La obesidad como factor de riesgo de gravedad por la infección de COVID-19

Los nuevos estilos de vida forzados por la pandemia, han mostrado un incremento en la incidencia en los niveles de índice de masa corporal de sobrepeso y obesidad en la población, a su vez estos casos, se visibilizaban más al estar relacionados con casos de gravedad por la enfermedad del COVID-19. Objetivo. Relacionar que el sobrepeso y obesidad, si son factores de riesgo y predicción de situaciones de gravedad por infección del COVID-19. Materiales y métodos. Se realizó un estudio, tipo descriptivo correlacional. Para esta investigación, se tomó muestra poblacional de personal voluntario de 48 personas, principalmente constituido por estudiantes y algunos docentes que pertenecen a la Facultad de Educación de la Universidad Nacional José Faustino Sánchez Carrión. Este personal fue evaluado en dos clínicas ubicadas en ciudades diferentes, la información biométrica y resultados de análisis de sangre, se consultó con personal médico asesor. Luego de un año se realizó una segunda evaluación, mediante una encuesta, para recabar información sobre la respuesta del sistema inmune del personal evaluado, ante una infección COVID-19 si fuera el caso. Se realizó la consulta médica respecto a los resultados obtenidos, sobre la correlación entre la obesidad, como factor de riesgo en el nivel de gravedad de la enfermedad COVID-19. Resultados. Se determinó que 13 personas evaluadas que corresponden: al 27.08% del total, registraron sobrepeso y presentaron clínicas leves o severas ocasionadas por el COVID-19. Conclusiones. Por lo que, este resultado demuestra que en personas con sobrepeso son propensos a padecer diversas enfermedades, esta situación de su comorbilidad, los expone a alto riesgo de llegar a situaciones graves de su salud por la infección del COVID-19.

The new lifestyles forced by the pandemic have shown an increase in the incidence of overweight and obesity body mass index levels in the population, and these cases are more visible because they are related to serious cases of COVID-19 disease. Objective. To relate that overweight and obesity are risk factors and predictors of severity situations due to COVID-19 infection. Materials and methods. A descriptive correlational study was carried out. For this research, a population sample of 48 volunteer personnel was taken, mainly made up of students and some teachers belonging to the Faculty of Education of the Universidad Nacional José Faustino Sánchez Carrión. These personnel were evaluated in two clinics located in different cities; the biometric information and blood test results were consulted with medical advisors. After one year, a second evaluation was carried out by means of a survey to gather information on the response of the immune system of the evaluated personnel to a COVID-19 infection, if applicable. A medical consultation was made regarding the results obtained on the correlation between obesity as a risk factor in the level of severity of COVID-19 disease. Results. It was determined that 13 people evaluated, corresponding to 27.08% of the total, were overweight and presented mild or severe symptoms caused by COVID-19. Conclusions. Therefore, this result shows that overweight people are prone to suffer from various diseases, this situation of their comorbidity, exposes them to high risk of reaching serious health situations due to COVID-19 infection.

Os novos estilos de vida forçados pela pandemia mostraram um aumento na incidência de níveis de índice de massa corporal de sobrepeso e obesidade na população, e esses casos se tornaram mais visíveis por estarem relacionados a casos graves da doença COVID-19. Objetivo. Relacionar que o sobrepeso e a obesidade são fatores de risco e preditores de situações de gravidade devido à infecção por COVID-19. Materiais e métodos. Foi realizado um estudo descritivo correlacional. Para esta pesquisa, foi tomada uma amostra populacional de 48 funcionários voluntários, composta principalmente por estudantes e alguns professores pertencentes à Faculdade de Educação da Universidad Nacional José Faustino Sánchez Carrión. Esses funcionários foram avaliados em duas clínicas localizadas em cidades diferentes, e as informações biométricas e os resultados dos exames de sangue foram consultados com consultores médicos. Após um ano, foi realizada uma segunda avaliação por meio de uma pesquisa para coletar informações sobre a resposta do sistema imunológico do pessoal avaliado a uma infecção por COVID-19, se aplicável. Foi realizada uma consulta médica com relação aos resultados obtidos sobre a correlação entre a obesidade como fator de risco no nível de gravidade da doença COVID-19. Resultados. Foi determinado que 13 pessoas avaliadas, correspondendo a 27,08% do total, estavam acima do peso e apresentavam sintomas leves ou graves causados pela COVID-19. Conclusões. Portanto, esse resultado mostra que as pessoas com sobrepeso são propensas a sofrer de várias doenças, essa situação de comorbidade as expõe a um alto risco de chegar a situações graves de saúde devido à infecção por COVID-19.

Consumo de hierbas medicinales para aliviar síntomas de afecciones respiratorias y COVID-19 / Use of medicinal herbs to relieve symptoms of respiratory conditions and COVID-19 / Uso de ervas medicinais para aliviar sintomas de doenças respiratórias e COVID-19

Con el brote de COVID-19, se incrementó el consumo de plantas medicinales a raíz de su fácil, económica disponibilidad y conocimientos empíricos de sus propiedades medicinales y efectos terapéuticos para algunas enfermedades. Esta realidad de consumo de hierbas medicinales para aliviar síntomas de afecciones respiratorias y COVID-19, motivó la presente investigación. Objetivo. Determinar el grado de asociación entre el consumo de hierbas medicinales y su efecto en alivio de síntomas del virus. Materiales y método. La metodología se basa en estudio descriptivo, enfoque cuantitativo, prospectivo. Se recolectó los datos desde febrero hasta mayo del 2021 con una muestra de 400 personas que comprendió ambos sexos. Se encuestó sobre ¿Qué hierbas medicinales consumieron en forma de infusión? y ¿Con qué frecuencia consumen para aliviar los síntomas relacionados a afecciones respiratorias y COVID-19? Resultados. Los resultados determinaron que las hierbas medicinales de mayor consumo fueron Matico (Buddleja globosa), Eucalipto (Eucalyptus globulus), Escorzonera (Perezia multiflora) y Huamanripa (Senecio tephrosioides); con una frecuencia de 2 a 3 veces por día y 4 o 5 días por semana; marzo se obtuvo 3% consumo de Huamanripa y mayo 6% de hierbas combinada para afecciones respiratorias y COVID-19 respectivamente, febrero con 29% para afecciones respiratorias y mayo con 73% para dolencias del COVID-19. Sintieron alivio al ingerir infusiones de hierbas medicinales en mayo con 79% y coeficiente de determinación de 0.9984 que indica una alta asociación. Conclusiones. Al analizar los datos entre consumo de hierbas medicinales y alivio de síntomas de COVID-19, se obtuvo una alta correlación; por lo tanto, indica que alivia los síntomas.

With the outbreak of COVID-19, the consumption of medicinal plants increased due to their easy, inexpensive availability and empirical knowledge of their medicinal properties and therapeutic effects for some diseases. This reality of consumption of medicinal herbs to alleviate symptoms of respiratory conditions and COVID-19, motivated the present investigation. Objective. To determine the degree of association between the consumption of medicinal herbs and their effect in relieving symptoms of the virus. Materials and method. The methodology is based on a descriptive study, quantitative approach, prospective. Data were collected from February to May 2021 with a sample of 400 people comprising both sexes. A survey was conducted on What medicinal herbs did they consume in the form of infusion? and How often do they consume them to alleviate symptoms related to respiratory conditions and COVID-19? Results. The results determined that the most consumed medicinal herbs were Matico (Buddleja globosa), Eucalyptus (Eucalyptus globulus), Escorzonera (Perezia multiflora) and Huamanripa (Senecio tephrosioides); with a frequency of 2 to 3 times per day and 4 or 5 days per week; In March there was 3% consumption of Huamanripa and May 6% of combined herbs for respiratory conditions and COVID-19 respectively, February with 29% for respiratory conditions and May with 73% for COVID-19 ailments. They felt relief by ingesting medicinal herbal infusions in May with 79% and coefficient of determination of 0.9984 indicating a high association. Conclusions. When analyzing the data between consumption of medicinal herbs and relief of COVID-19 symptoms, a high correlation was obtained; therefore, it indicates that it relieves symptoms.

Com o surgimento da COVID-19, o consumo de plantas medicinais aumentou devido à sua disponibilidade fácil e barata e ao conhecimento empírico de suas propriedades medicinais e efeitos terapêuticos para algumas doenças. Esta realidade de consumo de ervas medicinais para aliviar os sintomas de problemas respiratórios e a COVID-19 motivou a presente pesquisa. Objetivo. Para determinar o grau de associação entre o consumo de ervas medicinais e seu efeito no alívio dos sintomas do vírus. Materiais e método. A metodologia é baseada em um estudo descritivo, quantitativo e prospectivo. Os dados foram coletados de fevereiro a maio de 2021 com uma amostra de 400 pessoas de ambos os sexos. Pesquisamos quais ervas medicinais eles consumiram na forma de chá de ervas e com que freqüência consumiram para aliviar os sintomas relacionados às condições respiratórias e à COVID-19. Resultados. Os resultados determinaram que as ervas medicinais mais consumidas foram matico (Buddleja globosa), Eucalyptus (Eucalyptus globulus), Escorzonera (Perezia multiflora) e Huamanripa (Senecio tephrosioides); com uma freqüência de 2 a 3 vezes por dia e 4 a 5 dias por semana; Março teve 3% de consumo de Huamanripa e maio 6% de ervas combinadas para doenças respiratórias e COVID-19 respectivamente, fevereiro com 29% para doenças respiratórias e maio com 73% para doenças COVID-19. Eles sentiram alívio ao ingerir chás de ervas em maio com 79 % e um coeficiente de determinação de 0,9984 indicando uma alta associação. Conclusões. Ao analisar os dados entre o consumo de ervas medicinais e o alívio dos sintomas da COVID-19, foi obtida uma alta correlação; portanto, indica que ela alivia os sintomas.

El eucalipto utilizado como alternativa de tratamiento para afecciones respiratorias en la población de Barranca / Eucalyptus used as an alternative treatment for respiratory diseases in the population of Barranca / Eucalipto usado como alternativa de tratamento para doenças respiratórias na população de Barranca

Las hojas de eucalipto por muchos años se han empleado para aliviar las afecciones respiratorias; durante la pandemia su consumo se ha incrementado significativamente Objetivo. Determinar los efectos del consumo de eucalipto mediante diversas preparaciones caseras para el alivio de las afecciones respiratorias. Método. Se basa en la investigación descriptiva; pues se empleó cuestionario sobre que plantas se consumen para las afecciones respiratorias, con qué frecuencia se consume eucalipto y si el consumo de eucalipto alivia las afecciones respiratorias. Obtenidos los datos se procesaron con estadísticas básicas y análisis de correlación. Resultados. Se determinó que los pobladores encuestados utilizan plantas medicinales para el tratamiento de afecciones respiratorias, destacándose el uso de las hojas de eucalipto que consume el poblador con una frecuencia promedio de 2 veces por día de infusión de eucalipto. El porcentaje de alivio de los signos y síntomas de las afecciones respiratorias fue 80 %; la correlación del porcentaje de consumo de eucalipto con respecto al porcentaje de las personas que registraron alivio de sus afecciones respiratorias, alcanzó un valor de r= 0.989 y el análisis de varianza del porcentaje del consumo de eucalipto con relación al porcentaje que aliviaron las afecciones respiratorias, determinó un efecto significativo. Conclusión. Que el consumo de medicina natural a base de hojas de eucalipto se puede considerar como un tratamiento complementario y beneficioso para la salud; puesto que su composición tiene componentes activos tales como Cineol, α y ß-pineno, y limoneno, que tienen propiedades antibacterianas y antivirales.

Eucalyptus leaves have been used for many years to relieve respiratory conditions; during the pandemic its consumption has increased significantly Objective. To determine the effects of eucalyptus consumption through various home preparations for the relief of respiratory conditions. Method. It is based on descriptive research; since a questionnaire was used on which plants are consumed for respiratory conditions, how often eucalyptus is consumed and if the consumption of eucalyptus relieves respiratory conditions. Once the data was obtained, it was processed with basic statistics and correlation analysis. Results. It was determined that the surveyed residents use medicinal plants for the treatment of respiratory conditions, highlighting the use of eucalyptus leaves consumed by the population with an average frequency of 2 times per day of eucalyptus infusion. The percentage of relief of signs and symptoms of respiratory conditions was 80%; the correlation of the percentage of consumption of eucalyptus with respect to the percentage of people who reported relief from their respiratory conditions, reached a value of r= 0.989 and the analysis of variance of the percentage of consumption of eucalyptus with respect to the percentage that relieved respiratory conditions, determined a significant effect. Conclution. That the consumption of natural medicine based on eucalyptus leaves can be considered as a complementary and beneficial treatment for health; since its composition has active components such as Cineol, α and ß-pinene, and limonene, which have antibacterial and antiviral properties.

As folhas de eucalipto são usadas há muitos anos para aliviar problemas respiratórios; durante a pandemia seu consumo aumentou significativamente Objetivo. Determinar os efeitos do consumo de eucalipto através de diversas preparações caseiras para o alívio de problemas respiratórios. Método. Baseia-se em pesquisa descritiva; uma vez que foi aplicado um questionário sobre quais plantas são consumidas para condições respiratórias, com que frequência o eucalipto é consumido e se o consumo de eucalipto alivia as condições respiratórias. Uma vez obtidos os dados, estes foram processados com estatística básica e análise de correlação. Resultados. Constatou-se que os moradores pesquisados utilizam plantas medicinais para o tratamento de afecções respiratórias, destacando-se o uso de folhas de eucalipto consumidas pela população com frequência média de 2 vezes ao dia de infusão de eucalipto. O percentual de alívio dos sinais e sintomas de afecções respiratórias foi de 80%; a correlação do percentual de consumo de eucalipto com o percentual de pessoas que relataram alívio de suas condições respiratórias, atingiu um valor de r= 0,989 e a análise de variância do percentual de consumo de eucalipto com relação ao percentual que aliviou condições respiratórias, determinou um efeito significativo. Conclusão. Que o consumo de medicamentos naturais à base de folhas de eucalipto pode ser considerado um tratamento complementar e benéfico para a saúde; uma vez que sua composição possui componentes ativos como Cineol, α e ß-pineno e limoneno, que possuem propriedades antibacterianas e antivirais.

Algoritmo del tratamiento para el trastorno por déficit de atención con hiperactividad en niños y adolescentes

resumen está disponible en el texto completo

Summary The diagnostic criteria for the Attention Deficit Hyperactivity Disorder (ADHD) have been changing according to international classifications. It is currently included in the ICD-10 as an hyperkinetic disorder and in the DSM-IV as a disorder having its onset during childhood and adolescence. The reported prevalence for ADHD is between 3% and 6%; up to 60% of the patients remain symptomatic through adolescence and adulthood. Population-based surveys of physicians who treat children and adolescents reveal that the rate and the proportion of office visits associated with ADHD are high and have increased over the past decade. This fact points to the need of elaborating clinical guidelines for the treatment of this disorder. Evidence from controlled clinical trials confirms the superiority of medication management for ADHD over behavioral therapy and the combination of medication and behavioral treatment. Stimulants are the most studied drugs for ADHD and constitute the first treatment of choice. Methylphenidate (MPH) is the only stimulant available in Mexico. Its mechanism of action is based on the blocking of the dopamine reuptake, which increases the availability of this neurotransmitter in the synaptic cleft. Based on the dopaminergic theories of ADHD, dopamine genes have been the initial candidates for molecular studies regarding response to MPH. Variations of the dopamine D4 receptor gene (DRD4) and the dopamine transporter gene (DAT1) have been related with the response to MPH. The short half life of this drug (less than three hours) supports the shift from once-a-day to twice-a-day or thrice-a-day dosing. The Osmotic Release Oral System (OROS) of MPH allows to maintain therapeutic plasmatic doses with once-a-day dose. Its efficacy and tolerability have been shown in clinical trials. Regarding the long-term effects of MPH, this drug has demonstrated efficacy in a two-year follow-up controlled study. In addition, animal models have shown that the chronic exposure to MPH during developmental periods produces changes in the function of brain dopaminergic cells, as well as changes in behavior. The association between MPH and substance abuse has also been explored. The pharmacokinetic and pharmacodinamic differences between MPH and cocaine, which also acts by blocking the dopamine transporter, were examined: When administered intravenously, MPH, like cocaine, has a reinforcing effects at doses that exceed a 60% dopamine transporter blockade threshold. When administered orally at clinical doses, the pharmacological effects of MPH also exceed this threshold, but reinforcing effects rarely occur. So, the pharmacokinetic properties of MPH in brain differ for oral and intravenous routes of administration, suggesting that the oral administration of MPH mimics the tonic dopamine cell firing, which may be a critical factor associated with clinical effects. In addition, therapeutic doses of MPH do not act at the nucleus accumbens, a brain structure highly associated with reinforcing. These data suggest that oral administration of MPH does not lead to abuse. Follow-up studies have also shown that stimulant therapy is not associated with increased risk of substance abuse. Since 30% of the patients do not respond to stimulant treatment, the efficacy and safety of other drugs have been evaluated. Among them, tricyclic antidepressants (TCAs) are considered a good choice for the management of ADHD and conduct disorders. Their half life is longer than that of MPH, which allows a once-a-day or twice-a-day dosing. It has also been described that TCAs are effective for the treatment of comorbid tics. The main disadvantage of these drugs is their effect on cardiac conduction, which has been associated with sudden death. Bupropion is another antidepressant having an effect on dopamine activity. It has shown efficacy for the treatment of ADHD in children, adolescents, and adults, particularly in patients with nicotine dependence, patients with comorbid conduct disorder, or depression. Bupropion is available in a extended-release, once-daily formulation (XL). The main side effects of this antidepressant are the increased risk of seizure development, rash and mild elevation of blood pressure. This drug is not recommended for the treatment of patients with comorbid eating disorders. Venlafaxine (a serotonin and norepinephrine reuptake inhibitor) and reboxetine (a norepinephrine reuptake inhibitor) are recently introduced antidepressants which have shown efficacy in open label trials on patients with and without comorbid depressive disorder. Atomoxetine is another non-stimulant medication; its main mechanism of action is the inhibition or the reuptake of norepinephrine. Several clinical trials have shown its efficacy for the treatment of ADHD in children, adolescents and adults. This drug can also be administered in a single dose; in addition, it has a low potential for cardiotoxicity and a reduction of tic frequency and severity has been reported with its use. It is also recommended for the ADHD comorbid with anxiety or depression. Nausea and decreased appetite are the most common side effects of atomoxetine. Modafinil is another non-stimulant drug which was initially described for the treatment of narcolepsy. This drug increases the dopamine and norepinephrine activity through its direct effect on glutamate and GABA, among other neuromodulators. Some clinical trials have shown its superiority over placebo on ADHD symptoms. The main side effects of modafinil are gastrointestinal distress and insomnia. Clonidine and risperidone are drugs considered as second treatment of choice or adjunctive treatments for patients with comorbidity. Although medication is the first treatment of choice, patients often get benefits from psychosocial interventions, particularly parent training in contingency management methods and classroom applications of contingency management techniques. The value of these measurements lies in the temporary reduction of symptom levels and/or in the reduction of related behavioral and emotional difficulties, such as defiance and conduct problems, depression, low self-esteem, or academic underachievement. Parents' training focus on general contingency management tactics, such as contingent application of reinforcement or punishment following appropriate/inappropriate behaviors. Reinforcement procedures have typically relied on praise or tokens, while punishment methods have usually been the loss of tokens or time-out from reinforcement. The classroom management include a continuous communication with teachers, in order to maintain them informed about the illness and its treatment, as well as training on contingency management tactics. The aforementioned information was used in the elaboration of clinical guidelines for the treatment of youngsters with ADHD, either alone or comorbid with internalizing or externalizing disorders. Another guideline for the management of preschool children with ADHD is included. Psychoeducation follows the assessment of the children in each case. The pharmacological treatment recommendations give priority to monotherapy. Stimulants are the first treatment of choice in each guideline. The use of non-stimulant medications as second choice will depend on the age and comorbidity of patients.