Perception of personal protective equipment availability and mental health outcomes in workers from two national hospitals during the COVID-19 pandemic.

Background: During the first wave of the pandemic, a constant concern of healthcare workers, who are more vulnerable to contagion, is their personal safety. This is directly related to the availability of adequate PPE, which led to a perception of dissatisfaction and inequality with government responses. We aim t o determines whether perception of adequate PPE availability is associated with depressive, anxiety, and stress symptoms in different types of healthcare workers. Methods: Analytical cross-sectional study surveyed clinical and non-clinical healthcare workers in two third-level hospitals in Lima, Peru. An online self-survey assessed the perception of adequate PPE availability, using a Likert scale question, which was then dichotomized for the analysis. In addition, we assessed the depressive, anxiety, and stress symptoms using validated questionnaires. Results: 563 participants were included. In general, there is no association between perception of PPE availability and three mental health outcomes. However, in the subgroup analysis, physicians with better perception of PPE availability had less moderate-severe outcomes in mental health; in contrast, nurses had higher moderate-severe outcomes. The type of profession in healthcare workers may modify the effect of this association. Conclusion: The association between perception of PPE availability and mental health outcomes is complex in healthcare workers from two third-level hospitals. This association can vary according to the type of work.

Fístula pleurocutánea secundaria a empiema

RESUMEN Introducción: La fístula pleurocutánea es una rara entidad que aparece como complicación de traumatismos torácicos, de la cirugía pleuro pulmonar o procesos infecciosos que afectan el espacio pleural tales como el empiema. Objetivo: Describir hallazgos clínico imagenológicos de un paciente con fístula pleurocutánea secundaria a empiema. Caso clínico: Paciente masculino de 56 años de edad, blanco, de procedencia rural, fumador inveterado y consumidor habitual de bebidas alcohólicas, con antecedentes patológicos personales de neumonías extrahospitalarias que requirieron hospitalización por aparición de complicaciones pleurales. Acudió al servicio de medicina interna del Hospital "Vladimir Ilich Lenin" porque desde hacía dos meses notó un agujero debajo de la axila derecha, por el cual drenaba líquido fétido. Los estudios imagenológicos realizados incluyeron fistulografía y tomografía axial computarizada. El diagnóstico clínico imagenológico fue fístula pleurocutánea. El paciente ingresó en el servicio de Medicina para cumplir tratamiento antimicrobiano; se le realizaron procederes intervencionistas diagnósticos y terapéuticos; evolucionó con complicaciones y falleció. La fístula pleurocutánea es una complicación de difícil manejo para el médico de asistencia, pues no siempre suelen resolver con los métodos tradicionales de tratamiento y requiere períodos prolongados de curación. Conclusiones: La fístula pleurocutánea es infrecuente y de difícil manejo. El diagnóstico de certeza se realiza a través de la fistulografía.

ABSTRACT Introduction: Pleurocutaneous fistula is a rare entity that appears as a complication of thoracic trauma, pleuro-pulmonary surgery or infectious processes that affect the pleural space such as empyema. Objective: To describe clinical imaging findings of a patient with pleurocutaneous fistula secondary to empyema. Clinical case: 56-year-old white male patient of rural origin, inveterate smoker and habitual consumer of alcoholic beverages, with a personal pathological history of community-acquired pneumonia that required hospitalization due to the onset of pleural complications. He went to the internal medicine service of the "Vladimir Ilyich Lenin" Hospital because for two months he had noticed a hole under his right armpit, through which he was draining foul-smelling fluid. The imaging studies included fistulography and computerized axial tomography. The clinical imaging diagnosis was pleurocutaneous fistula. The patient was admitted to the Medicine service for antimicrobial treatment; diagnostic and therapeutic interventionist procedures were performed; he evolved with complications and passed away. Pleurocutaneous fistula is a complication difficult to manage for the attending physician, as it does not always usually resolve with traditional methods of treatment and requires prolonged healing periods. Conclusions: Pleurocutaneous fistula is rare and difficult to manage. The certainty diagnosis is made through fistulography.

Undifferentiated embryonal liver sarcoma: case report and review of the literature. / Sarcoma hepático embrionario indiferenciado: reporte de caso y revisión de la literatura.

BACKGROUND: Undifferentiated embryonal sarcoma of the liver accounts for 9-13% of malignant tumors in the pediatric age group, and is the third primary malignant neoplasm of the liver in children. However, few cases are reported in the literature. It may manifest with fever, weight loss, pain, and abdominal tumor sensation. In addition to pathology and immunohistochemistry, imaging studies are the appropriate tools for diagnosis. CASE REPORT: We present the case of a 6-year-old female patient diagnosed with undifferentiated embryonal sarcoma of the liver by surgery and subsequent biopsy results. CONCLUSIONS: When reviewing the literature, we found that this type of malignant neoplasm is not frequent in children. However, it is important to consider this type of tumor as a cause in those cases of hepatomegaly in the pediatric age.

INTRODUCCIÓN: El sarcoma hepático embrionario indiferenciado representa el 9-13% de los tumores hepáticos malignos en la edad pediátrica y es la tercera neoplasia maligna primaria de hígado en la infancia. Sin embargo, son pocos los casos reportados en la literatura. Se puede manifestar con fiebre, pérdida de peso, dolor y sensación de tumor abdominal. Los estudios de imagen, además de los estudios anatomopatológico e inmunohistoquímico, son las herramientas adecuadas para el diagnóstico. CASO CLÍNICO: Se presenta el caso de una paciente de 6 años de edad con diagnóstico de sarcoma hepático embrionario indiferenciado mediante cirugía y posterior resultado de la biopsia. CONCLUSIONES: Al revisar la literatura se encontró que este tipo de neoplasia maligna no es frecuente en la infancia. Sin embargo, es importante considerar este tipo de tumor como causa en aquellos casos de hepatomegalia en la edad pediátrica.

First Molecular Characterization of Cryptosporidium spp. in Patients Living with HIV in Honduras.

Cryptosporidiosis is one of the most important causes of gastroenteritis in the world, especially in low- and middle-income countries. It is caused by the Apicomplexan parasite Cryptosporidium spp., and mainly affects children and immunocompromised people, in whom it can pose a serious threat to their health, or even be life threatening. In Honduras, there are no data on parasite species or on molecular diversity or Cryptosporidium subtypes. Therefore, a cross-sectional study was conducted between September 2019 and March 2020 for the molecular identification of Cryptosporidium spp. in 102 patients living with HIV who attended a national hospital in Tegucigalpa. Stool samples were analyzed by direct microscopy, acid-fast stained smears, and a rapid lateral flow immunochromatographic test. All samples that tested positive were molecularly analyzed to identify the species and subtype of the parasite using three different markers: gp60, cowp, and 18Sr. PCR products were also sequenced. Four out of 102 samples (3.92%) were positive for Cryptosporidiumparvum, and all were assigned to subtype IIa. These findings suggest a possible zoonotic transmission in this population.

Intervenção motivacional breve para tabagismo aplicada a alcoolistas fumantes

A intervenção motivacional breve para tabagismo objetiva dar orientação e motivar sujeitos para parar de fumar. Neste trabalho avaliou se esta abordagem, aplicada a 38 alcoolistas do sexo masculino, dependentes do tabaco que recebiam tratamento hospitalar para alcoolismo. Os participantes deste estudo fizeram uma avaliação inicial para determinar o grau de dependência do tabaco, grau de dependência do álcool, intensidade de sintomas de ansiedade e depressão e a medida da intoxicação por Monóxido de Carbono (CO). A intervenção motivacional breve para tabagismo foi aplicada em única sessão e uma semana depois os sujeitos foram reavaliados utilizando questionário de tolerância de Fagerström para determinar o grau de dependência do tabaco; a escala URICA, para verificar os estágios de motivação para mudança em relação ao tabagismo e a intoxicação por CO. Concluiu-se que não houve modificações estatisticamente significativas entre antes e depois da intervenção, no que se refere aos estágios de motivação para mudança (pré-contemplação p=,144 contemplação p=.477; ação p=,329 e manutenção p=,142), dependência do tabaco (p=,556) e intoxicação por CO (p=921). Discute se a importância das intervenções para tabagismo em alcoolistas nos ambientes hospitalares (AU)