Factores diferenciales entre desistimiento individual y colectivo de mujeres de las FARC-EP en prisión / Differential factors between individual and collective desistance of FARC-EP women in prison / Fatores diferenciais entre a desistência individual e coletiva das mulheres das FARC-EP na prisão

Para el año 2017 se encontraban vigentes en Colombia dos marcos jurídicos para promover el desistimiento y desarticulación de las FARC-EP. Los dos, aunque desde contextos diferentes, han promovido, por un lado, el desistimiento individual y por otro, el desistimiento colectivo de sus miembros. Las mujeres han sido partícipes de ambos procesos, desde la libertad o la prisión de manera minoritaria y asimétrica en comparación con los hombres. Con el interés de analizar este fenómeno, el presente estudio buscó identificar los factores que llevaron a las mujeres a desistir según una u otra modalidad y de-terminar diferencias y similitudes. Para este propósito se diseñó un modelo probabilístico que captara las relaciones de causalidad entre desistimiento y factores predichos desde las teorías del aprendizaje social, de la elección racional y del control social informal, en una muestra de mujeres farianas en prisión que desistieron de forma individual y colectiva. Se encontró que factores como pertenecer a un rango de edad entre 20 y 31 años, tener pareja y haber participado en delitos graves, asociados al terrorismo, influyeron en la selección de la modalidad individual, mientras que tener más de 31 años, participar en delitos comunes junto a los asociados con el terrorismo, incluyendo el narcotráfico, y proceder de regiones con historia de conflicto arraigada predijeron el desistimiento colectivo.

By 2017, there were two legal frameworks in force in Colombia to promote the disbanding and dismantling of the FARC-EP. Both, although from different contexts, have promoted, on the one hand, the individual disbandment and, on the other, the collective disbandment of its members. Women have participated in both processes, from freedom or prison, in a minority and asymmetrical manner compared to men. In order to analyse this phenomenon, this study sought to identify the factors that led women to desist in one or the other modality and to determine differences and similarities. For this purpose, a probabilistic model was designed to capture the causal relationships between desistance and factors predicted from the theories of social learning, rational choice and informal social control, in a sample of women in prison who desisted individually and collectively. It was found that factors such as belonging to an age range between 20 and 31 years, having a partner and having participated in serious crimes associated with terrorism, influenced the selection of the individual modality, while being over 31 years old, participating in common crimes along with those associated with terrorism, including drug trafficking, and coming from regions with a history of deep-rooted conflict predicted collective desistance.

Até 2017, havia duas estruturas legais em vigor na Colômbia para promover a dissolução e o desmantelamento das FARC-EP. Ambos, embora de contextos diferentes, têm promovido, por um lado, a dissolução individual e, por outro, a dissolução coletiva de seus membros. As mulheres participaram de ambos os processos, da liberdade ou da prisão, de forma minoritária e assimétrica em relação aos homens. A fim de analisar este fenômeno, este estudo procurou identificar os fatores que levaram as mulheres a desistir em uma ou outra modalidade e determinar diferenças e semelhanças. Para este fim, um modelo probabilístico foi projetado para capturar as relações causais entre a desistência e os fatores previstos a partir das teorias de aprendizagem social, escolha racional e controle social informal, em uma amostra de mulheres na prisão que desistiram individual e coletivamente. Constatou-se que fatores como pertencer a uma faixa etária entre 20 e 31 anos, ter um parceiro e ter participado de crimes graves associados ao terrorismo, influenciaram a seleção da modalidade individual, embora tendo mais de 31 anos de idade, participar de crimes comuns juntamente com aqueles associados ao terrorismo, incluindo o tráfico de drogas, e vindo de regiões com um histórico de conflitos profundamente enraizados preveram a desistência coletiva.

High-resolution computed tomography (HRCT) analysis in anti-synthase antibody syndrome with organizing pneumonia

Objective: The organizing pneumonia (OP) pattern is the second most common finding in anti-synthase antibody syndrome (ASS), and nonspecific interstitial pneumonia (NSIP) is the most common finding. This study analysed the OP score changes by semiquantitative and quantitative analysis methods and the correlation between the high-resolution computed tomography (HRCT) indexes and the pulmonary function test parameters (PFTs) in ASS patients.MethodsData from ASS-OP patients admitted to the respiratory department of Ping Jin Hospital from October 2014 to June 2020 were retrospectively reviewed and analysed.ResultsFourteen ASS-OP patients were recruited for this study. (1) In method-1, the consolidation (CO) score and the mean lung attenuation (MA) of poorly aerated and fibrosis lung fields (MAfibrosis) (r=0.56, P=0.04), the ground-glass opacity (GGO) score and the MA of non-aerated lung fields (MAnonaerated) (r=−0.64, P=0.01), and the CO plus the GGO (CG) score and the MAnonaerated (r=−0.59, P=0.03) of the lung fields had liner correlations. In method-2, the GGO score to the MAnonaerated (r=−0.58, P=0.03), and the CG (r=−0.68, P=0.01) score to the MAnonaerated had liner correlations. The FVC% (r=0.68, P=0.01) and FEV1% (r=0.64, P=0.01) to the MAfibrosis had good linear correlations. (2) Compared to the values before treatment, the CO pattern score, volume and weight percentages of the extracted whole lung volume with attenuation values of the nonaerated area (Vnonated%, Wnonaerated%), the volume of poorly aerated and fibrosis lung tissue (Vfibrosis%, Wfibrosis%), the weight percentages of normal aerated lung (Wnormal%), and the MAfibrosis exhibited significant differences during the 3–6 month follow-up period. (AU)

Objetivo: El patrón de neumonía organizada (PNO) es el segundo hallazgo más común en el síndrome de anticuerpos antisintasa (SAA), y la neumonía intersticial inespecífica es el hallazgo más común. Este estudio analizó los cambios en la puntuación de PNO mediante métodos de análisis semicuantitativos y cuantitativos, y la correlación entre los índices de la tomografía computarizada de alta resolución y los parámetros de las pruebas de función pulmonar en pacientes con SAA.MétodosSe revisaron y analizaron retrospectivamente los datos de los pacientes SAA-PNO ingresados en el departamento respiratorio del Hospital Ping Jin desde octubre de 2014 hasta junio de 2020.ResultadosSe reclutaron 14 pacientes SAA-PNO para este estudio. (1) En el método 1, la puntuación de consolidación (PC) y la atenuación pulmonar media (APM) de los campos pulmonares mal aireados y fibrosis (APMfibrosis) (r=0,56; p=0,04), la puntuación de la opacidad del vidrio molido (OVM) y la PC de los campos pulmonares no aireados (APMnoaireado) (r=−0,64; p =0,01), y la PC más la puntuación OVM (PV) y el APMnoaireado de los campos pulmonares tenían correlaciones de revestimiento. En el método 2, la puntuación de OVM para el APMnoaireado (r=−0,58; p =0,03) y la puntuación de PV (r=−0,68; p=0,01) para el APMnoaireado tenían correlaciones de revestimiento. El FVC% (r=0,68; p =0,01) y el FEV1% (r=0,64; p =0,01) a la APMfibrosis tuvieron buenas correlaciones lineales. (2) En comparación con los valores anteriores al tratamiento, la puntuación del patrón de PC, los porcentajes de volumen y peso del volumen pulmonar total extraído con los valores de atenuación del área no aireada (Vnoaireado%, Pnoaireado%), el volumen de tejido pulmonar poco aireado y fibroso (Vfibrosis%, Pfibrosis%), los porcentajes de peso del pulmón aireado normal (Pnormal%) y la APMfibrosis mostraron diferencias significativas durante el período de seguimiento de 3 a 6 meses. (AU)

High-resolution computed tomography (HRCT) analysis in anti-synthase antibody syndrome with organizing pneumonia.

OBJECTIVE: The organizing pneumonia (OP) pattern is the second most common finding in anti-synthase antibody syndrome (ASS), and nonspecific interstitial pneumonia (NSIP) is the most common finding. This study analysed the OP score changes by semiquantitative and quantitative analysis methods and the correlation between the high-resolution computed tomography (HRCT) indexes and the pulmonary function test parameters (PFTs) in ASS patients. METHODS: Data from ASS-OP patients admitted to the respiratory department of Ping Jin Hospital from October 2014 to June 2020 were retrospectively reviewed and analysed. RESULTS: Fourteen ASS-OP patients were recruited for this study. (1) In method-1, the consolidation (CO) score and the mean lung attenuation (MA) of poorly aerated and fibrosis lung fields (MAfibrosis) (r=0.56, P=0.04), the ground-glass opacity (GGO) score and the MA of non-aerated lung fields (MAnonaerated) (r=-0.64, P=0.01), and the CO plus the GGO (CG) score and the MAnonaerated (r=-0.59, P=0.03) of the lung fields had liner correlations. In method-2, the GGO score to the MAnonaerated (r=-0.58, P=0.03), and the CG (r=-0.68, P=0.01) score to the MAnonaerated had liner correlations. The FVC% (r=0.68, P=0.01) and FEV1% (r=0.64, P=0.01) to the MAfibrosis had good linear correlations. (2) Compared to the values before treatment, the CO pattern score, volume and weight percentages of the extracted whole lung volume with attenuation values of the nonaerated area (Vnonated%, Wnonaerated%), the volume of poorly aerated and fibrosis lung tissue (Vfibrosis%, Wfibrosis%), the weight percentages of normal aerated lung (Wnormal%), and the MAfibrosis exhibited significant differences during the 3-6 month follow-up period. CONCLUSION: The GGO and CO scored by the semiquantitative or quantitative analysis methods was similar. The HRCT quantitative analysis parameters showed a good correlation with the PFTs in ASS-OP patients, can provide an accurate OP pattern interpretation, and may be used as a monitoring and therapeutic indicator for ASS-OP patients.

Relationship between the sociodemographic characteristics of participants in the DIADA project and the rate of compliance with follow-up assessments in the initial stage of the intervention.

OBJECTIVE: Analyse the relationship between the sociodemographic profile of the DIADA study participants and the rate of compliance with the follow-up assessments in the early stage of this project's intervention for depression and unhealthy alcohol use offered within primary care. METHODS: A non-experimental quantitative analysis was conducted. The sociodemographic data of DIADA [Detección y Atención Integral de Depresión y Abuso de Alcohol en Atención Primaria (Detection and Integrated Care for Depression and Alcohol Use in Primary Care)] study participants had been previously collected. At the time of the evaluation (September 12, 2019), only the participants who had been in the project for a minimum of 3 months were included. By using univariate (Chi-squared) analyses, we studied the association between participants' sociodemographic profile and their rate of compliance with the first follow-up assessment at 3 months after study initiation. RESULTS: At the date of the evaluation, 584 adult participants were identified, of which 389 had been involved in the project for more than 3 months. From the participants included, 320 performed the first follow-up, while 69 did not. The compliance rate to the first follow-up was 82.3% (95 % [CI] 78.1%-86%) and was not affected by: site location, age, sex, civil status, level of education, use of smartphone, PHQ9 score (measuring depression symptomatology) or AUDIT score (measuring harmful alcohol use). Participants who do not use a smartphone, from rural areas and with a lower socioeconomic status, tended to show higher compliance rates. Statistically significant associations were found; participants with lower job stability and a lack of access to the Internet showed higher compliance rates to the early initial follow-up assessment. CONCLUSIONS: The compliance rate was high and generally constant in spite of the variability of the sociodemographic profiles of the participants, although several sub-groups of participants showed particularly high rates of compliance. These findings may suggest that integrating mental health into primary care allows the structural and financial barriers that hinder access to health in Colombia to be broken down by raising awareness about mental illnesses, their high prevalence and the importance of timely and accessible medical management.

The combined used of quantitative and qualitative longitudinal methods in the study of obesity.

OBJECTIVE: To explore the combined use of quantitative and qualitative methods with a longitudinal perspective in the field of obesity diet and physical activity. METHOD: A systematic scoping review following PRISMA guidelines. The databases searched were Web of Science, PubMed, and ASSIA. RESULTS: 1592 records were returned from the searches. In total, nine studies met the inclusion criteria and were included in the review. Authors of included studies mixed quantitative and qualitative methods to obtain a deeper understanding of their study subjects, but few documents use longitudinal data. Authors value the combination of methods and try to integrate the results in their conclusions. CONCLUSIONS: Total integration is rarely achieved in the analysis. The origin of this divergence can be found in the lack of theoretical guidance in these articles, but also in the difficulty of working in multidisciplinary teams in the field of obesity.

Estimated prevalence of COVID-19 in Brazil with probabilistic bias correction / Prevalência estimada de COVID-19 no Brasil com correção probabilística de vieses / Prevalencia estimada de COVID-19 en Brasil con corrección probabilística de sesgo

Abstract: Using data collected by the Brazilian National Household Sample Survey - COVID-19 (PNAD-COVID19) and semi-Bayesian modelling developed by Wu et al., we have estimated the effect of underreporting of COVID-19 cases in Brazil as of December 2020. The total number of infected individuals is about 3 to 8 times the number of cases reported, depending on the state. Confirmed cases are at 3.1% of the total population and our estimate of total cases is at almost 15% of the approximately 212 million Brazilians as of 2020. The method we adopted from Wu et al., with slight modifications in prior specifications, applies bias corrections to account for incomplete testing and imperfect test accuracy. Our estimates, which are comparable to results obtained by Wu et al. for the United States, indicate that projections from compartmental models (such as SEIR models) tend to overestimate the number of infections and that there is considerable regional heterogeneity (results are presented by state).

Resumo: Estimamos o efeito da subnotificação de casos de COVID-19 no Brasil até dezembro de 2020, com base nos dados coletados pela Pesquisa Nacional de Amostra de Domicílios sobre COVID-19 (PNAD-COVID19) e a modelagem semi-bayesiana desenvolvida por Wu et al. O número total de indivíduos infectados é cerca de 3 a 8 vezes o número de casos notificados, a depender do estado do país. No final de 2020, os casos confirmados representavam 3,1% da população total, enquanto nossa estimativa aponta para quase 15% dos cerca de 212 milhões de brasileiros no mesmo período. O método de Wu et al., que adotamos com pequenas modificações nas especificações, aplica correções de vieses para compensar pela testagem incompleta e pela acurácia imperfeita dos testes. Nossas estimativas, que são comparáveis aos resultados obtidos por Wu et al. para os Estados Unidos, indicam que projeções a partir de modelos compartimentais (tais como modelos SEIR) tendem a superestimar o número de infecções, e que há uma heterogeneidade regional considerável (resultados apresentados por estado).

Resumen: Usando los datos recogidos por la Encuesta Nacional por Muestra de Domicilios - COVID-19 (PNAD-COVID19) y un modelado semibayesiano desarrollado por Wu et al., hemos estimado el efecto del subregistro de casos de COVID-19 en Brasil en diciembre de 2020. El número total de individuos infectados es de entre 3 a 8 veces más el número de casos informados, dependiendo del estado. Los casos confirmados son un 3,1% del total de población y nuestra estimación del total de casos es al menos un 15% de aproximadamente 212 millones de brasileños en 2020. El método que se tomó fue el de Wu et al., con leves modificaciones en las especificaciones previas, es aplicable a las correcciones de sesgo para tener en cuenta los test incompletos y la imprecisión de los tests. Nuestras estimaciones, que son comparables a los resultados obtenidos por Wu et al. para los Estados Unidos, indican las proyecciones de los modelos compartimentales (tales como los modelos SEIR), que tienden a sobreestimar el número de infecciones, así como la considerable heterogeneidad regional (los resultados se presentan por estado).

Fatores associados ao abandono do tratamento da tuberculose pulmonar / Factores asociados al abandono del tratamiento de la tuberculosis pulmonar / Factors associated with abandonment of pulmonary tuberculosis treatment

RESUMO Objetivo: analisar os fatores associados ao abandono do tratamento dos casos de tuberculose pulmonar de Rondonópolis, Mato Grosso, Brasil, de 2008 a 2017. Método: estudo quantitativo, transversal, descritivo e de série histórica. Os dados foram coletados no Sistema de Informações sobre Agravos de Notificação. Realizou-se análise descritiva e, para verificar associações, foram utilizados testes Qui-quadrado e Exato de Fisher nos casos de frequências menores que cinco. Foram estimados odds ratio e intervalos de 95% de confiança. Resultados: houve 584 casos de tuberculose pulmonar, destes 8,56% abandonaram o tratamento. O perfil dos casos de abandono foi: sexo masculino (62%), adultos (94%), pardos (54%), ensino fundamental (48%), zona urbana (90%) e realizaram Tratamento Diretamente Observado (56%). A faixa etária e TDO foram fatores associados ao abandono do tratamento. Conclusão: este estudo poderá contribuir no planejamento das ações em saúde com estratégias de prevenção com a finalidade de garantir adesão ao tratamento.

RESUMEN Objetivo: analizar los factores asociados al abandono del tratamiento de los casos de tuberculosis pulmonar en Rondonópolis, Mato Grosso, Brasil, de 2008 a 2017. Método: estudio cuantitativo, transversal, descriptivo y de series de casos. Los datos fueron recolectados en el Sistema de Información de Enfermedades de Notificación Obligatoria. Se realizó un análisis descriptivo y, para verificar asociaciones, se utilizaron las pruebas de Chi-cuadrado y Exacto de Fisher en los casos con frecuencias menores a cinco. Las razones de probabilidad y los intervalos de confianza se estimaron en 95%. Resultados: se registraron 584 casos de tuberculosis pulmonar, de los cuales el 8.56% abandonó el tratamiento. El perfil de los casos de deserción fue: sexo masculino (62%), adultos (94%), de piel morena (54%), escuela primaria (48%), zona urbana (90%) y sometidos a Tratamiento Directamente Observado (56%). El rango de edad y el TDO fueron factores asociados al abandono del tratamiento. Conclusión: este estudio puede contribuir a la planificación de acciones de salud con estrategias de prevención para garantizar la adherencia al tratamiento.

ABSTRACT Objective: to analyze the factors associated with the abandonment of pulmonary tuberculosis treatment in Rondonópolis, Mato Grosso, Brazil, from 2008 to 2017. Method: a quantitative, cross-sectional and descriptive study, of historical series. The data were collected from the Notifiable Diseases Information System. A descriptive analysis was carried out and, in order to verify associations, the Chi-square and Fisher's Exact tests were used in cases with frequencies below five. The Odds Ratio and 95% confidence intervals were estimated. Results: there were 584 cases of pulmonary tuberculosis, of which 8.56% abandoned the treatment. The profile of the abandonment cases was as follows: male (62%), adults (94%), brown-skinned (54%), elementary school (48%), urban area (90%), and who underwent Directly Observed Treatment (56%). Age group and DOT were factors associated with treatment abandonment. Conclusion: this study will be able to contribute to the planning of health actions with prevention strategies, aiming to ensure adherence to the treatment.

Caracterización psicosocial de deportistas y reconocimiento de la importancia del psicólogo deportivo / Psychosocial Characterization of Athletes and the Importance of Sports Psychologists / Caracterização psicossocial de atletas e reconhecimento da importância do psicólogo esportivo

Resumen Objetivo. Desarrollar la caracterización psicosocial de un grupo de deportistas del departamento del Huila (Colombia), e identificar su percepción acerca de la labor del psicólogo deportivo. Método. Investigación descriptiva, transversal, en la que participaron 817 deportistas (72.3% hombres, edad promedio 17.26 años [DE = 4.28]). La información fue obtenida mediante un instrumento ad hoc de autorreporte, validado por expertos, guardando las consideraciones éticas del caso. Resultados. Se evidenciaron asociaciones significativas (p < 0.05) entre los factores psicológicos emocionales (principalmente ansiedad y estrés) y cognitivos (atención, concentración, cohesión, motivación, autoconfianza y cohesión), con las variables sexo, sometimiento a cirugías, trabajo actual, asociación a club deportivo, participación en competencias y acompañamiento con psicólogo deportivo. Muchos de los encuestados no tenían acceso a los profesionales en psicología deportiva, pero resaltaron su importancia para el mejoramiento del rendimiento deportivo. Conclusión. El estudio permitió tener una panorámica general de las condiciones sociodemográficas de los deportistas y de sus necesidades psicosociales. No obstante, se deben llevar a cabo ejercicios más rigurosos que permitan no solo establecer relaciones estadísticas entre las variables reportadas, sino también realizar intervenciones efectivas.

Abstract Objective. To develop a psychosocial characterization of a group of athletes from the department of Huila-Colombia, and to identify their perception of the work of sports psychologists. Method. A descriptive, transversal research was conducted, in which 817 athletes (72.3% men, average age 17.26 years, [SD = 4.28]) participated. The information was obtained through an ad hoc instrument of self-reporting, validated by experts, keeping the ethical considerations of the case. Results. Significant associations (p < 0.05) exist between the psychological and emotional factors (mainly anxiety and stress) and cognitive factors (attention, concentration, cohesion, motivation, self-confidence and cohesion), with sex, surgery, current job, sports club association, participation in competitions and accompaniment with a sports psychologist as variables; even when many of the respondents do not have access to professional sports psychologists, they highlight the importance of their actions to improve performance. Conclusion. The study allows us to have a general overview of the sociodemographic conditions of athletes, as well as their psychosocial needs to be strengthened; nevertheless, more rigorous exercises must be carried out that allow establishing, not only statistical relationships between the variables reported, but also effective interventions.

Resumo Escopo. Desenvolver uma caracterização psicossocial de um grupo de atletas do departamento de Huila-Colômbia e identificar sua percepção do trabalho do psicólogo esportivo. Metodologia. Pesquisa descritiva, transversal, na que participaram 817 atletas (72,3% homens, média de idade 17.26 anos [DE = 4.28]). As informações foram obtidas por meio de um instrumento ad hoc de autorrelato, validado por especialistas, mantendo as considerações éticas do caso. Resultados. Existem associações significativas (p < 0.05) entre os fatores psicológicos emocionais (principalmente ansiedade e estresse) e cognitivos (atenção, concentração, coesão, motivação, autoconfiança e coesão), com as variáveis, sexo, cirurgia, trabalho atual, associação esportiva, participação em competições e acompanhamento com um psicólogo esportivo, e mesmo quando muitos dos entrevistados não têm acesso a profissionais em psicologia esportiva, destacam a importância de suas ações para melhorar o desempenho esportivo. Conclusão. O estudo permite uma visão geral das condições sociodemográficas dos atletas, bem como suas necessidades psicossociais a serem fortalecidas; no entanto, devem ser realizados exercícios mais rigorosos que permitam não apenas estabelecer relações estatísticas entre as variáveis relatadas, mas também realizar intervenções eficazes.

Fatores sociodemográficos e acadêmicos relacionados à resiliência de graduandos da área da saúde / Sociodemographical and academic factors related to health graduate resilience / Factores sociodemográficos y académicos relacionados con la resiliencia de los estudiantes universitarios de salud

Objetivo: analisar a associação de fatores sociodemográficos e acadêmicos ao nível de resiliência de graduandos da área de saúde. Método: trata-se de uma pesquisa quantitativa, transversal e analítica, realizada com 138 estudantes da área de saúde por meio de um questionário sociodemográfico e acadêmico e da escala de Resiliência de Wagnild & Young. O teste de qui-quadrado foi aplicado para analisar a associação entre as variáveis sociodemográficas(categóricas) e a resiliência. Valores de p<0,05 foram considerados significativos. Resultados: 21,7% dos alunos possui elevada resiliência e 71,7% possuem resiliência moderada. Os fatores que mais contribuem para a resiliência são Resoluções de Ações e Valores e Autoconfiança e capacidade de adaptação. Houve associação estatisticamente significativa das variáveis lazer, satisfação com o curso e pessoas com quem o discente reside e o nível de resiliência. Conclusão: os discentes da área de saúde apresentam de moderada à alta resiliência, sendo a realização de atividades de lazer, a satisfação com o curso e a convivência com os familiares elementos associados ao seu fortalecimento.

Objective: To analyze the association of sociodemographic and academic factors with the resilience level of undergraduate health students. Method: This is a quantitative, cross-sectional and analytical research conducted with 138 health students through a sociodemographic and academic questionnaire and the Wagnild & Young Resilience scale. Chi-square test was applied to analyze the association between sociodemographic (categorical) variables and resilience. P values <0.05 were considered significant. Results: 21.7% of students have high resilience and 71.7% have moderate resilience. The factors that most contribute to resilience are Actions and Values Resolutions and Self-confidence and adaptability. There was a statistically significant association between the variables leisure, satisfaction with the course and people with whom the student lives and the level of resilience. Conclusion: health students have moderate to high resilience, being the performance of leisure activities, satisfaction with the course and living with family members associated with its strengthening.

Objetivo: analizar la asociación de factores sociodemográficos y académicos con el nivel de resiliencia de los estudiantes de pregrado en el área de la salud. Método: es una investigación cuantitativa, transversal y analítica, realizada con 138 estudiantes en el área de la salud a través de un cuestionario sociodemográfico y académico y la escala de Resistencia de Wagnild & Young. La prueba de chi-cuadrado se aplicó para analizar la asociación entre las variables sociodemográficas (categóricas) y la resiliencia. Los valores de p <0.05 se consideraron significativos. Resultados: el 21.7% de los estudiantes tiene una alta capacidad de recuperación y el 71.7% tiene una capacidad de recuperación moderada. Los factores que más contribuyen a la resiliencia son las Resoluciones de acciones y valores y la autoconfianza y la adaptabilidad. Hubo una asociación estadísticamente significativa entre las variables ocio, satisfacción con el curso y las personas con quienes reside el estudiante y el nivel de resiliencia. Conclusión: los estudiantes de salud tienen una resiliencia de moderada a alta, con actividades de ocio, satisfacción con el curso y elementos de convivencia familiar asociados con su fortalecimiento

Comparison of morphological quantitative characteristics of the newly formed alveolar bone after the application of demineralized bone matrix and cortical bone allografts / Comparación de las características morfológicas cuantitativas del hueso alveolar recién formado después de la aplicación de matriz ósea desmineralizada y aloinjertos de hueso cortical

The allografts were used to obtain sufficient alveolar bone tissue for proper dental implant placement. The objective of the present study was to evaluate the morphological and quantitative characteristics (cellular and collagen densities) of the newly formed alveolar bone with the application of cortical bone (CB) and demineralized bone matrix (DBM) allografts. Six samples of alveolar bone tissue from 5 patients (50 ± 6.3 years) were obtained after 6 months of application of the allografts and immediately before the placement of the dental implants. The samples were fixed (buffered formaldehyde, pH7.2), decalcified (EDTA 10 %) and histologically processed (HE and Picro-Sirius) for histologic analysis. Morphological analysis revealed presence of osteocytes and trabeculae in neoformed bone tissue near the allografts and absence of inflammatory and allergic cells; the remnants of CB were located mainly in the periphery of the bone tissue and the remnants of DBM were more incorporated into the tissue. Osteogenitor cells were observed around the remaining material. The cell density was not modified in newly formed bone tissue with the application of both allografts as compared to mature bone tissue. The density of the type I and III collagens present in the osteoids interspersed with the remainder of the materials showed a tendency to increase in the samples treated with DBM. It was concluded that by the histological characteristics observed both grafts were biocompatible, however the bone treated with DBM presented better incorporation and a tendency of increase of the collagen content in the remnant region of the allografts.

Los aloinjertos son utilizados para obtener tejido óseo alveolar apropiado para la colocación correcta del implante dental. El objetivo de este trabajo fue evaluar las características morfológicas y cuantitativas (densidades celulares y de colágeno) del hueso alveolar recién formado con la aplicación de aloinjertos de hueso cortical (CB) y matriz desmineralizada de hueso (DBM). Seis muestras de tejido óseo alveolar fueron obtenidas de 5 pacientes (50 ± 6,3 años) después de 6 meses de aplicación de los aloinjertos e inmediatamente antes de la colocación de los implantes dentales. Las muestras fueron fijadas (formaldehído tamponado, pH 7,2), descalcificadas (EDTA al 10%) y procesadas histológicamente (HE y Picro-Sirius) para el análisis histológico. El análisis morfológico reveló la presencia de osteocitos y trabéculas en el tejido óseo neoformado cerca de los aloinjertos y la ausencia de células inflamatorias y alérgicas; los remanentes de CB se ubicaron principalmente en la periferia del tejido óseo y los remanentes de DBM se incorporaron más en el tejido. Se observaron células osteogenitoras alrededor del material restante. La densidad celular no se modificó en el tejido óseo recién formado con la aplicación de ambos aloinjertos en comparación con el tejido óseo maduro. La densidad de los colágenos de tipo I y III presentes en los osteoides intercalados con el resto de los materiales mostró una tendencia a aumentar en las muestras tratadas con DBM. Se concluyó que, debido a las características histológicas observadas, ambos injertos fueron biocompatibles, sin embargo, el hueso tratado con DBM presentó una mejor incorporación y una tendencia al aumento del contenido de colágeno en la región remanente de los aloinjertos.

Storytelling: una metodología de aprendizaje activo para la enseñanza de la psicología social en la educación superior / Storytelling: a methodology for active learning in Social Psychology teaching

En los últimos años la educación superior está promoviendo el uso de metodologías activas para la mejora del proceso de enseñanza-aprendizaje. En este artículo se analiza la utilidad del storytelling en la enseñanza de Psicología Social. Con este fin, 363 estudiantes universitarios participaron en la investigación, realizando una práctica grupal en la que debían escribir una historia utilizando conceptos de la asignatura, elaborar un informe explicativo, y leer las historias de otro grupo. Asimismo, cumplimentaron unos cuestionarios de valoración tanto de la práctica de storytelling como de otras dos representativas de la asignatura. La metodología empleada fue tanto cuantitativa como cualitativa. Los resultados muestran que el storytelling es percibido por los estudiantes como útil y es mejor valorado que los ejercicios de comparación, además de predecir el rendimiento académico (calificaciones en el examen teórico). Por último, se debaten las limitaciones del estudio (como la ausencia de grupo control) y las oportunidades de investigación futura, generalizando a otras áreas de conocimiento e incorporando una exposición pública de las historias desarrolladas

In recent years, higher education is promoting the use of active methodologies to improve the teaching-learning process. This paper analyzes the usefulness of storytelling in Social Psychology teaching. To that end, 363 university students participated in the research, performing a group exercise in which they had to write a story using concepts of Social Psychology, prepare an explanatory report, and read the stories of another group. Moreover, they also completed questionnaires assessing both the storytelling exercise and two other representative exercises of the subject. The methodology used was both quantitative and qualitative. The results show that storytelling is perceived as useful and it's valued higher than the comparison exercises by the students, in addition to predicting the academic performance (grades in the theory test). Finally, the limitations of the study are discussed, such as the absence of a control group and opportunities for further research, and also generalizing to other areas of knowledge and incorporating a public presentation of the stories

Adolescent idiopathic scoliosis and similar conditions: three-dimensional classification / Escoliose idiopática do adolescente e similares: classificação tridimensional / Escoliosis idiopática del adolescente y afecciones similares: clasificación tridimensional

ABSTRACT Objective: To create a new comprehensive, three-dimensional, applicable classification for Adolescent Idiopathic Scoliosis and similar conditions. Methods: The Three-Dimensional Classification was created with three components: the first, the quantitative factor, divides into three types according to the number of curves; the second, the locator factor defines the most structured point of the curve; and the third, the sagittal factor, evaluates the overall sagittal plane. To test the new classification, we studied the images of 99 patients comparing the intra- and interobserver agreement and reproducibility index of the Three-Dimensional Classification with that of Lenke. Results: It can be stated that, overall, the agreement between the three evaluators in relation to the Three-Dimensional Classification and that of Lenke in this series was considered very good. Conclusions: The case study showed a significant difference in the percentages between the two Classifications. In the evaluation of thoracic kyphosis, the Three-Dimensional Classification defined 26.6% of the cases as hyperkyphosis and 61.6% as normal, whereas the Lenke Classification defined 6.06% as hyperkyphosis and 84.18% as normal. However, in the global comparative analysis of the methods, the Three-Dimensional and Lenke systems presented statistically the same levels of agreement, since the values of the confidence intervals overlap. Level of Evidence II; Retrospective study.

RESUMO Objetivo: Criar uma nova Classificação para escoliose idiopática do adolescente e similares, abrangente, tridimensional e aplicativa. Métodos: Criou-se a Classificação Tridimensional com três componentes: o primeiro denominado de fator quantitativo, que divide-se em três tipos de acordo com o número de curvas; o segundo, o fator localizador evidencia o ponto mais estruturado da curva e o terceiro é o fator sagital que avalia globalmente o plano sagital. Para testar a nova Classificação, estudou-se as imagens de 99 pacientes, comparando o índice de concordância e reprodutibilidade intra e interobservador da Classificação Tridimensional com a de Lenke. Resultados: Pode-se afirmar que, no geral, o índice de concordância dos três avaliadores em relação a Classificação Tridimensional e a de Lenke nessa casuística foi considerada muito boa. Conclusões: O estudo da casuística evidenciou diferenças significativas dos percentuais entre as duas Classificações, referente a avaliação da cifose torácica, a Classificação Tridimensional apresentou 26,6% de hipercifose e normal 61,6%, ao passo que a Classificação Lenke evidenciou 6,06% de hipercifose e 84,18% normal. Contudo, na análise comparativa global, com os métodos Tridimensional e Lenke, apresentou-se estatisticamente os mesmos níveis de concordância, uma vez que os valores dos intervalos de confiança se sobrepõem. Nível de Evidência II; Estudo retrospectivo.

RESUMEN Objetivo: Crear una nueva clasificación abarcadora, tridimensional y de aplicación para escoliosis idiopática del adolescente y afecciones similares. Métodos: La Clasificación Tridimensional se creó con tres componentes: el primero, el factor cuantitativo, se divide en tres tipos según el número de curvas; el segundo, el factor de localización, define el punto más estructurado de la curva, y el tercero, el factor sagital, evalúa el plano sagital general. Para probar la nueva clasificación, estudiamos las imágenes de 99 pacientes comparando el índice de concordancia y reproducibilidad intra e interobservador de la Clasificación Tridimensional con la de Lenke. Resultados: Es posible afirmar que, en general, el índice de concordancia de los tres evaluadores en relación a la Clasificación Tridimensional y la de Lenke en esa casuística fue considerada muy buena. Conclusiones: El estudio de la casuística mostró una diferencia significativa de los porcentuales entre las dos clasificaciones. En la evaluación de la cifosis torácica, la clasificación tridimensional definió 26,6% como hipercifosis y 61,6% como normal, mientras que la Clasificación de Lenke definió el 6,06% como hipercifosis y el 84,18% como normal. Sin embargo, en el análisis comparativo global de los sistemas Tridimensional y Lenke presentaron estadísticamente los mismos niveles de concordancia, ya que los valores de los intervalos de confianza se superponen. Nivel de evidencia II; Estudio retrospectivo.

Motivación y logros en procesos de educación para la sexualidad con docentes / Motivation and achievement in education processes for teaching sexuality / Motivação e logros em processos de educação para a sexualidade com docentes

Resumen Objetivo: Evaluar la motivación como elemento esencial en el proceso de capacitación sobre educación para la sexualidad de un grupo docente de educación básica y media y apreciar los cambios alcanzados por el colectivo. Materiales y métodos: Estudio con diseño mixto secuencial explicativo-cuantitativocualitativo con 81 docentes de dos instituciones públicas de Oiba y Simacota (Santander), quienes participaron de manera voluntaria en la investigación durante 2016. La etapa cuantitativa, diseño de corte transversal y enfoque empírico analítico no experimental, evaluó la motivación del colectivo antes de iniciar la capacitación. Se utilizó instrumento construido y validado previamente por el equipo investigador; se analizó mediante el modelo de Rasch y se establecieron relaciones significativas entre variables sociodemográficas y tipos de motivación. En la etapa cualitativa se utilizó el enfoque fenomenológico y la técnica del conversatorio para recabar lo esencial de la experiencia del colectivo y logros alcanzados. Resultados: Más de la mitad del grupo mostró motivación interna alta; la motivación externa se distribuyó en baja, media y alta y hubo un grupo desmotivado en nivel bajo. La confiabilidad de las personas en los tres grupos fue muy baja, lo cual puede sugerir que la muestra no fue la mejor para medir el constructo, aunque el instrumento (ítems) mostró buenas propiedades para evaluarlo. La etapa cualitativa corroboró motivación interna alta en el grupo, amplió la comprensión de los resultados cuantitativos e identificó cambios importantes en el colectivo. Conclusiones: Los testimonios que aportaron muchos de los asistentes evidenciaron cambios en relación con la educación para la sexualidad, lo cual era el objetivo a lograr.

Abstract Objective: To evaluate motivation as an essential element to the training process on education for the sexuality of an elementary and middle school group of teachers and to appreciate the changes achieved by the group. Materials and methods: Explanatory-quantitative-qualitative sequential mixed design study with 81 teachers from two public educational institutions of Oiba and Simacota, Department of Santander, who participated voluntarily in the research project during 2016. The quantitative stage, a cross-sectional design and non-experimental analytical empirical approach, evaluated the motivation of the group before starting the training. An instrument built and validated previously by the research team was used and it was analyzed using the Rasch model, establishing significant relationships between sociodemographic variables and types of motivation. In the qualitative stage, the phenomenological approach and the conversational technique were used to gather the essential of the experience lived by the group and achievements. Results: More than half of the group showed high internal motivation; the external motivation was distributed in low, medium and high and a demotivated group in a low-level was identified. The reliability of the individuals in the three groups was very low which may suggest that the sample was not the best to measure the construct, although the instrument (items) showed good properties to evaluate it. The qualitative stage corroborated high internal motivation in the group, expanded the understanding of quantitative results and identified important changes in the group. Conclusions: The testimonies contributed by many of the attendees evidenced changes in relation to the education for the sexuality, which was the objective to be achieved.

Resumo Objetivo: Avaliar a motivação como elemento essencial no processo de capacitação sobre educação para a sexualidade de um grupo de professores de ensino fundamental e médio e apreciar os câmbios alcançados pelo coletivo. Materiais e métodos: Estudo com desenho misto seqüencial explicativo-quantitativo - qualitativo com 81 professores de duas instituições públicas de Oiba e Simacota em Santander- Colômbia, quem participaram de maneira voluntaria na pesquisa durante 2016. A etapa quantitativa, desenho de corte transversal e enfoque empírico analítico não experimental, avaliaram a motivação do coletivo antes de iniciar a capacitação. Utilizou se instrumento construído e validado previamente pela equipe pesquisador; analisou se mediante o modelo de Rasch e se estabeleceram relações significativas entre variáveis sóciodemográficas e tipos de motivação. Na etapa qualitativa se utilizou o enfoque fenomenológico e a técnica do dialogo para conseguir o essencial da experiência do coletivo e logros alcançados. Resultados: Mais da metade do grupo mostrou motivação interna alta; a motivação externa se distribuiu em baixa, media e alta e houve um grupo desmotivado no nível baixo. A confiabilidade das pessoas nos três grupos foi muito baixa, o qual pode sugerir que a amostra não foi à melhor para medir o constructo, porém o instrumento (itens) mostrou boas propriedades para avaliar-lo. A etapa qualitativa corroborou motivação interna alta no grupo, ampliou a compreensão dos resultados quantitativos e identificou câmbios importantes no coletivo. Conclusões: As testemunhas que aportaram muitos dos assistentes evidenciaram câmbios em relação com a educação para a sexualidade, o qual era o objetivo a lograr.

Risk factors for fall occurrence in hospitalized adult patients: a case-control study / Fatores de risco para quedas em pacientes adultos hospitalizados: um estudo caso-controle / Factores de riesgo para caídas en pacientes adultos hospitalizados: un estudio caso-control

ABSTRACT Objective: to identify risk factors for falls in hospitalized adult patients. Methods: a matched case-control study (one control for each case). A quantitative study conducted in clinical and surgical units of a teaching hospital in Southern Brazil. The sample comprised 358 patients. Data were collected over 18 months between 2013-2014. Data analysis was performed with descriptive statistics and conditional logistic regression using Microsoft Excel and SPSS version 18.0. Results: risk factors identified were: disorientation/confusion [OR 4.25 (1.99 to 9.08), p<0.001]; frequent urination [OR 4.50 (1.86 to 10.87), p=0.001]; walking limitation [OR 4.34 (2.05 to 9.14), p<0.001]; absence of caregiver [OR 0.37 (0.22 to 0.63), p<0.001]; postoperative period [OR 0.50 (0.26 to 0.94), p=0.03]; and number of medications administered within 72 hours prior the fall [OR 1.20 (1.04 to 1.39) p=0.01]. Conclusion: risk for falls is multifactorial. However, understanding these factors provides support to clinical decision-making and positively influences patient safety.

RESUMO Objetivo: identificar os fatores de risco para a ocorrência de quedas em pacientes adultos hospitalizados. Métodos: estudo do tipo caso-controle pareado (um controle para cada caso). Pesquisa quantitativa realizada em unidades clínicas e cirúrgicas de um hospital universitário da região Sul do Brasil. A amostra incluiu 358 pacientes. Os dados foram coletados durante 18 meses, entre 2013-2014. A análise dos dados foi realizada por meio de estatística descritiva e regressão logística condicional, utilizando o Microsoft Excel e o SPSS versão 18.0. Resultados: os fatores de risco identificados foram: desorientação/confusão [OR 4,25 (1,99 a 9,08), p<0,001]; micção frequente [OR 4,50 (1,86 a 10,87), p=0,001]; limitação para caminhar [OR 4,34 (2,05 a 9,14), p<0,001]; ausência de cuidador [OR 0,37 (0,22 a 0,63), p<0,001]; período pós-operatório [OR 0,50 (0,26 a 0,94), p=0,03]; e o número de medicamentos administrados nas 72 horas anteriores à queda [OR 1,20 (1,04 a 1,39) p=0,01]. Conclusão: os riscos para quedas são multifatoriais. Todavia, conhecê-los dá suporte à decisão clínica do enfermeiro, o que contribui para a busca das melhores intervenções preventivas e impacta positivamente na segurança dos pacientes.

RESUMEN Objetivo: identificar los factores de riesgo para la ocurrencia de caídas en pacientes adultos hospitalizados. Métodos: un estudio caso-control emparejado (un control para cada caso). Investigación cuantitativa llevada a cabo en unidades clínicas y quirúrgicas de un hospital universitario en el Sur de Brasil. La muestra constó de 358 pacientes. Se recopilaron datos durante 18 meses, entre 2013-2014. El análisis de los datos se realizó mediante estadística descriptiva y regresión logística condicional, utilizando el Microsoft Excel y el SPSS versión 18.0. Resultados: los factores de riesgo identificados fueron: desorientación/confusión [OR 4,25 (1,99 a 9,08), p<0,001]; micción frecuente [OR 4,50 (1,86 a 10,87), p=0,001]; limitación para caminar [OR 4,34 (2,05 a 9,14), p<0,001]; ausencia de cuidadores [OR 0,37 (0,22 a 0,63), p<0,001]; período postoperatorio [OR 0,50 (0,26 a 0,94), p=0,03]; y número de medicamentos administrados dentro de las 72 horas previas a la caída [OR 1,20 (1,04 a 1,39) p=0,01]. Conclusión: los riesgos de caídas son multifactoriales. Sin embargo, la comprensión de estos factores respalda la toma de decisiones clínicas y tiene un impacto positivo en la seguridad del paciente.

Nursing international student mobility in the University of São Paulo / Movilidad internacional estudiantil de Enfermería de la Universidad de São Paulo / Mobilidade internacional estudantil de Enfermagem da Universidade de São Paulo

ABSTRACT Objective: To characterize the experiences of undergraduate students of the School of Nursing of the University of São Paulo (EEUSP) who participated in international mobility programs between January 2011 and July 2017. Method: Exploratory, descriptive study with quantitative approach. Of 68 reports, only 38 (56%) were considered valid and were submitted to descriptive statistical analysis. Data were categorized in general, institutional, academic and cultural aspects and cost of living. Results: The main destination was Portugal and the years with most participation were 2012 and 2013. The mean stay was six months and the students took a mean of three to four courses. The main funder was the university of origin. Conclusion: Academic activities were limited to theoretical and practical courses, with little insertion in research. There is a need to increase investment in learning other languages and to expand partnerships with larger centers of foreign education and research.

RESUMEN Objetivo: Caracterizar las experiencias de los estudiantes de graduación de la Escuela de Enfermería de la Universidad de São Paulo (EEUSP), participantes de los programas de movilidad internacional, entre enero de 2011 y julio de 2017. Método: Se trata de un estudio exploratorio, descriptivo de abordaje cuantitativo, de 68 reportes. De estos, solamente 38 (56%) se consideraron válidos y se sometieron al análisis estadístico descriptivo. Los datos se recogieron según los aspectos generales de la experiencia: institucionales, académicos, culturales y costo de vida. Resultados: El destino principal fue Portugal, entre los años 2012 y 2013, con permanencia media de seis meses y cursando, promedio, de tres a cuatro disciplinas. La principal financiadora fue la universidad de origen. Conclusión: Las actividades académicas se limitaron a disciplinas teórico-prácticas, sin involucrarse mucho en la investigación. Existe la necesidad de aumentar las inversiones para el aprendizaje de otros idiomas y aumentar los convenios con los grandes centros de enseñanza e investigación extranjeros.

RESUMO Objetivo: Caracterizar as experiências dos estudantes de graduação da Escola de Enfermagem da Universidade de São Paulo (EEUSP), participantes dos programas de mobilidade internacional, entre janeiro de 2011 e julho de 2017. Método: Estudo exploratório, descritivo de abordagem quantitativa, de 68 relatórios. Desses, apenas 38 (56%) foram considerados válidos e submetidos à análise estatística descritiva. Os dados foram apreendidos em aspectos gerais da experiência, institucionais, acadêmicos, culturais e custo de vida. Resultados: O principal destino foi Portugal, entre os anos de 2012 e 2013, com permanência média de seis meses, cursando em média três a quatro disciplinas. O principal financiador foi a universidade de origem. Conclusão: As atividades acadêmicas limitaram-se a disciplinas teórico-práticas, com pouca inserção na pesquisa. Há necessidade de aumentar o investimento na aprendizagem de outros idiomas e ampliar parcerias com grandes centros de ensino e de pesquisa estrangeiros.

Coeducación y experiencias positivas. aportaciones a la convivencia desde la expresión motriz cooperativa / Coeducação e experiências positivas. contribuições para a convivência a partir da expressão motriz cooperativa / Co-education and positive experiences. contributions for coexistence by cooperative motor expression

Resumen: Crear experiencias positivas en Educación Física es uno de los aspectos clave para favorecer la educación de relaciones interpersonales. Este estudio examinó el efecto de las situaciones motrices de expresión cooperativa (SMEC) sobre los estados de ánimo (EA) de universitarios al participar en grupos segregados y mixtos. Participaron 81 alumnos (22 chicas y 59 chicos) del grado en Ciencias de la Actividad Física y el Deporte (INEFC Barcelona). Al inicio y final de cada sesión los participantes cumplimentaron el cuestionario POMS. El análisis estadístico mediante ecuaciones de estimación generalizadas mostró que en ambos grupos se mejoró el EA de los participantes. Los valores de tensión-ansiedad, depresión-abatimiento fueron más favorables en los grupos mixtos, mientras que puntuación global, vigor-actividad, fatigainmovilidad fueron superiores en los grupos segregados. Los hallazgos confirman la contribución de las SMEC para la creación de ambientes positivos y la mejora de la convivencia en y entre ambos géneros. (AU)

Resumo: Criar experiências positivas em Educação Física é um dos aspectos chave para favorecer a educação de relações interpessoais. Este estudo examinou o efeito das situações motrizes de expressão cooperativas (SMEC) sobre os estados de ânimo (EA) de universitários ao participarem em grupos separados e mistos. Participaram 81 alunos (22 meninas e 59 meninos) do curso de graduação em Ciências da Atividade Física e Esporte (INEFC Barcelona). Ao início e ao final de cada sessão os participantes preencheram o questionário POMS. A análise estatística mediante equações de estimativa generalizadas mostrou que em ambos os grupos melhorou os EA dos participantes. Os valores de tensãoansiedade e depressão-abatimento foram mais favoráveis nos grupos mistos; enquanto pontuação global, vigor-atividade e fadiga-imobilidade foram superiores para os grupos separados. Os resultados confirmam a contribuição das SMEC para a criação de ambientes positivos e a melhora da convivência em e entre ambos os gêneros. (AU)

Abstract: Creating positive experiences in Physical Education is one of the key aspects to promote education for interpersonal relations. This study examined the effects of cooperative expression motor situations (SMEC) on the moods of college students participating in segregated and mixed groups. It included 81 students (22 girls and 59 boys) of the Science of Physical Activity and Sport degree (INEFC Barcelona). At the beginning and end of each session, participants completed the POMS questionnaire. Statistical analysis using generalized estimating equations was conducted and showed that participants' moods were improved in both groups. Tension-anxiety, depression-dejection values were more favorable in mixed groups while overall score, vigor-activity, fatigue-immobility values were higher in segregated groups. The findings confirm the contribution of SMEC for creating positive environments and improving coexistence in and between both genders.

Computing quantitative indicators of structural renal damage in pediatric DMSA scans.

OBJECTIVES: The proposal and implementation of a computational framework for the quantification of structural renal damage from 99mTc-dimercaptosuccinic acid (DMSA) scans. The aim of this work is to propose, implement, and validate a computational framework for the quantification of structural renal damage from DMSA scans and in an observer-independent manner. MATERIALS AND METHODS: From a set of 16 pediatric DMSA-positive scans and 16 matched controls and using both expert-guided and automatic approaches, a set of image-derived quantitative indicators was computed based on the relative size, intensity and histogram distribution of the lesion. A correlation analysis was conducted in order to investigate the association of these indicators with other clinical data of interest in this scenario, including C-reactive protein (CRP), white cell count, vesicoureteral reflux, fever, relative perfusion, and the presence of renal sequelae in a 6-month follow-up DMSA scan. RESULTS: A fully automatic lesion detection and segmentation system was able to successfully classify DMSA-positive from negative scans (AUC=0.92, sensitivity=81% and specificity=94%). The image-computed relative size of the lesion correlated with the presence of fever and CRP levels (p<0.05), and a measurement derived from the distribution histogram of the lesion obtained significant performance results in the detection of permanent renal damage (AUC=0.86, sensitivity=100% and specificity=75%). CONCLUSIONS: The proposal and implementation of a computational framework for the quantification of structural renal damage from DMSA scans showed a promising potential to complement visual diagnosis and non-imaging indicators.

The value of quantitative analysis in 18F-NaF PET/CT.

AIM: To evaluate the ability of SUVmax to differentiate bone metastases from degenerative lesions, blastic from lytic metastases, as well as to determine the correlation between SUVmax with 18F-NaF and with 18F-FDG. MATERIAL AND METHODS: A review was performed on 115 18F-NaF PET/CT studies. Of the 64 patients with bone metastases, 49 (39 women, 10 men, 61±12 years (16-81)), in whom the PET/CT supported the diagnosis of bone metastases, were selected for analysis. A record was made of the SUVmax of a maximum of ten metastases in each patient (total 172: 141 blastic, 31 lytic), as well as four degenerative lesions (total 188) with the greatest 18F-NaF uptake intensity. Of the 49 patients analyzed, 43 also had a 18F-FDG PET/CT performed in which a record was made of the SUVmax values for 18F-FDG calculated in the locations corresponding to the bone metastases observed in the 18F-NaF PET/CT: 128 metastases (106 blastic, 22 lytic). RESULTS: The mean of the SUVmax values was significantly higher in metastases than in degenerative lesions, 26.8±17.3 vs. 15.3±6.3 (P<0.001) and in blastic than in lytic metastases, 27.9±18.3 vs. 22.1±11.3 (P=0.03). A SUVmax value above 42 always represented metastases, with all values above 49 representing blastic metastases. Using the SUVmax values, it was possible to predict the occurrence of metastases (AUC=0.723; P<0.001; 95% CI=0.671-0.776). The mean of the SUVmax with 18F-NaF was significantly higher in blastic metastases (27.9±18.3 vs. 22.1±11.3, P=0.03), whereas with 18F-FDG it was significantly higher in lytic ones (3.9±3.4 vs. 9.6±3.3; P<0.01). CONCLUSIONS: SUVmax can contribute to the differentiation of metastases from degenerative lesions, and blastic from lytic metastases.

Evaluación de la calidad del diagnóstico de apendicitis aguda en la atención primaria y secundaria / Evaluation of the quality of the diagnosis of acute appendicitis in the primary and secondary care

Fundamento: la apendicitis aguda es la enfermedad trazadora del abdomen agudo no traumático y su sobrediagnóstico es objeto de preocupación en medicina clínica. Objetivo: evaluar la calidad del diagnóstico de apendicitis aguda en los niveles primario y secundario de atención. Métodos: se realizó un estudio cuantitativo, prospectivo, observacional y descriptivo con fases analíticas donde se evaluaron los diagnósticos clínico, operatorio e histopatológico en un universo de 200 pacientes remitidos de la atención primaria de salud con diagnóstico de apendicitis aguda al servicio de cirugía general del Hospital Provincial Celia Sánchez Manduley, Manzanillo, Granma, en un periodo de cinco meses comprendidos entre noviembre de 2014 y marzo de 2015. Resultados: predominaron el sexo masculino (60, 5 %), el rango de edad 21-25 años y el estadio anatomopatológico catarral (28, 68 %). La correlación clínica entre los dos niveles de atención fue de 79 %. La correlación diagnóstica en la atención secundaria de salud fue de 81, 65 %; 68, 35 % y 83, 72 % entre los diagnósticos clínico y operatorio, clínico e histopatológico y operatorio e histopatológico respectivamente. La efectividad diagnóstica fue menor en los médicos generales (26, 03 %) y mayor en los especialistas en cirugía general (71, 93 %). Conclusiones: la calidad del diagnóstico de apendicitis aguda en el nivel primario de atención fue insatisfactoria y aunque este mejoró en el nivel secundario de atención, los parámetros de efectividad obtenidos no son satisfactorios. Aun cuando existe carencia de parámetros clínicos que otorguen certeza diagnóstica, la clínica aún es la base en la toma de decisiones.

Background: acute appendicitis is the tracer disease of non-traumatic acute abdomen. Its overdiagnosis is a matter of concern in clinical medicine. Objective: to evaluate the quality of the diagnosis of acute appendicitis in the primary and secondary care. Methods: a quantitative, prospective, observational and descriptive study with analytical facets was conducted. The clinical, operating and histopathological diagnoses were evaluated in a universe of 200 patients referred by the primary care to the general surgery department of Celia Sanchez Manduley Provincial Hospital, Manzanillo, Granma with the diagnosis of acute appendicitis in a period of five months, from November, 2014 to March, 2015. Results: male sex (60, 5 %), the 21 to 25 age group, and the catarrhal pathoanatomical stage (28, 68 %) predominated. The clinical correlation between both health care services was of 79 %. The diagnostic correlation between the clinical and the operating diagnoses, between the clinical and histopathological diagnoses and between the operating and the histopathological diagnoses was of 81, 65 %; 68, 35 % and 83, 72 % respectively in the secondary care. The diagnostic effectiveness was lower for general doctors (26, 03 %) and higher for specialists in general surgery (71, 93 %). Conclusion: the quality of the diagnosis of acute appendicitis in the primary care was unsatisfactory and although it improved in the secondary care, the parameters of effectiveness were not yet satisfactory. There is a lack of clinical parameters that provide diagnostic certainty; however, clinical medicine is still the base in decision-making.

Diagnostic contribution of quantitative analysis of salivary scintigraphy in patients with suspected Sjögren's syndrome.

AIM: The evaluation of the salivary scintigraphy is part of the classification criteria of Sjögren's syndrome (SS). The aim of the study was to determine a method of quantitative evaluation of this technique with easy application and high diagnostic accuracy. MATERIAL AND METHODS: A review was carried out on a total of 111 patients with clinical suspicion of SS, referred to our department over the last 4 years (94 women, range 14-82 years). Thirty-minute dynamic studies were performed after injection of (99m)Tc-pertechnetate, with secretory stimulus at 15 minutes. After drawing regions of interest in both parotids, submandibular glands, and in the background, quantitative parameters were determined. These included the ejection fraction, uptake ratio at 15 min, and the percentage uptake (PC). Based on the definitive diagnosis, the subjects were classified into patients with SS, with sicca syndrome, and healthy subjects. RESULTS: Significant differences were found between the SS group and healthy subjects in the 3 quantitative parameters for the 4 glands. Significant differences in the PC parameter were observed between the group with sicca syndrome and healthy subjects. ROC analysis showed that the best differentiation parameter for the 3 groups was the PC in both parotid and submandibular glands. CONCLUSIONS: The quantitative analysis of salivary scintigraphy has proved to be a useful method and easy to apply in daily practice to differentiate patients with SS from healthy subjects, with the PC, both in parotid and submandibular glands, being the parameter with highest diagnostic accuracy.