Complicações da comunicação buco-sinusal em cirurgias bucais: fatores de riscos, complicações e intervenções / Complications of oral-sinusal communication in oral surgery: risk factors and interventions

A comunicação buco-sinusal, uma conexão direta entre boca e seios maxilares, ocorre comumente pela extração de dentes próximos ao seio maxilar e outros procedimentos. O diagnóstico precoce é crucial para prevenir complicações graves. A abordagem terapêutica varia conforme o tamanho do defeito, presença de infecção e localização específica. Realizou-se uma breve revisão de literatura qualitativa abordando as principais complicações da comunicação buco sinusal na cirurgia bucal e como intervi-las. Buscou-se artigos científicos indexados nas seguintes bases de dados: Google Scholar, Pubmed e Biblioteca Scielo com lapso temporal de 2013 a 2023. Foram utilizados para esta busca os seguintes descritores: Comunicação buco-sinusal; Complicações; Seio maxilar. Os critérios de inclusão desta pesquisa foram artigos em inglês, português e espanhol, sendo selecionados 26 trabalhos. Os principais critérios de exclusão foram artigos com mais de 10 anos de publicação. A prevenção e gestão eficaz das complicações na comunicação oral em cirurgias são essenciais. Identificar fatores de risco, usar técnicas cirúrgicas precisas e agir imediatamente diante de sinais de comunicação com os seios da face são medidas cruciais para garantir a segurança do paciente e aprimorar os resultados cirúrgicos.

Oral-sinusal communication, a direct connection between the mouth and maxillary sinuses, commonly occurs due to the extraction of teeth close to the maxillary sinus and other procedures. Early diagnosis is crucial to prevent serious complications. The therapeutic approach varies according to the size of the defect, presence of infection and specific location. A brief qualitative literature review was carried out looking at the main complications of oral sinus communication in oral surgery and how to intervene. We searched for scientific articles indexed in the following databases: Google Scholar, Pubmed and Scielo Library with a time span from 2013 to 2023. The following descriptors were used for this search: Oral-sinus communication; Complications; Maxillary sinus. The inclusion criteria for this study were articles in English, Portuguese and Spanish, and 26 papers were selected. The main exclusion criteria were articles published more than 10 years ago. The prevention and effective management of oral communication complications during surgery are essential. Identifying risk factors, using precise surgical techniques and acting immediately in the event of signs of communication with the sinuses are crucial measures to ensure patient safety and improve surgical outcomes.

Factores de riesgo para neumonía asociada a ventilación mecánica en hospitales de tercer nivel / Risk Factors for Ventilator-Associated Pneumonia in Tertiary Care Hospitals

En El Salvador la neumonía asociada a ventilación mecánica es la tercera infección más frecuente asociada a la atención sanitaria, con un alto impacto por sus costos de atención. Objetivo. Analizar los factores de riesgo para desarrollar neumonía asociada a ventilación mecánica en hospitales de tercer nivel de El Salvador durante el 2022. Metodología. Estudio de casos y controles, la muestra se calculó para un nivel de confianza del 95%, potencia del 80%, Odds ratio (OR) de 2,5, y con una relación de tres controles por caso. Los criterios de inclusión para casos fueron pacientes ventilados que se diagnosticaron como neumonía durante el 2022 con confirmación bacteriológica por cultivo de secreción respiratoria, los controles fueron pacientes con ventilación mecánica mayor a 48 horas sin neumonía posterior a 72 horas de extubación, la información se obtuvo de los expedientes clínicos. Se utilizó un modelo de regresión logística para determinar los factores de riesgo. Resultados. Se revisaron 206 expedientes, 52 casos y 154 controles, el dato de laboratorio más frecuente fue la leucocitosis con un 78,6% de los casos, y el patógeno aislado con mayor frecuencia fue Acinetobacter baumannii con 27,8% de aislamientos; el sexo masculino (OR: 4,94; IC95%: 1,56-15,66), el trauma (OR: 10,52; IC95%: 2,73-40,59) y los días de intubación (OR: 1,24; IC95%: 1,14-1,36) fueron factores independientes de riesgo estadísticamente significativos. Conclusión. El sexo masculino, el antecedente de trauma y los días de intubación fueron factores de riesgo para neumonía asociada a ventilación mecánica en hospitales de tercer nivel de El Salvador.

In El Salvador ventilator associated pneumonia is the third most frequent health care associated infection, it has a high impact because it raises attention costs. Objective. Analize the risk factor for the development of ventilator associated pneumonia in tertiary care hospitals in El Salvador during 2022. Methodology. It was a case-control study, we calculated the sample with a 95% confidence level, 80% statistical power, Odds ratio (OR) of 2.5 and a 3controls per case ratio. Cases were ventilated patients diagnosed with pneumonia between January and December 2022 who have a confirmed microbiological isolation in a respiratory sample, Controls were patients without pneumonia for at least 72 hours after extubation, the information was obtain from the clinical files. We used a logistic regression model to determine risk factors. Results. We reviewed 206 clinical files, 52 cases and 154 controls, the most frequent sign of infection was leukocytosis, it was present in 78.6% of cases. The most isolated pathogen was Acinetobacter baumannii, reported in 27.8% of cultures. Male sex (OR: 4.94 CI95%:1.56-15.66), history of trauma (OR:10.52 CI95%: 2.73-40.59) and intubation days (OR: 1.24; CI95%: 1.14-1.36) were statistically significant independent risk factors. Conclusion. Male gender, history of trauma and intubation days were risk factors for ventilator associated pneumonia in tertiary care hospitals from El Salvador during 2022

Entre luces y sombras: Factores clave en la fuga anastomótica en cirugía colorrectal, estudio de casos y controles en dos centros de alto volumen en Bogotá / Between lights and shadows: Key factors in anastomotic leak in colorectal surgery, case-control study in two high-volume centers in Bogotá

Introducción. La fuga anastomótica es una complicación que en las últimas tres décadas ha mantenido sus tasas de incidencia entre 1 % y 19 % y ha alcanzado una mortalidad que varía entre 6 % y 22 %. Tiene una alta morbilidad, siendo responsable del 56 % de los estomas definitivos en pacientes sometidos a cirugía colorrectal. El objetivo de este estudio fue identificar los factores asociados con un mayor riesgo de incidencia de fuga anastomótica, para lograr impactar en la morbilidad y mortalidad de los pacientes llevados a cirugía colorrectal. Métodos. Estudio de casos y controles multicéntrico enfocado en los factores de riesgo preoperatorios e intraoperatorios asociados con la fuga anastomótica después de la resección de colon. Resultados. Se incluyeron 480 pacientes llevados a cirugía colorrectal entre enero de 2014 y diciembre de 2019. Se estimó que existe mayor riesgo de presentar dehiscencia de anastomosis con nivel de hemoglobina menor de 9 g/dl (p=0,001; OR=3,2; IC95%: 1,64-6,25), clasificación ASA > 3 (p=0,001; OR=9,96; IC95%: 4,75-20,9), duración prolongada de la cirugía (p=0,005) y necesidad de transfusión intraoperatoria (p=0,001; OR=4,57; IC95%: 2,32-9,01). El reforzamiento de la anastomosis se relacionó a un menor número de fugas anastomóticas (p=0,001; OR=0,14; IC95%: 0,04-0,46). Conclusión. La anemia y la transfusión de glóbulos rojos se relacionaron con un aumento de fuga anastomótica. Por otro lado, el refuerzo de la anastomosis se presenta como una medida potencialmente beneficiosa para mitigar la incidencia de esta complicación. La identificación precisa de estos factores de riesgo ofrece la oportunidad de transformar la fuga anastomótica en una complicación prevenible.

Introduction. Anastomotic leak is a complication that in the last three decades has maintained its incidence rates between 1% and 19% and has reached a mortality rate that varies between 6% and 22%. It has a high morbidity rate, being responsible for 56% of definitive stomas in patients undergoing colorectal surgery. The objective of this study was to identify factors associated with a higher risk of anastomotic leak incidence, in order to impact the morbidity and mortality of patients undergoing colorectal surgery. Methods. Multicentric case-control study focused on preoperative and intraoperative risk factors associated with anastomotic leak after colon resection. Results. 480 patients who underwent colorectal surgery between January 2014 and December 2019 were included. It was estimated that there is a higher risk of anastomotic dehiscence with hemoglobin levels <9 mg/dl (p=0.001; OR=3.2; 95% CI: 1.64-6.25), ASA classification >3 (p=0.001; OR=9.96; 95% CI: 4.75-20.9), prolonged surgery duration (p=0.005), and the need for intraoperative transfusion (p=0.001; OR=4.57; 95% CI: 2.32-9.01). Anastomosis reinforcement was related to fewer anastomotic leaks (p=0.001; OR=0.14; 95% CI: 0.04-0.46). Conclusion. Anemia and red blood cell transfusion were associated with an increased anastomotic leak. On the other hand, anastomosis reinforcement is presented as a potentially beneficial measure to mitigate the incidence of this complication. Accurate identification of these risk factors offers the opportunity to transform anastomotic leak into a preventable complication.

Dermatófitos em cães e gatos e seu contexto na saúde pública: revisão de literatura / Dermatophytes in dogs and cats and their context in public health: literature review

A dermatofitose é uma infecção micótica superficial dos tecidos queratinizados como pelos, unhas e o estrato córneo da epiderme. Nos cães e gatos, esta enfermidade é comumente causada por fungos dermatófitos dos gêneros Microsporum, Nannizzia e Trichophyton que podem acometer quaisquer pacientes, sendo os filhotes, os animais idosos e imunocomprometidos os mais propensos. Embora seja uma doença altamente contagiosa, sua mortalidade é baixa e, em alguns casos, pode haver remissão espontânea. A dermatofitose afeta cerca de 4-15% dos caninos e 20% dos felinos, sendo a principal infecção fúngica das espécies citadas. Além disso, a dermatofitose é uma antropozoonose que afeta cerca de 25% da população humana e está amplamente difundida pelos centros urbanos. Sabe-se que os cães e gatos são importantes carreadores da doença e que tanto os animais sintomáticos, quanto os assintomáticos, são capazes de transmitir os agentes entre si e para os seres humanos. Os portadores assintomáticos têm grande importância para disseminação da zoonose, devido à falta de informação e ao fato de não apresentarem lesões, o que aumenta os riscos de exposição em decorrência do estreito contato dos tutores com seus animais.(AU)

Dermatophytosis is a superficial mycotic infection of keratinized tissues such as hair, nails, and the stratum corneum of the epidermis. In dogs and cats, this disease is commonly caused by dermatophyte fungi of the genera Microsporum, Nannizzia, and Trichophyton, that can affect any patient, with puppies, and elderly, and immunocompromised animals being the most prone. Although it is a highly contagious disease, its mortality is low and in some cases, there can be spontaneous remission. It is estimated that it affects about 4-15% of canines and 20% of felines, being the most common fungal infection in the mentioned species. In addition, dermatophytosis is an anthropozoonosis that affects about 40% of the human population and is widespread in urban centers. It is known that dogs and cats are important carriers of the disease and that both symptomatic and asymptomatic animals are capable of transmitting the agents to each other and humans. Asymptomatic carriers are of great importance for the dissemination of the zoonosis, due to the lack of information and the fact that they do not present lesions, which increases the risks of exposure due to the close contact between tutors and their animals. (AU)

Assessment of the knowledge and awareness of toxoplasmosis among doctors and nurses in Casablanca, Morocco: a cross-sectional study

Introduction: toxoplasmosis is a zoonotic infectious disease caused by Toxoplasma gondii. Medical health professional specially doctors and nurses must have the best skills, knowledge and practices regarding toxoplasmosis to improve maternal and newborn health effectiveness. The aim of this current survey was to assess the knowledge of toxoplasmosis among doctors and nurses, working in selected health facilities of different parts of Casablanca prefecture in Morocco. Methods: a cross-sectional study was conducted. The data were collected from consenting doctors and nurses through a self-administered structured questionnaire. The questionnaire included the sociodemographic and knowledge regarding the general information, diagnosis, clinical and prevention of toxoplasmosis. Data were analyzed using descriptive statistics and association between variables explored with Chi-square test at P < 0.05. Results: one hundred and twenty-six health professionals participated in the study with mean age was 40.50 ±10.06 years. Of these, 83.3% were females while 16.7% were male. Fifty two (41.3%) of the respondents were doctors while 74 (58.7%) of the respondents were nurses. More than half of respondents (57.1%) had a moderate knowledge score about toxoplasmosis with doctors had better knowledge of toxoplasmosis than did nurses. Nineteen-five percent (95%) of respondents were aware of the definition of toxoplasmosis and more than 80% knew about the risk factors of this zoonosis. The majority of doctors and nurses (more than 90%) recognized the measures to follow to avoid the transmission of toxoplasmosis for pregnant women such as no contact with cats, eating cooked meat, washing their hands often and washing fruits and vegetable products before eating. However, the most of respondents were unaware of avidity test (91.7%). Conclusion: we concluded that the knowledge about various aspects of toxoplasmosis was average among medical health professionals in Casablanca. Therefore, educational intervention for nurses and doctors contributed to improving knowledge about the disease to reduce exposure the pregnant women to some risk factors of disease during pregnancy.

Predictors associated with giving birth at home among women in Ethiopia

Introduction: maternal mortality is a worldwide community health concern. Home deliveries are common in Ethiopia, and most births occur at home without the assistance of health experts. Maternal mortality reduced in recent decades but still has a very high maternal mortality rate in Ethiopia. Therefore, this study aimed to identify the risk factors surrounding giving birth at home among women in Ethiopia. Methods: this study's data source was the 2019 Ethiopian Demographic and Health Survey (EDHS). A total of 23,007 women who met the study's objective and criteria were included. A binary logistic regression model and a multistage stratified sampling technique were used. Results: women living in a rural area (AOR = 2.135, 95% CI: 1.805, 2.525), women in the middle (AOR = 0.670, 95% CI: 0.590, 0.760), and wealth index (AOR = 0.375, 95% CI: 0.326, 0.430), mothers who attended primary education (AOR = 0.819, 95% CI: 0.733, 0.915), secondary and above (AOR = 0.388, 95% CI: 0.303, 0.496), 4-6 living children (AOR= 0.780, 95% CI: 0.160, 0.873), mother age from 21-30 (AOR= 0.291, 95% CI: 0.243, 0.349) and mother age from 31 and above (AOR = 0.074, 95% CI: 0.060, 0.091) were significantly associated predictors for giving birth at home in Ethiopia. Conclusion: we discovered that geographical region, place of residence, education level, marital status, age of mother at first birth, mother age group, number of living children, religion, and wealth index were significantly associated predictors of giving birth at home among Ethiopian women.

A qualidade do sono está associada a determinantes sociodemográficos e clínicos em usuários acompanhados na Atenção Primária à Saúde durante a pandemia de COVID-19 / Sleep quality is associated with sociodemographic and clinical determinants in users attended in Primary Health Care during the COVID-19 pandemic / La calidad del sueño se asocia con determinantes sociodemográficos y clínicos en usuarios monitoreados en Atención Primaria de Salud durante la pandemia de COVID-19

Introdução: O avanço da pandemia de COVID-19 acarretou alterações no sono da população. Os distúrbios do sono têm relação com as principais alterações de saúde mental e também possuem relação com os fatores psicossociais. Objetivo: Estimar a prevalência e fatores associados às alterações na qualidade do sono em usuários acompanhados na Atenção Primária à Saúde durante a pandemia de COVID-19. Métodos: Estudo do tipo transversal, com adultos (idade >18 anos) de ambos os gêneros, acompanhados por uma unidade de saúde. Foram levantadas as informações do prontuário eletrônico da unidade e, durante a visita domiciliar (entre agosto e setembro de 2021), os dados socioeconômicos, fatores de risco, sinais vitais, variáveis antropométricas, hábitos de vida, medicações em uso, uso dos serviços de saúde, internação e consultas no último ano. A qualidade de vida foi avaliada pelo questionário SF-36 e foi usado o Índice de Qualidade do sono Pittsburgh (PSQI). Resultados: A amostra foi formada predominantemente por mulheres (82,9%) com 60,5±11,7 anos de idade, da cor branca (70,7%), com companheiro (61%) e pertencentes à classe C (65,8%). 53,7% da amostra apresentou até duas comorbidades, 87,8% apresentavam sobrepeso/obesidade e 80% faziam uso de anti-hipertensivo. A prevalência de qualidade do sono ruim foi de 87,8% (IC95% 73,1­95,0). Os achados apontam para uma relação entre má qualidade do sono com consumo de álcool, presença de ≥3 comorbidades, níveis de PAS, uso de ansiolíticos, nível de escolaridade e uso de serviços de saúde durante a pandemia. Conclusões: A alta prevalência de qualidade do sono ruim na amostra estudada sugere que determinantes sociodemográficos, presença de comorbidades e hábitos de vida devem ser considerados para minimizar os efeitos das alterações do sono na pandemia.

Introduction: The advancement of the COVID-19 pandemic has resulted in changes in the sleep patterns of the population. Sleep disorders are related to major mental health changes and are also associated with psychosocial factors. Objective: To estimate the prevalence and factors associated with sleep quality changes among users attended in Primary Health Care during the COVID-19 pandemic. Methods: This was a cross-sectional study involving adults (age >18 years) of both genders who were being followed at a healthcare unit. Information was gathered from the unit's electronic medical records, and during home visits (between August and September 2021), socioeconomic data, risk factors, vital signs, anthropometric variables, lifestyle habits, current medications, healthcare service utilization, hospitalization, and consultations in the past year were collected. Quality of life was assessed using the SF-36 questionnaire, and the Pittsburgh Sleep Quality Index (PSQI) was used to evaluate sleep quality. Results: The sample consisted predominantly of women (82.9%) with an average age of 60.5±11.7 years, of white ethnicity (70.7%), with a partner (61%), and belonging to class C (65.8%). 53.7% of the sample had up to two comorbidities, 87.8% were overweight/obese, and 80% were using antihypertensive medication. The prevalence of poor sleep quality was 87.8% (95%CI 73.1­95.0). The findings indicate a relationship between poor sleep quality and alcohol consumption, the presence of ≥3 comorbidities, systolic blood pressure levels, use of anxiolytics, education level, and the use of healthcare services during the pandemic. Conclusions: The high prevalence of poor sleep quality in the study sample suggests that sociodemographic determinants, presence of comorbidities, and lifestyle habits should be considered to minimize the effects of sleep disturbances during the pandemic.

Introducción: El avance de la pandemia de COVID-19 ha ocasionado cambios en el sueño de la población. Los trastornos del sueño están relacionados con los principales cambios en la salud mental y también se asocian con factores psicosociales. Objetivo: Estimar la prevalencia y los factores asociados con alteraciones en la calidad del sueño en usuarios atendidos en la Atención Primaria de Salud durante la pandemia de COVID-19. Métodos: Estudio transversal con adultos (edad >18 años) de ambos géneros que son atendidos en una unidad de salud. Se recopilaron datos del historial clínico electrónico de la unidad y durante la visita domiciliaria (entre agosto y septiembre de 2021) se obtuvieron datos socioeconómicos, factores de riesgo, signos vitales, variables antropométricas, hábitos de vida, medicamentos utilizados, uso de servicios de salud, hospitalización y consultas en el último año. La calidad de vida se evaluó mediante el cuestionario SF-36 y se utilizó el Índice de Calidad del Sueño de Pittsburgh (PSQI). Resultados: La muestra estuvo compuesta predominantemente por mujeres (82,9%) con una edad de 60,5±11,7 años, de raza blanca (70,7%), con pareja (61%) y pertenecientes a la clase C (65,8%). El 53,7% de la muestra presentó hasta dos comorbilidades, el 87,8% tenían sobrepeso/obesidad y el 80% utilizaba medicación antihipertensiva. La prevalencia de mala calidad del sueño fue del 87,8% (IC95% 73,1­95,0). Los hallazgos señalan una relación entre la mala calidad del sueño y el consumo de alcohol, la presencia de ≥3 comorbilidades, los niveles de presión arterial sistólica (PAS), el uso de ansiolíticos, el nivel de escolaridad y el uso de servicios de salud durante la pandemia. Conclusiones: La alta prevalencia de mala calidad del sueño en la muestra estudiada sugiere que se deben considerar los determinantes sociodemográficos, la presencia de comorbilidades y los hábitos de vida para minimizar los efectos de los trastornos del sueño en la pandemia.

Identificación de especies del género Mycobacterium asociadas a infección pulmonar y extrapulmonar / Identification of Species of the Mycobacterium Genus Associated with Pulmonary and Extrapulmonary Infection

Introducción: El aumento significativo de especies micobacterianas descritas como agentes patógenos implicó la necesidad de implementar métodos de identificación más avanzados que permitan acortar el tiempo diagnóstico. Desde el punto de vista clínico, es importante diferenciar el complejo Mycobacterium tuberculosis (MTBC) del resto de las especies micobacterianas no tuberculosas (MNT), con el fin de aplicar tratamiento específico. Objetivo: Identificar aislados micobacterianos procedentes de muestras clínicas pulmonares y extrapulmonares por las técnicas diagnósticas SD BIOLINE TB Ag MPT64 y Genotype Mycobacterium CM/AS. Material y métodos: Se recibieron 3.604 muestras clínicas procedentes de pacientes sintomáticos durante el período comprendido entre enero 2018­enero 2024. Estas fueron procesadas en el Laboratorio Nacional de Referencia e Investigaciones de Tuberculosis, Lepra y Micobacterias del Instituto de Medicina Tropical "Pedro Kourí" (IPK). Para la identificación de MTBC, se utilizó el test inmunocromatográfico SD TB Ag MPT64; para la identificación de MNT, las técnicas diagnósticas moleculares Genotype Mycobacterium CM/AS. Resultados: Del total de muestras procesadas, se obtuvieron 325 aislados micobac - terianos; 252 (77,53%) identificados como MTBC y 73 (22,45%) especies micobacte- rianas no tuberculosas. De estas, la de mayor frecuencia de aislamiento fue: Myco- bacterium fortuitum 19 (26,02%), Mycobacterium avium 17 (23,80%) y Mycobacterium intracellulare 13 (17,80%). Conclusiones: Los resultados obtenidos reafirman que los métodos de identificación utilizados son adecuados, ambas técnicas logran el acortamiento del tiempo diagnós- tico, lo que permite la implementación temprana del tratamiento adecuado, y así evitar la diseminación de la infección, sobre todo en pacientes con algún tipo de deterioro en su barrera inmunológica.

Introduction: The significant increase in mycobacterial species described as pathoge - nic agents implied the need to implement more advanced identification methods that would shorten the diagnostic time. From a clinical point of view, it is important to diffe- rentiate Mycobacterium tuberculosis complex (MTBC) from the rest of the nontubercu- lous mycobacterial species (NTM), in order to apply specific treatment. Objective: Identify mycobacterial isolates from pulmonary and extrapulmonary clinical samples using the SD BIOLINE TB Ag MPT64 and Genotype Mycobacterium CM/AS diagnostic techniques. Materials and methods: 3,604 clinical samples were received from symptomatic patients during the period between January 2018­January 2024. These were processed at the National Reference and Research Laboratory for Tuberculosis, Leprosy and Mycobacteria of the "Pedro Kourí" Institute of Tropical Medicine (IPK). For the identification of MTBC, the SD TB Ag MPT64 immunochromatographic test was used, and for the iden- tification of NTM, the Genotype Mycobacterium CM/AS molecular diagnostic techniques were used. Results: Of the total samples processed, 325 mycobacterial isolates were obtained; 252 (77.53%) identified as MTBC and 73 (22.45%) nontuberculous mycobacterial species, of which the highest frequency of isolation was: Mycobacterium fortuitum 19 (26.02%), Mycobacterium avium 17 (23. 80%) and Mycobacterium intracellulare 13 (17.80%). Conclusions: The results obtained reaffirm that the diagnostic methods used are adequate, both techniques achieve a shortening of the diagnostic time, which allows the early implementation of the appropriate treatment, thus avoiding the spread of the infection, especially in patients with some type of deterioration in their barrier immuno - logical.

Caracterización de fracturas pediátricas enun establecimientode atención médica tipo IV / Characterization of pediatric fractures in a type IV healthcare facility

El estudio tiene como objetivo caracterizar las fracturas pediátricas en la Policlínica Metropolitana de Caracas entre 2020 y 2024. con la finalidad de evidenciar si existen patrones específicos de fracturas en función de la edad, el sexo y los mecanismos de lesión, lo que permitiría diseñar mejores estrategias de prevención y tratamiento. Se realizó un estudio retrospectivo con enfoque cuantitativo. Se revisaron historias clínicas y registros radiológicos de 151 pacientes pediátricos (0-14 años) atendidos por fracturas. Las variables incluyeron sexo, edad, área anatómica afectada, y tipo de fractura. Se utilizaron análisis estadísticos descriptivos para calcular frecuencias y porcentajes, y pruebas de Chi-cuadrado para comparar grupos. El 45% de las fracturas se observaron en el grupo de 11 a 14 años, con predominio del sexo masculino (59,6 %). Las fracturas más comunes fueron completas (37,7 %) y afectaronprincipalmente la diáfisis (52,3 %). Los huesos más afectados fueron el radio (20,5 %) y el húmero (18,5 %). La mayoría de las fracturas ocurrieronen el esqueleto periférico (97,4 %). El estudio confirma que, en las fracturas pediátricas dela muestra estudiada, se encontraron presentes patrones específicos, como una mayor incidencia en adolescentes varones y en huesos de extremidades superiores, por lo que se sugiere medidas preventivas específicas para grupos de mayor riesgo: adolescentes activos en deportes de contacto. Las fracturas completas y diafisarias requieren atención especial debido a su impacto en el desarrollo óseo.

The study aims to characterize pediatric fractures at the Metropolitan Polyclinic of Caracas between 2020 and 2024, in order to demonstrate that there are specific fracture patterns based on age, sex, and injury mechanisms, which would allow for the designof better prevention and treatment strategies. A retrospective study with a quantitative approach was conducted. Medical records and radiological records of 151 pediatric patients (0-14 years) treated for fractures were reviewed. Variables included sex,age, affected anatomical area, and type of fracture. Descriptivestatistical analyses were used to calculate frequencies and percentages, and Chi-square tests were used to compare groups. 45 % of fractures were observed in the 11-14 age group, with a predominance in males (59,6 %). The most common fractures were complete (37,7 %) and mainly affected the diaphysis (52,3 %). The most affected bones were the radius (20,5 %) and the humerus (18,5%). Most fractures occurredin the peripheral skeleton (97,4 %). The study confirms that pediatric fractures in the sample studied showed specific fracture patterns, such as a higher incidence in adolescent boys and in arm bones, which is why specific preventive measures are suggested for higher risk groups: adolescentsactive in contact sports. Complete and diaphyseal fractures require special attention due to their impact on bone development.

Aterosclerosis: un desafío global con raíces multifactoriales / Atherosclerosis: aglobal challenge with multifactorial roots

El interés científico que existe sobre los mecanismos involucrados en el proceso que da origen a la aterosclerosis es considerablemente notable e importante. El gran volumen de artículos y conocimiento sobre este tema cada vez es mayor, permitiendo profundizar constantemente en los mecanismos fisiopatológicos que comprende la aterosclerosis, los factores de riesgo que predisponen a la misma, y las posibles consecuencias a esperar una vez que se desencadena la patología. Ahora se sabe que el carácter multifactorial de esta situación anormal de las arterias es lo que ha llevado a la alta morbimortalidad que representan las enfermedades cardiovasculares actualmente. Objetivo: Investigar los mecanismos de la aterosclerosis: Profundizar en los procesos fisiopatológicos que conducen al desarrollo de esta enfermedad. Comprender cómo diferentes elementos, incluyendo la inmunidad, genética y microbiota, contribuyen al desarrollo de la aterosclerosis. Métodos: Se realizó una revisión de la literatura científica existente sobre el tema. Análisis de estudios que relacionan factores de riesgo (hormonales, ambientales y genéticos) con el desarrollo de la enfermedad. La investigación sobre el papel del sistema inmunológico y la microbiota en la fisiopatología de la aterosclerosis. Se ha logrado dilucidar las diferentes causas, encontrando una fuerte relación entre el desarrollo de aterosclerosis y diversos factores, para tratar de explicar el sustrato fisiopatológico al cual nos enfrentamos en la búsqueda del tratamiento más eficaz para esta condición anormal del organismo.

The scientific interest that exists in the mechanisms involved in the process that gives rise to atherosclerosis is considerably notable and important. The large volume of articles and knowledge on this topic is increasing, allowing us to constantly delve deeper into the pathophysiological mechanisms that comprise atherosclerosis, the risk factors that predispose to it, and the possible consequences to be expected once the pathology is triggered. It is now known that the multifactorial nature of this abnormal situation of the arteries is what has led to the high morbidity and mortality that cardiovascular diseases currently represent. Objective: To investigate the mechanisms of atherosclerosis: To delve deeper into the pathophysiological processes that lead to the development of this disease. To understand how different elements, including immunity, genetics and microbiota, contribute to the development of atherosclerosis. Methods: A review of the existing scientificliterature on the subject was carried out. Analysis of studies that relate risk factors (hormonal, environmental and genetic) with the development of the disease. Research on the role of the immune system and microbiota in the pathophysiology of atherosclerosis. It has been possible to elucidate the different causes, finding a strong relationship between the development of atherosclerosis and various factors, in order to try to explain the pathophysiological substrate that we face in the search for the most effective treatment for this abnormal condition of the organism.

Prevalência de famílias em risco máximo e impactos nas visitas domiciliares em Caicó-Rio Grande do Norte / Prevalence of families at maximum risk and impacts on home visits in Caicó-Rio Grande do Norte / Prevalencia de familias en máximo riesgo e impactos en las visitas domiciliarias en Caicó-Rio Grande do Norte

Objetivo:Analisar a prevalência de famílias com risco máximo de vulnerabilidade através da aplicação da Escala de Risco Familiar de Coelho e Savassi e seus impactos nas visitas domiciliares realizadas pela equipe da Unidade Básica de Saúde da Família situada no município de Caicó-RN.Metodologia:Estudo descritivo, transversal, com abordagem quantitativa.A pesquisa envolveu 90 famílias adscritas pela Unidade de Saúde no período de junho a setembro de 2023.Após o processo de estratificação e sorteio aleatório houve a aplicação do Instrumento de coleta de dados Sociodemográficos e de saúde e aplicação da Escala de Risco Familiar. Os dados foram tabulados e processados no software IBM SPSS® Statistics 26. Resultados:Encontrou-se alto percentualde famílias em risco máximo de vulnerabilidade familiar e este fator se associou com a presença da necessidade de atendimento familiar, deficiência física, idoso acima de 70 anos, diabetes mellitus, analfabetismo, uso de drogas na família, comorbidade, hipertensão arterial, desemprego, deficiência mental e reduzida visitas domiciliares por profissionais de ensino superior. Conclusões:O estudo possibilitou, através da aplicação da Escala de Risco Familiar, verificar que há impactos na redução das visitas domiciliares realizadas por profissionais de ensino superior quando se tem uma área com prevalência de vulnerabilidade familiar. Permitiu, ainda, analisar quais sentinelas ou fatores de risco prevaleciam no grupo das famílias em risco máximo de vulnerabilidade (AU).

Objective:To analyze the prevalence of families at maximum risk of vulnerability through the application of the Coelho and Savassi Family Risk Scale and its impacts on home visits carried out by the team of the Basic Family Health Unit located in the municipality ofCaicó-RN. Methodology:Descriptive, cross-sectional study with a quantitative approach. The research involved 90 families enrolled by the Health Unit from June to September 2023. After the stratification process and random drawing, the Sociodemographic and health data collection instrument was applied and the Family Risk Scale was applied. The data were tabulated and processed using IBM SPSS® Statistics 26 software. Results:A high percentage of families at maximum risk of family vulnerability was found, and this factor was associated with the presence of the need for family care, physical disability, elderly individuals over 70 years of age, diabetes mellitus, illiteracy, drug use in the family, comorbidity, high blood pressure, unemployment, mental disability, and reduced home visits by higher education professionals. Conclusions:The study made it possible, through the application of the Family Risk Scale, to verify that there are impacts in the reduction of home visits carried out by higher education professionals when there is an area with a prevalence of family vulnerability. It also allowed us to analyze which sentinels or risk factors prevailed in the group of families at maximum risk of vulnerability (AU).

Objetivo:Analizar la prevalencia de familias en máximo riesgo de vulnerabilidad mediante la aplicación de la Escala de Riesgo Familiar de Coelho y Savassi y sus impactos en las visitas domiciliarias realizadas por el equipo de la Unidad Básica de Salud Familiar ubicada en el municipio de Caicó-RN. Metodología:Estudio descriptivo, transversal, con enfoque cuantitativo. La investigación involucró a 90 familias registradas por la Unidad de Salud de junio a septiembre de 2023. Tras elproceso de estratificación y sorteo aleatorio, se aplicó el instrumento de recolección de datos Sociodemográficos y de salud y la Escala de Riesgo Familiar. Los datos fueron tabulados y procesados en el software IBM SPSS®Statistics 26. Resultados:Se encontró un alto porcentaje de familias en riesgo máximo de vulnerabilidad familiar y este factor se asoció con la presencia de necesidad de cuidado familiar, discapacidad física, personas mayores de 70 años, diabetes mellitus, analfabetismo, consumo de drogas en la familia, comorbilidad, hipertensión arterial, desempleo, discapacidad mental y reducción de visitas domiciliarias por parte de profesionales de la educación superior. Conclusiones:El estudio permitió, mediante la aplicación de la Escala de Riesgo Familiar, verificar que existen impactos en la reducción de las visitas domiciliarias realizadas por profesionales de la educación superior cuando existe un área con prevalencia de vulnerabilidad familiar. También nos permitió analizar qué centinelas o factores de riesgo prevalecían en el grupo de familias de máximo riesgo de vulnerabilidad (AU).

Problemas psicológicos e sociais no puerpério e políticas públicas / Psychological and social problems in the puerperium and public policies / Problemas psicológicos ysociales en el puerperio y políticas públicas

Introdução: O puerpério constitui um momento de fragilidade na saúde da mulher e, quando associado com a menor assistência nos cuidados pós parto do que na gestação, contribuem para um período com morbimortalidade materna significativa, exigindo dessa forma a necessidade de atendimentos no cuidado pós-parto para atender às preocupações da paciente.Objetivo: Reunir a luz da literatura os fatores envolvidos na depressão pós-parto e discutir de que modo o estado lida com essa situação.Metodologia: Trata-se de um estudo do tipo revisão integrativa de literatura. A busca foi realizada a partir dos descritores e o operador booleano "AND": "Transtornos Puerperais" AND "Fatores Sociais" AND "Ajuste Emocional" e seus correspondentes em inglês nas bases de dados da BVS e Pubmed.Resultados e discussão: O estudo contou com 19 artigos, sendo 100% encontrados na base de dados BVS. Dentre as causas mencionadas nos estudos estão aquelas com etiologia relacionada a idade da mãe onde observa-se a diminuição da prevalência conforme o aumento da idade da mãe. Ademais, afalta de apoio, multiparidade, história pregressa de distúrbios psicológicos, desemprego, menor nível de escolaridade também constituifatores de risco para desenvolvimento da depressão pós parto. Conclusões: Considera-se o perfil de risco para o desenvolvimento de depressão pós-parto mulheres jovens, desamparadas, multíparas, com histórico de distúrbios psicológicos, desempregada e com baixa escolaridade constituindo dessa forma como fatores de risco para desenvolvimento da depressão pós-parto. Intensifica-se a necessidade do desenvolvimento de estratégias que permitam o rastreio precoce desses fatores (AU).

Introduction:The puerperium is a time of fragility in women's healthand, when combined with less assistance in postpartum care than during pregnancy, it contributes to a period of significant maternal morbidity and mortality, requiring postpartum care to address the patient's concerns. Objective:To compile the literatureabout the factors involved in postpartum depression and discuss how the state deals with this situation. Methodology:This is an integrative literature review. The search was carried out using the descriptors and the boolean operator "AND": "Puerperal Disorders" AND "Social Factors" AND "Emotional Adjustment" and their corresponding terms in English counterparts in the BVS and Pubmed databases. Results and discussion:The study included 19 articles, 100% of which were found in the BVS database. Among the causes mentioned in the studies are those with an etiology related to the mother's age, where there is a decrease in prevalence as the mother's age increases. In addition, lack of support, multiparity, previous history of psychological disorders, unemployment and lower levels of education are also risk factors for developing postpartum depression. Conclusions:The risk profile for developing postpartum depression is considered to be young, helpless, multiparous women, with ahistory of psychological disorders, unemployed, and with low levels of education, thus constituting risk factors for developing postpartum depression. There is a growing need to develop strategies that allow early screening of these factors (AU).

Introducción: El período posparto constituye un momento de fragilidad en la salud de la mujer y, cuando se asocia con menos asistencia en la atención posparto que durante el embarazo, contribuye a un período con importante morbilidad y mortalidad materna, requiriendo así la necesidad de asistencia en la atención posparto para abordar el parto. las preocupaciones del paciente.Objetivo: Recoger en la literatura los factores involucrados en la depresión posparto y discutir cómo el Estado aborda esta situación.Metodología:Se trata de un estudio de revisión integradora de la literatura. La búsqueda se realizó utilizando los descriptores y el operador booleano "AND": "Puerperal Disorders" AND "Social Factors" AND "Emotional Adjustment" y sus homólogos en inglés en las bases de datos Biblioteca Virtual en Salud (BVS) y Pubmed.Resultados y discusión:El estudio incluyó 19 artículos, el 100% de los cuales fueron encontrados en la base de datos de la BVS. Entre las causas mencionadas en los estudios se encuentran aquellas con una etiología relacionada con la edad de la madre, donde se observa una disminución de la prevalencia a medida que aumenta la edad de la madre. Además, la falta de apoyo, la multiparidad, la historia previa de trastornos psicológicos, el desempleo y el menor nivel educativo también constituyen factores de riesgo para el desarrollo de depresión posparto. Conclusiones: Se considera que el perfil de riesgo para el desarrollo de depresiónesel de mujeres jóvenes, indefensas, multíparas, con antecedentes de trastornos psicológicos, desempleadas y con bajo nivel educativo, constituyendo así factores de riesgo para el desarrollo de depresión posparto. Se intensifica la necesidad de desarrollar estrategias que permitan el cribado precoz de estos factores (AU).

Características maternas asociadas al diagnóstico de macrosomía neonatal, Hospital Regional de Talca entre los años 2017 y 2023 / Maternal characteristics associated with the diagnosis of neonatal macrosomia, Regional Hospital of Talca between 2017 and 2023

OBJECTIVE: To identify the maternal characteristics associated with the diagnosis of fetal macrosomia at the Regional Hospital of Talca in the period between January 2017 and December 2023. MATERIALS AND METHODS: An observational, descriptive and analytical, retrospective study was carried out among the years 2017 and 2023. The population studied were pregnant women with a diagnosis of fetal macrosomia treated in the Prepartum service of the Regional Hospital of Talca, clinical variables of mothers and newborns were collected from the digital database of the Prepartum Unit of the Maule Hospital and Health System. The data were processed using the IBM SPSS Statistics v27 program. RESULTS: A total of 24,409 births were analyzed, among which 61 cases were excluded due to lack of maternal information and 48 cases due to lack of newborn data, leaving a total of 24,300 newborns for the analysis. Maternal age varies between 12 years and 58 years, average age 28.4 years. An association was found between fetal macrosomia and the factors: pregnancy in the process of prolongation and post-term, sex of the newborn and age of the mother at the time of delivery. CONCLUSIONS: The maternal characteristics associated with the diagnosis of fetal macrosomia are post-term delivery, gestational diabetes, excessive weight gain during pregnancy and sex of the newborn.

OBJETIVO: Identificar cuáles son las características maternas asociadas al diagnóstico de macrosomía fetal en el Hospital Regional de Talca en el período transcurrido entre enero de 2017 y diciembre de 2023. MATERIALES Y MÉTODOS: Se realizó un estudio observacional, descriptivo y analítico, retrospectivo entre los años 2017 y 2023. La población estudiada fueron las gestantes con el diagnóstico de macrosomía fetal atendidas en el servicio de Prepartos del Hospital Regional de Talca, se recogieron variables clínicas de las madres y los recién nacidos de la base de datos digital de la Unidad de Preparto del Hospital y el Sistema de Salud del Maule. Los datos fueron procesados con la utilización del programa IBM SPSS Statistics v27. RESULTADOS: Se analizaron un total de 24.409 partos, dentro de los cuales se excluyeron 61 casos por falta de información materna y 48 casos por falta de datos del recién nacido dejando un total de 24.300 recién nacidos para el análisis. La edad materna varía entre los 12 años y 58 años, edad media 28.4 años. Se encontró asociación entre la macrosomía fetal y los factores: embarazo en vías de prolongación y postérmino, sexo del recién nacido y edad de la madre al momento del parto. CONCLUSIONES: Las características maternas asociadas al diagnóstico de macrosomía fetal son parto postérmino, diabetes gestacional, ganancia de peso excesiva durante el embarazo y sexo del recién nacido.

Mortalidad luego de una fractura de cadera: seguimiento a 10 años / Mortality after hip fracture: 10-year follow-up

Las fracturas de cadera por osteoporosis constituyen un problema de salud y se relacionan con el aumento de la morbimortalidad. Objetivo: determinar las tasas, las causas y factores de riesgo de mortalidad en los pacientes con fracturas de cadera, en un período de seguimiento de 10 años. Metodología: estudio de cohorte, retrospectivo, realizado en pacientes ≥ 50 años pertenecientes al Plan de Salud del Hospital Italiano de Buenos Aires que se internaron por frac-tura de cadera entre el 01-7-2005 y el 31-12-2010. Se evaluaron: sexo, edad, comorbilidades y tratamiento con bifosfonato prefractura y posfractura. Se utilizaron los métodos: Chi cuadrado, media, mediana y DS, sobrevida de Kaplan-Meier y modelos de riesgo proporcionales de Cox. Resultados: se incluyeron 965 pacientes. La media de edad al momento de la fractura fue 81,6 años; el 80,7% fueron mujeres. La mor-talidad global al año fue de 14,9% y de 73,2% a los 10 años, siendo mayor en hombres (HR: 1,31; IC 95%: 1,10-1,58; p=0,003), mayor (HR: 1,10; IC 95%: 1,09-1,11; p<0,001) y aumento del puntaje (score) de Charlson (HR:1,29; IC 95%: 1,23-1,34; p<0,001). Los factores de riesgo de mortalidad según el análisis multivariable de Cox en el período son: edad, índice de Charlson, sexo masculino, fractura medial, demencia e insuficiencia cardíaca congestiva. Los bifosfonatos favorecieron la sobrevida de la población (Cox). Las causas de muerte más frecuentes fueron las infecciosas y las cardiovasculares. A los 10 años sobrevivió la población que era más joven al inicio del estudio, más sana y tratada con bifosfonatos después de la fractura de cadera. Conclusiones: de esta observación a largo plazo surge la importancia del seguimiento y tratamiento con fármacos osteoactivos después de la fractura de cadera a toda la población, especialmente a la más añosa, masculina y con comorbilidades. (AU)

Hip fractures due to osteoporosis constitute a health problem and are associated with increased morbidity and mortality. Objective: To determine the rates, causes, and risk factors for mortality in patients with hip fractures over a 10-year follow-up period. Methodology: This retrospective cohort study included patients aged ≥50 years who were part of the health plan at the Italian Hospital of Buenos Aires and were hospitalized for hip fracture between July 1, 2005, and December 31, 2010. Sex, age, comorbidities, and pre- and post-fracture bisphosphonate treatment were evaluated. Statistical methods included chi-square tests, mean, median, standard deviation, Kaplan-Meier survival analysis, and Cox proportional hazards model. Results: A total of 965 patients were included. The mean age at the time of fracture was 81.6 years, and 80.7% were women. The overall mortality rate at one year was 14.9%, increasing to 73.2% at 10 years. Mortality was higher in men (HR: 1.31; 95% CI 1.10-1.58; p=0.003), older age (HR: 1.10; 95% CI 1.09-1.11; p<0.001), and Charlson comorbidity score (HR: 1.29; 95% CI 1.23-1.34; p<0.001) at ten years of follow-up.Risk factors for mortality during the study period, according to multivariate Cox analysis, included age, Charlson index, male sex, medial fracture, dementia, and congestive heart failure. Bisphosphonates improved survival (Cox analysis). The most common causes of death were infectious and cardiovascular. Patients that survived after ten years of follow-up were healthier, younger at baseline, and showed a higher proportion of treatment with bisphosphonates after hip fracture. Conclusions: This long-term observation highlights the importance of follow-up and osteoactive drug treatment after hip fracture, especially in older, male and patients with comorbidities. (AU)

Análise comparativa de pacientes acamados com e sem lesão por pressão em Uruguaiana. RS / Comparative analysis of bedridden patients withand without pressure injury in Uruguaiana. RS / Análisis comparativo de pacientes postrados cony sin lesión por presión en Uruguaiana. RS

Objetivo: comparar o perfil clínico de pacientes acamados com e sem lesão por pressão.Método: estudo transversal, descritivo e quantitativo, realizado em umaunidade deEstratégiaSaúde da Família no município de Uruguaiana, Rio Grande do Sul.A coleta dosdados deu-se por meio de um questionário paraacaracterizaçãosociodemográfica ede escalas específicas.Aplicou-se a analise estatística descritiva. Resultados: observou-se uma predominância de pacientes do sexo feminino (19,67,9%), cor branca (20,71,4%), ensino fundamental incompleto(12,23,1%), divorciados (11,40,7%), sendo os filhos os principais cuidadores. Álcool(15,57,1%) e fumo (14,57,1%) foram mais prevalentes entre aqueles com lesão por pressão,nos quaisouso de laxantes e de fraldas foirecorrente. Quanto às características das lesões, 64,3% apresentavam tamanho inferior a 4 cm², comperda parcial da espessura da pele envolvendo epiderme e/ou derme em 57,1% dos casos. O tratamento mais prevalente foi o uso de hidrocoloide(35,1%). Conclusão:considera-se que a pesquisa em tela expõe o perfil clínico e as principais características das lesões por pressão, servindo como instrumento norteador da assistência em saúde prestada no âmbito daEstratégiaSaúde da Família.

Objective:to compare the clinical profile of bedridden patients with and without pressure injury.Method: cross-sectional, descriptive and quantitative study, carried out in a Family Health Strategyunitin the city of Uruguaiana, Rio Grande do Sul. Data collection took placethrough a questionnaire for sociodemographic characterization and specific scales. Descriptive statistical analysis was applied. Results:there was a predominance of female patients (19.67.9%), white color (20.71.4%), incomplete elementary school (12.23.1%), divorced (11.40.7%), with children being the main caregivers. Alcohol (15.57.1%) and tobacco(14.57.1%) were more prevalent among thosewith pressure injury, in whomthe use of laxatives and diapers wasrecurrent. As for the characteristics of the injuries, 64.3% had a size of less than 4 cm², with partial loss of skin thickness involving theepidermis and/or dermis in 57.1% of cases. Themost prevalent treatment was the use of hydrocolloid (35.1%).Conclusion:itis considered that the research at stakeexposes the clinical profile and the main characteristics of pressure injuries, serving as a guiding instrument for health care provided within the scope of the Family Health Strategy.

Objetivo:comparar el perfil clínico de pacientes postrados en cama con y sin lesión por presión. Método:estudio transversal, descriptivo y cuantitativo, realizado en una Estrategia de Salud Familiaren el municipio de Uruguaiana, Rio Grande do Sul. La recolección de datos tuvo lugarpor medio de un cuestionario para caracterización sociodemográfica y escalas específicas. Se aplicó el análisis estadístico descriptivo. Resultados:se observó un predominio de pacientes del sexo femenino (19,67,9%), color blanco (20,71,4%), educación primaria incompleta (12,23,1%), divorciados (11,40,7%), siendo los niños los principales cuidadores. El alcohol (15,57,1%) y el tabaco (14,57,1%) fueron más prevalentes entre aquellos con lesión por presión, en quienesel uso de laxantes y pañales fue recurrente.En cuanto a las características de las lesiones, el 64,3% tenía un tamaño inferior a 4 cm², con pérdida parcial del grosor de la piel que involucra la epidermis y/o la dermis en el 57,1% de los casos. El tratamiento más prevalentefue el uso de hidrocoloide (35,1%). Conclusión:seconsidera que la investigación encuestiónexpone el perfil clínico y las principales características de las lesiones por presión, sirviendo como instrumento rector de la asistencia sanitaria prestada en el ámbito de la Estrategia Salud Familiar.

Factores de riesgo a la exposición al virus DENV 1-4 / Risk factors for exposure to DENV1-4 virus

Objetivo: Evaluar los factores de riesgo a la exposición de virus de dengue en el Municipio Chacao entre enero y marzo de 2024. Método: La población objeto de la presente investigación estuvo conformada por todos los habitantes del municipio Chacao atendidos en los distintos ambulatorios de Salud Chacao durante los meses enero-marzo del año 2024. El presente estudio es una investigación de campo, que utilizó como técnicas de procesamiento las entrevistas estructuradas para la recopilación de datos: el registro, la clasificación y la tabulación de la información aplicada a 50 pacientes del municipio. Resultados: en 50 personas estudiadas: 52 % han estado expuestos siempre o casi siempre a mosquitos, 10 % usa medidas de protección de barrera anti zancudos permanentemente y 28 % ocasionalmente, 42 % tiene aguas estancadas cerca de su vivienda. Conclusiones: Los factores de riesgo a la exposición a virus del dengue, son multifactoriales, incluyen como intrínsecos a edad, factores inmunitarios, falta de higiene, etc. y extrínsecos (ambientales) como: ausencia o incumplimiento de políticas de saneamiento, que trae como consecuencia: estancamiento de aguas, presencia de criaderos, poca o nulas campañas de concientización, etc. La prevención y el control de exposición a virus del dengue requieren un enfoque integral que aborde la acción de planes gubernamentales de control ambiental, la promoción de la salud y la participación comunitaria para reducir la incidencia de esta enfermedad transmitida por mosquitos

Objective: To evaluate the risk factors for exposure to the dengue virus in the Chacao Municipality between January and March 2024. Method: The population object of this investigation was made up of all the inhabitants of the Chacao municipality treated in the different outpatient clinics of Salud Chacao during the months of January-March of 2024. The present study is a field investigation, which was used as techniques processing structured interviews for data collection: registration, classification and tabulation of information applied to 50 patients from the municipality. Conclusions: It is necessary to affirm that the risk factors for contracting dengue are multifactorial and include aspects that range from intrinsic factors (age of the population, immune factors, etc.) to extrinsic factors (water stagnation, lack of hygiene, presence of breeding sites, little or no awareness campaigns, etc.). Dengue prevention and control requires a comprehensive approach that addresses breeding sites elimination, health promotion, and community engagement to reduce the incidence of this mosquito-borne disease.

Prevalência de diabetes mellitus autorreferidana população adulta no Brasil / Prevalence of self-reported diabetes mellitusin the adult population in Brazil

Objetivo: verificar a prevalência de diabetes mellitus (DM) autorreferida na população adulta no Brasil. Método: estudo epidemiológico ecológico descritivo realizado no período de 2006 a 2020, com base nos dados do Sistema de Monitoramento de Vigilância de Fatores de Risco e Proteção para Doenças Crônicas por Inquérito Telefônico (Vigitel), para doenças crônicas não transmissíveis. A população foi constituída por adultos (≥ 18 anos de idade) brasileiros de todas as capitais dos 26 estados brasileiros e o Distrito Federal e que participaram do Vigitel. As variáveis de interesse foram: ano, sexo, faixa etária, escolaridade, região e capital. Resultados: observou-se maior prevalência de DM autorreferida nas capitais do Rio de Janeiro (8,1%) e de São Paulo (7,8%), e a menor taxa em Palmas (4,1%). Com relação às grandes regiões, a maior prevalência foi na região Sudeste (7,1%) e a menor na região Norte (5,1%). Verificou-se ainda, maior prevalência no sexo feminino e entre as pessoas com 0 a 8 anos de estudo (11,7%). Conclusão: a prevalência de diabetes mellitus autorreferida na população adulta no Brasil entre os anos de 2006 e 2020 apresentou crescimento em todas as capitais dos estados brasileiros e o Distrito Federal por triênio, destacando-se as capitais do Rio de Janeiro e de São Paulo com os maiores valores e Palmas com o menor valor.

Objective: to verify the prevalence of self-reported diabetes mellitus (DM) in the adult population in Brazil. Method: descriptive ecological epidemiological study conducted in the period of 2006-2020, based on data from the Surveillance Monitoring System of Risk and Protection Factors for Chronic Diseases by Telephone Survey (Vigitel) for chronic non-communicable diseases. The population Abstract consisted of Brazilian adults (≥ 18 years of age) from all the 26 Brazilian state capitals and the Federal District who participated in Vigitel. The variables of interest were data collection year, sex, age, schooling, region, and capital. Results: there was a higher prevalence of self-reported DM in the capitals of Rio de Janeiro (8.1%) and São Paulo (7.8%), and the lowest rate in Palmas (4.1%). Regarding the five- major geographic regions of Brazil, the highest prevalence was in the Southeast (7.1%) and the lowest in the North (5.1%). There was also a higher prevalence in females and among people between 0 to 8 years of schooling (11.7%). Conclusion: the prevalence of self-reported diabetes mellitus in the adult population in Brazil from 2006 to 2020 showed a growth in all capitals of the Brazilian states and the Federal District every triennium. The capitals of Rio de Janeiro and São Paulo showed the highest values and Palmas the lowest one.

Prevalencia y factores asociados a dermatosis en la población adulta de Honduras, 2017-2018 / Prevalence and factors associated with dermatosis in the adult population of Honduras, 2017-2018

Introducción: En dermatología existen más de 2,000 entidades, alguna de las cuales afecta en determinado momento a un individuo de cualquier edad sin distinciones de raza o sexo. El último informe de The Global Burden of Disease (2014) reveló que la prevalencia de dermatosis en general oscilaba entre 30 y 70%. Objetivo: Determinar prevalencia y factores asociados a las dermatosis en adultos ≥ 18 años en áreas de influencia de los Médicos en Servicio Social (MSS) de la Universidad Nacional Autónoma de Honduras (UNAH), noviembre 2017-noviembre 2018. Métodos: Estudio descriptivo transversal con análisis de asociación, realizado en 18 departamentos de Honduras, se incluyó la población adulta ≥ 18 años, en las áreas geográficas de influencia (AGI) de 254 Médicos en Servicio Social. El muestreo fue aleatorio polietápico, asignándole a cada MSS 50 ± 2 adultos mayores de 18 años; muestra total de 12,775 adultos. Se aplicó encuesta, realizando análisis univariado y bivariado, razón de prevalencia (RP) e IC 95%, con valores de p<0.05. Resultados: Se encontró una prevalencia de dermatosis de 43.4%. Entre los factores asociados, sexo femenino (RP=1.03, IC=95% 1.01-1.06, P=0.00026), comorbilidades (RP=1.53, IC=1.46-1.61, P=0.00000), horario de exposición solar 9 am a 4 pm (RP=1.07, IC=1.04-1.11, P=0.00000). Discusión: Existe una asociación entre la presencia de comorbilidades y dermatosis; así como se establece que la exposición solar es un factor de riesgo asociado a la presencia de dermatosis en la población estudiada...(AU)

Lineamientos técnicos para la implementación del tamizaje ecográfico de la displasia del desarrollo de la cadera en niñas y niños menores de un año / Technical guidelines for the implementation of ultrasound screening for dysplasia of hip development in girls and boys under one year of age

El Ministerio de Salud dando cumplimiento a la Política Nacional de Apoyo al Desarrollo Infantil Temprano "Crecer Juntos" y enfocado en que uno de los pilares básicos del concepto de salud es la prevención, ha determinado invertir, en la detección oportuna de la displasia del desarrollo de la cadera (DDC) desde el período neonatal, considerada como una de las discapacidades motoras, que inciden en la deambulación de las personas desde la niñez temprana. Para tal fin, se incorpora el tamizaje ecográfico de cadera en establecimientos de la red del Sistema Nacional Integrado de Salud de tal manera que se garantice cobertura del 100%, de los recién nacidos en los que se identifiquen factores de riesgos para desarrollar displasia del desarrollo de la cadera. La creación de la red de atención de esta condición, lleva implícito el tratamiento y seguimiento de los casos que resulten positivos, logrando de esa forma prevenir o superar la discapacidad motora. Por lo que se vuelve necesario que todos los trabajadores de salud que realicen atención directa de los recién nacidos y lactantes menores compartan el compromiso de aplicación de los presentes lineamientos

The Ministry of Health, in compliance with the National Policy to Support Early Childhood Development "Grow Together" and focused on the fact that one of the basic pillars of the concept of health is prevention, has determined to invest in the timely detection of developmental dysplasia. of the hip (DDH) from the neonatal period, considered as one of the motor disabilities, which affects the ambulation of people from early childhood. For this purpose, hip ultrasound screening is incorporated in establishments in the National Integrated Health System network in such a way that 100% coverage is guaranteed for newborns in whom risk factors for developing developmental dysplasia are identified. of the hip. The creation of the care network for this condition implies the treatment and monitoring of cases that turn out to be positive, thus managing to prevent or overcome motor disability. Therefore, it becomes necessary for all health workers who provide direct care to newborns and infants to share the commitment to apply these guidelines

Hipotermia terapéutica: estudio descriptivo de una cohorte de 10 años en un hospital público de alta complejidad / Therapeutic hypothermia: A descriptive, cohort study conducted over 10 years at a tertiary care public hospital

Introducción. La hipotermia terapéutica (HT) reduce el riesgo de muerte o discapacidad en niños con encefalopatía hipóxico-isquémica (EHI) moderada-grave. Objetivo. Describir una población de pacientes con EHI que requirió HT y su evolución hasta el alta hospitalaria. Población y métodos. Estudio descriptivo de cohorte retrospectivo. Se analizaron todos los pacientes que ingresaron a HT entre 2013 y 2022. Se evaluaron datos epidemiológicos, clínicos, de monitoreo, tratamiento, estudios complementarios y condición al alta. Se compararon los factores de riesgo entre pacientes fallecidos y sobrevivientes, y de estos, los que requirieron necesidades especiales al alta (NEAS). Resultados. Se incluyeron 247 pacientes. Mortalidad: 11 %. Evento centinela más frecuente: período expulsivo prolongado (39 %). Inicio del tratamiento: mediana 5 horas de vida. Convulsiones: 57 %. Eritropoyetina intravenosa: 66,7 %. Patrón anormal de monitoreo de función cerebral: 52 %. Normalización del monitoreo: mediana 24 horas. Resonancia magnética patológica: 42 %. Variables predictoras de mortalidad: Sarnat y Sarnat grave, y ecografía patológica al ingreso. Conclusión. La mortalidad global fue del 11 %. Las derivaciones aumentaron en forma más evidente a partir del año 2018. El horario de inicio de HT fue más tardío que en reportes anteriores. Los signos neurológicos de gravedad según la escala de Sarnat y Sarnat y la ecografía cerebral basal patológica fueron predictores independientes de mortalidad al alta. Los pacientes con NEAS presentaron normalización del trazado del electroencefalograma de amplitud integrada más tardío. El hallazgo más frecuente en la resonancia fue la afectación de los ganglios basales. No se encontraron diferencias clínicas ni de complicaciones estadísticamente significativas entre los pacientes que recibieron eritropoyetina.

Introduction. Therapeutic hypothermia (TH) reduces the risk of death or disability in children with moderate to severe hypoxic ischemic encephalopathy (HIE). Objective. To describe a population of patients with HIE that required TH and their course until discharge. Population and methods. Retrospective, descriptive, cohort study. All patients admitted to TH between 2013 and 2022 were studied. Epidemiological, clinical, monitoring, and treatment data were assessed, together with supplementary tests and condition at discharge. Risk factors were compared between deceased patients and survivors; and, among the latter, those requiring special healthcare needs (SHCN) at discharge. Results. A total of 247 patients were included. Mortality: 11%. Most common sentinel event: prolonged second stage of labor (39%). Treatment initiation: median of 5 hours of life. Seizures: 57%. Intravenous erythropoietin: 66.7%. Abnormal pattern in brain function monitoring: 52%. Normalization of monitoring: median of 24 hours. Pathological magnetic resonance imaging: 42%. Predictor variables of mortality: severe Sarnat and Sarnat staging and pathological ultrasound upon admission. Conclusion. The overall mortality rate was 11%. Referrals increased more markedly since 2018. The time of TH initiation was later than in previous reports. Severe neurological signs as per the Sarnat and Sarnat staging and a pathological baseline cranial ultrasound were independent predictors of mortality at discharge. Patients with SHCN at discharge showed a normalized tracing in the amplitude-integrated electroencephalography performed later. The most common finding in the magnetic resonance imaging was basal ganglia involvement. No statistically significant differences were observed in terms of clinical characteristics or complications among patients who received erythropoietin.