Primer Consenso Nacional Intersociedades de Inmunización del Adulto. 2023

Las vacunas previenen millones de muertes cada año y su eficacia y seguridad han sido ampliamente establecidas. En términos económicos, la vacunación es una de las intervenciones sanitarias más costo efectivas, generando un importante ahorro y crecimiento económico que supone a largo plazo. Se ha demostrado que la vacunación de adultos disminuye la morbilidad y la mortalidad asociadas a enfermedades infecciosas prevenibles, reduciendo las complicaciones y las hospitalizaciones, incluidos los ingresos a las unidades de cuidados intensivos. Hemos elaborado este documento de consenso con el objeto de diseñar un esquema de vacunación pragmático, accesible y estandarizado del adulto, según categoría de riesgo y edad, sobre la base de la evidencia disponible de vacunas accesibles y nuevas vacunas habiendo utilizado el Tercer Consenso de la Sociedad Paraguaya de Infectología del 2019 como base para las recomendaciones finales.

SUMMARY Vaccines prevent millions of deaths each year, and their efficacy and safety have been widely established. In economic terms, vaccination is one of the most cost-effective health interventions, generating significant savings and long-term economic growth. Adult vaccination has been shown to decrease morbidity and mortality associated with preventable Infectious diseases, reducing complications and hospitalizations, including admissions to intensive care units. We have prepared this consensus document in order to design a pragmatic, accessible and standardized vaccination scheme for adults, according to risk category and age, based on the available evidence of available vaccines and new vaccines, having used the third consensus of the Paraguayan Infectious Diseases Society of 2019 as a basis for the final recommendations.

Adaptations for rehabilitation services during the COVID-19 pandemic proposed by scientific organizations and rehabilitation professionals.

OBJECTIVE: To describe adaptations in the provision of rehabilitation services proposed by scientific and professional rehabilitation organizations to avoid interruptions to patients rehabilitation process and delays in starting rehabilitation in patients with COVID-19. METHODS: A narrative review approach was used to identify the recommendations of scientific and professional organizations in the area of rehabilitation. A systematic search was performed in the main data-bases in 78 international and regional web portals of rehabilitation organizations. A total of 21 publications from these organizations were identified and selected. RESULTS: The results are presented in 4 categories: adequacy of inpatient services, including acute care services and intensive care unit for patients with and without COVID-19; adequacy of outpatient services, including home-based rehabilitation and tele-rehabilitation; recommendations to prevent the spread of COVID-19; and regulatory standards and positions during the COVID-19 pandemic expressed by organizations for protecting the rights of health workers and patients. CONCLUSION: Health systems around the world are rapidly learning from actions aimed at the reorganization of rehabilitation services for patients who are in the process of recovery from acute or chronic conditions, and the rapid response to the rehabilitation of survivors of COVID-19, as well as from efforts in the prevention of contagion of those providing the services.

Prevalencia de virus linfotrópico humano en donantes de sangre del Hospital Nacional, Paraguay / Prevalence of human t-lymphotropic virus in blood donors in the National Hospital, Paraguay

INTRODUCCIÓN: el virus linfotrópico humano tipo 1 (HTLV-1) está relacionado con leucemia y linfoma de células T del adulto y la paraparesia espástica tropical. Su transmisión se realiza por sangre y fluidos orgánicos. OBJETIVOS: determinar la prevalencia de HTLV y otras enfermedades de transmisión sexual en donantes de sangre del Hospital Nacional (Itauguá, Paraguay). METODOLOGÍA: estudio observacional descriptivo retrospectivo realizado en el tamizaje de donantes de sangre durante los años 2013 al 2015. RESULTADOS: entre 16.100 donaciones se encontraron 61 resultados reactivos para HTLV, lo que da una prevalencia de 0,37%. Las características demográficas de los casos positivos para HTLV son: edad media 37 ± 12 años (rango 19-67 años), leve predominio del sexo masculino 35 casos (57%). La asociación con otras enfermedades de transmisión sexual pudo detectarse en 11 de los 61 pacientes positivos para HTLV, de los cuales el 63% era portador de sífilis. CONCLUSIONES: la prevalencia de HTLV en Banco de sangre del Hospital Nacional es 0,37%. Los afectados por HTLV eran también portadores de serología sifilítica en 63%.

INTRODUCTION: the human lymphotropic virus type 1 (HTLV-1) is related to adult T cell leukemia and lymphoma and the tropical spastic paraparesis. The transmission is by blood and body fluids. OBJECTIVES: to determine the prevalence of HTLV and other sexually transmitted diseases in blood donors in the National Hospital (Itauguá, Paraguay). METHODOLOGY: descriptive retrospective study by screening blood donors between 2013 to 2015. RESULTS: between 16,100 donations we found 61 reactive results for HTLV, giving a prevalence of 0.37%. The demographic characteristics of positive cases for HTLV are: mean age 37 ± 12 years (range 19-67 years), slight predominance of males 35 cases (57%). The association with other sexually transmitted diseases could be detected in 11 of the 61 patients positive for HTLV-1, of which 63% were carrying syphilis. CONCLUSIONS: the prevalence of HTLV in the blood bank of the National Hospital is 0.37%. The affected by HTLV-1 carriers also syphilis serology in 63%.