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Introduction: Endemic coronaviruses have been found in acute bronchiolitis, mainly as a coinfecting virus. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been responsible for respiratory illness in hospitalized children. The characteristics of patients with bronchiolitis have not been extensively described. Methods: Cross-sectional study of patients with bronchiolitis and SARS-CoV-2 infection enrolled in a prospective multicenter cohort of children hospitalized with COVID-19 in Spain from March 1, 2020 to February 28, 2021. Results: Twelve of 666 children infected with SARS-CoV-2 who required hospital admission met the diagnostic criteria for bronchiolitis (1.8%). Median age was 1.9 months (range: 0.4-10.1). Six cases had household contact with a confirmed or probable COVID-19 case. Main complaints were cough (11 patients), rhinorrhea (10), difficulty breathing (8), and fever (8). Eleven cases were classified as mild or moderate and one as severe. Laboratory tests performed in seven patients did not evidence anemia, lymphopenia, or high C-reactive protein levels. Chest X-rays were performed in six children, and one case showed remarkable findings. Coinfection with metapneumovirus was detected in the patient with the most severe course; Bordetella pertussis was detected in another patient. Seven patients required oxygen therapy. Albuterol was administered in four patients. One patient was admitted to the pediatric intensive care unit. Median length of admission was 4 days (range: 3-14). No patient died or showed any sequelae at discharge. Two patients developed recurrent bronchospasms. Conclusion: SARS-CoV-2 infection does not seem to be a main trigger of severe bronchiolitis, and children with this condition should be managed according to clinical practice guidelines. Instituto de Salud Carlos III (Ministry of Economy, Industry and Competitiveness) 4.090 JCR (2021) Q1, 21/130 Pediatrics 0.927 SJR (2021) Q1, 49/320 Pediatrics, Perinatology and Child Health No data IDR 2021 UEM

Sin financiación 3.806 JCR (2021) Q3, 105/161 Inmunology No data IDR 2021 1.104 SJR (2021) Q1, 29/320 Pediatrics, Perinatology and Child Health No data IDR 2021 UEM

Background: The presence of any underlying heart condition could influence outcomes during the coronavirus disease 2019 (COVID-19). Methods: The registry HOPE-COVID-19 (Health Outcome Predictive Evaluation for COVID-19, NCT04334291) is an international ambispective study, enrolling COVID-19 patients discharged from hospital, dead or alive. Results: HOPE enrolled 2798 patients from 35 centers in 7 countries. Median age was 67 years (IQR: 53.0-78.0), and most were male (59.5%). A relevant heart disease was present in 682 (24%) cases. These were older, more frequently male, with higher overall burden of cardiovascular risk factors (hypertension, dyslipidemia, diabetes mellitus, smoking habit, obesity) and other comorbidities such renal failure, lung, cerebrovascular disease and oncologic antecedents (p < 0.01, for all). The heart cohort received more corticoids (28.9% vs. 20.4%, p < 0.001), antibiotics, but less hydroxychloroquine, antivirals or tocilizumab. Considering the epidemiologic profile, a previous heart condition was independently related with shortterm mortality in the Cox multivariate analysis (1.62; 95% CI 1.29-2.03; p < 0.001). Moreover, heart patients needed more respiratory, circulatory support, and presented more in-hospital events, such heart failure, renal failure, respiratory insufficiency, sepsis, systemic infammatory response syndrome and clinically relevant bleedings (all, p < 0.001), and mortality (39.7% vs. 15.5%; p < 0.001). Conclusions: An underlying heart disease is an adverse prognostic factor for patients suffering COVID-19. Its presence could be related with different clinical drug management and would benefit from maintaining treatment with angiotensin converting enzyme inhibitors or angiotensin receptor blockers during in-hospital stay. Fundacion Interhospitalaria para la Investigacion cardiovascular, FIC. Madrid, Spain 3.487 JCR (2021) Q2, 70/143 Cardiac & Cardiovascular Systems 0.52 SJR (2021) Q2, 163/356 Cardiology and Cardiovascular Medicine No data IDR 2021 UEM

Resumen Las enfermedades de transmisión vectorial (ETV), como dengue, zika y chikungunya, representan un problema de salud pública en Colombia. Autoridades e instituciones de salud municipales promovieron campañas de prevención y manejo de los factores asociados a estas enfermedades. No obstante, el municipio de Ocaña registró una alta prevalencia. Se realizó un análisis de contenido a 14 mensajes comunicativos impresos orientados a la prevención de enfermedades de transmisión vectorial durante el período de 2014 a junio de 2016. Las unidades de análisis comprendieron términos referidos a la enfermedad, términos generales, partes del texto (frases y oraciones) y función y objetivo de la imagen, bajo los constructos control y prevención de ETV con los códigos de vector, enfermedad y público. Se emplearon como instrumentos de recolección y análisis de datos los siguientes: instrumento de evaluación de material educativo de la OPS, instrumento específico ad-hoc para evaluación de contenido y la prueba objetiva INFLESZ. Si bien, el grado de legibilidad de las unidades comunicativas fue de 'normal' hasta 'muy fácil', se identificaron oportunidades de mejora para la comprensión e identificación del público meta, necesarios para la educación en salud, que no genere interpretaciones contrapuestas desde los aspectos semióticos y semánticos sobre conductas y comportamientos, y sobre todo, que se perciba como un mensaje que va dirigido a un público específico, con la exigencia de contextualización frente a los lineamientos generales y la participación de la comunidad. Abstract Vector-borne diseases (VTD), such as dengue, zika and chikungunya, represent a public health problem in Colombia. Municipal authorities and health institutions promoted campaigns to prevent and manage the factors associated with these diseases. However, the municipality of Ocaña registered a high prevalence. A content analysis was carried out on 14 printed communicative messages aimed at preventing vector-borne diseases during the period from 2014 to June 2016. The analysis units included terms referring to the disease, general terms, parts of the text (phrases and sentences) and function and objective of the image, under the control and prevention constructs of VTD with the vector, disease and public codes. The following instruments were used as data collection and analysis instruments: PAHO educational material evaluation instrument, ad-hoc specific instrument for content evaluation and the INFLESZ objective test. Although the legibility of the communicative units was from 'normal' to 'very easy', opportunities for improvement were identified for the understanding and identification of the target audience, necessary for health education, which does not generate conflicting interpretations from the semiotic and semantic aspects about behaviors and behaviors, and above all, that it is perceived as a message that is addressed to a specific audience, with the requirement of contextualization in front of the general guidelines and community participation.

Purpose: Although there is evidence supporting the benefits of corticosteroids in patients affected with severe coronavirus disease 2019 (COVID-19), there is little information related to their potential benefits or harm in some subgroups of patients admitted to the intensive care unit (ICU) with COVID-19. We aim to investigate to find candidate variables to guide personalized treatment with steroids in critically ill patients with COVID-19. Methods: Multicentre, observational cohort study including consecutive COVID-19 patients admitted to 55 Spanish ICUs. The primary outcome was 90-day mortality. Subsequent analyses in clinically relevant subgroups by age, ICU baseline illness severity, organ damage, laboratory findings and mechanical ventilation were performed. High doses of corticosteroids (≥ 12 mg/day equivalent dexamethasone dose), early administration of corticosteroid treatment (< 7 days since symptom onset) and long term of corticosteroids (≥ 10 days) were also investigated. Results: Between February 2020 and October 2021, 4226 patients were included. Of these, 3592 (85%) patients had received systemic corticosteroids during hospitalisation. In the propensity-adjusted multivariable analysis, the use of corticosteroids was protective for 90-day mortality in the overall population (HR 0.77 [0.65-0.92], p = 0.003) and in-hospital mortality (SHR 0.70 [0.58-0.84], p < 0.001). Significant effect modification was found after adjustment for covariates using propensity score for age (p = 0.001 interaction term), Sequential Organ Failure Assessment (SOFA) score (p = 0.014 interaction term), and mechanical ventilation (p = 0.001 interaction term). We observed a beneficial effect of corticosteroids on 90-day mortality in various patient subgroups, including those patients aged ≥ 60 years; those with higher baseline severity; and those receiving invasive mechanical ventilation at ICU admission. Early administration was associated with a higher risk of 90-day mortality in the overall population (HR 1.32 [1.14-1.53], p < 0.001). Long-term use was associated with a lower risk of 90-day mortality in the overall population (HR 0.71 [0.61-0.82], p < 0.001). No effect was found regarding the dosage of corticosteroids. Moreover, the use of corticosteroids was associated with an increased risk of nosocomial bacterial pneumonia and hyperglycaemia. Conclusion: Corticosteroid in ICU-admitted patients with COVID-19 may be administered based on age, severity, baseline inflammation, and invasive mechanical ventilation. Early administration since symptom onset may prove harmful. Instituto de Salud Carlos III de Madrid (ISCIII) (COV20/00110) Centro de Investigacion Biomedica En Red-Enfermedades Respiratorias (CIBERES) Instituto de Salud Carlos III European Commission Miguel Servet 2020: CP20/00041 Instituto de Salud Carlos III (PI19/00207) 41.787 JCR (2022) Q1, 2/35 Critical Care Medicine 4.344 SJR (2022) Q1, 2/98 Critical Care and Intensive Care Medicine No data IDR 2022 UEM

This case series describes the testing for and treatment of children with coronavirus disease 2019 (COVID-19) in Madrid, Spain. Sin financiación 16.193 JCR (2020) Q1, 1/129 Pediatrics 4.004 SJR (2020) Q1, 1/301 Pediatrics, Perinatology and Child Health No data IDR 2019 UEM

On 11 March 2020 the SARS-CoV&minus, 2 virus was officially declared a pandemic and measures were set up in various countries to avoid its spread among the population. This paper aims to analyse the perception of risk of COVID&minus, 19 infection in the Spanish population. A cross-sectional, descriptive observational study was conducted with a total of 16,372 Spanish participants. An online survey was used to gather data for 5 consecutive days over the compulsory lockdown period which was established after the state of emergency was declared. There is an association between socio-demographic variables and risk perception, and a very strong relationship between this perception and contact and direct experience with the virus in a family, social or professional setting. We also found that compared to working from home, working outside the home increased the perception of risk of infection and the perception of worsening health. Understanding the public perception of the risk of COVID&minus, 19 infection is fundamental for establishing effective prevention measures.

Sin financiación 16.193 JCR (2020) Q1, 1/129 Pediatrics 4.004 SJR (2020) Q1, 1/301 Pediatrics, Perinatology and Child Health No data IDR 2019 UEM

Summary Background To develop a prediction rule to describe the risk of death as a result of enterococcal bloodstream infection. Methods A prediction rule was developed by analysing data collected from 122 patients diagnosed with enterococcal BSI admitted to the Clinica Universidad de Navarra (Pamplona, Spain); and validated by confirming its accuracy with the data of an external population (Hospital del Mar, Barcelona). Results According to this model, independent significant predictors for the risk of death were being diabetic, have received appropriate treatment, severe prognosis of the underlying diseases, have renal failure, received solid organ transplant, malignancy, source of the bloodstream infection and be immunosuppressed. The prediction rule showed a very good calibration (Hosmer–Lemeshow statistic, P = 0.93) and discrimination for both training and testing sets (area under ROC curve = 0.84 and 0.83 respectively). Conclusions The predictive rule was able to predict risk of death as a result of enterococcal bloodstream infection as well as to identify patients, who being below the threshold value, will have a low risk of death with a negative predictive value of 96%.

La transmisión e incidencia del virus del dengue ha aumentado de manera importante en las tres últimas décadas, por lo cual se considera actualmente la enfermedad infecciosa re-emergente que genera mayor morbilidad y mortalidad en el mundo. Objetivo: Observar el comportamiento del dengue no complicado en los últimos cuatro años en Santander, Colombia. MetodologÍa: Se realizó un estudio analÍtico con datos secundarios de dengue no complicado en Santander, entre el año 2007 y el 2015. Se calculó la incidencia por semana epidemiológica y se construyeron canales endémicos de los años 2012 al 2015 mediante logaritmo en base 10, con media geométrica e intervalos de confianza del 95%. La investigación se clasificó como sin riesgo según la Ley 8430 de 1993 de la República de Colombia. Resultados: El Sistema Nacional de Vigilancia en Salud Pública (SIVIGILA) reportó 26,849 casos de dengue no grave en Santander entre el año 2007 y el 2015. Los puntos de corte (éxito, seguridad, riesgo y epidemia) varÍan para las diferentes zonas, con diferencias estadÍsticamente significativas con picos de incidencia de 4.2 (en el 2007), 2.9 (en el año 2010), 8.1 (entre el 2013 y 2014) por cada 100,000 habitantes. Conclusiones: Los canales endémicos de dengue se deben tener en cuenta junto con el impacto de la incidencia calculada para monitoreo de la enfermedad. Según la tendencia secular cada 3 a 4 años se presenta un pico de incidencia, por lo que es probable que en el 2016 se presente un nuevo pico de dengue incluso mayor a los registrados hasta el momento en Santander. Se requieren estrategias medidas e inmediatas para el control de la enfermedad. [Serrano-Gómez SE, De-Montijo C, Rey-Serrano JJ. Comportamiento del dengue no grave en los últimos cuatro años en Santander, Colombia. MedUNAB 2015; 18 (2): 107-115] Transmission and incidence of dengue virus have greatly increased during the last three decades which is the reason why it is currently considered the most emergent infectious disease that causes morbidity and mortality around the world. Objective: Observe simple dengue behavior in the last four years in Santander, Colombia. Method: An analytical study based on secondary data of simple dengue in Santander was performed between the years 2007 and 2015. The weekly epidemiological incidence was calculated and endemic channels between the years of 2012 and 2015 were built using logarithm base 10 with geometric mean and confidence intervals of 95%. The investigation was classified as non-risky according to Law 8430 of 1993, Republic of Colombia. Results: The National Service of Public Health Surveillance (SIVIGILA) reported 26.849 cases of simple dengue in Santander between the years of 2007 and 2015. The cutoff points (success, security, risk, and epidemic) vary in different zones, with significant statistically differences of 4.2 (in 2007), 2.9 (in 2010), and 8.1 (between 2013 and 2014) for each 100.000 inhabitants. Conclusions: The endemic channels of dengue must be taken into account as well as the impact of calculated incidence for monitoring the disease. According to the secular trend, every 3 to 4 years, there is a peak incidence. It is possible that in 2016 a new and bigger peak incidence of dengue will take place in Santander. It is therefore necessary to consider strategies and immediate measures to control this disease. [Serrano-Gómez SE, De-Montijo C, Rey-Serrano JJ. Behavior of simple dengue during the last four years in Santander, Colombia. MedUNAB 2015; 18(2):107-115]

In order to explore rationally the medical potential of the plant biodiversity of the Central and South American region as a source of novel antiparasitic molecules, a multinational Organization of American States (OAS) project, which included the participation of multidisciplinary research centers from Argentina, Bolivia, Colombia, Costa Rica, Guatemala, Nicaragua and Panama, was carried out during the period 2001-2004. This project aimed at screening organic plant extracts for antitrypanosomal, antileishmanial and antimalarial activities and subsequently isolating and characterizing bioactive molecules. Plants for antiparasitic screening were selected from a database of ethnomedical uses of Latin American plants (PlanMedia) based on the amount of biological and chemical information available in the literature. We report here the evaluation of 452 extracts from 311 plant species in vitro screens against Plasmodium falciparum, Leishmania mexicana, and Trypanosoma cruzi. Out of 311 species tested, 17 plants (5.4%) showed antiparasitic activities at IC50 values ≤ 10 µg/mL. The most active plants were Acnistus arborescens (L.) Schltdl. (Solanaceae) (leaf, EtOH, IC50: 4 µg/mL) Monochaetum myrtoideum Naudin (Melastomataceae) (leaf, MeOH, IC50: 5 µg/mL) and Bourreria huanita (Lex.) Hemsl. (Boraginaceae) (branch, EtOH, IC50: 6 µg/mL). These were selectively active against P. falciparum, L. mexicana and T. cruzi, respectively. UCR::Vicerrectoría de Docencia::Ciencias Básicas::Facultad de Ciencias::Escuela de Química

La planeación adecuada de una investigación en ciencias de la salud es necesaria para determinar la información que debe ser recolectada y que permitirá lograr los objetivos del estudio. Esta información conforma el grupo de variables que permiten, a su vez, realizar una aproximación a priori a la metodología de análisis de los datos. Este artículo académico busca aclarar la terminología empleada al hablar de variables y mostrar una forma sencilla de su presentación en un protocolo o proyecto de investigación.[ Castro-Jiménez MA, DÍaz-MartÍnez LA. Las variables en el proceso de investigación en salud: importancia, clasificación y forma de presentación en protocolos de investigación. MedUNAB2009; 12: 151-156 ]. Proper planning of an investigation in the health sciences is necessary to determine the information that must be collected and that will allow to achieve the objectives of the study. This information makes up the group of variables that allow, in turn, to make an a priori approach to the data analysis methodology. This academic article seeks to clarify the terminology used when talking about variables and show a simple way of presenting them in a protocol or research project. [Castro-Jiménez MA, DÍaz-MartÍnez LA. Variables in the health research process: importance, classification, and form of presentation in research protocols. MedUNAB2009; 12: 151-156].