Determinantes sociales de la salud predictores del grado de discapacidad en personas mayores de 18 años - estudio multicéntrico. Barranquilla 2018

Objetivo: Establecer los Determinantes Sociales de la Salud predictores del grado de discapacidad en personas mayores de 18 años de la Ciudad de Barranquilla. Materiales y métodos: se realizó un estudio de tipo descriptivo correlacional con 216 personas con discapacidad de la ciudad de Barranquilla. Se utilizó el cuestionario WHO DAS 2.0 (36 preguntas) para determinar la cantidad de dificultad encontrada en las actividades que una persona hace en su vida cotidiana independientemente del diagnóstico médico, dentro de los Determinantes Sociales de la Salud analizados están: sexo, edad, estado civil, etnia, tipo de afiliación al SGSSS, circunstancias materiales del trabajo, tipo de vivienda, número de personas en el hogar, utilización de ortesis y/o prótesis, servicios de rehabilitación. Resultados: Fueron estudiadas 216 personas con discapacidad, el 56,9% de la población perteneció al sexo femenino, con una edad promedio de 53,68 años, el 33,3% de la población vivía en estrato socioeconómico 2. De acuerdo con el grado de discapacidad por dominios del WHO- DAS 2.0, el mayor porcentaje se encontró en el grado extremo el dominio actividades de la vida diaria-trabajo remunerado y en el grado moderado los dominios de participación en la sociedad, seguido del dominio relacionarse con otras personas. Se identificó la asociación estadísticamente significativa p< 0,05 entre los determinantes estructurales e intermedios: edad, horas de trabajo, tiempo de trabajo y años sin rehabilitación y los dominios del WHO–DAS 2.0 comprensión y comunicación, movilidad, autocuidado, relaciones con otras personas, actividades de la vida diaria-trabajo no remunerado, actividades de la vida diaria-trabajo remunerado, participación en sociedad y discapacidad final. Se descartó la asociación entre el número de personas con quien comparte la vivienda y los dominios del WHO-DAS 2.0. Se estableció que las variables que pueden predecir el grado de discapacidad son edad en años, ingreso mensual promedio y recibe servicios de rehabilitación Conclusiones: Entre los determinantes estructurales e intermedios que se asocian con el grado de discapacidad en la ciudad de Barranquilla, se encuentran edad, ingreso, tiempo de trabajo, hora de trabajo, tipo de contrato, condiciones de seguridad, nivel de ruido, v exposición a temperaturas altas, en que se desplaza, actividad que realizaba antes de la discapacidad, recibe rehabilitación, factor a que atribuye su recuperación servicios de salud y servicios recibidos, tipo de rehabilitación ordenada terapia ocupacional y medicamentos. Las variables que pueden predecir el grado de discapacidad en este estudio son edad en años, nivel de ingresos y servicios de rehabilitación.Objective: To establish the Social Determinants of Health predictors of the degree of disability in 18-year-old people in Barranquilla's City. Methodology: A correlational descriptive study. The analysis included 216 people with disability. We used the WHO-DAS 2.0 questionnaire (36 questions) to determine the quantity of difficulty found in the activities that a person does in his daily living, independently of the medical diagnosis, the Social Determinants of Health analyzed were: sex, age, marital status, ethnic group, type of affiliation to the SGSSS, material circumstances of the work, housing, used of orthesis and / or prosthesis, people who they lived with, disability pension, rehabilitation services and recovery factors. Results: 216 people were studied with disability, 56,9 % of the population were female, with an average age of 53,68 years, 33,3 % of the population lives in socioeconomic status 2. According to the degree of disability for domains of the WHO-DAS 2.0, the major percentage found, was in the extreme degree in the domain life activities (work and school), the degree moderated was found in the domains participation , followed by the domain getting along. A significant association p< 0,05 was found between the structural and intermediate determinants: age, working hours, time of work and years without rehabilitation and the domains of the WHO-DAS 2.0 cognition, mobility, self-care, getting along, life activities (domestic responsibilities, leisure, work and school), participation and vi final Disability; there was no association between the number of people with whom they lived with and the domains of the WHO-DAS 2.0. The variables that can predict the degree of disability in this study are age in years, level of salary and rehabilitation services. Conclusions: Between the intermediate and structural determinants that are associated with the degree of disability in the city of Barranquilla, are age, salary, working hour, type of contract, safety conditions, level of noise, exhibition to high temperatures, transportation, activity performed before disability, rehabilitation treatment, recovery factors, services of health and received services, occupational therapy and medication. It was possible to establish that salary is a variable that can predict de degree of disability, also age in years, incomes level and rehabilitation services

Diagnóstico pré-natal de síndrome de Noonan: relato de caso: Prenatal diagnosis Noonan syndrome: a case report

A síndrome de Noonan caracteriza-se por se manifestar como uma doença do tipo genético na qual será apresentada uma tríade composta por cardiopatia congênita, baixa estatura e diferentes características faciais. Sua incidência em todo o mundo é de 1 caso em 1.000 a 2.500 recém-nascidos. Os sinais que ocorrem no pré-natal geralmente são inespecíficos e podem incluir aumento da transluscência nucal, higroma cístico e ascite. Quando houver suspeita, uma ultrassonografia pré-natal deve ser realizada nas semanas 12, 14 e 20 de gestação. No entanto, o diagnóstico pré-natal principalmente na síndrome de Noonan é feito através de vilosidades coriônicas ou líquido amniótico, quando há maior suspeita clínica, deve-se realizar estudo molecular. O presente caso é de uma paciente de 19 anos, primeira gestação, com histórico de hipotireoidismo e diabetes gestacional em tratamento. Ela vai ao centro de saúde para controle devido a uma gravidez de 36 semanas pela data da última menstruação, onde foi realizada uma ultrassonografia, que está dentro dos parâmetros normais, uma cesariana é realizada na semana 38 devido ao histórico patológico, onde recém-nascido com fácies é evidenciado sugestivo de síndrome de Noonan, que no pré e pós-natal não foi adequadamente diagnosticada, por ser um caso muito raro e complicado, apresentou um diagnóstico clínico difícil. Diagnosticar uma Síndrome de Noonan no pré-natal é útil no momento do parto, pois melhora a sobrevida do recém-nascido e ajuda a agir de forma interdisciplinar, devido às complicações que a própria síndrome acarreta. O diagnóstico pré-natal na Síndrome de Noonan é complicado devido à sua baixa prevalência, além das características ultrassonográficas indeterminadas que existem

Búsqueda de los virus del nilo occidental, de la encefalitis de san Luis y de la encefalitis equina venezolana en mosquitos de Paraguay – resultados preliminares.

El objetivo general del proyecto fue determinar la presencia de arbovirus encefalíticos (VEEV, WNV y SLEV) en poblaciones humanas y de mosquitos de Paraguay.CONACYT - Consejo Nacional de Ciencias y TecnologíaPROCIENCI

Búsqueda de virus encefalíticos (wnv, slev y veev) en sueros de pacientes con sospecha de síndrome febril agudo y trastornos neurológicos.

Los virus del Nilo Occidental (WNV), de la Encefalitis de San Luis (SLEV) y de la Encefalitis Equina Venezolana (VEEV) pueden producir enfermedades febriles agudas que podrían ser confundidas con el dengue u otras patologías; también pueden causar trastornos neurológicos graves. Estos virus todavía no han sido detectados en nuestro país, sin embargo, existen reportes de circulación de los mismos en países limítrofes. El Paraguay cuenta con las condiciones favorables para propiciar el mantenimiento del ciclo de transmisión de estos virus, por lo que se considera de suma importancia el estudio de ellos en pacientes con afecciones previamente mencionadas.CONACYT - Consejo Nacional de Ciencias y TecnologíaPROCIENCI

Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality

Annual Conference on Formative Research on EFL. Practices thar inspire change.

The conference papers of the Annual Conference on Formative Research on EFL. Practices thar inspire change collect pedagogical experiences, research reports, and reflections about social issues, language teaching, teaching training, interculturality under the panorama of the Covid-19 pandemic. Each paper invites the reader to implement changes in their teaching practice through disruptive pedagogies, reflect on the social and emotional consequences of the lockdown, new paths for teacher training and different approaches for teaching interculturality. We expect to inspire new ways to train pre-service teachers and teach languages in this changing times

Gestión del conocimiento. Perspectiva multidisciplinaria. Volumen 17

El libro “Gestión del Conocimiento. Perspectiva Multidisciplinaria”, Volumen 17 de la Colección Unión Global, es resultado de investigaciones. Los capítulos del libro, son resultados de investigaciones desarrolladas por sus autores. El libro es una publicación internacional, seriada, continua, arbitrada, de acceso abierto a todas las áreas del conocimiento, orientada a contribuir con procesos de gestión del conocimiento científico, tecnológico y humanístico. Con esta colección, se aspira contribuir con el cultivo, la comprensión, la recopilación y la apropiación social del conocimiento en cuanto a patrimonio intangible de la humanidad, con el propósito de hacer aportes con la transformación de las relaciones socioculturales que sustentan la construcción social de los saberes y su reconocimiento como bien público

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake