Subjects -> HEALTH AND SAFETY (Total: 1540 journals)
    - CIVIL DEFENSE (22 journals)
    - DRUG ABUSE AND ALCOHOLISM (86 journals)
    - HEALTH AND SAFETY (721 journals)
    - HEALTH FACILITIES AND ADMINISTRATION (390 journals)
    - OCCUPATIONAL HEALTH AND SAFETY (108 journals)
    - PHYSICAL FITNESS AND HYGIENE (131 journals)
    - WOMEN'S HEALTH (82 journals)

HEALTH AND SAFETY (721 journals)                  1 2 3 4 | Last

Showing 1 - 200 of 203 Journals sorted alphabetically
16 de Abril     Open Access   (Followers: 4)
Acta Informatica Medica     Open Access   (Followers: 2)
Acta Scientiarum. Health Sciences     Open Access   (Followers: 3)
Adultspan Journal     Hybrid Journal   (Followers: 1)
Advances in Child Development and Behavior     Full-text available via subscription   (Followers: 12)
Advances in Public Health     Open Access   (Followers: 28)
Adversity and Resilience Science : Journal of Research and Practice     Hybrid Journal   (Followers: 3)
African Health Sciences     Open Access   (Followers: 5)
African Journal for Physical, Health Education, Recreation and Dance     Full-text available via subscription   (Followers: 7)
African Journal of Health Professions Education     Open Access   (Followers: 6)
Afrimedic Journal     Open Access   (Followers: 3)
Ageing & Society     Hybrid Journal   (Followers: 47)
Air Quality, Atmosphere & Health     Hybrid Journal   (Followers: 7)
AJOB Empirical Bioethics     Hybrid Journal   (Followers: 3)
Akademika     Open Access   (Followers: 1)
American Journal of Family Therapy     Hybrid Journal   (Followers: 10)
American Journal of Health Economics     Full-text available via subscription   (Followers: 21)
American Journal of Health Education     Hybrid Journal   (Followers: 36)
American Journal of Health Promotion     Hybrid Journal   (Followers: 34)
American Journal of Health Sciences     Open Access   (Followers: 12)
American Journal of Health Studies     Full-text available via subscription   (Followers: 16)
American Journal of Preventive Medicine     Hybrid Journal   (Followers: 32)
American Journal of Public Health     Full-text available via subscription   (Followers: 279)
American Journal of Public Health Research     Open Access   (Followers: 28)
American Medical Writers Association Journal     Full-text available via subscription   (Followers: 6)
Analytic Methods in Accident Research     Hybrid Journal   (Followers: 8)
Annales des Sciences de la Santé     Open Access  
Annali dell'Istituto Superiore di Sanità     Open Access  
Annals of Global Health     Open Access   (Followers: 14)
Annals of Health Law     Open Access   (Followers: 6)
Annals of Tropical Medicine and Public Health     Open Access   (Followers: 15)
Applied Biosafety     Hybrid Journal   (Followers: 1)
Applied Research In Health And Social Sciences: Interface And Interaction     Open Access   (Followers: 5)
Apuntes Universitarios     Open Access   (Followers: 1)
Archive of Community Health     Open Access   (Followers: 1)
Archives of Community Medicine and Public Health     Open Access   (Followers: 2)
Archives of Medicine and Health Sciences     Open Access   (Followers: 5)
Archives of Suicide Research     Hybrid Journal   (Followers: 10)
Archivos de Prevención de Riesgos Laborales     Open Access   (Followers: 1)
Arquivos de Ciências da Saúde     Open Access  
Asia Pacific Journal of Counselling and Psychotherapy     Hybrid Journal   (Followers: 11)
Asia Pacific Journal of Health Management     Full-text available via subscription   (Followers: 5)
Asia-Pacific Journal of Public Health     Hybrid Journal   (Followers: 12)
Asian Journal of Gambling Issues and Public Health     Open Access   (Followers: 4)
Asian Journal of Medicine and Health     Open Access   (Followers: 1)
Atención Primaria     Open Access   (Followers: 2)
Atención Primaria Práctica     Open Access   (Followers: 1)
Australasian Journal of Paramedicine     Open Access   (Followers: 6)
Australian Advanced Aesthetics     Full-text available via subscription   (Followers: 4)
Australian Family Physician     Full-text available via subscription   (Followers: 3)
Australian Indigenous HealthBulletin     Free   (Followers: 5)
Autism & Developmental Language Impairments     Open Access   (Followers: 16)
Behavioral Healthcare     Full-text available via subscription   (Followers: 8)
Bijzijn     Hybrid Journal   (Followers: 1)
Bijzijn XL     Hybrid Journal  
Biomedical Safety & Standards     Full-text available via subscription   (Followers: 8)
Biosafety and Health     Open Access   (Followers: 5)
Biosalud     Open Access   (Followers: 1)
Birat Journal of Health Sciences     Open Access  
BLDE University Journal of Health Sciences     Open Access  
BMC Oral Health     Open Access   (Followers: 7)
BMC Pregnancy and Childbirth     Open Access   (Followers: 24)
BMJ Simulation & Technology Enhanced Learning     Hybrid Journal   (Followers: 12)
Boletin Médico de Postgrado     Open Access  
Brazilian Journal of Medicine and Human Health     Open Access  
British Journal of Health Psychology     Hybrid Journal   (Followers: 50)
Buletin Penelitian Kesehatan     Open Access   (Followers: 2)
Buletin Penelitian Sistem Kesehatan     Open Access  
Bulletin of the World Health Organization     Open Access   (Followers: 23)
Cadernos de Educação, Saúde e Fisioterapia     Open Access   (Followers: 1)
Cadernos de Saúde     Open Access   (Followers: 1)
Cadernos Saúde Coletiva     Open Access   (Followers: 1)
Cambridge Quarterly of Healthcare Ethics     Hybrid Journal   (Followers: 14)
Canadian Family Physician     Partially Free   (Followers: 13)
Canadian Journal of Community Mental Health     Full-text available via subscription   (Followers: 14)
Canadian Journal of Human Sexuality     Hybrid Journal   (Followers: 3)
Canadian Journal of Public Health     Hybrid Journal   (Followers: 27)
Cannabis and Cannabinoid Research     Hybrid Journal   (Followers: 2)
Carta Comunitaria     Open Access  
Case Reports in Women's Health     Open Access   (Followers: 4)
Case Studies in Fire Safety     Open Access   (Followers: 25)
CASUS : Revista de Investigación y Casos en Salud     Open Access   (Followers: 1)
Central Asian Journal of Global Health     Open Access   (Followers: 2)
CES Medicina     Open Access  
CES Salud Pública     Open Access   (Followers: 1)
Child Abuse Research in South Africa     Full-text available via subscription   (Followers: 1)
Child's Nervous System     Hybrid Journal  
Childhood Obesity and Nutrition     Open Access   (Followers: 11)
Children     Open Access   (Followers: 2)
CHRISMED Journal of Health and Research     Open Access   (Followers: 2)
Christian Journal for Global Health     Open Access  
Ciência & Saúde Coletiva     Open Access   (Followers: 2)
Ciencia & Salud     Open Access   (Followers: 2)
Ciencia & Trabajo     Open Access   (Followers: 1)
Ciencia e Innovación en Salud     Open Access  
Ciencia y Cuidado     Open Access   (Followers: 1)
Ciencia y Salud     Open Access   (Followers: 4)
Ciencia y Salud Virtual     Open Access  
Ciencia, Tecnología y Salud     Open Access   (Followers: 2)
Cities & Health     Hybrid Journal   (Followers: 2)
Clinical and Experimental Health Sciences     Open Access   (Followers: 1)
ClinicoEconomics and Outcomes Research     Open Access   (Followers: 2)
Clocks & Sleep     Open Access   (Followers: 2)
CME     Hybrid Journal   (Followers: 2)
CoDAS     Open Access  
Community Health     Open Access   (Followers: 6)
Conflict and Health     Open Access   (Followers: 8)
Contraception and Reproductive Medicine     Open Access   (Followers: 2)
Cuaderno de investigaciones: semilleros andina     Open Access   (Followers: 3)
Cuadernos de la Escuela de Salud Pública     Open Access  
Current Opinion in Behavioral Sciences     Hybrid Journal   (Followers: 10)
Current Opinion in Environmental Science & Health     Hybrid Journal   (Followers: 1)
Das österreichische Gesundheitswesen ÖKZ     Hybrid Journal   (Followers: 1)
Day Surgery Australia     Full-text available via subscription   (Followers: 2)
Design for Health     Hybrid Journal  
Digital Health     Open Access   (Followers: 9)
Disaster Medicine and Public Health Preparedness     Hybrid Journal   (Followers: 14)
Diversity and Equality in Health and Care     Open Access   (Followers: 9)
Diversity of Research in Health Journal     Open Access  
Dramatherapy     Hybrid Journal   (Followers: 3)
Drogues, santé et société     Open Access   (Followers: 2)
Duazary     Open Access   (Followers: 1)
Düzce Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi / Journal of Duzce University Health Sciences Institute     Open Access  
Early Childhood Research Quarterly     Hybrid Journal   (Followers: 26)
East African Journal of Public Health     Full-text available via subscription   (Followers: 4)
Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity     Hybrid Journal   (Followers: 24)
EcoHealth     Hybrid Journal   (Followers: 5)
Education for Health     Open Access   (Followers: 9)
ElectronicHealthcare     Full-text available via subscription   (Followers: 3)
Elsevier Ergonomics Book Series     Full-text available via subscription   (Followers: 5)
Emergency Services SA     Full-text available via subscription   (Followers: 2)
Ensaios e Ciência : Ciências Biológicas, Agrárias e da Saúde     Open Access  
Environmental Disease     Open Access   (Followers: 4)
Environmental Sciences Europe     Open Access   (Followers: 2)
Epidemics     Open Access   (Followers: 5)
Epidemiologic Perspectives & Innovations     Open Access   (Followers: 6)
Epidemiology, Biostatistics and Public Health     Open Access   (Followers: 22)
EsSEX : Revista Científica     Open Access   (Followers: 1)
Estudios sociales : Revista de alimentación contemporánea y desarrollo regional     Open Access   (Followers: 1)
Ethics & Human Research     Hybrid Journal   (Followers: 3)
Ethics, Medicine and Public Health     Full-text available via subscription   (Followers: 7)
Ethiopian Journal of Health Development     Open Access   (Followers: 7)
Ethiopian Journal of Health Sciences     Open Access   (Followers: 8)
Ethnicity & Health     Hybrid Journal   (Followers: 14)
Eurasian Journal of Health Technology Assessment     Open Access  
EUREKA : Health Sciences     Open Access   (Followers: 2)
European Journal of Investigation in Health, Psychology and Education     Open Access   (Followers: 5)
European Medical, Health and Pharmaceutical Journal     Open Access   (Followers: 1)
Evaluation & the Health Professions     Hybrid Journal   (Followers: 10)
Evidence-based Medicine & Public Health     Open Access   (Followers: 9)
Evidência - Ciência e Biotecnologia - Interdisciplinar     Open Access  
Expressa Extensão     Open Access  
Face à face     Open Access   (Followers: 1)
Families, Systems, & Health     Full-text available via subscription   (Followers: 9)
Family & Community Health     Hybrid Journal   (Followers: 14)
Family Medicine and Community Health     Open Access   (Followers: 10)
Family Relations     Partially Free   (Followers: 15)
Fatigue : Biomedicine, Health & Behavior     Hybrid Journal   (Followers: 2)
Finnish Journal of eHealth and eWelfare : Finjehew     Open Access  
Food and Public Health     Open Access   (Followers: 19)
Food Quality and Safety     Open Access   (Followers: 1)
Frontiers in Digital Health     Open Access   (Followers: 2)
Frontiers in Public Health     Open Access   (Followers: 9)
Frontiers of Health Services Management     Partially Free   (Followers: 4)
Gaceta Sanitaria     Open Access   (Followers: 3)
Galen Medical Journal     Open Access   (Followers: 1)
Ganesha Journal     Open Access  
Gazi Sağlık Bilimleri Dergisi     Open Access  
Geospatial Health     Open Access   (Followers: 1)
Gestão e Desenvolvimento     Open Access  
Gesundheitsökonomie & Qualitätsmanagement     Hybrid Journal   (Followers: 9)
Giornale Italiano di Health Technology Assessment     Full-text available via subscription  
Global Advances in Health and Medicine     Open Access  
Global Challenges     Open Access  
Global Health : Science and Practice     Open Access   (Followers: 8)
Global Health Annual Review     Open Access   (Followers: 4)
Global Health Journal     Open Access   (Followers: 2)
Global Health Promotion     Hybrid Journal   (Followers: 17)
Global Journal of Health Science     Open Access   (Followers: 10)
Global Journal of Public Health     Open Access   (Followers: 14)
Global Medical & Health Communication     Open Access   (Followers: 2)
Global Mental Health     Open Access   (Followers: 9)
Global Reproductive Health     Open Access   (Followers: 1)
Global Security : Health, Science and Policy     Open Access   (Followers: 1)
Global Transitions     Open Access   (Followers: 1)
Globalization and Health     Open Access   (Followers: 9)
Hacia la Promoción de la Salud     Open Access  
Hastane Öncesi Dergisi     Open Access  
Hastings Center Report     Hybrid Journal   (Followers: 5)
HCU Journal     Open Access  
HEADline     Hybrid Journal  
Health & Place     Hybrid Journal   (Followers: 19)
Health & Justice     Open Access   (Followers: 6)
Health : An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine     Hybrid Journal   (Followers: 15)
Health and Human Rights     Open Access   (Followers: 10)
Health and Research Journal     Open Access   (Followers: 4)
Health and Social Care Chaplaincy     Hybrid Journal   (Followers: 11)
Health and Social Work     Hybrid Journal   (Followers: 71)
Health Behavior and Policy Review     Full-text available via subscription   (Followers: 5)
Health Behavior Research     Open Access   (Followers: 6)

        1 2 3 4 | Last

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CES Medicina
Number of Followers: 0  

  This is an Open Access Journal Open Access journal
ISSN (Print) 0120-8705 - ISSN (Online) 2215-9177
Published by SciELO Homepage  [912 journals]
  • ¿Para qué somos médicos'

    •  
  • Medication adherence of patients with diabetes mellitus in a
           nephroprevention program: a shared responsibility

    • Abstract: Resumen Introducción: la diabetes mellitus tipo dos es una enfermedad crónica de gran impacto en salud pública; su mal control clínico está supeditado a la deficiente adherencia farmacológica. Los programas de nefroprotección intentan mejorar el control de esta enfermedad y una adecuada adherencia puede ser una estrategia. El objetivo del estudio fue determinar los factores asociados con la adherencia farmacológica de pacientes con diabetes en el contexto de un programa de nefroprotección. Materiales y métodos: estudio transversal analítico en 282 pacientes con diabetes mellitus tipo dos de un programa de nefroprotección en los municipios de Pasto y Túquerres en el año 2017, seleccionados mediante muestreo aleatorio, sistemático estratificado. La adherencia se midió con el test Morisky-Green. La información se obtuvo de bases de datos de las historias clínicas y mediante un cuestionario estructurado. Se efectuaron análisis descriptivo, bivariado y regresión logística binaria multivariada con fines explicativos. Las medidas de asociación fueron razones de prevalencia (RP). Resultados: la mediana de la edad fue de 67 años, 33 % fueron hombres y la proporción de adherencia del 68 %; los factores que se asociaron independientemente fueron, ser mujer RP: 1,25 (IC 95 %: 1,02-4,07), hemoglobina glicosilada entre 6 y 6,9 % RP: 1,66 (1,37-11,80), no uso de insulina RP: 1,36 (1,03-8,52), empleo de solo metformina RP: 1,76 (1,76-10,15) y consulta por medicina interna RP: 1,19 (1,19-4,78). Conclusión: la adherencia farmacológica está influenciada por múltiples factores que no sólo dependen del paciente, sino que involucran también a los profesionales de salud, el tipo de medicación y su disponibilidad, además de asociarse con el control glucémico.Abstract Introduction: The type two diabetes is a chronic disease of great impact on public health. Its deficient clinical control is subject to poor medication adherence. Nephroprevention programs seek to improve the contro of this disease and an adequate adherence may be a strategy. The aim of this study was to determine the factors associated with medication adherence in patients with diabetes in the context of a nephroprevention program. Materials and methods: A cross-sectional study was conducted among 282 patients with type two diabetes mellitus from a nephroprevention program in the municipalities of Pasto and Túquerres in 2017; they were selected by a systematic stratified random sampling. The Morisky-Green test assessed adherence. Information was obtained from databases, medical records and through a structured questionnaire. A descriptive, bivariate analysis and a multivariate binary logistic regression for explanatory purposes were performed. The association measures were prevalence ratios (PR). Results: The median age of the participants was 67 years, 33 % were men and the proportion of adherence was 68 %. Factors that were independently associated with adherence were being a wo- man, PR: 1,25 (95% CI: 1,02-4,07), glycosylated hemoglobin between 6 %-6,9 %, PR: 1,66 (1,37-11,80), not using insulin PR: 1,36 (1,03-8,52), use of only metformin PR: 1,76 (1,76-10,15) and consultation by internal medicine, PR: 1,19 (1,19-4,78). Conclusion: The adherence to medication is influenced by multiple factors which not only depend on the patient, but also involve health professionals, the type of medication and its availability, as well as being associated with glycemic control
       
  • Sociodemographic, clinical and pharmacological characteristics of older
           adults with fractures, in three reference centers, Colombia

    • Abstract: Abstract Introduction: Falls and bone fractures are important causes of morbidity and mortality in the elderly. Its etiology is multicausal, including inadequate prescriptions and osteoporosis. The aim was to identify the clinical and pharmacological characteristics of a group of older adults diagnosed with fractures in Colombia. Methods: Cross-sectional study that analyzed the prescriptions made one month before the fracture, during hospitalization and discharge. Patients aged 60 years and over were selected, assisted in three reference centers in Colombia. The quality of the prescriptions was analyzed using the STOPP criteria. Results: 220 pa- tients with fractures were included, with a mean age of 75.3±10.3 years and 68.2 % were women. Hip fracture was the most frequent (37.7 %) and in-hospital mortality was 2.3 %. Prescription of calcium/vitamin D supplements and antiabsortive therapy at discharge was 23.7 % and 12.1 %, respectively. Prescriptions potentially inappropriate to discharge were identified in 11.6 % of patients and having five or more comorbidities was associated with greater probability of having them (OR:9.44, 95 % CI: 2.16-41.20). Conclusions: Medical staff generally do not formulate antiosteporotic medications as secondary prevention or improve the quality of prescriptions for fractured patients once they are hospitalized and discharged, so it is necessary to develop pharmacological strategies to help prevent new episodes of falls and fractures.Resumen Introducción: las caídas y fracturas óseas son causas importantes de morbilidad y mortalidad en ancianos. Su etiología es multicausal comprendiendo, entre otros, prescripciones inadecuadas y osteoporosis. El objetivo fue identificar las características clínicas y farmacológicas de un grupo de adultos mayores con fracturas. Materiales y métodos: estudio de corte transversal que analizó las prescripciones realizadas un mes antes de la fractura, durante la hospitalización y al egreso de 220 pacientes de 60 o más años atendidos en tres centros de referencia de Colombia. Se analizó la calidad de las prescripciones mediante los criterios STOPP. Resultados: la edad media fue de 75,3±10,3 años y 68,2 % eran mujeres. La fractura de cadera fue la más frecuente (37,7 %) y se presentó una mortalidad intrahospitalaria del 2,3 %. La prescripción de suplementos de calcio/vitamina D y terapia antiabsortiva al egreso fue de 23,7 % y 12,1 %, respectivamente. Las prescripciones potencialmente inapropiadas al egreso se identificaron en 11,6 % de pacientes y tener cinco o más comorbilidades se asoció con mayor probabilidad de tenerlas (OR:9,44, IC95 %: 2,16-41,20). Conclusiones: generalmente, el personal médico no formula medicamentos antiosteporóticos como prevención secundaria, ni mejoran la calidad de las prescripciones de los pacientes con fracturas una vez que son dados de alta, por lo que se hace necesario el desarrollo de estrategias farmacológicas para ayudar a prevenir nuevos episodios de caídas y fracturas.
       
  • Correlatos das dimensões de Burnout com características de saúde e
           demográficas de estudantes de medicina

    • Abstract: Resumo Objetivo: Correlacionar as dimensões da Síndrome de Burnout com características de saúde e demográficas de estudantes de Medicina de uma faculdade do sertão nordestino. Métodos: Estudo descritivo, transversal, correlacional com abordagem quantitativa. Participaram da pesquisa 138 alunos do curso de Medicina do Centro Universitario de Patos (UNIFIP). Foram critérios de inclusão ser estudante de medicina regularmente ma- triculado no curso das UNIFIP e possuir 18 anos ou mais de idade. A coleta de dados foi realizada a partir da aplicação de um questionário social e demográfico e do Maslach Burnout Inventory - Students Survey. Os dados foram analisados no Statistical Package for the Social Sciences a partir de Correlações Bisseriais e de Pearson. Resultados: A maioria dos discentes era do sexo feminino (58,7%), com idades entre 18-24 anos (83,3%) e sol- teiros (96,4%). O estudo evidenciou altas médias de exaustão emocional e eficácia profissional, e baixo índice de descrença. Contudo, na medida em que os discentes evoluem no curso, há aumento da exaustão emocional e da descrença, e redução da realização profissional. Ainda, os estudantes que pensaram em desistir do curso apresentaram tendência a maior pon- tuação em exaustão emocional e descrença, com menor pontuação em realização profissional. Conclusões: Não foram constatados indicativos da Síndrome de Burnout na amostra, entretanto, há risco de desenvolvê-la entre alunos em períodos mais avançados, entre aqueles insatisfeitos com o curso e que pensaram em desistir do mesmo.Resumen Objetivo: correlacionar las dimensiones del Síndrome de Burnout con las características demográficas y de salud de los estudiantes de Medicina de una universidad del noreste de Brasil. Métodos: Estudio descriptivo, transversal, correlacional con enfoque cuantitativo. Un total de 138 estudiantes de la Facultad de Medicina del Centro Universitario UNIFIP en Patos-PB participaron en la investigación. Los criterios de inclusión fueron ser un estudiante de Medicina matriculado regularmente en el curso FIP y tener 18 años de edad o más. La recolección de datos se realizó mediante la aplicación de un cuestionario social y demográfico y el Inventario de Burnout de Maslach - Encuesta de estudiantes. Los datos se analizaron en SPSS a partir de las correlaciones de Bisserial y Pearson. Resultados: la mayoría de los estudiantes eran mujeres (58,7 %), de 18 a 24 años (83,3 %) y solteras (96,4 %). El estudio mostró altos promedios de agotamiento emocional y efectividad profesional, y un bajo nivel de desconfianza. Sin embargo, a medida que los estudiantes evolucionan con el tiempo, aumenta el agotamiento emocional y la desconfianza, y se reduce el rendimiento profesional. Aun así, los estudiantes que pensaron en abandonar el curso tendieron a obtener puntajes más altos en agotamiento emocional e incredulidad, y puntajes más bajos en logros profesionales. Conclusiones: no hubo indicios de síndrome de Burnout en la muestra; sin embargo, existe el riesgo de desarrollarlo entre los estudiantes en períodos más avanzados, entre aquellos insatisfechos con el curso y los que considerar abandonarlo.
       
  • Academic stress level by oral and written evaluation in medical students
           of a University of the Sucre Department

    • Abstract: Resumen Introducción: todas las personas, independientemente de su raza, sexo o cualquier otra diferencia puede experimentar estrés, puesto que cotidiana- mente estamos expuestos a factores estresantes, y el ámbito educativo no es ajeno a este fenómeno. El objetivo de este trabajo es comparar el nivel de estrés en los estudiantes de Medicina de la Facultad de Ciencias de la Salud sometidos a evaluación oral y escrita. Metodología: se evaluó el perfil de estrés en los estudiantes por lo menos una semana antes de pre- sentar una prueba oral o escrita. Posteriormente, se procedió a aplicar el test para evaluar estrés académico en los estudiantes sometidos a prueba oral y escrita empleando el inventario Sisco. Resultados: los estudiantes de Medicina tienen estrés académico cuando son sometidos a evaluación escrita u oral indistintamente. Además de la evaluación, los estresores con mayor impacto son sobrecarga de tareas y trabajos escolares, no entender los temas que se abordan en clase y el tiempo limitado para hacer el trabajo. Los síntomas más frecuentes que demuestran el estrés académico fueron somnolencia o mayor necesidad de dormir, ansiedad, angustia o desesperación, aumento o reducción del consumo de alimentos y como estrategia se afrontamiento se encontró una gran tendencia a practicar la religiosidad. Conclusiones: las evaluaciones son una fuente importante de estrés académico en los estudiantes, por lo cual se recomienda implementar un plan de acción para reducir los niveles de estrés académico.Abstract Introduction: all people, regardless of race, sex or any other difference, may experience stress, since we are daily exposed to stressors, and the educational environment is no stranger to this phenomenon. The objective of this paper is to compare the level of stress in medical students of the Faculty of Health Sciences undergoing oral and written evaluation. Methodology: the stress profile was evaluated in the students at least one week before presenting an oral or written test. Subsequently, the test was applied to assess academic stress in students undergoing oral and written tests using the Sisco inventory. Results: Medical students have academic stress when they are subject to written or oral evaluation. In addition to the evaluation, the stressors with the greatest impact are homework and school work overload, not understanding the topics addressed in class and the limited time to do the work. The most frequent symptoms that demonstrate academic stress were drowsiness or increased need for sleep, anxiety, anguish or despair, increased or reduced food consumption and as a coping strategy a great tendency to practice religiosity was found. Conclusions: Evaluations are an important source of academic stress in students, so it is recommended to implement an action plan to reduce levels of academic stress.
       
  • General approach of the patient with erythema nodosum

    • Abstract: Resumen El eritema nudoso es una reacción de hipersensibilidad cutánea consistente en nódulos eritematosos, sensibles a la palpación, que se encuentran generalmente sobre la región pretibial, aunque también pueden compro- meter muslos, extremidades superiores, glúteos y rostro. La fiebre y las artralgias pueden ser manifestaciones concomitantes. Las lesiones tipo placa pueden aparecer de forma aislada o ser confluentes, evolucionando luego a nódulos dolorosos en el transcurso de varios días. Usualmente, tiene un curso agudo, aunque se han descrito presentaciones crónicas, recurrentes, poco frecuentes. La mayoría de las veces el examen microscópico de las lesiones muestra paniculitis septal sin vasculitis, siendo en ocasiones mixta (lobulillar y septal). Clásicamente, se ha considerado el heraldo de una condición sistémica subyacente (infecciosa o autoinmune) o un fenómeno reactivo tras la exposición a un tóxico o un fármaco. De allí la importancia de conocer su abordaje diagnóstico por parte del médico de atención primaria.Abstract Erythema nodosum is a reaction of cutaneous hypersensitivity consisting of erythematous nodules, sensitive to palpation, which are usually found on the pretibial region, but which can also involve thighs, upper limbs, buttocks and face. Fever and arthralgia can be concomitant manifestations. The lesions appear in the form of isolated plaques or become confluent, then evolve into painful nodules over several days. Usually, it has an acute course, although chronic, recurrent, rare presentations have been described. Microscopic examination of the lesions shows septal panniculitis without vasculitis. Classically, is considered the herald of an underlying systemic condition (infectious or autoimmune) or a reactive skin phenomenon after exposure to a toxic or drug has been considered; hence the importance of knowing its diagnostic approach by the primary care physician.
       
  • Selective Immunoglobulin A deficiency: clinical manifestations, laboratory
           findings and accurate diagnosis

    • Abstract: Resumen La inmunoglobulina A (IgA) es el isotipo de anticuerpo más abundante en los humanos y fundamentalmente participa en la defensa contra las infecciones y el desarrollo de la tolerancia inmune en las mucosas. La deficiencia de IgA es la inmunodeficiencia más frecuente en humanos, pero comúnmente es asintomática y transitoria. Para diagnosticarla, se cuantifica la concentración de IgA en sangre y se evalúa la magnitud de su disminución. De acuerdo con esta evaluación se clasifica en deficiencia parcial (DPIgA) o deficiencia total (DTIgA). Adicionalmente, si solo se afectan los niveles de IgA sin alteraciones de otras inmunoglobulinas séricas como IgM e IgG o subclases de inmunoglobulina G, entonces se denomina como deficiencia selectiva de IgA (DSIgA). La deficiencia selectiva de IgA es de mayor relevancia clínica y considerada un error innato de la inmunidad, aunque su etiología aún es desconocida y clínicamente se asocia a infecciones de los tractos respiratorio y gastrointestinal, alergias y manifestaciones autoinmunes. Se realizó una búsqueda de artículos científicos en PubMed, Scopus, SciELO y Redalyc sobre la deficiencia selectiva de inmunoglobulina A, con el objetivo de realizar una revisión temática sobre las manifestaciones clínicas, el diagnóstico y el adecuado manejo clínico de los pacientes con esta inmunodeficiencia. Se propone un nuevo algoritmo clínico con el objetivo de mejorar el diagnóstico y brindar un adecuado manejo clínico de los pacientes con esta inmunodeficiencia. Un paciente con deficiencia selectiva de IgA se caracteriza por infecciones recurrentes de los tractos gastrointestinal y respiratorio, en asociación con manifestaciones alérgicas y autoinmunes en individuos mayores de cuatro años, con niveles de IgA sérica menores de 7 mg/dL y con niveles normales de IgG e IgM, y en quienes se hayan descartado defectos relacionados con los linfocitos T u otras causas de hipogammaglobulinemia. Con respecto al manejo clínico, se deben ajustar los esquemas de vacunación e implementar profilaxis antibiótica en las infecciones graves y recurrentes. Para mejorar el pronóstico se debe realizar una atención del paciente por un equipo médico interdisciplinario y un seguimiento continuo por un prolongado periodo de tiempo.Abstract Immunoglobulin A (IgA) is the most abundant antibody isotype in humans and participates in protection against infections and the development of immune tolerance in mucous membranes. IgA deficiency is the most common immunodeficiency in humans, but it is commonly asymptomatic and transient. To diagnose it, the concentration of IgA in blood is quantified and the magnitude of its decrease is evaluated. According to this evaluation, it is classified as partial deficiency (DPIgA) or total deficiency (DTIgA). Additionally, if only IgA levels are affected without alterations in other serum immunoglobulins such as IgM and IgG or subclasses of IgG, then it is referred to as selective IgA deficiency (DSIgA). Selective IgA deficiency is of greater clinical relevance and considered an innate immunity error, although its etiology is still unknown. This immunodeficiency is clinically associated with respiratory and gas- trointestinal tract infections, allergies and autoimmune manifestations. A search of scientific articles was conducted in bibliographic databases PubMed, Scopus, SciELO and Redalyc on selective immunoglobulin A deficiency. Our objective was to perform a review on clinical manifestations, diagnosis, and appropriate clinical management of patients with this immunodeficiency. A new clinical algorithm is proposed in order to improve the diagnosis and provide adequate clinical management of patients with this immunodeficiency. A patient with selective IgA deficiency is characterized by recurrent infections of the gastrointestinal and respiratory tracts, in association with allergic and autoimmune manifestations in individuals older than four years. Serum IgA levels are less than 7 mg/dL, with normal levels of IgG and IgM, and defects related to T lymphocytes or other causes of hypogammaglobulinemia have been ruled out. Regarding clinical management, vaccination schedules should be adjusted and antibiotic prophylaxis should be implemented in severe and recurrent infections. Additionally, to improve prognosis, patient care should be performed by an interdisciplinary medical team and continuous monitoring for a prolonged period of time.
       
  • Repeated endovascular therapy for refractory cerebral vasospasm

    • Abstract: Resumen El vasoespasmo cerebral es una complicación severa de la hemorragia subaracnoidea. La monitorización y la detección del vasoespasmo por mé- todos no invasivos, así como la terapia endovascular, han revolucionado la atención médica tradicional. Se presenta el caso de un paciente masculino de 45 años con aneurisma roto de la arteria comunicante anterior, quien desarrolló vasoespasmo severo refractario desde el octavo día de hemorragia subaracnoidea. El vasoespasmo fue detectado oportunamente con técnicas no invasivas y tratado en cinco ocasiones mediante terapia endovascular, logrando mejoría inmediata de los síntomas y sin secuelas neurológicas. Este reporte contribuye a demostrar el beneficio de la terapia endovascular múltiple para el manejo del vasoespasmo cerebral refractario, en combinación con la utilización de técnicas no invasivas para la monitorización y detección oportuna del vasoespasmo. Adicionalmente, se revisan las recomendaciones actuales de medicina basada en la evidencia sobre el uso del Doppler transcraneal para la detección del vasoespasmo cerebral.Abstract Cerebral vasospasm is a severe complication of subarachnoid hemorrhage. Monitoring and detection of vasospasm by non-invasive methods as well as the endovascular therapy have revolutionized healthcare. A 45-years-old male patient presented with a ruptured aneurysm in the anterior communicating artery and developed severe refractory vasospasm since the eighth day of aneurysm rupture. Vasospasm was timely detected with non-invasive techniques and successfully endovascular therapy was provided five times with neurological and radiological recovery each time and no neurological sequelae. This report contributes to current practice as it demonstrates the benefit of repeated endovascular therapy for refractory cerebral vasospasm, especially when clinical and non-invasive monitoring shows persistence of this complication. Furthermore, we review the current evidence-based medicine recommendations about Transcranial Doppler Ultrasonography that support the monitoring and detection of cerebral vasospasm.
       
  • Intravascular large b-cell Lymphoma with cerebral involvement

    • Abstract: Resumen El linfoma intravascular de células B grandes es una rara variante del linfoma no Hodgkin que se caracteriza por proliferación clonal de células linfoides neoplásicas que crecen dentro de la luz de la microvasculatura. La diversidad de su presentación clínica dada su posibilidad de aparición en cualquier órgano, a menudo lo convierte en un diagnóstico difícil. El espectro clínico es heterogéneo dominado por manifestaciones neurológicas y puede pasarse por alto o diagnosticarse erróneamente. El diagnóstico sigue siendo un reto, ya que no existen hallazgos patognomónicos de neuroimágenes y aún no se ha establecido un tratamiento óptimo. Presentamos el caso de una mujer de 38 años con linfoma intravascular de células B grandes con afección cerebral.Abstract Intravascular large B-cell lymphoma is a rare variant of non-Hodgkin lym- phoma characterized by clonal proliferation of neoplastic lymphoid cells that grow within lumen of the microvasculature. The diversity of the clinical presentation due to the possibility of its appearance in any organ often makes it a difficult diagnosis. Clinical spectrum is heterogeneous, dominated by neurological manifestations can be overlooked or misdiagnosed. Diagnosis remains a challenge, since there are no pathognomonic neuroimaging findings and optimal treatment has not yet been established. We present a 38-year-old female patient with intravascular large B-cell lymphoma with cerebral involvement.
       
  • Association between sedentary behavior and gestational diabetes

    • Abstract: Resumen El linfoma intravascular de células B grandes es una rara variante del linfoma no Hodgkin que se caracteriza por proliferación clonal de células linfoides neoplásicas que crecen dentro de la luz de la microvasculatura. La diversidad de su presentación clínica dada su posibilidad de aparición en cualquier órgano, a menudo lo convierte en un diagnóstico difícil. El espectro clínico es heterogéneo dominado por manifestaciones neurológicas y puede pasarse por alto o diagnosticarse erróneamente. El diagnóstico sigue siendo un reto, ya que no existen hallazgos patognomónicos de neuroimágenes y aún no se ha establecido un tratamiento óptimo. Presentamos el caso de una mujer de 38 años con linfoma intravascular de células B grandes con afección cerebral.Abstract Intravascular large B-cell lymphoma is a rare variant of non-Hodgkin lym- phoma characterized by clonal proliferation of neoplastic lymphoid cells that grow within lumen of the microvasculature. The diversity of the clinical presentation due to the possibility of its appearance in any organ often makes it a difficult diagnosis. Clinical spectrum is heterogeneous, dominated by neurological manifestations can be overlooked or misdiagnosed. Diagnosis remains a challenge, since there are no pathognomonic neuroimaging findings and optimal treatment has not yet been established. We present a 38-year-old female patient with intravascular large B-cell lymphoma with cerebral involvement.
       
 
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