ABSTRACT Using data from the 2020 higher education admission process, this article analyzes the distributive behavior of the special quotas of a Chilean socio-educational inclusion policy. Several indicators have been created to profile both the demand and the programmatic offer that adheres to this initiative. The results show that the allocation of special quotas is neither homogeneous nor random; the higher the elitism, academic profile and socioeconomic characteristics of a program's enrollment, the lower its number of vacancies for special admission. Likewise, special quotas increase in programs with low levels of demand and that concentrate students with low performance in admission tests. The conclusions discuss whether the contribution of the most prestigious programs make to social inclusion is more symbolic than real, as well as the configuration of a logic of instrumental use of special admission in programs with low demand.

RESUMEN Utilizando datos del proceso de admisión a la educación superior en 2020, este artículo analiza el comportamiento distributivo de los cupos especiales de una política de inclusión socioeducativa chilena. Se crearon distintos indicadores para perfilar tanto la demanda como la oferta programática que adhiere a esta iniciativa. Los resultados evidencian que la asignación de cupos especiales no es homogénea ni azarosa; conforme mayor es la elitización, perfil académico y atributos socioeconómicos de la matrícula de un programa, menor es su cantidad de vacantes para admisión especial. Asimismo, los cupos especiales aumentan en carreras con bajos niveles de demanda y que concentran estudiantes con bajo desempeño en pruebas de admisión. Las conclusiones discuten si la contribución que los programas de mayor prestigio hacen a la inclusión social es más simbólica que real, así como la configuración de una lógica de uso instrumental de la admisión especial en programas de baja demanda.

Abstract Objective To evaluate the effects of rosacea on ocular surface changes such as alterations in dry eye parameters, corneal densitometry, and aberrations, in comparison with healthy controls. Methods A total of 88 eyes of 44 patients diagnosed with rosacea and 88 eyes of 44 healthy controls were enrolled in this cross-sectional study. All participants underwent a comprehensive dermatologic and ophthalmic examination and Tear Break-Up Time (TBUT) and Schirmer-1 tests were performed. The rosacea subtype and Demodex count and OSDI scores of all participants were recorded. Corneal topographic, densitometric, and aberrometric measurements were obtained using the Scheimpflug imaging system. Results The mean age of the 44 patients was 41.2 ± 11.0 years of whom 31 (70.5%) were female. The mean TBUT and Schirmer-1 test values were significantly decreased and OSDI scores were significantly increased in the rosacea group compared to healthy controls (p < 0.01 for all). The most common subtype of rosacea was erythematotelangiectatic rosacea (70.4%). The severity grading of rosacea revealed that 18 (40.9%) patients had moderate erythema. The median (min-max) Demodex count was 14.0 (0-120) and the disease duration was 24.0 (5-360) months. The comparison of the corneal densitometry values revealed that the densitometry measurements in all concentric zones, especially in central and posterior zones were higher in rosacea patients. Corneal aberrometric values in the posterior surface were also lower in the rosacea group compared to healthy controls. The topographic anterior chamber values were significantly lower in the rosacea group. Study limitations Relatively small sample size, variable time interval to hospital admission, and lack of follow-up data are among the limitations of the study. Future studies with larger sample sizes may also enlighten the mechanisms of controversial anterior segment findings by evaluating rosacea patients who have uveitis and those who do not. Conclusion Given the fact that ocular signs may precede cutaneous disease, rosacea is frequently underrecognized by ophthalmologists. Therefore, a comprehensive examination of the ocular surface and assessment of the anterior segment is essential. The main priority of the ophthalmologist is to treat meibomian gland dysfunction and Demodex infection to prevent undesired ocular outcomes. parameters aberrations 8 4 crosssectional cross sectional study BreakUp Break Up (TBUT Schirmer1 Schirmer 1 Schirmer- performed recorded densitometric system 412 41 2 41. 110 11 0 11. 3 70.5% 705 70 5 (70.5% female p 001 01 0.0 all. . all) 70.4%. 704 70.4% (70.4%) 40.9% 409 40 9 (40.9% erythema minmax min max (min-max 140 14 14. 0120 120 (0-120 240 24 24. 5360 360 (5-360 months size admission followup follow up not ophthalmologists Therefore essential outcomes 70.5 7 (70.5 00 0. 70.4 (70.4% 40.9 (40.9 012 12 (0-12 536 36 (5-36 70. (70. (70.4 40. (40. (0-1 53 (5-3 (70 (40 (0- (5- (7 (4 (0 (5 (

Abstract: Pediatric rapid response teams (PRRT) aim to detect the clinical deterioration of a patient and implement timely treatment, avoiding cardiopulmonary arrests (CPA) and in-hospital mortality. Objective: To describe the experience with PRRT led by the pediatrician in a high-complexity hospital. Patients and Methods: Descriptive, retrospective, longitudinal study. Hospitalized children under 18 years of age who had a PRRT activation between August 2015 and May 2022 were included. Patients who simultaneously had an activation of the emergency system (suspected CPA) were excluded. Demographic and clinical variables were analyzed through a descriptive analysis. Results: We analyzed 225 PRRT events with an activation rate of 17 per 1,000 admissions. Activations were more common in children under two years of age (50%), oncology patients (35%), general hospitalization (88%), the night shift (44%), and respiratory compromise (48%). Most evaluations occurred within the first five minutes (74%). The most frequent interventions were oxygen administration (45%), fluid bolus (43%), laboratory tests (40%), and X-rays (34%). Admission to the pediatric intensive care unit was 45%. The decrease in inpatient CRP was progressive during the time of the study. Conclusions: With the implementation of the PRRT, we found a tendency toward fewer CPA events in hospital wards. Most of the therapeutic interventions derived from the PRRT were of low or medium complexity, which supports the pediatrician as the team leader.

Resumen: Los equipos de respuesta rápida pediátricos (ERRP) buscan detectar el deterioro clínico de un paciente e implementar tratamientos oportunos, evitando paro cardiorrespiratorio (PCR) y mortalidad intrahospitalaria. Objetivo: describir la experiencia del ERRP liderado por el pediatra en un hospital de alta complejidad. Pacientes y Método: Estudio descriptivo, retrospectivo, longitudinal. Se incluyeron menores de 18 años hospitalizados que generaron la activación de un ERRP entre agosto 2015 y mayo 2022. Se excluyeron pacientes que simultáneamente tenían una activación del sistema de emergencia (sospecha de PCR). Se analizaron variables demográficas y clínicas mediante un análisis descriptivo. Resultados: Analizamos 225 eventos de ERRP, con una tasa de activación de 17 por 1.000 admisiones. Predominaron las activaciones en menores de dos años (50%), pacientes oncológicos (35%), hospitalización general (88%), turno nocturno (44%) y el compromiso respiratorio (48%). La mayoría de las evaluaciones se produjeron dentro de los primeros cinco minutos (74%). Las intervenciones más frecuentes fueron administración de oxígeno (45%), bolo de líquidos (43%), laboratorios (40%) y rayos-x (34%). La admisión a la UCI pediátrica fue de 45%. La disminución de las PCR en hospitalización fue progresiva durante el tiempo del estudio. Conclusiones: Con la implementación de los ERRP encontramos una tendencia a presentarse menos eventos por PCR en salas de hospitalización. La mayoría de las intervenciones terapéuticas derivadas del ERRP fueron de baja o mediana complejidad, lo que avala al pediatra de hospitalización como líder del equipo.

RESUMEN Introducción: La Comisión Nacional de Residencias Médicas (CONAREM) es el principal sistema de admisión para la tutoría clínica de residencias médicas en Paraguay, avalado por Ministerio de Salud Pública y Bienestar Social. Objetivos. Determinar la relación entre el puntaje final obtenido y el promedio de grado en postulantes a convocatorias CONAREM 2019-2023. Metodología: Estudio transversal con variables sociodemográficas, académicas, puntajes del examen y puntaje final. Se aplicaron métodos descriptivos y pruebas de Kolmogórov-Smirnov, t de Student, U de Mann-Whitney, Kruskal-Wallis y correlación de Spearman; utilizando software Stata© 17.0 de StataCorp LLC. Se consideraron significativos cuando p<0.05. Resultados: De 2019 a 2023, 4.768 médicos postularon examen CONAREM. 62,12 % eran mujeres, 34,51 % tenían entre 22 y 25 años y 95,30 % estaban solteros. El promedio de grado fue 3,56 0, 49. La mayoría (69,09 %) provenían de universidades privadas. En las especialidades preferidas, clínica médica fue más común (20,31 %), luego cirugía general y pediatría (ambas 14,30 %), 39,14 % pudo acceder a especialidad preferida. El puntaje final promedio fue 67,92 (RIC 60,78 - 76,76) con diferencias significativas según edad, universidad de procedencia y año de examen. Con modelo de regresión logística se demostró que promedio de grado, edad, universidad pública y primera participación en examen estaban asociados con mayor probabilidad de obtener mejores puntajes. El modelo tenía coeficiente de ajuste de 0, 318, indicando que solo predice el 32 % de resultados. La correlación fue moderada y significativa entre puntaje final y promedio general de grado. Según universidad, la correlación fue baja y no significativa para universidades extranjeras, mientras que universidades públicas y privadas mostraron correlación moderada pero significativa. Discusión. Los mejores promedios de grado se correlacionan moderadamente con mayor probabilidad de puntajes altos y acceder a especialidades de preferencia de los médicos recientemente graduados, provenientes de universidades públicas que hayan rendido por primera vez el examen de la CONAREM.

ABSTRACT Introduction: The National Commission of Medical Residencies (CONAREM) is the main admission system for clinical tutoring of medical residencies in Paraguay, endorsed by the Ministry of Public Health and Social Welfare. Objectives: Determine the relationship between the final score obtained and the average degree in applicants to CONAREM calls 2019-2023. Methods: Cross-sectional study with sociodemographic and academic variables, exam scores and final score. Descriptive methods and tests of Kolmogorov-Smirnov, Student's t, Mann-Whitney U, Kruskal-Wallis and Spearman's correlation were applied; using Stata© 17.0 software from StataCorp LLC. They were considered significant when p<0.05. Results: From 2019 to 2023, 4,768 doctors applied for the CONAREM exam. 62.12% had a female female, 34.51% from 22 to 25, and 95.30% were single. The grade point average was 3.56(0.49. The majority (69.09%) came from private universities. As for preferred specialties, medical clinic was more common (20.31%), then general surgery and pediatrics (both 14.30%). 39.14% could access preferred specialty. The average final score was 67.92 and significant differences were found according to age, university of origin and year of examination. With logistic regression model, it was shown that average grade, age, public university and first participation in the exam were associated with a higher probability of obtaining better scores. The model had an adjustment coefficient of 0.318, indicating that it only predicts 32% of outcomes. The correlation was moderate and significant between final score and overall grade point average. By type of university, the correlation was low and not significant for foreign universities, while public and private universities showed moderate but significant correlation. Discussion: The best grade point averages correlate moderately with higher probability of high scores and access to specialties of preference and are associated with recently graduated doctors from public universities and took the exam for the first time.

Abstract Objective: The objective of the study was to explore red cell distribution width (RDW) as a surrogate marker of inflammation, alone and in conjunction with muscle wasting to predict malnutrition-related adverse outcomes. Methods: This was a single-center observational study including adult hospitalized patients. Demographic variables, malnutrition criteria, and RDW were captured within 24 hours of hospital admission. Correlation tests and regression models were performed between these variables (RDW and muscle wasting) and adverse outcomes (in-hospital mortality and unplanned transfer to critical care areas (CCA). Results: Five hundred and forty-five patients were included in the final analysis. Muscle wasting showed an independent association with adverse outcomes in every regression model tested. RDW alone showed fair predictive performance for both outcomes’ significance and the adjusted model with muscle wasting showed association only for unplanned transfer to CCA. Conclusion: RDW did not improve the prediction of adverse outcomes compared to muscle wasting assessed by physical examination and simple indexes for acute and chronic inflammation. Malnourished patients presented higher RDW values showing a possible metabolic profile (higher inflammation and lower muscle). It is still unknown whether nutrition support can influence RDW value over time as a response marker or if RDW can predict who may benefit the most from nutritional support.

Resumen Objetivo: Explorar el ancho de distribución eritrocitaria (ADE) como un marcador subrogado de inflamación, individualmente y en conjunto con el desgaste muscular, para predecir resultados adversos asociados a la desnutrición. Método: Estudio unicéntrico, observacional, incluyendo pacientes adultos hospitalizados. Se capturaron variables demográficas, criterios de desnutrición y el ADE en las primeras 24 horas de ingreso. Se realizaron pruebas de correlación y modelos de regresión entre dichas variables (ADE y desgaste) y resultados adversos (mortalidad hospitalaria y traslado no planeado a áreas críticas). Resultados: Se incluyeron 545 pacientes. El desgaste muscular mostró asociación independiente con los resultados adversos en cada modelo. El ADE individualmente mostró un desempeño aceptable para la predicción de ambos resultados, y en modelos ajustados con desgaste muscular mostró asociación únicamente con traslado no planeado a áreas críticas. Conclusiones: El ADE no mejoró la predicción de resultados adversos comparado con el desgaste muscular por exploración física e índices simples de inflamación. Los pacientes con desnutrición presentaron mayores valores de ADE, mostrando un posible perfil metabólico (mayor inflamación y menos músculo). Aún se desconoce si el soporte nutricional puede influenciar el ADE como un marcador de respuesta o si puede predecir una respuesta favorable al soporte nutricional.

RESUMEN Introducción: La enfermedad de Still del adulto es una enfermedad reumática, inflamatoria, sistémica y crónica cuya prevalencia en la población caucásica se estima en 1 caso por cada 100 000 adultos Objetivo: Presentar un paciente adulto joven, con una fiebre de origen desconocido como forma de presentación de la enfermedad de Still del adulto. Caso clínico: Paciente de 29 años de edad con antecedente de fiebre reumática, con un ingreso hospitalario anterior; que presentó un cuadro febril no infeccioso, de 50 días de duración, al cual no se le determinó la causa. Un año después reapareció la fiebre, de similares características, asociada a poliartralgia, hepatoesplenomegalia, anemia, hiperferritinemia, neutrofilia, factor reumatoideo negativo y se constató un cuadro de pericarditis durante el ingreso. Se realizó el diagnóstico de enfermedad de Still del adulto, por exclusión. Se inició tratamiento con esteroides, desapareció la fiebre en las primeras 24 horas y el paciente tuvo una evolución favorable. Conclusiones: La enfermedad de Still del adulto puede presentarse como una fiebre de origen desconocido y se diagnostica por exclusión, ya que no existen manifestaciones clínicas ni pruebas de laboratorio, patognomónicas. La hiperferritinemia es útil para la sospecha diagnóstica.

ABSTRACT Introduction: Adult Still's disease is a rheumatic, inflammatory, systemic and chronic disease whose prevalence in the Caucasian population is estimated at 1 case per 100,000 adults. Objective: To present a young adult patient with a fever of unknown origin as the presentation of adult Still's disease. Clinical case: 29-year-old patient with a history of rheumatic fever, with a previous hospital admission; who presented a non-infectious febrile illness lasting 50 days, for which the cause was not determined. A year later, the fever reappeared, with similar characteristics, associated with polyarthralgia, hepatosplenomegaly, anemia, hyperferritinemia, neutrophilia, negative rheumatoid factor, and pericarditis was noted during admission. The diagnosis of adult Still's disease was made by exclusion. Treatment with steroids was started, the fever disappeared in the first 24 hours and the patient had a favorable evolution. Conclusions: Adult Still's disease can present as a fever of unknown origin and is diagnosed by exclusion, since there are no pathognomonic clinical manifestations or laboratory tests. Hyperferritinemia is useful for diagnostic suspicion.

Abstract Background New-onset atrial fibrillation (NOAF) occurs in patients hospitalized due to COVID-19. It is still unknown whether clinical and laboratory data assessed upon hospital admission have predictive value for NOAF. Objectives To analyze, upon hospital admission, variables with predictive potential for the occurrence of NOAF in patients with COVID-19 pneumonia. Methods Observational, retrospective, case-control study. Electronic medical reports of consecutive patients, 60 years of age or older, hospitalized due to COVID-19 pneumonia between March 1st and July 15th, 2020, were reviewed. Non-paired Student or chi-squared tests compared variables. A Cox proportional hazard model was employed to identify independent predictors of NOAF. P value < 0.05 was considered statistically significant. Results Among 667 patients hospitalized due to COVID-19, 201 (30.1%) fulfilled the inclusion criteria. NOAF was documented in 29 patients (14.4%), composing group 1. Group 2 was composed of 162 patients without NOAF. Ten patients were excluded due to the AF rhythm upon hospital admission. In groups 1 and 2, there were differences in overall in-hospital survival rate (24.1 % vs. 67.9%; p<0.001), length of stay in ICU (11.1 ± 10.5 days vs. 4.9 ± 7.5 days; p=0.004) and need for mechanical ventilation rate (82.9% vs. 32.7%; p<0.001). In the Cox model, age > 71 y/o (HR=6.8; p<0.001), total leukocyte count ≤ 7,720 cels.μL-¹ (HR=6.6; p<0.001), serum [Na+] ≤ 137 mEq.L-¹ (HR=5.0; p=0.001), SAPS3 score > 55 (HR=5.6; p=0.002), and disorientation (HR=2.5; p=0.04) on admission were independent predictors of NOAF. Conclusion NOAF is a common arrhythmia in elderly hospitalized patients with COVID-19 pneumonia. Clinical and laboratory parameters evaluated on admission have a predictive value for the occurrence of NOAF during hospitalization. Newonset New onset (NOAF COVID19. COVID19 COVID 19. 19 analyze COVID-1 Observational retrospective casecontrol case control study 6 older st 15th th 2020 reviewed Nonpaired Non paired chisquared chi squared 005 0 05 0.0 significant 66 COVID19, 19, 20 30.1% 301 30 (30.1% criteria 14.4%, 144 14.4% , 14 4 (14.4%) 16 inhospital 24.1 241 24 (24. vs 67.9% 679 67 9 p<0.001, p0001 p p<0.001 001 p<0.001) 11.1 111 11 (11. 105 10 5 10. 49 4. 75 7 7. p=0.004 p0004 004 82.9% 829 82 (82.9 32.7% 327 32 p<0.001. . yo y o HR=6.8 HR68 HR 8 (HR=6.8 7720 720 7,72 cels.μL¹ celsμL¹ celsμL cels.μL ¹ cels μL cels.μL- HR=6.6 HR66 (HR=6.6 Na+ Na [Na+ 13 mEq.L¹ mEqL¹ mEqL mEq.L mEq L mEq.L- HR=5.0 HR50 (HR=5.0 p=0.001, p=0.001 p=0.001) SAPS HR=5.6 HR56 (HR=5.6 p=0.002, p0002 p=0.002 002 p=0.002) HR=2.5 HR25 (HR=2.5 p=0.04 p004 04 hospitalization COVID1 COVID- 202 00 0. 30.1 3 (30.1 14.4 (14.4% 24. (24 67.9 p000 p<0.00 11. (11 p=0.00 82.9 (82. 32.7 HR=6. HR6 (HR=6. 772 72 7,7 μL¹ [Na L¹ HR=5. HR5 (HR=5. HR=2. HR2 (HR=2. p=0.0 p00 30. (30. 14. (14.4 (2 67. p<0.0 (1 82. (82 32. HR=6 (HR=6 77 7, HR=5 (HR=5 HR=2 (HR=2 p=0. p0 (30 (14. ( p<0. (8 HR= (HR= p=0 (3 (14 p<0 (HR p= p<

Resumo Fundamento Fibrilação atrial nova (FAN) ocorre em pacientes internados por COVID-19. Há controvérsias quanto ao valor preditivo de dados clínicos e laboratoriais à admissão hospitalar para ocorrência de FAN. Objetivos Analisar, à admissão hospitalar, variáveis com potencial preditivo para ocorrência de FAN em pacientes com pneumonia por COVID-19. Método Estudo observacional, retrospectivo, caso-controle. Foram avaliados prontuários eletrônicos de pacientes consecutivos ≥ 60 anos, hospitalizados com pneumonia por COVID-19 entre 1º de março e 15 de julho de 2020. Comparações feitas pelos testes `t’ de Student ou qui-quadrado. Foi empregado modelo de risco proporcional de Cox para identificação de preditores de FAN. Considerou-se o valor de p < 0,05 como estatisticamente significativo. Resultados Entre 667 pacientes internados por COVID-19, 201 (30,1%) foram incluídos. FAN foi documentada em 29 pacientes (14,4%) (grupo 1). Grupo 2 foi composto por 162 pacientes que não apresentaram FAN. Dez pacientes excluídos por estarem em FA na admissão hospitalar. Houve diferenças entre os grupos 1 e 2, respectivamente, no tempo de permanência em UTI (11,1±10,5 dias vs. 4,9±7,5 dias; p=0,004), necessidade de ventilação invasiva (82,9% e 32,7%; p<0,001) e mortalidade hospitalar (75,9% vs. 32,1%; p<0,001). No modelo de Cox, idade > 71 anos (hazard ratio [HR]=6,8; p<0,001), leucometria ≤ 7.720 cels.μL-1 (HR=6,6; p<0,001), natremia ≤ 137 mEq.L-1 (HR=5,0; p=0,001), escore SAPS3 > 55 (HR=5,6; p=0,002) e desorientação (HR=2,5; p=0,04) foram preditores independentes de FAN. Conclusões FAN é uma arritmia comum em idosos hospitalizados com pneumonia por COVID-19. Parâmetros clínicos e laboratoriais avaliados na admissão são preditores de FAN durante internação. (FAN COVID19. COVID19 COVID 19. 19 Analisar observacional retrospectivo casocontrole. casocontrole caso controle. controle caso-controle 6 COVID-1 º 2020 `t t quiquadrado. quiquadrado qui quadrado. quadrado qui-quadrado Considerouse Considerou se 005 0 05 0,0 significativo 66 COVID19, 19, 20 30,1% 301 30 (30,1% incluídos 14,4% 144 14 4 (14,4% grupo 1. . 1) 16 respectivamente 11,1±10,5 111105 11 10 5 (11,1±10, vs 4975 9 7 4,9±7, p=0,004, p0004 p=0,004 , 004 p=0,004) 82,9% 829 82 (82,9 32,7% 327 32 p<0,001 p0001 001 75,9% 759 75 (75,9 32,1% 321 p<0,001. hazard HR=6,8 HR68 HR =6,8 8 [HR]=6,8 p<0,001, 7720 720 7.72 cels.μL1 celsμL1 celsμL cels.μL cels μL cels.μL- HR=6,6 HR66 (HR=6,6 13 mEq.L1 mEqL1 mEqL mEq.L mEq L mEq.L- HR=5,0 HR50 (HR=5,0 p=0,001, p=0,001 p=0,001) SAPS HR=5,6 HR56 (HR=5,6 p=0,002 p0002 002 HR=2,5 HR25 (HR=2,5 p=0,04 p004 04 internação COVID1 COVID- 202 00 0, 30,1 3 (30,1 14,4 (14,4 11,1±10, 11110 (11,1±10 497 4,9±7 p000 p=0,00 82,9 (82, 32,7 p<0,00 75,9 (75, 32,1 HR=6, HR6 68 =6, [HR]=6, 772 72 7.7 μL1 (HR=6, L1 HR=5, HR5 (HR=5, HR=2, HR2 (HR=2, p=0,0 p00 30, (30, 14, (14, 11,1±10 1111 (11,1±1 49 4,9± 82, (82 32, p<0,0 75, (75 HR=6 =6 [HR]=6 77 7. (HR=6 HR=5 (HR=5 HR=2 (HR=2 p=0, p0 (30 (14 11,1±1 111 (11,1± 4,9 (8 p<0, (7 HR= = [HR]= (HR= p=0 (3 (1 11,1± (11,1 4, ( p<0 [HR] (HR p= 11,1 (11, p< [HR 11, (11

ABSTRACT Dementia poses a significant societal and health challenge in the 21st century, with many hospitalized patients experiencing dementia without a documented diagnosis. Objective: To evaluate the prevalence of dementia and its associated risk factors among older patients admitted to hospitals. Methods: The study included older patients (≥ 60 years) admitted to medical departments of a general hospital in three major Iranian cities. Researchers utilized the Activities of Daily Living-Instrumental Activities of Daily Living (ADL-IADL) scale, the Geriatric Depression Scale (GDS), the Mini-Cog test, the 4 A’s test (4AT), and the Abbreviated Mental Test Score (AMTS). Among the 420 recruited older inpatients, 228 (54.3%) were female. Results: The mean age of participants was 71.39 years (standard deviation ±7.95), with 30.7% diagnosed with major neurocognitive disorder (dementia). The likelihood of dementia exhibited statistically significant correlations with gender, age, number of children, and occupation. Conclusions: Screening older individuals for cognitive impairment upon hospital admission holds the potential to prevent adverse outcomes and enhance the quality of treatment for patients concurrently dealing with dementia. st century diagnosis Objective hospitals Methods ≥ ( 6 cities LivingInstrumental Instrumental ADLIADL ADL IADL (ADL-IADL scale GDS, GDS , (GDS) MiniCog Mini Cog As A s 4AT, 4AT AT (4AT) AMTS. AMTS . (AMTS) 42 inpatients 22 54.3% 543 54 3 (54.3% female Results 7139 71 39 71.3 standard ±7.95, 795 ±7.95 7 95 ±7.95) 307 30 30.7 (dementia) gender children occupation Conclusions (GDS (4AT (AMTS 2 54.3 5 (54.3 713 71. 79 ±7.9 9 30. (dementia 54. (54. ±7. (54 ±7 (5 ±

RESUMO A demência representa um grande desafio social e de saúde no século 21, com muitos pacientes hospitalizados sofrendo de demência sem um diagnóstico documentado. Objetivo: Avaliar a prevalência de demência e seus fatores de risco associados entre pacientes idosos hospitalizados. Métodos: O estudo incluiu pacientes idosos (≥ 60 anos) internados em um hospital geral em três grandes cidades iranianas. Os pesquisadores utilizaram a escala de Atividades da Vida Diária-Atividades Instrumentais da Vida Diária (Activities of Daily Living-Instrumental Activities of Daily Living – ADL-IADL), a Escala de Depressão Geriátrica, o teste Mini-Cog, o teste dos 4 As (4AT) e o Pontuação do Teste Mental Abreviado (Abbreviated Mental Test Score – AMTS). Dos 420 idosos selecionados, 228 (54,3%) eram do sexo feminino. Resultados: A média de idade dos participantes foi de 71,39 anos (desvio padrão ±7,95), sendo 30,7% diagnosticados com transtorno neurocognitivo maior (demência). A probabilidade de demência apresentou correlações estatisticamente significativas com sexo, idade, número de filhos e ocupação. Conclusões: A triagem de idosos para comprometimento cognitivo na admissão hospitalar tem o potencial de prevenir resultados adversos e melhorar a qualidade do tratamento para pacientes que lidam simultaneamente com demência. 21 documentado Objetivo Métodos ≥ ( 6 iranianas DiáriaAtividades LivingInstrumental Instrumental ADLIADL, ADLIADL ADL IADL , ADL-IADL) Geriátrica MiniCog, MiniCog Mini Cog, Cog Mini-Cog 4AT AT (4AT Abbreviated AMTS. AMTS . AMTS) 42 selecionados 22 54,3% 543 54 3 (54,3% feminino Resultados 7139 71 39 71,3 desvio ±7,95, 795 ±7,95 7 95 ±7,95) 307 30 30,7 (demência) ocupação Conclusões 2 ADL-IADL 54,3 5 (54,3 713 71, 79 ±7,9 9 30, (demência 54, (54, ±7, (54 ±7 (5 ±

Abstract Denture biofilm acts as a potential reservoir for respiratory pathogens, considerably increasing the risk of lung infections, specifically aspiration pneumonia, mainly 48h after hospital admission. The establishment of a straightforward, affordable, and applicable hygiene protocol in a hospital environment for the effective control of denture biofilm can be particularly useful to prevent respiratory infections or reduce the course of established lung disease. Objectives To evaluate the anti-biofilm effectiveness of denture cleaning protocols in hospitalized patients. Methodology The maxillary complete dentures (MCDs) of 340 hospitalized participants were randomly cleaned once using one of the following 17 protocols (n=20): brushing with distilled water, toothpaste, or neutral liquid soap (controls); immersion in chemical solutions (1% sodium hypochlorite, alkaline peroxide, 0.12% or 2% chlorhexidine digluconate), or microwave irradiation (650 W for 3 min) combined or not with brushing. Before and after the application of the protocols, the biofilm of the intaglio surface of the MCDs was evaluated using two methods: denture biofilm coverage area (%) and microbiological quantitative cultures on blood agar and Sabouraud Dextrose Agar (CFU/mL). Data were subjected to the Wilcoxon and Kruskal-Wallis tests (α=0.05). Results All 17 protocols significantly reduced the percentage area of denture biofilm and microbial and fungal load (P<0.05). The highest percentage reductions in the area of denture biofilm were observed for 1% hypochlorite solution with or without brushing and for 2% chlorhexidine solution and microwave irradiation only in association with brushing (P<0.05). The greatest reductions in microbial and fungal load were found for the groups that used solutions of 2% chlorhexidine and 1% hypochlorite and microwave irradiation, regardless of the association with brushing (P<0.05). Conclusions A single immersion for 10 min in 1% sodium hypochlorite, even in the absence of brushing, proved to be a straightforward, rapid, low-cost, and effective protocol for cleaning the dentures of hospitalized patients. pathogens pneumonia h admission straightforward affordable disease antibiofilm anti patients (MCDs 34 1 n=20 n20 n 20 (n=20) water toothpaste controls (controls) (1 peroxide 012 0 12 0.12 2 digluconate, digluconate , digluconate) 650 (65 methods % (% CFU/mL. CFUmL CFU/mL . CFU mL (CFU/mL) KruskalWallis Kruskal Wallis α=0.05. α005 α α=0.05 05 (α=0.05) P<0.05. P005 P P<0.05 (P<0.05) rapid lowcost, lowcost low cost, cost low-cost n=2 n2 (n=20 (controls ( 01 0.1 65 (6 (CFU/mL α00 α=0.0 (α=0.05 P00 P<0.0 (P<0.05 n= (n=2 0. 6 α0 α=0. (α=0.0 P0 P<0. (P<0.0 (n= α=0 (α=0. P<0 (P<0. (n α= (α=0 P< (P<0 (α= (P< (α (P

Síntomas persistentes del síndrome post-COVID-19 provocan impactos negativos en la salud, calidad de vida y productividad. El objetivo fue describir los síntomas persistentes del síndrome post-COVID-19, sobre todo neurológicos, y las repercusiones cognitivas, emocionales, motoras, de calidad de vida y los costos indirectos, 12 meses tras la infección. Pacientes que tuvieron los primeros síntomas entre enero y junio de 2021, desarrollaron síndrome post-COVID-19 y buscaron atención en la unidad de la Red SARAH de Hospitales de Rehabilitación en Fortaleza, Ceará, Brasil. Las informaciones se obtuvieron al inicio del seguimiento y por entrevista telefónica 12 meses tras la infección. Participaron 58 personas, con edad de 52,8±10,5 años y el 60% permaneció en la UTI. Los síntomas más frecuentes al ingreso fueron: fatiga (64%), artralgia (51%) y disnea (47%); tras 12 meses fueron: fatiga (46%) y alteración de memoria (39%). Se identificaron alteraciones en las escalas/testes funcionales: PCFS, MoCA, HAD, FSS, SF-36, TLS5x, timed up and go, caminar por 6 minutos y prensión manual. Los costos indirectos totales fueron USD 227.821,00, con 11.653 días de absentismo. El 32% de los pacientes no volvió a trabajar. Mejor TLS5x y SF-36 en las dimensiones capacidad funcional, aspecto físico, vitalidad y dolor demostraron una asociación con el retorno al trabajo (p ≤ 0,05). Los síntomas persistentes más frecuentes fueron fatiga, artralgia, disnea, ansiedad y depresión, con repercusiones negativas en la funcionalidad cognitiva, emocional, motora y calidad de vida. Estos síntomas continuaron por más de un año, sobre todo la fatiga y la alteración de la memoria, siendo esta última reportada con más frecuencia tardíamente. Hubo una dificultad importante en el retorno al trabajo y costos indirectos de USD 4.847,25 persona/año. postCOVID19 postCOVID post COVID 19 post-COVID-1 salud productividad postCOVID19, 19, neurológicos cognitivas emocionales motoras 1 infección 2021 Fortaleza Ceará Brasil 5 personas 528105 52 8 10 52,8±10, 60 UTI 64%, 64 64% , (64%) 51% 51 (51% 47% 47 (47%) 46% 46 (46% 39%. 39 39% . (39%) escalastestes escalas testes funcionales PCFS MoCA HAD FSS SF36, SF36 SF 36, 36 TLSx TLS x go manual 22782100 227 821 00 227.821,00 11653 11 653 11.65 absentismo 32 trabajar SF-3 funcional físico p 0,05. 005 0,05 0 05 0,05) depresión cognitiva emocional año tardíamente 484725 4 847 25 4.847,2 personaaño persona persona/año postCOVID1 post-COVID- 202 52810 52,8±10 (64% (51 (47% (46 3 (39% SF3 2278210 22 82 227.821,0 1165 65 11.6 SF- 0,0 48472 84 2 4.847, post-COVID 20 5281 52,8±1 (64 (5 (47 (4 (39 227821 227.821, 116 11. 0, 4847 4.847 528 52,8± (6 ( (3 22782 227.821 484 4.84 52,8 2278 227.82 48 4.8 52, 227.8 4. 227.

The persistent symptoms of post-COVID-19 syndrome negatively impact health, quality of life, and productivity. This study aimed to describe the persistent symptoms of post-COVID-19 syndrome (especially neurological ones) and their 12-month post-infection cognitive, emotional, motor, quality of life, and indirect cost repercussions. Patients showing the first symptoms of COVID-19 from January to June 2021 who developed post-COVID-19 syndrome and sought care at the Fortaleza Unit (Ceará, Brazil) of the SARAH Network of Rehabilitation Hospitals were included in this study. Information was obtained at the baseline follow-up and by telephone interview 12 months post-infection. In total, 58 people participated in this study with an average age of 52.8±10.5 years, of which 60% required an ICU. The most frequent symptoms on admission included fatigue (64%), arthralgia (51%), and dyspnea (47%), whereas, after 12 months, fatigue (46%) and memory impairment (39%). The following scales/functional tests showed alterations: PCFS, MoCA, HAD, FSS, SF-36, TLS5x, timed up and go, 6-minute walk, and handgrip. Indirect costs totaled USD 227,821.00, with 11,653 days of absenteeism. Moreover, 32% of patients were unable to return to work. Better TLS5x and higher SF-36 scores in the functional capacity, physical functioning, vitality, and pain dimensions were associated with return to work (p ≤ 0.05). The most frequent persistent symptoms referred to fatigue, arthralgia, dyspnea, anxiety, and depression, which negatively affected cognitive, emotional, and motor function and quality of life. These symptoms lasted for over a year, especially fatigue and memory alteration, the latter of which being the most reported after COVID-19 infections. Results also show a significant difficulty returning to work and indirect costs of USD 4,847.25 per person/year. postCOVID19 postCOVID post COVID 19 post-COVID-1 health life productivity ones 12month month postinfection infection cognitive emotional repercussions COVID19 COVID-1 202 Ceará, Ceará (Ceará Brazil followup follow 1 postinfection. infection. total 5 528105 52 8 10 52.8±10. years 60 ICU 64%, 64 64% , (64%) 51%, 51 51% (51%) 47%, 47 47% (47%) whereas 46% 46 (46% 39%. 39 39% . (39%) scalesfunctional scales alterations PCFS MoCA HAD FSS SF36, SF36 SF 36, 36 TLSx TLS x go 6minute minute 6 walk handgrip 22782100 227 821 00 227,821.00 11653 11 653 11,65 absenteeism Moreover 32 SF-3 capacity functioning vitality p 0.05. 005 0.05 0 05 0.05) anxiety depression year alteration infections 484725 4 847 25 4,847.2 personyear person person/year postCOVID1 post-COVID- COVID1 COVID- 20 52810 52.8±10 (64% (51% (47% (46 3 (39% SF3 2278210 22 82 227,821.0 1165 65 11,6 SF- 0.0 48472 84 2 4,847. post-COVID 5281 52.8±1 (64 (51 (47 (4 (39 227821 227,821. 116 11, 0. 4847 4,847 528 52.8± (6 (5 ( (3 22782 227,821 484 4,84 52.8 2278 227,82 48 4,8 52. 227,8 4, 227,

Os sintomas persistentes da síndrome pós-COVID-19 acarretam impactos negativos na saúde, qualidade de vida e produtividade. O objetivo deste trabalho foi descrever os sintomas persistentes da síndrome pós-COVID-19, principalmente neurológicos, e as repercussões cognitivas, emocionais, motoras, de qualidade de vida e de custos indiretos, 12 meses após a infecção. Pacientes com primeiros sintomas entre janeiro e junho de 2021 evoluíram com síndrome pós-COVID-19 e procuraram atendimento na unidade da Rede SARAH de Hospitais de Reabilitação em Fortaleza, Ceará, Brasil. As informações foram obtidas no início do acompanhamento e por entrevista telefônica após 12 meses da infecção. Participaram do estudo 58 pessoas, com idade média de 52,8 anos (±10,5) e 60% permaneceram em UTI. Os sintomas mais frequentes na admissão foram: fadiga (64%), artralgia (51%) e dispneia (47%); e após 12 meses: fadiga (46%) e alteração de memória (39%). Foram identificadas alterações nas escalas/testes funcionais: PCFS, MoCA, HAD, FSS, SF-36, TLS5x, Timed up and go, caminhada de 6 minutos e preensão manual. Os custos indiretos totais foram de USD 227.821,00, com 11.653 dias de absenteísmo; 32% dos pacientes não voltaram a trabalhar. Melhores resultados de TLS5x e SF-36, nas dimensões capacidade funcional, aspecto físico, vitalidade e dor, demonstraram associação com retorno laboral (p ≤ 0,05). Os sintomas persistentes mais frequentes foram: fadiga, artralgia, dispneia, ansiedade e depressão, com repercussões negativas na funcionalidade cognitiva, emocional, motora e qualidade de vida. Esses sintomas perduraram por mais de um ano, principalmente fadiga e alteração de memória, sendo esta última mais relatada tardiamente. Houve dificuldade importante de retorno laboral e custos indiretos de USD 4.847,25 por pessoa/ano. pósCOVID19 pósCOVID pós COVID 19 pós-COVID-1 saúde produtividade pósCOVID19, 19, neurológicos cognitivas emocionais motoras 1 infecção 202 Fortaleza Ceará Brasil 5 pessoas 528 52 8 52, ±10,5 105 10 (±10,5 60 UTI 64%, 64 64% , (64%) 51% 51 (51% 47% 47 (47%) 46% 46 (46% 39%. 39 39% . (39%) escalastestes escalas testes funcionais PCFS MoCA HAD FSS SF36, SF36 SF 36, 36 SF-36 TLSx TLS x go manual 22782100 227 821 00 227.821,00 11653 11 653 11.65 absenteísmo 32 trabalhar funcional físico dor p 0,05. 005 0,05 0 05 0,05) depressão cognitiva emocional ano tardiamente 484725 4 847 25 4.847,2 pessoaano pessoa pessoa/ano pósCOVID1 pós-COVID- 20 ±10, (±10, (64% (51 (47% (46 3 (39% SF3 SF-3 2278210 22 82 227.821,0 1165 65 11.6 0,0 48472 84 2 4.847, pós-COVID ±10 (±10 (64 (5 (47 (4 (39 SF- 227821 227.821, 116 11. 0, 4847 4.847 ±1 (±1 (6 ( (3 22782 227.821 484 4.84 ± (± 2278 227.82 48 4.8 227.8 4. 227.

Os sintomas persistentes da síndrome pós-COVID-19 acarretam impactos negativos na saúde, qualidade de vida e produtividade. O objetivo deste trabalho foi descrever os sintomas persistentes da síndrome pós-COVID-19, principalmente neurológicos, e as repercussões cognitivas, emocionais, motoras, de qualidade de vida e de custos indiretos, 12 meses após a infecção. Pacientes com primeiros sintomas entre janeiro e junho de 2021 evoluíram com síndrome pós-COVID-19 e procuraram atendimento na unidade da Rede SARAH de Hospitais de Reabilitação em Fortaleza, Ceará, Brasil. As informações foram obtidas no início do acompanhamento e por entrevista telefônica após 12 meses da infecção. Participaram do estudo 58 pessoas, com idade média de 52,8 anos (±10,5) e 60% permaneceram em UTI. Os sintomas mais frequentes na admissão foram: fadiga (64%), artralgia (51%) e dispneia (47%); e após 12 meses: fadiga (46%) e alteração de memória (39%). Foram identificadas alterações nas escalas/testes funcionais: PCFS, MoCA, HAD, FSS, SF-36, TLS5x, Timed up and go, caminhada de 6 minutos e preensão manual. Os custos indiretos totais foram de USD 227.821,00, com 11.653 dias de absenteísmo; 32% dos pacientes não voltaram a trabalhar. Melhores resultados de TLS5x e SF-36, nas dimensões capacidade funcional, aspecto físico, vitalidade e dor, demonstraram associação com retorno laboral (p ≤ 0,05). Os sintomas persistentes mais frequentes foram: fadiga, artralgia, dispneia, ansiedade e depressão, com repercussões negativas na funcionalidade cognitiva, emocional, motora e qualidade de vida. Esses sintomas perduraram por mais de um ano, principalmente fadiga e alteração de memória, sendo esta última mais relatada tardiamente. Houve dificuldade importante de retorno laboral e custos indiretos de USD 4.847,25 por pessoa/ano.

The persistent symptoms of post-COVID-19 syndrome negatively impact health, quality of life, and productivity. This study aimed to describe the persistent symptoms of post-COVID-19 syndrome (especially neurological ones) and their 12-month post-infection cognitive, emotional, motor, quality of life, and indirect cost repercussions. Patients showing the first symptoms of COVID-19 from January to June 2021 who developed post-COVID-19 syndrome and sought care at the Fortaleza Unit (Ceará, Brazil) of the SARAH Network of Rehabilitation Hospitals were included in this study. Information was obtained at the baseline follow-up and by telephone interview 12 months post-infection. In total, 58 people participated in this study with an average age of 52.8±10.5 years, of which 60% required an ICU. The most frequent symptoms on admission included fatigue (64%), arthralgia (51%), and dyspnea (47%), whereas, after 12 months, fatigue (46%) and memory impairment (39%). The following scales/functional tests showed alterations: PCFS, MoCA, HAD, FSS, SF-36, TLS5x, timed up and go, 6-minute walk, and handgrip. Indirect costs totaled USD 227,821.00, with 11,653 days of absenteeism. Moreover, 32% of patients were unable to return to work. Better TLS5x and higher SF-36 scores in the functional capacity, physical functioning, vitality, and pain dimensions were associated with return to work (p ≤ 0.05). The most frequent persistent symptoms referred to fatigue, arthralgia, dyspnea, anxiety, and depression, which negatively affected cognitive, emotional, and motor function and quality of life. These symptoms lasted for over a year, especially fatigue and memory alteration, the latter of which being the most reported after COVID-19 infections. Results also show a significant difficulty returning to work and indirect costs of USD 4,847.25 per person/year.

Síntomas persistentes del síndrome post-COVID-19 provocan impactos negativos en la salud, calidad de vida y productividad. El objetivo fue describir los síntomas persistentes del síndrome post-COVID-19, sobre todo neurológicos, y las repercusiones cognitivas, emocionales, motoras, de calidad de vida y los costos indirectos, 12 meses tras la infección. Pacientes que tuvieron los primeros síntomas entre enero y junio de 2021, desarrollaron síndrome post-COVID-19 y buscaron atención en la unidad de la Red SARAH de Hospitales de Rehabilitación en Fortaleza, Ceará, Brasil. Las informaciones se obtuvieron al inicio del seguimiento y por entrevista telefónica 12 meses tras la infección. Participaron 58 personas, con edad de 52,8±10,5 años y el 60% permaneció en la UTI. Los síntomas más frecuentes al ingreso fueron: fatiga (64%), artralgia (51%) y disnea (47%); tras 12 meses fueron: fatiga (46%) y alteración de memoria (39%). Se identificaron alteraciones en las escalas/testes funcionales: PCFS, MoCA, HAD, FSS, SF-36, TLS5x, timed up and go, caminar por 6 minutos y prensión manual. Los costos indirectos totales fueron USD 227.821,00, con 11.653 días de absentismo. El 32% de los pacientes no volvió a trabajar. Mejor TLS5x y SF-36 en las dimensiones capacidad funcional, aspecto físico, vitalidad y dolor demostraron una asociación con el retorno al trabajo (p ≤ 0,05). Los síntomas persistentes más frecuentes fueron fatiga, artralgia, disnea, ansiedad y depresión, con repercusiones negativas en la funcionalidad cognitiva, emocional, motora y calidad de vida. Estos síntomas continuaron por más de un año, sobre todo la fatiga y la alteración de la memoria, siendo esta última reportada con más frecuencia tardíamente. Hubo una dificultad importante en el retorno al trabajo y costos indirectos de USD 4.847,25 persona/año.

ABSTRACT Objective: To evaluate symptoms, lung function, and quality of life of a cohort of patients hospitalized for severe COVID-19 12 months after hospital admission. Methods: This was a cross-sectional study. We included severe COVID-19 survivors hospitalized in one of three tertiary referral hospitals for COVID-19 in the city of Belo Horizonte, Brazil. Participants were submitted to lung function and six-minute walk tests and completed the EQ-5D-3L questionnaire. Results: The whole sample comprised 189 COVID-19 survivors (mean age = 59.6 ± 13.4 years) who had been admitted to a ward only (n = 96; 50.8%) or to an ICU (n = 93; 49.2%). At 12 months of follow-up, 43% of patients presented with dyspnea, 27% of whom had a restrictive ventilatory disorder and 18% of whom presented with impaired DLCO. There were no significant differences in FVC, FEV1, and TLC between the survivors with or without dyspnea. However, those who still had dyspnea had significantly more impaired DLCO (14.9% vs. 22.4%; p < 0.020) and poorer quality of life. Conclusions: After one year, survivors of severe COVID-19 in a middle-income country still present with high symptom burden, restrictive ventilatory changes, and loss of quality of life. Ongoing follow-up is needed to characterize long COVID-19 and identify strategies to mitigate its consequences. Objective symptoms COVID19 COVID 19 COVID-1 1 admission Methods crosssectional cross sectional study Horizonte Brazil sixminute six minute EQ5D3L EQDL EQ 5D 3L D L questionnaire Results 18 mean 596 59 6 59. 134 13 4 13. years n 96 50.8% 508 50 8 93 49.2%. 492 49.2% . 49 2 49.2%) followup, followup follow up, up 43 27 FVC FEV1 FEV However 14.9% 149 14 9 (14.9 vs 22.4% 224 22 0.020 0020 0 020 Conclusions year middleincome middle income burden changes consequences COVID1 COVID- 5 50.8 49.2 14.9 (14. 22.4 0.02 002 02 50. 49. 14. (14 22. 0.0 00 (1 0. (

RESUMO Introdução: o choque hemorrágico é a principal causa reversível de morte no trauma no Brasil e no mundo. Objetivo: comparar o valor de BE ao do lactato na admissão da UTI e vinte e quatro horas após o internamento na identificação de hipoperfusão tecidual e predição de mortalidade Método: coorte histórica de pacientes traumatizados, maiores de dezoito anos, submetidos à estratégia de controle de danos na admissão hospitalar, seguido de internamento em UTI. Foram coletados e analisados ISS, mecanismo e tipo de trauma, necessidade de terapia de substituição renal e transfusão maciça; BE, lactato, pH e bicarbonato coletados na admissão da UTI e vinte e quatro horas após, e a mortalidade. Os pacientes foram divididos em grupos conforme valores de BE (≥-6 e <-6mmol/L) já descritos na literatura como preditores de gravidade, e após redivididos de acordo com os valores de melhor acurácia encontrados nesta amostra, além de realização de regressão logística binária multivariada. Os dados foram comparados através de diversos testes estatísticos devido a diversidade e conforme a indicação para cada variável. Resultados: houve alterações perfusionais impactantes já na admissão da UTI. BE manteve-se com valor estatisticamente significativo para predição de mortalidade tanto quando utilizado os valores já conhecidos da literatura como quando aplicados os valores neste estudo identificados. Conclusão: valores de BE e de lactato foram capazes de predizer hipoperfusão tecidual e mortalidade nos dois momentos estudados, quando comparados, o BE tem boa performance como preditor de mortalidade, com rápido resultado e ampla disponibilidade. Introdução mundo Objetivo Método traumatizados anos hospitalar ISS maciça ≥6 6 ≥ (≥- <6mmol/L 6mmolL mmolL < 6mmol/L 6mmol L mmol <-6mmol/L gravidade amostra multivariada variável Resultados mantevese manteve se identificados Conclusão estudados disponibilidade (≥ (

ABSTRACT Introduction: hemorrhagic shock is a significant cause of trauma-related deaths in Brazil and worldwide. This study aims to compare BE and lactate values at ICU admission and twenty-four hours after in identifying tissue hypoperfusion and mortality. Methods: examines a historical cohort of trauma patients over eitheen years old submittet to damage control resuscitation approch upon hospital admission and were then admitted to the ICU. We collected and analyzed ISS, mechanism and type of trauma, need for renal replacement therapy, massive transfusion. BE, lactate, pH, bicarbonate at ICU admission and twenty-four hours later, and mortality data. The patients were grouped based on their BE values (≥-6 and <-6mmol/L), which were previously identified in the literature as predictors of severity. They were subsequently redivided using the most accurate values found in this sample. In addition to performing multivariate binary logistic regression. The data were compared using several statistical tests due to diversity and according to the indication for each variable. Results: there were significant changes in perfusion upon admission to the Intensive Care Unit. BE is a statistically significant value for predicting mortality, as determined by using values from previous literature and from this study. Conclusion: the results demonstrate the importance of monitoring BE levels in the prediction of ICU mortality. BE proves to be a valuable bedside marker with quick results and wide availability. Introduction traumarelated related worldwide twentyfour twenty four Methods ISS therapy transfusion pH later ≥6 6 ≥ (≥- <6mmol/L, 6mmolL mmolL < 6mmol/L , 6mmol L mmol <-6mmol/L) severity sample regression variable Results Unit Conclusion availability (≥ <6mmol/L <-6mmol/L (

RESUMEN Introducción: El curso optativo de Farmacoeconomía, impartido en el cuarto año de la carrera Licenciatura en Enfermería como parte de su habilitación profesional, pone a consideración de los estudiantes indicadores internacionales de evolución farmacoeconómica. Objetivo: Valorar la satisfacción de los estudiantes de la carrera de Licenciatura en Enfermería que recibieron Farmacoeconomía como curso optativo. Métodos: Investigación descriptiva de corte transversal en la Facultad de Enfermería-Tecnología de la Salud durante el curso 2021-2022, con el total de estudiantes de cuarto año de Licenciatura en Enfermería. Las variables que se midieron fueron sexo, edad, fuente de ingreso, situación escolar, asistencia a la asignatura, conocimiento previo y satisfacción del estudiante. Los indicadores fueron divididos en dos secciones: específicos y generales de la asignatura. La encuesta fue sometida a pruebas de confiabilidad y validez; la validación de los resultados se realizó mediante el análisis del factor Bayes y el análisis de la diversidad logarítmica. Resultados: En la valoración general de la asignatura, el 78,88 % de los estudiantes refirió estar muy satisfecho, el 20 % refirió estar bastante satisfecho, y el 1,12 % poco satisfecho. Conclusiones: La Farmacoeconomía como curso optativo del cuarto año de la carrera de Licenciatura en Enfermería de la Facultad de Enfermería-Tecnología, de Santiago de Cuba, es valorada por siete de cada 10 estudiantes de muy satisfactoria.

ABSTRACT Introduction: The optional course of Pharmacoeconomics, taught in the fourth year of the Bachelor’s Degree in Nursing as part of the students’ professional qualification, puts international indicators of pharmaoeconomics into consideration of students. Objective: To assess the satisfaction of the students of Bachelor’s Degree in Nursing who received Pharmacoeconomics as an optional course. Methods: Descriptive, cross-sectional research in the Faculty of Nursing-Health Technology during the 2021-2022 academic year, with all fourth-year students of the Bachelor’s Degree in Nursing. The variables that were measured were: sex, age, source of admission, school situation, attendance to the subject, previous knowledge and student satisfaction. The indicators were divided in two sections: specific and general of the subject. The survey was subjected to reliability and validity tests. Validation of the results was carried out through Bayes factor analysis and logarithmic diversity analysis. Results: In the general assessment of the subject 78.88% of the students reported being very satisfied, 20% reported being quite satisfied and 1.12% reported being few satisfied. Conclusions: Pharmacoeconomics as an optional course of the fourth year of the Bachelor’s Degree in Nursing of the Faculty of Nursing-Heath Technology of Santiago de Cuba is rated as very satisfactory by seven out of ten students.

ABSTRACT Objective: In order to study the scenario of respiratory infections in pediatrics after the emergence of SARS-CoV-2 in Brazil, this study aimed to compare characteristics of children admitted for SARS or upper airway infection caused by either RSV or SARS-CoV-2. Methods: This was a cross-sectional study involving children up to 48 months of age admitted to a tertiary pediatric hospital with a diagnosis of SARS or upper airway infection between April of 2020 and April of 2021. Respiratory secretion samples were collected 2-5 days after hospitalization, and antigen/PCR tests for viral etiologies were performed. In this analysis, patients with laboratorial diagnosis of SARS-CoV-2 and/or RSV were selected, and their clinical and epidemiological characteristics were compared using logistic regression. Results: Our sample initially comprised 369 participants. SARS-CoV-2 and RSV infections were confirmed in 55 (15%) and 59 children (16%), respectively. Mean age was 12 months (0-48 months), and 47 were female. The following characteristics were significantly more frequent in patients with RSV when compared with those with COVID-19: younger age (OR = 0.94; 95% CI: 0.90-0.98); lower frequency of fever (OR = 0.18; 95% CI: 0.05-0.66); and more frequent upper airway symptoms: cough (OR = 7.36; 95% CI: 1.04-52.25); and tachypnea (OR = 6.06; 95% CI: 1.31-28.0). Conclusions: Children with RSV-related SARS were younger, had lower frequency of fever at admission, but had a higher frequency of signs of upper airway infection and lower systemic inflammation when compared with children hospitalized for COVID-19 during the first year of the pandemic. Objective SARSCoV2 SARSCoV CoV 2 SARS-CoV- Brazil SARSCoV2. 2. Methods crosssectional cross sectional 4 202 2021 25 5 2- hospitalization antigenPCR antigen PCR performed analysis andor selected regression Results 36 participants 15% 15 (15% 16%, 16 16% , (16%) respectively 1 048 0 (0-4 months, months) female COVID19 COVID 19 OR 0.94 094 94 95 CI 0.900.98 090098 0.90 0.98 90 98 0.90-0.98) 0.18 018 18 0.050.66 005066 0.05 0.66 05 66 0.05-0.66) symptoms 7.36 736 7 1.0452.25 1045225 1.04 52.25 04 52 1.04-52.25) 6.06 606 6 06 1.3128.0. 131280 1.31 28.0 . 31 28 1.31-28.0) Conclusions RSVrelated related admission COVID-1 pandemic SARS-CoV 20 3 (15 (16% (0- COVID1 0.9 09 9 900 0.900.9 09009 090 098 0.90-0.98 0.1 01 050 0.050.6 00506 005 0.0 066 0.6 0.05-0.66 7.3 73 0452 1.0452.2 104522 104 1.0 5225 52.2 1.04-52.25 6.0 60 3128 1.3128.0 13128 131 1.3 280 28. 1.31-28.0 COVID- (1 (16 (0 0. 0.900. 0900 0.90-0.9 0.050. 0050 00 0.05-0.6 7. 045 1.0452. 10452 10 1. 522 52. 1.04-52.2 6. 312 1.3128. 1312 13 1.31-28. ( 0.900 0.90-0. 0.050 0.05-0. 1.0452 1045 1.04-52. 1.3128 1.31-28 0.90-0 0.05-0 1.045 1.04-52 1.312 1.31-2 0.90- 0.05- 1.04-5 1.31- 1.04-