Pediatric COVID-19 in Argentina: a comprehensive analysis of disease and economic burden through official data and a systematic literature review.

Background: Limited data are available on the clinical impact and economic burden of COVID-19 in the pediatric population in Argentina. We aimed to estimate the disease and economic burden of COVID-19 on children and adolescents. Methods: We analyzed official national databases and conducted a supplemental systematic review of the published literature with meta-analysis in children aged 0-18. The period of interest was from March 2020 to August 2021, before the introduction of vaccination in this age group as a national strategic plan. In addition, we used a cost of illness analysis to estimate the direct medical costs associated with COVID-19. All costs are reported in US dollars 2023. Results: A total of 450,503 confirmed COVID-19 cases and 180 multisystem inflammatory syndrome (MIS-C) were reported in Argentina in the study period. Fourteen observational clinical studies were identified. The meta-analyses of severity level from hospital patients showed that according to different studies 15%-28% of cases were asymptomatic, 68%-88% were mild or moderate, and 3%-10% were severe or critical. About 28% of children had an underlying disease. In addition, the estimated economic burden associated with COVID-19 was 80 million dollars and 4 million dollars corresponded to MISC. Conclusion: Significant impact of COVID-19 on the healthcare system and substantial economic implications for the pediatric population in Argentina were identified. The findings should help policymakers to make informed decisions and allocate resources effectively.

Liraglutide effectiveness in preoperative weight-loss for patients with severe obesity undergoing bariatric-metabolic surgery.

Preoperative management of patients living with severe obesity can be challenging; in this context, the preoperative weight loss may help to obtain better outcomes and less morbidity for bariatric surgery. Therefore, we evaluated the effectiveness of GLP-1 analogue Liraglutide in preoperative weight loss. We performed a single-center, quasi-experimental prospective study. Eligible participants were adults in preoperative management for bariatric-metabolic surgery with body-mass index ≥ 48 kg/m2. All patients were assigned liraglutide treatment, with an initial dose of 0.6 mg subcutaneous per day, the dose was increased each week until reaching 3.0 mg for 12 weeks. Weight loss and body composition were evaluated monthly using bioelectric impedance (BIA) (InBody 770 Scale®). We analyzed data using descriptive statistics, central tendency measures and dispersion for quantitative variables and absolute and relative frequencies for qualitative variables. A total of 37 individuals were included in this study, 28 (76%) were female and 9 (24%) were males, with an average age of 44 years. About the BMI, 19 patients (51%) had a BMI > 50 kg/m2, 10 (27%) > 40 kg/m2 and 8 (22%) > 60 kg/m2; with a total average BMI of 56.04 kg/m2. The initial weight was 147.4 ± 14.9 kg which decreased to 139.3 ± 16.8 kg; after 3 months of liraglutide administration. A total of 35 patients had some degree of weight loss (94.6%), while 2 (5.40%) had no weight changes. The total weight loss was 5.50% at 3 months of liraglutide treatment. Liraglutide could be an effective adjuvant therapy for preoperative weight loss in patients living with severe obesity.

Risk of Diabetes Mellitus in systemic lupus erythematosus: systematic review and meta-analysis.

OBJECTIVE: To investigate the risk of DM and evaluate the impact of SLE therapies on the risk of developing DM in patients with SLE. METHODS: Electronic database searches of PubMed, Embase, Cochrane Library, and Web of Science were performed from inception to February 2023. Cohort and cross-sectional studies that analyzed the risk of DM in patients with SLE were included. The associations between diabetes and antirheumatic agents, such as antimalarials and glucocorticoids, were analyzed in cohort studies. Data were pooled using fixed- or random-effects meta-analysis to estimate pooled odd ratios (OR), relative risks (RR), and 95% confidence intervals (CIs). This study was registered with PROSPERO (CRD42023402774). RESULTS: A total of 37 studies (23 cross-sectional and 14 cohort studies) involving 266 537 patients with SLE were included. The pooled analyses from cross-sectional studies and cohort studies did not show an increased risk of DM in SLE patients (OR = 1.05, 95% CI 0.87-1.27; p = 0.63 and RR = 1.32, 95% CI 0.93-1.87; p= 0.12, respectively). However, several cohort studies consistently demonstrated a reduced risk of diabetes with antimalarials, while glucocorticoid use has been associated with an increased risk of developing diabetes. Age, sex, hypertension, and immunosuppressants have not been identified as risk factors for DM in SLE patients. CONCLUSIONS: Although there was no increased risk of DM in patients with SLE compared with controls, HCQ users or adherents had a decreased risk, whereas glucocorticoid users had an increased risk.

Duration of SARS-CoV-2 shedding: A systematic review.

Background: Positive viral severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) cultures indicate shedding of infectious virus and corresponding transmission risk of coronavirus disease 2019 (COVID-19). The research question of this systematic review was: Is there a discernible pattern in the timing of SARS-CoV-2 virus isolation, and what is the proportion of positive and negative results for isolation of SARS-CoV-2 virus with viral culture relative to the onset of clinical symptoms or the day of diagnosis, as indicated by longitudinal studies? Methods: We systematically searched PubMed and Embase from inception to 16 February 2023 for English-language studies with serial viral culture testing within symptomatic or asymptomatic SARS-CoV-2 infected persons during the post-vaccination period. Outcomes of interest were the daily culture status per study and the overall daily culture positivity rate of SARS-CoV-2. We critically appraised the selected studies using the Newcastle-Ottawa quality assessment scale. Results: We included 14 viral shedding studies in this systematic review. Positive viral SARS-CoV-2 cultures were detected in samples ranging from 4 days before to 18 days after symptom onset. The daily culture SARS-CoV-2 positivity rate since symptom onset or diagnosis showed a steep decline between day 5 and 9, starting with a peak ranging from 44% to 50% on days -1 to 5, decreasing to 28% on day 7 and 11% on day 9, and finally ranging between 0% and 8% on days 10-17. Conclusions: Viral shedding peaked within 5 days since symptom onset or diagnosis and the culture positivity rate rapidly declined hereafter. This systematic review provides an overview of current evidence on the daily SARS-CoV-2 culture positivity rates during the post-vaccination period. These findings could be used to estimate the effectiveness of public health control measures, including treatment and preventive strategies, to reduce the spread of COVID-19.

Frecuencia de enfermedades periodontales y características clínicas de pacientes atendidos en la Cátedra de Periodoncia de la Universidad Autónoma de Asunción

Las enfermedades periodontales son consideradas entre las más comunes entre las patologías bucales. Su frecuencia es cada vez más elevada en la población y existen varias patologías sistémicas y hábitos que empeoran su cuadro clínico. El objetivo de este trabajo fue determinar la frecuencia y características clínicas de pacientes con enfermedades periodontales que acuden a la cátedra de periodoncia en la Universidad Autónoma de Asunción en el período de 2011 al 2019. Estudio Observacional, descriptivo, retrospectivo, se procesaron 477 fichas clínicas de pacientes de la cátedra de Periodoncia de la Universidad Autónoma de Asunción desde el año 2011 al 2019. El tipo de muestreo utilizado fue no probabilístico por conveniencia. De las 477 fichas solo se analizaron 317 pacientes que cumplieron con los criterios de inclusión. Fueron el 56.46 % de sexo femenino y 43,53 % de sexo masculino, la mediana de edad fue de 33 (23-48) años. El 53% los pacientes presentaban periodontitis crónica y comorbilidades como diabetes e hipertensión arterial. Solo el 11,9 % fueron fumadores. En cuanto a los pacientes diabéticos la mayoría eran de sexo femenino y de edad avanzada, presentando como diagnóstico más frecuente la periodontitis crónica. El diagnóstico clínico más frecuente de la población estudiada fue la periodontitis crónica, seguido por la gingivitis.

Periodontal diseases are considered among the most common among oral pathologies. Its frequency is increasingly higher in the population and there are several systemic pathologies and habits that worsen its clinical condition. The objective of this work was to determine the frequency and clinical characteristics of patients with periodontal diseases who attend the periodontics department at the Autonomous University of Asunción in the period from 2011 to 2019. Observational, descriptive, retrospective study, 477 clinical records were processed. of patients from the Department of Periodontics at the Autonomous University of Asunción from 2011 to 2019. The type of sampling used was non-probabilistic for convenience. Of the 477 records, only 317 patients who met the inclusion criteria were analyzed. They were 56.46% female and 43.53% male, the median age was 33 (23-48) years. 53% of the patients had chronic periodontitis and comorbidities such as diabetes and high blood pressure. Only 11.9% were smokers. Regarding diabetic patients, the majority were female and elderly, with chronic periodontitis as the most frequent diagnosis. The most frequent clinical diagnosis of the studied population was chronic periodontitis, followed by gingivitis.

Modelling the Potential Public Health Impact of Different COVID-19 Vaccination Strategies with an Adapted Vaccine in Singapore.

BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causing COVID-19 has been a dynamically changing virus, requiring the development of adapted vaccines. This study estimated the potential public health impact alternative vaccination strategies for COVID-19 in Singapore. RESEARCH DESIGN AND METHODS: The outcomes of alternative vaccination strategies with a future adapted vaccine were estimated using a combined Markov decision tree model. The population was stratified by high- and standard-risk. Using age-specific inputs informed by local surveillance data and published sources, the model estimated health (case numbers, hospitalizations, and deaths) and economic (medical costs and productivity losses) outcomes in different age and risk subpopulations. RESULTS: Booster vaccination in only the elderly and high-risk subpopulation was estimated to avert 278,614 cases 21,558 hospitalizations, 239 deaths, Singapore dollars (SGD) 277 million in direct medical costs, and SGD 684 million in indirect medical costs. These benefits increased as vaccination was expanded to other subpopulations. Increasing the booster vaccination coverage to 75% of the standard-risk population averted more deaths (3%), hospitalizations (29%), infections (145%), direct costs (90%), and indirect costs (192%) compared to the base case. CONCLUSIONS: Broader vaccination strategies using an adapted booster vaccine could have substantial public health and economic impact in Singapore.

Modelling the potential public health impact of different vaccination strategies with an omicron-adapted bivalent vaccine in Thailand.

BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causing COVID-19 has continuously evolved, requiring the development of adapted vaccines. This study estimated the impact of the introduction and increased coverage of an Omicron-adapted bivalent booster vaccine in Thailand. RESEARCH DESIGN AND METHODS: The outcomes of booster vaccination with an Omicron-adapted bivalent vaccine versus no booster vaccination were estimated using a combined cohort Markov decision tree model. The population was stratified into high- and standard-risk subpopulations. Using age-specific inputs informed by published sources, the model estimated health (case numbers, hospitalizations, and deaths) and economic (medical costs and productivity losses) outcomes in different age and risk subpopulations. RESULTS: Booster vaccination in only the elderly and high-risk subpopulation was estimated to avert 97,596 cases 36,578 hospitalizations, 903 deaths, THB 3,119 million in direct medical costs, and THB 10,589 million in indirect medical costs. These benefits increased as vaccination was expanded to other subpopulations. Increasing the booster vaccination coverage to 75% of the standard-risk population averted more deaths (95%), hospitalizations (512%), infections (782%), direct costs (550%), and indirect costs (687%) compared to the base case. CONCLUSIONS: Broader vaccination with an Omicron-adapted bivalent booster vaccine could have significant public health and economic benefits in Thailand.

Impact of vaccination and non-pharmacological interventions on COVID-19: a review of simulation modeling studies in Asia.

Introduction: Epidemiological modeling is widely used to offer insights into the COVID-19 pandemic situation in Asia. We reviewed published computational (mathematical/simulation) models conducted in Asia that assessed impacts of pharmacological and non-pharmacological interventions against COVID-19 and their implications for vaccination strategy. Methods: A search of the PubMed database for peer-reviewed, published, and accessible articles in English was performed up to November 2022 to capture studies in Asian populations based on computational modeling of outcomes in the COVID-19 pandemic. Extracted data included model type (mechanistic compartmental/agent-based, statistical, both), intervention type (pharmacological, non-pharmacological), and procedures for parameterizing age. Findings are summarized with descriptive statistics and discussed in terms of the evolving COVID-19 situation. Results: The literature search identified 378 results, of which 59 met criteria for data extraction. China, Japan, and South Korea accounted for approximately half of studies, with fewer from South and South-East Asia. Mechanistic models were most common, either compartmental (61.0%), agent-based (1.7%), or combination (18.6%) models. Statistical modeling was applied less frequently (11.9%). Pharmacological interventions were examined in 59.3% of studies, and most considered vaccination, except one study of an antiviral treatment. Non-pharmacological interventions were also considered in 84.7% of studies. Infection, hospitalization, and mortality were outcomes in 91.5%, 30.5%, and 30.5% of studies, respectively. Approximately a third of studies accounted for age, including 10 that also examined mortality. Four of these studies emphasized benefits in terms of mortality from prioritizing older adults for vaccination under conditions of a limited supply; however, one study noted potential benefits to infection rates from early vaccination of younger adults. Few studies (5.1%) considered the impact of vaccination among children. Conclusion: Early in the COVID-19 pandemic, non-pharmacological interventions helped to mitigate the health burden of COVID-19; however, modeling indicates that high population coverage of effective vaccines will complement and reduce reliance on such interventions. Thus, increasing and maintaining immunity levels in populations through regular booster shots, particularly among at-risk and vulnerable groups, including older adults, might help to protect public health. Future modeling efforts should consider new vaccines and alternative therapies alongside an evolving virus in populations with varied vaccination histories.

Utilidad del ultrasonido para el diagnóstico de enfermedad pulmonar intersticial en enfermedades difusas del tejido conectivo / Ultrasound for diagnosis of interstitial lung disease in diffuse connective tissue diseases

Las enfermedades difusas del tejido conectivo con frecuencia desarrollan enfermedad pulmonar intersticial, lo que conlleva peor pronóstico y acorta la supervivencia. La tomografía axial computarizada de alta resolución es la prueba diagnóstica de elección, ya que esta es muy competitiva con la histopatología; sin embargo, el costo y la radiación pueden limitar su empleo, particularmente como escrutinio. El ultrasonido pulmonar, estudio rápido, de acceso fácil, reproducible y de menor costo, resulta muy atractivo para determinar la existencia de enfermedad pulmonar intersticial. Adicionalmente, se requiere de poca experiencia para determinar las alteraciones correlacionables con estos padecimientos pulmonares. Las líneas B y las irregularidades pleurales conforman el denominado síndrome intersticial ultrasonográfico, aunque debemos tener en mente que no es específico y estamos obligados a considerar anormalidades hemodinámicas, cardiovasculares e infecciosas. En esta revisión, exponemos la alta prevalencia de esta enfermedad pulmonar en los principales padecimientos reumatológicos, con énfasis en la utilidad del ultrasonido pulmonar, su facilidad de realización y alto desempeño diagnóstico. (AU)

Patients with diffuse connective tissue diseases frequently develop interstitial lung disease, which carries a worse prognosis and shortens survival. High-resolution computed tomography is the first-choice test, and is competitive with histopathology, however, the cost and radiation may limit its use, particularly for screening. Lung ultrasound is a rapid, accessible, reproducible, and inexpensive study that is useful for diagnosis of interstitial lung disease. Furthermore, extensive training is not required to identify the alterations associated with these lung diseases. B lines and pleural irregularities compose the ultrasonographic interstitial syndrome, although it must be kept in mind that it is not specific, and it is necessary to rule out haemodynamic, cardiovascular, and infectious abnormalities. This review highlights the elevated prevalence of this lung condition in the main rheumatological diseases, with emphasis on the usefulness of pulmonary ultrasound. (AU)

Burden of COVID-19 during the omicron predominance in Brazil: a nationwide retrospective database study.

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has imposed significant burden on Brazil's health system. This study aimed to examine clinical characteristics, overall vaccine uptake, and to assess healthcare resource utilization (HCRU) and costs associated with acute COVID-19 in Brazil during the Omicron predominant period. METHODS: A nationwide retrospective study was conducted using various Brazilian databases including, COVID-19 related databases, public health systems, and other surveillance/demographic datasets. Individuals with positive COVID-19 test results between January 1 2022 and April 30 2022, during Omicron BA.1/BA.2 wave, were identified. Patients' demographics, vaccine uptake, HCRU and corresponding costs were described by age groups. RESULTS: A total of 8,160,715 (3.80%) COVID-19 cases were identified in the study cohort, ranging from 2.43% in <5 years to 62.05% in 19-49 years. The uptake of partial (Dose 1) or full immunization (Dose 2) was less than 0.1% in children aged <5 years, whereas in individuals ≥ 19 years, it exceeded 89.78% for Dose 1 and 84.07% for Dose 2. Overall booster vaccine uptake was 38.06%, which was significantly higher among individuals aged ≥ 65 years, surpassing 74.79%. Regardless of vaccination status, 87.2% cases were symptomatic, and 1.48% were hospitalized due to acute COVID-19 (<5 years: 2.33%, 5-11 years: 0.99%, 12-18 years: 0.32%, 19-49 years: 0.40%; 50-64 years: 1.50%, 65-74 years: 5.43%, and ≥ 75 years: 17.89%). Among the hospitalized patients (n = 120,450), 32.57% were admitted to ICU, of whom 31,283 (79.75%) individuals required mechanical ventilation (MV) support. The average cost per day in normal ward and ICU without MV in public/general hospital settings was $104.36 and $302.81, respectively. While average cost per day in normal ward and ICU with MV was $75.91 and $301.22 respectively. CONCLUSIONS: This study quantified the burden of COVID-19 in Brazil, suggesting substantial healthcare resources required to manage the COVID-19 pandemic.

Modeling the potential public health impact of different vaccination strategies with an omicron-adapted bivalent vaccine in Malaysia.

BACKGROUND: Coronavirus disease 2019 (COVID-19) case numbers have increased following the emergence of the Omicron variant. This study estimated the impact of introducing and increasing the coverage of an Omicron-adapted bivalent booster vaccine in Malaysia. RESEARCH DESIGN AND METHODS: A combined cohort Markov decision tree model was used to compare booster vaccination with an Omicron-adapted bivalent COVID-19 vaccine versus no booster vaccination in Malaysia. The model utilized age-specific data from January 2021 to March 2022 derived from published sources. The outcomes of interest included case numbers, hospitalizations, deaths, medical costs, and productivity losses. The population was stratified into high-risk and standard-risk subpopulations, and the study evaluated the benefits of increased coverage in different age and risk groups. RESULTS: Vaccinating only high-risk individuals and those aged ≥ 65 years was estimated to avert 274,313 cases, 33229 hospitalizations, 2,434 deaths, Malaysian ringgit (MYR) 576 million in direct medical costs, and MYR 579 million in indirect costs. Expanding vaccination coverage in the standard-risk population to 75% was estimated to avert more deaths (31%), hospitalizations (155%), infections (206%), direct costs (206%), and indirect costs (281%). CONCLUSIONS: These findings support broader population Omicron-adapted bivalent booster vaccination in Malaysia with potential for significant health and economic gains.

Late Diagnosis at Entry on Care in an HIV Clinic in Mexico City: Possibly COVID-19 Pandemic Impact.

BACKGROUND: HIV late-stage diagnoses have an important impact on mortality. Unfortunately, a significant number of patients are still diagnosed at late stages. On the other hand, the coronavirus disease 2019 (COVID-19) pandemic has created an unprecedented crisis in healthcare systems worldwide, including HIV care services. The aim of this study was to compare time-trends in HIV late diagnosis, prevalence, and initial CD4 cell counts of newly diagnosed HIV-positive individuals at the entry to HIV care in a General Hospital in Mexico City and to assess the Covid-19 pandemic possible effects on late diagnosis prevalence. METHODS: We retrospectively analyzed the data of HIV-infected patients (January 1999 to December 2021) to assess the prevalence of Late presentation (LP, CD4 count < 350 cells/mm3) and presentation with advanced HIV disease (AHIVD CD4 count < 200 cells/mm3). Differences across time were evaluated, focusing on years of the Covid-19 pandemic. RESULTS: We included 348 newly diagnosed HIV-positive individuals, of which 255 (73.2%) patients entered into care with LP, and 158 (45.4%) were on AHIVD. The proportion of patients with LP and AHIVD decreased significantly across the study period. Nevertheless, we found an increase in this proportion in the years 2020 (70% and 53%) and 2021 (86% and 68%). CONCLUSION: Despite the progressive decrease in late diagnosis prevalence in our population, it remains high. Even more, our results documented a possible increase in the prevalence of late diagnosis associated with the COVID-19 pandemic. These findings highlight the need to prioritize interventions to evaluate and reverse pandemic effects on people living with HIV care.

Phase transitions and topological defects in discotic liquid crystal droplets with planar anchoring: a Monte Carlo simulation study.

In this work we present the results of Monte Carlo (MC) simulations at the isothermal-isobaric ensemble for a discotic liquid crystal (DLC) droplet whose surface promotes edge-on (planar) anchoring. For a given pressure, we simulate an annealing process that enables observation of phase transitions within the spherical droplet. In particular, we report a first order isotropic-nematic transition as well as a nematic-columnar transition at the center of the droplet. We found the appearance of topological defects consisting of two disclination lines with ends at the surface of the sphere. We also observed that both transitions, isotropic-nematic and nematic-columnar, occur at lower temperatures as compared to the unconfined system.

Ipconazole Induces Oxidative Stress, Cell Death, and Proinflammation in SH-SY5Y Cells.

Ipconazole is an antifungal agrochemical widely used in agriculture against seed diseases of rice, vegetables, and other crops; due to its easy accumulation in the environment, it poses a hazard to human, animal, and environmental health. Therefore, we investigated the cytotoxic effect of ipconazole on SH-SY5Y neuroblastoma cells using cell viability tests (MTT), ROS production, caspase3/7 activity, and molecular assays of the biomarkers of cell death (Bax, Casp3, APAF1, BNIP3, and Bcl2); inflammasome (NLRP3, Casp1, and IL1ß); inflammation (NFκB, TNFα, and IL6); and antioxidants (NRF2, SOD, and GPx). SH-SY5Y cells were exposed to ipconazole (1, 5, 10, 20, 50, and 100 µM) for 24 h. The ipconazole, in a dose-dependent manner, reduced cell viability and produced an IC50 of 32.3 µM; it also produced an increase in ROS production and caspase3/7 enzyme activity in SH-SY5Y cells. In addition, ipconazole at 50 µM induced an overexpression of Bax, Casp3, APAF1, and BNIP3 (cell death genes); NLRP3, Casp1, and IL1B (inflammasome complex genes); and NFκB, TNFα, and IL6 (inflammation genes); it also reduced the expression of NRF2, SOD, and GPx (antioxidant genes). Our results show that ipconazole produces cytotoxic effects by reducing cell viability, generating oxidative stress, and inducing cell death in SH-SY5Y cells, so ipconazole exposure should be considered as a factor in the presentation of neurotoxicity or neurodegeneration.

Frecuencia de Bacilos Gram Negativos en la cavidad bucal de estudiantes de una Universidad de Asunción

Introducción: La cavidad bucal hospeda una gran cantidad de microorganismos, como los bacilos Gram negativos, y entre ellas, bacterias de gran importancia médica debido a su capacidad de producir enfermedades graves para el ser humano, especialmente en pacientes inmunodeprimidos. El objetivo de este trabajo fue determinar la presencia de Bacilos Gram Negativos y sus patrones de resistencia a antibióticos, en una población estudiantil de la ciudad de Asunción, en los años 2019 y 2020. Materiales y métodos: Se realizó un estudio observacional, descriptivo de corte transversal, donde se realizaron hisopados de la cavidad bucal a 35 alumnos de entre 18 a 24 años, de una universidad privada en la ciudad de Asunción. Se requirió consentimiento informado firmado por los participantes y fueron excluidos quienes tuvieron tratamientos antibióticos. Las muestras fueron obtenidas con un hisopo de algodón, posteriormente se colocaron en un medio de transporte para luego ser cultivadas en Agar MacConkey. El cultivo se realizó por 48 horas a 37° centígrados, luego se procedió a la identificación bacteriana. Por último, se realizó el antibiograma. Resultados: De los 35 alumnos se encontró una frecuencia de 48,57% de bacilos Gram negativos. Cepas de Klebsiella pneumoniae fueron las más frecuentes (35,29%). Se observó que las bacterias eran altamente resistentes a la Amoxicilina/Ácido Clavulánico. Conclusiones: La presencia de estos tipos de microorganismos puede ser peligrosa para la salud general de las personas, específicamente de los pacientes con algún tipo de inmunodepresión, debido a la gran la resistencia a antibióticos presentadas por algunas cepas.

Introduction: The oral cavity hosts a large number of microorganisms, such as Gram negative bacilli, and among them, bacteria of great medical importance due to their capacity to cause serious diseases for humans, especially in immunosuppressed patients. The objective of this work was to determine the presence of Gram Negative Bacilli and their patterns of resistance to antibiotics, in a student population of the city of Asunción, in the years 2019 and 2020. Materials and methods: An observational, descriptive cross-sectional study was carried out, where oral cavity swabs were made from 35 students between 18 and 24 years of age, from a private university in the city of Asunción. Informed consent signed by the participants was required and those who had antibiotic treatments were excluded. The samples were obtained with a cotton swab, later they were placed in a transport medium to later be cultured in MacConkey Agar. The culture was carried out for 48 hours at 37° Celsius, then the bacterial identification was carried out. Finally, the antibiogram was performed. Results: Of the 35 students, a frequency of 48,57% of Gram negative bacilli was found. Klebsiella pneumoniae strains were the most frequent (35.29%). The bacteria were found to be highly resistant to Amoxicillin/Clavulanic Acid. Conclusions: The presence of these types of microorganisms can be dangerous for the general health of people, specifically of patients with some type of immunosuppression, due to the great resistance to antibiotics presented by some strains.

Ultrasound for diagnosis of interstitial lung disease in diffuse connective tissue diseases.

Patients with diffuse connective tissue diseases frequently develop interstitial lung disease, which carries a worse prognosis and shortens survival. High-resolution computed tomography is the first-choice test, and is competitive with histopathology, however, the cost and radiation may limit its use, particularly for screening. Lung ultrasound is a rapid, accessible, reproducible, and inexpensive study that is useful for diagnosis of interstitial lung disease. Furthermore, extensive training is not required to identify the alterations associated with these lung diseases. B lines and pleural irregularities compose the ultrasonographic interstitial syndrome, although, it must be kept in mind that it is not specific, and it is necessary to rule out haemodynamic, cardiovascular, and infectious abnormalities. This review highlights the elevated prevalence of this lung condition in the main rheumatological diseases, with emphasis on the usefulness of pulmonary ultrasound.

Langer's arch in axillary dissections from patients with breast cancer: a retrospective study.

PURPOSE: The study aimed to assess the frequency of Langer's arch in patients undergoing axillary dissection for breast cancer. METHODS: From January-2015 to March-2020, in a general hospital in México City, female patients undergoing axillary dissection for breast cancer were studied. The analysis involved: demographic and anthropometric data, type of surgical treatment, histopathologic diagnosis, number of lymph nodes harvested, and frequency of Langer's arch finding. RESULTS: The sample studied was 123 axillary dissections. The mean age of the patients was 59 ± 10.5-years. Modified radical mastectomy was done in 117 cases (95.1%). Ductal carcinoma occurred in 96 cases (78%). The mean number of lymph nodes harvested was 24 ± 6.5. Langer's arch finding occurred in 33 cases (26.8%). CONCLUSION: Langer's arch is frequent in our patients undergoing axillary dissection for breast cancer.

Propiedades psicométricas del cuestionario de actitudes hacia la práctica de actividad físico-deportiva orientada a la salud en adolescentes peruanos / Propriedades psicométricas do Questionário de Atitudes em relação à Prática da Actividade Físico-Sportiva Orientada para a Saúde em adolescentes peruanos / Psychometric properties of the Questionnaire of Attitudes towards the Practice of Health-Oriented Physical-Sports Activity in Peruvian adolescents

Las actitudes predicen el compromiso hacia la práctica de actividad físico-deportiva. Cuanto más se conozcan, mejor será la predicción de los posibles hábitos que las personas adoptarán. Por tanto, es necesario contar con un instrumento que evidencie validez y fiabilidad, especialmente para adolescentes, ya que la adolescencia constituye una etapa fundamental en la adopción de estilos de vida saludables. El objetivo de esteestudio fue analizar las propiedades psicométricas del Cuestionario de Actitudes hacia la Práctica de Actividad Físico-Deportiva Orientada a la Salud (CAAFS) en adolescentes peruanos. Se trata de un estudio descriptivo transversal en el que participaron 1314 adolescentes de edades entre 13 y 19 años (15.59±1.05 años), conformados por 716 hombres y 598 mujeres provenientes de Lima y Callao, Perú. Mediante el software R versión 4.1.0., se efectuó la validez de constructo (Análisis Factorial Exploratorio [AFE] y el Análisis Factorial Confirmatorio [AFC]) y el cálculo de fiabilidad. Los resultados del AFE arrojaron un modelo con tres factores del CAAFS, que explica el 35 % de la varianza total. El AFC reportó un buen ajuste del modelo de tres factores del CAAFSde 19 ítems (Chi-cuadrado sobre los grados de libertad = 2.38; error de aproximacióncuadrático medio = .046; residuo cuadrático medio estandarizado = .060; índice de ajuste comparativo = .940; índice de Tuker-Lewis = .931). El coeficiente de fiabilidad Omega reportó un valor de .77. Finalmente se demostró que el CAAFS de 19 ítems evidencia validez y fiabilidad; por lo tanto, el cuestionario puede ser aplicado en adolescentes del contexto peruano. (AU)

Attitudes predict commitment to the practice of physical-sporting activity. The more they are known, the better the prediction of the possible habits that people will adopt. Therefore, it is necessary to havean instrument that shows validity and reliability, especially for adolescents, since adolescence is a fundamental stage in the adoption of healthy lifestyles. The aim of this study was to analyze the psychometric properties of the Questionnaire of Attitudes towards the Practice of Health-Oriented Physical-Sports Activity (CAAFS) in Peruvian adolescents. This was a descriptive cross-sectional study in which 1314 adolescents aged 13 to 19 years (15.59±1.05 years), made up of 716 males and 598 females from Lima and Callao, Peru, participated. Using R software version 4.1.0, construct validity (Exploratory Factor Analysis [EFA] and Confirmatory Factor Analysis [CFA]) and reliability calculation were performed. The results of the EFA yielded a three-factor modelof the CAAFS, which explains 35% of the total variance. The AFC reported a good fit of the 19-item CAAFS three-factor model (Chi-square over degrees of freedom = 2.38; root mean square error of approximation = .046; standardized root mean square residual = .060; comparative fit index = .940; Tuker-Lewis index = .931). The Omega reliability coefficient reported a value of .77. Finally, it was demonstrated that the 19-item CAAFS shows validity and reliability; therefore, the questionnaire can be applied to adolescents in the Peruvian context. (AU)

As atitudes prevêem o compromisso com a actividade física e o desporto. Quanto mais forem conhecidos, melhor será a previsão dos possíveis hábitos que as pessoas irão adoptar. Por conseguinte, é necessário ter um instrumento que demonstre validade e fiabilidade, especialmente para os adolescentes, uma vez que a adolescência é uma fase chave na adopção de estilos de vida saudáveis. O objectivo deste estudo era analisar as propriedades psicométricas do Questionário de Atitudes para a Prática da Actividade Físico-Sportiva Orientada para a Saúde (CAAFS) em adolescentes peruanos. Este foi um estudo transversal descritivo envolvendo 1314 adolescentes com idades compreendidas entre 13-19 anos (15,59±1,05 anos), compreendendo 716 homens e 598 mulheres de Lima e Callao, Peru. Utilizando o software R versão 4.1.0, foram efectuados cálculos de validade de construção (Análise Exploratória de Factores [EFA] e Análise Confirmativa de Factores [CFA]) e de fiabilidade. Os resultados da AAE produziram um modelo de três factores do CAAFS, o que explica 35% da variação total. O CFA relatou um bom ajuste do modelo de três factores CAAFS de 19 itens (Qui-quadrado sobre graus de liberdade = 2,38; erro quadrático médio de aproximação = 0,046; raiz média quadrada residual padronizada = 0,060; índice de ajuste comparativo = 0,940; índice Tuker-Lewis = 0,931). O coeficiente de fiabilidade ómega comunicou um valor de 0,77. Finalmente, foi demonstrado que o CAAFS de 19 itens mostra validade e fiabilidade; por conseguinte, o questionário pode ser aplicado aos adolescentes no contexto peruano. (AU)