ABSTRACT
Resumen Introducción: El impacto social y sanitario que ha generado la pandemia COVID-19 a nivel global permite repensar aspectos de vigilancia epidemiológica y comunicación en tiempos de crisis. Objetivo: Describir el comportamiento de la pandemia COVID-19 en los departamentos y distritos especiales de la región caribe colombiana. Materiales y Métodos: Análisis documental e interpretativo a partir de fuentes secundarias de vigilancia nacional "SIVIGILA" y datos de entes territoriales. Resultados: Cartagena de Indias es la primera unidad territorial del Caribe en presentar casos por COVID-19, seguido de Santa Marta y Barranquilla. El mayor número de casos se registró en Barranquilla, Atlántico, Cartagena y Córdoba. Así mismo, la mayor tasa de muertes por 100 000 habitantes se registró en Barranquilla, Atlántico, Córdoba, Santa Marta, Sucre y Cartagena. En el Caribe se implementaron estrategias de distanciamiento social como prohibición de eventos masivos y cierre de fronteras. Discusión: Para describir el comportamiento de la pandemia es importante que las autoridades sanitarias continúen asumiendo el reto para la detección, sistematización y manejo oportuno de los casos. El comportamiento de la pandemia ha sido similar en los departamentos del Caribe Colombiano, hay una homogeneidad al momento de acatar las normas del gobierno, y cada región adaptó diferentes estrategias dentro de un marco general para reducir la incidencia de la enfermedad. Se recomienda fortalecer la similitud entre los datos reportados por el Ministerio de Salud, SIVIGILA y los entes territoriales. El talento humano en salud cualificado puede soportar este ejercicio a fin de superar la actuación mediática y avanzar hacia la gobernanza.
Abstract Background: The social and health impact generated by the COVID-19 pandemic allows us to re-think aspects of epidemiological surveillance and communication in struggle-times. Objective: To describe the behavior of the COVID-19 pandemic in the departments and special districts of the Colombian Caribbean region. Methodology: This is a documentary and interpretive analysis from secondary sources of National Surveillance "SIVIGILA" and data from local governments. Results: Cartagena de Indias is the first territorial area in the Caribbean to present cases COVID-19, followed by Santa Marta and Barranquilla. The highest number of cases was registered in Barranquilla, Atlántico, Cartagena and Córdoba. Likewise, the highest death rate per 100,000 inhabitants was observed in Barranquilla, Atlántico, Córdoba, Santa Marta, Sucre and Cartagena. In the Caribbean, social distancing was implemented, as well as the limitation of mass gatherings and border closure. Discussion: To describe the pandemic behavior, it is important that health authorities continue to assume the challenges of detection, systematization, and timely handling of cases. The COVID-19 performance has been similar in the Colombian Caribbean. There is a homogeneity regarding the government regulations compliance and each region adapted different strategies to reduce the incidence of the dicease. It is recommended to strengthen the concordance between the data reported by the Ministry of Health, SIVIGILA, and the territorial entities. Qualified human talent can support this exercise in order to overcome the media performance through the strengthening of governance.
Subject(s)
Humans , Male , Female , Public Health , Disease Notification , Epidemiological Monitoring , Health Governance , ColombiaABSTRACT
BACKGROUND: Plasma concentrations of some lysophospholipids correlate with metabolic alterations in humans, but their potential as biomarkers of insulin resistance (IR) is insufficiently known. We aimed to explore the association between plasma linoleoylglycerophosphocholine (LGPC) and objective measures of IR in adults with different metabolic profiles. METHODS: We studied 62 men and women, ages 30 to 69 years, (29% normal weight, 59% overweight, 12% obese). Participants underwent a 5-point oral glucose tolerance test (5p-OGTT) from which we calculated multiple indices of IR and insulin secretion. Fifteen participants additionally underwent a hyperinsulinemic-euglycemic clamp for estimation of insulin-stimulated glucose disposal. Plasma LGPC was determined using high performance liquid chromatography/time-of-flight mass spectrometry. Plasma LGPC was compared across quartiles defined by the IR indices. RESULTS: Mean LGPC was 15.4±7.6 ng/mL in women and 14.1±7.3 ng/mL in men. LGPC did not correlate with body mass in-dex, percent body fat, waist circumference, blood pressure, glycosylated hemoglobin, log-triglycerides, or high density lipoprotein cholesterol. Plasma LGPC concentrations was not systematically associated with any of the studied 5p-OGTT-derived IR indices. However, LGPC exhibited a significant negative correlation with glucose disposal in the clamp (Spearman r=−0.56, P=0.029). Despite not being diabetic, participants with higher plasma LGPC exhibited significantly higher post-challenge plasma glucose excursions in the 5p-OGTT (P trend=0.021 for the increase in glucose area under the curve across quartiles of plasma LGPC). CONCLUSION: In our sample of Latino adults without known diabetes, LGPC showed potential as a biomarker of IR and impaired glucose metabolism.