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BACKGROUND: Increases in the diameter of the optic nerve sheath (ONSD) on ultrasound are associated with high intracranial pressure (hICP). The normal value varies with altitude and the population studied. The objective of this study is to describe the normal values of the ONSD in a healthy adult population of the city of Bogotá, Colombia, at 2640 meters above sea level (masl). PATIENTS AND METHODS: A prospective observational study was conducted on a total of 247 healthy individuals recruited from May 2021 to May 2022 who were subjected to the color, low power, optic disk, safety, elevated frequency, dual (CLOSED) protocol for measuring the bilateral ONSD adjusted to the eyeball transverse diameter (ETD). RESULTS: A total of 230 individuals were analyzed; the average ONSD of the right eye (RE) was 0.449 cm (range 0.288-0.7) and that of the left eye (LE) was 0.454 cm (range 0.285-0.698); the correlation between RE and LE was 0.93 (p < 0.005), and the correlation of the ONSD/ETD ratios for the RE and LE was lower (r2 = 0.79, p < 0.005). A total of 10.8% of the studied population had values greater than 0.55 cm. CONCLUSIONS: The median ONSD and ONSD/ETD ratio in the city of Bogotá are similar to those described in other populations; however, approximately 10.8% of the healthy population may present higher values, which would limit the use of ONSD on its own for clinical decision-making, only repeated measurements with significant changes in the ONSD and ONSD/ETD or asymmetries between the measurements of both eyes linked to clinical findings would allow the diagnosis of hICP.
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Resumen Este artículo presenta los resultados de un estudio correlacional sobre los controles y las mediaciones parentales frente al uso de internet por niños, niñas y adolescentes colombianos. Se trata de la encuesta EU Kids Online que fue aplicada en el año 2010 en 25 países europeos y, posteriormente, en Brasil en 2013 y en Chile en 2016. En el presente estudio, le encuesta fue adaptada y validada para la población colombiana mediante un panel de expertos y entrevistas cognitivas a usuarios. Se conformó una muestra estratificada y no probabilística de 303 estudiantes de ambos sexos de colegios públicos y privados, con edades entre 9 y 17 años y uno de sus padres o cuidadores, habitantes de 11 ciudades del país, quienes respondieron a los tres instrumentos de KidsOnline, una encuesta autoaplicada, otra dirigida a los estudiantes, y una tercera dirigida a los padres o cuidadores. Los resultados muestran relaciones entre el control parental y un menor tiempo de conexión a internet por parte de los hijos: el control del padre está relacionado con menor presencia de conductas adictivas a internet y al celular y, por el contrario, una relación autoritaria con la madre está relacionada con mayor presencia de conductas de riesgo en los hijos y específicamente, en el uso de internet. Además, las habilidades digitales de los padres son las que mejor están asociadas con una mediación activa, que los involucra más en las actividades digitales de sus hijos.
Abstract Nowadays, parents must develop strategies to accompany their children in the use of digital technologies. The reason for this is that the internet is a social space. Online life offers possibilities for individual and social development, but it also promotes the emergence of new risks such as sexting, cyberbullying, and cyber dependence. There are two ways parents can guide their children: parental mediation and parental control. Parental mediation is the set of actions that parents take to manage the use and consumption of the media by their sons and daughters. There are three types of parental mediation: restrictive mediation, permissive mediation, and active mediation. In this context, this research aims to correlate mediation and parental control strategies with their use of the internet for children and adolescents. The EU Kids Online survey was used to achieve this goal. This questionnaire was adapted for the Colombian population through expert review and cognitive validation to children and adolescents in Medellin, Cali, and Cartagena (Colombia). The adaptation followed the procedures and standards of Kids Online Brasil and Kids Online Chile. The stratified and non-probabilistic sample consisted of 303 children and adolescents aged 9 to 17 years from ten cities in Colombia. The results indicate that the more parental control, the shorter the child connection time. Whether it's behavioral or psychological control. While the greater the psychological control of the mother, the greater the presence of addictive behaviors of children and adolescents to the internet and cell phone. Besides, the more psychological control of the mother, the more risky behaviors the children assume. Conversely, if the mother performs greater behavioral control, the presence of risky behaviors in the child is less. Also, restrictive control of internet use has a higher relationship with a lower presence of general risk behaviors and lower risks assumed by children on the internet. This was also related to high rates of restrictive mediation by parents. As conclusions, it is possible to say that any type of control that parents exercise over their children's use of the internet (restrictive, co-visioned or technical) is related to shorter connection time and less cell phone addiction. Besides, a conflicting relationship with the mother increases the addictive behaviors of the internet and the smartphone. Especially when the kind of control the mother exerts is psychological. Whereas, if the mother exerts greater behavioral control, the presence of risky behaviors in the child is less. This research could serve as the basis for the design and implementation of psychoeducational training programs for parents and caregivers aimed at developing effective parental mediation skills and strategies to guide children and adolescents in their use of digital technologies. Also, the findings of this study could lay the scientific basis for the presentation of social projects that impact public policies on the responsible and healthy use of the internet. Moreover, when Colombia has a Ministry of Information and Communication Technologies and media outreach strategies on ICT care. Finally, researches done in psychology about this topic are limited in Latin America. For this reason, the findings of this work are a significant step forward on the explanation of ITC use in the region from a disciplinary point of view. This article seeks to encourage researchers to continue to advance their knowledge of the relationships between parental mediation and the use of the internet by children and adolescents.
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Chagas disease (CD) and tuberculosis (TB) are important health problems in Bolivia. Current treatments for both infections require a long period of time, and adverse drug reactions (ADRs) are frequent. This study aims to strengthen the Bolivian pharmacovigilance system, focusing on CD and TB. A situation analysis of pharmacovigilance in the Department of Cochabamba was performed. The use of a new local case report form (CRF) was implemented, together with the CRF established by the Unidad de Medicamentos y Tecnología en Salud (UNIMED), in several healthcare centers. Training and follow-up on drug safety monitoring and ADR reporting was provided to all health professionals involved in CD and TB treatment. A comparative analysis of the reported ADRs using the CRF provided by UNIMED, the new CRF proposal, and medical records, was also performed. Our results showed that out of all patients starting treatment for CD, 37.9% suffered ADRs according to the medical records, and 25.3% of them were classified as moderate/severe (MS). Only 47.4% of MS ADRs were reported to UNIMED. Regarding TB treatment, 9.9% of all patients suffered ADRs, 44% of them were classified as MS, and 75% of MS ADRs were reported to UNIMED. These findings show that the reinforcement of the Bolivian pharmacovigilance system is an ambitious project that should involve a long-term perspective and the engagement of national health workers and other stakeholders at all levels. Continuity and perseverance are essential to achieve a solid ADR reporting system, improving patient safety, drug efficacy and adherence to treatment.