Knowledge and Attitudes of Parents about Oral Health in the Primary Dentition Stage in a Peruvian High Andean City.

Children's oral health depends on parents' knowledge and attitudes. The primary dentition stage, in particular, plays a crucial role in the comprehensive development of children. Therefore, the objective was to evaluate parents' knowledge and attitudes about oral health in the primary dentition stage in Chachapoyas (Amazonas, NW Peru). A questionnaire was administered to 409 parents from 15 educational institutions, and the data were analyzed using multinomial logistic regression. Among the surveyed parents, 75.3% could identify at least one habit harmful to their children's teeth (such as excessive sugar consumption) and one of its effects (such as dental caries). Additionally, 77.5% reported that their children presented some dental problem, more frequent in the peripheral areas than in the city's center. Gender (odd ratio, OR = 0.484; p = 0.037), educational level (OR = 2.144; p = 0.043), and type of health insurance (OR = 2.627; p = 0.044) of the parents influenced awareness of taking care of their children's primary dental health. The geographic location of the school (1.729 < OR < 2.079; p ≤ 0.011) and family income (OR = 3.504; p = 0.028) influenced parents' identification of the different harmful effects of children's habits. Factors such as low socioeconomic status and never taking the child to the dentist increased the risk of dental problems (p < 0.05). It is suggested that peripheral areas, like rural areas, lack the same oral health programs and access to treatment as central urban areas, leading to disparities in parental knowledge and attitudes.

Transversus Abdominis Plane Block as Part of a Multimodal Analgesic Regimen in Patients Undergoing Anterior Lumbar Interbody Fusion: A Retrospective Cohort Study.

BACKGROUND: Opioids are a mainstay for pain control in patients undergoing lumbar spine surgery but are associated with a high risk of dependence and significant adverse effects. Efforts continue to be made to utilize non-narcotic agents such as regional nerve block for pain control as part of a multimodal analgesia regimen. Recently, transversus abdominis plane (TAP) blocks have proven beneficial for patients undergoing lumbar fusion procedures. The purpose of this study is to evaluate the efficacy of TAP blocks for postoperative pain control and the effect on opioid consumption and hospital length of stay (LOS) in patients undergoing anterior lumbar interbody fusion (ALIF). METHODS: A retrospective review of patients undergoing elective ALIF included collection of data on demographics, LOS, pain scores using visual analog scale (VAS), opioid consumption using morphine milligram equivalents (MME) from postoperative day (POD) 0 to 5, and any complications. Patients who underwent primary ALIF or ALIF with concomitant posterolateral lumbar fusion were included. RESULTS: A total of 99 patients met inclusion criteria; 47 had a preoperative TAP block and 52 did not. Demographic data and number of levels fused were equally distributed between the groups. The TAP group had significantly lower MME consumption postoperatively during POD 0 to 2 and 0 to 5. VAS pain scores were lower for TAP block patients on POD 3 and 4; otherwise, there was no significant difference. LOS and complication rates were not significantly different. A multiple regression analysis found male sex to be a predictor of increased postoperative MME, while age and TAP block were significant predictors of decreased MME. CONCLUSIONS: The use of TAP block for patients undergoing ALIF was associated with less cumulative MME consumption in the immediate postoperative period. TAP block may be an effective tool for reducing postoperative opioid consumption in patients undergoing ALIF. CLINICAL RELEVANCE: The data in this study provide clinical relevance supporting the use of TAP blocks for patients undergoing ALIF procedures.

Intraoperative Methadone Reduces Postoperative Opioid Requirements in Nuss Procedure for Pectus Excavatum.

INTRODUCTION: Surgical correction of pectus excavatum by Nuss procedure, commonly referred to as minimally invasive repair of pectus excavatum (MIRPE), often results in significant postoperative pain. This study investigated whether adding intraoperative methadone would reduce the postoperative opioid requirement during admission for patients undergoing MIRPE. METHODS: A retrospective cohort chart review was conducted for 40 MIRPE patients between 2018 and 2020. Patients were stratified into 2 groups: those who received multimodal anesthesia (MM, n = 20) and those who received multimodal anesthesia with the addition of intraoperative methadone (MM + M, n = 20). Data collected included total opioid consumption during hospital stay (morphine milligram equivalents [MMEs]), hospital length of stay (LOS), pain scores, time to ambulation, and time to tolerating solid food. RESULTS: Addition of intraoperative methadone for patients undergoing MIRPE significantly reduced postoperative opioid requirements (MME/kg) during admission (P = .007). On average, patients in the MM group received 1.61 ± .55 MME/kg while patients in the MM + M group received 1.16 ± .44 MME/kg. Hospital opioid (non-methadone) total was also significantly reduced between the MM (1.87 ± .54) and MM + M group (1.37 ± .46), P = .003. There was no significant difference in hospital opioid total MME/kg administered between the groups. There were no significant differences observed in hospital LOS, pain scores, time to ambulation, or time to toleration of solid food. DISCUSSION: Incorporating intraoperative methadone for patients undergoing MIRPE reduced postoperative opioid requirements and hospital opioid (non-methadone) totals without a significant change in pain scores. Patients undergoing the Nuss procedure may benefit from the administration of intraoperative methadone.

Filaggrin loss-of-function mutations are associated with persistence of egg and milk allergy.

BACKGROUND: A genetic defect in the epidermal barrier protein filaggrin (FLG) plays a major role in the etiology of eczema and associated allergic airways diseases. However, it is still controversial to what extend loss-of-function (LOF) mutations in FLG contribute to the development and persistence of food allergies. OBJECTIVES: This study tested association of FLG LOF mutations with allergic reactions to diverse foods and investigated their potential effect on the persistence of early food allergies. METHODS: This study recruited 890 children with challenge-proven food allergy for the German Genetics of Food Allergy Study (GOFA). Longitudinal data were available for 684 children. All children were clinically characterized, including their allergic responses to specific foods, and genotyped for the 4 most common LOF mutations in FLG; R501X, 2282del4, R2447X, and S3247X. Associations between FLG mutations and food allergies were analyzed by logistic regression using the German Multicenter Allergy Study cohort as the control population. RESULTS: FLG mutations were associated with allergies to diverse foods including hen's egg (HE), cow's milk (CM), peanut, hazelnut, fish, soy, cashew, walnut, and sesame with similar risk estimates. Effects remained significant after adjusting for the eczema status. Interestingly, FLG mutations increased the risk of a persistent course of HE and CM allergy. CONCLUSIONS: Using the gold standard for food allergy diagnosis, this study demonstrates that FLG LOF mutations confer a risk of any food allergy independent of eczema. These mutations predispose to the persistence of HE and CM allergy and should be considered in the assessment of tolerance development.

Prevalencia del síndrome de ovario poliquístico por ecografía en el hospital Virgen de Fátima - Chachapoyas / Prevalence of polycystic ovary syndrome by ultrasonography at the hospital Virgen of Fatima ­ Chachapoyas / Prevalência da síndrome dos ovários policísticos por ultrassonografia no hospital Virgem do Fátima ­ Chachapoyas

El síndrome de ovario poliquístico (SOP) es una anormalidad endocrino - metabólica común con una prevalencia a nivel mundial equivalente al 4% siendo una patología de interés que afecta la salud de las mujeres. OBJETIVO: determinar la prevalencia del síndrome de ovario poliquístico por Ecografía en el Hospital Virgen de Fátima, Chachapoyas. MATERIALES Y MÉTODOS: el estudio fue de enfoque cuantitativo, descriptivo de prevalencia, retrospectivo, trasversal, la muestra lo formaron 300 historias clínicas. RESULTADOS: del 100% historias clínicas, la tasa de prevalencia del SOP por ecografía fue del 56.3 x 100. Así mismo existe una Tasa de Prevalencia (TP) del SOP bilateral es de 52.6 x 100 historias clínicas; la TP del SOP derecho es de 2 x 100 y del SOP Izquierdo es de 1.6 x 100. CONCLUSIONES: la TP del SOP por ecografía es muy alta, ya que más de la mitad de la población sufre esta patología. Así mismo el SOP de tipo bilateral es el más predominante en un 52.6 x cada 100.

Polycystic ovary syndrome (PCOS) is a common endocrine-metabolic abnormality with a worldwide prevalence equivalent to 4% being a pathology of interest that affects women's health. OBJECTIVE: to determine the prevalence of polycystic ovary syndrome by ultrasound at the Hospital Virgen de Fatima, Chachapoyas. MATERIALS AND METHODS: the study was a quantitative, descriptive, retrospective, cross-sectional, retrospective, prevalence study, the sample consisted of 300 medical records. RESULTS: of the 100% medical records, the prevalence rate of PCOS by ultrasound was 56.3 x 100. Likewise, there is a Prevalence Rate (PT) of bilateral PCOS of 52.6 x 100 medical records; the PT of right PCOS is 2 x 100 and of left PCOS is 1.6 x 100. CONCLUSIONS: the PT of PCOS by ultrasound is very high, since more than half of the population suffers from this pathology. Likewise, bilateral PCOS is the most predominant at 52.6 per 100.

A síndrome do ovário policístico (PCOS) é uma anormalidade endócrina metabólica comum com uma prevalência mundial de 4% e é uma patologia de interesse que afeta a saúde da mulher. OBJETIVO: para determinar a prevalência da síndrome dos ovários policísticos por ultra-som no Hospital Virgen de Fátima, Chachapoyas. MATERIAIS E MÉTODOS: o estudo foi um estudo quantitativo, descritivo, retrospectivo, transversal, de prevalência retrospectiva, com uma amostra de 300 prontuários médicos. RESULTADOS: dos 100% dos registros médicos, a taxa de prevalência de PCOS por ultra-som foi 56,3 x 100. CONCLUSÕES: da mesma forma, a Taxa de Prevalência (TP) de PCOS bilateral é 52,6 x 100 registros médicos; o TP de PCOS direito é 2 x 100 e o de PCOS esquerdo é 1,6 x 100. O PT do PCOS por ultra-som é muito alto, pois mais da metade da população sofre desta patologia. O PCOS bilateral é o tipo mais predominante a 52,6 por 100.

COVID-19 y metabolismo: una mirada más allá del sistema respiratorio y de la enfermedad trombótica / COVID-19 and metabolism: a look beyond the respiratory system and thrombotic disease

Resumen La COVID-19 es una enfermedad infecciosa causada por el coronavirus del síndrome respiratorio agudo severo 2 (SARS-CoV-2) que tiene importantes manifestaciones sobre el sistema cardiovascular y respiratorio. Esta enfermedad, descrita en los primeros días de diciembre de 2019 en la ciudad de Wuhan, capital de la provincia de Hubei, en China, tuvo una rápida expansión mundial y fue declarada por la Organización Mundial de la Salud como pandemia el 11 de marzo de 2020. Tiene diferentes presentaciones clínicas, como neumonía, hipoxemia, falla renal, falla multisistémica, compromiso endotelial que lleva a lesiones trombóticas venosas y arteriales, y problemas cardiacos como insuficiencia cardiaca, miocarditis, arritmias e infarto de miocardio de los tipos 1 y 2. La mayoría de las personas presentan una enfermedad leve o no complicada (80%), y otras (20%) pueden desarrollar un cuadro grave con neumonía, síndrome de dificultad respiratoria, choque cardiogénico, trombosis y tormenta de citocinas (el 15% se manejan con oxigenoterapia y el 5% ameritan tratamiento en la unidad de cuidados intensivos). La mortalidad está relacionada con la edad y con la comorbilidad (hipertensión arterial, diabetes mellitus, enfermedades respiratorias, enfermedades cardiacas en general, enfermedades renales y obesidad). El objetivo de esta revisión narrativa es describir las alteraciones metabólicas y la relación de la diabetes mellitus, la obesidad, el síndrome metabólico y la dislipidemia con la morbilidad y la mortalidad vinculadas a la COVID-19.

Abstract COVID-19 is an infectious disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and that has important manifestations on the cardiovascular system and respiratory. This disease described in the first days of December 2019 in the city of Wuhan, capital of the province of Hubei, China, with a rapid global expansion and declared by the World Health Organization as a pandemic on March 11, 2020, has different clinical presentations such as pneumonia, hypoxemia, kidney failure, multisystem failure, endothelial involvement leading to venous and arterial thrombotic lesions, and heart problems such as heart failure, myocarditis, arrhythmias, and type 1 and 2 myocardial infarction. Most people have a mild or uncomplicated disease (80%), and others (20%) may develop a severe case with pneumonia, respiratory distress syndrome, cardiogenic shock, thrombosis, and cytokine storm (15% are managed with oxygen therapy and 5% merit treatment in the intensive care unit). Mortality is related to age and comorbidity (high blood pressure, diabetes mellitus, respiratory diseases, heart diseases in general, kidney diseases, and obesity). The objective of this narrative review is to describe the metabolic alterations and the relationship between diabetes mellitus, obesity, metabolic syndrome, and dyslipidemia with the morbidity and mortality associated with COVID-19 infection.

Propuesta de un nuevo diseño de órtesis post-tratamiento de pie equino varo congénito / Proposal for a new design of post-treatment congenital club foot orthosis

La investigación tuvo como objetivo rediseñar la órtesis utilizada post-tratamiento Ponseti, en niños con pie equino varo congénito, de forma tal que permita la reducción de rechazo a su uso. Método: Se identificaron las necesidades de los niños con pie equino varo congénito, para verificar los inconvenientes con respecto a la funcionalidad, diseño y adaptabilidad a la órtesis dado que si la férula no se usa adecuadamente el riesgo de recidiva es de 80 %, por el contrario con el uso de la férula el riesgo es de 4 %. Se realizó un estudio biomecánico del movimiento de un paciente durante el gateo, con y sin la órtesis. Resultados: Se elaboró un modelo 3D de la propuesta, para simular el diseño sometido a las fuerzas generadas por los bebés durante el pataleo en posición supina. Se evaluó experimentalmente el desempeño del prototipo alfa, para determinar si cumplía con la meta prevista. Se obtuvo la fabricación y pruebas de la órtesis en plataforma virtual y físico. Acorde al alcance del proyecto, se determinó que es probable que se reduzca el rechazo al uso y por consiguiente la formación de recidiva, al reducir los factores determinantes propios de la férula del mercado, que propiciaban el mal uso de esta en el tratamiento. La velocidad promedio de gateo es de 0.48 m/s y con la férula se reduce a 0.37 m/s. Discusión: La férula del mercado pesa 304.07 g y la propuesta pesa 209.26 g. Se sugiere que se continúe la investigación en el estudio biomecánico.

This research was developed with the objective of redesigning the orthosis used in the post- Ponseti treatment in children with clubfoot, with the intention of reducing the rejection to its use. Method: A research on the needs of children with congenital clubfoot was conducted to identify the disadvantages on functionality, design and adaptability of the orthosis if the splint is not used appropriately, the risk of relapse is 80 %, whereas using the splint, the risk is 4 %. A biomechanical study of a patient's movement during the crawl was performed with and without the orthosis. Results: A 3D model of the design was developed to simulate computationally its performance under the forces generated by the babies during the kick in supine position. Finally, an experimental evaluation of the alpha prototype performance was made to determine whether it met the intended goal. Thus, the manufacturing and testing of the orthosis on virtual and in physical platform took place. Taking in account the goal of this project, it 3 was determined that it is possible to reduce the reject to the use and therefore the formation of relapse by reducing the determinant factors of the common market splint, which promotes its incorrect use of this in the treatment. The average crawl speed is 0.48 m/s and with the splint, it decreases to 0.37 m/s. Discussion: The weight of the common market splint is 304.07 g and the weight of the one designed in the study is 209.26 g. Further biomechanical research is suggested to get conclusive results

Síndrome de ovario poliquístico y su potencial asociación con trastorno bipolar en pacientes con trastorno del comportamiento alimentario / Polycystic ovarian syndrome and its potential association with bipolar disorder in patients with eating disorder

Resumen La exploración del síndrome de ovario poliquístico (SOP) en mujeres con trastorno del comportamiento alimentario (TCA) es infrecuente, y particularmente su asociación con el trastorno bipolar (TB) ha sido poco estudiada. El propósito de este estudio fue evaluar la prevalencia de SOP en mujeres con TCA, y analizar su potencial asociación con TB. Participaron 388 pacientes de entre 14 y 61 años de edad (88 con SOP y 300 sin SOP). Se realizó ultrasonido pélvico, examen físico y de laboratorio. Se aplicaron análisis bivariados entre SOP, TB y otras variables, como son: comorbilidades psiquiátricas, índice de masa corporal y tipo de TCA. Se construyó un modelo de asociación. Las prevalencias de SOP y de TB en la muestra fueron 22.7 y 13.1%, respectivamente. Las variables asociadas con SOP fueron TB tipo II, sobrepeso u obesidad, y presentar un TCA con atracones y/o purgas. Controlando por obesidad y subtipos bulímicos de TCA, las pacientes con SOP tienen 5.8 veces mayor riesgo de presentar TB tipo II (OR = 5.85, IC 95% = 2.9-11.6). La comorbilidad entre estas tres patologías es frecuente, por lo que su exploración y manejo deben ser considerados.

Abstract Exploration of polycystic ovarian syndrome (PCOS) in women with eating disorders (ED) is uncommon, and its association with bipolar disorder (BD) has been understudied. The aim of this study was to determine the prevalence of PCOS in women with ED in an outpatient program and to analyze the potential associations with BD. A total of 388 patients (88 with PCOS and 300 without PCOS) aged among 14 to 61 years were included in the study. Pelvic ultrasound, laboratory tests, and physical exams were performed to each participant. Bivariate analyses were carried out between PCOS, BD and other variables such as: psychiatric comorbidities, body mass index and type of ED. An association model was built. PCOS and BD prevalence were 22.7% and 13.1% respectively. The variables associated with PCOS were: BD type II, overweight or obesity and having an ED with binges and/or purges. When obesity and bulimic ED subtypes were controlled, patients with PCOS and BD type have 5.8 times higher risk of BD type II (OR = 5.85; 95% IC = 2.9-11.6). Comorbidities among these three pathologies are frequent, therefore its exploration and management should be considered.

Anorexia nerviosa secundaria a un trastorno obsesivo-compulsivo con síntomas de escrupulosidad predominante en un hombre adulto / Anorexia nervosa secondary to an obsessive-compulsive disorder in an adult man with predominant symptoms of scrupulosity

Resumen Se presenta el caso clínico de un paciente joven adulto de sexo masculino, con diagnóstico de trastorno obsesivo-compulsivo (TOC), cuya sintomatología principal radica en las ideas obsesivas y los rituales de contenido religioso (escrupulosidad), que le conducen al ayuno, la restricción de la ingesta y la pérdida significativa de peso (índice de masa corporal [IMC] inicial de 17.1). Se discute la existencia de anorexia nerviosa secundaria al TOC, las relaciones descritas entre ambas patologías, la importancia del diagnóstico dual en este caso, y las particularidades y los retos de la intervención desde las técnicas de exposición y prevención de respuesta de la terapia cognitivo-conductual. Tras 20 semanas de tratamiento, los resultados evidencian la efectividad de la intervención propuesta, con disminución significativa (48%) de los síntomas obsesivos-compulsivos, de acuerdo con la Escala Yale-Brown para Trastorno Obsesivo-Compulsivo, y la recuperación nutricional, alcanzando un peso acorde a su estatura y edad (IMC = 22.3). Se concluye que, en casos como el descrito, se impone la necesidad de trabajar tanto los síntomas alimentarios como los obsesivos de manera simultánea, con base en un tratamiento con enfoque multimodal y multidisciplinario.

Abstract It is described the clinical case of a young adult male patient with obsessive-compulsive disorder (OCD) diagnosis, whose main symptomatology lies in obsessive ideas and religious rituals (scrupulosity), aimed at fasting, restricting food intake and losing significant weight (initial body mass index [BMI] of 17.1). We discuss the presence of anorexia nervosa secondary to OCD, it is described the relationships between the two pathologies, the relevance of the dual diagnosis in this case, and the particularities and the challenges of the intervention from the exposure techniques to the prevention response of the cognitive behavioral therapy. After 20 weeks of treatment, the results show the effectiveness of the intervention, with a significant decrease (48%) in obsessive-compulsive symptoms, according to the Yale-Brown Obsessive-Compulsive Scale, and nutritional recovery, reaching a body weight according to his height and age (BMI = 22.3). It is concluded that, in cases such as the one described, there is the need to work both the eating and obsessive symptoms simultaneously, based on a treatment with multimodal and multidisciplinary approach.

Mineral Profile of Children's Fast Food Menu Samples.

Children's fast food menus, including hamburgers served with french fries, dessert, and a soft drink, were analyzed to obtain the mineral profile of trace elements. The developed analytical methodology involved sample digestion under pressure inside a microwave oven with a mixture of HNO3 and H2O2 and inductively coupled plasma-optical emission spectrometry. The method was validated by carrying out the analysis of certified reference materials (NIST 1570a spinach leaves, NCS ZC73016 chicken, and NIST 1568a rice flour) and using recovery experiments. Repeatability was verified by analyzing replicate samples. Twenty-six elements were studied, 12 of which-aluminum, barium, calcium, copper, iron, potassium, lithium, magnesium, manganese, sodium, strontium, and zinc-were quantitatively determined. Results were compared with other studies of fast food and children's menus published in the literature, and the nutritional value of samples was assessed with dietary intake guidelines.

Impersonal Care or Humanized Care: a Decision Made by Nurses? Hourglass Model / Atenção impessoal ou cuidado humanizado: uma decisão das Enfermeiras? Modelo Relógio de Areia / Atención impersonal o cuidado humanizado: ¿una decisión de enfermeras? Modelo del Reloj de Arena

Abstract Objective. This work sought to understand the meaning of the experience of caring and how patients, family members, and nurses describe it. Methods This was a phenomenological interpretive study with 16 adult participants between 29 and 62 years of age, selected through purposeful sampling. The study was based on in-depth interviews to construct the information and on the procedures proposed by Munhal for the analysis. Results This work revealed a complex relation, understood as vicariant, between humanized care and impersonal care that influence upon independent aspects of the social and legal system, health institutions, and nurses. The themes comprising the experience of humanized care are described in the "hourglass" model. Conclusion Humanized care can displace impersonal care or vice versa, according to the orientation of nurses in the care practice and some elements from the institutional context.

Resumo Objectivo. Compreender o significado da experiência de cuidado e a forma como a descrevem os pacientes, familiares e enfermeiras. Metodos Estudo fenomenológico interpretativo com 16 participantes adultos entre 29 e 62 anos de idade, selecionados por amostragem com propósito. Se baseou em entrevistas em profundidade para a construção da informação e nos procedimentos propostos Munhal para a análise. Results O estudo mostrou uma complicada relação, entendida como vicariante, entre o cuidado humanizado e a atenção impessoal na qual influem aspectos dependentes do sistema social e legal, das instituições de saúde e das enfermeiras. Os assuntos que compõem a experiência de cuidado humanizado se descrevem no modelo denominado "relógio de areia". Conclusão O cuidado humanizado pode deslocar à atenção impessoal ou vice-versa, segundo a orientação das enfermeiras na prática do cuidado e alguns elementos do contexto institucional.

Resumen Objetivo. Comprender el significado de la experiencia de cuidado y la forma como la describen los pacientes, familiares y enfermeras. Métodos . Estudio fenomenológico interpretativo con 16 participantes adultos entre 29 y 62 años de edad, seleccionados por muestreo con propósito. Se basó en entrevistas en profundidad para la construcción de la información y en los procedimientos propuestos Munhal para el análisis. Resultados . El estudio mostró una complicada relación, entendida como vicariante, entre el cuidado humanizado y la atención impersonal en la cual influyen aspectos dependientes del sistema social y legal, de las instituciones de salud y de las enfermeras. Los temas que componen la experiencia de cuidado humanizado se describen en el modelo denominado "reloj de arena". Conclusión . El cuidado humanizado puede desplazar a la atención impersonal o viceversa, según la orientación de las enfermeras en la práctica del cuidado y algunos elementos del contexto institucional.

The meaning of humanized nursing care for those participating in it: Importance of efforts of nurses and healthcare institutions / El significado del cuidado de enfermería humanizado para quienes participan en él: importancia del esfuerzo de enfermeras e instituciones de salud / O significado do cuidado de enfermagem humanizado para quem participam nele: importância do esforço de enfermeiras e instituições de saúde

Objective.This study sought to understand this study sought to understand the meaning of the experience of humanized nursing care from the perspective of patients, relatives, and nurses. Methods.This was an interpretative phenomenological study that included 16 adult participants and which was based on in-depth interviews to gather the information and on the procedures proposed by Cohen, Kahn, and Steeves to analyze the information. Results. Efforts by healthcare institutions and nurses are key elements to advance from impersonal care toward humanized care because these will permit revising and eliminating the barriers present in the current exercise of caring. The results highlight the importance of the effort for humanized behavior from nurses, given that because they are human beings their behavior in the relationship with patients is not always have that connotation. Conclusion. Humanized care is not only supported on the human condition of nurses or on the institutional intentions, but on attitudes and on a disposition focused on the patient's wellbeing. Additionally, tensions in nursing care are solved through humanizing efforts.

Objetivo.Comprender el significado de la experiencia de cuidado de enfermería humanizado desde la perspectiva de pacientes, familiares y enfermeras. Métodos. Estudio fenomenológico interpretativo que incluyó a 16 participantes adultos, el cual se basó en entrevistas en profundidad para la construcción de la información y en los procedimientos propuestos por Cohen, Kahn y Steeves para el análisis de la información. Resultados. Los esfuerzos por parte de las instituciones de salud y enfermeras son elementos claves para avanzar desde la atención impersonal hacia el cuidado humanizado, porque permitirá revisar y eliminar las barreras que se presentan en el ejercicio actual del cuidado. Conclusión. El cuidado humanizado no se apoya únicamente en la condición humana de las enfermeras o en intenciones institucionales sino en actitudes y en una disposición enfocada al bienestar del paciente. De otro lado, las tensiones en cuidado de enfermaría se resuelve con esfuerzos humanizadores.

Objetivo.Compreender o significado da experiência de cuidado de enfermagem humanizado desde a perspectiva de pacientes, familiares e enfermeiras. Métodos. Estudo fenomenológico interpretativo que incluiu a 16 participantes adultos, o qual se baseou em entrevistas em profundidade para a construção da informação e nos procedimentos propostos por Cohen, Kahn e Steeves para a análise da informação. Resultados. Os esforços por parte das instituições de saúde e enfermeiras são elementos chaves para avançar desde a atenção impessoal ao cuidado humanizado, porque permitirá revisar e eliminar as barreiras que se apresentam no exercício atual do cuidado Se ressalta a importância do esforço por um comportamento humanizado por parte das enfermeiras devido a que pelo fato de ser seres humanos seu comportamento na relação com os pacientes não sempre tem essa conotação. Conclusão. O cuidado humanizado não se apoia unicamente na condição humana das enfermeiras ou em intenções institucionais senão em atitudes e em uma disposição enfocada ao bem-estar do paciente. De outro lado, as tensões em cuidado de enfermagem se resolve com esforços humanizadores.

Impersonal Care or Humanized Care:a Decision Made by Nurses? Hourglass Model.

OBJECTIVES: Facultad de Enfermería, Universidad de Antioquia. METHODS: This was a phenomenological interpretive study with 16 adult participants between 29 and 62 years of age, selected through purposeful sampling. The study was based on in-depth interviews to construct the information and on the procedures proposed by Munhal for the analysis. RESULTS: This work revealed a complex relation, understood as vicariant, between humanized care and impersonal care that influence upon independent aspects of the social and legal system, health institutions, and nurses. The themes comprising the experience of humanized care are described in the "hourglass" model. CONCLUSIONS: Humanized care can displace impersonal care or vice versa, according to the orientation of nurses in the care practice and some elements from the institutional context.

The meaning of humanized nursing care for those participating in it: Importance of efforts of nurses and healthcare institutions.

OBJECTIVE: This study sought to understand this study sought to understand the meaning of the experience of humanized nursing care from the perspective of patients, relatives, and nurses. METHODS: This was an interpretative phenomenological study that included 16 adult participants and which was based on in-depth interviews to gather the information and on the procedures proposed by Cohen, Kahn, and Steeves to analyze the information. RESULTS: Efforts by healthcare institutions and nurses are key elements to advance from impersonal care toward humanized care because these will permit revising and eliminating the barriers present in the current exercise of caring. The results highlight the importance of the effort for humanized behavior from nurses, given that because they are human beings their behavior in the relationship with patients is not always have that connotation. CONCLUSION: Humanized care is not only supported on the human condition of nurses or on the institutional intentions, but on attitudes and on a disposition focused on the patient's wellbeing. Additionally, tensions in nursing care are solved through humanizing efforts.

Humanized care: A relationship of familiarity and affectivity.

OBJECTIVE: This work sought to understand the meaning of humanized nursing care in the experience of participants, nurses, patients, and their relatives. METHODOLOGY: This was an interpretive phenomenological study based on in-depth interviews, which included 16 adult participants and was conducted in Medellín, Colombia, between December 2012 and March 2013. RESULTS: The patient’s situation, the nurses’ communication skills, and the condition of both, as human beings, influence upon the words, gestures and attitudes during the nurse-patient relationship, where the presence, that which is done, and how it is done permit leaving an important impression on patients and their relatives. CONCLUSION: The interaction between patients and nurses goes through various stages until achieving the necessary empathy, compassion, affection, and familiarity to account for humanized care.

Atención al detalle, un requisito para el cuidado humanizado / Paying attention to details, a requirement for humanized care

Objetivo: Comprender el significado de la experiencia de cuidado humanizado para los participantes. Metodología: Estudio fenomenológico interpretativo basado en entrevistas que incluyó a 16 participantes adultos. Resultados: la receptividad sin discriminación, el interés por cuidar, escuchar las quejas, cuidar en todas las esferas e involucrar a la familia son detalles imprescindibles en el cuidado humanizado. Conclusión: El cuidado humanizado incluye detalles para favorecer la interacción enfermera-paciente

Objective: understanding the meaning of humanized care experience for participants. Methodology: Interpretative phenomenological study based on interviews involving 16 adult participants. Results: receptivity without discrimination, interest in caring, listen to complaints, take care in all person´s areas and involve the family are essential details in humanized care. Conclusion: The humanized care includes details to promote nurse-patient interaction

Association of HMOX1 and NQO1 Polymorphisms with Metabolic Syndrome Components.

Metabolic syndrome (MetS) is among the most important public health problems worldwide, and is recognized as a major risk factor for various illnesses, including type 2 diabetes mellitus, obesity, and cardiovascular diseases. Recently, oxidative stress has been suggested as part of MetS aetiology. The heme oxygenase 1 (HMOX1) and NADH:quinone oxidoreductase 1 (NQO1) genes are crucial mediators of cellular defence against oxidative stress. In the present study, we analysed the associations of HMOX1 (GT)n and NQO1 C609T polymorphisms with MetS and its components. Our study population comprised 735 Mexican Mestizos unrelated volunteers recruited from different tertiary health institutions from Mexico City. In order to know the HMOX1 (GT)n and NQO1 C609T allele frequencies in Amerindians, we included a population of 241 Amerindian native speakers. Their clinical and demographic data were recorded. The HMOX1 (GT)n polymorphism was genotyped using PCR and fluorescence technology. NQO1 C609T polymorphism genotyping was performed using TaqMan probes. Short allele (<25 GT repeats) of the HMOX1 polymorphism was associated with high systolic and diastolic blood pressure, and the T allele of the NQO1 C609T polymorphism was associated with increased triglyceride levels and decreased HDL-c levels, but only in individuals with MetS. This is the first study to analyse the association between MetS and genes involved in oxidative stress among Mexican Mestizos. Our data suggest that polymorphisms of HMOX1 and NQO1 genes are associated with a high risk of metabolic disorders, including high systolic and diastolic blood pressure, hypertriglyceridemia, and low HDL-c levels in Mexican Mestizo individuals.

Cuidado humanizado: una relación de familiaridad y afectividad / Cuidado humanizado: uma relação de familiaridade e afetividade / Humanized care: A relationship of familiarity and affectivity

Objetivo. Comprender el significado del cuidado humanizado de enfermería en la experiencia de los participantes, enfermeras, pacientes y sus familiares. Metodología. Estudio fenomenológico interpretativo basado en entrevistas en profundidad que incluyó a 16 participantes adultos, realizado en Medellín, Colombia, entre diciembre de 2012 y marzo de 2013. Resultados. La situación del paciente, las habilidades comunicativas de las enfermeras y la condición de ambos, como seres humanos, influyen en las palabras, gestos y actitudes durante la relación enfermera-paciente, en la cual la presencia, lo que se hace y la forma de hacerlo permiten dejar una importante huella en los pacientes y sus familiares. Conclusión. La interacción entre pacientes y enfermeras pasa por varias etapas hasta lograr la empatía, compasión, afecto y familiaridad necesarios para dar cuenta de un cuidado humanizado...

Objective. This work sought to understand the meaning of humanized nursing care in the experience of participants, nurses, patients, and their relatives. Methodology. This was an interpretive phenomenological study based on in-depth interviews, which included 16 adult participants and was conducted in Medellín, Colombia, between December 2012 and March 2013. Results. The patient’s situation, the nurses’ communication skills, and the condition of both, as human beings, influence upon the words, gestures and attitudes during the nurse-patient relationship, where the presence, that which is done, and how it is done permit leaving an important impression on patients and their relatives. Conclusion. The interaction between patients and nurses goes through various stages until achieving the necessary empathy, compassion, affection, and familiarity to account for humanized care...

Objetivo. Compreender o significado do cuidado humanizado de enfermagem na experiência dos participantes, enfermeiras, pacientes e seus familiares. Metodologia. Estudo fenomenológico interpretativo baseado em entrevistas em profundidade que incluiu a 16 participantes adultos, realizado em Medellín, Colômbia, entre dezembro de 2012 e março de 2013. Resultados. A situação do paciente, as habilidades comunicativas das enfermeiras e a condição de ambos, como seres humanos, influem nas palavras, gestos e atitudes durante a relação enfermeira-paciente, na qual a presença, o que se faz e a forma de fazê-lo permitem deixar uma importante impressão nos pacientes e seus familiares. Conclusão. A interação entre pacientes e enfermeiras passa por várias etapas até conseguir a empatia, compaixão, afeto e familiaridade necessários para dar conta de um cuidado humanizado...

[Prevalence of gastrointestinal disorders in adults with common variable immunodeficiency at Specialty Hospital Dr. Bernardo Sepulveda]. / Prevalencia de alteraciones gastrointestinales en adultos con inmunodeficiencia común variable en el Hospital de Especialidades Dr. Bernardo Sepúlveda.

BACKGROUND: The common variable immunodeficiency (CVID) shows a variable incidence, from 1:15,000 to 1:117,000, without gender predominance. The incidence of gastrointestinal manifestations in these patients ranges from 20-60%, and these may be the first and only clinical manifestation of CVID, while other patients develop gastrointestinal complications during the course of it. In Mexico there is little information regarding the type and frequency of gastrointestinal disorders presented by adult patients with CVID. OBJECTIVE: To determine the prevalence of gastrointestinal manifestations in adult patients with CVID. MATERIAL AND METHOD: A descriptive, cross-sectional and observational study was made including patients with CVID attending Primary Immunodeficiency Clinic of Allergy and Clinical Immunology Department, Specialties Hospital, National Medical Center SXXI, Mexico City. All patients underwent gastrointestinal symptoms questionnaire, laboratory, cabinet, endoscopy and breath test for bacterial overgrowth. RESULTS: We evaluated 17 patients, 8 men and 9 women with an average age of 36 years with a definitive diagnosis of CVID according to international criteria; 59% had abdominal pain, 53% abdominal distension; only 3 patients (17.6%) reported constipation; 47% had chronic diarrhea, of which only 2 (11.8%) had rectal pushing. The diagnoses of gastrointestinal manifestations of this population were: 18% chronic diarrhea, celiac disease and bacterial overgrowth, 24% gastrointestinal functional disorder, 12% constipation and 6% dyspepsia. One patient (6%) had no gastrointestinal symptoms. CONCLUSIONS: Prevalence of gastrointestinal diseases in adult patients with common variable immunodeficiency was 94%. There was no gender predominance. It is therefore important that patients with CVID will conduct a study protocol that includes a complete medical history considering gastrointestinal symptoms and signs, in order to determine timely diagnosis and therapeutic approach.

Antecedentes: la incidencia de la inmunodeficiencia común variable (IDCV) es de 1 por cada 15,000 a 117,000 casos, sin predominio de género. La incidencia de manifestaciones gastrointestinales en estos pacientes es de 20 a 60% y pueden ser la primera y única manifestación clínica de IDCV. En México existe escasa información en relación con el tipo y frecuencia de alteraciones gastrointestinales que padecen los pacientes adultos con IDCV. Objetivo: determinar la prevalencia de alteraciones gastrointestinales en pacientes adultos con inmunodeficiencia común variable. Material y método: estudio descriptivo, observacional y transversal en el que participaron pacientes con inmunodeficiencia común variable de la Clínica de Inmunodeficiencias del Servicio de Alergia e Inmunología Clínica del Hospital de Especialidades, Centro Médico Nacional Siglo XXI. A todos los pacientes se les aplicó un cuestionario de síntomas gastrointestinales y se les realizaron estudios de laboratorio, gabinete, endoscopia y prueba de aliento para determinar sobrepoblación bacteriana. Resultados: evaluamos 17 pacientes, 8 hombres y 9 mujeres, con edad promedio de 36 años y diagnóstico definitivo de inmunodeficiencia común variable de acuerdo con criterios internacionales. El 59% refirió dolor abdominal, 53% distensión abdominal y 17.6% estreñimiento. El 47% tenía diarrea crónica, en dos de ellos (11.8%) acompañada de pujo rectal. Las enfermedades gastrointestinales de esta población fueron: 18% diarrea crónica, enfermedad celiaca y sobrepoblación bacteriana, 24% trastorno funcional digestivo, 12% estreñimiento, 6% dispepsia. Sólo un paciente (6%) no tenía síntomas gastrointestinales. Conclusión: la prevalencia de las enfermedades gastrointestinales en pacientes adultos con inmunodeficiencia común variable fue de 94%, sin predominio de género. Debido a la frecuencia de manifestaciones gastrointestinales, es importante realizar protocolos de estudio al respecto para iniciar de manera temprana su diagnóstico y tratamiento.