Prevalence of Occult Bacteremia in Infants With Very High Fever Without a Source.

We carried out a prospective registry-based cohort study at the emergency department of 363 previously healthy well-appearing infants 3-24 months of age with fever without a source ≥40.5°C based on local protocol. Four were diagnosed with occult bacteremia (1.1%; 95% confidence interval: 0-2.2). Recommendations for nontesting for occult bacteremia screening in these children may have to be reconsidered when fever ≥40.5°C. Larger studies are needed to confirm these results.

Sistema de acciones para fortalecer el abordaje terapéutico de afecciones cardiovasculares / Action System to Strengthen the Therapeutic Approach to Cardiovascular Diseases

Introducción: las enfermedades cardiovasculares continúan ascendiendo a pesar de las potencialidades transformadoras de estilos de vida que brinda la medicina familiar. Objetivo: caracterizar la situación de salud cardiovascular, la evaluación de los recursos humanos y las necesidades organizativas para las acciones cardiovasculares y proponer un sistema de acciones para fortalecer el abordaje terapéutico de las afecciones cardiovasculares. Métodos: estudio descriptivo longitudinal retrospectivo en el policlínico "Octavio de la Concepción y la Pedraja" del municipio Camajuaní, desde septiembre 2013 a septiembre del 2014. Se trabajó con una población integrada por 79 médicos especialistas en Medicina General Integral y 12 enfermeros vinculados a la atención médica ambulatoria y de urgencia, además de los 760 pacientes con afecciones cardiovasculares. Se utilizaron variables como: nivel de conocimiento, desempeño y factores de riesgo. Resultados: no hubo diferencia entre los grupos de edades (p> 0,05), con predominio del sexo masculino (p< 0,01), el mayor por ciento se encontraba por encima del 90 percentil (p< 0,001), con predominio del sedentarismo y antecedentes familiares de la enfermedad (p< 0,001). En el conocimiento de la temática resultó bien en los profesionales médicos, con un valor muy altamente significativo (p< 0,001), y en el desempeño predominó la calificación de BIEN, con una significación a la prueba p= 0,000. Conclusiones: la atención ambulatoria y de urgencia al paciente descompensado por afecciones cardiovasculares fue satisfactoria. Los pacientes en riesgo no desarrollan un adecuado proceso de rehabilitación comunitaria y continúan sufriendo descompensaciones(AU)

Introduction: cardiovascular diseases still have a growing rate in Cuba, but due to the possibilities the family medicine has of changing people´s life styles, and the role of doctors as promotors of a sanitary culture, it is possible to act upon risk factors, avoiding the emergence of cardiovascular diseases. Objective: to propose a system of actions to strengthen the management of cardiovascular diseases in the Primary Health Care. Methods: it was used a retrospective longitudinal descriptive method in Octavio de la Concepcion y la Pedraja Policlinic in Camajuani, from September 2013 to September 2014. The target population for this research consisted in 79 physicians, specialists in Integral General Medicine, and 12 nurses linked to ambulatoty and emergency health care, in addition to 760 patients suffering from cardiovascular conditions. The variables were level of knowledge about the topic, performance and risk factors. The information was gathered through the patients´medical records, the records of patients who had been admitted to the intensive care unit of the municipal policlinic, the records of death certificates, observation guides, surveys applied to professionals linked to Primary Health Care, interview to experts. Results: there was a difference among the age groups (p> 0.005), prevailing the male sex (p< 0.01), the highest percentage was above percentile 90 (p< 0.001), sedentarism and antecedents of the disease in the family history were predominant (p< 0.001). A qualification of GOOD was prevalent among the health professionals with a highly significant value of probability (p< 0.001) when evaluating knowledge about the topic, the performance in both groups of professionals was graded predominantly as GOOD with a signification to the test (p= 0.000). Conclusions: the ambulatory and emergency health care to decompensated patients suffering from cardiovascular diseases was satisfactry, the patients at risk continue suffering decompensations and they do not develop an appropriate process of communitary rehabilitation(AU)

Sistema de acciones para fortalecer el abordaje terapéutico de afecciones cardiovasculares / Action System to Strengthen the Therapeutic Approach to Cardiovascular Diseases

Introducción: las enfermedades cardiovasculares continúan ascendiendo a pesar de las potencialidades transformadoras de estilos de vida que brinda la medicina familiar. Objetivo: caracterizar la situación de salud cardiovascular, la evaluación de los recursos humanos y las necesidades organizativas para las acciones cardiovasculares y proponer un sistema de acciones para fortalecer el abordaje terapéutico de las afecciones cardiovasculares. Métodos: estudio descriptivo longitudinal retrospectivo en el policlínico Octavio de la Concepción y la Pedraja del municipio Camajuaní, desde septiembre 2013 a septiembre del 2014. Se trabajó con una población integrada por 79 médicos especialistas en Medicina General Integral y 12 enfermeros vinculados a la atención médica ambulatoria y de urgencia, además de los 760 pacientes con afecciones cardiovasculares. Se utilizaron variables como: nivel de conocimiento, desempeño y factores de riesgo. Resultados: no hubo diferencia entre los grupos de edades (p> 0,05), con predominio del sexo masculino (p< 0,01), el mayor por ciento se encontraba por encima del 90 percentil (p< 0,001), con predominio del sedentarismo y antecedentes familiares de la enfermedad (p< 0,001). En el conocimiento de la temática resultó bien en los profesionales médicos, con un valor muy altamente significativo (p< 0,001), y en el desempeño predominó la calificación de BIEN, con una significación a la prueba p= 0,000...

Introduction: cardiovascular diseases still have a growing rate in Cuba, but due to the possibilities the family medicine has of changing people´s life styles, and the role of doctors as promotors of a sanitary culture, it is possible to act upon risk factors, avoiding the emergence of cardiovascular diseases. Objective: to propose a system of actions to strengthen the management of cardiovascular diseases in the Primary Health Care. Methods: it was used a retrospective longitudinal descriptive method in Octavio de la Concepcion y la Pedraja Policlinic in Camajuani, from September 2013 to September 2014. The target population for this research consisted in 79 physicians, specialists in Integral General Medicine, and 12 nurses linked to ambulatoty and emergency health care, in addition to 760 patients suffering from cardiovascular conditions. The variables were level of knowledge about the topic, performance and risk factors. The information was gathered through the patients´medical records, the records of patients who had been admitted to the intensive care unit of the municipal policlinic, the records of death certificates, observation guides, surveys applied to professionals linked to Primary Health Care, interview to experts. Results: there was a difference among the age groups (p› 0.005), prevailing the male sex (p‹ 0.01), the highest percentage was above percentile 90 (p‹ 0.001), sedentarism and antecedents of the disease in the family history were predominant (p‹ 0.001). A qualification of GOOD was prevalent among the health professionals with a highly significant value of probability (p‹ 0.001) when evaluating knowledge about the topic, the performance in both groups of professionals was graded predominantly as GOOD with a signification to the test (p= 0.000)...