[Cardiotoxicity from anti-HER-2 therapies in patients with HER-2 positive breast cancer]. / Cardiotoxicidad por terapias anti-HER-2 en pacientes con cáncer de mama HER-2 positivo.

Background: HER-2 positive (+) breast cancer (BC) accounts for 20-25% of BC, it is more aggressive, and it has a lower survival rate. Since the approval of trastuzumab in 1998, other HER-2-targeted therapies such as pertuzumab and trastuzumab emtansine (TDM1) have been introduced, improving patient survival. However, cardiotoxicity is an adverse effect of these treatments. Objective: To estimate the incidence of cardiotoxicity with trastuzumab, trastuzumab/pertuzumab, and TDM1 in women with HER-2 + BC treated over a 6-year period at the Hospital de Clínicas and the Hospital Departamental de Soriano. Material and methods: Observational, descriptive, and retrospective study which included patients with HER-2 + BC treated with trastuzumab, trastuzumab/pertuzumab, or TDM1. Results: 81 patients were included, with a cardiotoxicity incidence of 23.4%. Cardiotoxicity was determined by a > 10% decrease in left ventricular ejection fraction (LVEF) (57.9%) and a LVEF < 50% evident during treatment (42.1%). Only 1 patient presented symptomatic heart failure. 63.1% of those who discontinued treatment due to cardiotoxicity managed to resume it. No relationship was evident between cardiovascular history or the administration regimen and the development of cardiotoxicity. Conclusion: The study showed a cardiotoxicity incidence similar to the international one. Most did not present cardiac toxicity, and if they did, it was asymptomatic and reversible.

Introducción: el cáncer de mama (CM) HER-2 positivo (+) representa el 20-25% de los CM, es más agresivo y tiene menor sobrevida. Desde la aprobación del trastuzumab en 1998, se han introducido otras terapias dirigidas al HER-2 como pertuzumab y trastuzumab emtansina (TDM1), con lo cual ha mejorado la supervivencia de las pacientes. Sin embargo, la cardiotoxicidad representa un efecto adverso de estos tratamientos. Objetivo: estimar la incidencia de cardiotoxicidad con trastuzumab, trastuzumab/pertuzumab y TDM1 en mujeres con CM HER-2 +, tratadas en un periodo de 6 años en el Hospital de Clínicas y el Hospital Departamental de Soriano. Material y métodos: estudio observacional, descriptivo y retrospectivo que incluyó pacientes con CM HER-2 +, tratadas con trastuzumab, trastuzumab/pertuzumab o TDM1. Resultados: se incluyeron 81 pacientes. La incidencia de cardiotoxicidad fue del 23.4%. La cardiotoxicidad se determinó por una disminución > 10% de la fracción de ejección del venticulo izquierdo (FEVI) (57.9%) y por una FEVI < 50%, evidenciada durante el tratamiento (42.1%). Únicamente una paciente presentó insuficiencia cardiaca sintomática. El 63.1% de quienes suspendieron el tratamiento por cardiotoxicidad logró reanudarlo. No se evidenció una relación entre los antecedentes cardiovasculares ni con el esquema de administración y el desarrollo de cardiotoxicidad. Conclusión: el estudio mostró una incidencia de cardiotoxicidad similar a la internacional. La mayoría no tuvo toxicidad cardiaca y si la hubo fue asintomática y reversible.

Comparison of grain traits and genetic diversity between Chinese and Uruguayan soybeans (Glycine max L.).

Soybeans (Glycine max L.), originating in China, were introduced to South America in the late 19th century after passing through North America. South America is now a major soybean-producing region, accounting for approximately 40% of the global soybean production. Crops like soybeans gradually adapt to the local climate and human-selected conditions, resulting in beneficial variations during cultivation in different regions. Comparing the phenotypic and genetic variations in soybeans across different regions is crucial to determining the variations that may enhance soybean productivity. This study identified seed-related traits and conducted a genetic diversity analysis using 46 breeding soybean varieties from China and Uruguay. Compared to the Chinese soybean germplasm, the Uruguayan equivalent had a lower 100-grain weight, higher oil content, lower protein content, and higher soluble sugar content. Using ZDX1 gene chips, genetic typing was performed on the 46 breeding varieties. Cluster analysis based on SNP sites revealed significant differences in the genetic basis of Sino-Uruguayan soybean germplasm. Selection analysis, including nucleotide polymorphism (π) and fixation indexes (Fst), identified several genomic regions under selection between Sino-Uruguayan soybean germplasm. The selected intervals significantly enriched gene ontology (GO) terms related to protein metabolism. Additionally, differentiation occurred in genes associated with the oil content, seed weight, and cyst nematodes between Sino-Uruguayan soybean germplasm, such as GmbZIP123 and GmSSS1. These findings highlight the differences in seed-related phenotypes between Sino-Uruguay soybean germplasm and provide genomic-level insights into the mechanisms behind phenotypic differences, offering valuable references for understanding soybean evolution and molecular breeding.

Follow up study of symptomatic human cystic echinococcosis treatment with albendazole and praziquantel, in Uruguay.

BACKGROUND: Cystic echinococcosis (CE) is a chronic disease considered a neglected one. Cystic echinococcosis is endemic in Uruguay and the region. Surgery, using various technical approaches, has the potential to safely remove the cyst(s) and lead to a complete cure in a high number of patients with simple forms of CE. However, surgery may be impractical in patients with multiple cysts in several organs, high surgical risk, or in patients with previous multiple surgeries. In these cases, the pharmacological treatment with the benzimidazolic drug Albendazole (ABZ) alone or combined with Praziquantel (PZQ), has been promising as the best choice to achieve improvement or cure. METHODS: In this study, we analyze the results obtained on the anti-parasitic treatment of 43 patients diagnosed with CE between the years 2003 and 2020. Patients were treated before and/or after surgery with ABZ or the combination ABZ/PZQ. The standardize protocol of the anti-parasitic drug treatment before surgery was 7 days, 15 days or 1 month depending on the urgency and availability of the surgical procedure. All cases that involved confirmed locations on lungs underwent immediate surgery with minimal pre-treatment when possible. After surgery, the standardize protocol of anti-parasitic drug treatment consisted of six cycles of 30 days each and resting intervals of 15 days in between. ABZ was used in all cases, administered orally, twice daily, at a total dosage of 15 mg/kg/day, with food high in fat content for improved absorption. The follow up was carried out according to WHO-IWGE guidelines for 5 years. RESULTS: Of the 43 patients fourteen were ≤ 15 years of age and had a differentiated pre-surgical treatment. From the ≥ 16 years of age, 36 completed the treatments and the 5 years follow up. Four patients changed geographical locations, without a forwarding contact, after the post-surgery treatment. No patient died during the study. Of the 36 patients that completed the study, 32 were treated only with ABZ; 93.75% achieved treatment success as determined by improvement or cure, and 6.25% treatment failure determined by no change or worsening. The last four patients received the ABZ/PZQ combination therapy and achieved 100% treatment success. CONCLUSION: The pharmacological treatment resulted in a good option not only as palliative but also as potentially curative. The main relevance of its use was in cases with previous multiple surgeries or surgeries with potential life-threatening complications due to the number and location of cysts and concurrent comorbidities. A follow-up of at least 5 years would be recommended to assure remission and control of the transmission. More randomized trials are needed to provide clear clinical evidence of different pharmacological treatments for CE.

Comparative genomics of canine parvovirus in South America: Diversification patterns in local populations.

Canine parvovirus (CPV) is a significant pathogen in domestic dogs worldwide, causing a severe and often fatal disease. CPV comprises three antigenic variants (2a, 2b, and 2c) distributed unevenly among several phylogenetic groups. The present study compared genetic variability and evolutionary patterns in South American CPV populations. We collected samples from puppies suspected of CPV infection in the neighboring Argentina and Uruguay. Antigenic variants were preliminarily characterized using PCR-RFLP and partial vp2 sequencing. Samples collected in Argentina during 2008-2018 were mainly of the 2c variant. In the Uruguayan strains (2012-2019), the 2a variant wholly replaced the 2c from 2014. Full-length coding genome and vp2 sequences were compared with global strains. The 2c and 2a strains fell by phylogenetic analysis into two phylogroups (Europe I and Asia I). The 2c strains from Argentina and Uruguay clustered in the Europe I group, with strains from America, Europe, Asia, and Oceania. Europe I is widely distributed in South America in the dog population and is also being detected in the wildlife population. The 2a strains from Uruguay formed the distinct Asia I group with strains from Asia, Africa, America, and Oceania. This Asia I group is increasing its distribution in South America and worldwide. Our research reveals high genetic variability in adjacent synchronic samples and different evolutionary patterns in South American CPV. We also highlight the importance of ancestral migrations and local diversification in the evolution of global CPV strains.

Adolescent health-risk behaviours in Uruguay: Patterns from national cross-sectional school surveys conducted in 2006, 2012 and 2019.

BACKGROUND: There are no trend studies on various health risk behaviours among adolescents in Uruguay. Therefore, this study looked at trends in a number of health-risky behaviours among adolescents in Uruguay from three separate surveys. METHODS: Data from 9272 adolescents (age range: 11-16 years), who took part in three cross-sectional national in-school surveys in Uruguay in 2006, 2012 and 2019 were analysed. A self-administered survey was used to evaluate 24 health risk behaviours. By using logistic regression analyses to treat the study year as a categorical variable and adjusting food insecurity and age, linear trends were examined. RESULTS: We found a significant increase in the prevalence of being overweight, having obesity, inadequate fruit intake, sedentary behaviour in leisure-time, physical inactivity, bullying victimisation, loneliness, suicidal ideation, and sexual activity. We found a significant decrease in current cigarette use, physical fighting and current alcohol use. Among males, a significant increase of non-condom use, and a decrease in current other tobacco use (other than cigarettes), being physically attacked and the number of sexual partners. Among females, we found an increase in food insecurity, trouble from alcohol use, multiple sexual partners, and sleep problems. CONCLUSION: Overall, from 2006 to 2019, there was a decrease in seven health risk behaviours among boys and/or girls. Among boys, there was an increase in 10 health risk behaviours and among girls, 15 health risk behaviours increased, highlighting adolescent girls' greater vulnerability, thereby perpetuating further gendered health inequalities. In Uruguay, school health programmes for adolescents are recommended.

Detection and Genetic Characterization of Bovine Torovirus in Uruguay.

Bovine torovirus (BToV) is an enteric pathogen that may cause diarrhea in calves and adult cattle, which could result in economic losses due to weight loss and decreased milk production. This study aimed to report the presence, the genetic characterization and the evolution of BToV in calves in Uruguay. BToV was detected in 7.9% (22/278) of fecal samples, being identified in dairy (9.2%, 22/239) but not beef (0.0%, 0/39) calves. BToV was detected in both diarrheic (14%, 6/43) and non-diarrheic (13.2%, 5/38) dairy calves. In addition, BToV was detected in the intestinal contents of 14.9% (7/47) of naturally deceased dairy calves. A complete genome (28,446 nucleotides) was obtained, which was the second outside Asia and the first in Latin America. In addition, partial S gene sequences were obtained to perform evolutionary analyses. Nucleotide and amino acid substitutions within and between outbreaks/farms were observed, alerting the continuous evolution of the virus. Through Bayesian analysis using BEAST, a recent origin (mid-60s) of BToV, possibly in Asia, was estimated, with two introductions into Uruguay from Asia and Europe in 2004 and 2013, respectively. The estimated evolutionary rate was 1.80 × 10-3 substitutions/site/year. Our findings emphasize the importance of continued surveillance and genetic characterization for the effective management and understanding of BToV's global epidemiology and evolution.

Salud mental en Uruguay: Ley 19.529 desde su implementación hasta la actualidad / Mental health in Uruguay: Law 19.529 from its implementation to the current time / Saúde mental no Uruguai: a Lei 19.529 desde sua implementação até o presente

El presente artículo es el resultado de una revisión documental de prensa sobre la situación actual en materia de salud mental en Uruguay a partir de la implementación de la Ley 19.529. Los textos tomados en consideración fueron difundidos durante el período comprendido entre enero de 2022 y diciembre de 2023. Tomando como criterio de elegibilidad las publicaciones que informaron a cerca de la realidad de la población con padecimientos mentales en el territorio nacional. La indagación se realizó mediante el motor de búsqueda Google y del total de la información recolectada se seleccionaron 20 artículos. Luego se realizó una descripción objetiva y sistemática del contenido de las publicaciones. El estudio de los resultados se realizó en base al objetivo de la revisión que propuso analizar la salud mental en Uruguay a partir de la implementación de la Ley19.529 desde la visión de la prensa. Como conclusión de los hallazgos presentados, se estableció un avance significativo en el replanteo de la gestión pública sobre salud mental. A pesar de esto se puede apreciar una brecha entre lo que el Estado promueve a través de sus políticas públicas en materia de salud mental y lo que las personas con este tipo de padecimiento reciben. Todo esto refleja que aún cuando se ha dictado una ley en materia de salud mental y su instrumento de aplicación, esta no responde a los verdaderos problemas que padecen los enfermos. Revelando en varios artículos de prensa las deficiencias del sistema sanitario e instituciones psiquiátricas uruguayas. Por otro lado, cabe destacar, que se evidencia una alerta en relación al aumento de casos de trastornos mentales en niños y adolescentes y en la tasa de suicidios en el país luego de la crisis sanitaria originada por el COVID -19.

This article is the result of a press documentary review on the current situation regarding mental health in Uruguay since the implementation of Law 19.529. The texts taken into consideration were published between January 2022 and December 2023. Taking as eligibility criteria, the publications that reported about the reality of population with mental illnesses in the national territory. The investigation was carried out using Google Research and from the total information collected, 20 articles were selected. Then an objective and systematic description of the content of the publications was made. The study of the results was carried out based on the objective of the review, which proposed to analyze mental health in Uruguay based on the implementation of Law 19,529 from the perspective of the press. As a conclusion a significant progress was established in the rethinking of public management on mental health. Despite this, there is a gap between what the State offers through its public policies on mental health and what people with this type of condition receive. All of this reflects the fact that even when regulations and execution plans have been issued, they do not respond to the real problems suffered by patients. Revealing in several press articles the deficiencies of the Uruguayan health system and psychiatric institutions. On the other hand, it should be noticed that there is evidence of an alert in relation to the increase in cases of mental disorders in children and adolescents and in the suicide rate after the health crisis caused by COVID -19.

Este artigo é resultado de uma revisão documental de imprensa sobre a situação atual da saúde mental no Uruguai desde a implementação da Lei 19.529. Os textos considerados foram divulgados no período entre janeiro de 2022 e dezembro de 2023. Tomando como critérios de elegibilidade as publicações que relatassem a realidade da população com doenças mentais no território nacional. A investigação foi realizada por meio do mecanismo de busca Google e foram selecionados 20 artigos do total de informações coletadas. Em seguida foi realizada uma descrição objetiva e sistemática do conteúdo das publicações. O estudo dos resultados foi realizado com base no objetivo da revisão, que se propôs analisar a saúde mental no Uruguai a partir da implementação da Lei 19.529 sob a perspectiva da imprensa. Como conclusão dos achados apresentados, constatou-se um avanço significativo no repensar da gestão pública em saúde mental. Apesar disso, percebe-se uma lacuna entre o que o Estado oferece por meio de suas políticas públicas de saúde mental e o que recebem as pessoas com esse tipo de condição. Tudo isto reflecte que mesmo quando foram emitidos regulamentos e planos de execução, estes não respondem aos problemas reais sofridos pelos pacientes. Revelando em diversos artigos de imprensa as deficiências do sistema de saúde e das instituições psiquiátricas uruguaias. Por outro lado, cabe destacar que fica evidente um alerta em relação ao aumento dos casos de transtornos mentais em crianças e adolescentes e na taxa de suicídio após a crise sanitária causada pela COVID -19.

Molecular survey of Piroplasmida, Hepatozoon spp. and Anaplasmataceae in anemic and thrombocytopenic dogs from Uruguay.

Canine tick-borne diseases, such as babesiosis, rangeliosis, hepatozoonosis, anaplasmosis and ehrlichiosis, are of veterinarian relevance, causing mild or severe clinical cases that can lead to the death of the dog. The aim of this study was detecting tick-borne protozoan and rickettsial infections in dogs with anemia and/or thrombocytopenia in Uruguay. A total of 803 domestic dogs were evaluated, and 10% were found positive (detected by PCR) at least for one hemoparasite. Sequence analysis confirmed the presence of four hemoprotozoan species: Rangelia vitalii, Babesia vogeli, Hepatozoon canis and Hepatozoon americanum, and the rickettsial Anaplasma platys. The most detected hemoparasite was R. vitalii, followed by H. canis and A. platys. This is the first report of B. vogeli in Uruguay and the second report of H. americanum in dogs from South America. The results highlight the importance for veterinarians to include hemoparasitic diseases in their differential diagnosis of agents causing anemia and thrombocytopenia.

Do predator attacks on productive species and the respective economic losses influence the psychological distress of farmers in Uruguay? A cross-sectional study.

INTRODUCTION: In Uruguay, productive animals are attacked by various predators, causing injuries and financial losses, leading to great concern for farmers. The objective of this study was to determine, using a cross-sectional study, if predator attacks on productive animals during the year 2021 influenced the psychological distress of farmers. METHODS: Four hundred and forty-two farmers from around the country were surveyed with questions according to the Kessler Psychological Distress Scale (dependent variable), and predator attacks received in 2021 (independent variable). RESULTS: Of the total number of farmers surveyed, approximately 49% (216/442) had animals that had been attacked by predators. Farmers whose productive species were attacked in 2021 had higher levels of psychological distress than those whose animals were not attacked (p<0.01). Additionally, farmers who reported the highest levels of psychological distress had more deaths of productive species (and more financial losses) from predator attacks in 2021 than those who did not. CONCLUSION: The losses of productive species and the financial costs negatively influenced the psychological distress of farmers. This information highlights the need to generate public policies about farmers wellbeing that help them in these situations.

Socioeconomic disparities and health literacy: Unraveling the impact on diagnostic and cancer care in Uruguay.

BACKGROUND: Disparities in the timely diagnosis and care of cancer patients, particularly concerning geographical, racial/ethnic, and economic factors, remain a global health challenge. This study explores the multifaceted interplay between socioeconomic status, health literacy, and specific patient perceptions regarding care access and treatment options that impact cancer care in Uruguay. METHODS: Using the Cancer Health Literacy Test, Spanish Version (CHLT-30-DKspa), and a highly comprehensive questionnaire, we dissected the factors influencing the pathway to diagnosis and route of cancer care. This was done to identify delays by analyzing diverse socioeconomic and sex subgroups across multiple healthcare settings. RESULTS: Patients with lower income took longer to get an appointment after showing symptoms (p = 0.02) and longer to get a diagnosis after having an appointment (p = 0.037). Race/ethnicity also had a significant impact on the length of time from symptoms to first appointment (p =0.019), whereas employment status had a significant impact on patients being susceptible to diagnostic delays beyond the advocated 14-day window (p = 0.02). Higher educational levels were positively associated with increased cancer health literacy scores (p = 0.043), revealing the potential to mitigate delays through health literacy-boosting initiatives. Women had significantly higher self-reported symptom duration before seeking an intervention (p = 0.022). We also found many other significant factors effecting treatment delays and cancer health literacy. CONCLUSIONS: While affirming the global pertinence of socioeconomic- and literacy-focused interventions in enhancing cancer care, the findings underscore a complex, gendered, and perceptually influenced healthcare navigation journey. The results highlight the urgent necessity for strategically crafted, globally relevant interventions that transcend equitable access to integrate literacy, gender sensitivity, and patient-perception alignments in pursuit of optimized global cancer care outcomes.

Genomic and eco-epidemiological investigations in Uruguay reveal local Chikungunya virus transmission dynamics during its expansion across the Americas in 2023.

Uruguay experienced its first Chikungunya virus outbreak in 2023, resulting in a significant burden to its healthcare system. We conducted analysis based on real-time genomic surveillance (30 novel whole genomes) to offer timely insights into recent local transmission dynamics and eco-epidemiological factors behind its emergence and spread in the country.

Tasas de suicidio y concentración de litio en agua corriente en Rocha y Montevideo: primer estudio en Uruguay, período 2019-2020 / Suicide rates and lithium concentration in tap water in Rocha and Montevideo: first study in Uruguay, period 2019-2020 / Taxas de suicídio e concentração de lítio na água encanada em Rocha e Montevidéu: primeiro estudo no Uruguai, período 2019-2020

El suicidio es un fenómeno que además de las pérdidas humanas que involucra, repercute negativamente en familiares y allegados, produciendo a su vez enormes gastos en el sistema sanitario. En Uruguay, la tasa de suicidio no solo ha experimentado un aumento sostenido, representando una preocupación constante para las autoridades, sino que suele ser una de la más altas de Latinoamérica, en 2022 fue de 23,08 cada 100.000 habitantes. Reconociendo que el suicidio es un fenómeno multifactorial grave, diversos estudios han indagado sobre la posible correlación entre la presencia de litio en agua corriente y tasas de suicidio, habiéndose observado una relación inversa, lo que permitiría considerar el litio como eventualmente protector de la conducta suicida. El presente estudio pretende abordar dicha correlación en los departamentos de Rocha y Montevideo, de Uruguay. Los resultados obtenidos no son concluyentes. En cuanto a las concentraciones de litio presentes en agua corriente, en general son menores a las señaladas en otros estudios como protectoras (30 µ/L). Es necesario profundizar en este eje de discusión, como en otros, para obtener un diagnóstico más detallado de este complejo y sentido fenómeno.

Suicide is a phenomenon that, in addition to the human losses it involves, has a negative impact on family members and acquaintances, leading to enormous costs in the healthcare system. In Uruguay, the suicide rate has not only experienced a sustained increase, representing a constant concern for authorities, but it also tends to be one of the highest in Latin America, reaching 23.08 per 100,000 inhabitants in 2022. Recognizing that suicide is a serious multifactorial phenomenon, several studies have investigated the possible correlation between the presence of lithium in tap water and suicide rates, noting an inverse relationship. This suggests that lithium could potentially be considered protective against suicidal behavior. This study aims to address this correlation in the departments of Rocha and Montevideo, Uruguay. The results obtained are inconclusive. Regarding the concentrations of lithium present in tap water, they are generally lower than those indicated in other studies as protective (30 µg/L). It is necessary to delve deeper into this axis of discussion, as in others, to obtain a more detailed diagnosis of this complex and profound phenomenon.

O suicídio é um fenómeno que, além das perdas humanas que envolve, tem um impacto negativo nos familiares e amigos, produzindo enormes gastos no sistema de saúde. No Uruguai, a taxa de suicídio não só tem registado um aumento sustentado, representando uma preocupação constante para as autoridades, mas geralmente é uma das mais altas da América Latina, sendo de 23,08 por 100.000 habitantes em 2022. Reconhecendo que o suicídio é um fenómeno multifatorial grave, vários estudos têm investigado a possível correlação entre a presença de lítio na água encanada e as taxas de suicídio; observa-se uma relação inversa, o que permitiria considerá-lo como um possível protetor do comportamento suicida. O presente estudo visa abordar esta correlação nos departamentos de Rocha e Montevidéu no Uruguai. Os resultados obtidos não são conclusivos. Quanto às concentrações de litio presentes na água corrente, são geralmente inferiores às indicadas em outros estudos como protetoras (30 µ/L). É necessário aprofundar esta área de discussão como em outras linhas de pesquisa, e obter um diagnóstico mais detalhado deste fenômeno complexo e significativo.

Estadio, perfil biológico y tendencias de incidencia y mortalidad de cáncer de mama en Uruguay: análisis por franjas etarias / Stage, biological profile and trends in the incidence and mortality of breast cancer in Uruguay: analysis by age groups / Estágio, perfil biológico e tendências da incidência e mortalidade por cáncer de mama no Uruguai: análise por faixa etária

Introducción: el cáncer de mama es el tumor maligno más frecuente y la primera causa de muerte por cáncer en mujeres en Uruguay y en el mundo. La evidencia epidemiológica sugiere que el cáncer de mama en diferentes grupos de edades se comportaría como patologías distintas. El objetivo de este trabajo es caracterizar el cáncer de mama en Uruguay para diferentes estratos de edades. Material y método: se analizaron las tendencias temporales de la incidencia de cáncer de mama en mujeres en Uruguay en el período 2002-2019, y de la mortalidad por esta causa en 1990-2020. Para el quinquenio 2015-2019, se analiza además la distribución de estadios al diagnóstico y de perfiles biológicos (luminales, triple negativos y HER2 positivos). Se analizan tres segmentos de edades: mujeres de 20 a 44 años, de 45 a 69 y de 70 y más años. Resultados: las tasas de incidencia para el conjunto de edades se presentaron estables en el período 2002-2019, mientras que la mortalidad presenta una tendencia decreciente en el período 1990-2020. En las mujeres menores de 45 años se encuentra un aumento en la incidencia, con mortalidad que decrece hasta el 2010, seguido de una estabilización de las tasas; en las mujeres de 45 a 69 años la incidencia se mantiene estable y la mortalidad decrece; en las mayores de 70 años, la incidencia decrece mientras la mortalidad se mantiene estable. Más del 70% de los casos se diagnostican en estadios I y II. Los tumores luminales (receptores hormonales positivos, HER2 negativos) son el subtipo más frecuente para todos los grupos, la proporción de tumores con estas características aumenta con la edad, mientras decrece la proporción de HER2 positivo y triple negativo. Conclusión: en las mujeres uruguayas el cáncer de mama presenta características diferenciales para las tres franjas de edades analizadas.

Introduction: Breast cancer is the most common malignant tumor and the leading cause of cancer death in women in Uruguay and worldwide. Epidemiological evidence suggests that breast cancer in different age groups behaves as distinct pathologies. The objective of this work is to characterize breast cancer in Uruguay for different age groups. Method: Temporal trends in the incidence of breast cancer in women in Uruguay are analyzed for the period 2002-2019, along with mortality trends for this cause from 1990 to 2020. For the five-year period 2015-2019, the distribution of stages at diagnosis and biological profiles (Luminal, Triple-negative, and Her2 positive) is also analyzed. Three age segments are analyzed: women aged 20 to 44 years, 45 to 69 years, and 70 years and older. Results: The incidence rates for all age groups remained stable during the period 2002-2019, while mortality showed a decreasing trend in the period 1990-2020. In women under 45, there is an increase in incidence, with mortality decreasing until 2010, followed by a stabilization of rates; in women aged 45 to 69, incidence remains stable and mortality decreases; in those over 70, incidence decreases while mortality remains stable. More than 70% of cases are diagnosed at stages I and II. Luminal tumors (hormone receptor positive, Her2 negative) are the most frequent subtype for all age groups. The proportion of tumors with these characteristics increases with age, while the proportion of Her2 positive and triple-negative tumors decreases. Conclusions: In Uruguayan women, breast cancer presents differential characteristics for the three age groups analyzed.

Introdução: O câncer de mama é o tumor maligno mais comum e a principal causa de morte por câncer em mulheres no Uruguai e no mundo. Evidências epidemiológicas sugerem que o câncer de mama se comportaria como patologias distintas em diferentes faixas etárias. O objetivo deste trabalho é caracterizar o câncer de mama no Uruguai para diferentes faixas etárias. Materiais e Métodos: São analisadas as tendências temporais da incidência de câncer de mama em mulheres no Uruguai no período 2002-2019 e a mortalidade por esta causa no período 1990-2020. Para o quinquénio 2015-2019 são também analisadas a distribuição dos estádios ao diagnóstico e os perfis biológicos (Luminal, Triplo negativo e Her2 positivo). São analisados três segmentos etários: mulheres dos 20 aos 44 anos, dos 45 aos 69 anos e dos 70 anos ou mais. Resultados: As taxas de incidência para todas as idades permaneceram estáveis no período 2002-2019 enquanto a mortalidade apresentou tendência decrescente no período 1990-2020. Nas mulheres com menos de 45 anos verifica-se um aumento da incidência, com uma redução da mortalidade até 2010, seguida de uma estabilização das taxas; nas mulheres de 45 a 69 anos, a incidência permanece estável e a mortalidade diminui; nas pessoas com mais de 70 anos, a incidência diminui enquanto a mortalidade permanece estável. Mais de 70% dos casos são diagnosticados nos estágios I e II. Os tumores luminais (receptor hormonal positivo, Her2 negativo) são o subtipo mais comum para todos os grupos sem do que a proporção de tumores com essas características aumenta com a idade, enquanto a proporção de (Her2 positivo e triplo negativo) diminui. Conclusão: Nas mulheres uruguaias, o câncer de mama apresenta características diferenciadas para as três faixas etárias analisadas.

Hábitos alimentarios y caries de la primera infancia en una población uruguaya: estudio piloto / Dietary habits and early childhood tooth cavities in a uruguayan population: pilot study / Hábitos alimentares e cárie dentária na primeira infância numa população uruguaia: estudo piloto

Objetivo: conocer la relación entre el perfil de consumo de alimentos (frecuencia y tipo) con la prevalencia, extensión y distribución de las lesiones de caries en niños de 18-35 meses de la ciudad de Montevideo, Uruguay. Material y método: se realizó un estudio transversal con una muestra no probabilística de 50 niños, de ambos sexos. Los padres respondieron a un cuestionario sobre datos sociodemográficos, hábitos alimenticios e higiene bucal. Dos examinadoras calibradas registraron las lesiones de caries de acuerdo al criterio ICDAS-epi, índice de placa visible e índice PUFA. Se realizaron análisis descriptivos para caries dental y dieta (tipo de alimento, incorporación y frecuencia). Resultados: los niños examinados presentaban una edad promedio de 26,6±5,9 meses. La prevalencia de caries fue de 34%, con una extensión de 2,3 y 4,3 para ceo-d y ceo-s, respectivamente. Mayoritariamente se observaron lesiones severas, no tratadas, en el sector anterosuperior y posteroinferior. El índice PUFA fue de 8%. El 30% consumía leche materna, 54% leche con azúcar y el 100% consumía diariamente bebidas azucaradas no lácteas y alimentos azucarados antes de los 11 meses de vida. Los niños que consumían bebidas azucaradas (no lácteas) en biberón presentaron mayor extensión y severidad de las lesiones de caries (ceo-d modificado = 3,5 y ceo-s modificado = 7,8). Conclusiones: el conocimiento de los patrones de alimentación en la primera infancia necesitan ser profundizados. La población estudiada mostró la temprana incorporación de azúcar a la dieta, alertando sobre la presencia de un factor de riesgo común a diversas enfermedades no transmisibles (caries, diabetes, obesidad, enfermedades cardiovasculares).

Objective: to learn the relation between the food consumption profile (frequency and type) and the prevalence, extension and distribution of cavity lesions in children of 18-35 months of age from the city of Montevideo, Uruguay. Material y Methods: a cross-sectional study was carried out in 50 children, of both sexes. Parents answered a questionnaire regarding sociodemographic data, eating habits and oral hygiene. Two examiners recorded caries lesions on each tooth surface according to ICDAS-epi criteria, visible plaque index and PUFA index. Descriptive analysis of the variables were performed. The diet analysis considered food type, incorporation time and frequency through percentages. Results: children examined had an average age of 26.6 ± 5.9 months of age. The cavity prevalence was 34%, with an extension of 2.3 and 4.3 for ceo-d and ceo-s respectively. For the most part, severe untreated injuries were observed located in the anterior superior and posterior-inferior sector. The PUFA index was 8%. 30% consumed breast milk, 54% milk with sugar, 100% consumed beverages and sugary foods, mostly before 11 months and daily. Children who consumed sugary drinks (non-milk) in a bottle presented greater extent and severity of cavity lesions (ceo-d modificated= 3.5 and ceo-s modificated = 7.8). Conclusions: we need to deepen our knowledge of feeding patterns in early childhood. The population studied showed the early incorporation of sugar into the diet, warning about the presence of a common risk factor for various non-communicable diseases (cavities, diabetes, obesity, cardiovascular diseases).

Objetivo: conhecer a relação entre o perfil de consumo alimentar (frequência e tipo) com a prevalência, extensão e distribuição das lesões de cárie em crianças de 18-35 meses da cidade de Montevidéu, Uruguai. Métodos: foi realizado um estudo transversal em 50 crianças, de ambos os sexos. Os pais responderam a um questionário sobre dados sociodemográficos, hábitos alimentares e higiene bucal. Dois examinadores calibrados registraram lesões de cárie em cada superfície dentária de acordo com os critérios ICDAS-epi, índice de placa visível e índice de PUFA. Foi realizada análise descritiva das variáveis. A análise da dieta considerou o tipo de alimento, o tempo de incorporação e a frequência por meio de porcentagens. Resultados: as crianças examinadas tinham idade média de 26,6 ± 5,9 meses. A prevalência de cárie foi de 34%, com extensão de 2,3 e 4,3 para ceo-d e ceo-s respectivamente. Em sua maioria, lesões graves não tratadas foram observadas localizadas no setor anterossuperior e póstero-inferior. O índice PUFA foi de 8%. 30% consumiam leite materno, 54% leite com açúcar, 100% consumiram bebidas e alimentos açucarados antes dos 11 meses e diariamente. Crianças que consumiram bebidas açucaradas (não lácteos) em mamadeira apresentaram maior extensão e gravidade das lesões de cárie (ceo-d = 3,5 e ceo-s = 7,8). Conclusões: o conhecimento dos padrões de alimentação na primeira infância precisa ser aprofundado. A população estudada mostrou a incorporação precoce do açúcar na dieta, alertando para a presença de um fator de risco comum para diversas doenças não transmissíveis (cárie, diabetes, obesidade, doenças cardiovasculares).

Percepción del efecto de la pandemia en la salud y formación del estudiante de posgrado de pediatría en Uruguay / Perception of the effect of the pandemic on the health and training of pediatric postgraduate students in Uruguay / Percepção do efeito da pandemia na saúde e na formação de estudantes de pós-graduação pediátrica no Uruguai

Introducción: La pandemia impactó en la calidad de vida, salud integral y formación de los estudiantes de posgrados a nivel mundial. Objetivos: Describir la percepción del efecto de la pandemia en la salud integral y formación académica de estudiantes de posgrado de pediatría de Uruguay durante los años 2019- 2021. Metodología: Estudio descriptivo, transversal mediante encuesta a estudiantes de las generaciones 2019, 20 y 21. Se analizaron variables sociodemográficas y percepción del efecto de la pandemia en calidad de vida, salud, formación académica y rendimiento. Resultados: Participaron 93 estudiantes (65% de los habilitados). La mediana de edad fue 30,5 años, de género femenino: 88%. Cursaron la especialidad por residencia: 78,4%, en Montevideo 96%. El 41,3% expresó que cursar el posgrado durante la pandemia repercutió de forma negativa en su calidad de vida. Reportando reducción de actividades sociales: 83,3%, oferta laboral: 33,3%. Manifestaron sentirse agotados: 84%, fatigados: 64,4%. Se le diagnosticó una enfermedad nueva a 12,2% trastorno de ansiedad 5, depresión 4; reportaron consumo de psicofármacos durante la pandemia 13,3% versus 5,5% previo a esta. Consideraron que su formación se afectó negativamente: 57,3% y afectación del rendimiento: 38,2%. Refirieron obstáculos en la participación de actividades virtuales: 94,3%, por superposición con otras actividades: 85,3%, o problemas de concentración: 22,4%. Conclusiones: Los encuestados reportaron efectos de la pandemia en su salud, sobre todo en el área psicoemocional, con repercusión en su calidad de vida. El efecto en la formación fue menor, identificándose puntos a mejorar, sobre todo evitar la superposición de actividades.

Introduction: The pandemic impacted the quality of life, comprehensive health and training of postgraduate students worldwide. Objectives: Describe the perception of the effect of the pandemic on the comprehensive health and academic training of postgraduate pediatrics students in Uruguay during the years 2019-2021. Methodology: Descriptive, cross-sectional study using a survey of students from the 2019, 20 and 21 generations. Sociodemographic variables and perception of the effect of the pandemic on quality of life, health, academic training and performance were analyzed. Results: 93 students participated (65% of those qualified). The median age was 30.5 years, female: 88%. They studied the specialty through residency: 78.4%, in Montevideo 96%. 41.3% expressed that pursuing postgraduate studies during the pandemic had a negative impact on their quality of life. Reporting reduction in social activities: 83.3%, job offer: 33.3%. They reported feeling exhausted: 84%, fatigued: 64.4%. 12.2% were diagnosed with a new illness: anxiety disorder 5, depression 4; 13.3% reported consumption of psychotropic drugs during the pandemic versus 5.5% before it. They considered that their training was negatively affected: 57.3% and performance was affected: 38.2%. They reported obstacles in participating in virtual activities: 94.3%, due to overlap with other activities: 85.3%, or concentration problems: 22.4%. Conclusions: Respondents reported effects of the pandemic on their health, especially in the psychoemotional area, with an impact on their quality of life. The effect on training was minor, identifying points for improvement, especially avoiding overlapping activities.

Introdução: A pandemia impactou a qualidade de vida, a saúde integral e a formação de estudantes de pós-graduação em todo o mundo. Objetivos: Descrever a percepção do efeito da pandemia na saúde integral e na formação acadêmica dos estudantes de pós-graduação em pediatria no Uruguai durante os anos 2019-2021. Metodologia: Estudo descritivo, transversal, através de inquérito a estudantes das gerações 2019, 20 e 21. Foram analisadas variáveis ​​sociodemográficas e percepção do efeito da pandemia na qualidade de vida, saúde, formação acadêmica e desempenho. Resultados: participaram 93 alunos (65% dos aprovados). A mediana de idade foi de 30,5 anos, sexo feminino: 88%. Estudaram a especialidade por meio de residência: 78,4%, em Montevidéu 96%. 41,3% expressaram que a realização de estudos de pós-graduação durante a pandemia teve um impacto negativo na sua qualidade de vida. Relatando redução de atividades sociais: 83,3%, oferta de emprego: 33,3%. Relataram sentir-se exaustos: 84%, fatigados: 64,4%. 12,2% foram diagnosticados com alguma doença nova: transtorno de ansiedade 5, depressão 4; 13,3% relataram consumo de psicotrópicos durante a pandemia versus 5,5% antes dela. Consideraram que o seu treino foi afetado negativamente: 57,3% e o desempenho foi afetado: 38,2%. Relataram obstáculos na participação em atividades virtuais: 94,3%, por sobreposição com outras atividades: 85,3%, ou problemas de concentração: 22,4%. Conclusões: Os entrevistados relataram efeitos da pandemia na sua saúde, especialmente na área psicoemocional, com impacto na sua qualidade de vida. O efeito no treinamento foi mínimo, identificando pontos de melhoria, principalmente evitando sobreposição de atividades.

Hospitalizaciones por diarrea con sangre en un centro pediátrico de referencia en Uruguay / Hospitalizations due to bloody diarrhea in a pediatric reference center in Uruguay / Internações por diarreia sanguinolenta em um centro de referência pediátrica no Uruguai

Introducción: La diarrea con sangre es un motivo frecuente de admisión hospitalaria en niños, con gastroenteritis aguda; en la mayoría de los casos se tratan de infecciones leves y autolimitadas, pero pueden producirse complicaciones graves. Objetivos: Describir la etiología y características clínico- evolutivas de los niños menores de 15 años hospitalizados por diarrea con sangre en el Hospital Pediátrico, Centro Hospitalario Pereira Rossell entre los años 2012- 2023. Materiales y métodos: Estudio retrospectivo mediante revisión de historias y registros de laboratorio. Variables: demográficas, estado nutricional, hidratación, motivos de hospitalización, ingreso unidades de cuidados intensivos (UCI), enteropatógenos, tratamientos, evolución. Resultados: Se incluyeron 229 niños, mediana de edad de 8 meses; sexo masculino 61%; eutróficos 88%, bien hidratados 55%, con comorbilidades 11%, prematurez 6,5%. El motivo de hospitalización fue diarrea con sangre/disentería sin otro síntoma 45%. Se solicitó coprovirológico/coprocultivo en 98% y detección por técnicas de ácidos nucleicos en materia fecal 5,2%. Se identificó al menos un agente patógeno en 34,3%: Shigella sp. 38%; Salmonella sp. 19,5%; coinfecciones en 12%. Se indicaron antibióticos a 86%; ceftriaxona 62%, azitromicina 35%. Ingresaron a UCI 6,5% (15), presentaron complicaciones 10/14, fallo renal agudo 5 y alteraciones del medio interno 3. La mayoría presentó buena evolución. Conclusiones: La diarrea con sangre/disentería continúa siendo una causa importante de hospitalización afectando en su mayoría a niños sanos menores de 5 años. Los patógenos detectados con mayor frecuencia fueron bacterias principalmente Shigella sp., Salmonella sp. y E coli diarreogénicas. Se reportó alta prescripción de antibióticos, cumpliendo en la mayoría de los casos con las recomendaciones.

Introduction: Bloody diarrhea is a common reason for hospital admission in children with acute gastroenteritis; In most cases these are mild and self-limiting infections, but serious complications can occur. Goals: To describe the etiology and clinical-evolutionary characteristics of children under 15 years of age hospitalized for bloody diarrhea at the Pediatric Hospital, Centro Hospitalario Pereira Rossell between the years 2012-2023. Materials and methods: Retrospective study through review of histories and laboratory records. Variables: demographics, nutritional status, hydration, reason for hospitalization, intensive care unit (ICU) admission, enteropathogens, treatments, evolution. Results: 229 children were included, median age 8 months; male sex 61%; eutrophic 88%, well hydrated 55%, with comorbidities 11%, prematurity 6.5%. The reason for hospitalization was bloody diarrhea/dysentery without other symptoms 45%. Coprovirological/coproculture was requested in 98% and detection by nucleic acid techniques in fecal matter was requested in 5,2%. At least one pathogenic agent was identified in 34,3%: Shigella sp. 38%; Salmonella sp 19,5%; coinfections in 12%. Antibiotics were indicated for 86%; ceftriaxone 62%, azithromycin 35%. Were admitted to the ICU 6,5% (15), 10/14 had complications, 5 had acute kidney failure and 3 had alterations in the internal environment. The majority had a good evolution. Conclusions: Bloody diarrhea/dysentery continues to be an important cause of hospitalization, affecting mostly healthy children under 5 years of age. The most frequently detected pathogens were bacteria, mainly Shigella sp., Salmonella sp. and diarrheagenic E coli. High prescription of antibiotics was reported, complying in most cases with the recommendations.

Introdução: A diarreia com sangue é um motivo comum de internação hospitalar em crianças com gastroenterite aguda; Na maioria dos casos, estas são infecções leves e autolimitadas, mas podem ocorrer complicações graves. Metas: Descrever a etiologia e as características clínico-evolutivas de crianças menores de 15 anos internadas por diarreia sanguinolenta no Hospital Pediátrico Centro Hospitalario Pereira Rossell entre os anos de 2012-2023. Materiais e métodos: Estudo retrospectivo por meio de revisão de histórias e registros laboratoriais. Variáveis: dados demográficos, estado nutricional, hidratação, motivo da internação, internação em unidade de terapia intensiva (UTI), enteropatógenos, tratamentos, evolução. Resultados: foram incluídas 229 crianças, mediana de idade 8 meses; sexo masculino 61%; eutrófico 88%, bem hidratado 55%, com comorbidades 11%, prematuridade 6,5%. O motivo da internação foi diarreia sanguinolenta/disenteria sem outros sintomas 45%. O estudo coprovirologico/coprocultivo foi solicitado em 98% e a detecção por técnicas de ácidos nucleicos em matéria fecal foi solicitada em 5,2%. Pelo menos um agente patogênico foi identificado em 34,3%: Shigella sp. 38%; Salmonella sp. 19,5%; coinfecções em 12%. Os antibióticos foram indicados para 86%; ceftriaxona 62%, azitromicina 35%. Foram internados em UTI 6,5% (15), 10/14 apresentaram complicações, 5 tiveram insuficiência renal aguda e 3 apresentaram alterações no meio interno, a maioria teve boa evolução. Conclusões: A diarreia/disenteria com sangue continua a ser uma causa importante de hospitalização, afetando sobretudo crianças saudáveis ​​com menos de 5 anos de idade. Os patógenos mais frequentemente detectados foram bactérias, principalmente Shigella sp., Salmonella sp. e E. coli diarreiogênica. Foi relatada elevada prescrição de antibióticos, cumprindo na maioria dos casos as recomendações.

Caracterización de recién nacidos con síndrome de Down: experiencia de cuatro años en el Servicio de Neonatología del Centro Hospitalario Pereira Rossell, Montevideo, Uruguay / Characterization of newborns with Down syndrome: 4-year experience at the Pereira Rossell Hospital's Neonatology Department, Montevideo, Uruguay / Caracterização de recém-nascidos com síndrome de Down: experiência de 4 anos no serviço de neonatologia do Centro Hospitalar Pereira Rossell, Montevidéu, Uruguai

Introducción: la trisomía 21 o síndrome de Down (SD) es la alteración cromosómica más frecuente, con una incidencia general de 1 en 600 a 800 recién nacidos vivos. Su diagnóstico es de sospecha clínica y confirmación citogenética. Las cardiopatías congénitas y las malformaciones gastrointestinales son frecuentes, al igual que las alteraciones hematológicas y desórdenes tiroideos. Material y método: estudio descriptivo con el objetivo de detallar las características fenotípicas, genéticas, malformaciones y morbilidades asociadas en los pacientes con trisomía 21 nacidos en el Servicio de Neonatología del Centro Hospitalario Pereira Rossell entre el 1 de julio de 2017 y el 1 de julio de 2021. Resultados: se incluyeron 56 pacientes, 30/56 fueron de sexo masculino, la media de edad gestacional fue de 37 semanas. Un total de 17 pacientes fue pretérmino. De los pacientes estudiados, 45/56 presentaron trisomía libre en el cariotipo. La hipotonía fue el signo más frecuentemente observado en el examen clínico. El defecto congénito más frecuente, en 34 pacientes, fue la cardiopatía congénita. La más frecuente fue la comunicación interauricular (CIA), seguida de la comunicación interventricular (CIV) en segundo lugar y el canal atrioventricular (canal AV) en tercer lugar. Se encontraron 23 pacientes con alteraciones en el hemograma, siendo la plaquetopenia la alteración más observada. A nueve pacientes se les realizó diagnóstico de hipotiroidismo y la mortalidad global durante la internación fue de 1,78%. Conclusiones: se destaca la alta prevalencia de prematurez y de defectos congénitos asociados, siendo la cardiopatía congénita la más frecuente.

Introduction: trisomy 21 or Down Syndrome is the most frequent chromosomal alteration, with a general incidence of 1 in 600 to 800 live newborns. Diagnosis is based on clinical suspicion and cytogenetic confirmation. Congenital heart disease and gastrointestinal malformations are frequent, as are hematological abnormalities and thyroid disorders. Materials and Methods: descriptive study with the objective of describing the phenotypic and genetic characteristics, malformations and associated morbidities in patients with trisomy 21 born in the neonatology service of the Pereira Rossell Hospital between July 1, 2017 and July 1, 2021. Results: 56 patients were included, 30/56 were male, the mean gestational age was 37 weeks. A total of 17 patients were preterm. Of the patients studied, 45/56 presented free trisomy in the karyotype. Hypotonia was the most frequently observed sign on clinical examination. The most common birth defect, in 34 patients, was congenital heart disease. Among them, the most frequent defect was interatrial septal defect (CIA), followed by interventricular septal defect (VSD) and thirdly, atrioventricular canal (AV canal). Twenty-three patients with alterations in the complete blood count were found, being thrombocytopenia the most observed alteration. Nine patients were diagnosed with hypothyroidism and overall mortality during hospitalization was 1.78%. Conclusions: we must highlight the high prevalence of prematurity and associated congenital defects, being congenital heart disease the most frequent.

Introdução: a Trissomia do 21 ou Síndrome de Down é a alteração cromossômica mais frequente, com incidência geral de 1 em 600 a 800 recém-nascidos vivos. Seu diagnóstico é baseado na suspeita clínica e na confirmação citogenética. Doenças cardíacas congênitas e malformações gastrointestinais são frequentes, assim como anomalias hematológicas e distúrbios da tireoide. Materiais e métodos: estudo descritivo com objetivo de descrever as características fenotípicas e genéticas, malformações e morbidades associadas em pacientes com trissomia dos 21 nascidos no serviço de Neonatologia do Hospital Pereira Rossell entre 1º de julho de 2017 e 1º de julho de 2021. Resultados: foram incluídos 56 pacientes, 30/56 do sexo masculino, idade gestacional média de 37 semanas. Um total de 17 pacientes foram prematuros. Dos pacientes estudados, 45/56 apresentavam trissomia livre no cariótipo. A hipotonia foi o sinal mais frequentemente observado no exame clínico. O defeito congênito mais comum, em 34 pacientes, foi a cardiopatia congênita. Dentre eles, o mais frequente foi a comunicação interatrial (CIA), seguida pela comunicação interventricular (CIV) em segundo lugar e pelo canal atrioventricular (canal AV) em terceiro lugar. Foram encontrados 23 pacientes com alterações no hemograma completo, sendo a trombocitopenia a alteração mais observada. Nove pacientes foram diagnosticados com hipotireoidismo e a mortalidade geral durante a internação foi de 1,78%. Conclusões: destaca-se a alta prevalência de prematuridade e defeitos congênitos associados, sendo as cardiopatias congênitas as mais frequentes.

Intervencionismo obstétrico y maternalización de las mujeres en la atención del parto en Uruguay, 1920-1940* / Obstetric interventionism and maternalization ofwomen in childbirth care in Uruguay, 1920-1940

Resumen En este artículo se analizan discursos de médicos de referencia en la creación de la especialidad en la atención del parto: la ginecotocología. Entre 1920 y 1940, bajo la influencia del pensamiento eugenésico y maternalista, en un contexto de valorización del bienestar de la infancia, la medicina construyó un nuevo intervencionismo obstétrico bajo el fundamento de mejorar la viabilidad fetal. En ese marco se apeló al supuesto "instinto maternal" femenino para mejorar la aceptación del mandato médico. A la vez, los médicos reconocieron sus dificultades para asistir de forma adecuada. No esperaban el tiempo suficiente y tendían a intervenir más de lo necesario en procesos fisiológicos que no lo requerían.

Abstract This article analyzes the speeches of leading doctors in the creation of the specialty in childbirth care: gynecotology. Between 1920 and 1940, under the influence of eugenic and maternalist thinking, in a context of valuing the well-being of children, medicine built a new obstetric interventionism under the foundation of improving fetal viability. The supposed female "maternal instinct" was, thus, appealed to improve acceptance of the medical mandate. At the same time, doctors recognized their difficulties in providing adequate care. They did not wait long enough and tended to intervene in unnecessary physiological processes.

Prevalencia de depresión en estudiantes de Facultad de Medicina de la Udelar en el año 2022 / Prevalence of depression in students of the Faculty of Medicine of the Udelar in 2022

La depresión es un trastorno primario del estado de ánimo que afecta el funcionamiento global de las personas. Los adultos jóvenes que ingresan a la educación superior, y en particular los estudiantes de medicina, se enfrentan a estresores que pueden conducir al padecimiento de esta patología. Revisiones sistemáticas reportan una prevalencia de depresión en estudiantes de medicina del 27 % al 30 %. El objetivo del estudio fue determinar la prevalencia de depresión en una muestra de estudiantes, describir sus características y analizar asociaciones entre variables. Se difundió una encuesta electrónica que incluía el Test de Beck II. Los datos fueron analizados con el cálculo de Chi Cuadrado y la medida de asociación elegida fue el odds ratio. Los resultados estadísticamente significativos fueron incluidos en un modelo de regresión múltiple. Se evidenció una prevalencia de depresión del 64,2 %, siendo un 20,3 % depresión leve, 24,5 % moderada y 19,4 % severa. Pertenecer al sexo femenino, estar cursando el primer trienio de la carrera, consumir psicofármacos y estar disconforme con el rendimiento académico aumentaron las probabilidades de alcanzar puntajes congruentes con depresión. Se concluye la necesidad de desarrollar investigación multicéntrica y de contar con intervenciones en salud enfocadas en la prevención no medicalizadora específicas para este grupo humano.

Depression is a primary mood disorder with an effect on global functioning. Young adults starting university and medical students in particular, face stressors which can lead to the development of this disease. Systematic reviews report 27 to 30 % depression prevalence in medical students. The aim of this study was the determination of depression prevalence in a student sample, description of features and analysis of associations between variables. An electronic survey including Beck's II scale was provided. Data was analyzed calculating Square Chi, and odds ratio was the chosen association. Statistically significant results were included in a multiple regression model. Depression prevalence was 64.2 %. 20.3 % corresponded to mild depression, 24.5 % to moderate depression and 19.4 to severe one. The probability of getting depression congruent scores increased for females, students of the first three years, psychophar- macological drug use, and dissatisfaction with academic performance. A need for multicentric research and health interventions focusing on non medicalized prevention becomes evident.

Poisoning by Baccharis coridifolia in Early-Weaned Beef Calves: Pathological Study and New Macrocyclic Trichothecene Identification.

This study investigated two outbreaks of spontaneous poisoning by Baccharis coridifolia (Asteraceae) in early-weaned beef calves in Tacuarembó, Uruguay. A total of 34 affected calves showed signs of salivation, anorexia, apathy, marked dehydration, and diarrhea. Deaths occurred 36-72 h after consumption and mortality varied from 37.5% to 43.3% for outbreak 1 and outbreak 2, respectively. The main pathological findings include diffuse severe necrosis of the prestomachs and lymphoid tissues. Ultrastructurally, epithelial cells of the rumen showed swelling, lysis of the organelles, degradation of intercellular attachments, and degradation of the nuclear chromatin. Using LC-MS with diagnostic fragmentation filtering, 56 macrocyclic trichothecenes including glycosyl and malonyl conjugates were identified. The total concentration of macrocyclic trichothecenes, including conjugates, was estimated to be 1.2 ± 0.1 mg/g plant material. This is the first report of these malonyl-glucose conjugates from Baccharis coridifolia.