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VULNERABILITY OF THE SANITARY INFRASTRUCTURE IN RELATION TO COVID-19 IN THE DISTRICT OF CASTILLA-PIURA 2021-2022 2021-2022年卡斯蒂利亚-皮乌拉地区卫生基础设施与新冠肺炎的脆弱性
Pub Date : 2023-09-30 DOI: 10.25176/rfmh.v23i3.5619
Luis F. Chero Córdova, Guisela Yabar-Torres
Objective: The relationship between the sanitary infrastructure, considering three aspects such as: equipment and supplies; built environments; humanization of care against COVID-19 in the district of Castilla - Piura in the year 2022. Methods: It adopts the Hermeneutic paradigm, with a cross-sectional, qualitative design, based on surveys applied to a statistical sample from the Castilla sector, unstructured interviews were conducted, aimed at health professional experts. Results: It is observed that 100% of the II and III level hospitals and health centers in Piura are in inadequate conditions to achieve efficiency and effectiveness in care, both in infrastructure-equipment, in built environment and humanized. Conclusion: The deficient state of health establishments has determined the increase in cases of COVID 19, during the pandemic, because they do not have adequate environments to treat different pathologies, as well as due to inadequate zoning of respiratory and vector isolation areas. , those that must respond to the reality of this Region; This situation raises the need to formulate a regional contingency plan, the same one that guarantees priority and quality care in emergency situations, as well as life during the pandemic.
目的:探讨卫生基础设施的关系,从三个方面考虑:设备和物资;建立环境;2022年在卡斯蒂利亚-皮乌拉区开展COVID-19人性化护理。方法:采用解释学范式,采用横断面定性设计,基于对卡斯蒂亚地区统计样本的调查,针对卫生专业专家进行了非结构化访谈。结果:据观察,皮乌拉100%的二级和三级医院和保健中心在基础设施设备、建筑环境和人性化方面的条件不足,无法实现护理的效率和效果。结论:大流行期间,卫生机构的缺陷状态决定了COVID - 19病例的增加,因为它们没有足够的环境来治疗不同的病症,以及由于呼吸道和媒介隔离区的分区不充分。必须对本区域的现实作出反应的国家;这种情况使我们有必要制定一项区域应急计划,即在紧急情况下保证优先和高质量的护理以及在大流行病期间保证生命的计划。
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引用次数: 0
ORAL HEALTH PRACTICES DURING THE FIRST 1000 DAYS OF LIFE: LITERATURE REVIEW 生命最初1000天的口腔健康实践:文献综述
Pub Date : 2023-09-30 DOI: 10.25176/rfmh.v23i3.4904
Kamila J. Sihuay Torres, Ivo Luna Mazzola, Rosa C. Lara Verástegui, Lauro M. Rivera Félix
Objective: To conduct a bibliographic literature review on current good practices in oral health during the first 1000 days of life, encompassing the gestation period and the initial two years of the child. Materials and methods: A scientific literature review was conducted in February and March 2022, utilizing the Pubmed and Scopus databases. The inclusion criteria encompassed original articles and systematic reviews (with or without meta-analysis) published between 2016 and 2022. Search strategies incorporating English keywords derived from MeSH were employed. Additionally, the grey literature was reviewed to define some key concepts. Results: 72 scientific articles, and four references from the grey literature (one clinical practice guide and three reports) were selected. The identified themes were categorized as follows: good oral hygiene practices, good feeding practices for pregnant women and infants, parafunctional habits, and dental visits. Based on the findings, the key recommendations for promoting good oral health practices during this crucial period include the use of fluoride toothpaste for oral hygiene once teeth erupt, avoidance of free sugar consumption, encouragement of breastfeeding over bottle-feeding, and early dental visits before birth. Conclusion: Good oral health practices during the first 1000 days of life significantly impact the child’s oral and general health, necessitating preventive measures starting from gestation, with a focus on oral hygiene and nutrition. The collaborative efforts of a multidisciplinary healthcare team during pregnancy and the initial two years of life are vital for enhancing both oral and general health outcomes for the population.
目的:对婴儿出生后1000天(包括妊娠期和出生后两年)口腔健康的现行良好做法进行文献综述。材料和方法:利用Pubmed和Scopus数据库,于2022年2月和3月进行了科学文献综述。纳入标准包括2016年至2022年间发表的原创文章和系统综述(有或没有荟萃分析)。采用从MeSH中衍生出的英文关键词作为搜索策略。此外,对灰色文献进行了回顾,以定义一些关键概念。结果:科学文献72篇,灰色文献4篇(临床实践指南1篇,报告3篇)。确定的主题分类如下:良好的口腔卫生习惯、孕妇和婴儿的良好喂养习惯、辅助功能习惯和牙科就诊。根据调查结果,在这一关键时期促进良好口腔卫生习惯的主要建议包括:一旦牙齿长出,使用含氟牙膏保持口腔卫生,避免食用游离糖,鼓励母乳喂养而不是奶瓶喂养,以及在出生前尽早进行牙科检查。结论:出生后1000天内良好的口腔卫生习惯对儿童的口腔和全身健康有重大影响,需要从妊娠期开始采取预防措施,重点是口腔卫生和营养。多学科保健团队在怀孕期间和生命最初两年的协作努力对于提高人口的口腔和一般健康结果至关重要。
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引用次数: 0
Medical vocation, beyond the duty of care: a review of literature from ethical and philosophical perspectives. 医疗职业,超越照顾的责任:从伦理和哲学的角度回顾文献。
Pub Date : 2023-09-30 DOI: 10.25176/rfmh.v23i3.5635
Ricardo J. Ayala García, Lisset G. Huamaní Huamán
This review article explores medical vocation as a phenomenon that extends beyond the mere duty of caring for patients, focusing on the significance of ethical commitment, empathy, and resilience in medical practice. The implications for medical training and clinical practice are discussed.
这篇综述文章探讨了医疗职业作为一种现象,它超越了仅仅照顾病人的责任,重点是医疗实践中道德承诺、同理心和弹性的重要性。讨论了对医学培训和临床实践的影响。
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引用次数: 0
Antiseptics solutions for Prevention of surgical wound infection in appendectomized patients by complicated acute appendicitis 预防并发急性阑尾炎阑尾切除患者手术创面感染的抗菌液
Pub Date : 2023-09-30 DOI: 10.25176/rfmh.v23i3.5906
Arturo García Galicia, Álvaro J. Montiel Jarquín, Leonardo Corona Olmedo, Yaciel E. Flores Ramos, Ricardo A. Parker Bosquez, Jorge Loría Castellanos, Víctor Victoria De la Rosa, Janeth Ramírez Mendoza
Surgical wound infection secondary to complicated acute appendicitis is frequent. The objective was to compare the Dakin and the Superoxidative solutions to prevent surgical wound infections in complicated acute appendicitis. It was a comparative, cross-sectional study, in 104 patients with complicated acute appendicitis (medium age 36.29 years, 69(66.43%) men). Group 1: 52 patients with surgical wound lavage with Dakin modified solution. Group 2: 52 patients with superoxidative solution (Microdacyn®). All patients received ceftriaxone 1 g before surgery; conventional appendectomy was performed and the wall closure with Vicryl 1 and Nylon 2/0. Surgical wound was evaluated 7 days after surgery, looking for pus, edema, erythema, local heat. X2 and Student's t were used. Surgical wound infection was present in 11 (10.6%) patients, 3(5.8%) patients from group 1 and 8(15.4%) from group 2 (p=0.1). Both solutions are useful to prevent surgical wound infections in patients operated by complicated acute appendicitis.
并发急性阑尾炎继发手术伤口感染是常见的。目的是比较Dakin和超氧化溶液在预防复杂急性阑尾炎手术伤口感染中的作用。这是一项比较、横断面研究,共纳入104例合并急性阑尾炎患者(中位年龄36.29岁,男性69例(66.43%))。第一组:52例手术创面灌洗用达金改良液。第二组:超氧化溶液(Microdacyn®)患者52例。所有患者术前均给予头孢曲松1 g;行常规阑尾切除术,用Vicryl 1和Nylon 2/0封闭阑尾壁。术后7天评估手术创面,观察有无脓液、水肿、红斑、局部发热。使用X2和Student's t。手术创面感染11例(10.6%),1组3例(5.8%),2组8例(15.4%)(p=0.1)。这两种解决方案都有助于预防复杂急性阑尾炎手术患者的手术伤口感染。
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引用次数: 0
Association between hematological parameters and metabolically unhealthy phenotypes in children and adolescents 儿童和青少年血液学参数与代谢不健康表型之间的关系
Pub Date : 2023-09-30 DOI: 10.25176/rfmh.v23i3.5603
Gabriel Horta-Baas, Maria L. Pizano Zárate, Arturo J. Núñez Hernández, Verónica De León Camacho, María del S. Romero Figueroa, Alvaro Montiel Jarquín
Introduction. Metabolic syndrome has been associated with changes in several hematological parameters, such as red blood cells, platelets, and leucocytes. Therefore, hematologic parameters can be used to identify the subjects at risk of metabolically unhealthy phenotypes (MUP). The current study investigated if hematological parameters can serve as biomarkers to distinguish metabolically healthy phenotype (MHP) from MUP in children and adolescents. Methods. Two hundred ninety-two children and adolescents were enrolled in this cross-sectional study. The MUP was diagnosed using consensus-based criteria. Group comparisons were performed using one-way ANOVA. Multiple logistic regression analysis was used to determine if sex, age group, nutritional status, puberty, hematological parameters, and insulin resistance were associated with MUP. Results. The subject's age mean was 11 years (SD: 2.61). RDW values were significantly lower in children in the metabolically unhealthy normal weight (MUNW) group compared to children with metabolically unhealthy obesity (MUO) group (12.33 ± 0.90 vs. 13.67 ± 0.52; p = 0.01) and in metabolically healthy obesity (MHO) compared to MUO group (13.15 ± 0.53 vs. 13.67 ± 0.52; p = 0.04). In adolescents, the platelet-to-lymphocyte ratio was higher in the MHNW group, with a mean value of 152.60 (SD 62.97) compared to 111.16 (SD 44.12) for the MHO group. However, after adjusting for age, nutritional status, and puberty, hematological indices were not associated with MUP. Conclusions. The study demonstrates that hematologic parameters are not independently associated with the MUP, and it is unlikely that they represent reliable biomarkers for screening for the MUP in the pediatric population.
介绍。代谢综合征与一些血液学参数的变化有关,如红细胞、血小板和白细胞。因此,血液学参数可用于识别代谢不健康表型(MUP)风险的受试者。目前的研究调查了血液学参数是否可以作为区分儿童和青少年代谢健康表型(MHP)和MUP的生物标志物。方法。232名儿童和青少年参加了这项横断面研究。MUP的诊断采用基于共识的标准。组间比较采用单因素方差分析。采用多元logistic回归分析确定性别、年龄组、营养状况、青春期、血液学参数和胰岛素抵抗是否与MUP相关。结果。受试者平均年龄11岁(SD: 2.61)。代谢不健康正常体重(MUNW)组儿童的RDW值显著低于代谢不健康肥胖(MUO)组儿童(12.33±0.90 vs 13.67±0.52;p = 0.01)和代谢健康肥胖(MHO)组(13.15±0.53∶13.67±0.52;P = 0.04)。在青少年中,MHNW组的血小板与淋巴细胞比率更高,平均值为152.60 (SD 62.97),而MHO组的平均值为111.16 (SD 44.12)。然而,在调整了年龄、营养状况和青春期后,血液学指标与MUP无关。结论。该研究表明,血液学参数与MUP并不独立相关,它们不太可能代表儿科人群中MUP筛查的可靠生物标志物。
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引用次数: 0
Systemic sclerosis sine scleroderma in a woman with centromere antinuclear antibodies, pulmonary and digestive involvement: Case report 有着丝粒抗核抗体累及肺部和消化道的女性硬皮病并发系统性硬化症1例报告
Pub Date : 2023-09-30 DOI: 10.25176/rfmh.v23i3.5670
Freddy Liñán Ponce, Juan Leiva Goicochea, José Chávez Corrales
Sine entities are rare in rheumatology. In progressive systemic sclerosis there is a variant of the limited cutaneous form called systemic sclerosis sine scleroderma, whose central feature is the lack of skin involvement, but visceral involvement is present. Positive anti-topoisomerase or anti-centromere antibodies confirm the diagnosis. We present the case of a 63-year-old woman with interstitial lung disease, intestinal transit involvement and Raynaud's phenomenon, with high titers of ANA with a centromeric pattern and positivity for anti-topoisomerase antibodies. When faced with a patient with Raynaud's phenomenon, visceral involvement and elevated ANA, specific antibodies should be requested for the diagnosis of systemic sclerosis in its sine variety.
在风湿病学中,正弦实体是罕见的。进行性系统性硬化症有局限性皮肤形式的一种变体,称为硬皮病的系统性硬化症,其主要特征是不累及皮肤,但累及内脏。抗拓扑异构酶或抗着丝粒抗体阳性证实诊断。我们报告一例63岁的女性肺间质性疾病,肠运输累及雷诺现象,有高滴度的ANA与着丝点模式和抗拓扑异构酶抗体阳性。当面对雷诺现象,内脏受累和ANA升高的患者时,应要求特异性抗体诊断系统性硬化症的正弦变化。
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引用次数: 0
Vaginal estrogen therapy and the risk of recurrence in women with a history of breast cancer 阴道雌激素治疗与有乳腺癌病史的妇女的复发风险
Pub Date : 2023-09-30 DOI: 10.25176/rfmh.v23i3.5692
María A. Boada Fuentes, Raquel E. Toncel Herrera, Andrea L. Wadnipar Gutiérrez, Daniel F. Delgado Ruiz, Julio M. Rojas Salinas, Robert A. Rodríguez Niño, Liliana C. Cortés Velásquez, Yelson A. Picón Jaimes
Breast cancer remains the most common malignant neoplasm and one of the leading causes of mortality in women, making it a significant target for global health efforts and a public health priority. Through the use of innovative therapies, survival rates have improved, leading to the emergence of associated conditions such as genitourinary menopausal syndrome. Hormonal therapy is employed for managing this condition, significantly alleviating its symptoms and, in some cases, serving as the sole solution. The most commonly utilized approach is vaginal estrogen therapy. Nevertheless, there have been reports of a potential risk of breast cancer recurrence associated with its use. In the Spanish-speaking context, there is limited evidence discussing this topic. A search was conducted across PubMed, ScienceDirect, and MEDLINE databases, using the terms "Vaginal Estrogen Therapy," "Recurrence," and "Breast Cancer." It was determined that, on a global scale, vaginal estrogen therapy is an effective and safe therapeutic option for managing genitourinary menopausal syndrome in women with a history of breast cancer. This therapy does not appear to increase the risk of recurrence, with the exception of those undergoing treatment with aromatase inhibitors. For these individuals, alternative therapies are recommended to mitigate this potential risk.
乳腺癌仍然是最常见的恶性肿瘤,也是妇女死亡的主要原因之一,使其成为全球卫生努力的重要目标和公共卫生优先事项。通过使用创新疗法,生存率有所提高,导致出现相关疾病,如泌尿生殖系统更年期综合征。激素疗法用于控制这种情况,显著减轻其症状,在某些情况下,作为唯一的解决方案。最常用的方法是阴道雌激素治疗。尽管如此,仍有报道称其使用有潜在的乳腺癌复发风险。在讲西班牙语的语境中,讨论这个话题的证据有限。在PubMed, ScienceDirect和MEDLINE数据库中进行了搜索,使用术语“阴道雌激素治疗”,“复发”和“乳腺癌”。研究确定,在全球范围内,阴道雌激素治疗是一种有效和安全的治疗选择,用于治疗有乳腺癌病史的妇女的泌尿生殖系统更年期综合征。除了那些接受芳香酶抑制剂治疗的患者外,这种疗法似乎不会增加复发的风险。对于这些个体,建议采用替代疗法来减轻这种潜在风险。
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引用次数: 0
Cytogenetic findings and maternal age in patients with Down syndrome in a pediatric referral hospital from Peru 秘鲁一家儿科转诊医院唐氏综合征患者的细胞遗传学发现和母亲年龄
Pub Date : 2023-09-30 DOI: 10.25176/rfmh.v23i3.5503
Yesica Llimpe Mitma de Barrón, Maribel S. Ccoyllo Álvarez, Milana Trubnykova, Rocío M. González Moreno
Introduction: Down syndrome is a congenital disorder caused by a total or partial trisomy of chromosome 21 and is considered the most common genetic cause of congenital malformations and intellectual disability. The objective of this study was to describe the cytogenetic alterations of patients with Down syndrome and their relationship with maternal age. Methods: Cross-sectional, descriptive-analytical study. 436 patients with Down syndrome admitted to the Instituto Nacional de Salud del Niño during the 2017-2019 period were included. The variables analyzed were: cytogenetic diagnosis and maternal age. Results: It was found that 99,3% (n=433) of patients presented some type of cytogenetic alteration and three patients presented a normal karyotype. The age of the patients at the time of sampling was between 0,03 and 17 years, the male/female ratio was 1.2:1. The most frequent cytogenetic alteration was free trisomy 21 (94,7%), followed by Robertsonian translocation (n=16) and mosaicism (n=6). In the case of maternal age, a median of 37 years was found (range: 13-47). Conclusions: Free trisomy 21 is the most common cytogenetic condition in Down syndrome; however, the Robertsonian translocation and mosaicisms were more frequent in patients whose mothers were les than 35 years old, suggesting that there are other risk factors than advanced maternal age in this group.
简介:唐氏综合症是由21号染色体的全部或部分三体引起的先天性疾病,被认为是先天性畸形和智力残疾最常见的遗传原因。本研究的目的是描述唐氏综合征患者的细胞遗传学改变及其与母亲年龄的关系。方法:横断面、描述性分析研究。2017-2019年期间,436名唐氏综合征患者在国立卫生研究院Niño就诊。分析的变量为:细胞遗传学诊断和母亲年龄。结果:99.3% (n=433)的患者出现不同类型的细胞遗传学改变,3例患者核型正常。抽样时患者年龄在0.03 ~ 17岁之间,男女比例为1.2:1。最常见的细胞遗传学改变是自由21三体(94,7%),其次是罗伯逊易位(n=16)和镶嵌(n=6)。在产妇年龄的情况下,中位数为37岁(范围:13-47岁)。结论:游离21三体是唐氏综合征最常见的细胞遗传学疾病;然而,罗伯逊易位和嵌合现象在母亲年龄小于35岁的患者中更为常见,这表明在这一群体中,除了高龄母亲之外,还有其他风险因素。
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引用次数: 0
Can vitamin D be the ray of sunshine that lights up the treatment of gastric cancer? 维生素D能成为照亮胃癌治疗的一缕阳光吗?
Pub Date : 2023-09-30 DOI: 10.25176/rfmh.v23i3.5904
Alfredo W. Campos Perez, Sacha Barrios Healey, José M. Vela Ruiz
Gastric cancer, a malignant neoplasm that originates in the cells of the stomach lining, represents a significant burden in terms of mortality worldwide. According to data from the American Cancer Society, the estimated mortality rate is 4.9 per 100,000 people in 2021. In South America, mortality rates from gastric cancer continue to be of concern, with countries such as Chile and Peru reporting mortality rates of 18.7 and 13.6 per 100,000 persons respectively in 2021.
胃癌是一种起源于胃内膜细胞的恶性肿瘤,是世界范围内死亡率的重要负担。根据美国癌症协会的数据,2021年的估计死亡率为每10万人4.9人。在南美洲,胃癌死亡率继续令人担忧,智利和秘鲁等国报告2021年的死亡率分别为每10万人18.7人和13.6人。
{"title":"Can vitamin D be the ray of sunshine that lights up the treatment of gastric cancer?","authors":"Alfredo W. Campos Perez, Sacha Barrios Healey, José M. Vela Ruiz","doi":"10.25176/rfmh.v23i3.5904","DOIUrl":"https://doi.org/10.25176/rfmh.v23i3.5904","url":null,"abstract":"Gastric cancer, a malignant neoplasm that originates in the cells of the stomach lining, represents a significant burden in terms of mortality worldwide. According to data from the American Cancer Society, the estimated mortality rate is 4.9 per 100,000 people in 2021. In South America, mortality rates from gastric cancer continue to be of concern, with countries such as Chile and Peru reporting mortality rates of 18.7 and 13.6 per 100,000 persons respectively in 2021.","PeriodicalId":33139,"journal":{"name":"Revista de la Facultad de Medicina Humana","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136271806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Spontaneous pneumothorax and bullous emphysema in a young patient? About a case 年轻患者自发性气胸和大疱性肺气肿?关于一个案例
Pub Date : 2023-09-30 DOI: 10.25176/rfmh.v23i3.5878
María M. Rodríguez Gutiérrez, Hernán Cardona Gaviria, Luisa M. Hincapie Cano, María C. Oyuela Gutiérrez, Tatiana X. Quevedo Cristancho, Daniela Valencia Riascos, Juliana Gómez Raigosa, María C. Díaz Rivera
Introduction Pneumothorax is a pathology prevalent in traumatic accidents in the thorax, but it can also be found spontaneously due to causes attributable to bullous disease, pneumonia, airway obstruction, malignancy, among others. Case report Young male patient who debuted with spontaneous pneumothorax who required management in the intensive care unit with subsequent appearance of bullae in diagnostic images and pathology. Discussion Primary spontaneous pneumothorax (PSP) in the young population is influenced by psychosocial factors such as age, gender, habits, environment, and genetic factors. In 80% of patients with PSP, the presence of bullae or apical blebs has been demonstrated, in addition from the porosity of the pleura that usually occurs in tall adolescents with athletic bodies; but it is also observed that tobacco use can increase the risk. Conclusions Spontaneous pneumothorax due to bullous emphysema has increased in young people due to the use of psychoactive substances, vapers, and cigarettes.
气胸是一种常见于胸部外伤事故的病理,但也可由大疱性疾病、肺炎、气道阻塞、恶性肿瘤等原因自发发生。病例报告年轻男性患者首次出现自发性气胸,需要在重症监护病房进行治疗,随后在诊断图像和病理中出现大疱。年轻人原发性自发性气胸(PSP)受年龄、性别、习惯、环境和遗传因素等社会心理因素的影响。在80%的PSP患者中,除了通常发生在体格健壮的高个青少年的胸膜孔隙外,还存在大泡或根尖泡;但也观察到,吸烟会增加风险。结论青少年因使用精神活性物质、电子烟和香烟所致的大疱性肺气肿自发性气胸增加。
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引用次数: 0
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Revista de la Facultad de Medicina Humana
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