RESUMO

Resumo Objetivo Identificar, analisar e caracterizar as ocorrências cometidas por profissionais de enfermagem acolhidas pela Comissão de Ética de Enfermagem. Métodos Revisão integrativa conduzida conforme a metodologia definida pelo Manual for Evidence Synthesis do Joanna Briggs Institute e registrada na plataforma Open Science Framework. Bases de dados pesquisadas: Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medical Literature Analysis and Retrieval System on-line (MEDLINE via PubMed®), Web of Science, SciVerse Scopus (SCOPUS), Literatura LatinoAmericana e do Caribe em Ciências da Saúde (LILACS) e Base de dados de Enfermagem (BDENF) via Biblioteca Virtual em Saúde (BVS). Incluídos estudos publicados integralmente em português, inglês ou espanhol de 2018 a 2023. Gerenciamento dos dados realizado com o Rayyan®. Resultados Verificado um crescente interesse pelas infrações em denúncias imputadas a profissionais de Enfermagem acolhidas pela Comissão de Ética de Enfermagem no contexto profissional da área da saúde, expressas pelas publicações predominantes nos últimos cinco anos. Conclusão Profissionais de nível médio foram os mais denunciados, com maior participação de Auxiliares de Enfermagem. Negligência e Exercício Ilegal da Profissão foram os tipos penais de infração ética com maior incidência. As categorias dos denunciantes de infração ética foram as Comissões de Ética de Enfermagem, seguidas pelos familiares das vítimas, Conselhos Regionais de Enfermagem, vítimas e enfermeiros como denunciantes principais. Advertência Verbal foi o tipo de penalidade aplicada com maior prevalência.

Resumen Objetivo Identificar, analizar y caracterizar infracciones cometidas por profesionales de enfermería admitidas por la Comisión de Ética de Enfermería. Métodos Revisión integradora llevada a cabo de acuerdo con la metodología establecida por el Manual for Evidence Synthesis del Joanna Briggs Institute y registrada en la plataforma Open Science Framework. Búsqueda en las siguientes bases de datos: Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medical Literature Analysis and Retrieval System on-line (MEDLINE vía PubMed®), Web of Science, SciVerse Scopus (SCOPUS), Literatura Latinoamericana y del Caribe en Ciencias de la Salud (LILACS) y Base de Datos de Enfermería (BDENF) a través de la Biblioteca Virtual en Salud (BVS). Se incluyeron estudios publicados con texto completo en portugués, inglés o español de 2018 a 2023. La gestión de los datos se realizó con Rayyan®.. Resultados Se verificó un creciente interés por las infracciones en denuncias imputadas a profesionales de enfermería admitidas por la Comisión de Ética de Enfermería en el contexto profesional del área de la salud, demostrado mediante las publicaciones predominantes en los últimos cinco años. Conclusión Los profesionales de nivel medio fueron los más denunciados, con una mayor participación de auxiliares de enfermería. Los tipos penales de infracción ética con mayor incidencia fueron negligencia y ejercicio ilegal de la profesión. Las categorías de los denunciantes de infracciones éticas fueron las Comisiones de Ética de Enfermería, seguidas de los familiares de las víctimas, Consejos Regionales de Enfermería, víctimas y enfermeros como denunciantes principales. La advertencia verbal fue el tipo de penalidad aplicada con mayor prevalencia.

Abstract Objective To identify, analyze, and characterize the incidents committed by nursing professionals received by the Nursing Ethics Committee. Methods Integrative review conducted according to the methodology defined by the Manual for Evidence Synthesis from the Joanna Briggs Institute and registered on the Open Science Framework platform. Databases searched: Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medical Literature Analysis and Retrieval System Online (MEDLINE via PubMed®), Web of Science, SciVerse Scopus (SCOPUS), Latin American and Caribbean Literature in Health Sciences (LILACS) and Nursing Database (BDENF) via Virtual Health Library (VHL). Studies entirely published in Portuguese, English, or Spanish (2018-2023) were included. Data management was carried out with Rayyan®. Results A growing interest in infractions in complaints attributed to nursing professionals, which were accepted by the Nursing Ethics Committee in the professional context of the health area and expressed by predominant publications in the last five years, was verified. Conclusion Mid-level professionals were the most reported, with a greater participation of Nursing Assistants. Negligence and Illegal Exercise of Profession were the criminal types of ethical infractions with the highest incidence. Nursing Ethics Committees, followed by victims' families, Regional Nursing Councils, victims, and nurses were the main categories of complainants of ethical violations. Verbal Warning was the most prevalent type of penalty applied.

RESUMO

Introduction: Student assistance policies in higher education, in their various modalities, seek to reduce the dropout of a new profile of students, non-traditional, with socioeconomic weaknesses, promoting quality of life (QoL) and mental health during the university journey. In this context, the Student Social Support Center (C.A.S.A) promotes assistance to students who need personal and/or economic support. Objectives: To evaluate the QoL and the presence of minor mental disorders (MMD) in students from the 1st to the 4th year of medicine at a public college in Brazil, comparing C.A.S.A beneficiaries and non-beneficiaries. Materials and methods: Cross-sectional study with 283 students. SRQ-20 and WHOQOL-BREF questionnaires were used, in addition to a questionnaire addressing sociodemographic data. Results: The general average of QoL was regular in the four evaluated domains (physical, psychological, social relationships, environment) and 55.5% of the students have evidence of MMD, in which the QoL scores are lower in all domains. The environment domain, which discusses socioeconomic conditions, has the worst score among C.A.S.A beneficiaries and the best among C.A.S.A non-beneficiaries. Discussion: The data corroborate the fragile situation of mental health and QoL of medical students. The student assistance modality of the analyzed program possibly presents vulnerabilities in its performance since the environment domain, the one with the lowest score among the program beneficiaries, precisely encompasses financial resources, access to goods and leisure and the individual's physical environment.

RESUMO

Introducción. Existen resultados inconsistentes con relación al planteamiento de la hipótesis que sugiere una mayor probabilidad de documentar un carcinoma papilar de tiroides en especímenes quirúrgicos con cambios compatibles con tiroiditis linfocítica crónica. En los metaanálisis existentes se han incluido estudios no comparables metodológicamente y no se proponen claras fuentes de sesgo, justificación para la realización del presente metaanálisis. Métodos. Se realizó una búsqueda bibliográfica en Pubmed y Embase. Fueron obtenidos estudios retrospectivos donde se comparaba la prevalencia de carcinoma papilar de tiroides en especímenes con y sin cambios por tiroiditis linfocítica crónica. La evidencia recolectada fue sintetizada estadísticamente. Resultados. Un total de 22 artículos fueron incluidos. La población estuvo conformada por 63.548 especímenes. El OR combinado fue 1,81 (IC95%: 1,51-2,21). Hubo heterogeneidad entre la distribución de las razones de oportunidad entre los estudios (I2= 91 %; p>0,00001). La forma del gráfico en embudo de los estudios incluidos en el análisis parece estar simétrica, lo que indica la ausencia del sesgo atribuible a los estudios pequeños. Conclusiones. La literatura actual sugiere que existe un mayor riesgo de documentar un carcinoma papilar de tiroides en especímenes quirúrgicos en los que se observan cambios compatibles con tiroiditis linfocítica crónica; sin embargo, existen fuentes de sesgo que no será posible controlar en estudios retrospectivos, por lo que recomendamos estudiar la hipótesis que sugiere una mayor probabilidad de diagnosticar un carcinoma papilar de tiroides en especímenes con cambios compatibles con tiroiditis linfocítica crónica mediante metodologías prospectivas

Introduction. Inconsistent results exist in the literature regarding the hypothesis statement suggesting an increased likelihood of documenting papillary thyroid carcinoma (PTC) in surgical specimens with changes compatible with chronic lymphocytic thyroiditis. Existing meta-analyses have included studies that are not methodologically comparable and do not propose clear sources of bias, thus, this is justification for the present meta-analysis. Methods. A literature search in Pubmed and Embase was performed from January 1, 1950 to December 31, 2020. Retrospective studies comparing the prevalence of papillary thyroid carcinoma in specimens with and without chronic lymphocytic thyroiditis changes were obtained. The collected evidence was statistically analyzed. Results. A total of 22 articles were included. The study population consisted of 63,548 surgical specimens. The pooled OR, based on the studies, was 1.81 (95% CI: 1.51-2.21). There was heterogeneity between the distribution of prevalence ratios and opportunity ratios across studies (I²= 91%; p>0.00001). The funnel plot shape of the studies included in the analysis appears to be symmetrical, indicating the absence of bias attributable to small studies. Conclusions. The current literature suggests that there is an increased risk of documenting papillary thyroid carcinoma in surgical specimens in which chronic lymphocytic thyroiditis-compatible changes are observed; however, there are sources of bias that will not be possible to control for in retrospective studies, so we recommend studying the hypothesis suggesting an increased likelihood of diagnosing PTC in specimens with chronic lymphocytic thyroiditis-compatible changes using prospective methodologies

Assuntos

RESUMO

RESUMEN La fundación de la Universidad Nacional de los Estados Unidos de Colombia en 1868 ocurrió casi una década después de la publicación del origen de las especies de Darwin (1859); en la Escuela de Ciencias Naturales se dictaron cursos que incluían temáticas de geografía de las plantas, geología y paleontología. ¿Seguirían estos cursos el paradigma de historia natural heredado de la expedición botánica del nuevo reino de granada, o se instalarían en la tradición biológica moderna, interpretando la naturaleza en el trasfondo de las teorías evolutivas que surgieron durante el siglo XIX? Esta investigación consultó fuentes históricas primarias y secundarias para determinar si entre 1868 y 1875, los cursos mencionados tenían un trasfondo esencialista-catastrofista, o evolucionista de estilo lamarckiano o darwiniano. El análisis permitió concluir que tuvieron como fuentes primarias textos franceses y españoles, de Decandolle y Orbigny, circunscritos a la escuela francesa principalmente esencialista y catastrofista. Aunque en los cursos se pudieron discutir algunos temas referentes al origen de las especies, lo más probable es que estas discusiones no se realizaron en un contexto Darwiniano.

ABSTRACT The foundation of the Universidad Nacional de los Estados Unidos de Colombia in 1868 occurred almost a decade after the publication of Darwin's Origin of Species (1859); in the Escuela de Ciencias Naturales, courses were given that included themes of plant geography, geology and paleontology. ¿Would these courses follow the paradigm of natural history inherited from the botanical expedition of the Nuevo Reino de Granada, or would they be contextualized in the modern biological tradition, interpreting nature within the background of evolutionary theories that emerged during the 19th century? This investigation consulted primary and secondary historical sources to determine ifbetween 1868 and 1875, the mentioned courses had an essentialist-catastrophist, or a Lamarckian or Darwinian evolutionist background. The analysis allowed us to conclude that these courses had as primary sources French and Spanish texts, particularly De Candolle and Orbigny, and circumscribed to the mainly catastrophic and essentialist French school. Although the courses could discuss some issues related to the origin of species, surely, they did not do so in a Darwinian context.

RESUMO

RESUMEN La fundación de la Universidad Nacional de los Estados Unidos de Colombia en 1867 ocurre casi una década después de la publicación del origen de las especies de Darwin (1859) y de la publicación de Die Cellular pathologie de Virchow (1859), textos representativos de las dos teorías básicas que sustentan la biología moderna: la teoría de evolución por selección natural y la teoría celular. Analizando las fuentes históricas primarias y secundarias determinamos que en la Escuela de Ciencias Naturales se enseñó entre 1868 y 1875 la teoría celular. El curso de botánica de Francisco Bayón (1868) explicó esta teoría, incluyendo las propuestas de Schleiden, Mirbel, Möhl y Unger; así como los procesos de polinización y fecundación de las plantas. La desactualización en algunos aspectos se explica porque las fuentes principales de Bayón son textos editados en España y Francia y por la ausencia de traducciones de los trabajos pioneros que surgían en Alemania. La Escuela de Ciencias Naturales dio un paso desde la historia natural hasta la biología moderna al incluir en sus cursos la teoría celular.

ABSTRACT The foundation of the Universidad Nacional de los Estados Unidos de Colombia in 1867 took place almost a decade after the publication of Darwin's Origin of Species (1859) and Virchow's Die Cellularpathologie (1859). The first of these works presents the theory of evolution by natural selection, the second the cell theory, both of which underpin modern biology. The analysis of primary and secondary historical sources led us to determine that cell theory was taught in the School of Natural Sciences between 1868 and 1875. The botany course of Francisco Bayón (1868) explained the cell theory, including the proposals of Schleiden, Mirbel, Mohl and Unger; as well as the processes of pollination and fertilization in plants. Some topics were outdated, mainly by the fact that Bayón's main sources were texts edited in Spain and France, and by the absence of translations of the pioneering works that emerged in Germany. The School of Natural Sciences took a step further from natural history to modern biology by including the cell theory in their courses.

RESUMO

Study design Literature review. OBJECTIVES: Describe the implications of post-COVID syndrome due to neurological sequelae including treatment and the differences that may exist between this group of patients and those who present these events not associated with COVID-19. METHODS: A non-systematic review of the literature was carried out in PubMed and Science Direct databases, using the keywords "Post-acute COVID-19 syndrome"; "Neurological complications"; "Neurologic Manifestations" "COVID-19″ and "Rehabilitation", as well as synonyms, which were combined with the operators "AND" and "OR". RESULTS: The COVID-19 viral caustive agent, SARS-CoV-2, has a high affinity for human angiotensin-converting enzyme 2 receptor on type II pneumocytes. This receptor is also expressed in neurons and glial cells. Based on the foregoing and other not so clear mechanisms, it is stated that SARS-CoV-2 has tropism for the nervous system, being evident through the neurological manifestations observed in patients with mild, moderate and severe phenotype of the disease such as anosmia, ageusia, headache, cerebrovascular accidents, Guillain-Barré syndrome, seizures, and encephalopathy. This can generate severe sequelae and even fatal outcomes in those affected. CONCLUSIONS: Neurological complications caused by COVID-19 are frequent and represent a risk that compromises the functional capacity and the life of patients. The suspicion of these conditions, the strict control of metabolic alterations and cardiovascular risk factors, the effective and safe treatment of these entities, are a current challenge throughout the pandemic. The rehabilitation process in these patients is a challenge. This is due to the limitations generated by multi-organ damage, as well as risk of brain death.

Assuntos

RESUMO

There has been a record surge of unaccompanied immigrant minors (UAMs) entering the United States, with 86% of those apprehended at the US-Mexico border originating from the Central American countries of El Salvador, Guatemala, and Honduras. A majority of immigrant children are separated from either one or both parents at various points during the migration process. Although average separations last 4 or more years, and may be deeply distressing, there is little research on family separations among Central American UAMs. Further, little is known about the developmental impact of separations from extended family networks, or about reunification. To address these empirical gaps, this study used community-participatory qualitative methods to deeply explore the lived experiences and emotional repercussions of family separation and reunification. The sample included 42 adolescents who had all recently migrated to the Western United States from Central America. Thematic analyses revealed that separation experiences are distressing, multifaceted, and have important developmental implications for Central American UAMs. Results illustrate the socioemotional toll that family separation and reunification can have on this vulnerable population, and highlight the need for culturally responsive, developmentally informed, and contextually appropriate care focused on family reunification in order to foster healthy psychosocial adjustment among UAMs.

Assuntos

RESUMO

BACKGROUND Mounier-Kuhn syndrome is a rare clinical condition characterized by marked tracheal and bronchial dilatation. It is commonly associated with multiple respiratory infections due to the inability to mobilize secretions, chronic cough, and decline in lung capacity. Although it is a rare disease, the number of cases reported in the literature has increased, and physicians should be aware of its existence to be able to recognize and diagnose it. Suspicion should arise regarding young adults who develop recurrent airway infections when immunosuppression has been ruled out. CASE REPORT We present the case of a young adult, previously healthy and immunocompetent, who was diagnosed with Mounier-Kuhn syndrome after 5 years of multiple respiratory infections and multiple respiratory failures, who received intensive care management with multiple complications and difficulties in achieving adequate ventilation. Due to the risk of respiratory failure and major complications, its management was challenging. We were able to treat this patient and prevent complications with a multidisciplinary approach with a strong emphasis on constant and intense pulmonary therapy. CONCLUSIONS Mounier-Kuhn syndrome is rare but does occur, and physicians need to have a high index of suspicion to diagnose it. Its management must be done by a multidisciplinary team, and respiratory therapy should be constantly available at bedside.

Assuntos

RESUMO

Introducción. La motivación conduce a las personas a ejecutar acciones en pro de alcanzar una meta u objetivo. Este estudio buscó examinar la correlación entre la motivación autodeterminada para la actividad física y la composición corporal, en una cohorte de sujetos adultos con sobrepeso. Métodos. Se utilizó la herramienta BREQ 2 de autoinforme y para la antropometría fue medida por un técnico ISAK 1 y la composición corporal con báscula Tanita BC 420. Resultados. 46% (n = 18) de los participantes eran mujeres y 54% (n = 21) hombres. Edad promedio 31 ± 11 años, IMC: 25 ± 3 kg/m2, masa muscular 49 ± 9%, masa grasa 27 ± 16%, circunferencia de cintura (CC) 80 ± 7cm, cadera 98 ± 6cm, ICC 0,8 ± 0,05 cm. Conclusión. Se observó una correlación negativa entre variables antropométricas como IMC e ICC con el índice de autodeterminación en mujeres (r = -1 p < 0,05). La evaluación de la motivación autodeterminada debe ser la base para la programación de actividad física en población con sobrepeso.

Introduction: Motivation leads people to carry out actions in order to achieve a goal or objective. This study tried to examine the correlation between self-determined motivation for physical activity and physical composition, in a cohort of overweight adults. Method: We used the tool BREW 2 of self-report and anthopometry was measured with an ISAK 1 techinician. Body composition was measured with a Tanita BC 420 scale. Results: 46% (n=18) of patients were women and 54% (n=21) were men. The average age was 31 ±, MMI: 25 ± 3 kg/m2, muscular mass 49 ± 9%, fat, 27 ± 16%, waist circumference 80 ± 7cm, hip 98 ± 6cm, CCI 0.8 ± 0.05 cm. Conclusions: we observed a negative correlation among anthropometric variables, such as MMI and CCI with the rate of self-determination in women. Evaluating the self-determined motivation must be the base to program any physical activity in an overweight population.

Introdução: a motivação leva as pessoas a agirem em prol de atingir uma meta. Nesse sentido, este estudo tem o objetivo de analisar a correlação entre a motivacão autodeterminada para a atividade física e a composição corporal, em um grupo de sujeitos adultos com obesidade. Métodos: foi utilizada a ferramenta BREQ 2 de autorrelato; a antropometria foi medida por um técnico ISAK 1, e a composição corporal, com báscula Tanita BC 420. Resultados: 46% (n = 18) dos participantes eram mulheres e 54% (n = 21), homens. A idade média foi de 31 ± 11 anos, IMC: 25 ± 3 kg/m2; massa muscular 49 ± 9%; massa gorda 27 ± 16%; circunferencia de cintura (CC) 80 ± 7cm; quadril 98 ± 6cm, ICC 0,8 ± 0,05 cm. Conclusões: foi observada correlação negativa entre variáveis antropométricas como IMC e ICC com o índice de autodeterminação em mulheres (r = -1 p < 0,05). A avaliação da motivacão autodeterminada deve ser a base para programar atividades físicas em população com obesidade.

RESUMO

Introducción. La motivación conduce a las personas a ejecutar acciones en pro de alcanzar una meta u objetivo. Este estudio buscó examinar la correlación entre la motivación autodeterminada para la actividad física y la composición corporal, en una cohorte de sujetos adultos con sobrepeso. Métodos. Se utilizó la herramienta BREQ 2 de autoinforme y para la antropometría fue medida por un técnico ISAK 1 y la composición corporal con báscula Tanita BC 420. Resultados. 46 % (n = 18) de los participantes eran mujeres y 54 % (n = 21) hombres. Edad promedio 31 ± 11 años, IMC: 25 ± 3 kg/m2, masa muscular 49 ± 9 %, masa grasa 27 ± 16%, circunferencia de cintura (CC) 80 ± 7cm, cadera 98 ± 6cm, ICC 0,8 ± 0,05 cm. Conclusión. Se observó una correlación negativa entre variables antropométricas como IMC e ICC con el índice de autodeterminación en mujeres (r = -1 p < 0,05). La evaluación de la motivación autodeterminada debe ser la base para la programación de actividad física en población con sobrepeso.

Introduction. Motivation drives people to perform actions in pursuit of a goal or objective. This study sought to examine the correlation between self-determined motivation for physical activity and body composition in a cohort of overweight adult subjects. Methods. The BREQ 2 self-report tool was used and for anthropometry was measured by an ISAK 1 technician and body composition with Tanita BC 420 scale.Results. 46 % (n = 18) of the participants were female and 54 % (n = 21) were male. Mean age 31 ± 11 years, BMI: 25 ± 3 kg/m2, muscle mass 49 ± 9 %, fat mass 27 ± 16%, waist circumference (WC) 80 ± 7cm, hip 98 ± 6cm, ICC 0.8 ± 0.05 cm. Conclusion. A negative correlation was observed between anthropometric variables such as BMI and WC with the self-determination index in women (r = -1 p < 0.05). The evaluation of self-determined motivation should be the basis for physical activity programming in overweight population.

Introdução. A motivação leva os indivíduos a realizar acções em busca de uma meta ou objetivo. Este estudo procurou examinar a correlação entre a motivação autodeterminada para a atividade física e a composição corporal numa coorte de adultos com excesso de peso. Métodos. Foi utilizado o instrumento de auto-relato BREQ 2 e a antropometria foi medida por um técnico do ISAK 1 e a composição corporal pela balança Tanita BC 420. Resultados. 46 % (n = 18) dos participantes eram do sexo feminino e 54 % (n = 21) do sexo masculino. Idade média 31 ± 11 anos, IMC: 25 ± 3 kg/m2, massa muscular 49 ± 9 %, massa gorda 27 ± 16 %, perímetro da cintura (PC) 80 ± 7cm, anca 98 ± 6cm, CC 0,8 ± 0,05 cm. Conclusões. Houve uma correlação negativa entre variáveis antropométricas como IMC e CC com o índice de autodeterminação em mulheres (r = -1 p < 0,05). A avaliação da motivação autodeterminada deve ser a base para a programação da atividade física na população com excesso de peso.

Assuntos

RESUMO

Adversity, such as living in poor socioeconomic conditions during early childhood, can become embedded in children's physiology and deleteriously affect their health later in life. On the other hand, maternal responsivity may have adaptive effects on physiology during early childhood development. The current study tested both the additive and interactive effects of socioeconomic status (SES) and maternal responsivity measured at 1year of age on resting autonomic nervous system (ANS) function and trajectory during the first 5years of life. Participants came from a birth cohort comprised of Mexican-origin families living in California. Children's resting ANS functioning (respiratory sinus arrhythmia; RSA; pre-ejection period; PEP; and heart rate; HR) was collected at 1, 3.5, and 5years of age (N=336) and modeled across time using Hierarchical Linear Modeling. Consistent with hypotheses, results showed that low SES predicted flatter trajectories of resting HR and PEP over early childhood (i.e., patterns of consistently higher heart rate; shorter PEP), whereas children who experienced positive maternal responsivity had steeper trajectories in RSA and PEP over time (i.e., increasing parasympathetic activation; decreasing sympathetic activation). The interaction between SES and maternal responsivity significantly predicted RSA intercept at age 5, such that among children living in low SES environments, high maternal responsivity mitigated the negative effect of poverty and predicted higher resting RSA at 5years of age. Results are consistent with the early life programming theory that suggests that environmental influences become biologically embedded in the physiology of children living in socially disadvantaged contexts, and identify increased maternal responsivity as a developmental mechanism that could offset the deleterious effects of low SES.

Assuntos

RESUMO

OBJECTIVE: Despite the high prevalence of mental disorders in Mexico, minimal mental health services are available and there are large gaps in mental health treatment. Community-based primary care settings are often the first contact between patients and the health system and thus could serve as important settings for assessing and treating mental disorders. However, no formal assessment has been undertaken regarding the feasibility of implementing these services in Mexico. Before tools are developed to undertake such an assessment, a more nuanced understanding of the microprocesses affecting mental health service delivery must be acquired. METHODS: A qualitative study used semistructured interviews to gather information from 25 staff in 19 community-based primary care clinics in Mexico City. Semistructured interviews were analyzed by using the meaning categorization method. In a second phase of coding, emerging themes were compared with an established typology of barriers to health care access. RESULTS: Primary care staff reported a number of significant barriers to implementing mental health services in primary care clinics, an already fragile and underfunded system. Barriers included the following broad thematic categories: service issues, language and cultural issues, care recipient characteristics, and issues with lack of knowledge. CONCLUSIONS: Results indicate that the implementation of mental health services in primary care clinics in Mexico will be difficult. However, the information in this study can help inform the integration of mental health into community-based primary care in Mexico through the development of adequate evaluative tools to assess the feasibility and progress of integrating these services.

Assuntos

RESUMO

La enfermedad crítica de los niños y su ingreso a la Unidad de Cuidados Intensivos (UCI) afecta de manera negativa a las familias. Enfermería tiene un papel importante frente a las necesidades de estas familias, identificándolas y valorándolas oportunamente para ser intervenidas y satisfechas. Este estudio propone una Guía de Práctica Clínica (GPC) basada en la evidencia científica con recomendaciones fiables, esenciales para el Cuidado de Enfermería a la familia del niño hospitalizado en la UCI. Para su elaboración se identificaron 12 temas de interés, a partir del consenso de expertos, agrupados en 4 categorías con un total de 29 preguntas en formato PICO. Se realizó una búsqueda de literatura en 16 bases de datos, 1 motor de búsqueda y 1 revista indexada, utilizando palabras claves en español e inglés. Se seleccionaron 43 de 279 estudios revisados, mediante el análisis y la aplicación de una lista de chequeo que evaluaba la calidad del estudio dependiendo de la metodología utilizada. Posteriormente se calificó el nivel de evidencia teniendo como referencia el sistema de clasificación de la SIGN. Las piezas investigativas, directamente relacionadas con el tema de interés, dieron respuesta a las preguntas y permitieron establecer 47 recomendaciones. En general, la evidencia científica encontrada corresponde a los niveles 1+, 2++, 2+, 3 y 4 según la clasificación SIGN y las recomendaciones generadas son grado B, C y D.

The critical illness of children and their admission to the Intensive Care Unit (ICU) negatively affects families. Nursing plays an important role in addressing the needs of these families, identifying and assessing them in a timely manner to be intervined and satisfied. This study proposes a Clinical Practice Guideline (CPG) based on the scientific evidence with reliable and essential recommendations for Nursing Care to the family of the child hospitalized in the ICU. For its elaboration, 12 topics of interest were identified, based on the consensus of experts, grouped into 4 categories with a total of 29 questions in PICO format. The literature search was carried out on 16 databases, 1 search engine and 1 indexed journal, using key words in Spanish and English. 43 of 279 studies reviewed were selected, through analysis and application of a checklist that evaluated the quality of the study depending on the methodology used. Subsequently, the level of evidence was rated based on the classification system of the SIGN. The pieces of research, directly related to the topic of interest, answered the questions and allowed 47 recommendations. In general, the evidence corresponds to levels 1+, 2++, 2+, 3 and 4 according to the SIGN classification and the recommendations generated are grade B, C and D.

Assuntos

RESUMO

La diabetes mellitus gestacional (DMG) se define como una intolerancia a los carbohidratos, de severidad variable, que se diagnostica por primera vez durante el embarazo. Los síntomas más comunes asociados con la diabetes mellitus gestacional son hambre y sed extremas, además de visión borrosa y aumento de peso excesivo. El origen étnico y la edad son factores de riesgo, al igual que el índice de masa corporal. Estudios como el de Hyperglycemia and Adverse Pregnancy Outcome (HAPO, Hiperglucemia y Resultado Adverso del Embarazo) se han llevado a cabo con el objetivo de clarificar el riesgo de desenlaces adversos asociados con varios grados de intolerancia a la glucosa materna. La International Association of Diabetes and Pregnancy Study Groups (IADPSG, Asociación Internacional de Grupos de Estudio de Diabetes y Embarazo) ha propuesto criterios para el diagnóstico y la clasificación de la hiperglucemia en el embarazo. El estudio HAPO reportó un alto porcentaje de complicaciones perinatales de la diabetes mellitus gestacional, por lo que actualmente se proponen 92 mg/dL de glucemia como punto de corte para el diagnóstico de la diabetes mellitus gestacional. En este momento están en proceso varios estudios para evaluar si el realizar intervenciones terapéuticas a partir del punto de corte señalado reduce la incidencia de complicaciones perinatales. El tratamiento de la diabetes mellitus gestacional consiste en una dieta limitada en carbohidratos que se debe administrar en pequeñas porciones, pero de manera más frecuente que la dieta habitual para mantener los niveles de glucosa estables.

Gestational diabetes is defined as an intolerance to carbohydrates not caused by the lack of insulin, but by contraregulation hormones that block insulin effects; this condition is named "resistance to insulin", and has generally its onset at > 20 weeks of gestation. The ethnic origin, the age and the body mass index have been identified as risk factors. The studies of diverse ethnic groups have demonstrated frequencies of 0.4% in Caucasian races, l.5% in blacks, 3.5 to 7.3% in Asian and up to 16% in Native American. Regarding the mothers' age, it has been pointed out that the incidence is of 0.4 to 0.5% in those younger than 25 years old and of 4.3 to 5.5% in those older than that age. These women have a greater probability of developing gestational diabetes in their next pregnancy and type 2 diabetes in the future. 95 mg/dL was previously considered as the limit in fasting glucose to diagnose gestational diabetes; however, the Hyperglycemia and Adverse Pregnancy Outcome study reported a high percentage of perinatal complications, so now 92 mg/dL is used as the glucose cutoff; studies are underway to evaluate if complications diminish in a significant way. The treatment has the objective of diminishing the risk of perinatal complications; a proportion of women requires intensive treatment of prenatal insulin. A diet limited in sweets and carbohydrates, with small snacks between meals is advisable to maintain the levels of glucose stable.

RESUMO

Se reporta una paciente de 36 años de edad, reclusa, con antecedentes de diabetes mellitus, hipertensión arterial y artritis gotosa para lo cual lleva tratamiento. Se recibe en el cuerpo de guardia del Hospital General Docente Dr Agostinho Neto con fiebre, ardor ocular y oral, así como eritema en piel de cara y miembros superiores. Evoluciona en días a la descamación o exfoliación de las mucosas oral y conjuntival, y de la piel de la cara, cuello, tronco anterior y posterior, región lumboglútea, y miembros superiores e inferiores. Se realiza diagnóstico de necrólisis epidérmica tóxica, pérdida del 80 por ciento de superficie corporal de piel (epidermis y dermis superficial), con pronóstico de crítico extremo, es atendida de forma multidisciplinaria y egresada curada al día 14(AU)

Patient of 36-year-old, prisoner is reported with a history of diabetes mellitus, arterial hypertension and gouty arthritis which one has treatment ,the patient was received by doctors at the General Teaching Hospital Dr AGostinho Net with fever, ocular and oral burning, erythema in skin face and upper limbs. The patient evolve un days to flaking or peeling of the oral and conjunctival mucus, skin of the face, neck, previous and posterior chest, lumbar region, and upper and lower limbs. It was Diagnosed toxic epidermal necrolysis, loss of 80 percent body surface skin (epidermis and superficial dermis), with bad health situation, is assisted by a multidisciplinary doctors staff and cured at day 14

Assuntos

RESUMO

El tromboembolismo pulmonar (TEP) es la principal causa de mortalidad materna relacionada con la gestación en los países desarrollados. Se demuestra que la edad mayor a 35 años y raza negra son los factores de riesgo más importantes. Requiere tratamiento prolongado con heparina de bajo peso molecular en el TEP confirmado; los antagonistas de la vitamina K no están recomendados durante el primer y el tercer trimestre. Se pueden utilizar todas las modalidades diagnósticas, incluida la tomografía computarizada (TC), sin que se produzca unriesgo significativo para el feto (AU)

Pulmonary embolism (PE) is the leading cause of maternal mortality related to pregnancy in developed countries. It is shown that age greater than 35 and black are the most important risk factors. Requires prolonged treatment, heparin with low molecular weight in the confirmed TEP. The vitamin K antagonists are not recommended during the first and third quarter. It can be used all the diagnostic modalities, including computed tomography (CT), without causing a significant risk to the fetus

Assuntos

RESUMO

En la primera parte se mostrarán algunos elementos históricos relacionados con la "Philosophie Zoologique" de Jean-Baptiste Lamarck, obra fundamental de la biología moderna merecedora de una mención especial en su aniversario número 200. Esta obra contiene algunos conceptos impor-tantes para "The Origin of species by means of natural selection, or the preservation of favoured races in the struggle for life" el trabajo fundamental de Charles Darwin. Posteriormente se revisará la idea general de la pangénesis y sus diferentes contradicciones en la explicación de la variabilidad necesaria para la acción de la selección natural que culminarían con el nacimiento de la genética. Es importante mostrar la posición particular de los experimentos mendelianos en relación con el paradigma evo-lutivo causado por el origen de las especies.

In the first part I present some historical elements related to the "Philosophie Zoologique" by Jean-Baptiste Lamarck, a fundamental work of modern biology. This work deserves a special mention in its 200th anniversary, since it contains some important concepts for "The Origin of Species by Means of Natural Selection, or the Preservation of favored races in the struggle for life" the principal work of Charles Darwin. Subsequently we review the pangenesis and various contradictions in the explanation of the variability required for the action of natural selection that culminate with the birth of genetics. In this paper is important show the particular position of Mendelian experiments in relation with the evolutionary paradigm caused by the origin of species.

RESUMO

El Angiostrongylus Cantonensis también conocido como el parásito pulmonar de la rata, en donde el hombre puede ser un hospedero accidental cuando consume moluscos con larvas viables, produce una meningoencefalitis que se caracteriza por un elevado número de eosinófilos en el líquido cefaloraquídeo. La angioestrongiloidiasis poco frecuente en nuestro medio, tiene dos especies de Angiostrongylus que producen dos enfermedades características en el hombre: la meningitis eosinofílica, por el A. Cantonensis y la angioestrongiloidiasis abdominal; producida por el A. Costarricensis, reportada en Ecuador por primera vez en 1974. La meningitis eosinofílica por A. cantonensis es una enfermedad endémica del sudeste asiático desde 1.935; en el continente americano, Cuba reportó los primeros casos en 1981; en Ecuador nunca antes se había informado esta parasitosis, considerándola hasta entonces como una enfermedad exótica. El reporte de este caso tiene por objetivo informar a la comunidad médica de la existencia de esta parasitosis en nuestro medio ambiente, así como revisar los hallazgos anatomopatológicos de esta enfermedad.

Angiostrongylus cantonense also known as pulmonary parasite of rats, of which men can be accidental hosts when ingesting molluscs with viable larvae, meningoencephalitis appears. It is characterized by a high amount of eosinophil in the cephalospinal fluid. Angiostrongiliasis, which is not very common in our environment, has two species of angiostrongylus which produce two characteristic diseases in men: eosinophilic meningitis produced by A. Cantonensis and abdominal Angioestrongiloidiasis; produced by A. Costa Rican, reported in Ecuador for the first time in 1974. Eosinophilic meningitis by A. Cantonese is a South-east Asian endemic disease since 1935; in the American continent, Cuba reported the first cases in 1981; Ecuador had never reported this parasitosis before, considered then, an exotic disease. The report of this case is meant to inform the community of the existence of this parasitosis in our environment, as well as to check the anatomic-patholigical findings of this disease.

Assuntos