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This study presents the design and implementation of an electronic system aimed at capturing vibrations produced during truck operation. The system employs a graphical interface to display vibration levels, ensuring the necessary comfort and offering indicators as a solution to mitigate the damage caused by these vibrations. Additionally, the system alerts the driver when a mechanical vibration that could potentially impact their health is detected. The field of health is rigorously regulated by various international standards and guidelines. The case of mechanical vibrations, particularly those transmitted to the entire body of a seated individual, is no exception. Internationally, ISO 2631-1:1997/Amd 1:2010 oversees this study. The system was designed and implemented using a blend of hardware and software. The hardware components comprise a vibration sensor, a data acquisition card, and a graphical user interface (GUI). The software components consist of a data acquisition and processing library, along with a GUI development framework. The system underwent testing in a controlled environment and demonstrated stability and robustness. The GUI proved to be intuitive and could be integrated into modern vehicles with built-in displays. The findings of this study suggest that the proposed system is a viable and effective method for capturing vibrations in trucks and informing drivers about vibration levels. This system has the potential to enhance the comfort and safety of truck drivers.

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Este artículo ofrece una exploración empírica y conceptual del odontograma, un dispositivo usado cotidianamente en la práctica odontológica para evaluar el estado dental. Se tomaron como base los aportes del "giro ontológico" y algunas de las propuestas más recientes de las teorías del afecto para reflexionar más allá de las concepciones epistemológicas de la representación. El propósito es comprender las relaciones materiales, corporales y afectivas puestas en acción en la formación odontológica en relación con el odontograma. Se tomó como caso de estudio un programa de educación odontológica ubicado en una ciudad intermedia de Colombia, particularmente lo ocurrido en prácticas clínicas y en reuniones de profesores. Para el análisis, se partió de la noción de momento etnográfico propuesta por Marilyn Strathern. Se encontraron diversas situaciones que muestran la capacidad del odontograma para articular afectos, como discutir convenciones, diligenciar con lápiz los formatos de la historia clínica, mover la silla de la unidad odontológica para ver los dientes, secar con la jeringa triple, explicar diferencias sutiles entre anatomía y patología, y evaluar los odontogramas hechos por los estudiantes. Se concluye que la relación entre la boca del paciente y el odontograma es compleja y de mutuo exceso, lo cual posibilita una experiencia más rica de los dientes

This paper offers an empirical and conceptual exploration of the dental chart, a tool used to assess dental status. It is built on the "ontological turn" and recent affect theories to reflect beyond the epistemological concept of representation. This paper aims to understand the material, embodied, and affective relationships implemented in dental training regarding the dental chart. A dental education program in an intermediate city in Colombia was taken as a case study, mainly what happened in clinical practices and faculty meetings. It adopted the notion of "ethnographic moment" proposed by Marilyn Strathern for the analysis. Diverse situations were observed, which demonstrated the capacity of the dental chart to articulate affects, such as discussing conventions, filling out clinical records using a pencil, moving the chair of the dental unit to see the teeth, drying with the triple syringe, explaining subtle differences between anatomy and pathology, and evaluating the dental charts carried out by the students. It was inferred that the relationship between the patient's mouth and the dental chart is complex and mutually excessive, enabling a richer experience of the teeth.

Este artigo oferece uma exploração empírica e conceitual do odontograma, um dispositivo usado diaria- mente na prática odontológica para avaliar o estado dentário. As contribuições da "virada ontológica" e algumas das propostas mais recentes das teorias do afeto foram tomadas como base para refletir para além das concepções epistemológicas da representação. O objetivo do texto é compreender as relações materiais, corporais e afetivas postas em ação na formação odontológica em relação ao odontograma. Um programa de educação odontológica localizado em uma cidade intermediária na Colômbia foi tomado como um estudo de caso, particularmente o que aconteceu nas práticas clínicas e nas reuniões de professores. Para a análise, partimos da noção de "momento etnográfico" proposta por Marilyn Strathern. Foram encontradas várias situações que mostram a capacidade do odontograma de articular afetos, como discutir convenções, preencher formatos de história clínica com lápis, mover a cadeira da unidade odontológica para ver os dentes, secar com a seringa tríplice, explicar diferenças sutis entre anatomia e patologia e avaliar os odontogramas feitos pelos alunos. Conclui-se que a relação entre a boca do paciente e o odontograma é complexa e de excesso mútuo, o que possibilita uma experiência mais rica dos dentes.

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INTRODUCTION: Neonatal cerebral aneurysms are very rare condition and distinct from those of the adults. CASE REPORT: We reported a 14-day-old male neonate who presented subarachnoid hemorrhage due to a ruptured anterior cerebral artery saccular aneurysm. In addition, we present a review of the relevant literature. CONCLUSION: Intracranial hemorrhage due to cerebral aneurysm rupture in a newborn is an uncommon diagnosis, but it must be unequivocally excluded.

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In emergent technologies, data integrity is critical for message-passing communications, where security measures and validations must be considered to prevent the entrance of invalid data, detect errors in transmissions, and prevent data loss. The SHA-256 algorithm is used to tackle these requirements. Current hardware architecture works present issues regarding real-time balance among processing, efficiency and cost, because some of them introduce significant critical paths. Besides, the SHA-256 algorithm itself considers no verification mechanisms for internal calculations and failure prevention. Hardware implementations can be affected by diverse problems, ranging from physical phenomena to interference or faults inherent to data spectra. Previous works have mainly addressed this problem through three kinds of redundancy: information, hardware, or time. To the best of our knowledge, pipelining has not been previously used to perform different hash calculations with a redundancy topic. Therefore, in this work, we present a novel hybrid architecture, implemented on a 3-stage pipeline structure, which is traditionally used to improve performance by simultaneously processing several blocks; instead, we propose using a pipeline technique for implementing hardware and time redundancies, analyzing hardware resources and performance to balance the critical path. We have improved performance at a certain clock speed, defining a data flow transformation in several sequential phases. Our architecture reported a throughput of 441.72 Mbps and 2255 LUTs, and presented an efficiency of 195.8 Kbps/LUT.

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The memristor is the fourth fundamental element in the electronic circuit field, whose memory and resistance properties make it unique. Although there are no electronic solutions based on the memristor, interest in application development has increased significantly. Nevertheless, there are only numerical Matlab or Spice models that can be used for simulating memristor systems, and designing is limited to using memristor emulators only. A memristor emulator is an electronic circuit that mimics a memristor. In this way, a research approach is to build discrete-component emulators of memristors for its study without using the actual models. In this work, two reconfigurable hardware architectures have been proposed for use in the prototyping of a non-linearity memristor emulator: the FPAA (Field Programing Analog Arrays) and the FPGA (Field Programming Gate Array). The easy programming and reprogramming of the first architecture and the performance, high area density, and parallelism of the second one allow the implementation of this type of system. In addition, a detailed comparison is shown to underline the main differences between the two approaches. These platforms could be used in more complex analog and/or digital systems, such as neural networks, CNN, digital circuits, etc.

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This paper presents the development of a multilayer feed-forward neural network for the diagnosis of hypertension, based on a population-based study. For the development of this architecture, several physiological factors have been considered, which are vital to determining the risk of being hypertensive; a diagnostic system can offer a solution which is not easy to determine by conventional means. The results obtained demonstrate the sustainability of health conditions affecting humanity today as a consequence of the social environment in which we live, e.g., economics, stress, smoking, alcoholism, drug addiction, obesity, diabetes, physical inactivity, etc., which leads to hypertension. The results of the neural network-based diagnostic system show an effectiveness of 90%, thus generating a high expectation in diagnosing the risk of hypertension from the analyzed physiological data.

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Background: The authors describe clinical and imaging findings, surgical technique, and outcomes in myelocystocele. Methods: We describe a surgical procedure performed in six patients, four males and two females, with myelocystocele treated at our hospital. We review the images obtained at the time of diagnosis and after surgery. The patients' age range was 12-56 months and had undergone surgery for terminal myelocystocele between 2015 and 2020. All patients had a large lumbar mass covered with healthy skin and presented spontaneous movements at birth. Two patients presented VACTERL syndrome. Results: A watertight closure of the soft tissues was performed in all cases. None of the patients presented postsurgical complications, such as cerebrospinal fluid leak or infection. All the patients had undergone excision of the meningocele sacs, the tethering bands were lysed, and the filum was detethered. The mean follow-up period was 34 (12-56) months. A motor deficit was seen in 2 patients (33.3%). Conclusion: Prenatal diagnosis and early corrective surgical intervention are recommended to prevent deterioration in neurological function. VACTERL association is a common condition and should be investigated.

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The design of neural network architectures is carried out using methods that optimize a particular objective function, in which a point that minimizes the function is sought. In reported works, they only focused on software simulations or commercial complementary metal-oxide-semiconductor (CMOS), neither of which guarantees the quality of the solution. In this work, we designed a hardware architecture using individual neurons as building blocks based on the optimization of n-dimensional objective functions, such as obtaining the bias and synaptic weight parameters of an artificial neural network (ANN) model using the gradient descent method. The ANN-based architecture has a 5-3-1 configuration and is implemented on a 1.2 µm technology integrated circuit, with a total power consumption of 46.08 mW, using nine neurons and 36 CMOS operational amplifiers (op-amps). We show the results obtained from the application of integrated circuits for ANNs simulated in PSpice applied to the classification of digital data, demonstrating that the optimization method successfully obtains the synaptic weights and bias values generated by the learning algorithm (Steepest-Descent), for the design of the neural architecture.

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Resumen: Introducción: la hemofilia es una enfermedad hereditaria, ligada al cromosoma X, debida al déficit de factor VIII (tipo A) o IX (tipo B). La prevalencia estimada al nacimiento es de 24,6 casos cada 100.000 varones para hemofilia A y 5 casos cada 100.000 para hemofilia B. El Departamento de Medicina Transfusional (DMT) del Centro Hospitalario Pereira Rossell (CHPR) es el Centro de Referencia Nacional (CDRN) para los menores de 18 años. El abordaje integral, inter-disciplinario del paciente con hemofilia en un centro especializado disminuye la morbi-mortalidad y contribuye a mejorar la calidad de vida. Objetivo: describir las características epidemiológicas y clínicas de los menores de 18 años con hemofilia asistidos en el DMT-CHPR entre el 1 enero de 2016 y el 31 de diciembre de 2018. Metodología: estudio descriptivo, retrospectivo, de todos los menores de 18 años con hemofilia. Se describió: edad y circunstancias del diagnóstico, tipo y severidad de la hemofilia, controles en salud, estudios complementarios, complicaciones, frecuencia y motivos de hospitalización, tratamiento. El protocolo de estudio fue aprobado por el Comité de Ética Institucional. Resultados: se asistieron 67 pacientes, 57 con hemofilia A y 10 con hemofilia B. La mediana de edad fue 8 años. Presentaban hemofilia severa 61 pacientes, moderada 2 y leve 4. Presentaban antecedentes familiares de coagulopatía 41. La mediana de edad al diagnóstico fue 2 meses. Se diagnosticaron en el período neonatal 24 de los pacientes con hemofilia A y 5 con hemofilia B. Desarrollaron inhibidores 7 pacientes, todos con hemofilia severa. Conclusiones: en esta serie, predominaron los pacientes con hemofilia A, severa, antecedentes familiares conocidos de coagulopatía, en tratamiento profiláctico con factores de la coagulación. Esta comunicación aporta información valiosa sobre las características de estos pacientes, lo que contribuye a la gestión clínica y a planificar estrategias de mejora de la calidad asistencial.

Summary: Introduction: hemophilia is a hereditary disease, linked to chromosome X and caused by the deficit of factor VIII (type A) and IX (type B). Estimated prevalence at birth is 24.6 cases every 100,000 boys for hemophilia A and 5 cases every 100,000 cases for hemphilia B. The Transfusion Medical Department (TMD) of the Pereira Rossell Children's Hospital Center (CHPR, acronym in Spanish) is the national reference center (NRC) for patients under 18 years of age. A comprehensive, inter-disciplinary approach to hemophilic patients at a specialized center decreases morbidity and mortality and contributes to improving quality of life. Objective: to describe the epidemiologic, clinical and progression characteristics of hemophilic patients of under 18 years of age assisted at the TMD-CHPR between January 1st 2016 and December 31st, 2018. Methodology: descriptive, retrospective study of all hemophilic patients of under 18 years of age. Variables described: age, circumstances of diagnosis, type and severity of hemophilia, health check-ups, tests, complications, frequency and reasons for hospital admittance, treatment. The study protocol was approved by the Institutional Ethics Committee. Results: 67 patients were assisted, 57 with hemophilia A and 10 with hemophilia B. Median age was 8 years. Severe hemophilia was present in 61 patients, moderate in 2 and mild in 4. 41 had a family history of coagulopathy. Median age at diagnosis was 2 months. 24 patients with hemophilia A and 5 patients with hemophilia B were diagnosed during the neonatal period. 7 patients developed inhibitors, all of them with severe hemophilia. Conclusions: in this study there is a predominance of patients with severe hemophilia A, known family history of coagulopathy, under prophylactic treatment with coagulation factors. This study provides valuable information about the characteristics of these patients, which contributes to improved clinical management and planning strategies to improve their quality of care.

Resumo: Introdução: o Departamento de Medicina Transfusional (DMT) do Centro Hospitalar Pereira Rossell (CHPR) é o Centro Nacional de Referência (CNR) para menores de 18 anos de idade. A abordagem abrangente e interdisciplinar do paciente com hemofilia em um centro especializado reduz a morbimortalidade e contribui para a melhoria da qualidade de vida. Objetivo: descrever as características epidemiológicas, clínicas e evolutivas em crianças menores de 18 anos com hemofilia atendidas no DMT-CHPR entre 1 de janeiro de 2016 e 31 de dezembro de 2018. Metodologia: estudo descritivo, retrospectivo, de todos os menores de 18 anos com hemofilia. Descrevemos: idade e circunstâncias do diagnóstico, tipo e gravidade da hemofilia, controles de saúde, estudos complementares, complicações, frequência e motivos de hospitalização, tratamento. O protocolo do estudo foi aprovado pelo Comitê de Ética Institucional. Resultados: 67 pacientes foram atendidos, 57 com hemofilia A e 10 com hemofilia B. A media de idade foi de 8 anos. Houve 61 pacientes com hemofilia grave, moderada 2 e leve 4. 41 tiveram história familiar de coagulopatia. A media de idade no diagnóstico foi de 2 meses. 24 dos pacientes com hemofilia A e 5 com hemofilia B foram diagnosticados no período neonatal e 7 desenvolveram inibidores, todos com hemofilia grave. Conclusões: neste estudo, predominaram pacientes com hemofilia A grave, história familiar conhecida de coagulopatia, em tratamento profilático com fatores de coagulação. O estudo fornece informações valiosas sobre as características desses pacientes, o que contribui para o manejo clínico e estratégias de planejamento para melhorar a qualidade do atendimento deles.

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A partir del estudio seminal Management of Myelomeningocele Study en el año 2011, el cual demostró que la reparación prenatal del defecto del mielomeningocele antes de la semana 26 mejoraba los resultados neurológicos, la cirugía fetal fue incorporada dentro de las opciones de estándar de cuidado. Así, el diagnóstico prenatal del mielomeningocele dentro de la ventana terapéutica se convirtió en un objetivo obligatorio y, por ello, se intensificó la investigación de estrategias de tamizaje, sobre todo, en el primer trimestre. Además, se desarrollaron distintas técnicas de cirugía fetal para mejorar los resultados neurológicos y disminuir los riesgos maternos. El objetivo de la siguiente revisión es actualizar los avances en tamizaje y diagnóstico prenatal en el primer y segundo trimestre, y en cirugía fetal abierta y fetoscópica del mielomeningocel

A seminal study titled Management of Myelomeningocele Study, from 2011, demonstrated that prenatal myelomeningocele defect repaired before 26 weeks of gestation improved neurological outcomes; based on this study, fetal surgery was introduced as a standard of care alternative. Thus, prenatal myelomeningocele diagnosis within the therapeutic window became a mandatory goal; therefore, research efforts on screening strategies were intensified, especially in the first trimester. In addition, different fetal surgery techniques were developed to improve neurological outcomes and reduce maternal risks. The objective of this review is to provide an update on the advances in prenatal screening and diagnosis during the first and second trimesters, and in open and fetoscopic fetal surgery for myelomeningocele

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A seminal study titled Management of Myelomeningocele Study, from 2011, demonstrated that prenatal myelomeningocele defect repaired before 26 weeks of gestation improved neurological outcomes; based on this study, fetal surgery was introduced as a standard of care alternative. Thus, prenatal myelomeningocele diagnosis within the therapeutic window became a mandatory goal; therefore, research efforts on screening strategies were intensified, especially in the first trimester. In addition, different fetal surgery techniques were developed to improve neurological outcomes and reduce maternal risks. The objective of this review is to provide an update on the advances in prenatal screening and diagnosis during the first and second trimesters, and in open and fetoscopic fetal surgery for myelomeningocele.

A partir del estudio seminal Management of Myelomeningocele Study en el año 2011, el cual demostró que la reparación prenatal del defecto del mielomeningocele antes de la semana 26 mejoraba los resultados neurológicos, la cirugía fetal fue incorporada dentro de las opciones de estándar de cuidado. Así, el diagnóstico prenatal del mielomeningocele dentro de la ventana terapéutica se convirtió en un objetivo obligatorio y, por ello, se intensificó la investigación de estrategias de tamizaje, sobre todo, en el primer trimestre. Además, se desarrollaron distintas técnicas de cirugía fetal para mejorar los resultados neurológicos y disminuir los riesgos maternos. El objetivo de la siguiente revisión es actualizar los avances en tamizaje y diagnóstico prenatal en el primer y segundo trimestre, y en cirugía fetal abierta y fetoscópica del mielomeningocele.

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BACKGROUND: Hydrocephalus is a common neurological disorder, caused by a progressive accumulation of cerebrospinal fluid (CSF) within the intracranial space that can lead to increased intracranial pressure, enlargement of the ventricles (ventriculomegaly) and, consequently, to brain damage. Ventriculo-peritoneal shunt systems are the mainstay therapy for this condition, however there are different types of shunt systems. OBJECTIVES: To compare the effectiveness and adverse effects of conventional and complex shunt devices for CSF diversion in people with hydrocephalus. SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials (2020 Issue 2); Ovid MEDLINE (1946 to February 2020); Embase (Elsevier) (1974 to February 2020); Latin American and Caribbean Health Science Information Database (LILACS) (1980 to February 2020); ClinicalTrials.gov; and World Health Organization International Clinical Trials Registry Platform. SELECTION CRITERIA: We selected randomised controlled trials or quasi-randomised trials of different types of ventriculo-peritoneal shunting devices for people with hydrocephalus. Primary outcomes included: treatment failure, adverse events and mortality. DATA COLLECTION AND ANALYSIS: Two review authors screened studies for selection, assessed risk of bias and extracted data. Due to the scarcity of data, we performed a Synthesis Without Meta-analysis (SWiM) incorporating GRADE for the quality of the evidence. MAIN RESULTS: We included six studies with 962 participants assessing the effects of standard valves compared to anti-syphon valves, other types of standard valves, self-adjusting CSF flow-regulating valves and external differential programmable pressure valves. All included studies started in a hospital setting and offered ambulatory follow-up. Most studies were conducted in infants or children with hydrocephalus from diverse causes. The certainty of the evidence for most comparisons was low to very low. 1. Standard valve versus anti-syphon valve Three studies with 296 randomised participants were included under this comparison. We are uncertain about the incidence of treatment failure in participants with standard valve and anti-syphon valves (very low certainty of the evidence). The incidence of adverse events may be similar in those with standard valves (range 0 to 1.9%) and anti-syphon valves (range 0 to 2.9%) (low certainty of the evidence). Mortality may be similar in those with standard valves (0%) and anti-syphon valves (0.9%) (RD 0.01%, 95% CI -0.02% to 0.03%, low certainty of the evidence). Ventricular size and head circumference may be similar in those with standard valves and anti-syphon valves (low certainty of the evidence). None of the included studies reported the quality of life of participants. 2. Comparison between different types of standard valves Two studies with 174 randomised participants were included under this comparison. We are uncertain about the incidence of treatment failure in participants with different types of standard valves (early postoperative period: RR 0.41, 95% CI 0.13 to 1.27; at 12 months follow-up: RR 1.17, 95% CI 0.72 to 1.92, very low certainty of the evidence). None of the included studies reported adverse events beyond those included under "treatment failure". We are uncertain about the effects of different types of standard valves on mortality (range 2% to 17%, very low certainty of the evidence). The included studies did not report the effects of these interventions on quality of life, ventricular size reduction or head circumference. 3. Standard valve versus self-adjusting CSF flow-regulating valve One study with 229 randomised participants addressed this comparison. The incidence of treatment failure may be similar in those with standard valves (42.98%) and self-adjusting CSF flow-regulating valves (39.13%) (low certainty of the evidence). The incidence of adverse events may be similar in those with standard valves (range 0 to 1.9%) and those with self-adjusting CSF flow-regulating valves (range 0 to 7.2%) (low certainty of the evidence). The included study reported no deaths in either group in the postoperative period. Beyond the early postoperative period, the authors stated that nine patients died (no disaggregated data by each type of intervention was available, low certainty of the evidence). The included studies did not report the effects of these interventions on quality of life, ventricular size reduction or head circumference. 4. External differential programmable pressure valve versus non-programmable valve One study with 377 randomised participants addressed this comparison. The incidence of treatment failure may be similar in those with programmable valves (52%) and non-programmable valves (52%)  (RR 1.02, 95% CI 0.84 to 1.24, low certainty of the evidence). The incidence of adverse events may be similar in those with programmable valves (6.19%) and non-programmable valves (6.01%) (RR 0.97, 95% CI 0.44 to 2.15, low certainty of the evidence). The included study did not report the effect of these interventions on mortality, quality of life or head circumference. Ventricular size reduction may be similar in those with programmable valves and non-programmable valves (low certainty of the evidence). AUTHORS' CONCLUSIONS: Standard shunt valves for hydrocephalus compared to anti-syphon or self-adjusting CSF flow-regulating valves may cause little to no difference on the main outcomes of this review, however we are very uncertain due to the low to very low certainty of evidence. Similarly, different types of standard valves and external differential programmable pressure valves versus non-programmable valves may be associated with similar outcomes. Nevertheless, this review did not include valves with the latest technology, for which we need high-quality randomised controlled trials focusing on patient-important outcomes including costs.

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School violence has been recognized worldwide as a public health problem that negatively impacts the educational process. However, in Puerto Rico official statistics and the media generally focus on isolated incidents of extreme violence in which weapons are used or property is destroyed. Little data is available about the most common forms of violence that often occur in schools on a daily basis. The Instrumento de Observación de Violencia Escolar (INOVE), developed with the input of school communities participating in Project VIAS (Violence and Asthma Health Disparity Network) of Universidad del Este (UNE), was used in this study to gather information about the characteristics of violence in two Puerto Rican schools. Among the study findings we highlight gender differences in observed violence and aggressive games and interactions between students. The data collected have served as a basis for decision-making regarding violence prevention in participating schools and have implications for the development of prevention strategies and programs.

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Community-Based Participatory Research promotes the inclusion of diverse voices in the research process and in decision-making processes. However, there are very few research studies that collaborate with children, especially within the context of schools. Promoting child participation has benefits both for children as well as for schools. Nonetheless, this may depend on how adults react to such participation. The present study is part of a broader study on school violence prevention. Our objective is to explore school personnel's concept of childhood and how it relates to their opinions about child school participation. We conducted a discussion group with nineteen (19) faculty and non-faculty members of a public school to ask them questions about the topic. We categorized participants' answers and analyzed relationships among them. Results suggest that participants' concept of childhood is linked to socio-cultural and historical factors and that it impacts their opinions about child participation. Also, school personnel recognize that child participation has benefits for children, the school and the wider society. This contrasts with deficiencies on how to articulate this participation beyond traditional classroom strategies. We discuss the implications of these results for pedagogical practice and for participatory research as promoters of children voices in context.

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Objective: To determine the efficacy of periodontal intervention on pregnancy outcome in mild preeclamptic women.Methods: A sample of 60 pregnant women with mild preeclampsia (blood pressure levels <160/110 mm and proteinuria >300 mg/l in 24 hours urine) from the Hospital Universitario del Valle (Cali, Colombia) was included to the study. Preeclamptic women were randomized in two groups, one with periodontal intervention (PIG, N=28) and another in which the periodontal intervention was practiced after childbirth (NPIG, N=32). Maternal socio-demographic, medical and periodontal data were obtained. PIG included patients in which supragingival and subgingival cleaning within ultrasonic and manual devices were performed after study inclusion. The progression from mild to severe preeclampsia, eclampsia or HELLP syndrome, the number of days of clinical stability and the percentile of birth-weight adjusted for gestational age were evaluated in both groups. Results: Most of the patients (60%) were multigravids. Gestational age at inclusion was 31.8±1.6 weeks. Chronic periodontitis was a frequent finding (61.7%). Social, demographic, medical and periodontal conditions were similar between both groups. Disease progression to severe preeclampsia, eclampsia or HELLP syndrome was also similar (89.2% PIG versus 84.4%, p=0.65) (OR=1.06 IC 95% 0.87-1.29, p=0.65). Days of clinical stability were similar between the groups (median 10 days , range 1-46, PIG versus 12 days, range 1-59, p=0.57) and the percentile of birth weight adjusted with gestational age had no differences between the groups (median percentil 50 range 5-90 PIG versus percentil 55 range 5-95, p=0.73). Conclusion: Periodontal intervention does not seem to harm the health, the severity or alter the frequency on maternal complications in mild preeclampsia subjects.

Objetivo: Determinar la eficacia y seguridad de la intervención periodontal sobre el producto del embarazo en gestantes hospitalizadas con diagnóstico de pre-eclampsia sin complicaciones. Métodos: En un ensayo clínico controlado se evaluaron 60 mujeres embarazadas con diagnóstico de pre-eclampsia leve (presión arterial <160/110 mm Hg y proteinuria >300 mg/l en orina de 24 horas), que se trataron en la unidad de alto riesgo obstétrico del Hospital Universitario del Valle (Cali, Colombia). Se evaluaron las características socio-demográficas, así como los aspectos médicos y periodontales. De este conjunto 28 (46.7%) gestantes se incluyeron al azar en el grupo con intervención periodontal anteparto (GIP) y 32 (53.3%) en el grupo sin intervención periodontal (GNIP). El análisis se hizo de acuerdo con la intención de tratamiento. La variable dependiente fue la proporción de mujeres que agravaron su condición pre-eclámptica hacia pre-eclampsia severa, eclampsia o síndrome de HELLP, el número de días de estabilidad clínica y el percentil de peso del recién nacido ajustado para la edad de la gestación. Resultados: De las pacientes 60% eran multíparas. La edad gestacional promedio de ingreso al estudio fue 31.8 semanas. El diagnóstico periodontal más frecuente fue periodontitis crónica (61.7%). Las características socio-demográficas, obstétricas y periodontales fueron afines en ambos grupos. La pre-eclampsia se agravó de manera comparable en los dos grupos (GIP 89.2% versus GNIP 84.4%, p=0.65) (OR=1.06 IC 95% 0.87-1.29, p=0.65). La estabilidad clínica en días, fue parecida en ambos grupos (GIP mediana 10 días, rango 1-46 versus GNIP 12 días, rango 1-59, p=0.57). La mediana del peso del recién nacido ajustado por la edad gestacional fue semejante en los dos grupos (GIP percentil 50, rango 5-90 versus GNIP percentil 53 rango 5-95, p=0.73).

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Introducción: La Secretaria Distrital de Bogota ha liderado un proceso para implementar áreas demostrativas de prestación de servicios de medicina alternativa y terapias complementarias en la red pública distrital. Como parte de la revisión de los antecedentes, la Secretaria Distrital de Salud de Bogota y el Hospital Pablo VI Bosa ESE sistematizaron experiencias de prestación de este tipo de servicios. Objetivos: Identificar avances, dificultades y aprendizajes obtenidos por diferentes experiencias en las que se han integrado servicios de Atencion convencional con servicios de medicina alternativa. Métodos: Se diseño un instrumento de sistematización, diligenciado por los responsables de los servicios; se sistematizo la información disponible. Resultados: Las experiencias de implementación de servicios de medicina alternativa y terapias complementarias son diversas. En la red pública estos servicios no se han articulado con los servicios convencionales, cuentan con poco tiempo de implementación y se enfrentan a las dificultades de la productividad financiera. Aun existe gran desinformación sobre la medicina alternativa en los profesionales de la salud. Conclusiones: Se debe avanzar en la discusión de lo que implica integrar la medicina alternativa en un sistema de salud como el colombiano. Es imperativo consolidar una política especifica para disminuir las brechas inequitativas de acceso a estos servicios.

Background: Bogota’s District Secretariat has led a process to implement demonstration areas for the provision of alternative medicine and complementary therapies in the public district’s network with the aim of generating evidences of the benefits and difficulties of their integration to the city’s formal health care system. As part of the background review, experiences of this type of services were systematized by Bogota’s Health Secretariat and Pablo VI, Bosa E.S.E. Hospital. This paper documents the process and its main findings. Aims:To identify advances, difficulties and lessons learned from different experiences in which alternative medicine services have been integrated with conventional medical health care services. Methods: A Sistematization tool was designed and filled out by the Service officials. Afterwards, a seminar-workshop was done in order to present the experiences, and each one of the objectives stated for the systematization process was discussed. Finally, the information available was systematized. Results: The experiences of implementation of alternative medicine services and therapies are diverse. These services have not been articulated with the conventional services into the public network. They have been implemented very recently and are facing financial productivitydifficulties. There is still disinformation about alternative medicine among health care service professionals. Conclusions: Further discussions have to be developed on the implication ofintegrating alternative medicine to a health system such as the Colombian one. The main difficulties are the result of an absence of a health care model that respects the philosophy ofthese therapeutic options. A specific policy to fill the gap of inequality regarding the access to these services must be consolidated.

Assuntos

RESUMO

La Secretaría Distrital de Bogotá ha liderado un proceso para implementar áreas demostrativas de prestación de servicios de medicina alternativa y terapias complementarias en la red pública distrital. Como parte de la revisión de los antecedentes, la Secretaría Distrital de Salud de Bogotá y el Hospital Pablo VI Bosa ESE sistematizaron experiencias de prestación de este tipo de servicios. Objetivos: Identificar avances, dificultades y aprendizajes obtenidos por diferentes experiencias en las que se han integrado servicios de atención convencional con servicios de medicina alternativa. Métodos: Se diseñó un instrumento de sistematización, diligenciado por los responsables de los servicios; se sistematizó la información disponible. Resultados: Las experiencias de implementación de servicios de medicina alternativa y terapias complementarias son diversas. En la red pública estos servicios no se han articulado con los servicios convencionales, cuentan con poco tiempo de implementación y se enfrentan a las dificultades de la productividad financiera. Aún existe gran desinformación sobre la medicina alternativa en los profesionales de la salud. Conclusiones: Se debe avanzar en la discusión de lo que implica integrar la medicina alternativa en un sistema de salud como el colombiano. Es imperativo consolidar una política específica para disminuir las brechas inequitativas de acceso a estos servicios.

Bogota's District Secretariat has led a process to implement demonstration areas for the provision of alternative medicine and complementary therapies in the public district's network with the aim of generating evidences of the benefits and difficulties of their integration to the city's formal health care system. As part of the background review, experiences of this type of services were systematized by Bogota's Health Secretariat and Pablo VI, Bosa E.S.E. Hospital. This paper documents the process and its main findings. Aims:To identify advances, difficulties and lessons learned from different experiences in which alternative medicine services have been integrated with conventional medical health care services. Methods: A systematization tool was designed and filled out by the Service officials. Afterwards, a seminar-workshop was done in order to present the experiences, and each one of the objectives stated for the systematization process was discussed. Finally, the information available was systematized. Results: The experiences of implementation of alternative medicine services and therapies are diverse. These services have not been articulated with the conventional services into the public network. They have been implemented very recently and are facing financial productivity difficulties. There is still disinformation about alternative medicine among health care service professionals. Conclusions: Further discussions have to be developed on the implication of integrating alternative medicine to a health system such as the Colombian one. The main difficulties are the result of an absence of a health care model that respects the philosophy of these therapeutic options. A specific policy to fill the gap of inequality regarding the access to these services must be consolidated.

Assuntos

RESUMO

En el marco de la estrategia promociona! de calidad de vida y salud, resulta indispensable implementar un enfoque diferencial para entender la complejidad y afectación de tales determinantes en las poblaciones étnicas de la ciudad. Gran parte de dicho proceso depende de la obtención adecuada de información sobre ellas. El objetivo de este estudio fue el de evaluar la forma como se entiende y utiliza el concepto de etnia en los sistemas de recolección de información sobre salud pública de la capital colombiana. Para ello se hace uso de la recopilada desde el ámbito familiar y Salud a su Casa (SASC) respecto de las familias pertenecientes a grupos étnicos en la localidad de Bosa. El método utilizado fue el de la discusión teórica sobre el concepto de etnia desde la antropología, disciplina que afianzó dicho término para referirse a la diferencia cultural. Posteriormente, usando metodologías cualitativas como etnografía, cartografía social, visitas domiciliarias y confirmación telefónica, el equipo de Transversalidad de etnias, del Hospital Pablo VI, Bosa ESE, revisó la pertinencia y exactitud de la información recogida por los equipos de Salud a su Casa. Los datos obtenidos por Salud a su Casa presentan grandes inconsistencias: al comparar dicha información con los censos de las comunidades étnicas de la localidad se descubre un importante subregistro. Este fenómeno se debe a la construcción conceptual de la herramienta de registro implementada. El artículo discute la pertinencia, exactitud y aplicación del concepto etnia visto desde el nivel distrital. Propone repensar lo étnico desde lo local. donde adquiere sentido desde un punto de vista socio-antropológico, y fortalecer las herramientas cualitativas de los equipos de salud pública. Finalmente, discute la posibilidad de construir métodos censales que obtengan eficientemente la información pertinente.

Assuntos

RESUMO

En el marco de la estrategia promocional de calidad de vida y salud, resulta indispensable implementar un enfoque diferencial para entender la complejidad y afectación de tales determinantes en las poblaciones étnicas de la ciudad. Gran parte de dicho proceso depende de la obtención adecuada de información sobre ellas. El objetivo de este estudio fue el de evaluar la forma como se entiende y utiliza el concepto de etnia en los sistemas de recolección de información sobre salud pública de la capital colombiana. Para ello se hace uso de la recopilada desde el ámbito familiar y Salud a su Casa (SASC) respecto de las familias pertenecientes a grupos étnicos en la localidad de Bosa. El método utilizado fue el de la discusión teórica sobre el concepto de etnia desde la antropología, disciplina que afianzó dicho término para referirse a la diferencia cultural. Posteriormente, usando metodologías cualitativas como etnografía, cartografía social, visitas domiciliarias y confirmación telefónica, el equipo de Transversalidad de etnias, del Hospital Pablo VI, Bosa ESE, revisó la pertinencia y exactitud de la información recogida por los equipos de Salud a su Casa. Los datos obtenidos por Salud a su Casa presentan grandes inconsistencias: al comparar dicha información con los censos de las comunidades étnicas de la localidad se descubre un importante subregistro. Este fenómeno se debe a la construcción conceptual de la herramienta de registro implementada. El artículo discute la pertinencia, exactitud y aplicación del concepto etnia visto desde el nivel distrital. Propone repensar lo étnico desde lo local, donde adquiere sentido desde un punto de vista socio-antropológico, y fortalecer las herramientas cualitativas de los equipos de salud pública. Finalmente, discute la posibilidad de construir métodos censales que obtengan eficientemente la información pertinente.

Special importance in the framework of the promotional strategy of Quality of Life and Health, has become the necessity to carry out a differential focus that allows to understand the social determinants affecting the quality of life and health of ethnic groups of the city. This process depends on the quality of information gathered about its population. The aim of this study is to evaluate how the collection system of public health in Bogotá understands and uses the ethnic concept. The main focus will be the collection process carried out by the SASC teams of ethnic families in Bosa.The methodology was theoretical discussion about the ethnic concept based on the collected information. We use qualitative methodologies like ethnography, social cartography, house visits, and phone calls, reviewing and comparing it with the collected information by the SASC teams. The information collected by the SASC teams has considerable inconsistencies. When compared with the information collected from ethnic groups in the locality, a sub-registry was discovered; this being a consequence of the concept construction in the registry tool. The article discusses the relevance, accuracy and application of the concept as established by the District Health Secretary. We suggest improving the qualitative tools in the different public health groups, rethinking the concept of “ethnic” at the local level, and discuss the relations between culture and health. Additionally, the possibility of developing a survey tool that could find an effective and pertinent information is discussed as well.

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