Ruta de trabajo para adecuación de la normativa técnica, Ley Crecer Juntos / Work route for adaptation of the technical regulations, Grow Together Law

El objetivo de la ruta es establecer las pautas formales, respecto a la atención integral en salud en las niñas, niños y adolescentes, ayudando a optimizar las acciones, disminuir costos, incrementar la satisfacción de los usuarios, así como mejorar la productividad y competitividad del personal de salud. En razón de lo anterior presentamos la ruta de trabajo, para la adecuación de la normativa técnica, producto del trabajo de las diferentes dependencias vinculadas directa e indirectamente a la atención en salud a niñas, niños y adolescentes

The objective of the route is to establish formal guidelines regarding comprehensive health care in the girls, boys and adolescents, helping to optimize actions, reduce costs, increase user satisfaction, as well as improving the productivity and competitiveness of health personnel. Due to the above, we present the work route, for the adaptation of the technical regulations, product of the work of the different agencies linked directly and indirectly to care in health for girls, boys and adolescents

Edentulism and quality of life in the Salvadoran population: a cross-sectional study.

INTRODUCTION: Edentulism is the partial or total loss of teeth, it is irreversible and disabling due to its sequelae in the masticatory, phonetic and aesthetic function that affect the quality of life. OBJECTIVE: To establish the impact of edentulism and sociodemographic factors on the quality of life of the Salvadoran population. MATERIALS AND METHODS: Secondary cross-sectional analysis of data in 3322 users of the Public Health System of El Salvador, aged 15 to > 60 years. The variables under study were sociodemographic, edentulismo and quality of life. Edentulism was determined by clinical examination using the Oral Impact on Daily Performance scale. The statistical analysis was performed using χ2, OR, multiple regression analysis and set the significance threshold at p < 0.05. RESULTS: Partial edentulism in the upper jaw was present in 68.24% people, partial edentulism in the lower jaw was present in 72.42% people and complete edentulism was observed in 2.02% people. There were significant sex differences and a relationship between sex and quality of life (p < 0.004); the self-perception of severe/very severe impacts was greater in women. People without education or with primary or secondary education only were the most affected (p < 0.05). Tooth loss increases with age, affecting quality of life in a severe/very severe manner. Complete edentulism had greater impacts on quality of life in terms of eating (25.64%), speaking (21.15%), and socializing/enjoying contact with people (10.90%). A severe/very severe impact on quality of life of teeth lost was reported mainly by those over 60 years of age, with an average of 11 missing posterior teeth, 6 missing anterior teeth and 13 missing teeth per patient. Those missing up to 6 anterior teeth were times more likely to perceive severe/very severe impacts on quality of life than those without any missing teeth (OR:5.788). Edentulism affected the quality of life of those examined, especially the loss of upper anterior teeth.

Do behavioral drivers matter for healthcare decision-making during crises? A study of low-income women in El Salvador during the COVID-19 pandemic.

Understanding health-seeking behaviors and their drivers is key for governments to manage health policies. A growing body of research explores the role of cognitive biases and heuristics in health and care-seeking behaviors, but little is known about how a context of heightened anxiety and uncertainty might influence these behavioral drivers. This study analyzes the association between four behavioral predictors-internal locus of control, impatience, optimism bias, and aspirations-and healthcare decisions among low-income women in El Salvador, controlling for other factors. We find positive associations between internal locus of control and preventive health behaviors during the COVID-19 pandemic. For instance, a one standard deviation increase in locus of control is associated with a 10% increase in an index measuring the use of masks, distancing, hand washing, and vaccination. Locus of control was also associated with women's use of preventive health services (one standard deviation improves the likelihood of having a hypertension test in the last six months by 5.8 percentage points). In a sub-sample of mothers, we find significant relationships between the four behavioral drivers and the decisions the mothers make for their children. However, we find these associations are less robust compared to the decisions they make for themselves. Some associations were stronger during the pandemic, suggesting that feelings of uncertainty and stress could amplify behavioral drivers' influence on health-related behaviors. This novel finding is relevant for designing policy responses for future shocks. JEL CODES: I12, D10, D91, I30.

Lineamientos técnicos de vigilancia centinela / Technical guidelines for sentinel surveillance

La vigilancia centinela incluye una amplia gama de actividades, dirigidas a conocer la evolución de determinados problemas de salud en la población general o en grupos específicos, para ello, intenta obtener una medida de la frecuencia de los eventos en el país, sin tener que acudir a encuestas amplias y costosas. El propósito fundamental de este tipo de vigilancia es obtener información puntual y de interés para la salud pública con un menor costo. El presente documento establece las actividades y roles de los equipos de vigilancia centinela, además los objetivos, sitios centinela, definición de caso, pasos para la vigilancia, datos necesarios para el análisis, flujograma, análisis de datos y procedimiento de laboratorio para la vigilancia centinela de rotavirus, neumonías y meningitis bacteriana, virus influenza y otros virus respiratorios

Sentinel surveillance includes a wide range of activities, aimed at knowing the evolution of certain health problems in the general population or in specific groups; to do so, it attempts to obtain a measure of the frequency of events in the country, without having to go to extensive and expensive surveys. The fundamental purpose of this type of surveillance is to obtain timely information of interest to public health at a lower cost. This document establishes the activities and roles of the sentinel surveillance teams, as well as the objectives, sentinel sites, case definition, steps for surveillance, data necessary for analysis, flowchart, data analysis and laboratory procedure for sentinel surveillance. rotavirus, pneumonia and bacterial meningitis, influenza virus and other respiratory viruses

Lineamientos técnicos para el proceso de ingreso al internado rotatorio y año social 2025 / Technical guidelines for the admission process to the rotating boarding school and social year 2025

Los presentes Lineamientos detallan las pautas necesarias para realizar el proceso de ingreso al internado rotativo y año social para el 2025

These Guidelines detail the necessary guidelines to carry out the admission process to the rotating boarding school and social year for 2025

Manual de organización y funciones de la Dirección de Monitoreo Estratégico de Servicios de Salud / Manual of organization and functions of the Directorate of Strategic Monitoring of Health Services

Las funciones de monitoreo a los servicios de salud, se ven fortalecidas por los sistemas de información en salud, en ese sentido el exitoso avance y consolidación del Sistema Integrado de Salud, la conectividad y funcionalidad del 98% de los establecimientos de salud del Ministerio, permiten ahora continuar con las siguientes etapas del proceso buscando la edificación, expansión, mantenimiento y mejora con el objeto de consolidar la gestión de la información como pieza clave en los procesos de evaluación, monitoreo y toma de decisiones. La Dirección de Monitoreo Estratégico de Servicios de Salud, es partícipe directa en el proceso de planificación, implementación, monitoreo, evaluación y seguimiento del Sistema Integrado de Salud y apuesta por su fortalecimiento como una herramienta efectiva y ágil para la ejecución del monitoreo estratégico

The monitoring functions of health services are strengthened by health information systems, in that sense the successful advancement and consolidation of the Integrated Health System, the connectivity and functionality of 98% of the Ministry's health facilities, They now allow us to continue with the next stages of the process seeking construction, expansion, maintenance and improvement in order to consolidate information management as a key piece in the evaluation, monitoring and decision-making processes. The Directorate of Strategic Monitoring of Health Services is a direct participant in the process of planning, implementation, monitoring, evaluation and follow-up of the Integrated Health System and is committed to its strengthening as an effective and agile tool for the execution of strategic monitoring

Norma técnica de terapia respiratoria / Respiratory therapy technical standard

La presente norma técnica tiene por objeto establecer las disposiciones técnicas para regular las actividades relacionadas a la prestación de servicios de terapia respiratoria en los distintos establecimientos del Sistema Nacional Integrado de Salud

The purpose of this technical standard is to establish the technical provisions to regulate activities related to the provision of respiratory therapy services in the different establishments of the National Integrated Health System.

A Case of Chagas Disease in South Dakota: Diagnosis and Treatment.

Chagas disease is a chronic, systemic parasitic infection caused by the protozoan Trypanosoma cruzi. The primary mode of transmission to humans is by the Reduviid insect, endemic to South America. Recent migration of the vector has led to increased cases in the southern United States and has prompted increased surveillance and blood donation screening. It is unusual to diagnose and treat individuals with Chagas disease in the northern United States. This case describes an immigrant female from El Salvador that was informed she had Chagas disease from a blood bank screening. Confirmation and treatment of the disease were performed by her South Dakota primary care provider thus demonstrating the importance of identifying Chagas disease in the immigrant population in regions where Chagas disease infection is uncommon.

Degradation as salvation: Reflections on El Salvador's punitive prison model.

The pictures of shaven men with naked upper bodies, sitting in rows back-to-back with fellow prisoners in close proximity, sur-rounded by heavily armed guards, encapsulates the essence of El Salvador's ongoing "war on gangs".

Surgical outreach for the Americas: a self-sustainable model for partnership and education.

INTRODUCTION: It is estimated that up to 28% of global disease burden is surgical with hernias representing a unique challenge as the only definitive treatment is surgery. Surgical Outreach for the Americas (SOfA) is a nongovernmental organization focused primarily on alleviating the disease burden of inguinal and umbilical hernias in Central America. We present the experience of SOfA, a model focused on partnership and education. METHODS: SOfA was established in 2009 to help individuals recover from ailments that are obstacles to working and independent living. Over the past 15 years, SOfA has partnered with local healthcare providers in the Dominican Republic, El Salvador, Honduras, and Belize. The SOfA team consists of surgeons, surgery residents, triage physicians, an anesthesiologist, anesthetists, operating room nurses, recovery nurses, a pediatric critical care physician, sterile processing technicians, interpreters, and a team coordinator. Critical partnerships required include the CMO, internal medicine, general surgery, nursing, rural health coordinators and surgical training programs at public hospitals. RESULTS: SOfA has completed 24 trips, performing 2074 procedures on 1792 patients. 71.4% of procedures were hernia repairs. To enhance sustainability of healthcare delivery, SOfA has partnered with the local facilities through capital improvements to include OR tables, OR lights, anesthesia machines, monitors, hospital beds, stretchers, sterilizers, air conditioning units, and electrosurgical generators. A lecture series and curriculum on perioperative care, anesthesia, anatomy, and operative technique is delivered. Local surgery residents and medical students participated in patient care, learning alongside SOfA teammates. Recently, SOfA has partnered with SAGES Global Affairs Committee to implement a virtual Global Laparoscopic Advancement Program, a simulation-based laparoscopic training curriculum for surgeons in El Salvador. CONCLUSION: A sustainable partnership to facilitate surgical care in low resource settings requires longitudinal, collaborative relationships, and investments in capital improvements, education, and partnership with local healthcare providers, institutions, and training programs.

Lineamientos técnicos de radiología e imágenes en el Primer Nivel de Atención / Technical guidelines for radiology and images in the First Level of Care

Los presentes lineamientos técnicos contienen las directrices para la regulación y estandarización de los procesos de atención en la realización de estudios radiológicos con base en las especificaciones técnicas de los equipos de rayos X portátiles, adquiridos para los establecimientos del Primer Nivel de Atención, incluye además los aspectos relacionados con la calidad, seguridad y eficacia, indicaciones, contraindicaciones y el flujograma de atención para la toma de imágenes

These technical guidelines contain the guidelines for the regulation and standardization of care processes in the performance of radiological studies based on the technical specifications of portable X-ray equipment, acquired for First Level Care establishments, and also includes the aspects related to quality, safety and efficacy, indications, contraindications and the care flow chart for image taking

Protocolos para la interpretación de pruebas de bienestar fetal ante parto e intraparto / Protocols for the interpretation of fetal well-being tests before delivery and intrapartum

Los presentes protocolos contiene las disposiciones para la realización de las pruebas de bienestar fetal ante e intraparto con el objetivo de prevenir la hipoxia fetal aguda en los establecimientos de atención del Sistema Nacional Integrado de Salud (SNIS) tanto en el Primer Nivel de Atención, como a nivel hospitalario, cuenta además con las disposiciones para realizar el monitoreo, supervisión y evaluación en los diferentes niveles de atención y de esta forma ayudar a disminuir la mortalidad infantil

These protocols contain the provisions for carrying out prenatal and intrapartum fetal well-being tests with the objective of preventing acute fetal hypoxia in the care facilities of the National Integrated Health System (SNIS) both at the First Level of Care and At the hospital level, it also has the provisions to carry out monitoring, supervision and evaluation at different levels of care and in this way help reduce infant mortality

Manual de procedimientos básicos de enfermería / Basic Nursing Procedures Manual

El presente manual de procedimientos, documenta las principales actividades de atención integral que ofrece el personal de enfermería, como parte del proceso de atención en salud, describe el cuidado y atenciones que se ofrecen a la persona en los establecimientos de salud, mediante el enfoque por procesos institucional. Este enfoque fomenta el desarrollo organizacional y el mejoramiento continuo para cumplir la misión del Ministerio de Salud

This manual of procedures documents the main activities of comprehensive care offered by nursing staff as part of the health care process. It describes the care and attention offered to people in health facilities, using the institutional process approach. This approach promotes organizational development and continuous improvement to fulfill the mission of the Ministry of Health

Un caso de Chagas agudo en edad pediátrica / Acute Vector-transmitted Chagas in Pediatric Age. A Case Reportt

Presentación del caso. Se trata una niña de siete años de edad, originaria de una zona rural del departamento de San Miguel, quién consultó por presentar fiebre y edema bipalpebral derecho indoloro, de seis semanas de evolución, sin otros síntomas acompañantes. El estudio para el diagnóstico de enfermedad de Chagas fue realizado en una clínica privada; la Inmunoglobulina M para Chagas tuvo un resultado positivo, luego, se realizó la microscopía directa mediante gota al fresco y técnica de Strout con resultado negativo. En las intervenciones comunitarias se identificó la presencia del vector y la positividad del mismo, así como el diagnóstico de un caso crónico en otro miembro de la familia. Intervención terapéutica. Se indicó tratamiento con nifurtimox 150 mg cada ocho horas por 60 días y se realizó el seguimiento clínico de la evolución y control de efectos secundarios del tratamiento y exámenes de laboratorio. Evolución clínica. Evolucionó con leve disminución del apetito, se manejó con protectores gástricos. El concentrado de Strout y la gota al fresco resultaron negativos y los demás exámenes de laboratorio se mantenían en los rangos normales.

Case presentation. A seven-year-old female patient, with no previous medical history, originally from a rural area of the department of San Miguel, who presented febrile process plus long-term right bipalpebral edema of six weeks of evolution, without accompanying symptoms. Immunoglobulin M for Chagas was positive, direct microscopy by fresh drop and Strout technique was performed with negative results. In community interventions, the presence of the vector and its positivity were identified, as well as the diagnosis of a chronic case in another family member. Treatment. The patient was treated with nifurtimox 150 mg every eight hours for 60 days, subsequent controls were performed to investigate side effects of the treatment, and control tests. Outcome. With the treatment, the patient evolved with a slight decrease in appetite, and was managed with gastric protectors. Strout's concentrate and fresh gout were negative and the other laboratory tests were within normal ranges.

Metástasis hepática metacrónica de un tumor sólido pseudopapilar de páncreas / Metachronous liver metastasis from a solid pseudopapillary pancreas tumor

Presentación del caso. Se trata de una mujer de 32 años quien consultó por dolor abdominal en el epigastrio no asociado a las comidas, tenía el antecedente de una pancreatectomía distal con preservación de bazo debido a un tumor en la cola del páncreas, cinco años previos. En el examen físico no presentó ninguna anormalidad y durante su abordaje se realizaron estudios de imagen. Intervención terapéutica. La tomografía axial computarizada evidenció una lesión en el segmento lateral izquierdo del hígado con características sugestivas de metástasis debido a su antecedente quirúrgico. Los exámenes de laboratorio y marcadores tumorales se encontraron dentro de límites normales. Se evaluó en conferencia multidisciplinaria y se recomendó un abordaje quirúrgico. Se realizó una hepatectomía izquierda con una evolución posquirúrgica sin complicaciones. Evolución clínica. Luego de seis meses posoperatorios, se encontraba sin evidencia de enfermedad activa o residual

Case presentation. A 32-year-old woman consulted for abdominal pain in the epigastrium not associated with meals. She had a history of distal pancreatectomy with spleen preservation due to a tumor in the tail of the pancreas five years earlier. Physical examination showed no abnormalities and imaging studies were performed during his approach. Treatment. Computed axial tomography revealed a lesion in the left lateral segment of the liver with characteristics suggestive of metastasis due to his surgical history. Laboratory tests and tumor markers were within normal limits. It was evaluated in a multidisciplinary conference, and a surgical approach was recommended. A left hepatectomy was performed with an uncomplicated postoperative evolution. Outcome. Six months postoperatively, there was no evidence of active or residual disease

Fístula carótido-cavernosa con hipertensión ocular secundaria: reporte de caso / Carotid-cavernous fistula with secondary ocular hypertension. A case report

Presentación del caso. Paciente femenina de 62 años con una historia de diez meses de dolor ocular pulsátil, proptosis e inyección conjuntival en el ojo izquierdo; posteriormente presentó un edema palpebral superior izquierdo. Se evaluó con mejor agudeza visual corregida de 20/30 en dicho ojo y presión intraocular de 30 mmHg. Intervención terapéutica.Resonancia magnética nuclear de órbitas evidencia proptosis y dilatación de vena oftálmica superior izquierda, por lo que se diagnosticó como defecto del drenaje venoso e hipertensión ocular del ojo izquierdo. Inició tratamiento hipotensor tópico de ojo izquierdo; estudios de imagen angiotomografía de órbitas y ultrasonido doppler de ojo izquierdo, con énfasis en párpado superior, evidencian fístula carótido-cavernosa izquierda de alto gasto. Se realizó angiografía cerebral diagnóstica y terapéutica con embolización de fístula en arterias meníngea media y faríngea ascendente con ausencia de flujo por dichas ramas después de la intervención. Evolución clínica. Presentó una evaluación clínica favorable, conservando agudeza visual y presión intraocular dentro de valores normales en ojo izquierdo, con evidente disminución de congestión venosa epiescleral, edema de párpado superior y ausencia de proptosis izquierda. Ultrasonido doppler control de párpado superior izquierdo con disminución de flujo venoso a valores normales

Case presentation. 62 years old female with ten months history of ocular pain, proptosis, and conjunctival hyperemia in left eye, developing swollen upper eyelid. Best corrected visual acuity was 20/30 in her left eye, with and intraocular pressure of 30 mmHg. Treatment. Nuclear magnetic resonance of the orbits showed proptosis and dilated superior ophthalmic vein. Initial diagnosis. Abnormal venous drainage and ocular hypertension in the left eye. Topical hypotensive treatment of the left eye was initiated with ocular hypotensive eyedrops. Angiotomography of the orbit and left eye Doppler ultrasound, with upper eyelid emphasis, gave visualization of high flow carotid-cavernous fistula. Cerebral diagnostic and therapeutic angiography with embolization of the fistula in middle meningeal and ascending pharyngeal arteries showed no vascular flow after the procedure. Outcome. Positive clinical outcome, with corrected visual acuity conserved and normal eye pressure. Notable relief of ocular congestion and swollen upper eyelid with no proptosis in the left eye. Doppler ultrasound in the upper eyelid showed normal flow rate measurement.

Paciente con leishmaniasis cutánea tratada con miltefosina en un área endémica de Brasil / Patient with cutaneous leishmaniasis treated with miltefosine in an endemic area in Brazil

Presentación del caso. Se trata de una mujer de 45 años con úlcera en el muslo izquierdo, con forma ovalada, bordes bien definidos y elevados, sin secreción, sin costra, e indolora, que presentó una lesión de 60 días de evolución, que inició como una pápula puntiforme de aumento progresivo en tamaño y profundidad hasta generar una úlcera, después de cuatro semanas de haber realizado un viaje de tres días a un área rural endémica para leishmaniasis tegumentaria americana. Intervención terapéutica. Se confirmó el diagnóstico de leishmaniasis cutánea localizada, en consecuencia, recibió tratamiento ambulatorio con miltefosina de 50 mg por vía oral cada ocho horas por un total de 28 días, acompañado de seguimiento clínico y de laboratorio. Evolución clínica. Se presentaron efectos secundarios leves, entre ellos, las náuseas que cedieron con el tratamiento con ondansetrón y omeprazol, luego presentó hiporexia, que persistió hasta el final del tratamiento. No hubo alteraciones laboratoriales significativas. La paciente fue evaluada periódicamente según las recomendaciones del Ministerio de Salud de Brasil y se observó una mejoría clínica gradual de la lesión, hasta que en la evaluación del día noventa fue determinada la cura clínica.

Case presentation. The patient is a 45-year-old woman with an oval-shaped ulcer on the left thigh, with well-defined and raised borders, no discharge, no crust, and painless; she presented a lesion of 60 days of evolution, which started as a punctate papule of progressive increase in size and depth until it became an ulcer, four weeks after a three-day trip to a rural area endemic for American tegumentary leishmaniasis. Treatment. The diagnosis of localized cutaneous leishmaniasis was confirmed; consequently, the patient received outpatient treatment with miltefosine 50 mg orally every eight hours for 28 days, accompanied by clinical and laboratory follow-up. Clinical outcome. There were mild side effects, including nausea that subsided with treatment with ondansetron and omeprazole, and later hyporexia, which persisted until the end of treatment. There were no significant laboratory alterations. The patient was periodically evaluated according to the recommendations of the Brazilian Ministry of Health, and the lesion improved gradually, reaching a clinical cure on the 90th day.

Efectos de la infección del Trypanosoma cruzi en ratones de las cepas Balb/c y NIH / Effects of Trypanosoma cruzi infection in Balb/c and NIH mouse strains

La enfermedad de Chagas es una infección causada por el parásito Trypanosoma cruzi y transmitida por el vector Triatoma dimidiata, conocido en El Salvador como «chinche picuda¼. Esta enfermedad siempre ha sido de interés científico en modelos animales. Objetivo. Identificar el efecto de la infección por Trypanosoma cruzi en ratones de diferentes cepas (BALB/c y NIH) y sexo. Metodología. Se establecieron ocho grupos: cuatro infectados con Trypanosoma cruzi y cuatro grupos no infectados, distribuidos por cepa y sexo, con cinco ratones por grupo. Durante seis semanas se registró el peso corporal de los ratones. Además, se prepararon muestras de sangre de los grupos infectados en láminas para realizar los conteos de parasitemia. Al final del estudio, se extrajeron el bazo y el corazón de ambos grupos para los análisis estadísticos. Resultados. Los grupos infectados mostraron un incremento de peso en comparación a sus grupos controles. En la cepa NIH, las hembras presentaron una mayor parasitemia, mientras que en la cepa BALB/c fueron los machos los de mayor parasitemia. Los órganos de los grupos infectados fueron significativamente más grandes comparados a los de los grupos de control, excepto en el corazón de la cepa BALB/c. Respecto al peso de los órganos, se observaron diferencias significativas únicamente en el corazón de los machos de la cepa BALB/c, mientras que en el bazo ocurrió lo contrario. Conclusión. Los machos de la cepa BALB/c son más susceptibles al Trypanosoma cruzi, presentando niveles de parasitemia más altos entre los grupos estudiados

Chagas disease is an infection caused by the parasite Trypanosoma cruzi and transmitted by the vector Triatoma dimidiata, known in El Salvador as "chinche picuda". This disease has always been of scientific interest in animal models. Objective. Identify the effect of Trypanozoma cruzi infection in mice of different strains (BALB/c and NIH) and sex. Methodology. Eight groups were established: four infected with Trypanosoma cruzi and four uninfected groups, distributed by strain and sex, with five mice per group. The body weight of the mice was recorded for six weeks. In addition, blood samples from the infected groups were prepared on slides for parasitemia counts. At the end of the study, the spleen and heart were extracted from both groups for statistical analyses. Results. The infected groups showed an increase in weight compared to their control groups. In the NIH strain, females had higher parasitemia, whereas in the BALB/c strain, males had higher parasitemia. The organs of the infected groups were significantly larger compared to those of the control groups, except in the heart of the BALB/c strain. Regarding organ weight, significant differences were observed only in the heart of the male BALB/c strain, while the opposite was true for the spleen. Conclusion. Males of the BALB/c strain are more susceptible to Trypanosoma cruzi, presenting higher levels of parasitemia among the groups studied.

Concordancia diagnóstica de las imágenes torácicas para enfermedad por Covid-19 / Diagnostic concordance of thoracic images for Covid-19 disease

La reacción en cadena de la polimerasa de transcripción inversa (RT-PCR) es el estándard de oro para el diagnóstico de enfermedad por SARS-CoV-2. En el contexto de la pandemia con accesibilidad limitada a esta prueba, las imágenes diagnósticas aportaron hallazgos que sustentan la sospecha diagnóstica, evitando retrasos en atención médica. Objetivo. Determinar la sensibilidad, especificidad, valor predictivo positivo y negativo de las imágenes diagnósticas y su concordancia respecto al resultado de RT-PCR. Metodología. Estudio transversal analítico. Se comparó el resultado del reporte por imágenes con los resultados de RT-PCR en 138 pacientes. Se calculó la sensibilidad, especificidad, valor predictivo positivo y valor predictivo negativo para los rayos X de tórax y tomografía computarizada para el diagnóstico de infección por SARS-CoV-2. Se utilizó el índice Kappa de Cohen y el factor de Bayes para medir la concordancia y fuerza de asociación entre las variables. Resultados. La tomografía computarizada presentó una sensibilidad de 92,9 %, una especificidad del 64 %, un valor predictivo positivo de 92,1 % y un valor predictivo negativo de 66,7 %; mientras que, los rayos X presentaron una sensibilidad del 86 %, una especificidad del 52,9 %, un valor predictivo positivo de 92,9 % y un valor predictivo negativo del 34,6 %. Conclusión. La tomografía mostró concordancia diagnóstica moderada; su utilidad es mayor en casos de sospecha clínica moderada-alta, discrepancia diagnóstica o confirmación de complicaciones. Los rayos X mostraron concordancia diagnóstica baja; este método es de utilidad en casos de alta sospecha clínica, pero necesita comprobación con RT-PCR para un diagnóstico definitivo.

Reverse transcription polymerase chain reaction (RT-PCR) is the gold standard method for diagnosing SARS-CoV-2 disease. However, due to limited accessibility to this test during the pandemic, diagnostic imaging was used to support diagnostic suspicion and avoid delays in medical care. Objective. Determine the accuracy of diagnostic imaging (chest X-ray and computed tomography) in diagnosing SARS-CoV-2 infection, compared to RT-PCR result. Methodology.An analytical cross-sectional study was conducted. The imaging reports of 138 patients were compared with their RT-PCR results to calculate sensitivity, specificity, positive predictive value, and negative predictive value for both chest X-ray and computed tomography. Concordance between the imaging results and RT-PCR was measured using Cohen's Kappa index and Bayes factor. Results. Computed tomography showed a sensitivity of 92.9 %, a specificity of 64 %, a positive predictive value of 92.1 %, and a negative predictive value of 66.7 %. On the other hand, X-rays showed a sensitivity of 86 %, a specificity of 52.9 %, a positive predictive value of 92.9 %, and a negative predictive value of 34.6 %. Conclusion. Computed tomography showed moderate diagnostic concordance and is particularly useful in cases of moderate to high clinical suspicion, diagnostic discrepancy, or the need to confirm complications. On the other hand, X-rays showed low diagnostic concordance and should be used in combination with RT-PCR for a definitive diagnosis, especially in cases of high clinical suspicion

Uso de mio-inositol y otros suplementos nutricionales para prevención primaria de la diabetes mellitus gestacional / Use of myo-inositol and other nutritional supplements for the primary prevention of gestational diabetes mellitus

La diabetes mellitus gestacional es la tolerancia anormal a los carbohidratos que inicia durante el embarazo y a su vez se considera un factor de riesgo para el desarrollo de complicaciones en la madre y el feto durante el embarazo. Su prevención se basa en intervenciones en el estilo de vida, monitoreo de la glicemia, terapia farmacológica y nutricional. Los suplementos nutricionales se presentan como una alternativa prometedora para tratar y/o prevenir dicho fenómeno. Esta revisión bibliográfica tiene por objetivo determinar la eficacia del mioinositol como suplemento profiláctico para prevenir el desarrollo de diabetes mellitus gestacional y sus complicaciones, así como mencionar otros suplementos alternativos. Se realizó una búsqueda bibliográfica en las bases de datos Pubmed, SciELO, Elsevier e Hinari, incluyendo artículos originales publicados entre el año 2019 hasta 2023. La evidencia encontrada demostró que la suplementación con mioinositol en el embarazo, aumenta la sensibilidad a la insulina, reduce los niveles de lipoproteínas de baja densidad, disminuye la hipertensión inducida por el embarazo, reduce la incidencia de parto pretérmino, macrosomía fetal, episodios de hipoglicemia fetal y defectos del tubo neural, siendo su implementación segura en el embarazo. Sin embargo, es necesario realizar investigaciones con un mayor número de participantes, con dosis estandarizadas que permitan establecer la eficacia de este suplemento para su uso como alternativa en la prevención de la diabetes gestacional.

Gestational diabetes mellitus is the abnormal carbohydrate tolerance that begins during pregnancy and is considered a risk factor for the development of complications in the mother and fetus during pregnancy. Its prevention is based on lifestyle interventions, glycemia monitoring, and pharmacological and nutritional therapy. Nutritional supplements are presented as a promising alternative to treat and prevent this phenomenon. This literature review aims to determine the efficacy of myo-inositol as a prophylactic supplement to prevent the development of gestational diabetes mellitus and its complications, as well as to mention other alternative supplements. A search was conducted in Pubmed, SciELO, Elsevier, and Hinari databases, including original articles published between 2019 and 2023. The evidence found showed that myo-inositol supplementation in pregnancy increases insulin sensitivity, reduces low-density lipoprotein levels, reduces pregnancy-induced hypertension, and reduces the incidence of preterm delivery, fetal macrosomia, episodes of fetal hypoglycemia and neural tube defects, being its implementation safe in pregnancy. However, it is necessary to conduct research with a larger number of participants, with standardized doses that allow for establishing the efficacy of this supplement for its use as an alternative in the prevention of gestational diabetes.