Revista del Nacional (Itauguá)

Maternal anxiety and depression and its impact on breastfeeding self-efficacy

Julio Torales — 2024-12-30

Introduction: breastfeeding self-efficacy is a crucial factor influencing success and duration. Studies have shown that maternal anxiety and depression can negatively affect breastfeeding self-efficacy, which may hinder continuation of breastfeeding. Understanding this relationship is essential in designing interventions to improve maternal well-being and breastfeeding practices.
Objective: this study aimed to explore the relationship between maternal anxiety and depression and breastfeeding self-efficacy, and to describe the sociodemographic and mental health characteristics of the participants.
Methodology: this was an observational descriptive study with a cross-sectional design was conducted on 108 breastfeeding women in Paraguay. A non-probabilistic convenience sampling method was used. Participants completed the Generalized Anxiety Disorder-7 (GAD-7), Edinburgh Postnatal Depression Scale (EPDS), and Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF). Data were analyzed using SPSS, and the Mann-Whitney U test was used to determine the associations between anxiety, depression, and self-efficacy.
Results: a total of 30.6 % of the participants reported anxiety, and 48.1% showed signs of postpartum depression. Women with anxiety and depression had significantly lower breastfeeding self-efficacy scores (p=0.044 and p=0.048, respectively).
Conclusion: these results suggest that maternal anxiety and depression negatively affect
breastfeeding self-efficacy. Addressing mental health issues in breastfeeding mothers is essential to improving self-efficacy and, consequently, breastfeeding outcomes.

Obstetric and perinatal characteristics in patients with birth canal tears

Karen Leticia Brítez Ramirez — 2024-12-30

Introduction: birth canal tears are undesirable complications that occur during vaginal delivery, causing aesthetic and functional problems in the perineum or in the birth canal itself. Its prevalence, far from decreasing with current knowledge of obstetric medicine, has been gradually increasing in recent years.
Objective: to determine the obstetric and perinatal characteristics in patients with birth canal tears treated at the Centro Médico Nacional– Hospital Nacional in the period of 2021-2022.
Methodology: this was an observational, descriptive, cross-sectional, and retrospective study, including women with birth canal injuries treated at the Centro Médico Nacional– Hospital Nacional in the period 2021-2022.Descriptive statistics were used for the data analysis.
Results: 198 women with birth canal injuries were identified. The most frequent age range was 19- 29 years and most of them lived in the Central department. Most of the birth canal tears were observed innulliparous women (47.5 %) and without a previous cesarean section (92.9 %); the most frequent injury was the cervical tear (64.1 %). The most common morbidity was uterine atony (20.7 %). Regarding perinatal data, normal weight and term gestational age were more frequent.
Conclusion: cervical tears were the most frequent birth canal injury in nulliparous women without previous cesarean section with an age range of 19-29 years and from the Central department.

Psychometric evidence of the Impact of Events Scale (IES-6) in Peruvian adolescents

Jonatan Baños-Chaparro — 2024-12-30

Introduction: symptoms of Post Traumatic Stress Disorder (PTSD) are a frequent public health problem in adolescent population. Empirical evidence shows that adverse events during adolescence can affect early adulthood and predict various psychological problems. Ongoing assessment of PTSD is essential for prevention and the availability of reliable, evidence-based psychological instruments is necessary.
Objective: to analyze the psychometric properties of the Impact of Events Scale-6 (IES-6) in the general adolescent population.
Methodology: we used an instrumental research, quantitative and cross-sectional approach. A total of 2877 adolescents from Huancavelica participated, who answered the IES-6 and other psychological instruments. Statistical analyses were performed with structural equation modeling and item response theory.
Results: the IES-6 presents adequate evidence of content validity, unidimensional structure, reliability, measurement invariance according to sex and relationship with suicidal ideation, generalized anxiety and depression. Items 5 and 3 presented the highest discrimination and information, and the scale is accurate for high levels of PTSD.
Conclusion: the IES-6 presents adequate sources of validity evidence and is a useful instrument for the assessment of PTSD symptoms in Peruvian adolescents. Its use is recommended in research and prevention and follow-up programs in public health and education.

Work stress and musculoskeletal symptoms in employees of a private company in the city of Asunción, Paraguay, 2023

Pablo Andrés Barboza Compte — 2024-12-30

Introduction: musculoskeletal disorders and work stress affect the quality of life of an organization's workers.
Objective: to describe the level of work stress and the degree of perception of musculoskeletal symptoms in employees of a private company in the city of Asunción.
Methodology: this was a descriptive, quantitative, observational and cross-sectional study. We used non-probabilistic convenience sampling. 45 administrative collaborators from a private company participated. The instruments used were: ILO-WHO Work Stress Scale and the Kuorinka Nordic Musculoskeletal Symptoms Questionnaire. The study variables were stress levels and musculoskeletal symptoms. MS-Excel 2016 software was used for data processing.
Results: of a sample of 45 people, 87 % (n = 39) reported a low level of stress. On the other hand, 96 % (n = 43) presented a perception of musculoskeletal symptoms.
Conclusion: the majority of employees reported a low level of stress. On the other hand, almost the entire sample perceived symptoms of musculoskeletal pain, located mainly in the lower back area. The relationship between the level of stress and the perception of musculoskeletal symptoms is a topic that requires more in-depth research to determine more precisely the effects of work stress on the human body. Kinesiology and Physiotherapy is a valid path for implementing plans for the prevention and treatment of musculoskeletal ailments in the context of organizations.

Training a neural network for estimating the homeostatic model of insulin resistance

Alberto Guevara Tirado — 2024-12-30

Introduction: the evaluation of the homeostatic model is a test very close to the gold standard (euglycemic clamp).
Objective: train a multilayer perceptron-type neural network to determine the homeostatic model of insulin resistance.
Methodology: analytical and cross-sectional study. The learning of the neural network was carried out from a database of 2004 Venezuelan adults. Subsequently, 4,363 Mexican adults were added to the database of the National Health and Nutrition Survey (ENSANUT). The variables were homeostatic model of insulin resistance (HOMA2-IR), basal insulin, and basal glucose. Multilayer perceptron-type neural networks were used.
Results: the training of the neural network model had a relative error of 0.003, while in the test it was 0.005. For qualitative HOMA2-IR, the percentage of incorrect predictions was 0.60 % in training, and 0.70 % in testing. After learning the model, insulin and basal glucose values from 4363 Mexican adults were added, observing that the HOMA2-IR values generated by multilayer perceptron maintained the efficiency of the model, obtaining a coefficient of determination R2 of 0.983, which implies that 98 % of the variation in HOMA2-IR values can be explained by HOMA2-IR values obtained using multilayer perceptron.
Conclusions: the multilayer perceptron-type neural network gives results virtually identical to those obtained using the HOMA2-IR calculator. The implementation of this algorithm can be beneficial as a tool that is easy to implement in primary and specialized care systems and in hospital environments.

Phenotypic and genotypic characterization of carbapenemases produced by Gram-negative bacterial pathogens isolated in hospitals in Paraguay

Nancy Lorena Melgarejo Touchet — 2025-03-07

Introduction: the dissemination of Gram-negative bacteria resistant to carbapenems represents an important cause of morbidity and mortality, being a growing threat to public health and of great concern worldwide. Although resistance to carbapenems can be due to several mechanisms, the most relevant, clinically and epidemiologically, is enzyme production. The goals of this study were to phenotypically and genotypically characterize carbapenemases produced by clinically important Gram-negative bacilli (GNB) isolated in hospitals in Paraguay in 2022 and evaluate the susceptibility to colistin.
Methodology: retrospective study, carried out on 1,226 GNB strains sent to the Central Laboratory during 2022 for phenotypic and genotypic characterization. Identification studies were performed out by conventional methods, susceptibility to colistin by microdilution in broth, and molecular studies for the confirmation of resistance genes.
Results: in total, of 1226 GNB isolates, 629 (51 %) were confirmed as non-carbohydrate-fermenting GNB (89 % Acinetobacter spp.) and 597 (49 %) as carbohydrate-fermenting GNB (74 % Klebsiella pneumoniae). Carbapenemases OXA-23 (94.9 %), NDM (3.1 %), OXA-23+NDM (1.8 %) and OXA-23+NDM+OXA-58 (0.2 %) were confirmed in Acinetobacter baumannii; in K. pneumoniae: NDM (84.5 %), KPC (11.7 %), KPC+NDM (3.7 %) and NDM+OXA-48like (0.2 %); and in P. aeruginosa the prevalent was NDM (50.9 %). Colistin-associated resistance was found mainly in K. pneumoniae (24%).
Conclusions: in our country the circulation of carbapenemase-producing bacteria is endemic. The co-production of these enzymes is confirmed. NDM is prevalent in Enterobacterales and P. aeruginosa, and OXA-23 in A. baumannii. The high resistance associated with colistin in K. pneumoniae makes it imperative to have new, more effective antimicrobials for the treatment of infections.

Neurophobia in Medical Students from Paraguay

Elías René Rolón Méndez — 2025-03-07

Introduction: neurophobia, defined as the fear or aversion to neurology due to its perceived complexity, poses a challenge in medical education. This study examines the prevalence and associated factors of neurophobia among medical students in Paraguay.
Objective: to explore perceptions, attitudes, and factors associated with neurophobia among medical students and identify educational strategies to enhance neurology teaching.
Methodology: this was an observational, descriptive, and cross-sectional study conducted with a sample of 413 medical students from various Paraguayan universities. Data on sociodemographic characteristics, prior experiences in neurology, and knowledge perceptions were collected using a validated questionnaire. Descriptive and inferential statistical analyses were performed.
Results: a total of 41.6 % of students reported a low likelihood of choosing neurology as a specialty, while 33.9 % expressed intermediate levels of fear toward this discipline. The main causes of neurophobia were theoretical teaching approaches (32.9 %) and the perceived difficulty of neuroanatomy (35.8 %). Additionally, 69.2 % considered neurology teaching to be insufficient, and 81.1 % reported a lack of extracurricular activities related to neurology.
Conclusions: the findings highlight the need for a more practical and interactive curriculum, emphasizing clinical simulations and extracurricular activities to foster interest and confidence in neurology. These changes could mitigate neurophobia and encourage professional development in this specialty.

Characteristics of maternal mortality in Paraguay

Miriam Espínola-Canata — 2025-03-22

Introduction: maternal mortality (MM) is a critical public health indicator, especially in low- and middle-income countries. In Paraguay, although progress was made in reducing MM between 2008 and 2018, the COVID-19 pandemic reversed many of these gains. This study examines the characteristics of MM in Paraguay between 2014 and 2021.
Objectives: to describe the sociodemographic and clinical characteristics of maternal mortality in Paraguay during the period 2014-2021.
Methodology: a retrospective cross-sectional descriptive study was conducted using data from death certificates of the General Directorate of Strategic Health Information (DIGIES) of the Ministry of Public Health and Social Welfare. We analyzed 740 cases of maternal deaths registered in the 18 Health Regions of the country, considering sociodemographic variables and variables
related to causes of death.
Results: there were 740 maternal deaths, with an average ratio of 83.91 per 100,000 live births. 2021 had the highest ratio (159.98). The majority occurred in young (58.65 %) and adult women (66.31 %), with predominant causes being diseases of Respiratory System 18.11 %, toxemia 15.81 %, and hemorrhaged 12.03 %.
Conclusion: MM presented an increase after the COVID 19 pandemic, so the study highlights the urgent need to strengthen access to quality prenatal and obstetric care, especially in public institutions, and to address the socioeconomic inequalities that affect maternal health.

Relationship between mouth breathing and malocclusion in children aged 6 to 12 years at the Enrique Solano López school,

Bethania Magali Portillo Duarte — 2025-04-30

Introduction: in Latin America, the prevalence of malocclusions, that is, alterations in the position and relationship of the teeth and jaws, reaches alarming levels and affects a high percentage of the children. Mouth breathing, a habit that deviates from the physiological pattern of nasal breathing, has become a public health problem. Worldwide, it is associated with the development of malocclusions, especially in children.
Methodology: this was a cross-sectional, descriptive and observational study. The sample size was 194 students. We evaluated the presence of mouth breathing, and malocclusion was classified according to Angle. The statistical program STATA 14.0 and the Chi-square test were used to determine the association between the variables.
Results: the prevalence of mouth breathing was 28.87 %. Class I malocclusion was the most frequent (61.86 %), followed by Class II (25.77 %). A statistically significant association was found between mouth breathing and malocclusion (p=<0.001). The most frequent clinical signs in children with mouth breathing were: posterior crossbite with 58.9 %, ogival palate (80.4 %) and increased overjet/overbite (98.2 %).
Conclusions: there is a significant association between mouth breathing and malocclusion in the population studied. The prevalence of mouth breathing is similar to that reported in other Latin American studies.

Enterotoxins in Staphylococcus aureus isolated from food handlers at a public market in Asunción,

Jazmín Peña Kieninger — 2025-04-30

Introduction: Staphylococcal food poisoning (SFA) is the most common foodborne toxin-borne illness in the world, but it is not a notifiable disease. Therefore, surveillance of Staphylococcus aureus carriage in food handlers is essential for outbreak prevention.
Objective: to detect enterotoxin-coding genes in S. aureus isolates collected from the nasal mucosa of food handlers from a public market in Asuncion, Paraguay in October 2023.
Methodology: descriptive observational design, cross-sectional, pilot project. Nasal swab samples were taken from 30 food handlers and cultured on blood agar and salted mannitol, the strains were identified by MALDI-TOF mass spectrometry technique. Detection of enterotoxin A, B, C, D, G, H, I, M, N, O and U genes was performed by PCR.
Results: we found a high prevalence of nasal carriage of S. aureus (40 %, 12/30) in food handlers of a public market in Asunción, with 50 % (6/12) carrying the enterotoxin M gene and other genes in smaller proportion: G, I, O, U (17 %, 2/12) and C (8 %, 1/12).
Conclusion: we report the asymptomatic nasal carriage of S. aureus carrying enterotoxins by food handlers in a public market in Asunción, whose importance lies in the severity of the clinical pictures that could be caused by the single expression of any of these virulence factors in the event of a food outbreak.

Biochemical and anthropometric changes in patients undergoing bariatric surgery in a referral hospital,

Fermina Romina Cabrera-Lezcano — 2025-05-01

Introduction: bariatric surgery constitutes an alternative treatment for obesity, being the onethatpresents the bestresults in weightloss and remission of comorbidities and, as a result, anincrease in the quality of life in the longterm.
Objective: to determine the biochemical and anthropometric changes in patients with obesity under going bariatric surgery at the Hospital General de Luque during the period 2018-2023.
Methodology: descriptive observational study, with secondary data collected from the clinical records of patients undergoing bariatric surgery during the period 2018-2023. Non-probabilistic sampling of consecutive cases. Demographic, clinical, biochemical and anthropometric data were collected before and after (6 months) surgery. They were analyzed in SPSS version 23.
Results: twenty-two clinical records wereincluded, 86.4 % (n = 19) were female, the mean age was 43 years. Among the clinical characteristics, the average age at onset of overweight was 24.6±8.2 years, the main reasons for weight gain being changes in physicalactivity (36.4 %) and stress (31.8 %). In the biochemical parameters, a significant difference was found with adecrease in the values of glucose, total cholesterol, LDL and triglycerides (p<0.05). Accordingto the bodymass index before bariatric surgery, 90.2 % (n = 20) had class III obesity, at 6 months after surgery 50 % had class I, therefore a significant difference was found.
Conclusion: changes in anthropometric and clinical parameters were observed in patients submitted to bariatric surgery.

Oral health status in people with HIV/AIDS

Dilce Natalia Rios-González — 2025-05-01

Introduction: HIV is associated with a high frequency of oral manifestations due to progressive immunosuppression, which favors opportunistic infections and oral pathologies such as caries, periodontitis, candidiasis, hairy leukoplakia, and xerostomia. These changes negatively impact quality of life and can hinder adherence to ART.
Objective: to describe the oral health status of users with HIV/AIDS treated in a regional hospital in Paraguay during the year 2024.
Methodology: an observational, descriptive, cross-sectional study with consecutive sampling. A demographic questionnaire was administered, and oral conditions were assessed using the Carious, Missing, and Filled Teeth Index (CMFT-D).
Results: a total of 176 patients were included, 62.5 % female, and 34.09 % were aged 18–24 years. The overall DMFT index was 10.03 %, indicating a high burden of caries and tooth loss. A greater number of decayed teeth (n = 126) and indicated extractions (n = 82) were identified in the 25–34 age group. The DMFT index was higher in low and middle socioeconomic strata. The main dental need identified was oral rehabilitation (57.17 %), followed by surgical dentistry (28.08 %) and oral surgery (14.75 %).
Conclusion: a high prevalence of caries, tooth loss, and the need for rehabilitation treatment was found, reflected in a high overall DM/D index. These findings underscore the importance of integrating dental prevention, diagnosis, and treatment strategies into comprehensive care programs for people living with HIV, especially in contexts of socioeconomic vulnerability.

Medical professionalism in clinical and surgical specialties

Alberto Guevara Tirado — 2025-06-06

Introduction: professionalism is crucial in medical practice and can vary by specialty. Factors such as ethical behavior and commitment to continuing education influence professional performance.
Objective: to identify behaviors associated with professionalism that differentiate clinical and surgical specialist physicians.
Methodology: 424 physicians from Peru, Paraguay, and Cuba were evaluated and classified intoclinical (n =296) and surgical (n=128) specialties. The CHAID (Chi-squared Automatic Interaction Detection) method was applied with 43 indicators and 7 dimensions to identify predictors of professionalism.
Results: the CHAID analysis showed significant differences between specialties. Themost influential variable was “I sneak out of the hospital while on duty” (p<0.001), with a higher representation of clinical specialist physicians who never did this (77.70 %) compared to surgical specialists (22.30 %), with means of 1.13 versus 1.31, respectively. The variable “neglecting continuing education” (p=0.002) showed that more clinical specialist physicians did not neglect their training (71.90%) with a mean of 1.14, while those who did so reached 88.8 % (surgical: 11.2 %) with a mean of 1.28. In the dimensions “dishonesty and unsafe practice” and “irresponsible conduct and disabilities”, physicians with negative behaviors had higher means (1.36 and 1.29) than those without these practices (1.13 and 1.10).
Conclusions: the CHAID analysis revealed key differences in medical professionalism by specialty, associating the absence of negative behaviors and commitment to continuing education with higher levels of professionalism, especially in clinical specialist physicians.

Detection of serotypes and antimicrobial resistance genes of Streptococcus pneumoniae

María Eugenia León Ayala — 2025-06-06

Introduction: Streptococcus Pneumoniae is the etiologic agent responsible for serious invasive diseases, such as community-acquired bacterial pneumonia, sepsis, and meningitis. It remains one of the most important causes of morbidity and mortality in children and adults worldwide. Data on serotypes and antimicrobial resistance profiles provide relevant information to inform treatment guidelines and vaccination policies.
Objectives: to detect serotypes and antimicrobial resistance genes in clinical samples from children and adults with invasive disease caused by Streptococcus pneumoniae in Paraguay during 2023.
Methods: this was a retrospective, cross-sectional and descriptive study. All clinical samples (N=145) from patients with invasive Streptococcus pneumoniae disease that were not isolated in bacteriological cultures from sentinel and collaborating centers were studied as part of meningitis and pneumonia surveillance in Paraguay during 2023.
Results: twenty serotypes were identified, the most frequent being serotype 3 in 56.5%, 19A in 11.0%, and 15A/15F in 4.1%. In serotype 3, the pbp2b gene was detected in 96.3% of cases, ermB in 18.3%, mefA in 6.1%, and tetMen in 74.4%; in serotype 19A, the pbp2b gene was detected in 12.5% of cases, ermB in 75.0%, mefA in 50.0%, and tetMen in 81.2%; in serotype 15A/15F, the pbp2b gene was detected in 83.3% of cases, ermB in 66.7%, mefA in 16.7%, and tetM in 83.3%.
Conclusion: a high percentage of pbp2b was detected, indicating high susceptibility to penicillin. However, high tetracycline resistance was also observed in serotype 3 and macrolide resistance in serotypes 19A and 15A/15F. Molecular techniques applied directly to clinical material have the potential to detect the infecting organism and determine its susceptibility to antimicrobials, thus facilitating timely therapy and intervention with appropriate antibiotics.

Urine culture results in outpatients attending

Estela Torres Taboada — 2025-08-27

Introduction: urine culture is the primary tool for diagnosing urinary tract infections, but positive results vary widely.
Objective: to describe urine culture results in outpatients attending the laboratory of the National Medical Center-National Hospital during the 2022-2023 period.
Methodology: this was an observational, descriptive, cross-sectional study with an analytical component. Patients over 15 years of age who attended the Laboratory Service of the Centro Médico Nacional-Hospital Nacional with a urine culture request and who agreed to participate in the study were included.
Results: a total of 900 patients were included, aged 38.9±17.0 years (range 15–91 years), 756 (84 %) were female, of whom 337 (44.9 %) were pregnant. Of the total patients, 98 (10.9 %) had positive urine cultures, with Escherichia coli being the most common microorganism isolated in 74 (75.5 %) and Klebsiella pneumoniae in 9 (9.2 %). Multivariate analysis found significant differences in positive results based on sex (Wald 2.306; p = 0.021), history of urinary tract infection (W 2.891; p = 0.004), and history of urinary catheter use (W 2.676; p = 0.007).
Conclusion: the frequency of positive urine cultures in the outpatient population of the Centro Médico Nacional-Hospital Nacional was 10.9 %, with Escherichia coli and Klebsiella pneumoniae being the most common microorganisms.

School snack coverage from the permanent household survey

Dalila Azucena Recalde Sckell — 2025-08-27

Introduction: School Feeding Programmes are social programmes that seek better academic performance of vulnerable children.
Objective: to describe the coverage of school meals obtained from the Permanent Household Survey, Paraguay (2017 - 2021).
Methodology: observational, descriptive, cross-sectional, temporally retrospective study. The survey conducted by the National Institute of Statistics corresponds to a probabilistic cluster design with probability proportional to size, two-stage and stratified in the first stage.
Results: 9,012,061 surveys were conducted, with an annual average of 1,802,412, 52 % (934,784) were male, 62 % (1,125,235) were aged 5 to 12. 81 % (1,467,488) belonged to public institutions and 69 % (1,238,366) of the beneficiaries were in Basic School Education. 58 % (923,994) responded that they received free breakfast or snack and 73.2 % (1,204,008) indicated that they did not receive free lunch and/or dinner. Receiving free breakfast or snacks was more frequent in the 5-12 years age group (51.7 %, 822,835). 54.4 % (865,86) of the beneficiaries were found in public institutions, being more frequent in the Central Department 15 % (237,951). On average, Caazapá and San Pedro had the lowest coverage over the five years.
Conclusion: the departments with the highest coverage are Central and Alto Paraná, Caazapá has the lowest coverage. Coverage should be improved by prioritizing departments with the greatest social exclusion.

Disorders of bone mineral metabolism in patients with chronic kidney disease

Cecilia Méndez — 2025-08-27

Introduction: alterations in bone mineral metabolism have an impact as a cardiovascular risk factor; it is necessary to recognize them early to prevent their progression. Objective: To describe the frequency of alterations in calcium-phosphorus metabolism in adult patients with chronic kidney disease (CKD) at different stages who attend the Hospital Nacional in the period 2023-2024.
Methodology: a descriptive, observational, cross-sectional, retrospective study that included adult patients with CKD at different stages. Demographic variables (sex, age, origin), laboratory variables (serum levels of PTH, calcium, vitamin D, and phosphorus), and clinical variables (CKD stage, presence of hypothyroidism, need for hemodialysis, comorbidities) were studied.
Results: 81 patients with CKD between 21 and 97 years of age (rIC:50,63)were included, 87 % from rural areas, 62 % (n = 50) male. Regarding comorbidities and etiologies of CKD, 52 % (n = 43) had type 2 diabetes mellitus, followed by arterial hypertension (13 %) among the most frequent. 86 % were in stage V, all on three-weekly dialysis. 85 % showed vitamin D deficiency. Hypothyroidism was found in 5 % (n = 4). An association was observed between higher levels of phosphate and lower levels of calcium in advanced stages of the disease and an increase in PTH from stage IV showing an association with higher levels of urea and creatinine.
Conclusion: a high frequency of alterations in bone mineral metabolism was found from early stages of the disease, therefore its routine study should be a common practice in order to provide adequate supplementation and avoid progression to secondary hyperparathyroidism

Bronchiolitis in a Referral Hospital

María Magdalena Salinas Díaz — 2005-08-21

Introduction: acute bronchiolitis is a common disease with a high rate of hospitalization.
Objective: to analyze the clinical characteristics, risk factors, and viral etiology in children under 18 months of age hospitalized for acute bronchiolitis at a referral hospital.
Methodology: this was a descriptive, retrospective and correlational study of 80 infants under 18 months of age with acute bronchiolitis, hospitalized in the Pediatric Emergency Department of the National Hospital, from July/2021-September/2022. Infants of both sexes with a positive nasopharyngeal swab for respiratory viruses were included, excluding those hospitalized in other
wards. Sampling: was non-probabilistic for convenience. The data were analyzed with EPI INFO7: for qualitative variables, absolute and relative frequencies were calculated, and for quantitative variables, median and interquartile range. To compare the continuous quantitative variables, the Mann-Whitney test was used, for the qualitative variables the Chi2 test, establishing a significance level of p < 0.05.
Results: a total of 80 infants were included, median age: 2 months (IQR: 1-6), 53.75 % male. Risk factors were: age less than 3 months, 52.5 %, absence of exclusive breastfeeding 51.2 %, malnutrition 41 %, immunodeficiency 38.5 %, prematurity 37.5 %. The most frequent complications were pneumonia (40 %) and dehydration (11.2 %), the most frequent viruses were
respiratory syncytial virus (78.4 %) and adenovirus (17 %). 80 % had severe bronchiolitis.
Conclusions: acute bronchiolitis was more frequent in male children under 3 months of age. The most prevalent etiological agents were respiratory syncytial virus and adenovirus, the most observed complication was pneumonia. 80 % had severe forms.

Acceptability of PrEP in men who have sex with men (MSM)

Carlos Miguel Rios-González — 2025-08-28

Objective: to analyze studies that investigate the acceptability of PrEP in men who have sex with men (MSM).
Methodology: a systematic search was conducted for studies published in English or Spanish, up to June 2024, that investigated the acceptability of PrEP in MSM. The search was conducted in the following electronic databases: The Cochrane Library, Medline (Pubmed), PsycINFO, EMBASE, Web of Science, and CINHAL.
Results: after searching the analyzed databases, 432 articles were found. Participants reported benefits such as reduced HIV-related anxiety, improved engagement in healthcare, and increased sexual comfort. However, significant barriers were also identified, including stigma, concerns about side effects, adherence issues, and challenges related to cost and access.
Conclusions: this qualitative review provides a nuanced and multifaceted understanding of the experiences, perceptions, and challenges related to PrEP among diverse populations of MSM.

University students and gender

Claudia Troncoso-Pantoja — 2025-08-28

Introduction: the life transition of becoming a university student allows us to remember and value the contribution of older adults to current dietary patterns.
Objective: to interpret the meanings that university students, according to binary gender, and the influence that older adults have on their current dietary patterns.
Methodology: an exploratory, phenomenological, hermeneutic qualitative study. In a Chilean university context, adult students who signed informed consent participated. Sampling was purposive, using the saturation point. A semi-structured interview was used to collect data. Data were analyzed using content analysis, concluding this stage with informant triangulation. The study was approved by the ethics committee.
Results: forty students (52.5 % women) participated. Three categories of meaning were identified: transfers of knowledge, gender roles, and emotional and meaningful appraisal of food transmission. Students recognize their grandmothers for their contribution to their food literacy, a situation consistent with the men's thinking. For the latter, older women respond to a heteronormative role related to food, a situation understood as role inequality by the female participants. Intergenerational emotions, meanings, and eating patterns are mentioned without gender differences for the grandmothers' contribution to their diet. Older men contribute to the teaching and learning process of culinary preparations.
Conclusions: older relatives persist as normative and affective referents of eating patterns in university students.

Effective strategies to improve food sovereignty and health

Guiomar Viveros de Cabello — 2025-08-07

Introduction: food sovereignty is defined as the right of peoples to define their own agricultural and food policies, prioritizing local production and access to nutritious foods. This concept is particularly relevant for indigenous communities, which face unique challenges that affect their ability to maintain traditional food practices.
Methodology: a systematic literature review was conducted following PRISMA guidelines, focusing on intervention studies addressing food sovereignty and health in indigenous communities. An exhaustive search was performed in databases such as PubMed and Taylor & Francis, identifying a total of 12 relevant studies after applying inclusion and exclusion criteria.
Results: the included studies focused on various indigenous communities in the United States and addressed strategies such as improving access to healthy foods through mobile stores and fruit and vegetable prescription programs, promoting traditional food practices through family gardens and education about native foods, as well as nutritional education that fosters lifestyle changes.
Additionally, multicomponent interventions, such as the delivery of healthy food boxes, showedeffectiveness in reducing hypertension. Facilitators and barriers for implementing traditional food activities were identified, highlighting the need to integrate indigenous knowledge into health programs.
Conclusions: the review suggests that a variety of strategies may be effective in improving food sovereignty and health in indigenous communities. Promoting food sovereignty not only contributes to physical health but also reinforces cultural identity and connection to the land, essential elements for the holistic well-being of these communities.

The challenge of antibiotic resistance in Paraguay

Julieta Méndez-Romero — 2025-08-07

Introduction: antibiotic resistance represents a growing threat to public health worldwide, and Paraguay is not exempt from this problem. This article analyses antibiotic resistance in the Paraguayan context from a multidisciplinary perspective, assessing the current situation, the factors contributing to its development and key strategies to combat it. Five key areas are addressed: the
epidemiology of resistance, education and awareness, the role of public health and legislation, the
importance of national policies, and the value of reports and studies for decision-making.
Methodology: a review of the literature on antibiotic resistance in Paraguay was conducted. Epidemiological studies, government reports, public policies and research studies were consulted. The search was conducted in scientific databases, as well as institutional repositories and documents from the Ministerio de Salud Pública y Bienestar Social of Paraguay. The information, collected in English and Spanish up to October 2024, was analysed and synthesised to provide a comprehensive overview of the situation and strategies for action.
Conclusion: the article concludes with a call for joint action between the health system, civil society and international agencies to address this challenge. Antimicrobial resistance requires a comprehensive approach based on education, regulation, monitoring and effective policies to mitigate its impact on public health and ensure health security in Paraguay.

Gestational trophoblastic disease

María Magdalena Prieto Agüero — 2024-12-30

Placental tissue proliferation gives rise to a set of related diseases, all of which are included in the term gestational trophoblastic disease (GTD). Lesions include:hydatidiform mole (complete and partial), invasive mole, choriocarcinoma, trophoblastic tumor of the placental site, and epithelioid trophoblastic tumor. This report describes a case of invasive mole diagnosed after a manual endouterine aspiration procedure, which was detected by increasing serum levels of quantitative BCHG in its controls.
Therefore, the importance of follow-up with serial controls of quantitative BCHG blood is demonstrated, for an opportune diagnosis and treatment.

Pytyriasis rubra pilaris

Elvis Javier Ibáñez Franco — 2005-08-21

Pityriasis rubra pilaris is a rare and heterogeneous disease that can be hereditary or acquired. Acquired forms have been associated with viral or bacterial infections, and the disease presents with erythematous and scaly plaques interspersed with areas of healthy skin.
We present the case of a 2-year-old male patient with no prior medical history who presented with a 45-day history of symptoms, beginning with erythema and edema of the hands and feet, followed by a morbilliform rash and generalized scaling, especially in the periocular, perioral, and periungual areas. His medical history included a febrile episode associated with an upper respiratory tract infection prior to the onset of symptoms. Physical examination revealed erythematous-orange scaly plaques with scaling in specific areas. A skin biopsy confirmed pityriasis rubra pilaris with typical histopathological features.

Mental health in Kinesiology and Physiotherapy Undergraduate Students at the Universidad Nacional de Asunción

Mery Leonardo Aiquipa — 2024-12-30

Today's digital environment has transformed the way young people interact and perceive reality. The excessive use of social networks, the phenomenon of “doomscrolling” and information overload have increased anxiety levels in 60% of post-pandemic youth, this scenario suggests that college students are particularly exposed to these stressors, which could influence their academic performance and overall well-being.

Reality of the Human Immunodeficiency Virus

Violeta Susana Herrera Olortiga — 2024-12-30

Currently, the Human Immunodeficiency Virus (HIV) continues to be one of the public health problems; according to the World Health Organization (WHO), in the last year it has claimed the lives of 32.9 to 51.3 million people with an average of 40.4 million lives worldwide. It is estimated that by 2025, 95% of people with HIV should have been diagnosed, 95% should be on retroviral treatment and 95% should be able to suppress their viral load.