RESUMO

BACKGROUND: In regions with controlled vector transmission of T. cruzi, congenital transmission is the most frequent route of infection. Treatment with benznidazole (BZ) or nifurtimox (NF) for 60 days in girls and women of childbearing age showed to be effective in preventing mother to child transmission of this disease. Reports on short-course treatment (≤30 days) are scarce. METHODS: Retrospective cohort study. Offspring of women with Chagas disease who received short-course treatment (≤30 days) with BZ or NF, attended between 2003 and 2022, were evaluated. Parasitemia (microhaematocrit and/or PCR) was performed at <8 months of age, and serology (ELISA and IHA) at ≥8 months to rule out congenital infection. RESULTS: A total of 27 women receiving ≤30 days of treatment and their children were included in this study. NF was prescribed in 17/27 (63%) women, and BZ in 10/27 (37%). The mean duration of treatment was 29.2 days. None of the women experienced serious adverse events during treatment, and no laboratory abnormalities were observed. Forty infants born to these 27 treated women were included. All newborns were full term, with appropriate weight for their gestational age. No perinatal infectious diseases or complications were observed. DISCUSSION: Several studies have shown that treatment of infected girls and women of childbearing age for 60 days is an effective practice to prevent transplacental transmission of T. cruzi. Our study demonstrated that short-duration treatment (≤30 days) is effective and beneficial in preventing transplacental transmission of Chagas disease.

Assuntos

RESUMO

Refractory hypoxemia (RH) during venovenous extracorporeal membrane oxygenation (VV ECMO) support is a complex problem that limits the benefit of this therapy. The need for sustained deep sedation and delays in active rehabilitation are considered as a direct consequence of RH. Changing from VV ECMO to a configuration that returns the flow to pulmonary artery, such as venopulmonary extracorporeal membrane oxygenation (VPa ECMO) may decrease recirculation and improve systemic oxygen delivery. We present a retrospective report that describes the impact of VPa ECMO on oxygenation during sedation withdrawal in 41 patients who received VV ECMO for coronavirus disease 2019 (COVID-19). We evidenced that arterial oxygen pressure (PaO 2 ) increased from 68 to 112.3 mm Hg ( p = 0.001) with a reduction of ECMO flow (5.7-4.8 L/m; p = 0.001). Other findings included lower rates of depth sedation (Richmond Agitation Sedation Scale [RASS] ≤3, 37-63%; p = 0.007) and lower requirement inotropic support assessed by LVIS score (4.7-1.1; p = 0.005). Discharge survival was 54% with a sustained benefit until day 79. This cannulation strategy improved effectively PaO 2 in this cohort, it may be an alternative in patients with RH in VV ECMO.

Assuntos

RESUMO

Recent research has documented the interest of organizations in training their staff in soft skills, but few studies have been found. Therefore, the objective of this research was to analyze 753 publications in the Scopus database related to soft skills in staff training during the period 1999-2021. These documents were analyzed to identify the main information, the most explored areas, and a future research agenda; all under a bibliometric and bibliographic approach with the help of RStudio and VOSviewer software. The results showed that the keywords with the most co-occurrence were personnel training (n = 110) and soft skills (n = 79). The year with the most documents was 2021 (n = 121). The country with the most publications was the United Kingdom (n = 199). Medicine is the subject area with the most documents (n = 278) and the Article is the type of document with the most studies (n = 566). Eleven areas of further exploration were identified: "Soft skills in software engineering at the higher education level", "Soft skills and communication", "Soft skills and engineering education", "Soft skills in virtual environments", "Soft skills in machine learning", "Serious games in teaching soft skills", "Soft skills for problem-based learning", "Soft skills for project management", "Soft skills and technical skills", "Project-based learning for the assessment of soft skills" and "Soft leadership skills". Five potential areas for future research were derived: soft skills in collaborative work (CSCL), soft skills in computer-aided collaborative work (CSCW), facial expressions as a mirror of soft skills, soft skills for employability and Professional Development Plan (PDP) to assess soft skills. In conclusion, this Review type document on soft skills in personnel training helped to identify the most studied topics during the evaluated period, as well as to identify the little explored topics for future research.

RESUMO

RESUMEN La biomecánica es una ciencia que ayuda al estudio de los movimientos aplicados en distintos deportes, incluyendo el fútbol, que permite identificar y corregir errores técnicos. Esta es una base fundamental para el control de la preparación del deportista. En tal sentido, se planteó como propósito de la investigación analizar biomecánicamente el pase con borde interno del pie en futbolistas prejuveniles y juveniles de Formativas y Academia. La investigación es de tipo descriptiva-explicativa, de orden correlacional; se diagnostican biomecánicamente a 40 futbolistas en dos grupos independientes (grupo 1: Formativas; grupo 2: Academia; entre 14-18 años). Se analizan diez indicadores, se incluye la edad. Se demostraron diferencias significativas en el indicador "DB" (p=0.000), el indicador "ÁFRA" (p=0.006), el indicador "DPAE" (p=0.000), y los indicadores "VF", "A" y "TE" (p=0.000) respectivamente, mientras que las variables o indicadores "ÁFRE" (p=1.000), "EX" (p=0.102) y "EY" (p=0.056) no presentaron diferencias significativas entre los grupos independientes. En la comparación realizada con los jugadores de un equipo profesional y los jugadores de una Academia de formación, se pudo evidenciar que existen diferencias notables desde la fase inicial del pase con el borde interno del pie, mostrando la distancia del jugador con respecto al balón, así como en la fase previa donde los jugadores de Formativas poseen una mejor ejecución del movimiento técnico; esto se refleja en la fase de contacto donde se evidencia una mayor velocidad y aceleración al momento del impacto con el balón.

RESUMO A biomecânica é uma ciência que ajuda o estudo dos movimentos aplicados em diferentes desportos, incluindo o futebol, o que permite a identificação e correção de erros técnicos. Esta é uma base fundamental para o controlo da preparação do atleta. Neste sentido, o objectivo da investigação era analisar biomecanicamente o passe com a extremidade interna do pé em jogadores de futebol pré-juvenil e juvenil em treino e academia. A investigação é de tipo descritivo-explicativo, de ordem correlativa; 40 jogadores de futebol são diagnosticados biomecanicamente em dois grupos independentes (Grupo 1: Formação; Grupo 2: Academia; entre 14-18 anos de idade). Foram analisados dez indicadores, incluindo a idade. Foram demonstradas diferenças significativas no indicador "DB" (p=0,000), o indicador "ÁFRA" (p=0,006), o indicador "DPAE" (p=0,000), e os indicadores "VF", "A" e "TE" (p=0,000) respectivamente, enquanto que as variáveis ou indicadores "ÁFRE" (p=1,000), "EX" (p=0,102) e "EY" (p=0,056) não apresentavam diferenças significativas entre os grupos independentes. Na comparação feita com os jogadores de uma equipa profissional e com os jogadores de uma academia de treino, constatou-se que existem diferenças notáveis em relação à fase inicial do passe com a borda interior do pé, mostrando a distância do jogador em relação à bola, bem como na fase anterior em que os jogadores da academia de treino têm uma melhor execução do movimento técnico; isto reflete-se na fase de contato onde é evidente uma maior velocidade e aceleração no momento do impacto com a bola.

ABSTRACT Biomechanics is a science that helps the study of movements applied in different sports, including soccer, which allows identifying and correcting technical errors. This is a fundamental basis for the control of the athlete's preparation. In this sense, the purpose of the research was to analyze biomechanically the pass with the inner edge of the foot in pre-juvenile and youth soccer players of training and academy. The research is of descriptive-explanatory type, of correlational order; 40 soccer players were biomechanically diagnosed in two independent groups (Group 1: Formative; Group 2: Academy; between 14-18 years). Ten indicators are analyzed, including age. Significant differences were demonstrated in the "DB" indicator (p=0.000), the "ÁFRA" indicator (p=0.006), the "DPAE" indicator (p=0.000), and the "VF", "A" and " TE" (p=0.000) respectively, while the variables or indicators "ÁFRE" (p=1.000), "EX" (p=0.102) and "EY" (p=0.056) did not present significant differences between the independent groups. In the comparison made with the players of a professional team and the players of a training academy, it was possible to show that there are notable differences from the initial phase of the pass with the inner edge of the foot, showing the distance of the player with respect to the ball, as well as in the previous phase where the players in formatiom have a better execution of the technical movement; this is reflected in the contact phase where greater speed and acceleration are evident at the moment of impact with the ball.

RESUMO

RESUMEN El tiro libre en el fútbol es una de las técnicas deportivas de importancia, la cual permite reanudar el juego luego de la falta cometida por el otro jugador. La potenciación de la habilidad motriz específica permite desarrollar mayores rendimientos a corto y largo plazo, por lo cual su caracterización es importante para desarrollar metodologías especializadas en las etapas de iniciación deportiva. En tal sentido, la presente investigación tuvo por objetivo analizar las diferencias biomecánicas del tiro libre entre jugadores avanzados y amateur de fútbol. Este estudio es de tipo descriptivo-explicativo de orden correlacional, se diagnostican intencionalmente a 30 futbolistas de la Escuela de Fútbol Chiqui Park (16-32 años de edad), clasificados en dos grupos independientes, el grupo 1 con futbolistas avanzados, y el grupo 2 con futbolistas de nivel amateur. Se evalúan tres variables: el ángulo inicial de la Fase unipodal (AIFU), el ángulo final de la fase final (AFF), y el tiempo de ejecución del tiro libre (TE). No se evidencian diferencias significativas entre grupos independientes en las variables angulares AIFU (p=0.683) y AFF (p=0.389), y una diferencia significativa a favor del grupo 2 en la variable TE (p=0.000). Sin embargo, todos los rangos promedios favorecieron a los futbolistas de nivel avanzado. Existe la necesidad de establecer integralmente mayores estudios que caractericen las categorías formativas estudiadas, sirviendo de base teórica y metodología que fundamente el desarrollo de acciones técnico-tácticas y físicas de consideración en los procesos de dirección del entrenamiento deportivo.

RESUMO O pontapé livre no futebol é uma das técnicas desportivas mais importantes, que permite o reinício do jogo após uma falta cometida pelo outro jogador. A potenciação da habilidade motora específica permite o desenvolvimento de desempenhos mais elevados a curto e longo prazo, razão pela qual a sua caracterização é importante para desenvolver metodologias especializadas nas fases de iniciação ao desporto. Neste sentido, o objectivo desta investigação era analisar as diferenças biomecânicas do pontapé livre entre jogadores de futebol avançados e amadores. Este estudo é de um tipo descritivo-explicativo de ordem correlacional, 30 jogadores de futebol da Escola de Futebol do Chiqui Park (16-32 anos de idade) são intencionalmente diagnosticados, classificados em dois grupos independentes, grupo 1 com jogadores de futebol avançados, e grupo 2 com jogadores de futebol amadores. São avaliados os seguintes São avaliadas três variáveis de interesse: o ângulo inicial da fase unipodal (AIFU), o ângulo final da fase final (AFF), e o tempo de execução do lançamento livre (TE). Não foram evidentes diferenças significativas entre grupos independentes nas variáveis angulares AIFU (p=0,683) e AFF (p=0,389), e uma diferença significativa a favor do grupo 2 na variável TE (p=0,000). No entanto, todas as gamas médias favoreceram os jogadores de nível avançado. Há necessidade de estabelecer de forma abrangente outros estudos que caracterizem as categorias de formação estudadas, servindo como base teórica e metodológica para o desenvolvimento de ações técnico-tácticas e físicas de consideração nos processos de gestão da formação desportiva.

ABSTRACT The free kick in soccer is one of the important sports techniques, which allows the game to resume after a foul committed by the other player. The enhancement of specific motor skills allows the development of higher performance in the short and long term, for which its characterization is important to develop specialized methodologies in the stages of sports initiation. In this sense, the present research aimed to analyze the biomechanical differences of the free kick between advanced and amateur soccer players. This study is of a descriptive-explanatory type of correlational order, 30 soccer players from the Chiqui Park Soccer School (16-32 years of age) are intentionally diagnosed, classified into two independent groups, group 1 with advanced soccer players, and group 2 with amateur level soccerers. Three variables of interest are evaluated: the Initial Angle of the Unipodal Phase (AIFU in Spanish), the Final Angle of the Final Phase (AFF in Spanish), and the Execution Time of the Free Throw (TE in Spanish). There are no significant differences between independent groups in the angular variables AIFU (p=0.683) and AFF (p=0.389), and a significant difference in favor of group 2 in the variable TE (p=0.000). However, all the average ranges favored the advanced level players. There is a need to comprehensively establish larger studies that characterize the training categories studied, serving as a theoretical basis and methodology that supports the development of technical-tactical and physical actions of consideration in the processes of sports training management.

RESUMO

BACKGROUND: The role that the genetic diversity of natural Trypanosoma cruzi populations plays in response to trypanocidal treatment of chronic Chagas disease (CD) patients remains to be understood. We analysed the genetic polymorphisms of parasite bloodstream populations infecting chronic CD patients enrolled in the E1224 clinical trial. METHODS: A total of 506 baseline and post-treatment follow-up samples from 188 patients were analysed. T. cruzi satellite DNA (satDNA) was amplified and sequenced using cruzi1/cruzi2 primers, and samples with TcI/III, TcII, TcIV or hybrid satDNA sequences were identified. Minicircle signatures were obtained after kinetoplast DNA amplification using 121/122 primers and restriction enzyme digestion. Genetic distances between baseline and post-treatment minicircle signatures were estimated using the Jaccard coefficient. RESULTS: At baseline, 74.3% TcII, 17.9% hybrid and 7.8% TcI/III satDNA sequences were found, whereas at the end of follow-up the distribution was 55.2% TcII, 35.2% hybrid and 9.5% TcI/III. The placebo arm was the treatment group with the highest variation of satDNA sequences between baseline and post-treatment follow-up. Genetic distances between baseline and post-treatment minicircle signatures were similar among all treatment arms. No association between minicircle signature variability and satDNA type distribution was found. CONCLUSIONS: Genetic variability of T. cruzi bloodstream populations during post-treatment follow-up did not differ from that observed during chronic infection in the absence of treatment, suggesting that there were no selection events of E1224-resistant parasite populations. This is the first report documenting the genetic polymorphism of natural T. cruzi populations in chronic patients in the context of clinical trials with trypanocidal drugs.

Assuntos

RESUMO

Introducción. El tumor de Wilms es la neoplasia abdominal más común en pacientes pediátricos. En la mayoría de los casos se presenta como una masa unilateral indolora en el abdomen. El objetivo de este artículo fue presentar el caso de una paciente de 4 años con tumor de Wilms unilateral derecho manejado con cirugía mínimamente invasiva en el Hospital Universitario del Valle. Métodos. Revisión de la historia clínica e imágenes de la paciente, descripción de la técnica quirúrgica y revisión de la literatura del manejo de tumor de Wilms unilateral. Caso clínico. Paciente femenina de 4 años quien consultó en abril de 2019 por un cuadro clínico de dolor abdominal y sensación de masa en flanco derecho. Se realizó ecografía abdominal donde se encontró imagen nodular heterogénea de contornos definidos en riñón derecho, con riñón izquierdo normal. Se hizo diagnóstico de tumor de Wilms unilateral y se llevó a cirugía mediante abordaje mínimamente invasivo, con buena evolución postoperatoria. Conclusión. La cirugía es el pilar del manejo, y la nefrectomía mediante abordaje laparoscópico para casos seleccionados, en manos entrenadas, tiene la suficiente eficacia, seguridad y cumplimiento de los principios quirúrgicos y oncológicos que provee la cirugía abierta.

Introduction. Wilms tumor is the most common abdominal neoplasm in pediatric patients. In most cases it presents as a painless unilateral mass in the abdomen. The objective of this article was to present the case of a 4-year-old patient with right unilateral Wilms tumor managed with minimally invasive surgery at the Hospital Universitario del Valle. Methods. Review of the patient's clinical history and images, description of the surgical technique and review of the literature on the management of unilateral Wilms tumor.Clinical case. A 4-year-old female patient who consulted on April 4, 2019 with a clinical presentation of abdominal pain and sensation of mass in the right flank. Abdominal ultrasound was performed where a heterogeneous nodular image of defined contours was found in the right kidney, with a normal left kidney. A diagnosis of unilateral Wilms tumor was made and surgery was carried out using a minimally invasive approach, with good postoperative evolution. Conclusion. Wilms tumor is the most common abdominal neoplasm in pediatric patients. The most common presentation is a painless palpable mass. Surgery is the mainstay of management, and nephrectomy using a laparoscopic approach for selected cases, in trained hands, has sufficient efficacy, safety, and compliance with surgical and oncological principles that open surgery provides.

Assuntos

RESUMO

Atherosclerosis is responsible for the majority of heart attacks and is characterized by several modifications of the arterial wall including an inflammatory reaction. The silent course of atherosclerosis has made it necessary to develop predictors of disease complications before symptomatic lesions occur. Vulnerable to rupture atherosclerotic plaques are the target for molecular imaging. To this aim, different radiopharmaceuticals for PET/CT have emerged for the identification of high-risk plaques, with high specificity for the identification of the cellular components and pathophysiological status of plaques. By targeting specific receptors on activated macrophages in high-risk plaques, radiolabelled somatostatin analogues such as 68Ga-DOTA-TOC, TATE,0 or NOC have shown high relevance to detect vulnerable, atherosclerotic plaques. This PET radiopharmaceutical has been tested in several pre-clinical and clinical studies, as reviewed here, showing an important correlation with other risk factors.

RESUMO

Introducción. El prolapso uretral es una entidad poco común, con una incidencia estimada de 1 en 3000 mujeres. Se presenta cuando la mucosa uretral sobresale espontáneamente más allá del meato uretral. Es una patología poco diagnosticada dada su baja frecuencia y de allí la importancia de conocer sobre su presentación, diagnóstico y tratamiento. El objetivo de este artículo fue presentar el caso de una paciente de 10 años con diagnóstico de prolapso uretral y su manejo quirúrgico. Caso clínico. Paciente femenina de 10 años, que consultó por cuadro clínico de 1 año de evolución consistente en dolor en región urogenital, que se irradiaba a hipogastrio, asociado a pujo y disuria, a quien se le diagnosticó prolapso uretral y se realizó corrección quirúrgica de mucosa uretral prolapsada mediante técnica de Kelly-Burnham modificada. Conclusión. El prolapso uretral es una entidad que con frecuencia es diagnosticada erróneamente pues su diagnóstico es eminentemente clínico. Si bien se ha descrito el tratamiento médico en primera instancia, éste tiene una alta tasa de recurrencia, por lo que en estos casos se prefiere la resección quirúrgica del tejido prolapsado.

Introduction. Urethral prolapse is a rare entity, with an estimated incidence of 1 in 3,000 women. It occurs when the urethral mucosa spontaneously protrudes beyond the urethral meatus. It is a poorly diagnosed pathology given its low frequency and hence the importance of knowing about its presentation, diagnosis and treatment. The objective of this article was to present the case of a 10-year-old patient with a diagnosis of urethral prolapse and its surgical management. Clinical case. A 10-year-old female patient, who consulted for a 1-year clinical picture consisting of pain in the urogenital region, radiating to the hypogastrium, associated with pushing and dysuria, who was diagnosed with urethral prolapse and a surgical correction of the urethral mucosa was performed prolapsed by modified Kelly-Burnham technique. Conclusion. Urethral prolapse is an entity that is frequently misdiagnosed because its diagnosis is eminently clinical. Although medical treatment has been described in the first instance, it has a high recurrence rate, so surgical resection of the prolapsed tissue is preferred in these cases.

Assuntos

RESUMO

BACKGROUND: Current algorithm for Congenital Chagas Disease (cCD) diagnosis is unsatisfactory due to low sensitivity of the parasitological methods. Moreover, loss to follow-up precludes final serodiagnosis after nine months of life in many cases. A duplex TaqMan qPCR kit for Trypanosoma cruzi DNA amplification was prospectively evaluated in umbilical cord (UCB) and peripheral venous blood (PVB) of infants born to CD mothers at endemic and non-endemic sites of Argentina. METHODS: We enrolled and followed-up 370 infants; qPCR was compared to gold-standard cCD diagnosis following studies of diagnostic accuracy guidelines. FINDINGS: Fourteen infants (3·78%) had cCD. The qPCR sensitivity and specificity were higher in PVB (72·73%, 99·15% respectively) than in UCB (66·67%, 96·3%). Positive and negative predictive values were 80 and 98·73% and 50 and 98·11% for PVB and UCB, respectively. The Areas under the Curve (AUC) of ROC analysis for qPCR and micromethod (MM) were 0·81 and 0·67 in UCB and 0·86 and 0·68 in PVB, respectively. Parasitic loads ranged from 37·5 to 23,709 parasite equivalents/mL. Discrete typing Unit Tc V was identified in five cCD patients and in six other cCD cases no distinction among Tc II, Tc V or Tc VI was achieved. INTERPRETATION: This first prospective field study demonstrated that qPCR was more sensitive than MM for early cCD detection and more accurate in PVB than in UCB. Its use, as an auxiliary diagnostic tool to MM will provide more accurate records on cCD incidence. FUNDING: FITS SALUD 001-CHAGAS (FONARSEC, MINCyT, Argentina) to the Public-Private Consortium (INGEBI-CONICET, INP-ANLIS MALBRAN and Wiener Laboratories); ERANET-LAC-HD 328 to AGS and PICT 2015-0074 (FONCYT, MinCyT) to AGS and FA.

Assuntos