Reliability and Validity of the Health-Promoting Lifestyle Profile II Spanish Version in University Students.

AIM: The purpose of this study was to assess the reliability and validity of the Spanish version of the Health Promoting Lifestyle Profile II (HPLP-II) scale in Colombian university students. METHODS: This was a methodological study to verify reliability and construct validity. A total of 763 undergraduate university students in Cali, Colombia, agreed to participate in the study by filling out a form that included information on sociodemographic characteristics and the HPLP-II scale Spanish version. Data were collected between February and June 2021. To determine construct validity, a confirmatory factor analysis was performed, and internal consistency was determined through Cronbach's alpha. RESULTS: The confirmatory factor analysis of the proposed theoretical model showed that the goodness-of-fit indices of the scale demonstrated an acceptable level of validity nearing an excellent level of fit (χ2 = 7168.98; gl = 1268; p < 0.001; root mean square error of approximation = 0.08; normed fit index, adjusted goodness-of-fit index = 0.95). Cronbach's alpha coefficient of the scale was 0.94, and the subscales ranged from 0.68 to 0.89. CONCLUSIONS: The HPLP-II Spanish version is a valid and reliable instrument to assess the health-promoting lifestyle profile of university students.

Effectiveness of an Interpersonal Influence Intervention to Increase Commitment to Adopt Health-Promoting Behavior in Nursing Students.

Purpose: To determine the efficacy of the "interpersonal influence intervention" conducted by health professionals to increase the commitment to adopt health-promoting behavior in nursing students compared to the usual care of a university wellness program. Patients and Methods: A quasi-experimental study was performed. The study included 114 nursing students from a university in Cali, Colombia, who were divided into a control group (n = 57) that received usual care and an experimental group (n = 57) that received the intervention designed and validated according to Nola Pender's Health Promotion Model. The main outcome was the lifestyle measured before and after the test using the Health-Promoting Lifestyle Profile II Spanish version. The effect of the intervention was carried out through the average comparison, effect size measures were calculated using Cohen's d and analysis of the effect of possible confounding variables on the intervention (ANCOVA). Results: A statistically significant difference was observed between the experimental group and the control group (p = 0.015; 95% CI -0.42, -0.05). The effect size of the intervention was 0.49. The interpersonal influences exhibited by health professionals can increase the commitment to adopt health-promoting behaviors (Hypothesis 1), and the greater the commitment to a specific action plan, the more likely it is that health-promoting behaviors will be maintained over time (Hypothesis 2). Conclusion: The effectiveness of the intervention interpersonal influences exerted by health professionals to increase the commitment to adopt health-promoting behavior is proven. Evidence demonstrates the practical utility of the Health Promotion Model.

Feminicide in Cali Colombia: Aview from public health / Feminicidio en Cali Colombia: Una mirada desde la salud pública / Feminicídio em Cali Colômbia: Uma visão da saúde pública

Introduction:In most cases, violence against women is committed by their partners or ex-partners and this violence is a global public health problem that almost always ends in their death. Femicide is understood as the murder of a woman just for the fact of being a female individual, perpetuating gender inequality. Objective:To analyze femicide in Cali from its epidemiological characterization. Materials and methods:A descriptive population-based study was carried out using secondary sources that included 287 recordsof violent deaths of women. 53 cases between 2017 and 2019 were identified and analyzed, which were investigated and classified as femicide by the Crimes Against Women Unit of the Prosecutor's Office. The epidemiological characterization was conducted based on the information provided, which was useful to identify the study variables: age, method, place of occurrence, imprisonment of perpetrator, and sentence. Results:Femicide occurred between the ages of 9 and 89, with stabbing being the most commonly used killing method. A conviction was executed only in 18.9% of the total cases. Conclusions: Femicide occurs at any age and has a high impunity degree mostly because of an ineffective judicial system.

Introducción: En la mayoría de ocasiones, la violencia contra la mujer, es cometida por su pareja o expareja, siendo un problema de salud pública mundial que casi siempre termina en un feminicidio. Este se entiende como el asesinato de una mujer por el hecho de serlo, perpetuando la inequidad de género.Objetivo: Visibilizar el feminicidio en Cali a partir de su caracterización epidemiológica.Materiales y métodos: Se realizó un estudio descriptivo de base poblacional de fuentes secundarias, a partir de 287 registros de muertes violentas en mujeres, de los cuales se identificaron y analizaron 53 casos atendidos en la unidad devida de delitos contra la mujer de la Fiscalía entre el 2017 al 2019, tipificados como feminicidio. La caracterización epidemiológica se realizó con base en la información suministrada que permitió identificar las variables de estudio: edad, mecanismo, lugar de ocurrencia, medida de aseguramiento del victimario y sentencia.Resultados: El feminicidio se presentó entre los 9 y 89 años, el mecanismo más utilizado fue el arma corto punzante. Sólo en el 18,9% se ha dictado sentencia condenatoria.Conclusiones: El feminicidio se presenta en cualquier edad, tiene un alto grado de impunidad en muchas ocasiones por la ineficiencia del sistema judicial.

Introdução: Na maioria das vezes, a violência contra a mulher é cometida pelo companheiro ou ex-parceiro, tratando-se de um problema de saúde pública mundial que quase sempre culmina em feminicídio. Isso é entendido como o assassinato de uma mulher pelo fato de ser uma delas, perpetuando a desigualdade de gênero. Objetivo:Tornar visível o feminicídio em Cali a partir de sua caracterização epidemiológica. Materiais e métodos:Foi realizado um estudo descritivo de base populacional de fontes secundárias, a partir de 287 registros de mortes violentas de mulheres, dos quais foram identificados e analisados 53 casos, atendidos na unidade de vida por crimes contra a mulher da denúncia publica (fiscalia) entre 2017 e 2019, classificados como feminicídio. A caracterização epidemiológica foi realizada com base nas informações prestadas que permitiram identificar as variáveis do estudo: idade, mecanismo, local de ocorrência, medida de segurança do agressor e pena. Resultados:O feminicídio ocorreu entre as idades de 9e 89 anos, o mecanismo mais utilizado foi arma branca. Apenas em 18,9% houve condenação. Conclusões:O feminicídio ocorre em qualquer idade, tem alto grau de impunidade em muitas ocasiões devido à ineficiência do sistema judicial.

Influence of Personal Factors on Health-Promoting Behavior in College Students: A Structural Equation Modeling Approach.

Purpose: This study aimed to determine how personal factors influence health-promoting behavior in university students using a structural equation modeling approach guided by the Health Promotion Model. Patients and Methods: An analytical cross-sectional study was conducted. The study included 763 health science students from four universities in Cali, Colombia, who answered a questionnaire on personal factors and Health Promoting Lifestyle Profile II, Spanish version, which was validated in the study population. The direct and indirect relationships between personal factors and health-promoting behaviors were assessed using structural equation modeling. Data analysis was performed using descriptive statistics and structural equation modeling. Results: A significant relationship was noted between the biological and psychological personal factors of the measurement model (p < 0.05). Psychological personal factors (self-esteem and perceived health status) positively influence health promoting behavior in university students (Hypothesis 2). It's not possible to demonstrate that health promoting behavior is positively influenced by personal biological factors (Hypothesis 1) and by personal sociocultural factors (Hypothesis 3). Conclusion: There is a need for interventions that help improve the health-promoting lifestyle profile and are focused on enhancing the self-esteem and perceived health status of university students.

Occipital encephalocele associated with Dandy-Walker malformation: a case-based review.

INTRODUCTION: Occipital encephalocele is a brain malformation that has been remotely associated with Dandy-Walker; only case reports and very small series have been published so far; therefore, their behavior and management are still under investigation. The goal of the present case-based review is to provide a summary of the state of the art in this association. METHODS AND RESULTS: The pertinent literature has been reviewed, and an exemplary case has been reported (an 11-month-old female with Dandy-Walker malformation and occipital encephalocele). So far, 33 cases have been described, with a mean age at surgery of 5, 1 day). The majority of the cases tend to present with hydrocephalus. There are no specific surgery approaches or global consensus about this association. The management possibly relies on surgery with shunt or encephalocele excision but without a dedicated protocol yet. CONCLUSIONS: The clinical research on occipital encephalocele in association with Dandy-Walker malformation is just at the beginning. New targets and wide-ranging clinical trials are needed to get an optimal management protocol.

Systemic lupus erythematosus/ANCA-associated vasculitis overlap: An explanation for atypical lupus manifestation.

The coexistence of systemic lupus erythematosus (SLE) and ANCA-associated vasculitis (AAV) as an overlapping syndrome is not common. Here, we report a case of a 33-year-old woman, with recent SLE diagnosis due to skin, kidney, articular, and immunologic compromise, in whom a chest CT scan showed bilateral nodules, consolidations, and tree-in-bud pattern; thoracoscopic lung biopsy revealed diffuse non-caseating granulomas, without other features of sarcoid, organizing pneumonia, or hypersensitivity pneumonitis with high positive p-ANCA titers. Overlap between SLE and AAV was a possible explanation for lupus granulomatous pneumonitis, and for this reason, a multidisciplinary meeting was held to evaluate complex patients with interstitial lung diseases patients.

Consecuencias de la hipertensión arterial en las funciones cognitivas / Consequences of Arterial Hypertension over Cognitive Functions

Introducción: La hipertensión arterial, por su influencia y afectación multisistémica, surge como un factor de riesgo potencial para el deterioro progresivo de las funciones cognitivas. Objetivo: Identificar las principales alteraciones cognitivas asociadas a la hipertensión arterial, específicamente en la atención y la memoria. Métodos: Se realizó revisión bibliográfica retrospectiva de 34 estudios, teniendo en cuenta los criterios de inclusión. Se estableció una ventana temporal en el período 2002 al 2019, incluyendo las bases de datos Pubmed, Scopus, Medline y SciELO. Los textos completos se sometieron a una lectura crítica y análisis documental mediante una matriz de rastreo. Conclusiones: Una de las consecuencias más importantes de esta enfermedad es la afectación en las funciones cognitivas particularmente la atención y la memoria, con una incidencia en el deterioro cognitivo leve, profundo y medio. Sin embargo, su impacto en la cognición es un área que recientemente ha despertado el interés en la neuropsicología y la neurociencia cognitiva. La hipertensión arterial está considerada como una de las enfermedades cardiovasculares que está vinculada con la demencia, proporciona en un 50 por ciento el desarrollo de dicha enfermedad(AU)

Introduction: Arterial hypertension, due to its influence and multisystemic involvement, emerges as a potential risk factor for the progressive deterioration of cognitive functions. Objective: To identify the main cognitive alterations associated with arterial hypertension, specifically in attention and memory. Methods: A retrospective literature review of 34 studies was carried out, taking into account inclusion criteria. A time window was established from 2002 to 2019, including the PUBMED, SCOPUS, MEDLINE and SCIELO databases. The full texts were subjected to critical reading and documental analysis using a tracking matrix. Conclusions: One of the most important consequences of this disease is the negative impact on cognitive functions, particularly attention and memory, with an incidence in mild, profound and medium cognitive impairment. However, its impact on cognition is an area that has recently aroused interest in neuropsychology and cognitive neuroscience. Arterial hypertension is considered one of the cardiovascular diseases linked to dementia, since it causes the development of this disease in 50 percent of cases(AU)

Asociación entre la esterilización quirúrgica y la disfunción sexual femenina: revisión narrativa / Association between tubal sterilization and female sexual dysfunction: narrative review

Resumen OBJETIVO: Revisar el estado actual del conocimiento acerca de la asociación entre la esterilización quirúrgica femenina y la disfunción sexual en la mujer. METODOLOGIA: Estudio retrospectivo efectuado con base en la búsqueda bibliográfica de artículos publicados en inglés y español en las bases de datos de PubMed, LILACS, MEDLINE y EBSCO entre los años 1990 y 2022. Se seleccionaron artículos con estudios de cohorte, observacionales, casos y controles, revisiones bibliográficas sistemáticas, ensayos clínicos y metanálisis. RESULTADOS: Se obtuvieron 50 artículos de los que se excluyeron 38 por duplicidad, idioma diferente al inglés o español, sin relación con el tema específico o no estaban completos. Al final se incluyeron 12 artículos que cumplieron con los criterios para la revisión. CONCLUSIONES: La asociación entre esterilización quirúrgica y disfunción sexual femenina ha sido ampliamente discutida, pero poco estudiada. Los ensayos disponibles son observacionales efectuados en contextos socioculturales diversos, con desenlaces contradictorios y con limitaciones metodológicas. Los resultados obtenidos varían según el contexto sociocultural y el papel de la mujer en la sociedad donde se estudia, las creencias religiosas y el grado de escolaridad. Es necesario emprender más estudios con mejor calidad metodológica para establecer recomendaciones más precisas y, así, repercutir en la salud sexual de las mujeres.

Abstract OBJECTIVE: Review current status of knowledge about the association between female surgical sterilization and sexual dysfunction in women. METHODOLOGY: Retrospective study based on a literature search of articles published in English and Spanish in PubMed, LILACS, MEDLINE and EBSCO databases between 1990 and 2022. Articles with cohort, observational, case-control, systematic literature reviews, clinical trials and meta-analyses were selected. RESULTS: We obtained 50 articles of which 38 were excluded due to duplicity, language other than English or Spanish, unrelated to the specific topic or not complete. In the end, 12 articles that met the criteria for review were included. CONCLUSIONS: The association between surgical sterilization and female sexual dysfunction has been widely discussed, but little studied. The available trials are observational conducted in diverse sociocultural contexts, with contradictory outcomes and methodological limitations. The results obtained vary according to the sociocultural context and the role of women in the society being studied, the religious beliefs and level of schooling. More studies with better methodological quality are needed to establish more precise recommendations and thus have an impact on women's sexual health.

The Effect of Demonstrator Social Rank on the Attentiveness and Motivation of Pigs to Positively Interact with Their Human Caretakers.

In this study, we addressed the social attentiveness, as well as the phenomenon of social facilitation and inhibition in the context of a positive human-pig relationship. Specifically, we investigated whether the social rank of an experienced pig (termed "demonstrator") has an effect on the attentiveness of the remaining pen mates (N = 40) when they observe the demonstrator being gently handled by a stockperson from behind an acrylic panel. We found that pigs preferentially attended to dominant demonstrators rather than subordinate demonstrators during their gentle handling sessions with the stockperson. Additionally, we also examined whether the presence of a demonstrator pig of different social rank, who previously established a positive relationship with the stockperson in presence of conspecifics, affects the behavior and motivation of their pen mates to positively interact with the stockperson. To test for the effect of the presence and demonstrator's social rank on pen mate interactions with the stockperson, we evaluated the behavior of domestic pigs (N = 65) toward the stockperson using a human-approach test in their home-pen. Pigs showed a decrease in their motivation to positively interact with the stockperson when a socially dominant demonstrator was present, behaving similarly to animals receiving minimal human contact (control group). Overall, they exhibited a greater latency to physical contact, a lower acceptance of stroking, and spent more time looking at the stockperson compared to pigs exposed to subordinate demonstrators. Taken together, these findings expand our current understanding of pigs' cognition and social behavior, and the nature of social attention bias in farm animals. Our findings indicate that positive handling of previously selected subordinate demonstrators seems to be the best strategy to reduce the level of fear in large groups of pigs.

Recomendaciones para reumatólogos sobre el manejo farmacológico durante la emergencia sanitaria por COVID-19: opinión de un grupo de expertos / Recommendations for rheumatologists on pharmacological management during the COVID-19 health emergency: Expert group opinion

RESUMEN La enfermedad por Coronavirus 2019 (COVID-19) es una pandemia inesperada que ha pro vocado un estado de emergencia y que ha generado cambios drásticos en los protocolos de atención clínica. Para su tratamiento se ha descrito el papel de algunos medicamen tos usados habitualmente en artritis reumatoide, lupus eritematoso sistémico y otras enfermedades autoinmunitarias sistémicas. Debido a ello, existe un inminente riesgo de desabastecimiento, por lo cual el objetivo de esta revisión narrativa y opinión de expertos es formular recomendaciones generales clínicas y administrativas sobre el manejo de pacien tes ambulatorios con enfermedad autoinmunitaria o inflamatoria sistémica en el contexto de la pandemia por COVID-19.

ABSTRACT Coronavirus 2019 (COVID-19) is an unexpected pandemic that has caused a state of emergency, as well as generating drastic changes in clinical care protocols. Some drugs commonly used in rheumatoid arthritis, systemic lupus erythematosus, and other systemic autoimmune diseases have been described for its treatment. Therefore, there is an imminent risk of shortages. The aim of this narrative review and expert opinion is to present general recommendations on the clinical and administrative management of outpatients with autoimmune or systemic inflammatory disease, in the context of the COVID-19 pandemic.

EXPRESIÓN DE LA PROTEÍNA CORE DEL VIRUS DE LA HEPATITIS C EN CÉLULAS HepG2 USANDO EL VIRUS DEL BOSQUE DE SEMLIKI / Hepatitis C virus core protein expression in HepG2 cells using Semliki Forest Virus

RESUMEN El Virus de la Hepatitis C (VHC) codifica la proteína Core. Que, además de ser la subunidad de la cápside, participa en diferentes mecanismos de patogénesis de la infección por VHC. Dado que el sistema de replicación in vitro del VHC presenta limitaciones, el uso de vectores virales podría ser una herramienta útil para estudiar las propiedades de la proteína Core. Con el fin de validar el vector con el Virus del Bosque de Semliki (SFV) para el estudio de Core en células HepG2, se evaluó la expresión de la proteína verde fluorescente (GFP) y la proteína Core utilizando este vector viral. Las expresiones de GFP y Core se detectaron en células HepG2 transducidas con rSFV de 24 a 96 horas postransducción. La expresión de la proteína Core fue inferior a la expresión de GFP en las células HepG2. Teniendo en cuenta que la proteína Core del VHC puede regular la actividad del gen p53, se evaluó el nivel transcripcional de este gen. Se observó una disminución en el nivel de mARN de p53 en las células luego de la transducción, comparado con las células control. Aunque las células transducidas con rSFV-Core presentaron el menor nivel de mARN de p53, la diferencia no fue significativa comparada con las células transducidas con rSFV-GFP. Los resultados confirman que rSFV permite la expresión transitoria de proteínas heterólogas en líneas celulares de hepatoma humano. Se necesitan estudios adicionales para determinar si la expresión disminuida de Core puede deberse a degradación de la proteína viral.

ABSTRACT The Hepatitis C Virus (HCV) encodes the structural protein Core, which in addition to being the capsid subunit, participates in different mechanisms of HCV infection pathogenesis. Since HCV in vitro replication system has limitations, the use of viral vectors could be a useful tool to study the Core protein properties. To validate the Semliki Forest Virus (SFV) strategy in transduced HepG2 cells to study the HCV Core protein, the expression of green fluorescent protein (GFP) and Core protein expressions were detected 24 to 96 hours post-transduction in HepG2 cells transduced with rSFV. Core protein expression was lower than GFP expression in HepG2 cells. Since HCV Core protein can regulate the activity of the p53 gene, the transcriptional level of this gene was evaluated. A decrease in the level of p53 mRNA was observed in the cells after transduction, compared to the control cells. Although the cells transduced with rSFV-Core had the lowest level of p53 mRNA, the difference was not significant compared to cells transduced with rSFV-GFP. The results confirm that rSFV allows the transient expression of heterologous proteins in human hepatoma cell lines. Additional studies are needed to determine whether the decreased expression of Core may be due to the degradation of the viral protein.

La profesión académica en salud: ¿formación o capacitación? / The academic profession in the health area: formation or capacity building?

Introducción: El papel del profesor universitario como orientador, facilitador e investigador necesita de una actualización permanente, no solo desde su saber disciplinar, sino desde el área pedagógica que le permita, durante el ejercicio académico, una postura más educativa que trascienda al sujeto para contribuir al mejoramiento de la calidad educativa. Objetivo: Identificar el nivel de formación de los profesores en ciencias de la salud en una institución de educación superior en Cali Colombia. Desarrollo: Como todas las profesiones, la académica ha estado sujeta a los cambios que la globalización impone. Por ello es pertinente que los profesores del campo de las ciencias de la salud comprendan que formar a los estudiantes requiere del mejoramiento permanente de prácticas que posibiliten la formación integral a partir de modelos activos participativos y no solo de la adquisición del conocimiento en un saber disciplinar propio. Conclusiones: La profesión académica, como un reconocimiento a la acción académica en la educación superior, ha centrado su importancia en la formación de los docentes. En el modelo de enseñanza de los profesionales persisten esquemas repetitivos, acríticos y poco reflexivos(AU)

Introduction: The role of the university professor as a counselor, facilitator and researcher needs to be updated permanently, not only from his/her disciplinary knowledge, but from the pedagogical area that allows him/her, during the academic practice, a more educational position transcending the subject to contribute to the improvement of educational quality. Objective: To identify the level of training of professors in health sciences. Development: Like all professions, teaching has been subject to changes imposed by globalization. For this reason, it is relevant for teachers in the field of health sciences to understand that training students requires permanent improvement of practices that enable comprehensive training based on active participatory models, and not only the acquisition of knowledge in disciplinary knowledge. Conclusions: The scholarly profession, as a recognition of academic action in higher education, has focused its importance on training teachers. In the professional teaching model, there are still repetitive, uncritical and not very reflective schemes(AU)

Do Domestic Pigs Acquire a Positive Perception of Humans through Observational Social Learning?

Farm animals can perceive humans positively by observing another animal being positively handled. This study evaluated whether pigs acquire a positive perception of humans after observing either a high or low socially ranked conspecific receiving gentle handling. Seventy-five 21-week-old pigs were housed in 15 nursery pens (five pigs/pen) and randomly assigned to one of three pen treatments: Dominant Demonstrator Group (DDG), Subordinate Demonstrator Group (SDG) and Control Group (CG). Pigs from DDG and SDG observed a high and low socially ranked conspecific ("demonstrator"), respectively, while the demonstrator received gentle stroking and a sucrose solution for 10 min, twice a day for 5 weeks. Control group pigs received minimal human contact. Following treatment, the behavior and heart rate variability of non-demonstrator pigs were evaluated in response to a stockperson in an open-field test. Pigs from the DDG and SDG contacted the stockperson sooner (p < 0.001), spent more time investigating the stockperson (p < 0.05), accepted more stroking (p < 0.001) and exhibited a lower low/high frequency ratio (p = 0.015) compared to the CG. No differences in learning between the pigs from the DDG and SDG were found. These results suggest that pigs can learn to perceive humans positively through observational social learning, regardless of the demonstrator conspecific's social rank.

Exploring Anhedonia in Kennelled Dogs: Could Coping Styles Affect Hedonic Preferences for Sweet and Umami Flavours?

Kennelled dogs are at risk of suffering chronic stress due to long-term spatial, social and feeding restrictions. Chronic stress may decrease the dogs' capacity to feel pleasure when facing hedonic experiences, modifying their perception for palatable ingredients. However, different abilities to cope with environmental stressors could prevent the onset of anhedonia. Fourteen kennelled Beagle dogs were used to study the acceptability and preference for different dilute sucrose and monosodium glutamate (MSG) solutions. Coping style of animals was previously evaluated through a human approach test (HAT) and classified as close dogs (CD; proactive) or distant dogs (DD; reactive) according to whether or not they approached an unfamiliar human when a feeding opportunity was presented. Consumption results were analysed taking into account the sucrose/MSG concentrations, HAT (CD or DD), age, and weight of the animals. DD presented a lower intake of sucrose (p = 0.041) and MSG (p = 0.069) solutions compared with CD. However, DD exhibited a higher consumption of MSG than CD at its highest concentrations, supporting that their intake depends on solution palatability. Finally, DD did not prefer sucrose or MSG solutions over water at any dilute solution offered. Together, these results suggest that dogs that are categorized as reactive animals could diminish their ability to perceive dilute palatable solutions, reflecting depressive-like behaviours as anhedonia.

Complicaciones neurológicas y extra neurológicas en pacientes con ACV internados en el Hospital de Clínicas de Montevideo durante un período de 2 años / Neurological and extra-neurological complications in stroke patients treated at Hospital de Clinicas during a 2 years period / Complicações neurológicas e extraneurológicas em pacientes com AVC internados no Hospital de Clínicas de Montevidéu por um período de 2 anos

Introducción: Los pacientes con Ataque Cerebrovascular (ACV) presentan un elevado riesgo de complicaciones durante la internación, que pueden condicionar su pronóstico. Objetivos: Describir las complicaciones neurológicas y extra neurológicas durante la internación. Evaluar sus características y diferencias de acuerdo al tipo de ACV. Identificar factores predictores de complicaciones y de mortalidad intrahospitalaria. Pacientes y métodos: Fueron incluidos en el estudio los pacientes atendidos en el Hospital de Clínicas (HC) de Montevideo con diagnóstico de ACV entre 1/1/14 y 31/12/15. Se analizaron las principales características clínico-epidemiológicas de los pacientes, se pesquisó la presencia o no de complicaciones según el subtipo y se clasificaron en Neurológicas y Extra Neurológicas (Sistémicas y Cardiovasculares). Resultados: Se analizaron 206 pacientes, 57 % de los cuales presentaron complicaciones, indistintamente del subtipo de ACV. Las más habituales fueron las sistémicas, en 49 % de los casos. La edad, diabetes, NIHSS al ingreso, cardiopatía previa y trombólisis se asociaron en forma significativa e independiente a complicaciones. La mortalidad intrahospitalaria fue 11 %, siendo significativamente menor en los pacientes que ingresaron a la Unidad de ACV del centro. Conclusiones: Las complicaciones fueron muy frecuentes y la principal causa de muerte, siendo las sistémicas las más prevalentes. Ciertas variables se asociaron a un mayor riesgo de complicaciones: edad, diabetes, cardiopatía previa, NIHSS al ingreso, y la trombolisis. La Unidad de ACV descendió la mortalidad en forma significativa.

Introduction: Stroke patients present high risk of complications conditioning its prognosis. Objectives: To describe neurological and extra-neurological complications during admission. To evaluate complications according with stroke subtype, identifying morbidity and mortality predictive factors. Patients and methods : All patients treated at the Hospital de Clínicas (HC) with a diagnosis of stroke between 01/01/14 and 12/31/15 were analyzed. The presence or absence of complications was also analyzed according to stroke subtype during the hospital stay and were classified into three groups: neurological and extra-neurological, the last ones subdivided into systemic and cardiovascular diseases. Results: Sample of 206 patients. 57 % of them presented complications, regardless to the stroke subtype. The most common complications were the systemic ones (49 %). Age, diabetes, NIHSS at admission, previous cardiac disease and thrombolysis were significantly associated with complications. Overall mortality was 11 %. Mortality was significantly lower for patients admitted to the institutional Stroke Unit. Conclusions : Stroke complications were very frequent and are the main cause of mortality, with systemic complications being the most common. Furthermore, there are other variables which are associated with a greater risk of complications such as older age, diabetes, previous heart disease, NIHSS at admission, and thrombolysis. Admission to stroke unit resulted in a significant decrease in the mortality rate.

Introdução: Pacientes com Ataque Cerebrovascular (AVC) apresentam alto risco de complicações durante a hospitalização, o que pode condicionar seu prognóstico. Objetivos: Descrever as complicações neurológicas e extra neurológicas durante a hospitalização. Avalie suas características e diferenças de acordo com o tipo de ACV. Identifique fatores que predizem complicações e mortalidade hospitalar. Pacientes e métodos: Os pacientes atendidos no Hospital de Clínicas (HC) de Montevidéu com diagnóstico de acidente vascular cerebral entre 1/1/14 e 31/12/15 foram incluídos no estudo. As principais características clínico-epidemiológicas dos pacientes foram analisadas e a presença ou ausência de complicações de acordo com o subtipo foi investigada e classificada em Neurológica e Extra Neurológica (Sistêmica e Cardiovascular). Resultados: foram analisados 206 pacientes, 57 % dos quais apresentaram complicações, independentemente do subtipo ACV. Os mais comuns foram sistêmicos, em 49 % dos casos. Idade , diabetes, NIHSS na admissão, Trombólise foram significativamente associados a complicações. A mortalidade intra-hospitalar foi de 11 %, sendo significativamente menor nos pacientes internados na Unidade de ACV do centro. Conclusões: As complicações foram muito freqüentes e a principal causa de morte, sendo as sistêmicas as mais prevalentes. Certas variáveis foram associadas a um risco aumentado de complicações: idade, diabetes, doença cardíaca prévia, NIHSS na admissão e trombólise. A Unidade de ACV diminuiu significativamente a mortalidade.

Calidad de vida en pacientes con esclerosis múltiple atendidos en una institución de salud de Medellín, Colombia / Quality of life of patients with multiple sclerosis treated at a health institution in Medellin, Colombia

Resumen Introducción: La calidad de vida relacionada con salud (CVRS) en la esclerosis múltiple (EM), puede verse afectada por factores físicos, clínicos y sociodemográficos. Objetivo: Determinar el efecto de factores sociodemográficos, clínicos y físicos en la calidad de vida (CV) de pacientes con EM. Materiales y métodos: Se aplicó el instrumento WHOQOL-BREF de la OMS a 173 pacientes de una institución de salud. Se realizó análisis descriptivo de características sociodemográficas, clínicas y físicas y sus puntajes de CV. Se observó la asociación entre CV global con factores sociodemográficos, clínicos y físicos; finalmente, por medio de análisis multivariado. Resultados: El 80,3% fueron mujeres, la mediana de edad de 43 años (RIC= 51-35). La fatiga fue el síntoma más frecuente ((71%). Los factores de riesgo para tener peor CV fueron: sexo femenino (RP=6,92. IC 95% 1,8-26,58), alteración en control de esfínteres (RP= 6,10 IC 95% 1,26-29,51), trastornos cognitivos (RP=4,46 IC 95% 1,07-18,56), riesgo de depresión (RP= 3,82 IC 95% 1,01-14,38) y no realizar fisioterapia (RP= 4,48 IC 95% 1,08-18,34). Conclusiones: La afectación de CV en la EM, según factores sociodemográficos y clínicos es variable. Evaluar la CVRS en la práctica clínica, permite entender el comportamiento y necesidades del paciente para intervenir factores de riesgo.

Abstract Introduction: Health-related quality of life (HRQL) in multiple sclerosis (MS) patients can be affected by physical, clinical and sociodemographic factors. Objective: To determine the effect of sociodemographic, clinical and physical factors on the quality of life (QL) of patients with MS. Materials and methods: The WHO WHOQOL-BREF instrument was applied to 173 patients of a health institution. Descriptive analysis of sociodemographic, clinical and physical characteristics and their QL scores were performed. The association between global QL with sociodemographic, clinical and physical factors was observed; finally, through multivariate analysis. Results: 80.3% were women, the median age was 43 years (IQR = 51-35). Fatigue was the most frequent symptom (71%). The risk factors for worse QL were: female sex (RP = 6.92. 95% CI 1.8-26.58), abnormal sphincter control (RP = 6.10 95% CI 1.26-29.51), cognitive disorders (RP = 4.46 95% CI 1.07-18.56), risk of depression (RP = 3.82 95% CI 1 , 01-14,38) and lack of physiotherapy (RP = 4.48 95% CI 1.08-18.34). Conclusions: The effect of QL in MS is variable and depends on sociodemographic and clinical factors. Evaluating the (HRQL) in clinical practice facilitates the understanding of the behavior and needs of the patient required for risk factors intervention.

Serosurveillance for vaccine-preventable diseases: A look inside the pertussis experience / Serovigilancia de enfermedades prevenibles por vacunación: una mirada desde la experiencia con la tosferina

INTRODUCTION: Serological surveillance (serosurveillance) provides the most direct measure of herd immunity of vaccine-preventable diseases. Little is known about the opportunities and challenges of serosurveillance experiences, particularly pertussis. OBJECTIVE: To describe the process of serosurveillance for vaccine-preventable diseases with an emphasis on the experience of pertussis in the metropolitan area of Antioquia (Valle de Aburrá) in 2015 and 2016 and analyze the contributions and challenges for its sustainability. MATERIALS AND METHODS: We described the planning and conduction of serosurveillance of pertussis antibodies of mothers and in the umbilical cord at the time of delivery in eight hospitals based on random sampling and their capacity to advance the serosurveillance periodically. We compared the contributions and the challenges of this experience with other probabilistic and non-probabilistic programs. RESULTS: We achieved the participation of hospitals and mothers respecting the delivery care process. We established a serum bank following ethical and technical guidelines. This program based on the random selection of hospitals and mothers has enabled the estimation of antibodies prevalence in mothers and in the umbilical cord, which has been possible given the high coverage of hospital care during childbirth at a lower cost and fewer risks than a population-based survey in conflictive areas. The main challenges for the sustainability of this program are the creation of stable jobs and access to funding and legal and methodological long-term frameworks. CONCLUSIONS: Hospital serosurveillance as described is an option to monitor the impact of vaccination on the population. Our experience could be reproduced in other regions under similar conditions if the above-mentioned challenges are solved.

Introducción. La vigilancia serológica es la forma más directa de medir la inmunidad de rebaño frente a las enfermedades prevenibles por vacunación. Poco se sabe acerca de las oportunidades y los desafíos de las experiencias de serovigilancia, en general y, específicamente, la de la tosferina.Objetivo. Describir el proceso de serovigilancia de enfermedades prevenibles por vacunación con énfasis en la experiencia en el caso de la tosferina en el área metropolitana de Antioquia (Valle de Aburrá) en el 2015 y el 2016 y analizar lo que dicha experiencia ha aportado y los desafíos que persisten para su sostenibilidad.Materiales y métodos. Se describió el proceso de planeación y el desarrollo de la serovigilancia de tosferina en el momento del parto en ocho hospitales seleccionados al azar, así como la capacidad para adelantar el programa de manera periódica. Se compararon los aportes y los desafíos en el curso de esta experiencia con los de otros programas poblacionales probabilistas e institucionales no probabilistas.Resultados. Se logró la participación de los hospitales y de las madres con pleno respeto del proceso de atención del parto, y se conformó un banco de sueros siguiendo lineamientos éticos y técnicos. El programa permitió estimar la prevalencia de anticuerpos en la madre y en el cordón umbilical, lo que se facilitó por la alta cobertura de atención hospitalaria del parto, a un menor costo y menos riesgos que los programas poblacionales en zonas conflictivas. Los principales desafíos para la sostenibilidad del programa son la estabilidad laboral del personal de salud, así como normas y una financiación de largo plazo.Conclusiones. La serovigilancia hospitalaria es una opción para monitorizar el impacto poblacional de la vacunación. Esta experiencia se podría extender a otras regiones en condiciones similares si se resuelven los retos mencionados.

Serosurveillance for vaccine-preventable diseases: A look inside the pertussis experience / Serovigilancia de enfermedades prevenibles por vacunación: una mirada desde la experiencia con la tosferina

Abstract Introduction: Serological surveillance (serosurveillance) provides the most direct measure of herd immunity of vaccine-preventable diseases. Little is known about the opportunities and challenges of serosurveillance experiences, particularly pertussis. Objective: To describe the process of serosurveillance for vaccine-preventable diseases with an emphasis on the experience of pertussis in the metropolitan area of Antioquia (Valle de Aburrá) in 2015 and 2016 and analyze the contributions and challenges for its sustainability. Materials and methods: We described the planning and conduction of serosurveillance of pertussis antibodies of mothers and in the umbilical cord at the time of delivery in eight hospitals based on random sampling and their capacity to advance the serosurveillance periodically. We compared the contributions and the challenges of this experience with other probabilistic and non-probabilistic programs. Results: We achieved the participation of hospitals and mothers respecting the delivery care process. We established a serum bank following ethical and technical guidelines. This program based on the random selection of hospitals and mothers has enabled the estimation of antibodies prevalence in mothers and in the umbilical cord, which has been possible given the high coverage of hospital care during childbirth at a lower cost and fewer risks than a population-based survey in conflictive areas. The main challenges for the sustainability of this program are the creation of stable jobs and access to funding and legal and methodological long-term frameworks. Conclusions: Hospital serosurveillance as described is an option to monitor the impact of vaccination on the population. Our experience could be reproduced in other regions under similar conditions if the above-mentioned challenges are solved.

Resumen Introducción. La vigilancia serológica es la forma más directa de medir la inmunidad de rebaño frente a las enfermedades prevenibles por vacunación. Poco se sabe acerca de las oportunidades y los desafíos de las experiencias de serovigilancia, en general y, específicamente, la de la tosferina. Objetivo. Describir el proceso de serovigilancia de enfermedades prevenibles por vacunación con énfasis en la experiencia en el caso de la tosferina en el área metropolitana de Antioquia (Valle de Aburrá) en el 2015 y el 2016 y analizar lo que dicha experiencia ha aportado y los desafíos que persisten para su sostenibilidad. Materiales y métodos. Se describió el proceso de planeación y el desarrollo de la serovigilancia de tosferina en el momento del parto en ocho hospitales seleccionados al azar, así como la capacidad para adelantar el programa de manera periódica. Se compararon los aportes y los desafíos en el curso de esta experiencia con los de otros programas poblacionales probabilistas e institucionales no probabilistas. Resultados. Se logró la participación de los hospitales y de las madres con pleno respeto del proceso de atención del parto, y se conformó un banco de sueros siguiendo lineamientos éticos y técnicos. El programa permitió estimar la prevalencia de anticuerpos en la madre y en el cordón umbilical, lo que se facilitó por la alta cobertura de atención hospitalaria del parto, a un menor costo y menos riesgos que los programas poblacionales en zonas conflictivas. Los principales desafíos para la sostenibilidad del programa son la estabilidad laboral del personal de salud, así como normas y una financiación de largo plazo. Conclusiones. La serovigilancia hospitalaria es una opción para monitorizar el impacto poblacional de la vacunación. Esta experiencia se podría extender a otras regiones en condiciones similares si se resuelven los retos mencionados.

Efectos de la prótesis dental en la función masticatoria de adultos mayores / Effects of dental prosthesis in the chewing function of the elderly

A medida que envejecemos, en la cavidad oral se producen cambios estructurales, por lo que adultos y adultos mayores requieren del uso de prótesis dental. Sin embargo, la implementación de la prótesis dental puede generar insatisfacción en relación a las diferentes funciones orofaciales. Se realizó una revisión de literatura con el propósito de determinar cómo el uso de prótesis dental afecta la función masticatoria en adultos mayores. La búsqueda consistió en artículos científicos originales en idioma español, inglés y portugués, sin límites temporales, en la base de datos PubMed y de forma manual. Se seleccionaron 45 artículos científicos tras la aplicación de filtros. El uso de prótesis dental afecta la función masticatoria en adultos y adultos mayores, siendo un factor crítico en términos de su nivel de satisfacción y calidad de vida, así como de la velocidad masticatoria, formación del bolo y preferencia de alimentos.

As we grow old, structural changes occur in the oral cavity, so elderly people require the use of dental prostheses. However, the implementation of the dental prosthesis can generate dissatisfaction in relation to the different orofacial functions. A literature review was conducted to determine how the use of dental prosthesis affects masticatory function in elderly people. The review consisted of original scientific articles in Spanish, English and Portuguese, without time limits, in the PubMed database and manually. Forty-five scientific articles were selected after the application of filters. The use of dental prosthesis affects chewing function in adults and older adults, being a critical factor in terms of their level of satisfaction and quality of life, as well as masticatory speed, bolus formation and food preference.