RESUMO
Fundamento: la pandemia de COVID-19 tensó enormemente los servicios de salud en el mundo entero y Cuba no fue una excepción. Aunque la proporción de casos confirmados en niños fue menor, es necesaria la descripción de la atención médica a este sector de la población. Objetivo: describir la organización de los servicios médicos y morbilidad hospitalaria durante la COVID-19, de enero 2021 a febrero 2022, en el pediátrico de Cienfuegos. Métodos: estudio descriptivo realizado en el Hospital Pediátrico de Cienfuegos sobre la atención médica a niños, durante la pandemia de COVID-19. Se analizaron las variables número de casos, edad, sintomatología, casos ingresados en unidades de cuidados intensivos, egreso. Resultados: fueron ingresados 2758 pacientes confirmados de COVID-19; los meses de junio a septiembre aportaron el mayor número de casos, con agosto como más representativo con 46,4 %. Cienfuegos y Cumanayagua fueron los municipios con más casos; predominaron los menores de cinco años (88,3 %) fundamentalmente los menores de un año (49,2 %). La presentación clínica asintomática fue preponderante y sintomatología leve. Requirieron cuidados intensivos el 1,1 % del total y la letalidad fue de 0,04 %. El enfrentamiento a la enfermedad tuvo un carácter intersectorial; el cumplimiento de los protocolos y guías se dieron en un contexto donde primó la reorganización de los servicios y la gestión del conocimiento. Conclusiones: la atención médica oportuna y encaminada a alcanzar el mayor detalle científico asistencial, acompañado de una continua gestión del conocimiento para su adherencia permitió que la mayoría de los niños con COVID-19 egresaran de manera satisfactoria.
Foundation: the COVID-19 pandemic greatly strained health services throughout the world and Cuba was no exception. Although the proportion of confirmed cases in children was lower, it is necessary to describe the medical care provided to this sector of the population. Objective: to describe the medical services organization and hospital morbidity during COVID-19, from January 2021 to February 2022, at the Cienfuegos pediatric hospital. Methods: descriptive study carried out at the Cienfuegos Pediatric Hospital on medical care for children, during the COVID-19 pandemic. The variables number of cases, age, symptomatology, cases admitted to intensive care units, and discharge were analyzed. Results: 2758 confirmed COVID-19 patients were admitted; from June to September contributed to the greatest number of cases, with August as the most representative with 46.4%. Cienfuegos and Cumanayagua were the municipalities with the most cases; there was a predominance of children under five years of age (88.3%), mainly those under one year of age (49.2%). The asymptomatic clinical presentation was preponderant and mild symptoms. 1.1% of the total required intensive care and the lethality was 0.04%. The confrontation with the disease had an intersectoral character; compliance with the protocols and guidelines occurred in a context where the reorganization of services and knowledge management prevailed. Conclusions: timely medical care aimed at achieving the greatest scientific care detail, accompanied by continuous knowledge management, allowed most children with COVID-19 to be discharged satisfactorily.
RESUMO
El análisis de la Situación de Salud (ASIS) de la Parroquia Simón Bolívar fue un estudio Descriptivo y Transversal para determinar el estado de Salud y de Calidad de Vida caracterizando su población y describiendo la situación social y de salud-enfermedad. Se aplicó una guía de observación en 12 localidades, con la participación de personas de la comunidad y personal del principal centro asistencial de la parroquia; se priorizo como problema: La Baja Capacidad Resolutiva del Ambulatorio Urbano tipo III Manoa. Aplicando el Enfoque Clínico Epidemiológico y Social, así como la Planificación Estratégica Situacional, utilizando la Técnica de Flujograma Situacional, se operacionalizaron las Causas del problema formulando estrategias para su resolución. La guía de observación permitió construir los territorios sociales estratificados de acuerdo a condiciones de vida y evidenciar las inequidades dentro de las localidades, de las cuales 75% (6) se ubican en los territorios sociales con condiciones de vida regulares, 25% (3) con condiciones de vida buenas y 25% (3) con condiciones de vida malas. Las principales causas de morbilidad fueron las enfermedades gastrointestinales, respiratorias y las ocasionadas por heridas. El ASIS es una herramienta que facilita la identificación de necesidades y prioridades en salud en una población y proporciona a los actores que tienen gobernabilidad y a la comunidad estrategias para modificar favorablemente la situación de salud.
The Situation Analysis of Health (ASIS) of the Parish Simón Bolívar was an observational, cross sectional to determine the status of Health and Quality of Life characterizing the population and describing the social and health and disease. Was used an observation guide some people in 12 locations and with the participation of people in the community and primary health center staff of the parish is prioritized as a problem: "The Low-solving capacity of the type III Manoa Urban Outpatient." Applying Clinical Epidemiological and Social Approach and Situational Strategic Planning, using Flowchart Technique Situational Causes was operationalized the problem by formulating strategies for their resolution. The observation guide allowed the construction of social territories stratified according to living conditions and highlight the inequities within the villages, of which 6 (75%) are located in the social territories with regular living conditions, 3 (25%) with good living conditions and 3 (25%) with poor living conditions. The leading causes of morbidity were gastrointestinal diseases, respiratory and those caused by injuries. The leading causes of morbidity were gastrointestinal diseases, respiratory and those caused by injuries. The ASIS is an useful tool for identifying needs and priorities in health in a population and provides the actors with community governance and strategies for change favorable health status.
RESUMO
OBJECTIVE: The aim of this study was to evaluate the degree of central and autonomic dysfunction by means of electroencephalographic (EEG) and cardio-pneumographic recording (CPGR) in infants with Post-Hemorrhagic Hydrocephalus (PHH). METHODS: Nineteen infants with PHH were studied, born from October 1998 to January 2000. Clinical diagnosis was confirmed by cephalic perimeter measurement and ultrasonographic study. Eight channel bipolar EEG and CPGR were performed after sleep deprivation, EEG features studied were: Temporal organization, symmetry, synchrony, frequency of normal and abnormal patterns. CPGR features studied were: Frequency of apnea and temporal organization by means of beat to beat variability. RESULTS: Averages of birth's age and weight, Apgar scores at one and five minutes, and cephalic perimeter showed lower values in PHH infants. PHH infants showed abnormalities in EEG and CPGR such as: Higher discontinuous activity (63), asymmetry (73), asynchrony (89), abnormal EEG patterns (89), apnea (26) and absence of heart rate variability (63). CONCLUSIONS: EEG and CPGR recordings are a useful tools in the examination of infants with PHH. These findings suggest cortical-subcortical, and brainstem dysfunction with severe encephalopathy and autonomic nervous dysfunction related to ventricular dilatation in infants with PHH.