Sistema Regional de Información
en línea para Revistas Científicas de América Latina,
el Caribe, España y Portugal

INTRODUCTION: Due to the rapid global expansion of COVID-19, Febrile Emergency Units (FEU) were created in the outpatient setting to stratify the clinical risk of patients. Pulmonary ultrasound has gained a growing interest as a sensitive method for the detection of pneumonia. This study aimed to at developing a simple and sensitive score to assess the risk of pneumonia during the first COVID-19 wave. METHODS: A cross-sectional study was conducted in a cohort of adult patients with laboratory-confirmed COVID-19, who received care at the FEU of a general hospital in the city of Buenos Aires from May through August 2020. Bivariate and multivariate analyses of sociodemographic and clinical variables were performed to build and internally validate a pneumonia predictive score. RESULTS: The final analysis included 936 patients; 17.6% had ultrasound compatible with pneumonia. The score included 5 statistically significant variables: age ≥50 years (3 points), cough (2 points), absence of odynophagia (1 point), dyspnea (2 points) and oxygen saturation ≤95% (3 points). A cut-off point ≥3 showed a sensitivity of 80.5% and a negative predictive value of 93.3%, with good discriminatory capacity both in derivation and validation cohorts (area under ROC curve 0.79 and 0.76, respectively). DISCUSSION: This score could be a useful tool to stratify the clinical risk of pneumonia in the pre-hospital setting and avoid imaging studies with a score <3. 

INTRODUCTION: Cannabidiol (CBD), a derivative of the cannabis plant, is authorized as a medicinal product for sale in Argentina and other countries for the treatment of drug-resistant epilepsy. Other potential indications are under study. METHODS: A health technology assessment was conducted for CONETEC (National Commission for Health Technology Assessment), analyzing CBD for drug-resistant epilepsy in Argentina. RESULTS: Legal, regulatory and economic aspects are described as well as the available evidence on efficacy and safety in epilepsy, and the budget impact. DISCUSSION: The assessment highlights a series of challenges for the Argentine health system, related to the CBD market for epilepsy, its size, the different actors, and their behavior. Inquiries are made about cost structure and profit margins, mentioning some strategies that were put into practice by the pharmaceutical industry in Argentina and other countries. The impact of competition on prices is discussed, and potential State tools for price regulation like the use of international reference prices, health technology assessment and joint purchases, as well as articulation with national producers and international actors are described.

Se presenta una descripción narrativa de los apspectos de la vida académica y personal del Dr. Fernando José Andarde Narváez, como investigador de la leishmaniosis en la Universidad Autónoma de Yucatán.

Introducción: Las mediciones antropométricas (MA) forman parte de la valoración clínica. Objetivo: Comparar las MA realizadas por pasantes de enfermería (PLE), nutrición (PLN), médicos internos de pregrado (MIP) y un evaluador certificado (GS). Métodos: Diseño descriptivo de corte transversal; se compararon las mediciones del peso, talla y circunferencia de cintura (CC); diagnósticos por índice de masa corporal (IMC) y CC, realizadas por PLE, PLN, MIP y un GS. Se evaluaron sujetos con ≥ 18 años; se excluyeron aquellos con IMC ≥ 40 Kg/m2, edema o ascitis, dificultad para mantenerse de pie, malformaciones y embarazadas. Se utilizó la prueba Shapiro-Wilk, ANOVA de un factor y T de Dunnett post hoc, Coeficiente de Correlación Intraclase e Índice Kappa. Resultados: No hubo diferencias significativas en los valores medios de las mediciones entre los evaluadores. Se observaron concordancias cuantitativas casi perfectas entre los estudiantes y el GS para el peso y la talla (CCI=0.9992-0.9995, IC95%=0.9850-0.9999; -1.8 a 0.1 kg y -4.7 a 3.7 cm), pero menores para la CC (CCI=0.8986-0.9436, IC95%=0.8247-0.9683; -16.6 a 9.7 cm). Se observó una concordancia cualitativa del IMC de los MIP, PLE y PLN (K=0.68-0.71, IC95%=0.59-0.79); casi perfecta de acuerdo con la CC de los MIP (K=0.86, IC95%=0.72-1), considerable con la de los PLN y PLE (K=0.65-0.78, IC95%=0.44- 0.96), cuando se compararon con el GS. Conclusión: Los PLN presentaron mayor concordancia cuantitativa con el GS. Se observó una mayor concordancia cualitativa de los PLN para el IMC y de los MIP para la CC, en comparación con el GS.Introduction: Anthropometric measurements (AM) are part of the clinical assessment. Objective: To compare AM made by nursing interns (NI), nutrition (NUI), undergraduate interns medical (UIM), and a certified evaluator (GS). Methods: Descriptive cross-sectional design; weight, height and waist circumference (WC) measurements were compared; diagnoses by body mass index (BMI) and WC, carried out by NI, NUI, UIM and GS. Subjects aged ≥ 18 years were evaluated; those with BMI ≥ 40 Kg / m2, edema or ascites, difficulty in standing, malformations and pregnant women were excluded. The Shapiro-Wilk test, one-way ANOVA and post hoc Dunnett's T, Intraclass Correlation Coefficient and Kappa Index were used. Results: There were no significant differences in the mean values of the measurements between the evaluators. Almost perfect quantitative concordances were observed between the students and the GS for weight and height (ICC=0.9992-0.9995, CI95%=0.9850-0.9999; -1.8 to 0.1 kg and -4.7 to 3.7 cm), but lower for the WC (ICC=0.8986-0.9436, CI95%=0.8247-0.9683; -16.6 to 9.7 cm). Qualitative agreement was observed for the BMI of the UIM, NUI and NI (K=0.68-0.71, CI95%= 0.59-0.79); almost perfect according to the WC of the UIM (K=0.86, CI95%=0.72-1), considerable with that of the NUI and NI (K=0.65-0.78, CI95%=0.44- 0.96), when compared with the GS. Conclusion: The NUI presented greater quantitative agreement with the GS. A higher qualitative concordance of NUI for BMI and UIM for WC was observed, compared to GS.

Las translocaciones robertsonianas se producen por la fusión de los brazos largos de dos cromosomas acrocéntricos y son frecuentes en los seres humanos. Sin embargo, su presencia puede no ser detectada en el fenotipo. Sólo se sospechan cuando los portadores tienen problemas de fertilidad, aunque no sucede en todos los casos.  El conocimiento de la presencia de dichas translocaciones es relevante para los médicos tratantes y parejas que desean una familia sin saber que son portadores. Ya que su descendencia puede heredar la translocación robertsoniana y ser portadora o tener desbalance cromosómico lo que genera un fenotipo clínico. Se realizó una revisión descriptiva de la literatura, con el objetivo de proporcionar a los profesionales de la salud la información sobre los últimos avances referentes a las translocaciones robertsonianas, así como dar una introducción accesible al tema. Se buscó información de 2014 a 2020, en bases de datos de artículos científicos. Se encontraron 254 referencias y seleccionaron 47. Se identificaron cuatro énfasis de estudio: las translocaciones y su efecto en la fertilidad, las translocaciones como causa de malformaciones congénitas, la importancia y utilidad del diagnóstico pre-implantación, y el efecto de las translocaciones en la población desde un enfoque estadístico. Los artículos publicados relacionados con la detección de estas translocaciones en individuos con un historial familiar de abortos espontáneos fueron los más numerosos. Se pone de manifiesto la necesidad de hacer una difusión más amplia sobre la identificación e implicaciones de las translocaciones robertsonianas, para el manejo oportuno de los afectados.

Las células presentadoras de antígeno, como los macrófagos y las células dendríticas, desencadenan vías de señalización que generan diversas moléculas efectoras importantes para la regulación de la respuesta inmune. En la leishmaniasis, el parásito Leishmania interrumpe diversas vías de señalización para manipular la respuesta inmune del hospedero con la finalidad de evitar ser eliminado y poder establecer una infección. Se ha descrito en muchos reportes que diferentes especies de Leishmania regulan dichas vías de señalización de manera diferencial. Por lo tanto, el objetivo del presente trabajo era hacer una revisión bibliográfica descriptiva para analizar cómo diferentes especies de Leishmania modulan la señalización del hospedero mamífero por la vía canónica y no canónica de la activación del inflamasoma. También se examina tanto el papel de la IL-1β y los polimorfismos del gen de IL-1β en la leishmaniasis como la manera en que algunos fármacos antileishmanicidas modulan el inflamasoma. Las bases de datos que se utilizaron para buscar artículos relevantes fueron Pubmed, Science Direct, y Clinical Key.

Oscar Velasco Castrejón, nació en Cihuatlán, Jalisco el 8 de agosto de 1938, falleció en la ciudad de México a la edad de 82 años, el 4 de agosto de 2021.  Desde pequeño gustaba mucho de la lectura. Pasaba horas enteras leyendo todo tipo de libros tal vez, decía él, para poder impresionar a su amor platónico de la niñez. Un hábito que practicó toda su vida y lo hizo conocedor de temas muy diversos. Se casó con Cecilia, sociología y catedrática de la UNAM con quien tuvo a sus tres hijas de las que estaba muy orgulloso

INTRODUCTION: The COVID-19 pandemic produced a reorganization of health systems and, in particular, affected the provision of services for people with psychosocial disabilities in a way that was pending an analysis in Argentina. The objective was to characterize the effects of the COVID-19 pandemic on services aimed at people with psychosocial disabilities in the cities of Rosario (Santa Fe), Resistencia (Chaco) and the Metropolitan Area of Buenos Aires from the perspective of their workers during 2020-2021. METHODS: An exploratory and descriptive study was carried out by interviewing 53 workers from three types of rehabilitation services (aimed at providing support for socialization, for work or for housing) in two moments (November-December 2020 and April-June 2021). Frequencies were calculated and a thematic analysis was performed. RESULTS: The impact on services was broad and long-lasting, they became less accessible and effective in contributing to rehabilitation. Common aspects such as the new centrality of technology, massive adaptations and deep subjective impact on workers marked by fatigue were observed. Within a year of the pandemic, two-thirds of socialization-oriented services were still severely affected or closed. DISCUSSION: From the description and analysis of how the rehabilitation services were affected, the question remains regarding their future and how the mental health reform will unfold.  

INTRODUCTION: One of the problems faced by the health system in different countries due to COVID-19 pandemic is the availability of medical care services in intensive care units (ICU). The objective was to evaluate survival in patients hospitalized for COVID-19 in the ICUs during the period January-April 2021 in the province of Buenos Aires. METHODS: Patients included in the surveillance system who had their correlate of information on percentage of bed occupancy in the ICUs from the general system were considered. With this information, a survival analysis was performed, considering life tables, Kaplan-Meier and Cox regression. The event was death, the 96-day follow-up and the dates of admission, death and discharge within the ICUs as individual periods for each patient. Inpatient capacity of the ICUs was measured through the percentage of bed occupancy at the time of admission. RESULTS: The ICUs with a bed occupancy greater than 80% showed patients with a lower survival curve than those below that figure at the time of admission. DISCUSSION: The differences in average survival were statistically significant, and show two different survival curves at the time the second wave of COVID-19 affected the country.  

INTRODUCTION: Hospital department cost systems allow to evaluate resource use efficiency and are the foundation for comparative studies between patient groups with differential characteristics. Neonatal admission of low birth weight children is of particular interest due to its complexity and high cost. The objective was to estimate the direct costs of hospitalization day in Penna Interzonal Hospital, considering neonatal patients with weight at admission less than or equal to 1500 grams in 2019. METHODS: A retrospective study was carried out using data collected from the neonatology, purchasing and personnel departments of the Hospital. The average cost per hospitalization day and discharge in the department as a whole and in newborns weighing less than 1500 grams was estimated. RESULTS: The study was carried out on 489 discharged patients. The average direct cost per hospitalization day was ARS 17,755. For the group ≤ 1500 grams, the average days of hospitalization was 55.9 and the average cost per discharge was ARS 992,191. For the group weighing ≤ 1000 grams, it was 80.6 days and ARS 1,430,229, respectively. A strong impact of low birth weight on costs was evidenced - 8% of neonatal patients discharged alive generate 33% of the costs of the neonatal hospitalization process. DISCUSSION: It is important to carry out cost studies per hospital department, especially by groups of cases, in order to generate useful information for decision-making.