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La anemia es un grave problema de salud pública en América Latina. En el Perú la proporción de niños entre 6 y 35 meses con anemia fue de 43,5% en el 2018. El objetivo de esta publicación es revisar las diferentes oportunidades de aplicación de las tecnologías de información y comunicación (TICs) en el fortalecimiento de la lucha contra la anemia en nuestro país; bajo la premisa de que la aplicación de las TICs puede convertirse en una excelente oportunidad para mejorar el acceso y calidad de los servicios de salud ofrecidos por el sistema público. La literatura revisada muestra diversas experiencias previas que incluyen la utilización de mensajes de texto a través de celulares y desarrollo de aplicativos para teléfonos inteligentes. Sin embargo, se requiere de más investigación, con mejores niveles de evidencias que, finalmente, ayuden a la elaboración de estrategias eficientes y a la mejora de políticas sanitarias en un tema que es una prioridad nacional de cara al bicentenario.

Anemia is a serious public health problem in Latin America. In Peru, the rate of 6- to 35- month old children with anemia was 43.5% in 2018. The aim of this publication is to review the different opportunities for using information and communication technology (ICT) aiming to strengthen campaigns against anemia in Peru. This concept is based on the idea stating that the use of ICT may become an excellent opportunity for improving both access to and quality of public Peruvian healthcare services. The reviewed literature shows many previous experiences, including smartphone text messages (SMS) and the development of apps for smartphones. However, more research is needed, with better evidence level; which finally may help to design efficient strategies and to improve public health policies in a topic that is a national priority for the forthcoming independence bicentennial.

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ABSTRACT INTRODUCTION: Tinnitus is a multifactorial condition and its prevalence has increased on the past decades. The worldwide progressive increase of the use of cell phones has exposed the peripheral auditory pathways to a higher dose of electromagnetic radiofrequency radiation (EMRFR). Some tinnitus patients report that the abusive use of mobiles, especially when repeated in the same ear, might worsen ipsilateral tinnitus. OBJECTIVE: The aim of this study was to evaluate the available evidence about the possible causal association between tinnitus and exposure to electromagnetic waves. METHODS: A literature review was performed searching for the following keywords: tinnitus, electromagnetic field, mobile phones, radio frequency, and electromagnetic hypersensitivity. We selected 165 articles that were considered clinically relevant in at least one of the subjects. RESULTS: EMRFR can penetrate exposed tissues and safety exposure levels have been established. These waves provoke proved thermogenic effects and potential biological and genotoxic effects. Some individuals are more sensitive to electromagnetic exposure (electrosensitivity), and thus, present earlier symptoms. There may be a common pathophysiology between this electrosensitivity and tinnitus. CONCLUSION: There are already reasonable evidences to suggest caution for using mobile phones to prevent auditory damage and the onset or worsening of tinnitus.

RESUMO INTRODUÇÃO: Zumbido é uma condição multifatorial cuja prevalência vem aumentando nas últimas décadas. Em todo o mundo, o aumento progressivo do uso de telefones celulares tem exposto as orelhas a uma maior carga de radiação eletromagnética de radiofrequência (REM-RF). Alguns pacientes com zumbido referem que o uso excessivo do telefone celular, especialmente quando sempre na mesma orelha, é um fator de piora do zumbido ipsilateral. OBJETIVO: O objetivo deste trabalho foi avaliar as evidências disponíveis sobre a possível associação causal entre zumbido e exposição a ondas eletromagnéticas. MÉTODO: Foi realizada uma revisão de literatura com palavras-chave como: tinnitus, electromagnectic field, cellular phone, radiofrequency, electromagnectic hypersensitivity. Foram selecionados 165 artigos com maior relevância clínica em pelo menos um dos assuntos. RESULTADOS: As REM-RF podem penetrar tecidos expostos e existem níveis seguros de exposição. Apresentam efeitos termogênicos comprovados e potenciais efeitos biológicos e genotóxicos. Alguns indivíduos são mais sensíveis à exposição eletromagnética (eletrossensibilidade) e, portanto, adquirem sintomas precocemente. A fisiopatologia da eletrossensibilidade pode ser semelhante à do zumbido. CONCLUSÃO: Consideramos que há evidências suficientes que sugerem maior cautela para o uso desses aparelhos e assim prevenir lesões na via auditiva e o aparecimento/agravamento do zumbido.

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INTRODUCTION: Tinnitus is a multifactorial condition and its prevalence has increased on the past decades. The worldwide progressive increase of the use of cell phones has exposed the peripheral auditory pathways to a higher dose of electromagnetic radiofrequency radiation (EMRFR). Some tinnitus patients report that the abusive use of mobiles, especially when repeated in the same ear, might worsen ipsilateral tinnitus. OBJECTIVE: The aim of this study was to evaluate the available evidence about the possible causal association between tinnitus and exposure to electromagnetic waves. METHODS: A literature review was performed searching for the following keywords: tinnitus, electromagnetic field, mobile phones, radio frequency, and electromagnetic hypersensitivity. We selected 165 articles that were considered clinically relevant in at least one of the subjects. RESULTS: EMRFR can penetrate exposed tissues and safety exposure levels have been established. These waves provoke proved thermogenic effects and potential biological and genotoxic effects. Some individuals are more sensitive to electromagnetic exposure (electrosensitivity), and thus, present earlier symptoms. There may be a common pathophysiology between this electrosensitivity and tinnitus. CONCLUSION: There are already reasonable evidences to suggest caution for using mobile phones to prevent auditory damage and the onset or worsening of tinnitus.

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En los últimos años, las tecnologías de la comunicación móvil se han expandido de manera rápida tanto en los países desarrollados como en vías de desarrollo. Estos países, incluyendo a Perú, son escenarios ideales donde las herramientas de la salud móvil (mSalud) se convierten en excelentes oportunidades para brindar y hacer más inclusivo los servicios de salud. La literatura revisada muestra que las intervenciones de mSalud en nuestro país, presentan un enorme potencial para mejorar el acceso y calidad de la los servicios de salud, aumentando la efectividad de los programas de salud pública y reduciendo los costos de la asistencia sanitaria. No obstante, se requiere de mayor investigación en estas áreas para com- prender en su totalidad el potencial de la mSalud para que puedan ser base y sustento de políticas de estado innovadoras, integradas al sistema de salud y costo-efectivas para la mejora en la atención e inclusión en salud en Perú.

Mobile communication technologies have become more prevalent in developed and developing countries. These coun- tries -including Peru- are becoming an ideal setting where mobile health (mHealth) projects can provide better health services. The reviewed literature shows that the mHealth interventions have enormous potential to improve access and the quality of health services, increasing the effectiveness of public health programs and reducing healthcare costs. It is noticeable that these projects have a positive impact; however, despite the current information, more research is needed to understand mHealth in-depth. These projects are the foundation for future health policies that will help the Peruvian health system to be more inclusive and more effective.

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Na era atual, em que os smartphones vêm ganhando espaço no meio médico, é fundamental a avaliação científica da real eficácia e reprodutibilidade dessas novas tecnologias. Nesse contexto, nosso objetivo foi avaliar, de forma inédita no nosso país, o esfigmomanômetro acoplado ao smartphone (Withings Blood Pressure Monitor) em comparação com outros métodos (esfigmomanômetros de mercúrio, aneroide e digital). Foram selecionados de forma aleatória 45 alunos sadios do curso de Medicina da Universidade Federal do Paraná (UFPR) e realizadas três medidas por aparelho, sendo comparadas entre as quatro modalidades, em ordem aleatória e em cada aluno. Também foi avaliada a preferência de método entre smartphone e digital. Os dados obtidos foram analisados nos modelos t de Student pareado e oneway ANOVA, com significância de p <0,05. Foram obtidas 576 medidas; na comparação individual das medidas, em relação à pressão arterial sistólica (PAS), quando confrontados cada aparelho entre si, o smartphone não apresentou diferença significativa comosdemaismétodos(p>0,05),emcadaleituraporaluno ou entre os diferentes métodos. Quanto à pressão arterial diastólica (PAD), houve diferença significativa entre o smartphone e os demais aparelhos (p < 0,05). Na análise específica das médias repetidas em cada aluno por cada método, em relação à PAD, o smartphone foi o único a diferir significativamente de todos os outros métodos, existindo uma variabilidade entre cada medida. Quanto à análise de preferência, os quesitos tempo de medida, desconforto à compressão do manguito e apresentação visual das medidas não influenciaram significativamente a escolha, sendo que 51,9% optaram pelo smartphone e 29,6%, pelo digital.

Nowadays, when smartphones are increasingly gaining space in the medical environment, the scientific evaluation of the real efficacy and reproducibility of this new technology is essential. In this context, our goal was to evaluate, unprecedently in Brazil, the smartphone-linked sphygmomanometer (Withings Blood Pressure Monitor) in comparison with other methods (mercury, aneroid and digital sphygmomanometers). We randomly selected 45 healthy medical students from Universidade Federal do Paraná (UFPR), and three measures by each modality were taken and compared between them, in random order and on each person. The preference for self-measurement method between digital and smartphone-linked sphygmomanometers was also evaluated. The obtained data were analyzed through paired t-Student and oneway ANOVA models, with significance of p <0.05. We obtained 576 measures; in the individual comparison of them, in relation to the systolic blood pressure (SBP), when the modalities were confronted between each other, the smartphone did not present significant difference with theothermethods(p>0.05)ineachmeasurebystudentorbetween methods. Regarding diastolic blood pressure (DBP), there was significant difference between smartphone and the other modalities (p < 0.05). In the specific analysis of the repeated means in each student by each method, regarding DBP, the smartphone was the only one to significantly differ of the other techniques, existing variability among each measure. Concerning the preference analysis, the matters of measurement time, discomfort of the compressive cuff and visual presentation of the measurements did not significantly influence the final choice, in which 51.9% chose the smartphone and 29.6%, the digital equipment

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Purpose Technological developments provide a lot of conveniences to our lives. This issue is one of the risks that arise along with these conveniences. In our study we tried to understand the impact of electromagnetic waves from mobile phones on bladder tissue. Materials and Methods Twenty-one adult male albino rats were divided into three equal groups. Group 1 was exposed to electromagnetic wave for 8 hours per day for 20 days and then their bladders were taken off immediately. Group 2 was firstly exposed to electromagnetic wave for 8 hours per day for 20 days then secondly another for 20 days without exposition to electromagnetic wave and then their bladders were taken off. Group 3 was the control group and they were not exposed to electromagnetic wave. Results Under microscopic examination of bladder tissue, in the first group severe inflammatory cell infiltration was seen in lamina propria and muscle layer in contrast to intact urothelium. In the second group mild inflammatory cell infiltration was seen in lamina propria and muscle layer. The mean scores for the three groups were 5.5 ± 2.5, 0.8 ± 1.3 and 1.2 ± 1.5 respectively. Mean score of group 1 was statistically higher than others (p = 0.001). Conclusion Intensive use of mobile phones has negative impact on bladder tissue as well as the other organs. Keeping a minimum level of mobile phone use makes it easy to be kept under control of diseases in which inflammation is an etiologic factor. .

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OBJETIVO: Avaliar o impacto da utilização das tecnologias de mobile health (mHealth) - prática da medicina ou saúde pública através de dispositivos móveis, como telefones celulares - na prevenção do ganho de peso ou tratamento do excesso de peso ou da obesidade. MÉTODOS: Foi realizada uma revisão sistemática de literatura utilizando-se a base de dados PubMed e as recomendações do protocolo PRISMA para revisões sistemáticas. Foram incluídos estudos de intervenção que avaliaram o impacto das tecnologias mHealth nas seguintes variáveis antropométricas: peso, índice de massa corporal (IMC) ou circunferência abdominal em adultos. RESULTADOS: Dos 98 artigos localizados, 14 atenderam aos critérios de inclusão e foram analisados no estudo de revisão. Dos artigos analisados, apenas dois avaliaram a prevenção do ganho de peso ao invés do tratamento do excesso de peso ou da obesidade. O uso de tecnologia mHealth teve efeitos positivos sobre os desfechos antropométricos em 13 artigos. Apenas um artigo não encontrou efeito no grupo que utilizou essas tecnologias. Oito artigos observaram impacto no IMC e sete na circunferência abdominal. O telefone celular foi a tecnologia mais utilizada, principalmente por meio do envio de mensagens de texto. CONCLUSÕES: As tecnologias mHealth apresentam potencial para serem utilizadas como ferramentas de prevenção e tratamento de excesso de peso e obesidade, principalmente com o uso de tecnologias como telefone celular e mensagens de texto, que já estão incorporadas ao cotidiano de grande parte da população.

OBJECTIVE: To evaluate the impact of using mobile health (mHealth) technologies- the practice of medicine or public health through mobile devices, such as mobile phones-on the prevention of weight gain or treatment of overweight or obesity. METHODS: A systematic literature review was conducted using the PubMed database and the Preferred Reporting Items for Systematic Reviews and Meta - Analyses (PRISMA) guidelines. Intervention studies evaluating the impact of mHealth technologies were selected on the following anthropometric measures: weight, body mass index, or waist circumference in adults. RESULTS: Out of 98 articles retrieved, 14 met the inclusion criteria and were selected for analysis. Of these, only two evaluated the prevention of weight gain instead of the treatment of overweight or obesity. mHealth technologies had a positive effect on anthropometric outcomes in 13 articles. Only one article reported no effects on the group that used these technologies. Eight articles reported impact on BMI, and seven on waist circumference. Mobile phones were the most common mHealth device, used mainly for text messages. CONCLUSIONS: mHealth technologies have the potential to be used as tools for the prevention and treatment of overweight and obesity, particularly with mobile phones and texting, which are already used daily by most of the population.

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As dimensões continentais de alguns países e a distribuição heterogênea da rede hospitalar dificultam o acesso ao atendimento inicial adequado ao trauma de face principalmente aos pacientes residentes em regiões mais remotas. Um modelo de atendimento por telemedicina pode ser uma opção ao atendimento especializado presencial. Os objetivos deste trabalho são apresentar um modelo de atendimento por especialistas à distância, por meio de videoconferência utilizando-se smartphone, e analisar a concordância deste atendimento por telemedicina com o atendimento presencial, considerado padrão ouro. Cinquenta pacientes com trauma de face e suspeita de fratura de face (n=50) foram atendidos, por duas equipes independentes, uma presencialmente e outra por telemedicina. A equipe presencial, que era formada pela equipe de plantão de cirurgia plástica na unidade de emergência, prestou o atendimento à beira do leito (história, exame físico e análise de imagens por tomografia computadorizada). A equipe telemedicina, composta por um médico generalista atendendo à beira do leito, prestou atendimento em conjunto com um cirurgião plástico à distância através de videoconferência com um smartphone. Após cada atendimento as duas equipes responderam a um questionário, com informações sobre dados epidemiológicos, dados do exame físico, sobre indicações de tomografia computadorizada, achados radiológicos da tomografia e conduta. Os dados foram analisados e comparados quanto à concordância das respostas através da análise estatística kappa, cálculo de acurácia, especificidade e sensibilidade. A amostra estudada foi representativa e concordante com a literatura, com predomínio de homens jovens. Acidentes de trânsito e violência interpessoal foram os principais mecanismos causadores do trauma. A concordância das respostas para os achados de exame físico foi considerada substancial (kappa=0,720), para a indicação da tomografia computadorizada foi quase perfeita (kappa=0,957), para os...

The continental size of some countries and heterogeneous distributed hospital network prevent many patients who live in remote areas from getting adequate initial assessment of facial trauma. The author presents a model for trauma assessment through telemedicine, which may be an alternative to face-to-face specialized attending. The goals of this study are presenting a model for non-attending specialized assessment through video conference via smartphones, and analyzing a comparison between telemedicine and face-to-face management, the latter currently being the gold standard. Fifty patients with either a confirmed or suspected diagnosis of facial trauma (n=50) were evaluated by two teams of physicians, one face-to-face and the other one telemedicine-based. The face-to-face team, which was made up by the attending plastic surgery team in the emergency unit, attended the patients at the bedside (physical examination and CT-scan analysis). The telemedicine team was made up by an in-house general practitioner working together with an on-call plastic surgeon through videoconference via smartphones. After each evaluation, both teams answered a similar questionnaire, which contained data concerning the patient's epidemiology, physical examination, CT-scan indications and findings, and the treatment option to be followed. The data were analyzed and compared regarding the similarity of answers, with the use of kappa statistics and analysis of data accuracy, sensitivity and specificity. The sample studied was representative and consistent with the literature, showing a predominance of young males. Traffic accidents and personal violence were the main causes of trauma. The agreement of answers for physical examination findings was considered substantial (kappa=0.720). For CT-scan indications, it was considered almost perfect (kappa=0.957); for CT-scan findings, it was almost perfect (kappa=0.899); and for defining the treatment option, it was...

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Objetivos: Avaliar o foto-eletrocardiograma (foto-ECG), como uma ferramenta de segunda opinião formativa a distância.Métodos: Cinquenta eletrocardiogramas (ECGs) em papel milimetrado foram fotografados duas vezes, a primeira utilizando-se uma câmera digital Canon, na resolução 0,3 megapixel, e a segunda com um celular Nokia com câmera acoplada, na resolução 2,0 megapixels, gerando 100 foto-ECGs. Por meio de estudos-piloto, definiu-se o método de aquisição das imagens. Os 100 foto-ECGs foram randomizados, criptografados e enviados a um cardiologista remoto por e-mail; enquanto os 50 ECGs em papel milimetrado lhe foram entregues pessoalmente, sem randomização. Sexo e idade foram as únicas informações dos pacientes disponibilizadas ao especialista.Resultados: A análise dos dados demonstrou divergência em 14 dos 50 laudos (28%) na comparação dos ECGs originais com os foto-ECGs adquiridos pela câmera Canon e de 13 dos 50 laudos (26%) entre os laudos dos ECGs originais e dos foto-ECGs capturados pelo celular Nokia. Houve concordância considerável (Kappa=0,356) entre as interpretações de foto-ECGs e ECGs em papel, tanto para o celular Nokia quanto para a câmera Canon.Conclusões: A concordância entre o foto-ECG e os traçados originais demonstrou que o método descrito nesse estudo tem potencial de ser utilizado como uma ferramenta de auxílio à prática clínica, desde que a obtenção dos foto-ECGs seja adaptada de forma a melhorar as imagens dos exames. Apenas com concordância boa a ótima em relação aos ECGs originais, o foto-ECG possibilitará a segunda opinião formativa a distância, conferindo melhores opções diagnósticas e terapêuticas...

Aims: This study aimed to evaluate the photo-electrocardiogram (photo-ECG), as an alternative tool to enable remote formative second opinion in cardiology.Methods: Fifty paper electrocardiograms (ECGs) were photographed two times, the first using a Canon digital camera, 0.3 megapixel resolution, and the second using a Nokia mobile phone integrated camera, 2.0 megapixel resolution, resulting in 100 Photo-ECGs. A pilot study was responsible for determining the acquisition method. The 100 Photo-ECGs were randomized, encrypted and sent by e-mail to a remote cardiologist, while the 50 paper ECGs were delivered to him in person, without randomization. Gender and age were the only patient information made available to the specialist.Results: Data analysis demonstrated a disagreement in 14 of 50 interpretations (28%) when comparing paper ECGs to the Canon camera photo-ECGs and in 13 of 50 interpretations (26%) when comparing paper ECGs to the Nokia camera photo-ECGs. The Kappa test revealed a fair agreement (Kappa=0.356) between interpretations when comparing the original ECGs to their respective photo-ECGs for both camera devices.Conclusion: The concordance between photo-ECGs and original tracings demonstrated that the method described herein has the potential for use as a tool to assist clinical practice, provided that the acquisition of photo-ECGs is adapted so as to improve exam images. Only with good to very good concordance between the original ECGs and photo-ECGs will remote formative second opinion be possible, giving better diagnostic and therapeutic options...

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OBJECTIVE: The objective of this study is to identify features and content that short message service (SMS) should have in order to motivate HIV testing among men who have sex with men (MSM) in Lima, Peru. METHODS: From October, 2010 to February, 2011, we conducted focus groups at two stages; six focus groups were conducted to explore and identify SMS content and features and two additional focus groups were conducted to tailor SMS content. The text messages were elaborated within the theoretical framework of the Information-Motivation-Behavioral Skills model and the Social Support Theory. RESULTS: A total of 62 individuals participated in the focus groups. The mean age of participants was 28 years (range 18-39). We identified important features and content items needed for the successful delivery of text messages, including: a) the use of neutral and coded language; b) appropriate frequency and time of delivery; c) avoiding mass and repetitive messages; and d) use of short, concise and creative messages. Although in Peru receiving text messages is usually a free service, it is important to remind participants that receiving messages will be free of charge. CONCLUSION: Text messages can be used to promote HIV testing among Peruvian MSM. It is important to consider adequate frequency, message content and cost when delivering messages to promote HIV testing in this population.

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OBJETIVO: Apresentar o conhecimento sobre efeitos biológicos dos campos eletromagnéticos, detalhes da absorção da energia dos campos de micro-ondas na criança, efeitos da exposição a esses campos no período pré e pós-natal e impacto do uso dos telefones celulares no sistema nervoso central e no comportamento de crianças. FONTES DE DADOS: Trabalhos em língua inglesa publicados entre 2004 e 2009 e indexados na base de dados PubMed com os unitermos: "crianças", "telefones celulares" e "micro-ondas". SÍNTESE DOS DADOS: Telefones celulares emitem radiofrequência na faixa de micro-ondas, cujos efeitos biológicos podem ser térmicos (aquecimento dos tecidos) ou não térmicos (estresse oxidativo e mudanças na conformação da cromatina). Pesquisas experimentais sugerem que a dissipação da energia de radiofrequência nos tecidos seria maior na criança do que no adulto. Em ratos, a exposição pré-natal à radiofrequência em níveis não térmicos não produz efeito teratogênico ou mutagênico, nem aumento da permeabilidade da barreira hematoencefálica ou da expressão de heat shock proteins no encéfalo. Não há evidência de efeito nocivo da radiação dos celulares na cognição de crianças. Fazer ligações ou enviar mensagens de texto no horário noturno aumenta a probabilidade de sonolência diurna em adolescentes. Crianças que usam mais o celular podem ter déficit de memória e comportamento impulsivo. CONCLUSÕES: Não está comprovado que a exposição à radiação dos celulares, pré ou pós-natal, dentro dos limites de segurança para humanos, induz dano ao desenvolvimento do sistema nervoso central. Entretanto, padrões culturais relacionados à posse e uso dos aparelhos influenciam o comportamento de crianças e adolescentes e podem provocar distúrbios do sono.

OBJECTIVE: To study the biological effects of electromagnetic fields, details of microwave electromagnetic field energy absorption in children, effects of pre and post-natal exposure to those fields, and the impact of mobile phones use on the central nervous system and behavior in children. DATA SOURCE: Articles written in English published from 2004 to 2009 and indexed on PubMed under the keywords: "children", "mobile phones", and "microwaves". DATA SYNTHESIS: Mobile phones emit radiofrequency in the microwave range, with possible thermal (tissue heating) or non-thermal (oxidative stress and chromatin conformation alteration) biological effects. Experimental research suggests that the dissipation of radiofrequency energy in tissues might be higher in children than in adults. Pre-natal exposure of rats to radiofrequency in non-thermal levels has not resulted in teratogenesis, mutagenesis, increased blood-brain barrier permeability or heat shock protein expression in the brain. There is no conclusive evidence of harmful effects of mobile phone radiation on cognitive function in children. Making voice calls or sending text messages at night increases the likelihood of day-time somnolence in adolescents. Children who use mobile phones may present memory impairment and impulsive behavior. CONCLUSIONS: There is no compelling evidence that pre- or post-natal exposure to mobile phone radiation, within the safety limits for human beings, causes damage to the central nervous system development. Nevertheless, cultural patterns related to mobile phones possession and use influence the behavior of children and adolescents and may trigger sleep disorders.

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Cell phones have become a vital part of everyday life. However, the health risks associated with their usage are often overlooked. Recently, evidence from several studies supports a growing claim that cell phone usage may have a detrimental effect on sperm parameters leading to decreased male fertility. Nonetheless, other studies showed no conclusive link between male infertility and cell phone usage. The ambiguity of such results is attributed to the lack of a centralized assay for measuring inflicted damage caused by cell phones. Study design, ethics, and reproducibility are all aspects which must be standardized before any conclusions can be made.

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Introducción: Con el desarrollo de nuevas tecnologías, la interacción entre las personas es cada vez más rápida y efectiva. Infortunadamente, estas herramientas han favorecido que el bullying (acoso) tradicional haya sobrepasado los límites del plantel escolar de forma virtual y que hayan dado lugar al ciberbullying. Objetivo: Describir y precisar sus diversas características, señalar algunos aspectos inherentes al bullying tradicional y revisar las diferencias entre ambos fenómenos. Métodos: Búsqueda computarizada de información utilizando bases de datos electrónicas. Resultados: Cerca del 40% de los alumnos han tenido algún tipo de contacto con el ciberbullying y se estima que uno de cada cuatro estudiantes está involucrado en este problema. El riesgo de ser cibervictimizado se duplica al tener un perfil en una red social electrónica. El 50% de las víctimas no comunica a nadie sobre la problemática o rara vez lo hacen, lo que implica un riesgo mayor de volver a ser ciberintimidado. Las consecuencias más graves generadas por el ciberbullying son depresión, ideación suicida y, en el peor de los casos, intentos suicidas u homicidas. Conclusiones: La práctica del ciberbullying representa en los hogares y las escuelas una problemática de actualidad y de suma importancia que debe tratarse integralmente. Se debe dar prioridad a la prevención e identificación oportuna...

Introduction: With the development of new technologies interactions between people are becoming faster and more effective. Unfortunately, this means that traditional bullying has moved from the schoolyard to a virtual form giving rise to cyberbullying. Objective: To describe and define the characteristics of cyberbullying, to show some aspects inherent in traditional bullying, and to review the differences between the two phenomena. Methods: Computerized search of information using electronic databases. Results: About 40% of students have had some contact with cyberbullying and it is estimated that one in four students is involved in this problem. The risk of being cyberbullied is doubled if they have a profile on a social network. 50% of victims do not tell anybody about the problem, which means a higher risk of being cyberbullied again. The most severe consequences produced by cyberbullying are depression, suicidal ideation, and suicidal or homicidal attempts. Conclusions: The practice of cyberbullying is currently an important problem in homes and schools that must be treated in an integral manner, giving priority to prevention and early identification...

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Resultados: se encontró un 80% de los estetoscopios contaminados, con una mediana de colonización de 2.58 Unidades Formadoras de Colonias (UFC)/cm2 y un 100% de los teléfonos móviles contaminados con una mediana de 0.401 UFC/cm2. En estetoscopios se aislaron SAMR (n=3) y Enterobacterias resistentes a cefalosporinas de tercera generación (n=2). En teléfonos móviles se aislaron SAMR(n=1), Candida spp (n=1) y Enterobacterias (n=5). La encuesta permitió establecer una tendencia de hábitos de higiene inapropiados sobre el uso de los fómites. Conclusiones: el hallazgo de bacterias resistentes en estos fómites los convierte en fuentes potenciales de transmisión cruzada y de brotes de infección intrahospitalaria. Estos resultados deben orientar el desarrollo de protocolos para el uso racional de dispositivos médicos y tecnología portátil dentro de ambientes hospitalarios.

Results: 80% of the stethoscopes (n=40) were found contaminated with a median count of 2,58 CFU/cm2 meanwhile 100% of cellular phones where found contaminated with a median count of 0,401 CFU/cm2. MRSA (n=3) and third generation cephalosporin-resistant Enterobacteriaceae (n=2) were isolated from stethoscopes, whereas in cellular phones MRSA (n=1), Candida (n=1) and third generation cephalosporin-sensitive Enterobacteriaceae (n=5) where found. Survey results indicated a trend towards inappropriate hygiene habits with fomites; however no statistical correlation could be established between these habits and colonization. Conclusion: The finding of nosocomial pathogens in these fomites transforms them in potential sources of crosscontamination and hospital-acquired infections outbreaks. Present results must steer development of protocols for rational use of medical devices and portable technology gadgets within hospital controlled environments.

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In July 2007 in Medellín, Colombia, 1 200 health care professionals were asked to complete a questionnaire: of the 493 who participated, the mean age was 31.2 years; 58.8 percent were physicians; and 97.6 percent had Internet access, 60.5 percent on a daily basis and 27.7 percent, weekly. The preferred place to access the Internet was from home (58 percent) or from the work place (12.5 percent); 98 percent reported having a cell phone, and of those, 80 percent were interested in using health education tools via cell phone. These are the first data published regarding Internet and cellular phone penetration among health care workers in Colombia. Acceptance of the Internet and mobile systems as health information tools is gaining, and as such, creating a new opportunity for training and harnessing of these new technologies.

Assuntos

RESUMO

Os sistemas de telecomunicações emitem radiofreqüência, uma radiação eletromagnética invisível. Telefones celulares transmitem microondas (450-900 MHz no sistema analógico e 1,8-2,2 GHz no sistema digital), muito próximo à orelha do usuário. Esta energia é absorvida pela pele, orelha interna, nervo vestibulococlear e superfície do lobo temporal. OBJETIVO: Revisar a literatura sobre influência dos telefones celulares na audição e equilíbrio. FORMA DE ESTUDO: Revisão sistemática. METODOLOGIA: Foram pesquisados artigos nas bases Lilacs e Medline sobre a influência dos telefones celulares nos sistemas auditivo e vestibular, publicados de 2000 a 2005, e também materiais veiculados na Internet. RESULTADOS: Os estudos sobre radiação do telefone celular e risco de neurinoma do acústico apresentam resultados contraditórios. Alguns autores não encontram maior probabilidade de aparecimento do tumor nos usuários de celulares, enquanto outros relatam que a utilização de telefones analógicos por 10 anos ou mais aumenta o risco para o tumor. A exposição aguda às microondas emitidas pelo celular não influencia a atividade das células ciliadas externas da cóclea, in vivo e in vitro, a condução elétrica no nervo coclear, nem a fisiologia do sistema vestibular em humanos. As próteses auditivas analógicas são mais suscetíveis à interferência eletromagnética dos telefones celulares digitais. CONCLUSÃO: Não há comprovação de lesão cocleovestibular pelos telefones celulares.

Telecommunications systems emit radiofrequency, which is an invisible electromagnetic radiation. Mobile phones operate with microwaves (450-900 MHz in the analogue system; and 1.8-2.2 GHz in the digital system) very close to the user’s ear. The skin, inner ear, cochlear nerve and the temporal lobe surface absorb the radiofrequency energy. AIM: literature review on the influence of cellular phones on hearing and balance. STUDY DESIGN: systematic review. METHODS: We reviewed papers on the influence of mobile phones on auditory and vestibular systems from Lilacs and Medline databases, published from 2000 to 2005, and also materials available in the Internet. RESULTS: Studies concerning mobile phone radiation and risk of developing an acoustic neuroma have controversial results. Some authors did not see evidences of a higher risk of tumor development in mobile phone users, while others report that usage of analog cellular phones for ten or more years increase the risk of developing the tumor. Acute exposure to mobile phone microwaves do not influence the cochlear outer hair cells function in vivo and in vitro, the cochlear nerve electrical properties nor the vestibular system physiology in humans. Analog hearing aids are more susceptible to the electromagnetic interference caused by digital mobile phones. CONCLUSION: there is no evidence of cochleo-vestibular lesion caused by cellular phones.

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