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Factors associated with hopelessness, depression and anxiety in the Honduran-Central America population during the COVID-19 pandemic

"Introduction: The mental health of the population has been affected by COVID-19, reporting in many populations higher levels of depressive, anxious and stress symptoms, however, in Honduras there are no studies showing the impact of COVID-19 on the mental health of the population. Aim: To determine the factors associated with hopelessness, depression and anxiety in times of COVID-19 in the Honduran population. Methods: Cross-sectional analytical study. Three scales were used, Beck for hopelessness, Hamilton for depression and anxiety, through interviews with the population attending different levels of health care throughout the country. Descriptive and analytical statistics were obtained. For hopelessness, the Beck Hopelessness Scale was used; for depression and anxiety, the Hamilton Scale was used. Results: Of the 8,125 participants, the population in general showed results of hopelessness 14.9%, depression 12.9% and anxiety 1.2%, there was less hopelessness among women (p = 0.004), university students (p < 0.001), but greater among those who had a family member deceased by COVID-19 (p < 0.001), among those who had diabetes mellitus (DM) (p < 0.001), history of mental illness (p < 0.001) or had consumed drugs in the last 6 months (p < 0.001). There was more depression among those with arterial hypertension (p = 0.002), obesity (p = 0.019), DM (p = 0.004), history of mental illness (p < 0.001) or had consumed drugs in the last 6 months (p < 0.001). There was more anxiety among those infected with COVID-19 (p = 0.023), according to having a family member deceased by COVID-19 (p = 0.045) and in those with a history of mental illness (p < 0.001). Discussion: The Honduran population presented important differences in the socio-pathological, according to the loss of family members or having previous illnesses, this according to the presentation of problems in the mental sphere. Conclusion: We found factors associated with hopelessness, we found factors associated with hopelessness, depression and anxiety in times of COVID-19 in the Honduran population

Estudio histopatológico comparativo del nervio frénico proveniente de cadáveres con enfermedad pulmonar obstructiva crónica y sin esta condición: Comparative histopathological study of the phrenic nerve from corpses with chronic obstructive pulmonary disease and without this condition

Introduction: Functional changes resulting from the evolution of chronic obstructive pulmonary disease (COPD) are progressive and irreversible, causing increased diaphragm work due to pulmonary hyperinflation and airway obstruction. Phrenic nerves have promoted innervation of the diaphragm and may have been compromised in COPD condition. Objective: To compare the morphology of the phrenic nerves of the cadavers with COPD and without COPD by optical microscopy. Materials and methods: An exploratory descriptive studio conducted on the Death Verification Service in Alagoas. Pulmonary and phrenic nerve biopsies will be bilaterally taken from the cadavers after a necropsy with the diagnosis of COPD. Tissue samples were fixed and processed by conventional histology for hematoxylin-eosin (HE) histological slides. Biopsies are divided into experimental groups, one composed by patients with COPD and the other with patients without COPD (control - CTR). This classification was realized after the histological analysis, when typical halls of COPD were found. Histological slides were analyzed by optical microscopy by a pathologist, who was able to assess the study. Results: According to the inclusion and exclusion criteria of the study, if it includes 38 cadavers in the initial evaluation, of which 31 are included in the COPD group and 7 in the CTR group. In the analysis of the phrenic nerves, 8 cadavers, 25.8%, of the COPD group had histopathological changes: perineural edema (75%, n=6), nervous atrophy (12.5%, n=1) and perineural eosinophilic infiltrate (12.5%, n=1). The CTR group does not present histopathological alterations of the phrenic nerves. Conclusions: Given the hallmarks of the biopsies performed on the phrenic nerves of the corpses with COPD, we can infer that there is a tendency for nerve alteration, with perineural edema, to be the major modification found.Introducción: Los cambios funcionales resultantes de la evolución de la enfermedad pulmonar obstructiva crónica (EPOC) son progresivos e irreversibles, lo que provoca un aumento del trabajo del diafragma debido a la hiperinflación. Los nervios frénicos promueven la inervación del diafragma y pueden verse comprometidos en la condición de EPOC. Objetivo: Comparar la morfología de los nervios frénicos de los cadáveres con y sin EPOC, mediante microscopía óptica. El Estudio: Estudio descriptivo en el que las muestras de los pulmones y los nervios frénicos bilateralmente de los cadáveres con y sin diagnóstico de EPOC. Las muestras de tejido fueron fijadas y procesaron por histología convencional para laminas histológicas teñidas con hematoxilina-eosina. Las muestras fueron compuestas por pacientes con EPOC (EPOC) y sin EPOC (CTR). Esta clasificación se realizó después del análisis histológico. Las láminas histológicas se analizaron mediante microscopía óptica por un patólogo, que fue un evaluador que no conocía datos del estudio. Resultados: De acuerdo con los criterios de inclusión del estudio, se incluyeron 31 cadáveres en el grupo de EPOC y 7 cadáveres en el grupo CTR. En el análisis de los nervios frénicos, 8 cadáveres, es decir, 25.8%, del grupo de EPOC tuvieron cambios histopatológicos: edema perineural (75%, n=6), atrofia nerviosa (12.5%, n=1) e infiltrado eosinofílico perineural (12.5%, n=1). Conclusiones: Los nervios frénicos de los cadáveres con EPOC tienen tendencia a alteraciones histopatológicas, siendo el edema perineural la principal modificación encontrada

Hallazgos microscópicos del tejido pulmonar y los músculos respiratorios en la Enfermedad Pulmonar Obstructiva Crónica (EPOC): Microscopic findings of lung tissue and respiratory muscles in Chronic Obstructive Pulmonary Disease (COPD)

Introduction: In chronic obstructive pulmonary disease (COPD), the diaphragm and sternocleidomastoid respiratory muscles (ECOM) work against increased mechanical loads due to limited air flow and changes in chest conformation due to the condition of pulmonary hyperinflation. Objective: To evaluate the histopathological changes present in the lungs and respiratory muscles (diaphragm and ECOM) of the corpses affected by COPD. Materials and methods: This is a blind and descriptive study with analysis of histological images of biopsy. The history of smoking associated with the presence of pulmonary anthracosis, septal thickening and emphysematous bullae included the inclusion criteria of the study. The study was conducted by optical microscopic analysis of histological sheets obtained from 36 corpses with COPD. The histopathological diagnosis was made by a pathologist who did not know the objectives of the study. Results: In the diaphragm, there was the presence of interposed adipose tissue, muscle atrophy, removal of muscle fibers and fibrosis. In ECOM, the elimination of muscle fibers, muscular atrophy, interposed adipose tissue, muscle hypertrophy and thickening of the tendons were also evident. Conclusions: The changes found in the diaphragm and ECOM muscle biopsies of the bodies with COPD were evidenced as a mechanism of compensation and / or dysfunction of the respiratory system due to biomechanical alterations promoted by the disease.Introducción: En la enfermedad pulmonar obstructiva crónica (EPOC), el diafragma y los músculos respiratorios esternocleidomastoideos (ECOM) funcionan contra el aumento de las cargas mecánicas debido a la limitación del flujo de aire y los cambios en la conformación del tórax debido a la condición de hiperinflación pulmonar. Objetivo: Evaluar los cambios histopatológicos presentes en los pulmones y los músculos respiratorios (diafragma y ECOM) de los cadáveres con Diagnostico&nbsp; de EPOC. El Estudio: Este es un estudio ciego y descriptivo con análisis de imágenes histológicas de biopsia. El historial de tabaquismo asociado con la presencia de antracosis pulmonar, engrosamiento septal y bullas enfisematosas comprendió los criterios de inclusión del estudio. La muestra consistió en biopsias de pulmón, diafragma y ECOM. El estudio se realizó mediante análisis microscópico óptico de lâminas histológicas obtenidas de 36 cadáveres con EPOC. El diagnóstico histopatológico fue realizado por un patólogo que desconocía los objetivos del estudio. Hallazgos: En el diafragma, hubo la presencia de tejido adiposo interpuesto, atrofia muscular, eliminación de las fibras musculares y fibrosis. En el ECOM, también se evidenció la eliminación de las fibras musculares, la atrofia muscular, el tejido adiposo interpuesto, la hipertrofia muscular y el engrosamiento de los tendones. Conclusiones: Los cambios encontrados en las biopsias musculares de diafragma y ECOM de los cadáveres con EPOC se evidenciaron como un mecanismo de compensación y/o disfunción del sistema respiratorio debido a alteraciones biomecánicas promovidas por la enfermedad

A influência do isolamento social na incidência de positividade nos testes de covid-19 em região metropolitana de São Paulo, Brasil

Introduction: With the arrival of the SARS-CoV-2 (Coronavirus 2 of severe acute respiratory syndrome) pandemic in Brazil, especially in the city of São Paulo, there was a need to apply social isolation policies associated with testing, covering all municipalities. The Clinical Analysis Laboratory of Centro Universitário FMABC was one of the first laboratories to receive certification and qualification to perform RT-PCR (reverse transcriptase reaction followed by polymerase chain reaction) tests in the metropolitan region of São Paulo. Objective: Aim to analyze the influence of adopting social isolation on the incidence of positivity in COVID-19 tests in the metropolitan region of São Paulo, Brazil. Methods: a descriptive study carried out from March to May 2020, epidemiological data were collected from each unit served and organized by the data controllership team of the Clinical Analysis Laboratory of FMABC. Epidemiological, demographic, and laboratory data were extracted from the Matrix® outpatient data management system. Clinically suspected cases and confirmed by laboratory tests (RT-PCR and serological tests) were entered. The tests were divided into serological tests using the RT-PCR molecular test, on samples of nasopharyngeal mucosal scrapings collected with sterile Swab. Results: It were evaluated PCR test and antibody presence (IgA, IgM and IgG) in blood samples of 16.297 patients. 22.718 tests were performed for the diagnosis of COVID-19, both RT-PCR (10.410 tests) and serological tests to detect anti-SARS-CoV-2 antibodies, IgA, IgM and IgG, a total of 16.297 patients were assessed, 63% women and 37% men. It was observed that the social isolation policies adopted during this period contained the massive expansion of contamination, at least while the social isolation rates were above 55%. Conclusion: The data of this study demonstrated the effectiveness of social isolation in containing the positive contamination of SARS-CoV-2 in the metropolitan region of São Paulo, at least for the first three months.Introdução: com a chegada da pandemia de SARS-CoV-2 (Coronavirus 2 da síndrome respiratória aguda grave) ao Brasil, especialmente na cidade de São Paulo, houve a necessidade de aplicar medidas de distanciamento social associado a testagem, que abrangesse todos os municípios. A região metropolitana de São Paulo compreende 39 municípios e possui uma rede de laboratórios habilitados a realizar a testagem para a detecção do coronavírus, tanto testes sorológicos quanto moleculares. O Laboratório de Análises Clínicas do Centro Universitário ABC/FMABC foi um dos primeiros laboratórios a receber a certificação e habilitação para realizar os testes RT-PCR (reação da transcriptase reversa seguida pela reação em cadeia da polimerase) na região metropolitana de São Paulo. Objetivo: analisar a influência da adoção do isolamento social na incidência de positividade nos testes de COVID-19 em região metropolitana de São Paulo, Brasil. Método: estudo descritivo realizado no período de março a maio de 2020, os dados epidemiológicos foram coletados de cada unidade atendida e organizada pela equipe de controladoria de dados do Laboratório de Análises Clínicas da FMABC. Os dados epidemiológicos, demográficos e laboratoriais foram extraídos do sistema Matrix® de gerenciamento de dados ambulatoriais. Foram inseridos os casos clinicamente suspeitos e confirmados por testes de laboratório (RT-PCR e testes sorológicos). Os testes foram divididos em testes sorológicos no teste molecular RT-PCR, em amostras de raspado de mucosa nasofaríngea coletada com Swab estéril. Resultados: foram avaliados o teste de RT-PCR e a presença de anticorpos (IgA, IgM e IgG) em amostras de sangue de 16.297 pacientes. Foram realizados 22.718 testes para o diagnóstico de COVID-19, tanto RT-PCR (10.410 testes), quanto testes sorológicos para detecção de anticorpos anti-SARS-CoV-2, IgA, IgM e IgG, um total de 16.297 pacientes foram avaliados, 63% mulheres e 37% homens. Observou-se que as políticas de isolamento social adotadas nesse período continham a expansão massiva da contaminação, pelo menos enquanto as taxas de isolamento social eram superiores a 55%. Conclusão: nossos dados demonstraram a efetividade do isolamento social na retenção da positividade da contaminação do SARS-CoV-2 nas cidades contempladas pelo serviço de testagem do Centro Universitário Saúde ABC, pelo menos nos três primeiros meses

Papel do sistema nervoso autônomo no risco cardiovascular em pacientes com Litíase Renal

Introduction: Kidney stone (KS) is a highly prevalent disease worldwide. Studies indicate that there is a direct correlation between the presence of KS and CVD and that individuals with KS are more likely to develop hypertension compared to individuals without KS. Aim: To investigate the possible role of the autonomic nervous system (ANS) in cardiovascular risk (CVR) of patients with kidney stone. Patients and Methods: We included in the KS group 19 patients of both sexes aged 18-60 years and diagnosed with KS. The control group (CTL) was composed of 21 individuals without diagnosis of KS. MAP, SBP, DBP and HR at rest and in response to cardiovascular challenges in orthostatism, modified orthostatism, Cold Pressor test (CPT) and Stroop test were evaluated. Biochemical analyzes were performed on blood and urine. For statistical analysis the General Linear Model (GLM) of repeated measures was used for comparison between groups. Results: Regarding biochemical and urinary parameters, the LR group presented higher LDL cholesterol fraction (KS: 102.9 ± 24.0 vs CTL: 92.4 ± 33.0 mg / dL, p = 0.02), blood glucose (KS: 87.5 ± 8.5 vs CTL: 80.3 ± 7.3 mg / dL, p = 0.003) and urinary volume (KS: 1966 ± 789 vs CTL: 1600 ± 574 mL, p = 0.006) compared to the CTL group. During orthostatism the KS group showed orthostatic hypertension during recovery different from the CTL group (SBP, KS: 126 ± 15 vs CTL: 122 ± 9 mmHg, p <0.05 and DBP, KS: 81 ± 8 vs CTL: 79 ± 7mmHg, p <0.05). No differences were observed in heart rate variability and baroreflex sensitivity. In the Stroop test there was no statistical difference between the groups during its performance and recovery. However, differences in the analysis of SBP absolute delta (KS: 9 ± 10 vs CTL: 2 ± 8 mmHg, p <0.05) and HR (KS: 13 ± 7 vs CTL: 8 ± 7bpm, p <0.05) were observed. the groups. Regarding CPT, no statistically significant differences were observed between groups. Conclusion: Subtle evidence of possible autonomic alterations in response to orthostatism and emotional stress testing was found, which could be related to the role of ANS in cardiovascular risk of patients with RS. However, further and more comprehensive studies are needed to determine the possible involvement of ANS in the cardiovascular risk of patients with KS.Introdução: A litíase renal (LR) é uma doença de alta prevalência mundial. Estudos indicam que existe uma correlação direta entre a presença de LR e as DCV e que indivíduos com LR são mais propensos a desenvolverem HAS comparados a indivíduos sem LR. Objetivo: Investigar o possível papel do sistema nervoso autônomo (SNA) no risco cardiovascular (RCV) dos pacientes com litíase renal. Casuística e Métodos: Foram incluídos no grupo LR, 19 pacientes de ambos os sexos com idades entre 18-60 anos e diagnóstico de LR. O grupo controle (CTL) foi composto por 21 indivíduos sem diagnóstico de LR. Foram avaliadas a PAM, PAS, PAD e FC em repouso e em resposta a desafios cardiovasculares no ortostatismo, ortostatismo modificado, Cold Pressor teste (CPT) e o teste de Stroop. Foram realizadas análises bioquímicas no sangue e na urina. Para a análise estatística foi utilizado o Modelo Linear Geral (GLM) de medidas repetidas para a comparação entre os grupos. Resultados: Em relação aos parâmetros bioquímicos e urinários, o grupo LR apresentou maior fração de colesterol LDL (LR: 102,9±24,0 vs CTL: 92,4±33,0 mg/dL, p=0,02), glicemia (LR: 87,5±8,5 vs CTL: 80,3±7,3 mg/dL, p=0,003) e volume urinário (LR: 1966±789 vs CTL: 1600±574 mL, p=0,006) comparado ao grupo CTL. Durante o ortostatismo o grupo LR apresentou hipertensão ortostática durante a recuperação diferente do grupo CTL (PAS, LR: 126±15 vs CTL: 122±9 mmHg, p<0,05 e PAD, LR: 81±8 vs CTL: 79±7 mmHg, p<0,05). Não foram observadas diferenças na variabilidade da frequência cardíaca e na sensibilidade barorreflexa. No teste de Stroop não houve diferença estatística entre os grupos durante sua realização e recuperação. No entanto, foi observada diferença na análise dos deltas absolutos da PAS (LR:9±10 vs CTL: 2±8 mmHg, p<0,05) e FC (LR: 13±7 vs CTL: 8±7 bpm, p<0,05) entre os grupos. Em relação ao CPT não foram observadas diferenças estatisticamente significantes entre os grupos. Conclusão: Foram encontrados indícios sutis de possíveis alterações autonômicas em resposta ao ortostatismo e ao teste de estresse emocional, que poderiam ser relacionadas ao papel do SNA no risco cardiovascular dos pacientes com LR. Entretanto, são necessários novos e mais abrangentes estudos para se determinar a possível participação do SNA no risco cardiovascular dos pacientes com LR.Dados abertos - Sucupira - Teses e dissertações (2020

Vacunación contra la COVID-19, retos y desafíos para el sistema de salud hondureño hasta mayo de 2021

Introducción: Dentro de los esfuerzos a nivel mundial por reducir la tasa de contagios y mortalidad, la vacunación contra COVID-19 se determina como un proceso seguro y universal. Para garantizar la distribución proporcionada de las vacunas la colaboración global (COVAX) se convierte en la estrategia primaria en la distribución de vacunas en países como Honduras, ubicado entre los 71 países del mundo que reportan más casos confirmados y uno de los más bajos de cobertura de vacunación en la región centroamericana pese a contar con una de las mejores cadenas de frío a nivel de las Américas

COVID-19 situation in Honduras: lessons learned

Several emerging and re-emerging diseases in the last decade showed the global weakness to detect and act in a timely manner in situations that threaten the health of the planet. Latin America has been vulnerable to outbreaks as a result of increased poverty, social inequity and the poor response capacity of the public health system.Diversas enfermedades emergentes y reemergentes en la &uacute;ltima d&eacute;cada han evidenciado la debilidad global para detectar y actuar de forma oportuna ante situaciones que amenazan la salud del planeta. Am&eacute;rica Latina ha sido vulnerable a brotes como consecuencia del incremento de la pobreza, la inequidad social y la pobre capacidad de respuesta del sistema de salud p&uacute;blico