Percepção do peso corporal e dificuldades encontradas pelas pessoas com deficiência visual na aquisição, na preparação e no consumo dos alimentos / Perception of body weight and difficulties encounteredby people with visual impairment in acquiring, preparing and consuming food

Objetivo: investigar a percepção do peso corporal e as dificuldades encontradas pelas pessoas com deficiência visual na aquisição, na preparação e no consumo dos alimentos. Metodologia: estudo observacional transversal, com adultos e idosos com deficiência visual em Pelotas/RS, realizado no período de abril a maio de 2023. Foi utilizado um questionário composto de 42 itens. Os dados coletados foram analisados por análise descritiva e analítica, e apresentados como média ± desvio padrão ou percentual. Resultados: a amostra contou com 20 pessoas, predominantemente do sexo feminino e idosas. Em relação ao consumo alimentar, 50% dos participantes consomem feijão, 75% frutas e hortaliças, 50% bebidas adoçadas, biscoitos recheados e doces. Referente à percepção do peso corporal, percebeu-se que a maior parte do grupo sente que está acima do peso adequado e se sentem "insatisfeitos(as)". Sobre as dificuldades encontradas, 85% dos participantes relataram dificuldade extrema para identificar a validade dos alimentos, 70% para comprar alimentos frescos e perecíveis e 40% para usar a faca para cortar e descascar os alimentos. Conclusão: verificou-se que a maior parte do grupo sente que está acima do peso adequado e estão "insatisfeitos(as)" em relação ao peso corporal. Além disso, dependem de outra pessoa para escolher os alimentos a serem comprados, saber o prazo de validade, preparar alimentos que precisam ser porcionados, servir refeições no prato, cortar carnes, descascar vegetais e frutas, utilizar faca, entre outros. Esta dependência pode influenciar diretamente no seu consumo alimentar quando essas pessoas se encontram sozinhas, optando por consumir alimentos industrializados de fácil preparo ou prontos.

Objective: to investigate the perception of body weight and the difficulties encountered by people with visual impairments in acquiring, preparing and consuming food. Methodology: cross-sectional observational study, with adults and elderly people with visual impairment in Pelotas/RS, carried out from April to May 2023. A questionnaire composed of 42 items was used. The collected data were analyzed using descriptive and analytical analysis, and presented as mean ± standard deviation or percentage. Results: the sample included 20 people, predominantly female and elderly. Regarding food consumption, 50% of participants consume beans, 75% fruits and vegetables, 50% sweetened drinks, stuffed cookies and sweets. Regarding the perception of body weight, it was noticed that the majority of the group feels that they are overweight and feel "dissatisfied". Regarding the difficulties encountered, 85% of participants reported extreme difficulty in identifying the expiration date of food, 70% in purchasing fresh and perishable foods and 40% in using a knife to cut and peel food. Conclusion: it was found that the majority of the group feels that they are overweight and are "dissatisfied" with their body weight. Furthermore, they depend on someone else to choose the food to be purchased, know the expiration date, prepare food that needs to be portioned, serve meals on the plate, cut meat, peel vegetables and fruits, use a knife, among others. This dependence can directly influence their food consumption when these people are alone, choosing to consume easily prepared or ready-made processed foods.

Avaliação da influência da pandemia de Covid-19 no risco de desenvolvimento de transtornos alimentares em mulheres / Assessment of the influence of the Covid-19 pandemicon the risk of developing eating disorders in women

Objetivo: verificar a influência da pandemia de Covid-19 no risco de desenvolvimento de transtornos alimentares em mulheres. Metodologia: pesquisa quantitativa, com mulheres com acesso ao computador, a celular e à internet. A coleta de dados foi realizada a partir de um questionário on-line contendo 60 perguntas, com respostas fechadas, que visavam conhecer a sua relação com a alimentação. Foram verificados o consumo alimentar e o risco de desenvolvimento de anorexia nervosa (Eating Attitudes Test - EAT-26) e bulimia nervosa (Bulimic Investigatory Test, Edinburgh- BITE). Resultados: participaram da pesquisa 92 mulheres, sendo que 81,50% (n=75) referiram que ficaram em casa durante a pandemia. Sobre a ingestão de alimentos, 45,70% (n=42) relataram que consumiram diariamente frutas e hortaliças, 55,40% (n=51) ingeriram de 1 a 2 vezes/semana bolachas, salgadinhos, doces e guloseimas e 62,00% (n=57) consumiam embutidos pelo menos 1 vez/semana. Ainda, 18,50% (n=17) apresentaram risco para o desenvolvimento de anorexia nervosa e 83,60% (n=73) risco de bulimia nervosa. Entretanto, analisando se esse risco estava associado à pandemia, verificou-se que não houve diferença significativa entre o grupo que permaneceu em casa e o grupo que saiu para trabalhar (p > 0,05). Conclusão: portanto, grande parte das voluntárias apresentaram um risco de desenvolver algum transtorno alimentar, entretanto, não houve uma relação entre o possível risco de desenvolver transtornos alimentares influenciado pela pandemia.

Objective: to verify the influence of the Covid-19 pandemic on the risk of developing eating disorders in women. Methodology: quantitative research, with women with access to a computer, cell phone and internet. Data collection was carried out using an online questionnaire containing 60 questions, with closed answers, which aimed to understand their relationship with food. Food consumption Abstract and the risk of developing nervous anorexia (Eating Attitudes Test - EAT-26) and nervous bulimia (Bulimic Investigatory Test, Edinburgh - BITE) were verified. Results: 92 women participated in the research, with 81.50% (n=75) reporting that they stayed at home during the pandemic. Regarding food intake, 45.70% (n=42) reported that they consumed fruits and vegetables daily, 55.40% (n=51) ate cookies, snacks, sweets and sweets 1 to 2 times/week and 62, 00% (n=57) consumed sausages at least once/week. Furthermore, 18.50% (n=17) were at risk for developing nervous anorexia and 83.60% (n=73) were at risk for nervous bulimia. However, analyzing whether this risk was associated with the pandemic, it was found that there was no significant difference between the group that remained at home and the group that went out to work (p > 0.05). Conclusion: therefore, most of the volunteers presented a risk of developing an eating disorder, however, there was no relationship between the possible risk of developing eating disorders influenced by the pandemic.

Substance use and adolescent mental health during the COVID-19 pandemic in Brazil: a longitudinal approach

Abstract Objective: To describe the changes in alcohol and drug use by Brazilian adolescents during the COVID-19 pandemic (April-August 2021), and to analyze the relationship between alcohol use changes and psychiatric symptomatology. Methods: A secondary analysis with a longitudinal approach was performed with data from a cluster-randomized controlled trial, conductedin73publicmiddleschoolsinthreeBrazilian cities, to evaluate the effectiveness of a drug use prevention program. The sample included 535 students (61% girls; Mage = 15.2 years). Data were collected pre-intervention (February-March 2019), after 9 months (November-December 2019), and after 26 months (April-August 2021), when the students were in their first year of high school. The authors analyzed drug use prevalence (alcohol, binge drinking, tobacco, inhalants, marijuana, cocaine, and crack) in a lifetime, past year, and past month periods, and the association between alcohol use change subsamples with psychiatric symptoms. Logistic regressions were adjusted by sex, age, socioeconomic status, city, and group (control and intervention). Results: The present findings suggest that the COVID-19 pandemic led to a decrease in past-year substance use and in past-month substance use frequency, despite the gradually increased (but decelerating) prevalence of lifetime use. However, some adolescents initiated, maintained, or increased the frequency of their alcohol use. Mainly, they were more likely to present behavioral problems, as well as symptoms of inattentive hyperactivity, and peer and emotional problems. Conclusions: Despite the extensive decline in substance use during the pandemic period, these results suggest an association between previous mental health conditions and behavioral risk factors, leading to increased alcohol consumption and behavioral disorders manifestations.

Rotafolio hepatitis B / Hepatitis B Flipchart

La presente publicación contiene todo lo referente a la epidemiología de la hepatitis viral B en el Perú y explica el porqué son necesarias las intervenciones que viene desarrollando el Ministerio de Salud para controlar esta infección en el país

Rotafolio. Hablemos del VIH/SIDA / Flipchart. Let's talk about HIV/AIDS

Uno de los objetivos de las intervenciones para el cambio de comportamiento es el de informar y educar a la población sobre las enfermedades transmisión sexual y el VIH, generando conciencia del riesgo de contraerlas, fomentando actitudes preventivas frente a estas enfermedades, mejorando la capacidad de reconocer su presencia y desarrollando adecuadas prácticas de búsqueda de servicios de salud. Un material educativo, el rotafolio que ha demostrado ser un instrumento de fácil comprensión y buena aceptación por parte del público reconoce la labor preventiva como tarea prioritaria y fundamental en el control de la ETS/VIH/SIDA. A continuación se desarrolla la guía de orientación que complementa el rotafolio "hablemos del...sida", teniendo como objetivo uniformizar criterios y mensajes a compartir con nuestras poblaciones

RELACIÓN ENTRE INGESTA ALIMENTICIA Y ESTRÉS ACADÉMICO, REACCIONES FISICAS, PSICOLÓGICAS Y COMPORTAMENTALES EN ESTUDIANTES DE LA UNIVERSIDAD AUTÓNOMA DE CHIHUAHUA, MÉXICO / RELATIONSHIP BETWEEN FOOD INTAKE AND ACADEMIC STRESS, PHYSICAL, PSYCHOLOGICAL AND BEHAVIORAL REACTIONS IN STUDENTS OF THE AUTONOMOUS UNIVERSITY OF CHIHUAHUA, MÉXICO

l estrés académico puede presentarse en estudiantes sometidos a diversas exigencias y requisitos universitarios, provocando diferentes reacciones de estrés, físicas, psicológicas y comportamentales, reduciendo su calidad de vida y provocando consecuencias como: depresión, tristeza, fatiga y dolores de cabeza, afectando su estado nutricional. Se investigó la relación entre ingesta de alimentos y estrés académico en estudiantes del cuarto semestre de la Licenciatura en Medicina de la Universidad Autónoma de Chihuahua. La población de estudio, dado el carácter piloto de la investigación, se realizó mediante muestreo simple, aleatorio, sin reemplazo, con un diseño mixto, descriptivo, comparativo y transversal, utilizándose el cálculo del tamaño muestral con un intervalo de confianza de 95%, resultando N=117; 51 hombres y 66 mujeres entre 19 y 43 años de la generación 2019, a quienes se les aplicó el inventario SISCO de estrés académico. Se encontró mayor frecuencia en situaciones que provocan preocupación y nerviosismo, sobrecarga de tareas y trabajo, inquietud, problemas de concentración, fatiga crónica y apatía. Las estrategias más utilizadas fueron: desarrollo de planes y ejecución de tareas y capacidad asertiva. El 92.2% (n=108) de la población encuestada manifestó preocupación y nerviosismo, resultando 52,1% (n=61) en mujeres y 40.1% (n=47) en hombres. El 38.5% (n=45) de las mujeres entre 21 y 43 años, muestran una mayor relación entre aumentar o reducir el consumo de alimentos en correspondencia con sentimientos de depresión y tristeza. El estrés académico, suele estar relacionado con diferentes manifestaciones psicológicas, físicas y conductuales, que pueden influir directamente en la población estudiantil, afectando gravemente sus hábitos alimenticios y nutricionales

Academic stress can occur in students subjected to various university demands and requirements, causing different, causing different physical, psychological and behavioral reactions. Reducing quality of life and causing consequences such as: depression, sadness, fatigue and headaches, affecting their nutritional status. The relationship between food intake and academic stress was investigated in students in the fourth semester of the Bachelor of Medicine at the Autonomous University of Chihuahua. The study population, given the pilot nature of the research, was carried out through simple, random sampling, without replacement, with a mixed, descriptive, comparative and transversal design, using the sample size calculation with a 95% confidence interval resulting in N=117; 51 men and 66 women between the ages of 19 and 43, from the 2019 generation, to whom the SISCO inventory of academic stress was applied. A greater frequency was found in situations that cause worry and nervousness, overload of tasks and work, restlessness, concentration problems, chronic fatigue and listlessness. The most used strategies were plan development and execution of tasks and assertive ability. 92.2% (n=108) of the surveyed population expressed concern and nervousness, in 52.1% (n=61) women and 40.1% (n=47) men. The 38.5% (n=45) of women between 21 and 43 years old show a greater relationship between increasing or reducing food consumption in correspondence with feelings of depression and sadness. Academic stress is usually related to different psychological, physical and behavioral manifestations, which can directly influence the student population, seriously affecting their eating and nutritional habits

Rol de la figura de enlace en el modelo e transición en endocrinología. Experiencia en el ámbito público / Role of the liaison person in the transition model in Endocrinology. Experience in the public setting

Un proceso de transición planificado entre los sistemas de salud pediátricos y de adultos es necesario para poder garantizar una continuidad en la atención de los adolescentes. El objetivo del trabajo fue evaluar la población de pacientes del Servicio de Endocrinología del Hospital Garrahan en fase de transición y sus familias, desarrollar un protocolo para la transición de los adolescentes con patología endocrinológica crónica al Hospital de Clínicas José de San Martin y evaluar el rol de la "figura de enlace" en este proceso. Materiales y Métodos: Estudio observacional, transversal/prospectivo. Se obtuvieron datos sobre la consulta ambulatoria de 72 adolescentes mayores a 15 años con patología endocrinológica a los cuales se los acompañó en el proceso de transición. Se realizaron entrevistas y encuestas a los adolescentes, sus familias y a 16 endocrinólogos intervinientes en el seguimiento (9 pediátricos- 7 adultos). Resultados: La mayoría de los adolescentes evidenciaron falta de autonomía general, con mayor afectación en el área de "seguimiento de los problemas de salud". Esto, junto al paternalismo del pediatra y la sobreprotección familiar representaron inconvenientes para la transición. La mitad de los adultos entrevistados consideraron falta de autonomía o preparación en sus hijos considerando la edad ideal para la transición entre los 18-21 años. Las sensaciones referidas por los pacientes como sus acompañantes incluyen principalmente el miedo y ansiedad, y llamativamente en los pacientes la vergüenza. La creación de un consultorio de transición en el centro de adultos y el acompañamiento de la "figura de enlace", permitieron una mejor articulación y continuidad en el cuidado de la salud (AU)

TA planned transition process between pediatric and adult health systems is necessary to ensure continuity of care for adolescents. The aim of this study was to evaluate the patient population of the Endocrinology Service at Garrahan Hospital during the transition phase, along with their families, to develop a protocol for transitioning adolescents with chronic endocrinological disorders to Hospital de Clínicas José de San Martín, and to evaluate the role of the "liaison person" in this process. Materials and Methods: This observational, cross-sectional/ prospective study obtained data from outpatient consultations of 72 adolescents over 15 years of age with endocrinological disorders who were accompanied during the transition process. Interviews and surveys were conducted with the adolescents, their families, and 16 endocrinologists involved in the follow-up (9 pediatricians and 7 adult physicians). Results: Most of the adolescents showed a general lack of autonomy, with greater challenges in the area of "follow-up of health problems." This, combined with the paternalism of the pediatrician and the overprotection of the family, represented obstacles to the transition. Half of the parents interviewed perceived a lack of autonomy or preparation in their children, considering the ideal age for transition to be between 18-21 years old. The primary feelings reported by the patients and those who accompanied them included fear and anxiety, with patients also feeling embarrassment. The creation of a transition clinic in the adult center and the support of a "liaison person" allowed for better coordination and continuity in health care (AU)

Anatomic Total Shoulder Arthroplasty Outcomes Were Not Negatively Affected by the COVID-19 Pandemic / Os desfechos da artroplastia anatômica total do ombro não foram afetados negativamente pela pandemia de Covid-19

Abstract Objective To investigate whether patients undergoing anatomic total shoulder arthroplasty (ATSA) between January and March 2020 experienced different postoperative outcomes than patients in 2019. We hypothesized that patients in 2020 would have less access to physical therapy (PT) and experience different postoperative outcomes. Methods Records from patients who received ATSA between January 1st, 2019, and March 17th, 2019, and January 1st, 2020, to March 17th, 2020, were analyzed. Patient data, including demographic information, range of motion (ROM), strength, and PT was collected and compared between the two groups. The 2020 patients were contacted by phone during October 2022 and patient-reported metrics were gathered. Results The present study identified 24 patients in 2019 and 27 patients in 2020 who underwent ATSA during the specified time frame and had a minimum 1-year follow-up. Patients in 2019 experienced improvements in forward elevation (FE) ROM (125.4° to 146.7°; p = 0.008), external rotation (ER; 33.0° to 47.7°; p < 0.001), and internal rotation (IR; S1 to L4; p = 0.019). Patients in 2020 also experienced significant improvements in FE (120.2° to 141.1°; p = 0.009), ER (32.9° to 42.0°; p = 0.037), and IR (S1 to L3; p = 0.002). Patients in 2020 terminated PT earlier (2019: 125.8 days; 2020: 91.1 days; p = 0.046) and completed fewer sessions (2019: 21.4 sessions; 2020: 13.1 sessions; p = 0.003). At the final follow-up, patients in 2020 reported an average Visual Analogue Scale (VAS) pain score of 1.67 ± 1.1. Conclusion Despite decreased PT, patients who underwent ATSA in 2020 had significant improvements in ROM and strength and were comparable to patients in 2019.

Resumo Objetivo Investigar se os pacientes submetidos à artroplastia total anatômica do ombro (ATAO) entre janeiro e março de 2020 tiveram resultados pós-operatórios diferentes dos pacientes operados em 2019. Nossa hipótese é a de que os pacientes de 2020 teriam menos acesso à fisioterapia (FT) e apresentariam desfechos pós-opera-tórios diferentes. Métodos Foram analisados os prontuários de pacientes submetidos à ATAO de 1° de janeiro de 2019 a 17 de março de 2019 e de 1° de janeiro de 2020 a 17 de março de 2020. Os dados dos pacientes, incluindo informações demográficas, amplitude de movimento (ADM), força e FT foram coletados e comparados entre os dois grupos. Os pacientes de 2020 foram contatados por telefone durante outubro de 2022, e as métricas relatadas por eles pacientes foram coletadas. Resultados Este estudo identificou 24 pacientes em 2019 e 27 pacientes em 2020 que foram submetidos à ATAO durante o período especificado e tiveram acompanhamento mínimo de 1 ano. Os pacientes em 2019 apresentaram melhoras na ADM de elevação anterior (EA; 125,4° a 146,7°; p = 0,008), rotação externa (RE; 33,0° a 47,7°; p < 0,001) e rotação interna (RI; S1 a L4; p = 0,019). Os pacientes em 2020 também apresentaram melhoras significativas de EA (120,2° a 141,1°; p = 0,009), RE (32,9° a 42,0°; p = 0,037) e RI (S1 a L3; p = 0,002). Os pacientes de 2020 terminaram a FT mais cedo (2019: 125,8 dias; 2020: 91,1 dias; p = 0,046) e fizeram menos sessões (2019: 21,4 sessões; 2020: 13,1 sessões; p = 0,003). No acompanhamento final, os pacientes de 2020 relataram uma pontuação média de dor na Escala Visual Analógica (EVA) de 1,67 ± 1,1. Conclusão Apesar da menor realização de FT, os pacientes submetidos à ATAO em 2020 apresentaram melhoras significativas na ADM e na força e foram comparáveis aos pacientes de 2019.

Características clínicas, virológicas, inmunológicas y psicosociales de los adolescentescon infección por HIV: 15 años después de la implementación del programa de transición / Clinical, virological, immunological, and psychosocial characteristics of adolescents with HIV infection: 15 years after the implementation of the transition program

Desde 2007, el Servicio de Epidemiología e Infectología, ha implementado un programa de transición que busca optimizar la atención de los adolescentes con infección por el HIV durante el paso de la atención pediátrica a la de adultos. Objetivo: Describir las características clínicas, epidemiológicas, virológicas y psicosociales de los adolescentes con infección HIV atendidos en el Programa y analizar el proceso de transición. Materiales y Métodos: Estudio de cohorte retrospectivo. Se incluyeron a los adolescentes, atendidos en el Programa de Transición entre enero de 2019 y diciembre de 2023, en el Hospital Garrahan, con al menos un resultado de CV y CD4+ en ese período. Se obtuvo la información de la historia clínica electrónica y se analizaron variables clínicas, epidemiológicas, virológicas, terapéuticas y psicosociales. Resultados: Se incluyeron 124 pacientes. La vía de transmisión fue vertical en el 92,74% y el estadio clínico e inmunológico era avanzado. En el momento de la transición 77,4% se encontraban con supresión virológica y con recuperación inmunológica. El 55,6% ya realizó la transición a un centro de adultos, 31,4% continúan en el programa, 11,3% se perdieron en el seguimiento y 1,7% fallecieron. Se recopilaron los datos de 31 pacientes transferidos. La mediana de seguimiento fue de 2 años; 25 pacientes (80,6%) continúan en seguimiento. Conclusiones: A pesar de la pandemia de COVID-19, el programa logró la retención de los adolescentes con infección por HIV y una transferencia sostenida en el tiempo. Además de un programa de transición estructurado para garantizar una atención continua y de calidad, es necesario continuar evaluando la evolución postransición (AU)

Since 2007, the Epidemiology and Infectious Diseases Department has implemented a transition program to optimize the care of adolescents with HIV infection during their transition from pediatric to adult care. Objective: To describe the clinical, epidemiological, virological, and psychosocial characteristics of adolescents with HIV infection treated in the program and to analyze the transition process. Materials and Methods: A retrospective cohort study was conducted. Adolescents followed in the Transition Program at Garrahan Hospital between January 2019 and December 2023, with at least one viral load and CD4+ result during that period, were included. Information was obtained from electronic medical records, and clinical, epidemiological, virological, therapeutic, and psychosocial variables were analyzed. Results: A total of 124 patients were included. The route of transmission was vertical in 92.74%, and the clinical and immunologic stage was advanced. At the time of transition, 77.4% were virologically suppressed and had achieved immunologic recovery. Of the patients, 55.6% had already transitioned to an adult center, 31.4% were still in the program, 11.3% were lost to follow-up, and 1.7% died. Data were collected from 31 transferred patients, with a median follow-up of 2 years; 25 patients (80.6%) remain in follow-up. Conclusions: Despite the COVID-19 pandemic, the program successfully retained HIVinfected adolescents and ensured sustained transition over time. In addition to a structured transition program to ensure continuous and quality care, it is necessary to continue evaluating post-transition outcomes (AU)

Boletín eídemiológico del Perú. Semana Epidemiológica (del 2 al 8 de junio de 2024) / Peru Epidemiological Bulletin. Epidemiological Week (June 2-8, 2024)

cuya información es producto de la notificación de los establecimientos de salud del Ministerio de Salud, Gobiernos regionales, EsSalud, Sanidades de fuerzas armadas y policiales, y privados, que conforman la Red Nacional de Epidemiología (RENACE), además de información o análisis especializado que desarrolla el CDC MINSA. Su finalidad es difundir la situación epidemiológica del país, la ocurrencia de brotes y/o epidemias para una adecuada y oportuna toma de decisiones en prevención y control en salud pública. gestionar de manera eficaz, eficiente y oportuna los procesos de vigilancia epidemiológica, inteligencia sanitaria, salud global, respuesta y control de brotes, epidemias y otros eventos de importancia en salud pública

Documento técnico: Plan de gobierno digital del Ministerio de Salud, UE 001- Administración Central MINSA 2024 - 2026 / Technical document: Digital government plan of the Ministry of Health, UE 001- Central Administration MINSA 2024 - 2026

El presente documento describe las pautas para optimizar la prestación de servicios digitales aplicados a la salud a fin de generar valor público, contribuyendo al desarrollo de la economía digital y la sociedad del conocimiento en materia de salud. Asimismo, contiene el diagnóstico situacional y enfoque estratégico del Ministerio de Salud, garantizando el alineamiento estratégico del Plan de Gobierno Digital del Ministerio de Salud Administración Central para una adecuada, moderna y eficaz gestión de las tecnologías digitales, alineándose al proceso de modernización del Estado

Aprendamos sobre la tuberculosis. Rotafolio / Let's learn about tuberculosis

La presente publicación que describe las pautas que orienta al personal de salud sobre su diagnóstico, antecedentes de la tuberculosis, otras enfermedades, la identificación de sus contactos que contribuye al bienestar de la comunidad, identificando oportunamente mediante el uso de rotafolios a la persona con síntomas relacionados a la tuberculosis

Manual de registro y codificación de las actividades de vigilancia epidemiológica e inteligencia sanitaria / Manual for registration and coding of epidemiological surveillance and health intelligence activities

a presente publicación describe los criterios en la recopilación y codificación de diagnósticos CIE 10. Asimismo, la metodología de registro estadístico sanitario en las actividades de vigilancia epidemiológica e inteligencia sanitaria , el cual se convierte en un sistema de información necesaria para la toma de decisiones en la solución de los problemas sanitarios en el marco del sistema de coordinación con actores sociales para el análisis de situación local

Manual de registro y codificación de las actividades de prevención y control de tuberculosis / Manual for registration and coding of tuberculosis prevention and control activities

La presente publicación describe los criterios en la recopilación y codificación de diagnósticos CIE 10 y Catálogo de Procedimientos médicos y sanitarios (CPMS) del Ministerio de Salud. Asimismo, la metodología de registros estadísticos sanitarios en salud de la población, el cual se convierte en un sistema de información necesaria para la toma de decisiones en la solución de los problemas sanitarios en el marco del sistema de coordinación para el control de la tuberculosis en el Perú

Medical and forensic aspects of performing a remote interrogation of persons with disabilities / Aspectos médicos y forenses de la realización de un interrogatorio a distancia a personas con discapacidad / Aspectos médicos e forenses da realização de um interrogatório remoto de pessoas com deficiências

The purpose of the study is to develop new proposals for improving criminal procedural legislation in the field of conducting remote investigative actions with disabled persons, taking into account their physiological and functional characteristics. Research material and methods: This study is based on an analysis of the norms regarding the criminal procedural legislation of the Republic of Kazakhstan and a number of foreign states that regulate the procedure for conducting remote investigative actions - as well as scientific publications on the research topic in the field of psychology and medicine. An integrated approach involves considering the studied phenomena of communication during an investigative action as a set of interconnected and interdependent elements, i.e., consideration of the issue from the medical, psychological and legal points of view. Situational and systemic types of analysis, complex sociological analysis, diagnostics and forecasting investigative situation were also used. Methods of analysis and synthesis, induction, deduction, methods of qualitative and quantitative analysis were employed to clarify the legal essence of the studied phenomenon. Findings: practical recommendations aimed at improving and developing the performance of remote investigative actions involving persons with disabilities (further ­ FWDs) y creating optimal conditions for the transfer of verbal, medical, and psychological information, as well as technical and forensic support for conducting RIAs. The following conclusions were made: in order to improve the current legislation, it is advisable to consider the issue of developing and including a special norm in the legislation, taking into account the characteristics of the communicative competencies of persons with disabilities. This norm regulates the procedure for conducting investigative actions involving the mute, deaf, blind and other persons with disabilities.

El objetivo del estudio es elaborar nuevas propuestas de mejora de la legislación procesal penal en el ámbito de la realización de actuaciones de investigación a distancia con personas con discapacidad, teniendo en cuenta sus características fisiológicas y funcionales. Material y métodos de investigación: Este estudio se basa en un análisis de las normas relativas a la legislación procesal penal de la República de Kazajstán y de una serie de Estados extranjeros que regulan el procedimiento para llevar a cabo acciones de investigación a distancia -, así como publicaciones científicas sobre el tema de investigación en el campo de la psicología y la medicina. Un enfoque integrado implica considerar los fenómenos estudiados de comunicación durante una acción de investigación como un conjunto de elementos interconectados e interdependientes, es decir, considerar la cuestión desde los puntos de vista médico, psicológico y jurídico. También se utilizaron los tipos de análisis situacional y sistémico, el análisis sociológico complejo, el diagnóstico y la previsión de la situación de investigación. Se emplearon métodos de análisis y síntesis, inducción, deducción, métodos de análisis cualitativo y cuantitativo para aclarar la esencia jurídica del fenómeno estudiado. Conclusiones: recomendaciones prácticas destinadas a mejorar y desarrollar la realización de acciones de investigación a distancia en las que participen personas con discapacidad (en adelante - RIA) y crear condiciones óptimas para la transferencia de información verbal, médica y psicológica, así como apoyo técnico y forense para la realización de las RIA. Se llegó a las siguientes conclusiones:con el fin de mejorar la legislación actual, es aconsejable considerar la cuestión de desarrollar e incluir una norma especial en la legislación, teniendo en cuenta las características de las competencias comunicativas de las personas con discapacidad. Esta norma regula el procedimiento para llevar a cabo acciones de investigación en las que estén implicadas personas mudas, sordas, ciegas y otras personas con discapacidad.

O objetivo do estudo é desenvolver novas propostas para aprimorar a legislação processual penal no campo da realização de ações investigativas remotas com pessoas com deficiência, levando em conta suas características fisiológicas e funcionais. Material e métodos de pesquisa: Este estudo baseia-se em uma análise das normas relativas à legislação processual penal da República do Cazaquistão e de vários países estrangeiros que regulamentam o procedimento para a realização de ações investigativas remotas, bem como em publicações científicas sobre o tópico de pesquisa no campo da psicologia e da medicina. Uma abordagem integrada envolve a consideração dos fenômenos estudados de comunicação durante uma ação investigativa como um conjunto de elementos interconectados e interdependentes, ou seja, a consideração da questão dos pontos de vista médico, psicológico e jurídico. Também foram usados tipos de análise situacional e sistêmica, análise sociológica complexa, diagnóstico e previsão da situação investigativa. Métodos de análise e síntese, indução, dedução, métodos de análise qualitativa e quantitativa foram empregados para esclarecer a essência legal do fenômeno estudado. Resultados: recomendações práticas com o objetivo de aprimorar e desenvolver o desempenho de ações investigativas remotas envolvendo pessoas com deficiência (mais adiante - FWDs), criando condições ideais para a transferência de informações verbais, médicas e psicológicas, bem como suporte técnico e forense para a realização de RIAs. Foram feitas as seguintes conclusões: para aprimorar a legislação atual, é aconselhável considerar a questão do desenvolvimento e da inclusão de uma norma especial na legislação, levando em conta as características das competências comunicativas das pessoas com deficiência. Essa norma regulamenta o procedimento para conduzir ações investigativas envolvendo pessoas mudas, surdas, cegas e outras pessoas com deficiência.

Pilomatrixomas: experiencia de 31 años en población menor y mayor de 18 años / Pilomatrixomas: 31 years of experience in population under and over 18 years of age

Resumen Introducción: El pilomatrixoma o epitelioma calcificado de Malherbe es una neoplasia cutánea benigna que muestra diferenciación hacia la porción de la matriz de los folículos pilosos. Es la neoplasia cutánea benigna más frecuente en la infancia y la juventud, aunque puede ocurrir a cualquier edad. Tiene una incidencia general que oscila entre el 0.001% y el 0.0031% de todos los tumores cutáneos. Se reporta una ligera predilección por el sexo femenino, con una relación mujer: hombre de 1.15:1. Métodos: Estudio observacional, descriptivo, retrospectivo y transversal en el que se utilizó la base de datos electrónica del departamento de dermatopatología del Hospital General Dr. Manuel Gea González, entre enero de 1992 y julio de 2023. Para la búsqueda de los casos solo se incluyeron aquellos con diagnóstico histopatológico de pilomatrixoma, pilomatricoma o epitelioma calcificado de Malherbe. Resultados: Se registraron 200 pilomatrixomas en 177 pacientes. El tumor predominó en mujeres de edad pediátrica; el promedio de edad de la población estudiada fue 22.98 años. La topografía más frecuente fue la cabeza (región periorbitaria), seguida de las extremidades superiores y el tronco. Al separar la población en pediátricos y adultos, se encontraron 111 y 89 casos, respectivamente. Conclusiones: Presentamos un estudio detallado sobre pilomatrixomas con una visión exhaustiva de las características demográficas, clínicas y epidemiológicas de esta neoplasia cutánea benigna. Los resultados revelaron datos estadísticos sólidos, destacando la distribución por edades, sexo, topografía, morfología, síntomas acompañantes y frecuencia de diagnósticos diferenciales clínicos. Este estudio contribuye significativamente al conocimiento existente sobre los pilomatrixomas y sirve como una referencia valiosa para futuras investigaciones y para la práctica clínica.

Abstract Background: Pilomatrixoma, also known as calcifying epithelioma of Malherbe, is a benign cutaneous neoplasm that demonstrates differentiation towards the matrix portion of hair follicles. It is the most common benign cutaneous neoplasm in childhood and youth, although it can occur at any age. With a general incidence ranging from 0.001% to 0.0031% of all cutaneous tumors. There is a slight predilection for females, with a female-to-male ratio of 1.15:1. Methods: Observational, descriptive, retrospective, and cross-sectional study conducted using the electronic database of the dermatopathology department of Dr. Manuel Gea González General Hospital, from January 1992 to July 2023. Only cases with a histopathological diagnosis of pilomatrixoma, pilomatricoma, and Malherbe's calcifying epithelioma were included. Results: A total of 200 pilomatrixomas were recorded in 177 patients. The tumor predominantly affected females in the pediatric age group, with an average age of 22.98 years in the studied population. The most common location was the head (periorbital region), followed by the upper extremities and trunk. Upon separating the population into pediatric and adult groups, 111 and 89 cases were identified, respectively. Conclusions: We present a detailed study on pilomatrixomas with a comprehensive overview of the demographic, clinical, and epidemiological characteristics of this benign cutaneous neoplasm. The results revealed robust statistical data highlighting the distribution by age, gender, topography, morphology, accompanying symptoms, and frequency of clinical differential diagnoses. This study significantly contributes to the existing knowledge of pilomatrixomas and serves as a valuable reference for future research and clinical practice.

Evaluation of Pan-Immuno-Inflammation Value for In-Hospital Mortality in Acute Pulmonary Embolism Patients

ABSTRACT Background: Pan-immuno-inflammation value is a new and comprehensive index that reflects both the immune response and systemic inflammation in the body. Objective: The aim of this study was to investigate the prognostic relevance of pan-immuno-inflammation value in predicting in-hospital mortality in acute pulmonary embolism patients and to compare it with the well-known risk scoring system, pulmonay embolism severity index, which is commonly used for a short-term mortality prediction in such patients. Methods: In total, 373 acute pulmonary embolism patients diagnosed with contrast-enhanced computed tomography were included in the study. Detailed cardiac evaluation of each patient was performed and pulmonary embolism severity index and pan-immuno-inflammation value were calculated. Results: In total, 60 patients died during their hospital stay. The multivariable logistic regression analysis revealed that baseline heart rate, N-terminal pro-B-type natriuretic peptide, lactate dehydrogenase, pan-immuno-inflammation value, and pulmonary embolism severity index were independent risk factors for in-hospital mortality in acute pulmonay embolism patients. When comparing with pulmonary embolism severity index, pan-immuno-inflammation value was non-inferior in terms of predicting the survival status in patients with acute pulmonay embolism. Conclusion: In our study, we found that the PIV was statistically significant in predicting in-hospital mortality in acute pulmonay embolism patients and was non-inferior to the pulmonary embolism severity index. (Rev Invest Clin. 2024;76(2):97-102)

Effective Inhibition of TNFalpha/mTOR Axis-Mediated Liver Inflammation and Fibrosis Induced by TAA Using a Combination of Metformin and Resveratrol in Association with the Inhibition of the Profibrotic Gene and Protein Expression / Inhibición Efectiva de la Inflamación Hepática Mediada por el Eje TNF-alfa/mTOR y la Fibrosis Inducida por TAA Utilizando una Combinación de Metformina y Resveratrol en Asociación con la Inhibición del Gen Profibrótico y la Expresión de Proteínas

SUMMARY: The response of the immune system to harmful stimuli leads to inflammation, and the adverse effects of the toxic hepatitis chemical, thioacetamide (TAA) on the human body are well documented. This article investigated the degree of protection provided by the combined pleotropic drug, metformin (Met) and the plant polyphenolic and the antiinflammatory compound, resveratrol (Res) on liver tissue exposed to TAA possibly via the inhibition of the inflammatory cytokine, tumor necrosis factor-α (TNF-α) / mammalian target of rapamycin (mTOR) axis-mediated liver fibrosis, as well as amelioration of profibrotic gene and protein expression. Rats were either given TAA (200 mg/kg via intraperitoneal injection) for 8 weeks beginning at the third week (experimental group) or received during the first two weeks of the experiment combined doses of metformin (200 mg/kg) and resveratrol (20 mg/kg) and continued receiving these agents and TAA until experiment completion at week 10 (treated group). A considerable damage to hepatic tissue in the experimental rats was observed as revealed by tissue collagen deposition in the portal area of the liver and a substantial increase (p<0.0001) in hepatic levels of the inflammatory marker, tumor necrosis factor-α (TNF-α), as well as blood levels of hepatocellular injury biomarkers, alanine aminotransferase (ALT) and aspartate aminotransferase (AST). TAA also augmented hepatic tissue levels of the signalling molecule that promotes liver fibrosis (mTOR), and profibrogenic markers; alpha-smooth muscle actin (α-SMA) protein, tissue inhibitor of metalloproteinases-1 (TIMP-1) mRNA, and matrix metalloproteinase-9 (MMP-9) mRNA. All these parameters were protected (p≤0.0016) by Met+Res. In addition, a significant correlation was detected between liver fibrosis score and inflammation, liver injury enzymes, mTOR, and profibrogenesis markers. Thus, these findings suggest that Met+Res effectively protect the liver against damage induced by thioacetamide in association with the downregulation of the TNF-α/mTOR/fibrosis axis.

La respuesta del sistema inmunológico a estímulos dañinos conduce a la inflamación y los efectos adversos de la tioacetamida (TAA), una sustancia química tóxica para el hígado, están bien documentadas. Este artículo investigó el grado de protección proporcionado por el fármaco pleotrópico combinado metformina (Met), el polifenólico vegetal y el compuesto antiinflamatorio resveratrol (Res) en el tejido hepático expuesto a TAA, posiblemente a través de la inhibición de la citoquina inflamatoria, factor de necrosis tumoral α (TNF-α)/objetivo de la fibrosis hepática mediada por el eje de rapamicina (mTOR), así como mejora de la expresión de genes y proteínas profibróticas. Las ratas recibieron TAA (200 mg/kg mediante inyección intraperitoneal) durante 8 semanas a partir de la tercera semana (grupo experimental) o recibieron durante las dos primeras semanas del experimento dosis combinadas de metformina (200 mg/kg) y resveratrol (20 mg/kg) y continuaron recibiendo estos agentes y TAA hasta completar el experimento en la semana 10 (grupo tratado). Se observó un daño considerable al tejido hepático en las ratas experimentales, como lo revela el depósito de colágeno tisular en el área portal del hígado y un aumento sustancial (p<0,0001) en los niveles hepáticos del marcador inflamatorio, el factor de necrosis tumoral-α (TNF- α), así como los niveles sanguíneos de biomarcadores de lesión hepatocelular, alanina aminotransferasa (ALT) y aspartato aminotransferasa (AST). TAA también aumentó los niveles en el tejido hepático de la molécula de señalización que promueve la fibrosis hepática (mTOR) y marcadores profibrogénicos; proteína actina del músculo liso alfa (α- SMA), inhibidor tisular de las metaloproteinasas-1 (TIMP-1) mRNA y matriz metaloproteinasa-9 (MMP-9) mRNA. Todos estos parámetros fueron protegidos (p≤0.0016) por Met+Res. Además, se detectó una correlación significativa entre la puntuación de fibrosis hepática y la inflamación, las enzimas de lesión hepática, mTOR y los marcadores de profibrogénesis. Por lo tanto, estos hallazgos sugieren que Met+Res protege eficazmente el hígado contra el daño inducido por la tioacetamida en asociación con la regulación negativa del eje TNF-α/mTOR/fibrosis.