Glove perforation in selected surgical procedures in a general hospital in La Habana, Cuba.

Background: Surgical glove perforation constitutes a risk for the maintenance of aseptic technique and the risk of surgical site infection and occupational exposure to blood borne infections for healthcare workers. Aim: To identify the frequency of glove perforation in selected surgical procedures. Methods: A cross-sectional descriptive observational study was carried out in the surgical unit of the Joaquin Albarrán Hospital (La Habana, Cuba) during the period September-December 2019. Gloves used by surgeons in major urgent or elective surgical procedures were collected and tested for perforations. Findings: 757 gloves from 149 surgeons and 8 surgical specialties were tested and 95 (25.8%) had perforations. The highest frequencies of glove perforations were reported in vascular surgery (50.0%), proctology (37.9%), urology (28.0%) and general surgery (26.1%). The selected surgical procedures with the highest frequencies were open radical nephrectomy (87.5%), splenectomy (57.1%), open adenomectomy (55.6%), limb amputation (46.2%) and hysterectomy (41.7%). Glove perforation occurred more frequently in consultant surgeons (28.8%) than in residents (20.9%) (P = 0.021), in surgeons with more years of surgical experience (P = 0.003) and longer procedure duration (P = <0.001). Most glove perforations were identified in the left hand (64.1%), while 23.1% were in the right hand and 12.8% in both hands. 51.2% occurred in thumb and index finger. Differences in the patterns of glove perforation were observed among the different surgical procedures. Conclusions: Our findings provide insights into the risk of glove perforation during selected surgical procedures and the need for prevention strategies to reduce adverse consequences of glove perforation in patients and healthcare workers.

Componente crítico en las estrategias de atención médica, prevención y control de la COVID-19 / The critical component as part of the strategies for medical care, prevention and control of COVID-19

Introducción: La educación médica es un elemento de vital importancia para mejorar el desempeño de los profesionales de la salud en la lucha contra la pandemia de COVID-19. Objetivo: Identificar los elementos fundamentales relacionados con la educación médica en su relación con la atención médica a pacientes con COVID-19, y las estrategias de prevención y control. Desarrollo: Los aspectos relacionados con la atención médica de pacientes sospechosos y confirmados, y con la prevención y el control de la transmisión de infecciones en entornos comunitarios o en centros de salud, se describen como áreas fundamentales para la educación médica. Asimismo, después de controlar la pandemia, los educadores de salud tienen el desafío de evaluar la modificación requerida en los programas de capacitación de profesionales de la salud para lograr un alto rendimiento en los nuevos entornos epidemiológicos. Por este motivo se realizó una sistematización del conocimiento relacionado con los desafíos y el papel de la educación médica en la lucha contra la COVID-19. Conclusiones: Los educadores han tenido un desafío durante la epidemia de COVID-19 en la educación de los profesionales de la salud para enfrentar la epidemia, que será un mayor en el futuro debido a la necesidad de lograr la sostenibilidad de la educación y la revisión de los programas de capacitación para enfrentar la nueva realidad epidemiológica(AU)

Introduction: Medical education is vitally important for improving the performance of health professionals in the fight against the COVID-19 pandemic. Objective: To identify the fundamental elements related to medical education in its relationship with medical care of patients with COVID-19, as well as prevention and control strategies. Development: Aspects related to medical care of suspected and confirmed patients, as well as to the prevention and control of infection transmission in the community settings or in health centers, are described as fundamental areas for medical education. Furthermore, after controlling the pandemic, health educators are challenged to assess the required modification to health professional training programs in order to achieve high performance in new epidemiological settings. Therefore, a systematization was carried out of knowledge related to the challenges and the role of medical education in the fight against COVID-19. Conclusions: Educators have faced a challenge during the COVID-19 epidemic in educating health professionals to face the epidemic, which will be even greater in the future due to the need to achieve sustainability of education and revision of training programs to face the new epidemiological reality(AU)

Clinical relevance of Zika symptoms in the context of a Zika Dengue epidemic.

BACKGROUND: The clinical characteristics of the most frequent arbovirosis (Dengue, Zika, Chikungunya) are very similar, which is a diagnostic challenge for clinicians. OBJECTIVE: To identify the presence of clinical characteristics related to Zika virus infection confirmed by the laboratory in patients during an epidemic of co-infection with Zika and Dengue viruses. METHOD: Cross-sectional descriptive study of patients with clinical - epidemiological suspicion of Zika virus infection, who were admitted in the Hospital "Joaquín Albarrán" (La Habana, Cuba), during June 1 to October 31 of 2017. Demographic and symptoms and signs were recorded. By PCR for Zika virus (in blood or urine) the disease was confirmed. RESULTS: 1541 patients were studied. The most frequent symptoms and signs were rash (93.8%), pruritus (77.9%), arthralgia (60.0%), headache (50.8%), myalgia (46.1%), fever (34.7%), asthenia (31.7%), and conjunctivitis (27.9%). Zika virus infection was confirmed in 279 patients (18.1%). Greater frequency of arthralgia, asthenia, and diarrhea was demonstrated in Zika confirmed patients. CONCLUSION: Minor clinical relevance was observed in the symptoms or signs of arboviral disease to support the clinical diagnosis of Zika virus infections by clinician during a Zika-Dengue epidemic. The assessment of the temporality of the onset of Zika and Dengue symptoms of these infections is recommended to assist clinicians in the differential diagnosis.

COVID-19 y el problema de los tiempos en las estrategias de control / COVID-19 and the problem of the times in the control strategies

Introducción: En el proceso de cuidados de paciente con sospecha de infección por el nuevo coronavirus (COVID-19) se incluyen elementos que deben ser considerados en las estrategias de prevención de la transmisión. Objetivo: Describir, a partir de la presentación de un caso confirmado con COVID-19, la cronología de los cuidados del paciente sospechoso o confirmado con la enfermedad y la necesidad de optimizar los tiempos de diagnóstico en la prevención de su transmisión. Presentación de caso: Paciente masculino de 59 años de edad con antecedentes de Hipertensión arterial y gota, y de profesión taxista. Siete días anteriores al ingreso comienza con los síntomas clínicos y se le realiza prueba rápida para COVID-19, la cual resultó negativa. Al quinto día de ingreso de aislamiento en habitación privada se le realiza PCR y se confirma la infección por coronavirus. Se traslada a institución dedicada a la atención de estos pacientes donde presenta recuperación sin complicaciones. Se describen los intervalos de tiempo en relación con los cuidados en especial énfasis a la demora diagnóstica. Conclusiones: Se requiere un monitoreo de la dinámica de los cuidados de los pacientes sospechosos de COVID-19 con un especial enfoque en el fortalecimiento de la prevención de la transmisión nosocomial y en la comunidad(AU)

Introduction: In the process of caring for patients with suspected coronavirus infection (COVID-19), elements that must be considered in transmission prevention strategies are included. Objective: To describe, based on the presentation of a case confirmed with COVID-19, the chronology of patients suspected or confirmed with the disease and the need to optimize diagnosis times in the transmission prevention. Case presentation: Fifty-nine-year-old male patient with a history of high blood pressure and gout, working as a taxi driver. Seven days before admission, he began with symptoms. A rapid test for COVID-19 was performed, which was negative. On the fifth day of isolation in a private room, PCR was performed and coronavirus infection was confirmed. He was moved to an institution dedicated to the care of these patients where he recovered without complications. Time intervals concerning care are described with special emphasis on diagnostic delay. Conclusion: Monitoring of the care dynamics of patients suspected of COVID-19 is required with a special focus on strengthening the prevention of nosocomial transmission and the prevention of the spreading of the disease in the community(AU)

Etica ecológica para América latina

En esta obra el autor toma la ecología como expresión del derecho a la vida, la ecología en perspectiva de alteridad, exigencias de la ecología en los distintos ámbitos de la vida social todos estos aspectos relacionados a América latina

Etica ecológica para América latina

En esta obra el autor toma la ecología como expresión del derecho a la vida, la ecología en perspectiva de alteridad, exigencias de la ecología en los distintos ámbitos de la vida social todos estos aspectos relacionados a América latina

Etica ecológica para América latina

En esta obra el autor toma la ecología como expresión del derecho a la vida, la ecología en perspectiva de alteridad, exigencias de la ecología en los distintos ámbitos de la vida social todos estos aspectos relacionados a América latina