Caracterización diagnóstica del tromboembolismo pulmonar en pacientes atendidos en el servicio de medicina interna del Hospital Escuela Antonio Lenin Fonseca Managua Enero 2010 a Diciembre 2016

La mortalidad del tromboembolismo pulmonar disminuye de manera considerable cuando este es diagnosticado precozmente. La sospecha diagnostica basada en los datos clínicos y complementarios es fundamental en el diagnostico precoz, para disminuir la mortalidad. Se realizó un estudio de tipo descriptivo, retrospectivo de corte transversal El estudio se realizó en el servicio de medicina interna del hospital Antonio Lenin Fonseca, hospital de referencia nacional la población a estudio fueron todos los pacientes adulto que se atendieron en dicho servicio que hayan presentado Enfermedad Tromboembolica Pulmonar, que según registro estadístico durante el periodo de Enero 2010 a Diciembre 2016 lo había presentado 32 pacientes. La muestra fue por conveniencia. De los 32 pacientes con TEP estudiados se identificó que el 71.9% tenían edades de 51 a 75 años de edad, El 59.4% de los TEP ocurrió más en mujeres y se observa que casi el total 96.9% procedían de Managua. El antecedente que más fue evidente en estos pacientes con TEP 40.6% fue HTA + DM tipo 2, seguido de 15.6% de HTA + Dm tipo 2 + Cardiopatía, Un poco más del 90.0% de los pacientes se sospechó la probabilidad del padecimiento de TEP. La manifestaciones clínicas más evidente fueron; 78.1% tenían más de 100 latidos por minuto (taquicardia), el 59.4% el antecedentes de TVP o TEP previa al evento actual y dolor unilateral de extremidades inferiores, Fue posible identificar alteraciones en 68.7% de los pacientes con el uso de Ecocardiograma y el mismo porcentaje para test de Wells y 40.6% la probabilidad era alta para el test de Ginebra, Con la Radiografía de Tórax se identificó que 28.1% tenían derrame pleural y ese mismo porcentaje se correlacionaba con la alta probabilidad de TEP según el test de Wells, El hallazgo más significativo con el Ecocardiograma fue el aumento del tamaño del ventrículo derecho en 50.0% de los pacientes con TEP

On the Reachability of a Feedback Controlled Leontief-Type Singular Model Involving Scheduled Production, Recycling and Non-Renewable Resources

This paper proposes and studies the reachability of a singular regular dynamic discrete Leontief-type economic model which includes production industries, recycling industries, and non-renewable products in an integrated way. The designed prefixed final state to be reached, under discussed reachability conditions, is subject to necessary additional positivity-type constraints which depend on the initial conditions and the final time for the solution to match such a final prescribed state. It is assumed that the model may be driven by both the demand and an additional correcting control in order to achieve the final targeted state in finite time. Formal sufficiency-type conditions are established for the proposed singular Leontief model to be reachable under positive feedback, correcting controls designed for appropriate demand/supply regulation. Basically, the proposed regulation scheme allows fixing a prescribed final state of economic goods stock in finite time if the model is reachable.RTI2018-094336-B-100 (MCIU/AEI/FEDER, UE) and Basque Government Grant IT1207-19

On the Properties of a Class of Impulsive Competition Beverton–Holt Equations

This paper is devoted to a type of combined impulsive discrete Beverton–Holt equations in ecology when eventual discontinuities at sampling time instants are considered. Such discontinuities could be interpreted as impulses in the corresponding continuous-time logistic equations. The set of equations involve competition-type coupled dynamics among a finite set of species. It is assumed that, in general, the intrinsic growth rates and the carrying capacities are eventually distinct for the various species. The impulsive parts of the equations are parameterized by harvesting quotas and independent consumptions which are also eventually distinct for the various species and which control the populations’ evolution. The performed study includes the existence of extinction and non-extinction equilibrium points, the conditions of non-negativity and boundedness of the solutions for given finite non-negative initial conditions and the conditions of asymptotic stability without or with extinction of the solutions.This research was supported by the Spanish Government through grant RTI2018-094336-B-100 (MCIU/AEI/FEDER, UE) and by the Basque Government through grant IT1207-19

On a Discrete SEIR Epidemic Model with Exposed Infectivity, Feedback Vaccination and Partial Delayed Re-Susceptibility

A new discrete Susceptible-Exposed-Infectious-Recovered (SEIR) epidemic model is proposed, and its properties of non-negativity and (both local and global) asymptotic stability of the solution sequence vector on the first orthant of the state-space are discussed. The calculation of the disease-free and the endemic equilibrium points is also performed. The model has the following main characteristics: (a) the exposed subpopulation is infective, as it is the infectious one, but their respective transmission rates may be distinct; (b) a feedback vaccination control law on the Susceptible is incorporated; and (c) the model is subject to delayed partial re-susceptibility in the sense that a partial immunity loss in the recovered individuals happens after a certain delay. In this way, a portion of formerly recovered individuals along a range of previous samples is incorporated again to the susceptible subpopulation. The rate of loss of partial immunity of the considered range of previous samples may be, in general, distinct for the various samples. It is found that the endemic equilibrium point is not reachable in the transmission rate range of values, which makes the disease-free one to be globally asymptotically stable. The critical transmission rate which confers to only one of the equilibrium points the property of being asymptotically stable (respectively below or beyond its value) is linked to the unity basic reproduction number and makes both equilibrium points to be coincident. In parallel, the endemic equilibrium point is reachable and globally asymptotically stable in the range for which the disease-free equilibrium point is unstable. It is also discussed the relevance of both the vaccination effort and the re-susceptibility level in the modification of the disease-free equilibrium point compared to its reached component values in their absence. The influences of the limit control gain and equilibrium re-susceptibility level in the reached endemic state are also explicitly made viewable for their interpretation from the endemic equilibrium components. Some simulation examples are tested and discussed by using disease parameterizations of COVID-19.The work has been funded by Grant RTI2018-094336-B-I00 from MCIU/AEI/FEDER, UE; by Grant IT1207-19, by the Basque Government and by Grant COV 20/01213 from Spanish Institute of Health Carlos III

On the Supervision of a Saturated SIR Epidemic Model with Four Joint Control Actions for a Drastic Reduction in the Infection and the Susceptibility through Time

This paper presents and studies a new epidemic SIR (Susceptible–Infectious–Recovered) model with susceptible recruitment and eventual joint vaccination efforts for both newborn and susceptible individuals. Furthermore, saturation effects in the infection incidence terms are eventually assumed for both the infectious and the susceptible subpopulations. The vaccination action on newborn individuals is assumed to be applied to a fraction of them while that on the susceptible general population is of linear feedback type reinforced with impulsive vaccination actions (in practice, very strong and massive vaccination controls) at certain time points, based on information on the current levels of the susceptible subpopulation. Apart from the above vaccination controls, it is also assumed that the average of contagion contacts can be controlled via intervention measures, such as confinements or isolation measures, social distance rules, use of masks, mobility constraints, etc. The main objectives of the paper are the achievement of a strictly decreasing infection for all time periods and that of the susceptible individuals over the initial period if they exceed the disease-free equilibrium value. The monitoring mechanism is the combined activation of intervention measures to reduce the contagion contacts together with the impulsive vaccination to reduce susceptibility. The susceptibility and recovery levels of the disease-free equilibrium point are suitably prefixed by the design of the regular feedback vaccination on the susceptible subpopulation.The research received support from the Spanish Government and the European commission through grant RTI2016-094336-BI00 (MCIU/AEI/FEDER, UE)

Conocimiento tradicional sobre el uso y conservación del tequelite chico en Chipahuatlan, Olintla, Puebla.

The small tequelite (Peperomia peltilimba C. DC. ex Trelease) is a wild plant, native to Mexico, considered vulnerable to extinction. The aim of this study was to document knowledge and attitudes towards conservation and use of the small tequelite in the Totonac community of Chipahuatlan, Olintla, in the state of Puebla (Mexico). 53 semi-structured interviews were applied to a sample of the population; the number of families was considered to be representative. The interview consisted of the following sections; knowledge about the species, conservation, commercialization, uses and benefits. We explored the natural habitat of the species to document accompanying flora and fauna. Results indicated that the stems and leaves of the small tequelite are used to prepare traditional foods such as mole (sauce), broths, tamales, and boiled beans; with or without sesame seeds. The species is obtained from its natural habitat and in local markets, although some families grow plants in their home gardens. Traditional knowledge about the small tequelite relates to flora and fauna; only the most developed plants are used and those with buds or inflorescences are preserved. We discovered interest in conserving this resource because of its cultural and economic importance; although its commercial value is low, it offers additional income for families, who are dedicated to its collection. These results summarize Totonac knowledge and the perception they have regarding the conservation and use of small tequelite.El tequelite chico (Peperomia peltilimba C. DC. ex Trelease) es una planta nativa y silvestre de México, considerada vulnerable a la extinción. El objetivo de este estudio fue documentar el conocimiento y la percepción sobre la conservación y el uso del tequelite chico en la comunidad totonaca de Chipahuatlan, Olintla, en el estado de Puebla (México). Se aplicaron 53 entrevistas semiestructuradas a una muestra representativa de la población; se consideró como universo al número de familias. La entrevista estuvo conformada por las secciones, conocimiento de la especie, conservación, comercialización, usos y beneficios. Se realizaron recorridos en el hábitat natural de la especie para documentar flora y fauna acompañantes. Los resultados indicaron que los tallos y hojas del tequelite chico se utilizan para la elaboración de alimentos tradicionales como mole, caldos, tamales y frijoles hervidos con o sin ajonjolí. La especie se obtiene a través de su hábitat natural y en tianguis locales, aunque algunas familias tienen plantas en sus traspatios. Los conocimientos tradicionales sobre el tequelite chico están relacionados con la flora y la fauna, se aprovechan solo las plantas más desarrolladas y se conservan las que presentan brotes o inflorescencias. Se identificó interés por conservar este recurso debido a su importancia cultural y económica; aunque su valor comercial es bajo, representa un ingreso adicional para las familias que se dedican a su recolección. Estos resultados son una aproximación al conocimiento totonaca y su percepción en torno a la conservación y el aprovechamiento del tequelite chico

On a New Epidemic Model with Asymptomatic and Dead-Infective Subpopulations with Feedback Controls Useful for Ebola Disease

This paper studies the nonnegativity and local and global stability properties of the solutions of a newly proposed SEIADR model which incorporates asymptomatic and dead-infective subpopulations into the standard SEIR model and, in parallel, it incorporates feedback vaccination plus a constant term on the susceptible and feedback antiviral treatment controls on the symptomatic infectious subpopulation. A third control action of impulsive type (or “culling”) consists of the periodic retirement of all or a fraction of the lying corpses which can become infective in certain diseases, for instance, the Ebola infection. The three controls are allowed to be eventually time varying and contain a total of four design control gains. The local stability analysis around both the disease-free and endemic equilibrium points is performed by the investigation of the eigenvalues of the corresponding Jacobian matrices. The global stability is formally discussed by using tools of qualitative theory of differential equations by using Gauss-Stokes and Bendixson theorems so that neither Lyapunov equation candidates nor the explicit solutions are used. It is proved that stability holds as a parallel property to positivity and that disease-free and the endemic equilibrium states cannot be simultaneously either stable or unstable. The periodic limit solution trajectories and equilibrium points are analyzed in a combined fashion in the sense that the endemic periodic solutions become, in particular, equilibrium points if the control gains converge to constant values and the control gain for culling the infective corpses is asymptotically zeroed.This research is supported by the Spanish Government and the European Fund of Regional Development FEDER through Grant DPI2015-64766-R

Supervision of the Infection in an SI (SI-RC) Epidemic Model by Using a Test Loss Function to Update the Vaccination and Treatment Controls

This paper studies and proposes some supervisory techniques to update the vaccination and control gains through time in a modified SI (susceptible-infectious) epidemic model involving the susceptible and subpopulations. Since the presence of linear feedback controls are admitted, a compensatory recovered (or immune) extra subpopulation is added to the model under zero initial conditions to deal with the recovered subpopulations transferred from the vaccination and antiviral/antibiotic treatment on the susceptible and the infectious, respectively. Therefore, the modified model is referred to as an SI(RC) epidemic model since it integrates the susceptible, infectious and compensatory recovered subpopulations. The defined time-integral supervisory loss function can evaluate weighted losses involving, in general, both the susceptible and the infectious subpopulations. It is admitted, as a valid supervisory loss function, that which involves only either the infectious or the susceptible subpopulations. Its concrete definition involving only the infectious is related to the Shannon information entropy. The supervision problem is basically based on the implementation of a parallel control structure with different potential control gains to be judiciously selected and updated through time. A higher decision level structure of the supervisory scheme updates the appropriate active controller (i.e., that with the control gain values to be used along the next time window), as well as the switching time instants. In this way, the active controller is that which provides the best associated supervisory loss function along the next inter-switching time interval. Basically, a switching action from one active controller to another one is decided as a better value of the supervisory loss function is detected for distinct controller gain values to the current ones.The authors are grateful to the Spanish Government for Grants RTI2018-094336-B-I00 and RTI2018-094902-B-C22 (MCIU/AEI/FEDER, UE), to the Institute of Health Carlos III for Grant COV20/01213 and to the Basque Government for Grant IT1207-19. They also thank the referees for their useful suggestions and corrections