Resumo Historicamente, são necessários, em média, 17 anos para que novos tratamentos passem da evidência clínica para a prática diária. Considerando os tratamentos altamente eficazes disponíveis atualmente para prevenir ou retardar o início e a progressão da doença renal, esse período é demasiadamente longo. Agora é o momento de reduzir a lacuna entre o que sabemos e aquilo que fazemos. Existem diretrizes claras para a prevenção e o manejo dos fatores de risco comuns para doenças renais, como hipertensão e diabetes, mas apenas uma fração das pessoas com essas condições é diagnosticada mundialmente, e um número ainda menor recebe tratamento adequado. Da mesma forma, a grande maioria das pessoas que sofrem de doença renal não têm conhecimento de sua condição, pois ela costuma ser silenciosa nos estágios iniciais. Mesmo entre pacientes que foram diagnosticados, muitos não recebem tratamento adequado para a doença renal. Levando em consideração as graves consequências da progressão da doença renal, insuficiência renal ou óbito, é imperativo que os tratamentos sejam iniciados precocemente e de maneira adequada. As oportunidades para diagnosticar e tratar precocemente a doença renal devem ser maximizadas, começando no nível da atenção primária. Existem muitas barreiras sistemáticas, que vão desde o paciente até o médico, passando pelos sistemas de saúde e por fatores sociais. Para preservar e melhorar a saúde renal para todos em qualquer lugar, cada uma dessas barreiras deve ser reconhecida para que soluções sustentáveis sejam desenvolvidas e implementadas sem mais demora. Historicamente necessários média 1 diária longo fazemos renais diabetes mundialmente forma condição iniciais diagnosticados óbito adequada maximizadas primária sistemáticas médico sociais lugar demora

Abstract Historically, it takes an average of 17 years for new treatments to move from clinical evidence to daily practice. Given the highly effective treatments now available to prevent or delay kidney disease onset and progression, this is far too long. Now is the time to narrow the gap between what we know and what we do. Clear guidelines exist for the prevention and management of common risk factors for kidney disease, such as hypertension and diabetes, but only a fraction of people with these conditions are diagnosed worldwide, and even fewer are treated to target. Similarly, the vast majority of people living with kidney disease are unaware of their condition, because it is often silent in the early stages. Even among patients who have been diagnosed, many do not receive appropriate treatment for kidney disease. Considering the serious consequences of kidney disease progression, kidney failure, or death, it is imperative that treatments are initiated early and appropriately. Opportunities to diagnose and treat kidney disease early must be maximized beginning at the primary care level. Many systematic barriers exist, ranging from the patient to the clinician to the health systems to societal factors. To preserve and improve kidney health for everyone everywhere, each of these barriers must be acknowledged so that sustainable solutions are developed and implemented without further delay. Historically 1 practice progression long diabetes worldwide target Similarly condition stages failure death appropriately level everywhere

Abstract Introduction The prevalence of otitis media (OM) is substantial all over the world. Epidemiological data related to the economic burden of OM globally is minimal. The present systematic review was undertaken to estimate the economic burden of this disease in various parts of the world. Objectives An extensive literature search was done using PRISMA guidelines to identify relevant studies that estimated the economic burden of OM in monetary terms. The databases searched were PubMed Central, Ovid, and Embase. The cost estimation was done for one specific year and then compared considering the inflation rate. Data Synthesis The literature search led to the inclusion of 10 studies. The studies evaluated direct and indirect costs in monetary terms. Direct costs (health system and patient perspective) ranged from USD (United States Dollar) 122.64 (Netherlands) to USD 633.6 (USA) per episode of OM. Looking at only the patient perspective, the costs ranged from USD 19.32 (Oman) to USD 80.5 (Saudi Arabia). The total costs (direct and indirect) ranged from USD 232.7 to USD 977 (UK) per episode of OM. The economic burden per year was highest in the USA (USD 5 billion). The incidence of OM episodes was found more in children < 5 years old. Introduction of pneumococcal conjugate vaccines decreased the incidence in children and now the prevalence in adults is of concern. Conclusion The economic burden of OM is relatively high globally and addressing this public health burden is important. Approaches for the prevention, diagnosis, and treatment should be undertaken by the health system to alleviate this disease burden. (OM world minimal terms Central Ovid Embase rate 1 perspective United Dollar 12264 122 64 122.6 Netherlands (Netherlands 6336 633 6 633. (USA 1932 19 32 19.3 Oman (Oman 805 80 80. Saudi Arabia. Arabia . Arabia) 2327 232 7 232. 97 UK (UK billion. billion billion) old concern important prevention diagnosis 1226 12 122. 63 193 3 19. 8 23 9 2

Abstract: At the end of the 19th century and during the first third of the 20th century, schools contributed to the spread of tuberculosis. The Modern School. Hispanic American Pedagogical Magazine (1892 to 1934) sought the prevention and overcoming of such a disease. And the aim of the analysis is to identify the measures to overcome the tuberculosis in childhood. The analysis indicates various types of actions. These could involve the school or not, but always giving prominence to childhood. This work is interesting because the source is revised for this purpose for the first time.

Resumen: A finales del siglo XIX y durante el primer tercio del siglo XX, los centros escolares tenían unas condiciones ambientales que contribuían con la expansión de la tuberculosis. La Escuela Moderna. Revista Pedagógica Hispano Americana es una publicación que destina varios de sus documentos a la prevención y superación de tal enfermedad. Es por ello por lo que se analizan sus impresiones desde 1892 hasta 1934, para identificar las medidas que se debían plantear para zanjar la presencia de la tuberculosis en la vida de la infancia. Desde tal análisis se han obtenido diferentes tipos de actuaciones que podían implicar o no a la escuela, pero tenían como protagonista a la salud infantil. Se considera de interés la revisión realizada al no haber sido planteada con anterioridad, poniendo la mirada en la fuente primaria seleccionada.

ABSTRACT Introduction: Chronic kidney disease is a global health problem. Its most serious manifestation, chronic kidney failure, affects the Cuban context and determines the growth of patients on hemodialysis. The objective of the text is to evaluate the main results of the diagnosis and characterization of the problematic situation in a psychosocial study with patients with Chronic Renal Failure in the Hemodialysis room of the Florida municipality, of the county of Camagüey. Method: It is an experimental participatory action research, which takes place between January 2023 and December 2024, which constitutes the output of the research project System of psychosocial actions for the improvement of comprehensive care for patients with non-communicable diseases. The universe is made up of 56 patients and the sample is made up of 22, who receive purifying and conservative treatment, 22 family members and 12 service professionals. The research instrument par excellence was the participant survey. Results: The age of the patients is not definitive of an age group; men predominate; A high percentage of patients are found to have low tolerance for adherence to treatment and insufficient development of psychosocial skills and declare the need to possess knowledge to achieve health states that lead to survival. Discussion: There is no coincidence with what was found in the determination of the prevalence age groups for the disease, but specialists insist that the disease is not exclusive to a specific period of life; recognize the importance of the patient's knowledge of risk factors for prevention, promotion and health education and highlight the need for communication and empathy between health personnel and the patient, to achieve favorable results and emotional states in the face of the disease and treatment.

RESUMEN Introducción: La enfermedad renal crónica es un problema de salud a nivel mundial, su manifestación más grave, la insuficiencia renal crónica, incide en el contexto cubano y determina el crecimiento de pacientes en hemodiálisis. El objetivo del texto es valorar los principales resultados del diagnóstico y caracterización de la situación problémica en un estudio de carácter psicosocial con pacientes con Insuficiencia Renal Crónica en la sala de Hemodiálisis del municipio Florida, de la provincia de Camagüey. Método: Es una investigación-acción participativa de corte experimental, que se desarrolla entre enero 2023 y diciembre del 2024 la cual constituye salida del proyecto de investigación Sistema de acciones psicosociales para el perfeccionamiento de la atención integral a los pacientes con enfermedades no transmisibles. El universo está constituido por 56 pacientes y la muestra por 22, que reciben tratamiento depurador y conservador, 22 familiares y 12 profesionales del servicio. El instrumento de investigación por excelencia fue la encuesta a participantes. Resultados: La edad de los pacientes no es definitiva de un grupo etario; predominan los hombres; se constata un elevado por ciento de pacientes con poca tolerancia a la adherencia al tratamiento e insuficiente desarrollo de las habilidades psicosociales y declaran la necesidad de poseer conocimientos para lograr estados de salud que conlleven a la sobrevida. Discusión: No existe coincidencia con lo constatado en la determinación de los grupos etarios de prevalencia para la enfermedad, pero los especialistas insisten en que la enfermedad no es privativa de un período de vida específico; reconocen la importancia del conocimiento de los factores de riesgo por el paciente para la prevención, promoción y educación en salud y resaltan la necesidad de la comunicación y la empatía entre el personal de salud y el paciente, para lograr resultados y estados emocionales favorables ante la enfermedad y el tratamiento.

Abstract Objectives: Identify potential barriers, delays, and missed opportunities in the prevention and diagnosis of childhood TB. Methods: Scoping review according to the PRISMA extension. The definitions considered for the selection followed the acronym PCC where the population (P) is children under 18years of age with TB disease, the concept (C) refers to missed opportunities for prevention and diagnosis, and context (C) is defined as a diagnosis of TB disease. The authors searched systematically in the databases; VHL/Lilacs, Medline via PubMed, Cochrane, Scopus, and Web of Science, without date or language limitation. Results: Seven studies were included. In developed countries, with low disease burden, the main shortcoming is the delay in diagnosing bacilliferous adults in contact with young children. This problem is concentrated in the portion of the population with socioeconomic vulnerability. In underdeveloped countries, with a high burden of disease, the biggest challenge is tracking children who come into contact with bacilliferous patients. Conclusions: There are still many missed opportunities in the prevention and diagnosis of childhood TB. The positive legacy of the COVID-19 pandemic should be taken advantage of and the encouragement of scientific development in the management of infectious diseases should be taken. Objectives barriers delays Methods extension P (P years C (C databases VHLLilacs VHL Lilacs VHL/Lilacs PubMed Cochrane Scopus Science limitation Results included countries vulnerability patients Conclusions COVID19 COVID 19 COVID-1 COVID1 1 COVID-

Resumen El embarazo ectópico se considera un problema de salud pública a nivel mundial, se hizo una investigación con el objetivo de establecer los fundamentos acerca del embarazo ectópico y las políticas de salud que se requieren para su mitigación. Esta revisión bibliográfica integrativa incluyó diversos textos, artículos, materiales impresos y digitales relacionados con el embarazo ectópico, consultando además en las bases de datos y directorios: SciELO, LILACS, Latindex, Medline; el proceso se realizó mediante el uso de palabras clave en español, quedando seleccionados 18 artículos publicados entre 1990 y 2023. Desde un enfoque histórico social del embarazo ectópico, se determinó que de la toma de decisiones clínicas oportunas, depende el diagnóstico temprano de esa patología; así como de la identificación de factores de riesgo y la actuación pertinente en consecuencia.

Abstract Ectopic pregnancy is considered a public health problem worldwide. This research aimed to establish the foundations of ectopic pregnancy and the health policies required for its mitigation. This bibliographic review included various texts, articles, printed and digital materials related to ectopic pregnancy, consulting databases and directories such as SciELO, LILACS, Latindex, and Medline; through the use of keywords in Spanish, 18 articles published between 1990 and 2023 were selected. Based on a social-historical approach to ectopic pregnancy, it was determined that timely clinical decision-making depends on the early diagnosis of this pathology, the identification of risk factors, and the relevant action accordingly.

Abstract Background: PRKAG2 syndrome typically manifests in adolescence and early adulthood, progressing with left ventricular hypertrophy, arrhythmias, and risk of sudden death. Findings of echocardiographic markers before clinical manifestation in children of patients affected by the disease can facilitate prevention strategies and therapeutic planning for this patient group. Objective: To identify the existence of echocardiographic findings that manifest early in children of parents affected by PRKAG2 syndrome, while they are still asymptomatic. Methods: In this cross-sectional observational study, 7 participants who were children of parents with established diagnosis of PRKAG2 syndrome, between the ages of 9 months and 12 years, with proven genetic diagnosis, underwent conventional and advanced echocardiography. Their findings were compared to those of a control group composed of 7 age- and sex-matched volunteers who were healthy from a cardiovascular point of view. P values < 0.05 were considered significant. Results: Conventional echocardiography showed statistically significantly higher values in the case group for left atrium, interventricular septum, left ventricular posterior wall, indexed ventricular mass, and relative wall thickness (p < 0.05). Global longitudinal systolic strain on 2-dimensional echocardiography did not show statistical significance between the case and control groups. None of the parameters on 3-dimensional echocardiography showed statistical significance between groups. Conclusion: Children diagnosed with PRKAG2 showed echocardiographic findings indicative of a tendency toward cardiac hypertrophy. Echocardiography can be a useful tool in the evaluation and follow-up of this patient group before the onset of clinical manifestations. Background PRKAG adulthood hypertrophy arrhythmias death Objective asymptomatic Methods crosssectional cross sectional study 1 years age sexmatched sex matched view 005 0 05 0.0 significant Results atrium septum mass p 0.05. . 0.05) 2dimensional dimensional 2 groups 3dimensional 3 Conclusion followup follow up manifestations 00 0.

Resumo Fundamento: A síndrome do PRKAG2 tipicamente se manifesta na adolescência e início da idade adulta, cursando com hipertrofia ventricular esquerda, arritmias e risco de morte súbita. O achado de marcadores ecocardiográficos antes da manifestação clínica nos filhos de pais acometidos pela doença pode facilitar a estratégia de prevenção e planejamento terapêutico para esse grupo de pacientes. Objetivo: Identificar a existência de achados ecocardiográficos que se manifestem precocemente nos filhos de pais acometidos por síndrome do PRKAG2, enquanto ainda assintomáticos. Métodos: Estudo observacional transversal em que sete participantes, filhos de pais com diagnóstico estabelecido de síndrome do PRKAG2, com idades entre 9 meses e 12 anos e diagnóstico genético comprovado, foram submetidos à ecocardiografia convencional e por técnicas avançadas, tendo seus achados comparados aos de grupo controle composto por sete voluntários pareados por sexo e idade, hígidos do ponto de vista cardiovascular. Um valor de p < 0,05 foi considerado significante. Resultados: A ecocardiografia convencional mostrou valores aumentados com significância estatística no grupo caso para átrio esquerdo, septo interventricular, parede posterior do ventrículo esquerdo, massa ventricular indexada e espessura relativa da parede (p < 0,05). O strain sistólico longitudinal global obtido pelo ecocardiograma bidimensional não mostrou diferença estatisticamente significativa entre os grupos caso e controle. Nenhum dos parâmetros ao ecocardiograma tridimensional apresentou significância estatística entre os grupos. Conclusão: Crianças diagnosticadas com PRKAG2 demonstraram achados ecocardiográficos indicativos de tendência à hipertrofia cardíaca. A ecocardiografia pode ser uma ferramenta útil na avaliação e seguimento desse grupo de pacientes, antes do início de manifestações clínicas. Fundamento PRKAG adulta esquerda súbita pacientes Objetivo assintomáticos Métodos participantes 1 comprovado avançadas cardiovascular 005 0 05 0,0 significante Resultados esquerdo interventricular 0,05. . 0,05) Conclusão cardíaca clínicas 00 0,

ABSTRACT Introduction: Recurrent dengue outbreaks underscore the need for more effective approaches to vector prevention and control. Often, interventions focus on a biomedical and health promotion approach from an individual approach, without integrating socio-environmental factors or being scientifically evaluated. Objetive: To evaluate the impact of large household waste collection on potential breeding sites of dengue-transmitting mosquitoes in Asuncion, Paraguay during the years 2017 to 2021. Material and methods: Quasi-experimental, longitudinal study, where 350 households were surveyed, as a baseline during 2017 and a closing line in 108 households in 2021. The Difference-in-Difference (DID) method was used to compare the presence of breeding sites before and after the intervention in 43 intervened and 65 non-intervened households. Results: Differentiated collection was mainly used by those households that had a large amount of large solid waste, but not to dispose of all these objects, but only part of them (DID of -52% in the total number of breeding sites and DID of 1% in the number of households with breeding sites). We found a significant reduction in the total number of large breeding sites but did not observe differences in the total number of households with breeding sites. Subjective factors, such as the belief that disused objects could become useful in the future, were largely responsible for the reduction in the number of large breeding sites. Conclusions: The municipal management approach to bulky waste can contribute to dengue prevention because it does not constitute rapidly generated waste in households, and its disposal can have a relatively long-lasting impact. The subjective factors related to the presence of these breeding sites in households warrant further study.

RESUMEN Introducción: Los brotes recurrentes de dengue subrayan la necesidad de abordajes más efectivos en la prevención y control de vectores. A menudo, las intervenciones se centran en un enfoque biomédico y de promoción de la salud desde un enfoque individual, sin integrar factores socioambientales ni ser evaluados científicamente Objetivo: Evaluar el impacto de la recolección de residuos domésticos de gran tamaño sobre potenciales criaderos de mosquitos transmisores del dengue en Asunción, Paraguay durante los años 2017 a 2021. Material y métodos: Estudio cuasiexperimental, longitudinal, donde se encuestaron 350 hogares, como línea de base durante el 2017 y una línea de cierre en 108 hogares en 2021. Se utilizó el método de Diferencia en Diferencia (DID) para comparar la presencia de criaderos antes y después de la intervención en 43 hogares intervenidos y 65 no intervenidos. Resultados: La recolección diferenciada fue utilizada principalmente por aquellos hogares que tenían una gran cantidad de residuos sólidos de gran tamaño, pero no para deshacerse de todos estos objetos, sino sólo de una parte (DID de -52% en el número total de criaderos y DID de 1% en número de hogares con criaderos). Encontramos una reducción significativa en el número de total de criaderos de gran tamaño, pero no observamos diferencias en el número total de hogares con criaderos. Factores subjetivos, como la creencia de que los objetos en desuso podrían llegar a ser útiles en el futuro explicaban en gran medida su presencia en los hogares, incluso con el servicio disponible. Conclusiones: El enfoque de la gestión municipal en los residuos voluminosos puede contribuir a la prevención del dengue por el hecho de que no constituyen residuos de generación rápida en los hogares, y su eliminación puede tener un impacto relativamente duradero. El factor subjetivo relacionado con la presencia de estos criaderos en los hogares debe ser objeto de mayores estudios.

Abstract Atopic dermatitis (AD) results from the interaction between dysfunction of the skin barrier, dysregulation of the immune system, and alteration of the skin microbiome. As the most common inflammatory skin disease worldwide and still increasing, it is a real health problem. Vitamin D deficiency is also considered a global problem affecting 13 out of 100 people in Europe. Since vitamin D is involved in the formation of the epidermal barrier, by the synthesis of structural proteins and regulation of keratinocyte proliferation and differentiation, there is a rational to evaluate the relation between vitamin D levels and the prevention or treatment of AD. The authors performed a review of the existing scientific literature on the role of vitamin D in AD. Although studies are scarce not very robust with no consensual results, most studies report lower serum levels of vitamin D in patients with AD. In addition, there seems to be an inverse relationship between plasma levels of vitamin D and clinical severity, a hypothesis that is reinforced by studies that demonstrated a statistically significant benefit of vitamin D supplementation for improving clinical symptoms and signs of AD. Some studies also suggest a possible influence of prenatal vitamin D levels on the onset of AD during childhood. Therefore, vitamin D supplementation may play a relevant role as a complement to the treatment of AD or for its prevention, but more and better scientific evidence is needed to confirm this.

Resumo A dermatite atópica resulta da interação entre a disfunção da barreira cutânea, a desregulação do sistema imunitário e a alteração do microbioma da pele. Sendo a doença inflamatória da pele mais comum a nível mundial e com incidência crescente é um verdadeiro problema de saúde. O défice de vitamina D é também um problema de saúde global, que afeta cerca de 13 em cada 100 cidadãos europeus. Uma vez que a vitamina D está envolvida na formação da barreira epidérmica, pela síntese de proteínas estruturais e pela regulação da proliferação e diferenciação dos queratinócitos, é expectável que os níveis séricos de vitamina D possam ter um papel na prevenção e/ou no tratamento da dermatite atópica. Neste artigo de revisão narrativa foi revista a literatura científica existente sobre o papel da vitamina D na dermatite atópica. Apesar de escassos, pouco robustos e não consensuais, a maioria dos estudos relatam níveis séricos de vitamina D mais baixos em doentes com dermatite atópica, com uma relação inversa entre os valores plasmáticos da vitamina e a gravidade da doença, hipótese reforçada por estudos que demonstraram uma relação estatisticamente significativa entre a suplementação e a melhoria dos sintomas e sinais clínicos. Existem também evidências que sugerem uma possível influência de valores pré-natais de vitamina D no surgimento de dermatite atópica durante a infância. Desta forma, a suplementação com vitamina D poderá ter um papel relevante como complemento do tratamento da dermatite atópica, mas são necessárias mais e melhores evidências científicas para o comprovar.

ABSTRACT Introduction Our society’s characteristics, with their constant evolution and globalization, have shown a significant impact on the way jobs have been structured over the years, with one of the most highlighted aspects being the possibility of practicing telecommuting. The prevalence of telecommuting and other forms of remote work enabled by technological innovations has increased in recent years. Objectives Exploring the most recently published literature on telecommuting; examining its relationship with psychosocial risk factors and making inferences about the need for the implementation and improvement of policies aimed at promoting mental health in occupational settings, with a focus on preventing psychosocial risks. Methodology Integrative literature review using the terms "teleworking," "remote work," "telework," "telecommuting," "psychosocial risks," "mental health," and "occupational health" in both Portuguese and English. The primary databases used for the research included Pubmed, UpToDate, Clinical Key, Medscape, World Health Organization, International Labour Organization, Centers for Disease Control and Prevention, “Revista Portuguesa de Saúde Ocupacional” and “Direção Geral de Saúde”. A total of 24 documents with the highest relevance to the study’s theme were selected, published between 2010 and 2023. Discussion Psychosocial risks in telecommuting are undergoing constant changes and align with demographic, nature, content and organization. These changes may increase exposure to already recognized psychosocial risks or give rise to new emergent ones. The widespread and unexpected adoption of telecommuting due to COVID-19 with the simultaneous advancement of digitization processes have made telecommuting a more common practice. However, this mass adoption has increased instances of technological stress among workers, potentially leading to adverse consequences for mental health. While the widespread implementation of telecommuting aimed to protect workers from biological risks, it has, in various situations, increased social isolation, work-family conflicts, and a lack of social support, with negative consequences for the mental health of the working population. Conclusion The increasing of telecommuting in our society is leading to assess the psychosocial risk factors that arise with it, so that they are recognized by occupational health experts and intervened upon, thus ensuring that telecommuting becomes healthier.

RESUMO Introdução As sociedades atuais e a sua constante evolução e globalização, têm demonstrado um impacto significativo na forma como se estruturam os postos de trabalho ao longo dos anos, nos quais, mais recentemente e com maior tradução mediática, se destaca a possibilidade de praticar teletrabalho, potenciada pela inovação tecnológica. Objetivos Conhecer a literatura mais recentemente publicada acerca do teletrabalho; bem como a sua relação com fatores de risco de origem psicossocial e inferir sobre a necessidade de implementação e aperfeiçoamento de políticas voltadas para promoção da saúde mental em contexto ocupacional, com enfoque na prevenção dos riscos psicossociais. Metodologia Revisão da literatura integrativa com os termos “teleworking”, “remote work”, “telework”, “telecommuting”, “psychosocial risks”, “mental health” e “occupational health”, em português e em inglês. Foram utilizadas como principais bases de dados a Pubmed, UpToDate, Clinical Key, Medscape, World Health Organization, International Labour Organization, Centers for Disease Control and Prevention, bem como a Revista Portuguesa de Saúde Ocupacional e a Direção Geral de Saúde. Selecionaram-se os 24 documentos com maior relevância na temática em estudo, publicados entre 2010 e 2023. Discussão As fontes de riscos psicossociais do teletrabalho encontram-se em constante mudança e acompanham as alterações demográficas e da organização. A prática de teletrabalho parece ser uma oferta cada vez mais comum, a sua adoção em larga escala e inesperada devido à COVID-19 e coligada ao enorme avanço dos processos de digitalização, aumentaram as situações de stress tecnológico entre os trabalhadores, com possíveis consequências adversas para a saúde mental. Esta massificação do Teletrabalho, embora com o intuito de proteger os trabalhadores relativamente a um risco biológico aumentou, em diversas situações, o isolamento social, os conflitos trabalho-família e a falta de suporte social, com consequências negativas na saúde mental da população ativa. Conclusão Com o aumento deste tipo de trabalho emerge a necessidade de avaliar os fatores de risco psicossociais que surgem em conformidade, para que estes sejam reconhecidos pelos peritos em saúde ocupacional e intervencionados, assegurando assim que o teletrabalho se torna mais saudável.

ABSTRACT Introduction: Diabetes mellitus is a public health issue affecting an increasing number of workers, representing a disease exacerbated by work with a high social, economic, and personal cost. The nature of the work performed, coupled with occupational risks in a hospital setting, significantly contribute to the disease's progression. This study aims to address the impact of this disease on work and the role of Occupational Health in the prevention of exposure to occupational risk factors in the hospital environment, which can contribute to the metabolic imbalance of type I diabetes mellitus. Methodology: The methodology included search in PubMed, Science Direct, and Google Scholar databases, using keywords such as "diabetes mellitus, occupational medicine, risk factors and occupational health”. Filters were applied, considering publications from 2010 to 2024, totaling 463 works. Exclusion criteria focused on non-diabetes-related diseases, exclusive focus on Type II, and non-occupational approaches. Articles on diabetes and occupational health and safety published in Revista Portuguesa de Saúde Ocupacional were also considered, in a total of five studies. Sources also included Direção Geral de Saúde Clinical Guidance, a national epidemiological study, and a technical manual on workplace diabetes, totaling 30 references in the discussion. Results: The authors report two cases of healthcare professionals from a hospital unit, both diagnosed with Type I Diabetes at the age of five. Case 1: A 35-year-old healthcare assistant with a history of depressive syndrome and recent diabetic retinopathy diagnosis. Case 2: A 57-year-old nurse with diabetic retinopathy, nephropathy, neuropathy, undergoing treatment for osteomyelitis of the right big toe, without cardiovascular changes. In both they work or have worked in shifts, including night shifts, engaging in physically demanding tasks. Discussion/Conclusion: Diabetes is a chronic disease requiring continuous medical care and patient education, alongside support in preventing acute complications and reducing the risk of chronic complications. The incidence of new Type I Dm cases is higher between 12-14 years. During the transition to adulthood and entry into the job market, patients face disease stigma, treatment management challenges, and psychosocial workplace-related issues. Implementing preventive measures and monitoring these workers should help reduce work absenteeism, productivity loss, and income loss for the worker.

RESUMO Introdução: A Diabetes mellitus é um problema de Saúde Pública que afeta um número crescente de trabalhadores. Pode ser considerada uma doença agravada pelo trabalho com um elevado custo social, económico e pessoal. O tipo de trabalho realizado e as exposições a riscos laborais em contexto hospitalar, podem contribuir para a sua progressão, segundo alguns autores. Este trabalho pretende abordar o impacto desta patologia no trabalho e o papel da Saúde Ocupacional na evicção da exposição a fatores de risco laborais, em ambiente hospitalar, que contribuem para o descontrolo metabólico da Diabetes Melitus tipo I. Pretende-se identificar as exposições laborais que podem constituir fatores de risco modificáveis, interferem com a aptidão para o trabalho, podem aumentar a frequência de acidentes laborais e acelerar a progressão crónica da doença. Metodologia: Na metodologia de pesquisa e seleção de estudos utilizou as bases de dados PubMed, Science Direct e Google Scholar, com as palavras-chave “diabetes mellitus, occupational medicine, risk factors, occupational health”. Aplicaram-se filtros de revisão e revisão sistemática, considerando publicações de 2010 a 2024, totalizando 463 trabalhos. Critérios de exclusão incidiram em doenças não relacionadas à diabetes, exclusividade na tipo II e abordagens não ocupacionais. Foram ainda considerados os artigos sobre diabetes e saúde e segurança no trabalho publicados na Revista Portuguesa de Saúde Ocupacional, num total de cinco estudos. Incluíram-se a Norma de Orientação Clínica da DGS, um estudo epidemiológico nacional e um caderno técnico sobre diabetes no local de trabalho, totalizando 30 fontes na discussão. Descrição dos casos: Os autores reportam dois casos de profissionais de saúde de uma unidade hospitalar, ambos com diagnóstico de Diabetes tipo I aos cinco anos de idade. Caso 1: Uma auxiliar de ação médica de 35 anos, com antecedentes pessoais de síndrome depressivo e diagnóstico recente de retinopatia diabética. Caso 2: Uma enfermeira de 57 anos com retinopatia e nefropatia diabética, neuropatia, em tratamento para uma osteomielite do 1º dedo do pé direito, sem alterações cardiovasculares. Ambas trabalham ou trabalharam por turnos, com trabalho noturno e com tarefas fisicamente exigentes. Discussão/Conclusão: A diabetes é uma doença crónica que requer cuidados médicos contínuos e educação do doente, juntamente com apoio na prevenção de complicações agudas e redução do risco de complicações crónicas. A incidência de novos casos de Dm tipo I é maior entre os 12-14 anos. Na transição para a idade adulta e entrada no mercado laboral, os doentes podem ser sujeitos ao estigma da doença, ter dificuldade na gestão do tratamento e/ou desafios psicossociais relacionados com o trabalho. A instituição de medidas preventivas e monitorização destes trabalhadores deverá ajudar a reduzir o absentismo laboral, a perda de produtividade e a perda de rendimento para o trabalhador.

HIV/AIDS remains one of the world's most significant public health and economic challenges, with approximately 36 million people currently living with the disease. Considerable progress has been made to reduce the impact of HIV/AIDS in the past years through successful multiple HIV/AIDS prevention and treatment interventions. However, barriers such as lack of engagement, limited availability of early HIV-infection detection tools, high rates of HIV/sexually transmitted infections (STIs), barriers to access antiretroviral therapy, lack of innovative resource optimisation and distribution strategies, and poor prevention services for vulnerable populations still exist and substantially affect the attainment of the UNAIDS 95-95-95 targets. A rapid review was conducted from 24 October 2022 to 5 November 2022. Literature searches were conducted in different prominent and reputable electronic database repositories including PubMed, Google Scholar, Science Direct, Scopus, Web of Science, IEEE Xplore, and Springer. The study used various search keywords to search for relevant publications. From a list of collected publications, researchers used inclusion and exclusion criteria to screen and select relevant papers for inclusion in this review. This study unpacks emerging opportunities that can be explored by applying machine learning techniques to further knowledge and understanding about HIV service design, prediction, implementation, and evaluation. Therefore, there is a need to explore innovative and more effective analytic strategies including machine learning approaches to understand and improve HIV service design, planning, implementation, and evaluation to strengthen HIV/AIDS prevention, treatment, and awareness strategies.

Abstract: The Internet of Things (IoT) has the potential to revolutionize healthcare by enabling remote patient monitoring, personalized care and disease prevention. In Ecuador, research on IoT in the healthcare field is rapidly expanding. However, there’s a need for a clearer understanding of the current state of this research. This study examines the contributions of Ecuadorian authors in this field through their publications in two globally impactful bibliographic databases. The methodology employed is a systematic review using the PRISMA statement, resulting in a final stage comprising 23 articles. These publications encompass system proposals, prototypes, and reviews with applications in areas such as epidemiology, cardiology and nursing. The recurrent mention of patient information privacy is a challenge in implementing IoT-based healthcare systems. The conclusions emphasize that future work perspectives should address the challenges identified, considering the growing trend of publications from Ecuadorian authors.

Resumen: El Internet de las Cosas (IoT) tiene el potencial de revolucionar la atención médica al permitir la monitorización remota de pacientes, atención personalizada y prevención de enfermedades. En Ecuador, la investigación sobre IoT en el campo de la salud está expandiéndose rápidamente. Sin embargo, es necesario tener una comprensión más clara del estado actual de esta investigación. Es así como el presente trabajo analiza las contribuciones de los autores ecuatorianos en este campo, a través de sus publicaciones en dos bases de datos bibliográficas de impacto global. La metodología empleada es una revisión sistemática utilizando la declaración PRISMA, lo que resulta en una etapa final con 23 artículos. Las publicaciones abarcan propuestas de sistemas, prototipos y revisiones con aplicaciones en áreas como epidemiología, cardiología y enfermería. Se destaca la mención recurrente de la privacidad de la información del paciente como un desafío en la implementación de sistemas de atención médica basados en IoT. En las conclusiones se enfatiza que las perspectivas de trabajo futuro deben abordar los desafíos expuestos, teniendo en cuenta la creciente tendencia de publicaciones de autores ecuatorianos.

Abstract Introduction: Acute kidney injury (AKI) occurs frequently in COVID-19 patients and is associated with greater morbidity and mortality. Knowing the risks of AKI allows for identification, prevention, and timely treatment. This study aimed to identify the risk factors associated with AKI in hospitalized patients. Methods: A descriptive, retrospective, cross-sectional, and analytical component study of adult patients hospitalized with COVID-19 from March 1 to December 31, 2020 was carried out. AKI was defined by the creatinine criteria of the KDIGO-AKI guidelines. Information, regarding risk factors, was obtained from electronic medical records. Results: Out of the 934 patients, 42.93% developed AKI, 60.59% KDIGO-1, and 9.9% required renal replacement therapy. Patients with AKI had longer hospital stay, higher mortality, and required more intensive care unit (ICU) admission, mechanical ventilation, and vasopressor support. Multivariate analysis showed that age (OR 1.03; 95% CI 1.02–1.04), male sex (OR 2.13; 95% CI 1.49–3.04), diabetes mellitus (DM) (OR 1.55; 95% CI 1.04–2.32), chronic kidney disease (CKD) (OR 2.07; 95% CI 1.06–4.04), C-reactive protein (CRP) (OR 1.02; 95% CI 1.00–1.03), ICU admission (OR 1.81; 95% CI 1.04–3.16), and vasopressor support (OR 7.46; 95% CI 3.34–16.64) were risk factors for AKI, and that bicarbonate (OR 0.89; 95% CI 0.84–0.94) and partial pressure arterial oxygen/inspired oxygen fraction index (OR 0.99; 95% CI 0.98–0.99) could be protective factors. Conclusions: A high frequency of AKI was documented in COVID-19 patients, with several predictors: age, male sex, DM, CKD, CRP, ICU admission, and vasopressor support. AKI occurred more frequently in patients with higher disease severity and was associated with higher mortality and worse outcomes. Introduction (AKI COVID19 COVID 19 COVID-1 identification prevention treatment Methods descriptive retrospective crosssectional, crosssectional cross sectional, sectional cross-sectional 31 202 out KDIGOAKI KDIGO guidelines Information records Results 93 4293 42 42.93 6059 60 59 60.59 KDIGO1, KDIGO1 1, KDIGO-1 99 9 9.9 therapy stay (ICU ventilation OR 1.03 103 03 95 1.02–1.04, 102104 1.02–1.04 , 02 04 1.02–1.04) 2.13 213 2 13 1.49–3.04, 149304 1.49–3.04 49 3 1.49–3.04) DM (DM 1.55 155 55 1.04–2.32, 104232 1.04–2.32 32 1.04–2.32) CKD (CKD 2.07 207 07 1.06–4.04, 106404 1.06–4.04 06 4 1.06–4.04) Creactive C reactive CRP (CRP 1.02 102 1.00–1.03, 100103 1.00–1.03 00 1.00–1.03) 1.81 181 81 1.04–3.16, 104316 1.04–3.16 16 1.04–3.16) 7.46 746 7 46 3.34–16.64 3341664 34 64 0.89 089 0 89 0.84–0.94 084094 84 94 oxygeninspired inspired 0.99 099 0.98–0.99 098099 98 Conclusions predictors outcomes COVID1 COVID- 20 429 42.9 605 6 5 60.5 KDIGO- 9. 1.0 10 10210 1.02–1.0 2.1 21 14930 1.49–3.0 1.5 15 10423 1.04–2.3 2.0 10640 1.06–4.0 10010 1.00–1.0 1.8 18 8 10431 1.04–3.1 7.4 74 3.34–16.6 334166 0.8 08 0.84–0.9 08409 0.9 09 0.98–0.9 09809 42. 60. 1. 1021 1.02–1. 2. 1493 1.49–3. 1042 1.04–2. 1064 1.06–4. 1001 1.00–1. 1043 1.04–3. 7. 3.34–16. 33416 0. 0.84–0. 0840 0.98–0. 0980 1.02–1 149 1.49–3 104 1.04–2 106 1.06–4 100 1.00–1 1.04–3 3.34–16 3341 0.84–0 084 0.98–0 098 1.02– 14 1.49– 1.04– 1.06– 1.00– 3.34–1 334 0.84– 0.98– 1.49 1.04 1.06 1.00 3.34– 33 0.84 0.98 1.4 3.34 3.3 3.

RESUMO Introdução: Lesão renal aguda (LRA) ocorre frequentemente em pacientes com COVID-19 e associa-se a maior morbidade e mortalidade. Conhecer riscos da LRA permite a identificação, prevenção e tratamento oportuno. Este estudo teve como objetivo identificar fatores de risco associados à LRA em pacientes hospitalizados. Métodos: Realizou-se estudo descritivo, retrospectivo, transversal e de componente analítico de pacientes adultos hospitalizados com COVID-19 de 1º de março a 31 de dezembro, 2020. Definiu-se a LRA pelos critérios de creatinina das diretrizes KDIGO-LRA. Informações sobre fatores de risco foram obtidas de prontuários eletrônicos. Resultados: Dos 934 pacientes, 42,93% desenvolveram LRA, 60,59% KDIGO-1 e 9,9% necessitaram de terapia renal substitutiva. Pacientes com LRA apresentaram maior tempo de internação, maior mortalidade e necessitaram de mais internações em UTIs, ventilação mecânica e suporte vasopressor. A análise multivariada mostrou que idade (OR 1,03; IC 95% 1,02–1,04), sexo masculino (OR 2,13; IC 95% 1,49–3,04), diabetes mellitus (DM) (OR 1,55; IC 95% 1,04–2,32), doença renal crônica (DRC) (OR 2,07; IC 95% 1,06–4,04), proteína C reativa (PCR) (OR 1,02; IC 95% 1,00–1,03), admissão em UTI (OR 1,81; IC 95% 1,04–3,16) e suporte vasopressor (OR 7,46; IC 95% 3,34–16,64) foram fatores de risco para LRA, e que bicarbonato (OR 0,89; IC 95% 0,84–0,94) e índice de pressão parcial de oxigênio arterial/fração inspirada de oxigênio (OR 0,99; IC 95% 0,98–0,99) poderiam ser fatores de proteção. Conclusões: Documentou-se alta frequência de LRA em pacientes com COVID-19, com diversos preditores: idade, sexo masculino, DM, DRC, PCR, admissão em UTI e suporte vasopressor. LRA ocorreu mais frequentemente em pacientes com maior gravidade da doença e associou-se a maior mortalidade e piores desfechos. Introdução (LRA COVID19 COVID 19 COVID-1 associase associa se identificação oportuno Métodos Realizouse Realizou descritivo retrospectivo º 3 dezembro 2020 Definiuse Definiu KDIGOLRA. KDIGOLRA KDIGO LRA. KDIGO-LRA eletrônicos Resultados 93 4293 42 42,93 6059 60 59 60,59 KDIGO1 1 KDIGO- 99 9 9,9 substitutiva internação UTIs OR 1,03 103 03 95 1,02–1,04, 102104 1,02–1,04 , 02 04 1,02–1,04) 2,13 213 2 13 1,49–3,04, 149304 1,49–3,04 49 1,49–3,04) DM (DM 1,55 155 55 1,04–2,32, 104232 1,04–2,32 32 1,04–2,32) DRC (DRC 2,07 207 07 1,06–4,04, 106404 1,06–4,04 06 4 1,06–4,04) PCR (PCR 1,02 102 1,00–1,03, 100103 1,00–1,03 00 1,00–1,03) 1,81 181 81 1,04–3,16 104316 16 7,46 746 7 46 3,34–16,64 3341664 34 64 0,89 089 0 89 0,84–0,94 084094 84 94 arterialfração arterial fração 0,99 099 0,98–0,99 098099 98 proteção Conclusões Documentouse Documentou COVID19, 19, preditores associouse associou desfechos COVID1 COVID- 202 429 42,9 605 6 5 60,5 9, 1,0 10 10210 1,02–1,0 2,1 21 14930 1,49–3,0 1,5 15 10423 1,04–2,3 2,0 20 10640 1,06–4,0 10010 1,00–1,0 1,8 18 8 1,04–3,1 10431 7,4 74 3,34–16,6 334166 0,8 08 0,84–0,9 08409 0,9 09 0,98–0,9 09809 42, 60, 1, 1021 1,02–1, 2, 1493 1,49–3, 1042 1,04–2, 1064 1,06–4, 1001 1,00–1, 1,04–3, 1043 7, 3,34–16, 33416 0, 0,84–0, 0840 0,98–0, 0980 1,02–1 149 1,49–3 104 1,04–2 106 1,06–4 100 1,00–1 1,04–3 3,34–16 3341 0,84–0 084 0,98–0 098 1,02– 14 1,49– 1,04– 1,06– 1,00– 3,34–1 334 0,84– 0,98– 1,49 1,04 1,06 1,00 3,34– 33 0,84 0,98 1,4 3,34 3,3 3,

Abstract Sudden cardiac death is a common occurrence. Out-of-hospital cardiac arrest is a global public health problem suffered by ≈3.8 million people annually. Progress has been made in the knowledge of this disease, its prevention, and treatment; however, most events occur in people without a previous diagnosis of heart disease. Due to its multifactorial and complex nature, it represents a challenge in public health, so it led us to work in a consensus to achieve the implementation of cardioprotected areas in Mexico as a priority mechanism to treat these events. Public access cardiopulmonary resuscitation (CPR) and early defibrillation require training of non-medical personnel, who are usually the first responders in the chain of survival. They should be able to establish a basic and efficient CPR and use of the automatic external defibrillator (AED) until the emergency services arrive at the scene of the incident. Some of the current problems in Mexico and alternative solutions for them are addressed in the present work.

Resumen La muerte súbita cardíaca (SCD) es un acontecimiento común. El paro cardiaco extrahospitalario (OHCA) es un problema de salud pública mundial que sufren ≈3.8 millones de personas al año. Se ha avanzado en el conocimiento de esta enfermedad, su prevención y tratamiento, sin embargo, la mayoría de los eventos se producen en personas sin diagnóstico previo de cardiopatía. Debido a su carácter multifactorial y complejo, representa un reto en salud pública, lo que obliga a trabajar en un consenso para lograr la implementación de "Espacios Cardio protegidos" en México, como mecanismo prioritario de atención a estos eventos. La reanimación cardiopulmonar básica (RCPB) y la desfibrilación temprana de acceso público requieren de entrenamiento al personal no médico, que suelen ser los primeros respondientes para iniciar la cadena de la supervivencia. Ellos deberían instaurar una RCPB eficiente y el uso del desfibrilador automático externo (AED) hasta que lleguen al lugar del incidente los servicios de emergencias. El presente trabajo menciona algunos de los problemas actuales en México y algunas opciones de solución para los mismos.