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

There are currently no official figures for the impact of HIV among the indigenous peoples of Mexico; and there are very few studies about it due to the exclusion that results —from certain dominant ideologies— refusing to explore and address this issue and its specificities. That is why, through ethnographic research and quantitative analysis of epidemiological data in Oaxaca, the Mexican state that has the most speakers of indigenous languages, this study documents and analyzes: a) disaggregated quantitative data on the prevalence of HIV and the rate of AIDS mortality by ethnic group; b) socio-cultural processes that lead to inequities in the prevention, detection and treatment of HIV and the AIDS mortality of this population compared to the non-indigenous one, and c) individual and collective strategies to take down the barriers hindering access to and continuation of treatment. Immunity guidelines and ethnic immunity are proposed as a theoretical-conceptual axis for the narratives and practices that are dominant in epidemiology, academia, and civil society regarding this issue, based on the acknowledgement of ethnicity as a protective factor vis-à-vis HIV.

Introduction: Healthcare workers are at high risk of COVID-19, a fact that is especially important in Peru which has one of the highest COVID-19 case fatality rates.Objective: To identify and compare the determinants of COVID-19 case fatality among healthcare workers in Peru between the first and second waves of the pandemic.Material and Methods: Secondary analysis of data from the COVID-19 Health Sector Workers Situation Room which included 95,966 confirmed cases of COVID-19 until October 21, 2021. Case fatality rate was calculated; crude and adjusted odds ratios with 95 % confidence intervals were obtained by applying binary logistic regression.Results: The results show that 65,5 % of the workers were female, aged 41,2 (S.D.=11,1) years on average. Case fatality rate was higher in the second wave. Male sex (3,49 [95 %CI=3,09–3,95] in the first wave (2,1 % [95 %CI=2,0-2,2] vs. 2,6 % [95 %CI=2,5-2,8]), and 2,65 [95 %CI=2,32–3,02] in the second wave), ≥40 years ofage (9,97 [95 %CI=8,19–12,13] in the first wave, and 10,77 [95 %CI=8,56–13,54] in the second wave), and healthcare professionals (1,14 [95 %CI=1,01–1,28] in the first wave, and 1,59 [95 %CI=1,39–1,82] in the second wave) were determinants for COVID-19 case fatality in both waves.Conclusions: COVID-19 case fatality was higher in the second wave, and was associated with individual, geographic and occupational determinants in Peruvian healthcare workers.

Introduction: The detection of SARS-CoV-2 genetic material from nasopharyngeal swab samples by RT-PCR is the most specific and sensitive way to test suspected cases. However, factors such as the sampling process, the type of hyssop used, and the anatomical area from which the sample is collected can distort the result and cause false negatives.Objective: To evaluate the reliability of CNUERO hyssops for sample collection for the SARS-CoV-2 diagnosis versus IMPROSWAB hyssops.  Material and Methods: To study the reliability of hyssops developed in Cuba for swabbing for the COVID-19 diagnosis by comparing them to other hyssops successfully used for this task, 2 swabbing samples were obtained from each patient (136). One of these two samples was taken using the hyssops made in Cuba, while the other was taken using another hyssop imported from Germany.The positive detections obtained with the use of both hyssops were compared using the Fisher’ s exact test. The result of the detection of each hyssop was evaluated and compared using the ROC curve. Results: The use of CNEURO hyssops allowed the detection of 45 out of 59 positive cases, while IMPROSAWAB hyssops detected 52 out of 59 true positive cases. There were no significant differences between positive cases detected with the use of each hyssop. The sensitivity of sample detection using CNEURO hyssops was 76,3 % while the one using IMPROSWAB hyssops was 88,1 %. Hence, there are no significant differences in the detection of cases using these two hyssops.Conclusion: CNEURO hyssops are safe and reliable to be used to take nasopharyngeal samples from COVID-19 patients.

Introducción: en la hepatitis autoinmune los mecanismos inmunopatogénicos no están totalmente esclarecidos, múltiples son las investigaciones en este campo, con vistas a enriquecer los conocimientos y ampliar las opciones terapéuticas.Objetivo: sintetizar los conocimientos más recientes acerca de la inmunopatogenia de esta enfermedad.Material y Método: se efectúa una búsqueda exhaustiva de la bibliografía disponible en SciELO, ScienceDirect, Google Académico y PubMed, incluyendo artículos de revisión, estudios experimentales, clínicos, de cohorte y metaanálisis.Desarrollo: se explican los principales mecanismos de tolerancia central y periférica, así como el papel de las subpoblaciones linfoides, las citocinas y el microambiente en la patogenia de la enfermedad.Conclusiones: los avances en el conocimiento de la inmunopatogenia de la hepatitis autoinmune permiten una mejor comprensión de esta enfermedad y son el referente para el diseño de estrategias futuras de tratamiento.

Introduction: Heterophoria is the misalignment of the ocular axes, which is compensated during binocular fixation using the fusion mechanism. It has a high prevalence in the population.Objective: To demonstrate the importance of a personalized optical correction in patients with heterophorias.Cases report: Four cases who attended an ophthalmology consultation for refraction due to asthenopic symptoms are presented. After a complete evaluation of every one of the cases, the presence of heterophoria was found in all of them. The existence of exophoria, mainly associated with insufficient convergence, was determined in three of them; and convergence excess esophoria was identified in one case. Personalized optical correction was indicated in all cases, taking into account the results of the examinations; also, the discomfort in the patients was eliminated.Conclusions: Heterophorias are a frequent cause of asthenopic symptoms. It is necessary to carry out an adequate study before indicating a refractive correction, considering the identification and quantification of phoria, evaluation of fusional vergences, the study of the near point of convergence, and the accommodation-convergence relationship.

La vida y obra de algunos hombres y mujeres de la historia de la Medicina, transita a veces, sin artilugios, acompañadas tan solo de la humildad y la sabiduría de estos. Es por ello, que al resumir en breves líneas el tiempo de enseñanzas y heroicidades de estos paradigmas, solo se cumple con el noble objetivo de exponer a las nuevas generaciones la labor realizada por maestros, como lo fue, el Dr. Netptali Taquechel Tusiente. A través de la realización de una revisión histórica de su vida y aportes y con la obtención de los datos por medio de la entrevista, el expediente laboral y académico como fuente primaria, se procesó la información. Los aportes de este internista estuvieron centrados en la especialidad de Medicina interna y en su actividad como líder del Ministerio de Salud Pública en diversos escenarios, pero el mayor de todos fue ser considerado una figura paradigmática de la salud pública. Se concluye que este médico cubano transitó de joven revolucionario y destacado estudiante a profesor de alto reconocimiento en la educación médica y figura inolvidable para todo el que lo conoció, con un merecido puesto entre los grandes de la historia de la Medicina cubana.

Introducción: La intensidad de la ventilación mecánica está reflejada por la presión de conducción dinámica y el poder mecánico. Es un predictor de lesión pulmonar inducida por el ventilador y está asociada a la mortalidad.Objetivo: Determinar si existe relación entre intensidad de la ventilación mecánica y el ΔSOFA>0 (agravamiento) en los pacientes con la COVID-19 a las 72 horas después de la intubación.Material y Método: Grupo de estudio conformado por 35 pacientes diagnosticados con la COVID-19 que estuvieron ventilados por más de 72 horas. Se empleó la prueba de Chi cuadrado (X2) o test exacto de Fisher para comparar variables cualitativas; para las cuantitativas se empleó la prueba t de Student o U de Mann-Whitney. Se realizó una Regresión Logística Binaria Simple para encontrar relación de las variables con ΔSOFA dicotomizada para ΔSOFA≤0 y ΔSOFA>0. La capacidad discriminativa de los modelos se evaluó mediante la Curva ROC.Resultados: Presentaron SOFA>0 21 pacientes (60 %). No se encontraron diferencias significativas de la Presión de Conducción entre ambos grupos (15 vs. 18, U=94.00, z= -1,795, p=0,77). Fueron buenas predictoras de ΔSOFA>0 el Poder Mecánico (OR 3,421 [95 % IC1,510 a 7,750, p=0,003]) y el Volumen Tidal (OR 1,03 [95 % IC 1,012 a 1,068], p=0,005). El Modelo Predictivo de ΔSOFA>0 en función del Poder Mecánico (AUC 0,888 [95 % IC 0,775 a 1], p<0,001) mostró una buena capacidad discriminatoria.Conclusiones: El Poder Mecánico está relacionado con el agravamiento de la disfunción multiorgánica en pacientes sometidos a ventilación mecánica por la COVID-19.

Introduction: Before cases of Covid-19 were registered in Cuba, a prevention and control plan was developed and a working group was formed to advise the Government on the confrontation of the pandemic with a crucial and cohesive participation of the community, the health workers, and the scientific community of the country.Objective: to explore the risk perception and attitudes of people residing in Havana in compliance with protection measures during Covid-19.Material and Methods: A cross-sectional descriptive study was carried out between May and July 2021 applying an online survey in Google Forms that remained online for three months and was answered voluntarily by 2 012 residents in all the municipalities of Havana that were members of population groups of interest on Telegram®, WhatsApp, and other social networks.Results: Low risk perception and non-compliance with protection measures were evidenced among the respondents.Conclusions: The low perception of population risk and non-compliance with protection measures contribute to increasing the severity of the epidemiological situation in Havana and the spread of the pandemic.

Introducción: La enfermedad de Rosai-Dorfman es una histiocitosis linfática masiva caracterizada por emperipolesis con inmunohistoquímica positiva para S100 y CD68. Es una entidad clínica rara y de curso benigno más comúnmente presentada en varones.Objetivo: El propósito de este caso clínico es demostrar el tratamiento exitoso de la enfermedad de Rosai-Dorfman con inmunomoduladores y quimioterapia metronómica.Presentación del caso: Paciente masculino de 57 años que acude por linfadenopatía cervical bilateral, a quien se le realiza tomografía y biopsia ganglionar con resultados positivos para S100 y CD68 con marcado fenómeno de emperipolesis. Recibió esquema inmunomodulador y quimioterapia metronómica exitosa con remisión de enfermedad.Conclusiones: Los pacientes diagnosticados con Rosai-Dorfman son muy pocos debido a lo inusual de esta entidad clínica. Es importante mencionar que esta enfermedad es una histiocitosis de células tipo No Langerhans con características de benignidad y buena respuesta al manejo con corticoides y quimioterapia metronómica, terapia instaurada en nuestro paciente con buena evolución.