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The terminology used to describe reflectance confocal microscopy (RCM) findings in both melanocytic and nonmelanocytic lesions has been standardized in English. We convened a panel of Spanish-speaking RCM experts and used the Delphi method to seek consensus on which Spanish terms best describe RCM findings in this setting. The experts agreed on 52 terms: 28 for melanocytic lesions and 24 for nonmelanocytic lesions. The resulting terminology will facilitate homogenization, leading to a better understanding of structures, more standardized descriptions in clinical registries, and easier interpretation of clinical reports exchanged between dermatologists.
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Melanoma , Neoplasias Cutâneas , Humanos , Neoplasias Cutâneas/patologia , Melanoma/diagnóstico por imagem , Melanoma/patologia , Técnica Delphi , Microscopia Confocal/métodos , Consenso , Dermoscopia/métodosRESUMO
Antecedentes: el intento de suicidio es el principal factor de riesgo de muerte por suicidio. La Organización Mundial de la Salud sugiere grupos de apoyo como intervención para esta población. Objetivo: Este estudio tuvo como objetivo determinar la eficacia de los grupos de apoyo de pares para sobrevivientes de intento de suicidio (SOSA). Método: Revisión sistemática (PROSPERO ID: CRD42022307581). Resultados: En total se identificaron 946 artículos potenciales, se revisaron 81 textos completos y se incluyó un artículo. El artículo informa sobre un estudio piloto abierto con evaluaciones pre y post intervención, sin grupo de control y con alto riesgo de sesgo. Esta es una intervención prometedora, porque los resultados mostraron una disminución de la ideación suicida (d=0,33), y del intento de suicidio (d=0,31). El pequeño número de investigaciones empíricas limita las generalizaciones. Conclusión: El nivel de certeza de la evidencia es bajo (baja certeza), por lo tanto, el grado de recomendación corresponde a evidencia insuficiente (I), para recomendar esta estrategia para las políticas públicas. En este artículo se analizan las razones de estos resultados y los posibles caminos para avanzar en este campo.
Background: Suicide attempt is the main risk factor for death by suicide. The World Health Organization (WHO) suggests support groups as an intervention for this population. Objective: This study aimed to assess the efficacy of peer-support groups for survivors of suicide attempt (SOSA). Method: Systematic review (PROSPERO ID: CRD42022307581). Results: In total, 946 potential articles were identified, 81 full texts were reviewed, and one article was included. The article reported an open-label pilot study with pre- and post-intervention evaluations, without a control group, and with a high risk of bias. This is a promising intervention because the results showed decreased suicidal ideation (d=0.33) and suicide attempt (d=0.31). The small number of empirical investigations limit generalizations. Conclusion: The level of certainty of evidence is low (low certainty); therefore, the grade of recommendation corresponds to insufficient evidence (I) to recommend this strategy for public policies. The reasons for these results and possible paths to advance the field are discussed in this article.
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A scoping review was conducted to identify the available evidence about frailty among older Hispanics living in the U.S. using the Integral Model of Frailty. A not time-limited search was conducted in five peer-reviewed databases. Identified factors associated with frailty among older Hispanics are presented in four categories: (1) Characteristics and prevalence of frailty, (2) Life course determinants of frailty, (3) Comorbidities associated with frailty, and (4) Adverse outcomes of frailty. A total of 1030 articles were identified, and 37 articles were included in the scoping review. Most studies measured frailty based on the Fried Frailty Phenotype (59.5%, n= 22) and had a longitudinal design (64.9%, n= 24). The overall prevalence of frailty among Hispanics ranged from 4.3% to 37.1% (n= 20 studies). Further research is needed that targets Hispanics from different backgrounds in the U.S., particularly those that are high in number (i.e., Mexicans, Puerto Ricans, and Central Americans).
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Fragilidade , Hispânico ou Latino , Estados Unidos , Humanos , Idoso , Prevalência , Comorbidade , Idoso FragilizadoRESUMO
We search for gravitational-wave signals produced by cosmic strings in the Advanced LIGO and Virgo full O3 dataset. Search results are presented for gravitational waves produced by cosmic string loop features such as cusps, kinks, and, for the first time, kink-kink collisions. A template-based search for short-duration transient signals does not yield a detection. We also use the stochastic gravitational-wave background energy density upper limits derived from the O3 data to constrain the cosmic string tension Gµ as a function of the number of kinks, or the number of cusps, for two cosmic string loop distribution models. Additionally, we develop and test a third model that interpolates between these two models. Our results improve upon the previous LIGO-Virgo constraints on Gµ by 1 to 2 orders of magnitude depending on the model that is tested. In particular, for the one-loop distribution model, we set the most competitive constraints to date: Gµâ²4×10^{-15}. In the case of cosmic strings formed at the end of inflation in the context of grand unified theories, these results challenge simple inflationary models.
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COVID-19 , Melanoma , Estudos de Coortes , Humanos , Melanoma/diagnóstico , Melanoma/epidemiologia , Pandemias , SARS-CoV-2RESUMO
CONTEXT: The rapid emergence of COVID-19 could have direct and indirect impacts on food production systems and livelihoods of farmers. From the farming perspective, disruption of critical input availability, supply chains and labor, influence crop management. Disruptions to food systems can affect (a) planting area; and (b) crop yields. OBJECTIVES: To quantify the impacts of COVID-19 on major cereal crop's production and their cascading impact on national economy and related policies. METHODS: We used the calibrated crop simulation model (DSSAT suite) to project the impact of potential changes in planting area and grain yield of four major cereal crops (i.e., rice, maize, sorghum, and millet) in Senegal and Burkina Faso in terms of yield, total production, crop value and contribution to agricultural gross domestic product (GDP). Appropriate data (i.e., weather, soil, crop, and management practices) for the specific agroecological zones were used as an input in the model. RESULTS AND CONCLUSIONS: The simulated yields for 2020 were then used to estimate crop production at country scale for the matrix of different scenarios of planting area and yield change (-15, -10, -5, 0, +5, +10%). Depending on the scenario, changes in total production of four cereals combined at country levels varied from 1.47 M tons to 2.47 M tons in Senegal and 4.51 M tons to 7.52 M tons in Burkina Faso. The economic value of all four cereals under different scenarios ranged from $771 Million (M) to $1292 M in Senegal and from $1251 M to $2098 M in Burkina Faso. These estimated total crop values under different scenarios were compared with total agricultural GDP of the country (in 2019 terms which was $3995 M in Senegal and $3957 M in Burkina Faso) to assess the economic impact of the pandemic on major cereal grain production. Based on the scenarios, the impact on total agricultural GDP can change -7% to +6% in Senegal and - 8% to +9% in Burkina Faso. SIGNIFICANCE: Results obtained from this modeling exercise will be valuable to policymakers and end-to-end value chain practitioners to prepare and develop appropriate policies to cope or manage the impact of COVID-19 on food systems.
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Previous studies have shown the presence of several subunits of the inhibitory glycine receptor (GlyR) in the reward system, specifically in medium spiny neurons (MSNs) of the nucleus Accumbens (nAc). It was suggested that GlyR α1 subunits regulate nAc excitability and ethanol consumption. However, little is known about the role of the α2 subunit in the adult brain since it is a subunit highly expressed during early brain development. In this study, we used genetically modified mice with a mutation (KR389-390AA) in the intracellular loop of the GlyR α2 subunit which results in a heteromeric α2ß receptor that is insensitive to ethanol. Using this mouse model denoted knock-in α2 (KI α2), our electrophysiological studies showed that neurons in the adult nAc expressed functional KI GlyRs that were rather insensitive to ethanol when compared with WT GlyRs. In behavioral tests, the KI α2 mice did not show any difference in basal motor coordination, locomotor activity, or conditioned place preference compared with WT littermate controls. In terms of ethanol response, KI α2 male mice recovered faster from the administration of ataxic and sedative doses of ethanol. Furthermore, KI α2 mice consumed higher amounts of ethanol in the first days of the drinking in the dark protocol, as compared with WT mice. These results show that the α2 subunit is important for the potentiation of GlyRs in the adult brain and this might result in reduced sedation and increased ethanol consumption.
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Etanol , Receptores de Glicina , Consumo de Bebidas Alcoólicas , Animais , Masculino , Camundongos , Núcleo Accumbens/metabolismo , Receptores de Glicina/metabolismo , Transmissão SinápticaRESUMO
This simulation study was carried out to assess the impact of climate change and adaptation strategies on maize production across 22 locations in Ethiopia using Decision Support System for Agrotechnology Transfer - Cropping System Model (DSSAT-CSM) CERES-Maize. Three maize varieties, i.e., [BH-660 (late maturing), BH-540 (medium maturing) and Melkasa-1 (short maturing)] along with three planting dates [early (25-Apr), normal (25-May) and late (25-Jun)], four N fertilizer rates (64, 96, 128 and 160 kg N/ha) and three water levels [rainfed (no irrigation), two irrigations (each 30 mm at time of flowering and 5 d after flowering with total = 60 mm) and five irrigations (each 30 mm at time of flowering to early grain-filing, which were applied every five days in total = 150 mm)] were evaluated as the adaptation strategy. The mid-century (2040-2069) temperatures and solar radiation were extracted from multiple model means across the Coordinated Regional Climate Downscaling Experiment (CORDEX) models under the highest Representative Concentration Pathway (RCP8.5). Maize productivity was evaluated assuming that maize was grown on shallow sandy loam soils. Yield of an early, medium and late maturing maize were changed by -13 to -8%, -10 to +4% and + 3 to +13%, respectively, relative to the baseline period (1980-2005). The days to maturity decreased by about 16%. Under rainfed condition, N application up to 64, 128 and 160 kg/ha significantly improved yield for early, medium and late maturing varieties, respectively. Relatively high yield and low inter-seasonal yield variability were simulated for BH-660 and Melkasa-1 when planted on 25-Apr and 25-May, respectively, for most locations. Application of two (60 mm) and five (150 mm) irrigation levels improved yield in drier locations. In conclusion, this study provides potential adaptation options under the future climate in maize producing regions of Ethiopia.
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Agricultura , Zea mays , Mudança Climática , Etiópia , Fertilizantes/análiseRESUMO
Several previous studies showed that hippocampus and cortex are affected in Alzheimer's disease (AD). However, other brain regions have also been found to be affected and could contribute with new critical information to the pathophysiological basis of AD. For example, volumetric studies in humans have shown a significant atrophy of the striatum, particularly in the nucleus Accumbens (nAc). The nAc is a key component of the limbic reward system and it is involved in cognition and emotional behaviors such as pleasure, fear, aggression and motivations, all of which are affected in neurodegenerative diseases such as AD. However, its role in AD has not been extensively studied. Therefore, using an AD mouse model, we investigated if the nAc was affected in 6 months old transgenic 2xTg (APP/PS1) mice. Immunohistochemistry (IHC) analysis in 2xTg mice showed increased intraneuronal Aß accumulation, as well as occasional extracellular amyloid deposits detected through Thioflavin-S staining. Interestingly, the intracellular Aß pathology was associated to an increase in membrane excitability in dissociated medium spiny neurons (MSNs) of the nAc. IHC and western blot analyses showed a decrease in glycine receptors (GlyR) together with a reduction in the pre- and post-synaptic markers SV2 and gephyrin, respectively, which correlated with a decrease in glycinergic miniature synaptic currents in nAc brain slices. Additionally, voltage-clamp recordings in dissociated MSNs showed a decrease in AMPA- and Gly-evoked currents. Overall, these results showed intracellular Aß accumulation together with an increase in excitability and synaptic alterations in this mouse model. These findings provide new information that might help to explain changes in motivation, anhedonia, and learning in the onset of AD pathogenesis.
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Doença de Alzheimer , Neurônios/fisiologia , Núcleo Accumbens/fisiologia , Transmissão Sináptica/fisiologia , Doença de Alzheimer/patologia , Animais , Biomarcadores/metabolismo , Modelos Animais de Doenças , Camundongos Endogâmicos C57BL , Camundongos Transgênicos , Neurônios/patologia , Técnicas de Patch-Clamp , Placa Amiloide/patologia , Receptores de Glicina/metabolismo , Transmissão Sináptica/efeitos dos fármacos , Ácido alfa-Amino-3-hidroxi-5-metil-4-isoxazol Propiônico/metabolismo , Ácido alfa-Amino-3-hidroxi-5-metil-4-isoxazol Propiônico/farmacologia , Ácido gama-Aminobutírico/metabolismo , Ácido gama-Aminobutírico/farmacologiaRESUMO
We present our current best estimate of the plausible observing scenarios for the Advanced LIGO, Advanced Virgo and KAGRA gravitational-wave detectors over the next several years, with the intention of providing information to facilitate planning for multi-messenger astronomy with gravitational waves. We estimate the sensitivity of the network to transient gravitational-wave signals for the third (O3), fourth (O4) and fifth observing (O5) runs, including the planned upgrades of the Advanced LIGO and Advanced Virgo detectors. We study the capability of the network to determine the sky location of the source for gravitational-wave signals from the inspiral of binary systems of compact objects, that is binary neutron star, neutron star-black hole, and binary black hole systems. The ability to localize the sources is given as a sky-area probability, luminosity distance, and comoving volume. The median sky localization area (90% credible region) is expected to be a few hundreds of square degrees for all types of binary systems during O3 with the Advanced LIGO and Virgo (HLV) network. The median sky localization area will improve to a few tens of square degrees during O4 with the Advanced LIGO, Virgo, and KAGRA (HLVK) network. During O3, the median localization volume (90% credible region) is expected to be on the order of 10 5 , 10 6 , 10 7 Mpc 3 for binary neutron star, neutron star-black hole, and binary black hole systems, respectively. The localization volume in O4 is expected to be about a factor two smaller than in O3. We predict a detection count of 1 - 1 + 12 ( 10 - 10 + 52 ) for binary neutron star mergers, of 0 - 0 + 19 ( 1 - 1 + 91 ) for neutron star-black hole mergers, and 17 - 11 + 22 ( 79 - 44 + 89 ) for binary black hole mergers in a one-calendar-year observing run of the HLV network during O3 (HLVK network during O4). We evaluate sensitivity and localization expectations for unmodeled signal searches, including the search for intermediate mass black hole binary mergers.
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Wheat production is expected to be challenged by future climate change. However, it is unclear how wheat grown in diverse agroecologies will respond to climate change and adaptation management strategies. A geospatial simulation study was conducted to understand the impacts of climate change and adaptation management strategies on wheat (Triticum aestivum L.) production in Ethiopia. Simulation results showed that the average long-term baseline (1980-2005) wheat yield ranged from 1593 to 3356 kg/ha. This wheat yield range is within the national average (2100-2700 kg/ha) for this decade. In regions with cooler temperatures (<21 °C), mid-century temperatures and elevated CO2, along with increased N fertilizer slightly improved attainable yield levels above 3000 kg/ha. Whereas, in regions with heat and drought conditions wheat yield declined regardless the increase of N or CO2 levels. Wheat yield increased at a diminishing rate with increase in N fertilizer rate. However, N fertilizer did not increase yields under low rainfall conditions. Two to five irrigation per season contributed to yield improvement for low rainfall locations, while yield did not substantially improve for locations receiving adequate seasonal rainfall. Therefore, based on this study, improved N fertilizer application in combination with increased CO2 could improve wheat yield under future climate in most wheat producing regions (with adequate rainfall) of Ethiopia. Our results provide valuable information regarding impacts of climate change factors and adaptation strategies for producers, researchers, extension professionals and policy makers.
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Mudança Climática , Triticum , Aclimatação , Secas , EtiópiaRESUMO
Inhibitory glycine receptors (GlyRs) are widely expressed in spinal cord and brain stem. They are also expressed in the nucleus Accumbens (nAc) where they have been implicated in the release of dopamine from the ventral tegmental area to the nAc in the presence of ethanol. One of the major types of neurons in the nAc are the Dopamine 1 receptor-expressing (D1+) medium spiny neurons (MSNs) that are activated when addictive drugs, like ethanol, are administrated. Thus, D1(+) MSNs are a relevant target for the study of ethanol effects. Here, using electrophysiological recordings, we report that GlyRs in D1(+) MSNs are highly sensitive to ethanol, with potentiation starting at 5 mM (26 ± 5%). Single channel recordings in D1(+) MSNs showed that 10 mM ethanol increased the open probability of the channel (0.22 ± 0.05 versus 0.66 ± 0.16), but did not affect channel conductance (~40 pS). A glycinergic mediated tonic current in D1(+) MSNs was potentiated by 10 and 50 mM ethanol causing a reduction in the excitability of these cells. A 34 ± 7% reduction in action potential firing was observed in these neurons in the presence of 50 mM ethanol. Interestingly, no effects of ethanol were detected in the presence of strychnine or in D1(-) MSNs in the nAc. These results indicate that GlyRs present in D1(+) MSNs are sensitive to low concentrations of ethanol, and that potentiation of this inhibitory current regulates the activation of nAc, acting as a homeostatic signal that would prevent over-activation of the reward system when drugs like ethanol are consumed.
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Etanol/farmacologia , Neurônios/efeitos dos fármacos , Núcleo Accumbens/efeitos dos fármacos , Receptores de Dopamina D1/efeitos dos fármacos , Receptores de Glicina/efeitos dos fármacos , Animais , Feminino , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Transgênicos , Neurônios/metabolismo , Receptores de Dopamina D1/metabolismo , Receptores de Dopamina D2/efeitos dos fármacos , Receptores de Dopamina D2/metabolismo , Receptores de Glicina/metabolismoRESUMO
OBJECTIVE: The aim of this study was to evaluate the effectiveness of thoracolumbar myofascial release to increase the resistance of the sternocleidomastoid (SCM) muscle bilaterally and to decrease the angle of forward head posture in young women enrolled at the Autónoma University of Chile. MATERIAL AND METHODS: This longitudinal study was based on the immediate measurement (5minutes) of muscular resistance (seconds) through the fatigue test by means of surface electromyography in the bilateral sternocleidomastoid and analysis of the angle of forward head posture after the application of thoracolumbar myofascial release (TMFR). The 35 women evaluated met the inclusion criteria of female sex, age between 22 and 27 years, sedentary lifestyle, senior students of the Autónoma University of Chile, forward angle head posture between 43.8 and 51 degrees, body mass index indicating normal weight or overweight, and without spinal abnormalities. All participants provided written informed consent. RESULTS: After the application of TMFR, there were statistically significant and immediate changes in the muscular resistance of the sternocleidomastoid with an average increase of 27.4seconds (P<.05) and an average decrease in the forward head posture angle of 2.8 degrees (P<.05). CONCLUSION: TMFR produces an immediate effect in increasing the muscular resistance of the bilateral sternocleidomastoid and reducing the forward head posture angle in young women with forward head posture.
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Fáscia/fisiologia , Cabeça , Tono Muscular , Músculos do Pescoço/fisiologia , Postura , Adulto , Índice de Massa Corporal , Eletromiografia/métodos , Feminino , Humanos , Estudos Longitudinais , Fadiga Muscular/fisiologia , Fatores de Tempo , Adulto JovemRESUMO
Pituitary diseases such as acromegaly and Cushing's disease require surgical or medical therapy. In some functioning pituitary tumors, a spontaneous remission of hormonal hypersecretion is observed, mainly associated to apoplexy or pituitary infarction. We report the evolution of two female patients older than 70 years at the time of diagnosis, with multiple comorbidities. In case 1, acromegaly was diagnosed at 74 years of age. Sellar CT scan showed a 10-mm adenoma. During her follow-up, IGF1 levels remained normal. Nine years later, a magnetic resonance (MR) showed a 7-mm adenoma. In case 2, clinical and biochemical diagnosis of Cushing's disease was done being 71 years old. Sellar MR showed a 6-mm adenoma. Three years later, urinary cortisol normalized with no changes in adenoma at MR. Seven years later, she remains without clinical or biochemical signs of hypercortisolism. In both cases, no signs of hemorrhage were observed at MR.
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Acromegalia/diagnóstico por imagem , Adenoma/diagnóstico por imagem , Hipersecreção Hipofisária de ACTH/diagnóstico por imagem , Neoplasias Hipofisárias/diagnóstico por imagem , Acromegalia/fisiopatologia , Adenoma/fisiopatologia , Idoso , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Hipersecreção Hipofisária de ACTH/fisiopatologia , Apoplexia Hipofisária , Neoplasias Hipofisárias/fisiopatologia , Remissão EspontâneaRESUMO
Pituitary diseases such as acromegaly and Cushing's disease require surgical or medical therapy. In some functioning pituitary tumors, a spontaneous remission of hormonal hypersecretion is observed, mainly associated to apoplexy or pituitary infarction. We report the evolution of two female patients older than 70 years at the time of diagnosis, with multiple comorbidities. In case 1, acromegaly was diagnosed at 74 years of age. Sellar CT scan showed a 10-mm adenoma. During her follow-up, IGF1 levels remained normal. Nine years later, a magnetic resonance (MR) showed a 7-mm adenoma. In case 2, clinical and biochemical diagnosis of Cushing's disease was done being 71 years old. Sellar MR showed a 6-mm adenoma. Three years later, urinary cortisol normalized with no changes in adenoma at MR. Seven years later, she remains without clinical or biochemical signs of hypercortisolism. In both cases, no signs of hemorrhage were observed at MR.
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Humanos , Masculino , Feminino , Idoso de 80 Anos ou mais , Neoplasias Hipofisárias/diagnóstico por imagem , Acromegalia/diagnóstico por imagem , Adenoma/diagnóstico por imagem , Hipersecreção Hipofisária de ACTH/diagnóstico por imagem , Neoplasias Hipofisárias , Remissão Espontânea , Acromegalia/fisiopatologia , Apoplexia Hipofisária , Imageamento por Ressonância Magnética , Adenoma/fisiopatologia , Hipersecreção Hipofisária de ACTH/fisiopatologiaRESUMO
We present possible observing scenarios for the Advanced LIGO, Advanced Virgo and KAGRA gravitational-wave detectors over the next decade, with the intention of providing information to the astronomy community to facilitate planning for multi-messenger astronomy with gravitational waves. We estimate the sensitivity of the network to transient gravitational-wave signals, and study the capability of the network to determine the sky location of the source. We report our findings for gravitational-wave transients, with particular focus on gravitational-wave signals from the inspiral of binary neutron star systems, which are the most promising targets for multi-messenger astronomy. The ability to localize the sources of the detected signals depends on the geographical distribution of the detectors and their relative sensitivity, and [Formula: see text] credible regions can be as large as thousands of square degrees when only two sensitive detectors are operational. Determining the sky position of a significant fraction of detected signals to areas of 5-[Formula: see text] requires at least three detectors of sensitivity within a factor of [Formula: see text] of each other and with a broad frequency bandwidth. When all detectors, including KAGRA and the third LIGO detector in India, reach design sensitivity, a significant fraction of gravitational-wave signals will be localized to a few square degrees by gravitational-wave observations alone.
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Los trastornos del sueño en el adulto mayor son un problema manifestado con frecuencia, que afecta la calidad de vida y tiene impacto en los costos y el cuidado de salud. La actual forma de manejo de estos problemas se relaciona con prescripciones de fármacos, los cuales tienen efectos secundarios y aumenta su vulnerabilidad. En este contexto, el objetivo de esta investigación es evaluar la efectividad de una intervención cognitivo y conductual, que pretende mejorar el sueño mediante el cambio de los hábitos deficientes, así como el desafío de los pensamientos, las actitudes y las creencias negativas acerca del mismo. El método incluyó intervenciones cognitivo-conductuales grupales, con evaluaciones pre y post intervención. Los resultados indican una media de 9 (Pittsburgh) al inicio del programa y 4.9 al finalizar. Se concluye que la intervención a corto plazo consigue cambios significativos en hábitos e higiene del sueño. Esta investigación orienta a los profesionales de enfermería en la aplicación de estrategias hacia el bienestar del adulto mayor y el desarrollo de la disciplina en el marco del fortalecimiento de cuidados esenciales y fundamentales en procesos vitales.
Sleep disorders among senior adults are a frequent problem which has important impacts on their quality of life, and the costs of healthcare. The current management of these disorders is based on drug prescriptions, which in turn, have secondary effects and also enhance underlying conditions and vulnerabilities. Within this context, the objective of this study was to assess the effectiveness of a cognitive behavioral intervention aimed at improving the quality of sleep of these persons by modifying negative habits, thoughts, and beliefs. The method included group cognitive-behavioral interventions with pre and post assessments. The corresponding results showed a mean of 9 (Pittsburg) at the beginning of the program, and a mean of 4.9 at the end. It was thus concluded that the intervention, in the short term, helped to achieve significant improvements in relation to the sleep hygiene of these persons. This study can orient nursing professionals to establish strategies aimed at the wellbeing of senior adults; all within the vital processes and essential care strengthening framework.
Os transtornos do sono no idoso são um problema manifestado com frequência e que afeta a qualidade de vida e tem impacto nos custos e no cuidado de saúde. A atual forma de manejo destes problemas relaciona-se com prescrições de fármacos, os quais têm efeitos secundários e aumenta sua vulnerabilidade. Neste contexto, o objetivo desta pesquisa é avaliar a efetividade de uma intervenção cognitivo e comportamental, que pretende melhorar o sono mediante a mudança dos hábitos deficientes, assim como o desafio dos pensamentos, as atitudes e as crenças negativas acerca de si próprio. O método incluiu intervenções cognitivo-comportamentais grupais, com avaliações pre e post intervenção. Os resultados indicam uma média de 9 (Pittsburg) ao início do programa e 4.9 para finalizar. Conclui-se que a intervenção a curto prazo consegue câmbios significativos em hábitos e higiene do sono. Esta pesquisa orienta aos profissionais de enfermagem na aplicação de estratégias para o bem-estar do idoso e do desenvolvimento da disciplina no marco do fortalecimento de cuidados essenciais e fundamentais em processos vitais.
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Humanos , Masculino , Feminino , Idoso , Idoso de 80 Anos ou mais , Qualidade de Vida , Transtornos do Sono-Vigília , IdosoRESUMO
Introducción: La inserción de estudiantes de pregrado en actividades de investigación es relevante para fomentar la crítica y aplicación de resultados de investigación. La formación de ayudantes de investigación se plantea como una alternativa válida para que los alumnos se expongan, experimenten y participen activamente en el proceso de investigación. Objetivo: Identificar el nivel de conocimiento y grado de satisfacción de los estudiantes después de participar en un programa de formación de ayudantes de investigación. Método: Estudio de pre y post test en 20 estudiantes de pregrado de Enfermería. Se evaluó el conocimiento alcanzado y la satisfacción de los estudiantes con el programa de formación, el cual considera tres módulos de aprendizaje distribuidos en 180 horas cronológicas. Resultados: El conocimiento de los estudiantes incrementó significativamente con el programa, no se relacionó con el conocimiento que el alumno trae al inicio del mismo, así como tampoco con el semestre que cursa. El grado de satisfacción fue en el 100% de los alumnos muy satisfecho. Discusión: Este artículo reporta un programa de formación de ayudantes de investigación que es posible ser replicado en otras realidades, que incrementa el conocimiento, con un alto grado de satisfacción en los estudiantes. La duración del programa podría considerarse una debilidad. Conclusión: La participación de estudiantes de pregrado en un programa de formación de ayudantes de investigación, puede considerarse una estrategia para involucrar a alumnos en investigación, y que valoren su aporte en la disciplina de enfermería.
Introduction: An early integration of undergraduate students into activities of research can help them develop skills for a critical application of the corresponding findings. The formation of research assistants program is proposed as an experience for students to expose, experiment, and actively participate in diverse researching related activities. Objective: To identify the level of knowledge and degree of satisfaction of students after their participation in a research assistant formation program. Method: This is pre-post-test study involving 20 undergraduate nursing students. Their achieved knowledge and satisfaction in the three-module-180-hours program were assessed. Results: Unrelated to parallel experiences, the students' knowledge increased significantly after the program. All students stated having felt very satisfied. Discussion: This article informs on a program of formation of research assistants which is prone to be extended to other contexts, however its duration could be adjusted. Conclusion: The participation of undergraduate students in a research assistant formation program is a novel strategy to engage students into nursing research.
Introdução: A inserção de estudantes de graduação em atividades de pesquisa é relevante para promover a crítica e aplicação de resultados de pesquisa. A formação de assistentes de pesquisa contempla-se como una alternativa válida para os alunos se exporem, experimentarem e participarem ativamente no processo de pesquisa. Objetivo: Identificar o nível de conhecimento e grau de satisfação dos estudantes depois de participarem em um programa de formação de assistentes de pesquisa. Método: Estudo de pre e post teste de 20 estudantes de graduação de Enfermagem. Avaliou-se o conhecimento atingido e a satisfação dos estudantes com o programa de formação, o qual considera três módulos de aprendizagem distribuídos em 180 horas cronológicas. Resultados: O conhecimento dos estudantes aumentou significativamente com o programa, não se relaciona com o conhecimento que o aluno traz ao início do mesmo, assim como também não, com o semestre que cursa. O grau de satisfação foi do 100% dos alunos: muito satisfeito. Discussão: Este artigo informa um programa de formação de assistentes de pesquisa que é possível ser reproduzido em outras realidades, que aumenta o conhecimento, com um alto grau de satisfação nos estudantes. A duração do programa podia considerar-se uma debilidade. Conclusão: A participação de estudantes de graduação em um programa de formação de assistentes de pesquisa, pode considerar-se uma estratégia para envolver os alunos em pesquisa, e que valorizem seu aporte na disciplina de enfermagem.
Assuntos
Humanos , Masculino , Feminino , Pesquisa , Estudantes de Enfermagem , AprendizagemRESUMO
Diabetes Mellitus (DM) and obesity are a public health problem in Chile. Bariatric surgery is the most effective treatment alternative to achieve a significant and sustained weight reduction in patients with morbid obesity. The results of controlled clinical trials indicate that, compared to medical treatment, surgery for obese patients with DM2 allows a better control of blood glucose and cardiovascular risk factors, reduces the need for medications and increases the likelihood for remission. Consensus conferences and clinical practice guidelines support bariatric surgery as an option to treat DM2 in Class III Obesity (Body Mass Index (BMI) > 40) regardless of the glycemic control and the complexity of pharmacological treatment and in Class II Obesity (BMI 35-39,9) with inadequate glycemic control despite optimal pharmacological treatment and lifestyle. However, surgical indication for patients with DM2 and BMI between 30-34.9, the most prevalent sub-group, is only suggested. The Chilean Societies of Endocrinology and Diabetes and of Bariatric and Metabolic Surgery decided to generate a consensus regarding the importance of other factors related to DM2 that would allow a better selection of candidates for surgery, particularly when weight does not constitute an indication. Considering the national reality, we also need a statement regarding the selection and characteristics of the surgical procedure as well as the role of the diabetologist in the multidisciplinary team.
Assuntos
Cirurgia Bariátrica/métodos , Diabetes Mellitus Tipo 2/cirurgia , Obesidade/cirurgia , Índice de Massa Corporal , Chile , Humanos , Ilustração Médica , Fatores de Risco , Sociedades Médicas , Resultado do TratamentoRESUMO
BACKGROUND: 99mTc-sestamibi parathyroid SPECT scintigraphy is a useful tool in the pre-operative study of hyperparathyroidism. False negatives (FN) have been reported in 5.7-14% of the examinations. AIM: To characterize 99mTc-sestamibi FN in cases referred for primary hyperparathyroidism (PHP) to a university hospital. MATERIAL AND METHODS: Descriptive retrospective analysis. We included patients with PHP, studied with SPECT scintigraphy, operated at our center between 2008 and 2015. Clinical and surgical data were recorded; biopsies of the FN were blindly reviewed by one pathologist. RESULTS: One hundred twenty one scintigraphies fulfilled the inclusion criteria. Seven (5.8%) were negative and 114 positive. There was no difference in age, sex and PTH levels between FN and true positive scintigraphies. At surgery, one FN case had two hyperplasic glands and two cases had ectopic glands. Pathology reported adenoma in three cases, hyperplasia in three and carcinoma in one. The largest diameter of the lesion was lower in FN (1.3 and 2.1 cm respectively, p = 0.02) and the proportion of adenomas was higher in true positive cases (29% and 75% respectively; p < 0.01). The interval between scintigraphy and parathyroidectomy was greater in FN with a median of 92 days (range 20 days-3.2 years, p < 0.01). The percentage of oxyphilic cells observed was similar in both groups. CONCLUSIONS: FN parathyroid SPECT scintigraphies in PHP are uncommon. They corresponded to lesions under the equipment's resolution limit and resulted in longer time lags between scintigraphy and surgery.