A deep learning model for Alzheimer's disease diagnosis based on patient clinical records.

BACKGROUND: Dementia, with Alzheimer's disease (AD) being the most common type of this neurodegenerative disease, is an under-diagnosed health problem in older people. The creation of classification models based on AD risk factors using Deep Learning is a promising tool to minimize the impact of under-diagnosis. OBJECTIVE: To develop a Deep Learning model that uses clinical data from patients with dementia to classify whether they have AD. METHODS: A Deep Learning model to identify AD in clinical records is proposed. In addition, several rebalancing methods have been used to preprocess the dataset and several studies have been carried out to tune up the model. RESULTS: Model has been tested against other well-established machine learning techniques, having better results than these in terms of AUC with alpha less than 0.05. CONCLUSIONS: The developed Neural Network Model has a good performance and can be an accurate assisting tool for AD diagnosis.

Representaciones sociales de bioética en epidemiólogos en formación

Introducción: La formación en bioética de los epidemiólogos repercute favorablemente en la salud de las comunidades, contribuye a la toma de decisiones éticas y ayuda a promover resultados sanitarios equitativos para todas las poblaciones. Objetivo: Identificar las representaciones sociales (RS) de bioética en estudiantes de la Especialización en Epidemiología de una universidad en Pereira, Risaralda, Colombia. Método: Estudio cualitativo desde el enfoque teórico de la antropología cognitiva mediante el análisis procesual, prototípico y estructural de las representaciones sociales, a través de las técnicas asociativas de listado libre y cuestionario de comparación de pares, para consolidar el contenido, la organización y representación gráfica de las RS de 17 estudiantes de especialización en Epidemiología. Resultados: Para los participantes, las RS sobre bioética gira en torno a la ética por la vida y respeto por los derechos humanos en su núcleo central, los aspectos que establecen los elementos periféricos de la representación se constituyen en principios, moral, equidad, respeto y normas. Discusión: Los resultados aquí presentados se discuten a la luz de los avances conceptuales de la ética aplicada, la bioética principialista y la bioética global, en perspectiva de derechos por el respeto a la vida. Conclusiones: las RS de bioética en los epidemiólogos en formación es comprendida de manera amplia como una rama de la ética desde una perspectiva de derechos y de respeto a la vida.

Introduction: Bioethics education for epidemiologists has a favorable impact on the health of communities, contributes to ethical decision making and helps promote equitable health outcomes for all populations. Objective: To identify the social representations (SR) of bioethics in students of the epidemiology specialization of a university in Pereira, Risaralda, Colombia. Method: qualitative study from the theoretical approach of cognitive anthropology by means of processual, prototypical and structural analysis of Social Representations through the associative techniques of free listing and peer comparison questionnaire, to consolidate the content, organization and graphic representation of the SRs of 17 students of the specialization in epidemiology. Results: For the participants, SR on Bioethics revolves around ethics for life and respect for human rights in its central core; the aspects that establish the peripheral elements of the representation are constituted by principles, morals, equity, respect and norms. Discussion: The results presented here are discussed in the light of conceptual advances in applied ethics, principlist bioethics and global bioethics in the perspective of rights for the respect of life. Conclusions: SR of bioethics in epidemiologists in training is broadly understood as a branch of ethics from a perspective of rights and respect for life.

Autoexamen de mama: Representaciones sociales en mujeres del litoral Pacífico en Colombia

En la prevención del cáncer de mama se hace necesario tener en cuenta los aspectos culturales de las personas involucradas para lograr un acercamiento al fenómeno de la salud y estos cómo influyen en el comportamiento del autocuidado. Objetivo: comprender las representaciones sociales sobre el cáncer y el autoexamen de mama de las mujeres del litoral Pacífico en Colombia durante el año 2019. Metodología: estudio con enfoque cualitativo interpretativista a través del análisis de las representaciones sociales, para la recolección de la información y construcción del fenómeno de estudio se realizaron entrevistas estructuradas a 21 mujeres entre los 19 y 71 años, habitantes de los municipios de Santa Bárbara de Iscuandé y Mosquera del departamento de Nariño y de los municipios de Guapi y Timbiquí del departamento del Cauca. Resultados: el autoexamen de mama para las mujeres es un concepto y práctica que se configura y se comprende a través de categorías teóricas y emergentes como las creencias, percepciones, conocimientos que tienen de la enfermedad, métodos de detección, consecuencias y vivencias. Conclusión: el cáncer de mama se asocia con malignidad, muerte y emociones negativas, reconocen que causa sufrimiento, afectando su entorno familiar y social, la representación social sobre el autoexamen está relacionada con la enfermedad y sus implicaciones, destacando las creencias, percepciones y categorías permeadas por los aspectos socioculturales.

It is necessary to take into account the cultural aspects of the people involved in the prevention of breast cancer to achieve an approach to the phenomenon of health and how these aspects influence the self-care behavior. Objective: To understand the social representations of cancer and breast self-examination of women on the Pacific coast in Colombia during the year 2019. Method: The study uses a qualitative interpretative approach through the analysis of Social Representations. Structured interviews were conducted for the collection of data and construction of the study phenomenon with 21 women between 19 and 71 years old, inhabitants of the municipalities of Santa Bárbara de Iscuandé and Mosquera in the department of Nariño and the municipalities of Guapi and Timbiquí in the department of Cauca. Results: Breast self-examination for women is a concept and practice that is configured and understood through theoretical and emergent categories such as beliefs, perceptions, knowledge they have about the disease, detection methods, consequences and life experiences. Conclusions: Breast cancer is associated with malignancy, death and negative emotions. Women recognize that it causes suffering and affects their family and social environment. The social representation of self-examination is related to the disease and its implications, highlighting beliefs, perceptions, and categories influenced by sociocultural aspects.

Na prevenção do câncer de mama é necessário ter em conta os aspectos culturais das pessoas envolvidas para obter um acercamento ao fenômeno da saúde e estes como influem no comportamento do autocuidado. Objetivo: compreender as representações sociais sobre o câncer e o auto-exame de mama das mulheres no litoral Pacífico na Colômbia durante o ano 2019. Metodologia: estudo com enfoque qualitativa interpretativa a través da análise das representações sociais, para a coleta da informação e construção do fenómeno de estudo se realizaram entrevistas estruturadas a 21 mulheres entre os 19 e 71 anos, habitantes dos municípios de Santa Bárbara de Iscuandé e Mosquera do departamento de Nariño e dos municípios de Guapi e Timbiquí do departamento do Cauca. Resultados: o auto-exame de mama para as mulheres é um conceito e prática que se configura e se compreende a través de categorias teóricas e emergentes como as crenças, percepções, conhecimentos que tem da doença, métodos de detecção, consequências e vivências. Conclusão: o câncer de mama se associa com malignidades, morte e emoções negativas, reconhecem que causa sofrimento, afetando seu entorno familiar e social, a representação social sobre o auto-exame está relacionada com a doença e suas implicações, destacando as crenças, percepções e categorias permeadas pelos aspectos socioculturais.

Aging, depression and dementia: The inflammatory process.

Population aging that we are currently witnessing has led to an increase in chronic age-related diseases, with dementia and depression being highlighted. Several studies establish a relationship between dementia and depression, although without defining the mechanism that links them. Some studies establish depression as a prodrome of dementia, while others consider it a risk factor for dementia. One of the events that is common between dementia and depression is the inflammatory process. In depression, an increase in inflammatory cytokines has been described, which would justify the serotonergic, noradrenergic and dopaminergic dysfunction of depression. This increase entails altering the activity of the hypothalamic-pituitary-adrenal (HPA) axis, thus linking chronic stress to depression, and the consequent weakening of the blood-brain barrier (BBB), facilitating the passage of pro-inflammatory factors. In this line, recent studies suggest that inflammation could direct the development of the pathogenesis of dementia, particularly Alzheimer's disease (AD), once the pathology has begun. In addition, sustained exposure to pro-inflammatory cytokines characteristic of aging could alter the microglial function and the expression of enzymes responsible for amyloid peptide metabolism, aggravating the pathological process. In view of the involvement of the inflammatory process in both conditions, it is necessary to investigate the events which both conditions share, such as the inflammatory process, to know the involvement of the inflammatory process in both dementia and depression, possible relationship of these 2 conditions, and consequently, to establish the clinical approach to both conditions.

Paternidad adolescente: significados y prácticas desde una perspectiva socioconstruccionista / Adolescent fatherhood: meanings and practices from a socio-constructionist perspective / Paternidade na adolescência: significados e práticas na perspectiva socioconstrucionista

Resumen (analítico) La paternidad en la adolescencia tradicionalmente ha sido estigmatizada, llevando a la generación de barreras y desconocimiento de vivencias, motivaciones y significados. Por ello se planteó como objetivo comprender la construcción y significados de la paternidad presente y activa de hombres adolescentes que residen en Guadalajara, Jalisco, México. Se realizó un estudio cualitativo socioconstruccionista en el que participaron hombres de 16 a 19 años que eran padres o que su pareja estaba en embarazo. Se realizaron entrevistas semiestructuradas y observación de redes sociales; se realizó un análisis de contenido. Los resultados dan cuenta de la intersección entre masculinidades y paternidades, demostrando que en las motivaciones para su paternidad se destacan la búsqueda de reconocimiento social, la conformación de una familia y la búsqueda de suplir necesidades emocionales a través de la pareja y del hijo/hija.

Abstract (analytical) Adolescent paternity has traditionally been stigmatized, which has generated barriers and ignorance of the experiences, motivations and meanings of young fathers. This is why this study has the objective of understanding the construction and meanings of the present and active paternity of adolescent men living in Guadalajara, Mexico. A qualitative socio-constructionist study was carried out with young men aged 16 to 19 who were parents or their partner was pregnant. Semi-structured interviews and observation of their social networks were carried out followed by content analysis. The results of the study highlight the intersections between masculinities and paternities. Notable motivations for their paternity include their desire for social recognition, their interest in forming a family and meeting their emotional needs through their partner and son/daughter.

Resumo (analítico) A paternidade na adolescência tem sido tradicionalmente estigmatizada, levando à geração de barreiras e ignorância de experiências, motivações e significados, razão pela qual o objetivo era compreender a construção e os significados da paternidade atual e ativa dos adolescentes homens residentes em Guadalajara, Jalisco, México. Foi realizado um estudo sócio-construcionista qualitativo, envolvendo homens de 16 a 19 anos que eram pais ou que o casal estava grávido. Foram realizadas entrevistas semiestruturadas e observação das redes sociais, análise de conteúdo. Os resultados mostram a interseção entre masculinidades e paternidades, demonstrando nas motivações de sua paternidade a busca pelo reconhecimento social, a formação de uma família e a busca de suprir necessidades emocionais por meio do casal e do filho / filha.

Spanish adaptation and validation of the Pain Assessment Scale in Advanced Dementia (PAINAD) in patients with dementia and impaired verbal communication: cross-sectional study.

OBJECTIVES: The aim of this study was to adapt and validate the Pain Assessment in Advanced Dementia (PAINAD) scale in Spanish. DESIGN: Cross-sectional observational study. SETTING: Two health districts of Andalusian provinces, located in the south of Spain, through the Andalusian network of Primary Healthcare centres and four institutions dedicated to the care of patients with dementia. PARTICIPANTS: A total of 100 older people, with a medical diagnosis of dementia and a score on the Global Deterioration Scale between 5 and 7 were assessed using the PAINAD scale. PRIMARY AND SECONDARY OUTCOME MEASURES: Psychometric properties including content validity, construct validity and reliability of the scale have been tested. RESULTS: The overall Item Content Validity Index was excellent (0.95). Regarding construct validity, it was confirmed that a lower use of analgesics implied a lower score on the PAINAD scale (p<0.05). The internal consistency of the scale was 0.76 and it increases to 0.81 if we remove the breathing item. Furthermore, the intraclass correlation coefficient (ICC) used to assess interobserver reliability was 0.94, whereas the ICC used to assess temporary stability was 0.55. CONCLUSIONS: The Spanish version of the PAINAD scale is a valid tool to assess pain in patients with dementia and inability to communicate verbally.

Correlation between Biomarkers of Pain in Saliva and PAINAD Scale in Elderly People with Cognitive Impairment and Inability to Communicate.

The pain assessment in advanced dementia (PAINAD) appears to be a clinically useful tool. However, the salivary determination of tumor necrosis factor receptor type II (sTNF-RII) and secretory IgA (sIgA) as pain biomarkers is still incipient. The aim was to correlate the PAINAD score with sTNF-RII and sIgA biomarker levels in the saliva of patients with advanced dementia. In this regard, a cross-sectional study was conducted. The sample consisted of 75 elderly patients with a clinical diagnosis of dementia and a global deterioration scale (GDS) score of 5 to 7. The PAINAD scale was determined by a previously trained professional and the collection of salivary samples was performed using the passive secretion method. Human sTNF-RII and sIgA using ELISA kits. The results showed a correlation between the PAINAD scale (numeric, binary, and recoded) and sTNF-RII and sIgA (p < 0.001). No association between the sociodemographic and clinical variables and the PAINAD scale was found (p > 0.05). Between 97.3% and 96.2% of patients with pain on the PAINAD scale also showed pain based on the sTNF-RII levels; in all of them, sIgA levels did not fit the logistic models. Therefore, the correlation highlights the usefulness of this scale and confirms the usefulness of sTNF-RII and sIgA as biomarkers of pain.

Moderate Beer Consumption Modifies Tumoral Growth Parameters and Pyrrolidone Carboxypeptidase Type-I and Type-II Specific Activities in the Hypothalamus-Pituitary-Mammary Gland Axis in an Animal Model of Breast Cancer.

AIMS: To determine the effect of moderate alcoholic and nonalcoholic beer consumption on tumoral growth parameters, the histopathology, pyrrolidone carboxypeptidase type I (Pcp I), and type II (Pcp II) specific activities in the hypothalamus-pituitary-mammary gland axis, and the circulating levels of estradiol (E2) and progesterone (P4) in rats with N-methyl-N-nitrosourea (NMU) induced mammary tumors. MATERIAL AND METHODS: Food and drink intake, weight gain and tumor growth parameters were collected. The malignant phenotype of the tumor was performed using the Scarff-Bloom-Richardson grading method. Pcp specific activities were fluorometrically analyzed using pyroglutamyl-ß-naphthylamide as substrate. Circulating steroid hormones were determined. RESULTS: Differences were found in tumoral parameters, depending on the drink. Animals that were given alcohol-containing beer (A/C) beer to drink showed the lowest values of hypothalamic Pcp I, in association with the lowest levels of circulating E2. The significant decrease in Pcp I activity in all NMU-treated groups suggest a clear role of the Pcp I in the tumoral process, and A/C beer interferes with it. DISCUSSION: Moderate consumption of alcoholic beer would have beneficial effects against mammary tumors through the modification of the endocrine status mediated by GnRH due to changes on Pcp I and II activities at different levels.

Estándares de calidad en un seguimiento a pacientes ancianos con insuficiencia cardiaca e importante comorbilidad

Resumen: Introducción: Los pacientes con insuficiencia cardiaca (IC) seguidos por los servicios de medicina interna son más ancianos y presentan más comorbilidades asociadas. Por ello presentan un riesgo elevado de ingreso hospitalario y de mortalidad. En este estudio se evaluaron los objetivos alcanzados en términos de ingresos, visitas a urgencias y mortalidad, así como la actividad realizada para conseguirlos, en una unidad dirigida a este perfil de pacientes y caracterizada por una atención integral y continuada (programa UMIPIC). Métodos: Se analizaron retrospectivamente los datos de los 329 pacientes con IC atendidos en la unidad de IC, modelo UMIPIC, del servicio de Medicina Interna del Hospital de Lugo. Se recogieron desde enero del 2020, hasta diciembre 2020 los ingresos por IC y totales, las visitas a urgencias por IC y totales, la mortalidad, las consultas realizadas, y los rescates realizados en régimen de hospital de día (HDD). Resultados: Se recogieron 108 ingresos, 40 por IC y 68 por otras causas, 99 visitas a urgencias, 25 por IC y 74 por otras causas. Se produjeron 57 fallecimientos, 37 fueron en el hospital (15 por IC, 12 por otras causas) y 20 fueron extra-hospitalarios. Se realizaron 1179 consultas médico-enfermería, 1554 consultas de enfermería exclusiva y se realizaron 406 tratamientos en HDD. Conclusiones: Los estándares de actividad y resultados conseguidos pueden ser orientativos de la actividad a desarrollar en una unidad de IC modelo UMIPIC.

Abstract: Introduction: Patients with heart failure (HF) followed by internal medicine services are older and have more associated comorbidities. For this reason, they present a high risk of hospital admission and mortality. In this study, the objectives achieved in terms of admissions, emergency room visits and mortality, as well as the activity carried out to achieve them, were evaluated in a unit aimed at this patient profile and characterized by comprehensive and continuous care (UMIPIC program). Methods: The data of the 329 patients with HF treated in the HF unit, model UMIPIC, of the Internal Medicine service of the Hospital de Lugo, were retrospectively analyzed. From January 2020, to December 2020, total and HF admissions, total and HF emergency visits, mortality, consultations made, and rescues performed in a day hospital (HDD) were collected. Results: 108 admissions were collected, 40 for HF and 68 for other causes, 99 visits to the emergency room, 25 for HF and 74 for other causes. There were 57 deaths, 37 were in the hospital (15 due to HF, 12 due to other causes) and 20 were extra-hospital. 1179 medical-nursing consultations were carried out, 1554 exclusive nursing consultations and 406 treatments were carried out in HDD. Conclusions: The activity standards and results achieved can be indicative of the activity to be carried out in an IC model UMIPIC unit.

Resumo: Introdução: Pacientes com insuficiência cardíaca (IC) acompanhados por serviços de medicina interna são mais velhos e apresentam mais comorbidades associadas. Portanto, apresentam alto risco de admissão hospitalar e mortalidade. Neste estudo, os objetivos alcançados em termos de internações, atendimentos de emergência e mortalidade, bem como a atividade desenvolvida para os atingir, foram avaliados numa unidade dirigida a este perfil de doente e caracterizada por um atendimento integral e contínuo (programa UMIPIC). Métodos: Foram analisados ​​retrospectivamente os dados dos 329 pacientes com IC atendidos na unidade de IC, modelo UMIPIC, do serviço de Clínica Médica do Hospital de Lugo. No período de janeiro de 2020 a dezembro de 2020, foram coletadas internações totais e por IC, atendimentos totais e de emergência por IC, mortalidade, consultas realizadas e resgates realizados em regime de hospital-dia (HDD). Resultados: foram coletadas 108 internações, sendo 40 por IC e 68 por outras causas, 99 visitas ao pronto-socorro, 25 por IC e 74 por outras causas. Ocorreram 57 óbitos, 37 foram hospitalares (15 por IC, 12 por outras causas) e 20 extra-hospitalares. Foram realizadas 1179 consultas médico-enfermagem, 1554 consultas exclusivas de enfermagem e 406 atendimentos em HDD. Conclusões: Os padrões de atividade e os resultados alcançados podem ser indicativos da atividade a ser desenvolvida numa unidade IC modelo UMIPIC.

Depression as a Risk Factor for Dementia and Alzheimer's Disease.

Preventing the onset of dementia and Alzheimer's disease (AD), improving the diagnosis, and slowing the progression of these diseases remain a challenge. The aim of this study was to elucidate the association between depression and dementia/AD and to identify possible relationships between these diseases and different sociodemographic and clinical features. In this regard, a case-control study was conducted in Spain in 2018-2019. The definition of a case was: A person ≥ 65 years old with dementia and/or AD and a score of 5-7 on the Global Deterioration Scale (GDS). The sample consisted of 125 controls; among the cases, 96 had dementia and 74 had AD. The predictor variables were depression, dyslipidemia, type 2 diabetes mellitus, and hypertension. The results showed that depression, diabetes mellitus, and older age were associated with an increased likelihood of developing AD, with an Odds Ratio (OR) of 12.9 (95% confidence interval (CI): 4.3-39.9), 2.8 (95% CI: 1.1-7.1) and 1.15 (95% CI: 1.1-1.2), respectively. Those subjects with treated dyslipidemia were less likely to develop AD (OR 0.47, 95% CI: 0.22-1.1). Therefore, depression and diabetes mellitus increase the risk of dementia, whereas treated dyslipidemia has been shown to reduce this risk.

COVID-19 y sus imaginarios socioculturales en Latinoamérica: una herramienta para la salud pública / COVID-19 and its socio-cultural imagery in Latin America: a tool for public health

RESUMEN Objetivo Identificar el contenido y organización de las representaciones sociales que tiene la población urbana de tres ciudades de América Latina sobre el COVID-19. Materiales y Métodos Estudio cualitativo hecho desde la antropología cognitiva a través del análisis estructural de las representaciones sociales. Se utilizaron técnicas de listados libres y comparación de pares de febrero a abril de 2020 en Pereira (Colombia), en la zona metropolitana de Guadalajara (México) y en León (también en México). Participaron 97 personas de ambos sexos (97 en la primera fase y 71 en la segunda), mayores de edad y que su ocupación o profesión no tuvieran relación con el área de salud; se realizó muestreo no probabilístico-propositivo. Resultados El imaginario sociocultural está asociado con términos como contagio y pandemia, con énfasis en los términos relacionados con la prevención de la enfermedad. Conclusiones Los saberes de la población sobre el COVID-19 privilegian aspectos clínicos y epidemiológicos, así como las medidas de contención y mitigación.

ABSTRACT Objective Identify the content and organization of social representations (SR) against COVID-19 in urban population of three cities in Latin America, 2020. Materials and Methods Qualitative study from cognitive anthropology through the structural analysis of SR. Free listing and pair comparison techniques were used from February-April 2020, in Pereira (Colombia), Guadalajara Metropolitan Area (ZMG)-(Mexico), León (Mexico). 97 participants were included in the first phase and 71 in the second phase, of both sexes, of legal age, whose occupation and profession had no relation to the health area; non-probability-purposeful sampling was performed. Results The socio-cultural imaginary is associated with terms such as contagion, pandemic, but highlighting the terms related to disease prevention. Conclusions The knowledge of the population about COVID-19 privileges clinical and epidemiological aspects, as well as containment and mitigation measures.

Representaciones sociales del cáncer de mama: una comparación de mujeres con diagnóstico reciente y mujeres sanas / Social Representations of Breast Cancer: a Comparison of Women with Recent Diagnosis and Healthy Women

Resumen Identificar las representaciones sociales (RS) del cáncer de mama en mujeres con diagnóstico y mujeres sanas o libres de enfermedad (MLE), Guadalajara-Jalisco, 2016. Se aplicó la técnica asociativa de listados libres y cuestionario de pares a 40 mujeres; para conocer la estructura de las RS se hizo análisis de contenido temático y estructural de la RS.Los hallazgos muestran que las mujeres diagnosticadas tienen mayor conciencia sobre la importancia de prevención y detección oportuna. MLE otorgaron mayor importancia a aspectos negativos como miedo y muerte. La RS sobre la enfermedad se construye a través de las vivencias, ya sea propia con el diagnóstico o a través de experiencias de una persona cercana o conocimientos sociales.

Abstract The objective of the study was to identify the social representations (SR) of breast cancer in diagnosed women and healthy or disease-free women (MLE), Guadalajara-Jalisco, 2016. The associative technique of free listing and peer questionnaire was applied to 40 women. In order to know the structure of SR, a thematic and structural content analysis of SR was carried out. The findings show that diagnosed women are more aware of the importance of prevention and timely detection. MLE gave greater importance to negative aspects such as fear and death. The SR on the disease is built through experiences, either one's own with the diagnosis, through the experiences of a close person, or through social knowledge.

Estimación del intervalo serial y número reproductivo básico para los casos importados de COVID-19 / Estimation of serial interval and basic reproductive number for imported cases of COVID-19

RESUMEN Objetivo Estimar el intervalo serial y el número básico de reproducción de COVID-19 entre casos importados durante la fase de contención en Pereira, Colombia, 2020. Método Se realizó un estudio cuantitativo para determinar algunos aspectos de la dinámica de transmisión de la COVID-19. Se utilizaron las entrevistas epidemiológicas de campo en los que se incluyeron 12 casos confirmados por laboratorio con PCR-RT para SARS-CoV-2 importados y sus correspondientes casos secundarios confirmados, entre los que estaban contactos familiares y sociales. Resultados Los intervalos seriales en la COVID-19 se ajustan a una distribución Gamma, con una media del intervalo serial de 3,8 días (± 2,7) y un R0 de 1,7 (IC 95% 1,06-2,7) inferior a lo encontrado en otras poblaciones con inicio del brote. Conclusiones Un intervalo serial inferior al periodo de incubación como el que se estimó en este estudio sugiere un periodo de transmisión presintomático que, según otras investigaciones, alcanza un pico promedio a los 3,8 días, hecho que sugiere que durante la investigación epidemiológica de campo la búsqueda de contactos estrechos se realice desde al menos 2 días antes del inicio de síntomas del caso inicial.(AU)

ABSTRACT Objective To estimate the serial interval and the basic reproduction number of COVID-19 between imported cases during the containment phase in Pereira-Colombia, 2020. Method A quantitative study was carried out to determine the transmission dynamics for COVID-19. Field epidemiological data were used, which included 12 laboratory-confirmed cases with RT-PCR for imported SARS-CoV-2 and their corresponding confirmed secondary cases, including family and social contacts. Results The serial intervals in COVID-19 fit a Gamma distribution, with a mean of the serial interval of 3.8 days (2.7) and an R0 of 1.7 (95% CI 1.06-2.7) lower than that found in other populations with onset of the outbreak. Conclusions A serial interval lower than the incubation period such as that estimated in this study, suggests a presymptomatic transmission period that according to other investigations reaches an average peak at 3.8 days, suggesting that during the field epidemiological investigation the search for contacts Narrowing is performed from at least 2 days before the onset of symptoms of the initial case.(AU)

[Estimation of serial interval and basic reproductive number for imported cases of COVID-19]. / Estimación del intervalo serial y número reproductivo básico para los casos importados de COVID-19.

OBJECTIVE: To estimate the serial interval and the basic reproduction number of COVID-19 between imported cases during the containment phase in Pereira-Colombia, 2020. METHOD: A quantitative study was carried out to determine the transmission dynamics for COVID-19. Field epidemiological data were used, which included 12 laboratory-confirmed cases with RT-PCR for imported SARS-CoV-2 and their corresponding confirmed secondary cases, including family and social contacts. RESULTS: The serial intervals in COVID-19 fit a Gamma distribution, with a mean of the serial interval of 3.8 days (2.7) and an R0 of 1.7 (95% CI 1.06-2.7) lower than that found in other populations with onset of the outbreak. CONCLUSIONS: A serial interval lower than the incubation period such as that estimated in this study, suggests a presymptomatic transmission period that according to other investigations reaches an average peak at 3.8 days, suggesting that during the field epidemiological investigation the search for contacts Narrowing is performed from at least 2 days before the onset of symptoms of the initial case.

[COVID-19 and its socio-cultural imagery in Latin America: a tool for public health]. / COVID-19 y sus imaginarios socioculturales en Latinoamérica: una herramienta para la salud pública.

OBJECTIVE: Identify the content and organization of social representations (SR) against COVID-19 in urban population of three cities in Latin America, 2020. MATERIALS AND METHODS: Qualitative study from cognitive anthropology through the structural analysis of SR. Free listing and pair comparison techniques were used from February-April 2020, in Pereira (Colombia), Guadalajara Metropolitan Area (ZMG)-(Mexico), León (Mexico). 97 participants were included in the first phase and 71 in the second phase, of both sexes, of legal age, whose occupation and profession had no relation to the health area; non-probability-purposeful sampling was performed. RESULTS: The socio-cultural imaginary is associated with terms such as contagion, pandemic, but highlighting the terms related to disease prevention. CONCLUSIONS: The knowledge of the population about COVID-19 privileges clinical and epidemiological aspects, as well as containment and mitigation measures.

OBJETIVO: Identificar el contenido y organización de las representaciones sociales que tiene la población urbana de tres ciudades de América Latina sobre el COVID-19. MATERIALES Y MÉTODOS: Estudio cualitativo hecho desde la antropología cognitiva a través del análisis estructural de las representaciones sociales. Se utilizaron técnicas de listados libres y comparación de pares de febrero a abril de 2020 en Pereira (Colombia), en la zona metropolitana de Guadalajara (México) y en León (también en México). Participaron 97 personas de ambos sexos (97 en la primera fase y 71 en la segunda), mayores de edad y que su ocupación o profesión no tuvieran relación con el área de salud; se realizó muestreo no probabilístico-propositivo. RESULTADOS: El imaginario sociocultural está asociado con términos como contagio y pandemia, con énfasis en los términos relacionados con la prevención de la enfermedad. CONCLUSIONES: Los saberes de la población sobre el COVID-19 privilegian aspectos clínicos y epidemiológicos, así como las medidas de contención y mitigación.

Correlation between biomarkers of pain in saliva and PAINAD scale in elderly people with cognitive impairment and inability to communicate: descriptive study protocol.

INTRODUCTION: Pain is an under-diagnosed problem in elderly people, especially in those with cognitive impairment who are unable to verbalise their pain. Although the Pain assessment in advanced dementia scale (PAINAD) scale is a tool recognised for its clinical interest in this type of patients, its correlation with the saliva biomarkers reinforced its utility. The aim of this research will be to correlate the scores of this scale with the levels of biomarkers of pain found in saliva samples of patients with cognitive impairment and inability to communicate. METHODS AND ANALYSIS: This is an observational study. The level of pain will be evaluated using the PAINAD scale. Moreover, pain biomarkers, in particular secretory IgA and soluble tumour necrosis factor receptor type II, will be determined in saliva. Both assessments will be conducted in 75 patients aged over 65 years with advanced cognitive impairment and inability to communicate. The PAINAD scores will be correlated with the levels of these biomarkers of pain. A control group consisting of 75 healthy subjects aged over 65 years will be included in the study. Moreover, sociodemographic variables and variables related to pain, dementia and other clinical conditions will be recorded. The analysis will be performed with the statistical package SPSS V.22 and the software R. ETHICS AND DISSEMINATION: The study has been reviewed and approved by the Andalusian Human Research Ethics Committee. In addition, this study has been financed by the Junta de Andalucía through a regional health research fund (Research code: PI-0357-2017). The results will be actively disseminated trough a high-impact journal in our study area, conference presentations and social media.

The Effect of Toileting Position in Uroflow Curves in Young Healthy Nulliparous Women.

The objective of our study was to determine the effect of voiding positions on uroflow parameters in young, healthy nulliparous women with no pelvic floor disorders. Material and Methods. From December 2017 to February 2018, we performed a single-institution cross-sectional study with 30 healthy volunteers comparing uroflow curves in sitting and hovering positions. 49 participants were initially prescreened with a validated tool questionnaire for pelvic floor disorders and 30 participants who had absent symptoms were included for the final analysis. From the selected participants, demographics were collected and comparisons between the sitting and hovering position groups regarding the maximum flow rate (Qmax), average flow rate (Qave), voided volume (VV), and time to peak flow (TQmax) were conducted using either the paired t-test or the Wilcoxon rank sum test. In addition, linear regression analysis was performed to determine whether height, BMI, and age have significant impact on the log-transformed average of the pre- and postvalues of either Qmax, Qave, VV, or TQmax, as the average of these values are not normally distributed. Results. There were no statistical differences between the hovering and sitting position groups on the maximum flow rate (p=0.93), average flow rate (p=0.82), voided volume (p=0.53), and time to peak flow (p=0.82). BMI had borderline significant impact on Qave with p value = 0.0531. Conclusion. Different voiding toileting habits do not affect the most commonly used uroflow parameters in young healthy nulliparous patients. Results need to be corroborated by a larger scale study considering the small sample size of our study.

Prevalencia de ambliopia en población escolar, pereira-colombia, 2014

Objetivo. Determinar la prevalencia de la ambliopía en población escolar de Pereira-Colombia, 2014. Metodología. Se realizó un estudio transversal en población mayor de 5 años de básica primaria de instituciones públicas de Pereira. Se incluyeron 474 individuos de 8 instituciones; para la selección de la población se realizó una muestra compleja por conglomerados bi-etápico y estratificada. Se realizaron pruebas optométricas para el diagnóstico de ambliopía. Resultados: La prevalencia de ambliopía fue 8,1% (IC 95% 5,3-10,9) para la población escolar entre 5 y 14 años; no hubo diferencia entre mujeres y hombres. Se encontraron diferencias según la afiliación al sistema de salud (p<0,05). La prevalencia de ambliopía en población escolar de Pereira fue superior a lo reportado en diferentes partes del mundo. Se evaluaron factores de riesgo clínico como defectos refractivos, severidad de estos y fotometría, así como factores sociales, lo cual es importante para el diagnóstico, manejo y pronóstico de la ambliopía.

Objective. Establish the prevalence of amblyopia in school children from Pereira-Colombia, 2014. Methodology. A cross-sectional study in a population of 5 years of primary basic public institutions Pereira. 474 individuals were included 8 institutions for the selection of the population a complex cluster sample stratified two-stage sampling was performed. Optometric tests for the diagnosis of amblyopia were performed. Results. The prevalence of amblyopia was 8.1% (95% CI 5.3 to 10.9) for school children between 5 and 14 years, there was no difference between men and women. Differences were found according to the health system affiliation (p <0.05). The prevalence of amblyopia in Pereira school population was higher than that reported in different parts of the world. Clinical risk factors such as refractive errors, and severity of these, photometry and social factors were evaluated, which is important for diagnosis, management and prognosis of amblyopia.

Objetivo. Determinar a prevalência de ambliopia em crianças em idade escolar de Pereira, na Colômbia, 2014. Metodologia. Um estudo transversal em uma população de 5 anos de instituições públicas básicas primárias Pereira. 474 indivíduos foram incluídos oito instituições para a seleção da população foi realizado um complexo amostra estratificada por conglomerados amostragem em duas fases. Optometric testes para o diagnóstico de ambliopia é realizada. Resultados. A prevalência de ambliopia foi de 8,1% (IC 95% 5,3-10,9) para crianças entre 5 e 14 anos, não houve diferença entre homens e mulheres. Foram encontradas diferenças de acordo com a filiação sistema de saúde (p <0,05). A prevalência de ambliopia em população escolar Pereira foi maior do que a relatada em diferentes partes do mundo. Fatores de risco clínicos, tais como erros de refração, e severidade destas, forometria e fatores sociais foram avaliados, o que é importante para o diagnóstico, tratamento e prognóstico da ambliopia.

Chondroitin sulfate, hyaluronic acid and chitin/chitosan production using marine waste sources: characteristics, applications and eco-friendly processes: a review.

In the last decade, an increasing number of glycosaminoglycans (GAGs), chitin and chitosan applications have been reported. Their commercial demands have been extended to different markets, such as cosmetics, medicine, biotechnology, food and textiles. Marine wastes from fisheries and aquaculture are susceptible sources for polymers but optimized processes for their recovery and production must be developed to satisfy such necessities. In the present work, we have reviewed different alternatives reported in the literature to produce and purify chondroitin sulfate (CS), hyaluronic acid (HA) and chitin/chitosan (CH/CHs) with the aim of proposing environmentally friendly processes by combination of various microbial, chemical, enzymatic and membranes strategies and technologies.

Neoadjuvant chemotherapy modifies serum angiotensinase activities in women with breast cancer.

PURPOSE: The aim of this study was to investigate the putative changes in serum angiotensinase activities (aminopeptidase N, APN; aminopeptidase B, APB; aminopeptidase A, APA; aspartyl aminopeptidase, ASAP) involved in the renin-angiotensin system (RAS) in women with breast cancer treated or not with a neoadjuvant therapy of paclitaxel and anthracycline and in healthy women volunteers. METHODS: We fluorometrically analysed serum APN, APB, APA and ASAP activities using their corresponding aminoacyl-ß-naphthylamides as substrates in women with breast cancer treated with a neoadjuvant therapy of paclitaxel and anthracycline. RESULTS: When compared with healthy controls, women with breast cancer not treated with neoadjuvant chemotherapy, showed a decrease in angiotensinase activity, which support the putative increase of angiotensin II (Ang II) levels, indicating that the tumour process would favour the development of the disease. Also, an increase in APN and APB activities was observed, which support a role for angiotensin IV (Ang IV). In women treated with a neoadjuvant therapy, we described an increase in ASAP and APA activities, supporting the idea that this treatment increases Ang II catabolism. The resulting decrease in Ang II level could lead to an inhibition of the tumour growth. CONCLUSION: Present results show changes in serum angiotensinase activities in women with breast cancer and in women with breast cancer treated with a neoadjuvant therapy of paclitaxel and anthracycline. Therefore, considerable attention should be focused on the development of RAS blockade therapy as a new strategy for breast cancer treatment.