Influenza aviar H5N1. ¿Debemos preocuparnos?

Desde la segunda mitad de 2022 se ha reportado un aumento de casos de influenza en aves migratorias en Latinoamérica. Los virus influenza A y B son los principales agentes asociados a influenza estacional epidémica en humanos. Los virus influenza A circulan no solo en humanos sino también en animales, incluyendo aves migratorias. El intercambio de segmentos de ARN genómico entre dos virus del mismo tipo aumenta la diversidad de los subtipos circulantes e incluso puede facilitar la generación de progenie viral potencialmente pandémica. La naturaleza zoonótica del virus influenza A puede generar infecciones en humanos con virus de origen animal. El virus influenza A de origen aviar ha ocasionado transmisiones en humanos, incluyendo casos graves y muertes, siendo la influenza A H5N1 la más destacada. Es importante tomar medidas de prevención y control en caso de aumento de casos de influenza en aves migratorias para prevenir posibles pandemias en Chile y el mundo.

Since the second half of 2022, an increase in influenza cases in migratory birds has been reported in Latin America. Influenza A and B viruses are the main agents associated with seasonal epidemic influenza in humans. Influenza A viruses circulate not only in humans but also in animals, including migratory birds. The exchange of genomic RNA segments among two viruses increases the diversity of circulating subtypes and may even facilitate the generation of potentially pandemic viral progeny. The zoonotic nature of influenza A virus can generate infections in humans with animal-origin viruses. Avian-origin influenza A virus has caused transmissions in humans, including severe cases and deaths, with influenza A H5N1 being the most prominent. It is important to take preventive and control measures in case of an increase in influenza cases in migratory birds to prevent possible pandemics in Chile and the world.

Medidas de prevenção da progressão da disfagia em pacientes com câncer de cabeça e pescoço submetidos a radioterapia: uma revisão sistemática com meta-análise / Preventive measures for the progression of dysphagia in patients with cancer of head and neck subjected to radiotherapy: a systematic review with meta-analysis

RESUMO Objetivo Identificar os efeitos de medidas profiláticas, não farmacológicas, sobre a progressão da disfagia em pacientes com câncer de cabeça e pescoço submetidos a radioterapia. Estratégia de pesquisa A busca foi realizada nas bases de dados Medline (via PubMed), Scopus e Embase, assim como na literatura cinzenta. Critérios de seleção Foram incluídos ensaios clínicos randomizados, com pacientes adultos (≥ 18 anos) e diagnóstico de câncer de cabeça e pescoço, tratados com radioterapia (associada ou não à cirurgia e quimioterapia) submetidos a protocolos não farmacológicos de prevenção da disfagia. Análise dos dados O risco de viés foi avaliado por meio da escala PEDRO e a qualidade global da evidência foi avaliada de acordo com o instrumento GRADE. Resultados Foram considerados elegíveis 4 estudos, e desses, dois foram incluídos na metanálise. O resultado favoreceu o grupo intervenção, com diferença média de 1,27 [IC 95%: 0,74 à 1,80]. Houve baixa heterogeneidade e a pontuação média para risco de viés foi de 7,5 de um total de 11 pontos. A falta de detalhamento nos cuidados com os vieses de seleção, performance, detecção, atrito e de relato contribuíram para o julgamento da qualidade da evidência, considerada baixa. Conclusão Medidas profiláticas de contenção da disfagia podem promover importantes benefícios sobre a ingesta oral dos pacientes com câncer de cabeça e pescoço, quando comparados aqueles que não realizaram tal medida terapêutica ao longo da radioterapia.

ABSTRACT Purpose To identify the effects of prophylactic, non-pharmacological measures on the progression of dysphagia in patients with head and neck cancer undergoing radiotherapy. Research strategies The search was performed in Medline (via PubMed), Scopus, and Embase databases, as well as in the gray literature. Selection criteria Randomized clinical trials were included, with adult patients (≥ 18 years old) and diagnosed with head and neck cancer, treated with radiotherapy (with or without surgery and chemotherapy), and submitted to non-pharmacological protocols for the prevention of dysphagia. Data analysis The risk of bias was assessed using the PEDRO scale and the overall quality of evidence was assessed using the GRADE instrument. Results Four studies were considered eligible, and of these, two were included in the meta-analysis. The result favored the intervention group, with a mean difference of 1.27 [95% CI: 0.74 to 1.80]. There was low heterogeneity and the mean score for risk of bias was 7.5 out of 11 points. The lack of detail in the care with selection, performance, detection, attrition, and reporting biases contributed to the judgment of the quality of the evidence, considered low. Conclusion Prophylactic measures to contain dysphagia can promote important benefits on the oral intake of patients with head and neck cancer when compared to those who did not undergo such a therapeutic measure during radiotherapy.

Factores asociados al conocimiento y medidas preventivas de mordedura de Loxosceles laeta en la población de la Encuesta Nacional de Programas Presupuestales (ENAPRES) en el Perú 2017-2019

Introducción: Las enfermedades metaxénicas y zoonóticas, son consideradas prioridades nacionales de investigación en salud en Perú 2019-2023. De estas, los casos reportados por loxoscelismo han ido aumentando progresivamente. Objetivo: Determinar los factores asociados al conocimiento y medidas preventivas de mordedura de Loxosceles laeta en la población de la ENAPRES en el Perú 2017-2019. Métodos: Estudio de tipo observacional, transversal, analítico y retrospectivo, basado en la información de la ENAPRES. Resultados: Se analizó una muestra total de 285.354 personas. De estas, aquellos con 60 a más años (RPa=1,48; IC95%: 1,45-1,51), los costeños (RPa=1,37; IC95%: 1,33-1,40), las mujeres (RPa=1,12; IC95%: 1,11-1,13), con primaria o secundaria (RPa=1,12; IC95%: 1,09-1,15), con viviendas inadecuadas [techo (RPa=1,07; IC95%: 1,05-1,10), piso (RPa=1,02; IC95%: 1,00-1,04)], se asociaron con mayor posibilidad de tener más conocimiento sobre mordedura de L. laeta. Por otra parte, los encuestados de 60 a más años (RPa=1,49; IC95%: 1,46-1,52), los costeños (RPa=1,39; IC95%: 1,35-1,43), con estudios superiores no universitarios (RPa=1,19; IC95%: 1,15-1,22), las mujeres (RPa=1,13; IC95%: 1,12-1,14) y con viviendas con techos inadecuados (RPa=1,07; IC95%: 1,05-1,10) se asociaron con mayor posibilidad de realizar adecuadas medidas preventivas. En ambas, se halló asociación con el desechar los residuos orgánicos en calle o vía pública (RPa=0,97; IC95%: 0,96-0,99). Conclusiones: Se encontró aquellos factores asociados a conocimientos y a las medidas preventivas de mordedura de L. laeta.

Background: Metaxenic and zoonotic diseases are one of the ten national priorities for health research in Peru 2019-2023. Of these, the cases reported by loxoscelism have been increasing progressively. Aim: To determine the factors associated with the knowledge and preventive measures of Loxosceles laeta bite in the population of the ENAPRES in Peru 2017-2019. Methods: Observational, cross-sectional, analytical and retrospective study, based on information from ENAPRES. Results: A total sample of 285,354 people was analyzed. Of these, those aged 60 or over (PRa=1,48; 95%CI: 1,45-1,51), those from the coast (PRa=1,37; 95%CI: 1,33-1,40), women (PRa=1,12; 95%CI: 1,11-1,13), with primary or secondary education (PRa=1,12; 95%CI: 1,09-1,15), with inadequate housing [ceiling (PRa=1,07; 95%CI: 1,05-1,10), floor (PRa=1,02; 95%CI: 1,00-1,04)], were associated with higher possibility ofhaving more knowledge about L. laeta bite. On the other hand, those aged 60 or over (PRa=1,49; 95%CI: 1,46-1,52), those from the coast (PRa=1,39; 95%CI: 1,35-1,43), with non-university higher education (PRa=1,19; 95%CI: 1,15-1,22), women (PR a=1,13; 95%CI: 1,12-1,14) and with inadequate housing ceilings (PRa=1,07; 95%CI 1,05-1,10) were associated with a greater possibility of taking adequate preventive measures. In both, an association was found between disposing of organic waste on the street or on public roads (RPa=0.97; 95%CI: 0.96-0.99) Conclusions: It were found factors associated with knowledge and preventive for L. laeta bite.

"Flattening the curve": effective measures from Niterói city (Rio de Janeiro, Brazil) for COVID-19 control / "Achatando a curva": medidas eficazes da cidade de Niterói (RJ, Brasil) para o controle da COVID-19

Abstract Background In Brazil, some local city government's adopted several measures, which probably had a positive impact on COVID-19 control. Objective To report the distribution of COVID-19 cases in Brazil, Rio de Janeiro state and Niterói city. In parallel, we aimed to demonstrate the preventive strategies adopted by Niterói city. Method Data provided by the Brazilian Ministry of Health and Municipal Health Foundation of Niterói were used to report COVID-19 cases and deaths. For some analysis, data were grouped by week and normalized for 100,000 inhabitants. Results By July 18th, 2020, Brazil reported 2,074,860 cases and 78,772 deaths and Rio de Janeiro state registered 135,230 cases and 11,919 deaths; both still presenting ascendant curves for COVID-19 deaths. In contrast, the rate of new deaths per 100,000 inhabitants is consistently lower in Niterói city. Importantly, we estimated that 712 deaths were prevented by the measures adopted by Niterói city, in comparison to which was observed in Rio de Janeiro. Conclusion The early preventive measures adopted in Niterói city were effective in reducing both the viral spread and rate of deaths. In this regard, this discussion could be relevant for making future decisions during the COVID-19 outbreak in Brazil.

Resumo Introdução No Brasil, algumas cidades adotaram várias medidas que provavelmente tiveram um impacto positivo no controle da Covid-19. Objetivo Relatar a distribuição dos casos de Covid-19 no Brasil, no estado do Rio de Janeiro e na cidade de Niterói. Paralelamente, buscamos demonstrar as estratégias preventivas adotadas pela cidade de Niterói para o controle da Covid-19. Método Dados fornecidos pelo Ministério da Saúde e Fundação Municipal de Saúde de Niterói foram usados ​​para relatar o número de casos e óbitos causados pela Covid-19. Para algumas análises, os dados foram agrupados por semana e normalizados para 100.000 habitantes. Resultados Até 18 de julho de 2020, o Brasil registrou 2.074.860 casos e 78.772 mortes e o estado do Rio de Janeiro registrou 135.230 casos e 11.919 mortes; ambos ainda apresentando curvas ascendentes para mortes por Covid-19. Em contrapartida, a taxa de novos óbitos/100.000 habitantes é consistentemente menor na cidade de Niterói. Estimamos que 712 mortes foram evitadas pelas medidas adotadas pela cidade de Niterói, em comparação com o que foi observado no Rio de Janeiro. Conclusão As medidas preventivas adotadas pela cidade de Niterói foram eficazes na redução tanto da disseminação do vírus quanto da taxa de óbitos. Portanto, esta discussão se mostra relevante para a tomada de decisões futuras durante o surto de Covid-19 no Brasil.

Conocimientos y medidas preventivas sobre arbovirosis en estudiantes universitarios de una zona endémica del Perú / Knowledge and preventive measures on arbovirus infections among university students in an endemic area of Peru / Conhecimento e medidas preventivas sobre arboviroses em estudantes universitários de uma área endêmica do Peru

RESUMEN Introducción: Las arbovirosis constituyen un grave problema sanitario en el Perú. Un mayor conocimiento y participación de la población en actividades preventivas puede minimizar su impacto. Objetivo: Evaluar el nivel de conocimientos y su relación con las medidas preventivas sobre arbovirosis en estudiantes universitarios de una zona endémica del Perú, septiembre a noviembre de 2020. Método: Se realizó un estudio observacional, transversal, correlacional y con diseño no experimental. La población estuvo conformada por 325 estudiantes de tecnología médica y la muestra por 176 estudiantes de ambos sexos. El nivel de conocimiento se categorizó en deficiente, regular y alto. Mientras que las medidas preventivas se clasificaron en adecuadas e inadecuadas. El cuestionario contenía 23 preguntas de opción múltiple, validadas por juicio de expertos. Resultados: El 69,9 % de los estudiantes presentó un nivel de conocimientos regular, observándose medidas preventivas inadecuadas en el 44,3 %. Un 92,0 % de encuestados consideró que las arbovirosis son enfermedades graves, pero solo 10,2 % reconoció el signo de alarma del zika. Las principales medidas preventivas fueron: la fumigación (50,6 %) y el uso de repelentes (49,6 %). Además, el 92,6 % de estudiantes consideró importante eliminar los criaderos de mosquitos para evitar la propagación de los arbovirus. Sin embargo, solo el 51,1 % revisó la presencia de criaderos y limpió diaria e interdiariamente su domicilio (43,8 %). Conclusiones: El nivel de conocimientos fue regular y se relacionó con medidas preventivas inadecuadas como no revisar frecuentemente la presencia de criaderos de mosquitos ni realizar limpieza en las viviendas.

ABSTRACT Introduction: Arbovirus infections are a serious health problem in Peru. Higher population awareness and their participation in preventive activities can minimize their impact. Objective: Assessment on the level of knowledge and its relationship with preventive measures concerning arbovirus infections in university students in an endemic area of Peru, September to November 2020. Method: An observational, cross-sectional, correlational and non-experimental design study was carried out. The population consisted of 325 medical technology students and the sample consisted of 176 students of both sexes. The level of knowledge was categorized as deficient, regular and high. Preventive measures were classified as adequate and inadequate. The questionnaire contained 23 multiple-choice questions, validated by expert judgment. Results: The knowledge level in 69.9% of the students was fair, and inadequate preventive measures were observed in 44.3%. The 92.0% of surveyed personnel considered the arbovirus infection as a serious disease, but only 10.2% recognized the warning sign of zika. The main preventive measures were: fumigation (50.6%) and the use of repellents (49.6%). In addition, 92.6% of students considered as an important action the act to eliminate mosquito breeding sites in order to prevent the spread of infection. However, only 51.1% checked for the presence of breeding sites and cleaned their homes on a daily and inter-daily basis (43.8%). Conclusions: The level of knowledge was regular and was related to inadequate preventive measures such as not frequently checking for the presence of mosquito breeding sites and not cleaning houses.

RESUMO Introdução: As arboviroses constituem um grave problema de saúde no Peru. Maior conhecimento e participação da população em atividades preventivas podem minimizar seu impacto. Objetivo: avaliar o nível de conhecimento e sua relação com medidas preventivas sobre arboviroses em estudantes universitários em uma área endêmica do Peru, de setembro a novembro de 2020. Método: Estudo observacional, transversal, correlacional com desenho não experimental foi realizado. A população foi composta por 325 estudantes de tecnologia médica e a amostra por 176 estudantes de ambos os sexos. O nível de conhecimento foi categorizado em deficiente, regular e alto. Enquanto as medidas preventivas foram classificadas como adequadas e inadequadas. O questionário continha 23 questões de múltipla escolha, validadas por julgamento de especialistas. Resultados: 69,9% dos alunos apresentaram nível regular de conhecimento, observando medidas preventivas inadequadas em 44,3%. 92,0% dos pesquisados consideraram que as arboviroses são doenças graves, mas apenas 10,2% reconheceram o sinal de alerta do Zika. As principais medidas preventivas foram: fumigação (50,6%) e uso de repelentes (49,6%). Além disso, 92,6% dos alunos consideraram importante eliminar os criadouros do mosquito para evitar a propagação de arboviroses. No entanto, apenas 51,1% verificaram a presença de criadouros e limparam suas casas diariamente e em dias alternados (43,8%). Conclusões: O nível de conhecimento foi regular e relacionado a medidas preventivas inadequadas, como não verificar com frequência a presença de criadouros do mosquito ou limpeza das residências.

Viruela símica: revisión bibliográfica / Monkeypox: Bibliographic Review

La viruela símica es una enfermedad que ocurre en los monos, sin embargo también se han presentado casos en humanos desde 1970, transformándose en una zoonosis de origen viral, la sintomatología es similar a la viruela pero menos grave. Objetivo: Proporcionar información actualizada sobre la viruela símica, situación epidemiológica, sintomatología, letalidad, diagnóstico, tratamiento y medidas de prevención Materiales y métodos: Se realizó una búsqueda de literatura científica en las bases de datos Organización Mundial de la Salud, Google Académico y PubMed, se eligieron los descriptores o palabras relacionadas con la enfermedad y se realizó la búsqueda para la descripción de reportes de casos y brotes producidas por la viruela símica. Resultados: Desde que se reportó el primer caso en humanos, han existido brotes en el continente africano, fuera de éste, se han reportados varios casos y brotes en otros países, la mayoría en los Estados Unidos. El último evento se reporta en mayo de 2022 y es de preocupación mundial, debido a la aparición en varios países no endémicos. Conclusiones: La presencia de casos de viruela símica en humanos se ha mantenido desde su aparición, la ausencia de un tratamiento específico y vacunas autorizadas para su administración, podrían generar un aumento en la morbimortalidad(AU)

Monkeypox is a disease that occurs in monkeys, however there have also been cases in humans since 1970, becoming a zoonosis of viral origin, the symptoms are similar to smallpox but less severe. Objective: To provide updated information on monkeypox, epidemiological situation, symptomatology, lethality, diagnosis, treatment and prevention measures. Materials and methods: A search of scientific literature was carried out in the World Health Organization, Google Scholar and PubMed databases. , the descriptors or words related to the disease were chosen and the search was performed for the description of case reports and outbreaks caused by monkeypox. Results: Since the first human case was reported, there have been outbreaks on the African continent, outside of Africa, several cases and outbreaks have been reported in other countries, most in the United States. The last event is reported in May 2022 and is of global concern, due to the appearance in several non-endemic countries. Conclusions: The presence of cases of monkeypox in humans has been maintained since its appearance, the absence of a specific treatment and vaccines authorized for its administration, could generate an increase in morbidity and mortality(AU)

Políticas públicas promovidas para el sistema educativo a partir de propagación del COVID-19 / Public policies promoted for the educational system from the spread of the COVID19

La pandemia por COVID-19 ha evidenciado la deficiencia de los sistemas de salud en América Latina, exponiendo a la población al contagio en ondiciones de desprotección. Con la finalidad de disminuir la propagación del virus, en Perú se decretó la medida de cuarentena nacional con cese de casi todas las actividades, incluyendo clases presenciales en universidades, sugiriendo la necesidad de laborar de manera no presencial. Se realizó un estudio descriptivo en 248 estudiantes de dos universidades de la provincia de Huancayo, Perú. Para ello, se caracterizó sociodemográficamente 248 estudiantes de ambas universidades, se categorizaron las políticas educativas de acuerdo a los objetivos del plan de acción para centros de educación superior, se establecieron indicadores y se evaluó la eficacia de las políticas públicas educativas para mitigar la propagación del COVID-19 usando los indicadores: adecuación, coherencia, y eficiencia. Las políticas socializables y logísticas arrojaron una eficacia de 76,8% y 73%, respectivamente. La promoción del correcto lavado de manos, hábitos de protección al toser y estornudar y, mantenimiento del mobiliario y equipamiento resultaron en medidas eficaces, mientras que, el monitoreo y reporte de casos sospechosos con posibles síntomas, fue la más ineficaz. El estudio aporta información novel acerca de indicadores para evaluar las políticas públicas promovidas por el sistema educativo Peruano para la contención de la transmisión del COVID-19, en el marco del retorno a la modalidad semipresencial y constituye un material de referencia para la evaluación de protocolos sanitarios implementados en otras universidades(AU)

The COVID-19 pandemic has shown the deficiency of health systems in Latin America, exposing the population to contagion in unprotected onditions. In order to reduce the spread of the virus, in Peru a national quarantine measure was decreed with the cessation of almost all activities, including face-to-face classes at universities, suggesting the need to work in a non-face-to-face way. A descriptive study was carried out in 248 students from two universities in the province of Huancayo, Peru. To this end, 248 students from both universities were characterized sociodemographically, educational policies were categorized according to the objectives of the action plan for higher education centers, indicators were established and the effectiveness of public educational policies to mitigate the spread of the disease was evaluated. COVID-19 using the indicators: adequacy, coherence, and efficiency. Socializable and logistics policies yielded an effectiveness of 76.8% and 73%, respectively. The promotion of proper hand washing, coughing and sneezing protective habits, and maintenance of furniture and equipment turned out to be effective measures, while the monitoring and reporting of suspected cases with possible symptoms was the most ineffective. The study provides novel information about indicators to evaluate the public policies promoted by the Peruvian educational system for the containment of the transmission of COVID-19, within the framework of the return to the blended modality and constitutes a reference material for the evaluation of protocols health facilities implemented in other universities(AU)

Prospect of microbial food borne diseases in Pakistan: a review / Perspectiva de doenças microbianas transmitidas por alimentos no Paquistão: uma revisão

Abstract Nowadays food borne illness is most common in people due to their epidemic nature. These diseases affect the human digestive system through bacteria, viruses and parasites. The agents of illness are transmitted in our body through various types of food items, water and uncooked. Pathogens show drastic changes in immunosuppressant people. This review gives general insights to harmful microbial life. Pakistan is a developed country and because of its improper food management, a lot of gastrointestinal problems are noted in many patients. Bacteria are most common agents to spread diarrhoea, villi infection, constipation and dysenteric disease in human and induce the rejection of organ transplant. Enhancement of their lifestyle, properly cooked food should be used and to overcome the outbreak of the diseases.

Resumo Hoje em dia, as doenças transmitidas por alimentos são mais comuns em pessoas devido à sua natureza epidêmica. Essas doenças afetam o sistema digestivo humano por meio de bactérias, vírus e parasitas. Os agentes das doenças são transmitidos em nosso corpo por meio de diversos tipos de alimentos, água e crus. Os patógenos mostram mudanças drásticas em pessoas imunossupressoras. Esta revisão fornece uma visão geral da vida microbiana prejudicial. O Paquistão é um país desenvolvido e, devido ao seu manejo alimentar inadequado, muitos problemas gastrointestinais são observados em muitos pacientes. As bactérias são os agentes mais comuns para espalhar diarreia, infecção de vilosidades, obstipação e doença disentérica em humanos e induzem a rejeição de transplantes de órgãos. Melhoria de seu estilo de vida, alimentos devidamente cozidos devem ser utilizados e para superar o aparecimento de doenças.

Prospect of microbial food borne diseases in Pakistan: a review / Perspectiva de doenças microbianas transmitidas por alimentos no Paquistão: uma revisão

Abstract Nowadays food borne illness is most common in people due to their epidemic nature. These diseases affect the human digestive system through bacteria, viruses and parasites. The agents of illness are transmitted in our body through various types of food items, water and uncooked. Pathogens show drastic changes in immunosuppressant people. This review gives general insights to harmful microbial life. Pakistan is a developed country and because of its improper food management, a lot of gastrointestinal problems are noted in many patients. Bacteria are most common agents to spread diarrhoea, villi infection, constipation and dysenteric disease in human and induce the rejection of organ transplant. Enhancement of their lifestyle, properly cooked food should be used and to overcome the outbreak of the diseases.

Resumo Hoje em dia, as doenças transmitidas por alimentos são mais comuns em pessoas devido à sua natureza epidêmica. Essas doenças afetam o sistema digestivo humano por meio de bactérias, vírus e parasitas. Os agentes das doenças são transmitidos em nosso corpo por meio de diversos tipos de alimentos, água e crus. Os patógenos mostram mudanças drásticas em pessoas imunossupressoras. Esta revisão fornece uma visão geral da vida microbiana prejudicial. O Paquistão é um país desenvolvido e, devido ao seu manejo alimentar inadequado, muitos problemas gastrointestinais são observados em muitos pacientes. As bactérias são os agentes mais comuns para espalhar diarreia, infecção de vilosidades, obstipação e doença disentérica em humanos e induzem a rejeição de transplantes de órgãos. Melhoria de seu estilo de vida, alimentos devidamente cozidos devem ser utilizados e para superar o aparecimento de doenças.

Predisposição a formas graves de COVID-19 e adesão às medidas de prevenção: o papel do apoio social / Predisposition to severe forms of COVID-19 and adherence to preventive measures: the role of social support

Resumo Objetivou-se verificar a adesão às medidas de prevenção em idosos com maior predisposição a formas graves de COVID-19 e sua associação e interação com o apoio social. Trata-se de um estudo transversal realizado em amostra de 3.477 participantes do inquérito telefônico do Estudo Longitudinal da Saúde dos Idosos Brasileiros (iniciativa ELSI-COVID-19), que informaram ter saído de casa na semana anterior à realização do inquérito. A adesão foi aferida pela frequência com que saiu de casa, necessidade de sair de casa, uso de máscara e higienização das mãos. As análises basearam-se no modelo Poisson com variância robusta. Idade ≥ 65 anos, hipertensão, diabetes e obesidade foram considerados fatores predisponentes para formas graves de COVID-19. O apoio social incluiu o arranjo domiciliar e a conexão social na pandemia. Aproximadamente 46% apresentaram melhor adesão, que foi associada positivamente ao número de fatores predisponentes para formas graves. O apoio social não foi associado à adesão e não modificou essa associação, após ajustamentos. Conclui-se que a adesão às medidas de prevenção, que deveria ser estendida a todos, está concentrada nos idosos com maior predisposição a formas graves de COVID-19, independentemente do apoio social.

Abstract This study sought to assess the adherence to preventive measures among the elderly more prone to severe forms of COVID-19, and the association and interaction with social support. It is a cross-sectional study conducted with a sample of 3,477 participants of the telephone survey of the Brazilian Longitudinal Study of Aging (ELSI-COVID-19 initiative), who reported going out of the home in the past week. The adherence was based on the frequency of leaving the house, the need to venture outside the home, use of masks, and sanitization of hands. Statistical analysis was based on the Poisson model with robust variance. Predisposing factors for severe forms of COVID-19 included age ≥65 years, hypertension, diabetes, and obesity. Social support included living arrangements and social distancing during the pandemic. Approximately 46% of the participants showed higher adherence, which was positively associated with the number of predisposing factors for severe forms of COVID-19. Social support was not associated with adherence, nor was this association modified after adjustments. The conclusion drawn is that higher adherence is concentrated among the elderly with greater predisposition to severe forms of COVID-19, irrespective of social support, albeit preventive measures should be adopted by all.

Factores asociados al nivel de conocimiento de las medidas preventivas de COVID-19 en gestantes y puérperas de dos comunidades peruanas / Factors Associated With The Level Of Knowledge Of COVID-19 Preventive Measures In Pregnant And Puerpal Women In Two Peruvian Communities

Se determinaron los factores asociados al nivel de conocimiento de las medidas preventivas de COVID-19 en gestantes y puérperas de dos comunidades peruanas. Estudio cuantitativo, prospectivo, transversal y analítico. Se trabajó con toda la población. El nivel de conocimiento se midió a través de un instrumento validado previamente. Se realizó análisis bivariado y multivariado, usando regresión lineal con un intervalo de confianza al 95%. Los resultados indican que la mayoría (64,7%) consideró como medida preventiva el uso de guantes de goma, mientras que el 33,8% consideró incorrecto el uso de mascarillas caseras y consideraba que los animales domésticos transmitían el COVID-19. En el análisis multivariado, el nivel de conocimiento se asoció a haber recibido información por su centro de salud. Existe un buen nivel de conocimientos sobre prevención de COVID-19 en gestantes y puérperas de dos comunidades peruanas, y que el principal factor asociado es haber recibido información por parte de su Centro de Salud.

The factors associated with the level of knowledge of the preventive measures of COVID-19 in pregnant and postpartum women from two Peruvian communities were determined. Quantitative, prospective, cross-sectional and analytical study. They worked with the entire population. The level of knowledge was measured through a previously validated instrument. Bivariate and multivariate analysis was performed, using linear regression with a 95% confidence interval. The results indicate that the 3 majority (64.7%) considered the use of rubber gloves as a preventive measure, while 33.8% considered the use of homemade masks incorrect and considered that domestic animals transmitted COVID-19. In the multivariate analysis, the level of knowledge was associated with having received information from their health center. There is a good level of knowledge about COVID-19 prevention in pregnant and postpartum women from two Peruvian communities, and that the main associated factor is having received information from their Health Center.

Assessment of the implementation of preventive measures by Iraqis people to reduce the spread of coviD-19 pandemic / Valoración de la implementación de medidas preventivas por parte del pueblo iraquí para reducir la propagación de la pandemia de COVID-19

ABSTRACT Background and aim The new outbreak "Coronavirus disease 2019 (COVID-19)" happened in china is caused by severe acute respiratory distress syndrome coronavirus 2 (SARS-CoV-2). Consequently, it spreads across the globe and is affecting wellbeing frameworks and the global economy. This pandemic disease places a heavy burden on governments in general, so individuals must adhere to WHO's instructions to limit its spread. The current study was applied to find out the extent of commitment among the Iraqi people to the standards of prevention measures against the coronavirus. Materials and Methods A cross sectional study was conducted with 1153 respondents widely in all governorates of Iraq to identify the commitment of the Iraqis to the preventive measures against COVID-19 in Iraq. This study covered the Iraqis in three main regions (Southern, middle, and Northern) for data collection. It was conducted between the 17th and 25th of March 2020, and Iraqis were administered with a structured questionnaire comprising of three domains. Results The results showed that the majority of the respondents (52%) were female, and most of them (42.3%) were observed between the age group of 31-40 years. About 82% of the respondents were residents of urban areas. Conclusion This study reveals the excellent implementation of preventive measures by the population. It is observed that the application of prevention standards in the countryside is less than in the city.(AU)

RESUMEN Antecedentes y objetivo El nuevo brote "Enfermedad del coronavirus 2019 (COVID-19)" que sufrió en China es el problema del coronavirus 2 del síndrome de dificultad respiratoria aguda grave (SARS-CoV-2). En consecuencia, se extiende por todo el mundo y está afectando los marcos de bienestar y la economía global. Esta enfermedad pandémica supone una gran carga para los gobiernos en general, por lo que las personas deben cumplir con las instrucciones de la OMS para limitar su propagación. El estudio actual se aplicó para determinar el grado de compromiso entre el pueblo iraquí con los parámetros de medidas de prevención contra el coronavirus. Materiales y Métodos Se realizó un estudio transversal con 1153 encuestados en todas las provincias de Iraq para identificar el compromiso de los iraquíes con las medidas preventivas contra COVID-19 en Iraq. Este estudio cubrió a los iraquíes en tres regiones principales (sur, medio y norte) para la recopilación de datos. Se realizó entre el 17 y el 25 de marzo de 2020, y los iraquíes fueron administrados con un cuestionario estructurado que consta de tres dominios. Resultados los resultados mostraron que la mayoría de los encuestados (52%) eran mujeres, y la mayoría de ellos (42,3%) se observaron entre el grupo de edad de 31-40 años. Alrededor del 82% de los encuestados eran residentes de áreas urbanas. Conclusión Este estudio revela la excelente implementación de medidas preventivas por parte de la población. Se observa que la aplicación de normas de prevención en el campo es menor que en la ciudad.(AU)

Susceptibility of the Bhopal-methyl isocyanate (MIC)-gas-tragedy survivors and their offspring to COVID-19: What we know, what we dont and what we should? / Suscetibilidade dos sobreviventes da tragédia de Bhopal-isocianato de metila (CIM)-gás e seus filhos ao COVID-19: O que sabemos, o que não sabemos e o que devemos?

Abstract There is credible evidence that the 1984-Bhopal-methyl isocyanate (MIC)-gas-exposed long-term survivors and their offspring born post-exposure are susceptible to infectious/communicable and non-communicable diseases. Bhopal's COVID-19 fatality rate suggests that the MIC-gas tragedy survivors are at higher risk, owing to a weakened immune system and co-morbidities. This situation emboldened us to ponder over what we know, what we don't, and what we should know about their susceptibility to COVID-19. This article aims at answering these three questions that emerge in the minds of public health officials concerning prevention strategies against COVID-19 and health promotion in the Bhopal MIC-affected population (BMAP). Our views and opinions presented in this article will draw attention to prevent and reduce the consequences of COVID-19 in BMAP. From the perspective of COVID-19 prophylaxis, the high-risk individuals from BMAP with co-morbidities need to be identified through a door-to-door visit to the severely gas-affected regions and advised to maintain good respiratory hygiene, regular intake of immune-boosting diet, and follow healthy lifestyle practices.

Resumo Há evidências plausíveis de que os sobreviventes a longo prazo da exposição a gás de 1984 e isocianato de metila (CIM), em Bhopal, e seus filhos nascidos após esse fato estão suscetíveis a doenças infecciosas/transmissíveis e não transmissíveis. A taxa de fatalidade COVID-19 de Bhopal sugere que os sobreviventes da tragédia do gás MIC estão em maior risco, devido a um sistema imunológico enfraquecido e comorbidades. Essa situação nos encorajou a refletir sobre o que sabemos, o que não sabemos e o que devemos saber sobre a suscetibilidade deles ao COVID-19. Este artigo objetiva responder a essas três perguntas que surgem na mente dos funcionários de saúde pública sobre estratégias de prevenção contra o COVID-19 e promoção da saúde na população afetada pelo Bhopal MIC (BMAP). Nossas visões e opiniões apresentadas neste artigo chamam a atenção para prevenir e reduzir as consequências do COVID-19 no BMAP. Da perspectiva da profilaxia com COVID-19, os indivíduos de alto risco do BMAP com condições comórbidas precisam ser identificados por meio de uma visita de porta em porta nas regiões severamente afetadas por gases e aconselhados a manter uma boa higiene respiratória, ingestão regular de dieta que estimule o sistema imunológico e seguir práticas de estilo de vida saudáveis.

Creencias de los docentes acerca de los factores causales, medidas preventivas y contingentes sobre el fenómeno bullying / Teachers' beliefs about causal factors, preventive and contingent measures on the Bullying phenomenon

Se presenta un estudio, en colaboración con la Defensoría del Pueblo de la Ciudad de Buenos Aires, en dos etapas. La primera tipo instrumental (Montero & León, 2007), la construcción y validación de escala de creencias de los docentes acerca de los factores causales, medidas preventivas y contingentes del hostigamiento de pares. La segunda de un diseño de tipo ex post facto prospectivo de grupo único (Montero & León, 2007). Participan en él 316 docentes de ambos sexos, 22,5% hombres y 77,5% mujeres, de colegios primarios de la Ciudad Autónoma de Buenos Aires con un rango etario que va de 22 a 69 años (M = 39,38; DT = 10,15). El objetivo del estudio es detectar y analizar las creencias de los docentes a nivel primario acerca de los factores causales, medidas preventivas y medidas contingentes del fenómeno Bullying. Por otra parte, detectar la coherencia entre los tres tipos en los docentes. Finalmente conocer el contenido de las creencias de los docentes al cotejarlas con datos objetivos de estudios precedentes válidos y confiables. Los resultados principales indican una codependencia entre las tres dimensiones de las creencias de los docentes. Asimismo, las creencias sobre las causas están directamente asociadas al tipo de medidas tanto preventivas como contingentes. Por otra parte, se verifica que poseen creencias con significados particulares que se ajustarían a sus propias referencias o referentes y a su propia experiencia, más que en estadísticas locales, que redundarían en de inclusión curricular de formación específica docente sobre el hostigamiento de pares y de un enfoque sistémico del fenómeno estrategias disfuncionales. Los resultados hallados en este estudio dan cuenta de la necesidad(AU)

A study in two stages, in collaboration with the Ombudsman of the City of Buenos Aires, is presented. The first of them, instrumental type (Montero & León, 2007), the construction and validation of scale of beliefs of teachers about the causal factors, preventive and contingent measures of Bullying. The second one, an ex post facto prospective type of single group design (Montero & León, 2007). Participate in it 316 teachers of both sexes (22.5% men and 77.5% women) of primary schools of the Autonomous City of Buenos Aires with an age range ranging from 22 to 69 years (M = 39.38; = 10.15). The objective of the study is to detect and analyze the beliefs of teachers at the primary level about the causal factors, preventive measures and contingent measures of the Bullying phenomenon. On the other hand, it is verified that they have beliefs with meanings that would fit their own references and their own experience, rather than in local statistics, which would result in dysfunctional strategies. The main results indicate a codependency between the three dimensions of teachers' beliefs. Likewise, beliefs about the causes are directly associated with the type of preventive as well as contingent measures. On the other hand, it is verified that there are conceptual mistakes in teachers, which will surely result in dysfunctional strategies. The results found in this study show the need for curricular inclusion of specific teacher training on Bullying and a system approach to the phenomenon(AU)

Recomendaciones sobre el consumo de agua y alimentos en circunstancias especiales

El agua de uso y consumo humano debe reunir ciertas características de potabilidad para evitar que causen enfermedades, los gobiernos de los países son responsables de la calidad del agua, la purificación se realiza por varios procesos que aseguran que esté libre de patógenos, de sustancias químicas, físicas y radiológicas, siguiendo pautas de la Organización Mundial de la Salud (OMS). Las diarreas infecciosas son causadas por diferentes patógenos y muy frecuentemente asociadas al consumo de agua no potable. Desde hace varios años, en Venezuela, se presentan fallas en el suministro regular de agua potable intra-domiciliario, por fallas en la cadena de distribución y almacenamiento, además son frecuentes problemas deficitarios del suministro de energía eléctrica. Más reciente, en marzo de 2019, se presentó a escala nacional un colapso total del suministro de energía eléctrica que duró de 3 a 7 días, lo cual dejó a los ciudadanos sin el suministro de agua en sus hogares, además de fallas del transporte, colapso hospitalario, colocando en riesgo socio-sanitario a millones de personas. El objeto del documento es servir de guía e informar a la comunidad sobre las enfermedades más frecuentes asociadas al consumo de agua no potable; aconsejar sobre los cuidados especiales en los niños y, brindar medidas preventivas prácticas recomendadas para la purificación del agua de uso y consumo humano.

Water use and human consumption must meet certain characteristics of drinking to avoid causing diseases, the Governments of the countries are responsible for the quality of the water, purification is performed by several processes which ensure that it is free of pathogenic substances chemical, physical and radiological, following guidelines of the World Health Organization (WHO). Infectious diarrhea are caused by different pathogens and often associated with the consumption of non-potable water. For several years, in Venezuela, failures occur at regular drinking water supply intra-household, for failures in the chain of distribution and storage, they are also frequent electricity supply deficit. Most recently, in March 2019, arose nationwide a total collapse of the supply of electrical energy that lasted from 3 to 7 days, which left the people without water in their homes, in addition to transport, hospital collapse in putting at risk health to millions of people. The object of the document is to guide and inform the community about the most frequent illnesses associated with the consumption of non-potable water; advise on special child care and, provide preventive measures recommended for purification practices water use and human consumption.

Aspectos criminogénicos de la reincidencia y su problema / Criminogenic aspects of recidivism and its problem

Resumen Introducción: La reincidencia penitenciaria se constituye en uno de los indicadores de mayor relevancia para percibir el impacto que la pena privativa de la libertad tiene sobre el proceso de resocialización. A su vez, es el referente de mayor objetividad para valorar la efectividad o inefectividad de las medidas que el gobierno nacional colombiano viene implementando en materia política criminal. Objetivo El objetivo de este estudio es presentar un marco comprensivo del problema de la reincidencia criminal para el estado colombiano, y dar a conocer algunos de los estudios científicos que tratan de explicarla. Metodología: El proceso para la construcción del marco comprensivo fue guiado mediante la diagramación CPC (causas - problemática - consecuencias); en tanto que la revisión de antecedentes se realizó con una estrategia de búsqueda sistemática usando como palabras clave: "recidivism" "criminal recidivism", en las bases de datos Google Scholar, Pubmed, Redalyc, Scielo, Dialnet. Resultados y discusión. La información que sustenta este escrito sugiere que la reincidencia criminal de tipo penitenciario se ha convertido no solo en consecuencia de la inefectividad de las medidas públicas que se han implementado, sino que en la actualidad es causa de sí misma. Aunado a esto, se constituye en un fenómeno multicausal, que exige una intervención pública compleja.

Abstract Introduction: Penitentiary recidivism is one of the most relevant indicators to perceive the impact of the deprivation of liberty on the process of resocialization. In turn, it is the benchmark of greater objectivity to assess the effectiveness or ineffectiveness of the measures that the Colombian national government has been implementing in matters of criminal politics. Objective The objective of this study is to present a comprehensive framework of the problem of criminal recidivism for the Colombian state, and to present some of the scientific studies that try to explain it. Methodology: The process for the construction of the comprehensive framework was guided by the CPC diagram (causes - problematic - consequences); whereas the background check was carried out with a systematic search strategy using as keywords: "recidivism" "criminal recidivism", in Google Scholar, Pubmed, Redalyc, Scielo, Dialnet databases. Results and Discussion. The information that supports this writing suggests that criminal recidivism of the penitentiary type has become not only a consequence of the ineffectiveness of the public measures that have been implemented, but that it is currently a cause of itself. In addition to this, it is a multi-causal phenomenon that requires complex public intervention.

Abordaje Terapéutico de la Hipomineralización Molar - Incisal. Revisión Narrativa / Peripheral Odontogenic Fibroma: Case Report

RESUMEN: Hipomineralización Molar-Incisal (MIH) es un trastorno del desarrollo dentario asociado a factores sistémicos, producido por una incompleta mineralización y maduración del esmalte. La prevalencia en niños, a nivel mundial, varía en la literatura entre el 2,4 % y el 40,2 %. Este trastorno que implica al menos un primer molar permanente, pudiendo también verse afectados los incisivos, dependiendo del momento, la duración, la susceptibilidad del individuo y la gravedad de la injuria prenatal, perinatal o postnatal. El esmalte presenta un grado variable de alteración en la translucidez, siendo éste de un espesor normal y de color blanco, o café-amarillo. Si bien se encuentra intacto en el momento de la erupción, puede sufrir fracturas post eruptivas debido a las fuerzas de la masticación, dejando límites definidos. Por lo general, los molares gravemente afectados son extremadamente hipersensibles, propensos a lesiones de caries de rápida progresión, y pueden ser difíciles de tratar en pacientes jóvenes. La atención debe abordar el comportamiento y la ansiedad del niño, con el objetivo de proporcionar restauraciones duraderas en condiciones libres de dolor. La ejecución de medidas preventivas individuales puede posponer el inicio del tratamiento restaurador y reducir la incomodidad del paciente a largo plazo. El diagnóstico precoz permitirá el seguimiento y la instauración de dichas medidas preventivas tan pronto las superficies afectadas sean accesibles. Pese a que los enfoques de tratamiento para MIH han comenzado a ser más claros y los avances en los materiales dentales han proporcionado soluciones clínicas en los casos que se consideraban sin posibilidad de restauración en el pasado, deben llevarse a cabo ensayos clínicos a largo plazo para facilitar aún más el manejo clínico de este cuadro.

ABSTRACT: Molar Incisor Hypomineralization (MIH) is a tooth development disorder, which is associated with systemic factors, produced by incomplete enamel mineralization and maturation below the enamel surface that is intact at the time of eruption. In literature, the prevalence in children worldwide varies between 2.4 % and 40.2 %. This disorder which involves at least one first permanent molar, and depending on duration, the child's susceptibility as well as the severity of prenatal, perinatal or postnatal insult may also compromise incisors. The defect reveals a variable degree of alteration in the translucency of the enamel, that has initially normal thickness and can be white, yellow or brown. Enamel surface may breakdown after eruption, due to masticatory forces, leaving sharp borders. Usually, severely affected molars are extremely hypersensitive, prone to rapid caries development, and can be difficult to manage in young patients. The complex care involved must address the child's behavior and anxiety, aiming to provide pain free treatment and durable restorations. Intensive individually prescribed preventive programs may postpone the onset of restorative treatment and reduce patient discomfort in the long term. Early identification of such children will allow monitoring and implementation of preventive measures as soon as affected surfaces are accessible. Although treatment approaches for MIH have become more clear, and advances in dental materials have provided clinical solutions in cases that in the past were regarded as unrestorable, long-term clinical trials should be realized to further facilitate clinical management of this dental defect.

Actitudes y conocimientos ante la ocurrencia de sismos en personal de salud en Ica, 2016 / Attitudes and knowledge to the occurrence of earthquakes in health personnel of Ica, 2016

Introducción:El ser humano está expuesto a muchas amenazas según el entorno que lo rodea; el Perú no es la excepción; las experiencias ante las consecuencias de los desastres originados por la naturaleza que vienen ocurriendo desde los últimos años, han puesto en relieve la vulnerabilidad de la salud pública, donde las instituciones incumplen con las acciones de prevención y la poca preparación de la población para hacer frente a estos desastres naturales. En ello como respuesta, el sector salud forma parte de la toma de decisiones dentro del comité operativo de emergencia para la coordinación intersectorial en situaciones de crisis, donde se altera el equilibrio de la naturaleza y fraccionan al grupo humano residente en distintos escenarios. Objetivos: Determinar la relación entre las actitudes y conocimientos ante la ocurrencia de sismos en estudiantes de medicina, y médicos del Hospital Regional de Ica. Material y métodos: Nivel de investigación relacional, tipo descriptivo, prospectivo y transversal. Realizado mediante una encuesta auto aplicada. Análisis mediante SPSS 24.0 aplicando regresión lineal y chi-cuadrado (p < 0.05) y análisis multivariado mediante el modelo de regresión logística.Resultados: Como factores de riesgo se tiene el grado académico, la convivencia con personas con discapacidad, la falta de experiencia en un sismo, no pertenecer a una brigada, no haber llevado un curso en prevención de desastres y el bajo conocimiento en el tema. (AU)

Introduction: The human being is exposed to many threats according to the surrounding environment and Peru is no exception. The experiences of the natural disasters that have been occurring since the last years have highlighted the vulnerability of public health, where institutions fail to comply with prevention actions and the lack of preparedness of the population to cope to these natural disasters. As a response, the health sector is partofthedecision-makingprocesswithintheemergencyoperationalcommitteeforintersectoral coordination in crisis situations, where the balance of nature is altered and the human group residing in different scenarios is divided. Objetive: To determine the relationship between attitudes and knowledge regarding the occurrence of earthquakes in medical students and physicians at the Regional Hospital of Ica. Materials and Methods: Relational research level, analytical type, prospective and transversal. Made through a self-administered survey. Analysis using SPSS 24.0 applying linear and chi-square regression (p <0.05) and multivariate analysis using the logistic regression model. Results: Risk factors include academic degree, coexistence with people with disabilities, lack of experience in an earthquake, not joing to a brigade, not having taken a course in disaster prevention and low knowledge in the subject. (AU)

Microcefalia e Zika Vírus: características e associações / Microcephaly and Zika Virus: clinical features and associations / Microcefalia y Virus Zika: características y asociaciones

Objetivo: Discutir a associação entre microcefalia e a infecção materna por Zika Vírus. A microcefalia é o tamanho da cabeça menor do que o esperado em comparação com bebês do mesmo sexo e idade. Entre as causas conhecidas, estão as infecções congênitas. O aumento de casos entre outubro e novembro de 2015 no nordeste brasileiro, que coincidiu com a presença da circulação de novo vírus no país, em maio do mesmo ano, criou a hipótese de associação entre a microcefalia e a infecção materna durante a gravidez. O Zika Vírus é um arbovírus similar ao da Febre Amarela e da Dengue, transmitido principalmente através da picada do Aedes aegypti. A provável transmissão por relação sexual e transfusão de sangue, além de outros vetores como o Aedes albopictus e possivelmente até o pernilongo (Culex sp) aumentam a necessidade de cuidados preventivos em relação à infecção. O exame para detecção viral idealmente é realizado até o quinto dia após o início dos sintomas. Sorologias ainda não são amplamente disponíveis no Brasil. Métodos: Revisão narrativa da literatura. Conclusão: A associação entre casos de microcefalia e o Zika Vírus é embasada nos relatos de relação têmporo-espacial, padrão de alterações neurológicas associado a malformações congênitas, presença do RNA viral no líquido amniótico e nos tecidos de fetos. As respostas definitivas de causalidade serão possíveis após pesquisas e disponibilidade de exames laboratoriais. As evidências até agora apoiam fortemente esta hipótese e todas as medidas preventivas devem ser estimuladas.

Objective: To discuss the association between microcephaly and intrauterine infection by Zika virus. Microcephaly occurs when a child is born with a head smaller than expected when compared to babies of the same sex and age. Known causes of microcephaly include congenital infections. The increase in the number of microcephaly cases in Northeast Brazil between October and November 2015, which coincided with the emergence of Zika virus in the country in May of the same year, led to the hypothesis of an association between microcephaly and intrauterine Zika virus infection. Zika is an arbovirus that is closely related to yellow fever and dengue viruses. Aedes aegypti mosquitoes are the primary vector of transmission. Possible transmission through sexual contact and blood transfusion, as well as the implication of other vectors, such as Aedes albopictus and even Culex sp increases the need for preventive action. The test for viral detection is ideally performed before the 5th day following the onset of symptoms. Serology tests are not yet widely available in Brazil. Methods: We performed a narrative literature review. Conclusion: The hypothesis of an association between microcephaly and Zika virus is based on reports of spatial/temporal relationship, pattern of neurologic alterations associated with congenital malformations, and findings of viral RNA in amniotic fluid and fetal tissue. Definitive conclusions about the causality can only be reached after further research and availability of laboratory tests. The current evidence strongly supports the association between microcephaly and Zika infection, and all preventive measures must be stimulated.

Objetivo: Discutir las asociaciones entre microcefalia e infección materna por Virus Zika. La microcefalia es el tamaño de la cabeza menor de lo esperado en comparación con los bebés del mismo sexo y edad. Entre las causas conocidas están las infecciones congénitas. El aumento de casos entre octubre y noviembre de 2015 en el nordeste de Brasil, que coincidió con la presencia de la nueva circulación del virus en el país en mayo del mismo año, creó la hipótesis de asociación entre la microcefalia y la infección de la madre por Virus Zika durante el embarazo. El virus Zika es un arbovirus similar al dengue y la fiebre amarilla. El virus se transmite a través de la picadura del mosquito Aedes aegypti. La probable transmisión por vía sexual y por la transfusión de sangre - además de otros vectores como el Aedes albopictus y posiblemente el mosquito Culex sp - aumentan la necesidad de atención preventiva contra la infección. El cuadro clínico es benigno, autolimitado, caracterizado por erupción maculopapular asociado con otros síntomas tales como conjuntivitis, artralgia y la inflamación de las articulaciones. El examen para la detección del virus se realiza idealmente por el quinto día después de la aparición de los síntomas. Las pruebas serológicas no están ampliamente disponibles en Brasil. Métodos: Revisión de literatura. Conclusión: La asociación entre los casos de microcefalia y el virus Zika se basa en informes de patrón de relación temporo-espacial de los trastornos neurológicos asociados con malformaciones congénitas, el ARN viral presente en el líquido amniótico y tejidos de fetos. Las respuestas definitivas de causalidad serán posibles después de la investigación y la disponibilidad de pruebas de laboratorio. Hasta ahora, las evidencias apoyan firmemente esta hipótesis y todas las medidas preventivas deben ser estimuladas.

Exposición radiológica en urología: conocimientos y medidas preventivas generales en Chile / Radiation exposure in urology: knowledge and general preventive measures in Chile

Existe una creciente exposición a la radiación ionizante en la práctica médica habitual tanto para el paciente como para el médico tratante, debido a un incremento en exámenes imagenológicos solicitados como al uso de rayos X como soporte en procedimientos y cirugías. Parte importante de la práctica médica en urología involucra exposición a radiación. Por este motivo, decidimos evaluar el nivel de conocimientos y medidas preventivas que realizan los urólogos y residentes de urología en Chile al exponerse a la radiación. MATERIAL Y MÉTODO: Se aplicó una encuesta a residentes de urología y urólogos que ejercen dicha especialidad en Chile. Esta encuesta fue aplicada de manera voluntaria y anónima vía e-mail y evaluó los conocimientos generales y medidas preventivas frente a la exposición radiológica. Se analizan resultados según año de residencia y nivel de formación académica. RESULTADOS: Existe un bajo nivel de conocimientos y de prácticas preventivas de tanto los residentes como especialistas encuestados en el tema de protección radiológica. No se observaron diferencias significativas entre los distintos niveles de formación. CONCLUSIÓN: Se detectó un bajo nivel de conocimiento y un bajo empleo de medidas preventivas. Se postula la necesidad de incorporar un curso obligatorio de exposición radiológica durante la residencia de urología.

There has been an increase in the exposure to ionizing radiation in current medical practice in the past few decades. This raise is the result of an increase in the amount of radiological images solicited and use of X-rays in procedures and surgeries. Clinical practice in urology involves high levels of exposure. We decided to evaluate knowledge and preventive measures when urology specialists and residents are exposed to radiation. MATERIALS AND METHODS: A survey previously utilized in international centers for similar purposes was applied to urology residents and specialists that practice medicine in Chile. This survey was applied electronically via email and evaluated general knowledge and preventive measures when exposed to ionizing radiation. Results are analyzed between years of residency and academic formation. RESULTS: A low level of knowledge and preventive measures were detected among both urology residents and specialists. No significant differences were observed when analyzing results according to year of residency. CONCLUSION: Given the low level of knowledge and preventive measures utilized when exposed to radiation, we propose to include an obligatory course in radiologic exposure during urology residency.