Influencia de determinantes de género en la anticoncepción de estudiantes de Enfermería y Obstetricia mexicanas / Influence of gender determinants on anticonception among Mexican Nursing and Obstetrics students / Influência de determinantes de gênero na anticoncepção de estudantes de Enfermagem e Obstetrícia Mexicanas

Objetivo: Analizar la influencia de los determinantes de género en la anticoncepción de estudiantes de Enfermería y Obstetricia de la Universidad Nacional Autónoma de México (UNAM). Método: Estudio observacional analítico con enfoque cuantitativo. Se administró el cuestionario COGANT, anónimo, voluntario y autocumplimentado de forma digital. Muestreo no probabilístico, incidental. Se incluyó a todas las estudiantes mujeres que aceptaron participar en el estudio de forma voluntaria, matriculadas en la asignatura de Obstetricia I de la Escuela Nacional de Enfermería y Obstetricia de la UNAM (n = 121). Análisis descriptivo de la media, desviación típica, rango y mediana de la puntuación total. Análisis factorial y test de normalidad de K-S. Se analizaron las puntuaciones obtenidas en cada ítem mediante porcentajes utilizando SPSS v. 23. Resultados: La puntuación media del cuestionario fue 58.68, DT 8.39, rango 43-87. En este estudio se comprobó que el eje central de la relación de pareja ya no es la maternidad. No se encontró gran influencia de los condicionantes de género en la salud reproductiva de las alumnas, predominó la autonomía y una actitud más igualitaria. Sin embargo, persisten algunos estereotipos de género, como la actitud pasiva o sumisa de las mujeres y un rol de género inseguro. Conclusiones: Desde las universidades los estudiantes de Enfermería deben capacitarse en salud sexual y reproductiva con perspectiva de género para que, al involucrarse después como profesionales de enfermería en la educación sexual integral de adolescentes, promuevan la igualdad de género y normas sociales equitativas e influyan sobre la conducta sexual más segura, ya que aplaza el inicio de las relaciones sexuales y aumenta el uso de los preservativos.

Objective: To analyze the influence which gender determinants have on Nursing and Obstetrics students of the National Autonomous University of Mexico. Method: This is an analytic observational study with a quantitative focus. The COGANT questionnaire was digitally offered to be voluntarily and anonymously completed. Sampling was non-probabilistic and incidental. The sample was constituted by n = 121 women students from the Obstetrics I course who voluntarily decided to participate. A descriptive analysis which included mean, typical deviation, range, and median calculation from the total scores was carried out. A factorial analysis and a K-S normality test were performed. SPSS v. 23 was used. Results: The median score in the questionnaire was 58.68, TD =8.39, range =43 to 87. The findings suggested that maternity is no longer the main core of the couple relationship. Gender conditions were not found to be highly influential on the students' reproductive health. An autonomous and equalitarian attitude prevailed among; nevertheless, some gender stereotypes such as passive or submissive attitude and an uncertain gender role still prevailed among some students. Conclusions: Within universities, nursing students should train and strengthen their sexual and reproductive health under a gender perspective so that they can also project, and promote, gender equalitarian social norms which can foster safe health behaviors including the use of preservatives and an older age of sexual relations initiation.

Objetivo: Analisar a influência dos determinantes de género na anticoncepção de estudantes de Enfermagem e Obstetrícia da Universidade Nacional Autónoma de México (UNAM). Método: Estudo observacional analítico com enfoque quantitativo. Administrou-se o questionário COGANT, anónimo, voluntário e auto oferecido de forma digital. Amostragem não probabilística, incidental. Incluíram-se todas as estudantes mulheres que aceitaram participar no estudo de forma voluntaria, matriculadas na disciplina de Obstetrícia I da Escola Nacional de Enfermagem e Obstetrícia da UNAM, corresponderam a uma n = 121. Análise descritiva da média, desvio típico, faixa e media da pontuação total. Análise fatorial e teste de normalidade de K-S. Analisaram-se as pontuações obtidas em cada item mediante porcentagens utilizando SPSS v. 23. Resultados: A pontuação média do questionário foi 58.68, DT 8.39, faixa 43-87. Neste estudo comprovou-se que o eixo central da relação do casal já não é a maternidade. Não se encontrou grande influência das condicionantes de género na saúde reprodutiva das alunas, predominou a autonomia e uma atitude mais igualitária. Porém, persistem alguns estereótipos de género como a atitude passiva ou submissa das mulheres e um rolo de género inseguro. Conclusões: Desde as universidades os estudantes de Enfermagem devem capacitar-se na saúde sexual e reprodutiva com perspectiva de género, para que ao envolver-se depois como profissionais de enfermagem na educação sexual integral de adolescentes, promovam a igualdade de género e normas sociais equitativas e influenciem sobre uma conduta sexual mais segura, já que adia o início das relações sexuais e aumenta o uso dos preservativos.

Elastografía tipo ARFI: modificación tras tratamiento antiviral en el trasplante hepático con recidiva por VHC / ARFI elastography: changes after direct-acting antiviral treatment in transplanted livers with relapse of hepatitis C virus infection

Objetivo. Evaluar la modificación de los valores en la elastografía hepática tipo ARFI tras el tratamiento antiviral en pacientes con trasplante hepático e infección por el virus de la hepatitis C (VHC) con recidiva durante el postrasplante. Material y métodos. Se han estudiado 15 pacientes receptores de trasplante hepático con infección por el VHC y recidiva sobre el injerto durante el primer año tras el trasplante que fueron tratados con antivirales de acción directa. A todos ellos se les realizó ecografía basal, Doppler y elastografía hepática tipo ARFI en los 3 meses anteriores al inicio del tratamiento y durante los 3 meses posteriores a su finalización. En la misma semana de la elastografía se realizó analítica con perfil hepático y determinación de la carga viral (ARN-VHC) en sangre periférica mediante técnica de reacción en cadena de la polimerasa. Se ha estudiado el cambio en las velocidades de cizallamiento de la elastografía antes y después del tratamiento. El análisis estadístico se ha efectuado mediante el test de Wilcoxon para datos apareados. Resultados. Todos los pacientes alcanzaron una respuesta viral mantenida a los 3 meses de finalizar el tratamiento. Se han encontrado diferencias estadísticamente significativas en las velocidades de la elastografía, con disminución de estas tras finalizar el tratamiento (la mediana de los valores de la onda de cizallamiento previos al tratamiento fue de 1,97m/s, y tras finalizarlo fue de 1,58m/s; p=0,001). Conclusión. La velocidad de la onda de cizallamiento disminuye de manera significativa tras el tratamiento antiviral en los pacientes receptores de trasplante hepático con recidiva de la infección por VHC (AU)

Objective. To evaluate the changes in the values obtained in acoustic radiation force impulse (ARFI) elastography of the liver after antiviral treatment in patients with liver transplants and hepatitis C virus (HVC) infection recurring after transplantation. Material and methods. We studied 15 patients infected with HVC who had received liver transplants where an HVC infection recurring in the graft within one year after the transplant was treated with direct-acting antivirals. All patients underwent ultrasonography including Doppler and ARFI elastography in the three months before starting treatment with direct-acting antivirals (baseline study) and again in the three months after finishing the treatment. In the same week when the elastography study was done, liver function tests were done and the viral load (HCV RNA) was determined in peripheral blood with the polymerase chain reaction method. We used the Wilcoxon test for paired samples to compare the changes in the shear wave velocities before and after treatment. Results. All patients achieved a virologic response that was sustained at 3 months after the end of treatment. On elastography, median shear wave velocities decreased after treatment (1.97m/s before treatment vs. 1.58m/s after treatment; p=0.001). Conclusion. The shear wave velocity decreased significantly after antiviral treatment in patients who had relapsed HVC infection after liver transplantation (AU)

ARFI elastography: changes after direct-acting antiviral treatment in transplanted livers with relapse of hepatitis C virus infection. / Elastografía tipo ARFI: modificación tras tratamiento antiviral en el trasplante hepático con recidiva por VHC.

OBJECTIVE: To evaluate the changes in the values obtained in acoustic radiation force impulse (ARFI) elastography of the liver after antiviral treatment in patients with liver transplants and hepatitis C virus (HVC) infection recurring after transplantation. MATERIAL AND METHODS: We studied 15 patients infected with HVC who had received liver transplants where an HVC infection recurring in the graft within one year after the transplant was treated with direct-acting antivirals. All patients underwent ultrasonography including Doppler and ARFI elastography in the three months before starting treatment with direct-acting antivirals (baseline study) and again in the three months after finishing the treatment. In the same week when the elastography study was done, liver function tests were done and the viral load (HCV RNA) was determined in peripheral blood with the polymerase chain reaction method. We used the Wilcoxon test for paired samples to compare the changes in the shear wave velocities before and after treatment. RESULTS: All patients achieved a virologic response that was sustained at 3 months after the end of treatment. On elastography, median shear wave velocities decreased after treatment (1.97m/s before treatment vs. 1.58m/s after treatment; p=0.001). CONCLUSION: The shear wave velocity decreased significantly after antiviral treatment in patients who had relapsed HVC infection after liver transplantation.

La tecnología 2.0 al servicio de la salud materno-infantil / Technology 2.0 at the service of maternal and child health

No disponible

Evaluación por los estudiantes al tutor de enfermería en el contexto del aprendizaje basado en problemas / Student assessment on nursing mentor within the context of Problem Based Learning / Avaliação do orientador pelos estudantes de enfermagem no contexto de Aprendizagem Baseada em Problemas

IntroducciónLa universidad necesita incorporar metodologías docentes activas para adaptarse a las demandas de la sociedad del conocimiento en la que el alumno debe ser responsable de su propio aprendizaje. El rol del profesor como un tutor permite dar mayor protagonismo a los estudiantes en su proceso de aprendizaje.ObjetivoInvolucrar al alumnado de enfermería en la evaluación a sus tutoras después de utilizar metodología del aprendizaje basado en problemas y comprobar si existen diferencias en el proceso tutorial entre una tutora experta y una tutora novel.MétodosEstudio transversal, descriptivo, en una muestra de 128 estudiantes de 2.° curso de Enfermería de la Universidad de Valladolid (España) que contestaron a un cuestionario tipo Likert.ResultadosSe encontraron diferencias estadísticamente significativas (p < 0.01) en todos los ítems entre ambas tutoras. La evaluación fue muy satisfactoria.ConclusionesEvaluar al tutor permite una reflexión y retroalimentación entre los estudiantes y sus tutores, mejora la calidad docente y proporciona más autonomía a los estudiantes en su aprendizaje, implicándoles en la responsabilidad de ser honestos al evaluar las actividades de otros miembros del equipo, incluyendo las del tutor y las propias.

IntroductionThe University needs to incorporate active teaching methodologies to respond to the demands of knowledge societies in which the student must be responsible for their own learning. The role of the professor as a mentor allows students to be protagonists of their learning process.ObjectiveTo involve nursing students in the assessment of their mentors after using the methodology of Problem Based Learning, and to verify if there are differences in the mentoring process between an expert mentor and a novice one.MethodsTransversal and descriptive study with a sample of 128 students in their 2 nd Nursing course at the Valladolid University (Spain) who answered a Likert scaled questionnaire.ResultsStatistically significant differences (p < .01) were found in all items between both mentors. The assessment was very satisfactory.ConclusionsAssessing the tutor allows reflection and feedback of students and their mentors, encouraging them to be honest at evaluating the activities of other team members, including those of the tutor and their own.

IntroduçãoA universidade precisa incorporar metodologias docentes ativas para se adaptar às demandas da sociedade do conhecimento, na qual o aluno deve ser responsável de sua própria aprendizagem. O papel do professor como um orientador permite dar maior protagonismo aos estudantes no seu processo de aprendizagem.ObjetivoEnvolver o alunado de enfermagem na avaliação e as suas orientadoras depois da utilização da metodologia de aprendizagem baseada em problemas e comprovar a existência de diferenças no processo da orientação entre uma orientadora experiente e uma orientadora novel.MétodosEstudo transversal, descritivo, em uma amostra de 128 estudantes do 2.° curso de enfermagem da Universidade de Valladolid (Espanha), que responderam um questionário tipo Likert.ResultadosEncontraram-se diferenças estatisticamente significativas (p < 0,01) em todos os itens entre ambas as orientadoras. A avaliação foi muito satisfatória.ConclusõesAvaliar o orientador permite uma reflexão e retroalimentação entre os estudantes e os seus orientadores, melhora a qualidade docente e proporciona mais autonomia aos estudantes na sua aprendizagem, envolvendo-os na responsabilidade de ser honestos para avaliar as atividades dos outros membros da equipe, incluindo as do orientador e as próprias.

Hábitos sexuales en los adolescentes de 13 a 18 años / Sexual behavior in adolescents 13 to 18 years old

Introducción: la población adolescente es especialmente vulnerable a los riesgos relacionados con su conducta sexual, dado que se trata de un periodo de maduración en el que experimentar forma parte de esta etapa evolutiva. El embarazo en adolescentes y la maternidad temprana están asociados con el fracaso escolar, el deterioro de la salud física y mental, aislamiento social, pobreza y otros factores relacionados. Por otra parte, no usar métodos anticonceptivos de barrera aumenta el riesgo de infecciones de transmisión sexual (ITS), con serias consecuencias a corto y largo plazo en la salud biopsicosocial de los adolescentes. Objetivos: conocer las características sobre sexualidad de los adolescentes de la provincia de Valladolid. Métodos: estudio transversal descriptivo mediante encuesta anónima a una muestra de 2412 escolares de 13 a 18 años, en el curso académico 2011-2012. Resultados: el 81% de los alumnos consideran que tienen una información muy buena o buena sobre sexualidad. El 75% de los alumnos consideran que la información que tienen sobre infecciones de transmisión sexual es muy buena o buena. Han tenido relaciones con penetración el 30,4% de los alumnos. La edad de inicio de las relaciones sexuales completas se sitúa entre los 15 y 16 años (50,9%). La mayoría declaran que utilizan algún método anticonceptivo en sus relaciones (91,3%), pero todavía hay un 8,7% que refiere no utilizar ninguno. La mayoría utilizan como método anticonceptivo el preservativo (89,6%). Un 20,9% de los adolescentes que mantienen relaciones sexuales con penetración han utilizado en alguna ocasión la píldora del día después o anticoncepción de urgencia. El 3,6% declara haberse quedado embarazada o haber dejado embarazada a su pareja. Conclusiones: a pesar de considerarse suficientemente informados sobre sexualidad e ITS, los adolescentes presentan comportamientos de riesgo en sus actividades sexuales (AU)

Introduction: the adolescent population is particularly vulnerable to the risks related with their sexual behavior, because it is a period of maturation and experience which is part of this evolutionary stage. Teenage pregnancy and early motherhood are associated with school failure, impaired physical and mental health, social isolation, poverty and other related factors. Moreover the non-use of appropriate protective barriers increases the risk of sexually transmitted infections (STI), with serious consequences in the short and long term biopsychosocial adolescent health. Objectives: to determine the characteristics of adolescent sexuality in the province of Valladolid. Methods: cross-sectional study, using an anonymous survey to 2412 schoolchildren 13-18 years old in the academic year 2011-2012. Results: 81% of students feel they have very good or good information on sexuality. 75% of students believe that the information they have about STI is very good or good. 30.4% have had sexual intercourse. The age of first complete sexual intercourse is between 15 and 16 years (50.9%). Most of the adolescents use a contraceptive method in their relationships (91.3%), but there are still 8.7% referring not using any. Most of the students use the condom for contraceptive method (89.6%). 20.9% of teens who have had sex with penetration have used 'the morning-after pill' or emergency contraception at some time. 3.6% reported having being pregnant or having left his partner pregnant (AU)

Evaluación por competencias de los estudiantes de Enfermería a través de Aprendizaje Basado en Problemas / Nursing student's competency assessment through Problem Based Learning

Introducción: El objetivo fue evaluar la adquisición de competencias del alumnado de enfermería aplicando Aprendizaje Basado en Problemas. Métodos: Estudio descriptivo y transversal. La muestra incluyó 23 grupos de estudiantes de enfermería de la Universidad de Valladolid que siguieron la metodología Aprendizaje Basado en Problemas, durante un cuatrimestre académico del año 2012. Los instrumentos utilizados fueron cuestionarios de evaluación a pares, autoevaluación y evaluación a la tutora, determinándose las proporciones de las respuestas; observación sistemática de las tutorías; análisis de contenido del informe escrito sobre un caso clínico realizado por cada grupo de alumnos y observación de la comunicación oral. Resultados: Se desarrollaron habilidades comunicativas, uso de herramientas tecnológicas, autonomía, trabajo colaborativo y razonamiento clínico. Conclusiones: El Aprendizaje Basado en Problemas permite evaluar competencias transversales en estudiantes de enfermería utilizando distintos instrumentos. La participación de los alumnos en la evaluación fortalece actitudes (saber ser) como la honestidad, la responsabilidad y la autonomía.

Introduction: The objective was to assess competency acquisition in nursing students using the Problem Based Learning approach. Methods: Transversal and descriptive study with a sample of 23 groups of nursing students from the Universidad de Valladolid who followed the Problem Based Learning methodology during an academic four month period in the year of 2012. The instruments used were pair evaluation questionnaires, self-evaluation, and preceptor evaluation to assess responses proportions, tutoring observation, clinical case written inform content analysis, and oral communication observation. Results: Improvements in communication skills development, technological tools use, autonomy, collaborative work, and clinical reasoning. Conclusions: The Problem Based Learning allows the assessment of transversal competencies in nursing students using different instruments. students participation in the assessment process strengthens attitudes (know being) such as honesty, responsibility, and autonomy.

La píldora anticonceptiva a debate / The contraceptive pill submitted for debate

El propósito de este trabajo es hacer una revisión sobre los riesgos y beneficios de la píldora anticonceptiva y la necesidad de informar desde las consultas de enfermeras/os y de matronas con base en la evidencia científica. Desde su comercialización en los años 60, se ha publicado una gran cantidad de información sobre los riesgos de la píldora , tanto en el ámbito científico como en los medios de comunicación social y sin embargo, los beneficios han sido poco difundidos. La píldora combinada es uno de los métodos anticonceptivos reversibles con mayor eficacia para evitar el embarazo. Se asocia a un aumento de riesgo de tromboembolismo venoso y presenta efectos beneficiosos no anticonceptivos relacionados con la menstruación, la fertilidad, la masa ósea, el acné, y reduce el riesgo de cáncer de ovario y de endometrio. Los profesionales de enfermería, al igual que el resto de profesionales del equipo de salud, deben abordar el derecho a la información de la población basada en datos científicos y deben implicarse en funciones de orientación en planificación familiar para mejorar la salud materno-infantil, promoviendo los embarazos deseados y que el derecho a tener el número de hijos e intervalo entre ellos sea respetado.

The objective of this research is to reflect on the risks and benefits of the contraceptive pill and the need for women to be informed by qualified health care providers including nurse midwives and nurse practitioners based on scientific evidence. Since its commercialization in the 60's, a lot of information has been published about the risks of the pill by both scientists and the social media and yet the benefits have been little known. The combined pill is one of the most effective reversible methods of preventing pregnancy. It is associated with increased risk factors for venous thromboembolism and it has non-contraceptive benefits not related to menstruation, fertility, bone mass, acne, and it reduces the risk of ovarian and endometrial cancer. Nursing professionals, like all other health care team professionals should address the right to inform the population based on scientific data as well as get involved in family planning counseling to improve maternal and child health, promoting unintended pregnancies and the right to decide the number of children and the time interval be respected.

The role of magnetic resonance imaging in oncology

Conventional diagnostic magnetic resonance imaging (MRI) techniques have focused on improving the spatial resolution and image acquisition speed (whole-body MRI) or on new contrast agents. Most advances in MRI go beyond morphologic study to obtain functional and structural information in vivo about different physiological processes of tumor microenvironment, such as oxygenation levels, cellular proliferation, or tumor vascularization through MRI analysis of some characteristics: angiogenesis (perfusion MRI), metabolism (MRI spectroscopy), cellularity (diffusion-weighted MRI), lymph node function, or hypoxia [blood-oxygen-level-dependent (BOLD) MRI]. We discuss the contributions of different MRI techniques than must be integrated in oncologic patients to substantially advance tumor detection and characterization risk stratification, prognosis, predicting and monitoring response to treatment, and development of new drugs (AU)

Tomografía axial computarizada en el asma / Computed tomography in asthma

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Paciente con doble lesión pulmonar y antecedentes de adenocarcioma renal / Patient with double lung lesion and history of renal adenocarcinoma

No disponible

[Solitary pulmonary nodule: application of Bayes theorem in prediction of malignancy]. / Nódula pulmonar solitario: aplicación del teorema de Bayes en la predicción de malignidad.

Most radiological signs are of low specificity for predicting malignancy in patients with a solitary pulmonary nodule (SPN), making clinical management difficult. Only certain calcification patterns in SPN or the absence of growth over a period two years assures that the nodule is benign. The clinical and radiological characteristics of 31 patients with SPN were studied. Twenty-two were cases bronchopulmonary carcinoma and 9 were pulmonary tuberculoma. Accuracy in the prediction of malignancy was assessed using Bayes' theorem, which is based on degrees of likelihood of various radiological and clinical characteristics. Patients with carcinoma (mean age 65 +/- 9 years) were significantly older than those with tuberculoma (38 +/- 19 years) (p < 0.05). The proportion of smokers was significantly higher among patients with carcinoma (91%) than those with tuberculoma (44%) (p < 0.05). In 50% of the patients with SPN due to bronchopulmonary carcinoma (11 patients), the nodule was in the upper right lobe; in 55% of those with tuberculomas (5 patients) the nodule was found in the upper left lobe. There were no significant differences in the characteristics of the computerized tomography images for the two groups. Mean likelihood of malignancy for patients with carcinoma, by Bayes' theorem, was 83.7%, a rate that was significantly higher than that of tuberculoma patients (46%) (p < 0.05). The application of Bayes' probability theorem for a set of clinical and radiological characteristics can orient the physician as to whether an SPN is likely to be malignant or not, thereby providing guidance on the advisability of performing invasive diagnostic procedures to determine etiology.