Background: Skin diseases represent an important part of the morbidity among children and are possibly influenced by geographic, racial, social, cultural, and economic factors. Despite being so frequent around the world, skin diseases have not been important in developing strategies in public health. Aim: The purpose of this study was to evaluate the prevalence of skin diseases among the student population between 1 and 6 years of age in Bogotá, Colombia between March 2009 and June 2011. Materials and methods: This cross-sectional study was performed across a probabilistic, stratified, randomized sampling by proportional assignment (based on locality and type of institution) and was developed in schools in Bogotá, Colombia. Results: A total of 2437 children between 1 and 6 years of age were examined, and 42.8% (1035) presented a dermatologic disease. Papular urticaria was the most frequent (62.9%) (IC: 58.4%; 67.1%), followed by dermatitis/eczema (13.0%) (IC: 10.8%; 15.4%), and infectious diseases (12.3%) (IC: 9.7%; 15.3%). Conclusion: The research demonstrates a high prevalence of papular urticaria as a result of flea and mosquito bites and infectious diseases of the skin in the studied population. The dermatologic diseases found are easy to diagnose, respond to the proper treatment, and are preventable. However, the fact that many of the examined children likely had not visited the doctor for the detected pathology could indicate the lack of access to health services affecting this population.
The study detected deficiencies in educational factors, specifically regarding the initial contact with the patient and regular follow-up by the team of health professionals. It also showed insufficient strategies for the training of patients in the use of the inhalers. There were no significant differences by gender (p>0.05) in the implementation of the various aspects of the proper use sequence for MDIs. However, there were significant differences related to education levels, socioeconomic status, age, and current occupation. A worse inhaler technique was associated with lower education level (0.034), higher age (p=0.003), and absence of job (p=0.005). Changes in the education of patients on the issue, together with the use of the spacer/valved holding chamber proved to be valid strategies that, with the support of the patients' health-care team, were able to improve the MDI technique of the studied group.
The aim of this article was to assess the validity of the emotional and developmental components of the Koppitz human figure drawing test. 2420 children's drawings available in a database resulting from a previous cross sectional study designed to determine the prevalence of neurological diseases in children between 0 and 12 years old in Bogota schools were evaluated. They were scored using the criteria proposed by Koppitz, and classified into 16 groups according to age, gender, and presence/absence of learning or attention problems. The overall results were then compared with the normative study to assess whether descriptive parameters of the two populations were significantly different. There were no significant differences associated with presence/absence of learning and attention disorders or school attended within the overall sample. An Interrater reliability test has been made to assure the homogeneity of scoring by the evaluator team. There were significant differences between this population and that of the original study. New scoring tables contextualized for our population based on the frequency of appearance in this sample are presented. We can conclude that various ethnic, social, and cultural factors can influence the way children draw the human figure. It is thus important to establish local reference values to adequately distinguish between normality and abnormality. The new scoring tables proposed here should be followed up with a clinical study to corroborate their validity.
BackgroundCandida albicans remains as the first cause of nosocomial fungal infections in hospitals worldwide and its susceptibility pattern should be better described in our tertiary care hospitals.MethodsThis study aimed at identifying the caspofungin susceptibility pattern regarding nosocomial Candida albicans infection in ten tertiary care hospitals using the methodology proposed by CLSI M27-A3 and CLSI M27-S4, and its association with risk factors and clinical outcome. The approach involved descriptive research concerning the diagnosis of nosocomial infection during a 7-month period in 10 hospitals in Bogotá, Colombia. Associations were established using exact non-parametric statistical tests having a high statistical power (>95%), suitable for small samples. The exact Mann Whitney test or Kruskall-Wallis non-parametric ANOVA tests were used for distributions which were different to normal or ordinal variables when comparing three or more groups. Multivariate analysis involved using binomial, multinomial and ordinal exact logistical regression models (hierarchical) and discrimination power was evaluated using area under the ROC curve.Results101 nosocomial infections were found in 82,967 discharges, for a Candida spp. infection rate of 12.2 per 10,000 discharges, 30.7% caused by C. albicans, 22.8% by C. tropicalis, 20.8% by C. parapsilosis, 19.8% by other Candida, 3% by C. krusei and 3% by C. glabrata. Statistically significant associations between mortality rate and the absence of parenteral nutrition were found in multivariate analysis (OR = 39.746: 1.794-880.593 95% CI: p = 0.020). The model’s predictive power was 83.9%, having an 85.9% significant prediction area (69.5%-100 95% CI; p = 0.001).ConclusionsSignificant differences were found regarding susceptibility results when comparing CLSI M27-A3 to CLSI M27-S4 when shifting clinical break-point values. However, one nosocomial strain was consistent in having reduced susceptibility when using both guidelines without having been directly exposed to echinocandins beforehand and no mutations were found in the FKS1 gene for hot spot 1 and/or hot spot 2 regions, thereby highlighting selective pressure regarding widespread antifungal use in tertiary healthcare centres. Nutritional conditions and low family income were seen to have a negative effect on survival rates.
Introduction: Hearing loss is a frequent problem in childhood with an incidence of about one case per 1000 births. Control of deafness should be aimed at prevention and early diagnosis in efforts to provide appropriate treatment and stimulate adequate communication in children affected. The objective of this study was to determine the prevalence of different etiologies among deaf children with a diagnosis of prelingual sensorineural hearing loss referred to the Fundación CINDA in Bogotá, Colombia, between 1997 and 2008. Materials and methods: The medical records were selected from those with prelingual hearing loss. Information was gathered in a format containing variables related to the risk factors suggested by the Joint Committee of Infant Hearing. Results: We studied 254 children; boys and girls were equally distributed. The most common etiological diagnosis was «unknown cause», followed by genetic causes (31 cases), and 38 cases from TORCH infections (toxoplasmosis, others – syphilis, rubella, cytomegalovirus, herpes), with rubella as the most common cause. Conclusions: Review of prenatal, perinatal, and postnatal history often reveals the cause of the deafness in children; therefore, appropriate evaluation of pregnant mothers could result in decreased frequency of deafness in children in our country.
Investigación de aseguramiento, cuyos objetivos generales son: identificar el grado de conocimiento que tiene la población residente en el Distrito Capital, las asociaciones de usuarios y los veedores ciudadanos sobre el sistema general de seguridad social en salud y su aplicación en el Distrito Capital. Sus objetivos específicos son: a) identificar el conocimiento de la comunidad sobre el sistema general de seguridad social en salud; b) identificar el conocimiento que tienen las asociaciones de usuarios y los veedores ciudadanos sobre el sistema general de seguridad social en salud; c) identificar el conocimiento que tienen la comunidad en general, los veedores y las asociaciones de usuarios sobre derechosy deberes como personas afiliadas al sistema de salud, de acuerdo con el régimen de afiliación; d) presentar recomendaciones a la Secretaría Distrital de Salud sobre mejores alternativas de información, comunicación y metodologías educativas a la comunidad, los veedores y las asociaciones de usuarios y su participación en el sistema general de seguridad social en salud.Debido a la falta de conocimiento por parte de los usuarios, especialmente en relación con sus derechos y deberes, la forma de acceder y los diversos mecanismos de participación, la Secretaría Distrital de Salud demandó la realización de esta investigación para saber cuál es el grado de conocimiento por parte de los usuarios sobre el sistema general de seguridad social en salud.
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