Severity of COVID-19 reinfection among healthcare workers in a grade A tertiary hospital in Shanghai by the end of 2022 / 上海预防医学

ObjectiveTo describe the epidemic characteristics of COVID-19 after policy adjustment from “Category B notifiable disease with category A management” to “Category B notifiable disease with category B management”， and to explore the protective effect of previous infection with SARS-CoV-2 on common symptoms of reinfection. MethodsHealthcare workers infected with SARS-CoV-2 in a grade A tertiary hospital in Shanghai were included in the study from December 4， 2022 to January 11， 2023. Data on demographic characteristics， clinical symptoms， medical history， and COVID-19 vaccination history were collected. We determined the epidemiological curve and characteristics， and then compared the difference in the severity of clinical symptoms between primary and reinfection subjects. ResultsA total of 2 704 cases were included in the study， of which 45 had reinfection， 605 （22.4%）were males， 608 （22.5%）were doctors， 1 275 （47.2%） were nurses， and 2 351 （86.9%） received ≥3 doses of COVID-19 vaccination. The average age of these healthcare workers was （34.9±9.1） years old. The number of cases with mild/moderate illness， asymptomatic infection， fever， headache， dry cough， expectoration， and chest tightness were 2 704 （100.0%）， 92 （3.4%）， 2 385 （88.2%）， 2 066 （76.4%）， 1 642 （60.7%）， 1 807 （66.8%）， and 439 （16.2%）， respectively. Reinfection was a protective factor for fever （OR=0.161， P<0.001）， headache （OR=0.320， P<0.001）， and peak body temperature （β=-0.446， P<0.001）. ConclusionFollowing the COVID-19 policy adjustment as a category B notifiable disease， healthcare workers at a grade A tertiary hospital in Shanghai predominantly experiences mild to moderate COVID-19 symptoms. Reinfection results in milder clinical manifestations， with a lower proportion of being asymptomatic.

Exploration on the Cultivation Path of Medical Students’ Professional Spirit in the Post-epidemic Era / 中国医学伦理学

In the fight against COVID-19, under the guidance of medical professionalism, the majority of medical workers adhered to the scientific spirit of rigorous truth-seeking and innovation, and the humanitarian feelings of boundless love and dedication, and made outstanding contributions to prevention and control. However, the epidemic situation fluctuates repeatedly, the virus mutates frequently, and the risk of major public health emergencies has caused deep thinking on the cultivation of medical students’ professionalism. Medical students are the reserve force for the sustainable development of China’s medical and health undertakings. The times and society endow medical students with a more lofty and arduous historical mission, and also call for strengthening the cultivation of medical students’ professional spirit. Under the background of normalization of epidemic prevention and control, responding to the demands of the times, providing high-quality medical talents for the society, promoting building the doctor-patient desting community, and promoting the reality of the healthy China strategy, efforts to explore the path of cultivating medical students’ professionalism with "three combinations, two considerations and one emphasis".

Challenges and Countermeasures of Mental Health Social Work in Shanghai in Post-Epidemic Era / 中国医学伦理学

This paper summarized three developing conditions and five service modes of mental health social work in Shanghai by reading literature and investigating and interviewing the social work service of mental health medical institutions in Shanghai. Three challenges to mental health social work after COVID -19 were identified: firstly, the reduction of direct services led to a decrease in the number of service beneficiaries, and the effectiveness of services could not be guaranteed; secondly, the application of social work methods was forced to adjust, which challenges the service ability of social workers; thirdly, the expansion or increase of the scope of service objects and the insufficient number of social workers led to difficulties in service response. In view of the above challenges and problems, countermeasures are proposed: ensure the continuity of professional relationship and service effectiveness through flexible and diversified service methods; knit for social work online working ability training, increasing network service experience; the scope of service objects expanding gradually and multi-sectoral cooperation to prevent psychological problems in key groups; set up a volunteer team to serve mental health.

Discussion on the Social Return after the Outbreak of COVID -19 / 中国医学伦理学

After COVID -19, patients, medical workers and the whole society in COVID -19 were faced with the challenge of how to quickly return to normal life. Patients cured in COVID -19 would face mental or psychological barriers, or be discriminated against, or face problems such as overweight of local epidemic prevention policies. The front-line medical personnel experienced job burnout and a variety of mental and psychological disorders, with some even developing physical symptoms. During the epidemic, ordinary people were in a state of psychological stress, education, production and economic activities were affected, and the incidence of mental or psychological disorders increases. It was necessary to provide COVID -19 patients with mental health monitoring and counseling. Give professional guidance to front-line medical staff, arrange rotation reasonably, and pay attention to their mental health status. Local governments should strictly implement the national epidemic prevention system, formulate epidemic prevention policies with humanistic care, actively publicize epidemic related knowledge and safeguard the rights and interests of the people.

Study on the Protection of the Rights and Interests of Tumor Subjects in Clinical Trials in the Prevention and Control of the COVID -19 / 中国医学伦理学

The outbreak of the COVID -19 has had a big impact on the implementation of clinical trials of tumor drugs and the prevention and control measures such as traffic control and home isolation has caused clinical trials couldn’t proceed normally, so the protection of tumor subjects in clinical trials faces many new challenges. Based on Western and Chinese policies and guidelines on the management of clinical trials during the COVID -19, this paper expounded the impacts of the COVID -19 on tumor patients and tumor clinical trials, analyzed the challenges faced by the protection of tumor subjects in the prevention and control of the COVID -19, and then protected tumor subjects from aspects of optimizing the allocation of health resources, improving non-face-to-face informed consent procedures, strengthening subject visit management, and enhancing clinical trial safety evaluation. It is hoped that these optimization measures can face the future and continue to protect subjects after the end of the epidemic or in new public health emergencies.

Research on the Path of Optimizing the "Ideological and Creative Integration" in Traditional Chinese Medicine Universities under the Perspective of the Great Anti-epidemic Spirit / 中国医学伦理学

The great anti-epidemic spirit is the brightest spiritual symbol of the anti-epidemic struggle and the inheritance and development of the spirit of patriotism, collectivism and socialism. Under the context of normalized epidemic prevention and control, it is necessary to give full play to the leading role of the great anti-epidemic spirit and explore the new mode of innovation and entrepreneurship education of "ideological and creative integration" in Traditional Chinese Medicine(TCM) universities. Summarized the educational value of anti-epidemic spirit, boost TCM universities to realize cultural education and promote TCM cultural inheritance and innovation; analyzed the difficulties existing in the process of "ideological and creative integration" in TCM universities, and provide accurate direction for optimizing the path of "ideological and creative integration" in TCM universities. To explore the multiple paths of "ideological and creative integration" in TCM universities requires multi-party cooperation, joint management, accelerating the optimization of "ideological and creative integration", and establishing a hierarchical "ideological and creative integration" system, so as to provide new ideas for us to implement the educational goal of "establishing moral integrity in cultivation" under the background of normalized epidemic prevention and control.

Ethical Consideration of Chinese Ancient Disasters and Diseases: Centered on the Basic Principles of Public Health Ethics / 中国医学伦理学

The ethical problems in the prevention and control of public disasters and epidemics have attracted more and more attention. Briefly combed the disaster and epidemic events in ancient China. From the view of the several basic principles of public health ethics, this paper took four aspects of the distribution of medical and health resources for epidemic diseases, the isolation prevention and control, the skeleton convergence and the protection of public health conditions as examples, to dialectically treat the measures taken by ancient people to deal with disasters and epidemics and explore some enlightenment of public health ethics in ancient Chinese disasters and epidemics. The measures of epidemic prevention and disaster resistance in ancient China have their own formation and development process. Although the historical limitations are insurmountable, interpreting it by using the basic principles of public health ethics will help us understand the development process of epidemic prevention and control, promote the development of medical archaeology, and provide some reference for the construction of public health undertakings today.

Realistic Consideration and Path Choice: Research on the Integration of Epidemic Narrative into College Students’ Ideological and Political Education / 中国医学伦理学

It takes a long time to repair the social damage caused by a major epidemic, which is both a rebuilding of social order and a long process of social psychology. How to reproduce the collective memory of major epidemic events through narration, start from the reality of the epidemic narrative to the should and finally back to practice, and use epidemic narrative as an educational means and carrier in ideological and political education, it will be a beneficial attempt to realize the unification of knowledge and practice in college students’ ideological and political education in the post-epidemic period. To integrate the epidemic narrative into the ideological and political education of college students, it is necessary to adhere to the mainstream ideological direction of the narrative, unblock the narrative channel, reasonably choose the narrative method and optimize the narrative content, adhere to student-oriented, and give full play to the educational function of students’ individual narration.

The Significance and Function of Marx’s View of Life on COVID-19 Epidemic Prevention and Control / 中国医学伦理学

Finding a way of life education with Chinese characteristics and making up for the shortcomings of life education, which should become a major issue for the in-depth study of COVID-19 epidemic prevention and control in China. Marx’s view of life is a correct and scientific view of life, which is not only the guiding ideology of life education, but also the important resources for life education. While criticizing the views of life and death based on the western philosophy of life, it can also overcomes the limitations of Chinese traditional view of life. In the epidemic prevention and control, the in-depth study of Marx’s view of life will help to promote the practice of life education, enable people to establish a correct and scientific view of life and obtain the life sublimation in life practice.

Factores de riesgo relacionados con el síndrome poscovid-19 en pobladores pinareños / Risk factors related to postcovid­19 syndrome in residents from Pinar del Río i: en

Introducción: Las posibilidades de padecer el síndrome poscovid-19 crecen en la medida en que se expande la pandemia. Objetivo: Identificar los factores de riesgo relacionados con el síndrome poscovid-19 en pobladores pinareños. Métodos: Se realizó un estudio de casos y controles, que incluyó a convalecientes de covid-19, atendidos en la consulta multidisciplinaria del Policlínico Luis Augusto Turcios Lima de la provincia de Pinar del Río durante el 2022, quienes fueron incluidos de forma aleatoria en 2 grupos, a razón de 1:2 (100 casos y 200 controles). El análisis estadístico se basó en una estrategia univariada, que consistió en la determinación del odds ratio para cada factor de riesgo, así como en la estimación de los intervalos de confianza al 95 % y la prueba de la Χ2, con un nivel de significación de p<0,05. Resultados: En el estudio predominaron el sexo femenino, la diabetes mellitus, el tratamiento farmacológico, el soporte ventilatorio, la presencia de secuelas establecidas y las complicaciones. Conclusiones: A pesar de identificar los factores de riesgo más frecuentes relacionados con el síndrome poscovid-19, este continúa siendo un desafío para los profesionales de la salud.

Introduction: The possibilities to suffer from the postcovid-19 syndrome grow as the pandemic expands. Objective: To identify the risk factors related to the postcovid-19 syndrome in residents from Pinar del Río. Methods: A cases and controls study that included covid-19 convalescents was carried out. They were assisted in the multidisciplinary service of Luis Augusto Turcios Lima Polyclinic of Pinar del Rio province during 2022 that were included in 2 groups at random, at a ratio of 1:2 (100 cases and 200 controls). The statistical analysis was based on an univaried strategy, for which the odds ratio was determined for each risk factor and the confidence intervals were considered at 95 %, as well as the chi-square test, with a significance level of p<0,05. Results: In the study there was a prevalence of the female sex, diabetes mellitus, pharmacological treatment, ventilation support, the presence of established sequels and complications. Conclusions: In spite of identifying the most frequent risk factors related to the postcovid-19 syndrome, it is still a challenge for health professionals.

Manifestaciones mucocutáneas de la fiebre de chikungunya / Mucocutaneous manifestations of chikungunya fever

Las manifestaciones típicas de la Chikungunya son la fiebre y las artralgias en la mayoría de los casos, pero debemos recordar que presentan manifestaciones mucocutáneas, donde la más frecuente es el exantema, además pueden presentar manifestaciones mucocutáneas atípicas con un gran polimorfismo simulando varias dermatosis como los casos expuestos anteriormente. Este reporte cuenta con 5 casos clínicos del mes de enero y febrero del año 2023 en el departamento Central de Paraguay, durante la mayor epidemia de Chikungunya registrada en el país hasta el momento. Es importante conocerlas y correlacionar con los demás signos y síntomas de la enfermedad para un diagnóstico y tratamiento adecuados.

The typical manifestations of Chikungunya are fever and arthralgia in most cases, but we must remember that they present mucocutaneous manifestations, where the most frequent is rash, they can also present atypical mucocutaneous manifestations with great polymorphism simulating various dermatoses such as cases outlined above. This report has 5 clinical cases from the month of January and February 2023 in the Central area of Paraguay, during the largest recorded Chikungunya epidemic in the country so far. It is important to know them and correlate them with the other signs and symptoms of the disease for proper diagnosis and treatment.

Learning from history in the midst of the COVID-19: epidemics/pandemics of antiquity up to the fall of the Western Roman Empire / Aprendiendo de la historia en medio del COVID-19: epidemias/pandemias de la antigüedad hasta la caída del Imperio Romano de Occidente

Abstract When humans discovered agriculture and livestock, they ceased to be nomads and began to settle in towns until they created large cities. From the first human settlements in Egypt, Mesopotamia, and the Anatolian Peninsula, populations were exposed and susceptible to new infectious agents, leading to epidemics and pandemics. Great civilizations emerged, such as Egypt, the land of Hatti, Israel, Greece, Carthage, and Rome, among others. Contact between different populations through wars or maritime trade is well documented and has been described as a source of epidemics throughout history. Epidemics described as plagues or pestilences, such as those of Egypt, the Hebrews, or the Hittites, are based on biblical texts or evidence such as tablets or hieroglyphic writings. We also reviewed classical books by authors such as Homer, Aeschylus, Herodotus of Halicarnassus, Thucydides, Diodorus Siculus, Dionysius of Halicarnassus, Titus Livius, Suetonius, and others; and described all epidemics/pandemics chronologically. This article describes the epidemics/pandemics for which there is written evidence from ancient Egypt to the fall of the Roman Empire. We should not be surprised when new epidemics/pandemics appear as causes of political and economic collapse, as this has been common throughout history, decimating, blocking, or even destroying cultures and civilizations repeatedly.

Resumen Cuando el hombre descubrió la agricultura y la ganadería, dejó de ser nómada y empezó a asentarse en pueblos hasta crear grandes ciudades. Desde los primeros asentamientos humanos en Egipto, Mesopotamia y la península de Anatolia, las poblaciones estuvieron expuestas y susceptibles a nuevos agentes infecciosos, dando lugar a epidemias y pandemias. Aparecieron grandes civilizaciones como Egipto, la Tierra de Hatti, Israel, Grecia, Cartago y Roma, entre otras. El contacto entre las distintas poblaciones a través de las guerras o el comercio marítimo está muy bien establecido y descrito como focos de epidemias a lo largo de la historia. Las epidemias descritas como plagas o pestilencias, como las que ocurrieron a los egipcios, los judíos, o los hititas, se describen con base en textos bíblicos o mediante evidencias como tablillas o escritos jeroglíficos. También revisamos libros clásicos de autores como Homero, Esquilo, Herodoto de Halicarnaso, Tucídides, Diodoro Sículo, Dionisio de Halicarnaso, Tito Livio, Suetonio, entre otros. Este artículo describe cronológicamente todas las epidemias/pandemias de las que existe evidencia a través de la escritura desde el antiguo Egipto hasta la caída del Imperio Romano. No debemos sorprendernos cuando aparecen nuevas epidemias/pandemias como causantes del colapso político y económico, ya que ha sido algo común a lo largo de la historia, diezmando, bloqueando o incluso destruyendo culturas y civilizaciones reiteradamente.

Impacto da pandemia de Covid-19 no consumo alimentare treinamento de praticantes de musculação / Impact of the Covid-19 pandemic on food consumptionand training of bodybuilders

A pandemia de Covid-19 impactou a vida de milhares de pessoas no mundo, e mesmo com a vacinação o número de infectados foi elevado. Esta pesquisa teve como objetivo verificar o impacto da pandemia de Covid-19 no consumo alimentar e no treinamento de praticantes de musculação. Foi realizada uma pesquisa transversal, com 134 praticantes de musculação, de ambos os sexos, do Sudoeste do Paraná, Brasil, com idade entre 18 e 50 anos, em setembro de 2021. A pesquisa foi realizada através do siteGoogle Forms®, enviada aos voluntários através de mensagens diretas e mídias sociais. Os dados foram tabulados e analisados no software PSPP. A maioria dos pesquisados relatou percepção de aumento no apetite (50%) e de aumento da quantidade de alimentos ingeridos durante o dia (47%) e do peso corporal (41,8%), sendo que a maioria acreditava que o ganho de peso foi de gordura corporal. Ainda, 40,3% dos pesquisados referiram que a frequência de prática de musculação diminuiu durante a pandemia. Apesar disso, observou-se que os indivíduos relataram consumir mais frutas (50,7%), verduras (49,3%) e legumes (45,5%), e menos açúcar ou adoçantes (34,3%), bebidas açucaradas (31,3%) e lanches tipo fast food (29,9%). Foi possível concluir que apesar do impacto da pandemia na prática de musculação, percepção de aumento de apetite, peso e ingestão alimentar, notou-se melhora da qualidade do consumo alimentar dessa população.

The Covid-19 pandemic has impacted the lives of thousands of people around the world and even with vaccination, the number of infected was high. This research aimed to verify the impact of the Covid-19 pandemic on food consumption and training of bodybuilders. A cross-sectional survey was carried out with 134 bodybuilders, of both sexes, from the Southwest of Paraná, Brazil, aged between 18 and 50 years, in September 2021. The survey was carried out through the Google Forms® website, sent to volunteers through direct messages and social media. Data were tabulated and analyzed using the GNU PSPP 1.4.1-g79ad47 software. Most respondents reported an increase in appetite (50%), the amount of food eaten during the day (47%) and body weight (41.8%), with the majority believing that the weight gain was due to fat body. Also, 40.3% of respondents reported that the frequency of bodybuilding practice decreased during the pandemic. Despite this, it was observed that individuals reported consuming more fruits (50.7%), green (49.3%), vegetables (45.5%) and less sugar or sweeteners (34.3%), sugary drinks (31.3%) and fast food snacks (29.9%). It was possible to conclude that despite the impact of the pandemic on bodybuilding practice, perception of increased appetite, weight and food intake, there was an improvement in the quality of food consumption in this population.

Epidemic retinitis during pregnancy

Purpose: To study the clinical presentation and treatment outcome of epidemic retinitis (ER) during pregnancy. Methods: This is a retrospective, observational chart review of pregnant patients diagnosed with ER from January 2014 to February 2023. Demographic details, month of pregnancy at the onset of ocular symptoms, history of present illness, clinical manifestations, and treatment outcomes were studied. Results: In 9 years, ER was seen in 86 females, of whom 12 (13.9%) were pregnant. Twenty?one eyes of those 12 patients were studied. Most of the patients presented in the sixth month of pregnancy (range: 5–9 months, mean: 6.3 months). Physicians diagnosed viral exanthematous fever in six, typhoid in three, and suspected rickettsia in one patient. Medical termination of pregnancy (MTP) was performed in two patients before presentation. Weil–Felix test was positive in five, Brucella in one, WIDAL in three, and coronavirus disease 2019 (COVID?19) IgG and dengue IgG in one patient each. Oral antibiotics were given in five patients (two post?medical termination of pregnancy [MTP]) for the retinitis. All except four received oral steroids. Mean presenting corrected distant visual acuity (n = 21) was 20/125 (range: 20/20–20/20,000), which improved to (n = 18) 20/30 (range: 20/20–20/240). Macular edema (n = 11) resolved in 33.18 days (range: 20–50 days), and retinitis (n = 13) resolved in 58 days (range: 30–110 days). Ocular and systemic examination of newborn was possible in two and the babies were normal. Conclusion: ER is seen commonly at the beginning of the third trimester. Lack of antibiotics may delay the resolution of retinitis. Ocular health needs to be assessed in larger series to conclude absence of retinal involvement in newborns.

Epidemic retinitis during the COVID-19 pandemic

Purpose: To study the impact of the novel coronavirus disease?2019 (COVID?19) pandemic on incidence, seasonal variation, clinical presentation, and disease outcome of epidemic retinitis (ER) and to compare clinical outcomes with positive and negative COVID?19 serology. Methods: This is a retrospective, observational study conducted at a tertiary eye care hospital from August 2020 to June 2022. A graph of ER cases against the month of presentation was compared with the graph of the COVID?19 pandemic in the same region. Cases presented before COVID?19 vaccination, with positive COVID?19 serology (Group 1) were compared with cases with negative serology (Group 2). Results: One hundred and thirty?two cases of ER were seen. The least number of cases were seen during and immediately after the peak of the pandemic (May 2021–August 2021). COVID?19 serology was positive in 13 (22 eyes)/60 (21.6%) unvaccinated cases. Along with COVID?19, positive serology for other ER etiologies was seen in 5/13 cases (38.4%). All patients received oral doxycycline with/without steroids. Groups 1 and 2 included 22 and 21 eyes of 13 cases each. Macular edema resolved in 43.6 and 32 days in groups 1 and 2, respectively. Retinitis resolved at 1 month in both groups. Corrected distant visual acuity was 20/50 and 20/70 at the presentation, which improved to 20/20 and 20/25 in groups 1 and 2, respectively. Mean and median follow?up was 6 months and 4.5 months, respectively, in both groups. No complications or recurrences were seen. Conclusion: No significant impact of the COVID?19 pandemic on ER was observed

Viruela símica grave en un paciente con infección por VIH, Ecuador

En mayo de 2022 se reportó un aumento de casos de viruela símica (mpox en inglés) en el mundo, cuyo comportamiento epidemiológico y clínico, particularmente en pacientes con infección por VIH, condujo a la declaración del brote de mpox 2022 como emergencia de salud pública internacional. Se presenta el caso de un paciente con infección por VIH que cursó con mpox grave y fulminante, con placas necróticas en párpado y membrana inflamatoria sobre la superficie ocular; mucosa oral con lesiones blanquecinas y úlceras en lengua; induración de tejidos blandos y lesiones necróticas en los pies. Tras múltiples complicaciones, se convirtió en la primera víctima fatal reportada en Ecuador en 2022. En pacientes con infección por VIH, mpox puede presentarse como un agente oportunista, causando lesiones cutáneas graves, con o sin manifestaciones sistémicas.

In May 2022 several cases of mpox were reported worldwide, whose epidemiological and clinical outcome, particularly in patients seropositive for HIV, led to declaring the 2022 mpox outbreak as a public health emergency. We describe a case of a patient with HIV infection and severe and fulminant mpox, with necrotic plaques on the eyelid and an inflammatory membrane on the ocular surface; oral mucosa with whitish lesions and ulcers on the tongue; soft tissues induration, and necrotic lesions on the feet. After multiple complications, he became the first fatality reported in Ecuador in 2022. In HIV-infected patients mpox can be considered an opportunistic agent, with severe skin lesions with or without systemic manifestations.

Dengue como fenómeno epidemiológico emergente: dinámica de los brotes en la provincia de Buenos Aires en 2016 Y 2020 / Dengue as an emergent epidemiological phenomenon: dynamics of the outbreaks of 2016 and 2020 in Buenos Aires province

RESUMEN INTRODUCCIÓN: El dengue constituye un problema emergente en Argentina. En la provincia de Buenos Aires se inició un primer brote en 2016, y el de 2020 registró un 82% más de casos y afectó municipios sin antecedentes previos. El objetivo de este estudio fue caracterizar la dinámica de los brotes bonaerenses de 2016 y 2020 . MÉTODOS: Se realizó un estudio descriptivo, retrospectivo y transversal. Los casos fueron registrados en el Sistema Nacional de Vigilancia de la Salud. Fueron calculadas las distribuciones de frecuencia de los casos notificados, considerando también el origen: importados o autóctonos. Las tasas de incidencia y las razones de tasas se calcularon por Región Sanitaria. La difusión de la onda epidémica para ambos brotes fue obtenida mediante el cálculo de métricas adimensionales . RESULTADOS: Ambos brotes manifestaron ondas de similar comportamiento, pero con diferente expansión temporal y velocidades de difusión que se distanciaron en el inicio y luego hacia el final, presentando el último brote una mayor incidencia pero con una tasa de propagación de menor variación . DISCUSIÓN: La investigación realizada permitió caracterizar los brotes ocurridos en 2016 y 2020, y focalizar regionalmente la incidencia del fenómeno reemergente de la infección por arbovirus dengue (principalmente DEN-1 circulante) en la provincia de Buenos Aires, con cifras de incidencia que superaron lo conocido en la historia de la enfermedad en Argentina.

ABSTRACT INTRODUCTION: Dengue is an emerging problem in Argentina. In the province of Buenos Aires, the first outbreak was in 2016, and the one occurred during 2020 caused 82% more cases and affected districts with no previous cases. The objective of this study was to characterize the outbreak dynamics in the province of Buenos Aires in 2016 and 2020 . METHODS: A descriptive, retrospective and crosssectional study was conducted. The cases were registered in the National Health Surveillance System. The frequency distributions of the reported cases were calculated, considering also the origin: imported or autochthonous. Incidence rates and rate ratios were calculated for each Health Region. The diffusion of the epidemic wave for both outbreaks was obtained by calculating dimensionless metrics . RESULTS: Both outbreaks showed waves with similar behavior, but with different temporal expansion and diffusion speeds that distanced from each other at the beginning and then towards the end. The last outbreak had a higher incidence, but a propagation rate with less variation . DISCUSSION: This research allowed to characterize the two outbreaks occurred in 2016 and 2020, and to focus regionally on the incidence of the re-emerging phenomenon of dengue arbovirus infection (mainly circulating DEN-1) in the province of Buenos Aires, with incidence figures that exceeded those known in the history of the disease in Argentina.

Brote de histoplasmosis en el contexto de la pandemia por COVID-19 / Histoplasmosis outbreak in the context of the COVID-19 pandemic

La histoplasmosis es una micosis profunda de distribución mundial causada por el Histoplasma capsulatum var. capsulatum. Se caracteriza por una variabilidad clínica que depende principalmente de la carga fúngica, del estado inmunológico del paciente y de la virulencia del germen. Se describe un brote de histoplasmosis pulmonar aguda en militares, producido en el contexto epidemiológico de la COVID-19. El episodio tuvo lugar a partir de actividad laboral en cuevas donde participaron cuatro militares, tres de los cuales desarrollaron síntomas y fueron admitidos en el Hospital Dr. Gustavo Aldereguía Lima de Cienfuegos en enero de 2022. La información fue obtenida a través de la entrevista médica y la historia clínica. Se evidenció que en el contexto epidemiológico de la pandemia por COVID-19 no se debe subestimar el diagnóstico de otras enfermedades respiratorias, incluidas las micosis endémicas(AU)

Histoplasmosis is a deep mycotic infection of worldwide distribution caused by Histoplasma capsulatum var. capsulatum. It is characterized by clinical variability that depends mainly on the fungal load, the patient's immune status and the virulence of the germ. We describe an outbreak of acute pulmonary histoplasmosis among military officers, which occurred in the epidemiological context of COVID-19. The episode occurred during work activities in caves in which four soldiers participated, three of whom developed symptoms and were admitted to the "Dr. Gustavo Aldereguía Lima" Hospital in Cienfuegos in January 2022. The information was obtained through medical interviews and clinical records. It was evidenced that in the epidemiological context of the COVID-19 pandemic, the diagnosis of other respiratory diseases, including endemic mycoses, should not be underestimated(AU)

Monitoring Weil–Felix test in epidemic retinitis

Purpose: The objective was to study the positivity of the Weil–Felix test (WFT) in epidemic retinitis (ER) during the course of the disease. Methods: This is a retrospective, observational case series of patients diagnosed with ER and presented to a tertiary eye care hospital in south India. Patients with positive WFT at the presentation, and who underwent a follow?up WFT during or after the resolution of ER were studied from September 2019 to March 2022. Patient’s demographics, timings of clinical presentation and resolution, and investigation details with a special focus on WFT positivity and its duration were noted. Results: Sixteen patients were studied. Patients presented after 5 weeks of the fever (range: 2?12 weeks, median: 4). After 1?2 months, WFT was still positive in eight patients (50%). Only in one patient titers increased after 1 month, while in others, the titers decreased (n = 11) or remained the same (n = 4). Repeated tests in those patients (n = 6) after 3?4 months turned negative. Resolution of ER was seen at 1.35 months (range: 1?3 months) after the presentation. The mean duration for WFT to turn negative was 2 months from the presentation (range: 1?4 months) or 3.2 months of the fever (range: 1.5?6 months). Conclusion: In contrast to the reported physician’s observation of increasing titers of WFT after rickettsial fever, ophthalmologists may observe decreasing WFT titers in ER. The clinical resolution of ER may precede the normalization of WFT. Follow?up WFT titers should be studied in larger series in confirmed cases of rickettsial?ER to validate the affordable and readily available WFT in India

TONG Xiaolin's Cold-Damp Epidemic Differentiation and Treatment Concepts and Diagnostic and Therapeutic Key Points / 中医杂志

Building on a clear understanding of the diagnosis and treatment patterns for cold-damp epidemics， and incorporating the insights of Academician TONG Xiaolin regarding the differentiation and treatment of such epidemics， this article have distilled the key diagnostic principles. These principles primarily entail observing color and pulse， initially distinguishing between yin and yang， with treatment focusing on dispelling cold and dampness. A comprehensive approach is adopted throughout treatment， with a combination of overall strategies and tailored treatments that evolve in line with the patient's condition. In critical and severe cases， particular attention is given to aspects such as sweating， pulse analysis， and consciousness， preventing the pathogen from penetrating deeply. Efforts are made to open and close organ networks， expelling external pathogens without fixating on resolving constipation. The dosage and efficacy of herbal remedies are adjusted based on individual circumstances and clinical symptoms. The objective is to eliminate pathogens comprehensively， while being vigilant against relapses， ultimately achieving a full recovery. This overview of the thought processes and clinical principles for diagnosing and treating cold-damp epidemics will guide precise clinical practices and provide a theoretical foundation for the involvement of traditional Chinese medicine in epidemic prevention and treatment.