On the Frontlines: Protecting and Advancing Gender-Affirming Care in a Hostile Sociopolitical Environment.

Since 2020, there has been a significant cultural and political backlash in the USA to growing acceptance of gender diversity and gender-affirming care. Legislative attacks, particularly targeting gender-affirming care access for transgender and gender diverse youth, have occurred in a media environment rife with misinformation and disinformation. Even in states where a ban is not enacted, we have seen significant harm caused by such misinformation and disinformation, to transgender and gender diverse patients, their families, and clinicians who provide this important and much needed care, in the form of clinic closures and disruption of services. In this hostile sociopolitical environment, we present strategies for health care organizations and workers to continue to provide this lifesaving care thoughtfully, to safeguard the protections currently in place, and to continue to advocate for patients, families, and health care staff.

Global stability of an SAIRD epidemiological model with negative feedback.

In this work, we study the dynamical behavior of a modified SIR epidemiological model by introducing negative feedback and a nonpharmaceutical intervention. The first model to be defined is the usceptible-Isolated-Infected-Recovered-Dead (SAIRD) epidemics model and then the S-A-I-R-D-Information Index (SAIRDM) model that corresponds to coupling the SAIRD model with the negative feedback. Controlling the information about nonpharmaceutical interventions is considered by the addition of a new variable that measures how the behavioral changes about isolation influence pandemics. An analytic expression of a replacement ratio that depends on the absence of the negative feedback is determined. The results obtained show that the global stability of the disease-free equilibrium is determined by the value of a certain threshold parameter called the basic reproductive number R 0 and the local stability of the free disease equilibrium depends on the replacement ratios. A Hopf bifurcation is analytically verified for the delay parameter. The qualitative analysis shows that the feedback information index promotes more changes to the propagation of the disease than other parameters. Finally, the sensitivity analysis and simulations show the efficiency of the infection rate of the information index on an epidemics model with nonpharmaceutical interventions.

Terapia audiovisual. Propuesta para disminuir ansiedad en pacientes quemados durante su estancia en la unidad de cuidados intensivos / Audiovisual therapy. Proposal to decrease anxiety in burned patients during their stay in the Intensive Care Unit / Terapia audiovisual. Proposta para reduzir a ansiedade em pacientes queimados durante sua estadia em Unidade de Terapia Intensiva

Resumen: La atención y manejo del paciente quemado en México representa un reto para el personal médico, la estancia intrahospitalaria del quemado generalmente es prolongada, por lo que los pacientes pueden desarrollar complicaciones psicológicas derivadas del cambio en su aspecto físico y los tratamientos que este tipo de patología requiere, por lo que la aparición de ansiedad es común. El propósito de este trabajo es plantear una propuesta de terapia audiovisual como tratamiento alternativo y/o complementario en el control de la ansiedad en el paciente durante su estancia en la unidad de cuidados intensivos.

Abstract: The care and management of the burn patient in Mexico represents a challenge for the medical staff, the hospital stay of the burn is generally prolonged so that patients can develop psychological complications derived from the change in their physical appearance and the treatments that this type of pathology requires, so the appearance of anxiety is common. The purpose of this work is to propose a proposal of audiovisual therapy as an alternative and/or complementary treatment in the control of anxiety in the patient during his stay in the intensive care unit.

Resumo: O cuidado e o manejo do paciente queimado no México representam um desafio para a equipe médica, a internação do paciente queimado é geralmente prolongada para que os pacientes possam desenvolver complicações psicológicas derivadas da mudança em sua aparência física e dos tratamentos que este tipo de a patologia exige, então o aparecimento de ansiedade é comum. O objetivo deste trabalho é propor uma proposta de terapia audiovisual como alternativa e/ou tratamento complementar no controle da ansiedade do paciente durante sua permanência em unidade de terapia intensiva.

Ectoparasitism by Chigger Mite Larvae (Acari: Trombiculidae) in a Wintering Population of Catharus ustulatus (Turdidae) in Southeastern Peru.

We document chigger mite (Acari: Trombiculidae) ectoparasitic infestation (prevalence and intensity) on a population of Catharus ustulatus (Turdidae) wintering at a site (PAD A) in southeastern Peru undergoing development for natural gas exploration. We compare prevalence (i.e., the proportion of individuals infested by chigger mites) and intensity (i.e., the average number of larvae and larvae clusters in infested individuals) at forest edge (<100 m) and interior (>100 m) from PAD A because variations in biotic (e.g., vegetation cover) and abiotic (e.g., relative humidity and temperature) factors are expected to influence chigger mite abundance. Chigger mite prevalence was 100%; all C. ustulatus captured were infested regardless of distance. The range of variation in larvae (2-72 larvae/individual) and cluster intensity (1-4 clusters/individual) did not differ between edge and interior ( P > 0.05), despite differences in herbaceous vegetation cover (UM-W = 180, n = 30, 31; P < 0.01). Ectoparasitic prevalence and intensity in long-distance migratory birds might add risks to an already hazardous journey; because ectoparasitic variation and other selective pressures experienced by individuals at each locality not only may be a cause of within-site mortality, but, by affecting the physical condition of birds, may be carried over to subsequent sites and affect reproductive success and survival. Documenting ectoparasitism at any phase of the life cycle of migrants could improve understanding of population declines of migratory birds.

Strategies for Disseminating Information on Biomedical Research on Autism to Hispanic Parents.

Low income Hispanic families experience multiple barriers to accessing evidence-based information on Autism Spectrum Disorders (ASD). This study utilized a mixed-strategy intervention to create access to information in published bio-medical research articles on ASD by distilling the content into parent-friendly English- and Spanish-language ASD Science Briefs and presenting them to participants using two socially-oriented dissemination methods. There was a main effect for short-term knowledge gains associated with the Science Briefs but no effect for the dissemination method. After 5 months, participants reported utilizing the information learned and 90% wanted to read more Science Briefs. These preliminary findings highlight the potential benefits of distilling biomedical research articles on ASD into parent-friendly educational products for currently underserved Hispanic parents.

Complicaciones maternas y fetales de la preeclampsia diagnosticadas en un hospital del sur del Perú, 2013 / Maternal and fetal complications of preeclampsia diagnosed in a hospital in southern Peru, 2013

Objetivo: Identificar las complicaciones materno fetales más frecuentes de la preeclampsia en pacientes atendidas en el Hospital Santa María del Socorro de Ica, Perú en el año 2013. Materiales y métodos: Se realizó un estudio de tipo transversal, el grupo de casos fueron 62 mujeres que presentaron preeclampsia y que cumplían con los criterios de inclusión. Se utilizó un instrumento validado que permitió recoger la información necesaria de las historias clínicas. Para el análisis de datos se utilizaron tablas y gráficos estadísticos en el programa Microsoft Excel 2010 y para la interpretación se aplicó promedios y frecuencias porcentuales. Resultados: Con respecto a las características sociodemográficas de los pacientes, tenemos que la mayor frecuencia se encuentran entre los 19 a 34 años (60%); el estado civil de mayor frecuencia fue el conviviente (58%) y con grado de instrucción secundaria (52%).Las características ginecoobstétricas con mayor frecuencia fueron que las que presentaron gestación a término (80%); multíparas (66%); con adecuado control prenatal (94%) y con término de la gestación mediante la operación cesárea en (81%).En cuanto a las complicaciones maternas encontradas fueron eclampsia (3%) y abruptio placentario (3%), no encontramos ninguna muerte materna; dentro de las complicaciones fetales halladas encontramos retardo de crecimiento intrauterino (13%), sufrimiento fetal agudo (5%) y muerte fetal (2%). Conclusiones: Existen complicaciones materno fetales de la preeclampsia que pueden ser modificables por lo que es necesario que los hospitales cuenten con la tecnología y recursos humanos idóneos para realizar actividades preventivas, de tratamiento y evitar sus posibles complicaciones. (AU)

Objective: To identify the most common fetal maternal complications of preeclampsia in patients treated at the Hospital of Santa Maria Socorro Ica, Peru in 2013. Materials and Methods: A cross sectional study was conducted, the case group were 62 women that preeclampsia and who met the inclusion criteria. A validated instrument that allowed to collect the necessary information from the clinical records. For data analysis statistical tables and graphs were used in the Microsoft Excel 2010 program and for interpreting averages and percentage frequencies were applied. Results: With regard to the demographic characteristics of patients, we have most often found between 19-34 years (60%); marital status was more often cohabiting (58%) and high school degree (52%) The ginecoobstétricas characteristics most frequently were those that had term pregnancy (80%).; multiparous (66%); with adequate prenatal care (94%) and the end of gestation by cesarean section (81%). In terms of maternal complications encountered were eclampsia (3%) and abruption placenta (3%), we found no maternal deaths ; within fetal complications are found IUGR (13%), fetal distress (5%) and stillbirth (2%). Conclusions: There are fetal maternal complications of preeclampsia that can be modified so it is necessary that hospitals have the technology and suitable for performing preventive, treatment and avoid possible complications human resources. (AU)

Falla de medro / Failure to thrive

Presentamos el caso clínico de un paciente atendido en el hospital del Niño Dr. Ovidio Aliaga Uría, que corresponde a una falla de medro como causa de desnutrición secundaria. Aprovechamos el tema para hacer una revisión del mismo.

We present a clinical case of patient seen at Childrens' Hospital "Ovidio Aliaga Uria", suffering from failure to thrive due to a secondary malnutrition. We decided to revise the subject.

Enfermedad celiaca con presentación atípica / Atipical celiac disease

Presentamos tres casos clínicos de pacientes que fueron internados en el Hospital del Niño "Dr. Ovidio Aliaga Uría" por enfermedad celiaca con manifestaciones clínicas de presentación infrecuentes.

We describe three cases of atypical clinical presentation of celiac disease who were admitted to the Hospital del Niño "Dr. Ovidio Aliaga Uría".