COVID-19 mortality in two waves of the pandemic in Cali, Colombia, before and during vaccination roll-out / Mortalidad por COVID-19 en dos olas de la pandemia en Cali, Colombia, antes y durante el despliegue de las vacunas / Mortalidade por COVID-19 em duas ondas da pandemia em Cali, Colômbia, antes e durante a disponibilização das vacinas

ABSTRACT Objective. To describe the variation in COVID-19 mortality among residents of Cali, Colombia, in the second wave of the pandemic, before vaccines, and in the fourth wave, with vaccination roll-out in process, taking into account variables of sex, age group, comorbidities, and interval between onset of symptoms and death, and to estimate the number of deaths averted by vaccination. Methods. A cross-sectional study of second wave and fourth wave deaths and vaccination coverage. The frequencies of attributes of deceased population in the two waves were compared, including comorbidities. Machado's method was used to calculate an estimate of the number of deaths averted in the fourth wave. Results. There were 1 133 deaths in the second wave and 754 deaths in the fourth wave. It was calculated that approximately 3 763 deaths were averted in the fourth wave in Cali in the context of vaccination roll-out. Conclusions. The decline in COVID-19-associated mortality observed supports the continuation of the vaccination program. Given the lack of data to explain other possible reasons for this decline, such as on the severity of novel viral variants, the limitations of the study are discussed.

RESUMEN Objetivo. Describir la variación en la mortalidad por COVID-19 en los residentes de Cali, Colombia, en la segunda ola de la pandemia (antes de las vacunas) y en la cuarta ola (durante el despliegue de las vacunas). Se tomaron en cuenta las variables referidas al sexo, grupo de edad, comorbilidades e intervalo entre el inicio de los síntomas y la muerte y se estimó el número de muertes evitadas por la vacunación. Métodos. Estudio transversal sobre las muertes en la segunda y cuarta olas de la pandemia de COVID-19 y la cobertura de vacunación. Se compararon las frecuencias de los atributos correspondientes a la población fallecida durante las dos olas, incluidas las comorbilidades. Se utilizó el método de Machado para estimar el número de muertes evitadas en la cuarta ola. Resultados. Se registraron 1 133 muertes en la segunda ola y 754 en la cuarta. Se calculó que, en el contexto del despliegue de las vacunas, en la cuarta ola se evitaron aproximadamente 3 763 muertes en Cali. Conclusiones. La disminución observada en la mortalidad asociada a la COVID-19 respalda la continuación del programa de vacunación. Dada la falta de datos para explicar otras posibles causas de esta disminución, como puede ser la gravedad causada por las nuevas variantes virales, se analizan las limitaciones del estudio.

RESUMO Objetivo. Descrever a variação da mortalidade por COVID-19 entre residentes de Cali, Colômbia, na segunda onda da pandemia (antes das vacinas) e na quarta onda (com a implantação da vacinação já em andamento), considerando as variáveis sexo, faixa etária, comorbidades e intervalo entre início dos sintomas e óbito, bem como estimar o número de óbitos evitados pela vacinação. Métodos. Estudo transversal de mortes e cobertura vacinal na segunda e quarta ondas da pandemia. Foram comparadas as frequências dos atributos da população que foi a óbito durante as duas ondas, incluindo comorbidades. Foi utilizado o método de Machado para estimar o número de mortes evitadas na quarta onda. Resultados. Houve 1.133 mortes na segunda onda e 754 mortes na quarta onda. Calcula-se que cerca de 3.763 mortes foram evitadas na quarta onda em Cali, no contexto da disponibilização das vacinas. Conclusões. A queda observada na mortalidade associada à COVID-19 apoia a continuidade do programa de vacinação. Considerando a falta de dados para explicar outros possíveis motivos para esta queda, como a gravidade das novas variantes do vírus, discutem-se as limitações do estudo.

A systematic review of smartphone applications and devices for obstructive sleep apnea

Abstract Objective: Sleep is fundamental for both health and wellness. The advent of "on a chip" and "smartphone" technologies have created an explosion of inexpensive, at-home applications and devices specifically addressing sleep health and sleep disordered breathing. Sleep-related smartphone Applications and devices are offering diagnosis, management, and treatment of a variety of sleep disorders, mainly obstructive sleep apnea. New technology requires both a learning curve and a review of reliability. Our objective was to evaluate which app have scientific publications as well as their potential to help in the diagnosis, management, and follow-up of sleep disordered breathing. Methods: We search for relevant sleep apnea related apps on both the Google Play Store and the Apple App Store. In addition, an exhaustive literature search was carried out in MEDLINE, EMBase, web of science and Scopus for works of apps or devices that have published in the scientific literature and have been used in a clinical setting for diagnosis or treatment of sleep disordered breathing performing a systematic review. Results: We found 10 smartphone apps that met the inclusion criteria. Conclusions: The development of these apps and devices has a great future, but today are not as accurate as other traditional options. This new technology offers accessible, inexpensive, and continuous at home data monitoring of obstructive sleep apnea, but still does not count with proper testing and their validation may be unreliable.

Experiencias de cuidado de padres y profesionales de enfermería en la Unidad de Cuidados intensivos neonatal / Care experiences of parents and nursing professionals in the Neonatal Intensive Care Unit

Objetivo Analizar de manera comprensiva la relación entre el cuidador informal y Profesional de enfermería en el acto de cuidado al Recién Nacido hospitalizado en la Unidad de cuidados intensivos neonatales. Metodología Estudio cualitativo, fenomenológico-hermenéutico, empleando el referente teórico de Van Manen, 5 cuidadores informales de recién nacidos hospitalizados en la Unidad de cuidados intensivos y 3 Profesionales de Enfermería en la ciudad de Neiva; información recolectada mediante entrevista en profundidad. Resultados Emergen los siguientes temas: el significado de cuidado en la relación cuidador-profesional de Enfermería; el cuidado: una forma de brindar y recibir apoyo y, la comunicación: trascendental para construir una relación del cuidado. Conclusiones La relación establecida entre cuidador informal- enfermera en la unidad de cuidados intensivos neonatales, se desarrolla en un ambiente desconocido para el cuidador, y propio del cuidado de enfermería, los cuidadores manifiestan la necesidad de sentirse cuidados, apoyados y escuchados; mediante una comunicación efectiva reciban información y educación continua, aspectos que contribuyen para que el profesional de Enfermería transforme la práctica de cuidado haciéndola más humana.

Objetive To comprehensively analyze the relationship between informal caregiver and nursing professional in the act of hospitalized newborn care in the Neonatal Intensive Care Unit. Methodology Qualitative, phenomenological-hermeneutic study, using the theoretical reference of Van Manen, 5 informal caregivers of newborns hospitalized in the Intensive Care Unit and 3 Nursing Professionals in the city of Neiva; information collected through in-depth interviews. Results The following topics emerge: the meaning of care in the caregiver-nursing professional relationship; care: a way to provide and receive support; and, communication: transcendental to build a caring relationship. Conclusions The relationship established between informal caregiver-nurse in the neonatal intensive care unit, develops in an environment unknown to the caregiver, and typical of nursing care, caregivers express the need to feel cared for, supported and listened to; through effective communication, they receive continuous information and education, aspects that contribute to the nursing professional transforming the practice of care, making it more humane.

Diffuse alveolar hemorrhage syndrome secondary to bocavirus and rhinovirus infection in a pediatric patient / Síndrome de hemorragia alveolar difusa secundaria a coinfección por Rhinovirus y Bocavirus en un paciente pediátrico

Abstract The diffuse alveolar hemorrhage syndrome is characterized by the presence of blood in the pulmonary alveolus from arterioles, venules and pulmonary capillaries, as a consequence of the lesion of the alveolar wall and without an endobronchial alteration. Its presentation includes a classic triad of hemoptysis, anemia and diffuse alveolar infiltrates. It's a rare but potentially fatal entity and there are no clear data on its real incidence in the pediatric population. We present the case of a previously healthy pediatric patient, immunocompetent, who presented diffuse alveolar hemorrhage syndrome with secondary ventilatory failure. After discarding all possible etiologies, coinfection by Rhinovirus and human Bocavirus was detected through the polymerase chain reaction, determining them as causal factors of the event. Recently, viral infections have been postulated as causing serious lung disease, especially coinfection in immunocompromised patients, in this case Rhinovirus and human Bocavirus; however there are no reports on the syndrome caused by these viruses.

Resumen El síndrome de hemorragia alveolar difusa se caracteriza por la presencia de sangre los alveolos pulmonar procedente de arteriolas, vénulas y capilares pulmonares, como consecuencia de la lesión de la pared alveolar y sin identificársele una alteración endobronquial. Su presentación incluye una triada clásica de hemoptisis, anemia e infiltrados alveolares difusos. Es una entidad poco frecuente aunque potencialmente fatal y no hay datos claros de su real incidencia en la población pediátrica. Se presenta el caso de un paciente pediátrico previamente sano, inmunocompetente, quien presentó síndrome de hemorragia alveolar difusa con falla ventilatoria secundaria. Después de descartar todas las posibles etiologías, se detectó, a través de reacción en cadena de polimerasa, coinfeccion por Rhinovirus y Bocavirus humano, determinándolos como causales del evento. Recientemente se postula las infecciones virales como causantes de enfermedad pulmonar grave, en especial la coinfeccion en pacientes inmunocomprometidos, en este caso Rhinovirus y Bocavirus humano, sin embargo no existen reportes sobre el síndrome causada por estos virus.