ABSTRACT
On October 18, 2019, Chile experienced the most important social upheaval since the country regained democracy in the late 1980s. The "Social Outbreak" surprised economic and political elites and seemed paradoxical to the international community who had often praised Chile as a model of successful development. In this paper, we used structural-demographic theory to analyze the interaction between the overproduction of elites and the stagnation in the relative income of the population as the underlying structural cause of Chilean political instability. This theory was able to predict the three most significant instances of political tension in the recent history of Chile: the crisis of the late 1960s that culminated in the coup d'état of 1973, popular mobilizations during the 1980s, and the recent student mobilizations and social upheaval. Our results suggest that, at least during the period 1938-2019, Chilean sociopolitical dynamics is determined by the same structural drivers.
Subject(s)
Politics , Chile , Humans , Demography , Income , Models, Theoretical , Socioeconomic FactorsABSTRACT
RESUMEN Objetivo Analizar la evolución temporal de la primera etapa del COVID-19 en Colombia a través del modelo SIRD. Métodos Se analizó la evolución temporal del COVID-19 según los individuos infectados en Colombia del 6 de marzo al 15 de abril de 2020. Se realizó el modelo SIRD modificando la tasa de transmisión (b) bajo tres escenarios: 1) cuarentena hasta el 1 de julio, 2) cuarentena flexible., hasta el 11 de mayo con un b del 4%, y 3) cuarentena flexible2 hasta el 11 de mayo con b del 8%, con el fin de predecir el número de casos totales y el 5% de infectados en UCI para contrastarlo con el número de camas y personal UCI. Resultados Los escenarios mostraron que levantar la cuarentena el 11 de mayo significará un aumento en el número de infectados, entre 54 105 a 116 081 individuos con COVID-19. Así mismo, la rápida aceleración en la tasa de contagios se traduce en una mayor demanda de camas y personal en UCI: en el escenario de cuarentena flexible2 se colapsarían las 2 650 camas disponibles y se necesitaría de 5 intensivitas y 4 enfermeras por paciente al 1 julio. Conclusión Las medidas de distanciamiento social obligatorias contribuyen al retraso de la saturación del sistema de salud; sin embargo, son difíciles de sostener en el tiempo desde una perspectiva económica. Por lo tanto, para tener una distensión de la cuarentena es necesario adoptar medidas para ampliar la capacidad del sistema de salud y así evitar su colapso.(AU)
ABSTRACT Objective To analyze the temporal progress in the early stage of COVID-19 in Colombia using the SIRD model. Methods We analyzed the temporal progress of COVID-19 based on the number of infected persons between March 6th and April 15th, 2020. The SIRD model was implemented with variation in the rate of transmission (b) in three ways. A. Quarantine until July 11. 2. B. Flexible quarantine, [b=4%]. C. Flexible quarantine2 [b=8%]. Consecutively, we aimed to predict the number of total cases and 5% of infected persons in ICU to match them with the hospital beds and ICU staff. Results The results show that the number of COVID-19 cases will increase from 54 105 to 116 081 approximately, if the quarantine is lifted on May 11. If the infection rate increase, more hospital beds and a bigger ICU staff will be mandatory. The currently 2 650 beds won't be enough in the flexible quarantine2, and five intensive care specialist and four nurses per patient will be needed. Conclusion Measures like mandatory social distancing help delay the saturation of the health care system. However, it's impracticable to maintain them due to a possible economic crisis. Therefore, it's necessary to take action to enhance the ability of the health care system to avoid a collapse.(AU)
Subject(s)
Humans , Population Dynamics , Quarantine/methods , Coronavirus Infections/transmission , Coronavirus Infections/epidemiology , Colombia/epidemiology , Spatio-Temporal AnalysisABSTRACT
RESUMEN Objetivo Analizar la evolución temporal de la primera etapa del COVID-19 en Colombia a través del modelo SIRD. Métodos Se analizó la evolución temporal del COVID-19 según los individuos infectados en Colombia del 6 de marzo al 15 de abril de 2020. Se realizó el modelo SIRD modificando la tasa de transmisión (b) bajo tres escenarios: 1) cuarentena hasta el 1 de julio, 2) cuarentena flexible., hasta el 11 de mayo con un b del 4%, y 3) cuarentena flexible2 hasta el 11 de mayo con b del 8%, con el fin de predecir el número de casos totales y el 5% de infectados en UCI para contrastarlo con el número de camas y personal UCI. Resultados Los escenarios mostraron que levantar la cuarentena el 11 de mayo significará un aumento en el número de infectados, entre 54 105 a 116 081 individuos con COVID-19. Así mismo, la rápida aceleración en la tasa de contagios se traduce en una mayor demanda de camas y personal en UCI: en el escenario de cuarentena flexible2 se colapsarían las 2 650 camas disponibles y se necesitaría de 5 intensivitas y 4 enfermeras por paciente al 1 julio. Conclusión Las medidas de distanciamiento social obligatorias contribuyen al retraso de la saturación del sistema de salud; sin embargo, son difíciles de sostener en el tiempo desde una perspectiva económica. Por lo tanto, para tener una distensión de la cuarentena es necesario adoptar medidas para ampliar la capacidad del sistema de salud y así evitar su colapso.(AU)
ABSTRACT Objective To analyze the temporal progress in the early stage of COVID-19 in Colombia using the SIRD model. Methods We analyzed the temporal progress of COVID-19 based on the number of infected persons between March 6th and April 15th, 2020. The SIRD model was implemented with variation in the rate of transmission (b) in three ways. A. Quarantine until July 11. 2. B. Flexible quarantine, [b=4%]. C. Flexible quarantine2 [b=8%]. Consecutively, we aimed to predict the number of total cases and 5% of infected persons in ICU to match them with the hospital beds and ICU staff. Results The results show that the number of COVID-19 cases will increase from 54 105 to 116 081 approximately, if the quarantine is lifted on May 11. If the infection rate increase, more hospital beds and a bigger ICU staff will be mandatory. The currently 2 650 beds won't be enough in the flexible quarantine2, and five intensive care specialist and four nurses per patient will be needed. Conclusion Measures like mandatory social distancing help delay the saturation of the health care system. However, it's impracticable to maintain them due to a possible economic crisis. Therefore, it's necessary to take action to enhance the ability of the health care system to avoid a collapse.(AU)
Subject(s)
Humans , Population Dynamics/trends , Quarantine , Coronavirus Infections/transmission , Coronavirus Infections/epidemiology , Betacoronavirus , Colombia/epidemiologyABSTRACT
OBJECTIVE: To analyze the temporal progress in the early stage of COVID-19 in Colombia using the SIRD model. METHODS: We analyzed the temporal progress of COVID-19 based on the number of infected persons between March 6th and April 15th, 2020. The SIRD model was implemented with variation in the rate of transmission (b) in three ways. A. Quarantine until July 11. 2. B. Flexible quarantine, [b=4%]. C. Flexible quarantine2 [b=8%]. Consecutively, we aimed to predict the number of total cases and 5% of infected persons in ICU to match them with the hospital beds and ICU staff. RESULTS: The results show that the number of COVID-19 cases will increase from 54 105 to 116 081 approximately, if the quarantine is lifted on May 11. If the infection rate increase, more hospital beds and a bigger ICU staff will be mandatory. The currently 2 650 beds won't be enough in the flexible quarantine2, and five intensive care specialist and four nurses per patient will be needed. CONCLUSION: Measures like mandatory social distancing help delay the saturation of the health care system. However, it's impracticable to maintain them due to a possible economic crisis. Therefore, it's necessary to take action to enhance the ability of the health care system to avoid a collapse.
Subject(s)
COVID-19 , Humans , COVID-19/epidemiology , COVID-19/prevention & control , Colombia/epidemiology , SARS-CoV-2 , Quarantine , Delivery of Health CareABSTRACT
No disponible
No disponible
Subject(s)
Humans , Blood Pressure/physiology , Blood Pressure Monitoring, Ambulatory/statistics & numerical data , Hypertension/physiopathology , Inflammation Mediators/analysis , Arteriosclerosis/physiopathologyABSTRACT
No disponible
Subject(s)
Female , Aged , Humans , Cystitis/microbiology , Pseudomonas aeruginosa/pathogenicity , Pseudomonas Infections/complications , Cystitis/complications , Urination , Pseudomonas aeruginosa/isolation & purification , Hematuria/etiology , Calcinosis/pathologyABSTRACT
METHODS: In order to investigate the effect of chronic inhibition of nitric oxide synthesis along pregnancy, pregnant rats were given drinking water alone (control group) or drinking water containing nonselective nitric oxide synthase inhibitor N(omega)-nitro-L-arginine methyl ester (L-NAME; 15 mg/day/rat equivalent to 50 mg/kg/day; treated group), from postmating days 1 to 18 of pregnancy. On days 1 to 17 of pregnancy, urinary volume, urinary sodium and potassium excretion, and urine protein concentration were measured. Systolic blood pressure (SBP) was recorded daily. On days 6, 11 and 18 of pregnancy the number of sites of implantation, number of embryos, litter size, fetal and placenta weight were determined. RESULTS: Systolic blood pressure (mmHg) increased (p<0.001) on the 2nd day of administration of L-NAME and remained high throughout the experiment. This treatment increased urinary protein excretion and urine volume (p<0.01), with changes in the sodium and potassium excretion rate along the study. On day 6 of gestation in treated group, the number of implantation sites (0.14+/-0.10) significantly decreased (p<0.05) compared with the control group (1.45+/-0.58), but on day 11 of pregnancy the number of embryos was similar in both groups. By day 18 of pregnancy, L-NAME caused a substantial decrease (p<0.001) in litter weight (6.30+/-0.77 to 12.00+/-0.92 g), weight of placenta (3.17+/-0.22 to 4.74+/-0.21 g) (p<0.001) and litter size (7.95+/-0.59 to 11.95+/-0.45 fetus/litter; p<0.001). Also, treatment with L-NAME caused an important number of fetal resorptions (2.93+/-0.42 No./litter to 0 in control group). CONCLUSION: Thus, treatment of pregnant rats with L-NAME, has an important effect on systolic blood pressure and on the physiology of reproduction, mainly in the third stage of pregnancy.
Subject(s)
Blood Pressure/drug effects , Enzyme Inhibitors/pharmacology , Fetal Development/drug effects , Litter Size/drug effects , NG-Nitroarginine Methyl Ester/pharmacology , Nitric Oxide Synthase/antagonists & inhibitors , Animals , Body Weight , Enzyme Inhibitors/administration & dosage , Female , NG-Nitroarginine Methyl Ester/administration & dosage , Nitric Oxide/biosynthesis , Nitric Oxide/physiology , Nitric Oxide Synthase/administration & dosage , Pregnancy , Rats , Rats, Sprague-DawleyABSTRACT
BACKGROUND AND OBJECTIVE: The objective of this study was to determine the percentage of patients with high and very high cardiovascular risk, with their risk factors globally well controlled (hypertension, dyslipemia, diabetes mellitus, tobacco and obesity). PATIENTS AND METHOD: Transversal study of ambulatory patients of internal medicine with an estimated cardiovascular risk high or very high (Framingham stratification scale over 20% in ten years). We evaluated the degree of control of their cardiovascular risk factors attending to the recommendations provided by recent international guidelines (WHO/ISH, JNC-VI, NCEP-ATP-III, ADA). RESULTS: We studied 2,264 patients (53.7% males; mean age: 66.1 +/- 11.5 years; 74.6% hypertensive, 61.1% dyslipidemic, 59.8% type 2 diabetes, 31.1% smokers, 38.0% obese and 36.7% in secondary prevention). Control of hypertension was achieved in 34.5%, dyslipidemia in 50.3% and diabetes in 35.5%. Global control of every risk factor was achieved in 6.9% (in 10.2% if we exclude obesity since it is not a risk factor used for cardiovascular stratification). Factors independently associated with a bad integral control were: diabetes (OR = 0.33; 95%CI: 0.23-0.47), dyslipidemia (OR = 0.34; 95%CI: 0.24-0.48), proteinuria (OR = 0.36; 95%CI: 0.18-0.71). Factors independently associated with a better cardiovascular control were: male sex (OR = 1.67; 95%CI: 1.18-2.38), ventricular hypertrophy (OR = 1.62; 95%CI: 1.15-2.30) and the number of exploratory tests (OR = 1.01; 95%CI: 1.01-1.08). CONCLUSIONS: Only 6.9% of patients with a high or very high cardiovascular risk have all their principal risk factors under control. The presence of diabetes, dyslipidemia or proteinuria predisposed to a worse control and the number of complementary tests performed to the patients was related to a better control.
Subject(s)
Cardiovascular Diseases/epidemiology , Aged , Cardiovascular Diseases/prevention & control , Cross-Sectional Studies , Female , Humans , Male , Risk Factors , SpainABSTRACT
FUNDAMENTO Y OBJETIVO: El objetivo del presente estudio es determinar el porcentaje de pacientes con alto riesgo cardiovascular que tienen controlados de forma global todos sus factores de riesgo mayores (hipertensión arterial, hipercolesterolemia, diabetes mellitus, tabaco y obesidad). PACIENTES Y MÉTODO: Estudio transversal sobre pacientes ambulatorios de medicina interna, mayores de 18 años y con riesgo cardiovascular alto o muy alto (según la escala de Framingham, superior al 20% a los 10 años). Se evaluó el grado de control de los factores de riesgo cardiovascular (hipertensión arterial, diabetes mellitus, colesterol unido a lipoproteínas de baja densidad, tabaquismo y obesidad) según las definiciones de control de la Organización Mundial de la Salud/Sociedad Internacional de Hipertensión, Joint National Committee VI, National Cholesterol Education Program-Adult Treatment Panel III y American Diabetes Association. RESULTADOS: Se estudió a 2.264 pacientes (el 53,7% eran varones), con una edad media (desviación estándar) de 66,1 (11,5) años. El 74,6% eran hipertensos; el 61,1%, dislipémicos; el 59,8%, diabéticostipo 2; el 31,1%, fumadores; el 38%, obesos, y el 36,7% se hallaba en prevención secundaria. El control de la hipertensión arterial fue del 34,5%; el de la dislipemia, del 50,3%; y el de la diabetes mellitus, del 35,5%. El control de todos los factores de riesgo de forma global fue del 6,9% (y del 10,2% si se excluye la obesidad). Los factores relacionados de forma independiente con un mal control integral fueron la diabetes mellitus (odds ratio [OR] = 0,33; intervalo de confianza [IC] del 95%,0,23-0,47), la dislipemia (OR = 0,34; IC del 95%, 0,24-0,48) y la existencia de proteinuria (OR =0,36; IC del 95%, 0,18-0,71); se relacionaron con un mejor control integral el sexo varón (OR =1,67; IC del 95%, 1,18-2,38), la hipertrofia ventricular izquierda (OR = 1,62; IC del 95%, 1,15-2,30) y la realización de pruebas complementarias (OR = 1,01; IC del 95%, 1,01-1,08). CONCLUSIONES: Solamente el 6,9% de los pacientes de alto o muy alto riesgo cardiovascular tienen controladoslos 5 principales factores de riesgo mayores. La existencia de diabetes mellitus, dislipemia o proteinuria predisponen a un mal control integral de dichos factores, mientras que el número de exploraciones complementarias realizadas se asocia con un mejor control
BACKGROUND AND OBJECTIVE: The objective of this study was to determine the percentage of patients with high and very high cardiovascular risk, with their risk factors globally well controlled (hypertension,dyslipemia, diabetes mellitus, tobacco and obesity). PATIENTS AND METHOD: Transversal study of ambulatory patients of internal medicine with an estimated cardiovascular risk high or very high (Framingham stratification scale over 20% in ten years). We evaluated the degree of control of their cardiovascular risk factors attending to the recommendations provided by recent international guidelines (WHO/ISH, JNC-VI, NCEP-ATP-III, ADA). RESULTS: We studied 2,264 patients (53.7% males; mean age: 66.1 ± 11.5 years; 74.6% hypertensive, 61.1% dyslipidemic, 59.8% type 2 diabetes, 31.1% smokers, 38.0% obese and 36.7%in secondary prevention). Control of hypertension was achieved in 34.5%, dyslipidemia in 50.3% and diabetes in 35.5%. Global control of every risk factor was achieved in 6.9% (in 10.2% if we exclude obesity since it is not a risk factor used for cardiovascular stratification). Factors independently associated with a bad integral control were: diabetes (OR = 0.33; 95%CI: 0.23-0.47), dyslipidemia(OR = 0.34; 95%CI: 0.24-0.48), proteinuria (OR = 0.36; 95%CI: 0.18-0.71). Factors independently associated with a better cardiovascular control were: male sex (OR = 1.67; 95%CI: 1.18-2.38),ventricular hypertrophy (OR = 1.62; 95%CI: 1.15-2.30) and the number of exploratory tests (OR =1.01; 95%CI: 1.01-1.08).CONCLUSIONS: Only 6.9% of patients with a high or very high cardiovascular risk have all their principal risk factors under control. The presence of diabetes, dyslipidemia or proteinuria predisposed to a worse control and the number of complementary tests performed to the patients was related to a better control
Subject(s)
Male , Female , Aged , Middle Aged , Humans , Cardiovascular Diseases/epidemiology , Risk Management , Risk Factors , Hypertension/epidemiology , Tobacco Use Disorder/epidemiology , Obesity/epidemiology , Diabetes Mellitus/epidemiology , Hypercholesterolemia/epidemiology , Cross-Sectional StudiesABSTRACT
We examined the test profile of changes in systolic blood pressure (SBP), urinary volume, urinary sodium, and protein excretion in normotensive (Sprague Dawley) and spontaneously hypertensive rats (SHR) up to the 18th day of pregnancy. On days 6, 11, and 18 of pregnancy, the number of implantation sites, number of embryos, litter size, placenta, and litter weight were determined. In SHR, SBP (mmHg) increased significantly from the start of the test and remained high throughout the experiment. There was also a significant increase in urine volume (mL per 24 hrs) and urinary sodium excretion (mEq per 24 hrs) but no significant changes in protein excretion rate. The number of implantation sites on day 6 of pregnancy and the number of embryos on day 11 were similar in both groups. Uterus weight in SHR on days 6 and 11 of pregnancy was significantly lower than in normotensive rats. On day 18 of pregnancy in SHR, a substantial decrease in litter weight (7.10 +/- 0.40 vs. 12.00 +/- 0.92 g; p < 0.001) and weight of placenta (2.35 +/- 0.07 vs. 4.74 +/- 0.21 g; p < 0.001) was observed, with no modification in litter size. The hypertension associated with pregnancy in SHR increased urine volume and urinary sodium excretion and decreased weight of uterus, litter, and placenta relative to control rats.
Subject(s)
Fetal Growth Retardation/physiopathology , Animals , Female , Organ Size , Pregnancy , Rats , Rats, Inbred SHR , Rats, Sprague-Dawley , Sodium/urine , Uterus/physiopathologyABSTRACT
METHODS: The relationship between progesterone (P4), 17beta-estradiol, insulin-like growth factor (IGF-I) and embryonic and fetal development, were examined. Female Sprague Dawley rats were divided into two groups: control untreated (n=60) and treated (n=63) with L-NAME (N(omega)-nitro-L-arginine methyl ester), 15 mg/day in drinking water from the first day after mating to day 18 of gestation. A further group was formed (n=63) of spontaneously hypertensive rats (SHR). Mean systolic blood pressure was recorded daily. On days 6, 11 and 18 of pregnancy, the number of sites of implantation, litter and placenta weight was examined. In addition, serum levels of P4, 17beta-estradiol and IGF-I were determined. RESULTS: Systolic blood pressure (SBP) (mmHg) increased significantly in L-NAME and SHR rats over the course of the experiment. On day 6 of pregnancy, in the L-NAME group the number of implantation sites, levels of IGF-I and 17beta-estradiol were significantly lower than in the control group. In SHR, only the concentration of IGF-I was low (p<0.05). In contrast, on day 11 of pregnancy no variation was found in the parameters under study. On day 18 of gestation, a significant decrease in litter and placenta weight, concentration of P4 and IGF-I was observed in the experimental groups. CONCLUSION: The data further suggest that nitric oxide might regulate IGF-I production, indicating that growth factors may play an important role in fetal-placental development.
