bluuebunny/crossref_metadata_2025 huggingface dataset:
Study protocol of a single-arm pre-post study to assess the preliminary effectiveness and feasibility of a home-based bimodal prehabilitation program on preoperative aerobic fitness in high-risk patients scheduled for liver or pancreatic resection
Authors: Berkel Annefleur E. M. , Wijk Laura Van , Bongers Bart C. , Palen Job Van Der , Buis Carlijn I. , Reudink Muriel , Liem Mike S. L. , Slooter Gerrit D. , Van Meeteren Nico L. U. , Klaase Joost M.
Published: April 2020

Background: Controversial evidence currently exists regarding the feasibility and effectiveness to improve preoperative aerobic fitness during home-based prehabilitation in patients scheduled for liver or pancreatic resection, whereas morbidity rates are high following these resections. The primary aim of this study is to evaluate the preoperative oxygen uptake (VO2) at the ventilatory anaerobic threshold before and after a four-week home-based preoperative training program with nutritional supplementation in high-risk patients scheduled for elective liver or pancreatic resection. Secondary aims are to evaluate program feasibility, immune system function, cardiopulmonary exercise test responses, individual progression profiles on training responses, quality of life, and postoperative course.

Methods: In this multicenter study with a pretest-posttest design, patients with a liver or pancreatic tumor scheduled for elective resection will be recruited. To select the high-risk fraction of this surgical population, their VO2 at the ventilatory anaerobic threshold should be <11 ml/kg/min for final inclusion. A planned total of 24 high-risk patients will participate in a four-week (three sessions per week) home-based bimodal prehabilitation program. The partly supervised home-based preoperative training program consists of individualized goal setting followed by titration of interval and endurance training on an advanced cycle ergometer, combined with functional task exercises. Additionally, patients will be given protein and vitamin/mineral supplementation.

Discussion: Effects of a partly supervised home-based bimodal prehabilitation regimen are unknown in high-risk patients opting for liver or pancreatic resection. Improved preoperative aerobic fitness might translate into improved postoperative outcomes and a reduced demand on care resources.

Trial Registration: The study is registered in the Netherlands Trial Registry (NL6151) and was approved by the Institutional Ethics Committee, Twente, Enschede, the Netherlands (P17-08).
Testing for baseline differences in clinical trials
Authors: Chen Henian , Lu Yuanyuan , Slye Nicole
Published: April 2020

Reporting statistical tests for baseline measures of clinical trials does not make sense since the statistical significance is dependent on sample size, as a large trial can find significance in the same difference that a small trial did not find to be statistically significant. We use 3 published trials using the same baseline measures to provide the relationship between trial sample size and p value. For trial 1 sequential organ failure assessment (SOFA) score, p=0.01, 10.4±3.4 vs. 9.6±3.2, difference=0.8; p=0.007 for vasopressors, 83.0% vs. 72.6%. Trial 2 has SOFA score 11±3 vs. 12±3, difference=1, p=0.42. Trial 3 has vasopressors 73% vs. 83%, p=0.21. Based on trial 2, supine group has a mean of 12 and an SD of 3 for SOFA score, while prone group has a mean of 11 and an SD of 3 for SOFA score. The p values are 0.29850, 0.09877, 0.01940, 0.00094, 0.00005, and <0.00001 when n (per arm) is 20, 50, 100, 200, 300 and 400, respectively. Based on trial 3 information, the vasopressors percentages are 73.0% in the supine group vs. 83.0% in the prone group. The p values are 0.4452, 0.2274, 0.0878, 0.0158, 0.0031, and 0.0006 when n (per arm) is 20, 50, 100, 200, 300 and 400, respectively. Small trials provide larger p values than big trials for the same baseline differences. We cannot define the imbalance in baseline measures only based on these p values. There is no statistical basis for advocating the baseline difference tests
Pilot testing of sticker tool method for monitoring DOTS providers under revised national tuberculosis control program in Khammam: operational research
Authors: Veerapu Nagapraveen , Bear Ravi Kumar Philip , Varikuti Subbarao , Kurada Jayakrishna
Published: April 2020

Background: Globally, tuberculosis (TB) is one of the leading causes of death. In 2016, 10.4 million people were affected with TB and accounted for 1.7 million deaths. India ranks the first among the seven leading countries that account for 64% of the total burden of TB. To fill the gaps in adherence to therapy and to make the TB Control programs successful, evidence based supplementary low cost effective monitoring tools and techniques are needed. The aims were to determine whether the new sticker tool method acts as supplementary to direct observation component of ‘Directly observed treatment, short course (DOTS) strategy’ used for monitoring adherence to anti-tuberculosis therapy among newly diagnosed sputum positive TB patients; and to compare Sputum smear conversion rate between the intervention group and control group at the end of Intensive phase (IP).Methods: A pragmatic cluster randomized control trial was conducted for a period of 9 months from April 2018 to December 2018 in Rural Khammam district. Data was represented in frequencies and percentages and Means.Results: The delay in sending SMS decreased after field visit (1st week of therapy) but delay again increased as the days passed. The study measured indirectly measured the adherence to the therapy by sputum conversion rate (83.3%). It was noticed that 45.5% stickers did not tally with the date of consumption of TB medications or with the date of sticking on the sticker chart.   Conclusions: The study shows self administration is also a good option. There may be other factors that play an important role in adherence to anti tuberculosis treatment (ATT).
Anti- cyclic citrullinated peptide antibodies in tuberculosis and human immunodeficiency virus
Authors: Yadav Rakesh K. , K. Raj , V. Kachnar , Mathur Manoj K. , Shukla Amitabh D.
Published: April 2020

Background: Anti-cyclic citrullinated peptide (anti-CCP) antibodies have been considered very specific for rheumatoid arthritis (RA). Some studies have shown that these antibodies can be positive in infectious diseases like tuberculosis, human immunodeficiency virus infection, etc.Methods: Eighty patients of tuberculosis both pulmonary and extra-pulmonary tuberculosis and thirty patients of human immunodeficiency virus were enrolled in this study from inpatient and outpatient departments from September 2018 to August 2019. Anti-CCP antibody test was done in all the patient by enzyme linked immunosorbent assay.Results: Fifty-three patients were of pulmonary tuberculosis, 27 patients were extra-pulmonary tuberculosis and 30 patients were human immunodeficiency virus infection. Of the 53 cases of pulmonary tuberculosis, 21 (39.6%) cases were positive for anti-CCP antibodies and 32 (60.4%) cases were negative for the same. Of the 27 cases of extra-pulmonary tuberculosis, 3(11.1%) cases were positive for anti-CCP antibodies and 24 (88.9%) cases were negative. Of the 53 patients of pulmonary tuberculosis, 16 were sputum positive and 37 were sputum negative. Of those withsputum positive 9 (56.2%) cases were positive for anti-CCP antibodies and those with sputum negative, 12 (32.4%) cases were positive for anti-CCP antibodies. Of the 30 cases of human immunodeficiency virus, 5 (16.7%) cases were positive for anti-CCP antibodies and 25 (83.3%) cases were negative.Conclusions: Anti-CCP can be positive in cases of infectious diseases like tuberculosis and human immunodeficiency virus. Positivity of anti-CCP antibodies for tuberculosis is more for pulmonary (more for sputum-positive than sputum-negative) than extra-pulmonary tuberculosis. Anti-CCP, thus is not very specific for rheumatoid arthritis.
Methicillin resistant Staphylococcus aureus: a review of the present Indian scenario and drug treatment
Authors: Parasher Anant , Khatana Pushpender
Published: April 2020

Methicillin-resistant strains of S. aureus cause infections that are associated with higher mortality rates and increased length of hospital stays, than infections caused by methicillin-susceptible strains. The mechanism by which MRSA strains develop resistance is by the production of an altered penicillin-binding protein (PBP), which has a decreased affinity for most semisynthetic penicillins. MRSA has increased in prevalence and has become endemic in the Indian subcontinent, with incidence varying from 25% in Western regions to 50% in Southern India. A multi-centric study conducted across 15 tertiary care centers in India from 2008 to 2009 showed overall prevalence of MRSA infection to be 41% among S. aureus isolates, and recent Indian studies from 2014 and 2018 have also suggested an increasing prevalence of MRSA. Transmission is mainly horizontal and concerns high risk populations (patients with prolonged hospital stay, on haemodialysis, receiving cancer treatment or specific medications that affect immune function, intravenous drug users and individuals who have had surgery in the recent past. Community Acquired MRSA has emerged as significant pathogen responsible for potentially fatal infections including life-threatening pneumonia, necrotizing fasciitis, endocarditis, osteomyelitis, severe sepsis, and toxic shock syndrome. Diagnosis is mainly by gram stain, culture and quantitative PCR. Newer techniques include Multi-locus sequence typing (MLST), Pulsed-field gel electrophoresis (PFGE), Bacteriophage typing, spa locus typing and SCCmec typing. Although Vancomycin was previously considered the definitive treatment for serious MRSA infections, the emergence of less-susceptible strains, poor clinical outcomes, and increased nephrotoxicity with high-dose therapy have deterred its use as first-line therapy in many cases. Although a number of new and effective antimicrobial agents are now available for the treatment of MRSA, their exact role and choice of agent needs to be well-defined.
Is digital or internet addiction a reality: study from King Khalid University Saudi Arabia
Authors: Wani Mudassir M. , Wani Javed I.
Published: April 2020

Background: Internet and digital devices are one of the essentialities of present-day life as we depend on them for information, inter-personal relationships, entertainment and even economic transactions. The number of hours being spent by individuals has been increasing day by day. Due to addictive nature of the problem, internet addiction or digital addiction disorder has been coined. This study was carried among medical students associated with King Khalid University Abha Saudi Arabia, with aim to analyze epidemiological aspects of internet/digital usage among the group specified.Methods: It was a prospective study. 153 subjects responded to online questionnaire sent through Whatsapp. Majority of subjects responding were female medical students, followed by dental students.Results: Results from the study found that about 21.57% of students were using internet for more than 10 hours out of 24 on daily basis. The most common used applications on mobiles was WhatsApp (94.12%). 42.48% of students suffered from sleep disturbance. 44.4% thought that digital devices are very important for their lives.Conclusions: Study reveals a very serious trend in terms of time spent by students on internet and also the adverse health issues due to same, with evidence of dependence in a subset of students. Study recommend that awareness is a key factor as internet usage is more personal but having an impact not only on individual but also on society as well.
Prediction model of overweight and obesity in primary school children in urban areas
Authors: Harjatmo Titus Priyo , Marbun Rosmida M. , Puspitaningtyas Ratih
Published: April 2020

Background: Overweight and obesity can occur both in children to adulthood. The prevalence of obesity for children aged 5-12 years is still high at 18.8% consisting of 10.8% overweight and obese at 8.8%. The prevalence of childhood obesity has increased in various countries including Indonesia. The results of previous data collection shows that the proportion of fat and obesity is quite high at 34.5%.Methods: This type of research is a cross sectional study because the independent and dependent variables are measured at the same time. The sample was a portion of elementary school children in SD Kramat Pela Kebayoran Baru. Case samples are elementary school children who are overweight and obese (weight/height >1.0 SD) as many as 35 children and the control sample is elementary school children with normal weight/height ≤1.0 SD as many as 35 children.Results: From the results of the analysis of physical activity variables showed that the group of children who are overweight or obese have an average activity lower than normal school children. Odds ratio analysis shows that the risk of being obese or obese is 18.1 times in inactive children compared to active ones (95% CI: 4.60-70.9). Screen time analysis with the incidence of obesity did not show significance.Conclusions: Growth monitoring needs to be pursued regularly so that efforts to control obesity in school children can be done.
Assessment of risk factors, central foveal thickness, visual acuity outcome and therapeutic approach in retinal vein occlusion patients of different age groups: a retrospective record based study
Authors: Gohil Neepa R. , Shinde Vijay Mahadeo , Shinde Kaumudi K.
Published: April 2020

Background: This study was conducted to investigate associated systemic diseases, other risk factors, visual prognosis, treatment approach and central foveal thickness in retinal vein occlusion patients of different age groups.Methods: This single centre, retrospective record based hospital study included patients with retinal vein occlusion presenting to ophthalmic department. All the records of 30 patients were reviewed and data was abstracted and analysed. Initial and final clinical parameters e.g. visual acuity, central foveal thickness, age-group distribution, risk factors, therapeutic approach were analysed.Results: Out of 30 patients, 19 patients were of age-group >50 years and 11 were <50 years. In present study, most common type of retinal vein occlusion (RVO) was ST- BRVO in both the groups. Most common association of RVO in group >50 years was hypertension (84%), and <50 years was hypertension (27.3%), raised lipid level (TG, cholesterol) (27%) and raised serum homocysteine. Patients with uncontrolled DM and hypertension (in our study, 2 patients) required multiple injections even after 4 months of follow-up. Age-group <50 years had better visual acuity and central foveal thickness at initial and final presentation. Raised serum homocysteine level associated with RVO in age-group <50 years (27.3%) versus age-group >50 years (5%).Conclusions: Patients with good control of systemic disorders with RVO shows significantly improved (p value<0.05) visual acuity and central foveal thickness, in both the age-groups. Patients of age group >50 years were more associated with systemic disorder e.g., hypertension and DM. Patients of age group <50 years were more associated with medical condition e.g. hyperlipidemia, raised serum homocysteine. In present study, single patient in age-group <50 years was associated only with sudden and severe dehydration.
Study of psychosocial aspects contributing to stress among women with primary infertility
Authors: Manikkam Banumathy , Bhargavi Vijaya
Published: April 2020

Background: Infertility remains a global problem since ages and lot of stigma in society even in the modern era. The burden of psychosocial stress in primary infertility is overwhelming, still there is limited literature regarding this.Methods: We conducted a prospective study on 300 primary infertile women to determine the prevalence of psychosocial stress and the contributing factors. Data was collected using a semi structured questionnaire through a one-one interview, after narrating the purpose analysed the relationship of various psychosocial factors to infertility related stress.Results: In the present study, female factor 41%, 25% had male factor, 9% couple with combined factor and 25% with unexplained infertility. Polycystic ovarian syndrome was the most common, 25.6%, and tubal factor 13.3%. The sperm abnormalities and oligozoospermia in 20.3%. Earlier 52% had undergone ovulation induction, 38% had intrauterine insemination and only 10% undergone in vitro fertilization. 23% women and 4% men suffered psychological trauma in the past, 4% women had already been treated for psychiatric problem. We found higher scores for failed period, mind distraction, avoiding social gatherings. Parenthood desire seen in 82%, 8% for continuation of progeny, 7.6% for future security and 2.3% for social obligation. 53% were willing to adopt on failure of treatment. The prevalence of psychosocial stress was 70% in present study.Conclusions: Understanding the psycho social factors associated with stress helps to alleviate and improve the quality of life. Public health awareness programs and coping strategies are the need of the hour. Encouraging adoption will solve the twin problems of infertility and abandoned kids.
Study on knowledge, attitude and practice about breast feeding and complementary feeding among the mothers attending health camp
Authors: Mallesh Vidya , Udgiri Rekha S. , Patil Shailaja S.
Published: April 2020

Background: Malnutrition among under 5 children is a major public health concern in India, sub-optimal feeding and inadequate knowledge of mothers on optimal child feeding practice not only increases the risk of infections and malnutrition but also considered as an important determinant of under-5 children mortality. Objective: Assess knowledge, attitude and practice on breastfeeding, and complementary feeding among mothers with the children under-2 years of age attending the health camp.Methods: This cross-sectional study was conducted on all the mothers with the children under 2 years of age attending the health camp at Shri B. M. Patil Medical College Hospital and Research Center, Vijayapura. A verbal consent was taken and pre structured questionnaire was used to assess knowledge, attitude and practice on breastfeeding and complementary feeding in the mother attending the health camp.Results: In the present study, only 42.1% of the mothers had practiced early initiation breastfeeding and only 38.3% of mothers had practice exclusive breastfeeding for the first 6 months. 36% of the mothers had given prelactial feeds, 62.8% of mothers had fed their children with colostrum and timely initiation of complementary feeding was practiced only among 18.2% of mothers.Conclusions: This study shows inadequate knowledge among mothers regarding infant and young child feeding methods and faulty child feeding practices were followed by mothers.
Mid-upper arm circumference versus weight for height Z-score for detecting malnutrition in children aged 06-59 months in rural and urban areas of Jabalpur district, Madhya Pradesh, India
Authors: Shukla Nandini , Toppo Neelam Anupama , Kasar Pradeep Kumar , Sharma Brajesh
Published: April 2020

Background: WHO and UNICEF propose two independent criteria for diagnosing malnutrition in children aged 6-60 months, viz. mid upper arm circumference and weight-for-height. However, both these criteria do not identify same set of children as having malnutrition, and using only one of the diagnostic criteria proposed by WHO may potentially leave some high-risk children untreated. Therefore, the purpose of this study was to determine the prevalence of malnutrition by using both mid-upper arm circumference (MUAC) and weight for height (W/H) and their differences among children.Methods: Cross sectional study carried out in rural and urban areas of Jabalpur district among 1237 children of age group 06-59 months in randomly selected eight ward and two blocks of Jabalpur district. Where 720 children were from urban wards and 517 from rural villages. Multistage random sampling technique was used for the selection of study subjects. Pre-designed and pretested questionnaire was used for interview, Salter’s Scale for weighing, non-stretchable Measuring Tape for measuring height and Shakir’s tape for mid upper arm circumference.Results: In rural area, prevalence of malnutrition according to MUAC is 74 (14.3%) while according to w/h is 102 (19.7%). While in urban, prevalence according to MUAC is 104 (14.4%) while according to w/h is 136 (18.9%).Conclusions: The findings are clear that, prevalence of wasting by W/H is more than by MUAC. With the use of the currently recommended WHO cut-off for MUAC, a significant number of children would not have been identified. A higher cut off value, therefore recommended for screening.
Age and sex patterns of mortality in a tertiary care teaching hospital in Bagalkot, North Karnataka, India
Authors: Shankar Gowri , Kalburgi Eshwar B.
Published: April 2020

Background: Mortality is an inevitable component of hospital practice and patient outcomes. The age and cause of death and sex mortality pattern and the audit give a myriad of information. This helps to identify the trend of mortality. Hence, this study was done to identify age and sex patterns of mortality of the patients admitted to Hangal Sri Kumareshwar Hospital and Research Centre, Navanagar, Bagalkot, Karnataka, India.Methods: A retrospective study of all deaths that occurred in the year 2018 in Hangal Sri Kumareshwar hospital and Research Centre, Navanagar, Bagalkot, Karnataka was done by analysing the records from medical records department after institutional review board clearance. Data regarding age, sex, area of residence, ward of admission and cause of death was noted and analysed using percentages and chi square test.Results: Out of 411 deaths during 2018 in HSK hospital, 64.96% were males and 35.04% were females. Majority (71.53%) were from rural areas. Maximum number of deaths (27.98%) was observed in those more than 61 years of age followed by those between 41 to 60 years of age. Overall, maximum number of deaths (69.35%) was due to a Non communicable disease. Infectious and parasitic disease contributed to 10.46% of deaths. Cardio vascular disease contributed to 16.30% deaths.Conclusions: Primary prevention of non-communicable diseases by creating awareness in the community and secondary prevention by early identification is needed to prevent premature mortality before the age of 60 years.
Clinico-epidemiologic-profile and associated behaviour patterns of patients presenting to sexually transmitted infections clinic in tertiary care hospital in South Gujarat: an observational cross-sectional study
Authors: Patil Priyanka Chandrakant , Umrigar Dipak D.
Published: April 2020

Background: Sexually transmitted infections (STI)/respiratory tract infections (RTIs) constitute major public health problems in society since they increase the risk of HIV transmission. As the different regions in the country show variability in the clinical profile and high-risk behaviors of patients, it is important to study the trend in the particular region before formulating control measures. To study the clinico-epidemiologic profile of patients presenting to STI clinic along with the high-risk behaviors associated with transmission of STIs.Methods: This was an observational cross-sectional retrospective study by data analysis of hospital records in STI clinic done from April 2012 to March 2013. The detailed history was taken into consideration with special emphasis on sexual history, sexual behaviours, specific exposures, socio-demographics and other high-risk markers.Results: Females formed the majority of the affected population with marital status, illiteracy, migrant status of the population being the independent demographic factors. The important findings were that the high-risk behaviors were more common in married population and the inconsistent condom use in marital encounters were found to be the cause of increasing prevalence in the study population.Conclusions: The spread of the STIs from high risk population to no risk general population is an alarming sign.
Assessment of prevalence and risk factors for anaemia in pregnant women attending Karnataka institute of medical sciences, outpatient department, Hubballi, Karnataka, India
Authors: Bant Dattatraya D. , Kumar Shiv
Published: April 2020

Background: Anaemia in pregnancy is one of the major causes of maternal morbidity and mortality in India and world. Anaemia in pregnancy continues to be a problem in spite of national programs for its prevention and control. It accounts for 1/5th of maternal deaths worldwide and 16% in India and is the major factor responsible for low birth weight, abortions, premature birth, and post-partum haemorrhage. Hence determining the status and factors influencing anaemia among pregnant women is essential to treat and prevent the same. Objective of this study was to assess the prevalence and risk factors associated with anaemia among pregnant women.Methods: A cross sectional study was conducted among 200 pregnant women attending for antenatal care at KIMS OPD from 3rd June to 4th July. A pretested, semi-structured questionnaire was applied to collect data. Haemoglobin estimation was done by Sahli’s method.Results: Prevalence of anaemia among pregnant women was found to be 81%; majority had moderate anaemia 57%. The mean age of pregnant women in the study is 24.55 years and 46.5% belong to lower socioeconomic status, 43% lived in joint families. Factors influencing anaemia were multi-parity, short inter-pregnancy interval, no history of recent deworming and iron and folic acid tablets intake.Conclusions: In the present study, the prevalence of anaemia among pregnant women was found to be very high i.e., 81% especially among illiterates, low income groups, multiparous women, short inter-pregnancy interval, no history of recent deworming and iron and folic acid tablets intake.
Assessment and association of various factors affecting pulmonary function of workers of a factory
Authors: Singhvi Shreyans D. , Singh Preksha T. , Khan Rafe M.
Published: April 2020

Background: Occupational health diseases are becoming vividly active in the present scenario of the generation. Because of the active industrialization of the world, in the last century various industries are growing each and every day in various fields in multiple countries. Textile industries alone are one of the most common industry and a source of occupation for more than 20 million workers in India itself. Therefore, it is very important to ensure proper preventive and medical strategies for the industrial workers.Methods: A cross sectional study of 240 workers in a textile industry, was performed. For the study, a well structural questionnaire and peak expiratory flow rate (PEFR) examination was used. Several factors were considered for the abnormality of the PEFR and considerable associations were questioned. The statistical analysis is made by chi-square test and p-values.Results: There are positive association found with abnormal PEFR found and multiple factors including age of the workers, duration of exposure and type of exposure.Conclusions: The industrial workers are very prone to develop pulmonary occupational diseases; therefore, it is very important to make preventive measures for its associative factors causing it.
Study of utilization of antenatal care services and its determinants among pregnant women admitted in a tertiary care hospital in Mangaluru, Karnataka, India
Authors: Kumar Hemant , Chacko Iybu V. , Mane Seema , N. Govindan Narayanan , Prasanth Sneha
Published: April 2020

Background: Globally only 64% of women receive antenatal (prenatal) care four or more times throughout their pregnancy. National family health survey (NFHS) -4, brings out that in India, 21% of pregnant women utilized full ANC, ranging from 2.3-65.9% across the states. Quality health care during pregnancy and childbirth can prevent many pregnancy related deaths. The objective of the present study was to examine utilization of antenatal care services among the study subjects and find out its determinants, including out of pocket expenditure incurred on management of the pregnancies.Methods: The study was conducted in a tertiary care teaching hospital among full term pregnant mothers and those who had recently delivered. Purposive sampling method was used and sample size of 368 was calculated.Results: The study brought out that 100% women had their registration, 75.5% of them within 12 weeks of pregnancy. Majority of the women (69.5%) preferred private health care facility clinic for antenatal check-up. However, the utilization of various government schemes in place for the benefit of pregnant mothers were underutilized (26.6%).The study also revealed that 16.0% of the families suffered catastrophic expenditure as the cost of treatment on antenatal care and treatment went beyond household budget and they had to borrow money for the treatment.Conclusions: A significant association was found between number of antenatal visits and increasing age, higher socio-economic status, higher educational status, Hindu religion, place of residence (urban), nuclear type of family and early registration.
Encephalitis with autoimmune disease in pediatric patients General X Hospital Yogyakarta Indonesia: a case report study
Authors: Adi Giri Susilo , Priliana Wiwi Kustio , Pratiwi Etik , Nurzulaekha Anisa Guntias
Published: April 2020

Encephalitis is an infection of brain parenchymal tissue by various microorganisms. In encephalitis inflammation of brain tissue occurs. The purpose of this case study is to introduce the case of encephalitis and nursing care that occurs in children, especially in the area of Central Java as one area in Indonesia. This is a case study; the case was taken from a case of managed patient in the X central hospital. Patient management is carried out for 3 days. A 7 years old pediatric patient coming from neurology poly. One year before the hospital, the child had a seizure of GTC with a duration of 6 hours, was unconscious and then taken to the general hospital after the seizure the child appeared to be hyperactive and had no eye contact. Six months before being admitted to the hospital, the child was taken to the RSA then blood tested and a positive CMV check was performed. The child is then managed as autoimmune encephalitis. nurses perform nursing care for 7 days. Families understand more about the care process in children with encephalitis, especially in terms of infection problems, growth and development, the risk of falls, and drug management. be at home later.
Integração das Tecnologias Móveis em Aulas de Cursos Superiores da Área da Saúde
Authors: Nascimento Karla Angélica Silva do , Fialho Lia Machado Fiuza
Published: April 2020

A proliferação do uso das tecnologias móveis como ferramentas didáticas em aulas de graduação em cursos superiores de saúde vem ampliando-se, no entanto, tais recursos precisam ser adotados com responsabilidade, considerando realidades específicas, com vistas a qualificar o ensino e a aprendizagem; temática que merece reflexão crítica. O estudo teve como objetivo discutir a compreensão dos docentes dos cursos de Fisioterapia e Enfermagem de uma instituição de ensino superior particular da cidade de Fortaleza, no Ceará, sobre a importância e a adoção das tecnologias móveis no processo de ensino e aprendizagem em suas aulas. A pesquisa, de abordagem qualitativa, do tipo estudo de caso, utilizou como técnica de coleta de dados um questionário on-line composto de 15 questões – abertas e fechadas – para identificar a importância atribuída à integração da tecnologia móvel nas aulas e a maneira como os docentes a utilizavam didaticamente. Os resultados mostram que os professores acreditam que a utilização de tecnologias móveis pode contribuir significativamente no processo de ensino e aprendizagem na área da Saúde, contudo, consideram fundamental investir na formação docente em serviço, pois inferem que não adianta apenas a Instituição de Ensino Superior possuir estrutura e recursos tecnológicos se não há o conhecimento profissional necessário para uma utilização qualificada.
Palavras-chave: Tecnologia móvel. Prática docente. Ensino superior. Educação em saúde.
Migracje a zmiana celowa
Authors: Romaniszyn Krystyna
Published: April 2020

Przedmiotem analizy podjętej w artykule jest kwestia zmiany celowej jako rezultatu wprowadzania w życie ustaleń Globalnego Paktu dla Migracji (The Global Compact for Safe Orderly and Regular Migration), powstałego pod auspicjami ONZ i sygnowanego przez liczne kraje świata w grudniu 2018 r. w Maroku. Wychodząc od ogólnego omówienia związku między migracjami i zmianą, przechodzę do omówienia procesów formujących współczesnych ludzi tak, iż stają się oni przygotowani do stałej mobilności. W rezultacie powstaje „człowiek mobilny”, jak go nazywam, odpowiadający zapotrzebowaniu na mobilną siłą roboczą, jako wymogu powstałej gospodarki światowej.
National–European identity and notions of citizenship: A comparative study between Portuguese and Greek university student teachers
Authors: Apostolidou Eleni , Solé Gloria
Published: April 2020

This paper reports a study of prospective teachers' views about Europe, and European and national identity, in Greece and Portugal. The paper analyses written responses to a closed multiple-choice questionnaire provided by 33 Greek and 35 Portuguese prospective teachers following courses
in Ioannina and Braga universities in early 2018. First, students were asked to answer 15 closed questions related to their perceptions of national, European and other identities. More specifically they were asked to choose among different associations of Europe and different levels of how
their country is integrated into Europe. Also, they were asked to choose their preferred 'identification with particular identities' (Villaverde Cabral and Machado Pais, 1998) and to articulate their notions of citizenship by commenting on different criteria for the naturalization of immigrants.
Finally, they were asked to predict the future of the European Union by answering an open question. Data analysis focused on the 2018 data and on comparisons with existing data sets, collected in Greece and Portugal since 1994, relating to perceptions of national and European identity and
to notions of citizenship. The authors expected to find change over time in data on attitudes in the two countries, reflecting the impacts of the recent economic crisis in both Portugal and Greece and the refugee crisis, particularly in Greece. Portuguese participants were found to manifest
a more positive perspective on Portuguese–European integration than had been the case in earlier data sets, while at the same time wishing to preserve some specific aspects of national identity. The Greek students were found generally to be consistent with their pro-European viewpoints,
but at the same time there seems to have been an increasing distrust of the European Union after the experience of the 2010–18 economic crisis – indications of which were apparent in some earlier findings .
Teaching bias in history lessons: An example using Maltese history
Authors: Vella Yosanne
Published: April 2020

Historians collect and verify evidence and then interpret it in an acceptable way. A general consensus is that history does not present us with an absolute truth – the most we can hope for is historians' reliable, evidentially based interpretations of the historical topic. History
not viewed as interpretation has long raised alarm bells in history pedagogy circles. History educators are acutely aware that history taught as an uncontested body of positivistic knowledge with a canon of given factual information can promote prejudice, bias and bigotry – it can ultimately
fuel civil and international conflict and violence. Alternatively, history teaching as a constructivist process with multiple interpretations can be used to promote positive values – history pedagogy can be a tool to support peace, reconciliation and conflict resolution. This places
a major responsibility on a key objective of history teaching: addressing the concept of historical bias with effective methods of teaching on how to detect and analyse bias in historical sources for both primary and secondary schools. This paper reports an attempt at teaching secondary school
students (aged 13 to 14 years) how to detect bias in primary written history sources while learning about a controversial topic in Maltese history – church– state relations in Malta in the 1960s. The method employed is qualitative research – specifically pedagogical research
– which is research into the processes and practices of learning and teaching. In this case, the researcher tries new teaching methods with a small group of students, and their feedback regarding the exercise is examined. The students' ultimate answers after trying out the new scaffolding
activities were quite encouraging, and show that breakdown of tasks is the key to helping understanding in history learning. The pedagogy employed is discussed in comparison to other approaches to teaching about bias. The paper also analyses student feedback on their learning about bias. Crucially,
the paper addresses the impact of a specific intervention strategy to improve student understanding of, and ability to detect, bias in historical sources.
Simulação realística de atendimento a incidentes com múltiplas vítimas pelo programa de residência em enfermagem
Authors: Vilaça Luana Vilela , Penido Bianca Vechia , Santos Marielle Aparecida , Dutra Cíntia Machado , Ferreira Lúcia Aparecida , Chavaglia Suzel Regina Ribeiro
Published: April 2020

Este é um relato de experiência desenvolvido no primeiro semestre de 2018, que tem como objetivo discorrer sobre a vivência na organização e desenvolvimento da simulação realística de atendimento a múltiplas vítimas. Utilizou-se o método Simple Triage And Rapid Treatment, de modo que os profissionais tiveram a oportunidade de evidenciar suas limitações. Participaram 40 profissionais, sendo 15 da equipe do corpo de bombeiros, 20 profissionais do Serviço de Atendimento Móvel de Urgência e 5 alunos da residência uniprofissional em enfermagem em urgência, emergência e trauma. Foram abordados aspectos que vão desde a chamada, classificação, até modo de atendimento. O processo de aprendizagem por meio de situações simuladas se mostrou útil e efetivo para avaliar desempenhos e habilidades, além de viabilizar e incentivar a cooperação mútua entre as equipes.
Diagnóstico matemático de la monitoría fetal con la Ley de Zipf-Mandelbrot y la teoría de los sistemas dinámicos aplicados a la fisiología cardiaca
Authors: Rodríguez Javier , Prieto Signed , Ortiz Liliana , Bautista Alejandro , Álvarez Luis , Correa Catalina , Avilán Nicolás
Published: April 2020

Objetivo: desarrollar un diagnóstico matemático de la monitoría fetal a partir de la aplicación de la ley de Zipf-Mandelbrot y las concepciones de salud y enfermedad de los sistemas dinámicos a la aparición de Componentes Dinámicos del Sistema (CDS) en el trazado de la monitoría. Esta evaluación se hace calculando el grado de complejidad de la distribución de los CDS.Diseño: este estudio es de concordancia diagnóstica basado en una aplicación de la ley de los lenguajes naturales y de simplificaciones fisiológicas basadas en la teoría de sistemas dinámicos a la aparición de CDS de las frecuencias cardiacas fetales para construir una generalización diagnóstica.Materiales y métodos: se evaluaron 100 monitorías de mujeres gestantes divididas en dos grupos: grupo A, 50 gestantes con factores de riesgo, y grupo B, 50 sin factores de riesgo. Basados en simplificaciones dinámicas, prototipos seleccionados y en la aplicación de la ley de Zipf-Mandelbrot para caracterizar el grado de complejidad usando todos los CDS posibles, se realizaron comparaciones con el resto de las monitorías diferenciando salud de enfermedad.Resultados: la dinámica cardiaca de un feto sano tiene una autorganización matemática caracterizada por su grado de complejidad y la ausencia de CDS Invertidos Pronunciados (CDSiP) y la enfermedad es caracterizada por la pérdida de complejidad o la presencia de uno o más CDSiP, o la presencia de un CDS Invertido (CDSi) mayor o igual a 20x40 hasta 20x50 asociado a la aparición de otro CDSi mayor o igual de 20x50 o de la ausencia de CDS del grupo de 15 y/o de 20 latidos/minuto de altura, o combinaciones de las medidas diagnósticas. De acuerdo a las medidas obtenidas una de cada dos monitorías del grupo B y una de cada seis del grupo A tienen un diagnóstico equivocado según los parámetros clínicos convencionales.Conclusiones: la caracterización matemática de las monitorías permitió diferenciar salud de enfermedad de manera objetiva y reproducible en el desarrollo de un diagnóstico de aplicación clínica.
Más cerca de SciELO
Authors: Agudelo Carlos A.
Published: April 2020

Es bien sabido que en el concierto mundial, los países de América Latina representan solo una pequeña parte de los investigadores y la inversión en ciencia y tecnología. Colombia, a su vez, representa en América Latina una parte aún más pequeña en estos mismos aspectos. América Latina y Colombia en particular no están bien representadas en el material publicado por las revistas científicas indexadas, de acuerdo con el potencial que tienen y lo que producen. Así, por ejemplo, la revista British Medical Journal (http://bmj.bmjjournals. com/advice/ms_breakdown.shtml) informa que recibió 5.751 artículos para publicación en el año 2000 y aceptó sólo el 12 % de los mismos. De América Central y del Sur se recibieron 27 artículos de los cuales fueron aceptados 2. Ninguno de estos provino de Colombia, que muestra una enorme debilidad aún frente a vecinos cuyo gasto en ciencia y tecnología es, en algunos casos, inferior. De lo anterior se deriva una consecuencia: América Latina y Colombia están mal representadas en los index internacionales.
Estudio piloto de prevalencia de infección por Chlamydia trachomatis detectada por PCR en mujeres con parto prematuro en el Instituto Materno Infantil de Bogotá
Authors: Ruiz Ariel Iván , Sanchez Ruth , Ostos Olga , Angel Edith , Bonilla Hernando , Cifuentes Carolina , Correa Constanza
Published: April 2020

Objetivo: determinar la prevalencia de infección por C. trachomatis en mujeres con parto prematuro.Metodología: estudio de corte transversal en el que se analizaron 50 muestras de orina de mujeres que asistieron al Instituto Materno Infantil de Bogotá entre febrero y junio de 2004, quienes presentaron parto prematuro entre las 25 y las 36 semanas de gestación. Para su detección se utilizó la técnica de reacción en cadena de la polimerasa (PCR COBAS AMPLICOR CT, Roche diagnostic Systems).Resultados: se encontraron dos muestras positivas para C. trachomatis, lo que corresponde a una prevalencia del 4% (IC95% 0,5 - 13,7) en mujeres con parto prematuro y del 4,5% (IC95% 0,6 - 15,5) en pacientes con RPM.Conclusión: la C. trachomatis debe investigarse en pacientes con trabajo de parto prematuro o con RPM pretérmino, aún en ausencia del antecedente de flujo genital patológico y particularmente en quienes no se encuentra la causa del trabajo de parto prematuro.
El Instituto Materno Infantil y los planes de reducción de la mortalidad materna: un reto para el sistema de seguridad social en salud
Authors: Gaitán Hernando
Published: April 2020

Cada minuto muere una mujer por complicaciones del embarazo o el parto en el mundo. Por cada mujer que muere, hay 30 más que presentan secuelas de las complicaciones de este periodo,1 sin mencionar el serio impacto que se genera sobre la salud de los recién nacidos. Los hijos de madres que fallecen por problemas relacionados con el embarazo, parto o puerperio tienen 10 veces más riesgo de morir que los recién nacidos de madres que sobreviven.2 La mortalidad materna es un indicador del desarrollo de una nación, es una señal acerca de la disparidad e inequidad en la distribución de la riqueza entre países y dentro de ellos mismos, entre hombres y mujeres, así como también brinda una seña del sitio que ocupa la mujer en una sociedad.3
Situación actual de la Revista Colombiana de Obstetricia y Ginecología
Authors: León José William
Published: April 2020

Es altamente gratificante presentar este número de la Revista Colombiana de Obstetricia y Ginecología, que es patrocinada por la Federación Colombiana de Asociaciones de Obstetricia y Ginecología (antigua Sociedad Colombiana de Obstetricia y Ginecología), en el momento que ésta atraviesa por su mejor momento desde el punto de vista académico y por ser evidente que ha respondido a las expectativas de los autores, de los lectores, de los asociados y del personal científico nacional e internacional, que la han adoptado como texto de imprescindible consulta.
Manejo de la infección materna con VIH y del recién nacido expuesto
Authors: Fonseca Carlos Eduardo , Prieto Franklyn Edwin
Published: April 2020

El VIH/SIDA afecta cada vez más a las mujeres, lo que aumenta la posibilidad de transmisión perinatal. La detección temprana del VIH mediante el acceso a la consejería y prueba voluntaria durante el control prenatal facilitan el tratamiento anti-retroviral oportuno que disminuye la transmisión durante el embarazo y el parto, y en el puerperio, asociado a la lactancia materna. En la presente revisión se condensan los principales aspectos del manejo de la infección materna con VIH y del recién nacido expuesto. La aplicación de un protocolo integral de atención facilita la disminución de la transmisión a niveles menores de 2%.
Nódulo palpable de mama
Authors: Gallego Gildardo
Published: April 2020

Se realiza una revisión completa del nódulo palpable de mama, con énfasis en su importancia como causa de consulta ginecológica. Se describen las entidades más comunes de la glándula mamaria, tanto benignas como malignas, que se manifiestan como un nódulo palpable, desde los fibroadenomas, lipomas, cistosarcoma fillodes, quistes mamarios, necrosis grasa, hasta el cáncer de mama.La revisión también presenta las pautas que permiten realizar un diagnóstico diferencial tanto en mujeres mayores como en las menores de cuarenta años, así como las ayudas diagnósticas paraclínicas y las opciones de tratamiento disponibles. Se pretende brindar una visión práctica de la aproximación al nódulo palpable de mama, para que el médico realice un diagnóstico y tratamiento adecuados, que redundan en bien de la paciente.
Pseudoaneurisma de arteria iliaca externa izquierda: hallazgo intraoperatorio incidental en un caso de histerectomía por leiomiomas
Authors: Gómez Carlos Alberto
Published: April 2020

Se presenta el caso de una paciente de 42 años sometida a histerectomía abdominal por diagnóstico de miomatosis. En el acto operatorio ginecológico se halló incidentalmente un pseudoaneurisma de la arteria iliaca izquierda, posiblemente relacionado con el antecedente quirúrgico de un cateterismo durante la implantación de una válvula mitral protésica meses antes del procedimiento ginecológico. Posteriormente la paciente fue sometida a reparación de la anomalía mediante un injerto vascular. Tuvo buena evolución de ambos procedimientos.