Uso y complicaciones del cateterismo urinario en salas de cuidados moderados de un hospital universitario

Introducción: El cateterismo urinario es un procedimiento frecuente y en ocasiones es utilizado por fuera de las indicaciones aceptadas para el mismo. Esto aumenta el riesgo de complicaciones vinculadas a su uso, por lo que pueden ser prevenibles. El objetivo del estudio es conocer las características del uso de cateterismo urinario en pacientes ingresados en salas de cuidados moderados de un hospital universitario del tercer nivel de atención, determinar la frecuencia, duración e indicaciones más frecuentes, así como evaluar la presencia de complicaciones asociadas al mismo Metodología: Estudio de corte transversal, realizado en salas de cuidados moderados de un hospital terciario y universitario de Montevideo, Uruguay, el 21 de diciembre de 2022. Se incluyeron pacientes hospitalizados que presentaban o presentaron catéter vesical en la presente internación y se completó la recolección de variables mediante la revisión de la historia clínica. Resultados: De 155 pacientes ingresados en salas de cuidados moderados, a 26 (16,7%) les fue colocado un catéter urinario. La mediana de edad fue 61 años, 80% eran de sexo masculino. La mediana de internación fue de 22 días. En todos los pacientes se utilizó sonda vesical y el 54% fue colocado en el Departamento de Emergencia. En el 46% de los pacientes no se encontró indicación escrita de colocación en la historia clínica. En 50% de los casos no está especificado el motivo de indicación de sonda vesical, mientras que las indicaciones identificadas más frecuentes fueron el control de diuresis (27%) y la desobstrucción de vía urinaria baja (23%). La duración de cateterismo fue de una mediana de 13,5 días, mientras que el 27% de los pacientes la usaron más de 30 días. 35% de los pacientes presentaron complicaciones vinculadas a la sonda vesical, en su mayoría no infecciosas (27%) y 15% presentaron infección urinaria. Estos pacientes tuvieron una duración de cateterismo mayor a los que no presentaron complicaciones (23 vs 10 días, p=0,411). Conclusiones: El catéter vesical fue utilizado en un porcentaje no despreciable de pacientes ingresados en salas de cuidados moderados, de forma prolongada y frecuentemente sin indicación precisa, lo cual expone a un riesgo aumentado de complicaciones vinculadas.

Introduction: Urinary catheterization is a frequent procedure and is sometimes used outside of its accepted indications. This increases the risk of complications related to its use, so they may be preventable. The objective of this study is to know the characteristics of the use of urinary catheterization in patients admitted to moderate care wards of a tertiary care university hospital, to determine the frequency, duration and most frequent indications, as well as to evaluate the presence of associated complications. Methodology: Cross-sectional study, carried out in moderate care wards of a tertiary care and university hospital in Montevideo, Uruguay, on December 21, 2022. Hospitalized patients who present or presented a bladder catheter during the present hospitalization were included, and the collection of variables was completed by reviewing the medical history. Results: Of 155 patients admitted to moderate care wards, 26 (16.7%) had a urinary catheter placed. The median age was 61 years, 80% were male. The median hospitalization was 22 days. In all patients a bladder catheter was used and 54% were placed in the Emergency Department. In 46% of the patients, no written indication for placement was found in the clinical history. In 50% of cases, the reason for indicating the bladder catheter is not specified, while the most frequent indications identified were diuresis control (27%) and lower urinary tract obstruction (23%). The duration of catheterization was a median of 13.5 days, while 27% of the patients used it for more than 30 days. 35% of the patients presented complications related to the bladder catheter, mostly non-infectious (27%) and 15% presented urinary tract infection. These patients had a longer duration of catheterization than those without complications (23 vs 10 days, p=0,411). Conclusions: The bladder catheter was used in a non-negligible percentage of patients admitted to moderate care wards, for a long time and often without a precise indication, which exposes them to an increased risk of related complications.

Introdução: O cateterismo urinário é um procedimento frequente e às vezes é usado fora de suas indicações aceitas. Isso aumenta o risco de complicações relacionadas ao seu uso, portanto, podem ser evitáveis. O objetivo deste estudo é conhecer as características do uso do cateterismo urinário em pacientes internados em enfermarias de cuidados moderados de um hospital universitário terciário, determinar a frequência, duração e indicações mais frequentes, bem como avaliar a presença de complicações associadas ao mesmo. Metodologia: Estudo transversal, realizado em quartos de cuidados moderados de um hospital terciário e universitário em Montevidéu, Uruguai, em 21 de dezembro de 2022. Foram incluídos pacientes que apresentaram ou apresentaram sonda vesical durante a internação atual e a coleta de variáveis ​​foi concluída .revisando o histórico médico. Resultados: Dos 155 pacientes admitidos em enfermarias de cuidados moderados, 26 (16,7%) tiveram um cateter urinário colocado. A idade média foi de 61 anos, 80% eram do sexo masculino. A mediana de internação foi de 22 dias. Em todos os doentes foi utilizada sonda vesical e 54% foram internados no Serviço de Urgência. Em 46% dos pacientes, nenhuma indicação escrita para colocação foi encontrada na história clínica. Em 50% dos casos não é especificado o motivo da indicação da sonda vesical, enquanto as indicações mais frequentes identificadas foram controle da diurese (27%) e desobstrução do trato urinário inferior (23%). A duração do cateterismo foi em média de 13,5 dias, enquanto 27% dos pacientes o utilizaram por mais de 30 dias. 35% dos pacientes apresentaram complicações relacionadas ao cateter vesical, em sua maioria não infecciosas (27%) e 15% apresentaram infecção urinária. Esses pacientes tiveram uma duração mais longa de cateterismo do que aqueles sem complicações (23 vs 10 dias, p=0,411). Conclusões: A sonda vesical foi utilizada em percentual não desprezível de pacientes internados em quartos de cuidados moderados, por tempo prolongado e muitas vezes sem indicação precisa, o que os expõe a um risco aumentado de complicações associadas.

Epidemiological indicators and predictors of lethality associated with fungal infections in a NICU: a historical series

Abstract Objectives: Fungal infections (FI) pose a public health concern and significantly increase mortality rates, especially within Neonatal Intensive Care Units (NICU). Thus, this study aimed to investigate epidemiological indicators, risk factors, and lethality predictors associated with FI in a NICU. Methods: This study included 1,510 neonates admitted to the NICU of a reference hospital in Brazil between 2015 and 2022. Demographic data, such as sex, birth weight, gestational age, and use of invasive devices were analyzed. Results: Thirty neonates developed invasive FI, totaling 33 episodes and an incidence of 1.2 per 1,000 patient days. Candida albicans was the most frequent species (52.9 %), the bloodstream was the most affected site (78.9 %), and 72.7 % of infections occurred between 2015 and 2018. The lethality rate associated with FI was 33.3 %, and 90 % of deaths occurred within 30 days of diagnosis of infection. Weight < 750 g, prolonged hospital stay, use of parenteral nutrition, and broad-spectrum antimicrobials were independent risk factors for infection occurrence, especially glycopeptides and 4th generation cephalosporins, having a considerable role in the increase in fungal infections. Weight < 750 g was considered a significant predictor of lethality, and C. albicans had the highest lethality rate (40 %). Conclusion: These findings highlight the elevated lethality rate associated with these infections, reinforcing the importance of developing strategies to control FI within NICU.

Linezolid and vancomycin for nosocomial infections in pediatric patients: a systematic review

Abstract Objective: To investigate the effectiveness of linezolid and vancomycin for the treatment of nosocomial infections in children under 12 years old. Data sources: This is a systematic review in which five randomized clinical trials about the effectiveness of linezolid and vancomycin, involving a total of 429 children with nosocomial infections, were evaluated. They were searched in scientific databases: PubMed, Bvs, and SciELO. Summary of findings: The main nosocomial infections that affected children were bacteremia, skin, and soft tissue infections followed by nosocomial pneumonia. Most infections were caused by Gram-positive bacteria, which all studies showed infections caused by Staphylococcus aureus, with methicillin-resistant S. aureus (MRSA) and methicillin-resistant coagulase-negative staphylococci strains being isolated. Both linezolid and vancomycin showed high therapeutic efficacy against different types of nosocomial infections, ranging from 84.4% to 94% for linezolid and 76.9% to 90% for vancomycin. Patients receiving linezolid had lower rates of rash and red man syndrome compared to those receiving vancomycin. However, despite the adverse reactions, antimicrobials can be safely administered to children to treat nosocomial infections caused by resistant Gram-positive bacteria. Conclusion: Both linezolid and vancomycin showed good efficacy in the treatment of bacterial infections caused by resistant Gram-positive bacteria in hospitalized children. However, linezolid stands out regarding its pharmacological safety. Importantly, to strengthen this conclusion, further clinical trials are needed to provide additional evidence.

Risk factors for acute kidney injury in patients hospitalized with COVID-19 / Fatores de risco para lesão renal aguda em pacientes hospitalizados com COVID-19

Abstract Introduction: Acute kidney injury (AKI) occurs frequently in COVID-19 patients and is associated with greater morbidity and mortality. Knowing the risks of AKI allows for identification, prevention, and timely treatment. This study aimed to identify the risk factors associated with AKI in hospitalized patients. Methods: A descriptive, retrospective, cross-sectional, and analytical component study of adult patients hospitalized with COVID-19 from March 1 to December 31, 2020 was carried out. AKI was defined by the creatinine criteria of the KDIGO-AKI guidelines. Information, regarding risk factors, was obtained from electronic medical records. Results: Out of the 934 patients, 42.93% developed AKI, 60.59% KDIGO-1, and 9.9% required renal replacement therapy. Patients with AKI had longer hospital stay, higher mortality, and required more intensive care unit (ICU) admission, mechanical ventilation, and vasopressor support. Multivariate analysis showed that age (OR 1.03; 95% CI 1.02-1.04), male sex (OR 2.13; 95% CI 1.49-3.04), diabetes mellitus (DM) (OR 1.55; 95% CI 1.04-2.32), chronic kidney disease (CKD) (OR 2.07; 95% CI 1.06-4.04), C-reactive protein (CRP) (OR 1.02; 95% CI 1.00-1.03), ICU admission (OR 1.81; 95% CI 1.04-3.16), and vasopressor support (OR 7.46; 95% CI 3.34-16.64) were risk factors for AKI, and that bicarbonate (OR 0.89; 95% CI 0.84-0.94) and partial pressure arterial oxygen/inspired oxygen fraction index (OR 0.99; 95% CI 0.98-0.99) could be protective factors. Conclusions: A high frequency of AKI was documented in COVID-19 patients, with several predictors: age, male sex, DM, CKD, CRP, ICU admission, and vasopressor support. AKI occurred more frequently in patients with higher disease severity and was associated with higher mortality and worse outcomes.

RESUMO Introdução: Lesão renal aguda (LRA) ocorre frequentemente em pacientes com COVID-19 e associa-se a maior morbidade e mortalidade. Conhecer riscos da LRA permite a identificação, prevenção e tratamento oportuno. Este estudo teve como objetivo identificar fatores de risco associados à LRA em pacientes hospitalizados. Métodos: Realizou-se estudo descritivo, retrospectivo, transversal e de componente analítico de pacientes adultos hospitalizados com COVID-19 de 1º de março a 31 de dezembro, 2020. Definiu-se a LRA pelos critérios de creatinina das diretrizes KDIGO-LRA. Informações sobre fatores de risco foram obtidas de prontuários eletrônicos. Resultados: Dos 934 pacientes, 42,93% desenvolveram LRA, 60,59% KDIGO-1 e 9,9% necessitaram de terapia renal substitutiva. Pacientes com LRA apresentaram maior tempo de internação, maior mortalidade e necessitaram de mais internações em UTIs, ventilação mecânica e suporte vasopressor. A análise multivariada mostrou que idade (OR 1,03; IC 95% 1,02-1,04), sexo masculino (OR 2,13; IC 95% 1,49-3,04), diabetes mellitus (DM) (OR 1,55; IC 95% 1,04-2,32), doença renal crônica (DRC) (OR 2,07; IC 95% 1,06-4,04), proteína C reativa (PCR) (OR 1,02; IC 95% 1,00-1,03), admissão em UTI (OR 1,81; IC 95% 1,04-3,16) e suporte vasopressor (OR 7,46; IC 95% 3,34-16,64) foram fatores de risco para LRA, e que bicarbonato (OR 0,89; IC 95% 0,84-0,94) e índice de pressão parcial de oxigênio arterial/fração inspirada de oxigênio (OR 0,99; IC 95% 0,98-0,99) poderiam ser fatores de proteção. Conclusões: Documentou-se alta frequência de LRA em pacientes com COVID-19, com diversos preditores: idade, sexo masculino, DM, DRC, PCR, admissão em UTI e suporte vasopressor. LRA ocorreu mais frequentemente em pacientes com maior gravidade da doença e associou-se a maior mortalidade e piores desfechos.

Jovens cientistas: enfrentamento às arboviroses e participação juvenil no território / Young scientists: facing arboviruses and youth participation in the territory / Jóvenes investigadores: enfrentamiento a las arbovirosis y participación juvenil en el território

O estudo analisa uma formação em Iniciação Científica sobre arboviroses, a partir da percepção de jovens estudantes, em Ceilândia ­ Distrito Federal. Objetivo: compreender em que medida a Iniciação Científica mobiliza esses jovens a participarem de ações de vigilância e promoção da saúde no território, e entender sua motivação para participar do projeto. Metodologia: abrangeu-se a análise das redações escritas para a seleção ao Curso de Formação para Iniciação Científica na Educação Básica e as Arboviroses; a administração desse curso e; posteriormente, um grupo focal com estudantes para análise do processo educativo da Iniciação Científica que vivenciaram. Resultados: a análise de conteúdo evidenciou a percepção dos alunos sobre a Iniciação Científica, centrada em seis categorias analíticas: motivação dos alunos para Iniciação Científica; processo de formação do saber; formação de jovens cientistas; saúde e meio ambiente; participação e empoderamento juvenil e percepções acerca do Sistema Público de Saúde. Conclusão: o enfrentamento às arboviroses exige políticas e intervenções de amplo espectro, e a Iniciação Científica fortaleceu esses jovens estudantes enquanto sujeitos de direitos, ampliou sua percepção sobre ciência, saúde, relação com o ambiente, com o Sistema Único de Saúde e estimulou o interesse em ações preventivas no combate às arboviroses nesses territórios.

This study analyzes a Scientific Initiation (SI) program on arboviroses, from the perception of young high school students in Ceilândia ­ Distrito Federal. Objective: It aims to understand to what extent the SI mobilizes these young people to participate in surveillance and health promotion actions in the territory and understand their motivation to participate in this project. Methodology: The methodology included the analysis of the essays written for the selection to the Training Course for Scientific Initiation in Basic Education and the Arboviroses, the administration of this course, and later a focus group with students to analyze the SI educational process they experienced. Results: The result of the Content Analysis showed that the students' perception about the SI could be grouped into six categories: students' motivation for the scientific initiation; the learning process; the training of young scientists; health and environment; youth participation and empowerment, and perceptions of the Public health system in Brazil (SUS). Conclusion: Confronting arboviroses requires broad-spectrum policies and interventions, and the SI strengthened these young students as subjects of rights, broadened their perception of science, health, relationship with the environment, with the Sistema Único de Saúde and stimulated interest in preventive actions to combat arboviroses in these territories. Keywords: Health education; Arbovirus infections; Adolescents; Public health.

Analiza una formación en Iniciación Científica (IC) sobre arbovirus, desde la percepción de jóvenes estudiantes de secundaria en Ceilândia, Distrito Federal. Objetivo: el objetivo es comprender en qué medida la IC moviliza a estos jóvenes a participar en acciones de vigilancia y promoción de la salud en el territorio, así como entender su motivación para participar en proyectos de IC. Metodología: la metodología incluyó el análisis de las redacciones escritas para la selección al Curso de Formación para Iniciación Científica en Educación Básica y Arbovirus, la administración de este curso y, posteriormente, un grupo focal con los estudiantes para analizar el proceso educativo de IC que vivieron. Resultados: los resultados del Análisis de Contenido mostraron la percepción de los estudiantes sobre la IC enfocada en seis categorías analíticas: motivación de los estudiantes por la iniciación científica; proceso de formación de conocimientos; formación de jóvenes científicos; salud y medio ambiente; participación y empoderamiento de los jóvenes y percepciones sobre el Sistema Público de Salud (SUS). Conclusiones: Enfrentar los arbovirus requiere políticas e intervenciones de amplio espectro, y la IC fortaleció a estos jóvenes estudiantes como sujetos de derechos, ampliando su percepción sobre ciencia, salud, relación con el entorno, con el Sistema Único de Salud y estimuló el interés en acciones preventivas en la lucha contra los arbovirus en estos territorios.

Compromiso inmunológico en pacientes con síndrome de Down. Serie de casos / Immune compromise in patients with Down syndrome. A case series

El síndrome de Down, o trisomía 21, tiene una mortalidad mayor que la población general, debido principalmente a infecciones respiratorias. El objetivo de este trabajo es describir el compromiso inmunológico en una serie de casos de pacientes con síndrome de Down derivados a Inmunología por infecciones recurrentes o por hallazgo patológico de laboratorio, entre el 1 de junio de 2016 y el 31 de mayo de 2022. Se describe el compromiso de la inmunidad en 24 pacientes. Doce pacientes presentaron falla de respuesta a polisacáridos y recibieron quimioprofilaxis antibiótica y/o gammaglobulina sustitutiva. En 3 pacientes, se observó agammaglobulinemia con linfocitos B presentes y se indicó gammaglobulina sustitutiva. En 9 pacientes, se observó linfopenia T y en 1 paciente, compromiso inmune combinado.

Down syndrome, or trisomy 21, has a higher mortality than the general population, mainly due to respiratory tract infections. The objective of this study was to describe immune compromise in a series of cases of patients with Down syndrome referred to the Pediatric Immunology Section due to recurrent infections or pathological laboratory findings between 6/1/2016 and 5/31/2022. Here we describe immune compromise in 24 patients. Twelve patients failed to develop a polysaccharide response and received antibiotic chemoprophylaxis, or gamma globulin replacement therapy. Three patientsdeveloped agammaglobulinemia with presence of B cells and gamma globulin replacement therapy was indicated. Nine patients had T-cell lymphopenia and 1 patient, combined immune compromise.

Incidência de sífilis no estado do Rio de Janeiro e nomunicípio de Seropédica nos anos de 2010 a 2022 / Incidence of syphilis in the state of Rio de Janeiro andmunicipality of Seropédica in the years 2010 to 2022

Sífilis é uma infecção sexualmente transmissível (IST) que sinaliza a necessidade de efetivas políticas públicas devido ao aumento de casos na última década. Dessa forma, o objetivo do trabalho é descrever a incidência de sífilis no estado do Rio de Janeiro e no município de Seropédica. Métodos: foi realizado um estudo descritivo, com abordagem quantitativa. A coleta dos dados foi realizada por meio do Sistema de Informação de Agravos de Notificação (Sinan), referentes ao município de Seropédica e ao estado do Rio de Janeiro, no período de 2010 a 2022. Resultados: foram identificados 105.138, 79.609 e 42.819 casos de sífilis adquirida, em gestantes e congênita, respectivamente, no estado do Rio de Janeiro e 187, 140 e 79 casos de sífilis adquirida, em gestantes e congênita, respectivamente, no município de Seropédica. Foi observado uma incidência maior para sífilis adquirida entre homens em comparação com mulheres tanto no estado do Rio de Janeiro (62.719 versus 42.346) quanto no município de Seropédica (110 versus 77). Houve um aumento nas taxas de incidência de sífilis no estado do Rio de Janeiro e no município de Seropédica ao longo dos anos. Conclusão: a sífilis segue sendo uma doença com alta incidência no território do Rio de Janeiro. Nesse sentido, é importante elaborar estratégias em saúde pública mais efetivas às pessoas acometidas por tal infecção.

Syphilis is a sexually transmitted infection (STI) that signals the need for effective public policies due to the increase in cases in the last decade. Thus, the aim of this study is to describe the incidence of syphilis in the state of Rio de Janeiro and in the municipality of Seropédica. Methods: a descriptive study with a quantitative approach was carried out. Data collection was performed through the Sistema de Informação de Agravos de Notificação (Sinan), referring to the municipality of Seropédica and the state of Rio de Janeiro, from 2010 to 2022. Results: overall, 105.138, 79.609 and 42.819 cases of acquired syphilis, in pregnant women, and congenital syphilis, respectively, were identified in the state of Rio de Janeiro, and 187, 140, and 79 cases of acquired syphilis, in pregnant women, and congenital syphilis, respectively, were identified in the municipality of Seropédica. A higher incidence of acquired syphilis was observed among men compared to women both in the state of Rio de Janeiro (62.719 versus 42.346) and in the municipality of Seropédica (110 versus 77). There has been an increase in the incidence rates of syphilis in the state of Rio de Janeiro and the municipality of Seropédica over the years. Conclusion: syphilis continues to be a disease with a high incidence in the territory of Rio de Janeiro. In this sense, it is important to develop more effective public health strategies for people affected by this infection.

Estresse percebido e sofrimento psíquico em gestoresde saúde na pandemia da Covid-19 / Perceived stress and psychic suffering in healthmanagers in the Covid-19 pandemic

Objetivo: analisar o nível de estresse percebido e sofrimento psíquico em gestores de saúde na pandemia da Covid-19. Método: estudo descritivo, transversal com abordagem quantitativa. A coleta ocorreu de abril a setembro de 2021, com 40 gestores de serviço de saúde. Utilizou-se para a coleta de dados um instrumento para caracterização sociodemográfica e ocupacional e as escalas "Perceived Stress Scale-14" e "Self Reporting Questionnaire" para avaliação do estresse percebido e sofrimento psíquico. Os dados coletados foram analisados no Statistical Package for the Social Sciences versão 22.0. O presente estudo faz parte de um projeto intitulado "Trabalhadores dos Serviços de Saúde Frente à Pandemia de Covid-19", aprovado pelo Comitê de Ética em Pesquisa sob CAAE número 35260620.9.0000.5231. Resultados: a maioria dos profissionais eram do sexo feminino (90%, N=36), casados (70%, N=28), com filhos (80%, N=32), com média de idade de 45 anos e com pós--graduação (47,5%, N=19). A média dos escores relacionados ao estresse percebido foi 31,13 pontos (DP=3,77) sendo o mínimo 24 e máximo de 42 pontos. Com relação ao sofrimento psíquico, (40%, N=16) os gestores apresentaram prováveis casos de transtornos. A prática de atividades físicas e de lazer (p<0,05) tem papel importante na diminuição do estresse percebido e do sofrimento psíquico. Conclusão: os gestores em saúde apresentaram, durante a pandemia, estresse e sofrimento psíquico, resultados esses que devem ser considerados para promoção de autocuidado aos gestores de saúde, enfatizando a necessidade da realização de atividades físicas e de lazer.

Objective: to analyze the level of perceived stress and psychological suffering in health managers during the Covid-19 pandemic. Method: descriptive, cross-sectional study with a quantitative approach. The collection took place from April to September 2021, with 40 health service managers. An instrument for socio-demographic and occupational characterization and the "Perceived Stress Scale-14" and "Self Reporting Questionnaire" scales were used for the assessment of perceived stress and psychic suffering. The collected data were analyzed using the Statistical Package for the Social Sciences version 22.0. The present study is part of a project entitled "Health Service Workers in the Face of the Covid-19 Pandemic", approved by the Research Ethics Committee under CAAE number 35260620.9.0000.5231. Results: most professionals were female (90%, N=36), married (70%, N=28), with children (80%, N=32), with a mean age of 45 years and with a postgraduate degree. -graduation (47.5%, N=19). The average score related to perceived stress was 31.13 points (SD=3.77), with a minimum of 24 and a maximum of 42 points. With regard to psychic suffering, (40%, N=16) the managers presented probable cases of disorders. The practice of physical and leisure activities (p<0.05) plays an important role in reducing perceived stress and psychological distress. Conclusion: health managers presented, during the pandemic, stress and psychic suffering, results that should be considered for promoting self-care to health managers, emphasizing the need to carry out physical and leisure activities.Keywords: Health manager; Occupational stress; Covid-19; Coronavirus infections.

Comparative analysis of the incidence of enteroparasitosis andthe COVID-19 pandemic profile in the city of Bananeiras - PB / Análise comparativa da incidência de enteroparasitoses e doperfil pandêmico da COVID-19 na cidade de Bananeiras - PB

Enteroparasitosis are diseases caused by parasitic agents present in the environment and in the gastrointestinal tract of living beings. In addition, they are still considered neglected diseases, but of great importance for public health, especially when they are related to secondary infections and currently their co-infection profile with COVID-19. The interaction of protozoa and/or helminths with the SARS-CoV-2 virus is timely and its signs and symptoms are confused with other pathogen relationships. In this way, this study aims to correlate the incidence of enteroparasitosis and COVID-19, in the pandemic period from 2020 to April 2022. This is a documentary and exploratory study of secondary data from laboratory tests of patients who were treated and diagnosed with COVID-19 and enteroparasitosis at Hospital Doutor Cloves Bezerra Cavalcante, Municipal Hospital of Bananeiras, Paraíba, Brazil. In the analysis of the database, a significant increase of approximately 48.85% in the incidence of COVID-19 cases from 2020 to 2021 stands out, remaining high until 2022. In contrast, cases of enteroparasites peaked at 48.74% in 2021, followed by an average reduction of 23.12%, with a deviation of 1.49%, in relation to the years 2020 and 2022. It was concluded that COVID-19 is predominantly associated with an increase in secondary infections, highlighting the crucial need to promote health education, improve basic sanitation and guarantee access to health services as essential components in combating the increase in parasitic infections, especially those related to viral pathologies.

As enteroparasitoses são enfermidades originadas por agentes parasitários presentes no meio ambiente e no trato gastrointestinal dos seres vivos. Ademais, ainda são consideradas doenças negligenciadas, porém de grande importância para a saúde pública, em especial, quando estão relacionadas com infecções secundárias e atualmente seu perfil de coinfecção com a COVID-19. A interação de protozoários e/ou helmintos com o vírus SARS-CoV-2 é oportuna e seus sinais e sintomas são confundidos com outras relações de patógenos. Desta maneira, este estudo visa correlacionar a incidência de enteroparasitoses e COVID-19, no período pandêmico de 2020 a abril de 2022. Trata--se de uma pesquisa documental e exploratória, de dados secundários dos exames laboratoriais de pacientes que foram atendidos e diagnosticados com COVID-19 e enteroparasitoses no Hospital Doutor Cloves Bezerra Cavalcante, Hospital Municipal de Bananeiras, Paraíba, Brasil. Na análise da base de dados, destaca-se um aumento significativo de aproximadamente 48,85% na incidência de casos de COVID-19 de 2020 a 2021, mantendo-se elevado até 2022. Em contraste, os casos de enteroparasitas atingiram um pico de 48,74% em 2021, seguido por uma redução média de 23,12%, com um desvio de 1,49%, em relação aos anos de 2020 e 2022. Conclui-se que a COVID-19 está predominantemente associada ao aumento de infecções secundárias, destacando a necessidade crucial de promover a educação em saúde, melhorar o saneamento básico e garantir o acesso aos serviços de saúde como componentes essenciais no combate ao aumento de infecções parasitárias, especialmente aquelas relacionadas a patologias virais.

Epidemiological characteristics of mortality from infectious intestinal diseases (diarrhea) Paraguay (2015-2019)

Introduction: Infectious intestinal diseases (diarrhea) are a major cause of morbidity and mortality worldwide. In 2015, it constituted the ninth leading cause of death for all ages. Objective: To describe the epidemiological characteristics of mortality due to infectious intestinal diseases (diarrhea) in Paraguay from 2015 to 2019. Methods: Descriptive, ecological, cross-sectional, retrospective, and non-probabilistic sampling of consecutive cases was performed. ICD-10 deaths included cholera (A01), typhoid and paratyphoid fever (A01), shigellosis (A03), other bacterial intestinal infections (A04), other bacterial food poisoning (A05), amebiasis (A06), other intestinal diseases due to protozoa (A07), intestinal infections due to viruses (A08), and diarrhea and gastroenteritis of presumed infectious origin (A09). Open access data were obtained from the WEB page of the General Directorate of Strategic Information in Health of the MSP and BS of all the Departments of the country. Crude and adjusted rates (per 100,000 inhabitants) were calculated. Excel and EPI INFO 7.0 were used. Results: 495 deaths were registered; the highest prevalence was in 2019 (adjusted rate of 1.83) and the lowest in 2017 (1.36). The months with the highest mortality rates were January and July (9.9%). 51.72% were women (256), 30.91% were over 80 years old and 28.28% (140) were under 5 years old, average age 50.8, single 56.77% (281) and without any type of education 41.82% (207). A total of 80.61% (399) of the respondents resided in urban areas. The highest rates were registered in Boquerón (33.3) and Amambay (15.2). Diarrhea and gastroenteritis of infectious origin accounted for 95.56% of the cases (473). Discussion: There was a high percentage of mortality from infectious diarrhea. Extremes of life were the most vulnerable populations.

Introducción: Las enfermedades infecciosas intestinales (diarrea) son una causa importante de morbilidad y mortalidad a nivel mundial. En 2015, constituyeron la novena causa principal de muerte para todas las edades. Objetivo: describir las características epidemiológicas de la mortalidad por enfermedades infecciosas intestinales (diarreas) en Paraguay durante los años 2015 al 2019. Metodología: Estudio descriptivo, ecológico, transversal, retrospectivo, muestreo no probabilístico de casos consecutivos. Se consideraron los óbitos del CIE - 10, que incluyen al cólera (A01), fiebres tifoidea y paratifoidea (A01), shigelosis (A03), otras infecciones intestinales bacterianas (A04), otras intoxicaciones alimentarias bacterianas (A05), amebiasis (A06), otras enfermedades intestinales debidas a protozoarios (A07), infecciones intestinales debidas a virus (A08) y diarrea y gastroenteritis de presunto origen infeccioso (A09). Se utilizaron datos de acceso abierto de la página WEB de la Dirección General de Información Estratégica en Salud del MSP y BS de todos los Departamentos del país. Se calcularon tasas crudas y ajustadas (por 100.000 habitantes). Se utilizaron Excel y EPI INFO 7.0. Resultados: Se registraron 495 muertes, la mayor prevalencia fue en 2019 (tasa ajustada de 1,83) y menor en 2017 (1,36). Los meses con mayor mortalidad fueron enero y julio (9,9%). El 51,72% fueron mujeres (256), 30,91% mayores de 80 años y 28,28% (140) menores de 5 años, edad promedio 50,8, solteros 56,77% (281) y sin ningún tipo de educación 41,82% (207). El 80,61% (399) residía en área urbana. Las mayores tasas se registraron en Boquerón (33,3) y Amambay (15,2). El 95,56% (473) fueron diarreas y gastroenteritis de origen infeccioso. Discusión: Se registra alto porcentaje de mortalidad de diarreas de origen infeccioso. Los extremos de la vida constituyen la población más vulnerable.

Construcción y validación de un cuestionario sobre actitudes hacia la higiene de manos / Construction and validation of a questionnaire on attitudes towards hand hygiene

INTRODUCCIÓN: La higiene de manos es la medida más eficaz para prevenir las infecciones asociadas al cuidado de la salud. Las actitudes hacia esta práctica tan sencilla, influyen en el grado de adherencia. OBJETIVO: Desarrollar y validar un instrumento para evaluar las actitudes hacia la higiene de manos en estudiantes de Licenciatura en Enfermería. MÉTODO: Se realizó un estudio observacional y de corte transversal. Una vez construido el instrumento se realizó la validez de contenido mediante el juicio de expertos. Para la validez de constructo se realizó análisis factorial exploratorio. Posteriormente se calculó la confiabilidad, que incluyó la consistencia interna y la estabilidad del cuestionario. RESULTADOS: Participaron 313 estudiantes de Licenciatura en Enfermería de ocho universidades de Argentina. Se calculó el Kaiser-Meyer-Olkin (KMO = 0,720) y se obtuvo una prueba de esfericidad de Bartlett significativa (x2 = 831,2; = 0,000). El análisis factorial exploratorio determinó la existencia de un único factor. El modelo explicó el 54% de la varianza. Se utilizó la implementación mejorada de la estimación Bayesiana EAP integrada en el programa FACTOR, que fue de 0,85 y se realizó test-retest utilizando análisis de correlación que arrojó un r = 0,64 (p ≤ 0,001). CONCLUSIONES: El cuestionario sobre actitudes hacia la higiene de manos (CAHM) presenta una adecuada validez y confiablidad, por lo que puede ser utilizado para indagar sobre este factor predisponente de adherencia hacia la higiene de manos.

BACKGROUND: Hand hygiene is the most effective measure to prevent health care-associated infections. Attitudes towards this simple practice influence the level of adherence. AIM: To develop and validate an instrument for the evaluation of attitudes towards hand hygiene in nursing students. METHOD: An observational and cross-sectional study was carried out. Once the instrument was constructed, content validity was carried out through expert judgment. For construct validity, exploratory factor analysis was performed. Subsequently, the analysis of construct validity and reliability was calculated, which included the internal consistency and stability of the questionnaire. RESULTS: 313 Nursing undergraduate students from 8 universities in Argentina participated. The Kaiser-Meyer-Olkin (KMO = 0.720) was calculated, and a significant Bartlett sphericity test was obtained (x2 = 831.2; = 0.000). The exploratory factor analysis determined the existence of a single factor. The model explained 54% of the variance. The improved implementation of the Bayesian EAP estimation integrated in the FACTOR program was used, which was 0.85; and test-retest was also performed using correlation analysis that yielded r = 0.64 (p ≤ 0.001). CONCLUSIONS: The Questionnaire on attitudes towards hand hygiene (CAHM) has adequate validity and reliability, so it can be used to investigate this predisposing factor of adherence to hand hygiene.

Educational interventions to prevent urinary infections in institutionalized elderly people. Quasi-experimental Study / Intervención educativa para prevenir las infecciones urinarias en ancianos institucionalizados. Estudio cuasi-experimental / Intervenção educativa para prevenção de infecções urinárias de idosos institucionalizados. Estudo quase-experimental

Objective. To analyze the effectiveness of an educational intervention among nursing professionals and caregivers to prevent urinary tract infections in institutionalized elderly people. Methods. this is a quasi-experimental study carried out with 20 people (7 nurses and 13 formal caregivers). A questionnaire was applied during the pre-intervention stage, then professional training was carried out and finally, the questionnaire was reapplied 6 months after the intervention. The prevalence profile and factors associated with urinary infections in 116 elderly people was evaluated before and after the educational interventions. Statistical analysis was performed using association and correlation tests, logistic regression model comparison and prevalence rates. Results. The average number of correct answers by the nursing professionals Invest Educ Enferm. 2024; 42(1): e05Educational interventions to prevent urinary infections in institutionalized elderly people. Quasi-experimental Studyand caregivers after the educational intervention increased from the pre to the post-test by 52% regarding signs of urinary infection, 32% regarding its symptoms, 72.5% regarding its treatment, 40% regarding personal/behavioral and morbidity-related risk factors, 59% regarding conditional factors and 43.8% regarding its preventive measures. The team of caregivers showed a greater gain in knowledge compared to the nursing team in almost every question (p<0.05). The length of time working in elderly care showed no positive correlation with any variable (R<1; p>0.05). The prevalence of urinary tract infection in the pre-intervention period was 33.62%, and 20% in the post-intervention period. Conclusion.The educational intervention was effective in preventing urinary tract infections in the elderly. The increased knowledge acquired by nurses and caregivers was associated with a reduction in the infection rate and an improvement in the most prevalent modifiable factors for the development of this type of pathology

Objetivo. Analizar la eficacia de una intervención educativa con profesionales de enfermería y cuidadores para prevenir las infecciones urinarias en ancianos institucionalizados. Métodos. Estudio cuasi-experimental realizado con 20 personas (7 enfermeros y 13 cuidadores formales). Se aplicó un cuestionario antes de la intervención, se llevó a cabo la capacitación de los enfermeros y se volvió a aplicar el cuestionario 6 meses después de la intervención. Se evaluó el perfil de prevalencia de las infecciones urinarias y los factores asociados de 116 ancianos antes y después de las intervenciones educativas. En el análisis estadístico se utilizaron pruebas de asociación y correlación, comparación de modelos de regresión logística y tasas de prevalencia. Resultados. El promedio de respuestas correctas del equipo de enfermería y de los cuidadores tras la intervención educativa aumentó del pre al post-test en un 52% con los signos de infección urinaria, un 32% con los síntomas, un 72.5% con el tratamiento, y un 40% con los factores de riesgo personales/conductuales y los relacionados con la morbilidad, un 59% con los factores condicionales y un 43.8% con las medidas preventivas. El equipo de cuidadores mostró una mayor aprehensión de conocimientos en relación al equipo de enfermería en casi todas las preguntas (p<0.05). El tiempo dedicado al cuidado de ancianos no mostró correlación positiva con ninguna variable (R<1; p>0.05). La prevalencia de infección urinaria en el período pre-intervención fue del 33.62% y en el post-intervención del 20%. Conclusión. La intervención educativa fue eficaz en la prevención de las infecciones urinarias en ancianos. El aumento de conocimientos adquiridos por los enfermeros y por los cuidadores se relacionó con la reducción de la tasa de infecciones y el mejoramiento de los factores modificables más prevalentes para desarrollar este tipo de patología.

Objetivo. Analisar a efetividade de intervenção educativa com profissionais de enfermagem e cuidadores para prevenção de infecções do trato urinário de idosos institucionalizados. Métodos. Estudo quase experimental realizado com 20 pessoas (7 enfermeiros e 13 cuidadores formais). Aplicou-se questionário na pré-intervenção, realizou-se capacitação dos profissionais e reaplicação do questionário 6 meses pós-intervenção. O perfil de prevalência de infecções urinárias e fatores associados de 116 idosos foi avaliado antes e após as intervenções educativas. Na análise estatística utilizou-se testes de associação e de correlação, comparação de modelos de regressão logística e de taxas de prevalência. Resultados. A média de acertos da equipe de enfermagem e de cuidadores, após intervenção educativa, aumentou do pré para o pós-teste em 52% com relação aos sinais de infecção urinária, 32% a sintomas, 72.5% tratamento, e 40% sobre fatores de risco pessoais/comportamentais e relacionados a morbidade, 59% a fatores condicionais e 43,8% sobre medidas preventivas. A equipe de cuidadores apresentou maior ganho de conhecimento em relação à equipe de enfermagem em quase todas as questões (p<0.05). O tempo de cuidado com idoso não apresentou correlação positiva com nenhuma variável (R<1; p>0.05). A prevalência de infecção do trato urinário no período pré-intervenção foi de 33.62% e pós intervenção 20%. Conclusão. A intervenção educativa foi efetiva na prevenção às infecções do trato urinário dos idosos. O aumento do conhecimento adquirido por enfermeiros e cuidadores foi associado à redução da taxa de infecções e à melhoria dos fatores modificáveis mais prevalentes para o desenvolvimento desse tipo de patologia.

Infección tras mordedura de perro por Neisseria weaveri / Infection after dog bite by Neisseria weaveri / Infecção após mordedura canina por Neisseria weaveri

Resumen Las infecciones por mordeduras de perros y gatos presentan una etiología bacteriana mixta con microorganismos aerobios y anaerobios que provienen de la cavidad oral del agresor y, en menor medida, de la piel del agredido y el medio ambiente. Con mayor frecuencia se aíslan Pasteurella multocida, Pasteurella canis, Streptococcus spp., Staphylococcus spp., Corynebacterium spp., Capnocytophaga canimorsus y anaerobios. Si bien las infecciones por mordeduras de animales no son infrecuentes, algunos de los microorganismos implicados son excepcionales. Neisseria weaveri forma parte de la microbiota orofaríngea de perros y gatos; sin embargo, los casos comunicados debidos a mordeduras son escasos.

Abstract Infections caused by dog and cat bites have a mixed bacterial etiology with aerobic and anaerobic microorganisms that come from the mouth of the offender and, to a lesser extent, from the skin of the victim and the environment. Pasteurella multocida, Pasteurella canis, Streptococcus spp., Staphylococcus spp., Corynebacterium spp., Capnocytophaga canimorsus and anaerobes can be frequently isolated. Although animal bite infections are not uncommon, some of the microorganisms involved are rare. Neisseria weaveri is part of the oropharyngeal microbiota of dogs and cats; however, reported cases due to bites are rare.

Resumo As infecções causadas por mordeduras de cães e gatos têm etiologia bacteriana mista com microrganismos aeróbicos e anaeróbicos que provêm da cavidade bucal do agressor e, em menor grau, da pele da vítima e do meio ambiente. Pasteurella multocida, Pasteurella canis, Streptococcus spp., Staphylococcus spp., Corynebacterium spp., Capnocytophaga canimorsus e aneróbios podem ser isoladas mais frequentemente. Embora as infecções por mordeduras de animais não sejam incomuns, alguns dos microorganismos envolvidos são raros. A Neisseria weaveri faz parte da microbiota orofaríngea de cães e gatos, porém são escassos os casos relatados como consequência de mordeduras.

Changes in Neonatal Intensive Care Unit statistics during the COVID-19 pandemic / Cambios en las estadísticas de una Terapia Intensiva Neonatal durante la pandemia COVID-19

Abstract Background: With the identification of COVID-19 disease in China, a pandemic began that affected health-care systems. The Neonatal Intensive Care Unit (NICU) of the Hospital de Ginecobstetricia del Centro Médico Nacional de Occidente experienced an increase in patient flow as part of the COVID-19 strategy of the Instituto Mexicano del Seguro Social (IMSS). This study aimed to analyze the impact of the COVID-19 pandemic on neonatal care and mortality indicators in our unit. Methods: We conducted a retrospective study to compare the number of hospital births, pre-term newborns (PTNB), NICU admissions, and deaths. Changes in frequencies between 2019 and 2021 were analyzed using Poisson distribution. Changes in PTNB births, proportion of admissions, and deaths/NICU discharges were analyzed by z-test for two proportions. Results: Between 2019 and 2021, the number of births increased by more than 2-fold. NICU admissions increased from 770 in 2019 to 1045 in 2021 (p < 0.01). The ratio of deaths/discharge from the service was 16.9% in 2019 and 13.1% in 2021 (p = 0.02). Conclusions: Mortality indicators in the NICU decreased from 2019 to 2021, even with the increase in the number of patients admitted during the COVID-19 pandemic.

Resumen Introducción: Con la identificación de la enfermedad por COVID-19 en China, inició una pandemia que afectó a los sistemas de salud. La Unidad de Cuidados Intensivos Neonatales (UCIN) del Hospital de Ginecobstetricia del Centro Médico Nacional de Occidente del Instituto Mexicano del Seguro Social (IMSS) vio incrementado su flujo de pacientes como parte de la Estrategia COVID-19 del IMSS. El objetivo fue analizar el impacto de la pandemia COVID-19 en los indicadores de atención y mortalidad neonatal en nuestra unidad. Métodos: Se realizó un estudio retrospectivo para comparar el número de nacimientos en el hospital, nacimientos de recién nacidos prematuros (RNPT), ingresos a UCIN y defunciones. Se analizaron los cambios en frecuencias entre los años 2019 a 2021 mediante la distribución de Poisson. Los cambios en nacimientos de RNPT, proporción de ingresos y defunciones/egreso en UCIN se analizaron mediante prueba Z para dos proporciones. Resultados: Entre los años 2019 a 2021, el número de nacimientos incrementó más de 2 veces. Los ingresos a UCIN aumentaron de 770 en 2019, a 1045 en 2021 (p < 0.01). La proporción de defunciones/egreso del servicio fue de 16.9% en 2019, y 13.1% en 2021 (p = 0.02). Conclusiones: Los indicadores de mortalidad en la UCIN disminuyeron de 2019 a 2021, aun con el incremento en el número de pacientes atendidos durante la pandemia COVID-19.

Características clínicas y epidemiológicas de embarazadas y puérperas con covid-19 ingresadas en cuidados intensivos

Introducción: La infección por el virus SARS-CoV-2 se ha convertido en una pandemia que ha ocasionado gran número de complicaciones y suele ser fatal para embarazadas y puérperas. Objetivo: Describir las características clínicas y epidemiológicas de embarazadas y puérperas con covid-19 ingresadas en cuidados intensivos. Métodos: Se realizó un estudio observacional descriptivo, de corte transversal, de 56 embarazadas y puérperas con diagnóstico confirmado de covid-19, ingresadas en el Servicio de Cuidados Intensivos del Hospital Provincial Docente Dr. Joaquín Castillo Duany de Santiago de Cuba durante el 2021. Las variables analizadas fueron la edad, los antecedentes personales, la causa de ingreso, el estado al egreso y la principal causa de muerte. A tal efecto, se calcularon las frecuencias, los porcentajes y la tasa de letalidad. Resultados: Hubo predominio de las gestantes en todos los grupos de edades (58,9 %) en relación con las puérperas (41,1 %), principalmente en el grupo etario de 31-35 años (30,3 %). La hipertensión arterial resultó ser la comorbilidad más frecuente con 71,4 y 28,6 %, para embarazadas y puérperas, respectivamente; en tanto, 66,6 % de las primeras y 33,3 % de las segundas fueron ingresadas por neumonía. Todas las embarazadas egresaron vivas y 7 puérperas fallecieron. La tasa de letalidad fue de 12,5 y el síndrome de disfunción multiorgánica apareció en 57,2 % de las afectadas. Conclusiones: La hipertensión arterial fue la comorbilidad más frecuente, la neumonía viral, el principal diagnóstico al ingreso y el síndrome de disfunción multiorgánica, la primera causa directa de muerte.

Introduction: Infection due to SARS-CoV-2 virus has become a pandemic that has caused great number of complications and is usually fatal for pregnant and newly-delivered women. Objective: To describe the clinical and epidemiological characteristics of pregnant and newly-delivered women with Covid-19 admitted to intensive care units. Methods: An observational descriptive, cross-sectional study of 56 pregnant and newly-delivered women with confirmed diagnosis of Covid-19 was carried out; they were admitted to the Intensive Care Unit of Dr. Joaquín Castillo Duany Teaching Provincial Hospital in Santiago de Cuba during 2021. The analyzed variables were age, past health history, cause of admission, state when discharged from the institution and the main cause of death. For this purpose, the frequencies, percentages and case fatality rate were calculated. Results: There was a prevalence of pregnant women in all the age groups (58.9%) relative to the newly-delivered women (41.1%), mainly in the 31- 35 age group (30.3%). Hypertension was the most frequent comorbidity with 71.4 and 28.6%, for pregnant and newly-delivered women, respectively; as long as, 66.6% of the first ones and 33.3% of the second ones were admitted due to pneumonia. All the pregnant women were discharged alive and 7 newly-delivered women died. Case fatality rate was 12.5 and multiple organ dysfunction syndrome appeared in 57.2% of those affected. Conclusions: Hypertension was the most frequent comorbidity, viral pneumonia was the main admission diagnosis and multiple organ dysfunction syndrome, the first direct cause of death.

Terapia multimodal en ancianos con manifestaciones psicosomáticas por el síndrome poscovid-19

Introducción: Un elevado porcentaje de pacientes que han padecido la covid-19 refiere una serie de manifestaciones clínicas que persisten luego del cuadro original. Uno de los grupos poblacionales en el que esto ocurre con mayor frecuencia es el de adultos mayores, a los cuales se les debe prestar máxima atención. Objetivo: Evaluar la efectividad de la terapia multimodal en ancianos con manifestaciones psicosomáticas por síndrome poscovid-19. Métodos: Se realizó un estudio cuasiexperimental de intervención terapéutica, sin grupo de control, en el Hospital General Docente Dr. Juan Bruno Zayas Alfonso de Santiago de Cuba, durante el periodo de marzo a mayo de 2021. La población estudiada se conformó por 25 pacientes de 60 y más años de edad con síndrome poscovid-19, quienes presentaron manifestaciones psicosomáticas y recibieron tratamiento multimodal (psicoterapia grupal y terapia floral). Se analizaron las variables sexo, edad, manifestaciones psicosomáticas y respuesta al tratamiento, cuya efectividad se evaluó según la proporción de pacientes con respuesta satisfactoria, considerando un nivel de significación de 5 %. Resultados: Predominaron el sexo masculino y los grupos etarios de 65-69 y 70-74 años. Las manifestaciones más frecuentes fueron la disnea, la astenia y la ansiedad. Después de aplicar la terapia multimodal, se logró una proporción significativa de pacientes con condición favorable, pues disminuyó el número de manifestaciones psicosomáticas. Conclusiones: La terapia multimodal resultó ser efectiva para reducir el número de manifestaciones psicosomáticas en los adultos mayores con síndrome poscovid-19.

Introduction: A high percentage of patients that have suffered from covid-19 refer a series of clinical manifestations that persist after the original pattern. One of the population groups in which this happens most frequently is the elderly, to whom maximum care should be paid. Objective: To evaluate the effectiveness of the combined modality therapy in elderly with psychosomatic manifestations due to postcovid-19 syndrome. Methods: A quasi-experiment study without control group of therapeutic intervention was carried out at Dr. Juan Bruno Zayas Alfonso General Teaching Hospital in Santiago de Cuba, from March to May, 2021. The population studied was made up of 25 patients of 60 years and over with postcovid-19 syndrome, who presented psychosomatic manifestations and received combined modality treatment (group psychotherapy and floral therapy). Sex, age and psychosomatic manifestations were analyzed as variables, as well as the response to treatment, which effectiveness was evaluated according to the proportion of patients with a satisfactory response, taking into account a significance level of 5 %. Results: There was a prevalence of the male sex and the 65-69 and 70-74 age groups. The most frequent manifestations were dyspnea, asthenia and anxiety. After applying the combined modality therapy, a significant proportion of patients with a favorable condition was achieved, since the number of psychosomatic manifestations decreased. Conclusions: Combined modality therapy was effective to reduce the number of psychosomatic manifestations in elderly with postcovid-19 syndrome.

Resolutividad del tratamiento con Jusvinza en pacientes confirmados de COVID-19. Santiago de Cuba, 2021

Fundamento la infección por SARS-CoV-2 es la enfermedad emergente más importante del presente siglo. En dicho contexto, el Grupo de las Industrias Biotecnológica y Farmacéutica Cubanas (BioCubaFarma) creó alternativas terapéuticas para combatir la COVID-19, entre ellas el uso de Jusvinza, la cual forma parte del protocolo utilizado en el país. Objetivo determinar la resolutividad terapéutica de Jusvinza en pacientes confirmados de COVID-19. Métodos se realizó un estudio descriptivo, durante el periodo de enero a septiembre de 2021, en el Hospital Militar Dr. Joaquín Castillo Duany, de Santiago de Cuba. El universo estuvo constituido por 166 confirmados de COVID-19, a quienes se administró Jusvinza. Se analizaron algunas variables clínicas (estado clínico, enfermedades no transmisibles asociadas, progresión clínica), epidemiológicas (edad, sexo) y farmacológicas (resolutividad, duración en días). Se utilizó una planilla de vaciamiento de datos, los cuales fueron tomados de las historias clínicas. Resultados la morbimortalidad por COVID-19 fue superior en el sexo masculino, asociado a comorbilidades y edad mayor de 60 años; el sexo femenino resultó el de mayor resolutividad al tratamiento con Jusvinza (71,7 %), la cual incrementó su porcentaje en ausencia de enfermedades crónicas no transmisibles asociadas (81,4 %). Los pacientes de alto riesgo fueron los de más baja mortalidad (15,8 %). Conclusiones la resolutividad en pacientes confirmados de COVID-19 tratados con Jusvinza fue más elevada en casos de alto riesgo que en graves y críticos.

Foundation SARS-CoV-2 infection is the most important emerging disease of this century. In this context, the Cuban Biotechnology and Pharmaceutical Industries Group (BioCubaFarma) created therapeutic alternatives to combat COVID-19, including the use of Jusvinza, which is part of the protocol used in the country. Objective to determine the Jusvinza therapeutic resolution in confirmed COVID-19 patients. Methods a descriptive study carried out from January to September 2021, at the Dr. Joaquín Castillo Duany Military Hospital, in Santiago de Cuba. The universe consisted of 166 confirmed COVID-19 cases, to whom Jusvinza was administered. Some clinical variables (clinical status, associated non-communicable diseases, clinical progression), epidemiological (age, sex) and pharmacological (resolving, duration in days) were analyzed. A data extraction form was used, which was taken from the medical records. Results morbidity and mortality from COVID-19 was higher in males, related to comorbidities and age over 60 years; The female sex was the one with the greatest response to treatment with Jusvinza (71.7%), which increased its percentage in the absence of associated chronic non-communicable diseases (81.4%). High-risk patients had the lowest mortality (15.8%). Conclusions resolution in confirmed COVID-19 patients treated with Jusvinza was higher in high-risk cases than in severe and critical cases.

Guías Latinoamericanas de Infecciones Congénitas y Perinatales de la Sociedad Latinoamericana de Infectología Pediátrica (SLIPE). Parte II

Las infecciones perinatales son una causa de morbilidad, tanto fetal como neonatal, y que compromete la salud de la mujer embarazada, por lo que su diagnóstico, tratamiento, e intento de eliminación son una prioridad en América Latina y el Caribe. Este documento representa la segunda entrega realizada por expertos en la región dentro de la Sociedad Latinoamericana de Infectología Pediátrica (SLIPE), brindando una mirada actualizada en el manejo de las infecciones congénitas y entrega herramientas para detectar posibles momentos estratégicos de intervención y cambio en el manejo de las infecciones congénitas.

Perinatal infections are a major cause of morbidity and mortality in the fetus, neonate, and the health of the pregnant woman. Diagnosis, treatment, and the search for elimination of these diseases are a priority in Latin America and the Caribbean. This document represents the second delivery by a group of experts in the region inside the Latin-American Society of Pediatric Infectious Diseases (SLIPE), presenting a up-to-date look into the management of congenital infectious diseases and give a tool to detect possible strategic sceneries and a change in the management of congenital infections in our region.

Educación sexual, conocimiento de ITS y conductas protectoras/de riesgo en personas entre 18 y 30 años

Introducción: Las infecciones de transmisión sexual (ITS) se adquieren principalmente por el contacto sexual y pueden afectar a personas de cualquier edad, sin embargo los adolescentes son el grupo etario más afectado, por tanto es probable que sus conductas sean más de riesgo que protectoras. Objetivo: El objetivo de la investigación es determinar la relación entre el nivel de educación sexual y el conocimiento sobre ITS y las conductas de riesgo y protectoras en los jóvenes. Método: Investigación de diseño analítico, estudio de tipo descriptivo, transversal con datos de tipo cuantitativos, con una muestra de 130 hombres y mujeres, considerando 10 personas por edad desde los 18 a los 30 años. Resultados: No existe relación estadísticamente significativa entre la educación sexual y las conductas de riesgo y/o protectores (p > 0,05), ni tampoco entre la educación sexual y el uso del preservativo, tanto interno como externo (p > 0,05). Conclusión: A pesar de tener educación sexual, no todas las personas utilizan de forma frecuente los anticonceptivos de barrera y principalmente es sorprendente el poco uso del condón de vagina en la población en general, siendo las personas de orientación heterosexual las que lo utilizan menos.

Introduction: Sexually transmitted infections (STIs) are mainly acquired through sexual contact and can affect people of any age; however, adolescents are the most affected age group, therefore, it is likely that their behaviors are more risky than protective. Objective: The objective of the research is to determine the relationship between the level of sexual education and knowledge about STIs and risk and protective behaviors in young people. Method: Analytical design research, descriptive, cross-sectional study with quantitative data, with a sample of 130 men and women, considering 10 people by age from 18 to 30 years. Results: There is no statistically significant relationship between sexual education and risk and/or protective behaviors (p > 0.05) nor between sexual education and condom use, both internal and external (p > 0.05). Conclusion: Despite having sexual education, not all people use frequently barrier contraceptives and, mainly, the little use of the vaginal condom in the general population is surprising, with people of heterosexual orientation being those that use it less.