ABSTRACT
En estudios preliminares objetivamos alta prevalencia de uso de sustancias psicoactivas (SP) entre alumnos de Anatomía, con mayor impacto entre los recursantes o aquellos con actividades laborales. La causa del uso es multifactorial, pero se destacan factores de riesgo y precipitantes como la carga horaria de la currícula, exigencias de estudio, el distrés por el afrontamiento cadavérico negativo, el nuevo contexto educativo y la cantidad de horas de sueño. El objetivo fue comparar la prevalencia de uso de SP entre las cohortes de 2011-2019, con focalización en los factores determinantes conductuales. Estudio observacional, transversal y comparativo mediante encuesta estandarizada y anónima en 945 alumnos (año 2011= 122; año 2013= 158; año 2015=204; año 2017= 228; año 2019= 233). Se aplicaron parámetros estadísticos, se definió la significación como p -0.84; AA: r> -0.71). En el caso de ansiolíticos benzodiacepínicos, se asoció con falta de sueño y distrés por el afrontamiento negativo al estudio con cadáveres. En las cohortes comparadas por el lapso de 9 años hallamos alta prevalencia de uso de sustancias psicoactivas con tendencia al incremento. Las variables actividad laboral y recursante fueron determinantes para el uso de sustancias, y se asociaron cuestiones relativas a la adaptabilidad universitaria y afrontamiento de estudio negativo con el cadáver; todos con incidencia pedagógica en el proceso de enseñanza y aprendizaje.
SUMMARY: In preliminary studies, we observed a high prevalence of the use of psychoactive substances (PS) among Anatomy students, with a greater impact among recurrent students or those with work activities. The cause of use is multifactorial, but risk and precipitating factors stand out, such as the workload of the curriculum, study demands, distress due to negative cadaveric coping, the new educational context and the number of hours of sleep. The objective was to compare the prevalence of SP use between the 2011-2019 cohorts, with a focus on behavioral determinants. Observational, cross-sectional and comparative study using a standardized and anonymous survey in 945 students (year 2011= 122; year 2013= 158; year 2015=204; year 2017= 228; year 2019= 233). Statistical parameters were applied, significance was defined as p -0.84; AA: r> -0.71). In the case of benzodiazepine anxiolytics, it was associated with lack of sleep and distress due to negative coping with the study with cadavers. In the cohorts compared for a period of 9 years, we found a high prevalence of psychoactive substance use with an increasing trend. The variables work activity and recurrence were determinants for the use of substances, and issues related to university adaptability and negative study coping with the corpse were associated; all with pedagogical impact on the teaching and learning process.
Subject(s)
Humans , Male , Female , Young Adult , Students, Medical/psychology , Students, Medical/statistics & numerical data , Substance-Related Disorders/epidemiology , Anatomy/education , Argentina , Adaptation, Psychological , Attitude to Death , Prevalence , Cross-Sectional Studies , Surveys and Questionnaires , Risk Factors , Cohort Studies , Dissection/education , Dissection/psychology , Psychological DistressABSTRACT
During the pandemic of COVID-19, numerous waves of infections affected the two hemispheres with different impacts on each country. Throughout these waves, and with the emergence of new variants, health systems and scientists have tried to provide real-time responses to the complex biology of SARS-CoV-2, dealing with different clinical presentations, biological characteristics, and clinical impact of these variants. In this context, knowing the extent period in which an infected individual releases infectious viral particles has important implications for public health. This work aimed to investigate viral RNA shedding and infectivity of SARS-CoV-2 beyond 10 days after symptom onset (SO). A prospective multicenter study was performed between July/2021 and February/2022 on 116 immunized strategic personnel with COVID-19 diagnosed by RT-qPCR, with asymptomatic (7%), mild (91%) or moderate disease (2%). At the time of diagnosis, 70% had 2 doses of vaccines, 26% had 2 plus a booster, and 4% had one dose. After day 10 from SO, sequential nasopharyngeal swabs were taken to perform RT-qPCR, viral isolation, and S gene sequencing when possible. Viral sequences were obtained in 98 samples: 43% were Delta, 16% Lambda, 15% Gamma, 25% Omicron (BA.1) and 1% Non-VOC/VOI, in accordance with the main circulating variants at each moment. SARS-CoV-2 RNA was detected 10 days post SO in 57% of the subjects. Omicron was significantly less persistent. Noteworthy, infective viruses could not be isolated in any of the samples. In conclusion, a 10-days isolation period was useful to prevent further infections, and proved valid for the variants studied. Recently, even shorter periods have been applied, as the Omicron variant is prevalent, and worldwide population is largely vaccinated. In the future, facing the possible emergence of new variants and considering immunological status, a return to 10 days may be necessary.
Subject(s)
COVID-19 , RNA, Viral , Humans , Prospective Studies , Argentina/epidemiology , RNA, Viral/genetics , SARS-CoV-2/genetics , COVID-19/epidemiologyABSTRACT
Introduction: Pandemics throughout human history have caused global crises. Given their multifactorial impact, they generate changes in the functioning of the health pole, in the adaptation of the health system, the economy of nations, in political decision-making, and lifestyles. At the individual level, changes in behavior, emotions, thoughts, and quality of life in its many aspects (physical, psychological, social, and environmental) are glimpsed. Materials and method: With a quantitative approach of cross-sectional ex post facto design, and exploratory scope, the psychosocial and sociodemographic aspects related to adherence to health policies and the search for support were investigated in the adult population of the city of Córdoba (20 to 60 years). 704 people were surveyed, to whom the perceived stress questionnaire (pss-10), a sociodemographic questionnaire, and a questionnaire carried out with an ad hoc modality were applied. Results and Conclusions: Age, sex, schooling, health history, psychiatric/psychological history, and having relatives/partners belonging to a risk group; they presented an association with respect to adherence to health policy regulations; fear of getting infected; help/support seeking; and perceived stress. This research aims to be a starting point to promote local studies that investigate adherence to health policy regulations necessary to cope with the spread of a disease worldwide with the fewest possible adverse reactions.
Introducción: A lo largo de la historia de la humanidad las pandemias han sido causantes de crisis globales. Dado su impacto multifactorial, generan modificaciones en el funcionamiento del polo sanitario, en la adaptación del sistema de salud, la economía de las naciones, en la toma de decisiones políticas, y estilos de vida. A nivel individual se vislumbran modificaciones en el comportamiento, emociones, pensamientos, y la calidad de vida en sus múltiples vertientes (física, psicológica, social, y ambiental). Materiales y método: Con un enfoque cuantitativo de diseño ex post facto transversal, y alcance exploratorio se indagaron los aspectos psicosociales y sociodemográficos relacionados a la adhesión de las políticas sanitarias y la búsqueda de apoyo en población adulta de la ciudad de Córdoba (20 a 60 años). Se encuestó a 704 personas a las cuales se les aplicó el cuestionario de estrés percibido (pss- 10), un cuestionario sociodemográfico, y un cuestionario realizado con modalidad ad hoc. Resultados y conclusiones: La edad, el sexo, escolaridad, antecedentes de salud, antecedentes psiquiátrico/psicológicos y tener familiares/pareja perteneciente a grupo de riesgo; presentaron asociación respecto a la adherencia a la normativa político sanitaria; miedo a contagiarse; búsqueda de ayuda/apoyo; y estrés percibido. La presente investigación pretende ser un puntapié inicial para promover estudios locales que indaguen la adherencia a las normativas políticas sanitarias necesarias para sobrellevar la propagación de una enfermedad a nivel mundial con las menores reacciones adversas posibles.
Subject(s)
Pandemics , Quality of Life , Humans , Adult , Argentina , Cross-Sectional Studies , Health PolicyABSTRACT
It is quite well documented that the COVID-19 pandemic disrupted cancer screening services in all countries, irrespective of their resources and healthcare settings. While quantitative estimates on reduction in volume of screening tests or diagnostic evaluation are readily available from the high-income countries, very little data are available from the low- and middle-income countries (LMICs). From the CanScreen5 global cancer screening data repository we identified six LMICs through purposive sampling based on the availability of cancer screening data at least for the years 2019 and 2020. These countries represented those in high human development index (HDI) categories (Argentina, Colombia, Sri Lanka, and Thailand) and medium HDI categories (Bangladesh and Morocco). No data were available from low HDI countries to perform similar analysis. The reduction in the volume of tests in 2020 compared to the previous year ranged from 14.1% in Bangladesh to 72.9% in Argentina (regional programme) for cervical screening, from 14.2% in Bangladesh to 49.4% in Morocco for breast cancer screening and 30.7% in Thailand for colorectal cancer screening. Number of colposcopies was reduced in 2020 compared to previous year by 88.9% in Argentina, 38.2% in Colombia, 27.4% in Bangladesh, and 52.2% in Morocco. The reduction in detection rates of CIN 2 or worse lesions ranged from 20.7% in Morocco to 45.4% in Argentina. Reduction of breast cancer detection by 19.1% was reported from Morocco. No association of the impact of pandemic could be seen with HDI categories. Quantifying the impact of service disruptions in screening and diagnostic tests will allow the programmes to strategize how to ramp up services to clear the backlogs in screening and more crucially in further evaluation of screen positives. The data can be used to estimate the impact on stage distribution and avoidable mortality from these common cancers.
Subject(s)
COVID-19 , Uterine Cervical Neoplasms , Female , Humans , Thailand , Early Detection of Cancer , Uterine Cervical Neoplasms/diagnosis , Uterine Cervical Neoplasms/epidemiology , Pandemics , Bangladesh , Sri Lanka , Argentina , Colombia/epidemiology , Morocco/epidemiology , COVID-19/diagnosis , COVID-19/epidemiology , Developing CountriesABSTRACT
INTRODUCTION: In 2020 the pandemic caused by SARS-COV-2 demanded an enormous number of healthcare resources in order to guarantee adequate treatment and support for those patients. This study aims to assess caloric and protein intake and evaluate its associations with relevant clinical outcomes in critically ill with coronavirus disease (COVID-19) patients. METHODS: A nationwide, multicentre prospective observational study including twelve Argentinian intensive care units (ICUs,) was conducted between March and October 2020. INCLUSION CRITERIA: Adult ICU patients>18 years admitted to the ICU with COVID-19 diagnosis and mechanical ventilation for at least 48h. Statistical analysis was carried out using IBM-SPSS© 24 programme. RESULTS: One hundred and eighty-five patients were included in the study. Those who died had lower protein intake (0.73g/kg/day (95% confidence interval (CI) 0.70-0.75 vs 0.97g/kg/day (CI 0.95-0.99), P<0.001), and lower caloric intake than those who survived (12.94kcal/kg/day (CI 12.48-13.39) vs 16.47kcal/kg/day (CI 16.09-16.8), P<0.001). A model was built, and logistic regression showed that factors associated with the probability of achieving caloric and protein intake, were the early start of nutritional support, modified NUTRIC score higher than five points, and undernutrition (Subjective Global Assessment B or C). The patients that underwent mechanical ventilation in a prone position present less caloric and protein intake, similar to those with APACHE II>18. CONCLUSIONS: Critically ill patients with COVID-19 associated respiratory failure requiring mechanical ventilation who died in ICU had less caloric and protein intake than those who survived. Early start on nutritional support and undernutrition increased the opportunity to achieve protein and caloric goals, whereas the severity of disease and mechanical ventilation in the prone position decreased the chance to reach caloric and protein targets.
Subject(s)
COVID-19 , Malnutrition , Adult , Humans , Critical Illness/therapy , Argentina , COVID-19 Testing , SARS-CoV-2 , Malnutrition/epidemiology , Malnutrition/etiology , Malnutrition/therapyABSTRACT
SARS-CoV-2 vaccine protection has encountered waning of immune response and breakthrough infections. The hybrid immune response generated by the combination of vaccination and infection was shown to offer higher and broader protection. Here, we present a seroprevalence study of anti-SARS-CoV-2 spike/RBD IgG in 1,121 health care workers immunized with Sputnik V and a follow-up of humoral response at 2 and 24 weeks postvaccination (wpv), including neutralizing antibody response (NAT) against ancestral, Gamma, and Delta variants. The first seroprevalence study showed that among 122 individuals with one dose, 90.2% were seropositive versus 99.7% seropositivity among volunteers with the complete two-dose regimen. At 24 wpv, 98.7% of the volunteers remained seropositive, although antibody levels decreased. IgG levels and NAT were higher in individuals that had acquired COVID-19 previous to vaccination than in naive individuals at 2 and 24 wpv. Antibody levels dropped over time in both groups. In contrast, IgG levels and NAT increased after vaccine breakthrough infection. At 2 wpv, 35/40 naive individuals had detectable NAT against SARS-CoV-2 Gamma and 6/40 against Delta. In turn, 8/9 previously infected individuals developed a neutralizing response against SARS-CoV-2 Gamma and 4/9 against Delta variants. NAT against variants followed a trajectory similar to NAT against ancestral SARS-CoV-2, and breakthrough infection led to an increase in NAT and complete seroconversion against variants. In conclusion, Sputnik V-induced humoral response persisted at 6 months postvaccination, and hybrid immunity induced higher levels of anti-S/RBD antibodies and NAT in previously exposed individuals, boosted the response after vaccination, and conferred wider breadth of protection. IMPORTANCE Since December 2020, Argentina has begun a mass vaccination program. The first vaccine available in our country was Sputnik V, which has been approved for use in 71 countries with a total population of 4 billion people. Despite all the available information, there are fewer published studies on the response induced by Sputnik V vaccination compared to that of other vaccines. Although the global political context has paralyzed the verification by the WHO of the efficacy of this vaccine, our work aims to add new clear and necessary evidence to Sputnik V performance. Our results contribute to general knowledge of the humoral immune response developed by vaccines based on viral vector technology, highlighting the higher immune protection conferred by hybrid immunity and reinforcing the importance of completing vaccination schedules and booster doses to maintain adequate antibody levels.
Subject(s)
COVID-19 , SARS-CoV-2 , Humans , Argentina/epidemiology , COVID-19 Vaccines , Follow-Up Studies , Seroepidemiologic Studies , COVID-19/prevention & control , Vaccination , Antibodies, Neutralizing , Antibodies, Viral , Breakthrough Infections , Health PersonnelABSTRACT
Introduction: Due to the measures imposed by the argentine government during the SARS-CoV-2 pandemic, the capacity of universities and hospitals for the development of face-to-face educational activities has been restricted. Therefore, we set out to explore the perceptions of the educational impact and the experience in the virtual environment of Argentine medical students. Methods: We carried out an observational, analytical, cross-sectional study. The data collection was carried out through a national questionnaire in the period between April 19 and June 15, 2020 through a "snowball" type sampling. Results: The study population involved medical students from Argentina (n = 1520 students). From which we observed that 95.41% (n = 1505) believed that their formation was affected, only 56.14% (n = 850) of the universities were able to virtualize all the subjects, and 97.69% (n = 1479) believed that argentine universities were not fully prepared. As for their experience in virtuality; 92.98% (n = 1364) reported that virtual education allowed them to advance in their career, 76.89% (n = 1128) indicated that the quality of the virtual classes got worse compared to the face-to-face ones, and 58.55% (n = 859) did not have the possibility to take an exam virtually. Conclusion: Consequently, we concluded that the COVID-19 pandemic exposed the need to prepare medical careers for the management of educational contingencies. The results of this research reflect a student population affected in their learning by this situation. Educational policies that take into account the needs expressed by students are crucial.
Introducción: Debido al aislamiento impuesto por el gobierno durante la pandemia por SARS-CoV-2, se restringió la presencialidad en actividades educativas de universidades y hospitales. Objetivo: Nos propusimos explorar el efecto de la pandemia sobre el sistema educativo y la experiencia en el entorno virtual de los estudiantes de medicina de Argentina. Métodos: Llevando a cabo un estudio observacional, analítico, de tipo corte transversal. La recolección de datos se realizó mediante un cuestionario nacional en el período comprendido entre el 19 de abril y el 15 de junio del 2020 a través de un muestreo tipo "bola de nieve". La población en estudio involucró a estudiantes de medicina de la República Argentina (n=1520 estudiantes). Resultados: Observamos que el 95.41% (n=1505) señaló que su formación se vio afectada, tan solo el 56.14% (n=850) de las universidades pudo virtualizar todas las asignaturas, y el 97.69% (n=1479) expresó que las universidades argentinas no estaban completamente preparadas. En cuanto a la experiencia en virtualidad; el 92.98% (n=1364) comunicó que la educación virtual le permitió avanzar en la carrera, el 76.89% (n=1128) indicó que la calidad de las clases virtuales fue peor que las presenciales, y el 58.55% (n=859) no tuvo posibilidad de rendir algún examen de manera virtual. Conclusión: Concluimos que la pandemia expone la necesidad de preparar a las carreras de medicina para el manejo de las contingencias educativas. Los resultados reflejan una población estudiantil afectada en sus aprendizajes por esta situación coyuntural. Políticas educativas que tomen en cuenta las necesidades expuestas por los estudiantes resultan cruciales.
Subject(s)
COVID-19 , Students, Medical , Humans , Pandemics , SARS-CoV-2 , Argentina , Retrospective StudiesABSTRACT
BACKGROUND: On March 11, 2020 the WHO declared the state of pandemic by COVID-19. As of July 29, 2020, 17 106 007 cases and 668 910 deaths have been reported globally. The region of the Americas has reported 9 152 173 cases (53%) and 351 121 deaths (52,2%), so the aggregate analysis of the data in countries in this region is of interest. Argentina, Chile and Colombia, due to their demographic and economic characteristics, are countries that can be studied. OBJETIVE: Analyze variables related to health systems and epidemiological data of SARS-CoV-2 virus disease in Argentina, Chile and Colombia. METHODS: A descriptive study of variables reported by the official organisms of each state was used. RESULTS: There is an important difference in active cases and mortality among the three countries; the Autonomous City of Buenos Aires has the highest number of active cases as of July 2020. Colombia has the highest numbers of deaths confirmed by COVID-19 in the months of February to July 2020. We suggest the unification of an information system for Latin America that allows a comprehensive monitoring of variables, improves the qua-lity of data and unifies the technical language.
Subject(s)
COVID-19 , Humans , Latin America/epidemiology , SARS-CoV-2 , Americas , Morbidity , Argentina/epidemiologyABSTRACT
BACKGROUND: Depression is one of the most common mental health problems worldwide and, while prevalence rates in Latin America are relatively high, most people who meet the criteria for diagnosis do not receive treatment. Family and friends of a person with depression can play an important role in supporting a person to seek and engage with treatment. However, many people do not have the necessary skills or confidence to help. English-language mental health first aid guidelines have been developed to support people to provide such help. The aim of this study was to culturally adapt these guidelines for Chile and Argentina. METHODS: A Delphi expert consensus study was conducted with two expert panels, one of people with lived experience of depression (either their own or as a carer; n = 26) and one of health professionals (n = 29). Overall, 172 statements from the English-language guidelines were translated and compiled into a questionnaire. Participants were asked to rate statements based on how essential or important those statements were for Chile and Argentina and to suggest new statements if necessary. RESULTS: Data were obtained over two survey rounds. Consensus was achieved on 172 statements. A total of 137 statements were adopted from the English-language guidelines, whereas 35 new endorsed statements were generated from panel suggestions. There were similarities between the English-language guidelines and those for Chile and Argentina. The adapted guidelines did not include some of the items from the English-language guidelines related to commenting on a person's strengths or making judgements about their character, and also incorporated new items related to the incorporation of sociocultural considerations as causes of depression and attention to inequities in mental health. CONCLUSIONS: The significant number of new items underscores the importance of undertaking a careful process of cultural adaptation. Further research on dissemination and incorporation of the guidelines into the Mental Health First Aid training course for Chile and Argentina is still required.
Subject(s)
Depression , Mental Health , Humans , Depression/diagnosis , Depression/therapy , First Aid , Argentina , Chile , Delphi Technique , Surveys and QuestionnairesABSTRACT
The COVID-19 pandemic has lately been driven by Omicron. This work aimed to study the dynamics of SARS-CoV-2 Omicron lineages during the third and fourth waves of COVID-19 in Argentina. Molecular surveillance was performed on 3431 samples from Argentina, between EW44/2021 and EW31/2022. Sequencing, phylogenetic and phylodynamic analyses were performed. A differential dynamic between the Omicron waves was found. The third wave was associated with lineage BA.1, characterized by a high number of cases, very fast displacement of Delta, doubling times of 3.3 days and a low level of lineage diversity and clustering. In contrast, the fourth wave was longer but associated with a lower number of cases, initially caused by BA.2, and later by BA.4/BA.5, with doubling times of about 10 days. Several BA.2 and BA.4/BA.5 sublineages and introductions were detected, although very few clusters with a constrained geographical distribution were observed, suggesting limited transmission chains. The differential dynamic could be due to waning immunity and an increase in population gatherings in the BA.1 wave, and a boosted population (for vaccination or recent prior immunity for BA.1 infection) in the wave caused by BA2/BA.4/BA.5, which may have limited the establishment of the new lineages.
Subject(s)
COVID-19 , SARS-CoV-2 , Humans , SARS-CoV-2/genetics , COVID-19/epidemiology , Argentina/epidemiology , Pandemics , PhylogenyABSTRACT
With their particular body plan within amniotes and their amazing fossil record, turtles represent a great interest for both neontologists and paleontologists with a strong anatomical background. The Turtle Evolution Symposia are regular international meetings that gather scientists working with different aspects related to the evolutionary history of turtles, from their origin and early evolution until recent times. The latest edition of the Turtle Evolution Symposium was organized in 2021 amidst the COVID-19 outbreak and held virtually from the facilities of the Museo Paleontológico Egidio Feruglio in Trelew (Patagonia, Chubut, Argentina). More than 75 scientists from 25 countries presented their latest advances on topics related to turtle evolution, some of which are published in this Special Volume of The Anatomical Record. Both the Turtle Evolution Symposium 2021 and this Special Volume are dedicated to Marcelo S. de la Fuente who was the first researcher who specialized in the study of extinct turtles in South America, and his studies have an important regional and international impact.
Subject(s)
COVID-19 , Turtles , Animals , Biological Evolution , Turtles/anatomy & histology , Fossils , Argentina , PhylogenyABSTRACT
BACKGROUND: Early initiation with high efficacy therapies seems to be better than an escalation approach in terms of disability prevention in patients with relapsing-remitting MS (RRMS). Although efficacy and safety of cladribine tablets have been shown in clinical trials, real-world evidence (RWE) studies from Latin America are scarce. OBJECTIVE: To describe the baseline characteristics of patients enrolled in the Argentina Patient Support Program (PSP) for cladribine tablets (Adveva®), with at least 1 treatment course, evaluate treatment persistence, adverse event reports from PSP patients and reported relapses characterization. METHODS: Anonymized data routinely collected by Adveva® team of patients that received the first dose of cladribine from April 16th 2018 to March 31st 2021 were analyzed. Treatment persistence was defined as the percentage of patients that initiated year 2 (Y2) from the population of patients with elapsed time since year 1 (Y1) cladribine tablet initiation of at least 18 months. In addition, using the pharmacovigilance data, reported adverse events and the time elapsed from treatment initiation to relapse were analyzed. RESULTS: The present analysis included 269 patients (mean age: 41.7 ± 16 years) that had initiated Y1 of cladribine tablets treatment between April 16th 2018 and March 31st 2021. Although only 29.4% (79/269) of our population was treatment naïve, the ratio of naïve/switch patients that initiated cladribine tablets increased from April 2018-March 2019 to April 2020-March 2021. From the 110 patients with elapsed time since treatment initiation ≥18 months, 101 patients initiated Y2 indicating a persistence level of 91.8%. During follow-up, 425 adverse events were reported, mainly MS relapse (8.9%, 38/425), fatigue (3.8%, 16/425) and headache (3.5%, 15/425). Lymphopenia and infections were rarely reported by RRMS patients treated with cladribine tablets. MS relapse was more frequently reported in patients switching from a previous treatment (87.5%, 27/32) than in the naïve cohort (12.5%, 5/32). CONCLUSIONS: The first real life experience in RRMS patients from Latin America demonstrated that the Adveva® enrolled support program patients have a high persistence level to oral treatment with cladribine tablets. Our results also confirmed the known safety profile of cladribine tablets, with a low incidence of lymphopenia and infections.
Subject(s)
Lymphopenia , Multiple Sclerosis, Relapsing-Remitting , Multiple Sclerosis , Humans , Adult , Middle Aged , Cladribine/therapeutic use , Immunosuppressive Agents/adverse effects , Argentina , Multiple Sclerosis, Relapsing-Remitting/drug therapy , Multiple Sclerosis, Relapsing-Remitting/chemically induced , Lymphopenia/chemically induced , Tablets , Multiple Sclerosis/drug therapyABSTRACT
Background: COVID-19 severity has been linked to an increased production of inflammatory mediators called "cytokine storm". Available data is mainly restricted to the first international outbreak and reports highly variable results. This study compares demographic and clinical features of patients with COVID-19 from Córdoba, Argentina, during the first two waves of the pandemic and analyzes association between comorbidities and disease outcome with the "cytokine storm", offering added value to the field. Methods: We investigated serum concentration of thirteen soluble mediators, including cytokines and chemokines, in hospitalized patients with moderate and severe COVID-19, without previous rheumatic and autoimmune diseases, from the central region of Argentina during the first and second infection waves. Samples from healthy controls were also assayed. Clinical and biochemical parameters were collected. Results: Comparison between the two first COVID-19 waves in Argentina highlighted that patients recruited during the second wave were younger and showed less concurrent comorbidities than those from the first outbreak. We also recognized particularities in the signatures of systemic cytokines and chemokines in patients from both infection waves. We determined that concurrent pre-existing comorbidities did not have contribution to serum concentration of systemic cytokines and chemokines in COVID-19 patients. We also identified immunological and biochemical parameters associated to inflammation which can be used as prognostic markers. Thus, IL-6 concentration, C reactive protein level and platelet count allowed to discriminate between death and discharge in patients hospitalized with severe COVID-19 only during the first but not the second wave. Conclusions: Our data provide information that deepens our understanding of COVID-19 pathogenesis linking demographic features of a COVID-19 cohort with cytokines and chemokines systemic concentration, presence of comorbidities and different disease outcomes. Altogether, our findings provide information not only at local level by delineating inflammatory/anti-inflammatory response of patients but also at international level addressing the impact of comorbidities and the infection wave in the variability of cytokine and chemokine production upon SARS-CoV-2 infection.
Subject(s)
COVID-19 , Humans , Cytokines/metabolism , SARS-CoV-2/metabolism , Argentina , Chemokines , Cytokine Release Syndrome , PandemicsABSTRACT
The present study evaluated the factors associated with the perception of anxiety during the first wave of covid-19 in Ibero-American countries. This cross-sectional study was carried out with 5.845 participants of both sexes, over 18 years of age, and residents of four Latin American countries-Argentina (16.7%), Brazil (34.5%), Mexico (11.1%), and Peru (17.5%), and one European country-Spain (20.1%). Data were collected in 2020, between April 1st and June 30th in Spain and between July 13th and September 26th in the Latin American countries. We used an online questionnaire with sociodemographic, lifestyle, self-reported anxiety, and covid-19 related questions. The chi-square statistical test and Multivariate logistic regressions were performed to analyze the factors associated with self-reported anxiety. The presence of self-reported anxiety was found in 63.8% of the participants during the isolation period. The association occurred mainly in women (OR:1.52; CI: 1.3-1.7), those aged 18 to 29 years (OR: 1.51; CI: 1.2-1.9) and 30 to 49 years (OR: 1.56; CI: 1.3-1.9), residents of Argentina (OR: 1.55 CI: 1.2-1.9), Brazil (OR: 2.38; CI: 2.0-2.8) and Mexico (OR: 1.52; CI: 1.2-1.9), those who gained weight (OR:1.71 CI: 1.5-1.9) or lost weight (OR: 1.40; CI: 1.2-1.6), and those who reported having slept more (OR: 1.56; CI: 1.3-1.8) or less (OR: 2.89; CI: 2.5-3.4). We conclude that the prevalence of self-reported anxiety in Ibero-American countries was high during the period studied, highlighting a higher likelihood of its occurrence in Brazil, in those who began to sleep less and gained weight.
Subject(s)
COVID-19 , Pandemics , Male , Adult , Female , Humans , Adolescent , Cross-Sectional Studies , Self Report , Spain , Brazil/epidemiology , Mexico/epidemiology , Peru/epidemiology , Prevalence , Argentina/epidemiology , COVID-19/epidemiology , Anxiety/epidemiologyABSTRACT
Using a lagged polynomial regression model, which used COVID-19 data from 2020 with no vaccines, the prediction of COVID-19 was performed in a scenario with vaccine administration for Tucumán in 2021. The modeling included the identification of a contagion breaking point between both series with the best correlation. Previously, the lag that served to obtain the smallest error between the expected and observed values was indicated by means of cross correlation. The validation of the model was carried out with real data. In 21 days, 18,640 COVID-19 cases out of 20,400 reported cases were predicted. The maximum peak of COVID-19 was estimated 21 days in advance with the expected intensity.
Usando un modelo de regresión polinomial con retraso, que empleó datos de COVID-19 de 2020 con ausencia de vacunas, se realizó la predicción de COVID-19 en un escenario con administración de vacunas para Tucumán en 2021. La modelación incluyó la identificación de un punto de quiebre de contagios entre ambas series con la mejor correlación. Previamente, se indicó por medio de correlación cruzada el lag que sirvió para obtener el menor error entre los valores esperados y los observados. La validación del modelo fue realizada con datos reales. En 21 días fueron predichos 18.640 casos de COVID-19 de 20.400 casos informados. El pico máximo de COVID-19 fue estimado 21 días antes con la intensidad esperada.
Subject(s)
COVID-19 , Argentina/epidemiology , Brazil , COVID-19/epidemiology , Humans , Models, StatisticalABSTRACT
BACKGROUND Numerous treatment options are available for patients with multiple myeloma (MM). Because of the course of the disease, most patients will experience serial relapse or the MM will become refractory to most of these treatments, leaving patients with few or no treatment options over time. Selinexor, a treatment with a novel mechanism of action, is an oral selective inhibitor of nuclear export (SINE) compound that blocks exportin 1, the major nuclear exporter of tumor suppressor proteins. CASE REPORT In this case series, we report on treatment with the weekly oral administration of selinexor combined with bortezomib and dexamethasone (XVd) in 3 patients from Argentina who were heavily treated (5-7 prior therapies) for MM that relapsed or was refractory to each previous treatment. Two patients had the high-risk cytogenetic abnormality del(17p). All 3 patients experienced efficacy with XVd reaching a best response of partial response or very good partial response. These responses were consistent with those of patients from the BOSTON study who were treated with XVd but were less heavily pretreated (1-3 prior therapies) and had a shorter median time since diagnosis of MM (7 years vs 3.7 years). The 3 patients experienced adverse events (AEs) that included nausea, thrombocytopenia, asthenia, and fatigue, which were similar to the most commonly reported AEs associated with selinexor treatment. CONCLUSIONS With its oral administration, novel mechanism of action, and responses in heavily pretreated patients, selinexor may help to address an important clinical need in the treatment of patients with relapsed/refractory MM.
Subject(s)
Multiple Myeloma , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Argentina , Dexamethasone , Humans , Hydrazines , Multiple Myeloma/drug therapy , Multiple Myeloma/pathology , Neoplasm Recurrence, Local/drug therapy , TriazolesABSTRACT
According to the social stress process model, global crises are macro-level stressors that generate physiological stress and psychological distress. However, existing research has not identified immigrants' COVID-19 containment policy stressors or examined the social stress of sending remittances amid crises. Drawing on in-depth longitudinal interviews with 46 Venezuelan immigrants-half before and half during the pandemic-in Chile and Argentina, we identified the COVID-19 containment policies' stressors. We focused on Venezuelan immigrants because they constitute one of the largest internationally displaced populations, with most migrating within South America. We found that the governmental COVID-19 containment measures in both countries generated four stressors: employment loss, income loss, devaluation of employment status, and inability to send needed remittances. Moreover, sending remittances helped some migrants cope with concerns about loved ones in Venezuela. However, sending remittances became a social stressor when immigrants struggled to simultaneously sustain their livelihoods and send financial support to relatives experiencing hardships in Venezuela. For some immigrants, these adversities generated other stressors (e.g., housing instability) and symptoms of anxiety and depression. Broadly, for immigrants, the stressors of global crises transcend international borders and generate high stress, which strains their psychological well-being.
Subject(s)
COVID-19 , Transients and Migrants , Humans , Pandemics , Population Dynamics , Emigration and Immigration , Argentina , Chile , Venezuela , Developing Countries , Housing , Policy , EconomicsABSTRACT
Due to the present pandemic situation and the many animal species that are epidemiologically involved, there has been a surge of renewed interest in investigating the coronavirus (CoV) population circulating in wildlife, especially bats and rodents, which are potential reservoirs of new human pathogens. In Argentina, information about the viruses present in these mammals is very limited. To investigate the presence of coronaviruses in this country, we obtained 457 samples from hematophagous, insectivorous, and frugivorous bats and rodents from two regions of Argentina. We report here the detection of alphacoronavirus sequences in three groups of bats as well as in rodents. Phylogenetic analysis showed the closest relationships to alphacoronaviruses from Brazil.