Impacto de la implementación de la estrategia multimodal de la OMS para mejorar la higiene de manos en una Unidad de Cuidados Intensivos / Impact on implementation of multimodal of World Health Organization strategies to improve hand hygiene in an Intensive Care Unit

INTRODUCCIÓN: La higiene de manos (HM) es la principal medida para disminuir las IAAS, las que en las Unidades de Cuidados Intensivos (UCI) presentan una alta prevalencia. En Chile no existe información sobre el impacto de la estrategia multimodal de la OMS para la HM en adultos. El objetivo fue evaluar el impacto de la implementación de la estrategia en una UPC. METODOLOGÍA: Estudio longitudinal con evaluación pre y post-intervención, entre los años 2018 y 2021, en la UCI del Hospital del Trabajador (HT), Santiago, Chile. La implementación se evaluó con pautas de cumplimiento de HM, consumo de jabón y productos en base alcohólica (PBA). El impacto se midió con las tasas de neumonía asociada a ventilación mecánica (NAVM), infecciones del torrente sanguíneo asociadas a CVC (ITS- CVC) y del tracto urinario por CUP (ITU-CUP), y la incidencia anual de dermatitis. RESULTADOS: El cumplimiento de pautas aumentó de 91 a 96% (p < 0,05). El consumo total de productos para la HM aumentó de 0,17 a 0,31 L/día/cama y de PBA en 10%. Las tasas de IAAS pre y post-intervención fueron para NAVM de 10,3 y 8,4; ITS-CVC de 0,8 y 1,5 e ITU-CUP de 4,2 y 5,3 por 1.000 días de exposición. La incidencia anual de dermatitis disminuyó en 30% (p < 0,05). CONCLUSIONES: La implementación de la estrategia multimodal se asoció a una disminución de las tasas de NAVM y de dermatitis en la UCI del HT.

INTRODUCTION: Hand hygiene is the main measure to decrease infections related to healthcare and the Intensive Care Unit has a high prevalence. In Chile there aren't reports about the impact of the World Health Organization multimodal hand hygiene improvement strategy. AIM: To assess the implementation impact of this strategy at the ICU. METHODOLOGY: Longitudinal study with pre- and postintervention evaluation during the years 2018-2021 at ICU. The implementation was assessed against hand hygiene compliance guidelines, soap consumption and alcohol-based products. The impact was evaluated with the rates of ventilator-associated pneumonia (VAP), catheter related bloodstream infection (CRBSI) and catheter associated urinary tract infection (CAUTI) and the annual dermatitis incidence. RESULTS: The guidelines compliance increased from 91% to 96% (p < 0.05). The total product consumption increased from 0.17 to 0.31 Liters/day/bed. The use of alcohol-based products increased by 10%. HAI rates pre- and post-intervention were for VAP 10.3 and 8.4, CRBSI 0.8 and 1.5 and CAUTI 4.2 and 5.3. The annual dermatitis incidence decreased by 30.8% (p < 0.05). CONCLUSIONS: The strategy implementation benefited the decrease of VAP and the dermatitis prevention in ICU.

The ICOPE-WHO and the IVCF-20: a critical view of the Handbook for Multidimensional Geriatric Assessment in Primary Care / O ICOPE-OMS e o IVCF-20: observações críticas sobre o Manual de Avaliação Multidimensional da Pessoa Idosa para a Atenção Primária à Saúde

O rápido envelhecimento populacional impulsiona iniciativas com o objetivo de otimizar a saúde da população idosa em todo o mundo. Recentemente, no Brasil, foi publicado pelo Conselho Nacional dos Secretários de Saúde (CONASS) o Manual de Avaliação Multidimensional da Pessoa Idosa, que propõe a adoção combinada e em larga escala da ferramenta de triagem do ICOPE da Organização Mundial da Saúde (OMS) e do instrumento Índice de Vulnerabilidade Clínico-Funcional-20 (IVCF-20) para definir linhas de cuidado à pessoa idosa. Embora iniciativas dessa natureza sejam prementes, os instrumentos propostos ainda não têm validação adequada na população brasileira, e a sua utilização com o objetivo de balizar diretrizes em saúde em todo o território nacional parece precipitada e arriscada. Diante disso, propõe-se um debate amplo e urgente entre os especialistas da área, com o objetivo de planejar políticas de saúde pública eficazes e seguras para a população idosa brasileira. (AU)

Rapid population aging is driving initiatives aimed at optimizing the health of older populations worldwide. In Brazil, the National Council of State Secretaries of Health (CONASS) recently published the Handbook for Multidimensional Geriatric Assessment in Primary Care, which proposes the combined, large-scale adoption of the World Health Organization (WHO) ICOPE screening tool and the Clinical-Functional Vulnerability Index-20 (IVCF-20) instrument to define care pathways for older people. Although there is a pressing need for initiatives of this nature, the proposed instruments have not yet been adequately validated in the Brazilian population, and their use for the purpose of establishing countrywide health guidelines appears hasty and risky. Therefore, we propose a broad, urgent debate among experts in the field with the aim of planning effective and safe public health policies for the Brazilian older population. (AU)

Interpretation of the 5th edition WHO classification of adrenal cortical tumors / 中华病理学杂志

Non-neoplastic lesions were added in the 5th edition WHO classification of adrenal cortical tumor based on the recent update, including adrenal rests, adrenal cysts, congenital adrenal hyperplasia and adrenocortical nodular disease. A range of tumor concepts were updated or refined based on tumor cell origin, histopathology, oncology and molecular biology. The most significant nomenclature change in the field of adrenal cortical pathology involves the refined classification of adrenal cortical nodular disease, which now includes sporadic nodular adrenocortical disease, bilateral micronodular adrenal cortical disease, and bilateral macronodular adrenal cortical disease. The 5th edition WHO classification endorses the nomenclature of the HISTALDO classification to help the classification of aldosterone producing adrenal cortical lesions, which uses CYP11B2 immunohistochemistry to identify functional sites of aldosterone production. The 5th edition WHO classification does not change the Weiss and Lin-Weiss-Bisceglia histopathologic criteria for diagnosing adrenal cortical carcinomas, and underscores the diagnostic and prognostic impact of angioinvasion in these tumors. Reticulin algorithm and Helsinki scoring system were added to assist the differential diagnosis of adrenal cortical neoplasms in adults. Pediatric adrenal cortical neoplasms are assessed using the Wieneke system. The 5th edition WHO classification places an emphasis on an accurate assessment of tumor proliferation rate using both the mitotic count (mitoses per 10 mm2) and Ki-67 labeling index which play an essential role in the dynamic risk stratification of affected patients. This review highlights advances in knowledge of histological features, ancillary studies, and associated genetic findings that increase the understanding of the adrenal cortex pathologies in the 5th edition WHO classification.

Interpretation of histiocytic/dendritic cell neoplasms and stromal-derived neoplasms of lymphoid tissues in the 5th edition of WHO classification of haematolymphoid tumors / 中华病理学杂志

The 5th edition of the World Health Organization classification of hematolymphoid tumors (WHO Blue Book) is soon to be published. Significant revisions have been made in the chapters on histiocytic/dendritic cell neoplasms and stroma-derived neoplasms of lymphoid tissues, leading to the reclassification and renaming of specific diseases. This article provides a concise interpretation and summary of these updates, highlighting the differences from the fourth edition. Pertinent changes from clinical pathological diagnosis to treatment and prognosis are explored, with an emphasis on recent advancements in molecular genetics. Newly introduced disease classifications are discussed, and the section on follicular dendritic cell sarcoma contributed by the author is detailed to assist readers in quickly understanding and assimilating the new classification standards.

Introduction on the update of the 5th edition WHO classifications of B-cell neoplasms / 中华病理学杂志

The 5th edition WHO classification of B-cell tumors is a systematic update to the fourth revised version of the classification. The changes include updated names of entities, sharpened diagnostic criteria, and upgrades from provisional to definite entities. This review focuses on the changes in the content of each chapter of B-cell tumors, facilitating domestic colleagues engaged in the diagnosis and treatment of lymphohematopoietic tumors to understand the latest progress and guide daily work.

Pay attention to the updates of 5th edition WHO classification of haematolymphoid tumours / 中华病理学杂志

Two review articles summarizing the fifth edition of the World Health Organization (WHO) classification of haematolymphoid tumours were officially published on Leukemia journal in 2022. This article briefly summarizes some important advances and changes in the fifth edition of WHO classification of haematolymphoid tumours, and describes how to apply the classification dialectically and reasonably in the daily practice of pathologists, so as to accurately guide clinical treatments.

Caminando hacia el final de la pandemia COVID-19: caso México / Moving towards the end of the COVID-19 pandemic: the case of Mexico

Introducción: se vive una crisis de confianza en la ciencia y una época de menosprecio a los conocimientos y evidencias. Las opiniones de los líderes políticos y otras figuras públicas ajenas a los problemas de salud tienen una mayor consideración y peso que los juicios emitidos por los expertos. Una evidencia que demuestra la debilidad de México en el campo de la salud son dos hechos en los cuales las autoridades del país son los culpables que son: la desaparición del Seguro Popular y la pobre respuesta a la pandemia de COVID-19. Conclusiones: la pandemia no termina por decreto, se logrará con cuidados y prevención realizada por el gobierno, instituciones y personal de salud y la sociedad (AU)

Introduction: we are living through a crisis of confidence in science and an era of disregard for knowledge and evidence. The opinions of political leaders and other public figures who are not involved in health problems are given greater consideration and weight than the judgments made by experts. Evidence that demonstrates Mexico's weakness in the field of health are two facts in which the country's authorities are to blame: the disappearance of Seguro Popular and the poor response to the COVID-19 pandemic. Conclusions: the pandemic does not end by decree, it will be achieved with care and prevention carried out by the government, health institutions and personnel and society (AU)

Noticias de suicidio en canales de televisión peruanos: evaluación del cumplimiento de las recomendaciones de la OMS para su notificación / Suicide news on peruvian television channels: evaluation of compliance with WHO's reporting recommendations

Objetivo. Determinar el cumplimiento a las recomendaciones de la Organización Mundial de la Salud (OMS) de las noticias sobre suicidio emitidas por canales de la televisión peruana. Materiales y métodos. Estudio cuantitativo y descriptivo. La unidad de análisis fueron las noticias de suicidio emitidas por ocho canales de televisión peruana durante los años 2020 y 2021. Las noticias se clasificaron en tres categorías: noticias sobre suicidio, intento de suicidio y prevención del suicidio. Se utilizó un instrumento de evaluación compuesto por las recomendaciones de la OMS. Resultados. Se analizaron un total de 126 noticias. Ninguna de estas noticias cumplió en su totalidad con las recomendaciones de la OMS. Las noticias sobre suicidio o intento de suicidio cumplieron con 4 de 13 recomendaciones, siendo la recomendación más acatada la de evitar publicar notas suicidas (97,4%), mientras que la menos cumplida fue la de instruir a la población sobre el suicidio y su prevención, y no difundir mitos (0,9%). Las noticias de prevención de suicidio cumplieron 5 de 7 recomendaciones. Conclusiones. Las noticias sobre suicidio emitidas en la televisión peruana en los años 2020 y 2021 mostraron un bajo cumplimiento a las recomendaciones de la OMS. Los profesionales de la comunicación tienen un rol fundamental en la prevención del suicidio, limitando la información sensible y difundiendo información de ayuda. Es fundamental el conocimiento de estas recomendaciones por los comunicadores, y el trabajo conjunto entre el equipo periodístico y los profesionales de la salud mental en la comunicación de noticias relacionadas con el suicidio.

Objective. To determine if suicide news reports broadcasted by Peruvian television channels comply with the World Health Organization (WHO) recommendations for reporting suicide news. Materials and methods. Quantitative and descriptive study. The unit of analysis was the suicide news broadcasted by eight Peruvian television channels during the years 2020 and 2021. News were classified into three categories: news about suicide, attempted suicide and suicide prevention. We used an evaluation instrument composed of WHO recommendations. Results. A total of 126 news reports were analyzed; but none of these complied fully with the WHO recommendations. The news reports on suicide or attempted suicide complied with 4 of 13 recommendations. Most reports complied with avoiding to publish suicide notes (97.4%); on the other hand, educating about suicide and its prevention, and not disseminating myths was the recommendation least complied with (0.9%). Suicide prevention news reports complied with 5 of 7 recommendations. Conclusions. Suicide news reports on Peruvian television in 2020 and 2021 showed low compliance with WHO recommendations. Communication professionals have a fundamental role in suicide prevention, limiting sensitive information and disseminating helpful information. It is essential for communicators to be aware of these recommendations and for the journalism team and mental health professionals to work together in the communication of news related to suicide.

Consenso SOCHOG/SOCHUMB: utilizar en Chile la curva estándar OMS ultrasonográfica de crecimiento fetal / SOCHOG/SOCHUMB consensus: OMS fetal ultrasound curve is the standard curve for ultrasound growth assessment to use in Chile

La Sociedad Chilena de Obstetricia y Ginecología (SOCHOG) y la Sociedad Chilena de Ultrasonido en Medicina y Biología (SOCHUMB) convocaron a un comité de expertos en el tema de ultrasonido y crecimiento fetal con el fin de proponer utilizar la curva fetal que mejor se adapte a la población chilena. Luego de la discusión, al no contar con curvas chilenas de crecimiento fetal, se concluye proponer que la curva estándar de la Organización Mundial de la Salud (OMS) sería la indicada dada la calidad de su metodología y por ser multicéntrica.

The Chilean Society of Obstetrics and Gynecology (SOCHOG) and the Chilean Society of Ultrasound in Medicine and Biology (SOCHUMB) have convened a committee of experts on the subject of ultrasound and fetal growth in order to propose using the fetal curve that best adapts to the Chilean population. After the discussion, since there are no Chilean fetal growth curves, it is concluded that the World Health Organization (WHO) standard curve would be the one to use given the quality of its methodology and the fact that it is multicentric.

¿Cuál es el periodo de infección de la variante ómicron del SARS-CoV-2?: síntesis rápida de evidencia / What is the infection period of the omicron variant of SARS-Cov-2?: rapid evidence synthesis

ANTECEDENTES Y OBJETIVO Tras 3 años de pandemia, la OMS ha declarado que el COVID-19 no constituye una Emergencia de Salud Pública de Importancia Internacional. En Chile, la Comisión Nacional de Respuesta Pandémica del Ministerio de Salud se ha propuesto reevaluar las medidas de aislamiento y las licencias laborales de casos positivos por COVID-19, para lo cual ha solicitado la presente Síntesis Rápida de Evidencia. METODOLOGÍA Se realizó una estrategia de búsqueda amplia en EMBASE y MEDLINE, a través de OVID, y una búsqueda específica en GOOGLE, sin filtrar por estudios primarios o secundarios. Se identificaron 2.128 referencias, de las cuales se incluyeron 3 estudios tras eliminar los duplicados y aplicar los criterios de inclusión y exclusión. Se utiliza la metodología de la certeza de evidencia GRADE. RESULTADOS Se describen normativas de 12 países - La variante ómicron tiene un periodo medio de contagio de 3,6 días, IC 95%: 3,5 a 6,6 días (certeza de la evidencia alta). - El 81% de los contagios ocurren antes del 5to día desde el inicio de síntomas (certeza de la evidencia alta). - No se identificó evidencia respecto al impacto del aislamiento obligatorio en la morbi-mortalidad asociada al COVID-19, en los estudios incluidos.

Autorregulación del aprendizaje y rendimiento académico en estudiantes de Medicina: el caso de tres Universidades de Paraguay / Self-regulation of learning and academic performance in medical students: The case of three Universities of Paraguay

Introducción: La autorregulación del aprendizaje se refiere a la modulación de los procesos afectivos, cognitivos y conductuales a lo largo de una experiencia de aprendizaje para alcanzar un nivel de logro deseado. Los estudiantes que tienen un mejor manejo de sus habilidades cognitivas y metacognitivas aprenden de una mejor forma que aquellos que no, por lo tanto, es fundamental estudiar a qué nivel los estudiantes universitarios son capaces de aprender a aprender y a ser gestores de su aprendizaje. Objetivos: Analizar la relación entre la autorregulación del aprendizaje y el rendimiento académico en estudiantes de la carrera medicina de tres universidades en el año 2022. Materiales y métodos: Esta investigación siguió un enfoque cuantitativo, el tipo de investigación fue observacional de tipo descriptivo. Se utilizó un instrumento previamente validado para identificar los tipos de autorregulación, la Autorregulación del Aprendizaje a partir de Textos (ARATEX-R). Resultados: No se encontró relación significativa entre el perfil académico de los estudiantes de medicina y el puntaje total del ARATEX-R. Al estudiar la relación entre las dimensiones de la autorregulación se encontró relación entre el rendimiento académico y la planificación y la gestión de la motivación, lo que implica que los que tienen mejores habilidades de planificación y que son capaces de gestionar su motivación tienen mejor rendimiento académico. Conclusión: Las principales dimensiones que caracterizan la autorregulación del aprendizaje en estudiantes de medicina fueron: gestión del contexto, gestión de la cognición y evaluación de la comprensión.

Introduction: Self-regulation of learning refers to the modulation of affective, cognitive and behavioral processes throughout a learning experience to reach a desired level of achievement. Students who have a better management of their cognitive and metacognitive skills learn in a better way than those who do not, therefore, it is essential to study at what level university students are capable of learning to learn and to be managers of their learning. Objectives: To analyze the relationship between self-regulation of learning and academic performance in medical students from three universities in the year 2022. Materials and methods: This research followed a quantitative approach; the type of research was observational and descriptive. A previously validated instrument was used to identify types of self-regulation, the Self-Regulation of Learning from Texts (ARATEX-R). Results: No significant relationship was found between the academic profile of medical students and the total ARATEX-R score. When studying the relationship between the dimensions of self-regulation, a relationship was found between academic performance and motivation planning and management, which implies that those who have better planning skills and who are able to manage their motivation have better academic performance. Conclusion: The main dimensions that characterize the self-regulation of learning in medical students were: context management, cognition management and comprehension evaluation.

Percentiles de peso, talla e índice de masa corporal de escolares de Mendoza. Comparación con la referencia de la Organización Mundial de la Salud / Body mass index, weight, and height percentiles in school-aged children from Mendoza. A comparison with the WHO reference

Introducción. La Organización Mundial de la Salud (OMS) recomienda el uso de tablas de referencia para monitorear el crecimiento y estado nutricional de niños, niñas y adolescentes. El peso corporal, la talla y el índice de masa corporal (IMC) son las variables más utilizadas. El presente trabajo tiene como objetivos estimar los percentiles de peso, talla e IMC de escolares (2009-2011) residentes en el departamento San Rafael (Mendoza) y compararlos con la referencia internacional de la Organización Mundial de la Salud, a fin de establecer su pertinencia para la evaluación del crecimiento y estado nutricional de dicha población. Población y métodos. Se realizó un estudio antropométrico transversal en 3448 escolares de entre 4,00 y 13,49 años de edad. Se utilizó el programa LMS ChartMarker Pro para calcular los valores percentilares de peso/edad, talla/edad e IMC/edad, por sexo y edad, y se compararon con las curvas de la OMS. Además, se calcularon diferencias porcentuales (D%) para estimar las diferencias y su significación estadística mediante prueba de Wilcoxon. Resultados. La población de San Rafael mostró, en varones y mujeres, valores percentilares superiores de peso e IMC (D% ≈7 % y 9 %, respectivamente), y menores de talla (D% ≈0,8 %) que los de la OMS (p <0,05). Conclusión. Las diferencias encontradas alertan sobre el empleo de la referencia OMS en la población escolar de San Rafael, ya que sobreestimaría las prevalencias de sobrepeso, obesidad y desnutrición crónica, y subestimaría la de desnutrición aguda y global. Esta situación resalta la importancia de contar con una referencia local.

Introduction. The World Health Organization (WHO) recommends the use of reference tables to monitor the growth pattern and nutritional status of children and adolescents. Body mass index (BMI), weight, and height are the most commonly used variables. The objective of this study was to estimate the BMI, weight, and height percentiles for school-aged children (2009-2011) living in the department of San Rafael (Mendoza) and compare them to the international World Health Organization reference to establish their relevance for the evaluation of the growth pattern and nutritional status of this population. Population and methods. A cross-sectional anthropometric study was conducted in 3448 school-aged children aged 4.00 to 13.49 years. The LMS ChartMarker Pro software was used to estimate the BMI- for-age, weight-for-age, and height-for-age percentiles, by sex and age, and they were compared with the WHO curves. Besides, percentage differences (%D) were calculated to estimate the differences and their statistical significance using the Wilcoxon test. Results. The population of boys and girls in San Rafael showed higher weight and BMI (%D ≈ 7% and 9%, respectively) percentiles, and lower height (%D ≈ 0.8%) values than WHO reference (p < 0.05). Conclusion. The differences found warn about the use of the WHO reference in the school-aged population of San Rafael since it would overestimate the prevalence of overweight, obesity, and chronic malnutrition and underestimate the prevalence of acute and global malnutrition. This situation highlights the importance of having a local reference resource

Variante mexicana de COVID-19: ómicron BW. 1 o Xibalbá / Mexican variant of COVID-19: omicron BW. 1 o Xibalbá

Introducción: desde la aparición del COVID-19 a principios de diciembre del año 2019, en la ciudad China de Wuhan, esta enfermedad respiratoria empezó a avanzar a nivel mundial. El 30 de enero de 2020, la Organización Mundial de la Salud declaró a esta enfermedad con carácter epidémico y como una situación de emergencia a nivel mundial. El propósito de este estudio es presentar información de la variante ómicron BW.1 o Xibalbá. Conclusión: México está en un proceso de transición de pandemia hacia endemia, pero no quiere decir que no seguirán apareciendo nuevas variantes como ocurrió en la quinta ola (ómicron BA.5) o con subvariantes que emergieron como BW.1 «Xibalbá¼, BQ.1 «perro del infierno¼ y XBB «pesadilla¼. La población y los gobiernos deberán continuar con las medidas preventivas establecidas desde el inicio de la pandemia como son el uso de cubrebocas, el correcto lavado de manos y de ropa, los hábitos de higiene, limpieza, desinfección personal y de nuestro entorno, el aislamiento precoz ante alguna sintomatología y la vacunación (ya sea la primera o sus refuerzos subsecuentes).(AU)

Introduction: since the appearance of COVID-19 in early December 2019 in the Chinese city of Wuhan, this respiratory disease began to spread worldwide. On the thirtieth of January of the year two thousand and twenty, the World Health Organization (WHO) declared this disease to be epidemic and with a worldwide emergency situation. The purpose of the study is to present information on the Omicron BW.1 or Xibalba variant. Conclusion: Mexico is in a process of transition from pandemic to endemic but this does not mean that new variants will not continue to appear as they did in the fifth wave (omicron BA.5) or subvariants that emerged such as: BW.1 or «Xibalbá¼, BQ.1 «hellhound¼ and XBB «nightmare¼. The population and governments should continue with the preventive measures established since the beginning of the pandemic, such as: use of masks, proper hand and clothing washing, hygiene habits, personal and environmental cleaning and disinfection, early isolation in case of any symptomatology, and vaccination, either first or subsequent boosters.(AU)

The epidemiological burden of reducing salt intake in Paraguay: A modeling study / A carga epidemiológica da redução do sal no Paraguai: um estudo de modelagem

ABSTRACT Objective This study aims to estimate the epidemiological burden of excessive salt intake reduction and achieve the World Health Organization salt reduction target for 2025 in Paraguay, in 2019. Methods We used the Preventable Risk Integrated Model, a comparative risk assessment macro-simulation model, to estimate the averted deaths, disease incidence, and disability-adjusted life years from cardiovascular disease attributable to salt intake in the population of Paraguay for different salt reduction policy scenarios. Results As a result, in Paraguay, excessive salt intake (over 5 g/day) is responsible for approximately 2,656 cardiovascular disease deaths (95% Uncertainty Interval: 1,250-3,765), 4,816 cardiovascular disease cases (95% UI: 2,251-6,947), and 60,529 disability-adjusted life years (95% UI: 27,828-86,258) per year. By reducing salt consumption by 30%, as recommended by the World Health Organization until 2025, approximately 1,188 deaths (95% UI: 520 to 1,820), 2,100 incident cases (95% UI: 923-3,234), and 27,272 disability-adjusted life years (95% UI: 11,999-41,675) from cardiovascular disease could be averted every year. Conclusion In conclusion, the burden of cardiovascular disease attributable to excessive salt intake is significant and salt reduction policies must become a priority in Paraguay.

RESUMO Objetivo Este estudo visa estimar a carga epidemiológica do consumo excessivo de sal e o alcance da meta da Organização Mundial de Saúde para 2025 no Paraguai, em 2019. Métodos Foi usado um modelo de avaliação comparativa de risco (Preventable Risk Integrated Model) para análise comparativa de risco para estimar mortes, casos incidentes e anos de vida ajustados por incapacidade (DALYs) por doenças cardiovasculares atribuíveis ao consumo excessivo de sal na população paraguaia em diferentes cenários. Resultados No Paraguai, o consumo excessivo de sal é responsável por aproximadamente 2.656 mortes (Intervalo de Incerteza 95%: 1.250-3.765), 4.816 casos incidentes (95% II: 2.251-6.947) e 60.529 DALYs (95% II: 27.828-86.258) por doenças cardiovasculares por ano. Com uma redução de 30% no consumo de sal, como recomendado pela Organização Mundial de Saúde até 2025, aproximadamente 1.188 mortes (95% II: 520-1.820), 2.100 casos incidentes (95% II: 923-3.234) e 27.272 DALYs (95% II: 11.999-41.675) por doenças cardiovasculares poderiam ser prevenidos ou adiados por ano. Conclusão Concluiu-se que a carga de doenças cardiovasculares atribuível ao consumo excessivo de sal no Paraguai é significante e políticas de redução deveriam ser priorizadas no país.

A transformation of trigeminal neuralgia into SUNCT/SUNA: A case report and literature review / Uma transformação da neuralgia do trigêmeo em SUNCT/SUNA: relato de caso e revisão da literatura

Introduction: Trigeminal neuralgia and Short-lasting Unilateral Neuralgiform Headache with Conjunctival injection and Tearing (SUNCT)/Short-lasting Unilateral Neuralgiform Headache Attacks with Cranial Autonomic Symptoms (SUNA) are characterized by similar clinical manifestations, which may lead to diagnostic confusion. However, the transformation of trigeminal neuralgia into SUNCT/SUNA is a rare phenomenon. This report describes a case of trigeminal neuralgia transformation into SUNCT/SUNA due to neurovascular compression and reviews all previously published cases of trigeminal neuralgia to SUNCT/SUNA transformation in the literature. Case presentation: A 49-year-old Thai male patient presented with progressive right facial pain for a period of three months. One year prior, he developed trigeminal neuralgia along the maxillary branch of the trigeminal nerve, characterized by electrical shock-like pain in the right upper molar, exacerbated by eating. His symptoms were effectively managed with carbamazepine. Nine months later, he began experiencing recurrent electrical shock-like pain along the ophthalmic division of the right trigeminal nerve, accompanied by lacrimation, which failed to respond to continued treatment with carbamazepine. Three months prior to presentation, his symptoms evolved into SUNCT/SUNA, characterized by electrical shock-like pain in the right periorbital area and conjunctival injection, lacrimation. Neuroimaging revealed high-grade neurovascular compression of the right trigeminal nerve by the right superior cerebellar artery. The patient's symptoms resolved following microvascular decompression. Conclusion: Clinicians should be aware that patients with longer disease duration of trigeminal neuralgia who develop new neuralgic pain in the ophthalmic branch division with mild autonomic symptoms may be at risk for transformation into SUNCT/SUNA.

Introduction: Trigeminal neuralgia and Short-lasting Unilateral Neuralgiform Headache with Conjunctival injection and Tearing (SUNCT)/Short-lasting Unilateral Neuralgiform Headache Attacks with Cranial Autonomic Symptoms (SUNA) are characterized by similar clinical manifestations, which may lead to diagnostic confusion. However, the transformation of trigeminal neuralgia into SUNCT/SUNA is a rare phenomenon. This report describes a case of trigeminal neuralgia transformation into SUNCT/SUNA due to neurovascular compression and reviews all previously published cases of trigeminal neuralgia to SUNCT/SUNA transformation in the literature. Case presentation: A 49-year-old Thai male patient presented with progressive right facial pain for a period of three months. One year prior, he developed trigeminal neuralgia along the maxillary branch of the trigeminal nerve, characterized by electrical shock-like pain in the right upper molar, exacerbated by eating. His symptoms were effectively managed with carbamazepine. Nine months later, he began experiencing recurrent electrical shock-like pain along the ophthalmic division of the right trigeminal nerve, accompanied by lacrimation, which failed to respond to continued treatment with carbamazepine. Three months prior to presentation, his symptoms evolved into SUNCT/SUNA, characterized by electrical shock-like pain in the right periorbital area and conjunctival injection, lacrimation. Neuroimaging revealed high-grade neurovascular compression of the right trigeminal nerve by the right superior cerebellar artery. The patient's symptoms resolved following microvascular decompression. Conclusion: Clinicians should be aware that patients with longer disease duration of trigeminal neuralgia who develop new neuralgic pain in the ophthalmic branch division with mild autonomic symptoms may be at risk for transformation into SUNCT/SUNA

Atendimento psicossocial à mulher que comete ofensa sexual / Psychosocial attention for women that commit sexual offenses / Atención psicosocial para mujeres que cometen delitos sexuales

Objetivamos apresentar uma proposta de atendimento psicossocial grupal oferecida para mulheres adultas que cometeram ofensa sexual, cuidadoras e mães. A experiência está sendo desenvolvida no Distrito Federal, Brasil, com pessoas do gênero feminino provenientes de encaminhamento judicial. Carece que os profissionais das áreas da justiça, saúde, serviço social e psicologia avancem no estudo e na compreensão desta temática, de modo a pensarem a atuação e o apoio terapêutico a essas mulheres. O modo de atendimento é focal e breve, com ênfase na criação de um ambiente lúdico como facilitador das interações grupais e da discussão sobre os temas: identidade; confiança nas relações afetivas e sociais; vivência pessoal com violência física e sexual; configuração de gênero; e expressão da sexualidade e futuro. A abordagem individual também se baseia no enfoque dos temas mencionados. O oferecimento de ajuda à mulher cuidadora ou à mãe tem participação ativa na interrupção do circuito abusivo sexual, pois essa violência é extremamente ocultada, ocasionando uma prolongada vulnerabilidade para as vítimas. Ressalta-se o valor do texto indicando a descrição de ação voltada para uma população permanentemente não estudada e evitada em seu reconhecimento. Os limites desta proposta encontram-se na falta de outras iniciativas que possibilitem uma discussão sobre essa experiência.(AU)

We aim to present a proposal of a group psychosocial intervention offered for adult female sexual offenders, caregivers, and mothers. The intervention is being developed at Federal District, Brazil, with female people coming from judicial referrals. Professionals in the areas of justice, health, social work, and psychology need to advance in the study and understanding this theme to think about action and therapeutic support for these women. The intervention is a focal and brief approach, with emphasis on the creation of a ludic environment as a facilitator of group interactions and discussion about the themes: identity; trust in affective and social relationships; personal experience with physical and sexual violence; gender configuration; and sexuality expression and future. The individual approach is also based on focusing on these themes. The offering of help to the female caregiver or the mother has an active participation in the interruption of the sexual offense circuit, since this violence is extremely hidden, bringing a prolonged condition of vulnerability to the victims. The value of this text is highlighted indicating the description of an action directed to a population that is permanently not studied and whose recognition is avoided. The limits of this proposal are found in the absence of other initiatives that would allow a discussion about this experience.(AU)

Este texto presenta una propuesta de atención psicosocial grupal destinada a mujeres adultas que han cometido delito sexual, a cuidadoras y madres. La intervención se está desarrollando en el Distrito Federal (Brasil), con personas del género femenino provenientes de remisiones judiciales. Es necesario que los profesionales de las áreas de justicia, salud, trabajo social y psicología avancen en el estudio y comprensión de esta temática para pensar en el desempeño y apoyo terapéutico de estas mujeres. El servicio es enfocado y breve, con énfasis en la creación de un ambiente lúdico como facilitador de interacciones grupales y discusión sobre los temas: identidad; confianza en las relaciones afectivas y sociales; experiencia personal con violencia física y sexual; configuración de género; y expresión de la sexualidad y el futuro. El enfoque individual también se centra en estos temas. La oferta de ayuda a la mujer cuidadora o a la madre es importante para la interrupción del circuito de abuso sexual, ya que esta violencia es extremadamente oculta y provoca una vulnerabilidad prolongada a las víctimas. Se destaca el valor del texto con la descripción de la acción dirigida a una población que no es objeto de estudios ni reconocida. Los límites de esta propuesta se encuentran en la ausencia de otras iniciativas que permitan un debate sobre esta experiencia.(AU)

Inter-University Network for Healthy Aging, Latin America and the Caribbean (RIES-LAC): a university contribution to the Decade of Healthy Aging / Rede interuniversitária para o envelhecimento saudável, América Latina e Caribe (RIES-ALC): uma contribuição universitária para a década do envelhecimento saudável / Red interuniversitaria de envejecimiento saludable, Latinoamérica y Caribe (RIES-LAC): un aporte universitario a la década del envejecimiento saludable

A população mundial está envelhecendo e a América Latina e o Caribe (ALC) não são exceção. Atualmente, 8% da população da ALC tem mais de 65 anos e prevê-se que esse número aumente para 30% até 2050. Sabe-se que o processo de envelhecimento envolve alterações moleculares, fisiológicas, funcionais, psicoafetivas e sociais. Todos envelhecemos, a questão é envelhecer com saúde. Como nem sempre é esse o caso, a Organização Mundial da Saúde (OMS) declarou esse período (2021-2030) como a Década do Envelhecimento Saudável. A Década é uma iniciativa global de colaboração de diferentes setores e partes interessadas (governos, sociedade civil, organizações internacionais, profissionais, instituições universitárias, meios de comunicação social e setor privado) para melhorar a vida de pessoas idosas, suas famílias e comunidades. A colaboração centra-se em quatro pilares de ação estreitamente interligados: mudar a forma como pensamos, sentimos e agimos em relação à idade e ao envelhecimento; garantir que as comunidades promovam as capacidades dos idosos; fornecer cuidados integrados e centrados nas pessoas e serviços de saúde primários que respondam às necessidades dos idosos; e fornecer acesso a cuidados de longo prazo para idosos que deles necessitem.

The world's population is aging, and the Latin America and the Caribbean (LAC) region is no exception. Currently, 8% of the LAC population is over 65 years old, and this number is estimated to increase to 30% by 2050. The aging process is known to involve molecular, physiological, functional, psychosocial, and social changes. We all age; the point is to age healthily. As this is not always the case, the World Health Organization (WHO) declared the period from 2021 to 2030 as the Decade of Healthy Aging. The Decade is a global collaboration involving diverse sectors and stakeholders (governments, civil society, international organizations, professionals, academic institutions, the media, and the private sector) to improve the lives of older people, their families, and communities. The collaboration is centered on four closely interconnected pillars of action: changing how we think, feel, and act towards age and aging; ensuring that communities foster the abilities of older people; providing person-centered integrated care and primary health services responsive to older people; and providing access to long-term care for older people who need it. In light of this situation, what can academics from universities in LAC do? If we organize ourselves and unite efforts, we can contribute to the Decade of Healthy Aging and, consequently, influence the quality of life of older people.

La población mundial está envejeciendo y Latinoamérica y Caribe (LAC) no son una excepción. Actualmente, el 8% de la población en LAC tiene sobre 65 años, y se proyecta un aumento al 30% para 2050. Es conocido que el proceso de envejecimiento implica cambios moleculares, fisiológicos, funcionales, psicoafectivos y sociales. Todos envejecemos, el punto es envejecer saludablemente. Como no siempre ocurre así, la Organización Mundial de la Salud(OMS) ha declarado a este período (2021­2030) como la Década del Envejecimiento Saludable. La Década es una iniciativa de colaboración mundial de distintos sectores y partes interesadas (gobiernos, sociedad civil, organizaciones internacionales, profesionales, instituciones universitarias, medios de comunicación y el sector privado) para mejorar la vida de las personas mayores, sus familias y comunidades. La colaboración se centra en cuatro pilares de actuación estrechamente interconectados: cambiar nuestra forma de pensar, sentir y actuar con respecto a la edad y el envejecimiento; asegurar que las comunidades fomenten las capacidades de las personas mayores; ofrecer una atención integrada y centrada en las personas, y servicios de salud primarios que respondan a las necesidades de las personas mayores; y proporcionar acceso a la atención a largo plazo para las personas mayores que lo necesiten.

Protecting healthcare workers during a pandemic: what can a WHO collaborating centre research partnership contribute? / Protección de los trabajadores de salud durante una pandemia: ¿qué puede aportar una alianza para la investigación entre centros colaboradores de la OMS? / Proteção dos trabalhadores da saúde em uma pandemia: qual seria a contribuição de uma parceria de pesquisa entre centros colaboradores da OMS?

ABSTRACT Objectives. To ascertain whether and how working as a partnership of two World Health Organization collaborating centres (WHOCCs), based respectively in the Global North and Global South, can add insights on "what works to protect healthcare workers (HCWs) during a pandemic, in what contexts, using what mechanism, to achieve what outcome". Methods. A realist synthesis of seven projects in this research program was carried out to characterize context (C) (including researcher positionality), mechanism (M) (including service relationships) and outcome (O) in each project. An assessment was then conducted of the role of the WHOCC partnership in each study and overall. Results. The research found that lower-resourced countries with higher economic disparity, including South Africa, incurred greater occupational health risk and had less acceptable measures to protect HCWs at the onset of the COVID-19 pandemic than higher-income more-equal counterpart countries. It showed that rigorously adopting occupational health measures can indeed protect the healthcare workforce; training and preventive initiatives can reduce workplace stress; information systems are valued; and HCWs most at-risk (including care aides in the Canadian setting) can be readily identified to trigger adoption of protective actions. The C-M-O analysis showed that various ways of working through a WHOCC partnership not only enabled knowledge sharing, but allowed for triangulating results and, ultimately, initiatives for worker protection. Conclusions. The value of an international partnership on a North-South axis especially lies in providing contextualized global evidence regarding protecting HCWs as a pandemic emerges, particularly with bi-directional cross-jurisdiction participation by researchers working with practitioners.

RESUMEN Objetivos. Determinar si la asociación de dos centros colaboradores de la Organización Mundial de la Salud, ubicados uno en el hemisferio norte y el otro en el hemisferio sur, puede aportar información sobre "qué es necesario para proteger a los trabajadores de salud durante una pandemia, en qué contextos, con qué mecanismos, con el objetivo de lograr qué resultados". Métodos. Se realizó una síntesis realista de siete proyectos en este programa de investigación para caracterizar el contexto (C) (incluida la posición del investigador), el mecanismo (M) (incluidas las relaciones de servicio) y el resultado (R) en cada proyecto. A continuación, se realizó una evaluación del papel que desempeñó la alianza de centros colaboradores de la OMS en términos generales y en cada estudio. Resultados. En la investigación se encontró que los países de escasos recursos con mayor disparidad económica, como Sudáfrica, incurrieron en un mayor riesgo para la salud ocupacional y tenían medidas menos aceptables para proteger a los trabajadores de salud al inicio de la pandemia de COVID-19 que los países homólogos de mayores ingresos y mayor equidad. Se de mostró que la adopción rigurosa de medidas de salud ocupacional puede proteger al personal de salud; la capacitación y las iniciativas preventivas pueden reducir el estrés en el lugar de trabajo; los sistemas de información se consideran valiosos; y los trabajadores de salud de mayor riesgo (como los asistentes de atención en el entorno canadiense) pueden identificarse con facilidad para la adopción de medidas de protección. El análisis de C-M-R mostró que las diferentes formas de trabajar por medio de una alianza de centros colaboradores de la OMS no solo facilitaron el intercambio de conocimientos, sino que además permitieron triangular los resultados y, en última instancia, las iniciativas para la protección de los trabajadores. Conclusiones. El valor de una alianza internacional radica especialmente en proporcionar evidencia mundial contextualizada sobre la protección de los trabajadores de salud cuando surge una situación de pandemia, particularmente con la participación bidireccional entre distintas jurisdicciones de investigadores que trabajan con el personal de salud.

RESUMO Objetivo. Determinar se, e como, o trabalho em parceria entre dois centros colaboradores da Organização Mundial da Saúde (OMS), localizados no Norte e no Sul global, pode contribuir com conhecimento sobre "o que é eficaz para proteger os trabalhadores da saúde em uma pandemia, em que contextos, com que mecanismos e para obter quais resultados". Métodos. Foi realizada uma síntese realista de sete projetos de pesquisa do programa da OMS para determinar o contexto (C) (incluindo a posicionalidade dos pesquisadores), o mecanismo (M) (incluindo as relações entre os serviços) e o resultado (O, do inglês outcome) de cada projeto e avaliar o papel da parceria entre os centros colaboradores em cada estudo e em geral. Resultados. Este estudo demonstrou que, nos países de baixa renda com maior desigualdade econômica (por exemplo, na África do Sul), o risco à saúde ocupacional foi maior e as medidas adotadas para proteger os trabalhadores da saúde na pandemia de COVID-19 foram menos adequadas em comparação ao observado em países comparáveis de alta renda com menor desigualdade. Verificou-se que a adoção rigorosa de medidas de saúde ocupacional efetivamente protege os trabalhadores da saúde, e que iniciativas de prevenção e capacitação dos profissionais reduzem o estresse no trabalho. Também se reconhece a importância dos sistemas de informação e que o pessoal com maior risco de exposição ao vírus (incluindo os cuidadores auxiliares, no caso do Canadá) pode ser prontamente identificado para que sejam adotadas medidas de proteção. A análise do tipo C-M-O indicou que as diferentes formas de trabalho em parceria entre os centros colaboradores possibilitaram não apenas dividir conhecimentos, mas também compartilhar resultados e, sobretudo, iniciativas para a proteção dos trabalhadores da saúde. Conclusões. A parceria internacional no eixo Norte-Sul é particularmente importante para obter evidências globais contextualizadas relativas à proteção dos trabalhadores da saúde em uma situação de pandemia, com a participação bidirecional entre foros de pesquisadores que trabalham com o pessoal da saúde.