Revista científica ciencias de la salud

Parasitic infections in children of Paraguay: A systematic review from 2014 to 2024

Sat, 29 Mar 2025 00:00:00 +0000

Parasitoses affect millions of people worldwide, mostly in developing countries. Children are the most vulnerable group due to their developing immune system, poor hygiene habits and increased exposure to the environment. This systematic review identified parasitosis in children in Paraguay between 2014 and 2024. A documentary methodology and retrospective study were used, following PRISMA-SR and JBI guidelines. Experimental and observational studies were included, excluding narrative reviews. MEDLINE, Embase, Scopus and gray literature databases were used. Two reviewers selected and extracted data using Rayyan QCRI and Excel, the quality of the process was assessed with the JBI Critical Appraisal Tool. A total of 537 articles were identified, of which 21 met the inclusion criteria. These studies reported the most frequent parasitic infections caused by Giardia lamblia, Blastocystis hominis and Ascaris lumbricoides (76%). 95% of the samples were diagnosed by the coproparasitological method. Most of the samples came from Concepción, Central and Alto Paraná. The main risk factors were age, overcrowding, poor access to drinking water and poor sanitation. Parasitosis was more prevalent in indigenous children and in dwellings with dirt floors. A high prevalence of intestinal parasites was found in vulnerable communities. Hemoparasites were poorly recorded, suggesting underreporting of these parasitoses. It is essential to improve diagnosis by molecular and immunological techniques and to promote prevention strategies to reduce the burden of parasitosis in Paraguay.

Microplastics and nanoplastics: mechanisms of bioaccumulation and toxicity

Sun, 31 Aug 2025 00:00:00 +0000

Introduction. Microplastic (MP) and nanoplastics (MNP) contaminations are characterized by their microscopic size have been detected in almost all ecosystems of the planet. Objective. To perform a systematic review of the current scientific evidence corresponding to the mechanisms of interaction and affectation of MP and MNP on biological systems. Materials and Methods. The PRISMA method was applied. Results. The review and analysis of the literature refers to epidemiological evidence concerning the toxicity of PM and MNP. The analyzed literature expresses comparative and complementary trends, coming from independent lines of research, which convergently offer convincing evidence in relation to four paradigmatic mechanisms of PM and NPM toxicity: bioaccumulative capacity, vectorial role in the transport of environmental pollutants, intrinsic capacity as endocrine disruptors and translocation capacity. Conclusion. Scientific evidence shows the presence of PM and NPMs in the environment and their capacity to penetrate the human being, overcoming the blood-brain barrier or the placental barrier, which raises fears about the alterations that may be caused in the fetus and, therefore, about any transgenerational impact. The vector effect can replicate the damage, since it can also transport other contaminants to the organs of biological relevance. Their capacity as endocrine disruptors should be considered as a possible contributing factor in the emergence of metabolic dysfunctions at the global level.

Acute kidney injury in trauma patient

Mon, 16 Jun 2025 00:00:00 +0000

Trauma is considered one of the leading causes of mortality globally, among the complications most frequently associated with trauma is acute kidney injury triggered by hemorrhage, rhabdomyolysis, inflammation, infections or metabolic response to the surgical process. The objective is to present a narrative review on aspects related to the pathophysiological, diagnostic and therapeutic approach in trauma patients with acute kidney injury. Methods: Narrative review of relevant and outstanding articles in the area of management of the trauma patient with acute kidney injury, from different databases such as PubMed, Science Direct, Embase, EBSCO and MEDLINE. The pathophysiological mechanisms that lead the trauma patient to generate acute kidney injury have been widely described, mainly associated with processes derived from the same trauma with hematological, immune, musculoskeletal and other compromises. An initial approach should then be made from translational medicine to establish optimal therapeutic actions. An optimal approach in trauma patients with acute renal compromise can significantly improve their prognosis, as well as the complications associated with a detriment of renal function and other associated sequelae.

Standard patients: key to clinical learning in medicine

Fátima Ayala de Mendoza, Nelson López Esquivel — Sat, 29 Mar 2025 00:00:00 +0000

This review article synthesizes the literature on the use of standardized patients (SPs) in medical education. The goal is to synthesize the existing evidence on the impact of SPs on clinical learning, identify best practices in their use, and explore their validity as assessment tools in medical education. SPs are individuals trained to accurately and consistently simulate real patients, providing a controlled environment for learning and assessing clinical skills. Their applications are diverse, ranging from training medical students to evaluating standards of care in clinical practice and research in health informatics. The use of SPs presents significant advantages in terms of standardization, temporal flexibility, safety, and efficiency, allowing for the practice of complex skills and the objective evaluation of performance. However, their implementation involves challenges, such as the costs and time required for high-quality recruitment and training, as well as limitations in simulating all aspects of real patient experience. In conclusion, standardized patients are a valuable and complementary tool in medical education, facilitating the acquisition of clinical competencies and performance evaluation, without intending to replace interaction with real patients.

Coexistence of mycobacterial infections in a patient with Lucio phenomenon. Case report

Tue, 30 Sep 2025 00:00:00 +0000

Leprosy is a chronic infectious disease, acquired by people susceptible to Mycobacterium leprae, with a neurodermatological predilection, with a high socio-health impact. In addition, it can include episodes of changes in the immune system, known as reactionary states, which includes the Lucio phenomenon, whose pathogenesis is poorly understood so far. Tuberculosis continues to be an endemic mycobacterial infection in Paraguay; however, co-infection with Mycobacterium Leprae is rarely seen. The transmission dynamics of both infections make the concomitant occurrence of Tuberculosis and Leprosy an infrequent phenomenon and the clinical symptoms of both diseases depend on the immune response of the host. We present a male patient who presents to the Internal Medicine service for a disseminated dermatosis of polymorphous appearance, with multiple disseminated scabrous and ulcerated erythemato-violet lesions of different types of sizes, associated with daily fever. A lymphocutaneous sample was taken at the level of the ear, which returned positive for Hansen's disease. The findings of the physical examination of the respiratory system revealed data suggestive of Pulmonary Tuberculosis, supported by the Computed Tomography report and the confirmation of the XPERT gene of sputum which returns positive for Mycobacterium Tuberculosis with sensitivity to rifampicin. Anti-tuberculosis medication and multidrug therapy for multibacillary leprosy substantially improved patient health. The relationship between the two mycobacterial diseases remains enigmatic despite decades of research, and case reports are of vital importance to the medical community.

Kaposi's Sarcoma in an Immunocompromised Patient: A case report

María Victoria Benítez Pérez, Paddy Cimar Calvo Torales, Alma María Duarte Díaz — Thu, 31 Jul 2025 00:00:00 +0000

Introduction: Kaposi’s sarcoma (KS) is a vascular neoplasm associated with HHV-8 infection, commonly seen in immunocompromised individuals, particularly those with HIV/AIDS. Its epidemic form is the most aggressive and is considered an AIDS-defining illness. Case Report: We present the case of a 36-year-old male diagnosed with HIV five years ago, with poor adherence to antiretroviral therapy (ART) and a CD4 count of 78 cells/mm³. He presented with progressive violaceous skin lesions on the extremities, face, and neck, accompanied by systemic symptoms. Physical examination revealed violaceous macules and nodules, and a skin biopsy confirmed the diagnosis of Kaposi’s sarcoma. No visceral involvement was detected. ART was initiated along with close clinical follow-up. Discussion: KS in HIV-infected patients reflects severe immunosuppression. Diagnosis requires clinical, serological, and histopathological evaluation. Treatment focuses on immune restoration through ART, and systemic chemotherapy may be required in advanced cases. This case highlights the importance of early diagnosis, adherence to treatment, and comprehensive care to improve patient outcomes and quality of life.

Cervicofacial cellulitis and its association with systemic diseases as a mortality factor, report of a clinical case

Francisco Carcelen, Miguel Mavárez Reyes — Sat, 29 Mar 2025 00:00:00 +0000

Odontogenic infections represent a reason for hospital admission in maxillofacial surgery, with a low mortality rate. However, some systemic pathologies increase the risk of infectious process exacerbation turning them into an emergency. This case report tries to show the relationship between cervicofacial infections and systemic diseases. We present a case of a 70-year-old patient admitted to the Hospital Dr. Adolfo Prince Lara Puerto Cabello- Venezuela with a diagnosis of Ludwig's Angina, which was drained in the operating room and transferred to the ICU. The patient was diagnosed in hospital with diabetes mellitus among other systemic diseases, so her evolution was unfavorable and she remained in the ICU and died of complications such as mediastinitis and pulmonary thromboembolism. We have shown the high complexity of the management of odontogenic infections in patients with systemic pathologies due to the faster and more severe progression of the infectious picture than in healthy patients.

Bacteremia as a Complication of Severe Dengue

Fredy Rolando Sotelo Cáceres, María José Gómez Álvarez — Thu, 13 Feb 2025 00:00:00 +0000

Introduction. Bacterial coinfection in patients with dengue is an emerging concern that increases morbidity and mortality. Coinfections with pathogens such as Staphylococcus aureus highlight the importance of a comprehensive approach in diagnosis and treatment. Clinical case. A 35-year-old male patient with high blood pressure comes in due to fever. He has a positive NS1 result and has received outpatient treatment with multiple punctures. There is persistence of fever with elevated infectious parameters, chest pain and dyspnea. Ancillary studies revealed purulent pericarditis and necrotizing pneumonia with isolation of methicillin-resistant S. aureus in both. The diagnosis was dengue fever, purulent pericarditis, necrotizing pneumonia. He received treatment with vancomycin for 48 days and showed clinical improvement. Conclusion. Bacteremia concurrent with dengue includes serious complications, especially due to S. aureus. Although they have high mortality, the case reported had good results.

Galenic development of a Magnolia officinalis-based gel with antimicrobial properties for acne treatment

Thu, 27 Nov 2025 00:00:00 +0000

Introduction. Acne is a highly prevalent multifactorial inflammatory disease whose conventional treatment with antibiotics and retinoids is limited by adverse effects, bacterial resistance, and poor adherence. This drives the search for safer and more effective alternatives, such as natural products. Magnolia officinalis contains honokiol and magnolol, compounds with documented antimicrobial and anti-inflammatory activity. Developing topical formulations like gels can optimize their cutaneous delivery, improve stability, and facilitate application on oily or acne-prone skin. Objective. To develop and characterize a topical gel based on Magnolia officinalis extract with antimicrobial properties for acne treatment.
Materials and Methods. Three gel variants with different excipient ratios were formulated, selecting the optimal one based on physicochemical and organoleptic parameters. Quality controls (pH, viscosity, density, TLC) were performed, and antimicrobial activity was evaluated against Staphylococcus aureus ATCC 25923 using disk and well diffusion methods. Results. The selected formulation showed pH 5.5, viscosity of 159.7 cP, density of 1.039 g/mL, and positive identification of the extract by TLC. Antimicrobial testing recorded average inhibition halos of 9.6 mm (disks) and 10.6 mm (wells) against S. aureus. Conclusion. The gel developed with Magnolia officinalis showed suitable physicochemical properties and good in vitro antibacterial activity against S. aureus, suggesting its potential as a natural, safe, and sustainable topical alternative for acne management.

Evaluation of sunscreen plus α-arbutin in photoexposure-induced melasma in Peruvian workers

Diana Carolina Pinedo Moreno — Thu, 27 Nov 2025 00:00:00 +0000

Introduction. Agricultural workers are highly exposed to UV radiation, increasing the risk of photoaging, cataracts, immunosuppression, carcinoma, and melasma. The latter is chronic, costly, and prone to frequent relapses, aggravated by hormonal factors and skin type. Although sunscreens and depigmenting agents reduce its intensity, they have adverse effects. α-Arbutin shows promising results but with limited evidence. Objective. To determine the effect of sunscreen plus α-arbutin on photo-induced melasma in workers at an agricultural company in Chilca in 2021. Materials and method. The design was quantitative, an open clinical trial, with a sample of 36 workers. Observation and interviews were used as data collection techniques, and the MASI index was used to assess melasma, which was measured at two points in time, on days 1 and 30 of treatment with SPF 50+ sunscreen plus 6% α-arbutin. Results. It was observed that the density of melasma decreased significantly 30 days after application of SPF 50+ sunscreen plus α-arbutin (13,1 vs. 9 median MASI score, p=0.000). 44,4% of workers had moderate MASI on day 1, and this category was reduced to 22,2% on day 30. 69,5% of employees did not experience any adverse events, and when they did, the most frequent was burning. Conclusion. A significant decrease in photo-induced melasma was observed with the combined treatment of SPF 50+ sunscreen plus α-arbutin for 30 days.

Maternal-perinatal complications in patients admitted with hypertensive disorders of pregnancy in a reference hospital in Paraguay

Fri, 31 Oct 2025 00:00:00 +0000

Introduction. Hypertensive disorders of pregnancy constitute one of the leading reasons for serious morbidity, which can cause maternal and perinatal death. Objective. To describe the frequency of maternal-perinatal complications in patients hospitalized with hypertensive disorders of pregnancy in the Department of Gynecology and Obstetrics of the National Hospital of Itauguá, period September 2024 to February 2025. Materials and Method. Observational, descriptive-analytical cross-sectional study of consecutive sampling. Pregnant women with hypertensive disorders admitted to the National Hospital from September 2024 to February 2025 were included. Results. A total of 95 patients were studied with a mean age of 28 ± 7 years and a mean gestational age of 35.6 ± 3.9 weeks; 78.9% were from Central department and 72.6% had secondary education. Comorbidities were present in 29.5% predominantly chronic arterial hypertension (75%). Pregnancy-induced hypertension developed 77.9% of the cases and pre-eclampsia 60.8%. Intensive care admission was required in 8.4% and maternal mortality was 4.2%. Among newborns, 34% had low birth weight, 36.8% were premature and 7.4% had intrauterine growth restriction. Fetal mortality was 7.4%. Conclusion. The high frequency of preeclampsia and low birth weight or premature newborns reflects the impact of these complications on maternal and fetal health. The observed mortality underlines the urgent need to strengthen prenatal care, early detection, and comprehensive management of pregnant women with risk factors.

First level care in action, a medical intern's perspective in Lima-Peru

Fri, 31 Oct 2025 00:00:00 +0000

Introduction. Primary Health Care (PHC) is the most effective strategy for equitably improving the health of populations. However, its implementation faces challenges, especially in Latin American countries such as Peru. The perception of future medical professionals regarding this model is key to strengthening their training and adaptation to the health system. Objective. To evaluate the perception of medical interns regarding the primary health care model in Peru in 2025, identifying perceived strengths and weaknesses in accessibility, efficiency, and quality. Materials and Methods. This was a descriptive, cross-sectional study. The population included human medicine interns. A sample size of 107 participants was calculated fusing the formula for descriptive proportion studies. A survey validated by the Latin American Federation of Scientific Societies of Medical Students was administered. Data were analyzed in Excel and SPSS v. 26 using descriptive statistics. Results. A total of 107 medical interns were surveyed, primarily rotating through MINSA facilities. Fifty-seven percent had a positive perception of primary care, compared to 43% with a negative perception, with slight variations depending on the Peruvian Integrated Health Networks Directorate or the type of facility. Conclusion. This study demonstrates the urgent need to strengthen medical training with a more primary care-oriented approach. It is recommended to include early care practices in primary care, strengthen training in family medicine, and highlight its strategic role.

Clinical and epidemiological characteristics of pediatric patients with acute bronchiolitis hospitalized in a referral hospital

Fri, 31 Oct 2025 00:00:00 +0000

Introduction. Acute bronchiolitis is the leading cause of hospitalization in infants and represents a major burden for the public health system in Paraguay. Objective: To determine the clinical, sociodemographic, and outcome characteristics of pediatric patients hospitalized for bronchiolitis in the Emergency Department of the Hospital Nacional de Itauguá during 2023–2024. Materials and Methods. A retrospective observational study was conducted including 151 patients aged 0–24 months admitted with acute bronchiolitis. Demographic, clinical, and outcome variables were analyzed using descriptive statistics. Results. Median age was 3 months (IQR: 2–6), with a male predominance (59.6%). Prematurity was recorded in 15.9% of patients. Hospital admissions peaked in winter (62.9%). Respiratory Syncytial Virus (RSV) was the most frequently detected pathogen (31.1%), while no etiologic agent was identified in 49% of cases. According to the TAL scale, 62.3% had moderate severity, and 88.1% required oxygen therapy. Median hospital stay was 3 days (IQR: 2–4). Conclusion. Bronchiolitis predominantly affects male infants, especially those born prematurely, and follows a clear winter seasonal pattern. The high proportion of cases without etiologic diagnosis underscores the need to strengthen viral detection capacity, epidemiological surveillance, and clinical management strategies.

Construction of an observation record associated with the prevention of tuberculosis behaviors in peruvian adolescents, 2025

Tue, 30 Sep 2025 00:00:00 +0000

Introduction. Tuberculosis (TB), caused by Mycobacterium tuberculosis, remains one of the most prevalent diseases worldwide and spreads rapidly in contexts of precarious health systems, which led to the creation of Goal 3.3 of the Sustainable Development Goals to reduce its incidence by 90% by 2030. In this regard, any intervention method requires the measurement of associated behaviors at both the preventive and promotional levels. Objective. To develop a structured observation record associated with the prevention of tuberculosis behaviors in a sample of school-aged adolescents. Materials and Method. The study was instrumental in design with a sample of 11 expert judges and 30 high school students. Results. The findings showed the presence of four distinct dimensions: “Use of a mask (KN-95) in enclosed spaces,” “Social distancing, separation from other people by at least one and a half meters or the length of both arms of the participant,” “Hand washing,” and “Covering the mouth when sneezing/coughing in enclosed spaces.” explaining up to 90% of the variance attributed to the items on the scale, which had high levels of discrimination, high levels of difficulty (b>.970), and an acceptable level of reliability (KR-20=.720). Conclusion. The instrument has optimal evidence of validity based on the content of the items, internal structure, and reliability due to internal consistency.

Method to evaluate the in vitro efficacy of formulations against Herpes simplex type I

Sun, 31 Aug 2025 00:00:00 +0000

Introduction. Herpes Simplex Virus type I (HSV-1) has a high prevalence, incidence, and morbidity worldwide. The usual treatment employs nucleoside analogues; however, its prolonged use has led to viral resistance, prompting the search for new therapeutic alternatives. In this context, in vitro preclinical assays in the formulation processes offer advantages such as variable control, standardization, and simplicity compared to in vivo studies, although there is limited evidence regarding their use in the evaluation of topical antiviral formulations. Objective. To evaluate a method for determining the in vitro safety and efficacy of formulations against HSV-1. Materials and Methods. Creams, gels, and ointments were formulated with 5% acyclovir as the reference active ingredient. Cytotoxicity was assessed using Resazurin, and antiviral activity was evaluated by quantifying the viral genome through qPCR. Results. The ointment showed a CC₅₀ of 495 µg/mL, IC₅₀ of 3.6 µg/mL, and an SI of 137.5. The gel showed a CC₅₀of 582.4 µg/mL, an inhibitory concentration 50 ˂1.2 µg/mL, and a selectivity index SI ˃465. Conclusion. The in vitro system based on cytotoxicity and viral quantification by qPCR was effective for evaluating topical formulations. The values obtained were within expected ranges, highlighting the method’s potential as a preliminary tool to optimize and simplify the design of subsequent in vivo studies.

Psychosocial work factors and job performance of medical internship tutors at a University in Lima

Thu, 31 Jul 2025 00:00:00 +0000

Introduction. Occupational well-being is crucial for medical internship tutors, since psychosocial factors such as workload, organizational support, and stress impact their performance and medical teaching. Objective. This study aimed to identify the association between psychosocial work factors and job performance in medical internship tutors at a university in Lima in 2024. Materials and Methods. An observational, cross-sectional, and analytical study was conducted with 96 medical internship tutors in Human Medicine surveyed using validated questionnaires by Reynoso et al. and Ocharán-Guardia. Sociodemographic variables, psychosocial work factors, and job performance were analyzed. Results. Of the 96 tutors, 64% were men, 70.8% were married, and 79% had at least one child. In the statistical analysis, psychosocial work factors were found to have a positive association with job performance (p = 0.001, RPA = 1.344, 95% CI: 1.231-2.051), a negative association with interpersonal relationships (p = 0.036; RPA = 0.782; 95% CI: 0.586 - 0.944) and practical skills (p = 0.012; RPC = 1.178; 95% CI: 1.060 to 1.310). However, no statistically significant association was found with job satisfaction (p > 0.05). Conclusion. This study showed a statistically significant positive association between psychosocial work factors and job performance in general terms.

Body-Focused Repetitive Behaviors and Their Association with Symptoms of Depression, Anxiety, and Stress in Paraguayan Medical Students: A Cross-Sectional Study

Thu, 31 Jul 2025 00:00:00 +0000

Introduction. Body-focused repetitive behaviors (BFRBs), such as trichotillomania and excoriation disorder, significantly impact quality of life, psychological well-being, and academic performance. However, research on their association with mental health symptoms in Paraguayan medical students is limited. Objective. To describe the prevalence of BFRBs in medical students and their association with symptoms of depression, anxiety, and stress. Materials and Methods. This was an observational study involving 158 medical students in Paraguay, selected through non-probabilistic convenience sampling. Validated Spanish-language instruments were used, including the Skin Picking Scale-Revised, the Massachusetts General Hospital Hair Pulling Scale, and the Depression Anxiety Stress Scale-21. Associations between variables were assessed using the chi-square test (significance level of 5%). Results. The prevalence of excoriation disorder was 22.8%, and that of trichotillomania was 7%. Depression was present in 63.3% of students, anxiety in 62.7%, and stress in 56.3%. Depression increased the odds of excoriation disorder ninefold (OR = 9.03; p < 0.001), while anxiety (OR = 4.9; p < 0.001) and stress (OR = 5.34; p < 0.001) also showed significant associations. Trichotillomania was not associated with these symptoms. Conclusion. The high prevalence of BFRBs and their association with mental health symptoms highlight the need for targeted interventions in medical students to improve their psychological well-being and academic performance.

Traditional midwifery in the Andes of Peru: lived experiences

José Pepe Díaz Quispe, José Ander Asenjo Alarcón — Mon, 16 Jun 2025 00:00:00 +0000

Introduction. Traditional midwifery has made an important contribution to maternal care since ancient times, with favorable results for the mother and the newborn in most cases. Objective. To understand the experiences lived by traditional midwives in the Andes of northern Peru, to promote their inclusion in the maternal health care team and their safe, responsible and adequate participation. Materials and methods. This qualitative, exploratory study, with a phenomenological-empirical design, was conducted with six traditional midwives from the community of Pampa La Laguna, Chota province. They were recruited using chain sampling and provided open-ended responses to a previously validated interview guide. The inductive coding process allowed for the organization of the results into categories and subcategories. Results. The midwives have been doing this work for 17 to 58 years, they learned from their predecessors or from their own experiences. The favorable experiences with their subcategories were obtained as categories: first experiences in midwifery, techniques used in labor, use of plants in midwifery, feeling of well-being after childbirth and the category fortuitous events in labor. Conclusion. The midwives showed great security and confidence with the work they do, they attend to all the labors that occur through ancestral techniques and traditional medicine based on plants, they are fully satisfied when the results are favorable, by chance they arise incidents, which are valued according to their seriousness, to be resolved by them or seek professional help.

Knowledge of Basic life support in paraguayan medical students

Guillermo Insfran Mendez — Mon, 16 Jun 2025 00:00:00 +0000

Introduction. Basic life support (BLS) is critical for cardiorespiratory arrests, but previous studies in Paraguay (2017) reported only 12.7% of sufficient knowledge among medical students. Objective. To assess current BLS knowledge and associated factors in Paraguayan medical students. Materials and Methods. Cross-sectional study of 167 students from 10 universities using a validated American Heart Association questionnaire (10 items). Sufficient knowledge was defined as ≥70% correct answers. Statistical analysis with χ² (Epi Info v7.2.3.1). Results. 75.4% (n=126) demonstrated sufficient knowledge. Weaknesses were identified in: recognizing national emergency number (44.9% correct) and time between defibrillations without pulse (28.1%). Knowledge was significantly higher among interns (p=0.03), second-year students (p=0.003), and those trained during clinical vs. preclinical cycles (87.3% vs 12.7%; p<0.001). Conclusion. Substantial improvement exists compared to prior studies, but gaps persist in critical BLS components. Theoretical-practical training during clinical stages is associated with better performance, highlighting the need for continuous practical reinforcement.

Resolving capacity and quality of care in patients in a Peruvian hospital

Jonathan Gustavo Achachao Almerco — Mon, 16 Jun 2025 00:00:00 +0000

Introduction. The resolutive capacity of health facilities has become key to improve the quality of care, especially after the health crisis given that poor user confidence, operational efficiency and adherence to treatments have been identified. Objective. to analyze the relationship between resolution capacity and the quality of care of users of the San Martín de Pangoa Hospital in Junín, Peru. Materials and Methods. A relational methodology based on partial least squares structural equation modeling (PLS-SEM) was used to estimate the data in a sample of 251 users of the Hospital San Martín de Pangoa de Junín, Peru, to whom the EMFUCARE Multidimensional Scale was applied to measure resolution capacity and the SERVQUAL questionnaire to measure perceived quality of care. Results. The results indicated that there is a statistically significant correlation between the dimensions of resolution capacity and quality of care with Rho coefficients between 0.354 and 0.890 with a positive direction, it had optimal discriminant validity indices since they differentiated the dimensions of one variable from the dimensions of the other variables, and it was found that resolution capacity was a significant predictor of perceived quality of care (β=0.517; p<0.05). Conclusion. Thus, it was concluded that high levels of resolution capacity were positioned as a predictor of high levels of perceived quality of care in users of the Hospital San Martín de Pangoa de Junín, Peru.

Adjustment of reference Equations to Carbon Monoxide Diffusion Tests (DLCO) in reports from a laboratory in Asunción city

Thu, 22 May 2025 00:00:00 +0000

Introduction. The diffusion test for carbon monoxide (DLCO) constitutes an important adjunct in the arsenal of resources for pulmonary function studies. Objective. To compare the performance of DLCO predicted values proposed by four equations. Material and Methods. Qualitatively acceptable reports of DLCO tests from a pulmonary function laboratory in Asuncion, Paraguay were analyzed by means of an observational study. The adequacy to the predictions proposed by Miller, Knudson, Paoletti and the Global Lung Initiative (GLI) was studied. Results. In both sexes, the GLI reference parameters were better adjusted to the values measured in this sample. Conclusion. It is relevant to have a single language for the expected values when measuring pulmonary function variables in order to homogenize key aspects of the diagnosis and management of certain respiratory diseases.

Disparities in access to maternal and child health services among indigenous communities in Paraguay

Carlos Miguel Rios-Gonzalez — Thu, 22 May 2025 00:00:00 +0000

Introduction. Access to maternal and child health services is crucial to reduce maternal and child mortality, especially in vulnerable populations such as indigenous communities. In Paraguay, these communities face geographical, cultural and socioeconomic barriers that perpetuate health inequalities. This study analyzes the disparities in access to maternal and child health services among indigenous communities, considering geographical, linguistic and resource availability factors. Objective. To analyze the disparities in access to and utilization of maternal and child health services among indigenous communities in Paraguay. Materials y Methods. An observational, descriptive and cross-sectional study was conducted based on data from the IV National Population and Housing Census for Indigenous Peoples (2022). A total of 789 indigenous communities were included, stratified by region and language family. Variables such as access to prenatal care, type of health personnel and provision of medicines were analyzed. Descriptive analyzes were applied. Results. 77.06% of the communities receive services from a Family Health Unit (USF), but their effective use varies significantly. The communities in the Western region have greater coverage of indigenous promoters (51.57%) than those in the Eastern region (30.57%). Home deliveries are predominant (42.57%) and care by indigenous midwives is still common (48.92%). The provision of medicines reaches only 60.20% of the communities. Conclusion. This study highlights the urgency of implementing policies adapted to the cultural and contextual needs of indigenous communities, improving the coverage, quality and relevance of services.

Psychometric characteristics of the exam anxiety inventory in paraguayan students

Nilda Celeste Cano Acosta — Thu, 22 May 2025 00:00:00 +0000

Introduction. Instrumental adaptation is essential to ensure that items are understandable, relevant, and culturally appropriate in the context in which they are applied. Objective. To linguistically and culturally adapt the Spanish version of the Test Anxiety Inventory (TAI) and the Rosenberg Self-Esteem Scale (RSES) into a virtual format. Additionally, to examine their psychometric properties through reliability analysis, and exploratory and confirmatory factor analysis.
Materials and Methods. A non-experimental survey design was used with a sample of 359 students aged 17 to 44 from the National University of Asunción, enrolled in the Psychology, Communication Sciences, Literature, and History programs. Of the participants, 66,4% were female; the mean age ± standard deviation was 22 ± 5,26 years. The linguistic comprehension test was conducted with 18 students from the UNA Medicine program, and a preliminary evaluation was performed by an expert committee consisting of two local professors in Spanish language and literature, who verified semantic, idiomatic, and conceptual equivalence to Paraguayan Spanish. Results. The TAI obtained a Cronbach’s alpha of 0,895 and showed a multidimensional structure with four factors. The Self-Esteem Scale obtained a Cronbach’s alpha of 0,884 and a two-factor structure. The sample showed a high level of test anxiety, while the self-esteem level was moderate. According to Pearson’s coefficient, the correlation between the two variables was extremely weak. Conclusion. Both instruments demonstrated sufficient empirical evidence; their use is recommended in Paraguayan university populations.

Evaluation of Dengue Surveillance in the Guairá Department, Paraguay in 2024

Sat, 29 Mar 2025 00:00:00 +0000

Introduction. Dengue is a highly prevalent and costly disease in Paraguay. Objective. To evaluate the dengue surveillance system in the department of Guairá in 2024. Materials and methods. Descriptive study evaluating dengue surveillance according to CDC guidelines. The structure and surveillance data were analyzed for the period 2019–2023, and a questionnaire was applied to the personnel involved in surveillance. Results. Between 2020-2023, 7,459 suspected cases were reported in the department of Guairá, with the highest number of reports in 2020 and 2023. According to the perception of 86.5% of respondents, the quality of the surveillance system was good, its usefulness was good for the diagnosis and recognition of epidemics for 72.6%, but decreased for vector control actions. Simplicity was considered good for the form and reporting flowchart, according to 68.5% of the respondents, and average for the dependence of reporting on the availability of diagnostic methods, according to 31.5% of the respondents; flexibility and acceptability were rated as good by 86.3% and 91.8%, respectively. Representativeness was rated as good in general by 78.1%, although 19.2% rated it as average for outpatient cases, subpopulations, or territories. Conclusion: To improve the dengue surveillance system in Guairá, staff should focus on the clinical and universal detection of suspected cases, regardless of severity or availability of diagnostic methods.

¡Viral Challenge! How much do health students really know about the novel disease Monkeypox? A Study in a Developing Country, Lima-Perú

Sat, 29 Mar 2025 00:00:00 +0000

Introduction. Monkeypox (Mpox), caused by the MPV virus, is a zoonotic disease endemic in Africa, with a first case in humans in 1970. Since 2022, cases have been reported in non-endemic countries, leading to the declaration of a public health emergency. Objective. To assess the level of knowledge about Monkeypox in students of the Human Medicine program at Ricardo Palma University, focusing on the pathogenic cause, epidemiological measures, clinical manifestations, management and prevention of the disease. Material and Methods. The research was based on an observational descriptive and cross-sectional study, in which knowledge about monkeypox was analyzed. For this purpose, a 15-question questionnaire validated by the Clinical Epidemiology and Evidence-Based Medicine Research Center of the Faculty of Human Medicine of the San Martín Porres University (Lima-Perú) was used. Results. A total of 151 health students were surveyed, showing that 92.7% knew about the forms of contagion, but only 49.7% understood the incubation time. Although age did not significantly influence, younger students (20 - 23 years) showed similar levels of knowledge to the other age groups. Conclusion. The study showed that students have adequate knowledge about monkeypox, especially in basic aspects. However, there are common deficiencies in knowledge of emerging diseases.

Correlation between sleep quality, stress and academic performance in medical students

Sat, 29 Mar 2025 00:00:00 +0000

Introduction. Sleep quality and stress in the medical career are factors that alter students' quality of learning and academic performance. In a career as competitive as medicine, it is normal to see high stress regarding grades and sleep deprivation is often a common practice in studies. This work describes the relationship between sleep quality and academic stress of students at a medical school in the city of Pedro Juan Caballero, in the department of Amambay, Paraguay, in the first semester of 2024. Materials and Methods. Observational, prospective, cross-sectional correlational study. Sleep quality was evaluated using the Pittsburg scale, and the stress level was measured using the academic sphere of the adolescent stress scale. These data were correlated with academic performance using the Spearman coefficient. Results. It was seen that 77.8% of the subjects suffered from poor sleep quality, the most frequent stress score was 17 and the median was 21 points. The correlation between sleep quality and academic performance was r= -0.168 (p<0.001) and the correlation between stress score and academic performance was r= -179 (p<0.001). Conclusion. Sleep quality and academic stress level are negatively correlated with the academic performance of a medical student.

Parents' level of knowledge about parasitosis in boys and girls

Thu, 13 Feb 2025 00:00:00 +0000

Introduction. Intestinal parasitosis constitutes the involvement of the digestive tract by protozoa and helminths. These parasites represent a serious public health problem since they affect developing countries like ours. Objective. Determine the level of knowledge of parents about parasitosis in children who attend the National Hospital of Itaugua in 2024. Material and methods. A cross-sectional descriptive observational study was carried out on 120 parents who attend the National Hospital of Itaugua. A survey was applied to identify sociodemographic data and the level of knowledge of parents about general aspects of parasitosis. Results. 120 parents participated in the study. 70.83% belonged to the female sex. Regarding knowledge about parasitosis, 68.33% correctly identified that worms are the causal agent, while 30% correctly mentioned protozoa. 64.17% recognized diseases such as Giardiasis, taeniasis and Oxuriasis as parasitic. In addition, 70% indicated that diarrhea is a symptom of parasitosis, and 66.66% stated that it can cause malnutrition. Regarding prevention and knowledge about parasites, the levels were greater than 60%. Lastly, 34.17% had heard about the “Jaityke Sevo’i” National Campaign, mainly through the Hospital (39%). Conclusion. Knowledge about childhood intestinal parasitosis is limited in some general aspects, but is remarkably high in terms of the consequences of the disease and preventive measures.

Clinico-epidemiological characteristics and sequelae in patients with Chikungunya at the National Hospital of Itauguá

Karen Elisabeth Harder Penner, Manuela Mouro Castelar, Laura Silvana Aria Zaya — Thu, 13 Feb 2025 00:00:00 +0000

Introduction. Chikungunya virus (CHIKV) belongs to the Alphavirus genus and is transmitted by Aedes aegypti or A. albopictus mosquitoes. The main symptoms of this viral disease are high fever, myalgia, arthralgia, headache, and rash.

General. The objective of this research protocol is to determine the clinical, epidemiological characteristics and sequelae of patients with Chikungunya attended at the Itauguá National Hospital in 2023. Materials and methods. The design of this research is observational, descriptive and cross-sectional. The study subjects were patients who suffered from the disease in 2023. The variables were sociodemographic, clinical characteristics. The alarm symptoms and sequelae of this viral disease were also studied through digital surveys sent by link via WhatsApp in Google Forms. Protocol approved by the Ethics Committee, respecting the ethical principles of research. Results. The most frequent symptom among the 130 participants was joint pain with 96.15% and in second place fever with 90.77%. The majority of participants, 67.69% did not show alarm symptoms. The predominant alarm symptom was abdominal pain. Joint and/or body pain was the most frequent sequela, present in 70% of cases, followed by difficulty moving the joints in 45.38%. Conclusion. With this we can conclude that the most prevalent symptom was joint pain. Although most patients did not present any alarm symptoms, among those who did present abdominal pain was predominant.

Enteric helminthiasis in schoolchildren from an Andean-populated center in Peru

Teófilo Torrel, Verónica Narro, Juan Rojas-Moncada, Luis Vargas-Rocha — Thu, 13 Feb 2025 00:00:00 +0000

Introduction. Cajamarca is a region in Peru that faces significant challenges regarding the quality of life and hygiene practices for much of its population. The lack of robust educational programs in health and food safety is evident in rural areas of the region. Objective. To determine the prevalence of intestinal parasites by observing eggs in the feces of schoolchildren from a populated center in the Cajamarca Valley. Materials and Methods. Fecal samples were collected from 117 children from an educational institution and processed using the zinc sulfate saturated solution flotation concentration method. Results. Helminth eggs were observed in the feces of 73 schoolchildren (62.39% [95% CI: 53.62 – 71.17]). The gender of the schoolchildren was associated with the presence of positive parasite cases (p<0.05), with a higher prevalence in girls. Older schoolchildren were more affected, but this did not show a statistical association (p>0.05). Most infected schoolchildren had Ascaris lumbricoides (54.70%), followed by Taenia spp (3.42%). Additionally, three cases of co-infection with A. lumbricoides and Taenia spp (2.56%) were observed, along with one case of A. lumbricoides with Trichuris spp and Trichuris spp with Taenia spp (0.85%). Conclusion. The prevalence of enteric parasites in the schoolchildren from the evaluated populated center was high, highlighting the need to improve hygiene practices and health education programs, especially those focused on children.

Influence of abdominal circumference on blood pressure in the peruvian population, 2022

Alberto Guevara Tirado — Thu, 13 Feb 2025 00:00:00 +0000

Introduction. An increased abdominal circumference may enhance the vascularization of newly formed adipose tissue, leading to higher cardiac output and blood pressure. However, the impact and degree of association of these factors in the Peruvian population remain unknown. Objective. To evaluate the association between abdominal circumference and high blood pressure in Peruvian adults. Materials and Methods. Observational, analytical, retrospective, and cross-sectional study. Data from 27,356 adults in the National Demographic and Family Health Survey were analyzed. The dependent variable was mean blood pressure. Explanatory variables included age, educational level, mother tongue, ethnic group, body mass index (BMI), and abdominal circumference. Chi-square test, Cramér's V, Spearman's correlation, and Poisson regression were used to calculate adjusted prevalence ratios. Results. Adults with an increased abdominal circumference had higher blood pressure levels, especially men. The association between abdominal circumference and mean blood pressure was significant and weak in women (V=0.176) and moderate in men (V=0.331). The correlation was weak in women (Rho=0.393) and moderate in men (Rho=0.436). In the multivariate analysis, women with an increased abdominal circumference had a 1.43 times higher risk of high blood pressure, with BMI being the main predictor. In men, the risk was 2.31 times higher, with abdominal circumference as the primary predictor. Conclusion. Increased abdominal circumference is associated with higher blood pressure in Peruvian adults, being a key predictor in men and a secondary factor in women.

Impact of COVID-19 on the surgery department of a hospital in Paraguay

Lilian Acosta Sánchez, Rosarito Coronel Teixeira — Thu, 27 Nov 2025 00:00:00 +0000

En diciembre de 2019, el brote global de Sars-cov-2 (COVID-19) impactó drásticamente innumerables aspectos de la vida diaria en todo el mundo, incluyendo la educación, la economía y el bienestar emocional. Esta pandemia cambió la profesión médica, especialmente en el campo de la cirugía torácica. Según varios informes médicos, los procedimientos quirúrgicos electivos se retrasaron o reprogramaron; las cirugías de trasplante de órganos fueron las más afectadas. Se han establecido numerosos protocolos y recomendaciones para las cirugías de emergencia. Hoy en día, el sistema de salud está priorizando la formación del personal de salud y asegurando que los hospitales estén debidamente equipados para responder de manera efectiva en caso de futuras pandemias^(1–3).

El propósito de esta carta es compartir las experiencias y ajustes realizados en el servicio de cirugía del Instituto Nacional de Enfermedades Respiratorias y del Ambiente (INERAM) en Asunción, Paraguay, durante la COVID-19 y en la actualidad.

Trends in radiology research in Latin America: A brief bibliometric analysis

Fri, 31 Oct 2025 00:00:00 +0000

La integración de la radiología en diversas disciplinas ha fortalecido su alcance diagnóstico, terapéutico y pronóstico. La versatilidad de esta especialidad ha permitido alcanzar diversos avances a lo largo del tiempo. Por ejemplo, en cardiología, la tomografía computarizada coronaria (TC) y la resonancia magnética cardíaca (RMC) permiten una evaluación precisa de las enfermedades coronarias. En oncología, la tomografía por emisión de positrones (PET-TC) es crucial para la estadificación y el monitoreo de neoplasias. En neurología, la resonancia magnética cerebral y la TC detectan accidentes cerebrovasculares y tumores. Por lo tanto, es necesario comprender el impacto científico actual de la radiología para generar nuevas preguntas de investigación, así como para identificar brechas de conocimiento y profundizar en la creación de nuevos conocimientos en áreas con menor producción científica^(1–3).