ABSTRACT
OBJECTIVE: One of the steps adopted to mitigate the pandemic due to SARS-CoV-2 is the use of face masks by the general population. For a face mask to be effective it should cover the nose and the mouth. We wanted to measure the correct use of the face mask by the general population in open public spaces through direct observation. METHODS: We conducted an observational study of the proper use of face masks among the general population in open public places in Bilbao, Santander, Oviedo and Zaragoza from 16th to 26th July, 2020 and from 23rd January to 2nd March, 2021. Sampling for convenience; compliance of the proper use of a mask was evaluated when adults completely covered their mouth and nose. The type of mask and its improper use was registered using a standardized form. The results were obtained using frequency distribution, Pearson's chi-squared test and multivariate logistic regression analysis. RESULTS: A total of 5,464 observations were documented. The overall compliance was 89.5%. We observed that the compliance in 2021 (94.7%) was 10.9 percentage points higher than in 2020 (83.8%) (p<0.001). The main cause of non-compliance was the incorrect placement of face masks (64%); 36% were without masks. The non-reusable face masks were most commonly worn (54.1%). We observed a significant increase in use of high-efficiency face masks in 2021 (27.1%) versus 2020 (13.7%). CONCLUSIONS: In all the cities where the study was conducted we observed an increase in compliance of the proper use of face masks as well as an increased usage of high-efficiency masks. The main cause of non-compliance was incorrect placement.
OBJETIVO: Dentro de las medidas adoptadas para mitigar la pandemia por SARS-CoV-2 se encuentra el uso de mascarillas en la población general. Para que esta medida sea efectiva las mascarillas deben cubrir la nariz y la boca. Nos propusimos conocer su uso correcto por la población general en espacios públicos abiertos mediante observación directa. METODOS: Estudio prospectivo observacional del correcto uso de mascarillas en la población general en espacios abiertos en Bilbao, Santander, Oviedo y Zaragoza, del 16 al 26/07/2020 y del 23/01 al 02/03/2021. Se realizó un muestreo por conveniencia evaluando el cumplimiento del uso de mascarilla cuando los adultos la llevaban cubriendo completamente nariz y boca. Se registró el tipo e inadecuación de su uso mediante formulario estandarizado. Se realizó distribución de frecuencias, comparaciones con χ2 de Pearson y regresión logística multivariable. RESULTADOS: Se realizaron 5.464 observaciones. El cumplimiento global fue del 89,5%; 10,9 puntos mayor en 2021 (94,7%) que en 2020 (83,8%) (p<0,001). La principal causa de incumplimiento fue la colocación incorrecta (64%) frente no llevar nada (36%). Respecto al tipo de mascarillas, las más utilizadas fueron las no reutilizables (54,1%), aumentando en 2021 el uso de las de alta eficacia (13,7% versus 27,6%) de forma significativa. CONCLUSIONES: En todas las ciudades estudiadas se observa un aumento del uso correcto de la mascarilla desde que se hizo obligatorio en espacios públicos, así como aumento de las mascarillas de alta eficacia. La principal causa de incumplimiento es llevar la mascarilla mal colocada.
Subject(s)
COVID-19 , Masks , Adult , Cities , Humans , Pandemics/prevention & control , SARS-CoV-2 , Spain/epidemiologyABSTRACT
Fundamentos: Dentro de las medidas adoptadas para mitigar la pandemia por SARS-CoV-2 se encuentra el uso de mascarillas en la población general. Para que esta medida sea efectiva las mascarillas deben cubrir la nariz y la boca. Nos propusimos conocer su uso correcto por la población general en espacios públicos abiertos mediante observación directa. Métodos: Estudio prospectivo observacional del correcto uso de mascarillas en la población general en espacios abiertos en Bilbao, Santander, Oviedo y Zaragoza, del 16 al 26/07/2020 y del 23/01 al 02/03/2021. Se realizó un muestreo por conveniencia evaluando el cumplimiento del uso de mascarilla cuando los adultos la llevaban cubriendo completamente nariz y boca. Se registró el tipo e inadecuación de su uso mediante formulario estandarizado. Se realizó distribución de frecuencias, comparacionescon χ2 de Pearson y regresión logística multivariable. Resultados: Se realizaron 5.464 observaciones. El cumplimiento global fue del 89,5%; 10,9 puntos mayor en 2021 (94,7%) que en 2020 (83,8%) (p<0,001). La principal causa de incumplimiento fue la colocación incorrecta (64%) frente no llevar nada (36%). Respecto al tipo de mascarillas, las más utilizadas fueron las no reutilizables (54,1%), aumentando en 2021 el uso de las de alta eficacia (13,7% versus 27,6%) de forma significativa. Conclusiones: En todas las ciudades estudiadas se observa un aumento del uso correcto de la mascarilla desde que se hizo obligatorio en espacios públicos, así como aumento de las mascarillas de alta eficacia. La principal causa de incumplimiento es llevar la mascarilla mal colocada.(AU)
Background: One of the steps adopted to mitigate the pandemic due to SARS-CoV-2 is the use of face masks by the general population. For a face mask to be effective it should cover the nose and the mouth. We wanted to measure the correct use of the face mask by the general population in open public spaces through direct observation. Methods: We conducted an observational study of the proper use of face masks among the general population in open public places in Bilbao, Santander, Oviedo and Zaragoza from 16th to 26th July, 2020 and from 23rd January to 2nd March, 2021. Sampling for convenience; compliance of the proper use of a mask was evaluated when adults completely covered their mouth and nose. The type of mask and its improper use was registered using a standardized form. The results were obtained using frequency distribution, Pearsons chisquared testand multivariate logistic regression analysis. Results: A total of 5,464 observations were documented. The overall compliance was 89.5%. We observed that the compliance in 2021 (94.7%) was 10.9 percentage points higher than in 2020 (83.8%) (p<0.001). The main cause of noncompliance was the incorrect placement of face masks (64%); 36% were without masks. The nonreusable face masks were most commonly worn (54.1%). We observed a significant increase in use of highefficiency face masks in 2021 (27.1%) versus 2020 (13.7%). Conclusions: In all the cities where the study was conducted we observed an increase in compliance of the proper use of face masks as well as an increased usage ofhighefficiency masks. The main cause of non-compliance was incorrect placement.(AU)
Subject(s)
Humans , Male , Female , Population , Masks , Pandemics , Coronavirus Infections/epidemiology , Severe acute respiratory syndrome-related coronavirus , Guideline Adherence , Infection Control , Spain , Prospective Studies , Public Health , Health PromotionSubject(s)
Family Practice/organization & administration , Certification/standards , Family Practice/education , Family Practice/history , Family Practice/trends , Forecasting , Government Agencies , History, 20th Century , History, 21st Century , Mexico , Physicians, Family/education , Physicians, Family/statistics & numerical data , Publishing , Social Security , Societies, Medical , UniversitiesABSTRACT
In Mexico informed consent is a legal requirement that ensures that patients who are invited to participate in clinical trials are provided with all the information needed to decide whether to participate, or not, in a research protocol. To improve our understanding of the problems physicians in developing countries encounter, when obtaining informed consent (IC), we examined their opinion on the importance of IC in clinical research, the quantity and quality of the information provided to the participant, and the conditions in which the IC is obtained. Investigators considered that IC was useful to the patients, providing information that helped the patient to make a decision about his/her participation. Nevertheless, they felt that for some aspects of the research, like drug development in general, the use of placebos, and the randomization process, many of the patients were not capable of fully understanding the information provided, referring to the complexity of the information and illiteracy as the main reasons. Many investigators were not acquainted with some of the guidelines established in the Mexican General Law of Health,(1) 36% of them admitting to not having completed their IC letters. Most investigators gave only minutes to the patient to make a decision and 20% of ICs were obtained while the patient was hospitalized. Except for one investigator, all of them considered that specific training in medical ethics would be useful for the daily clinical work.
Subject(s)
Attitude , Clinical Trials as Topic , Informed Consent , Research Personnel/psychology , Clinical Trials as Topic/ethics , Clinical Trials as Topic/standards , Comprehension , Disclosure/ethics , Disclosure/standards , Ethics, Medical/education , Humans , Informed Consent/psychology , Informed Consent/statistics & numerical data , Mexico , Physician-Patient Relations , Research Design , Research Subjects , Risk AssessmentABSTRACT
INTRODUCTION: Velo-cardio-facial syndrome (VCFS) (also known as DiGeorge sequence, and 22q11.2 deletion syndrome among other labels) is now recognized as the most common syndrome associated with cleft palate and velopharyngeal insufficiency. 22q11.2 deletion syndrome has been associated with medially positioned internal carotid arteries. This anomaly may be associated with posterior pharyngeal pulsations seen on endoscopy. The purpose of this paper is to study the diagnostic efficacy of the endoscopy for the detection of patients with 22q11.2 deletion syndrome, using as gold standard test the fluorescence in situ hybridization (FISH) test. MATERIAL AND METHODS: Twenty nine patients with submucous cleft palate, velopharyngeal insufficiency, and 22q11.2 deletion as demonstrated by FISH were studied. Also, 29 patients with submucous cleft palate, and without abnormalities in the FISH procedure, were studied as controls. All patients from both groups underwent endoscopy. A double-blind procedure was utilized whereby all videonasopharyngoscopies were independently revised by the two examiners. RESULTS: Twenty five patients with VCFS demonstrated posterior pharyngeal pulsations seen on endoscopy (sensitivity of 86%). In contrast, none of the patients from the control group showed posterior pulsations (specificity of 100%). Positive predictive value was 100%, and negative predictive value was 87%. CONCLUSIONS: Endoscopy seems to be a safe and reliable procedure for evaluating patients with 22q11.2 deletion syndrome. The observations of posterior pharyngeal wall pulsations on endoscopy should alert clinicians to the diagnosis of 22q11.2 deletion, and also, can be useful for preventing the risk of damage to the carotid arteries during velopharyngeal surgery. This indicates another important role of endoscopy in the preoperative assessment of children for palatopharyngoplasty.
Subject(s)
Abnormalities, Multiple/diagnosis , Cleft Palate/diagnosis , Endoscopy , Face/abnormalities , Heart Defects, Congenital/diagnosis , Jaw Abnormalities/diagnosis , Child , Child, Preschool , Female , Humans , Male , Sensitivity and Specificity , SyndromeABSTRACT
La epilepsia en el trastorno neurológico más frecuente durante la gestación. Una de las principales preocupaciones que enfrenta el médico se relaciona con los potenciales efectos indeseables que los fármacos anticonvulsivos pudieron ejercer sobre el curso del embarazo y el desarrollo fetal. El objetivo del presente trabajo fue investigar las complicaciones maternas y obstétricas en 50 epilépticas embarazadas, así como los posibles efectos teratogénicos de diversos agentes anticonvulsivos sobre los recién nacidos de dichas pacientes atendidas en el Hospital General "Dr. Manuel Gea González" SSA, de 1989 a 1992. Los resultados indican que el 78 por ciento de las pacientes recibieron tratamiento a base de carbamezepina o difenilhidantoína y solamente 10 por ciento requirieron una combinacion de fármacos. La mayor parte de las gestaciones (76 por ciento) se resolvió por vía vaginal, y únicamente en tres neonatos (6 por ciento) se detectaron malformaciones congénitas menores, como hipoplasia de falanges y anomalías estructurales del pabellón auricular. Estos datos sugieren que existe un margen de seguridad aceptable en el empleo de anticonvulsivos en pacientes epilépticas durante el embarazo, especialmente cuando el control de las crisis convulsivas puede lograrse con un sólo fármaco
Subject(s)
Pregnancy , Infant, Newborn , Adolescent , Adult , Middle Aged , Humans , Female , Anticonvulsants/adverse effects , Anticonvulsants/therapeutic use , Carbamazepine/adverse effects , Carbamazepine/therapeutic use , Congenital, Hereditary, and Neonatal Diseases and Abnormalities , Epilepsy/drug therapy , Phenytoin/adverse effects , Pregnancy Complications , Teratogens/analysisABSTRACT
Entre 1978 y 1991, el Hospital General ®Dr. Manuel Gea González¼ de la Secretaría de Salud, se realizaron 2,525 autopsias, encontrándose que en 66 casos (2.6 por ciento) se estableció el diagnóstico postmortem de tuberculosis, de los cuales solamente 30 de ellos contaban con diagnóstico clínico de la enfermedad. La proporción de casos diagnosticados postmortem fue mayor en hombres y se incrementó con la edad. Más del 60 por ciento de los casos de tuberculosis diseminada pasaron inadvertidos al diagnóstico clínico. Estos datos indican que la tuberculosis continúa siendo un problema subestimado clínicamente, particularmente en los pacientes de mayor edad y en aquellos con manifestaciones atípicas o extrapulmonares de la enfermedad
