[Psychological Impact of COVID-19 on Health Workers During the Second Year of the Pandemic in Latin America: Cross-Sectional Survey Study]. / Impacto psicológico del COVID-19 en los trabajadores sanitarios durante el segundo año de pandemia en Latinoamérica: estudio de encuesta transversal.

Introduction: The coronavirus pandemic continues to affect the mental health of healthcare personnel in Latin America (LA). Objective: To estimate the prevalence of psychological disturbances and associated risk factors for mental health in healthcare personnel in LA during the second year of the COVID-19 pandemic. Method: This multicenter cross-sectional study included a total sample of 5437 healthcare professionals from Argentina, Bolivia, Chile, Colombia, Ecuador, and Peru. The PHQ-9, GAD-7, and a brief demographic questionnaire were used. The prevalence of anxiety and depression was estimated based on the cut-off points of the instruments. Two multivariate logistic regressions were performed. Results: A population burden of anxiety (40.1%) and depression (62.2%) was found in healthcare personnel in LA. Among professionals in Argentina (OR = 1.374; P<.001), those working in state hospitals (OR = 1.536; P<.003), frontline healthcare workers for COVID patients (OR = 1.848; P<.001), general practitioners (OR = 1.335; P<.001), and specialists (OR = 1.298; P<.001), a higher risk of experiencing mental disorders was observed. Among women, younger personnel, and administrative staff, a higher probability of experiencing anxiety and depression was identified. Conclusions: The burden of mental disorders on healthcare personnel in Latin America is alarming. Psychological support services are necessary, aimed at providing measures for professionals to develop healthy coping mechanisms that mitigate the impact of the pandemic on their well-being and facilitate post-crisis adjustment.

[Prevalence and factors associated with subjective cognitive complaints in Latin American health workers during the COVID-19 pandemic]. / Prevalencia y factores asociados con las quejas cognitivas subjetivas del personal sanitario latinoamericano durante la pandemia de COVID-19.

Background and objectives: An increase in emotional disturbances and complaints about cognitive performance has been observed in Latin American healthcare workers during the SARS-CoV-2 pandemic, which can affect attention capacity and increase the levels of stress and burnout of these professionals. The objective was to analyse subjective cognitive complaints (SCC) and associated factors in health personnel during the COVID-19 pandemic in five Latin American countries.Methods: Multicentre cross-sectional study, which included 3,738 professionals from Colombia, Chile, Argentina, Ecuador, Bolivia, and Peru. The Generalized Anxiety Disorder Scale (GAD-7) and the Patient Health Questionnaire (PHQ-9) was used to assess depression, and the Mini-Z to assess Burnout. For the SCC, an item on cognitive concerns in attention and memory was used.Results: The prevalence of cognitive complaints was 69.2%. The factors associated with a higher risk of SCC were the scores in the GAD-7, PHQ and Mini-Z, in addition to being part of the Ecuadorian health personnel.Conclusions: There is a high prevalence of SCC in health personnel, which is modulated by emotional states and stress.

Cambios en la composición corporal en pacientes con enfermedad isquémica en fase II de rehabilitación cardíaca / Changes in body composition in patients with ischemic disease undergoing phase II cardiac rehabilitation

Introducción. La enfermedad isquémica cardíaca es la principal causa de mortalidad en Colombia, por lo que los servicios de rehabilitación cardíaca juegan un papel fundamental en la prevención secundaria. El sobrepeso y la obesidad son factores intervenidos mediante composición corporal a través de bioimpedancia eléctrica para discriminar el agua corporal total, el agua extracelular, la masa magra, la masa grasa y la grasa visceral, siendo este último parámetro uno de los predictores de nuevos eventos cardiovasculares. Objetivo. analizar los cambios en la composición corporal en pacientes con enfermedad isquémica. Materiales y métodos. Estudio analítico retrospectivo realizado en 34 pacientes con diagnóstico de cardiopatía isquémica que entre el 3 de agosto de 2020 y el 4 de agosto de 2021 asistieron a rehabilitación cardíaca fase II de forma presencial en el Hospital Militar Central de Bogotá, Colombia. Se aplicó un muestreo probabilístico. Resultados. La mediana de la edad de los participantes fue de 58 años y la mayoría fueron hombres (88,2%). Con respecto a las medidas antropométricas, la mediana del peso inicial fue 69,3 kg y la final, 68,7 kg (p=0,025); la mediana inicial del índice de masa corporal (IMC) fue 26,3 kg/m2 y la final, 26,1 kg/m2 (p=0,003); la mediana del perímetro abdominal inicial fue 91,5 cm y la final, 89,5 cm (p=0.000), y la mediana del perímetro de cadera inicial fue 98,5 cm y la final, 94 cm (p=0.000). En la composición corporal se encontró que la masa grasa disminuyo: la mediana pasó de 7,3 kg/m2 a 6,0 kg/m2 (p=0,002), al igual que la grasa visceral, cuya mediana pasó de 3,4 L a 3,1 L (p=0,003). La mediana de la capacidad física aumentó pasando de 7,2 MET a 10,4 MET (p=0.000). Conclusión. Los pacientes con diagnóstico de cardiopatía isquémica que asistieron a rehabilitación cardíaca al Hospital Militar Central presentaron cambios estadísticamente significativos entre el ingreso y el final del programa en peso, IMC, perímetro abdominal y de cadera, masa grasa, grasa visceral y capacidad física.

Introduction. Ischemic heart disease is the main cause of mortality in Colombia, so cardiac rehabilitation services play a fundamental role in secondary prevention. Overweight and obesity are factors intervened by means of body composition through electrical bioimpedance to discriminate total body water, extracellular water, lean mass, fat mass and visceral fat, the latter parameter being one of the predictors of new cardiovascular events. Objective. to analyze changes in body composition in patients with ischemic disease. Materials and Methods. Retrospective analytical study conducted in 34 patients with a diagnosis of ischemic heart disease who between August 3, 2020 and August 4, 2021 attended phase II cardiac rehabilitation in person at the Hospital Militar Central de Bogotá, Colombia. Probabilistic sampling was applied. Results. The median age of the participants was 58 years and the majority were men (88.2%). Regarding anthropometric measurements, the median initial weight was 69.3 kg and the final weight was 68.7 kg (p=0.025); the median initial body mass index (BMI) was 26.3 kg/m2 and the final weight was 26.1 kg/m2 (p=0.003); the median initial abdominal perimeter was 91.5 cm and the final perimeter was 89.5 cm (p=0.000), and the median initial hip perimeter was 98.5 cm and the final hip perimeter was 94 cm (p=0.000). In body composition, fat mass decreased: the median went from 7.3 kg/m2 to 6.0 kg/m2 (p=0.002), as did visceral fat, whose median went from 3.4 L to 3.1 L (p=0.003). Median physical capacity increased from 7.2 MET to 10.4 MET (p=0.000). Conclusion. Patients with a diagnosis of ischemic heart disease who attended cardiac rehabilitation at the Central Military Hospital presented statistically significant changes between admission and the end of the program in weight, BMI, abdominal and hip circumference, fat mass, visceral fat and physical capacity.

Economic impact of the liver condemnation of cattle infected with Fasciola hepatica in the Peruvian Andes.

Fasciolosis is a zoonotic food- and waterborne infection related to great economic losses on ruminant production. In order to determine the prevalence of bovine liver condemnations due to fasciolosis in an abattoir at the Central Andes of Peru, we evaluated the records of an authorized slaughterhouse in Huancayo, at 3300 m above sea level, over 16 months. Subsequently, the average weights of condemned viscera and carcasses were also estimated to determine the direct and indirect economic losses. Fasciolosis was the main cause of liver condemnation, with a prevalence of 55.72% (3926/7046; CI 95%: 56.88-54.56%). The livers infected were more than double the amount of livers supplied to markets in this period. Although the average price of liver in the Peruvian Andes is very cheap, approximately 16.45 tons of livers were destroyed, estimating a direct economic loss of US$ 35,080 (CI 95%: US$ 29,178-40,938). The indirect loss due to decreased body weight gain (calculated using 10% of the average weight of a healthy animal carcass) was estimated at US$ 354,570 (CI 95%: US$ 387,908-US$ 321,227). Fasciolosis is an important zoonotic disease that threatens food security in the Andean region, with major repercussions on the income of the livestock industry and the availability of cheap protein sources.

Manifestaciones cardiacas de la infección por Covid-19 y su enfoque rehabilitador. Revisión narrativa / Cardiac manifestations of Covid-19 infection and its rehabilitative approach. Narrative review

La infección por el nuevo coronavirus (Covid-19), descrita desde diciembre de 2019, ha ocasionado una pandemia de gran magnitud con consecuencias devastadoras a nivel mundial e implicaciones en la salud de las personas que la padecen y presentan síntomas, lo cual genera complicaciones a corto y a largo plazo, éstas últimas aún desconocidas en su totalidad. Se han descrito complicaciones cardiovasculares secundarias a la infección por Covid -19 entre las que se cuenta la aparición de arritmias, infarto agudo del miocardio, miocarditis y eventos trombótico. Sin embargo, las complicaciones a largo plazo aún no se dilucidan en su totalidad teniendo en cuenta el corto periodo de evolución de la enfermedad. A pesar de esto, es clara la asociación que existe entre las enfermedades cardiovasculares previas y la coinfección por Covid-19, lo cual favorece la aparición de enfermedades severas y peores desenlaces en las personas que las presentan. Teniendo en cuenta esta asociación, es importante crear o fortalecer programas de rehabilitación cardiaca que utilicen herramientas tecnológicas para favorecer la telerrehablitación y así mejorar la calidad de vida de las personas, favoreciendo su independencia.

The infection by the new coronavirus (Covid-19), described since December 2019, has caused a pandemic of great magnitude with devastating consequences worldwide and implications in the health of people who suffer from it and present symptoms, which generates short and long term complications, the latter still unknown in its entirety. Cardiovascular complications secondary to Covid-19 infection have been described, including arrhythmias, acute myocardial infarction, myocarditis and thrombotic events. However, long-term complications are not yet fully elucidated considering the short evolution period of the disease. Despite this, there is a clear association between previous cardiovascular disease and Covid-19 coinfection, which favors the onset of severe disease and worse outcomes in those who present it. Taking this association into account, it is important to create or strengthen cardiac rehabilitation programs that use technological tools to favor telerehablitation and thus improve the quality of life of people, favoring their independence.

Mortalidad asociada a la presión arterial de ingreso a urgencias en pacientes con trauma encéfalo-craneano: un estudio de cohorte retrospectiva / Mortality and blood pressure in emergency patients with traumatic brain injury: a retrospective cohort study / Mortalidade associada a pressão arterial de entra-da a urgências em doentes com trauma encéfalo-craneano: um estudo de coorte retrospectiva

Introducción: en pacientes con trauma encéfalo-craneano (TEC) la presión arterial en el momento de la admisión por urgencias tiene una relevancia especial por ser la base de la presión de perfusión cerebral. El propósito de esta investigación fue estimar la asociación entre los valores de presión arterial al ingreso a urgencias y la mortalidad hospitalaria en dichos pacientes. Métodos: cohorte retrospectiva en pacientes mayores de 18 años con diagnóstico de TEC admitidos al Hospital Pablo Tobón Uribe entre enero de 2012 y enero de 2014. Se hizo una regresión logística multivariable para estimar el efecto independiente de los valores de presión arterial en la mortalidad. Resultados: en 582 pacientes la mediana de edad fue 36 años (rango intercuartílico = 25-59) y el 77,1 % (n = 449) eran hombres. La mortalidad según los valores de presión arterial sistólica al ingreso en las categorías de <100, 100-150 y >150 mm Hg fue 34,6 % (18/52), 13,3 % (56/421) y 29,4 % (32/109), respectivamente. En el análisis univariable tanto la presión menor de 100 como la mayor de 150 mm Hg se asociaron con mortalidad, pero dicha asociación perdió magnitud y significado estadístico (OR = 1,81; IC95 % = 0,94-3,48 y OR = 1,91; IC95 % = 0,86-4,54, respectivamente) al ajustar por la escala de coma de Glasgow, la saturación de oxígeno y la presencia de edema cerebral. Conclusiones: no se demostró asociación estadísticamente significativa entre los valores de presión arterial al ingreso a urgencias y la mortalidad en los pacientes con TEC.

Introduction: Blood pressure is of special relevance in patients with traumatic brain injury (TBI) at admission to emergency services, since it is the basis of cerebral perfusion pressure. The purpose of this research was to estimate the association between blood pressure values measured on admission and hospital mortality in patients with TBI. Methods: Retrospective cohort study in patients older than 18 years admitted with TBI to Hospital Pablo Tobón Uribe, in Medellín (Colombia) between January 2012 and January 2014. A multivariate logistic regression model was performed to estimate the independent effect of blood pressure values on mortality. Results: 582 patients with a median age of 36 years (IQR = 25-59) 77.1 % of them males (n = 449) were evaluated. Mortality according to categories of systolic blood pressure at admission (<100, 100-150 and >150 mmHg) was as follows: 34.6 % (18/52), 13.3 % (56/421) and 29.4 % (32/109), respectively. Univariate analysis showed that blood pressure less than 100 or greater than 150 mm Hg were associated with hospital mortality, but that association lost magnitude and statistical significance (OR = 1.81; 95 % CI = 0.94-3.48 and OR = 1.91; 95 % CI = 0.86-4.54, respectively) after adjustment by Glasgow coma scale, oxygen saturation and cerebral edema. Conclusions: We did not demonstrate a statistically significant association between blood pressure values at admission to the emergency service and mortality in patients with TBI.

Introdução: em doentes com trauma encéfalo-craneano (TEC) a pressão arterial no momento da admissão por urgências tem uma relevância especial por ser a base da pressão de perfusão cerebral. O propósito desta investigação foi estimar a associação entre os valores de pressão arterial ao ingresso a urgências e a mortalidade hospitalar em ditos doentes. Métodos: coorte retrospectiva em doentes maiores de 18 anos com diagnóstico de TEC admitidos no Hospital Pablo Tobón Uribe entre janeiro de 2012 e janeiro de 2014. Se fez uma regressão logística multi-variável para estimar o efeito independente dos valores de pressão arterial na mortalidade. Resultados: em 582 doentes a média de idade foi 36 anos (RIC = 25-59) e 77,1 % (n = 449) eram homens. A mortalidade segundo os valores de pressão arterial sistólica ao ingresso nas categorias de <100, 100-150 y >150 mm Hg foi 34,6 % (18/52), 13,3 % (56/421) e 29,4 % (32/109), respectivamente. Na análise univariável tanto a pressão menor de 100 como a maior de 150 mm Hg se associaram com mortalidade, mas dita associação perdeu magnitude e significado estatístico (OR = 1,81; IC95 % = 0,94-3,48 e OR = 1,91; IC95 % = 0,86-4,54, respectivamente) ao ajustar pela escala de coma de Glasgow, a saturação de oxigeno e a presença de edema cerebral. Conclusões: não se demostrou associação estatisticamente significativa entre os valores de pressão arterial ao ingresso a urgências e a mortalidade nos doentes com TEC.