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

The objective of this article is to determine which factors are associated with severity and the requirement for admission to the pediatric intensive care unit (PICU). This is a retrospective cross-sectional observational study, which includes patients between 1 month and 17 years of age with a diagnosis of dengue with alarm signs or laboratory-confirmed severe dengue, who were admitted to the PICU of the Club Noel Children's Clinic Foundation (FCICN) between September 2013 to December 2019. 152 patients who met selection criteria were included. 31.6% were classified as severe dengue. The average age was 9.5 ± 3.4 years, with a predominance of females (55%). The most common alarm sign was pleural effusion (44.1%), and the most frequent criterion for severe dengue was dengue shock (79.2%). Tachycardia was more frequent in the severe dengue group; hypotension was associated with dengue shock and severe dengue with statistical significance. Mortality was 2%, no factors associated with mortality were found. Most of the patients in this study presented with dengue with alarm signs (ASD), which differs from what is reviewed in the literature, differences were also found in terms of the count platelet and age of presentation. It is reaffirmed that the clinic, and more specifically, the altered vital signs, are early indicators to detect those patients at increased risk of developing severe forms of dengue.   Key words: Dengue, Critical care, Pediatrics. Source: DeCS.

Clinical reasoning is a process by which the health professional, based on clinical data, on the evolution of the patient, and with their knowledge, judgment, opinion and expertise, structures their performance from the evaluative process to the construction of objectives and intervention strategies of consulting individuals. It should be noted that the teaching-learning process of clinical reasoning is difficult, since generally health professionals are not aware of the brain processes involved in their reasoning and therefore it is difficult to explain it to others. Based on the above, this article describes a teaching experience oriented to clinical reasoning; integrates the theoretical syllogism and the literary works of Sir Arthur Conan Doyle within the framework of the course ST-0110 Records, information and quality of services given for the Baccalaureate and Bachelor's degree in Physical Therapy at the University of Costa Rica. The didactic experience included three moments: the theoretical foundation, the literary exercise and the elaboration of an analytical report. The preliminary scope of said experience is also presented, as well as the main challenges in aspects such as the construction of measurement instruments, the incorporation of qualitative aspects related to student learning and the implementation of additional activities that complement the experience.   Key words: Physical Therapy Specialty, Clinical Reasoning, Educational Activity. Source: MeSH.

In construction practice, very few structural designers currently make use of coupling beams for the construction of tall buildings, due to the architectural limitations with respect to the mezzanine height and useful height since they have ratio restrictions that generally architecture does not accept as a parameter of structural elements. The detailed correctness of a coupling beam must comply with several conditions that the ACI code 318 establishes, overcoming these limitations, if everything was done correctly the coupling beams offer a reduction of about 50% of the maximum allowed lateral drift compared to the use of beams governed by flexed behavior as will be seen in the present study. The research proposal is focused on making use of dynamic nonlinear structural analysis, the amount of energy absorbed in the coupled dual structural system and each coupling beam must be quantified to know what dimensions optimize the building beams of 20 level building proposed in this investigation, previously designed with ACI Code 318-19, which allows the use of high strength steels up to grade 100 in longitudinal and diagonal reinforcement, reducing the seismic vulnerability of the structure by having a correct seismic-resistant performance.

In this paper, the authors summarize the results of a parametric study devoted to assess the influence of different parameters that may affect the assessment of cracked moments of inertia of reinforced concrete sections subjected to flexure. Among the assessed variables are: the shape of the cross sections (rectangular, inverted L and T), the width (b), the aspect ratio (h/b), the compressive strength (f'c), the tensile reinforcement ratio (ρ), the relationship between the tensile and compression reinforcement ratio (ρ/ρ'), different section detailing (ductile and non-ductile) and the transverse steel confinement (considered through the specified separation of stirrups, s). Based on the obtained results, it is possible to identify the main variables that influence the definition of the cracked moments of inertia of reinforced concrete beam sections, which could be taken into account during the seismic design process. Also,equations are presented for the assessment of the cracked moments of inertia of reinforced concrete sections. Finally, these equations are used as input information to assess the effective flexural stiffness of beam members.

When a structure is founded in soft soils it is mandatory to include soil-structure interaction (SSI) effects. Otherwise, important design forces and displacement might be overlooked. If in addition the structure has the potential to develop a soft or weak story, the risk might considerably increase. A parametric study was conducted to obtain the dynamic response of simplified mathematical models representing real structures of six and eight stories, considering soil-structure interaction (SSI) effects for soft soils (seismic zone III-a of Mexico City), and using strength and stiffness balanced configurations between the first story and second story to represent plausible weak and soft story failure scenarios in one of both analyzed stories. Likewise, it is presented one way to include satisfactorily SSI parameters according to the proposed method established in the seismic guidelines of Mexico City since 1995, in particular those of the most recent building codes (2004 and 2020).

The program called: "Knowledge does not stop Dr. Roberto Aguiar", was born as a way to make confinement more bearable due to the coronavirus pandemic. This initiative was launched in the last months of 2020 and its objective has been to bring together outstanding researchers from Latin America, students graduated from master's degrees or in doctoral courses at prestigious universities in the United States, Chile and Mexico, recently graduated doctors and a large number of prominent professionals who have presented the results of their research work. The events have been held on Monday of each week at 7:00 p.m. in Ecuador.The quality of the papers presented has set the precedent for these conferences to be considered as magisterial, therefore, a video record of each of them has been generated. Aware of the contribution to the scientific community, all these videos can be found on the CEINCI-LAB Blog and in this article a summary of the last conferences is presented with their respective audiovisual registration link.

In Ecuador, mezzanines are traditionally built with reticular reinforced concrete slabs with various types of lightening.  Another increasingly popular mezzanine system is the composite slab (steel deck).  In these systems, various pathologies have been observed that increase the global vulnerability of the structures, ranging from small defects to failures that could reduce the useful life of the building. The main constructive pathologies or those related to the material used are misaligned nerves with a width of less than 10 cm, improperly located pipes or ducts, concrete casting errors that cause cold joints, poor or non-existent curing, permeability formwork that allows the grout to leak, incorrect vibrating or dosage of the mixture, among others. In recent years, the use of galvanized steel panels, known as steel deck slabs, has increased.  This increase is mainly due to the advantages of building slabs quickly.  Regarding the observation of this mezzanine system, the main pathologies were cataloged, such as damage to the collaborating plate (dent), fixing of the secondary steel beam with ceiling screws, incorrect concreting, among others.  Classifying and disseminating these pathologies affects the improvement of construction, which is the objective of this work

When a structure has a great contrast of stiffness and strength between two consecutive stories, a soft and weak story mechanism can be generated, as it has a great vulnerability in those stories. If in addition the structure is founded in soft soils, its vulnerability may seriously increase. During the earthquake in September 19, 2017 earthquake which hit Mexico City strongly, many buildings with a soft and weak story configurations resulted experienced severe local and global structural damage. Most of the seriously affected structures were found at soft soils. In this study, the analyses of two buildings which developed severe structural damage due to a soft and weak story configuration are presented. In addition, an alternate design proposal is presented, where a better contrast of stiffness and strength was used, and may have kept both structures safe during this strong earthquake. These proposals take as starting point current design guidelines of Mexico City, in particular the most recent buildings codes (2004 and 2017).

The use of pre-molded reinforced concrete structures has recently increased because the simplicity of its assembly reduce of construction times, however, the use of the technique located in seismic regions have shown partial and total collapse as demonstrated in the earthquake Northridge, 1994. After that event, the Precast Seismic Structural System technology was consolidated in the specialty. The technique consists of hybrid connection between the beam and columns of pre-molded structures that allows to dissipate energy through a rigid rotation of the node without damage to the structural elements of the frame. The paper shows a theoretical study of the responses of traditional frame of reinforced concrete and pre-cast frame of post-tensioned concrete with hybrid joints. Different non-linear models are used to evaluate the response where use date of experimental tests carried out by other authors. The responses an educational building designed with a structure of traditional reinforced concrete and the same building but with pre-molded frame of post-tensioned concrete with hybrid joints are also studied. The results show that the hybrid joint has energy dissipation capacity and turns it a suitable technique for a ductile behavior of the structure.

Six years after the Pedernales earthquake of April 16, 2016 that affected Manabí and other cities in Ecuador, the perception is that the quality of design and construction in Portoviejo has improved, to which attention is given in this article with the actors involved. in the quality of that construction that are the structural designers and the builders, the control entities, the civil engineering careers and the citizenry. The most common types of reinforcement used in reconstruction are shown, such as shear walls, jackets, reinforcement with metal plates or angles and steel plates, weight reduction, elimination of floors and irregularities. It is also shown that there are still many non-structural hazards such as loose masonry and plaster, broken glass that can cause injuries to pedestrians.