Simulación de escenarios para predecir el comportamiento de la COVID-19 en Perú / Scenario simulation to predict the behavior of COVID-19 in Peru

Introducción: La COVID-19 ha constituido un reto de múltiples dimensiones para la humanidad, aún más para los decisores responsables de accionar de manera certera y oportuna para su enfrentamiento. En Perú, con una tendencia actual favorable de la Pandemia, es inminente la propagación de la variante Delta, de allí que requieran de informaciones predictivas que posibiliten adoptar decisiones anticipadas para mitigar sus efectos. Objetivo: Simular escenarios aplicando la modelación físico-matemática, para la predicción del comportamiento de la COVID-19 en Perú que facilite la adopción de decisiones. Material y Métodos: Modelación físico-matemática mediante herramientas y funciones del software MATLAB. Resultados: Determinación del comportamiento de las principales variables de la COVID-19 en Perú; modelo físico-matemático basado en el clásico SIR con nuevos compartimientos relacionados con la vacunación y los expuestos, así como su ajuste a los datos de Perú; simulación de escenarios, incluyendo la variante Delta, para fallecidos, infectados acumulados, infectados no vacunados e infectados vacunados. Conclusiones: El modelo concebido para la simulación de escenarios de evolución de la COVID-19, demostró su capacidad de predicción del comportamiento de las variables más importantes que determinan dicha evolución en Perú; debe ocurrir otra ola de contagios y llegarse a cifras acumulativas entre 2,9 y 3,36 millones de infectados y entre 215 y 255 mil fallecidos; las principales estrategias de mitigación deben dirigirse a garantizar el distanciamiento y aislamiento social, así como a incrementar el régimen de vacunación(AU)

Introduction: COVID-19 has been a multi-dimensional challenge for humanity, even more so for decision-makers responsible for acting in an accurate and timely manner to confront it. In Peru, with is a current favorable trend of the Pandemic, the spread of the Delta variant is imminent, hence the need for predictive information that makes it possible to make early decisions to mitigate its effects. Objective: To simulate scenarios applying the physical-mathematical modeling to predict the behavior of COVID-19 in Peru and facilitate decision-making. Material and Methods: Physical-mathematical modeling using MATLAB software tools and functions. Results: Determination of the behavior of the main variables associated with COVID-19 in Peru; physical-mathematical modeling based on the classic SIR with new compartments related to vaccination and those exposed, as well as its adjustment to the data from Peru; simulation of scenarios including the Delta variant for deceased persons, cumulative number of infected individuals, and infection in vaccinated and unvaccinated individuals. Conclusions: The model conceived for the simulation of COVID-19 evolution scenarios demonstrated its ability to predict the behavior of the most important variables that determine such evolution in Peru; another wave of infections may occur and cumulative figures between 2.9 and 3.36 million infected individuals and between 215 and 255 thousand deaths may be reached. The main mitigation strategies should be aimed at guaranteeing social distancing and isolation, as well as increasing the vaccination regimen(AU)

Sesquiterpene lactones from Ambrosia arborescens Mill. inhibit pro-inflammatory cytokine expression and modulate NF-κB signaling in human skin cells.

BACKGROUND: Ambrosia arborescens has been used in Andean traditional medicine to reduce problems associated with various inflammatory diseases and conditions, although the underlying mechanism is unknown. HYPOTHESIS/PURPOSE: The sesquiterpene lactones (SLs) coronopilin and damsin, which are major secondary metabolites of A. arborescens, have anti-inflammatory activity by attenuation of IL-6 and MCP-1 expression and inhibition of NF-κB in human dermal fibroblasts (HDFa) and human keratinocytes (HaCaT). STUDY DESIGN: In order to confirm a high concentration of damsin and coronopilin in the plant material, a quantitative method was developed. The effect of the pure compounds on cytokine and NF-κB expression was examined, as well as their effects on HDFa and HaCaT cell morphology and viability. METHODS: Coronopilin and damsin were quantified by HPLC-DAD analysis, from EtOAc extracts of the aerial parts of A. arborescens. Cell morphology was investigated by phase-contrast microscopy and cell viability by the MTT assay. IL-6 and MCP-1 cytokine gene expression was assessed by quantitative real-time RT-PCR in LPS stimulated cells. The NF-κB pathway was studied through western blotting of the phosphorylated forms of p65 and p50/p105, as well as the non-phosphorylated IκB. Dexamethasone was used as positive control. RESULTS: Dry aerial parts contained 12.3  mg/g and 13.4  mg/g of coronopilin and damsin, respectively. Treatment with either compound (1-10 µM) for 24  h attenuated LPS-induced mRNA expression of the pro-inflammatory cytokine IL-6 and the chemokine MCP-1 in HDFa cells. The down-regulation of MCP-1 mRNA induced by coronopilin and damsin was confirmed on the protein level. Damsin reduced phosphorylated p65 and p105 subunits in HDFa cells. Neither coronopilin nor damsin affected HDFa cell morphology and viability within the used concentration range (1-10 µM). Also, in HaCaT cells, treatment with damsin (1-10 µM) for 24  h inhibited the MCP-1 expression, and damsin thereby attenuated cytokine expression both in HDFa and HaCaT cells. CONCLUSION: We show that coronopilin and damsin from A. arborescens inhibit pro-inflammatory IL-6 and MCP-1 expression in human skin cells via NF-κB inhibition, suggesting that they may be useful for antagonizing inflammatory conditions of the human skin.

How is the ultrasound in rheumatology used, implemented, and applied in Latin American centers? Results from a multicenter study.

This study aimed to perform an overview of how ultrasound (US) is being used, implemented, and applied in rheumatologic centers in Latin America (LA). A retrospective, multicenter 1-year experience study was undertaken. Eighteen centers from eight countries were involved. The following information were collected: demographic data, indication to perform an US examination, physician that required the examination, and the anatomical region required for the examination. A total of 7167 patients underwent an US examination. The request for US examinations came most frequently from their own institution (5981 (83.45 %)) than from external referral (1186 (16.55 %)). The services that more frequently requested an US examination were rheumatology 5154 (71.91 %), followed by orthopedic 1016 (14.18 %), and rehabilitation 375 (5.23 %). The most frequently scanned area was the shoulder in 1908 cases (26.62 %), followed by hand 1754 (24.47 %), knee 1518 (21.18 %), ankle 574 (8.01 %), and wrist 394 (5.50 %). Osteoarthritis was the most common disease assessed (2279 patients (31.8 %)), followed by rheumatoid arthritis (2125 patients (29.65 %)), psoriatic arthritis (869 patients (12.1 %)), painful shoulder syndrome (545 (7.6 %)), connective tissue disorders (systemic sclerosis 339 (4.7 %), polymyositis/dermatomyositis 107 (1.4 %), Sjögren's syndrome 60 (0.8 %), and systemic lupus erythematosus 57 (0.8 %)). US evaluation was more frequently requested for diagnostic purposes (3981 (55.5 %)) compared to follow-up studies (2649 (36.9 %)), research protocols (339 (4.73 %)), and invasive guided procedures (198 (2.76 %)). US registered increasing applications in rheumatology and highlighted its positive impact in daily clinical practice. US increases the accuracy of the musculoskeletal clinical examination, influence the diagnosis, and the disease management.