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3.
J Community Health ; 49(1): 17-25, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-37314631

RESUMO

BACKGROUND: Despite being disproportionately impacted by COVID-19 due to a lack of structural support, marginalized communities have been largely ignored in the politically polarized debate over school masking. In response to this, we sought to explore masking attitudes by centering the voices of parents and children at historically marginalized, predominantly Hispanic schools in southern California. METHODS: We conducted a mixed-methods study with parents and children attending 26 low-income predominantly Hispanic-serving elementary schools. A random sample of parents was asked to provide a freelist of words they associate with masking. A subset of parents with children aged 4-6 was recruited from these surveys to participate in parent-child interviews (PCI). We calculated Smith's salience index for all unique items, stratifying by language (English/Spanish). Item salience guided PCI thematic analysis for additional context and meaning. RESULTS: 648 participants provided 1118 unique freelist items in English and Spanish. 19 parent-child pairs were interviewed, 11 in Spanish and 8 in English. The most salient words were "safety"(0.37), "protection"(0.12), "prevention"(0.05), "health"(0.04), "good"(0.03), "can't breathe"(0.03), "necessary"(0.02), "care"(0.02), "precaution"(0.02), and "unnecessary"(0.02). Spanish speakers had a more favorable view of masking than English speakers, particularly regarding "protection" (0.20 vs 0.08) and "prevention" (0.10 vs 0.02). DISCUSSION: Masking is an affordable individual-level risk mitigation that protects the communities that have inequitably shouldered the burdens of the COVID-19 pandemic. We recommend that policymakers prioritize the views of those most impacted when deciding on risk mitigation policies like school masking.


Assuntos
Hispânico ou Latino , Máscaras , Pandemias , Humanos , Atitude , Pandemias/prevenção & controle , Pais , Instituições Acadêmicas , Inquéritos e Questionários , Política de Saúde
4.
Heliyon ; 9(11): e22070, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-38034679

RESUMO

The COVID-19 pandemic influenced teaching and learning in higher education. The transformation towards digital education challenged Faculty and students. This research examines the online learning readiness of students in a Higher Education Institution in Mexico. Specifically, we investigated how much prior digital skills, as well as having used the digital resources available by the university, influenced their academic achievement in distance learning settings. Seven dimensions of online learning readiness were selected to evaluate the student's preparation for the online learning process. Questionnaires were applied before the start and at the end of digital courses. Follow-up tools were offered to support the student, and two groups were observed, users and non-users of the digital devices. It was observed that students who used the support developed significantly better critical thinking, problem-solving, and time organization skills than non-users. On the other hand, although the evaluations were not significantly different, the lowest averages were found in the non-user group. Our results indicate that prior training in the use of digital tools is essential for the success of online education; in the same way, a timely follow-up with technical and pedagogical assistance is necessary for developing competencies. Training more autonomous and independent students capable of distance learning in a global world demands experts in digital education urgently. Educational institutions must embrace new technologies and teaching methods to meet the ever-changing needs of students. This research is expected to play a crucial role in promoting constructive discussions and facilitating informed decisions concerning the creation of future educational models.

5.
Mycorrhiza ; 33(5-6): 345-358, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-37851276

RESUMO

Arbuscular mycorrhizal fungi (AMF) establish symbioses with the major cereal crops, providing plants with increased access to nutrients while enhancing their tolerance to toxic heavy metals. However, not all plant varieties benefit equally from this association. In this study, we used quantitative trait loci (QTL) mapping to evaluate the combined effect of host genotypic variation (G) and AMF across 141 genotypes on the concentration of 20 mineral elements in the leaves and grain of field grown maize (Zea mays spp. mays). Our mapping design included selective incorporation of a castor AMF-incompatibility mutation, allowing estimation of AMF, QTL and QTLxAMF effects by comparison of mycorrhizal and non-mycorrhizal plants. Overall, AMF compatibility was associated with higher concentrations of boron (B), copper (Cu), molybdenum (Mo), phosphorus (P), selenium (Se) and zinc (Zn) and lower concentrations of arsenic (As), iron (Fe), magnesium (Mg), manganese (Mn), potassium (K) and strontium (Sr). In addition to effects on individual elements, pairwise correlation matrices for element concentration differed between mycorrhizal and non-mycorrhizal plants. We mapped 22 element QTLs, including 18 associated with QTLxAMF effects that indicate plant genotype-specific differences in the impact of AMF on the host ionome. Although there is considerable interest in AMF as biofertilizers, it remains challenging to estimate the impact of AMF in the field. Our design illustrates an effective approach for field evaluation of AMF effects. Furthermore, we demonstrate the capacity of the ionome to reveal host genotype-specific variation in the impact of AMF on plant nutrition.


Assuntos
Micorrizas , Micorrizas/genética , Zea mays/microbiologia , Raízes de Plantas/microbiologia , Simbiose , Genótipo
6.
RSC Adv ; 13(43): 29819-29829, 2023 Oct 11.
Artigo em Inglês | MEDLINE | ID: mdl-37829715

RESUMO

Developing borophene films with good structural stability on non-metallic substrates to maximize their potential in photosensitivity, gas detection, photothermia, energy storage, and deformation detection, among others has been challenging in recent years. Herein, we succeeded in the pulsed laser deposition of multilayered borophene films on Si (100) with ß12 or χ3 bonding by tuning the mean kinetic energy in the plasma during the deposition process. Raman and X-ray photoelectron spectroscopies confirm ß12 and χ3 bonding in the films. Borophene films with ß12 bonding were obtained by tuning a high mean kinetic energy in the plasma, while borophene with χ3 bonding required a relatively low mean kinetic energy. Atomic force microscopy (AFM) micrographs revealed a granular and directional growth of the multilayered borophene films following the linear atomic terraces from the (100) silicon substrate. AFM nanofriction was used to access the borophene surfaces and to reveal the pull-off force and friction coefficient of the films where the surface oxide showed a significant contribution. To summarize, we show that it is possible to deposit multilayered borophene thin films with different bondings by tuning the mean kinetic energy during pulsed laser deposition. The characterization of the plasma during borophene deposition accompanies our findings, providing support for the changes in kinetic energy.

7.
Eur J Pharmacol ; 959: 176068, 2023 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-37775016

RESUMO

Oxidative stress and inflammation induced by abundant consumption of high-energy foods and caloric overload are implicated in the dysfunction of the blood‒brain barrier (BBB), cognitive impairment, and overactivation of acetylcholinesterase (AChE) and butyrylcholinesterase (BChE). These enzymes hydrolyse acetylcholine, affecting anti-inflammatory cholinergic signalling. Our aim was to evaluate whether nicotinamide (NAM) attenuates the impairment of the BBB and cognitive function, improving cholinergic signalling. Forty male rats were distributed into five groups: one group was fed a standard diet, and the remaining groups were fed a high-fat diet and a beverage with 40% sucrose (HFS; high-fat sucrose). In three of the HFS groups, the carbohydrate was replaced by drinking water containing different concentrations of NAM for 5 h every morning for 12 weeks. The biochemical profile, levels of stress and inflammation markers, cholinesterase activities, BBB permeability, and cognitive capacity were evaluated. The results showed that the HFS diet disturbed the metabolism of carbohydrates and lipids, causing insulin resistance. Simultaneously, AChE and BChE activities, levels of proinflammatory cytokines, oxidation of proteins and lipoperoxidation increased along with decreased antioxidant capacity in serum. In the hippocampus, increased activity of cholinesterases, protein carbonylation and lipoperoxidation were associated with decreased antioxidant capacity. Systemic and hippocampal changes were reflected in increased BBB permeability and cognitive impairment. In contrast, NAM attenuated the above changes by reducing oxidative stress and inflammation through decreasing cholinesterase activities, especially by uncompetitive inhibition. NAM may be a potential systemic and neuroprotective agent to mitigate cognitive damage due to hypercaloric diets.


Assuntos
Acetilcolinesterase , Niacinamida , Ratos , Masculino , Animais , Acetilcolinesterase/metabolismo , Niacinamida/farmacologia , Inibidores da Colinesterase/farmacologia , Antioxidantes/metabolismo , Butirilcolinesterase/metabolismo , Barreira Hematoencefálica/metabolismo , Estresse Oxidativo/fisiologia , Cognição , Inflamação/tratamento farmacológico , Inflamação/metabolismo , Dieta Hiperlipídica , Sacarose
8.
Artigo em Inglês | MEDLINE | ID: mdl-37640253

RESUMO

OBJECTIVE: There is an urgent need for accurate biomarkers to support timely diagnosis of acute mesenteric ischaemia (AMI) and thereby improve clinical outcomes. With this systematic review, the aim was to substantiate the potential diagnostic value of biomarkers for arterial occlusive AMI. DATA SOURCES: The Pubmed, Embase, and the Cochrane Library electronic databases were searched. REVIEW METHODS: A systematic review of the literature has been conducted to define the potential diagnostic value of biomarkers for arterial occlusive AMI. All studies including ≥ 10 patients describing biomarkers for macrovascular occlusive AMI between 1950 and 17 February 2023 were identified within the Pubmed, Embase, and the Cochrane Library electronic databases. There were no restrictions to any particular study design, but letters and editorials were excluded. The QUADAS-2 tool was used for the critical appraisal of quality. The study protocol was registered on Prospero (CRD42021254970). RESULTS: Fifty of 4334 studies were eligible for inclusion in this review. Ninety per cent of studies were of low quality. A total of 60 biomarkers were identified, with 24 in two or more studies and 15 in five or more studies. There was variation in reported units, normal range, and cut off values. Meta-analysis was not possible due to study heterogeneity. Biomarkers currently recommended by the European Journal of Vascular and Endovascular Surgery, European Society for Trauma and Emergency Surgery 2016, and World Society of Emergency Surgery 2017 guidelines also had heterogeneous low quality data for use in the diagnosis of AMI. CONCLUSION: This systematic review demonstrates high heterogeneity and low quality of the available evidence on biomarkers for arterial occlusive AMI. No clinical conclusions can be drawn on a biomarker or combination of biomarkers for patients suspected of arterial occlusive AMI. Restraint is advised when rejecting or determining AMI solely based on biomarkers.

9.
Prev. tab ; 25(2): 44-54, Abril/Junio 2023. tab
Artigo em Espanhol | IBECS | ID: ibc-223577

RESUMO

Objetivo. El tabaquismo materno es un factor de riesgo conductual, evitable y cuyos efectos perjudiciales alcanzan todo el ciclo vital del niño. El objetivo es valorar el conocimiento de una población de puérperas atendidas en el Hospital de la Línea de la Concepción, sobre los efectos perinatales del tabaquismo materno. Material y métodos. Estudio exploratorio, transversal (septiembre a noviembre de 2022). Muestreo consecutivo y aplicación de encuesta a 151 puérperas/ expedientes de neonatos, para recolectar información sociodemográfica, clínica obstétrica y del neonato, de consumo de tabaco y de conocimiento sobre efectos perinatales del tabaquismo materno con preguntas cerradas. Estadísticas descriptivas y comparación de grupos independientes con las pruebas t de Student y chi-cuadrado. Resultados. El consumo de tabaco previo al embarazo distinguió un 32% (48/151) de fumadoras. Se obtuvo un nivel global de aciertos entre el 45% y el 76,8%; mayor proporción de aciertos entre no fumadoras (rango 45,6-79,6%) que entre fumadoras (rango 37,5-72,9%). Para cada enunciado, el nivel de aciertos resultó sin diferencias (p>0,05) entre ambos grupos. Conclusiones. El nivel de conocimientos registrado no mostró diferencias entre fumadoras y no fumadoras. Se discuten alternativas para profundizar en la investigación y acciones integrales orientadas a reducir y eliminar el consumo de tabaco por la población femenina general y las mujeres embarazadas. (AU)


Objective. Maternal smoking is an avoidable behavioral risk factor whose harmful effects reach the entire life cycle of the child. The objective is to evaluate the knowledge of a population of puerperal women treated at the Hospital de la Linea de la Concepción (Cádiz, Spain), about the perinatal effects of maternal smoking. Material and methods. Exploratory, cross-sectional study –September to November 2022. Consecutive sampling and survey application to 151 puerperal women/newborn records, to collect sociodemographic, obstetric, and neonatal clinic information on tobacco use and knowledge about the perinatal effects of maternal smoking with closed questions. Descriptive statistics and comparison of independent groups with Student’s t and chi-square tests. Results . Tobacco use prior to pregnancy distinguished 32% (48/151) smokers. A level global of hits between45% and 76.8% was obtained; higher proportion of correct answers among non-smokers (range 45.6%-79.6%) than among smokers (range 37.5%-72.9%). For each statement, the level of correct answers was not different between both groups (p>0.05). Conclusions. The level of knowledge registered did not show differences between smokers and non-smokers. Alternatives are discussed to deepen the research and integral actions aimed at reducing and eliminating tobacco use by the general female population and pregnant women. (AU)


Assuntos
Humanos , Feminino , Letramento em Saúde , Período Pós-Parto , Tabaco , Tabagismo
10.
Braz J Biol ; 84: e270998, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37162122

RESUMO

Urban ecosystems could jeopardize the existence of vascular epiphytes (VE) given that their occurrence is linked to phorophyte availability and particular climatic conditions. Despite reports of VE in cities, nothing is known about their demography. A first step in this direction is to describe their population structures (PS). We established the PS of VE present in urban parks in Oaxaca City (Mexico), addressing the following questions: 1) what is their demographic status? and 2) are there differences in the structure of populations growing in native versus exotic phorophytes? During 2021, we censused all the trees in six urban parks, recording their origin (native or exotic), the epiphytic species found on them and the development stages present in each VE population. Overall, five VE species were documented: Tillandsia ionantha, T. makoyana, T. sp., T. schiedeana and T. recurvata (Bromeliaceae); the first three with only one individual and the latter two with 95 and 5,694, respectively. A MANOVA test indicated significant differences in PS between T. recurvata (type I structure, suggesting a growing population) and T. schiedeana (type III structure, suggesting a senile population) (Wilkes' λ= 0.821, F-Radio= 11.96 P<0.001). PS showed no differences related to tree origin. Our results indicate that it is necessary to conduct demographic studies to have a more accurate idea of the current condition of vascular epiphytes in cities. For instance, even though we found five VS species, only one of them seems to have viable populations in Oaxaca city.


Assuntos
Bromeliaceae , Ecossistema , Cidades , México , Árvores , Demografia
12.
Appl Opt ; 62(6): 1483-1491, 2023 Feb 20.
Artigo em Inglês | MEDLINE | ID: mdl-36821308

RESUMO

The simultaneous surface and internal measurements from a chemically modified cortical bovine bone suffering a plastic range deformation are presented. Since the bone is an anisotropic structure, its mechanical response could be modified if its organic or inorganic phases change. The latter could result in high plastic deformations, where the interferometrical signal from an optical analysis is easily de-correlated. In this work, digital holography interferometry (DHI) and Fourier domain optical coherence tomography (FD-OCT) are used to analyze the plastic range deformation of the bone under compression. The simultaneous use of these two optical methods gives information even when one of them de-correlates. The surface results retrieved with DHI show the high anisotropy of the bone as a continuously increasing displacement field map. Meanwhile, the internal information obtained with FD-OCT records larger deformations at different depths. Due to the optical phase, it is possible to complement the measurements of these two methods during the plastic deformation.

13.
Front Mol Biosci ; 10: 1072751, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36845546

RESUMO

Amblyomin-X is a Kunitz-type FXa inhibitor identified through the transcriptome analysis of the salivary gland from Amblyomma sculptum tick. This protein consists of two domains of equivalent size, triggers apoptosis in different tumor cell lines, and promotes regression of tumor growth, and reduction of metastasis. To study the structural properties and functional roles of the N-terminal (N-ter) and C-terminal (C-ter) domains of Amblyomin-X, we synthesized them by solid-phase peptide synthesis, solved the X-Ray crystallographic structure of the N-ter domain, confirming its Kunitz-type signature, and studied their biological properties. We show here that the C-ter domain is responsible for the uptake of Amblyomin-X by tumor cells and highlight the ability of this domain to deliver intracellular cargo by the strong enhancement of the intracellular detection of molecules with low cellular-uptake efficiency (p15) after their coupling with the C-ter domain. In contrast, the N-ter Kunitz domain of Amblyomin-X is not capable of crossing through the cell membrane but is associated with tumor cell cytotoxicity when it is microinjected into the cells or fused to TAT cell-penetrating peptide. Additionally, we identify the minimum length C-terminal domain named F2C able to enter in the SK-MEL-28 cells and induces dynein chains gene expression modulation, a molecular motor that plays a role in the uptake and intracellular trafficking of Amblyomin-X.

14.
AJNR Am J Neuroradiol ; 44(2): E12, 2023 02.
Artigo em Inglês | MEDLINE | ID: mdl-36657952
15.
Clin Oral Investig ; 27(5): 2359-2374, 2023 May.
Artigo em Inglês | MEDLINE | ID: mdl-36640178

RESUMO

OBJECTIVES: The aim of this study is to answer the question: "Is guided endodontics an effective technique for locating calcified canals?". METHODS: A systematic search was carried out by two independent authors in PubMed, Web of Science, Scopus, and Scielo databases. According to the PIOS criteria, observational studies, ex vivo studies, clinical case reports, and case series were included. The quality of evidence of observational studies, case reports, and case series were assessed using the respective Joanna Briggs Institute critical appraisal tool, and a previous personalized tool was used to assess the quality of the ex vivo studies. RESULTS: Forty-five studies were included. Of them, 21 were clinical case reports, 11 case series, 12 ex vivo studies, and 1 cohort study. Of the 45 studies analyzed, 43 reported that guided endodontics is an effective and precise technique to access the permeable portion of calcified canals. Only 2 studies report accidents or failures related to the use of endodontic guides. CONCLUSIONS: Guided endodontics allows conservative access, minimizes accidents, and is effective in locating calcified canals; however, it is a technique that still presents limitations. CLINICAL RELEVANCE: Guided endodontics has been proposed as a simple and effective technique for the treatment of calcified canals. The expansion of this technique requires knowing its benefits and limitations to ensure success and avoid accidents.


Assuntos
Endodontia , Tratamento do Canal Radicular , Humanos , Cavidade Pulpar , Estudos de Coortes , Tomografia Computadorizada de Feixe Cônico
16.
Eur J Vasc Endovasc Surg ; 64(6): 720-732, 2022 12.
Artigo em Inglês | MEDLINE | ID: mdl-36075541

RESUMO

OBJECTIVE: Since the first description of the median arcuate ligament syndrome (MALS), the existence for the syndrome and the efficacy of treatment for it have been questioned. METHODS: A systematic review conforming to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement was conducted, with a broader view on treatment for MALS including any kind of coeliac artery release, coeliac plexus resection, and coeliac plexus blockage, irrespective of age. Online databases were used to identify papers published between 1963 and July 2021. The inclusion criteria were abdominal symptoms, proof of MALS on imaging, and articles reporting at least three patients. Primary outcomes were symptom relief and quality of life (QoL). RESULTS: Thirty-eight studies describing 880 adult patients and six studies describing 195 paediatric patients were included. The majority of the adult studies reported symptom relief of more than 70% from three to 228 months after treatment. Two adult studies showed an improved QoL after treatment. Half of the paediatric studies reported symptom relief of more than 70% from six to 62 months after laparoscopic coeliac artery release, and four studies reported an improved QoL. Thirty-five (92%) adult studies and five (83%) paediatric studies scored a high or unclear risk of bias for the majority of the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) items. The meaning of coeliac plexus resection or blockage could not be substantiated. CONCLUSION: This systematic review suggests a sustainable symptom relief of more than 70% after treatment for MALS in the majority of adult and paediatric studies; however, owing to the heterogeneity of the inclusion criteria and outcome parameters, the risk of bias was high and a formal meta-analysis could not be performed. To improve care for patients with MALS the next steps would be to deal with reporting standards, outcome definitions, and consensus descriptions of the intervention(s), after which an appropriate randomised controlled trial should be performed.


Assuntos
Síndrome do Ligamento Arqueado Mediano , Adulto , Humanos , Criança , Síndrome do Ligamento Arqueado Mediano/diagnóstico , Síndrome do Ligamento Arqueado Mediano/etiologia , Síndrome do Ligamento Arqueado Mediano/cirurgia , Qualidade de Vida , Constrição Patológica/etiologia , Artéria Celíaca/diagnóstico por imagem , Artéria Celíaca/cirurgia , Descompressão Cirúrgica/métodos
19.
Eur Rev Med Pharmacol Sci ; 26(12): 4354-4366, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35776036

RESUMO

OBJECTIVE: In animal models and humans, mutations in voltage-dependent calcium channel gamma-2 subunit gene (CACNG2) have been associated with neuronal hyperexcitability, including neuropathic pain. The objective of this study was to determine the allelic and genotypic frequencies of CACNG2 polymorphisms (rs4820242, rs2284015 and rs2284017) and their association with the risk of chronic peripheral neuropathic pain (CPNP) in the Mexican population. PATIENTS AND METHODS: Single nucleotide polymorphisms (SNPs) were determined by real-time PCR, and allelic and genotypic frequencies were compared between healthy Mexican subjects and CPNP patients. The risk of association of CACNG2 SNPs with the presence of CPNP and its characteristics was evaluated. RESULTS: The allele G (OR 2.08, p = 0.01) of rs2284015 was observed as a risk factor for developing CPNP. The allele A of rs4820442 showed a risk of association with a history of surgery (OR 3.92, p = 0.04), radiculopathy (OR 4.29, p = 0.0001), bilateral presentation of pain (OR 3.15, p = 0.003), and neuropraxia (OR 0.36, p = 0.01). The allele C of rs2284015 was associated with an increased risk of burning and allodynia. In the analysis of the association of genotype frequencies and inheritance patterns, as well as in the analysis of interaction with sex, a modification of risk was observed. CONCLUSIONS: The allele G of rs2284015 and the AGC haplotype of CACNG2 rs4820242, rs2284015 and rs2284017, regardless of sex and etiology could contribute to the risk of CPNP. Certain alleles and genotypes could constitute severity markers in CPNP with sex-biased effects; however, further studies are required to confirm these observations.


Assuntos
Canais de Cálcio , Neuralgia , Polimorfismo de Nucleotídeo Único , Alelos , Canais de Cálcio/genética , Genótipo , Haplótipos , Humanos , Neuralgia/genética
20.
Rev. esp. cir. ortop. traumatol. (Ed. impr.) ; 66(4): 235-241, Jul - Ago 2022. tab
Artigo em Espanhol | IBECS | ID: ibc-204987

RESUMO

Objetivo: Evaluar la validez y seguridad de las reglas de Ottawa para medio pie y tobillo (ROmPT) en el servicio de urgencias de un hospital de referencia en Perú. Materiales y métodos: El estudio fue observacional, transversal con duración de 5 meses (de febrero a junio de 2016). La población fueron los pacientes mayores de 18 años con un traumatismo de pie y/o tobillo que acudieron al servicio de urgencias. Se realizó un muestreo no aleatorizado por conveniencia. Se aplicaron las ROmPT y se realizaron rayos X de pie y/o tobillo a los pacientes que cumplieron los criterios de inclusión y exclusión. Los datos fueron tabulados y analizados con el programa SPSS v. 20.0. Se calcularon medidas de validez diagnóstica (sensibilidad, especificidad), seguridad diagnóstica (valor predictivo positivo, valor predictivo negativo) y likelihood ratio positiva y negativa. Resultados: Se evaluaron 428 pacientes. El uso de las ROmPT obtuvo una sensibilidad del 97,2%, una especificidad del 30,3%, un valor predictivo positivo del 22,0%, un valor predictivo negativo del 98,2%, una likelihood ratio positiva de 1,39 y negativa de 0,09. Con la aplicación de las ROmPT, se evidenció una reducción del 31,2% del total de rayos X, que pudo generar un ahorro de 1.165$. Conclusiones: Se concluye que la validez y seguridad de las ROmPT en nuestro medio son comparables a las de estudios internacionales, con una posible reducción del uso de rayos X. Son necesarios estudios multicéntricos, con mayor tiempo de duración y cantidad de pacientes, para protocolizar el uso de este método en servicios de urgencias.(AU)


Objective: The aim of the study was to evaluate the validity and safety of Ottawa's ankle rules (OAR) in the urgency department of referral hospital in Peru. Materials and methods: An observational-transversal study was conducted for a duration of 5 months (April-June 2016). Target population were all patients older than 18 years with a foot and ankle injury who came to the urgency department. A convenience non-randomized sampling was used. The OAR test was applied and X-rays of the foot and/or ankle were performed in all patients who met the inclusion and exclusion criteria. The data obtained was analyzed using the SPSS 20.0 software. Sensitivity, specificity, positive predictive value, negative predictive value and likelihood ratio positive and negative were calculated from statistical analysis. Results: A total of 428 patients were evaluated. The OAR test's sensitivity was 97.2%, specificity was 30.3%, positive predictive value was 22.0%, negative predictive value was 98.2%, likelihood ratio positive and negative were 1.39 and 0.09, respectively. With the application of the OAR test, a reduction of 31.2% of the total X-rays was evidenced, which could generate a saving of US $1165. Conclusions: In conclusion, OAR's validity and safety in our environment are comparable to international data, with a reduction in the unnecessary use of radiographs. Multicentric studies involving a larger sample and longer study time are necessary to protocolize OAR in emergency units.(AU)


Assuntos
Peru , Traumatismos do Tornozelo/cirurgia , Fraturas do Tornozelo/cirurgia , Fraturas do Tornozelo/terapia , Unidades de Terapia Intensiva , Traumatismos do Tornozelo , Traumatismos do Pé , Radiologia , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Estudos Transversais , Ortopedia , Traumatologia
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