Infancias y adolescencias: vivencias durante la pandemia por covid-19 en Argentina / Childhood and adolescence: experiences during the COVID-19 pandemic in Argentina / Infância e adolescência: experiências durante a pandemia de Covid-19 na Argentina

Resumen (analítico) El advenimiento de la pandemia del covid-19 y el aislamiento social, preventivo y obligatorio, impactó en la vida cotidiana y tuvo efectos en la subjetividad de niños, niñas y adolescentes. A través de un estudio exploratorio-descriptivo de carácter cualitativo se indaga sobre la construcción de sentidos, y las emociones en torno a la pandemia y cuarentena, las experiencias escolares y las prácticas de cuidado. Participaron 68 niñas, niños y adolescentes de cuatro jurisdicciones de Argentina, entre marzo y junio de 2020. Se recolectaron narrativas orales, fotos, dibujos y videos. Relataron cómo reinventaron modos de vincularse, de jugar y habitar espacios, erigiéndose como sujetos ético-políticos capaces de cuidar y de transformar su entorno, a pesar de la profundización de situaciones de desigualdad, del miedo al contagio y pérdida de seres queridos.

Abstract (analytical) The advent of the COVID-19 pandemic and the preventive and compulsory social confinement established as a response by the national government of Argentina had an impact on the daily lives and subjectivities of children and adolescents. The authors carried out a qualitative exploratory-descriptive study that focused on the construction of meanings and emotions in relation to the pandemic, lockdowns, school experiences and care practices. A total of 68 children and adolescents from four different jurisdictions in Argentina participated in the study between March and June 2020. The authors collected oral narratives, photos, drawings and videos produced by the children and adolescents. The participants reinvented ways of bonding, playing and inhabiting spaces, establishing themselves as ethical-political subjects who are capable of caring and transforming the roles assigned to them by society despite worsening situations of inequality, fear of contagion and loss of loved ones.

Resumo (analítico) O advento da pandemia da Covid-19 e o isolamento social preventivo e compulsório tiveram impacto na vida diária e tiveram efeitos sobre a subjetividade de crianças e adolescentes. Através de um estudo exploratório-descritivo qualitativo, investigamos a construção de significados e emoções em torno da pandemia e quarentena, experiências escolares e práticas de cuidado. Sessenta e oito crianças e adolescentes de quatro jurisdições na Argentina participaram entre março e junho de 2020. Foram coletadas narrativas orais, fotos, desenhos e vídeos. Os participantes reinventaram formas de união, brincando e habitando espaços, estabelecendo-se como sujeitos ético-políticos capazes de cuidar e transformar seu ambiente, apesar do aprofundamento de situações de desigua0ldade, medo de contágio e perda de entes queridos.

Conscious and pre-conscious attentional bias to food images in patients subjected to Roux-en-Y gastric bypass.

Attentional bias (AB) to food after bariatric surgery might be a cognitive marker for weight regain. The visual probe task (VPT) is commonly used to capture AB at automatic, pre-conscious, and conscious orientation of attention. The aim of this study was to investigate how the preoperative BMI of patients submitted to Roux-en-Y gastric bypass (RYGB) impacts AB to food. We assessed patients who had preoperative BMI>50 (n = 28) or preoperative BMI<50 (n = 31) months after the RYGB procedure. Participants underwent clinical, psychological, and VPT evaluations. In VPT, pairs of food and matching non-food images were shown for 100 ms, 500 ms or 2000 ms and AB for food was assessed for each exposure time. A significant AB to food was observed at 2000 ms for all patients in this study, suggesting that the overall sample were consciously orienting their attention toward food cues after surgery, a finding that might be relevant for understanding weight control. When groups with preoperative BMI higher and lower than 50 kg/m2 were compared, a significant difference on AB to food stimuli at 500 ms was observed, controlling for excess weight lost since surgery and postoperative time. Subjects with preoperative BMI>50 had a positive and reliable AB to food while subjects with preoperative BMI<50 had a negative AB. This suggests that food stimuli have a higher incentive salience even after surgery for those with BMI>50, which might explain why subjects with higher preoperative weight have higher risks for weight regain. These results may indicate that RYGB can impact incentive salience for food cues in a differential manner, increasing conscious AB in all patients and decreasing pre-conscious AB only in those with BMI<50 kg/m2.

-866G/A and Ins/Del polymorphisms in UCP2 gene are associated with reduced short-term weight loss in patients who underwent Roux-en-Y gastric bypass.

BACKGROUND: Uncoupling protein 2 (UCP2) plays an important role in energy expenditure regulation. Previous studies have associated the common -866G/A (rs659366) and Ins/Del polymorphisms in the UCP2 gene with metabolic and obesity-related phenotypes. However, it is still unclear whether these polymorphisms influence weight loss after bariatric surgery. OBJECTIVES: To investigate whether UCP2 -866G/A and Ins/Del polymorphisms are associated with weight loss outcomes after bariatric surgery. SETTING: Longitudinal study in a university hospital. METHODS: We retrospectively evaluated 186 patients who underwent Roux-en-Y gastric bypass (RYGB) surgery for clinical and laboratory characteristics in the preoperative period, 6, 12, and 18 months after RYGB. The -866G/A (rs659366) polymorphism was genotyped using real-time PCR, while the Ins/Del polymorphism was genotyped by direct separation of PCR products in 2.5% agarose gels. RESULTS: Patients with the -866A/A genotype showed higher body mass index (BMI) after 6, 12, and 18 months of surgery and excess body weight after 6 and 12 months compared with G/G patients. They also showed lower excess weight loss (EWL%) after 6 and 12 months of surgery. Ins allele carriers (Ins/Ins + Ins/Del) had lower delta (Δ) BMI 12 months after surgery compared with Del/Del patients. Accordingly, patients carrying haplotypes with ≥2 risk alleles of these polymorphisms had higher BMI and excess weight and lower EWL% during follow-up. CONCLUSION: UCP2 -866A/A genotype is associated with higher BMI and excess weight and lower EWL% during an 18-month follow-up of patients who underwent RYGB, while the Ins allele seems to be associated with lower ΔBMI 12 months after surgery. Further studies are needed to confirm the associations of the -866G/A and Ins/Del polymorphisms with weight loss after bariatric surgery.

Representaciones y prácticas de profesionales de la guardia de un hospital pediátrico de la Ciudad de Buenos Aires / Representations and Practices of On-Duty Professionals of a Pediatric Hospital in Buenos Aires City

INTRODUCCIÓN: La sanción de la Ley Nacional de Salud Mental N° 26.657 (2010) dio inicio a un proceso de reforma en la atención de personas con padecimiento mental. Los hospitales psiquiátricos deben sustituirse por servicios comunitarios, y las internaciones por Salud Mental se harán sólo en hospitales generales. Para niños, niñas y adolescentes existe en la ciudad de Buenos Aires un solo hospital pediátrico, que interna en salas generales a través de una admisión por Guardia. OBJETIVOS: Describir representaciones y prácticas de profesionales de guardia del citado hospital vinculadas a la atención de niños, niñas y adolescentes de 0 a 18 años de edad con padecimiento mental, identificando modificaciones a partir de la Ley. MÉTODOS: Se efectuó un estudio exploratorio descriptivo de corte retrospectivo. Se utilizaron, como técnicas cualitativas, entrevistas semiestructuradas a profesionales de diferentes disciplinas (Enfermería, Pediatría, Psicología, Psiquiatría, Trabajo Social y Toxicología) efectuadas en 2014-2015. Se realizó un análisis de contenido. RESULTADOS: Según los profesionales, sus prácticas concuerdan con el paradigma de la Ley, y los obstáculos en la atención e implementación se deben a insuficiencias en los recursos intra y extrahospitalarios, en especial en las internaciones en salas generales. CONCLUSIONES: La transformación de prácticas según la Ley debe ser acompañada de la participación de distintos actores sociales y de políticas públicas en Salud Mental.

INTRODUCTION: Since the approval of the Mental Health National Law No. 26.657 (2010), a process of reform has started for the care of people with mental illnesses. Psychiatric hospitals must be replaced by community services, and admissions will only be carried out in general hospitals. For children and adolescents there is only one pediatric hospital in Buenos Aires city that admits them in general rooms through the emergency room. OBJECTIVES: To describe representations and practices of on-duty professionals from the above mentioned hospital related to the care of children and adolescents aged 0-18 years with mental disorders, identifying changes triggered by the Law. METHODS: A retrospective, exploratory and descriptive research was performed. It used qualitative techniques: semi-structured interviews to professionals from different fields (nursing, pediatrics, psychology, psychiatry, social work and toxicology) conducted during 2014-2015. Content analysis was performed. RESULTS: According to the professionals, their practices are in line with the paradigm proposed by the Law, and the obstacles in care and implementation are due to insufficient intra and extra hospital resources, especially in general admission rooms. CONCLUSIONS: The transformation of practices according to the Law should be accompanied by the participation of the different social actors and public policies in mental health.

Niños y adolescentes con artritis idiopática juvenil: estudio cuali-cuantitativo sobre el impacto de la enfermedad en la familia / Children and adolescents with juvenile idiopathic arthritis: qualitative and quantitative study about the impact on families

INTRODUCCIÓN La artritis idiopática juvenil (AIJ) es una enfermedad reumática crónica prevalente en la infancia. No sólo afecta la calidad de vida, sino que también ocasiona emociones negativas en pacientes y familias. OBJETIVOS Evaluar funcionamiento familiar (grado de disfunción) y áreas afectadas, comprender cómo es vivida la enfermedad por adolescentes y padres, y analizar su impacto en la vida cotidiana. MÉTODOS Se realizó un estudio observacional cuali-cuantitativo en el Hospital de Niños Dr. Ricardo Gutiérrez de la ciudad de Buenos Aires. Se entrevistó a adolescentes con AIJ y a un familiar cuidador. Se analizaron variables demográficas, clínico-funcionales y socioeconómicas. Los instrumentos utilizados fueron cuestionario de capacidad funcional CHAQ (Moroldo 2001), cuestionario autoadministrable de funcionamiento familiar (OPS 1996) y entrevista semiestructurada basada en Medicina Narrativa, marco de investigación diseñado para evaluar comprensión del diagnóstico, percepción de la información médica, impacto y vivencias relacionadas con la enfermedad. RESULTADOS Ingresaron 39 pacientes (26 mujeres) de 13,9 años de edad promedio. La forma más frecuente de AIJ fue la oligoarticular. El tiempo medio de evolución de la enfermedad fue de 5,2 años, y la capacidad funcional final resultó buena (score: 0,23). La prevalencia de disfunción familiar fue del 43,5%; se asoció significativamente a mayor tiempo de evolución y menor edad de inicio de la enfermedad. El área más afectada fue el de las fuentes de apoyo al adolescente. La entrevista narrativa mostró un alto impacto emocional en el paciente y su familia. DISCUSIÓN La disfunción familiar y la narrativa demostraron que, a pesar de la buena capacidad funcional de los pacientes, el diagnóstico de la enfermedad y su peregrinaje (trayectoria) determinan cambios en la personalidad del paciente, en el vínculo padre-hijo y en las actividades familiares.