANOVA. The umbilical cord was first visualized at 28 days. Of the variables evaluated, RIUMB and PIUMB correlated with gestational age (p<0.001; and 0.046; respectively) and RIUMB had a low negative correlation with the number of fetuses per pregnancy (p = 0.003; r- Spearman = - 0.218). PSVUMB and EDVUMB values did not correlate with gestational age (p=0.737 and 0.768, respectively), but there was a decrease in the mean values throughout pregnancy (PSVUMB= 0.07; 0.31 and EDVUMB= 0.01; 0.06) as well as the change in the flow pattern of the spectral trace. The mean values of the uterine artery dopplervelocimetric variables PSVUT, EDVUT, PIUT and RIUT did not correlate with gestational age (p= 0.324; 0.372, 0.143; 0.13; respectively). It is expected that the results obtained will contribute to a broader understanding of the hemodynamic changes resulting from pregnancy in goats.