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This chapter uses discourse analysis to study the statements made by two main players of the Mexican government: President Andrés Manuel López Obrador and Hugo López-Gatell, the Undersecretary for Health Prevention and Promotion. This analysis also discusses the ¡Quédate en casa! audiovisual advertisement campaign and its main character: the heroine SuSana Distancia. It suggests that the government's advertisement campaigns failed to promote the importance of health care and joint responsibility among the community;this is reflected in the number of people infected and deaths in Mexico. This study is made up of six parts: the first introduces the importance of a strategic communication plan;the second discusses the frame of reference;the third describes the analysis method and the corpus study configuration;the fourth includes the results;the fifth ponders the analysis;and the sixth includes the conclusions. The main findings are that the Mexican government never had the intention of promoting the use of masks as an essential measure. Two spots taught the population how to wear a mask;however, the discourse of both the Undersecretary and the President was that wearing a mask was not an essential measure to control infections. © Springer Nature Switzerland AG 2023. All rights reserved.
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This chapter focuses on the concern about the implementation strategy of the Federal Government's Vaccination Plan. Both the public and private health professionals, as well as those persons who must leave their homes to earn their livelihood, have been the most affected by the Covid-19 pandemic. Therefore, the objective of this research was to study the interactions carried out on two social media, in order to analyze what people think about the way the Federal Government's Vaccination Plan has been implemented. A mixed methodology (quantitative) was used to carry out this analysis, in order to gather the data and carry out a numerical visualization with the aim of obtaining a general appraisal about the study object. Additionally, digital ethnography was used to observe the type of interaction carried out in the fora. The data was gathered during three episodes. The first episode included informants, who were asked to get the opinion of their groups about a discussion-generating question, which raised doubts about the vaccination strategy. The second episode consisted of following a person's post expressing his opinion about the senior citizens' first vaccination day. The aim of the third episode of this analysis was to study the first 150 comments that Internet users made on the walls of two prestigious Mexican research-professors: Lorenzo Meyer and Sergio Aguayo. © Springer Nature Switzerland AG 2023. All rights reserved.
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Intro The concept of training immunity originally developed for other diseases has gained attraction during the epidemic. Several clinical trials and epidemiological analyses of populations previously immunized with BCG and other vaccines were the focus of scientific discussions. Here we show the activation of innate immunity markers both at mucosal and systemic levels with a mucosal vaccine CIGB2020 (HeberNasvacTM) containing virus-like particles (HBsAg) and nucleocapsid particle (HBcAg) of the hepatitis B virus. Moreover, the immune potentiating capacity of the HBcAg combined with RBD protein was used to formulate a specific mucosal vaccine candidate against SARS-CoV-2 (MambisaTM). Methods With CIGB 2020 (100µg HBsAg and 100 µg HBcAg) were conducted two proof of concept trials in human volunteers and a Phase I-II open, randomized, and controlled trial in 46 volunteers older than 60 years, symptomatic or close contact of COVID-19 patients. The volunteers were randomly assigned to the treatment group or not treated group. The nasal spray was administered to the treatment group on days 0, 7, and 14 together with daily sublingual administrations. Mucosal and serum samples were collected on days 0, 4, and 8. With MambisaTM vaccine (50µg RBD and 40 µg HBcAg) was conducted one proof of concept trial and a Phase I-II open and randomized trial in 1131 volunteers 19 to 60 years old, evaluating three different devices for nasal administration. All the volunteers gave written informed consent. Findings CIGB2020 activates interferon-induced genes and TLR 3, 7, and 8 at the level of oropharyngeal mucosa and PBMC. Monocyte and lymphocyte populations were also activated. One dose of the MambisaTM vaccine induces high levels of specific IgG. The serum and mucosal antibodies show RBD-ACE2 binding inhibition capacity and neutralization activity. Conclusion Nasal immunization exhibits advantages in inducing immunity at the level of the nasopharyngeal mucosa in addition to the systemic response.
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ECMO offering is limited to advanced HIV/AIDS patients. The Covid-19 pandemic exposed primary care shortage with resurgence of STDs, including HIV. At the same time, immunocompromised hosts with COVID-19 infection carried worse outcomes. We report a case of successful use of VV-ECMO in a newly diagnosed HIV/AIDS patient with severe ARDS as bridge to respiratory and immunologic recovery A 36-year-old white male diagnosed with moderate COVID-19 pneumonia in early August 2022, treated with steroids and remdesivir, found with HIV/AIDS stage 3 (CD4 of 28/5%) and high viral load (7 million cop/mL). Respiratory status declined to require invasive mechanical ventilation (MV) and unsuccessful trial of proning. Due to persistent hypoxemia, VV- ECMO was initiated in late August 2022. HIV antiretroviral therapy (ARV) was bictegravir/emtricitabine/tenofovir, then Dolutegravir + emtricitabine/tenofovir to enable nasogastric administration. Empirically treated with Bactrim and continued steroids for PJP, confirmed positive by PCR, in addition to high CMV titers in blood (129.000 IU/mL) and BAL (42.000 IU/mL), suggestive of CMV pneumonitis co-infection treated with Ganciclovir IV. Tracheostomy was performed on day 15. ECMO run faced formidable challenges including circuit insufficiency in the settings of possible Immune Reconstitution Inflammatory Syndrome with elevated cardiac output, managed with addition of right jugular vein return cannula;RV failure secondary to Pulmonary HTN, supported with inotropes and inhaled pulmonary vasodilators;uncertain ECMO pharmacodynamics for ARV and high sedative demands;thrombocytopenia (HIV and iatrogenic) deriving in spontaneous small subdural hematoma with no sequela. After 7 weeks of ECMO therapy, MV via tracheostomy was transitioned to High Flow Nasal Cannula while improving ECMO settings towards circuit weaning, HIV and CMV had virtually suppressed (252 cop/mL and 751 IU/mL, respectively), and CD4 increased to 122/18% COVID-19 pandemic propelled the use of ECMO therapy for severe ARDS and spotlighted healthcare access disparities with resurgence of vulnerable populations such the advanced HIV/AIDS patients. High-volume ECMO centers are acquiring expertise to enable survival of complex patients historically deprived of high-end therapies [ FROM AUTHOR] Copyright of Journal of Heart & Lung Transplantation is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)
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The National Breast and Cervical Cancer Early Detection Program (NBCCEDP) of the Centers for Disease Control and Prevention (CDC) reported that for the month of In April 2020, screening tests for breast cancer decreased by 87% and for cervical cancer by 84% compared to the previous 5year averages for that month. In response to this finding, the Puerto Rico Breast and Cervical Cancer Prevention and Early Detection Program (PR-BCCPEDP) in collaboration with the insurer Triple S-Salud, implemented a virtual educational intervention and/or face-to-face for breast and cervical cancer in the health centers where Triple-S Salud insurer provides services. The purpose of this initiative was aimed at strengthen knowledge in the early detection of breast and cervical cancer, increase the use of screening tests in the population of interest, and increase the reach of women who do not have health insurance who can qualify for the Program. Methodology: The PRBCCPEDP entered into a collaborative agreement with the insurer Triple-S Salud to implement an educational intervention for breast and cervical cancer in 12 primary health centers around the island. In the period from October to December 2020, 12 health educators from the Triple-S Salud insurer carried out 131 educational activities with the participation of 875 participants. The educational activities were carried out in person through educational flip charts and virtually using an educational PowerPoint on both types of cancer. The educational materials included topics related to breast and cervical cancer such as: statistics, risk factors, signs and symptoms, early detection guidelines, myths and facts, and barriers to not having early detection tests. Result(s): The educational intervention in breast and cervical cancer obtained the following results: A total of 875 participated in the intervention, where 100% were women, with an average age of 50 years and the majority (97%) had coverage from the government health plan. The towns with the most registered participants were Bayamon with 18% and Mayaguez with 16% respectively. The virtual form was the most used by the participants (58%) compared to the face-to-face form. Regarding screening tests for breast and cervical cancer, of 75 women who had overdue the breast cancer guidelines, 20% had a mammogram after the intervention. Similarly, 142 women had overdue the cervical cancer guidelines, and 22.6% were carried out the tests after the intervention. Other hand, of the women, referred to the PR-BCCPEDP, 3% indicated not having health insurance, of which 29.6% were recruited and cared for by the Program. Conclusion(s): Despite security restrictions as a result of the pandemic, collaborations with a health system helped reach a greater number of women to provide education and awareness about breast and cervical cancer. In addition, it can be inferred that the virtual form allowed for increasing the scope of participation in times of pandemic. Lastly, I also helped reach women without health insurance who were recruited into the Program.
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Introduction:?Puerto Rico Libre de Enfermedades Prevenibles (Puerto Rico Free of Preventable Diseases) was an online, community-based initiative consisting of eight educational training programs regarding school entry vaccines, including HPV vaccine as the most recent requirement. The Community Advisory Board of the HPV-PIVac study (CAB-PIVac) developed this activity in response to barriers identified on school personnel by the HPV-PIVac study: lack of knowledge about the HPV vaccine and its school entry requirement and need for training. In February 2020, CAB-PIVac members collected data through a self-administrated survey to identify potential topics. After several meetings, members identified the topics and resources for these webinar series. Our purpose is to present how the integration of community members into an ongoing research study allowed rapid response to developing an educative initiative to impact school staff concerning preventable diseases and the HPV vaccine. Methods: Eight webinars in four weeks were transmitted in-live through the Zoom platform from June 26 to July 17, 2020. They were on-demand until July 24, 2020. Theme per week: World without vaccine: COVID-19;Teenager vaccine in School;Future free of HPV-related cancer;and Legal aspects of vaccination for the school-entry. The participants received via email an evaluation form to assess the impact of these webinars. Using data from the registration form, we collected the following participants' characteristics: sex, age, education sector, and role in the school. We performed a thematic analysis collecting all the messages posted in the Q & A section of each webinar to identify the topics in which the participants had doubts or more interest. Results: A unique participation of 954 participants were registered, and the range of involvement on the education webinars was 588 to 780 participants. Based on the type of education, 28.8% were private, and 70.9% were from public education. Most of the participants were females (89.6%) and with an average age of 42 years (range: 21 -74). Of the participants who reported their role at their schools (n=648), 31.4% were school nurses, followed by the school director (22.7%). Twelve percent of the participants were teachers. The evaluation was satisfactory (99.7%) considering the tools offered and the clear information presented. The thematic analysis results showed that the two topics discussed in the Q &A section were the immunization registry (problems with system access) and the vaccination series (age to initiate the series). Conclusion: This initiative was developed and performed in less than five months. Many national and international organizations, coalitions, and government agencies are working to achieve the same goal: eradicated HPV-related cancers and strengthen the awareness for HPV prevention. Involve these community members in the research is crucial to secure how the results of the investigation studies could impact the community quickly and accurately.
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The global pandemic disease COVID-19 commands a number of host immunological responses to deadly cytokine-storm manifestations. Mitigation of incoming infectious comorbidities ushered by immunosuppression such as tuberculosis (TB) is warranted including the requirement of new drugs. Employment of computational screening methods and intricate selection of putative viral protein targets allows identification of lead mitigating compounds against COVID-19. Antitubercular natural products may offer privileged starting points as potential antagonistic prospects for SARS-CoV-2 non-structural proteins implicated in viral replication and infection mechanisms. In this study, antitubercular natural products from Philippine medicinal plants are repurposed as inhibitors of vital SARS-CoV-2 nsps such as 3CLpro (3-chymotrypsin-like protease), PLpro (papain-like protease), and RdRp (RNA-dependent RNA polymerase) using in silico methods. A total of 67 antitubercular compounds were computationally screened using molecular docking in 3CLpro, PLpro, and RdRp followed by subsequent ADMET (absorption, distribution, metabolism, excretion, and toxicity) analysis of top-binding compounds to assess their drug-likeness and pharmacokinetic properties. Based on the results of our molecular docking analysis, 10 antitubercular natural product cocktails exhibited strong binding propensities against 3CLpro, PLpro, and RdRp. Several compounds demonstrated multi-targeting inhibition to at least two vital non-structural proteins (nsps). Vobtusine lactone (1), deoxyvobtusine lactone (6), and deoxyvobtusine (7) exhibited superior target-specific binding while globospiramine (3) was found to be a potential multi-targeting alkaloid with amenable drug-like properties. The study elaborated for the first time, the computational screening of antitubercular compounds against three vital targets of SARS-CoV-2 yielding potential drug-like compounds against COVID-19 infection. A combination of excellent binding scores, dynamic stability, drug-likeness, and pharmacokinetic properties identified vobtusine lactone (1), deoxyvobtusine lactone (6), deoxyvobtusine (7), and the triple targeting globospiramine (3) as promising leads representing new anti-SARS-CoV-2 scaffolds. © 2022, Department of Science and Technology. All rights reserved.
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Background: As the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has remained in Latin America, Mexico has become the third country with the highest death rate worldwide. Data regarding in-hospital mortality and its risk factors, as well as the impact of hospital overcrowding in Latin America has not been thoroughly explored. Methods and findings: In this prospective cohort study, we enrolled consecutive adult patients hospitalized with severe confirmed COVID-19 pneumonia at a SARS-CoV-2 referral center in Mexico City from February 26th, 2020, to June 5th, 2020. A total of 800 patients were admitted with confirmed diagnosis, mean age was 51.9 +or- 13.9 years, 61% were males, 85% were either obese or overweight, 30% had hypertension and 26% type 2 diabetes. From those 800, 559 recovered (69.9%) and 241 died (30.1%). Among survivors, 101 (18%) received invasive mechanical ventilation (IMV) and 458 (82%) were managed outside the intensive care unit (ICU);mortality in the ICU was 49%. From the non-survivors, 45.6% (n = 110) did not receive full support due to lack of ICU bed availability. Within this subgroup the main cause of death was acute respiratory distress syndrome (ARDS) in 95% of the cases, whereas among the non-survivors who received full (n = 105) support the main cause of death was septic shock (45%) followed by ARDS (29%). The main risk factors associated with in-hospital death were male sex (RR 2.05, 95% CI 1.34-3.12), obesity (RR 1.62, 95% CI 1.14-2.32)-in particular morbid obesity (RR 3.38, 95%CI 1.63-7.00) - and oxygen saturation < 80% on admission (RR 4.8, 95%CI 3.26-7.31). Conclusions: In this study we found similar in-hospital and ICU mortality, as well as risk factors for mortality, compared to previous reports. However, 45% of the patients who did not survive justified admission to ICU but did not receive IMV/ICU care due to the unavailability of ICU beds. Furthermore, mortality rate over time was mainly due to the availability of ICU beds, indirectly suggesting that overcrowding was one of the main factors that contributed to hospital mortality.
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COVID-19 , Pityriasis Rosea , COVID-19 Vaccines , Humans , Pityriasis Rosea/etiology , SARS-CoV-2 , Vaccination/adverse effectsABSTRACT
The purpose of the current study was to explore the delivery of the Group Lifestyle Triple P (GLTP) parent group programme through digital practice. Eight mothers of obese children aged 6–11 were recruited from a university hospital. Using a mixed-methods approach, the study sought to characterise the perceived changes throughout the intervention and explore the outcome measures on children’s BMI z-score, weight-related behaviour problems, parents’ self-efficacy, interparental conflict and parenting styles assessed pre- and post-intervention. Participants identified changes in themselves, in positive parenting, and in their ability to manage children’s nutrition and physical activity, contributing to improve children’s lifestyle behaviours. The clinical results were similar to the findings of studies in which GLTP was delivered in-person. Delivering GLTP through digital practice seems to be a possible way of implementing the intervention, particularly during the COVID-19 pandemic. Practitioner points: GLTP sessions’ contents and activities were adapted for digital delivery without compromising the programme’s implementation fidelity. Parents perceived an increase in positive parenting behaviours and their ability to manage children’s nutrition and physical activity. The clinical results of the GLTP delivered through digital practice were similar to those of studies in which the programme was delivered in-person. © 2021 The Association for Family Therapy and Systemic Practice
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The pandemic produced by the new SARS-CoV-2 coronavirus has indelibly marked the history of humanity. The conducts, actions and habits of people have changed substantially, redefining our activities at all levels. Our specialty is dedicated to the care of pediatric patients with congenital heart defects, from the neonatal stage to adolescence. In this age group, the symptomatic picture of COVID-19 is not present in most cases, therefore, anesthetic practice is carried out with precautions aimed to assist asymptomatic patients considered not carriers of the virus SARS-CoV-2, without the complete elements of personal protective equipment. This document compiles the practices and guidelines adopted by the anesthetists of the KARDIAS program for the care of children with congenital heart defects during the COVID-19 pandemic. We have made an adaptation of the different guidelines reported on anesthetic, pediatric, cardiovascular and echocardiographic management, adhering to the evidence reported to date. These recommendations are applicable for any center that performs pediatric cardiovascular anesthesia with modifications according to its institutional requirements and they should be periodically reviewed regarding new scientific evidence reported. Finally, we comment about the appearance of a probable new clinical presentation of SARS-CoV-2 infection as an atypical variety of Kawasaki disease in children.
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In a context of community transmission and shortage of vaccines, COVID-19 vaccination should focus on directly reducing the morbidity and mortality caused by the disease. It is thus essential to define priority groups for vaccination by the National Immunization Program (PNI in Portuguese), based on the risk of hospitalization and death from the disease. We thus calculated overrisk according to sex, age group, and comorbidities using hospitalization and death records from severe acute respiratory illness with confirmation of COVID-19 (SARI-COVID) in all of Brazil in the first six months of the epidemic. Higher overrisk was associated with male sex (hospitalization=1.1 and death=1.2), age over 45 years for hospitalization (OvRag ranging from 1.1 to 8.5), and age over 55 year for death (OvRag ranging from 1.5 to 18.3). In the groups of comorbidities, chronic kidney disease, diabetes mellitus, cardiovascular disease, and chronic lung disease were associated with overrisk, while there was no such evidence for asthma. Chronic kidney disease or diabetes plus age over 60 showed an even stronger association, reaching overrisk of death 14 and 10 times greater than in the general population, respectively. For all the comorbidities, there was higher overrisk at older ages, with a downward gradient in the oldest age groups. This pattern was reversed when examining overrisk in the general population, for both hospitalization and death. The current study provided evidence of overrisk of hospitalization and death from SARI-COVID, assisting the definition of priority groups for COVID-19 vaccination.