Estudiar y trabajar como factores de riesgo en estudiantes de enfermería, Universidad Nacional Formosa, 2022 / Study and work as risk factors in nursing students, National University of Formosa,2022

Objetivo: Correlacionar la variable principal sostén del hogar con las variables género, edad, horas de trabajo, horas de sueño y factores de riesgo cardiovascular (índice de masa corporal, hipertensión arterial, dislipemia y diabetes mellitus), en estudiantes de 3º, 4 y 5º año de la Licenciatura en Enfermería, Universidad Nacional de Formosa. Metodología: estudio descriptivo, correlacional, transversal realizado en 214 estudiantes, durante el año 2022, utilizándose un cuestionario on-line autoadministrado, estructurado y medición de peso y talla. Resultados: el 76% fueron mujeres; 64%, principal fueron principal sostén del hogar, 57% refirió dormir menos de 6 horas al día, 15 % trabaja más de 41 horas semanales; 67% tuvo respuestas no saludables a la variable estrés, para la variable actividad física este valor ascendió a 71% y el 53,8% presentó exceso de peso. Se encontró asociación significativa entre ser el principal sostén del hogar con exceso de peso, trabajar 41 horas o más semanalmente, dormir menos de 6 horas al día y con la presencia de 3 o más factores de riesgo cardiovascular. Conclusiones: Las condiciones de vida que afrontan los estudiantes que de manera simultánea estudian, trabajan y son principal sostén del hogar pueden generar estrés, el cual es un factor de riesgo para las enfermedades cardiovasculares[AU]

Objetive: to correlate the main variable of primary income earner or primary breadwinner with gender, age, working hours, sleep hours, and cardiovascular disease risk factors (body mass index, hypertension, dyslipidemia, and diabetes mellitus) in 3rd, 4th, and 5th-year nursing students at the Nursing Program at the National University of Formosa. Methodology: The study was a descriptive, correlational, cross-sectional, conducted with 214 students during 2022 using a self-administered structured online questionnaire and measurement of weight and height. Results: 76% were women, 64% were the main breadwinner, 57% reported sleeping less than 6 hours a day, 15% working more than 41 hours per week; 67% had unhealthy responses to the stress variable, this value rose to 71% for the physical activity variable, and 53.8% were overweight. A significant association was found between the main variable of primary breadwinner and being overweight, working 41 or more hours weekly, and the presence of 3 or more cardiovascular risk factors. Conclusions: The living conditions faced by students who simultaneously study and work, and being the main breadwinner in the household can generate stress, which is a risk factor for cardiovascular diseases[AU]

Objetivo:: correlacionar a variável principal de sustento econômico do lar com as variáveis gênero, idade, horas de trabalho, horas de sono e fatores de risco cardiovascular (índice de massa corporal,hipertensão arterial, dislipidemia e diabetes mellitus) em estudantes do 3º, 4º e 5º ano do curso de graduação em Enfermagem, Universidade Nacional de Formosa. Metodologia: O estudo foi descritivo, correlacional e transversal, realizado em 214 estudantes durante o ano de 2022. Foi utilizado um questionário online autoadministrado e estruturado, e a medição de peso e altura dos estudantes foi realizada. Resultados: 76% dos estudantes eram mulheres; 64% eram o principal sustento econômico do lar; 57% relataram dormir menos de 6 horas por dia, 15% responderam que trabalham mais de 41 horas por semana; em relação aos fatores de risco cardiovascular, 67% tiveram respostas não saudáveis para a variável estresse, para a variável atividade física esse valor aumentou para 71% e 53,8% apresentaram excesso de peso. Foi encontrada uma associação significativa entre a variável principal de sustento econômico do lar com as variáveis excesso de peso, trabalhar 41 horas ou mais por semana, dormir menos de 6 horas al día e a presença de 3 ou mais fatores de risco cardiovascular. Conclusões: As condições de vida enfrentadas pelos estudantes que simultaneamente estudam, trabalham e são o principal sustento do lar podem gerar estresse, que é um fator de risco para doenças cardiovasculares[AU]

Do immunosuppressive treatments influence immune responses against adenovirus-based COVID-19 vaccines in patients with multiple sclerosis? An Argentine multicenter study.

Introduction: There are no reports in LATAM related to longitudinal humoral and cellular response to adenovirus based COVID-19 vaccines in people with Multiple Sclerosis (pwMS) under different disease modifying therapies (DMTs) and neutralization of the Omicron and Wuhan variants of SARS-COV-2. Methods: IgG anti- SARS-COV-2 spike titer were measured in a cohort of 101 pwMS under fingolimod, dimethyl fumarate, cladribine and antiCD20, as well as 28 healthy controls (HC) were measured 6 weeks after vaccination with 2nd dose (Sputnik V or AZD1222) and 3nd dose (homologous or heterologous schedule). Neutralizing capacity was against Omicron (BA.1) and Wuhan (D614G) variants and pseudotyped particles and Cellular response were analyzed. Results: Multivariate regression analysis showed anti-cd20 (ß= -,349, 95% CI: -3655.6 - -369.01, p=0.017) and fingolimod (ß=-,399, 95% CI: -3363.8 - -250.9, p=0.023) treatments as an independent factor associated with low antibody response (r2 adjusted=0.157). After the 2nd dose we found a correlation between total and neutralizing titers against D614G (rho=0.6; p<0.001; slope 0.8, 95%CI:0.4-1.3), with no differences between DMTs. Neutralization capacity was lower for BA.1 (slope 0.3, 95%CI:0.1-0.4). After the 3rd dose, neutralization of BA.1 improved (slope: 0.9 95%CI:0.6-1.2), without differences between DMTs. A fraction of pwMS generated anti-Spike CD4+ and CD8+ T cell response. In contrast, pwMS under antiCD20 generated CD8+TNF+IL2+ response without differences with HC, even in the absence of humoral response. The 3rd dose significantly increased the neutralization against the Omicron, as observed in the immunocompetent population. Discussion: Findings regarding humoral and cellular response are consistent with previous reports.

Desigualdad en las prácticas de lactancia y alimentación complementaria en la Argentina, según nivel de ingresos del hogar en 2018-19 / Inequality in breastfeeding and complementary feeding practices in Argentina by household income level in 2018­2019

Introducción. La calidad de la alimentación es un derecho vinculado con la supervivencia, el crecimiento saludable, la prevención de enfermedades crónicas y malnutrición en todas sus formas. El objetivo de este trabajo fue analizar las prácticas de lactancia y de alimentación de menores de 2 años de áreas urbanas de la Argentina en 2018-19, según el nivel de ingreso de los hogares. Población y métodos. Estudio secundario con datos de la 2da. Encuesta Nacional de Nutrición y Salud 2018-19. Se analizaron indicadores de lactancia y alimentación complementaria, según metodología de la Organización Mundial de la Salud (OMS) y Unicef. Se estratificó según nivel de ingresos del hogar. Resultados. El análisis incluyó 5763 menores de 24 meses. Aunque el 97 % fue alguna vez amamantado, solo el 47 % de los menores de 6 meses tuvo lactancia exclusiva el día previo y el 48 % mantenía la lactancia luego del año, con mayor prevalencia en los niños/as de menores ingresos. En el día previo, el 23 % de los niños/as de 6 a 23 meses no consumió ninguna verdura o fruta; el 60 % consumió alimentos no saludables y el 50 %, bebidas dulces. Las bebidas dulces y la ausencia de frutas y verduras fueron mayores en aquellos de hogares de menores ingresos. Conclusión. La calidad de la alimentación de los niños/as dista de las recomendaciones y está condicionada por los ingresos. En los sectores empobrecidos, es menor el inicio temprano de la lactancia, la diversidad alimentaria mínima y el consumo de frutas y verduras, y es mayor el consumo de bebidas dulces.

Introduction. Diet quality is a right related to survival, healthy growth, prevention of chronic diseases, and malnutrition in all its forms. The objective of this study was to analyze breastfeeding and feeding practices in children younger than 2 years from urban areas of Argentina in 2018­2019 according to their household income level. Population and methods. Secondary analysis of data of the Second National Survey on Nutrition and Health (ENNyS2) of 2018­2019. Breastfeeding and complementary feeding indicators proposed by the World Health Organization (WHO) and the United Nations Children's Fund (UNICEF) were analized. Data were stratified by household income level. Results. The analysis included 5763 children younger than 24 months old. Although 97% was ever breastfed, only 47% of infants younger than 6 months were exclusively breastfed the previous day and 48% continued with breastfeeding after 1 year old, with a higher prevalence in low-income children. The previous day, 23% of children aged 6 to 23 months did not eat any fruit or vegetable, 60% consumed unhealthy foods, and 50% consumed sweet beverages. The consumption of sweet beverages and the absence of fruit and vegetables were higher in low-income households. Conclusion. The quality of children's diet is far from the recommendations and is conditioned by income. Early initiation of breastfeeding, minimum dietary diversity, fruit and vegetable consumption are lower and sweet beverage consumption is greater in impoverished sectors.

Virus entéricos distintos de rotavirus y norovirus en menores de 5 años con gastroenteritis en Argentina, 2010-2021. Estudio descriptivo / Enteric viruses other than rotavirus and norovirus in children under 5 years of age with gastroenteritis in Argentina, 2010­2021. A descriptive study

Introducción. Los datos de frecuencia de los adenovirus entéricos, sapovirus y astrovirus en casos de gastroenteritis aguda esporádica en Argentina son escasos. Métodos. Diseño descriptivo sobre una selección de muestras de heces de menores de 5 años con diarrea remitidas durante el período 2010-2021, con resultado previo negativo para rotavirus y norovirus. Se estudió la presencia de adenovirus entéricos, sapovirus y astrovirus por métodos moleculares, con posterior genotipificación de las muestras positivas. Resultados. De 574 muestras seleccionadas, en 226 (39,4 %) se identificó al menos uno de los virus estudiados. En particular, se detectaron adenovirus, sapovirus y astrovirus en el 30,7 %, el 5,6 % y el 3,1 %, respectivamente. El adenovirus 41, los sapovirus GI.1 y GI.2, y el astrovirus 1 fueron los más frecuentemente detectados. Se identificaron dos muestras con astrovirus no clásicos. Conclusiones. A pesar de ser menos frecuentes, estos enteropatógenos son responsables de un número considerable de episodios de diarrea esporádica. Por lo tanto, su estudio y vigilancia contribuye significativamente a reducir la brecha de casos no diagnosticados.

Introduction. Data on the frequency of enteric adenoviruses, sapoviruses, and astroviruses in cases of sporadic acute gastroenteritis in Argentina are scarce. Methods. Descriptive design of a selection of fecal samples of children with diarrhea younger than 5 years referred between 2010 and 2021, with a previous negative result for rotavirus and norovirus. The presence of enteric adenovirus, sapovirus, and astrovirus was tested by molecular methods, with subsequent genotyping of positive samples. Results. At least 1 of the tested viruses was detected in 226 (39.4%) of the 574 selected samples. Specifically, adenovirus, sapovirus, and astrovirus were detected in 30.7%, 5.6%, and 3.1% of the samples, respectively. The most frequent viruses detected were adenovirus 41, sapoviruses GI.1 and GI.2, and astrovirus 1. Non-classic astroviruses were detected in 2 samples. Conclusions. Despite being less frequent, these enteropathogens are responsible for a large number of sporadic diarrhea events. Therefore, their study and surveillance contribute significantly to reduce the gap of undiagnosed cases.

[What about extending Specialised Health Training to architecture and engineering?] / ¿Y si ampliamos la Formación Sanitaria Especializada para la arquitectura e ingeniería?

Projects and construction management in healthcare facilities are usually assigned to architectural firms and engineering companies with previous experience. However, there is no evaluation system to ensure their level of competence in the healthcare sector. In the past, this was also the case for clinicians when they were self-appointed specialists without any supervision. Currently, the Specialised Health Training (SHT) programme in Spain is the only official specialisation pathway and consists of a period that combines training and paid healthcare practice. Similarly, but from Argentina, hospital residencies in architecture have been carried out for specialised postgraduate training. The aim of this article was to show the experience in Argentina and to propose the extension of the SHT in Spain. Our proposal consists of a programme of residencies in architecture and engineering to be developed in healthcare centres. We believe that this initiative has great potential to address health from its multiple disciplines and to reinforce the maturity of a National Health System in constant change.

Los proyectos y la dirección de obras en los centros sanitarios se suelen asignar a estudios de arquitectura y empresas de ingeniería con experiencia previa. Sin embargo, no hay un sistema de evaluación que asegure su nivel de competencia en el sector sanitario. Antiguamente, esta situación también se daba en los profesionales clínicos, cuando se autotitulaban especialistas sin ningún tipo de supervisión. En la actualidad, el programa de Formación Sanitaria Especializada (FSE) en España es la única vía de especialización oficial y consiste en un periodo que aúna formación y práctica asistencial remunerada. De manera similar, pero desde Argentina, se llevan realizando unas residencias hospitalarias de arquitectura para la formación especializada de posgrado. El objetivo de este artículo fue mostrar la experiencia en Argentina y proponer la ampliación de la FSE en España. Nuestra propuesta consiste en un programa de residencias en arquitectura e ingeniería a desarrollar en centros sanitarios. Consideramos que esta iniciativa tiene un gran potencial para abordar la salud desde sus múltiples disciplinas y reforzar la madurez de un Sistema Nacional de Salud en constante cambio.

Utilizing spiders for biomonitoring air pollution from road traffic: a novel approach and preliminary findings.

Polycyclic aromatic hydrocarbons (PAHs) are air pollutants generated mainly by fuel combustion, industry, and other anthropogenic sources. The level of these pollutants can be assessed by employing biomonitors, a cost-effective and less contaminating alternative than conventional methods. In the present study, we aimed to investigate whether spiders inhabiting areas around a major city like Córdoba, Argentina, adsorb and retain PAHs in their exoskeletons. Additionally, we aimed to determine if spiders' life traits influence their capacity to accumulate PAHs and explore potential relationships between PAH levels and the types of roads where they were collected. Specimens of a funnel-shaped web spider (Aglaoctenus lagotis) and an orb-weaver (Metepeira spp.) were collected from roadsides. Roads were classified into four categories based on their traffic intensity. Using high-performance liquid chromatography (HPLC), we identified 15 different PAHs. Both species exhibited varying concentrations of PAHs, although Metepeira spp. showed 15-18 times higher PAH levels compared to A. lagotis. Moreover, A. lagotis individuals living alongside highways accumulated up to six times more PAHs compared to those along other road types. These findings suggest that spiders' life traits may influence pollutant concentrations. Our study demonstrates that spiders near roads are exposed to and accumulate PAHs on their exoskeletons, likely sourced from petrogenic vehicular emissions, highlighting their value as biomonitors and emphasizing the need for mitigation measures to address air pollutants emitted from mobile sources.

Revealing the diversity of Parasmittina Osburn, 1952 (Bryozoa, Cheilostomatida) from the Southwest Atlantic: Species complexes, non-native and new species.

Parasmittina is the most representative cheilostome genus of the family Smittinidae, often reported in the fouling non-indigenous marine community. Here, we present a review of Parasmittina species reported in the Southwestern Atlantic including the characterization of one species from Argentina (P. dubitata) and ten from the Brazilian coast: P. abrolhosensis, P. alba, P. bimucronata, P. ligulata comb. nov., P. longirostrata, P. pinctatae, P. serrula, P. simpulata, P. winstonae and the new species Parasmittina falciformis sp. nov. The new species is characterized by a smooth distally primary orifice with 1-2 oral spines, large lyrula, serrated condyles with hooked tips, and two types of avicularia-small and subtriangular and large sublanceolate. This study does not recognize four species previous recorded in Brazil: reports of P. betamorphaea and P. trispinosa are now assigned to P. pinctatae; records of P. munita belong to P. falciformis sp. nov.; and reports of P. spathulata encompass at least two taxa, including P. abrolhosensis and P. simpulata. In this study, five species complexes (P. alba, P. longirostrata, P. serrula, P. simpulata and P. winstonae) were identified and require further investigations. While six species characterized here were first described based on specimens from the Southwestern Atlantic (P. abrolhosensis, P. alba, P. dubitata, P. ligulata comb. nov., P. simpulata and P. falciformis sp. nov.), the remaining species are mainly known from the Indo-Pacific. These taxa are here recognized as exotic (P. longirostrata) and cryptogenic (P. bimucronata, P. pinctatae, P. serrula and P. winstonae) in the studied area. Most of the non-native taxa are widespread along the Brazilian coast, growing on both artificial and natural surfaces, indicating that they are well-established in the area. As non-native bryozoans can negatively influence the environment, affecting human economic activities and beach usage, further studies on the fauna presented here are suggested to determine the origin of these taxa and help prevent bioinvasion events along the SW Atlantic.

First detection of V410L kdr mutation in Aedes aegypti populations of Argentina supported by toxicological evidence.

BACKGROUND: Aedes aegypti (L.) is the main vector of dengue, yellow fever, Zika, and chikungunya viruses in many parts of the world, impacting millions of people worldwide each year. Insecticide-based interventions have been effective in controlling Aedes mosquito populations for several years, but in recent times, resistance to these compounds has developed, posing a global threat to the control of this mosquito. METHODS: Ovitraps were used to collect A. aegypti eggs in the cities of Tartagal and San Ramón de la Nueva Orán (Salta), Puerto Iguazú (Misiones), and Clorinda (Formosa). World Health Organization (WHO)-impregnated papers with the discriminating concentration (DC) of permethrin, 5X, 10X and pirimiphos methyl were used for the toxicological bioassays. We also genotyped each sample for the three kdr single nucleotide polymorphisms (SNP): V410L, V1016I, and F1534C in individual TaqMan quantitative PCR (qPCR) reactions. RESULTS: All investigated A. aegypti populations were highly resistant to permethrin, as the mortality percentage with the permethrin 10×DC remained below 98%. However, all populations were 100% susceptible to pirimiphos-methyl. Kdr genotyping demonstrated the presence of the V410L mutation for the first time in Argentina in all the populations studied. A prevalence of the triple mutant genotype (LL + II + CC) was observed in the northeastern cities of Clorinda (83.3%) and Puerto Iguazú (55.6%). CONCLUSIONS: This study demonstrates for the first time the presence and intensity of resistance to permethrin in different populations from Argentina, and correlates the observed phenotype with the presence of kdr mutations (genotype).

A model of long-term population growth with an application to Central West Argentina.

We propose an Ideal Specialization Model to help explain the diversity of population growth trajectories exhibited across archaeological regions over thousands of years. The model provides a general set of expectations useful for guiding empirical research, and we provide a concrete example by conducting a preliminary evaluation of three expectations in Central West Argentina. We use kernel density estimates of archaeological radiocarbon, estimates of paleoclimate, and human bone stable isotopes from archaeological remains to evaluate three expectations drawn from the model's dynamics. Based on our results, we suggest that innovations in the production of food and social organization drove demographic transitions and population expansion in the region. The consistency of population expansion in the region positively associates with changes in diet and, potentially, innovations in settlement and social integration.

Anthelmintic resistance of gastrointestinal nematodes in cattle in Brazil and Argentina - current status and global perspectives.

This review outlines the current state of anthelmintic resistance (AHR) of gastrointestinal nematodes (GINs) among cattle in Argentina and Brazil, emphasizing the economic repercussions, animal health and welfare. The analysis explores factors associated with AHR and proposes a potential solution: the use of drug combinations. Both countries are grappling with a severe AHR scenario in cattle, having progressed through incipient, established, and advanced phases, leading to extreme cases of animal mortality due to ineffective control strategies. Genera such as Cooperia and Haemonchus have the highest reports of resistance, with Oesophagostomum radiatum also posing significant problems. While oral benzimidazoles and levamisole remain effective in most herds, moxidectin is entering an advanced resistance phase, and avermectins are increasingly deemed ineffective. The review explores the impact ofclimate, mixed grazing, animal movement and other husbandry practices, and the relationship between ectoparasite control and the emergence of resistant helminths. Notably, the discussion includes the strategic use of drug combinations as a valuable approach to address resistant GINs control in livestock, highlighting its significant potential to mitigate the challenges posed by AHR in the cattle industry of these countries.

First report of abdominal sepsis caused by a recently described species: Chimaeribacter arupi.

We present a case of a 34-year-old patient with abdominal sepsis caused by an infrequent species: Chimaeribacter arupi. Genomic analysis confirmed the identification which is difficult to achieve by other methods so far. To our knowledge, this represents the first case of infection by this species reported in Argentina.

Implementation of WHO guidelines for cervical cancer screening, diagnosis and treatment: knowledge and perceptions of health providers from Argentina.

BACKGROUND: The 2021 World Health Organization (WHO) guidelines on cervical cancer screening and treatment provide countries with evidence-based recommendations to accelerate disease elimination. However, evidence shows that health providers' adherence to screening guidelines is low. We conducted a study in Argentina to analyze health providers' knowledge and perceptions regarding the 2021 WHO Guidelines. METHODS: A qualitative study was conducted based on individual, semi-structured interviews with health providers specializing in gynecology (n = 15). The themes explored were selected and analyzed using domains and constructs of the Consolidated Framework for Implementation Research. RESULTS: Although health providers perceive WHO as a reliable institution, they do not know the 2021 guidelines, its supporting evidence, and its elaboration process. Their clinical practice is mainly guided by local recommendations developed by national professional medical associations (PMAs). For interviewees, WHO guidelines should be disseminated through health authorities and national PMAs, mainly through in-service training. Health providers had a positive assessment regarding WHO Recommendation 1 (screen, triage, and treatment for women aged 30 + with HPV-testing every 5 to 10 years) and perceived a favorable climate for its implementation. HPV-testing followed by triage was considered a low-complexity practice, enabling a better detection of HPV, a better selection of the patients who will need diagnosis and treatment, and a more efficient use of health system resources. However, they suggested adapting this recommendation by removing screening interval beyond 5 years. WHO Recommendation 2 (screen-and-treat approach with HPV-testing for women aged 30 + every 5 to 10 years) was predominantly rejected by interviewees, was considered an algorithm that did not respond to women's needs, and was not adequate for the Argentinean context. Regarding the HPV-test modality, clinician-collected tests were the preferred mode. Health providers considered that HPV self-collection should be used primarily among socially vulnerable women to increase screening coverage. CONCLUSION: WHO guidelines should be widely disseminated among health providers, especially in settings that could benefit from a screen-and-treat approach. Identifying areas of partnership and collaboration with PMAs in implementing WHO guidelines is essential.

Thubunaea acostai sp. nov. (Nematoda: Physalopteridae) from the lizard Liolaemus gracielae (Squamata: Iguania: Liolaemidae) in Argentina.

Thubunaea acostai sp. nov. is described and illustrated here, based on specimens found in the digestive tract of Liolaemus gracielae in the province of San Juan, Argentina. The new species differs from all other species assigned to Thubunaea by the number of caudal papillae. Thubunaea acostai sp. nov. has 30-31 papillae (12 pedunculated and 18-19 sessile), differing from other Neotropical species such as Thubunaea eleodori with 26 papillae (12 pedunculated and 14 sessile) and Thubunaea parkeri with 20 papillae, all pedunculated. The new species represents the third species for the Neotropics and the second described for Argentina.

Benthic foraminifera diversity from the south Atlantic Ocean: Tierra del Fuego and surrounding waters (South America).

The present study provides a detailed record of foraminiferal fauna and their ecological implications from surface sediments from Atlantic shelf of Tierra del Fuego, Argentina. The foraminiferal assemblage is mostly composed by four main hyaline genera, such as Cibicidoides, Cibicides, Globocassidulina and Buccella, which allowed the identification of three environmental zones. Zone 1 (Z1, 37 to 90 m) encompasses the eastern Beagle Channel and San Sebastian Bay. The assemblage reflected well-oxygenated marine inner shelf habitat, adapted to cold temperate waters. Zone 2 (Z2, up to 98.4 m), is located around the southern tip of Tierra del Fuego. The assemblage suggested a deeper marine environment, well oxygenated and with higher energy, probably due to the effect of tides and mainly by the influence of Malvinas Current. Finally, Zone 3 (Z3, up to 195 m) is located furthest from the Atlantic coast and the assemblage suggested an environment characteristic of outer shelf, with well-oxygenated cold waters and high-energy environment, reflected by species adhered to the substrate and coarse sediments. The distribution and abundance of certain species showed the influence of the Malvinas Current, while others evidenced a contribution of the Cape Horn waters.

Budget impact of upadacitinib in patients with moderate to severe rheumatoid arthritis in Argentina. / Impacto presupuestario de upadacitinib en pacientes con artritis reumatoide moderada a severa en Argentina.

OBJECTIVES.: To analyze the budget impact of upadacitinib (UPA) 15 mg + methotrexate (MTX) for the treatment of moderate-to-severe rheumatoid arthritis (RA) in patients with an inadequate response to conventional disease-modifying antirheumatic drugs (cDMARD-IR) from the perspective of social security and the private health sector in Argentina. MATERIALS AND METHODS.: A budget impact analysis model was developed for a hypothetical cohort of 100,000 adults with health insurance coverage who were diagnosed with RA over a 5-year time horizon. The model parameters were obtained through literature review and validated by local experts. The costs are expressed in 2024 US dollars (USD). RESULTS.: The introduction of UPA 15 mg + MTX for the treatment of moderate-to-severe RA and cDMARD-IR resulted in minimal increase, with a five-year total cumulative incremental cost of USD 1,855 for social security and USD 1,812 for the private health sector, representing 2% of the total budget. The acquisition cost of UPA was the most influential variable in the sensitivity analysis. CONCLUSIONS.: The introduction of UPA 15 mg + MTX for the treatment of moderate-to-severe RA and cDMARD-IR can provide an effective treatment option with a minimal increase in costs for the healthcare system in Argentina, which is especially important in developing countries where health system budgets are more limited. Providing evidence-based estimates is a valuable tool for informing healthcare policies and can help policymakers make informed decisions about the allocation of healthcare resources to improve patient outcomes while also managing costs.Motivation for the study. Rheumatoid arthritis (RA) is a disease that hasn't cure, so it's important to know the budget impact of treatment with upadacitinib (UPA) 15 mg + methotrexate (MTX) in patients with moderate to severe RA who didn't respond well to conventional antirheumatic drugs. Main findings. UPA + MTX would entail a minimal increase in costs for the healthcare system in Argentina, potentially making this effective treatment option more accessible to patients with RA. Access to this treatment can improve the outcome of patients with RA. Public health implications. In resource-constrained settings such as Argentina, providing evidence-based cost estimates can help healthcare managers allocate resources efficiently while improving patient outcomes. This study provides evidence to inform healthcare policies and decisions regarding the inclusion of UPA + MTX in treatment guidelines or formularies for RA management.

Analysis of long COVID in health personnel: comparing gender and work factors.

INTRODUCTION: This study aimed to describe the reported prevalence of post-COVID-19 syndrome and its characteristics by gender, profession, and other determinants among health care workers. METHODS: A cross-sectional study was conducted among health workers with a history of COVID-19 in Latin America, and the 2030 responses from Argentina were selected for this analysis. Sociodemographic information, as well as data on initial course of COVID-19, and the persistence of 21 symptoms beyond the first month, their severity, clinical evolution, and health care demands were collected. RESULTS: The reported prevalence of post-COVID-19 syndrome was higher in women for each of the symptom clusters studied. Severity of the initial symptoms, female gender, nursing profession, multi-employment, and working in emergency areas were all independent variables. DISCUSSION: The greater strain of health care workers during the pandemic -highly feminized- and the associated gender conditions may partially explain these findings.

Introducción: El objetivo del estudio fue describir la prevalencia del reporte de síndrome post-COVID-19 y sus características según género, profesión y otros determinantes sociales, en personal de salud. Métodos: Se realizó un estudio de corte transversal en profesionales de salud con antecedentes de COVID-19 en América Latina, y para este análisis se seleccionaron las 2030 respuestas de Argentina. Se recolectaron datos sociodemográficos, información sobre el curso inicial de la enfermedad COVID-19, y persistencia de 21 síntomas más allá del primer mes, su gravedad, evolución clínica y requerimiento de servicios de salud. Resultados: Se identificó que la prevalencia reportada de síndrome post-COVID-19 fue mayor en mujeres para cada uno de los grupos de síntomas explorados. La gravedad del cuadro inicial, el género femenino, la profesión de enfermería, el multiempleo y trabajar en áreas de emergencia fueron variables independientes. Discusión: La mayor sobrecarga del personal de salud durante la pandemia ­altamente feminizado­ y las determinaciones de género asociadas podrían explicar parcialmente estos hallazgos.

[Perceived self-efficacy scale on shared care planning (ACP-SEs) Argentina]. / Escala autoeficacia percibida sobre planificación compartida de la atención (ACP-SEs) Argentina.

INTRODUCTION: Shared care planning (ACP) is a reflective, deliberative and structured process involving the sick person and his or her caring environment. Health professionals recognize barriers to initiating ACP.Perceived self-efficacy is one of the main predictors of success in learning processes. OBJECTIVES: 1) To crossculturally adapt the ACP self-efficacy scale in Spanish for Argentina (ACP-SEs); 2) To explore the reliability and validity of the scale; and 3) To explore self-efficacy in ACP in Argentinean professionals. METHOD: Exploratory instrumental study carried out on health professionals who assist patients with advanced chronic diseases, interdisciplinary through a comprehension test of the ACP-SEs instrument and psychometric validation in a purposive sample of professionals. Sociodemographic variables and previous experience were analyzed. RESULTS: After the comprehension test and linguistic adaptation of the scale through cognitive testing with eight professionals with experience with advanced chronic patients, the ACP-SEs Ar version of the scale was achieved. 236 professionals participated in the exploration, 83% attended patients with advanced chronic disease, 52.9 % were physicians, 52% received informal training in ACP, and 11% had a personal advance directive document. The scale's internal consistency was high (Cronbach's alpha = 0.89). Questions about prognosis, treatment options, goals, treatment preferences, and reassessment of goals of care showed significant differences between physicians and nonphysicians. CONCLUSION: We explored PCA self-efficacy in health professionals with the ACP-SEs Ar scale validated for the first time in Argentina.

Introducción: La planificación compartida de la atención (PCA) es un proceso reflexivo, deliberativo y estructurado. Involucra a la persona enferma y su entorno afectivo. Los profesionales sanitarios reconocen barreras para iniciar la PCA. La autoeficacia percibida es un principal predictor del éxito en los procesos de aprendizaje. Objetivos: 1) Adaptar transculturalmente la escala de autoeficacia percibida en PCA en español para Argentina (ACP-SEs); 2) Explorar la confiabilidad y la validez de la escala y 3) Explorar la autoeficacia en PCA en profesionales argentinos. Métodos: Estudio instrumental exploratorio realizado a profesionales de la salud que asisten pacientes con enfermedades crónicas avanzadas, interdisciplinarios, a través de una prueba de comprensión del instrumento ACP-SEs y la validación psicométrica en una muestra intencional de profesionales. Se analizaron variables sociodemográficas y la experiencia previa. Resultados: Luego de la prueba de comprensión y adaptación lingüística de la escala a través de un test cognitivo con 8 profesionales con experiencia con pacientes crónicos avanzados se logró la versión de la escala ACP-SEs Ar. Participaron en la exploración 236 profesionales, el 83% asistía pacientes con enfermedad crónica avanzada; el 52.9% médicos; 52% recibió formación informal en PCA y 11% tenía un documento de directivas anticipadas personal. La consistencia interna de la escala fue alta (alfa de Cronbach = 0.89). Las preguntas sobre pronóstico, objetivos y preferencias de tratamiento, y reevaluación de los objetivos de cuidados mostraron diferencias significativas entre médicos y no médicos. Conclusión: La escala ACP-SEs Ar demostró propiedades psicométricas adecuadas.

[Sarcopenia: new cut-off value of handgrip in postmenopausal Argentine women]. / Sarcopenia: nuevo valor de handgrip en mujeres argentinas postmenopáusicas.

INTRODUCTION: Sarcopenia is a global health problem, there are currently several criteria for its diagnosis and the implementation of its own cut-off values for each population is recommended. The objective was to evaluate the handgrip strength (HG) in postmenopausal women from Buenos Aires and establish a cut-off value. METHODS: A total of 704 women ≥50 years of age were evaluated, who answered a questionnaire on osteoporosis risk and HG was taken. Those with arthritis or pain in the hands were excluded, leaving 678 women for analysis. A subpopulation of 148 healthy women was selected to define the minimum normal value of the HG of our population. RESULTS: The HG was 20.44 ± 5.19 kg, with a significant decrease in values after 70 years. The HG in the group of healthy women was 22.08 ± 5.13 kg. And the cutoff value of 17.5 kg was established in our population (first quintile). 28.6% of the total population presented decreased HG and reached 53.7% in women >80 years. HG <17.5 kg was associated with a 67% increased risk of falls in the total group of women >50 years. DISCUSSION: The HG is a simple tool that is easy to implement in clinical practice and is considered the first step for the diagnosis of sarcopenia. The cut-off value of HG <17.5 kg could be used for the evaluation of sarcopenia in women >50 years of Buenos Aires.

Introducción: La sarcopenia es un problema de salud mundial, actualmente existen varios criterios para su diagnóstico y se recomienda la implementación de valores de corte propios para cada población. El objetivo fue evaluar la fuerza de prensión palmar (FPP), en mujeres postmenopáusicas de Buenos Aires y establecer un valor de corte para nuestra población. Métodos: Se evaluaron 704 mujeres ≥50 años, quienes respondieron un cuestionario sobre riesgo de osteoporosis y se tomó la FPP. Se excluyeron aquellas con artritis o dolor en las manos, quedando 678 mujeres para el análisis. Se seleccionó una subpoblación de 148 mujeres sanas para definir el valor mínimo normal de la FPP de nuestra población. Resultados: La FPP fue de 20.44 ± 5.19 kg, con una disminución significativa a partir de los 70 años. La FPP en el grupo de mujeres sanas fue de 22.08 ± 5.13 kg. Y se estableció el valor de corte de 17.5 kg en nuestra población (primer quintil). El 28.6% de la población total presentaban FPP disminuida y alcanzaba a un 53.7% en las mujeres >80 años. La FPP <17.5 kg se asoció con un incremento del 67% del riesgo de caídas en el grupo total de mujeres >50 años. Discusión: La FPP constituye una herramienta sencilla y de fácil implementación en la práctica clínica del consultorio y es considerada el primer paso para el diagnóstico de sarcopenia. El valor de corte de FPP <17.5 kg podría ser utilizado para la evaluación de sarcopenia en mujeres >50 años de Buenos Aires.

[Perception and identification of barriers to the use of digital technologies in arterial hypertension]. / Percepción e identificación de barreras para la utilización de tecnologías digitales en hipertensión arterial.

INTRODUCTION: Electronic devices and communication technologies are increasingly used to provide medical care to patients with high blood pressure. The main objective was to evaluate doctors' perception on the usefulness of digital technologies in hypertension. The secondary objectives were to evaluate the prevalence of use of digital technologies in the follow-up of patients with hypertension and to identify the barriers perceived by doctors for their implementation in the Argentine Republic. METHODS: Observational, cross-sectional, multicenter study, based on a self-administered questionnaire, in the Argentine Republic, and coordinated by the Epidemiology group of the Argentine Society of Arterial Hypertension. POPULATION: Doctors who care for patients with high blood pressure. RESULTS: 247 responses were obtained, 35.6% were women and 64.4% men; 92.3% indicated that the use of digital technologies was useful to improve therapeutic adherence; 54.7% received blood pressure results at home through some digital means; 41.3% regularly carry out teleconsultations, only 6.1% through specific digital health platforms, 29.1% through non-specific platforms, by telephone 21.9% and by email (asynchronous) 10.9%. The main perceived barriers were: availability, financial remuneration, regulations, connectivity problems and lack of time. CONCLUSION: The perception of professionals is favorable, as they considered these technologies useful to improve therapeutic adherence, which could have a facilitating effect on their implementation, although the perceived barriers are part of organizational issues to be resolved.

Introducción: Los dispositivos electrónicos y tecnologías de la comunicación se emplean cada vez más frecuentemente para brindar atención médica a los pacientes con hipertensión arterial. El objetivo principal del trabajo fue evaluar la percepción de los médicos sobre la utilidad de las tecnologías digitales en hipertensión arterial. Los objetivos secundarios fueron evaluar la prevalencia de uso de tecnologías digitales en el seguimiento de pacientes con hipertensión arterial e identificar las barreras percibidas por los médicos para la implementación de las mismas en la República Argentina. Métodos: Estudio observacional, de corte transversal, multicéntrico, basado en un cuestionario autoadministrado, en el ámbito de la República Argentina y coordinado por el grupo de Epidemiología de la Sociedad Argentina de Hipertensión Arterial. Población: Médicos que realizan atención de pacientes con hipertensión arterial. Resultados: Se obtuvieron 247 respuestas, 35.6% fueron mujeres y 64.4% hombres; el 92.3 % consideró de utilidad el uso de tecnologías digitales para mejorar la adherencia terapéutica. Reciben resultados de presión arterial en domicilio por algún medio digital 54.7%. Realizan habitualmente teleconsultas 41.3%, solamente el 6.1% por plataformas digitales específicas de salud, el 29.1% por plataformas no específicas, telefónicamente 21.9% y correo electrónico (asincrónicas) 10.9%. Las principales barreras percibidas fueron: disponibilidad, remuneración económica, reglamentación, problemas de conectividad y falta de tiempo. Conclusión: La percepción de los profesionales es favorable, considerándolas útiles para mejorar la adherencia terapéutica, por lo que podría tener un efecto facilitador en la implementación de las mismas, aunque las barreras percibidas forman parte de cuestiones organizacionales a resolver.