Disease Delineation for Multiple Sclerosis, Friedreich Ataxia, and Healthy Controls Using Supervised Machine Learning on Speech Acoustics.

Neurodegenerative disease often affects speech. Speech acoustics can be used as objective clinical markers of pathology. Previous investigations of pathological speech have primarily compared controls with one specific condition and excluded comorbidities. We broaden the utility of speech markers by examining how multiple acoustic features can delineate diseases. We used supervised machine learning with gradient boosting (CatBoost) to delineate healthy speech from speech of people with multiple sclerosis or Friedreich ataxia. Participants performed a diadochokinetic task where they repeated alternating syllables. We subjected 74 spectral and temporal prosodic features from the speech recordings to machine learning. Results showed that Friedreich ataxia, multiple sclerosis and healthy controls were all identified with high accuracy (over 82%). Twenty-one acoustic features were strong markers of neurodegenerative diseases, falling under the categories of spectral qualia, spectral power, and speech rate. We demonstrated that speech markers can delineate neurodegenerative diseases and distinguish healthy speech from pathological speech with high accuracy. Findings emphasize the importance of examining speech outcomes when assessing indicators of neurodegenerative disease. We propose large-scale initiatives to broaden the scope for differentiating other neurological diseases and affective disorders.

Cell Count Differentials by Cytomorphology and Next-Generation Flow Cytometry in Bone Marrow Aspirate: An Evidence-Based Approach.

Despite a lack of evidence, a bone marrow aspirate differential of 500 cells is commonly used in the clinical setting. We aimed to test the performance of 200-cell counts for daily hematological workup. In total, 660 consecutive samples were analyzed recording differentials at 200 and 500 cells. Additionally, immunophenotype results and preanalytical issues were also evaluated. Clinical and statistical differences between both cutoffs and both methods were checked. An independent control group of 122 patients was included. All comparisons between both cutoffs and both methods for all relevant types of cells did not show statistically significant differences. No significant diagnostic discrepancies were demonstrated in the contingency table analysis. This is a real-life study, and some limitations may be pointed out, such as a different sample sizes according to the type of cell in the immunophenotype analysis, the lack of standardization of some preanalytical events, and the relatively small sample size of the control group. The comparisons of differentials by morphology on 200 and 500 cells, as well as by morphology (both cutoffs) and by immunophenotype, are equivalent from the clinical and statistical point of view. The preanalytical issues play a critical role in the assessment of bone marrow aspirate samples.

A Cross-sectional Study of Perceptual and Acoustic Voice Characteristics in Healthy Aging.

PURPOSE: The human voice qualitatively changes across the lifespan. Although some of these vocal changes may be pathologic, other changes likely reflect natural physiological aging. Normative data for voice characteristics in healthy aging is limited and disparate studies have used a range of different acoustic features, some of which are implicated in pathologic voice changes. We examined the perceptual and acoustic features that predict healthy aging. METHOD: Participants (N = 150) aged between 50 and 92 years performed a sustained vowel task. Acoustic features were measured using the Multi-Dimensional Voice Program and the Analysis of Dysphonia in Speech and Voice. We used forward and backward variable elimination techniques based on the Bayesian information criterion and linear regression to assess which of these acoustic features predict age and perceptual features. Hearing thresholds were determined using pure-tone audiometry tests at frequencies 250 Hz, 500 Hz, 1000 Hz, 2000 Hz, and 4000 Hz. We further explored potential relationships between these acoustic features and clinical assessments of voice quality using the Consensus Auditory-Perceptual Evaluation of Voice. RESULTS: Chronological age was significantly predicted by greater voice turbulence, variability of cepstral fundamental frequency, low relative to high spectral energy, and cepstral intensity. When controlling for hearing loss, age was significantly predicted by amplitude perturbations and cepstral intensity. Clinical assessments of voice indicated perceptual characteristics of speech were predicted by different acoustic features. For example, breathiness was predicted by the soft phonation index, mean cepstral peak prominence, mean low-high spectral ratio, and mean cepstral intensity. CONCLUSIONS: Findings suggest that acoustic features that predict healthy aging are different than those previously reported for the pathologic voice. We propose a model of healthy and pathologic voice development in which voice characteristics are mediated by the inability to monitor vocal productions associated with age-related hearing loss. This normative data of healthy vocal aging may assist in separating voice pathologies from healthy aging.

Performance of resin composite restorations placed in high caries risk children: a clinical retrospective study / Performance of resin composite restorations placed in high caries risk children: a clinical retrospective study / Rendimiento de las restauraciones de resina compuesta colocadas en niños con alto riesgo de caries: un estudio clínico retrospectivo

Background: Resin composite has been usually used for restoring primary teeth. Nevertheless, there is a lack of supporting clinical data regarding the survival of resin composite restorations and risk factors that may dictate the service time of the treatment in children. Aim: To evaluate the survival and factors associated with composite resin restoration failure in high caries risk children treated under risk-factor management clinical protocol for dental caries prior to restorative therapy. Design: A total of 230 restorations in primary teeth from records of 48 patients were included in the study. Restoration longevity, up to 3-year follow-up, was assessed using the Kaplan-Meier survival test. Multivariate Cox regression analysis with shared frailty was used to evaluate the factors associated with failures (p<0.05). Results: Mean survival time was 2.7 -year (95 percent CI: 0.75-0.87). Restoration survival reached 82.5 percent up to 3-year evaluation, with an overall annual failure rate of 6.2 percent. The unadjusted model showed restorations performed in children with dmf-t greater than 10 had more restoration failure risk (HR 5.59, 95 percent CI 1.03-30.34; p=0.04) However, this association lost significance in the adjusted analysis (p=0.08). Conclusions: Composite resin restorations in primary teeth presented satisfactory survival after 3-year follow-up (AU)

Antecedentes: El composite de resina se ha utilizado habitualmente para restaurar dientes primarios. Sin embargo, se carece de datos clínicos de apoyo sobre la supervivencia de las restauraciones de resina compuesta y los factores de riesgo que pueden dictar el tiempo de servicio del tratamiento en los niños. Objetivo: Evaluar la supervivencia y los factores asociados al fracaso de las restauraciones de resina compuesta en niños con alto riesgo de caries tratados con un protocolo clínico de gestión de factores de riesgo de caries dental antes del tratamiento restaurador. Diseño: Se incluyeron en el estudio un total de 230 restauraciones en dientes primarios de registros de 48 pacientes. La longevidad de las restauraciones, hasta los 3 años de seguimiento, se evaluó mediante la prueba de supervivencia de Kaplan-Meier. Se utilizó un análisis multivariante de regresión de Cox con fragilidad compartida para evaluar los factores asociados a los fracasos (p<0,05). Resultados: El tiempo medio de supervivencia fue de 2,7 -años (IC95 por ciento: 0,75-0,87). La supervivencia de la restauración alcanzó el 82,5 por ciento hasta la evaluación a los 3 años, con una tasa global anual de fracasos del 6,2 por ciento. El modelo no ajustado mostró que las restauraciones realizadas en niños con dmf-t superior a 10 tenían más riesgo de fracaso de la restauración (HR 5,59; IC 95 por ciento: 1,03-30,34; p=0,04). Sin embargo, esta asociación perdió significación en el análisis ajustado (p=0,08). Conclusiones: Las restauraciones de resina compuesta en dientes primarios presentaron una supervivencia satisfactoria tras un seguimiento de 3 años (AU)

Tuberculosis in the colombian-venezuelan border: geospatial distribution. / Tuberculosis en la frontera colombo-venezolana: distribución geoespacial.

The geospatial distribution of pulmonary and extrapulmonary tuberculosis (TB) morbidity in the municipality of Cúcuta in 2019 and 2020 was described by the Kulldorff method using the geographic location and reporting date of incident TB cases. The unit of analysis was the event reported to the National Epidemiological Surveillance System (SIVIGILA). A total of 607 cases were identified in 392 neighborhoods distributed in ten communes. Most cases of pulmonary TB were reported in the northern commune, with the El Salado neighborhood being the most affected repeatedly. Incident cases of extrapulmonary TB did not show patterns of repetition in the distribution between spatial and temporal units. Strategies to mitigate and control the spread of pulmonary infection should prioritize the western region.

La distribución geoespacial de la morbilidad por tuberculosis (TB) pulmonar y extrapulmonar en el municipio de Cúcuta en los años 2019 y 2020 se describió utilizando el método de Kulldorff usando la ubicación geográfica y la fecha de reporte de los casos incidentes de TB. La unidad de análisis fue el evento reportado al Sistema Nacional de Vigilancia Epidemiológica (SIVIGILA). Se identificaron 392 barrios distribuidos en diez comunas, donde se ubicaron 607 casos. En la distribución de la TB pulmonar, la comuna norte fue la que más casos reportó, siendo el barrio El Salado el más afectado de manera repetitiva. Los casos incidentes de TB extrapulmonar no mostraron patrones de repetición en la distribución entre las unidades espaciales y temporales. Se debe priorizar la región occidental dentro de las estrategias de mitigación y control de la propagación de la infección pulmonar del territorio.

The effect of orthodontic forces on calcitonin gene-related peptide (CGRP) expression in the human periodontal ligament and its relationship with the human dental pulp.

Background: The purpose of this study was to quantify the effect of moderate and severe orthodontic forces on Calcitonin gene-related peptide (CGRP) expression in the healthy human periodontal ligament (PDL) and its possible relationship with the human dental pulp. Material and Methods: Ninety human periodontal ligament samples were obtained from healthy premolars where extraction was indicated for orthodontic reasons. Prior to extraction, teeth were divided in 3 groups of 30 samples each: I) Untreated teeth control group; II) Moderate force group: A 56 g force was applied to the premolars for 24 hours; and III) Severe force group: A 224 g force was applied to the premolars for 7 days. All periodontal ligament samples were processed and CGRP was measured by radioimmunoassay. Results: Greater CGRP expression was found in the severe force group, followed by the moderate force group. The lower CGRP values were for the untreated teeth. Kruskal-Wallis test showed statistically significant differences between groups (p<0.001). LSD post hoc tests showed statistically significant differences in CGRP expression between the untreated teeth and the severe forces group (p<0.001). Differences between the moderate and severe force groups were statistically significant (p<0.001). There was no statistically significant differences between the untreated teeth and the moderate forces group (p<0.261). Conclusions: CGRP expression in human periodontal ligament increases when teeth are submitted to severe orthodontic forces. This elevated expression of CGRP, which is proportional to the applied force, may affect the way the dental pulp responds to different stimuli from the orthodontic forces. Key words:Calcitonin gene-related peptide, orthodontic force, human periodontal ligament, neurogenic inflammation.

Are Occupational Voice Disorders Accurately Measured? A Systematic Review of Prevalence and Methodologies in Schoolteachers to Report Voice Disorders.

PURPOSE: Different measuring instruments have been described to determine the prevalence of voice disorders in schoolteachers. However, the heterogeneity of prevalence figures has made it difficult in determining the impact of voice disorders in this group. This investigation aims to review and identify scientific evidence of methodological analysis of voice disorders in teachers, the relevance of measuring instruments, the prevalence of dysphonia, and the impact on the development of vocal health prevention programs. METHODS: A systematic review was conducted by searching six important scientific databases. Preferred Reporting Items for Systematic Reviews (PRISMA) guidelines were carried out. Articles were included whether they presented data related to the prevalence of dysphonia and the impact of therapy programs on teachers. RESULTS: Twenty articles out of 8,998 were selected. The cross-sectional design type was predominant throughout the investigations. Differences were observed in the number of participants across studies, leading to heterogeneous prevalence figures - which ranged from 10.5% to 69.1%. The assessment instruments are not standardly used to effectively determine the disease burden. Despite the fact of the extensive evidence of the effectiveness of programs that address dysphonia in teachers, the scarcity of literature is yet evident on systematic programs promoted by either the government or educational institutions. CONCLUSION: Findings suggest that future investigations should consider the consensus of a global definition for occupational dysphonia in teachers in order to develop accurately measuring instruments and to assist with voice care programs and treatment approaches in this population. This might be crucial since it could also assist with the implementation of Delphi-type studies that could support the development of further evidence-based agreements around these programs (voice care and treatment approaches) in schoolteachers.

Tuberculosis en la frontera colombo-venezolana: distribución geoespacial / Tuberculosis in the colombian-venezuelan border: geospatial distribution

RESUMEN La distribución geoespacial de la morbilidad por tuberculosis (TB) pulmonar y extrapulmonar en el municipio de Cúcuta en los años 2019 y 2020 se describió utilizando el método de Kulldorff usando la ubicación geográfica y la fecha de reporte de los casos incidentes de TB. La unidad de análisis fue el evento reportado al Sistema Nacional de Vigilancia Epidemiológica (SIVIGILA). Se identificaron 392 barrios distribuidos en diez comunas, donde se ubicaron 607 casos. En la distribución de la TB pulmonar, la comuna norte fue la que más casos reportó, siendo el barrio El Salado el más afectado de manera repetitiva. Los casos incidentes de TB extrapulmonar no mostraron patrones de repetición en la distribución entre las unidades espaciales y temporales. Se debe priorizar la región occidental dentro de las estrategias de mitigación y control de la propagación de la infección pulmonar del territorio.

ABSTRACT The geospatial distribution of pulmonary and extrapulmonary tuberculosis (TB) morbidity in the municipality of Cúcuta in 2019 and 2020 was described by the Kulldorff method using the geographic location and reporting date of incident TB cases. The unit of analysis was the event reported to the National Epidemiological Surveillance System (SIVIGILA). A total of 607 cases were identified in 392 neighborhoods distributed in ten communes. Most cases of pulmonary TB were reported in the northern commune, with the El Salado neighborhood being the most affected repeatedly. Incident cases of extrapulmonary TB did not show patterns of repetition in the distribution between spatial and temporal units. Strategies to mitigate and control the spread of pulmonary infection should prioritize the western region.

Creencias y prácticas en salud oral en comunidades indígenas para el diseño de un modelo de atención integral de salud con enfoque intercultural en Colombia. Una revisión / Cosmovision of oral health in indigenous communities for the design of a comprehensive health care model with intercultural approach in Colombia. A review

Objetivo: identifcar, con base en la literatura disponible, la cosmovisión de la salud oral para los pueblos indígenas. Métodos: se realizó una revisión sistemática de la literatura a través de diferentes bases de datos. Resultados: las creencias y prácticas de las comunidades indígenas responden a la cosmovisión del proceso de salud-enfermedad oral, las cuales dan cuenta de una perspectiva mítica, espiritual y en muchas ocasiones se aborda desde un punto de vista naturalista. Conclusión: las creencias y prácticas de la salud oral para las comunidades indígenas han trascendido, en gran medida, la perspectiva mágica y se ubican actualmente en una óptica tanto técnica como medicinal.

Objective: To identify, based on the available literature, the worldview of oral health for indigenous peoples. Methods: A literature search was carried out through diferent databases. Results: The cosmovision of the oral health-disease process revolves around a mythical, spiritual perspective and in many occasions, it is approached from a naturalistic perspective. Conclusion: The worldview of oral health-disease for indigenous communities has largely transcended the magical perspective and is currently located in a technical as well as a medicinal perspective.

Relación entre bienestar psicológico y la percepción de calidad de vida en pacientes en hemodiálisis / Relationship between psychological well-being and perception of quality of life in hemodialysis patients

Introducción: La hemodiálisis es la alternativa terapéutica más empleada en los pacientes con enfermedad renal cró-nica; sin embargo, no se han establecido de forma multi-dimensional las condiciones de bienestar psicológico y la calidad de vida de estos pacientes. Objetivo: Analizar el perfil de bienestar psicológico y per-cepción de calidad de vida de pacientes en hemodiálisis, así como diferenciar e identificar la relación entre estas varia-bles. Material y método: Estudio observacional descriptivo trans-versal realizado a 173 pacientes en hemodiálisis. Se emplea-ron los cuestionarios PGWBI para evaluar el bienestar psi-cológico y el WHOQOL-BREF para la calidad de vida.Resultados: Pacientes con ERC en tratamiento con HD con un promedio de 57,59±13,31 años, predominantemente de género masculino (n=110; 63,58%). Se encontraron altos índices de bienestar psicológico (78,61%) y percepciones moderadas de calidad de vida (54,91%), acompañadas de sintomatología depresiva (97,11%) y ansiosa (97,11%). La edad, nivel educativo, condición laboral, ingresos económicos, tener Diabetes Mellitus y concentraciones sanguíneas inadecuadas de hemoglobina, potasio y fósforo, mostraron diferencias en los dominios y categorías (p<0,01). El análisis correlacional encontró una estrecha relación lineal entre las dos variables estudiadas (r=0,81; p=0,0001). Conclusiones: Los participantes del estudio mostraron altas percepciones de bienestar psicológico y moderadas apreciaciones de calidad de vida a expensas de elevadas valoraciones de positividad, autocontrol, vitalidad y percepciones de salud física, psicológica y relaciones sociales. El bienestar psicológico desde sus diferentes categorías influencia directamente la percepción de calidad de vida de los pacientes en hemodiálisis. (AU)

Introduction: Hemodialysis is the most widely used therapeutic alternative in patients with chronic kidney disease; however, the conditions of psychological well-being and quality of life of these patients have not been established in a multidimensional way. Objective: To analyse the profile of psychological well-being and perception of quality of life of hemodialysis patients, as well as to differentiate and identify the relationship between these variables. Material and method: Cross-sectional descriptive observatio-nal study carried out on 173 hemodialysis patients. The PGW-BI questionnaires were used to assess psychological well-be-ing and the WHOQOL-BREF for quality of life. Results: Patients with CKD on hemodialysis with an average age of 57.59±13.31 years, predominantly male (n=110; 63.58%). High indices of psychological well-being (78.61%) and moderate perceptions of quality of life (54.91%) were found, accompanied by depressive (97.11%) and anxious (97.11%) symptomatology. Age, educational level, employment status, income, having diabetes mellitus and inadequate blood concentrations of haemoglobin, potassium and phosphorus showed differences in the domains and categories (p<0.01). Correlational analysis found a strong linear relationship between the two variables studied (r=0.81; p=0.0001). Conclusions: Study participants showed high perceptions of psychological well-being and moderate appreciations of qua-lity of life at the expense of high ratings of positivity, self-con-trol, vitality and perceptions of physical health, psychological health and social relationships. Psychological well-being ac-cording to different categories directly influences the percei-ved quality of life of hemodialysis patients. (AU)

Quality of life at 3 and 6 months in military personnel with a history of thoracic trauma suffered in combat.

OBJECTIVE: To measure the score and variation in the SF-36 quality of life questionnaire at 3 and 6 months of evaluation in military personnel with a history of chest trauma in combat. METHOD: Comparative study between military with chest trauma and healthy military personnel from 2011 to 2016, evaluating the SF-36 quality of life questionnaire. RESULTS: 45 subjects were analyzed, 25 with a history of chest trauma and 10 healthy controls with combat experience. 25 of the cases were evaluated at 3 months and 11 at 6 months. The average age was 28.2 years (standard deviation: 7.22), and 76% had projectile wounds with a high-speed firearm. 44 % (11/25) of the subjects with chest trauma at three months of assessment presented a lot of limitation for the performance of moderate activities (p < 0.001) and only 5% (1/20) of the controls reported a lot of limitation (p < 0.001). CONCLUSIONS: There is significant deterioration in the quality of life in all domains through the SF-36 questionnaire in patients with chest trauma at 3 and 6 months after the evaluation.

OBJETIVO: Medir el puntaje y la variación en el cuestionario de calidad de vida SF-36 a los 3 y 6 meses de valoración en militares con antecedente de trauma de tórax en combate. MÉTODO: Estudio comparativo entre militares con trauma de tórax y militares sanos entre los años 2011 y 2016, evaluando el cuestionario de calidad de vida SF-36. RESULTADOS: Se analizaron 45 sujetos, 25 con antecedente de trauma de tórax y 10 controles sanos con experiencia en combate. De los sujetos con trauma, 25 se evaluaron a los 3 meses y 11 a los 6 meses. El promedio de edad fue de 28.2 años (desviación estándar: 7.22). El 76% tuvieron heridas por proyectil con arma de fuego de alta velocidad. El 44% (11/25) de los sujetos con trauma de tórax, a los 3 meses de valoración, presentaba mucha limitación para la realización de actividades moderadas (p < 0.001) y solo el 5% (1/20) de los controles referían mucha limitación (p < 0.001). CONCLUSIONES: Hay un deterioro significativo en la calidad de vida en todos los dominios del cuestionario SF-36 en pacientes con trauma de tórax a los 3 y 6 meses de la valoración.

Bienestar psicológico en enfermeras que realizan terapia de reemplazo renal en tiempos de COVID-19 / Psychological well-being in nurses performing renal replacement therapy in times of COVID-19 pandemic

Introducción: La pandemia por COVID-19 ha generado deterioro de la salud mental en los profesionales del sector salud, siendo desconocida su situación en las enfermeras al cuidado de pacientes con enfermedad renal crónica.Objetivo: Identificar el bienestar psicológico y sus diferencias de acuerdo a las variables demográficas y profesionales en enfermeras que realizan hemodiálisis en tiempos de COVID-19.Material y Método: Estudio cuantitativo, descriptivo transversal, realizado en 52 enfermeras que realizan terapia de reemplazo renal en unidades de cuidado intensivo y de terapia renal en tiempos de COVID-19. Fueron obtenidas variables de tipo sociodemográfico, académico, laboral y se empleó la escala PGWBI para establecer los niveles de bienestar psicológico. Se utilizó el test de Mann-Whitney y Kruskall-Wallis realizando el post test de Dunn para comparar diferencias entre las variables estudiadas.Resultados: La edad promedio fue de 36,56±6,95 años. Los niveles de bienestar psicológico fueron positivos en todas las categorías de la escala, con excepción de la ansiedad y la depresión. De igual forma, se encontró que las variables género, estado civil, estabilidad, antigüedad laboral, remuneración salarial y formación académica, muestran comportamiento diferenciado en las categorías que evalúa el instrumento.Conclusiones: Se identificaron altos niveles de bienestar psicológico en enfermeras que prestan cuidados en pacientes en terapia de reemplazo renal en tiempos de pandemia por COVID-19, donde factores como el estado civil, formación post gradual y tener estabilidad laboral con mejores ingresos salariales, influencian positivamente las categorías que contribuyeron a los resultados de bienestar psicológico de las enfermeras evaluadas. (AU)

Introduction: The COVID-19 pandemic has led to deterioration of mental health in health care professionals, and the situation of nurses caring for patients with chronic kidney disease is currently unknown.Objective: To identify psychological well-being and differences according to demographic and professional variables in nurses performing haemodialysis in times of the COVID-19 pandemic.Method: Quantitative, descriptive, cross-sectional study carried out on 52 nurses performing renal replacement therapy in intensive care and renal therapy units in COVID-19 times, who gave their consent. Sociodemographic, academic and work-related variables were obtained and the PGWBI scale was used to establish levels of psychological well-being. The Mann-Whitney and Kruskall-Wallis tests were used, and Dunn’s post-test was performed to compare differences between the variables studied.Results: The mean age of the nurses studied was 36.56±6.95 years. The levels of psychological well-being were positive in all the categories of the scale, with the exception of anxiety and depression. Similarly, it was found that the variables gender, marital status, job stability, length of service, salary remuneration and academic training showed differential behaviour in the categories assessed by the instrument.Conclusions: High levels of psychological well-being were identified in nurses providing care in renal replacement therapy patients in times of COVID-19 pandemic, where factors such as marital status, post-graduate training and having job stability with better salary income positively influence the categories that contributed to the psychological well-being scores of the nurses assessed. (AU)

Professional profile and work conditions of nurses working in intensive care units: A multicentre study.

AIM: To determine the professional profile and the work conditions of nurses working in intensive care units (ICU) in Colombia, Argentina, Peru and Brazil. BACKGROUND: ICUs require a differentiated professional profile to provide quality care, and appropriate working conditions, leading to a transformation of care and management practices. DESIGN: Descriptive multicentre cross-sectional observational study. METHODS: An online survey was applied to identify both the characteristics of the professional profile and the working conditions. 1,427 ICU nursing professionals were included. RStudio statistical software was used for the analysis of the information. Descriptive statistics were used for the presentation of the results. The STROBE checklist for cross-sectional studies was used in this study. RESULTS: Only 33.6% of the professionals had a specialisation degree in intensive care. The skills that were most frequently put into practice were communication (68.5%) and care management (78.5%). The most predominant nurse-to-patient ratios were 1:2, and greater than 1:6. 59.1% of the nurses had an indefinite term contract, 38.8% worked 48 hours per week and 49.8% had rotating shifts. Only 50.4% of them received incentives. The average salary ranged between 348 and 1,500 USD. 64.5% of the participants were satisfied with their job. CONCLUSION: It is necessary to strengthen nurses' professional profile by promoting both postgraduate education and the development of troubleshooting and teamwork skills. It is necessary to standardise the nurse-to-patient ratio, improve wages and increase incentives to achieve greater job satisfaction. RELEVANCE TO PRACTICE: The knowledge and the improvement of both the professional profile and the work conditions of nurses working in intensive care units will improve the quality of the care given to critical patients and, therefore, the quality of health outcomes.

Panorama de la automedicación en estudiantes de educación superior: una mirada global / Overview of self-medication in higher education students: a global view / Panorama da automedicação em estudantes do ensino superior: uma visão global

Introducción: La automedicación es una práctica que llevan a cabo especialmente los jóvenes universitarios, al percibirse inmunes a enfermedades, sin tener en cuenta los efectos sobre el uso de fármacos sin prescripción. Objetivo: Analizar los hallazgos de la literatura existente sobre la automedicación en estudiantes de educación superior. Materiales y métodos: Se em-pleó la metodología Scoping Review, utilizando los términos DeCS y MeSH en español, in-glés y portugués en cuanto a: "automedicación", "estudiantes", "educación superior", "COV-ID-19". A continuación, se articularon las ecuaciones de búsqueda empleando los operadores booleanos AND y OR, en las bases de datos: IBECS, Scielo, BVS, Google Scholar, LILACS, Science Direct y Pubmed. Al respecto se limitó el tiempo de publicación entre 2016 ­ 2021. Resultados: Se obtuvieron 23 artículos, consolidando seis núcleos temáticos: motivos para automedicarse; grupos farmacológicos que se consumen; fuentes de recomendación; factores sociodemográficos; semestres y programas académicos; y, conocimientos sobre los riesgos de la automedicación. Los analgésicos son los medicamentos que más se consumen, siendo el principal motivo de uso el dolor de cabeza. Los farmacéuticos junto con los medios de comunicación suelen ser fuentes de recomendación. Predominaron bajos niveles de cono-cimiento acerca de los riesgos de la automedicación. Conclusiones: La literatura indica que este problema de salud pública es cada vez mayor y evidencia la necesidad de abordarlo con estrategias eficaces

Introduction: Self-medication is a practice carried out especially by university students, be-cause they perceive themselves to be immune to effects on their health as a result of the use of non-prescription drugs. Objective: To analyze the findings of the existing literature on self-medication in higher education students. Materials and Methods: The Scoping Review methodology was used, using the DeCS and MeSH terms in Spanish, English and Portuguese "self-medication", "students", "higher education", "COVID-19", articulating them by creat-ing search equations using Boolean operators. AND and OR, in the databases: IBECS, Scielo, VHL, Google Scholar, LILACS, Science Direct and Pubmed, limiting the publication time between 2016 - 2021. Results: 23 articles were obtained, consolidating six thematic nuclei: reasons for self-medicate; pharmacological groups consumed; recommendation sources; so-ciodemographic factors; semesters and academic programs; and, knowledge about the risks of self-medication. Analgesics are the most consumed medications, with headaches being the main reason for use. Pharmacists along with the media are often sources of recommendation. Low levels of knowledge about the risks of self-medication prevailed. Conclusions: The literature indicates that this public health problem is increasing and evidences the need to address it with effective strategies.

Introdução: A automedicação é uma prática realizada principalmente por estudantes uni-versitários, pois se percebem imunes aos efeitos sobre sua saúde decorrentes do uso de me-dicamentos isentos de prescrição. Objetivo: Analisar os achados da literatura existente so-bre automedicação em estudantes do ensino superior. Materiais e Métodos: Foi utilizada a metodologia Scoping Review, utilizando os termos DeCS e MeSH em espanhol, inglês e português "automedicação", "alunos", "ensino superior", "COVID-19", articulando-os através da criação de equações de busca utilizando operadores booleanos AND e OR, nas bases de dados: IBECS, Scielo, BVS, Google Acadêmico, LILACS, Science Direct e Pu-bmed, limitando o tempo de publicação entre 2016 - 2021. Resultados: Obtiveram-se 23 artigos, consolidando seis núcleos temáticos: motivos para automedicação; grupos farma-cológicos consumidos; fontes de recomendação; fatores sociodemográficos; semestres e pro-gramas acadêmicos; e, conhecimento sobre os riscos da automedicação. Os analgésicos são os medicamentos mais consumidos, sendo as dores de cabeça o principal motivo de uso. Os farmacêuticos junto com a mídia são muitas vezes fontes de recomendação. Predominaram baixos níveis de conhecimento sobre os riscos da automedicação. Conclusões: A literatura in-dica que este problema de saúde pública é crescente e evidencia a necessidade de enfrentá-lo com estratégias eficazes

Estilos de vida en adolescentes de la Provincia Sabana Centro departamento de Cundinamarca, Colombia (2017) / Lifestyles in adolescents of the Sabana Centro Province, department of Cundinamarca, Colombia (2017)

Objetivo: caracterizar los estilos de vida de estudiantes de grado 11 en los colegios oficiales de la Provincia Sabana Centro, Cundinamarca, a partir de creencias y prácticas en torno a la actividad física, el manejo del tiempo libre, los hábitos alimentarios, el consumo de sustancias psicoactivas y el autocuidado. Métodos: se realizó un estudio cuantitativo, descriptivo transversal en una muestra de 281 estudiantes. Resultados: la población objeto del estudio presenta hábitos y conductas no favorables, especialmente en lo concerniente a prácticas alimentarias, actividad física, manejo del sueño, uso de sustancias psicoactivas y sexualidad. Conclusión: la población escolar adolescente evidencia estilos de vida, actitudes y prácticas poco saludables, principalmente en lo relacionado a actividad física, hábitos alimentarios, manejo del sueño, uso de sustancias psicoactivas y sexualidad. Estos aspectos constituyen factores de riesgo frente al padecimiento de enfermedades crónicas no transmisibles a edades tempranas. Es necesario diseñar programas de fomento y promoción de la salud y prevención de la enfermedad que involucren procesos psicosociales.

Objective: to characterize the lifestyles of 11th grade students in the official schools of the Sabana Centro Province, Cundinamarca, based on beliefs and practices around physical activity, free time management, eating habits, consumption of psychoactive substances and self-care. Methods: a quantitative, descriptive cross-sectional study was carried out in a sample of 281 students. Results: the population object of the study presents unfavorable habits and behaviors, especially regarding eating practices, physical activity, sleep management, use of psychoactive substances and sexuality. Conclusion: the adolescent school population shows unhealthy lifestyles, attitudes and practices, mainly in relation to physical activity, eating habits, sleep management, use of psychoactive substances and sexuality. These aspects constitute risk factors for suffering from chronic non-communicable diseases at an early age. It is necessary to design programs for the promotion and promotion of health and disease prevention that involve psychosocial processes.

Relación entre estado funcional y complicaciones quirúrgicas en adultos mayores varones con cáncer / The Relationship between Functional Status and Surgical Complications in Male Older Adults with Cancer

Introducción: La pérdida de funcionalidad es una condición común en adultos mayores con cáncer y la decisión de intervenir quirúrgicamente depende de las comorbilidades y estado funcional. Objetivo: Determinar la asociación entre el estado funcional y complicaciones quirúrgicas en adultos mayores varones con cáncer en el Centro Médico Naval. Métodos: Se realizó un estudio de tipo cohorte retrospectiva, análisis secundario de una base de datos de adultos mayores varones con cáncer, seguidos por dos años y atendidos en el Centro Médico Naval del Perú. Las variables fueron: complicaciones quirúrgicas, estado funcional, comorbilidades, síndromes geriátricos y tipo de cáncer. Resultados: Se evaluó a 385 participantes, edad promedio de 79,69 años (desviación estándar = 4,55). El 39,74 por ciento (n =153) presentó complicaciones quirúrgicas, con una asociación a la presencia de comorbilidades, presencia de dos o más síndromes geriátricos 69,93 por ciento (n =107), dependencia funcional para actividades básicas 51,63 por ciento (n =79) y dependencia funcional para actividades instrumentales 35,95 por ciento (n = 55). De acuerdo con la frecuencia de complicaciones según el tipo de neoplasia se encontró más frecuente para cáncer colorrectal en un 46,41 por ciento (n = 71). Conclusiones: Existe una asociación significativa entre la dependencia funcional y complicaciones quirúrgicas, por lo que es importante no solamente para el tratamiento quirúrgico sino también farmacológico, considerar el estado funcional del paciente para un tratamiento favorable y por lo tanto un mejor pronóstico(AU)

Introduction: Loss of functionality is a common condition in older adults with cancer, while any decision to intervene surgically depends on comorbidities and functional status. Objective: To determine the association between functional status and surgical complications in male older adults with cancer at Centro Médico Naval. Methods: A retrospective cohort-type study was carried out, with secondary analysis of a database of male older adults with cancer followed up for two years and treated at Centro Médico Naval of Peru. The variables were surgical complications, functional status, comorbidities, geriatric syndromes and type of cancer. Results: A number of 385 participants were assessed. Their mean age was 79.69 years (standard deviation: 4.55). 39.74 percent (n=153) presented surgical complications, with an association to the presence of comorbidities, the presence of two or more geriatric syndromes in 69.93 percent (n=107), functional dependence for basic activities in 51.63 percent (n=79), and functional dependence for instrumental activities in 35.95 percent (n=55). Regarding the frequency of complications according to type of neoplasm, the most frequent occurrence was that of colorectal cancer, accounting for 46.41 percent (n=71). Conclusions: There is a significant association between functional dependence and surgical complications, a reason why it is important, not only in surgical but also in pharmacological treatment, to consider the functional status of the patient in view of a favorable treatment and, therefore, a better prognosis(AU)

Prueba de ejercicio cardiopulmonar en militares colombianos con trauma torácico de guerra / Cardiopulmonary exercise test of Colombian military with war thoracic trauma

Introducción: Existen pocas publicaciones relacionadas con las pruebas de esfuerzo cardiopulmonar de soldados heridos en combate, y las diversas complicaciones que puede ocasionar el trauma de guerra. Objetivo: Describir las variables cardiopulmonares en soldados con trauma torácico de guerra, sometidos a pruebas de esfuerzo. Método: Se realizó un estudio descriptivo, entre los años 2010 - 2016, en el Hospital Militar Central de Bogotá, D.C., Colombia. La población de estudio estuvo constituida por 27 pacientes con antecedente de trauma torácico derivado de la guerra, quienes fueron sometidos a pruebas de esfuerzo cardiopulmonar. Se exploran las variables edad, sexo, síntomas, consumo de oxígeno, variables cardiopulmonares medidas por espirometría, tipo de cirugía, trauma y arma. Resultados: El consumo de oxígeno pico medio ml/min fue 2 891,8 (DE: 621,86), consumo de oxígeno pico mL/kg/min 43,25 (DS: 9,72), capacidad vital forzada prebroncodilatador (L) 4,5 (DS: 1, 3) y posbroncodilatador (L) 4,3 (DS: 1,01). El análisis exploratorio encontró diferencias significativas entre quienes tenían heridas por arma de fuego de alta velocidad, y heridas por otros tipos de armas. Conclusión: En pacientes con antecedentes de trauma de guerra, el consumo de oxígeno pico ml/min, oxígeno pico mL/kg/min y capacidad vital forzada, es menor que en población sana; aparentemente, el tipo de herida por arma de fuego de alta velocidad afecta en mayor medida a estas variables evaluadas por las pruebas de esfuerzo cardiopulmonar(AU)

Introduction: There are few publications related to cardiopulmonary stress tests in soldiers wounded in combat, and the various complications cause war trauma. Objective: To describe the cardiopulmonary variables in patients with war thoracic trauma submitted to stress tests. Methods: A descriptive study was carried out between 2010 and 2016, at the Hospital Militar Central de Bogotá, D.C., Colombia. The study population consisted of 27 patients with a history of war-derived thoracic trauma, who were submitted to cardiopulmonary stress tests. The variables of age, sex, symptoms, oxygen consumption, cardiopulmonary variables measured by spirometry, type of surgery, trauma and weapon were explored. Results: A total of 27 participants were included. Mean oxygen consumption peak ml / min was 2 891,8 (SD: 621,86), oxygen consumption peak mL/kg/min 43,25 (DS: 9,72), forced vital capacity pre-bronchodilator (L) 4,5 (DS: 1, 3) and post-bronchodilator (L) 4,3 (DS: 1,01). Exploratory analysis found significant differences among those who had a high velocity firearm wounds against other types of weapons. Conclusions: In patients with a history of trauma, peak oxygen consumption ml / min, peak oxygen mL/kg/min and forced vital capacity is lower than in the healthy population; Apparently, the type of high-velocity firearm wound has a greater effect on these variables evaluated by cardiopulmonary stress tests(AU)

Cooperation During Orthodontic Treatment of Patients with I Phase and Phase Orthodontic Treatment

ABSTRACT: To evaluate differences in cooperation of adolescent patients in active orthodontic treatment between those who received one phased treatment (no prior interceptive or early treatment) and two phased treatment (prior interceptive or early treatment and subsequent corrective treatment). A prospective cohort study was carried out in 132 patients undergoing orthodontic treatment between 10 and 17 years old at CES University Dental Clinics and in 9 private practices in Medellín Colombia; two groups of 66 patients were defined; one that received two phased treatment and one that received one phased treatment. The Orthodontic Patient Cooperation Scale (OPCS) was applied to all individuals every three months during the first year of treatment in order to assess cooperation. Statistical differences between both groups were assessed using the SSPS® software program. Significantly greater cooperation (M = 4.6) was observed in patients who had received two phased treatment compared with those who were only subjected to one phased treatment (M = 2.3). Patient cooperation during orthodontic treatment does not seem to be affected by two phased treatment and to the contrary seems to have a positive impact when comparing it with individuals with one phased treatment. The most important factors found to influence cooperation were correlated with attitude, interest and commitment to treatment, patient and parental motivation. The OPCS scale proved to be useful for evaluating cooperation and making comparisons with other studies.

RESUMEN: Evaluar las diferencias en la cooperación de los pacientes adolescentes en el tratamiento de ortodoncia activa entre los que recibieron una fase de tratamiento (sin tratamiento interceptivo previo o temprano) y los que recibieron el tratamiento de dos fases (tratamiento interceptivo previo o temprano y tratamiento correctivo posterior). Se realizó un estudio de cohorte prospectivo en 132 pacientes sometidos a tratamiento de ortodoncia entre 10 y 17 años en la clínica odontológica de la Universidad CES y en 9 consultorios privados en Medellín Colombia; se definieron dos grupos de 66 pacientes; uno que recibió dos fases de tratamiento y otro que recibió una fase de tratamiento. La Escala de Cooperación del Paciente de Ortodoncia (OPCS) se aplicó a todas las personas cada tres meses durante el primer año de tratamiento para evaluar la cooperación. Las diferencias estadísticas entre ambos grupos se evaluaron utilizando el programa de software SSPS®. Se observó una cooperación significativamente mayor (M = 4.6) en pacientes que habían recibido tratamiento dos fases en comparación con aquellos que solo fueron sometidos a una fase de tratamiento. (M = 2.3). La cooperación del paciente durante el tratamiento de ortodoncia no parece verse afectada por el tratamiento en dos fases y, por el contrario, parece tener un impacto positivo cuando se compara con individuos con un tratamiento en una fase. Los factores más importantes que influyeron en la cooperación se correlacionaron con la actitud, el interés y el compromiso con el tratamiento, la motivación del paciente y de los padres. La escala OPCS demostró ser útil para evaluar la cooperación y hacer comparaciones con otros estudios.

Experiencia del cuidador entrenado en diálisis peritoneal durante la hospitalización del enfermo renal crónico / Experience of the caregiver trained in peritoneal dialysis during the hospitalization of chronic kidney patients

INTRODUCCIÓN: El cuidador entrenado en diálisis peritoneal del paciente con enfermedad renal crónica debe afrontar los retos del cuidado del paciente, además de lo que implica la realización de la técnica de la terapia dialítica. OBJETIVO: Analizar la experiencia del cuidador entrenado en diálisis peritoneal durante la hospitalización del enfermo renal crónico. MATERIAL Y MÉTODO: El abordaje fue cualitativo fenomenológico. Se realizaron entrevistas semiestructuradas a 10 cuidadores entrenados de familiares que estuvieron hospitalizados en una institución de salud pertenecientes a la unidad renal. Para el análisis e interpretación de los datos, se utilizó programa ATLAS.ti, el cual permitió codificar, crear categorías y subcategorías. RESULTADOS: De los cuidadores entrenados en diálisis peritoneal, 9 fueron mujeres y 1 hombre, 6 en modalidad de diálisis peritoneal continua ambulatoria 4 en diálisis peritoneal automatizada, 5 ingresaron en el servicio de hospitalización por causa infecciosa y 5 por complicaciones propias de la patología. Se codifico obteniéndose 527 citaciones de los diferentes códigos, resultando 2 categorías y 6 subcategorías, las cuales fueron: desgaste emocional, desgaste físico, desgaste psicológico, fortaleza espiritual, ausencia de la calidad de los servicios y desarrollo del cuidado. CONCLUSIONES: La experiencia del cuidador entrenado en Diálisis Peritoneal, durante la hospitalización de la enfermedad renal crónica, es que asume una sobrecarga que afecta la salud en los componentes físico, psicológico y emocional, compensándose casi siempre con lo espiritual. Destaca la habilidad del cuidador entrenado en el periodo de la hospitalización y la falta de especialización del equipo de salud

INTRODUCTION: The caregiver trained in peritoneal dialysis of the patient with chronic kidney disease must face the challenges of patient care, in addition to what is related to the performance of the dialysis therapy technique. OBJECTIVE: To analyze the experience of the caregiver trained in peritoneal dialysis during hospitalization of chronic renal patients. MATERIAL AND METHOD: Qualitative phenomenological approach in which semi-structured interviews were conducted with 10 trained caregivers of relatives who were hospitalized in a health institution belonging to the renal unit. For the analysis and interpretation of the data, the ATLAS.ti program was used, which allowed coding, creating categories and subcategories. RESULTS: Of the caregivers trained in peritoneal dialysis, 9 were women and 1 man, 6 in continuous ambulatory peritoneal dialysis modality, 4 in automated peritoneal dialysis, 5 were admitted to the hospitalization service due to an infectious cause and 5 due to complications of the pathology. 527 citations were obtained from the different codes, resulting in 2 categories and 6 subcategories, which were: emotional exhaustion, physical exhaustion, psychological exhaustion, spiritual strength, lack of quality of services and development of care. CONCLUSIONS: The experience of the caregiver trained in peritoneal dialysis, during the hospitalization of chronic kidney disease, is that an overload is assumed affecting physical, psychological and emotional health, usually being compensated with the spiritual sphere. The skill of the trained caregiver in the hospitalization period and the lack of specialization of the health team are identified

Perfil profesional y experiencia escolar en la validación de categorías observacionales de interacciones en aula / Professional prof le and school experience in the validation of observational categories of classroom interactions / Perf profissional e experiência escolar na validação de categorias observacionais de interacções de sala de aula

RESUMEN Este artículo analiza en qué medida las observaciones realizadas por un grupo de profesionales de la educación, con y sin experiencia en docencia, difieren durante la validación de un sistema de análisis de interacciones en aula entre estudiantes y profesores videograbada. Metodológicamente se optó por un estudio cuantitativo exploratorio y descriptivo, con estudio de caso único. El sistema de análisis propone cinco categorías: intercambios, intervención del profesor, hablante principal, dirección del habla del profesor y estructura de la clase. Para determinar la consistencia y validez de contenido mediante el coeficiente kappa de Cohen, los observadores codificaron una clase de 45 minutos de la asignatura de Lenguaje y Comunicación de Octavo Básico de una escuela particular subvencionada en Santiago de Chile. Los resultados muestran que los niveles de acuerdo de los observadores en torno a las categorías definidas varían de fuerte a débiles. Las diferencias observadas podrían ser explicadas por la formación profesional y la experiencia previa en docencia de los observadores.

ABSTRACT This article analyzes to what extent the observations made by a group of professionals, with and without teaching experience, differ during the validation of a classroom interaction analysis system between videotaped students and teachers. Methodologically, a quantitative exploratory and descriptive study was chosen, with a single case study. The analysis system proposes five categories: exchanges, teacher intervention, main speaker, teacher's speech direction and class structure. To determine content consistency and validity using Cohen's kappa coefficient, observers coded a 45-minute Spanish class from a private subsidized school in Santiago de Chile. The results show that the levels of agreement of the observers around the defined categories vary from strong to weak. The observed differences depend on profesional training and previous classroom work experience.

RESUMO Este artigo analisa até que ponto as observações feitas por um grupo de profissionais da educação, com e sem experiência de ensino, diferem durante a validação de um sistema de análise das interações em sala de aula entre alunos e professores gravados em vídeo. Metodologicamente, foi escolhido um estudo exploratório e descritivo quantitativo, com um único estudo de caso. O sistema de análise propõe cinco categorias: intercâmbios, intervenção do professor; orador principal, direcção da fala do professor e estrutura da turma. Para determinar a consistência e validade do conteúdo por meio do coeficiente kappa de Cohen, os observadores codificaram uma aula de 45 minutos na disciplina de Língua e Comunicação na 8a série em uma escola privada subsidiada em Santiago, Chile. Os resultados mostram que os níveis de concordância dos observadores em torno das categorias definidas variam de fortes a fracos. As diferenças observadas poderiam ser explicadas pela formação profissional dos observadores e pela sua experiência de ensino anterior