Parasitismo intestinal en población de 1 a 10 años

Introduction: diseases caused by intestinal parasites are a serious health problem in children. Objective: to characterize the intestinal parasitism in the population between one and ten years of the community attended by the medical clinic No. 2 of the Pedro Borras Astorga Polyclinic, during the year 2017. Method: an observational, descriptive and transversal study was carried out. The universe consisted of 123 children, selecting a sample of 57. A bibliographic review of materials and sources was made on the different aspects treated in the research and the documentary analysis of the individual clinical histories; In addition, a data collection form was prepared, based on the medical interview. All variables were given an absolute and relative percentage frequency distribution. Results: male sex prevailed (54,4 %) and the age group between six and ten years old (51,2 %). Giardia lamblia was the main intestinal parasite (43,9 %). Abdominal pain was the main clinical manifestation (49,1 %). 70,2 % of the patients were normal weight. 38,6 % washed their hands before eating and 43,9 % after defecating. 42,1 % washed the food before ingesting it. 71,9 % drink treated water. The treatment of choice was effective in 61,4 % of the patients. Conclusions:the actions of prevention of health by the basic work team contribute to diminish the incidence of intestinal parasitism in the infantile population.Introducción: las enfermedades producidas por parásitos intestinales constituyen un grave problema de salud en la población infantil.Objetivo: caracterizar el parasitismo intestinal en la población entre uno y diez años de la comunidad atendida por el consultorio médico No. 2 del Policlínico Pedro Borras Astorga, durante el año 2017.Método: se realizó un estudio observacional, descriptivo y transversal. El universo estuvo constituido por 123 niños, seleccionándose una muestra de 57. Se realizó una revisión bibliográfica de materiales y fuentes sobre los diferentes aspectos tratados en la investigación y el análisis documental de las historias clínicas individuales; además se confeccionó una planilla de recolección de datos, a partir de la entrevista médica. A todas las variables se les realizó distribución de frecuencias absoluta y relativa porcentual.Resultados: predominó el sexo masculino (54,4 %) y el grupo de edad entre seis y diez años (51,2 %). La giardia lamblia constituyó el principal parásito intestinal (43,9 %). El dolor abdominal fue la principal manifestación clínica (49,1 %). El 70,2 % de los pacientes eran normopeso. El 38,6 % se lavaban las manos antes de ingerir alimentos y el 43,9 % después de defecar. El 42,1 % lavaban los alimentos antes de ingerirlos. El 71,9 % beben agua tratada. En el 61,4 % de los pacientes fue efectivo el tratamiento de elección.Conclusiones: las acciones de prevención de salud por parte del equipo básico de trabajo contribuyen a disminuir la incidencia del parasitismo intestinal en la población infanti

Proyecto El Patio de Ana la Cub-ANA y sus aportes a la educación ciudadana en la comunidad

Introduction: at present it is indispensable to modify behaviors and structure the values in the new generations of Cubans through didactic instruments involve in the teaching-learning process, making it enjoyable, especially in the population of a community project, where there is a greater need of training.Objective: to design a leaflet that contains poems with implicit messages for the development of values in children belonging to the community project "El Patio de Ana la Cub-ANA".Method: a technological development study was carried out at Pinar del Río University of Medical Sciences, during December 2017 to March 2018 in the population participating in the community project “El Patio de Ana la Cub-ANA”, including an extension activity working with medical students. The target group was comprised of 1238 people from the project, and the sample included 326, chosen by a non-probabilistic, unintentional way.Development: the leaflet contains project reviews, as well as criteria expressed by its members and a set of poems as a central theme in order to transmit teachings and knowledge for future generations. The users expressed that it represented a didactic model that meets the educational needs of a group of people who are vulnerable to social influences in their community.Conclusions: a learning resource was created to facilitate the performance in the modification of behaviors in the community, which is very useful, and where the users expressed excellent evaluations regarding the project.Introducción: en la actualidad se hace necesario modificar conductas y formar valores en las nuevas generaciones de cubanos mediante instrumentos didácticos que hagan ameno el proceso enseñanza-aprendizaje, sobre todo en la población de un proyecto comunitario, donde existen mayores necesidades formación.Objetivo: diseñar un plegable que contenga poesías con mensajes implícitos para la formación de valores en niños pertenecientes al proyecto comunitario “El Patio de Ana la Cub-ANA”.Método: se realizó un estudio de desarrollo tecnológico de la Universidad de Ciencias Médicas de Pinar del Río, durante el período de diciembre de 2017 a marzo de 2018 en la población participante en el proyecto comunitario El Patio de Ana la Cub-ANA, en su tarea extensionista con estudiantes de Medicina. El universo estuvo constituido por 1 238 personas del proyecto, y la muestra por 326 seleccionadas de forma no probabilística, accidental.Desarrollo: se trató de un plegable que contiene reseñas del proyecto, así como criterios expresados por sus integrantes y un conjunto de poesías que hacen de él su tema central en función de transmitir enseñanzas y conocimientos para las futuras generaciones. Los usuarios expresaron que representó un modelo didáctico que satisface las necesidades educativas en un grupo de personas vulnerables a las influencias sociales en su comunidad.Conclusiones: se confeccionó un recurso de aprendizaje para facilitar la actuación en la modificación de conductas en la comunidad muy provechoso, y donde los usuarios emitieron excelentes valoraciones

Community Project: “El Patio de Ana la Cub-ANA”, its contributions to the citizen education in the neighborhood

Introduction: at present it is indispensable to modify behaviors and structure the values in the new generations of Cubans through didactic instruments involve in the teaching-learning process, making it enjoyable, especially in the population of a community project, where there is a greater need of training. Objective: to design a leaflet that contains poems with implicit messages for the development of values in children belonging to the community project "El Patio de Ana la Cub-ANA". Method: a technological development study was carried out at Pinar del Río University of Medical Sciences, during December 2017 to March 2018 in the population participating in the community project “El Patio de Ana la Cub-ANA”, including an extension activity working with medical students. The target group was comprised of 1238 people from the project, and the sample included 326, chosen by a non-probabilistic, unintentional way. Development: the leaflet contains project reviews, as well as criteria expressed by its members and a set of poems as a central theme in order to transmit teachings and knowledge for future generations. The users expressed that it represented a didactic model that meets the educational needs of a group of people who are vulnerable to social influences in their community. Conclusions: a learning resource was created to facilitate the performance in the modification of behaviors in the community, which is very useful, and where the users expressed excellent evaluations regarding the project

Principales consecuencias del alcoholismo en la salud

Aimed at describing the main consequences of alcoholism on health, a medical literature review was conducted, consulting a total of 29 references, from the sources as SciELO and PubMed. It was concluded that excessive alcohol consumption is the cause of a series of disorders that include gastrointestinal, embryonic, respiratory, neurodegenerative, cardiovascular, psychological, renal, immune diseases and cancer.Con el objetivo de describir las principales consecuencias del alcoholismo en la salud se realizó la siguiente revisión bibliográfica, consultándose un total de 29 referencias, de fuentes como SciELO y PubMed. Se arribó a la conclusión de que el consumo excesivo de alcohol es causante de una serie de trastornos que incluyen enfermedades gastrointestinales, embrionarias, respiratorias, neurodegenerativas, cardiovasculares, psicológicas, renales, inmunes y padecimientos como el cáncer

Comportamiento de las infecciones respiratorias agudas en un consultorio médico

Introduction: acute respiratory infections are a group of diseases of the respiratory tract caused by viral, bacterial, mycotic and parasitic microorganisms, with a period of less than 15 days. Objective: to characterize the behavior of acute respiratory infections in a medical office. Method: an observational, descriptive and cross-sectional study was carried out at No. 17 medical clinic at Hermanos Cruz University Polyclinic in Pinar del Río, between January and May of 2018. The sample consisted of 92 patients who met the criteria of inclusion and exclusion. Data were obtained from primary and secondary sources of information collection. To process these data, theoretical, empirical and statistical methods were used. The principles of medical ethical were observed. Results: female patients predominated (61,0 %), age group 0 to 9 years (31,5 %), smoking as the main risk factor associated (14,1 %), cough and sputum (88,0 %) and fever (85,9 %) as the most common symptoms; acute bronchitis (30,4 %) and common cold (26,1 %) were the most frequent types of ARI. Conclusions: acute respiratory infections is considered an important problem for public health, because they are the most common diseases present in both, children and adults, the early diagnosis based on knowledge of their symptoms and detection of risk factors, reduce complications and mortality.Introducción: las infecciones respiratorias agudas son un conjunto de enfermedades del aparato respiratorio causadas por microorganismos virales, bacterianos, micóticos y parasitarios, con un período inferior a 15 días.Objetivo: caracterizar el comportamiento de las infecciones respiratorias agudas en un consultorio médico.Método: se realizó un estudio observacional, descriptivo y transversal en el consultorio médico No. 17 del Policlínico Universitario “Hermanos Cruz” en Pinar del Río, entre enero y mayo del 2018. La muestra quedó conformada por 92 pacientes que cumplieron con los criterios de inclusión y exclusión. Los datos se obtuvieron de fuentes primarias y secundarias de recolección de información. Para su procesamiento se emplearon métodos teóricos, empíricos y estadísticos. Se cumplió con los principios de la ética médica.Resultados: predominaron los pacientes del sexo femenino (61,0 %), el grupo de edad de 0 a 9 años (31,5 %), el tabaquismo como principal factor de riesgo asociado (14,1 %), la tos y expectoración (88,0 %) y la fiebre (85,9 %)como síntomas más habituales; la bronquitis aguda (30,4 %) y el catarro común (26,1 %) fueron los tipos de IRA más frecuentes.Conclusiones: las infecciones respiratorias agudas constituyen un importante problema para la salud pública, debido a que son las enfermedades más comunes que se producen tanto en niños como en adultos, por lo cual su diagnóstico precoz a partir del conocimiento de su sintomatología y la detección de factores de riesgo, minimizan las complicaciones y la mortalidad

Hyperoxemia and excess oxygen use in early acute respiratory distress syndrome : Insights from the LUNG SAFE study

Publisher Copyright: © 2020 The Author(s). Copyright: Copyright 2020 Elsevier B.V., All rights reserved.Background: Concerns exist regarding the prevalence and impact of unnecessary oxygen use in patients with acute respiratory distress syndrome (ARDS). We examined this issue in patients with ARDS enrolled in the Large observational study to UNderstand the Global impact of Severe Acute respiratory FailurE (LUNG SAFE) study. Methods: In this secondary analysis of the LUNG SAFE study, we wished to determine the prevalence and the outcomes associated with hyperoxemia on day 1, sustained hyperoxemia, and excessive oxygen use in patients with early ARDS. Patients who fulfilled criteria of ARDS on day 1 and day 2 of acute hypoxemic respiratory failure were categorized based on the presence of hyperoxemia (PaO2 > 100 mmHg) on day 1, sustained (i.e., present on day 1 and day 2) hyperoxemia, or excessive oxygen use (FIO2 ≥ 0.60 during hyperoxemia). Results: Of 2005 patients that met the inclusion criteria, 131 (6.5%) were hypoxemic (PaO2 < 55 mmHg), 607 (30%) had hyperoxemia on day 1, and 250 (12%) had sustained hyperoxemia. Excess FIO2 use occurred in 400 (66%) out of 607 patients with hyperoxemia. Excess FIO2 use decreased from day 1 to day 2 of ARDS, with most hyperoxemic patients on day 2 receiving relatively low FIO2. Multivariate analyses found no independent relationship between day 1 hyperoxemia, sustained hyperoxemia, or excess FIO2 use and adverse clinical outcomes. Mortality was 42% in patients with excess FIO2 use, compared to 39% in a propensity-matched sample of normoxemic (PaO2 55-100 mmHg) patients (P = 0.47). Conclusions: Hyperoxemia and excess oxygen use are both prevalent in early ARDS but are most often non-sustained. No relationship was found between hyperoxemia or excessive oxygen use and patient outcome in this cohort. Trial registration: LUNG-SAFE is registered with ClinicalTrials.gov, NCT02010073publishersversionPeer reviewe

Principales consecuencias del alcoholismo en la salud

Aimed at describing the main consequences of alcoholism on health, a medical literature review was conducted, consulting a total of 29 references, from the sources as SciELO and PubMed. It was concluded that excessive alcohol consumption is the cause of a series of disorders that include gastrointestinal, embryonic, respiratory, neurodegenerative, cardiovascular, psychological, renal, immune diseases and cancer.Con el objetivo de describir las principales consecuencias del alcoholismo en la salud se realizó la siguiente revisión bibliográfica, consultándose un total de 29 referencias, de fuentes como SciELO y PubMed. Se arribó a la conclusión de que el consumo excesivo de alcohol es causante de una serie de trastornos que incluyen enfermedades gastrointestinales, embrionarias, respiratorias, neurodegenerativas, cardiovasculares, psicológicas, renales, inmunes y padecimientos como el cáncer

Immunocompromised patients with acute respiratory distress syndrome: Secondary analysis of the LUNG SAFE database

Background: The aim of this study was to describe data on epidemiology, ventilatory management, and outcome of acute respiratory distress syndrome (ARDS) in immunocompromised patients. Methods: We performed a post hoc analysis on the cohort of immunocompromised patients enrolled in the Large Observational Study to Understand the Global Impact of Severe Acute Respiratory Failure (LUNG SAFE) study. The LUNG SAFE study was an international, prospective study including hypoxemic patients in 459 ICUs from 50 countries across 5 continents. Results: Of 2813 patients with ARDS, 584 (20.8%) were immunocompromised, 38.9% of whom had an unspecified cause. Pneumonia, nonpulmonary sepsis, and noncardiogenic shock were their most common risk factors for ARDS. Hospital mortality was higher in immunocompromised than in immunocompetent patients (52.4% vs 36.2%; p &lt; 0.0001), despite similar severity of ARDS. Decisions regarding limiting life-sustaining measures were significantly more frequent in immunocompromised patients (27.1% vs 18.6%; p &lt; 0.0001). Use of noninvasive ventilation (NIV) as first-line treatment was higher in immunocompromised patients (20.9% vs 15.9%; p = 0.0048), and immunodeficiency remained independently associated with the use of NIV after adjustment for confounders. Forty-eight percent of the patients treated with NIV were intubated, and their mortality was not different from that of the patients invasively ventilated ab initio. Conclusions: Immunosuppression is frequent in patients with ARDS, and infections are the main risk factors for ARDS in these immunocompromised patients. Their management differs from that of immunocompetent patients, particularly the greater use of NIV as first-line ventilation strategy. Compared with immunocompetent subjects, they have higher mortality regardless of ARDS severity as well as a higher frequency of limitation of life-sustaining measures. Nonetheless, nearly half of these patients survive to hospital discharge. Trial registration: ClinicalTrials.gov, NCT02010073. Registered on 12 December 2013

Immunocompromised patients with acute respiratory distress syndrome : Secondary analysis of the LUNG SAFE database

The aim of this study was to describe data on epidemiology, ventilatory management, and outcome of acute respiratory distress syndrome (ARDS) in immunocompromised patients. Methods: We performed a post hoc analysis on the cohort of immunocompromised patients enrolled in the Large Observational Study to Understand the Global Impact of Severe Acute Respiratory Failure (LUNG SAFE) study. The LUNG SAFE study was an international, prospective study including hypoxemic patients in 459 ICUs from 50 countries across 5 continents. Results: Of 2813 patients with ARDS, 584 (20.8%) were immunocompromised, 38.9% of whom had an unspecified cause. Pneumonia, nonpulmonary sepsis, and noncardiogenic shock were their most common risk factors for ARDS. Hospital mortality was higher in immunocompromised than in immunocompetent patients (52.4% vs 36.2%; p < 0.0001), despite similar severity of ARDS. Decisions regarding limiting life-sustaining measures were significantly more frequent in immunocompromised patients (27.1% vs 18.6%; p < 0.0001). Use of noninvasive ventilation (NIV) as first-line treatment was higher in immunocompromised patients (20.9% vs 15.9%; p = 0.0048), and immunodeficiency remained independently associated with the use of NIV after adjustment for confounders. Forty-eight percent of the patients treated with NIV were intubated, and their mortality was not different from that of the patients invasively ventilated ab initio. Conclusions: Immunosuppression is frequent in patients with ARDS, and infections are the main risk factors for ARDS in these immunocompromised patients. Their management differs from that of immunocompetent patients, particularly the greater use of NIV as first-line ventilation strategy. Compared with immunocompetent subjects, they have higher mortality regardless of ARDS severity as well as a higher frequency of limitation of life-sustaining measures. Nonetheless, nearly half of these patients survive to hospital discharge. Trial registration: ClinicalTrials.gov, NCT02010073. Registered on 12 December 2013

Geoeconomic variations in epidemiology, ventilation management, and outcomes in invasively ventilated intensive care unit patients without acute respiratory distress syndrome: a pooled analysis of four observational studies

Background: Geoeconomic variations in epidemiology, the practice of ventilation, and outcome in invasively ventilated intensive care unit (ICU) patients without acute respiratory distress syndrome (ARDS) remain unexplored. In this analysis we aim to address these gaps using individual patient data of four large observational studies. Methods: In this pooled analysis we harmonised individual patient data from the ERICC, LUNG SAFE, PRoVENT, and PRoVENT-iMiC prospective observational studies, which were conducted from June, 2011, to December, 2018, in 534 ICUs in 54 countries. We used the 2016 World Bank classification to define two geoeconomic regions: middle-income countries (MICs) and high-income countries (HICs). ARDS was defined according to the Berlin criteria. Descriptive statistics were used to compare patients in MICs versus HICs. The primary outcome was the use of low tidal volume ventilation (LTVV) for the first 3 days of mechanical ventilation. Secondary outcomes were key ventilation parameters (tidal volume size, positive end-expiratory pressure, fraction of inspired oxygen, peak pressure, plateau pressure, driving pressure, and respiratory rate), patient characteristics, the risk for and actual development of acute respiratory distress syndrome after the first day of ventilation, duration of ventilation, ICU length of stay, and ICU mortality. Findings: Of the 7608 patients included in the original studies, this analysis included 3852 patients without ARDS, of whom 2345 were from MICs and 1507 were from HICs. Patients in MICs were younger, shorter and with a slightly lower body-mass index, more often had diabetes and active cancer, but less often chronic obstructive pulmonary disease and heart failure than patients from HICs. Sequential organ failure assessment scores were similar in MICs and HICs. Use of LTVV in MICs and HICs was comparable (42·4% vs 44·2%; absolute difference -1·69 [-9·58 to 6·11] p=0·67; data available in 3174 [82%] of 3852 patients). The median applied positive end expiratory pressure was lower in MICs than in HICs (5 [IQR 5-8] vs 6 [5-8] cm H2O; p=0·0011). ICU mortality was higher in MICs than in HICs (30·5% vs 19·9%; p=0·0004; adjusted effect 16·41% [95% CI 9·52-23·52]; p&lt;0·0001) and was inversely associated with gross domestic product (adjusted odds ratio for a US$10 000 increase per capita 0·80 [95% CI 0·75-0·86]; p&lt;0·0001). Interpretation: Despite similar disease severity and ventilation management, ICU mortality in patients without ARDS is higher in MICs than in HICs, with a strong association with country-level economic status