Early Diagnosis, Treatment and Follow-Up of Cystic Echinococcosis in Remote Rural Areas in Patagonia: Impact of Ultrasound Training of Non-Specialists

Cystic echinococcosis (CE) is an important and widespread disease that affects sheep, cattle, and humans living in areas where sheep and cattle are raised. CE is highly endemic in rural sections of Rio Negro, Argentina, where our group is based. However, it requires continuous monitoring of both populations with human disease best assessed by means of ultrasound (US) screening. This is challenging in remote rural areas due to the shortage of imaging specialists. To overcome this hurdle, we set up a two-day training program of Focused Assessment with Sonography for Echinococcosis (FASE) on CE for family medicine practitioners with no previous experience in US. After the course, they were equipped with portable US scanners and dispatched to remote rural areas in Rio Negro where they screened patients, located and staged the cysts and decided on the treatment with the help of surgeons and radiologists in local tertiary care centers

Performance of Screening Strategies for Latent Tuberculosis Infection in Patients with Inflammatory Bowel Disease: Results from the ENEIDA Registry of GETECCU

(1) Aims: Patients receiving antitumor necrosis factor (anti-TNF) therapy are at risk of developing tuberculosis (TB), usually due to the reactivation of a latent TB infection (LTBI). LTBI screening and treatment decreases the risk of TB. This study evaluated the diagnostic performance of different LTBI screening strategies in patients with inflammatory bowel disease (IBD). (2) Methods: Patients in the Spanish ENEIDA registry with IBD screened for LTBI between January 2003 and January 2018 were included. The diagnostic yield of different strategies (dual screening with tuberculin skin test [TST] and interferon-gamma-release assay [IGRA], two-step TST, and early screening performed at least 12 months before starting biological treatment) was analyzed. (3) Results: Out of 7594 screened patients, 1445 (19%; 95% CI 18-20%) had LTBI. Immunomodulator (IMM) treatment at screening decreased the probability of detecting LTBI (20% vs. 17%, p = 0.001). Regarding screening strategies, LTBI was more frequently diagnosed by dual screening than by a single screening strategy (IGRA, OR 0.60; 95% CI 0.50-0.73, p < 0.001; TST, OR 0.76; 95% CI 0.66-0.88, p < 0.001). Two-step TST increased the diagnostic yield of a single TST by 24%. More cases of LTBI were diagnosed by early screening than by routine screening before starting anti-TNF agents (21% [95% CI 20-22%] vs. 14% [95% CI 13-16%], p < 0.001). The highest diagnostic performance for LTBI (29%) was obtained by combining early and TST/IGRA dual screening strategies in patients without IMM. (4): Conclusions: Both early screening and TST/IGRA dual screening strategies significantly increased diagnostic performance for LTBI in patients with IBD, with optimal performance achieved when they are used together in the absence of IMM

Tele-entomology and tele-parasitology: A citizen science-based approach for surveillance and control of Chagas disease in Venezuela.

Chagas Disease (CD), a chronic infection caused by the Trypanosoma cruzi parasite, is a Neglected Tropical Disease endemic to Latin America. With a re-emergence in Venezuela during the past two decades, the spread of CD has proved susceptible to, and inhibitable by a digital, real-time surveillance system effectuated by Citizen Scientists in communities throughout the country. The #TraeTuChipo (#BringYourKissingBug) campaign implemented in January 2020, has served as such a strategy counting on community engagement to define the current ecological distribution of CD vectors despite the absence of a functional national surveillance program. This pilot campaign collected data through online surveys, social media platforms, and/or telephone text messages. A total of 79 triatomine bugs were reported from eighteen Venezuelan states; 67 bugs were identified as Panstrongylus geniculatus, 1 as Rhodnius pictipes, 1 as Triatoma dimidiata, and 10 as Triatoma maculata. We analyzed 8 triatomine feces samples spotted from 4 Panstrongylus geniculatus which were confirmed positive by qPCR for T. cruzi. Further molecular characterization of discrete typing units (DTUs), revealed that all samples contained TcI, the most highly diverse and broadly distributed strain of T. cruzi. Moreover, analysis of the mitochondrial 12S gene revealed Myotis keaysi, Homo sapiens, and Gallus gallus as the main triatomine feeding sources. This study highlights a novel Citizen Science approach which may help improve the surveillance systems for CD in endemic countries

Salud mental y derecho. Derechos Sociales e Intersectorialidad.

Contenido Nos volvemos a encontrar. Un poco de historia............................... 5 PRIMERA PARTE: LÍNEAS GENERALES Capítulo 1. Los derechos sociales como derechos fundamentales. Reflexiones introductorias en un libro sobre derecho a la salud (mental) Andrés Rosetti.............................................................................................. 17 Capítulo 2. Los modelos de la discapacidad y la Convención sobre los Derechos de las Personas con Discapacidad Mariana Gandolfo y Martín Passini....31 SEGUNDA PARTE: Capítulo 3 Derecho a la tierra y vivienda: una mirada crítica a las políticas públicas en la provincia de Córdoba (2001-2015) Ana Laura Elorza y Mariana Gamboa.......................................................................................55 Capítulo 4. Casa de convivencia autogestionada en Córdoba: Una experiencia de externación. Roxana Serafín, Alejandra Arizó y Mirna Ramos............. 73 TERCERA PARTE: TRABAJO Capítulo 5. La Salud Mental en el Derecho del Trabajo. Silvia Díaz ................. 87 Capítulo 6. Una experiencia de inclusión laboral en salud mental. Adriana Vitelli y Eugenia Fruttero............................................................................. 113 CUARTA PARTE: EDUCACIÓN Capítulo 7. ¿Qué significa tener “derecho a la educación”? Horacio Etchichury 123 Capítulo 8. Educación, niñez y salud mental: El Forum Infancias y la salud mental. Analía Giannone y Marta Moreno........................................ 137 QUINTA PARTE: JUSTICIA Capítulo 9. Proceso de limitación de capacidad: Rol del Ministerio Público. Eloisa del Valle Sacco...................................................................... 153 Capítulo 10. Salud Mental Forense: Superación del esquema biologicista por el enfoque psicosocial. Alfonsina Gabriela Muñiz............................... 169 Capítulo 11. Medidas de seguridad respecto de inimputables adultos por incapacidad mental: principios generales y garantías. José Daniel Cesano ........................................................................................... 179 Capítulo 12. Nadie muere porque sí: Suicidio, libertad y control. Natalia Monasterolo.................................................................................... 193 SEXTA PARTE: INTERSECTORIALIDAD Capítulo 13. Políticas intersectoriales para el abordaje integral en salud mental: La complejidad de la acción conjunta. Jacinta Burijovich................ 221 Capítulo 14. Cobertura Universal en Salud: entre los derechos y el mercado. Iván Ase ................................................................................................ 235 Capítulo 15 Derechos Sociales y Salud Mental: De la vulneración de derechos y la exclusión social a políticas públicas integrales. Solana María Yoma.259 SÉPTIMA PARTE: PRODUCCIONES y RECORRIDOS ESPECÍFICOS EN EL TERRENO DE LA SALUD MENTAL Capítulo 16. La atención en salud mental en Hospitales Generales. María Paz Caminada Rossetti, Sol Victoria del Carpio y Ana Heredia................. 275 Capítulo 17. Resolución de las situaciones de crisis y urgencia en salud mental desde el enfoque de Derechos Humanos. Soledad Buhlman, Jéssica Ferreyra y Ana Heredia.................................................................... 295 OCTAVA PARTE: INTERVENCIONES ORALES Registro auditivo: Presentación del libro Cruzar el muro: desafíos y propuestas para la externación del manicomio (Centro de Estudios Legales y Sociales- CELS) Macarena Sabin Paz y Víctor Rodríguez.. 313 Registro auditivo: El Órgano de Revisión de la Ley Nacional de Salud Mental................................................................................. 325 Datxs de los autorxs ..................................................................... 337Después de "Salud mental y derecho. Reflexiones en torno a un nuevo paradigma", sociabilizado durante el año 2016, nos volvemos a encontrar en este texto correlato literario del Seminario de Salud mental y Derechos Humanos, ese espacio de poli-formación que comenzamos a construir durante un cálido septiembre del año 2014 y que aún hoy continúa marchando. Dos año pasaron desde la primera poligrafía, suficientes para acumular experiencias e intercambios, mas para volver a asomarnos desde la escritura a una coyuntura ciertamente distinta. En la ocasión, producto de algunos cruces efectuados durante el año 2015 y de las intensas jornadas que dieron cuerpo al Seminario del año 2016, nos colocamos en clave de Derechos Económicos, Sociales y Culturales (injustamente designados como derechos de segunda y acertadamente nominados como derechos sociales), para abrir la puerta a la intersectorialidad. A lo largo de este texto, construído colectivamente a partir de diferentes posiciones epistémicas, el lector podrá reflexionar en clave de salud mental desde diversos derechos y circulaciones (trabajo, vivienda, educación, justicia, etc.) para preguntar y responder(se) al mismo tiempo de qué hablamos cuando hablamos de salud. Esperamos que la inquietud resulte lo suficientemente intolerable para voltear esta contratapa y auspiciar una zambullida en las páginas que se le anteponen (Extraído de la contratapa).Universidad Nacional de Córdob

Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Stochastic and infinite dimensional analysis

This volume presents a collection of papers covering applications from a wide range of systems with infinitely many degrees of freedom studied using techniques from stochastic and infinite dimensional analysis, e.g. Feynman path integrals, the statistical mechanics of polymer chains, complex networks, and quantum field theory. Systems of infinitely many degrees of freedom create their particular mathematical challenges which have been addressed by different mathematical theories, namely in the theories of stochastic processes, Malliavin calculus, and especially white noise analysis. These proceedings are inspired by a conference held on the occasion of Prof. Ludwig Streit’s 75th birthday and celebrate his pioneering and ongoing work in these fields

Intention to receive the monkeypox vaccine and its psychological and sociodemographic predictors: a cross-sectional survey in the general population of Peru

Abstract Objective The objective of this study was to identify predictors of intention to be vaccinated against Monkeypox (Mpox) in a sample of Peruvian citizens.  Methods A set of sociodemographic and psychological predictors were used, such as sex, sexual orientation, educational level, previous diagnosis of COVID-19, marital status, complete vaccination against COVID-19, employment status, living with vulnerable people, presence of chronic disease, area of residence, perceived usefulness of COVID-19 vaccines, fear of Mpox, conspiracy beliefs about Mpox, among others. A total of 472 Peruvian adults participated, selected by non-probabilistic snowball convenience sampling. A sociodemographic survey, the Mpox Fear Scale, was used. Conspiracy Beliefs about Mpox was assessed using three questions created specifically for this study. For inferential purposes, simple ordinal regressions ("crude models") were performed between each factor and the outcome.  Results Regarding their intention to be vaccinated against Mpox, more than 60% expressed clear approval. Being non-heterosexual, having greater emotional fear of Mpox, and perceiving some potential for this disease to become the next pandemic were related to greater intention to vaccinate. On the other hand, being older, having low perceived usefulness of COVID-19 vaccines, and having higher conspiracy beliefs about Mpox were associated with lower intention to vaccinate.  Conclusion The study provides initial information for future research seeking to better analyze Mpox vaccination intention. In addition, cross-sectional data are provided that can be used to develop public health policies that target subgroups with low prevalence of intention to vaccinate against Mpox

Internado en Psicología Organizacional 2 - PS338 - 202102

El curso Internado en Psicología Organizacional 2, de carácter práctico, está dirigido a los estudiantes del décimo segundo ciclo. Una vez concluidos los 11 semestres de estudios, el estudiante está en condiciones de demostrar las competencias del perfil profesional. El curso busca consolidar el desarrollo de las competencias generales y específicas aplicadas al campo de la Psicología Clínica. Para ello el estudiante participa de la experiencia de aplicar conocimientos a situaciones simuladas o reales en su centro de rotación. Con esta fase de aprendizaje concluye su formación universitaria poniendo en práctica sus roles pre profesionales. El espacio de internado en Psicología Organizacional 2 ofrece al estudiante de la especialidad el acompañamiento académico a través de la asesoría y supervisión de los docentes del curso quienes harán seguimiento de las diferentes actividades que desempeñará en el mundo pre profesional. Es requisito cumplir horas de prácticas distribuidas de la siguiente manera: horas de actividades en aula, trabajo individual, prácticas 1con simulación y prácticas de campo. Es importante respetar las condiciones establecidas en el reglamento de Internado y las de rotación, aceptando que son ineludibles y configuran parte de los objetivos de este curso, es por ello que, hay que cumplir a cabalidad con las funciones o tareas que le sean asignadas en este espacio pre profesional, así como con las actividades de asesoría correspondientes en la Universidad, asistiendo a todas las actividades programadas. Propósito: El curso Internado en Psicología Organizacional 2 tiene el propósito de facilitar al futuro psicólogo, experiencias de aprendizaje que le permitan demostrar el nivel de logro más alto en las diferentes competencias del perfil profesional que ha venido desarrollando a través de los años de su formación académica; se hará énfasis en las Competencias generales de Pensamiento Crítico y Ciudadanía y en las competencias específicas siguientes: Desarrollo Personal y Autoconocimiento, Fundamento Teórico-conceptual, Análisis Social y Sistémico, Diagnóstico y Diseño e Intervención y Evaluación de la especialidad de psicología organizacional, teniendo como curso requisito Internado en Psicología Organizacional 1