Mandatory immediate notification diseases

La vigilancia epidemiológica es el sostén del proceso de prevención y control de enfermedades desde el punto de vista de salud pública, ya que aporta información para la toma de decisiones. En Colombia existen un listado de enfermedades, la mayoría infectocontagiosas, que deben ser reportadas por el médico a la autoridad sanitaria de su jurisdicción inmediatamente hace el diagnóstico o se plantea la sospecha diagnóstica.Epidemiological surveillance is the support of the disease prevention and control process from the public health point of view, since it provides information for decision-making. In Colombia there is a list of diseases, the majority of which are infectious, which must be reported by the doctor to the health authority of their jurisdiction immediately when the diagnosis is made or the diagnosis is suspected

Incidencia de infección nosocomial, ESE Hospital Universitario Ramón González Valencia, 1995-2000

ResumenAntecedentes: La infección nosocomial (IN) es un evento adverso que afecta negativamente la evolución del paciente hospitalizado. Las estrategias de prevención y control se fundamentan en el conocimiento de la epidemiológia de las infecciónes adquiridas a nivel institucional.[MedUNAB 2002; 5(13):5-13].Palabras clave: Infección nosocomial, neumonía nosocomial, infección de sitio quirúrgico, flebitis, vigilancia epidemiológica

Prognostic Factors in Patients with Rocky Mountain Spotted Fever

Background: Rocky Mountain Spotted Fever (RMSF) is a disease with a high mortality rate, caused by Rickettsia rickettsii, a bacteria transmitted to humans by infected ticks. In 2008 there was a Rocky Mountain Spotted Fever (RMSF) outbreak in the city of Mexicali, México, resulting in an increased mortality rate amongst the area population. Methods: Case-series study of patients admitted to the General Hospital of Mexicali between 2014 and 2019 with a confirmed diagnosis of RMSF. Mortality was compared dividing the population on those ?20 and younger than ?21 years of age. Results: A total of 129 patients’ records during a 5-year period whose diagnosis was RMSF confirmed with PCR were included. Mortality was compared among patients admitted who were younger than ?20 years of age with that among patients who were older than ?20 years of age (61 versus 68 respectively), the latter being higher with an OR 4.2 (p<0.0001). Conclusion: RMSF in hospitalized patients has a high mortality rate in spite of early treatment in all age groups, without showing any predominance in gender. However, patients older than 20 years of age had a higher mortality rate than those younger than 20 years, without any predominance in gender

Microsatellite Genotyping of Plasmodium vivax Isolates from Pregnant Women in Four Malaria Endemic Countries

Plasmodium vivax is the most widely distributed human parasite and the main cause of human malaria outside the African continent. However, the knowledge about the genetic variability of P. vivax is limited when compared to the information available for P. falciparum. We present the results of a study aimed at characterizing the genetic structure of P. vivax populations obtained from pregnant women from different malaria endemic settings. Between June 2008 and October 2011 nearly 2000 pregnant women were recruited during routine antenatal care at each site and followed up until delivery. A capillary blood sample from the study participants was collected for genotyping at different time points. Seven P. vivax microsatellite markers were used for genotypic characterization on a total of 229 P. vivax isolates obtained from Brazil, Colombia, India and Papua New Guinea. In each population, the number of alleles per locus, the expected heterozygosity and the levels of multilocus linkage disequilibrium were assessed. The extent of genetic differentiation among populations was also estimated. Six microsatellite loci on 137 P. falciparum isolates from three countries were screened for comparison. The mean value of expected heterozygosity per country ranged from 0.839 to 0.874 for P. vivax and from 0.578 to 0.758 for P. falciparum. P. vivax populations were more diverse than those of P. falciparum. In some of the studied countries, the diversity of P. vivax population was very high compared to the respective level of endemicity. The level of inter-population differentiation was moderate to high in all P. vivax and P. falciparum populations studied

Building and surroundings: thermal coupling

Energy building performance can be different according to outdoor conditions or urban environment, at the same time that this last assess, buildings are also affected by the building envelope, as obvious consequence of the thermal and Aeraulic coupling existing between the indoor and outdoor conditions in buildings. Thus, in this coupling is fundamental to typify the transmission phenomenon through the building envelope. Doing this, it is possible to estimate transmission heating losses and gains and also the superficial temperatures of the envelope. In order to assess the transient behaviour of the building envelope it is necessary to develop a predictive model, precise enough, to be integrated in a simulating tool. Detailed and multidimensional models, based in numerical methods, like Finite Element Method (FEM), has a high precision, but its complexity imply resources consumption and computational time, too high to be integrated in these kind of tools. On the contrary, simplified methods are good enough because they are simple and fast, with an acceptable precision in almost all the situations. The present work is focused: (a) Firstly, to develop a simplified RC-network model. The aim of the model is to characterize and to implement with precision the behaviour of a wall in a simulating software tool based on urban environment, (b) secondly, to express in form of equivalences, the different indoor and outdoor excitations that can exist in the building envelope, and (c) finally, to calibrate the simplified model through its characteristic parameters. For a homogeneous wall and two types of excitations, it has been obtained the characteristic parameters of the model that represent the better adjustment to the real wall. In a first step, it has been obtained the results of the proposal model and a reference model based on FEM, in terms of wall external surface heat flow. Results of both models have been compared, and the resultant characteristic parameters of the model have been obtained through an optimisation method. Results for the wall and for the excitations under analysis show: (1) Characteristic longitude ec, or capacitive node position, it is determined according to a certain value of Fo equal to 2 for both excitations, this value remains constant in time, (2) useful wall thickness, on the contrary, vary as time function, according to a logarithmic law for both excitations, although this function is different depending on the considered excitation, (3) using a constant excitation, coefficients from the previous logarithmic function depends on the range of the excitation, while these are practically independent of the lineal excitation gradient

Naturally Acquired Binding-Inhibitory Antibodies to Plasmodium vivax Duffy Binding Protein in Pregnant Women Are Associated with Higher Birth Weight in a Multicenter Study

A vaccine to eliminate malaria would need a multi-stage and multi-species composition to achieve robust protection, but the lack of knowledge about antigen targets and mechanisms of protection precludes the development of fully efficacious malaria vaccines, especially for Plasmodium vivax (Pv). Pregnant women constitute a risk population who would greatly benefit from a vaccine preventing the adverse events of Plasmodium infection during gestation. We hypothesized that functional immune responses against putative targets of naturally acquired immunity to malaria and vaccine candidates will be associated with protection against malaria infection and/or poor outcomes during pregnancy. We measured (i) IgG responses to a large panel of Pv and Plasmodium falciparum (Pf) antigens, (ii) the capacity of anti-Pv ligand Duffy binding protein (PvDBP) antibodies to inhibit binding to Duffy antigen, and (iii) cellular immune responses to two Pv antigens, in a subset of 1,056 pregnant women from Brazil, Colombia, Guatemala, India, and Papua New Guinea (PNG). There were significant intraspecies and interspecies correlations for most antibody responses (e.g., PfMSP119 versus PfAMA1, Spearman's rho = 0.81). Women from PNG and Colombia had the highest levels of IgG overall. Submicroscopic infections seemed sufficient to boost antibody responses in Guatemala but not antigen-specific cellular responses in PNG. Brazil had the highest percentage of Duffy binding inhibition (p-values versus Colombia: 0.040; Guatemala: 0.047; India: 0.003, and PNG: 0.153) despite having low anti-PvDBP IgG levels. Almost all antibodies had a positive association with present infection, and coinfection with the other species increased this association. Anti-PvDBP, anti-PfMSP1, and anti-PfAMA1 IgG levels at recruitment were positively associated with infection at delivery (p-values: 0.010, 0.003, and 0.023, respectively), suggesting that they are markers of malaria exposure. Peripheral blood mononuclear cells from Pv-infected women presented fewer CD8+IFN-gamma+ T cells and secreted more G-CSF and IL-4 independently of the stimulus used in vitro. Functional anti-PvDBP levels at recruitment had a positive association with birth weight (difference per doubling antibody levels: 45 g, p-value: 0.046). Thus, naturally acquired binding-inhibitory antibodies to PvDBP might confer protection against poor outcomes of Pv malaria in pregnancy

H3K4me1 marks DNA regions hypomethylated during aging in human stem and differentiated cells

In differentiated cells, aging is associated with hypermethylation of DNA regions enriched in repressive histone post-translational modifications. However, the chromatin marks associated with changes in DNA methylation in adult stem cells during lifetime are still largely unknown. Here, DNA methylation profiling of mesenchymal stem cells (MSCs) obtained from individuals aged 2 to 92 yr identified 18,735 hypermethylated and 45,407 hypomethylated CpG sites associated with aging. As in differentiated cells, hypermethylated sequences were enriched in chromatin repressive marks. Most importantly, hypomethylated CpG sites were strongly enriched in the active chromatin mark H3K4me1 in stem and differentiated cells, suggesting this is a cell type-independent chromatin signature of DNA hypomethylation during aging. Analysis of scedasticity showed that interindividual variability of DNA methylation increased during aging in MSCs and differentiated cells, providing a new avenue for the identification of DNA methylation changes over time. DNA methylation profiling of genetically identical individuals showed that both the tendency of DNA methylation changes and scedasticity depended on nongenetic as well as genetic factors. Our results indicate that the dynamics of DNA methylation during aging depend on a complex mixture of factors that include the DNA sequence, cell type, and chromatin context involved and that, depending on the locus, the changes can be modulated by genetic and/or external factors

Modifiable risk factors associated with prediabetes in men and women: A cross-sectional analysis of the cohort study in primary health care on the evolution of patients with prediabetes

Background: Prediabetes is a high-risk state for diabetes development, but little is known about the factors associated with this state. The aim of the study was to identify modifiable risk factors associated with the presence of prediabetes in men and women. Methods: Cohort Study in Primary Health Care on the Evolution of Patients with Prediabetes (PREDAPS-Study) is a prospective study on a cohort of 1184 subjects with prediabetes and another cohort of 838 subjects without glucose metabolism disorders. It is being conducted by 125 general practitioners in Spain. Data for this analysis were collected during the baseline stage in 2012. The modifiable risk factors included were: smoking habit, alcohol consumption, low physical activity, inadequate diet, hypertension, dyslipidemia, and obesity. To assess independent association between each factor and prediabetes, odds ratios (ORs) were estimated using logistic regression models. Results: Abdominal obesity, low plasma levels of high-density lipoprotein cholesterol (HDL-cholesterol), and hypertension were independently associated with the presence of prediabetes in both men and women. After adjusting for all factors, the respective ORs (95% Confidence Intervals) were 1.98 (1.41-2.79), 1.88 (1.23-2.88) and 1.86 (1.39-2.51) for men, and 1.89 (1.36-2.62), 1.58 (1.12-2.23) and 1.44 (1.07-1.92) for women. Also, general obesity was a risk factor in both sexes but did not reach statistical significance among men, after adjusting for all factors. Risky alcohol consumption was a risk factor for prediabetes in men, OR 1.49 (1.00-2.24). Conclusions: Obesity, low HDL-cholesterol levels, and hypertension were modifiable risk factors independently related to the presence of prediabetes in both sexes. The magnitudes of the associations were stronger for men than women. Abdominal obesity in both men and women displayed the strongest association with prediabetes. The findings suggest that there are some differences between men and women, which should be taken into account when implementing specific recommendations to prevent or delay the onset of diabetes in adult population