Experiencia de un servicio de pediatría del ámbito privado del área metropolitana de Buenos Aires durante la pandemia por COVID-19 / Experience at the Department of Pediatrics of a private facility in the Metropolitan Area of Buenos Aires during the COVID-19 pandemic

Introducción. A fin de 2019 se identificó una nueva variedad de coronavirus causante de COVID-19 que alcanzó categoría de pandemia. En Argentina, el área metropolitana de Buenos Aires (AMBA) concentra alrededor del 37 % de la población total y el mayor número de casos diagnosticados. El objetivo de este estudio fue describir las características clínico-epidemiológicas de los pacientes con COVID-19 y describir el impacto en el funcionamiento del Servicio de Pediatría de una institución privada de la zona. Métodos. Diseño retrospectivo, observacional, desarrollado en una institución de la zona oeste del AMBA entre el 12 de marzo y el 31 de agosto de 2020. Se incluyeron todos los menores de 16 años con diagnóstico de COVID-19. Se registraron características demográficas, epidemiológicas, clínicas, indicación de internación/control ambulatorio, número de consultas externas, internación por infecciones virales estacionales, licenciamiento del personal, modificación del número de camas y de las actividades de los profesionales. Resultados. Hubo 5454 consultas ambulatorias pediátricas totales, sospecha de COVID-19 en 753/5 454 (13,8 %), se confirmaron 152/753 (20,2 %). Mediana de edad 82 meses (rango intercuartílico: 20,5-147 m), el 50 % fueron varones. La fiebre fue el síntoma más frecuente. Se internaron 22/152 (14,5 %). Las consultas disminuyeron el 87 %, no hubo internación por infecciones virales estacionales y el 52,9 % (91/172) del personal fue licenciado. Conclusiones. La mayoría de los casos fueron leves y la fiebre fue el principal síntoma. Observamos un notable impacto en el funcionamiento del servicio en cuanto al recurso humano. Destacamos la necesidad de la organización logística del servicio para enfrentar esta contingencia.

Introduction. Towards the end of 2019, a novel coronavirus that causes COVID-19 was identified and became a pandemic. In Argentina, approximately 37 % of the total population lives in the Metropolitan Area of Buenos Aires (AMBA), where most cases have been diagnosed. The objective of this study was to describe the clinical and epidemiological characteristics of COVID-19 patients and the impact on the operations of the Department of Pediatrics of a private facility located in the AMBA. Methods. Retrospective, observational study conducted at a facility in the west of AMBA between March 12th and August 31st, 2020. All patients younger than 16 years diagnosed with COVID-19 were included. Demographic, epidemiological, and clinical characteristics; indication for hospitalization/outpatient follow-up; number of outpatient visits; hospitalization due to seasonal viral infections; staff on leave; changes in bed availability and health care providers' activities were recorded. Results. There were 5454 pediatric outpatient visits, COVID-19 was suspected in 753/5454 (13.8 %) and 152/753 (20.2 %) were confirmed cases. Their median age was 82 months (interquartile range: 20.5-147 months); 50 % were males. Fever was the most common symptom. In total, 22/152 (14.5 %) patients were hospitalized. Outpatients visits decreased by 87 %; there were no hospitalizations due to seasonal viral infections; and 52.9 % (91/172) of staff took a leave. Conclusions. Most cases were mild, and fever was the main symptom. The department operations were considerably affected in terms of human resources. It is worth noting the need for a logistic organization at the Department of Pediatrics to face such contingency.

Oferta da disciplina de Estomatologia nos cursos de Odontologia do sudeste brasileiro / Offer of Stomatology discipline in the Dentistry courses of the Brazilian Southeast

Objetivo: oferecer um panorama sobre a presença da disciplina de Estomatologia nos projetos pedagógicos dos cursos de graduação em Odontologia da Região Sudeste do Brasil no ano de 2019. Métodos: estudo exploratório, quantitativo e transversal, no qual as grades curriculares dos cursos foram analisadas, totalizando uma amostra de 144 cursos, incluindo instituições públicas e privadas. As variáveis avaliadas foram oferta da disciplina, categoria administrativa e localização da instituição de ensino superior (IES), natureza do componente curricular, forma em que o conteúdo é ministrado e carga horária. Resultados: apenas 88 (61,11%) instituições ofertavam a disciplina em sua grade curricular, sendo que 82 (93,1%) ofertavam o conteúdo de forma obrigatória, e a maioria de forma teórico-prática. A carga horária variou de 33 a 285 horas, com média de 111,9 horas. Conclusão: o presente estudo evidenciou a dissonância com a qual a disciplina de Estomatologia é ministrada, bem como a deficiência de sua oferta por parte de muitas instituições averiguadas.(AU)

Objective: to provide an overview of the presence of the stomatology discipline in the pedagogical projects of undergraduate dentistry courses in the Southeast region of Brazil in 2019. Methods: exploratory, quantitative and cross-sectional study. The curriculums of the courses were analyzed, totaling a sample of 144 courses, from public and private ones. The variables evaluated were the offer of the subject, administrative category and location of the Higher Education Institution (HEI), nature of the curriculum component, form in which the content is taught and workload. Results: 88 (61.11%) institutions offered the discipline in their curriculum, 82 (93.1%) offer the content in a compulsory way, and most in a theoretical-practical way. The workload ranged from 33 to 285 hours, with an average of 111.95 hours. Conclusion: the present study showed the dissonance in which the discipline of stomatology is taught, as well as the deficiency of its offer by many investigated institutions.(AU)

Condom use and associated factors among HIV-positive patients accessing care at a private tertiary health institution in the southwest, Nigeria

Objective: This study aimed to assess the knowledge, attitude and practice towards condom utilization and other associated factors among people living with HIV/AIDS enrolled in the Virology clinic in Babcock University Teaching Hospital (BUTH) Ilishan, Ogun state, Nigeria. Methods: This cross-sectional study was conducted among 285 ART users selected using a systematic random sampling method. The minimum sample size was estimated using the formula z2pq/d2 and a 24% prevalence extracted from a previous similar study. Data were elicited using a structured interviewer-administered questionnaire, analyzed using SPSS version 20, and presented as tables. The Chi-square test was used to assess associations between categorical variables. The level of significance was set at the 95% confidence interval with a p-value of 0.05.Results: From the total respondents, 180(63.2%) were females, 93.7% had good knowledge, 141(49.5%) believed ARV prevents transmission of HIV and 144 (50.5%) strongly agreed that condom reduces sexual pleasure. Majority 254 (89.1%) were currently using condoms, 131 (46.0%) used a condom consistently, while 108 (37.9%) frequently use a condom during sexual intercourse. The Use of condoms had statistically significant associations with occupation (p<0.001), married at pre-diagnosis of HIV (p<0.001), married at post-diagnosis of HIV (p<0.001) and education (p= 0.015).Conclusion: The majority of the respondents had good knowledge and were using condoms. Discussions on safe sex and improved positive attitudes towards condom-use should, however, be encouraged further

Factores asociados con la exposición al humo de tabaco de segunda mano en lugares públicos y privados en México. Encodat 2016 / Correlates of secondhand smoke exposure in public and private settings in Mexico. Encodat 2016

Resumen: Objetivo: Determinar los factores asociados con la exposición al humo de tabaco de segunda mano (HTSM) en lugares públicos y privados. Material y métodos: Se analizó la Encuesta Nacional de Consumo de Drogas, Alcohol y Tabaco 2016. La exposición al HTSM se evaluó mediante modelos Poisson multinivel. La muestra del estudio incluye únicamente no fumadores. Resultados: La exposición al HTSM fue similar en los estados que tienen prohibición total para fumar en espacios cerrados en comparación con estados con prohibición parcial. Adultos jóvenes, hombres y personas con nivel educativo alto tienen mayor exposición al HTSM en bares y restaurantes. Los hombres tienen mayor exposición al HTSM en el trabajo, los adultos de mayor edad en el transporte público, mientras las mujeres y adolescentes en el hogar. Conclusiones: La exposición al HTSM continúa elevada y afecta diferencialmente a la población mexicana. Para reducirla, se requiere aplicar totalmente el artículo octavo del Convenio Marco para el Control del Tabaco.

Abstract: Objective: To assess the correlates of secondhand smoke exposure (SHS) in public and private settings. Materials and methods: Data came from the 2016 National Survey of Drug, Alcohol and Tobacco use. Multilevel Poisson models were conducted to evaluate factors associated with SHS. Results: Having a higher education, being male and being a young adult were associated with higher SHS in bars and restaurants. Men had greater SHS at work, while women and adolescents had greater exposure at home. Adults older than 45 years had higher SHS on public transportation compared to adolescents between 12-17 years old. Conclusions: Exposure to SHS remains high and affects the population differentially. To reduce SHS, it is necessary to apply Article 8 of the Framework Convention on Tobacco Control.

Danceterias como espaço de lazer: o cenário legislativo posterior ao desastre na boate Kiss / Dance clubs as leisure space: the legislative scenario after the disaster at Kiss nightclub / Discotecas como espacios de ocio: el escenario legislativo posterior al desastre en la boate Kiss

Este estudo objetiva analisar as ações do poder público para com os estabelecimentos privados de lazer (danceterias) no âmbito da legalidade, posterior ao desastre na Boate KISS. Utilizamos como caminho a Análise Documental, como a Lei Complementar nº 14.376, de 26 de dezembro de 2013, o Inquérito Policial da boate KISS e a mídia impressa Diário de Santa Maria e, a Análise de Conteúdo. Inferimos a mobilização do poder público, posterior ao desastre, na criação de legislações que garantissem a segurança nas danceterias, em especial a Lei Kiss, bem como sua flexibilização, explicitando que o sistema econômico e interesses privados são balizadores da política e das relações entre o público e o privado. O desastre da Boate KISS registra a gravidade de riscos na esfera do lazer e nas tecnologias que incitam desejos, a necessidade de garantia de direitos sociais e de equidade social.

This study aims to analyze the actions of the public power towards private leisure establishments (dance clubs) in the scope of legality, after the disaster at KISS Nightclub. We used as a way the Document Analysis (Complementary Law nº 14.376, of December 26, 2013, the Police Investigation of the KISS Nightclub and the print media Diário de Santa Maria) and the Content Analysis. We inferred the mobilization of the public power, after the disaster, in the creation of legislations that would guarantee safety in the dance clubs, especially the Kiss Law, as well as its flexibility, explaining that the economic system and private interests are benchmarks of politics and of the relations between the public and the private. The KISS Nightclub disaster registers the seriousness of risks in the leisure sphere and in the technologies that incite desires, and the need to guarantee social rights and social equity.

Este estudio objetiva analizar las acciones del poder público hacia establecimientos privados de ocio (discotecas) en el ámbito de la legalidad posterior al desastre en la Boate Kiss. Utilizamos como instrumento el Análisis Documental de la Ley Complementar n.° 14.376, de 26 de diciembre de 2013, la investigación policial de la Boate Kiss, noticias del periódico Diário de Santa Maria, y el análisis de contenido. Inferimos la movilización del poder público, posterior al desastre, en la creación de legislaciones que garanticen la seguridad en discotecas, en especial la Ley Kiss y su flexibilización, evidenciando que el sistema económico e intereses privados son balizadores de la política y de relaciones entre el público y el privado. El desastre de la Boate Kiss registra la gravedad de riesgos en el ámbito del ocio y en las tecnologías que incitan deseos, la necesidad de garantía de derechos sociales y de equidad social.

Breast cancer in a private medical services center: a 10-year experience

Introduction: Breast cancer is the most common cancer in the world in women and its incidence is rising, especially in low- and middle-income countries. In Africa, breast cancer has become a leading cancer among women. In sub-Saharan Africa, it is less common, occurs in younger age groups, and majority present late. In Ethiopia, the actual magnitude of the disease is unknown.Objective: The aim of this retrospective study is to analyze the pattern and treatment outcome of patients with breast cancer at our center.Methods: The study includes analysis of the clinical findings and treatment outcome of 404 patients with breast cancer managed from October 1, 2005 to September 30, 2015 at the United Vision Medical Services center, Addis Ababa, Ethiopia.Results: The median age was 45 years; majority (61.2%) in the age group 35-54 years. The female to male ratio was 66.3:1.0. The most common presenting symptom was breast lump (85.3%). The mean duration of presenting symptoms was 9.2 months. On examination, breast lump was noted in 82.2% of the patients. The most frequent histological type was grade II ductal carcinoma. Most patients (80%) underwent breast surgery, mastectomy in nearly 97%. During follow up, 107 of 370 patients (28.9%) developed recurrences/ metastasis. The overall 5 year survival was 69.5%.Conclusion: Our study has shown that relatively young females are commonly affected; majority presented in advanced stage of the disease and the recurrence rates were high

Sweat test and cystic fibrosis: overview of test performance at public and private centers in the state of São Paulo, Brazil / Teste do suor e fibrose cística: panorama da realização do teste em centros públicos e privados do estado de São Paulo

ABSTRACT Objective: The sweat test (ST) measures chloride levels in sweat and is considered the gold standard for the diagnosis of cystic fibrosis (CF). However, the reliability of a ST depends on their being performed by experienced technicians and in accordance with strict guidelines. Our aim was to evaluate how sweat stimulation, sweat collection, and chloride measurement are performed at 14 centers (9 public centers and 5 private centers) that routinely perform STs in the state of São Paulo, which has the highest frequency of CF in Brazil. Methods: This was a cross-sectional cohort study, using a standardized questionnaire administered in loco to the staff responsible for conducting STs. Results: No uniformity regarding the procedures was found among the centers. Most centers were noncompliant with the international guidelines, especially regarding the collection of sweat (the samples were insufficient in 10-50% of the subjects tested); availability of stimulation equipment (which was limited at 2 centers); modernity and certification of stimulation equipment (most of the equipment having been used for 3-23 years); and written protocols (which were lacking at 12 centers). Knowledge of ST guidelines was evaluated at only 1 center. Conclusions: Our results show that STs largely deviate from internationally accepted guidelines at the participating centers. Therefore, there is an urgent need for standardization of STs, training of qualified personnel, and acquisition/certification of suitable equipment. These are essential conditions for a reliable diagnosis of CF, especially with the increasing demand due to newborn screening nationwide, and for the assessment of a possible clinical benefit from the use of modulator drugs.

RESUMO Objetivo: O teste do suor (TS) mede os níveis de cloro no suor e é considerado o padrão ouro para o diagnóstico da fibrose cística (FC). Contudo, a confiabilidade do TS depende de sua realização por técnicos experientes e segundo diretrizes rígidas. Nosso objetivo foi avaliar como são realizadas a estimulação e coleta do suor e a dosagem de cloro em 14 centros (9 públicos e 5 privados) que realizam TS rotineiramente no estado de São Paulo, que possui a maior frequência de FC do Brasil. Métodos: Estudo de coorte transversal utilizando um questionário padronizado aplicado in loco ao pessoal responsável pela realização dos TS. Resultados: Não houve uniformidade entre os centros quanto aos procedimentos. A maioria dos centros não era aderente às diretrizes internacionais, especialmente quanto à coleta do suor (amostras insuficientes em 10-50% dos indivíduos testados), disponibilidade de equipamentos de estimulação (limitada em 2 centros), modernidade e certificação dos mesmos (a maioria utilizada há 3-23 anos) e protocolos escritos (ausentes em 12 centros). Avaliou-se o conhecimento sobre diretrizes para TS em apenas 1 centro. Conclusões: Nossos resultados mostram que, nos centros participantes, os TS estão muito distantes das diretrizes internacionalmente aceitas. Portanto, há necessidade urgente de padronização dos TS, de treinamento de pessoal qualificado e de aquisição/certificação de equipamentos adequados. Essas são condições essenciais para um diagnóstico confiável de FC, especialmente com a crescente demanda resultante da triagem neonatal em todo o país, e para a avaliação do possível benefício clínico do uso de moduladores.

Educación sexual integral: cobertura, homogeneidad, integralidad y continuidad en escuelas de México / Comprehensive sexual education in Mexico: an analysis of coverage, comprehensiveness and continuity of contents in Mexican public and private schools

Resumen: Objetivo: Analizar la cobertura de la educación sexual integral (ESI) en México y describir su integralidad, homogeneidad y continuidad en cuanto a contenidos sobre salud sexual y reproductiva, autoeficacia, derechos y relaciones. Material y métodos: En una encuesta probabilística transversal con muestreo estratificado y por conglomerados, se aplicó un cuestionario sobre ESI a una muestra representativa a nivel nacional de 3 824 adolescentes de 45 escuelas de educación media superior públicas y privadas, en localidades urbanas y rurales. Resultados: El porcentaje de adolescentes que reportan recibir educación sexual integral varía dependiendo de los temas y nivel escolar. Los temas más frecuentes están relacionados con salud sexual y reproductiva; los menos tratados con derechos y relaciones. Los contenidos de educación sexual se trasmiten mayoritariamente durante la escuela secundaria. Conclusiones: Se requiere garantizar la integralidad, homogeneidad y continuidad de los contenidos de la ESI, asegurando que se imparta la totalidad de los temas planteados en recomendaciones nacionales e internacionales.

Abstract Objective: To analyze coverage of comprehensive sex education (CSE) in high schools in Mexico and describe whether it is comprehensive, homogeneous and has continuity based on student reports of exposure to topics in three dimensions: reproductive and sexual health, self-efficacy and rights and relations. Materials and methods: Within a probabilistic, cross-sectional survey with stratified, cluster sampling, a nationally representative sample of 3 824 adolescents attending 45 public and private high-schools in urban and rural areas completed questionnaires on CSE. Results: The proportion of adolescents reporting having received sex education from school personnel varies depending on topics and grade level. Topics most frequently covered are those related to sexual and reproductive health while rights and relations are least frequently dealt with. Most sex education topics are covered during junior high school and much less frequently in elementary or high school. Conclusions: CSE needs to be comprehensive and homogenous in terms of content, ensure inclusion of priority topics, meet national and international recommendations, ensure continuity and adapt contents to student age through all education levels.

Implantação de salas de apoio à amamentação em empresas públicas e privadas: potencialidades e dificuldades / Despliegue de habitaciones lactancia de apoyo en empresas públicas y privadas: capacidades y dificultades / Establishment of lactaton rooms in public and private companies: potentialities and difficulties

RESUMO Objetivo Conhecer a visão de gestores de empresas públicas e privadas acerca das salas de apoio à amamentação, com vistas à sua implantação. Método Pesquisa qualitativa, exploratória descritiva, realizada em 2015, da qual participaram 20 gestores da Grande Florianópolis. Para a coleta de dados, foram utilizadas entrevistas semiestruturadas/projetivas e, para a análise, a Análise de Conteúdo, associada aos recursos do software Atlas.ti. Resultados Emergiram duas categorias, a saber, dificuldades e facilidades na implantação de sala de apoio à amamentação, com predomínio de aspectos dificultadores, especialmente financeiros, envolvidos na disponibilização de espaço físico. Dialeticamente, também houve reconhecimento do baixo custo envolvido, o que facilitaria sua implantação. Conclusões Aspectos financeiros, culturais e políticos dificultam a implantação de salas de apoio à amamentação, mas há o reconhecimento da importância da medida. Para o sucesso da amamentação, a implantação de salas de apoio é importante, porém, não suficiente, sendo necessárias múltiplas ações e, principalmente, uma atuação mais efetiva da enfermagem e dos demais profissionais de saúde.

RESUMEN Objetivo Conocer la visión de los gestores de la empresa pública y privada sobre las habitaciones de apoyo a la lactancia, con vistas a su puesta en práctica. Método La investigación fue cualitativa, exploratoria y descriptiva. Participaron 20 gerentes en Florianópolis en 2015. Para la recolección de datos se utilizaron entrevistas semiestructuradas/proyectiva y para análisis, Análisis de Contenido asociado a los recursos del software Atlas.ti. Resultados Surgieron dos categorías, las dificultades y las facilidades en la implantación de sala de apoyo a la lactancia, donde predominan los aspectos que obstaculizan, especialmente los financieros, involucrados en el espacio físico. Dialécticamente, también hubo reconocimiento del bajo costo involucrado, lo que facilitaría su aplicación. Conclusión Los aspectos financieros, culturales y políticos dificultan la implantación de salas de lactancia materna,es importsnte implantar salas de apoyo, sin embargo, no es suficiente, requiere múltiples acciones y, sobre todo, un funcionamiento más eficaz de la enfermería y otros profesionales de la salud.

ABSTRACT Objective To know how managers of public and private companies view lactation support rooms and their implantation. Method This is study is based on qualitative, exploratory, and descriptive research. Twenty managers from Greater Florianópolis participated in the research, in 2015. Data were collected by means of semi-structured/projective interviews, and subjected to content analysis associated with Atlas.ti software. Results Data analysis led to the following two categories: difficulties and facilities of establishing a lactation room, with a predominance of financial difficulties and the lack of physical space. Dialectically, the subjects also recognised the low cost involved, which facilitates establishment. Conclusion Financial, cultural, and political aspects make it difficult to set up lactation rooms, but the importance of this measure was acknowledged. Although the success of breastfeeding partly depends on these support rooms, it also requires multiple actions, especially the effective participation of nurses and other health workers.

HIV prevalence, sociodemographic characteristics, and sexual behaviors among transwomen in Mexico City / Prevalencia de VIH, características sociodemográficas y comportamientos en mujeres transgénero en la Ciudad de México

Objective. To present results from HIV testing, knowledge of HIV status and socioeconomic factors associated with the probability of having a HIV positive result among transwomen (TW) in Mexico. Materials and methods. In 2012, we conducted an HIV seroprevalence survey to 585 TW in Mexico City in three strata: gathering places, the Condesa HIV Clinic and in four detention centers. We estimated the prevalence of HIV in each strata and applied a probit model to the overall sample to analyze factors associated with the probability of a HIV positive result. Results. The prevalence of HIV was 19.8% in meeting places; 31.9% in detention centers and 64% among the participants of the clinic. Age, low education and number of sexual partners was positively associated with HIV. Conclusions. Results from the study provide relevant information to design HIV prevention interventions tailored to the needs of the TW population.

Objetivo. Identificar la prevalencia, conocimiento de estatus de VIH y factores socioeconómicos asociados con la probabilidad de tener un resultado de VIH positivo en mujeres transgénero (MT) en México. Material y métodos. En 2012, se realizó una encuesta de seroprevalencia de VIH a 585 MT en sitios de encuentro, centros penitenciarios y una clínica de VIH, en la Ciudad de México. Se estimó la prevalencia de VIH en cada estrato y se aplicó un modelo probit para analizar los factores asociados con la probabilidad de un resultado positivo. Resultados. La prevalencia de VIH fue de 19.8% en lugares de encuentro y de 32% en centros de detención; a su vez, 64% de las participantes en la clínica eran VIH positivas. La edad, el bajo nivel de educación y el número de parejas sexuales se asoció positivamente con VIH. Conclusiones. Los resultados del estudio aportan información relevante para el diseño de intervenciones de prevención de VIH de acuerdo con las necesidades de esta población.