Reflexiones acerca de algunos de los efectos de la pandemia en la clínica con niños y adolescentes / Reflections on some of the effects of the pandemic in the clinic with children and adolescents / Réflexions sur certains effets de la pandémie dans la clinique avec les enfants et les adolescents / Reflexões sobre alguns dos efeitos da pandemia na clínica com crianças e adolescentes

El presente artículo plantea reflexiones respecto de algunas consecuencias en la clínica con niños/as y adolescentes debidos al impacto de la pandemia por Covid19. Se señala la acción de la incertidumbre y lo imprevisible sobre la subjetividad de la población y se propone recordar los acontecimientos ligados a las medidas de protección (Aislamiento Social Preventivo y Obligatorio, de dos años de duración) y resignificarlos para aventurar una incipiente historización sobre algunos de los efectos que la pandemia produjo sobre la labor clínica con niños/as y adolescentes. A tal fin, se toma como eje conceptual rector el desarrollo freudiano sobre la retracción libidinal y sus consecuencias para el Yo, y los cambios en los recursos técnicos que debieron implementarse al incluirse las sesiones on-line. Se puntualizan las consecuencias perturbadoras de la pandemia respecto de los niños pequeños, con patologías graves y en los adolescentes tomando en cuenta la especificidad de sus características subjetivas AU

The following paper presents reflections on certain consequences on the clinic with children and teenagers due to the impact of the Covid-19 pandemic. The action of uncertainty and the unpredictable on the subjectivity of the population is pointedout and it is proposed to recall the events linked to protection measures (Mandatory Preventive Isolation, lasting two years) and resignify them to venture an incipient historicization about some of the effects that the pandemic produced on clinical work with children and adolescents.For this purpose, the Freudian development on libidinal withdrawal and its consequences for the Self, and the changes in the technical resources that had to be implemented when online sessions were installed, are taken as theguiding conceptual axis. The disturbing consequences of the pandemic are pointed out regarding young children, those with serious pathologies and in adolescents, taking into account the specificity of their subjective characteristics AU

Cet article propose des réflexions concernant certaines conséquences en clinique auprès des enfants et des adolescents dû à l'impact de la pandémie de Covid19. Les conséquences de l'incertitude et de l'imprévisible sur la subjectivité de la population sont dénotées et il est proposé de rappeler les événements liés aux mesures de protection (Isolement Préventif Obligatoire, d'une durée de deux ans) et de les resignifier pour s'aventurer à un début d'historisation de certains des effets que la pandémie a eu sur le travail clinique avec les enfants et les adolescents. Pour cela, le développement freudien sur le retrait libidinal et ses conséquences sur le Moi, et les évolutions des moyens techniques qu'il a fallu mettre en œuvre lors de l'implémentation des séances en ligne, sont pris comme axe conceptuel directeur.Les conséquences inquiétantes de la pandémie sont dénotées concernant les jeunes enfants, atteints de pathologies graves, et les adolescents, tout en prenant en compte la spécificité de leurs caractéristiques subjectives AU

Este artigo traz reflexões sobre algumas consequências na clínica com crianças e adolescentes devido ao impacto da pandemia de Covid19. Aponta-se a ação da incerteza e do imprevisível sobre a subjetividade da população e propõe-se relembrar os eventos vinculados às medidas de proteção (Isolamento Preventivo Obrigatório, com duração de dois anos) e ressignifica esses para arriscar uma incipiente historicização sobre alguns dos efeitos que a pandemia produziu no trabalho clínico com crianças e adolescentes. Para tanto, toma-se como eixo conceitual constitutivo o desenvolvimento freudiano sobre a retirada libidinal e suas consequências para o Ego, e as mudanças nos recursos técnicos que tiveram que ser implementados quando da inclusão das sessões online. As consequências perturbadoras da pandemia são apontadas em relação às crianças pequenas, aos portadores de patologias graves e aos adolescentes, tendo em conta a especificidade das suas características subjetivas AU

Whey protein supplementation and its potentially adverse effects on health: a systematic review.

Whey protein comprises soluble whey proteins and its benefits are well described in the literature. However, there are not many studies investigating the potential adverse effect of a diet with indiscriminate use of this supplement. The aim of this study was to perform a systematic review of papers that addressed this theme. A search was conducted in Medline, LILACS, TOXNET, Web of science, and Scopus electronic databases. In the end, 11 documents comprised this review. The majority of the papers associated the damaging effect with the chronic and abusive use of whey protein, with the kidneys and liver being the main organs affected. The other studies related whey protein to aggravation of aggression, presence of acne, and modification of the microbiota. Therefore, excessive consumption over a long period of protein supplementation may have some adverse effects on the body, which is aggravated when associated with sedentary lifestyle. PROSPERO registration no.: CRD42020140466. Novelty: A systematic review of experimental and randomized studies about the use of whey proteins supplements and its impact on physical health. Analysis revealed that chronic and without professional guidance use of whey protein supplementation may cause some adverse effects specially on kidney and liver function. Presented data support a need for future studies co-relating the use of different types of whey protein with and without exercise to better see the impact on human physical health.

[Systematic review of the impact of chlordecone on human health in the French West Indies]. / Revue systématique de l'impact du chlordécone sur la santé humaine aux Antilles françaises.

INTRODUCTION: Several publications have highlighted the adverse effects of chlordecone on human and animal species. The possible long-term consequences continue to be explored as chlordecone still contaminates Caribbean soils. The objective of this literature review is to determine the long-term effects of chlordecone on human health. MATERIAL AND METHOD: We searched for the keyword "chlordecone" on different scientific databases: Medline®, ISI Web of Knowledge, Google Scholar, EM Premium. We have enriched our research with first degree references, related articles on PubMed and grey literature. RESULTS: Of the 192 articles analyzed, 12 responded to the impact of chlordecone on human health in the French West Indies. In obstetrics, exposure to chlordecone was associated with a lower incidence of gestational hypertension. In pediatrics, these studies have shown an association between prenatal exposure to chlordecone and increased risk of prematurity, decreased birth weight (especially when the mother gained excessive weight during pregnancy), decreased fine cognitive and motor acquisition, and changes in circulating concentrations of certain thyroid hormones. In oncology, exposure was associated with an increased risk of prostate cancer, particularly if there was a family history of prostate cancer. CONCLUSION: While the effects of acute exposure to chlordecone at high doses are well described (Kepone Shake syndrome at the time of the Hopewell accident), the effects at environmental doses are becoming clearer even if they remain complex to identify.

Conocimiento e Implementación de la seguridad del paciente quirúrgico en una institución pediátrica del sureste de México / Knowledge and Implementation of safety in Surgical patients' in a pediatric institution in southeastern Mexico / Conhecimento e Implementaçâo de segurança dos pacientes cirúrgicos numa instituiçâo pediátrica no sudeste do México / Connaissance et mise en œuvre de la sécurité des patients chirurgicaux dans un établissement pédiatrique du sud-est du Mexique

Resumen: Objetivo: Evaluar el nivel de conocimiento e implementación de la seguridad del paciente quirúrgico en una institución pediátrica. Materials and methods: Estudio observacional, descriptivo y de corte transversal, en el periodo comprendido de abril 2014-diciembre 2015. La muestra de 78 profesionales de salud del equipo quirúrgico del Hospital Regional de Alta Especialidad del Niño "Dr. Rodolfo Nieto Padrón" de los diversos turnos laborales, los instrumentos de recolección de datos fueron 1) Cuestionario de conocimiento de seguridad del paciente quirúrgico y 2) Cuestionario de cumplimiento de seguridad quirúrgica. Resultados: El nivel de conocimiento del equipo quirúrgico acerca de la seguridad quirurgica fue bueno en 77% de los participantes. En la evaluación del cumplimiento se sumaron las puntuaciones del total de ítems del instrumento y se dividieron entre el total de las medidas para estimar las medias. Se encontró un promedio de 85.6 % en la fase 1 antes de la anestesia que corresponde a un cumplimiento bueno, en la fase 2 antes de la incisión de la piel 79.86% o cumplimiento regular y en los factores del entorno interno y externo del área quirúrgica que influyen en la seguridad del paciente quirúrgico de la fase 3, antes que el paciente abandone el quirófano 85.2% o cumplimiento bueno. Conclusión: Las evaluaciones de las tres etapas de la verificación de la seguridad quirúrgica en el paciente pediátrico permitieron identificar las áreas de oportunidades para mejorar su implementación, disminuir el número de complicaciones, muertes evitables y avanzar sobre una cultura de seguridad del paciente quirúrgico.

Abstract: Objective: To evaluate the level of knowledge and implementation of the safety of surgical patients in a pediatric institution. Materials and methods: Observational, descriptive and cross-sectional study in the period April 2014- December 2015. The sample of 78 health professionals who are members of the surgical team Regional High Specialty Hospital del Niño "Dr. Rodolfo Nieto Padrón "of various work shifts, using 2 assessment instruments. 1) Knowledge Questionnaire safety of surgical patients and 2) Compliance Questionnaire surgical safety. Results: The level of knowledge of the surgical team regarding surgical safety was good with 77% in study participants. In compliance assessment scores of all instrument items were added and divided by the total of measures to estimate the means. an average of 85.6 was found in phase 1 before anesthesia corresponding to a good compliance in phase 2 before the skin incision 79.86 or regular compliance and factors internal and external environment of the surgical area that influence in the safety of the surgical patient phase 3 before the patient leaves the operating room or 85.2 good compliance. Conclusions: Evaluations of the three stages of verification of surgical safety in pediatric patients helped identify areas of opportunities to improve their implementation, reduce the number of complications, avoidable and advance a culture of safety of the surgical patient deaths.

Resumo: Objetivo: Avaliar o nível de conhecimento e implementação da segurança dos pacientes cirúrgicos numa instituição pediátrica. Materiais e métodos: Estudo de observação, descritivo e transversal no período de abril 2014 a Dezembro de 2015. A amostra foi constituída por 78 profissionais de saúde que são membros da equipe cirúrgica do Hospital Regional de Alta Especialidade del Niño "Dr. Rodolfo Nieto Padrón" e incluiu vários turnos de trabalho. Foram usados dois instrumentos de avaliação: 1) questionário de conhecimento de segurança do paciente cirúrgico e 2) questionário de cumprimento de segurança cirúrgica. Resultados: O nível de conhecimento da equipe cirúrgica em relação à segurança cirúrgica foi bom, com 77% dos participantes do estudo. Na avaliação do cumprimento de todos os itens do instrumento foram sumadas as pontuações do total de itens e foram divididas pelo total de medidas para estimar as médias. Foi encontrada uma média de 85,6% na fase 1 antes da anestesia, correspondendo a um bom cumprimento. Na fase 2, antes da incisão na pele, 79,86% manifestaram um cumprimento regular e fatores de ambiente interno e externo da área cirúrgica influenciaram na segurança do paciente cirúrgico da fase 3, antes de o paciente sair da sala de operação, com 85,2% de boa adesão. Conclusão: As avaliações das três fases de verificação de segurança cirúrgica em pacientes pediátricos ajudou a identificar áreas de oportunidade para melhorar a sua aplicação, reduzir o número de complicações evitáveis e promover uma cultura de segurança das mortes cirúrgicas de pacientes.

Résumé: Objectif: Évaluer le niveau de connaissances et de mise en œuvre de la sécurité des patients chirurgicaux dans un établissement pédiatrique. Matériel et méthodes: Étude observationnelle, descriptive et transversale, réalisée entre avril 2014 et décembre 2015. L'échantillon est constitué de 78 professionnels de santé, de différents horaires de travail, de l'équipe chirurgicale de l'Hospital Regional de Alta Especialidad del Niño Dr. Rodolfo Nieto Padrón". Les instruments de collecte de données utilisés sont: 1) Questionnaire de connaissance sur la sécurité des patients chirurgicaux et 2) Questionnaire sur le respect de la sécurité chirurgicale. Résultats: Le niveau de connaissance de l'équipe chirurgicale sur la sécurité chirurgicale s'est montré bon pour 77% des participants. Pour l'évaluation du respect de la sécurité, le total des scores de tous les items de l'instrument a été divisé par le nombre de mesures contenues dans le questionnaire. Les moyennes suivantes ont été calculées: 85,6% pour la phase 1 pré-anesthésique (considéré comme une bonne observance); 79,86% pour la phase 2 antérieur à l'incision cutanée (observance régulière) et 85,2% pour les facteurs de l'environnement interne et externe du bloc opératoire qui influent sur la sécurité du patient dans la phase 3, avant qu'il ne quitte la salle d'opération (bonne observance). Conclusion: Les évaluations des trois étapes de vérification de la sécurité chirurgicale envers les patients pédiatriques ont permis d'identifier les domaines susceptibles d'amélioration de leur mise en œuvre pour réduire le nombre de complications, de décès évitables, et progresser dans la culture de la sécurité des patients chirurgicaux.