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

Evaluación dosimétrica del tratamiento de cráneo total con protección al hipocampo

El Radiation Therapy Oncology Group (RTOG) en su reporte 0933 propone proteger el hipocampo para prevenir la disminución de las funciones neurocognitivas asociada a la radioterapia de cráneo total, estableciendo la tolerancia en el hipocampo en 16 Gy. Verificar la precisión en el tratamiento de cráneo total con protección al hipocampo (WBRT-HA) desempeña un papel fundamental para asegurar la entrega de la dosis en el cerebro y la protección al hipocampo

Cálculo de la incertidumbre en la medida de dosis absorbida basado en el TRS 398

La determinación de la dosis absorbida en agua a la profundidad de referencia, para un haz de calidad Q, según el TRS 398

A vector-valued ground motion intensity measure incorporating normalized spectral area

A vector-valued intensity measure is presented, which incorporates a relative measure represented by the normalized spectral area. The proposed intensity measure is intended to have high correlation with specific relative engineering demand parameters, which collectively can provide information regarding the damage state and collapse potential of the structure. Extensive dynamic analyses are carried out on a single-degree-of-freedom system with a modified Clough–Johnston hysteresis model, using a dataset of 40 ground motions, in order to investigate the proposed intensity measure characteristics. Response is expressed using the displacement ductility, and the normalized hysteretic energy, both of which are relative engineering demand parameters. Through regression analysis the correlation between the proposed intensity measure and the engineering demand parameters is evaluated. Its domain of applicability is investigated through parametric analysis, by varying the period and the strain-hardening stiffness. Desirable characteristics such as efficiency, sufficiency, and statistical independence are examined. The proposed intensity measure is contrasted to another one, with respect to its correlation to the engineering demand parameters. An approximate procedure for estimating the optimum normalized spectral area is also presented. It is demonstrated that the proposed intensity measure can be used in intensity-based assessments, and, with proper selection of ground motions, in scenario-based assessments

Experiencias interdisciplinarias en alimentación y daños a la salud en las fronteras sur y norte de México

Los problemas de salud y alimentación en diferentes contextos como las fronteras sur y norte de México exige de trabajo interdisciplinar, con lenguajes y bases comunes para los grupos académicos. El objetivo de esta ponencia es reflexionar sobre la experiencia del grupo Seminario de “Alimentación y Daños a la Salud” (ADAS), el cual busca consolidar una propuesta de colaboración interinstitucional para el abordaje interdisciplinario de los problemas de salud relacionados con la alimentación y vulnerabilidad social en la frontera sur y norte de México.Facultad de Humanidades y Ciencias de la Educació

Grade V small bowel injury after blunt abdominal trauma: a case report

Injury of the small intestine or mesentery that requires surgical intervention is relatively uncommon, presenting less than 1% of all trauma. Unstable hemodynamically patients with peritoneal irritation signs and stable hemodynamically patients with radiological signs of intestine or mesentery lesions need an exploratory laparotomy. A 33-year-old male patient, suffered a car accident in which he had a frontal impact collision and was between two structures for 30 minutes, and rescued by the fire department. Physical examination of the abdomen presents generalized pain on palpation of moderate intensity and rebound sign. An exploratory laparotomy was performed, the findings were: hemoperitoneum of 1500 ml was found, lesion in the bucket loop of 1.2 meters, 1.8 meters from the Treitz angle and 70 cm from the ileocecal valve. We managed with drainage, vascular control, resection of the devascularized intestinal loop and small bowel shotgun stoma were. The patient was transferred to the intensive care unit for hemodynamic management and a second look was performed 5 days after surgery where cavity lavage, stoma dismantling and end-to-end anastomosis of the small intestine in two planes were performed. On post-operative day 7 drains were removed, and the patient was discharged from the surgical service due to improvement, without complications. We recommend a multidisciplinary approach to patients with polytrauma, since they lead to a better and faster recovery, in the same way it allows us to detect and treat any abnormality that impacts the quality of life of patients early

Insecticide-Treated House Screens to Reduce Infestations of Dengue Vectors

The public health importance of the endophilic mosquito Aedes aegypti increased dramatically in the recent decade, because it is the vector of dengue, chikungunya, Zika and yellow fever. The use of long-lasting insecticidal nets (LLINs) fixed on doors and windows, as insecticide-treated screening (ITS), is one innovative approach recently evaluated for Aedes control in South Mexico. From 2009 to 2014, cluster-randomised controlled trials were conducted in Acapulco and Merida. Intervention clusters received Aedes-proof houses (‘Casas a prueba de Aedes’) with ITS and were followed up during 2 years. Overall, results showed significant and sustained reductions on indoor adult vector densities in the treated clusters with ITS after 2 years: ca. 50% on the presence (OR ≤ 0.62, P < 0.05) and abundance (IRR ≤ 0.58, P < 0.05). ITS on doors and windows are ‘user-friendly’ tool, with high levels of acceptance, requiring little additional work or behavioural change by householders. Factors that favoured these interventions were (a) house construction, (b) high coverage achieved due to the excellent acceptance by the community and (c) collaboration of the vector control services; and only some operational complaints relating to screen fragility and the installation process. ITS is a housing improvement that should be part of the current paradigms for urban vector-borne disease control