Características epidemiológicas de la infección por SARS-CoV-2 en hogares de escolares de tres instituciones educativas en Asunción y departamento Central entre octubre a noviembre de 2021 / Epidemiological characteristics of SARS-CoV-2 infection in households of schoolchildren from three educational institutions in Asunción and the Central department between October and November 2021

Introducción. Caracterizar la epidemia del SARS-CoV-2 en la comunidad puede aportar datos útiles a las autoridades en la toma de decisiones sobre las instituciones educativas en Paraguay. Objetivo. Describir las características epidemiológicas de la infección por SARS-CoV-2 en los hogares de escolares de tres instituciones de Asunción y departamento Central. Materiales y Métodos. Estudio descriptivo transversal realizado entre el 25 de octubre al 5 de noviembre de 2021. Se aplicaron encuestas estructuradas a los padres o encargados de escolares mediante un cuestionario en formato del formulario de Google enviado a través del WhatsApp desde la Dirección de las instituciones educativas. El cuestionario incluía preguntas sobre el número integrantes del hogar, datos demográficos del encuestado, número de personas con co-morbilidad, personas con COVID-19, con necesidad de hospitalización, número de fallecidos y vacunados contra COVID-19. Resultado. Se obtuvieron datos de 780 hogares, 379 (48,6%) de San Lorenzo, 217 (27,8) de Limpio, 93 (11,9%) de Asunción y 91 de otras localidades de Central (11,7%), el 18,6 % (731/3920) de los integrantes del hogar tuvo COVID-19, de ellos 9,7% (71/731) fue hospitalizado. La mortalidad fue de 0,79% (31/3920) y la letalidad 4,2% (31/731). El 52,7% (2340/3920) ya fue vacunado contra COVID-19 y el 88,2% (2065/2340) de ellos con dosis completa. Conclusión. La prevalencia de COVID-19 estuvo dentro del rango esperado para las infecciones sintomáticas con un alto índice de transmisión intradomiciliaria. Tanto la tasa de mortalidad como letalidad fueron consistentes con los datos nacionales. Palabras Clave: COVID-19; instituciones académicas; Paraguay; características de estudios epidemiológicos

Introduction. Characterizing the SARS-CoV-2 epidemic in the community can provide useful data for the authorities in making decisions on the educational institutions in Paraguay. Objective.To describe the epidemiological characteristics of SARS-CoV-2 infection in the homes of schoolchildren from three institutions in Asunción and the Central Department. Materials and Methods. Cross-sectional descriptive study carried out between October 25 and November 5, 2021. Structured surveys were applied to parents or guardians of schoolchildren through a questionnaire in the format of the Google form sent through WhatsApp from the Directorate of the educational institutions. The questionnaire included questions about the number of household members, demographic data of the respondent, number of people with co-morbidity, people with COVID-19, need of hospitalization, number of death and vaccinated against COVID-19. Results.Data from 780 households were obtained, 379 (48.6%) from San Lorenzo, 217 (27.8) from Limpio, 93 (11.9%) from Asunción and 91 from other localities from Central (11.7%); 18.6% (731/3920) of household members had COVID-19, of them 9.7% (71/731) were hospitalized. Mortality rate was 0.79% (31/3920) and lethality 4.2% (31/731). 52.7% (2,340/3,920) were already vaccinated against COVID-19 and 88.2% (2,065/2,340) of them fully vaccinated. Conclusion.The prevalence of infection was within the expected range for symptomatic COVID-19 infections with a high rate of intradomiciliary transmission. Both the hospitalization and fatality rates were within the range for the country. Key words: COVID-19; schools; Paraguay; epidemiologic study characteristics

Boletim Genômico 01/2021 / Genomic bulletin 01/2021

Estudo sobre as mutações entre os vírus do SARS-COV-2 no Rio Grande do Sul. (AU)

Boletim Genômico 02/2021 / Genomic bulletin 02/2021

Estudo sobre as mutações entre os vírus do SARS-COV-2 no Rio Grande do Sul. (AU)

Caracterización epidemiológica de los accidentes en el hogar: atención médica inmediata. Servicio desconcentrado Hospital Pediátrico Dr Agustín Zubillaga / Epidemiological characterization of accidents at home: immediate medical attention. Deconcentrated service Dr Agustín Zubillaga Pediatric Hospital

Se realizó una investigación de tipo no experimental, transversal y descriptiva para establecer las características epidemiológicas de los accidentes en el hogar de 112 pacientes entre 2 a 13 años de edad que ingresaron a la Atención Médica Inmediata (AMI) del Servicio Desconcentrado Hospital Pediátrico Dr. Agustín Zubillaga entre diciembre 2018 y enero 2019. La mayoría de los pacientes son preescolares (46%), del sexo masculino (71%) y de procedencia urbana (59,8%). En cuanto a las madres, predominaron aquellas mayores de 30 años (39,2%), con grado de instrucción secundaria (44,6%) y amas de casa (69,6%). La mayoría de los padres son mayores de 30 años (54,5%), tienen educación primaria (37,5%) y trabajan fuera del hogar (90,1%). Con respecto a los cuidadores, predominaron los mayores de 30 años (67%) y en su mayoría son familiares del niño (93%). El día de mayor frecuencia de los accidentes en el hogar fueron los viernes (18,8%), en el horario de 1 a 6:59 pm (46%) y el lugar más frecuente fue en el patio (36,6%). El tipo de accidente predominante fueron las caídas (34,9%), seguida de las quemaduras (25%) e intoxicaciones (21,4%). Este estudio permitió conocer las características epidemiológicas de los accidentes en el hogar y aporta datos para la toma de decisiones y la elaboración de protocolos de prevención(AU)

A non-experimental, transversal, descriptive study was conducted to establish the epidemiological characteristics of accidents in the home of 112 patients between 2 and 13 years of age who attended the Atención Médica Inmediata (AMI) of the Servicio Desconcentrado Hospital Pediátrico Dr. Agustín Zubillaga between December 2018 and January 2019. Most patients are preschoolers (46%), male sex (71%) and from urban areas (59.8%). In most cases, mothers were older than 30 years (39.2%), with secondary education (44.6%) and homemakers (69.6%). The majority of fathers were older than 30 years (54.5%), with primary education (37.5%) and worked outside the home (90.1%). Most caregivers were older than 30 years (67%) and relatives of the child (93%). Accidents occurred predominantly on Friday (18.8%), from 1 to 6:59 pm (46%) and in the yard (36.6%). Most frequent type of accident were falls (34.9%), followed by burns (25%) and poisoning (21.4%). This study allowed us to know the epidemiological characteristics of accidents in the home and provides data for decision-making and the development of prevention protocols(AU)

Importancia de la inmunización anti virus de Hepatitis B en estudiantes de Enfermería / Importance of immunization against Hepatitis B virus in nursing students

La hepatitis B constituye un problema de salud pública, con alta morbilidad asociada a daño hepático agudo, crónico y cáncer. Esta situación agrava por deficiencias en los programas de vacunación en niños y poblaciones de alto riesgo. Los profesionales y estudiantes de la salud están expuestos a riesgo biológico y la prevalencia de infección puede llegar a 11.1%, siendo hasta tres veces mayor que en la población general. La profesión de enfermería está expuesta a riesgos biológicos, siendo superior durante el proceso de formación por la escasa experiencia, que eleva el peligro de accidentes en sus prácticas y estancias hospitalarias. La vacunación es la forma más eficaz de prevención. En este artículo se analizala necesidad de que los estudiantes de salud, en específico los de enfermería, reciban el esquema de vacunación, tomando en cuenta que aún cumplido, puede no generarse inmunidad al virus y aumentar su exposición y susceptibilidad

Hepatitis B is a public health problem, with high morbidity associated with acute, chronic liver damage and cancer. This situation is aggravated by deficiencies in vaccination programs in children and high-risk populations. Professionals and students of health are exposed to biological risk and the prevalence of infection can reach 11.1%, being up to three times higher than in the general population. The nursing profession is exposed to biological risks, being superior during the training process due to thescarce experience, which increases the risk of accidents in their practices and hospital stays. Vaccination is the most effective form of prevention. This article analyzes the need for health students, specifically nursing students, to receive the vaccination schedule, taking into account that even when it is completed, immunity to the virus cannotbe generated and its exposure and susceptibility increased

Utilização de diagramas causais e a comunicação de fontes de incerteza em estudos observacionais / Use of causal DAG and reporting of uncertainty in observational studies

Os diagramas causais (gráficos acíclicos direcionados ­ DAG) têm sido apontados como uma das principais ferramentas que podem contribuir para a qualidade metodológica e do relato de estudos observacionais. No entanto, pouco se sabe sobre como essas ferramentas têm sido utilizadas nas investigações empíricas. Neste trabalho, foi realizada uma revisão da literatura com o objetivo de descrever o quanto, como e onde os diagramas causais têm sido utilizados em estudos observacionais analíticos nos últimos 18 anos. Foram realizadas buscas por citações e pesquisas por palavras-chaves nas bases de dados do PubMed e Web of Science. Em uma amostra de 100 artigos que apresentaram a estrutura causal, foram avaliadas as características dos modelos gráficos e o relato de confundimento. Além disso, foi realizada uma análise comparativa do relato das limitações do estudo e da frequência de marcadores linguísticos de incerteza (hedges) nos artigos com e sem a utilização de DAG causais. Foram identificadas 1034 publicações, totalizando 5021 autores e 85 países de afiliação. Apenas 430 artigos (42%) forneceram a estrutura gráfica. A maioria das publicações contém apenas um DAG causal (87%) e poucos modelos gráficos contêm confundidores não observados (23%), ou a representação de erros de mensuração (6%) e mecanismos de seleção (3%). O relato de modificações no conjunto de ajuste foi observado em 19% das publicações. Além disso, 20% foram classificadas como possível ocorrência da falácia da tabela 2. O número de limitações do estudo reconhecidas pelos autores e a frequência de marcadores de incerteza foram semelhantes nas amostras de artigos com e sem diagramas causais. No entanto, o relato de avaliações quantitativas das limitações do estudo foi mais frequente entre os artigos com DAG (52% vs. 21%). Há necessidade de mais discussões e estudos sobre a construção e análise de modelos causais e o desenvolvimento de recomendações gerais para apresentação de DAG causais nos artigos científicos

Derivaciones fecales y urinarias en un centro de atención especializado, México 2016 / Fecal and urinary derivations at a specialized attention center, Mexico 2016 / Derivações fecais e urinarias em um centro de atenção especializado, México 2016

Objetivo: Describir las características epidemiológicas de las derivaciones fecales y urinarias, las características demográficas de los pacientes ostomizados y las características de los productos utilizados en un Centro Especializado en Cuidado de Heridas y Ostomías de la Ciudad de México. Metodología: Estudio descriptivo, retrospectivo y transversal en el cual se revisaron los expedientes clínicos de personas ostomizadas atendidas durante el año 2016. Resultados: Se analizaron 143 expedientes. La media de edad fue de 56.3±15.2 años. El diagnóstico más común fue el cáncer de colon (27.8%). Las características presentes en mayor proporción fueron: colostomías descendentes (44.7%), regulares (56.6%), diámetro medio de 30±8 mm; ángulo de drenaje al centro (36.4%), de una boca (69.2%), sin marcaje quirúrgico (55.2%), mucosa viable (100%), planos (49.6%), efluente pastoso (51.0%). El 51.7% de los pacientes presentaron complicaciones estomales y el 54.5% complicaciones de la piel periestomal, las cuales fueron resueltas en el 68.0% de los casos, en un tiempo medio de 16.3± 11.5 días. Conclusión: Los resultados del presente estudio aportan evidencia respecto a la necesidad permanente de desarrollar profesionales de Enfermería especializados en terapia enterostomal e incorporarlos al Sistema Nacional de Salud como miembros indispensables del equipo multidisciplinario.

Objective: To describe the epidemiologic characteristics of fecal and urinary derivations, the demographic characteristics of ostomized patients, and the characteristics of utilized products, in a Specialized Center of Wounds and Ostomy Care in Mexico City. Methodology: This is a descriptive, retrospective, and transversal study in which, clinical registers of ostomized patients in 2016 were reviewed. Results: 143 registers were reviewed. The mean age was 56.3±15.2. The most common underlying diagnosis was colon cancer (27.8%). The most prevailing characteristics were: descending colostomy (44.7%), regular (56.6%), median diameter 30±8mm, angle of drainage at center (36.4%), one mouth (69.2%), without surgical mark (55.2%), viable mucous membrane (100%), planes (49.6%), and thick discharge (51.0%). Fifty one point seven percent of the patients showed stomal complications and 54.7% showed peristomal skin complications, which were further solved in 68.0% of these cases in a mean time of 16.3±11.5 days. Conclusion: The results of this study provided evidence regarding the permanent need to prepare enterostomal therapy specialized nursing professionals and incorporate them into the National Health System as indispensable members of the multidisciplinary teams.

Objetivo: Descrever as características epidemiológicas das derivações fecais e urinarias, características demográficas dos pacientes ostomizados e características dos produtos utilizados em um Centro Especializado em Cuidado de Feridas e Ostomias da Cidade do México. Metodologia: Estudo descritivo, retrospectivo e transversal onde se revisaram os expedientes clínicos de pessoas ostomizadas atendidas durante o ano de 2016. Resultados: Analisaram-se 143 expedientes. A média de idade foi de 56.3±15.2. O diagnóstico mais comum foi o câncer de cólon (27.8%). As características presentes em maior proporção foram: colostomias descendentes (44.7%), regulares (56.6%), diâmetro médio de 30±8 mm; ângulo de drenagem ao centro (36.4%), de uma boca (69.2%), sem marcação cirúrgica (55.2%), mucosa viável (100%), planos (49.6%), efluente pastoso (51.0%). O 51.7% dos pacientes apresentaram complicações estomacais e o 54.5% de complicações da pele periestomal, as quais foram resolvidas no 68.0% dos casos, em um tempo médio de 16.3±11.5 dias. Conclusão: Os resultados do presente estudo aportam evidência respeito à necessidade permanente de desenvolver profissionais de Enfermagem especializados em Terapia Enterostomal e incorporá-los ao Sistema Nacional de Saúde como membros indispensáveis da equipe multidisciplinar.

CARACTERÍSTICAS CLÍNICO-EPIDEMIOLÓGICAS DE CÂNCER DE MAMA EM PACIENTES DE UNIDADE DE ALTA COMPLEXIDADE EM ONCOLOGIA / CLINICAL AND EPIDEMIOLOGICAL CHARACTERISTICS OF BREAST CANCER IN HIGH-COMPLEXITY ONCOLOGY PATIENTS / CARACTERÍSTICAS CLÍNICAS Y EPIDEMIOLÓGICAS DE CÁNCER DE MAMA EN PACIENTES ONCOLÓGICOS DE ALTA COMPLEJIDAD

O câncer de mama figura como uma das patologias que mais atinge a população feminina no mundo. Este trabalho objetivou identificar as características clínico-epidemiológicas e subtipos do câncer de mama mais frequente em pacientes atendidas pela Unidade de Alta Complexidade em Oncologia de Teixeira de Freitas, Bahia, Brasil, no período de 2010 a 2012. Realizou-se estudo transversal do tipo descritivo-quantitativo e os dados obtidos foram verificados pelo teste de Análise de Variância e o teste de Tukey (p<0,05). Foram analisados 122 prontuários de mulheres diagnosticadas e submetidas a tratamento de câncer de mama. Os resultados apontaram que o tipo histológico mais frequente foi ductal (71,31%) e a gradação histológica II a mais recorrente (47,54%). Em 55,75% dos casos, os tumores foram classificados como ≥IIB e em 41,80% das pacientes havia comprometimento linfonodal. O subtipo de câncer mamário predominante foi Luminal A (36,07%) e os subtipos triplo-negativos foram mais frequentes em pacientes com idade inferior a 43 anos. O intervalo temporal entre o diagnóstico e o início de tratamento foi de 3,7 meses em 52,24%. Concluiu-se que os resultados são compatíveis com a literatura, no que se refere às características clinico-epidemiológicas e ao subtipo de carcinoma mamário mais frequente (Luminal A), que apresenta o melhor prognóstico, quando comparado com os demais. Entretanto, o diagnóstico e o início do tratamento das pacientes pesquisadas não ocorreram precocemente.

Breast cancer stands as one of the most frequent diseases affecting women worldwide. This study evaluated the clinical and epidemiological characteristics of as well as identified the most common breast cancer types in patients treated in the High-complexity Oncology Unit in the municipality of Teixeira de Freitas, state of Bahia, Brazil, between 2010 and 2012. For the descriptive and quantitative method adopted, the medical records of 122 women with confirmed breast cancer in treatment were analyzed, and the results were compared using an Analysis of Variance and the Tukey test (p<0.05). Ductal breast cancer was the most common histological manifestation (71.31%), and stage II was the grade most frequently observed (47.54%). Also, 55.75% of cases were ≥IIB, and lymph nodes were affected in 41.80%. Luminal A was the most common cancer subtype diagnosed (36.07%), and the triple negative subtypes were more often observed in patients under 43 years of age. Mean time elapsed between diagnosis and beginning of treatment was 3.7 months in 52.24% of patients. The results obtained are in accordance with the literature about the clinical and epidemiological characteristics and the most common breast cancer subtype (luminal A), which has the best prognosis amongst breast cancers. However, neither early screening nor the beginning of treatment happened within the period conventionally considered appropriate to breast cancer cases.

El cáncer de mama representa una de las patologías que más afectan a la población femenina en el mundo. Este trabajo objetivó identificar las características clínico-epidemiológicas y subtipos del cáncer de mama más frecuente en pacientes atendidos por la Unidad de Alta Complejidad en Oncología de Teixeira de Freitas, Bahia, Brasil, en el período de 2010 a 2012. Se realizó un estudio transversal de tipo descriptivo-cuantitativo y los datos obtenidos fueron verificados por la prueba de Análisis de Varianza y la prueba de Tukey (p<0,05). Se analizaron 122 prontuarios de mujeres diagnosticadas y sometidas a tratamiento de cáncer de mama. El tipo histológico más frecuente fue ductal (71,31%) y la gradación histológica II la más recurrente (47,54%). En el 55,75% de los casos, los tumores fueron clasificados como ≥IIB y en el 41,80% de las pacientes había un compromiso linfonodal. El subtipo de cáncer mamario predominante fue Luminal A (36,07%) y los subtipos triple-negativos fueron más frecuentes en pacientes menores de 43 años. El intervalo temporal entre el diagnóstico y el inicio de tratamiento fue de 3,7 meses en el 52,24% de los pacientes. Los resultados son compatibles con la literatura, en lo que se refiere a las características clínico-epidemiológicas y al subtipo de carcinoma mamario más frecuente (Luminal A), que presenta el mejor pronóstico, en comparación con los demás. Sin embargo, el diagnóstico y el inicio del tratamiento de las pacientes investigadas no ocurrieron precozmente.

Ensayos clínicos por conglomerados (clusters) / Clinical trials by conglomerates (clusters)

Un ensayo clínico aleatorizado por conglomerados se da cuando se aleatorizan grupos (clusters) de individuos a las distintas ramas. Puede ser la única o mejor opción de diseño ante determinadas circunstancias: si hay un claro agrupamiento (biológico o funcional) en donde algunos individuos de análisis son más parecidos entre sí que otros; si las intervenciones a evaluar se realizan a nivel del conglomerado; cuando hay riesgo de contaminación; o por practicidad, costos o conveniencia. Entre los problemas más importantes que conllevan se encuentran posibles sesgos (especialmente cuando el reclutamiento de los individuos se realiza luego de la aleatorización, o no existe ceguera), así como mayor complejidad en el diseño y análisis. Asimismo, si no se tienen en cuenta la agrupación de individuos por conglomerados para el cálculo del tamaño muestral o del análisis de los datos, se podrían obtener resultados incorrectos. Estos estudios deben explicitar, además de lo habitualmente reportado: por qué se decidió realizar un diseño por conglomerados; si los objetivos, intervenciones y puntos finales a evaluar apuntan a nivel del conglomerado, individual, o ambos; describir los criterios de inclusión a nivel del conglomerado e individual; mostrar cómo se hicieron el cálculo del tamaño muestral y los análisis considerando los conglomerados; aclarar si los pacientes, profesionales actuantes e investigadores estaban ciegos a las ramas de investigación; y discutir la generalizabilidad de los resultados, entre otros. Si bien tienen mayor complejidad, estos estudios son cada vez más frecuentes. Es un diseño muy útil si está bien desarrollado y es importante conocer sus particularidades. (AU)

We perform a cluster randomized controlled trial when we randomize groups (or clusters) of individuals (whether humans, cells, or clinics) to different study arms, and not simply individuals. It can be the only or best study design option in certain circum-stances: if there is a clear grouping, when some subjects of analysis are more similar among them than the rest; if interventions to be evaluated are made at cluster level; when there is risk of "contamination" or cross-over; or because of practicality, costs or convenience according to researchers judgment. Cluster trials are associated with important issues: risk of bias (especially when individuals recruitment is made after randomization, or if there was no blinding); and the need of more complex design and analysis. If we do not take clusters into account in the sample size estimation and data analysis, we could get misleading results.When reporting these studies, researchers should make explicit (in addition to standard reporting requirements): the rationale for a cluster design; if the objectives, interventions and endpoints are for clusters, individuals or both; the inclusion criteria for clusters and individuals; how they did sample size estimations and data analysis considering cluster design; if patients, health care profes-sionals and researchers were blind; and if results can be generalized. Even though cluster randomized controlled trials are more complex, these studies are increasingly common. It is a very useful design, if correctly done. And it is important to understand its main characteristics. (AU)

Clinical Characteristics of Status Epilepticus as the First Presentation of Fever Related Seizure in Children

PURPOSE: Status epilepticus (SE) is a neurological emergency disease because it can cause severe neurological complications. In order to avoid these complications, early diagnosis and appropriate treatment is required in SE. Febrile SE is the most common form of SE in children. We investigated the clinical characteristics and prognosis of patients with febrile SE is the first seizure of life. METHODS: We retrospectively reviewed the medical records of patients with SE as the first presentation of fever related seizures who visited our hospital from July 1996 to January 2013. Clinicodemographic characteristics, brain magnetic resonance imaging (MRI) and electro-encephalogram (EEG) findings, and anti-epileptic treatment were compared between two groups divided according to prognosis; fair vs. poor prognosis. RESULTS: Seventy-eight children were included in this study. The median age of the subjects was 20.0 months (interquartile range [IQR] 12.0–42.8). Fifty-one subjects had a fair prognosis, while twenty-seven subjects had a poor prognosis. Statistically significant differences was observed in the duration of seizure (P=0.043), the number of antiepileptic drugs (P<0.001) and the presence of abnormal EEG findings (P<0.001). CONCLUSION: Children with febrile SE as the first seizure of life are likely to reveal a poor prognosis in those whose seizure last longer or are controlled only through high step anti-epileptic drugs. Thus, in order to ensuring a better prognosis for such patients, appropriate treatment is needed to stop the seizure.

Clasificación de los estudios médicos y análisis de la literatura médica publicada / Classification of medical studies and analysis of published medical literature

La aproximación del médico práctico a la literatura científica no es sencilla. No hemos tenido una formación sistemática en tal sentido, y la disponibilidad de la literatura, que en una época pasada era muy dificultosa, ha evolucionado a una abundancia de publicaciones muy difícil de abarcar, llegando en muchas ocasiones a saturarnos de información, la cual no siempre nos resulta útil en su totalidad. Este trabajo está orientado a compartir una forma de leer los trabajos científicos para extraer información que pueda ser útil en la práctica clínica, a través de una serie de preguntas que debemos de formularnos al tener de frente una publicación científica, logrando analizar de forma secuencial la validez interna del estudio, evaluar los resultados, y determinar la aplicabilidad del mismo a la práctica clínica diaria...(AU)

Centro de Documentação/CCD

O Centro de Documentação da Secretaria de Estado da Saúde de São Paulo visa reunir, organizar e disseminar a produção técnico-científica institucional, constituindo-se como depósito legal das publicações produzidas no âmbito da instituição.

Clinical Characteristics of Pandemic Influenza A (H1N1) 2009 Pediatric Infection in Busan and Gyeongsangnam-do: One Institution / 결핵및호흡기질환

BACKGROUND: This study investigated the clinical characteristics and risk factors of the severity of pandemic influenza A (H1N1) 2009 infection in pediatric patients in Busan and Gyeongsangnam-do. METHODS: Cases of influenza A (H1N1) 2009 in patients under the age of 18 years, confirmed by reverse transcription polymerase chain reaction, at Pusan National University Hospital and Pusan National University Yangsan Hospital from the last week of August 2009 through the last week of February 2010 were retrospectively analyzed. RESULTS: Of the 3,777 confirmed cases of influenza A (H1N1) 2009, 2,200 (58.2%) were male and 1,577 (41.8%) were female. The average age of the patients was 8.4+/-4.8 years. The total cases peaked during 44th to 46th week. Most of the patients were in the 5- to 9-year-old age group. Oseltamivir was administered to 2,959 (78.3%) of the patients. 221 patients (5.9%) were hospitalized, age an average of 6.7+/-4.5 years. The average duration of hospitalization was 7.4+/-5.6 days. One hundred cases (45.2%) had pneumonia. Risk factors for hospitalization included male gender, <2 years of age, and underlying disease. Children with asthma were at very high risk of hospitalization, over 20 times the non-asthmatic children (odds ratio [OR], 21.684; confidence interval [CI], 13.295~39.791). Likewise the children with neurologic deficits faced a 16 times higher risk (OR, 15.738; CI, 7.961~31.111). Ten of the patients (4.5%) were admitted to the intensive care unit, and eight (3.6%) required mechanical ventilation. CONCLUSION: Of the pediatric patients with pandemic influenza A (H1N1) 2009, most of the patients were in the 5- to 9-year-old age group. Risk factors for hospitalization included male gender, <2 years of age, and underlying disease. The most common complication was pneumonia. The very high risk of severe morbidity in children with asthma or neurologic disease shows the critical importance of targeted vaccine coverage, special awareness and swift care by both guardians and primary care providers.

Tópicos en investigación clínica: la pregunta de investigación / Topics on clinical research: the research question

El proceso de la investigación en epidemiología requiere el reconocimiento de los elementos que lo constituyen, con el fin de alcanzar un desarrollo exitoso del mismo. Algunos de estos temas no son de fácil abordaje para el investigador clínico, que necesita guías claras para lograr reflejar sus preguntas en estudios clínicos. El siguiente artículo es el primero de una serie de documentos que presentarán los tópicos más importantes en investigación y epidemiología clínica iniciando con el tema de la pregunta de investigación.

Achievement of a succesful epidemiological research process requires knowledge on the elements comprised in it. Some of these matters are not easy to approach by the clinical researcher who needs clear guidelines to be able to reflect his questions in clinical trials. This article is the first of a series of documents that will present major topics in research and clinical epidemiology starting with the research question.

Epidemiological characteristics of female sterilization clients at the Mother and Children Health Protection and Family Planing Center, Tay Ninh Province

This investigation involved 26 women who had sterilized at the Mother and Children Health Protection and Family Planing Center, Tay Ninh Province between February 1993 to February 1998. 86% of these clients aged from 25-39 years. Youngest clients were 21 years of age (2 women) and oldest were 45 years of age (3 women). Mean number of live births is 3.39+/-1.41 per one client, with more than 72% of the clients have had 3 live children or more. 81% of the clients are farmers and none of them are officials. Almost two thirds are illiteracy or have extremely low level of education. More than 37% of the clients reported that their income was less than 268,000 VND per month. 55% of the clients and 86% of their sex partners have not used any contraceptive method previously.

Impacto de un programa educativo para el control del paciente hipertenso / Impact of an educational program for the control of the hypertensive patient

Introducción: la hipertensión arterial es una patología importante por su elevada frecuencia y por la capacidad que tiene de disminuir la esperanza de vida de quien la padece. En México, durante 1980 se ubicó en el segundo lugar como causa de muerte. En Nuevo León ocupó el tercer lugar en demanda de atención en medicina familiar. Objetivo: evaluar el impacto de un programa educativo para el control del paciente hipertenso. Metodología: personal de enfermería efectuó la intervención educativa. Se seleccionaron al azar 38 pacientes, entre 25 y 55 años de edad; se excluyeron aquéllos que presentaron limitaciones auditivas o visuales que les impidieran participar en el estudio. La duración de la estrategia educativa fue de cinco días, tres horas diarias. Se efectuaron mediciones antes y después de la intervención, así como monitoreo de la tensión arterial cada mes. Se utilizó estadística descriptiva y t de Student pareada, con nivel de significancia de 0.05. Resultados: la edad promedio de la población fue de 49 años (DE=8.3); 73% perteneció al sexo femenino; 87% era casado. La diferencia en ganancia de conocimientos fue de 42.6 puntos (DE=22.9, p=0.000); la diferencia de la tensión arterial diastólica fue de 15.2 mmHg (DE=8.9, p=0.000). Conclusiones: en el presente trabajo el incremento en el nivel de conocimiento sobre la enfermedad se asoció con niveles normales de presión arterial, dando como resultado el control de este tipo de pacientes.

Introduction: the high blood pressure is an important pathology, because of its high frequency and its capacity to shorten life expectancy in the patient who suffer it. During 1980 in Mexico the high blood pressure is identified as the second cause of death. In 1989 Nuevo León it occupied the third place in family medicine health care demand. Objective: to evaluate the impact of an educational program for controlling the high blood pressure patient. Methodology: an educational intervention was realized by nursing. Thirty eight patients were randomly selected, whit the age ranging from 25 to 55 years, those presenting auditory and visuals limitations were excluded. Educational intervention lasted five days, three hours a day with pre-and post-test measurements, as well as monitory of high blood pressure each month. Descriptive statistic was used and Student paired t-test, with significant level of .05. Results: population studied was 49 years (DE=8.3), 73% were women and 87% were married. The increased in knowledge difference was 42.6 (DE=22, p=0.000), the difference in diastolic high blood pressure was 15.2 mmHg (DE = 8.9, p=0.000). Conclusions: the present work revels a very substantial improvement in the increment in the level if knowledge about the illness, rebounding in the levels of high blood pressure, given as result the control of this type patients.

Serviço de urgência odontológica: aspectos epidemiológicos e administrativos / Emergency dental service: epidemiological and administrative aspects

Foram analisadas 30.918 fichas de atendimento realizado pelo Serviço de Urgência Odontológica (SUO) da Faculdade de Odontologia de Bauru (FOB), Universidade de Säo Paulo (USP), entre 1987 e 1995. Foram discutidos aspectos como idade, gênero e procedência dos pacientes, total de atendimentos e média diária, diagnósticos e tratamentos realizados, além da participaçäo do SUO no convênio com o Sistema Unico de Saúde (SUS). Concluiu-se que: 1) a cárie e suas conseqüências ainda säo as principais causas de atendimento; 2) näo houve a formaçäo de clientela própria; 3) o SUO realizou 19 por cento de procedimentos pagos pelo SUS, através do convênio com a FOB/USP, e 4) o SUO desempenha um importante papel em relaçäo a ensino de graduaçäo, aperfeiçoamento profissional e extensäo de serviços para a saúde da comunidade

Coordinación de los estudios generales para el diseño del programa para la erradicación de la fiebre aftosa en Bolivia: cuarto informe mensual consultoría / sss

El siguiente documento permite conocer la situación epidemiológica, y determinar la demanda de recursos humanos y materiales necesarios para la elaboración del proyecto para el "Plan nacional de control y erradicación de la fiebre aftosa en la República de Bolivia". Se trabajo con el asesoramiento técnico de la OPS/PANAFTOSA los meses de septiembre-octubre

Contribution to study on the model of the local health network

A survey was performed by using a set of questionnaires and by holding systematic interviews addressed to leading authorities of the health system from village to district and province. Results were analyzed and synthesized to establish a model of health service network as manifested on the governmental Decree No 01/1998.