https://revistascientificas.una.py/index.php/RP/issue/feedAnales of the Faculty of Medical Sciences2023-12-11T14:25:30+00:00ANALES de la Facultad de Ciencias Médicasefacim@fcmuna.edu.pyOpen Journal Systems<p><strong>ANALES of the Faculty of Medical Sciences</strong></p> <p>Is the official journal of the School of Medicine of the Universidad Nacional de Asunción, FCM-UNA, in Asunción - Paraguay, published by the Editorial Board of the aforementioned School, EFACIM.</p> <p>Its primary purpose is the publication of findings included in scientific papers in the field of medicine and/or health sciences, in the form of high-quality scientific articles, that follow the methodology of scientific research and the concepts of ethics, providing scientific knowledge that contribute with the solution of community health problems. It is published quarterly in one volume per year.</p> <p>Facultad de Ciencias Médicas. Universidad Nacional de Asunción. Asunción - Paraguay. Email address: <em><a href="mailto:efacim@fcmuna.edu.py">efacim@fcmuna.edu.py</a></em></p>https://revistascientificas.una.py/index.php/RP/article/view/3931Medical rigor during the Chaco war2023-12-11T11:47:23+00:00Alfredo Boccia Pazalfredoboc3@gmail.com<p>This book by Professor Isaías Ricardo Fretes, released in October 2023, covers an extensive gap in national medical history. The fact is that, although the Chaco conflict occurred less than a century ago, our unwritten tradition meant that the testimonies of many of those who personally lived the experiences of field hospitals and the care of the wounded and sick were lost forever. Even in the years after the war, with the country mired in painful internal political confrontations, there were not many conditions for journalistic or historical investigations based on interviews with doctors or students who provided health services on the combat fronts. In reality, it was above all our ancestral orality that overshadowed the knowledge of later generations.</p>2023-12-11T00:00:00+00:00Copyright (c) 2023 https://revistascientificas.una.py/index.php/RP/article/view/3908Skin sensitization to aero-allergens in children with rhinitis and asthma2023-12-06T11:05:07+00:00Cinthia Elizabeth Pérez Ortizcinpermat@gmail.comAna Campuzano de Colónacampuzano@gmail.comPerla Alcaraz Duartepalcaraz@gmail.comPedro Piraino Sosappiraino@gmail.comDomingo Santiago Avalosdsavalos@gmail.com<p>Introduction: Allergic diseases are very common in the pediatric population. Among the frequent causes are aeroallergens from the environment and the identification of these is a great help for diagnosis and treatment. Objectives: To determine the frequency of aeroallergens, through the determination of Immunoglobulin E (IgE) specific to common allergens by the skin sensitivity test in pediatric patients with symptoms of asthma and allergic rhinitis. Materials and Methods: Observational, descriptive, prospective, cross-sectional design, population of patients from 4 to 17 years old with symptoms compatible with asthma and allergic rhinitis who attended a pediatric care center during the study period. It was carried out by means of Skin Puncture Tests (PCP). Results: The mean age of the patients was 8 years, 57% male patients and 43% female. 53% of the patients presented Rhinitis and Asthma, 45% only Rhinitis and 2% only Asthma. 79% of the patients presented a positive allergic sensitization reaction through PCP. Taking into account the sensitization by type of aeroallergens, 64% of the patients had a positive reaction to mites, 19 % to animals 18% to cockroaches, 8% to pollens and 6% to fungi. Conclusion: The vast majority of patients with asthma suffered from concomitant allergic rhinitis and dust mites were the most frequently determined aeroallergens in allergic skin tests in children with asthma and rhinitis in our population.</p>2023-12-11T00:00:00+00:00Copyright (c) 2023 https://revistascientificas.una.py/index.php/RP/article/view/3909Follow-up of the graduates of the Master´s Degree in Human Nutrition2023-12-06T11:27:10+00:00Gustavo Machaín Vegagmachain@gmail.comMaría Gisela Pineda Ozunagisepineda638688@gmail.com<p>Introduction: Different graduate follow -up studies speak of the value of obtaining information about the professional activities they exercise and determining the impact of the training received and the perception of the same. Objectives: Determine the performance of graduates of the Master in Human Nutrition FCM One of the promotions from 2007 to 2020. Materials and methods: Descriptive study with observational design and quantitative approach that obtained the participation of 83 of the 91 graduates who completed the survey sent through the Google form. Results: Graduates women (90.4 %). The work area exercised; greater amount in the clinical area (61.4 %), office (24.1 %), public health at 6 %. 55.4 % replied that they had more work chances, only 28.9 % perform thesis tutoring. 79.1 % have improved their teaching or care activities and 55.4 % have responded that they do not perform teaching activity. 71.1%have collaborated in research papers being Master, in clinical area (47%), in public health (14.5%), in food area, (6%), others (3.6%); 64.9 % have not published the research work of the master’s degree. 95.2 % have not yet done the doctorate in nutrition and at 89.2 % they would like to do it. 87.9 % describe the mastery of human nutrition FCM an excellent or very good one. Conclusion: A greater number of women graduates is identified, in terms of the performance field, there is a greater amount in the clinical area, more than half of the graduates have participated in a research work being a magister in the clinical area, the work of Master’s research has not been published by the majority. Almost the total has not done a doctorate in nutrition. It is presented for the first time, at the national level, a study on the professional development of graduates of the Master in Human Nutrition that could be useful for future research works.</p>2023-12-11T00:00:00+00:00Copyright (c) 2023 https://revistascientificas.una.py/index.php/RP/article/view/3910Nutritional profile of ostomized patients. General Hospital of the second department of San Pedro Paraguay - Korea. 20222023-12-06T11:44:37+00:00Sandra Chamorro Aldanamabelcham3@hotmail.comRaquel Franco Núñezrfrancon@gmail.com<p>The nutritional profile of ostomized patients acquires special attention due to the conditions that could predispose to malnutrition. The objective of the study was to determine the nutritional profile of ostomized patients who receive outpatient care at the General Hospital of the Second Department of San Pedro-Paraguay Korea, in the year 2022, an observational study of a cross-section was conducted. The data obtained were loaded in an electronic form Microsoft-Excel, for the analysis was used descriptive statistics. To describe the nutritional status of patients, anthropometric indicators and nutritional risk screening (NRS-2002) were used, applied through nutritional clinical interview and evaluation. The study had a global duration of 9 months, 20 ostomized patients were included in the National Program for Comprehensive Care of the Ostomized Patient provided by the General Paraguay-Corea Hospital that complied with the inclusion criteria. Ethical research principles were respected. The most representative age group was 41 to 64 years or more, followed by the age group from 20 to 40 years; Greater proportion of male sex, rural origin. The most frequent type of ostomy was terminal colostomy followed by lateral colostomy; The most frequent base disease was the oncological type, followed by intestinal obstruction, trauma and finally fistulas and diverticular disease. In conclusion, the global appreciation of the nutritional status evaluated by the NRS-2002 tool indicated that the nutritional profile of ostomized patients has a risk of malnutrition in all cases evaluated.</p>2023-12-11T00:00:00+00:00Copyright (c) 2023 https://revistascientificas.una.py/index.php/RP/article/view/3911Economic impact of surgical debridements and lower limb amputations in diabetic patients2023-12-06T12:04:13+00:00Alexandra Coluccialexcolucci92@hotmail.comJorge Giubijgiubi@gmail.com<p>Introduction: Type 2 diabetes mellitus (T2DM) constitutes a public health problem. Objectives: Determine the frequency of surgical debridement and lower limb amputations in type 2 diabetic patients and their economic impact. Materials and methods: A descriptive cross-sectional observational study was carried out. The direct medical costs of both surgical debridement and lower limb amputations in diabetic patients at the Hospital de Clínicas, San Lorenzo were estimated during 2019. Results: The total of surgical debridement and lower limb amputations in 2019 represents the 1.9% (314/16,484) of surgical procedures performed at the Hospital de Clínicas. The total amount of expenses is 1,804,185,116 (262,541 USD), of which 172,514,000 (38,857 USD) constitute out-of-pocket expenses and 1,631,671,116 (237,437 USD) constitute expenses disbursed to the Paraguayan State through the Hospital de Clínicas de San Lorenzo. Conclusion: The complications of diabetes impose considerable costs both in out-of-pocket spending, on the health sector and on the economy in general in Paraguay, so it is necessary to re-evaluate the management of this problem taking into account the great impact that these procedures have on the lives of patients on a physical, emotional, family and social level, as well as the economic burden that the treatment entails for the Health System.</p>2023-12-11T00:00:00+00:00Copyright (c) 2023 https://revistascientificas.una.py/index.php/RP/article/view/3912Clinical-ophthalmological characteristics and evolution of patients with moderately severe active thyroid ophthalmopathy treated with methylprednisolone boluses who attended the Central Hospital of the Instituto de Previsión Social, Paraguay2023-12-06T12:13:27+00:00Alejandra Mülleramuller@gmail.comMaría Galiana Rodríguezmaga.rodriguezc@gmail.comFabiola Romerofromero@gmail.comDahiana Ferreiradferreira@gmail.comHelen Lópezhlopez@gmail.comGrecia Espinozagespinoza@gmail.comLis Alarcónlalarcon@gmail.comRoque Rodríguezrrodriguez@gmail.comLorena Careagalcareaga@gmail.comNadia Gómezngomez@gmail.comAnaly Barretoabarreto@gmail.comElizabeth Valinottievalinotti@gmail.com<p>Introduction: Graves’ orbitopathy (GO) is a debilitating disorder in patients with autoimmune thyroid disease, mainly Graves’ disease, which develops in 30 to 50% of cases. Objectives: To describe the clinical-ophthalmological characteristics and evolution of patients with moderate-to- severe active GO treated with methylprednisolone boluses who attended the Central Hospital of the Institute of Social Security between January 2018 and September 2021. Materials and methods: Observational design research, descriptive, retrospective study. Results: Records of 34 patients with active moderate-to-severe GO who received boluses of methylprednisolone based on the EUGOGO 2016 guidelines, were reviewed, of which 3 patients were excluded due to having incomplete records and another 3 patients since they required second-line treatment prior to end the 12-session scheme. Of the 28 patients studied, the average age was 43.6 ±13.1 years, 89% were female and 28.5% were smokers. Regarding the thyroid function of the population prior to treatment, hyperthyroidism was found in 82%, hypothyroidism in 11% and euthyroidism in 7%; and after treatment, hyperthyroidism was found in 78.6% (subclinical), euthyroidism in 17.9% and hypothyroidism in 3.5%. The majority (92.6%) had positive thyrotropin receptor antibodies, with an average of 18 ± 9.9 mIU/Ml. Regarding the activity of orbitopathy according to the CAS scale, an average of 4.1 ±1.0 was found before treatment and 1.2 ±1.4 after; Of them, 46.4% presented a mild condition according to the severity scale, 39% without severity criteria and 14% persisted in moderate-severe. Improvement in visual acuity was noted after treatment (57.1%), the average exophthalmia before treatment was 22.2 mm and after 21.1 mm; Diplopia occurred in 7.1% before treatment and in 3.6% after treatment. Conclusion: Treatment with intravenous glucocorticoids in moderate-severe Graves’ orbitopathy (EUGOGO 2016 scheme) was very effective, reversing the activity and consequently helping to reduce the severity, in the vast majority of our patients. This could be explained because the orbitopathy was incipient and by the high degree of patient adherence in the context of well-protocolized multidisciplinary management.</p>2023-12-11T00:00:00+00:00Copyright (c) 2023 https://revistascientificas.una.py/index.php/RP/article/view/3913Reconstructive techniques in Fournier’s disease sequels2023-12-06T12:59:05+00:00José Sandovalsandovalperez@hotmail.comCelso Aldanacaldana@gmail.comBruno Balmellibbalmelli@gmail.com<p>Introduction: Fournier’s gangrene is currently defined as a specific form of synergistic, rapid, progressive and multibacterial necrotizing fasciitis, which mainly affects the muscular fascia of the perineal, genital, or perianal region and even the abdominal wall; with genitourinary, colorectal, or idiopathic starting point. All of this, accompanied by skin gangrene in these areas due to thrombosis of subcutaneous blood vessels. Objectives: To describe the epidemiological and surgical characteristics of the sequelae patients of Fournier’s disease in the Plastic Surgery Unit of the Hospital de Clínicas in a period of 2 years. Materials and methods: Observational, descriptive, cross-sectional, temporally retrospective, case series type study. The type of sampling was non-probabilistic at convenience. Eighteen sequelae patients of Fournier’s disease reconstructed in the Plastic Surgery Unit of Hospital de Clínicas between 2020 and 2021 are presented. Results: During the study period, 395 surgeries were performed in the Plastic Surgery Service of the Hospital de Clínicas, of which 18 patients underwent surgery for sequelae of Fournier’s disease, which represents 5% of the total. Regarding demographic variables, age ranged between 37 and 85 years with greater impact in the sixth decade of life with an average of 61 years. 94% of the patients were male; 89% of the patients had type 2 diabetes mellitus as an underlying pathology, followed by obesity in 72% and high blood pressure in 56% of cases; In 83% of the cases, the scrotal region was affected, followed by the perineal region in 56% of the patients and the penis in 50% of the cases. The most frequently used reconstructive technique was flaps in 10 patients, followed by skin grafting in 8 patients, and primary closure in 6 patients. It is worth mentioning that in some patients several reconstructive techniques were used following the concept of reconstruction by sub- anatomical units, among the flaps the most used were the medial femoral circumflex perforator flap (gracilis perforator) with 50% of the cases followed by the fasciocutaneous transposition flap of the internal pudendal with 30%, and finally the fasciocutaneous advancement flap with 20% (Table 3). The average hospital stay was 3 days, with a minimum of 1 day and a maximum of 5 days postoperatively. Suture dehiscence was reported as a complication in 3 patients; no complications were observed in 77% of the cases. Conclusion: The sequelae of Fournier’s disease undergoing surgeries represent 5% of the total number of surgeries performed in our Service, they are more prevalent in the sixth decade of life, it affects more males with type 2 diabetes mellitus as the underlying pathology, the reconstructive techniques used in the sequelae are variable according to the anatomical regions affected and can range from primary closure to the use of flaps for repair.</p>2023-12-11T00:00:00+00:00Copyright (c) 2023 https://revistascientificas.una.py/index.php/RP/article/view/3915Factors associated with fear of the coronavirus in health professionals who work at the first level of care2023-12-06T13:18:00+00:00Diana Valdiglesias Ochoadiana.valdiglesias@upsjb.edu.peEfraín Cehua Álvarezecehua@gmail.comHugo Gutiérrez Crespohgutierrez@gmail.com<p>Introduction: Fear is an emotional disorder that can also manifest itself in health professionals when faced with an unknown infectious disease. This emotion can trigger depressive symptoms, ranging from discouragement, fatigue, and lack of interest to a lack of concentration. Objectives: To determine the factors associated with fear of the coronavirus in health professionals who work at the first level of care during the year 2022. Materials and methods: This study is observational, cross-sectional, and analytical. The study population consisted of 200 health professionals who work at the first level of care. A simple random probabilistic sampling was carried out. To determine the prevalence of fear towards the coronavirus, the instrument “Scale of Fear of COVID-19” was applied. To identify the factors associated with fear, the instrument of epidemiological and occupational variables was used. The data was processed using the statistical package SPSSv28. Results: A prevalence of fear of coronavirus of 72% was found, related to epidemiological factors with being female (p-value 0,021) and labor factors such as time worked (p=0,015) and access to equipment of individual protection (p-value 0,003), all with a statistically significant value. Conclusion: The factors associated with fear of the coronavirus in health professionals showed a significant impact on the female sex, in the working period of 6 to 10 years and daily access to personal protective equipment.</p>2023-12-11T00:00:00+00:00Copyright (c) 2023 https://revistascientificas.una.py/index.php/RP/article/view/3916Malignant syphilis: report of 2 cases in patients without AIDS2023-12-06T13:29:23+00:00Arnaldo Aldama Caballeroarnaldo_aldama@hotmail.comMaría Melissa Ellimelli@gmail.comCamila Montoyacmontoya@gmail.com<p>Syphilis is a multifaceted disease that always requires differential diagnoses. A rare form of<br>secondary syphilis is the so-called malignant syphilis characterized by necrotic ulcerated lesions<br>covered by thick crusts with a rupioid or ostraceous appearance. Currently observed mainly in<br>patients infected with the human immunodeficiency virus, but it was previously described in<br>other debilitating situations such as alcoholism, y malnutrition.<br>Eventually it can be seen in immunocompetent patients like the 2 cases we present.</p>2023-12-11T00:00:00+00:00Copyright (c) 2023 https://revistascientificas.una.py/index.php/RP/article/view/3917Mucocutaneous manifestations of chikungunya fever2023-12-06T13:36:47+00:00María Noemí Da Ponte Rojasdapontenoemi50@gmail.comMaría Verónica Miltos Roamvmiltos@gmail.comFátima Belén Barrios Escuderofbarrios@gmail.comRosalba Riverosrriveros@gmail.comArnaldo Aldamaaaldama@gmail.com<p>The typical manifestations of Chikungunya are fever and arthralgia in most cases, but we must remember that they present mucocutaneous manifestations, where the most frequent is rash, they can also present atypical mucocutaneous manifestations with great polymorphism simulating various dermatoses such as cases outlined above.<br>This report has 5 clinical cases from the month of January and February 2023 in the Central area of Paraguay, during the largest recorded Chikungunya epidemic in the country so far.<br>It is important to know them and correlate them with the other signs and symptoms of the disease for proper diagnosis and treatment.</p>2023-12-11T00:00:00+00:00Copyright (c) 2023 https://revistascientificas.una.py/index.php/RP/article/view/3918Acute abdomen due to torsion of greather omentun simulating acute appendicitis2023-12-06T13:51:53+00:00Agustín Rodríguez Gonzálezagustinrodriguezg@gmail.comHerald René Segovia Lohsehsegovia@gmail.comDarío Zárate Centurióndzarate@gmail.comMarina Arzamendiamarzamendia@gmail.com<p>Torsion of the greater omentum is a rare pathology with non-specific symptoms, so historically its diagnosis is made in the operating room since it simulates pathologies such as appendicitis or cholecystitis. Auxiliary diagnostic methods such as ultrasound or tomography are of very useful for the suspicion of this pathology, although it does not have pathognomonic signs of the disease, the images associated with the patient’s symptoms can lead to a precise diagnosis. We present the case of a young male patient who came to the emergency department due to moderately intense colic-like abdominal pain in the right iliac fossa, accompanied by a feverish sensation, without alterations in blood tests, without any finding of value in the abdominal ultrasound, due to the persistence of pain and fever, a contrast-enhanced tomography was performed in which a filling of the omentum was observed, undergoing an exploratory laparoscopy with the discovery of a torsion of the greater omentum.</p>2023-12-11T00:00:00+00:00Copyright (c) 2023 https://revistascientificas.una.py/index.php/RP/article/view/3932Training physicians for the 21st century: The crucial role of competency-based education2023-12-11T11:57:30+00:00Fernando Ramos Zagafernando.ramos@upn.edu.pe<p>Throughout history, the field of medicine has adapted to the changing needs of society and the healthcare system. Faced with this situation, the need arises to consider the transformation of medical education through a competency-based approach and thus define the profile of a physician for the 21st century. The aim of this article is to analyze the role of competency-based training in medical education and its impact on the preparation of medical students. To this end, an exhaustive literature review has been carried out in which the key concepts of competency-based medical education are analyzed. The results highlight the importance of integrating skills development in medical education taking into account social and cultural factors, as well as encouraging critical reflection in medical education. It is concluded that medical education must adapt to the changing demands of the field, involving diverse stakeholders and evolving teaching methods.</p>2023-12-11T00:00:00+00:00Copyright (c) 2023 https://revistascientificas.una.py/index.php/RP/article/view/3920Neurotoxic impact of glyphosate on the development of Autism Spectrum Disorders2023-12-06T14:15:03+00:00Patricia Rojas Avellanedapatriciaravellaneda@gmail.comSasha Barrios Healeysbarrios@gmail.comJosé Vela Ruizjvela@gmail.com<p>Glyphosate (Roundup TM) is an acid<br>in salt form used as a herbicide<br>broad-spectrum systemic, being effective<br>and economic field was opened in agriculture<br>and world horticulture, developing<br>genetic varieties resistant to its use and<br>increasing exposure to soil, air and<br>water, although it is only aimed at plants,<br>fungi and bacteria, in recent times<br>have discovered health repercussions<br>human, from reproductive alterations,<br>endocrinological, even neuronal defects<br>that predispose spectrum disorders<br>autistic (ASD).</p>2023-12-11T00:00:00+00:00Copyright (c) 2023 https://revistascientificas.una.py/index.php/RP/article/view/3929Psychotic disorders in Paraguay: Are there any significant differences between urban and rural areas?2023-12-11T10:34:28+00:00Eliana Ayala Veraeayalav@gmail.comJuan José Balbuena Díazjjbalbuena@gmail.comJorge Javier Cano Fernándezjcano@gmail.comEsteban Daniel Encina Rodríguezedencina@gmail.comMarco Antonio Mancuello Mallorquínmamancuello@gmail.comFanny Giselle Ramos Galeanofgramos@gmail.comMarcelo Gerardo O’Higginsmgohiggins@gmail.comDiego Amarilla Salvionidamarillas@gmail.comIván Barrios Coronelbivan@gmail.comJulio César Toralesjtorales@fcmuna.edu.py<p>Currently there is a global trend of displacement of the rural population towards increasingly urbanized areas.</p> <p>There is evidence that the development of mental illnesses has an important relationship with both internal (for example, genetic) and external (environment, among others) factors. Regarding the latter, the way in which the environment affects mental health is an object of study of global interest and it has been reported that urban areas have higher rates of common mental disorders compared to rural areas. In the case of psychosis, although the genetic factor is the most proven (and studied in recent years), the environmental factor represented by the urban environment has already been analyzed by researchers at the beginning of the 20th century.</p>2023-12-11T00:00:00+00:00Copyright (c) 2023 https://revistascientificas.una.py/index.php/RP/article/view/3930Urban violence and mental health of young adults in Paraguay2023-12-11T11:20:59+00:00María Belén Aquino Aguilerambaquino@gmail.comMaría Cristina Limousin Trinidadmclimousin@gmail.comSusana Beatriz Quiñonez Quiñonezsquiñonez@gmail.comMariam Magdalena Castello Martínezmcastello@gmail.comSara Johana González Olmedosgonzalez@gmail.comLiz Graciela Bergottini Maldonadolbergottini@gmail.comÁngel Gustavo Cristaldo Castilloacristaldo@gmail.comLuz Romina Noemí Guanes Escobarlguanes@gmail.comEstela Marilyn Ramírez Armoaeramirez@gmail.comJosé Luis Villalba Benítezjlvillalba@gmail.comMarcelo Gerardo O’Higginsmgohiggins@gmail.comDiego Amarilla Salvionidamarillas@gmail.comIván Barrios Coronelibarrios@gmail.comJulio César Toralesjtorales@fcmuna.edu.py<p>Globally, urban violence has become a major public health concern. Research highlights that violence is a significant risk factor for the mental health of individuals. Exposure to traumatic events related to urban violence, such as assaults, robberies, or interpersonal violence, can have serious mental health consequences. In the continental context, Latin America has been especially affected by urban violence. Epidemiological studies in Latin American countries have shown that urban violence is associated with an increased risk of anxiety, stress and depression disorders in young and adult populations.</p>2023-12-11T00:00:00+00:00Copyright (c) 2023 https://revistascientificas.una.py/index.php/RP/article/view/3907ANALES of the Faculty of Medical Sciences: Evolution, pauses and projection in the scientific field2023-12-06T10:54:31+00:00Hassel Jimmy Jiménezhasseljimenez@gmail.com<p>Almost four decades after the creation of the Faculty of Medical Sciences, FCM, the journal ANALES appeared as a scientific organ, in August 1927. It emerged intending to document the progress of academic and scientific production. An important effort was emphasized in the organization of research resources as well as support for the evolution of laboratories and technical-clinical services.</p>2023-12-11T00:00:00+00:00Copyright (c) 2023