Zika virus disease-associated Guillain-Barré syndrome-Barranquilla, Colombia 2015-2016.

BACKGROUND: An outbreak of Guillain-Barré syndrome (GBS), a disorder characterized by acute, symmetric limb weakness with decreased or absent deep-tendon reflexes, was reported in Barranquilla, Colombia, after the introduction of Zika virus in 2015. We reviewed clinical data for GBS cases in Barranquilla and performed a case-control investigation to assess the association of suspect and probable Zika virus disease with GBS. METHODS: We used the Brighton Collaboration Criteria to confirm reported GBS patients in Barranquilla during October 2015-April 2016. In April 2016, two neighborhood and age range-matched controls were selected for each confirmed GBS case-patient. We obtained demographics and antecedent symptoms in the 2-month period before GBS onset for case-patients and the same period for controls. Sera were collected for Zika virus antibody testing. Suspected Zika virus disease was defined as a history of rash and ≥2 other Zika-related symptoms (fever, arthralgia, myalgia, or conjunctivitis). Probable Zika virus disease was defined as suspected Zika virus disease with laboratory evidence of a recent Zika virus or flavivirus infection. Conditional logistic regression adjusted for sex and race/ethnicity was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS: We confirmed 47 GBS cases. Incidence increased with age (10-fold higher in those ≥60years versus those <20years). We interviewed 40 case-patients and 79 controls. There was no significant difference in laboratory evidence of recent Zika virus or flavivirus infection between case-patients and controls (OR: 2.2; 95% CI: 0.9-5.1). GBS was associated with having suspected (OR: 3.0, 95% CI: 1.1-8.6) or probable Zika virus disease (OR: 4.6, CI: 1.1-19.0). CONCLUSIONS: Older individuals and those with suspected and probable Zika virus disease had higher odds of developing GBS. KEY POINTS: We confirmed a Guillain-Barré syndrome (GBS) outbreak in Barranquilla, Colombia, during October 2015-April 2016. A case-control investigation using neighborhood controls showed an association of suspected and probable Zika virus disease with GBS.

Resultados de la aplicación de un modelo de prestación de servicios en salud familiar con enfoque de riesgo en una población rural de Bogotá / Results of the application of a family health service delivery model with a risk approach in a rural population of Bogota / Results of the application of a model of benefit of services of familiar health with approach of risk in a rural population of Bogotá

Antecedentes El Hospital Nazareth, I Nivel, Empresa Social del Estado durante la vigencia 2001, realizaba la prestación de los servicios concentrada en los centros de atención con intervenciones extramurales esporádicas. Objetivo Desarrollar un nuevo modelo de prestación de servicios en salud familiar con enfoque de riesgo, que reconozca a la familia como sujeto de sus intervenciones y explore el contexto en el que viven sus integrantes, aproximándose al conocimiento de su cultura. Métodos El modelo de prestación de servicios se desarrolló en cuatro fases: aprestamiento, caracterización, implementación y seguimiento y evaluación. Con el fin de cubrir al 100% de la población el campo aplicativo del modelo se realizó en tres ámbitos, a saber: familiar, de jomada e institucional. Resultados Durante el segundo semestre del año 2001 se inició la planeación de una nueva forma de prestación de servicios, considerándose innovadora, exitosa, con proyección de resultados que impactaron positivamente la estabilidad financiera de la institución, y que de igual manera lograron contribuir al mejoramiento de la calidad de vida de las familias de la localidad 20 del Sumapaz. Conclusiones Como resultados del desarrollo de este modelo cabe mencionar haber deshospitalizado las acciones en salud, haber realizado una atención integral a partir de procesos de interacción y haber incentivado la demanda inducida.

Background During 2001, the Nazareth Hospital, Level I, Empresa Social del Estado, provided services concentrated in care centers with sporadic extra-mural interventions. Objective To develop a new model for the provision of family health services with a risk approach, which recognizes the family as the subject of its interventions and explores the context in which its members live, approaching the knowledge of their culture. Methods The service delivery model was developed in four phases: preparation, characterization, implementation, and monitoring and evaluation. In order to cover 100% of the population, the model was applied in three areas, namely: family, day care and institutional. Results During the second semester of 2001, the planning of a new form of service provision began, which was considered innovative, successful, with projected results that had a positive impact on the financial stability of the institution, and which also contributed to the improvement of the quality of life of the families of the Sumapaz locality 20. Conclusions As results of the development of this model, it is worth mentioning that health actions have been dehospitalized, that comprehensive care has been provided based on interaction processes and that induced demand has been encouraged.

El niño y su cuerpo / The child and his body

A formação do futuro psicólogo deve incluir um treino adequado em atendimento geral de problemas de natureza psicológica, independentemente da área de especialização que o estudante venha a adotar. Relata-se uma experiência em que a situação real de Aconselhamento Psicológico é vivenciada pelos discentes durante um estágio prático. Observa-se que a conjunção do atendimento de clientes e da supervisão centrada no aluno oferece resultados satisfatórios. A situação descrita pode ser indicada para cursos similares como um tipo de solução à carência, freqüente entre nós, de recursos humanos e materiais suficientes para um treinamento ideal (AU)