Sentido de vida en personas adultas mayores semi-institucionalizadas

RESUMEN Introducción: El envejecimiento poblacional impone la necesidad de prever servicios de salud de calidad y especializados, así como un soporte psicológico y social adecuado para la promoción del bienestar de las personas mayores. Objetivo: Caracterizar el sentido de vida en personas mayores semi-institucionalizadas de la ciudad de Santa Clara, Cuba. Métodos: Se asumió un enfoque cualitativo con un diseño fenomenológico. Se emplearon como técnicas la entrevista en profundidad, el Registro de la Actividad Método Directo e Indirecto y el Cuestionario PIL. Los datos fueron procesados mediante el análisis de contenido y la triangulación de datos. Resultados: Como principales resultados se señala que, en las personas mayores participantes, se apreciaron limitaciones en las dimensiones experiencias de sentido, metas y tareas y dialéctica destino-libertad. Discusión: El sentido de vida en las personas mayores participantes se configuró en torno a la salud, los contactos sociales y familiares, las metas propias, la necesidad de trascendencia, la libertad, la felicidad y la participación. La ausencia de sentido se asoció a la carencia de un objetivo específico, a la incapacidad de legar sus conocimientos y experiencias de vida; así como a llevar una vida rutinaria.

ABSTRACT Introduction: Population aging imposes the need to provide quality and specialized health services, as well as adequate psychological and social support to promote the well-being of the elderly. Objective: To characterize the meaning of life in semi-institutionalized elderly people in the city of Santa Clara, Cuba. Methods: A qualitative approach with a phenomenological design was assumed. The in-depth interview, the Direct and Indirect Method Activity Record and the PIL Questionnaire were used as techniques. The data were processed through content analysis and data triangulation. Results: As main results, it is pointed out that, in the elderly participants, limitations were seen in the dimensions experiences of meaning, goals and tasks and the destination-freedom dialectic. Discussion: The sense of life in the participating elderly people was configured around health, social and family contacts, their own goals, the need for transcendence, freedom, happiness and participation. The absence of meaning was associated with the lack of a specific objective, the inability to pass on their knowledgement and life experiences; as well as leading a routine life.

Subjective Well-being during the Pandemic: A Pilot Study in the Cuban Population.

Background: The study of aspects related to positive mental health and well-being in the general population with a gender approach is a necessity in the current context imposed by COVID-19. Objective: To explore gender as a predictor of subjective well-being during COVID-19 in a sample of the Cuban population. Design: A cross-sectional web-based survey design was adopted. The sample consisted of 129 Cuban participants. The Subjective Well-being-Reduced Scale (SW-RS) was used to explore subjective well-being in the sample. Descriptive statistics were used to explore the participants' characteristics. A multinomial logistic regression analysis was conducted to identify variables independently associated with the participants' subjective well-being. Results: The gender of participants significantly predicted subjective well-being levels. The probability of males having middle or high levels of subjective well-being, rather than low levels, was 4.16 times greater than in females. The probability of males having a high self-image instead of a low one was 4.35 times greater than in females. According to the self-satisfaction dimension, the odds of males having high rather than low self-satisfaction were five times more than in females. In this sample, gender did not predict whether participants had middle or high levels of the hedonic dimension. Conclusion: Our results corroborated international studies that have indicated the coincidence of lower well-being and greater psychosocial risk in women during the COVID-19 pandemic. The results also indicated the need to dig deeper into the experiences of subjective well-being from a gender perspective, and to strengthen the sufficiency and effectiveness of the actions and guidance that are offered to the population from psychological care services, the media, and public policies.

La autoayuda en tiempos de la COVID-19 / Self-help in times of COVID-19

Introducción: Ante la presencia del SARS-CoV-2, nuevo coronavirus y agente causal de la COVID-19, se ha desencadenado a nivel mundial una pandemia traducida en millones de enfermos y altas tasas de letalidad. Esta crisis presenta desafíos a todos los niveles, de ahí que la Psicología como ciencia del comportamiento, tenga la función no solo de predecir cómo va a afectar a las personas, sino cómo ayudar a reducir su impacto emocional. Objetivo: Proponer Boletines de autoayuda como herramientas de apoyo psicológico para el fomento de estrategias de afrontamiento ante la crisis generada por la COVID-19. Métodos: Se realizó un estudio cualitativo mediante un diseño de investigación - acción, este se estructuró como un proceso de difusión de innovaciones y siguió tres etapas de trabajo: conocimiento de la innovación, persuasión para la adopción de la innovación y decisión de adopción de la innovación Resultados: Hasta el cierre de este informe, se alcanzó un promedio de 23 930 visitas para la totalidad de los 10 boletines publicados. Se manifestó el predominio de visualizaciones en las féminas, sin embargo, coinciden hombres y mujeres en las edades comprendidas entre 25 - 34 años. Se valoraron de forma favorable los temas relacionados con el cuidado y el autocuidado; la familia; alteraciones en el comportamiento y adultos mayores. Conclusiones: Los comentarios realizados por los beneficiarios de las acciones de autoayuda propuestas, muestran la pertinencia para la situación de crisis actual. Se identificó una dinámica de cambio favorecedora a nivel reflexivo - vivencial y conductualAU)

Introduction: In the presence of SARS-CoV-2, the new coronavirus and causative agent of COVID-19, a pandemic has been triggered worldwide, resulting in millions of patients and high fatality rates. This crisis presents challenges at all levels, hence Psychology as a behavioral science, has the function not only of predicting how it will affect people, but also how to help reduce their emotional impact. Objective: Propose self-help bulletins as psychological support tools to promote coping strategies in the face of the crisis generated by COVID-19. Methods: A qualitative study was conducted through an action-research design, this was structured as a process of diffusion of innovations and followed three stages of work: knowledge of innovation, persuasion for adoption of innovation and decision to adopt innovation Results: Until the closing of this report, an average of 23930 visits were reached for the totality of the 10 published bulletins. The predominance of visualizations in females was manifested, however, men and women between the ages of 25-34 years coincide. Issues related to care and self-care; family; behavioral alterations and older adults were favorably evaluated. Conclusions: The comments made by the beneficiaries of the proposed self-help actions show the relevance for the current crisis situation. A favorable dynamic of change was identified at the reflective-experiential and behavioral levelAU).

Efectividad en la suplementación con omega 3 (Pescado) y vitamina D durante el periodo gestacional para la prevención de diversas alergias en el lactante de 0-1 año de edad / Effectiveness in the omega 3 (Fish) and vitamin D supplementation during the gestational period for the prevention of various allergies in the 0-1 year old infant / Eficácia na suplementação de ômega 3 (peixe) e vitamina D durante o período gestacional para a prevenção de várias alergias na criança de 0 a 1 ano

Resumen El objetivo de esta investigación fue describir la efectividad de la suplementación con omega 3 (pescado) y vitamina D durante la etapa gestacional para la prevención de diversas alergias en el lactante de 0 a 1 año. Se presenta los resultados de una compilación y categorización de la mejor evidencia científica disponible. Se aplicó la metodología sugerida para la práctica clínica basada en la evidencia, la cual inició con el establecimiento de una pregunta clínica seguido por la búsqueda de la información en las bases de datos Medline, Science Direct y Cochrane Library, obteniendo 334 artículos de los cuales al aplicar los criterios de selección se conservan 9. Luego se llevó a cabo un análisis crítico utilizando la plataforma FLC 2.0 y clasificando la evidencia por su calidad y grados de recomendación según Canadian TaskForce on Preventive Health Care.Se concluye que a pesar de que los beneficios de la vitamina D y el omega 3 son múltiples, y que el uso en conjunto de ambos en el embarazo, podría significar una mejora no solo sobre la salud materna sino también sobre el feto y lactante; al no contar con estudios con resultados contundentes, no se puede generalizar o recomendar en la práctica clínica.

Abstract The objective of this research was to describe the effectiveness of omega 3 (fish) and vitamin D supplementation during the gestational stage for the prevention of various allergies in infants aged 0 to 1 year. The results of a compilation and categorization of the best available scientific evidence are presented. The methodology suggested for the clinical practice based on the evidence was applied, which began with the establishment of a clinical question followed by the search of the information in the Medline, Science Direct and Cochrane Library databases, obtaining 334 articles of which when the selection criteria are applied, they are kept 9. Then, a critical analysis was carried out using the FLC 2.0 platform and the evidence was classified by its quality and degrees of recommendation according to the Canadian Task Force on Preventive Health Care. It is concluded that although the benefits of vitamin D and omega 3 are multiple, and that the joint use of both in pregnancy, could mean an improvement not only on maternal health but also on the fetus and infant; By not having studies with conclusive results, it can not be generalized or recommended in clinical practice.

Resumo O objetivo desta pesquisa foi descrever a eficácia da suplementação de ômega 3 (peixe) e vitamina D durante o estágio gestacional para a prevenção de várias alergias em lactentes de 0 a 1 ano de idade. Os resultados de uma compilação e categorização das melhores evidências científicas disponíveis são apresentados. Foi aplicada a metodologia sugerida para a prática clínica baseada na evidência, que começou com o estabelecimento de uma questão clínica seguida pela busca da informação nos bancos de dados da Medline, Science Direct e Cochrane Library, obtendo 334 artigos dos quais quando os critérios de seleção são aplicados, eles são mantidos 9. Então, uma análise crítica foi realizada usando a plataforma FLC 2.0 e a evidência foi classificada por sua qualidade e graus de recomendação de acordo com a Canadian Task Force on Preventive Health Care. Conclui-se que, embora os benefícios da vitamina D e omega 3 sejam múltiplos e que o uso conjunto de ambos na gravidez, pode significar uma melhora não só na saúde materna, mas também no feto e no bebê; Ao não ter estudos com resultados conclusivos, não pode ser generalizada ou recomendada na prática clínica.

C -kit en tumores estromales gastrointestinales y neoplasias asociadas: estudio en población con aislamiento genético / C-KIT in gastrointestinal stromal tumors and associated malignancies: A Study in a population with genetic isolation

INTRODUCCIÓN: Los tumores estromales gastrointestinales (GIST) son los tumores mesenquimales más frecuentes del tracto gastrointestinal. Han surgido numerosas publicaciones de GIST asociados con otras neoplasias. OBJETIVOS: El objetivo de este estudio fue investigar esta posible asociación en una población aislada genéticamente. MÉTODOS: Se realizó un estudio retrospectivo de pacientes con GIST en nuestro centro entre los años 2002-2009. Se compararon datos epidemiológicos, patológicos y familiares de pacientes con GIST sin neoplasias asociadas (grupo A) frente a pacientes con GIST y neoplasias asociadas (grupo B). Se investigó un posible mecanismo genético común entre GIST y las neoplasias asociadas mediante la detección, en todos los tumores, por el marcador inmunohistoquímico CD117. RESULTADOS: Se hallaron 22 pacientes con GIST, 10 del grupo A (45%) y 12 del grupo B (55%). En el grupo B, el tumor asociado fue maligno en 6 pacientes (50%) y benigno en otros 6 (50%). De 22 pacientes con GIST, 8 (36%) presentaron antecedentes familiares de neoplasia maligna. De estos 8 pacientes, 7 eran (87,5%) del grupo B (p = 0,03) y en 3 (37,5%) coincidieron el tipo anatomopatológico de neoplasia padecida por el paciente y su familiar. No hubo GIST en ningún familiar. Todos los GIST mostraron positividad para el CD117, mientras que las neoplasias asociadas fueron negativas para este marcador. CONCLUSIONES: No se ha demostrado positividad inmunohistoquímica para CD117 en las neoplasias asociadas. Dadas las especiales características de la población a estudio, la relación entre GIST y las neoplasias asociadas posiblemente sea casual

INTRODUCTION: Gastrointestinal stromal tumors (GIST) are the most common mesenchymal tumors of the gastrointestinal tract. Numerous studies have reported the association between GIST and other neoplasms. OBJECTIVES: The aim of this study was to investigate the possible association between GIST and other tumors in a genetically isolated population. METHODS: A retrospective study was conducted of patients with GIST between 2002 and 2009 at our center. Epidemiological, pathological and family data in patients with GIST alone (group A) were compared with those in patients with GIST associated with other neoplasms (group B). A possible common genetic mechanism was investigated between GIST and associated malignancies by testing the detection of the immunohistochemical marker, CD117, in all tumors. RESULTS: Twenty-two patients with GIST were identified, 10 in group A (45%) and 12 in group B (55%). In group B, the associated tumor was malignant in 6 patients (50%) and benign in another 6 (50%). Of the 22 patients with GIST, 8 (36%) had a family history of malignancies. Of these 8 patients, 7 (87.5%) were in group B (p = 0.03) and 3 (37.5%) showed the same pathological type of neoplasm as their relatives. All GIST were positive for CD117 whereas associated malignancies were negative for this marker. CONCLUSION: We did not find immunohistochemical positivity for CD117 in malignancies associated with GIST. Given the special characteristics of the study population, the association between GIST and associated malignancies may be incidental

[C-KIT in gastrointestinal stromal tumors and associated malignancies: A Study in a population with genetic isolation]. / C-kit en tumores estromales gastrointestinales y neoplasias asociadas: estudio en población con aislamiento genético.

INTRODUCTION: Gastrointestinal stromal tumors (GIST) are the most common mesenchymal tumors of the gastrointestinal tract. Numerous studies have reported the association between GIST and other neoplasms. OBJECTIVES: The aim of this study was to investigate the possible association between GIST and other tumors in a genetically isolated population. METHODS: A retrospective study was conducted of patients with GIST between 2002 and 2009 at our center. Epidemiological, pathological and family data in patients with GIST alone (group A) were compared with those in patients with GIST associated with other neoplasms (group B). A possible common genetic mechanism was investigated between GIST and associated malignancies by testing the detection of the immunohistochemical marker, CD117, in all tumors. RESULTS: Twenty-two patients with GIST were identified, 10 in group A (45%) and 12 in group B (55%). In group B, the associated tumor was malignant in 6 patients (50%) and benign in another 6 (50%). Of the 22 patients with GIST, 8 (36%) had a family history of malignancies. Of these 8 patients, 7 (87.5%) were in group B (p=0.03) and 3 (37.5%) showed the same pathological type of neoplasm as their relatives. All GIST were positive for CD117 whereas associated malignancies were negative for this marker. CONCLUSION: We did not find immunohistochemical positivity for CD117 in malignancies associated with GIST. Given the special characteristics of the study population, the association between GIST and associated malignancies may be incidental.

Clinicopathological analysis of factors related to colorectal tumor perforation: influence of angiogenesis.

Colorectal tumor perforation is a life-threatening complication of this disease. However, little is known about the anatomopathological factors or pathophysiologic mechanisms involved. Pathological and immunohistochemical analysis of factors related with tumoral neo-angiogenesis, which could influence tumor perforation are assessed in this study. A retrospective study of patients with perforated colon tumors (Group P) and T4a nonperforated (controls) was conducted between 2001 and 2010. Histological variables (differentiation, vascular invasion, and location) and immunohistochemical (CD31, Growth Endothelial Vascular Factor (VEGF) and p53) related with tumor angiogenesis were analyzed. Of 2189 patients, 100 (4.56%) met the inclusion criteria. Of these, 49 patients had nonperforated (2.23%) and 51 had perforated tumors (2.32%). The P group had lower number of right-sided tumors (7/51, 13.7%) compared with controls (13/49, 36.7%) (P = .01). The high-grade tumors (undifferentiated) represented only 3.9% of the perforated tumors; the remaining 96.1% were well differentiated (P = .01). No differences between groups in the frequency of TP53 mutation or VEGF and CD31 expression were found. In the P group, only 2 (3.9%) had vascular invasion (P = .01). Of the 12 tumors with vascular invasion, only 2 were perforated (16.6%). The median number of metastatic lymph-nodes in P Group was 0 versus 3 in controls (Z = -4.2; P < .01). Pathological analysis of variables that indirectly measure the presence of tumor angiogenesis (differentiation, vascular invasion, and the number of metastatic lymph nodes) shows a relationship between this and the perforation, location, and tumor differentiation. We could not directly validate our hypothesis, by immunohistochemistry of TP53, VEGF, and CD31, that perforated tumors exhibit less angiogenesis.

Metastatic lymphs nodes and lymph node ratio as predictive factors of survival in perforated and non-perforated T4 colorectal tumors.

AIMS: Recently it has been hypothesized that perforation of colorectal cancer (CRC) itself is not a predictor of poor prognosis. The aim of this study was to analyze the prognostic impact, of the spontaneous perforation of the tumour, metastatic lymph nodes and lymph node ratio (LNR) after potentially curative surgery. METHODS: Retrospective analysis of oncologic outcomes of patients with T4a CRC grouped by perforated and non-perforated tumours. Between 2001 and 2010, 100 patients were included. Oncologic outcomes, disease-free survival and global survival were analyzed. RESULTS: Forty-nine patients had a non-perforated cancer and 51 presented a perforated neoplasm. Perforated cancers had a lower mean number of lymph nodes (1.16 vs. 4.14, P < 0.001), lower LNR (0.13 vs. 0.33, P = 0.001), better TNM-stage (P < 0.001), and lower metastases during follows-up (P = 0.02). The perforated-group had higher survival (P = 0.017) and higher metastasis-free time (P = 0.03). LNR cutoffs (<0.05, 0.05-0.4, and >0.4) had significant differences in overall survival (log-rank < 0.001). The predictive value of LNR and metastatic lymph nodes in mortality was similar. CONCLUSIONS: In our experience, perforated cancers had higher survival rates and metastasis-free interval that non-perforated cancers, probably by a lower number of metastatic lymph nodes, smaller LNR and better TNM stage. Moreover the predictive value, in mortality rate, of metastatic lymph nodes and LNR was similar.

Consideraciones generales en el hipema secundario a trauma ocular a globo ocular cerrado / General considerations about hyphema secondary to ocular trauma and closed globe injure

El hipema, consecuencia común del trauma ocular, es considerado una emergencia diagnóstica y terapéutica por las lesiones oculares que determinan su aparición y las complicaciones que puede originar. Sin embargo, su tratamiento continúa siendo un desafío donde aún no existe un consenso unánime. En esta investigación se profundiza en cuestiones que han resultado polémicas como la hospitalización, uso de midriáticos, parches oculares, fibrinolíticos, esteroides sistémicos, inhibidores del ácido aminocaproico, cirugía precoz, entre otros(AU)

Hyphema, common consequence of the ocular trauma, is considered a diagnostic and therapeutic emergency due to the ocular lesions that determine their appearance and the complications that may occur. However, the treatment of hyphema continues being a challenge since unanimous consent does not exist yet. This study intended to delve into questions that are controversial as the hospitalization, the use of midriatic drops use, ocular patches, systemic steroids, aminocaproic acid inhibitors, the early surgery, among others(AU)

Consideraciones generales en el hipema secundario a trauma ocular a globo ocular cerrado / General considerations about hyphema secondary to ocular trauma and closed globe injure

El hipema, consecuencia común del trauma ocular, es considerado una emergencia diagnóstica y terapéutica por las lesiones oculares que determinan su aparición y las complicaciones que puede originar. Sin embargo, su tratamiento continúa siendo un desafío donde aún no existe un consenso unánime. En esta investigación se profundiza en cuestiones que han resultado polémicas como la hospitalización, uso de midriáticos, parches oculares, fibrinolíticos, esteroides sistémicos, inhibidores del ácido aminocaproico, cirugía precoz, entre otros

Hyphema, common consequence of the ocular trauma, is considered a diagnostic and therapeutic emergency due to the ocular lesions that determine their appearance and the complications that may occur. However, the treatment of hyphema continues being a challenge since unanimous consent does not exist yet. This study intended to delve into questions that are controversial as the hospitalization, the use of midriatic drops use, ocular patches, systemic steroids, aminocaproic acid inhibitors, the early surgery, among others

Pneumomediastinum as a complication of emphysematous cholecystitis: case report.

BACKGROUND: Emphysematous cholecystitis is a variant of acute cholecystitis which is generally caused by gas-forming organisms. Emphysematous cholecystitis may cause gas spreading within the subcutaneous tissue, peritoneal cavity and retroperitoneum. CASE PRESENTATION: We present a case of emphysematous cholecystitis in a middle-aged diabetic patient who, postoperatively, presented edema in both flanks and left chest crepitation on palpation, associated with hemodynamic worsening. Computed tomography scan of the chest and abdomen revealed a large pneumomediastinum, pneumoretroperitoneum, gas in subcutaneous tissue and flank abscesses. In both blood and surgical wound exudate cultures, Escherichia coli was found. CONCLUSION: Emphysematous cholecystitis should be considered as a possible cause of pneumomediastinum.