Tumores del sistema nervioso central. Clasificación de la Organización Mundial de la Salud 2021. Hacia un cambio de paradigma / Tumors of the central nervous system. Classification of the World Health Organization 2021. Towards a paradigm shift

El estudio de los tumores del sistema nervioso central (SNC) resulta ser un tema de gran consideración y su conocimiento reviste una alta importancia en la práctica médica. Las clasificaciones de las neoplasias del SNC comenzaron a mediados del siglo XIX hasta que en 1979 la Organización Mundial de la Salud (OMS) publicó la primera edición de una sistemática útil con el objetivo de establecer un lenguaje común para todas las especialidades médicas. Al día de hoy, 5 ediciones actualizaron la taxonomía neoplásica. La quinta edición del año 2021 consolida el cambio de paradigma dado por los avances moleculares, si bien todavía la transición se encuentra en proceso entre la caracterización morfológica y la biológica molecular. En este artículo, se analizan las nuevas modificaciones incorporadas en las diferentes familias tumorales más frecuentes en pediatría haciendo hincapié en aquella información de utilidad para el médico pediatra en su práctica diaria y la consulta multidisciplinaria.

The study of central nervous system (CNS) tumors is a subject of great interest and such knowledge is of great importance in medical practice. The classifications of CNS neoplasms began in the mid-19 th century, until the World Health Organization (WHO) published, in 1979, the first edition of a useful systematic review for the purpose of establishing a common language for all medical specialties. To date, 5 updated editions of neoplastic taxonomy have been published.The fifth edition, from 2021, consolidates the paradigm shift brought about by molecular advances, although the transition between morphological and molecular biological characterization is still in progress. In this article, the new modifications introduced in the different most frequent families of tumors in pediatrics are analyzed, emphasizing useful information for pediatricians in their daily practice and multidisciplinary consultations.

Estudio comparativo de guías de atención prenatal en Latinoamérica / Comparative study of prenatal care guidelines in Latin America

Objetivo: Realizar una síntesis comparativa sobre las guías de control prenatal en países hispanohablantes de Latinoamérica. Métodos: Se seleccionaron las guías de atención prenatal más actualizadas de cada país latinoamericano y se expusieron sus criterios en un cuadro comparativo. Resultados: Se evidenció que la mayoría de las guías de control prenatal comparten criterios guiados por las recomendaciones dadas por la Organización Mundial de la Salud (OMS). Sin embargo, existen diferencias que dependen del riesgo epidemiológico o de exposición que se presente en cada país. Conclusión: A través de esta investigación, se ha reafirmado que el control prenatal desempeña un papel crucial en la promoción de la salud materno-fetal, permitiendo detectar y abordar de manera temprana factores de riesgo, así como proporcionar la atención y seguimiento adecuados durante el embarazo(AU)

Objective: To perform a comparative synthesis of prenatal care guidelines in Spanish-speaking countries of Latin America. Methods: The most up-to-date prenatal care guidelines from each Latin American country were selected, and their criteria were presented in a comparative table. Results: It was evident that the majority of prenatal care guidelines share criteria guided by recommendations from the World Health Organization (WHO). However, there are differences that depend on the epidemiological risk or exposure present in each country. Conclusion: Through this research, it has been reaffirmed that prenatal care plays a crucial role in promoting maternalfetal health by allowing the early detection and management of risk factors, as well as providing adequate care and monitoring during pregnancy(AU)

The ICOPE-WHO and the IVCF-20: a critical view of the Handbook for Multidimensional Geriatric Assessment in Primary Care / O ICOPE-OMS e o IVCF-20: observações críticas sobre o Manual de Avaliação Multidimensional da Pessoa Idosa para a Atenção Primária à Saúde

O rápido envelhecimento populacional impulsiona iniciativas com o objetivo de otimizar a saúde da população idosa em todo o mundo. Recentemente, no Brasil, foi publicado pelo Conselho Nacional dos Secretários de Saúde (CONASS) o Manual de Avaliação Multidimensional da Pessoa Idosa, que propõe a adoção combinada e em larga escala da ferramenta de triagem do ICOPE da Organização Mundial da Saúde (OMS) e do instrumento Índice de Vulnerabilidade Clínico-Funcional-20 (IVCF-20) para definir linhas de cuidado à pessoa idosa. Embora iniciativas dessa natureza sejam prementes, os instrumentos propostos ainda não têm validação adequada na população brasileira, e a sua utilização com o objetivo de balizar diretrizes em saúde em todo o território nacional parece precipitada e arriscada. Diante disso, propõe-se um debate amplo e urgente entre os especialistas da área, com o objetivo de planejar políticas de saúde pública eficazes e seguras para a população idosa brasileira. (AU)

Rapid population aging is driving initiatives aimed at optimizing the health of older populations worldwide. In Brazil, the National Council of State Secretaries of Health (CONASS) recently published the Handbook for Multidimensional Geriatric Assessment in Primary Care, which proposes the combined, large-scale adoption of the World Health Organization (WHO) ICOPE screening tool and the Clinical-Functional Vulnerability Index-20 (IVCF-20) instrument to define care pathways for older people. Although there is a pressing need for initiatives of this nature, the proposed instruments have not yet been adequately validated in the Brazilian population, and their use for the purpose of establishing countrywide health guidelines appears hasty and risky. Therefore, we propose a broad, urgent debate among experts in the field with the aim of planning effective and safe public health policies for the Brazilian older population. (AU)

Impacto de la implementación de la estrategia multimodal de la OMS para mejorar la higiene de manos en una Unidad de Cuidados Intensivos / Impact on implementation of multimodal of World Health Organization strategies to improve hand hygiene in an Intensive Care Unit

INTRODUCCIÓN: La higiene de manos (HM) es la principal medida para disminuir las IAAS, las que en las Unidades de Cuidados Intensivos (UCI) presentan una alta prevalencia. En Chile no existe información sobre el impacto de la estrategia multimodal de la OMS para la HM en adultos. El objetivo fue evaluar el impacto de la implementación de la estrategia en una UPC. METODOLOGÍA: Estudio longitudinal con evaluación pre y post-intervención, entre los años 2018 y 2021, en la UCI del Hospital del Trabajador (HT), Santiago, Chile. La implementación se evaluó con pautas de cumplimiento de HM, consumo de jabón y productos en base alcohólica (PBA). El impacto se midió con las tasas de neumonía asociada a ventilación mecánica (NAVM), infecciones del torrente sanguíneo asociadas a CVC (ITS- CVC) y del tracto urinario por CUP (ITU-CUP), y la incidencia anual de dermatitis. RESULTADOS: El cumplimiento de pautas aumentó de 91 a 96% (p < 0,05). El consumo total de productos para la HM aumentó de 0,17 a 0,31 L/día/cama y de PBA en 10%. Las tasas de IAAS pre y post-intervención fueron para NAVM de 10,3 y 8,4; ITS-CVC de 0,8 y 1,5 e ITU-CUP de 4,2 y 5,3 por 1.000 días de exposición. La incidencia anual de dermatitis disminuyó en 30% (p < 0,05). CONCLUSIONES: La implementación de la estrategia multimodal se asoció a una disminución de las tasas de NAVM y de dermatitis en la UCI del HT.

INTRODUCTION: Hand hygiene is the main measure to decrease infections related to healthcare and the Intensive Care Unit has a high prevalence. In Chile there aren't reports about the impact of the World Health Organization multimodal hand hygiene improvement strategy. AIM: To assess the implementation impact of this strategy at the ICU. METHODOLOGY: Longitudinal study with pre- and postintervention evaluation during the years 2018-2021 at ICU. The implementation was assessed against hand hygiene compliance guidelines, soap consumption and alcohol-based products. The impact was evaluated with the rates of ventilator-associated pneumonia (VAP), catheter related bloodstream infection (CRBSI) and catheter associated urinary tract infection (CAUTI) and the annual dermatitis incidence. RESULTS: The guidelines compliance increased from 91% to 96% (p < 0.05). The total product consumption increased from 0.17 to 0.31 Liters/day/bed. The use of alcohol-based products increased by 10%. HAI rates pre- and post-intervention were for VAP 10.3 and 8.4, CRBSI 0.8 and 1.5 and CAUTI 4.2 and 5.3. The annual dermatitis incidence decreased by 30.8% (p < 0.05). CONCLUSIONS: The strategy implementation benefited the decrease of VAP and the dermatitis prevention in ICU.

Vacinar ou arriscar? A mensagem da Organização Mundial de Saúde para promover a vacinação contra a covid-19 / Vaccinate or taking chances? The World Health Organization's message to promote vaccination against COVID-19

Resumo Centrando-se no impacto que a comunicação de risco emitida pelas organizações de saúde pública tem na mudança dos comportamentos da sociedade, esta investigação pretende analisar as mensagens-chave que a Organização Mundial de Saúde (OMS) definiu para promover o programa de vacinação contra a covid-19. Para cumprir este objetivo, enveredou-se por uma metodologia de estudo qualitativa, que privilegiou o uso da análise do conteúdo publicado nas páginas de Facebook e de Instagram da OMS, no período de 1 de abril a 31 de agosto de 2021. No total, foram analisadas 62 publicações. Os resultados mostraram que a OMS utilizou quatro eixo de comunicação para promover a importância da vacinação na sociedade: garantir a credibilidade e a transparência da informação transmitida; certificar a segurança e a eficácia da vacina; apelar ao sentido de responsabilidade coletiva; e associar a vacina à solução para pôr fim à pandemia. As conclusões do estudo mostram que, embora a equidade no acesso à vacina ainda seja uma realidade em construção, os quase 70% da população mundial vacinada sugerem que as mensagens enviadas pela OMS no contexto de comunicação de risco podem ter contribuído para a construção de uma imagem positiva do programa de vacinação.

Abstract Focusing on the impact that risk communication issued by public health organizations brings to changing societal behaviors, this research aimed to analyze the key messages that the World Health Organization (WHO) has defined to promote the COVID-19 vaccination program. In order to achieve this goal, a qualitative study methodology was used to analyze the content published on the WHO's Facebook and Instagram pages from April 1 to August 31, 2021. In total, 62 publications were analyzed. The results showed that the WHO used four key communication messages to promote the importance of vaccination in society: ensuring the credibility and transparency of the information transmitted; certifying the safety and efficacy of the vaccine; appealing to a sense of collective responsibility; and associating the vaccine with the solution to end the pandemic were the chosen communication axes. The conclusions of this study show that, although fair access to the vaccine is still a reality in the making, the fact that almost 70% of the world's population has been vaccinated suggests that the messages sent by the WHO in the context of risk communication may have contributed to building a positive image of the vaccination program.

Evaluation of antiseptic mouthwashes protocol against SARS-CoV-2 on orthodontic appliances (an in vitro study) / Avaliação do protocolo de enxaguantes bucais antissépticos contra SARS-CoV-2 em aparelhos ortodônticos (estudo in vitro)

Objective: The objective of this study was to evaluate the impact of daily mouthwash rinsing protocols recommended against SARS-CoV-2 on metal ions discharged from fixed orthodontic appliances, specifically Nickel (Ni) and Chromium (Cr). Material and Methods: Total of 400 hemi-arch fixed appliances were segregated into two groups, namely Nickel Titanium (NiTi) and Stainless Steel (SS), based on the type of archwire employed. Each set was submerged in 2% povidone-iodine, 1% hydrogen peroxide, 0.2% chlorhexidine and cetylpyridinium chloride mouthwashes. Distilled water was used for comparative measurements of the ions released as a control group (n=10/group). They were incubated for four periods at 37°C (one hour, twenty-four hours, one, and 3 weeks). Nil and Cr ions released from the fixed appliance were evaluated by atomic absorption spectroscopy. The data were analyzed by the Kruskal-Wallis test and paired comparison analysis. Results: The worst levels of Ni and Cr liberated from the SS group observed in povidone-iodine mouthwash at 1.173 and 1.701 ppm, respectively, while the chlorhexidine mouthwash released accepted level of Ni and Cr at 0.033 and 0.056 ppm, respectively. The NiTi group displayed the appalling ions released of Ni and Cr in povidone-iodine mouthwash at 1.87 and 2.4 ppm, respectively. Whereas the released levels of Ni and Cr ions from the chlorhexidine group and cetylpyridinium chloride were 0.048 and 0.127 ppm, respectively, with significant differences between the tested groups and intervals. Conclusion: Chlorhexidine and Cetylpyridinium chloride mouthwashes were the appropriate options for orthodontic patients to minimized ions released according to this study protocol.(AU)

Objetivo: O objetivo deste estudo é avaliar o impacto dos protocolos diários de enxaguatório bucal recomendados contra SARS-CoV-2 em íons metálicos liberados de aparelhos ortodônticos fixos, especificamente Níquel (Ni) e Cromo (Cr). Material e Métodos: Um total de 400 aparelhos fixos de hemiarcada foram segregados em dois grupos, Níquel Titânio (NiTi) e Aço Inoxidável (SS), com base no tipo de fio utilizado. Cada conjunto foi submerso em enxaguantes bucais com iodopovidona a 2%, peróxido de hidrogênio a 1%, clorexidina a 0,2% e cloreto de cetilpiridínio. Água destilada foi utilizada para medições comparativas dos íons liberados como grupo controle (n=10/grupo). Eles foram incubados por cinco períodos a 37°C (uma hora, vinte e quatro horas, uma e 3 semanas). Os íons Nil e Cr liberados do aparelho fixo foram avaliados por espectroscopia de absorção atômica. Os dados foram analisados pelo teste de Kruskal-Wallis e análise de comparação pareada. Resultados:Os piores níveis de Ni e Cr liberados no grupo SS foram observados no enxaguatório bucal com iodopovidona em 1,173 e 1,701 ppm, respectivamente, enquanto o enxaguatório bucal com clorexidina liberou níveis aceitos de Ni e Cr em 0,033 e 0,056 ppm, respectivamente. O grupo NiTi exibiu os terríveis íons liberados de Ni e Cr no enxaguatório bucal com iodopovidona a 1,87 e 2,4 ppm, respectivamente. Já os níveis liberados de íons Ni e Cr do grupo clorexidina e cloreto de cetilpiridínio foram 0,048 e 0,127 ppm, respectivamente, com diferenças significativas entre os grupos e intervalos testados. Conclusão: Enxaguatórios bucais com clorexidina e cloreto de cetilpiridínio foram as opções adequadas para pacientes ortodônticos para minimizar a liberação de íons de acordo com o protocolo deste estudo(AU)

Application of the infant and young child feeding index and the evaluation of its relationship with nutritional status in 6-24 months children / Aplicação do índice de alimentação de lactentes e crianças pequenas e avaliação de sua relação com o estado nutricional de crianças de 6 a 24 meses

ABSTRACT Objective To evaluate the complementary feeding practices of mothers in infant and child nutrition using Infant and Young Child Feeding Indicator and Infant and Child Feeding Index and to determine their relationship with nutritional status. Methods Study data were collected through an online questionnaire administered to 141 parents on healthy 6-24 month infants/children. Complementary feeding practices for infants/children were evaluated in line with the Infant and Child Feeding Index and Infant and Young Child Feeding Indicator. In the evaluation of growth, weight for age z-scores, length for age z-scores, and weight for length z-scores of infants/children were calculated with the World Health Organization Anthro program. Results 74.5% of 141 infants and children (71 boys, 70 girls) evaluated in the study are breastfed. The prevalence of stunting, wasted, and underweight was determined as 6.4%, 0.7%, and 4.3%, respectively. When evaluated using Infant and Young Child Feeding Indicator, it was determined that 82.3% of children met the minimum meal frequency, 80.9% met the minimum dietary diversity, and 67.4% met the minimum acceptable diet. Regarding Infant and Child Feeding Index evaluations of the children, while there was no difference between 9-11 and 12-24 month age groups, the mean Infant and Child Feeding Index score in the 6-8 month group was significantly lower than the other age groups (p=0.000). The Infant and Child Feeding Index scores used to evaluate complementary feeding practices in our study were found to be high in most infants/children. No clear relationship was found between stunting and minimum acceptable diet, minimum dietary diversity or minimum meal frequency, which are indicators of both Infant and Child Feeding Index scores and World Health Organization, Infant and Young Child Feeding Indicator. Conclusion The Infant and Child Feeding Index scores used to evaluate complementary feeding practices in our study were high in most infants/children. In addition, the high rates of MMF, minimum dietary diversity, and minimum acceptable diet coverage in evaluating infants/children in terms of World Health Organization indicators show that they have appropriate complementary feeding practices. However, study found no clear relationship between stunting and minimum acceptable diet, minimum dietary diversity or MMF, which are indicators of both Infant and Child Feeding Index I scores and WHO Infant and Young Child Feeding Indicator. It was concluded that World Health Organization Infant and Young Child Feeding Indicator indicators may be better than length for age z-scores in the weight for length z-scores explanation.

RESUMO Objetivo Avaliar as práticas de alimentação complementar das mães na nutrição de lactentes e crianças utilizando o Indicador de Alimentação de Lactentes e Crianças Pequenas e o Índice de Alimentação de Lactentes e Crianças e determinar sua relação com o estado nutricional. Métodos Os dados do estudo foram coletados por meio de um questionário online administrado a 141 pais de bebês/crianças saudáveis de 6 a 24 meses. As práticas de alimentação complementar de lactentes/crianças foram avaliadas de acordo com o Índice de Alimentação de Lactentes e Crianças e o Indicador de Alimentação de Lactentes e Crianças Pequenas. Na avaliação do crescimento, os escores z de peso para idade, escores z de comprimento para idade e escores z de peso para comprimento de bebês/crianças foram calculados com o programa Organização Mundial da Saúde Anthro. Resultados Quando avaliadas por meio do Indicador de Alimentação de Lactentes e Crianças Pequenas, constatou-se que 82,3% das crianças atendiam à frequência mínima de refeições, 80,9% atingiam a diversidade alimentar mínima e 67,4% atingiam a dieta mínima aceitável. Em relação às avaliações do Índice de Alimentação de Lactentes e Crianças das crianças, embora não tenha havido diferença entre as faixas etárias de 9 a 11 e 12 a 24 meses, a pontuação média do Índice de Alimentação de Lactentes e Crianças no grupo de 6 a 8 meses foi significativamente menor do que nas outras faixas etárias (p=0,000). Os escores do Índice de Alimentação de Lactentes e Crianças utilizados para avaliar as práticas de alimentação complementar em nosso estudo foram elevados na maioria dos bebês/crianças. Não foi encontrada nenhuma relação clara entre o atraso no crescimento e a dieta mínima aceitável, diversidade alimentar mínima ou frequência mínima de refeição ,que são indicadores tanto das pontuações do Índice de Alimentação de Lactentes e Crianças como do Indicador de Alimentação de Lactentes e Crianças Pequenas da Organização Mundial da Saúde. Conclusão Escores altos do Índice de Alimentação de Lactentes e Crianças na maioria dos bebês/crianças são um bom indicador de Indicador de Alimentação de Lactentes e Crianças Pequenas nessa população. No entanto, nenhuma relação clara foi encontrada entre o déficit de estatura e os escores do Índice de Alimentação de Lactentes e Crianças e do Indicador de Alimentação de Lactentes e Crianças Pequenas neste estudo.

Consensus of the Brazilian association of hematology, hemotherapy and cellular therapy on patient blood management: History and scenario of patient blood management in the world and in Brazil

Abstract Patient Blood Management (PBM) is a multidimensional approach that seeks to optimize the use of blood and its components in patients. This matter emerged as a response to the need to reduce unnecessary exposure to blood transfusions and their potential risks. In the past, blood transfusion was often overused resulting in complications and high costs. The advent of Patient Blood Management has caused a paradigm shift, highlighting anemia prevention, bleeding control and maximizing the production of blood cells by the organism itself. Patient Blood Management guidelines include the early identification of anemia, strategies to minimize blood loss during surgery, intraoperative blood conservation techniques, preoperative hemoglobin optimization and evidence-based approaches to the rational use of blood transfusions. Aiming to improve clinical outcomes, decrease transfusion-related complications and reduce associated costs, this multidisciplinary approach counts on doctors, nurses, pharmacists and other healthcare professionals. Based on research and clinical evidence, Patient Blood Management continues to evolve thereby promoting safer, more effective patient-centered practices. Its implementation has proven beneficial in various medical contexts thereby contributing to improvements in the quality of care provided to patients. Our goal with this Consensus is to present readers with a broad and diverse view of Patient Blood Management so that they have the building blocks to implement this new technique.

Caminando hacia el final de la pandemia COVID-19: caso México / Moving towards the end of the COVID-19 pandemic: the case of Mexico

Introducción: se vive una crisis de confianza en la ciencia y una época de menosprecio a los conocimientos y evidencias. Las opiniones de los líderes políticos y otras figuras públicas ajenas a los problemas de salud tienen una mayor consideración y peso que los juicios emitidos por los expertos. Una evidencia que demuestra la debilidad de México en el campo de la salud son dos hechos en los cuales las autoridades del país son los culpables que son: la desaparición del Seguro Popular y la pobre respuesta a la pandemia de COVID-19. Conclusiones: la pandemia no termina por decreto, se logrará con cuidados y prevención realizada por el gobierno, instituciones y personal de salud y la sociedad (AU)

Introduction: we are living through a crisis of confidence in science and an era of disregard for knowledge and evidence. The opinions of political leaders and other public figures who are not involved in health problems are given greater consideration and weight than the judgments made by experts. Evidence that demonstrates Mexico's weakness in the field of health are two facts in which the country's authorities are to blame: the disappearance of Seguro Popular and the poor response to the COVID-19 pandemic. Conclusions: the pandemic does not end by decree, it will be achieved with care and prevention carried out by the government, health institutions and personnel and society (AU)

Noticias de suicidio en canales de televisión peruanos: evaluación del cumplimiento de las recomendaciones de la OMS para su notificación / Suicide news on peruvian television channels: evaluation of compliance with WHO's reporting recommendations

Objetivo. Determinar el cumplimiento a las recomendaciones de la Organización Mundial de la Salud (OMS) de las noticias sobre suicidio emitidas por canales de la televisión peruana. Materiales y métodos. Estudio cuantitativo y descriptivo. La unidad de análisis fueron las noticias de suicidio emitidas por ocho canales de televisión peruana durante los años 2020 y 2021. Las noticias se clasificaron en tres categorías: noticias sobre suicidio, intento de suicidio y prevención del suicidio. Se utilizó un instrumento de evaluación compuesto por las recomendaciones de la OMS. Resultados. Se analizaron un total de 126 noticias. Ninguna de estas noticias cumplió en su totalidad con las recomendaciones de la OMS. Las noticias sobre suicidio o intento de suicidio cumplieron con 4 de 13 recomendaciones, siendo la recomendación más acatada la de evitar publicar notas suicidas (97,4%), mientras que la menos cumplida fue la de instruir a la población sobre el suicidio y su prevención, y no difundir mitos (0,9%). Las noticias de prevención de suicidio cumplieron 5 de 7 recomendaciones. Conclusiones. Las noticias sobre suicidio emitidas en la televisión peruana en los años 2020 y 2021 mostraron un bajo cumplimiento a las recomendaciones de la OMS. Los profesionales de la comunicación tienen un rol fundamental en la prevención del suicidio, limitando la información sensible y difundiendo información de ayuda. Es fundamental el conocimiento de estas recomendaciones por los comunicadores, y el trabajo conjunto entre el equipo periodístico y los profesionales de la salud mental en la comunicación de noticias relacionadas con el suicidio.

Objective. To determine if suicide news reports broadcasted by Peruvian television channels comply with the World Health Organization (WHO) recommendations for reporting suicide news. Materials and methods. Quantitative and descriptive study. The unit of analysis was the suicide news broadcasted by eight Peruvian television channels during the years 2020 and 2021. News were classified into three categories: news about suicide, attempted suicide and suicide prevention. We used an evaluation instrument composed of WHO recommendations. Results. A total of 126 news reports were analyzed; but none of these complied fully with the WHO recommendations. The news reports on suicide or attempted suicide complied with 4 of 13 recommendations. Most reports complied with avoiding to publish suicide notes (97.4%); on the other hand, educating about suicide and its prevention, and not disseminating myths was the recommendation least complied with (0.9%). Suicide prevention news reports complied with 5 of 7 recommendations. Conclusions. Suicide news reports on Peruvian television in 2020 and 2021 showed low compliance with WHO recommendations. Communication professionals have a fundamental role in suicide prevention, limiting sensitive information and disseminating helpful information. It is essential for communicators to be aware of these recommendations and for the journalism team and mental health professionals to work together in the communication of news related to suicide.

Consenso SOCHOG/SOCHUMB: utilizar en Chile la curva estándar OMS ultrasonográfica de crecimiento fetal / SOCHOG/SOCHUMB consensus: OMS fetal ultrasound curve is the standard curve for ultrasound growth assessment to use in Chile

La Sociedad Chilena de Obstetricia y Ginecología (SOCHOG) y la Sociedad Chilena de Ultrasonido en Medicina y Biología (SOCHUMB) convocaron a un comité de expertos en el tema de ultrasonido y crecimiento fetal con el fin de proponer utilizar la curva fetal que mejor se adapte a la población chilena. Luego de la discusión, al no contar con curvas chilenas de crecimiento fetal, se concluye proponer que la curva estándar de la Organización Mundial de la Salud (OMS) sería la indicada dada la calidad de su metodología y por ser multicéntrica.

The Chilean Society of Obstetrics and Gynecology (SOCHOG) and the Chilean Society of Ultrasound in Medicine and Biology (SOCHUMB) have convened a committee of experts on the subject of ultrasound and fetal growth in order to propose using the fetal curve that best adapts to the Chilean population. After the discussion, since there are no Chilean fetal growth curves, it is concluded that the World Health Organization (WHO) standard curve would be the one to use given the quality of its methodology and the fact that it is multicentric.

¿Cuál es el periodo de infección de la variante ómicron del SARS-CoV-2?: síntesis rápida de evidencia / What is the infection period of the omicron variant of SARS-Cov-2?: rapid evidence synthesis

ANTECEDENTES Y OBJETIVO Tras 3 años de pandemia, la OMS ha declarado que el COVID-19 no constituye una Emergencia de Salud Pública de Importancia Internacional. En Chile, la Comisión Nacional de Respuesta Pandémica del Ministerio de Salud se ha propuesto reevaluar las medidas de aislamiento y las licencias laborales de casos positivos por COVID-19, para lo cual ha solicitado la presente Síntesis Rápida de Evidencia. METODOLOGÍA Se realizó una estrategia de búsqueda amplia en EMBASE y MEDLINE, a través de OVID, y una búsqueda específica en GOOGLE, sin filtrar por estudios primarios o secundarios. Se identificaron 2.128 referencias, de las cuales se incluyeron 3 estudios tras eliminar los duplicados y aplicar los criterios de inclusión y exclusión. Se utiliza la metodología de la certeza de evidencia GRADE. RESULTADOS Se describen normativas de 12 países - La variante ómicron tiene un periodo medio de contagio de 3,6 días, IC 95%: 3,5 a 6,6 días (certeza de la evidencia alta). - El 81% de los contagios ocurren antes del 5to día desde el inicio de síntomas (certeza de la evidencia alta). - No se identificó evidencia respecto al impacto del aislamiento obligatorio en la morbi-mortalidad asociada al COVID-19, en los estudios incluidos.

Autorregulación del aprendizaje y rendimiento académico en estudiantes de Medicina: el caso de tres Universidades de Paraguay / Self-regulation of learning and academic performance in medical students: The case of three Universities of Paraguay

Introducción: La autorregulación del aprendizaje se refiere a la modulación de los procesos afectivos, cognitivos y conductuales a lo largo de una experiencia de aprendizaje para alcanzar un nivel de logro deseado. Los estudiantes que tienen un mejor manejo de sus habilidades cognitivas y metacognitivas aprenden de una mejor forma que aquellos que no, por lo tanto, es fundamental estudiar a qué nivel los estudiantes universitarios son capaces de aprender a aprender y a ser gestores de su aprendizaje. Objetivos: Analizar la relación entre la autorregulación del aprendizaje y el rendimiento académico en estudiantes de la carrera medicina de tres universidades en el año 2022. Materiales y métodos: Esta investigación siguió un enfoque cuantitativo, el tipo de investigación fue observacional de tipo descriptivo. Se utilizó un instrumento previamente validado para identificar los tipos de autorregulación, la Autorregulación del Aprendizaje a partir de Textos (ARATEX-R). Resultados: No se encontró relación significativa entre el perfil académico de los estudiantes de medicina y el puntaje total del ARATEX-R. Al estudiar la relación entre las dimensiones de la autorregulación se encontró relación entre el rendimiento académico y la planificación y la gestión de la motivación, lo que implica que los que tienen mejores habilidades de planificación y que son capaces de gestionar su motivación tienen mejor rendimiento académico. Conclusión: Las principales dimensiones que caracterizan la autorregulación del aprendizaje en estudiantes de medicina fueron: gestión del contexto, gestión de la cognición y evaluación de la comprensión.

Introduction: Self-regulation of learning refers to the modulation of affective, cognitive and behavioral processes throughout a learning experience to reach a desired level of achievement. Students who have a better management of their cognitive and metacognitive skills learn in a better way than those who do not, therefore, it is essential to study at what level university students are capable of learning to learn and to be managers of their learning. Objectives: To analyze the relationship between self-regulation of learning and academic performance in medical students from three universities in the year 2022. Materials and methods: This research followed a quantitative approach; the type of research was observational and descriptive. A previously validated instrument was used to identify types of self-regulation, the Self-Regulation of Learning from Texts (ARATEX-R). Results: No significant relationship was found between the academic profile of medical students and the total ARATEX-R score. When studying the relationship between the dimensions of self-regulation, a relationship was found between academic performance and motivation planning and management, which implies that those who have better planning skills and who are able to manage their motivation have better academic performance. Conclusion: The main dimensions that characterize the self-regulation of learning in medical students were: context management, cognition management and comprehension evaluation.

Percentiles de peso, talla e índice de masa corporal de escolares de Mendoza. Comparación con la referencia de la Organización Mundial de la Salud / Body mass index, weight, and height percentiles in school-aged children from Mendoza. A comparison with the WHO reference

Introducción. La Organización Mundial de la Salud (OMS) recomienda el uso de tablas de referencia para monitorear el crecimiento y estado nutricional de niños, niñas y adolescentes. El peso corporal, la talla y el índice de masa corporal (IMC) son las variables más utilizadas. El presente trabajo tiene como objetivos estimar los percentiles de peso, talla e IMC de escolares (2009-2011) residentes en el departamento San Rafael (Mendoza) y compararlos con la referencia internacional de la Organización Mundial de la Salud, a fin de establecer su pertinencia para la evaluación del crecimiento y estado nutricional de dicha población. Población y métodos. Se realizó un estudio antropométrico transversal en 3448 escolares de entre 4,00 y 13,49 años de edad. Se utilizó el programa LMS ChartMarker Pro para calcular los valores percentilares de peso/edad, talla/edad e IMC/edad, por sexo y edad, y se compararon con las curvas de la OMS. Además, se calcularon diferencias porcentuales (D%) para estimar las diferencias y su significación estadística mediante prueba de Wilcoxon. Resultados. La población de San Rafael mostró, en varones y mujeres, valores percentilares superiores de peso e IMC (D% ≈7 % y 9 %, respectivamente), y menores de talla (D% ≈0,8 %) que los de la OMS (p <0,05). Conclusión. Las diferencias encontradas alertan sobre el empleo de la referencia OMS en la población escolar de San Rafael, ya que sobreestimaría las prevalencias de sobrepeso, obesidad y desnutrición crónica, y subestimaría la de desnutrición aguda y global. Esta situación resalta la importancia de contar con una referencia local.

Introduction. The World Health Organization (WHO) recommends the use of reference tables to monitor the growth pattern and nutritional status of children and adolescents. Body mass index (BMI), weight, and height are the most commonly used variables. The objective of this study was to estimate the BMI, weight, and height percentiles for school-aged children (2009-2011) living in the department of San Rafael (Mendoza) and compare them to the international World Health Organization reference to establish their relevance for the evaluation of the growth pattern and nutritional status of this population. Population and methods. A cross-sectional anthropometric study was conducted in 3448 school-aged children aged 4.00 to 13.49 years. The LMS ChartMarker Pro software was used to estimate the BMI- for-age, weight-for-age, and height-for-age percentiles, by sex and age, and they were compared with the WHO curves. Besides, percentage differences (%D) were calculated to estimate the differences and their statistical significance using the Wilcoxon test. Results. The population of boys and girls in San Rafael showed higher weight and BMI (%D ≈ 7% and 9%, respectively) percentiles, and lower height (%D ≈ 0.8%) values than WHO reference (p < 0.05). Conclusion. The differences found warn about the use of the WHO reference in the school-aged population of San Rafael since it would overestimate the prevalence of overweight, obesity, and chronic malnutrition and underestimate the prevalence of acute and global malnutrition. This situation highlights the importance of having a local reference resource

Variante mexicana de COVID-19: ómicron BW. 1 o Xibalbá / Mexican variant of COVID-19: omicron BW. 1 o Xibalbá

Introducción: desde la aparición del COVID-19 a principios de diciembre del año 2019, en la ciudad China de Wuhan, esta enfermedad respiratoria empezó a avanzar a nivel mundial. El 30 de enero de 2020, la Organización Mundial de la Salud declaró a esta enfermedad con carácter epidémico y como una situación de emergencia a nivel mundial. El propósito de este estudio es presentar información de la variante ómicron BW.1 o Xibalbá. Conclusión: México está en un proceso de transición de pandemia hacia endemia, pero no quiere decir que no seguirán apareciendo nuevas variantes como ocurrió en la quinta ola (ómicron BA.5) o con subvariantes que emergieron como BW.1 «Xibalbá¼, BQ.1 «perro del infierno¼ y XBB «pesadilla¼. La población y los gobiernos deberán continuar con las medidas preventivas establecidas desde el inicio de la pandemia como son el uso de cubrebocas, el correcto lavado de manos y de ropa, los hábitos de higiene, limpieza, desinfección personal y de nuestro entorno, el aislamiento precoz ante alguna sintomatología y la vacunación (ya sea la primera o sus refuerzos subsecuentes).(AU)

Introduction: since the appearance of COVID-19 in early December 2019 in the Chinese city of Wuhan, this respiratory disease began to spread worldwide. On the thirtieth of January of the year two thousand and twenty, the World Health Organization (WHO) declared this disease to be epidemic and with a worldwide emergency situation. The purpose of the study is to present information on the Omicron BW.1 or Xibalba variant. Conclusion: Mexico is in a process of transition from pandemic to endemic but this does not mean that new variants will not continue to appear as they did in the fifth wave (omicron BA.5) or subvariants that emerged such as: BW.1 or «Xibalbá¼, BQ.1 «hellhound¼ and XBB «nightmare¼. The population and governments should continue with the preventive measures established since the beginning of the pandemic, such as: use of masks, proper hand and clothing washing, hygiene habits, personal and environmental cleaning and disinfection, early isolation in case of any symptomatology, and vaccination, either first or subsequent boosters.(AU)

Intervención de la representante de la OPS para Colombia. Gina Tambini Gómez / Intervention of the PAHO representative for Colombia. Gina Tambini Gómez

Iniciamos la presentación estableciendo un paralelismo histórico entre dos instituciones la Academia Nacional de Medicina con 150 años y la Organización Panamericana de la Salud (OPS) con 120 años, destacando el contexto sanitario que le dio origen a ambas instituciones. En los inicios de la Organización Panamericana de la Salud y la Academia Nacional de Medicina buscaron sus miembros responder a brotes epidémicos, epidemias de enfermedades transmisibles buscando el saneamiento básico, la salubridad e higiene de la población.