La Organización Mundial de la Salud cataloga a mujeres, lactantes, niños y adolescentes como los principales expuestos a la malnutrición. En Ecuador según la Encuesta Nacional de Salud y Nutrición del año 2018 la prevalencia de sobrepeso y obesidad en escolares es del 35.4%. Determinar el rendimiento académico y su relación con el estado nutricional en escolares de la Unidad Educativa del Milenio Sayausí de la ciudad de Cuenca-Ecuador, en el periodo lectivo septiembre de 2022 julio de 2023.Estudio observacional, analítico y de corte transversal. Universo finito, conformado por 960 escolares de la Unidad Educativa del Milenio Sayausí. Tamaño muestral 530 participantes aleatorizados calculado por la fórmula de Fisher y Navarro, mediante criterios de inclusión y exclusión. Los datos fueron anonimizados y codificados. La información se analizó a través de la herramienta estadística SPSS, obteniendo tablas para llegar a una conclusión. La media de edad de la población fue de 8,84 años; El 50,6% fueron hombres y el 49,4% mujeres; 47,2% tiene estrato socio-económico III; El 42,8% de los participantes domina los aprendizajes requeridos; El 8,7% presentó desnutrición, el 12,3% obesidad y el 16,6% sobrepeso, representando 37,5% de malnutrición. Se encontró asociación estadísticamente significativa entre rendimiento académico y estado nutricional OR 1,60 (IC95%:1,12-2,30) y el valor p = 0,011. Se encontró asociación estadísticamente significativa entre el rendimiento académico y el estado nutricional de los escolares de la Unidad Educativa del Milenio Sayausí. Recomendamos implementar plan preventivo para estudiantes y comunidad en general para brindar información nutricional.

BACKGROUND: PIMS/MIS-C involves an innate immune response of the host against a trigger, in this case a virus, which causes hyperinflammation induced by a cytokine storm; this immune response is responsible for the systemic clinical manifestations and cardiac complications. The syndrome has been diagnosed usually between 2 and 6 weeks after infection by SARS-CoV-2; however, many patients have negative PCR (polymerase chain reaction) tests for the virus and positive immunoglobulin tests, suggesting that the syndrome appears in the early stages of convalescence from COVID-19. CASE REPORT: A 15-year-old female patient, previously healthy, with a history of close contact with a relative with COVID-19 confirmed by PCR 15 days before the onset of symptoms. He presented a 5-day history of fever, vomiting, and diarrheal stools; 48 hours later she presented with generalized asthenia, hyporexia and epistaxis. We evidenced elevation of immunoglobin G against SARS-COV-2 and negative PCR. In complementary tests, we evidenced elevation of inflammatory markers (CRP, procalcitonin, ferritin, D-dimer) and BNP; the echocardiogram revealed a condensation process in the pericardium, as well as coronary ectasia. Evolution: After confirming the diagnosis of PIMS/MIS-C, we started treatment with immunoglobulin, prednisone, and acetylsalicylic acid. On the fourth day of hospitalization, she presented diaphoresis and moderate pain in the epigastric region that did not subside; Abdominal CT revealed signs of mesenteric adenitis, which reconfirmed the proposed diagnosis. After completing 72 hours of treatment, and being evaluated again, she was discharged. We prescribed continuance of prednisone treatment and acetylsalicylic acid and 500 milligrams of amoxicillin orally every 8 hours. In addition, we recommended follow-up by the cardiology service one week after hospital discharge. The patient remains without complications after this episode. CONCLUSION: The diagnostic suspicion of PIMS/MIS-C must be present in all patients with characteristic symptoms, under the age of 20 years, with a history of contact with a positive COVID-19 patient and who in most cases will have a positive PCR test or positive serology. Given the multiple and variable clinical manifestations, it is important to take into account the differential diagnoses, especially Kawasaki Disease, whose clinical manifestations this syndrome mimics. Management and treatment depend on the patient's condition, but treatment with intravenous immunoglobulin is generally recommended; most patients respond to a single dose, as in the present case.

A tuberculose extrapulmonar é causada por Mycobacterium Tuberculosis em órgãos fora do pulmão, e está principalmente relacionada com a imunossupressão, geralmente secundária ao vírus da imunodeficiência humana, embora haja pacientes que desenvolvem a doença sem relação com o supracitado. Esta patologia deve-se à disseminação hematogênica ou linfática do bacilo devido à infecção anterior, ou reativação de um foco latente, com envolvimento subsequente de outro órgão, como a pleura, sistema nervoso central, gânglios linfáticos, pele, entre outros. O presente caso é de um paciente masculino de 77 anos, com história de diabete mellitus tipo II, sem tratamento, que apresentou um quadro clínico de 5 meses de evolução, apresentando lesões cutâneas, mais súbita perda de peso, há 2 meses apresentou tosse intensa, o esfregaço da expectoração foi negativo, no entanto, foi possível identificar um aumento da perda de peso do paciente e um aumento do tamanho do gânglio linfático cervical, razão pela qual foi realizada uma biópsia do gânglio linfático, que relatou tuberculose extrapulmonar.

BACKGROUND: Benign tracheal stenosis in adults has three etiologies: secondary to prolonged intubation, idiopathic, and rheumatologic. The one associated with prolonged intubation has been described as a lesion due to the persistent pressure of the balloon on the tracheal mucosa, which predisposes to a regional hyperinflammatory response; for that reason, modulating treatments for this response have been proposed as an alternative to classical surgical treatment. To date there is no treatment defined as Gold-Standard; both open and endoscopic treatments are practiced, among the last described, an option is intralesional corticosteroids injection. CASE REPORT: This is a 47-year-old woman with a history of prolonged mechanical ventilation; months later she was diagnosed with tracheal stenosis, initial treated with dilation and stent placement, with subsequent complications (stent migration, reinterventions due to respiratory distress). The patient sought medical attention due to dyspnea, stridor, productive cough, halitosis and general malaise, finding severe tracheal stenosis (98%) by flexible fiberoptic bronchoscopy. EVOLUTION: Using rigid bronchoscopy, the stent was removed, dilation was performed, and we administered intralesional corticosteroid for one time, with a good immediate response; in addition, a course of intramuscular corticosteroids was administered for two days. Six months after the procedure, the patient remained without recurrences, with a stable tracheal stenosis of 30%. CONCLUSION: After the bibliographic review carried out, as well as the successful experience we had with the patient, we agree with the available literature that this new treatment option is adequate for its application, although we recognize that larger studies are required to define the precise indications and an optimal protocol for its establishment.

La infección por Clostridioides difficile es una amenaza para la salud pública, está asociada a la atención médica, cuya complicación más frecuente es la infección recurrente, con tasas de hasta el 60% después del tercer episodio. Las opciones de tratamiento para la recurrencia de esta infección son limitadas. Una gran paradoja es tratar una infección asociada a antibióticos con más antibióticos, por ello, la piedra angular en el manejo de esta infección es la restauración de la microbiota intestinal mediante el trasplante de microbiota fecal. Objetivo. Determinar la eficacia y seguridad del trasplante de microbiota fecal para el tratamiento de la infección recurrente por Clostridioides difficile. Metodología. Se realizó una revisión bibliográfica narrativa de la literatura científica en las bases de datos PubMed y Cochrane Library empleando los Descriptores en Ciencias de la Salud (DeCS) y Medical Subject Headings (MeSH), junto con los operadores booleanos “AND/Y”, “OR/O”; donde se recopilaron los estudios que cumplieron con los criterios de inclusión. Conclusión. Se concluyó que el trasplante de microbiota fecal en la infección recurrente por Clostridioides difficile es un tratamiento eficaz y seguro, con eventos adversos mínimos, aunque la seguridad a largo plazo no está bien establecida.