Manual de organización y funciones de la Dirección de Inmunizaciones / Manual of organization and functions of the Directorate of Immunizations

La Dirección de Inmunizaciones, es una dirección especializada del Ministerio de Salud de El Salvador, que tiene asignada la rectoría de todos los aspectos relacionados a la vacunación e inmunización de la población salvadoreña. Esta Dirección es el resultado de una acción conjunta entre los países de la Región de las Américas y de organismos internacionales como la Organización Mundial de la Salud (OMS), su interés es contribuir con acciones tendientes a lograr coberturas universales de vacunación, con el fin de disminuir las tasas de mortalidad y morbilidad causadas por las enfermedades inmunoprevenibles y está sujeta conforme a la Ley de Vacunas. En este sentido y para documentar la organización y funcionamiento de dicha Dirección, se ha elaborado el presente manual como un instrumento técnico normativo de gestión institucional, en el cual se integra la organización y funcionamiento de las diferentes dependencias que lo componen, se describen y establecen los objetivos generales y específicos, las relaciones de autoridad y dependencia de cada ambiente, así como las relaciones de trabajo internas y externas. Tiene el propósito de identificar con claridad las funciones de cada una de las áreas administrativas que la integran, evitar la duplicidad de funciones, conocer las líneas de comunicación y de mando; permitiendo así contar con un instrumento técnico administrativo integrado, que sirva de referencia y consulta a todo el personal laborando en la institución

The Immunization Directorate is a specialized department of the Ministry of Health of El Salvador, who is assigned the rectory of all aspects related to vaccination and immunization of the Salvadoran population. This Address is the result of an action collaboration between the countries of the Region of the Americas and international organizations such as the World Health Organization (WHO), its interest is to contribute with actions aimed at achieving universal vaccination coverage, in order to reduce the rates of mortality and morbidity caused by vaccine preventable diseases and is subject to according to the Vaccination Law. In this sense and to document the organization and operation of said Directorate, has prepared this manual as a regulatory technical management instrument institution, which integrates the organization and operation of the different dependencies that compose it, describe and establish the general objectives and specific, the relationships of authority and dependency of each environment, as well as the internal and external working relationships. Its purpose is to clearly identify the functions of each of the areas that integrate it, avoid duplication of functions, know the lines of communication and command; thus allowing to have a technical administrative instrument integrated, that serves as a reference and consults all the personnel working in the institution

Sobrevida en población pediátrica con leucemia linfoblástica aguda tratada con protocolo ALLIC-BFM de quimioterapia. Revisión sistemática / Survival of pediatric population with acute lymphoblastic leukemia treated with ALLIC-BFM chemotherapy protocol. Systematic review

La leucemia linfoblástica aguda constituye la neoplasia infantil más frecuente. Los tratamientos actuales posibilitan más del 80% de supervivencia libre de enfermedad por cinco años. En el 2000, se probó un protocolo de quimioterapia llamado leucemia linfoblástica intercontinental Berlín-Frankfurt-Münster (ALLIC BFM). El proceso investigativo se realizó mediante la metodología PRISMA, con el propósito de sistematizar la información acerca de la supervivencia de los pacientes pediátricos con leucemia linfoblástica aguda tratados con el uso del protocolo de quimioterapia ALLIC BFM en sus versiones de 2002 o 2009. La supervivencia global en pacientes donde se utilizó el protocolo de 2002 fue del 52% al 91,7% y la libre de enfermedad fue del 45% a 83,3%; mientras que, con el uso del protocolo 2009 se reportó una supervivencia global del 71,1% al 90% y la libre de enfermedad fue del 69,4% al 90,3%. Los principales factores que afectaron la supervivencia fueron las complicaciones relacionadas con el tratamiento, los pacientes de alto riesgo y la medicación insuficiente.

Acute lymphoblastic leukemia is the most common childhood neoplasia. Current treatments allow more than 80% disease-free survival for five years. In 2000, a chemotherapy protocol called Berlin-Frankfurt-Münster intercontinental lymphoblastic leukemia (ALLIC BFM) was tested. The investigative process was carried out using the PRISMA methodology. This study aimed to systematize the information about the survival of pediatric patients with acute lympho-blastic leukemia treated with the ALLIC BFM chemotherapy protocol in its 2002 or 2009 versions. 52% to 91.7% of patients showed an overall survival in patients where the 2002 proto-col was used, and disease-free was from 45% to 83.3%; while, with the use of the 2009 protocol, an overall survival of 71.1% to 90% was reported, and disease-free survival was 69.4% to 90.3%. The main factors affecting survival were treatment-related complications, high-risk patients, and insufficient medication.

Quantification of Polycyclic Aromatic Hydrocarbons in Commonly Consumed Salami in Brazil

Polycyclic aromatic hydrocarbons (PAHs) are organic compounds that have been found in different food categories, and meat products can have high concentrations of PAHs, since the technological processes to which they are subjected, such as smoking, can produce several compounds. Considering the risk that these compounds can bring to the population's health, it is essential to develop an accurate and reliable method to evaluate the contamination of PAHs in products of animal origin. The objective of this study was to optimize and validate a method for the quantification of 4 PAHs (benz[a]anthracene, chrysene, benzo[b]fluoranthene, and benzo[a]pyrene) in salami. The methodology included saponification, liquid­liquid extraction, solid-phase purification, and quantification by ultra-high-performance liquid chromatography. The effects of saponification parameters were investigated by experimental design, whereas the model obtained by regression analysis was considered satisfactory with the dissolution solvent of potassium hydroxide providing the highest global sum of areas. In validation, the parameters studied were adequate and within European and INMETRO Guidelines limits. The evaluation of 22 samples indicated that 27% were contaminated with at least one of the 4 PAHs, and benz[a]anthracene being the prevalent one with content varying between < 1.00 and 17.58 µg/kg. Two samples showed PAHs contamination above the maximum tolerable limit in the European Commission Regulation.

Pandemia da Covid-19 Efeitos no ambiente alimentar de varejo em três municípios da região metropolitana de Belo Horizonte / Covid-19 pandemic: Effects on the retail food environment in three municipalities in the metropolitan region of Belo Horizonte

Objetivo: Identificar mudanças no ambiente alimentar de varejo decorrentes da pandemia de covid-19, no ano de 2020, bem como analisar o fechamento dos estabelecimentos de venda de alimentos diante das medidas restritivas implementadas na região metropolitana de Belo Horizonte- MG. Metodologia: Estudo ecológico realizado em três cidades da região metropolitana de Belo Horizonte. Foram utilizados dados secundários da Secretaria Estadual da Fazenda, do Instituto Brasileiro de Geografia e Estatística, da Secretaria Estadual de Saúde do Estado de Minas Gerais e das e Secretarias Municipais de Saúde. Avaliaram-se as seguintes variáveis: abertura e fechamento de estabelecimentos que comercializavam alimentos segundo o tipo e categorias de estabelecimentos, sendo comparadas as medidas restritivas implementadas em cada cidade com o fechamento desses estabelecimentos. Os estabelecimentos foram classificados de acordo com o código da Classificação Nacional das Atividades Econômicas (CNAE), a partir da CNAE, os estabelecimentos de alimentos foram classificados conforme a atividade fim realizada e predominância dos alimentos comercializados, sendo agrupados seguindo os critérios apresentados no Relatório Técnico de Mapeamento de Desertos Alimentares para o Brasil elaborado pela Câmara Interministerial de Segurança Alimentar e Nutricional (CAISAN), sendo categorizados em três categorias, (1) estabelecimentos de aquisição de in natura, (2) estabelecimentos mistos, (3) estabelecimentos de aquisição de ultraprocessados. Por fim, estes estabelecimentos foram agregados segundo o perfil de aquisição e consumo de alimentos sendo agrupados em duas categorias (1) estabelecimentos para consumo imediato, (2) estabelecimentos para consumo no domicílio. Ademais, por se tratar de um estudo que avaliou o ambiente alimentar durante a pandemia de Covid-19, foram incluídas no estudo variáveis que descreviam o comportamento da pandemia nas cidades, tais como, a incidência da doença, taxa de mortalidade e medidas legislativas que foram utilizadas durante o primeiro ano da pandemia. Por fim, os estabelecimentos que fecharam em 2020 foram descritos de acordo com a vulnerabilidade do setor censitário onde estavam localizados os estabelecimentos. A vulnerabilidade foi determinada pela renda per capita do setor (renda total/ população total), foram utilizados dados do Censo Demográfico de 2010. Foi realizada análise descritiva (frequência relativa) com o auxílio do software Stata 14.0 e mapas com o uso do software QGIS 2.10.1. Resultados: Dentre os estabelecimentos que fecharam durante o primeiro ano de pandemia, a maioria comercializava alimentos para consumo imediato (Belo Horizonte 76,53%; Betim 69,95% e Contagem 70,87%). Além disso, foi possível perceber um aumento na abertura de estabelecimentos do tipo delivery nas três cidades do estudo. Apesar disso, as características gerais do ambiente alimentar de varejo se mantiveram inalteradas nas três cidades, com alta disponibilidade dos estabelecimentos que comercializavam predominantemente alimentos ultraprocessados. Conclusão: A pandemia de Covid-19 parece ter impactado mais os estabelecimentos que comercializam alimentos para consumo imediato. Contudo, ainda não é possível afirmar a dimensão do impacto gerado pela pandemia, para isso é necessário um acompanhamento a longo prazo para identificar se ocorre remodelação do ambiente alimentar

Objective: To identify changes in the retail food environment resulting from the covid-19 pandemic, in the year 2020, as well as to analyze the closure of food outlets in the face of the restrictive measures implemented in the metropolitan region of Belo Horizonte-MG. Methodology: Ecological study carried out in three cities in the metropolitan region of Belo Horizonte. Secondary data from the State Department of Finance, the Brazilian Institute of Geography and Statistics, the State Department of Health of the State of Minas Gerais and the Municipal Health Departments were used. The following variables were evaluated: opening and closing of establishments that sold food according to the type and categories of establishments, comparing the restrictive measures implemented in each city with the closure of these establishments. The establishments were classified according to the code of the National Classification of Economic Activities (CNAE), based on the CNAE, the food establishments were classified according to the core activity carried out and the predominance of food sold, being grouped according to the criteria presented in the Technical Report Mapping of Food Deserts for Brazil prepared by the Interministerial Chamber of Food and Nutritional Security (CAISAN), being categorized into three categories, (1) establishments for the acquisition of in natura, (2) mixed establishments, (3) establishments for the acquisition of ultra-processed. Finally, these establishments were aggregated according to the profile of acquisition and consumption of food, being grouped into two categories (1) establishments for immediate consumption, (2) establishments for consumption at home. Furthermore, as this is a study that evaluated the food environment during the Covid-19 pandemic, variables that described the behavior of the pandemic in cities were included in the study, such as the incidence of the disease, mortality rate and legislative measures that were used during the first year of the pandemic. Finally, establishments that closed in 2020 were described according to the vulnerability of the census sector where the establishments were located. Vulnerability was determined by the sector's per capita income (total income/total population), data from the 2010 Population Census were used. Descriptive analysis (relative frequency) was performed using Stata 14.0 software and maps using QGIS software 2.10.1. Results: Among the establishments that closed during the first year of the pandemic, most sold food for immediate consumption (Belo Horizonte 76.53%; Betim 69.95% and Contagem 70.87%). In addition, it was possible to notice an increase in the opening of delivery establishments in the three cities of the study. Despite this, the general characteristics of the retail food environment remained unchanged in the three cities, with high availability of establishments that predominantly sold ultra-processed foods. Conclusion: The Covid-19 pandemic seems to have had a greater impact on establishments that sell food for immediate consumption. However, it is still not possible to state the dimension of the impact generated by the pandemic, for which long-term monitoring is necessary to identify whether there is a remodeling of the food environment.

Estimación de la frecuencia del parto vaginal instrumentado en Colombia en los años 2015 - 2019. Estudio transversal de registros poblacionales / Estimated frequency of instrumented vaginal delivery in Colombia between 2015 and 2019. Population registry-based cross-sectional study

Objetivos: evaluar la frecuencia del parto instrumentado en Colombia y por regiones entre el 2015 y 2019. Materiales y métodos: estudio de corte transversal a partir de registros poblacionales. Se incluyeron los registros de mujeres con edad gestacional mayor a 28 semanas y parto vaginal. Muestreo consecutivo. La información se obtuvo a partir del certificado de nacido vivo del Departamento Administrativo Nacional de Estadística (DANE). Se realizó la descripción de las variables sociodemográficas y clínicas. La frecuencia del parto instrumentado fue calculada y descrita por año y departamento. Resultados: se incluyeron 3.224.218 registros de recién nacidos vivos. De estos, 1.719.405 (53,33 %) correspondieron a partos vaginales, y 1.468.726 (45,55 %) a partos por vía cesárea. La frecuencia nacional del parto instrumentado entre el 2015 y 2019 fue de 36.087 nacimientos (1,11 %); Antioquia y Bogotá, D.C. fueron los lugares con mayor ocurrencia, 16.201 (4,5 %) y 13.686 (2,52 %), respectivamente. Conclusiones: el parto vaginal instrumentado es la vía de parto con menor ocurrencia en Colombia con tendencia a la disminución. La formación en este recurso para el uso durante el trabajo de parto no debe perderse en la formación del profesional de salud, especialmente en los programas de Ginecología y Obstetricia. Se debe evaluar si el aumento en el adecuado uso de esta técnica puede disminuir la tasa de cesáreas observadas actualmente, así como describir los escenarios clínicos donde su uso es seguro para la madre y el feto. Se requieren estudios prospectivos, pues pueden permitir establecer las causas del descenso en el uso de esta herramienta obstétrica, los resultados maternos y perinatales en términos de su riesgo/beneficio.

Objectives: To assess the frequency of instrumented delivery in Colombia and by regions between 2015 and 2019. Materials and methods: Cross-sectional study based on population registries. Records of women with a gestational age of more than 28 weeks and vaginal delivery were included. Consecutive sampling was used. The information was taken from live birth certificates of the National Administrative Department of Statistics (DANE). Sociodemographic and clinical variables were described. The frequency of instrumented deliveries was calculated and described by year and by department. Results: Overall, 3,224,218 live birth records were included. Of these 1,719,405 (53.33 %) were vaginal deliveries and 1,468,726 (45.55 %) were cesarean births. At a national level, the frequency of instrumented deliveries between 2015 and 2019 was 36,087 births (1.11 %); Antioquia and Bogotá, D.C. were the places with the highest occurrence, with 16,201 (4.5 %) and 13,686 (2.52 %), respectively. Conclusions: The occurrence of instrumented vaginal delivery in Colombia is the lowest and tends to diminish. Training of healthcare professionals in this approach during labor must not be abandoned, particularly in Obstetrics and Gynecology training programs. Further studies should be conducted to determine whether the increased adequate use of this technique could contribute to a lower rate of cesarean sections, and also to describe the clinical setting in which its use is safe for both the mother and the fetus. Prospective studies are required to identify the causes leading to the lower use of this obstetric tool as well as the risks and benefits in terms of maternal and perinatal outcomes.

Caminho contra a dengue: relato de experiência de um projeto de extensão universitário / Path against dengue: experience report of a university extension project / El camino contra el dengue: informe de una experiencia de un proyecto de extensión universitaria

dengue é uma doença febril aguda com etiologia viral típica e de evolução benigna que é grave quando se apresenta na forma hemorrágica. Sua transmissão ocorre pela picada do Aedes aegypti, em um ciclo humano-Aedes aegypti-humano. Sendo assim, o cuidado e a prevenção contra a dengue é uma prática que deve ser sempre incentivada, especialmente em áreas de risco, além de buscar incluir a população como partícipes nas ações de prevenção contra essa arbovirose. O artigo trata-se de um relato de experiência cujo objetivo é descrever a experiência desenvolvida e vivenciada pelos acadêmicos do curso de graduação em Medicina da UniFipMoc-Afya durante o projeto de extensão "Caminho Contra a Dengue" que ocorreu em maio de 2022 no Parque Municipal Cândido Canelas, localizado no bairro Canelas, Montes Claros ­ MG. As ações realizadas tinham caráter socioeducativo, tendo como objetivo reconhecer e demarcar os determinantes da dengue dos bairros Canelas e Antônio Canelas, para se realizar uma sensibilização da comunidade local sobre as medidas preventivas contra a proliferação da doença e, dessa forma, contribuir para a integralização da saúde dos moradores. As estratégias empregadas trouxeram a reflexão, a problematização da pauta e a valorização de uma mudança de comportamento visando à diminuição da transmissão da dengue no bairro Antônio Canelas e no Canelas. Logo, esse conjunto de experiências proporcionou a possibilidade de promover um avanço no cuidado e na prevenção da dengue, colocando a própria comunidade como precursora e responsável pelos atos que irão fornecer uma promoção da saúde e melhorias em suas vidas.

Dengue is an acute febrile illness with a typical viral etiology and a benign course that is severe when it presents in the hemorrhagic form. Its transmission occurs through the bite of Aedes aegypti, in a human-Aedes aegypti-human cycle. Therefore, care and prevention against dengue is a practice that should always be encouraged, especially in risk areas, in addition to seeking to include the population as participants in prevention actions against this arbovirus. The article is an experience report whose objective is to describe the experience developed and lived by the academics of the undergraduate course in Medicine at UniFipMoc-Afya during the extension project "Caminho Contra a Dengue" that took place in May 2022 at Parque Municipal Cândido Canelas, located in the Canelas neighborhood, Montes Claros - MG. The actions carried out had a socio-educational character, with the objective of recognizing and demarcating the determinants of dengue in the Canelas and Antônio Canelas neighborhoods, in order to raise the awareness of the local community about preventive measures against the proliferation of the disease and, in this way, contribute to the integralization of the population. residents' health. The strategies used and employed brought reflection, problematization of the agenda and the appreciation of a change in behavior aimed at reducing dengue transmission in the Antônio Canelas and Canelas neighborhoods. Therefore, this set of experiences provided the possibility of promoting progress in the care and prevention of dengue, placing the community itself as a precursor and responsible for the acts that will provide health promotion and improvements in their lives.

El dengue es una enfermedad febril aguda de etiología vírica típica y evolución benigna que es grave cuando se presenta en forma hemorrágica. Su transmisión se produce por la picadura de Aedes aegypti, en un ciclo humano-Aedes aegypti-humano. Así, el cuidado y la prevención contra el dengue es una práctica que siempre debe ser incentivada, especialmente en las zonas de riesgo, y buscar incluir a la población como partícipe de las acciones preventivas contra esta arbovirosis. El artículo es un relato de experiencia cuyo objetivo es describir la experiencia desarrollada y vivida por estudiantes de pregrado de medicina de la UniFipMoc-Afya durante el proyecto de extensión "Camino Contra el Dengue", que tuvo lugar en mayo de 2022 en el Parque Municipal Cândido Canelas, ubicado en Canelas, Montes Claros - MG. Las acciones realizadas tuvieron un carácter socioeducativo, con el objetivo de reconocer y demarcar los determinantes del dengue en los barrios Canelas y Antônio Canelas, a fin de sensibilizar a la comunidad local sobre las medidas preventivas contra la proliferación de la enfermedad y contribuir así a la integralización de la salud de los residentes. Las estrategias empleadas propiciaron la reflexión, la problematización del tema y la valorización de un cambio de comportamiento dirigido a reducir la transmisión del dengue en los barrios Antônio Canelas y Canelas. Así, este conjunto de experiencias proporcionó la posibilidad de promover un avance en la atención y prevención del dengue, colocando a la propia comunidad como precursora y responsable de actos que proporcionarán una promoción de la salud y mejoras en sus vidas.

Diagnóstico Nacional de Salud Visual en El Salvador / National Diagnosis of Visual Health in El Salvador

La salud visual se define como la ausencia de aquellas alteraciones visuales, que impiden al ser humano conseguir un estado físico, cultural, estructural y funcional de bienestar social. También es considerada como la ausencia de enfermedad ocular, acompañada de una buena agudeza visual. El Ministerio de Salud, como rector del Sistema Nacional Integrado de Salud (SNIS), ha implementado un estudio diagnóstico de la atención de la salud visual en el país, para establecer el recurso humano, capacidad instalada y portafolio de servicios con los que cuenta y que esto permita establecer políticas, lineamientos y planes que a través de diversas estrategias puedan fortalecer y generar nuevas ofertas de servicios para satisfacer la demanda de la población salvadoreña. En ese sentido, se presenta a continuación la sistematización de la recopilación de información de la red de establecimientos del SNIS, a fin de contar con la información actualizada de la situación de la salud visual según la realidad local, para que sirva de base a fin de valorar las diferentes alternativas o propuestas que permitan atender las brechas o necesidades detectadas en el tema en mención

Visual health is defined as the absence of those visual alterations that prevent the human being from achieving a physical, cultural, structural and functional state of social well-being. It is also considered as the absence of eye disease, accompanied by good visual acuity. The Ministry of Health, as rector of the National Integrated Health System (SNIS), has implemented a diagnostic study of visual health care in the country, to establish the human resources, installed capacity and portfolio of services available and that this allows the establishment of policies, guidelines and plans that through various strategies can strengthen and generate new service offers to satisfy the demand of the Salvadoran population. In this sense, the systematization of the collection of information from the network of SNIS establishments is presented below, in order to have updated information on the visual health situation according to local reality, to serve as a basis for to assess the different alternatives or proposals that allow addressing the gaps or needs detected in the subject in question

Guía de práctica clínica basada en la evidencia para el manejo farmacológico de la hipertensión en población mayor de 18 años. Versión resumida / Evidence-based clinical practice guideline for the pharmacological management of hypertension in the population over 18 years of age. Short version

La presente guía de práctica clínica es un esfuerzo realizado por profesionales del Sistema Integrado de Salud (SNIS) coordinado por el Instituto Nacional de Salud (INS) ante la evidencia de alta prevalencia de hipertensión arterial en la población salvadoreña adulta y la carga social y económica que genera. En este documento se presenta el proceso que se realizó para la adaptación de la guía para el tratamiento farmacológico del paciente adulto con hipertensión de la OMS año 2021

This clinical practice guideline is an effort made by professionals from the Integrated Health System (SNIS) coordinated by the National Institute of Health (INS) given the evidence of high prevalence of arterial hypertension in the adult Salvadoran population and the social and economic burden that generates This document presents the process that was carried out for the adaptation of the guide for the pharmacological treatment of the adult patient with hypertension of the WHO year 2021

Guía de práctica clínica basada en la evidencia para el manejo farmacológico de la hipertensión en población mayor de 18 años. Versión completa / Evidence-based clinical practice guideline for the pharmacological management of hypertension in the population over 18 years of age. Complete version

El Instituto Nacional de Salud ha desarrollado el proceso de adaptación de guías de práctica clínicas (GPC) a fin de proveer de un documento científico como herramienta útil para los profesionales de la salud y contribuir en la mejora de la salud del país. La presente guía de práctica clínica es un esfuerzo realizado por profesionales del Sistema Integrado de Salud (SNIS) coordinado por el Instituto Nacional de Salud (INS) ante la evidencia de alta prevalencia de hipertensión arterial en la población salvadoreña adulta y la carga social y económica que genera. En este documento se presenta el proceso que se realizó para la adaptación de la guía para el tratamiento farmacológico del paciente adulto con hipertensión de la OMS año 2021

The National Institute of Health has developed the process of adaptation of clinical practice guidelines (GPC) in order to provide a scientific document as a useful tool for health professionals and contribute to the improvement of the country's health. This clinical practice guideline is an effort made by professionals from the Integrated Health System (SNIS) coordinated by the National Institute of Health (INS) given the evidence of high prevalence of arterial hypertension in the adult Salvadoran population and the social and economic burden that generates This document presents the process that was carried out for the adaptation of the guide for the pharmacological treatment of the adult patient with hypertension of the WHO year 2021

Estimación poblacional y sanitaria de Canis lupus familiaris en zonas rurales y urbanas de Huancarama, Perú / Population and health estimate of Canis lupus familiaris in rural and urban areas of Huancarama, Peru

RESUMEN El objetivo de la investigación fue estimar la población de canes con propietario y evaluar algunos aspectos de su estado sanitario en el distrito de Huancarama. El estudio fue cuantitativo, observacional, descriptivo y transversal. Se efectuó en noviembre de 2020. Las viviendas se seleccionaron mediante un muestreo estratificado aleatorio proporcional que contemplaba a los centros poblados como estratos. Se realizó una encuesta a los jefes de familia en las viviendas utilizando como instrumento una guía de entrevista validada por expertos. La información recolectada se transfirió a una hoja de Excel® para ser procesada con el software Epidat 4.2. El 70% (IC95% = 65,8-74,2%) de las viviendas tuvo canes. Los centros poblados con mayor tenencia de canes fueron Tunyabamba y Mateclla (100%, respectivamente). La mayoría de viviendas tuvo un solo can (51,3%), con predominio del sexo macho (68,8%) y edades entre 2 y 8 años (77,6%). Pocas familias tuvieron en confinamiento a sus canes (19%) y los han esterilizado (2%). Sin embargo, aunque la mayoría de los canes fueron vacunados contra la rabia (81,9%), son pocos los que tuvieron control veterinario (16%). Todos los centros poblados, a excepción de California, tuvieron en promedio un can por vivienda. En el distrito existen 1.717 canes con propietario y una razón de tres personas por cada can. Los centros poblados de Llactabamba, Acco, Tunyabamba, Lambraspata, Los Ángeles, Sotapa Pararani y otros tuvieron una razón de dos personas por can. En conclusión, existe excesiva cantidad de canes en el distrito de Huancarama, constituyendo una proporción elevada en relación con la de personas.

ABSTRACT The objective of the research was to estimate the population of dogs with an owner and to evaluate some aspects of their sanitary status in the district of Huancarama. The study was quantitative, observational, descriptive and cross-sectional. It was carried out in November 2020. The dwellings were selected through a proportional random stratified sampling considering the populated centers as strata. A survey of household heads was conducted using an interview guide validated by experts as an instrument. The information collected was transferred to an Excel* sheet to be processed later with the Epidat 4.2 software. 70% (95% CI = 65, 8-74, 2%) of the dwellings had dogs. The populated centers with the highest proportion of dog ownership were Tunyabamba and Mateclla (100%, respectively). Most of the dwellings had only one dog (51, 3%), with a predominance of the male sex (68, 8%) and ages between 2-8 years (77, 6%). Few families have their dogs confined (19%) and have them sterilized (2%). However, although the majority of the dogs were vaccinated against rabies (81,9%), few had veterinary control (16%). All populated centers, with the exception of California, had an average of one can per dwelling. In the district there are 1.717 dogs with owners and a ratio of three people to each dog. The population centers of Llactabamba, Acco, Tunyabamba, Lambraspata, Los Angeles, Sotapa Pararani, and others had a ratio of two people per dog. In conclusion, there is an excessive number of dogs in the district of Huancarama, constituting a high proportion in relation to that of people.

Actitud ante la vacuna contra COVID-19 de los habitantes del estado de Guerrero, México / Attitude towards the COVID-19 vaccine in residents of the Guerrero State, México

Introducción: Las vacunas representan una solución prometedora para mitigar la COVID-19; sin embargo, esta estrategia tiene importantes retos, uno de ellos la actitud hacia el nuevo biológico. Objetivo: Conocer la actitud de los habitantes del Estado de Guerrero (México), ante la vacuna para controlar la COVID-19. Materiales y métodos: Investigación cuantitativa no experimental de corte transversal descriptivo, a través de un muestreo tipo conglomerados, la muestra se conformó de 296 personas de las diferentes regiones del Estado de Guerrero; se incluyeron personas mayores de 18 años y que desearan participar del estudio a través de consentimiento informado. La recolección de datos fue a través de cuestionarios de Google. Se utilizó la escala para determinar la actitud frente a la vacuna contra COVID-19, compuesta por 2 secciones: Datos sociodemográficos, Actitud ante la Vacuna, esta última sección se estructura de tres subsecciones; Dimensión cognitiva, Dimensión subjetiva y Dimensión conductual, que integra las dos dimensiones. El instrumento tiene 25 ítems con opciones de respuestas cerradas en una escala tipo Likert. Resultados: La actitud hacia la vacuna contra SARS-CoV-2 es predominantemente negativa (52,7%) en la población guerrerense. Conclusión: La dimensión conductual podría considerarse un predictor de aceptación hacia la vacuna contra la COVID-19.

Introduction: Vaccines have become a promising solution to mitigate COVID-19. However, it faces important challenges, including people's attitude towards this new therapeutic. Objective: To determine the attitude of the inhabitants of the Guerrero State (Mexico) towards the vaccine to mitigate COVID-19. Materials and methods: Quantitative, non-experimental, descriptive, and cross-sectional research was conducted using a conglomerate-type sampling method. The sample included 296 people from the different regions of the State. The study included participants who were older than 18 years of age and expressed their desire to participate through the informed consent. Questionnaires in Google were used for data collection. The scale to determine the attitude towards COVID-19 vaccine contained two sections: sociodemographic data and attitude towards the vaccine. The last section was subdivided into cognitive, subjective, and behavioral (which includes cognitive and subjective) dimensions. The instrument had 25 items with closed answer options on a Likert-type scale. Results: The attitude towards the COVID-19 vaccine is predominantly negative (52.70%) in the population from Guerrero. Conclusions: The behavioral dimension could be considered a predictor of acceptance towards the COVID-19 vaccine.

Concordancia entre criterios de clasificación nutricional en adultos mayores, Colombia / Accordance between different nutritional classification criteria in older adults, Colombia

Introducción: El envejecimiento es un proceso irreversible que genera aumento permanente de la población de 60 o más años. Esta población vulnerable, vive en condiciones de discapacidad, abandono, falta de atención y presenta enfermedades asociadas con su estado nutricional, esto hace necesario determinarlo de forma adecuada. Objetivo: Analizar la concordancia entre diferentes criterios de clasificación nutricional según el Índice de Masa Corporal, a partir de una encuesta poblacional de envejecimiento, Colombia 2015. Material y métodos: Se utilizaron cuatro criterios y la concordancia entre las categorías del estado nutricional. Se calculó con los índices de Kappa directo y ponderado. Resultados: Las concordancias fueron moderadas y buenas, la menor proporción de bajo peso (3,4%) se obtuvo utilizando el criterio Organización Mundial de la Salud y la más alta (22,6%) con Organización Panamericana de Salud (p<0,05). El bajo peso se incrementa a medida que aumenta la edad, mientras el exceso de peso disminuye. Conclusiones: La clasificación nutricional cambia según el criterio y puntos de corte, el de la Sociedad Española de Nutrición Parenteral y Enteral, tuvo la mayor concordancia comparado con el de la Organización Mundial de la Salud y mejor capacidad para detectar deficiencia nutricional en la población adulta mayor.

Introduction: Aging is an irreversible process that generates a permanent increase in the 60 and older population. This vulnerable population lives in conditions of disability, neglect, lack of attention, and they present with illnesses related to their nutritional status, which is why it is necessary to understand it fully. Objective: To analyze the accordance between different criteria of nutritional classification according to the Body Mass Index, using an aging population survey, Colombia 2015. Materials and methods: Four criteria were used as well as accordance between categories of nutritional status. Direct and weighted Kappa indices were calculated. Results: The accordance was moderate and good, the lowest proportion of low weight (3.4%) was obtained using the World Health Organization criteria and the highest (22.6%) with the Pan American Health Organization (p<0.05). Low weight is increased as one ages, while excessive weight decreases. Conclusions: Nutritional classification changes depending on the criteria and cut-off points. The criteria of the Spanish Society of Parenteral and Enteral Nutrition had the highest accordance with the World Health Organization and the best capacity in detecting nutritional deficiency in the older adult population.

Viruela del mono, ¿nueva amenaza epidemiológica? / Monkeypox, a new epidemiological threat?

El virus de la enfermedad viruela símica es poco frecuente, cuyo primer caso se detectó en un niño africano en 1970. Animales que viven en las zonas de la selva de África central y occidental resultan sus portadores naturales. Actualmente, los sistemas de salud de diversos países reportan nuevos casos a nivel mundial, levantando alarmas entre diversos organismos y en la población en general.

The monkeypox disease virus is rare, the first case of it was detected in an African child in 1970. Animals living in the jungle areas of central and western Africa are its natural carriers. Currently, the health systems of various countries report new cases worldwide, raising alarms among various organizations and in the general population.

Lineamientos técnicos para la vacunación contra el SARS-CoV-2 (Versión 5) / Technical guidelines for vaccination against SARS-CoV-2 (Version 5th)

Ante la necesidad apremiante de brindar alternativas esperanzadoras para el control de la mortalidad por la enfermedad del SARS-Cov-2, en nuestro país están por introducirse las vacunas que han mostrado la más alta eficacia, considerando los resultados prometedores de estudios existentes al momento. Este hecho marca la necesidad de diseñar los Lineamientos técnicos para la vacunación contra el SARS-CoV-2, a fin de establecer las disposiciones técnicas al personal de salud del Sistema Nacional Integrado de Salud en los procesos de conservación, transporte y aplicación de la vacuna a la población objetivo

Given the pressing need to provide hopeful alternatives for the control of mortality from SARS-Cov-2 disease, the vaccines that have shown the highest efficacy are about to be introduced in our country, considering the promising results of existing studies at the moment. This fact marks the need to design the Technical Guidelines for vaccination against SARS-CoV-2, in order to establish the technical provisions for health personnel of the National Integrated Health System in the processes of conservation, transport and application of the vaccine. to the target population

Relación de la caries dental y el índice de masa corporal en población infantil / Relationship between dental caries and body mass index in children

La nutrición y salud bucal son temas de interés en salud pública por su alto impacto en el bienestar y desarrollo de las personas. Existe una alta prevalencia e incidencia de caries y malnutrición en los primeros años de vida. Determinar la relación entre el índice de caries en dentición primaria y permanente e índice de masa corporal en niños de 5 a 11 años en las unidades de salud de San Miguel Tepezontes y Panchimalco en el año 2019. Investigación cuantitativa con una muestra de 265 niños de 5 a 11 años. Se evaluó el índice de masa corporal y el índice de caries; se hizo un análisis estadístico descriptivo e inferencial, realizando la prueba estadística de correlación de Spearman. Se encontró que el índice de caries es de 2,11 en dentición permanente con una prevalencia de 70,5 % y el índice de caries de 7,02 en dentición primaria con una prevalencia de un 94,98 %. El coeficiente de correlación de Spearman entre índice de masa corporal e índice de caries en dentición permanente fue de 0,226, que indica una correlación positiva baja y el índice de masa corporal e índice de caries en dentición primaria fue - 0,158, que indica una correlación negativa muy baja. Existe relación entre el índice de caries en ambas denticiones y el índice de masa corporal

Nutrition and oral health are topics of interest in public health due to their high impact on the well-being and development of people. There is a high prevalence and incidence of caries and malnutrition in the first years of life. To determine the relationship between the caries index in primary and permanent dentition and body mass index in children aged 5 to 11 years in the health units of San Miguel Tepezontes and Panchimalco in the year 2019. Quantitative research with a sample of 265 children from 5 to 11 years. Body mass index and caries index were evaluated; A descriptive and inferential statistical analysis was performed, performing the Spearman correlation statistical test. It was found that the caries index is 2.11 in permanent dentition with a prevalence of 70.5% and the caries index is 7.02 in primary dentition with a prevalence of 94.98%. Spearman's correlation coefficient between body mass index and caries index in permanent dentition was 0.226, indicating a low positive correlation, and body mass index and caries index in primary dentition was -0.158, indicating a negative correlation. very low. There is a relationship between the caries index in both dentitions and the body mass index

Lineamientos técnicos para la prevención y control de la rabia / Technical guidelines for the prevention and control of rabies

Los casos de rabia en animales no se registran en nuestro país desde el año 2018, pero es importante que el MINSAL continúe ejecutando acciones de promoción de salud y prevención de la enfermedad para lo cual contamos con documentación regulatoria relacionadas con la realización de las campañas de vacunación felina y canina con la participación intersectorial para mantener los logros alcanzados de cero casos de rabia en humanos en los últimos 13 años. Los presentes lineamientos técnicos establecen las directrices para que el abordaje integral al paciente expuesto al virus de la rabia, vigilancia epidemiológica y medida de prevención y control en los animales causantes de la exposición, para disminuir el riesgo de transmisión de rabia en la población

Cases of rabies in animals have not been registered in our country since 2018, but it is important that MINSAL continues to carry out health promotion and disease prevention actions, for which we have regulatory documentation related to carrying out rabies campaigns. feline and canine vaccination with intersectoral participation to maintain the achievements of zero cases of rabies in humans in the last 13 years. These technical guidelines establish the guidelines for a comprehensive approach to the patient exposed to the rabies virus, epidemiological surveillance and prevention and control measures in the animals causing the exposure, to reduce the risk of rabies transmission in the population

The post-organic cowboy: A biopolitical response of daily resistance to the dispossession of land in Meta (Colombia) / El vaquero post-orgánico: una respuesta biopolítica de resistencias cotidianas ante el despojo de tierras en el meta (colombia)

RESUMEN Con el objetivo de entender las dinámicas en las que se piensa e interviene el territorio para llevar a la población al desplazamiento y despojo vía armada o administrativa se efectuaron 87 entrevistas a líderes sociales entre 2019-2021 que permitieron realizar un análisis histórico de procesos asociados a la ocupación de tierras en el departamento del Meta, bajo la relación Monstruo-Monstruosidad asociada a la tecnología desde los métodos mecánicos del Estado y/o los métodos bioinformáticos del mercado". Los resultados exponen un territorio que inicia desde el cuerpo, como un espacio biopolítico y bioeconómico de confrontación. Lo anterior es analizado a través de las metáforas del vaquero-romántico, la devoradora-de-Hombres, la tierra-del-futuro y el vaquero-post-orgánico, exponiendo un pensamiento nómada con un espíritu de resistencia intelectual y de emancipación histórica. Se concluye que el carácter semiológico de la vida cotidiana con la tecnología permite el empoderamiento, la visibilización y la reconfiguración político-económica del territorio.

ABSTRACT In order to understand the dynamics in which the territory is thought of and interfered with, to lead to the displacement and dispossession of the population by armed or administrative means, 87 interviews with social leaders between 2019-2021 were carried out to allow for a historical analysis of processes associated with the occupation of lands in the department of Meta, under the Monster-Monstrosity relationship associated with technology from the mechanical methods of the State and / or the bioinformatics methods of the market. The results expose a territory that begins in the body, as a biopolitical and bioeconomic space of confrontation. The above is analyzed through the metaphors of the romantic cowboy, the man-eater, the land-of-the-future, and the post-organic cowboy, exposing a nomadic thought with a spirit of intellectual resistance and historical emancipation. It is concluded that the semiological character of daily life with technology allows for the empowerment, the visibility, and the political-economic reconfiguration of the territory

Gastrointestinal food allergy: Prevalence, characterization, and direct costs in a referral center in Bogotá / Alergia alimentaria gastrointestinal: prevalencia, caracterización y costos directos en un centro de remisión en Bogotá

Abstract Introduction: The prevalence and incidence of gastrointestinal food allergy has increased in recent years with high associated costs, but usually with a good prognosis; nonetheless, in Colombia, information is scarce. This study intends to describe demographic variables, symptomatology, clinical picture, nutritional status, management, and natural history of the disease, determine its prevalence in the Colombian pediatric population by age group, and describe its direct costs. Materials and methods: The study was conducted in three phases. In the first, we estimated the prevalence of the disease from the review of the RIPS and MIPRES databases between 2015 and 2019. Secondly, we checked the medical records selected per the inclusion and exclusion criteria for characterization and costs. Lastly, through a telephone survey, we asked about the current state of the disease and its resolution. Results: The estimated prevalence adjusted for underreporting was 0.04 % for the pediatric population and 0.148 % for those under five. The most frequent diagnoses were allergic proctocolitis (59.3 %) and secondary functional gastrointestinal disorders (13.9 %). The most frequent allergen was cow's milk protein. Early management is related to an excellent nutritional prognosis. Direct costs are mainly related to using formulas (92 %) and medical appointments (3.4 %); 89 % of parents consider that the food allergy will resolve over time. Conclusions: This retrospective study is the most extensive in Colombia, drawing local conclusions that may be compared with other countries.

Resumen Introducción: la prevalencia e incidencia de la alergia alimentaria gastrointestinal ha aumentado en los últimos años, con importantes costos asociados, pero usualmente de buen pronóstico; sin embargo, en Colombia la información es escasa. Los objetivos del presente estudio son describir variables demográficas, sintomatología, clínica, estado nutricional, manejo e historia natural de la enfermedad; conocer su prevalencia en la población pediátrica colombiana por grupo etario, y describir sus costos directos. Materiales y métodos: el estudio se desarrolló en 3 fases: en la primera, se estimó la prevalencia de la enfermedad a partir de la revisión de las bases RIPS y MIPRES de 2015 a 2019; en la segunda, se revisaron las historias clínicas seleccionadas por los criterios de inclusión y exclusión para caracterización y costos; y en la tercera, por medio de una encuesta telefónica se interrogó el estado actual de la enfermedad y su resolución. Resultados: la prevalencia estimada ajustada por subregistro fue de 0,04 % para la población pediátrica y de 0,148 % para los menores de 5 años. Los diagnósticos más frecuentes fueron proctocolitis alérgica (59,3 %) y trastornos gastrointestinales funcionales secundarios (13,9 %). El alérgeno más frecuente fue la proteína de leche de vaca. El manejo temprano está relacionado con buen pronóstico nutricional. Los costos directos se relacionan principalmente con el uso de fórmulas (92 %) y consultas médicas (3,4 %). El 89 % de los padres considera la resolución de la alergia a través del tiempo. Conclusiones: este es el estudio retrospectivo más grande en Colombia, lo que permite conclusiones locales que pueden ser comparadas con otros países.

Hábitos de vida durante la cuarentena por covid-19 en una muestra de la población colombiana / Lifestyle Habits during the Coronavirus Disease 2019 Quarantine in a Colombian Population Sample / Hábitos de vida duram a quarentena por covid-19 em uma amostra de indivíduos colombianos

Introducción: la cuarentena mundial decretada produjo cambios en los hábitos de la población. La investigación tuvo como objetivo identificar el efecto de la cuarentena en los hábitos de una muestra de sujetos colombianos. Materiales y métodos: se realizó un estudio transversal, observacional en 1928 sujetos mayores de edad, a través de una encuesta de Google Forms entre las semanas 9 y 10 de con-finamiento en Colombia. Se preguntó por: ejercicio físico, estado nutricional, estrés, ansiedad, miedo, consumo de tabaco y alcohol, y hábitos de sueño. Resultados: se reunieron datos de hombres y mujeres de 128 ciudades del país y todos los estratos socioeconómicos. La mayoría de los participantes tomaba clases virtuales (53.8 %) o estaba en teletrabajo (39.7 %). El 51.6 % de los sujetos reportaron no hacer o hacer menos de 150 minutos de ejercicio semanal; el 27.0 % de las personas estaban en sobrepeso u obesidad; el 37.5 % comió más saludable; el 56.1 % usaba más redes sociales, y el 72.6 % refirieron depresión, ansiedad y estrés. El antecedente patológico familiar predominante es la hipertensión arterial (53.2 %). Conclusión: aunque muchos de los sujetos encuestados han buscado mantenerse activos físicamente a través de ejercicio en casa, es importante generar de forma continua recomendaciones para mejorar su adherencia; además, se deben realizar campañas más agresivas usando las redes sociales, para compartir información sobre alimentación, descanso y salud mental. Es importante reducir el impacto de la cuarentena en el desarrollo de enfermedades crónicas no transmisibles más adelante.

Introduction: The worldwide quarantine led to several changes in the habits of the population. This research aimed to identify the effect of quarantine on the habits of a sample Colombian population. Materials and methods: A cross-sectional, observational study was conducted on 1928 participants through a Google survey form between weeks 9 and 10 of the quarantine in Colombia. Questions related to the following topics were included: physical exercise, nutritional status, stress, anxiety, fear, tobacco and alcohol consumption, and sleeping habits. Results: Data were collected from men and women from 128 Colombian cities belonging to all socio-economic strata. Most of the participants took virtual classes (53.8%) or teleworking (39.7%), 51.6% reported did not do or did <150 min of weekly activity; 27.0% were overweight or obese, 37.5% ate healthier, 56.1% used more social networks, and 72.6% reported depression, anxiety, and stress. The predominant familial pathological condition reported was arterial hypertension (53.2%). Conclusion: Although several participants sought to remain physically active through exercise at home, it is important to continuously generate recommendations to improve their adherence; further, more aggressive campaigns need to be performed using social media to share infor-mation about the importance of nutrition, rest, and mental health. It is crucial to reduce the effects of quarantine that may lead to chronic non-communicable diseases in future.

Introdução: a quarentena decretada mundialmente produziu mudanças nos hábitos da população. Esta pesquisa visa identificar o efeito da quarentena nos hábitos de uma amostra de sujeitos colombianos. Materiais e métodos: um estudo transversal e observacional foi realizado com 1928 indivíduos maiores de idade por meio de uma pesquisa usando o Google Forms entre as semanas 9-10 de confinamento na Colômbia. Foram feitas perguntas sobre: prática de exercícios físicos, estado nutricional, estresse, ansiedade, medo, consumo de tabaco e álcool e hábitos de sono. Resultados: foram coletados dados de homens e mulheres de 128 cidades do país e de todos os estratos socioeconômicos. A maioria dos parti-cipantes fez aulas virtuais (53,8%) ou teletrabalho (39,7%), 51,6% dos sujeitos relatam não fazer ou fazer menos de 150 minutos de exercício por semana, 27,0% das pessoas estão com sobrepeso ou obesidade, 37,5% se alimentam de forma mais saudável, 56,1% usam mais redes sociais e 72,6% relataram depres-são, ansiedade e estresse. O histórico patológico familiar predominante é a hipertensão arterial (53,2%). Conclusão: embora muitos dos sujeitos pesquisados tenham buscado se manter fisicamente ativos por meio da prática de exercícios em casa, é importante gerar continuamente recomendações para melhorar sua adesão, além disso, campanhas mais agressivas devem ser realizadas utilizando as redes sociais para compartilhar informações sobre alimentação, descanso e saúde mental. É importante reduzir o impacto da quarentena no desenvolvimento de doenças crônicas não transmissíveis posteriormente

Anthropometric Tomographic Study of the Hip in a Brazilian Regional Population / Estudo antropométrico tomográfico do quadril em uma população regional brasileira

Abstract Objective The present study aimed to determine the average hip anthropometry of a regional Brazilian population using measurements based on computerized axial tomography (CAT). Methods Retrospective, descriptive analysis of hip measurements from 200 abdominal CATs from patients visiting a medical center. The tests were selected at random to determine 30 previously defined anthropometric measurements. The data were statistically analyzed and compared according to gender and age. Results The prevalence of hip dysplasia was 6%. Signs suggesting femoroacetabular impingement were seen in 26% of cases. Patients over 50 years old presented significantly greater measures of horizontal acetabulum sectors, center-edge angle, and acetabular arch, as well as lower extrusion index, cervical-diaphyseal angle and vertical offset. Some measurements were significantly different according to gender: the lateral center-edge angle (µ » 35.5°) and the acetabular arch (µ » 68.7°) were higher in females. Males presented increased extrusion index (µ » 16%), lateral offset (µ » 38.3 mm), depth (µ » 19.5 mm), and neck diameter (µ » 26.4 mm). Conclusion The present study characterized the hip anthropometry of a regional Brazilian population. It also demonstrated significant morphological differences per age group and gender.

Resumo Objetivo Determinar a antropometria média do quadril de uma população regional brasileira através de medidas obtidas pela tomografia axial computadorizada (TAC). Método Análise analítico-descritiva, retrospectiva, de medidas coxofemorais de 200 TACs do abdômen de pacientes atendidos em um centro médico. Foram selecionados aleatoriamente exames que permitissem a aferição de 30 medidas antropométricas previamente definidas. Os dados foram estatisticamente analisados e comparados quanto a sexo e idade. Resultados A prevalência de displasia do quadril foi de 6%. Sinais sugestivos de impacto fêmoro-acetabular foramvistosem26% doscasos.A análise dos resultadosnogrupoacima de 50 anos demonstrou medidas significativamente maiores dos: setores horizontais do acetábulo,doângulocentro-bordaedoarcoacetabular,acompanhadosdemenoríndicede extrusão, ângulo cérvico-diafisário e offset vertical. Algumas medidas foram significativamente diferentes em função do sexo: o ângulo centro-borda lateral (µ» 35.5°) e o arco acetabular(µ» 68.7°)semostraram maioresnosexo feminino.Nogrupomasculino,foram maiores o índice de extrusão (µ» 16%), o offset lateral (µ» 38,3mm), a profundidade (µ» 19,5mm) e o diâmetro do colo (µ» 26,4mm). Conclusão O presente estudo caracterizou a antropometria do quadril de uma população brasileira. Demonstrou ainda diferenças morfológicas significativas do quadril entre diferentes faixas etárias e sexos.