Motor development in premature infants: Study protocol for an interdisciplinary hospital-home intervention.

BACKGROUND: Deviations occur in the neuropsychomotor development of premature infants; early interventions minimize delay motor. This study aimed to determine the effect of an interdisciplinary hospital-home intervention addressing motor development adaptation in premature infants in Colombia in comparison with traditional interventions. METHODS: This study was based on a parallel design, with two groups, namely, experimental and control. The experimental group, hospital-home intervention (HHI) performed in two settings (i.e., hospital neonatal care units and homes), and the control group, traditional intervention, (TI) performed in institutions for premature infants. The sample will be composed of 130 randomly-allocated infants, 65 in the experimental group (HHI) and 65 in the control group (TI) of moderate to late preterm infants (gestational age between 34 and 37 weeks), weighing more than or equal to 1.800 g, who are hemodynamically stable and reside in the cities of Tunja and Bogotá-Colombia recruited between 2021 and 2022. For the pre- and post-intervention assessments, the TIMPSI and the CapDMP are the instruments used to assess motor development and the degree of parents' or caregivers' knowledge about motor development. The HHI is composed of 10 intervention strategies based on stimulation of motor development, performed twice a day for 10 min for two months, in combination with calls to a mobile device, using software (Baby Motor Skills) and an instant messaging system (WhatsApp). RESULTS: This hospital-home intervention program proposes an approach focused on the motor development of premature infants, based on sensory and motor stimulation strategies, in addition to follow-up performed at home with the use of a mobile application that improves the motor development of premature infants. Register Clinical Trial: NCT04563364. CONCLUSION: The HHI provides the opportunity to determine whether the individualized four-week from admission to follow up at home with parent training will improve the motor skills of premature infants.

Paternal Experiences of Perinatal Loss-A Scoping Review.

BACKGROUND: Perinatal grief is one of the most complex and devastating types of mourning for both mothers and fathers; however, there is still little research on the psychological impact on men who experience it. Therefore, the objective of this study was to summarize and synthetize the existing literature on the way men's grief is experienced. METHODS: A search was carried out to examine three databases for articles published in the last four years; 56 articles were obtained, and 12 were retained for analysis. RESULTS: Four common themes were found: the men's experience of grief, their role as fathers, the impact of the death, and their needs regarding grief and how to face it. CONCLUSIONS: There is also a need for discussion of the importance of validating perinatal grief in men and studies that examine it without social gender stigmas in order to provide them with effective emotional support.

Factors That Influence, Exacerbate, Contribute or Promote Violence in Couples.

Life as a couple, and their ability to solve problems or not, can result in the relationship being satisfactory and functional or unsatisfactory and dysfunctional, which increases the risk of violence with serious implications. For that reason, it is important to isolate the risk factors to prevent and treat unsatisfactory and dysfunctional relationships. The qualitative interpretive exploratory method was used, analysing 50 sessions of group psychotherapy with patients from a reproductive health institution whose relationships faced violent problems. The identified factors were the lack of autonomy in one of the partners, unresolved internal factors, a combination of external factors and factors caused by their interaction; symmetrical and asymmetrical violence, subjugation of one before the other, intergenerational violence, family violence during childhood and normalisation of violence. Isolating factors to understand relationship problems at risk of manifesting violence opens the possibility of effective, specific and preventive treatments of family and intimate partner violence.

Diseño y validación de un cuestionario sobre factores de riesgo en niños con parálisis cerebral / Design and Validation of a Questionnaire about Risk Factors in Children with Cerebral Palsy

Objetivo. Diseñar y validar, en su apariencia, un cuestionario para recolectar información sobre factores de riesgo en niños con parálisis cerebral. Metodología. Estudio descriptivo, metodológico, que incluyó una fase de diseño y otra de validación facial de un cuestionario. Esta última se llevó a cabo a través de la participación de 43 madres y 10 profesionales del área de la salud. Resultados. De acuerdo con el modelo teórico de Rutter alrededor de los factores de riesgo, se diseñó un cuestionario que permite recolectar información sobre condiciones pre y perinatales, que puede ser utilizado como parte de la documentación de la historia clínica de los niños con parálisis cerebral. Se realizó la validación facial del instrumento, cuyos resultados sugirieron la aceptación de 17 ítems y la reformulación de 12, equivalentes al 41,4% de la totalidad de preguntas del Cuestionario FR-PC. Limitaciones. El tamaño de la muestra pudo ser superior. De igual forma, no se encontró suficiente literatura que permitiera contrastar los resultados del estudio con otros similares. Valor. El producto de esta investigación es el Cuestionario FR-PC, herramienta que facilita la organización y la integración de los datos de la historia clínica del niño con PC, para la toma de decisiones. Así mismo, su contenido puede ser considerado para el desarrollo de proyectos de investigación en salud. Conclusiones. El Cuestionario FR-PC es una herramienta clara y comprensible para recolectar información sobre factores de riesgo en niños con parálisis cerebral

Objective. To design and validate, in its appearance, a questionnaire to collect in-formation on risk factors in children with cerebral palsy. Methodology. Descriptive, methodological study, which included a design phase and a phase of facial validation of a questionnaire. The latter was carried out through the participation of 43 mothers and 10 health professionals. Results. According to Rutter's theoretical model around risk factors, a question-naire was designed to collect information on pre- and perinatal conditions, which can be used as part of the documentation of the clinical history of children with cerebral palsy and for research processes. The facial validation of the instrument was carried out, whose results suggested the acceptance of 17 items and the reformulation of 12, equivalent to 41.4% of the totality of questions of the FR-PC Questionnaire. Limitations. Sample size could have been bigger. In addition, not enough literature was found to allow us to compare our results with other studies. Value. The product of this research is the RF-PC Questionnaire, a tool that facilitates the organization and integration of data from the clinical history of children with CP, for decision making. Conclusions. The FR-PC Questionnaire is a clear and understandable tool to collect information on risk factors in children with cerebral palsy.

Identification of risk factors in pre-term infants with abnormal general movements.

Introduction: This study aimed to investigate the relationship between prenatal, perinatal, and postnatal risk factors for neurodevelopmental impairment (NDI) with the outcomes of General Movement (GM) Assessment (GMA) in pre-term infants at 3-5 months of age. We sought to identify the risk factors associated with the predictors of psychomotor development in pre-term newborns, such as normal fidgety movements (FMs), absent FMs, or abnormal FMs, assessed during the fidgety period of motor development. Methods: The SYNAGIS program (prophylactic of Respiratory Syncytial Virus Infection) was used to identify risk factors for the development of neuromotor deficits in 164 pre-term infants who were at high risk of developing these deficits. Based on the GMA, all participants were divided into three groups of infants who presented: (1) normal FMs; (2) absent FMs; and (3) abnormal FMs. Results: The results of the current study suggest that abnormal GMs not only indicate commonly known factors like birth asphyxia (BA), respiratory distress syndrome (RDS), periventricular leukomalacia (PVL), intraventricular hemorrhage (IVH) grades 3-4, but also predict the development of motor impairments. In the present study, several specific risk factors including bronchopulmonary dysplasia (BPD), infertility treatments, maternal acute viral/bacterial infections during pregnancy, and elevated bilirubin levels were identified as attributes of an atypical fidgety movement pattern. Conclusions: Additional clinical data, such as risk factors for NDI associated with early predictors of psychomotor development in pre-term newborns, i.e., absent or abnormal FMs, may be helpful in predicting neurological outcomes in pre-term infants with developmental concerns in the 1st month of life.

Remnant cholesterol levels are associated with severity and death in COVID-19 patients.

Coronavirus disease-19 (COVID-19) patients with severe complications present comorbidities like cardiovascular-disease, hypertension and type-2 diabetes mellitus (DM), sharing metabolic alterations like insulin resistance (IR) and dyslipidemia. Our objective was to evaluate the association among different components of the lipid-lipoprotein profile, such as remnant lipoprotein (RLP)-cholesterol, in patients with COVID-19, and to analyze their associations with the severity of the disease and death. We studied 193 patients (68 (29-96) years; 49.7% male) hospitalized for COVID-19 and 200 controls (46 (18-79) years; 52.5% male). Lipoprotein profile, glucose and procalcitonin were assessed. Patients presented higher glucose, TG, TG/HDL-cholesterol and RLP-cholesterol levels, but lower total, LDL, HDL and no-HDL-cholesterol levels (p < 0.001). When a binary logistic regression was performed, age, non-HDL-cholesterol, and RLP-cholesterol were associated with death (p = 0.005). As the COVID-19 condition worsened, according to procalcitonin tertiles, a decrease in all the cholesterol fractions (p < 0.03) was observed with no differences in TG, while levels of RLP-cholesterol and TG/HDL-cholesterol increased (p < 0.001). Lower levels of all the cholesterol fractions were related with the presence and severity of COVID-19, except for RLP-cholesterol levels and TG/HDL-cholesterol index. These alterations indicate a lipid metabolic disorder, characteristic of IR states in COVID-19 patients. RLP-cholesterol levels predicted severity and death in these patients.

Translation and Cross-Cultural Adaptation of the Test of Infant Motor Performance to Colombian Spanish / Traducción y adaptación transcultural del Test of Infant Motor Performance al español de Colombia / Tradução e adaptação transcultural do Test of Infant Motor Performance para o espanhol colombiano

Introduction: There has been growing interest in recent years in the cross-cultural adaptation of mea-suring instruments for various conditions treated by physiotherapy. Validation of an instrument within a target language and culture creates a final version that is conceptually and linguistically adapted to the context but remains valid and reliable. This paper describes the process of translation and cross-cul-tural adaptation of the Test of Infant Motor Performance (timp) from us English to Colombian Spanish. This was performed in accordance with international methodological guidelines. Materials and meth-ods: A group of trained translators and field experts participated in the five stages presented herein. These stages were translation and adaptation of the instrument to Colombian Spanish, validation of its content and appearance, back-translation, revision by the original author, and, finally, a pilot test.Results: The existence of two intralingual translated and revised versions of this instrument led to a more appropriate preliminary version from conceptual, discursive, and terminological perspectives. Therefore, the adjustments made in the first stage were primarily semantic. During the second stage, field experts positively assessed the translated version and suggested adjustments to grammar, spell-ing, and word choices. There were no significant discursive problems during the back-translation stage so conceptual and terminological adjustments were minor. The revision stage and the pilot test were satisfactory. Conclusion: This translation and cross-cultural adaptation was successful. The Colombian Spanish version of the measure was culturally relevant and used appropriate language, yet remained a valid and reliable tool

Introducción: la adaptación transcultural de distintos instrumentos de medición, y para diferentes tipos de condiciones en el campo de la fisioterapia, ha sido un tema de interés en los últimos años. La validación lingüística de un instrumento a una lengua y cultura meta implica que la versión final es adaptada conceptual y lingüísticamente al contexto meta. El objetivo de este artículo es describir el proceso de traducción y adaptación transcultural al español de Colombia del Test of Infant Motor Performace(timp) siguiendo los lineamientos metodológicos internacionales. Materiales y método: se conformó un grupo de traductores calificados y de expertos que participaron en cinco fases: traducción y adaptación al español de Colombia, validez de contenido y apariencia, retrotraducción, revisión por autora original y prueba piloto. Resultados: la posibilidad de contar con dos versiones intralinguales revisadas llevó a una versión preliminar más adecuada desde las perspectivas conceptual, discursiva y terminológica. Por lo tanto, los ajustes en esta fase se realizaron principalmente desde una perspectiva semántica. En cuanto a la segunda fase, los expertos validaron positivamente dicha versión y sugirieron cambiar algunas palabras y cuestiones ortográficas. La fase de retrotraducción y la validación no presentaron problemas discursivos, así que las adecuaciones conceptuales y terminológicas fueron mínimas. La fase de revisión y la prueba piloto fueron satisfactorias. Conclusión: este proceso de traducción y adaptación transcultural fue exitoso. La versión al español de Colombia fue apropiada culturalmente, además de ser una herramienta válida y confiable

Introdução: a adaptação transcultural de diferentes instrumentos de medida e para diferentes tipos de condições no campo da fisioterapia tem sido um tema de interesse nos últimos anos. A validação linguís-tica de um instrumento para uma língua e cultura alvo implica que a versão final seja conceitual e lin-guisticamente adaptada ao contexto alvo. O objetivo deste artigo é descrever o processo de tradução e adaptação transcultural para o espanhol colombiano do Test of Infant Motor Performace (timp) de acordo com as diretrizes metodológicas internacionais. Materiais e métodos: foi conformado um grupo de tradu-tores qualificados e especialistas que participaram em cinco fases: tradução e adaptação para o espanhol colombiano, validade de conteúdo e aparência, retrotradução, revisão pelo autor original e teste piloto. Resultados: a possibilidade de haver duas versões intralinguais revisadas levou a uma versão preliminar mais adequada do ponto de vista conceitual, discursivo e terminológico, portanto, os ajustes nesta fase foram feitos principalmente do ponto de vista semântico. Já na segunda fase, os especialistas validaram positivamente essa versão e sugeriram alterações em algumas palavras e problemas ortográficos. A fase de retrotradução e a validação não apresentaram problemas discursivos, portanto as adaptações conceituais e terminológicas foram mínimas. A fase de revisão e o teste pilotoforam bem-sucedidos. Conclusão: este processo de tradução e adaptação transcultural foi favorável do ponto de vista de validade e aparência para o contexto colombiano

Evaluación de la fuerza muscular en niños: una revisión de la literatura / Evaluation of muscle strength in children: a review of literature

Introducción: la fuerza muscular es un indicador importante de la función neuromuscular y un componente de la aptitud física esencial para el desempeño en actividades cotidianas. Su alteración puede causar deficiencias funcionales, afectar la independencia y los roles que desempeña una persona. Por esto, evaluar la fuerza muscular en niños es necesario para determinar el grado de rendimiento motor e identificar riesgos asociados al crecimiento y al desarrollo. Objetivo: describir el estado del arte relacionado con la utilización de escalas de valoración de la fuerza muscular en niños entre 3 y 8 años de edad. Materiales y Métodos: se realizó una revisión de la literatura empleando la estrategia PICO, con búsqueda bibliográfica en las bases de datos Ovid, Sage, Science Direct, Proquest y Clinical Key. Resultados: en la fase inicial del proceso de cribado se identificaron 69 registros elegibles por título y resumen, de los cuales se excluyeron 56 por no cumplir con los criterios de inclusión. Adicionalmente se identificaron 3 libros con información relevante, razón por la cual fueron tenidas en cuenta 16 referencias que hacen parte de la síntesis cualitativa del presente estudio. Conclusiones: estrategias y pruebas como la dinamometría, la Functional Strength Measurement, el Test de Competencias Motoras de Bruininks Oseretsky, el Fitness Testing Preschool Children y FUPRECOL son herramientas que permiten evaluar la fuerza muscular en la infancia, y aportan elementos importantes en la identificación temprana de factores de riesgo para la salud de la persona..Au

Introduction: muscle strength is an important indicator of neuromuscular function and a component of physical fitness essential for performance in different activities of daily life. Its alteration may cause functional limitations and affects the independence and the roles that a person develops. That is why the evaluation of muscle strength is necessary to determine the level of motor performance and identify risks associated with growth and development. Objective: to describe the state of art related to the use of muscle strength assessment scales in children between 3 and 8 years of age. Materials and Methods: a review of the literature was performed using the PICO strategy, with bibliographic search in the Ovid, Sage, Science Direct, Proquest and Clinical Key databases. Results: in the initial phase of the screening process, 69 eligible records were identified by title and abstract, of which 56 were excluded because they did not meet the inclusion criteria. Additionally, 3 books with relevant information were identified, which is why 16 references that are part of the qualitative synthesis of this study were taken into account. Conclusions: srategies and tests such as dynamometry, Functional Strength Measurement, Bruininks Oseretsky's Motor Skills Test, Fitness Testing Preschool Children and FUPRECOL are tools that allow evaluating muscle strength in childhood, and provide important elements in early identification of risk factors for the person's health..Au

[Case report: intestinal pneumatosis] / Caso clínico: pneumatosis intestinal.

Objective: To present a recent to increase understanding, diagnosis and treatment of intestinal pneumatosis clinical case, considering the distinctive characteristics of the disease and to expand knowledge about the management of this condition. Methods: The case of a female patient aged 65, originally from Bolivia, with a history of osteoarthritis, osteoporosis, asthma and allergies repetition occurs. The patient was admitted to the Department of Surgery No. 1 HNC in November 2015, with an unclear clinical picture. During admission of air bubbles present in the colonic mucosa and tumor lesion is discovered duodenum. Quickly it begins with treatment and adequate support for stabilization. A literature search and an update of the latest updates regarding this disease arises. medical seekers popularity as PUBMED, UP TO DATE, VBS were used. a series of articles about it were selected. The patient cited in this work has given us the corresponding written consent for the anonymous publication with scientific purposes about her information. Also we declare the absence of external financing and conflicts of interest. Conclusions: it was concluded that management should generally be conservative, excluding the case of complications (obstruction, perforation) and suspected intestinal ischemia. Exploratory laparoscopy may be helpful to determine the appropriate behavior. Conservative treatment includes antibiotics, hyperbaric oxygen and supportive measures.

Objetivo: presentar un caso clínico reciente para aumentar el entendimiento, diagnóstico y tratamiento de la neumatosis intestinal, considerar las características distintivas de la enfermedad y así poder ampliar los conocimientos acerca del manejo de esta patología. Métodos: se presenta el caso de una paciente femenina de 65 años, originaria de Bolivia, con historial de artrosis, osteoporosis, asma y alergias a repetición. La paciente ingresa al Servicio de Cirugía N° 1 del HNC, en el mes de noviembre del 2015, con un cuadro clínico poco claro. En el transcurso de la internación se descubre la presencia de burbujas aéreas en la mucosa del colon y una lesión tumoral en duodeno. Rápidamente se comienza con el tratamiento y soporte adecuado para su estabilización. Se plantea una búsqueda bibliográfica y una puesta al día de las últimas actualizaciones en relación a esta patología. Se utilizaron buscadores médicos de renombre como PUBMED, UP TO DATE, VBS. Se seleccionaron una serie de artículos al respecto.La paciente citada en este trabajo ha otorgado el correspondiente consentimiento por escrito para la publicación anónima y con fines científicos de su infomación.Declaramos además la ausencia de financiamiento externo y conflictos de interés alguno. Conclusiones: se pudo concluir que el manejo en general debe ser conservador, excluyendo el caso de las complicaciones (oclusión, perforación) y a la sospecha de isquemia intestinal. La laparoscopía exploradora puede ser de ayuda para determinar la conducta apropiada. El tratamiento conservador incluye antibióticos, oxígeno hiperbárico y medidas de sostén.

Efectos del masaje terapéutico sobre la ansiedad y el estrés en población pediátrica / Effects of therapeutic massages on anxiety and stress in the pediatric population

Resumen Introducción. El masaje es una estrategia terapéutica estudiada por diferentes profesionales de la salud y de la cual la literatura reporta efectos que redundan en el bienestar físico y emocional del niño. Objetivo. Describir el estado del arte en relación con los efectos que genera la aplicación de masaje terapéutico sobre la ansiedad y el estrés en población pediátrica a partir de la evidencia disponible. Materiales y métodos. Revisión sistematizada que incluyó artículos de naturaleza experimental, en su mayoría ensayos clínicos aleatorizados evaluados mediante la escala PEDro. Las bases de datos consultadas fueron EBSCO, Embase, ScienceDirect, PubMed, BVS y PEDro. Resultados. En total, se seleccionaron 7 artículos, incluyendo 4 ensayos clínicos aleatorizados y 3 cuasi experimentales. Conclusiones. La literatura reporta efectos beneficiosos del masaje terapéutico aplicado en población pediátrica; entre ellos, disminución de los niveles de cortisol, mejor adaptación de respuestas fisiológicas frente a estresores, ganancia de peso y mejor organización comportamental y del sueño. Dichos efectos se potencializan al aplicar presión moderada, en comparación con técnicas de masaje realizadas con presión ligera.

Abstract Introduction: Massages are a therapeutic strategy studied by different health professionals. Literature has reported positive effects on the physical and the emotional well-being of children. Objective: To describe the state of the art regarding the effects of therapeutic massages on anxiety and stress relief in the pediatric population based on the available evidence. Materials and methods: Systematic review including experimental articles, mostly randomized clinical trials, evaluated using the PEDro scale. The databases consulted were EBSCO, Embase, ScienceDirect, PubMed, VHL and PEDro. Results: Seven articles were selected, including 4 randomized and 3 quasi-experimental clinical trials. Conclusions: The literature reports beneficial effects of therapeutic massages on the pediatric population, including decreased cortisol levels, better adaptation of physiological responses to stressors, weight gain and better behavioral and sleep patterns. These effects are potentiated by moderate pressure, compared to massage techniques performed with light pressure.

Efectos de la terapia física intensiva sobre la función motora de un niño con hemiparesia espástica / Effects of intensive physical therapy on the motor function of a child with spastic hemiparesis

Resumen Introducción. La fisioterapia es una profesión del área de la salud cuyo objeto de estudio es el movimiento corporal humano, por lo que es responsable de aquellos casos que involucran problemas en el desarrollo motor, como el manejado en la presente investigación. Objetivo. Describir el efecto a corto plazo causado por un tratamiento intensivo de terapia física, realizado con Therasuit, sobre la función motora de un niño con hemiparesia espástica derecha. Materiales y métodos. Investigación descriptiva de tipo cualitativo llevada a cabo bajo la metodología de estudio de caso con un periodo de observación de dos años. Resultados. Los resultados incluyen, además de la detección y el diagnóstico del caso, el análisis de la información a partir de la aplicación de la metodología y la observación de resultados en pruebas clínicas para valorar el movimiento, el diseño y la implementación de un plan terapéutico basado en el método Therasuit. Conclusiones. En este estudio de caso es posible observar cómo la presencia del programa de fisioterapia en la institución de práctica clínica permitió que un niño de cuatros años fuera diagnosticado con secuelas de hemiparesia espástica derecha y fuera tratado con el método Therasuit, el cual mejoró su marcha y función motora.

Abstract Introduction: Physical therapy is a health profession whose object of study is the movement of the human body, therefore, it is responsible for cases involving motor development problems, as in the case presented here. Objective: To describe the short-term effect caused by intensive physical therapy treatment, performed with Therasuit, on motor function of a child with spastic right hemiparesis. Materials and methods: Descriptive qualitative research conducted based on the case study methodology with an observation period of two years. Results: The results include, besides the detection and diagnosis of the case, the analysis of information based on the application of the methodology and the observation of results in clinical trials to assess movement, design and implementation of a treatment plan using the Therasuit method. Conclusions: This case study makes possible to observe how the presence of a physical therapy program at a clinical practice institution allowed Therasuit method treatment to a four-year-old child diagnosed with right spastic hemiparesis sequelae, which improved gait and motor function.

Propiedades psicométricas del test de competencias motoras Bruininks Oseretsky en versión corta para niños entre 4 y 7 años en Chía y Bogotá, D.C., Colombia / Psychometric properties of the short form of the Bruininks Oseretsky test of motor proficiency in children between 4 and 7 years in Chía and Bogotá - Colombia

Antecedentes. Existen importantes pruebas de valoración que miden habilidades o competencias motoras en el niño; a pesar de ello y teniendo presente que la intervención debe basarse en la rigurosidad que exigen los procesos de evaluación del movimiento corporal humano, Colombia carece de estudios que demuestren la validez y confiabilidad de un test de medición que permita emitir un juicio valorativo relacionado con las competencias motoras infantiles. Objetivo. El presente estudio se centró en determinar las propiedades psicométricas del test de competencias motoras Bruininks Oseretsky segunda edición (BOT 2). Materiales y métodos. Se realizó una evaluación de pruebas diagnósticas con 24 niños aparentemente sanos, de ambos géneros, entre 4 y 7 años y residentes en las ciudades de Chía y Bogotá, D.C. La evaluación fue realizada por tres evaluadores expertos: el análisis para consistencia interna se realizó utilizando el coeficiente Alfa de Cronbach; el análisis de reproducibilidad se estableció a través del coeficiente de correlación intraclase (CCI) y para el análisis de la validez concurrente se utilizó el coeficiente de correlación de Pearson, considerando α=0.05. Resultados. Para la totalidad de las pruebas se encontraron altos índices de confiabilidad y validez. Conclusiones. El BOT 2 es un instrumento válido y confiable que puede ser utilizado para la evaluación e identificación del nivel de desarrollo en que se encuentran las competencias motoras del niño.

Background. There are several important tests that measure or motor skills in children; however, and taking into account that the intervention should be based on rigorous assessment processes of body movement, in Colombia does not exist any research that shows the validity and reliability of a test that allows assessing children's motor skills. Objective. The objective of this study was to determine the psychometric properties of the short form from the Bruininks Oseretsky Test of Motor Proficiency (BOT 2) Second Edition. Materials and methods. To get the results an evaluating diagnostic test was performed in 24, apparently healthy, children, both male and female, with ages between 4 and 7 years old, living in the cities of Chia and Bogotá, D.C. The assessment was carried out by three experts, with three different methods; the internal consistency analysis was performed using the Cronbach's Alpha Coefficient; the reproducibility analysis was established by the Intraclass Correlation Coefficient; for analyzing the concurrent validity the Pearson correlation coefficient was used, considering that α = 0.05. Results. High reliability and validity ranges were obtained for all the tests. Conclusions. The BOT 2 is a valid and reliable test. It can be used in our context to assess and identify children's motor skills development levels.

Hipoglucemia severa intradiálisis asociada a marihuana / Severe intradialytic hypoglycemia associated with marijuana use

No disponible

Life-Threatening Cryoglobulinemic Patients With Hepatitis C: Clinical Description and Outcome of 279 Patients.

Cryoglobulinemia is characterized by a wide range of causes, symptoms, and outcomes. Hepatitis C virus (HCV) infection is detected in 30%-100% of patients with cryoglobulins. Although more than half the patients with cryoglobulinemic vasculitis present a relatively benign clinical course, some may present with potentially life-threatening situations. We conducted the current study to analyze the clinical characteristics and outcomes of HCV patients presenting with life-threatening cryoglobulinemic vasculitis. We evaluated 181 admissions from 89 HCV patients diagnosed with cryoglobulinemic vasculitis consecutively admitted to our department between 1995 and 2010. In addition, we performed a systematic analysis of cases reported to date through a MEDLINE search.The following organ involvements were considered to be potentially life-threatening in HCV patients with cryoglobulinemic vasculitis: cryoglobulinemic, biopsy-proven glomerulonephritis presenting with renal failure; gastrointestinal vasculitis; pulmonary hemorrhage; central nervous system (CNS) involvement; and myocardial involvement. A total of 279 patients (30 from our department and 249 from the literature search) fulfilled the inclusion criteria: 205 presented with renal failure, 45 with gastrointestinal vasculitis, 38 with CNS involvement, 18 with pulmonary hemorrhage, and 3 with myocardial involvement; 30 patients presented with more than 1 life-threatening cryoglobulinemic manifestation. There were 146 (52%) women and 133 (48%) men, with a mean age at diagnosis of cryoglobulinemia of 54 years (range, 25-87 yr) and a mean age at life-threatening involvement of 55 years (range, 25-87 yr). In 232 (83%) patients, life-threatening involvement was the first clinical manifestation of cryoglobulinemia. Severe involvement appeared a mean of 1.2 years (range, 1-11 yr) after the diagnosis of cryoglobulinemic vasculitis. Patients were followed for a mean of 14 months (range, 3-120 mo) after the diagnosis of life-threatening cryoglobulinemia. Sixty-three patients (22%) died. The main cause of death was sepsis (42%) in patients with glomerulonephritis, and cryoglobulinemic vasculitis itself in patients with gastrointestinal, pulmonary, and CNS involvement (60%, 57%, and 62%, respectively). In conclusion, HCV-related cryoglobulinemia may result in progressive (renal involvement) or acute (pulmonary hemorrhage, gastrointestinal ischemia, CNS involvement) life-threatening organ damage. The mortality rate of these manifestations ranges between 20% and 80%. Unfortunately, this may be the first cryoglobulinemic involvement in almost two-thirds of cases, highlighting the complex management and very elevated mortality of these cases.

[Periodontal condition and tooth loss in diabetic patients]. / Condición periodontal y pérdida dental en pacientes diabéticos del Hospital Universitario San Vicente de Paúl.

INTRODUCTION: Diabetes is a systemic disease which affects the metabolism of glucose,and it has been associated with the development of periodontal disease. OBJECTIVE: The periodontal condition and tooth loss was evaluated in diabetic subjects. MATERIALS AND METHODS: At the San Vicente de Paúl Hospital (Medellín, Colombia), 117 subjects with type 1 and 2 diabetes mellitus were examined. Patients underwent a comprehensive periodontal evaluation, glycosylated hemoglobin analysis, oral hygiene habits and history of diabetes. A descriptive and comparative analysis between the clinical parameters, tooth loss and type of diabetes was performed. RESULTS: The prevalence of gingivitis was 27.4% and periodontitis 72.6%. The most frequent systemic complication was hypertension (51.3%). The most frequently lost teeth were molars and in general, the subjects had lost an average of 7 teeth and had a poor plaque control (55.4%). No differences were seen in clinical parameters between type 1 and 2 diabetes patients. The mean probing depth was 2.6 mm. The first and second upper and lower molars showed the highest values of PD. The mean clinical attachment loss was 3.3 mm . Maxillary teeth 17, 16, and mandibular 37, 47 showed the highest values of clinical attachment loss. CONCLUSIONS: In conclusion, the periodontal condition in diabetic patients was poor, presenting periodontitis in most cases. This can be a major cause of tooth loss in diabetic subjects and requires special attention by clinicians.

Condición periodontal y pérdida dental en pacientes diabéticos del Hospital Universitario San Vicente de Paúl / Periodontal condition and tooth loss in diabetic patients

Introducción. La diabetes es una enfermedad sistémica que afecta el metabolismo de la glucosa y se ha relacionado con el desarrollo de enfermedad periodontal. Objetivo. El objetivo de este estudio fue determinar la condición periodontal y la pérdida dental de un grupo de pacientes diabéticos del Hospital Universitario San Vicente de Paúl. Materiales y métodos. A 117 sujetos con diabetes de tipo 1 y 2 se les practicó un examen periodontal completo, determinación de valores de la hemoglobina A1C (glycosilated hemoglobin) y radiografías periapicales, y se les indagó sobre hábitos de higiene oral e historia de diabetes. Los datos se analizaron de forma descriptiva y comparativa entre los parámetros clínicos, pérdida dental y tipo de diabetes. Resultados. La prevalencia de gingivitis fue de 27,4 % y la de periodontitis de 72,6 %. La complicación sistémica más frecuente fue la hipertensión arterial (51,3 %). Los dientes más frecuentemente perdidos fueron los molares y, en promedio, los sujetos habían perdido siete dientes. El control de placa bacteriana fue pobre (55,4 %). No hubo diferencias en los parámetros clínicos entre pacientes diabéticos de tipo 1 y de tipo 2. El promedio de profundidad con sonda fue 2,62 mm, siendo los molares los dientes más afectados. El promedio de pérdida de inserción fue de 3,03 mm. Los dientes 17, 16, 27, 37 y 47 presentaron los valores más altos de pérdida de inserción. Conclusiones. En conclusión, la condición periodontal en pacientes diabéticos fue mala, y presentaban periodontitis en la mayoría de los casos. Esto puede ser una causa importante de pérdida dental en sujetos diabéticos y requiere de especial atención por parte de los odontólogos y médicos.

Introduction. Diabetes is a systemic disease which affects the metabolism of glucose,and it has been associated with the development of periodontal disease. Objective. The periodontal condition and tooth loss was evaluated in diabetic subjects. Materials and methods. At the San Vicente de Paúl Hospital (Medellín, Colombia), 117 subjects with type 1 and 2 diabetes mellitus were examined. Patients underwent a comprehensive periodontal evaluation, glycosylated hemoglobin analysis, oral hygiene habits and history of diabetes. A descriptive and comparative analysis between the clinical parameters, tooth loss and type of diabetes was performed. Results. The prevalence of gingivitis was 27.4% and periodontitis 72.6%. The most frequent systemic complication was hypertension (51.3%). The most frequently lost teeth were molars and in general, the subjects had lost an average of 7 teeth and had a poor plaque control (55.4%). No differences were seen in clinical parameters between type 1 and 2 diabetes patients. The mean probing depth was 2.6 mm. The first and second upper and lower molars showed the highest values of PD. The mean clinical attachment loss was 3.3 mm . Maxillary teeth 17, 16, and mandibular 37, 47 showed the highest values of clinical attachment loss. Conclusions. In conclusion, the periodontal condition in diabetic patients was poor, presenting periodontitis in most cases. This can be a major cause of tooth loss in diabetic subjects and requires special attention by clinicians.

[Psychosocial factors predicting postnatal anxiety symptoms and their relation to symptoms of postpartum depression]. / Factores psicosociales que predicen síntomas de ansiedad posnatal y su relación con los síntomas depresivos en el posparto.

OBJECTIVES: To study perinatal anxiety symptoms in a sample of Mexican mothers. A) To evaluate the effect of certain psychosocial factors during pregnancy on anxiety symptoms at two postpartum time intervals; and B) to determine whether this symptomatology is related to symptoms of postnatal depression. MATERIAL AND METHODS: In this secondary data analysis, 156 women were interviewed during pregnancy (T1): 149 were interviewed again at 6 weeks postpartum (T2) and 156 at 4-6 months postpartum (T3). Subjects were selected from women seeking prenatal attention at three health centers in Mexico City who presented with depressive symptomatology and/or previous history of depression. Two models were subjected to multivariate regression analysis to determine the influence of psychosocial factors in pregnancy (age, education, partner status, social support [APGAR], stress events, self-esteem [Coopersmith], depressive symptomatology [BDI-II], and anxiety [SCL-90]) on anxiety symptomatology (SCL-90) in T2 and T3. Two additional linear regression analyses were performed to evaluate the influence of prenatal anxiety symptomatology (SCL-90) on postpartum depression symptoms (BDI-II), one for each postnatal period (T2, T3). RESULTS: The variables that predicted postpartum anxiety symptomatology in T2 were anxiety symptoms and lack of social support; in T3 they were anxiety symptoms, lack of a partner, and lack of social support. Prenatal anxiety symptoms predicted postpartum depressive symptomatology at both postpartum intervals (T2, T3). CONCLUSIONS: Untreated prenatal anxiety symptomatology is predictive of symptoms of anxiety and depression in the postpartum period, suggesting the need for timely detection and treatment. Women lacking social support or partners are a population particularly vulnerable to anxiety symptoms, and merit interventions that address these issues.

[Conflict areas in two psychotherapeutic groups of climacteric women]. / Areas de conflicto en mujeres en la etapa del climaterio en dos grupos de psicoterapia.

BACKGROUND: An important consideration is to specify the areas of conflict that will be worked on during the psychotherapeutic process in order to develop a specific psychological model for a group intervention with menopausal women. OBJECTIVE: To determine the most relevant areas of psychological conflict for women in the menopausal stage by means of a focalization technique. PATIENTS AND METHOD: A descriptive, cross-sectional, longitudinal study with non-experimental design was done in 29 patients from the Perinatology National Institute of Mexico (INPer). Two groups were formed (A and B), each one with 17 participants; however, in the first session only 12 women from group A assisted. Seventeen therapy sessions were analyzed. Group formation and the number of sessions were based on research and patients needs. Women were given psychotherapeutic care once a week at the psychology department of INPer, for 90 minutes by session. Psychotherapeutic management during sessions was in charge of psychologist responsible of climacteric program of psychology department; while Gesell chamber observer was a psychologist with groups' specialization. For the statistical analysis frequency measures were used. RESULTS: Eleven areas were identified, which showed a great similarity in both groups. Main ones were: relation of the patient to relatives or extensive family, relation to the partner and relation to the children. CONCLUSIONS: This work favors a dynamic therapeutic process with the patients, in addition to being a technique, which provides structure and guidance during menopause.

Anestesia para el paciente politraumatizado. Un enfoque actual

El presente artículo intenta realizar un enfoque anestesiológico del paciente traumatizado, basándose en la importancia y el entendimiento de la fisiopatología y las múltiples respuestas sistémicas que se dan en el paciente, algunas como defensa, otras como compensación, pero cuya intensidad pudiera ser desproporcionada al estímulo resultando en una autorregresión celular y tisular de consecuencias tardías y fatales en el periodo post-trauma. La fisiopatología del trauma conlleva a establecer una alteración básica en la oxigenación tisular con una relación inadecuada de la entrega/consumo de oxígeno, que debe ser en lo posible corregida antes de someter al paciente a un segundo estímulo nocivo como son la anestesia y la cirugía, lo que aumenta el riesgo de morbi-mortalidad, si en el período preoperatorio no se repara la deuda de O2. La anestesia con sus agentes y técnicas debe individualizarse y guiarse con la monitoría, para continuar los esfuerzos de la resucitación, plasmados en la consecusión y mantenimiento de unas metas hemodinámicas terapéuticas y de preservación de la función de los órganos en el período postoperatorio