ABSTRACT
Introducción. El dengue es una infección viral que puede cursar de forma asintomática o incluir manifestaciones graves. El objetivo del trabajo es describir las características de una población pediátrica durante el brote epidémico del 2023. Población y métodos. Estudio de corte transversal que incluyó pacientes con dengue probable o confirmado atendidos del 13 de marzo de 2023 al 19 de mayo de 2023 en un hospital pediátrico de la Ciudad Autónoma de Buenos Aires. Resultados. Se incluyeron 112 pacientes. La mediana de edad fue 12 años; el 58 % fueron varones. El 76 % procedía de la Ciudad Autónoma de Buenos Aires. El 25 % tenía convivientes con sintomatología compatible con caso sospechoso. Las manifestaciones clínicas más frecuentes fueron fiebre, cefalea con dolor retroocular y mioartralgias. Las alteraciones de laboratorio más frecuentes fueron la leucopenia (65 %) y la elevación de transaminasas (60 %). El 21 % (24/112) presentó signos de alarma y requirió internación. La leucopenia, la plaquetopenia y el aumento de transaminasas se asociaron con la presencia de signos de alarma. Se confirmaron 53 pacientes por PCR-RT detectable, el serotipo 2 fue el más frecuente. Se asumieron como casos probables de dengue 21 pacientes con prueba NS1 positiva, 18 pacientes con IgM positiva y 20 pacientes con clínica y nexo epidemiológico. No hubo casos de dengue grave. Conclusión. Durante la infección por dengue, la sospecha clínica precoz y el reconocimiento de los parámetros de laboratorio asociados a los signos de alarma resultan esenciales para un adecuado abordaje de la enfermedad y un tratamiento de sostén precoz.
Introduction. Dengue is a viral infection that may be asymptomatic or include severe manifestations. This study aims to describe the characteristics of a pediatric population during the epidemic outbreak in 2023. Population and methods. This cross-sectional study included patients with probable or confirmed dengue fever who were seen from March 13, 2023, to May 19, 2023, in a pediatric hospital in the Autonomous City of Buenos Aires. Results. A total of 112 patients were included. The median age was 12 years; 58% were male. Seventysix percent of them came from the City of Buenos Aires. Twenty-five percent had cohabitants with symptoms compatible with a suspected case. The most frequent clinical manifestations were fever, headache, retro-ocular pain, myalgia, and arthralgia. The most frequent laboratory alterations were leukopenia (65%) and elevated transaminases (60%). Twenty-one percent (24/112) presented alarm signs and required hospitalization. Leukopenia, plateletopenia, and elevated transaminases were associated with the presence of alarm signs. RT-PCR was detected in fifty-three patients; serotype 2 was the most frequent. Twenty-one patients had positive NS1 tests, 18 patients had positive IgM, and 20 patients with clinical and epidemiological links were assumed to be probable dengue cases. There were no cases of severe dengue. Conclusion. Early clinical suspicion and recognition of laboratory parameters associated with alarm signs are essential for an adequate approach to the disease and early supportive treatment during dengue infection.
Subject(s)
Humans , Male , Female , Child , Adolescent , Dengue/diagnosis , Dengue/epidemiology , Hospitals, Pediatric , Argentina/epidemiology , Urban Health , Disease Outbreaks , Cross-Sectional Studies , EpidemicsABSTRACT
Introducción. La población trans en Argentina representa el 0,43 %. Nuestro objetivo fue describir las características de niñas, niños y adolescentes trans y no binarios. Población y métodos. Se diseñó un estudio de corte transversal. La población fueron todas las personas menores de 24 años trans o no binarias atendidas por un equipo interdisciplinario en un hospital universitario de tercer nivel desde enero de 2019 hasta mayo de 2023. La muestra se obtuvo de la base de datos de pacientes atendidos a través de la revisión de las historias clínicas electrónicas (HCE). Resultados. Se analizaron las HCE de 107 personas; el promedio de la primera consulta fue 15,3 años y la edad de autopercepción de identidad de género trans, 11,1 años. El 72 % se percibió con una identidad varón trans; en el 89,7 %, su expresión de género fue acorde a su autopercepción y el 46,3 % tuvo una orientación sexual bisexual. El 76 % reconoció tener contención familiar; el 87,3 %, contención escolar; y el 92,5 %, contención de sus pares. El 44,8 % realizó una estrategia hormonal; el 14,1 %, intervención quirúrgica; el 57,1 %, intervención con salud mental; y el 29,1 % recibió medicación psiquiátrica. Solo 3 pacientes (2,8 %) detransicionaron su identidad de género. Conclusión. La mayoría de las personas eran varones trans y percibieron una buena contención de sus entornos. Casi la mitad recibió una estrategia hormonal; menos de un cuarto, una intervención quirúrgica; más de la mitad, una intervención con salud mental. La detransición fue infrecuente.
Introduction. The trans population in Argentina represents 0.43%. Our objective was to describe the characteristics of trans and non-binary children and adolescents. Population and methods. A cross-sectional study was designed. The population was all trans or nonbinary persons under 24 years of age seen by an interdisciplinary team in a tertiary university hospital from January 2019 to May 2023. The sample was obtained from the database of patients seen by reviewing electronic medical records (EMR). Results. The EMRs of 107 individuals were analyzed; the average age at first consultation was 15.3 years, and the age of self-perceived transgender identity was 11.1 years. Seventy-two percent perceived themselves as having a trans male identity; in 89.7%, their gender expression was by their self-perception, and 46.3% had a bisexual sexual orientation. Seventy-six percent acknowledged having family support; 87.3%, school support; and 92.5%, peer support. 44.8% had a hormonal strategy, 14.1% had surgery, 57.1% had mental health intervention, and 29.1% received psychiatric medication. Only three patients (2.8%) detransitioned their gender identity. Conclusion. Most individuals were trans men and perceived good support from their environments. Almost half received a hormonal strategy; less than a quarter received a surgical intervention; more than half received a mental health intervention. The detransition was infrequent.
Subject(s)
Humans , Adolescent , Young Adult , Transgender Persons/psychology , Tertiary Care Centers , Argentina , Cross-Sectional Studies , Gender IdentityABSTRACT
Introducción. La llegada de internet y las redes sociales ha revolucionado el acceso a la información sobre temas de salud y crianza. Las consultas virtuales se extienden en el mundo, van en aumento y representan un desafío para el ejercicio profesional. Objetivo. Caracterizar el uso, por parte de madres y padres, de internet y redes sociales como fuente de información sobre la salud y/o crianza de sus hijos. Población y métodos. Estudio descriptivo, transversal en un centro pediátrico ambulatorio de la Ciudad Autónoma de Buenos Aires para conocer hábitos de consulta en línea de cuidadores de niños sanos o con problemas de salud. Resultados. Se analizaron 201 encuestas, respondidas predominantemente por madres de niños sanos. El 70,6 % realiza búsquedas en línea sobre temas de salud y/o crianza; de ellos, el 80 % consulta más de una vez al mes. Si bien el 36 % de las familias usa la información en forma complementaria a la consulta médica, el 95 % no reemplazaría la consulta pediátrica por la búsqueda en línea. Los participantes no tienen el hábito de seguir páginas oficiales ni suelen verificar la veracidad de los contenidos. Los temas de búsqueda se relacionan con la edad del niño y la satisfacción con los resultados de la información se modifican según el niño sea sano o tenga un problema de salud. Solo el 4,7 % respondió que la búsqueda siempre responde sus dudas. Conclusiones. Los cuidadores buscan información en línea sobre crianza y salud con alta frecuencia, pero las fuentes no siempre son confiables. Aunque la consulta con pediatras no se ve desplazada, desconocemos el impacto de la información en línea en la toma de decisiones sobre la salud. Los pediatras podemos intervenir y orientar hacia fuentes seguras.
Introduction. The Internet and social media have revolutionized access to information on health and parenting issues. Virtual consultations are spreading worldwide, are increasing, and represent a challenge for professional practice. Objective. To characterize the use of the Internet and social media by mothers and fathers as a source of information on the health and parenting of their children. Population and methods. A descriptive, cross-sectional study in an outpatient pediatric center in the City of Buenos Aires to determine the online consultation habits of caregivers of healthy children or children with health problems. Results. Two hundred-one surveys were analyzed, and the answers were predominantly from mothers of healthy children; 70.6% search online for health and parenting topics; 80% consult more than once a month. Although 36% of the families use the information to complement the medical consultation, 95% would not replace the pediatric consultation with the online search. The participants are not in the habit of following official pages, nor do they tend to verify the veracity of the contents. The search topics are related to the child's age, and satisfaction with the information results are modified according to whether the child is healthy or has a health problem. Only 4.7% responded that the search always answers their questions. Conclusions. Caregivers frequently seek online parenting and health information, but the sources are not always reliable. Although consultation with pediatricians is not displaced, we need to know the impact of online information on health decision-making. Pediatricians can intervene and guide caregivers to safe sources.
Subject(s)
Humans , Infant , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Parenting , Internet/statistics & numerical data , Social Media/statistics & numerical data , Parents/psychology , Cross-Sectional Studies , Consumer Health Information , Information Seeking Behavior , Information SourcesABSTRACT
INTRODUCTION: Inflammation is hypothesized to be a pivotal factor influencing muscle function, with C-Reactive Protein (CRP) serving as a common biomarker of inflammation. However, the literature pertaining to the relationship between CRP and muscle mass remains scant, particularly among representative adult populations in the United States. The present study aimed to delve into the association between serum CRP levels and muscle mass among American adults, leveraging data from the National Health and Nutrition Examination Survey (NHANES) conducted from 1999 to 2006. METHODS: A cohort of 13,518 participants, representative of the US adult population, underwent dual-energy X-Ray Absorptiometry (DXA) to assess Appendicular Skeletal Muscle Mass (ASM) and had their CRP levels measured. Muscle mass was defined using ASM adjusted by Body Mass Index (ASM/BMI) criteria. Employing weighted logistic regression models, restricted cubic spline analysis, and subgroup analyses, the authors examined the association between serum CRP and low muscle mass. RESULTS: After meticulously adjusting for various covariates, the present findings revealed a positive association between serum CRP levels and the risk of low muscle mass in American adults (OR = 1.07, 95 % CI 1.01â1.14, p = 0.016). Notably, an inverse J-shaped relationship was observed, with serum CRP inflection points of 0.273 mg/dL for the overall population, 0.172 mg/dL for males, and 0.296 mg/dL for females. Subgroup analysis further demonstrated that factors such as gender, race, educational level, smoking status, congestive heart failure, stroke, renal weakness/failure, coronary heart disease, diabetes, hypertension, vigorous physical activity, moderate physical activity, and muscle strengthening activities did not significantly impact this positive correlation (all p for interaction values > 0.05). CONCLUSIONS: This nationally representative cross-sectional study provides robust evidence of an inverse J-shaped association between serum CRP levels and the risk of low muscle mass in adults in the United States, with a critical inflection point of 0.273 mg/dL. These findings may inform future research and clinical strategies aimed at mitigating the negative effects of inflammation on muscle mass and function in the adult population.
Subject(s)
Absorptiometry, Photon , Biomarkers , C-Reactive Protein , Muscle, Skeletal , Nutrition Surveys , Humans , C-Reactive Protein/analysis , Male , Female , Adult , Middle Aged , United States , Muscle, Skeletal/anatomy & histology , Biomarkers/blood , Body Mass Index , Cross-Sectional Studies , Sarcopenia/blood , Aged , Risk Factors , Young AdultABSTRACT
Resilience refers to one's ability to face life's challenges and achieve positive outcomes, and has drawn increasing interest from researchers and policymakers. The Adolescent Resilience Questionnaire (ARQ) is a measure that assesses resilience in adolescents according to a multidimensional perspective, encompassing its several different domains. This cross-sectional study aimed to translate and evaluate the measurement properties of the Brazilian version of the ARQ (B-ARQ) for use with Brazilian adolescents. Two native speakers in Brazilian Portuguese language who were also fluent in English language translated the ARQ from English into Portuguese. A committee of experts in validation studies compared the translated versions. A summarized version was produced and back-translated by a translator native of the English language and fluent in Portuguese. The B-ARQ was pre-tested in a sample of 21 adolescents. An expert committee considered the suggestions and defined the final version of the instrument, which was tested in a sample of 210 adolescent students from public and private schools in the city of Dom Pedrito, Brazil. All students filled out the 88-item instrument as well as a socio-demographic questionnaire. Statistical analysis included descriptive statistics of all variables (frequency distribution, floor, ceiling effects), internal consistency, and confirmatory factor analysis of the version with 88 items and the shortened version with 49 items. The short version with 49 items was validated in a cross-sectional study in an adolescent population of high school students using exploratory factor analysis in the Unites States. The 88-item ARQ had poor structural validity with unsatisfactory model fit indices. Therefore, the investigation focused on the short 49-item version of the ARQ (B-ARQ-SV). The final model presented satisfactory RMSEA = 0.042 (p = 0.994, 90% CI: 0.037-0.047) and SRMR of 0.076, despite the low CFI (0.878). The internal consistency was estimated with McDonald's Omega for each factor: Confidence (ω = 0.480), Negative Cognition (ω = 0.588), Empathy/tolerance (ω = 0.295), Emotional insight (ω = 0.425), Social Skill (ω = 0.235), Family Domain Connectedness (ω = 0.785), Family Domain Availability (ω = 0.847), Peers Domain Connectedness (ω = 0.719), Peers Domain Availability (ω = 0.402), School Domain Supportive environment (ω = 0.677), School Domain Connectedness (ω = 0.013), Community Domain Connectedness (ω = 0.791). One scale showed a ceiling effect (frequency higher than 15.0%), but we identified no critical floor effect. The B-ARQ-SV is a valid (in terms of content and structural validity) and reliable (in terms of internal consistency) measurement instrument to assess resilience in Brazilian adolescents.
Subject(s)
Resilience, Psychological , Humans , Adolescent , Brazil , Female , Male , Surveys and Questionnaires , Cross-Sectional Studies , Reproducibility of Results , Psychometrics/methods , Translations , LanguageABSTRACT
PURPOSE: to describe sociodemographic characteristics of individuals with multiple sclerosis and correlate and compare vocal fatigue, voice handicap, and voice-related quality of life of individuals with and without the disease. METHODS: Cross-sectional, quantitative study with 52 volunteers with multiple sclerosis and 52 control volunteers, matched by sex, age, and education level. Sociodemographic and clinical data were collected through a questionnaire and medical record analysis. Participants responded to the reduced Voice Handicap Index (VHI-10), Vocal Fatigue Index (VFI), and Voice-Related Quality of Life (V-RQOL). Correlational and comparative analyses were performed, with a 5% significance level (p < 0.05). RESULTS: There was a greater predominance of females diagnosed with multiple sclerosis, with a mean age of 40 years, who graduated from high school, and with a relapsing-remitting disease course. Voice handicap was positively correlated with vocal fatigue, and voice handicap and vocal fatigue were negatively correlated with voice-related quality of life in both groups. Participants with multiple sclerosis exceeded the VHI-10 and VFI cutoff scores and were below the V-RQOL cutoff score. CONCLUSION: There was a prevalence of the disease in young, educated females with relapsing-remitting disease. The greater the voice handicap and/or vocal fatigue, the lower the voice-related quality of life in both groups. However, people with multiple sclerosis self-reported greater voice handicap and vocal fatigue and poorer voice-related quality of life.
OBJETIVO: descrever características sociodemográficas de indivíduos com esclerose múltipla, correlacionar e comparar a fadiga, desvantagem vocal e a qualidade de vida em voz de indivíduos com e sem a doença. MÉTODO: Estudo transversal, quantitativo e com 52 voluntários com esclerose múltipla e 52 voluntários-controle, pareados por sexo, idade e escolaridade. Dados sociodemográficos e clínicos foram coletados com questionário e análise de prontuários. Os participantes responderam ao Índice de Desvantagem Vocal reduzido (IDV-10), Índice de Fadiga Vocal (IFV) e Qualidade de Vida em Voz (QVV). Análises correlacionais e comparativas foram realizadas, com um nível de significância de 5% (p<0,05). RESULTADO: Maior predomínio de participantes diagnosticados com esclerose múltipla do sexo feminino, média de 40 anos, ensino médio completo e curso da doença do tipo remitente-recorrente. Houve correlação positiva entre a desvantagem e a fadiga vocal, e correlação negativa entre a desvantagem e fadiga vocal com a qualidade de vida em voz em ambos os grupos. Além disso, os participantes com esclerose múltipla ultrapassaram as notas de corte do IDV-10 e do IFV e ficaram abaixo da nota de corte do QVV. CONCLUSÃO: Houve prevalência da doença em indivíduos jovens do sexo feminino, escolarizados e do tipo remitente-recorrente. Quanto maior a desvantagem e/ou a fadiga vocal, menor é a qualidade de vida em voz em ambos os grupos. No entanto, pessoas com esclerose múltipla autorreferem maior desvantagem e fadiga vocal, além de menor qualidade de vida relacionada à voz.
Subject(s)
Multiple Sclerosis , Quality of Life , Voice Disorders , Voice Quality , Humans , Female , Cross-Sectional Studies , Adult , Male , Voice Disorders/etiology , Voice Disorders/physiopathology , Middle Aged , Multiple Sclerosis/complications , Multiple Sclerosis/physiopathology , Case-Control Studies , Surveys and Questionnaires , Young Adult , Socioeconomic Factors , Severity of Illness Index , BrazilABSTRACT
PURPOSE: To analyze the Benefit of Modulated Masking (BMM) in electrophysiological and behavioral measurements in young and adult normal-hearing individuals. METHODS: Observational and cross-sectional analytical study, with a final research sample consisted of 40 participants, 20 individuals aged 18 to 30 years (young adults) and 20 individuals aged 31 to 50 years (adults), to carry out behavioral assessment (Sentence recognition test in the presence of stable and modulated noise) and electrophysiological (Cortical Auditory Evoked Potential) for BMM investigation. The results were analyzed using the paired t-test and ANOVA for repeated measures, applied by the Bonferroni post-hoc test (p-value <0.05). RESULTS: Less interference from modulated noise was identified in the latency and amplitude measurements of cortical components, generating a significant reduction in P1 latency and an increase in P2 amplitude in both groups of participants. Stable noise generated higher electrophysiological and behavioral thresholds compared to modulated noise. A greater magnitude of BMM was observed in the young-adult group. CONCLUSION: In both groups of participants, less interference from modulated noise was identified in the encoding time of the neural auditory response and in the process of neural discrimination of speech. Furthermore, behavioral and electrophysiological thresholds were typically higher in stable noise when compared to modulated noise, pointing to a correspondence between BMM measurements between hearing domains. The magnitude of the higher BMM in the young-adult group, especially in the electrophysiological domain, suggests a greater temporal resolution ability in younger individuals.
OBJETIVO: Analisar o Benefício do Mascaramento Modulado (BMM) em medidas eletrofisiológicas e comportamentais em indivíduos jovens e adultos normouvintes. MÉTODO: Estudo analítico observacional e transversal, com amostra final da pesquisa composta por 40 participantes, sendo 20 indivíduos de 18 a 30 anos (jovens-adultos) e 20 indivíduos de 31 a 50 anos (adultos), para realização de avaliação comportamental (Teste de reconhecimento de sentença na presença de ruído estável e modulado) e eletrofisiológica (Potencial Evocado Auditivo Cortical) para investigação do BMM. Os resultados foram analisados através do Test-t pareado e ANOVA para medidas repetidas, seguido pelo teste post-hoc de Bonferroni (p-valor <0,05). RESULTADOS: Foi identificada uma menor interferência do ruído modulado nas medidas de latência e amplitude dos componentes corticais, gerando uma redução significativa na latência de P1 e aumento da amplitude de P2 em ambos os grupos de participantes. O ruído estável gerou limiares eletrofisiológicos e comportamentais mais elevados comparado ao ruído modulado. Uma maior magnitude do BMM foi observada no grupo jovem-adulto. CONCLUSÃO: Identificou-se em ambos os grupos de participantes uma menor interferência do ruído modulado no tempo de codificação da resposta auditiva neural e no processo de discriminação neural da fala. Além disso, os limiares comportamentais e eletrofisiológicos foram tipicamente mais elevados diante do ruído estável quando comparado ao ruído modulado, apontando para uma correspondência da medida do BMM entre os domínios da audição. A magnitude do BMM superior no grupo de jovens-adultos, especialmente no domínio eletrofisiológico, sugere uma maior habilidade de resolução temporal em indivíduos mais jovens.
Subject(s)
Auditory Threshold , Evoked Potentials, Auditory , Noise , Perceptual Masking , Humans , Adult , Cross-Sectional Studies , Young Adult , Evoked Potentials, Auditory/physiology , Perceptual Masking/physiology , Adolescent , Middle Aged , Male , Female , Auditory Threshold/physiology , Speech Perception/physiology , Acoustic Stimulation/methodsABSTRACT
BACKGROUND: A new formula for estimating small, dense, low-density lipoprotein cholesterol (sdLDL-C) based on the results of the standard lipid panel is proposed. OBJECTIVES: To assess the association between estimated sdLDL-C (EsdLDL-C) and atherosclerotic cardiovascular disease (ASCVD) risk. METHODS: A total of 12,192 participants from the Korea National Health and Nutrition Examination Survey (KNHANES) database between 2010 and 2020 were included in this cross-sectional study. EsdLDL-C was calculated as EsdLDL-C= LDL-C - [1.43 × LDL-C - (0.14 × (ln (TG) × LDL-C)) - 8.99]. Logistic regression analyses were utilized to assess the association between EsdLDL-C and ASCVD risk. Subgroup analyses were performed based on age, body mass index (BMI), hypertension, and diabetes. An odds ratio (OR) with a 95% confidence interval (CI) was used for evaluation. P<0.05 was considered statistically significant. RESULTS: Among 12,192 participants, 1,239 (10.16%) had ASCVD. The mean sdLDL-C of participants was estimated to be 42.43±14.75 mg/dL using the formula. Elevated EsdLDL-C levels (OR=1.33; 95%CI, 1.06-1.66) were associated with an increased risk of ASCVD. Subgroup analyses found that there may be an interaction between EsdLDL-C (Pinteraction= 0.001) or non-HDL-C (Pinteraction= 0.015) and hypertension on ASCVD risk. CONCLUSIONS: Elevated estimated sdLDL-C levels were associated with the risk of ASCVD, and estimated sdLDL-C might be an alternative to sdLDL-C measurement for ASCVD risk assessment.
FUNDAMENTO: Uma nova fórmula para estimar o colesterol de lipoproteínas pequenas, densas e de baixa densidade (sdLDL-C) com base nos resultados do painel lipídico padrão é proposto. OBJETIVOS: Para avaliar a associação entreestimado sdLDL-C (EsdLDL-C) e o risco de doença cardiovascular arterosclerótica (DCVA). MÉTODOS: Um total de 12.192 participantes do banco de dados do Korea National Health and Nutrition Examination Survey (KNHANES) entre 2010 e 2020 foram incluídos neste estudo transversal. EsdLDL-C foi calculada como EsdLDL-C = LDL-C- [1,43 × LDL-C - (0,14 × (ln (TG) × LDL-C)) - 8,99]. Análises de regressão logística foram utilizadas para avaliar a associação entre EsdLDL-C e risco de DCVA. As análises de subgrupos foram realizadas com base na idade, índice de massa corporal (IMC), hipertensão, e diabetes. Uma razão de possibilidades (OR) com um intervalo de confiança de 95% (IC) foi utilizado para avaliação. P<0,05 foi considerado estatisticamente significativo. RESULTADOS: Entre 12.192 participantes, 1.239 (10,16%) tinham DCVA. A média de sdLDL-C dos participantes foi estimada em 42,43±14,75 mg/dL usando a fórmula. Níveis elevados de EsdLDL-C (OR=1,33; IC 95%, 1,06-1,66) foram associados a um aumento do risco de DCVA. As análises de subgrupos descobriram que pode haver uma interação entre EsdLDL-C (Pinteração=0,001) ou não-HDL-C (Pinteração=0,015) e hipertensão no risco de DCVA. CONCLUSÕES: Níveis elevados estimados de sdLDL-C foram associados ao risco de DCVA, e o sdLDL-C estimado pode ser uma alternativa à medição do sdLDL-C para avaliação do risco de DCVA.
Subject(s)
Atherosclerosis , Cholesterol, LDL , Nutrition Surveys , Humans , Male , Female , Cross-Sectional Studies , Middle Aged , Cholesterol, LDL/blood , Atherosclerosis/blood , Risk Factors , Republic of Korea/epidemiology , Risk Assessment , Adult , Aged , Body Mass Index , Logistic Models , Cardiovascular Diseases/blood , Biomarkers/blood , Hypertension/blood , Heart Disease Risk FactorsABSTRACT
The aim of this study was to assess the oral condition of individuals diagnosed with COVID-19 and its impact on their quality of life. The cross-sectional study participants were patients with or without a diagnosis of COVID-19, on room air, and conscious, admitted to the ICUs and wards of Public Hospital Units in São Luís, Maranhão, Brazil. The data collected included: demographic information, length of stay, comorbidities, and type of diet, obtained from medical records; Oral Health-Related Quality of Life (OHRQoL) [Oral Health Impact Profile (OHIP-14)]questions patients were asked; oral health (measured by the Bedside Oral Exam Scale); oral hygiene status (assessed by the Oral Hygiene Index - Simplified and lingual: degree of lingual coating); and salivary flow. The prevalence of COVID-19 was associated with gender (p = 0.038), with a higher incidence observed in male patients (61.9%). Moreover, there was a correlation between the hospitalization sector (p = 0.037) and the frequency of ICU admissions (53.7%). The prevalence of comorbidities was comparable between the two groups. Relative to oral health, 53% of individuals with confirmed COVID-19 had moderate oral health, while 9% exhibited poor oral health. The prevalence of hyposalivation was higher in the group with a confirmed diagnosis of COVID-19. The quality of life of individuals with confirmed COVID-19 was most significantly impacted by moderate to severe oral health concerns. The most significant alteration in oral health was a reduction in salivary flow, negatively impacting the quality of life of individuals hospitalized for COVID-19 complications.
Subject(s)
COVID-19 , Hospitalization , Oral Health , Quality of Life , Humans , COVID-19/epidemiology , Male , Female , Cross-Sectional Studies , Middle Aged , Brazil/epidemiology , Oral Health/statistics & numerical data , Hospitalization/statistics & numerical data , Adult , Aged , Sex Factors , SARS-CoV-2 , Prevalence , Oral Hygiene Index , Young Adult , Oral Hygiene/statistics & numerical dataABSTRACT
An association between bruxism and musculoskeletal disorders, such as neck pain, has been established. This study investigated the association of possible sleep bruxism (PSB) activities, including grinding, bracing, and thrusting, with smartphone use, smartphone-induced neck pain, and sleep features. This cross-sectional study involved 403 Brazilian adolescents aged 11 to 19 years. A self-administered questionnaire was used to assess the severity of PSB, smartphone use, smartphone-induced neck pain, and sleep features (sleep duration and quality and history of nightmares). Sociodemographic factors, as well as snoring and drooling on the pillow, were considered potential confounders and were assessed based on reports from parents/caregivers. Participants were selected using multiple-stage sampling. Descriptive analysis and multinomial regression were performed (p ≤ 0.05). Adolescents reporting nightmares at least once a month (OR = 3.402; 95%CI: 1.315-8.802) and sometimes experiencing smartphone-induced neck pain (OR: 3.697, 95%CI: 1.103-12.388) were more likely to report moderate/severe grinding. Drooling on the pillow (OR = 3.105, 95%CI: 1.316-7.329), poor/fairly good sleep quality (OR = 2.717, 95%CI: 1.279-5.770), and smartphone-induced neck pain (OR = 3.227, 95%CI: 1.121-9.285) were associated with mild bracing. Adolescents experiencing nightmares once a week (OR = 3.209, 95% CI: 1.202- 8.565) had a higher prevalence of mild thrusting. Self-reported smartphone-induced neck pain, nightmares, poor/fairly good sleep quality, and drooling on the pillow were associated with a higher prevalence of PSB activities among Brazilian adolescents. Clinicians and researchers are encouraged to include assessments of smartphone use and sleep features in anamnesis, promoting a comprehensive approach to PSB, from diagnosis to treatment.
Subject(s)
Neck Pain , Sleep Bruxism , Smartphone , Humans , Adolescent , Sleep Bruxism/epidemiology , Female , Male , Cross-Sectional Studies , Neck Pain/epidemiology , Neck Pain/etiology , Smartphone/statistics & numerical data , Child , Brazil/epidemiology , Young Adult , Surveys and Questionnaires , Socioeconomic Factors , Severity of Illness Index , Sleep/physiology , Prevalence , Risk FactorsABSTRACT
to analyze the vaccination status of individuals with type 1 and type 2 diabetes in Primary Healthcare.cross-sectional, analytical study conducted in 25 Family Health teams with 274 individuals with diabetes. Sociodemographic and clinical variables were evaluated, as well as the full vaccination schedule for each vaccine recommended by the National Immunization Program, through bivariate analysis and logistic regression.among individuals with diabetes mellitus, the following incomplete vaccination rates were found: 69.1% for hepatitis B; 64.6% for diphtheria and tetanus; 74.3% for yellow fever; 87.9% for pneumococcus; 87.9% for varicella; 24.5% for influenza; and 0.7% for COVID-19. The reported reasons for low vaccination rates included not knowing the importance of vaccination and not being informed by healthcare providers. A statistically significant association was found between sociodemographic and clinical profile regarding the full vaccination schedule between the influenza vaccine and age and income; COVID-19 and age, type of diabetes and duration of diabetes.individuals with type 1 and type 2 diabetes treated in Primary Healthcare showed low vaccination rates, which is concerning due to increased vulnerability to vaccine-preventable infections and mortality within this group. BACKGROUND: (1) Individuals with diabetes have low vaccination rates. (2) It is essential to provide vaccination opportunities in health services for individuals with diabetes. (3) Education for vaccine-prescribing professionals is necessary. (4) Young people are less likely to get vaccinated than older adults. (5) It is essential to understand the predisposing factors related to vaccination status.
Subject(s)
Diabetes Mellitus, Type 1 , Diabetes Mellitus, Type 2 , Primary Health Care , Humans , Cross-Sectional Studies , Male , Female , Primary Health Care/statistics & numerical data , Adult , Middle Aged , Diabetes Mellitus, Type 2/therapy , Vaccination/statistics & numerical data , Young Adult , Adolescent , Aged , COVID-19/prevention & control , COVID-19/epidemiologyABSTRACT
to analyze the relationship between the exercise of authentic leadership by coordinators and job satisfaction among professors of undergraduate nursing courses at federal public universities.this is a quantitative study with an observational, analytical, and cross-sectional design. Twelve undergraduate nursing courses at public higher education institutions were chosen to participate in the study. The information collected was analyzed using descriptive statistical techniques, Spearman's correlation test, and binary logistic regression analysis, with a 5% significance level.the sample consisted of 179 professors who completed the Sociodemographic Questionnaire, the Authentic Leadership Questionnaire, and the Job Satisfaction Questionnaire. The professors rated the course coordinators as having high levels of authentic leadership practice. As for the binary logistic regression, only the Relational and Moral domain showed significance (p-value < 0.0001), indicating that when this domain is present, there is a 5.48-fold increase in the chance of professors being satisfied.the results of the study indicate that the job satisfaction of professors in undergraduate nursing courses is influenced by the practice of authentic leadership on the part of the coordinators. BACKGROUND: (1) Advances in the practice of authentic leadership in educational management. (2) The instruments used are useful for assessing leadership and satisfaction. (3) Relationships between authentic leadership and job satisfaction were identified. (4) Measuring authentic leadership and job satisfaction in the educational environment.
Subject(s)
Faculty, Nursing , Job Satisfaction , Leadership , Humans , Faculty, Nursing/psychology , Cross-Sectional Studies , Male , Female , Adult , Middle Aged , Surveys and QuestionnairesABSTRACT
OBJECTIVE: to verify the internal and structural consistency of the Ambivalent Sexism Inventory in young undergraduate nursing students. METHOD: this is a cross-sectional methodological study carried out with young university students enrolled in the undergraduate Nursing course at a public university. Data was obtained by means of a sociodemographic/academic questionnaire and the Ambivalent Sexism Inventory. The analysis used Pearson's correlation, Cronbach's alpha, intraclass correlation, t-test and chi-square ratio and degrees of freedom, as well as confirmatory factor analysis to test the consistency of the existence of the bifactor model. RESULTS: the sample consisted of 305 undergraduates. The oblique bifactor model showed statistical indicators that justify the consistency of the bifactor structure of sexism in the study's target population. In addition, the psychometric indicators of the inventory showed satisfactory results. The predictive regression analysis confirmed the structure, demonstrating its consistency and robustness for assessing both hostile sexism and benevolent sexism among young university nursing students. CONCLUSION: support for the theory of ambivalent sexism was identified, reflecting the consistency of the oblique bifactor model. The analysis of the psychometric properties of the inventory, including validity and reliability, reinforces its applicability and relevance in research on gender issues in the health area. BACKGROUND: (1) Phlebitis was the most prevalent complication. (2) Pressure in the bag was associated with catheter removal before indication. (3) Length of stay and use of sedation were related to the onset of phlebitis.
Subject(s)
Psychometrics , Sexism , Students, Nursing , Humans , Students, Nursing/psychology , Students, Nursing/statistics & numerical data , Female , Male , Cross-Sectional Studies , Young Adult , Adult , Adolescent , Reproducibility of Results , Surveys and QuestionnairesABSTRACT
OBJECTIVE: to analyze the reproductive autonomy of women during the COVID-19 pandemic, considering sociodemographic, clinical, and reproductive factors. METHOD: a quantitative study with a cross-sectional design, conducted with 314 women aged 18 to 49 years old. Data were collected through an online questionnaire containing sociodemographic, clinical, and reproductive data, as well as the Reproductive Autonomy Scale. The Mann-Whitney and Student's t tests were used to compare variables. RESULTS: significant differences were found between the average scores of "decision-making" and marital status (p = <0.001); and "absence of coercion" and "communication" with age group (p = 0.03 e <0.001), residence (p = <0.001 and <0.01), schooling level (p = 0.02 e 0.02), pregnancy (p = <0.001 e 0.04) and contraception (p = 0.02 e <0.001). CONCLUSION: not having a sexual partner positively influenced autonomy in reproductive decision-making during the COVID-19 pandemic. Women of younger age, living in the capital, with higher education levels, who had never been pregnant, and who used contraceptives during the pandemic showed greater autonomy in the absence of coercion and communication. It was possible to identify the groups that require greater attention and interventions to support their sexual health and reproductive choices. BACKGROUND: (1) A high reproductive autonomy score was observed even during the pandemic. (2) Not having a stable partner positively influenced reproductive decision-making. (3) Women living in the capital, of younger age, and with lower education levels experienced less coercion. (4) Being nulligravida and using contraception were associated with less coercion and better communication. (5) The use of an online tool during the pandemic expanded the program's reach to women.
Subject(s)
COVID-19 , Decision Making , Personal Autonomy , Humans , COVID-19/epidemiology , Female , Cross-Sectional Studies , Adult , Middle Aged , Young Adult , Adolescent , Pregnancy , Pandemics , Surveys and Questionnaires , SARS-CoV-2 , Contraception/statistics & numerical dataABSTRACT
OBJECTIVE: to analyze the validity evidence of the BAT - General version in a sample of Brazilian nursing workers. METHOD: a cross-sectional study design with non-probability sampling method was used among 3594 Brazilian nursing workers. The validity evidence was assessed by means of analysis based on the internal structure, on the relations to external variables, and on response process of the items. RESULTS: the factor models of the BAT - General version showed goodness-of-fit to the data. However, the complete factor model enabled a better understanding of burnout syndrome in the sample. It was attested the BAT - General version dimensions were positively correlated with depression, anxiety and stress symptoms and negatively correlated with job satisfaction and satisfaction with life. The validity evidence analysis based on response process of the items revealed that BAT - General version works properly both in the group of nursing workers who reported having emotional or psychological health problems and in the group who denied these problems. CONCLUSION: the results provided robust validity evidence of the BAT - General version in Brazilian nursing workers. BACKGROUND: (1) BAT - General version was shown to be a robust and consistent instrument. (2) BAT - General version can become an important management tool for nursing leaders. (3) It is a tool that can be used in the individual assessment of burnout symptoms. (4) BAT - General version should not be used for clinic diagnosis of burnout.
Subject(s)
Burnout, Professional , Psychometrics , Humans , Burnout, Professional/diagnosis , Burnout, Professional/psychology , Cross-Sectional Studies , Male , Female , Adult , Middle Aged , Nursing , Brazil , Young AdultABSTRACT
OBJECTIVE: to analyze the relationship between the knowledge, prevention, attitudes and opinion of nursing professionals in adult intensive care units regarding COVID-19 and their sociodemographic and work characteristics. METHOD: cross-sectional, analytical study. 124 nursing professionals who worked in adult intensive care units after the COVID-19 pandemic were included. To measure the variables, the Awareness, Attitudes, Prevention and Perceptions of COVID-19 Outbreak among Nurses questionnaire was used. To identify differences between the groups, the following tests were used: Kruskal-Wallis and Mann-Whitney U, Pearson correlation, and multiple analysis in logistic regression for each dimension. RESULTS: participants with a workplace in private institutions showed a tendency towards better scores in awareness OR=3.92 (95%CI:1.50; 10.25), in prevention OR=8.93 (95%CI:3.12; 25.565), in attitude OR=2.77 (95%CI: 1.16; 6.58) and in perception with an OR= 19.65 (95%CI: 5.85; 65.94). In attitude, male participants showed a better result with OR=3.31 (95%CI: 1.18; 9.23) and in relation to perception, those who showed the best results were those with postgraduate studies as specialists OR=7.60 (95%CI: 1.73; 33.23). CONCLUSION: working in a private institution and having a postgraduate specialization degree were related to better scores in the dimensions of the scale. BACKGROUND: (1) Years of experience presented a positive correlation with knowledge. (2) High levels of awareness, practices, prevention and opinions were obtained. (3) Professionals with specialization have higher COVID-19 KAB scores. (4) Older nursing professionals tended to have lower scores in the dimensions of the instrument (knowledge, prevention, attitude and opinion). (5) The pandemic period improves knowledge and practices in nursing.
Subject(s)
Attitude of Health Personnel , COVID-19 , Health Knowledge, Attitudes, Practice , Humans , COVID-19/prevention & control , Cross-Sectional Studies , Male , Female , Adult , Middle Aged , Surveys and Questionnaires , Intensive Care UnitsABSTRACT
BACKGROUND: The study of gratitude has been a trending subject in psychology and emerging in health sciences education. For the past several years, interest has been aroused through various published contributions that still lack scientific support, so it is necessary to have instruments that obtain valid and reliable data about it. Gratitude has proven to be sensitive to different cultures. This research aims to determine the psychometric properties using a combined scale to measure dispositional gratitude in health sciences faculty. METHOD: A quantitative study was conducted with a non-experimental trans-sectional design with a correlational scope, with a sample of 216 professors of health sciences in a northeastern Mexico private university divided into subsamples for an Exploratory Factor Analysis (n = 113) and a Confirmatory Factor Analysis (n = 103). The Gratitude Questionnaire, Work Questionnaire and Brief Interactive Optimism-Garcia was applied to 110 women, 104 men and 2 who prefer not to specify their gender. RESULTS: The result was a unifactorial measurement model composed of 10 items with evidence of construct validity (χ2 = 59.83, df = 20, p < 0.001, χ2/df = 59.83/20 = 2.99, SRMR = 0.11, GFI = 0.96; NFI = 0.93, RFI = 0.91, AGFI = 0.93), PRATIO = 0.78, PNFI = 0.73; concurrent validity with interactive optimism (r = 0.45, p < 0.001); convergent validity (AVE = 0.42); and reliability (α = 0.88; ω = 0.88). CONCLUSIONS: This model measures dispositional gratitude in health sciences Mexican faculty and contributes a vital instrument to advance future educational innovations involving this construct. The validation of the one-factor model with convergent reliability and validity suggests that the total scale score serves as an adequate measure of gratitude. Finally, it represents a valuable contribution to the teaching of health sciences since it generates healthy environments with prosocial attitudes that facilitate flourishing in personal and academic life, and in the future, health professionals with humanism as their standard.
Subject(s)
Faculty, Medical , Psychometrics , Humans , Female , Male , Surveys and Questionnaires , Cross-Sectional Studies , Reproducibility of Results , Faculty, Medical/psychology , Adult , Mexico , Factor Analysis, Statistical , Middle Aged , Faculty/psychologyABSTRACT
INTRODUCTION: Influenza represents a global public health challenge. Influenza vaccination is crucial for preventing complications. The World Health Organization recommends a coverage rate of at least 75% for the at-risk population. The aim of this study was to evaluate vaccination coverage among members of the Health Plan of the Hospital Italiano de Buenos Aires. MATERIALS AND METHODS: Cross-sectional study nested within a dynamic cohort. All members of the Health Plan during the influenza vaccination campaigns of 2022 and 2023 were included. The influenza vaccination rate was calculated and reported as a percentage with its respective 95% confidence interval (CI95%). Demographic variables and comorbidities were analyzed. RESULTS: The influenza vaccination rate was 12% in 2022 and 10% in 2023. Subjects aged between 6 and 23 months had the highest vaccination rates in both periods, at 43% (CI95% 41-46) in 2022 and 48% (CI95% 45-51) in 2023, followed by the population over 65 years old with a rate of 23% (CI95% 23-24) in 2022 and 18% (CI95% 18-19) in 2023. The most common comorbidities were hypertension and dyslipidemia. DISCUSSION: Influenza vaccination coverage in our population fell below the recommendations of the World Health Organization, highlighting the presence of barriers to influenza immunization.
Introducción: La gripe es un grave problema global de salud pública. La vacunación antigripal es crucial para prevenir complicaciones. La Organización Mundial de la Salud recomienda un porcentaje de cobertura de al menos 75% para la población en riesgo. El objetivo de este estudio fue evaluar la cobertura de vacunación en los afiliados al Plan de Salud del Hospital Italiano de Buenos Aires. Materiales y métodos: Estudio de corte transversal anidado en una cohorte dinámica. Se incluyeron todos los afiliados al Plan de Salud durante las campañas de vacunación antigripal de 2022 y 2023. Se calculóla tasa de vacunación antigripal y se reportócomo porcentaje con su respectivo intervalo de confianza del 95% (IC95%). Se analizaron las variables demográficas y comorbilidades. Resultados: La tasa de vacunación antigripal fue de 12% en 2022 y de 10% en el 2023. Los sujetos entre 6 y 23 meses tuvieron las tasas de vacunación más alta en ambos periodos, siendo de 43% (IC95% 41-46) en 2022 y de 48% (IC95% 45-51) en 2023, seguido de la población mayor de 65 años con una tasa de 23% (IC95% 23-24) en 2022 y 18% (IC95% 18-19) en 2023. Las comorbilidades más frecuentes fueron la hipertensión y la dislipidemia. Discusión: La cobertura de vacunación antigripal en nuestra población se situópor debajo de las recomendaciones de la Organización Mundial de la Salud poniendo de manifiesto la presencia de barreras en la inmunización antigripal.
Subject(s)
Influenza Vaccines , Influenza, Human , Vaccination Coverage , Humans , Cross-Sectional Studies , Vaccination Coverage/statistics & numerical data , Male , Argentina/epidemiology , Female , Influenza Vaccines/administration & dosage , Aged , Middle Aged , Adult , Infant , Influenza, Human/prevention & control , Child, Preschool , Adolescent , Young Adult , ChildABSTRACT
INTRODUCTION: Diastolic function has a dynamic behavior according to modifying factors. We describe the variables used in its assessment by echocardiography in different population groups of men and women to determine whether changes can be predicted according to their risk factors. MATERIALS AND METHODS: Observational and descriptive cross-sectional registry. A systematic collection of anthropometric characteristics, risk factors and specific echocardiographic variables of diastolic function was performed in an outpatient echocardiography laboratory. Quantitative variables were expressed as mean and standard deviation for Gaussian distribution variables. Discrete variables were analyzed using contingency tables, qualitative variables are expressed as percentages. Means were compared using the Student t test. RESULTS: A total of 107 patients were admitted. Those with sedentary lifestyle had a mean left atrial volume of 29 ml/m2, a deceleration time of 218 ms, a transmittal flow ratio E/A (EA) of 1.5, tissue Doppler ratio Ee´ (Ee) of 6 and e´a´ (ea) of 1.4; those who performed physical activity 3 times a week were characterized by having a left atrial volume of 35 ml/m2, a deceleration time of 210 ms, EA of 1.8, Ee of 5 and ea of 1.8. Patients with obesity had a left atrial volume of 35 ml/m2, deceleration time of 226 ms, E/A 1.1, Ee of 9 and ea of 1.2. Those with arterial hypertension had a left atrial volume of 33 ml/m2, deceleration time of 224 ms and E/A ratio of 1, Ee of 8 and ea of 1. DISCUSSION: The inclusion of certain risk factors in the history prior to echocardiographic evaluation can predict subgroups with different diastolic function.
Introducción: La función diastólica tiene un comportamiento dinámico según factores modificantes. Describimos las variables utilizadas en su valoración por ecocardiografía en diferentes grupos poblacionales de hombres y mujeres, para determinar si pueden predecirse cambios acordes a sus factores de riesgo. Materiales y métodos: Registro transversal observacional y descriptivo. En laboratorio ambulatorio de ecocardiografía se efectuóla recolección sistemática de características antropométricas, factores de riesgo y variables ecocardiográficas específicas de función diastólica. Las variables cuantitativas se expresaron como media, y las de distribución gausiana como desviación estándar. Las variables discretas se analizaron por tablas de contingencia, las cualitativas se expresan como porcentaje. Se usóT de Student para comparar las medias. Resultados: Ingresaron 107 pacientes. Aquellos con sedentarismo presentaron volumen medio-auricularizquierdo: 29 ml/m2, tiempo de desaceleración: 218 ms, relación flujo transmitral E/A (EA): 1.5, relación Doppler tisular Ee´(Ee): 6, y e´a´ (ea): 1.4; quienes realizaban actividad física 3 veces/ semana tenían un volumen-auricularizquierdo de 35 ml/m2, tiempo de desaceleración de 210 ms, EA de 1.8, Ee de 5 y ea de 1.8. Los pacientes con obesidad presentaron un volumen-auricular-izquierdo de 35 ml/m2, tiempo de desaceleración de 226 ms, E/A 1.1, Ee: 9 y ea: 1.2. Quienes presentaban hipertensión arterial tenían un volumen-auricular-izquierdo de 33 ml/m2, tiempo de desaceleración 224 ms, relación E/A 1, Ee 8 y ea 1. Discusión: La inclusión de determinados factores de riesgo en la anamnesis previa a la valoración ecocardiográfica puede predecir subgrupos con función diastólica diferente.
Subject(s)
Diastole , Humans , Female , Male , Cross-Sectional Studies , Diastole/physiology , Middle Aged , Risk Factors , Aged , Echocardiography, Doppler , Heart Disease Risk Factors , Sedentary Behavior , Adult , Obesity/physiopathology , Obesity/complications , Echocardiography , Hypertension/physiopathology , Hypertension/diagnostic imagingABSTRACT
INTRODUCTION: Given the importance of reducing lowvalue care practices and acknowledging that vitamin D testing in the general population is rising despite the absence of evidence to support such conduct, we decided to investigate its overuse. MATERIALS AND METHODS: Design: cross-sectional study. DATA SOURCE: electronic medical records. POPULATION: patients aged between 18 and 64 on the Hospital Italiano de Buenos Aires Health Maintenance Organization membership list, to whom at least one test of vitamin D had been performed between July 1st and December 31st 2022. A sample of electronic medical records was manually analyzed. In the presence/suspicion of a clinical condition that counts with recommendation for Vitamin D testing, its indication was considered appropriate; however, in its absence, it was considered inappropriate. RESULTS: A total of 10 095 vitamin D tests were performed on 9623 patients (mean age 47, 78.1% female). These patients were 10% of the 97 584 HMO members aged between 18 and 64 in 2022. A hundred and sixty of the 242 patients whose electronic medical records were analyzed (66%, CI 95% 60 - 72), did not have a clinical condition that justified vitamin D testing. The most frequent clinical conditions found for testing were osteopenia in 37/242 patients (15%); osteoporosis, 13/242 (5%) and chronic kidney disease 11/242 (5%). DISCUSSION: Two-thirds of the vitamin D tests performed did not have a clinical condition that justified the practice. These findings represent an opportunity to design strategies to institutionally reduce this low-value care practice.
Introducción: Dada la importancia de reducir las prácticas de bajo valor y teniendo en cuenta que los dosajes séricos de vitamina D en la población general están aumentando, a pesar de la ausencia de evidencia que respalde dicha conducta, decidimos investigar su sobreúso. Materiales y métodos: Diseño: corte transversal. Fuente de datos: historia clínica electrónica. Población: pacientes de entre 18 y 64 años afiliados al plan de medicina prepaga del Hospital Italiano de Buenos Aires a quienes se les realizóal menos un dosaje de vitamina D en el segundo semestre de 2022. Se analizó manualmente una muestra de historias clínicas. Ante la presencia/sospecha de una condición clínica que contase con recomendación de dosaje de vitamina D, la indicación para realizarlo se consideróadecuada, mientras que ante su ausencia se consideróinapropiada. Resultados: Un total de 10 095 determinaciones de vitamina D fueron realizadas a 9623 pacientes (78% mujeres, edad media 47 años), quienes representan el 10% de la población (97 584). En 160 (66%, CI 95% 60-72) de los 242 pacientes cuyas historias clínicas fueron revisadas, no había documentada condición clínica que avalara la prueba. En 37/242 (15%) se constatóosteopenia como motivo de la determinación; en 13/242 (5%), osteoporosis y en 11/242 (5%), enfermedad renal crónica. Discusión: Dos tercios de las determinaciones de vitamina D pueden ser interpretadas como inapropiadamente indicadas. Estos datos representan una oportunidad para diseñar estrategias que reduzcan esta práctica de bajo valor a nivel institucional.