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To inform future policies, the study objectives were to determine to what extent the policies included in the 5-year Plan of Action for the Prevention of Obesity in Children and Adolescents-proposed by Pan American Health Organization (PAHO) and signed by 19 Latin America countries in 2014-have been implemented and evaluated.A scoping review of the Governmental websites for Latin American countries and a literature review was conducted to identify whether policies have been implemented and evaluated. Key information was abstracted.The review identified 115 PAHO policies/interventions implemented (43% implemented after signing the proposed plan in 2014). Nearly all (18/19) countries implemented food guidelines or school feeding programs, but fiscal and marketing policies were less commonly implemented (6/19). Through the review, 44 evaluations of PAHO policies were identified of which 23% were qualitative and 77% quantitative. The results of these evaluations were in general positive (e.g., decrease in sugar-sweetened beverages consumption following tax implementation) but no studies evaluated the outcome of reduced obesity.PAHO recommended policies have been implemented to various degrees in Latin America since 2014 and more research is required to understand their impacts on child and adolescent obesity.

La indicación farmacéutica es un servicio de Atención Farmacéutica realizado en las farmacias de comunidad de Costa Rica. Este artículo posee como objetivo elaborar un procedimiento de indicación farmacéutica en quimioterapia preventiva de personas con parasitosis intestinales, principalmente, geohelmintiasis. Se dirige a farmacéuticos de comunidad costarricenses que promuevan el uso efectivo y seguro de los antiparasitarios, y se adecúa a los lineamientos de la Organización Panamericana de la Salud (OPS). Con relación a la metodología se llevó a cabo una revisión bibliográfica del 2005 al 2021. La estrategia de búsqueda consistió en una revisión de fuentes prefiltradas de evidencia en parasitosis intestinales, guías de atención farmacéutica e indicación farmacéutica, libros de infectología, bases de datos de evidencia científica y bases de datos de medicamentos. La información recolectada permitió la elaboración del procedimiento de indicación farmacéutica en quimioterapia preventiva. Este procedimiento pretende ser una herramienta de utilidad para el farmacéutico costarricense con el objetivo de contribuir en este servicio profesional y el uso racional de los medicamentos antiparasitarios. En conclusión, la farmacia de comunidad, como centro de atención primaria en salud, debe contar con procedimientos de trabajo, destacando a la indicación farmacéutica en quimioterapia preventiva y este procedimiento es un aporte relevante. The minor ailments service is a pharmaceutical service that takes place in the community pharmacies of Costa Rica. The objective in this article is to development a minor ailments procedure on preventive chemotherapy in people with intestinal parasitosis, mainly, soil-transmitted helminth infections. It is focused on pharmacists from community pharmacies of Costa Rica that promote the effectiveness and safety use of antiparasitic agents. To make this objective, the literature was reviewed from 2005 until 2021. The search strategy consisted of a review of pre-filtered sources of evidence in intestinal parasitosis, pharmaceutical care and minor ailments guidelines, infectious disease books, databases of scientific evidence and drug databases. The information collected allowed the elaboration of the procedure of minor ailments service in people with intestinal parasitosis based on the guidelines of massive chemotherapy recommendations for the control of soil-transmitted helminth infections of the Pan American Health Organization. This procedure aims to be a useful strategy for the Costa Rican pharmacists that contributes with this pharmaceutical service and the rational use of antiparasitic agents. In conclusion, the community pharmacy, as a primary health care center, must have standard operating procedures, highlighting the preventive chemotherapy and this procedure is a relevant contribution. UCR::Vicerrectoría de Investigación::Unidades de Investigación::Ciencias de la Salud::Instituto de Investigaciones Farmacéuticas (INIFAR) UCR::Vicerrectoría de Docencia::Salud::Facultad de Farmacia

In order to achieve the Sustainable Development and Health Goals, it is essential to increase the technological capacity of the most disadvantaged populations. In the 21st century, the necessary technologies for this exist. The gap in technological capacity reflects the existence of a technological gradient between large- and small-scale production, due to an absence of incentives for innovation and a lack of technological dissemination in small businesses and communities. Technological change is central to development, but it is a public good that the market economy does not provide efficiently. Providing it requires the implementation of public policies aimed at technological innovation and dissemination. Reducing the technological gradient is therefore a major part of the United Nations 2030 Agenda for Sustainable Development and the Pan American Health Organization's 2018-2030 Sustainable Health Agenda for the Americas. This also applies to the development of health systems, which function as a redistribution mechanism to break poverty traps. In addition, experiences in these systems are relevant to the implementation of policies that increase technological capacities aimed at reducing poverty, improving social determinants of health, and thereby reducing the scale of the human development trap.Para lograr los objetivos de desarrollo y salud sostenibles, es esencial incrementar las capacidades tecnológicas de las poblaciones más desfavorecidas. Entrado el siglo XXI, existen las tecnologías necesarias para ello. El déficit en capacidades tecnológicas se debe a la existencia de un gradiente tecnológico entre la producción de gran y de pequeña escalas, debido a la falta de incentivos para la innovación y la difusión en empresas y comunidades pequeñas. En estos ámbitos el cambio tecnológico, punto medular del desarrollo, es un bien público que la economía de mercado no provee eficientemente. Su provisión requiere la aplicación de políticas públicas de innovación y difusión tecnológicas. La reducción del gradiente tecnológico constituye, pues, parte medular de la Agenda 2030 para el Desarrollo Sostenible, de las Naciones Unidas, y la Agenda de Salud Sostenible para las Américas 2018-2030, de la Organización Panamericana de la Salud. Esto es aplicable, así mismo, al desarrollo de los sistemas de salud, que funcionan también como mecanismos de redistribución para romper las trampas de pobreza. Asimismo, las experiencias en esos sistemas tienen relevancia para aplicar políticas de incremento de capacidades tecnológicas que disminuyan la pobreza, mejoren los determinantes sociales de la salud y, con ello, reduzcan la magnitud de la trampa de desarrollo humano.Para alcançar os objetivos de desenvolvimento e saúde sustentáveis, é fundamental aumentar a capacidade tecnológica das populações mais desfavorecidas. Com a entrada do século XXI, há tecnologias necessárias para isso. O déficit em capacidade tecnológica decorre de um gradiente tecnológico entre a produção em pequena e larga escala pela falta de incentivos à inovação e difusão em empresas e comunidades pequenas. Nestas esferas, a evolução tecnológica, que é o eixo do desenvolvimento, é um bem público que não é provido de forma eficiente pela economia de mercado. Políticas públicas de inovação e difusão tecnológicas são necessárias. Diminuir o gradiente tecnológico constitui, portanto, a base da Agenda 2030 para o Desenvolvimento Sustentável, da Agenda das Nações Unidas e da Agenda de Saúde Sustentável para as Américas 2018-2030 da Organização Pan-Americana da Saúde. Requer também o desenvolvimento dos sistemas de saúde que servem como mecanismos de redistribuição para romper com as armadilhas da pobreza. Ademais, a experiência adquirida nesses sistemas é indispensável para instituir políticas de aumento da capacidade tecnológica que diminuam a pobreza, melhorem os determinantes sociais da saúde e, assim, reduzam a dimensão da armadilha do desenvolvimento humano.

The Health Sciences Descriptors (DeCS) vocabulary establishes a unique and common language that allows the organization and facilitates the search and retrieval of technical and scientific literature on health available in the information sources of the Virtual Health Library. The DeCS, created by the Latin American and Caribbean Center on Health Sciences Information (BIREME), a specialized center of the Pan American Health Organization/World Health Organization (PAHO/WHO), is the translation and extension of the Medical Subject Headings (MeSH) vocabulary, maintained by the United States National Library of Medicine. BIREME, in coordination with experts from Latin America and the Caribbean, has included in the DeCS the topics of equity, gender, ethnicity and human rights-cross-cutting themes in the programmatic framework of PAHO/WHO technical cooperation-to ensure better retrieval and use of scientific information and evidence related to these topics. The objective of this article is to describe the methodology used during the terminology review of the DeCS and to report the results obtained and the impacts of the terminology expansion in the field of equity, which included the inclusion of 35 new descriptors.El vocabulario Descriptores en Ciencias de la Salud (DeCS) establece un lenguaje único y común que permite la organización y facilita la búsqueda y recuperación de la literatura técnica y científica en salud disponible en las fuentes de información de la Biblioteca Virtual en Salud. El DeCS, creado por el Centro Latinoamericano y del Caribe de Información en Ciencias de la Salud (BIREME), un centro especializado de la Organización Panamericana de la Salud/Organización Mundial de la Salud (OPS/OMS), es la traducción y la extensión del vocabulario Medical Subject Headings (MeSH), mantenido por la National Library of Medicine de los Estados Unidos. BIREME, en coordinación con expertos de América Latina y el Caribe, ha incluido en el DeCS los temas de equidad, género, etnicidad y derechos humanos —temas transversales en el marco programático de la cooperación técnica de la OPS/OMS— para garantizar una mejor recuperación y uso de la información y evidencia científica relacionadas a estos temas. El objetivo de este artículo es describir el método de revisión terminológica del DeCS e informar los resultados obtenidos y los impactos de la ampliación terminológica en el área de equidad, que comprendió la inclusión de 35 nuevos descriptores.

Nutrient profiling (NP) is a growing issue in Turkey. We aimed to assess two different NP models (the Health Star Rating (HSR) and Pan American Health Organization models (PAHO)) based on the conte...

Introducción: la República Dominicana es un país en vías de desarrollo, por lo que la prevención y llegar a tiempo juegan un papel fundamental en el manejo de las enfermedades. La Organización Panamericana de la Salud advirtió que el crecimiento de la Diabetes Mellitus está tomando proporciones epidémicas. Las personas con DM tipo 1 pueden desarrollar nefropatía en un 15 % y aquellos con DM tipo 2 entre 20-40 %. Materiales y métodos: se realizó un estudio observacional-descriptivo y transversal. Se tomaron pacientes mayores de 18 años del centro de atención primaria del Hospital General de la Plaza de la Salud (HGPS), con diagnóstico de DM tipo 2 en el periodo febrero-marzo 2019. Se determinó el riesgo pronóstico y diagnóstico para el desarrollo de ND, por la detección de la tasa de filtrado glomerular y biomarcadores por espectrometría de masa con aplicación de un algoritmo matemático diseñado para la predicción y diagnóstico de ND. Resultados: se incluyeron 92 pacientes con un tiempo de evolución de DM2 menor de 10 años. Se determinó una especificidad de 70.59 % y una sensibilidad de 100 % de esta prueba en la población dominicana. Conclusión: este tipo de pruebas tienen gran peso para la prevención del desarrollo de ND en pacientes que padecen DM2.

Currently, there are vaccines with proven efficacy and safety in the mother-child binomial, such as the anti-influenza, anti-diphtheria, anti-tetanus, and acellular anti-pertussis vaccines. The most effective method in the control of epidemics and pandemics is vaccination, especially in priority groups that could have serious and complicated manifestations of the disease such as pregnant women. Currently, there are candidates for COVID-19 vaccines with different platforms: mRNA, non-replicative adenovirus vectors, DNA, inactivated whole virus, and protein subunits, among others. The Health Organization (WHO), the Centers for Disease Control (CDC), the American College of Obstetrics and Gynecology of the United States, and the National Academy of Medicine of Venezuela have pronounced on the subject and agree that pregnant and lactating women should be included in the priority group in the immunization plans of the countries, with the COVID-19 vaccines approved in that population group. © 2021 Academia Nacional de Medicina. All rights reserved.

The review reflects the theoretical preconditions explaining the importance of iodine for flora and fauna, its participation in the synthesis of thyroid hormones and in body metabolic processes by these hormones and due to their insufficiency — in the occurrence of iodine-dependent diseases. In addition to the participation of this trace element in the synthesis of thyroid hormones, the extrathyroid action of iodine is considered. Antioxidant, antimicrobial and antitumor effects of iodine are show in a number of publications. The data on the results of long-term mass epidemiological studies of the scientists of the Department of Epidemiology of Endocrine Diseases of State Institution «V.P. Komisarenko Institute of Endocrinology and Metabolism of NAMS of Ukraine» (hereinafter — the Institute), are aimed to study the iodine supply of the Ukrainian population, and clinical observations. The most important results of the researches received during performance of scientific subjects of the Institute are elucidated. The negative impact of iodine deficiency on pregnancy, thestatus of pregnant women and newborns is shown. Data on disorders of physical and intellectual development of children with insufficient iodine supply are given. A significant number of these studies were supported by the National Academy of Medical Sciences of Ukraine and the Ministry of Health of Ukraine, international organizations: World Health Organization, United Nations Children’s Fund in Ukraine, and the Centers for Disease Control and Prevention (USA). For almost 20 years, the latter has been monitoring the quality of research on one of the most important indicators of iodine status — ioduria in thepopulation of Ukraine. On the example of other countries, the need and permanence of continuous prevention of iodine-dependent diseases is indicated. The article was prepared as a scientific information material for the public and the authorities of Ukraine in connection with the need for a legislative solution to the problem of prevention of iodine-dependent diseases in Ukraine.

Introduction A patient safety culture (PSC) is a complex phenomenon, representing an essential part of the organizational culture and refers to the shared values, conceptions and beliefs which contribute to the formation and encouragement of safe behavioural models in a health organization. With this study, the authors wanted to delineate the attitude of hospital staff in Bulgaria regarding PSC and to document to whether attitudes differ between physicians and other healthcare professionals (HCPs). Methods A national cross-sectional survey among 384 HCPs was conducted using an online version of the Bulgarian version of Hospital Survey on Patient Safety Culture (B-HSOPSC). The data was analysed with descriptive statistics, non-parametric Mann-Whitney U and x 2 tests. Results The physicians represented 37.50% (144) of the sample and other HCPs 62.50% (240). Respondents from governmental/municipal hospitals prevailed (53.6%). The dimensions “Staffing” and “Non-punitive response to error” were most problematic, as their percentage of positive response rates (PRRs) were lowest. However, “Handoffs and transitions” and “Supervisor/manager expectations and actions promoting safety“ showed the highest mean values in both physicians and other HCPs. From all participants, 76.0% have never reported an adverse event or error. Conclusion The results of the study show that all respondents demonstrate a positive attitude regarding PSC. A comparison of the mean values and that of PRRs in the dimensions did not show any group differences, according to the type of staff position, i.e. physicians or other HCPs.

Nowadays one of the main agents morbidity and mortality, in worldwide, is exposure to air pollution. Based on reported health organization, air pollution is the second most important factor in nonc...

Construct and evaluate the care cascade for pulmonary tuberculosis in the indigenous population of the department of Cauca (Colombia) and identify existing gaps.Mixed-methods sequential explanatory design. In the first phase, the pulmonary tuberculosis care cascade for the indigenous population of Cauca was evaluated. Data were obtained from secondary sources and all cases diagnosed from 1 January 2016 to 31 December 2017 were included. In the second phase, semi-structured interviews were done with nine program coordinators and 11 nursing auxiliaries to explain identified gaps. Absolute and percentage values were estimated for each of the steps and gaps in the care cascade. Quantitative and qualitative results were triangulated.In 2016 and 2017, an estimated 202 patients with respiratory symptoms were expected to be positive and 106 cases of pulmonary tuberculosis were reported among the indigenous population of the department of Cauca. A gap of 47.5% was found for diagnosis, since only 52.5% of subjects were diagnosed in health services. This gap was explained by poor quality of samples and flawed smear techniques; flaws in correct identification of patients with respiratory symptoms; limited access to diagnostic methods, such as culture and molecular tests; and limited training and high turnover of personnel in health service provider institutions.The tuberculosis control program should focus actions on bridging the gap in case detection in the indigenous population.Construir y evaluar la cascada de atención de la tuberculosis pulmonar en la población indígena del departamento del Cauca (Colombia) e identificar las brechas existentes.Metodología mixta con diseño secuencial explicativo. En la primera fase se evaluó la cascada de atención de la tuberculosis pulmonar para la población indígena del Cauca. Se obtuvieron datos de fuentes secundarias y se incluyeron todos los casos diagnosticados entre el 1 de enero del 2016 y el 31 de diciembre de 2017. En la segunda fase, se aplicaron entrevistas semiestructuradas a nueve coordinadores de programa y 11 auxiliares de enfermería para explicar las brechas identificadas. Se estimaron los valores absolutos y porcentuales en cada uno de los pasos y las brechas de la cascada de atención. Se triangularon los resultados cuantitativos y cualitativos.Durante 2016 y 2017 se estimaron 202 sintomáticos respiratorios esperados positivos y se notificaron 106 casos de tuberculosis pulmonar en la población indígena del departamento del Cauca. Se encontró una brecha de 47,5% para el diagnóstico, ya que solo 52,5% de los sujetos recibieron el diagnóstico en los servicios de salud. Las explicaciones a esta brecha fueron la mala calidad de muestras y fallas en la técnica del extendido, fallas en la correcta identificación del sintomático respiratorio, acceso limitado a métodos diagnósticos como cultivo y pruebas moleculares, así como capacitación escasa y rotación alta de personal al interior de las instituciones prestadoras de servicios de salud.Las acciones del programa de control de tuberculosis deben enfocarse en reducir la brecha de detección de casos en la población indígena.Elaborar e avaliar a cascata de atenção da tuberculose pulmonar na população indígena do Departamento de Cauca (Colômbia) e identificar as lacunas existentes.Metodologia mista com desenho sequencial explicativo. Na primeira fase, avaliamos a cascata de atenção da tuberculose pulmonar para a população indígena de Cauca. Os dados foram obtidos de fontes secundárias, incluindo todos os casos diagnosticados entre 1 de janeiro de 2016 e 31 de dezembro de 2017. Na segunda fase, realizamos entrevistas semiestruturadas com nove coordenadores do programa e 11 auxiliares de enfermagem para explicar as lacunas identificadas. Estimamos os valores absolutos e percentuais em cada uma das etapas e as lacunas na cascata de atenção. Os resultados quantitativos e qualitativos foram triangulados.Nos anos de 2016 e 2017, foi estimada a ocorrência de 202 casos com sintomas respiratórios com diagnóstico esperado positivo; no entanto, os serviços de saúde só diagnosticaram e notificaram 106 casos de tuberculose pulmonar na população indígena do Departamento de Cauca. Portanto, identificamos uma lacuna diagnóstica de 47,5%, já que apenas 52,5% dos casos receberam um diagnóstico nos serviços de saúde. As explicações para esta lacuna foram a má qualidade das amostras e falhas na técnica de esfregaço, falhas na identificação correta dos sintomas respiratórios, acesso limitado aos métodos de diagnóstico, tais como cultura e testes moleculares, bem como capacitação deficiente e alta rotatividade de pessoal nas instituições de saúde.As ações do programa de controle da tuberculose devem se concentrar em reduzir a lacuna na detecção de casos na população indígena.

Estimate the acceptability and adoption by health care workers of clinical practice guidelines and treatment protocols for women with preeclampsia/eclampsia and identify the facilitating factors and barriers to their implementation.A qualitative study was conducted, using semi-structured interviews and focus groups in five maternity hospitals. Interviews were compiled for analysis, and barriers and facilitators were characterized.Seventy health professionals (52 female and 18 male) participated, representing different levels of the health system. The majority of workers and managers were aware of the existence and content of clinical practice guidelines (CPGs) for preeclampsia/eclampsia, especially the participants with more time in the health service. With respect to facilitating factors, both medical and nursing staff were positive about continued development and implementation of high-quality CPGs. There was consensus that limitations exist, especially with respect to a lack of the necessary medicines, supplies, and equipment to meet and implement the established recommendations.The results of the study show the need to strengthen strategies that help close the gap between research and public policy. Studies suggest that research should focus on users, policymakers, and decisionmakers in the health system. The actors in the Dominican health system recognize the GRADE methodology as an appropriate instrument for the development and implementation of CPGs. Implementation barriers require systemic and comprehensive approaches.Estimar la aceptabilidad y adopción de las guías de prática clínica (GPC) y protocolos de atención a la mujer con preeclampsia-eclampsia por parte del personal prestador de los servicios de salud, e identificar los factores facilitadores y las barreras para su implementación.Se desarrolló un estudio cualitativo por medio de entrevistas semiestructuradas y grupos focales en cinco maternidades. Se recopilaron las entrevistas para su análisis y se caracterizaron las barreras y facilitadores.Participaron 70 profesionales de la salud (52 de sexo femenino y 18 de sexo masculino) que se desempeñan en distintos niveles del sistema de salud, participaron. La mayoría de los prestadores y gerentes conocen la existencia de las GPC de eclampsia-preeclampsia y su contenido, sobre todo los participantes con más tiempo en el servicio. Para los facilitadores, se estableció una valoración positiva entre el personal médico y de enfermería ante el proceso de continuar con la elaboración e implementación de GPC de alta calidad. Hubo consenso en cuanto a la existencia de limitaciones, sobre todo, por la falta de medicamentos, insumos y equipos requeridos, para cumplir y aplicar las recomendaciones formuladas.Los resultados del estudio exponen la necesidad de fortalecer estrategias que ayuden a cerrar la brecha entre la investigación y la política pública. Estudios fundamentan la investigación en priorizar la atención a los usuarios, y los encargados de formular políticas y los tomadores de decisiones en el sistema de salud. Los actores del sistema de salud dominicano reconocen la metodología GRADE como un instrumento apropiado para la formulación e implementación de GPC. Las barreras de implementación requieren de abordajes sistémicos e integrales.Estimar a aceitabilidade e a adoção de diretrizes de prática clínica (DPCs) e protocolos de atenção para mulheres com pré-eclâmpsia e eclâmpsia por profissionais da saúde e identificar os fatores facilitadores e barreiras à sua implementação.Desenvolvemos um estudo qualitativo baseado em entrevistas semiestruturadas e grupos focais em cinco maternidades. As entrevistas foram coletadas para análise, sendo caracterizadas as barreiras e fatores facilitadores.O estudo contou com a participação de 70 profissionais da saúde (52 mulheres e 18 homens) que trabalham em diferentes níveis do sistema de saúde. Em sua maioria, os profissionais e administradores estão cientes da existência de DPCs para pré-eclâmpsia e eclâmpsia e conhecem seu conteúdo, especialmente os que têm mais tempo de experiência. Em relação aos fatores facilitadores, os profissionais médicos e de enfermagem consideraram positivo o processo de elaboração e implementação de DPCs de alta qualidade. Houve consenso sobre a existência de limitações, especialmente no que diz respeito à falta de medicamentos, insumos e equipamentos necessários para cumprir e implementar as recomendações.Os resultados do estudo deixam clara a necessidade de reforçar as estratégias que ajudam a estabelecer vínculos entre a pesquisa e as políticas públicas. A pesquisa futura deve priorizar a atenção aos usuários e o apoio aos decisores e responsáveis pela elaboração de políticas no sistema de saúde. Os atores do sistema de saúde dominicano reconhecem a metodologia GRADE como um instrumento apropriado para a formulação e implementação de DPCs. As barreiras à implementação exigem abordagens sistêmicas e abrangentes.

Objective: To show the evolution and characteristics of SARS-Cov2 pandemia in Peru from april 5th to september 30th, 2020. Material and methods: In an observational, descriptive, retrospective and longitudinal study, informatión from the Peruvian Ministry of Health, COVID-19 Situational Room, warnigs from the National Epidemiology Center, Prevention and Disease Control and the Panamerican Health Organization (PAHO), from april 05th to september 30th 2020 concerning to the SARS-Cov2 pandemia in Peru were analysed. Results: In this period of time, 818,297 persons were infected, 32535 died and 690528 recovered from the disease, the letality index was 3,34 % and mortality rate per 100,000 inhabitants was 27,65. Peru is the third most affected country by the pandemia in South America and its incidence first growed up overwhelming the health facilities and now it is lowering. The prevalence along the country is heterogeneous, it is lower in the mountain departaments than in the coast and jungle ones, related to geographic and social factors; this pandemia has produced very serious health, economic and social problems. Conclusions: The SARS-Cov2 pandemia has produced a very strong impactc on the Peruvian health, economy social status, demonstrating that it is very vulnerable country to this type of health situations. Objetivo: Mostrar la evolución y características de la pandemia del SARS-Cov2 en el Perú del 05 de abril al 30 de setiembre de 2020. Material y métodos: Estudio descriptivo, observacional, longitudinal, retrospectivo, en el que se ha consultado y analizado la información del Ministerio de Salud (MINSA), Sala Situacional del COVID-19, de las Alertas Epidemiológicas del Centro Nacional de Epidemiología, Prevención y Control de Enfermedades, MINSA y de la Organización Panamericana de la Salud (OPS), en el lapso del 05 de abril al 30 de setiembre de 2020 sobre el desarrollo de la pandemia del SARS-Cov2 en el Perú. Resultados: En ese lapso, se infectaron 818297 personas, fallecieron 32535 y 690528 personas se recuperaron, el índice de letalidad fue 3,34 % y la mortalidad 27,65 por 100,000 habitantes, que ponen al Perú en el segundo lugar entre los países de Suramérica más afectados y cuya incidencia muestra primero un incremento hasta agosto y luego una disminución progresiva. La prevalencia en el territorio nacional es muy heterogénea, es menor en los departamentos de la sierra que en los de la costa y selva, situación que obedece a factores geográficos y sociales. Esta enfermedad ha ocasionado serios problemas de salud, económicos y sociales. Conclusiones: La pandemia de SARS-Cov2 ha ocasionado un grave impacto sobre la salud, social y economía del Perú y demuestra que es un país muy vulnerable ante situaciones de esta naturaleza.

Objective The popularity of social networks provide an incredible opportunity to enhance the impact of preventive medicine programs. We aimed to assess whether a targeted Facebook campaign among mothers may increase the uptake of human Papilloma virus (HPV) immunization among their 8th-grade daughters. Methods This field study was conducted among the members of a state-mandated health organization in Israel. Included were all 21,592 members who were mothers to 14 year-old daughters in the 2018-19 school-year. A total of 17,271 (80%) were randomly allocated to the campaign arm and the rest (n=4,321) were selected as a reference group. The Facebook ads addressed issues and concerns regarding HPV-related diseases and HPV vaccine. Main outcome measures were Facebook metrics on exposure to campaign and HPV immunization among eighth grade daughters of the study participants. Results Between 8/2018-10/2018, Facebook ads were shown 1.8-million times (a reach of 88%). The uptake of HPV vaccine among daughters of women allocated to the campaign arm (55.3%) was similar (p = 0.749) to 55.0% in the control group. The only significant differences between study groups were observed when stratifying by SES level. In the lowest SES quartile, Facebook campaign significantly (p = .02) reduced vaccine uptake (35% vs. 39.0%), with a relative risk of 0.90 (95%CI: 0.82-0.98), while in the second SES quartile, Facebook campaign increased vaccine uptake from 52.6% to 55.8%, with a RR of 1.06 (95%CI,1.00-1.12). Among mothers in higher SES levels, daughters of exposed and unexposed mothers had similar immunization rates. Conclusions Facebook campaign may increase the uptake of HPV vaccine among daughters to mothers of medium-to-low SES level, but it may reduce vaccination among lower SES groups.

Describe the implementation of the Continuity of Care and Rehabilitation Program (PCC-R) in community mental health centers (CSMCs, Spanish acronym) in Peru.Qualitative study of the implementation of the PCC-R in four CSMCs in Lima and La Libertad, Peru. Forty-two individual semi-structured interviews were conducted, as well as a focus group with five participants, for a total of 47 informants, including users, family members, and professionals involved in the design, implementation, and monitoring of the program.The PCC-R is a key program for community mental health services in Peru and it enjoys broad acceptability. Providers and users report satisfaction with its results; however, the program lacks a policy document specifying its objectives, organization, and activities. This would explain the variability in its implementation. The PCC-R has limitations in terms of management of financial and human resources, and it is necessary to improve training and supervision. There is consensus on the need, usefulness, and viability of developing a system to monitor the PCC-R. Good practices and suggestions are presented with a view to addressing these challenges.The PCC-R is a flagship program for the CSMCs and for mental health reform in Peru. It has achieved broad acceptability among providers and users. Its implementation combines successes and difficulties, with pending tasks that include developing a policy document, improving resource management, strengthening training and supervision, and implementing a monitoring system for continuous improvement of the program.Describir la implementación del Programa de continuidad de cuidados y rehabilitación (PCC-R) en centros de salud mental comunitaria (CSMC) del Perú.Estudio cualitativo sobre la implementación del PCC-R en cuatro CSMC de Lima y La Libertad, Perú. Se realizaron 42 entrevistas semiestructuradas individuales y un grupo focal con cinco participantes, para un total de 47 informantes entre usuarios, familiares y profesionales vinculados al diseño, la implementación y el monitoreo del PCC-R.El PCC-R es un programa central de los servicios de salud mental comunitaria en Perú, goza de amplia aceptación y los prestadores y usuarios refieren estar satisfechos con sus resultados. Sin embargo, el programa carece de un documento normativo que detalle sus objetivos, organización y actividades, lo que explicaría la variabilidad en su aplicación. Existen limitaciones en la gestión de recursos financieros y humanos del PCC-R y necesidades de capacitación y supervisión, que deben ser mejoradas. Existe consenso sobre la necesidad, la utilidad y la viabilidad de desarrollar un sistema de monitoreo del PCC-R. Se recogen buenas prácticas y sugerencias para enfrentar estos retos.El PCC-R es un programa insignia de los CSMC y de la reforma de la salud mental en Perú, y ha logrado amplia aceptación entre los prestadores y usuarios. Su implementación combina aciertos y dificultades, y revela tareas pendientes como desarrollar un documento normativo, mejorar la gestión de recursos, fortalecer la capacitación y acompañamiento, y aplicar un sistema de monitoreo para favorecer la mejora continua del programa.Descrever a implementação do Programa de Continuidade de Cuidados e Reabilitação (PCC-R) em centros de saúde mental comunitária (CSMCs) do Peru.Estudo qualitativo sobre a implementação do PCC-R em quatro CSMCs em Lima e La Libertad, no Peru. Realizamos 42 entrevistas semiestruturadas individuais e um grupo focal com cinco participantes, com um total de 47 participantes, entre usuários, familiares e profissionais envolvidos na elaboração, implementação e monitoramento do PCC-R.O PCC-R é um programa central dos serviços de saúde mental comunitária no Peru, conta com ampla aceitabilidade e os prestadores e usuários dizem estar satisfeitos com seus resultados. No entanto, o programa não possui um documento normativo que detalhe os seus objetivos, organização e atividades, o que pode explicar a variabilidade em sua aplicação. Existem limitações na gestão dos recursos financeiros e humanos do PCC-R e necessidades de capacitação e supervisão, que devem ser melhoradas. Há consenso sobre a necessidade, utilidade e viabilidade de se desenvolver um sistema de monitoramento do PCC-R.Apresentamos aqui um conjunto de boas práticas e sugestões para enfrentar esses desafios.O PCC-R é um programa emblemático dos CSMCs e da reforma da saúde mental no Peru, tendo obtido ampla aceitação entre prestadores e usuários. A sua implementação combina acertos e dificuldades e revela tarefas pendentes, tais como o desenvolvimento de um documento normativo, uma melhor gestão de recursos, o reforço da capacitação e supervisão e a aplicação de um sistema de monitoramento para fomentar a melhoria contínua do programa.

Objectives To measure protocol adherence and antigen-based detection tests (AgDT) negative predictive value after 3 months of massive use as a diagnostic tool for COVID-19 in Guatemala Methods The study period included nasopharyngeal swabs taken between March 12 and August 31, 2020, which results were entered in the national COVID-19 information system Proportional increase in testing between one month before and one month after the introduction of AgDT (May 9–June 8 vs June 9–July 8) was measured Results After AgDT introduction, there was a 139% increase in SARS-CoV-2 testing Between June 9 and August 31, 7 8% of 110 657 AgDT-negative patients had follow-up RT-PCR testing Of them, 30% were RT-PCR positive Conclusions While introducing AgDT improved access to diagnostics, ensuring the availability of timely RT-PCR capacities to confirm diagnosis is also key © 2020 Pan American Health Organization All rights reserved

Background Amebiasis has been defined by World Health Organization (WHO) and Pan American Health Organization (PAHO) as the infection with Entamoeba histolytica regardless of symptoms. Necrotizing amoebic colitis is a rare clinical form of amebosis that is associated with high morbidity and mortality. Case report We present a 68-years-old-female patient with necrotizing amoebic colitis with multiple perforations who survived after right hemicolectomy with ileus-transverse anastomosis. Conclusions Effective interventions to prevent amebic colitis, and additional therapies to treat fulminant amebic colitis are needed to improve outcomes.

The number of multidrug-resistant tuberculosis (MDR-TB) cases reported in the Americas has increased by 21.2%, from 3737 in 2016 to 4791 in 2018. The WHO has been recommending changes on the treatment of DR-TB, moving from long-duration treatment with injectables to a short oral regimen with new drugs such as bedaquiline (BDQ) and delamanid (DLM), in selected cases and only under programmatic conditions. Injectables are no longer recommended by the WHO due to lower efficacy and the increasing seriousness of adverse events. The introduction of new oral drugs for DR-TB received a boost with a global donation of BDQ to some eligible countries, which continues with the countries purchasing drugs through the Pan American Health Organization Strategic Fund. The main challenges in the scaling up of new drugs for DR-TB include low DR-TB detection rate, the slow pace in transitioning to molecular testing and delays in the introduction of new oral short regimens for MDR-TB. The Americas need to accelerate the scale up of new oral treatments, improve detection rates, increase molecular diagnosis of resistance, and ensure the registration and introduction of the shorter treatment regimen in national MDR-TB guidelines.

Objective The objective of this study was to verify the agreement between the alcohol policies score estimated from documental analysis of Brazilian federal regulatory documents (RD), with primary data collection, and the results previously presented by the Pan American Health Organization (PAHO) in its Alcohol Policy Scoring (APS) report. Study design Document identification and content analysis. Methods Documental research was carried out in two phases: a document identification and content analysis. In the first phase, we carried out the search, identification, and systematization of laws, decrees, and federal ordinances in Brazil, with primary data collection. The second phase consisted of three steps: 1) an RD content analysis and classification into the 10 PAHO/World Health Organization (WHO) policy domains; 2) a score estimation of alcohol policies, based on the APS instrument attached to their report; and 3) comparison of the results for Brazil presented at the APS report and the one estimated by the researchers. Results The study showed divergences between the results for APS published by PAHO about Brazil and the one achieved with primary data collection. 1146 federal promulgated RD were identified, of which 21 were eligible for content analysis. Only the domains “Community and workplace action” (Domain 3) and “Reducing the public health impact of illicit and informally produced alcohol” (Domain 9) had convergent scores. On the other domains, usually the APS score estimated by PAHO differs from the one estimated with the primary data collection. Conclusions We conclude that Brazil is not providing the best data for PAHO/WHO estimate its APS report, leading to the dissemination of imprecise results worldwide.

El cáncer y su tratamiento implican cambios en la dieta y metabolismo que aumentan el riesgo de desarrollar desnutrición, especialmente cuando los pacientes desconocen cómo alimentarse. Aunque se han desarrollado materiales psicoeducativos para favorecer conductas alimentarias saludables, la mayoría son extensos, están dirigidos a pacientes diagnosticados con tumores sólidos o no señalan datos de validación. Con el objetivo de construir y validar un material psicoeducativo breve, orientado a la promoción de conductas alimentarias y nutricionales saludables del paciente oncohematológico adulto, se diseñó y validó la infografía Recomendaciones para la alimentación del paciente oncohematológico. Se empleó la metodología propuesta por la Organización Panamericana de la Salud y por Ziemendorff y Krause en un grupo de jueces expertos (n=18) y otro de pacientes oncohematológicos (n=20). Se obtuvieron acuerdos porcentuales superiores a 80 % y κ>.68 en ambos grupos de validación, por lo tanto, la infografía diseñada es un instrumento conciso, válido y específico que puede ser distribuida entre la población diana.

Decubitus ulcers are important health problems and one of the maintrials that health organization facingevery day. Now a day various innovative modality of wound treatmenthave been endorsed including wound care. Recently, application of topical insulin helpsin healing ofdecubitus ulcers. Therefore, the aim of this study was to investigate the efficacy of applying topical insulin therapy in healing processof decubitus ulcers in immobilized patients.Design: ARandomized control trial research design was conducted in Neurological and Medical Departments at Alexandria Main University Hospital. Subjects: this study composed of 60 patients divided into two equal groups, study group who receive topical insulin dressing and control group who receive routine hospital dressing. Results, indicates significant improvement in decubitus ulcers healing forthe study group compared control to their where p value (˂0.05)Conclusion, topical application of insulin has a very powerful effect in healing process for decubitus ulcers. Recommendation: in service education program for nurses working in neurological and medical departments

Objective: We mapped and generated hot spots for potential meningitis outbreak from existing data in Upper East region, Ghana.Design: This was a cross-sectional study conducted in 2017Data Source: Meningitis data in the Upper East Region from January 2007, to December 2016.Main outcome measure: We used spatial tools in Quantum Geographic Information System (QGIS) and Geoda to draw choropleth map of meningitis incidence, case fatality and hotspot for potential meningitis outbreak Results: A total of 2312 meningitis cases (suspected and confirmed) were recorded from 2016-2017 with median incidence of 15.0cases/100,000 population (min 6.3, max 47.8). Median age of cases was 15 years (IQR: 6-31 years). Most (44.2%) of those affected were 10 years and below. Females (51.2%) constituted the highest proportion. Median incidence from 2007-2011 was 20cases/100,000 population (Min 11.3, Max 39.9) whilst from 2012-2016 was 11.1cases/100,000 populations (Min 6.3, Max 47.8). A total of 28 significant hotspot sub-districts clusters (p=0.024) were identified with 7 High-high risk areas as potential meningitis outbreak spots.Conclusion: The occurrence of meningitis is not random, spatial cluster with high –high-risk exist in some sub-districts. Overall meningitis incidence and fatality rate have declined in the region with district variations. Districts with high meningitis incidence and fatality rates should be targeted for intervention.Keywords: meningitis outbreak, geospatial clustering, Upper East Region, meningitis incidence, GhanaFunding: Author EA was supported by the West Africa Health Organization (Ref.: Prog/A17IEpidemSurveillN°57212014/mcrt).

Anatomic stage of cancer is a key factor in cancer prognosis and provides vital information in almost all types of cancer. The anatomic stage used to represent stage of cancer which shows attributes of tumor - T, number of affected lymph node -N and distant metastasis - M. Experts retrieve the anatomic stage information from clinical and pathological reports and most of these are unstructured. The main aim of the research study is to propose generalized decision-making tool for most accurate anatomic stage extraction from medical reports of different health organizations. Most previous work considered single health organization for research; extracted only TNM value, did not identify anatomic stage from TNM value; used pathology reports only. This research addresses the extraction of anatomic stage from Breast Cancer medical reports using Natural Language Processing because most of these reports are unstructured and require text processing to extract stage information from them. To detect most accurate anatomic stage, TNM information will be extracted from medical reports using NLP, machine learning technique and rule-based methodology. Average T, N and M accuracy for the rural region is 98%, 94% and 99% respectively whereas for urban region, average accuracy is 95%, 88% and 98% respectively. The average stage accuracy for rural and urban region is 93% and 85% respectively. 87% average stage accuracy achieved in both regions. Anatomic stage extraction with high accuracy in different health organizations of different regions shows that the proposed study is promising and generalized for most accurate anatomic stage extraction.

COVID-19 is the ailment realized by an illness of the SARS-CoV-2 contamination, first perceived in the city ofWuhan, in China’s Hubei region in December 2019. COVID-19 was as of late known as 2019 Novel Coronavirus (2019-nCoV) respiratory disease before the World Health Organization (WHO) articulated the official name as COVID-19 in February 2020. Many drugs are being tried for coronavirus, but the favipiravir which was accepted for Chinese flu. The dynamic favipiravir restrains RNA polymerase and forestalls replication of the viral genome, this is main work done by the favipiravir. In this review we will learn about how favipiravir can be used and its mechanism its mechanism of action and various trials that support that favipiravir can be medication for treatment of coronavirus. Keywords: Favipiravir, World health organization, Coronavirus, Chinese flu.

According to the word health organization (WHO) in 2014 Statistical data states that 247% of the population of shoutheast Asia and 23,3% of indonesia aged 18 years and over exverience hypertension. This study aims to determine the relationship of smoking habits with hypertension events in Sindang Barang village of Bogor City. The type of this research is the research that will be carried out is quantitative research with a correlationnal approach and the cross sectional method of population in this study are population with a total of 250 respondents the sampling technique on this research is taking samples non probable and obtained and questionnaire. Based on the results of the bivariate analysis of dani, 250 respondents as many as 89 respondents, the habit of smoking with hypertension was as much as (69,5%) more than Moderate smokingn habits with moderate hypertension as many as 53 respondents (50,5%) and 15 respondents (88,2%) Baed on the statistics of bivariate analysis table statistics obtained p,value 0,000 and a co.05 then pvalue

To assess the distribution of Mayaro virus (MAYV) in Latin America and the Caribbean and evaluate existing country-level MAYV surveillance mechanisms.Research was conducted from May 2018 through May 2019 to collect data from academic literature on Mayaro fever in Latin America and the Caribbean. PubMed, ClinicalKey, Scopus, Nature, SciELO, LILACS, and Google Scholar were searched for peer-reviewed journal articles, and data from health authorities, including the Pan American Health Organization (PAHO) and ministries of health, was also sought. MAYV-related publications published from 1954 through 2019 were screened. Publications that added to the overall understanding of MAYV, including its geographical and epidemiological distribution, were included in this report.A total of 901 MAYV cases have been reported in humans in countries in Latin America and the Caribbean. Since its discovery in 1954 in Trinidad and Tobago, MAYV has been isolated from individuals living in Argentina, Bolivia, Brazil, Ecuador, French Guiana, Haiti, Mexico, Panama, Peru, and Venezuela. Of those 901 cases, 42 of them were reported exclusively by health authorities. In contrast, 843 confirmed and presumptive autochthonous cases and an additional 16 imported cases were identified in academic literature. No country-level surveillance mechanisms for MAYV were recorded in academic literature or by health authorities.This report demonstrates that MAYV surveillance efforts are limited in comparison to the virus's presence in Latin America and the Caribbean, highlighting the importance of enhancing arboviral surveillance systems in the affected countries.Evaluar la distribución del virus Mayaro (MAYV) en América Latina y el Caribe y los mecanismos de vigilancia de nivel nacional.Entre mayo de 2018 y mayo de 2019 se llevó a cabo una revisión bibliográfica sobre la fiebre de Mayaro en América Latina y el Caribe en las bases de datos PubMed, ClinicalKey, Scopus, Nature, SciELO, LILACS y Google Académico para identificar artículos en revistas arbitradas; también se revisó información suministrada por las autoridades sanitarias, entre ellas la Organización Panamericana de la Salud y los ministerios de salud. Se revisaron artículos relacionados con MAYV publicados entre 1954 y 2019. En este informe se incluyeron artículos que contribuyeran a la comprensión general sobre el MAYV, incluida su distribución geográfica y su epidemiología.Se han reportado 901 casos de MAYV en seres humanos en 11 países de América Latina y el Caribe. Desde su descubrimiento en 1954 en Trinidad y Tobago, MAYV ha sido aislado de personas en Argentina, Bolivia, Brasil, Ecuador, Guayana Francesa, Haití, México, Panamá, Perú y Venezuela. De estos 901 casos, 42 fueron reportados exclusivamente por las autoridades sanitarias. A la vez, en la bibliografía se identificaron 844 casos autóctonos confirmados o presuntivos y 15 casos importados. A través de la bibliografía o las autoridades sanitarias no se identificaron mecanismos de vigilancia de nivel nacional para el MAYV.En América Latina y el Caribe la vigilancia del MAYV es limitada en comparación con la presencia del virus en la región; es necesario mejorar los sistemas de vigilancia de arbovirus en los países afectados.Analisar a distribuição do vírus Mayaro (MAYV) na América Latina e Caribe e avaliar os mecanismos nacionais de vigilância.Dados da literatura acadêmica sobre a febre Mayaro na América Latina e Caribe foram coletados de maio de 2018 a maio de 2019. Foram pesquisadas as bases de dados PubMed, ClinicalKey, Scopus, Nature, SciELO, LILACS e Google Acadêmico para identificar artigos em revistas revisadas por pares; também foram examinados dados de autoridades sanitárias, incluindo a Organização Pan-Americana da Saúde (OPAS), e dos ministérios de saúde. Artigos relacionados com MAYV publicados de 1954 a 2019 foram revisados. Este relatório incluiu artigos que contribuíssem para o entendimento geral do MAYV, com informações sobre distribuição geográfica e epidemiologia.Foram registrados 901 casos de MAYV em humanos em 11 países da América Latina e do Caribe. Desde a sua descoberta em 1954 em Trinidad e Tobago, o MAYV foi isolado em indivíduos na Argentina, Bolívia, Brasil, Equador, Guiana Francesa, Haiti, México, Panamá, Peru e Venezuela. Desses 901 casos, 42 foram comunicados exclusivamente pelas autoridades sanitárias. Por sua vez, 844 casos autóctones confirmados ou suspeitos e 15 casos importados foram descritos na literatura. Nenhum mecanismo nacional de vigilância do MAYV foi identificado na literatura ou pelas autoridades sanitárias.Na América Latina e Caribe, a vigilância do MAYV é limitada em contraste com a presença do vírus na região; é importante melhorar os sistemas de vigilância desse arbovírus nos países afetados.

To compare national essential medicines lists (NEMLs) from countries in the Region of the Americas and to identify potential opportunities for improving those lists.In June of 2017, NEMLs from 31 countries in the Americas were abstracted from documents included in a World Health Organization (WHO) repository. The lists from the Americas were compared to each other and to NEMLs from outside of the Americas, as well as with the WHO Model List of Essential Medicines, 20The number of differences between the NEMLs from the Americas and the WHO Model List were similar within those countries (median: 295; interquartile range (IQR): 265 to 347). The NEMLs from the Americas were generally similar to each other. While the NEMLs from the Americas coincided well with the Strategic Fund list, some medicines were not included on any of those NEMLs. All the NEMLs in the Americas included some medicines that were withdrawn due to adverse effects by a national regulatory body (median: 8 withdrawn medicines per NEML; IQR: 4 to 12).The NEMLs in the Americas were fairly similar to each other and to the WHO Model List and the Strategic Fund list. However, some areas of treatment and some specific medicines were identified that the countries should reassess when revising their NEMLs.Comparar las listas nacionales de medicamentos esenciales (LNME) de países de la Regi delas Américas e identificar oportunidades potenciales de mejorarlas.En junio de 2017, se extrajeron las LNME de 31 países de la Regi de documentos incluidos en un repositorio de la Organizaci Mundial de la Salud (OMS). Se compararon estas listas entre sí y con listas de fuera de la Regi, así como con la Lista Modelo de Medicamentos Esenciales de la OMS (20El nero de diferencias entre las LNME de la Regi y la Lista Modelo de la OMS fue similar dentro de esos países (mediana: 295; rango intercuartil (RIC): 265 a 347). Las LNME de la Regi en general fueron similares entre sí. Si bien las LNME de la Regi mostraron una coincidencia adecuada con la lista del Fondo Rotatorio, algunos medicamentos no estaban incluidos en ninguna de las primeras. Todas las LNME de la Regi incluían algunos medicamentos que habían sido retirados del mercado por las autoridades regulatorias nacionales debido a efectos adversos (mediana: 8 medicamentos retirados en cada lista; RIC: 4 a 12).Las LNME en la Región de las Américas son bastante similares entre sí y con la Lista Modelo de la OMS y la lista del Fondo Rotatorio de la OPS. Sin embargo, se identificaron algunas áreas terapéuticas y algunos medicamentos específicos que los países deberían reevaluar al revisar sus LNME.Comparar as listas nacionais de medicamentos essenciais (LNME) dos países da Região das Américas e identificar oportunidades potenciais de melhoria.Em junho de 2017, as LNME de 31 países das Américas foram obtidas de documentos incluídos em um repositio da Organização Mundial da Sae (OMS). As listas foram comparadas entre si, com listas de fora da Região, com a Lista Modelo de Medicamentos Essenciais da OMS (20As LNME dos países das Américas eram semelhantes entre si e apresentaram um nero semelhante de diferenças em relação à Lista Modelo da OMS (mediana: 295; intervalo interquartil: 265-347). Embora as LNME nas Américas fossem altamente consistentes com a lista do Fundo Estratégico, alguns dos medicamentos do Fundo não apareciam em nenhuma dessas LNME. Todas as LNME nas Américas incluíam medicamentos retirados do mercado por algum organismo regulador nacional devido a efeitos adversos (mediana: 8 medicamentos retirados por LNME; intervalo interquartil: 4-12).As LNME nas Américas são bastante semelhantes entre si e próximas da Lista Modelo da OMS e da lista do Fundo Estratégico. Contudo, foram identificadas algumas áreas terapêuticas e alguns medica mentos específicos que os países deveriam reavaliar ao rever as suas LNME.

El Centro para el Desarrollo Humano e Integral de los Universitarios –CEnDHIU– es la entidad de la Universidad Veracruzana encargada de la “promoción de la salud y el fomento de entornos saludables” (Organización panamericana de la Salud, 1986). Mediante acciones de educación para la salud integral, servicios de salud mental, salud sexual, reproductiva, VIH, prevención de consumo de drogas lícitas e ilícitas, orientación psicopedagógica y atención personalizada a estudiantes viviendo con discapacidad. CEnDHIU contribuye a que la formación de los jóvenes no solo sea focalizada en lo técnico y profesional sino también con conciencia de la importancia de su propia salud, familia y comunidad para adquirir, durante su vida universitaria, estilos de vida saludable. Este trabajo muestra el modelo de promoción de salud implementado en esta entidad manteniendo actualizado el registro epidemiológico en estudiantes universitarios, así como sus principales resultadosPalabras clave: promoción; salud; estudiantes; universitarios; centinelas AbstractThe Center for the Human and Integral Development of University Students -CEnDHIU-, is the entity of the Universidad Veracruzana responsible for the "promotion of health and the promotion of healthy environments" (Pan-American Health Organization, 1986). Through education actions for integral health, mental health services, sexual and reproductive health, HIV, prevention of licit and illicit drug use, psychopedagogical guidance and personalized attention to students living with disabilities, CEnDHIU contributes to the formation of young people not only be focused on the technical and professional but also with awareness of the importance of their own health, family and community to acquire healthy lifestyles during their university life. This work shows the model of health promotion implemented in this entity, keeping the epidemiological record in university students updated, as well as its main resultsKeywords: promotion; health; students; university; sentinels

This chapter recounts past efforts to tackle vector-borne infections, by reviewing the decision made in 1947 by the Pan American Health Organization to eradicate the Aedes aegypti mosquito species throughout the entire continental Americas, as a means of eradicating urban yellow fever. Though vaccination was also employed, the policy contrasted with the reliance on mass vaccination in Francophone Africa. Why, given the existence of an excellent vaccine against yellow fever, was the eradication of a mosquito species chosen as the main focus in the Americas? And with what effect? Was complete eradication of a mosquito species feasible, ethical or necessary? Are there any lessons to be drawn from this history? The chapter ends by bringing the issue of mosquito eradication/control back to our present worries about the return and spread of the Aedes aegypti mosquito in the Americas, Africa and Asia, in the epidemiologically difficult conditions of contemporary urban life. Is mass vaccination the path to follow? Or is vector control still a necessary part of disease control?

Aim In patients with COVID‐19, no validated efficient treatment has been reported. Herein, we examine the effect of treatment with teicoplanin in hospitalised patients with COVID‐19. Methods This retrospective study included 115 hospitalised patients in one medical centre. Fifty‐four patients with laboratory‐confirmed COVID‐19 who received teicoplanin plus standard care were included in the Teicoplanin arm of this study, whereas 61 patients who were treated with standard care (SC) according to the Turkish Health Organization guidelines were included in the control arm. Patients’ baseline characteristics, clinical presentation, treatment and outcomes were compared between the two groups. Results In this non‐randomised control study, all baseline characteristics were comparable between the two arms and there were no significant differences in the presenting symptoms, comorbidities and clinical outcomes between the two groups. However, the mortality rate was significantly lower in the teicoplanin group than in the control group (1.9% vs 14.8%; P

On 15 February 2020, during the Munich Security Conference(1), the Director of the World Health Organization (WHO), Dr.Tedros Adhanom Ghebreyesus, stated that the fight against the COVID-19 pandemic was accompanied by a fight against an “infodemic”, leading to a series of initiatives by the WHO and other organizations to face this challenge. This situation is not new: others have occurred during other health emergen-cies, but never one of the current magnitude, resulting from the increased use of digital applications (2). In the age of digital interdependence, this phenomenon is amplified by the conver-gence of increased access to mobile devices, internet access, and the use of social networks, which are spreading it like a virus, further and faster than ever before (3).

espanolLa Tuberculosis (TB) sigue siendo un flagelo, a nivel mundial se estima que 10 millones (8,9-11,0 millones) de personas enfermaron de TB en 2019 y 1,2 millones (1,1– 1,3 millones) de personas VIH negativas con un adicional de 208 000 personas con VIH (177 000 a 242 000) murieron por esta causa en 2019. La TB es una enfermedad de la pobreza, y la angustia, la vulnerabilidad, la marginacion, el estigma y la discriminacion a menudo se enfrentan a las personas afectadas por la esta enfermedad. En este contexto la Organizacion Panamericana de la Salud publico en 2020 los lineamientos para la prevencion y el control de la tuberculosis en los pueblos indigenas de la Region de las Americas, el cual muestra la grave situacion de la epidemia de tuberculosis (TB) entre los pueblos indigenas, con incidencias estimadas de TB de 2 hasta 10 veces mas entre indigenas que las presentadas en la poblacion general de los mismos paises (cabe destacar que solo 12 paises de las Americas contaban con la informacion de TB entre indigenas). EnglishTuberculosis (TB) continues to be a scourge, worldwide it is estimated that 10 million (8.9-11.0 million) people became ill with TB in 2019 and 1.2 million (1.1-1.3 million) of HIV negative people with an additional 208,000 people with HIV (177,000 to 242,000) died from this cause in 2019. TB is a disease of poverty, and distress, vulnerability, marginalization, stigma and Discrimination often faced by people affected by the this disease. In this context, the Pan American Health Organization published in 2020 the guidelines for the prevention and control of tuberculosis in the indigenous peoples of the Region of the Americas, which shows the serious situation of the tuberculosis (TB) epidemic among the indigenous peoples, with estimated TB incidences of 2 to 10 times more among indigenous peoples than those in the general population of the same countries (it should be noted that only 12 countries in the Americas had information on TB among indigenous peoples).

Introdução: A Organização Pan-Americana da Saúde estima que 2,0% da população deveria doar sangue regularmente. Os países da América Latina e Caribe coletam sangue equivalente a 1,5% de sua população, abaixo do preconizado, deixando a oferta para viabilidade transfusional indisponível. Objetivo: Realizar a identificação de anticorpos irregulares (IAI) no plasma de doadores de sangue com relevância clínico-transfusional dos sistemas Rh, KELL, DUFFY, KIDD e MN oriundos dos hemocomponentes descartados de doadores com pesquisa de anticorpos irregulares (PAI) positiva com idade entre 18 e 69 anos, independente de sexo, no Hemocentro do Estado do Amapá. Método: Foi utilizado para a realização dos testes para PAI e IAI o Gel Teste®. A análise estatística realizada foi o teste Qui-quadrado. Resultados: Durante os períodos entre junho de 2009 a janeiro de 2013 (Período I) e setembro de 2016 e março de 2017 (Período II), foram encontradas 144 amostras PAI positivas (0,28%) em 51.985 doações de sangue, porém foi realizado o IAI em apenas 111 amostras (0,21%), tendo como anticorpo mais frequente o anti-D em 26 amostras (22,8%), anti-Kpa em 19 amostras (19,3%), anti-Dia em 18 amostras (15,8%), e outros com menor frequência. Os sistemas Rh e KELL foram os mais frequentes e de grande relevância transfusional, o que corrobora a literatura científica sobre o assunto. Conclusões: Observou-se que bolsas positivas para os testes de PAI são desprezadas, gerando um custo em torno de R$ 163.772,64, visto que os hemocomponentes poderiam ser, em alguns casos, utilizados, o que aumentaria o número de bolsas no estado do Amapá e auxiliaria o serviço de hemoterapia.

Nutritional requirements increase for people in general and for adolescents in particular between the agesof (13-18) years to increase the speed of growth, as adolescence is considered a rapid stage after childhood.In general, the importance and necessity of nutritional elements remain, as they affect the growth of theteenager’s body, so the amount of food that the teenager eats should be increased in proportion to hisnutritional needs for this stage, however during this stage, he may be exposed to some practices related tothe dietary approach and among these practices smoking, so the aim of the research is to identify the effectof smoking on the nutrition of male adolescents aged (13-18) years and its relationship to some variables,the results indicated a decrease in the average of the daily intake of a teenager smoker of age (13-15)and (15-18) of all proteins, carbohydrates, energy, vitamin B12, B6, E, C, A, folic acid, iron, calcium andphosphorous, respectively for smokers adolescents aged (15-13) years, while the rates of these elementswere high among non-smoking adolescents for the same age group when compared with global courses.It was also observed through the results, the continued failure to meet the prescribed daily need for thesenutrients for adolescent smokers aged 15-18 years, as the levels of nutrients reached, respectively, while therates of these elements were reached in non-smoking adolescents for the same category, The statistics of theWorld Health Organization for the year 2008 indicated that smoking is more prevalent among adolescentsaged (13-15) and (15-18) years for both sexes. Yemen was the first in the world and Kuwait in the Gulf interms of youth smoking.

Gliomas used to be classified mainly based on histopathological criteria. In 2016, the Word Health Organization introduced a new classification system incorporating the molecular profile of gliomas. This has prompted research on the utility of molecular signature of gliomas to predict prognosis and response to therapy. While experimental data appear to be promising, the clinical use of molecular markers to predict prognosis and drive individual treatments is still a challenge. This chapter presents an overview of the major genes and markers associated with the characterization and development of gliomas, and the potential of these molecular markers in clinical decision-making. The current challenges and future directions are discussed.

Background: Seasonal agricultural workers group is one of the most disadvantageous groups of working life in Turkey same as many other countries. We aimed to determine the status of cardiovascular disease risk factors among migrant seasonal agricultural workers (MSAW) and to compare obtained data with local residents. Methods: This study cross-sectional study was conducted among MSAW in Eskisehir, Turkey and closest town residents in 2015 during agricultural season. These 455 MSAW were living in camps composed of 20 or more tents. Local residents sample composed of 532 local residents were reached at their houses by using random sampling method with data acquired from health organization records. Both groups were subjected to same questionnaire. Results: The prevalence of overweight/obesity among MSAW women was 40.5%, hypertension 19.9%, diabetes 4.9% and hypercholesterolemia 6.5%. These prevalences were 68.0%, 38.6%, 13.9% and 20.8% respectively among local residents. The prevalence of smoking risk among local residents was 1.5 times more than MSAW. In addition, the prevalence of overweight/obese risk was 4 times more; hypertension risk 1.8 times more, diabetes risk 3.8 times more and hypercholesterolemia risk 2.7 times more among local residents than MSAW (P

The Pan American Health Organization (PAHO) has emphasized the need to maintain efforts to prevent, detect, and treat vector-borne diseases during the COVID-19 pandemic since the combined impact of both could have potentially devastating consequences on the population at risk. Cuba during the COVID-19 pandemic established its protocol for its combat, respecting the provisions of the World Health Organization (WHO) and adding other internal measures in the country that have ensured its effective control. Parallel to the epidemic, the country continues to monitor and control of Aedes aegypti to avoid a possible dengue epidemic. This article provides some considerations that must be taken into account in the presence of COVID-19 and dengue cases that contribute to the strengthening of effective and rapid surveillance and control of Ae. aegypti.

Segundo a Organização Pan-Americana de Saúde (OPAS), o envelhecimento é definido como um processo sequencial, individual, acumulativo, irreversível, universal, não patológico, de deterioração de um organismo maduro. Considerando o aumento progressivo da população idosa e todas as alterações funcionais envolvidas no processo do envelhecimento, destacam-se as alterações provenientes por declínio imunológico, como doenças por contaminações fúngicas, como onicomicose e Tinea pedis. Os fungos possuem características oportunistas e utilizam fatores como doenças sistêmicas, deficiência imunológica e uso de medicamentos, que são muito comuns aos idosos, e acabam por predispor a contaminação. As doenças causadas por fungos em idosos são frequentes e necessitam de tratamentos e orientações adequadas [6]. No entanto, observa-se a falta de orientação e cuidados básicos que são essenciais e atuam tanto na prevenção, quanto no tratamento dessas doenças. Segundo Pinto, 2018, [8], o podólogo possui um importante papel através dos serviços prestados pela podologia, demonstrando a importância dos cuidados básicos, associados a prática de higiene diária. Objetivo deste trabalho foi demonstrar que a correta orientação de higiene e cuidados com os pés podem auxiliar na prevenção de podopatias relacionadas a contaminação de fungos em idosos. Este estudo se caracterizou por uma revisão da literatura. Foi feita uma Pesquisa de Campo através de questionário, com aprovação do Comitê de Ética da Universidade Anhembi Morumbi.

Explore the effect of the implementation and strengthening of the primary care strategy (PHC) on hospitalizations for ambulatory care-sensitive conditions (HACSC).Descriptive cross-sectional observational study that considered the data from public hospital admissions records for the entire country for the period 2000-2017. The starting point of the PHC strategy is considered to be 2009. The diagnoses proposed by the Pan American Health Organization/World Health Organization were used in defining the HACSC diagnoses. The analysis of HACSC behavior considered two stages: 2000-2008 and 2009-2017.HACSC trended downward, with a difference of 6.75% between the final years of each stage. The greater the PHC coverage, the larger the reduction. The leading causes of HACSC were pneumonia and acute diarrheal disease. Admissions for chronic diseases largely fell, while admissions for infectious diseases rose.The degree of population coverage and access to family health units can limit the impact of PHC on HACSC. A reduction in HACSC was confirmed after PHC implementation in Paraguay. The results for admissions for chronic diseases are better than those for infectious diseases.Explorar a influência da implementação e fortalecimento da estratégia de atenção primária à saúde (APS) nas internações hospitalares por causas sensíveis à atenção ambulatorial.Estudo observacional descritivo transversal realizado com dados de registros de internações em hospitais públicos de todo o país no período entre 2000 e 2017. O ano de 2009 é considerado o ponto inicial da estratégia de APS no Paraguai. Os diagnósticos das internações hospitalares por causas sensíveis à atenção ambulatorial foram definidos segundo os critérios propostos pela Organização Pan-Americana da Saúde/Organização Mundial da Saúde (OPAS/OMS). A análise foi realizada em duas fases distintas: 2000–2008 e 2009–2017.Verificou-se uma tendência de redução das internações hospitalares por causas sensíveis à atenção ambulatorial, com uma diferença de 6,75% entre os anos finais de cada fase. A redução foi maior à medida que se ampliou a cobertura de APS. As principais causas de internações hospitalares foram pneumonia e doença diarreica aguda. Houve redução das internações por doenças crônicas na sua maioria e, em contraste, houve aumento das internações por doenças infecciosas.A cobertura e o acesso da população a unidades de saúde da família são fatores limitantes ao impacto da APS nas internações hospitalares por causas sensíveis à atenção ambulatorial. Verifica-se uma redução das internações hospitalares após a implementação da APS no Paraguai. Os resultados são melhores para internações por doenças crônicas em comparação às internações por doenças infecciosas.

PulseNet Latin America and Caribbean (PNLAC) was established in 2003 and is one of seven Regional networks within PulseNet International. The main objectives of the network are to strengthen national and regional laboratory-based foodborne disease surveillance for early detection and investigation of outbreaks to setup control and prevention strategies in contribution to Public Health. Participants perform standardized pulsed-field gel electrophoresis (PFGE) protocols and analysis. For functioning, it is important for the network, the development of national and regional databases (RDBs) and the communication between countries, regionally and internationally. Metadata from over 8600 cases/outbreaks are profiled and isolated by PFGE and are incorporated into the RDB, hosted by the Pan American Health Organization. Currently PNLAC is moving toward whole-genome sequencing to use as a complementary strategy for surveillance. The aim of this article was to describe the experience of the construction of PNLAC, and its contribution to the surveillance of the foodborne diseases at the country and regional levels.

Background Military life leads to a great personal sacrifice and labor in the aircrew because they are constantly subjected to innumerable activities which have a great work pressure; therefore, the aim of this study was to determine the level of work stress associated with bruxism in the aircrew of the Peruvian Air Force. Methods This was a cross-sectional study. A total of 204 crew members of the Peruvian Air Force from the Air Group were surveyed, and the stomatological clinical inspection was carried out. Each crew member was evaluated using the validated International Labor Organization-World Health Organization (ILO-WHO) Work Stress Scale, and clinical records were used to diagnose bruxism using the Smith and Knight wear index. Results It was found that 93.7% (n = 191) of the crew members were men and 6.3% (n = 13) were women; and the percentage of intermediate-level stress was found to be high in the grade of non-commissioned officers, whereas in the officer grade, the level of stress was low. There was also a statistically significant association between the variables military grade, sex, and age group. The sub-officers presented a higher percentage in the category "with bruxism", while in the rank of officers the category of "non-bruxism" was the most prevalent. Conclusions This study showed a statistically significant association between the variable bruxism and the level of work stress between the military aviators of the Peruvian Air Force (p

La atención del parto centrada en el paciente abre una nueva perspectiva para mejorar la calidad de atención de los pacientes. Existen desde hace un par de décadas muchos esfuerzos por lograr este anhelo. Desde la publicación del libro ‘Errar es humano’, ha habido múltiples esfuerzos por evitar el evento adverso en el paciente. En ese sentido, el reto es cómo cumplir este objetivo, sabiendo que el proceso de atención del trabajo de parto es uno en los que más eventos adversos reporta. Basados en recomendaciones de la OMS, se plantea un enfoque que consiste en: a) Sistemas de salud: siendo la cultura de seguridad un hito importante para lograr las metas, que involucra cambios en la organización, es uno de los puntos más álgidos por resolver; b) Profesionales sanitarios: no solo involucra al médico sino a la organización sanitaria, desde un enfoque médico; las personas deberán no solamente tener formación médica, sino especializada y en constante actualización, siendo los retos diferentes si se trata de un personal en formación o de un médico especialista. Existen actualmente formas de cómo lograrlo. Además, se tendrá que romper con los mitos de la atención obstétrica, la cual debe ser basada en evidencias; c) Familia y comunidad: el componente emocional que brinda la familia siempre es una columna fundamental. Sinergizando estos lineamientos, se puede enfocar mejor la atención del parto centrada en la persona.

The practice of preventive medicine remains ill-defined, and the specialty is threatened by a void in the definition of the specialty's practice. The authors propose a cohesive, active identification of skills provided by trained preventive medicine physicians through the credentialing and privileging process. The privileging process should incorporate clinical skills specific to the provider and non-clinical skills based on preventive medicine residency training competency requirements, preventive medicine board certification examination requirements, and the ten essential public health services. The specialty may benefit from development of clinical training based on public health clinical services as well as privileging of physicians in health organization leadership positions.