Sistema Regional de Información
en línea para Revistas Científicas de América Latina,
el Caribe, España y Portugal

La bacteriemia es una presentación atípica de la infección por Campylobacter jejuni, y es más frecuente en pacientes con inmunodepresión avanzada debido al VIH u otras enfermedades sistémicas. Debido a la terapia antiretroviral, en las últimas décadas el número de casos ha disminuido. Presentamos el caso de una mujer en situación de calle, con VIH en etapa C3, que cursó con una bacteriemia por C. jejuni durante su hospitalización por una tuberculosis pulmonar. Realizamos una breve revisión de bacteriemia por C. jejuni en pacientes VIH.

The term transgender denotes a person whose gender identity (male-female) is different from their sex (men-women). A transgender person presents a contradiction between sexual identity and biological condition, because the latter is determined by certain given characteristics since birth. One of the most difficult issues is the feminization of the person’s voice (in the case if male to female), since it is perceived as being in the opposite end of gender. For this reason, usually male to female transgenders engage in vocal changes without appropriate techniques, resorting mostly to surgical procedures or hormonal treatments and ignoring speech and language therapy as an alternative to improve their vocal quality and social interaction. Therefore, the main goal of this work was to determine the effectiveness of the phoniatric intervention in order to produce the feminization of the voice in a transgender individual MTF. The methodology used is a quantitative, descriptive, using a longitudinal design of ABA reversion case study series. The intervention was structured in three main sections: initial evaluation, intervention and final re-evaluation. The results showed a significant variation in the acoustic perceptual qualities of the voice, with a more feminine voice involving modifications in the phonorespiratory pattern and in the posture. In conclusion, the phoniatric intervention was effective because achieved changes led to a more feminine voice.

In the Evidence-Based Practice model, the speech and language therapist must know the diagnostic criteria and be aware of the evidence supporting the intervention procedures, to provide an effective treatment. However, the literature describes both low levels of academic training and scarce use of evidence-based practices as a base of speech and language diagnosis and treatments. This study probes into the difficulties speech and language therapists face to access the diagnostic criteria and their bibliographic references. A massive online survey was conducted with 384 speech therapists, using a quantitative, descriptive and transectional method. Results show that 79.7% of respondents use secondary sources to access criteria on which subsequently base their speech and language diagnoses, 46% do not know reliable sources of information to access criteria for diagnoses and 73.4% maintain that they had difficulties in accessing diagnostic criteria. These difficulties do not recede with years of practice. Based on these results it is possible to conclude that surveyed therapists presented difficulty to find information on which to establish their diagnostic criteria and they do not use primary sources for access information. All of this supports training students on Evidence Based Practice when in their University programs.

In Chile, Speech and Language therapists (SLT) are the professionals in charge of topics as diverse as evaluation, diagnosis, rehabilitation and health promotion of language disorders, speech, swallowing, hearing, voice, and communication. Currently, 29 higher education institutions include majors in SLT in Chile. Given the evolution of the profession, some reflections and considerations on the practices of SLT training are in order. The objective of this study was to describe some aspects related with the characteristics of speech therapists in academic activity in Chile and present a discussion about practices of SLT training. A descriptive observational study was conducted by applying a structured survey to 33 academic representatives of 12 Chilean universities. The results showed that 60.6% of the attending academics hold the Master's degree. A 59.4% of the teachers consulted have a complete work dedication, focusing their load on management or teaching. Only 12.1% of the informants report the development of activities related to research. An 87.9%, of respondents say that undergraduate training in Chile is of quality and 57.6% consider that the national postgraduate offer is not useful for the development of the profession. According to this background, aspects related to: affiliation, academic activities, workload distribution, undergraduate training and continuing training in speech therapy are discussed.

International evidence recommends different cuff pressure to use with patients with an artificial airway. In Chile, some health institutions have created internal protocols referencing this evidence. However, there is no national guidelines, thus different health professionals use different criteria to manage these patients. The present researched aimed at creating a valid and reliable questionnaire on the use and management of the cuff pressure in adult patients with an artificial airway for health professionals in Chile. A qualitative-quantitative, descriptive and longitudinal design was implemented. This process was divided in three phases. In phase A, a draft of the questionnaire was developed in English and then translated to Spanish by three native Spanish speakers. In phase B, ten Chilean, ten clinical experts in the management of users with artificial airway analysed the tool and recommended modifications of some of the questionnaire. After the modifications, the tool was validated through a Content Validity Index form. In phase C, thirty-three Chilean health professional voluntarily responded the questionnaire twice, with a period of thirty days between responses, to measure the reliability of the tool through ‘test-retest’. The questionnaire had a validity of .93, while 72.73% and 27.27% of the items had an excellent reliability and good reliability, respectively. This allows us to conclude that this questionnaire meets its objectives and will serve to know the techniques and pressure of the cuff that health professionals in Chile use for the management of adult patients with an artificial airway.

The present study addresses the incidence of Parkinson's disease in the processing of semantic information during visual word recognition tasks. In order to do so, the performance of a group of patients with Parkinson's was compared with the performance of subjects without neurological impairment in two experiments. We evaluate the effects of presentation time of a semantic prime (Experiment 1) and an ortho-phonologically mediated semantic prime (Experiment 2), and the impact of the lexical frequency of both the prime and the target words. Participants divided into three groups (a clinical group, an age control group and a group of young adults), completed a reaction time lexical decision task in the go-no-go modality. They had to respond by pressing a computer key if the stimulus presented on the screen was a word. Otherwise, the participants should not press any key. The results, based on response accuracy and reaction times, show a semantic deficit in the clinical group, while this group was, nevertheless, sensitive to the frequency of the words and their presentation time. As a whole, the results are consistent with the existing literature, and contribute to a better understanding of the linguistic deficit present in Parkinson's disease.

A higher cognitive reserve is linked to higher resistance to deterioration among subjects suffering from neurodegenerative disorders. In healthy persons the cognitive reserve explains inter-individual differences in task performance. Measuring the cognitive reserve factors involves obtaining a numerical index of the cumulative cognitive gain accumulated by a subject. This index can be correlated with other measurable functions. This study was conceived to determine the reserve indexes accumulated by a Chilean sample, by means of the administration of the Cognitive Reserve Index Questionnaire (CRIq).In order to do so, 90 adults (18-85 years old) without evidence of cognitive disorder, living in Valparaíso region, Chile, were interviewed about their education, their work environment and their and leisure activities carried out since they were 18 years old. Results showed that reserve indexes of the subjects vary as a function of the time of execution of reserve-promoting activities, not age. Statistically significant differences were found among age-groups. These findings allow us to conclude that studying, working and engaging in social activities, among other things, increase the cognitive reserve indexes, which are a differentiating variable among individuals. The measurement of these indexes can be useful in a wide array of disciplines: medicine, neurology, neuropsychology, education, psychology, phonoaudiology, neurosciences and cognitive sciences in general.

The present study explores evidence on swallowing assessment using ultrasound technique. Regarding the search strategy, the review was carried out in PubMed and Scielo, using an adaptation of the recommendations from the Cochrane manual for systematic reviews. The terms "Deglutition" "Swallowing", "Ultrasonography" and "Ultrasound" were selected in English and Spanish. Original studies published between January 2000 and January 2019 were initially selected. According to the elegibility criteria, 24 original studies dealing with the use of ultrasound to evaluate some aspect of swallowing in both oral and pharyngeal stages. Selected articles offer quantitative data on swallowing parameters and indicators. From these studies, qualitative and quantitative information on lingual mobility, laryngeal elevation, lateral pharyngeal mobility, hyoid mobility, genihyoid muscle mobility, upper esophageal sphincter opening, glotic closure was collected, in addition to studies on the possibility of detecting episodes of laryngeal penetration and aspiration. The results suggest that there is positive evidence on the usefulness of ultrasound to assess swallowing, however, more studies are required to analyze diagnostic efficiency in a population with dysphagia.

Introducción: Ertapenem ha demostrado eficacia frente a Enterobacteriaceae productoras de beta-lactamasas de espectro extendido, pero carece de actividad contra bacterias no fermentadoras; el desescalamiento a este antibiótico cuando no existe la presencia de P. aeruginosa podría reducir la presión selectiva contra esta bacteria y mejorar los resultados clínicos.Objetivo: Evaluar el impacto clínico del desescalamiento de antibióticos con cubrimiento anti-pseudomona, a agentes sin este espectro, en pacientes críticos con infecciones por Enterobacteriaceae. Métodos: Se realizó un estudio de cohorte prospectivo en adultos admitidos a unidades de cuidado intensivo (UCI) con infecciones por Enterobacteriaceae, que habían sido desescalados de un cubrimiento anti-pseudomonas, a un antibiótico sin el mismo (ertapenem).   Se realizó un modelo de riesgo proporcional de Cox comparando mortalidad por cualquier causa y duración de estancia hospitalaria entre aquellos pacientes que permanecieron con cubrimiento anti-pseudomona versus aquellos que fueron desescalados a ertapenem.Resultados: 105 pacientes en el grupo anti-pseudomonas fueron comparados con 148 pacientes del grupo de desescalamiento a ertapenem. El desescalamiento estuvo asociado con una menor mortalidad por cualquier causa comparado con los pacientes que permanecieron con el cubrimiento anti-pseudomonas (Hazard Ratio ajustado 0,24; IC 95%: 0,12-0,46). La estancia hospitalaria en UCI fue similar en ambos grupos.Discusión: Los pacientes de UCI con infecciones por Enterobacteriaceae desescalados a terapia con ertapenem tuvieron mejores resultados clínicos comparados con aquellos que permanecieron en terapia anti-pseudomonas, sugiriendo que el desescalamiento es una práctica segura en esta población.