South Health and Policy (Journal)
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Calcium Role In The Treatment Of Hemorrhagic Shock
No full textHemorrhagic Shock is a type of Hypovolemic Shock caused by large blood loss, making tissue perfusion difficult. Advanced Trauma Life Support (ATLS) emphasizes the need for a systematic and organized approach to the management of hemorrhagic shock, prioritizing rapid control of hemorrhage and restoration of adequate tissue perfusion through aggressive and timely resuscitation. Due to its effects on coagulation, cardiac function and nerve conduction, in recent years there has been a need to monitor and eventually administer calcium supplements to patients with Hemorrhagic Shock as part of a package of measures to improve hemostasis. Citrate used as an anticoagulant in blood products during massive transfusions can result in the reduction of ionized calcium, with negative results on hemostasis as well as other physiological processes in which calcium is central. To improve clinical results in these patients, proactive monitoring and correction of calcium levels, a situation that occurs more and more frequently and is evident in a number of recent publications on the matter. Objective: To deepen the understanding of how calcium regulation can influence the clinical evolution and therapeutic management of patients with hemorrhagic shock, based on available scientific publications. Material and Methods: To collect data, a search was carried out in digital databases such as PUBMED, SCIELO (Scientific Electronic Library Online). The articles were downloaded from these platforms and the Vancouver system was used to manage appropriate citations and references. The study is based on latest literature that highlights the importance of monitoring calcium levels and its adequate replacement to prevent complications associated with hypocalcemia during the treatment of hemorrhagic shock, in order to ament clinical outcomes
Evidence of the usefulness of clinical simulation in building the profesionalcompetencies of medical students
No full textBackground: Clinical simulation is a key tool for balancing the development of medical skills and patient safety. Following reports from the institute of medicine highlighting the need to prevent medical errors In the United States, an initiative that extended to global healthcare, simulation was implemented as a tool in medical training to bridge the theory - practice gap. The UAI reaffirmed this commitment to clinical simulation training, despite challenges in its implementation, to strengthen education and ensure the competence of future healthcare professionals. The aim of this study is to obtain feedback from UAI students who have received clinical simulation classes. Material and methods: (Complete here). Results: (Complete here). Conclusion: (Complete here). (Utilizar texto justificado)
Systematic review: Microbiota And Chronic Inflammatory Diseases In Young Adults
No full textIntroduction: The gut microbiota plays a pivotal role in human health, influencing digestion, vitamin synthesis, and immune regulation. Dysbiosis, or microbiota imbalance, is linked to chronic inflammatory diseases (CIDs), such as Crohn\u27s disease and ulcerative colitis. Factors including genetics, environmental influences, and high-fat Western diets contribute to the prevalence of these conditions, particularly among young adults (18–35 years) in Argentina.Objectives: This study aims to examine the relationship between gut microbiota and CIDs in young adults in Argentina. It seeks to identify risk factors and dysbiosis patterns by:●Characterizing microbial composition,●Identifying dietary and environmental influences,●Correlating dysbiosis with inflammation and symptom severity, and●Proposing therapeutic interventions.Materials and Methods: This systematic review follows the PRISMA methodology.●Population: Young adults with CIDs reported in studies from 2015 to 2024.●Variables: Microbiota composition, inflammatory markers, dietary and environmental factors, and probiotic use.●Analysis: Data will be extracted and visualized through graphs and tables, with an assessment of the quality of selected studies.Results: The study aims to identify dysbiosis patterns and their association with environmental factors. It will also evaluate the effectiveness of probiotic interventions in improving symptoms and enhancing the quality of life for CID patients.Conclusions: This research underscores the significance of gut microbiota as both a diagnostic and therapeutic tool. It aims to propose personalized strategies that could be incorporated into public health policies to mitigate the impact of CIDs
Determinants of Hemolytic Uremic Syndrome in children under five years of agein Argentina
No full textIntroduction: hemolytic uremic syndrome (HUS), associated with Shiga toxin-producing Escherichia coli (STEC), is a leading cause of acute renal failure in children under five years of age. In Argentina, its high incidence reflects challenges in access to drinking water, food hygiene and health education.Objective: to evaluate the determinants of the incidence of HUS in Argentine children, focusing on hygiene practices, food consumption, access to water and knowledge of caregivers.Method: observational and descriptive study with three phases: literature review, survey to 33 parents of children <5 years old (food habits, hygiene, knowledge of HUS) and comparative analysis with data from the National Epidemiological Bulletin.Results: 90,9 % of respondents resided in urban areas, with access to treated water (81,8 %) and high hygiene practices (84,8 % hand washing). However, risks persist: 48,5 % consume unpasteurized products, 33,3 % do not use separate cutting boards and 30,3 % do not know about HUS. The Bulletin highlights higher incidence in rural areas with poor infrastructure and in hot seasons. Cross-contamination and food handling in restaurants were factors highlighted.Conclusions: the incidence of HUS in Argentina is linked to gaps in the rigorous implementation of hygiene practices, unequal access to drinking water and lack of knowledge about prevention. Educational campaigns, improvement of sanitary infrastructure and food controls are recommended, especially in vulnerable areas and during periods of higher risk. The integration of public policies and community education could reduce the burden of the disease in the child population.
Pediatric oncology: past, present, and future
No full textThe infantile cancer has a marked importance in the environment of the pediatrics; since it is the second cause of mortality in the childhood. The oncopediatría has gone perfecting the diagnosis and the treatment protocols, getting better indexes of survival. At the present time, the advances in the technical diagnose and therapies facilitate a significant increment of survivors among the sick cancer infantojuveniles. He was carried out the present bibliographical revision with the objective of characterizing the evolution of the Oncopediatria. For the achievement of this objective 15 bibliographies were consulted. The improvement of the survival of the patients is not due to the improvements diagnose, therapeutic and assistance, to a decrease of the incidence. The future of the oncopediatría is directed to less toxic, more effective and more selective treatments; and to be able to identify the patients for their genetic profile predicting if they will respond or not to certain drug or outline.
Inclusion of the variable “skin color” in the Complementary Statistical Information Health Subsystem of Cuba
No full textIntroduction: The inclusion of skin color as a sociodemographic variable in health information systems represents a challenge to strengthening health equity in Cuba. Despite having a universal and free healthcare system, the omission of this variable hinders analytical capabilities and the design of inclusive public policies.Objective: To characterize the status of the inclusion process of the “skin color” variable in Cuba’s Complementary Statistical Information Health Subsystem in 2024.Method: A cross-sectional descriptive study was conducted, combining document review, a focus group with specialists, and surveys of healthcare professionals. A total of 67 SIEC systems were analyzed, assessing primary and secondary records, the categories used, and staff perceptions regarding the inclusion of the variable.Results: The variable is present in only 25% of primary records and absent in all flow forms, preventing its consolidation at higher levels. A lack of standardization in the categories used was identified. Strategic systems were prioritized for initial inclusion, such as Classified patients in primary health care, Notifiable Diseases, and Outpatient Consultations.Conclusions: The study characterized the status of the inclusion of the skin color variable in Cuba’s SIEC health information systems in 2024, revealing limited and non-standardized integration. Effective incorporation requires a gradual and structured process that includes technical redesign, staff training, regulatory adjustments, and continuous monitoring.
Sertoli-Leydig cell tumor in a child and adolescent consultation patient. Case presentation
No full textIntroduction: ovarian cancer is the third most common gynecological cancer and the one with the worst prognosis. Among non-epithelial tumors, there are three groups: pure stromal tumors, pure tumors of the sexual cords and mixed tumors, which originate from the sexual cords and stromal cells, with cell tumors belonging to the latter group. by Sertoli-Leydig.Objective: to describe the clinical case of a patient diagnosed with a Sertoli-Leydig cell tumor at the “Dr. Antonio Luaces Iraola” Provincial Teaching Hospital in Ciego de Ávila.Case presentation: the case of a 14-year-old adolescent was presented, with a history of apparent health, with early onset of sexual relations since the age of 13, who attended the Provincial Outpatient Consultation of Child and Youth Gynecology reporting menstrual delay accompanied by an increase in abdominal volume without other symptoms. The study carried out confirmed the presence of a right adnexal tumor mass, which is why it was decided to perform surgery. The biopsy performed confirmed the diagnosis of Sertoli-Leydig cell tumor.Conclusions: the case presented constitutes the first and only existing record of its type attended in the province of Ciego de Ávila. The diagnosis of this entity is due to a thorough physical examination and joint assessment by a multidisciplinary team
Training competencies in dysmorphology: learning needs for professionals involved in clinical genetics
No full textIntroduction: Recent advances in molecular genetics and the use of artificial intelligence require professionals whose work is related to clinical genetics to have a basic knowledge of dysmorphology. It is therefore necessary to design a teaching strategy to improve their professional performance. Objective: To identify learning needs in dysmorphology for professions related to clinical genetics.Methods: A descriptive cross-sectional observational study was conducted on a non-probabilistic accidental sample of 80 professionals who attended the face-to-face conference “Dysmorphology: current challenges” and who were willing to respond to an anonymous printed questionnaire. Descriptive statistical methods were used to process the data. Results: The average age of those who responded to the questionnaire was 46.83, the majority were female (92.5%), predominantly doctors (48.75%), with an average of 23 years of professional experience. Fifty-one point twenty-five percent were in teaching positions and fifty-two point five percent were scientists. Most attendees were satisfied with the conference, and the majority of proposals for postgraduate activities to be carried out during the course (sixty-three point three percent) included the use of technology for diagnosis (one hundred percent) and the use of nomenclature in dysmorphology (ninety-five point five percent). Conclusion: The handling of nomenclature in semiology and the application of technology for diagnosis were identified as learning needs
Use of colostrum as an innovative therapy in Neonatal Intensive Care Units
No full textColostrum is part of the lactomaterno component, it is a right of the human being and its benefits are widely known, but; it is not equally applied in the different NICU services of the city and the need to be implemented in a rigorous and standardized manner is urgent. For this reason, this research set out to investigate the situation of the use of colostrum in the city of Rosario, specifically; the level of compliance with colostrum therapy as a treatment and the obstacles they hinder. To achieve this, a research was carried out with a quantitative, descriptive, bivariate, comparative approach of the Observational and cross-sectional type. The design was descriptive, multicenter, where variables were proposed to be measured, such as: a) Level of compliance with the use of colostrum. (b) Obstacles to implementation; Nurses in the NICU who for some reason did not wish to participate in the study and those who are not working in service, for example, due to illness, were excluded from the study.In the first measurement, a written survey was applied to a total of 45 members of the nursing team from the different NICUs of the city of Rosario in both public and private institutions.
Puerperal eclampsia in the immediate postoperative period of cesarean section: a critical obstetric emergency
No full textEclampsia is a serious and potentially life-threatening complication of hypertensive disorders of pregnancy, characterized by the onset of new-onset seizures (tonic-clonic, focal, or multifocal) in the absence of other identifiable neurological causes. Most cases of eclampsia manifest postpartum, with the first 48 hours being the highest risk period. Recent literature has documented the emergence of atypical forms of eclampsia, in which seizures can occur in the absence of hypertension or proteinuria. The unpredictable nature of these cases makes timely diagnosis and management difficult. A 29-year-old female patient at approximately 40.6 weeks presented to the emergency department with prodromes of labor. An obstetric ultrasound was performed, and given the diagnosis of risk of loss of fetal well-being, an emergency segmental cesarean section was performed. Approximately four hours after the cesarean section, the patient presented two generalized tonic-clonic seizures. Anticonvulsant treatment was administered, a diagnosis of puerperal eclampsia was established, and her transfer to the Intensive Care Unit (ICU) was coordinated. The therapeutic plan in the ICU included an infusion of phenytoin as an anticonvulsant, antihypertensive management with alpha-methyldopa, hemodynamic support, correction of fluid and electrolyte imbalance, and empirical antibiotic therapy due to suspected urinary tract infection. Her subsequent evolution was favorable, remaining afebrile, hemodynamically stable, and without recurrence of seizures. The unusual presentation of puerperal eclampsia in the immediate postoperative period, in the initial absence of the classic diagnostic criteria of hypertension and proteinuria, is significant and of academic value. This case underscores the importance of maintaining a high level of clinical suspicion for eclampsia in the immediate postpartum period, even without prior criteria for preeclampsia. Early recognition and the timely use of magnesium sulfate are essential to reduce maternal morbidity and mortality