bluuebunny/crossref_metadata_2025 huggingface dataset:
Combination of Thyroxine with Vitamin B12 on Motor Nerve Conduction Study of Ulanr Nerve in Newly Diagnosed Hypothyroid Female
Authors: Ahmed Farjana , Sultana Nayma , Chowdhury Md Arifuzzaman , Banik Shyamal Chandra , Saha Kartik Chandra , Rahman Mahaboba
Published: October 2022

Introduction: Combination of thyroxine with vitamin B12 can improve the motor nerve conduction study of ulnar nerve in newly diagnosed hypothyroid female.
Objectives: To observe the combined effects of thyroxine with vitamin B12 on motor nerve conduction study of ulnar nerve of newly diagnosed hypothyroid female
Materials and Methods: This prospective interventional study was carried out in the Department of Physiology, Sir Salimullah Medical College (SSMC) between July’ 2015 to June’ 2016 on 40 newly diagnosed hypothyroid female. Among them, 20 hypothyroid patients received only thyroxine (HT-T4 ) and another 20 hypothyroid patients received combined therapy of thyroxine with vitamin B12 (HT-C) for 90 consecutive days. Motor 2 nerve conduction study of ulnar nerve was studied to observe the electrophysiological status and vitamin B12 level was also estimated to observe its level by using standard method. The statistical analysis was done by ANOVA test, paired, independent sample ‘t’ test and Chi-square (χ 2 ) test as applicable.
Results: In this study, latency was significantly decreased, amplitude and NCV were significantly increased in motor functions of ulnar nerve of hypothyroid patients after 90 days supplementation of combined therapy of thyroxine with vitamin B12 in comparison to those of their pre-supplemented state and also to those of patients with only thyroxine treatment.
Conclusion: The combination of thyroxine with vitamin B12 can reduce the symptoms of hypothyroid neuropathy and accelerate the nerve conduction velocity of motor functions of ulnar nerve more efficiently than the treatment with thyroxine alone.
Medicine Today 2022 Vol.34(2): 117-120
Evaluation of Extra-Cranial Carotid Arteries by Digital Subtraction Angiogram (DSA) in Stroke Patients in a Tertiary Care Hospital
Authors: Ahmed Reza Nasim , Begum Most Mahmuda , Rashid Md Abdur , Azam Md Shafiul , Fatematujjahura Mst , Kabir Md Raseul
Published: October 2022

Introduction: Carotid artery stenosis is one of the important causes of ischemic stroke. This may be diagnosed by Doppler Ultrasound and Digital Subtraction Angiogram (DSA) both of which have some advantages and disadvantages.
Objective: The aim of this study was to assess extra-cranial carotid artery with the help of DSA among patients of ischemic stroke and transient ischemic attack (TIA).
Materials and Methods: This observational cross sectional study was conducted in the Department of Neurology in Bangabandhu Sheikh Mujib Medical University (BSMMU) Dhaka from July 2013 to June 2015 for a period of two years. This study included a total of 50 patients. Diagnostic performance test of DSA was done at 50%, 50-69%, 70-99%, 100% cut off point of stenosis of right internal carotid artery (RICA) and Left internal carotid artery (LICA).
Results: The mean age of cases was 61 ± 11.42 years. Out of 50 vessels, maximum cases were diagnosed as <50% stenosis of carotid artery (26 cases of RICA, 23 cases of LICA. Out of 50 vessels, 50%-69%, 70 but _ less than near occlusion and total occlusion were found among 10, 10, 4 vessels in RICA and 10, 9, 8 vessels in LICA respectively. The present study showed that 50 vessels of RICA was measured by DSA and diagnosed 28 (56%), 10 (20%), 7 (14%) and 5 (10%) carotid vessels as _ 50%, 50-69%, _70% but less than total occluded and total occluded cases respectively. This study also showed that 50 vessels of LICA was measured by DSA and diagnosed 23 (56%), 12 (24%), 8 (16%), 7 (14%) carotid vessels as _ 50%, 50-69%, _ 70% but less than total occluded and total occluded cases respectively.
Conclusion: DSA as the gold standard has amply been performed in most diagnostic circumstances of carotid artery stenosis. So, the present study was done to evaluate extra cranial carotid arterial system by DSA in stroke patients in Bangladesh.
Medicine Today 2022 Vol.34(2): 121-124
Effect of Activity (ADL) Modification on Reduction of Pain in Patients with Chronic Non-Specific Low Back Pain
Authors: Kamrul Islam Khandaker Md , Hoque Md Ahsanul , Akter Mahamuda
Published: October 2022

Introduction & Objective: : Low back pain is the commonest cause of activity limitations and absence of work in developing country like Bangladesh. The aim of this study was to chalk out the association between ADL modification with chronic low back pain.
Materials & Methods: : This Randomized Clinical Trial was performed in the Department of Physical Medicine and Rehabilitation, JRRMCH, Sylhet. Eighty patients of 30 to 60 years old, fulfilling the selection criteria were included in this study. Patients were divided into two groups after randomization by lottery method. Patients of Group-A were treated with NSAID, Anti-ulcerant & Activity (ADL) Modification while patients of Group-B were treated with NSAID and Anti-ulcerant only. Patients of both groups were treated for six weeks. Main outcome measures were Subjective Pain Intensity Score, VAS, Tenderness Index, Disability due to pain, Spinal Mobility Index and Oswestry Disability Index.
Results: Majority of the patients of both groups were 30 to 40 years old (52.5% in Group-A and 47.5% in Group-B). Males were predominant in both groups. While majority belongs to middle socio-economic class, occupationally farmers were majority in both groups (22.5% in Group-A and 20% in Group-B). VAS was better in patients who received instructions about activity (ADL) modification than those who did not receive them. Subjective Pain Intensity Score and Tenderness Index improved in both groups but their difference was not statistically significant. Disability due to Pain and Spinal Mobility Index, both the variables improved at the end of 3rd week and their difference was statistically significant (P<0.05).
Conclusion: From the study it can be concluded that Activity (ADL) Modification helps to reduce pain in patients with chronic non-specific low back pain.
Medicine Today 2022 Vol.34(2): 140-144
Study of Changes in Serum Calcium Level during Postmenopausal Period of Women in Bangladesh
Authors: Nargis Susmita , Bhuyan Rasel , Roy Heera Lal , Mahmudul Hasan Kazi Muhammad , Chakraborty Pijush Kumar
Published: October 2022

Introduction: The study was designed to evaluate the serum calcium levels may be altered in postmenopausal women.
Materials and Methods: This case control study was carried out in the Department of the Biochemistry, Mymensingh Medical College, Mymensingh, from January 2015 to December 2015. The subjects were selected on the basis of inclusion and exclusion criteria by purposive (non-random) method. This study included 50 postmenopausal women as case.
Results: The results were compared with 50 apparently healthy premenopausal women as control. All statistical analysis was done by SPSS windows package. The values were expressed as Mean ± SD. Statistical significance of difference between two groups were evaluated by using student’s unpaired t-test. Serum calcium level was analyzed. Serum calcium was determined by using colorimetric method. The mean value of serum calcium was 8.59±1.02 (mg/dl) respectively in group B (Case) and 6.36 ± 1.06 (mg/dl ) in group A(Control). The levels of serum calcium was significantly decreased in group B.
Conclusion: Menopause has an effect on serum calcium which leads to increased risk of development of osteoporosis. The present study may facilitated the clinicians and gynecologists to update their knowledge in regard to serum calcium level of women associated with menopause.
Medicine Today 2022 Vol.34(2): 150-152
Health Education Services in the Selected District Hospitals: Service Providers and Service Receivers Perspective
Authors: Begum Razia , Begum Most Rowshona , Akter Margia , Sultana Nihar
Published: October 2022

This descriptive cross-sectional study was carried out for one year in two district hospitals under Dhaka division among 71 service providers and 135 service receivers with the aim of assessing the status of health education services in district hospitals from both service receivers and service providers' perspective. Data was collected from the respondents through face-to-face interviews using a pretested semi-structured questionnaire. The study revealed that health education was provided in the district hospitals mainly by nurses (78.9%), followed by physicians (14.1%) and health education officers (7.0%). Among them, 54.9% were trained in health education. They were providing health education on environmental and personal hygiene, food and nutrition, immunization, diarrhoea, breast feeding, antenatal care, postnatal care, tuberculosis and pneumonia through different methods. In spite of having limitations on health education support services, most of the service receivers were satisfied with the cooperation as well as the media or methods of health education used by the service providers during health education sessions. The findings of this study may be useful for the improvement of the health education service status in the district level hospitals.
Update Dent. Coll. j: 2022; 12(2): 3-6
Post traumatic stress disorder and the associated factors among the survivors of road traffic accident attending in a specialized hospital in Dhaka
Authors: Haque Shayla , Sultana Nihar , Banu Nelufar , Tahsin Tania
Published: October 2022

Background: Post traumatic stress disorder (PTSD) is the most common mental disorder occurring among survivors of road traffic accidents (RTA). It could result in long-term adverse consequences if left untreated, mainly leading to social and functional impairments of RTA survivors, which finally results in a poor quality of life. Objectives: To assess the prevalence of PTSD among the RTA survivors and the associated factors of it. Materials & methods: An institution-based cross-sectional study was carried out among 202 admitted RTA patients in the inpatient department of a specialized hospital in Dhaka city for one year duration. Data were collected from these patients using a semi structured interview administered questionnaire where the Diagnostic and Statistical Manual-IV DSM-IV(PCL-S) checklist used to assess PTSD. The collected data were analyzed by using SPSS software (Version 21) and p < 0.05 considered as significant.  Results: A total 202 RTA patients were included in the study and the prevalence of probable PTSD among RTA survivors was 41.1% according to DSM-IV(PCL-S) checklist. The mean age of RTA survivors found 37.6 (±13.2) years, majority 57.4% belongs to 18-30 years age group. The mean PTSD score found was 44.1(±8.2), 9.2% RTA survivors had previous history of known depressive symptoms. Among the socio-demographic attributes, age and occupation were significantly associated with the PTSD; other accident related factors like time since accident and type of accident were strongly associated with the PTSD. Conclusion: This study found a high prevalence of PTSD among RTA survivors with some associated significant sociodemographic and accident-related factors. The findings suggest a need for early screening for PTSD among the survivors of RTA.
Update Dent. Coll. j: 2022; 12(2): 14-18
Clinical Profile and Management of Oral Cancer Patients in a Tertiary Care Hospital in Bangladesh
Authors: Khandker Md Nazmul Hasan , Haque Aminul , Hasan Md Nadimul , Chowdhury Md Tawfique Hossain , Ali Syed Mohammad Moshab , Afroze Yeasmin Jahan , Baidya Pulok
Published: October 2022

Introduction:  Oral cavity cancer is the 11th most common cancer worldwide, and the incidence rate of lip & oral cavity cancer in Bangladesh in 2020 was 8.9%. The National Institute of Cancer Research and Hospital (NICRH) is a specialized hospital for cancer patient care where all treatment modalities are available. This study was conducted in the faciomaxillary surgical oncology department (FMSO) to see the patient profile and management of oral cancer patients at NIRCH. Materials and methods: This observational study was carried out from January 2017 to December 2020 with hitopathologically proven oral cancer patients. Data of outdoor patients were collected from the OPD and tumor board registers, and indoor patient’s data were collected from the discharge register.  Relevant variables were included in the data collection, such as epidemiological features (age, sex) and clinicopathological data (primary site of tumor, disease pattern, TNM staging, presentation status, management of patients by tumor board decision, and surgical management). Collected data were summarized and analyzed by statistical package for the social science SPSS (version 24.0) and results were presented in table, chart, and graph form.
Results: A total of 6869 patients were enrolled in the study, where 55% were female and 45% were male, with a male to female ratio of 0.82:1. Buccal mucosa was the most common site (44%) followed by lower gingivo-buccal sulcus (21%). Eighty-eight percent of the total cases were squamous cell carcinoma. Early-stage lesions were only 6% whereas advanced-stage lesions were 94%.  Among preoperative patients, 1992 (29%) were operable and 4877 (71%) were inoperable. The tumor board decided nearly 50% of patients for chemo-radiation, 10% for surgery and radiotherapy each. Among the operable patients, only 244 (20%) were operated on in our department in a four-year period. Conclusion: It is evident from this study that most of the patients present in the advanced stage illustrate the necessity for the inclusion of oral health care in primary health care by the government for early detection of oral cancer in Bangladesh.
Update Dent. Coll. j: 2022; 12(2): 27-31
Uji Model Keberlangsungan dan Status Keberhasilan Kelompok Usaha Bersama Sebagai Bahan Evaluasi Program
Authors: Risnandar Risnandar
Published: October 2022

This study's aim is to evaluate the development of the KUBE Stimulant Assistance Program, both technically and non-technically. This background study is to examine the structural model built by constructing variables that hypothetically affect the sustainability of a KUBE unit. In addition, when we reviewed the successful aspects of the KUBE, which aspect is the most dominant factor. This sample took purposively from 186 KUBE (Fiscal Year 2016-2017) in 13 provinces and 16 cities. The results show us that from the aspect of program assistance, the quality of the human resources of the assistance is quite capable in terms of the age range, length of assistance, and education, in the other hand, from the Beneficiary Families (KPM) aspect, their age are still in productive age and there is a tendency for the type of KPM's business, these results can be important information for policymakers to make a policy that is relevant to the program in the future, especially in budgeting. Furthermore, for the structural model test, in the first model (Sustainability Model) the construct variables yet cannot explain the model significantly, but what needs to be underlined is that the partnership and social support variables become valid construct variables, so that it can be used in the next model improvement. Meanwhile, in the second model (Success rate Model), the construct variables indeed explain the model significantly, the model test results that the institutional aspect becomes the dominant factor in explaining the success rate of KUBE.
Pengaruh Promosi, Harga Dan Kualitas Pelayanan Terhadap Kepuasan Pelanggan Jasa Transportasi Kereta Api
Authors: Retno Yuniar Tyas , Rohmatiah Ahadiati
Published: October 2022

This study aims to find out (1) Is there an influence between promotion and customer satisfaction of rail transportation services at Madiun Besar Station (2) Is there an effect of price on customer satisfaction of rail transportation services at Madiun Besar Station (3) Is there an influence between service quality and customer satisfaction of rail transportation services at Madiu Besar Station. The sample in this study were customers of rail transportation services at the Madiun station with 100 respondents. The sample method used was purposive sampling of primary data using a questionnaire measured using a Likert scale and distributed to 100 respondents. The data analysis technique used classical assumption test, multiple linear regression analysis, coefficient of determination analysis, and hypothesis testing using t test and F test. The results showed that (1) promotion, price, and service quality simultaneously had a significant positive effect on customer satisfaction. on rail transportation services at the Madiun big station (2) promotion, price, and service quality simultaneously have a significant positive effect on customer satisfaction on rail transportation services at the Madiun big station.
Pengaruh Strategi Segmenting, Targeting Dan Positioning Terhadap Keputusan Pembelian Pada Produk Respiro Di Madiun
Authors: Nareswari Meyliana Mega Putri , Warnaningtyas Hartirini , Imron Muhammad
Published: October 2022

This research aims to test the Effect of Strategy of Segmenting, Targeting and Positioning on the Purchase Decision of Respiro in the City of Madiun. The population in this research are consumers of Respiro products in Madiun. The data used is primary data obtained from distributing questionnaires through Google Form. The amount of data obtained is 100 respondents. The data obtained were tested with validity test, reliability test, multiple linear regression analysis test, and classical assumption test using SPSS version 18.00. The results of this research indicate that the segmenting variable has a partial influence on purchasing decisions on Respiro products in Madiun, the targeting variable has no partial influence on purchasing decisions for respiro products in Madiun, positioning has a partial influence on purchasing decisions for respiro products in Madiun and Segmenting, Targeting and Positioning simultaneously affect the Purchase Decision on Respiro Products in Madiun.
La Lista del Patrimonio Mundial: el riesgo de morir de éxito
Authors: De Miguel Riera Laura
Published: October 2022

La Convención de Patrimonio Mundial, Cultural y Natural (1972) es uno de los textos internacionales de la UNESCO más exitosos y reconocidos mundialmente. La inclusión de un bien en la Lista de Patrimonio Mundial se ha convertido en un objetivo perseguido por muchos países. Sin embargo, la construcción de esta lista a lo largo de las últimas cinco décadas ha sido fruto de amplias reflexiones no exentas de dificultades y complejidades tanto teóricas como prácticas. El éxito alcanzado por este instrumento de salvaguarda del patrimonio de Valor Universal Excepcional podría conducir, paradójicamente, al socavamiento de sus valores fundacionales y se plantean incertidumbres acerca de su futuro.
Seis años del Programa de Liderazgo del Patrimonio Mundial: panorama actual
Authors: Jo Eugene , Franceschini Nicole
Published: October 2022

Desde su lanzamiento, en septiembre de 2016, durante el Congreso Mundial de la Naturaleza de la Unión Internacional para la Conservación de la Naturaleza (UICN), el Programa de Liderazgo del Patrimonio Mundial (WHLP) está centrado en la promoción de enfoques integrados, basados en el lugar y las personas, para la gestión de los sitios Patrimonio Mundial. Ha contado con la colaboración de numerosos Estados Partes, coordinadores de sitios y profesionales del patrimonio especializados en la generación de recursos y actividades para el desarrollo de las capacidades. Con la clausura de la primera fase en diciembre de 2022, el WHLP realiza un repaso de los hitos alcanzados en los últimos seis años.
Los paisajes del olivar en Andalucía. Expediente para su declaración como Patrimonio Mundial por la Unesco
Authors: Sánchez Ruiz Marcelino , Coronado Sánchez Ana
Published: October 2022

Este escrito pretende exponer los principios y características que rodean al expediente de los paisajes del olivar en Andalucía, historia milenaria de un mar de olivos, para su declaración como Patrimonio Mundial, donde se han pretendido sintetizar los paisajes del olivar andaluces en varias zonas de distintas escalas y contextos que explican la historia de Andalucía a través de su especialización olivarera, expresada en la diversidad paisajística y riqueza patrimonial vinculada al cultivo, producción y comercialización del aceite así como, junto al vasto sistema de ciudades medias olivareras que lo acompañan, la configuración de diferentes tipos de hábitats. Todo ello le otorga relevancia universal excepcional, por sus valores escénicos, su dilatada historia, la densidad y diversidad de elementos patrimoniales asociados y la energía de los valores sociales y culturales inmateriales relativos a la cooperación y el esfuerzo compartido, la tenacidad y saber hacer oleicultor, los relatos y las manifestaciones populares y artísticas que han inspirado estos paisajes.
Programa de Voluntarios del Patrimonio Mundial en Casa Batlló, un hito en la historia de la Convención en España
Authors: Vargas Amilcar
Published: October 2022

El programa de voluntarios del Patrimonio Mundial de la UNESCO inició en el año 2008 para promover la participación activa de los jóvenes en la conservación y difusión de los bienes inscritos en la lista del Patrimonio Mundial y su lista indicativa. En 2019, Casa Batlló fue el primer sitio en la historia de España en ser aceptado en el programa, lo que supuso un hito tanto en la historia del bien, componente de las Obras de Antoni Gaudí, como para el Estado parte. La colaboración con la ONG European Heritage Volunteers, coordinador en esa época de los proyectos en Europa, fue clave para lograr integrar el expediente correctamente. Los retos que se plantearon para participar incluyeron la concepción de las actividades educativas y formativas y las tareas concretas de conservación, enfocadas en trabajo en archivos y documentación, que realizaron durante los 10 días de ejecución del proyecto. Casa Batlló, una entidad privada que había sido rehabilitada para la visita pública por sus dueños con recursos propios y de la venta de entradas, encontró la fórmula para realizar el proyecto como un proceso de formación para jóvenes profesionales del patrimonio. El satisfactorio resultado ha permitido que otros sitios Patrimonio Mundial en España se hayan interesado en participar y, por otra parte, ha hecho que Casa Batlló se haya posicionado como un referente en la implementación del programa.
El EIP y la participación ciudadana en Valparaíso como buenas prácticas de gestión del patrimonio cultural
Authors: Andrade-Pérez Martín , Isaza Londoño Juan Luis
Published: October 2022

El Estudio de Impacto Patrimonial, EIP, es la herramienta creada por ICOMOS y utilizada por la Unesco para evaluar el impacto potencial de los proyectos de desarrollo en el valor universal excepcional, VUE, de los sitios culturales inscritos en la Lista del Patrimonio Mundial, aunque son utilizados para sitios con valores culturales y patrimoniales en general. Entre 2015 y 2016, debido a la inminencia de la construcción de dos megaproyectos de infraestructura en Valparaíso, en Chile, el Gobierno de Chile contrató un EIP que se llevó a cabo para analizar cuáles serían los impactos de estos proyectos en el área histórica de la Ciudad Puerto de Valparaíso, sitio inscrito en la Lista del Patrimonio Mundial en 2003. El proceso y los resultados detrás de este EIP mostraron que este tipo de estudios puede ser más que herramientas técnicas de evaluación y se pueden convertir en espacios de participación ciudadana, de reflexión conjunta y de discusión sobre el pasado, el presente y el futuro del patrimonio cultural. Al mismo tiempo, este proceso sirvió para mostrar que la participación ciudadana puede y debe ser de gran importancia para la planeación del patrimonio urbano y para la toma de decisiones, así como para el que conceptos como el de paisaje urbano histórico, PUH, pueden ayudar a democratizar las determinaciones que se tomen sobre el patrimonio cultural urbano.
Gestión municipal del Patrimonio Mundial: Tarragona
Authors: Bravo Póvez Pilar , Menchón Bes Joan
Published: October 2022

El conjunto arqueológico de Tarraco fue incluido en la Lista de Patrimonio Mundial de UNESCO en la asamblea de Cairns, el 30 de noviembre de 2000. Los criterios aplicados son los (ii) y (iii): la excepcional importancia en el desarrollo urbanístico romano, como modelo para las capitales provinciales, y testimonio de un período significativo en la historia Antigua del Mediterráneo.

Más allá de esto, la ciudad es un paisaje histórico urbano inserido en un paisaje cultural que es el antiguo ager tarraconensis, ahora Campo de Tarragona.

En este artículo se realiza una reflexión sobre los patrimonios de Tarragona, que van más allá del romano, como es lógico en toda ciudad histórica, a los cuales hemos de sumar el rico patrimonio inmaterial. No en vano la provincia de Tarragona es de los lugares del mundo con más reconocimientos por parte de UNESCO: el monasterio de Poblet, la Pintura Rupestre del Arco Mediterráneo, la reserva de la Biosfera del Delta del Ebro, los Castellers, la Cocina Mediterránea, el Arte de la Piedra Seca y finalmente el Priorato como Paisaje Cultural.

El sumatorio de patrimonios genera una inusitada riqueza y a un tiempo la necesidad de un planteamiento holístico, casi de funcionamiento biológico, para su correcta comprensión, gestión y puesta en valor. Así pues, se presenta una reflexión sobre estos temas.
La evaluación de 50 años de Convención del Patrimonio Mundial enfatiza la necesidad de su adecuada implementación
Authors: Luengo Añón Mónica
Published: October 2022

Entre los días 8 y 10 de junio de 2022, se celebró en Cracovia el congreso internacional sobre el 50 aniversario de la Convención del Patrimonio Mundial. Organizado por el Comité Nacional de ICOMOS Polonia y el International Cultural Centre de Cracovia, el conjunto de ponencias y conferencias que lo integraban analizaron los retos de futuro y las oportunidades de la Convención. Con el lema “Logros y desafíos en Europa”, los participantes en el congreso evaluaron la actual situación de protección de los sitios declarados Patrimonio Mundial destacando su deficiente gestión como el talón de Aquiles de la Convención.
Meskell, L. A future in ruins. Unesco, World Heritage, and the dream of peace
Authors: Alhama García Patricia Del Valle
Published: October 2022

A future in ruins: UNESCO, World Heritage and the dream of peace (2018) es el fruto de una investigación de dos años sobre la historia de la UNESCO llevada a cabo por la Dra. Lynn Meskell, en la que nos presenta una revisión crítica acerca de la institución, el funcionamiento de la Lista de Patrimonio Mundial y cómo algunos países la usan para sus propios intereses políticos. Este trabajo supone un acercamiento al funcionamiento de la Unesco y cómo afecta al patrimonio cultural y a las comunidades que se desarrollan en él, demandando un cambio de sus estrategias y un alejamiento de lo político en favor de lo social.
Weydt, J. World Heritage and wind energy. Planning Protecting visual integrity in the context of the energy transition. Inspiring practices from four European countries
Authors: González Méndez Matilde
Published: October 2022

Reseña del libro de Weydt, J. World Heritage and wind energy. Planning Protecting visual integrity in the context of the energy transition. Inspiring practices from four European countries. Paris: UNESCO, 2021
50 años de aplicación de la Convención sobre la Protección del Patrimonio Mundial: logros, lagunas, presiones y desafíos entre el espíritu universal y la praxis nacional
Authors: Martínez Yáñez Celia
Published: October 2022

La celebración del cincuenta aniversario de la Convención sobre la Protección del Patrimonio Mundial Cultural y Natural presenta luces y sombras. Es el tratado internacional más influyente en la protección del patrimonio y sus tipos de bienes en todo el mundo y un sistema de monitoreo muy complejo. Sin embargo no todos sus efectos son positivos cuando se miran con la suficiente distancia. Diversos intereses y presiones dificultan la correcta implementación de la Convención y la incapacidad para frenarlos acarrea incluso efectos negativos y un cuestionamiento continuo del sistema creado en torno a los bienes Patrimonio Mundial. Este artículo reflexiona sobre los logros y lagunas de la Convención, identificando los seculares y emergentes, así como los principales retos a los que se enfrenta en su complejo futuro.
Emergency Nursing of Patients with Acute Left Heart Failure
Authors: Can Lu , Meng-meng LIU , Huai-feng YAN , lin Qi- , xing Qi- , Chun-mei QI
Published: October 2022

Objective: We are aimed at exploring the emergency treatment and nursing measures for patients with acute left heart failure. Methods: We selected 48 patients with acute left heart failure in our department monitored by ecg immediately after admission. Open venous access;Sitting position, sagging legs, inhalation of alcohol humidified oxygen, heart strengthening, diuresis, sedation, asthma, vasodilation, shock patients were given vasopressor drugs or intra-aortic balloon counterpulsation;And psychological care. Results: 44 cases were improved after active rescue, with only 4 cases died, which the success rate of rescue was 91.67%. Conclusion: Timely, rapid and standardized nursing is very important to improve the success rate of acute left heart failure and prognosis of patients.
Concurrent Deep T-Wave Inversions and QT Prolongation with Azithromycin Treatment
Authors: Wasilewski Melissa , Kwiatkowski Sara , Kapoor Kunal , Roy Sumon
Published: October 2022

The tendency of macrolide antibiotics to prolong the QT interval in certain patient populations is well documented. In contrast, limited reports exist of medication-induced deep T-wave inversions. We recently encountered a case of azithromycin-induced QT prolongation with concurrent deep TWI, an association that is rarely observed in clinical practice. As similar ECG changes can be seen with life-threatening conditions such as coronary ischemia and cerebral hemorrhage, comprehensive workup to rule out acute pathologies is critical when this pattern is recognized.
Idiopathic Aortic Thrombosis and Thromboembolism in Young Women
Authors: Zhang Suyue M. , Joshi Gaurang , Khoury Rym El , Parker Benjamin , Labchuk Andrii , Jacobs Chad E , White John V , Schwartz Lewis B.
Published: October 2022

Introduction: Spontaneous aortic thrombosis causing distal embolization and acute limb ischemia is an ominous medical condition with a poor prognosis. Herein are reported the clinical courses of two women who presented with severe lower extremity ischemia caused by distal embolization of spontaneous aortic thrombus without obvious antecedent arterial disease. This unusual diagnosis should be expected in patients presenting with persistent lower extremity pain and numbness even in the absence of overt physical findings. Case 1: A 42 year-old woman with mild hyperlipidemia complained of left leg numbness and weakness. She was treated with analgesia but her symptoms worsened. Lower extremity ultrasound revealed a significant infra-inguinal perfusion defect; computed tomography revealed mural thrombus in a normal aorta along with extensive thrombotic occlusion of the left popliteal and tibial arteries. Attempts at endovascular recanalization were unsuccessful; the patient underwent successful left popliteal-to-plantar artery bypass with autologous vein. Case 2: A 57 year-old woman without medical history presented to a local Emergency Room with a five-day history of numbness in the right lower extremity. Computed tomographic angiography revealed complete infrarenal aortic occlusion in a 3 cm diameter area of mild aortic ectasia along with iliac and distal right infrainguinal thromboembolism. The patient was treated with aortobifemoral bypass grafting with right leg fasciotomy, which restored perfusion and function. Conclusion: Spontaneous aortic thrombosis causing distal embolization and acute limb ischemia is an ominous medical condition with a poor prognosis. Episodes of embolization may be intermittent and asymptomatic such that, when symptoms finally occur, the distal thrombus is often chronic and inaccessible. The diagnosis should be suspected in patients with unexplained lower extremity symptoms and pulse deficits; it can be readily established with computed tomography.
Two-Year Incidence of Permanent Pace-Maker Implantation Post Modified SAVR
Authors: Kawkabani Nadine , Boustros Omar , Pharm Rita Farah , Darwish Rola , Ghanem Moussa Abi , Jdaidani Jennifer , Khalil Bassam Abu
Published: October 2022

Background and Aim of this Study: Patients presenting with aortic stenosis are offered surgical aortic valve (SAVR) or transcatheter aortic valve replacement (TAVR) as therapeutic options. However, both techniques are associated with postoperative conduction abnormalities necessitating PPMI. We evaluate in this paper the impact of a modified technique of SAVR- which aims to decrease the stress on the conduction system- on the incidence of PPMI for a 24 months period post-surgery. Methods: The perioperative course of 184 patients who underwent SAVR in Saint George Hospital University Medical center between January 2016 and June 2019 was assessed. The study compares the incidence of PPMI between two groups of patients. In group A, 92 patients underwent the classic SAVR and in-group B, and 92 patients underwent a modified SAVR. Results: The results revealed a significant decrease of PPMI from 12 to 2.2% during a two-year period follow up. A multi variate analysis showed that the modified technique was a strong predictor for PPMI post SAVR. In addition, this rate (2.2%) was lower than the ones reported after TAVR. Conclusion: This reproducible and reliable technique should be recommended whenever SAVR is performed. On the other hand, the low incidence observed may be adopted as a benchmark whenever TAVR is offered as a therapeutic option specially to intermediate and low risk patients. Moreover, this less traumatic technique should be retained whenever stent design modifications for TAVR are considered.
Fronteiras de si: as narrativas e a experiência docente
Authors: Kich Bruna Viedo , Marquezan Lorena Inês Peterini
Published: October 2022

Esse estudo busca analisar diários de classe escritos por uma das autoras durante os anos de 2014 e 2015 durante a disciplina de Estágio Supervisionado em Letras Inglês na Universidade Federal de Santa Maria. Os escritos narram o cotidiano escolar a cada encontro na escola da professora como regente de uma turma de sexto ano do ensino fundamental em uma escola pública durante sua primeira experiência como professora. Essa pesquisa tem como objetivo refletir sobre o processo (auto) biográfico na formação docente e os reflexos da documentação, divulgação e leitura de narrativas privadas. Tendo como método a abordagem qualitativa de cunho (auto) biográfico, as narrativas foram analisadas por meio de apreciação semântica e agrupadas em categorias, chamadas de cenários formativos, através das recorrências no discurso. Foram identificadas quatro categorias: a família, a política e a ideologia, a frustração e as mazelas sociais.  A pesquisa está aportada teoricamente nos estudos de Bertaux (2010), Ferraroti (2014), Larossa (2008), Passeggi (2011) e Rodrigues e Prado (2015), entre outros. Contatou-se que as narrativas de si têm função reflexiva e formadora para pesquisadores, sujeitos e leitores de pesquisa, e que essa formação tem caráter não linear e intermitente ao longo das trajetórias pessoais e profissionais. Compreendeu-se também que documentos confessionais, mais do que uma representação singular de um único sujeito, tem também valor histórico social ao versar sobre um determinado espaço/tempo e contexto. Assim, verificou-se que narrativas de si tem potencial para consolidarem-se como conhecimento acadêmico transformando em teoria vivências e experiências narradas pelo sujeito.
Análise de prontuários dos pacientes acometidos por dor residual crônica após cirurgia de quadril com terapia medicamentosa
Authors: Casagrande Enzo Pizoni , Sabec Pereira Dayane Kelly
Published: October 2022

As cirurgias de quadril estão entre as mais realizadas na ortopedia e uma das complicações mais comuns é a dor residual. A dor residual é uma complicação crônica e que não depende de movimentação para ser deflagrada. O tratamento mais comum para ela é com medicamentos opióides, como tramadol, morfina e oxicodona, porém esses medicamentos apresentam alto potencial de causar dependência e podem desencadear muitos efeitos colaterais, como sonolência, constipação intestinal, náusea, vômitos e até mesmo rebaixamento do nível de consciência e consequente parada respiratória. O objetivo é analisar o perfil epidemiológico dos casos de dor residual em pacientes no pós-operatório tardio de cirurgias ortopédicas na articulação do quadril de acordo com o tratamento medicamentoso utilizado. O estudo apresenta-se como qualitativo e exploratório, no qual foi realizado a avaliação de prontuários pós-cirúrgicos que apresentam a terapêutica realizada, seus resultados e suas complicações. Foi observado nos prontuários estudados que mais de 80% dos pacientes utilizaram analgésicos opióides. A maioria teve um bom controle analgésico, mas as terapias com opioides foram as que mais apresentaram efeitos colaterais. Quando as terapias eram associadas à dipirona, foi observado uma alta relação entre a efetividade e efeitos colaterais.
Cuidados gerais aos pacientes com Doença Pulmonar Obstrutiva Crônica em Terapia Intensiva
Authors: Santos Jéssica Batista dos , Costa Christefany Régia Braz
Published: October 2022

O referido trabalho tem como foco a discussão acerca da assistência de enfermagem prestada aos pacientes com Doença Pulmonar Obstrutiva Crônica (DPOC) em terapia intensiva. Objetivos do artigo: Analisar quais os cuidados a serem aplicados a um paciente com Doença Pulmonar obstrutiva Crônica em terapia intensiva. Identificar na literatura os cuidados aos pacientes com Doença Obstrutiva Crônica em terapia intensiva. Metodologia: A metodologia utilizada na pesquisa, baseou-se numa revisão narrativa, sobre obras que tratam sobre a temática abordada pesquisadas em sites de pesquisa como: Scielo, Revista Gestão & Saúde, Research, Society and Development e Revista Brasileira Clínica Médica. Conclusão: Os cuidados, identificados na literatura sobre pacientes com DPOC, são o emprego do bronco dilatador, que irá agir diretamente no combate da inflamação dos brônquios, que estão enrijecidos devido à criação de colágeno durante o processo de defesa das células, neutrófilos e macrófagos, produzindo proteases, dilatando-os de forma a facilitar a respiração e melhor absorção do O2. Outro tipo de cuidado é a administração de medicamentos pelo profissional de saúde, como, β2 agonista, e os de curta duração, como o fenoterol, que agirá no sistema nervoso simpático para tentar dilatar a via respiratória e assim promover uma melhor respiração. Além desses cuidados, também podemos empregar o procedimento de estimulação elétrica que pode favorecer o retorno das atividades respiratórias após a retirada do sistema ventilatório artificial. E o emprego da oxigenoterapia que permite a suplementação de oxigênio com o intuito de tratar e aumentar os níveis de oxigênio no sangue arterial.
Correction of malocclusion in individuals with osteogenesis imperfecta: a systematic review
Authors: Prado Heloisa Vieira , Rabello Flavia , Carneiro Natália Cristina Ruy , Debossan Suélen Alves Teixeira , Abreu Lucas Guimarães , Borges-Oliveira Ana Cristina
Published: October 2022

The aim of the study was to verify the viability of the correction of malocclusion in individuals with osteogenesis imperfecta (OI). A systematic review was developed using PubMed, Web of Science, Scopus, Lilacs, Ovid, Google Scholar and OpenGrey databases. The review was registered in PROSPERO (CRD42018114217). Data extraction was conducted by two researchers. Studies describing orthodontic treatment, orthognathic surgery or orthodontic treatment combined with orthognathic surgery for the correction of malocclusion in individuals with OI were eligible. The methodological quality of the articles was appraised using the case report assessment tool proposed by the Joanna Briggs Institute. The results were synthesized qualitatively. The 22 case reports included in the present review involved a total of 28 clinical cases. Malocclusion was considered severe in 11 cases, with records of negative overjet between nine and 26mm. Orthodontic treatment was performed in four cases, orthognathic surgery was performed in five cases and orthodontic treatment combined with orthognathic surgery was performed in 19 cases. All treated cases had favorable clinical results. Overall, the methodological quality of the articles included was satisfactory. Based on the analyzed cases, which reported only cases with successful results, treatment for malocclusion is viable in individuals with OI. When duly indicated, treatment can be performed with orthodontic treatment, orthognathic surgery or a combination of both, providing satisfactory esthetic and functional results with adequate stability.
Principais complicações em gestantes com síndrome do anticorpo antifosfolipídeo: revisão integrativa
Authors: Carvalho Thiozano Afonso de , Rodrigues Raquel Vieira , Santos Thalita Regina Morais dos , Brito Magna Jaíne Alves de , Carvalho Verônica Mendes de , Martins Suzana Marques , Nascimento Maria Berenice Gomes , Cabral Symara Abrantes Albuquerque de Oliveira
Published: October 2022

Síndrome do Anticorpo Antifosfolípide (SAF), doença autoimune caracterizada pela ocorrência de eventos trombóticos em qualquer leito vascular e de eventos gestacionais. Este trabalho tem o objetivo de identificar as principais complicações obstétricas em gestantes portadoras da SAF, a partir da análise de produções científicas. Trata-se de uma revisão integrativa da literatura, de abordagem qualitativa, com utilização dos DeCS: gravidez, aborto, trombose. Foram utilizadas as bases de dados Medical Literature Analysis and Retrievel System Online (MEDLINE) e Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), através da Biblioteca Virtual em Saúde (BVS), no mês de outubro de 2021, por meio dos Descritores em Ciências da Saúde (DeCS): “gravidez”, “aborto” e “trombose”, com utilização do termo booleano AND nas buscas. Foram encontrados 249 artigos, e através dos critérios de inclusão e exclusão foram selecionados 4 artigos para análise. Os resultados mostraram que a SAF é tratada como uma imunodeficiência e dentre as principais complicações na gravidez estão: morte fetal, abortos recorrentes nos primeiros meses devido a insuficiência placentária, trombose venosa profunda (TVP) em membros inferiores, e tromboembolismo pulmonar (TEP). Pode ter como desfecho o óbito materno. Para isso, é de extrema importância que quaisquer sinais de sangramento e abortamento que aconteçam, a gestante deve procurar assistência médica especializada para condução do problema. A atenção básica tem o papel de instruir essas mulheres para realização dos exames laboratoriais, como também se faz presente na oferta do pré-natal e do acompanhamento obstétrico de qualidade.
The medical education and health care for the LGBTQIA+ population
Authors: Machado Gabriel Couto , Ziembowicz Henrique , Batista Daniela Cardoso , Souza Irene , Drescher Carina Louise , Hinterholz Carolina Loebens , Geisler Rafaela Manetti , Paul Marcelo Felipe , Abi Nathalia de Oliveira , Theissen Isadora Fussiger , Frighetto Isabela , Beling Janaína Carine , Schaefer Catiane Kelly , Darsie Camilo
Published: October 2022

The LGBTQIA+ population is marginalized in contemporary society. The obstacles to which they are exposed promote vulnerabilities and social negligence, including those related to access in the context of health care. Besides, professional mistakes are common during consultations with LGBTQIA+ people and, therefore, they should be argued in the field of medical education. This manuscript aims to discusses the medical education and health practices addressed to these people. Narrative review, through scientific platforms, and qualitative analysis. Sixteen texts related to the theme were used. The invisibility of data that could guide best professional practices and strengthen public policies applied to the group stands out. It is observed that the LGBTQIA+ population is commonly marginalized in health care, due to inadequate professional practices. As a cause, medical training is noteworthy, both for the curricula that involve medical schools and for teaching practices that disregard the subject. Ensuring adequate health care may promote improvements in the experiences lived by the LGBTQIA+ population, given their health demands and confrontations in their daily lives. Health support should consider specific demands, especially related to health promotion. Medical education must be modified in order to ensure that professionals work properly with the LGBTQIA+ population. The lack of consistent data on the population under discussion jeopardizes public policies and health practices. Moreover, the topic receives little attention in medical education courses, a fact that indicates the need for changes in the curricula as well as in didactic actions of professors.
Os impactos da radioterapia na estrutura dental e suas consequências no tratamento odontológico
Authors: Faria Amanda Reven , Corrêa Mariana Tamila Ribeiro , Pereira Marília Karolyne Soares , Martins Victor da Mota , Montes Tatiana Carvalho
Published: October 2022

A radioterapia de cabeça e pescoço afeta negativamente a estrutura dental de dentes permanentes, causando alterações orgânicas e morfológicas em esmalte e dentina. O objetivo deste trabalho foi avaliar quais mudanças acontecem nesses substratos e de que forma essas alterações podem prejudicar o tratamento odontológico reabilitador. Foi realizado uma revisão integrativa da literatura, por meio da qual foram selecionados a partir dos critérios de elegibilidade propostos na estratégia PICO, 20 artigos foram analisados, utilizando os descritores: radioterapia, dente, câncer de cabeça e pescoço e tratamento odontológico, cruzando-os com o operador booleando AND. As bases de dados consultadas foram o National Library of Medicine (PubMed), Scientific Electronic Library Online (SciELO) e Medical Literature Analysis and Retrievel System online (MEDLINE). Foi verificado uma prevalência de estudos experimentais tratando das alterações observadas, uma revisão sistemática e comparações de materiais e seus desempenhos diante da radioterapia. De acordo com esse estudo, alterações orgânicas e morfológicas são perceptíveis a partir de 30Gy, assim, alguns materiais se mostraram com melhores desempenhos frente a essas limitações encontradas, podendo oferecer melhor adesividade, selamento e uma longevidade maior nos tratamentos reabilitadores.