Estimating the impact of the COVID-19 pandemic on dengue in Brazil.

Atypical dengue prevalence was observed in 2020 in many dengue-endemic countries, including Brazil. Evidence suggests that the pandemic disrupted not only dengue dynamics due to changes in mobility patterns, but also several aspects of dengue surveillance, such as care seeking behavior, care availability, and monitoring systems. However, we lack a clear understanding of the overall impact on dengue in different parts of the country as well as the role of individual causal drivers. In this study, we estimated the gap between expected and observed dengue cases in 2020 using an interrupted time series design with forecasts from a neural network and a structural Bayesian time series model. We also decomposed the gap into the impacts of climate conditions, pandemic-induced changes in reporting, human susceptibility, and human mobility. We find that there is considerable variation across the country in both overall pandemic impact on dengue and the relative importance of individual drivers. Increased understanding of the causal mechanisms driving the 2020 dengue season helps mitigate some of the data gaps caused by the COVID-19 pandemic and is critical to developing effective public health interventions to control dengue in the future.

Day and night trophic variations of dominant fish species in a lagoon influenced by freshwater seeps.

The aim of this study was to determine the trophic structure and nycthemeral variations in the diet of dominant fish species (Ariopsis felis, Bairdiella chrysoura, Micropogonias undulatus, Eucinostomus gula, Eucinostomus argenteus, Lagodon rhomboides and Sphoeroides testudineus) in Celestun Lagoon, a biosphere reserve located in the southern Gulf of Mexico, and influenced by freshwater seeps. A total of 1473 stomachs were analysed and nine trophic groups were recorded. Bray-Curtis analyses with analyses of similarity (ANOSIM) statistical tests were used to determine two groups of feeding guilds: zoobenthivores and omnivores, with significant differences between time and habitat. The relationships between fish feeding habits, size class and environmental variables were investigated using canonical correspondence analysis (CCA). Most of the species showed a low niche breadth with high specialization towards amphipod consumption, with the exception of L. rhomboides (0·60), which indicated generalist feeding. This study in a protected area is an important source of information for drawing up conservation policies in relation to the management of aquatic resources, and will aid in the establishment of priority areas for conservation.

[Non-compliance with pharmacological treatment in patients with epilepsy]. / Incumplimiento farmacológico en pacientes con epilepsia.

INTRODUCTION: The factors that affect adherence to pharmacological treatment with anticonvulsive drugs are manifold and can be classified as psychosocial, educational and related to the medication and the relation between physician and patient. Non-compliance with pharmacological treatment leads to: lack of control over seizures, recurrence, increased absenteeism from work and, possibly, injury to oneself or to others. AIMS: To determine and to analyse the variables associated to compliance with pharmacological treatment in a sector of the population in Peru. PATIENTS AND METHODS: The sample consisted of 114 patients evaluated between June 2001 and December 2002 at the Epilepsy and Clinical Electroencephalography Department of the National Neurological Sciences Institute Oscar Trelles Montes in Lima. RESULTS: In this study the rate of non-compliance with the pharmacological regimen was 67.2% and those who did not adhere to the anticonvulsive therapy had poorer control over their seizures. The variables that were significantly associated to non-compliance with the pharmacological treatment were: lack of money to buy the medicine, patient's failure to acknowledge the disease, poor response to treatment, belief that the treatment is of no use or has no beneficial effects, and factors linked to the relationship between physician and patient. Patients who did not comply claimed that not being able to afford the medication was the most frequent reason why they had stopped following the treatment.

Surgical complications of typhoid fever: enteric perforation.

Typhoid fever remains a prevalent disease in developing nations as the result of adverse socioeconomic factors. The most frequent complication, and principal cause of mortality, is perforation of the terminal ileum. This report presents our experience with 96 patients surgically treated at Cayetano Heredia University Hospital in Lima, Peru from 1972 to 1986. The clinical characteristics and the diverse surgical procedures utilized in the management of these patients are reviewed.