Application progress of predictive models in the prevention and control of myopia in children and adolescents / 国际眼科杂志(Guoji Yanke Zazhi)

In medical research,predictive models have been widely used to predict disease progression and identify high-risk populations in advance, especially in the prevention and diagnosis of chronic diseases. In ophthalmology, the predictive and diagnostic models for fundus diseases such as age-related macular degeneration and diabetic retinopathy have demonstrated expert-level accuracy. However, the application of predictive models is still in the exploratory stage as for myopia prevention and control. The establishment of a predictive model is helpful to identify the high-risk myopic children in advance, so that preventive measures such as adequate outdoor activities and reducing near work can be taken in time, which is of great significance to prevent or slow down the occurrence and development of myopia. Because the mechanism of myopia has not been fully elucidated, there are still challenges and limitations in the selection of application objects, predictors and predictive outcomes. This paper reviews the research progress of different types of myopia predictive models in order to provide reference for further development and improvement.

Status risk factors and prevention and control strategies of familial aggregation of Helicobacter pylori infection / 公共卫生与预防医学

Objective To investigate the status of familial aggregation of Helicobacter pylori (Hp) infection in Jinniu District, Chengdu, and analyze its risk factors so as to provide a basis for developing prevention and control strategies of family aggregation of Hp infection. Methods A total of 172 subjects in the Second Affiliated Hospital of Chengdu Medical College · 416 Hospital of Nuclear Industry from January 2022 to January 2023 were selected as the research subjects. All subjects underwent 13C-urea breath test (13C-UBT) to diagnose whether there was Hp infection. Analyze the current situation of family aggregation of Hp infection in the region, collect general data of survey subjects, analyze the relevant factors affecting Hp family aggregation infection, and develop prevention and control strategies based on this. Results A total of 242 people from 97 households were surveyed, and the Hp family aggregation rate was 29.33%. Univariate analysis showed that there were statistically significant differences in family aggregation of Hp infection in terms of different age groups (χ2=9.719, P=0.008), marital status (χ2=8.496, P=0.014), occupations (χ2=19.462, P2=5.457, P=0.019), previous Hp test results (χ2 =4.131, P=0.042) and test results after treatment (χ2=12.000, P=0.001), with statistical significance (P<0.05). Multivariate logistic regression analysis showed that the frequency of dining out 2 days or more per week and a positive Hp test results in the past were risk factors for family aggregation of Hp infection, while the occupation of teachers/medical staff/management/technology personnel and a negative Hp results after treatment were protective factors (P<0.05). Conclusion Family aggregation of Hp infection is related to family members' occupation, frequency of dining out, previous Hp test results and Hp test results after eradication, which deserves attention in clinical practice.

Study on the Protection of the Rights and Interests of Tumor Subjects in Clinical Trials in the Prevention and Control of the COVID -19 / 中国医学伦理学

The outbreak of the COVID -19 has had a big impact on the implementation of clinical trials of tumor drugs and the prevention and control measures such as traffic control and home isolation has caused clinical trials couldn’t proceed normally, so the protection of tumor subjects in clinical trials faces many new challenges. Based on Western and Chinese policies and guidelines on the management of clinical trials during the COVID -19, this paper expounded the impacts of the COVID -19 on tumor patients and tumor clinical trials, analyzed the challenges faced by the protection of tumor subjects in the prevention and control of the COVID -19, and then protected tumor subjects from aspects of optimizing the allocation of health resources, improving non-face-to-face informed consent procedures, strengthening subject visit management, and enhancing clinical trial safety evaluation. It is hoped that these optimization measures can face the future and continue to protect subjects after the end of the epidemic or in new public health emergencies.

Ethical Consideration of Chinese Ancient Disasters and Diseases: Centered on the Basic Principles of Public Health Ethics / 中国医学伦理学

The ethical problems in the prevention and control of public disasters and epidemics have attracted more and more attention. Briefly combed the disaster and epidemic events in ancient China. From the view of the several basic principles of public health ethics, this paper took four aspects of the distribution of medical and health resources for epidemic diseases, the isolation prevention and control, the skeleton convergence and the protection of public health conditions as examples, to dialectically treat the measures taken by ancient people to deal with disasters and epidemics and explore some enlightenment of public health ethics in ancient Chinese disasters and epidemics. The measures of epidemic prevention and disaster resistance in ancient China have their own formation and development process. Although the historical limitations are insurmountable, interpreting it by using the basic principles of public health ethics will help us understand the development process of epidemic prevention and control, promote the development of medical archaeology, and provide some reference for the construction of public health undertakings today.

The Significance and Function of Marx’s View of Life on COVID-19 Epidemic Prevention and Control / 中国医学伦理学

Finding a way of life education with Chinese characteristics and making up for the shortcomings of life education, which should become a major issue for the in-depth study of COVID-19 epidemic prevention and control in China. Marx’s view of life is a correct and scientific view of life, which is not only the guiding ideology of life education, but also the important resources for life education. While criticizing the views of life and death based on the western philosophy of life, it can also overcomes the limitations of Chinese traditional view of life. In the epidemic prevention and control, the in-depth study of Marx’s view of life will help to promote the practice of life education, enable people to establish a correct and scientific view of life and obtain the life sublimation in life practice.

Advances in peripheral defocus and myopia prevention and control / 国际眼科杂志(Guoji Yanke Zazhi)

The global prevalence of myopia is increasing year by year, leading to many ocular health issues and social problems. In recent years, it has been confirmed that peripheral defocus is closely related to the occurrence and development of myopia. Alteration of the state of peripheral defocus can significantly influence the progression of myopia and emmetropization, but the exact mechanisms are still unclear. At present, there is no method that can completely control myopia. Nowadays, the main controlling methods, including orthokeratology lens, peripheral defocus lens and multi-focal soft lens, have been confirmed to be closely related to peripheral defocus. In this paper, we will review and summarize the development and effect of these peripheral defocus relating control methods. In addition, the researches on the related mechanisms of peripheral retinal defocus and myopia prevention and control at home and abroad are reviewed, as well as the potential mechanisms of peripheral defocus, with a view to further improving the controlling effects of existing methods, developing new prevention and control methods and reducing the incidence and progression of myopia.

Application of metagenomic next-generation sequencing in prevention and control of infection in solid organ transplantation / 器官移植

Organ transplantation has become an effective treatment for multiple end-stage diseases. However, the recipients of organ transplantation need to take immunosuppressive drugs for a long time after operation, which leads to low immune function and relatively high incidence of bacterial, viral and fungal infections. Traditional microbial detection methods, such as pathogen culture, immunological detection and polymerase chain reaction, have been widely applied in infection detection, whereas these methods may cause problems, such as long detection time and presumed pathogens. Metagenomic next-generation sequencing has been widely adopted in infection prevention and control in organ transplantation in recent years due to high detection rate and comprehensive detection of pathogen spectrum. In this article, the application of metagenomic next-generation sequencing in the prevention and control of infection in solid organ transplantation was reviewed, aiming to provide reference for the diagnosis and treatment of transplantation-related infection.

Uso inconsistente del preservativo masculino en hombres VIH negativos que tienen sexo con hombres / Inconsistent use of male condoms among HIV-negative men who have sex with other men / Uso inconsistente do preservativo masculino entre homens HIV negativos que fazem sexo com homens

Objetivo: analizar los factores asociados con el uso inconsistente del preservativo masculino en hombres VIH negativos que tienen sexo con hombres. Método: estudio transversal, analítico, nacional realizado de forma online en todas las regiones de Brasil, en 2020, a través de redes sociales y sitios de citas. El uso inconsistente del preservativo se definió como el uso ocasional o no usarlo nunca. Se realizaron análisis estadísticos descriptivos, pruebas de asociación y regresión logística binaria. Resultados: 1222 (85%) de los 1438 participantes informaron uso inconsistente del preservativo. Las variables "homosexuales" (ORA: 2,03; IC 95%: 1,14-3,59; p = 0,016), "tener pareja estable" (ORA: 2,19; IC 95%: 1,55-3,09; p<0,001), "sexo oral" (ORA: 2,41; IC 95%: 1,31-4,43; p = 0,005), "anal insertivo" (ORA: 1,98; IC 95%: 1,10-3,58; p = 0,023) y "diagnóstico de ITS" (ORA: 1,59; IC 95%: 1,13-2,24; p = 0,007) se asociaron de forma independiente con el uso inconsistente del preservativo masculino. Las variables "recibió consejo de un amigo sobre la prueba del VIH" (ORA: 0,71; IC 95%: 0,52-0,96; p = 0,028) y "trabajador sexual" (ORA: 0,26; IC 95%: 0,11-0,60; p = 0,002) fueron factores protectores. Conclusión: las variables estudiadas indicaron que hay una fuerte relación entre las parejas estables y el aumento de la confianza y la baja adherencia al uso del preservativo, lo que coincide con otros estudios.

Objective: to analyze the factors associated with inconsistent use of male condoms among HIV-negative men who have sex with other men. Method: a cross-sectional, analytical and nationwide study conducted online in all the Brazilian regions in 2020, via networks and in dating websites. Inconsistent condom use was defined as occasional use or as never using it. Descriptive statistical analyses were performed, as well as association and binary logistic regression tests. Results: inconsistent condom use was reported by 1,222 (85%) of all 1,438 participants. The "homosexuals" (ORAdj: 2.03; 95% CI: 1.14-3.59; p=0.016), "having a fixed partner" (ORAdj: 2.19; 95% CI: 1.55-3.09; p<0.001), "oral sex" (ORAdj: 2.41; 95% CI: 1.31-4.43; p=0.005), "insertive anal" (ORAdj: 1.98; 95% CI: 1.10-3.58; p=0.023) and "STI diagnosis" (ORAdj: 1.59; 95% CI: 1.13-2.24; p=0.007) variables were independently associated with inconsistent use of male condoms. The "receiving advice on HIV test from a friend" (ORAdj: 0.71; 95% CI: 0.52-0.96; p=0.028) and "sex worker" (ORAdj: 0.26; 95% CI: 0.11-0.60; p=0.002) variables were protective factors. Conclusion: the variables under study pointed to a strong relationship between steady partners and increased trust and low adherence to condom use, corroborating other studies.

Objetivo: analisar os fatores associados ao uso inconsistente do preservativo masculino entre homens HIV negativos que fazem sexo com homens. Método: estudo transversal, analítico, de abrangência nacional realizado on-line em todas as regiões do Brasil, em 2020, por meio de redes sociais e em sites de relacionamento. O uso inconsistente do preservativo foi definido como uso ocasional ou nunca ter usado. Foram realizadas análises estatísticas descritivas, testes de associação e regressão logística binária. Resultados: o uso inconsistente do preservativo foi relatado por 1222 (85%) dos 1438 participantes. As variáveis "homossexuais" (ORA: 2,03; IC 95%: 1,14- 3,59; p = 0,016), "ter parceiro fixo" (ORA: 2,19; IC 95%: 1,55-3,09; p<0,001), "sexo oral" (ORA: 2,41; IC 95%: 1,31-4,43; p = 0,005), "anal insertivo" (ORA: 1,98; IC 95%: 1,10-3,58; p = 0,023) e "diagnóstico de IST" (ORA: 1,59; IC 95%: 1,13-2,24; p = 0,007) foram independentemente associadas ao uso inconsistente do preservativo masculino. As variáveis "recebeu aconselhamento de amigo sobre teste de HIV" (ORA: 0,71; IC 95%: 0,52-0,96; p = 0,028) e "profissional do sexo" (ORA: 0,26; IC 95%: 0,11-0,60; p = 0,002) foram fatores de proteção. Conclusão: as variáveis estudadas apontaram uma forte relação das parcerias fixas com o aumento da confiança e uma baixa adesão ao uso do preservativo, o que corrobora com outros estudos.

Medidas poblacionales para la seguridad vial: más allá de la responsabilidad individual

Las lesiones causadas por el tránsito (LCT) se encuentran dentro de las principales causas de mortalidad y discapacidad a nivel mundial, hecho reflejado en el puesto que ocupan dentro de las primeras diez causas de vida ajustados por discapacidad, con importantes costos e impacto económico y social para las sociedades que las padecen. En 2004, la Organización Mundial de la Salud (OMS) lanzó el primer informe sobre prevención de LCT. Sin embargo, en años posteriores esa situación no mejoró, por lo cual las Naciones Unidas lanzó la Década de Acción para la Seguridad Vial (2011-2020), donde se invitaba a los gobiernos a diseñar e implementar acciones para reducir la carga asociada a este problema; entre estas se encuentra diseño y mejoramiento de vías, atención oportuna pos siniestro, control de la velocidad, medidas de control administrativo, diseño y mejoramiento de estándares vehiculares, entre otras. Las medidas basadas en enfoque poblacional han demostrado ser más poderosas que las medidas que inducen cambios de comportamiento individual.

Injuries caused by traffic (ICT) are among the main causes of mortality and disability worldwide, reflected in the fact that they occupy the first ten causes of disability adjusted life years with economic and social cost impacts for the societies that suffer from them. In 2004, the World Health Organization (WHO) released the first Prevention Report about ICT. Nevertheless, in subsequent years this situation has not improved, motivating the United Nations to launch the Decade of Action for Road Safety (2011-2020), where governments were invited to design and implement actions to reduce the burden associated with this problem: designing and improving of roads, increasing timely post-crash care, speed control, administrative control measures, designing and improving vehicle safety standards, among others. Population-based measures have been shown to be more powerful than measures that induce individual behavior changes.

Valoración de algunos indicadores del programa de atención a la conducta suicida en adolescentes / Evaluation of Some Indicators of the Program of Attention to Suicidal Behavior in Adolescents

Introducción: El suicidio está entre las tres primeras causas de muerte en el grupo de adolescentes y adultos jóvenes, su incidencia no ha descendido en el presente siglo. Objetivo: Valorar algunos indicadores relevantes del programa de atención a la conducta suicida en adolescentes. Métodos: Investigación en sistema y servicios de salud con diseño de estudio observacional descriptivo en tres áreas de salud del municipio Cienfuegos: áreas V, VII y VIII, de enero a septiembre del 2019. El universo fue de 46 profesionales de los Equipos de Salud Mental y Equipo Básicos de Salud. Se utilizaron como instrumentos dos encuestas, diseñadas y validadas por criterio de experto. Fueron seleccionados 6 indicadores en las dimensiones estructura y proceso y 4 en resultado. Se utilizó una media ponderada para procesar los datos. Resultados: Los indicadores valorados de regular fueron: en la estructura: capacitación de los recursos humanos y capacidad técnica del personal; en el proceso: confección de las historias clínicas, diseminación del programa en las unidades de salud y su verificación y las modalidades terapéuticas; y en resultado: la participación del equipo de salud mental en las investigaciones relacionadas con la conducta suicida. Conclusiones: Existe un grupo de deficiencias que conlleva a que el cumplimiento del programa de atención a la conducta suicida en adolescentes sea valorado como regular, en las tres áreas de salud del municipio Cienfuegos estudiadas(AU)

Introduction: Suicide is among the first three causes of death in the group of adolescents and young adults; its incidence has not decreased in the present century. Objective: To assess some relevant indicators of the adolescent suicidal behavior care program. Methods: Research in health system and services with descriptive observational study design in health areas V, VII and VIII of Cienfuegos municipality from January to September 2019. The universe was 46 professionals of the Mental Health Teams and Basic Health Team. Two surveys were used as instruments, designed and validated by expert criteria. Six indicators were selected in the structure and process dimensions and four in outcome. A weighted average was used to process the data. Results: The indicators rated as fair were: in the structure: training of human resources and technical aptitude of personnel; in the process: preparation of clinical histories, dissemination of the program in health units and its verification and therapeutic modalities; and in the outcome: participation of the mental health team in research related to suicidal behavior. Conclusions: There is a group of deficiencies that leads to the fact that compliance with the program of attention to suicidal behavior in adolescents is valued as regular in the three health areas of the Cienfuegos municipality studied(AU)

Diet Quality and Associated Factors in Atherosclerotic Cardiovascular Disease Patients with and without Diabetes at a Specialized Outpatient Clinic in the City of Pelotas, Brazil

Abstract Background In most cases, atherosclerotic cardiovascular disease (ACVD) is preventable through primary prevention and control of traditional risk factors, such as smoking cessation, regular physical activity, and adherence to healthy dietary patterns. The assessment of diet quality of ACVD patients would be important for a dietary intervention. Objectives This study aimed to evaluate diet quality of ACVD patients and its association with clinical conditions. Methods This cross-sectional study was nested within a randomized clinical trial entitled "Programa Alimentar Cardioprotetor Brasileiro." Baseline data of 80 patients from Pelotas, Brazil, were obtained. Food consumption was assessed using 24-h food recall and the Revised Diet Quality Index (IQD-R). Data on smoking status and comorbidities were reported by the patients during medical history taking. To analyze the associations between IQD-R and clinical variables, unpaired Student's t-test or the analysis of variance was performed. The significance level was 5%. Results Most of the sample consisted of men (66.5%), elderly individuals (52.50%), patients with hypertension (78.75%), dyslipidemia (58.75%), and overweight (73.75%). The average IQD-R score was 56.7 ± 12.6 points. Better quality of diet was observed for patients with diabetes compared to those without diabetes (61.1 ± 11.8 versus 54.0 ± 12.6 points; p=0.014). Conclusion There is a need to improve diet quality of ACVD patients. Patients ACVD and diabetes had better diet quality compared to those without diabetes.

Indicación profiláctica de aspirina para prevención de preeclampsia y sus complicaciones en embarazos de alto y moderado riesgo / Prophylactic use of aspirin for the prevention of preeclampsia and its complications in high and moderate risk pregnancies

Resumen OBJETIVO: Sintetizar la evidencia disponible de los últimos 10 años respecto de la indicación de la aspirina para prevenir la preeclampsia y sus complicaciones en embarazos de alto y moderado riesgo. METODOLOGÍA: Revisión de cinco bases de datos [Pubmed/Medline, ProQuest, Lilacs, HINARI y Cochrane Central Register of Controlled Trials (CENTRAL)]. Se incluyeron ensayos clínicos aleatorizados, controlados, escritos en español o inglés publicados entre enero de 2010 y enero de 2020. Se emplearon los términos de vocabulario controlado DeCS y MeSH en las distintas interfases. En el caso de ProQuest se introdujeron, además, términos de vocabulario libre. Los detalles de la estrategia de búsqueda se visualizan en anexos. RESULTADOS: Se identificaron 410 estudios, de los que se seleccionaron 8 que reunieron los criterios de elegibilidad. En dos estudios se encontró un efecto reductor de la aspirina en la incidencia de preeclampsia en comparación con placebo; otros dos estudios encontraron el mismo efecto en la incidencia de preeclampsia con parto pretérmino. No se encontraron estudios con bajo riesgo de sesgo que hubieran reportado un efecto significativo de la aspirina en las complicaciones de preeclampsia, ni en preeclampsia con y sin criterios de severidad. CONCLUSIONES: La evidencia señala que la aspirina en bajas dosis, indicada antes de las 16 semanas de embarazo, reduce la incidencia de preeclampsia debido a su efecto reductor en el parto pretérmino. A pesar de lo encontrado, la información sigue siendo limitada; de ahí la necesidad de contar con una mayor cantidad de estudios con bajo riesgo de sesgo.

Abstract OBJECTIVE: To synthesize the available evidence of the last 10 years regarding the use of aspirin for the prevention of preeclampsia and its complications in high and moderate risk pregnancies. Methodology: Five electronic databases [Pubmed/Medline, ProQuest, Lilacs, HINARI, and Cochrane Central Register of Controlled Trials (CENTRAL)] were reviewed. Randomized controlled clinical trials in Spanish and English published between 01/01/2010 and 01/01/2020 were considered. The DeCS and MeSH controlled vocabulary terms were used in the different interfaces. In the case of ProQuest, free vocabulary terms were also introduced. The details of the search strategy are displayed in annexes. RESULTS: 410 studies were identified, of which 8 studies that met the eligibility criteria were selected. 2 studies found a reducing effect of aspirin on the incidence of preeclampsia compared to placebo and another 2 studies found the same effect on the incidence of preeclampsia with preterm delivery. No studies with low risk of bias were found that have reported a significant effect of aspirin on the complications of preeclampsia, nor on preeclampsia with and without criteria of severity. CONCLUSIONS: there is evidence indicating that low-dose aspirin before 16 weeks of gestation reduces the incidence of preeclampsia, this is due to the reducing impact it has on the incidence of preeclampsia with preterm delivery. Despite the results found, the information is still limited, and it is necessary to have a greater number of studies with low risk of bias.

Breast and gynecologic cancers as a Brazilian health priority

SUMMARY OBJECTIVE: Cancer imposes a profound burden on low- and middle-income countries where 65% of the global cancer deaths occurred in 2020. The objective of the present review was to describe female cancer epidemiology in Brazil, barriers to prevention, screening, and treatment, and to propose strategies to a better control. METHODS: For the process of literature search and scientific acquisition, we have utilized the terms "female cancer" AND "breast cancer," AND "cervical cancer" AND "endometrial cancer" AND "ovarian cancer" AND "Brazil" in PubMed. References of the articles included in this review were manually searched in order to identify relevant studies on the topic. The official Brazilian epidemiology data were extensively analyzed at the governmental site www.inca.gov.br. RESULTS: Considering cases of breast and gynecologic cancers together, 105,770 new cases are expected to be diagnosed yearly, positioning female cancer as the highest cancer incidence in Brazil. Female breast cancer is the most common and the leading cause of death from cancer in the female population in all regions of Brazil, except in the North, where cervical cancer ranks first. Cervical cancer, a preventable disease, corresponds to the third-most common neoplasia in women, with higher incidences in the North and Northeast regions of Brazil. An upward trend has been observed in endometrial cancer incidence, a tendency that follows the increase of its two most common risk factors: population aging and obesity. Ovarian cancer currently occupies the eighth position among female cancers in Brazil, but it is the most lethal gynecologic cancer. The main strategies to reduce female cancer mortality rates are the reduction of inequalities in healthcare services and the early diagnosis of cases. The lack of a specific national cancer program results in a reactive and unplanned approach to healthcare provision, ultimately leading to suboptimal resource utilization and higher expenditure. CONCLUSION: Analyzed together, breast and gynecologic cancers correspond to the leading cause of cancer in Brazil. A heterogeneous group, female cancer includes diseases with a high primary and secondary prevention potential. The organization of a female cancer program in Brazil prioritizing primary and secondary prevention strategies, such as adequate mammography screening and human papillomavirus vaccination coverage, could significantly improve female cancer control in the country.

Barriers to Pre-Exposure Prophylaxis (PrEP) use for HIV: an integrative review / Barreras para el uso de la Profilaxis Previa a la Exposición (PrEP) para el VIH: una revisión integradora / Barreiras para o uso da Profilaxia Pré-Exposição (PrEP) ao HIV: uma revisão integrativa

ABSTRACT Objectives: to identify and synthesize scientific evidence on the barriers and difficulties for Pre-exposure Prophylaxis (PrEP) use and compliance for HIV. Methods: an integrative literature review, using the MEDLINE/PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Academic Search Premier and Scopus (Elsevier) databases. Results: all (100%) the articles included identified that PrEP users experience some type of structural barrier related to health services such as long distance from the units, suboptimal logistics for taking pills and professional resistance to prescribing PrEP. Furthermore, 63.21% identified social barriers, such as stigma about sexuality and HIV, in addition to individual barriers such as alcohol use, adverse effects, and concerns about long-term toxicity. Conclusions: the barriers to PrEP use are multifactorial. Effective interventions are needed to support PrEP users in accessing, complying with, and retaining health services.

RESUMEN Objetivos: identificar y sintetizar evidencias científicas sobre las barreras y dificultades para el uso y la adherencia a la Profilaxis Pre-Exposición (PrEP) para el VIH. Métodos: revisión integrativa de la literatura, utilizando las bases de datos MEDLINE/PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Academic Search Premier y Scopus (Elsevier). Resultados: todos (100%) de los artículos incluidos identificaron que los usuarios de PrEP experimentan algún tipo de barrera estructural relacionada con los servicios de salud, como la larga distancia de las unidades, la logística subóptima para la toma de pastillas y la resistencia profesional a prescribir la PrEP. Además, el 63,21% identificó barreras sociales, como el estigma sobre la sexualidad y el VIH, además de las barreras individuales como el consumo de alcohol, los efectos adversos y las preocupaciones sobre la toxicidad a largo plazo. Conclusiones: las barreras para el uso de la PrEP son multifactoriales. Se necesitan intervenciones eficaces para ayudar a los usuarios de la PrEP a acceder, adherirse y conservar los servicios de salud.

RESUMO Objetivos: identificar e sintetizar as evidências científicas sobre as barreiras e dificuldades para o uso e adesão da Profilaxia Pré-exposição (PrEP) para o HIV. Métodos: revisão integrativa da literatura, utilizando as bases de dados MEDLINE/PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Academic Search Premier e Scopus (Elsevier). Resultados: todos (100%) os artigos incluídos identificaram que os usuários da PrEP experimentam algum tipo de barreira estrutural relacionada aos serviços de saúde, como longa distância das unidades, logística subótima para retirada de pílulas e resistência profissional para prescrição da PrEP. Ademais, 63,21% identificaram barreiras sociais, como estigma sobre a sexualidade e HIV, além de barreiras individuais, como uso de álcool, efeitos adversos e preocupações com a toxicidade a longo prazo. Conclusões: multifatoriais são as barreiras para o uso da PrEP. Intervenções efetivas são necessárias para apoiar os usuários da PrEP no acesso, adesão e retenção nos serviços de saúde.

Quemaduras y corrosiones: una descripción epidemiológica según sexo y rango etario periodo 2018 - 2022, en Chile / Burns and corrosions: an epidemiological description by gender and age range for the period 2018-2022 in Chile

Introducción: Las quemaduras son lesiones de gravedad variable causadas por exceso de calor. En Chile, son causa importante de hospitalización y muerte, especialmente en niños, lo que ha llevado a la implementación de medidas como su adición a las Garantías Explícitas en Salud, y la creación de un registro nacional para mejorar la atención. El siguiente estudio busca describir las tasas de egresos hospitalarios y mortalidad de pacientes con quemaduras y corrosiones en Chile, durante el período 2018-2022, con la finalidad de contribuir a la epidemiología actual. Metodología: Se realizó un estudio retrospectivo utilizando datos del DEIS sobre quemaduras y corrosiones en la población chilena entre 2018 y 2022. Se analizaron los datos por año, sexo y rango etario. No requirió consentimiento informado ni revisión ética debido a la disponibilidad pública de los datos. Resultados: Se observó una tendencia a la disminución de los egresos hospitalarios desde 2018 hasta 2022, con el máximo en 2019. En cuanto a la mortalidad, se registró la mayor cifra en 2022 y la menor en 2019, con una tendencia al alza a lo largo del periodo. Los hombres presentaron una mayor proporción de egresos hospitalarios y mortalidad en comparación con las mujeres. Discusión: Las quemaduras y corrosiones mostraron una disminución en los egresos hospitalarios durante el periodo estudiado, mientras que la mortalidad aumentó. Se destacaron eventos específicos que podrían explicar los años con mayores egresos hospitalarios y mortalidad, como ataques incendiarios e incendios forestales. Con tal de reducir la incidencia y mortalidad de estas lesiones, se resalta la importancia de promover medidas de prevención y educación, y fortalecer los protocolos de atención y tratamiento.

Introduction: Burns are injuries of variable severity caused by excessive heat. In Chile, they are an important cause of hospitalization and death, especially in children, which has led to the implementation of measures such as their addition to the Explicit Health Guarantees, and the creation of a national registry to improve care. The following study seeks to describe the hospital discharge and mortality rates of patients with burns and corrosions in Chile, during the period 2018-2022, with the aim of contributing to the current epidemiology. Methodology: A retrospective study was conducted using DEIS data on burns and corrosions in the Chilean population between 2018 and 2022. Data were analyzed by year, gender, and age range. Informed consent and ethical review were not required due to the public availability of the data. Results: A decreasing trend in hospital discharges for burns was observed from 2018 to 2022, with a peak in 2019. For mortality, the highest number of deaths was recorded in 2022 and the lowest in 2019, with an upward trend throughout the period. Males had a higher proportion of hospital discharges and mortality compared to females. Discussion: Burns and corrosions showed a decrease in hospital admissions during the period studied, while mortality increased. Specific events that could explain the years with higher hospital admissions and mortality were highlighted, such as arson attacks and forest fires. In order to reduce the incidence and mortality of these injuries, the importance of promoting prevention and education measures and strengthening care and treatment protocols is highlighted.