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Introducción: El virus chikungunya (CHIKV), es un alfavirus con genoma de ARN monocatenario, perteneciente a la familia Togaviridae, transmitido a través de la picadura de mosquitos del género Aedes sp., caracterizada por fiebre y dolores articulares incapacitantes. Objetivo: Determinar las características clínicas y epidemiológicas del virus chikungunya en pacientes pediátricos que acudieron a un Hospital Regional de Paraguay entre enero y junio del 2023. Material y Métodos: Estudio cuantitativo, observacional, descriptivo de corte transversal. Se incluyeron en el estudio todos los pacientes que presenten variables de interés; sexo, edad, procedencia, hallazgos clínicos y síntomas atípicos. Resultados: Se ha realizado la revisión de 465 fichas clínicas de pacientes con cuadro confirmado de chikungunya. La edad mínima de los pacientes fue de 4 días y la máxima de 17 años, la mitad de los pacientes estuvieron ubicados entre 1 y 10 años de edad. El 62,6% tuvo una presentación típica del cuadro de infección por chikungunya, el 37,4% tuvo una forma de presentación atípica. El 4,3% presentó complicaciones entre las que se citan encefalitis-meningoencefalitis y miocarditis. El 10,8% tuvo desenlace fatal, obitó. Conclusión: En cuanto a los datos demográficos, hubo predominio del sexo masculino y procedencia urbana. En cuanto a la presentación clínica, se reportaron formas típicas con fiebre, polialtralgias y mialgias. Las formas atípicas se presentaron con alteración del sistema cardiovascular, discrasia sanguínea y neumonías asociadas. Los casos que se consideraron complicados representan el 4,3% de la muestra y fue del 10,8% la mortalidad.

Introduction: Chikungunya virus (CHIKV) is an alphavirus with a single-stranded RNA genome belonging to the Togaviridae family. It is transmitted through the bite of mosquitoes of the Aedes sp. genus and is characterized by fever and disabling joint pain. Objetive: Determine the clinical and epidemiological characteristics of the chikungunya virus in pediatric patients who attended a Regional Hospital in Paraguay between January and June 2023. Materials and method: Quantitative, observational, descriptive cross-sectional study. All patients with variables of interest were included in the study; sex, age, origin, clinical findings and atypical symptoms. Results: A total of 465 clinical records of patients with confirmed chikungunya were reviewed. The minimum age of the patients was four days, and the maximum was 17 years; half of the patients were between 1 and 10 years of age. Male predominance in 52.7%, patients from urban areas in 72.5%. 62.6% had a typical presentation of chikungunya infection, and 37.4% had an atypical presentation. Fever, polyarthralgia, myalgia, headache, vomiting, and nausea predominated in the usual manner. In the atypical form, alterations of the cardiovascular system, bleeding dyscrasias, and pneumonia, among others, predominate. 4.3% presented complications, including encephalitis-meningoencephalitis and myocarditis. There was a death rate of 10.8%. Conclusion: Male sex predominated, coming from urban areas with typical presentation of chikungunya, with predominant symptoms of fever, polyarthralgia, and myalgia. Atypical form alteration of the cardiovascular system, bleeding dyscrasias, pneumonia. 4.3% presented complications, 10.8% died.

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Infectious disease (ID) cohorts are key to advancing public health surveillance, public policies, and pandemic responses. Unfortunately, ID cohorts often lack funding to store and share clinical-epidemiological (CE) data and high-dimensional laboratory (HDL) data long term, which is evident when the link between these data elements is not kept up to date. This becomes particularly apparent when smaller cohorts fail to successfully address the initial scientific objectives due to limited case numbers, which also limits the potential to pool these studies to monitor long-term cross-disease interactions within and across populations. CE data from 9 arbovirus (arthropod-borne viruses) cohorts in Latin America were retrospectively harmonized using the Maelstrom Research methodology and standardized to Clinical Data Interchange Standards Consortium (CDISC). We created a harmonized and standardized meta-cohort that contains CE and HDL data from 9 arbovirus studies from Latin America. To facilitate advancements in cross-population inference and reuse of cohort data, the Reconciliation of Cohort Data for Infectious Diseases (ReCoDID) Consortium harmonized and standardized CE and HDL from 9 arbovirus cohorts into 1 meta-cohort. Interested parties will be able to access data dictionaries that include information on variables across the data sets via Bio Studies. After consultation with each cohort, linked harmonized and curated human cohort data (CE and HDL) will be made accessible through the European Genome-phenome Archive platform to data users after their requests are evaluated by the ReCoDID Data Access Committee. This meta-cohort can facilitate various joint research projects (eg, on immunological interactions between sequential flavivirus infections and for the evaluation of potential biomarkers for severe arboviral disease).

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Introducción: La diabetes mellitus constituye una enfermedad de elevada morbilidad y mortalidad. Objetivo: Caracterizar clínica y epidemiológicamente la diabetes mellitus tipo 2 y el uso de la microalbuminuria en el daño renal precoz. Materiales y métodos: Se realizó un estudio transversal mediante una muestra no probabilística de 94 pacientes, en un universo de 187 enfermos con diabetes mellitus 2, en el Servicio de Medicina Interna del Hospital Clínico Quirúrgico Docente Amalia Simoni, de Camagüey. El mismo tuvo lugar entre enero de 2020 y enero de 2021. Se analizaron variables como edad, sexo, hábitos tóxicos, estado nutricional, tiempo de evolución de la diabetes, comorbilidades, valor de la microalbuminuria y su relación con el tiempo de evolución de la enfermedad. Para el procesamiento de los datos se empleó el programa estadístico SPSS 19.0. Resultados: Prevalecieron el grupo de 60 años y más, el sexo femenino, el tabaquismo como hábito tóxico, y el sobrepeso. Según el tiempo de evolución de la enfermedad, prevaleció el rango de 6 a 10 años. Las comorbilidades principales fueron la hipertensión arterial y la cardiopatía isquémica. La relación entre el tiempo de evolución de la enfermedad y la aparición de microalbuminuria patológica, demostró la utilidad de esta en la detección del daño renal precoz en pacientes con 6 a 10 años de evolución. Conclusiones: Se demostró el papel de la microalbuminuria en la detección del daño renal precoz en pacientes con diabetes mellitus tipo 2.

Introduction: Diabetes mellitus is a disease with high morbidity and mortality. Objective: To characterize clinically and epidemiologically type 2 diabetes mellitus and the use of microalbuminuria in early kidney damage. Materials and methods: A cross-sectional study was carried out using a non-probabilistic sample of 94 patients from a universe of 187 patients with type2 diabetes mellitus treated in the Internal Medicine Service of the Teaching Clinical-Surgery Hospital "Amalia Simoni", of Camagüey. It was conducted between January 2020 and January 2021. Variables such as age, sex, toxic habits, nutritional status, time of evolution of diabetes, comorbidities; value of albuminuria and its relationship with the time of evolution of the disease were analyzed. The SPSS 19.0 statistical program was used for data processing. Results: The age group of 60 years old and over, female sex, smoking as a toxic habit, and overweight prevailed. According to the time of evolution of the disease, the range of 6 to 10 years prevailed. The main comorbidities were arterial hypertension and ischemic heart disease. The relationship between the time of evolution of the disease and the appearance of pathological microalbuminuria demonstrated its usefulness in the detection of early kidney damage in patients with 6 to 10 years of evolution. Conclusions: The role of microalbuminuria in the detection of early kidney damage in patients with type 2 diabetes mellitus was demonstrated.

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Mother-to-children transmission (MTCT) is the main infection route for HIV-1 in children, and may occur during pregnancy, delivery, and/or postpartum. It is a multifactorial phenomenon, where genetic variants play an important role. This study aims at analyzing the influence of clinical epidemiological characteristics and a variant (rs12252) in interferon-induced transmembrane protein 3 (IFITM-3), a gene encoding an important viral restriction factor, on the susceptibility to HIV-1 mother-to-children transmission (MTCT). A case-control study was performed on 209 HIV-1-infected mothers and their exposed infected (87) and uninfected (122) children from Pernambuco, Brazil. Clinical-epidemiological characteristics are significantly associated with MTCT susceptibility. Transmitter mothers have a significantly lower age at delivery, late diagnosis, deficiency in ART use (pregnancy and delivery), and detectable viral load in the third trimester of pregnancy compared with non-transmitter mothers. Infected children show late diagnosis, vaginal delivery frequency, and tend to breastfeed, differing significantly from uninfected children. The IFITM-3 rs12252-C allele and TC/CC genotypes (dominant model) are significantly more frequent among infected than uninfected children, but the statistical significance does not remain when adjusted for clinical factors. No significant differences are observed between transmitter and non-transmitter mothers in relation to the IFITM-3 variant.

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Introdução: O câncer é um conjunto de mais de 100 tipos de diferentes doenças que têm em comum o crescimento desordenado de células anormais com potencial invasivo. Além disso, sua origem se dá por condições multifatoriais. Esses fatores causais podem agir em conjunto ou em sequência para iniciar ou promover a formação do câncer. O objetivo desta pesquisa foi analisar o perfil clínico-epidemiológico de pacientes atendidos na Unidade de Oncologia (UNIONCO) do Hospital Nossa Senhora da Conceição, Tubarão (SC), no período de Dezembro de 2014 a Julho de 2015. Métodos: Foi realizado um estudo epidemiológico, observacional e descritivo através de revisão de 158 prontuários, de pacientes em tratamento na UNIONCO. Resultados: Dos 158 pacientes em tratamento para neoplasia: 58,23% são do sexo masculino e 41,77% são do sexo feminino. A faixa etária variou de 19 a 88 anos, com maior frequência entre 60 - 69 anos: 37 (23,42%). Em relação aos fatores clínicos-epidemiológicos observou-se: município de residência, idade, gênero, cor, diagnóstico clínico, diagnóstico etiológico, motivo do encaminhamento, presença de história familiar para neoplasia, exames complementares. Conclusões: A ocorrência do câncer segue o perfil: homem, branco, com idade entre 60 - 69 anos, diagnosticado com câncer de próstata. Os resultados encontrados evidenciam a necessidade de investimentos na detecção precoce e adoção de medidas educativas no sentido de promover ações que conscientizam a população quanto à importância do autocuidado com a saúde.

Introduction: Cancer is a set of more than 100 types of different diseases that share the disordered growth of abnormal cells with invasive potential. In addition, its origin is due to multifactorial conditions. These causal factors can act together or in sequence to initiate or promote cancer formation. The objective of this research was to analyze the clinical-epidemiological profile of patients treated at the Oncology Unit (UNIONCO) of Hospital Nossa Senhora da Conceição, Tubarão (SC), from December 2014 to July 2015. Methods: An epidemiological, observational and descriptive study was carried out through a review of 158 medical records of patients undergoing treatment at UNIONCO. Results: Of the 158 patients undergoing treatment for neoplasia: 58.23% were male and 41.77% were female. The age group ranged from 19 to 88 years, with a higher frequency between 60 and 69 years: 37 (23.42%). Regarding clinical-epidemiological factors, the following were observed: municipality of residence, age, gender, color, clinical diagnosis, etiological diagnosis, reason for referral, presence of family history of neoplasia, complementary exams. Conclusions: The occurrence of cancer follows the profile: male, white, aged 60-69 years, diagnosed with prostate cancer. The findings show the need for investments in early detection and adoption of educational measures in order to promote actions that raise the population's awareness of the importance of self-care in health.

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COVID-19 affects the paediatric population less frequently than adults. A retrospective study was performed in a tertiary paediatric hospital in Mexico City in children <18 years of age who were hospitalized with a positive reverse transcription-polymerase chain reaction for SARS-CoV-2. Included in the study were 86 patients with a median age of 10 years old (IQR 2.6-14.3 years), who were classified in three groups: previously healthy, with chronic disease and immunosuppressed patients. The principal signs and symptoms were fever (81%), cough (51%) and headache (35%). A total of 20 patients (23%) required management in the paediatric intensive care unit (PICU) and 17% needed mechanical ventilation for an average of 12.7 days (IQR 2-29 days). There was no statistically significant difference between the three clinical classification groups in those patients admitted to the PICU, most of which were previously healthy patients. The mortality rate was 5% (four patients). Given that the paediatric population is susceptible to infection, potential transmitters and to clinical presentations with variable degrees of severity, it is important to continue reinforcing social distancing measures.

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Introducción: La enfermedad producida por el Coronavirus 2019 ha impactado al mundo más allá de los límites de la salud pública a tres meses del diagnóstico del primer caso en China. En la actualidad afecta a 182 países, por lo que fue declarada pandemia por la Organización Mundial de la Salud. Objetivo: Revisar los aspectos clínico-epidemiológicos más importantes reportados sobre esta enfermedad. Desarrollo: La enfermedad se trasmite por las microgotas de saliva entre personas y por contacto con superficies contaminadas o heces. El periodo de incubación es hasta 14 días, en los cuales puede ocurrir trasmisión viral. Se caracteriza por un espectro sintomático variable, los pacientes pueden permanecer asintomáticos o presentar síntomas como fiebre, dolor de garganta, tos, anosmia y disnea. Aproximadamente 14 por ciento de los casos presenta formas graves y 5 por ciento evoluciona a estado crítico, asociado a complicaciones como el síndrome de distress respiratorio o shock séptico. El diagnóstico confirmatorio es a través de los estudios de reacción en cadena de polimerasa en tiempo real, en muestras respiratorias. No existe un tratamiento efectivo, aunque se emplean medicamentos, la mayoría de ellos como parte de ensayos clínicos. Conclusiones: Es un fenómeno sin precedentes en el último siglo en relación al número de personas y países que ha afectado y al impacto en las dinámicas sociales y económicas del mundo actual(AU)

Introduction: The disease caused by Coronavirus 2019 has impacted the world beyond the limits of public health three months after the first case was diagnosed in China. It currently affects 182 countries; hence it is was declared a pandemic by the World Health Organization. Objective: To review the most important clinical-epidemiological aspects reported on this disease. Findings: The disease is transmitted by droplets of saliva between people and by contact with contaminated surfaces or faeces. The incubation period is up to 14 days, in which viral transmission can occur. It is characterized by a variable symptom spectrum, patients can remain asymptomatic or present symptoms such as fever, sore throat, cough, anosmia and dyspnea. Approximately 14 percent of cases present severe forms and 5 percent progresses to a critical state, associated with complications such as respiratory distress syndrome or septic shock. The confirmatory diagnosis is through real-time polymerase chain reaction studies in respiratory samples. There is no effective treatment, although medications are used, most of them as part of clinical trials. Conclusions: It is, in the last century, an unprecedented phenomenon regarding the number of people and countries it has affected and concerning the impact on the social and economic dynamics currently in the world(AU)

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Objetivo. Describir las características clínico-epidemiológicas en pacientes con diagnóstico confirmado COVID-19 de la Red de Salud Virú marzo a mayo 2020. Material y Métodos: Estudio de enfoque cuantitativo y diseño observacional descriptiva con datos secundarios. La población conformada por pacientes diagnosticados positivos a COVID-19 con pruebas moleculares y serológicas. Se aplicó la técnica de la documentación. El instrumento establecido, basado en la ficha de investigación clínico epidemiológica COVID-19 usada durante la consulta clínica. Se identificó variables sociodemográficas, antecedentes y manifestaciones clínicas. Se procesó la data mediante tablas dinámicas en Excel y software SPSS 26.0. Resultados: Se halló un 67,7% de casos COVID-19 en la Red de Salud Virú en las etapas de vida adulto y adulto mayor. Predominio de pacientes de sexo masculino (57,4 %) frente al sexo femenino (42,6 %). El distrito de Virú presentó 52,9 % de los casos confirmados de pacientes con COVID-19. Los síntomas fueron: Tos (48,7%), malestar general (48,2%), dolor de garganta (39,1%) y fiebre/escalofrío (37,5 %), congestión nasal (22,0 %), cefalea (21,3%) dificultad respiratoria (17,1 %), dolor muscular (12,2 %) y dolor de pecho (8,4%). Otros síntomas en menor proporción, náuseas/vómitos (5,6%), diarrea (5,2 %), dolor abdominal y de articulaciones (1,9%). Las comorbilidades predominantes son: diabetes (3,7%), enfermedad cardiovascular (3,5%), embarazo(1,9%) enfermedad pulmonar crónica (0,5%), enfermedad hepática y cáncer con (0,2%) respectivamente. Conclusiones: Dentro de las características clínico-epidemiológicas tenemos que el sexo más frecuente fue varones, siendo la tos el síntoma principal y la diabetes mellitus la comorbilidad más frecuente.

Objetive. To describe the clinical-epidemiological characteristics in patients with a confirmed diagnosis of COVID-19 from the Viru Health Network from March to May2020. Material and Methods: Study with a quantitative approach and descriptive observational design with secondary data. The population made up of patients diagnosed positive for COVID-19 with molecular and serological tests. The documentation technique was applied. The established instrument, based on the COVID-19 clinical epidemiological investigation card used during the clinical consultation. Sociodemographic variables, antecedents and clinical manifestations were identified. The data was processed using dynamic tables in Excel and SPSS 26.0 software. Results: 67.7% of COVID-19 cases were found in the Virú Health Network in the adult and elderly life stages. Prevalence of male patients (57.4%) compared to female (42.6%). The Virú district presented 52.9% of the confirmed cases of patients with COVID-19. The symptoms were: cough (48.7%), general malaise (48.2%), sore throat (39.1%) and fever / chills (37.5%), nasal congestion (22.0%), headache (21.3%) respiratory distress (17.1%) ), muscle pain (12.2%) and chest pain (8.4%). Other symptoms to a lesser extent, nausea / vomiting (5.6%), diarrhea (5.2%), abdominal and joint pain(1.9%).The predominant comorbidities are: diabetes(3.7%),cardiovascular disease (3.5%), pregnancy (1.9%), chronic lung disease (0.5%), liver disease and cancer (0.2%) respectively. Conclusions: Within the clinical-epidemiological characteristics, we have that the most frequent sex was male, being cough the main symptom and diabetes mellitus the most frequent comorbidity.

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Objetivo: Este estudio descriptivo se orientó a conocer el perfil clínico-epidemiológico de la Enfermedad de Parkinson (EP) y la coexistencia entre síntomas no motores (SNM) y diagnósticos fonoaudiológicos (DF). Método: La muestra estuvo conformada por 34 personas con Parkinson idiopático (26 hombres y 8 mujeres), cuyas historias clínicas fueron analizadas para describir la coexistencia de DF, como la hipofonía, la disprosodia, la disartria y la disfagia, con síntomas no motores, tales como: trastornos gastrointestinales, depresión, trastornos del sueño y deterioro cognitivo. Resultados: Los resultados señalan que las personas con Parkinson tenían edades entre los 25 a los 86 años. En cuanto a la fase, se clasificaron en: estadio I el 11,7%, II el 17,6%, III el 47%, IV el 14,7% y V el 8,8%. El 47% de los pacientes llegó al servicio de Fonoaudiología en una etapa avanzada de la EP. Los SNM más frecuentes fueron trastornos del sueño (67,6%), depresión (58,8%), alteraciones gastrointestinales (29,4%) y deterioro cognitivo (15%). Los DF se distribuyeron así: disprosodia (38%), hipofonía (33%), disartria (18%) y disfagia (11%). Discusión: se observa una alta frecuencia tanto de SNM (como la depresión y los trastornos del sueño), como de SF (especialmente disprosodia e hipofonía). Esta sintomatología provoca, por una parte, la reducción del deseo de relacionarse socialmente y por otro, dificultades para hacerse entender al presentar un volumen de voz reducido o prosodia (además de trastornos de la melodía, inflexiones, marcadores paralingüísticos) de la expresión oral del lenguaje. Conclusión: los trastornos del sueño y la depresión podrían tener un impacto negativo significativo en las funciones fonoaudiológico de las personas con Parkinson.

Objective: This descriptive study was aimed at understanding the clinical-epidemiological profile of Parkinson's disease (PD) and the coexistence between non-motor symptoms (NMS) and phonoaudiological diagnoses (PD). Methods: The sample comprised 34 people with idiopathic Parkinson's (26 men and 8 women). Their clinical histories were analysed to describe the coexistence of PD, such as hypophonia, dysprosody, dysarthria and dysphagia, with non-motor symptoms, such as gastrointestinal disorders, depression, sleep disorders and cognitive impairment. Results: The results indicate that people with Parkinson's are between the ages of 25 and 86. In terms of phase, they were classified as: stage I 11.7%, II 17.6%, III 47%, IV 14.7% and V 8.8%. 47% of patients reached the Speech Therapy service at an advanced stage of PD. The most frequent NMS were sleep disorders (67.6%), depression (58.8%), gastrointestinal disorders (29.4%) and cognitive impairment (15%). The PD were distributed as follows: dysprosody (38%), hypophonia (33%), dysarthria (18%) and dysphagia (11%). Discussion: a high frequency of both NMS (such as depression and sleep disorders) and PD (especially dysprosody and hypophonia) is observed. This symptomatology causes a reduction in the desire to relate socially, and difficulties in making oneself understood by presenting a reduced voice volume or prosody (in addition to melody of speech disorders, inflections, paralinguistic markers) of the oral language expression. Conclusion: sleep disorders and depression could have a significant negative impact on the speech and hearing functions of people with Parkinson's.

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A diabetes mellitus gestacional (DMG) consiste em qualquer intolerância à glicose com início durante a gestação. É a desordem metabólica mais comum da gravidez, atingindo entre 3 a 25% das gestações, sendo que 90% das gestantes apresentam um ou mais fatores de risco para a doença. O estudo teve por finalidade descrever o perfil clínico-epidemiológico das gestantes portadoras de diabetes mellitus gestacional com parto no ano de 2016 atendidas no serviço de alto risco no município de Itajaí (SC), bem como os fatores de risco e desfechos gestacionais associados à doença. Tratou-se de uma análise retrospectiva, descritiva, quantitativa e transversal, com a coleta de dados dos prontuários. De 328 parturientes atendidas no serviço, 54 (16,46%) preencheram os critérios de inclusão (data do parto entre 01 de janeiro a 31 de dezembro de 2016 e que possuíam prontuário na unidade). Entre essas pacientes, a maioria era de etnia branca (55,55%) com idade entre 31 e 35 anos (29,62%) e ensino médio completo (29,62%). Obesidade prévia foi descrita em 64,81%. A idade gestacional média de diagnóstico foi de 26,44 semanas. O tratamento com insulinoterapia foi instituído em 25,92%. Houve relato de doença hipertensiva da gravidez em 16,66%. A taxa de cesariana foi de 59,2%; a prevalência de recém-nascidos grandes para a idade gestacional foi de 12,96%; sendo que 5,5% de neonatos foram admitidos em unidade de terapia intensiva. Constatou-se que a maioria das gestantes teve um pré-natal adequado e sem intercorrências e que em alguns casos houve encaminhamento tardio ao serviço especializado.

Gestational Diabetes Mellitus (GDM) consists of any glucose intolerance beginning during pregnancy. It's pregnancy's most common metabolic disorder reaching 3 to 25% of pregnancies, and 90% of pregnant women present one or more risk factors for the disease. The purpose of this study was to describe the clinical-epidemiological profile of pregnant women forwarded to the reference center diagnosed with gestational diabetes mellitus and who delivered in 2016 at Itajaí city, SC, as well as the risk factors and gestational outcomes associated with the disease. It was a retrospective, descriptive, quantitative and cross-sectional analysis, with data collected from patients records. Of the 328 parturients attended in the service, 54 (16.46%) met the inclusion criteria (date of delivery between January 1 and December 31, 2016, and that they had medical records in the unit). Among these patients, the majority were white (55.55%) aged 31-35 years (29.62%) and with complete secondary education (29.62%). Previous obesity was described in 64.81%. The average gestational age at diagnosis of gestational diabetes was 26.44 weeks. The treatment with insulin therapy was instituted in 25.92%. There were reports of hypertension in pregnancy in 16.66%. The cesarean rate was 59.2%; the prevalence of large newborns for gestational age was 12.96%; and 5.5% of newborns were admitted in intensive care unit. It was found that most of the pregnant women had an adequate prenatal and without intercurrences and that in some cases delayed referral to the specialized service.

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Resumen: Introducción: El padecimiento de labio paladar hendido es una de las alteraciones congénitas más comunes que afecta las estructuras de la cara. El objetivo de este trabajo fue generar el perfil epidemiológico y clínico de la población con LPH atendida en el Hospital de Especialidades del Niño y la Mujer Dr. Felipe Núñez Lara de la Secretaría de Salud del estado de Querétaro, México, en el periodo de 2011-2014, a través de la Clínica de Labio Paladar Hendido, para brindar tratamientos interdisciplinarios a los pacientes con esta afección con base en la información de los expedientes registrados en el periodo mencionado. Métodos: Estudio observacional, transversal, retrospectivo usando análisis univariado con frecuencias para variables cualitativas, y estadísticas centrales y de dispersión para variables cuantitativas y perfil clínico. Se revisaron 100 expedientes; se descartaron 15 por tratarse de casos sindrómicos. Las variables estudiadas fueron sociodemográficas, epidemiológicas y clínicas. Resultados: Se presentan los perfiles epidemiológicos (variables relativas al embarazo de la madre y salud del paciente al momento de su nacimiento, desarrollo nutricional y psicomotor; antecedentes heredo-familiares y presencia de adicciones; datos socioeconómicos familiares) y clínicos (clasificación del padecimiento por sexo, estructura y lado de afectación; clasificación de las cirugías y orden en que se efectuó el procedimiento) de la población considerada. Conclusiones: Los resultados del estudio mostraron la necesidad de estandarizar el registro de datos en expedientes para mejorar el seguimiento y tratamiento de los pacientes y enfatizar en acciones preventivas que permitan mantener la baja incidencia del labio paladar hendido en Querétaro.

Abstract: Background: One of the most common congenital disorders that affects the facial structures is the cleft lip palate (CLP). The aim of this study was to generate the clinical-epidemiological profile of CLP patients from Hospital de Especialidades del Niño y la Mujer (HENM) Dr. Felipe Nuñez Lara, from the Ministry of Health, Queretaro, Mexico, from 2011 to 2014, who received treatment from the Cleft Lip Palate Clinic in order to provide interdisciplinary treatments for CLP patients based on the information from the pediatric records. Methods: Retrospective, cross-sectional, observational study using univariate analysis frequencies for qualitative variables; central statistical and dispersion for quantitative variables and clinical profile. One hundred records were reviewed, from which 15 were discarded for being syndromic cases. Epidemiological, clinical, and socio-demographic variables were studied. Results: The epidemiological profile (variables associated with mother's pregnancy, patient's health at birth, nutritional and psychomotor development; family medical records, addictions, and socioeconomic factors) and clinical profile (disease classification by sex, structure, and side; surgeries classification and order in which they took place) of the treated population were registered. Conclusions: The results showed the need to standardize the data registration on medical records to improve the monitoring and treatment of patients and emphasize actions to maintain low incidence of CLP in Queretaro.

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BACKGROUND: One of the most common congenital disorders that affects the facial structures is the cleft lip palate (CLP). The aim of this study was to generate the clinical-epidemiological profile of CLP patients from Hospital de Especialidades del Niño y la Mujer (HENM) Dr. Felipe Nuñez Lara, from the Ministry of Health, Queretaro, Mexico, from 2011 to 2014, who received treatment from the Cleft Lip Palate Clinic in order to provide interdisciplinary treatments for CLP patients based on the information from the pediatric records. METHODS: Retrospective, cross-sectional, observational study using univariate analysis frequencies for qualitative variables; central statistical and dispersion for quantitative variables and clinical profile. One hundred records were reviewed, from which 15 were discarded for being syndromic cases. Epidemiological, clinical, and socio-demographic variables were studied. RESULTS: The epidemiological profile (variables associated with mother's pregnancy, patient's health at birth, nutritional and psychomotor development; family medical records, addictions, and socioeconomic factors) and clinical profile (disease classification by sex, structure, and side; surgeries classification and order in which they took place) of the treated population were registered. CONCLUSIONS: The results showed the need to standardize the data registration on medical records to improve the monitoring and treatment of patients and emphasize actions to maintain low incidence of CLP in Queretaro.

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INTRODUCTION: Tetanus, an acute infectious disease, is highly prevalent worldwide, especially in developing countries. Due to respiratory failure and hemodynamic instability associated with dysautonomia, severe cases require intensive care, but little has been published regarding the management in the Intensive Care Unit. OBJECTIVE: To draw a 10-year clinical-epidemiological profile of Intensive Care Unit patients with severe tetanus, observe their evolution in the Intensive Care Unit and identify risk factors for mortality. METHODS: In this retrospective study, we used a standardized questionnaire to collect information from the records of patients with severe tetanus admitted to the intensive care unit of a referral hospital for infectious and contagious diseases in Northeastern Brazil. RESULTS: The initial sample included 144 patients, of whom 29 were excluded due to incomplete information, leaving a cohort of 115 subjects. The average age was 49.6±15.3 years, most patients had no (or incomplete) vaccination against tetanus, and most were male. The main intensive care-related complications were pneumonia (84.8%) and dysautonomia (69.7%). Mortality (44.5%) was higher than expected from the mean APACHE II score (11.8), with shock/multiple organ failure as the main cause of death (72.9%). The independent factors most predictive of mortality were APACHE II score, dysautonomia, continuous neuromuscular blockade and age. CONCLUSION: A high mortality rate was observed in our cohort of Intensive Care Unit patients with severe tetanus and a number of risk factors for mortality were identified. Our results provide important insights for the development of intervention protocols capable of reducing complications and mortality in this patient population.

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Introducción: las pruebas diagnósticas son herramientas de ayuda para la decisión clínica, de manera que su uso se considera inapropiado cuando aportan información escasa o nula para tal decisión. La medicina de laboratorio basada en la evidencia combina la epidemiología clínica, la estadística y las ciencias sociales con la bioquímica clásica y la molecular, con vistas a mejorar la efectividad y la eficiencia de las pruebas de laboratorio. Objetivo: demostrar el uso irracional de las pruebas de laboratorio por parte de los médicos de asistencia. Métodos: se realizó un estudio longitudinal y descriptivo de 174 236 determinaciones de laboratorio, de 40 424 pacientes, atendidos en el Hospital Pediátrico Provincial Universitario "Eduardo Agramante Piña" de Camagüey, desde julio hasta diciembre de 2013. Resultados: en la serie predominaron los exámenes realizados por consulta externa, entre ellos los hematológicos; asimismo, un porcentaje elevado de indicaciones no guardó relación con la clínica. Conclusiones: la utilización adecuada del método clinicoepidemiológico, evita el uso inapropiado de los exámenes complementarios, de ahí la necesidad de una mayor interrelación entre los médicos de asistencia y el personal del laboratorio.

Introduction: the diagnosis tests are tools to help for the clinical decision, so that their use is considered inappropriate when they result in scarce or null information for such a decision. The laboratory medicine based on evidence combines the clinical epidemiology, statistic and the social sciences with the classic and the molecular biochemistry, with the aim of improving the effectiveness and the efficiency of the laboratory exams. Objective: to demonstrate the irrational use of the laboratory exams by the assistance doctors. Methods: was carried out A longitudinal and descriptive study of 174 236 laboratory determinations, of 40 424 patients, assisted in "Eduardo Agramante Piña" University Provincial Pediatric Hospital in Camagüey, from July to December, 2013. Results: in the series the exams carried out by the out-patients department prevailed, among them the hematological exams; also, a high percentage of indications tests keep relationship with the clinic. Conclusions: the appropriate use of the clinical and epidemiological method, avoids the inappropriate use of complementary exams, so, a wider interrelation between the assistance doctors and the laboratory staff is recommended.

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INTRODUCCIÓN. La pesquisa activa de afecciones oftalmológicas y la detección precoz y tratamiento adecuado de estos defectos en la infancia previene afectaciones futuras de la salud visual con elevado costo en la calidad de vida. Esta investigación se realizó con el propósito de describir el comportamiento clínico-epidemiológico de la miopía en la población infantil, entre 5 y 15 años, del municipio Rafael Urdaneta del estado de Miranda (Venezuela), durante el segundo semestre del 2008. MÉTODOS. Se realizó un estudio observacional descriptivo de corte transversal. Se analizaron las variables edad, sexo, color de la piel y características clínico-epidemiológicas del defecto refractivo: grado, síntomas, signos, enfermedades oculares asociadas, antecedentes familiares de miopía y antecedentes patológicos familiares y personales de enfermedades sistémicas y oculares. El universo y la muestra estuvieron conformados por pacientes entre 5 y 15 años de edad, con diagnóstico de miopía, a los que se aplicaron criterios de inclusión (muestra de 104 pacientes). El procesamiento y análisis de los datos se realizó mediante estadígrafos descriptivos. RESULTADOS. La miopía predominó en pacientes entre 10 y 15 años (57,7 por ciento), en uno y otro sexo, aunque en el femenino fue ligeramente más frecuente entre el total de casos (58,7), así como entre los mestizos (54,8 por ciento). La miopía leve fue el defecto más común (61,5 por ciento) y la disminuci¾n visual para lejos y de la hendidura palpebral, el síntoma y signo más representados (100 por ciento y 91,3 por ciento del total de pacientes, respectivamente). El 47,1 por ciento de los miopes tenía el antecedente familiar de miopía, y el asma bronquial fue el antecedente sistémico más importante. CONCLUSIONES. La miopía leve fue el defecto más común hallado en la población estudiada, frecuencia que se incrementó con la edad y en presencia de los factores de riesgo(AU)

INTRODUCTION. The active screening of the ophthalmologic affections, the early detection and the appropriate treatment of these defects during childhood prevent future affection of visual health with a high cost in quality of life. The objective of present research was to describe the clinical-epidemiological behavior of myopia in children aged 5-15 from the Rafael Urdaneta municipality of Miranda state, Venezuela during the second trimester of 2008. METHODS. A cross-sectional, descriptive and observational study was conducted. The variables analyzed included age, sex, skin color and clinical-epidemiological features of refractive defect: degree, signs, symptoms, associated ocular diseases, family background of myopia and family and personal pathological backgrounds of systemic and ocular diseases. The universe and sample included patients aged between 5 -15 diagnosed with myopia applying inclusion criteria (sample of 104 patients). The data analysis and processing was by descriptive statistical techniques. RESULTS. There was predominance of myopia among 10 and 15 years old (57,7 percent in both sexes, although in the female one it was slightly more frequent among the cases (58,7 percent), as well as among the half-castes (54,8 percent). The mild myopia was the commonest defect (61,5 percent) and the visual decrease from a distance and the palpebral cleavage were the more represented sign and symptom (100 percent and 91.3 percent of patients, respectively). The 47,1 percent of myopic persons had the background of family myopia and the bronchial asthma was the more significant systemic background. CONCLUSIONS. The mild myopia was the commonest defect found in study population whose frequency increasing with age and in presence of risk factors(AU)

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INTRODUCCIÓN. La pesquisa activa de afecciones oftalmológicas y la detección precoz y tratamiento adecuado de estos defectos en la infancia previene afectaciones futuras de la salud visual con elevado costo en la calidad de vida. Esta investigación se realizó con el propósito de describir el comportamiento clínico-epidemiológico de la miopía en la población infantil, entre 5 y 15 años, del municipio Rafael Urdaneta del estado de Miranda (Venezuela), durante el segundo semestre del 2008. MÉTODOS. Se realizó un estudio observacional descriptivo de corte transversal. Se analizaron las variables edad, sexo, color de la piel y características clínico-epidemiológicas del defecto refractivo: grado, síntomas, signos, enfermedades oculares asociadas, antecedentes familiares de miopía y antecedentes patológicos familiares y personales de enfermedades sistémicas y oculares. El universo y la muestra estuvieron conformados por pacientes entre 5 y 15 años de edad, con diagnóstico de miopía, a los que se aplicaron criterios de inclusión (muestra de 104 pacientes). El procesamiento y análisis de los datos se realizó mediante estadígrafos descriptivos. RESULTADOS. La miopía predominó en pacientes entre 10 y 15 años (57,7 por ciento), en uno y otro sexo, aunque en el femenino fue ligeramente más frecuente entre el total de casos (58,7), así como entre los mestizos (54,8 por ciento). La miopía leve fue el defecto más común (61,5 por ciento) y la disminuci¾n visual para lejos y de la hendidura palpebral, el síntoma y signo más representados (100 por ciento y 91,3 por ciento del total de pacientes, respectivamente). El 47,1 por ciento de los miopes tenía el antecedente familiar de miopía, y el asma bronquial fue el antecedente sistémico más importante. CONCLUSIONES. La miopía leve fue el defecto más común hallado en la población estudiada, frecuencia que se incrementó con la edad y en presencia de los factores de riesgo

INTRODUCTION. The active screening of the ophthalmologic affections, the early detection and the appropriate treatment of these defects during childhood prevent future affection of visual health with a high cost in quality of life. The objective of present research was to describe the clinical-epidemiological behavior of myopia in children aged 5-15 from the Rafael Urdaneta municipality of Miranda state, Venezuela during the second trimester of 2008. METHODS. A cross-sectional, descriptive and observational study was conducted. The variables analyzed included age, sex, skin color and clinical-epidemiological features of refractive defect: degree, signs, symptoms, associated ocular diseases, family background of myopia and family and personal pathological backgrounds of systemic and ocular diseases. The universe and sample included patients aged between 5 -15 diagnosed with myopia applying inclusion criteria (sample of 104 patients). The data analysis and processing was by descriptive statistical techniques. RESULTS. There was predominance of myopia among 10 and 15 years old (57,7 percent in both sexes, although in the female one it was slightly more frequent among the cases (58,7 percent), as well as among the half-castes (54,8 percent). The mild myopia was the commonest defect (61,5 percent) and the visual decrease from a distance and the palpebral cleavage were the more represented sign and symptom (100 percent and 91.3 percent of patients, respectively). The 47,1 percent of myopic persons had the background of family myopia and the bronchial asthma was the more significant systemic background. CONCLUSIONS. The mild myopia was the commonest defect found in study population whose frequency increasing with age and in presence of risk factors