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Peripartum cardiomyopathy (PPCM) poses a significant challenge in maternal health, characterized by heart failure with reduced ejection fraction during late pregnancy or early postpartum. Despite advances in understanding PPCM, it remains life-threatening with substantial maternal morbidity and mortality. This article reviews the epidemiology, etiology, diagnostic challenges, management strategies, and outcomes associated with PPCM. A case report of a 29-year-old woman with PPCM is presented, emphasizing the importance of early recognition and tailored management. The patient's presentation was marked by atypical symptoms, including dysuria, lumbar pain, persistent fever, and oral intake intolerance. Despite aggressive medical intervention, the patient experienced a tragic outcome, succumbing to cardiopulmonary arrest within 48 h of admission. This case underscores the challenges in diagnosing and managing PPCM, particularly when presenting with nonspecific symptoms and emphasizes the urgent need for improved diagnostic criteria and therapeutic interventions to mitigate adverse outcomes in affected individuals.
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OBJETIVO: Estimar la diversidad de garrapatas, la prevalencia de infestación y tasa de infección de Rickettsia spp. en ganado bovino en la costa del estado de Chiapas. Material y métodos. Se realizó un estudio transversal de octubre de 2021 a marzo de 2022, que incluyó la extracción de garrapatas de 297 vacas pertenecientes a 5 municipios. Se calcularon los índices de diversidad. El diagnóstico de Rickettsia spp en las garrapatas se realizó mediante PCR anida. RESULTADOS: Se encontró una baja diversidad de especies. Las especies Rhipicephalus microplus, Amblyomma cajennense y Rhipicephalus sanguineus hembra adultas fueron positivas a Rickettsia spp. Los municipios de Pijijiapan y Tonalá presentaron la TMI más alta con 7.5 y 7.2%. Conclusión. Este es primer estudio México que reporta infección de Rickettsia spp, en garrapatas colectadas de ganado bovino, lo cual indica un riesgo de salud pública.
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This article presents an approach to the phenomenon of migratory mourning of migrant mothers in Chile. Between 2021 and 2022, a qualitative exploratory study based on symbolic interactionism was carried out, in which semi-structured interviews were conducted with 39 migrant mothers of Venezuelan (18), Peruvian (11) and Haitian (9) origin. Based on a theoretically-informed thematic analysis, three analytical categories emerged: 1) the loss of social ties and distance to their place of origin; 2) expectations versus reality; and 3) the validation of overexertion. Migrant mothers express migratory mourning with varying levels of nuance depending on their country of origin, and to a greater or lesser degree signify their experiences in terms of uprooting and the absence of support networks, which they identify as the main cause of the sadness they experience on a daily basis. This sadness increases when they negotiate their ideals regarding the upbringing of their sons and daughters in favor of material subsistence in order to achieve the goals of a better life, and for which they justify overexertion as a strategy for improvement. These pressures bring with them psychological and physical consequences and interfere with their processes of migratory mourning, compromising their mental health and that of their children.
Este artículo da cuenta de una aproximación al fenómeno de duelo migratorio de las madres migrantes en Chile. Entre 2021 y 2022 se realizó un estudio cualitativo y exploratorio sustentado en el interaccionismo simbólico, en el que se realizaron entrevistas semiestructuradas a 39 madres migrantes: 18 de origen venezolano, 11 peruano y 9 haitiano. A partir del análisis de contenido temático y de la teorización, se obtuvieron tres categorías de análisis: 1) la pérdida de los vínculos y la lejanía con el origen, 2) expectativas versus realidad y 3) validando sobreesfuerzos. Las madres migrantes manifiestan el duelo migratorio con distintos matices según su país de origen e imprimen en cada una de sus experiencias, en mayor o menor grado, el desarraigo y la ausencia de redes de apoyo como principal detonante de la tristeza que viven día a día. Esta tristeza se acrecienta al negociar su ideal de criar personalmente a sus hijos e hijas en pro de la subsistencia material para alcanzar la ansiada vida mejor, para la cual validan el sobreesfuerzo como estrategia de superación. Estas presiones traen consigo consecuencias psíquicas y físicas que impiden la elaboración del duelo migratorio, comprometiendo su salud mental y la de sus hijos e hijas.
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Migrantes , Feminino , Criança , Humanos , Chile , Haiti , Mães/psicologia , Pesar , Pesquisa QualitativaRESUMO
INTRODUCTION: Rehabilitation is considered a key intervention in health care. Clinical registries, defined as an organized system that uses observational methods to collect information to assess specific outcomes in a defined population, can contribute to assessing the impact of the rehabilitation intervention. This review aims to identify and describe rehabilitation-specific registry systems with an emphasis on identifying outcomes that enable the assessment of vital areas and activities of daily living. EVIDENCE ACQUISITION: A systematic scoping review was conducted. A systematic search was conducted up to August 2022 in MEDLINE/PubMed, Embase, Cochrane Library, Epistemonikos, and other search resources. Studies related to rehabilitation registries presented data on people with health problems that could limit their functioning were selected. The inclusion of studies/clinical registries was not limited by methodological design, year of publication, country, or language. The unit of analysis was rehabilitation registries. The measurement instruments used to assess the outcomes were explored to estimate the domain assessed from the vital areas related to functioning and disability as described by the International Classification of Functioning, Disability and Health (ICF). The vital areas were classified according to activities of daily living (ADLs). EVIDENCE SYNTHESIS: Seventy-one registries in rehabilitation were identified. The registries included a median of 3 (IQR 2-5) assessment instruments designed to assess the impact of different rehabilitation programs. In total, 137 different assessment scales or instruments were identified. Each rehabilitation registry assessed 6 (IQR 2-8) domains of the ICF, and 15.4% of registries assessed all domains. The most assessed domain was "Mobility" (89.7%), and the least assessed was "General Tasks and Demands" (25.6%). In addition, 92.3% of rehabilitation registries assessed basic ADLs, 76.9% advanced ADLs, and 71.8% instrumental ADLs. CONCLUSIONS: Although clinical registries do not claim to directly assess the impact of rehabilitation programs on people's functioning according to the ICF framework, it was identified that a low percentage of them assessed the nine vital areas through different outcome assessment instruments. However, most rehabilitation registries directly or indirectly assess some basic, instrumental, and advanced ADLs. The findings of this review highlight the need to improve the design of clinical registries focused on assessing the impact of rehabilitation programs to assess people in all areas of their lives.
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Atividades Cotidianas , Pessoas com Deficiência , Humanos , Avaliação de Resultados em Cuidados de SaúdeRESUMO
Introduction. Tinea capitis is a mycosis of keratinized tissue, which affects the scalp and may cause alopecia, pruritus, and desquamation. This type of mycosis is more frequent in school-age children, and it may represent a public health problem; the main etiological agents reported for Colombia are zoophilic dermatophytes. Objective. To characterize an outbreak of Tinea capitis in 32 children from a rural school in the department of Cauca. Materials and methods. We conducted an epidemiological field study using a structured survey to characterize sociodemographic aspects and predisposing factors for this mycosis. We collected samples of affected scalp scales and hair for mycological studies. The children and the general population received recommendations, about these mycoses' prevention, from Cauca's health authorities and the local hospital. The parents verbally approved the informed consent. Results. The etiological agent isolated in 63% of the collected samples was Trichophyton tonsurans, an anthropophilic dermatophyte, and the main predisposing factor was sharing razors (87.5%). Conclusions. Ideally, mycological studies define the etiological agent to propose therapeutics and recommendations in agreement with management guidelines. Implementation of multidisciplinary measures to control the outbreak and educate the population is required.
Introducción. La tiña de la cabeza es una micosis que se presenta en el tejido queratinizado, afecta al cuero cabelludo y puede causar alopecia, prurito y descamación. Este tipo de micosis es más frecuente en niños de edad escolar, por lo que puede desencadenar un problema de salud pública. En Colombia, los principales agentes etiológicos reportados son los dermatofitos zoofílicos. Objetivo. En el presente estudio se buscó caracterizar un brote de tinea capitis en 32 niños de un colegio de la zona rural del departamento del Cauca. Materiales y métodos. Se llevó a cabo una investigación epidemiológica de campo en la que se aplicó una encuesta estructurada para caracterizar aspectos sociodemográficos y factores predisponentes para su ocurrencia. Se recolectaron muestras de escamas de cuero cabelludo y cabellos afectados para estudios micológicos. Finalmente, por medio de la Secretaría Departamental del Cauca y del hospital local, se manejó el brote de tinea capitis y se hicieron recomendaciones a los niños, los padres de familia y la población en general para prevenir estas micosis. Este estudio contó con el consentimiento informado verbal por parte de los padres de familia y los niños. Resultados. El agente etiológico aislado en el 63 % de las muestras recolectadas fue Trichophyton tonsurans y el principal factor predisponente para esta micosis fue compartir máquinas rasuradoras (87,5 %). El agente etiológico de este brote de tinea capitis no inflamatoria fue un dermatofito antropofílico.
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Tinha do Couro Cabeludo , Criança , Humanos , Colômbia/epidemiologia , Tinha do Couro Cabeludo/epidemiologia , Surtos de Doenças , Cabelo , Saúde PúblicaRESUMO
RESUMEN Este artículo da cuenta de una aproximación al fenómeno de duelo migratorio de las madres migrantes en Chile. Entre 2021 y 2022 se realizó un estudio cualitativo y exploratorio sustentado en el interaccionismo simbólico, en el que se realizaron entrevistas semiestructuradas a 39 madres migrantes: 18 de origen venezolano, 11 peruano y 9 haitiano. A partir del análisis de contenido temático y de la teorización, se obtuvieron tres categorías de análisis: 1) la pérdida de los vínculos y la lejanía con el origen, 2) expectativas versus realidad y 3) validando sobreesfuerzos. Las madres migrantes manifiestan el duelo migratorio con distintos matices según su país de origen e imprimen en cada una de sus experiencias, en mayor o menor grado, el desarraigo y la ausencia de redes de apoyo como principal detonante de la tristeza que viven día a día. Esta tristeza se acrecienta al negociar su ideal de criar personalmente a sus hijos e hijas en pro de la subsistencia material para alcanzar la ansiada vida mejor, para la cual validan el sobreesfuerzo como estrategia de superación. Estas presiones traen consigo consecuencias psíquicas y físicas que impiden la elaboración del duelo migratorio, comprometiendo su salud mental y la de sus hijos e hijas.
ABSTRACT This article presents an approach to the phenomenon of migratory mourning of migrant mothers in Chile. Between 2021 and 2022, a qualitative exploratory study based on symbolic interactionism was carried out, in which semi-structured interviews were conducted with 39 migrant mothers of Venezuelan (18), Peruvian (11) and Haitian (9) origin. Based on a theoretically-informed thematic analysis, three analytical categories emerged: 1) the loss of social ties and distance to their place of origin; 2) expectations versus reality; and 3) the validation of overexertion. Migrant mothers express migratory mourning with varying levels of nuance depending on their country of origin, and to a greater or lesser degree signify their experiences in terms of uprooting and the absence of support networks, which they identify as the main cause of the sadness they experience on a daily basis. This sadness increases when they negotiate their ideals regarding the upbringing of their sons and daughters in favor of material subsistence in order to achieve the goals of a better life, and for which they justify overexertion as a strategy for improvement. These pressures bring with them psychological and physical consequences and interfere with their processes of migratory mourning, compromising their mental health and that of their children.
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La investigación se refiere a un estudio de la rentabilidad de la acción del viraje del estilo libre en nadadoras escolares. El objetivo para la investigación se centró en evaluar las características temporales durante la acción del viraje en nadadoras de la categoría 13 y 14 años de la provincia de Sancti Spíritus. Para la recogida de la información, se utilizaron los métodos del nivel empírico: la observación científica, así como la de medición. Se utilizaron dos cámaras de videos, ubicadas en serie, y una cámara subacuática marca Sony. Para el análisis temporal, se requirió del software Kinovea, ver 0.9.3. Se aplicó el test de 15 m. para comprobar la rentabilidad del viraje. Se pudo comprobar una pobre efectividad de este elemento técnico en el estilo libre en las nadadoras evaluadas, lo que mostró, de forma generalizada, deficiencias durante la fase de impulso y se comprobó la formación de ángulos muy abiertos de las piernas que favoreció un déficit en la utilización de la potencia de las piernas durante el empuje de la pared, aspecto este que ayudó a disminuir el deslizamiento y comenzar a realizar los movimientos de salida a la superficie de forma prematura, aumentó el tiempo de forma general en la ejecución del viraje, concluyendo que para las categorías escolares es oportuno obtener ángulos entre las articulaciones de tobillos, rodillas y cadera en el rango de los 90° y 110° al momento de iniciar el impulso de la pared.
A pesquisa diz respeito a um estudo sobre a rentabilidade da ação de viragem em estilo livre em nadadores escolares. O objectivo da investigação foi centrado na avaliação das características temporárias durante a ação de viragem em nadadores de 13 e 14 anos de idade na província de Sancti Spíritus. Para a recolha de informação, foram empregues métodos empíricos: observação científica e medição. Foram instaladas duas câmaras de vídeo, colocadas em série, e uma câmara subaquática Sony. Para a análise temporal, foi utilizado o software Kinovea, ver 0.9.3. O teste de 15 m foi executado para verificar a relação custo-benefício da curva. Foi possível constatar uma baixa eficácia deste elemento técnico no estilo livre dos nadadores avaliados, que mostraram, em geral, deficiências durante a fase de impulso e a formação de ângulos de pernas muito abertos que favoreceram um défice na utilização da força das pernas durante o impulso para a parede, Este aspecto permitiu reduzir o deslizamento e começar a realizar os movimentos de saída para a superfície antecipadamente, aumentou o tempo total na execução da curva, concluindo-se que para as categorias escolares é adequado obter ângulos entre o calcanhar, o joelho e as articulações da anca na gama de 90° e 110° no momento de iniciar o impulso da parede.
The research refers to a study of the profitability of the freestyle turning action in school swimmers. The objective of the research was focused on evaluating the temporal characteristics during the action of the turn in swimmers of the 13 and 14 years old category in the province of Sancti Spíritus. For the collection of information, the empirical level methods used were: scientific observation, as well as measurement. Two video cameras, placed in series, and a Sony underwater camera were used. For the temporal analysis, the Kinovea software, ver 0.9.3, was used. The 15 m test was applied to check the profitability of the turn. It was possible to verify a poor effectiveness of this technical element in the freestyle in the swimmers evaluated, which showed, in a generalized way, deficiencies during the impulse phase and the formation of very open angles of the legs that favored a deficit in the use of the power of the legs during the wall push, This aspect helped to decrease the sliding and to begin to perform the exit movements to the surface prematurely, increased the time in general in the execution of the turn, concluding that for the school categories it is appropriate to obtain angles between the ankle, knee and hip joints in the range of 90° and 110° at the moment of initiating the wall push.
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En la formación deportiva, tener presente cómo desarrollar la fuerza en tierra y su transferencia al medio acuático es de vital importancia en la formación de los atletas que comienzan la práctica del polo acuático. La presente investigación tuvo como objetivo determinar cómo los ejercicios de transferencia de fuerza influyen en las acciones motrices del polo acuático, lo que ayudaría a una adecuada conducción del proceso de formación deportiva de las atletas investigadas. Para lograr las metas propuestas, los autores se apoyaron en métodos teóricos y empíricos, se utilizó la herramienta de la estadística descriptiva (cálculo porcentual) para procesar la información, tomando como muestra a atletas que se iniciaban en el polo acuático en el área deportiva masiva de Polo Acuático. Para ello, se realizó una encuesta a entrenadores y se analizaron sus opiniones y criterios durante la conducción de este proceso. El resultado final es que son insuficientes los conocimientos de cómo seleccionar los ejercicios para que se desarrolle una transferencia positiva al medio acuático de los ejercicios de fuerza en tierra. No dominan los métodos, procedimientos, contenidos y metodologías, a partir de las investigaciones realizadas sobre el principio y ejercicios de transferencia. Entre las conclusiones más relevantes de esta investigación, se encuentran los referentes teóricos sobre los ejercicios de transferencia de fuera en tierra al medio acuático, lo que aportará desde la teoría una argumentación sólida para su aplicación a la práctica.
No treino desportivo, é de importância primordial ter em conta como evoluir a força em terra e a sua transferência para o meio aquático ou entorno hídrico, no treino dos atletas iniciantes na prática de pólo aquático. O objectivo desta investigação era descobrir como os exercícios de transferência de força influenciam as ações motoras no pólo aquático, o que contribuiria para a correta condução do processo de treino desportivo dos atletas inquiridos. Para alcançar os objectivos propostos, os autores apoiaram-se em métodos teóricos e empíricos, recorrendo à ferramenta da estatística descritiva (cálculo de percentagens) para processar a informação, tomando como modelo os atletas que estavam a começar no pólo aquático no campo do pólo aquático de desportos coletivos. Para este efeito, foi realizado um inquérito com os treinadores e as suas opiniões e critérios foram analisados durante a realização deste processo. O resultado final é que não há conhecimentos suficientes sobre como escolher exercícios para desenvolver uma transferência positiva de força em terra, para o ambiente aquático. Não dominam os métodos, procedimentos, conteúdos e metodologias, com base na investigação efetuada sobre o princípio e exercícios de transferência. Entre as conclusões mais relevantes desta investigação figuram as referências teóricas sobre os exercícios de transferência da terra para o meio aquático, que fornecerão da teoria uma argumentação sólida para a sua aplicação à prática.
In sports training, having in mind how to develop strength on land and its transfer to the aquatic environment is of vital importance in the training of athletes who begin the practice of water polo. The present research had the objective of determining how the strength transfer exercises influence the motor actions of water polo, which would help in an adequate conduction of the sports training process of the female athletes studied. To achieve the proposed goals, the authors relied on theoretical and empirical methods, the descriptive statistics tool (percentage calculation) was used to process the information, taking as a sample athletes who were starting in water polo in the massive sports area of Water Polo. For this purpose, a survey was made to coaches and their opinions and criteria were analyzed during the conduction of this process. The final result is that there is insufficient knowledge of how to select exercises so that a positive transfer to the aquatic environment of strength exercises on land is developed. They do not master the methods, procedures, contents and methodologies, based on the research carried out on the principle and exercises of transfer. Among the most relevant conclusions of this research are the theoretical references on the transfer exercises from land to the aquatic environment, which will provide from the theory a solid argumentation for its application to practice.
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Hypertension is a risk factor for vascular dementia, which is the second most prevalent type of dementia, just behind Alzheimer's disease. This highlights the brain vulnerability due to hypertension, which may increase with aging. Thus, studying how hypertension affects neural cells and behavior, as well as the effects of antihypertensives on these alterations, it's important to understand the hypertension consequences in the brain. The spontaneously hypertensive rat (SHR) has been useful for the study of hypertension alterations in diverse organs, including the brain. Thus, we studied the losartan effects on cognitive and structural neuroplasticity impairments in SHR of 10 months of age. In the first instance, we evaluated the losartan effects on exploratory behavior and novel object recognition test (NORT) in the SHR. Then, we assessed the density and morphology of dendritic spines of pyramidal neurons from the prefrontal cortex (PFC) layers 3 and 5, and CA1 of the dorsal Hp (dHp). Our results indicate that in SHR, losartan treatment (2 months, 15 mg/Kg/day) reduces high blood pressure to age-matched vehicle-treated Wistar-Kyoto (WKY) rat levels. Moreover, losartan improved long-term memory in SHR compared with age-matched vehicle-treated WKY rats, without affecting the locomotor and anxiety behaviors. The behavioral improvement of the SHR can be associated with the increase in the number of dendritic spines and the mushroom spine population in the PFC and the dHp. In conclusion, losartan enhances cognitive impairments by controlling the high blood pressure and improving neuroplasticity in animals with chronic hypertension.
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Losartan , Plasticidade Neuronal , Animais , Pressão Sanguínea , Cognição , Losartan/farmacologia , Ratos , Ratos Endogâmicos SHR , Ratos Endogâmicos WKYRESUMO
Introducción: La lesión renal aguda asociada con el uso de medios de contrastes yodados (LRA-MCI) es un trastorno iatrogénico con potenciales implicaciones en morbilidad y mortalidad, motivo de preocupación en los servicios de imágenes. Los últimos años han marcado cambios importantes en la concepción que se tiene sobre esta entidad, desde una definición más precisa y su verdadera incidencia hasta el impacto real de algunas estrategias para su prevención.Objetivo: Generar recomendaciones basadas en la evidencia para el uso de medios de contraste yodados e n pacientes sometidos a procedimientos radiológicos terapéuticos y de diagnóstico, mediante un consenso de expertos. Metodología: A partir de la formulación de preguntas de investigación relacionadas con la LRA-MCI se realizó la búsqueda de evidencia en PubMed, Embase y Scopus, entre enero de 2013 y agosto de 2022. Los artículos se seleccionaron por medio de una revisión sistemática y con la metodología de consenso Delphi modificado. La calidad de los documentos se valoró aplicando instrumentos de evaluación de calidad de la evidencia de los documentos. Resultados:Se formularon 22 recomendaciones para el manejo de pacientes que requieren administración de medio de contraste yodado. Un panel de 11 expertos, entre los que se contó con 4 nefrólogos, 4 radiólogos y 1 nefrólogo pediatra, participaron en la elaboración del consenso en 5 sesiones virtuales y 15 horas de trabajo.Conclusiones: El término lesión renal aguda asociada al uso de medios de contraste yodados (LRA-MCI) debe usarse idealmente y abandonar otras definiciones que infieren una causalidad manifiesta. Su incidencia: los datos recientes demuestran que se ubica muy por debajo de lo tradicionalmente considerado. Solo una baja tasa de filtración glomerular estimada (TFGe) se considera factor de riesgo independiente. Respecto a su prevención, únicamente la hidratación ha mostrado un potencial beneficio como medida nefroprotectora.
Introduction: Acute kidney injury associated with the use of iodinated contrast media (AKI-ICM) is an iatrogenic disorder with potential implications in morbidity and mortality, a cause for concern in imaging services. The last few years have marked important changes in the conception of this entity, from a more precise definition and its true incidence to the real impact of some strategies for its prevention. Objective: To generate evidence-based recommendations for the use of iodinated contrast media in patients undergoing diagnostic and therapeutic radiological procedures, by means of an expert consensus. Methodology: Based on the formulation of research questions related to AKI-ICM, a search for evidence was carried out in PubMed, Embase and Scopus, between January 2013 and August 2022. The articles were selected by means of a systematic review and with the modified Delphi consensus methodology. The quality of the papers was assessed by applying paper evidence quality assessment instruments. Results: Twenty-two recommendations were formulated for the management of patients requiring administration of iodinated contrast medium. A panel of 11 experts, including 4 nephrologists, 4 radiologists and 1 pediatric nephrologist, participated in the development of the consensus in 5 virtual sessions and 15 hours of work. Conclusions: The term acute kidney injury associated with the use of iodinated contrast media (AKI-ICM) should ideally be used and other definitions that infer overt causality abandoned. Its incidence: recent data show that it is well below that traditionally considered. Only a low estimated glomerular filtration rate (eGFR) is considered an independent risk factor. Regarding its prevention, only hydration has shown a potential benefit as a nephroprotective measure
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Injúria Renal Aguda , Meios de Contraste , Taxa de Filtração GlomerularRESUMO
Introducción: Un correcto estilo de vida es vital en los adultos mayores para reducir su riesgo de enfermedades y de perder funcionalidad. Objetivo: Determinar las características coligadas al estilo de vida en pacientes adultos mayores en un Centro de Salud de los andes peruanos. Método: Estudio observacional, descriptivo con pacientes adultos mayores de un centro de salud. Se trabajó con una base de datos previamente recolectada. Se usó estadística descriptiva. El estudio fue aprobado por el comité de ética institucional. Resultados: De los 74 pacientes evaluados, la media de edad fue de 75,4 años y el 52% fue de sexo femenino. La media del IMC fue de 24,8 Kg/m2 y la del perímetro abdominal de 86,8 cm. 32,7% tuvieron una agudeza visual de 70 en el ojo derecho y 36,4% de 50 en el ojo izquierdo. La glucosa (mg/dL), hemoglobina (g/dL) y el ácido úrico (mg/dL) tuvieron una mediana de 97, 15,4 y 7; respectivamente. Los triglicéridos y el colesterol tuvieron una media de 182,2 mg/dL y 189,9 mg/dL; respectivamente. Un 5,4% de hombres tuvieron PSA reactivo. 4% tuvieron diabetes, 21,6% hipertensión arterial y 22,2% anemia; mientras que 70,3% consumía alcohol, 6,8% tenía tabaquismo y 89,2% consumía bebidas gaseosas. Conclusiones: Se encontraron algunos indicadores de mal estilo de vida, como el consumo de alcohol y bebidas gaseosas, así como indicadores de condiciones relacionadas a un mal estilo de vida como una media del IMC cercano al sobrepeso, de triglicéridos y colesterol elevados.
Introduction: A correct lifestyle is vital in older adults to reduce their risk of diseases and loss of functionality. Objective: To determine the lifestyles of elderly patients in a Health Center in the Peruvian Andes. Method: Observational, descriptive study with elderly patients from a health center. We worked with a previously collected database. Descriptive statistics were used. The study was approved by the institutional ethics committee. Results: Of the 74 patients evaluated, the mean age was 75.4 years and 52% were females. The mean BMI was 24.8 kg / m2 and that of the abdominal circumference was 86.8 cm. 32.7% had a visual acuity of 70 in the right eye and 36.4% of 50 in the left eye. Glucose (mg / dL), hemoglobin (g / dL) and uric acid (mg / dL) had a median of 97, 15.4 and 7; respectively. Triglycerides and cholesterol had a mean of 182.2 mg / dL and 189.9 mg / dL; respectively. 5.4% of men had reactive PSA. 4% had diabetes, 21.6% hypertension, and 22.2% anemia; while 70.3% consumed alcohol, 6.8% smoked and 89.2% consumed soda. Conclusions: Some indicators of poor lifestyle were found, such as the consumption of alcohol and soft drinks, as well as indicators of conditions related to a poor lifestyle such as an average BMI close to being overweight, high triglycerides and cholesterol.
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COVID-19 , Coinfecção , Vírus da Dengue , Dengue , Região do Caribe , Colômbia/epidemiologia , Dengue/epidemiologia , Humanos , SARS-CoV-2RESUMO
El dolor pélvico crónico (DPC) se define como un dolor de localización pélvica con una duración mayor a 6 meses. Es una causa importante de consulta médica, y afecta entre el 24 % y el 45 % de las mujeres en el mundo. El síndrome de congestión pélvica (SPC) es una fuente notable y muchas veces poco diagnosticada de dolor pélvico crónico en pacientes, en su mayoría premenopáusicas, que afecta de forma relevante la calidad de vida. El principal objetivo de este artículo es demostrar las múltiples opciones diagnósticas y diferentes dispositivos terapéuticos que se usan para la embolización selectiva, para dar un adecuado manejo y resolución al síndrome de congestión pélvica. En conclusión, el SPC es una entidad altamente dolorosa, incapacitante e importante para tener en cuenta por su alta prevalencia y morbilidad asociadas. El tratamiento endovascular ha demostrado ser una opción altamente confiable, segura, con bajas tasas de complicaciones, menor tiempo de recuperación y estancias hospitalarias más cortas, en comparación con la opción quirúrgica. Es importante conocer el material y utilizarlo correctamente, lo cual ayudará a evitar complicaciones.
Chronic pelvic pain (CPP) is defined as pain in the pelvic area with a duration more than 6 months. It's an important cause of medical consultation, affecting approximately between 24 and 45% of women in the world. Pelvic congestion syndrome (PCS) is a notable and often under-diagnosed cause of chronic pelvic pain in patients, mostly premenopausal, that significantly affects quality of life. The main objective of this paper is to demonstrate the multiple diagnostic options and different therapeutic devices that are used for selective embolization, giving adequate management and resolution of pelvic congestion syndrome. In conclusion, PCS is a highly painful, disabling and important pathology to take into account due to its high prevalence and associated morbidity. Endovascular treatment has proven to be a highly reliable and safe option, with low complication rates, shorter recovery time, and briefer hospital stays compared to the surgical option. It's important to know the material and use it correctly which will help avoid complications.
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Insuficiência Venosa , Dor Pélvica , DispareuniaRESUMO
BACKGROUND: Blastocystis is a protist that lives in the intestinal tract of a variety of hosts, including humans. It is still unclear how Blastocystis causes disease, which presents an ongoing challenge for researchers. Despite the controversial findings on the association between Blastocystis and clinical digestive manifestations, there is currently no consensus as to whether this protozoan actually behaves as a pathogen in humans. Furthermore, the relationship between Blastocystis and the intestinal microbiota composition is not yet clear. For that reason, the aim of this study was to identify if colonization by Blastocystis is related to changes in the diversity and relative abundance of bacterial communities, compared with those of Blastocystis-free individuals in a group of Colombian children. METHODS: We took stool samples from 57 school-aged children attending a daycare institution in Popayán (Southwest Colombia). Whole DNA was extracted and examined by 16S-rRNA amplicon-based sequencing. Blastocystis was detected by real time PCR and other intestinal parasites were detected by microscopy. We evaluated if Blastocystis was associated with host variables and the diversity and abundance of microbial communities. RESULTS: The composition of the intestinal bacterial community was not significantly different between Blastocystis-free and Blastocystis-colonized children. Despite this, we observed a higher microbial richness in the intestines of children colonized by Blastocystis, which could, therefore, be considered a benefit to intestinal health. The phylum Firmicutes was the predominant taxonomic unit in both groups analyzed. In Blastocystis-free individuals, there was a higher proportion of Bacteroidetes; similarly, in children colonized by Blastocystis, there was a higher relative abundance of the phylum Proteobacteria; however, no statistically significant differences were found between the comparison groups. CONCLUSIONS: The presence of Blastocystis showed a decrease in Bacteroides, and an increase in the relative abundance of the genus Faecalibacterium. It was also evident that the presence of Blastocystis was unrelated to dysbiosis at the intestinal level; on the contrary, its presence did not show statistically differences in the intestinal microbiota composition. Nevertheless, we believe that Blastocystis plays a role in the ecology of the intestinal microbiota through its interaction with other microbial components.
Assuntos
Infecções por Blastocystis/epidemiologia , Blastocystis/isolamento & purificação , Firmicutes/isolamento & purificação , Microbioma Gastrointestinal , Blastocystis/genética , Infecções por Blastocystis/parasitologia , Pré-Escolar , Colômbia/epidemiologia , Fezes/microbiologia , Fezes/parasitologia , Feminino , Firmicutes/genética , Humanos , Intestinos/microbiologia , Intestinos/parasitologia , MasculinoRESUMO
OBJECTIVES: To determine the probability of controlling the outbreak of COVID-19 in Peru, in a pre- and post-quarantine scenario using mathematical simulation models. MATERIALS AND METHODS: Outbreak si mulations for the COVID-19 pandemic are performed, using stochastic equations under the following assumptions: a pre-quarantine population R0 of 2.7 or 3.5, a post-quarantine R0 of 1.5, 2 or 2.7, 18% or 40%, of asymptomatic positives and a maximum response capacity of 50 or 150 patients in the intensive care units. The success of isolation and contact tracing is evaluated, no other mitigation measures are included. RESULTS: In the pre-quarantine stage, success in controlling more than 80% of the simulations occurred only if the isolation of positive cases was implemented from the first case, after which there was less than 40% probability of success. In post-quarantine, with 60 positive cases it is necessary to isolate them early, track all of their contacts and decrease the R0 to 1.5 for outbreak control to be successful in more than 80% of cases. Other scenarios have a low probability of success. CONCLUSIONS: The control of the outbreak in Peru during pre-quarantine stage demanded requirements that were difficult to comply with, therefore quarantine was necessary; to successfully suspend it would require a significant reduction in the spread of the disease, early isolation of positives and follow-up of all contacts of positive patients.
OBJETIVOS: Determinar la probabilidad de control del brote de la COVID-19 en el Perú, en un escenario pre y poscuarentena en modelos de simulaciones matemáticas. MATERIALES Y MÉTODOS: Se realizan simu laciones de brotes para la pandemia de COVID-19, usando ecuaciones estocásticas bajo los siguientes supuestos: un R0 poblacional precuarentena de 2,7 o 3,5, y un R0 poscuarentena de 1,5, 2 o 2,7, positivos asintomáticos del 18% o 40%, y una capacidad resolutiva máxima de 50 o 150 pacientes en las unidades de cuidados intensivos. Se evalúa el éxito del aislamiento y rastreo de contactos, no se incluyen otras medidas de mitigación. RESULTADOS: En la etapa precuarentena, el éxito en el control de más del 80% de las simulaciones se daba solo si el aislamiento de casos positivos se implantaba desde el primer caso, luego se tenía menos de un 40% de probabilidad de éxito. En la poscuarentena, con 60 casos positivos es necesario aislarlos precozmente, rastrear al 100% sus contactos y disminuir el R0 a 1,5 para que el control del brote tenga éxito en más del 80% de los casos. Otros escenarios tienen baja probabilidad de éxito. CONCLUSIONES: El control del brote en el Perú en la etapa precuarentena demandaba requisitos de difícil cumplimiento, por ello la cuarentena era necesaria; para suspenderla con éxito se requeriría una impor tante reducción de la dinámica de propagación de la enfermedad, el aislamiento precoz de los positivos y el seguimiento de todos los contactos.
Assuntos
Simulação por Computador , Infecções por Coronavirus/epidemiologia , Surtos de Doenças/prevenção & controle , Pneumonia Viral/epidemiologia , COVID-19 , Busca de Comunicante/métodos , Infecções por Coronavirus/prevenção & controle , Humanos , Unidades de Terapia Intensiva/estatística & dados numéricos , Modelos Teóricos , Pandemias/prevenção & controle , Peru/epidemiologia , Pneumonia Viral/prevenção & controle , Probabilidade , QuarentenaRESUMO
EL HOMA-IR (homeostasis model assessment-insulin-resistance) es un estimador de insulinorresistencia (IR) pero depende de la determinación de insulina. Los índices triglicéridos-glucosa (T-G)-circunferencia de la cintura (CC) (T-G-CC) o triglicéridos-glucosa-índice de masa corporal (TG- IMC) podrían ser sustitutos. Los objetivos de este trabajo consistieron en investigar en personas con riesgo de desarrollar diabetes tipo 2 (DT2): a) los índices T-G, T-G-CC y T-G-IMC como estimadores de HOMA-IR>2,1; b) determinar su poder discriminante. Se realizó un estudio prospectivo en el que se estudiaron 223 individuos ≥45 años con riesgo de desarrollar diabetes tipo 2 (DT2). La relación T-G se calculó como ln [triglicéridos (mg/dL) x glucemia (mg/dL)/2]. La relación T-G-CC y T-G-IMC fue el producto de T-G por CC o IMC. Se utilizó análisis de regresión logística y se calcularon las áreas bajo las curvas ROC (receiver operating characteristic curves) (ABC) para comparar las asociaciones de T-G, T-G-CC y T-G-IMC con HOMA-IR>2,1. Mediante análisis discriminante se evaluó la clasificación de los sujetos entre HOMA-IR>2,1 y HOMA-IR≤2,1. ABC, sensibilidad, especificidad, poder predictivo positivo y negativo para T-G-CC y T-G-IMC fueron mayores que para T-G, con los siguientes valores de corte: T-G=8,75, T-G-CC=821 y T-G-IMC=255. Los odds ratios (OR) para HOMA-IR>2,1, ajustados para confusores, fueron: T-G>8,75, OR: 4,85 (IC 95% 2,73-8,62); T-G-CC>821, OR: 10,41 (IC 95% 5,55-19,53); T-GIMC> 255, OR: 10,41 (IC 95% 5,55-19,53). Con el análisis discriminante T-G>8,75 clasificó correctamente 69,2% individuos con HOMA-IR≤2,1 y 68,3% con HOMA-IR>2,1; T-G-CC y T-G-IMC clasificaron 74,4% y 78,2% respectivamente (p<0,001 en todos los casos). Se concluyó que T-GCC> 821 y T-G-IMC>255 fueron mejores estimadores de HOMA-IR>2,1 que T-G>8,75. Estas son determinaciones simples y accesibles y podrían ser útiles en la práctica clínica y en estudios epidemiológicos.
HOMA-IR ((homeostasis model assessment-insulin-resistance) is a surrogate estimator of insulin resistance (IR) but it depends on insulin determination. Triglyceride-glucose-waist circumference (T-G-WC) or triglyceride-glucose-body mass index (BMI) (T-G-BMI) could be substitutes. The objectives of this work were: to investigate in people at risk of developing type 2 diabetes (T2D): a) T-G, T-G-CC and T-G-BMI as estimators of HOMA-IR>2.1 and b) to determine their discriminating power. A prospective study was conducted studying 223 individuals ≥45 years of age at risk of developing type 2 diabetes (T2D). The T-G ratio was calculated as ln [triglycerides (mg/dL) x glycemia (mg/dL)/2]. The T-G-CC and T-G-BMI ratio was the product of T-G by CC or BMI. Logistic regression analysis was used and the areas under the receiver operating characteristic curves (ROC) curves were calculated to compare the associations of T-G, T-G-CC and T-G-BMI with HOMA-IR>2.1. Using a discriminant analysis, the classification of the subjects between HOMA-IR>2.1 or HOMA-IR≤2.1 was evaluated. AUC, sensitivity, specificity, positive and negative predictive powers for T-G-CC and T-G-BMI were higher than for T-G, with the following cut-off values: TG=8.75, T-G-CC=821 and T-G-BMI=255. Odds ratios (OR) for HOMA-IR>2.1, adjusted for confounders, were: T-G>8.75, OR 4.85 (95% CI 2.73-8.62); T-G-CC>821, OR 10.41 (95% CI 5.55-19.53); T-G-BMI>255, OR 10.41 (95% CI 5.55-19.53). With the discriminant analysis T-G>8.75, 69.2% correctly classified with HOMA-IR≤2.1 and 68.3% with HOMA-IR>2.1; T-G-CC and T-G-BMI correctly classified 74.4% and 78.2% respectively (p <0.001 in all cases). It is concluded that T-G-CC>821 and T-G-BMI>255 were better estimators of HOMA-IR>2.1 than T-G>8.75. T-G-WC and T-G-BMI are simple and reliable determinations and could be useful in clinical practice and epidemiological studies.
O HOMA-IR (homeostasis model assessment-insulin-resistance) e um estimador de resistencia a insulina (RI), mas depende da determinacao da insulina. Triglicerideos-glicose (T-G), circunferencia da cintura (CC) (T-G-CC) ou triglicerideos-glicose-indice de massa corporal (T-G-IMC) poderiam ser substitutos. Os objetivos desse trabalho foram investigar em pessoas com risco de desenvolver diabetes tipo 2 (DT2): a) os indices T-G, T-G-CC e T-G-IMC como estimadores de HOMA-IR> 2,1; b) determinar seu poder discriminante. Um estudo prospectivo foi realizado em 223 pessoas ≥45 anos com risco de desenvolver diabetes tipo 2 (DT2). A razao T-G foi calculada como ln [triglicerideos (mg/dL) x glicemia (mg/dL)/2]. A razao T-G-CC e T-G-IMC foi o produto de T-G por CC ou IMC. A analise de regressao logistica foi utilizada e as areas sob as curvas ROC (receiver operating features) ABC foram calculadas para comparar as associacoes de T-G, T-G-CC e T-G-IMC com HOMA-IR>2.1. Por meio de analise discriminante, avaliou-se a classificacao dos sujeitos entre HOMA-IR>2,1 e HOMA-IR≤2,1. ABC, sensibilidade, especificidade, poder preditivo positivo e negativo para TG-CC e TG-IMC foram maiores que para TG, com os seguintes valores de corte: TG=8,75, TG-CC=821 e TG-IMC=255. Odds Ratios (OR) para HOMA-IR>2,1, ajustados para fatores de confusao, foram: TG>8,75, OR 4,85 (IC95% 2,73-8,62); T-G-CC>821, OR 10,41 (IC 95% 5,55-19,53); T-G-IMC>255, OR 10,41 (IC 95% 5,55-19,53). Com a analise discriminante T-G>8,75, 69,2% foram classificados corretamente com HOMA-IR≤2,1 e 68,3% com HOMA-IR>2,1; T-G-CC e T-G-IMC classificaram 74,4% e 78,2%, respectivamente (p<0,001 em todos os casos). Conclui-se que T-G-CC>821 e TG- IMC>255 foram melhores estimadores de HOMA-IR>2,1 que T-G>8,75. Elas sao determinacoes simples e acessiveis e poderiam ser uteis na pratica clinica e em estudos epidemiologicos.
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Humanos , Triglicerídeos , Poder Psicológico , Estudos Epidemiológicos , Modelos Logísticos , Razão de Chances , Fatores de Confusão Epidemiológicos , Curva ROC , Sensibilidade e Especificidade , Classificação , Área Sob a Curva , Corte , Diabetes Mellitus Tipo 2 , Diabetes Mellitus Tipo 2/complicações , Glucose , Objetivos , Insulina , Pessoas , Organização e Administração , Associação , Glicemia , Resistência à Insulina , Índice de Massa Corporal , Análise Discriminante , Risco , Análise de Regressão , Circunferência da CinturaRESUMO
RESUMEN Objetivos: Determinar la probabilidad de control del brote de la COVID-19 en el Perú, en un escenario pre y poscuarentena en modelos de simulaciones matemáticas. Materiales y métodos: Se realizan simu laciones de brotes para la pandemia de COVID-19, usando ecuaciones estocásticas bajo los siguientes supuestos: un R0 poblacional precuarentena de 2,7 o 3,5, y un R0 poscuarentena de 1,5, 2 o 2,7, positivos asintomáticos del 18% o 40%, y una capacidad resolutiva máxima de 50 o 150 pacientes en las unidades de cuidados intensivos. Se evalúa el éxito del aislamiento y rastreo de contactos, no se incluyen otras medidas de mitigación. Resultados: En la etapa precuarentena, el éxito en el control de más del 80% de las simulaciones se daba solo si el aislamiento de casos positivos se implantaba desde el primer caso, luego se tenía menos de un 40% de probabilidad de éxito. En la poscuarentena, con 60 casos positivos es necesario aislarlos precozmente, rastrear al 100% sus contactos y disminuir el R0 a 1,5 para que el control del brote tenga éxito en más del 80% de los casos. Otros escenarios tienen baja probabilidad de éxito. Conclusiones: El control del brote en el Perú en la etapa precuarentena demandaba requisitos de difícil cumplimiento, por ello la cuarentena era necesaria; para suspenderla con éxito se requeriría una impor tante reducción de la dinámica de propagación de la enfermedad, el aislamiento precoz de los positivos y el seguimiento de todos los contactos.
ABSTRACT Objectives: To determine the probability of controlling the outbreak of COVID-19 in Peru, in a pre- and post-quarantine scenario using mathematical simulation models. Materials and methods: Outbreak si mulations for the COVID-19 pandemic are performed, using stochastic equations under the following assumptions: a pre-quarantine population R0 of 2.7 or 3.5, a post-quarantine R0 of 1.5, 2 or 2.7, 18% or 40%, of asymptomatic positives and a maximum response capacity of 50 or 150 patients in the intensive care units. The success of isolation and contact tracing is evaluated, no other mitigation measures are included. Results: In the pre-quarantine stage, success in controlling more than 80% of the simulations occurred only if the isolation of positive cases was implemented from the first case, after which there was less than 40% probability of success. In post-quarantine, with 60 positive cases it is necessary to isolate them early, track all of their contacts and decrease the R0 to 1.5 for outbreak control to be successful in more than 80% of cases. Other scenarios have a low probability of success. Conclusions: The control of the outbreak in Peru during pre-quarantine stage demanded requirements that were difficult to comply with, therefore quarantine was necessary; to successfully suspend it would require a significant reduction in the spread of the disease, early isolation of positives and follow-up of all contacts of positive patients.
Assuntos
Humanos , Pneumonia Viral/epidemiologia , Simulação por Computador , Surtos de Doenças , Surtos de Doenças/prevenção & controle , Técnicas de Apoio para a Decisão , Infecções por Coronavirus/epidemiologia , Assistência ao Convalescente , COVID-19 , Peru/epidemiologia , Pneumonia Viral/prevenção & controle , Quarentena , Probabilidade , Busca de Comunicante/métodos , Infecções por Coronavirus/prevenção & controle , Pandemias/prevenção & controle , Unidades de Terapia Intensiva/estatística & dados numéricos , Modelos TeóricosRESUMO
Background and Purpose: Survey-based research was conducted in Yantalo, Peru, a rural Amazonian community, to assess the knowledge base among women surrounding cervical cancer, human papilloma virus (HPV), and preventative health practices as well as to gain a better understanding of barriers to accessing care. Methods: A total of 217 women were interviewed out of the 1612 female inhabitants of Yantalo utilizing a structured interview-style questionnaire with both closed and open-ended questions. Results: Our average respondent was 41.6 years old with the equivalent of some high school education. Approximately 75% of respondents reported that they had heard of HPV and/or cervical cancer, with 44.4% reporting they had received a test to check for cervical cancer within their lifetime. When given a 10-question knowledge assessment regarding safe sex practices and cervical cancer, women obtained an average score of 57.3%. When asked about receiving the HPV vaccine, 29% reported "Yes", 59.4% reported "No", and 11.6% reported "I don't know." Although 62.6% of women indicated that they have "easy access to cervical cancer screening," 37.4% of women reported experiencing at least one barrier to accessing care. The highest reported barriers include fear of the test causing them pain and/or lack of knowledge of the necessity cervical cancer testing. Cervical cancer rates in Peru are approximately three times that in developed countries. Conclusions: Gathering data surrounding knowledge and the barriers among the female population in rural communities is essential to developing targeted initiatives that address pertinent obstacles within these and other vulnerable communities.
RESUMO
Pediculosis capitis is the most frequent ectoparasitosis around the world. The infestation is caused by Pediculus humanus capitis (head louse), which affects hair, scalp, and skin. It rarely presents with more symptoms and in the majority of the cases, it shows a benign course if treated properly. We present the case of a nursery school girl with head lice infestation for 18 months. She did not improve after the shampoo treatment. This case was associated with furunculosis, skin lesions, multiple adenopathies, and anemia. Initially, the presence of boils, alopecia, and lymphadenopathy was evident. The persistence of pediculosis capitis and intense scratching induced changes on skin integrity, facilitating opportunistic bacterial superinfection that led to impetiginization, furunculosis, excoriations, hematic scabs, anemia, alopecia, and lymphadenopathies. Pediculosis capitis affected the patient triggering psychological, economic, social, and other health problems. The patient presented uncommon symptoms (furunculosis, anemia, fever, alopecia, and adenopathies) resulting from the persistence of risk factors and the absence of head inspection and mechanical removal of insects. The education about the risk factors, as well as sanitary controls, are essential to contain the infestation.
La pediculosis capitis es la ectoparasitosis más frecuente a nivel mundial. La infestación es causada por Pediculus humanus capitis (piojo de la cabeza) y afecta el cabello, el cuero cabelludo y la piel. Rara vez se manifiesta con otro tipo de sintomatología y, por lo general, su curso es benigno si se trata adecuadamente. Se presenta el caso de una menor con pediculosis capitis de 18 meses de evolución, asociada con forúnculos, lesiones cutáneas, múltiples adenopatías y anemia, que no mejoró tras la aplicación del champú. Inicialmente, llamó la atención la presencia de forúnculos, alopecia y adenopatías. La persistencia de la pediculosis capitis y el rascado intenso alteraron la integridad de la epidermis y facilitaron las infecciones secundarias por bacterias patógenas y oportunistas que produjeron impétigo, forunculosis, excoriaciones, costras hemáticas, anemia, alopecia y linfadenopatías. La pediculosis capitis afectó notoriamente a la paciente al causarle problemas psicológicos y de salud, agudizados por su condición económica y social. La paciente presentó manifestaciones clínicas poco frecuentes (forunculosis, anemia, fiebre, alopecia y adenopatías), lo cual se vio facilitado por la persistencia de los factores de riesgo y el hecho de que no se le inspeccionaba la cabeza ni se removían los insectos. La educación sobre los factores de riesgo y el control sanitario es indispensable para controlar la infestación.
Assuntos
Infestações por Piolhos/complicações , Pediculus , Alopecia/etiologia , Anemia/etiologia , Animais , Pré-Escolar , Dermatoses Faciais/etiologia , Feminino , Furunculose/etiologia , Furunculose/patologia , Humanos , Resistência a Inseticidas , Inseticidas/administração & dosagem , Infestações por Piolhos/diagnóstico , Infestações por Piolhos/terapia , Linfadenopatia/etiologia , Permetrina/administração & dosagem , Pobreza , Prurido/etiologia , Escolas MaternaisRESUMO
La pediculosis capitis es la ectoparasitosis más frecuente a nivel mundial. La infestación es causada por Pediculus humanus capitis (piojo de la cabeza) y afecta el cabello, el cuero cabelludo y la piel. Rara vez se manifiesta con otro tipo de sintomatología y, por lo general, su curso es benigno si se trata adecuadamente. Se presenta el caso de una menor con pediculosis capitis de 18 meses de evolución, asociada con forúnculos, lesiones cutáneas, múltiples adenopatías y anemia, que no mejoró tras la aplicación del champú. Inicialmente, llamó la atención la presencia de forúnculos, alopecia y adenopatías. La persistencia de la pediculosis capitis y el rascado intenso alteraron la integridad de la epidermis y facilitaron las infecciones secundarias por bacterias patógenas y oportunistas que produjeron impétigo, forunculosis, excoriaciones, costras hemáticas, anemia, alopecia y linfadenopatías. La pediculosis capitis afectó notoriamente a la paciente al causarle problemas psicológicos y de salud, agudizados por su condición económica y social. La paciente presentó manifestaciones clínicas poco frecuentes (forunculosis, anemia, fiebre, alopecia y adenopatías), lo cual se vio facilitado por la persistencia de los factores de riesgo y el hecho de que no se le inspeccionaba la cabeza ni se removían los insectos. La educación sobre los factores de riesgo y el control sanitario es indispensable para controlar la infestación.
Pediculosis capitis is the most frequent ectoparasitosis around the world. The infestation is caused by Pediculus humanus capitis (head louse), which affects hair, scalp, and skin. It rarely presents with more symptoms and in the majority of the cases, it shows a benign course if treated properly. We present the case of a nursery school girl with head lice infestation for 18 months. She did not improve after the shampoo treatment. This case was associated with furunculosis, skin lesions, multiple adenopathies, and anemia. Initially, the presence of boils, alopecia, and lymphadenopathy was evident. The persistence of pediculosis capitis and intense scratching induced changes on skin integrity, facilitating opportunistic bacterial superinfection that led to impetiginization, furunculosis, excoriations, hematic scabs, anemia, alopecia, and lymphadenopathies. Pediculosis capitis affected the patient triggering psychological, economic, social, and other health problems. The patient presented uncommon symptoms (furunculosis, anemia, fever, alopecia, and adenopathies) resulting from the persistence of risk factors and the absence of head inspection and mechanical removal of insects. The education about the risk factors, as well as sanitary controls, are essential to contain the infestation.