Conocimiento de infarto cerebral y educación en usuarios del Departamento de Neurología - Hospital de Especialidades Carlos Andrade Marín / Knowledge of ischemic stroke and education in users of the Neurology Department - Carlos Andrade Marín Specialty Hospital

INTRODUCCIÓN: El riesgo de sufrir un infarto cerebral se relaciona con factores de riesgo, el reconocimiento y actuación del paciente/familia se relaciona con el nivel educativo. Pese al avance en el tratamiento, la mejor forma de enfrentarla es la prevención. OBJETIVO: Determinar el nivel de conocimiento de infarto cerebral en población no médica. Demostrar la hipótesis de que la educación mejora los niveles de conocimiento de la enfermedad. MATERIALES Y MÉTODOS: Ensayo Clínico Cuasiexperimental de tipo antes/después con cohorte única. Población: 113 familiares de pacientes ingresados al área de Neurología del Hospital de Especialidades Carlos Andrade Marín en el periodo marzo ­ septiembre del 2022. Criterios de inclusión: familiares en cuidado/vigilancia directa de pacientes ingresados con diagnóstico clínico/ imagenológico de infarto cerebral agudo, firma de consentimiento informado. Criterios de exclusión: No aceptación de participar. Se realizó a cada participante una encuesta a la admisión, luego se le entregó un documento educativo acerca del tema y posteriormente se aplicó nuevamente la encuesta. Se utilizó la prueba Chi cuadrado de Mcnemar para comprobación de hipótesis y los porcentajes de frecuencias se analizaron con diferencia porcentual. RESULTADOS: El síntoma más conocido fue la alteración del lenguaje con un 44,2% de conocimiento en la población estudiada, 25,7% sospecharon de ictus, 87,6% lo consideraban como emergencia, 31% sabían de la existencia de factores de riesgo, la diferencia porcentual luego de la intervención educativa incrementó en: 76,4% en la necesidad de llamar a una ambulancia, en más de 47,3% y de 111,1% en conocimiento de síntomas y de los factores de riesgo, respectivamente. El nombre del ictus más conocido fue ´Derrame´. DISCUSIÓN: El conocimiento para reconocer a un infarto cerebral es bajo, el de reconocerlo como emergencia es alto, la intervención educativa mejoró notablemente ese conocimiento al igual que literatura publicada. CONCLUSIÓN: Se comprobó la hipótesis de que es necesario incrementar el conocimiento de infarto cerebral y la conciencia de cómo proceder ante la presentación de esta enfermedad.

recognition and action of the patient/family is related to the educational level. Despite advances in treatment, the best way to deal with it is prevention. OBJECTIVE: To determine the level of knowledge of ischemic stroke in the non-medical population. To demonstrate the hypothesis that education improves levels of knowledge of the disease. MATERIALS AND METHODS: Quasi-experimental before/after clinical trial with single cohort. Population: 113 relatives of patients admitted to the Neurology area of the Carlos Andrade Marín Specialties Hospital during the period March - September 2022. Inclusion criteria: family members in direct care/monitoring of patients admitted with clinical/imaging diagnosis of acute ischemic stroke, signature of informed consent. Exclusion criteria: non-acceptance to participate. Each participant was given a survey at admission, then given an educational document about the topic, and then the survey was administered again. The Mcnemar Chi-square test was used for hypothesis testing and the percentages of frequencies were analyzed with percentage difference. RESULTS: The most known symptom was language impairment, with 44,2% of the population studied being aware of it, 25,7% suspected stroke, 87,6% considered it as an emergency, 31% knew of the existence of risk factors, the percentage difference after the educational intervention increased by: 76,4% in the need to call an ambulance, by more than 47,3% and 111,1% in knowledge of symptoms and risk factors, respectively. The name of the most known stroke was ´stroke´. DISCUSSION: The knowledge to recognize a stroke is low, the knowledge to recognize it as an emergency is high, the educational intervention improved notably this knowledge as well as published literature. CONCLUSION: The hypothesis that it is necessary to increase knowledge of stroke and awareness of how to proceed when faced with this disease was proven.

Assessing the quality of care for people dying of cancer in hospital: development of the QualDeath framework.

Objective High-quality end-of-life care involves addressing patients' physical, psychosocial, cultural and spiritual needs. Although the measurement of the quality of care associated with dying and death is an important component of health care, there is a lack of evidence-based, systematic processes to examine the quality of dying and death of patients in hospital settings. Our purpose was to develop a systematic appraisal framework (QualDeath) for reviewing the quality of dying and death for patients with advanced cancer. The objectives were to: (1) explore the evidence regarding existing tools and processes related to appraisal of end-of-life care; (2) examine existing practices related to appraisal of quality of dying and death in hospital settings; and (3) develop QualDeath with consideration of potential acceptability and feasibility factors. Methods A co-design multiple methods approach was used. For objective 1, a rapid literature review was undertaken; for objective 2 we carried out semi-structured interviews and focus groups with key stakeholders in four major teaching hospitals; and for objective 3 we interviewed key stakeholders and held workshops with the project team to reach consensus. Results We developed QualDeath, a framework to assist hospital administrators and clinicians to systematically and retrospectively review the quality of dying and death for patients expected to die from advanced cancer. It offers four levels of potential implementation for hospitals to select from and incorporates medical record review, multidisciplinary meetings, quality of end-of-life care surveys and bereavement interviews with family carers. Conclusions The QualDeath framework provides hospitals with recommendations to formalise processes to evaluate end-of-life care. Although QualDeath was underpinned by several research methods, further research is needed to rigorously explore its impact and test its feasibility.

Genetic diversity, structure, and admixture in Mayans from Guatemala and Mexico based on 15 short tandem repeats.

OBJECTIVE: To analyze the genetic origin, relationships, structure, and admixture in Mayan Native American groups from Guatemala and Mexico based on 15 autosomal short tandem repeats (STRs) loci commonly used in human identification (HID). METHODS: We genotyped 513 unrelated Mayan samples from Guatemala based on 15 STR loci (AmpFlSTR® Identifiler kit). Moreover, we included 4408 genotypes previously reported, as following: Mayas from Guatemala and Mexico (n = 1666) and from Latin American, European, and African (n = 2742) populations. Forensic parameters, genetic distances, admixture, and population structure were assessed. RESULTS: Forensic parameters of the 15 STRs in different Mayan groups from Guatemala were reported. Low (Fst = 0.78%; p = 0.000) and non-significant differentiation (Fst = 1.8%; p = 0.108) were observed in Mayas from Guatemala and Mexico, respectively. The relative homogeneity observed among Mayan groups supported theories of extensive pre-Columbian gene flow and trade throughout the Mayan Empire. The distribution of the three Native American ancestries among these Mayan groups did not support the presumable Guatemalan origin of Tojolabal and Lacandon people (South, Mexico). The nonsignificant differentiation between Ladinos and Mayas suggests a relative panmixia in Guatemala. Mestizos from southeastern Mexico and Guatemala constitute a core of Native American ancestry in Latin America related to the Mayan Empire in Central America. CONCLUSIONS: The higher European admixture and homogeneity in Mexican Mayas of the Yucatan Peninsula suggest more intensive post-Columbian gene flow in this region than in Guatemalan Mayas.

Embarazo espontáneo en una paciente con agenesia de cuello uterino / Spontaneous pregnancy in patient with cervical agenesis

Resumen ANTECEDENTES: La incidencia de agenesia cervical con endometrio funcional se desconoce, aunque se calcula menor a 0.1% en la población general. El pronóstico reproductivo de pacientes con malformaciones müllerianas es limitado y requiere múltiples intervenciones quirúrgicas. CASO CLÍNICO: Paciente primigesta de 21 años, con antecedente de agenesia de cuello uterino y dos tercios superiores de la vagina. Acudió a consulta a las 38.1 semanas de embarazo establecido conforme a la fecha de la última menstruación. Refirió haber concebido de forma espontánea y negó complicaciones durante el embarazo. Se programó para finalizar el embarazo mediante cesárea. El periodo trans y posquirúrgico transcurrió sin complicaciones maternas ni fetales. CONCLUSIÓN: El embarazo espontáneo en pacientes con malformaciones müllerianas debe tratarse a tiempo para asegurar que no surjan complicaciones que pongan en riesgo la vida de la madre y su hijo.

Abstract BACKGROUND: The incidence of cervical agenesis with functional endometrium is unknown, but it's estimated to be less than 0.1% in the general population. The reproductive prognosis in Müllerian malformations is limited and, in most cases, requires multiple surgical interventions to be improved. CASE REPORT: A 21-year-old primiparous patient with a history of agenesis of the cervix and two upper thirds of the vagina. Attended a first-time obstetric appointment at 38.1 weeks of gestation. She refers that the pregnancy was conceived spontaneously and denied complications during pregnancy. A cesarean section was scheduled to end the pregnancy, which had no trans or post-operative maternal-fetal morbidity. CONCLUSIONS: Spontaneous pregnancy in patients with congenital agenesis of the cervix should be addressed in time to ensure a favorable obstetric outcome.

Hábitos de consumo del tabaco en estudiantes de cuarto y quinto año, de la Facultad de Odontología de la Universidad Nacional Autónoma de Honduras, (UNAH). Tegucigalpa, Honduras. Primer Semestre del 2012 / Snuff consumption habits of students in fourth and fifth year, the Faculty of Dentistry at the National Autonomous University of Honduras (UNAH). Tegucigalpa, Honduras. First Half of 2012

Estudio descriptivo. Se concontró que la mayoría de los jóvenes de cuarto y quinto año de la carrera de odontología conviven en familias integradas, y existe una situación familiar y comunitaria de práctica y tolerancia social al consumo de tabaco, puesto que los padres, primos y los profesores de la Facultad también fuman, aparte de que es aceptada en el entorno comunitario

Salud bucal en escolares de la Escuela 11 de Junio de Nueva Suyapa, Tegucigalpa, M.D.C, Honduras. Marzo a Septiembre del 2012 / Buccal health in schoolchildren in the June 11 School of Nueva Suyapa, Tegucigalpa, MDC, Honduras. March to September of 2012

Estudio cuantitativo, descriptivo. Se encontró que se han implementado las acciones tanto preventivas, educativas y de atención en Salud Bucal, dirigidas a mejorar la situación de la Salud Bucal de los escolares. Sin embargo, aunque se realizan evaluaciones de resultados de esta intervención, no se conoce con exactitud los beneficios en materia de Salud Bucal en estos escolares