La sensibilidad ética en personal de enfermería de un hospital rural mexicano / Ethical sensitivity among nursing staff of a rural Mexican hospital / Sensibilidade ética da equipe de enfermagem em um hospital rural mexicano

Introducción: los avances en salud y un entorno sanitario cada vez más exigente están causando diversos problemas éticos. La sensibilidad ética otorga una nueva perspectiva para la toma de decisiones acerca del cuidado. En área rural, la fuerza laboral de salud es un factor que afecta a la comunidad. Objetivo:Determinar el nivel de SE en personal de enfermería de un hospital rural mexicano.Metodología: estudio descriptivo y transversal. La muestra estuvo conformada por 42 profesionales en enfermería, seleccionados mediante muestreo probabilístico aleatorio estratificado; se incluyó personal de cualquier tipo de contratación, edad y sexo que aceptaron participar en el estudio; se excluyeron quienes no asistieron al hospital o no aceptaron participar en el estudio. Se utilizó una cédula de datos sociodemográficos y laborales, así como el Cuestionario de sensibilidad ética.Resultados: el 92,9 % del personal de enfermería reportó un nivel mayor de sensibilidad ética. La dimensión Sentido de la carga moral presentó una media más alta de puntaje con 18,19 (DE = 4,94), seguido de Fortaleza moral con una media de 15,83 (DE = 3,26) y de Responsabilidad moral con una media de 9,00 (DE = 2 , 73 ). No se encontraron diferencias significativas entre la sensibilidad ética y las variables sociodemográficas y laborales, en el puntaje total ni por dimensiones.Conclusiones: el personal enfermero de un hospital rural mexicano mostró en su mayoría un nivel alto de SE, aunque por dimensiones quizás se requiere analizar la dimensión negativa de carga moral y promover la fortaleza y responsabilidad moral.

Introduction: Advances in health and an increasingly demanding healthcare environment are causing various ethical problems. Ethical sensitivity (ES) provides a new perspective for decision-making about care. In rural areas, the health workforce is a factor affecting the community.Objective: To determine the ES level among nursing staff in a rural Mexican hospital.Methods: This is a descriptive and cross-sectional study. The sample consisted of 42 nursing professionals selected using stratified random sampling. Staff with any employment contract, age, and sex who agreed to participate in the study were included. Those who did not attend the hospital or did not agree to participate in the study were excluded. A sociodemographic and occupational data questionnaire and the Ethical Sensitivity Questionnaire (ESQ) were used.Results: Of nurses, 92.9% reported a higher ES level. The dimension sense of moral burden presented a higher mean score of 18.19 (SD = 4.94), followed by moral strength with a mean score of 15.83 (SD = 3.26), and moral responsibility with a mean score of 9.00 (SD = 2.73). No significant differences were found between ethical sensitivity and sociodemographic and occupational variables, either in the total score or the score by dimensions.Conclusions: Most nurses in a rural Mexican hospital showed a high level of ES; however, by dimensions, perhaps it is necessary to analyze the dimension of moral burden and to promote moral strength and responsibility

Introdução: Os avanços na área da saúde e um ambiente de saúde cada vez mais exigente estão causando uma série de problemas éticos. A sensibilidade ética, confere uma nova perspectiva para a tomada de decisões sobre o cuidado. Nas áreas rurais, a força de trabalho em saúde é um fator que afeta a comunidade.Objetivo: Determinar o nível de SE na equipe de enfermagem de um hospital rural mexicano.Metodologia: Estudo descritivo e transversal. A amostra foi de 42 enfermeiros, selecionados por amostragem probabilística, aleatória estratificada, incluindo profissionais de qualquer tipo de contratação, idade e sexo que aceitaram participar no estudo, foram excluídos aqueles que não compareceram ao hospital ou não concordaram em participar do estudo. Utilizou-se uma identificação de dados sociodemográficos e laborais e o questionário de sensibilidade ética. Resultados: 92,9 % da equipe de enfermagem relatou um nível superior de sensibilidade ética. A dimensão sentido de carga moral apresentou maior pontuação média com 18,19 (DP = 4,94), seguida da força moral com média de 15,83 (DP = 3,26) e por fim responsabilidade moral com média de 9 (DP = 2,73). Não foram encontradas diferenças significativas entre a sensibilidade ética e variáveis sociodemográficas e trabalhistas, na escore total nem também não por dimensões.Conclusões: a equipe de enfermagem de um hospital rural mexicano, em sua maioria, apresentou um alto nível de SE, embora por dimensões considera-se necessário analisar a dimensão negativa da carga moral e promover a força e responsabilidade moral.

Caracterización del dengue en el área de internados del Servicio de Pediatría del Hospital de Clínicas

RESUMEN El dengue es una patología endémica en varios países de África, Asia y Sudamérica, especialmente del área del Cono Sur. A pesar de que generalmente afecta mayormente a los adultos, en nuestro país la epidemia no dejó de afectar a los niños. El objetivo del presente estudio fue describir características clínico - epidemiológicas de los pacientes pediátricos hospitalizados por dengue en la Cátedra de Pediatría, en el periodo comprendido entre octubre del 2019 a marzo de 2020. Se realizó un estudio de tipo observacional, descriptivo con componente analítico, de corte transversal, en el que se incluyeron pacientes de 0 a 17 años con el diagnóstico probable dengue o confirmado. El reclutamiento de la muestra se realizó en forma no probabilística por conveniencia en base al total de pacientes que cumplieran los criterios de inclusión. Los datos obtenidos fueron obtenidos de las historias clínicas de los pacientes que reunían los criterios de inclusión e introducidos a una base de datos del programa Excel ® de Microsoft Office 2007 y se trasladaron al paquete estadístico Stata v14. Fueron incluidos un total de 109 pacientes, 60 (55%) fueron de sexo femenino y 49 (45%) de sexo masculino con un promedio de edad de 9 años. El síntoma más frecuente fue la fiebre 105 (98,1%), seguido de cefalea 35 (33%), náuseas y vómitos 33 (31,1%) y mialgias 25 (23,6%). El 46.29% (50/109) presentaron signos de alarma; siendo el signo más frecuente el dolor abdominal y siendo que el 66.7% (72/109) fueron casos del grupo B2. Al momento de su internación los pacientes se encontraban en su día 3,5 de enfermedad y permanecieron internados en promedio 3,98 días. Durante la internación 33 (31,3%) pacientes requirieron expansiones. En cuanto a los hallazgos laboratoriales, el hematocrito al ingreso fue de 40,3±7, los leucocitos fueron en promedio de 5.573±3.862 y plaquetas de 187.054±100.649. La plaquetopenia ≤100.000 fue significativamente más frecuente en los pacientes con signos de alarma (p: 0,02 OR: 3,73 IC: 1,02 - 13,88). La letargia fue significativamente más frecuente en los pacientes con comorbilidades (p: 0,02. OR: 5,64 IC: 1,05 - 44,02). La mayoría de los pacientes presentaron buena evolución y fueron dados de alta y solo uno (0,91%) obitó. Los casos de dengue en pacientes hospitalizados fueron más frecuentes en el grupo de adolescentes y en el sexo femenino. La mayoría fueron del grupo B2, siendo el síntoma más frecuente la fiebre y entre los signos de alarma lo más frecuente fue el dolor abdominal. La mayoría de los pacientes acudieron a consultar en el día 4 de inicio de los síntomas y la duración promedio de las internaciones fue cercana a los 3 días, con una letalidad de 0,9%.

ABSTRACT Dengue is an endemic disease in several countries in Africa, Asia and South America, especially in the Southern Cone area. Although it generally affects mostly adults, in our country the epidemic did not stop affecting children. The objective of the present study was to describe clinical-epidemiological characteristics of pediatric patients hospitalized for dengue in the Department of Pediatrics, in the period between October 2019 and March 2020. An observational, descriptive, cross-sectional study with an analytical component was carried out, in which patients aged 0 to 17 years with a probable or confirmed diagnosis of dengue were included. The sample was recruited in a non-probabilistic manner for convenience based on the total number of patients who met the inclusion criteria. The data were obtained from the medical records of the patients who met the inclusion criteria and entered into a database of the Microsoft Office 2007 Excel ® program and transferred to the statistical package Stata v14. A total of 109 patients were included, 60 (55%) were female and 49 (45%) male with a mean age of 9 years. The most frequent symptom was fever 105 (98.1%), followed by headache 35 (33%), nausea and vomiting 33 (31.1%) and myalgia 25 (23.6%). 46.29% (50/109) presented warning signs; abdominal pain being the most frequent sign and 66.7% (72/109) were cases of severe dengue. At the time of hospitalization, the patients were on their 3.5th day of illness and remained hospitalized for an average of 3.98 days. During hospitalization, 33 (31.3%) patients required expansions. Regarding the laboratory findings, the hematocrit at admission was 40.3±7, leukocytes were on average 5,573±3,862 and platelets 187,054±100,649. Platetopenia ≤100,000 was significantly more frequent in patients with warning signs (p: 0.02 OR: 3.73 CI: 1.02 - 13.88). Lethargy was significantly more frequent in patients with comorbidities (p: 0.02. OR: 5.64 CI: 1.05 - 44.02). Most of the patients had a good evolution and were discharged and only one (0.91%) died. The cases of dengue in hospitalized patients were more frequent in the group of adolescents and in the female sex. Most were from group B2, the most frequent symptom being fever and among the alarm signs the most frequent was abdominal pain. Most of the patients attended the clinic on day 4 of the onset of symptoms and the average duration of hospitalization was close to 3 days, with a case fatality rate of 0.9%.

Prevalence of alcohol consumption in nursing students. / Prevalencia de consumo de alcohol en estudiantes universitarios de enfermería.

Introduction: Alcohol consumption is a public health problem that affects university students. The legality of alcohol facilitates consumption among the young and makes it the most used drug in this population, impacting health and university education. Objective: To identify alcohol consumption among nursing students of a public institution in Minatitlán, Veracruz, Mexico. Methods: Descriptive cross-sectional study, conducted between October and November 2020. A total of 260 nursing students participated voluntarily and anonymously. The information was collected using two instruments. The first one inquired about personal data, and the second one evaluated drinking through the Alcohol Use Disorders Identification Test (AUDIT). Results: We found that 64.6% of students reported drinking at least once, with a mean age at drinking onset of 16.3 years. The preferred beverage was beer (53.6%), and the main providers of alcoholic beverages were friends (62.5%) and family (34.5%). A total of 59.6% of students had a low risk drinking patter, 4.6% had a high-risk drinking patter, and 0.4% reported dependence. There were no significant differences between drinking patterns and leisure time activities (X2 = 25.970; p = 0.355). There was a significant relationship between students' alcohol consumption patterns and age, current semester, drinking at least once, and drinking with family and friends (p < 0.01). Conclusions: There is a close relationship between the initiation and maintenance of alcohol consumption with nursing students' social, family, and school context. These findings should encourage health programs that follow up on alcohol consumption during university training.

Introducción: El consumo de alcohol es un problema de salud pública, que afecta la vida de los jóvenes universitarios. Esto debido a que, al ser una droga de tipo legal, estimula el consumo y hace que se coloque como la de mayor uso con impacto en la salud y la formación universitaria. Objetivo: Identificar el consumo de alcohol en estudiantes universitarios de enfermería de una institución pública de Minatitlán Veracruz, México. Métodos: Estudio descriptivo y transversal, realizado entre octubre y noviembre de 2020. Participaron de forma voluntaria y anónima 260 estudiantes universitarios de licenciatura en enfermería. La información fue recolectada mediante dos instrumentos. El primero indagó datos personales y el segundo fue el Test de Identificación de los Trastornos Debidos al Consumo de Alcohol (AUDIT). Resultados: El 64,6% de los estudiantes indicó consumo de alcohol alguna vez en la vida, con inicio a los 16,3 años. La bebida de preferencia fue la cerveza (53,6%). Los principales proveedores de la bebida alcohólica fueron amigos (62,5%) y familiares (34,5%). El 59,6% tiene consumo de bajo riesgo, 4,6% consume de riesgo y 0,4% reporta dependencia. No hubo diferencias significativas entre el patrón de consumo y las actividades en el tiempo libre (X2 = 25,970; p = 0,355). Se encontró relación de los patrones de consumo de alcohol de los estudiantes con la edad, semestre que cursa actualmente, consumo alguna vez en la vida, así como el consumo de la familia y los amigos (p < 0,01). Conclusiones: Existe una estrecha relación entre el inicio y mantenimiento del consumo de alcohol con el contexto social, familiar y escolar de los estudiantes de enfermería. Este resultado indica la necesidad de realizar programas de salud que den seguimiento al consumo durante la formación universitaria.

Prevalencia de consumo de alcohol en estudiantes universitarios de enfermería / Prevalence of alcohol consumption in nursing students

Introducción El consumo de alcohol es un problema de salud pública, que afecta la vida de los jóvenes universitarios. Esto debido a que, al ser una droga de tipo legal, estimula el consumo y hace que se coloque como la de mayor uso con impacto en la salud y la formación universitaria. Objetivo Identificar el consumo de alcohol en estudiantes universitarios de enfermería de una institución pública de Minatitlán Veracruz, México. Métodos Estudio descriptivo y transversal, realizado entre octubre y noviembre de 2020. Participaron de forma voluntaria y anónima 260 estudiantes universitarios de licenciatura en enfermería. La información fue recolectada mediante dos instrumentos. El primero indagó datos personales y el segundo fue el Test de Identificación de los Trastornos Debidos al Consumo de Alcohol (AUDIT). Resultados El 64,6% de los estudiantes indicó consumo de alcohol alguna vez en la vida, con inicio a los 16,3 años. La bebida de preferencia fue la cerveza (53,6%). Los principales proveedores de la bebida alcohólica fueron amigos (62,5%) y familiares (34,5%). El 59,6% tiene consumo de bajo riesgo, 4,6% consume de riesgo y 0,4% reporta dependencia. No hubo diferencias significativas entre el patrón de consumo y las actividades en el tiempo libre (X2 = 25,970; p = 0,355). Se encontró relación de los patrones de consumo de alcohol de los estudiantes con la edad, semestre que cursa actualmente, consumo alguna vez en la vida, así como el consumo de la familia y los amigos (p < 0,01). Conclusiones Existe una estrecha relación entre el inicio y mantenimiento del consumo de alcohol con el contexto social, familiar y escolar de los estudiantes de enfermería. Este resultado indica la necesidad de realizar programas de salud que den seguimiento al consumo durante la formación universitaria.

Introduction Alcohol consumption is a public health problem that affects university students. The legality of alcohol facilitates consumption among the young and makes it the most used drug in this population, impacting health and university education. Objective To identify alcohol consumption among nursing students of a public institution in Minatitlán, Veracruz, Mexico. Methods Descriptive cross-sectional study, conducted between October and November 2020. A total of 260 nursing students participated voluntarily and anonymously. The information was collected using two instruments. The first one inquired about personal data, and the second one evaluated drinking through the Alcohol Use Disorders Identification Test (AUDIT). Results We found that 64.6% of students reported drinking at least once, with a mean age at drinking onset of 16.3 years. The preferred beverage was beer (53.6%), and the main providers of alcoholic beverages were friends (62.5%) and family (34.5%). A total of 59.6% of students had a low risk drinking patter, 4.6% had a high-risk drinking patter, and 0.4% reported dependence. There were no significant differences between drinking patterns and leisure time activities (X2 = 25.970; p = 0.355). There was a significant relationship between students' alcohol consumption patterns and age, current semester, drinking at least once, and drinking with family and friends (p < 0.01). Conclusions There is a close relationship between the initiation and maintenance of alcohol consumption with nursing students' social, family, and school context. These findings should encourage health programs that follow up on alcohol consumption during university training.

Expectativas hacia el consumo de Alcohol en estudiantes de primaria / Expectations toward alcohol consumption in elementary school students

Objetivo: indagar las expectativas sobre el consumo de alcohol que poseen los niños estudiantes de quinto año de primaria. Metodología: Estudio descriptivo, transversal, realizado en estudiantes de quinto año de primaria de Minatitlán, Veracruz (México). La muestra fueron 384 estudiantes, seleccionados mediante muestreo aleatorio simple. Se utilizó la escala de Expectativas hacia el Consumo de Alcohol para niños CEA-N. El análisis descriptivo fue complementado con la prueba Chi cuadrado, U de Mann-Whitney y Regresión logística. Resultados: La expectativa positiva sociabilidad mostró diferencias significativas para el consumo alguna vez en la vida (z=-3.679, p<.01), en el último año (z=-2.230, p<.05), en el último mes (z=-2.901, <.01), en la última semana (z=-2.101, p=.036). La expectativa negativa estados negativos (z=-2.531, p<.05) mostró diferencias para el consumo alguna vez en la vida. Conclusión: El consumo de alcohol de los niños y niñas se asoció a las expectativas positivas de sociabilidad, consumo de padres y amigos.(AU)

Objective: Investigate expectations about alcohol consumption among fifth grade elementary school students. Methods: Descriptive and transversal study, carried out in primary school students in Minatitlán, Veracruz (Mexico). The sample consisted in 384 students, selected by simple random sampling. It was used the scale of Expectations towards Alcohol Consumption for children CEA-N. Descriptive analysis was complemented with Chi-square test, Mann-Whitney U test and logistic regression. Results: The positive expectancy sociability showed significant differences for consumption ever in life (z=-3.679, p<.01), in the last year (z=-2.230, p<.05), in the last month (z=-2.901, <.01), in the last week (z=-2.101, p=.036). The negative expectancy negative states (z=-2.531, p<.05) showed differences in consumption ever in life. Conclusions: Children's alcohol consumption was associated with positive expectancies of sociability, parental and friend consumption.(AU)

Intervención de enfermería para disminuir la depresión en pacientes con diálisis peritoneal en un hospital de Veracruz / Nursing intervention to reduce depression in patients with peritoneal dialysis in a Veracruz hospital

Introducción: la depresión en personas con enfermedad renal crónica (ERC) tiene efectos en el cumplimiento y aceptación del régimen terapéutico empleado. Objetivo: evaluar la eficacia de una intervención psicoeducativa de enfermería en la disminución de los síntomas de depresión en pacientes adscritos al Programa de Diálisis Peritoneal del Hospital General de Zona No.32 de Minatitlán, Veracruz. Metodología: estudio cuasi experimental; la muestra se integró con 8 pacientes y el muestreo se estableció por conveniencia. Se utilizó el inventario de depresión de Beck II y se aplicó una intervención de enfermería. Resultados: participaron más mujeres (75%), con 50% que utiliza DPA y 50% DPCA. La depresión mínima (37.5%) y la depresión leve (37.5%) predominaron antes de la intervención; luego de la intervención predominó el grado de depresión mínima (87.5%). La media fue de 14.88 en la prueba preliminar y 5.88 en la posterior (p = 0.007). Conclusiones: la intervención de enfermería mostró eficacia al disminuir los grados de depresión en los pacientes con ERC.

Introduction: Depression in a person with chronic kidney disease (CKD), has an impact on the fulfillment and acceptance of the therapeutic regimen used. Objective: To evaluate the efficacy of a psychoeducational nursing intervention to reduce depression symptoms in patients assigned to the peritoneal dialysis program of the General Hospital of Zone No.32 of Minatitlán, Ver. Methods: Quasi-experimental, study. Sample was 8 patients. Sampling was by Convenience. The Beck-II Depression Inventory was used; a nursing psychoeducational intervention was applied. Results: Most of the participants were women (75%); 50% uses DPA and 50% DPCA. Minimum depression (37.5%) and mild depression (37.5%) predominated before the intervention; after intervention, the minimum depression level predominated (87.5%). The average in the Pretest was 14.88 and 5.88 in the Posttest (p = .007). Conclusion: The nursing psychoeducational intervention showed efficacy to decrease depression levels in the group of CKD patients studied.

Consumo de alcohol en mujeres universitarias del Sur del Estado de Veracruz, México / Alcohol Consumption in University Female Students from the South of the State of Veracruz, Mexico / Consumo de álcool em mulheres universitárias do Sul do Estado de Veracruz, México

Introducción: el consumo de alcohol en las mujeres es una problemática cada día mayor, debido al aumento en los patrones nocivos y la edad a la que inician el consumo, por lo que representa un tema de vital relevancia en la agenda de la salud pública mundial. Objetivo: identificar el consumo de alcohol en mujeres universitarias del Sur del Estado de Veracruz, México. Método: estudio cuantitativo, descriptivo y transversal. Participaron 229 mujeres estudiantes de una universidad tecnológica de la zona sur del estado de Veracruz México, seleccionadas mediante muestreo probabilístico aleatorio simple, estratificado. Se utilizó un instrumento de recolección de datos personales y el Test de Identificación de los Trastornos debidos al Consumo de Alcohol (Audit). Resultados: se identificó que la media de edad de inicio de consumo fue de 17,1 años, 55,8% de las participantes refirieron consumo de alcohol en el último año, la bebida preferida fue la cerveza (27%), 67,2% de las universitarias tiene consumo de bajo riesgo, 27,3% consumo de riesgo, 4,7% consumo perjudicial y 0,8% consumo dependiente. Las estudiantes de Ingeniería Química Industrial reportan mayor consumo de riesgo (11,7%), perjudicial (1,6%) y dependiente (0,8%). Conclusiones: más de la mitad de las participantes reportaron ingerir bebidas alcohólicas, con patrones de consumo de riesgo, mostrando la vulnerabilidad en la que se encuentran para adoptar conductas que ponen en riesgo su salud.

Introduction: the consumption of alcohol in women is a problem that grows every day due to the increase in harmful patterns and the age at which they start consumption. Therefore, it has become an issue of utmost relevance in the global public health agenda. Objective: to identify alcohol consumption in university female students from the south of the State of Veracruz, Mexico. Method: quantitative, descriptive, and cross-sectional study in which 229 female students from a technological university in the southern zone of the state of Veracruz, Mexico, participated. They were selected by simple, stratified random probability sampling. A personal data collection instrument and the Alcohol Use Disorders Identification Test (AUDIT) were used. Results: we identified that the mean age when consumption started was 17.1 years; 55.8% of the participants reported alcohol consumption in the last year; the preferred drink was beer (27%); 67.2% of the university students had low risk consumption, 27.3% had high-risk consumption, 4.7% harmful consumption, and 0.8% dependence consumption. Industrial Chemistry Engineering students report a higher high-risk (11.7%), harmful (1.6%), and dependence (0.8%) consumption. Conclusions: more than half of the participants reported drinking alcoholic beverages, with high-risk consumption patterns, showing how vulnerable they are to adopt behaviors that put their health at risk.

Introdução: o consumo de álcool em mulheres é uma problemática a cada dia maior, devido ao aumento dos padrões nocivos e à idade em que iniciam o consumo, pelo qual representa um tema de vital relevância na agenda global de saúde pública. Objetivo: identificar o consumo de álcool em mulheres universitárias do Sul do Estado de Veracruz, México. Método: estudo quantitativo, descritivo e transversal. Participaram 229 mulheres alunas de uma universidade tecnológica da zona sul do estado de Veracruz México, selecionadas mediante amostragem probabilística aleatória simples, estratificada. Foi utilizado um instrumento de coleta de dados pessoais e o Teste de Identificação de Transtornos devidos ao Consumo de Álcool (Audit). Resultados: identificou-se que a idade média de início de consumo foi 17,1 anos, 55,8% das participantes referiram consumo de álcool no último ano, a bebida preferida foi cerveja (27%), 67,2% das universitárias tem consumo de baixo risco, 27,3% consumo de risco, 4,7% consumo prejudicial e 0,8% consumo dependente. As alunas de Engenharia Química Industrial relatam maior consumo de risco (11,7%), prejudicial (1,6%) e dependente (0,8%). Conclusões: mais da metade das participantes relatam ingerir bebidas alcoólicas, com padrões de consumo de risco, evidenciando a vulnerabilidade em que estão para adotar comportamentos que colocam em risco sua saúde.

Athetoid Movements as Initial Manifestation of Primary Sjögren Syndrome.

Background: Primary Sjögren syndrome (pSS) is an autoimmune disorder characterized by exocrine gland and extraglandular symptoms. We present a case report of pSS with an initial presentation of athetoid movements. Case Report: A 74-year-old female presented with a 2-month history of slow undulating movements in her trunk and thighs that eventually spread to her neck and lower extremities. She also reported dry eyes, dry mouth, as well as pain in her shoulders and thighs. Her proinflammatory markers and rheumatologic profile were positive. Her salivary gland biopsy revealed a Focus score > 2. Brain magnetic resonance imaging was normal. A diagnosis of pSS was made. The patient's symptoms improved with hydroxychloroquine, pilocarpine, gabapentin, and clonazepam. Discussion: Clinicians should consider and screen for primary autoimmune disorders as a cause of subacute athetoid movements in elderly patients. Although aggressive treatment has been recommended, treatment should be tailored to each patient's specific needs.

"A dismantled society": meta-synthesis of the phenomenon of violence in indigenous populations.

OBJECTIVE: To analyze publications of qualitative studies that addressed the phenomenon of violence in indigenous population. METHOD: Meta-synthesis of studies published in the period of 2006 to 2016, with search in the Ebsco Host, Cuiden Plus, Science Direct, Springer, and Web of Science databases. RESULTS: A new reinterpretation of the findings was generated from the codes and categories of the primary articles. Five categories emerged: living violence, factors associated with patterns of violence, consequences of violence, interaction dynamics in situations of violence, and how to deal with violence. CONCLUSIONS: Indigenous people experience different types of violence at an early age; experienced in the family. This makes it an emerging social problem that must be taken care of urgently and represents an area of opportunity for the nursing professionals whose central focus is human care.

"A dismantled society": meta-synthesis of the phenomenon of violence in indigenous populations / "Uma sociedade desmantelada": metassíntese do fenômeno da violência nas populações indígenas / "Una sociedad desmantelada": metasíntesis del fenómeno de violencia en poblaciones indígenas

Abstract OBJECTIVE To analyze publications of qualitative studies that addressed the phenomenon of violence in indigenous population. METHOD Meta-synthesis of studies published in the period of 2006 to 2016, with search in the Ebsco Host, Cuiden Plus, Science Direct, Springer, and Web of Science databases. RESULTS A new reinterpretation of the findings was generated from the codes and categories of the primary articles. Five categories emerged: living violence, factors associated with patterns of violence, consequences of violence, interaction dynamics in situations of violence, and how to deal with violence. CONCLUSIONS Indigenous people experience different types of violence at an early age; experienced in the family. This makes it an emerging social problem that must be taken care of urgently and represents an area of opportunity for the nursing professionals whose central focus is human care.

Resumo OBJETIVO Analisar as publicações de estudos qualitativos que abordaram o fenômeno da violência na população indígena. MÉTODO Trata-se de uma metassíntese de estudos publicados entre os anos de 2006 a 2016, indexados nas bases de dados eletrônicos Ebsco Host, Cuiden Plus, Science Direct, Springer, e Web of Science. RESULTADO Uma nova reinterpretação dos códigos e das categorias de artigos primários foi gerada. Emergiram cinco categorias: viver a violência, fatores associados aos padrões de violência, consequências da violência, interação dinâmica nas situações de violência, e como a violência é enfrentada. CONCLUSÕES Os povos indígenas experimentam diferentes tipos de violência desde a infância, vividos no seio familiar. Isto se converte em um problema social emergente, que deve ser abordado com urgência, e representa uma área que precisa de atenção dos profissionais de enfermagem, cujo foco principal é o cuidado humano.

Resumen OBJETIVO Analizar las publicaciones de estudios cualitativos que abordaron el fenómeno de violencia en población indígena. MÉTODO Metasíntesis de estudios publicados en el periodo 2006 al 2016, con búsqueda en la base de datos Ebsco Host, Cuiden Plus, Science Direct, Springer, y Web of Science. RESULTADOS Se generó una nueva reinterpretación a partir de los códigos y categorías de los artículos primarios. Emergieron cinco categorías: vivir la violencia, factores asociados a los patrones de violencia, consecuencias de la violencia, dinámicas de interacción en situaciones de violencia y cómo enfrentar la violencia. CONCLUSIONES Las personas indígenas experimentan diferentes tipos de violencia a edad temprana; vividas en el seno familiar. Esto la convierte en un problema social emergente que debe ser atendido con urgencia y representa un área de oportunidad para el profesional de enfermería cuyo foco central es el cuidado humano.

High frequency of primary refractory disease and low progression-free survival rate of Hodgkin's lymphoma: a decade of experience in a Latin American center

Abstract Background: Reports dealing with clinical outcomes of classical Hodgkin's lymphoma in low- to middle-income countries are scarce and response to therapy is poorly documented. This report describes the characteristics and clinical outcomes of patients with classical Hodgkin's lymphoma from a single institution in Latin America. Method: A retrospective study was conducted over ten years of patients with classical Hodgkin's lymphoma treated at a referral center. Progression-free and overall survival rates were estimated by Kaplan-Meier analysis. The univariate Cox regression model was used to estimate associations between important variables and clinical outcomes. Main results: One hundred and twenty-eight patients were analyzed. The mean age was 28.5 years. The five-year progression-free and overall survival were 37.3% and 78.9%, respectively. Of the whole group, 55 (43%) were primary refractory cases. Only 39/83 (47%) patients with advanced disease vs. 34/45 (75.6%) in early stages (p-value = 0.002) achieved complete remission. Those with advanced disease had a five-year overall survival of 68.7% vs. 91.8% for early disease (p-value = 0.132). Thirty-one patients relapsed (24.2%) and 20 (64.5%) received a transplant. The hazard ratio for progression with bone marrow infiltration was 2.628 (p-value = 0.037). For death, an International Prognostic Score ≥4 had a hazard ratio of 3.355 (p-value = 0.050) in univariate analysis. Two-thirds of classical Hodgkin's lymphoma patients diagnosed at advanced stages had a low progression-free survival but an overall survival similar to high-income countries. Conclusion: Patients diagnosed with classical Hodgkin's lymphoma in Northeastern Mexico had a significantly low progression-free survival rate and presented with advanced disease, underscoring the need for earlier diagnosis and improved contemporary therapeutic strategies in these mainly young productive-age Hodgkin's lymphoma patients.

High frequency of primary refractory disease and low progression-free survival rate of Hodgkin's lymphoma: a decade of experience in a Latin American center.

BACKGROUND: Reports dealing with clinical outcomes of classical Hodgkin's lymphoma in low- to middle-income countries are scarce and response to therapy is poorly documented. This report describes the characteristics and clinical outcomes of patients with classical Hodgkin's lymphoma from a single institution in Latin America. METHOD: A retrospective study was conducted over ten years of patients with classical Hodgkin's lymphoma treated at a referral center. Progression-free and overall survival rates were estimated by Kaplan-Meier analysis. The univariate Cox regression model was used to estimate associations between important variables and clinical outcomes. MAIN RESULTS: One hundred and twenty-eight patients were analyzed. The mean age was 28.5 years. The five-year progression-free and overall survival were 37.3% and 78.9%, respectively. Of the whole group, 55 (43%) were primary refractory cases. Only 39/83 (47%) patients with advanced disease vs. 34/45 (75.6%) in early stages (p-value=0.002) achieved complete remission. Those with advanced disease had a five-year overall survival of 68.7% vs. 91.8% for early disease (p-value=0.132). Thirty-one patients relapsed (24.2%) and 20 (64.5%) received a transplant. The hazard ratio for progression with bone marrow infiltration was 2.628 (p-value=0.037). For death, an International Prognostic Score ≥4 had a hazard ratio of 3.355 (p-value=0.050) in univariate analysis. Two-thirds of classical Hodgkin's lymphoma patients diagnosed at advanced stages had a low progression-free survival but an overall survival similar to high-income countries. CONCLUSION: Patients diagnosed with classical Hodgkin's lymphoma in Northeastern Mexico had a significantly low progression-free survival rate and presented with advanced disease, underscoring the need for earlier diagnosis and improved contemporary therapeutic strategies in these mainly young productive-age Hodgkin's lymphoma patients.

Nivel de depresión en los pacientes con tratamiento de diálisis peritoneal en un hospital de Minatitlán, Veracruz, México / Level of depression in patients with peritoneal dialysis treatment in a hospital in Minatitlán, Veracruz, Mexico

Resumen

Introducción: la depresión es el trastorno mental que más afecta a los individuos y un grupo vulnerable son los pacientes con enfermedades crónicas como la diabetes mellitus y la enfermedad renal crónica (ERC), entre otras.

Objetivo: describir el nivel de depresión en los pacientes que reciben tratamiento de diálisis peritoneal en dos modalidades.

Metodología: estudio descriptivo transversal con una muestra de 26 pacientes con tratamiento de diálisis peritoneal. Para valorar el nivel de depresión se aplicó el Inventario de depresión de Beck.

Resultados: la edad promedio fue de 55.6 años. Predominaron las mujeres en el 57.7% y el estado civil casado, con 65.4%. El 100% de los pacientes presentó depresión: 65.4% en nivel mínimo, 19.2% en nivel moderado y 15.4% en nivel leve. No se encontró significación entre el nivel de depresión y la modalidad de diálisis peritoneal.

Conclusiones: la depresión se presentó en todos los pacientes con diálisis peritoneal, probablemente por el cambio radical en su entorno, la incertidumbre de saber qué va a pasar con su vida, las limitaciones a partir del tratamiento y las modificaciones socioeconómicas que puedan atribuirse para el adecuado tratamiento de la enfermedad.

Abstract

Introduction: Depression is the mental disorder that affects most individuals. A vulnerable group are patients with chronic diseases such as diabetes mellitus and chronic kidney disease, among others.

Objective: To describe the level of depression in patients receiving peritoneal dialysis treatment in two types.

Methods: Descriptive cross-sectional study with a sample of 26 patients with peritoneal dialysis treatment. To assess the level of depression the Beck Depression Inventory was applied.

Results: The average age was 55.6 years. There were more women, with 57.7%, and the main marital status was married, with 65.4%. All the patients had depression: 65.4% at minimum level, 19.2% moderate level and 15.4% mild level. No significance was found between the level of depression and the type of peritoneal dialysis.

Conclusions: All the patients with peritoneal dialysis had depression, probably due to the radical change in their environment. The uncertainty of knowing what is going to happen with their life, the limitations from the treatment and the socioeconomic modifications that can be attributed to the adequate treatment of the disease.

Estudio comparativo de morbimortalidad del prematuro tardío y el recién nacido de termino. Hospital de Clínicas. Asunción, Paraguay

Introducción: Comparado con el recién nacido a término, la tasa de morbimortalidad en el prematuro tardío es mayor a causa de las características específicas limítrofes que presentan en sus diferentes órganos. Objetivos: Describir las causas, las características clínicas y determinar la incidencia y la tasa de mortalidad de prematuros tardíos en comparación con los recién nacidos de término en un Departamento de Neonatología. Materiales y Métodos: Estudio observacional analítico retrospectivo, muestreo no probabilístico de casos consecutivos de recién nacidos prematuros tardíos, así como el siguiente recién nacido de término, de las fichas clínicas para una relación 1/1. Resultados: Durante el año 2012 nacieron 2741 RN vivos, 210 fueron RN prematuros tardíos (7,6%). El 61% de los nacimientos fue por parto normal en RN de término, y por cesárea 60% en RN pretérmino tardío (p=0,003). Presentaron alguna complicación posterior al nacimiento 95/210 de los RN pretérmino tardíos (45%), y 11/210 de los RN de término (5%) con un OR de 14,9 (IC= 7-29, P < 0.0001). La complicación más frecuente fue la dificultad respiratoria en 54/210 RN pretérmino tardíos y así como en 8/210 RNT, requerimiento de luminoterapia en 41/210 RN pretérmino tardíos y en 8/210 RNT. Se encontraron diferencias significativas en la presencia de dificultad respiratoria OR 8,74, requerimiento de luminoterapia OR 6, de antibioticoterapia OR 6 y de ingreso a terapia intensiva 9,6. No se detectó diferencias significativas en cuanto al óbito de los pacientes (p=0.29). Conclusiones: Los RN pretérminos tardíos presentan mayor morbilidad que los nacidos a término. La incidencia de RN pretérmino tardíos fue similar a lo encontrado a nivel mundial. La causa más frecuentemente asociada fue el elevado número de cesáreas. En comparación con los de término, presentaron mayor número de complicaciones como dificultad respiratoria y requerimiento de luminoterapia, y mayor tiempo de hospitalización.

Introduction: Compared with term newborns, the morbidity and mortality rate in late prematurity is higher because of the specific borderline development of the different organ systems. Objectives: To describe the causes, clinical characteristics and determine the incidence and mortality rate of late preterm infants compared with term infants in a Neonatology Department. Materials and Methods: This was a retrospective analytical observational study, with non-probabilistic sampling of consecutive cases of late preterm infants, as well as the following term newborn, as obtained from clinical records for a 1/1 ratio. Results: During 2012, 2741 live births were born, 210 were premature newborns (7.6%). 61% of births were due to normal delivery in term newborns, and 60% in late preterm newborns (p = 0.003). There were 95/210 complications of late preterm infants (45%) and 11/210 of term infants (5%) with an OR of 14.9 (CI = 7-29, P <0.0001) . The most frequent complication was respiratory distress in 54/210 late preterm infants, as well as in 8/210 in term newborns; luminotherapy in 41/210 late preterm infants and 8/210 in term newborns. Significant differences were found in the presence of respiratory distress, OR 8.74, luminotherapy, OR 6, antibiotic therapy, OR 6, and admission to intensive care unit, OR 9,6. There were no significant differences in patient deaths (p = 0.29). Conclusions: Late preterm infants present higher morbidity than those born at term. The incidence of late preterm newborns was similar to that found worldwide. The most frequent associated cause was a high number of cesarean sections. Compared with term newborns, late preterm newborns developed a greater number of complications such as respiratory distress and light therapy requirements, and longer hospitalization time.

Altered CSF cytokine network in amyotrophic lateral sclerosis patients: A pathway-based statistical analysis.

INTRODUCTION: Increased cytokine expression is a prominent finding in amyotrophic lateral sclerosis (ALS). Due to their interdependence and pleiotropism, interpretation of CSF concentrations of a single cytokine is challenging. We describe a cytokine analysis in ALS patients using a pathway-based statistical method to identify changes in the whole cytokine network. METHODS: We analyzed 19 cytokines in CSF of ALS patients and controls. An equality of concentration matrices was conducted that allowed us to evaluate disturbances in the relationship of cytokines between controls and ALS patients with less and more than 12months of disease length. MANOVA assessed differences in cytokines and interdependence was compared by partial correlations among specific pairs of cytokines. RESULTS: Seventy-seven ALS patients and 13 control subjects were included. Significant differences were identified in the cytokine pathway between controls and ALS patients with less (p<0.0001) and more than 12months of disease length (p<0.0001), and between ALS patients with less than 12months and those with more than 12months (p=0.0058). In ALS patients with a shorter disease length, IL4 and IL6 were negatively correlated (-0.3571), whereas in ALS>12months, a positive correlation was detected (0.4080). CONCLUSIONS: The pathway-based statistical method revealed remarkable variations in the whole cytokine pathway in ALS patients and controls. Cytokine-network changes and the positive correlation between IL4 and IL6 were related to disease length; these variations might explain the deleterious immunological effects on motor neurons. A further analysis using this method is needed to confirm the exact interaction among cytokines in ALS.

ZO-2 silencing induces renal hypertrophy through a cell cycle mechanism and the activation of YAP and the mTOR pathway.

Renal compensatory hypertrophy (RCH) restores normal kidney function after disease or loss of kidney tissue and is characterized by an increase in organ size due to cell enlargement and not to cell proliferation. In MDCK renal epithelial cells, silencing of the tight junction protein zona occludens 2 (ZO-2 KD) induces cell hypertrophy by two mechanisms: prolonging the time that cells spend at the G1 phase of the cell cycle due to an increase in cyclin D1 level, and augmenting the rate of protein synthesis. The latter is triggered by the nuclear accumulation and increased transcriptional activity of Yes-associated protein (YAP), the main target of the Hippo pathway, which results in decreased expression of phosphatase and tensin homologue. This in turn increased the level of phosphatidylinositol (3,4,5)-triphosphate, which transactivates the Akt/mammalian target of rapamycin pathway, leading to activation of the kinase S6K1 and increased synthesis of proteins and cell size. In agreement, in a rat model of uninephrectomy, RCH is accompanied by decreased expression of ZO-2 and nuclear expression of YAP. Our results reveal a novel role of ZO-2 as a modulator of cell size.

Fibrosis pulmonar idiopática en un ecuatoriano adulto de la provincia de Riobamba / Idiopathic lung fibrosis in an adult Ecuadorian from Riobamba province

Se presenta el caso clínico de un paciente de 52 años, expuesto a las cenizas del volcán Tungurahua en erupción, quien acudió a la Consulta de Medicina Familiar Comunitaria del Cantón Guano, provincia ecuatoriana de Riobamba, por presentar cuadro de tos productiva en horario matutino, mucoide de coloración blanco amarillenta, toma del estado general, fiebre vespertina, pérdida de apetito y peso. Según los resultados radiográficos y tomográficos presentó signos sugestivos de tuberculosis pulmonar; los esputos BAAR directos y los cultivos negativos. Los hallazgos anatomopatológicos permitieron confirmar el diagnóstico de fibrosis pulmonar idiopática.

The case report of a 52 years patient is presented, exposed to the ashes of Tungurahua volcano in eruption, who went to the Community Family Medicine Department of the Canton Guano, Ecuadorian province of Riobamba, for presenting productive cough in the morning, mucoid of yellowish white coloration, bad general state, evening fever, appetite and weight loss. According to the radiographic and topographic results, he had suggestive signs of lung tuberculosis; direct BAAR sputa and negative cultures. The pathological findings allowed to confirm the diagnosis of idiopathic lung fibrosis.

Fibrosis pulmonar idiopática en un ecuatoriano adulto de la provincia de Riobamba / Idiopathic lung fibrosis in an adult Ecuadorian from Riobamba province

Se presenta el caso clínico de un paciente de 52 años, expuesto a las cenizas del volcán Tungurahua en erupción, quien acudió a la Consulta de Medicina Familiar Comunitaria del Cantón Guano, provincia ecuatoriana de Riobamba, por presentar cuadro de tos productiva en horario matutino, mucoide de coloración blanco amarillenta, toma del estado general, fiebre vespertina, pérdida de apetito y peso. Según los resultados radiográficos y tomográficos presentó signos sugestivos de tuberculosis pulmonar; los esputos BAAR directos y los cultivos negativos. Los hallazgos anatomopatológicos permitieron confirmar el diagnóstico de fibrosis pulmonar idiopática(AU)

The case report of a 52 years patient is presented, exposed to the ashes of Tungurahua volcano in eruption, who went to the Community Family Medicine Department of the Canton Guano, Ecuadorian province of Riobamba, for presenting productive cough in the morning, mucoid of yellowish white coloration, bad general state, evening fever, appetite and weight loss. According to the radiographic and topographic results, he had suggestive signs of lung tuberculosis; direct BAAR sputa and negative cultures. The pathological findings allowed to confirm the diagnosis of idiopathic lung fibrosis(AU)

Estrés laboral en enfermeros de un hospital de Veracruz. México / Occupational stress in nurses at a hospital in Veracruz. México

Resumen:

Objetivo: determinar el nivel de estrés e identificar los principales elementos estresores que afectan a enfermeros de un hospital de segundo nivel de la Secretaría de Salud en el Sur de Veracruz, México. Método: estudio descriptivo y transversal. Participaron 41 enfermeros seleccionados mediante muestreo aleatorio simple. Se utilizó la Nursing Stress Scale para medir situaciones percibidas como estresantes, con una confiabilidad de 0,84. Resultados: se encontró que el 100% de los enfermeros presenta algún nivel de estrés, un 65,9% lo presenta a veces y un 34,1% de manera frecuente. El aspecto más afectado fue el físico, la carga de trabajo fue el factor que les genera más estrés (48,8%), seguido de la muerte y el sufrimiento (29,3%); así como la incertidumbre en el tratamiento (29,3%). Los varones se perciben más estresados (83,3%) que las mujeres (25,7%). Conclusiones: los enfermeros se perciben a sí mismos como personas estresadas, con sobrecarga de trabajo y sensibles al sufrimiento de los usuarios.