Desempeño de los sistemas de vigilancia de salud pública durante la pandemia de influenza A (H1N1) en las Américas: prueba de un nuevo método basado en la Ley de Benford

The A(H1N1) influenza pandemic has been a challenge for public health surveillance systems in all countries. An objective evaluation has not been conducted, as yet, of the performance of those systems during the pandemic. This paper presents an algorithm based on Benford’s Law and the mortality ratio in order to evaluate the quality of the data and the sensitivity of surveillance systems. It analyses records of confirmed cases reported to the Pan American Health Organization by its 35 member countries between epidemiological weeks 13 and 47 in 2009. Seventeen countries did not fulfil Benford’s Law, and mortality exceeded the regional average in 40% of the countries. The results suggest uneven performance by surveillance systems in the different countries, with the most frequent problem being low diagnostic coverage. Benford’s Law proved to be a useful tool for the evaluation of a public health surveillance system’s performance

Proyecto para la implementación de un complejo de canchas deportivas de césped sintético en la ciudad de Guayaquil

Soccer Land nace gracias al importante lugar que ha tomado la cultura deportiva a nivel mundial y a la aparición de las alfombras de césped sintético utilizadas para la práctica de deportes. El objetivo de la creación de este complejo es la de brindar una alternativa más a los habitantes de la ciudad de Guayaquil, que demuestran una gran aceptación hacia este tipo de lugares. Según los resultados obtenidos en la investigación de mercado, existe un mercado potencial insatisfecho que permitirá tener un crecimiento, basados en la prestación de un servicio de calidad orientado siempre a cubrir los gustos, necesidades y preferencias de los clientes potencial. De igual manera, basados en la investigación de mercados se estableció la ubicación del complejo. Este cuenta con la infraestructura, la misma que cumple con todas las normas técnicas establecidas tanto por el proveedor como por los organismos de control, y el personal necesario para un buen desempeño de las actividades; amparados y ajustados en el marco legal respectivo. Para la ejecución del proyecto será necesaria una inversión de $167.675,83, que luego de los 5 años de duración del mismo obtendrá un VAN positivo de$ 65000 y una TIR del 33%, la misma que supera la TMAR; demostrando así la rentabilidad del mismo

AICAR attenuates organ injury and inflammatory response after intestinal ischemia and reperfusion

Intestinal ischemia and reperfusion (I/R) is encountered in various clinical conditions and contributes to multiorgan failure and mortality as high as 60% to 80%. Intestinal I/R not only injures the intestine, but affects remote organs such as the lung leading to acute lung injury. The development of novel and effective therapies for intestinal I/R are critical for the improvement of patient outcome. AICAR (5-aminoimidazole-4-carboxyamide ribonucleoside) is a cell-permeable compound that has been shown to possess antiinflammatory effects. The objective is to determine that treatment with AICAR attenuates intestinal I/R injury and subsequent acute lung injury (ALI). Male Sprague Dawley rats (275 to 325 g) underwent intestinal I/R injury with blockage of the superior mesenteric artery for 90 min and subsequent reperfusion. At the initiation of reperfusion, vehicle or AICAR (30 mg/kg BW) was given intravenously (IV) for 30 min. At 4 h after reperfusion, blood and tissues were collected for further analyses. Treatment with AICAR significantly decreased the gut damage score and the water content, indicating improvement in histological integrity. The treatment also attenuated tissue injury and proinflammatory cytokines, and reduced bacterial translocation to the gut. AICAR administration after intestinal I/R maintained lung integrity, attenuated neutrophil chemotaxis and infiltration to the lungs and decreased lung levels of tumor necrosis factor (TNF)-alpha and interleukin (IL)-6. Inflammatory mediators, lung-inducible nitric oxide synthase (iNOS) and cyclooxygenase-2 (COX-2) proteins, were decreased in the lungs and lung apoptosis was significantly reduced after AICAR treatment. These data indicate that AICAR could be developed as an effective and novel therapeutic for intestinal I/R and subsequent ALI

Los dominios culturales de la malaria: una aproximación a los saberes no institucionales

Introduction: Malaria control policies have not fully achieved the expected results due to little consideration of cultural aspects, among other factors.Objective: To explore the cultural domains pertaining to this disease in an endemic Colombian population, in order to both design and implement effective action plans.Materials and methods: A convenience sampling was conducted to select inhabitants from 12 villages in Tierralta, Córdoba. In order to generate free-lists, participants were asked about their communities’ health problems, causes of malaria, control measures and those responsible for malaria control. Smith’s indexes were calculated for each item answered.Results: Between 30 and 38 individuals per village participated in the study (N=401). The mean age was 40.24 years (standard deviation (SD)=14.22) and women were 45.39% of the total. Participants recognized malaria and respiratory infections as the primary health problems in the community (median Smith’s indexes: 0.83 and 0.63, respectively). A lack of environmental interventions was identified as the main determinant of malaria (median Smith´s index: 0.65). Finally, the health care center (median Smith’s index: 0.71) and health professionals (median Smith´s index: 0.52) were identified as those most responsible for malaria control.Conclusions: The design of programs to reduce the impact of malaria requires developing interventions or initiatives that are adapted to the community’s needs, demands and available resources. Free-listing is proposed as an effective tool to collect information about cultural domains related to health.Introducción. Las políticas de control de la malaria o paludismo no han logrado todos los resultados esperados, debido, entre otras razones, a la poca consideración prestada a los aspectos culturales.Objetivo. Explorar los dominios culturales en torno a esta enfermedad en una población colombiana asentada en zona endémica, con el propósito de diseñar e implementar planes de intervención efectivos.Materiales y métodos. Mediante muestreo por conveniencia se seleccionaron residentes de 12 veredas de Tierralta, Córdoba. Con el fin de generar listados libres, se les preguntó a los participantes sobre los problemas de salud en la comunidad, las causas de la malaria, las medidas de control y los responsables de aplicarlas. Para cada uno de estos ítems se calcularon índices de Smith.Resultados. Participaron entre 30 y 38 personas por vereda (n=401), con una edad promedio de 40,24 años (desviación estándar (DE)=14,22); las mujeres representaban 45,39 % del total de la población. El grupo de participantes reconoció la malaria y las infecciones respiratorias como los problemas de salud más importantes de la comunidad (mediana de los índices de Smith: 0,83 y 0,63, respectivamente). Se reconoció la falta de intervención en las condiciones ambientales como el factor más importante generador de la malaria (mediana del índice de Smith=0,65). Por último, los participantes identificaron al centro de salud (mediana del índice de Smith=0,71) y a los profesionales de la salud (mediana del índice de Smith=0,52) como los principales responsables del control de la malaria.Conclusiones. El diseño de programas para la reducción del impacto de la malaria exige la formulación de intervenciones o iniciativas que involucren la perspectiva de las comunidades y se adapten a las necesidades, demandas y recursos disponibles. La técnica de listados libres se propone como una alternativa eficiente de recolección de información sobre los dominios culturales relacionados con la salud

Comparison of influenza type A and B with COVID-19: A global systematic review and meta-analysis on clinical, laboratory and radiographic findings

We compared clinical symptoms, laboratory findings, radiographic signs and outcomes of COVID-19 and influenza to identify unique features. Depending on the heterogeneity test, we used either random or fixed-effect models to analyse the appropriateness of the pooled results. Overall, 540 articles included in this study; 75,164 cases of COVID-19 (157 studies), 113,818 influenza type A (251 studies) and 9266 influenza type B patients (47 studies) were included. Runny nose, dyspnoea, sore throat and rhinorrhoea were less frequent symptoms in COVID-19 cases (14, 15, 11.5 and 9.5, respectively) in comparison to influenza type A (70, 45.5, 49 and 44.5, respectively) and type B (74, 33, 38 and 49, respectively). Most of the patients with COVID-19 had abnormal chest radiology (84, p < 0.001) in comparison to influenza type A (57, p < 0.001) and B (33, p < 0.001). The incubation period in COVID-19 (6.4 days estimated) was longer than influenza type A (3.4 days). Likewise, the duration of hospitalization in COVID-19 patients (14 days) was longer than influenza type A (6.5 days) and influenza type B (6.7 days). Case fatality rate of hospitalized patients in COVID-19 (6.5, p < 0.001), influenza type A (6, p < 0.001) and influenza type B was 3(p < 0.001). The results showed that COVID-19 and influenza had many differences in clinical manifestations and radiographic findings. Due to the lack of effective medication or vaccine for COVID-19, timely detection of this viral infection and distinguishing from influenza are very important. © 2020 John Wiley & Sons Ltd

Comparison of confirmed COVID-19 with SARS and MERS cases - Clinical characteristics, laboratory findings, radiographic signs and outcomes: A systematic review and meta-analysis

Introduction: Within this large-scale study, we compared clinical symptoms, laboratory findings, radiographic signs, and outcomes of COVID-19, SARS, and MERS to find unique features. Method: We searched all relevant literature published up to February 28, 2020. Depending on the heterogeneity test, we used either random or fixed-effect models to analyze the appropriateness of the pooled results. Study has been registered in the PROSPERO database (ID 176106). Result: Overall 114 articles included in this study; 52 251 COVID-19 confirmed patients (20 studies), 10 037 SARS (51 studies), and 8139 MERS patients (43 studies) were included. The most common symptom was fever; COVID-19 (85.6, P <.001), SARS (96, P <.001), and MERS (74, P <.001), respectively. Analysis showed that 84 of Covid-19 patients, 86 of SARS patients, and 74.7 of MERS patients had an abnormal chest X-ray. The mortality rate in COVID-19 (5.6, P <.001) was lower than SARS (13, P <.001) and MERS (35, P <.001) between all confirmed patients. Conclusions: At the time of submission, the mortality rate in COVID-19 confirmed cases is lower than in SARS- and MERS-infected patients. Clinical outcomes and findings would be biased by reporting only confirmed cases, and this should be considered when interpreting the data. © 2020 John Wiley & Sons, Lt

Clinical characteristics, laboratory findings, radiographic signs and outcomes of 61,742 patients with confirmed COVID-19 infection: A systematic review and meta-analysis

Introduction: In the current time where we face a COVID-19 pandemic, there is no vaccine or effective treatment at this time. Therefore, the prevention of COVID-19 and the rapid diagnosis of infected patients is crucial. Method: We searched all relevant literature published up to February 28, 2020. We used Random-effect models to analyze the appropriateness of the pooled results. Result: Eighty studies were included in the meta-analysis, including 61,742 patients with confirmed COVID-19 infection. 62.5 (95 CI 54.5�79, p 50 years old was 39.5, and in all range group was 6. Conclusions: Fever and cough are the most common symptoms of COVID-19 infection in the literature published to date. Thombocytosis, lymphopenia, and increased CRP were common lab findings although most patients included in the overall analysis did not have laboratory values reported. Among Chinese patients with COVID-19, rates of hospitalization, critical condition, and hospitalization were high in this study, but these findings may be biased by reporting only confirmed cases. © 202