Proposal of Eoetvoesiella gen. nov., Paludihabitans gen. nov., Rivihabitans gen. nov. and Salella gen. nov. as replacement names for the illegitimate prokaryotic generic names Eoetvoesia, Paludicola, Rivicola and Sala, respectively.

The prokaryotic generic names Eoetvoesia Felföldi et al. 2014, Paludicola Li et al. 2017, Rivicola Sheu et al. 2014 and Sala Song et al. 2023 are illegitimate because they are later homonyms of the genus names Eoetvoesia Schulzer et al. 1866 (Ascomycota), Paludicola Wagler 1830 (Amphibia) and Paludicola Hodgson 1837 (Aves), Rivicola Fitzinger 1833 (Mollusca) and Sala Walker 1867 (Hemiptera) and the subgenus name Sala Ross 1937 (Hymenoptera), respectively (Principle 2 and Rule 51b(4) of the International Code of Nomenclature of Prokaryotes). We therefore propose the replacement generic names Eoetvoesiella, Paludihabitans, Rivihabitans and Salella, with type species Eoetvoesiella caeni, Paludihabitans psychrotolerans, Rivihabitans pingtungensis and Sallella cibi, respectively.

Prevalence of soil-transmitted helminth infections and associated risk factors among elderly individuals living in rural areas of southern Thailand.

BACKGROUND: Soil-transmitted helminth (STH) infection is a neglected tropical disease affecting approximately 1.5 billion people worldwide. In past decades, most studies focused on STH infection in preschool-aged and school-aged children in different regions of Thailand. However, little is known about the prevalence and intensity of STH infection in the elderly population. Therefore, the aim of this study was to determine the current prevalence and intensity of STH infections and to identify associated risk factors among the elderly population. METHODS: A cross-sectional study was conducted from July to November 2019 to assess the prevalence of STH infections and associated risk factors among elderly populations living in five subdistricts of Thasala District, Nakhon Si Thammarat Province, Thailand. A total of 439 elderly individuals were selected using a random sampling technique. Each fresh stool sample was examined using the formalin ethyl acetate concentration technique (FECT), Kato-Katz thick smears and agar plate culture (APC). A structured questionnaire was used to obtain relevant information regarding associated risk factors for STH infection. RESULTS: The overall prevalence of STH infection was 15.7%. Hookworms (10.9%, 48/439) were the most prevalent STH species, followed by Strongyloides stercoralis (3.4%, 15/439) and Trichuris trichiura (2.1%, 9/439). Most elderly individuals infected with hookworms or T. trichiura had light-intensity infections. A higher prevalence of STH infection was observed among individuals aged older than 80 years (23.4%) than among those aged between 70 and 79 years (15.2%) and 60-69 years (14.5%). Males were 1.85-times more likely to present with STH infections than females. Not washing vegetables before eating increased the risk of STH infection by 3.19 times, while defecation in an open field increased the risk of STH infection by 2.65 times. CONCLUSIONS: The findings suggested that STH infection is prevalent, and that hookworms are the most common STH species among elderly populations in southern Thailand. Personal hygiene and deworming programs should be implemented among the elderly population to reduce the risk and prevent the spread of STH infections.

Microbiological quality of honey from the Pampas Region (Argentina) throughout the extraction process.

The microbiological quality of honey obtained from different processing points and the environmental quality within honey houses were assessed in the Pampas Region (Argentina). Mold and yeast (MY), culturable heterotrophic mesophilic bacteria (CHMB), the number of spore-forming bacteria as well as the presence of Shigella spp., Salmonella spp. and fecal coliforms were evaluated in 163 samples. These samples were taken from eight honey houses. Results showed that 89 samples had ≤10CFU of MY/g honey, 69 ranged from 10 to 50CFU/g and two reached 65.5CFU/g. Eighty one percent of the samples showed ≤30CFU of CHMB/g honey and only seven samples had between 50 and 54.25CFU/g. Thirty six honey samples were obtained from drums: in 25 samples (69.4%) CHMB counts were less than ≤30CFU/g of honey; in 20 samples (55.5%) the values of MY were between 10 and 50CFU/g honey and total coliforms were only detected in 20 samples. Fecal coliforms, spores of clostridia as well as Salmonella spp. and Shigella spp were not detected and less than 50 spores of Bacillus spp. per g were observed in the honey from drums. Therefore, the microbiological honey quality within the honey houses did not show any sanitary risks. Our results were reported to honey house owners to help them understand the need to reinforce proper honey handling and sanitation practices.

Measles outbreak transmission in the ER waiting room: The role of vaccination.

BACKGROUND: Measles is one of the most contagious infectious diseases. Spain was declared free of endemic measles transmission in 2017. However, less than half of EU/EEA countries have achieved vaccination coverage goals and measles outbreaks have been reported recently, some of them in healthcare facilities. The aim of this study was to present an outbreak in the pediatric emergency (ER) waiting room affecting a vaccinated healthcare worker. METHODS: Descriptive study of an outbreak whose transmission occurred in the pediatric ER waiting room of a tertiary level hospital on the island of Tenerife (Canary Islands) in April 2024. RESULTS: Between April 23 and May 12, 2024, four PCR-confirmed measles cases were identified, resulting in 407 contacts in healthcare center waiting rooms. One of the cases was a 26-year-old male nurse who had been correctly vaccinated with two doses of measles, mumps, and rubella vaccine during childhood. Between May 7 and 10, during his infective period, he took two two-and-a-half-hour flights and lived together with nine people during a trip. No evidence of infection has been identified among the individuals with whom he lived neither the passengers and crew of the two flights. CONCLUSIONS: In the emergency waiting room, an unvaccinated girl gave measles to two infants who were not yet old enough to be vaccinated and to a nurse who had been properly vaccinated as an infant. Despite generating more than 300 close contacts, the nurse did not infect anyone, suggesting that vaccination may help prevent both infection and transmission of measles.

Implementation of a traceability system and safe manufacturing medications in a clean room. / Implantación de un sistema de trazabilidad y elaboración segura de medicamentos en la sala blanca.

OBJECTIVE: To describe the process of implementing a traceability and safe drug manufacturing system in the clean room of a Pharmacy Service to increase patient safety, in accordance with current legislation. METHODS: The process was carried out between September 2021 and July 2022. The software program integrated all the recommended stages of the manufacturing process outlined in the "Good Practices Guide for Medication Preparation in Pharmacy Services" (GBPP). The following sections were parameterized in the software program: personnel, facilities, equipment, starting materials, packaging materials, standardized work procedures, and quality controls. RESULTS: A total of 50 users, 4 elaboration areas and 113 equipments were included. 435 components were parameterized (195 raw materials and 240 pharmaceutical specialties), 54 packaging materials, 376 standardized work procedures (123 of them corresponding to sterile medicines and 253 to non-sterile medicines, of which 52 non-sterile were dangerous), in addition 17 were high risk, 327 medium risk, 32 low risk, and 13 quality controls. CONCLUSIONS: The computerization of the production process has allowed the implementation of a traceability and secure drug manufacturing system in a controlled environment in accordance with current legislation.

[Translated article] Implementation of a traceability and safe drug preparation system in a clean room.

OBJECTIVE: To describe the process of implementing a traceability and safe manufacturing system in the clean room of a pharmacy service to increase patient safety, in accordance with current legislation. METHODS: The process was carried out between September 2021 and July 2022. The software program integrated all the recommended stages of the manufacturing process outlined in the "Good Practices Guide for Medication Preparation in Pharmacy Services" (GBPP). The following sections were parameterised in the software program: personnel, facilities, equipment, starting materials, packaging materials, standardised work procedures, and quality controls. RESULTS: A total of 50 users, 4 elaboration areas and 113 equipments were included. 435 components were parameterized (195 raw materials and 240 pharmaceutical specialties), 54 packaging materials, 376 standardised work procedures (123 of them corresponding to sterile medicines and 253 to non-sterile medicines, of which 52 non-sterile were dangerous), in addition, 17 were high risk, 327 medium risk, and 32 low risk, and 13 quality controls. CONCLUSIONS: The computerization of the production process has allowed the implementation of a traceability and secure manufacturing system in a controlled environment in accordance with current legislation.

Salvianolic acid A preconditioning confers protection against concanavalin A-induced liver injury through SIRT1-mediated repression of p66shc in mice.

Salvianolic acid A (SalA) is a phenolic carboxylic acid derivative extracted from Salvia miltiorrhiza. It has many biological and pharmaceutical activities. The purpose of this study was to investigate the effect of SalA on concanavalin A (ConA)-induced acute hepatic injury in Kunming mice and to explore the role of SIRT1 in such an effect. The results showed that in vivo pretreatment with SalA significantly reduced ConA-induced elevation in serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) activities and decreased levels of the hepatotoxic cytokines such as interferon-gamma (IFN-γ) and tumor necrosis factor-alpha (TNF-α). Moreover, the SalA pretreatment ameliorated the increases in NF-κB and in cleaved caspase-3 caused by ConA exposure. Whereas, the pretreatment completely reversed expression of the B-cell lymphoma-extra large (Bcl-xL). More importantly, the SalA pretreatment significantly increased the expression of SIRT1, a NAD(+)-dependent deacetylase, which was known to attenuate acute hypoxia damage and metabolic liver diseases. In our study, the increase in SIRT1 was closely associated with down-regulation of the p66 isoform (p66shc) of growth factor adapter Shc at both protein and mRNA levels. In HepG2 cell culture, SalA pretreatment increased SIRT1 expression in a time and dose-dependent manner and such an increase was abrogated by siRNA knockdown of SIRT1. Additionally, inhibition of SIRT1 significantly reversed the decreased expression of p66shc, and attenuated SalA-induced p66shc down-regulation. Collectively, the present study indicated that SalA may be a potent activator of SIRT and that SalA can alleviate ConA-induced hepatitis through SIRT1-mediated repression of the p66shc pathway.

Genetic and Functional Characterization of a Salicylate 1-monooxygenase Located on an Integrative and Conjugative Element (ICE) in Pseudomonas stutzeri AJR13.

Pseudomonas stutzeri strain AJR13 was isolated for growth on the related compounds biphenyl (BPH) and diphenylmethane (DPM). The BPH and DPM degradative pathway genes are present on an integrative and conjugative element (ICE) in the chromosome. Examination of the genome sequence of AJR13 revealed a gene encoding a salicylate 1-monooxygenase (salA) associated with the ICE even though AJR13 did not grow on salicylate. Transfer of the ICE to the well-studied Pseudomonas putida KT2440 resulted in a KT2440 strain that could grow on salicylate. Knockout mutagenesis of the salA gene on the ICE in KT2440 eliminated the ability to grow on salicylate. Complementation of the knockout with the cloned salA gene restored growth on salicylate. Transfer of the cloned salA gene under control of the lac promoter to KT2440 resulted in a strain that could grow on salicylate. Heterologous expression of the salA gene in E. coli BL21 DE3 resulted in the production of catechol from salicylate, confirming that it is indeed a salicylate 1-monooxygenase. Interestingly, transfer of the cloned salA gene under control of the lac promoter to AJR13 resulted in a strain that could now grow on salicylate, suggesting that gene expression for the downstream catechol pathway is intact.

Relationships between plant species richness and grazing intensity in a semiarid ecosystem.

Plant species richness is an important property of ecosystems that is altered by grazing. In a semiarid environment, we tested the hypotheses that (1) small-scale herbaceous plant species richness declines linearly with increasing grazing intensity by large ungulates, (2) precipitation and percent sand interact with grazing intensity, and (3) response of herbaceous plant species richness to increasing intensity of ungulate grazing varies with patch productivity. During January-March 2012, we randomly allocated 50, 1.5-m × 1.5-m grazing exclosures within each of six 2500 ha study sites across South Texas, USA. We counted the number of herbaceous plant species and harvested vegetation in 0.25-m2 plots within exclosures (ungrazed control plots) and in the grazed area outside the exclosures (grazed treatment plots) during October-November 2012-2019. We estimated percent use (grazing intensity) based on the difference in herbaceous plant standing crop between control plots and treatment plots. We selected the negative binomial regression model that best explained the relationship between grazing intensity and herbaceous plant species richness using the Schwarz-Bayesian information criterion. After accounting for the positive effect of precipitation and percent sand on herbaceous plant species richness, species richness/0.25 m2 increased slightly from 0% to 30% grazing intensity and then declined with increasing grazing intensity. Linear and quadratic responses of herbaceous plant species richness to increasing grazing intensity were greater for the least productive patches (<15.7 g/0.25 m2) than for productive patches (≥15.7 g/0.25 m2). Our results followed the pattern predicted by the intermediate disturbance hypothesis model for the effect of grazing intensity on small-scale herbaceous plant species richness.

Sala cibi gen. nov., sp. nov., an extremely halophilic archaeon isolated from solar salt.

Two novel halophilic archaeal strains, CBA1133T and CBA1134, were isolated from solar salt in South Korea. The 16S rRNA gene sequences of the isolates were identical to each other and were closely related to the genera Natronomonas (92.3-93.5%), Salinirubellus (92.2%), Halomarina (91.3-92.0%), and Haloglomus (91.4%). The isolated strains were coccoid, Gram-stain-negative, aerobic, oxidase-positive, and catalase-negative. Growth occurred under temperatures of 25-50°C (optimum, 45°C), NaCl levels of 10-30% (optimum, 15%), pH levels of 6.0-8.5 (optimum, 7.0), and MgCl2 concentrations of 0-500 mM (optimum, 100 mM). Digital DNA-DNA hybridization values between the strains and related genera ranged from 18.3% to 22.7%. The major polar lipids of the strains were phosphatidyl glycerol, phosphatidyl glycerol phosphate methyl ester, and phosphatidyl glycerol sulfate. Genomic, phenotypic, physiological, and biochemical analyses of the isolates revealed that they represent a novel genus and species in the family Halobacteriaceae. The type strain is CBA1133T (= KACC 22148T = JCM 34265T), for which the name Sala cibi gen. nov., sp. nov. is proposed.

Surgical activation protocol COVID-19 (SAP COVID).

BACKGROUND: The coronavirus disease 2019 (COVID-19) outbreak have major implications in conventional surgical practice. As the number of patients with this diagnosis is rising, the infection risk for the surgical staff will be higher. Few publications have addressed the surgical management of patients diagnosed with COVID-19. OBJECTIVE: To assess recommendations for care of patients and surgical team during the COVID-19 pandemic. METHOD: MEDLINE, Embase and the Cochrane Database of Systematic Reviews (April 2020) were searched the key words "COVID-19", "PROTOCOL" and "SURGERY". Relevant recommendations, guidelines and cases series were checked for the most accurate information for apply to our center. RESULTS: We found 379 papers that included the key words. A total of 25 papers were included in the manuscript based in the pertinence of the recommendations. Three major topics were selected: perioperative, intraoperative and postoperative. CONCLUSION: As an attempt to regulate the surgical team approach, we present recommendations to preserve patients and surgical staff safety with high quality standards of care through reproducible strategies applicable in most hospital centers.

ANTECEDENTES: La pandemia de COVID-19 ha tenido un gran impacto en la práctica quirúrgica convencional. Conforme el número de pacientes diagnosticados con esta enfermedad vaya en aumento, el riesgo de contagio para el equipo quirúrgico será mayor. Pocas publicaciones han abordado el manejo del paciente diagnosticado con COVID-19 dentro del quirófano. OBJETIVO: Evaluar las recomendaciones para el cuidado de pacientes y del equipo quirúrgico durante la pandemia de COVID-19. MÉTODO: La búsqueda bibliográfica principal utilizó las bases de datos MEDLINE, Embase y Cochrane, utilizando las palabras clave "COVID-19", "PROTOCOL" y "SURGERY". Se verificaron recomendaciones, guías y series de casos relevantes para obtener la información más precisa y aplicable. RESULTADOS: Se hizo la revisión de 379 artículos que contenían las palabras clave. Se incluyeron 25 artículos basándose en la pertinencia de las recomendaciones. Los tres temas principales seleccionados fueron las fases preoperatoria, transoperatoria y posoperatoria. CONCLUSIÓN: En un esfuerzo por tratar de normar el manejo quirúrgico, presentamos recomendaciones para preservar la seguridad del paciente y del equipo quirúrgico con estándares de alta calidad, mediante estrategias reproducibles en la mayoría de los centros hospitalarios.

Using a lactation room at the workplace is associated with longer breastfeeding duration in working mothers.

INTRODUCTION: IIntroduction: maternal employment after childbirth is associated with abandonment of breastfeeding; however, lactation rooms in the workplace increase the practice of breastfeeding. Objective: to compare the frequency and duration of breastfeeding among working mothers based on the presence of lactation rooms in their workplaces. Methods: we included mothers from different institutions whose infants were between 6 and 35 months (n = 158), and an ad hoc questionnaire was applied to assess breastfeeding, exclusive breastfeeding (EBF), partial breastfeeding (PBF), and use of human milk substitutes (HMS). Two groups were compared: working mothers with a lactation room at their workplace (n = 76) versus working mothers without this resource (n = 82). Results: breastfeeding duration (7.5 vs. 5.0 months, p < 0.001) and EBF (3.0 vs. 1.2 months, p = 0.005) were higher in mothers who had a lactation room. HMS use was shorter in mothers who had a lactation room (2.5 vs. 10.0 months, p = 0.001). There were more working mothers who breastfed for more than six months (75.0 % vs. 48.8 %) [OR = 3.15 (95 % CI, 1.60-6.19), p = 0.001] and 12 months (31.6 % vs. 14.6 %) [OR = 2.69 (95 % CI, 1.23-5.87), p = 0.014] when lactation rooms were available in their workplaces. Conclusion: the presence of a lactation room in the workplace was associated with a higher frequency and duration of breastfeeding.

INTRODUCCIÓN: RESUMEN Introducción: el empleo materno después del parto se asocia con el abandono de la lactancia materna, mientras que las salas de lactancia en el lugar de trabajo aumentan la práctica de la lactancia. Objetivo: comparar la frecuencia y duración de la lactancia materna entre madres trabajadoras en función de la presencia o no de salas de lactancia en sus lugares de trabajo. Métodos: incluimos madres de diferentes instituciones cuyos bebés tenían entre 6 y 35 meses (n = 158) y se aplicó un cuestionario ad hoc para evaluar la lactancia materna, la lactancia materna exclusiva (LME), la lactancia materna parcial (LMP) y el uso de sucedáneos de la leche humana (SLH). Se compararon dos grupos: madres trabajadoras con una sala de lactancia en su lugar de trabajo (n = 76) y madres trabajadoras sin este recurso (n = 82). Resultados: la duración de la lactancia (7,5 vs. 5,0 meses, p < 0,001) y LME (3,0 vs. 1,2 meses, p = 0,005) fueron mayores en las madres que tenían sala de lactancia. El uso de SLH fue más corto en las madres que tenían sala de lactancia (2,5 vs. 10,0 meses, p = 0,001). Hubo más madres trabajadoras que amamantaron más de seis meses (75,0 % vs. 48,8 %) [OR = 3,15 (IC 95 %: 1,60-6,19), p = 0,001] y 12 meses (31,6 % vs. 14,6 %) [OR = 2,69 (IC 95 %: 1,23-5,87), p = 0,014] cuando había salas de lactancia disponibles en sus lugares de trabajo. Conclusión: la presencia de una sala de lactancia en el lugar de trabajo se asoció a una mayor frecuencia y duración de la lactancia materna.

Rapid on-site cytologic evaluation during endoscopic ultrasound-guided biopsies of pancreatic solid lesions.

BACKGROUND: Endoscopic ultrasound-guided fine needle biopsy (EUS-FNB) is safe and effective for the diagnosis of pancreatic adenocarcinoma. Although rapid on-site evaluation (ROSE) can improve tissue collection and increase diagnostic yield, its utility has been recently questioned. OBJECTIVE: Determine the diagnostic efficacy of EUS-FNB with ROSE of pancreatic masses in a new echoendoscopy unit. METHOD: Cross-sectional and comparative study of patients who underwent EUS-FNB of pancreatic masses between January and July 2017. Patient demographics, ultrasonographic details and pathology reports were examined. RESULTS: A total of 23 procedures were analyzed. Median age was 59 years (range: 46-77). The group with ROSE had 13 patients (56.5%) and the group without ROSE 10 (43.5%). The final pathology report showed enough and adequate sample in 100% of the group with ROSE (13/13 vs. 5/10; p = 0.007). Diagnosis of malignancy was established in 84.6% of the biopsies (11/13 vs. 2/10; p = 0.003) in the group with ROSE. CONCLUSIONS: ROSE is useful to improve the diagnostic efficacy of EUS-FNB of pancreatic masses, especially in new EUS centers or in centers with a low diagnostic yield.

ANTECEDENTES: La biopsia con aguja fina guiada por ultrasonido endoscópico (BAF-USE) es segura y eficaz para el diagnóstico del adenocarcinoma pancreático. La revisión citológica rápida en sala (ROSE, rapid on-site evaluation) puede mejorar la calidad de la muestra y el rendimiento diagnóstico; en años recientes se ha cuestionado su utilidad. OBJETIVO: Determinar la eficacia diagnóstica de la ROSE durante las BAF-USE de lesiones pancreáticas sólidas en un nuevo centro de ecoendoscopia. MÉTODO: Estudio transversal y comparativo en el que se incluyeron todos los pacientes a quienes se realizó BAF-USE de lesiones pancreáticas sólidas entre enero y julio de 2017. Se evaluaron datos demográficos, ecográficos y de patología de las BAF-USE. RESULTADOS: Se analizaron 23 procedimientos. La mediana de edad fue de 59 años (rango: 46-77). En el grupo con ROSE hubo 13 pacientes (56.5%) y en el grupo sin ROSE hubo 10 (43.5%). En el grupo con ROSE, el reporte de patología mostró muestra adecuada en el 100% (13/13 vs. 5/10; p = 0.007), así como diagnóstico de malignidad en el 84.6% (11/13 vs. 2/10; p = 0.003). CONCLUSIONES: La ROSE es una herramienta útil para mejorar el diagnóstico de BAF-USE de lesiones pancreáticas sólidas, principalmente cuando hay bajo rendimiento diagnóstico y en nuevas unidades de ecoendoscopia.

Factores que influyen en la cancelación de cirugías programadas: una revisión de la literatura / Factors influencing the cancellation of scheduled surgeries: a literature review

Introduction: Scheduled surgery cancellation is a major problem in healthcare provision, negatively affecting patients and their families, the healthcare staff, and the healthcare institution itself. It carries an increase in hospital costs, lost time, and creates physical issues for healthcare staff. Methodology: A narrative review of the literature was carried out based on concepts that specified the meaning of the search in the PubMed, Scielo, and Google academic databases. The inclusion criteria were all articles, on the topic, published between 2014 and 2021, in Spanish and English, including an abstract, and that could be accessed for free. Results: the main causes for surgery cancellation were identified and grouped as patient-related factors, administrative aspects, logistics failures, such as lack of medical/surgical devices, and surgeon-related or anesthesiologist-related causes. Conclusion: this topic will always be valid and a subject of continuous analysis, due to the repercussions on patients, the institution, costs, and the operating room staff. To review the causes for surgery cancellation, is important, so they may be addressed when detected, and may contribute to improve the quality of healthcare

Introducción: la cancelación de una cirugía es un tema relevante en la asistencia en salud, debido a las consecuencias en los pacientes y su familia, el personal de salud y la institución. Está implícita el alza en los costos hospitalarios, el tiempo perdido y las repercusiones físicas para el personal de salud. Metodología: revisión narrativa de la literatura sobre conceptos que precisan el sentido de la búsqueda con herramientas en las bases de datos PubMed, Scielo y Google académico. Los criterios de inclusión de los artículos fueron aquellos publicados desde 2014 hasta 2021 en español e inglés, que tuvieran resumen y fueran accesibles sin algún tipo de pago. Resultados: las causas más frecuentes para cancelar las cirugías están enmarcadas en factores propios del paciente, en la parte administrativa, en fallas de la logística como la ausencia de dispositivos médico-quirúrgicos, y a la cancelación por el especialista y el anestesiólogo. Conclusión: esta temática siempre estará vigente y en continuo análisis debido a las repercusiones en los pacientes, la institución, los costos y el personal del quirófano. Es importante revisar las causas de la cancelación de cirugías, que al ser detectadas puedan solucionarse y contribuyan a la mejora de la calidad de atención en la salud

Aula invertida o clase magistral: innovar o morir / Inverted classroom or master class: innovate or die / Sala de aula invertida ou sala de aula magistral: inovar ou morrer

RESUMEN Las estrategias para comunicar la información han experimentado muchos cambios, los cuales se han evidenciado en la pandemia. La idea es lograr que se pueda conectar con el estudiante y que la información la reciba de manera clara, oportuna y pertinente, de modo que tendrá los saberes previos para lograr integrar la información de la teoría y la práctica, con el fin de enfrentar con éxito la actividad simulada, así como cuando interactúe con el paciente. En ese contexto, el aula invertida es una estrategia didáctica que brinda videos, podcast, entre otros, para que sean revisados con anticipación, de tal forma que cuando el estudiante realice la actividad presencial o virtual se profundice y se hagan precisiones sobre los conceptos más importantes, usando metodologías activas de participación para lograr el siguiente propósito: El aprendizaje invertido busca un cambio en la dinámica del aprendizaje que apunte como eje del mismo al estudiante. El objetivo de la presente contribución docente es compartir las bondades de esta estrategia usada en estudiantes de la carrera de Odontología dentro del marco del curso de Clínica Estomatológica del Adulto I, dictado en 2023 y que pertenece al quinto ciclo de la carrera de Estomatología en la Universidad Peruana Cayetano Heredia.

ABSTRACT Strategies for communicating information have undergone many changes, which have been evidenced in the pandemic. The idea is to be able to connect with the student and that the information is received in a clear, timely and relevant manner, so that he/she will have the prior knowledge to integrate information from theory and practice, in order to successfully face the simulated activity, as well as when interacting with the patient. In this context, the inverted classroom is a didactic strategy that provides videos, podcasts, among others, to be reviewed in advance, so that when the student performs the face-to-face or virtual activity, the most important concepts are deepened and clarified, using active participation methodologies to achieve the following objective: flipped learning seeks a change in the dynamics of learning that points to the student as its axis. The objective of this teaching contribution is to share the benefits of this strategy used with students of the Dentistry degree program within the framework of the Adult Stomatology Clinic I course, taught in 2023 and which belongs to the fifth semester of the Stomatology degree program at the Universidad Peruana Cayetano Heredia.

RESUMO As estratégias de comunicação de informação sofreram muitas alterações, que são evidentes na pandemia. A ideia é conseguir conectar-se com o aluno e que a informação seja recebida de forma clara, oportuna e relevante, para que ele tenha o conhecimento prévio para poder integrar informações da teoria e da prática, a fim de enfrentar com sucesso a atividade simulada, bem como ao interagir com o paciente. Neste contexto, a sala de aula invertida é uma estratégia didática que disponibiliza vídeos, podcasts, entre outros, para serem revistos previamente, de modo a que, quando o aluno realiza a atividade presencial ou virtual, os conceitos mais importantes sejam aprofundados e clarificados, utilizando metodologias de participação ativa para atingir o seguinte objetivo: A aprendizagem investida procura uma mudança na dinâmica da aprendizagem que aponta para o aluno como eixo da mesma. O objetivo desta contribuição didática é partilhar os benefícios desta estratégia utilizada com os alunos da disciplina de Medicina Dentária no âmbito do curso de Clínica de Estomatologia de Adultos I, ministrada em 2023 e que pertence ao quinto semestre da disciplina de Estomatologia da Universidad Peruana Cayetano Heredia.

Design of an instrument to measure midwives' workloads based on nursing interventions classification / Design de um instrumento para medir a carga de trabalho das parteiras com base nas intervenções de classificação das intervenções de enfermagem / Diseño de un instrumento para medir cargas de trabajo de matronas basado en intervenciones nursing interventions classification

ABSTRACT Objective: to design a qualitative and quantitative scale for measuring specific workloads for obstetric-gynecological nurses (midwives) within the delivery unit and based on the Nursing Interventions Classification (NIC). Method: this is a mixed qualitative study through focus groups and quantitative with real measurements of NIC times, descriptive and cross-sectional. From September 2020 to May 2021, an extensive bibliographic search, mapping, ad hoc scale development and configuration of three focus groups were carried out to agree on scale design. Moreover, a comparison was carried out on the subjective perception of the time spent providing care (NIC) during the delivery process by focus groups with respect to times actually measured between March and April 2021 in a delivery unit. Results: the qualitative data obtained in focus groups were analyzed and related, agreeing on the ad hoc measuring instrument's final structure and the importance of having this measuring instrument representative of their work, with standardized language adapted to real health demands. Furthermore, when comparing the subjective and real execution times of each of the NIC, we found a significant correlation when presenting different mean execution times with a variation of 13 minutes. Conclusion: the midwives in this study determined the measurement instrument construct validity for their workloads.

RESUMO Objetivo: elaborar uma escala qualitativa e quantitativa para mensuração de cargas de trabalho específicas para enfermeiras obstétrico-ginecológicas (parteiras) na unidade de parto e baseada na Classificação das Intervenções de Enfermagem (NIC). Método: trata-se de um estudo qualitativo misto por meio de grupos focais e quantitativo com medidas reais de tempos NIC, descritivo e transversal. De setembro de 2020 a maio de 2021, foi realizada uma extensa pesquisa bibliográfica, mapeamento, desenvolvimento de escala ad hoc e configuração de três grupos focais para chegar a um acordo sobre o desenho da escala. Além disso, foi realizada uma comparação da percepção subjetiva do tempo gasto na prestação de cuidados (NIC) durante o processo de parto pelos grupos focais com os tempos efetivamente medidos entre março e abril de 2021 em uma unidade de parto. Resultados: os dados qualitativos obtidos nos grupos focais foram analisados ​​e relacionados, concordando com a estrutura final do instrumento de medição ad hoc e a importância de ter este instrumento de medição representativo do seu trabalho, com linguagem padronizada e adaptada às reais demandas de saúde. Além disso, ao comparar os tempos de execução subjetivos e reais de cada uma das NIC, encontramos correlação significativa ao apresentar tempos médios de execução diferentes com variação de 13 minutos. Conclusão: as parteiras deste estudo determinaram a validade de construto do instrumento de medida para suas cargas de trabalho.

RESUMEN Objetivo: diseñar cualitativa y cuantitativa, una escala de medición de cargas de trabajo, específica para las enfermeras obstétrico-ginecológicas (matronas), dentro de la unidad de partos y basada en la Clasificación de Intervenciones de Enfermería (NIC). Método: estudio mixto cualitativo mediante grupos focales y cuantitativo con mediciones reales de tiempos NIC, descriptivo y transversal. Durante los meses de septiembre de 2020 a mayo de 2021, se realizó una extensa búsqueda bibliográfica, mapeo, elaboración ad hoc de la escala, y la configuración de tres grupos focales, para consensuar el diseño de la escala. Además, se ejecutó una comparativa sobre la percepción subjetiva del tiempo empleado en la prestación de cuidados (intervenciones NIC) durante el proceso de parto por parte de los grupos focales, con respecto a los tiempos medidos realmente entre marzo y abril del 2021 en una unidad de partos. Resultados: se analizaron y relacionaron los datos cualitativos obtenidos de los grupos focales, coincidiendo en la estructura final del instrumento ad hoc de medida, y en la importancia de tener este instrumento de medida representativo de su trabajo, con un leguaje estandarizado y adaptado a la demanda sanitaria real. Además, al comparar los tiempos subjetivos y reales de ejecución de cada una de las intervenciones NIC, encontramos una correlación significativa, al presentar distintos promedios de tiempos de ejecución con una variación de 13 minutos. Conclusión: las matronas de este estudio determinaron la validez del constructo del instrumento de medición para sus cargas de trabajo.

Recuperación y satisfacción anestésica de los pacientes postoperados de cirugía general / Recovery and anesthetic satisfaction of patients' postoperative General surgery

En anestesiología influyen varios factores para garantizar satisfacción y calidad adecuada, aunque la satisfacción va encaminada a evaluarse en todo tipo de anestesia aplicada, esta revisión se enfocó en el análisis de la satisfacción de los pacientes sometidos a anestesia general. La satisfacción en la recuperación postopera- toria del paciente depende de lo que espera previo a su procedimiento quirúrgico, el tiempo de espera para la realización de la cirugía, la información que se le brinda al paciente, el manejo adecuado de la ansiedad. La mayoría de las mediciones de los indicadores utilizados para evaluar la calidad de la recuperación posanestésica involucran situaciones desde la percepción del personal de salud y poco sobre la percepción del paciente, de tal manera que en las investigaciones recientes se incluyen variables que evalúan el estado del paciente , como el dolor, vómito, tiempo para despertar entre otras, como parámetros para conocer su satisfacción. Para analizar esta problemática es necesario identificar que las personas hospitalizadas para una intervención quirúrgica desde ya tienen miedo a la cirugía, anestesia y a las diferentes complicaciones de la intervención propiamente dicha, si le sumamos la falta de empatía del personal de salud aumentaremos un desequilibrio emocional que afectara en su recuperación. Se debe tomar en cuenta que una adecuada adaptación psicológica preoperatoria suele ser seguida por una buena adaptación postoperatoria; de tal manera que el estado psíquico del paciente influye en su recuperación posanestésica...(AU)

Escala de Engajamento dos Alunos na Escola Inferido por Professores para o Ensino Fundamental / Elementary School Student Engagement Scale Inferred by Teachers / Escala de Compromiso de Estudiantes de primaria Inferido por Profesores

Resumo Avaliar o engajamento escolar é crucial para identificar alunos em risco de evasão e monitorar o progresso acadêmico. O objetivo deste estudo foi construir e obter evidências de validade para uma Escala de Engajamento dos Alunos na Escola Inferido por Professores (EEAE-IP). Participaram do estudo 488 alunos do 2ª ao 5ª ano do Ensino Fundamental de escolas de Minas Gerais. A EEAE-IP apresenta boas propriedades psicométricas, com Análise Fatorial Confirmatória atestando o modelo de quatro fatores (comportamental, cognitivo, afetivo e agente). A evidência da consistência interna da escala foi boa com um Alfa de Crombach de 0,92 e a fidedignidade interobservador sugere que o construto é avaliado da mesma forma por diferentes observadores. A EEAE-IP é de rápida aplicação e utiliza o professor como informante. Sugerimos novos estudos que forneçam dados para a validade em outras populações. Este estudo reforça o papel da EEAE-IP em futuras pesquisas psicoeducacionais.

Abstract Evaluating school engagement is crucial to identifying students at risk of dropping out and monitoring academic progress. The aim of this study was to develop and obtain evidence of validity for a Student School Engagement Scale Inferred by Teachers (EEAE-IP). The study included 488 students from the 2nd to the 5th year of elementary school in Minas Gerais. The EEAE-IP presents good psychometric properties, with Confirmatory Factor Analysis attesting to the four-factor model (behavioral, cognitive, affective and agent). Evidence of the scale's internal consistency was good with a Cronbach's Alpha of 0.92 and the inter-rater reliability suggests that the construct is assessed in the same way by different observers. The EEAE-IP is quick to apply and uses the teacher as an informant. Further studies that provide data for validity in other populations were suggested. This study reinforces the role of the EEAE-IP in future psychoeducational research.

Resumen Evaluar la participación escolar es crucial para identificar a los estudiantes en riesgo de abandonar la escuela y monitorear el progreso académico. El objetivo de este estudio fue construir y obtener evidencias de validez para una Escala de Compromiso Estudiantil Inferida por los Profesores (EEAE-IP). El estudio incluyó a 488 alumnos del 2º al 5º año de la enseñanza fundamental de Minas Gerais. La EEAE-IP presenta buenas propiedades psicométricas, con el Análisis Factorial Confirmatorio dando fe del modelo de cuatro factores (conductual, cognitivo, afectivo y agente). La evidencia de la consistencia interna de la escala fue buena con un Alfa de Cronbach de 0,92 y la confiabilidad entre evaluadores sugiere que el constructo es evaluado de la misma manera por diferentes observadores. La EEAE-IP es rápida de aplicar y utiliza al profesor como informante. Sugerimos más estudios que proporcionen datos para la validez en otras poblaciones. Este estudio refuerza el papel de la EEAE-IP en futuras investigaciones psicoeducativas.

[The use of flumazenil for benzodiazepine associated respiratory depression in postanesthesia recovery: risks and outcomes]. / O uso de flumazenil para depressão respiratória associada ao benzodiazepínico na recuperação pós­anestésica: riscos e resultados.

BACKGROUND AND OBJECTIVES: The primary aim was to determine risk factors for flumazenil administration during postanesthesia recovery. A secondary aim was to describe outcomes among patients who received flumazenil. METHODS: Patients admitted to the postanesthesia recovery room at a large, academic, tertiary care facility after surgery under general anesthesia from January 1, 2010, to April 30, 2015, were identified and matched to 2 controls each, by age, sex, and surgical procedure. Flumazenil was administered in the recovery phase immediately after general anesthesia, according to the clinical judgment of the anesthesiologist. Demographic, procedural, and outcome data were extracted from the electronic health record. Conditional logistic regression, accounting for the 1:2 matched-set case-control study designs, was used to assess characteristics associated with flumazenil use. RESULTS: The incidence of flumazenil administration in the postanesthesia care unit was 9.9 per 10,000 (95% CI, 8.4-11.6) general anesthetics. History of obstructive sleep apnea (Odds Ratio [OR]=2.27; 95% CI 1.02-5.09), longer anesthesia (OR=1.13; 95% CI 1.03-1.24 per 30minutes), use of total intravenous anesthesia (OR=6.09; 95% CI 2.60-14.25), and use of benzodiazepines (OR=8.17; 95% CI 3.71-17.99) were associated with risk for flumazenil administration. Among patients who received midazolam, cases treated with flumazenil received a higher median (interquartile range) dose than controls: 3.5mg (2.0-4.0mg) vs. 2.0mg (2.0-2.0mg), respectively (p<0.001). Flumazenil use was correlated with a higher rate of unanticipated noninvasive positive pressure ventilation, longer postanesthesia care unit stay, and increased rate of intensive care unit admissions. CONCLUSIONS: Patients who required flumazenil postoperatively had received a higher dosage of benzodiazepines and utilized more postoperative health care resources. More conservative perioperative use of benzodiazepines may improve postoperative recovery and use of health care resources.

Avaliação da intensidade e do desconforto da sede de pacientes em pós-operatório imediato* / Evaluación de la intensidad y malestar de la sed en pacientes en el postoperatorio inmediato / Assessment of the intensity and discomfort of the thirst of patients in the immediate postoperative period

Objetivo: avaliar a intensidade e o desconforto provocados pela sede em pacientes em pós-operatório imediato. Método: estudo exploratório-descritivo, desenvolvido com pacientes internados na sala de recuperação pós-anestésica de um hospital público paranaense. Avaliaram-se indivíduos maiores de 18 anos, de ambos os sexos, com cognitivo preservado, internados de junho de 2021 a janeiro de 2022. A intensidade e o desconforto da sede foram mensurados por escalas específicas. Resultados: avaliaram-se 150 pacientes, com média de 43,9 anos. A maioria era do sexo masculino (65,3%), sem comorbidades (68,7%), submetida à raquianestesia (58%) e cirurgia ortopédica (59,3%), com soroterapia em curso (92,7%). O tempo médio de cirurgia foi 1,5 hora e 14,6 horas de jejum; 72,7% da amostra verbalizou sede, sendo que 37,6% queixaram-se de forma espontânea. Conclusão: os participantes de pesquisa apresentaram intensidade (6,6) e desconforto (7,6) moderados de sede no pós-operatório, tornando-se necessário discutir protocolos institucionais de intervenção para diminuir tal evento.

Objective: to evaluate the intensity and discomfort caused by thirst in patients in the immediate postoperative period. Method: exploratory-descriptive study developed with patients hospitalized in the post-anesthetic recovery room of a public hospital in Paraná. Individuals over 18 years of age, of both sexes, with preserved cognitive function, hospitalized from June 2021 to January 2022, were evaluated. Thirst intensity and discomfort were measured by specific scales. Results: 150 patients were evaluated, with a mean of 43.9 years. Most were male (65.3%), without comorbidities (68.7%), underwent spinal anesthesia (58%) and orthopedic surgery (59.3%), with ongoing serotherapy (92.7%). The mean surgery time was 1.5 hours and 14.6 hours of fasting; 72.7% of the sample verbalized thirst, and 37.6% complained spontaneously. Conclusion: the research participants presented moderate intensity (6.6) and discomfort (7.6) of thirst in the postoperative period, making it necessary to discuss institutional intervention protocols to reduce such event.

Objetivo: evaluar la intensidad y el malestar causado por la sed en pacientes en el postoperatorio inmediato. Método: estudio exploratorio-descriptivo, desarrollado con pacientes internados en la sala de recuperación postanestésica de un hospital público de Paraná. Se evaluaron personas mayores de 18 años, de ambos sexos, con habilidades cognitivas conservadas, hospitalizadas entre junio de 2021 y enero de 2022. Se midió la intensidad y el malestar de la sed mediante escalas específicas. Resultados: Se evaluaron 150 pacientes, con una edad media de 43,9 años. La mayoría eran hombres (65,3%), sin comorbilidades (68,7%), con anestesia espinal (58%) y cirugía ortopédica (59,3%), con sueroterapia en curso (92,7%). El tiempo promedio de cirugía fue de 1,5 horas y 14,6 horas de ayuno; El 72,7% de la muestra verbalizó sed, con un 37,6% quejándose espontáneamente. Conclusión: los participantes de la investigación presentaron moderada intensidad (6,6) y malestar (7,6) de la sed en el postoperatorio, siendo necesario discutir protocolos de intervención institucional para la reducción de ese evento.