Incidencia y características clínicas de neonatos con infección por virus de inmunodeficiencia humana del Hospital Martín Icaza de Babahoyo, Ecuador

Objetivo: Determinar la incidencia y características clínicasde los pacientes neonatos con infección por virus de inmunodeficienciahumana (VIH) del Hospital Martín Icaza de Babahoyo,Ecuador. Materiales y métodos: Se trató de un estudiodescriptivo y retrospectivo en neonatos con diagnósticode infección por VIH adquirido por transmisión vertical, duranteel periodo comprendido entre enero de 2016 a diciembrede 2017, se emplearon los datos clínicos de las historiasque se encuentran en el departamento de registros médicosdel mencionado hospital, se calculó la incidencia acumuladadurante periodo de estudio. Resultados: De los 684 reciénnacidos, 60 fueron ingresados por infección por VIH, con unaincidencia acumulada de 6,9% en 2 años. El factor de riesgomaterno más frecuente fue el uso de drogas parenterales(38%; n=23), el factor de riesgo durante el embarazo más comúnfue el parto prolongado (25%; n=15), el bajo peso al nacerla condición perinatal más prevalente. El 63% (n=38) tuvoun APGAR <4 puntos al primer minuto, las complicacionesmás frecuentes fueron la encefalopatía hipóxico-isquémica(43,3%; n=26) y la hemorragia cerebral (20%; n=12), todoslos sujetos presentaron acidosis, siendo la acidosis metabólicala más común (70%; n=42). Conclusión: La incidencia deinfección por VIH en neonatos del Hospital Martín Icaza deBabahoyo, Ecuador fue 6,9% durante el periodo 2016-2017,similar a la mostrada en diversos estudios poblacionales anivel mundial. Siendo importante considerar los numerososfactores de riesgo maternos y perinatales, cuyo control adecuadopermitiría disminuir las probabilidades de transmisiónal neonato

Game-Based Learning and Just-in-Time Teaching to Address Misconceptions and Improve Safety and Learning in Laboratory Activities

Serious game-based learning coupled with just-in-time teaching strategies was applied by offering six different questionnaires to evaluate student knowledge about the safety issues and theoretical concepts and protocols of laboratory exercises. The questionnaires were presented with an appearance similar to that of computer games by means of the Kahoot! platform. Passing the safety questionnaire was mandatory, and high scores were achieved by all the students, ensuring they all properly knew the laboratory safety rules. We consider this point essential in chemistry and engineering education, because future professionals must be aware of the importance of safety. In addition, responses to the questionnaires regarding the theory and procedures of each laboratory session allowed us to detect the main problems students had in the acquisition of the theoretical concepts before starting the practical activities. Additionally, the satisfaction of teachers and students with this methodology was also evaluated through surveys in the Moodle platform, showing consensus about the fact that the questionnaires are a valuable tool.Se aplicó el aprendizaje basado en juegos serios junto con estrategias de enseñanza justo a tiempo al ofrecer seis cuestionarios diferentes para evaluar el conocimiento de los estudiantes sobre temas de seguridad y conceptos teóricos y protocolos de ejercicios de laboratorio. Los cuestionarios se presentaban con una apariencia similar a la de los juegos de ordenador mediante el Kahoot! plataforma. La superación del cuestionario de seguridad era obligatoria y todos los alumnos obtuvieron altas puntuaciones, lo que garantiza que todos conocían correctamente las normas de seguridad del laboratorio. Este punto lo consideramos fundamental en la formación en química e ingeniería, porque los futuros profesionales deben ser conscientes de la importancia de la seguridad. Además, Las respuestas a los cuestionarios sobre teoría y procedimientos de cada sesión de laboratorio permitieron detectar los principales problemas que tenían los estudiantes en la adquisición de los conceptos teóricos antes de iniciar las actividades prácticas. Adicionalmente, también se evaluó la satisfacción de docentes y estudiantes con esta metodología a través de encuestas en la plataforma Moodle, mostrando consenso acerca de que los cuestionarios son una herramienta valiosa

Incidencia y características clínicas de neonatos con infección por virus de inmunodeficiencia humana del Hospital Martín Icaza de Babahoyo, Ecuador

Objetivo: Determinar la incidencia y características clínicasde los pacientes neonatos con infección por virus de inmunodeficienciahumana (VIH) del Hospital Martín Icaza de Babahoyo,Ecuador. Materiales y métodos: Se trató de un estudiodescriptivo y retrospectivo en neonatos con diagnósticode infección por VIH adquirido por transmisión vertical, duranteel periodo comprendido entre enero de 2016 a diciembrede 2017, se emplearon los datos clínicos de las historiasque se encuentran en el departamento de registros médicosdel mencionado hospital, se calculó la incidencia acumuladadurante periodo de estudio. Resultados: De los 684 reciénnacidos, 60 fueron ingresados por infección por VIH, con unaincidencia acumulada de 6,9% en 2 años. El factor de riesgomaterno más frecuente fue el uso de drogas parenterales(38%; n=23), el factor de riesgo durante el embarazo más comúnfue el parto prolongado (25%; n=15), el bajo peso al nacerla condición perinatal más prevalente. El 63% (n=38) tuvoun APGAR <4 puntos al primer minuto, las complicacionesmás frecuentes fueron la encefalopatía hipóxico-isquémica(43,3%; n=26) y la hemorragia cerebral (20%; n=12), todoslos sujetos presentaron acidosis, siendo la acidosis metabólicala más común (70%; n=42). Conclusión: La incidencia deinfección por VIH en neonatos del Hospital Martín Icaza deBabahoyo, Ecuador fue 6,9% durante el periodo 2016-2017,similar a la mostrada en diversos estudios poblacionales anivel mundial. Siendo importante considerar los numerososfactores de riesgo maternos y perinatales, cuyo control adecuadopermitiría disminuir las probabilidades de transmisiónal neonato

Sepsis neonatal en pacientes del hospital general del norte de Guayaquil IESS Los Ceibos

Objective: To evaluate the incidence and clinical characteristics of patients with neonatal sepsis of the Hospital General del Norte de Guayaquil IESS Los Ceibos. Materials and Methods: This was a descriptive and retrospective study in newborn patients admitted with neonatal sepsis diagnosis to the Neonatal Intensive Care Unit (NICU) of this hospital, during the period from May 2017 to August 2018, the clinical data in medical records department of the institution were used. Results: Out of the 7240 newborns, 160 were admitted with neonatal sepsis diagnosis to the NICU, evidencing an accumulated incidence of 2.2% in 15 months. There was a male predominance (80%; n=128), with birth weight >2500 grams (73.1%; n=117). The majority had 37 weeks of gestation or more (86.9%; n=139), caesarean section was the most common route of birth (60%; n=96), as well as <3 prenatal outpatient visits (75%; n=120), premature membrane rupture was 45% (n=72), and urinary tract infection in 60% (n=96) of the cases. The main microorganisms, isolated in blood cultures, were the group B streptococcus (65.2%; n=104), followed by Staphylococcus aureus (15.9%; n=26). Conclusion: This analysis shows an important incidence of neonatal sepsis in our region, especially in male neonates and in those with mothers with premature membrane rupture and / or urinary tract infection, it is worth highlighting the high percentage of normal-weight and normal term pregnancy

Sepsis neonatal en pacientes del Hospital General del Norte de Guayaquil IESS Los Ceibos

Objetivo: Evaluar la incidencia y caracter&iacute;sticas cl&iacute;nicas de los pacientes con sepsis neonatal del Hospital General del Norte de Guayaquil IESS Los Ceibos. Materiales y m&eacute;todos: Se trat&oacute; de un estudio descriptivo y retrospectivo en pacientes reci&eacute;n nacidos ingresados con el diagn&oacute;stico de sepsis neonatal a la Unidad de Cuidados Intensivos Neonatales (UCIN) del mencionado hospital, durante el periodo comprendido entre mayo de 2017 a agosto de 2018, se emplearon los datos cl&iacute;nicos de las historias que se encuentran en el departamento de registros m&eacute;dicos de la instituci&oacute;n. Resultados: De los 7240 reci&eacute;n nacidos, 160 fueron ingresados con diagn&oacute;stico de sepsis neonatal a la UCIN, evidenci&aacute;ndose una incidencia acumulada de 2,2% en 15 meses. Se evidenci&oacute; un predominio de afectados del sexo masculino (80%; n=128), con peso al nacer &gt;2500 gramos (73,1%; n=117). La mayor&iacute;a tuvo 37 semanas de gestaci&oacute;n o m&aacute;s (86,9%; n=139), la ces&aacute;rea fue la v&iacute;a de nacimiento m&aacute;s com&uacute;n (60%; n=96), as&iacute; como &lt; 3 consultas prenatales (75%; n=120), la ruptura prematura de membrana estuvo en 45% (n=72) y la infecci&oacute;n del tracto urinario en 60% (n=96) de los casos. Los microorganismos, aislados en hemocultivos, m&aacute;s frecuentes fueron el estreptococo del grupo B (65,2%; n=104), seguido del Staphylococcus aureus (15,9%; n=26). Conclusi&oacute;n: Este an&aacute;lisis muestra una importante incidencia de sepsis neonatal en nuestra regi&oacute;n, especialmente en los neonatos masculinos y en aquellos con madres con ruptura prematura de membrana y/o infecci&oacute;n del tracto urinario, cabe destacar el alto porcentaje en reci&eacute;n nacidos normopeso y con edad gestacional a t&eacute;rmino.&nbsp

Effects of pre-operative isolation on postoperative pulmonary complications after elective surgery: an international prospective cohort study an international prospective cohort study

We aimed to determine the impact of pre-operative isolation on postoperative pulmonary complications after elective surgery during the global SARS-CoV-2 pandemic. We performed an international prospective cohort study including patients undergoing elective surgery in October 2020. Isolation was defined as the period before surgery during which patients did not leave their house or receive visitors from outside their household. The primary outcome was postoperative pulmonary complications, adjusted in multivariable models for measured confounders. Pre-defined sub-group analyses were performed for the primary outcome. A total of 96,454 patients from 114 countries were included and overall, 26,948 (27.9%) patients isolated before surgery. Postoperative pulmonary complications were recorded in 1947 (2.0%) patients of which 227 (11.7%) were associated with SARS-CoV-2 infection. Patients who isolated pre-operatively were older, had more respiratory comorbidities and were more commonly from areas of high SARS-CoV-2 incidence and high-income countries. Although the overall rates of postoperative pulmonary complications were similar in those that isolated and those that did not (2.1% vs 2.0%, respectively), isolation was associated with higher rates of postoperative pulmonary complications after adjustment (adjusted OR 1.20, 95%CI 1.05–1.36, p = 0.005). Sensitivity analyses revealed no further differences when patients were categorised by: pre-operative testing; use of COVID-19-free pathways; or community SARS-CoV-2 prevalence. The rate of postoperative pulmonary complications increased with periods of isolation longer than 3 days, with an OR (95%CI) at 4–7 days or ≥ 8 days of 1.25 (1.04–1.48), p = 0.015 and 1.31 (1.11–1.55), p = 0.001, respectively. Isolation before elective surgery might be associated with a small but clinically important increased risk of postoperative pulmonary complications. Longer periods of isolation showed no reduction in the risk of postoperative pulmonary complications. These findings have significant implications for global provision of elective surgical care. We aimed to determine the impact of pre-operative isolation on postoperative pulmonary complications after elective surgery during the global SARS-CoV-2 pandemic. We performed an international prospective cohort study including patients undergoing elective surgery in October 2020. Isolation was defined as the period before surgery during which patients did not leave their house or receive visitors from outside their household. The primary outcome was postoperative pulmonary complications, adjusted in multivariable models for measured confounders. Pre-defined sub-group analyses were performed for the primary outcome. A total of 96,454 patients from 114 countries were included and overall, 26,948 (27.9%) patients isolated before surgery. Postoperative pulmonary complications were recorded in 1947 (2.0%) patients of which 227 (11.7%) were associated with SARS-CoV-2 infection. Patients who isolated pre-operatively were older, had more respiratory comorbidities and were more commonly from areas of high SARS-CoV-2 incidence and high-income countries. Although the overall rates of postoperative pulmonary complications were similar in those that isolated and those that did not (2.1% vs 2.0%, respectively), isolation was associated with higher rates of postoperative pulmonary complications after adjustment (adjusted OR 1.20, 95%CI 1.05–1.36, p = 0.005). Sensitivity analyses revealed no further differences when patients were categorised by: pre-operative testing; use of COVID-19-free pathways; or community SARS-CoV-2 prevalence. The rate of postoperative pulmonary complications increased with periods of isolation longer than 3 days, with an OR (95%CI) at 4–7 days or ≥ 8 days of 1.25 (1.04–1.48), p = 0.015 and 1.31 (1.11–1.55), p = 0.001, respectively. Isolation before elective surgery might be associated with a small but clinically important increased risk of postoperative pulmonary complications. Longer periods of isolation showed no reduction in the risk of postoperative pulmonary complications. These findings have significant implications for global provision of elective surgical care