Coronel (SM-M) Doctor Waldemar Vanini Perrone: segundo Director Técnico del Servicio de Sanidad Militar (1974 - 1978) / Colonel (SM-M) Dr. Waldemar Vanini Perrone: second Technical Director of the Military Health Service (1974 - 1978) / Coronel (SM-M) Dr. Waldemar Vanini Perrone: segundo Diretor Técnico do Serviço de Saúde Militar (1974 - 1978)

El 23 de diciembre de 1918 se creó por ley el Servicio de Sanidad del Ejército y la Armada, dependencia del Ministerio respectivo y remoto antecedente de la actual Dirección Nacional de Sanidad de las Fuerzas Armadas de Uruguay. Un Director General con título médico fue designado como jerarca del nuevo Servicio y presidente de su Consejo de Administración. Fue asimilado al grado militar acorde con su jerarquía administrativa: coronel. Mientras la dirección general estuvo a cargo de médicos, éstos fueron designados por ley como Directores Científicos de Sanidad Militar. El Director General Científico tuvo amplísimas atribuciones técnicas y administrativas: reglamentación de los servicios a crearse; representación de la institución; superintendencia técnica de todos los establecimientos; propuesta de nombramientos; asesoramiento del ministerio respectivo; remoción y propuesta de destituciones. El primer Director General de Sanidad fue el médico Francisco Fernández Enciso (1878-1925) quien ejerció el cargo entre 1918 y 1920. Y el último, el médico Guillermo Rodríguez Guerrero, entre 1948 y 1953. Desde entonces, y en forma definitiva, la dirección general quedó a cargo de militares de carrera, pero no médicos, asistidos de un Consejo Técnico Consultivo por médicos del hospital central. El 24 de abril de 1962, se insertó en la Orden del Servicio de Sanidad el nombramiento del coronel médico Hugo Brugnini como Subdirector del Servicio e Inspector General de Servicios de Sanidad. De acuerdo a esta documentación, la Subdirección Técnica del Servicio de Sanidad Militar se inició en 1962 y su primer titular fue el médico Hugo Brugnini. Desde entonces se han nombrado numerosos profesionales para ocupar el cargo de subdirección o lisa y llanamente dirección técnica. Quien sucedió al doctor Brugnini fue el coronel médico Waldemar Vanini, nacido en Montevideo el 16 de febrero de 1924 y fallecido en 1979 en la misma ciudad a la edad de 55 años.

Study on the current situation and influencing factors of job involvement for employed nurses in military hospital / 中华劳动卫生职业病杂志

Objective: To investigate the current situation of job involvement of nurses in military hospitals in Henan Province and analyze the influencing factors, so as to provide reference for improving the level of job involvement of military nurses. Methods: In February 2022, the employed nurses of 4 military hospitals in Henan Province were investigated by convenient sampling method. A total of 663 questionnaires were collected, including 632 valid questionnaires, with an effective recovery rate of 95.32%. The self-designed questionnaire was used to investigate the basic information of nurses, the Job Involvement Scale was used to investigate the job involvement of nurses, the Emotional Labor Scale for Nurses was used to investigate nurses' emotions, and the Work-Family Conflict Scale was used to investigate the work-family conflict of nurses. Independent sample t-test and univariate analysis of variance were used to compare the job involvement of military employed nurses with different demographic characteristics, Pearson correlation analysis was used to explore the correlation between emotional labor, work-family conflict and job involvement, and hierarchical regression analysis was used to explore the impact of relevant variables on the job involvement of military employed nurses. Results: The total average score of job involvement of military employed nurses was (3.68±1.13), and the scores of vitality, dedication and focus were (3.64±1.15), (3.74±1.25) and (3.67±1.21) respectively. The total score of emotional labor of nurses was 33-80 (62.95±8.12), with an average score of (3.93±0.51). The total score of work-family conflict was 18-94 (55.16±13.53), with an average score of (3.06±0.75). Professional emotional regulation, patient-centered emotional inhibition and standardized emotional play were positively related to the job involvement (r=0.46, 0.41, 0.22, P<0.01). Time-based conflict, stress-based conflict and behavior-based conflict had negative correlation with the job involvement (r=-0.12, -0.23, -0.20, P<0.01). In hierarchical regression analysis, after controlling demographic variables, emotional labor and work-family conflict accounted for 17.2% and 4.2% of the variation of job involvement. Conclusion: The job involvement of military employed nurses tends to be at a moderate level. Emotional labor and work-family conflict can significantly affect their job involvement.

El campo inglés / The English countryside / O campo inglês

This article is a historical research that focuses on the site where the National Directorate of Health of the Armed Forces, the Central Hospital, the General Directorate of Peripheral Care, the Supply Division and the Directorate of Architecture and Hospital Engineering are currently located. It has belonged to the Uruguayan State since its creation. During the decades of 1880 and 1890, it was given on loan to one of the oldest clubs in our country, the Montevideo Cricket Club. The first two soccer matches of which there are historical references took place there. Of those first years, there are no photographs of that area, but there is an oil painting made around 1930-34 by a member of the Cricket that until now the only thing that is known of the person is the name, A.W. Hall. Hall. This painting is currently located in the aforementioned clubhouse.

Este artigo é uma pesquisa histórica que se concentra no local onde se encontram atualmente a Diretoria Nacional de Saúde das Forças Armadas, o Hospital Central, a Diretoria Geral de Atenção Periférica, a Divisão de Abastecimento e a Diretoria de Arquitetura e Engenharia Hospitalar. Pertence ao Estado uruguaio desde sua criação. Durante os anos 1880 e 1890, ela foi emprestada a um dos clubes mais antigos de nosso país, o Montevideo Cricket Club. As duas primeiras partidas de futebol, das quais há referências históricas, aconteceram ali. Desde aqueles primeiros anos, não há fotografias desta área, mas há uma pintura a óleo feita por volta de 1930-34 por um membro do Cricket Club, cujo único nome conhecido é A.W. Hall. Salão. A pintura está atualmente alojada na sede do clube acima mencionado.

El presente artículo es una investigación histórica que tiene como eje el predio donde actualmente se erige la Dirección Nacional de Sanidad de las Fuerzas Armadas, Hospital Central, Dirección General de Atención Periférica, División Abastecimientos y Dirección de Arquitectura e Ingeniería Hospitalaria. El mismo pertenece al Estado Uruguayo desde su creación. Durante las décadas de 1880 y 1890, se entregó en comodato a uno de los clubes más antiguos de nuestro país, el Montevideo Cricket Club. En él se llevaron a cabo los dos primeros partidos de fútbol de los cuales se tienen referencias históricas. De esos primeros años, no existen fotografías de dicha área, sí, un óleo realizado alrededor de 1930-34 por un miembro del Cricket que hasta el momento lo único que se conoce de la persona es el nombre, A.W. Hall. Dicha pintura, se localiza actualmente en la sede del club mencionado.

Níveis séricos de antígeno prostático específico em pacientes de um hospital de Goiânia ­ GO / Serum levels of prostatic specific antigen in patients at a hospital in Goiânia ­ GO

O antígeno prostático específico (PSA) é o marcador mais importante para a detecção e monitoramento do câncer de próstata. Objetivo: O estudo objetivou analisar os dados laboratoriais e epidemiológicos do antígeno prostático específico de pacientes atendidos no Laboratório Clínico do Hospital do Policial Militar de Goiânia-GO (LC/HPM), considerando as medidas preventivas em relação ao câncer de próstata. Trata-se de um estudo retrospectivo baseado na análise de 1.249 prontuários de usuários do LC/HPM. O levantamento de dados laboratoriais e epidemiológicos, como idade, resultados do PSA total e PSA livre foi realizado por meio de um formulário padronizado pelos pesquisadores. Foram analisados 1.249 exames de PSA L/T, dos quais 58 (4,6%) apresentaram PSA total com resultados entre 4,0 e 10,0 ng/mL e 16 (1,3%) apresentaram concomitantemente valores de PSA total entre 4,0 e 10,0 ng/mL e relação PSA L/T < 25%. Os pacientes apresentaram faixa etária entre 34 e 93 anos, sendo a média 60 anos. Tornou-se evidente que tanto no ano de 2018 quanto em 2019, realizou-se um número maior de exames de PSA L/T, em comparação ao ano de 2020. O estudo revelou que 16 (1,3%) pacientes apresentaram risco aumentado para o desenvolvimento de neoplasia prostática, sendo observada uma diminuição do número de indivíduos que procuraram o LC/HPM para realização de exames de PSA livre e total no ano de 2020, quando comparado aos anos de 2019 e 2018, possivelmente em razão da pandemia de Covid-19, uma tendência global

Prostate-specific antigen (PSA) is the most important marker for the detection and monitoring of prostate cancer. This study aimed to analyse the epidemiological and laboratory data of prostate-specific antigen of patients treated at the Clinical Laboratory of the Military Police Hospital at Goiânia-GO (CL/MPH), considering preventive measures in relation to prostate cancer. Methods: This is a retrospective study with analysis of 1,249 medical records of CL/MPH users. The collection of epidemiological and laboratory data, such as age, total PSA and free PSA results, was performed using a form standardized by the researchers. We analyzed 1,249 PSA T/F tests, and of these, of which 58 (4.6%) total PSA sink with results between 4.0 and 10.0 ng/mL and 16 (1.3%) were concomitantly presenting total PSA values between 4.0 and 10.0 ng/mL and PSA T/F < 25%. The patients were aged between 34 and 93 years, with a mean age of 59 years. It became evident that both in 2018 and in 2019, there were a greater number of PSA T/F exams, compared to 2020. This study revealed that 16 (1.3%) patients were at increased risk for the development of prostate cancer, with a decrease in the number of individuals who sought the CL/MPH for free and total PSA tests in 2020, compared to 2019 and 2018, possibly due to Covid-19 pandemic, a global trend

Causes of death and post-mortem testing for SARS-CoV-2 in a tertiary hospital during the COVID-19 pandemic in Ghana

Background: Causes of death during the coronavirus disease 2019 (COVID-19) pandemic ranhttp://crossmark.crossref.org/dialog/?doi=10.4102/ajlm.v11i1.1766=pdf&date_stamp=2022-11-23ge from direct consequences of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection to deaths unrelated to SARS-CoV-2. Another feature of the pandemic is the post-mortem testing for SARS-CoV-2. Understanding these aspects of COVID-19 are essential in planning and limiting the impact of SARS-CoV-2 virus on healthcare systems. Objective: This study investigated the underlying causes of death and the presence of SARS-CoV-2 in bodies received at the 37 Military Hospital, Accra, Ghana, during the COVID-19 pandemic. Methods: The study was conducted from 4­27 May 2020. Deceased patients that met the inclusion criteria were prospectively selected during the expanded surveillance period for SARS-CoV-2 testing, autopsy and determination of underlying and immediate cause of death. Results: A total of 161 deceased patients were analysed with 53 autopsies. The overall positive test rate for SARS-CoV-2 was 14.9% (24/161 patients), with a positive rate of 5.0% (8/161 patients) for nasopharyngeal samples and 30.2% (16/161 patients) for bronchopulmonary samples. The underlying causes of death were not related to SARS-CoV-2 infection in 85.1% (137/161) of patients, SARS-CoV-2-associated 12.4% (20/161) and SARS-CoV-2-induced in 2.5% (4/161). Cardiovascular complications formed the most common cause of death in patients with or without SARS-CoV-2. Conclusion: There was a high positive rate of SARS-CoV-2 in post-mortem cases. However, most deaths were not caused by SARS-CoV-2 but by cardiovascular complications. The high rate of bronchopulmonary positive results for SARS-CoV-2 requires that autopsies be done in suspicious cases with negative nasopharyngeal sampling.

Estilos de vida y estado nutricional en el personal militar sanitario durante la COVID-19 / Lifestyles and nutritional status in military health personnel during COVID-19

Introducción: El personal militar sanitario posee características laborales y factores propios de la vida militar, que los predisponen a alterar sus estilos de vida, más aún con las medidas restrictivas que se establecen por la emergencia sanitaria de la COVID-19. Objetivo: Determinar la asociación entre los estilos de vida y el estado nutricional del personal militar sanitario. Métodos: El estudio fue transversal, la muestra estuvo conformada por 104 profesionales sanitarios militares que laboran en el Hospital Militar Central. Se aplicó el Cuestionario de Estilos de Vida de Arrivillaga, Salazar y Gómez; se pesó y talló a los sujetos, para obtener el índice de masa corporal, también se obtuvo la medida del perímetro abdominal, que indicó el riesgo cardiometabólico, se realizó el análisis descriptivo, bivariado (prueba de ji cuadrado) y multivariado para obtener razones de prevalencia. Resultados: Se evidenció asociación entre estilo de vida poco saludable con el índice de masa corporal (razón de prevalencia = 15,467; IC 95 por ciento: 2,228 - 107,357: p < 0,001) de igual manera cuando fue ajustado para las variables edad, sexo, profesión y grado militar (razón de prevalencia ajustado =18,515; IC 95 por ciento: 2,98 - 114,913: p < 0,001). Conclusiones: Se concluye que existe asociación entre el estilo de vida y el estado nutricional, determinado por el IMC y el PA en el personal militar sanitario estudiado(AU)

Introduction: Military health personnel have work characteristics and factors inherent to military life that predispose them to alter their lifestyles, even more so with the restrictive measures that were established by the health emergency of COVID-19. Objective: To determine the association between lifestyles and nutritional status of military health personnel. Methods: The study was cross-sectional, the sample consisted of 104 military health professionals who work in the Central Military Hospital. The Lifestyle Questionnaire of Arrivillaga, Salazar and Gómez was applied; subjects were weighed and carved to obtain the body mass index, the measurement of the abdominal perimeter was also obtained, which indicated the cardiometabolic risk, the descriptive, bivariate analysis (chi-square test) and multivariate analysis was performed to obtain prevalence ratio values. Results: The association between "unhealthy" lifestyle with the Body Mass Index (prevalence ratio = 15,467; 95 percent CI: 2,228-107,357: p < 0,001) was evidenced in the same way when it was adjusted for the variables age, sex, profession and military rank (adjusted prevalence ratio = 18,515; 95 percentCI: 2,98-114,913: p < 0,001). Conclusions: There is an association between lifestyle and nutritional status determined by body mass index and abdominal circumference in military health personnel(AU)

Sala de emergencias Bagdad. La evolución en la cirugía de control de daños / Baghdad ER. The evolution of damage control surgery

Las características de las heridas producidas en los atentados terroristas en varias ciudades del mundo y en los combates de las operaciones militares en Afganistán e Irak, han determinado un nuevo tipo de manejo de las lesiones por parte del personal medico involucrado. La categorización de las hemorragias, el nuevo esquema de atención prehospitalaria MARCH y la incorporación de la resucitación balanceada a la cirugía de control de daños, en un hospital de soporte en combate en Bagdad, representan parte del cambio. La retroalimentación entre la experiencia civil y militar ha permitido el progreso del tratamiento de los traumatismos. Los hospitales venezolanos han desarrollado su propia experiencia en el desarrollo de la cirugía de control de daños. Un nuevo tipo de ingresos en las emergencias capitalinas y la covid 19 señalan los nuevos desafíos a los que se enfrentan los cirujanos venezolanos(AU)

The large number of casualties produced as a result of terrorist attacks and the wars in Afghanistan and Iraq, stimulated the medical community to rethink the management of trauma. The categorization of the haemorrhages, the new mnemonic MARCH and the incorporation the balanced resuscitation in the damage control surgery, in a combat support hospital in Baghdad, represent a change. The feedback between the civil and military permitted the progress in the treatment of the injuries. The venezuelans hospitals development their experience in the damage control surgery. A new kind of injuries in the capital and the covid 19 indicate the news challenges for the surgeons(AU)

Hábito de fumar y comorbilidad en pacientes con enfermedad pulmonar obstructiva crónica / Smoking habit and comorbidity in patients with chronic obstructive pulmonary disease

RESUMEN Introducción: La enfermedad pulmonar obstructiva crónica constituye un problema de salud en Cuba y el mundo; su pronóstico está en relación con varios factores. Objetivo: Caracterizar a una serie de pacientes hospitalizados con enfermedad pulmonar obstructiva crónica, según edad, sexo, fenotipo, hábito de fumar y enfermedades comórbidas. Métodos: Se realizó un estudio descriptivo transversal que incluyó a los 296 pacientes que ingresaron en el Servicio de Medicina Interna del Hospital Militar Central "Dr. Carlos J. Finlay" con el diagnóstico de enfermedad pulmonar obstructiva crónica, en el período de dos años. Se determinaron las enfermedades comórbidas, el fenotipo dado por la forma clínica de presentación de los pacientes (A, B, C y D); la edad, sexo, hábito de fumar, tiempo y cantidad que fuma. Se utilizó el índice de comorbilidad de Charlson, para valorar la comorbilidad asociada en la enfermedad. Resultados: El 54 % de los pacientes fueron masculinos, el 96,9 % mayor de 50 años, el 36,1 % del fenotipo C y el 76,6 % fumadores. La hipertensión arterial fue más frecuente en los fenotipos B, C y D, en más del 70 %, la diabetes mellitus en el 73,7 % del fenotipo B y la cardiopatía isquémica en el 61,7 % del fenotipo D. Conclusiones: La mayoría de los pacientes estudiados fueron masculinos, mayores de 50 años, fumadores por más de 10 años y del fenotipo C. Las enfermedades comórbidas más frecuentes fueron la hipertensión arterial, la diabetes mellitus y la cardiopatía isquémica.

ABSTRACT Introduction: Chronic obstructive pulmonary disease constitutes a health problem in Cuba and the world, its prognosis is related to several factors. Objective: To characterize a series of hospitalized patients with chronic obstructive pulmonary disease, according to age, sex, phenotype, smoking habit and comorbid diseases. Method: A descriptive cross-sectional study was carried out that included the 296 patients who were admitted to the Internal Medicine Service of the Central Military Hospital Dr. Carlos J. Finlay with the diagnosis of chronic obstructive pulmonary disease in the period of two years. Comorbid diseases were determined, the phenotype given by the clinical presentation of the patients (A, B, C and D); age, sex, smoking habit, time and amount of smoking. The Charlson comorbidity index was used to assess the associated comorbidity in COPD. Results: 54% of the patients were male, 96,9% older than 50 years, 36,1% phenotype C, and 76,6% smokers. Hypertension was more frequent in phenotypes B, C and D, in more than 70%, diabetes mellitus in 73,7% of phenotype B, and ischemic heart disease in 61,7% of phenotype D. Conclusions: Most of the patients studied were male, older than 50 years, smokers for more than 10 years and phenotype C. The most frequent comorbid diseases were arterial hypertension, diabetes mellitus and ischemic heart disease.

Pacientes asintomáticos positivos a la COVID-19 / COVID-19 positive asymptomatic patients

Introducción: La COVID-19 es una enfermedad emergente de categoría pandémica. Las formas clínicas son variables y existe una elevada frecuencia de la forma asintomática. Objetivo: Describir las características clínicas y epidemiológicas en los pacientes de la COVID-19 asintomáticos. Métodos: Se realizó un estudio descriptivo, con todos los pacientes asintomáticos al ingreso, con diagnóstico confirmado, por la prueba de reacción en cadena de la polimerasa-transcriptasa inversa en tiempo real, para el SARS-CoV-2 en el Hospital Militar Dr. Fermín Valdés Domínguez, desde marzo hasta julio de 2020. Fueron estudiadas las variables expresividad clínica, proporción de asintomáticos, edad, sexo, antecedentes epidemiológicos y clínicos. Se utilizaron medidas de frecuencias. Resultados: El 41,8 por ciento de los pacientes permanecieron asintomáticos, predominó el grupo etario entre 20 y 39 años (33,3 por ciento) y el sexo femenino (55,6 por ciento). La fuente de infección más frecuente fue el contacto con caso confirmado (88,9 por ciento) y los municipios de mayor frecuencia fueron Holguín, Gibara y Banes. Los factores de riesgo clínico preponderante fueron: la condición de adulto mayor (20 por ciento) y la hipertensión arterial (17,8 por ciento). El 57, 8 por ciento de los pacientes no tenían comorbilidades. Conclusiones: Predominaron los adultos jóvenes, del sexo femenino, pertenecientes a los municipios Holguín, Gibara y Banes, con antecedentes epidemiológicos de ser contactos de casos confirmados. La condición adulto mayor y la hipertensión arterial fueron los factores de riesgo más frecuentes y la mayoría de los casos no presentaron comorbilidades(AU)

Introduction: COVID-19 is an emerging disease of pandemic category. The clinical forms are variable and the asymptomatic form has high frequency. Objective: To describe the clinical and epidemiological characteristics of COVID-19 positive and asymptomatic patients. Methods: A descriptive study was carried out, including all asymptomatic patients on admission, whit a confirmed diagnosis, by the real-time reverse transcriptase-polymerase chain reaction test for SARS-CoV-2 infection at Military Hospital Dr. Fermín Valdés Domínguez from March to July 2020. The variables age, sex, clinical expressiveness, clinical and epidemiological history were studied. Frequencies and percentage were used. Results: The 41,8 percent of the patients remained asymptomatic, the age group between 20 and 39 years (33,3 percent) and female sex predominated (55,6 percent). The most frequent source of infection was contact with confirmed case (88,9 percent) and the most frequent municipalities were Holguín, Gibara and Banes. Older adults and hypertension were most frequent clinical risk factors (20,0 and 57,8 percent respectively) and 57,8 percent of the patients had no comorbidities. Conclusions: Young adults predominated, female sex, from Holguín, Gibara and Banes municipalities with a history of being a contact confirmed case. Elderly condition and hypertension were the most frequent risk factors and most of the cases did not have comorbidities(AU)

Oficiais enfermeiros no hospital militar no ano de 1995 / Oficiales enfermeros en el hospital militar en el año de 1995 / Nursing officers at the military hospital in the year of 1995

Resumo Objetivo analisar a lotação e distribuição da primeira turma de oficiais enfermeiros, ao término do Curso de Formação de Oficiais, com a patente de 2º Tenente, no Hospital Central da Polícia Militar do Estado do Rio de Janeiro, em 1995. Método estudo histórico em fontes documentais escritas e orais produzidas por meio de 19 entrevistas, sendo 18 oficiais enfermeiros e um civil. Os conceitos de poder simbólico e capital de Pierre Bourdieu consubstanciaram a análise dos achados. Resultados a classificação obtida no curso de formação de oficiais e a experiência profissional, embora com menor peso, foram preponderantes na distribuição nos setores do hospital. Considerações finais e implicações para prática os critérios de antiguidade da vida militar influenciaram na configuração da equipe de enfermagem no hospital militar. Destaca-se que a ocupação das chefias pelos oficiais enfermeiros foi determinada pelo capital incorporado no estágio probatório, o qual foi institucionalizado pela patente.

Resumen Objetivo analizar la capacidad y la distribución de la primera clase de oficiales enfermeros al término del Curso de Formación de Oficiales, con el grado de 2º Teniente, en el Hospital Central da Polícia Militar do Estado do Rio de Janeiro, en 1995. Método estudio histórico en fuentes de documentos escritos y orales producidos a través de 19 entrevistas, 18 de las cuales fueron enfermeras y una civil. Los conceptos de poder simbólico y capital de Pierre Bourdieu fundamentaron el análisis de los hallazgos. Resultados la clasificación obtenida en el curso de formación para oficiales y la experiencia profesional predominaron en la distribución en los sectores hospitalarios, aunque con menor peso. Conclusión e implicaciones para práctica los criterios de antigüedad en la vida militar influyeron en la configuración del equipo de enfermería. Se destaca que la ocupación de los comandos por oficiales enfermeros fue determinada por el capital incorporado en la etapa probatoria, institucionalizada por el grado.

Abstract Objective to analyze the capacity and distribution of the first class of nurse officers, at the end of the Officer Training Course, with the rank of 2nd Lieutenant, at the Hospital Central da Polícia Militar of the State of Rio de Janeiro, in 1995. Method historical study in written and oral documentary sources produced through 19 interviews, of which 18 are nurse officers and one civilian. Pierre Bourdieu's concepts of symbolic power and capital substantiated the analysis of the findings. Results the classification obtained in the training course for officers and professional experience, although with less weight, were preponderant for the distribution in the hospital sectors. Final considerations and implications for practice the criteria of seniority in military life influenced the configuration of the nursing team at the military hospital. It is noteworthy that the occupation of the heads by the nurse officers was determined by the capital incorporated in the probationary period, which was institutionalized by the patent.

Design and Application of Perioperative Multi-center Data Center / 中国医疗器械杂志

Based on 18 hospitals including the Chinese People's Liberation Army General Hospital and Peking University People's Hospital, and based on the "Specifications for Perioperative Data", explore the construction and application of perioperative multi-center data centers in the era of medical big data. The use of data ferry technology avoids hidden safety hazards in hospitals, realizes the integration and sharing of perioperative medical data of various medical institutions, and forms a complete data chain combining patient medical data and follow-up data.

Infecciones bacterianas asociadas a la COVID-19 en pacientes de una unidad de cuidados intensivos / Bacterial infections associated with COVID-19 in patients of the Intensive Care Unit

Introducción: Los primeros informes de China sugirieron que la coinfección con otros patógenos en la COVID-19 era anómala, las últimas evidencias han demostrado que pueden aparecer otras infecciones, sobre todo en pacientes graves. Objetivo: Describir las infecciones bacterianas asociadas a la COVID-19, en pacientes de una unidad de cuidados intensivos. Métodos: Se realizó un estudio descriptivo en el período comprendido de marzo 24 a mayo 24 del año 2020, en la unidad de cuidados intensivos del Hospital Militar "Comandante Manuel Fajardo Rivero". La población de estudio estuvo constituida por 13 pacientes de 49 a 91 años, quienes permanecieron hospitalizados en esa sala, con diagnóstico confirmado, por la prueba de reacción en cadena de la transcriptasa inversa - polimerasa en tiempo real, para el SARS-CoV-2. Las variables de estudio fueron: edad, sexo, confección, antecedentes patológicos personales, estado al egreso, microorganismos aislados y susceptibilidad antimicrobiana. Resultados: El 61,5 por ciento de los pacientes fueron del sexo femenino, la edad media fue de 78,8 años, el 61,5 por ciento falleció y entre estos, el 44,4 por ciento presentó coinfección. El 66,7 por ciento y el 55,6 por ciento de los que padecían hipertensión arterial y cardiopatía isquémica respectivamente, desarrollaron una coinfección. La Escherichia coli fue el microorganismo que se aisló con mayor frecuencia. Conclusiones: En la serie estudiada predominaron las féminas, la mortalidad fue alta, se evidenció un porcentaje elevado de confección bacteriana y de comorbilidades. Más de la mitad de los pacientes falleció. Fueron las bacterias gramnegativas los microorganismos que más se aislaron. Los niveles de resistencia a los antimicrobianos fueron elevados(AU)

Introduction: The first reports from China suggested that coinfection with other pathogens in COVID-19 was abnormal, the latest evidence has shown that other infections may appear, especially in severe patients. Objective: To describe the bacterial infections associated with COVID-19, in patients in an intensive care unit. Methods: A descriptive study was carried out in the period from March 24 to May 24, 2020, in the intensive care unit of the Military Hospital "Comandante Manuel Fajardo Rivero". The study population consisted of 13 patients from 49 to 91 years, those who remained hospitalized in that room, with a confirmed diagnosis, by the real-time reverse transcriptase-polymerase chain reaction test for SARS-CoV-2. The study variables were: age, sex, clothing, personal pathological history, status at discharge, isolated microorganisms and antimicrobial susceptibility. Results: 61.5 percent of the patients were female, the mean age was 78.8 years, 61.5 percent died, and among these, 44.4 percent had coinfection. 66.7 percent and 55.6 percent of those with high blood pressure and ischemic heart disease, respectively, developed a coinfection. Escherichia coli was the most frequently isolated microorganism. Conclusions: Females predominated in the series studied, mortality was high, a high percentage of bacterial preparation and comorbidities was evident. More than half of the patients died. Gram-negative bacteria were the microorganisms that were most isolated. Antimicrobial resistance levels were high(AU)

Complicaciones de la COVID -19 en un paciente hipertenso / Complications of the COVID-19 in a hypertensive patient

Introducción: La rápida expansión de la COVID-19 hizo que la Organización Mundial de la Salud, el 30 de enero de 2020, la declarara emergencia sanitaria y la reconoció como pandemia el 11 de marzo del mismo año. Objetivo: Describir la evolución clínica de un paciente hipertenso, afectado por la COVID-19. Caso clínico: Se trata de un paciente de 49 años de edad, hipertenso, afectado por la COVID-19, atendido en el Hospital Militar Dr. "Joaquín Castillo Duany", quien durante su estancia en la unidad de cuidados intensivos, sufrió graves complicaciones tales como: síndrome de distrés respiratorio agudo, neumonía asociada a la ventilación artificial mecánica y tromboembolismo pulmonar. La demora en acudir al centro hospitalario, la hipertensión arterial y el tratamiento previo con inhibidores de la enzima convertidora de la angiotensina, figuraron entre las variables presentes en este paciente, las cuales incidieron posiblemente de manera negativa en su evolución. Conclusión: Con el tratamiento intensivo, la estrategia ventilatoria y de anticoagulación empleadas, evolucionó favorablemente hasta su egreso hospitalario(AU)

Introduction: The rapid expansion of COVID-19 caused the World Health Organization, on January 30, 2020, to declare it a health emergency and recognized it as a pandemic on March 11 of the same year. Objective: To describe the clinical evolution of a hypertensive patient, affected by COVID-19. Clinical case: This is a 49-year-old patient, hypertensive, affected by COVID-19, treated at the Dr. "Joaquín Castillo Duany" Military Hospital, who during his stay in the intensive care unit, suffered serious complications such as: acute respiratory distress syndrome, pneumonia associated with mechanical artificial ventilation, and pulmonary thromboembolism. The delay in going to the hospital, arterial hypertension, and previous treatment with angiotensin-converting enzyme inhibitors, were among the variables present in this patient, which possibly had a negative impact on his evolution. Conclusion: With intensive treatment, the ventilatory and anticoagulation strategy used, evolved favorably until his hospital discharge(AU)

An expectant role of Korean military hospital on impacted third molar research

No abstract available.

Factores asociados a fractura por estrés: estudio de casos y controles en un centro médico de la marina de guerra de Perú / Factors associated with stress fracture: a case-control study in a Peruvian navy medical center

INTRODUCCIÓN: Las fracturas por estrés son lesiones producidas por el sobreuso de ciertas extremidades, generando fatigas repetitivas en el hueso con insuficientes periodos de descanso, trastornos hormonales, entre otras. Se produce una elevada actividad osteoclástica y una menor actividad de los osteoblastos a nivel cortical. OBJETIVO: Determinar los factores asociados a fractura por estrés en un centro médico de la Marina de Guerra de Perú. METODOLOGÍA: Se realizó una investigación de tipo observacional analítica de casos y controles. La variable dependiente fue la fractura por estrés, confirmada por resonancia magnética de los pacientes. Las variables independientes fueron edad, sexo y nivel de calcemia tomadas a partir de la historia clínica; el nivel socioeconómico y tiempo de actividad física diaria fueron datos recogidos mediante encuesta. Se obtuvieron los Odds ratio crudos y ajustados con un intervalo de confianza de 95%. RESULTADOS: Se trabajó con un total de 238 pacientes (119 casos y 119 controles), de los cuales 79,8% fueron varones y 20,2% fueron mujeres; la media de edad fue de 20,25 años. En el análisis bivariado se encontró asociación de fracturas por estrés con el sexo masculino (Odds ratio: 3,00; intervalo de confianza 95%: 1,51 a 5,95), hipocalcemia (Odds ratio: 2,83; intervalo de confianza 95%: 2,32 a 3,44), más de dos horas de actividad física diaria (Odds ratio: 24,74; intervalo de confianza 95%: 12,51 a 48,95) y un nivel socioeconómico C (Odds ratio: 6,66; intervalo de confianza 95%: 2,82 a 15,74). Mantuvieron su asociación en el análisis multivariado el tiempo de actividad física (Odds ratio: 44,46; intervalo de confianza 95%: 17,93 a 110,22) y el nivel socioeconómico C (Odds ratio: 22,57; intervalo de confianza 95%: 7,03 a 72,74). CONCLUSIÓN: Las fracturas por estrés estuvieron asociadas al tiempo de actividad física y a un nivel socioeconómico menor. Son necesarios más estudios para evaluar la relación con otros factores en la población militar de Perú.

INTRODUCTION: Stress fractures are injuries produced by the overuse of certain extremities, generating repetitive fatigue in the bone with insufficient rest periods and hormonal disorders, among others. High osteoclastic activity and lower activity of the osteoblasts at the cortical level occurs. OBJECTIVE: To determine the factors associated with a stress fracture in a single medical center of the Peruvian navy. METHODS: We conducted an observational, analytical case-control study. The dependent variable was stress fracture confirmed by magnetic resonance imaging of the patients; the independent variables were age, sex, calcemia, socioeconomic status, and time of daily physical activity. All data were extracted from the medical records. Crude and adjusted odds ratios were calculated with 95% confidence intervals. RESULTS: The sample was comprised of 238 patients (119 cases and 119 controls), of which 79.8% were male, and 20.2% were female; the average age was 20.25. In the bivariate analysis, stress fractures were associated with male sex (odds ratio 3.00; 95% confidence interval 1.51 to 5.95), hypocalcemia (2.83; 2.32 to 3.44), more than two hours of daily physical activity (24.7; 12.51 to 48.95) and socioeconomic level C (6.66; 2.82 to 15.74). Time dedicated to physical activity (adjusted odds ratio 44.46; 95% confidence interval 17.93 to 110.22) and socioeconomic level C (adjusted odds ratio 22.57; 95% confidence interval 7.03 to 72.74) were associated in the multivariate analysis. CONCLUSION: We found that stress fractures were associated with physical activity time and a lower socioeconomic level. Further studies are needed to evaluate the relationship with other factors in the military population of Peru.

COVID-19 autopsies from the Ga-East municipal and the 37 military hospitals, Accra, Ghana

Introduction: Since the declaration of COVID-19 by the World Health Organisation (WHO) as a global pandemic on 11th March 2020, the number of deaths continue to increase worldwide. Reports on its pathologic manifestations have been published with very few from the Sub-Saharan African region. This article reports autopsies on COVID19 patients from the Ga-East and the 37 Military Hospitals to provide pathological evidence for better understanding of COVID-19 in Ghana. Methods: Under conditions required for carrying out autopsies on bodies infected with category three infectious agents, with few modifications, complete autopsies were performed on twenty patients with ante-mortem and/or postmortem RT -PCR confirmed positive COVID 19 results, between April and June ,2020. Results: There were equal proportion of males and females. Thirteen (65%) of the patients were 55years or older with the same percentage (65%) having Type II diabetes and/or hypertension. The most significant pathological feature found at autopsy was diffuse alveolar damage. Seventy per cent (14/20) had associated thromboemboli in the lungs, kidneys and the heart. Forty per cent (6/15) of the patients that had negative results for COVID-19 by the nasopharyngeal swab test before death had positive results during postmortem using bronchopulmonary specimen. At autopsy all patients were identified to have pre-existing medical conditions. Conclusion: Diffuse alveolar damage was a key pathological feature of deaths caused by COVID-19 in all cases studied with hypertension and diabetes mellitus being major risk factors. Individuals without co-morbidities were less likely to die or suffer severe disease from SARS-CoV-2

Utility of Hyperbaric Oxygen Therapy for Acute Acoustic Trauma: 20 years' Experience at the Japan Maritime Self-Defense Force Undersea Medical Center

Introduction: Acute acoustic trauma, which is a kind of sensorineural hearing loss, is caused by acoustic overstimulation. Hyperbaric oxygen therapy (HBOT) is reported to be effective against acute acoustic trauma. Objective: We aimed to evaluate the efficacy of HBOT against acoustic hearing loss based on our 20 years of experience with such cases. Methods: Patients who were treated with HBOT for acute acoustic trauma between April 1997 and August 2017 were evaluated in this study. Thirty-five patients with a mean age of 25.7 ± 9.2 (range: 16­48) years were included. Thirty-nine out of 70 ears (35 patients) were damaged. We investigated the initial level of hearing loss; the extent to which hearing recovered; subjective symptoms, such as tinnitus and aural fullness; and the treatment administered. Results: The planned HBOT was completed in 37 of 39 ears. Twenty-six of the 37 ears (70.2%) displayed improved hearing, and 31 of the 37 ears (83.9%) exhibited symptom improvement. Twenty-three (76.7%) and 26 (86.7%) of the 30 ears treated with steroids demonstrated improvements in hearing and subjective symptoms, respectively. Conclusion: A combination of HBOT and steroids should be considered as a treatment for acute acoustic trauma in cases involving symptoms such as tinnitus and aural fullness (AU)

Perfil do usuário e demanda protética do serviço de odontologia de uma Policlínica Militar / The profile of dental service users and demand for prosthetic care in a military polyclinic

Objetivou-se avaliar o perfil dos usuários e identificar os trabalhos protéticos realizados em um serviço odontológico de uma policlínica militar. Foram incluídos prontuários abertos durante os anos de 2014 a 2016 com indicação de tratamento no serviço de prótese dentaria. Foram coletados dados sócios-demográficos e informações referentes ao tipo de trabalho protético planejado, o status do tratamento, o número de consultas clínicas e informações relacionadas a satisfação do usuário frente ao tratamento realizado. Dados relativos ao Índice de Desenvolvimento Humano (IDH) das cidades cujos usuários residiam também foram analisados. A classificação de cada trabalho protético foi dada a partir da sua aplicabilidade. A amostra foi composta por 203 prontuários em que foram descritos 320 procedimentos protéticos. Destes prontuários avaliados, a maioria era de dependentes (34%), do sexo feminino (58,6%), casados (63,5%) com média de idade de 50 anos (±17,08). Em relação ao nível de escolaridade, a maior parte dos usuários (33,5%) tinha o 2º grau completo e era natural da região sudeste (80,8%). O município de Niterói, com IDH médio, era a residência de 47,3% da amostra (96 indivíduos). O principal motivo pela procura do atendimento protético foram as consultas de rotina (89,2%) e houve a conclusão dos trabalhos em 68,1% dos prontuários, predominando a prótese fixa seguida da prótese removível. Em relação a queixas durante o tratamento, em 71,9% dos prontuários não haviam relatos de pacientes insatisfeitos. O número médio de consultas para a realização dos procedimentos foi de 4 (±2,73), variando entre 1 e 15 consultas. Diante dos resultados deste estudo, pode-se concluir que a maioria dos usuários do serviço são dependentes, do sexo feminino, casados, com o 2º grau completo, com média de idade 50 anos, residentes na sua maioria em Niterói-RJ e em municípios com IDH médio e que receberam prótese fixa seguida pela prótese removível.

The aim of this study was to evaluate the profile of dental service users and to identify the prosthetic work performed at the Dentistry Division of the Military Polyclinic. Open charts were included during the years 2014 to 2016 with indication of treatment in the dental prosthesis service. Socio-demographic data and information regarding the type of planned prosthetic work, the status of the treatment, the number of clinical consultations and information related to the user's satisfaction with the treatment performed were collected. Data on the Human Development Index (HDI) of the cities whose users resided were also analyzed. The classification of each prosthetic work was given from its applicability. The sample consisted of 203 dental records in which 320 prosthetic procedures were described. Of these records, the majority were dependent (34%), female (58.6%), married (63.5%) and mean age 50 years (± 17.08). Regarding education level, the majority of users (33.5%) had a high school degree and were from the Southeast region (80.8%). The municipality of Niterói, with average HDI, was the residence of 47.3% of the sample (96 individuals). The main reason for the demand for prosthetic care was routine consultations (89.2%) and work was completed in 68.1% of the medical records, with fixed prosthesis predominating followed by removable prosthesis. Regarding complaints during treatment, there were no reports of dissatisfied patients in 71.9% of the records. The mean number of visits to the procedures was 4 (± 2.73), ranging from 1 to 15 visits. Considering the results of this study, it can be concluded that the majority of the users of the service are dependent, female, married, with a high school diploma, with a mean age of 50 years, residing mostly in Niterói-RJ and in municipalities with average HDI and who received fixed prosthesis followed by the removable prosthesis.

Relación clínico patológica en los servicios médicos militares, un logro para el sistema de salud cubano / Clinical-pathological relationship in military medical services, an achievement for the Cuban Health System

Recientemente fue publicado en su revista un artículo(1) en el que se realiza un acercamiento bibliométrico a la situación de las coincidencias y discrepancias diagnósticas de causas de muerte en los servicios médicos militares, donde se demuestra la calidad de la relación clínico-patológica en los hospitales militares cubanos. Llama la atención el estado de esta relación entre los hospitales civiles y no civiles. La media nacional es de una discrepancia cada cuatro autopsias. En dicha investigación,(1) se muestran de dos a tres diferencias diagnósticas cada cuatro fallecimientos en los hospitales civiles. Aunque estos datos no se deben establecer como un patrón estándar, sí se pueden considerar como una guía sobre el estado actual de la relación clínico-patológica en Cuba, sobre la que se debe actuar para mejorar los índices diagnósticos en la mortalidad hospitalaria(AU)