La gestión municipal y su impacto en la gobernabilidad en los gobiernos locales del Perú, 2021

The purpose of this research is to detail and examine the conceptual approach to the management of municipalities and its influence on governance as a very important factor in the well-being of citizens, the foundation is centered on organizational theory as the main source that should be promote the state in its public institutions, likewise improve the capacities of human resources for a better efficient performance to achieve its objectives in the same way in the research carried out we make relevance that it is very important that citizens participate since this contributes to the development of localities. For this, a systematic review of articles published in scientific journals of scielo, Redalyc and Latindex indexed journals whose publications are between 2015 and 2020 has been made, for which a database of 10 articles has been developed. It will allow the discussions to be held and thus reach the conclusions of how effective municipal management has a positive impact on good governance and its study, diagnosis will influence in a timely manner for future research.La finalidad de esta investigación es  detallar y examinar la aproximación conceptual de la gestión de los municipios y su influencia en la gobernabilidad como un factor muy importante en el bienestar de los ciudadanos, el fundamento está centrado en la teoría organizacional como principal fuente que se debería impulsar el estado en sus instituciones públicas, así mismo mejorar las capacidades de los recursos humano para un mejor desempeño eficiente para el logro de sus objetivo del mismo modo en la investigación realizada hacemos relevancia que es muy importante que los ciudadanos participen   ya que  esto contribuye al desarrollo de las localidades. Para ello se ha hecho revisión sistemática  de artículos publicadas en revistas científicas de scielo, Redalyc y revistas indexadas latindex cuyas publicaciones estén comprendidas entre el 2015 al 2020 para el cual se ha desarrollado una base de datos de 10 artículos  los resultados obtenidos de estas investigaciones nos permitirá hacer las discusiones y con ello llegar a las conclusiones de como la gestión municipal efectiva tiene un impacto positivo para una buena gobernabilidad y su estudio, diagnostico incidirá de manera oportuna para futuras investigaciones

Diabetes with Hypertension as Risk Factors for Adult Dengue Hemorrhagic Fever in a Predominantly Dengue Serotype 2 Epidemic: A Case Control Study

Dengue is a major vector borne disease in the tropical and subtropical regions. An estimated 50 million infections occur per annum in over 100 countries. A severe form of dengue, characterized by bleeding and plasma leakage, known as dengue hemorrhagic fever (DHF) is estimated to occur in 1–5% of hospitalized cases. It can be fatal if unrecognized and not treated in a timely manner. Previous studies had found a number of risk factors for DHF. However, screening and clinical management strategies based on these risk factors may not be applicable to all populations and epidemics of different serotypes. In this study, we found significant association between DHF and diabetes mellitus and diabetes mellitus with hypertension during the epidemic of predominantly serotype 2 (year 2007 and 2008), but not during the epidemic of predominantly serotype 1 (year 2006). Diabetes mellitus and hypertension are prevalent in Singapore and most parts of South-East Asia, where dengue is endemic. Therefore, it is important to address the risk effect of these co-morbidities on the development of DHF so as to reduce morbidity and mortality. Our findings may have impact on screening and clinical management of dengue patients, when confirmed in more studies

Should colloid boluses be prioritized over crystalloid boluses for the management of dengue shock syndrome in the presence of ascites and pleural effusions?

<p>Abstract</p> <p>Background</p> <p>Although the WHO guideline for the management of dengue fever considers the presence of ascites or pleural effusions in the diagnosis of DSS, it does not emphasize the importance of their presence when selecting fluids for resuscitation.</p> <p>Case presentation</p> <p>We highlight three patients with DSS who received boluses of crystalloids on priority basis as recommended by WHO guidelines during resuscitation. All three patients had varying degrees of third space fluid loss (ascites and pleural effusions) at the time of development of DSS. Ascites and pleural effusions were detected in all 3 patients at the time of shock irrespective of whether iv fluids were given or not. All three patients had documented liver involvement at the time of shock evidenced by elevation of AST (4800 iu/L, 5000 iu/L and 1960 iu/L). One patient who had profound shock died 6 hours after admission with evidence of acute pulmonary oedema in the convalescence phase. All of them needed CPAP ventilator support and potent diuretics.</p> <p>Conclusions</p> <p>We therefore feel that resuscitation of patients with DSS who already have third space fluid accumulation with crystalloid boluses on priority basis may contribute to recovery phase pulmonary oedema.</p

The Diagnostic Sensitivity of Dengue Rapid Test Assays Is Significantly Enhanced by Using a Combined Antigen and Antibody Testing Approach

Dengue is a serious public health concern with around 3 billion people at risk of infection. Severe forms of the infection can be fatal and with no licensed vaccine or effective therapeutic currently available, early detection is important to assist with the clinical management of symptoms. Isolation of the virus and the detection of viral RNA using RT-PCR are commonly used methods for early diagnosis but are time-consuming, expensive and require skilled operation. Rapid immunochromatographic tests (ICT) are relatively simple, inexpensive and easy to perform at or near the point of care. Here, we report on the clinical performance of a new rapid ICT for the non-structural protein 1 (NS1) of dengue virus, a marker of acute infection. At two clinical study sites, NS1 was detected in 60–70% of laboratory-confirmed dengue cases and specificity of the test was >95%. We have also shown that a combined testing approach for both circulating NS1 antigen and antibody responses to the glycoprotein E of the virus can significantly improve diagnostic sensitivity compared to the detection of NS1 alone. Importantly, the combined antigen and antibody testing approach also provides an expanded window of detection from as early as day 1 post-onset of illness