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ABSTRACT Objective: To evaluate autoinflammatory diseases (AID) according to age at diagnosis and sex, and response to therapy in a large population. Methods: This is a cross-sectional observational study of a Latin American registry using a designed web system for data storage, collected between 2015 and 2018. Any altered findings during follow-up were recorded. The forms were translated into Portuguese and Spanish, including demographic, clinical, laboratory, genetic and treatment characteristics. Results: We included 152 patients, 51.3% male and 75% Caucasian. The median age at disease onset was 2.1 years (0–15.6 years) and median age at diagnosis 6.9 years (0–21.9 years); 111 (73%) were children (0–9 years old), and 41 (27%) were adolescents and young adults (AYA) (10–21 years old). Periodic fever, aphthous stomatitis, pharyngitis, and adenitis syndrome (PFAPA) occurred in 46/152 (30%), chronic non-bacterial osteomyelitis (CNO) in 32/152 (21%), and familial Mediterranean fever (FMF) in 24/152 (15.7%). PFAPA was significantly higher in young children than in AYA (38.7% vs. 7.3%, p<0.001), while CNO were lower (13.5% vs. 41.5%, p<0.001). The frequency of females was significantly higher in CNO (28.4% vs. 14.1%, p=0.031) and lower in FMF (8.1% vs. 23.1%, p=0.011). The most used drugs were glucocorticoids, non-steroidal anti-inflammatory drugs (NSAID), and colchicine. Glucocorticoids and colchicine treatment were used in all AID with good to moderate response. However, cryopyrin-associated periodic syndromes (CAPS) seemed unresponsive to glucocorticoids. NSAIDs and methotrexate were the main medications used to treat CNO. Conclusions: Differences among AID patients were observed in the LA population regarding sex and age at disease diagnosis.

RESUMO Objetivo: Avaliar as doenças autoinflamatórias (DAI) de acordo com sexo e idade no momento do diagnóstico e a resposta terapêutica em uma grande população. Métodos: Este é um estudo observacional transversal de um registro latino-americano que usou um sistema de dados coletados entre 2015 e 2018. Quaisquer achados alterados ao longo do acompanhamento foram registrados. Os formulários foram traduzidos para os idiomas português e espanhol, incluindo características demográficas, clínicas, laboratoriais, genéticas e de tratamento. Resultados: Incluímos 152 pacientes, sendo 51,3% do sexo masculino e 75% da raça branca. A média de idade de início da doença foi de 2,1 anos (0–15,6 anos) e a média de idade de diagnóstico 6,9 anos (0–21,9 anos); 111 (73%) eram crianças (0–9 anos) e 41 (27%) adolescentes/adultos jovens (10–21 anos). A síndrome de febre periódica, estomatite aftosa, faringite e adenite (PFAPA) ocorreu em 46/152 (30%), osteomielite não bacteriana crônica (CNO) em 32/152 (21%) e febre familiar do Mediterrâneo (FMF) em 24/152 (15,7%). A PFAPA foi significativamente maior em crianças pequenas (38,7 vs. 7,3%, p<0,001), e a CNO, em adolescentes/adultos jovens (13,5 vs. 41,5%, p<0,001). A frequência do sexo feminino foi significativamente maior na CNO (28,4 vs. 14,1%, p=0,031) e menor na FMF (8,1 vs. 23,1%, p=0,011). Os medicamentos mais utilizados foram glicocorticoides, anti-inflamatórios não esteroidais (AINE) e colchicina. O tratamento com glicocorticoides e colchicina foi usado em todas as DAI com resposta boa a moderada. No entanto, as síndromes periódicas associadas à criopirina (CAPS) pareciam não responder aos glicocorticoides. AINE e metotrexato foram os principais medicamentos utilizados no tratamento da CNO. Conclusões: Diferenças de pacientes com DAI foram observadas na população latino-americana em pacientes agrupados por sexo e idade ao diagnóstico da doença.

https://doi.org/10.1590/1984-0462/2024/42/2022184

Homenaje al prof. dr. José Alberto Mainetti (1938 2022)
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Fracapani, Marta Teresa

Acta bioethica

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Jun 2023, Volumen 29 Nº 1 Paginas 131 - 132

Resumen: Es | Texto: Es | PDF: Es

Estandarización de la batería neuropsicológica de funciones ejecutivas y lóbulos frontales BaNFE-2 en muestra paraguaya con esclerosis múltiple tipo recaída remisión
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Doldán, María Celeste

; Díaz De Bedoya, Fernando Hamuy

; Nacimiento, Belen

; Fleitas, Cynthia Verónica

; Galeano, Martha Sady

; Ramirez, María Teresa

; Gonzalez, Lourdes

; Martinez, Montserrat

; Paredes Ramírez, Paola

; Rolon, Marta Beatriz

Revista del Instituto de Medicina Tropical

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Jun 2023, Volumen 18 Nº 1 Paginas 38 - 56

Resumen: En Es | Texto: En Es | PDF: En | PDF: Es

ABSTRACT Introduction: Multiple sclerosis (MS) is a chronic, neurodegenerative, inflammatory disease of the central nervous system (CNS) that significantly compromises cognitive functions. In Paraguay, it occurs with a prevalence of 9.2/100,000 inhabitants, 72% in the clinical form of relapsing remission (RRMS) and an incidence of 2 to 3 women/men, affecting more people of productive age with high economic and emotional costs. Objectives: To characterize the Paraguayan patient with RRMS, to assess the state of their executive functions (EFs) with the BaNFE-2 battery, and to establish cut-off values adjusted to the country. Methods: Research based on the theory of cognitive neuroscience of non-experimental, quantitative and descriptive design for analytical purposes. It is empirical, retrospective and cross-sectional. The psychometric technique and neuropsychological interview were used in a convenience sample of 40 patients aged 25 to 55 (37.78 ± 7.89) and 82.5% women. Results: Demographic and clinical data of the participants were reported. The BaNFE-2 coded and normalized scales were statistically characterized, the internal consistency of which was significant. 52.5% of the alteration was obtained in the anterior prefrontal scale and 42.5% in FEs; there are significant relationships with schooling, physical disability (PD), number of outbreaks and cognitive impairment (CI); there were also significant differences by sex, education, PD and CI. Standardized scores adjusted for schooling were calculated such that z<-1 establishes the cutoff between normality and abnormality. Conclusion: BaNFE-2 battery tests profile the affectation of execution time, attention, working memory, and FEs. This study provides the adjusted scales for the country and opens a new line of research applying the BaNFE-2 battery in people with MS.

RESUMEN Introducción: la esclerosis múltiple (EM), enfermedad crónica del sistema nervioso (SNC), compromete significativamente la cognición. Su prevalencia en Paraguay es 9,2/100.000 habitantes, 72% con recaída remisión (EMRR) e incidencia de 2-3mujeres/hombre, afecta más a personas en edad productiva, con altos costos económicos y afectivos. Objetivos: caracterizar al paciente con EMRR, evaluar sus funciones ejecutivas (FEs) con BaNFE-2; establecer valores de corte ajustados al país. Metodología: con fundamento en teoría de la neurociencia cognitiva, diseño no experimental, cuantitativo, descriptivo, empírico, retrospectivo y transversal; técnica psicométrica y entrevista neuropsicológica en una muestra por conveniencia de 40 pacientes, 82,5% mujeres y edad 25-55 años (37,78±7,89). Resultados: se reportaron datos demográficos y clínicos, se caracterizaron las escalas de BaNFE-2 cuya consistencia interna resultó significativa. Se obtuvo 52,5% de alteración en la escala prefrontal y 42,5% en FEs; relaciones significativas con escolaridad, discapacidad física (DF), cantidad de brotes y deterioro cognitivo (DC); diferencias significativas por sexo, escolaridad, DF y DC. Se calcularon puntuaciones tipificadas por escolaridad, z<-1 establece el corte entre normalidad y alteración. Conclusión: las pruebas de BaNFE-2 perfilan la afectación del tiempo de ejecución, atención, memoria de trabajo y FEs. Este estudio aporta baremos ajustados al país y abre una novedosa línea de investigación aplicando BaNFE-2 en EM.

https://doi.org/10.18004/imt/2023.18.1.6

Factors related to the readiness of Brazilian chronic pediatric patients to transition to care in adult clinics
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Carrara, Fernanda Souza Angotti

; Piotto, Daniela Gerent Petry

; Silva, Ilana Izidoro

; Len, Claudio Arnaldo

; Russo, Gleice Clemente Souza

; Chiba, Sonia Mayumi

; Sdepanian, Vera Lucia

; Braga, Josefina Aparecida Pellegrini

; Figueiredo, Maria Stella

; Andrade, Maria Cristina

; de Almeida Maia, Marta Liliane

; Abreu, Ana Lúcia

; Silva, Celia Maria Camelo

; Terreri, Maria Teresa

Jornal de Pediatria

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Jun 2023, Volumen 99 Nº 3 Paginas 254 - 262

Resumen: En | Texto: En | PDF: En

Abstract Objective Advances in medicine have increased the life expectancy of pediatric patients with chronic illnesses, and challenges with the guided transition of adolescents and young adults from pediatric clinics to adult clinics have grown. The aim of this study was to better understand readiness and factors related to this transition process in Brazil. Method In this cross-sectional study of 308 patients aged from 16 to 21 years under follow-up in pediatric specialties, the degree of readiness for transition was assessed using the Transition Readiness Assessment Questionnaire (TRAQ) and its domains. Associations with demographic data, clinical data, socio-economic level, medication adherence, family functionality, and parental satisfaction with health care were evaluated. Results The median TRAQ score was 3.7 (3.2 - 4.2). Better readiness was associated with female patients, socio-economic class A-B, current active employment, higher level of education, not failing any school year, attending medical appointments alone, functional family, and a good knowledge of disease and medications. A low correlation was observed between TRAQ and age. TRAQ presented good internal consistency (alpha-Cronbach 0.86). In the multiple linear regression, TRAQ score showed a significant association with female gender, advanced age, socio-economic class A-B, better knowledge of disease and medications, and independence to attend appointments alone. Conclusion TRAQ instrument can guide healthcare professionals to identify specific areas of approach, in order to support adolescents with chronic disease to set goals for their own personal development and improve their readiness to enter into the adult healthcare system. In this study, some factors were related to better TRAQ scores.

https://doi.org/10.1016/j.jped.2022.10.006

Valoración de la fragilidad en un centro de diálisis. ¿Son más frágiles los pacientes con diabetes?
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Guerrero-Carreño, Sonia

; Elías-Sanz, Eva

; Gómez-Umbert, Miquel

; Quintela-Martínez, Marta

; Gabarró-Taulé, Teresa

; Arias-Guillén, Marta

Enfermería Nefrológica

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Mar 2023, Volumen 26 Nº 1 Paginas 24 - 32

Resumen: En Es | Texto: En Es | PDF: En | PDF: Es

ABSTRACT Introduction: The increase in the inclusion of elderly people in hemodialysis programs is connected to a rise in the prevalence of their frailty, considered as well as a prediction of disability and often associated with adverse health events. Given its reversible nature, screening is essential to improve clinical practice. Objective: To assess the frailty index and the patient functional status in our hemodialysis unit, as well as analyze the differences between diabetics and non-diabetics. Material and Method: Observational cross-sectional study. Frailty was measured using the Fried phenotype and functional assessment using the Barthel, Lawton, Downton, and Short Physical Performance Battery scales. Comorbidity and fall risk were evaluated with the Charlson and Downton scales, respectively. Diabetic and non-diabetic groups were compared, as well as the relationship between frailty and age, dependency, comorbidity, and fall hazard was analyzed. Results: A hundred and twenty-eight patients were included in the study. 45% had diabetes. Diabetic patients had a higher average age than non-diabetics (74.2±11 vs 67.8±15 years) and higher comorbidity (Charlson 8.2±2.2 vs 5.8±2.4). Twenty-five percent of the patients had frailty, observing a trend that suggests higher frailty, worse functional capacity, and a higher degree of dependency in diabetic patients, although not significantly. Conclusions: A quarter of the sampled analyzed presents frailty, with a more pronounced tendency to suffer from it in the case of diabetic patients, which could be related to older age, higher comorbidity, and less functional capacity than non-diabetic people.

RESUMEN Introducción: El incremento en la inclusión de personas de edad avanzada a los programas de hemodiálisis se relaciona con un aumento de la prevalencia de fragilidad, considerada predictora de discapacidad y asociada a eventos adversos de salud. Dado su carácter reversible, es importante hacer un cribaje para mejorar la práctica clínica. Objetivo: Evaluar el grado de fragilidad y estado funcional del paciente en nuestra unidad de hemodiálisis y analizar las diferencias entre diabéticos y no diabéticos. Material y Método: Estudio observacional de corte transversal. La fragilidad se midió utilizando el fenotipo de Fried y la valoración funcional mediante las escalas Barthel, Lawton, Downton y la Short Physical Performance Battery. Se evaluó comorbilidad y riesgo de caídas con las escalas Charlson y Downton respectivamente. Se comparó entre grupos de diabéticos y no diabéticos y se analizó la relación entre la fragilidad y la edad, dependencia, comorbilidad y riesgo de caídas. Resultados: Se incluyeron 128 pacientes. El 45% tenían Diabetes. Los pacientes con diabetes tenían una edad media mayor que los no diabéticos (74,2±11 vs 67,8±15 años) y mayor comorbilidad (Charlson 8,2±2,2 vs 5,8±2,4). El 25% de los pacientes presentaron fragilidad, observando una tendencia que sugirió mayor fragilidad, peor capacidad funcional y mayor grado de dependencia en los pacientes diabéticos, aunque de forma no significativa. Conclusiones: Una cuarta parte de la población estudiada presenta fragilidad, con una tendencia más acusada a padecerla los pacientes diabéticos, que podría estar relacionada con mayor edad, mayor comorbilidad y menor capacidad funcional que los no diabéticos.

https://doi.org/10.37551/s2254-28842023003

Baby trich: the role of psychosocial stressors in pediatric trichotillomania
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Falcão, Mariana

; Magalhães, Patrícia

; Sá, Teresa

; Liz, Mariana

; Lopes, Ana Filipa

; Antunes, Marta

; Silva, Ana Filipa

; Martins, Vânia

Nascer e Crescer

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Mar 2023, Volumen 32 Nº 1 Paginas 34 - 37

Resumen: En Pt | Texto: En Pt | PDF: En | PDF: Pt

Abstract Pediatric trichotillomania is characterized by the persistent pulling of one’s own hair, resulting in areas of hair loss and affecting the child and family’s daily functioning. Studies investigating the etiology, evolution, and treatment of pediatric trichotillomania are scarce. Scientific data suggests that pediatric trichotillomania can persist into adulthood and indicate the role of external stressors in its etiology. This article describes five clinical cases of children aged between 21 months and four years diagnosed with pediatric trichotillomania, with several external stressors as possible etiology. Psychoeducation and caregiver-child psychotherapy or child-centered play therapy were proposed as treatments. The authors highlight the importance of external stressors in the etiology of pediatric trichotillomania and suggest the beneficial effect of psychoeducation and psychotherapy in its course. Further research is critical to improve the screening and treatment of pediatric trichotillomania.

Resumo A tricotilomania infantil caracteriza-se pela necessidade recorrente de arrancar o cabelo/pêlo, resultando em áreas de rarefação capilar/pilosa e com impacto funcional na vida da criança e família. Os estudos acerca da etiologia, evolução e tratamento da condição são escassos. A evidência científica sugere que pode persistir até à idade adulta e ressalva a importância dos fatores psicossociais na sua etiologia. Neste artigo, são apresentados cinco casos clínicos de crianças com idades compreendidas entre 21 meses e quatro anos com diagnóstico de tricotilomania infantil com vários stressores como possível etiologia. O tratamento proposto consistiu em psicoeducação e psicoterapia cuidador-criança ou terapia de jogo centrada na criança. O presente estudo reforça a importância dos fatores psicossociais no desenvolvimento desta perturbação e o benefício da psicoeducação e da psicoterapia. São necessários mais estudos para otimizar o diagnóstico e tratamento da tricotilomania infantil.

https://doi.org/10.25753/birthgrowthmj.v32.i1.25718

A year of pandemic: psychological effects in Spanish children from 3 to 11 years of age
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Giménez-Dasi, Marta

; Quintanilla, Laura

; López, Teresa Simón

Psicothema

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2023, Volumen 35 Nº 2 Paginas 119 - 128

Resumen: Es En | Texto: Es En | PDF: Es | PDF: En

Resumen: Antecedentes: Tras el confinamiento, la escuela se adaptó a las restricciones para controlar el COVID-19. Evaluamos si el regreso al colegio constituyó un estresor para los niños o contribuyó a su recuperación tras el impacto del confinamiento. Método: Participaron 291 familias con niños entre 3 y 11 años. Los padres evaluaron a los niños a través del Sistema de Evaluación de Niños y Adolescentes (SENA) en tres momentos: T1 (unas semanas antes del confinamiento), T2 (después de estar entre 4 y 6 semanas confinados) y T3 (un año después del inicio de la pandemia). Resultados: Para los niños de Infantil, las comparaciones no mostraron diferencias en ninguna de las escalas y ninguno de los tiempos evaluados. Para los niños de Primaria, no se hallaron diferencias entre T1 y T3. La comparación entre T2 y T3 indicó una mejora en las escalas Disposición al estudio, Regulación emocional e Hiperactividad e impulsividad. Conclusiones: La vuelta al colegio contribuyó a mejorar algunas dimensiones en los niños de Primaria. Sin embargo, parece que ni el confinamiento ni las posteriores medidas restrictivas han tenido un impacto negativo en los niños de esta muestra. Para interpretar estos resultados discutimos los factores de protección y vulnerabilidad psicológica.

Abstract: Background: After the lockdown, schools adopted measures to avoid infection, which changed pre-pandemic routines. We evaluated whether the new school conditions constituted a stress factor for children or contributed to their recovery after the impact of the lockdown period. Method: Participants included 291 families with children between 3 and 11 years of age. The children were assessed by parents through the Child and Adolescent Assessment System (SENA) at three time points: T1 (before COVID-19 confinement), T2 (after the children had spent between 4 and 6 weeks confined), and T3 (one year after the beginning of the pandemic). Results: For Preschoolers, no statistical differences were found in any scale or time point. For primary-school children, the differences between T1 and T3 were not significant. Comparisons between T2 and T3 showed significant differences in Willingness to study, Emotional regulation and Hyperactivity and impulsivity. Conclusions: Our results suggest that returning to school might have improved some dimensions of primary-school children's well-being. However, it seems that neither the confinement nor the restrictive measures have had a negative effect on our sample. To interpret these findings, we discuss the psychological factors of protection and vulnerability.

https://doi.org/10.7334/psicothema2022.223

CHOose Study: contraceptive choices in women with class 2 and class 3 obesity in the Primary Care of Vila Nova de Gaia and Espinho
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Napoleão, Leonardo

; Costa, Ana Carolina

; Araújo, Ana Catarina

; Silva, Ana Isabel

; Vidal, Ana

; Cardoso, Carla

; Baía, Catarina

; Saraiva, Daniela

; Alves, Eduarda

; Almeida, Eduardo

; Santos, Filipe

; Rodrigues, Inês O.

; Silva, Joana

; Louçano, João

; Lira, Luís Terroso

; Cruz, Mariana

; Horta, Mariana

; Neves, Marta Perro

; Graça, Paulo

; Sonié, Pedro

; Borges, Raquel

; Albuquerque, Sara

; Leite, Sara

; Teixeira, Sara

; Andrade, Teresa

Acta Obstétrica e Ginecológica Portuguesa

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Dic 2022, Volumen 16 Nº 4 Paginas 332 - 340

Resumen: Pt En | Texto: Pt En | PDF: Pt | PDF: En

Resumo Introdução e Objetivos: A prevalência da obesidade entre mulheres em idade fértil tem aumentado nos últimos anos, devendo ser considerada na escolha do método contracetivo. Estas mulheres apresentam maior risco de eventos tromboembólicos, sendo superior com a utilização de contraceção hormonal combinada (CHC). Por este motivo, algumas sociedades médicas não recomendam a utilização de CHC nas mulheres com obesidade classe 2 e 3. Este estudo tem como objetivo avaliar a terapêutica contracetiva nas mulheres obesas de classe 2 ou superior em nove Unidades de Saúde Familiar (USF’s) da região norte de Portugal. Tipo de Estudo: Estudo multicêntrico observacional retrospetivo transversal. População: Todas as mulheres em idade fértil (15-49 anos), com IMC ≥35 kg/m2, inscritas nas USF’s intervenientes e inseridas no programa de planeamento familiar (PF). Métodos: A amostra foi recolhida através da plataforma MIM@UF® e a identificação do método anticoncecional e antecedentes tromboembólicos através do processo clínico (SClínico®). Foram excluídas mulheres grávidas, mulheres sem consulta nos últimos cinco anos e mulheres com dados inválidos. Resultados: Da amostra inicial de 1063 mulheres, 123 foram excluídas. A idade média era 36,8 ± 8,8 anos e o IMC médio era 39,2 ± 4,0 kg/m2. Desta amostra, 36,2% (n=340) estavam sob progestativos (70,9% progestativo oral, 14,7% sistema intrauterino com levonorgestrel, 13,8% com implante progestativo, 0,6% com progestativo injetável); 27,7% (n=260) estavam sob CHC, 12,8% (n=120) estava sob métodos não hormonais (55,8% métodos de barreira; 37,5% dispositivo intrauterino de cobre; 6,7% métodos naturais); 6,4% (n=60) estavam com métodos permanentes e 17,0% não utilizavam método contracetivo (n=160). Nesta amostra, 2,2% (n=21) tinham antecedentes tromboembólicos. Conclusões: A CHC é o segundo método mais usado nas USF intervenientes, apesar do seu uso não estar recomendado. Dado o elevado risco de eventos tromboembólicos, é essencial implementar medidas corretivas para a melhoria do aconselhamento contracetivo nas consultas de PF.

Abstract Overview and Aims: The prevalence of obesity among fertile women has increased over the last few years and should be considered when choosing a contraceptive method. These women have a higher risk of thromboembolic events that increases with the use of combined hormonal contraception (CHC). Therefore, some medical societies do not recommend the use of CHC in women with class 2 obesity or higher. This study aims to assess the contraceptive methods used in women with class 2 obesity or higher in nine Primary Healthcare Units (PHU) in northern Portugal. Study Design: Multicentric retrospective, observational, cross-sectional study. Population: All women of reproductive age (between ages 15 and 49), with a BMI ≥ 35 kg/m2, enrolled in the intervening PHU and included in the family planning (FP) program. Methods: The sample was collected using the MIM@UF® database, obtaining the contraceptive method and thromboembolic history through the individual electronic medical record system, Sclínico®. Pregnant women, women without a medical appointment in the previous five years and women with invalid data were excluded. Results: From the initial sample of 1063 women, 123 were excluded. The mean age was 36.8 ± 8.8 years, the mean BMI was 39.2 ± 4.0 kg/m2. From the sample, 36.2% (n=340) were using progestogen (70.9% progestogen-only pill, 14.7% levonorgestrel intrauterine system, 13.8% progestogen-only implant, 0.6% progestogen-only injectables); 27.7% (n=260) were taking CHC; 12.8% (n=120) were with a non-hormonal methods (55.8% barrier methods; 37.5% copper intrauterine contraceptive device, 6.7% natural methods); 6.4% (n=60) were with permanent methods, 17.0% were not using any type of contraception (n=160). In this sample, 2,2% (n=21) had a thromboembolic event. Conclusions: CHC was the second most used method in the intervening FHU, although its use is not recommended. Given the high risk of thromboembolic events, it is essential to implement corrective measures to improve contraceptive counselling in FP consultations.

Tumor paravertebral dorsal solitario: caracterización radiológica e histopatológica de un caso pediátrico de fascitis nodular
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Arredondo-Montero, Javier

; Dot-Gómara, Teresa

; Hernández-Martín, Sara

; Bronte-Anaut, Mónica

; Montes, Marta

Anales del Sistema Sanitario de Navarra

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Dic 2022, Volumen 45 Nº 3 elocation e1025

Resumen: Es En | Texto: Es En | PDF: Es | PDF: En

Resumen La fascitis nodular es una lesión benigna de tejidos blandos de rápida proliferación fibroblástica o miofibroblástica, excepcional en pediatría. Presentamos el caso de un varón de siete años, sin antecedentes, que debutó con una tumoración dorsal asintomática identificada incidentalmente. La resonancia magnética mostró una lesión paravertebral dorsal izquierda con hipointensidad en T1, hiperintensidad en T2, captación periférica de contraste y el denominado signo de la cola fascial. Se realizó una resección quirúrgica completa de la lesión. El estudio histopatológico mostró una proliferación de células fusiformes o estrelladas con núcleos sin atipia en un estroma mixoide o colagenizado. El perfil inmunohistoquímico mostró positividad para actina de músculo liso SMA, actina músculo específica HHF35 y calponina. Se diagnosticó fascitis nodular, entidad que presenta un diagnóstico diferencial amplio y complejo. La presencia de signos radiológicos específicos y la adecuada caracterización inmunohistoquímica de la lesión contribuyen a realizar un diagnóstico preciso.

Abstract Nodular fasciitis is a benign soft tissue lesion with rapid fibroblastic or myofibroblastic proliferation, rarely observed in pediatric patients. Here, we present the case of a seven-year-old boy with no relevant medical records, in whom an asymptomatic dorsal tumor was incidentally identified. Magnetic resonance imaging showed a left dorsal paravertebral lesion with hypointensity on T1, hyperintensity on T2, peripheral contrast enhancement, and the so-called fascial tail sign. Complete surgical resection of the lesion was achieved. The histopathological study showed a proliferation of spindle or stellate cells with nuclei without atypia in a myxoid or collagenized stroma. The immunohistochemical profile showed positivity for smooth muscle actin, muscle-specific actin antibody HHF35, and calponin. The lesion was diagnosed as nodular fasciitis, an entity with broad and complex differential diagnosis. Presence of specific radiological signs and adequate immunohistochemical characterization of the lesion help perform an accurate diagnosis.

https://doi.org/10.23938/assn.1025

10.

Prevalencia de síndrome metabólico en adolescentes escolarizados del Departamento Central en el año 2021
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Gaona, Nelly

; Sanabria, Marta Cristina

; Piris, Angela

; Suh Dong, Chin

; Pereira, Patricia

; Cuevas, María Teresa

Pediatría (Asunción)

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Dic 2022, Volumen 49 Nº 3 Paginas 142 - 153

Resumen: Es En | Texto: Es En | PDF: Es | PDF: En

RESUMEN Introducción : El Síndrome Metabólico (SM) es una entidad clínica que se manifiesta por obesidad central, dislipidemia, hiperglicemia y/o hipertensión arterial y se relaciona con el desarrollo de Diabetes Mellitus tipo 2 y enfermedades cardiovasculares. Objetivo : Determinar la prevalencia del SM en adolescentes escolarizados del Departamento Central en el 2021 y evaluar los factores de riesgo relacionados. Materiales y Métodos: Estudio descriptivo con componente analítico. Ingresaron 279 adolescentes de 10 a 16 años de 6 escuelas elegidas aleatoriamente. Se realizó una encuesta sobre estilos de vida, prácticas alimentarias, antecedentes familiares y perinatales. Se realizó medición de peso, talla, circunferencia de cintura (CC), glicemia, perfil lipídico y presión arterial. Para el diagnóstico de SM se utilizó los criterios de Cook. Aprobado por el Comité de Ética del IICS y del Hospital de Clínicas. Para el análisis se utilizaron tablas de frecuencias, mediana y Prueba del Chi cuadrado para razón de prevalencias (RP) con nivel de significancia p < 0,05. Resultados : Mediana de edad 13 años en general y 11,5 años en SM, 53 % fueron hombres. La prevalencia de sobrepeso fue del 22,9 % y de obesidad 26,16 %. La hiperglicemia fue del 0,01 %, hipertrigliceridemia 16 %, HDL bajo 37,9 %, Prehipertensión arterial 11% y CC > p90 36%. La prevalencia de SM fue del 10,7 %. La CC >p90 con RP de 31,4 (7,6-128), y la hipertrigliceridemia con RP de 46,8(14,8-147,7), fueron los componentes preponderantes de SM. El peso elevado al nacer y no realizar actividad física, fueron identificados como factores de riesgo significativo. Conclusiones: La prevalencia de SM fue 10,7%, se relacionó con mayor peso al nacimiento, obesidad y sedentarismo.

ABSTRACT Introduction: Metabolic Syndrome (MS) is a clinical entity that is manifested by central obesity, dyslipidemia, hyperglycemia and/or arterial hypertension and is related to the development of Type 2 Diabetes Mellitus and cardiovascular diseases. Objective: To determine the prevalence of MS in adolescents enrolled in school in the Central Department in 2021 and to evaluate their related risk factors. Materials and Methods: This was a descriptive study with an analytical component. 279 adolescents aged 10 to 16 years old from 6 randomly chosen schools were included. A survey on lifestyles, eating practices, family and perinatal history was performed. Weight, height, waist circumference (WC), glycemia, lipid profile, and blood pressure were measured. Cook's criteria were used for the diagnosis of MS. The study was approved by the Ethics Committee of the IICS and the University Hospital. For data analysis, tables of frequencies, median and Chi-square test were used for the prevalence ratio (PR) with a significance level of p < 0.05. Results: Median age was 13 years in general and 11.5 years in MS, 53% were male. The prevalence of overweight adolescents was 22.9% and 26.16% were obese. Hyperglycemia was present in 0.01%, hypertriglyceridemia in 16%, low HDL in 37.9%, arterial prehypertension in 11% and WC > p90 in 36%. The prevalence of MS was 10.7%. WC >p90 with a PR of 31.4 (7.6-128), and hypertriglyceridemia with a PR of 46.8 (14.8-147.7), were the predominant components of MS. High birth weight and physical inactivity were identified as significant risk factors. Conclusions: The prevalence of MS was 10.7%, it was related to higher birth weight, obesity and sedentary lifestyle.

https://doi.org/10.31698/ped.49032022003

11.

Resistencia pretratamiento del virus de inmunodeficiencia humana tipo 1 a fármacos antirretrovirales en Cuba: 2009-2017
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Machado Zaldivar, Liuber Yans

; Blanco de Armas, Madeline

; Dubed Echevarría, Marta

; Díaz Torres, Héctor Manuel

; Romay Franchi, Dania

; Valdés de Calzadilla, Neisy

; Noa Romero, Enrique

; López Rizo, Laura Sofía

; Pérez Guevara, María Teresa

; Suárez Batista, Anamary

; Rodríguez Acosta, Mireida

Anales de la Academia de Ciencias de Cuba

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Dic 2022, Volumen 12 Nº 3 elocation e1154

Resumen: En Es | Texto: En Es | PDF: En | PDF: Es

ABSTRACT Introduction. The World Health Organization (WHO) recommends conducting nationally representative studies to estimate the prevalence of HIV pretreatment resistance to antiretrovirals (PDRs) to assess the effectiveness of first-line therapies. The objective of the present study was to determine the prevalence of PDR in Cuban adults infected with HIV-1. Methods. HIV resistance to antiretrovirals was determined in 610 Cuban patients in two time periods (469 patients between 2009-2016 and 141 patients during the national survey of HIV-1 PDR conducted during 2017, according to the recommendations issued by the WHO). Results and Discussion. In the period 2009-2016, 19% of the patients presented viruses with some mutation associated with the PDR of HIV-1 to antiretrovirals (10,4 % to some nucleoside reverse transcriptase inhibitor (NRTI), 12,8 % to some non nucleoside reverse transcriptase inhibitor (NNRTI), 2,8 % to some protease inhibitor (PI). In 2017, the prevalence of PDR was 29,8 % (95 %, CI 22,3-38.1). The prevalence was 10,6 % (95 %, IC 6,07-16,9) for some NRTI, 23,4 % (95 %, CI 16,7-31,3) for some NNRTI, and 1,4 % (95 %, CI 0,17-5,03) for some PI. It was concluded that the NNRTI prevalence above 10 % in our study indicates that the first-line antiretroviral therapy in Cuba may be less effective and supports the need to look for new treatment options.

RESUMEN Introducción. La Organización Mundial de la Salud (OMS) recomienda la realización de estudios representativos a nivel nacional para estimar la prevalencia de la resistencia pretratamiento del VIH a los antirretrovirales (PDR) para evaluar la efectividad de las terapias de primera línea. El objetivo del presente estudio fue determinar la prevalencia de PDR en adultos cubanos infectados por el VIH-1. Métodos. Se determinó la resistencia del VIH a los antirretrovirales a 610 pacientes cubanos en dos períodos de tiempo (469 pacientes entre 2009-2016 y 141 pacientes durante la encuesta nacional de PDR del VIH-1 efectuada durante el año 2017, según las recomendaciones emitidas por la OMS). Resultados y Discusión. En el período 2009-2016, el 19 % de los pacientes presentaron virus con alguna mutación asociada a la PDR del VIH-1 a los antirretrovirales (10,4 % a algún inhibidor de la transcriptasa inversa análogo de nucleósidos (ITIAN), 12,8 % a algún inhibidor de la transcriptasa inversa no análogo de nucleósidos (ITINAN), 2,8 % a algún inhibidor de proteasa (IP). En el año 2017, la prevalencia de PDR fue de 29,8 % (95 %, IC 22,3-38,1). La prevalencia fue de 10,6 % (95 %, IC 6,07-16,9) para algún ITIAN, 23,4 % (95 %, IC 16,7-31,3) para algún ITINAN y 1,4 % (95 %, IC 0,17-5,03) para algún IP. Se concluyó que los valores por encima del 10 % en la prevalencia de la PDR a los ITINAN evidencia el comprometimiento de la primera línea de terapia antirretroviral empleada en Cuba y la necesidad de buscar nuevas opciones de tratamiento.

12.

Demografía y COVID-19: Diferenciales sociales y epidemiológicos
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Aja Díaz, Antonio

; Molina Cintra, Matilde de la Caridad

; Trinquete Díaz, Dixie Edith

; Barros Díaz, Otilia Zenaida

; Rodríguez García, Arianna

; Orbea López, Marbelis

; Mora Pérez, Arelis Rosalen

; Araujo González, Rafael

; Farnós Morejón, Alfonso

; Martin Fernández, Consuelo M.

; Dujarric Bermúdez, Gabriela

; Rodríguez Javiqué, Daylin Cecilia

; Terrero Trinquete, Amanda

; Díaz Fernández, Marta

; Benítez Jiménez, Iliana

; Bourzac Macia, Lisset

; Oliveros Domínguez, Eloy Rafael

; Alfonso de Armas, Marisol

; Quintana Llanio, Livia

; Rodríguez Gómez, Grisell

; Castellanos Cabrera, Roxanne

; Bárcenas Alfonso, Jany

; López Bauta, Adis Aymee

; Oroza Fraíz, Teresa

; Cancio-Bello Ayes, Claudia

; Pérez León, Marta Valeria

; Vera Vergara, Vivian

; Llantá Abreu, María del C.

; Lozano Pérez, Teresa Isabel

; Zas Ros, Bárbara

; Gener Serralta, Sandra

; Rivera Fernández, Rosa M.

; Martínez Debs, Leyti

; Quintosa Puebla, Yissel

; Pérez Rodríguez, Nancy

; Oviedo Álvarez, Vivian

; Fernández Lorenzo, Juan Manuel

; Remond Noa, Ricardo

; Torres Reyes, Antonio

; Veranes Miranda, Alejandro

; de la Garma García, Lic. Diana

Anales de la Academia de Ciencias de Cuba

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Dic 2022, Volumen 12 Nº 3 elocation e1115

Resumen: En Es | Texto: En Es | PDF: En | PDF: Es

ABSTRACT Introduction. The behavior of COVID-19 is influenced by diverse social differentials that transcend demographic variables and include morbidity, the conditions of their homes, family dynamics, job performance, gender roles and stereotypes, care tasks, habits, and behaviors of life and consumption, among others. Methods. Statistical and demographic analysis and tools of metric studies of the information were used. Results and Discussion. The research showed the importance of incorporating into the analysis of the behavior of COVID-19 in Cuba the influence of social and epidemiological differentials determined by skin color, marital status, employment status, income levels, types of families, mobility, hygienic environmental conditions, access to health services, among others, which can place populations in greater or lesser conditions of vulnerability. Conclusions: The composition and dynamics of the population together with other social differentials are determinants of the behavior and expression of the pandemic. The crossing of epidemiological factors with the analysis of containment measures and the composition and structure of the affected population allows for the design of health policies that are more adjusted to the needs of the pandemic. Distance psychological counseling makes it possible to identify and deal with situations related to confinement and changes in life routines that affect the mental health of different groups of people.

RESUMEN Introducción. El comportamiento de la COVID-19 está influenciado por diferenciales sociales que trascienden las variables demográficas e incluyen la morbilidad, las condiciones de sus viviendas, las dinámicas familiares, el desempeño laboral, los roles y estereotipos de género, las tareas de cuidado, los hábitos y comportamientos de vida y consumo, entre otros. Métodos. Se empleó el análisis estadístico y demográfico y herramientas de los estudios métricos. Resultados y Discusión. La investigación mostró la importancia de incorporar a los análisis del comportamiento de la COVID-19 en Cuba la influencia de diferenciales sociales y epidemiológicos determinados por el color de la piel, el estado conyugal, la situación laboral, los niveles de ingreso, los tipos de familias, la movilidad, las condiciones higiénico ambientales, el acceso a los servicios de salud, entre otros, que pueden ubicar a las poblaciones en mayores o menores condiciones de vulnerabilidad. Conclusiones, la composición y la dinámica de la población junto a otros diferenciales sociales son determinantes del comportamiento de la pandemia. El cruzamiento de los factores epidemiológicos con el análisis de las medidas de contención y la composición y estructura de población afectada permite diseñar políticas sanitarias más ajustadas a las necesidades de la pandemia. La orientación psicológica a distancia permite identificar y atender situaciones vinculadas al confinamiento y los cambios en las rutinas de vida que afectan la salud mental de diferentes grupos de personas.

13.

Percepciones y vivencias de escolares de 7 a 8 años del País Vasco durante la alerta sanitaria COVID-19
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Tíscar-González, Verónica

; Santiago-Garín, Jaione

; Moreno-Casbas, Teresa

; Zorrilla-Martínez, Iñaki

; Nonide-Robles, Marta

; Portuondo-Jiménez, Janire

Gaceta Sanitaria

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Feb 2022, Volumen 36 Nº 1 Paginas 19 - 24

Resumen: En Es | Texto: En Es | PDF: En | PDF: Es

Abstract Objective To explore the experiences of schoolchildren in an exceptional health alert situation in which strict confinement measures have been applied to the population. Method Qualitative exploratory study through the analysis of illustrations carried out by schoolchildren aged 7 to 8. The analysis was carried out according to Rose's theoretical framework. Descriptive analysis of socio-demographic data was performed. Results Five categories emerged from the analysis of the content: 1) feelings of sadness and fear; 2) importance of the family nucleus, safety and protection; 3) sedentary living habits during confinement; 4) housing infrastructure and social inequalities (life through a window); and 5) social response, collective struggle and through health professionals. Conclusions The COVID-19 pandemic situation and the strict confinement measures have had a significant impact on the school population, who had experienced the greatest restrictions. Household infrastructure has been shown to be a clear differentiator that deepens social inequalities and the impact that the situation has on school children. More studies are needed on the long-term psychosocial impact of this situation on their physical and mental health.

Resumen Objetivo Explorar las experiencias y las vivencias de escolares de 7-8 años en una situación excepcional de alerta sanitaria en la que se han aplicado a la población estrictas medidas de confinamiento. Método Estudio cualitativo exploratorio a través del análisis de ilustraciones realizadas por 71 escolares de 7-8 años de edad. El análisis se llevó a cabo según el marco teórico de Rose. Se realizó análisis descriptivo de los datos sociodemográficos. Resultados Del análisis del contenido emergieron cinco categorías: 1) sentimientos de tristeza y miedo; 2) importancia del núcleo familiar, seguridad y protección; 3) hábitos de vida sedentarios durante el confinamiento; 4) infraestructuras de las viviendas y desigualdades sociales (la vida tras una ventana); y 5) respuesta social, lucha colectiva y de los/las profesionales de la salud. Conclusiones La situación de pandemia de COVID-19 y las medidas estrictas de confinamiento han tenido un importante impacto en la población escolar, que es la que ha vivido las mayores restricciones. La infraestructura del hogar se ha mostrado como un claro diferenciador que ahonda en las desigualdades sociales y el impacto que la situación tiene en los/las escolares. Es necesario ampliar los estudios acerca del impacto psicosocial que esta situación va a tener a largo plazo en su salud física y mental.

https://doi.org/10.1016/j.gaceta.2020.11.006

14.

Percepciones y vivencias de escolares de 7 a 8 años del País Vasco durante la alerta sanitaria COVID-19
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Tíscar-González, Verónica

; Santiago-Garín, Jaione

; Moreno-Casbas, Teresa

; Zorrilla-Martínez, Iñaki

; Nonide-Robles, Marta

; Portuondo-Jiménez, Janire

Gaceta Sanitaria

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Feb 2022, Volumen 36 Nº 1 Paginas 19 - 24

Resumen: En Es | Texto: En Es | PDF: En | PDF: Es

https://doi.org/10.1016/j.gaceta.2020.11.006

15.

Spotlight on latent tuberculosis infection screening for juvenile idiopathic arthritis in two countries, comparing high and low risk patients
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Piotto, Daniela

; Nicacio, Aline

; Neto, Agna

; Mourão, Ana Filipa

; Oliveira-Ramos, Filipa

; Campanilho-Marques, Raquel

; Guedes, Margarida

; Cabral, Marta

; Santos, Maria José

; Fonseca, João Eurico

; Canhão, Helena

; Aikawa, Nádia Emi

; Oliveira, Sheila K. F.

; Ferriani, Virginia P. L.

; Pileggi, Gecilmara C. S.

; Magalhães, Claudia S.

; Silva, Clovis Artur

; Terreri, Maria Teresa

Advances in Rheumatology

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2022, Volumen 62 elocation 20

Resumen: En | Texto: En | PDF: En

Abstract Background: Rheumatic diseases are associated with an increase in overall risks of tuberculosis (TB). The aim of this study was to evaluate the frequency of TB and the frequency of latent TB infection (LTBI), in clinical practice, for juvenile idiopathic arthritis (JIA) patients from high and low risk of TB incidence endemic countries. Methods: This is an international, multicenter, cross-sectional, observational study of data collection from Brazil and Registry of Portugal at REUMA.PT. The inclusion criteria were patients with Juvenile Idiopathic Arthritis (JIA) with age ≤ 18 years who underwent screening for Mycobacterium tuberculosis infection [tuberculin skin test (TST) and/or interferon gamma release assay (IGRA)]. Chest X-rays and history of exposure to TB were also assessed. Results: 292 JIA patients were included; mean age 14.3 years, mean disease duration 7.5 years, 194 patients (66.4%) performed only TST, 14 (4.8%) only IGRA and 84 (28.8%) both. The frequency of LTBI (10.6%) and TB was similar between the two countries. The reasons for TB screening were different; in Brazil it was performed more often at JIA onset while in Portugal it was performed when starting Disease Modified Anti-Rheumatic Drugs (DMARD) treatment (p < 0.001). Isoniazid therapy was prescribed in 40 (13.7%) patients (31 with LTBI and 9 with epidemiologic risks and/or due to contact with sick people). Only three patients (1%) developed active TB. Conclusion: We found nearly 10% of patients with LTBI, a small percentage of patients with treatment due to epide-miologic risks and only 1% with active TB. Distinct reasons and screening methods for LTBI were observed between the two countries.

https://doi.org/10.1186/s42358-022-00251-6

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