Preparación y control de la enfermedad por coronavirus 2019 (COVID-19) en América Latina

Durante las últimas décadas, el mundo se ha expuesto a una serie de amenazas por brotes virales emergentes de diferente índole, los cuales, sólo al estudiarlos en detalle, surge la posibilidad de comprender su verdadero impacto, no sólo de forma inmediata, si no también, a largo plazo. Recientemente, el 12 de diciembre de 2019, la Comisión Municipal de Salud de Wuhan, en la República Popular de China, hizo público un reporte de 27 casos humanos quienes cursaron con una neumonía viral, de los cuales 7 pacientes se encontraban en condiciones críticas, la cual tenía como etiología un nuevo patógeno humano con alta capacidad zoonótica, conocido provisionalmente como Coronavirus novel 2019 (2019-nCoV), y unas semanas después como Enfermedad por Coronavirus 2019 (COVID-19) causada por el virus SARS-CoV-2

Preparation and control of the coronavirus disease 2019 (COVID-19) in Latin America

Durante las últimas décadas, el mundo se ha expuesto a una serie de amenazas por brotes virales emergentes de diferente índole, los cuales, sólo al estudiarlos en detalle, surge la posibilidad de comprender su verdadero impacto, no sólo de forma inmediata, si no también, a largo plazo

Latin America: situation and preparedness facing the multi-country human monkeypox outbreak

Fundación Universitaria Autónoma de las Américas. Faculty of Medicine. Grupo de Investigación Biomedicina. Pereira, Risaralda, Colombia / Universidad Científica del Sur. Master of Clinical Epidemiology and Biostatistics. Lima, Peru / Latin American network of Monkeypox Virus Research. Pereira, Risaralda, ColombiaUniversity of Buenos Aires. Cátedra de Enfermedades Infecciosas. Buenos Aires, Argentina.Hospital Britanico de Buenos Aires. Servicio de Infectología. Buenos Aires, Argentina.University of Buenos Aires. Cátedra de Enfermedades Infecciosas. Buenos Aires, Argentina / Hospital de Enfermedades Infecciosas F. J. Muniz. Buenos Aires, Argentina.University of Buenos Aires. Cátedra de Enfermedades Infecciosas. Buenos Aires, Argentina / Hospital de Enfermedades Infecciosas F. J. Muniz. Buenos Aires, Argentina.Hospital Clínico Viedma. Cochabamba, Bolivia.Gobierno Autonomo Municipal de Cochabamba. Secretaría de Salud. Centros de Salud de Primer Nivel. Direction. Cochabamba, Bolivia.Franz Tamayo University. National Research Coordination. La Paz, Bolivia.Paulista State University Júlio de Mesquita Filho. Botucatu Medical School. Infectious Diseases Department. São Paulo, SP, Brazil / Brazilian Society for Infectious Diseases. Sãao Paulo, SP, Brazil.Universidade de São Paulo. Faculdade de Saúde Pública. Departamento de Epidemiologia. São Paulo, SP, Brazil.Institute of Infectious Diseases Emilio Ribas. São Paulo, Brazil.Ministério da Saúde. Secretaria de Ciência, Tecnologia, Inovação e Insumos Estratégicos. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Centro de Referencia de Salud Dr. Salvador Allende Gossens. Policlínico Neurología. Unidad Procedimientos. Santiago de Chile, Chile.Pontificia Universidad Católica de Chile. School of Medicine. Department of Pediatric Infectious Diseases and Immunology. Santiago de Chile, Chile.Universidad Austral de Chile. Facultad de Medicina. Instituto de Salud Publica. Valdivia, Chile.Ministerio de Salud. Hospital de San Fernando. San Fernando, VI Region, Chile.Fundación Universitaria Autónoma de las Américas. Faculty of Medicine. Grupo de Investigación Biomedicina. Pereira, Risaralda, Colombia.Universidad Nacional de Colombia. Department of Pediatrics. Bogota, DC, Colombia / Hospital Pediatrico La Misericordia. Division of Infectious Diseases. Bogota, DC, Colombia.Hemera Unidad de Infectología IPS SAS. Bogota, Colombia.Hospital San Vicente Fundacion. Rionegro, Antioquia, Colombia.Clinica Imbanaco Grupo Quironsalud. Cali, Colombia / Universidad Santiago de Cali. Cali, Colombia / Clinica de Occidente. Cali, Colombia / Clinica Sebastian de Belalcazar. Valle del Cauca, Colombia.National Institute of Gastroenterology. Epidemiology Unit. La Habana, CubaHospital Salvador Bienvenido Gautier. Santo Domingo, Dominican Republic.Pontificia Universidad Catolica Madre y Maestra. Santiago, Dominican Republic.International University of Ecuador. School of Medicine. Quito, Ecuador.Universidad Tecnica de Ambato. Ambato, Ecuador.Hospital Roosevelt. Guatemala City, Guatemala.Universidad Nacional Autonoma de Honduras. Faculty of Medical Sciences. School of Medical. Unit of Scientific Research. Tegucigalpa, Honduras.Hospital Infantil de Mexico. Federico Gomez, Mexico City, Mexico.Hospital General de Tijuana. Departamento de Infectología. Tijuana, Mexico.Hospital General de Tijuana. Departamento de Infectología. Tijuana, Mexico.Asociacion de Microbiólogos y Químicos Clínicos de Nicaragua. Managua, Nicaragua.Hospital Santo Tomas. Medicine Department-Infectious Diseases Service. Panama City, Panama / Instituto Oncologico Nacional. Panama city, Panama.University of Arizona College of Medicine-Phoenix. Division of Endocrinology. Department of Medicine. Phoenix, AZ, USA / Indian School Rd. Phoenix, AZ, USA.Dirección Nacional de Vigilancia Sanitaria. Dirección de Investigación. Asunción, Paraguay.Universidad Nacional de Asuncion. Faculty of Medical Sciences. Division of Dermatology. Asuncion, Paraguay.Instituto Nacional de Salud del Nino San Borja. Infectious Diseases Division. Lima, Peru / Universidad Privada de Tacna. Facultad de Ciencias de la Salud. Tacna, Peru.Universidad San Juan Bautista. Lima, Peru.Universidad San Ignacio de Loyola. Vicerrectorado de Investigación. Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud. Lima, Peru.Hospital Evangelico de Montevideo. Montevideo, Uruguay.Icahn School of Medicine at Mount Sinai. Molecular and Cell-based Medicine. Department of Pathology. Molecular Microbiology Laboratory. New York, USA / Universidad del Rosario. Facultad de Ciencias Naturales. Centro de Investigaciones en Microbiología y Biotecnología-UR. Bogota, Colombia.Hospital Evangélico de Montevideo. Montevideo, Uruguay / Venezuelan Science Incubator and the Zoonosis and Emerging Pathogens Regional Collaborative Network. Infectious Diseases Research Branch. Cabudare, Lara, Venezuela.Universidad Central de Venezuela. Faculty of Medicine. Caracas, Venezuela.Universidad Central de Venezuela. Faculty of Medicine. Caracas, Venezuela / Biomedical Research and Therapeutic Vaccines Institute. Ciudad Bolivar, Venezuela.Universidad Central de Venezuela. Tropical Medicine Institute, Infectious Diseases Section. Caracas, Venezuela.Instituto Conmemorativo Gorgas de Estudios de la Salud. Clinical Research Department. Investigador SNI Senacyt Panama. Panama City, Panama

Rationale, design, and baseline characteristics in Evaluation of LIXisenatide in Acute Coronary Syndrome, a long-term cardiovascular end point trial of lixisenatide versus placebo

BACKGROUND: Cardiovascular (CV) disease is the leading cause of morbidity and mortality in patients with type 2 diabetes mellitus (T2DM). Furthermore, patients with T2DM and acute coronary syndrome (ACS) have a particularly high risk of CV events. The glucagon-like peptide 1 receptor agonist, lixisenatide, improves glycemia, but its effects on CV events have not been thoroughly evaluated. METHODS: ELIXA (www.clinicaltrials.gov no. NCT01147250) is a randomized, double-blind, placebo-controlled, parallel-group, multicenter study of lixisenatide in patients with T2DM and a recent ACS event. The primary aim is to evaluate the effects of lixisenatide on CV morbidity and mortality in a population at high CV risk. The primary efficacy end point is a composite of time to CV death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for unstable angina. Data are systematically collected for safety outcomes, including hypoglycemia, pancreatitis, and malignancy. RESULTS: Enrollment began in July 2010 and ended in August 2013; 6,068 patients from 49 countries were randomized. Of these, 69% are men and 75% are white; at baseline, the mean ± SD age was 60.3 ± 9.7 years, body mass index was 30.2 ± 5.7 kg/m(2), and duration of T2DM was 9.3 ± 8.2 years. The qualifying ACS was a myocardial infarction in 83% and unstable angina in 17%. The study will continue until the positive adjudication of the protocol-specified number of primary CV events. CONCLUSION: ELIXA will be the first trial to report the safety and efficacy of a glucagon-like peptide 1 receptor agonist in people with T2DM and high CV event risk

Evolution over Time of Ventilatory Management and Outcome of Patients with Neurologic Disease∗

OBJECTIVES: To describe the changes in ventilator management over time in patients with neurologic disease at ICU admission and to estimate factors associated with 28-day hospital mortality. DESIGN: Secondary analysis of three prospective, observational, multicenter studies. SETTING: Cohort studies conducted in 2004, 2010, and 2016. PATIENTS: Adult patients who received mechanical ventilation for more than 12 hours. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Among the 20,929 patients enrolled, we included 4,152 (20%) mechanically ventilated patients due to different neurologic diseases. Hemorrhagic stroke and brain trauma were the most common pathologies associated with the need for mechanical ventilation. Although volume-cycled ventilation remained the preferred ventilation mode, there was a significant (p < 0.001) increment in the use of pressure support ventilation. The proportion of patients receiving a protective lung ventilation strategy was increased over time: 47% in 2004, 63% in 2010, and 65% in 2016 (p < 0.001), as well as the duration of protective ventilation strategies: 406 days per 1,000 mechanical ventilation days in 2004, 523 days per 1,000 mechanical ventilation days in 2010, and 585 days per 1,000 mechanical ventilation days in 2016 (p < 0.001). There were no differences in the length of stay in the ICU, mortality in the ICU, and mortality in hospital from 2004 to 2016. Independent risk factors for 28-day mortality were age greater than 75 years, Simplified Acute Physiology Score II greater than 50, the occurrence of organ dysfunction within first 48 hours after brain injury, and specific neurologic diseases such as hemorrhagic stroke, ischemic stroke, and brain trauma. CONCLUSIONS: More lung-protective ventilatory strategies have been implemented over years in neurologic patients with no effect on pulmonary complications or on survival. We found several prognostic factors on mortality such as advanced age, the severity of the disease, organ dysfunctions, and the etiology of neurologic disease