We report an arrhythmic complication in two patients in whom a procedure directed at isolating one or two pulmonary veins had been performed. The complication was related to pulmonary vein disconnection scars after ablation. Both patients developed new clinical tachycardia (atypical atrial flutter) secondary to a reentrant phenomena in the vicinity of a previously ablated pulmonary vein.
Resumen En este artículo se utiliza la herramienta de análisis didáctico denominada Criterios de Idoneidad Didáctica (CID) para valorar las secuencias didácticas elaboradas por maestros que han cursado un Diplomado en la Universidad de Panamá. Dicha herramienta se ha desarrollado en el marco del Enfoque Ontosemiótico (EOS), revelándose útil para este tipo de acciones, tal como lo han validado las investigaciones previas. En esta investigación se propone un uso sistemático de los CID, aplicando una escala ordinal (tipo Likert) de cuatro posiciones, para cuantificar cada uno de los criterios y, así, evaluar las secuencias didácticas. Los investigadores (uno de los cuales es el formador de los docentes) discuten las secuencias didácticas elaboradas por los docentes, a partir de las grabaciones de aula, donde el análisis les permite sacar conclusiones sobre las decisiones didácticas que realizan los maestros. El uso de los CID revela fortalezas y debilidades en las secuencias didácticas de los maestros. El análisis de la idoneidad didáctica de las secuencias didácticas presentadas por los y las maestras sugiere que el Diplomado ha servido para mejorar su competencia de análisis didáctico, aunque también se han encontrado evidencias que sugieren que la experiencia previa docente aporta elementos importantes que explican el mayor uso de algunos criterios para orientar su práctica.
The purpose of the study is to validate a culturally sensitive adaptation of the community-oriented program for the control of rheumatic diseases (COPCORD) methodology in several Latin American indigenous populations. The COPCORD Spanish questionnaire was translated and back-translated into seven indigenous languages: Warao, Kariña and Chaima (Venezuela), Mixteco, Maya-Yucateco and Raramuri (Mexico) and Qom (Argentina). The questionnaire was administered to almost 100 subjects in each community with the assistance of bilingual translators. Individuals with pain, stiffness or swelling in any part of the body in the previous 7 days and/or at any point in life were evaluated by physicians to confirm a diagnosis according to criteria for rheumatic diseases. Overall, individuals did not understand the use of a 0-10 visual analog scale for pain intensity and severity grading and preferred a Likert scale comprising four items for pain intensity (no pain, minimal pain, strong pain, and intense pain). They were unable to discriminate between pain intensity and pain severity, so only pain intensity was included. For validation, 702 subjects (286 male, 416 female, mean age 42.7 ± 18.3 years) were interviewed in their own language. In the last 7 days, 198 (28.2 %) subjects reported having musculoskeletal pain, and 90 (45.4 %) of these had intense pain. Compared with the physician-confirmed diagnosis, the COPCORD questionnaire had 73.8 % sensitivity, 72.9 % specificity, a positive likelihood ratio of 2.7 and area under the receiver operating characteristic curve of 0.73. The COPCORD questionnaire is a valid screening tool for rheumatic diseases in indigenous Latin American populations.
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