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.

Study of the metabolic syndrome severity index as a predictive factor of a major cardiovascular event in premenopausal women with systemic lupus erythematosus. / Estudio del índice de gravedad del síndrome metabólico como factor predictivo de un episodio cardiovascular mayor en mujeres premenopáusicas con lupus eritematoso sistémico.

BACKGROUND: Patients with systemic lupus erythematosus (SLE) have an increased risk of metabolic syndrome (MS) and cardiovascular (CV) disease. MS is evaluated binary, limiting the understanding of each component's severity individually. Therefore, severity scores for MS that evaluate them separately have been developed. This study aims to determine the prognosis between MS severity and the occurrence of major adverse cardiovascular events (MACE) in SLE patients. METHODS: Ten-year follow-up cohort study. Premenopausal>18-year-old women with a previous diagnosis of SLE were included. Patients with recent CV events, pregnancy, thyroid disease, and liposuction were excluded. The variables of interest were CV events; the confounding variables, and the MS severity indexes were examined. Hazard ratios and Kaplan-Meier survival curves were estimated through Cox regression. RESULTS: A total of 238 women were analyzed: 22 presented MACE, and 216 did not. MS prevalence, measured according to consensus and ATP-III criteria, was higher in MACE patients (50 and 40,95%, respectively). The MetSx-IMC severity index was higher within the MACE group. Cox analysis showed an increase in the MetSx-IMC associated with the risk of suffering MACE in a 1.107 ratio. CONCLUSIONS: The MetSx-IMC severity index, contrary to the binary approaches, is recommended to evaluate MS as a predictor of MACE in SLE patients. Offering improved and more accurate prognosis in patients at risk of developing MCE.

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

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.

Participation of Oxidative Stress in the Activity of Compounds Isolated from Eleutherine plicata Herb.

From Eleutherine plicata, naphthoquinones, isoeleutherine, and eleutherol were isolated, and previous studies have reported the antioxidant activity of these metabolites. The present work evaluated the role of oxidative changes in mice infected with Plasmodium berghei and treated with E. plicata extract, fraction, and isolated compounds, as well as to verify possible oxidative changes induced by these treatments. E. plicata extracts were prepared from powder from the bulbs, which were submitted to maceration with ethanol, yielding the extract (EEEp), which was fractionated under reflux, and the dichloromethane fraction (FDMEp) was submitted for further fractionation, leading to the isolation of isoeleutherine, eleutherine, and eleutherol. The antimalarial activity was examined using the suppressive test, evaluating the following parameters of oxidative stress: trolox equivalent antioxidant capacity (TEAC), thiobarbituric acid reactive substances (TBARS), and reduced glutathione (GSH). Furthermore, the molecular docking of naphthoquinones, eleutherol, eleutherine, and isoeleutherine interactions with antioxidant defense enzymes was investigated, which was favorable for the formation of the receptor-ligand complex, according to the re-rank score values. Eleutherine and isoeleutherine are the ones with the lowest binding energy for catalase (CAT), glutathione reductase (GR), and glutathione peroxidase (GPx1), showing themselves as possible targets of these molecules in the involvement of redox balance. Data from the present study showed that treatments with E. plicata stimulated an increase in antioxidant capacity and a reduction in oxidative stress in mice infected with P. berghei, with naphthoquinones being responsible for reducing oxidative changes and disease severity.

Spatio-temporal assessment of soil properties immediately and eight months after a high intensity-controlled burn in the south of Spain.

In recent years, the use of fire as a means by which to manage forest ecosystems has become more frequent in Europe. Fire has a significant impact on the soil, and it is therefore necessary to understand how controlled burns affect this invaluable resource. The purpose of this study was to evaluate the main alterations in the physical-chemical and biological properties of the soil because of a high intensity-controlled burn in "Los Boquerones" area (Villaviciosa de Córdoba, Spain). Additionally, we assessed the spatial heterogeneity of the alterations of different soil properties. A grid of 12 points was established on a hillside in Sierra Morena (Córdoba). Thermocouples were placed at each point, and soil samples were collected at two depths (0-2 cm and 2-5 cm) before burning, immediately after burning and eight months later. Soil pH, electrical conductivity, nutrient content and/or availability, among others, and their spatio-temporal variations were analysed. Soil pH, increased in the first centimetres of the soil (0-2 cm) immediately after burning up to >2 units, and the increase was maintained eight months following the burn. Additionally, the high-intensity burn had a positive short-term effect on some of the soil properties, such as nutrient availability for plants, which was considerably increased. The magnitude of the alterations in the soil indicators assessed was spatially explained by the behaviour of the fire during the controlled burning. The burn also had both direct and indirect effects on soil microorganisms. In conclusion, the possible immediate and short-term effects of burning on the soil resource should be considered for a more holistic management of fire in forest ecosystems, as its functionality and capacity to provide ecosystem services is largely altered by these events as a function of their intensity.

Nurses' promotion of Mental Health First Aid Training Programmes for upper secondary students: a modified Delphi approach.

BACKGROUND: Mental Health First Aid Training Programmes can be carried out by nurses in schools. Adolescents have reported the importance of these interventions, the contents to be addressed, and intervention strategies that should be used. Mental health nurses have also discussed the characteristics of these training programmes. This study sought to create a consensus on the features of Mental Health First Aid Training Programmes promoted by nurses aimed at upper secondary students. METHODS: A descriptive mixed method study was developed using the modified e-Delphi technique. Original statements on the topic were drawn from the results section of previous studies with nurses and adolescents. The statements were included in a structured online questionnaire. An expert panel of 78 mental health nurses participated in the two-rounds online survey from October to December 2021. Absolute and relative frequencies of responses were analysed. The experts' comments were also considered. RESULTS: In the first round, experts suggested 4 new ideas about training programmes. Experts took a position on a total of 59 declarations. At least 75% of participants agreed with 58 statements about training programmes, namely about facilitators, intervention foci, evaluation methodology, participants, the implementation context, period and regularity, intervention strategies and content. The experts' opinions differed only in one statement that expressed the impaired sexual behaviour as a mental health problem to be addressed in the training programmes. CONCLUSIONS: Mental health nurses can lead the delivery of training programmes in upper secondary schools, improving adolescent competencies in mental health. Several educational approaches can be used to teach about mental health, related problems and actions underlying these conditions. Valid and appropriate assessment methods must be used. Our findings guide the planning, implementation and evaluation of these interventions in upper secondary schools and encourage nurses to explore these programmes and include them in their educational curricula.

Dating Violence among Undergraduate Medical Students at a Public University in Mexico City: An Exploratory Study.

Gender-based violence (GBV) and cyber-aggression are growing problems in Mexico, but there is a dearth of information on their associated risks. We aimed to determine the prevalence of dating violence (DV) and cyber-aggression in a public campus and compared students' acceptability of abusive DV based on their sex and sexual orientation. We employed a cross-sectional design to survey 964 first-year medical students attending a public university. We analyzed who found "acceptable" abusive behaviors from a dating partner and carried out descriptive analyses of sample characteristics by sex. We included 633 women and 331 men. Homosexual and bisexual orientation was lower among women (1.5%, 4.8%) vs. men (16.9%, 7.2%). Of women and men, respectively, 64.2% and 35.8% reported having been in a dating relationship. Experiencing abusive behaviors in the year prior to the study was associated with students' level of "acceptability". A total of 43.5% of the students who experienced cyber-aggression did not report any mental health consequences, 32.6% did not seek professional help, and 17.4% reported feeling depressed. Students that accepted emotionally abusive DV behaviors displayed a fourfold risk of experiencing physical abuse. Women and sexual minorities are more at risk of experiencing GBV and DV. More male students reported being victims of cyber-aggression.

Potential Benefits of Lycopene Consumption: Rationale for Using It as an Adjuvant Treatment for Malaria Patients and in Several Diseases.

Malaria is a disease that affects thousands of people around the world every year. Its pathogenesis is associated with the production of reactive oxygen and nitrogen species (RONS) and lower levels of micronutrients and antioxidants. Patients under drug treatment have high levels of oxidative stress biomarkers in the body tissues, which limits the use of these drugs. Therefore, several studies have suggested that RONS inhibition may represent an adjuvant therapeutic strategy in the treatment of these patients by increasing the antioxidant capacity of the host. In this sense, supplementation with antioxidant compounds such as zinc, selenium, and vitamins A, C, and E has been suggested as part of the treatment. Among dietary antioxidants, lycopene is the most powerful antioxidant among the main carotenoids. This review aimed to describe the main mechanisms inducing oxidative stress during malaria, highlighting the production of RONS as a defense mechanism against the infection induced by the ischemia-reperfusion syndrome, the metabolism of the parasite, and the metabolism of antimalarial drugs. Furthermore, the effects of lycopene on several diseases in which oxidative stress is implicated as a cause are outlined, providing information about its mechanism of action, and providing an evidence-based justification for its supplementation in malaria.

Effects of cilostazol, a Phosphodiesterase-3 inhibitor, on kidney function and redox imbalance in acute kidney injury caused by Bothrops alternatus venom.

The mechanisms of pathogenesis of acute kidney injury (AKI) in snakebites is multifactorial and involves hemodynamic disturbances, with release of free radical causing cytotoxic effects. The phosphodiesterase-3 (PDE3) inhibitor, Cilostazol, has been reported to provide protection against renal oxidative stress. OBJECTIVE: We evaluated the protective effects of cilostazol against Bothrops alternatus snake venom (BaV)-induced nephrotoxicity. METHODS: Wistar rat kidneys (n = 6, 260-300 g) were isolated and perfused with Krebs-Henseleit solution containing 6 g/100 mL of bovine serum albumin. After 30 min, the kidneys were perfused with BaV to a final concentration of 1 and 3 µg/mL, and subsequently evaluated for perfusion pressure (PP), renal vascular resistance (RVR), urinary flow (UF), glomerular filtration rate (GFR), and percentage of electrolyte tubular sodium and chloride transport (%TNa+, %TCl-). Oxidative stress and renal histological analyses were performed. RESULTS: BaV caused a reduction in all the evaluated renal parameters (PP, RVR, GFR, UF, %TNa+, and %TCl-). Although only the effects on PP and UF were reversed with cilostazol treatment, the decrease in the malondialdehyde levels, without changes in glutathione levels, further reduced the venom-induced renal tissue changes. CONCLUSION: Our data suggest that PDE3 is involved in BaV-induced nephrotoxicity, as cilostazol administration significantly ameliorated these effects.

Factores psicológicos protectores y desestabilizadores en pacientes con cardiopatía isquémica / Protective and destabilizing psychological factors in patients with ischemic heart disease / Fatores psicológicos protetores e desestabilizadores em pacientes com doença isquêmica do coração

RESUMEN En el estudio actual de las patologías cardíacas se consideran cada vez más los factores psicológicos por el papel relevante que poseen en la evolución de estas enfermedades. El objetivo de este trabajo fue determinar los principales factores psicológicos protectores y desestabilizadores que se manifiestan en los pacientes con cardiopatía isquémica. Para ello se realizó un estudio descriptivo de corte transversal, en los pacientes con cardiopatía isquémica atendidos en el servicio de cardiología del Hospital Clínico Quirúrgico "Celia Sánchez Manduley", del municipio Manzanillo, en el período octubre- diciembre del 2019. El universo estuvo constituido por 60 pacientes con cardiopatía isquémica. En el estudio el 78,33% de los pacientes tenían más de 60 años, 40 pacientes eran hombres y el 75% pertenecía a la zona urbana. Los principales factores psicológicos protectores presentes fueron el apoyo social reportado por todos los participantes y el cumplimiento terapéutico en el 91,67% de la población estudiada. Dentro de los factores psicológicos desestabilizadores el de mayor reporte fue la ansiedad presente en el 66,66% de los pacientes incluidos en el estudio. Se deben tomar en cuenta tanto los factores psicológicos protectores para poder potenciarlos y generar un mejor estado general del paciente, como los factores psicológicos desestabilizadores que generan descompensación y deben ser atendidos con intencionalidad una vez identificados.

ABSTRACT In the current study of cardiac pathologies, psychological factors are increasingly considered due to the relevant role they have in the evolution of these diseases. The objective of this work was to determine the main protective and destabilizing psychological factors that manifest themselves in patients with ischemic heart disease. To this end, a descriptive cross-sectional study was carried out in patients with ischemic heart disease treated in the cardiology service of the "Celia Sánchez Manduley" Clinical Surgical Hospital, in the municipality of Manzanillo, in the period October-December 2019.The universe consisted of 60 patients with ischemic heart disease. In the study, 78.33% of the patients were over 60 years old, 40 patients were men and 75% belonged to the urban area. The main protective psychological factors present were social support reported by all participants and therapeutic compliance in 91.67% of the studied population. Among the destabilizing psychological factors, the one with the highest report was the anxiety present in 66.66% of the patients included in the study. Both the protective psychological factors must be taken into account in order to enhance them and generate a better general condition of the patient, as well as the destabilizing psychological factors that generate decompensation and must be addressed with intentionality once identified.

RESUMO No presente estudo das patologias cardíacas, fatores psicológicos são cada vez mais considerados devido ao papel relevante que têm na evolução dessas doenças. O objetivo deste trabalho foi determinar os principais fatores psicológicos protetores e desestabilizadores que se manifestam em pacientes com doença isquêmica do coração. Para isso, foi realizado um estudo transversal descritivo em pacientes com doença isquêmica do coração tratada no serviço de cardiologia do Hospital Cirúrgico Clínico "Celia Sánchez Manduley", no município de Manzanillo, no período de outubro a dezembro de 2019.O universo era composto por 60 pacientes com doença isquêmica do coração. No estudo, 78,33% dos pacientes tinham mais de 60 anos, 40 eram homens e 75% pertenciam à área urbana. Os principais fatores psicológicos protetores presentes foram o apoio social relatado por todos os participantes e o cumprimento terapêutico em 91,67% da população estudada. Entre os fatores psicológicos desestabilizadores, o com maior relato foi a ansiedade presente em 66,66% dos pacientes incluídos no estudo. Tanto os fatores psicológicos protetores devem ser levados em conta para melhorantá-los e gerar uma melhor condição geral do paciente, bem como os fatores psicológicos desestabilizadores que geram descompensação e devem ser tratados com intencionalidade uma vez identificados.

Características clínicas y factores de riesgo de mortalidad en menores de 18 años con COVID-19 en México y Ciudad de México / Clinical characteristics and mortality risk factors in patients aged less than 18 years with COVID-19 in Mexico and Mexico City

Introducción: En la población pediátrica, el COVID-19 suele ser asintomático o leve, pero puede haber casos graves y mortales. Métodos: Se analizaron datos de los casos de COVID-19 registrados en las bases de datos nacional y regional de la Secretaría de Salud Federal de México y la Secretaría de Salud de Ciudad de México para establecer las características clínicas y los factores de riesgo de mortalidad en la población pediátrica. El riesgo de defunción se calculó mediante el método de regresión de riesgos proporcionales de Cox. Resultados: Las bases de datos nacional y de Ciudad de México, respectivamente, registraban un total de 18.465 (2,8%) y de 5.733 (4,2%) de casos confirmados de COVID-19 en menores de 18 años en septiembre de 2020. La edad mediana al diagnóstico fue de 12 años (rango: 0-17). Las diferencias encontradas en los casos registrados a nivel nacional en comparación con los registrados en la Ciudad de México fueron: 12,5 vs. 8,2% de pacientes hospitalizados; 6 vs. 3,5% con diagnóstico de neumonía; 2,4 vs. 1,9% ingresados en la unidad de cuidados intensivos (UCI) y 1,3 vs. 0,7% fallecidos. Los factores de riesgo independientes asociados a una probabilidad mayor de defunción fueron el diagnóstico de neumonía, la hipertensión, la obesidad, la inmunosupresión y la intubación. Conclusiones: En México, el 2,8% del total de casos confirmados COVID-19 se dan en pacientes menores de 18 años, con una mediana de edad de 12 años y una mortalidad del 1,3%. Los factores de riesgo de mortalidad identificados fueron el diagnóstico de neumonía, el ingreso en la UCI, la obesidad, la hipertensión, la inmunosupresión, la diabetes, la enfermedad pulmonar crónica y la enfermedad renal. (AU)

Introduction: In the paediatric population, coronavirus disease (COVID-19) is usually asymptomatic or mild, but there are also severe and fatal cases. Methods: We analysed data on COVID-19 cases from the national and state-level databases of the Federal Ministry of Health of Mexico and the Department of Health of Mexico City to determine the clinical characteristics and risk factors for mortality in children. We used Cox proportional hazards regression analysis to calculate the risk of death. Results: The national and Mexico City databases had recorded a total of 18,465 (2.8%) and 5,733 (4.2%) confirmed cases of COVID-19, respectively, in individuals aged less than 18 years as of September 2020. The median age at diagnosis was 12 years (range: 0–17). The differences between cases in the national vs Mexico City databases were: 12.5% vs 8.2% of patients were hospitalised; 6% vs 3.5% had pneumonia; 2.4% vs 1.9% were admitted to the intensive care unit (ICU), and 1.3% vs 0.7% died. The independent risk factors significantly associated with a higher probability of death were pneumonia, hypertension, obesity, immunosuppression and intubation. Conclusion: In Mexico, 2.8% of all confirmed cases of COVID-19 occurred in individuals under 18 years, with a median age of 12 years and a mortality of 1.3%. The identified predictors of mortality were pneumonia, admission to the ICU, obesity, hypertension, immunosuppression, diabetes, chronic lung disease and renal disease. (AU)

Clinical characteristics and mortality risk factors in patients aged less than 18 years with COVID-19 in Mexico and Mexico City.

INTRODUCTION: In the paediatric population, coronavirus disease (COVID-19) is usually asymptomatic or mild, but there are also severe and fatal cases. METHODS: We analysed data on COVID-19 cases from the national and state-level databases of the Federal Ministry of Health of Mexico and the Department of Health of Mexico City to determine the clinical characteristics and risk factors for mortality in children. We used Cox proportional hazards regression analysis to calculate the risk of death. RESULTS: The national and Mexico City databases had recorded a total of 18,465 (2.8%) and 5,733 (4.2%) confirmed cases of COVID-19, respectively, in individuals aged less than 18 years as of September 2020. The median age at diagnosis was 12 years (range: 0-17). The differences between cases in the national vs Mexico City databases were: 12.5% vs 8.2% of patients were hospitalised; 6% vs 3.5% had pneumonia; 2.4% vs 1.9% were admitted to the intensive care unit (ICU), and 1.3% vs 0.7% died. The independent risk factors significantly associated with a higher probability of death were pneumonia, hypertension, obesity, immunosuppression and intubation. CONCLUSION: In Mexico, 2.8% of all confirmed cases of COVID-19 occurred in individuals under 18 years, with a median age of 12 years and a mortality of 1.3%. The identified predictors of mortality were pneumonia, admission to the ICU, obesity, hypertension, immunosuppression, diabetes, chronic lung disease and renal disease.

Oxidative Stress in Malaria: Potential Benefits of Antioxidant Therapy.

Malaria is an infectious disease and a serious public health problem in the world, with 3.3 billion people in endemic areas in 100 countries and about 200 million new cases each year, resulting in almost 1 million deaths in 2018. Although studies look for strategies to eradicate malaria, it is necessary to know more about its pathophysiology to understand the underlying mechanisms involved, particularly the redox balance, to guarantee success in combating this disease. In this review, we addressed the involvement of oxidative stress in malaria and the potential benefits of antioxidant supplementation as an adjuvant antimalarial therapy.

Aplicación de terapia trombolítica en pacientes con infarto agudo de miocardio durante dos años / Two-year application of thrombolytic therapy in patients with acute myocardial infarction

RESUMEN Introducción: La estrategia trombolítica no solo mejora la esperanza de supervivencia del infarto, sino que también reduce la mortalidad general a un mes en los pacientes que reciben este tratamiento. Objetivo: Caracterizar los pacientes con infarto agudo de miocardio con elevación del segmento ST tratados con estreptoquinasa recombinante en el Hospital Clínico Quirúrgico Docente «Celia Sánchez Manduley». Métodos: Se realizó un estudio descriptivo, longitudinal y retrospectivo en 94 pacientes que recibieron tratamiento trombolítico desde diciembre de 2018 a noviembre de 2020. Las variables utilizadas fueron: edad, sexo, comorbilidades, tiempo de ventana terapéutica, causas de suspensión temporal, complicaciones, topografía, criterios de reperfusión clínico, eléctrico y enzimático y mortalidad. Se calculó la frecuencia absoluta y relativa, y la media aritmética con desviación estándar. Resultados: Predominó el sexo masculino y el grupo de edad entre 61 - 70 años. Prevalecieron los pacientes con antecedentes de hipertensión y diabetes. La hipotensión arterial fue la causa de suspensión más frecuente. El 69,1 % fueron trombolizados pasadas las 6 horas. Solo 27 pacientes sufrieron complicaciones, de las cuales, el bloqueo auriculoventricular y Killip - Kimball II fueron las más vistas. Por otra parte, 9 pacientes no presentaron criterios de reperfusión, y solo el 7,4 % fallecieron. Conclusiones: La trombolisis se realiza en una minoría de los pacientes aun en período de ventana terapéutica. La hipotensión fue la causa más frecuente de suspensión temporal de la trombolisis, y la letalidad fue inferior a la letalidad general por infarto agudo de miocardio.

ABSTRACT Introduction: thrombolytic strategy not only improves survival expectancy after infarction, but also reduces overall one-month mortality in patients receiving this treatment. Objective: to characterize patients with ST-segment elevation acute myocardial infarction treated with recombinant streptokinase at "Celia Sánchez Manduley" Clinical and Surgical Teaching Hospital. Methods: a descriptive, longitudinal and retrospective study was conducted in 94 patients who received thrombolytic treatment from December 2018 to November 2020. Age, gender, comorbidities, time-related therapeutic window, causes of temporary suspension, complications, topography, clinical, electrical and enzymatic reperfusion criteria as well as mortality were the variables used in this study. Absolute and relative frequency and arithmetic mean with standard deviation were calculated. Results: male gender and group aged 61-70 years predominated. Patients with a history of hypertension and diabetes predominated. Arterial hypotension was the most frequent cause of thrombolysis discontinuation. The 69.1 % were thrombolyzed after 6 hours. Only 27 patients suffered complications; atrioventricular block and Killip-Kimball II were the most frequently seen complications. On the other hand, 9 patients did not show reperfusion criteria and only 7.4 % died. Conclusions: thrombolysis is performed in a minority of patients even in the therapeutic window period. Hypotension was the most frequent cause of temporary suspension of thrombolysis, and case fatality was lower than the overall case fatality for acute myocardial infarction.

Symptom cluster analysis of long COVID-19 in patients discharged from the Temporary COVID-19 Hospital in Mexico City.

INTRODUCTION: Several reports have emerged describing the long-term consequences of COVID-19 and its effects on multiple systems. METHODS: As further research is needed, we conducted a longitudinal observational study to report the prevalence and associated risk factors of the long-term health consequences of COVID-19 by symptom clusters in patients discharged from the Temporary COVID-19 Hospital (TCH) in Mexico City. Self-reported clinical symptom data were collected via telephone calls over 90 days post-discharge. Among 4670 patients, we identified 45 symptoms across eight symptom clusters (neurological; mood disorders; systemic; respiratory; musculoskeletal; ear, nose, and throat; dermatological; and gastrointestinal). RESULTS: We observed that the neurological, dermatological, and mood disorder symptom clusters persisted in >30% of patients at 90 days post-discharge. Although most symptoms decreased in frequency between day 30 and 90, alopecia and the dermatological symptom cluster significantly increased (p < 0.00001). Women were more prone than men to develop long-term symptoms, and invasive mechanical ventilation also increased the frequency of symptoms at 30 days post-discharge. CONCLUSION: Overall, we observed that symptoms often persisted regardless of disease severity. We hope these findings will help promote public health strategies that ensure equity in the access to solutions focused on the long-term consequences of COVID-19.

Nurses' perspective about the Mental Health First Aid Training Programmes for adolescents in upper secondary schools: A focus group study.

WHAT IS KNOWN ON THE SUBJECT?: Mental Health First Aid Training Programmes with a pathogenic perspective are implemented worldwide for different participants and contexts. These interventions can promote the medicalization and psychiatrization movement of human suffering. Training programmes should teach about mental health nursing problems rather than disorders. However, there seem to be no studies describing these healthier interventions targeting adolescents in upper secondary schools. Nurses can explore these interventions and target them towards these participants and contexts. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: The perspective of nurses on the characteristics of Mental Health First Aid Training Programmes for adolescents in Portuguese upper secondary schools is reported. Experts recognize that the nurses who perform these interventions must have personal, pedagogical and mental health competencies. Therefore, mental health nurses may be considered. The components of mental health literacy, mental health nursing problems and a dynamic first aid plan can be taught using different classroom training strategies. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The role of mental health nurses in promoting health literacy is highlighted. They have the opportunity to lead multidisciplinary teams in using these healthier training programmes. These expert opinions can shape the planning, implementation and evaluation of these interventions. In turn, training programmes can promote the identification, assistance and/or adequate and timely referral of people with mental health nursing problems. ABSTRACT: Introduction Mental Health First Aid Training Programmes performed by nurses can empower adolescents to aid people with mental health problems. There do not appear to be any studies that describe these healthier interventions aimed at adolescents in upper secondary schools. The development of these educational interventions benefits from the input of their participants and facilitators. Aim To explore the perspective of nurses about Mental Health First Aid Training Programmes for adolescents in upper secondary schools. Method A qualitative, descriptive and exploratory study was conducted. Data were collected from seven mental health nurses during two focus group sessions. Data were analysed using content analysis. Results Twelve themes were identified around nine main areas: facilitators, intervention foci, outcomes assessment methods, process assessment methods, participants, implementation context, duration and frequency, intervention methods and strategies, and contents. Discussion Mental health nurses can regularly perform these classroom interventions to improve the mental health competencies of adolescents. Various educational methods can facilitate learning related to mental health literacy components, mental health nursing problems and the first aid plan. Valid and appropriate assessment methods enhance a good representation of these interventions. Implications for Practice This evidence can guide the creation and modelling of these first aid training programmes.

Sexuality in people living with a serious mental illness: A meta-synthesis of qualitative evidence.

WHAT IS KNOWN ON THE SUBJECT: A serious mental illness influences sexual life and people affected have worries about their sexual health. People living with a serious mental illness can and want to participate in interventions related to sexual health. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE: People who suffer a serious mental illness are interested in maintaining an active sex life. People who suffer a serious mental illness experience rejection when they open up and they lose intimate relationships or possibilities of meeting other people because of ignorance and prejudices surrounding mental health. WHAT ARE THE IMPLICATIONS FOR PRACTICE: Mental health services must respond to this need, that is including sexual needs assessment among routine standard practices or training nurses on sexual education to allow them to advise patients and their families and friends. Health systems should promote awareness programmes and reduce the stigma surrounding mental health and sexuality. ABSTRACT: INTRODUCTION: Sexuality-related nursing care is scarce and mainly focuses on biological issues. There is also a lack of knowledge about how serious mental illnesses affect sexuality. AIM: To explain how people with a serious mental illness perceive and experience their sexuality. METHOD: A meta-synthesis was conducted to integrate qualitative studies. Four databases were used to perform the search, focused in the last ten years. Nine articles were included, and their results analysed thematically. RESULTS: Four categories were identified: "Pathologized sexuality," which explains how the disorder and treatment affect sexuality; "Not my sexuality anymore," which describes feelings emerging from the perceived limitations and the role of self-acceptance; "Learning to manage intimate relationships," which explains the desire to establish intimate personal relationships and define their meaning; and "Reconstructing my sexuality," which elucidates the influence of the environment on sexuality. DISCUSSION: Sexuality is influenced by several factors, the main ones being: the clinical complications, the side effects of drug treatment, the social support, the relationship with the health sector and stigma. IMPLICATIONS FOR PRACTICE: Having a serious mental illness affects sexuality and can provoke suffering and social isolation. Mental health services should address this issue and carry out community interventions to reduce stigma.

[Clinical characteristics and mortality risk factors in patients aged less than 18 years with COVID-19 in Mexico and Mexico City]. / Características clínicas y factores de riesgo de mortalidad en menores de 18 años con COVID-19 en México y Ciudad de México.

Introduction: In the paediatric population, coronavirus disease (COVID-19) is usually asymptomatic or mild, but there are also severe and fatal cases. Methods: We analysed data on COVID-19 cases from the national and state-level databases of the Federal Ministry of Health of Mexico and the Department of Health of Mexico City to determine the clinical characteristics and risk factors for mortality in children. We used Cox proportional hazards regression analysis to calculate the risk of death. Results: The national and Mexico City databases had recorded a total of 18,465 (2.8%) and 5,733 (4.2%) confirmed cases of COVID-19, respectively, in individuals aged less than 18 years as of September 2020. The median age at diagnosis was 12 years (range: 0-17). The differences between cases in the national vs Mexico City databases were: 12.5% vs 8.2% of patients were hospitalised; 6% vs 3.5% had pneumonia; 2.4% vs 1.9% were admitted to the intensive care unit (ICU), and 1.3% vs 0.7% died. The independent risk factors significantly associated with a higher probability of death were pneumonia, hypertension, obesity, immunosuppression and intubation. Conclusion: In Mexico, 2.8% of all confirmed cases of COVID-19 occurred in individuals under 18 years, with a median age of 12 years and a mortality of 1.3%. The identified predictors of mortality were pneumonia, admission to the ICU, obesity, hypertension, immunosuppression, diabetes, chronic lung disease and renal disease.

A qualitative study exploring adolescents' perspective about Mental Health First Aid Training Programmes promoted by nurses in upper secondary schools.

Mental Health First Aid Training Programmes are educational interventions that aim to disseminate basic first aid skills in the community. Adolescents in the context of their secondary school education are a particularly appropriate population for literacy promotion interventions. This study explores adolescents' perspectives on Mental Health First Aid Training Programmes promoted by nurses in Portuguese upper secondary schools. A qualitative and exploratory study was conducted. Data were collected through semi-structured interviews with 12 adolescents who participated voluntarily and with the consent of their parents. Data were analysed using content analysis. Fourteen themes were identified around three main areas: (i) Relevance of training programmes, (ii) Content of training programmes and (iii) Intervention methods of training programmes. The results obtained indicate that adolescents consider Mental Health First Aid Training Programmes in school relevant and necessary. Adolescents identified the content they deemed most appropriate and how it could be taught. These results can guide the development of training programmes. Nurses should take the lead in implementing these interventions in schools. Adolescents can take a more active role in mental health issues by improving their literacy.

Factores psicológicos protectores y desestabilizadores en pacientes concardiopatía isquémica / Protective and destabilizing psychological factors in patients with ischemic heart disease

En el estudio actual de las patologías cardíacas se consideran cada vez más los factores psicológicos por el papel relevante que poseen en la evolución de estas enfermedades. El objetivo de este trabajo fue determinar los principales factores psicológicos protectores y desestabilizadores que se manifiestan en los pacientes con cardiopatía isquémica. Para ello se realizó un estudio descriptivo de corte transversal, en los pacientes con cardiopatía isquémica atendidos en el servicio de cardiología del Hospital Clínico Quirúrgico Celia Sánchez Manduley, del municipio Manzanillo, en el período octubre- diciembre del 2019. El universo estuvo constituido por 60 pacientes con cardiopatía isquémica. En el estudio el 78,33 por ciento de los pacientes tenían más de 60 años, 40 pacientes eran hombres y el 75 por ciento pertenecía a la zona urbana. Los principales factores psicológicos protectores presentes fueron el apoyo social reportado por todos los participantes y el cumplimiento terapéutico en el 91,67 por ciento de la población estudiada. Dentro de los factores psicológicos desestabilizadores el de mayor reporte fue la ansiedad presente en el 66,66 por ciento de los pacientes incluidos en el estudio. Se deben tomar en cuenta tanto los factores psicológicos protectores para poder potenciarlos y generar un mejor estado general del paciente, como los factores psicológicos desestabilizadores que generan descompensación y deben ser atendidos con intencionalidad una vez identificados(AU)

In the current study of cardiac pathologies, psychological factors are increasingly considered due to the relevant role they have in the evolution of these diseases. The objective of this work was to determine the main protective and destabilizingpsychological factors that manifest themselves in patients with ischemic heart disease. To this end, a descriptive cross-sectional study was carried out in patients with ischemic heart disease treated in the cardiology service of the Celia Sánchez Manduley Clinical Surgical Hospital, in the municipality of Manzanillo, in the period October-December 2019.The universe consisted of 60 patients with ischemic heartdisease. In the study, 78.33 percent of the patients were over 60 years old, 40 patients were men and 75 percent belonged to the urban area. The main protective psychological factors present were social support reported by all participants and therapeutic compliance in 91.67 percent of the studied population. Among the destabilizing psychological factors, the one with the highest report was the anxiety present in 66.66 percent of the patients included in the study. Both the protective psychological factors must be taken into account in order to enhance them and generate a better general condition of the patient, as well as the destabilizing psychological factors that generate decompensation and must beaddressed with intentionality once identified(EU)