Admissions by tuberculosis in a regional reference Center. A complex and worrying scenario / Ingresos por tuberculosis en un hospital regional. Un escenario complejo y preocupante

OBJECTIVES: To characterize clinical aspects, evaluate the diagnostic opportunity, and identify factors associated with mortality in patients hospitalized for tuberculosis (TB). METHODS: Retrospective study of patients admitted for TB to a Regional Hospital in Chile between 2011 and 2019. RESULTS: 142 TB events required hospitalization in this period (38.2% of total cases). All risk groups were identified, with a significant increase in patients with diabetes mellitus. The pulmonary location was the most frequent (71.1%), followed by disseminated forms (16.2%). The sensitivity of microscopy smear in cases of pulmonary TB (isolated or combined) was 78.8% and lower in cases of bronchoalveolar lavage (58.3%). PCR was only occasionally applied (< 10%) with a sensitivity of 100% in sputum samples. Its use increased progressively and reached a positivity of 33% (6 out of 18 cases) in cases with negative sputum staining. The median time between symptom onset and diagnosis was prolonged (9 weeks), and 32.5% of all regional events were diagnosed at the hospital. Dose adjustments (22.1%), corticosteroid use (25%), and treatment interruptions were frequent (11%). Lethality reached 19%, and by multivariate analysis, only shock was associated with a fatal outcome. CONCLUSIONS: In this case series, the diagnosis of TB cases was delayed, scarcely diagnosed by molecular methods, highly concentrated at the hospital level, required admission in a large percentage of cases, and had a high case-fatality rate.

OBJETIVOS: Caracterizar aspectos clínicos, evaluar la oportunidad diagnóstica e identificar factores asociados a mortalidad en pacientes ingresados por tuberculosis (TB). MÉTODOS: Estudio retrospectivo de pacientes ingresados por TB a un Hospital Regional en Chile entre el 2011 y 2019. RESULTADOS: Un total de 142 eventos de TB requirieron hospitalización en el período (38,2% del total). Todos los grupos de riesgo fueron identificados con un aumento significativo de los pacientes con diabetes mellitus. La localización pulmonar fue la más frecuente (71,1%), seguida de la forma diseminada (2 o más sitios; 16,2%). La sensibilidad de la tinción de expectoración en casos de TB pulmonar (aislada o combinada) fue de 78,8% y más baja en casos de lavado broncoalveolar (58,3%). La PCR fue sólo ocasionalmente aplicada (< 10%) con una sensibilidad del 100% en muestras de expectoración. Su uso aumentó progresivamente en el período y el incremento diagnóstico de TB en casos con tinción negativa de expectoración estudiados con PCR fue de 33% (6 de 18 casos). La mediana entre inicio de síntomas y el diagnóstico fue prolongada (9 semanas) y el 32,5% de los eventos regionales fueron diagnosticados en el hospital. Los ajustes de dosis (22,1%), uso de corticoides (25%) e interrupciones del tratamiento fueron hechos frecuentes (11%). La letalidad alcanzó 19% y en el análisis multivariado sólo la aparición de shock se asoció a un desenlace fatal. CONCLUSIONES: En esta serie de casos, el diagnóstico de casos de TB fue tardío, infrecuentemente diagnosticado por métodos moleculares, concentrado en la atención terciaria, requirió hospitalización en un gran porcentaje de casos y tuvo una elevada letalidad.

Admissions by tuberculosis in a regional reference Center. A complex and worrying scenario.

OBJECTIVES: To characterize clinical aspects, evaluate the diagnostic opportunity, and identify factors associated with mortality in patients hospitalized for tuberculosis (TB). METHODS: Retrospective study of patients admitted for TB to a Regional Hospital in Chile between 2011 and 2019. RESULTS: 142 TB events required hospitalization in this period (38.2% of total cases). All risk groups were identified, with a significant increase in patients with diabetes mellitus. The pulmonary location was the most frequent (71.1%), followed by disseminated forms (16.2%). The sensitivity of microscopy smear in cases of pulmonary TB (isolated or combined) was 78.8% and lower in cases of bronchoalveolar lavage (58.3%). PCR was only occasionally applied (< 10%) with a sensitivity of 100% in sputum samples. Its use increased progressively and reached a positivity of 33% (6 out of 18 cases) in cases with negative sputum staining. The median time between symptom onset and diagnosis was prolonged (9 weeks), and 32.5% of all regional events were diagnosed at the hospital. Dose adjustments (22.1%), corticosteroid use (25%), and treatment interruptions were frequent (11%). Lethality reached 19%, and by multivariate analysis, only shock was associated with a fatal outcome. CONCLUSIONS: In this case series, the diagnosis of TB cases was delayed, scarcely diagnosed by molecular methods, highly concentrated at the hospital level, required admission in a large percentage of cases, and had a high case-fatality rate.

Conocimiento en VIH/SIDA y comportamiento sexual en estudiantes de la Universidad Nacional de la Amazonía Peruana, Iquitos 2009 / HIV/AIDS knowledge and sexual behaviour in students of the peruvian amazon national university, Iquitos 2009

El presente estudio trata de determinar la relación entre el nivel de conocimiento y comportamiento sexual en estudiantes del primer nivel de las trece facultades de la Universidad Nacional de la Amazonía Peruana de la ciudad de Iquitos, durante el periodo 2009, cuyo alcance es llevar a la práctica estrategias preventivas. El tipo de estudio es descriptivo correlacional realizado en una muestra de 286 estudiantes. Para el efecto de la recolección de datos se seleccionaron como técnicas la encuesta y el test, y como instrumentos el cuestionario de conocimiento y el test tipo Likert. Los resultados muestran: 62,6% evidencian adecuados conocimientos sobre VIH/sida y 37,4% inadecuado conocimiento. El 61,8% del grupo de mujeres refiere tener conducta sexual de bajo riesgo y el 76% del grupo de varones también refiere la misma conducta; pero 11,7% y 15,3% tanto en mujeres como en varones, respectivamente, refieren tener una conducta sexual de alto riesgo. En cuanto a comportamiento social, el 69,2% evidencia inadecuado conocimiento sobre VIH/sida y refiere conducta sexual de alto riego: el 64,1% evidencia adecuado conocimiento sobre VIH/sida y refiere conducta sexual de bajo riesgo y el 81,6% evidencia adecuado conocimiento sobre VIH/sida y refiere conductua sexual sin riesgo. Se aplico la prueba χ², obteniendo χ²c = 24,657, p= ,000, que nos permite aceptar la hipótesis planteada.

The objective of the research was to determine the relation between the level of knowledge and sexual behavior in students of the first level of the 13 faculties of the Peruvian Amazon National University in the city of Iquitos during the period of 2009. The research tries to put into practice preventive stragies. The research is a co relational descriptive one, carried out in a sample of 286 students. For the collection of data the opinion poll and test were selected as techniques of research, and as instruments: questionnaire of knowledge. In 62,6% the exists knowledge on HIV/IADS and in 37,4% poor knowledge. In 61,8% of women there exists low risk and, in 76% of men there exists the same attitude. In 11,8% and 15,3% of women and men there is high risk sexual behavior, in 64,1% there is HIV/AIDS knowledge and low risk sexual behavior, and in 81,6% there is sufficient HIV/AIDS knowledge and no risk sexual behavior. The x2 test was applied having as result x2c 24,657, p=,000 allowing the hypothesis being accepted.

Efeito do congelamento nas características físicas e químicas do pão de queijo / Effect of freezing on the physical and chemical characteristics of cheese bread

A qualidade do pão de queijo está diretamente ligada à matéria-prima utilizada, a preparação da massa, ao congelamento e ao assamento, sendo que falhas nestes processos podem resultar em um produto de baixa aceitação no mercado, tanto nacional quanto internacional. O presente trabalho foi desenvolvido no Departamento de Ciência dos Alimentos da Universidade Federal de Lavras, Minas Gerais e objetivou acompanhar as características físico-químicas da massa e do pão de queijo, durante um período de 120 dias de congelamento. Observou-se para a massa modelada de pão de queijo um menor valor de umidade na massa fresca; os teores de cinzas, extrato etéreo e pH decresceram com o congelamento; já o conteúdo de acidez titulável aumentou durante o período. Com relação aos pães de queijo, verificou-se que os valores de umidade e cinzas não apresentaram variação durante o período; o teor de pH apresentou variações durante todo o congelamento, com menores valores ao final de 120 dias; o conteúdo lipídico apresentou decréscimo em todo o período e a acidez titulável decresceu até próximo aos 60 dias, com posterior aumento até o final do congelamento. O armazenamento congelado também levou a um aumento na força de compressão, ou seja, a uma maior firmeza dos pães de queijo.

The quality of cheese bread is directly linked to the raw material used, the preparation of the dough, freezing, and baking. Fail in these processes may result in a product of low acceptance in the national and international market. The present research was carried out at the Food Science Department of the Universidade Federal de Lavras, Minas Gerais with the aim to accompany the physical and chemical characteristics of the dough and cheese bread, during a period of 120 days of freezing. The modeled dough of cheese bread presented lower moisture content value in the fresh dough; the ash content, ethereal extract and pH decreased with freezing however, the acidity increased during this period. In relation to the cheese bread it was verified that the moisture content and ash values did not present variation during the period; the pH presented variations during the freezing, with smaller values at the end of 120 days; the lipid content decreased with the freezing, and the acidity decreased until approximately the 60th day, with subsequent increase until the end of the freezing. The frozen storage also led to an increase in the compression force, that is, a larger firmness of the cheese breads.

Estudo comparativo dentre os métodos de laboratório Hoffmann e direto na prevalência de parasitos intestinais / Comparative study between the Hoffmann and direct laboratory methods in the prevalence of intestinal parasites

Examinaram-se 100 amostras e fezes pelos métodos de Hoffmann e Direto constataram-se maior prevalência de parasitos intestinais (60% de helmintos e 49% de protozoários) pelo método de Hoffmann, enquanto que o método Direto apresentou positividade de 52% para helmintos e 64% para protozoários

Prevalência dos parasitos intestinais nos moradores da favela do bairro dos Ipês em Joäo Pessoa / Prevalence of intestinal parasite in inhabitants of Ipês district in Joäo Pessoa

Apresenta-se um estudo sobre a prevalência dos parasitos intestinais nos habitantes da favela do bairro dos Ipês, pessoas de baixo nível sócio-econômico e sem saneamento básico. Foi elaborado pelos alunos do curso de Medicina e monitores da disciplina Parasitologia supervisionados por professores no período de janeiro a julho de 1986. Foram obtidas 100 amostras para exame de fezes, com resultados de maior prevalência para Ascaris lumbricoides, Trichocephalus thichiurus, Hymenolepis nana, Entamoeba histolytica, Endolimax nana, Entamoeba coli e Giardia lamblia