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1.
World J Surg ; 48(4): 855-862, 2024 04.
Article in English | MEDLINE | ID: mdl-38353292

ABSTRACT

BACKGROUND: Isolated perforations of hollow viscus (HV) represent less than 1% of injuries in blunt abdominal trauma (BAT). When they do present, they are generally due to high-impact mechanisms in the segments of the intestine that are fixed. The aim of this study is to determine the incidence of major HV injuries in BAT at the "Dr. Domingo Luciani" General Hospital (HDL), and address the literature gap regarding updated HV perforations following BAT, especially in low-income settings. METHODS: A retrospective review was conducted on the medical records of patients admitted to our trauma center with a diagnosis of complicated BAT with HV perforation over 14 years. RESULTS AND DISCUSSION: Seven hundred sixty-one patients were admitted under the diagnosis of BAT. Of them, 36.79% underwent emergency surgical resolution, and 6.04% had HV perforation as an operative finding. Almost half (44.44%) of these cases presented as a single isolated injury, while the remaining were associated with other intra-abdominal organ injuries. The most common lesions were Grade II-III jejunum and Grade I transverse colon, affecting an equal proportion of patients at 13.33%. In recent years, an increased incidence of HV injuries secondary to BAT has been observed. Despite this, in many cases, the diagnosis is delayed, so even in the presence of negative diagnostic studies, the surgical approach based on the trauma mechanism, hemodynamic status, and systematic reevaluation of the polytraumatized patient should prevail.


Subject(s)
Abdominal Injuries , Intestinal Perforation , Wounds, Nonpenetrating , Humans , Trauma Centers , Wounds, Nonpenetrating/epidemiology , Wounds, Nonpenetrating/surgery , Wounds, Nonpenetrating/complications , Abdominal Injuries/epidemiology , Abdominal Injuries/surgery , Abdominal Injuries/complications , Jejunum , Intestinal Perforation/surgery , Retrospective Studies
2.
J Med Virol ; 94(3): 1175-1185, 2022 03.
Article in English | MEDLINE | ID: mdl-34761824

ABSTRACT

The coronavirus disease 2019 (COVID-19) pandemic has particularly affected countries with weakened health services in Latin America, where proper patient management could be a critical step to address the epidemic. In this study, we aimed to characterize and identify which epidemiological, clinical, and paraclinical risk factors defined COVID-19 infection from the first confirmed cases through the first epidemic wave in Venezuela. A retrospective analysis of consecutive suspected cases of COVID-19 admitted to a sentinel hospital was carried out, including 576 patient cases subsequently confirmed for severe acute respiratory syndrome coronavirus 2 infection. Of these, 162 (28.1%) patients met the definition criteria for severe/critical disease, and 414 (71.2%) were classified as mild/moderate disease. The mean age was 47 (SD 16) years, the majority of which were men (59.5%), and the most frequent comorbidity was arterial hypertension (23.3%). The most common symptoms included fever (88.7%), headache (65.6%), and dry cough (63.9%). Severe/critical disease affected mostly older males with low schooling (p < 0.001). Similarly, higher levels of glycemia, urea, aminotransferases, total bilirubin, lactate dehydrogenase, and erythrocyte sedimentation rate were observed in severe/critical disease patients compared to those with mild/moderate disease. Overall mortality was 7.6% (44/576), with 41.7% (28/68) dying in hospital. We identified risk factors related to COVID-19 infection, which could help healthcare providers take appropriate measures and prevent severe clinical outcomes. Our results suggest that the mortality registered by this disease in Venezuela during the first epidemic wave was underestimated. An increase in fatalities is expected to occur in the coming months unless measures that are more effective are implemented to mitigate the epidemic while the vaccination process is ongoing.


Subject(s)
COVID-19 , COVID-19/diagnosis , COVID-19/epidemiology , Female , Humans , Male , Middle Aged , Pandemics , Retrospective Studies , SARS-CoV-2 , Venezuela/epidemiology
3.
PeerJ ; 9: e12200, 2021.
Article in English | MEDLINE | ID: mdl-34616634

ABSTRACT

BACKGROUND: High doses of ethylenebisdithiocarbamate (EBDC) are used in banana production, and unused pesticide mixture (solution) is often disposed of improperly. This can result in soil and water contamination and present an undue risk to rural communities and the environment. An alternative to reduce the environmental impacts caused by pesticide residues is the biobeds treatment. It is necessary to establish if the composition of the proposed biomixtures supports microbial activity to degrade pesticides in biobeds. This research aimed to evaluate the EBDC effect on the distribution and abundance of microbial populations in polluted biomixtures . METHODS: For this purpose, a biomixture based on banana stem, mulch, and Fluvisol soil (50:25:25% v/v) was prepared and polluted with 1,000 mg L-1 EBDC. The response variables kinetics were determined every 14 days for three months, such as pH, organic matter, moisture, cation exchange capacity, microbial colonies, and cell counts at three depths within the experimental units. RESULTS: EBDC reduced the number of microbial colonies by 72%. Bacterial cells rapidly decreased by 69% and fungi 89% on the surface, while the decrease was gradual and steady at the middle and bottom of the biobed. The microbial populations stabilized at day 42, and the bacteria showed a total recovery on day 84, but the fungi slightly less. At the end of the experiment, the concentration of EBDC in the biomixture was 1.3-4.1 mg L-1. A correlation was found between fungal count (colonies and cells) with EBDC concentration. A replacement of the biomixture is suggested if the bacterial population becomes less than 40 × 106 CFU mL-1 and the fungal population less than 8 × 104 CFU mL-1 or if the direct cell count becomes lower than 50 × 104 cells mL-1 in bacteria and 8 × 102 cells mL-1 in fungi. CONCLUSION: The biomixture based on banana stem supports the microbial activity necessary for the degradation of the EBDC pesticide. It was found that fungi could be used as indicators of the pollutant degradation process in the biomixtures. Microbial counts were useful to establish the mobility and degradation time of the pesticide and the effectiveness of the biomixture. Based on the results, it is appropriate to include the quantification of microbial populations to assess the effectiveness of pesticide degradation and the maturity level of the biomixture.

4.
Biomedica ; 41(Sp. 2): 48-61, 2021 10 15.
Article in English, Spanish | MEDLINE | ID: mdl-34669278

ABSTRACT

INTRODUCTION: The studies on knowledge, attitudes, and practices (KAP) regarding COVID-19 help to identify erroneous concepts and inadequate practices related to the disease. This baseline information is essential to design effective strategies and improve adherence to prevention measures. OBJECTIVE: To identify the COVID-19-related KAP in Venezuelan patients screened at the Hospital Universitario de Caracas triage tent. MATERIALS AND METHODS: We conducted a cross-sectional study among 215 patients between April 25th and May 25th, 2020, with in-person interviews using a KAP survey. RESULTS: Most surveyed patients (53.5%) were asymptomatic. Most of them, both from the symptomatic and the asymptomatic groups, had adequate knowledge about the symptoms and transmission of the disease and the majority said they were practicing quarantine, frequent handwashing, and the use of face masks in public areas. However, the daily replacement of cloth face masks was more frequent in the asymptomatic group whereas replacement every three days was more frequent in the symptomatic group. Finally, more than half of the participants admitted having been in crowded places, a common practice among the symptomatic compared to the asymptomatic patients. CONCLUSIONS: This is the first KAP study in Venezuela about COVID-19. Knowledge and practices among Venezuelans could be improved by strengthening education and training programs. This information from the early phase of the pandemic in Venezuela may contribute to the design of COVID-19 promotion and prevention strategies.


Introducción: Los estudios sobre conocimientos, actitudes y prácticas (CAP) sobre COVID-19 ayudan a identificar conceptos erróneos y prácticas inadecuadas relacionadas con la enfermedad. Esta información de referencia es fundamental para diseñar estrategias efectivas y mejorar la adherencia a las medidas de prevención. Objetivo: Identificar la CAP relacionada con COVID-19 en pacientes venezolanos cribados en la carpa de triaje del Hospital Universitario de Caracas. Materiales y métodos: Realizamos un estudio transversal entre 215 pacientes entre el 25 de abril y el 25 de mayo de 2020, con entrevistas en persona utilizando una encuesta KAP. Resultados: La mayoría de los pacientes encuestados (53,5%) se encontraban asintomáticos. La mayoría de ellos, tanto del grupo sintomático como asintomático, tenían un conocimiento adecuado sobre los síntomas y la transmisión de la enfermedad y la mayoría dijo que practicaban la cuarentena, el lavado frecuente de manos y el uso de mascarillas en las áreas públicas. Sin embargo, el reemplazo diario de mascarillas de tela fue más frecuente en el grupo asintomático, mientras que el reemplazo cada tres días fue más frecuente en el grupo sintomático. Finalmente, más de la mitad de los participantes admitieron haber estado en lugares concurridos, una práctica común entre los sintomáticos en comparación con los asintomáticos. Conclusiones: Este es el primer estudio CAP en Venezuela sobre COVID-19. El conocimiento y las prácticas entre los venezolanos podrían mejorarse fortaleciendo los programas de educación y capacitación. Esta información de la fase inicial de la pandemia en Venezuela puede contribuir al diseño de estrategias de promoción y prevención del COVID-19.


Subject(s)
COVID-19/prevention & control , COVID-19/transmission , Health Knowledge, Attitudes, Practice , Adult , Asymptomatic Infections/epidemiology , Cross-Sectional Studies , Crowding , Female , Hand Disinfection , Health Surveys/methods , Health Surveys/statistics & numerical data , Humans , Male , Masks/statistics & numerical data , Physical Distancing , Symptom Assessment , Triage , Venezuela/epidemiology
5.
Biomédica (Bogotá) ; Biomédica (Bogotá);41(supl.2): 48-61, oct. 2021. tab, graf
Article in English | LILACS | ID: biblio-1355759

ABSTRACT

Abstract | Introduction: The studies on knowledge, attitudes, and practices (KAP) regarding COVID-19 help to identify erroneous concepts and inadequate practices related to the disease. This baseline information is essential to design effective strategies and improve adherence to prevention measures. Objective: To identify the COVID-19-related KAP in Venezuelan patients screened at the Hospital Universitario de Caracas triage tent. Materials and methods: We conducted a cross-sectional study among 215 patients between April 25th and May 25th, 2020, with in-person interviews using a KAP survey. Results: Most surveyed patients (53.5%) were asymptomatic. Most of them, both from the symptomatic and the asymptomatic groups, had adequate knowledge about the symptoms and transmission of the disease and the majority said they were practicing quarantine, frequent handwashing, and the use of face masks in public areas. However, the daily replacement of cloth face masks was more frequent in the asymptomatic group whereas replacement every three days was more frequent in the symptomatic group. Finally, more than half of the participants admitted having been in crowded places, a common practice among the symptomatic compared to the asymptomatic patients. Conclusions: This is the first KAP study in Venezuela about COVID-19. Knowledge and practices among Venezuelans could be improved by strengthening education and training programs. This information from the early phase of the pandemic in Venezuela may contribute to the design of COVID-19 promotion and prevention strategies.


Resumen | Introducción. Los estudios de conocimientos, actitudes y prácticas (CAP) relacionados con la Covid-19 permiten establecer los conceptos erróneos y las prácticas inadecuadas en torno a esta enfermedad, información fundamental para diseñar estrategias eficaces y mejorar el cumplimiento de las medidas de prevención. Objetivo. Establecer los conocimientos, actitudes y prácticas relacionadas con la Covid-19 en pacientes venezolanos cribados en la carpa de triaje del Hospital Universitario de Caracas. Materiales y métodos. Se hizo un estudio transversal en 215 pacientes entre el 25 de abril y el 25 de mayo de 2020, mediante entrevistas personales y utilizando una encuesta sobre conocimientos, actitudes y prácticas. Resultados. La mayoría (53,5 %) de los pacientes encuestados se encontraba asintomática; los encuestados tenían un conocimiento adecuado sobre los síntomas y la transmisión de la enfermedad, sin distinción entre sintomáticos y asintomáticos. La mayoría de ellos indicó estar respetando las prácticas de cuarentena, lavado de manos frecuente y uso de tapabocas en público; sin embargo, el reemplazo diario de los tapabocas de tela fue más frecuente en el grupo de los asintomáticos, en tanto que el reemplazo cada tres días fue más común entre los sintomáticos. Por último, más de la mitad de los participantes admitió haber estado en lugares concurridos, siendo esta práctica más frecuente entre los sintomáticos que entre los asintomáticos. Conclusiones. Este es el primer estudio de conocimientos, actitudes y prácticas sobre la Covid-19 en Venezuela. El conocimiento y las prácticas de los venezolanos podrían mejorar mediante el fortalecimiento de los programas de educación y capacitación. Esta información, obtenida durante la fase inicial de la pandemia en Venezuela, podría contribuir al diseño de estrategias de promoción y prevención de la Covid-19.


Subject(s)
Health Knowledge, Attitudes, Practice , Coronavirus Infections , Venezuela , Health Promotion
6.
Heliyon ; 6(1): e03131, 2020 Jan.
Article in English | MEDLINE | ID: mdl-31909284

ABSTRACT

A rapid bioassay is presented for determining acute toxicity directly in soil. Modifying the Organisation for Economic Cooperation and Development (OECD) protocol 207, it uses a thin layer of moistened soil laid directly in the bottom of the bioassay jar into which the earthworms are placed and incubated. Examples are presented in comparisons between the soil contact bioassay vs. the filter paper bioassay run on Toxicity Characteristic Leaching Procedure (TCLP) extracts of pesticide contaminated soil and petroleum drilling cuttings. In 2,4-dichlorophenoxyacetic acid (2,4-D) contaminated soil (300mg/Kg), no mortality was found in soil extracts, but 100% mortality was found when exposed directly to soil. Treatment with the Daremend® product in five anaerobic/aerobic cycles slowly reduced the 24 h mortality (0%) but still showed 100% mortality at 48 h. However, severe sub-lethal effects (expulsion of celomic/bloody fluids) were reduced from 50% to 37%, and further treatment may reduce the toxicity to acceptable levels. The petroleum drilling cuttings treated by chemical oxidation (1.3% H2O2, w/w) and bioremediation (simulation of biopiles), showed a similar response, where 0% mortality in soil extracts was found, but 100% mortality with soil contact. Post-treatment with chemical oxidation resulted in a reduction in the soil contact bioassay to 3% and 13% mortality, within the accepted range (≤10%) of the OECD protocol. Observations are presented with respect to moisture control to prevent earthworm desiccation and recommendation for confirmation using the sub-chronic test in the OECD protocol but by testing the contaminated/treated soil itself rather than artificial soil.

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