Survival and pulmonary function in stage IA non-small cell lung cancer after sublobar resection versus lobectomy: An updated meta-analysis.

Traditionally, lobectomy was standard for stage IA non-small-cell lung cancer (NSCLC). Recent RCTs suggest sublobar resection's comparable outcomes. Our meta-analysis, incorporating 30 studies (including four RCTs), assessed sublobar resection's efficacy. Employing a random-effects model and I2 statistics for heterogeneity, we found sublobar resection reduced DFS (HR 1.31, p < 0.01) and OS (HR 1.27, p < 0.01) overall. However, RCT subgroup analysis showed no significant differences in DFS (p = 0.28) or OS (p = 0.62). Sublobar resection is a viable option for well-selected patients.

Baseline surveillance in Li Fraumeni syndrome using whole-body MRI: a systematic review and updated meta-analysis.

OBJECTIVES: Li-Fraumeni syndrome (LFS) is a cancer syndrome associated with early-onset neoplasias. The use of whole-body magnetic resonance imaging (WBMRI) is recommended for regular cancer screening, however, evidence supporting the benefits in asymptomatic LFS patients is limited. This study aims to assess the clinical utility of WBMRI in germline TP53 mutation carriers at baseline and follow-up. MATERIALS AND METHODS: We systematically searched PubMed, Cochrane, and Embase databases for studies evaluating WBMRI as an early detection method for tumor screening in patients with LFS. We pooled the prevalence of the included variables along with their corresponding 95% confidence intervals (CIs). Statistical analyses were performed using R software, version 4.3.1. RESULTS: From 1687 results, 11 comprising 703 patients (359 females (51%); with a median age of 32 years (IQR 1-74)) were included. An estimated detection rate of 31% (95% CI: 0.28, 0.34) for any suspicious lesions was found in asymptomatic TP53 carriers who underwent baseline WBMRI. A total of 277 lesions requiring clinical follow-up were identified in 215 patients. Cancer was confirmed in 46 lesions across 39 individuals. The estimated cancer diagnosis rate among suspicious lesions was 18% (95% CI: 0.13, 0.25). WBMRI detected 41 of the 46 cancers at an early-disease stage, with an overall detection rate of 6% (95% CI: 0.05, 0.08). The incidence rate was 2% per patient round of WBMRI (95% CI: 0.01, 0.04), including baseline and follow-up. CONCLUSION: This meta-analysis provides evidence that surveillance with WBMRI is effective in detecting cancers in asymptomatic patients with LFS. CLINICAL RELEVANCE STATEMENT: Our study demonstrates that whole-body MRI is an effective tool for early cancer detection in asymptomatic Li-Fraumeni Syndrome patients, highlighting its importance in surveillance protocols to improve diagnosis and treatment outcomes. KEY POINTS: Current evidence for whole-body MRI screening of asymptomatic Li-Fraumeni Syndrome (LFS) patients remains scarce. Whole-body MRI identified 41 out of 46 cancers at an early stage, achieving an overall detection rate of 6%. Whole-body MRI surveillance is a valuable method for detecting cancers in asymptomatic LFS patients.

Conductas de salud en estudiantes universitarios: un análisis bayesiano / Health behaviors in college students: a Bayesian analysis / Comportamentos de saúde em estudantes universitários: uma análise bayesiana

En la actualidad, diversos estudios han explorado las diferencias de las conductas de salud en los estudiantes universitarios de acuerdo con características como edad, sexo y ciclo de estudio, no obstante, estos se han centrado en un enfoque frecuentista basado en la prueba de significancia de la hipótesis nula (NHST). Objetivo. Explorar las diferencias de las conductas de salud de acuerdo con el sexo, edad y ciclo académico, así como establecer la relación entre estas y la percepción de salud general en estudiantes universitarios peruanos, desde un enfoque bayesiano. Materiales y métodos. Se ejecutó un estudio cuantitativo, comparativo, correlacional y transversal, en una muestra de 708 universitarios seleccionados de manera intencional. Se utilizó el cuestionario de conductas de salud (CEJUV-R) y una ficha de datos sociodemográficos. Resultados. Los hallazgos muestran que los hombres tienen mejores hábitos de actividad y condición física y organización del sueño, con respecto a las mujeres. Asimismo, se observa una evidencia moderada a favor de la hipótesis alternativa del autocuidado en función de la edad y el ciclo académico. Finalmente, la actividad física, la organización del descanso, el autocuidado y la organización del sueño presentan evidencias muy fuertes (BF>100) de su relación con la percepción general de salud. Conclusión. El análisis bayesiano mostró evidencia a favor de la hipótesis alterna en algunas de las conductas de salud en función del sexo, edad y ciclo académico, lo que resaltan la importancia de promover conductas más saludables entre los estudiantes universitarios peruanos atendiendo a sus características personales.

Currently, several studies have explored the differences in health behaviors in university students according to characteristics such as age, sex and study cycle; however, these have focused on a frequentist approach based on the null hypothesis significance test (NHST). Objective. To explore the differences in health behaviors according to sex, age and academic cycle, as well as to establish the relationship between these and the perception of general health in Peruvian university students, from a Bayesian approach. Materials and methods. A quantitative, comparative, correlational and cross-sectional study was carried out in a sample of 708 intentionally selected university students. The health behaviors questionnaire (CEJUV-R) and a sociodemographic data sheet were used. Results. The findings show that men have better habits of activity and physical condition and sleep organization, with respect to women. Likewise, there is moderate evidence in favor of the alternative hypothesis of self-care as a function of age and academic cycle. Finally, physical activity, rest organization, self-care and sleep organization present very strong evidence (BF>100) of their relationship with the general perception of health. Conclusion. The Bayesian analysis showed evidence in favor of the alternative hypothesis in some of the health behaviors as a function of sex, age and academic cycle, which highlights the importance of promoting healthier behaviors among Peruvian university students according to their personal characteristics.

Atualmente, vários estudos exploraram as diferenças nos comportamentos de saúde em estudantes universitários de acordo com características como idade, gênero e ciclo de estudos; no entanto, eles se concentraram em uma abordagem frequentista baseada no teste de significância da hipótese nula (NHST). Objetivo. Explorar as diferenças nos comportamentos de saúde de acordo com o sexo, a idade e o ciclo acadêmico, bem como estabelecer a relação entre eles e a percepção da saúde geral em estudantes universitários peruanos, a partir de uma abordagem bayesiana. Materiais e métodos. Foi realizado um estudo quantitativo, comparativo, correlacional e transversal em uma amostra de 708 estudantes universitários selecionados intencionalmente. Foram utilizados o questionário de comportamento de saúde (CEJUV-R) e uma planilha de dados sociodemográficos. Resultados. Os achados mostram que os homens têm melhores hábitos de atividade física, condicionamento físico e organização do sono do que as mulheres. Também há evidências moderadas a favor da hipótese alternativa de autocuidado em função da idade e do ciclo acadêmico. Por fim, a atividade física, a organização do descanso, o autocuidado e a organização do sono mostram evidências muito fortes (BF>100) de sua relação com a percepção geral da saúde. Conclusão. A análise bayesiana mostrou evidências a favor da hipótese alternativa em alguns dos comportamentos de saúde em função do sexo, da idade e do ciclo acadêmico, destacando a importância de promover comportamentos mais saudáveis entre os estudantes universitários peruanos de acordo com suas características pessoais.

7 topics that business ecosystems navigate: Assessment of scientific activity and future research agenda.

Business Ecosystems are made up of a group of companies that cooperate with each other to innovate in a product. This research had the purpose of assessing the scientific activity and thus be able to extract the topics explored by the authors involved, geographical gaps of scientific production and research topics for future studies. In the methodological design, the statistical software VOSviewer and RStudio were used, with which the documentation obtained from Scopus was analyzed and reflected in tables and figures. The results yielded: a) the 7 topics most worked on by researchers on the variable in question, b) a notable geographical scientific gap in Africa, and c) 5 topics of research that can be explored for future scientific papers. In short, this research was performed with high citation documents, therefore, authors are recommended to carry out research in collaboration with authors located in the geographical scientific gap or vice versa but based on the 5 topics of future research, in the niche topics and a declining topic.

Soft skills in personnel training: Report of publications in scopus, topics explored and future research agenda.

Recent research has documented the interest of organizations in training their staff in soft skills, but few studies have been found. Therefore, the objective of this research was to analyze 753 publications in the Scopus database related to soft skills in staff training during the period 1999-2021. These documents were analyzed to identify the main information, the most explored areas, and a future research agenda; all under a bibliometric and bibliographic approach with the help of RStudio and VOSviewer software. The results showed that the keywords with the most co-occurrence were personnel training (n = 110) and soft skills (n = 79). The year with the most documents was 2021 (n = 121). The country with the most publications was the United Kingdom (n = 199). Medicine is the subject area with the most documents (n = 278) and the Article is the type of document with the most studies (n = 566). Eleven areas of further exploration were identified: "Soft skills in software engineering at the higher education level", "Soft skills and communication", "Soft skills and engineering education", "Soft skills in virtual environments", "Soft skills in machine learning", "Serious games in teaching soft skills", "Soft skills for problem-based learning", "Soft skills for project management", "Soft skills and technical skills", "Project-based learning for the assessment of soft skills" and "Soft leadership skills". Five potential areas for future research were derived: soft skills in collaborative work (CSCL), soft skills in computer-aided collaborative work (CSCW), facial expressions as a mirror of soft skills, soft skills for employability and Professional Development Plan (PDP) to assess soft skills. In conclusion, this Review type document on soft skills in personnel training helped to identify the most studied topics during the evaluated period, as well as to identify the little explored topics for future research.

Psychological capital in university students: analysis of scientific activity in the scopus database.

Lately there has been an increase in the number of publications on psychological capital, especially in the specialty of organizational psychology, and not so much in the field of educational psychology. This study aims to analyze the main bibliometric indicators of production, collaboration and impact of scientific literature related to psychological capital in university students. We searched the Scopus database for documents using the comprehensive search strategy until June 27, 2021. Data were collected regarding title, keywords, authors, co-authors, citations received, details of the most productive journals, year of publication, countries, and institutions. From 2009 to 2021, 82 documents were published, mainly from countries such as China, Australia, the United Kingdom, the United States and Spain; the most productive journal was the so-called Revista Argentina de Clínica Psicológica while Curtin University was the most influential institution in the subject of study. The author's co-occurrence network analysis, trend topics, and keyword analysis highlighted themes involving psychological capital with educational and health variables in college students. The findings can help both academics and professionals to obtain an overview of advances in the subject and thus identify important gaps in the literature and propose promising new lines of research.

Detection of Mansonella ozzardi in peripheral blood in two malaria-endemic areas in Panama.

Introduction: Studies conducted in 1984 demonstrated the presence of Mansonella ozzardi in the Darien and Colon provinces. Since then, there have not been further reports of this parasitic infection in Panama. Methodology: We conducted a cross-sectional assessment of peripheral blood samples of individuals across Panama over a 4-year period (2013-2016) as part of malaria surveillance activities. Results: We identified microfilaria in 96 cases. Most of these cases were found in East Panama (78%) followed by the Darien region (22%). Mansonella ozzardi was the filarial parasite identified by morphological features in all cases. Conclusion: After 36 years of epidemiological silence, we identified human cases of Mansonella ozzardi infection in Panama. This is, however, the first report of this filarial parasite's presence in the Eastern region of Panama. There is a need for further surveillance efforts to elucidate the epidemiology associated with Mansonella infections in Panama.

Satisfacción con la vida y Conductas de salud en estudiantes universitarios de nuevo ingreso / Satisfaction with life and health behaviors in incoming college students / Satisfação com a Vida e Comportamentos de Saúde em Novos Estudantes Universitários

En la actualidad resultan escasos los estudios que relacionen la satisfacción con la vida y las conductas saludables en estudiantes que inician sus estudios universitarios, aun cuando se sabe que la transición a la etapa universitaria puede originar diversos cambios con repercusiones importantes para la salud de los estudiantes. OBJETIVO: determinar la relación entre la satisfacción con la vida y las conductas de salud en estudiantes de primer semestre de una universidad pública venezolana. MÉTODO: estudio de naturaleza cuantitativa, no experimental, descriptivo, correlacional y transversal, utilizó una muestra conformada por 636 estudiantes (65% mujeres y 35% hombres) con edades entre los 15 y 27 años, seleccionados bajo un muestreo no probabilístico intencional. RESULTADOS: los estudiantes se caracterizan por estar satisfechos con su vida y presentan niveles moderados de conductas saludables en general. Asimismo, la satisfacción con la vida difiere según el sexo y el estrato socioeconómico, mientras que algunas conductas de salud difieren según el sexo, el estrato socioeconómico y la edad. Por otra parte, la satisfacción con la vida presenta relación significativa con las conductas de salud a nivel general y en las dimensiones conductas preventivas, sueño, actividad física, control en el consumo de drogas y chequeo médico. CONCLUSIÓN: la satisfacción con la vida resulta ser una variable protectora que fomenta conductas saludables en estudiantes universitarios, en especial los que recién inician los estudios, siendo importante considerarla en futuras intervenciones y programas de promoción de la salud.

Currently, there are few studies that relate satisfaction with life and healthy behaviors in students starting their university studies, even though it is known that the transition to the university stage can cause various changes with important repercussions on the health of students. OBJECTIVE: to determine the relationship between life satisfaction and health behaviors in first semester students at a Venezuelan public university. METHOD: a quantitative, non-experimental, descriptive, correlational, and cross-sectional study, using a sample of 636 students (65% women and 35% men) between 15 and 27 years of age, selected under a non-probabilistic intentional sampling. RESULTS: the students are characterized by being satisfied with their lives and present moderate levels of healthy behaviors in general. Also, life satisfaction differs by gender and socioeconomic status, while some health behaviors differ by gender, socioeconomic status, and age. On the other hand, life satisfaction is significantly related to health behaviors at the general level and in the dimension's preventive behaviors, sleep, physical activity, drug use control and medical check-up. CONCLUSION: life satisfaction turns out to be a protective variable that promotes healthy behaviors in university students, especially those who are just starting their studies, and it is important to consider it in future interventions and health promotion programs.

Atualmente, há poucos estudos que relacionam a satisfação com a vida e comportamentos saudáveis em estudantes que iniciam seus estudos universitários, embora se saiba que a transição para a etapa universitária pode causar diversas mudanças com repercussões importantes para a saúde dos alunos. OBJETIVO: determinar a relação entre satisfação com a vida e comportamentos de saúde em alunos do primeiro semestre de uma universidade pública venezuelana. MÉTODO: um estudo quantitativo, não experimental, descritivo, correlacional e transversal utilizou uma amostra de 636 estudantes (65% mulheres e 35% homens) com idade entre 15 e 27 anos, selecionados em amostragem não probabilística intencional. RESULTADOS: os alunos se caracterizam por estarem satisfeitos com suas vidas e apresentam níveis moderados de comportamentos saudáveis em geral. Além disso, a satisfação com a vida difere por sexo e status socioeconômico, enquanto alguns comportamentos de saúde diferem por sexo, estrato socioeconômico e idade. Por outro lado, a satisfação com a vida apresenta uma relação significativa com os comportamentos de saúde em nível geral e nas dimensões comportamentos preventivos, sono, atividade física, controle no uso de drogas e check-up médico. CONCLUSÃO: a satisfação com a vida acaba por ser uma variável protetora que incentiva comportamentos saudáveis em estudantes universitários, especialmente aqueles que estão apenas iniciando seus estudos, e é importante considerá-lo em intervenções futuras e programas de promoção da saúde.

Ocular toxoplasmosis in immunocompetent adults: current cost-effectiveness of four treatment regimens in Colombia.

BACKGROUND: Ocular toxoplasmosis is an infection caused by Toxoplasma gondii. In South America, the clinical course of ocular toxoplasmosis is more severe than in Europe and North America because virulent strains of the parasite are present. Ocular toxoplasmosis is the leading cause of posterior uveitis and retinochoroiditis in Colombia, requiring timely and appropriate treatment. However, there is no standardized therapy protocol based on economic studies for the country. PURPOSE: To compare the cost-effectiveness of four first-line treatment regimens for active ocular toxoplasmosis in immunocompetent adults in Colombia, using the number of averted therapeutic failures as the outcome. METHODS: We performed an economic and cost-effectiveness analysis to compare four first-line treatment regimens for ocular toxoplasmosis from the perspective of a third-party payer (Colombian General System of Social Security in Health). A decision analysis tree was used over a 24-week time horizon, considering only direct costs. Additionally, we performed a discrete sensitivity analysis and a probabilistic sensitivity analysis with 10,000 iterations in the Monte Carlo simulation. RESULTS: For the base case, trimethoprim/sulfamethoxazole showed 86% effectiveness at a cost of <57 United States Dollars, resulting in the most cost-effective first-line alternative. When performing the probabilistic sensitivity analysis and maintaining the willingness to pay 466.00 United States Dollars, the trimethoprim/sulfamethoxazole regimen remained the most cost-effective alternative. CONCLUSION: Ocular toxoplasmosis is a public health issue in Latin America. Despite severe visual consequences for affected patients, there are no standardized treatment guidelines in countries such as Colombia. Our evidence supports the use of trimethoprim/sulfamethoxazole as first-line treatment in Colombia because of its availability and optimal cost-effectiveness performance; it reduces recurrences and complications, while averting therapeutic failure. Furthermore, our evidence can be generalized to other Latin American countries with similar frequencies and severities of Toxoplasma gondii ocular infection and health systems similar to the Colombian system.

Infección por uncinarias en un lactante menor: Reporte de caso / Infantile hookworm infection: Clinical case report

La uncinariasis es endémica en zonas tropicales. Es común en preescolares y escolares pero infrecuente en lactantes antes de los 6 meses debido al mecanismo de transmisión que implica contacto de la piel con el suelo contaminado. La infección se caracteriza por anemia ferropénica secundaria a sangrado digestivo crónico. Una forma inusual de presentación es el sangrado digestivo masivo que causa anemia severa. Presentación del caso: Niña shuar de 4 meses sin antecedentes patológicos, referida del Hospital General Puyo por un cuadro de melenas de 3 meses de evolución. Al mes de edad inició con deposiciones melénicas ocasionales y palidez que empeoraron dos semanas antes del ingreso. Se apreció palidez generalizada, hipoactividad y edema en miembros inferiores. Presentó hemoglobina 2,8 g/dL, hematocrito 9%, volumen corpuscular medio 73 fl, ancho de distribución de eritrocitos 18%, reticulocitos 1% y eosinófilos 4%. El coprológico y coproparasitario reportaron heces alquitranosas, sangre positiva y huevos de uncinarias más Kato-Katz compatible con intensidad de infección moderada. Se diagnosticó anemia severa por sangrado digestivo secundario a uncinarias. Se trató con Albendazol 400 mg vía oral en una toma más transfusión sanguínea. A los 5 días mejoró la hemoglobina y disminuyó el edema. Las melenas cesaron. Se dió el alta para control ambulatorio. Conclusión: La uncinariasis es una enfermedad endémica cuya presencia e impacto en lactantes se ha subestimado pues no es considerada como causa de sangrado digestivo. Debe pensarse en esta parasitosis en contextos de zonas endémicas en niños que cumplan un perfil clínico similar al descrito

Hookworms are endemic nematodes from tropical regions. Infection is more common in preschool and school children, but it is less frequent in infants under 6 months, because of the transmission mechanism that implies contact between contaminated soil and skin. The clinical disease is characterized by manifestations related to iron-deficiency anemia, secondary to a chronic digestive blood loss. An unusual way of presentation is the massive digestive bleeding that causes severe anemia. Case report: A four month shuar girl with no significant medical history, referred from General Puyo hospital, presented upper digestive bleeding of 3 months duration. At month of age, the girl presented self-limited melenas and skin pallor that worsen two weeks before the admission. The girl was hypo active, with a pale complexion, and had edema of feet. Her blood count showed hemoglobin 2.8 g/dl, hematocrit 9%, mean corpuscular volume 73 fl, red cell distribution width 18%, reticulocyte count 1%, eosinophils 4%. Coprological analysis reported tarry stools, positive fecal occult blood test, and hookworm eggs determined by Kato ­ Katz as a moderate infection. It was diagnosed iron-deficiency anemia secondary to an upper digestive bleeding caused by hookworms. The infection was treated with a single oral dose of albendazole 400mg plus blood transfusion. After 5 days of treatment, hemoglobin increased and edema was reduced. Melenas disappeared completely. Finally the discharge was indicated for outdoor control. Conclusion: Hookworm infestation is an endemic disease whose presence and impact in infants has been underestimated because it is not necessary as a cause of digestive bleeding. This disease should be considered in contexts of endemic areas in children who meet a clinical profile similar to that described

Comparación de la utilidad clínica de datos antropométricos de recién nacidos prematuros empleando las gráficas Fenton e Intergrowth-21st / Comparison of the clinical utility of anthropometric data of preterm infants using Fenton and Intergrowth -21 st charts

Introducción: no existe consenso sobre la gráfica idónea para monitorizar el crecimiento de prematuros, sin embargo, Fenton es la más difundida. Desde el aparecimiento de INTERGROWTH-21st ésta se perfila como una herramienta eficaz. Nuestro objetivo fue comparar INTERGROWTH-21st y Fenton en la valoración antropométrica de prematuros. Población y Métodos: estudio transversal que analizó datos antropométricos de prematuros entre enero de 2014 a diciembre de 2016 mediante la revisión de registros. La clasificación se realizó por edad gestacional y sexo usando Fenton y se compararon con INTERGROWTH-21st categorizando los percentiles 10, 50 y 90. Se realizaron pruebas de correlación y concordancia (p < 0.05, intervalo de confianza 95%). Se mantuvieron los respectivos lineamientos éticos. Resultados: en 232 prematuros la prevalencia de peso bajo fue de 13.7% con Fenton y 15.9% con INTERGROWTH-21st y para peso elevado 2.5% y 6% respectivamente. Presentaron una concordancia de 0.7 peso y perímetro cefálico. De 194 prematuros adecuados para la edad gestacional por Fenton, INTERGROWTH-21st clasificó al 4% como bajos y altos y el resto como adecuados. Existió correlación positiva en los tres parámetros antropométricos. Tomando como estándar a INTERGROWTH-21st y como criterio a evaluar a Fenton, la especificidad fue mayor que la sensibilidad en la antropometría baja (98.4 y 78.3 peso, 98.3 y 62.5 longitud y 100 y 64.2 perímetro cefálico) y elevada (100 y 42.8 peso, 97.5 y 22.2 longitud y 96.3 y 70 perímetro cefálico). Conclusión: Fenton clasifica con menor frecuencia pesos bajos y elevados para la edad gestacional en relación a INTERGROWTH-21st.

Introduction: there is no consensus on the ideal graph to monitor the growth of premature infants; however, the Fenton graph is the most widespread. Since the appearance of the INTERGROWTH-21st chart, this is emerging as an effective tool. Our objective was to compare INTERGROWTH-21st and Fenton in the anthropometric assessment of premature infants. Population and methods: a cross-sectional study that analyzed anthropometric data of premature infants between January 2014 and December 2016 by reviewing records. The classification was made by gestational age and sex using Fenton and was compared with INTERGROWTH-21st by categorizing the 10th, 50th and 90th percentiles. Correlation and concordance tests were performed (p <0.005, 95% confidence interval). The respective ethical guidelines were maintained. Results: in 232 preterm infants the prevalence of low weight was 13.7% with Fenton and 15.9% with INTERGROWTH-21st and for high weight 2.5% and 6% respectively. Weight and cephalic perimeter presented a concordance of 0.7. Of 194 premature babies suitable for gestational age by Fenton, INTERGROWTH-21st classified 4% as low and high, the rest as adequate. There was positive correlation in the three anthropometric parameters. Taking as standard INTERGROWTH-21st and as a criterion to evaluate Fenton, the specificity was greater than the sensitivity in low anthropometry (98.4 and 78.3 weight, 98.3 and 62.5 length, 100 and 64.2 cephalic perimeter) and high (100 and 42.8 weight, 97.5 and 22.2 length, 96.3 and 70 cephalic perimeter). Conclusion: Fenton classified less frequently low and high weights for gestational age in relation to INTERGROWTH-21st.

La simulación clínica como estrategia de enseñanza-aprendizaje en ciencias de la salud / Clinical simulation as a teaching-learning strategy in health sciences

Las estrategias de enseñanza-aprendizaje en Salud han evolucionado sustancialmente, ubicando a la simulación clínica como parte esencial de los procesos curriculares y de acreditación; sin embargo, debido al tiempo e inversión que requiere, puede verse relegada de incorporarla de forma eficiente y temprana en los procesos educativos. Se expone una panorámica sobre su importancia en la docencia y cómo influye en las competencias clínicas para la atención de salud.

Health teaching-learning strategies have evolved substantially, locating clinical simulation as an essential part of curricular and accreditation processes; however, due to the time and the investment required, it can be relegated to incorporate efficiently and early to education processes. A panoramic view of its importance with teaching a

Factores de riesgo asociados con hemorragia pulmonar neonatal / Risk factors associated with neonatal pulmonary haemorrhage

Objetivo: determinar la prevalencia de la hemorragia pulmonar en pacientes ingresados en Cuidado Intensivo Neonatal e identificar los factores de riesgo asociados. Metodología: estudio de casos y controles en pacientes en soporte ventilatorio con diagnóstico confirmado de hemorragia pulmonar con criterios de inclusión previamente definidos. Los controles fueron pareados por sexo y se seleccionaron en relación con el siguiente ingreso a la sala de Neonatología después de un caso con una diferencia de peso de ±200 gramos y una edad gestacional de ±1 semana. Se identificaron características asociadas con el cuadro sintomático divididas en factores prenatales y postnatales. La recolección de datos se hizo mediante el paquete estadístico SPSS; se usó estadística descriptiva y para el análisis se usó tablas cruzadas y evaluación de odds ratio. Se calculó la prevalencia del problema. Resultados: un total de 1.039 pacientes fueron atendidos en la sala de Neonatología. Se registraron 17 casos de hemorragia pulmonar. Con los criterios de inclusión planteados, solamente se tomaron en cuenta 12 y se parearon con 24 controles. La prevalencia de la hemorragia pulmonar fue de 1.15% con una mortalidad del 66.7%. Del total de casos, la hemorragia pulmonar se presentó en 33.3% en pacientes menores de 1.500 g y en 83.3% de prematuros, particularmente menores de 32 semanas. Factores de riesgo identificados: no uso de corticoides para maduración pulmonar en la madre gestante (OR 1.73 IC 1.40-7.36 p 0.45), hipertensión pulmonar persistente (OR 1.73 IC 1.40-7.36 p 0.45), enfermedad de membrana hialina (OR 2.0 IC 1.47-8.46 p 0.34) y uso de surfactante exógeno para el manejo de esta última (OR 3.40 IC 1.80-14.41 p 0.09). De forma independiente, la coagulopatía presentó significancia estadística relevante como causa (OR 35.0 IC 5.02-93.85 p 0.01). Conclusión: la hemorragia pulmonar es una complicación poco prevalente pero de alta mortalidad en la cual la edad gestacional y los factores asociados al manejo inmediato de las complicaciones de la prematurez son fundamentales para mejorar el pronóstico. (AU)

Objective: to determine the prevalence of pulmonary bleeding in patients admitted to neonatal intensive care and identify associated risk factors. Methodology: case-control study in patients with ventilatory support and a confirmed pulmonary hemorrhage diagnosis, with predefined inclusion criteria. Controls were matched by sex and selected in relation to the following entry in the Neonatology Intensive Care Unit after a case with a weight difference of ± 200 g and a gestational age of ± 1 week. Associated characteristics to the clinical features were identified and divided into prenatal and postnatal factors. The selection and analysis of data were made with the SPSS statistical basis; descriptive statistics were used and crossing variables with odds ratio evaluation were performed for the analysis. The problem's prevalence was also calculated. Results: a total of 1039 patients were treated at the Neonatal ICU, where we recorded 17 cases of pulmonary hemorrhage, with inclusion criteria defined, there were taken 12 that matched with 24 controls. The prevalence of pulmonary hemorrhage was 1.15% with a mortality of 66.7%. From all the cases, pulmonary hemorrhage occurred in 33.3%, in patients with less than 1500 g and in 83.3% of preterm infants, particularly in those under 32 weeks. They were identified as risk factors not to use steroids for lung maturity during the pregnancy (OR 1.73 CI 1.40 to 7.36 p 0.45), persistent pulmonary hypertension (OR 1.73 CI 1.40-7.36 p 0.45), hyaline membrane disease (OR 2.0 CI 1.47 to 8.46 p 0.34) and the use of exogenous surfactant therapy for the management of it (OR 3 40 CI 1.80 to 14.41 p 0.09). Independently, disseminated intravascular coagulopathy, had more relevant statistical significance as a cause (OR 35.0 CI 5.02 to 93.85 p 0.01). Conclusion: pulmonary hemorrhage is a poor prevalent complication with a high mortality, in which gestational age and associated factors to the immediate management of prematurity complications are essential to improve the prognosis. (AU)

[Child and adolescent abuse recorded at a national referral hospital, 2006 - 2011]. / Maltrato infantil y del adolescente registrado en un hospital de referencia nacional, 2006 - 2011.

OBJECTIVES: To describe the records of child and adolescent abuse of the Instituto Nacional de Salud del Niño (INSN) from January 2006 to September 2011, characterizing the victim and perpetrator. MATERIALS AND METHODS: A secondary sources analysis was performed, based on the domestic violence and child abuse records, from froms administered by Child Abuse and Adolescent Health Unit (MAMIS) at the INSN. The records include data of the victim, offender and characteristics of the aggression. Types of aggression were categorized as: sexual, physical, psychological or neglection. Frequencies and percentages are presented. RESULTS: A total of 1798 records were included. From them 63.9% were girls, and 39.9% were adolescents. Males accounted for 60.6% of the offenders, and 65.8% of assaults occurred at home. Sexual assault was recorded in 48.6%, with more frequency among girls (73.2%) and adolescents (44.4%); and intercourse occurred in 9.6% of the cases. CONCLUSIONS: From the INSN MAMIS records, aggressions to girls was the most frequent type of report, the aggressor was often a male and most of the attacks occurred in the child's home. Sexual assault accounted for almost half of the series.

Maltrato infantil y del adolescente registrado en un Hospital de referencia nacional, 2006 2011 / Child and adolescent abuse recorded at a national referral hospital, 2006 - 2011

Objetivos. Realizar una descripción de los registros del Instituto Nacional de Salud del Niño (INSN), desde enero de 2006 hasta septiembre de 2011, sobre maltrato infantil y del adolescente, lo cual permite la caracterización del agredido y del agresor. Materiales y métodos. Se realizó un análisis de fuentes secundarias, basado en registros de la “Ficha de evaluación de violencia familiar y maltrato infantil”, aplicada por el Módulo de Atención al Maltrato Infantil y del Adolescente en Salud (MAMIS) del INSN. La ficha incluye datos del agredido, del agresor y las características de la agresión. Se diferenció el tipo de agresión como: sexual, física, psicológica o por abandono. Se muestran los resultados en frecuencias y porcentajes. Resultados. Se incluyeron 1798 registros. El 63,9 por ciento eran niñas y el 39,9 por ciento fueron adolescentes. El 60,6 por ciento de los agresores fueron varones y el 65,8 por ciento de las agresiones ocurrieron en casa. El 48,6 por ciento fueron registros de agresión sexual, que fue más frecuente en niñas (73,2por ciento) y adolescentes (44,4 por ciento); en el 9,6 por ciento de los casos existió coito. Conclusiones. En los registros del MAMIS del INSN, la agresión en niñas fue la más frecuente; el agresor con frecuencia era un varón y la mayoría de las agresiones ocurrieron en el domicilio del menor. La agresión sexual fue casi la mitad de la serie.(AU)

Maltrato infantil y del adolescente registrado en un hospital de referencia nacional, 2006 - 2011 / Child and adolescent abuse recorded at a national referral hospital, 2006 - 2011

Objetivos. Realizar una descripción de los registros del Instituto Nacional de Salud del Niño (INSN), desde enero de 2006 hasta septiembre de 2011, sobre maltrato infantil y del adolescente, lo cual permite la caracterización del agredido y del agresor. Materiales y métodos. Se realizó un análisis de fuentes secundarias, basado en registros de la "Ficha de evaluación de violencia familiar y maltrato infantil", aplicada por el Módulo de Atención al Maltrato Infantil y del Adolescente en Salud (MAMIS) del INSN. La ficha incluye datos del agredido, del agresor y las características de la agresión. Se diferenció el tipo de agresión como: sexual, física, psicológica o por abandono. Se muestran los resultados en frecuencias y porcentajes. Resultados. Se incluyeron 1798 registros. El 63,9% eran niñas y el 39,9% fueron adolescentes. El 60,6% de los agresores fueron varones y el 65,8% de las agresiones ocurrieron en casa. El 48,6% fueron registros de agresión sexual, que fue más frecuente en niñas (73,2%) y adolescentes (44,4%); en el 9,6% de los casos existió coito. Conclusiones. En los registros del MAMIS del INSN, la agresión en niñas fue la más frecuente; el agresor con frecuencia era un varón y la mayoría de las agresiones ocurrieron en el domicilio del menor. La agresión sexual fue casi la mitad de la serie.

Objectives. To describe the records of child and adolescent abuse of the Instituto Nacional de Salud del Niño (INSN) from January 2006 to September 2011, characterizing the victim and perpetrator. Materials and methods. A secondary sources analysis was performed, based on the domestic violence and child abuse records, from froms administered by Child Abuse and Adolescent Health Unit (MAMIS) at the INSN. The records include data of the victim, offender and characteristics of the aggression. Types of aggression were categorized as: sexual, physical, psychological or neglection. Frequencies and percentages are presented. Results. A total of 1798 records were included. From them 63.9% were girls, and 39.9% were adolescents. Males accounted for 60.6% of the offenders, and 65.8% of assaults occurred at home. Sexual assault was recorded in 48.6%, with more frequency among girls (73.2%) and adolescents (44.4%); and intercourse occurred in 9.6% of the cases. Conclusions. From the INSN MAMIS records, aggressions to girls was the most frequent type of report, the aggressor was often a male and most of the attacks occurred in the child’s home. Sexual assault accounted for almost half of the series.

Caracterización de la violencia en niños y adolescentes en el Instituto Nacional de Salud del Niño 2000-2010 / Characterization of the violence in children and teenagers in the National Institute of Health of the Child 2000-2010

Objetivos: describir las características del agresor, de la víctima y según tipo de violencia en niños y basado en la ficha multisectorial de violencia familiar que es conducida por el MAMIS (Módulo de Atención al Maltrato Infantil en Salud) del Instituto Nacional de Salud del Niño (INSN) en el periodo 2006-2011. Metodología: estudio descriptivo observacional retrospectivo análitico retrsopectivo basado en la ficha multisectorial de violencia familiar que es conducida por la MAMIS (Módulo de Atención al Maltrato Infantil en Salud)del Instituto Nacional de Salud del Niño (INSN) en el periodo 2006-2011. La ficha recolecta datos de filiación del agredido, del agresor, del lugar de la agresión las medidas que se tomarán y el seguimiento y es aplicada a niñas y niños de 0 a 18 años atendidos o referidos al INSN por sospecha del maltrato infantil. Análisis de datos usando el programa estadístico SPSS V.18 se aplica Chi cuadrado para las variables cualitativas...

Descripción de la conducta sexual en adultos jóvenes limeños / Description of sexual behaviors in Peruvian younger adults

Objetivo: Describir las conductas sexuales en una muestra de adultos jóvenes limeños de nivel socioeconómico C y D. Diseño: Estudio descriptivo transversal. Lugar: EIGER. Participantes: 156 adultos jóvenes. Intervenciones: Se usó un cuestionario semi-estructurado auto-administrado y se realizó el análisis con el Software STATA 9.0. Principales medidas de resultados: Para comparar las variables cuantitativas de acuerdo a variables cualitativas dicotómicas se usó el test T de Student, previo examen de los supuestos de normalidad por el test de Shapiro Wilk y de homogeneidad de varianzas por el test de Levene, de no cumplirse los supuestos se usó el test de suma de Rangos de Wilxocon. Para evaluar la asociación entre dos variables cualitativas se usó el Test exacto de Fisher. Resultados: La edad promedio de inicio sexual fue de 17.23 ±3.51 años. La primera relación sexual se da con la pareja sentimental, el número promedio de parejas sexuales 1.88 ±1.01 en mujeres y 4.35 ±3.57 en hombres. Tener más de una pareja sexual durante la misma época, usar el Internet para buscar parejas sexuales, acudir a los servicios de prostitución y tener RS con parejas ocasionales conocidas o desconocidas son conductas mayoritariamente practicadas por hombres en nuestro estudio. Conclusiones: La población masculina se encuentra en mayor riesgo por presentar conductas y actitudes más riesgosas que la población femenina.

Objective: To describe sexual behavior patterns in a sample of Peruvian young adults of socioeconomic levels C and D. Study Design: Descriptive, cross- sectional study. Participants: 156 young adults Interventions: We used a self-completed questionnaire and analyzed it with the statistical software package STATA. Main outcome measures: The T test of Student was used to compare the quantitative variables according to the dichotomy qualitative variables, with a previous examination of the suppositions of normality by the test of Shapiro Wilk and the homogeneity of variances by the test of Levene. If the suppositions were not completed, we used the test of sum of Ranges of Wilxocon. To evaluate the association between two qualitative variables, the exact Test of Fisher was used. Results: Respondents have on average, started their sexual life by the age of 17.23 ±3.51 years. Mostly, the initial intercourse is with their partner ; the average number of sexual partners is 1.88 ±1.01 in women and 4.35 ±3.57 in men. To have more than one sexual partner at the same time, to use the Internet with a sexual purpose, to attend prostitution services and to have intercourse with occasional well-known or strangers are behavior patterns practiced mainly by men in our study. Conclusions: Male population is more threatened because of high-risk behavior and attitudes than female population.

Acceso a páginas pornográficas en Internet y Comunicación familiar sobre sexualidad en adolescentes del distrito de ôEl Agustinoõ, Lima - Péru 2006- 2007 / Access to pornographic web and familiar communication on sexuality in teenagers of the district of ôEl Agustinoõ, Lima - Peru 2006-2007

Se ha realizado un estudio descriptivo transversal, en 10 colegios del Distrito de El Agustino-Lima; desarrollándose un cuestionario en una población total de 1107 adolescentes, siendo el 50% (n=553) de sexo masculino y 50% (n=554) de sexo femenino, indagando sobre el acceso a las páginas pornográficas en Internet, el lugar donde lo realizan y la comunicación familiar global entre progenitores y los mismos. El 30.4% (n=337) de los adolescentes visitan páginas pornográficas; siendo los lugares predominantes de acceso a éstas páginas pornográficas: en cabinas de Internet 22.3% (n=247), en hogares 2.7% (n=30) y en colegios 2.7% (n=30). La comunicación familiar global entre los progenitores y los adolescentes fue insuficiente en un 95.4% (n=1056). Se demostró que el sexo masculino tiene mayor accesibilidad a páginas pornográficas en Internet (33.1%; n=183) con un Chi Cuadrado de Pearson p=0.000; Los adolescentes de 13 y 14 años de edad (33.8%; n=114) son los que más páginas pornográficas en Internet visitan (p=0.000). Finalmente la comunicación familiar global fue deficiente tanto en el grupo de adolescentes que visitan páginas pornográficas (29%; n=321) como en el grupo de adolescentes que no visitan páginas pornográficas en Internet (66.4; n=735) con un Chi Cuadrado de Pearson p=0.538.

A descriptive transverse study, in 10 high schools of the District of ôEl Agustinoõ- Lima was performed, developing a questionnaire in a total population of 1107 teenagers, 50 % (n=553) male and 50 % (n=554) female. We researched on the access to pornography pages in Internet, the place where they do get access to pornography and the family global communication between teenagers and their parents. Pornography pages were visited by 30.4 % (n=337) of the teenagers. The predominant places of access to these in Internet were: internet public places 22.3 % (n=247), homes 2.7 % (n=30) and in schools 2.7 % (n=30). Family global communication between parents and teenagers was insufficient in 95.4 % (n=1056) of cases. It was shown that males have greater accessibility to pornography pages in Internet (33.1 %; n=183) with a Chi Square of Pearson p=0.000. Thirteen and fourteen year old teenagers (33.8 %; n=114) are the ones with more visits to the Internet pornography pages (p=0.000). Finally, family global communication was poor in the group of teenagers who visit pornography pages (29 %; n=321) as well as in the group of teenagers who did not visit pornography pages in Internet (66.4; n=735) with a Square Chi of Pearson p=0.538.

Factores de aterogenicidad y angiopatía en la diabetes mellitus tipo 2 de región andina

En la diabetes mellitus (DM) tipo 2 múltiples factores de riesgo general (ej. sexo, obesidad, dislipidemia, nefropatía progresiva, etc) son determinantes de la acelerada y severa aterosclerosis, con elevada morbilidad y prematura mortalidad. Estos factores fueron evaluados protocolizados transversalmente en 5 años a 258 pacientes con DM tipo 2 de la región andina (Quito 2815 m/snm).