Clinical Aspects Of Hypertensive Patients With COVID-19 Hospitalized In A Campaign Hospital In Northeast Brazil

Abstract Background In view of the absence of effective therapy for COVID-19, many studies have been conducted seeking to identify determining factors for the development of severe forms, aiming to direct efforts to avoid the worst outcomes in patients susceptible to severe conditions. One of the main comorbidities associated with complicated forms of the disease is systemic arterial hypertension (SAH). Objective To assess aspects of the clinical, demographic, laboratory, and radiological characteristics of hypertensive patients with COVID-19 to contribute to the knowledge of the relationship between the presence of this comorbidity and the severity of the disease. Methods A total of 380 patients with a diagnosis of acute SARS-CoV-2 infection hospitalized between June and August 2020 were included. Patients were divided into two groups according to the presence or absence of a previous diagnosis of hypertension. For comparison between groups, a significant difference was established if p < 0.05. Results Of the total of 380 patients, 202 (53.16%) had a clinical diagnosis of SAH. Hypertensive patients were significantly older (p < 0.01) and had more comorbidities (p < 0.01) than the non-hypertensive group. In laboratory tests, hypertensive patients had higher levels of blood glucose (p = 0.014), creatinine (p = 0.002), and urea (p = 0.003), while values for alanine aminotransferase (ALT) (p < 0.01), aspartate aminotransferase (AST) (p = 0.006), and sodium (p = 0.024) were lower. There was no difference between groups in radiographic parameters. Conclusions This study showed that, although the hypertensive group had some laboratory alterations that elicited severe disease, these patients did not have worse outcomes.

Public Health Research and Scheduled Tribes: An ethical lens.

In this commentary, it is argued that greater attention paid to ethical considerations related to doing Public Health Research with Scheduled Tribes (STs) should be prioritized. Given the high levels of health needs among STs as well as their high levels of deprivation, cultural oppression, and impingement on their rights, there is a need to revisit our research practices to contribute to better health and overall empowerment. Specific strategies that could be integrated into research practice are offered. The paper concludes with a call for the development of national guidelines for Public Health Research with STs.

Perceptions of State Government stakeholders & researchers regarding public health research priorities in India: An exploratory survey.

Public health research has several stakeholders that should be involved in identifying public health research agenda. A survey was conducted prior to a national consultation organized by the Department of Health Research with the objective to identify the key public health research priorities as perceived by the State health officials and public health researchers. A cross-sectional survey was done for the State health officials involved in public health programmes and public health researchers in various States of India. A self-administered semi-structured questionnaire was used for data collection. Overall, 35 State officials from 15 States and 17 public health researchers participated in the study. Five leading public health research priorities identified in the open ended query were maternal and child health (24%), non-communicable diseases (22%), vector borne diseases (6%), tuberculosis (6%) and HIV/AIDS/STI (5%). Maternal and child health research was the leading priority; however, researchers also gave emphasis on the need for research in the emerging public health challenges such as non-communicable diseases. Structured initiatives are needed to promote interactions between policymakers and researchers at all stages of research starting from defining problems to the use of research to achieve the health goals as envisaged in the 12th Plan over next five years.

Representación gráfica de información multivariante: aplicación al sistema de salud de Chile (2010 / Graphical representation of multivariate data, applied to the Chilean healthcare system

Objetivo: Divulgar entre los investigadores en salud pública algunas propuestas de gráficos estadísticos multivariantes, tales como las caras de Chernoff, los gráficos de estrella, las curvas de Andrews y gráficos de radar. Material y método: Los gráficos estadísticos multivariantes propuestos son aplicados para describir los Sistemas de Salud Públicos de Chile, año 2010, (n=29) en base a información cuantitativa de dimensión p=7; ellos son procesados usando software estadísticos standard como R, STATA y SAS. Resultados: La descripción de los 29 Sistemas de Salud Públicos de Chile en base a información cuantitativa de dimensión siete, representados en cada uno de los gráficos multivariantes exhibidos, permite determinar conglomerados, estándares y tendencias. Conclusiones: La disponibilidad de eficientes software estadísticos sugiere complementar las indispensables estrategias de análisis exploratorio de nuestra información con representaciones gráficas adecuadas al contexto multidimensional que pueden ayudar a alcanzar una mejor comprensión del problema de interés. La síntesis gráfica generada por la aplicación de gráficos estadísticos multivariantes para describir los Sistemas de Salud Públicos de Chile complementa nuestro conocimiento de este aspecto de la realidad nacional, puede sugerir algunas hipótesis, refutar otras y ayudar en la interpretación de resultados complejos. Naturalmente esto es extensible a muchas otras situaciones de interés para el investigador salubrista.

Objective: To inform public health researches about some proposal of multivariate statistical graphics, such as Chernoff faces, star charts, Andrews curves and radar graphs. Its use is now possible thanks to recent software development. Material and method: Proposed multivariate statistical graphics are used to describe the Systems of Public Health of Chile, year 2010 (n = 29), using quantitative information with dimension p =7; these graphics are processed using standard statistical software such as R, STATA and SAS. Results: The description of the 29 systems of public health of Chile based on quantitative information from dimension seven, represented in each of multivariate graphs, allow to determine clusters, standards and trends. Conclusions: The availability of efficient statistical software indispensable suggests to complement strategies of exploratory analysis of our data with appropriate graphical representations of multidimensional context that can help us to achieve a better understanding of the problem of interest. The graphical summary generated by the application of multivariate statistical graphs to describe Public Health Systems of Chile complements our knowledge of this aspect of national life, may suggest hypotheses, refute others and assist in the interpretation of complex results. Naturally this can be extended to many other situations of interest to the health care professional.

Ethical Issues In Public Health Research.

Abstract: Public health is the societal approach to protecting and promoting health. Public health ethics can be defined as the identification, analysis, and resolution of ethical problems arising in public health practice and research. The emerging interest in ethical issues in public health research and practice reflects both the important societal role of public health and the growing public interest in the scientific integrity of health information and the equitable distribution of health care resources. This article provides an overview of ethical issues in public health research for young researchers and readers who do not necessarily have an in-depth knowledge of public health ethics. A framework of ethics analysis geared specifically for public health is needed to provide practical guidance for public health professionals and researchers in Bangladesh. Bangladesh Medical Research Council is playing a role in setting a standard in the field of biomedical research including public health concerning its strategy and ethical issues and by helping different health institutes to build up a research environment. Though public policy is based on many factors in addition to public health goals and ethical reasoning, it should not lead to the politically preferable option for a given time.

La investigación en salud pública: de la transición epidemiológica a la transición epistemológica / Public health research: going from epidemiological transition to epistemological transition

Se intenta una aproximación crítico-hermenéutica a algunas de las diferentes manifestaciones de la relación entre la Investigación en Salud Pública y algunos de los escenarios contextuales histórico-políticos en que se ha desarrollado en el período que se toma en consideración. Se intenta una caracterización del fenómeno y, a partir de esta, identificar posibles fundamentos epistemológicos para dicha relación que permita colaborar en su comprensión. La relación Investigación-Contexto muestra ciertas regularidades y correspondencias que ayudan a explicar el énfasis puesto en diferentes "momentos históricos" en "determinados" problemas de salud pública. La denominación como "problema de salud pública" va desnudando el "fondo epistemológico" en el cual dicha denominación se hace posible. El sistema de determinantes en el cual un problema de salud pública se constituye y emerge como tal, puede ser visualizado e identificado en los diferentes momentos considerados. La transición epidemiológica descrita en los años 70 y los 80, parece cruzarse con una insinuante transición epistemológica cuya cristalización va acelerándose durante el período. Esto permite al mismo tiempo, establecer las condiciones de posibilidad o imposibilidad según el caso para la realización de determinados tipos de investigación sobre determinadas problemáticas. Los diversos fondos epistemológicos van delineándose y, revelando estrechas relaciones con la posibilidad/imposibilidad para el ejercicio de la soberanía, no sólo en el campo de la investigación en Salud Pública, sino sobre todo en la formulación de las Políticas Nacionales de Salud y la construcción del Sistema Público Nacional de Salud en Venezuela que se bace en el estudio y comprensión sistemática de la realidad del país.

A critical-hermeneutic approach to some of the several manifestations of the relationship between public health research in Venezuela and the contextual historical-political scenarios where it is made was presented in this article. It was attempted to characterize the phenomenon and identify the possible epistemological fundamentals for such a relationship. Research/context relationship shows certain regularities and equivalences that assist in explaining the emphasis at different "historical times" on "specific" healthcare problems. The designation as a "healthcare problem" progressively discloses the "epistemological background" in which such designation is possible. The system of determinants where a public health problem emerges as such can be viewed and identified at the different considered times. The epidemiological transition described in the 70's and the 80's of the 20th century seems to meet with a suggestive epistemological transition that takes place in an accelerated way during this period. At the same time, the above-mentioned allows setting the conditions for making particular types of research on certain problems possible or impossible. Then, various epistemological backgrounds begin to be delineated, thus showing close relationships with possibility or impossibility for sovereign practice not only in public health research but also in formulating national health policies and building the National Public Health System of Venezuela on the basis of the systematic study and understanding of the realities of the country.

Avances en la investigación en salud pública. Cinco años de labores del Centro de Investigaciones en Salud pública, 1984-1989 / Advances in public health research. Five year balance of the Center for Public Health Research, México, 1984-1989

A los cinco años de haberse creado el Centro de Investigaciones en Salud Pública (CISP), se hace en este ensayo una recapitulación sobre sus orígenes y desarrollo, y se analizan los retos para el futuro. Se presentan los siete principios básicos de organización que han regido el desarrollo académico del CISP. En el aspecto cuantitativo, el crecimiento institucional se hace patente a través de un incremento en el número de investigadores, de proyectos y de publicaciones científicas, así como en el monto del financiamiento externo recibido. En el aspecto cualitativo se resalta el creciente número de temas abordados por las siete líneas de investigación, la elaboración de modelos conceptuales, la creación de bases de datos y el desarrollo metodológico. Para el CISP, los retos a futuro giran alrededor de problemas de organización, de vinculación con quienes toman decisiones y básicamente los relativos al equilibrio entre pertinencia y excelencia de la investigación en salud pública