A novel scale based on biomarkers associated with COVID-19 severity can predict the need for hospitalization and intensive care, as well as enhanced probabilities for mortality.

Prognostic scales may help to optimize the use of hospital resources, which may be of prime interest in the context of a fast spreading pandemics. Nonetheless, such tools are underdeveloped in the context of COVID-19. In the present article we asked whether accurate prognostic scales could be developed to optimize the use of hospital resources. We retrospectively studied 467 files of hospitalized patients after COVID-19. The odds ratios for 16 different biomarkers were calculated, those that were significantly associated were screened by a Pearson's correlation, and such index was used to establish the mathematical function for each marker. The scales to predict the need for hospitalization, intensive-care requirement and mortality had enhanced sensitivities (0.91 CI 0.87-0.94; 0.96 CI 0.94-0.98; 0.96 CI 0.94-0.98; all with p < 0.0001) and specificities (0.74 CI 0.62-0.83; 0.92 CI 0.87-0.96 and 0.91 CI 0.86-0.94; all with p < 0.0001). Interestingly, when a different population was assayed, these parameters did not change considerably. These results show a novel approach to establish the mathematical function of a marker in the development of highly sensitive prognostic tools, which in this case, may aid in the optimization of hospital resources. An online version of the three algorithms can be found at: http://benepachuca.no-ip.org/covid/index.php.

Growing taller unequally? Adult height and socioeconomic status in Spain (Cohorts 1940-1994).

Socioeconomic inequalities and their evolution in different historical contexts have been widely studied. However, some of their dimensions remain relatively unexplored, such as the role played by socioeconomic status in the trajectory of biological living standards, especially net nutritional status. The main objective of this article is to analyze whether the power of socioeconomic status (SES) to explain differences in the biological dimensions of human well-being (in this case, adult height, a reliable metric for health and nutritional status) has increased or diminished over time. Educational attainment and occupational category have been used as two different proxies for the SES of Spanish men and women born between 1940 and 1994, thus covering a historical period in Spain characterized by remarkable socioeconomic development and a marked increase in mean adult height. Our data is drawn from nine waves of the Spanish National Health Survey and the Spanish sample of two waves of the European Health Interview Survey (ENSE) for the period 1987 to 2017 (N = 73,699 citizens aged 23-47). A multivariate regression analysis has been conducted, showing that, as a whole, height differentials by educational attainment have diminished over time, whereas differences by occupational category of household heads have largely persisted. These results indicate the need for further qualification when describing the process of convergence in biological well-being indicators across social groups. For instance, the progressive enrollment of a greater proportion of the population into higher educational levels may lead us to underestimate the real differences between socioeconomic groups, while other proxies of SES still point to the persistence of such differences.

Ameloblastoma: caso clínico patológico en pediatría / Ameloblastoma: a pathological clinical case in pediatrics

El ameloblastoma es un tumor benigno derivado del epitelio odontogénico, clasificado actualmente de acuerdo al CIE 10-EO/SNOMED en el capítulo de tumores (neoplasia) benigna como D16.5/M-93100. Presenta un patrón de crecimiento lento, localmente agresivo, pudiendo causar, o no, grandes deformaciones faciales, en mandíbula o maxilar superior. De localización preferencial mandibular, el 75%, en el área molar y rama ascendente; mientras que, en maxilar superior, se concentran en el área molar con posible compromiso de seno maxilar y suelo de fosas nasales. La edad de presentación más frecuente es entre 20-40 años, siendo rara en pacientes pediátricos. En el tratamiento del mismo se valora tipo clínico, localización y tamaño del tumor, y la edad del paciente. El presente caso clínico destaca la importancia del oportuno diagnóstico clínico-patológico, su clasificación y el uso de nuevas técnicas complementarias (AU)

Ameloblastoma is a benign tumor derived from the Odontogenic epithelium, currently classified according to ICD 10-EO / SNOMED in the Chapter of Benign Tumors (Neoplasia) as D16.5 / M-93100. It has a slow growth pattern, locally aggressive, may or may not cause large facial deformations, in the jaw or upper jaw. Preferential mandibular location, 75% in the molar area and ascending limb; while in the upper jaw they are concentrated in the molar area with possible involvement of the maxillary sinus and the floor of the nostrils. The most frequent age of presentation is between 20-40 years, being rare in pediatric patients. In the treatment of the same, clinical type, location and size of the tumor, as the age of the patient, is assessed. The present clinical case highlights the importance of the appropriate clinical-pathological diagnosis, its classification and the use of new complementary techniques (AU)

Virus del Papiloma Humano como factor etiopatogénico de lesiones cervicales: Revisión de literatura / Human Papilloma Virus asetiopathogenic factor of cervical lesions: Literature review

El cáncer de Cuello Uterino (CaCu) representa un problema de salud pública a nivel mundial, es el segundo más frecuente de la población femenina y se caracteriza por ser precedido por un conjunto de displasias denominadas lesiones intraepiteliales escamosas (LIE), además se conoce que el Virus del Papiloma Humano (VPH), principalmente los genotipos de alto riesgo están implicados en la génesis del cáncer. En el año 2012 fallecieron en el Ecuador 9.709 personas por cáncer, siendo más frecuentes enel sexo femenino, el cáncer de cérvix y el de mama. Datos generados a nivel país aunado al criterio de algunos expertos tienen a contradecirse, por cuanto la población desconoce el riesgo de padecer cáncer y la importancia de un diagnóstico oportuno, provocando un subdiagnóstico. Es vital difundir conocimientos a los profesionales de la salud, con el propósito de fomentar prácticas que permitan la prevención y la detección oportuna de casos.

Cervical Cancer (CaCu) represents a public health problem worldwide, it is the second most frequent of the female population and is characterized by being preceded by a set of dysplasias called squamous intraepithelial lesions (LIE), it is also known that Human Papillomavirus (HPV), mainly high-risk genotypes are involved in the genesis of cancer. In 2012, 9,709 people died of cancer due to cancer, with cervical and breast cancer being more frequent in females. Data generated at the country level, together with the criteria of some experts, have to be contradicted, as the population is unaware of the risk of cancer and the importance of an opportune diagnosis, causing a subdiagnostic. It is vital to disseminate knowledge to health professionals, with the purpose of promoting practices that allow the prevention and timely detection of cases

Los profesionales de la salud mental ante situaciones de violencia familiar / Role of mental health professionals in domestic violence situations

La violencia familiar (VF) o doméstica tiene fuerte impacto en la salud mental de las víctimas. La prevalencia real es muy difícil de medir. Los registros suelen subestimar su magnitud. El principal obstáculo para la visualización del problema que representa la VF es la falta de claridad en el funcionamiento de redes de trabajo entre los ámbitos pertenecientes a la salud, el poder judicial y desarrollo social, lo cual genera un abordaje incompleto de la problemática. Grupos especialmente vulnerables son los niños, adolescentes, mujeres embarazadas o personas en situaciones especialmente difíciles. Como adultos mayores, hombres y mujeres con enfermedad física o mental incapacitante, en desventaja física, económica o cultural, los cuales comparten factores de riesgo que propician la perpetuación de las situaciones de VF. La prevención es presentada como el abordaje más eficaz para esta problemática. Esta perspectiva propone una nueva dinámica de trabajo, de observación, de comprensión y de intervención para que los trastornos no se presenten, avancen y repitan. Para una elaboración acertada de estrategias de trabajo y de intervenciones posibles del profesional, resulta indispensable conocer el marco legal ya que es de vital importancia intervenir y es responsabilidad de todos los profesionales de la salud formarnos en detección y atención a las víctimas. También es fundamental informarnos a cerca de las responsabilidades que nos atañen y de las herramientas con la que contamos en materia legal, para acercar a nuestros pacientes a sus derechos

A violência tem forte impacto sobre a saúde mental das vítimas. A verdadeira prevalência é difícil de medir, pois os dados disponíveis tendem a subestimar a sua magnitude. O principal obstáculo para a visualização do problema do VF é a falta de clareza na operação de rede entre as áreas relativas à saúde, judiciário e de desenvolvimento social, o que gera uma abordagem incompleta do problema. Os grupos particularmente vulneráveis incluem crianças, adolescentes, mulheres grávidas ou pessoas em circunstâncias particularmente difíceis. Como idosos, homens e mulheres com a desativação doença física ou mental, desvantagem física, econômica ou cultural, que compartilham fatores de risco que favorecem a perpetuação de situações de VF. Prevenção é apresentado como a abordagem mais eficaz para este problema. Esta abordagem oferece uma nova forma de trabalhar, observando-se, compreensão e intervenção para os transtornos não estão presentes, mover e repetir. Para um bom desenvolvimento de estratégias e intervenções possíveis de trabalho profissional, é essencial conhecer o enquadramento legal, pois é vital para intervir e é da responsabilidade de todos os profissionais de saúde a se formar na detecção e tratamento das vítimas. Também é essencial para nos informar sobre as responsabilidades que nos afetam e as ferramentas com que nós em matéria jurídica, para trazer os nossos pacientes para os seus direitos

Violence has strong impact on the mental health of the victims. The true prevalence is difficult to measure because the available data tend to underestimate its magnitude. The main obstacle for the visualization of the problem of the VF is the lack of clarity in the operation of networking among the areas pertaining to health, judiciary and social development, which generates an incomplete approach to the problem. Particularly vulnerable groups include children, adolescents, pregnant women or people in particularly difficult circumstances. As seniors, men and women with disabling physical or mental illness, physical, economic or cultural disadvantage, which share risk factors that promote the perpetuation of situations VF. Prevention is presented as the most effective approach to this problem. This approach offers a new way of working; observing, understanding and intervention for the disorders are not present, move and repeat. For a successful development of strategies and possible interventions working professional, it is essential to know the legal framework as it is vital to intervene and is the responsibility of all health professionals to form in detection and care of victims. It is also essential to inform us about the responsibilities that affect us and the tools with which we in legal matters, to bring our patients to their rights