Medicina Clínica y Social
type: channel
description: 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.
publisher: Cátedra de Socioantropología, Facultad de Ciencias Médicas - Filial Santa Rosa del Aguaray (Universidad Nacional de Asunción)
language: en
publication name: Medicina Clínica y Social
issn: 2521-2281
items: Implications of new diagnostic criteria for obesity on mental health comorbidities
items: Coverage, missed opportunities and reasons for not vaccinating children under 5 years of age in Paraguay
items: Nutritional Status of Patients with Chronic Kidney Disease undergoing Hemodialysis
items: Patients’ Knowledge and Habits Regarding Diabetic Foot Prevention Measures: Polyclinic of a Private University, Asunción, Paraguay, 2024
items: Knowledge and Compliance of Mothers of Children Under 5 Years Regarding the Vaccination Schedule: San Expedito Settlement, Paraguay, 2024
items: Susceptibility of Healthcare Professionals to Vaccine-Preventable Diseases: Critical Care Unit, Hospital de Clínicas, San Lorenzo-Paraguay 2021
items: https://medicinaclinicaysocial.org/index.php/MCS/en/article/view/576
items: Patterns and Trends of Antimicrobial Resistance in Staphylococcus aureus Isolated in a Private Laboratory in Paraguay from 2020 to 2024
items: Gender gap in pharmacological reperfusion and outcomes of ST-elevation acute myocardial infarction: Paraguayan cohort 2019–2023.
items: Difficult treatment of superinfected with pseudomonas aeruginosa verrucous leishmaniasis
items: Beyond the Rash: The Neuropsychiatric Impact of Measles and the Urgency of Prevention
items: Evaluation of an educational intervention on arbovirus prevention at basic school no. 1973 "Costa Alegre" in the city of Coronel Oviedo, year 2024.
items: Discrimination capacity of the pirate test to detect vision disorders in preschool children
items: Long-term effects of childhood abuse on mental health and delinquent behavior in adulthood: A systematic review
items: Acute myeloid leukemia with NPM1, IDH1 and IDH2 mutations in Paraguayan patients
items: Assessment of the risk of developing Type 2 Diabetes Mellitus through the Findrisc Test in Villa Mano Abierta, Central - Paraguay 2024
items: Microbiological quality of community water from tanks, wells, and sanitation companies
items: Aesthetic Medicine and Public Health: a necessary reflection
items: Choroidal neovascularization by active ocular toxoplasmosis: a case report
items: Professional exhaustion syndrome in health personnel of a public hospital in the Department of Ñeembucu
items: Clinical characteristics and frequency of autoantibodies in patients with Systemic Lupus Erythematosus who attend the National Hospital in the period 2018 -2023
items: Perception of Loneliness and Self-Esteem as Predictors of Mental Health in Adults: A Study in a South American Country
items: The Distance to Mental Health Services and the Use of Public Transportation: A Challenge for Timely Care
items: Consumption of prebiotics and probiotics and their relationship with the presence of metabolic syndrome and/or associated risk markers in ambulatory patients
items: Anxiety in health personnel of the Hospital of the Ministry of Health during the COVID-19 pandemic in the Southern Region of Peru
items: A Adaptation and translation of the Psy-Flex in university students in Lima Metropolitana
items: Hantavirus in pediatrics: Three forms of presentation
items: Epidemiological concepts and arrhythmogenic mechanisms in patients with atrial fibrillation
items: Epidemiological situation of congenital anomalies in Paraguay in the period 2017-2021
items: Comparative analysis of neuroretinal alterations between patients with type 2 diabetes mellitus without evidence of diabetic retinopathy and a healthy control group

Implications of new diagnostic criteria for obesity on mental health comorbidities
type: item
description: 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.
subject: Editorial
  topic: section
creator: Julio Torales
creator: Marcelo O'Higgins
creator: Tomás Caycho-Rodríguez
creator: Antonio Ventriglio
creator: João Mauricio Castaldelli-Maia
creator: Iván Barrios
rights: 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
date: 2026-02-01
publication date: 2026-02-01
starting page: e767
ending page: e767
doi: 10.52379/mcs.v10.767

Coverage, missed opportunities and reasons for not vaccinating children under 5 years of age in Paraguay
type: item
description: 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.
subject: Original Articles
  topic: section
subject: vaccination
  topic: keywords
subject: vaccination coverage
  topic: keywords
subject: delay in vaccination
  topic: keywords
subject: children
  topic: keywords
subject: parents
  topic: keywords
subject: Paraguay
  topic: keywords
creator: Ivonne Montiel
creator: Andrea Ferloni
creator: Silvia Gómez
creator: Mónica Arellano
creator: Miryam Soliz
creator: Rossanna Prado
creator: Claudia Barrios
creator: Lorena Romero
creator: Adriana Benítez
creator: Lina Molina
creator: Margarita Samudio
creator: Águeda Cabello
rights: 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
date: 2026-02-01
publication date: 2026-02-01
starting page: e578
ending page: e578
doi: 10.52379/mcs.v10.578

Nutritional Status of Patients with Chronic Kidney Disease undergoing Hemodialysis
type: item
description: 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
subject: Original Articles
  topic: section
subject: Hemodialysis
  topic: keywords
subject: Nutrional status
  topic: keywords
subject: Body mass index
  topic: keywords
subject: Chronic kidney disease
  topic: keywords
subject: anthropometry
  topic: keywords
creator: Igor Ernesto Marcet Franco
creator: Juan Daniel Acosta González
creator: Claudia Patrícia Quintana
creator: Edis Emanuel Ortigoza
creator: Jazmín Barrios
creator: Patricia Ríos Mujica
rights: 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
date: 2025-09-24
publication date: 2025-09-24
starting page: e712
ending page: e712
doi: 10.52379/mcs.v9.712

Patients’ Knowledge and Habits Regarding Diabetic Foot Prevention Measures: Polyclinic of a Private University, Asunción, Paraguay, 2024
type: item
description: 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.
subject: Original Articles
  topic: section
subject: Knowledge
  topic: keywords
subject: habits
  topic: keywords
subject: diabetic foot
  topic: keywords
creator: Igor Ernesto Marcet Franco
creator: Clara Margarita Cáceres Bogado
creator: María Belén Giménez Reyes
creator: Ema Soledad Maidana Pont
creator: Jazmín Barrios
creator: Patricia Ríos Mujica
rights: 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
date: 2025-09-24
publication date: 2025-09-24
starting page: e710
ending page: e710
doi: 10.52379/mcs.v9.710

Knowledge and Compliance of Mothers of Children Under 5 Years Regarding the Vaccination Schedule: San Expedito Settlement, Paraguay, 2024
type: item
description: 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
subject: Original Articles
  topic: section
subject: Schedule
  topic: keywords
subject: vaccination
  topic: keywords
subject: immunization
  topic: keywords
subject: mothers
  topic: keywords
subject: children
  topic: keywords
creator: Fidelina Portillo Villalba
creator: Arturo Silva Estigarribia
creator: Anyelo David Romero Vallejos
creator: María Isabel Rodríguez-Riveros
rights: Copyright (c) 2025 Fidelina Portillo Villalba, Arturo Silva Estigarribia, Anyelo David Romero Vallejos, María Isabel Rodríguez-Riveros https://creativecommons.org/licenses/by/4.0
date: 2025-09-24
publication date: 2025-09-24
starting page: e709
ending page: e709
doi: 10.52379/mcs.v9.709

Susceptibility of Healthcare Professionals to Vaccine-Preventable Diseases: Critical Care Unit, Hospital de Clínicas, San Lorenzo-Paraguay 2021
type: item
description: 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
subject: Original Articles
  topic: section
subject: Vaccine
  topic: keywords
subject: Healthcare professional
  topic: keywords
subject: Susceptibility
  topic: keywords
creator: Arturo Yvan Silva Estigarribia
creator: María Isabel Rodríguez-Riveros
rights: Copyright (c) 2025 Arturo Yvan Silva Estigarribia, María Isabel Rodríguez-Riveros https://creativecommons.org/licenses/by/4.0
date: 2025-09-24
publication date: 2025-09-24
starting page: e708
ending page: e708
doi: 10.52379/mcs.v9.708

https://medicinaclinicaysocial.org/index.php/MCS/en/article/view/576
type: item
title: 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
description: 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.
subject: Original Articles
  topic: section
subject: Diabetes mellitus
  topic: keywords
subject: educational intervention
  topic: keywords
subject: level of knowledge
  topic: keywords
subject: lifestyle
  topic: keywords
subject: metabolic control
  topic: keywords
subject: adherence to treatment
  topic: keywords
creator: Luciana Echeverría Acosta
creator: Lorena Elizabeth Giménez
creator: Miguela Ruiz Romero
creator: Eva Natalia Giménez Legal
creator: Ignacio Ortiz Galeano
rights: 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
date: 2025-11-06
publication date: 2025-11-06
starting page: e576
ending page: e576
doi: 10.52379/mcs.v9.576

Patterns and Trends of Antimicrobial Resistance in Staphylococcus aureus Isolated in a Private Laboratory in Paraguay from 2020 to 2024
type: item
description: 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
subject: Original Articles
  topic: section
subject: Staphylococcus aureus
  topic: keywords
subject: Methicillin resistance
  topic: keywords
subject: Multidrug Resistance
  topic: keywords
creator: Julio César Barrios Leiva
creator: Margarita Samudio Acevedo
creator: Rosa María Guillén Fretes
creator: Norma Fariña
creator: Ana Vega
creator: Alicia Pereira Fariña
creator: Fátima Rodríguez Acosta
rights: 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
date: 2025-12-08
publication date: 2025-12-08
starting page: e598
ending page: e598
doi: 10.52379/mcs.v9.598

Gender gap in pharmacological reperfusion and outcomes of ST-elevation acute myocardial infarction: Paraguayan cohort 2019–2023.
type: item
description: 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 s…
subject: Original Articles
  topic: section
subject: Myocardial infarction
  topic: keywords
subject: Reperfusion
  topic: keywords
subject: Gender equity
  topic: keywords
creator: José Ortellado
creator: Graciela González
creator: Gabriel Gaona Figueredo
creator: Angel Ricardo Rolón Ruiz Diaz
creator: Marta Ferreira Gaona
rights: 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
date: 2025-10-06
publication date: 2025-10-06
starting page: e701
ending page: e701
doi: 10.52379/mcs.v9.701

Difficult treatment of superinfected with pseudomonas aeruginosa verrucous leishmaniasis
type: item
description: 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.
subject: Case Reports
  topic: section
subject: verrucous leishmaniasis; tegumentary leishmaniasis; therapeutic; cryotherapy
  topic: keywords
creator: Beatriz Di Martino
creator: Zulema Alexandra Celeste Valiente Rebull
creator: Maria Lorena Re Dominguez
creator: Lourdes Bolla
creator: Mirtha Rodriguez Masi
creator: Oilda Knopfelmacher
rights: 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
date: 2025-09-01
publication date: 2025-09-01
starting page: e692
ending page: e692
doi: 10.52379/mcs.v9.692

Beyond the Rash: The Neuropsychiatric Impact of Measles and the Urgency of Prevention
type: item
description: 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?
subject: Letter to the Editor
  topic: section
creator: Julio Torales
creator: Gladys Estigarribia
creator: Guillermo Sequera
rights: Copyright (c) 2025 Julio Torales, Gladys Estigarribia, Guillermo Sequera https://creativecommons.org/licenses/by/4.0
date: 2025-08-11
publication date: 2025-08-11
starting page: e682
ending page: e682
doi: 10.52379/mcs.v9.682

Evaluation of an educational intervention on arbovirus prevention at basic school no. 1973 "Costa Alegre" in the city of Coronel Oviedo, year 2024.
type: item
description: 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
subject: Original Articles
  topic: section
subject: Arbovirosis
  topic: keywords
subject: educational intervention
  topic: keywords
subject: prevention
  topic: keywords
creator: Patricia Ríos Mujica
creator: Catalina Elizabeth Segovia Barboza
creator: Gladys Mercedes Estigarribia Sanabria
creator: Julieta Méndez
creator: Guiomar Viveros de Cabello
creator: Gloria González
creator: Deisy Galeano
rights: 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
date: 2025-09-26
publication date: 2025-09-26
starting page: e645
ending page: e645
doi: 10.52379/mcs.v9.645

Discrimination capacity of the pirate test to detect vision disorders in preschool children
type: item
description: 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.
subject: Original Articles
  topic: section
subject: Screening
  topic: keywords
subject: vision disorders
  topic: keywords
subject: amblyopia
  topic: keywords
subject: preschool
  topic: keywords
creator: Jenny Kam Lin Ku Lozano
creator: Jorge Enrique Osada Liy
creator: Eduardo Maron Ku Lu
creator: Maria Esther Lozano Ponce
creator: Margarita Samudio
rights: 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
date: 2025-09-26
publication date: 2025-09-26
starting page: e600
ending page: e600
doi: 10.52379/mcs.v9.600

Long-term effects of childhood abuse on mental health and delinquent behavior in adulthood: A systematic review
type: item
description: 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.
subject: Original Articles
  topic: section
subject: Childhood abuse
  topic: keywords
subject: mental health
  topic: keywords
subject: delinquent behavior
  topic: keywords
subject: systematic review
  topic: keywords
subject: long-term impact
  topic: keywords
creator: Thaís Puente-Ortega
creator: Rodrigo Moreta-Herrera
creator: Julio Torales
rights: Copyright (c) 2025 Thaís Puente-Ortega, Rodrigo Moreta-Herrera, Rocío Játiva, Julio Torales https://creativecommons.org/licenses/by/4.0
date: 2025-06-04
publication date: 2025-06-04
starting page: e568
ending page: e568
doi: 10.52379/mcs.v9.568

Acute myeloid leukemia with NPM1, IDH1 and IDH2 mutations in Paraguayan patients
type: item
description: 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.
subject: Original Articles
  topic: section
subject: Acute Myeloid leukemia
  topic: keywords
subject: NPM1
  topic: keywords
subject: IDH1
  topic: keywords
subject: IDH2
  topic: keywords
subject: molecular diagnosis
  topic: keywords
creator: Lady Franco-Benegas
creator: Maria Paz Mujica
creator: Valerie Jolly
creator: Victor Salinas
creator: Jose Zarza
creator: Diana Gonzalez
creator: Denisse Di Tore
creator: Laura Morel
creator: Juan Jose Bogado
creator: Monica Labrano
creator: Samadi Leiva
creator: José Manuel Ovando
creator: Rodrigo Santacruz
creator: Miguel Britez
creator: Ana Ilda Ayala-Lugo
rights: 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
date: 2025-09-10
publication date: 2025-09-10
starting page: e591
ending page: e591
doi: 10.52379/mcs.v9.591

Assessment of the risk of developing Type 2 Diabetes Mellitus through the Findrisc Test in Villa Mano Abierta, Central - Paraguay 2024
type: item
description: 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.
subject: Original Articles
  topic: section
subject: Diabetes mellitus
  topic: keywords
subject: glycemia
  topic: keywords
subject: risk factor
  topic: keywords
subject: Findrisc test
  topic: keywords
creator: Luciana Echeverria Acosta
creator: María Beatriz Ojeda
creator: Lorena Beatriz Jara
creator: Carlos Fabián Ayala
creator: Nancy Carolina Cuevas
creator: María Pastora Duarte
creator: María Teresa Duarte
creator: Laura María Riquelme
creator: Liliana Soledad Ayala
creator: Lorena Romero
creator: Rosa Alicia Galeano
creator: Margarita Samudio
rights: 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
date: 2025-12-08
publication date: 2025-12-08
starting page: e574
ending page: e574
doi: 10.52379/mcs.v9.574

Microbiological quality of community water from tanks, wells, and sanitation companies
type: item
description: 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
subject: Original Articles
  topic: section
subject: drinking water, antibacterials, heterotrophic bacteria, sanitation
  topic: keywords
creator: Cristel Kennedy
creator: Gladys Estigarribia
creator: Luz Paredes
creator: Ahabeli Espinola
creator: Camila Mino
creator: Maria Cano
creator: Marian Cárdenas
creator: Eliana Rodriguez
creator: José Robadin
rights: 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
date: 2025-09-01
publication date: 2025-09-01
starting page: e644
ending page: e644
doi: 10.52379/mcs.v9.644

Aesthetic Medicine and Public Health: a necessary reflection
type: item
description: 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.
subject: Letter to the Editor
  topic: section
subject: Salud pública
  topic: keywords
creator: Carlos Miguel Rios-González
rights: Copyright (c) 2026 Carlos Miguel Rios-González https://creativecommons.org/licenses/by/4.0
date: 2026-02-09
publication date: 2026-02-09
starting page: e643
ending page: e643
doi: 10.52379/mcs.v10.643

Choroidal neovascularization by active ocular toxoplasmosis: a case report
type: item
description: 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.
subject: Case Reports
  topic: section
subject: Coroidal neovascularization
  topic: keywords
subject: treatment
  topic: keywords
subject: ocular toxoplamosis
  topic: keywords
subject: antiVEGF
  topic: keywords
creator: Jenny Kam Lin Ku Lozano
creator: Charles Gino Conde Obregon
creator: Eduardo Maron Ku Lu
creator: Margarita Samudio
rights: 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
date: 2025-09-25
publication date: 2025-09-25
starting page: e592
ending page: e592
doi: 10.52379/mcs.v9.592

Professional exhaustion syndrome in health personnel of a public hospital in the Department of Ñeembucu
type: item
description: 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.
subject: Original Articles
  topic: section
subject: agotamiento profesional
  topic: keywords
subject: personal de salud
  topic: keywords
subject: burnout
  topic: keywords
creator: Alejandra Argüello
creator: Vanessa Meaurio
creator: Alicia Saucedo
creator: Sofia Barboza
creator: Ángel Rolón Ruiz Díaz
rights: Copyright (c) 2025 Alejandra Argüello, Vanessa Meaurio, Alicia Saucedo, Sofia Barboza, Ángel Rolón Ruiz Díaz https://creativecommons.org/licenses/by/4.0
date: 2025-06-04
publication date: 2025-06-04
starting page: e601
ending page: e601
doi: 10.52379/mcs.v9.601

Clinical characteristics and frequency of autoantibodies in patients with Systemic Lupus Erythematosus who attend the National Hospital in the period 2018 -2023
type: item
description: 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 autoant…
subject: Original Articles
  topic: section
subject: Systemic lupus erythematosus
  topic: keywords
subject: autoantibodies
  topic: keywords
subject: clinical manifestations
  topic: keywords
creator: Luis Fernando Sánchez
creator: Dora Montiel-Jarolin
creator: Magali Jarolin Montiel
creator: Margarita Samudio
rights: Copyright (c) 2025 Luis Fernando Sánchez, Dora Montiel-Jarolin, Magali Jarolin Montiel, Margarita Samudio https://creativecommons.org/licenses/by/4.0
date: 2025-12-08
publication date: 2025-12-08
starting page: e577
ending page: e577
doi: 10.52379/mcs.v9.577

Perception of Loneliness and Self-Esteem as Predictors of Mental Health in Adults: A Study in a South American Country
type: item
description: 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.
subject: Original Articles
  topic: section
subject: Self-esteem
  topic: keywords
subject: adults
  topic: keywords
subject: predictors
  topic: keywords
subject: mental health
  topic: keywords
subject: loneliness perception
  topic: keywords
creator: Lourdes Maribel Chango Velva
creator: Rodrigo Moreta-Herrera
creator: Rocío Játiva
creator: Julio Torales
rights: Copyright (c) 2025 Lourdes Maribel Chango Velva, Rodrigo Moreta-Herrera, Rocío Játiva, Julio Torales https://creativecommons.org/licenses/by/4.0
date: 2025-02-19
publication date: 2025-02-19
starting page: e567
ending page: e567
doi: 10.52379/mcs.v9.567

The Distance to Mental Health Services and the Use of Public Transportation: A Challenge for Timely Care
type: item
description: 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 whe…
subject: Editorial
  topic: section
creator: Julio Torales
creator: Mainor Márquez
creator: Iván Barrios
rights: Copyright (c) 2025 Julio Torales, Mainor Márquez, Iván Barrios https://creativecommons.org/licenses/by/4.0
date: 2025-02-18
publication date: 2025-02-18
starting page: e566
ending page: e566
doi: 10.52379/mcs.v9.566

Consumption of prebiotics and probiotics and their relationship with the presence of metabolic syndrome and/or associated risk markers in ambulatory patients
type: item
description: 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.
subject: Original Articles
  topic: section
subject: Palabras claves: Síndrome Metabólico – Factores de riesgo asociados al Síndrome Metabólico – Prebióticos – Probióticos.
  topic: keywords
creator: Clarisse María Luz Balbuena
creator: Diego Báez Torres
creator: María Eugenia Ruíz Díaz
creator: Misael Pintos Belloto
creator: Erdulfo J. Galeano
creator: Giannina Vittone Méndez
creator: Marta Jazmín Duarte Herrera
creator: María Noel Luccini Aguilera
creator: Osmar Centurión
rights: 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
date: 2025-03-25
publication date: 2025-03-25
starting page: e559
ending page: e559
doi: 10.52379/mcs.v9.559

Anxiety in health personnel of the Hospital of the Ministry of Health during the COVID-19 pandemic in the Southern Region of Peru
type: item
description: 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.
subject: Original Articles
  topic: section
subject: Anxiety
  topic: keywords
subject: COVID-19
  topic: keywords
subject: healthcare workers
  topic: keywords
subject: pandemic
  topic: keywords
creator: Agueda Muñoz-del-Carpio-Toia
creator: Yury Merma Barazorda
creator: Walter L. Arias Gallegos
creator: Lucía Begazo-Muñoz-del-Carpio
creator: Francesca Diaz Del Olmo Calvo
creator: Renzo Rivera
creator: Patricio Diaz Del Olmo Calvo
creator: Paulina Patricia Valdivia Carazas
creator: Magly Liesbeth Larico
creator: Tomás Caycho-Rodríguez
rights: 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
date: 2025-09-03
publication date: 2025-09-03
starting page: e554
ending page: e554
doi: 10.52379/mcs.v9.554

A Adaptation and translation of the Psy-Flex in university students in Lima Metropolitana
type: item
description: 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.
subject: Original Articles
  topic: section
subject: Psychometrics
  topic: keywords
subject: Acceptance and Commitment Therapy
  topic: keywords
subject: Clinical Psychology
  topic: keywords
subject: Perú
  topic: keywords
subject: Students
  topic: keywords
creator: Pedro Luis Arroyo Pizarro
creator: Gonzalo Peña-Muñante
creator: Margot Osorio Chipana
creator: Esteban Moreno-Montero
rights: Copyright (c) 2025 Pedro Luis Arroyo Pizarro, Gonzalo Peña-Muñante, Margot Osorio Chipana, Esteban Moreno-Montero https://creativecommons.org/licenses/by/4.0
date: 2025-08-18
publication date: 2025-08-18
starting page: e549
ending page: e549
doi: 10.52379/mcs.v9.549

Hantavirus in pediatrics: Three forms of presentation
type: item
description: 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.
subject: Case Reports
  topic: section
subject: Hantavirus
  topic: keywords
subject: Síndrome cardiopulmonar
  topic: keywords
subject: Fiebre hemorrágica
  topic: keywords
creator: Gloria Celeste Samudio Domínguez
creator: Natalia Berenice Ortega Gaona
creator: Patrick Guillerme Da Silva Sandy
creator: Dalila Recalde Sckell
creator: Lorena Quintero
rights: 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
date: 2025-02-21
publication date: 2025-02-21
starting page: e541
ending page: e541
doi: 10.52379/mcs.v9.541

Epidemiological concepts and arrhythmogenic mechanisms in patients with atrial fibrillation
type: item
description: Many fundamental aspects of atrial fibrillation (AF) have been little known until a few years ago, and there are several features in AF mechanisms that hinder their proper evaluation. Various external factors induce a slow but progressive process of structural remodeling in the atria. Fibroblast activation, increased connective tissue deposits and fibrosis are the most important elements of this process. The structural remodeling produces an electrical dissociation between the muscle bundles and heterogeneity of the local conduction that favors the phenomenon of reentry and the perpetuation of the arrhythmia. All localized sources of AF, such as ectopic foci, rotors and other stable reentry circuits, cause non-homogeneous and anisotropic conduction away from the source. This conduction is difficult to differentiate from the propagation of multiple waves that the AF maintains, and any of these phenomena can generate rotors detected in intracardiac recordings. The mechanism of focal activity by a source in the pulmonary veins can trigger episodes of AF due to both the triggered activity and the localized reentry mechanism. Patients with a history of AF that in sinus rhythm have an alteration of the P wave morphology and dispersion of the P wave in the ECG have a high susceptibility to develop sustained AF and generally have abnormally prolonged and fractionated atrial electrograms. Additionally, they have a longer P wave duration, and a significantly longer intraauricular and interatrial conduction time of sinus impulses; and a higher incidence of sustained AF induction.
subject: Review Articles
  topic: section
subject: Atrial fibrillation
  topic: keywords
subject: Abnormal Atrial Electrograms
  topic: keywords
subject: Rotors
  topic: keywords
creator: Orlando Robert Sequeira
creator: Laura Beatriz García
creator: Christian Osmar Chávez
creator: Rocío del Pilar Falcón
creator: Alfredo Javier Meza
creator: Osmar Centurión
rights: Copyright (c) 2025 Orlando Robert Sequeira, Laura Beatriz García, Christian Osmar Chávez, Rocío del Pilar Falcón, Alfredo Javier Meza, Osmar Centurión https://creativecommons.org/licenses/by/4.0
date: 2025-02-26
publication date: 2025-02-26
starting page: e529
ending page: e529
doi: 10.52379/mcs.v9.529

Epidemiological situation of congenital anomalies in Paraguay in the period 2017-2021
type: item
description: Introduction: Congenital anomalies (CA) are structural or functional defects that occur during fetal development and are detected before, during or after birth. They represent an important public health problem due to their contribution to neonatal morbidity and mortality. Objective: To analyze the epidemiological situation of congenital anomalies in Paraguay from 2017-2021, in terms of prevalence and mortality using public data. Methods: Ecological study with data obtained from the digital platform of the Vital Statistics Computer Subsystem (SSIEV) and the Latin American Network of Congenital Malformations (ReLAMC) for the period 2017-2021. Results: Data from 273,239 births were analyzed, cardiac and large vessel anomalies were the most prevalent, accounting for 64% of all CAs. In terms of mortality, 2090 of 2639 deaths occurred in the first 11 months of life. The Central department had the highest frequency of deaths related to CA, with 881 deaths, representing 33.38% of the total. Conclusion: Congenital anomalies, particularly those related to heart defects, represent an important cause of morbidity and mortality in Paraguay. The most affected population was the pediatric population, and a high prevalence of heart and ear defects was observed. These results highlight the need to improve diagnostic and treatment capacities to reduce mortality associated to congenital anomalies.
subject: Original Articles
  topic: section
subject: Congenital anomalies
  topic: keywords
subject: congenital heart diseases
  topic: keywords
subject: Paraguay
  topic: keywords
creator: Sara Aguilar-Coronel
creator: Florencia del Puerto
creator: Moisés Ó. Fiesco-Roa
creator: Juan Mereles
creator: Margarita Samudio
rights: Copyright (c) 2025 Sara Aguilar-Coronel, Florencia del Puerto, Moisés Ó. Fiesco-Roa, Juan Mereles, Margarita Samudio https://creativecommons.org/licenses/by/4.0
date: 2025-02-20
publication date: 2025-02-20
starting page: e523
ending page: e523
doi: 10.52379/mcs.v9.523

Comparative analysis of neuroretinal alterations between patients with type 2 diabetes mellitus without evidence of diabetic retinopathy and a healthy control group
type: item
description: Introduction: Type 2 Diabetes Mellitus (T2DM) causes insulin resistance and can lead to complications like Diabetic Retinopathy (DR), affecting vision. Optical Coherence Tomography (OCT) enables early detection. Objective: The study aimed to compare neuroretinal alterations between patients with Type 2 Diabetes Mellitus (T2DM) without evidence of Diabetic Retinopathy (DR) and a healthy control group. Methodology: The study included 220 eyes from 110 patients with T2DM without DR and 220 eyes from 110 healthy controls. Detailed interviews, comprehensive ophthalmologic evaluations, and Optical Coherence Tomography (OCT) were used to measure the thickness of the retinal nerve fiber layer (RNFL) and the ganglion cell-inner plexiform layer (GC-IPL). Results: Patients with T2DM showed significant thinning of the RNFL and GC-IPL compared to healthy controls. The average RNFL thickness in T2DM patients was 92.89 ± 7.87 µm, while in controls it was 97.28 ± 11.1 µm (p < 0.001). The GC-IPL thickness in T2DM patients was 80.03 ± 3.58 µm, compared to 81.09 ± 4.09 µm in controls (p < 0.001). Conclusion: There are significant differences in retinal layers between patients with T2DM without evidence of DR and healthy controls. These findings highlight the importance of early and continuous retinal monitoring in T2DM patients to prevent the progression of DR.
subject: Original Articles
  topic: section
subject: Diabetes mellitus tipo 2
  topic: keywords
subject: Retinopatía Diabética
  topic: keywords
subject: Tomografía de coherencia óptica
  topic: keywords
subject: capa de fibras nerviosas retinianas
  topic: keywords
subject: complejo células ganglionares-plexiforme interna
  topic: keywords
creator: Rubén Darío Picco Pérez
creator: Guillermo Raúl Vera Duarte
creator: Sara Fernández
creator: Verónica Elisa Castillo Benitez
creator: Martín Fernando Arrúa Caballero
creator: Luis González-Sanabria
rights: Copyright (c) 2025 Rubén Darío Picco Pérez , Guillermo Raúl Vera Duarte, Sara Fernández , Verónica Elisa Castillo Benitez, Martín Fernando Arrúa Caballero, Luis González-Sanabria https://creativecommons.org/licenses/by/4.0
date: 2025-02-27
publication date: 2025-02-27
starting page: e496
ending page: e496
doi: 10.52379/mcs.v9.496