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Introducción: Las patologías tiroideas se encuentran entre los trastornos endocrinológicos más frecuentes reportados durante el embarazo, en parte debido a los cambios fisiológicos que ocurren generalmente en el primer trimestre y que puede llevar a la pérdida de este. Objetivo: El objetivo fue determinar la prevalencia de hipotiroidismo en mujeres con diagnóstico de aborto espontaneo en el Hospital Distrital de Presidente Franco durante el periodo 2019 a 2021. Materiales y Métodos: Estudio observacional, descriptivo, retrospectivo de corte transversal con muestreo no probabilístico de casos consecutivos, se estudiaron a todas las mujeres que tuvieron aborto espontáneo en el hospital distrital de presidente franco durante los años 2019 a 2021. Se utilizo el software estadístico Stata®12.0 para los cálculos estadísticos. Resultados: Se estudiaron a 432 mujeres que tuvieron abortos espontáneos. En dicho periodo se registró una prevalencia de 3,9%, la mayoría con hipotiroidismo subclínico con un 3,4%. El 52,9% en las edades comprendidas entre 20 a 35 años, 52,9% presentaron unión libre y 47% escolaridad primaria. El 52,9% proceden de zonas urbanas. Conclusión: Se determinó que aquellas perdidas de embarazo relacionado a hipotiroidismo corresponden con mayor frecuencia a Alto Paraná comparado con otra región de nuestro país y a nivel internacional. Además, se encontró el hipotiroidismo subclínico con mayormente en adultos jóvenes, con nivel de escolaridad primaria, la mayoría proveniente de zona rural.
Introduction: Thyroid pathologies are among the most common endocrinological disorders reported during pregnancy, partly due to the physiological changes that typically occur in the first trimester, which can lead to pregnancy loss. Objective: determine the prevalence of hypothyroidism in women diagnosed with spontaneous abortion at the Hospital Distrital de Presidente Franco from 2019 to 2021. Materials and Methods: This observational, descriptive, retrospective, cross-sectional study utilized non-probabilistic sampling of consecutive cases, examining all women who experienced spontaneous abortion at the Hospital Distrital de Presidente Franco during the years 2019 to 2021. Stata®12.0 statistical software was employed for statistical calculations. Results: A total of 432 women who had miscarriages were analyzed. During this period, a prevalence of 3.9% was recorded, with most cases being subclinical hypothyroidism (3.4%). Among these, 52.9% of the 20-35 age group were in a common-law union, and 47% had completed primary school. Additionally, 52.9% were from urban areas. Conclusion: Those pregnancy losses related to hypothyroidism were determined to correspond more frequently in Alto Paraná compared to other regions of our country and internationally. Also, subclinical hypothyroidism was found in young adults, with primary schooling, most of them coming from rural areas.
ABSTRACT
Introducción: Los estados hipertensivos del embarazo son un conjunto de patologías que puede producir muerte o discapacidad crónica en las madres, en los fetos y recién nacidos. Objetivo: Determinar la frecuencia de los estados hipertensivos del embarazo y las complicaciones materno-perinatales en el Hospital Regional de Ciudad del Este. Materiales y métodos: Estudio transversal descriptivo con muestreo no probabilístico. Se estudiaron a todas las mujeres embarazadas con estados hipertensivos del embarazo o asociado al mismo que tuvieron eventos obstétricos en el Hospital Regional de Ciudad del Este en los años 2018 al 2020. Los datos fueron analizados en el Software Stata 12.0. Resultados: Se estudiaron a 7056 pacientes. Se encontraron 11,9% participantes con estados hipertensivos del embarazo, 55,3% con mayor frecuencia entre los 20 a 35 años, el 71,3% tuvieron control prenatal de mala calidad, se encontraron el 42,8% con preeclampsia. El 65,2% terminaron por cesárea, 27,8% Síndrome de HELLP, el 1,4% presentaron requerimiento de terapia intensiva y 0,6% muerte materna. Con respecto a las complicaciones perinatales se encontraron bajo peso al nacer en 30,2% y muerte del 2%. Conclusión: Se registró alta frecuencia de estados hipertensivos del embarazo con alto porcentaje de complicaciones, mala calidad de control prenatal. Entre las complicaciones perinatales más frecuentes fueron el bajo peso al nacer y la más grave es la muerte.
Introduction: Hypertensive states of pregnancy are a set of pathologies that can cause death or chronic disability in mothers, fetuses and newborns. Objective: To determine the frequency of hypertensive states of pregnancy and maternal-perinatal complications at the Regional Hospital of Ciudad del Este. Materials and methods: Descriptive cross-sectional study with non-probability sampling. All pregnant women with hypertensive states of pregnancy or associated with pregnancy who had obstetric events at the Regional Hospital of Ciudad del Este in the years 2018 to 2020 were studied. The data were analyzed in Stata 12.0 software. Results: A total of 7056 patients were studied. 11.9% of participants had hypertensive states of pregnancy, and among them, 55.3% were found to be more frequent from 20 to 35 years of age, 71.3% had poor prenatal care, and 42.8% had preeclampsia. 65.2% of the participants ended up with cesarean delivery, 27.8% had HELLP syndrome, 1.4% required intensive care and 0.6% ended in maternal death. Regarding perinatal complications, low birth weight was found in 30.2%, and death at birth in 2%. Conclusion: A high frequency of hypertensive states of pregnancy with a high percentage of complications and poor quality of prenatal control was registered. One of the most common perinatal complications were low birth weight, and the most serious was death.
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INTRODUCTION: The recent discovery of SARS-CoV-2 and the disease COVID-19 which affects different organs and systems, mainly the respiratory one, representing a new challenge for physicians. Pancreatic affection is barely described, with only a few cases reported in the literature. OBJECTIVE: to communicate a case of acute pancreatitis associated with SARS-CoV-2 infection, to contribute to the knowledge of this new virus and its possible forms of presentation. CLINICAL CASE: An eleven-year-old male adolescent, with no history of contact with people confirmed or suspected of COVID-19, was admitted to the hospital with a 3-day history of periumbilical and epigastric abdominal pain, vomiting, and absence of stools, with no other symptoms. The laboratory tests showed increased pancreatic enzymes. Com puted tomography was compatible with acute edematous pancreatitis, without signs of biliary patho logy, diagnosing acute pancreatitis, at the same time that SARS-CoV-2 was isolated in the respiratory tract. Other possible differential diagnoses and history of epidemiological contact were ruled out. The patient was managed in the Critical Patient Unit with support measures. He evolved favorably, without respiratory symptoms. CONCLUSION: SARS-CoV-2 infection can be associated with atypical presentations, including acute pancreatitis. The physiopathological mechanism of pancreatic damage is not yet clear. Physicians should be aware of the COVID-19 involvement of other systems, beyond the respiratory one.
Subject(s)
COVID-19 , Pancreatitis , Acute Disease , Adolescent , COVID-19/complications , COVID-19/diagnosis , Child , Humans , Male , Pancreas , Pancreatitis/complications , Pancreatitis/diagnosis , SARS-CoV-2ABSTRACT
Background: Early growth faltering accounts for one-third of child deaths, and adversely impacts the health and human capital of surviving children. Social as well as biological factors contribute to growth faltering, but their relative strength and interrelations in different contexts have not been fully described. Objective: The aim of this study was to use structural equation modelling to explore social and biological multidetermination of child height at age 2 y in longitudinal data from 4 birth cohort studies in low- and middle-income countries. Methods: We analyzed data from 13,824 participants in birth cohort studies in Brazil, India, the Philippines, and South Africa. We used exploratory structural equation models, with height-for-age at 24 mo as the outcome to derive factors, and path analysis to estimate relations among a wide set of social and biological variables common to the 4 sites. Results: The prevalence of stunting at 24 mo ranged from 14.0% in Brazil to 67.7% in the Philippines. Maternal height and birthweight were strongly predictive of height-for-age at 24 mo in all 4 sites (all P values <0.001). Three social-environmental factors, which we characterized as "child circumstances," "family socioeconomic status," and "community facilities," were identified in all sites. Each social-environmental factor was also strongly predictive of height-for-age at 24 mo (all P values <0.001), with some relations partly mediated through birthweight. The biological pathways accounted for 59% of the total explained variance and the social-environmental pathways accounted for 41%. The resulting path coefficients were broadly similar across the 4 sites. Conclusions: Early child growth faltering is determined by both biological and social factors. Maternal height, itself a marker of intergenerational deprivation, strongly influences child height at 2 y, including indirect effects through birthweight and social factors. However, concurrent social factors, many of which are modifiable, directly and indirectly contribute to child growth. This study highlights opportunities for interventions that address both biological and social determinants over the long and short term.
Subject(s)
Developing Countries , Family Characteristics , Growth Disorders/etiology , Models, Biological , Mothers , Birth Weight , Body Height , Brazil/epidemiology , Child, Preschool , Cohort Studies , Environment , Female , Growth Disorders/epidemiology , Humans , India/epidemiology , Infant , Latent Class Analysis , Male , Philippines/epidemiology , Prevalence , Residence Characteristics , Sanitation , Social Class , South Africa/epidemiologyABSTRACT
Hepatopulmonary syndrome is a rare disease that affects patients of any age with acute or chronic liver disease. The prevalence and its outcome in children are unknown. Clinically are common shortness of breath, orthodeoxia and platypnoea, together with cyanosis, digital clubbing and spider naevi. Its diagnosis is based in a clinical triad characterized by liver disease with or whithout portal hypertension, hypoxemia and intrapulmonary vascular dilatation leading to right and left shunts, demonstrated by echocardiography with contrast, the perfusion lung scanning using technetium-labelled macro-aggregates albumin estimate the shunt fraction. Pulmonary angiography is useful to demonstrate macroscopic arteriovenous communications. The orthotopic liver transplantation is the only efficacy treatment in patients without several gas exchange abnormality.
El síndrome hepatopulmonar es una enfermedad poco frecuente que afecta a pacientes de cualquier edad con enfermedad hepática aguda o crónica. La prevalencia y la evolución en pediatría son desconocidas. Clínicamente es común encontrar disnea de esfuerzo, platipnea y ortodeoxia, además de cianosis, acropaquia y nevi aracniformes. El diagnóstico está basado en una tríada clínica caracterizada por una enfermedad hepática con o sin hipertensión portal, hipoxemia y vasodilatación intrapulmonar que conduce a un shunt de derecha a izquierda, demostrado mediante ecocardiografía con contraste y cintigrafía de perfusión pulmonar con albúmina macroagregada marcada contecnesio-99m que permite la estimación de la fracción del shunt. La angiografía pulmonar es útil para demostrar comunicaciones arteriovenosas macroscópicas. El trasplante hepático es el único tratamiento demostradamente eficaz, excepto en aquellos pacientes con un trastorno ventilatorio grave, por su mayor morbimortalidad.
Subject(s)
Humans , Adolescent , Female , Liver Diseases/diagnosis , Hepatopulmonary Syndrome/diagnosis , Fatal OutcomeABSTRACT
La presente investigación tuvo como propósito elaborar un perfil de los estudiantes de primer año de la carrera de Enfermería de la Universidad Santo Tomás, con la finalidad de obtener información sobre los diversos ámbitos del funcionamiento del alumno. Se realizó un estudio de tipo exploratorio-descriptivo, con una muestra compuesta por 71 sujetos de ambos sexos. A éstos se les aplicaron los inventarios de personalidad MIPS (Inventario Millón de Estilos de Personalidad) y el POI (Inventario de Auto-Actualización Personal). Los resultados indican que los sujetos en el MIPS manifiestan una presencia marcada de los rasgos: apertura, sensación, sistematización, firmeza, conformismo y control. Los hallazgos del POI indican que los estudiantes presentan un alto nivel de autoaprecio, y un adecuado nivel de autonomía, espontaneidad, autoaceptación y aceptación de la agresión.
The present research protocol was designed to develop a psychological profile of first year nursing students at Santo Tomás University, and therefore obtain information related to different behavioral areas. An exploratory-descriptive research protocol for 71 students of both genders was designed. Million Indexes of Personality Styles (MIPS) and Personal Orientation Inventory (POI) were used. The results of MIPS showed a marked presence of these traits: Openness, Feeling, Systematization, Strength, Conformity and Control. The POI results showed the students possessed a high level of self regard, and an adequate level of support ratio, spontaneity, self acceptance and acceptance of aggression.