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1.
PLoS Negl Trop Dis ; 17(10): e0011615, 2023 10.
Article in English | MEDLINE | ID: mdl-37815991

ABSTRACT

Bartonella bacilliformis is a Gram-negative, aerobic bacterium and the known causal agent of Carrion's disease, still considered a neglected disease. There is limited information about the nucleotide sequences of this bacterium in international databases, and few studies have addressed the genetic diversity of B. bacilliformis. We analyzed a total of 20 isolates of B. bacilliformis from the Peruvian regions of Ancash and Cajamarca. Three genes (ialB, gltA, and rpoB) were sequenced in each isolate and nucleotide sequences retrieved from GenBank (16 B. bacilliformis genomes) were also included in the study. All this information was merged in order to obtain clearer evidence of the phylogenetic relationships of B. bacilliformis. In the phylogenetic analysis conducted with the concatenated markers, four isolates (B.b-1, B. b-3, B. b- 7, B.b-8) from the Ancash region were observed to form a subgroup different from B. bacilliformis type strain KC583, showing dissimilarity levels of 5.96% (ialB), 3.69% (gltA) and 3.04% (rpoB). Our results suggest that B. bacilliformis consists of two different subgroups. Future investigations are needed to establish the taxonomic status of these subgroups.


Subject(s)
Bartonella Infections , Bartonella bacilliformis , Bartonella , Humans , Peru/epidemiology , Phylogeny , Polymorphism, Single Nucleotide , Bartonella Infections/epidemiology , Bartonella Infections/microbiology , Bartonella/genetics
2.
Orthop Nurs ; 42(5): 304-309, 2023.
Article in English | MEDLINE | ID: mdl-37708528

ABSTRACT

Postoperative constipation is a common problem among orthopaedic surgical patients leading to discomfort, increased length of stay, and other complications. The primary purpose of this study was to determine the effectiveness of polyethylene glycol compared with docusate sodium for the prevention of constipation, after total knee arthroplasty. The secondary purpose was to examine the effectiveness of polyethylene glycol on pain and strain with bowel movement. A two-group nonequivalent cohort design was used to evaluate the effect of one 17-g dose of polyethylene glycol by mouth on postoperative day 1 compared with usual care with docusate sodium 100 mg starting the day of surgery and continued twice daily at home. There was no significant difference in the rate of constipation between the two cohorts in the 3 days after surgery. There was no difference in reported pain and strain. Future research should focus on the use of pharmacologic and nursing interventions together for prevention of postoperative constipation in patients with arthroplasty surgery.


Subject(s)
Arthroplasty, Replacement, Knee , Laxatives , Humans , Laxatives/therapeutic use , Dioctyl Sulfosuccinic Acid/therapeutic use , Arthroplasty, Replacement, Knee/adverse effects , Treatment Outcome , Constipation/drug therapy , Polyethylene Glycols/therapeutic use , Pain/drug therapy
3.
Comput Biol Med ; 165: 107335, 2023 10.
Article in English | MEDLINE | ID: mdl-37633087

ABSTRACT

Chronic wounds are a latent health problem worldwide, due to high incidence of diseases such as diabetes and Hansen. Typically, wound evolution is tracked by medical staff through visual inspection, which becomes problematic for patients in rural areas with poor transportation and medical infrastructure. Alternatively, the design of software platforms for medical imaging applications has been increasingly prioritized. This work presents a framework for chronic wound tracking based on deep learning, which works on RGB images captured with smartphones, avoiding bulky and complicated acquisition setups. The framework integrates mainstream algorithms for medical image processing, including wound detection, segmentation, as well as quantitative analysis of area and perimeter. Additionally, a new chronic wounds dataset from leprosy patients is provided to the scientific community. Conducted experiments demonstrate the validity and accuracy of the proposed framework, with up to 84.5% in precision.


Subject(s)
Deep Learning , Humans , Diagnostic Imaging/methods , Image Processing, Computer-Assisted/methods , Algorithms , Software
4.
PLoS Negl Trop Dis ; 17(5): e0011321, 2023 05.
Article in English | MEDLINE | ID: mdl-37228134

ABSTRACT

Carrion´s disease is caused by Bartonella bacilliformis, it is a Gram-negative pleomorphic bacterium. B. bacilliformis is transmitted by Lutzomyia verrucarum in endemic areas of the Peruvian Inter-Andean valleys. Additionally, the pathogenicity of B. bacilliformis involves an initial infection of erythrocytes and the further infection of endothelial cells, which mainly affects children and expectant women from extreme poverty rural areas. Therefore, the implementation of serological diagnostic methods and the development of candidate vaccines for the control of CD could be facilitated by the prediction of linear b-cell epitopes in specific proteins of B. bacilliformis by bioinformatics analysis. In this study, We used an in-silico analysis employing six web servers for the identification of epitopes in proteins of B. bacilliformis. The selection of B. bacilliformis-specific proteins and their analysis to identify epitopes allowed the selection of seven protein candidates that are expected to have high antigenic activity.


Subject(s)
Bartonella Infections , Bartonella bacilliformis , Bartonella , Child , Animals , Female , Humans , Epitopes, B-Lymphocyte , Endothelial Cells , Bartonella Infections/diagnosis , Bartonella Infections/epidemiology , Peru/epidemiology
5.
Article in Spanish | IBECS | ID: ibc-224277

ABSTRACT

Objetivo: La investigación buscó analizar si el liderazgo de servicio predice el rendimiento laboral en los colaboradores municipales de la provincia de San Martín en el contexto de la pandemia por COVID-19. Material y Métodos: El diseño es no experimental de corte transversal y de tipo predictivo. Se analizaron los datos de 424 trabajadores municipales de los distritos: Morales, Tarapoto y la Banda de Shilcayo, con edades entre 20 y 65 años y de ambos sexos. Los instrumentos utilizados fueron: La Escala de Liderazgo de Servicio (ELSVA), creada por Dennis, Winston, Page, and Wong (2003) y la Escala de Rendimiento Laboral Individual, creada por Koopmans et al. (2014), ambas escalas validadas por Gabini and Salessi (2016). Resultados y conclusión: Los coeficientes β indican que el liderazgo (variable predictora) predijo significativamente el rendimiento laboral (β =, 512, p < .01); se infiere que las cualidades del liderazgo de servicio de los colaboradores pronostican la eficacia de los trabajadores en sus respectivos puestos. (AU)


Objective: This study sought to analyze whether service leadership predicts work performance on municipal employees in the province of San Martín - Peru, in the context of the COVID-19 pandemic. Material and Methods: The design is non-experimental, cross-sectional, and predictive. We analyzed data of 424 municipal employees from the districts: Morales, Tarapoto, and Banda Shilcayo, aged between 20 and 65 years, of both sexes. The instruments used were: Service Leadership Scale (ELSVA), created by Dennis, Winston, Page, and Wong (2003); and Individual Work Performance Scale, created by Koopmans et al. (2014), both scales validated by Gabini and Salessi (2016). Results and conclusion: The β coefficients indicate that leadership (predictor variable) significantly predicted work performance (β =, 512, p < .01); it is inferred that service leadership qualities of employees predict the effectiveness of workers in their respective job positions. (AU)


Subject(s)
Humans , Male , Female , Young Adult , Adult , Middle Aged , Pandemics , Coronavirus Infections/epidemiology , Leadership , Peru , Severe acute respiratory syndrome-related coronavirus , Work Performance , Public Sector , Cross-Sectional Studies
7.
Sex., salud soc. (Rio J.) ; (39): e22306, 2023. tab
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1530513

ABSTRACT

Resumen Esta investigación fue realizada bajo el alero de Amaranta, una ONG activista feminista chilena. Su objetivo fue explorar con perspectiva de género la violencia digital que afectó a mujeres de Chile y el estudio se realizó al inicio de la pandemia de COVID-19. Para ello, se encuestó a 531 mujeres de todas las regiones del país. De esta muestra no probabilística, un 73,8% habían sufrido violencia digital. Los ataques más reportados fueron: violencia verbal, acoso, envío de imágenes sexuales sin consentimiento, difamación, amenazas y pérdida de cuenta o acceso no consentido y tendían a provenir de personas anónimas y de hombres de su entorno. Entre las consecuencias de estas violencias, mencionan: efectos emocionales, en la autoestima o relación con su cuerpo y sentirse vigiladas. Se concluye que la violencia digital afecta de forma desmedida a mujeres, jóvenes y niñas y que, a raíz del poco o nulo acceso a educación sexual integral y alfabetización digital, podría costarles reconocerla, prevenirla y abordarla a tiempo.


Resumo Esta pesquisa foi realizada sob os auspícios da Amaranta, uma ONG ativista feminista chilena. Seu objetivo foi explorar a violência digital que afetou as mulheres no Chile desde uma perspectiva de gênero e o estudo foi realizado no início da pandemia da COVID-19. Para isso, foram entrevistadas 531 mulheres de todas as regiões do país. Desta amostra não probabilística, 73,8% sofreram violência digital. Os ataques mais relatados foram: violência verbal, assédio, envio de imagens sexuais sem consentimento, difamação, ameaças e perda de contas ou acesso não consentido, e sua origem tende a ser de pessoas anônimas e de homens ao seu redor. Dentre as consequências dessa violência citam: efeitos emocionais, na autoestima ou na relação com o corpo e o sentimento de ser vigiadas. Conclui-se que a violência digital afeta desproporcionalmente as mulheres, mulheres jovens e meninas que, como resultado do pouco ou nenhum acesso à educação sexual abrangente e à alfabetização digital, pode ser difícil para eles reconhecê-la, preveni-la e combatê-la a tempo.


Abstract This research was carried out under the wing of Amaranta, a Chilean feminist and activist NGO. Its objective was to explore from a gender perspective the digital violence that affected women in Chile. The study that was conducted at the beginning of the COVID-19 pandemic. For this purpose, 531 women from all regions of the country were surveyed. Of this non-probabilistic sample, 73.8% had suffered digital violence. The most reported attacks were: verbal violence, harassment, sending sexual images without consent, defamation, threats and loss of account or non-consensual access and tended to come from anonymous persons and men in their immediate circle. Among the consequences they mention: emotional effects, effects on self-esteem or relationship with their body and feeling watched. It is concluded that digital violence has a disproportionate impact on women, young women and girls and that, due to little or no access to comprehensive sexual education and digital literacy, it may be difficult for them to recognize, prevent and address it in time.

8.
Ecancermedicalscience ; 17: 1614, 2023.
Article in English | MEDLINE | ID: mdl-38414970

ABSTRACT

Introduction: Prostate cancer has increased in recent years, increasing the costs associated with its treatment. Second-generation oral antiandrogens have emerged as an attractive therapeutic option. Objective: To compare the health value provided by enzalutamide and apalutamide, by evaluating two stages of prostate cancer: non-metastatic castration-resistant prostate cancer (nmCRPC) and metastatic hormone-sensitive prostate cancer (mHSPC). Methods: To establish, through the American Society of Clinical Oncology (ASCO) value framework, a contrast between two technologies in two stages of prostate cancer. The monthly cost of the two technologies was calculated according to the current price regulation norm in Colombia. Results: Enzalutamide showed a higher net health benefit score compared to apalutamide for both nmCRPC (48.33 versus 33.46) and mHSPC (52.0 versus 40.75). The cost per net health benefit point for the nmCRPC stage was $214,723 Colombian Pesos (COP) ($54.84 USD) with enzalutamide compared to $291,925 COP ($74.56 USD) with apalutamide, and for the mHSPC stage was $199,692 COP ($51.00 USD) with enzalutamide and $239,701 COP ($61.22 USD) with apalutamide. Conclusion: After comparing enzalutamide versus apalutamide in the nmCRPC and mHSPC stages through the ASCO value framework, enzalutamide showed a more prominent net clinical benefit and a lower investment per point awarded.

9.
Sci Rep ; 12(1): 20740, 2022 12 01.
Article in English | MEDLINE | ID: mdl-36456626

ABSTRACT

Ascent to high altitude (> 3000 m height above sea level or m.a.s.l) exposes people to hypobaric atmospheric pressure and hypoxemia, which provokes mountain sickness and whose symptoms vary from the mild acute mountain sickness to the life-threatening, high-altitude pulmonary edema (HAPE). This study analysed the risk factors underlying HAPE in dwellers and travellers of the Ecuadorian Andes after sojourning over 3000 m height. A group of HAPE patients (N = 58) was compared to a NO HAPE group (N = 713), through demographic (ethnicity, sex, and age), red blood cell parameters (erythrocytes counts, hematocrit, median corpuscular volume, median corpuscular haemoglobin, and median corpuscular haemoglobin concentration (MCHC)), altitude (threshold: 3000 m.a.s.l.), and health status (vital signs) variables. Analysis of Deviance for Generalised Linear Model Fits (logit regression) revealed patterns of significant associations. High-altitude dwellers, particularly children and elder people, were HAPE-prone, while women were more tolerant of HAPE than men. Interestingly, HAPE prevalence was strongly related to an increment of MCH. The residence at middle altitude was inversely related to the odds of suffering HAPE. Ethnicity did not have a significant influence in HAPE susceptibility. Elevated MCHC emerges like a blood adaptation of Andean highlanders to high altitude and biomarker of HAPE risk.


Subject(s)
Altitude Sickness , Pulmonary Edema , Child , Male , Humans , Female , Aged , Altitude Sickness/diagnosis , Altitude Sickness/epidemiology , Erythrocyte Indices , Altitude , Ecuador/epidemiology , Biomarkers
10.
IEEE Trans Med Imaging ; 41(11): 3278-3288, 2022 11.
Article in English | MEDLINE | ID: mdl-35687646

ABSTRACT

Recent advances in deep learning led to several algorithms for the accurate diagnosis of pneumonia from chest X-rays. However, these models require large training medical datasets, which are sparse, isolated, and generally private. Furthermore, these models in medical imaging are known to over-fit to a particular data domain source, i.e., these algorithms do not conserve the same accuracy when tested on a dataset from another medical center, mainly due to image distribution discrepancies. In this work, a domain adaptation and classification technique is proposed to overcome the over-fit challenges on a small dataset. This method uses a private-small dataset (target domain), a public-large labeled dataset from another medical center (source domain), and consists of three steps. First, it performs a data selection of the source domain's most representative images based on similarity constraints through principal component analysis subspaces. Second, the selected samples from the source domain are fit to the target distribution through an image to image translation based on a cycle-generative adversarial network. Finally, the target train dataset and the adapted images from the source dataset are used within a convolutional neural network to explore different settings to adjust the layers and perform the classification of the target test dataset. It is shown that fine-tuning a few specific layers together with the selected-adapted images increases the sorting accuracy while reducing the trainable parameters. The proposed approach achieved a notable increase in the target dataset's overall classification accuracy, reaching up to 97.78 % compared to 90.03 % by standard transfer learning.


Subject(s)
Deep Learning , Pneumonia , Humans , Nicardipine , X-Rays , Neural Networks, Computer , Pneumonia/diagnostic imaging
11.
Epilepsy Behav ; 133: 108803, 2022 08.
Article in English | MEDLINE | ID: mdl-35753110

ABSTRACT

An international consortium with a focus on Epilepsy Surgery Education was established with members from different centers in Latin America and Canada. All members of the consortium and attendees from different centers in Latin America and Canada have been meeting to discuss epilepsy surgery cases in a virtual manner. We surveyed all to assess the value of the meetings. The results and description of these meetings are being presented.


Subject(s)
Epilepsy , Canada , Epilepsy/surgery , Humans , Latin America
12.
J Child Fam Stud ; 31(8): 2248-2265, 2022.
Article in English | MEDLINE | ID: mdl-35539282

ABSTRACT

Although pregnancy and the first year of life are sensitive windows for child development, we know very little about the lived experiences of mothers living in poverty or near poverty during the perinatal period; specifically, how they perceive and use public resources to support themselves and their newborn. In this qualitative study, we explore how predominantly Black and Latinx mothers with infants living in or near poverty and engaged in public assistance manage to meet their family's needs with available resources from safety net programs and social supports. We conducted 20 qualitative interviews with mothers living in (85%) or near poverty in New York City (NYC). All participants (mean age = 24) had an 11-month-old infant at the time of the interview. Using thematic analysis, we identified five main themes reflecting how mothers experience and navigate living with very low incomes while engaging in public assistance programs: (1) experiencing cascading effects of hardships during pregnancy, (2) relying on food assistance and informal supports amid scarcity, (3) waiting for limited affordable housing: 'life on hold', (4) finding pathways towards stability after the baby's birth, (5) making it work: efforts to look forward. Results describe how the current focus on "work first" of existing federal and state policies adds a layer of stress and burden on the lives of single mothers experiencing low incomes and entangled hardships during pregnancy and after birth. We document how mothers experience coverage gaps and implementation challenges navigating the patchwork of public assistance programs, yet how the support of flexible caseworkers accessing, using, and coordinating assistance has the potential to help mothers plan for longer-term goals.

13.
Bol Med Hosp Infant Mex ; 79(2): 83-90, 2022.
Article in English | MEDLINE | ID: mdl-35468121

ABSTRACT

Acne is a chronic inflammatory disease of the pilosebaceous unit with multifactorial etiology. Abnormal proliferation of keratinocytes, altered sebum production, inflammation of the sebaceous follicle, and colonization by Cutibacterium acnes have been traditionally implicated. However, the diet has also been highlighted in the pathogenesis because of its direct relation with some biochemical markers and the transcription of specific genes associated with sebaceous gland activity, inflammation, and bacterial proliferation, which together promote the development of the disease, affect the severity of the condition, and modify its response to treatment.


El acné es una enfermedad inflamatoria crónica de la unidad pilosebácea de etiología multifactorial, en la que clásicamente se han implicado la proliferación anormal de queratinocitos, la producción alterada de sebo, la inflamación del folículo sebáceo y la colonización por Cutibacterium acnes. Sin embargo, también destaca la dieta en la patogenia al relacionarse directamente con la alteración de algunos marcadores bioquímicos y transcripción de ciertos genes que se asocian con la actividad de la glándula sebácea, la inflamación y la proliferación bacteriana, que en conjunto promueven el desarrollo de la enfermedad, afectan la gravedad del cuadro y modifican su respuesta al tratamiento.


Subject(s)
Acne Vulgaris , Acne Vulgaris/microbiology , Acne Vulgaris/pathology , Diet , Humans , Inflammation/complications , Propionibacterium acnes/physiology , Sebum
14.
Travel Med Infect Dis ; 47: 102282, 2022.
Article in English | MEDLINE | ID: mdl-35314344

ABSTRACT

BACKGROUND: Malaria remains a serious public health problem. Malaria caused 409,000 deaths in 2019, and 67% were children under 5 years old. Malaria-infected mothers exhibit several complications, including babies with low birth weight, stillbirth, preterm delivery, poor fetal intrauterine growth and maternal anemia. This review aims to provide an update on the immune response in pregnant women and the role of cytokines and chemokines in modulating immunity after infection by the Plasmodium parasite. METHODS: This review collects information from articles indexed in the main databases associated with malaria in pregnancy and its relationship with the immune response and cytokines. RESULTS: and Discussion: The most influential event in malaria pregnancies for pathology development is placental sequestration. During the gestation period, an imbalance in the immune response due to the over- and under-expression of cytokines promotes high rates of fetal mortality, miscarriage, maternal anemia, and low birth weight. In addition, hormones, parity, gestational age, and age of the mother are risks associated with malaria severity during pregnancy. CONCLUSIONS: The pathology of malaria pregnancy is dependent on factors such as cytokine imbalances, placental sequestration and hormones, parity, gestational age and age of the mother. Thus, a better understanding of immune mechanisms will provide information to improve results for disease treatment.


Subject(s)
Anemia , Malaria, Falciparum , Malaria , Pregnancy Complications, Parasitic , Chemokines , Child , Child, Preschool , Cytokines , Female , Hormones , Humans , Infant, Newborn , Malaria/complications , Malaria, Falciparum/complications , Placenta/parasitology , Pregnancy , Stillbirth
15.
Appl Opt ; 61(8): E21-E32, 2022 Mar 10.
Article in English | MEDLINE | ID: mdl-35297870

ABSTRACT

In recent years, compressive spectral imaging (CSI) has emerged as a new acquisition technique that acquires coded projections of the spectral scene, reducing considerably storage and transmission costs. Among several CSI devices, the single-pixel camera (SPC) architecture excels due to its low implementation cost when acquiring a large number of spectral bands. Although CSI allows efficient sampling, a complete reconstruction of the underlying scene is needed to perform any processing task, which involves solving a computationally expensive optimization problem. In this paper, we propose a fast method to classify the underlying spectral image by directly using compressed SPC measurements, avoiding reconstruction. In particular, the proposed method acquires an RGB image of the scene as side information to design the SPC coding patterns. Our design approach allows incorporating the similarity information of neighboring pixels from the RGB image into compressed measurements. After acquiring the compressed measurements with our designed coding patterns, we extract features of the scene to perform classification without reconstruction. After simulations, we obtained an overall accuracy of 95.41% and 97.72% for the Pavia University and Salinas spectral images, respectively. Furthermore, we tested our approach in the laboratory and classified our own dataset, which has four different materials: flowers, sand, grass, and dry leaves, with an overall accuracy of 94.66%.

16.
An. Fac. Med. (Perú) ; 83(1): 6-11, ene.-mar. 2022. tab
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1374216

ABSTRACT

RESUMEN Introducción. El primer caso de COVID-19 en el Perú fue reportado el 5 de marzo del 2020 y se declaró el aislamiento social el 16 de marzo, quedando con ello interrumpida la actividad académica en las instituciones educativas. Objetivo. Determinar la seroprevalencia y los factores de riesgo asociados a la infección por SARS-CoV-2 en estudiantes de pregrado de una facultad de medicina en una universidad pública. Métodos. Estudio descriptivo, transversal mediante una encuesta serológica a una muestra aleatoria representativa de la población de estudiantes de pregrado de ciencias de la salud, utilizando una prueba rápida para la detección de anticuerpos IgG, IgM, o ambos, mediante la toma de muestra de sangre total del pulpejo de dedo. Resultados. Para el mes de agosto del 2021, el 24,92% (IC95% 18,2-33,0) de los estudiantes de ciencias de la salud presentaron anticuerpos contra el SARS-CoV-2, de ellos el 21,2% a IgG, 2,3% a IgM y 0,8% a ambos, el 75,08% (IC95% 66,9-82,0) no presentaron anticuerpos. Conclusiones. La seroprevalencia en estudiantes no muestra diferencia con la seroprevalencia de la enfermedad en la población general. Por lo tanto, para reiniciar las actividades académicas presenciales, esta población debe ser vacunada y debe cumplir además con las medidas no farmacológicas para la prevención y el control de la pandemia como son la ventilación natural de los ambientes, el uso de medidas de protección personal- mascarillas, lavado de manos y el distanciamiento físico.


ABSTRACT Introduction. On March 5 2020, the first case of COVID-19 was reported and on March 16, order of quarantine was issued which resulted in interruption of academic activities. Objective. Determine the seroprevalence and risk factors associated to SARS-CoV-2 infection in undergraduate students of the school of medicine in a public university. Methods. Descriptive cross-sectional study by means of a serology survey to a representative sample of the population of undergraduate students of a health sciences school using a rapid test to detect antibodies IgG, IGM or both in a total blood sample by digital punction. Results. On August 2021, 24,92% (IC95% 18,2-33,0) of students of health sciences tested positive for antibodies anti SARS-CoV-2, 21,2% for IgG, 2,3% for IGM and 0,8% for both; 75,08% (IC95% 66,9-82,0) tested negative antibodies. Conclusions. The seroprevalence in students was not different from the seroprevalence in general population. Therefore, in order to restart presential academic activities this population must be vaccinated and other nonpharmacological requirements should be accomplished for prevention and control of the pandemics such as natural ventilation of classrooms, use of personal protection equipment - masks, hand washing and keeping physical distancing.

19.
Med Hypotheses ; 146: 110418, 2021 Jan.
Article in English | MEDLINE | ID: mdl-33268002

ABSTRACT

Exposure to hypoxic environments when ascending at high altitudes may cause life-threatening pulmonary edema (HAPE) due to a rapid accumulation of extracellular fluid flooding in the pulmonary alveoli. In Andeans, high-altitude adaptation occurs at the expense of being more prone to chronic mountain sickness: relative hypoventilation, excess pulmonary hypertension, and secondary polycythemia. Because HAPE prevalence is high in the Andes, we posit the hypothesis that a high hemoglobine mass may increase HAPE risk. In support of it, high intrapulmonary hypertension along with hyperviscosity produced by polycytemia may enhance sear forces and intravascular hemolysis, thus leading to increased acellular hemoglobin and the subsequent damage of the alveolar and endothelial barrier. It is proposed to investigate the relationship between the vaso-endothelial homeostasis and erythropoiesis in the maladaptation to high altitude and HAPE. This research is especially important when reentry HAPE, since rheologic properties of blood changes with rapid ascent to high altitudes.


Subject(s)
Altitude Sickness , Pulmonary Edema , Altitude , Altitude Sickness/complications , Hemoglobins , Humans , Lung
20.
Horiz. sanitario (en linea) ; 19(3): 375-384, sep.-dic. 2020. tab, graf
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1154335

ABSTRACT

Resumen Objetivo: Desarrollar un modelo de pronóstico, para apoyar la toma de decisiones en medidas de mitigación de COVID-19 en Jalisco. Material y métodos: Se desarrolló un modelo matemático, con enfoque determinístico S.E.I.R. para mostrar la evidencia en el desarrollo de la pandemia de COVID-19 en Jalisco. Los estados considerados fueron Susceptibles (S), Expuestos (E), Infectados (I) y Recuperados/ fallecidos (R). Los datos poblacionales se obtuvieron en base a CONAPO 2020, con una población de 8´368,311 habitantes. Se tomaron los parámetros siguientes β, γ y σ, para calibrarlo a partir de las estimaciones de R0, para que el modelo se reproduzca lo mejor posible, dado que el supuesto es que no existe intervención externa que afecte la tasa de contacto y debido a que en Jalisco se aplicaron medidas de intervención. Se plantearon 5 diferentes escenarios, variando el número básico de reproducción (R0) como variable de mitigación. Se extendieron las series en el tiempo. Resultados: El peor de los escenarios (sin intervención) se daría en la primera semana del mes de junio con R0=3 afectando a un 73.2% de la población, pero debido a las medidas de mitigación aplicadas, se observa que el mejor ajuste para el estado es para Ro=2.2 (mitigación 37.2%) dando inicio en la última semana del mes de julio afectando un 58.9% de la población, mostrando una fase menos aguda que la de sin intervención, pero de más larga de duración aproximadamente 40 semanas. Conclusiones: Se requiere un monitoreo, ajuste y adecuación permanente de las medidas de mitigación en las fases de contención y de transmisión sostenida, con un aumento de la capacidad diagnóstica mediante pruebas e incrementar el distanciamiento social. Además, se requerirían nuevos períodos de distanciamiento social intermitente, para prevenir el colapso del sistema estatal de salud, que se activaría con el incremento de la tasa básica de reproducción R0.


Abstract Objective: To develop a forecasting model to support decision-making on mitigation measures of covid-19 in jalisco. Material and methods: A mathematical model with a deterministic approach s.e.i.r. was developed. To show the evidence in the development of the covid-19 pandemic in jalisco. The states considered were susceptible (s), exposed (e), infected (i) and recovered / deceased (r). Population data were obtained based on conapo 2020, with a population of 8,368,311 inhabitants. The following parameters β, γ and σ were taken to calibrate it from the estimates of r0, so that the model reproduces itself as best as possible, since the assumption is that there is no external intervention that affects the contact rate and due to that in jalisco intervention measures were applied. 5 different scenarios were proposed, varying the basic number of reproduction (r0) as a mitigation variable. The series were extended in time. Results: The worst case scenario (without intervention) would occur in the first week of june with r0 = 3 affecting 73.2% of the population, but due to the mitigation measures applied, it is observed that the best adjustment for the state it is for ro = 2.2 (mitigation 37.2%) beginning in the last week of july, affecting 58.9% of the population, showing a less acute phase than that of no intervention but of longer duration, approximately 40 weeks. Conclusions: Continuous monitoring, adjustment and adaptation of mitigation measures are required in the containment and sustained transmission phases, with an increase in diagnostic capacity through tests and increased social distancing. In addition, new periods of intermittent social distancing would be required to prevent the collapse of the state health system, which would be activated with the increase in the basic rate of reproduction r0.


Resumo Objetivo: Desenvolva um modelo de previsão para apoiar a tomada de decisões sobre medidas de mitigação do COVID-19 em Jalisco. Material e métodos: Um modelo matemático com uma abordagem determinística S.E.I.R. foi desenvolvido. mostrar as evidências no desenvolvimento da pandemia de COVID-19 em Jalisco. Os estados considerados foram Susceptíveis (S), Expostos (E), Infectados (I) e Recuperados / Falecidos (R). Os dados populacionais foram obtidos com base no CONAPO 2020, com uma população de 8.368.311 habitantes. Os seguintes parâmetros β, γ e σ foram tomados para calibrá-lo a partir das estimativas de R0, para que o modelo seja reproduzido da melhor forma possível, pois pressupõe-se que não há intervenção externa que afete a taxa de contato e devido a que em Jalisco foram aplicadas medidas de intervenção. Foram propostos 5 cenários diferentes, variando o número básico de reprodução (R0) como variável de mitigação. As séries foram estendidas no tempo. Resultados: O pior cenário (sem intervenção) ocorreria na primeira semana de junho com R0 = 3 afetando 73,2% da população, mas devido às medidas de mitigação aplicadas, observa-se que o melhor ajuste para o estado é para Ro = 2,2 (mitigação 37,2%) a partir da última semana de julho, afetando 58,9% da população, mostrando uma fase menos aguda do que a de nenhuma intervenção, mas de maior duração, aproximadamente 40 semanas. Conclusões: O monitoramento, ajuste e adaptação contínuos das medidas de mitigação são necessários nas fases de contenção e transmissão sustentada, com aumento da capacidade de diagnóstico por meio de testes e aumento do distanciamento social. Além disso, novos períodos de distanciamento social intermitente seriam necessários para evitar o colapso do sistema de saúde do estado, que seria ativado com o aumento da taxa básica de reprodução R0.


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