Factores de riesgo para Escabiosis en pacientes atendidos porconsultorio externo del Hospital La Caleta, 2018 - 2019

La escabiosis (sarna) es una infección contagiosa relacionada principalmente con las consecuencias de la pobreza como el hacinamiento, se extiende rápidamente de persona a persona, especialmente en las que no poseen una adecuada higiene. Nuestro principal objetivo fue determinar los factores de riesgo para escabiosis en pacientes atendidos por consultorio externo en el Hospital la Caleta durante los años 2018 y 2019, a través de un estudio tipo analítico, observacional, retrospectivo y transversal, de diseño casos y controles. Se analizó un total de 110 historias clínicas y se usó un muestreo de tipo aleatorio simple. En el análisis bivariado los factores de riesgo asociados fueron Hacinamiento (OR=6.02, IC 95% 2.63 ? 13.77 y p=0.000), grupo etario niñez (OR=2.84, IC 95% 1.31 ? 6.16 y p=0.008), pobre aseo personal (OR=4.92, IC 95% 1.89 ? 12.83 y p=0.000), contacto con una persona con prurito (OR=10.872, IC 95% 2.361 ? 50.059 y p=0.000) y antecedente de escabiosis (OR=16.714, IC 95% 2.102 ? 132.927 y p=0.001); al análisis de regresión lineal se encontró una fuerte asociación para las variables hacinamiento (p=0.000), pobre aseo personal (p=0.005), contacto con una persona con prurito (p=0.008) y grupo etario niñez (p=0.018). Se concluye que en el Hospital La Caleta los principales factores de riesgo para escabiosis fueron el hacinamiento, el pobre aseo personal, el contacto con una persona con prurito, el grupo etario niñez y el antecedente de escabiosis.Tesi

Global attitudes in the management of acute appendicitis during COVID-19 pandemic: ACIE Appy Study

Background: Surgical strategies are being adapted to face the COVID-19 pandemic. Recommendations on the management of acute appendicitis have been based on expert opinion, but very little evidence is available. This study addressed that dearth with a snapshot of worldwide approaches to appendicitis. Methods: The Association of Italian Surgeons in Europe designed an online survey to assess the current attitude of surgeons globally regarding the management of patients with acute appendicitis during the pandemic. Questions were divided into baseline information, hospital organization and screening, personal protective equipment, management and surgical approach, and patient presentation before versus during the pandemic. Results: Of 744 answers, 709 (from 66 countries) were complete and were included in the analysis. Most hospitals were treating both patients with and those without COVID. There was variation in screening indications and modality used, with chest X-ray plus molecular testing (PCR) being the commonest (19\ub78 per cent). Conservative management of complicated and uncomplicated appendicitis was used by 6\ub76 and 2\ub74 per cent respectively before, but 23\ub77 and 5\ub73 per cent, during the pandemic (both P < 0\ub7001). One-third changed their approach from laparoscopic to open surgery owing to the popular (but evidence-lacking) advice from expert groups during the initial phase of the pandemic. No agreement on how to filter surgical smoke plume during laparoscopy was identified. There was an overall reduction in the number of patients admitted with appendicitis and one-third felt that patients who did present had more severe appendicitis than they usually observe. Conclusion: Conservative management of mild appendicitis has been possible during the pandemic. The fact that some surgeons switched to open appendicectomy may reflect the poor guidelines that emanated in the early phase of SARS-CoV-2