Factores asociados al desarrollo de secuelas por trauma craneoencefálico en menores de 15 años: un estudio de cohorte retrospectiva en un hospital de Medellín, Colombia. 2010-2014

Introducción: el trauma craneoencefálico es una de las principales causas de morbimortalidad infantil en Colombia, sus secuelas impactan gravemente la calidad de vida de los pacientes y la evidencia científica actual de los factores asociados al trauma es escasa. Objetivo: analizar los factores asociados al desarrollo de secuelas por trauma craneoencefálico en menores de 15 años que consultaron a un hospital de Medellín entre 2010 y 2014. Materiales y métodos: estudio de cohorte retrospectivo. Se incluyeron 812 pacientes en un periodo de 5 años, de los cuales 294 no cumplieron los criterios de inclusión. Se evaluaron variables sociodemográficas, clínicas y se estimó la incidencia de secuelas con el método estadístico de Wilson. El riesgo relativo se calculó mediante regresión log-binomial. Resultados: en total se analizaron 518 pacientes. La mediana de edad fue de 5 años, el 64,3 % eran hombres, el 75,4 % de los participantes tenía un trauma leve y el 5 % un trauma grave. Las caídas fueron la principal causa (64,2 %), seguidas de los accidentes de tránsito (25,3 %). La incidencia de secuelas fue del 7.3 % (IC: 5,4 % - 9,9 %). Conclusiones: la carga de enfermedad en el paciente posterior a TCE representa un problema de salud pública. La probabilidad de desarrollar una secuela en este estudio fue del 7,3 %, la cual se relaciona con los siguientes factores que se identifican en el servicio de urgencias: lesión difusa, una escala de Glasgow al ingreso moderada o grave y sufrir un accidente de tránsito.

Background: traumatic brain injury is one of the main causes of infant morbidity and mortality. The sequelae after trauma seriously impact the quality of life of patients and the scientific evidence of associated factors is scarce. Objective: to analyze the factors associated with the development of sequelae due to head trauma in children under 15 years old who went to the emergency room of a hospital in Medellín between 2010 and 2014. Materials and methods: retrospective cohort study. 812 patients were included in a period of 5 years, of which 294 did not meet the inclusion criteria. Sociodemographic and clinical variables were evaluated and the incidence of sequelae was estimated with 95 % confidence intervals using the Wilson statistical method. The relative risk was calculated using log-binomial regression. Results: a total of 518 patients were analyzed. The median age was 5 years, 64,23 % were male children, 75,4 % had mild trauma, and 5 % suffered severe trauma. Falls were the main cause (64,2 %), followed by traffic accidents (25,3 %). The incidence of sequelae was 7,3 % (CI: 5,4% - 9,9 %). Conclusions: the burden of disease in the patient after TCE represents a public health problem. The probability of developing a sequel in this study was 7,3 %, which is related to the following factors that identify in the emergency department: diffuse injury, a moderate or severe Glasgow scale on admission, and suffering a traffic accident.

Validity and Reliability of an Isometric Row in Quantifying Maximal Force Production in Collegiate Rowers.

ABSTRACT: Pineda, D, Hudak, J, Bingham, GE, and Taber, CB. Validity and reliability of an isometric row in quantifying maximal force production in collegiate rowers. J Strength Cond Res 37(8): e462-e465, 2023-The objective of this study was to examine the relationship between a maximal isometric strength test with a maximal dynamic strength test. The main outcome was to evaluate the isometric test to determine if it was a valid and reliable measurement tool for testing and monitoring of rowing athletes. Collegiate Division 1 rowers were tested on measures of maximal dynamic and isometric strength on 2 occasions separated by 14 days. Thirty-two female athletes (age: 19.9 11.0 years; height: 168.2 ± 7.6 cm; body mass: 71.3 as13.2 kg) participated in this study. Although the isometric test had greater reliability, both tests displayed good-to-excellent reliability (intraclass correlation coefficient = 0.79-0.92). Strong correlations were present for the relationship between isometric and dynamic strength tests ( r = 0.76-0.82, p = <0.001). The data indicate that the isometric row test is valid and reliable compared with dynamic testing and may be used in conjunction with dynamic testing in the evaluation of collegiate rowers.

Descripción de los planes de estudio de programas de terapia ocupacional ofertados a nivel mundial / Description of curricula of occupational therapy programmes offered worldwide / Description of curricula of occupational therapy programmes offered worldwide

Resumen Introducción La descripción de los planes de estudio en la formación universitaria permite realizar actualizaciones de sus contenidos, de acuerdo con las tendencias mundiales y las necesidades de los contextos locales y regionales, con miras a ofertar una educación de calidad. Así mismo, es uno de los criterios para acreditar los programas de educación superior, según la normatividad de cada país. Objetivo Describir los planes de estudio de programas de terapia ocupacional a nivel mundial. Método Estudio descriptivo, con una muestra a conveniencia de 36 planes de estudios. Para la recolección y análisis de la información, se elaboró una matriz de identificación de cada plan de estudios a partir de variables previamente establecidas. Posteriormente, se establecieron sus similitudes y diferencias. Resultados El tiempo de formación varía por región; con un promedio de 4,1 años para Latinoamérica; la línea de estudio del área clínica cuenta con mayor número de cursos a nivel mundial, excepto en Latinoamérica donde predomina la línea en salud mental. Conclusión Se evidenció un panorama general sobre la estructura de los diversos planes de estudio a escala mundial, lo cual permite reflexionar sobre las tendencias de los perfiles profesionales de acuerdo con el desarrollo epistemológico, profesional, disciplinar y a las necesidades mundiales, regionales y locales.

Resumo Introdução A análise dos planos de estudo na educação universitária permite que as atualizações sejam feitas de acordo com as tendências globais e as necessidades dos contextos locais e regionais. É também um dos critérios para a avaliação da qualidade do ensino superior de acordo com as regulamentações de cada país. Objetivo Descrever os planos de estudo de diferentes programas de terapia ocupacional em todo o mundo. Método Estudo descritivo, com uma amostra de conveniência de 36 planos de estudo. Para a coleta e análise das informações, foi criada uma matriz de identificação para cada plano de estudo, com base em variáveis previamente estabelecidas. Posteriormente, suas semelhanças e diferenças foram identificadas. Resultados Verificou-se que o tempo médio de treinamento foi de 4,1 anos para a América Latina; a linha de estudo da área clínica tem um número maior de cursos em todo o mundo, exceto na América Latina, onde predomina a linha de saúde mental. Conclusão Foi encontrada uma visão geral da estrutura dos vários planos de estudo em escala global, o que nos permite refletir sobre as tendências dos perfis profissionais, de acordo com a mudança epistemológica da profissão e as necessidades globais, regionais e locais.

Abstract Introduction The description of study programs in university education allows for updates, according to global trends and the needs of local and regional contexts. It is also one of the criteria for the evaluation of the quality of higher education according to the regulations of each country. Objective To describe the study programs of different occupational therapy programs worldwide. Method A descriptive study, with a convenience sample of 36 study programs. For the collection and analysis of the information was elaborate an identification matrix based on previously established variables. Subsequently, their similarities and differences were established. Results It was found that the average training time was 4.1 years for Latin America. The clinical line of study has a greater number of courses worldwide, except in Latin America where the mental health line predominates. Conclusion A general overview of the structure of the various study programs worldwide was shown, which allows reflection on the trends of professional profiles according to the epistemological change of the profession and global, regional, and local needs.

Early Stimulation and Nutrition: The Impacts of a Scalable Intervention.

Early childhood development is becoming the focus of policy worldwide. However, the evidence on the effectiveness of scalable models is scant, particularly when it comes to infants in developing countries. In this paper, we describe and evaluate with a cluster-Randomized Controlled Trial an intervention designed to improve the quality of child stimulation within the context of an existing parenting program in Colombia, known as FAMI. The intervention improved children's development by 0.16 of a standard deviation (SD) and children's nutritional status, as reflected in a reduction of 5.8 percentage points of children whose height-for-age is below -1 SD.

Reproducibility of a protocol for standardized reading of chest X-rays of children household contact of patients with tuberculosis.

BACKGROUND: The interpretation of the chest radiograph may vary because it depends on the reader and due to the non-specificity of findings in tuberculosis (TB). We aim to assess the reproducibility of a standardized chest radiograph reading protocol in contacts of patients with pulmonary TB under the 5 years of age. METHODS: Descriptive, cross-sectional study with children under the age of five, household contacts of patients with confirmed pulmonary TB from Medellín, Bello and Itagüí (Colombia) between Jan-01-2015 and May-31-2016. Standardized reading protocol: two radiologists, blinded independent reading, use of template (Dr. Andronikou design) in case of disagreement a third reading was performed. Kappa coefficient for intra and inter observer agreement, and prevalence ratio were estimated of sociodemographic characteristics, TB exposure and interpretation of chest X-ray. RESULTS: From 278 children, standardized reading found 255 (91.7%) normal X-rays, 10 (3.6%) consistent with TB, and 13 (4.7%) other alterations. Global agreement was 91.3% (Kappa = 0.51). Inter-observer agreement between readers 1-2 was 90.0% (Kappa = 0.59) and 1-3 93.2% (Kappa = 0.59). Intra-observer agreement for reader 1 was 95.5% (Kappa = 0.86), 2 84.0% (Kappa = 0.51), and 3 94.7% (Kappa = 0.68). Greater inter-observer disagreement was between readers 1-2 for soft tissue density suggestive of adenopathy (4.6%), airspace opacification (1.17%) and pleural effusion (0.58%); between readers 1-3 for soft tissue density suggestive of adenopathy (4.2%), opacification of airspace (2.5%) and cavities (0.8%). CONCLUSIONS: Chest radiographs are an affordable tool that contributes to the diagnosis of TB, so having a standardized reading protocol showed good agreement and improves the reproducibility of radiograph interpretation.

Mesohepatectomía, una alternativa para el manejo del hepatocarcinoma en paciente no cirrótico: serie de casos / Mesohepatectomy, an alternative for the management of hepatocellular carcinoma in non-cirrhotic patient: case series

Introducción. La resección quirúrgica es el tratamiento de elección de las neoplasias primarias y secundarias del hígado. Los pacientes con hepatocarcinoma de los segmentos centrales representan un reto, siendo la hepatectomía extendida la técnica más usada, sin embargo, el riesgo postquirúrgico de falla hepática es alto, dado que la resección puede comprometer entre el 65 % y el 80 % del volumen hepático. La mesohepatectomía es una alternativa que permite dejar un volumen hepático residual suficiente. El objetivo de este trabajo es presentar nuestra experiencia en el tratamiento de pacientes con hepatocarcinomas en segmentos centrales a quienes se les realizó mesohepatectomía. Serie de casos. Se presentan tres pacientes no cirróticos, con hepatocarcinoma en los segmentos 4, 5 y 8, que fueron atendidos en el Hospital San Vicente Fundación, en las sedes de Medellín y de Rionegro, entre 2018 y 2020. Resultados. La mesohepatectomía se realizó mediante ligadura selectiva de los pedículos del segmento 4 y del sector anterior derecho. Se utilizó aspirador ultrasónico y endograpadora para la transección hepática. La duración de la maniobra de Pringle varió entre 16 y 43 minutos. El sangrado promedio fue de 1000 ml. Solo un paciente presentó fuga biliar tipo B. No hubo mortalidad a 30 días. Conclusiones. La mesohepatectomía es una alternativa segura para pacientes con tumores en los segmentos centrales, que permite disminuir el riesgo de falla hepática luego de la resección.

Introduction. Surgical resection is the treatment of choice for primary and secondary neoplasms of the liver. Patients with central segment hepatocarcinoma represent a challenge, with extended hepatectomy being the most widely used technique. However, the postsurgical risk of liver failure is high since resection can compromise between 65% and 80% of liver volume. Mesohepatectomy is an alternative that allows a sufficient residual liver volume to be left. The objective of this work is to present treatment of patients with central segment hepatocarcinoma.Clinical cases. Three non-cirrhotic patients are presented, with hepatocarcinoma in segments 4, 5 and 8, who were treated at the San Vicente Fundación Hospital in Medellín and Rionegro, between 2018 and 2020.Results. Mesohepatectomy was performed by selective ligation of the pedicles of segment 4 and the right anterior sector. An ultrasonic aspirator and endostapler were used for liver transection. The duration of the Pringle ma-neuver ranged from 16 to 43 minutes. The average bleeding was 1000 cc. Only one patient had type B bile leakage. There was no 30-day mortality.Conclusions. Mesohepatectomy is a safe alternative for patients with tumors in the central segments, which reduces the risk of liver failure after resection.

Reduction of chronic malnutrition for infants in Bogotá, Colombia.

BACKGROUND: According to the 2015 National Survey of the Nutritional Situation in Colombia the prevalence of stunting in children under 5 years of age was 10.8%. In terms of region, Bogotá, presented the highest prevalence rate (13%), a figure that exceeded national records. With the collaboration of local and national government, and nongovernmental it was decided to develop a pilot study involving a public health intervention with residents of Bogotá under 1 year of age with nutritional classification by anthropometry compatible with stunting risk or stunting. METHODS: Pre-experimental, before and after study that sought to determine the magnitude of the change in nutritional status through a 10 months public health nutrition intervention in children under one-year-old residing in 3 prioritized territories of Bogotá. RESULTS: The intervention comprised 1126 children living in the following territories in Bogotá: Kennedy, San Cristóbal, and Engativá. A total of 43.3% children presented delay in height for age, and 56.7% presented risk of short stature. In the final measurement, data were obtained from 686 children, identifying that 17% of the children progressed from stunting to a stunting risk and that 4.5% recovered their growth trajectory, achieving an adequate length for their age. CONCLUSION: That children classified as at risk or stunting at the beginning of the intervention showed an increased probability of approaching or being in the appropriate growth trajectory according to the length-for-age indicator after the intervention.

Air pollution, sociodemographic and health conditions effects on COVID-19 mortality in Colombia: An ecological study.

OBJECTIVE: The present study aimed to determine the association between chronic exposure to fine particulate matter (PM2.5), sociodemographic aspects, and health conditions with COVID-19 mortality in Colombia. METHODS: We performed an ecological study using data at the municipality level. We used COVID-19 data obtained from government public reports up to and including July 17th, 2020. We defined PM2.5 long-term exposure as the 2014-2018 average of the estimated concentrations at municipalities obtained from the Copernicus Atmospheric Monitoring Service Reanalysis (CAMSRA) model. We fitted a logit-negative binomial hurdle model for the mortality rate adjusting for sociodemographic and health conditions. RESULTS: Estimated mortality rate ratios (MRR) for long-term average PM2.5 were not statistically significant in either of the two components of the hurdle model (i.e., the likelihood of reporting at least one death or the count of fatal cases). We found that having 10% or more of the population over 65 years of age (MRR = 3.91 95%CI 2.24-6.81), the poverty index (MRR = 1.03 95%CI 1.01-1.05), and the prevalence of hypertension over 6% (MRR = 1.32 95%CI1.03-1.68) are the main factors associated with death rate at the municipality level. Having higher hospital beds capacity is inversely correlated to mortality. CONCLUSIONS: There was no evidence of an association between long-term exposure to PM2.5 and COVID-19 mortality rate at the municipality level in Colombia. Demographics, health system capacity, and social conditions did have evidence of an ecological effect on COVID-19 mortality. The use of model-based estimations of long-term PM2.5 exposure includes an undetermined level of uncertainty in the results, and therefore they should be interpreted as preliminary evidence.

Etiological prevalence of urinary tract infections in symptomatic pregnant women in a high complexity hospital in Medellín, Colombia, 2013-2015 / Prevalencia etiológica de infección del tracto urinario en gestantes sintomáticas, en un hospital de alta complejidad de medellín, colombia, 2013-2015

RESUMEN Objetivo: determinar la prevalencia de infección del tracto urinario (ITU), el perfil microbiológico y la resistencia a los antibióticos en mujeres gestantes con sospecha de infección del tracto urinario. Materiales y métodos: estudio de corte transversal. Ingresaron gestantes con sospecha de infección del tracto urinario adquirida en la comunidad, remitidas a consulta externa desde su control prenatal o atención por urgencias, y hospitalizadas entre agosto de 2013 y septiembre de 2015 en un hospital universitario de referencia ubicado en Medellín, Colombia. Se excluyeron gestantes que hubieran recibido antibióticos el día anterior a la admisión. Muestreo aleatorio simple. Variables medidas: sociodemográficas, clínicas y bacteriológicos. Se aplicó estadística descriptiva. Resultados: la prevalencia de infección del tracto urinario fue del 29 %. Predominaron los aislamientos de bacterias Gram negativas, principalmente E. coli y K. pneumoniae en un 57,7 y 11,4 % respectivamente. Se observó resistencia a trimetoprim-sulfametoxazol en el 19,5 % y ampicilina-sulbactam en el 17,5 % de los aislamientos. Conclusiones: se requieren estudios de base poblacional para una mejor aproximación a la resistencia de las bacterias causantes de la ITU en la comunidad. Por otra parte, la alta resistencia observada podría sugerir que algunos antibióticos expuestos no sean incluidos en las guías locales de manejo de la ITU.

ABSTRACT Objective: To determine the prevalence of urinary tract infections (UTIs), the microbiological profile and antibiotic resistance in pregnant women with suspected urinary tract infection. Materials and methods: Cross-sectional study of pregnant women with suspected community- acquired urinary tract infection referred to the outpatient clinic by prenatal care practitioners or seen in the emergency room, and hospitalized between August 2013 and September 2015 in a referral teaching hospital located in Medellin, Colombia. Pregnant women who had received antibiotics on the day before admission were excluded. Random sampling. Measured variables: sociodemographic, clinical and bacteriological. Descriptive statistics were applied. Results: The prevalence of urinary tract infections was 29%. Gram negative bacteria isolates were found predominantly, the main ones being E. coli and K. pneumoniae at 57.7 and 11.4%, respectively. Resistance to trimethoprim- sulfamethoxazole and to ampicillin-sulbactam was observed in 19.5% and 17.5% of isolates, respectively. Conclusions: Population-based studies are needed to provide a better approach to bacterial resistance in community-acquired UTIs. On the other hand, the high resistance observed may suggest that some of the exposed antibiotics might not be included in the local guidelines for the management of UTIs.

Prevalencia etiológica de infección del tracto urinario en gestantes sintomáticas, en un hospital de alta complejidad de Medellín, Colombia, 2013-2015 / Etiological prevalence of urinary tract infections in symptomatic pregnant women in a high complexity hospital in Medellín, Colombia, 2013-2015

Objective: To determine the prevalence of urinary tract infections (UTIs), the microbiological profile and antibiotic resistance in pregnant women with suspected urinary tract infection. Materials and methods: Cross-sectional study of pregnant women with suspected community- acquired urinary tract infection referred to the outpatient clinic by prenatal care practitioners or seen in the emergency room, and hospitalized be- tween August 2013 and September 2015 in a referral teaching hospital located in Medellin, Colombia. Pregnant women who had received antibiotics on the day before admission were excluded. Random sampling. Measured variables: sociodemographic, clinical and bacteriological. Descriptive statistics were applied. Results: The prevalence of urinary tract infections was 29%. Gram negative bacteria isolates were found predominantly, the main ones being E. coli and K. pneumoniae at 57.7 and 11.4%, respectively. Resistance to trimethoprim- sulfamethoxazole and to ampicillin-sulbactam was observed in 19.5% and 17.5% of isolates, respectively. Conclusions: Population-based studies are needed to provide a better approach to bacterial resistance in community-acquired UTIs. On the other hand, the high resistance observed may suggest that some of the exposed antibiotics might not be included in the local guidelines for the management of UTIs.

TITULO: PREVALENCIA ETIOLÓGICA DE INFECCIÓN DEL TRACTO URINARIO EN GESTANTES SINTOMÁTICAS, EN UN HOSPITAL DE ALTA COMPLEJIDAD DE MEDELLÍN, COLOMBIA, 2013-2015. Objetivo: Determinar la prevalencia de infección del tracto urinario (ITU), el perfil microbiológico y la resistencia a los antibióticos en mujeres gestantes con sospecha de infección del tracto urinario. Materiales y métodos: Estudio de corte transversal. Ingresaron gestantes con sospecha de infección del tracto urinario adquirida en la comunidad, remitidas a consulta externa desde su control prenatal o atención por urgencias, y hospitalizadas entre agosto de 2013 y septiembre de 2015 en un hospital universitario de referencia ubicado en Medellín, Colombia. Se excluyeron gestantes que hubieran recibido antibióticos el día anterior a la admisión. Muestreo aleatorio simple. Variables medidas: sociodemográficas, clínicas y bacteriológicos. Se aplicó estadística descriptiva. Resultados: La prevalencia de infección del tracto urinario fue del 29 %. Predominaron los aislamientos de bacterias Gram negativas, principalmente E. coli y K. pneumoniae en un 57,7 y 11,4 % respectivamente. Se observó resistencia a trimetoprim- sulfametoxazol en el 19,5 % y ampicilina-sulbactam en el 17,5 % de los aislamientos. Conclusiones: Se requieren estudios de base poblacional para una mejor aproximación a la resistencia de las bacterias causantes de la ITU en la comunidad. Por otra parte, la alta resistencia observada podría sugerir que algunos antibióticos expuestos no sean incluidos en las guías locales de manejo de la ITU.

Letter to the editors regarding the paper: Prognostic factors in HIV-positive patients with non-Hodgkin lymphoma: a Peruvian experience.

Non-Hodgkin Lymphoma (NHL) is a neoplasm associated with a group of malignancies called AIDs-Defining Malignancies (ADMs) in Human-Immunodeficiency Virus (HIV) -patients. Similar to the case of NHL in Latin America, particularly in Peru, the amount of research done on others ADMs is limited, especially in the case of Kaposi's Sarcoma (KS). Prior investigations have talked about the great potential risk that represents this illness in latin american population, but topics as prognosis factors are yet to be well defined. In this letter, we address the importance of investigation in this area and include previously reported data that may enlighten the current national standpoint.

Obesity Prevention in Latin America.

In Latin American countries, obesity prevalence has increased significantly as a result of rapid urbanization and an improvement in socioeconomic conditions. We report the prevalence of overweight and/or obesity and prevention efforts in five countries: Mexico, Colombia, Brazil, Peru, and Chile. In children, the highest and lowest rates of obesity are found in Chile (23 % in 6-year-olds) and Peru (1.8 % in those <5 years), respectively. In adults, Mexico and Chile present similar high rates of obesity (around 35 %), whereas in Brazil and Colombia, the rates are around 20 % and 16.5 %, respectively. In general, the highest prevalence occurs in low-income women. Every country has developed initiatives to target obesity, from the government to the private sector and academia, mainly at the health sector and school settings. Food labeling is being addressed, but has not been implemented yet. Two interventions are described, a community-based in Mexico and a school-based in Chile. Because the increase in chronic diseases, especially diabetes, has paralleled that of obesity, effective prevention efforts are urgently needed.

Well-being and suicidal ideation of secondary school students from military families.

BACKGROUND: The mental health of children is a primary public health concern; adolescents of military personnel may be at increased risk of experiencing poorer well-being overall and depressive symptoms specifically. These adolescents experience individual and intrafamilial stressors of parental deployment and reintegration, which are directly and indirectly associated with internalizing behaviors. PURPOSE: The present study sought to better understand the influence of parental military connectedness and parental deployment on adolescent mental health. METHODS: Data from the 2011 California Healthy Kids Survey examined feeling sad or hopeless, suicidal ideation, well-being, and depressive symptoms by military connectedness in a subsample (n = 14,299) of seventh-, ninth-, and 11th-grade California adolescents. Cross-classification tables and multiple logistic regression analyses were used. RESULTS: More than 13% of the sample had a parent or sibling in the military. Those with military connections were more likely to report depressive symptoms and suicidal ideation. Controlling for grade, gender, and race/ethnicity, reporting any familial deployment compared with no deployments was associated with increasing odds of experiencing sadness or hopelessness, depressive symptoms, and suicidal ideation. CONCLUSIONS: Findings emphasize the increased risk of mental health issues among youth with parents (and siblings) in the military. Although deployment-related mental health stressors are less likely during peace, during times of war there is a need for increased screening in primary care and school settings. Systematic referral systems and collaboration with community-based mental health centers will bolster screening and services.

Nivel de adherencia al protocolo de administración de medicamentos / Level of adherence to medication administration protocol / Adesão ao protocolo de gerenciamento de nível droga

Objetivo: Determinar el nivel de adherencia al protocolo de administración de medicamentos por el personal auxiliar de enfermería en una institución de salud de cuarto nivel. Materiales y Métodos: La presente investigación es de carácter cuantitativo de tipo descriptivo de corte transversal, se trabajó con una muestra de 150 auxiliares de enfermería que cumplieron los criterios de inclusión. Para la recolección de la información se utilizó dos instrumentos: una lista de chequeo y un test de conocimientos elaborados y validados por los investigadores. Resultados: El nivel de conocimientos sobre la administración de medicamentos que tiene el personal fue adecuado en un 50%, y la aplicabilidad del protocolo se cumple en el 65% del personal. Conclusión: El nivel de adherencia al protocolo de administración de medicamentos que tiene el personal auxiliar de enfermería es del 65%, existiendo una adecuada relación entre los conocimientos y la aplicabilidad de los mismos.

Goal. Determine the level of adherence to protocol management drugs by the auxiliary nurse in a fourth level health institution. Materials and Methods. This research is a quantitative type descriptive cross-sectional, we worked with a sample of 150 nursing assistants who met the inclusion criteria. For data collection was used two instruments: a checklist and a knowledge test developed and validated by researchers. Results. The level of knowledge about managing drug that the staff has, it was adequated in 50%, and the applicability protocol is met in 65% of the staff. Conclusion. The level of adherence to medication administration protocol that the auxiliary nurses have in 65%, there will be an adequate relationship between knowledge and the applicability of these ones.

Objetivo: Determine o nível de adesão ao protocolo de gestão drogas por parte do auxiliar de enfermagem em uma unidade de saúde na sala nível. Materiais e Métodos: Esta pesquisa é do tipo quantitativa descritivo transversal, trabalhamos com uma amostra de 150 auxiliares de enfermagem que preencheram os critérios de inclusão. Para a coleta de dados foi utilizado dois instrumentos: uma lista de verificação e um teste de conhecimento desenvolvido e validado pelos pesquisadores. Resultados. O nível de conhecimento sobre o gerenciamento droga que tem o pessoal foi adequado em 50%, e a aplicabilidade protocolo é cumprida em 65% do pessoal. Conclusão. O nível de adesão ao protocolo de administração de medicamentos que tem os auxiliares de enfermagemé de 65%, será uma relação adequada entre o conhecimento ea aplicabilidade dos.

Dinámica de la ppidemia del dengue en Colombia: predicciones de la trayectoria de la epidemia / Dyamics of the ddengue epidemic in Colombia: predictions of the epidemic trajectory / Dinâmica da epieemia da dengue na Colômbia: predições da trajetória da epidemia

Las ecuaciones diferenciales se clasifican de acuerdo con el tipo, el orden y si son o no lineales; pueden expresar leyes de los fenómenos naturales como las leyes del movimiento de Newton, enunciadas en el contexto de la cinemática para el sistema dinámico planetario. La teoría de los sistemas dinámicos ha sido base, junto con otras teorías físicas y matemáticas, para el desarrollo de metodologías predictivas en medicina. En un trabajo previo se hizo una predicción para la dinámica de la epidemia de la malaria en Colombia, a partir de una analogía en el contexto de las ecuaciones diferenciales de segundo orden, encontrando una predicción correcta para los rangos de casos de infectados en los años 2005 a 2007, cuyas trayectorias representadas corresponden a atractores circulares concéntricos. En el presente trabajo se desarrolló esta misma metodología para la predicción de la dinámica de la epidemia del dengue, tomando los datos de casos desde 1990 hasta 2007. Se calculó la velocidad inicial y la aceleración inicial para rangos de tres años, haciendo predicciones de la trayectoria a partir de la ecuación diferencial de segundo orden para la aceleración. Se predijeron correctamente los rangos de valores de las trayectorias de la epidemia de dengue para el 2005, 2006 y 2007 a través de atractores circulares concéntricos, concluyendo que dentro del contexto de la ley diferencial acausal se pueden predecir los rangos de la trayectoria de la dinámica, de forma útil para las decisiones de salud pública.

Differential equations are classified according to type, order and whether they are linear or not; they can express natural phenomena laws such as Newton's movement laws, set in the context of kinematics for the planetary dynamic system. Dynamical systems theory has been a foundation along with other physical and mathematical theories, for the development of predictive methodologies in medicine. In a previous study, a prediction for the dynamics of Malaria Epidemic in Colombia was made, beginning with an analogy in the context of second order differential equations, finding a successful prediction for the infected ranges for the years 2005-2007, which represented trajectories correspond to concentric circular attractors. In the present study, the same methodology for Dengue Epidemic prediction was developed; considering the cases data from 1990 to 2007, initial velocity and initial acceleration for three year-ranges, making predictions of the epidemic from the second order differential equation for acceleration. Values of ranges were successfully predicted for Dengue Epidemic trajectories for 2005, 2006 and 2007, through concentric circular attractors; it was concluded that within the context of acausal differential equation the dynamic trajectory ranges may be predicted in a useful way for the Public Health decision making.

As equações diferençais classificam-se de acordo com o tipo, a ordem e se são ou não lineares; podem expressar leis dos fenômenos naturais como as leis do movimento de Newton, enunciadas no contexto da cinemática para o sistema dinâmico planetário. A teoria dos sistemas dinâmicos tem sido base, junto com outras teorias físicas e matemáticas, para o desenvolvimento de metodologias preditivas em medicina. Em um trabalho prévio se fez uma predição para a dinâmica da epidemia da Malaria na Colômbia, a partir de uma analogia no contexto das equações diferençais de segunda ordem, encontrando uma predição correta para os intervalos de casos de infectados nos anos 2005 a 2007, cujas trajetórias representadas correspondem a atratores circulares concêntricos. No presente trabalho se desenvolveu esta mesma metodologia para a predição da dinâmica da epidemia da dengue, tomando os dados de casos desde 1990 até 2007, calculou-se a velocidade inicial e a aceleração inicial para intervalos de três anos, fazendo predições da trajetória a partir da equação diferencial de segundo ordem para a aceleração. Predisseram-se corretamente os intervalos de valores das trajetórias da epidemia de dengue para 2005, 2006 e 2007 através de atratores circulares concêntricos, concluindo que dentro do contexto da lei diferencial acausal podem-se predizer os intervalos da trajetória da dinâmica, de forma útil para as decisões de saúde pública.

Teoria de conjuntos aplicada al recuento de linfocitos y leucocitos: prediccion de linfocitos T CD4 de pacientes con virus de la inmunodeficiencia humana/sida / Set theory applied to white cell and lymphocyte counts: prediction of CD4T lymphocytes in patients with human immunodeficiency virus/aids

Basados en la teoria de conjuntos se desarrolla una metodologia de prediccion del recuento de linfocitos T CD4 (LT-CD4) a partir del numero de leucocitos y linfocitos totales. Se aplica esta metodologia a 500 muestras provenientes de pacientes con VIH con el fin de confirmar la capacidad predictiva de la metodologia. Las triplas de datos de leucocitos/ml3, linfocitos/ml3 y (..) (AU)

Based on set theory a predictive method of LT-CD4 count was developed based on the number of white blood cells and total lymphocytes. The method was applied to 500 samples, in order to confirm the method's predictive capacity. The data triplets of WBC/ml3, lymphocytes/ml3 and CD4/¦Ìl for each patient were organized in descending order according to the number of white blood cells and separated in groups of 1.000. Triplets were organized in sets A, B, C and D, and then AUC, BUD, and their intersections were established. Finally, the elements of each group were calculated and their corresponding percentage for each group of WBC was determined. As a result it was found that five of the nine groups of WBC showed an assertive percentage of 80.39% or above, and percentages of 92.54% and 100% were obtained for groups of values below 4.000/ml3 and 3.000/ml3, respectively. Results confirm that the method can be effectively applied in a clinical setting regardless of statistical measurements, and will reduce human and economic resources (AU)

The female condom: a promising but unavailable method for Dominican sex workers, their clients, and their partners.

Despite evidence of the potential of the female condom as a method that effectively protects against sexually transmitted infections (STIs), HIV, and pregnancy, it is still not widely available. We conducted in-depth interviews with 18 sex workers, 15 male clients, and seven partners in the Dominican Republic to assess the acceptability of the female condom. The majority of the sex workers found the female condom acceptable and welcomed the option of a female-controlled method. Clients and partners of the sex workers were also positive about the female condom and, particularly with regard to pleasure; almost all preferred it to the male condom. These findings suggest that the female condom offers an acceptable option for protection against HIV, STIs, and pregnancy. The positive attitudes of women and men could be developed into messages in marketing campaigns for the female condom, targeting not only vulnerable groups but also the general population.