Google Trends relacionado a la influenza

The recent paper on Using Google Trends (GT) to Estimate the Incidence of Influenza-Like Illness in Argentina 1 is very interesting. Orellano et al. studied Google Flu Trends (GFT) and GT with a conclusion regarding “the utility of GT to complement influenza surveillance”. Indeed, the usefulness of GFT and GT has been mentioned in some earlier reports 2,3. However, as a computational model, there are several things to be considered in the simulation 4. Under- or over-estimation can be expected and this is still the present problem in using the Google system for predicting influenza 4. There is a need for modifications of GT and GFT into a more specific tool that is appropriate for each context. A good example of this is the development of FluBreaks by Pervaiz et al.Fil: Wiwanitkit, Viroj. Wiwanitkit House; Tailandia. Surin Rajabhat University; Tailandia. Hainan Medical College; ChinaFil: Orellano, Pablo Wenceslao. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Surin Rajabhat University; TailandiaFil: Reynoso, Julieta Itati. Wiwanitkit House; TailandiaFil: Antman, Julián. Hainan Medical College; ChinaFil: Argibay, Osvaldo. Hainan Medical College; Chin

Short-term exposure to particulate matter (PM10 and PM2.5), nitrogen dioxide (NO2), and ozone (O3) and all-cause and cause-specific mortality: Systematic review and meta-analysis

Background: Air pollution is a leading cause of mortality and morbidity worldwide. Short-term exposure (from one hour to days) to selected air pollutants has been associated with human mortality. This systematic review was conducted to analyse the evidence on the effects of short-term exposure to particulate matter with aerodynamic diameters less or equal than 10 and 2.5 µm (PM10, PM2.5), nitrogen dioxide (NO2), and ozone (O3), on all-cause mortality, and PM10 and PM2.5 on cardiovascular, respiratory, and cerebrovascular mortality. Methods: We included studies on human populations exposed to outdoor air pollution from any source, excluding occupational exposures. Relative risks (RRs) per 10 µg/m3 increase in air pollutants concentrations were used as the effect estimates. Heterogeneity between studies was assessed using 80% prediction intervals. Risk of bias (RoB) in individual studies was analysed using a new domain-based assessment tool, developed by a working group convened by the World Health Organization and designed specifically to evaluate RoB within eligible air pollution studies included in systematic reviews. We conducted subgroup and sensitivity analyses by age, sex, continent, study design, single or multicity studies, time lag, and RoB. The certainty of evidence was assessed for each exposure-outcome combination. The protocol for this review was registered with PROSPERO (CRD42018087749). Results: We included 196 articles in quantitative analysis. All combinations of pollutants and all-cause and cause-specific mortality were positively associated in the main analysis, and in a wide range of sensitivity analyses. The only exception was NO2, but when considering a 1-hour maximum exposure. We found positive associations between pollutants and all-cause mortality for PM10 (RR: 1.0041; 95% CI: 1.0034–1.0049), PM2.5 (RR: 1.0065; 95% CI: 1.0044–1.0086), NO2 (24-hour average) (RR: 1.0072; 95% CI: 1.0059–1.0085), and O3 (RR: 1.0043; 95% CI: 1.0034–1.0052). PM10 and PM2.5 were also positively associated with cardiovascular, respiratory, and cerebrovascular mortality. We found some degree of heterogeneity between studies in three exposure-outcome combinations, and this heterogeneity could not be explained after subgroup analysis. RoB was low or moderate in the majority of articles. The certainty of evidence was judged as high in 10 out of 11 combinations, and moderate in one combination. Conclusions: This study found evidence of a positive association between short-term exposure to PM10, PM2.5, NO2, and O3 and all-cause mortality, and between PM10 and PM2.5 and cardiovascular, respiratory and cerebrovascular mortality. These results were robust through several sensitivity analyses. In general, the level of evidence was high, meaning that we can be confident in the associations found in this study.Fil: Orellano, Pablo Wenceslao. Universidad Tecnológica Nacional. Facultad Regional San Nicolás; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Reynoso, Julieta Itati. Hospital General “San Felipe"; ArgentinaFil: Quaranta, Nancy Esther. Universidad Tecnológica Nacional. Facultad Regional San Nicolás; Argentina. Provincia de Buenos Aires. Gobernación. Comisión de Investigaciones Científicas; ArgentinaFil: Bardach, Ariel Esteban. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; ArgentinaFil: Ciapponi, Agustín. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; Argentin

Nuevo método para elaborar corredores endémicos New method for determining endemic levels

OBJETIVO: Diseñar un instrumento para elaborar corredores o canales endémicos mediante cálculos sencillos y, en el caso de enfermedades transmisibles, identificar y estimar parámetros relacionados con la dinámica de la transmisión. MÉTODOS: Se obtuvieron parámetros para elaborar una curva teórica de incidencia esperada, basada en el modelo logístico de crecimiento. Los parámetros se estimaron por medio de una regresión no lineal, a partir de datos de incidencia acumulada de los cinco años anteriores. Se tomó como ejemplo la incidencia semanal acumulada de casos de enfermedad tipo influenza para Argentina en 2009 y se la comparó con la serie de casos de 2004 a 2008 para construir los canales endémicos acumulados y no acumulados. RESULTADOS: De acuerdo a los canales endémicos acumulados obtenidos, el país entró en zona de brote a partir de la semana dos. El máximo número esperado de casos o capacidad de carga (K) de acuerdo a los datos de años previos fue de 1 090 660. Considerando los corredores no acumulados, la situación de brote se presentó en 34 de las 51 semanas. Se estimó un rango para la tasa básica de reproducción (R0) de 1,05 a 1,13 para el período no epidémico 2004-2008. CONCLUSIONES: El nuevo método permitió elaborar canales endémicos de una manera sencilla, con la obtención de parámetros importantes para la transmisión. Si bien tiene limitaciones, entre ellas que la ecuación utilizada es más útil para evaluar enfermedades con un ciclo anual marcado y menos exacta para ciclos menores de un año, puede ser considerado como una alternativa valiosa para elaborar corredores endémicos y una nueva contribución al estudio de brotes epidémicos en los niveles locales de vigilancia de la salud.<br>OBJECTIVE: Design an instrument for determining endemic levels or ranges using simple calculations; identify and estimate the parameters related to the dynamic transmission of communicable diseases. METHODS: The parameters for establishing a theoretical curve of expected incidence based on the logistic growth model were identified. The parameters were estimated by nonlinear regression based on the cumulative incidence data from the previous five years. The weekly cumulative incidence of cases of influenza-like illness in Argentina in 2009 was used as an example. It was compared to the 2004-2008 case series in order to determine the cumulative and non-cumulative endemic levels. RESULTS: According to the cumulative endemic levels identified, the country entered the outbreak area in week 2. The data from previous years showed that the maximum expected number of cases or carrying capacity (K) was 1 090 660. When the non-cumulative levels were considered, the outbreak was present in 34 out of 51 weeks. A range of 1.05 to 1.13 was estimated for the basic reproductive rate (R0) in the non-epidemic period from 2004-2008. CONCLUSIONS: The new method facilitated the determination of endemic levels using a simple procedure with the identification of parameters that are important for transmission. Although it has limitations such as the fact that the equation used is more appropriate for evaluating diseases with a pronounced annual cycle and less accurate for cycles of less than 1 year, it can be considered a valuable alternative method for determining endemic ranges and a new contribution to the study of epidemic outbreaks at local health surveillance levels

Short-term exposure to sulphur dioxide (SO2) and all-cause and respiratory mortality: A systematic review and meta-analysis

Background: Many studies have assessed the harmful effects of ambient air pollution on human mortality, but the evidence needs further exploration, analysis, and refinement, given the large number of studies that have been published in recent years. The objective of this study was to evaluate all the available evidence of the effect of short-term exposure to ambient sulphur dioxide (SO2) on all-cause and respiratory mortality. Methods: Articles reporting observational epidemiological studies were included, comprising time-series and case-crossover designs. A broad search and wide inclusion criteria were considered, encompassing international and regional databases, with no geographical or language restrictions. A random effect meta-analysis was conducted, and pooled relative risk for an increment of 10 µg/m3 in SO2 concentrations were calculated for each outcome. We analysed the risk of bias (RoB) in individual studies for specific domains using a new domain-based RoB assessment tool, and the certainty of evidence across studies with an adaptation of the Grading of Recommendations Assessment, Development and Evaluation approach. The certainty of evidence was judged separately for each exposure-outcome combination. A number of subgroup and sensitivity analyses were carried out, as well as assessments of heterogeneity and potential publication bias. The protocol for this review was registered with PROSPERO (CRD42019120738). Results: Our search retrieved 1,128 articles, from which 67 were included in quantitative analysis. The RoB was low or moderate in the majority of articles and domains. An increment of 10 µg/m3 in SO2 (24-hour average) was associated with all-cause mortality (RR: 1.0059; 95% CI: 1.0046–1.0071; p-value: <0.01), and respiratory mortality (RR: 1.0067; 95% CI: 1.0025–1.0109; p-value: <0.01), while the same increment in SO2 (1-hour max.) was associated with respiratory mortality (RR:1.0052; 95% CI: 1.0013–1.0091; p-value: 0.03). Similarly, the association was positive but non-significant for SO2 (1-hour max.) and all-cause mortality (RR: 1.0016; 95% CI: 0.9930–1.0102; p-value: 0.60). These associations were still significant after the adjustment for particulate matter, but not for other pollutants, according to the results from 13 articles that evaluated co-pollutant models. In general, linear concentration–response functions with no thresholds were found for the two outcomes, although this was only evaluated in a small number of studies. We found signs of heterogeneity for SO2 (24-hour average) – respiratory mortality and SO2 (1-hour max.) – all-cause mortality, and funnel plot asymmetry for SO2 (24-hour average) – all-cause mortality. The certainty of evidence was high in two combinations, i.e. SO2 (24-hour average) – all-cause mortality and SO2 (1-hour max.) – respiratory mortality, moderate in one combination, i.e. SO2 (24-hour average) – respiratory mortality, and low in the remaining one combination. Conclusions: Positive associations were found between short-term exposure to ambient SO2 and all-cause and respiratory mortality. These associations were robust against several sensitivity analyses, and were judged to be of moderate or high certainty in three of the four exposure-outcome combinations.Fil: Orellano, Pablo Wenceslao. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Reynoso, Julieta Itati. Hospital General “San Felipe”; ArgentinaFil: Quaranta, Nancy Esther. Universidad Tecnológica Nacional. Facultad Regional San Nicolás; Argentin

Effects of air pollution on restricted activity days: systematic review and meta-analysis

Background: The adverse effects of air pollution on human health include many diseases and health conditions associated with mortality, morbidity and disability. One example of these outcomes that can be translated into economic costs is the number of days of restricted activity. The aim of this study was to assess the effect of outdoor exposure to particulate matter with an aerodynamic diameter less than or equal to 10 and 2.5 μm (PM10, PM2.5), nitrogen dioxide (NO2), and ozone (O3), on restricted activity days. Methods: Observational epidemiological studies with different study designs were included, and pooled relative risks (RR) with 95% confidence intervals (95%CI) were calculated for an increase of 10 μg/m3 of the pollutant of interest. Random-effects models were chosen because of the environmental differences between the studies. Heterogeneity was estimated using prediction intervals (PI) and I-Squared (I2) values, while risk of bias was assessed using a tool developed by the World Health Organization specifically designed for air pollution studies, and based on different domains. Subgroup and sensitivity analyses were performed where possible. The protocol for this review was registered with PROSPERO (CRD42022339607). Results: We included 18 articles in the quantitative analysis. Associations between pollutants and restricted activity days in time-series studies of short-term exposures, measured as work-loss days, school-loss days, or both were significant for PM10 (RR: 1.0191; 95%CI: 1.0058–1.0326; 80%PI: 0.9979–1.0408; I2: 71%) and PM2.5 (RR: 1.0166; 95%CI: 1.0050–1.0283; 80%PI: 0.9944–1.0397; I2: 99%), but not for NO2 or O3. Some degree of heterogeneity between studies was observed, but sensitivity analysis showed no differences in the direction of the pooled relative risks when studies with a high risk of bias were excluded. Cross-sectional studies also showed significant associations for PM2.5 and restricted activity days. We could not perform the analysis for long-term exposures because only two studies analysed this type of association. Conclusion: Restricted activity days and related outcomes were associated with some of the pollutants under evaluation, as shown in studies with different designs. In some cases, we were able to calculate pooled relative risks that can be used for quantitative modelling.Fil: Orellano, Pablo Wenceslao. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Tecnológica Nacional. Facultad Regional San Nicolás; ArgentinaFil: Reynoso, Julieta Itati. Hospital General “San Felipe”; ArgentinaFil: Quaranta, Nancy Esther. Universidad Tecnológica Nacional; Argentina. Provincia de Buenos Aires. Gobernación. Comisión de Investigaciones Científicas; Argentin

Uso de la herramienta Google Trends para estimar la incidencia de enfermedades tipo influenza en Argentina

El objetivo del presente estudio fue hallar un modelo para estimar la incidencia de enfermedades tipo influenza (ETI), a partir de los t&#233;rminos de b&#250;squeda relacionados recolectados por el Google Trends (GT). Los datos de vigilancia de ETI para los a&#241;os 2012 y 2013 se obtuvieron del Sistema Nacional de Vigilancia de la Salud de Argentina. Las b&#250;squedas de Internet se obtuvieron de la base de datos del GT, usando 6 t&#233;rminos: gripe, fiebre, tos, dolor de garganta, paracetamol e ibuprofeno. Se desarroll&#243; un modelo de regresi&#243;n de Poisson a partir de datos del a&#241;o 2012, y se valid&#243; con datos del 2013 y resultados de la herramienta Google Flu Trends (GFT). La incidencia de ETI del sistema de vigilancia present&#243; fuertes correlaciones con las estimaciones de ETI del GT (r = 0,927) y del GFT (r = 0,943). Sin embargo, el GFT sobreestim&#243; el pico de incidencia por casi el doble, mientras que el modelo basado en el GT subestim&#243; el pico de incidencia por un factor de 0,7. Estos resultados demuestran la utilidad del GT como un complemento para la vigilancia de la influenz

Effect of outdoor air pollution on asthma exacerbations in children and adults: Systematic review and multilevel meta-analysis.

BACKGROUND:Several observational studies have suggested that outdoor air pollution may induce or aggravate asthma. However, epidemiological results are inconclusive due to the presence of numerous moderators which influence this association. The goal of this study was to assess the relationship between outdoor air pollutants and moderate or severe asthma exacerbations in children and adults through a systematic review and multilevel meta-analysis. MATERIAL AND METHODS:We searched studies published in English on PubMed, Scopus, and Google Scholar between January 2000 and October 2016. Studies following a case-crossover design with records of emergency departments and/or hospital admissions as a surrogate of moderate or severe asthma exacerbations were selected. A multilevel meta-analysis was employed, taking into account the potential clustering effects within studies examining more than one lag. Odds ratios (ORs) and 95% confidence intervals were estimated. A subgroup analysis in children aged 0 to 18 years and a sensitivity analysis based on the quality of the included studies as defined in the Newcastle-Ottawa Scale were performed. Publication bias was evaluated through visual inspection of funnel plots and by a complementary search of grey literature. (Prospero Registration number CRD42015032323). RESULTS:Database searches retrieved 208 records, and finally 22 studies were selected for quantitative analysis. All pollutants except SO2 and PM10 showed a significant association with asthma exacerbations (NO2: 1.024; 95% CI: 1.005,1.043, SO2: 1.039; 95% CI: 0.988,1.094), PM10: 1.024; 95% CI: 0.995,1.053, PM2.5: 1.028; 95% CI: 1.009,1.047, CO: 1.045; 95% CI: 1.005,1.086, O3: 1.032; 95% CI: 1.005,1.060. In children, the association was significant for NO2, SO2 and PM2.5. CONCLUSION:This meta-analysis provides evidence of the association between selected air pollutants and asthma exacerbations for different lags

Degradación de un contaminante emergente, Triclocarban, mediante procesos fotosensibilizado por vitamina B2

En los últimos tiempos, ha habido un aumento en la preocupación sobre el impacto negativoque tienen los denominados contaminantes emergentes (CE) sobre los ecosistemas y la salud humana, lo que ha requerido el desarrollo de numerosos métodos de tratamiento [1,2]. Se denomina CE a todos los compuestos que no están cubiertos actualmente por las regulaciones existentes de calidad del agua, los cuales se consideran amenazas potenciales para los ecosistemas ambientales, la salud y la seguridad humana [3] . Son generalmente compuestos persistentes, no biodegradables. Dentro de las vías posibles para la degradación, la fotoquímica resulta una de las más prometedoras. En la fotólisis sensibilizada no es necesario que los CE absorba la radiación, estos son degradados a través de la acción de sustancias fotosensibilizadoras cuya propiedad es absorber luz y producir estados excitados con capacidad de iniciar una cascada de fotoprocesos en los cuales se generan especies altamente reactivas. En particular, en este trabajo se estudió el CE Triclocarban (TCC), el cual posee toxicidad a altas concentraciones, persistencia y potencial bioacumulación. Se trata de un agente antimicrobiano utilizado como antiséptico en productos de cosmética. El TCC no presenta absorción en el visible, por lo cual, se usó como fotosensibilizador el pigmento Riboflavina (Rf, vitamina (B2)), la cual está presente naturalmente en sistemas biológicos y en aguas naturales. La absorción de luz por parte de Rf puede generar una cascada de procesos oxidativos degradativos, donde los estados electrónicamente excitados de la Rf pueden reaccionar con un sustrato electrodonante (TCC) o bien generar especies reactivas de oxígeno (ROS), las cuales actuarían como oxidantes del sustrato en estudio. La evaluación de los espectros de absorción UV-VIS de la fotólisis sensibilizada de una solución de Rf + TCC (50% MeOH/H2O v/v) mostraron cambios atribuibles no solo a la degradación de TCC sino también a la Rf. Estos cambios espectrales se evaluaron en presencia como en ausencia de oxígeno observándose cambios en condiciones anóxicas, los cuales podrían estar indicando que existe una interacción química entre el TCC y los estados excitados del sensibilizador. Por tal motivo se realizaron determinaciones por láser flash fotólisis para obtener la constante de interacción bimolecular, como así también las especies transitorias intervinientes. Los resultados obtenidos demostraron que TCC es altamente reactivo frente al triplete excitado de Rf (3Rf*), con una constante de velocidad 3kq= 5,4x108 M1s-1. Para dilucidar las ROS que intervienen en la degradación del TCC se realizaron experiencias de consumo de oxígeno. A partir de estos resultados es que se puede concluir que la posible degradación del TCC es principalmente a través del estado excitado triplete del sensibilizador, y esto podría estar ocurriendo en el los medioambientes acuáticos como a nivel cuáteo por la Rf presente en la piel.Fil: Reynoso, Agustina. Universidad Nacional de Río Cuarto. Instituto para el Desarrollo Agroindustrial y de la Salud. - Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto para el Desarrollo Agroindustrial y de la Salud; ArgentinaFil: Sacchetto, Julieta Lorena. Universidad Nacional de Río Cuarto. Instituto para el Desarrollo Agroindustrial y de la Salud. - Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto para el Desarrollo Agroindustrial y de la Salud; ArgentinaFil: Natera, Jose Eduardo. Universidad Nacional de Río Cuarto. Instituto para el Desarrollo Agroindustrial y de la Salud. - Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto para el Desarrollo Agroindustrial y de la Salud; ArgentinaFil: Massad, Walter Alfredo. Universidad Nacional de Río Cuarto. Instituto para el Desarrollo Agroindustrial y de la Salud. - Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto para el Desarrollo Agroindustrial y de la Salud; ArgentinaV Reunión Grupo Argentino de FotobiologíaLa PlataArgentinaGrupo Argentino de Fotobiologí