CO2 Levels in the Naso-Buccal Area Due to the Use of Different Face Masks in Different Ventilation Conditions

In this work, CO2 levels were estimated in the naso-buccal area due to the use of face masks. Tests were performed on a healthy volunteer subject sitting at rest and breathing regularly, who used five types of face masks in well-ventilated and poorly ventilated rooms. The ventilation conditions were determined by the natural ventilation of the room. Each of the tests lasted one hour. To estimate the CO2 level, a sensor based on the Non-dispersive Infrared (NDIR) principle was used. The results revealed that while wearing a face mask, the ventilation conditions affected the CO2 concentration levels in the naso-buccal area of the user, especially in those that offered a higher level of protection, and in those that best fit the face of the subject. A multiple comparison method (Tukey) revealed significant differences in the levels of CO2 between all the facemask tested (p < 0.0001). The CO2 levels were also compared with the exposure limits recommended by NIOSH, showing that the use of N95 for 1 h exceeded the recommended 5,000 ppm for an 8-h workday. None of the masks tested exceeded the NIOSH-recommended short-term limit in the first 15 min of use. © 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.

Ivermectin-Induced Liver Injury when Used as Self-Medication in SARS-CoV-2 Infection

Introduction: In the context of the global health emergency due to SARS-CoV-2 pandemic, ivermectin has been repurposed in some Latin American countries to treat COVID-19;in these countries its use as self-medication has been frequent (1). Ivermectin-induced liver injury, though extremely rare(2,3), had been previously described even before the COVID-19 pandemic Objective: To characterize clinical features of liver injury associated with ivermectin when used as self-medication for treating COVID-19. Method(s): Clinical records of those patients diagnosed with severe COVID-19 at the Emergency Room in Rebagliati Hospital in Lima, Peru, during March 2021, were carefully revised. To establish diagnosis of drug-induced liver injury (DILI) and causality assessment, the criteria of DILI-Expert Working Group and the Council for International Organizations of Medical Sciences/Roussel Uclaf Causality Assessment Method (CIOMS/RUCAM), respectively, were used Results: Out of 327 patients identified, 38 took ivermectin as selfmedication (11%);of those 38, five were diagnosed with liver injury presumably related to that medication (13.2%). The mean age of those patients who developed the condition was 49.3 (12.3) [men, 4;woman, 1]. The mean (standard deviation) of Tomographic Severity Score (TSS), C-reactive protein, ferritin levels, Lymphocyte count and D-dimer were 52.2% (22.6), 13.8 (12.2) mg/dl, 1325.375 (239.7072) ng/ml, 2.0 (2.0) K/mul and 0.9 (0.7) lg/ml. The patients had no identified risk factors, but two;one patient had type I diabetes mellitus, and other, obesity. Mean daily ivermectin dose, duration, and total ivermectin dose were 32.9 (21.8) mg/day, 2.6 (0.6) days, and 89.6 (71.4) mg, respectively. As an average, liver injury occurred 11 (3.8) days after the start of treatment, none developed jaundice. Mean levels of alanine aminotransferase, alkaline phosphatase, gammaglutamyltransferase were increased 8 (4.4), 1.66 (0.9), 10.9 (5.0) times above the upper limit of normal. Two patients presented a hepatocellular pattern, 2 mixed and 1 cholestatic. All cases were mild and recovered. As for causality assessment, 4 cases were considered as ''possible'', and one, as ''highly probable''. Conclusion(s): Given its widespread use in some countries, ivermectininduced liver injury requires further pharmacovigilance studies when used for treating COVID-19.

Hepatic Disorders in Adults Associated with the Use of Ivermectin for SARS-CoV-2 Infection: A Pharmacovigilance Study in VigiBase

Introduction: In the face of the global health emergency due to SARS-CoV-2, Ivermectin has been, among other drugs, repurposed in some Latin American countries to treat COVID-19 [1]. Studies are needed on the safety of Ivermectin for this new indication. VigiBase is the WHO pharmacovigilance database that registers all Individual Case Safety Reports (ICSRs) from more than 130 countries. Objective(s): To review in VigiBase the reports of serious hepatic disorders in adults associated with the use of Ivermectin for COVID- 19. Method(s): We extracted, in men or women aged >= 18 years between 1 January 2020 and 7 march 2021, all ICSRs registered as ''serious'' associated with the use of ivermectin, and established the prevalence of serious hepatic disorders when Ivermectin was indicated for COVID-19 Results: During the study period, there were 1,393 ICSRs in Vigi- Base associated with Ivermectin, of which 60 (4.3%) were registered as ''serious'';in 25 of those, Ivermectin had been used for COVID-19. Out of those 25, five reported serious cases of hepatic disorders (hepatitis, hepatocellular injury, cholestasis, increased alanine aminotransferase and aspartate aminotransferase, abnormal liver function test). Three patients were male and overall mean age was 59.2 +/- 9.7 years. Ivermectin was administered during a mean of 2.5 +/- 2.4 days, and the mean daily dose was 14.3 +/- 2.9 mg. Two patients simultaneously received other drugs (Remdesivir, Hydroxychloroquine, Azithromycin). Two patients had concurrent conditions (strongyloidiasis, diabetes mellitus). Only in 2 patients liver enzyme data were reported. In all patients the evolution was favorable after stopping the drug (de-challenge), and no patient was re-exposed (rechallenge). Causality analysis was reported in 3 cases, qualifying as possible or probable. Conclusion(s): The safety of the use of Ivermectin should be studied more exhaustively, especially as regards the probability of hepatic disorders when used for COVID-19.

Previous Use of Proton Pump Inhibitors (PPI) in Hospitalized Patients and COVID-19 Mortality in Peru

Introduction: One of the known adverse reactions among long-term proton pump inhibitor (PPI) users, especially the elderly, is that it increases the risk of community-acquired pneumonia [1]. The probable mechanism is that the increase in gastric pH produces a decrease in elimination or an increase in colonization of bacteria;PPIs promote the proliferation of bacteria in the mouth and oropharynx and would increase in this manner the risk of pneumonia [2]. In COVID-19, lungs are particularly at risk. Currently, there is a great interest in establishing the relationship between the severity and mortality of SARS-CoV-2 infection in patients using PPIs [3]. Objective(s): To explore the relationship between the previous use of PPIs and mortality due to COVID-19 Methods: A retrospective observational study was carried out in a tertiary care hospital in Lima, Peru. Patients hospitalized in March 2021 for severe SARS-CoV-2 infection, confirmed by molecular tests (reverse transcription polymerase chain reaction), were included. Severe COVID-19 disease was defined as peripheral oxygen saturation on admission less than 93% (without supplemental oxygen) or pulmonary involvement greater than 30% (on the total severity score or TSS) in the lung tomography Results: A total of 327 patients entered the study (mean age, 61.36 +/- 16.0 years;male, 59.95%). PPIs users and non-users were 10 (3.06%) and 317 (96.94%), respectively. The mean age, Charlson score and total severity score (TSS) between PPIs users and non-users were 68.8 +/- 17.11 vs. 61.12 +/- 15.93 (p = 0.134), 3.6 +/- 2.32 vs. 2.25 +/- 1.715 (p = 0.019) and 55 +/- 25.28 vs. 48.44 +/- 24.30 (P = 0.399), respectively. Mortality in those using and not using PPIs were 80.0% (8 out of 10) and 38.49% (122 out of 317), respectively (Crude odds ratio, 6.39;95% confidence interval 1.34-30.61;p = 0.008). No significant difference was observed in the leukocyte count, mean lactate dehydrogenase concentration, Ferritin, D-dimer and fibrinogen and serum levels of C-Reactive Protein, in those users of PPIs compared to nonusers. Conclusion(s): Among hospitalized patients for severe SARS-CoV-2 infection, prior use of PPIs was associated with a higher mortality risk. This association does not necessary imply causality. Further research would be required to clarify potential mechanisms. Keywords: COVID-19, SARS-COV-2, proton pump inhibitor, mortality (Source: DeCS-BIREME).

Ivermectin-Induced Liver Injury when Used as Self-Medication in SARS-CoV-2 Infection: An International Journal of Medical Toxicology and Drug Experience

Introduction: In the context of the global health emergency due to SARS-CoV-2 pandemic, ivermectin has been repurposed in some Latin American countries to treat COVID-19;in these countries its use as self-medication has been frequent (1). Ivermectin-induced liver injury, though extremely rare(2,3), had been previously described even before the COVID-19 pandemic Objective: To characterize clinical features of liver injury associated with ivermectin when used as self-medication for treating COVID-19. Methods: Clinical records of those patients diagnosed with severe COVID-19 at the Emergency Room in Rebagliati Hospital in Lima, Peru, during March 2021, were carefully revised. To establish diagnosis of drug-induced liver injury (DILI) and causality assessment, the criteria of DILI-Expert Working Group and the Council for International Organizations of Medical Sciences/Roussel Uclaf Causality Assessment Method (CIOMS/RUCAM), respectively, were used Results: Out of 327 patients identified, 38 took ivermectin as selfmedication (11%);of those 38, five were diagnosed with liver injury presumably related to that medication (13.2%). The mean age of those patients who developed the condition was 49.3 (12.3) [men, 4;woman, 1]. The mean (standard deviation) of Tomographic Severity Score (TSS), C-reactive protein, ferritin levels, Lymphocyte count and D-dimer were 52.2% (22.6), 13.8 (12.2) mg/dl, 1325.375 (239.7072) ng/ml, 2.0 (2.0) K/pl and 0.9 (0.7) pg/ml. The patients had no identified risk factors, but two;one patient had type I diabetes mellitus, and other, obesity. Mean daily ivermectin dose, duration, and total ivermectin dose were 32.9 (21.8) mg/day, 2.6 (0.6) days, and 89.6 (71.4) mg, respectively. As an average, liver injury occurred 11 (3.8) days after the start of treatment, none developed jaundice. Mean levels of alanine aminotransferase, alkaline phosphatase, gammaglutamyltransferase were increased 8 (4.4), 1.66 (0.9), 10.9 (5.0) times above the upper limit of normal. Two patients presented a hepatocellular pattern, 2 mixed and 1 cholestatic. All cases were mild and recovered. As for causality assessment, 4 cases were considered as possible, and one, as highly probable. Conclusion: Given its widespread use in some countries, ivermectininduced liver injury requires further pharmacovigilance studies when used for treating COVID-19.

Hepatic Disorders in Adults Associated with the Use of Ivermectin for SARS-CoV-2 Infection: A Pharmacovigilance Study in VigiBase: An International Journal of Medical Toxicology and Drug Experience

Introduction: In the face of the global health emergency due to SARS-CoV-2, Ivermectin has been, among other drugs, repurposed in some Latin American countries to treat COVID-19 [1]. Studies are needed on the safety of Ivermectin for this new indication. VigiBase is the WHO pharmacovigilance database that registers all Individual Case Safety Reports (ICSRs) from more than 130 countries. Objective: To review in VigiBase the reports of serious hepatic disorders in adults associated with the use of Ivermectin for COVID19. Methods: We extracted, in men or women aged > 18 years between 1 January 2020 and 7 march 2021, all ICSRs registered as serious associated with the use of ivermectin, and established the prevalence of serious hepatic disorders when Ivermectin was indicated for COVID-19 Results: During the study period, there were 1,393 ICSRs in VigiBase associated with Ivermectin, of which 60 (4.3%) were registered as serious;in 25 of those, Ivermectin had been used for COVID-19. Out of those 25, five reported serious cases of hepatic disorders (hepatitis, hepatocellular injury, cholestasis, increased alanine aminotransferase and aspartate aminotransferase, abnormal liver function test). Three patients were male and overall mean age was 59.2 ± 9.7 years. Ivermectin was administered during a mean of 2.5 ± 2.4 days, and the mean daily dose was 14.3 ± 2.9 mg. Two patients simultaneously received other drugs (Remdesivir, Hydroxychloroquine, Azithromycin). Two patients had concurrent conditions (strongyloidiasis, diabetes mellitus). Only in 2 patients liver enzyme data were reported. In all patients the evolution was favorable after stopping the drug (de-challenge), and no patient was re-exposed (rechallenge). Causality analysis was reported in 3 cases, qualifying as possible or probable. Conclusion: The safety of the use of Ivermectin should be studied more exhaustively, especially as regards the probability of hepatic disorders when used for COVID-19

Previous Use of Proton Pump Inhibitors (PPI) in Hospitalized Patients and COVID-19 Mortality in Peru: An International Journal of Medical Toxicology and Drug Experience

Introduction: One of the known adverse reactions among long-term proton pump inhibitor (PPI) users, especially the elderly, is that it increases the risk of community-acquired pneumonia [1]. The probable mechanism is that the increase in gastric pH produces a decrease in elimination or an increase in colonization of bacteria;PPIs promote the proliferation of bacteria in the mouth and oropharynx and would increase in this manner the risk of pneumonia [2]. In COVID-19, lungs are particularly at risk. Currently, there is a great interest in establishing the relationship between the severity and mortality of SARS-CoV-2 infection in patients using PPIs [3]. Objective: To explore the relationship between the previous use of PPIs and mortality due to COVID-19 Methods: A retrospective observational study was carried out in a tertiary care hospital in Lima, Peru. Patients hospitalized in March 2021 for severe SARS-CoV-2 infection, confirmed by molecular tests (reverse transcription polymerase chain reaction), were included. Severe COVID-19 disease was defined as peripheral oxygen saturation on admission less than 93% (without supplemental oxygen) or pulmonary involvement greater than 30% (on the total severity score or TSS) in the lung tomography Results: A total of 327 patients entered the study (mean age, 61.36 ± 16.0 years;male, 59.95%). PPIs users and non-users were 10 (3.06%) and 317 (96.94%), respectively. The mean age, Charlson score and total severity score (TSS) between PPIs users and non-users were 68.8 ± 17.11 vs. 61.12 ± 15.93 (p = 0.134), 3.6 ± 2.32 vs. 2.25 ± 1.715 (p = 0.019) and 55 ± 25.28 vs. 48.44 ± 24.30 (P = 0.399), respectively. Mortality in those using and not using PPIs were 80.0% (8 out of 10) and 38.49% (122 out of 317), respectively (Crude odds ratio, 6.39;95% confidence interval 1.34-30.61;p = 0.008). No significant difference was observed in the leukocyte count, mean lactate dehydrogenase concentration, Ferritin, D-dimer and fibrinogen and serum levels of C-Reactive Protein, in those users of PPIs compared to nonusers. Conclusion: Among hospitalized patients for severe SARS-CoV-2 infection, prior use of PPIs was associated with a higher mortality risk. This association does not necessary imply causality. Further research would be required to clarify potential mechanisms.

Association between low serum vitamin D and increased mortality and severity due to COVID-19: reverse causality?

We are very close to completing two years since the start of the COVID-19 pandemic. Even though vaccines have been developed and applied to more than 4 billion people in the world, SARS-CoV-2 continues to be a challenge for humanity. Therefore, it is important to study modifiable risk factors that may increase the severity of COVID-19, and one of the most discussed has been vitamin D. Currently, there is some evidence of association between low serum 25-hydroxyvitamin D [25(OH)D3] and increased mortality and severity due to SARS-CoV-2 infection. Before the pandemic, experimental evidence in animal and human studies had reported that an acute inflammatory process can cause a secondary decrease in 25(OH)D3. COVID-19 can be associated with a severe inflammatory process with an elevation of inflammatory markers;in this light, the reported association between low 25(OH)D3 and COVID-19 severity and/or mortality may be an epiphenomenon of the inflammatory process induced by SARS-CoV-2 and be an example of reverse causality. Copyright © 2022 Via Medica.

Web-Based Engineering Design Activity in Biology: An Assessment on the Demonstration of Higher-Order Thinking Skills

Senior High School (SHS) STEM curriculum in the Philippines is on its infancy stages which lacks technology-related and engineering-oriented courses. Along with the challenges in education sector brought by the COVID-19 pandemic and ineffective teaching of 21st century higher-order thinking skills in a Philippine setting, this study aims to utilize an engineering design activity to introduce engineering principles using technological tools and assess the presence or absence of higher-order thinking skills in the design solutions using an engineering design rubric. A design activity was developed by the researcher. The average and total scores of each group as evaluated by the subject teacher, students and researcher using the engineering design rubric to measure the demonstration of higher-order thinking skills in the outputs were analyzed. Based on the components assessed, problem-solving skills and critical thinking were demonstrated on the design solutions at competent and sophisticated level of performance. This shows that incorporating collaborative engineering design activities in an online setting allow the students to exhibit higher-order thinking skills. © 2021 29th International Conference on Computers in Education Conference, ICCE 2021 - Proceedings. All rights reserved

Students' Attention Monitoring System in Learning Environments based on Artificial Intelligence

The students' attention level to the explanation of a given lecture is a factor that might determine the capability of retention and subsequent application of a learned concept. For this reason, students that pay attention are generally more participatory in the learning/teaching process than those who don't, and consequently, they succeed in reaching the competencies proposed in the courses. Hence, it is important to design strategies and tools that help teachers to monitor in a non-invasive way the attention level of the students, allowing them to take actions to modify the dynamics of the lectures when needed. In this work, we introduce a fully automated system to monitor the students' attention based on computer vision algorithms. To this end, we feed a recurrent neural network with one-second sequences generated by facial landmarks. This spatiotemporal analysis of video recordings allows for identifying when a student is attending a given explanation in online educational environments. The system is tested in a database with more than 3000 sequences of students who pay or no attention to online video lectures. Obtained results show that the proposed system is suitable to monitor the students' attention to a particular explanation.

The Relationship Between the Severity and Mortality of SARS-CoV-2 Infection and Ibuprofen: A Meta- Analysis: An International Journal of Medical Toxicology and Drug Experience

Background/Introduction: Ibuprofen is a non-steroidal anti-inflammatory drug (NSAID);it is considered as relatively safe and is widely used in the world. However, at the beginning of the COVID-19 pandemic, ibuprofen was associated with an increase in severity or mortality of the infection [1-4]. Objective/Aim: To conduct a meta-analysis of the association between ibuprofen use and SARS-CoV-2 infection severity or mortality. Methods: We searched PubMed, EMBASE, Google Scholar and the Cochrane Database of Systematic Reviews for observational studies published between January 2020 and May 2021. Studies were included if they contained data on ibuprofen use and SARS-CoV-2 infection severity or mortality. Information upon study design, location, year of publication, number of participants, sex, age at baseline, outcome and exposure definitions was gathered. The quality of studies included was assessed with the Newcastle-Ottawa Scale (NOS). The analysis was performed based on a random-effects model;the summary effect and its confidence interval were calculated. Results: Eight observational studies comprising a total of 1785.730 participants were identified for inclusion (cohort, 5;case-control, 2;cross-sectional, 1). Mean age was 54.4 (SD 12.6) years-old and 50.2% were men. The mean NOS score of included studies was 7.7 (range 7-9). The studies were from Austria, Denmark (2), Israel, Saudi Arabia, UK (2) and USA. Patients exposed to ibuprofen while infected with SARS-CoV-2 had not higher severity or mortality;summary odds ratios were 0.81 (95% CI 0.58-1.12, p = 0.14) and 0.95 (95% CI 0.79-1.14, p = 0.42), respectively. Conclusion: At present, the available evidence does not support the hypothesis of an increased SARS-CoV-2 risk associated with ibuprofen. However, more evidence needs to accumulate before this controversy can be resolved.

Considerations about COVID-19 vaccines in pregnant and nursing mothers

Currently, there are vaccines with proven efficacy and safety in the mother-child binomial, such as the anti-influenza, anti-diphtheria, anti-tetanus, and acellular anti-pertussis vaccines. The most effective method in the control of epidemics and pandemics is vaccination, especially in priority groups that could have serious and complicated manifestations of the disease such as pregnant women. Currently, there are candidates for COVID-19 vaccines with different platforms: mRNA, non-replicative adenovirus vectors, DNA, inactivated whole virus, and protein subunits, among others. The Health Organization (WHO), the Centers for Disease Control (CDC), the American College of Obstetrics and Gynecology of the United States, and the National Academy of Medicine of Venezuela have pronounced on the subject and agree that pregnant and lactating women should be included in the priority group in the immunization plans of the countries, with the COVID-19 vaccines approved in that population group. © 2021 Academia Nacional de Medicina. All rights reserved.

Prevalence of SARS-CoV-2 infection in general practitioners and nurses in primary care and nursing homes in the Healthcare Area of León and associated factors.

OBJECTIVE: To evaluate the prevalence of and factors associated with SARS-CoV-2 infection in general practitioners and nurses from primary care centers and nursing homes in the Healthcare Area of León (Spain). MATERIALS AND METHODS: Cross-sectional study in a convenience sample of professionals from 30 health centers and 30 nursing homes from the primary care management division of the Healthcare Area of Leon. The work center, type of profession, COVID-19 infection, level of exposure, compliance with preventive measures, isolation (if required) and diagnostic tests carried out were collected. The determination of infection was made by differentiated rapid diagnostic test (dRDT), using a finger-stick whole-blood sample. The association of variables with infection was assessed by multivariable non-conditional logistic regression. The true prevalence of SARS-CoV-2 infection was calculated according to two scenarios for RDT (Sensitivity=0.6 and Specificity=0.985; Sensitivity=0.8 and Specificity=1). RESULTS: The true prevalence of SARS-CoV-2 infection was between 4.9% and 11.0%. The observed prevalence was 5.9% and was higher in nursing homes than in primary care centers (9.5% vs. 5.5%). No statistically significant differences were observed by sex, type of professional, level of exposure or compliance with preventive measures. CONCLUSIONS: The prevalence of SARS-CoV-2 infection in this group is low. A high number of professionals remain susceptible to SARS-CoV-2 infection and therefore protective measures should be taken, especially for professionals working in nursing homes.

Severity of SARS-COV-2 infection and angiotensin converting enzyme inhibitors and angiotensin receptor blockers: A meta-analysis

Background: The mechanism of entry of SARS-CoV-2 into the human host cell is through the ACE2 receptor. During the pandemic, a hypothesis has been proposed that angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs) could be risk factors for the development of severe SARS-CoV-2 infection. The objective of the study was to conduct a meta-analysis of the association between ACEI or ARB use and SARS-CoV-2 infection severity or mortality. Material and methods: We searched PubMed, EMBASE, Google scholar and the Cochrane Database of Systematic Reviews for observational studies published between December 2019 and August 4, 2020 Studies were included if they contained data on ACEI or ARB use and SARS-CoV-2 infection severity or mortality. Effect statistics were pooled using random-effects models. The quality of included studies was assessed with the Newcastle-Ottawa Scale (NOS). Data on study design, study location, year of publication, number of participants, sex, age at baseline, outcome definition, exposure definition, effect estimates and 95% CIs were extracted. Results: Twenty-six studies (21 cohort studies and 5 case-control studies) were identified for inclusion, combining to a total sample of 361467 participants. Mean age was 61.48 (SD 8.26) years and 51.63% were men. The mean NOS score of included studies was 7.85 (range: 7-9). Results suggested that ACEI or ARB use did not increase the risk of severe disease or mortality from SARS-CoV-2 infection (OR = 0.88, 95% CI: 0.75-1.02, p > 0.05). Conclusions: At present, the evidence available does not support the hypothesis of increased SARS-CoV-2 risk with ACEI or ARB drugs. Copyright © 2020 Via Medica, ISSN 2449-6170

Response of the Mexican national seismological service to significant earthquakes, under normal and COVID-19 pandemic circumstances

Mexico is a seismically active country. Earthquakes with magnitudes larger than 7.0 happen, on average, every other year. This fact requires a rapid and consistent response from the national monitoring agency, the Servicio Sismológico Nacional, SSN (Mexican National Seismological Service). For this purpose, in 2014, the SSN created a set of procedures for the daily operations and rapid response called “Protocolo de Respuesta Inmediata ante Sismos Amenazantes” (PRISA, protocol of immediate response to threatening earthquakes). This protocol has been triggered for 292 events with a magnitude larger than or equal to 5.0 that occurred between April 2014 and July 2020. Here we present the response of the SSN, based on this protocol, to three significant earthquakes: the 8 and 19 September 2017 events (Mw 8.2 and 7.1, respectively) and the 23 June 2020 (Mw 7.4). The first two quakes caused severe damage in southern and central Mexico, whereas the third occurred during the coronavirus disease 2019 pandemic and confinement in Mexico. Having PRISA in place contributed to the efficient SSN response in the three events, even though some activities for the 2020 earthquake were performed remotely. © Seismological Society of America

COVID-19 and the Limitations of Official Responses to Gender-Based Violence in Latin America: Evidence from Ecuador

As the COVID-19 lockdowns were implemented, Latin American countries raced to announce plans to address gender-based violence in response to the increase in reports of intrafamily abuse. However, states' interventions had limited results. This article explores the Ecuadorian case. The Andean country's emergency strategy was based on reporting violence via the 911 emergency number, a plan that failed to consider that women quarantined with their aggressors would not have the opportunity to make the call. This article lays bare the extent of the gap between policy and practice in gender mainstreaming and the acute consequences of this during the pandemic. © 2020 The Author. Bulletin of Latin American Research published by John Wiley & Sons Ltd on behalf of Society for Latin American Studies.

Brain MR Spectroscopic Findings in 3 Consecutive Patients with COVID-19: Preliminary Observations.

Brain multivoxel MR spectroscopic imaging was performed in 3 consecutive patients with coronavirus disease 2019 (COVID-19). These included 1 patient with COVID-19-associated necrotizing leukoencephalopathy, another patient who had a recent pulseless electrical activity cardiac arrest with subtle white matter changes, and a patient without frank encephalopathy or a recent severe hypoxic episode. The MR spectroscopic imaging findings were compared with those of 2 patients with white matter pathology not related to Severe Acute Respiratory Syndrome coronavirus 2 infection and a healthy control subject. The NAA reduction, choline elevation, and glutamate/glutamine elevation found in the patient with COVID-19-associated necrotizing leukoencephalopathy and, to a lesser degree, the patient with COVID-19 postcardiac arrest, follow a similar pattern as seen with the patient with delayed posthypoxic leukoencephalopathy. Lactate elevation was most pronounced in the patient with COVID-19 necrotizing leukoencephalopathy.

Nuevo coronavirus (SARS-CoV-2) y embarazo

Currently a new infectious agent of zoonotic origin and viral etiology, identified on January 7, 2020, belonging to the Coronaviridae family, SARS-CoV-2, has been name by the World Health Organization as a very high risk for all countries. The disease has been named COVID-19, it has its origin in Wuhan, Hubei Province, China, epicenter of the disease;the first cases were presented in December 2019. Information on pregnant women with COVID-19 is limited;there are many things to know about it: One of them is if there is vertical transmission of SARS-CoV-2 and other is about presence of the virus in the different maternal and newborn fluids. Health professionals responsible for the care of pregnant women should be familiar with the epidemiological evolution, the clinical manifestations during pregnancy, the care of the exposed newborn and the measures of prevention to avoid disease. © 2020 Sociedad de Obstetricia y Ginecologia de Venezuela. All rights reserved.

Predictive factors of COVID-19 in patients with negative RT-qPCR.

OBJECTIVE: To evaluate the factors associated with false negatives in RT-qPCR in patients with mild-moderate symptoms of COVID-19. MATERIALS AND METHODS: This was a cross-sectional study that used a random sample of non-hospitalized patients from the primary care management division of the Healthcare Area of Leon (58 RT-qPCR-positive cases and 52 RT-qPCR-negative cases). Information regarding symptoms was collected and all patients were simultaneously tested using two rapid diagnostic tests - RDTs (Combined - cRDT and Differentiated - dRDT). The association between symptoms and SARS-CoV-2 infection was evaluated by non-conditional logistic regression, with estimation of Odds Ratio. RESULTS: A total of 110 subjects were studied, 52% of whom were women (mean age: 48.2±11.0 years). There were 42.3% of negative RT-qPCRs that were positive in some RDTs. Fever over 38°C (present in 35.5% of cases) and anosmia (present in 41.8%) were the symptoms most associated with SARS-CoV-2 infection, a relationship that remained statistically significant in patients with negative RT-qPCR and some positive RDT (aOR=6.64; 95%CI=1.33-33.13 and aOR=19.38; 95% CI=3.69-101.89, respectively). CONCLUSIONS: RT-qPCR is the technique of choice in the diagnosis of SARS-CoV-2 infection, but it is not exempt from false negatives. Our results show that patients who present mild or moderate symptoms with negative RT-qPCR, but with fever and/or anosmia, should be considered as suspicious cases and should be evaluated with other diagnostic methods.