Medicina Clínica y Social (https://www.medicinaclinicaysocial.org) is the first peer-reviewed scientific journal in the field of Medicine and Health Sciences published, as a contribution of the Social Anthropology Department, in the Santa Rosa del Aguaray Campus of the School of Medical Sciences of the National University of Asunción, Paraguay. Its primary purpose is the dissemination of the results of scientific works in the fields of Medicine, Health Sciences and Social Sciences applied to Health, in the form of high-quality scientific articles that follow scientific research methods and the concepts of ethics, providing scientific knowledge that contributes to the knowledge and solution of health problems.
Cátedra de Socioantropología, Facultad de Ciencias Médicas - Filial Santa Rosa del Aguaray (Universidad Nacional de Asunción)
Body and Self-Worth: Association Between Body Dissatisfaction and Self-Esteem in Medical Students
Introduction: Body dissatisfaction is a relevant psychological factor in university students’ mental health, particularly in demanding fields such as Medicine. Its association with self-esteem has been widely documented, although evidence from Latin American contexts remains limited. Objective: To analyze the association between body dissatisfaction and self-esteem among medical students, and to explore differences according to sociodemographic and academic variables. Methodology: A cross-sectional study was conducted among medical students. Self-esteem was assessed using the Rosenberg Self-Esteem Scale (RSES), and body dissatisfaction using the Body Shape Questionnaire–8C (BSQ-8C). Descriptive analyses, bivariate comparisons (Mann–Whitney U and Kruskal–Wallis tests), and adjusted linear regression were performed. Results: A significant negative association was found between body dissatisfaction and self-esteem. Body dissatisfaction was higher in women, while self-esteem showed borderline differences by sex. No significant differences in self-esteem were observed across academic years, although body dissatisfaction varied by year. In the multivariate model, body dissatisfaction and history of mental disorders were significantly associated with lower self-esteem, whereas BMI and sex were not significant predictors. Conclusion: Body dissatisfaction emerges as a central factor influencing self-esteem in medical students, with relevant clinical implications. These findings highlight the need for preventive strategies and early interventions targeting mental health in this population.
Copyright (c) 2026 Julio Torales, Antonio Ventriglio, João Mauricio Castaldelli-Maia, Tomás Caycho-Rodríguez, Gladys Estigarribia, Marcelo O’Higgins, Victoria Ocampo-Rojas, Camila Martínez-Villalba, Tamara Horvath-Mereles, Eva Giménez-Legal, Iván Barrios https://creativecommons.org/licenses/by/4.0
Uso de benzodiacepinas en niños, niñas y adolescentes: declaración del Departamento de Psiquiatría Pediátrica de la Facultad de Ciencias Médicas de la Universidad Nacional de Asunción (Paraguay)
El Departamento de Psiquiatría Pediátrica de la Facultad de Ciencias Médicas de la Universidad Nacional de Asunción (Paraguay) manifiesta su preocupación por el aumento del uso de benzodiacepinas (BZD) en niños, niñas y adolescentes. Estos fármacos (como diazepam, clonazepam, lorazepam o alprazolam) continúan prescribiéndose con frecuencia para el tratamiento de ansiedad, insomnio, agitación o síntomas conductuales asociados a trastornos del espectro del autismo y a discapacidad intelectual, a menudo en ausencia de supervisión especializada y sin un fundamento clínico suficientemente sólido. Esta tendencia resulta particularmente relevante en el contexto de la psiquiatría infantojuvenil, donde las decisiones terapéuticas deben considerar no solo la sintomatología actual, sino también el impacto potencial sobre el neurodesarrollo. En los últimos años, diversos estudios han documentado un crecimiento sostenido en la prescripción de agonistas de los receptores benzodiacepínicos en población joven, incluso en sistemas de salud con marcos regulatorios estrictos. En Hong Kong, un seguimiento poblacional de más de dos décadas evidenció un incremento progresivo en la administración de estos fármacos en menores de 24 años (1). De forma similar, en Francia, la investigación de Driot et al. identificó una asociación significativa entre vulnerabilidad social y mayor uso de BZD en población pediátrica (2), sugiriendo que factores estructurales y contextuales pueden influir de manera relevante en los patrones de prescripción. En Paraguay, la escasez de psiquiatras pediátricos ha llevado a que médicos de otras especialidades (particularmente psiquiatras de adultos y pediatras) asuman el desafío de abordar cuadros complejos de salud mental en población infantojuvenil. Si bien esta situación refleja un compromiso asistencial valioso, también pone de manifiesto la necesidad de contar con orientaciones claras que permitan reducir la variabilidad en la práctica clínica y evitar intervenciones potencialmente inapropiadas o de riesgo. En este contexto, la ausencia de lineamientos específicos puede favorecer el uso de estrategias farmacológicas de rápida acción, como las BZD, aun cuando su perfil beneficio-riesgo sea desfavorable en esta población. Por ello, la presente declaración tiene como objetivo ofrecer una orientación clínica clara, basada en evidencia, que reconozca las particularidades del contexto nacional, promueva la cooperación interdisciplinaria y establezca límites seguros para la prescripción de BZD en niños, niñas y adolescentes. Asimismo, busca contribuir al debate clínico y ético sobre el uso de psicofármacos en etapas tempranas del desarrollo, enfatizando la necesidad de priorizar intervenciones seguras, efectivas y sostenibles en el tiempo. El Departamento de Psiquiatría Pediátrica de la Facultad de Ciencias Médicas de la Universidad Nacional de Asunción agradece a la revista Medicina Clínica y Social por brindar el espacio editorial para la difusión de esta declaración en su versión íntegra, reconociendo la relevancia del tema para la práctica clínica, la formación médica y la salud pública.
Benzodiazepine use in children and adolescents: A statement from the Department of Child and Adolescent Psychiatry, School of Medical Sciences, National University of Asunción (Paraguay)
Copyright (c) 2026 Julio Torales, Viviana Riego, José Almirón, Oscar García, Pamela Figueredo, Martín Laterza, Mathías Cantero https://creativecommons.org/licenses/by/4.0
Implications of new diagnostic criteria for obesity on mental health comorbidities
A recent report published by The Lancet Diabetes & Endocrinology Commission entitled Definition and diagnostic criteria of clinical obesity (2025) represents a major conceptual shift in how obesity is defined and understood. Moving beyond the long-standing reliance on body mass index (BMI), the Commission proposes a framework that conceptualizes obesity as a multifactorial, chronic, and systemic disease, emphasizing its functional, metabolic, and organ-specific consequences rather than body size alone. This reconceptualization has profound implications not only for medical practice but also for mental health research and care. For decades, BMI has served as the primary diagnostic proxy for obesity despite well-documented limitations. BMI does not capture body composition, fat distribution, metabolic heterogeneity, or psychosocial burden. Individuals with elevated BMI may present preserved physical and mental functioning, whereas others with lower BMI values may experience marked psychological distress and functional impairment related to adiposity. Consequently, the exclusive use of BMI has often obscured clinically meaningful subgroups and contributed to both underdiagnosis and overmedicalization. By prioritizing disease impact over numerical thresholds, the concept of “clinical obesity” allows for a more nuanced understanding of obesity and its associated comorbidities. Importantly, this shift provides a valuable opportunity to integrate mental health more explicitly into obesity assessment and management, acknowledging that psychological distress may be both a consequence and a constituent dimension of the disease.
Copyright (c) 2026 Julio Torales, Marcelo O'Higgins, Tomás Caycho-Rodríguez, Antonio Ventriglio, João Mauricio Castaldelli-Maia, Iván Barrios https://creativecommons.org/licenses/by/4.0
In vitro antitumor effect of essential oil of leaves from ñandypa (Genipa americana L.) on human pancreatic carcinoma cell lines (MIA PaCa2)
Introduction: South American biodiversity offers a source of new therapeutic compounds. Cancer remains a major global health issue with high morbidity and mortality. ñandypa (Genipa americana L.), a medicinal plant with various reported properties, was tested for citotoxic activity of the essential oil from their leaves. Objective: to determine the in vitro antitumor effect of an essential oil derived from ñandypa on human pancreatic carcinoma cell lines (MIA PaCa2). Methodology:Essential oils from G. americana leaves were obtained via hydrodistillation, and their chemical composition was analyzed using Gas Chromatography-Flame Ionization Detection-Mass Spectrometry (GC-FID-MS). Pancreatic tumor cells and normal fibroblast cells were then tested for antitumor activity. The cells were treated with serial dilutions of the essential oil (0.1%, 0.5%, 1%, 1.5%, 5%, and 10%). Cell viability was measured using an MTT assay, with results read on a spectrophotometer at 570nm and 630nm. Results: GC-FID-MS analysis revealed the oil's primary components were alcohols (17.83%), aldehydes (9.58%), and esters (5.18%). Exposure to the oil for four hours resulted in a high rate of tumor cell mortality, with the effect being more pronounced at higher concentrations. Importantly, the oil was not found to be toxic to normal cells (MRC-5). Conclusion: The essential oil of Genipa americana L. exhibits significant, dose-dependent antitumor activity against human pancreatic carcinoma cells (MIA PaCa-2). Notably, it showed no toxicity toward normal human fibroblast cells (MRC-5). These findings, supported by the presence of bioactive compounds like BHT, ?-pinene, and ?-caryophyllene, suggest its potential as a selective therapeutic agent for pancreatic cancer.
Copyright (c) 2026 Eva Ruzena Montiel Fernández, Jorge L M. Ruíz https://creativecommons.org/licenses/by/4.0
Coverage, missed opportunities and reasons for not vaccinating children under 5 years of age in Paraguay
Introduction: Vaccine-preventable diseases remain one of the main causes of infant mortality, despite advances in immunization. Globally and in the Region of the Americas, vaccination coverage has decreased, falling below the recommended 95%. In Paraguay, low vaccination rates reflect barriers that compromise public health. Objective: To determine the coverage, vaccination opportunity, and the main reasons for non-vaccination in children under 5 years of age in Fernando de la Mora, Paraguay, in 2023. Methodology: Descriptive cross-sectional study carried out in 318 children selected by two-stage probability sampling. Vaccination coverage for BCG, pentavalent, and MMR were analyzed. Data were collected using questionnaires designed in Epi.Info 7.2, recording sociodemographic variables, vaccination status, coverage, opportunity, source of information on vaccines, reasons for non-vaccination, knowledge, attitudes, practices, and sources of information, analyzed with descriptive statistics such as frequency and percentages. Results: 53% of children had complete vaccination schedules. Vaccination coverage was high for BCG (98.43%) and low for MMR-2 (37.02%). Vaccination opportunity was complete for BCG, but decreased for MMR-1 (42.01%). The main reasons for not vaccinating were lack of knowledge about the schedule (38.9%), erroneous beliefs (21.48%) and lack of time on the part of parents (21.48%). 77% of that responsible received information about vaccination, with television, radio and print media being the most frequent sources (42.5%). Conclusion: Although the initial BCG and pentavalent coverage are high, there is still a marked decline in the continuity of the schedules and the opportunity to vaccinate. Lack of knowledge and erroneous beliefs are the main barriers identified, which highlights the need to strengthen educational and awareness-raising strategies to improve coverage.
Copyright (c) 2026 Ivonne Montiel, Andrea Ferloni, Silvia Gómez, Mónica Arellano, Miryam Soliz, Rossanna Prado, Claudia Barrios, Lorena Romero, Adriana Benítez, Lina Molina, Margarita Samudio, Águeda Cabello https://creativecommons.org/licenses/by/4.0
Nutritional Status of Patients with Chronic Kidney Disease undergoing Hemodialysis
Introduction: Chronic kidney disease (CKD) is a major public health issue, with a global prevalence of nearly 13% and a growing burden in Latin America and Paraguay. In advanced stages, hemodialysis becomes indispensable but may negatively affect nutritional status, leading to both undernutrition and overweight. Nutritional assessment through indicators such as body mass index (BMI) and sociodemographic data is essential to understand these alterations and guide intervention strategies. Objective: To evaluate the nutritional status of patients undergoing hemodialysis in a private center in Asunción, Paraguay, using anthropometric measurements and sociodemographic data. Methodology: Observational, descriptive, cross-sectional study in 120 adult hemodialysis patients. Sociodemographic information and anthropometric measurements (weight, height, BMI) were collected. Descriptive statistics and association tests were applied. Results: The mean age was 57.2 ± 13.2 years, with a male predominance (56.7%). Mean BMI was 27.3 ± 5.3 kg/m². A high prevalence of overweight (40.8%) and obesity (28.4%) was observed, with no cases of undernutrition. No significant differences in BMI were found between sexes or age groups, although variations in weight and height were noted. Conclusion: Hemodialysis patients showed a high prevalence of overweight and obesity, challenging the traditional perception of undernutrition in this population. These findings highlight the need for personalized nutritional interventions that address the complex nutritional profile of CKD patients
Copyright (c) 2025 Igor Ernesto Marcet Franco, Juan Daniel Acosta González, Claudia Patrícia Quintana, Edis Emanuel Ortigoza, Jazmín Barrios, Patricia Ríos Mujica https://creativecommons.org/licenses/by/4.0
Patients’ Knowledge and Habits Regarding Diabetic Foot Prevention Measures: Polyclinic of a Private University, Asunción, Paraguay, 2024
Introduction: Diabetes mellitus is a metabolic disorder associated with severe complications, including diabetic foot, a frequent cause of disability, hospitalization, and amputations. Despite the key role of healthcare personnel in patient education, knowledge and prevention gaps persist. Objective: To determine patients’ knowledge and habits regarding diabetic foot prevention measures at the Polyclinic of a Private University in Asunción, Paraguay, in 2024. Methodology: An observational, descriptive, and cross-sectional study was conducted among adult diabetic patients attending the Polyclinic. All consenting patients were included, while those with communication difficulties were excluded. A structured questionnaire was applied, and data were analyzed using descriptive statistics. Adequate knowledge or habits were defined as more than 50% of positive responses. Results: A total of 131 patients were included, predominantly male (70%), aged between 19 and 60 years. Overall, 64% demonstrated global knowledge of preventive measures. High awareness was observed regarding systemic complications of diabetes and the importance of specialized consultation, but lower knowledge was found concerning proper nail trimming and immediate action in case of injuries. Regarding habits, 79% of patients reported adequate preventive practices. Conclusion: Most patients showed favorable knowledge and habits for diabetic foot prevention, although specific areas for improvement were identified. These findings highlight the importance of continuous and targeted educational interventions to strengthen self-care practices.
Copyright (c) 2025 Igor Ernesto Marcet Franco, Clara Margarita Cáceres Bogado , María Belén Giménez Reyes, Ema Soledad Maidana Pont, Jazmín Barrios, Patricia Ríos Mujica https://creativecommons.org/licenses/by/4.0
Knowledge and Compliance of Mothers of Children Under 5 Years Regarding the Vaccination Schedule: San Expedito Settlement, Paraguay, 2024
Introduction: Vaccination schedules are evidence-based recommendations that allow populations to prevent communicable diseases in different age groups through immunization. Objective: To determine the knowledge and compliance with vaccination schedules among mothers of children under 5 years of age in the San Expedito settlement, San Lorenzo, Paraguay, 2024. Methodology: A descriptive, observational, non-experimental, quantitative study was conducted. The study population consisted of mothers of children under 5 years of age. The sample included 40 mothers selected through non-probabilistic sampling. Data were collected through interviews using a structured questionnaire. Information was tabulated in Microsoft Excel 2010 and analyzed with EpiInfo 7.2.0.1. Tables and descriptive graphs were generated. Results: Participants ranged in age from 18 to 36 years (mean 27). More than half of the children were infants. Half of the mothers had completed secondary education, a quarter were housewives, and over 10% worked as cashiers. More than half of the households reported incomes below the minimum wage. Regarding knowledge, more than half of the mothers lacked information about vaccination. However, more than half complied with the vaccination schedule according to the child’s age. Conclusion: Limited knowledge about vaccination was observed among mothers, although compliance with the vaccination schedule was above 50%. These findings highlight the need to strengthen education and awareness strategies in the community
Copyright (c) 2025 Fidelina Portillo Villalba, Arturo Silva Estigarribia, Anyelo David Romero Vallejos, María Isabel Rodríguez-Riveros https://creativecommons.org/licenses/by/4.0
Susceptibility of Healthcare Professionals to Vaccine-Preventable Diseases: Critical Care Unit, Hospital de Clínicas, San Lorenzo-Paraguay 2021
Introduction: Vaccination is a key strategy to prevent communicable diseases and reduce occupational risks among healthcare workers. In critical care units, it ensures not only individual protection but also patient safety. Objective: To determine susceptibility to vaccine-preventable diseases among healthcare professionals in the Critical Care Unit of Hospital de Clínicas, San Lorenzo, Paraguay, 2021. Methodology: An observational, descriptive, cross-sectional, quantitative study was conducted with a non-probabilistic sample of 90 professionals. Data were collected using a validated questionnaire and analyzed with EpiInfo 7.2. Susceptibility was assessed based on knowledge, vaccination coverage, institutional factors, and use of personal protective equipment. Results: Most participants were female (68%), aged 31–40 years (57%), and nurses (80%). A total of 97% correctly identified hepatitis B as viral in origin, but only 60% had a complete vaccination scheme. Regarding influenza, 99% recognized the annual schedule and 80% were immunized. Tdpa coverage reached 78%, while 97% had received the COVID-19 vaccine. Overall, 73% complied with the recommended vaccination scheme for healthcare workers. Institutionally, 96% reported that the hospital managed and required vaccination; 77% acknowledged provision of masks and 71% of gloves. In terms of susceptibility, 68% showed low risk as they had five or more complete vaccines. Conclusions: Healthcare workers showed high coverage and low susceptibility, though gaps remain in incomplete schemes and vaccination record availability. Strengthening institutional policies is recommended to ensure complete and updated immunization for all professionals
Copyright (c) 2025 Arturo Yvan Silva Estigarribia, María Isabel Rodríguez-Riveros https://creativecommons.org/licenses/by/4.0
Effect of an educational intervention on the level of knowledge, healthy lifestyle practices and metabolic control of patients in the diabetes mellitus 2 program of the department of Concepción, Paraguay: a single-blind experimental study
Introduction: Diabetes mellitus 2 is considered the new epidemic of the 21st century, its incidence and prevalence are increasing rapidly, and it is considered the second cause of death in Paraguay. Objective: To evaluate the effect of an educational intervention on the level of knowledge, healthy lifestyle practices, and metabolic control of patients in the Diabetes Mellitus 2 Program of the Department of Concepción. Methodology: Experimental, single-blind study in patients of the Diabetes Mellitus 2 Program of the Department of Concepción, year 2023. A simple random sampling was used, including 158 patients for the intervention group and 320 patients for the control group. The sample size was calculated with the Epidat 3.1 statistical program. For data collection, diabetic patients were summoned to the health services of their community and were collected through an interview in two periods, pre and post intervention, using two validated questionnaires: Diabetes knowledge Questionnaire 24 to measure the level of knowledge and for the healthy lifestyle the IMEVID instrument. In the intervention group an educational program was implemented for 3 months. Results: 480 patients participated, mean age 60.7 years ± 1, female sex control group 76.9% and intervention group 75.3%. Significant difference was found in the level of knowledge, lifestyle, metabolic control and adherence to treatment between the intervention and control group after three months of educational intervention (p <0.0001). Conclusion: the educational intervention significantly improved the level of knowledge, healthy lifestyle, metabolic control and adherence to treatment in patients with type 2 Diabetes Mellitus.
Copyright (c) 2025 Luciana Echeverría Acosta, Lorena Elizabeth Giménez, Miguela Ruiz Romero, Eva Natalia Giménez Legal, Ignacio Ortiz Galeano https://creativecommons.org/licenses/by/4.0
Patterns and Trends of Antimicrobial Resistance in Staphylococcus aureus Isolated in a Private Laboratory in Paraguay from 2020 to 2024
Introduction: Staphylococcus aureus, a pathogen of global concern, has the ability to develop antimicrobial resistance, a factor that demands continuous surveillance. Objective: The objective was to determine the patterns and trends of antimicrobial resistance of S. aureus isolated from purulent secretions of patients attended at a private laboratory in Paraguay between 2020 and 2024. Methodology: This was a descriptive, retrospective study that used data from the electronic database of a private laboratory for the statistical analysis of variables such as antimicrobial susceptibility of S. aureus, from purulent secretion culture requests between 2020 and 2024. Results: S. aureus was isolated in 28.6% (220/770). Of these, 56.8% (n=125) were resistant to methicillin. A total of 61.5% (n=88) of the isolates were from outpatients. A moderate correlation was observed between methicillin resistance and resistance to ciprofloxacin (R²=0.709) and erythromycin (R²=0.705). The isolates showed resistance to erythromycin (66%), ciprofloxacin (34%), clindamycin (32%), and gentamicin (19%), but were 100% susceptible to trimethoprim-sulfamethoxazole and vancomycin. Among the multidrug resistance patterns in methicillin-resistant S. aureus, co-resistance to erythromycin-ciprofloxacin (37.5%) stood out. Conclusion: The increasing resistance to erythromycin, ciprofloxacin, and clindamycin limits their use in empirical treatments and highlights the importance of improving epidemiological surveillance strategies
Copyright (c) 2025 Julio César Barrios Leiva, Margarita Samudio Acevedo, Rosa María Guillén Fretes, Norma Fariña, Ana Vega, Alicia Pereira Fariña, Fátima Rodríguez Acosta https://creativecommons.org/licenses/by/4.0
Gender gap in pharmacological reperfusion and outcomes of ST-elevation acute myocardial infarction: Paraguayan cohort 2019–2023.
Introduction: ST-elevation acute myocardial infarction (STEMI) is one of the leading causes of cardiovascular morbidity and mortality. Early reperfusion, mainly through fibrinolysis in developing countries, is essential to reduce complications and mortality. However, multiple international registries have documented gender inequities in access to reperfusion therapies, with greater delays and worse outcomes in women. In Paraguay, where fibrinolysis remains the most widely used strategy under the IAM Code, there had been no national analysis to assess these differences. Objective: To assess the gender gap in pharmacological reperfusion and in-hospital outcomes in patients with STEMI in Paraguay between 2019 and 2023. Methodology: Observational, retrospective, multicenter study based on the national registry of the IAM Code. Consecutive patients with acute coronary syndrome were included. Clinical characteristics, risk factors, reperfusion strategies, critical times, and in-hospital outcomes were analyzed using ?² and Mann–Whitney U tests, with significance set at p<0.05. Results: A total of 1,831 patients were included. Women were older (65.6 ± 12.4 vs. 60.3 ± 11.4 years; p<0.001) and had more hypertension, diabetes, and obesity, while smoking and alcohol consumption were more common in men. Fibrinolysis was performed in 64.1% of patients, less frequently in women than in men (61.1% vs. 66.2%; p=0.048). Critical times were longer in women: symptom-to-door (310 vs. 280 min), door-to-needle (50 vs. 40 min), and total ischemia (370 vs. 340 min; p<0.001). In-hospital mortality was higher in women (12.4% vs. 7.8%; p<0.001), as was heart failure (15.2% vs. 10.5%; p=0.01), while no significant sex differences were found in ventricular arrhythmias, stroke, or major bleeding. Conclusion: Women with STEMI in Paraguay have lower access to fibrinolysis, longer treatment delays, and worse in-hospital outcomes, confirming persistent gender inequities that require targeted health strategies.
Copyright (c) 2025 Dr. José Ortellado Maidana, Graciela González, Gabriel Gaona Figueredo, MSc. Dr. Ángel R. Rolón Ruiz Díaz, Marta Ferreira Gaona https://creativecommons.org/licenses/by/4.0
Difficult treatment of superinfected with pseudomonas aeruginosa verrucous leishmaniasis
Leishmaniasis is an endemic pathology produced by protozoans of the genus Leishmania, of which there are different species, which can affect skin, mucous membranes and /or viscera. We report the case of a 53-year-old male with erythematous violaceous plaque with verrucous borders, net limits in the thorax and back of 10 years of evolution, with a diagnosis of verrucous leishmaniasis, in whom systemic treatment was made with two different drugs and cryotherapy, with excellent result.
verrucous leishmaniasis; tegumentary leishmaniasis; therapeutic; cryotherapy
Zulema Alexandra Celeste Valiente Rebull
Copyright (c) 2025 Beatriz Di Martino, Celeste Valiente Rebull, Maria Lorena Re Dominguez, Lourdes Bolla, Mirtha Rodriguez Masi, Oilda Knopfelmacher https://creativecommons.org/licenses/by/4.0
Beyond the Rash: The Neuropsychiatric Impact of Measles and the Urgency of Prevention
Estimado editor: El pasado 7 de agosto de 2025, la Dirección General de Vigilancia de la Salud del Ministerio de Salud Pública de Paraguay emitió una alerta epidemiológica por sarampión, tras la confirmación de cuatro casos en el departamento de San Pedro, todos ellos sin antecedentes de vacunación documentada (1). El último brote con transmisión autóctona en el país se registró en 1998. Más recientemente, en 2023, se notificó un caso confirmado de fuente de infección desconocida, que no generó casos secundarios (1). Esta señal de alarma no es un hecho aislado: se enmarca en un contexto global de reemergencia del virus, favorecido por las brechas en la cobertura vacunal, la circulación internacional de personas y la complacencia que a veces se instala cuando una enfermedad ha sido declarada eliminada en un país. La rápida diseminación y el riesgo de brotes secundarios en comunidades vulnerables invitan a replantear una pregunta que, pese a décadas de evidencia científica, sigue sin recibir suficiente atención en el discurso público: ¿continuamos subestimando al sarampión como una enfermedad meramente febril y exantemática?
Copyright (c) 2025 Julio Torales, Gladys Estigarribia, Guillermo Sequera https://creativecommons.org/licenses/by/4.0
Evaluation of an educational intervention on arbovirus prevention at basic school no. 1973 "Costa Alegre" in the city of Coronel Oviedo, year 2024.
Introduction: Arbovirosis represent a major global public health concern due to their high prevalence and concentration in tropical and subtropical regions. They are mainly transmitted by Aedes aegypti and may cause clinical manifestations ranging from mild to severe. Objective: To evaluate the impact of an educational intervention on arbovirosis prevention at Costa Alegre School in Coronel Oviedo during 2024. Materials and Methodology: A longitudinal quasi-experimental study was conducted among fourth, fifth, and sixth-grade students between July and September 2024. A validated questionnaire developed by Vivas was applied, consisting of 10 knowledge questions (scored 0–1) and 6 skills questions assessed with a Likert scale. The Pan American Health Organization’s arbovirosis prevention booklet was used as educational material. Data were analyzed with Stata 16. Results: In the pretest, 27% of students demonstrated insufficient knowledge and 73% sufficient knowledge; in the post-test, sufficient knowledge increased to 99% and insufficient knowledge decreased to 1%. The McNemar test revealed a statistically significant increase in correct responses after the intervention (p < 0.001). Regarding skills, the Wilcoxon test indicated a moderate but significant improvement (p < 0.05), reflecting positive changes in preventive practices such as household cleaning, use of repellents, and control of water containers. Conclusion: The educational intervention significantly improved students’ knowledge and prevention skills, confirming its effectiveness as a school-based health promotion strategy. Replication in other educational and community settings is recommended to evaluate its long-term impact and applicability. Future studies should explore complementary strategies to strengthen learning and promote sustainable preventive practices
Copyright (c) 2025 Patricia Ríos Mujica, Catalina Elizabeth Segovia Barboza, Estigarribia G., Julieta Méndez, Guiomar Viveros de Cabello, Gloria González, Deisy Galeano https://creativecommons.org/licenses/by/4.0
Discrimination capacity of the pirate test to detect vision disorders in preschool children
Introduction: The presence of amblyopia due to untreated vision disorders is a serious global problem, which prevalence will increase from 13 to 26% in 2060. Despite having stablished screening programs for early detection of vision disorders in schools and training teachers for the correct use of ophthalmic instruments. However, due to the high rate of false positive results, its validity decreased. This situation implies the need to find a simple, low cost and reproducible test that allows the detection of vision disorders without prior ophthalmological knowledge, which is the main reason why the Pirate Test was proposed. Objective: To determine the discrimination capacity of Pirate Test to detect vision disorders in preschool children in Piura city. Methodology: Diagnostic study test (“Pirate Test”) was applied to 447 preschoolers by their parents and then they were evaluated by an ophthalmologist who determined if they really had vision disorders and specify the validity of the applied Test through the analysis of its sensitivity (Se), specificity (Sp), and ROC curve using SPSS v16. Results: The Se and Sp values to detect refractive errors were 85.4% and 78.8%, whereas for amblyopia the values were 83% and 93.7%, respectively. Also, ROC curves in both cases reported good discrimination capacity to detect visual disorders and amblyopia. Conclusion: Pirate Test has good discrimination capacity to detect visual disorders and amblyopia in preschoolers. The cut-off point was less than 5 minutes, which implies that the possibility of having important visual disorders or amblyopia is high.
Copyright (c) 2025 Jenny Kam Lin Ku Lozano, Jorge Enrique Osada, Eduardo Maron Ku Lu, Maria Esther Lozano Ponce, Margarita Samudio https://creativecommons.org/licenses/by/4.0
Long-term effects of childhood abuse on mental health and delinquent behavior in adulthood: A systematic review
Introduction: This research examines the long-term effects of childhood abuse on adult mental health and delinquent behavior. Methods: A systematic review was conducted following PRISMA guidelines. From 500 studies initially identified, 100 duplicates were removed. Titles and abstracts were screened, excluding studies that did not meet inclusion criteria, such as non-systematic reviews or those lacking relevant data. Fifty studies underwent full-text review, and 25 met the final inclusion criteria. Results: A significant association was found between childhood abuse and adult mental health disorders, including anxiety, depression, and personality disorders. Moreover, childhood abuse was strongly linked to adult involvement in both violent and non-violent crimes. Conclusions: The evidence highlights the long-term impact of childhood abuse on mental health and delinquent behavior, emphasizing the need for focused research within specific national contexts.
Copyright (c) 2025 Thaís Puente-Ortega, Rodrigo Moreta-Herrera, Rocío Játiva, Julio Torales https://creativecommons.org/licenses/by/4.0
Acute myeloid leukemia with NPM1, IDH1 and IDH2 mutations in Paraguayan patients
Introduction: Acute myeloid leukemia (AML) arises from the clonal expansion of myeloid blasts in peripheral blood, bone marrow, or other tissues. Its etiology is associated with the development of genetic mutations. Identifying actionable mutations is clinically relevant for the diagnosis, prognosis, and treatment of AML. Objective: To identify and describe the mutation profile of the NPM1, IDH1, and IDH2 genes in Paraguayan patients diagnosed with AML. Methodology: A retrospective molecular epidemiological study was conducted on 32 AML patient samples harboring NPM1 mutations. Real-time PCR and Sanger sequencing were performed to detect genetic variants. Results: The most frequently detected NPM1 mutation was type A, identified in 94% (30/32) of cases. Additionally, IDH1 and IDH2 mutations were found in 40% (13/32) of cases, with the IDH2 R140Q variant being the most predominant. The most frequent co-occurrence of mutations was observed between NPM1 and IDH2. Conclusion: This study provides valuable insights into the mutational profile of NPM1, IDH1, and IDH2 in AML patients in Paraguay, highlighting the relevance of these markers for risk stratification and their potential benefit for targeted therapies.
Copyright (c) 2025 Lady Franco-Benegas, Maria Paz Mujica, Valerie Jolly, Victor Salinas, Jose Zarza, Diana Gonzalez, Denisse Di Tore, Laura Morel, Juan Jose Bogado, Monica Labrano, Samadi Leiva, José Manuel Ovando, Rodrigo Santacruz, Miguel Britez, Ana Ayala-Lugo https://creativecommons.org/licenses/by/4.0
Assessment of the risk of developing Type 2 Diabetes Mellitus through the Findrisc Test in Villa Mano Abierta, Central - Paraguay 2024
Introduction: The FINDRISC test is a simple, fast, inexpensive, and reliable tool to identify the risk of developing type 2 diabetes mellitus (DM2). Objective: To assess the risk of developing DM2 in the adult population of the social territory of the Mano Abierta Family Health Unit, Julián Augusto Saldívar district of the Central department of Paraguay in 2024. Methodology: A descriptive study with a cross-sectional analytical component and a population base with systematic random sampling was carried out. People between 18 and 64 years of age were included, who were present in the home at the time of the visit and signed the informed consent. Pregnant women and people diagnosed with type 1 or type 2 diabetes mellitus were excluded. A structured questionnaire containing general data and the items of the FINDRISC test was applied. Results: 396 people aged 18 to 64 years (median 40), 295 (74.5%) women, participated in the study. 15% (n: 61) and 25% (n: 99) of participants were at high and moderate risk, respectively. Factors associated with an increased risk of developing diabetes mellitus in 10 years were: female sex (p=0.0055; OR: 1.9 (1.2-3.2)); age group 55 to 64 years (p<0.0001); lower educational level (p=0.0005; OR: 2.5 (1.5-3.9)); obesity (p=0.0055; OR: 23.5 (9.6-56.9)); sedentary lifestyle (p=0.0001; OR: 2.2 (1.4-3.3)); high-risk waist circumference (p=0.0001); direct family history of DM2 (OR: 5.6 (3.6-8.8)); history of antihypertensive medication (p=0.0001; OR: 5 (5.6-16.1)) and high basal glycemia at any check-up (p=0.0001; OR: 14.4 (6.3-32.9)); but not the daily consumption of fruits and vegetables (p value=0.278; OR: 1.3 (0.8-2.1)). Conclusion: The risk of developing diabetes according to the FINDRISC test was elevated. All components of the test contributed significantly to the increased risk, except the consumption of fruits and vegetables.
Copyright (c) 2025 Luciana Echeverria Acosta, María Beatriz Ojeda, Lorena Beatriz Jara, Carlos Fabián Ayala, Nancy Carolina Cuevas, María Pastora Duarte, María Teresa Duarte, Laura María Riquelme, Liliana Soledad Ayala, Lorena Romero, Rosa Alicia Galeano, Margarita Samudio https://creativecommons.org/licenses/by/4.0
Microbiological quality of community water from tanks, wells, and sanitation companies
Introduction: Microbiologically unacceptable community water may pose a risk to the health of citizens. Objective: To evaluate the microbiological quality of community water samples in urban facilities. Methodology: A cross-sectional analytical study using non-probability convenience sampling. Water samples from 100 community facilities were processed from sources such as wells, tanks, and sanitation companies. Microbiological quality was assessed by counting mesophilic aerobic bacteria and determining the presence of pathogenic microorganisms. Isolated pathogens were identified, and their antibiotic susceptibility profiles were determined. The chi-square test was used for statistical analysis of the relationship between variables. Results: The most common type of water source was artesian wells in 50% of cases; the type of facility from which the most samples were collected was family homes in 40% of cases. Microbiological quality was acceptable in 56% of cases and unacceptable in 44%. The most common cause of unacceptability was the presence of pathogens. The most frequently isolated pathogens were Pseudomonas aeruginosa in 14% of samples and Klebsiella aerogenes in 8% of samples. The isolated pathogens demonstrated broad antibiotic susceptibility and were negative for extended-spectrum beta-lactamases and carbapenemases. Microbiological quality was statistically associated with the water source (p value 0.000). Conclusion: Although the majority of community water tested was microbiologically acceptable, the frequent isolation of pathogens in artesian wells requires corrective measures
drinking water, antibacterials, heterotrophic bacteria, sanitation
Copyright (c) 2025 Cristel Kennedy, Gladys Estigarribia , Luz Paredes, Ahabeli Espinola, Camila Mino, Maria Cano, Marian Cárdenas, Eliana Rodriguez, José Robadin https://creativecommons.org/licenses/by/4.0
Aesthetic Medicine and Public Health: a necessary reflection
This article offers a critical reflection on the need to integrate aesthetic medicine into the field of public health, moving beyond its traditional perception as merely cosmetic. It argues that this discipline can significantly contribute to physical, mental, and social well-being, particularly among vulnerable populations. Key aspects discussed include improvements in quality of life, the reduction of aesthetic inequalities, the positive impact on mental health, and the preventive role of certain procedures. The recent enactment of Law No. 7344/2024 in Paraguay, which regulates the professional practice of aesthetic medicine, is highlighted as a milestone in advancing its professionalization and health oversight. The article concludes that incorporating aesthetic medicine into public policy can help promote more inclusive and human-centered health systems.
Copyright (c) 2026 Carlos Miguel Rios-González https://creativecommons.org/licenses/by/4.0
Choroidal neovascularization by active ocular toxoplasmosis: a case report
A 33– year–old woman attended to the eye clinic with a 5-day history of decreased unilateral visual acuity with no previous medical history. Clinical-ophthalmological examination revealed an elevated macular lesion compatible with active ocular toxoplasmosis which was treated with both antibiotics and anti-VEGF therapy, with which the patient evolved favorably.
Copyright (c) 2025 Jenny Kam Lin Ku Lozano, Charles Gino Conde Obregon, Eduardo Maron Ku Lu, Margarita Samudio https://creativecommons.org/licenses/by/4.0
Professional exhaustion syndrome in health personnel of a public hospital in the Department of Ñeembucu
Introduction: Burnout syndrome is a mental and physical wear and tear that cut across any profession and is very prevalent in medical work, it deserves special attention since PAS can lead to a detriment in the quality of the professional functions provided and affect the mental health of health personnel. Objective: To describe the dimensions of professional burnout syndrome in health personnel in a public hospital in the Department of Ñeembucú in the year 2024. Methodology: Observational, descriptive, cross-sectional study, from April to September 2024 of a convenience sample where health personnel from the Regional Hospital of Pilar were included and administrative staff were excluded. The standard instrument was applied; Maslach Burnout Inventory Human Services Survey (MBI-HSS) for the study of PAS in its dimensions; emotional exhaustion (EA), depersonalization (DESP) and personal fulfillment (PR). A high score of the AE and DESP dimensions and a low PR score make up the SAP. The continuous variables are expressed as means and standard deviation, and the categorical variables as absolute and relative frequencies. Results: Of a total of 82 participants, the mean age was 37 years (± 9), with a predominance of 61 (74.39%) females. About 31 (37.80%) participants had PAS, of which women predominated; 25/31(80,6%). The largest proportion of participants were physicians; 45 (54.87%), of these presented the three criteria of PAS; 17 (20.73%) participants. Emotional exhaustion was mostly presented by 14/31 (45.16%) participants, followed by depersonalization 10/31 (32.25%) participants. Conclusion: In the population studied, emotional exhaustion is the most frequently affected dimension and with a predominance of female medical personnel.
Copyright (c) 2025 Alejandra Argüello, Vanessa Meaurio, Alicia Saucedo, Sofia Barboza, Ángel Rolón Ruiz Díaz https://creativecommons.org/licenses/by/4.0
Clinical characteristics and frequency of autoantibodies in patients with Systemic Lupus Erythematosus who attend the National Hospital in the period 2018 -2023
Introduction: Systemic lupus erythematosus (SLE) is characterized by immune system dysfunction and presents renal, dermatological, neuropsychiatric, and cardiovascular symptoms. Biomarkers play a key role in improving SLE diagnosis, evaluation, and control. Objective: To determine the clinical characteristics and frequency of autoantibodies in patients with SLE hospitalized at the National Hospital of Itauguá between 2018 and October 2023. Methodology: Descriptive, observational, cross-sectional study with an analytical component that included patients with SLE hospitalized at the National Hospital of Itauguá. Demographic and clinical characteristics, and the presence of autoantibodies (anti-DNA, anti-Sm, anti-RNP, anti-Ro, anti-La, anti-Jo, rheumatoid factor, anti-ribosomal factor, anti-histone, anticardiolipin, and lupus anticoagulant) were analyzed. Descriptive statistics and the chi square test were used at a significance level of 0.05 to establish associations. Results: 164 patients between 13 and 87 years of age (median: 28.5) were included, 87% were female, 53% from the Central Department. 51.8% of the patients had severe disease activity, among the most frequent manifestations were alopecia (81.7%), arthralgia (75.6%), headache (67.7%), malar erythema (58.5%), arthritis (34.8%) and in the proportion (31,7%) nephritis and prolonged fever. Anti-DNA was present in 59.8% (n=98), FR 23.78% (n=39), anti-Ro 43.90% (n=72), anti-Sm 32.32% (n=53), anti-RNP 23.8% (n=39), anti-La 17.68% (n=29), anti p ribosomal 13.41% (n=22), anti-centromere 4.88% (n=8), anti SL70 2.44% (n=4), anti-histone 9.76% (n=16), anti-cardiolipin 7.3% (n=12), lupus anticoagulant 8.54% (n=14). Anti-DNA, anti-rnp and anti-p ribosomal autoantibodies were significantly associated with nephritis; and anti Sm with Reyunad syndrome. Conclusion. A high prevalence of severe disease activity was identified in SLE patients, with predominant symptoms such as alopecia and arthralgia. The most frequent autoantibodies were anti-DNA, anti-Ro, and anti-Sm, with significant associations with nephritis and Raynaud’s syndrome. These findings highlight the importance of biomarkers in SLE management.
Copyright (c) 2025 Luis Fernando Sánchez, Dora Montiel-Jarolin, Magali Jarolin Montiel, Margarita Samudio https://creativecommons.org/licenses/by/4.0
Perception of Loneliness and Self-Esteem as Predictors of Mental Health in Adults: A Study in a South American Country
Introduction: The presence of mental health problems among adults in Ecuador underscores the need to identify potential predictors of their occurrence. This study aimed to examine the impact of loneliness perception and self-esteem as potential predictors of mental health problems in a sample of Ecuadorian adults. Methods: A descriptive, correlational, predictive, and cross-sectional study was conducted with a sample of 1,293 Ecuadorian adults aged 18 to 63 years, of whom 42.3% were men and 57.7% were women. Results: Loneliness and self-esteem levels were found to be moderate, while the prevalence of mental health problems was low. Loneliness showed a positive moderate correlation with somatization, whereas self-esteem displayed a slight negative correlation with depression. Both loneliness and self-esteem emerged as significant predictors of these conditions. Conclusions: Loneliness and self-esteem influence the development and progression of specific mental health problems, such as somatization and depression, highlighting their relevance in interventions aimed at promoting mental health.
Copyright (c) 2025 Lourdes Maribel Chango Velva, Rodrigo Moreta-Herrera, Rocío Játiva, Julio Torales https://creativecommons.org/licenses/by/4.0
The Distance to Mental Health Services and the Use of Public Transportation: A Challenge for Timely Care
Access to mental health services is a crucial issue in healthcare worldwide, particularly in low- and middle-income countries, such as Paraguay. Factors such as geographical distance to care centers and availability of public transportation can significantly influence how quickly a person receives treatment. This editorial draws on findings from a study conducted at the Hospital de Clínicas of the National University of Asunción, which analyzed the relationship between distance to psychiatric services, use of public transportation, and duration of untreated mental disorders (1). Effective treatment of mental disorders depends on timely and continuous access to specialized services. However, physical distance from health centers and limited public transportation options often delay treatment, exacerbate symptoms, and diminish the quality of life. In this study, it was found that, although the average distance to the hospital was 10 km, there was no significant relationship between distance and the severity of anxiety or depression symptoms. Nevertheless, patients who spent more time traveling reported higher levels of anxiety, indicating that it is the duration of the journey, rather than the distance itself, that impacts anxiety levels (2,3). Access to mental health services, particularly in urban areas, depends heavily on public transportation. In the aforementioned study by Márquez (1), 45.2% of the patients relied on public transport to reach the hospital, and most had to take two buses. A small percentage required more connections, leading to long and exhausting trips. These findings highlight how public transportation quality and availability directly affect access to mental health services, a trend also observed in studies from other countries, where inadequate transport is a major barrier to timely mental healthcare (4). Research has consistently shown that inefficient public transportation is a significant obstacle in accessing psychiatric care. In areas where transportation is limited or expensive, the likelihood of seeking treatment drops dramatically (5). This issue is particularly pressing in rural areas, where people often travel long distances without access to regular public transportation or emergency psychiatric services, which adds another layer of difficulty in receiving adequate care. The duration of untreated mental disorders is a critical factor for symptom severity. This study found a correlation between delayed diagnosis and the severity of depression symptoms, reinforcing existing evidence that untreated mental health issues tend to worsen over time, increasing the burden on both patients and the healthcare system. The phenomenon known as "distance decay," which refers to the decreasing likelihood of seeking medical care as the distance to health services increases, has been documented in numerous studies (5). Given these findings, it is imperative to consider strategies for improving access to mental health services. One potential solution is to decentralize psychiatric care, allowing rural and disadvantaged communities to receive quality care without having to travel long distances. Establishing community mental health centers in peripheral areas, staffed with trained personnel, and equipped with telehealth capabilities could ease the strain on urban hospitals and ensure earlier access to treatment (5,6). Moreover, enhancing the public transportation infrastructure is essential for improving access to mental health services. Implementing policies that subsidize transportation costs for patients, such as free or reduced-fare bus passes for medical appointments, could help mitigate barriers related to transportation (7). In some countries, such measures have successfully improved mobility and healthcare access for vulnerable populations, suggesting that similar policies in Paraguay can yield comparable benefits. Ultimately, access to mental health services should not depend on geographical location or reliable transportation. Distance and transportation barriers are avoidable obstacles that, if properly addressed, can reduce the duration of untreated mental disorders and substantially improve the quality of life of affected individuals. Achieving this will require coordinated efforts among health authorities, urban planners, and policymakers to ensure that public transportation is accessible and that mental health services are available to all, regardless of location. Access to mental health services is a basic right and ensuring efficient provision is crucial for the well-being of the population. As the mental health systems in Paraguay and other low- and middle-income countries continue to evolve, addressing barriers such as distance and transportation must be a priority. Only then can it be guaranteed that all citizens, regardless of where they live, have access to the mental health care they need.
Copyright (c) 2025 Julio Torales, Mainor Márquez, Iván Barrios https://creativecommons.org/licenses/by/4.0
Consumption of prebiotics and probiotics and their relationship with the presence of metabolic syndrome and/or associated risk markers in ambulatory patients
Introduction: The global prevalence of Metabolic Syndrome (MS) has been increasing in recent years, constituting a challenge for public health. There is scientific evidence that demonstrates positive effects of prebiotics and probiotics in the prevention and treatment of MS and associated risk markers. Objectives: We aimed to evaluate the consumption of prebiotics and probiotics and its relationship with the presence of MS, and associated risk markers in outpatients in the period from September to October 2022. Materials and Methods: Analytical, cross-sectional observational study, with primary data, carried out on 70 patients, obtained by non-probabilistic sampling. Anthropometric, biochemical, body composition, blood pressure, and level of physical activity variables were recorded to determine the presence of MS and its risk markers. Results: The sample consisted of 54 female subjects and 16 male subjects. The average age was 38.63 ±12.15 years. Only 29% of the subjects consumed the recommended daily amount of inulin every day. Significant differences were found between the consumption of prebiotics with nutritional status and skeletal muscle mass, with a lower proportion of overweight and greater skeletal muscle mass observed in those who consumed prebiotics. Conclusion: The consumption of prebiotics could exert a protective effect in overweight patients and, in relation to the presence of MS, in those patients who have a family history of arterial hypertension. Likewise, a positive relationship was found between the consumption of prebiotics and skeletal muscle mass.
Palabras claves: Síndrome Metabólico – Factores de riesgo asociados al Síndrome Metabólico – Prebióticos – Probióticos.
Copyright (c) 2025 Clarisse María Luz Balbuena, Diego Báez Torres, María Eugenia Ruíz Díaz, Misael Pintos Belloto, Erdulfo J. Galeano, Giannina Vittone Méndez, Marta Jazmín Duarte Herrera, María Noel Luccini Aguilera, Osmar Centurión https://creativecommons.org/licenses/by/4.0
Anxiety in health personnel of the Hospital of the Ministry of Health during the COVID-19 pandemic in the Southern Region of Peru
Introduction: The pandemic of COVID-19 had affected dramatically the mental health of general population, but specifically the health personnel, so there were reported higher levels of anxiety in physicians and nurses in several countries. Objective: To determine the levels of anxiety in health personnel who work in Hospital from Ministry of Health Hospital from Arequipa City and its association with the attemption of patients with COVID-19. Methodology: This is a descriptive transectional study, in which there were assessed 147 healthcare workers in Hospital with and there Zung Axiety Scale. Results: The 53.1% of the health personnel assessed presents some levels of anxiety, that is associated in the 66% of the cases with ethical dilemmas for working with people infected with COVID-19. Conclusion: There is a significant association between anxiety and the attemption of patients with COVID-19.
Copyright (c) 2025 Agueda Muñoz-del-Carpio-Toia, Yury Merma Barazorda, Walter L. Arias Gallegos, Lucía Begazo-Muñoz-del-Carpio, Francesca Diaz Del Olmo Calvo, Renzo Rivera, Patricio Diaz Del Olmo Calvo, Paulina Patricia Valdivia Carazas, Magly Liesbeth Larico, Tomás Caycho-Rodríguez https://creativecommons.org/licenses/by/4.0
A Adaptation and translation of the Psy-Flex in university students in Lima Metropolitana
Introduction: The PsyFlex is a relevant measure for clinical practice given that it facilitates therapeutic planning and represents a measure of change in intervention sessions; however, it is not adapted to the Peruvian context. Objective: To adapt and translate the Psy-Flex in a sample of Peruvian university students. Methodology: Two samples of 273 participants, each aged 18 to 59 years of both sexes, were used. Results: Absolute (RMSEA=.000 to .074; SRMR=.014 to .031) and relative (CFI=.977 to 1.000; TLI=.962 to 1.005) optimal fit indices and reliability indices above .85 for the one-factor structure were identified, thus, the instrument has optimal evidence of validity and reliability. Discussion: The findings are partially consistent with other studies due to morpho-syntactic characteristics of the translation process from English to Spanish, reflecting the unidimensional nature of the test.
Copyright (c) 2025 Pedro Luis Arroyo Pizarro, Gonzalo Peña-Muñante, Margot Osorio Chipana, Esteban Moreno-Montero https://creativecommons.org/licenses/by/4.0
Hantavirus in pediatrics: Three forms of presentation
The Hantavirus genus, which belongs to the Bunyaviridae family, is a virus transmitted by aerosolization of feces from infected rodents belonging to the Muridae family. This virus can cause two types of conditions: hemorrhagic fever with renal syndrome (HFRS) and hantavirus pulmonary syndrome (HPS). Knowing the different types of presentation is important for the therapeutic approach. Three pediatric cases of hantavirus disease, confirmed by specific IgM, with different presentations and evolutions, are presented, with the intention of alerting about the pathology and forms of presentation. All cases come from an endemic area for hantavirus, in Paraguay. Case 1: pulmonary syndrome: schoolchild with fever, cough, respiratory distress, interstitial pneumonia, decreased oxygen saturation. Admitted to intermediate care room, with oxygen and support measures. Good evolution and discharged after 7 days. Case 2: Cardiopulmonary syndrome: Preschooler with cough, dyspnea, arterial hypotension. 90% O2 saturation. Admitted to ICU, ARM, with pulmonary hypertension, with antibiotics until serology and cultures return. Discharged after 6 days Case 3: Hemorrhagic fever with renal syndrome: Older infant patient, with history of fever, general malaise. Admitted with generalized purpuric lesions, edematous, hypotensive, stuporous. With progressive acute renal failure. No response to supportive treatments. Died on day 7. The disease caused by hantavirus can have various expressions and can be fatal. The origin of the patients must be taken into account and included in the differential diagnoses.
Copyright (c) 2025 Gloria Celeste Samudio Domínguez, Natalia Berenice Ortega Gaona, Patrick Guillerme Da Silva Sandy, Dalila Recalde Sckell, Lorena Quintero https://creativecommons.org/licenses/by/4.0