Condición pos-neoliberal en países emergentes de América Latina: el caso de Bolivia

Trabajo en el que se analizan los diferentes modelos de desarrollo por los que ha cursado América Latina a través de su historia. Se exploran las fases de desarrollo y proceso de industrialización de la región y se analiza el tránsito del modelo proteccionista al modelo de economía abierta y de libre mercado (modelo neoliberal). Se estudia particularmente el caso de Bolivia, al ser una nación en donde se dan en forma particular los procesos de desarrollo que se gestaron históricamente en América Latina. En este sentido, se repasan puntos importantes como la lucha por la democracia en Bolivia, desde las dictaduras militares hasta los primeros pasos hacia la democracia, y la instauración y crisis del modelo neoliberal durante el periodo democrático. Se finaliza con un análisis de la lucha del país por lograr una condición pos-neoliberal encaminada a buscar una salida socialista para su pueblo como solución a sus problemas

A mobile app to issue warning for food and nutrition security

Este documento presenta la aplicación móvil EVANI, como herramienta informática de apoyo a las comunidades, que les permita en sus territorios la identificación de casos de desnutrición en niños y niñas menores de 60 meses de edad, así como el reporte de las coordenadas del caso y la generación de alertas ante el riesgo de mortalidad derivada de esta causa. Una vez desarrollada la aplicación, se realizó un piloto para validar el funcionamiento de la app y tratar de identificar el posible impacto, obteniendo como resultado, su utilidad en casos de alerta temprana. Lo anterior permitió identificar la viabilidad de EVANI como una herramienta de notificación de alertas nutricionales, las cuales se constituyen en un elemento necesario dentro de los sistemas de alertas tempranas en Seguridad Alimentaria y Nutricional del país, que permita a los diferentes sectores de Gobierno brindar de manera oportuna la atención necesaria para evitar la mortalidad por desnutrición.This document presents the mobile application EVANI, as a solution to support communities, which allows them in their territories, the identification of cases of malnutrition in children under 60 months of age, as well as the report of the coordinates of the case and the generation of alerts against the risk of mortality derived from this cause. Once the application was developed, a pilot was conducted to validate the operation of the app and try to identify the possible impact, obtaining as a result, its usefulness in cases of early warning. This allowed us to identify the viability of EVANI as a nutritional alert notification tool, which is a necessary element within the early warning systems of food and nutritional security in the country, which allows the different sectors of government to provide in a timely manner, the necessary care to avoid mortality due to malnutrition

Effect of an Albumin Infusion Treatment Protocol on Delayed Cerebral Ischemia and Relevant Outcomes in Patients with Subarachnoid Hemorrhage

Un protocolo de manejo institucional para pacientes con hemorragia subaracnoidea (HSA) basado en la evaluación cardíaca inicial, la permisividad de los balances negativos de líquidos y el uso de una infusión continua de albúmina como fluidoterapia principal durante los primeros 5 días de estancia en la unidad de cuidados intensivos (UCI). se implementó en nuestro hospital en 2014. Tenía como objetivo lograr y mantener la euvolemia y la estabilidad hemodinámica para prevenir eventos isquémicos y complicaciones en la UCI reduciendo los períodos de hipovolemia o inestabilidad hemodinámica. Este estudio tuvo como objetivo evaluar el efecto del protocolo de manejo implementado sobre la incidencia de isquemia cerebral retardada (ICD), la mortalidad y otros resultados relevantes en pacientes con HSA durante la estancia en la UCI.Q1Background An institutional management protocol for patients with subarachnoid hemorrhage (SAH) based on initial cardiac assessment, permissiveness of negative fluid balances, and use of a continuous albumin infusion as the main fluid therapy for the first 5 days of the intensive care unit (ICU) stay was implemented at our hospital in 2014. It aimed at achieving and maintaining euvolemia and hemodynamic stability to prevent ischemic events and complications in the ICU by reducing periods of hypovolemia or hemodynamic instability. This study aimed at assessing the effect of the implemented management protocol on the incidence of delayed cerebral ischemia (DCI), mortality, and other relevant outcomes in patients with SAH during ICU stay. Methods We conducted a quasi-experimental study with historical controls based on electronic medical records of adults with SAH admitted to the ICU at a tertiary care university hospital in Cali, Colombia. The patients treated between 2011 and 2014 were the control group, and those treated between 2014 and 2018 were the intervention group. We collected baseline clinical characteristics, cointerventions, occurrence of DCI, vital status after 6 months, neurological status after 6 months, hydroelectrolytic imbalances, and other SAH complication. Multivariable and sensitivity analyses that controlled for confounding and considered the presence of competing risks were used to adequately estimate the effects of the management protocol. The study was approved by our institutional ethics review board before study start. Results One hundred eighty-nine patients were included for analysis. The management protocol was associated with a reduced incidence of DCI (hazard ratio 0.52 [95% confidence interval 0.33–0.83] from multivariable subdistribution hazards model) and hyponatremia (relative risk 0.55 [95% confidence interval 0.37–0.80]). The management protocol was not associated with higher hospital or long-term mortality, nor with a higher occurrence of other unfavorable outcomes (pulmonary edema, rebleeding, hydrocephalus, hypernatremia, pneumonia). The intervention group also had lower daily and cumulative administered fluids compared with historic controls (p < 0.0001). Conclusions A management protocol based on hemodynamically oriented fluid therapy in combination with a continuous albumin infusion as the main fluid during the first 5 days of the ICU stay appears beneficial for patients with SAH because it was associated with reduced incidence of DCI and hyponatremia. Proposed mechanisms include improved hemodynamic stability that allows euvolemia and reduces the risk of ischemia, among others.Revista Internacional - IndexadaS

Allelic Diversity at Abiotic Stress Responsive Genes in Relationship to Ecological Drought Indices for Cultivated Tepary Bean, Phaseolus acutifolius A. Gray, and Its Wild Relatives

Some of the major impacts of climate change are expected in regions where drought stress is already an issue. Grain legumes are generally drought susceptible. However, tepary bean and its wild relatives within Phaseolus acutifolius or P. parvifolius are from arid areas between Mexico and the United States. Therefore, we hypothesize that these bean accessions have diversity signals indicative of adaptation to drought at key candidate genes such as: Asr2, Dreb2B, and ERECTA. By sequencing alleles of these genes and comparing to estimates of drought tolerance indices from climate data for the collection site of geo-referenced, tepary bean accessions, we determined the genotype x environmental association (GEA) of each gene. Diversity analysis found that cultivated and wild P. acutifolius were intermingled with var. tenuifolius and P. parvifolius, signifying that allele diversity was ample in the wild and cultivated clade over a broad sense (sensu lato) evaluation. Genes Dreb2B and ERECTA harbored signatures of directional selection, represented by six SNPs correlated with the environmental drought indices. This suggests that wild tepary bean is a reservoir of novel alleles at genes for drought tolerance, as expected for a species that originated in arid environments. Our study corroborated that candidate gene approach was effective for marker validation across a broad genetic base of wild tepary accessions

Infectious Diseases, Social, Economic and Political Crises, Anthropogenic Disasters and Beyond: Venezuela 2019 – Implications for Public Health and Travel Medicine

During last months, there have been a significant increase in the evidences showing the catastrophic health situation in Venezuela. There are multiple epidemics, increase in emerging and reemerging infectious, tropical and parasitic diseases as consequences of the social, economic and political crises, which would be considered today a clearly anthropogenic disaster. Venezuela is facing in 2019, the worse sanitary conditions, with multiple implications for public health and travel medicine. So far, from a global perspective, this situation will be an impediment for the achievement of the sustainable development goals (SDG) in 2030. In this multiauthor review, there is a comprehensive analysis of the situation for infectious diseases, non-communicable diseases, their impact in the Americas region, given the migration crisis as well as the comparative status of the SDG 2030. This discussion can provide input for prioritizing emerging health problems and establish a future agenda

Infectious Diseases, Social, Economic and Political Crises, Anthropogenic Disasters and Beyond: Venezuela 2019 – Implications for Public Health and Travel Medicine

During last months, there have been a significant increase in the evidences showing the catastrophic health situation in Venezuela. There are multiple epidemics, increase in emerging and reemerging infectious, tropical and parasitic diseases as consequences of the social, economic and political crises, which would be considered today a clearly anthropogenic disaster. Venezuela is facing in 2019, the worse sanitary conditions, with multiple implications for public health and travel medicine. So far, from a global perspective, this situation will be an impediment for the achievement of the sustainable development goals (SDG) in 2030. In this multiauthor review, there is a comprehensive analysis of the situation for infectious diseases, non-communicable diseases, their impact in the Americas region, given the migration crisis as well as the comparative status of the SDG 2030. This discussion can provide input for prioritizing emerging health problems and establish a future agenda

Hidden Sylvatic Foci of the Main Vector of Chagas Disease Triatoma infestans: Threats to the Vector Elimination Campaign?

Triatoma infestans, a highly domesticated species and historically the main vector of Trypanosoma cruzi, is the target of an insecticide-based elimination program in the southern cone countries of South America since 1991. Only limited success has been achieved in the Gran Chaco region due to repeated reinfestations. We conducted full-coverage spraying of pyrethroid insecticides of all houses in a well-defined rural area in northwestern Argentina, followed by intense monitoring of house reinfestation and searches for triatomine bugs in sylvatic habitats during the next two years, to establish the putative sources of new bug colonies. We found low-density sylvatic foci of T. infestans in trees located within the species' flight range from the nearest infested house detected before control interventions. Using multiple methods (fine-resolution satellite imagery, geographic information systems, spatial statistics, genetic markers and wing geometric morphometry), we corroborated the species identity of the sylvatic bugs as T. infestans and found they were indistinguishable from or closely related to local domestic or peridomestic bug populations. Two sylvatic foci were spatially associated to the nearest peridomestic bug populations found before interventions. Sylvatic habitats harbor hidden foci of T. infestans that may represent a threat to vector suppression attempts