ABSTRACT
Is observed a structure of five factors: representations, habitus, fields, capital, capabilities and enterprise that explained 54% of the total variance explained, although the research design limited findings local scenario, suggesting the inclusion of variables that the literature identifies Sociodemographic and socioeconomic variables to establish entrepreneurial profiles according to risk events;landslides, fires, droughts, floods, frosts or earthquakes. If a representation links coffee farming with other personal or community needs, then it supposes provisions that facilitate the objectification or anchoring of information related to sowing, harvesting, weather, pests, prices and prices. Faced with the environmental problems of droughts or floods, social capital networks in Xilitla respond with organization of the crop in diversified stages but confined to the achievement of goals that guarantee the productive cycle. The representations are discursive innovations from which scientific knowledge is disseminated in common sense and social thought, although this is exclusive of not only science, art or culture in general since the symbols to discover or invent are also prone to its transformation into interpretations of reality and more primarily discursive senses.
ABSTRACT
During the COVID-19 pandemic, the Pan American Health Organization (PAHO) promoted several activities to strengthen the countries' emergency response. Vaccines represented a breakthrough in the pandemic evolution, even though they have not been equitably distributed. As most vaccines have received emergency authorizations for their timely delivery, vaccine safety surveillance has been highlighted for detecting early signals of potential adverse events following immunization (AEFI, also known as ESAVI). The objective of this article is to share the different steps, methodologies, and preliminary results of a regional policy to strengthen the ESAVI surveillance system in the Americas, including the adoption of HL7 FHIR for health information exchange between countries and PAHO.
Subject(s)
COVID-19 Vaccines , COVID-19 , Health Level Seven , Adverse Drug Reaction Reporting Systems , Americas , COVID-19/prevention & control , COVID-19 Vaccines/adverse effects , Humans , Pandemics/prevention & control , Vaccination/adverse effectsABSTRACT
The term 'porphyria' comes from the Greek 'porphyra'. It refers to a heterogeneous group of metabolic disorders caused by the enzymatic deficiency in the biosynthesis of the heme group. Acute intermittent porphyria is caused by a deficiency of the porphobilinogen deaminase enzyme. A 40-year-old woman presented with abdominal pain for ten days (which required laparotomy that evidenced no surgical pathology), severe hydroelectrolytic disorder due to hyponatremia and resistant hypokalemia, persistent tachycardia and hypertension. Seven days later, she developed acute flabby quadriparesis and presented a single generalized tonic-clonic convulsive crisis. Neurophysiological studies supported mixed axonal polyneuropathy and urine results of porphobilinogen and porphyrins were elevated. After acute intermittent porphyria was diagnosed, hemin was administered, which stabilized the patient's clinical signs and normalized the porphobilinogen. The prevalence of this entity is 1 in 2,000 people. It is an autosomal dominant disease, which affects mainly women between 20 and 40 years of age. This entity manifests with neurological and visceral symptoms. Management consists of hematin and dextrose administration avoiding hypotonic solutions because of the risk of exacerbating hyponatremia.
El término 'porfiria' proviene del griego 'porphyra' y alude a un grupo heterogéneo de trastornos metabólicos causados por una deficiencia enzimática en la biosíntesis del grupo hemo. La causa de la porfiria intermitente aguda es la deficiencia de la enzima deaminasa del porfobilinógeno. Se presenta el caso de una mujer de 40 años que presentó dolor abdominal de 10 días de evolución, trastorno hidroelectrolítico grave debido a hiponatremia e hipopotasemia, taquicardia e hipertensión arterial sistémica persistentes, por lo cual fue sometida a una laparotomía en la que no se encontró ninguna afección de origen quirúrgico, A los siete días del examen inicial, la paciente desarrolló cuadriparesia flácida aguda y presentó una crisis convulsiva tónico-clónica generalizada. Los estudios neurofisiológicos evidenciaron una polineuropatía axonal mixta, y los valores de porfobilinógeno y porfirinas en orina eran elevados. Tras diagnosticarse porfiria intermitente aguda, esta se trató con hemina, lo que estabilizó los signos clínicos y normalizó el porfobilinógeno. La prevalencia de esta enfermedad es de 1 en 2.000 personas. Tiene un patrón de herencia autosómico dominante y se manifiesta principalmente en mujeres con edades entre los 20 y los 40 años. La enfermedad cursa con síntomas neurológicos y viscerales, y se trata con la administración de hemina y dextrosa, evitando las soluciones hipotónicas por el riesgo de exacerbar la hiponatremia.