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Resumen Estudio exploratorio-descriptivo sobre un grupo de profesionales costarricenses en psicología acerca de sus actitudes hacia la aplicación de los principios psicológicos en la práctica odontológica. La muestra fue de 377 psicólogos (activos en el Colegio de Profesionales en Psicología de Costa Rica). A partir del cuestionario original diseñado por Gómez y Gómez (2007), el cual fue construido para estimar la necesidad de conformar programas universitarios que integren la psicología y la odontología, se aplicó una adaptación consistente en una encuesta de 10 preguntas autoadministradas de selección simple, la cual se efectuó en línea a través del sistema QuestionPro®. Se pudo evidenciar que existe una actitud positiva ante el enfoque interdisciplinario entre la Odontología y la Psicología; se demostró que un 74% de la muestra sostiene que los aspectos psicosociales son "Bastante importantes" en el marco de la atención odontológica. A pesar de ello, la mayoría (57%) de las personas consultadas indicó que no ha tenido ocasión de aplicar sus conocimientos y experiencia en psicología al contexto odontológico. Asimismo, un 72% de los participantes considera "Bastante importante" que los profesionales en Odontología reciban capacitación básica en el área psicológica para la prevención o contención de ciertos síntomas que puedan incidir en la salud mental. Por otra parte, el 80% de quienes respondieron la encuesta indicaron que las iniciativas interdisciplinarias de colaboración científica (investigación) y aplicada (ejercicio profesional) son "Bastante importantes" para producir beneficios tangibles en la prestación de servicios integrales a los pacientes y el bienestar del personal sanitario.

Abstract Exploratory-descriptive study on a group of Costa Rican professionals in psychology about their attitudes towards the application of psychological principles in dental practice. The sample consisted of 377 psychologists (active in the Association of Psychology Professionals of Costa Rica). From the original questionnaire designed by Gómez and Gómez (2007), which was built to estimate the need to create university programs that integrate psychology and dentistry, an adaptation consisting of a survey of 10 self-administered questions of simple selection was applied, which was carried out online through the QuestionPro® system. It was possible to show that there is a positive attitude towards the interdisciplinary approach between Dentistry and Psychology; it was shown that 74% of the sample maintains that psychosocial aspects are "Quite important" in the context of dental care. Despite this, the majority (57%) of the people consulted indicated that they had not had the opportunity to apply their knowledge and experience as psychologists to the dental context. Likewise, 72% of the participants consider it "Quite important" that dental professionals receive basic training in the psychological area for the prevention or containment of certain symptoms that may affect mental health. On the other hand, 80% of the survey respondents indicated that interdisciplinary initiatives of professional scientific (research) and applied (practice) collaboration are "Quite important" to produce tangible benefits in the provision of comprehensive services to patients and wellbeing of health personnel.

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INTRODUCTION: The COVID-19 pandemic led to the collapse of the Peruvian health system, disrupting healthcare access for indigenous communities in the Amazon. Our study analysed how community health workers (CHWs) from indigenous communities in the Peruvian Amazon expanded their roles to mitigate the effects of the COVID-19 pandemic. METHODS: Fourteen CHWs from Loreto, Peru, participated in a community-based participatory research project using Photovoice, a technique encouraging vulnerable groups to take photos and develop stories illustrating their lived experiences. Participants were recruited from Mamás del Río, a local university-based programme, through purposive sampling. CHWs were asked to photograph how the pandemic affected their lives and work. Participants met four times over 5 months to share photos and develop action items. Data were organised into key themes using thematic analysis. CHWs shared photo galleries with policy-makers in Loreto and Lima. RESULTS: CHWs produced 36 photos with 33 texts highlighting their roles during COVID-19. Three core themes emerged: the (1) collapse of health infrastructure, (2) use of medicinal plants versus pharmaceuticals and (3) community adaptations and struggles. The leadership of CHWs emerged as a cross-cutting theme as CHWs supported COVID-19 efforts without government training or resources. CHWs asked policy-makers for formal integration into the health system, standardisation of training and management of community pharmacies. CONCLUSION: CHWs demonstrated their leadership and expanded their roles during the pandemic with little to no training from the government. Global investment in robust CHW programmes can fortify healthcare delivery.

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BACKGROUND: Kangaroo Mother Care (KMC) is an evidence-based intervention focused on premature and low-birth-weight (LBW) infants. In different healthcare systems, outpatient KMC programmes (KMCPs) have been pioneers in the follow-up of these high-risk newborns.Here, we describe an overview analysis performed in an unprecedented data set comprising Colombian infants and spanning 28 years. METHODS: Cohort study of 57 154 infants discharged home in kangaroo position (KP) for follow-up in four KMCPs between 1993 and 2021. RESULTS: At birth and at hospital discharge to a KMCP, median gestational age and weight were 34.5 and 36 weeks, 2000 g and 2200 g, respectively. Chronological age at admission was 8 days. Over time, anthropometric measures at birth and somatic growth during follow-up improved; on the other hand, percentages of mechanical ventilation, intraventricular haemorrhage and need for intensive care decreased as neuropsychomotor, sensory disorders and bronchopulmonary dysplasia incidence at 40 weeks. Risk of cerebral palsy and teenage mothers' frequency was higher in the poorest population. Early home discharge in KP in less than 72 hours was possible in 19% of the cohort. During the COVID-19 pandemic, we observed a more than twofold increase in exclusive breast feeding at 6 months and a reduction in readmission rates. CONCLUSION: This study provides a general overview of KMCPs follow-up during the last 28 years within the Colombian healthcare system. These descriptive analyses have allowed us to structure KMC as an evidence-based method. KMCPs allow close monitoring with regular feedback about preterm or LBW infants' perinatal care, quality of care over time and health status during their first year of life. Monitoring these outcomes is challenging but guarantees access to high-risk infants' care with equity.

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Following the first COVID-19 case in Chiapas, Mexico in March 2020, the non-governmental organisation Compañeros En Salud (CES) and the state's Ministry of Health (MOH) decided to join forces to respond to the global pandemic. The collaboration was built over 8 years of partnership to bring healthcare to underserved populations in the Sierra Madre region. The response consisted of a comprehensive SARS-CoV-2 infection prevention and control programme, which included prevention through communication campaigns to combat misinformation and stigma related to COVID-19, contact tracing of suspected and confirmed COVID-19 cases and their contacts, outpatient and inpatient care for patients with respiratory symptoms, and CES-MOH collaboration on anti-COVID-19 immunisation campaigns. In this article, we describe these interventions and their principal outcomes, as well as reflect on notable pitfalls identified during the collaboration, and we suggest a series of recommendations to prevent and mitigate their occurrence. As with many cities and towns across the globe, the poor preparedness of the local health system for a pandemic and pandemic response led to the collapse of the medical supply chain, the saturation of public medical facilities and the exhaustion of healthcare personnel, which had to be overcome through adaptation, collaboration and innovation. For our programme in particular, the lack of a formal definition of roles and clear lines of communication between CES and the MOH; thoughtful planning, monitoring and evaluation and active engagement of the communities served in the design and implementation of health interventions affected the outcomes of our efforts.

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BACKGROUND: Cardiovascular effects for drugs such as hyoscine butylbromide are poorly documented in the literature, unlike atropine, which is considered the antimuscarinic of choice in the presence of intraoperative bradycardia. AIM: The aim of the study was to describe the dose-related cardiovascular effect of hyoscine butylbromide in patients between 18 and 65 years of age, with low perioperative risk undergoing elective surgery under general anaesthesia on an outpatient basis or hospitalised at our institution between 1 January and 31 May 2019. METHODS: Descriptive, cross-sectional, retrospective study; 28 patients with low perioperative risk who underwent general anaesthesia were selected. Changes in heart rate and blood pressure were analysed during the first 6 minutes after the administration of hyoscine butylbromide. The data obtained was recorded in a Microsoft Excel database and analysed using the Excel analysis tool and IBM SPSS. RESULTS: The average dose of 0.15mg/kg of hyoscine butylbromide achieved an increase in heart rate and mean arterial pressure in 96% and 92.8%, respectively, in the first 6 minutes after the administration. Significant changes in heart rate and blood pressure were obtained during the first 6 minutes at doses between 0.05mg/kg and 0.15mg/kg. CONCLUSION: Hyoscine butylbromide generates positive effects on the heart rate and blood pressure of patients under general anaesthesia, representing a possible alternative in the management of intraoperative bradycardia.

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OBJECTIVES: To examine news coverage of Mexico's front-of-package food labelling policy. METHODS: We used Lexis Nexis to identify newspaper articles that mention the proposed law in four Mexican newspapers representing politically centre-left and centre-right perspectives. We coded for type and valence of arguments, sources and research evidence cited. RESULTS: We identified N=361 relevant articles. Coverage of the front-of-package food label policy was primarily news (vs editorial/opinion). While most were neutral in tone, left-leaning newspapers had slightly more positive overall coverage compared with right-leaning newspapers, indicated by publishing more stories in favour of the policy, fewer in opposition, more propolicy arguments and more frequent inclusion of perspectives by government officials and public health advocates. Despite some evidence of bias, there was a general lack of credible opposition to the policy and mention of opponents across newspapers. CONCLUSIONS AND POLICY IMPLICATIONS: The relative absence of food and beverage industry stakeholders in news coverage of the food label policy is unexpected given their documented involvement in prior food policy debates. We discuss possible reasons for their conspicuous absence and lessons for public health advocates around the globe.

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ABSTRACT Background: Haiti is one of the Caribbean countries where malaria persists. More than 99% of malaria cases are caused by Plasmodium falciparum, the main vector being the mosquito Anopheles albimanus. In this paper, we describe the epidemiological profile of malaria in Haiti between 2009 and 2018. Methods We analyzed information on cases reported by the Ministry of Health of Haiti and the World Health Organization (WHO). Results: Between 2009 and 2018, 232,479 malaria cases were reported by the Ministry of Public Health and Population (MSPP); an increase in the incidence of malaria in the country in 2010, followed by a decrease in 2011, was primarily observed. Due to recent efforts to reduce malaria by 2020, its incidence declined from 60,130 cases in 2010 to 8,978 cases in 2018. Controversially, in terms of the number of reported cases, the MSPP and WHO report conflicting data. However, the results from both datasets present the same trend in Haiti from 2009 to 2018. The results also illustrate the endemicity of the disease throughout Haiti, both in rural and urban areas, especially along the coast. Conclusions: This study emphasizes the need to promote official data collection and analyses, as well as the application of epidemiological surveillance of malaria at the municipal level, for a better understanding of the real impact of malaria on the Haitian population and to create more appropriate interventions.

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INTRODUCTION: To present an analysis of the Brazilian health system and subnational (state) variation in response to the COVID-19 pandemic, based on 10 non-pharmaceutical interventions (NPIs). MATERIALS AND METHODS: We collected daily information on implementation of 10 NPI designed to inform the public of health risks and promote distancing and mask use at the national level for eight countries across the Americas. We then analyse the adoption of the 10 policies across Brazil's 27 states over time, individually and using a composite index. We draw on this index to assess the timeliness and rigour of NPI implementation across the country, from the date of the first case, 26 February 2020. We also compile Google data on population mobility by state to describe changes in mobility throughout the COVID-19 pandemic. RESULTS: Brazil's national NPI response was the least stringent among countries analysed. In the absence of a unified federal response to the pandemic, Brazilian state policy implementation was neither homogenous nor synchronised. The median NPI was no stay-at-home order, a recommendation to wear masks in public space but not a requirement, a full school closure and partial restrictions on businesses, public transportation, intrastate travel, interstate travel and international travel. These restrictions were implemented 45 days after the first case in each state, on average. Rondônia implemented the earliest and most rigorous policies, with school closures, business closures, information campaigns and restrictions on movement 24 days after the first case; Mato Grosso do Sul had the fewest, least stringent restrictions on movement, business operations and no mask recommendation. CONCLUSIONS: The study identifies wide variation in national-level NPI responses to the COVID-19 pandemic. Our focus on Brazil identifies subsequent variability in how and when states implemented NPI to contain COVID-19. States' NPIs and their scores on the composite policy index both align with the governors' political affiliations: opposition governors implemented earlier, more stringent sanitary measures than those supporting the Bolsonaro administration. A strong, unified national response to a pandemic is essential for keeping the population safe and disease-free, both at the outset of an outbreak and as communities begin to reopen. This national response should be aligned with state and municipal implementation of NPI, which we show is not the case in Brazil.

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Resumen Introducción: debido al fenómeno de globalización actual, cada vez es más necesario aportar una visión inclusiva e intercultural al ámbito educativo. No responder adecuadamente a esta demanda puede provocar situaciones de exclusión, segregación y discriminación del alumnado. El gobierno colombiano ha planteado diferentes acciones para fortalecer este enfoque y evitar dichas problemáticas. No obstante, estas acciones deben ser analizadas en profundidad para evidenciar la promoción de la educación inclusiva e intercultural en las instituciones educativas. Objetivo: el propósito de la investigación es determinar el nivel de conocimiento y ejecución de las prácticas inclusivas e interculturales en el Colegio Llano de Palmas (Colombia). Materiales y métodos: el diseño de investigación se acomete mediante un estudio de caso. La metodología utilizada es cuantitativa descriptiva (Hernández, Fernández & Baptista, 2010), implementando el cuestionario sobre el reconocimiento y aplicabilidad de la competencia inclusiva e intercultural. Resultados: el análisis de datos revela que la educación inclusiva e intercultural apenas se fomenta de forma regular en el centro educativo (10 %), siendo mayoritaria su promoción inadecuada (90 %) mediante una implementación esporádica (49 %), no aplicándose en absoluto (36 %) o desconociendo por completo su estado de desarrollo (5 %). Conclusiones: los resultados obtenidos indican que el conocimiento y la ejecución de prácticas inclusivas e interculturales en el Colegio Llano de Palmas es notablemente mejorable. Esta situación demanda el diseño y aplicación de estrategias específicas de promoción más efectivas, así como el análisis de distintos entornos educativos para determinar la situación actual del país en este sentido.

Abstract Introduction. Due to the current phenomenon of globalization, it is increasingly necessary to provide an inclusive and intercultural vision to the education. Not responding adequately to this demand can lead to situations of exclusion, segregation, and discrimination for students. The Colombian government has proposed several actions to strengthen this approach and avoid those problems. However, these actions must be analyzed in depth to demonstrate the promotion of inclusive and intercultural education in institutions. Objective: the purpose of this research is to determine the level of knowledge and execution of inclusive and intercultural practices at Llano de Palmas School (Colombia). Materials and methods: this research applies a case study design. The methodology used is descriptive quantitative (Hernández et al., 2010), implementing the questionnaire on the recognition and applicability of inclusive and intercultural competency. Results: the data analysis reveals that inclusive and intercultural education is hardly encouraged on a regular basis in the school (10 %), with a widely inadequate promotion (90 %) through sporadic implementations (49 %), not being applied at all (36 %), or being completely unaware of their development status (5 %). Conclusions: the results obtained indicate that the knowledge and execution of inclusive and intercultural practices at Llano de Palmas School is remarkably low. This situation demands the design and application of specific strategies for more effective promotion, as well as the analysis of different educational contexts to determine the current situation of the country in this regard.

Resumo Introdução: devido ao atual fenômeno da globalização, é cada vez mais necessário fornecer uma visão inclusiva e intercultural ao campo educacional. Não responder adequadamente a essa demanda pode levar a situações de exclusão, segregação e discriminação de estudantes. O governo colombiano propôs diferentes ações para fortalecer essa abordagem e evitar esses problemas. No entanto, essas ações devem ser analisadas em profundidade para demonstrar a promoção da educação inclusiva e intercultural nas instituições de ensino. Objetivo: o objetivo da pesquisa é determinar o nível de conhecimento e execução de práticas inclusivas e interculturais na Escola Llano de Palmas (Colombia). Materiais e métodos: o desenho da pesquisa é realizado através de um estudo de caso. A metodologia utilizada é quantitativa descritiva (Hernández et al., 2010), implementando o questionário sobre o reconhecimento e aplicabilidade da competência inclusiva e intercultural. Resultados: a análise dos dados revela que a educação inclusiva e intercultural dificilmente é incentivada regularmente no centro educacional (10 %), sendo sua promoção inadequada a maioria (90 %) através de implementação esporádica (49 %), não sendo aplicada de forma alguma (36 %) ou desconhecem completamente o seu estado de desenvolvimento (5 %). Conclusões: os resultados obtidos indicam que o conhecimento e na execução de práticas inclusivas e interculturais na Escola Llano de Palmas são notavelmente melhorados. Essa situação exige o desenho e aplicação de estratégias específicas para promoção mais efetiva, bem como a análise de diferentes ambientes educacionais para determinar a situação atual do país nesse quesito.

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Introducción: El plagio junto a la fabricación y falsificación de resultados constituyen las formas más graves de mala conducta científica. Sin embargo, la escasez de estudios concretos sobre esta mala práctica, motivó realizar la presente investigación. Objetivo: Caracterizar los artículos que incurren en plagio publicado en revistas biomédicas cubanas indizadas en SciELO, durante 2016. Material y métodos: Estudio descriptivo, transversal, con una muestra probabilística de 50 artículos originales, obtenida por muestreo aleatorio simple de 786 investigaciones publicadas en 32 revistas biomédicas cubanas indizadas en SciELO. Se realizó un análisis textual a través de Google Scholar, para identificar textos idénticos. Luego se cotejaron los artículos con similitudes, y se seleccionó como original el de fecha de publicación más antigua. Para el análisis se utilizó el Software RStudio 1.0.136. No se revelan títulos de artículos, autores, instituciones ni revistas en que se publicaron. Resultados: Más de la mitad de los artículos (52 por ciento) cumplía el criterio de plagio. Los hallazgos se encontraron en todas las secciones del artículo, fundamentalmente en introducción (52 por ciento), discusión (18 por ciento) y material y métodos (10 por ciento). El patrón de plagio más frecuente fue "en mosaico" (sustitución, adición, sustracción), seguido por "plagio directo" (copia exacta de bloques de texto). Conclusiones: La frecuencia de plagio en los artículos revisados es alta, con predominio hacia las estructuras teóricas del artículo (introducción y discusión), y fundamentalmente a partir del uso de sinónimos, cambios de verbos, adición y/o sustracción de texto, correspondiente al plagio en mosaico(AU)

Introduction: Plagiarism and the fabrication and falsification of results constitute the most serious forms of scientific misconduct. However, there is a lack of solid studies on this malpractice which motivated us to carry out this research work. Objective: To characterize the articles engaged in plagiarism published in Cuban biomedical journals indexed in SciELO in 2016. Material and Methods: A descriptive cross-sectional study was conducted using a probabilistic sample of 50 original articles obtained by simple random sampling of 786 research studies published in 32 Cuban biomedical journals indexed in SciELO. A textual analysis was performed using Google Scholar to identify identical texts. After that, similar articles were compared and the oldest data of publication was taken into account to determine the original article. R Studio Software 1.0.136 was used for the analysis. The titles of the articles, authors, institutions and journals were not shown. Results: More than half of the articles (52 percent) met the criteria of plagiarism. Similarities were found in all sections of the article, mainly in the introduction (52 percent), discussion (18 percent) and material and methods (10 percent). The most frequent pattern of plagiarism was in "mosaic" (substitution, addiction, subtraction), followed by "direct plagiarism" (exact copy of sections of text). Conclusions: The frequency of plagiarism in the articles reviewed is high, predominating in the theoretical structures of the article (introduction and discussion), where synonyms, changes in verbs, addition or omission of parts of the text were identified, corresponding to plagiarism in mosaic.

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RESUMEN Introducción: en el último trienio la mortalidad por cáncer mamario en el sexo femenino en Cuba disminuyó ligeramente sus tasas, sin embargo no se han realizado estudios de supervivencia por esta enfermedad en la provincia Matanzas. Objetivo: evaluar el comportamiento del tiempo de supervivencia global a los 5 años en esta serie y valorar la sobrevida en función de variables seleccionadas. Materiales y métodos: se realizó un estudio observacional descriptivo, longitudinal y retrospectivo, en el que participaron 288 mujeres diagnosticadas con cáncer de mama en la consulta de mastología del Hospital "José Ramón López Tabranes" de la provincia Matanzas, desde el 1 de Enero del 2010 hasta el 31 de Diciembre del 2015. Se utilizó el método de Kaplan Meier para determinar el tiempo de supervivencia global a los 5 años y en función de variables seleccionadas. La comparación de las diferentes curvas para las variables de exposición se realizó con la prueba de Rangos Logarítmicos (Log Rank). Se consideró estadísticamente significativo el valor del estadígrafo mayor de 1 y p < 0.05. Resultados: la supervivencia global a los 5 años fue de un 66 %. Se registran supervivencias muy por debajo de los estándares internacionales para las pacientes en estadios III (37 %) y IV (0). La supervivencia global disminuye de manera significativa en la medida en que se incrementan el número de ganglios afectados y el tamaño del tumor al momento del diagnóstico. Conclusiones: la supervivencia global a los 5 años resultó inferior a la registrada en la mayoría de los estudios internacionales consultados. Se muestra una disminución marcada de la sobrevida en pacientes con estadios clínicos avanzados de la enfermedad: (III y IV).

ABSTRACT Introduction: in the last three years, mortality rates due to breast cancer in the female sex in Cuba slightly decreased, but studies of this disease survival have not been carried out in the province of Matanzas. Objective: to evaluate the behavior of the global survival time of this series at the 5th year and to assess survival according to chosen variables. Material and method: a retrospective, longitudinal, observational descriptive study was carried out; 288 women diagnosed with breast cancer took part on it; they were diagnosed in the mastology consultation of the hospital "Jose Ramon Lopez Tabrane", province of Matanzas during the period January 1st 2010- December 31st 2015. The Kaplan-Meier method was used to determine the global survival time at the 5th year according to chosen variables. The comparison of the different curves for the exposition variables was made using the Log Rank test. The test value higher than 1 and p < 0.05 was considered statistically significant. Results: global survival at the 5th year was 66 %. There are survival rates well below the international standards for the stage III (37 %) and stage IV (0) patients. Global survival significantly decreases insofar as the number of affected ganglia and the size of the tumor at the moment of the diagnosis increase. Conclusions: global survival at the 5th year was lower than the one recorded in most of the consulted international studies. There is a remarkable decrease of survival in patients with disease advanced clinical stages: III and IV.

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BACKGROUND: The need to have a variety of tools to deal with end-stage heart failure (ES-HF), along with the limited heart transplantation availability encouraged us to create a pilot Left ventricular assist device (LVAD) program in a public health care system hospital in Chile. METHODS: A retrospective analysis of the first nine patients of an ongoing LVAD program initiated on August 2013 was performed, completing an average of 30 months of follow-up. The most important events regarding to morbidity and mortality are described. RESULTS: Nine patients with ES-HF underwent LVAD implantation surgery; one of them died 23 days after surgery and another died after 11 months. One patient successfully underwent heart transplantation after 16 months of HeartWare ventricular assist device (HVAD) support; the other six patients remain in the program and have an average follow-up of 846 days at the time of this study (range, 23-1,481 days). The survival rate at 6, 12 and 18 months follow-up was 89%, 78% and 78% respectively. CONCLUSIONS: This new pioneering LVAD program in Chile has been successful and now constitutes a vital adjunct to all who work in heart transplantation and ES-HF programs. It offers an effective therapeutic alternative when there is a severe donor shortage, in cases of atypical blood types, emergencies, exceptional cases with contraindication for heart transplantation or when there is important donor-receiver size mismatch.

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Background/Objective: Several diagnostic criteria of Post-traumatic Stress Disorder (PTSD) are remarkably similar to symptoms reported by individuals with depression, particularly as they manifest as cognitive processing deficits in children. Because of this overlap in profile and the high rate of comorbidity of PTSD and depression (48% to 69%), pinpointing similarities/differences in cognitive processes related to each of these disorders is essential to accurate diagnosis. This study aims to examine cognitive performance profiles of 23 children who have been victims of PTSD and to compare their results with 23 children with depression and 24 controls. Method: Empirical study, observational and descriptive methodologies were performed using several neuropsychological tests to assess IQ, attention, memory and executive function. Statistical comparisons between groups were made using the non-parametric Kruskall-Wallis test and post-hoc analyses were conducted using a Mann Whitney U test, as well as Quade's co-variance analysis. Results: Data show different profiles of cognitive performance in those with PTSD compared to those with depression and controls. Conclusions: The findings suggests that PTSD and depressed children differ somewhat in their cognitive profiles, and the differences in IQ found between those with PTSD and those without are not necessarily a confounding variable, but may rather be a consequence of their traumatic experience.

Antecedentes/Objetivo: Varios criterios diagnósticos del trastorno de estrés post-traumático (PTSD, por sus siglas en inglés) son similares a los síntomas de la depresión, particularmente relacionados con aspectos cognitivos de niños afectados por estas condiciones. Debido a esta superposición del perfil cognitivo y dada la alta comorbilidad entre PTSD y depresión (48% y 69%), identificar las características en los perfiles cognitivos de cada trastorno pudiera ser útil para hacer diagnósticos más precisos. El objetivo fue examinar el rendimiento cognitivo en 23 niños con PTSD y comparar sus resultados con 23 niños con depresión y 24 controles. Método: Estudio empírico, observacional y descriptivo mediante aplicación de una batería neuropsicológica que evaluó inteligencia, atención, memoria y función ejecutiva. Las comparaciones estadísticas se realizaron mediante la prueba no paramétrica Kruskal-Wallis. Los análisis post-hoc se realizaron utilizando U de Mann Whitney y el análisis de covarianza de Quade. Resultados: Los datos muestran diferentes perfiles cognitivos del grupo con PTSD en comparación con los grupos de depresión y controles. Conclusiones: Los hallazgos sugieren que el grupo de PTSD y el grupo de depresión difieren en sus perfiles cognitivos y que las diferencias en el nivel intelectual encontradas en los niños con PTSD pudieran no ser una variable de confusión sino una consecuencia de la experiencia traumática.

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Introdução: A manometria anorretal é, atualmente, o padrão ouro, como método de diagnóstico laboratorial dos distúrbios evacuatórios. O objetivo do presente estudo é descrever uma experiência brasileira, da realização da manometria anorretal, valorizando-a como meio diagnóstico. Métodos: Estudo retrospectivo, com revisão dos laudos dos exames, no Laboratório de Motilidade Digestiva da Santa Casa de Misericórdia de Porto Alegre, Brasil. Foram incluídos os pacientes consecutivos, acima de 12 anos de idade, submetidos à manometria anorretal, entre março de 2003 e outubro de 2015. Resultados: No período, foram realizados 1319 exames, em pacientes com média de idade de 53,4±19,4 anos, sendo 70,7% do sexo feminino. A incontinência anal, com 62,4% dos exames, foi a principal indicação da manometria anorretal, a segunda foi constipação com 29,4% e por outros motivos em 8,2% dos pacientes. No período entre 2011 e 2015, houve um aumento significativo dos exames realizados por incontinência anal, em relação ao de 2003 até 2010. Conclusões: As duas principais indicações da manometria anorretal, no presente estudo e na literatura, são constipação e incontinência anal. O aumento significativo dos exames por incontinência anal, após 2011, sugere uma maior consciência dos médicos e pacientes em relação às possibilidades de diagnóstico e tratamento das disfunções evacuatórias. Este é o primeiro estudo brasileiro, que discute as indicações da manometria anorretal e as características dos pacientes encaminhados para o exame. Os autores sugerem a valorização da manometria anorretal como ferramenta de diagnóstico nas disfunções evacuatórias AU)

Introduction: Anorectal manometry is currently the gold standard for laboratory diagnosis of bowel disorders. The aim of the present study is to describe a Brazilian experience in performing anorectal manometry, valuing it as a diagnostic tool. Methods: A retrospective study, with review of test reports, in the Digestive Motility Laboratory of Santa Casa de Misericórdia, Porto Alegre, Brazil. We included consecutive patients, over 12 years of age, undergoing anorectal manometry from March 2003 to October 2015. Results: 1319 tests were performed in the studied period in patients with mean age of 53.4 ± 19.4, 70.7% of whom females. Anal incontinence, accounting for 62.4% of the tests, was the main indication for anorectal manometry, the second was constipation with 29.4%, and other reasons in 8.2% of the patients. In the 2011-2015 period there was a significant increase in the number of tests due to anal incontinence as compared to the 2003-2010 period. Conclusions: The two main indications for anorectal manometry in this study and in the literature are constipation and anal incontinence. The significant increase in the number of tests performed due to anal incontinence after 2011 suggests clinicians' and patients' greater awareness of the possibilities for diagnosis and treatment of bowel dysfunction. This is the first Brazilian study discussing the indications of anorectal manometry and the characteristics of the patients referred to the test. The authors suggest the use of anorectal manometry as a diagnostic tool in evacuation dysfunctions (AU)

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El objetivo de esta investigación fue analizar la asociación entre autoeficacia percibida, personalidad resistente, locus de control, percepción de estrés y síndrome de Burnout en 40 estudiantes de medicina de pregrado. El análisis de los datos se efectuó considerando estadística descriptiva y técnicas exploratorias multivariadas. Los resultados muestran la pertinencia que puede tener la personalidad resistente en la atenuación del estrés crónico al asociarse negativamente con el síndrome de Burnout y agruparse dentro de los componentes que explicaban mayor variación en la combinación lineal de variables en comparación con la autoeficacia y el locus de control. Se confirma la necesidad de reforzar la formación de los estudiantes de medicina a través del establecimiento de recursos de afrontamiento ante el estrés y formación de una personalidad resistente, ya que los datos muestran niveles altos en percepción de estrés y síndrome de Burnout a seis meses de estar realizando el internado.

The objective of this research was to analyze the association between perceived self-efficacy, hardiness, locus of control, perceived stress and Burnout syndrome in 40 undergraduate medical students. The data analysis was performed considering descriptive statistics and multivariate exploratory techniques. The results show the relevance that may have the hardiness in the attenuation of chronic stress negatively associated with Burnout and grouped within components that explained more variation in the linear combination of variables compared to self-efficacy and locus of control. The need to strengthen the training of medical students through the establishment of resources Coping Stress and formation of a strong personality is confirmed as the data show high levels of perceived stress and Burnout six months of doing the internship.

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Introducción. La cetoacidosis diabética (CAD) es una complicación importante de la diabetes mellitus tipo 1 (DM1) que se presenta de novo o en pacientes ya diagnosticados, sin datos publicados en la literatura nacional. Objetivos. Describir las características epidemiológicas, clínicas y bioquímicas de los pacientes admitidos al Hospital de Especialidades Pediátricas "Omar Torrijos Herrera" (HEPOTH) con diagnóstico de CAD. Métodos. Se realizó una revisión retrospectiva de los expedientes clínicos de los pacientes con diagnóstico de CAD admitidos a las salas de hospitalización del HEPOTH para describir las variables edad, sexo, glicemia, gravedad de la CAD, tiempo de resolución, complicaciones y uso de bicarbonato. Se utilizó estadística descriptiva (frecuencias, media y desviación estándar) y analítica con α=0.05 para cada comparación. Resultados. Encontramos 58 casos de CAD (28 masculinos, 30 femeninos). Observamos un pico bimodal de frecuencias entre los 8 y 11 años para ambos sexos. En el 62% de los casos no se encontró un factor evidente para la descompensación. Las variables metabólicas de todos los casos fueron evaluadas y se establecieron las medias (desviación estándar) de glicemia (530.9 [144.9]), bicarbonato (8.16 [3.58]) y pH (7.12 [0.12]). Se observó que, a mayor gravedad, menor valor de bicarbonato y de pH sanguíneo; además de una relación inversa, estadísticamente significativa (p<0.001) entre el pH al inicio del tratamiento con el tiempo requerido hasta alcanzar el pH de 7.30. La complicación más frecuente fue la hipokaliemia (44.8%). El edema cerebral ocurrió en 9% de los casos, de los cuales se registró una muerte (tasa de letalidad cruda = 1.7%). Conclusiones. La CAD es más frecuente entre los 8 y 11 años de edad y usualmente se presenta con criterios de gravedad. La hipokaliemia es la complicación más frecuente y el factor predisponente es difícil de detectar. A pesar de la baja letalidad encontrada, se debe vigilar por edema cerebral.

Background Diabetic ketoacidosis (DKA) is an important complication of type 1 diabetes mellitus, presenting either de novo or in patients already diagnosed, without data published in the national literature. Aims To describe the epidemiological, clinical, and biochemical characteristics of patients admitted to the "Omar Torrijos Herrera" Pediatric Specialties with diagnosis of DKA. Methods We performed a restrospective review of clinical records of patients diagnosed with DKA admitted to the wards of the Hospital to describe the variables age, sex, glycemia, DKA severity, time to resolution, complications, and use of bicarbonate. Descriptive (frequencies, mean, standard deviation [SD]) and analysitcal statistics were used with α=0.05 for each comparison. Results We found 58 cases of DKA (28 males, 30 females). We observed a bimodal peak of frequencies between ages 8 and 11 for both genders. In 62% of the cases there was no evident factor for the descompensation. Metabolica variables in all of the cases were assessed and mean (SD) of glycemia (530.9 [144.9]), bicarbonate (8.16 [3.58]) and blood pH (7.12 [0.12]) were established. The higher the severity, the lower bicarbonate and blood pH value; besides an inverse and statistically significant relationship (p<0.001) between pH at the beginning of the treatment and the time required to reach a blood pH value of 7.30. The most frequent complication was hypokalemia (44.8%). Cerebral edema occurred in 9% of the cases, among which one decease was registered (crude lethality rate = 1.7%). Conclusions Diabetic ketoacidosis is more frequent between 8 and 11 years of age and usually presents with severity criteria. Hypokalemia is the most frequent complication and the predisposing factor is difficult to detect. Even though we found a low lethality rate secondary to cerebral edema, this complication must be always beared in mind.

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Introducción: la enfermedad hemorroidal constituye un problema de salud mundial y Cuba; sin embargo, la literatura no recoge información epidemiológica sobre la población cubana. Por lo que este trabajo caracteriza la enfermedad hemorroidal aguda en hospitales cubanos seleccionados, con particular énfasis en los factores de riesgo que favorecen su aparición. Objetivos: identificar los principales factores de riesgo, sus características demográficas y de base; hábitos tóxicos y alimenticios, así como modos y estilos de vida, que favorecen la aparición de una enfermedad hemorroidal aguda. Métodos: se realizó un estudio observacional descriptivo en 11 servicios cubanos de Coloproctología. Se incluyeron 510 pacientes con diagnóstico de enfermedad hemorroidal aguda, con edades comprendidas entre 18 y 75 años, que dieron su consentimiento de participación en el estudio. A todos los pacientes se les aplicó una encuesta epidemiológica que indagaba acerca de los hábitos tóxicos y alimenticios, así como modos y estilos de vida, los cuales son reconocidos como factores de riesgo para la aparición de la enfermedad. Resultados: casi el 75 por ciento de los pacientes comenzó con la enfermedad. Predominaron las hemorroides externas y los signos y síntomas más frecuentes fueron el dolor anal, la sensación de masa, el edema y el sangramiento rectal. La mitad de los pacientes ingiere bebidas alcohólicas y la mayoría consume café, alimentos condimentados y requiere una posición erecta o permanecer sentado durante largos períodos de tiempo, para sus actividades cotidianas. Pocos pacientes consumen altos contenidos de fibras en la dieta, así como abundante agua. Conclusiones: se corrobora la presencia de factores de riesgo e inadecuados modos y estilos de vida en la población cubana que facilitan o propician la aparición de un episodio agudo hemorroidal(AU)

Introduction: hemorrhoidal disease is a global health problem. In Cuba, however, epidemiological data about the population is not available in the literature on the subject. That is the reason why the present paper is aimed at characterizing acute hemorrhoidal disease in selected Cuban hospitals, with particular emphasis on the risk factors leading to its appearance. Objectives: identify the main risk factors, demographic and base features, toxic and eating habits, and life styles and modes, leading to the appearance of acute hemorrhoidal disease. Methods: an observational descriptive study was conducted in 11 Cuban coloproctology services. The sample consisted of 510 patients aged 18-75 diagnosed with acute hemorrhoidal disease, who gave their consent to participate in the study. All patients were given an epidemiological survey about toxic and eating habits, and life styles and modes perceived as risk factors for the disease. Results: almost 75 percent of the patients developed the disease. There was a predominance of external hemorrhoids, and the most common signs and symptoms were anal pain, mass sensation, edema and rectal bleeding. Half the patients consume alcohol and most drink coffee, eat spicy foods and must remain in a standing or sitting position for long periods during their daily activities. Few patients consume a fiber-rich diet and abundant water. Conclusions: corroboration was made of the presence of risk factors and inadequate life styles and modes among the Cuban population which lead to the occurrence of acute hemorrhoidal episodes(AU)

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Este estudo destaca os recursos em neurologia, neurologistas eequipamentos de diagnóstico por meio de imagem, segundo os estadosbrasileiros e sua distribuição populacional. Há grandes desigualdadesentre as regiões. A informação apresentada pode ser útil para o planejamento em saúde e para os especialistas atuais ou futuros. Os resultados deste estudo sugerem a necessidade de aumento substancial dos serviços de neurologia em alguns locais do Brasil, mas de modo geral o atendimento neurológico parece ter indicadores satisfatórios. Entretanto, o material apresentado é apenas uma primeira abordagem da situação real, sendo necessário obter informações mais completas e precisas, em estudos futuros.

This study highlights neurological resources, mainly neurologists and diagnostic imaging equipment, according to the Brazilian states and their population distribution. There is great inequality between regions. The presented information may be useful for health planning and for current or future specialists. The results of this study suggest the need for substantial increase in neurology services in some locations of Brazil, but in general, neurological care seems to have satisfactory indicators. However, the presented material is only a first approach of the real situation, being necessary to acquire more complete and accurate information, in future studies.

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The present study evaluates the personal values reported by a sample of New York Hispanic residents using an open evaluation format in which the participants identified and prioritized their personal values. Four hundred and forty-five participants were assigned to one of three groups: Young (N= 159), Adult (N= 168) and Senior (N= 118). The values reported were categorized into post-materialist, materialist or non-classifiable. The Percentage Difference Index between post-materialist and materialist values was calculated in order to determine the value profile for each age group. The results showed that reports of personal values and values attributed to the participants' own generation were similar in Adult and Senior groups, but were very different in the Young Group, with a differential report of post-materialist values. Furthermore, exposure to American culture did not appear to have a significant effect on the reported values of NYC Hispanics. To confirm these findings, we need to conduct additional studies with larger samples of culturally diverse populations.

Se exploran los valores en una muestra de hispanos de New York, empleando un formato abierto en el que los participantes identifican y priorizan su valores personales y los de su generación. Los 445 participantes se distribuyeron en tres grupos: Jóvenes (N = 159), Adultos (N = 168) y Mayores (N = 118). Los informes de valores se categorizaron como postmaterialistas, materialistas o no clasificables, y se calculó el Percentage Difference Index entre valores postmaterialistas y materialistas para determinar el perfil de valores de cada grupo. Los resultados mostraron que los informes de valores personales y generacionales fueron similares en los grupos Adulto y Mayor, y diferentes en el Grupo Joven con un reporte diferencial entre valores personales y generacionales. Por otro lado, el tiempo vivido bajo la influencia de la cultura norteamericana parece no tener un efecto significativo en el informe de valores para esta población. Para confirmar estos hallazgos son necesarios estudios adicionales con muestras más amplias y en poblaciones culturalmente diversas.

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