ABSTRACT
In Latin America, there has been tremendous progress towards eliminating canine rabies. Major components of rabies elimination programs leading to these successes have been constant and regular surveillance for rabid dogs and uninterrupted yearly mass dog vaccination campaigns. Unfortunately, vital measures to control COVID-19 have had the negative trade-off of jeopardizing these rabies elimination and prevention activities. We aimed to assess the effect of interrupting canine rabies surveillance and mass dog vaccination campaigns on rabies trends. We built a deterministic compartment model of dog rabies dynamics to create a conceptual framework for how different disruptions may affect rabies virus transmission. We parameterized the model for conditions found in Arequipa, Peru, a city with active rabies virus transmission. We examined our results over a range of plausible values for R0 (1.36-2.0). Also, we prospectively evaluated surveillance data during the pandemic to detect temporal changes. Our model suggests that a decrease in canine vaccination coverage as well as decreased surveillance could lead to a sharp rise in canine rabies within months. These results were consistent over all plausible values of R0. Surveillance data from late 2020 and early 2021 confirms that in Arequipa, Peru, rabies cases are on an increasing trajectory. The rising rabies trends in Arequipa, if indicative to the region as whole, suggest that the achievements made in Latin America towards the elimination of dog-mediated human rabies may be in jeopardy.
Subject(s)
COVID-19/epidemiology , Dog Diseases/epidemiology , Mass Vaccination/veterinary , Pandemics , Rabies virus/immunology , Rabies/epidemiology , SARS-CoV-2/physiology , Animals , COVID-19/virology , Disease Eradication , Dog Diseases/prevention & control , Dog Diseases/virology , Dogs , Humans , Latin America/epidemiology , Peru/epidemiology , Rabies/prevention & control , Rabies/virology , Rabies Vaccines/administration & dosage , Vaccination CoverageABSTRACT
El osteoma osteoide es una lesión ósea benigna que, habitualmente, se acompaña de clínica típica caracterizada por dolor nocturno que mejora con antiinflamatorios no esteroideos. Aunque la presentación clínica es típica, con frecuencia, es común la demora diagnóstica, en especial, en los casos con localización atípica.Se presenta el caso de una paciente de 10 años con dolor en la muñeca izquierda de dos años de evolución con diagnóstico de osteoma osteoide localizado en el hueso grande del carpo. La localización atípica de la lesión conllevó un retraso diagnóstico importante
Osteoid osteoma is a benign bone lesion that is usually accompanied by a typical clinical condition characterized by night pain that improves with non-steroidal anti-inflammatory drugs. Although the clinical presentation is frequently typical, diagnostic delay is common, especially in cases with an atypical location.We report the case of a 10-year-old patient with left wrist pain of two years of evolution with diagnosis of osteoid osteoma located in capitate bone. The atypical location of the lesion led to a significant diagnostic delay.
Subject(s)
Humans , Female , Child , Osteoma, Osteoid/diagnostic imaging , Osteoma, Osteoid/surgery , Wrist , Curettage , Capitate BoneABSTRACT
Osteoid osteoma is a benign bone lesion that is usually accompanied by a typical clinical condition characterized by night pain that improves with non-steroidal anti-inflammatory drugs. Although the clinical presentation is frequently typical, diagnostic delay is common, especially in cases with an atypical location. We report the case of a 10-year-old patient with left wrist pain of two years of evolution with diagnosis of osteoid osteoma located in capitate bone. The atypical location of the lesion led to a significant diagnostic delay.
El osteoma osteoide es una lesión ósea benigna que, habitualmente, se acompaña de clínica típica caracterizada por dolor nocturno que mejora con antiinflamatorios no esteroideos. Aunque la presentación clínica es típica, con frecuencia, es común la demora diagnóstica, en especial, en los casos con localización atípica. Se presenta el caso de una paciente de 10 años con dolor en la muñeca izquierda de dos años de evolución con diagnóstico de osteoma osteoide localizado en el hueso grande del carpo. La localización atípica.
Subject(s)
Bone Neoplasms , Chronic Pain , Osteoma, Osteoid , Bone Neoplasms/complications , Bone Neoplasms/diagnosis , Child , Chronic Pain/etiology , Humans , Osteoma, Osteoid/complications , Osteoma, Osteoid/diagnosis , WristABSTRACT
Over the past decades, there has been tremendous progress towards eliminating canine rabies in Latin America. Major components of rabies prevention programs in Latin America leading to these successes have been constant and intense surveillance for rabid dogs and uninterrupted yearly mass dog vaccination campaigns. However, vital measures to control COVID-19 in Latin America have had the negative trade-off of jeopardizing these rabies elimination and prevention activities. In this paper, we aimed to assess the effect of interrupting canine rabies surveillance and mass dog vaccination campaigns on rabies trends. We built a deterministic compartment model of dog rabies dynamics parameterized for conditions found in Arequipa, Peru, where there is an ongoing dog rabies epidemic. Our model suggests that a decrease in canine vaccination coverage as well as decreased surveillance leading to an increased length of survival of infected dogs could lead to a sharp rise in canine rabies and, subsequently, human rabies risk. We examined our results over the best estimate of the basic reproductive number in Arequipa (R0 = 1.44) and a range of plausible values for R0 (1.36 - 2). The rising trend was consistent. It is very possible that COVID-19 will continue to challenge our public health departments in the short- and medium-term. Innovative strategies to conduct dog vaccination and rabies surveillance during these trying times should be considered to safeguard the achievements made in Latin America towards the elimination of dog-mediated human rabies.
En las últimas décadas ha habido un tremendo progreso hacia la eliminación de la rabia canina en América Latina. Los principales componentes de los programas de prevención de la rabia en América Latina que condujeron a estos éxitos han sido la vigilancia constante e intensa de los perros con rabia y las campañas anuales de vacunación masiva ininterrumpida. Sin embargo, las medidas esenciales para controlar el COVID-19 en América Latina han tenido el balance negativo de poner en peligro estas actividades de prevención y eliminación de rabia. En este artículo, nuestro objetivo fue evaluar el efecto que la interrupción de la vigilancia de la rabia canina y las campañas de vacunación masiva de perros tendría en las tendencias de la rabia. Modelamos la dinámica de la rabia canina mediante un modelo determinístico de comportamientos parametrizado para las condiciones que se encuentran en Arequipa, Perú, donde hay una epidemia de rabia canina en curso. Nuestro modelo sugiere que una disminución en la cobertura de vacunación canina, así como una disminución en la vigilancia (que llevaría a una mayor supervivencia de los perros infectados), podría llevar a un aumento súbito de rabia canina y, seguidamente, del riesgo de rabia humana. Examinamos nuestros resultados sobre la mejor estimación del número reproductivo básico en Arequipa (R0 = 1.44) y un rango de valores plausibles para R0 (1.36 2). La tendencia al alza fue consistente. Es muy posible que el COVID-19 continúe desafiando a nuestros departamentos de salud pública a corto y mediano plazo. Por lo tanto, deben considerarse estrategias innovadoras para llevar a cabo la vacunación de perros y la vigilancia de la rabia durante estos tiempos difíciles para salvaguardar los logros alcanzados en América Latina hacia la eliminación de la rabia humana mediada por perros.
Subject(s)
Abdominal Pain/etiology , Ribs/abnormalities , Thoracic Wall/abnormalities , Adolescent , Athletes , Humans , Male , SyndromeABSTRACT
Menciona que el coaching se revela como una técnica clave para superar este reto y una de sus características principales es la participación que se da a las personas y la oportunidad de poner en acción sus habilidades y conocimientos...motivación muy particular y diferente al estilo tradicional de liderar
Subject(s)
Personnel Management , Motivation , Leadership , WorkforceABSTRACT
Dynamical behavior of a silent Hodgkin-Huxley neuron subjected to external periodic perturbations is investigated. Induced dynamics for this forced system, exhibit nonlinear resonance with respect to the forcing frequency. Within the U-shaped resonance curve, both regular (phase locked) and irregular spike sequences are invoked. For appropriate tuning frequencies, this simple system generates spike trains recordings similar to ones observed in actual experiments.
