Administracion de los Servicios de Salud del Estado

El signo de Chilaiditi es un hallazgo radiológico infrecuente, corresponde a la interposición del intestinal entre el hígado y el diafragma. Generalmente, esta anomalía es asintomática, en algunos casos puede generar síntomas y complicaciones que llevan al diagnóstico de un "síndrome de Chilaiditi”. El presente análisis se originó a partir de un caso clínico en nuestro servicio, lo cual motivó una reflexión sobre la importancia de un diagnóstico preciso.

El teatro y la poesía siempre han ido de la mano y juntos seguirán durante largo tiempo, aunque el matrimonio verso y teatro se ha roto, a la vista de la escasa presencia de aquél en los textos dramáticos actuales. En este trabajo, que se une a lo expuesto en el trigésimo seminario internacional del SELITEN@T, se realiza un panorama sobre las relaciones del teatro con la poesía en el siglo XX y especialmente en el XXI. Abstract: Theater and poetry have always gone in hand and will continue together for a long time, although the marriage of verse and theater has broken down, in view of its scarce presence in current dramatic texts. In this work, which joins what exposed in the thirtieth international seminar of SELITEN@T, an overview of the relations between theater and poetry in the 20th and particularly the 21st centuries. Keywords: Theater. Poetry. Spain. 20th Century. 21st Century.

The vital crisis of adolescence is experienced by adolescents with different degrees of impact on their mental health, according to the greater or lesser presence of social networks and the strength of family support. This pilot experience aimed to bring to the classroom tools for cultivating emotional intelligence and mindfulness as strategies to promote mental health in adolescents. The perception of the teachers of the institution is that the intervention generated a positive result and was well received by the students, perceiving an improvement in the climate of coexistence in the classroom. The evaluation made to the students shows a positive impact on the control of emotions such as anger, and is perceived by the participants as useful, especially for interpersonal relationships with classmates and friends.

Introduction: Advances in cancer treatments have determined an increase in survival rates. However, these lifesaving therapies may have a negative impact on reproductive health. To diminish the infertility risk; different fertility preservation strategies have been designed. Sperm freezing is the gold standard fertility preservation method in the case of post-pubertal men. The main objective of this study is to evaluate the fertility status of Uruguayan male cancer survivors who have gone through sperm freezing, as well as to assess oncofertility counseling received by these patients. Methods: This is a descriptive, cross-sectional, observational, and transversal study. A survey was conducted on male cancer survivors who cryopreserved sperm between 1985 and 2021 in "Reprovita Lab and Biobank" which is the only sperm bank in this country. Results: One hundred thirty-five participants answered the survey. At the time of diagnosis, the mean age of patients was 28.8 ± 6.4 years old. Testicular was the most frequent type of cancer (64%). Only, 12% (n = 15) already had children at the time of diagnosis. Among the interviewed survivors, 50% (n = 62) attempted to conceive after cancer treatment, and 68% (n = 42) achieved natural pregnancy. Patients who did not achieve spontaneous conception (n = 11), used their cryopreserved samples, and 45.4% achieved pregnancy. About 86% (n = 107) of survivors believed that the timing of oncofertility referrals was appropriate and 97% considered that having the possibility of protecting their fertility was very important. Eighty percent (n = 101), were advised by their attending physicians, 14% (n = 18) sought advice from family members or friends, and 4% (n = 5) from oncofertility specialists. Discussion: To our knowledge, this is the first study evaluating the reproductive outcomes of male cancer survivors in our country and the region. Most of the interviewed survivors considered fertility preservation as a positive initiative, independent of their reproductive outcomes, reflecting the importance of fertility preservation counseling as one of the most important aspects for futurequality of life of young cancer patients.

Background and PurposeRecent trials showed a clear benefit of mechanical thrombectomy for patients with emergent large vessel occlusion and large core infarction. However, limited number of patients were included in the late window. This study aimed to compare outcomes of low ASPECTS stroke patients who underwent mechanical thrombectomy in the early versus late time window.MethodsA retrospective cohort study was conducted using data from the Stroke Thrombectomy and Aneurysm Registry (STAR) from 2013 to 2023. Patients with low ASPECTS (2-5) who underwent mechanical thrombectomy for ICA or M1 stroke were included. Patients were divided into early (within 6 hours) and late (6-24 hours) time window groups. The primary outcome was 90-day favorable outcome (modified Rankin Scale [mRS] score 0-3).ResultsAmong the 10,081 patients who underwent mechanical thrombectomy, 387 met the inclusion criteria. Of those, 219 (56.6%) were treated in the early window. Median (IQR) age was 70.4 (60-78) years, 180 (46.5%) were female, and 221 (68.4%) were White. There was no significant difference in successful recanalization rates (Thrombolysis in Cerebral Infarction [TICI] 2C/3) between the early and late window groups (56.6% versus 52.4%, P=0.478). Additionally, there was no significant difference in favorable outcomes at 90 days between the two groups (25.4% versus 35.9%, P=0.142). In Binary regression analysis, age (OR 0.94; 95% CI 0.92-0.97; P<0.001), admission NIHSS (OR 0.88; 95% CI 0.83-0.94; P<0.001), and successful recanalization (OR 4.01; 95% CI 1.94-8.71; P<0.001) were predictors of a favorable outcome at 90 days.ConclusionMechanical thrombectomy appears to carry a similar benefit profile among patients treated in the late window as those in the early window. P-002 Figure 1DisclosuresS. Samir Elawady: None. M. Mahdi Sowlat: None. I. Maier: None. P. Jabbour: None. J. Kim: None. S. Quintero Wolfe: None. A. Rai: None. R. M Starke: None. M. Psychogios: None. E. Samaniego: None. A. Arthur: None. S. Yoshimura: None. J. A. Grossberg: None. A. Alawieh: None. J. Mascitelli: None. I. Fragata: None. H. Cuellar: None. A. Polifka: None. J. Osbun: None. R. Crosa: None. C. Matouk: None. M. S. Park: None. M. R. Levitt: None. W. Brinjikji: None. T. Dumont: None. R. Williamson Jr: None. P. Navia: None. A. M Spiotta: None. S. Al Kasab: None.

Antecedentes: los pacientes neurocríticos constituyen un subgrupo especial en la medicina intensiva. Estudios internacionales recientes han mostrado variabilidad en su monitorización y manejo terapéutico. Objetivo: conocer las características de la atención y manejo de los pacientes neurocríticos en Uruguay. Métodos: estudio prospectivo y descriptivo. Se realizó una encuesta telefónica basada en un cuestionario de estructuras y procesos en la asistencia del paciente neurocrítico. Fue diseñado por la comisión de neurocríticos de la SUMI. Se entrevistó a jefes o coordinadores de cada unidad de cuidado intensivo (UCI), de forma voluntaria y anónima. Resultados: se encuestaron 52 UCI (98% del país), 67% correspondieron al Interior y 65% al sector privado del país. 96% de las UCI reciben pacientes neurocríticos. Se cuenta con neurocirugía presencial en 46%. El estudio de neuroimagen más disponible es la tomografía computada (81%). Se realiza: monitorización de presión intracraneana en 65%, oximetría yugular en 27% y neuromonitorización no invasiva en 58%, siendo la ultrasonografía la más frecuente. Las estrategias más utilizadas para el tratamiento de la hipertensión intracraneana son: osmoterapia (salino hipertónico en 100%), propofol (85%), bloqueo muscular (78%) y descompresiva (75%). Reperfusión en ataque cerebrovascular: trombolisis (88%) y trombectomía mecánica (44%). Los fármacos antiepilépticos más utilizados son: midazolam (100%), levetiracetam y fenitoína (96%). Tratamiento del aneurisma cerebral: clipado quirúrgico (98%) y endovascular (66%). Protocolización en 96% y realización de ateneos clínicos en 61%. Conclusiones: se presenta el primer trabajo realizado en nuestro país sobre el tema. Se encontró variabilidad en la monitorización así como en la disponibilidad de neuroimagenología y especialidades neurointervencionistas. Este estudio proporciona una oportunidad para la investigación comparativa de efectividad.

A pandemia da COVID-19 impulsionou o ensino remoto como uma forma de manter o ensino continuado, o que trouxe a necessidade de capacitação dos professores para se adaptarem a essa nova modalidade de ensino. OBJETIVOS: A capacitação de professores no ensino remoto tem como objetivo aprimorar as habilidades e competências dos docentes para atuarem com mais eficácia e qualidade no ambiente virtual de aprendizagem, além de possibilitar que os alunos obtenham um ensino de qualidade mesmo a distância. METODOLOGIA: A pesquisa do presente resumo foi elaborada seguindo alguns pontos, inicialmente foi feito uma revisão bibliográfica a cerca do tema e posteriormente uma analise criteriosa dos estudos já publicados, tendo em vista abordar a relevância que o tema apresenta na atualidade e a necessidade de explanar tal assunto. RESULTADOS: A capacitação de professores em todas as áreas do ensino na modalidade remota embora seja algo que apresente resistência por parte de alguns profissionais tem apresentado resultados positivos e promissores na melhoria da qualidade do ensino, na utilização adequada de tecnologias educacionais, na criação de conteúdos pedagógicos adequados e na formação de uma comunidade de professores que compartilham conhecimentos e experiências. CONCLUSÃO: Em resumo, a capacitação de professores no ensino remoto é fundamental para que eles possam desempenhar seu papel com mais eficiência e qualidade no ambiente virtual de aprendizagem, garantindo uma educação de qualidade para os alunos, mesmo à distância. É preciso que as instituições de ensino invistam nessa formação para que os professores estejam preparados para enfrentar os desafios dessa nova modalidade de ensino.

Stroke accounts for 5.5% of the national Global Burden of Disease (GBD) and ~2,000 deaths per year in Uruguay. To respond to this medical emergency, the Ministry of Public Health (MPH) of Uruguay devised the National Stroke Plan (NSP). Scientific associations, universities, scholars, and patient organizations, both at the national and international levels, took part in the process, which ended with the generation of the national stroke management guidelines, including measures based on the best evidence available. This was accompanied by presidential regulatory decrees and several ordinances that set the foundations of the legal framework for their implementation as of 2020. Forty-two Stroke Ready Centers (SRC) and seven Comprehensive Stroke Centers (CSC) were strategically established and interlinked to ensure compliance with international accessibility recommendations, offering, in turn, the required training for their healthcare teams. A pre-hospital care protocol was also created for all countrywide mobile units. For NSP assessment, stroke was included as a “Care Goal (objective)” for the whole health system, providing the involved healthcare organizations with a financial incentive for compliance with the basic objectives related to the treatment of hyper acute stroke. The NSP came into force during the COVID-19 pandemic and, considering the special circumstances imposed, it made it possible to maintain hyper acute medical care and increase population access to recanalization treatment, particularly mechanical thrombectomy. The purpose of this article is to share our experience in the development of the NSP by describing some preliminary outcomes.