Legibilidad lingüística de materiales informativos impresos, divulgados por el Ministerio de Salud Pública y Bienestar Social, Paraguay, aplicando el Índice de Niebla de Gunning / Linguistic legibility of printed informational materials, disclosed by the Ministry of Public Health and Social Welfare, Paraguay, applying the Gunning Fog Index

Introducción: Para la Teoría de Enfermería del Déficit de Autocuidado (TEDA), el enfermero trabaja con "sistemas de enfermería": parcialmente compensatorio, totalmente compensatorio y sistema de apoyo educativo. Para este último, los materiales informativos (educativos) impresos son importantes. De la legibilidad de ellos depende la eficacia de los programas del Ministerio de Salud Pública y Bienestar Social (MSP y BS) del Paraguay. Sin embargo, esta legibilidad no ha sido estudiada en el país. Objetivo: Analizar la legibilidad lingüística de materiales informativos impresos, divulgados por el MSP y BS, aplicando el Índice de Niebla de Gunning (ING). Materiales y métodos: De los materiales informativos impresos, publicados por el MSP y BS entre 2003 y 2018, se identificó un corpus de 49 materiales. De ellos, por muestreo aleatorio polietápico, fueron seleccionados 250 párrafos. Se calculó el ING de cada uno. La media de ING de dichos párrafos se comparó con un "patrón oro", elaborado para el español paraguayo estándar a partir de una muestra artículos de opinión de periódicos de circulación nacional. Resultados: La media de legibilidad lingüística calculada fue 20,50, valor de un nivel de dificultad "normal" en la escala del patrón oro elaborado con artículos periodísticos de opinión. Conclusión: Los párrafos estudiados, en promedio, tienen niveles de legibilidad comparables con los de artículos de opinión de periódicos de circulación nacional. Dado que la media de años de escolaridad de la población del país (8,4 años) es baja, la eficacia de los materiales informativos impresos, para fines de autocuidado, no está garantizada. Palabras clave: Autocuidado, Sistemas de enfermería, Materiales informativos impresos, Legibilidad lingüística.

Introduction: The Orem's Self-Care Deficit Nursing Theory (SCDNT) states that nurses work with "nursing systems": Partly compensatory, Wholly compensatory and Supportive-educative. For the latter, printed health instructional resources are important. The efficacy of the programs of the Ministry of Public Health and Social Welfare (MPH & SW) of Paraguay depends on the readability of those informational aids. However, there are no studies about the readability of these health educational resources in the country. Objective: To analyze the readability of printed health educational resources published by the MPH & SW, applying the Gunning Fog Index (GFI). Methods: A corpus of 49 health informational resources, published by the MPH & SW between 2003 and 2018, was identified. From these, by random multi-stage sampling, 250 paragraphs were selected. The GFI of each one was calculated. The mean of GFI of these paragraphs was compared with a "gold standard", designed for the Paraguayan Spanish, based on a sample of opinion articles of national newspapers. Results: The mean of GFI calculated was 20.50, which can be read as a "normal" difficulty level on the gold standard scale developed with newspaper opinion articles. Conclusion: The paragraphs studied, on average, have comparable readability levels with opinion articles of national newspapers. Since the schooling year average of the country's population is low (8.4 years), the efficacy of the printed health educational resource for self-care purposes is not guaranteed. Keywords: Self-Care, Nursing Systems, Printed Health Educational Resources, Readability.

Dementia, gait disturbance, and urinary incontinence in a patient with pulmonary sarcoidosis.

Hydrocephalus is an uncommon presentation of neurosarcoidosis. We discuss the case of a 67-year-old woman with a prior diagnosis of hypothyroidism, systemic hypertension, and lung sarcoidosis who presented with a 1-month history of progressive impairment of consciousness leading to prostration and loss of sphincter control. At admission, patient was febrile with altered speech and without focalization. Laboratory results showed leucocytosis and mild anaemia. Cerebrospinal fluid (CSF) analysis was characterized by mild elevated protein level, increased cell count, normal glucose and adenosine deaminase (ADA), negative cytology, and no bacterial isolations. Electroencephalogram showed toxic-metabolic encephalopathy. Computed tomography (CT) of the brain revealed hydrocephalus without structural damage, and magnetic resonance imaging of the brain demonstrated non-specific diffuse meningeal enhancement and periventricular changes supporting normal pressure hydrocephalus. Chest X-ray showed mediastinal adenopathy and parenchymatous lesions, consistent with stage II lung sarcoidosis. A ventriculoperitoneal shunt was installed, and the patient experienced rapid improvement in her symptoms.

Respuestas socio-sanitarias frente al consumo de pasta base: límites y potencialidades de los centros de rehabilitación de la zona sur del área metropolitana de Buenos Aires / Socio-sanitary answers to the consumption of cocaine paste: limits and potentials of rehabilitation centers

INTRODUCCIÓN: el número creciente de politratamientos realizados por los jóvenes de la zona sur del Área Metropolitana de Buenos Aires (AMBA) para abandonar el consumo de pasta base (PB)/paco revela la necesidad de estudiar cómo describen los jóvenes elfuncionamiento de los centros de rehabilitación. OBJETIVOS: Analizar loslímites y las potencialidades de los centros de rehabilitación para personascon consumos problemáticos de pasta base/paco desde la perspectiva de los jóvenes. Analizar las políticas en materia de adicciones y determinarla accesibilidad a los espacios de tratamiento. MÉTODOS: Se realizó unestudio cualitativo entre mediados de 2012 y principios de 2013 en la zona sur del AMBA. Los datos se analizaron con Atlas.ti 7.0. Se trabajó con jóvenes que concurrían a diferentes organizaciones de la sociedad civil, tales como centros de día, comunidades terapéuticas o espaciosde recuperación y rehabilitación de personas adictas. RESULTADOS: Elconsumo de pasta base comienza entre los 11 y 15 años. Los jóvenes que culminaron el tratamiento no responsabilizaron del consumo a susfamilias, sino al contexto. Los usuarios de pasta base concurren a las guardias médicas sólo por emergencias y sienten que no hay espacio para ellos. El acceso a los centros de rehabilitación está garantizado, perose dificulta la permanencia por las dinámicas que facilitan el abandono delos mismos. CONCLUSIONES: Existen barreras para acceder a la atenciónhospitalaria y para permanecer en los centros de rehabilitación. No se cumplen los derechos y las garantías proclamados en la Ley 26.657. Esnecesario realizar controles exhaustivos y propiciar espacios comunitarios que contemplen el contexto de los jóvenes.

INTRODUCTION: the growing number of polytreatments received by young people in the south of the MetropolitanArea of Buenos Aires (MABA) to stop the consumption of cocaine paste (CP), or paco, reveals the need to study therehabilitation center functioning taking into account the descriptions of the young patients. OBJECTIVES: To analyze limits and potentials of rehabilitation centers for paco addicts from the perspective of young people. To analyze addiction policies andto determine the accessibility to treatment facilities. METHODS: A qualitative study was conducted between mid-2012 and early 2013 in the southern MABA zone. Data were analyzed with Atlas. ti 7.0. The study included young people attending different civil society organizations, such as day centers, therapeutic communities or facilities for the recovery and rehabilitation of addictedpeople. RESULTS: CP consumption starts at 8-15 years of age. The young people who completed the treatment did not blame their families, but the context. CP users attend medical services only in case of emergency and feel there is no place for them. Access to rehabilitation centers is guaranteed, but it is difficult to stay there due to certain dynamics leading to treatment dropout. CONCLUSIONS: There are barriers to access hospital care andto tay in rehabilitation centers. Law 26657 establishes rights andguarantees which are not respected. It is necessary to perform detailed checks and promote community spaces considering the context of young people.

Congenital vesicovaginal fistula with menouria: an anomaly of the urogenital sinus.

OBJECTIVE: To describe the diagnostic and therapeutic process for a congenital exceptional anomaly. To analyze the pathogenesis of the embryologic anomalies associated with menouria and congenital vesicovaginal fistula (VVF). STUDY DESIGN: The case of a 28-year-old female with menouria and impossibility of consummating coitus is described. The diagnostic method is analyzed. The type of treatment is described and finally we conclude with a hypothesis about embryology of congenital anomalies with VVF and menouria. RESULTS: For management of anomalies as congenital VVF, imaging tests including cystography and urography could not correctly visualize the fistulous tract. It was identified by cystoscopy, performed during the time of menouria. Surgical treatment consisted in repairing the VVF and vaginoplasty according to the McIndoe technique. CONCLUSIONS: All women with menouria need complete investigation with exhaustive exploration, analytic evaluation, ultrasound, imaging tests (principally magnetic resonance) and, very importantly, cystoscopy on the days of menouria. Surgical treatment must be careful and individualized. This case allows us to hypothesise that the blind vagina encountered reflects an anomaly of correct urogenital sinus development.