Do predator attacks on productive species and the respective economic losses influence the psychological distress of farmers in Uruguay? A cross-sectional study.

INTRODUCTION: In Uruguay, productive animals are attacked by various predators, causing injuries and financial losses, leading to great concern for farmers. The objective of this study was to determine, using a cross-sectional study, if predator attacks on productive animals during the year 2021 influenced the psychological distress of farmers. METHODS: Four hundred and forty-two farmers from around the country were surveyed with questions according to the Kessler Psychological Distress Scale (dependent variable), and predator attacks received in 2021 (independent variable). RESULTS: Of the total number of farmers surveyed, approximately 49% (216/442) had animals that had been attacked by predators. Farmers whose productive species were attacked in 2021 had higher levels of psychological distress than those whose animals were not attacked (p<0.01). Additionally, farmers who reported the highest levels of psychological distress had more deaths of productive species (and more financial losses) from predator attacks in 2021 than those who did not. CONCLUSION: The losses of productive species and the financial costs negatively influenced the psychological distress of farmers. This information highlights the need to generate public policies about farmers wellbeing that help them in these situations.

Socioeconomic disparities and health literacy: Unraveling the impact on diagnostic and cancer care in Uruguay.

BACKGROUND: Disparities in the timely diagnosis and care of cancer patients, particularly concerning geographical, racial/ethnic, and economic factors, remain a global health challenge. This study explores the multifaceted interplay between socioeconomic status, health literacy, and specific patient perceptions regarding care access and treatment options that impact cancer care in Uruguay. METHODS: Using the Cancer Health Literacy Test, Spanish Version (CHLT-30-DKspa), and a highly comprehensive questionnaire, we dissected the factors influencing the pathway to diagnosis and route of cancer care. This was done to identify delays by analyzing diverse socioeconomic and sex subgroups across multiple healthcare settings. RESULTS: Patients with lower income took longer to get an appointment after showing symptoms (p = 0.02) and longer to get a diagnosis after having an appointment (p = 0.037). Race/ethnicity also had a significant impact on the length of time from symptoms to first appointment (p =0.019), whereas employment status had a significant impact on patients being susceptible to diagnostic delays beyond the advocated 14-day window (p = 0.02). Higher educational levels were positively associated with increased cancer health literacy scores (p = 0.043), revealing the potential to mitigate delays through health literacy-boosting initiatives. Women had significantly higher self-reported symptom duration before seeking an intervention (p = 0.022). We also found many other significant factors effecting treatment delays and cancer health literacy. CONCLUSIONS: While affirming the global pertinence of socioeconomic- and literacy-focused interventions in enhancing cancer care, the findings underscore a complex, gendered, and perceptually influenced healthcare navigation journey. The results highlight the urgent necessity for strategically crafted, globally relevant interventions that transcend equitable access to integrate literacy, gender sensitivity, and patient-perception alignments in pursuit of optimized global cancer care outcomes.

Genomic and eco-epidemiological investigations in Uruguay reveal local Chikungunya virus transmission dynamics during its expansion across the Americas in 2023.

Uruguay experienced its first Chikungunya virus outbreak in 2023, resulting in a significant burden to its healthcare system. We conducted analysis based on real-time genomic surveillance (30 novel whole genomes) to offer timely insights into recent local transmission dynamics and eco-epidemiological factors behind its emergence and spread in the country.

Estadio, perfil biológico y tendencias de incidencia y mortalidad de cáncer de mama en Uruguay: análisis por franjas etarias

Introducción: el cáncer de mama es el tumor maligno más frecuente y la primera causa de muerte por cáncer en mujeres en Uruguay y en el mundo. La evidencia epidemiológica sugiere que el cáncer de mama en diferentes grupos de edades se comportaría como patologías distintas. El objetivo de este trabajo es caracterizar el cáncer de mama en Uruguay para diferentes estratos de edades. Material y método: se analizaron las tendencias temporales de la incidencia de cáncer de mama en mujeres en Uruguay en el período 2002-2019, y de la mortalidad por esta causa en 1990-2020. Para el quinquenio 2015-2019, se analiza además la distribución de estadios al diagnóstico y de perfiles biológicos (luminales, triple negativos y HER2 positivos). Se analizan tres segmentos de edades: mujeres de 20 a 44 años, de 45 a 69 y de 70 y más años. Resultados: las tasas de incidencia para el conjunto de edades se presentaron estables en el período 2002-2019, mientras que la mortalidad presenta una tendencia decreciente en el período 1990-2020. En las mujeres menores de 45 años se encuentra un aumento en la incidencia, con mortalidad que decrece hasta el 2010, seguido de una estabilización de las tasas; en las mujeres de 45 a 69 años la incidencia se mantiene estable y la mortalidad decrece; en las mayores de 70 años, la incidencia decrece mientras la mortalidad se mantiene estable. Más del 70% de los casos se diagnostican en estadios I y II. Los tumores luminales (receptores hormonales positivos, HER2 negativos) son el subtipo más frecuente para todos los grupos, la proporción de tumores con estas características aumenta con la edad, mientras decrece la proporción de HER2 positivo y triple negativo. Conclusión: en las mujeres uruguayas el cáncer de mama presenta características diferenciales para las tres franjas de edades analizadas.

Introduction: Breast cancer is the most common malignant tumor and the leading cause of cancer death in women in Uruguay and worldwide. Epidemiological evidence suggests that breast cancer in different age groups behaves as distinct pathologies. The objective of this work is to characterize breast cancer in Uruguay for different age groups. Method: Temporal trends in the incidence of breast cancer in women in Uruguay are analyzed for the period 2002-2019, along with mortality trends for this cause from 1990 to 2020. For the five-year period 2015-2019, the distribution of stages at diagnosis and biological profiles (Luminal, Triple-negative, and Her2 positive) is also analyzed. Three age segments are analyzed: women aged 20 to 44 years, 45 to 69 years, and 70 years and older. Results: The incidence rates for all age groups remained stable during the period 2002-2019, while mortality showed a decreasing trend in the period 1990-2020. In women under 45, there is an increase in incidence, with mortality decreasing until 2010, followed by a stabilization of rates; in women aged 45 to 69, incidence remains stable and mortality decreases; in those over 70, incidence decreases while mortality remains stable. More than 70% of cases are diagnosed at stages I and II. Luminal tumors (hormone receptor positive, Her2 negative) are the most frequent subtype for all age groups. The proportion of tumors with these characteristics increases with age, while the proportion of Her2 positive and triple-negative tumors decreases. Conclusions: In Uruguayan women, breast cancer presents differential characteristics for the three age groups analyzed.

Introdução: O câncer de mama é o tumor maligno mais comum e a principal causa de morte por câncer em mulheres no Uruguai e no mundo. Evidências epidemiológicas sugerem que o câncer de mama se comportaria como patologias distintas em diferentes faixas etárias. O objetivo deste trabalho é caracterizar o câncer de mama no Uruguai para diferentes faixas etárias. Materiais e Métodos: São analisadas as tendências temporais da incidência de câncer de mama em mulheres no Uruguai no período 2002-2019 e a mortalidade por esta causa no período 1990-2020. Para o quinquénio 2015-2019 são também analisadas a distribuição dos estádios ao diagnóstico e os perfis biológicos (Luminal, Triplo negativo e Her2 positivo). São analisados três segmentos etários: mulheres dos 20 aos 44 anos, dos 45 aos 69 anos e dos 70 anos ou mais. Resultados: As taxas de incidência para todas as idades permaneceram estáveis no período 2002-2019 enquanto a mortalidade apresentou tendência decrescente no período 1990-2020. Nas mulheres com menos de 45 anos verifica-se um aumento da incidência, com uma redução da mortalidade até 2010, seguida de uma estabilização das taxas; nas mulheres de 45 a 69 anos, a incidência permanece estável e a mortalidade diminui; nas pessoas com mais de 70 anos, a incidência diminui enquanto a mortalidade permanece estável. Mais de 70% dos casos são diagnosticados nos estágios I e II. Os tumores luminais (receptor hormonal positivo, Her2 negativo) são o subtipo mais comum para todos os grupos sem do que a proporção de tumores com essas características aumenta com a idade, enquanto a proporção de (Her2 positivo e triplo negativo) diminui. Conclusão: Nas mulheres uruguaias, o câncer de mama apresenta características diferenciadas para as três faixas etárias analisadas.

Poisoning by Baccharis coridifolia in Early-Weaned Beef Calves: Pathological Study and New Macrocyclic Trichothecene Identification.

This study investigated two outbreaks of spontaneous poisoning by Baccharis coridifolia (Asteraceae) in early-weaned beef calves in Tacuarembó, Uruguay. A total of 34 affected calves showed signs of salivation, anorexia, apathy, marked dehydration, and diarrhea. Deaths occurred 36-72 h after consumption and mortality varied from 37.5% to 43.3% for outbreak 1 and outbreak 2, respectively. The main pathological findings include diffuse severe necrosis of the prestomachs and lymphoid tissues. Ultrastructurally, epithelial cells of the rumen showed swelling, lysis of the organelles, degradation of intercellular attachments, and degradation of the nuclear chromatin. Using LC-MS with diagnostic fragmentation filtering, 56 macrocyclic trichothecenes including glycosyl and malonyl conjugates were identified. The total concentration of macrocyclic trichothecenes, including conjugates, was estimated to be 1.2 ± 0.1 mg/g plant material. This is the first report of these malonyl-glucose conjugates from Baccharis coridifolia.

'We never thought this would be considered drug trafficking': International finance rules, policy space and Uruguay's regulation of recreational cannabis.

ABSTRACTFollowing landmark legislation in 2013, Uruguay became the first country to regulate the legal production, distribution and sale of recreational cannabis. While broader debates anticipated the significance of the UN drug conventions, the extent to which Uruguay's drug treaty obligations shaped regulation is unclear and the relevance of finance norms has been neglected. Drawing on institutionalist and governance theories, this study explores how international drug and finance regulations limited Uruguay's policy space to implement cannabis regulation, and how this was perceived by policy actors. Policy documents and 43 semi-structured interviews were thematically analysed. The analysis demonstrates how Uruguay's drug treaty obligations were less directly constraining to policy space compared to international finance norms, including the US Patriot Act, anti-money laundering standards and financial inclusion practices. Such norms exerted powerful influence over Uruguay's ability to implement aspects of cannabis supply that interact with broader financial systems, allowing banks to terminate business relationships with clients deemed as high risks for money laundering. The Uruguayan case suggests that financial regulations at diverse levels are likely to constrain policy space in other contexts where the market-based policies of cannabis regulation raise tensions with a narrowly constructed risk management principle in approaches to financial supply.

[Health policy dialogue to strengthen nursing in UruguayDiálogo político-sanitário para o fortalecimento da enfermagem no Uruguai]. / El diálogo político sanitario para el fortalecimiento de enfermería en Uruguay.

This article presents the experience of the health policy dialogue on nursing held in Uruguay in 2021, based on the theory of change. Four working groups were held, with the participation of 725 people. The points discussed included: the shortage of registered nurses to implement programs and cover functions at all levels of health care; the poor visibility of the healthcare impact of the activities carried out; insufficient financial resources for undergraduate and postgraduate training; and poor integration of nurses in management teams and policy decision-making spaces in the country. Participants expressed the need to implement the national nursing development plan so that the country can: reduce the shortage of professionals; invest in job creation to meet the demand for professional care; improve staffing of services at all levels of care; improve working conditions; create new spaces for nurses by expanding their role through postgraduate training, while continuously improving the quality of training. Participants emphasized the need to increase intersectoral coordination in the areas of governance, regulation, and management, and to step up efforts to increase investment in health professionals in Uruguay.

Este artigo apresenta a experiência do diálogo político-sanitário sobre enfermagem realizado no Uruguai em 2021 com base na teoria da mudança. Foram organizados quatro grupos de trabalho, dos quais participaram 725 pessoas. Entre os pontos discutidos, destacam-se: a falta de profissionais graduados em enfermagem para desenvolver programas e cobrir funções em todos os níveis de atenção à saúde; a falta de visibilidade do impacto assistencial das atividades desenvolvidas; a insuficiência de recursos financeiros para programas de graduação e pós-graduação; e a pouca integração desses profissionais às equipes de gestão e aos espaços de tomada de decisão política no país. Os participantes indicaram a necessidade de implementar o plano nacional de desenvolvimento da enfermagem para que o país reduza o déficit de profissionais; invista na criação de cargos para atender à demanda por cuidados profissionais; melhore a dotação de pessoal nos serviços em todos os níveis de atenção; melhore as condições de trabalho; crie novas oportunidades de inserção para profissionais de enfermagem, ampliando suas funções por meio da pós-graduação; e aprimore continuamente a qualidade da formação. Os participantes enfatizaram a necessidade de aumentar a coordenação intersetorial nos aspectos de governança, regulação e gestão, bem como de acelerar os esforços no sentido de aumentar o investimento em profissionais de saúde no Uruguai.

Epidemiology Update of Hepatitis E Virus (HEV) in Uruguay: Subtyping, Environmental Surveillance and Zoonotic Transmission.

Hepatitis E Virus (HEV) infection is an emergent zoonotic disease of increasing concern in developed regions. HEV genotype 3 (HEV-3) is mainly transmitted through consumption of contaminated food in high-income countries and is classified into at least 13 subtypes (3a-3n), based on p-distance values from complete genomes. In Latin America, HEV epidemiology studies are very scant. Our group has previously detected HEV3 in clinical cases, swine, wild boars, captive white-collared peccaries, and spotted deer from Uruguay. Herein, we aimed to provide novel insights and an updated overview of the molecular epidemiology of zoonotic HEV in Uruguay, including data from wastewater-based surveillance studies. A thorough analysis of HEV whole genomes and partial ORF2 sequences from Uruguayan human and domestic pig strains showed that they formed a separate monophyletic cluster with high nucleotide identity and exhibited p-distance values over the established cut-off (0.093) compared with reference subtypes' sequences. Furthermore, we found an overall prevalence of 10.87% (10/92) in wastewater, where two samples revealed a close relationship with humans, and animal reservoirs/hosts isolates from Uruguay. In conclusion, a single, new HEV-3 subtype currently circulates in different epidemiological settings in Uruguay, and we propose its designation as 3o along with its reference sequence.

Genomics-based timely detection of Dengue Virus type I genotypes I and V in Uruguay.

We report the first whole-genome sequences of Dengue Virus type I genotypes I and V from Uruguay, including the first cases ever reported in the country. Through timely genomic analysis, identification of these genotypes was possible, aiding in timely public health responses and intervention strategies to mitigate the impact of dengue outbreaks.

El químico farmacéutico Juan José Olivero, referente de la ciencia y la industria farmacéutica uruguaya / The pharmaceutical chemist Juan José Olivero, reference of uruguayan science and the pharmaceutical industry

El químico farmacéutico (doctor) Juan José Olivero Muñoz (Buenos Aires, 1921-Montevideo, 1993) fue uno de los destacados profesionales de la docencia e industria farmacéutica uruguaya. Ejerció como técnico en los laboratorios Athena; EMAR (Eduardo Márques Castro S. A.) y Dispert. Especialista en antibióticos, desarrolló asimismo distintos productos. Estudió la cloromicetina, publicando en Anales de la Asociación de Química y Farmacia del Uruguay y Chemical Abstracts. Fue autor de trabajos sobre hidrotropización en tecnología farmacéutica; valoración química del elixir de clorhidrato de difenhidramina y solvotropización de hormonas esteroides. Escribió varios capítulos de la enciclopedia Farmacotecnia teórica y práctica, texto de referencia. Presidió la Asociación de Química y Farmacia del Uruguay y fue docente de la Facultad de Química en varias asignaturas, principalmente Farmacotecnia, siendo catedrático y consejero de dicha facultad. Desde 1966 y hasta su fallecimiento, fue académico de la Real Academia Nacional de Farmacia (España), honor al que pocos químicos accedieron por nuestro país. Fue reconocido luego de su fallecimiento, como uno de los prohombres de la profesión en Uruguay.(AU)

Pharmaceutical chemist (doctor) Juan José Olivero Muñoz (Buenos Aires, 1921-Montevideo, 1993) was one of the outstanding professionals in the uruguayan pharmaceutical teaching and industry. He worked as a technician in the laboratories Athena; EMAR (Eduardo Márques Castro S. A.) and Dispert. A specialist in antibiotics, he also developed different products. He studied chloromycetin, publishing in Annals of the Uruguayan Chemistry anf Pharmacy Association and Chemical Abstracts. He was author of papers on hydrotropization in pharmaceutical technology; chemical titration of diphenhydramine hydrochloride elixir and solvotropization of steroid hormones. He wrote several chapters of the encyclopedia Theoretical and practical Pharmacotechnics, a reference text. He was president of the Uruguayan Chemistry and Pharmacy Association and was a professor and advisor of the Faculty of Chemistry in several subjects, mainly Pharmacotechnics. From 1966 until his death, he was a member of the Royal National Academy of Pharmacy (Spain), an honor to which few chemists had access in our country. After his death, he was recognized as one of the leading figures of the profession in Uruguay.(AU)

Sistematización de los resultados de los primeros diez años del Tribunal de Ética Médica del Colegio Médico del Uruguay

Introducción: la colegiación médica obligatoria es el ámbito con competencia exclusiva para el juzgamiento de la responsabilidad ética de los médicos en Uruguay. Objetivos: sistematizar los resultados de los primeros diez años de la vigencia de la colegiación obligatoria, conocer el número de denuncias y su evolución histórica, algunas características relevantes de las denuncias, los denunciantes y los médicos denunciados por presuntos apartamientos de la ética médica, características y resultados de los procedimientos, así como relevar las normas éticas y jurídicas referenciadas por los tribunales en los fallos sancionatorios. Material y método: se analizaron fuentes de información de acceso público: fallos del Tribunal de Ética y del Tribunal de Alzada, resoluciones del Ministerio de Salud Pública y datos de la actividad del Tribunal de Ética Médica contenidos en las memorias anuales del Colegio Médico del Uruguay. Resultados: a la fecha de cierre del reporte se habían publicado 100 fallos firmes. Los denunciantes fueron principalmente personas físicas (n=85), y, dentro de ellos, mayoritariamente médicos (n=56); los 29 restantes fueron pacientes, familiares de pacientes u otros miembros de la comunidad. Hubo 15 denuncias interpuestas por instituciones: 8 privadas y 7 públicas. La mayoría de las denuncias fueron promovidas por médicos o por instituciones médicas (n=63). Las denuncias involucraron a 131 médicos, de los cuales 89 son hombres (FR: 0,68); la edad promedio fue 52 años. Los fallos definitivos tuvieron por probado que 71 médicos habían cometido la falta ética denunciada. Conclusiones: 1. Hubo cierta estabilidad en el número de denuncias admitidas, con tendencia al crecimiento. 2. El universo de los denunciados es más masculinizado y envejecido que el promedio, con mayor exposición en servicios de emergencia o internación, especialidades quirúrgicas o que ejecutan procedimientos invasivos, así como para los cargos de gestión, administración o políticos. 3. La mayoría de las denuncias instruidas y de las sanciones aplicadas derivaron de conflictos en la interna de los equipos de salud. 4. Las sanciones más graves derivaron de conflictos con pacientes o sus familias, y, en especial, de actos abusivos con connotación sexual. 5. Los fallos sancionatorios se fundaron en normas jurídicas diversas que en los últimos años incluyeron referencias a convenciones internacionales y legislación nacional de derechos humanos.

Mandatory medical membership is the exclusive jurisdiction for the adjudication of ethical responsibilities of physicians in Uruguay. Objectives: To systematize the results of the first ten years of mandatory membership, to learn about the number of complaints and their historical evolution, to identify relevant characteristics of the complaints, the complainants, and the physicians accused of alleged breaches of medical ethics, to examine the features and outcomes of the proceedings, and to document the ethical and legal standards referenced by the courts in punitive rulings. Method: Publicly accessible sources of information were analyzed, including rulings from the Ethics Tribunal and the Court of Appeal, Resolutions from the Ministry of Public Health, and data regarding TEM's (Tribunal de Ética Médica or Medical Ethics Tribunal) activities found in the annual reports of the CMU (Colegio Médico del Uruguay or Medical Association of Uruguay). Results: As of the report's closing date, 100 final rulings had been published. The reporting individuals were primarily individuals (n=85), with most of them being medical professionals (n=56). The remaining 29 reporting individuals included patients, patients' family members, or other community members. There were 15 complaints filed by institutions: 8 private institutions and 7 public institutions. Most of the allegations were initiated by physicians or medical institutions (n=63). The reports involved 131 physicians, of whom 89 were male (male-to-female ratio: 0.68), with an average age of 52 years. The final rulings established that 71 physicians had committed the alleged ethical misconduct. Conclusions: 1. There was a degree of stability in the number of admitted allegations, with a trend toward growth. 2. The group of individuals who were reported is characterized by a higher proportion of males and tends to be older compared to the average. They also have a greater exposure to emergency or inpatient services, surgical specialties, or fields involving invasive procedures, as well as holding positions in management, administration, or politics. 3. Most of the investigations and sanctions issued stemmed from conflicts within healthcare teams. 4. The most severe sanctions resulted from conflicts with patients or their families, particularly those involving abusive acts with sexual connotations. 5. The punitive rulings were based on various legal standards, including recent references to international conventions and national human rights legislation.

A filiação médica obrigatória ao Colegio Médico del Uruguay (CMU) é a área de competência exclusiva para julgar a responsabilidade ética dos médicos no Uruguai. Objetivos: sistematizar os resultados dos dez primeiros da vigência da adesão obrigatória, conhecer o número de reclamações e a sua evolução histórica, algumas características relevantes das reclamações, os denunciantes e os médicos denunciados por supostos desvios à ética médica, características e resultados dos procedimentos, bem como destacar os padrões éticos e legais mencionadas pelos tribunais nas decisões sancionatórias. Material e método: foram analisadas fontes de informação de acesso público: acórdãos do Tribunal de Ética e do Tribunal da Relação, Resoluções do Ministério da Saúde Pública e dados sobre a atividade do Tribunal de Ética Médica constantes dos relatórios anuais do CMU. Resultados: até a data de encerramento do relatório, 100 decisões finais foram publicadas. Os reclamantes eram, em sua maioria indivíduos (n=85) e, entre eles, principalmente médicos (n=56); os 29 restantes eram pacientes, familiares de pacientes ou outros membros da comunidade. Quinze denúncias foram apresentadas por instituições: 8 privadas e 7 públicas. A maioria das reclamações forma iniciadas por médicos ou instituições médicas (n=63). As denúncias envolveram 131 médicos, dos quais 89 eram homens (FR: 0,68); a idade média era de 52 anos. As decisões finais provaram que 71 médicos haviam cometido os desvios éticos relatados. Conclusões: 1. Verificou-se alguma estabilidade no número de reclamações admitidas, com tendência ao crescimento. 2. O universo dos denunciados é mais masculino e mais velho que a média, com maior exposição a serviços de urgência ou de internação, especialidades cirúrgicas ou que realizam procedimentos invasivos, bem como a cargos de gestão, administração ou políticos. 3. A maioria das queixas apresentadas e das sanções aplicadas decorrem de conflitos no seio das equipes de saúde. 4. As sanções mais graves derivam de conflitos com pacientes ou seus familiares e, especialmente, de atos abusivos com conotações sexuais. 5. As decisões de sanção foram baseadas em diversas normas legais, que nos últimos anos incluíram referências a convenções internacionais e legislação nacional em matéria de direitos humanos.

Estrategias de control de la Equinococosis quística en el Uruguay / Strategies for the control of cystic echinococcosis in Uruguay / Estratégias de controle da equinococose cística no Uruguai

La equinococosis quística es una zoonosis de origen parasitario con distribución cosmopolita. En nuestro país continúa siendo una enfermedad endémica, afectando principalmente pequeños centros poblados y áreas rurales pobres relacionadas a la producción ovina. Los planes de control requieren de un abordaje holístico, con la participación de diferentes instituciones, profesionales y en especial de la comunidad. La cooperación regional busca monitorizar el avance de la enfermedad y centrar las medidas de acción sobre cuatro ejes, definidos según los puntos de intervención más comunes para la quiebra del ciclo de transmisión y la consecuente reducción en incidencia y prevalencia de la enfermedad. La presente revisión utilizó literatura obtenida en diferentes bases de datos, bibliotecas virtuales y sitios web regionales y locales con el objetivo describir las principales estrategias de control, vigilancia y prevención aplicadas actualmente en nuestro país.

Cystic echinococcosis is a zoonosis of parasitic origin with cosmopolitan distribution. In our country it continues to be an endemic disease, affecting mainly small population centers and poor rural areas related to sheep production. Control plans require a holistic approach, with the participation of different institutions, professionals and especially the community. Regional cooperation seeks to monitor the progress of the disease and focus action measures on four axes, defined according to the most common points of intervention to break the transmission cycle and consequently reduce the incidence and prevalence of the disease. This review used literature obtained from different databases, virtual libraries and regional and local websites with the aim of describing the main control, surveillance and prevention strategies currently applied in our country.

A equinococose cística é uma zoonose de origem parasitária com distribuição cosmopolita. Em nosso país, continua a ser uma doença endêmica, afetando principalmente pequenos centros populacionais e áreas rurais pobres relacionadas à produção de ovinos. Os planos de controle exigem uma abordagem holística, com a participação de diferentes instituições, profissionais e, principalmente, da comunidade. A cooperação regional busca monitorar o progresso da doença e concentrar as medidas de ação em quatro eixos, definidos de acordo com os pontos de intervenção mais comuns para interromper o ciclo de transmissão e, consequentemente, reduzir a incidência e a prevalência da doença. Esta revisão utilizou a literatura obtida em diferentes bases de dados, bibliotecas virtuais e sites regionais e locais com o objetivo de descrever as principais estratégias de controle, vigilância e prevenção aplicadas atualmente em nosso país.

Honores a Sir Ernest Shackleton en Sanidad Militar / Honors to Sir Ernest Shackleton in Military Health / Honras a Sir Ernest Shackleton em Saúde Militar

Ernest Shackleton ha sido en la historia, un personaje que dejó huella como ejemplo de resiliencia y liderazgo. En 1914 realizó como jefe de expedición su segundo viaje antártico, frustrado por el hundimiento de su buque insignia. La operación de rescate del grueso de la tripulación varada en el continente más meridional lo llevó a recalar en Montevideo. Desde este puerto partió el buque Instituto de Pesca N°1, con tripulación de Uruguay y Shackleton incluido, no logrando completar el salvamento. De esta acción nació el aprecio hacia la persona del explorador por parte del gobierno de la República. En su postrer travesía, ya fallecido llegó a las Islas Georgia del Sur y a su cuerpo se le realizó un proceso de conservación para ser traído a nuestro país y continuar viaje al puerto de origen en Inglaterra. Es en esa circunstancia que el gobierno del doctor Baltasar Brum solicitó a la Comisión Permanente del Parlamento, se le rindieran honores fúnebres de Ministro de Estado. El embalsamado del cuerpo fue realizado el 30 de enero de 1922, por parte de personal médico y técnico del Hospital Militar, así como los honores que le rindieron por el Servicio de Sanidad del Ejército y la Armada.

Ernest Shackleton has been in history, a character who left his mark as an example of resilience and leadership. In 1914, as expedition leader, he made his second Antarctic voyage, frustrated by the sinking of his flagship. The operation to rescue the bulk of the crew stranded on the southernmost continent led him to Montevideo. The Instituto de Pesca N°1, with Uruguayan crew and Shackleton included, departed from this port, but was unable to complete the rescue. From this action was born the appreciation of the explorer by the government of the Republic. In his last voyage, when he died, he reached the South Georgia Islands and his body underwent a preservation process to be brought to our country and continue his voyage to the port of origin in England. It is in this circumstance that the government of Dr. Baltasar Brum requested the Permanent Commission of the Parliament to pay him the funeral honors of a Minister of State. The embalming of the body was carried out on January 30, 1922, by medical and technical personnel of the Military Hospital, as well as the honors rendered by the Army and Navy Health Service.

Ernest Shackleton deixou sua marca na história como um exemplo de resiliência e liderança. Em 1914, ele fez sua segunda viagem à Antártica como líder da expedição, frustrado pelo naufrágio de seu navio principal. A operação para resgatar a maior parte da tripulação encalhada no continente mais ao sul o levou a Montevidéu. O Instituto de Pesca N°1, com tripulação do Uruguai e Shackleton incluído, partiu desse porto, mas não conseguiu concluir o resgate. Essa ação deu origem ao reconhecimento do explorador pelo governo da República. Em sua última viagem, quando morreu, chegou às Ilhas Geórgia do Sul e seu corpo foi preservado para que pudesse ser trazido ao nosso país e continuar sua viagem até o porto de origem na Inglaterra. Foi nessa circunstância que o governo do Dr. Baltasar Brum solicitou ao Comitê Permanente do Parlamento que lhe prestasse as honras fúnebres de um Ministro de Estado. O embalsamamento do corpo foi realizado em 30 de janeiro de 1922, pela equipe médica e técnica do Hospital Militar, bem como as honras prestadas a ele pelo Serviço de Saúde do Exército e da Marinha.

Encuesta a profesionales sobre la nueva base de datos de composición de alimentos de Uruguay / Survey of professionals on the new database of food composition in Uruguay

Introducción. El Capítulo Nacional URUGUAYFOODS, perteneciente a la Red Latinoamericana de Composición de Alimentos (LATINFOODS, INFOODS, FAO), realizó recientemente una investigación para identificar cuáles tablas/bases de datos de composición de alimentos (TCA/ BDCA) utilizan los profesionales nacionales, así como la percepción de sus limitaciones, con el fin de ser tenidos en cuenta en la creación de la nueva BDCA nacional. Objetivo. Caracterizar el uso de las TCA/BDCA de composición de alimentos y describir las características y limitaciones de las mismas, mediante el análisis de la encuesta realizada a profesionales del área de salud, nutrición y alimentos de Uruguay en el año 2022. Materiales y métodos. Se trató de un estudio cuantitativo, descriptivo y transversal. La información fue obtenida a través de una encuesta de participación voluntaria. La muestra estuvo conformada por 94 profesionales nacionales. Se analizó la variable uso y frecuencia de uso de dichas herramientas respecto a la edad y población específica con la que trabaja el profesional encuestado. Resultados. La preferencia de uso fue la base de datos USDA y CENEXA, antes que la TCAU, resultando en una debilidad importante en todas las áreas en donde se utilicen estos datos, pues no refleja los hábitos ni costumbres de la población. Conclusiones. Los potenciales usuarios de la nueva BDCA nacional pretenden que sea de acceso fácil y gratuito, en idioma español, en formato digital, con información actualizada y con posibilidad de elección de datos en porción o cada 100 gramos(AU)

Introduction. The URUGUAYFOODS National Chapter, belonging to the Latin American Food Composition Network (LATINFOODS, INFOODS, FAO), recently carried out an investigation to identify which food composition tables and databases (TCA and BDCA) are used by national professionals, as well as the perception of their limitations, in order to be taken into account in the creation of the new national BDCA. Objective. Characterize the use of TCAs and BDCAs for food composition and describe their characteristics and limitations through the analysis of the survey carried out among professionals in the area of health, nutrition, and food in Uruguay in 2022. Materials and methods. It was a quantitative, descriptive, and cross-sectional study. The information was obtained through a voluntary participation survey. The sample consisted of 94 national professionals. The variable use and frequency of these tools were analyzed with respect to the age and specific populations with which the surveyed professional works. Results. The preference for use was the USDA and CENEXA databases rather than the TCAU, resulting in a significant weakness in all areas where these data are used since they do not reflect the habits and customs of the population. Conclusions. Potential users of the new national BDCA want it to be easily and freely accessible, in Spanish, in digital format, with up-to-date information, and with the possibility of choosing data in portions or every 100 grams(AU)

Genomic and eco-epidemiological investigations in Uruguay reveal local Chikungunya virus transmission dynamics during its expansion across the Americas in 2023.

Uruguay experienced its first Chikungunya virus outbreak in 2023, resulting in a significant burden to its healthcare system. We conducted analysis based on real-time genomic surveillance (30 novel whole genomes) to offer timely insights into recent local transmission dynamics and eco-epidemiological factors behind its emergence and spread in the country.

Suicide in Later Life in Uruguay: A Suicide Note Analysis.

Suicide is a significant public health challenge worldwide, with inconsistent behavioral patterns. This study examined the psychological processes underlying 191 suicide notes left by older adults in Uruguay, a country doubling global and regional suicide rates, with the highest prevalence among those aged 60+. Uruguay highlights in the region as a high-income country. Through content analysis with an inter-judge strategy, the notes revealed that loneliness, loss of interest, and loss of meaning for life, were prevalent. Financial hardship was not a primary reason for suicide. Social connectedness was highlighted as a factor for reducing suicide risk in older adults, particularly those with ill health and physical impairment. The study sheds light on the need to expand social services aimed at reducing loneliness and the need to combat ageism and social prejudice towards suicide in Uruguay, providing valuable insights into suicide prevention strategies for older adults in diverse social settings.

Subdermal contraceptive implants and repeat teenage motherhood: Evidence from a major maternity hospital-based program in Uruguay.

Teenage fertility is a social problem because of its private and public costs in countries of different development levels. Reductions in adolescent birth rates do not necessarily follow drops in overall fertility due to the demographic transition model. This paper analyses the impact of a subdermal contraceptive program on repeat teenage motherhood. Using a regression discontinuity design, we find that the intervention reduced mothers' likelihood of having another child in the next 48 months by 10 percentage points. This reduction is not random, and we also identify small positive selection in subsequent births.

Conflicting forces in the implementation of medicinal cannabis regulation in Uruguay.

BACKGROUND: Uruguay is widely known as a pioneer country regarding cannabis regulation policies, as it was the first state to regulate the cannabis market for both recreational and medicinal purposes in 2013. However, not all aspects of the regulation have moved forward at the same speed. Medicinal uses keep facing several challenges that undermine patients' effective access to treatments and products. What are those persistent challenges for the medicinal cannabis policy in Uruguay? This paper aims to describe and understand the current state of medicinal cannabis in the country and identify the most critical challenges and conflicting forces for its proper implementation. METHODS: To do so, we conduct twelve in-depth interviews with key informants, including governments officials, activists, entrepreneurs, researchers, and doctors. These interviews are complemented with information from the congressional committees' public records and other documentary sources. RESULTS: This research shows that the legal framework was thought to assure quality products over access. The main challenges of medicinal cannabis in Uruguay are related to three issues: (i) the timid development of the industry, (ii) a limited and expensive supply, and (iii) the emergence of an informal productive sector. CONCLUSIONS: The political decisions regarding medicinal cannabis made in the last seven years have derived from a halfway policy that fails to guarantee patient access or promote the growth of a vibrant national industry. Positively, the several actors involved are aware of the extent of these challenges and new decisions have been made to overcome them, meaning that monitoring the future of the policy is very much needed.

Dietary Acid Load and Cancer Risk: A Review of the Uruguayan Experience.

Dietary acid load (DAL) is recognized as a risk factor for several chronic disorders, including obesity, diabetes, and osteoporosis. Recent evidence suggests that an elevated DAL, as measured by the validated potential renal acid load (PRAL) and net endogenous acid production (NEAP) scores, could also increase the risk for several cancers. This narrative review summarizes the potential role of DAL in Uruguayan cancer patients and outlines the potentially involved pathophysiological pathways that mediate the role of DAL in both cancer development and growth. Although Uruguay is a developing country, its average diet is a heavily meat-based Western one, translating into a supraphysiological acid burden from diet. In recent years, we have published epidemiologic evidence based on ten case-control studies involving 3736 cancer cases and 9534 hospital-based controls. Odds ratios and 95% confidence intervals were estimated for each interest variable to analyze the association between the exposure levels of DAL scores and cancer, calculated by unconditional logistic regression. In a majority of the cases, the highest DAL scores tended to double the cancer risk as compared to the lowest category. We also found high risks for methionine intake, an acidifying amino acid found in higher concentrations in animal-based foods, which may increase cancer risks at least by a joint action based on the pH and the proliferation enhancing properties of the amino acid itself.

Niveles de aprobación de ESFUNO entre los años 2019 y 2020. Facultad de Enfermería Udelar / Approval levels of ESFUNO between the years 2019 and 2020. Faculty of Nursing Udelar / Níveis de aprovação do ESFUNO entre os anos de 2019 e 2020. Faculdade de Enfermagem da Udelar

El presente trabajo muestra los resultados de un estudio de carácter diagnóstico sobre el efecto de la aplicación de una metodología de enseñanza totalmente virtual para el curso ESFUNO de Facultad de Enfermería en el marco de la pandemia por Covid-19. Se realizó un estudio observacional descriptivo y analítico comparando el desempeño académico entre las generaciones del año 2019 y 2020 mediante contraste de proporciones. Se sistematizaron los datos de desempeño estudiantil para la exoneración del curso ESFUNO y los dos primeros períodos de exámenes a partir de la finalización del curso desarrollados desde la implementación del Plan 2016. A partir de los datos obtenidos se pudo observar que predominó la exoneración del curso con un porcentaje para el año 2019 de 56 % y para el año 2020 de 79 % siendo este un aumento significativo (p<0.05). Se observó un aumento significativo de la desvinculación en el año 2020 con respecto al año 2019 (27 % y 19 % respectivamente) (p<0.05). La proporción de estudiantes que salvaron el examen de ESFUNO aumento significativamente en el segundo periodo para el año 2019 (p<0.05) pero no así para el año 2020 (p>0.05). Al comparar la proporción de aprobación del primer periodo entre la generación que cursó en 2019y la generación que cursó en 2020 se observó un aumento significativo para el año 2020 (p<0.05). Finalmente se observó que en el año 2020 hubo una asociación positiva entre aquellos alumnos que sin exonerar tuvieron una nota media (5) y un mayor porcentaje de aprobación del examen. Se concluye que la utilización de la total virtualidad aplicada en el año 2020 en el curso ESFUNO no tuvo un impacto negativo sobre los niveles de aprobación del mismo ya sea a nivel de exoneración como a nivel de aprobación en el primer y segundo periodo de examen.

This work shows the results of a diagnostic study on the effect of the application of a totally virtual teaching methodology for the ESFUNO course of the School of Nursing, in the frame work of the Covid-19 pandemic. A descriptive and analytical observational study was carried out to compare academic performances between the 2019 and 2020 class by comparing proportions. Student performance data were systematized for the ESFUNO exam exemption and the first two exam periods immediately after the end of the course, for all the years since the implementation of the 2016 Plan. From the data obtained, it was observed that the exam exemption prevailed with a 56 % for the 2019 class and for a 79 % for the2020 class, this being a significant increase (p<0.05). A significant increase in disengagement was observed in 2020compared to 2019 (27 % and 19 % respectively) (p<0.05). The proportion of students who saved the ESFUNO exam in the second period, increased significantly for 2019 (p<0.05) but not for 2020 class (p>0.05). When comparing the passing rate during the first period between the 2019 and 2020 classes, a significant increase was observed for 2020 (p<0.05). Finally, it was observed that in 2020 there was a positive association between those students who, without exam exemption, had an average grade (5) and a higher percentage of students passing the exam. It is concluded that the use of the total virtuality applied in the year 2020 for the ESFUNO course did not have a negative impact on the approval rate, either at the exemption level or at the approval level in the first and second period of exam.

O presente trabalho mostra os resultados de um estudo diagnóstico sobre o efeito da aplicação de uma metodologia de ensino totalmente virtual para o curso ESFUNO da Faculdade de Enfermagem no contexto da pandemia Covid-19. Realizou-se um estudo observacional descritivo e analítico comparando o desempenho acadêmico entre as gerações de 2019 e 2020 através da comparação de proporções. Se sistematizaram os dados do desempenho estudantil para aprovação direta do curso ESFUNO e os dois primeiros períodos das provas a partir da finalização do curso desenvolvidos após a implementação do Plano 2016. Pelos dados obtidos, observou-se que houve predomínio da aprovação direta do curso, com uma porcentagem de 56% para o ano de 2019 e de 79 % para o ano de 2020, sendo este um aumento significativo (p<0.05). Observou-se, ainda, no ano de 2020 um aumento significativo da desvinculação do curso quando comparado ao ano de 2019 (27 % e 19 %, respectivamente) (p<0.05). A proporção de estudantes que passaram na prova de ESFUNO aumentou significativamente no segundo período para o ano de 2019 (p<0.05), porém não se observou o mesmo no ano de 2020 (p>0.05). Ao comparar a taxa de aprovação no primeiro período de recuperação entre a geração que cursou no ano de 2019 com a geração que cursou no ano de 2020, se observou um aumento significativo para o ano de 2020 (p<0.05). Finalmente, foi observado que no ano de 2020 houve uma associação positiva entre aqueles alunos que não obtiveram aprovação direta, mas tiveram nota média (5) e maior percentual de aprovação. Conclui-se que a utilização da modalidade totalmente virtual aplicada no ano de 2020 para realização do curso ESFUNO não teve um impacto negativo sobre os níveis de aprovação do mesmo, seja no nível de aprovação direta, como no nível de aprovação no primeiro e segundo períodos de provas.