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La propuesta de extender hasta dos o tres años la observación de las consecuencias negativas de la infección por el virus SARS-CoV-2 se considera razonable, al alargar el tiempo de seguimiento de un padecimiento anteriormente desconocido. El propósito de esta comunicación es aportar nuevas consideraciones sobre una realidad: existen personas que no se han recuperado totalmente, en un tiempo prudencial, después de haber padecido de COVID-19. Se enfatiza que todavía estamos lejos de conocer todos los efectos biológicos que tendrá en el tiempo, la "inmunoestimulación masiva" de la pandemia en algunas personas. Se plantean algunas recomendaciones prácticas como a) Incluir el dato de haber padecido de COVID-19 en los antecedentes patológicos personales de los pacientes; b) Insistir en el seguimiento periódico de los enfermos, sobre todo los que manifiesten quejas de una convalecencia prolongada. Otras consecuencias, además de las netamente biológicas, son también importantes, entre ellas: mentales, sociales, laborales, económicas, consumo de servicios de salud y de servicios sociales. En relación a la pos-COVID siempre el reto estará vinculado a la aplicación de estrategias eficaces para la prevención y el control de la COVID-19. Pero si se presentan enfermos, el desafío consistirá en evitar las posibles causas de la pos-COVID, así como prevenir o atenuar la aparición de sus diferentes formas clínicas con conductas coherentes, en dependencia de las características de cada caso, así como atenuar, por todos, las consecuencias que se han provocado en las personas afectadas y para la sociedad.

The proposal to extend the negative consequences of infection with the SARS-CoV-2 virus observation to two or three years is considered reasonable, by lengthening the follow-up time of a previously unknown condition. This communication' purpose is to provide new considerations about a fact: there are people who have not fully recovered, in a reasonable time, after having suffered from COVID-19. It is emphasized that we are still far from knowing all the biological effects that the "massive immunostimulation" of the pandemic will have over time on some people. Some practical recommendations are proposed, such as a) Include the information of having suffered from COVID-19 in the patients' personal pathological history; b) Insist on periodic monitoring of patients, especially those who express complaints of prolonged convalescence. Other consequences, in addition to the purely biological ones, are also important, including: mental, social, labor, economic, consumption of health services and social services. In relation to post-COVID, the challenge will always be linked to the application of effective strategies for the COVID-19 prevention and control. But if illness people appear, the challenge will be to avoid the possible causes of post-COVID, as well as prevent or mitigate the appearance of its different clinical forms with coherent behaviors, depending on the characteristics of each case, as well as mitigate, by all, the consequences that have been caused to the affected people and to society.

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INTRODUCTION: Severe Acute Respiratory Syndrome-Coronavirus-2 Virus (SARS-CoV-2) is responsible for Coronavirus Disease 2019 (COVID-19). A substantial number of SARS-CoV-2 infection cases have been reported during the pandemic, and vaccination coverage in some regions, particularly in developing countries, remains very low. SARS-CoV-2 variants of concern (VOCs) have also emerged as some of the most pressing public health issues. In this scenario, it is crucial to know whether COVID-19 convalescent antibodies have cross-neutralizing action against VOCs to contribute to the analysis of the future progress of the pandemic. METHODOLOGY: The plasma of individuals infected with SARS-CoV-2 from June to November 2020 in Paraguay (before the first recorded infections associated with VOCs in the country) was selected. Anti-spike antibodies were determined in plasma samples (n = 626) obtained from this convalescent and unvaccinated group. Using a pseudotyped virus neutralization assay, we then investigated the neutralizing response against D614G variant and Gamma, and Delta VOCs. RESULTS: IgG antibodies against spike were detected in 85.6% of convalescent individuals. Samples from individuals previously infected by a non-VOC showed a 6.6- and 8.1-fold reduction in neutralizing capacity to the Gamma and Delta variants, respectively, when compared to the D614G variant. CONCLUSIONS: Our findings show that antibodies generated by non-VOC infection have reduced neutralizing capabilities against Gamma and Delta variants that appeared subsequently and might have implications for immunity strategies.

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Hypoxic exposure is safely associated with exercise for many pathological conditions, providing additional effects on health outcomes. COVID-19 is a new disease, so the physiological repercussions caused by exercise in affected patients and the safety of exposure to hypoxia in these conditions are still unknown. Due to the effects of the disease on the respiratory system and following the sequence of AEROBICOVID research work, this study aimed to evaluate the effectiveness, tolerance and acute safety of 24 bicycle training sessions performed under intermittent hypoxic conditions through analysis of peripheral oxyhemoglobin saturation (SpO2), heart rate (HR), rate of perceived exertion (RPE), blood lactate concentration ([La-]) and symptoms of acute mountain sickness in patients recovered from COVID-19. Participants were allocated to three training groups: the normoxia group (GN) remained in normoxia (inspired fraction of O2 (FiO2) of ∼20.9%, a city with 526 m altitude) for the entire session; the recovery hypoxia group (GHR) was exposed to hypoxia (FiO2 ∼13.5%, corresponding to 3,000 m altitude) all the time except during the effort; the hypoxia group (GH) trained in hypoxia (FiO2 ∼13.5%) throughout the session. The altitude simulation effectively reduced SpO2 mean with significant differences between groups GN, GHR, and GH, being 96.9(1.6), 95.1(3.1), and 87.7(6.5), respectively. Additionally, the proposed exercise and hypoxic stimulus was well-tolerated, since 93% of participants showed no or moderate acute mountain sickness symptoms; maintained nearly 80% of sets at target heart rate; and most frequently reporting session intensity as an RPE of "3" (moderate). The internal load calculation, analyzed through training impulse (TRIMP), calculated using HR [TRIMPHR = HR * training volume (min)] and RPE [TRIMPRPE = RPE * training volume (min)], showed no significant difference between groups. The current strategy effectively promoted the altitude simulation and monitoring variables, being well-tolerated and safely acute exposure, as the low Lake Louise scores and the stable HR, SpO2, and RPE values showed during the sessions.

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BACKGROUND: The Bacillus Calmette-Guérin (BCG) vaccine may confer cross-protection against viral diseases in adults. This study evaluated BCG vaccine cross-protection in adults with convalescent coronavirus disease 2019 (COVID-19). METHOD: This was a multicenter, prospective, randomized, placebo-controlled, double-blind phase III study (ClinicalTrials.gov: NCT04369794). SETTING: University Community Health Center and Municipal Outpatient Center in South America. PATIENTS: a total of 378 adult patients with convalescent COVID-19 were included. INTERVENTION: single intradermal BCG vaccine (n = 183) and placebo (n = 195). MEASUREMENTS: the primary outcome was clinical evolution. Other outcomes included adverse events and humoral immune responses for up to 6 months. RESULTS: A significantly higher proportion of BCG patients with anosmia and ageusia recovered at the 6-week follow-up visit than placebo (anosmia: 83.1% vs. 68.7% healed, p = 0.043, number needed to treat [NNT] = 6.9; ageusia: 81.2% vs. 63.4% healed, p = 0.032, NNT = 5.6). BCG also prevented the appearance of ageusia in the following weeks: seven in 113 (6.2%) BCG recipients versus 19 in 126 (15.1%) placebos, p = 0.036, NNT = 11.2. BCG did not induce any severe or systemic adverse effects. The most common and expected adverse effects were local vaccine lesions, erythema (n = 152; 86.4%), and papules (n = 111; 63.1%). Anti-severe acute respiratory syndrome coronavirus 2 humoral response measured by N protein immunoglobulin G titer and seroneutralization by interacting with the angiotensin-converting enzyme 2 receptor suggest that the serum of BCG-injected patients may neutralize the virus at lower specificity; however, the results were not statistically significant. CONCLUSION: BCG vaccine is safe and offers cross-protection against COVID-19 with potential humoral response modulation. LIMITATIONS: No severely ill patients were included.

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Coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, was first reported in Wuhan, China, in December 2019. Diagnostic methods for the detection of the virus and seroconversion of neutralizing antibodies (NAbs) in plasma have been developed specifically, but some of them require a BSL3 facility. In this study, we used the SARS-CoV-2 Surrogate Virus Neutralization Test Kit to determine the presence or absence of NAbs anti-receptor binding domain of the viral spike (S) glycoprotein in a BSL2 facility. The sample population was chosen in Quito, Ecuador, with a total of 88 COVID-19 positive convalescent patients. We determined that 97.7% of the analyzed convalescent sera maintained the presence of NAbs with neutralizing activity, and this activity remained until 10 months after the infection in some cases. In addition, the relationship between the presence of NAbs and immunoglobulin G was significant compared to immunoglobulin M, which tended to be absent over time.

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The emergence of new SARS-CoV-2 variants represents a constant threat to world public health. The SARS-CoV-2 Delta variant was identified in late 2020 in India; since then, it has spread to many other countries, replacing other predominant lineages and raising concerns about vaccination efficiency. We evaluated the sensitivity of the Delta variant to antibodies elicited by COVID-19 vaccinated (CoronaVac and ChAdOx1) and convalescent individuals previously infected by earlier lineages and by the Gamma variant. No reduction in the neutralizing efficacy of the Delta variant was observed when compared to B lineage and a reduced neutralization was observed for the Gamma variant. Our results indicate that neutralization of the Delta variant is not compromised in individuals vaccinated by CoronaVac or ChAdOx1; however, a reduction in neutralization efficacy is expected for individuals infected by the Gamma variant, highlighting the importance of continuous vaccination even for previously infected individuals.

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RESUMEN La convalecencia es la última etapa de la "historia natural de una enfermedad" -si no ocurre la muerte- y con frecuencia no se le presta toda la atención, por lo que no es ocioso revisitar algunos de sus conceptos básicos. Una vez transcurrido un año del inicio de la pandemia inédita del SARS-CoV-2, la mirada se ha vuelto a esta etapa evolutiva de los enfermos y a la identificación y seguimiento de manifestaciones clínicas y posibles secuelas. Con el propósito de profundizar en la importancia de esta etapa en enfermos de COVID-19 y precisar sus características principales, se llevó a cabo este trabajo para contribuir a su mejor comprensión con información actualizada y favorecer los resultados en su manejo. Se abordan los conceptos de alta clínica y alta epidemiológica y la necesidad de valoración del diagnóstico previo. Se insiste sobre los factores que pueden influir en la convalecencia: las características propias de cada persona (biológicas, psicológicas, sociales, culturales y espirituales); el "estado de gravedad" que tuvo el paciente en la fase aguda de la enfermedad y si hubo necesidad de ingreso en cuidados intensivos; los efectos adversos de medicamentos y otros procederes llevados a cabo durante su atención y las comorbilidades.

ABSTRACT Convalescence is the last stage of the "natural history of a disease" - if death does not occur - and it is often not given full attention, so it is not idle to review some of its basic concepts. One year after the onset of the unprecedented SARS-CoV-2 pandemic, the gaze has turned to this evolutionary stage of the patients and to the identification and monitoring of clinical manifestations and possible effect. With the purpose of deepening the importance of this stage in COVID-19 patients and specifying its main characteristics, this work was carried out to contribute to its better understanding with updated information and favor the results in its management. The concepts of clinical discharge and epidemiological discharge and the need to assess the previous diagnosis are addressed. It insists on the factors that can influence convalescence: the characteristics of each person (biological, psychological, social, cultural and spiritual); the "state of seriousness" that the patient had in the acute phase of the disease and whether there was a need for admission to intensive care; adverse effects of medications and other procedures carried out during care and comorbidities.

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La enfermedad del coronavirus 2019 (COVID-19) causada por la infección por el nuevo coronavirus (SARS-CoV-2) ha creado una pandemia que ha llevado a una lucha mundial para hacer frente al gran número de personas infectadas, muchas de las cuales requieren cuidados intensivos. Hasta la fecha, no existe un tratamiento antivirus específico para COVID-19. El uso de transfusiones de plasma de convalecientes podría ser de gran valor en la pandemia actual. Los pacientes con SRAS-CoV-2 recuperados recientemente que pueden ser donantes adecuados se someten a aféresis para obtener plasma de convalecencia que contenga anticuerpos con títulos elevados, siempre que cumplan los criterios de donación de sangre. En esta revisión, resumimos la literatura existente sobre el plasma convaleciente como una opción terapéutica para COVID-19. Es importante señalar que es necesario estudiar más a fondo el momento adecuado para la administración de plasma de convalecencia y la gravedad de sus efectos adversos. El plasma de convalecencia ofrece la posibilidad de convertirse en una opción de tratamiento prometedora inmediata al evaluar los medicamentos existentes y desarrollar nuevas vacunas y terapias específicas.

The coronavirus disease 2019 (COVID-19) caused by novel coronavirus (SARS-CoV-2) infection has created a pandemic leading to a global struggle to cope with the sheer numbers of infected persons, many of whom require intensive care support. To date, there is no specific antivirus treatment for COVID-19. The use of convalescent plasma transfusions could be of great value in the current pandemic. Recently recovered SARS-CoV-2 patients who may be suitable donors undergo apheresis in order to obtain convalescent plasma containing high-titer antibodies, granted they meet blood donation criteria. In this review, we summarize existing literature around convalescent plasma as a therapeutic option for COVID-19. It is important to note that the appropriate timing on convalescent plasma administration and the severity of its adverse effects needs to be further studied. Convalescent plasma provides the potential to render an immediate promising treatment option while evaluating existing drugs and developing new specific vaccines and therapies.

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Resumen: La pandemia por COVID-19, originada en diciembre de 2019 en Wuhan, China, obligó a los países, incluido Chile, a un confinamiento masivo para evitar la propagación de SARS-CoV2. Desde marzo de 2020 en Chile, también se afectó la realización de actividad física y deporte en los niños, niñas y adolescentes (NNA). En un esfuerzo por reunir la escasa evidencia disponible sobre el retorno a la práctica de ejercicio en NNA post pandemia COVID-19 y la opinión de expertos de 4 sociedades científicas y académicas (Sociedad Chilena de Medicina del Deporte, Sociedad Chilena de Pediatría, Sociedad Chilena de Kinesiología Deportiva y la Consejo Académico Nacional de Educación Física) se han generado recomendaciones para un retorno seguro a la actividad para el ramo Educación Física y Salud, deporte escolar y federado tanto para disminuir los riesgos asociados a los efectos del confinamiento como para evitar la propagación de COVID-19. Adicionalmente, se incluyen una guía de recomendación para padres y profesores y otra para médicos sobre la vigilancia y evaluación de los pacientes NNA que sostendrán enfermedad COVID-19 y deseen volver al deporte y ejercicio.

Abstract: The COVID-19 pandemic, originated in December 2019 in Wuhan, China, forced a massive quaran tine in most countries including Chile to avoid the propagation of SARS-CoV2. Since March 2020 in Chile, it affected the participation of children and youth athletes as well in education, physical activity and sports. In an effort to assess the scarce available evidence about return to sport and exercise in children and adolescents post COVID-19 pandemic and gather the opinion of experts of 4 Chilean scientific and academic societies (Sociedad Chilena de Medicina del Deporte, Sociedad Chilena de Pediatría, Sociedad Chilena de Kinesiología Deportiva and Consejo Académico Nacional de Edu cación Física) we have produced recommendations for a safe return to activities in Physical Activity and Health class, School Sports and Federation Sports to reduce the risks associated with the effects of confinement and to avoid the propagation of COVID-19 and. Additionally, a recommendation for parents and teachers and a another for physicians for surveillance and evaluation of children and adolescents who were or will become COVID-19 patients and wish to return to sports end exercise.

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BACKGROUND: Dengue is commonly considered an acute illness and follows three phases: febrile, critical in some cases and recovery. However, a number of studies have described a continuation of dengue symptoms for weeks or months, extending the recovery phase. Here we evaluate this persistence of dengue symptoms during convalescence. METHODS: Our clinical cohort study included patients who sought medical services 48 to 144 h from the onset of fever at seven hospitals or ambulatory centers in Morelos, Mexico. Seventy-nine laboratory-confirmed dengue patients were followed up regularly using clinic and/or home visits and telephone calls for as long as symptoms persisted or up to 6 mo. RESULTS: In total, 55.7% of patients had dengue-related symptoms 1 mo after the onset of fever; pain and dermatological manifestations were the most common persistent symptoms. Prognostic factors for symptom persistence were: ≥4 d of fever (RR 1.72; 95% CI 1.35 to 2.19), platelet count ≤100 000/mm3 (RR 1.20; 95% CI 1.20 to 2.20), petechiae/bruises (RR 1.97; 95% CI 1.56 to 2.48) and abdominal pain/hepatomegaly (RR 1.79; 95% CI 1.41 to 2.28). CONCLUSIONS: Persistence of dengue symptoms were common in laboratory-confirmed dengue patients. Manifestations related to tissue damage were associated with persistence after 30 d; host characteristics, such as age and health status before infection, were associated with prolonged persistence (>60 d). The burden of dengue may be higher than previously estimated.

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"\"\\\"[{\\\\\\\"text\\\\\\\": \\\\\\\"Objetivo: identificar as percepções vivenciadas por familiares acompanhantes de crianças durante a\\\\\\\\r\\\\\\\\nhospitalização. Método: pesquisa exploratória, qualitativa, realizada em um setor pediátrico no interior de Mato\\\\\\\\r\\\\\\\\nGrosso, de maio a junho de 2015. Os dados foram obtidos por meio de entrevistas semiestruturadas com os\\\\\\\\r\\\\\\\\nfamiliares de crianças hospitalizadas e submetidos à análise temática. Resultados: as mães estavam mais presentes como acompanhantes durante a hospitalização e que, em alguns casos, aquele foi o primeiro contato com o setor de pediatria. A estrutura física foi considerada satisfatória. Alguns dos sentimentos e atitudes expressados foram desespero, medo, impotência/incapacidade, saudade e esperançaConsiderações finais: o estudo apontou a necessidade de acolhimento dos familiares durante a internação da criança por parte de toda a equipe de saúde, incluindo-os no processo de tratamento, atendendo suas necessidades físicas e psicológicas, contribuindo, desse modo, para a melhoria da assistência à criança.\\\\\\\", \\\\\\\"_i\\\\\\\": \\\\\\\"pt\\\\\\\"}, {\\\\\\\"text\\\\\\\": \\\\\\\"Aim: to identify the perceptions experienced by accompanying relatives of children during hospitalization. Method: exploratory, qualitative research carried out in a pediatric sector in the interior of Mato Grosso from May to June 2015. Data were obtained through semi-structured interviews with the relatives of hospitalized children and submitted to thematic analysis. Results: the mothers were more present as companions during the hospitalization and, in some cases, was the first contact with the pediatrics sector. The physical structure was considered satisfactory. Some of the feelings and expressed attitudes were despair, fear, impotence/ helplessness, longing, and hope. Final considerations: the study pointed out the need of reception of family members by the entire health team during the hospitalization of the child, including them in the treatment process, attending to their physical and psychological needs, thus contributing to the improvement of child care.\\\\\\\", \\\\\\\"_i\\\\\\\": \\\\\\\"en\\\\\\\"}, {\\\\\\\"text\\\\\\\": \\\\\\\"Objetivo: identificar las impresiones vividas por familiares acompañantes de niños durante la hospitalización. Método: investigación exploratoria, cualitativa, realizada en un sector pediátrico en el interior de Mato Grosso, de mayo a junio de 2015. Los datos fueron recolectados por medio de entrevistas semiestructuradas con los familiares de niños hospitalizados y sometidos al análisis temático. Resultados: las madres estaban más presentes como acompañantes durante la hospitalización y, en algunos casos, ese fue el primer contacto con el sector de pediatría. La estructura física fue considerada satisfactoria. Algunos de los sentimientos y actitudes expresados fueron desesperación, miedo, impotencia / incapacidad, nostalgia y esperanza. Consideraciones finales: el estudio destacó la necesidad de la acogida de los familiares durante la internación del niño por parte de todo el equipo de salud, incluyéndolos en el proceso de tratamiento, atendiendo sus necesidades físicas y psicológicas, contribuyendo así para la mejora de la asistencia al niño.\\\\\\\", \\\\\\\"_i\\\\\\\": \\\\\\\"es\\\\\\\"}]\\\"\""

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RESUMOObjetivo:compreender o significado atribuído pela família à sua vivência no processo de recuperação da criança acometida por doença aguda, após a alta hospitalar e elaborar um modelo teórico a respeito dessa experiência. O Interacionismo Simbólico foi adotado como referencial teórico e a Grounded Theory como metodológico.Método:os dados foram coletados por meio de entrevista e observação participante com 11 famílias, totalizando 15 entrevistas. A análise levou à formulação de um Modelo Teórico composto por dois fenômenos interativos: Mobilizando-se para resgatar o equilíbrio de seu funcionamento e Sofrendo com a possibilidade de reintegrar a criança.Resultados:estes revelaram que a família mantém-se em alerta para identificar precocemente alterações de saúde da criança na tentativa de evitar uma reinternação.Conclusão:os efeitos da doença e hospitalização continuam a manifestar-se no funcionamento familiar, gerando sofrimento mesmo após a alta e a recuperação da criança.

RESUMENObjetivo:comprender el significado atribuido por la familia de su experiencia en la recuperación de los niños afectados por el proceso de la enfermedad aguda, después de la descarga y desarrollar un modelo teórico sobre la experiencia. El Interaccionismo Simbólico fue adoptado como un teórico y la Teoría Fundamentada como metodológico.Método:los datos fueron recolectados a través de entrevistas y observación participante con 11 familias, con un total de 15 entrevistas. El análisis dio lugar a la formulación de un modelo teórico consta de dos fenómenos interactivos: Movilización para restaurar el balance de su funcionamiento y Sufriendo con la posibilidad de reinternar el niño.Resultados:éstos revelaron que la familias e mantiene en alerta para la identificación temprana de la salud el niño en un intento de evitar un reingreso.Conclusión:Los efectos de la enfermedad y la hospitalización aún se manifiesta en el funcionamiento familiar, que produce sufrimiento, incluso después de la descarga y la recuperación del niño.

ABSTRACTObjective:to understand the meaning attributed by the family to its experience in the recovery process of a child affected by an acute disease after discharge, and to develop a theoretical model of this experience. Symbolic interactionism was adopted as a theoretical reference, and grounded theory was adopted as a methodological reference.Method:data were collected through interviews and participant observation with 11 families, totaling 15 interviews. A theoretical model consisting of two interactive phenomena was formulated from the analysis: Mobilizing to restore functional balance and Suffering from the possibility of a child's readmission.Results:the family remains alert to identify early changes in the child's health, in an attempt to avoid rehospitalization.Conclusion:the effects of the disease and hospitalization continue to manifest in family functioning, causing suffering even after the child's discharge and recovery.

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Introducción: el dengue es una enfermedad infecciosa producida por un virus de genoma ARN, al cual se le reconocen 4 serotipos (DEN-1, DEN-2, DEN-3 y DEN-4) transmitidos por el Aedes aegypti como principal vector. En el embarazo se manifiesta clínicamente de forma similar a la población general, pero con la diferencia de estar en presencia de un ecosistema constituido por la madre y el feto, donde se introduce el virus con sus características genéticas con condiciones especiales para su desarrollo y evolución. Objetivo: investigar la evolución de los síntomas del dengue en mujeres que enfermaron durante el embarazo por 1 año de seguimiento. Métodos: se realizó una investigación observacional y descriptiva con el fin de conocer la presencia de secuelas con posterioridad a la infección por dengue 3 en mujeres que enfermaron durante su embarazo. Se estudió una cohorte de 28 embarazadas que ingresaron en el Hospital General Dr Juan Bruno Zayas Alfonso durante el brote de dengue de abril a noviembre de 2006. El diagnóstico se confirmó por métodos serológicos. Resultados: se observó hasta el año de seguimiento, pérdida de memoria (25 por ciento) y trastornos menstruales (14,3 por ciento). La pérdida de memoria resultó significativa cuando la infección se produjo en el tercer trimestre del embarazo, p= 0,0377. Conclusión: la infección por el virus dengue 3 es capaz de dejar secuela de pérdida de memoria en mujeres que sufrieron dengue durante el embarazo, preferentemente en el tercer trimestre de gravidez(AU)

Introduction: dengue is an infectious disease caused by ARN genome virus and has 4 recognized serotypes (DEN-1, DEN-2, DEN-3 and DEN-4) that are transmitted by Aedes aegypti as the main vector. The clinical manifestations of dengue in pregnancy are similar to those of the general population, except that the ecosystem is made up by the mother and the fetus where the virus with its genetic characteristics is introduced and finds special conditions for development and evolution. Objective: to study the progression of the dengue symptoms in women who got sick during their pregnancy for one year of follow-up. Methods: an observational descriptive research was conducted to find out the existence of sequelae in women who were infected with dengue 3 during their pregnancy. A cohort of 28 pregnant women, who had been admitted to Juan Bruno Zayas Alfonso General Hospital at the time of the dengue outbreak from April to November 2006, was studied. The diagnosis was serologically confirmed. Results: after one-year of follow-up, it was observed that amnesia (25 percent) and menstrual disorders (14.3 percent) affected these women. Amnesia was significant when the infection occurred in the third trimester of pregnancy, p= 0.0377. Conclusions: dengue 3 infection may cause amnesia in pregnant women who suffered this disease, particularly in their third trimester of pregnancy(AU)

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Introducción: el dengue es una enfermedad infecciosa producida por un virus de genoma ARN, al cual se le reconocen 4 serotipos (DEN-1, DEN-2, DEN-3 y DEN-4) transmitidos por el Aedes aegypti como principal vector. En el embarazo se manifiesta clínicamente de forma similar a la población general, pero con la diferencia de estar en presencia de un ecosistema constituido por la madre y el feto, donde se introduce el virus con sus características genéticas con condiciones especiales para su desarrollo y evolución. Objetivo: investigar la evolución de los síntomas del dengue en mujeres que enfermaron durante el embarazo por 1 año de seguimiento. Métodos: se realizó una investigación observacional y descriptiva con el fin de conocer la presencia de secuelas con posterioridad a la infección por dengue 3 en mujeres que enfermaron durante su embarazo. Se estudió una cohorte de 28 embarazadas que ingresaron en el Hospital General "Dr. Juan Bruno Zayas Alfonso" durante el brote de dengue de abril a noviembre de 2006. El diagnóstico se confirmó por métodos serológicos. Resultados: se observó hasta el año de seguimiento, pérdida de memoria (25 por ciento) y trastornos menstruales (14,3 por ciento). La pérdida de memoria resultó significativa cuando la infección se produjo en el tercer trimestre del embarazo, p= 0,0377. Conclusión: la infección por el virus dengue 3 es capaz de dejar secuela de pérdida de memoria en mujeres que sufrieron dengue durante el embarazo, preferentemente en el tercer trimestre de gravidez.

Introduction: dengue is an infectious disease caused by ARN genome virus and has 4 recognized serotypes (DEN-1, DEN-2, DEN-3 and DEN-4) that are transmitted by Aedes aegypti as the main vector. The clinical manifestations of dengue in pregnancy are similar to those of the general population, except that the ecosystem is made up by the mother and the fetus where the virus with its genetic characteristics is introduced and finds special conditions for development and evolution. Objective: to study the progression of the dengue symptoms in women who got sick during their pregnancy for one year of follow-up. Methods: an observational descriptive research was conducted to find out the existence of sequelae in women who were infected with dengue 3 during their pregnancy. A cohort of 28 pregnant women, who had been admitted to "Juan Bruno Zayas Alfonso" General Hospital at the time of the dengue outbreak from April to November 2006, was studied. The diagnosis was serologically confirmed. Results: after one-year of follow-up, it was observed that amnesia (25 percent) and menstrual disorders (14.3 percent) affected these women. Amnesia was significant when the infection occurred in the third trimester of pregnancy, p= 0.0377. Conclusions: dengue 3 infection may cause amnesia in pregnant women who suffered this disease, particularly in their third trimester of pregnancy.

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PURPOSE: The aim of this study was to discover if elderly patients exhibit comparable outcomes and survival benefits to those achieved in younger patients. MATERIALS AND METHODS: We assessed 35 patients over 80 years old treated by radical nephrectomy or nephroureterectomy for malignant and inflammatory conditions within the previous 4 years. A multivariate analysis regarding survival and recovery was conducted and included various preoperative parameters. The subjective opinion of patients or patient's relatives (in cases where the patient had past away) was estimated by answering the following questions: (a) are you satisfied with your decision to undergo the operation? (b) would you undergo it once more if needed? (c) would you advise it to a patient your age? RESULTS: The median age was 83.5 years. Radical nephrectomy with a flank approach was performed in 65.7 percent of cases and nephroureterectomy with a transabdominal approach in 34.3 percent of cases. The median recovery was 13 weeks. During a median follow-up of 31 months (range 12 to 53), 80 percent of patients were disease free. The remaining 20 percent passed away demonstrating a median survival of 25 months (range 13-38). Eighty-eight percent of patients were satisfied with their decision to undergo the operation, 91.4 percent would undergo it once more if needed and 91.4 percent would advise it to a patient their age. CONCLUSIONS: Radical nephrectomy and nephroureterectomy are safe and effective in well-selected patients over 80 years old. Elderly patients exhibit comparable preoperative outcomes and survival benefits to those achieved in younger patients. Various preoperative clinical variables that effect the survival of patients but not their recovery could be identified.

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RESUMO

OBJETIVO: Identificar o conhecimento disponível a respeito do processo de recuperação da criança hospitalizada e de sua família após a alta. MÉTODOS: Revisão integrativa da literatura realizada em bases de dados, de âmbito nacional e internacional, com abordagem qualitativa dos dados. RESULTADOS: Os 16 artigos selecionados pertencem a periódicos internacionais, foram publicados entre 1990 a 2005 e permitiram a identificação dos seguintes temas: Manifestações biopsicossociais da criança e da família. Fatores relacionados às manifestações biopsicossociais da criança e da família; Benefícios da alta precoce da criança e Necessidades de informação e apoio. CONCLUSÕES: As intervenções voltadas à criança e à família devem ser iniciadas ainda na hospitalização, a fim de melhorar sua capacidade de enfrentamento. Há necessidade de aprimorar as pesquisas sobre essa temática nos países em desenvolvimento incluindo a perspectiva da família como unidade.

OBJECTIVE: To identify the available knowledge about the process of recovery of hospitalized children and their families after discharge. METHODS: Integrative review of literature in databases - national and international - with a qualitative approach. RESULTS: The 16 selected articles belonging to international journals were published between 1990 and 2005; they allowed the identification of the following topics: biopsychosocial manifestations of the child and his family; Biopsychosocial factors related to the manifestations of the child and his family; benefits of early discharge of the child; and, information and support needed. CONCLUSIONS: The interventions focused on the child and his family should be started in the hospital check-in in order to improve their ability to cope with the situation. There is need to enhance research on this topic in developing countries, including the prospect of the family as a unit.

OBJETIVO: Identificar el conocimiento disponible sobre el proceso de recuperación de los niños hospitalizados y sus familias después del alta. MÉTODOS: Revisión integradora de la literatura en bases de datos nacionales e internacionales, con enfoque cualitativo de los datos. RESULTADOS: Los 16 artículos seleccionados pertenecientes a las revistas internacionales, fueron publicados entre 1990 y 2005, estos permitieron identificar los siguientes temas: manifestaciones biopsicosociales del niño y la familia; factores biopsicosociales relacionados con las manifestaciones del niño y la familia; beneficios del alta temprana del niño; y, necesidades de información y apoyo. CONCLUSIONES: Las intervenciones dirigidas al niño y la familia se deben iniciar durante la hospitalización con la finalidad de mejorar su capacidad enfrentamiento. Se concluye, que existe la necesidad de mejorar la investigación sobre este tema en los países en desarrollo, incluyendo la perspectiva de la familia como una unidad.

RESUMO

A los albores del 1800, y poco tiempo después de nuestra independencia, salíamos del período colonial, con una materia sanitaria en déficit; las instituciones asistenciales, eran muy pocas y solo controladas por órdenes religiosas. La Salud mental, solo era contemplada como anexos o patios adjuntos, en donde la cura era pre-Pineleana; por tal, 100 años de cambios de la Psiquiatría, no nos habían llegado. Con el gobierno de Rivadavia, éste espacio comienza a acortarse, y de la mano de la Sociedad de Damas de la Beneficencia, junto a la Sociedad Filantrópica, nace el cambio, a los avances Europeos, en materia de Salud Mental. El Hospicio de la Convalecencia, marcó un vuelco asistencial y una solución a la problemática social del enfermo mental; fue el símbolo de cambio e inicio de un camino que llega a nuestros días. Los enfermos mentales, por primera vez, tenían un lugar para la asistencia, bajo atentos controles médicos.

Looking forward at the beginnings of the XIX century, getting out of the colonial period and with few years as an Independent State, the sanitary was still an unsettled subject with lot of deficits. The quantities of Institutions were poor and under control of religious groups. The mental health was seen just as an attached part of something else but all the changes in the psychiatry were coming. At the Rivadavia’s government, the idea comes from, and during 1854 was founded “El Hospicio de la Convalecencia” (or women specialized mental institution) by the “Sociedad de Damas de la Beneficencia” (Ladies Charity Society) and the “Sociedad Filantrópica” (Philanthropic Society); at that times new treatments and solutions appeared and from now on the mental diseases would have an specialized place with different and permanents Doctor controls bringing a great social solution.

Assuntos

RESUMO

Incisional complications after equine midline laparotomy have an incidence of 35 to 87.5% and lead an increase in the convalescence period or to death. Predisposed factors to these complications are little approached in the equine medicine literature and consist of inherent factors to the patient, surgery, anesthesia and postoperative period. Preoperative cares, size of the incision, surgeon clothes, the choice of the suture material and equine clinical and behaviour conditions may be considered and well known in order to decrease the incisional complications after the midline laparotomy.

As complicações incisionais após laparotomia mediana em eqüinos têm prevalência de 35 a 87,5% e levam a aumento no período de convalescença ou mesmo ao óbito. Os fatores predisponentes destas complicações são pouco abordados na literatura médica eqüina e são inerentes ao paciente, ao ato cirúrgico, à anestesia e ao período pós-operatório. Considerações sobre os cuidados no pré-operatório, tamanho da incisão, roupa do cirurgião, escolha do fio cirúrgico e as condições clínicas e comportamentais do eqüino são salientadas entre os fatores predisponentes que, quando bem conhecidos, podem ser melhor administrados, no sentido de minimizar as complicações incisionais na laparotomia mediana.

RESUMO

Incisional complications after equine midline laparotomy have an incidence of 35 to 87.5% and lead an increase in the convalescence period or to death. Predisposed factors to these complications are little approached in the equine medicine literature and consist of inherent factors to the patient, surgery, anesthesia and postoperative period. Preoperative cares, size of the incision, surgeon clothes, the choice of the suture material and equine clinical and behaviour conditions may be considered and well known in order to decrease the incisional complications after the midline laparotomy.

As complicações incisionais após laparotomia mediana em eqüinos têm prevalência de 35 a 87,5% e levam a aumento no período de convalescença ou mesmo ao óbito. Os fatores predisponentes destas complicações são pouco abordados na literatura médica eqüina e são inerentes ao paciente, ao ato cirúrgico, à anestesia e ao período pós-operatório. Considerações sobre os cuidados no pré-operatório, tamanho da incisão, roupa do cirurgião, escolha do fio cirúrgico e as condições clínicas e comportamentais do eqüino são salientadas entre os fatores predisponentes que, quando bem conhecidos, podem ser melhor administrados, no sentido de minimizar as complicações incisionais na laparotomia mediana.