Septic shock upon admission to pediatric intensive care units: prognostic analysis of mortality in a retrospective cohort.

Background: Septic shock is a common cause of admission to pediatric intensive care units (PICU) and is associated with significant mortality. Our objective was to analyze the association between septic shock diagnosis at PICU admission and mortality during hospitalization.

Method: This retrospective cohort study was conducted in the PICU of Hospital Nacional Edgardo Rebagliati Martins (HNERM) in Lima, Peru, from January 2018 to December 2021.

Evaluation of three fixation methods in tibiotalocalcaneal fusion for chronic osteomyelitis following ankle fracture.

Introduction: In the scenario of chronic osteomyelitis following an ankle fracture, limb salvage and ideally infection eradication, can be an alternative to amputation.Tibiotalocalcaneal arthrodesis is perhaps the most popular procedure. When performing fusion in osteomyelitis patients, external fixation is more commonly used, although there is some experience with internal fixation.

[Conceptual framework and historical perspective of intermediate care].

The aging of the population is raising the need to make structural changes in the National Health System. First, the need to increase geriatric services in all hospitals. Second, implement and integrate intermediate care (IC), and Third and last, guarantee medical care in long-term care.

Cardiovascular death in patients with acute heart failure in sinus rhythm: results from the RICA registry.

Introduction: Patients with heart failure in sinus rhythm may be at significant risk of major cardiovascular events, including cardiovascular death (CV death).

Objective: To assess CV mortality at a one-year follow up of those patients with heart failure and sinus rhythm, according to LVEF subgroups.

Methods: A prospective and multicentric study was conducted with patients in sinus rhythm included in the National Registry of Heart Failure.

Macrophage Activation Syndrome in MIS-C.

Background: Multisystem inflammatory syndrome (MIS-C) represents a diagnostic challenge because of its overlap with Kawasaki disease, Kawasaki disease shock syndrome, and toxic shock syndrome. Macrophage activation syndrome (MAS) is a frequently fatal complication of various pediatric inflammatory disorders and has been reported in MIS-C. Early diagnosis and prompt initiation by immune modulating therapies are essential for effectively managing MAS.

Effect of early administration of dexamethasone in patients with COVID-19 pneumonia without acute hypoxemic respiratory failure and risk of development of acute respiratory distress syndrome: EARLY-DEX COVID-19 trial.

Introduction And Objectives: Corticosteroids are among the drugs demonstrating a mortality benefit for coronavirus disease 2019 (COVID-19). The RECOVERY trial highlighted that dexamethasone reduced 28-day mortality for hospitalized COVID-19 patients requiring either supplemental oxygen or mechanical ventilation. It is noted that approximately 30% of COVID-19 patients, initially presenting with mild symptoms, will advance to acute respiratory distress syndrome (ARDS), especially those with detectable laboratory markers of inflammation indicative of disease progression.

[Psychiatric rehospitalizations: Clinical, social and demographic determinants in a hospital of the City of Buenos Aires].

Objective: This study aims to determine variables associated with multiple rehospitalizations in a women's hospitalization Unit in a Psychiatric Emergency Hospital in the City of Buenos Aires, Argentina.

Method: In this an analytical, cross-sectional study 350 patients between 18 and 65 years of age, hospitalized from 2013 to December 2017 in the women's hospitalization room of the Psychiatric Emergency Hospital “Torcuato de Alvear” were included. At the time of discharge, sociodemographic, clinical and discharge conditions data were collected from all patients.

From liver to hormones: The endocrine consequences of cirrhosis.

Hepatocrinology explores the intricate relationship between liver function and the endocrine system. Chronic liver diseases such as liver cirrhosis can cause endocrine disorders due to toxin accumulation and protein synthesis disruption. Despite its importance, assessing endocrine issues in cirrhotic patients is frequently neglected.

Importance about use of high-throughput sequencing in pediatric: case report of a patient with Fanconi-Bickel syndrome.

Background: Fanconi-Bickel syndrome is characterized by hepatorenal disease caused by anomalous glycogen storage. It occurs due to variants in the SLC2A2 gene. We present a male patient of 2 years 7 months old, with failure to thrive, hepatomegaly, metabolic acidosis, hypophosphatemia, hypokalemia, hyperlactatemia.

Examining the impact of a 9-component bundle and the INICC multidimensional approach on catheter-associated urinary tract infection rates in 32 countries across Asia, Eastern Europe, Latin America, and the Middle East.

Background: Catheter-Associated Urinary Tract Infections (CAUTIs) frequently occur in the intensive care unit (ICU) and are correlated with a significant burden.

Methods: We implemented a strategy involving a 9-element bundle, education, surveillance of CAUTI rates and clinical outcomes, monitoring compliance with bundle components, feedback of CAUTI rates and performance feedback. This was executed in 299 ICUs across 32 low- and middle-income countries.

International Nosocomial Infection Control Consortium (INICC) report of health care associated infections, data summary of 45 countries for 2015 to 2020, adult and pediatric units, device-associated module.

Background: Reporting on the International Nosocomial Infection Control Consortium study results from 2015 to 2020, conducted in 630 intensive care units across 123 cities in 45 countries spanning Africa, Asia, Eastern Europe, Latin America, and the Middle East.

Methods: Prospective intensive care unit patient data collected via International Nosocomial Infection Control Consortium Surveillance Online System. Centers for Disease Control and Prevention/National Health Care Safety Network definitions applied for device-associated health care-associated infections (DA-HAI).

Incidence and risk factors for catheter-associated urinary tract infection in 623 intensive care units throughout 37 Asian, African, Eastern European, Latin American, and Middle Eastern nations: A multinational prospective research of INICC.

Objective: To identify urinary catheter (UC)-associated urinary tract infection (CAUTI) incidence and risk factors.

Design: A prospective cohort study.

Setting: The study was conducted across 623 ICUs of 224 hospitals in 114 cities in 37 African, Asian, Eastern European, Latin American, and Middle Eastern countries.

Decreasing central line-associated bloodstream infections rates in intensive care units in 30 low- and middle-income countries: An INICC approach.

Background: Central line (CL)-associated bloodstream infections (CLABSIs) occurring in the intensive care unit (ICU) are common and associated with a high burden.

Methods: We implemented a multidimensional approach, incorporating an 11-element bundle, education, surveillance of CLABSI rates and clinical outcomes, monitoring compliance with bundle components, feedback of CLABSI rates and clinical outcomes, and performance feedback in 316 ICUs across 30 low- and middle-income countries. Our dependent variables were CLABSI per 1,000-CL-days and in-ICU all-cause mortality rates.

Assessing the impact of a multidimensional approach and an 8-component bundle in reducing incidences of ventilator-associated pneumonia across 35 countries in Latin America, Asia, the Middle East, and Eastern Europe.

Background: Ventilator associated pneumonia (VAP) occurring in the intensive care unit (ICU) are common, costly, and potentially lethal.

Methods: We implemented a multidimensional approach and an 8-component bundle in 374 ICUs across 35 low and middle-income countries (LMICs) from Latin-America, Asia, Eastern-Europe, and the Middle-East, to reduce VAP rates in ICUs. The VAP rate per 1000 mechanical ventilator (MV)-days was measured at baseline and during intervention at the 2nd month, 3rd month, 4-15 month, 16-27 month, and 28-39 month periods.

External validation of the CHEDDAR score for suspected pulmonary embolism in patients with SARS-CoV-2 infection in an independent cohort.

The accuracy of the classic scores that help stratify the pretest clinical probability of pulmonary embolism (PE) in SARS-CoV-2 infection (COVID-19) is low. Therefore, to estimate the risk of PE in these patients, a new set of guidelines must be established. The recently published CHEDDAR score proposes a new diagnostic strategy to reduce the use of computed tomography pulmonary angiography (CTPA) in non-critically ill SARS-COV-2 patients with suspected PE.

Streptococcus pneumoniae serotype 19A in hospitalized children with invasive pneumococcal disease after the introduction of conjugated vaccines in Lima, Peru.

Background: The Pneumococcal conjugate vaccine (PCV) has decreased cases of invasive pneumococcal disease (IPD) worldwide. However, the impact of PCVs introduction may be affected by the serotype distribution in a specific context.

Methods: Cross-sectional multicenter passive surveillance study of IPD cases in pediatric patients hospitalized in Lima, Peru between 2016 and 2019 (after PCV13 introduction) to determine the serotype distribution and antimicrobial resistance of Streptococcus pneumoniae.

Development of a Randomized Trial Comparing ICP-Monitor-Based Management of Severe Pediatric Traumatic Brain Injury to Management Based on Imaging and Clinical Examination Without ICP Monitoring-Research Algorithms.

Background And Objectives: The efficacy of our current approach to incorporating intracranial pressure (ICP) data into pediatric severe traumatic brain injury (sTBI) management is incompletely understood, lacking data from multicenter, prospective, randomized studies. The National Institutes of Health-supported Benchmark Evidence from Latin America-Treatment of Raised Intracranial Pressure-Pediatrics trial will compare outcomes from pediatric sTBI of a management protocol based on ICP monitoring vs 1 based on imaging and clinical examination without monitoring. Because no applicable comprehensive management algorithms for either cohort are available, it was necessary to develop them.

Results of phase 2 randomized multi-center study to evaluate the safety and efficacy of infusion of memory T cells as adoptive therapy in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia and/or lymphopenia (RELEASE NCT04578210).

Background Aims: There are currently no effective anti-viral treatments for coronavirus disease 2019 (COVID-19)-hospitalized patients with hypoxemia. Lymphopenia is a biomarker of disease severity usually present in patients who are hospitalized. Approaches to increasing lymphocytes exerting an anti-viral effect must be considered to treat these patients.

Efficacy of cognitive behavioural therapy for bipolar disorder: A systematic review.

Introduction: Bipolar disorder (BD) is a serious mental illness with a chronic course and significant morbidity and mortality. BD has a lifetime prevalence rate of 1%-1.5% and is characterised by recurrent episodes of mania and depression, or a mixture of both phases.

Prospective cohort study of incidence and risk factors for catheter-associated urinary tract infections in 145 intensive care units of 9 Latin American countries: INICC findings.

Purpose: Identify urinary catheter (UC)-associated urinary tract infections (CAUTI) incidence and risk factors (RF) in Latin American Countries.

Methods: From 01/01/2014 to 02/10/2022, we conducted a prospective cohort study in 145 ICUs of 67 hospitals in 35 cities in nine Latin American countries: Argentina, Brazil, Colombia, Costa Rica, Dominican Republic, Ecuador, Mexico, Panama, and Peru. To estimate CAUTI incidence, we used the number of UC-days as the denominator, and the number of CAUTIs as numerator.

[Simultaneous use of contraceptives and hormone replacement therapy in women receiving psychoactive drugs. From theory to integral health practice].

Sexuality in people with mental disorders is a topic usually tinged with prejudice and stigma. Women with severe mental disorders are more exposed to suffer sexually transmitted diseases, becoming victims of gender violence and being involved with unintended pregnancies. In adults and adolescents, sexual intercourse under the influence of alcohol or other drugs, or during worsening or exacerbation of baseline symptoms or condition, are often unplanned, unprotected, with casual partners from high risk groups, without contraceptive methods and with less capacity to agree or deny safe sexual practices.

[Are there verbal hallucinations in autism? Review from a historical and transparadigmatic perspective].

The differential diagnosis between autism and schizophrenia in childhood has been the subject of numerous controversies. Because verbal hallucinations could be one of the main clinical phenomena when establishing a differential diagnosis, the objective was to investigate the presence or absence of verbal hallucinations in autism. For this, a selective and unsystematic review of the current scientific evidence was carried out.

Development of a Randomized Trial Comparing ICP-Monitor-Based Management of Severe Pediatric Traumatic Brain Injury to Management Based on Imaging and Clinical Examination Without ICP Monitoring-Study Protocol.

Background And Objectives: Traumatic brain injury (TBI) is a major global public health problem. It is a leading cause of death and disability in children and adolescents worldwide. Although increased intracranial pressure (ICP) is common and associated with death and poor outcome after pediatric TBI, the efficacy of current ICP-based management remains controversial.