RESUMEN Reportamos el caso clínico de un lactante menor con una presentación anular de hemangioma, que nos plantea dudas en su clasificación. Se precisan los diagnósticos diferenciales y la necesidad de la determinación del marcador GLUT 1 en hospitales públicos.

ABSTRACT We report the clinical case of a young infant with an annular presentation of hemangioma, which raises doubts regarding its classification. Differential diagnoses and the need to determine the GLUT 1 marker in public hospitals are specified.

ABSTRACT Introduction: Chikungunya fever is characterized by fever, joint pain and skin rash. Paraguay in recent months has suffered an epidemic with significant morbidity and mortality. Many not only systemic but also cutaneous manifestations were very striking and are considered atypical of the disease. Objective: to communicate the various mucocutaneous manifestations in probable and confirmed cases of chikungunya fever. Metodology: prospective, descriptive and observational study of the mucocutaneous manifestations of chikungunya fever registered in the Servicio de Dermatología of the Hospital Nacional in the period February to April 2023. Patients of all ages and both sexes with the diagnosis confirmed by laboratory studies or probable by epidemiological link. Results: In this series of 58 patients, the maculopapular erythematous rash was the most frequent finding (41.3 %) followed by edema of the extremities (24.1 %). Vesico-bullous lesions were observed in 8 cases, all pediatric. Aphthoid lesions in the mouth and genitals, urticarial and purpuric lesions, acral and facial cyanosis, and acneiform eruption were other findings of interest, as well as exacerbation of previous dermatoses such as psoriasis and seborrheic dermatitis. Patterns of hyperpigmentation were observed in a small number of patients. A combination of lesions was observed in 28 patients. The diagnosis was confirmed in 44.8 % by means of the study of RT-PCR molecular techniques, 1 by ELISA with Positive Igm and the rest by epidemiological link. Conclusion: in our study, a wide variety of mucocutaneous manifestations was observed, with maculopapular rash being the most frequent manifestation, as well as manifestations considered atypical of the disease.

RESUMEN Introducción: la fiebre chikungunya se caracteriza por fiebre, dolores articulares y erupción cutánea. El Paraguay en los últimos meses ha sufrido una epidemia con importante morbimortalidad. Muchas manifestaciones no solo sistémicas sino también cutáneas fueron muy llamativas y se consideran como atípicas de la enfermedad. Objetivo: comunicar las diversas manifestaciones mucocutáneas en casos probables y confirmados de fiebre chikungunya. Metodología: estudio prospectivo, descriptivo y observacional de las manifestaciones mucocutáneas de la fiebre chikungunya registradas en el Servicio de Dermatología del Hospital Nacional, periodo febrero-abril 2023. Se incluyen pacientes de todas las edades y ambos sexos con el diagnóstico confirmado por estudios laboratoriales o probable por nexo epidemiológico. Resultados: en esta serie de 58 pacientes, la erupción eritematosa maculopapular fue el hallazgo más frecuente (41,3 %) seguido por el edema de extremidades (24,1 %). Las lesiones vesico-ampollares fueron observadas en 8 casos, todos pediátricos. Lesiones aftoides en boca y genital, lesiones urticariformes, purpúricas, cianosis acral y facial y erupción acneiforme fueron otros hallazgos de interés, así como la exacerbación de dermatosis previas como psoriasis y dermatitis seborreica. Se observaron patrones de hiperpigmentación en un pequeño número de pacientes. En 28 pacientes se observaron combinación de lesiones. El diagnóstico se confirmó en el 44,8% por medio del estudio de técnicas moleculares de RT-PCR, 1 por ELISA con IgM positivo y los restantes por nexo epidemiológico. Conclusiones: en nuestro estudio se observó una amplia variedad de manifestaciones mucocutáneas, siendo el exantema maculopapular la manifestación más frecuente, así como también manifestaciones consideradas atípicas de la enfermedad.

Resumo Objetivo Avaliar o estado emocional, nas dimensões ansiedade e depressão, e a qualidade de vida, em pessoas com artrite reumatóide. Métodos Estudo primário, descritivo e transversal, desenvolvido na região norte de Portugal, com uma amostra de 139 pessoas com artrite reumatóide (79,86% mulheres) e com média de idades de 63.05 anos. Foram aplicados: um questionário sociodemográfico, a escala “Hospital Anxiety and Depression Scale” e o questionário “EQ-5D – Avaliação de Ganhos em Saúde”. Na análise de dados, por meio do programa IBM Statistical Package for the Social Sciences (SPSS) Statistics 24 , recorreu-se à estatística inferencial, considerando-se estatisticamente significativo um p < 0,05. Resultados Os achados sobre o estado emocional mostraram níveis de ansiedade severos em 45,3%, ansiedade moderada em 36,7%, ansiedade leve em 10,1% e apenas 7,9% dos participantes pontuaram sem ansiedade. A maioria não apresenta sintomatologia depressiva (71,9%) e 13,7% manifestou depressão leve. Os baixos níveis de depressão foram associados a uma melhor qualidade-de-vida, contrariamente aos níveis de ansiedade, onde uma diminuição dos mesmos diminui a qualidade-de-vida (p=0,000). Conclusão Observou-se que a ansiedade e a depressão emergiram como preditores da QDV em pessoas com AR. Para proteger e melhorar a saúde dos pacientes, destaca-se a necessidade de implementar intervenções de enfermagem direcionadas ao controle dos fatores que induzem comportamentos ansiogênicos e depressivos.

Abstract Objective To assess the emotional states of the anxiety and depression dimensions and the quality of life in patients with rheumatoid arthritis. Methods A primary, descriptive, and cross-sectional study conducted in the northern region of Portugal, using a sample of 139 people suffering from rheumatoid arthritis (79.86% of whom were women) with a mean age of 63.05 years. A sociodemographic questionnaire, the “Hospital Anxiety and Depression Scale” and the “EQ-5D – Health Gains questionnaire were administered. Inferential statistics were used to conduct data analysis. IBM Statistical Package for the Social Sciences (SPSS) Statistics 24 program was the instrument of choice and p < 0.05 was deemed statistically significant. Results Findings on emotional state showed severe/extreme anxiety levels in 45.3% of the respondents, moderate anxiety in 36.7% of them, mild anxiety in 10.1% and only 7.9% of participants showed no sign of anxiety. Most of the participants did not present any sort of depressive symptoms (71.9%) and 13.7% of them were diagnosed with mild depression. Low levels of depression were associated with a better quality of life. On the other hand, low levels of anxiety see to lead to poorer quality of life (p=0.000). Conclusion Evidence shows that anxiety and depression are predictors of QOL in patients with RA. That way, nursing interventions aimed at controlling the factors that trigger anxiogenic and depressive behaviours must be implemented to protect and improve patients’ health.

Resumen Objetivo Evaluar el estado emocional, en las dimensiones ansiedad y depresión, y la calidad de vida, en personas con artritis reumatoide. Métodos Estudio primario, descriptivo y transversal, desarrollado en la región norte de Portugal, con una muestra de 139 personas con artritis reumatoide (79,86 % mujeres) con un promedio de edad de 63.05 años. Se aplicaron: un cuestionario sociodemográfico, la escala “Hospital Anxiety and Depression Scale” y el cuestionario “EQ-5D – Avaliação de Ganhos em Saúde”. En el análisis de datos, por medio del programa IBM Statistical Package for the Social Sciences (SPSS) Statistics 24 , se recorrió a la estadística inferencial, y se consideró estadísticamente significante un p < 0,05. Resultados Los hallazgos sobre el estado emocional mostraron niveles de ansiedad severos en 45,3 %, ansiedad moderada en 36,7 %, ansiedad leve en 10,1 % y apenas el 7,9 % de los participantes puntuaron sin ansiedad. La mayoría no presenta sintomatología depresiva (71,9 %) y el 13,7 % manifestó depresión leve. Los bajos niveles de depresión estuvieron asociados a una mejor calidad de vida, contrariamente a los niveles de ansiedad, en la que una disminución en ellos disminuyó la calidad de vida (p=0,000). Conclusión Se observó que la ansiedad y la depresión emergieron como predictores de la CDV en personas con AR. Para proteger y mejorar la salud de los pacientes, se destaca la necesidad de implementar intervenciones de enfermería direccionadas al control de los factores que inducen a comportamientos ansiogénicos y depresivos.

Resumen Marco contextual: La artritis reumatoide (AR) es una enfermedad autoinmune, crónica, progresiva y potencialmente incapacitante. Las actividades de autocuidado alivian los síntomas y las complicaciones de la enfermedad, reducen el tiempo de recuperación y la tasa de hospitalización. Objetivo: Evaluar la relación de la autonomía funcional con la calidad de vida (CDV) en personas con AR. Metodología: Estudio descriptivo, analítico-correlacional y transversal, desarrollado en la región norte de Portugal, con una muestra de 139 personas con AR (79,86% mujeres). Se usó un instrumento de recogida de datos, donde consta: caracterización sociodemográfica; escala Health Assessment Questionnaire (evaluación de la autonomía funcional) y Cuestionarios EQ-5D (evaluación de la CDV). Resultados: El valor medio de incapacidad fue de 1,029 (incapacidad moderada), el 48,9% de la muestra presentó incapacidad leve, el 43,2% moderada y el 7,9% elevada. El 90,6% de los participantes puntuaron la CVD como razonable y el 9,4% como mala. Las personas con mayor incapacidad, por lo tanto, menor autonomía funcional, presentan menor CDV. Conclusión: La autonomía funcional impacta la CDV e influye en ella de forma positiva. Las intervenciones de enfermería deben ajustarse a las necesidades de la persona con AR para promover su autonomía.

Resumo Enquadramento: A artrite reumatóide (AR) é uma doença autoimune, crónica, progressiva e potencialmente incapacitante. As atividades de autocuidado aliviam os sintomas e complicações das doenças, reduzem o tempo de recuperação e a taxa de hospitalização. Objetivos: Avaliar a relação da autonomia funcional com a qualidade de vida (QDV) em pessoas com AR. Metodologia: Estudo descritivo, analítico-correlacional e transversal, desenvolvido na região norte de Portugal, com amostra de 139 pessoas com AR (79,86% mulheres). Instrumento de colheita de dados, onde consta: caracterização sociodemográfica; escala Health Assessment Questionnaire (avaliação da autonomia funcional) e Questionário EQ-5D (avaliação da QDV). Resultados: O valor médio de incapacidade foi de 1,029 (incapacidade moderada), apresentando 48,9% da amostra incapacidade leve, 43,2% moderada e 7,9% elevada. Pontuaram com razoável QDV 90,6% dos participantes e 9,4% com fraca. As pessoas com maior incapacidade, logo menor autonomia funcional, apresentam menor QDV. Conclusão: A autonomia funcional impacta a QDV, influenciando-a positivamente. As intervenções de enfermagem carecem de ser ajustadas às necessidades da pessoa com AR na promoção da autonomia.

Abstract Background: Rheumatoid arthritis (RA) is a chronic, progressive, and potentially disabling autoimmune disease. Self-care activities relieve symptoms and complications of diseases and reduce recovery time and hospital admission rates. Objective: To assess the association between functional autonomy and quality of life (QOL) in people with RA. Methodology: Descriptive, analytical-correlational, and cross-sectional study, developed in the northern region of Portugal, with a sample of 139 people with RA (79.86% women). The data collection instrument included a sociodemographic characterization, the Health Assessment Questionnaire (assessment of functional autonomy), and the EQ-5D Questionnaire (assessment of QOL). Results: The mean value of disability was 1.029 (moderate disability), with 48.9% of the sample showing mild disability, 43.2% moderate disability, and 7.9% severe disability. 90.6% of participants had a reasonable QOL, and 9.4% had a poor QOL. People with greater disability and consequently less functional autonomy have lower QOL. Conclusion: Functional autonomy impacts QOL, influencing it positively. Nursing interventions need to be adjusted to the needs of patients with RA to promote their autonomy.

ABSTRACT In November 2019, in Wuhan, China, what would be a new pandemic started, due to a coronavirus that had not been previously identified, SARS-CoV-2. Subsequently, the first case of COVID-19 was reported in Paraguay in March 2020. Despite the fact that it is a virus of preferential respiratory manifestation, we know to date that it can present with other symptoms, including asymptomatically. Skin lesions, like in many other infectious diseases, have been shown to be caused by this new virus as well, making the dermatologist play an important role in this battle. We report the first case registered by the Dermatology service of the Itaugua National Hospital of cutaneous manifestations in an infant, secondary to COVID-19 disease.

RESUMEN En noviembre del 2019 inicia en Wuhan, lo que sería una nueva pandemia, por un coronavirus que no había sido identificado previamente, el SARS-CoV-2. Posteriormente fue reportado en Paraguay el primer caso de covid-19 en marzo del 2020. A pesar de que se trata de un virus de manifestación preferentemente respiratoria, sabemos hasta la fecha que pueden presentar otros síntomas, incluso ser totalmente asintomáticos. Se ha visto que las lesiones en piel, al igual que en muchas otras enfermedades infecciosas, también son causadas por este nuevo virus, por lo que el dermatólogo juega un rol importante en esta batalla. Reportamos el primer caso registrado por el servicio de Dermatología del Hospital Nacional de Itaugua, de manifestaciones cutáneas en un lactante, secundarias a la enfermedad de COVID-19.

Abstract Introduction: Self-care and self-management are part of daily life and involve intentional activities to prevent or limit diseases and slow their progression (Barley 2016; Jones et al, 2011). The self-management / self-care capacity of people with RA can be influenced by multiple factors, from beliefs about medication, which can influence adherence, to external factors, such as lack of access to certain health care. Objectives: To identify the factors that influence self-care in people with RA. Methods: Integrative literature review. in the main databases. The critical evaluation, extraction and synthesis of data were performed by two independent reviewers. Results: 12 studies were included, of which emerged as factors influencing self-care, factors related to: social support, emotional, socioeconomic and cultural support, illness and comorbidities, health services and professionals, treatment, knowledge, intrinsic to the person and physical barriers. Conclusions: the knowledge of the categories identified in the present study is useful in the development of programs that try to reduce barriers and increase reinforcement factors, with a view to improving and developing self-care behaviours.

Resumen Introducción: el autocuidado y el autocuidado son parte de la vida diaria e involucran actividades intencionales para prevenir o limitar enfermedades y retrasar su progresión. La capacidad de autogestión / autocuidado de las personas con AR puede verse influenciada por múltiples factores, desde creencias sobre la medicación, que pueden influir en la adherencia, hasta factores externos, como la falta de acceso a cierta atención médica. Objetivos: identificar los factores que influyen en el autocuidado en personas con AR. Métodos: revisión integral de la literatura. en las principales bases de datos. La evaluación crítica, la extracción y la síntesis de los datos fueron realizadas por dos revisores independientes. Resultados: se han incluido 12 estudios, de los cuales surgieron como factores que influyen en el autocuidado, factores relacionados con: apoyo social, apoyo emocional, socioeconómico y cultural, enfermedades y comorbilidades, servicios de salud y profesionales, tratamiento, conocimiento, intrínseco a la persona y barreras físicas. Conclusiones: el conocimiento de las categorías identificadas en el presente estudio es útil en el desarrollo de programas que intentan reducir las barreras y aumentar los factores de refuerzo, con miras a mejorar y desarrollar comportamientos de autocuidado.

Resumo Introdução: O autocuidado e a autogestão fazem parte da vida diária e envolvem atividades intencionais para prevenir ou limitar doenças e retardar a sua progressão. A capacidade de autogestão/autocuidado da pessoa com AR pode ser influenciada por múltiplos fatores, desde crenças sobre a medicação, que podem influenciar a adesão, a fatores externos, como falta de acesso a determinados cuidados de saúde. Objetivos: Identificar os fatores que influenciam o autocuidado nas pessoas com AR. Métodos: Revisão integrativa da literatura. nas principais bases de dados. A avaliação crítica, extração e síntese dos dados foram realizadas por dois revisores independentes. Resultados: Foram incluídos 12 estudos, dos quais emergiram como fatores influenciadores do autocuidado, fatores relacionados com: suporte social, suporte emocional, socioeconómicos e culturais, doença e comorbilidades, serviços e profissionais de saúde, tratamento, conhecimento, intrínsecos à pessoa e barreiras físicas. Conclusões: o conhecimento das categorias identificadas no presente estudo constitui-se útil na elaboração de programas que tentam reduzir barreiras e aumentar fatores de reforço, com vista à melhoria e desenvolvimento de comportamentos de autocuidado.

Abstract Next-generation sequencing (NGS) platforms allow the analysis of hundreds of millions of molecules in a single sequencing run, revolutionizing many research areas. NGS-based microRNA studies enable expression quantification in unprecedented scale without the limitations of closed-platforms. Yet, whereas a massive amount of data produced by these platforms is available, comparisons of quantification/discovery capabilities between platforms are still lacking. Here we compare two NGS-platforms: SOLiD and PGM, by evaluating their microRNA identification/quantification capabilities using two breast-derived cell-lines. A high expression correlation (R2 > 0.9) was achieved, encompassing 97% of the miRNAs, and the few discrepancies in miRNA counts were attributable to molecules that have very low expression. Quantification divergences indicative of artefactual representation were seen for 14 miRNAs (higher in SOLiD-reads) and another 10 miRNAs more abundant in PGM-data. An inspection of these revealed an increased and statistically significant count of uracyls and uracyl-stretches for PGM-enriched miRNAs, compared to SOLiD and to the miRBase. In parallel, adenines and adenine-stretches were enriched for SOLiDderived miRNA reads. We conclude that, whereas both platforms are overall consistent and can be used interchangeably for microRNA expression studies, particular sequence features appear to be indicative of specific platform bias, and their presence in microRNAs should be considered for database-analyses.

Studies based on shell or reproductive organ morphology and genetic considerations suggest extensive intraspecific variation in Biomphalaria snails. The high variability at the morphological and genetic levels, as well as the small size of some specimens and similarities between species complicate the correct identification of these snails. Here we review our work using methods based on polymerase chain reaction (PCR) amplification for analysis of genetic variation and identification of Biomphalaria snails from Brazil, Argentina, Uruguay and Paraguay. Arbitrarily primed-PCR revealed that the genome of B. glabrata exihibits a remarkable degree of intraespecific polymorphism. Low stringency-PCR using primers for 18S rRNA permited the identification of B. glabrata, B. tenagophila and B. occidentalis. The study of individuals obtained from geographically distinct populations exhibits significant intraspecific DNA polymorphism, however specimens from the same species, exhibit some species specific LSPs. We also showed that PCR-restriction fragment of length polymorphism of the internal transcribed spacer region of Biomphalaria rDNA, using DdeI permits the differentiation of the three intermediate hosts of Schistosoma mansoni. The molecular biological techniques used in our studies are very useful for the generation of new knowledge concerning the systematics and population genetics of Biomphalaria snails.