Kounis syndrome in poisoning due to bee stings, a narrative review.

Kounis syndrome is defined by the appearance of acute coronary events associated to anaphylactic symptoms. The pathophysiological mechanism is still uncertain, however, coronary vasospastic activity secondary to a hypersensitivity type I response is postulated as a triggering factor. In the con-text of an accident due to a massive bee's attack, poisoning syndrome also occurs, where the poison components directly damage the myocardium. Kounis syndrome has been reported in SARS-CoV-2 infection, opening the possibility of other mechanisms, among which the cytokine storm stands out. This narrative review aims to consider the mechanisms of damage in Kounis syndrome secondary to poisoning by a massive bee attack and its relationship with the development of short-term complications.Copyright © 2023 Universidad de Antioquia.

Feasibility and effect of a self-help online acceptance and commitment therapy program focused on repetitive negative thinking for Colombian young women

Online psychological interventions (OPI) are evidence-based programs that provide mental health treatment over the internet. Meta-analytic data suggests that OPI's effectively treat emotional symptomatology. RNT-focused ACT consider psychological inflexibility and RNT as trans-diagnostic process that significantly predict emotional symptomatology. The present study analyzed the effect of a self-help OPI which contents have previously shown content validity, user feasibility and effectivity. This is an open trial design with repeated measures of emotional symptomatology and behavioral change processes. Bayesian analysis of variance for repeated measures was conducted with JASP for each variable, Bayes Factors (BF10) determined how much the evidence favored OPI effect. Effect sizes, reliable and significant change and moderation analyses were also conducted. 18 cisgender women around 30 years old mostly heterosexual, single and unemployed finished the OPI. There is decisive evidence for OPI effect on emotional symptomatology and behavioral change processes (experiential avoidance, cognitive fusion and RNT). There is also anecdotal evidence for the moderating role of the number of hierarchical RNT triggers ( private events), their type and intimate partner relationship distress as well as anecdotal evidence against the moderating role of being a psychologist. Results need to be considered in the context of the study limitations and future research should explore the program's feasibility and effect in other populations and cultures. However, the program is feasible and efficacious for the treatment of emotional symptomatology at least for young cisgender women in Colombia.

Non-contrast cardiac magnetic resonance imaging after SARS-CoV2 infection or vaccination in asymptomatic adolescents: Insights from the EnIGMA study

Background: Myocarditis after SARS-CoV2 infection or vaccination is rare, but seems to be relatively more frequent in young population. Cardiac magnetic resonance (CMR) T2 weighted sequences have the potential to detect subclinical myocarditis. However, there is paucity of data on the potential myocardial involvement after SARS-CoV2 infection or vaccination in asymptomatic adolescents. Purpose(s): To evaluate the presence of subclinical myocardial damage in adolescents who were infected with SARS-CoV2 or vaccinated against SARS-CoV2 using non-contrast CMR imaging. Method(s): Asymptomatic adolescents enrolled in the Early ImaginG Markers of unhealthy lifestyles in Adolescents (EnIGMA) project were scanned using a 3-Tesla CMR scanner between March 2021 and October 2021. CMR scans included CINE imaging and myocardial T2-mapping sequences. SARS-CoV2 IgG antibody testing was performed in capillary blood samples, and date of confirmed SARS-CoV2 infection and/or vaccination if any was collected. Participants were assigned to three different groups according to SARS-CoV2 status: Group 1 (non-infected and nonvaccinated), Group 2 (infected and non-vaccinated), and Group 3 (vaccinated, independently of past infection status). CMR images were analyzed by experienced observers blinded to adolescent's SARS-CoV2 status. ANOVA and multiple regression analysis, together with correlation coefficients, were used to study between-group differences and associations among variables of interest. Result(s): A total of 115 adolescents with a mean age of 16.0 years (standard deviation (SD)=0.4), 54% girls, completed the CMR study and SARSCoV2 data successfully, and were assigned to Group 1 (n=72), Group 2 (n=22), and Group 3 (n=21). Left and right ventricular ejection fraction (LVEF/RVEF) did not significantly differ among groups: Mean LVEF was 62.8% (SD=4.1), 63.0% (SD=3.7) and 60.9% (SD=3.9) [p=0.12] and mean RVEF was 56.5% (SD=4.2), 56.5% (SD=5.5) and 54.5% (SD=5.1) [p=0.23] in Groups 1, 2 and 3, respectively. Similarly, there were no between-group significant differences in myocardial T2 relaxation values: Mean T2 values were 44.1 ms (SD=2.2), 44.1 ms (SD=1.8) and 44.4 ms (SD=1.9) in Groups 1, 2, and 3, respectively (p=0.63) (Figure 1). No differences were found either after adjusting for age and gender. Median time (interquartile range) from date of infection or vaccination to CMR acquisition was 133 (121) days and 28 (38) days in Group 2 and Group 3, respectively. No correlation between time from infection/vaccination to CMR acquisition and T2 values was detected (Figure 2). Conclusion(s): This observational study did not find evidence of subclinical myocardial involvement after SARS-CoV2 infection or vaccination in asymptomatic adolescents, as assessed with T2-mapping magnetic resonance imaging.

HLA Class I allele is associated with a lower risk to develop Post-COVID19 interstitial lung manifestations

Introduction: The HLA Class I genes codify crucial molecules in developing the immunological response against pathogenic agents such as SARS-CoV-2. We aimed to assess HLA-A alleles associated with COVID-19 subsequent pulmonary complications as interstitial lung manifestations (ILM). Material(s) and Method(s): 209 Mexican mestizo patients with a positive RT-PCR test for SARS-CoV-2 and confirmed clinical diagnosis of COVID-19 were included. The participants were monitored three months after the hospital discharge through tomography;They were divided into two groups, 1) patients who developed ILM post-COVID19 (n = 85) and 2) those patients without tomographic evidence of ILM (n = 124). The HLA-A locus was genotyped by endpoint PCR using Micro SSP Generic HLA Class I kits. The clinical and demographic variables were analyzed by SPSS software. The alleles and genotypes were analyzed by 2 x 2 contingency tables, the value of p was obtained by Yates' correction. Result(s): There is no significant difference in age, sex, BMI, hospitalization days, PAO2/FIO2, or invasive mechanical ventilation. The alleles HLA-A*02:01, *24:02, and *68:01 are the most frequent in both study groups, grouping more than 60% of the alleles identified. On the other hand, the frequency of the HLA-A*01:01 allele was decreased in the group with interstitial lung manifestations at 3 months of discharge, compared to the group without interstitial lung manifestations (p= 0.004, OR = 0.13, IC95% 0.03-0.58). There is no significant difference in the genotypic frequencies. Conclusion(s): Subjects carrying the HLA-A*01:01 allele have a lower risk of developing interstitial lung manifestations posterior from COVID-19.

Effectiveness of the contingency plan of the internal inflammatory disease unit before COVID-19 infection

Background: Decision making in hospitals, and especially in their own healthcare services, is hardly referenced in the literature. During the pandemic period, healthcare services have put in place contingency plans to minimize the consequences of the coronavirus on professionals and patients. However, the deployment of contingency plans and results are hardly shared, depriving other services of references to refute, compare or emulate the aforementioned plans. The objective of this work was the description of the implementation and evaluation of Contingency Plans in the Covid-19 pandemic in a unit of inflammatory bowel disease of a Digestive Service in the Sanitary Area of Pontevedra and O Salnes.

SARS-CoV-2 transmission dynamics in the urban-rural interface.

OBJECTIVES: As the world responds to the coronavirus outbreak, the role of public health in ensuring equitable health care that considers the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) dynamics in rural communities is still a challenge. The same suppression and mitigation measures have been implemented homogeneously, ignoring the differences between urban and rural areas. We propose an epidemiological model and simulate the dynamics of SARS-CoV-2 in urban and rural areas considering the interaction between these regions. STUDY DESIGN: This was a population modeling study. METHODS: A compartmental epidemiological model was formulated to simulate the transmission of SARS-CoV-2 in urban and rural areas. We use the model to investigate the impact of control strategies focused on the urban-rural interface to contain the epidemic size of SARS-CoV-2 in rural areas. RESULTS: Considering five different levels for the exposition rate in urban areas and keeping intrarural and urban-rural exposition rates fixed, the preventive measures reduce the size and delay the peak for the urban infectives. The response of infected individuals and cumulative deaths in rural areas upon changes in the urban dynamics was small but not negligible. On the other hand, preventive measures focused on the urban-rural interface impact the number of infected individuals and deaths in rural areas. CONCLUSIONS: The maintenance of SARS-CoV-2 in rural areas depends on the interaction of individuals at the urban-rural interface. Thus, restrictive measures established by the governments would not be required within rural areas. We highlight the importance of focused preventive measures on the urban-rural interface to reduce the exposure and avoid the transmission of SARS-CoV-2 to rural communities.

RE-SIGNIFY the DOMESTIC SPACE in TIMES of CONFINEMENT from the APPLICATION of ETHNOGRAPHIC TOOLS and PERSONAL CENTERED DESIGN

The Covid-19 crisis has been described as the “greatest challenge that humankind has faced since the 2nd World War,” having an impact on health, society, and the global economy. Houses and domestic spaces are key sites through which COVID-19 is experienced, thus, an interdisciplinary approach is needed. The goal of this research project is to forge an analytical approach while experimenting with micro-ethnography and auto-ethnography tools to analyse how we inhabit the domestic spaces in complex situations of confinement imposition in order to arrive at an outward reflection from within. The project reflects on an innovative social experiment that opens up new paths of design provoking to help us rethink the domestic space. This paper has the objective to compile, compare and explain the processes and results around the characterization of the domestic space, centring on the person in times of confinement through an ethnographic approach. © PDE 2021.

Financialization and Consumerism: Multipolarisms and the Covid-19 Crisis

This work posits that under the terrible global crisis caused by the Covid-19 health crisis lies an economic-financial crisis, stemming from a continuum of multiple financial speculative practices in an asymmetrical multipolar environment and a driving force of global and local inequalities. Two important factors reviewed here are the financialization and consumerism whose causal environment has been influenced and intertwined with local and international governance and governability patterns fostered by the interests and hegemony of transnational and multinational enterprises (TM). Methodologically, we propose research that sheds light on these companies, as well as on multipolarity, governance and governability. The evidence analyzed confirms that underlying the health crisis lies a structural economic and financial crisis whose imbalances and abuses deepen the Covid-19 crisis.

Coronavirus (COVID-19) infection in pregnancy

Coronavirus illness 2019 (COVID-19) is an airways infection caused by the new coronavirus (SARS-CoV-2) which has been quickly disseminated all over the world, affecting to the general population including women in pregnancy time. As being a recent infection, the evidence that supports the best practices for the management of the infection during pregnancy is limited, and most of the questions have not been completely solved yet. This publication offers general guidelines focused on decision-making people, managers, and health's teams related to pregnant women attention and newborn babies during COVID-19 pandemic. Its purpose is to promote useful interventions to prevent new infections as well as prompt and adequate attention to avoid serious complications or deaths, trying to be adapted to the different contexts in which attention to expectant mothers is provided. Guidelines are set within a well-scientific evidence and available recommendations up to date.

Impact of social lags on the number of deaths and confirmed cases by COVID-19 in Mexico: Artificial neural network analysis employing municipal information

The situation that Mexico is going through, due to the COVID19 pandemic, has evidenced the vulnerability of certain localities because of the deficiencies related to health services access, education, and basic services in households (electricity, water and sewer system). This research aims to analyze the impact of the lack of those services, on the number of COVID19 cases and deaths. To achieve that purpose, Artificial Neural Network approach is employed, using the municipal Social Lags Index, published by the National Council of Social Development Policy Evaluation (CONEVAL) and the number of cumulative COVID19 deaths and cases reported by Mexican government. Findings suggest that structural deficiencies related to lack of sanity conditions and access to water are the main determinates of the number of contagions and deaths by the pandemic. © 2020 Universidad Nacional Autonoma de Mexico. All rights reserved.

SARS-CoV-2: From its genomic and structural aspects to its treatment

The sars-CoV-2 pandemic has been the greatest health challenge humanity has faced in recent times. The efforts made by the scientific community on a global scale to understand its behavior at the molecular level and to search for different therapeutic options have been transcendental if we take into account the time of its appearance. The objective of the present writing is to give a general panorama of the genomic and structural aspects of sars-CoV-2, its epidemiological behavior in Mexico, clinical picture, diagnosis and treatment;all these elements are crucial in the understanding, approach, and containment of covid-19.