Estado de las actividades de Enfermería en el apoyo nutricional. Resultados de un estudio piloto multicéntrico en hospitales de América Latina / On the current state of Nursing activities in nutritional support. Results of a pilot multicenter study in Latin American hospitals

Justificación: El personal de Enfermería juega varios e importantes roles dentro de los equipos multidisciplinarios de terapia nutricional (EMTN) relacionados con la implementación, administración y supervisión de la terapia nutricional (TN). Sin embargo, no se tienen documentos sobre las prácticas corrientes de Enfermería en las TN que se administran en los países de América Latina (AL). Objetivo: Documentar el estado actual de las prácticas de Enfermería comprendidas dentro de las TN conducidas en los países AL. Diseño del estudio: Transversal, descriptivo. Locación del estudio. Cincuenta hospitales de las ciudades-capitales de 8 países de AL. La encuesta se desarrolló durante el mes de Noviembre del 2019. Métodos: Mediante una encuesta anónima distribuida sobre la plataforma Survey Monkey™ (SurveyMonkey LLC, Palo Alto, California, Estados Unidos) entre los profesionales en Enfermería en los hospitales participantes se documentó la existencia de un EMTN (u otra forma de organización hospitalaria), la dedicación exclusiva de los integrantes del mismo a la provisión de la TN, la existencia de legislaciones sobre la provisión de TN, las actividades que realiza el personal de Enfermería dentro del EMTN, la existencia de protocolos propios para la evaluación nutricional del enfermo, la administración de la TN, y la educación nutricional del enfermo y los familiares al alta hospitalaria; el monitoreo de los indicadores de calidad de la TN, el gerenciamiento del riesgo relacionado con la TN; y la formación local en temas de TN. Resultados: El 95 % de las instituciones participantes cuenta con un EMTN, pero el 55 % de los encuestados se dedica en forma exclusiva a la provisión de TN. La mitad de los encuestados conocía las legislaciones nacionales existentes sobre la TN. El 65 % de los profesionales en Enfermería se ocupa de la TN como parte de la atención de pacientes críticamente enfermos, y durante la convalecencia posquirúrgica...(AU)

Rationale: Nursing personnel plays several and important roles within the nutritional therapy multidisciplinary teams (NTMT) regarding implementation, management and supervision of nutritional therapy (NT). However, current Nursing practices in nutritional therapy (NT) administered in Latin American (LA) countries are not well documented. Objective: To document the current state of Nursing practices followed with NT administered in LA countries. Study design: Cross-sectional, descriptive. Study location: Fifty hospitals in the capitol-cities of eight LA countries. The survey was conducted during the month of November 2019. Methods: By means of an anonymous survey distributed through Survey Monkey™ platform (SurveyMonkey LLC, Palo Alto, California, United States) among Nursing professionals dedicated to TN in participating hospitals existence of a NTMT (or any other form of hospital organization) dedicated to NT administration, exclusive dedication of their members to NT provision, existence of legislations on NT provision, activities performed by Nursing personnel as part of the NTMT, existence of proprietary protocols for nutritional assessment of the patient, NT administration, and nutritional education of patients and relatives upon hospital discharge; and monitoring of NT quality indicators, management of risks related with NT, and local formation in NT issues were documented. Results: Ninety-five percent of participating institutions has a NTMT, but 55 % of the respondents are dedicated to NT provision in an exclusive manner. Half of the respondents knew of nationally existent legislations on NT. Sixty-five percent of the surveyed Nursing personnel delivers NT as part of the care of critically ill patients and those convalescing after surgery. Seventy-seven percent of Nursing personnel conducts hospital NT schemes according with locally-derived protocols...(AU)

Hierarchical modelling of immunoglobulin coated bacteria in dogs with chronic enteropathy shows reduction in coating with disease remission but marked inter-individual and treatment-response variability.

Chronic enteropathies are a common problem in dogs, but many aspects of the pathogenesis remain unknown, making the therapeutic approach challenging in some cases. Environmental factors are intimately related to the development and perpetuation of gastrointestinal disease and the gut microbiome has been identified as a contributing factor. Previous studies have identified dysbiosis and reduced bacterial diversity in the gastrointestinal microbiota of dogs with chronic enteropathies. In this case-controlled study, we use flow cytometry and 16S rRNA sequencing to characterise bacteria highly coated with IgA or IgG in faecal samples from dogs with chronic enteropathy and evaluated their correlation with disease and resolution of the clinical signs. IgA and IgG-coated faecal bacterial counts were significantly higher during active disease compared to healthy dogs and decreased with the resolution of the clinical signs. Characterisation of taxa-specific coating of the intestinal microbiota with IgA and IgG showed marked variation between dogs and disease states, and different patterns of immunoglobulin enrichment were observed in dogs with chronic enteropathy, particularly for Erysipelotrichaceae, Clostridicaceae, Enterobacteriaceae, Prevotellaceae and Bacteroidaceae, families. Although, members of these bacterial groups have been associated with strong immunogenic properties and could potentially constitute important biomarkers of disease, their significance and role need to be further investigated.

Longitudinal Survey of Fecal Microbiota in Healthy Dogs Administered a Commercial Probiotic.

The aim of this longitudinal microbiome study was to investigate the effects of a commercially available veterinary synbiotic product (Blackmore's® Paw DigestiCare 60™) on the fecal microbiome of healthy dogs using 16S rRNA gene microbial profiling. Fifteen healthy, privately-owned dogs participated in a 2-week trial administration of the product. Fecal samples were collected at different time points, including baseline (prior to treatment), during administration and after discontinuation of product. Large intra- and inter-individual variation was observed throughout the study, but microbiome composition at higher phylogenetic levels, alpha and beta diversity were not significantly altered after 2 weeks of probiotic administration, suggesting an absence of probiotic impact on microbial diversity. Administration of the synbiotic preparation did, however, result in transient increases in probiotic species from Enterococacceae and Streptococacceae families as well as an increase in Fusobacteria; with the fecal microbiota partially reverting to its baseline state 3-weeks after cessation of probiotic administration.

Effect of sequentially fed high protein, hydrolyzed protein, and high fiber diets on the fecal microbiota of healthy dogs: a cross-over study.

BACKGROUND: Dietary content and environmental factors can shape the gut microbiota, and consequently, the way the gut microbiota metabolizes fats, carbohydrates, and proteins, affecting overall health of the host. We evaluated the impact of 3 diets (all meat [raw], high-insoluble fiber dry extruded diet and hydrolyzed protein dry extruded diet) on the gut microbiota of healthy dogs in a cross-over sequential study. RESULTS: We showed that diet can have an effect on the gut microbiome in dogs, which was influenced by the order of feeding. High-protein (all meat) diets were characterized by an increase in bacteria belonging to the Fusobacteria and Bacteroidetes phyla, whereas a high-insoluble fiber commercial diet correlated with increases in Firmicutes and Actinobacteria phyla. However, the individual dog's baseline microbiota had the most impact on the magnitude and nature of the changes in response to dietary intervention. CONCLUSION: Our results suggest that the dog fecal microbiota is driven by protein and fiber composition to different degrees in individual animals, and targeted modification of these patterns could be useful in the modulation of the gut microbiota in different diseases.

Association Between Social Pensions With Depression, Social, and Health Behaviors Among Poor Older Individuals in Colombia.

OBJECTIVES: Many low- and middle-income countries have introduced social pensions to alleviate extreme poverty and improve the well-being of older individuals. However, evidence remains inconclusive about the potential effects of such programs on mental health, social, and health behaviors. METHODS: Data for individuals aged 60 or older came from the nationally representative Encuesta Nacional de Salud, Bienestar y Envejeciamiento survey in Colombia 2015 (N = 9,456). We used propensity score matching to estimate the association between the country's social pension program (Colombia Mayor) with depression, self-rated health, food insecurity, alcohol consumption, social participation, and labor force participation. RESULTS: Results show that receiving the program does not significantly affect the likelihood of suffering from depression or self-rated health among either men or women. However, receiving the program is associated with significant reductions in the likelihood of experiencing food insecurity and significant increases in the likelihood of participating socially. Among women, receiving the program is associated with significant reduction in the likelihood of participating in the labor force. DISCUSSION: The absence of a measurable effect on depression and self-rated health may be explained, at least partly, by the program's comparatively small cash benefit and the sharing of resources with other family members. Policymakers should assess possibilities to maximize the health and social benefits of social pensions.

Changes in duodenal CD163-positive cells in dogs with chronic enteropathy after successful treatment.

Chronic enteropathy (CE) in dogs is characterized retrospectively per treatment response as food-responsive enteropathy (FRE), antibiotic-responsive enteropathy (ARE), and immunosuppressant-responsive enteropathy (IRE) - the latter most resembling inflammatory bowel disease in people. The aim of this study was to characterize duodenal macrophages (Mϕ) in CE using immunohistochemistry; with calprotectin (CAL) as a marker of early differentiated Mϕ and CD163 expression as a marker for resident Mϕ in the duodenum before and after treatment. Prior to treatment, dogs with FRE and IRE had a lower CD163+/CAL+ ratio than control dogs (CTRL) in crypts; this increased significantly and normalized compared with CTRL after treatment. Conversely, the CD163+/CAL+ ratio in dogs with ARE was comparable to that in healthy dogs before and after treatment. In summary, these results suggest that Mϕ play a role in the pathogenesis of CE in FRE and IRE, with a decrease in resident Mϕ and an increase in early differentiated Mϕ, but not in ARE dogs. Mϕ normalize after successful treatment.

Impacto de los inhibidores de la bomba de protones en los niveles de vitamina B12 en pacientes con ERO estadio 5 en hemodiálisis. Experiencia de un centro en Manizales, Colombia / Impact of proton-pump inhibitors on vitamin B12 levels in patients with CKD stage 5 in hemodialysis. Experience of a Center in Manizales, Colombia

Resumen Objetivo: establecer si en pacientes con enfermedad renal crónica (ERC) estadio 5 en terapia de hemodiálisis y uso crónico de inhibidores de bomba de protones (IBPs) se presenta deficiencia de vitamina B12. Métodos: pacientes con ERC estadio 5 mayores de 18 años, en terapia de hemodiálisis crónica, quienes se encontraban recibiendo terapia con IBP. En ellos se evaluaron variables demográficas, antropométricas, etiología de la enfermedad renal crónica, tiempo en diálisis, tipo de IBP que el paciente estaba recibiendo, dosis y tiempo que llevaban usando el medicamento. Las variables de laboratorio relacionadas fueron concentraciones séricas de vitamina B12, ácido fólico, KTV, hemoglobina y volumen corpuscular medio. Tipo de estudio: analítico de corte transversal. Para el análisis estadístico se utilizaron medidas de tendencia central y de dispersión (media, desviación estándar) en las variables cuantitativas y frecuencias relativas en las cualitativas. Para determinar la correlación entre los niveles de vitamina B12 y las variables se utilizó el método de regresión lineal simple para cada una de las variables continuas y el de regresión logística para las categóricas Resultados: de un total de 106 pacientes en terapia de hemodialisis crónica, 37 pacientes cumplieron con los criterios de inclusión, 45.9% mujeres, edad promedio 63.6 años, etiología de la ERC 48.6% idiopática. Respecto al tiempo en diálisis 56.7% de los pacientes tenían menos de cuatro años, el resto entre cuatro y 19 años. En cuanto al tiempo de consumo de IBP 15 pacientes (40.5%) habían recibido al menos tres años y 22 pacientes (59.5%) más de tres años. El 100% de los pacientes exhibían cifras normales o por encima de lo normal de niveles séricos de ácido fólico. Se encontró correlación positiva, aunque no estadísticamente significativa entre los niveles séricos de vitamina B12 y la dosis de IBP, tiempo de consumo de IBP y tiempo en diálisis. Conclusiones: contrariamente a lo planteado en la hipótesis de trabajo, en este estudio se encontró que los valores séricos de vitamina B12, tienden a aumentar a mayor tiempo en diálisis y el consumo de IBP, tanto en tiempo, como en dosis (Acta Med Colomb 2017; 42: 172-179).

Abstract Objective: To determine if vitamin B12 deficiency occurs in patients with chronic renal disease (CKD) stage 5 in hemodialysis therapy and chronic use of proton pump inhibitors (PPIs). Methods: patients with stage 5 CKD over 18 years of age on chronic hemodialysis therapy who were receiving PPI therapy. Demographic and anthropometric variables, chronic renal disease etiology, time on dialysis, type of PPI received by the patient, dose and time taking the medication, were evaluated. The related laboratory variables were serum levels of vitamin B12, folic acid, KTV, hemoglobin and mean corpuscular volume. Type of Study: cross-sectional analytical. Statistical analysis used central tendency and dispersion measures (mean, standard deviation) in the quantitative variables and relative frequencies in the qualitative ones. To determine the correlation between vitamin B12 levels and variables, the simple linear regression method was used for each of the continuous variables and the logistic regression method for the categorical variables. Results: Of a total of 106 patients undergoing chronic hemodialysis therapy, 37 patients met the inclusion criteria. 45.9% were women, mean age 63.6 years, etiology of CKD 48.6% idiopathic. Regarding the time on dialysis 56.7% of the patients had less than four years; the rest between four and 19 years. Regarding the time of PPIs consumption, 15 patients (40.5%) had received at least three years and 22 patients (59.5%) more than three years. 100% of the patients exhibited normal or above normal levels of serum folic acid levels. A positive correlation was found, although not statistically significant, between serum vitamin B12 levels and PPI dose, PPI consumption time and dialysis time. Conclusions: Contrary to what was proposed in the hypothesis of this study, it was found that serum levels of vitamin B12 tend to increase over time in dialysis and PPI consumption, both in time and in doses (Acta Med Colomb 2017; 42: 172-179).

La profesionalización del community manager: claves para una formación especializada de posgrado

Introducción. La investigación que se presenta plantea una síntesis epistemológica sobre el perfil y funciones del community manager. Materiales y métodos. Se realizó desde el análisis crítico de un conjunto de opiniones valiosas de académicos, y profesionales. relacionándola con los resultados de un estudio cualitativo realizado sobre el programa académico de 19 cursos (en su mayoría conducentes a la titulación de máster) ofrecidos mayoritariamente por universidades españolas para la especialización de tales profesionales. Resultados. Este análisis comparado ha permitido establecer notables coincidencias entre los perfiles, ámbitos de trabajo y funciones asignadas a los community manager por los estudios epistemológicos existentes y las competencias que se pretenden adquirir en estas acciones formativas de posgrado. Conclusión. En esencia los cursos preparan a expertos en comunicación hipermedia y sus canales, creadores de contenidos de calidad e impacto emotivo, a profesionales, ubicuos en continuo estado de análisis de audiencias y de estudios de posicionamiento.

Introduction. This research shows an epistemological synthesis about the profile and functions of the community manager. Materials and methods. It was carried out from the critical analysis of a group of valuable opinions from academics and professionals. Relating it to the results of a qualitative study carried out on the academic program of 19 courses (mostly pursuing a master's degree) offered mainly by Spanish universities for the specialization of such professionals. Results. This comparative analysis has made it possible to establish remarkable coincidences among profiles, work areas, and functions assigned to community managers by existing epistemological studies and the competences that are intended to be acquired in these formative graduate actions. Conclusion. In essence, the courses prepare hypermedia communication experts and their channels, creators of quality content and emotional impact to professionals, ubiquitous in a continuous state of analysis of audiences and of positioning studies.

Introdução. A investigação que se apresenta planteia uma síntese epistemológica sobre o perfil e funções do community manager. Materiais e métodos. Se realizou desde a análise crítica de um conjunto de opiniões valiosas de acadêmicos, e profissionais. Relacionando ela com os resultados de um estudo qualitativo realizado sobre o programa acadêmico de 19 cursos (na sua maioria conducentes à titulação de Máster) oferecidos maioritariamente por universidades espanholas para a especialização de tais profissionais. Resultados. Este análise comparado há permitido estabelecer notáveis coincidências entre os perfis, âmbitos de trabalho e funções designadas aos community manager pelos estudos epistemológicos existentes e as competências que se pretendem adquirir nestas ações formativas de pós graduação. Conclusão. Em essência os cursos preparam a especialistas em comunicação hipermídia e seus canais, criadores de conteúdos de qualidade e impacto emotivo, a profissionais, ubíquos em contínuo estado de análise de audiências e de estudos de posicionamento.

Percepción de la crítica familiar en pacientes ambulatorios con diabetes mellitus, trastorno bipolar I y sujetos sanos / Perceived Familial Criticism in Outpatients with Diabetes Mellitus, Bipolar Disorder and Healthy Individuals

Objetivos: Determinar las diferencias en la percepción de la crítica familiar entre pacientes de consulta externa con diabetes mellitus y trastorno bipolar I y sujetos sanos. Métodos: Se tomó una muestra de 114 sujetos con diabetes, 122 con trastorno bipolar y 116 sanos.La crítica familiar fue medida con la subescala de crítica de la Escala de Envolvimiento Emocional y Crítica (FEICS) y se compararon los puntajes entre los tres grupos empleando la prueba Kruskal-Wallis. Resultados: Los pacientes con trastorno bipolar son los que se perciben más criticados en su familia (mediana 17,5) y los pacientes sanos se perciben menoscriticados (mediana 12). Los pacientes con trastorno bipolar se perciben más censurados y con mayor intrusión (p<0,0001). Conclusión: La percepción de la crítica familiar es mayor en pacientes con trastorno bipolar comparado con los pacientes diabéticos y participantessanos. Esto podría ser explicado por las características de los trastornos mentales y sus implicaciones sociales y familiares.

Evaluación de medios de cultivo alternativos para el diagnóstico de la tuberculosis pulmonar / Alternative culture media evaluation for the diagnosis of pulmonary Tuberculosis

Objetivos: el uso de nuevos métodos que proporcionen rapidez al diagnóstico es necesario en laboratorios que hacen diagnóstico de tuberculosis y no poseen recursos para el uso de tecnología costosa. Nuestro objetivo fue evaluar MGIT (mycobacterial growth indicator tube) comparativamente con el cultivo en Ogawa- Kudoh (OK) y el cultivo en agar de capa delgada (CD) para el diagnóstico de tuberculosis. Materiales y métodos: se procesaron 218 muestras de esputo en 1 año, en pacientes con diagnóstico clínico de tuberculosis. Todas las muestras se decontaminaron por un método estándar y se les realizó coloración directa de Kinyoun. Resultados: De las 218 muestras 15.1 por ciento fueron positivas por CD, 24.3 por ciento lo fueron por MGIT y 24.7 por ciento lo fueron por OK. La sensibilidad, especificidad, valores predictivos positivos y negativos y la eficiencia se calcularon para MGIT y capa delgada con respecto al OK y fueron respectivamente 84.0 por ciento, 94.1 por ciento, 87.5 por ciento, 92.3 por ciento, 90.8 por ciento en MGIT y para CD 71.1 por ciento, 99.1 por ciento, 96.9 por ciento, 90.0 por ciento, 91.4 por ciento. La frecuencia de contaminación fué 11.4 por ciento, 20.6 por ciento y 22.9 por ciento para OK, CD y MGIT respectivamente. En los primeros 15 días fueron positivas el 56.2 por ciento de las muestras en CD, el 38.8 por ciento en MGIT y el 7.2 por ciento en OK. MGIT fue más sensible en muestras paucibacilares 15.5 por ciento, con respecto a OK 4.6 por ciento y CD 5.6 por ciento. Conclusión: El MGIT y la CD son alternativas para incrementar la rapidez en el diagnóstico de tuberculosis, el MGIT provee mayor sensibilidad en muestras paucibacilares