South Health and Policy (Journal)
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Pathological puerperium: challenges and complications of the postpartum period
No full textWith the aim of providing you with more information about the challenges and complications of the postpartum period, which lead to physiological, pathological and emotional alterations, and can even lead to disability or even death of the patient, this thesis aims to present the main causes and complications of the pathological puerperium, caused by: postpartum hemorrhages, infections, changes in the breasts. Furthermore, it is important to highlight the correlation of period- related thromboembolic diseases, as well as the psychiatric disorders faced by these women. In this way, doing a bibliographic review, with the collection of data, a search was carried out in the online databases: PubMed, sciELO, SCIENSE, published and updated literatures that reflect the importance of knowledge on the understanding of the challenges and consequences in postpartum women, as well as the best form of prevention and effective treatment. Furthermore, show that the main way to attempt to reduce complications of the pathological puerperium is by providing adequate prenatal control during pregnancy, with specialized medical care before, during and postpartum.
Evaluation of CSF Physicochemical Analysis in The Diagnosis of CNS Infections in Post-Surgical Patients
No full textIntroduction: Central nervous system (CNS) infections in post-surgical patients represent a serious complication with high morbidity and mortality. The physicochemical analysis of cerebrospinal fluid (CSF) is a key diagnostic tool that allows for the evaluation of parameters such as glucose, proteins, and lactate to detect infections. With the development of molecular techniques, such as PCR, the accuracy in pathogen detection has improved. However, there are still questions regarding the reliability of traditional methods compared to these advanced techniques, especially in patients who have received prior antibiotic treatment. Objectives: The primary objective of this study is to evaluate the reliability of the physicochemical analysis of CSF as a diagnostic tool for CNS infections in post-surgical patients and to compare it with alternative methods such as PCR, bacterial cultures, and biological markers. The study aims to determine the sensitivity and specificity of each method to improve diagnostic accuracy in this clinical context. Material and Methods: This study is a systematic literature review that includes studies evaluating the physicochemical analysis of CSF, PCR, and bacterial cultures in post-surgical patients with suspected CNS infection. Scientific databases were used, applying specific inclusion and exclusion criteria to ensure the relevance and quality of the selected studies. Results: The results suggest that although the physicochemical analysis of CSF is useful as an initial tool, it has limitations in terms of sensitivity and specificity in patients who have received antibiotic treatment, with sensitivity ranging between 60% and 70%. In contrast, multiplex PCR offers superior sensitivity and specificity, reaching 92% and 98%, respectively. The combination of methods, including the use of biomarkers such as procalcitonin, improves diagnostic accuracy by 30% compared to traditional physicochemical analysis. Conclusion: The physicochemical analysis of CSF remains useful as an initial test, but its effectiveness is limited in post-surgical patients who have received antibiotic treatment. Combining this analysis with molecular techniques and biomarkers significantly enhances the accuracy and speed of diagnosis, thereby supporting a comprehensive diagnostic approach that optimizes the clinical management of CNS infections in the post-surgical context
The development and validation in hypertensive patients of the Health Belief Model for pharmacological adherence (HBM-FA) scale
No full textIntroduction: pharmacological adherence in hypertensive patients is essential, so the study of the factors that influence it is essential.Objective: to develop and validate a scale based on the health belief model to measure factors influencing drug adherence in hypertensive patients.Methods: the development process of the HBM-FAS scale included the review of the literature, the generation of the items that conformed it (grouped in the six constructs that respond to the theoretical framework of the Health Belief Model), the evaluation of its content by a panel of experts, and the subsequent application of a pilot test. A confirmatory factor analysis of the proposed model was carried out, and its validity and reliability were subsequently evaluated. Results: a panel of experts evaluated the content validity of the instrument, showing a high degree of content validity. The CFA indicated poor fit indices (CFI=.763; TLI=.735; RMSEA=.118; SRMR=.143; CMIN/DF=.07), leading to modifications (removal of 9 out of 30 items). The refined model showed an acceptable fit (CMIN/DF=1.69; CFI=.977; TLI=.972; SRMR=.0393; RMSEA=.0434). The scale demonstrated high internal consistency reliability (.895) as well as good discriminant validity.Conclusions: the HBM-FA scale showed good psychometric properties, being suitable for measuring health beliefs associated with pharmacological adherence in hypertensive patients, which makes its use in future intervention studies beneficial
Exploring fMRI Biomarkers for Early Autism Prediction in Fragile X Syndrome
No full textNeurodevelopmental disorders like Autism Spectrum Disorder (ASD) and Fragile X Syndrome (FXS) often share similar behavioral and cognitive traits, which can make diagnosis and treatment more complex. While ASD typically arises from a mix of genetic and environmental influences, FXS is directly linked to mutations in the FMR1 gene. This review highlights recent progress in the use of neuroimaging—especially functional MRI (fMRI)—and machine learning, both of which are playing a growing role in improving diagnostic accuracy and deepening our understanding of how the brain functions in ASD and FXS. By exploring the latest research, we show how these tools help uncover both unique and overlapping patterns in brain activity, laying the groundwork for earlier diagnosis and more personalized interventions. These developments point to the powerful potential of combining brain imaging and AI to transform the way we approach diagnosis and care. Continued collaboration across disciplines is key to refining these techniques and moving closer to precision medicine in the field of neurodevelopmental disorders
Transforming rural healthcare: a mobile app for digital consultation and diagnostics
No full textAccess to quality medical care is essential for maintaining a healthy life, yet it remains challenging for many, particularly in addressing health issues promptly and effectively. Digital diagnostics and virtual consultations are transforming healthcare by leveraging technology to enhance patient care and streamline medical processes. These tools enable remote communication between patients and healthcare professionals, eliminating geographical barriers and increasing access to expert medical advice. This is especially beneficial in rural areas of India, where timely consultations and proactive health management can be difficult. To address this need, we have developed a mobile application powered by Recurrent Neural Networks (RNNs) that simplifies remote healthcare through online consultations. The app analyzes symptoms—submitted as text or images—generates relevant medical insights, and provides appropriate prescriptions. Acting as a virtual medical mentor, it educates patients about their health conditions and recommended treatments. The application features a chatbot that utilizes both text and image inputs to accurately identify diseases and deliver tailored medical guidance. This diagnostic bot not only improves patient-doctor communication but also minimizes unnecessary lab tests and costly treatments. It complements traditional in-person care by enhancing diagnostic accuracy, reducing the need for physical visits, and significantly cutting down waiting times
Caregiver Empowerment in the Community: Health Gains and Multicultural Challenges in Rehabilitation Nursing
No full textThe Caregiver Status was legally recognized in Portugal in 2019. Portuguese aging index and elderly dependency index increased in the last three decades, which has developed burden on caregivers. The empowerment of caregivers is an essential strategy to promote health gains, which is an indicator of rehabilitation nursing care. However, the multicultural nature of Portuguese society represents a significant challenge in this process. This theoretical-reflective article aims to analyze the empowerment process of the Caregiver in a community context, their health gains and the multicultural challenges for Rehabilitation Nursing. Caregiver empowerment is carried out by a reference Nurse, preferentially at home. The intervention of the Rehabilitation Nurse Specialist is essential to provide the Caregiver with the knowledge and skills needed to ensure performance of the activities of daily living, tools for the management of chronic disease, the prevention of complications and coping strategies. The empowerment process results in health gains for the Caregiver (for example, reduction of emotional overload and improvement in quality of life) and for the Person Cared For (for example, improvement in functional capacity and less exacerbation of chronic disease). Empowerment is efficient when it is structured, continuous and culturally sensitive, combined with appropriate monitoring by a Rehabilitation Nurse Specialist, with specific competencies on cultural diversity and training methods. It’s suggested that health policies and multicultural community programs be created that facilitate the empowerment of Informal Caregivers and contribute to the sustainability of health systems
Combined diagnosis of CNS infections in the post-surgical setting.
No full textIntroduction: Central nervous system (CNS) infections following neurosurgical interventions represented a serious, although infrequent, complication. Despite their low incidence, they generated high morbidity and mortality. These infections included meningitis, ventriculitis or brain abscesses, with factors such as the type of procedure and antibiotic prophylaxis being determining factors in their occurrence. Against this background, cerebrospinal fluid (CSF) analysis played a key role in the initial diagnosis.Development:The physicochemical analysis of CSF made it possible to identify alterations suggestive of infection through parameters such as glucose, proteins, pleocytosis and lactate. However, in patients who had received antibiotic treatment, these values were modified, making diagnosis difficult with conventional methods such as cultures and Gram staining. To overcome these limitations, molecular technologies such as multiplex PCR were introduced, which offered greater sensitivity and made it possible to detect specific pathogens such as Neisseria meningitidis or Streptococcus pneumoniae in less time. However, these tests also presented risks, such as false positives, requiring careful clinical interpretation.Conclusions: CSF physicochemical analysis continued to be useful, but insufficient as the only diagnostic tool. Combination with molecular methods increased the accuracy and speed of diagnosis, allowing more timely treatment. Consequently, it was concluded that the most effective approach was integrated diagnosis, which combined traditional techniques with molecular testing within an appropriate clinical framework
Evolution and challenges in the treatment of inguinal hernias
No full textThe study addressed inguinal hernias as a frequent cause of surgical intervention in adults, focusing on their classification, risk factors and the main surgical treatment techniques. It explained that these hernias could be divided into direct, indirect and crural hernias, according to their anatomical location. It analysed that recurrent hernias arose after previous interventions, influenced by technical factors or patient conditions such as age, chronic respiratory diseases or smoking. It also explained that surgical treatment had evolved, highlighting two main methods: open surgery and laparoscopic surgery. The latter offered advantages such as less postoperative pain and faster recovery, although it had certain limitations in patients with extensive surgical histories. Finally, he concluded that the choice of treatment should be individualised, assessing the risks and benefits on a case-by-case basis
Prevalence of multidrug-resistant microorganisms in patients admitted to the intensive care unit
No full textThe objective of this study is to determine the characteristics observed in the analysis of the medical records of patients admitted to the intensive care unit of the Manuel Belgrano General Acute Care Hospital, during the period from 1 January to 30 June 2024. The study analyses multi-resistant microorganisms, the pathology of admission, the requirement for mechanical ventilation, the antibiotics used empirically and/or directed according to cultures and mortality. The methodology used is a retrospective and observational study to identify the microorganisms present in the intensive care unit of a hospital in a province of Buenos Aires. The main objectives are: 1. To evaluate the number of patients in intensive care with infection by multi-resistant microorganisms in the period from 1 January to 30 June 2024 at Manuel Belgrano Hospital. 2. To determine the types of multi-resistant microorganisms most frequently found in intensive care. 3. To assess the mortality of infected patients. Results: The analysis included 28 patients hospitalised in the ICU from 1 January to 30 June 2024, with an average age of 58.3 years, of whom 70% were men. The most common comorbidities were hypertension (35%), chronic lung disease (26%) and a history of cancer (22%). The main pathogens identified were methicillin-resistant Staphylococcus aureus (15%) and Acinetobacter baumannii (13%). The most commonly used antibiotic treatments included meropenem and vancomycin, although 70% of the cases presented resistance to multiple drugs, resulting in a mortality rate of 47%. The average length of hospitalisation was 34 days, and 40% of patients discharged required follow-up in specialised care. Respiratory failure affected 65% of patients, with 50% requiring mechanical ventilation. Conclusion: This study has highlighted the complexities and challenges associated with infections caused by multidrug-resistant microorganisms in hospitalised patients. The high mortality rate highlights the urgent need for effective management and prevention strategies. Resistance to multiple antibiotics significantly affects treatment options, highlighting the importance of accurate diagnoses. In addition, the use of mechanical ventilation in a considerable number of patients indicates the severity of respiratory infections. It is essential to strengthen collaboration between multidisciplinary teams, implement rigorous infection control protocols and promote continuous education to face this growing challenge in medical care
Strategies to reduce renal risks associated with the use of contrast
No full textThe use of contrast agents transformed diagnostic and therapeutic procedures, allowing for better internal visualisation. However, it also generated complications such as contrast-induced acute kidney injury (CI-AKI), especially in patients with risk factors such as chronic kidney disease, diabetes or heart failure. In Argentina, during 2024, the importance of evaluating patients before the use of contrast, adequate hydration and the use of low-osmolality agents was recognised. Strategies such as standardised protocols, medical training and monitoring were established to reduce the incidence of this complication. Prevention and equitable access to resources were key to improving renal health outcomes