Perfil clínico e incidência de eventos cardiovasculares em 36 meses em pacientes com Minoca: registro de 126 pacientes em um hospital terciário de cardiologia / Clinical profile and incidence of cardiovascular events at 36 months in patients with Minoca: registry of 126 patients in a tertiary cardiology hospital

INTRODUÇÃO: Em 5% a 6% dos IAM não são observadas lesões obstrutivas maiores que 50%, sendo estes classificados como MINOCA (Infarto do Miocárdio com Artérias Coronárias não Obstrutivas). Estudos maiores de longo prazo demonstraram que o prognóstico desses pacientes não é benigno com risco aumentado de morte e novos eventos cardiovasculares. MÉTODOS: Nesta coorte de centro único, todos os pacientes que preencheram os critérios diagnósticos para MINOCA com (1) IAM (2) ausência de estenose coronária ≥ 50% na artéria relacionada ao infarto e (3) nenhuma outra causa específica clinicamente evidente entre março de 2000 e junho de 2022 foram incluídos com um acompanhamento médio de 30 (9,5-67,3) meses. As características da amostra foram descritas em frequências e valores medianos (p25%-p75%). A incidência de um novo evento cardiovascular (CV) em 36 meses após a MINOCA foi estimada pelo método de Kaplan-Meier e o teste de log-rank aplicado para comparar os grupos, acompanhado de intervalos de confiança de 95% e alfa de 5% (R 3,6,1 para MacOS). RESULTADOS: Dos 126 pacientes, 57,1% eram mulheres com cerca de 50 anos de idade (42,0-57,8). 20,6% tinham diabetes, 47,6% dislipidemia, 60,3% hipertensão e 20% IAM prévio. A apresentação clínica predominante foi IAMSSST (55,6%) e 7 pacientes tiveram um episódio de morte súbita abortada durante a internação. 38,1% dos pacientes não tiveram uma etiologia identificada. O mecanismo fisiopatológico mais prevalente foi ruptura da placa < 50% (16,7%), seguido de tromboembolismo (13,5%) e dissecção espontânea de coronária (13,5%). Apenas 3,2% realizaram tomografia de coerência óptica (OCT) ou ultrassom intravascular (IVUS). Nenhum teste provocativo foi realizado. 44,4% realizaram ressonância magnética cardíaca (RMC), com mediana de tempo para realização de 180,0 (60,0-707,5) dias após o evento. Em relação à medicação prescrita na alta hospitalar, 79,4% tiveram betabloqueador e IECA/BRA prescritos, 14,3% iniciaram anticoagulação e apenas 34,1% receberam dupla antiagregação plaquetária (DAP). A incidência do desfecho composto (morte CV, novo IAM, AVC e internação CV) em 36 meses foi de 15% (IC95% 8,9%-24,6%). A incidência de novo IAM foi de 6,3% (N=8), de AVC 2,4% (N=3), de hospitalização CV 17,5% (N=22) e apenas um óbito. CONCLUSÃO: Chama a atenção o risco do desfecho primário em 36 meses. Notavelmente, a maior parte da incidência foi atribuída à hospitalização CV. Um número importante de pacientes recebeu alta sem etiologia conhecida para sua apresentação clínica e, consequentemente, sem tratamento individualizado.

Conocimientos, actitudes y prácticas asociados a diarrea aguda en la zona norte de Bucaramanga. Estudio observacional analítico, 2014-2015 / Knowledge, attitudes and practices associated with acute diarrhea in the northern zone of Bucaramanga. An observational analytic study. 2014 to 2015

RESUMEN Introducción: la diarrea aguda y la mortalidad por diarrea continúan siendo un problema de salud pública a nivel mundial, especialmente en los países de ingreso medio o bajo. Gran parte de las enfermedades diarreicas son prevenibles mediante el acceso al agua potable y a servicios adecuados de saneamiento e higiene. Objetivo: caracterizar los conocimientos, actitudes y prácticas de cuidadores de niños menores de cinco años asociados a prevalencia de diarrea. Materiales y métodos: estudio observacional analítico de corte transversal, realizado durante el periodo 2014-2015. Se realizó un muestreo por conglomerados en la comuna norte de la ciudad de Bucaramanga y se aplicó una encuesta dirigida. Resultados: solo uno de cada diez cuidadores conoce todas las características de la diarrea aguda (cambios en la consistencia, número y duración de los síntomas) y ninguno reconoce totalmente los signos de deshidratación. El uso de remedios caseros y la creencia en causas sobrenaturales y esotéricas como causas de diarrea tuvo una alta prevalencia. La menor edad del cuidador, tener aseguramiento y mayor nivel conocimientos sobre la diarrea se asociaron a un mayor reporte de episodios de diarrea en los últimos seis meses. Conclusiones: el 49% de todos los cuidadores encuestados manifestaron que sus niños han tenido al menos un episodio de diarrea en los últimos seis meses. El nivel de conocimientos de los cuidadores es bajo. Se encontró asociación estadísticamente significativa entre la edad del cuidador, conocimiento de los síntomas diarreicos, régimen de aseguramiento y prevalencia de diarrea en menores de cinco años. MÉD.UIS. 2017;30(1):21-33.

ABSTRACT Introduction: acute diarrhea and mortality from diarrhea remains a public health problem worldwide, particularly in middle-income countries or low. Much of diarrheal diseases are preventable through access to safe water and adequate sanitation and hygiene. Objective: to characterize the knowledge, attitudes and practices of caregivers of children under five years associated with prevalence of diarrhea. Materials and methods: cross-sectional observational study, made during the period 2014-2015. Cluster sampling was conducted in the northern district of the city of Bucaramanga. A targeted survey was conducted. Results: only one in ten caregivers know all the characteristics (changes in consistency, number and duration of symptoms) of acute diarrhea. None fully recognize the signs of dehydration. The use of home remedies and belief in supernatural and esoteric causes as causes of diarrhea had a high prevalence. Caregiver younger, having higher-level assurance and knowledge on diarrhea associated with increased reporting of episodes of diarrhea in the last six months. Conclusions: 49% of all respondents report that their children caregivers have had at least one episode of diarrhea in the last six months. The level of knowledge of caregivers is low. Age of the caregiver, knowledge about diarrhea symptoms and healthcare affiliation was statistically associated with the onset of diarrhea in children up to five years. MÉD.UIS. 2017;30(1):21-33.

Cambios percibidos por personas con diversidad funcional motora adquirida en sus vidas cotidianas tras la obtención de perros de servicio / Changes perceived by people with acquired motor functional diversity in their daily lives after obtainment service dogs

El presente estudio surge del interés por analizar los cambios percibidos por personas con diversidad funcional motora adquirida en sus vidas cotidianas tras la adquisición de perros de servicio. La revisión de investigaciones internacionales sobre efectividad de la tenencia de estos animales, así como la revisión de las teorías del vínculo y de la biofilia proporcionan un primer acercamiento para comprender los posibles cambios. A partir de todo ello surge la pregunta: ¿Cómo perciben los cambios en sus vidas cotidianas las personas en estudio tras la obtención de perros de servicio otorgado por la corporación Bocalán Confiar? El estudio se visualiza desde el paradigma interpretativo y contempla la revisión teórica y fuentes directas a través de entrevistas semi-estructuradas, mediante las cuales se obtuvo una perspectiva personal acerca de la situación. Se analizaron los cambios desde nueve categorías: Actividades de la vida diaria, trabajo remunerado, tiempo libre, relaciones interpersonales, familia, accesibilidad, responsabilidad, seguridad y vínculo. Los hallazgos dejan en evidencia que la obtención del perro de servicio no sólo influye en independencia funcional, sino también en el ámbito emocional, social y familiar...

This study arises from the interest in analyzing the changes perceived by people with motor functional diversity acquired in their daily lives following the acquisition of service dogs. The revision of international research on effectiveness of tenure of these animals, as well as the revision of the theories on bonding and biophilia provides insight to understand the possible changes. From all this, the question arises: How do the people under study perceive the changes in their daily lives after obtaining service dogs by Bocalán Confiar Corporation? The study is visualized from the interpretive paradigm and provides the theoretical review and direct sources through semistructured interviews, by means of which a personal perspective on the situation was obtained. Changes were analyzed from nine categories: activities of daily living, paid work, free time, relationships, family, accessibility, accountability, security and link. Findings evidence that the obtainment of the service dog does not only influences functional independence, but also in the emotional, social and family field...

Headache of recent onset in adults: a prospective population-based study.

One hundred consecutive adult patients with headache of recent onset were prospectively studied. Every patient was examined by craneal CT scan. Their mean age was 46 years (range 17-82). Neurological examination was normal in 80 patients. Organic headache represented 39% of the entire group, and 26% of them had a normal neurological examination. The yield of CT scan in patients with headaches and a normal neurological examination was 22.5% (95% IC: 14%-33%); of which we encountered the following pathologies: intracranial tumors (13), hydrocephalus (2), arachnoid cyst (1), toxoplasmic abscess (1) and parenchymal hemorrhage (1). The clinical characteristics of the headache on their own was insufficient to rule out the possibility of an intracranial tumor. Neuroimaging studies should be performed in all adult patients with non-vascular headache of recent onset, and previously headache-free individuals.

In vitro studies of Dermatophilus congolensis antimicrobial susceptibility by determining minimal inhibitory and bacteriocidal concentrations.

The Minimal Inhibitory Concentration (MIC) and Minimal Bacteriocidal Concentration (MBC) of 19 antimicrobials on 16 isolates of D. congolensis were determined. The potential field efficacy of the agents was evaluated by comparing the results with serum levels of drug unbound to proteins and the in vitro and in vivo findings of other authors. A modified standard microtechnique was used for serial dilution-antimicrobial sensitivity and found to be easy and reproducible. Erythromycin, spiramycin, penicillin G, ampicillin, chloramphenicol, the streptomycin, amoxicillin, the tetracyclines and novobiocin had high serum concentrations in comparison with their MBCs and were shown to have potential use for the treatment of dermatophilosis.

Atopic dermatitis. Findings of skin biopsies.

Twenty-eight adult patients with a clinical diagnosis of atopic dermatitis (according to the criteria of Hanifin and Lobitz) were studied at the Allergy Outpatient Service, the Dermatology Service and the Pathological Anatomy Service of the Hermanos Ameijeiras Clinical Surgical Hospital, from January to September 1986. The patients were submitted to a quantification of total serum IgE by means of the ELISA enzymatic ultramicromethod, developed at the Radioimmunoassay National Center, and skin biopsies were carried out by means of the paraffin and direct immunofluorescence methods. The most frequent histopathological findings were acanthosis, espongiosis, parakeratosis and exocitosis, as a chronic inflammatory infiltrate, mainly composed of lymphocytes, mast cells and eosinophils. In the skin direct immunofluorescence method we found depots of IgE in all the patients, having no relation in intensity to total serum IgE values.

Comparación del nivel de ansiedad en los pacientes de cirugía programada mediante la aplicación de la escala de ansiedad e información preoperatoria de Ámsterdam realizada en la visita pre anestésica y comparada con grupo control en los Hospitales Eugenio Espejo y Clínicas Pichincha Marzo – Octubre 2012 / Comparison of the level of anxiety in elective surgery patients by applying the scale of preoperative anxiety and information visit Amsterdam held in pre-anesthetic and compared with control group in the Eugenio Espejo Hospital and Clinics Pichincha March to October 2012

Lugar: Hospitales Eugenio Espejo y Clínicas Pichincha Tipo de estudio: Ensayo clínico controlado aleatorizado Muestra: Se calcula una muestra con un nivel de confianza del 95% y un poder del 80%. Se utilizaron como parámetros un porcentaje de ansiedad de 50%, tomando un valor de ansiedad en el grupo experimental de 25% lo cual resulta en una muestra mínima de 55 pacientes por cada grupo con asignación 1 a 1 (50% - 50%), este cálculo se lo realizó en el Iceberg Sim beta 4.0.3. Universo: Pacientes de cirugía programada para Cirugía General, Ginecología, Traumatología, Cirugía Vascular, Otorrinolaringología, Proctología, Urología, y Oftalmología, estado físico I y II según la clasificación de la Sociedad Americana de Anestesiología. Tamaño de la muestra: 294 pacientes Variables: Edad, Sexo, Escolaridad, Tipo de establecimiento, Cirugía previa, Conoce al Cirujano, Conoce al Anestesiólogo... (AU)

Place: Eugenio Espejo Hospital and Pichincha Clinic. Research Design: Clinical Test, randomized and controlled Sample: This sample was calculated with a 95% of confidence and 80% of power. As parameters were used a 50% of anxiety, taking a value of 25% of anxiety in the experimental group resulting a minimum sample of 55 patients for each group with 1 to 1 (50% - 50%), allocation. This estimate was made in the Iceberg Sim beta 4.0.3. Universe: Patients of scheduled surgery for General Surgery, Gynecology, Traumatology, Vascular Surgery, Otolaryngology, Proctology, Urology, and Ophthalmology, Fitness I and II according to the American Society of Anesthesiologists. Sample Size: 294 patients. Variables: Age, gender, scholarship, type of establishment, prior surgery, knows the surgeon, knows the anesthesiologist... (AU)