Universidad Privada Del Chaco

Introduction: More than 140 million people in the world live at high altitudes, above 2,500 meters (m) above sea level. Oxygen is vital for cellular metabolism; therefore, hypoxic conditions found at high altitude affect all physiological functions. Metods: A search for information was carried out in the SciELO, Scopus, PubMed/MedLine databases, the Google Scholar search engine, as well as in the ClinicalKeys services. Advanced search strategies were used to retrieve the information, by structuring search formulas using the terms "Cardiovascular Physiology", "Cardiovascular Physiology at Altitude", as well as their translations into Spanish " Fisiología Cardiovascular " and " Fisiología Cardiovascular en la altitud ". Results discussion: The heart is composed of three main types of cardiac muscle: atrial muscle, ventricular muscle, and specialized excitatory and conductive muscle fibers. The efficiency and work of the heart as a pump is often measured in terms of cardiac output, or the amount of blood the heart pumps per minute. Cardiac output is the product of stroke volume and heart rate Cardiovascular Changes at Altitude It is possible to think of the goal of acclimatization as maintaining oxygen delivery to the tissues as close to normal as possible. The cardiovascular system is central to this. Acute exposure to high altitude produces an increase in heart rate and cardiac output both at rest and for a given amount of work compared with sea level. In general, the normal heart tolerates even severe hypoxia very well. The heart, as a hemodynamic pump, has two mechanisms at its disposal to enhance its performance: heart rate and stroke volume, which together constitute cardiac output. The altitude electrocardiogram shows a variably increased amplitude of the P wave, deviation of the QRS axis to the right, and signs of right ventricular overload and hypertrophy. Conclusions: Advances in high-altitude research have shown that the cardiovascular system deploys some efficient mechanisms of acclimatization to oxygen deprivation, and the healthy heart adapts to hypoxia, even when severe, with preservation of systolic function and only minor impairment of LV and RV diastolic function. With acclimatization, desensitization of the adrenergic system, together with increased parasympathetic influence, leads to a decrease in maximum heart rate and protection of the myocardium against potentially damaging energy imbalances. Acute exposure to high altitude stimulates the adrenergic system, increasing heart rate and cardiac output; although arterial pressure remains stable, pulmonary artery pressure increases due to hypoxic pulmonary vasoconstriction. Our improved understanding of the effect of altitude hypoxia on the cardiovascular system will allow better-informed, evidence-based advice for patients with pre-existing cardiovascular disease

Introduction: the years 2020 and 2021 were characterized by the COVID-19 epidemic in Cuba, which caused the adaptation of academic courses, with the premise of making the training process more flexible, based on the suspension of face-to-face activities and the modification of the teaching curriculum. Objective: to describe the state exam results during the epidemic period. Methods: an observational, descriptive, retrospective study was carried out based on analyzing the promotion reports and the official models 36.19 and 36.20 of the Postgraduate Department, corresponding to 2020-2021. Results: 173 residents took the state examination, 111 from medical specialties and 62 from stomatological specialties, with promotion of 100 %. 49,7 % obtained final grades above 95 points and 78,0 % above 90 points in the state exam. The residents of the Dermatology and Intensive and Emergency Medicine specialties received the best teaching results. Conclusions: the Faculty of Medical Sciences "Miguel Enríquez", during the epidemic period, graduated, with quality, all the residents who took the state exam

Metaverse references an immersive three-dimensional digital space, conceptions about its specific nature and organization have changed over time, and more strongly emphasize the evolution from considering the metaverse as an extended version of a single virtual world to a wide network of an infinite number of interconnected worlds. The aim of this article is to describe the potential of the metaverse in health care. One potential feature of a doctor's office in the metaverse could be the use of virtual reality technology to create immersive, personalized treatment environments for patients. The doctor may also be able to use virtual reality tools to demonstrate treatment options or procedures, or to provide educational materials to the patient. There are several potential applications of the metaverse in medicine, including the use of virtual reality and other immersive technologies for patient care. Some examples of these applications include: Virtual reality exposure therapy for anxiety disorders; Virtual reality-based cognitive behavioral therapy for depression; Virtual reality-based rehabilitation and physical therapy; Virtual reality pain management; and Virtual reality education and training. There are several potential benefits to delivering clinical care in the metaverse. Metaverse may allow for more efficient and convenient access to care, particularly for patients who live in remote or underserved areas. These platforms will contribute for more personalized and immersive treatment experiences, as virtual reality technology can be used to create tailored environments and experiences for patients. There may also be concerns around patient privacy and security, as well as the potential for cyber-attacks.

Introducción.La evidencia internacional ha demostrado una respuesta humoral en anticuerpos IgG contra SARCoV2 en sujetos que han recibido dos dosis de vacunas alcanza el 95%.Se realizó este estudio prospectivo, para describir la se roprevalencia de IgG contra COVID19 en una población de personal de la sa lud que presenta el esquema de vacunación completo con la vacuna Sputnik V. Materiales y métodos.Se tomaron muestras de sangre para realizar la determi nación de anticuerpos IgG contra SARSCoV2 en personal administrativo y sa nitario que completaron el esquema de vacunación contra el COVID19 de los sanatorios y consultorios de FEMECHACO.Resultados.Se incluyeron un total de 105 miembros del personal administrati vo y profesionales de la salud que habían recibido el esquema completo de va cunación con Sputnik V. Se observó serología positiva de anticuerpos IgG para SARSCoV2 en 102 sujetos (97.14%).Los 3 sujetos que no desarrollaron anti cuerpos a pesar de haber recibido el esquema completo de vacunación contra el COVID fueron de sexo masculino.Las mujeres presentaron concentraciones significativamente mayores de IgG contra SARSCoV2 que los hombres (1436; rango: 451.14470 vs. 512.2;rango: 1037069).Conclusiones.Se encontró una robusta respuesta humoral en la población que recibió el esquema completo de vacunación, de manera similar a lo reporta do en la literatura.

Tropical anemia can have multiple causes, whether socioeconomic, dietary, or infectious. In the Bolivian Chaco, soil-transmitted helminthiases (STH), malaria, and Chagas disease are potential infectious causes of anemia among school-aged children (SAC). Following years of preventive chemotherapy with mebendazole, the prevalence of STH among SAC living in that area is now negligible, whereas protozoan infections are still highly prevalent (81%); Hymenolepis nana is the most frequent intestinal helminth (∼13%). We present results of hemoglobin (Hb) assessment and the association between parasitic infections and Hb levels of that SAC population. Overall, 511 SAC (girls:boys ratio 1:1, mean age 9.4 years [95% confidence interval {CI}: 9.3-9.5]) had Hb levels measured by using a point of care testing (HemoCue® Hb 301 System; HemoCue, Angelhome, Sweden). The prevalence of anemia was 23% (117/511), with mean and median Hb level = 12.2 g/dL (95% CI: 12.1-12.3; range 9.2-15.4 g/dL). By multivariate analysis, H. nana infection was associated with an increased risk of anemia (odds ratio 2.9, 95% CI: 1.5-5.7, P = 0.002). Two samples (0.5%) were positive for Trypanosoma cruzi and none for Plasmodium spp. by polymerase chain reaction of the 439 children tested. Anemia is still a concern among SAC living in the Bolivian Chaco. Our findings call for a greater attention to fecal-oral emerging pathogens, such as H. nana, and highlight the importance of water, sanitation, and hygiene improvements for disadvantaged population such as those living in the Bolivian Chaco.

Preventive chemotherapy is the WHO-recommended control method for soil-transmitted helminthiases. In the Bolivian Chaco, 6-monthly single-dose mebendazole delivery to school-age children achieved a dramatic decrease in soil-transmitted helminthiases prevalence between 1987 and 2013. Consequently, in September 2016, preventive chemotherapy delivery was interrupted in nine rural communities. In compliance with WHO recommendations, we intensified surveillance to monitor soil-transmitted helminthiases prevalence and detect potential changes that would require interventions. We conducted two cross-sectional parasitology surveys 12 months apart (September 2016-2017) among school-age children living in the communities where preventive chemotherapy delivery had been halted. Study design, methods of sampling and sample analysis technique (direct microscopy, Kato-Katz technique) followed WHO recommendations, aiming to obtain data representative of the Bolivian Chaco ecological zone. We collected 426 samples in 2016 and 520 in 2017. Soil-transmitted helminthiasis prevalence was unremarkable: 0.7% (95% CI 0-1.5%) in 2016 and 0.8% (0-1.5%) in 2017. Conversely, the prevalence of tapeworms (13% in 2016, 12% in 2017) and intestinal protozoan infections (81% in 2016 and 75% in 2017) continued to be high. Our findings support the role of preventive chemotherapy in reducing soil-transmitted helminthiases transmission, as otherwise poor hygienic and health conditions persist in the Bolivian Chaco. A national survey, involving areas from all the ecological zones of Bolivia, is now warranted.