Experiencia en el manejo de anafilaxia en un Departamento de Emergencias Pediátricas

Introducción: La anafilaxia es una reacción multisistémica potencialmente mortal; su reconocimiento temprano y abordaje oportuno son fundamentales. La variabilidad de presentación y gravedad requieren la utilización de criterios diagnósticos para la mejora de la atención en urgencias. Objetivo: Describir las características clínicas, criterios de diagnóstico y tratamiento de los pacientes con anafilaxia atendidos en un Departamento de Emergencias Pediátricas (DEP). Materiales y métodos: Revisión retrospectiva, descriptiva, de casos ingresados en el DEP de enero 2015 a diciembre 2020. Los criterios diagnósticos fueron aplicados por dos observadores emergentólogos evaluando la concordancia con el índice к de Cohen. Se utilizó estadística descriptiva: proporciones, medianas y rango intercuartílico. Resultados: Se aplicaron los criterios NIAID/FAAN a 65 historias clínicas con diagnóstico de egreso de anafilaxia encontrándose una concordancia de 0,64 (IC 95%: 0,41-0,88). De ellos, 35 (54%) cumplieron los criterios diagnósticos. El 66% (23/35) recibió adrenalina. La mediana de edad fue de 7 años (RIC: 3-11,5). Antecedente de asma en 9/35, atopia en 7/35 y anafilaxia previa en 7/35. Como factor desencadenante se constató consumo de medicamentos en 16/35, alimentos en 8/35. La estadía hospitalaria tuvo una mediana de 18 horas (RIC: 12-24). Conclusiones: Los resultados sugieren una brecha entre identificación precisa de los casos de anafilaxia y el tratamiento oportuno con adrenalina cuando se utilizan criterios estandarizados.

Introduction: Anaphylaxis is a potentially fatal multisystem reaction; early recognition and timely approach are essential. The variability in its presentation and severity requires the use of diagnostic criteria to improve emergency care. Objective: To describe the clinical characteristics, diagnostic criteria and treatment of patients with anaphylaxis treated in a Pediatric Emergency Department (PED). Materials and methods: This was a retrospective and descriptive review of cases admitted to the PED from January 2015 to December 2020. The diagnostic criteria were applied by two emergentologist observers; Cohen's к index was used to evaluate their agreement. Descriptive statistics were used: proportions, medians and interquartile range. Results: The NIAID/FAAN criteria were applied to 65 medical records with a discharge diagnosis of anaphylaxis, finding an agreement of 0.64 (95% CI: 0.41-0.88). Of these, 35 (54%) met the diagnostic criteria. 66% (23/35) received adrenaline. The median age was 7 years (IQR: 3-11.5). 9/35 had a history of asthma, 7/35 had atopy and previous anaphylaxis was noted in 7/35. As a triggering factor, medication consumption was found in 16/35, and food in 8/35. The hospital stay had a median of 18 hours (IQR: 12-24). Conclusions: The results suggest a gap between accurate recognition of anaphylaxis cases and timely treatment with adrenaline when standardized criteria are used.

Videoteca como recurso didáctico audiovisual de apoyo en la asignatura Proceso de Atención de Enfermería Perinatal y Ginecológico / Video Library as Support Audiovisual Learning Resource for the subject Process of Care in Perinatal and Gynaecological Nursing

Objetivo: evaluar la satisfacción de los estudiantes que optaban a la titulación de Matrona sobre el uso de una videoteca online como complemento al proceso enseñanza-aprendizaje en la asignatura Proceso de Atención de Enfermería Perinatal y Ginecológico. Método: se llevó a cabo un estudio transversal. Población de estudio: 123 estudiantes de segundo año que cursaban la asignatura Proceso de Atención de Enfermería Perinatal y Ginecológico (I), para optar al título de matrona en la Universidad San Sebastián (Santiago, Chile). El estudio se realizó durante el primer semestre del año 2020. Muestreo no probabilístico. Se creó un canal de YouTube® llamado “Saber y Salud USS” donde se subieron diez vídeos (videoteca). La satisfacción de los estudiantes se evaluó mediante un instrumento adaptado y validado. Resultados: participaron 89 (72,4%) estudiantes. En la dimensión integración teórico-práctica un 82% refirió estar “muy de acuerdo” y un 18% está “de acuerdo” con que hubo mejoras en la compresión de la teoría al visualizar los vídeos. En la dimensión formato y estructura de la videoteca, un 85,3% contestó estar “muy de acuerdo” y un 14,7% “de acuerdo” con que la organización de los procedimientos fue clara y ordenada. En la dimensión aportación al proceso enseñanza-aprendizaje, un 82% refirió estar “muy de acuerdo”, un 16,9% “de acuerdo” en haber obtenido mejores resultados en el aprendizaje.Conclusión: los estudiantes presentaron un alto grado de satisfacción respecto al uso de la videoteca online, como complemento al proceso enseñanza-aprendizaje en la asignatura Proceso de Atención de Enfermería Perinatal y Ginecológico.(AU)

Objective: to assess the satisfaction by students applying for the Midwife degree regarding the use of an online video library as a complement to the teaching-learning process for the subject Process of Care in Perinatal and Gynaecological Nursing. Method: a cross-sectional study was conducted. Study population: 123 students in their second year taking the subject Process of Care in Perinatal and Gynaecological Nursing (I), in order to apply for the Midwife degree at the Universidad San Sebastián (Santiago, Chile). The study was conducted during the first semester of 2020, with non-probability sampling. A YouTube® channel was created, called “Saber y Salud USS”, where ten videos were uploaded (video library). The satisfaction by students was measured through an adapted and validated instrument. Results: the study included 89 (72.4%) students. Regarding the Theoretical and Practical Integration dimension, 82% reported “strong agreement” and 18% “agreement” with improvement in understanding the theory by visualising the videos. In the dimension Format and Structure of the Video Library, 85.3% reported “strong agreement” and 14.7% “agreement” that the procedures were organized in a clear and systematic manner. In the dimension Contribution to the Teaching-Learning process, 82% reported “strong agreement” and 16.9% “agreement” regarding achieving better learning results. Conclusion: students presented a high level of satisfaction regarding the use of the online video library as a complement to the teaching-learning process in the subject Process of Care in Perinatal and Gynaecological Nursing.(AU)

Hydrocarbon-degrading bacteria in Colombia: systematic review.

Petroleum industry activities worldwide have caused pollution and resulted in environmental degradation. Microorganisms with the potential to reduce pollutant levels by degradation processes have been reported, and bacteria are among such organisms. The first study on bacterial degradation in Colombia was published in 1996. The study isolated bacteria belonging to the Pseudomonas genus from hydrocarbon-polluted sediments. Since then, different reports on degrading bacteria have been published. The objective of this systematic review is to identify and analyze all the studies on hydrocarbon-degrading bacteria performed in Colombia. To accomplish this goal, a literature search was conducted. Inclusion and exclusion criteria were applied, and 37 relevant articles were obtained. We found that 2018 was the year with the largest number of publications in Colombia, and most frequently identified bacterial genera were Pseudomonas and Bacillus. Some studies showed that the degradation of hydrocarbons is more efficient when bacterial consortia are used rather than pure cultures. This study provides information about bacteria with the potential to degrade hydrocarbons in Colombia, which in turn will be a source of information for future studies in this field.