RESUMO
La OMS declaró en el año 2020 estado de pandemia con la llegada del COVID-19, el virus no hizo distinción sin embargo la población adulta mayor fue la más propensas al contagio. Los adultos mayores bajo los lineamientos sanitarios fueron considerados población vulnerable y las directrices como el confinamiento y el distanciamiento social provocó algunas implicancias en su salud y bienestar social. El trabajo tuvo como objeto realizar un análisis descriptivo a partir de la mirada que tuvieron los adultos mayores sobre la desigualdad, incertidumbre y oportunidades durante el confinamiento y el distanciamiento social de la pandemia en la ciudad de Catamarca. Se tomó como parámetros de análisis las variables sexo, edad, situación socio-económico y estado de salud físico y emocional. La estrategia metodológica fue cuantitativa con un enfoque mixto (cuantitativo-cualitativo), la muestra de estudios es intencional no probabilística, en la cual participaron adultos mayores; y se utilizó como técnica de recopilación de datos la encuesta de elaboración propia. Como resultado, se observó que durante el confinamiento por la pandemia del COVID-19, si bien los adultos mayores sintieron temor al virus, el cual fue por etapas, pero por medio de diferentes mecanismos pudieron superar la situación y levantar el ánimo participando de diferentes actividades integrales. La investigación permitió concluir que la situación socioeconómica marco un parámetro de acceso/des-acceso para obtener los recursos, pero las estructuras socio-familiares como factores de contención social, económica y de salud fueron determinantes para superar problemas socio-sanitarios durante el confinamiento y el distanciamiento social[AU]
Te WHO declared a state of pandemic in 2020 with the arrival of COVID-19, the virus made no distinction, however, the older adult population was the most prone to contagion. Older adults under the health guidelines were considered a vulnerable population and guidelines such as confnement and social distancing caused some implications for their health and social wellbeing. Te purpose of the work is to carry out a descriptive analysis based on the view that older adults had on inequality, uncertainty and opportunities during the confnement and social distancing of the pandemic in the city of Catamarca. Te variables sex, age, socio-economic situation and physical and emotional health status were taken as analysis parameters. Te methodological strategy is quantitative with a mixed approach (quantitative-qualitative), the study sample is intentional, non-probabilistic, in which adults participated; and the self-made survey was used as a data collection technique. As a result, it is observed that during the confnement due to the COVID-19 pandemic, although older adults felt fear of the virus, which was in stages, but through diï¬erent mechanisms they were able to overcome the situation and lif their spirits by participating in diï¬erent comprehensive activities. Te research allows us to conclude that the socioeconomic situation marks a parameter of access/deaccess to obtain the resources, but the socio-family structures as factors of social, economic and health containment were decisive in overcoming socio-sanitary problems during confnement and social distancing[AU]
A OMS declarou estado de pandemia em 2020 com a chegada do COVID-19, o vírus não fez distinção, porém, a população idosa foi a mais propensa ao contágio. Os idosos sob as diretrizes de saúde foram considerados uma população vulnerável e diretrizes como confnamento e distanciamento social causaram algumas implicações para sua saúde e bem-estar social. O objetivo do trabalho é realizar uma análise descritiva a partir da visão que os idosos tiveram sobre desigualdade, incerteza e oportunidades durante o confnamento e distanciamento social da pandemia na cidade de Catamarca. As variáveis sexo, idade, situação socioeconômica e estado de saúde física e emocional foram tomadas como parâmetros de análise. A estratégia metodológica é quantitativa com abordagem mista (quantitativa-qualitativa), a amostra do estudo é intencional, não probabilística, da qual participaram adultos; e como técnica de coleta de dados utilizou-se o questionário auto-feito. Como resultado, observa-se que durante o confnamento devido à pandemia do COVID-19, embora os idosos sentissem medo do vírus, que estava em etapas, mas por meio de diferentes mecanismos conseguiram superar a situação e elevar o ânimo participando de diferentes atividades abrangentes. A pesquisa permite concluir que a situação socioeconômica marca um parâmetro de acesso/desacesso para obtenção dos recursos, mas as estruturas sociofamiliares como fatores de contenção social, econômica e sanitária foram determinantes na superação de problemas sociossanitários durante o confnamento e distanciamento social[AU]
Assuntos
Humanos , Masculino , Feminino , Idoso , Idoso de 80 Anos ou mais , Seguridade Social , Fatores Socioeconômicos , Incerteza , Populações Vulneráveis , Medo , Pandemias , COVID-19 , Acontecimentos que Mudam a VidaRESUMO
Parkinson's disease is the second most common neurodegenerative disease, with an estimated prevalence of 41/100,000 individuals affected aged between 40 and 49 years old and 1,900/100,000 aged 80 and over. Based on the essentiality of ascertaining which wearable devices have clinical literary evidence and with the purpose of analyzing the information revealed by such technologies, we conducted this scientific article of integrative review. It is an integrative review, whose main objective is to carry out a summary of the state of the art of wearable devices used in patients with Parkinson's disease. After the review, we retrieved 8 papers. Of the selected articles, only 3 were not systematic reviews; one was a series of cases and two prospective longitudinal studies. These technologies have a very rich field of application; however, research is still necessary to make such evaluations reliable and crucial to the well-being of these patients.
Assuntos
Doença de Parkinson/fisiopatologia , Dispositivos Eletrônicos Vestíveis , Humanos , Monitorização Ambulatorial/instrumentação , Monitorização Fisiológica/instrumentaçãoRESUMO
SUMMARY Parkinson's disease is the second most common neurodegenerative disease, with an estimated prevalence of 41/100,000 individuals affected aged between 40 and 49 years old and 1,900/100,000 aged 80 and over. Based on the essentiality of ascertaining which wearable devices have clinical literary evidence and with the purpose of analyzing the information revealed by such technologies, we conducted this scientific article of integrative review. It is an integrative review, whose main objective is to carry out a summary of the state of the art of wearable devices used in patients with Parkinson's disease. After the review, we retrieved 8 papers. Of the selected articles, only 3 were not systematic reviews; one was a series of cases and two prospective longitudinal studies. These technologies have a very rich field of application; however, research is still necessary to make such evaluations reliable and crucial to the well-being of these patients.
RESUMO A doença de Parkinson figura como a segunda doença neurodegenerativa mais comum. Sua prevalência é estimada de 41 por 100.000 pessoas entre 40 e 49 anos a 1.900 por 100.000 pessoas com 80 anos ou mais. Baseando-se na essencialidade de averiguar os dispositivos vestíveis que possuem evidências clínicas literárias e com o objetivo de analisar as informações reveladas por tais tecnologias, temos a construção deste artigo científico de revisão integrativa. Trata-se de uma revisão integrativa que tem como principal objetivo realizar um sumário do estado da arte de dispositivos vestíveis utilizados em pacientes com doença de Parkinson. Após realizada a revisão, obtiveram-se oito artigos. Pode-se observar que dos artigos selecionados, apenas três não eram revisões sistemáticas, sendo um deles uma série de casos e outros dois, estudos longitudinais prospectivos. A utilização dessas tecnologias possui um campo muito rico para atuar, contudo ainda são necessárias pesquisas para que tais avaliações sejam fidedignas e cruciais para o bem-estar desses pacientes.
Assuntos
Humanos , Doença de Parkinson/fisiopatologia , Dispositivos Eletrônicos Vestíveis , Monitorização Ambulatorial/instrumentação , Monitorização Fisiológica/instrumentaçãoRESUMO
El cáncer es una enfermedad que se presenta de diferentes formas y con distintos orígenes, con evidencias de que su incidencia está en aumento. La relación entre cáncer y factores socio-ambientales es muy fuerte, siendo la información sobre esta patología de vital importancia para una comunidad. Aunque existe varias maneras de abordar la problemática, es difícil desarrollar una modalidad que permita de manera rápida y efectiva relacionar en lugar y tiempo la aparición de nuevos pacientes. De lograrlo, en un futuro no muy lejano se podría formular hipótesis de trabajo sobre factores sociales o ambientales relacionados con esta patología. En consecuencia, hemos trabajado en el desarrollo e implantación de un Sistema de Información Geográfico Integral en base a datos aportados por el Servicio de Anatomía Patológica y Oncología de pacientes con cáncer, contando con datos espaciales y temporales de vivienda y trabajo. El objetivo del presente trabajo fue que el sistema aporte datos útiles para realizar registro y detección de asociaciones de cáncer y posibles focos contaminantes.
Assuntos
Humanos , Epidemiologia , Neoplasias , Mapeamento Geográfico , Sistemas de Informação em SaúdeRESUMO
BACKGROUND: Medical education must emphasize communication practices mostly for undergraduate medical students. OBJECTIVES: To introduce an approach for teaching and learning communication in medicine. METHODS: Review of the literature. RESULTS: An approach for developing communicational practices for both undergraduate and post graduate students is presented. CONCLUSION: Medical communication is not taught adequately in modern medical schools and is allotted a brief curricular space. This curricular time must be widened in order to support communication's central role.
Assuntos
Comunicação , Currículo/normas , Educação Médica/métodos , Ensino/tendências , Humanos , Estudantes de MedicinaRESUMO
BACKGROUND: Pertussis, or whooping cough, caused by Bordetella pertussis (BP) is a re-emerging problem in our environment. Although generally considered that the disease is relatively easy to identify infections respiratory syncytial virus (RSV) can present with similar symptoms in infants remains difficult discrimination. OBJECTIVE: Compare clinical symptoms at admission and complementary studies in infants hospitalized with acute respiratory infection (ARI) and RSV by BP to establish markers that enable their early clinical prediction. MATERIALS AND METHODS: Observational, analytical, case-crossover cross comparing younger than 6 months hospitalized with suspected IRA and pertussis (2007-2012) in which BP identified (PCR and culture) and / or VRS (immunofluorescence in nasal secretions). Coinfections were excluded. Bivariate analysis was performed by calculating OR with 95% CI. Were considered significant at p <0.05. The variables studied were age, sex, hits cough, cyanosis, vomiting, apnea, wheezing and CBC with differential RESULTS: We included 174 infants, 72 (41%) BP and 102 (59%) VRS. Age 2 ± 1 months (range :1-6). In both groups was documented cough and wheeze (OR: 1.2 (0.9 to 1.5) p: 0.1 and OR = 0.9 (0.8 to 1.06) p: 0.2, respectively ). Cyanosis (87% vs. 6%, OR: 14.8 p <0.01), apnea (38% vs. 3%, OR: 13.4 p <0.01) and vomiting (26% vs. 5% , OR: 3.4 p <0.01) were more frequent in infants with BP. The absolute lymphocyte count was significantly higher in children with BP (9387 ± 6317 vs. 5127 ± 2766, p <0.01). By ROC curve was identified at 9000 cells / ml as the best point to differentiate VSR BP (AUC = 0.73, 95% CI :0,64-0, 81). CONCLUSIONS: In infants under 6 months with IRA income presence of apnea, cyanosis and lymphocytosis allowing predict significantly differentiate between pertussis those with RSV infections.
Antecedentes. La tos ferina o coqueluche, producida por Bordetella pertussis (BP) representa un problema re-emergente en nuestro medio. Aunque suele considerarse que la enfermedad es relativamente fácil de identificar, las infecciones por Virus Respiratorio Sincicial (VRS) pueden presentarse con síntomas similares en los lactantes siendo difícil su discriminación. Objetivo. Comparar síntomas clínicos y estudios complementarios al ingreso en lactantes hospitalizados con infección respiratoria aguda (IRA) por BP y por VSR a fin de establecer marcadores que posibiliten su predicción clínica temprana. Material y método. Estudio observacional, analítico, transversal de casos cruzados, comparando menores de 6 meses internados por IRA y sospecha de coqueluche (2007-2012) en los que se identificó BP (PCR y cultivo) y/o VRS (inmunofluorescencia en secreciones nasales); se excluyeron los pacientes con coinfecciones. Se realizó un análisis bivariado mediante el cálculo de OR con IC95%. Se consideró significativo un valor de p<0,05. Las variables en estudio fueron: edad, sexo, tos en accesos, cianosis, vómitos, apneas, sibilancias y hemograma completo con fórmula leucocitaria Resultados. Se incluyeron 174 lactantes; 72 (41%) BP y 102 (59%) VRS. Edad 2±1 mes (Rango:1-6). En ambos grupos se documentó tos y sibilancias (OR:1,2 (0,9-1,5) p:0,1 y OR:0,9 (0,8-1,06) p:0,2, respectivamente). Cianosis (87% vs. 6%;OR:14,8 p<0,01), apnea (38% vs. 3%;OR:13,4 p<0,01) y vómitos (26% vs. 5%;OR:3,4 p<0,01) fueron más frecuentes en lactantes con BP. El recuento absoluto de linfocitos fue significativamente mayor en niños con BP (9387±6317 vs. 5127±2766;p<0,01). Por curva ROC se identificó a 9000 cel/ml como el mejor punto para diferenciar BP de VSR (abc= 0,73; IC95%:0,64-0,81). Conclusiones. En lactantes menores de 6 meses con IRA la presencia al ingreso de apnea, cianosis y linfocitosis predicen significativamente coqueluche permitiendo diferenciarlos de aquellos con infecciones por VRS.
Assuntos
Hospitalização/estatística & dados numéricos , Infecções por Vírus Respiratório Sincicial/diagnóstico , Coqueluche/diagnóstico , Argentina , Tosse/diagnóstico , Estudos Transversais , Diagnóstico Diferencial , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Reação em Cadeia da Polimerase , Curva ROC , Coqueluche/complicações , Coqueluche/microbiologiaRESUMO
BACKGROUND: Pertussis, or whooping cough, caused by Bordetella pertussis (BP) is a re-emerging problem in our environment. Although generally considered that the disease is relatively easy to identify infections respiratory syncytial virus (RSV) can present with similar symptoms in infants remains difficult discrimination. OBJECTIVE: Compare clinical symptoms at admission and complementary studies in infants hospitalized with acute respiratory infection (ARI) and RSV by BP to establish markers that enable their early clinical prediction. MATERIALS AND METHODS: Observational, analytical, case-crossover cross comparing younger than 6 months hospitalized with suspected IRA and pertussis (2007-2012) in which BP identified (PCR and culture) and / or VRS (immunofluorescence in nasal secretions). Coinfections were excluded. Bivariate analysis was performed by calculating OR with 95
CI. Were considered significant at p <0.05. The variables studied were age, sex, hits cough, cyanosis, vomiting, apnea, wheezing and CBC with differential RESULTS: We included 174 infants, 72 (41
) BP and 102 (59
) VRS. Age 2 ± 1 months (range :1-6). In both groups was documented cough and wheeze (OR: 1.2 (0.9 to 1.5) p: 0.1 and OR = 0.9 (0.8 to 1.06) p: 0.2, respectively ). Cyanosis (87
, OR: 13.4 p <0.01) and vomiting (26
, OR: 3.4 p <0.01) were more frequent in infants with BP. The absolute lymphocyte count was significantly higher in children with BP (9387 ± 6317 vs. 5127 ± 2766, p <0.01). By ROC curve was identified at 9000 cells / ml as the best point to differentiate VSR BP (AUC = 0.73, 95
CI :0,64-0, 81). CONCLUSIONS: In infants under 6 months with IRA income presence of apnea, cyanosis and lymphocytosis allowing predict significantly differentiate between pertussis those with RSV infections.
Assuntos
Coqueluche/diagnóstico , Hospitalização/estatística & dados numéricos , Infecções por Vírus Respiratório Sincicial/diagnóstico , Argentina , Coqueluche/complicações , Coqueluche/microbiologia , Curva ROC , Diagnóstico Diferencial , Estudos Transversais , Feminino , Humanos , Lactente , Masculino , Reação em Cadeia da Polimerase , Recém-Nascido , Tosse/diagnósticoRESUMO
BACKGROUND: Pertussis, or whooping cough, caused by Bordetella pertussis (BP) is a re-emerging problem in our environment. Although generally considered that the disease is relatively easy to identify infections respiratory syncytial virus (RSV) can present with similar symptoms in infants remains difficult discrimination. OBJECTIVE: Compare clinical symptoms at admission and complementary studies in infants hospitalized with acute respiratory infection (ARI) and RSV by BP to establish markers that enable their early clinical prediction. MATERIALS AND METHODS: Observational, analytical, case-crossover cross comparing younger than 6 months hospitalized with suspected IRA and pertussis (2007-2012) in which BP identified (PCR and culture) and / or VRS (immunofluorescence in nasal secretions). Coinfections were excluded. Bivariate analysis was performed by calculating OR with 95
CI. Were considered significant at p <0.05. The variables studied were age, sex, hits cough, cyanosis, vomiting, apnea, wheezing and CBC with differential RESULTS: We included 174 infants, 72 (41
) BP and 102 (59
) VRS. Age 2 ± 1 months (range :1-6). In both groups was documented cough and wheeze (OR: 1.2 (0.9 to 1.5) p: 0.1 and OR = 0.9 (0.8 to 1.06) p: 0.2, respectively ). Cyanosis (87
vs. 6
, OR: 14.8 p <0.01), apnea (38
vs. 3
, OR: 13.4 p <0.01) and vomiting (26
vs. 5
, OR: 3.4 p <0.01) were more frequent in infants with BP. The absolute lymphocyte count was significantly higher in children with BP (9387 ± 6317 vs. 5127 ± 2766, p <0.01). By ROC curve was identified at 9000 cells / ml as the best point to differentiate VSR BP (AUC = 0.73, 95
CI :0,64-0, 81). CONCLUSIONS: In infants under 6 months with IRA income presence of apnea, cyanosis and lymphocytosis allowing predict significantly differentiate between pertussis those with RSV infections.
Assuntos
Hospitalização/estatística & dados numéricos , Infecções por Vírus Respiratório Sincicial/diagnóstico , Coqueluche/diagnóstico , Argentina , Tosse/diagnóstico , Estudos Transversais , Diagnóstico Diferencial , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Reação em Cadeia da Polimerase , Curva ROC , Coqueluche/complicações , Coqueluche/microbiologiaRESUMO
BACKGROUND: The etiology of pneumonia is important to indicate antibiotics. A clinical prediction score (RP) has been designed, although the radiological interpretation is not easy. OBJECTIVE: To design a simple prediction score (PRs) to identify etiology in children with pneumonia, including radiological patterns, clinical and laboratory features. METHODS: Cross sectional study. We prospectively included children under 5 years hospitalized for pneumonia with microbiological evidence (2007-2008). According to the RP, were allocated 3 points when the temperature value was ≥ 39 º C, 2 when the patient age was ≥ 9 months, 2 when the number of neutrophils was 8000/mm3 and 1 when the immature neutrophils number was ≥ 5%. Radiography was evaluated as one point when consolidation was diagnosed and 0 point when pleural effusion or other infiltrations were present. RPS range was from 0 to 9 points. We determined the best cutoff for predicting bacterial pneumonia (ROC) and was calculated based on the same sensitivity (S), specificity (Sp), positive predictive value (PPV) and negative (NPV) and positive likelihood ratio ( RVP) and negative (NLR). RESULTS: 196 patients (viral: 82%, bacteria: 18%), 8.7 ± 10 months. We identified a score ≥ 3 (auROCc = 0.87 95% CI 0.81 to 0.94) as the best point to predict bacterial pneumonia (S: 88.6%, E: 68.9%, PPV: 38.3 %, NPV: 96.5% RVP: 2.85; RPN: 0.17). CONCLUSION: The PRs showed an acceptable performance, but less sensitive than the original score to predict bacterial pneumonia. Although this tool may be easily applied, it should be validated in future studies.
Assuntos
Pneumonia Bacteriana/diagnóstico , Pneumonia Viral/diagnóstico , Argentina/epidemiologia , Pré-Escolar , Estudos Transversais , Hospitalização , Humanos , Lactente , Recém-Nascido , Pneumonia Bacteriana/epidemiologia , Pneumonia Viral/epidemiologia , Valor Preditivo dos Testes , Prevalência , Estações do AnoRESUMO
INTRODUCTION: Although not useful, antibiotics are commonly prescribed in infants with viral pneumonia. OBJECTIVE: To compare initial prescription and suspension rates of antibiotics in infants hospitalized with pneumonia by respiratory syncytial virus (RSV) in 2002, when introducing the viral testing, and in 2007, after 5 years of this practice. POPULATION AND METHODS: Children aged under 13 months hospitalized for RSV pneumonia during two years (2002 and 2007) were included. Prescription and discontinuation of antibiotics were registered. Data were analyzed using Chi squared and T tests, assuming p <0.05 as significance level. RESULTS: Antibiotics were prescribed in 57% (40/70) of patients in 2002 and 46% of then (29/63) in 2007. After achieving RSV diagnosis, antibiotics were more frequently discontinued in 2007 than in 2002 (31/63 vs. 14/70; p= 0.012; OR: 3.73; IC 95%:1.1512.49). CONCLUSION: Although antibiotic empirical prescription rate was similar in both periods, after achieving RSV diagnosis antibiotics were more frequently discontinued in 2007.