Pilot study of a telehealth intervention for personalized self-management for eating symptoms after gastroesophageal cancer surgery.

BACKGROUND AND OBJECTIVES: Following gastric and esophageal cancer surgery, patients often experience significant, prolonged eating-related symptoms. One promising approach to help patients improve their eating-related quality of life (QOL) is through self-management coaching to aid in diet modification. We performed a randomized pilot study of a nutritionist-led telehealth intervention for the self-management of eating after gastroesophageal cancer surgery. METHODS: Patients who were within 30 days of resuming oral intake after undergoing surgery for gastric and/or esophageal cancer were consented and then randomized to the intervention or usual care. The intervention was performed by a nutritionist trained in self-management coaching and delivered in four telehealth sessions over 4 months. The following outcomes were measured at baseline and at 6 months after baseline: QOL (EORTC QLQC30), weight, body mass index, and sarcopenia. RESULTS: Fifty-three patients were enrolled. 22/27 usual care and 21/26 intervention patients completed the study for a retention rate of 81%. Differences between the intervention and control groups were not statistically significant, but the intervention group had indications of greater improvements in overall QOL as measured by EORTC QLQC30 Summary Score (8.7 vs. 2.3, p = 0.17) as well as greater improvements in 4/5 functional domains (p > 0.3). The intervention group also had slightly more weight gain (6 kg vs. 3 kg, p = 0.3) and less sarcopenia (3/16 vs. 9/18, p = 0.07). CONCLUSIONS: This pilot study demonstrated the feasibility and acceptability of a telehealth intervention for self-management of eating symptoms after gastroesophageal cancer surgery. There were trends toward improved overall QOL in the intervention group. A larger study is needed to validate the results.

Analysis of Knowledge of Smoking-Related Diseases in Spanish Nursing Students.

Smoking causes significant morbidity and mortality worldwide, mainly in developed countries. In addition, it is the cause of numerous diseases in the body, despite the fact that the prevalence of tobacco use is decreasing. Nursing students, as future professionals, should be aware of action plans for cessation and information designed for smokers. To determine the level of knowledge among nursing students about smoking-related diseases and analyze the prevalence of student who smoke at the University of Leon, Spain, a descriptive cross-sectional study was carried out in which students were given an anonymous questionnaire, which was previously validated, during the 2021-2022 academic year. In a sample of 477 (79.5%) nursing students, a smoking prevalence of 17.6% was obtained. In addition, students' knowledge about the diseases directly caused by tobacco consumption and others associated with exposure to environmental smoke was assessed, and in both cases (8.03 points of 9 for consumption and 5.24 of 6 to exposure), scores were obtained that allow us to state that students do not know for sure the types of diseases that are related to tobacco use and passive smoking. In spite of this, it is necessary to continue to reduce the prevalence of smoking through different programs implemented in schools and universities, as it is also necessary to improve teaching plans when explaining smoking-related diseases, so that students, in the future, will be able to advise patients correctly.

Seroepidemiological Survey of Anti-Toxoplasma gondii and Anti-Neospora caninum Antibodies in Domestic Cats (Felis catus) in Rolim de Moura, State of Rondônia, North Brazil.

Epidemiological studies on infections by Toxoplasma gondii and Neospora caninum in cats in the North Region of Brazil are scarce. We intended to assess the seroprevalence in cats of anti-T. gondii and anti-N. caninum antibodies, as well as the associated risk factors that may lead them to contract these infections in Rolim de Moura, state of Rondônia, North Brazil. For this, blood serum samples of 100 cats from different regions of the city were evaluated. To assess possible factors associated with infections, epidemiological questionnaires were applied to tutors. The Immunofluorescence Antibody Test (IFAT) was performed for anti-T. gondii (cutoff 1:16) and anti-N. caninum (cutoff 1:50) antibodies. After identifying the positive samples, antibody titration was performed. The results showed the prevalence of 26% (26/100) of anti-T. gondii antibodies, with titration varying between 1:16 to 1:8192. There were no factors associated with the prevalence of anti-T. gondii antibodies in the multivariate analysis in this study. There was no occurrence of seropositive cats for anti-N. caninum. It was concluded that there was a high prevalence of anti-T. gondii antibodies in cats in Rolim de Moura, state of Rondônia, North Brazil. However, the evaluated animals did not present anti-N. caninum antibodies. Therefore, knowing that T. gondii has different transmission forms, we emphasize the importance of spreading more information to the population about cat's relevance in the T. gondii life cycle and how to avoid the parasite transmission and proliferation.

Sleep During Menopause.

Postmenopause is defined retrospectively after 12 consecutive months of amenorrhea. It represents the end of the reproductive period and ovarian failure. A decrease in estrogen leads to several changes in the short and long term. Among the early changes, vasomotor symptoms (hot flashes) are particularly common, occurring in about 70% of women. In addition, there are changes in mood, anxiety, depression, and insomnia. Insomnia occurs in almost 60% of postmenopausal women. Psychosocial aspects may also affect sleep. Proper diagnosis may lead to adequate treatment of sleep disturbances during menopause. Hormonal or other complementary therapies can improve sleep quality.

Cardiopulmonary Imaging Utilization and Findings among Hospitalized COVID-19 Patients in Latin America: (From "RIMAC: Registry IMAging Cardiopulmonary among Hospitalized COVID-19 Patients in LATAM").

Objectives: Describe the use and findings of cardiopulmonary imaging-chest X-ray (cX-ray), echocardiography (cEcho), chest CT (cCT), lung ultrasound (LUS), and/or cardiac magnetic resonance imaging (cMRI)-in COVID-19 hospitalizations in Latin America (LATAM). Background: There is a lack of information on the images used and their findings during the SARS-CoV-2 pandemic in LATAM. Methods: Multicenter, prospective, observational study of COVID-19 inpatients, conducted from March to December 2020, from 12 high-complexity centers, in nine LATAM countries. Adults (>18 years) with at least one imaging modality performed, followed from admission until discharge and/or in-hospital death, were included. Results: We studied 1,435 hospitalized patients (64% males) with a median age of 58 years classified into three regions: Mexico (Mx), 262; Central America and Caribbean (CAC), 428; and South America (SAm), 745. More frequent comorbidities were overweight/obesity, hypertension, and diabetes. During hospitalization, 58% were admitted to the ICU. The in-hospital mortality was 28%, and it was highest in Mx (37%).The most frequent images performed were cCT (61%), mostly in Mx and SAm, and cX-ray (46%), significant in CAC. The cEcho was carried out in 18%, similarly among regions, and LUS was carried out in 7%, with a higher frequently in Mx. Abnormal findings on the cX-ray were peripheral or basal infiltrates, and in cCT abnormal findings were the ground glass infiltrates, more commonly in Mx. In LUS, interstitial syndrome was the most abnormal finding, predominantly in Mx and CAC.Renal failure was the most prevalent complication (20%), predominant in Mx and SAm. Heart failure developed in 13%, predominant in Mx and CAC. Lung thromboembolism was higher in Mx while myocardial infarction was in CAC.Logistic regression showed associations of abnormal imaging findings and their severity, with comorbidities, complications, and evolution. Conclusions: The use and findings of cardiopulmonary imaging in LATAM varied between regions and had a great impact on diagnosis and prognosis.

Cardiac and obstetric outcomes in pregnant patients with heart disease: a retrospective cohort study.

BACKGROUND: Cardiac diseases complicate 4% of pregnancies, with a mortality rate between 0 and 15%. Early referral has shown to reduce the risk of maternal major cardiac events (MACEs). METHODS: We retrospectively analyzed a cohort of pregnant women with heart disease from two referral centers in Mexico City. We examined MACEs: maternal death, pulmonary edema, acute heart failure, endocarditis, stroke, myocardial infarction, acute aortic syndromes, arrhythmias requiring urgent treatment, and the need for an urgent intervention; preterm birth and obstetric events such as HELLP syndrome, preeclampsia, eclampsia, placental abruption, obstetric hemorrhage. We analyzed the association between each modified World Health Organization (mWHO) group and MACEs, preterm birth and obstetric outcomes between March 2014 and March 2019. RESULTS: Using the mWHO classification, 399 deliveries were included and stratified as follows: I, 162; II, 133; II-III, 21; III, 18; and IV, 52 patients. MACEs were observed in 12.5% of the cohort and were associated with mWHO II (odds ratio [OR], 3.0; 95% confidence interval [95% CI], 1.1-8.1; p = 0.027), II-III (OR, 3.3; 95% CI, 0.9-1.0; p = 0.116), III (OR, 5.3; 95% CI, 1.2-23; p = 0.026), and IV (OR, 8.2; 95% CI, 2.7-24.5; p < 0.001) after adjusting for age, desaturation, previous functional class, and gestational age at referral. An association between mWHO and frequency of preterm birth was observed. Association between mWHO and obstetric events, even when adjusted, was not observed. CONCLUSIONS: The prevalence of MACEs and preterm birth is similar to that seen worldwide; MACEs and preterm birth are associated with the severity of heart disease stratified by mWHO, but there is no association between the severity of heart disease and obstetric events.

Qualidade de vida de idosos inseridos em um programa de atendimento em saúde e associações com as características do paciente, da doença, da terapêutica e suporte social / Quality of life of elderly people enrolled in a health care program and associations with the characteristics of the patient, the disease, the therapy, and social support

O aumento da expectativa de vida entre indivíduos acima de 65 anos, vem modificando a pirâmide etária da população brasileira. Qualidade de vida (QV) é um parâmetro importante para avaliação do estado de saúde. O objetivo do estudo foi descrever a QV de idosos inseridos em um programa de atendimento ao idoso, evidenciar associações com as características do paciente, doença, terapêutica e suporte social contribuindo para melhor assistência a idosos que frequentam o serviço. Tratou-se de estudo, descritivo, quantitativo, transversal, correlacional com 85 indivíduos com 60 anos ou mais, alfabetizados, independentes nas atividades da vida diária, sem deficiência cognitiva/psíquica diagnosticada e que frequentavam o Centro Social Nossa Senhora do Rosário há no mínimo um mês. Para coleta das variáveis independentes utilizou-se um instrumento elaborado pelas autoras; além do teste de Morisk-Green e Índice de Complexidade Terapêutica (ICFT). A QV foi avaliada pelo WHOQOL-breve. 89,4% eram mulheres; 38,8% apresentavam 60 a 70 anos; 77,6% até 3 comorbidades, a mais frequente foi hipertensão (77,65%); 49,41% fazia uso de polifarmácia, o ICTF variou de 2,5 a 48,0 pontos para um a doze medicamentos/dia; 57,65% adquiriam a medicação pelo SUS; 64,80% apresentaram média/baixa adesão; 43,53% declararam como boa percepção de saúde. Quanto aos domínios do WHOQOL-breve, obteve-se como maior média no domínio social (75,5), seguido do psicológico (68,3), físico (67,1) e (64,8) no meio ambiente. Os resultados deste estudo destacaram que o sexo feminino, presença de doenças, a complexidade terapêutica e percepção de saúde ruim estão associados com menores índices de qualidade de vida desta população.

The increase in life expectancy among individuals over 65 years of age has changed the age pyramid of the Brazilian population. Quality of life (QoL) is an important parameter to assess health status. The aim of the study was to describe the QoL of elderly people enrolled in an elderly care program, showing associations with the characteristics of the patient, disease, therapy, and social support, contributing to improve care for the elderly who receive this service. This was a descriptive, quantitative, cross-sectional, correlational study with 85 individuals aged 60 years or more, who were literate, independent in activities of daily living, without diagnosed cognitive/psychological impairment, and who had been going to the Nossa Senhora do Rosário Social Center for at least one month. To collect the independent variables, an instrument developed by the authors was used; in addition to the Morisk-Green test and Medication Regimen Complexity Index (MRCI). QoL was assessed by WHOQOL-brief. 89.4% were women; 38.8% were 60 to 70 years old; 77.6% had up to 3 comorbidities, the most frequent was hypertension (77.65%); 49.41% used polypharmacy, the MRCI ranged from 2.5 to 48.0 points for one to twelve medications/day; 57.65% acquired their medication through the SUS; 64.80% had medium/low adherence; 43.53% declared having a good perception of health. As for the WHOQOL-brief domains, the highest mean was obtained in the social domain (75.5), followed by the psychological (68.3), physical (67.1), and environmental (64.8) domains. The results of this study highlighted that the female gender, presence of diseases, therapeutic complexity, and perception of poor health are associated with lower quality of life indices in this population.

Cov-hep study: heparin in standard anticoagulation based on citrate for continuous veno-venous hemodialysis in patients with COVID-19: a structured summary of a study protocol for a randomized controlled trial.

OBJECTIVES: The primary objective is to test if heparin added to a standard regional anticoagulation protocol based on citrate is able to reduce dialysis circuit losses by clotting without increasing the risk of thrombocytopenia or bleeding, in patients with COVID-19 with acute kidney injury requiring dialysis. TRIAL DESIGN: Randomized, parallel-group, open-label trial, with two arms (ratio 1:1) comparing different continuous renal replacement therapy anticoagulation strategies. PARTICIPANTS: Eligibility conditions: All ICU patients of University of Sao Paulo General Hospital (Hospital das Clínicas), Brazil will be screened for eligibility conditions. Adults (> 18 years old) with confirmed COVID-19 and acute kidney injury requiring dialysis with agreement between ICU and nephrology teams for the introduction of renal continuous replacement therapy in daily ICU rounds. Continuous renal replacement therapy will be prescribed by consulting nephrologists based on standard clinical guidelines, including acute kidney injury with hemodynamic instability plus hyperkalemia, severe acidosis, volume overload, respiratory distress, multiorgan failure or some combination of these factors. DATA COLLECTION: Patients demographics and associated clinical data and comorbidities will be recorded at ICU entry. Demographic information will include the patient's age, sex, and admission dates. Clinical data comprise comorbidities, APACHE 2, SAPS 3, need for mechanical ventilation, and use of vasopressor drugs. Physiological data collected by the day of CRRT start will be vital signs, the arterial oxygen tension/fraction of inspired oxygen (PaO2/FiO2) index, and serum creatinine, blood urea nitrogen, bilirubin, hemoglobin, hematocrit, platelets, white blood cell count levels and Peak D-dimer levels. Patients will be analyzed for the first 72h of CRRT, and they will be evaluated regarding clinical variables, filter patency and any adverse events that could be related to the anticoagulation choice, as bleeding (mild or major) or low platelets counts (<100.000 ui/uL) during treatment period. Mild and major bleeding will be defined by hemorrhagic event without clinical impact or hemoglobin (Hb) fall lesser than 1g/dL and hemorrhagic event with clinical impact or Hb fall higher than 1g/dL, respectively. EXCLUSION CRITERIA: Hypersensitivity to any of the substances going to be used in the study (Citric acid dextrosol 2.2% and unfractionated heparin); Previous diagnosis of coagulopathy or thrombophilia; Contraindication to the use of unfractionated heparin; Risk of citrate poisoning - (Lactate> 30 mg/dL, international normalized ratio > 2.5, Total bilirubin> 15 mg/dL); Pregnancy; Patients unlikely to survive for more than 24 hours. The trial is being undertaken at the University of Sao Paulo General Hospital (Hospital das Clinicas), Brazil. INTERVENTION AND COMPARATOR: Group A (control) - Patients on continuous renal replacement therapy (blood flow 150 ml/min, dose of 30 mL/Kg/h) receiving anticoagulation with sodium citrate at 4 mmol/L Group B (experiment): Patients on continuous hemodialysis (blood flow 150 mL/min, dose of 30 mL/Kg/h) receiving anticoagulation with sodium citrate at 4 mmol/L associated with unfractionated heparin at 10 U/Kg/h. MAIN OUTCOMES: The percentage of clotted dialyzers within 72 hours in each of the studied groups (Primary outcome) Secondary outcomes: Number of dialyzers used in the first 72 hours of dialysis protocol, Mortality in the first 72 h of dialysis protocol, Bleeding events (Major or minor) in the first 72 h of dialysis protocol, Thrombocytopenia (less than 50.000 platelets) proportion in the first 72 h of dialysis protocol, Dialysis efficiency (Urea sieving) - variation in urea sieving between the first, second and third days of dialysis protocol, Continuous renal replacement therapy pressures (Arterial, Venous, dialysate and pre-filter pressure) in the first 72 h of dialysis protocol, in-hospital mortality. RANDOMIZATION: RedCap→ randomization - 2 blocks randomization by D-dimer level (5000ng/dL cut-off) and catheter site (Right Internal Jugular versus other sites) with 1:1 allocation ratio. BLINDING (MASKING): No blinding - Open label format NUMBERS TO BE RANDOMIZED (SAMPLE SIZE): Total number of patients 90 (45 per group) TRIAL STATUS: Trial version 2.0 - ongoing recruitment. First recruitment: June 29, 2020 Estimated date for last recruitment: December 31, 2020 TRIAL REGISTRATION: Responsible Party: University of Sao Paulo General Hospital (Hospital das Clinicas) ClinicalTrials.gov Identifier: NCT04487990 , registered July 27, 2020, ReBec www.ensaiosclinicos.gov.br/rg/RBR-45kf9p/ Other Study ID Numbers: U1111-1252-0194 FULL PROTOCOL: The full protocol is attached as an additional file, accessible from the Trials website (Additional file 1) In the interest in expediting dissemination of this material, the familiar formatting has been eliminated; this Letter serves as a summary of the key elements of the full protocol.

Evaluation of Three Methods for CPR Training to Lifeguards: A Randomised Trial Using Traditional Procedures and New Technologies.

Background and objectives: When the drowning timeline evolves and drowning occurs, the lifeguard tries to mitigate the event by applying the last link of the drowning survival chain with the aim of treating hypoxia. Quality CPR (Cardiopulmonary Resuscitation) and the training of lifeguards are the fundamental axes of drowning survival. Mobile applications and other feedback methods have emerged as strong methods for the learning and training of basic CPR in the last years so, in this study, a randomised clinical trial has been carried out to compare the traditional method as the use of apps or manikins with a feedback system as a method of training to improve the quality of resuscitation. Materials and Methods: The traditional training (TT), mobile phone applications (AP) and feedback manikins (FT) are compared. The three cohorts were subsequently evaluated through a manikin providing feedback, and a data report on the quality of the manoeuvres was obtained. Results: Significant differences were found between the traditional manikin and the manikin with real-time feedback regarding the percentage of compressions with correct depth (30.8% (30.4) vs. 68.2% (32.6); p = 0.042). Hand positioning, percentage correct chest recoil and quality of compressions exceeded 70% of correct performance in all groups with better percentages in the FT (TT vs. FT; p < 0.05). Conclusions: As a conclusion, feedback manikins are better learning tools than traditional models and apps as regards training chest compression. Ventilation values are low in all groups, but improve with the feedback manikin.

Severe Aplastic Anemia Developed after Thymectomy: A Case Report and Literature Review.

Thymus neoplasms are frequently related to paraneoplastic autoimmune manifestations. Its most common associations are myasthenia gravis and pure red cell aplasia. Aplastic anemia has been increasingly documented as an initial presentation of thymoma. Nevertheless, its development after successful surgical resection of thymoma is a rare condition. We report a case of a 53-year-old man with severe aplastic anemia preceded by amegakaryocytic thrombocytopenia three years after thymectomy with no signs of disease recurrence. He underwent immunosuppressive therapy with cyclosporine 5 mg/kg/day and prednisone 2 mg/kg/day for six weeks. Considering the availability of a compatible donor, allogeneic stem cell transplantation was carried out. However, the patient died 11 days after transplant. A literature review was conducted, and another ten cases of aplastic anemia, diagnosed three months to four years after thymectomy, were identified. These cases suggest persistence of peripheral self-reactive T lymphocytes even years after tumor definitive treatment.

Cardiovascular Risk Factors and Risk Measurement in Patients with Psoriatic Arthritis in a University Hospital

Abstract Background: Psoriatic Arthritis is the spondyloarthritis associated with psoriasis, which is often related to high mortality due to cardiovascular causes. Objectives: To quantify cardiovascular risk factors (hypertension, diabetes, dyslipidemia, obesity and smoking) and to measure risk by the Global Cardiovascular Risk Score in patients with psoriatic arthritis. Methods: Patients with psoriatic arthritis according to the Classification Criteria for Psoriatic Arthritis, aged between 30 and 74 years and without any other clinically manifest chronic inflammatory disease, atherosclerotic disease or heart failure were included. After an interview, clinical examination and data extraction from medical records, risk stratification was performed using a calculator available on the online platform of the Framingham Heart Study. We considered p < 0.05 as significant. Chi-square test and Fisher's exact test were used to compare frequencies, as well as correlation measurements. Results: 45 patients were included, 68,9% of which were women and the mean age was 53,94 years. Dyslipidemia was confirmed in approximately 93%, hypertension in 46%, obesity in 40%, 33.3% were diabetics and, 13.3%, smokers; 95% had increased abdominal circumference. It was observed that 53% had high cardiovascular risk, 29% had intermediate risk and 18% had low risk. Individuals with altered C-reactive protein and erythrocyte sedimentation rate presented, respectively, higher levels of LDL-C and total cholesterol. Conclusions: There was a high occurrence of risk factors and the majority of the sample was stratified into high or intermediate cardiovascular risk.

Análisis de aspectos del ámbito emocional de los profesionales de la salud y los pacientes en una unidad de oncología / Analysis of aspects of the emotional scope of health professionals and patients in an oncology unit

INTRODUCCIÓN: En España, seis de cada diez enfermeras padecen el síndrome de Burnout y ocho de cada diez sufren de estrés. OBJETIVOS. El objetivo del estudio fue determinar los niveles de desgaste profesional en profesionales de la salud del Servicio de Oncología del Complejo Asistencial Universitario de León y analizar los niveles de ansiedad y depresión de familiares/pacientes, con el fin de justificar la necesidad de crear un equipo de intervención psicológica. METODOLOGÍA: Estudio transversal de prevalencia llevado a cabo en el Servicio de Oncología del Complejo Asistencial Universitario de León. Los instrumentos utilizados fueron el Maslach Burnout Inventory (MBI) y la Escala HADS de ansiedad y depresión. El análisis estadístico se realizó mediante el programa estadístico EpiInfo 7. RESULTADOS: Participaron en el estudio 85 profesionales de la salud del Servicio de Oncología, 210 pacientes y 226 familiares/acompañantes que acudieron a las consultas del Servicio. El síndrome de desgaste profesional presentó niveles altos en el 17,6% de los profesionales de la salud. Las enfermeras presentaron de modo estadísticamente significativo mayor desgaste profesional según MBI, con un 27,9% en relación al 10% de los médicos y 4,5% de las TCAE. No se encontraron diferencias estadísticas por sexo. En las tres dimensiones del MBI las enfermeras mostraron mayor agotamiento laboral. En la escala HADS las personas acompañantes presentaron mayor nivel de ansiedad (p < 0,01) y los pacientes, mayor nivel de depresión (p < 0,01) al compararlos. CONCLUSIONES: La prevalencia de desgaste profesional en las unidades de Oncología y los niveles de ansiedad y depresión en paciente y familiares/acompañantes deben ser prevenidos y tratados adecuadamente. La necesidad de un equipo de intervención psicológica en unidades de oncología en vista de los resultados resulta de vital importancia

INTRODUCTION: In Spain, six of ten nurses suffer Burnout and eight of ten suffer stress. OBJECTIVES: The aim of the study was to determine the level of Burnout in health workers in the Oncology Unit of the León University Hospital and analyze the levels of anxiety and depression in patients and families, in order to justify the need to create a team of psychological intervention. METHODOLOGY: Cross-sectional prevalence study conducted in the Department of Oncology. The instruments employed were the Maslach Burnout Inventory (MBI) and the HADS anxiety and depression scale. Statistical analysis was performed using the statistical software EpiInfo 7. RESULTS: 85 healthcare professionals of Oncology, 210 patients and 226 relatives participated in the study who attended the consultations of the Service. Burnout syndrome showed high levels in 17.6% of health professionals. Nurses showed statistically significantly greater Burnout MBI, as 27.9% compared to 10% of physicians and 4.5% of TCAE. No statistical differences were found by sex. In the three dimensions of MBI, nurses showed higher Burnout. In relation to HADS, relatives had a higher level of anxiety (p <0.01) and patients, higher levels of depression (p <0.01) when compared. CONCLUSIONS: The prevalence of Burnout in oncology units and levels of anxiety and depression in patients and relatives/companion must be prevented and treated appropriately. The need for a team of psychological intervention in oncology units in view of the results is vital

Desarrollo de la Imagen corporal, la autoestima y el autoconcepto físico al finalizar la Educación Primaria / Development of Body Image, Self-esteem and Physical self-Concept at the end of Primary Education

Resumen En este trabajo se analiza la relación entre la satisfacción con la imagen corporal, la autoestima y el autoconcepto físico. Los participantes fueron 310 alumnos, de 5º y 6º de Educación Primaria, y 22 profesores en activo, de la zona educativa Motril-Costa (España). Como técnicas cuantitativas, se utilizaron: el Cuestionario de Siluetas Corporales, Cuestionario de Autoconcepto Físico y la Escala de Autoestima de Rosenberg. Como técnica cualitativa, se utilizó la entrevista semi-estrucutrada. Los resultados muestran que difiere la imagen que tienen y que les gustaría tener. También se aprecia que los chicos tienen un mayor nivel de autoestima. Son las chicas las que se consideran menos hábiles para realizar actividad física y disfrutan en menor medida de estas actividades.

Abstract In this paperis analyzed the relationshipbetween satisfaction withbody image,self-esteem andphysical self.Participants were310students,grades 5 and 6primary and22practicing teachers,the educationalareaMotril-Costa (Spain). Asquantitative techniquesQuestionnairebody silhouettes, Physical SelfQuestionnaire and theRosenbergSelf-Esteem Scale.Asthe qualitative technique was used semi-structured interview. The results show thatdifferent fromthe image they haveand would like tohave.It is also appreciatedthat the boyshave a higher levelofself-esteem.It isthe girls whoare consideredless abletoenjoyphysical activityandto a lesser extentof these activities.

Functional Role of Intracellular Calcium Receptor Inositol 1,4,5-Trisphosphate Type 1 in Rat Hippocampus after Neonatal Anoxia.

Anoxia is one of the most prevalent causes of neonatal morbidity and mortality, especially in preterm neonates, constituting an important public health problem due to permanent neurological sequelae observed in patients. Oxygen deprivation triggers a series of simultaneous cascades, culminating in cell death mainly located in more vulnerable metabolic brain regions, such as the hippocampus. In the process of cell death by oxygen deprivation, cytosolic calcium plays crucial roles. Intracellular inositol 1,4,5-trisphosphate receptors (IP3Rs) are important regulators of cytosolic calcium levels, although the role of these receptors in neonatal anoxia is completely unknown. This study focused on the functional role of inositol 1,4,5-trisphosphate receptor type 1 (IP3R1) in rat hippocampus after neonatal anoxia. Quantitative real-time PCR revealed a decrease of IP3R1 gene expression 24 hours after neonatal anoxia. We detected that IP3R1 accumulates specially in CA1, and this spatial pattern did not change after neonatal anoxia. Interestingly, we observed that anoxia triggers translocation of IP3R1 to nucleus in hippocampal cells. We were able to observe that anoxia changes distribution of IP3R1 immunofluorescence signals, as revealed by cluster size analysis. We next examined the role of IP3R1 in the neuronal cell loss triggered by neonatal anoxia. Intrahippocampal injection of non-specific IP3R1 blocker 2-APB clearly reduced the number of Fluoro-Jade C and Tunel positive cells, revealing that activation of IP3R1 increases cell death after neonatal anoxia. Finally, we aimed to disclose mechanistics of IP3R1 in cell death. We were able to determine that blockade of IP3R1 did not reduced the distribution and pixel density of activated caspase 3-positive cells, indicating that the participation of IP3R1 in neuronal cell loss is not related to classical caspase-mediated apoptosis. In summary, this study may contribute to new perspectives in the investigation of neurodegenerative mechanisms triggered by oxygen deprivation.

Escala Glamorgan para la valoración del riesgo de desarrollar úlceras por presión en pediatría. Estudio piloto para la versión española / Glamorgan Scale to assess the risk of developing pressure ulcers in Pediatrics. Pilot study for the Spanish version

OBJETIVO: validar lingüísticamente, a través del proceso de traducción y adaptación cultural, la escala Glamorgan para la valoración del riesgo de desarrollar úlceras por presión en pacientes pediátricos. MATERIAL Y MÉTODO: estudio descriptivo llevado a cabo en el Servicio de Pediatría del Complejo Asistencial Universitario de León. Se realizó la traducción-retrotraducción de la escala original al español. Formaron parte del estudio todos los niños ingresados en el servicio de pediatría desde el 9/04/2012 al 8/06/2012, cuyos padres dieron su consentimiento por escrito. Se determinó la consistencia interna y concordancia intra e interobservador con el programa SPSS. RESULTADOS: se realizaron un total de 38 registros procedentes de launidad de pediatría, neonatología y UCI pediátrica. El 84,2% correspondieron a niños en estado no crítico. La estancia media de ingreso fue de3,5 días y el promedio de peso de 7,63 kg. El 55,3% fueron varones y el86,8% fueron blancos/caucásicos. El motivo de ingreso más frecuente fue la prematuridad (34%). La escala ha mostrado una buena consistencia interna con un alfa de Cron Bach de 0,7. La concordancia intraobservador para el total de la puntuación medida mediante el coeficiente de correlación intraclase fue de 0,997, mientras que la concordancia interobservador fue de 0,584.CONCLUSIONES: la escala Glamorgan ha presentado una alta consistencia interna. La concordancia intraobservador ha sido elevada a diferencia de la concordancia interobservador, lo cual puede ser debido al escaso número de registros, a la falta de comprensión de algún ítem o a la influencia de los observadores. Se propone incrementar el número de registros, elaborar una planilla explicativa para la valoración de cada uno de los ítems y una mejora en la selección de los observadores, en aras de continuar el proceso de validación de la herramienta

OBJECTIVE: linguistic validation, through a process of translation and cultural adaptation, of the Glamorgan Scale to assess the risk of developing pressure ulcers in pediatric patients. MATERIALS AND METHOD: descriptive study conducted in the Pediatric Department of the Complejo Asistencial Universitario de León. The original scale was translated-back translated into Spanish. All children admitted to the Pediatric Department from 9/04/2012 to 8/06/2012were included, with their parents signing a written consent form. Internal consistency and intra and inter-observer concordance were determined with the SPSS program. RESULTS: a total of 38 records were conducted, from the Pediatric, Neonatologyand Pediatric ICU departments. Out of these, 84.2% were for children in non-critical condition. Their mean hospitalization was 3.5days, and their weight average was 7.63 kg. 55.3% were male and86.8% were white/Caucasian. The most frequent reason for admission was premature birth (34%). The scale has shown a good internal consistency, with 0.7 Cronbach's Alpha. The intra-observer concordance for the total score measured through the interclass correlation coefficient was 0.997, while inter-observer concordance was 0.584.CONCLUSIONS: the Glamorgan Scale has presented a high internal consistency. Intra-observer consistency has been high, unlike inter-observer concordance, which could be due to the low number of records, tack of understanding about any of the items, or to the influence of observers. It is suggested to increase the number of records, to preparea form explaining the assessment of each one of the items, and to improve observer selection, for the sake of continuing the validation process of the tool

Metal separation from mixed types of batteries using selective precipitation and liquid-liquid extraction techniques.

The purpose of this paper is to study metal separation from a sample composed of a mixture of the main types of spent household batteries, using a hydrometallurgical route, comparing selective precipitation and liquid-liquid extraction separation techniques. The preparation of the solution consisted of: grinding the waste of mixed batteries, reduction and volatile metals elimination using electric furnace and acid leaching. From this solution two different routes were studied: selective precipitation with sodium hydroxide and liquid-liquid extraction using Cyanex 272 [bis(2,4,4-trimethylpentyl) phosphoric acid] as extracting agent. The best results were obtained from liquid-liquid extraction in which Zn had a 99% extraction rate at pH 2.5. More than 95% Fe was extracted at pH 7.0, the same pH at which more than 90% Ce was extracted. About 88% Mn, Cr and Co was extracted at this pH. At pH 3.0, more than 85% Ni was extracted, and at pH 3.5 more than 80% of Cd and La was extracted.

Ensino de massoterapia: habilidades envolvidas na relação fisioterapeuta-paciente / Massotherapy teaching: abilities involved in the therapist-patient relationship

Desenvolvido no âmbito da disciplina Recursos Terapêuticos Manuais, o objetivo deste trabalho foi elaborar, aplicar e avaliar a eficácia de um programa de treinamento de habilidades profissionalizantes em sessão de massoterapia, com foco na relação fisioterapeuta-paciente, sem descuidar do autocuidado do terapeuta. Para elaboração do programa, foram identificadas 21 habilidades envolvidas nessa relação, com base na literatura e na observação de 120 sessões de massoterapia. Dez peritos validaram a definição operacional das habilidades, que foram organizadas em um programa de treinamento aplicado a alunos. O desempenho destes nas habilidades treinadas (classificado como adequado, parcialmente adequado, inadequado ou não-realizado) foi avaliado em prova prática. Também foi analisado relato escrito dos alunos sobre o programa. Participaram do estudo 25 graduandos. A análise dos resultados mostrou que todos realizaram 12 das 21 habilidades treinadas adequadamente. Quatro habilidades foram realizadas de forma parcialmente adequada por cinco alunos. Não ocorreu situação de execução inadequada...

This work was developed within the discipline Manual Therapy Resources. It consisted in designing, applying, and assessing the efficacy of a program of massotherapy training with a focus on therapist-patient relationship, also stressing therapist self care. By drawing on literature and on the observation of 120 massotherapy sessions, 21 professional abilities were defined and organised into a training program. Ten experts validated the abilities operating definition. The program was then applied to a class of 25 undergraduates, whose performance at the end of the program was assessed, in a practical test, as adequate, partially adequate, inadequate or not undertaken. Written final reports by students were also analysed. Twelve out of the 21 trained abilities were found to be adequately performed by all students; four abilities were partially adequately carried out by five students. There was no case of inadequate performance. The analysis of the written reports showed that 19 out of the 25 students approved of the training program, found relevant and necessary. The self-care training was pointed out as relevant for professional development and appropriate to the teaching context by 10 students. The program proved thus efficient in enabling students to perform with adequate therapist-patient relationship, being also well accepted by students...

Detecção e descrição das habilidades profissionalizantes na relação fisioterapeuta-paciente durante massoterapia clínica / Detection and description of the professional abilities in the physical therapist-patient during the clinical massotherapy

Objetivo: Detectar e descrever as habilidades profissionalizantes envolvidas na relação fisioterapeuta-paciente durante a prática de massoterapia clínica. Método: Sujeitos: 10 alunos treinados em massoterapia clássica, 10 voluntários adultos saudáveis que se submeteram a 12 sessões de massoterapia e 10 fisioterapeutas peritos na área. Procedimentos: 1, Revisão da literatura para fundamentar o estudo e organizar lista-guia de habilidades para levantamento de habilidades necessárias para execução adequada da sessão de massoterapia, seguida de elaboração e definição operacional das habilidades categorizadas. 3. Submissão da lista a peritos. Resultados: A revisão de literatura apontou para dez habilidades, não técnicas, necessárias para prática de massoterapia clínica. A observação mostrou um conjunto de outras onze habilidades complementares. A avaliação dos peritos mostrou que a lista e definições elaboradas eram pertinentes e adequadas ao propósito do estudo. Conclusão: O estudo gerou uma lista com 21 habilidades e suas descrições operacionais a serem ensinadas e treinadas durante a aplicação de massoterapia em situação clínica. O método de pesquisa se mostrou adequado para atingir os objetivos do estudo.