Salud Integral y Comunitaria (Journal)
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Ozone therapy as an adjuvant treatment for diabetic foot ulcers: a case series from Asunción, Paraguay
Full text linkIntroduction: Diabetes mellitus is a major public health concern due to its chronic complications, including diabetic foot ulcers. Methods: This descriptive retrospective observational case series aimed to explore the potential effects of ozone therapy as an adjuvant treatment for wound healing in diabetic patients at the Centro del Pie in Asunción during 2023. A purposive sample of seven patients was analyzed through medical records using the Texas and RESVECH 2.0 scales. Results: Results showed complete healing in five patients, particularly those with less severe lesions (Texas II/B) and higher ozone session counts. Although a favorable clinical trend was observed, the small sample size and non-experimental design limit causal inference. Conclusions: Further controlled studies with greater methodological rigor are required to confirm the efficacy of ozone therapy and support its broader clinical adoption
When Life and Heart Collide: A Series of 50 Peripartum Cardiomyopathy Cases
Full text linkIntroduction: Peripartum cardiomyopathy (PPCM) is a rare but serious form of heart failure occurring in late pregnancy or early postpartum. Data on Cuban women remain scarce.Objective: To describe the clinical characteristics, management, and six-month outcomes of Cuban women with PPCM and identify predictors of poor recovery.Methods: This prospective observational study included 50 consecutive women diagnosed with PPCM at Hospital ClínicoQuirúrgico Miguel Enríquez, Havana, Cuba (January 2022–December 2024). Demographic, obstetric, clinical, laboratory, and echocardiographic data were collected, including left ventricular ejection fraction (LVEF) and global longitudinal strain (GLS). Treatment, intensive care use, and follow-up at 1, 3, and 6 months were recorded. Recovery was classified as complete (LVEF ≥50%) or partial (LVEF 35–49%). Logistic regression identified predictors of poorrecovery.Results: The mean age was 29 ± 6 years; 70% were diagnosed postpartum. Common comorbidities included preeclampsia (18%),gestational diabetes (10%), and hypertension (12%). Dyspnea (84%), edema (62%), and fatigue (56%) predominated. The mean baseline LVEF was 33 ± 7%. ICU admission was required in 28%, inotropic support in 10%, and mechanical circulatory support in 2%. At six months, 42% achieved complete recovery, 26% partial, and 32% had persistent dysfunction. Predictors of poor recovery were baseline LVEF <30% (OR 4.2), preeclampsia (OR 3.1), and diagnosis more than two weeks postpartum (OR 3.7). Mortality was 4%.Conclusions: PPCM in this Cuban cohort was predominantly postpartum and showed high recovery rates with early diagnosis and therapy. Low LVEF, preeclampsia, and diagnostic delay predicted adverse outcomes
Epidemiology of toxoplasmosis in pregnant women in Loma Pyta (January - August 2025)
Full text linkIntroduction: Toxoplasmosis, a parasitic infection caused by Toxoplasma gondii, represents a major concern during pregnancy due to the risk of vertical transmission and its potential consequences for the fetus, such as congenital malformations, spontaneous abortion, or stillbirth. In many cases, the infection in pregnant women is asymptomatic, making it difficult to detect without adequate prenatal monitoring. In countries like Paraguay, where socioeconomic and environmental conditions can favor transmission of the parasite, controlling this infection in pregnant women is essential to prevent complications in maternal and child health. Objective: To determine the prevalence of toxoplasmosis in pregnant women in the first trimester treated at the Loma Pyta Maternal and Child Hospital in the period from January to August 2025. Methodology: A descriptive, retrospective, cross-sectional study based on a review of 30 medical records of pregnant women treated during the defined period. Conclusion: Most women were young, with secondary education, and occupational diversity. They presented mild symptoms, received treatment with spiramycin, and had a good clinical response, with few maternal and fetal complications. IgG and IgM serology was positive in 100% of cases, while 23.3% tested positive for the IgG avidity test, highlighting the importance of timely clinical follow-up
Difficulties faced by medical students during the COVID-19 pandemic
Full text linkIntroduction: During the COVID-19 pandemic, medical education faced a rapid transition to virtual modalities that impacted clinical and theoretical learning. Health restrictions limited access to hospitals and practices, affecting student training. This study analyzes medical students\u27 perceptions of virtual teaching during the pandemic, their main difficulties, and the resources used.Objective: To identify the problems associated with virtual medical education during the COVID-19 pandemic, evaluate the availability of technological resources, and analyze students\u27 perceptions of the effectiveness of distance learning.Methods: An observational, descriptive, cross-sectional study with a quantitative approach was conducted. The population included 134 final-year medical students from a private university in Asunción. Data were obtained through validated surveys and analyzed statistically.Results: Seventy-three percent of participants were women, with an average age of 24.6 years. Ninety-nine percent had internet access, and 88% learned to use new educational platforms. Laptops were the main tool used. Sixty-one percent expressed satisfaction with virtual education, highlighting the availability of materials and the increased time available for studying. However, 54% reported difficulties in maintaining grades, and 60% considered the clinical knowledge acquired to be insufficient.Conclusions: Students recognize advantages in virtual education, such as flexibility and access to resources, but emphasize the need for in-person practice for comprehensive medical learning and adequate clinical preparatio
Adrenal lipomyoma, a common incidentaloma. Presentation of two cases and review of the role of imaging
Full text linkIntroduction: Adrenal incidentaloma is a condition that radiologists frequently encounter in their daily practice due to the increasing number of radiological examinations performed worldwide. An adrenal incidentaloma is defined as a mass greater than or equal to 1 cm in diameter discovered incidentally during an abdominal or thoracic imaging examination in a patient with no symptoms or signs suggestive of adrenal disease. In our setting, there has been an increase in incidentally discovered tumors, and among their causes, myelolipoma occupies a significant place in terms of frequency. Our caseload has recently been enriched with the diagnosis of myelolipomas, which are part of the incidentaloma group, despite being a benign tumor with an incidence of 0.2-0.4% in the population. Objective: The aim of this article is to demonstrate the value of imaging studies in the diagnosis of this entity through the presentation of two clinical cases. The first case is a male patient with chronic kidney disease and adrenal incidentaloma, which turned out to be a bilateral adrenal myelolipoma from a radiological point of view, unusual due to its bilateral presentation, and the second case, a 57-year-old female patient who presented with renal colic and incidentally had a unilateral adrenal myelolipoma. Conclusions: All radiologists should actively participate in the diagnosis of adrenal lesions using appropriate imaging techniques. Tomography was an effective diagnostic tool in our study
Nursing assessment of people with Multiple Sclerosis
Full text linkIntroduction:Multiple Sclerosis is a chronic neurological disease that affects the myelin of the central nervous system, causing motor, sensory, and cognitive impairment. Its unpredictable evolution requires a comprehensive nursing assessment to identify needs and promote self-care.Objective:To describe the nursing assessment process in a person diagnosed with Multiple Sclerosis, applying Marjory Gordon’s functional health patterns to identify actual and potential problems.Methods:A clinical case study conducted in an outpatient care setting. Data were collected through a semi-structured interview, direct observation, and clinical record review. Information was analyzed using Gordon’s functional patterns, and nursing diagnoses were formulated according to NANDA taxonomy, NOC outcomes, and NIC interventions.Results:Alterations were identified in activity-exercise, health perception-management, and coping-stress tolerance patterns. Interventions focused on health education, therapeutic adherence promotion, and psychological coping enhancement, showing improvement in autonomy and perceived well-being.Conclusions:Nursing assessment based on theoretical models enables a holistic understanding of the needs of people with Multiple Sclerosis, fostering individualized, continuous, and patient-empowering care
Invasive Klebsiella syndrome in a case in Bolivia
Full text linkKlebsiella pneumoniae is a Gram-negative bacterium that requires oxygen and is capable of fermenting lactose. It can cause serious infections such as pneumonia, bacteremia, and liver abscesses. There are two main subtypes: the classic strain (cKP) and the hypervirulent strain (hvKP), the latter being identified by its highly viscous mucus phenotype and its remarkable ability to invade.The most common hvKP lineage is ST23-K1, although K2 lineages (ST65, ST86, ST66) have also been recognized in different parts of the world, including South America. hvKP can affect healthy individuals and those with additional diseases, with diabetes mellitus being a relevant risk factor due to its association with immune dysfunction and hyperglycemia, conditions that favor bacterial growth and spread through the circulatory system. The case presented concerns a 45-year-old diabetic woman who was admitted with severe diabetic ketoacidosis and pneumonia caused by Klebsiella pneumoniae. Despite intensive treatment that included antibiotics and respiratory support, the patient developed multiple lung abscesses and a possible septic embolism, dying after 18 days in intensive care unit
Nursing Care for Pregnant Women with COVID-19: A Characterization Based on Narrative Review
Full text linkIntroduction: the COVID-19 pandemic represented a global health emergency with particular implications for pregnant women, who were considered a vulnerable population due to associated clinical and psychosocial risks. In this context, nursing professionals played a key role in direct care, facing challenges related to the novelty of the virus, resource limitations, and the need to adapt protocols in real time.Objective: to characterize nursing care for pregnant women with COVID-19.Methods: A narrative literature review was conducted in April 2023. Scientific articles and technical documents published in English, Spanish, or Portuguese over the past five years were included, focusing on nursing interventions in pregnant women diagnosed with COVID-19 in outpatient or primary care settings. The search was carried out in databases such as PubMed, ScienceDirect, ResearchGate, Dialnet, and SciELO, using descriptors in three languages. From a total of 1030 records, 16 studies were selected for qualitative synthesis.Results: identified interventions included clinical actions such as oxygen saturation monitoring, postural changes, and non-pharmacological therapies, as well as psychosocial support, effective communication, and health education. Institutional barriers, social inequalities, and psychological impacts on both pregnant women and healthcare personnel were documented. Strategies varied by geographic context, highlighting hybrid care models and the need for humanized approaches.Conclusions: nursing care for pregnant women with COVID-19 was characterized by an integrative approach combining clinical and psychosocial actions, within a complex environment marked by structural limitations and continuous adaptation
Pediatric radiology: a comprehensive approach to the diagnosis of lung injuries and congenital malformations
Full text linkIntroduction: The comprehensive study of cavitary lung lesions, congenital diaphragmatic anomalies, and pneumonia in children depends to a greater or lesser extent on chest X-rays. Objective: To describe the importance of X-rays in the accurate diagnosis of cavitary lung lesions and congenital anomalies in children. Development: Cavitary lesions—gas-filled spaces within an area of pulmonary consolidation or a mass/nodule—are linked to various benign and/or malignant pathologies. The diagnostic criteria depend more on CT scans than on X-rays. In the case of diaphragmatic hernias, X-rays are mainly used in cases that could not be diagnosed in the prenatal stage. For the differential diagnosis of pneumonia in pediatrics and its evolution, it is necessary to consult chest radiological studies, due to the variety of infectious agents. Conclusions: Chest radiography allows the location, extent, lobar or segmental involvement, and associated complications to be established; it can also provide guidance on the etiology, given the existence of atypical viral or bacterial pneumonias. Radiology is of great importance in the accurate diagnosis of cavitary lung lesions and congenital anomalies in the pediatric population and contributes significantly to the early diagnosis and effective management of these pathologies
“Waiting time and satisfaction level in adult outpatient traumatology patients in a hospital in Cajamarca, 2025”
Full text linkIntroduction: Patient satisfaction is an essential indicator of healthcare quality, and waiting time significantly influences their perception of the service received. Objective: To determine the degree of relationship between waiting time and the level of satisfaction in adult outpatients attending the traumatology service of a hospital in Cajamarca, 2025. Materials and methods: This is a quantitative, analytical, and cross-sectional study with a non-probabilistic convenience sample of 83 patients. A validated 25-item questionnaire is used, measuring five dimensions of satisfaction and waiting times across different areas. Statistical analysis includes the chi-square test and Spearman\u27s rho. Results: A significant negative correlation is found between waiting time and satisfaction level (p<0.001; Rho=-4.16). A total of 60.2% of patients report being satisfied, and 37.3% report being pleased. The longest delays are identified in the admissions area. Variables such as age (p=0.049) and type of insurance (p<0.001) show a significant association with satisfaction. Conclusions: Reducing waiting times, especially in initial administrative processes, may increase outpatient satisfaction