4 research outputs found
Relaciones interpersonales y emocionalidad en adolescentes embarazadas
In the present article, the research work carried out with pregnant teenagers from the Sim贸n Bol铆var neighborhood in the city ofC煤cuta, between the ages of 12 and 21 years old, was captured. The research was carried out with the objective of analyzing the effects ofinterpersonal relationships on the emotionality of pregnant teenagers. This study was carried out with qualitative methodologies, data collectionwith interview techniques, focal group and documentary analysis, the respective instruments were validated by expert judgement, and the minorsattended, as well as the parents of the minors authorized by means of consent the participation in the investigation as informant. The resultsreveal behavioral variations in the adolescent's system or subsystems specified in family, couple and friends, as well as the identification ofperspective and future projection.En el presente art铆culo se plasma el trabajo de investigaci贸n realizado con adolescentes embarazadas del barrio Sim贸n Bol铆varde la ciudad de C煤cuta, en edades de 12 a 21 a帽os de edad, la investigaci贸n se realiz贸 con el objetivo de analizar los efectos de las relacionesinterpersonales en la emocionalidad de las adolescentes embarazadas. Este estudio se realiz贸 con metodolog铆as cualitativa, recolecci贸n de datoscon t茅cnicas entrevista, grupo focal y an谩lisis documental, los instrumentos respectivos fueron validados por juicio de expertos, y las menoresasistieron, al igual que los padres de las menores autorizaron por medio de consentimiento la participaci贸n en la investigaci贸n en calidad deinformante. Los resultados develan variaciones comportamentales en el sistema o subsistemas de la adolescente especificados en familia, parejasy amigos, adem谩s de la identificaci贸n de perspectiva y proyecci贸n a futuro
Immunoglobulin, glucocorticoid, or combination therapy for multisystem inflammatory syndrome in children: a propensity-weighted cohort study.
BACKGROUND: Multisystem inflammatory syndrome in children (MIS-C), a hyperinflammatory condition associated with SARS-CoV-2 infection, has emerged as a serious illness in children worldwide. Immunoglobulin or glucocorticoids, or both, are currently recommended treatments. METHODS: The Best Available Treatment Study evaluated immunomodulatory treatments for MIS-C in an international observational cohort. Analysis of the first 614 patients was previously reported. In this propensity-weighted cohort study, clinical and outcome data from children with suspected or proven MIS-C were collected onto a web-based Research Electronic Data Capture database. After excluding neonates and incomplete or duplicate records, inverse probability weighting was used to compare primary treatments with intravenous immunoglobulin, intravenous immunoglobulin plus glucocorticoids, or glucocorticoids alone, using intravenous immunoglobulin as the reference treatment. Primary outcomes were a composite of inotropic or ventilator support from the second day after treatment initiation, or death, and time to improvement on an ordinal clinical severity scale. Secondary outcomes included treatment escalation, clinical deterioration, fever, and coronary artery aneurysm occurrence and resolution. This study is registered with the ISRCTN registry, ISRCTN69546370. FINDINGS: We enrolled 2101 children (aged 0 months to 19 years) with clinically diagnosed MIS-C from 39 countries between June 14, 2020, and April 25, 2022, and, following exclusions, 2009 patients were included for analysis (median age 8路0 years [IQR 4路2-11路4], 1191 [59路3%] male and 818 [40路7%] female, and 825 [41路1%] White). 680 (33路8%) patients received primary treatment with intravenous immunoglobulin, 698 (34路7%) with intravenous immunoglobulin plus glucocorticoids, 487 (24路2%) with glucocorticoids alone; 59 (2路9%) patients received other combinations, including biologicals, and 85 (4路2%) patients received no immunomodulators. There were no significant differences between treatments for primary outcomes for the 1586 patients with complete baseline and outcome data that were considered for primary analysis. Adjusted odds ratios for ventilation, inotropic support, or death were 1路09 (95% CI 0路75-1路58; corrected p value=1路00) for intravenous immunoglobulin plus glucocorticoids and 0路93 (0路58-1路47; corrected p value=1路00) for glucocorticoids alone, versus intravenous immunoglobulin alone. Adjusted average hazard ratios for time to improvement were 1路04 (95% CI 0路91-1路20; corrected p value=1路00) for intravenous immunoglobulin plus glucocorticoids, and 0路84 (0路70-1路00; corrected p value=0路22) for glucocorticoids alone, versus intravenous immunoglobulin alone. Treatment escalation was less frequent for intravenous immunoglobulin plus glucocorticoids (OR 0路15 [95% CI 0路11-0路20]; p<0路0001) and glucocorticoids alone (0路68 [0路50-0路93]; p=0路014) versus intravenous immunoglobulin alone. Persistent fever (from day 2 onward) was less common with intravenous immunoglobulin plus glucocorticoids compared with either intravenous immunoglobulin alone (OR 0路50 [95% CI 0路38-0路67]; p<0路0001) or glucocorticoids alone (0路63 [0路45-0路88]; p=0路0058). Coronary artery aneurysm occurrence and resolution did not differ significantly between treatment groups. INTERPRETATION: Recovery rates, including occurrence and resolution of coronary artery aneurysms, were similar for primary treatment with intravenous immunoglobulin when compared to glucocorticoids or intravenous immunoglobulin plus glucocorticoids. Initial treatment with glucocorticoids appears to be a safe alternative to immunoglobulin or combined therapy, and might be advantageous in view of the cost and limited availability of intravenous immunoglobulin in many countries. FUNDING: Imperial College London, the European Union's Horizon 2020, Wellcome Trust, the Medical Research Foundation, UK National Institute for Health and Care Research, and National Institutes of Health
ENGIU: Encuentro Nacional de Grupos de Investigaci贸n de UNIMINUTO.
El desarrollo del prototipo para el sistema de detecci贸n de Mina Antipersona
(MAP), inicia desde el semillero ADSSOF perteneciente al programa de Administraci贸n en Seguridad y Salud en el trabajo de la UNIMINUTO, se realiza a partir de un
detector de metales que emite una se帽al audible, que el usuario puede interpretar
como aviso de presencia de un objeto met谩lico, en este caso una MAP. La se帽al
audible se interpreta como un dato, como ese dato no es perceptible a 5 metros de
distancia, se implementa el transmisor de Frecuencia Modulada FM por la facilidad
de modulaci贸n y la escogencia de frecuencia de transmisi贸n de acuerdo con las
normas y resoluci贸n del Ministerio de Comunicaciones; de manera que esta sea la
plataforma base para enviar los datos obtenidos a una frecuencia establecida. La
idea es que el ser humano no explore zonas peligrosas y buscar la forma de crear
un sistema que permita eliminar ese riesgo, por otro lado, buscar la facilidad de uso
de elementos ya disponibles en el mercado
Worldwide Disparities in Recovery of Cardiac Testing 1 Year Into COVID-19
BACKGROUND The extent to which health care systems have adapted to the COVID-19 pandemic to provide necessary cardiac diagnostic services is unknown.OBJECTIVES The aim of this study was to determine the impact of the pandemic on cardiac testing practices, volumes and types of diagnostic services, and perceived psychological stress to health care providers worldwide.METHODS The International Atomic Energy Agency conducted a worldwide survey assessing alterations from baseline in cardiovascular diagnostic care at the pandemic's onset and 1 year later. Multivariable regression was used to determine factors associated with procedure volume recovery.RESULTS Surveys were submitted from 669 centers in 107 countries. Worldwide reduction in cardiac procedure volumes of 64% from March 2019 to April 2020 recovered by April 2021 in high- and upper middle-income countries (recovery rates of 108% and 99%) but remained depressed in lower middle- and low-income countries (46% and 30% recovery). Although stress testing was used 12% less frequently in 2021 than in 2019, coronary computed tomographic angiography was used 14% more, a trend also seen for other advanced cardiac imaging modalities (positron emission tomography and magnetic resonance; 22%-25% increases). Pandemic-related psychological stress was estimated to have affected nearly 40% of staff, impacting patient care at 78% of sites. In multivariable regression, only lower-income status and physicians' psychological stress were significant in predicting recovery of cardiac testing.CONCLUSIONS Cardiac diagnostic testing has yet to recover to prepandemic levels in lower-income countries. Worldwide, the decrease in standard stress testing is offset by greater use of advanced cardiac imaging modalities. Pandemic-related psychological stress among providers is widespread and associated with poor recovery of cardiac testing. (C) 2022 The Authors. Published by Elsevier on behalf of the American College of Cardiology Foundation