Carga postural en cuidadoras del hogar geriátrico Madre Marcelina

Introducción: El trabajo realizado por el cuidador de un anciano lo expone a posturas y cargas inadecuadas siendo este riesgo uno de los menos estudiados a pesar de sus efectos nocivos en la salud y bienestar del cuidador. Objetivos: Determinar la carga postural y síntomas músculo esqueléticas en las cuidadoras de adultos mayores del Hogar Madre Marcelina. Método: Estudio transversal en 12 cuidadoras de adultos mayores en el Hogar Geriátrico Madre Marcelina de la ciudad de Barranquilla. Previo consentimiento informado, se indagó sobre molestias músculo esqueléticas en 9 regiones corporales, durante los últimos 7 días y 12 meses anteriores al estudio, mediante el Cuestionario Nórdico. Se evaluaron las posturas de riesgo adoptadas y la carga soportada por el cuidador durante la tarea observada, a través del Método OWAS. Resultados: Todas las cuidadoras son mujeres, con una media de edad de 36,5 años y antigüedad menor de 5 años ejerciendo la labor. El 50% presenta molestias en el cuello y zona alta de la espalda en los últimos 7 días; el 33,3% presenta molestias en hombros, caderas/muslos, rodillas y pies/tobillos en los últimos 7 días; igual porcentaje refiere molestias en la zona alta de la espalda en los últimos 12 meses. El 83,3% adopta posturas dañinas para el sistema músculo esquelético. Conclusiones: Teniendo en cuenta la categoría de riesgo más frecuente en las cuidadoras estudiadas, se requieren acciones correctivas lo antes posible, toda vez que pueden desarrollar o agravar las molestias musculo-esqueléticas que comprometan la funcionalidad de las cuidadoras. ABSTRACTIntroduction: The work done by the caretaker of an elderly man exposes you to positions and loads unsuitable to being this risk one of the least studied despite its harmful effects on the health and well-being of the caregiver. Objectives: To determine the postural load and symptoms muscle skeletal in carers of adults home mother Marcelina. Method: Transversal study in 12 caregivers of older adults in the mother Marcelina geriatric home in the city of Barranquilla. Prior informed consent, asked about skeletal muscle discomfort in 9 parts of the body, during the last 7 days and 12 months prior to the study, by the Nordic questionnaire. We evaluated the risk positions taken and load on the caregiver during the observed task, through the OWAS method. Results: All caregivers are women, with an average age of 36.5 years and less than 5 years old practicing the work. 50% presents discomfort in the neck and upper area of his back in the last 7 days; 33.3% presents discomfort in shoulders, hips/thighs, knees and feet/ankles in the last 7 days; equal percentage means discomfort in the upper area of the back in the past 12 months. 83.3% adopts positions to the musculo-skeletal system. Conclusions: Taking into account the most frequent in the studied nurses risk category, corrective actions are required as soon as possible, since that can develop or aggravate musculoskeletal discomfort that would compromise the functionality of carers

INDICE DE FRAGILIDAD EN EL ADULTO MAYOR DEL HOGAR MADRE MARCELINA

INTRODUCCIÓN: El envejecimiento individual es el proceso de evolución hasta ahora irreversible que experimenta cada persona en el trascurso de la vida. El estado de fragilidad es un síndrome clínico-biológico caracterizado por un descenso de la resistencia y de las reservas fisiológicas del adulto mayor ante situaciones de estrés; todo esto trae como consecuencia mayor riesgo de sufrir efectos adversos para la salud como caídas, discapacidad, hospitalización e inclusive la muerte. OBJETIVO: Determinar el índice de fragilidad del adulto mayor en el Hogar Madre Marcelina. MATERIALES Y MÉTODO: Estudio descriptivo analítico que mide el índice de fragilidad en el adulto mayor en el hogar geriátrico Madre Marcelina de la ciudad de Barranquilla teniendo como muestra 14 adultos de edad ≥60 años durante el mes de abril de 2015; evaluando la fragilidad según los criterios de Fried, perdida involuntaria de peso, Baja energía o agotamiento, Lentitud de la marcha, fuerza de agarre y baja actividad física. RESULTADOS: Se observó que los criterios de fragilidad de mayor frecuencia fueron baja actividad física y Lentitud de la marcha con (85,7%) y de menor frecuencia la pérdida involuntaria de peso con (21,4%). CONCLUSIÓN: Los criterios con mayor prevalencia son la actividad física y lentitud en la marcha pero es necesario realizar nuevos estudios con una muestra mayor para así poder obtener resultados que arrojen cifras significativas con relación a la población estudiada; según la investigación la mayoría de los adultos mayores se consideran frágiles ya que presentan tres criterios de fragilidad.  ABSTRACT Introduction: The individual aging is the process of evolution until now irreversible experienced by each person in the course of life. The state of fragility is a clinical-biological syndrome characterized by a decrease in resistance and physiological reserves the elderly in stressful situations; this results in increased risk of adverse health effects such as falls, disability, hospitalization and even death. Objectives: To determine the rate of fragility of the elderly at home Mother Marcelina. Materials and methods: Analytical descriptive study that measures the rate of frailty in the elderly in nursing home Mother Marcelina city of Barranquilla taking as sample 14 adults aged ≥60 years during the month of April 2015; evaluating the fragility according to the criteria of Fried, involuntary weight loss, low energy or fatigue, slow motion, grip strength and low physical activity. RESULTS: It was observed that the fragility criteria most frequently were low physical activity and slow march (85.7%) and less often involuntary weight loss (21.4%). Conclusion: The most prevalent criteria are physical activity and slow progress but need further studies with a larger sample in order to obtain results that yield significant figures in relation to the population studied; according to research most older adults are considered fragile since they have three criteria of fragility.

IMAGEN DEL CUERPO EN ADULTOS MAYORES

Introducción: La imagen corporal se conforma por representaciones, percepciones, afectos, significados y vínculos que el sujeto construye respecto a su cuerpo durante toda la vida. El cuerpo siempre es referido a determinadas normas y valores, de belleza, roles etc. por lo tanto la imagen del cuerpo siempre es evaluativa. Objetivo: Conocer la imagen del cuerpo que tiene un grupo de adultos mayores materiales y método: Estudio realizado bajo el paradigma histórico hermenéutico, con un enfoque fenomenológico. La muestra está formada por 5 adultos mayores que viven en sus hogares y que cumplieron los criterios de inclusión. Los datos se obtuvieron de dos preguntas de una entrevista semiestructurada y de 10 comerciales de televisión en donde aparecían adultos mayores, presentados durante un fin de semana en dos canales nacionales. Los resultados se sistematizaron en dos matrices que permitieron su análisis. Resultados: Se evidencia una imagen del cuerpo negativa, relacionando el cuerpo envejecido con arrugas, cambios poco estéticos, lentitud de los movimientos y falta de energía. Los comerciales trasmitidos por televisión muestra una imagen corporal sesgada e idealizada de la vejez acorde con la cultura imperante. Conclusión: Existe una imagen negativa en los adultos mayores que se asocia con la estética y la funcionalidad aunque la sociedad trata de “vender” una imagen idealizada del cuerpo del adulto mayor, que dista de la percepción que tiene la persona de sí misma.  ABSTRACTIntroduction: Body image is formed by representations, perceptions, emotions, meanings and links regarding the subject builds his body over a lifetime. The body is always referred to certain norms and values, beauty, roles etc. therefore the image of the body is always evaluative. Objective: Promote the image of the body that has a group of seniors. Materials and Methods: Study under the hermeneutic historical paradigm, with a phenomenological approach. The sample consists of five seniors living in their homes and who met the inclusion criteria. The data were obtained from two questions of a semi-structured interview and 10 television commercials where seniors appeared, presented during a weekend in two national channels. The results were systematized in two arrays that allowed analysis. Results: An image of the body negative evidence, relating the aged with wrinkles, some cosmetic changes, slowness of movement and lack of energy body. The commercial aired on television showing a biased and idealized body image of old age in line with the prevailing culture. Conclusion: There is a negative image in older adults is associated with aesthetics and functionality but society tries to "sell" an idealized image of the elderly body, which is far from the perception that the person itself.

Planeamiento estratégico de las entidades promotoras e instituciones prestadoras de salud en Colombia

En Colombia, las Entidades Promotoras de Salud (EPS) y las Instituciones Prestadoras de Salud (IPS) se encuentran reglamentadas para ofrecer la afiliación, administración, y prestación de servicios de salud bajo la supervisión, regulación, y apoyo del Estado. Al 2016 estas instituciones se caracterizan por tener importante prestigio debido al aumento de la cobertura en medio de grandes desafíos, como: (a) incrementar el acceso a los servicios de salud, (b) mejorar el porcentaje de la población afiliada, (c) establecer un modelo de financiamiento óptimo, e (d) incrementar la confianza de los usuarios a través de una prestación de servicios de salud basada en principios de eficiencia en el uso de los recursos, calidad en la prestación de los servicios, equidad y universalidad en el acceso, solidaridad hacia los regímenes de seguridad, integralidad en la cobertura de las contingencias, y participación activa de la comunidad, entre otros principios que logren dotar de ventajas competitivas a estas instituciones de la salud. Es por ello que se elabora un planeamiento estratégico, en el cual las EPS e IPS se proponen reorientar la oferta de los servicios de salud y la prestación de los mismos, utilizando sus instalaciones y capacidades existentes en materia de idoneidad de profesionales de la salud, tiempos de atención y de espera, acceso a atención y cobertura universal, y el prestigio de algunas clínicas y hospitales que atraen un amplio mercado internacional de la salud. A lo largo de este planeamiento, se describieron los antecedentes del sistema de salud y la situación general en el ámbito nacional para detallar el estado actual de las EPS e IPS en Colombia. Además, se conoció la estructura general y financiera de la salud en el país, identificando las fortalezas y debilidades del sistema, destacándose las entradas en el ámbito internacional, provenientes del turismo de la salud. Este último factor hace que las expectativas en el sector sean altamente favorables para mejorar la prestación de servicios de salud. Las ventajas competitivas que tienen que desarrollar las EPS e IPS para ser competitivas en el sector de la salud son las siguientes: equipamiento médico tecnológico, capacidad e infraestructura hospitalaria, recursos humanos calificados, solvencia financiera, tiempos de hospitalización, servicios médicos ofrecidos, niveles de complejidad dentro de los hospitales, inversión en investigación y desarrollo, acreditación de los sistemas de salud, entre otras. Por esta razón, se exponen estrategias que permitan aprovechar las fortalezas existentes y desarrollar nuevas, con lo cual para 2026 se espera que las EPS e IPS logren destacarse dentro del sistema de salud nacional y se posicionen como entidades de la salud líderes en Latinoamérica. Para el desarrollo de estas ventajas competitivas, se han planteado cinco objetivos a largo plazo: (a) Al 2026, aumentar la cobertura en el acceso al 100%; (b) al 2026, certificar al 70% de las 2,500 IPS por organismos de acreditación de calidad en salud, calificando su alto desempeño; (c) al 2026, incrementar a 25 la cantidad de IPS dentro del ranking de las mejores clínicas y hospitales de Latinoamérica; (d) al 2026, mejorar la tasa de satisfacción global en 10% para las EPS e IPS; y (e) al 2026, el 70% de las EPS calificadas con un desempeño medio en 2015 por el Ministerio de Salud y Protección Social obtendrán la calificación de desempeño alto, al prestar servicios de salud de forma óptima, generando un alto valor agregado. La manera en que se lograrán estos objetivos a largo plazo es mediante la implementación de las estrategias elaboradas en el presente planIn Colombia, the EPS and IPS are regulated to offer the affiliation, administration, and provision of health services under the supervision and support of the State. Currently, these health institutions enjoy good prestige, due to: (a) increase coverage amidst major challenges such as increase access to health services, (b) improve the percentage of the affiliated population, (c) establish an optimal financing model, and (d) increase trust of users through the provision of health services based on principles of efficiency in the use of resources, quality in service provision, equity and universality of access, solidarity towards security regimes, integrality of coverage of the contingencies, and active participation of the community, among other principles, that manage to give competitive advantages to these health institutions. It is for this reason, that based on this strategic planning, the EPS and IPS intend to reorient the provision of health services, using their existing facilities and capacities regarding the suitability of health professionals, times of care and waiting, access to universal care and coverage, and the prestige of some clinics and hospitals that attract a large international health market. Throughout the document the background of the health system and the general situation at the national level are reflected to detail the current state of the promoting entities and the institutions that provide health services. In addition, was identified the general and financial structure of health in Colombia, identifying the strengths and weaknesses of the health system, highlighting the entries at the international level, coming from health tourism. This last factor makes expectations in the health sector are favorable to improve the delivery of health services. Competitive advantages must develop EPS and IPS to be competitive in the health sector are: technological medical equipment, hospital capacity and infrastructure, qualified human resources, financial solvency, hospitalization times, medical services offered, levels of complexity within hospitals, investment in research and development, accreditation of health systems, among others. For this reason, strategies are presented that allow take advantage existing strengths and developing new ones. So, in the year 2026, the EPS and IPS are expected to excel within the national health system and position themselves as leading health entities in Latin America. For the development of these competitive advantages, have been raised five goals long-term: (a) By 2026, will be increase coverage in access to 100%; (b) by 2026, accreditation bodies of quality in health will be certify to 70% of the 2,500 IPS , qualifying it's high performance; (c) by 2026, will be increase to 25 the number of IPS within the ranking of the best clinics and hospitals in Latin America; (d) by 2026, will be improved the overall satisfaction rate by 10% for EPS and IPS; (e) by 2026, 70% of the EPS rated with an average performance in 2015 by the Ministry of Health and Social Protection, will obtain the high performance rating, providing optimal health services, which generate a high added value. The way these long-term objectives will be achieved is by implementing strategies developed in this studyTesi

Peak systolic velocity at arterial Doppler ultrasound in pediatric liver transplantation: A predictor of acute severe complications

Pediatria; Ecografia Doppler; Velocitat sistòlica màximaPediatric; Doppler ultrasound; Peak systolic velocityPediatría; Ecografía Doppler; Velocidad sistólica máximaThe diagnosis of arterial complications in children after Liver Transplantation (LT) urges prompt diagnosis and treatment. This study aims to determine whether hepatic artery Doppler Ultrasound (DUS) parameters can predict arterial complications in the immediate period after LT in children. A retrospective review of the pediatric liver database at our tertiary-care pediatric hospital was performed. The study included 70 pediatric patients who underwent a liver transplantation from 2016 to 2021. Clinical, laboratory and Doppler findings were recorded daily the first 5 days after transplantation, with special attention given to post-anastomotic Peak Systolic Velocity (PSV) and Resistive Index (RI). Patients with hepatic artery complications, including acute thrombosis and stenosis, had lower PSV values after surgery compared to the group with non-complications, with a statistical significance (< 0.001). Receiver operating characteristic (ROC) curve analysis determined an optimal cut-off value of PSV less than 29 cm/s the 2nd day after LT, 25.2 cm/s the 3rd day, 28.5 cm/s the 4th day and 29.4 cm/s the 5th day, to discriminate children with and without hepatic arterial complications. Notably, these cut-off values are lower than those proposed in adults. Optimal PSV cutt-off values in children in the immediate period after LT are presented. Knowledge of these cutt-off values improves the interpretation of DUS measurements and thereby, may help to accurately guide the clinical management

Knowledge, Attitudes, and Practices Regarding COVID-19 Among Healthcare Workers in Venezuela:An Online Cross-Sectional Survey

Background: The deterioration of Venezuela's health system in recent years undoubtedly contributes to an increased impact of the COVID-19 pandemic. Understanding healthcare workers' (HCWs) knowledge, attitudes, and practices (KAPs) toward COVID-19 in the early stages of the pandemic could inform their medical training and improve their preparedness. Methods: A online national cross-sectional survey was conducted between May 26th and May 30th, 2020, to assess KAPs among HCWs in Venezuela. Results: A total of 1,441 HCWs from all 24 regions of the country responded to the survey. The mean age of the HCWs was 44 (SD [standard deviation] 14) years; most were women (66.4%). Most HCWs were specialized doctors (48%), followed by nurses (13%) and resident doctors (12.3%). The majority of HCWs had good knowledge (76.3%), obtained information mainly from scientific literature (85.4%); had negative attitudes (53.6%), felt uncomfortable with their work during the current pandemic (59.8%); and reported appropriate practices (76.9%). However, participation in COVID-19 related training was absent in more than half of the HCWs. Positive attitudes were significantly more frequent in frontline workers than in non-frontline workers (p = 0.001). Bioanalysts, students, and doctors were more likely to have good knowledge; participating in training was a predictor for positive attitudes and older age was an appropriate practice predictor. Conclusions: HCWs, knowledge in Venezuela could be improved by strengthening education and training programs. Strategies should focus on reducing fear and improving attitudes toward the care of COVID-19 patients, as well as the promotion of preventive practices

Development and external validation of a faecal immunochemical test-based prediction model for colorectal cancer detection in symptomatic patients

Background: Risk prediction models for colorectal cancer (CRC) detection in symptomatic patients based on available biomarkers may improve CRC diagnosis. Our aim was to develop, compare with the NICE referral criteria and externally validate a CRC prediction model, COLONPREDICT, based on clinical and laboratory variables. Methods: This prospective cross-sectional study included consecutive patients with gastrointestinal symptoms referred for colonoscopy between March 2012 and September 2013 in a derivation cohort and between March 2014 and March 2015 in a validation cohort. In the derivation cohort, we assessed symptoms and the NICE referral criteria, and determined levels of faecal haemoglobin and calprotectin, blood haemoglobin, and serum carcinoembryonic antigen before performing an anorectal examination and a colonoscopy. A multivariate logistic regression analysis was used to develop the model with diagnostic accuracy with CRC detection as the main outcome. Results: We included 1572 patients in the derivation cohort and 1481 in the validation cohorts, with a 13.6 % and 9. 1 % CRC prevalence respectively. The final prediction model included 11 variables: age (years) (odds ratio [OR] 1.04, 95 % confidence interval [CI] 1.02-1.06), male gender (OR 2.2, 95 % CI 1.5-3.4), faecal haemoglobin >= 20 mu g/g (OR 17.0, 95 % CI 10.0-28.6), blood haemoglobin = 3 ng/mL (OR 4.5, 95 % CI 3.0-6.8), acetylsalicylic acid treatment (OR 0.4, 95 % CI 0.2-0.7), previous colonoscopy (OR 0.1, 95 % CI 0.06-0.2), rectal mass (OR 14.8, 95 % CI 5.3-41.0), benign anorectal lesion (OR 0.3, 95 % CI 0.2-0.4), rectal bleeding (OR 2.2, 95 % CI 1.4-3.4) and change in bowel habit (OR 1.7, 95 % CI 1.1-2.5). The area under the curve (AUC) was 0.92 (95 % CI 0.91-0.94), higher than the NICE referral criteria (AUC 0.59, 95 % CI 0.55-0.63; p < 0.001). On the basis of the thresholds with 90 % (5.6) and 99 % (3.5) sensitivity, we divided the derivation cohort into three risk groups for CRC detection: high (30.9 % of the cohort, positive predictive value [PPV] 40.7 %, 95 % CI 36.7-45.9 %), intermediate (29.5 %, PPV 4.4 %, 95 % CI 2.8-6.8 %) and low (39.5 %, PPV 0.2 %, 95 % CI 0.0-1.1 %). The discriminatory ability was equivalent in the validation cohort (AUC 0.92, 95 % CI 0.90-0.94; p = 0.7). Conclusions: COLONPREDICT is a highly accurate prediction model for CRC detection.This study was funded by a grant from Instituto de Salud Carlos III (PI11/00094). JC and VH have received an intensification grant through the European Commission funded "BIOCAPS" project (FP-7-REGPOT 2012-2013-1, Grant agreement no. FP7-316265). The validation cohort recruitment was funded by a grant from Fundacio de la Marato TV3 2012 (785/U/2013). The funding institutions had no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the article for publication

Development and external validation of a faecal immunochemical test-based prediction model for colorectal cancer detection in symptomatic patients

Background: risk prediction models for colorectal cancer (CRC) detection in symptomatic patients based on available biomarkers may improve CRC diagnosis. Our aim was to develop, compare with the NICE referral criteria and externally validate a CRC prediction model, COLONPREDICT, based on clinical and laboratory variables. Methods: this prospective cross-sectional study included consecutive patients with gastrointestinal symptoms referred for colonoscopy between March 2012 and September 2013 in a derivation cohort and between March 2014 and March 2015 in a validation cohort. In the derivation cohort, we assessed symptoms and the NICE referral criteria, and determined levels of faecal haemoglobin and calprotectin, blood haemoglobin, and serum carcinoembryonic antigen before performing an anorectal examination and a colonoscopy. A multivariate logistic regression analysis was used to develop the model with diagnostic accuracy with CRC detection as the main outcome. Results: we included 1572 patients in the derivation cohort and 1481 in the validation cohorts, with a 13.6 % and 9.1 % CRC prevalence respectively. The final prediction model included 11 variables: age (years) (odds ratio [OR] 1.04, 95 % confidence interval [CI] 1.02-1.06), male gender (OR 2.2, 95 % CI 1.5-3.4), faecal haemoglobin ≥20 μg/g (OR 17.0, 95 % CI 10.0-28.6), blood haemoglobin <10 g/dL (OR 4.8, 95 % CI 2.2-10.3), blood haemoglobin 10-12 g/dL (OR 1.8, 95 % CI 1.1-3.0), carcinoembryonic antigen ≥3 ng/mL (OR 4.5, 95 % CI 3.0-6.8), acetylsalicylic acid treatment (OR 0.4, 95 % CI 0.2-0.7), previous colonoscopy (OR 0.1, 95 % CI 0.06-0.2), rectal mass (OR 14.8, 95 % CI 5.3-41.0), benign anorectal lesion (OR 0.3, 95 % CI 0.2-0.4), rectal bleeding (OR 2.2, 95 % CI 1.4-3.4) and change in bowel habit (OR 1.7, 95 % CI 1.1-2.5). The area under the curve (AUC) was 0.92 (95 % CI 0.91-0.94), higher than the NICE referral criteria (AUC 0.59, 95 % CI 0.55-0.63; p < 0.001). On the basis of the thresholds with 90 % (5.6) and 99 % (3.5) sensitivity, we divided the derivation cohort into three risk groups for CRC detection: high (30.9 % of the cohort, positive predictive value [PPV] 40.7 %, 95 % CI 36.7-45.9 %), intermediate (29.5 %, PPV 4.4 %, 95 % CI 2.8-6.8 %) and low (39.5 %, PPV 0.2 %, 95 % CI 0.0-1.1 %). The discriminatory ability was equivalent in the validation cohort (AUC 0.92, 95 % CI 0.90-0.94; p = 0.7). Conclusions: COLONPREDICT is a highly accurate prediction model for CRC detection

Identification of new sources of resistance to RHBV- rice hoja blanca virus

With the aim to find new sources of resistance to rice hoja blanca (white leaf) disease, transmitted by the insect Tagosodes orizicolus, 660 genotypes were evaluated under greenhouse and field conditions. Seven resistant genotypes were identified, and genomic studies were performed to demonstrate that the resistance in these sources is genetically different from that of Fedearroz 2000, which is currently the variety with the most resistance to hoja blanca. These new resistance sources constitute a resource that can be used to sustainably extend hoja blanca disease management throughout all of the rice-growing regions of tropical America. This is the first report of hoja blanca resistance in indica rice and different from that of Fedearroz 2000.Con el objetivo de encontrar nuevas fuentes de resistencia a la enfermedad de la hoja blanca del arroz, transmitida por el insecto Tagosodes orizicolus, se evaluaron 660 genotipos en condiciones de invernadero y campo. Se identificaron siete genotipos con resistencia a la enfermedad y se realizaron estudios del genoma para evidenciar que eran genéticamente diferentes a Fedearroz 2000, la variedad de mejor comportamiento ante el virus, en el momento. Estas nuevas fuentes de resistencia constituyen un recurso que puede utilizarse para extender un manejo sostenible de la enfermedad, en todas las regiones productoras de arroz en América tropical. Este es el primer reporte de fuentes de resistencia, tipo indica, diferentes a Fedearroz 2000

Understanding the clinical spectrum of complicated Plasmodium vivax malaria: a systematic review on the contributions of the Brazilian literature

The resurgence of the malaria eradication agenda and the increasing number of severe manifestation reports has contributed to a renewed interested in the Plasmodium vivax infection. It is the most geographically widespread parasite causing human malaria, with around 2.85 billion people living under risk of infection. The Brazilian Amazon region reports more than 50% of the malaria cases in Latin America and since 1990 there is a marked predominance of this species, responsible for 85% of cases in 2009. However, only a few complicated cases of P. vivax have been reported from this region. A systematic review of the Brazilian indexed and non-indexed literature on complicated cases of vivax malaria was performed including published articles, masters' dissertations, doctoral theses and national congresses' abstracts. The following information was retrieved: patient characteristics (demographic, presence of co-morbidities and, whenever possible, associated genetic disorders); description of each major clinical manifestation. As a result, 27 articles, 28 abstracts from scientific events' annals and 13 theses/dissertations were found, only after 1987. Most of the reported information was described in small case series and case reports of patients from all the Amazonian states, and also in travellers from Brazilian non-endemic areas. The more relevant clinical complications were anaemia, thrombocytopaenia, jaundice and acute respiratory distress syndrome, present in all age groups, in addition to other more rare clinical pictures. Complications in pregnant women were also reported. Acute and chronic co-morbidities were frequent, however death was occasional. Clinical atypical cases of malaria are more frequent than published in the indexed literature, probably due to a publication bias. In the Brazilian Amazon (considered to be a low to moderate intensity area of transmission), clinical data are in accordance with the recent findings of severity described in diverse P. vivax endemic areas (especially anaemia in Southeast Asia), however in this region both children and adults are affected. Finally, gaps of knowledge and areas for future research are opportunely pointed out