Sobreuso de ecografía transvaginal en un hospital universitario privado de Argentina: estudio de corte transversal / Transvaginal ultrasound overuse in a private university hospital in Argentina: a cross-sectional study

Introducción. Si bien contamos con recomendaciones basadas en la evidencia en contra de realizar tamizaje de cáncer ovárico con ecografía transvaginal debido a que aumenta el riesgo de resultados falsamente positivos y de cascadas diagnósticas, sin disminuir la mortalidad por esta enfermedad, su solicitud en mujeres sanas es frecuente. Sin embargo, no conocemos la magnitud de la implementación de esta práctica, que constituye un cuidado de bajo valor. Objetivo. Documentar el sobreuso de ecografías transvaginales realizadas en forma ambulatoria en un hospital universitario privado de Argentina. Métodos. Estudio de corte transversal de una muestra aleatoria de ecografías realizadas en forma ambulatoria durante 2017 y 2018. Mediante revisión manual de las historias clínicas, la solicitud de cada ecografía fue clasificada como apropiada cuando algún problema clínico justificaba su realización, o inapropiada cuando había sido realizada con fines de control de salud o por una condición clínica sin indicación de seguimiento ecográfico. Resultados. De un total de 1.997 ecografías analizadas, realizadas a 1.954 mujeres adultas (edad promedio 50 años),1.345 (67,4 %; intervalo de confianza [IC] 95 % 65,2 a 69,4) habían sido solicitadas en el contexto de un control de saludo sin un problema asociado en la historia clínica y otras 54 (8,3 %; IC 95 % 6,3 a 10,7), por condiciones de salud para las que no hay recomendaciones de realizar seguimiento ecográfico. Conclusiones. Esta investigación documentó una alta proporción de sobre utilización de la ecografías transvaginales en nuestra institución. Futuras investigaciones permitirán comprender los motivos que impulsan esta práctica y ayudarán a diseñar intervenciones para disminuir estos cuidados de bajo valor. (AU)

Background. Although we have evidence-based recommendations against screening for ovarian cancer with transvaginalultrasound because it increases the risk of false positive results and diagnostic cascades without reducing mortality from this disease, its request in healthy women is frequent. However, we do not know the magnitude of the implementation of this practice, which constitutes low-value care. Objective. To document the overuse of transvaginal ultrasounds performed on an outpatient basis in a private university hospital in Argentina. Methods. Cross-sectional study of a random sample of outpatient ultrasounds performed during 2017 and 2018. Through a manual review of the medical records, the request for each ultrasound was classified as appropriate when a clinical problem justified its performance or inappropriate when it was carried out for health control purposes or for a clinical condition that had no indication for ultrasound follow-up. Results. Of a total of 1997 ultrasounds analyzed, performed on 1954 adult women (average age 50 years), 1,345 (67.4 %;95 % confidence interval [CI] 65.2 to 69.4) had been requested in the context of a health check-up or without a documented problem in the medical history that would support its performance, and another 54 (8.3 %; 95 % CI 6.3 to 10.7), for health conditions for which there are no treatment recommendations to perform ultrasound follow-up. Conclusions. This research documented a high proportion of overuse of transvaginal ultrasound in our institution. Future research will allow us to understand the reasons that drive this practice and will help design interventions to reduce thislow-value care. (AU)

Prescripción de antipsicóticos de depósito en la policlínica del Hospital Vilardebó / Prescripción de antipsychotics deposito in the polyclinic of the Hospital Vilardebó

Los medicamentos en su formulación de depósito son utilizados como una intervención para la adherencia cuando se dificulta el cumplimiento vía oral. Es frecuente la baja adherencia a los tratamientos por vía oral en las personas con enfermedades crónicas. Se llevó a cabo un estudio observacional, descriptivo de corte transversal, de una muestra aleatorizada de los pacientes que reciben antipsicóticos de depósito, asistidos en la Policlínica del Hospital Vilardebó en el año 2014. El objetivo fue describir las características de la población que tiene prescripto antipsicótico de depósito en la consulta ambulatoria y conocer los hábitos prescriptivos de estos para favorecer su uso racional. La patología psiquiátrica más prevalente fue la esquizofrenia con 56,4 %, donde se usó con más frecuencia la pipotiazina, siendo este más oneroso que el tratamiento con haloperidol y con un perfil de seguridad y efectividad similar. No se encontraron diferencias entre el uso de anticolinérgicos para los efectos extrapiramidales. Más de dos tercios de los pacientes (69,7 %) estuvieron con polifarmacia antipsicótica y un cuarto de los pacientes (24,7 %) con más de 2 antipsicóticos, a pesar de que en las pautas internacionales no recomiendan tratamientos que justifiquen el uso de más de dos antipsicóticos, dado que no existe evidencia que avale esta práctica, además del riesgo aumentado de reacciones adversas. Un bajo porcentaje (20 %) recibió la medicación de depósito todos los meses del año, resultando de vital importancia evaluar en estudios posteriores las causas intervinientes.

Depot formulation drugs are used as an adherence intervention when oral adherence is difficult to achieve. Low adherence to oral drugs is commonly observed in people with chronic diseases. An observational, descriptive, cross-sectional study was carried out on a randomized sample of patients receiving depot antipsychotics, treated at Hospital Vilardebó Outpatient Clinic in 2014. The aim was to describe this population's characteristics and prescription habits at the clinic in order to promote rational use. The most prevalent disorder was Schizophrenia (56.4%); pipothiazine was the most frequently used drug. It is more expensive than haloperidol with similar safety and efficacy profiles. There was no difference in the use of anticholinergic drugs to prevent extrapyramidal side effects. More than two thirds of the patients (69.7%) received antipsychotic polypharmacy and a fourth of the patients (24.7%) received more than two antipsychotics in spite of the fact that international treatment guides do not recommend the use of more than two because of lack of benefit evidence and increased risk of adverse reactions. Only 20 % of the patients received the depot every month of the year, being of vital importance to evaluate in subsequent studies the intervening causes.

O uso de aplicativo de celular para medir frequência cardíaca e saturação periférica de oxigênio / The use of cellular application to measure heart rate and peripheral oxygen saturation

Avaliar a associação da medida de frequência cardíaca (FC) e saturação periférica de oxigênio (SpO2 ) utilizando um aplicativo de celular e um monitor multiparamétrico. Métodos: Estudo experimental e randomizado entre participantes saudáveis. Investigou o aplicativo Samsung Health® e o monitor multiparamétrico da marca Midway®, modelo: PM-60. O estudo foi estruturado em quatro etapas. Para análise estatística, aplicou correlação de Pearson e Spearman, com nível de significância de 5%. Resultados: Dos 150 participantes a idade média foi de 22,3±4,5 anos, o sexo feminino foi predominante (71,3%). Verificouse forte correlação da FC medida pelo monitor com a FC do aplicativo de celular (r=0,93) indicando correlação positiva (p<0,001). A SpO2 medida por monitor multiparamétrico e pelo aplicativo de celular revelou um r=0,05 (p=0,51), o que atesta uma correlação nula e não significativa. Conclusão: Não houve correlação entre a medida da SpO2 do monitor multiparamétrico e do aplicativo Samsung Health®, não sendo confiável a utilização deste aplicativo para monitorar e gerenciar o sinal vital SpO2 em pessoas saudáveis. A FC medida com o aplicativo é significativa, e pode ser utilizada para monitorar e gerenciar esse sinal vital.

Assess the association of the measure of heart rate (HR) and oxygen saturation (SpO2 ) using a mobile application and a multiparameter monitor. Methods: Study experimental and randomized healthy participants. Investigated the application Samsung Health® and multiparameter monitor Midway® make, model: PM-60. The study was divided into four stages. Statistical analysis was applied Pearson and Spearman correlation with 5% significance level. Results: Of the 150 participants average age was 22.3±4.5 years, females were predominant (71.3%). There was a strong correlation HR measured by the monitor application to cell FC (r=0.93) indicating a positive correlation (p<0.001). SpO2 measured by multiparameter monitor and the mobile application revealed r=0.05 (p=0.51), which demonstrates a zero and no significant correlation. Conclusion: There was no correlation between the SpO2 measurement of the multiparameter monitor and the Samsung Health® app, not being trusted to use this application to monitor and manage the vital sign SpO2 in healthy people. The HR measured with the application is significant, and can be used to monitor and manage this vital sign.

Precisión del método de Moyers para predecir tamaño de dientes no erupcionados. Municipio Centro Habana. 2020 / Accuracy of the Moyers method to predict size of non-erupted teeth. Centro Habana Municipality. 2020

Introducción: El método de Moyers se utiliza en Cuba para predecir el tamaño de caninos y bicúspides no erupcionados. Objetivo: Determinar la precisión del método de Moyers para predecir tamaño de dientes no erupcionados en pacientes de Centro Habana. Material y métodos: Investigación de desarrollo en el Policlínico Luis Galván Soca de marzo 2019 a mayo de 2020. Universo formado por individuos de 12 a 24 años. Muestra de 100 personas seleccionadas por muestreo aleatorio simple. Se analizó la tabla de Moyers por sexos para todos los percentiles. Resultados: En el sexo femenino para la arcada superior e inferior el error cuadrático medio menor correspondió al percentil 50: 0,476 y 0,464 respectivamente; único donde las diferencias entre el valor estimado y el real no fueron significativas. Por tanto, el percentil elegible para féminas en ambas arcadas sería el 50 por ciento. En masculinos para la arcada superior el error cuadrático medio menor (0,576) para el percentil 65 con diferencias entre el valor estimado y el real no significativas(p=0,269); mientras en la arcada inferior fue de 0,592 para el percentil 75. Por tanto, el percentil elegible para hombres en la arcada superior fue el 65 y en la inferior el 75; la fuerza de esta correspondencia es intensa para ambas arcadas. Conclusiones: En la población que se estudia el método de Moyers, para predecir el tamaño de dientes no erupcionados es preciso en el sexo femenino, pero no en el masculino(AU)

Introduction: In Cuba, the Moyers method is used to predict the size of non-erupted canines and bicuspids. Objective: To determine the precision of the Moyers method to predict the size of non-erupted teeth in patients from Centro Habana municipality. Material and Methods: A development research was conducted in Luis Galván Soca Polyclinic from March 2019 to May 2020. The universe consisted of individuals aged 12-24 years. The sample was composed of 100 people who were selected by simple random sampling. Moyers table was analyzed by sex for all percentiles. Results: In the female sex, the lower mean square error for the upper and lower arches corresponded to the 50th percentile: 0.476 and 0.464 respectively, the only one in which the difference between the estimated and the real values was not significant. Therefore, for females, the eligible percentile in both arches would be 50 percent. In males, in the upper arches, the lower mean square error (0.576) for the 65th percentile showed no significant differences between the estimated and the real values (p = 0,269); however, in the lower arch it was 0,592 for the 75th percentile. Therefore, in the upper arch, the eligible percentile for males was 65 while, in the lower arch, it was 75; the strength of this correspondence is intense for both arches. Conclusions: In the population studied, the Moyers method was found to be accurate in predicting the size of non-erupted teeth in females, but not in males(AU)

Sobrecarga y asociaciones de riesgo en cuidadores de personas con demencia durante la pandemia por la COVID-19 / Overburden and correlates among caregivers of people with dementia during the COVID-19 pandemic

Introducción: La existencia del SARS-CoV-2 coronavirus (COVID-19) representa un problema de salud sin precedentes en todo el mundo, incluidas las personas con demencia, sus familias y cuidadores. Objetivo: Estudiar las características del cuidado y el grado de sobrecarga en cuidadores de personas con demencia durante la pandemia causada por la COVID-19. Material y Métodos: Estudio observacional prospectivo. El universo comprendió 3000 personas de 65 años seleccionadas por un muestreo aleatorio simple sin reposición procedentes del estudio poblacional Envejecimiento y Alzheimer, de ellas 160 participantes, residentes en La Habana fueron evaluados en dos momentos diferentes; 2016 - 2018 y del 1 de octubre al 30 de noviembre de 2020. Resultados: Los cuidadores evaluados durante la pandemia presentaron mayor estrés o sobrecarga según la escala de Zarit (p=0,017) y mayor morbilidad según el cuestionario general de salud (p<0,0001) en relación con el estudio realizado en 2016-2018. El estrés en los cuidadores se asoció con la presencia y severidad de los síntomas psicológicos y conductuales, OR=1.02 (IC 95 por ciento 1,00-1,03), el estadio de la demencia OR= 1,61 (IC 95 P, 1,45-1,76), mayores necesidades de cuidados OR=1.56 (IC 95 por ciento, 1.14-2.77), temor a enfermar por la COVID-19 OR= 1.52 (IC 95 por ciento, 1.11-4.12), inseguridad en el futuro OR= 1,26 (IC 95 por ciento, 1,04-2,53) y el abandono del trabajo por el cuidado OR= 1,19 (IC 95 por ciento, 1,01-2,12). Conclusiones: Nuestros hallazgos confirman mayor estrés y sobrecarga en cuidadores de personas que viven con demencia durante la pandemia y la necesidad de una acción coordinada en las estrategias del sistema nacional de salud, dirigida a las personas con demencias y los cuidadores(AU)

Introduction: The existence of the SARS-CoV-2 coronavirus (COVID-19) represents an unprecedented health problem around the world, including people with dementia, their families and caregivers. Objectives: To study the characteristics of caregivers and care recipients as well as the burden among caregivers of people with dementia during the COVID-19 pandemic. Material and Methods: Prospective observational study. The universe comprised 3000 people aged 65 years who were selected by simple random sampling without replacement from the population based study of Aging and Alzheimer's Disease. Of them, 160 participants from Havana were evaluated at two different moments: in 2016 - 2018 and from October 1 to November 30, 2020. Results: The caregivers who were evaluated during the pandemic presented higher levels of stress or higher Zarit burden Interview scores (p=0,017) as well as a greater morbidity as measured by the General Health Questionnaire (p<0,0001) in relation to the study conducted in 2016-2018. Stress among caregivers was associated with the presence and severity of behavioral and psychological symptoms, OR = 1,02 (95 percent CI 1.00-1.03); stages of dementia, OR = 1,61 (95 percent CI, 1.45-1.76); greater care needs, OR = 1,56 (95 percent CI, 1.14-2.77); fear of getting sick from COVID-19, OR = 1,52 (95 percent CI, 1.11-4.12); insecurity about the future, OR = 1,26 (95 percent CI, 1.04 -2.53) and job abandonment due to care, OR = 1,19 (95 percent CI, 1.01-2.12). Conclusions: Our findings confirm that there is greater stress and burden among caregivers of people living with dementia during the COVID-19 pandemic and that there is a need to achieve coordinated actions in the national health system strategies aimed at supporting people with dementia and caregivers(AU)

Periodontitis, dislipidemia y obesidad. Su relación / Relationship between periodontitis and dyslipidemia and obesity

Introducción: Desde hace algunos años, se reporta en la literatura médica una posible asociación entre la periodontitis con otras enfermedades y condiciones sistémicas. Objetivo: Determinar la relación entre la periodontitis con las dislipidemia, obesidad o ambas. Material y Método: Estudio analítico transversal. Del universo de 9 350 individuos residentes en el municipio Plaza de la Revolución en edades entre 35 y 70 años, ambos sexos; se seleccionó una muestra probabilística utilizando el esquema muestreo aleatorio simple de 1 200 individuos que otorgaron su consentimiento para participar. Debían presentar, en su historia clínica médica, resultados de análisis complementarios para detectar dislipidemia en los últimos seis meses y como mínimo seis dientes en boca. Las variables estudiadas fueron: periodontitis, dislipidemia, obesidad y presencia de dislipidemia y obesidad en el mismo individuo. Los sujetos se clasificaron en tres grupos: con presencia de dislipidemia, obesos y ambas entidades (dislipidemia+obesidad). Resultados: La variable más encontrada fue dislipidemia (73,0 por ciento), seguida de periodontitis (62,2 por ciento). La periodontitis se encontró con mayor frecuencia en individuos que presentaban dislipidemia (48,1 por ciento), los obesos presentaron en su mayoría periodontitis, en los sujetos que presentaron dislipidemia + obesidad, la periodontitis fue más frecuente que en los que no presentaban ambas entidades unidas. Conclusiones: La periodontitis se relacionó con la dislipidemia, obesidad y ambas unidas, no así con la obesidad, aunque fue más frecuente en estos últimos que en los no obesos(AU)

Introduction: A possible association between periodontitis and other diseases and systemic conditions has been reported by the medical literature for many years. Objective: To determine the relationship between periodontitis and dyslipidemia and obesity or both of them. Material and Methods: An analytical cross-sectional study was conducted. The universe consisted of 9 350 individuals between the ages of 35 and 70 years, of both sexes who live in Plaza de la Revolución Municipality. From this universe, a sample composed of 1 200 individuals who gave their consent to participate in the study was selected by simple random sampling method. Their clinical records should include the results of complementary tests to determine dyslipidemia in the last six months; also, they should have at least six teeth in the mouth. The variables studies included: periodontitis, dyslipidemia, obesity and the presence of dyslipidemia and obesity in the same individual. The subjects were divided into three groups: with dyslipidemia, obese and with both entities (dyslipidemia+obesity). Results: The most common variable found was dyslipidemia (73,0 percent), followed by periodontitis (62,2 percent). Periodontitis was more frequently found in individuals with dyslipidemia (48,1 percent), and the majority of obese subjects had periodontitis. Periodontitis was more frequent in individuals with dyslipidemia + obesity than in the ones that did not present both entities at the same time. Conclusions: Periodontitis was associated with dyslipidemia, obesity and with both entities at the same time, but it was not associated with obesity only. However, it was more frequent in obese subjects than in non-obese ones(AU)

Factores de riesgo asociados a colonización nasofaríngea en niños vacunados con vacunas antineumocócicas. Cienfuegos 2015-16 / Risk factors associated with nasopharyngeal colonization in children vaccinated with pneumococcal vaccines. Cienfuegos, 2015-16

Introducción: La colonización nasofaríngea por neumococo se define como el momento inicial en el que la bacteria se aloja en la nasofaringe del individuo. Objetivo: Estimar la proporción de factores de riesgo asociados a la colonización nasofaríngea por neumococo en niños vacunados con vacunas conjugadas antineumocócicas (PCV). Material y Métodos: Un año después de la vacunación antineumócocica mediante un ensayo clínico fase II/III, controlado, aleatorizado y doble ciego en niños de 1 a 5 años, se ejecutó un estudio de seguimiento con un diseño casos y controles, tipo caso-caso. El horizonte temporal fue desde noviembre de 2015 hasta abril de 2016. Se incluyó 50 por ciento del total de vacunados en el estudio experimental. El universo lo constituyó los 1 135 niños vacunados en el ensayo clínico. Se siguió un muestreo aleatorio simple y se incluyeron 555 sujetos. Se realizó una encuesta y una toma de muestra de exudado nasofaríngeo. Se presentaron tablas de frecuencias. Se utilizó la razón de prevalencia como medida de asociación. Se calcularon los intervalos de confianza a 95 por ciento para cada proporción. Resultados: Tener entre 2 y 5 años actúa como factor protector para la colonización nasofaríngea con respecto al niño pequeño. Convivir con personas mayores de 65 años constituye un factor de riesgo significativamente relacionado con la colonización nasofaríngea. Conclusiones: La introducción de vacunas antineumocócicas en niños preescolares puede impactar de manera significativa la carga de colonización y en la trasmisión de la enfermedad neumocócica(AU)

Introduction: Nasopharyngeal colonization by pneumococci is defined as the initial moment when the bacterium lodges in the nasopharynx of the person. Objective: To estimate the proportion of risk factors associated with nasopharyngeal colonization by pneumococci in children vaccinated with conjugate pneumococcal vaccines (CPV). Material and Methods: One year after pneumococcal vaccination, a follow-up case-case-control study was conducted in children aged 1-5 years by means of a phase II/III controlled, randomized, double-blind clinical trial. The time horizon was from November 2015 to April 2016. The study included 50 percent of the total of children vaccinated during the experimental study. The universe consisted of 1135 children who were vaccinated during the clinical trial. A simple random sampling that included 555 persons was applied. A survey was conducted and nasopharyngeal exudate samples were taken. Tables of frequencies were presented. Prevalence ratio was used as a measure of association. Also, 95 percent confidence intervals were calculated for each proportion. Results: Being between the ages of 2-5 years acts as protective factor against nasopharyngeal colonization with respect to the young child. Living with persons older than 65 years is a significantly associated risk factor with nasopharyngeal colonization. Conclusions: The introduction of pneumococcal vaccines in pre-school children can have a significant impact on colonization burden and the transmission of pneumococcal diseases(AU)

Modelo predictivo para la recidiva en pacientes con cáncer de tiroides / Predictive model for recurrence in patients with thyroid cancer

Introducción: El cáncer de tiroides es el tumor maligno más común originado en órganos endocrinos (más del 92 por ciento) y comprende un grupo de tumores que son diferentes clínicamente y epidemiológicamente. En los últimos años se ha incrementado el uso de los modelos predictivos en la práctica médica para determinar la mejor conducta en pacientes con tumores de la glándula tiroides. Objetivo: Desarrollar un modelo probabilístico de predicción de la recidiva en pacientes con cáncer de tiroides. Métodos: Se realizó un estudio prospectivo longitudinal, en el Hospital Militar Central Dr. Carlos J. Finlay, desde enero de 2015 hasta febrero del 2020. Se incluyeron 63 pacientes que ingresaron al estudio por muestreo aleatorio simple con remplazo, se confeccionó un modelo predictivo utilizando una regresión logística binaria en el programa R. Resultados: El grupo de edad más afectado estuvo entre los 40 y 59 años, predominó el sexo femenino y el carcinoma papilar, la vascularización y la irregularidad fueron los elementos ultrasonográficos más detectados. El estadístico de Wald fue significativo con una distribución normal en todas las variables analizadas lo cual indica que sus coeficientes son diferentes de 0 y deben ser incluidos en el modelo La variable con mayor influencia en el índice de recidiva resultó ser la diferenciación celular Conclusiones: Los factores con mayor influencia en la recidiva en la serie estudiada resultaron el grado de diferenciación, la presencia de vascularización e irregularidad en la ecografía y el tamaño tumoral con cifras similares a las reportadas nacional e internacionalmente(AU)

Introduction: Thyroid cancer is the most common malignant tumor originating in endocrine organs (more than 92%) and comprises a group of tumors that are clinically and epidemiologically different. In recent years, the use of predictive models has increased in medical practice to determine the best behavior in patients with tumors of the thyroid gland. Objective: To develop a probabilistic model for predicting recurrence in patients with thyroid cancer. Methods: A longitudinal prospective study was carried out at the Dr. Carlos J Finlay Central Military Hospital, from January 2015 to February 2020. 63 patients who entered the study by simple random sampling with replacement were included; a predictive model was made using a binary logistic regression in program R. Results: The most affected age group was between 40 and 59 years old, female sex predominated and papillary carcinoma, vascularization and irregularity were the most detected ultrasound elements. The Wald statistic was significant with a normal distribution in all variables analyzed, which indicates that their coefficients are different from 0 and should be included in the model. The variable with the greatest influence on the recurrence rate turned out to be cell differentiation. Conclusions: The final binary logistic regression model had an adequate goodness of fit and discrimination was very good, with an acceptable receiving operator area under the curve (AU)

Encuesta de infección por coronavirus tipo 2 del síndrome respiratorio agudo grave (SARS-CoV-2), a nivel comunitario en habitantes de un barrio vulnerable urbano de la ciudad de Buenos Aires: un ejemplo de muestreo probabilístico / Survey of infection by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), community level in inhabitants of a marginal urban neighborhood of the city of Buenos Aires: an example of a probability sampling

Entre el 1 y el 26 de junio se llevó a cabo el estudio de investigación "Encuesta de infección por coronavirus tipo 2 del síndrome respiratorio agudo grave (SARS-CoV-2), nivel comunitario en habitantes de un barrio vulnerable urbano de la ciudad de Buenos Aires", que determinó que un 54,3% de los habitantes del barrio presentaban anticuerpos inmunoglobulina tipo G para SARS-CoV-2. El objetivo de este artículo es proporcionar un ejemplo de un muestreo probabilístico que fue utilizado para estimar la prevalencia de seropositividad en este estudio. (AU)

Between 1st and 26th of june, a research named "Survey of infection by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), community level in inhabitants of a marginal urban neighborhood of the city of Buenos Aires" was carried on. The study showed that 54.3% of the that 54.3% of the people of the neighborhood had antibodies immunoglobulin type G for SARS-CoV-2. The objective of this article is to provide an example of a probability sampling carried out in the study, to measuring the prevalence of seropositivity. (AU)

Descripción del problema de dengue con enfoque de la determinación social de la salud en una comunidad: estudio de campo / Description of the dengue problem with a focus on the social determinants of health in a community: field study

Este trabajo quiere contribuir con otra perspectiva a la solución del problema del Dengue en México. El objetivo fue determinar tipos de criadero de Aedes aegypti, condiciones de la vivienda e identificar dimensiones que determinen la enfermedad con enfoque integral social en la colonia centro de Mazatepec, Morelos. El estudio es de corte transversal descriptivo, se llevó a cabo en temporada de sequía (2015), se realizó colecta entomológica para identificar criaderos del vector, aplicación de Índice de Condición de Vivienda (ICV) y cuestionario con perspectiva de la Determinación Social de la Salud a 80 casas. Se detectaron 3,221 recipientes sin agua y 655 con agua, 25.34% tratables (tanques, tinacos), 9.46% controlables (botes y cubetas) y 4.7% diversos chicos, el ICV identificó 14 casas positivas (57.69%-tratables), 47.5% de medio riesgo para crecimiento del vector, el 83.3% atribuyó el problema a condiciones de vida y posesión de recursos, 40.83% responsabilizó a la comunidad, falta de interés y mala organización. Las estrategias y políticas en salud deben de tomar en cuenta la perspectiva social y análisis de las comunidades, mejorar las condiciones de vivienda, trabajo y organización comunitaria para preservar la salud(AU)

This work aims to contribute to the solution to the dengue problem in Mexico with a different approach. The objectives of the research were to determine the types of hatcheries for Aedes aegypti and housing conditions, as well as to identify the dimensions that determine the disease with an integral social approach in the Colonia Centro of Mazatepec, Morelos, Mexico. This is a descriptive cross-sectional studycarried out during the dry season in 2015, an entomological collection was made to identify the vector hatcheries, the Housing Condition Index (HCI) and a questionnaire were applied to establish the Social Determinants of Health for 80 houses. A total of 3,221 containers without water and 655 with water were detected, out of these 25.34% were tagged as manageable (water tanks), 9.46% as controllable (buckets and cans) and 4.7% as various small items. The HCI identified 14 positive houses (57.69% as manageable), 47.5% as medium risk for the development of the vector. Eighty three point three percent of the questionnaire participants attributed the problem to life conditions and resources property, 40.83% to the community, the lack of interest and disorganization as responsible. Health strategies and policies must take into account the social approach and analysis of the communities, improving housing, work and community organization conditions to preserve health(AU)

Usos de las tecnologías de la información y la comunicación en la Carrera de Enfermería, UNA, Paraguay 2017 / Uses of information and communication technologies in the Career of Nursing, UNA, Paraguay 2017

Introducción: la introducción de las Tecnologías de la Información y la Comunicación, es un desafío para el proceso de la enseñanza aprendizaje, sin embargo, su inclusión es fundamental para el éxito de la educación. Objetivo: este trabajo plantea como objetivo, describir las competencias de los docentes en el uso de las Tecnologías de la Información y la Comunicación, Carrera de Enfermería, Casa Central, Facultad de Enfermería y Obstetricia de la Universidad Nacional de Asunción, durante el año 2017, dispuesto en tres componentes cognitivo, procedimental y actitudinal. Metodología: es un estudio descriptivo observacional, con enfoque cuantitativo, de corte transversal, muestreo probabilístico, incluye como muestra a 109 docentes, se aplicó un instrumento con 40 reactivos, para la medición de los componentes cognitivos y procedimental. Se utilizó cuestionario estructurado cerrado, y para el componente actitudinal se aplicó un cuestionario con medición según escala de Likert con valores de 1 a 5. Resultado: el resultado refleja que los docentes poseen competencia cognitiva de nivel básico, que los medios audiovisuales e informáticos son los más utilizados por los docentes y un componente actitudinal positivo para la integración de las Tecnologías de la Información y la Comunicación en el proceso de la enseñanza aprendizaje. Conclusión: se recomienda crear espacios para desarrollar el conocimiento e incorporar en forma progresiva las Tecnologías de la Información y la Comunicación en la práctica de la docencia, asegurar la accesibilidad a una red y programar planes de formación permanente.

Introduction: the introduction of Information and Communication Technologies is a challenge for the teaching-learning process, however, its inclusion is fundamental to the education success. Objetive: this work objective raises to describe the teachers competencies in the using of Information and Communication Technologies, Career Nursing, Headquarters, School of Nursing and Obstetrics of the National University of Asuncion, during the year 2017, arranged in three cognitive, procedural and attitudinal components. It is an observational descriptive study, with a quantitative approach, cross-sectional, probabilistic sampling approach. Metodology: it includes 109 teachers as a sample, an instrument with 40 reagents was applied, for the cognitive measurement and procedural components, a closed structured questionnaire was used, and for the Attitudinal component was applied a questionnaire with measurement according to Likert scale with values from 1 to 5. Results: the result reflects that teachers have basic level cognitive competence, that audiovisual and computer media are the most used by teachers and a positive attitudinal component for the integration of Information and Communication Technologies in the teaching-learning process. Conclusion: it is recommended to create spaces to develop knowledge and progressively incorporate Information and Communication Technologies in the practice of teaching, ensure accessibility to a network and program ongoing training plans.

Prevalencia de Síndrome de Hellp en el servicio de ginecología y obstetricia del Hospital Central del Instituto de Previsión Social. 2017 / Prevalence of Hellp Syndrome in the gynecology and obstetrics service of the Central Hospital of the Instituto de Previsión Social

Introducción: En la actualidad, la mortalidad materna va aumentando, debido a ciertas complicaciones producidas durante la gestación, una de ellas es el Síndrome de HELLP que es considerada una de las complicaciones más severas de las enfermedades hipertensivas del embarazo que mayoritariamente se presenta en embarazadas que cursan con preeclampsia. Objetivo: Determinar la prevalencia de Síndrome de HELLP en el Servicio de Ginecología y Obstetricia del Hospital Central del Instituto de Previsión Social durante el año 2017. Materiales y método: Estudio observacional descriptivo de corte transversal, muestreo probabilístico aleatorio simple. Fueron incluidas las fichas clínicas de las embarazadas que acudieron al servicio de Ginecología y Obstetricia del Hospital Central del Instituto de Previsión Social desde enero a diciembre del 2017. Resultados: Fueron incluidas en el estudio 177 embarazadas; de las cuales el 14,2% presentó Síndrome de HELLP. La mediana de edad fue de 28 años; el estado civil predominante fue unión libre en un 49,15%; el 62,71% de las gestantes procedieron de áreas urbanas, mayoritariamente del departamento Central y el 33,90% de ellas son ama de casa. La edad gestacional estuvo comprendida predominantemente entre las 33,2 a 37,6 semanas; la mediana del número de controles prenatales fue de 5. Con respecto a las enfermedades hipertensivas del embarazo la mayor parte de las gestantes presentaron preeclampsia. Conclusión: La prevalencia de Síndrome de HELLP en las embarazadas que acudieron al servicio de Ginecología y Obstetricia en el Hospital Central del Instituto de Previsión Social durante el año 2017 fue del 14,2%; dato similar a otros estudios realizados.

Incidencia del paro cardio-respiratorio en la unidad de terapia intensiva del Hospital J. R. Vidal en el período de enero de 2014 a enero de 2015 / Incidence of cardio-respiratory arrest in the intensive care unit of Hospital J. R. Vidal in the period from January 2014 to January 2015

Se realizó una investigación cuantitativa, descriptiva, retrospectiva, transversal y observacional. El objetivo fue determinar la incidencia de paro cardiorrespiratorio (PCR) en pacientes internados en unidad de terapia intensiva (UTI) del Hospital Juan R. Vidal en la Ciudad de Corrientes, entre enero de 2014 y enero de 2015. Las variables fueron: grupo etario, sexo, diagnóstico al ingreso, PCR previo, causa del PCR, tiempo de internación en la UTI, estación del año de ocurrencia del PCR y tiempo de reanimación. Para la muestra se seleccionó 50 pacientes reuniendo los criterios de inclusión, exclusión y eliminación, mediante muestreo aleatorio simple. Para la recolección de datos se usó un formulario que contenía las variables en estudio. Los resultados determinaron una incidencia de PCR del 14% con un intervalo de confianza del 95% entre 3 y 25%. El grupo etario de mayor frecuencia fue entre 52-62 años, el sexo predominante masculino, el diagnóstico al ingreso y las causas del PCR coinciden en enfermedades respiratorias, hubo pocos casos de PCR previo, el tiempo de internación en UTI fue entre 1-10 días, la estación del año de ocurrencia otoño, y se estimó un tiempo de reanimación de 40 minutos (DS +/- 5) con un IC al 95% entre 38,5- 41,4 minutos. Discusión: En líneas comparativas con trabajos citados los resultados obtenidos son muy similares, sobre todo en lo referente a la edad, sexo, causa precipitante y estación del año de ocurrencia. Conclusión: Se determinó una incidencia de PCR del 14%

A quantitative, descriptive, retrospective, transverse and observational investigation was carried out. The objective was to determine the incidence of cardiorespiratory arrest (CRP) in patients admitted to the intensive care unit of the Juan R. Vidal Hospital in the city of Corrientes between January 2014 and January 2015. The variables were: age group, Sex, diagnosis at admission, previous CRP, cause of CRP, length of stay in the ICU, season of the year of CRP occurrence and resuscitation time. For the sample, 50 patients were selected meeting the inclusion, exclusion and elimination criteria, using simple random sampling. For data collection, a form containing the variables under study was used. The results determined a CRP incidence of 14% with a 95% confidence interval between 3 and 25%. The most frequent age group was between 52-62 years, the predominant male sex, the diagnosis at admission and the causes of CRP coincide in respiratory diseases, there were few cases of previous CRP, the time of ICU admission was between 1-10 Days, the season of the year of fall occurrence, and a resuscitation time of 40 minutes (SD +/- 5) with a 95% CI of 38.5-41.4 minutes was estimated. Discussion: In comparative lines with cited works the results obtained are very similar, especially in relation to age, sex, precipitating cause and season of the year of occurrence. Conclusion: A PCR incidence of 14% was determined

Association between the perceived environment and overweight in adults and elderly: a cross-sectional study

BACKGROUND: Overweight is a global issue of epidemic proportions, and its negative influence on individual health is clear. However, the relation between environment and overweight is not thoroughly clear, especially concerning to the perceived environment and the physical and social aspects. Therefore, this study aimed to analyze potential associations between the perceived environment and overweight in adults and elderly in a medium-sized city. METHODS: A cross-sectional population-based study was conducted with 808 adult and elderly individuals. Overweight was defined as body mass index≥25 kg/m2based on the World Health Organization criteria. The Neighborhood Environment Walkability Scale was used evaluating the perceived environment. Poisson regression was performed evaluating the relationships between the perceived environment and overweight .RESULTS: The frequency of overweight was 50.4 %. Adjusted models showed association between overweight and the variable of surrounding neighborhood as follows:"1- to 3-story apartments or condos"(most category; PR = 0.30; CI 0.12­0.76) and"4- to 6-story apartments or condos"(all categories) (PR ranged 0.40 to 0.46;p< 0.05), and also,"l and-use mix-diversity" was associated with overweight in this population (PR 0.81; CI 0.66­0.99).CONCLUSIONS: In addition to individual characteristics, the environmental aspects are relevant to the occurrence of overweight in this population. Population-based studies using primary data on overweight remain scarce in Brazil. Finally, this study contributes to improve the understanding of the complex relationship between perceived environment and overweight, and we believe that our findings provide further justification for the development of future interventions and health promotion strategies.

Prevalência de ansiedade e depressão em pacientes oncológicos e identificação de variáveis predisponentes / Prevalence of anxiety and depression in cancer patients and identifying predisposing variables / La prevalencia de ansiedad y depresión en pacientes con cáncer y la identificación de las variables que predisponen

Introdução: O diagnóstico de câncer pode ser acompanhado de transtornos psiquiátricos como a ansiedade e a depressão. Objetivo: Avaliar a ocorrência de depressão e ansiedade em paciente oncológicos, além de analisar as associações entre as variáveis clínicas e sociodemográficas e as comorbidades psiquiátricas. Método: Trata-se de um estudo transversal, analítico-descritivo, no qual foram selecionados de maneira aleatória prontuários de pacientes oncológicos em tratamento no hospital referência da Região Centro-Oeste de Minas Gerais. Os dados sociodemográficos e clínicos (gênero, idade, tipo de câncer, tipo de tratamento e tempo de tratamento) foram coletados, e a amostra foi triada para depressão e ansiedade, por meio do Hospital Anxiety and Depression Scale (HADS), já validada para o Brasil. Os dados obtidos foram interpretados por frequência absoluta e relativa. Posteriormente, foram analisadas as associações por meio do Teste Qui-Quadrado. Resultados: A amostra é formada por 233 pacientes, sendo 65% mulheres; 55% dos entrevistados no setor de quimioterapia; e 37% com até três anos de tratamento. Entre os entrevistados, foram encontrados 31,33% (IC 95%: 25,37-37,28) dos pacientes com ansiedade provável ou possível, e 26,18% (IC 95% 20,53-31,82) com depressão provável ou possível. Após correlação dos dados encontrados por meio do Qui-Quadrado, não se identificou diferença nos subgrupos, porém houve uma tendência maior a mulheres apresentarem depressão. Conclusão: A ansiedade e depressão são distúrbios prevalentes em pacientes oncológicos. Neste estudo, mais de um quarto dos pacientes demonstram componentes de transtorno psicológico (26,18% ansiedade e 31,33% depressão), tendo um predomínio de depressão em mulheres.

Introduction: The diagnosis of cancer can often be followed by psychiatric disorders such as anxiety and depression. Objective: to evaluate the occurrence of depression and anxiety in cancer patients, besides analyzing the association between clinical and sociodemographic variables and psychiatric comorbidities. Method: This was a cross-sectional, analytical-descriptive study based on randomly-selected charts of cancer patients undergoing treatment at the referral hospital in the central-western region of Minas Gerais. Sociodemographic and clinical data (gender, age, and type of cancer, type of treatment and time of treatment) were collected. The sample was screened for depression and anxiety by using the Hospital Anxiety and Depression Scale (HADS), already validated in Brazil. The obtained data were interpreted by absolute and relative frequency. Then, associations were analyzed using the Chi-Square Test. Results: The sample consisted of 233 patients, 65% of whom were women, 55% were interviewed in the chemotherapy sector and 37% with up to 3 years of treatment. Among the interviewees, 31.33% (IC 95%: 25.37-37.28) of the patients showed probable or possible anxiety and 26.18% (CI 95% 20.53-31.82) presented probable or possible depression. After correlation of the data found using the Chi-square, no difference was identified in the subgroups, but there is a higher tendency for women to have depression. Conclusion: Anxiety and depression are prevalent disorders in cancer patients. In this study, more than a quarter of the patients demonstrated components of psychological disorder (26.18% anxiety and 31.33% depression), with depression predominating in women.

Introducción: El diagnóstico de cáncer puede ser acompañado de trastornos psiquiátricos como ansiedad y depresión. Objetivo: Evaluar la incidencia de la depresión y la ansiedad en pacientes con cáncer, y analizar la asociación entre las variables clínicas y sociodemográficas y comorbilidades psiquiátricas. Método: Se trata de un estudio transversal, analítico-descriptivo, en el cual fueron seleccionados al azar los registros de pacientes en tratamiento oncológico en el hospital referencia de Minas Gerais, en la región del Medio Oeste de Brasil. Fueron recogidos los datos sociodemográficos y clínicos (sexo, edad, tipo de cáncer, el tipo de tratamiento y tiempo de tratamiento) y analizados de manera descriptiva por medio de una tabla de frecuencias. Una muestra fue seleccionada para la depresión y la ansiedad al utilizarse la Escala Hospitalaria de Ansiedad y Depresión (HADS), ya validada en Brasil. Los datos fueron interpretados por frecuencia absoluta y relativa. Luego fue analizada la asociación por medio de la prueba de chi-cuadrado. Resultados: La muestra es compuesta por 233 pacientes, entre los cuales 65% son mujeres, 55% están en la quimioterapia y el 37% presentan hasta 3 años de tratamiento. Entre los entrevistados, se encontró 31,33% (IC 95%: 25,37-37,28) de pacientes con ansiedad probable o posible y 26,18% (IC 95% 20,53-31,82) con la depresión probable o posible. Después de la correlación de los datos encontrados utilizando la prueba de Chi-cuadrado, no identificamos diferencias en los subgrupos sin embargo, hay una mayor tendencia a que las mujeres tengan depresión. Conclusión: La ansiedad y la depresión son trastornos frecuentes en los pacientes con cáncer. En este estudio, más de una cuarta parte de los pacientes tienen componentes de trastornos psicológicos (26,18% 31,33% de ansiedad y depresión), y hay una mayor tendencia a que las mujeres tengan depresión.

Alterações palpebrais: frequência de ocorrência e perfil dos portadores em amostra populacional brasileira / Eyelid disorders: frequency of occurrence and profile of carriers in a Brazilian population sample

Objetivo: Apresentar a frequência de ocorrência das alterações palpebrais em uma amostra populacional brasileira, assim como as características de seus portadores. Métodos: Estudo transversal utilizando amostra populacional aleatorizada, realizado nos anos de 2004/2005, em nove cidades da região centro-oeste do estado de São Paulo. Foram examinadas 7654 pessoas sendo os participantes avaliados segundo variáveis demográficas e exame oftalmológico completo. As alterações palpebrais foram avaliadas por meio de exame externo usando lanterna e lâmpada de fenda. Os dados obtidos foram analisados estatisticamente. Resultados: As alterações palpebrais como a triquíase e o ectrópio foram mais relacionadas às características homens, brancos, queixa de redução de acuidade visual para perto. Foi realizado tratamento cirúrgico em 72,7% das triquíases detectadas, assim como 28,5% dos ectrópios. Já os casos de ptose palpebral foram relacionados ao sexo feminino, brancas, com queixa de diminuição da acuidade visual para perto e 26,3% necessitaram de cirurgia. Entrópio foi detectado em um caso, masculino, branco e epibléfaro foi observado em um indivíduo do sexo feminino, parda. Conclusão: A alteração palpebral mais presente na população geral brasileira é a triquíase, seguida da ptose palpebral e do ectrópio. Os autores chamam a atenção para o fato de os portadores não possuírem queixas relacionadas às alterações palpebrais.

Purpose: to show the frequency of occurrence of the eyelid disorders in a Brazilian population sample, as well as the characteristics of the carriers. Methods: a transversal study using a random population sample was carried out in the years 2004/2005, involving nine cities of the middle west region of the State of São Paulo - Brazil. We had 7654 participants which were evaluated according to demographic variables and complete ophthalmological examination. The eyelid disorders were detected using a lantern and slit lamp. Data were statistically analyzed. Results: eyelid disorders such as of trichiasis and ectropion were more related to the characteristics men, whites, complaining of reduced near visual acuity and 72.7% of trichiasis underwent surgical treatment, as well as 28.5% of patients with ectropion. Ptosis was related to the females, whites, complaining of reduced near visual acuity and 26.3% required surgery. Entropion was detected only in one case, male, white and a case of epiblepharon was observed in a female, brown. Conclusion: the most frequent palpebral disorder observed in the Brazilian general population is trichiasis, followed by ptosis and ectropion. The authors call attention to the fact that carriers do not have complaints related to the eyelid disorders.

Calázio e características demográficas dos portadores em uma amostra populacional / Chalazion and demographic characteristics of patients in a population sample

Objetivo: Apresentar a frequência de ocorrência do calázio em uma amostra populacional, assim como as características de seus portadores. Métodos: Estudo transversal utilizando amostra populacional aleatorizada, realizado nos anos 2004/2005, na região centro-oeste do estado de São Paulo. Os participantes foram avaliados segundo variáveis demográficas e exame oftalmológico. Resultados: A frequência de ocorrência do calázio foi de 1,56%, sendo mais frequente em mulheres, portadores de astigmatismo ou hipermetropia de pequenos graus, com grande variação de idade de acometimento. Foi necessária prescrição de correção óptica e cirurgia em número expressivo de casos. Conclusão: O calázio tem baixa frequência de ocorrência na população geral. Ocorre predominantemente em mulheres e há associação importante com ametropia.

Purpose: To show the frequency of occurrence of chalazion in a population sample, as well as the characteristics of patients. Methods: A cross-sectional study using randomized population sample was carried out during 2004/2005, in the Midwest region of the state of São Paulo. Participants were evaluated according to demographic variables and ocular examination. Results: The frequency of occurrence of chalazion was 1.56‰, more common in women, people with astigmatism or low hyperopia, with wide variation in age of onset. It was necessary to prescribe optical correction and surgery in a significant number of cases. Conclusion: The chalazion has low frequency of occurrence in the general population. It occurs predominantly in women and there is a significant association with refractive error.

Prevalência de hipomineralização molar-incisivo e fatores associados em escolares de um município do sudeste brasileiro / Prevalence of molar incisor hypomineralization and associated factors among schoolchildren from a city in southeastern Brazil

Estudos no mundo todo têm investigado os potenciais fatores envolvidos na ocorrência da hipomineralização molar-incisivo (HMI), porém os resultados relatados são variados e inconclusivos. Desta forma, os objetivos deste estudo foram verificar a prevalência de HMI em um grupo de escolares de oito e nove anos de idade e investigar os possíveis fatores associados. Um estudo transversal foi realizado com uma amostra de base populacional. A amostra aleatória, estratificada entre escolas públicas e privadas, foi composta por 1.181 escolares residentes em Lavras, Minas Gerais, Brasil. Previamente ao estudo principal, um estudo piloto foi desenvolvido para testar a metodologia. Os dados foram coletados através de exame clínico e questionários autoaplicáveis respondidos pelas mães. As mães responderam a um questionário autoaplicável contendo questões abrangendo características pré-natais, perinatais e saúde da criança nos quatro primeiros anos de vida e a outro sobre características socioeconômicas e demográficas. A HMI foi diagnosticada a partir dos critérios da Academia Europeia de Odontopediatria. Por meio do exame bucal, avaliou-se também a cárie dentária nas dentições decídua e permanente, de acordo com as recomendações da Organização Mundial de Saúde (OMS) e os defeitos de desenvolvimento de esmalte (DDE) nos segundos molares decíduos utilizando o Developmental Defects of enamel Index (DDE index). Os exames bucais foram realizados por um único examinador previamente calibrado. A análise estatística incluiu descrição dos dados, testes bivariados e modelos de regressão de Poisson com variância robusta (p<0.05, IC95%). Este estudo foi aprovado pelo Comitê de Ética em Pesquisa da Universidade Federal de Minas Gerais (CAAE 10659812.0.0000.5149). A prevalência de HMI foi de 20,4%. Observou-se maior frequência de HMI entre as crianças com cárie na dentição permanente (RP: 2,67; IC95%: 1,98-3,61), DDE nos segundos molares decíduos (RP: 2,54; IC95%: 1,87- 3,45) e que tiveram asma e/ou bronquite até os quatro anos de idade (RP: 1,93; IC95%: 1,45-2,56). Conclui-se que a prevalência de HMI foi alta na amostra estudada. A HMI foi mais frequente em crianças com experiência de cárie na dentição permanente, com presença de DDE nos segundos molares decíduos e 10 naquelas que tiveram asma e/ou bronquite até os quatro anos de idade, mesmo após controle para os fatores potencialmente associados

Although studies worldwide have investigated potential factors involved in the occurrence of molar incisor hypomineralization (MIH), the findings are varied and inconclusive. Thus, the aim of this study was to determine the prevalence and investigate the factors associated with the occurence of molar incisor hypomineralization in a group of schoolchildren aged eight and nine years. A crosssectional study was conducted with a population-based sample. The random sample, stratified between public and private schools, consisted of 1181 children residents in Lavras, Minas Gerais, Brazil. Prior to the main study, a pilot study was carried out to test the methodology. Data were collected via clinical examination and selfadministered questionnaires completed by mothers. Mothers completed a selfadministered questionnaire with questions on prenatal, perinatal and postnatal aspects, and another questionnaire on socioeconomic and demographic aspects. MIH was diagnosed using the criteria of the European Academy of Pediatric Dentistry. During the clinical examination, the presence of caries in permanent and primary dentitions, according to the recommendations of the World Health Organization (WHO) and developmental defects of enamel (DDE) in the second primary molars using the Developmental Defects of enamel Index (DDE index) also were evaluated. Oral examinations were performed by a single examiner who had undergone a training exercise. Data analysis involved descriptive statistics, bivariate tests and Poisson regression with robust variance (p<0.05, IC95%). This study was approved by the Ethics Committee of the Federal University of Minas Gerais, Brazil (CAAE 10659812.0.0000.5149).The prevalence of MIH was 20.4%. MIH was more frequent among children with dental caries in permanent dentition (PR: 2,67; 95%CI: 1,98-3,61); those with DDE on the primary second molars (PR: 2,54; 95%CI: 1,87- 3,45) and those who experienced asthma and/or bronchitis in the first 4 years of life (PR: 1,93; 95%CI: 1,45-2,56). In conclusion, the prevalence of MIH was high in the present sample. The occurrence of MIH was more frequent in children with caries experience in the permanent dentition, those with enamel defects on primary second 12 molars and those who had asthma experience in the first four years of life, even after controlling for potential confounding factors

Perfil epidemiológico, necesidades y comportamiento de la comunidad de San Estanislao, distrito de General Delgado, durante el primer semestre año 2015 / Epidemiological profile, needs and behavior of the community of San Estanislao, General Delgado district, during the first semester of 2015

El fomento de la salud debe dirigirse hacia dos vertientes fundamentalmente: una dirigida a controlar los factores determinantes y otra a identificar los individuos susceptibles de riesgo para ofrecerle protección individual. Los indicadores de nivel comunitario pueden ser útiles en las evaluaciones de la comunidad para varios propósitos. Con el presente trabajo se tiene el objetivo de analizar el perfil epidemiológico, las necesidades y el comportamiento de la comunidad de San Estanislao, Distrito de General Delgado, durante el primer semestre del año 2015. El estudio realizado es descriptivo, experimental, prospectivo, con metodología cualitativa y cuantitativa. Se tomó como muestra el 15% de la población enfocada, se realizó un muestreo aleatorio simple. Fueron incluidos los registros de 1781 consultas realizadas a la población de cobertura de la comunidad de San Estanislao, Distrito de General Delgado, durante el primer semestre del año 2015. Todas las consultas estudiadas comparativamente aumentaron su cobertura según el análisis de nuevos casos atendidos. Las adicciones que manifestaron los encuestados estuvieron por debajo del 50% de incidencia en todos los casos. Casi la mitad de los miembros de la comunidad de San Estanislao se automedican, de los que utilizan los servicios médicos, la gran mayoría asiste al centro de salud, otros al Hospital Regional y la minoría lo hace en IPS o servicio privado. Los motivos más frecuentes por los que las personas de la comunidad no asisten a las instituciones de salud son: falta de infraestructura y lejanía de las instalaciones; y falta de recursos propios para movilizarse hasta los lugares de atención. La minoría refirió una atención deficiente o ausente en algunos casos. Las escuelas y colegios son la mayor fuente de información sobre salud sexual y reproductiva, seguidos de la televisión y las charlas o talleres desarrollados en el entorno comunitario. Los adolescentes son el grupo que mayoritariamente se piensa deben asistir a las charlas y talleres desarrollados, seguidos de los padres de familias y los profesores de la comunidad. Entre los temas de más interés se encuentran la planificación familiar, la sexualidad y las adicciones. Se mencionan también como temas de interés las ITS-VIH/SIDA, la violencia doméstica y los agrotóxicos

The health promotion should be directed primarily towards two aspects: one aimed at controlling the determinants and identify other risk individuals susceptible to provide individual protection. The community-level indicators can be useful in the evaluation of the community for various purposes. With the present work aims to analyze the epidemiological profile, needs and behavior of the community of San Estanislao, Districto de General Delgado, during the first half of 2015. The study is descriptive, experimental, prospective, qualitative and quantitative methodology. Was sampled 15% of the targeted population, simple random sampling was performed. We included 1781 records consultations with the population coverage of the community of St. Stanislaus, District General Delgado, during the first half of 2015. All inquiries studied comparatively increased their coverage under the analysis of new cases seen. Addictions respondents who reported were below the 50% incidence in all cases. Almost half of the members of the community of San Estanislao self-medicate, using the medical services, the vast majority attending the health center, the Regional Hospital and other minority does IPS or private service. The most common reasons why people in the community do not attend health institutions are: lack of infrastructure and remoteness of facilities; and lack of own resources to be mobilized to the point of care. The minority referred attention deficient or absent in some cases. Schools and colleges are the largest source of information on sexual and reproductive health, followed by television and lectures or workshops held in the community setting. Teenagers are the group mostly they think should attend lectures and workshops developed, followed by parents of families and teachers of the community. Among the topics of most interest are family planning, sexuality and addiction. Also they mentioned as topics of interest STI-HIV / AIDS, domestic violence and pesticides