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1.
Vet Parasitol ; 310: 109790, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-36054969

RESUMO

Cystic echinococcosis (CE) is a zoonosis caused by species of the complex Echinococcus granulosus, sensu lato in their larval stage. It is an endemic disease in the province of Río Negro, where small farmers generally have both sheep and goats. Lamb vaccination with EG95 was incorporated in 2009 with very good results: in fact, it contributed to a significant drop in prevalence of infection in both sheep and goats, when determined by necropsy and serology in 2018. In the design of the activity, it was decided not to vaccinate goats in order to minimize the operational requirements of vaccination and comments from producers about the rarity of observing hydatid cysts in goat viscera were considered. OBJECTIVE: To identify causes which can still generate infection in dogs, and to detect species/genotypes in circulation in the province of Río Negro. MATERIALS AND METHODS: In indigenous reserves comprised within the area of lamb vaccination with 3 doses of EG95, (dose 1 in December, dose 2 in January and dose 3 in December of the year following, at the time of application of dose 1 to the new lambs). Prevalence in adult goats and sheep was determined by necropsy and serology (ELISA). Infective species/genotypes present in the work area and in the rest of the province of Río Negro were identified by Cox1 mitochondrial gene sequencing. Epidemiological analysis was completed with surveys among farmers about slaughter habits for human consumption. RESULTS: Through serology and necropsy, infection rates in vaccinated and nonvaccinated sheep were significantly different (21% versus 66%). Non-vaccinated sheep and non-vaccinated goats were also significantly different in that there was less infection in goats compared to sheep (7% versus 66% for necropsy, 30% versus 61% for serology); After many years of sheep vaccination the infection positives were low, and differences between vaccinated sheep and non-vaccinated goats turned out non-significant (21% versus 7%). With reference to epidemiology and control along the period 2018-2022, PZQ dosing of dogs 4 times a year was maintained, and 2 extra deworming tasks were introduced together with dose 1 and 2 of EG95, performed by the veterinary vaccination team, ensuring the ingestion of PZQ by dogs. Assessment of animal slaughter for consumption in 41 producers showed that 21 of them slaughter a monthly average of 18 goats (an average of 0.43 goat per month per farm) and 36 in all slaughter 35 old sheep in a year (average of 0.85 sheep per month per farm). With respect to identification of species/genotypes as from 2010, genotypes G1 have been found in 11 sheep (out of which 6 belong to vaccination zone) and genotypes G7, in one pig. A goat cyst within vaccination zone turned out unfertile and it was not possible to sequence it. CONCLUSION: Design and implementation of a vaccine programme combined with the use of PZQ resulted as cost-effective, since it was possible to maintain the vaccine over time, with clear impact on prevalence decrease in sheep and goats.


Assuntos
Doenças do Cão , Equinococose , Echinococcus granulosus , Doenças das Cabras , Doenças dos Ovinos , Doenças dos Suínos , Vacinas , Afro-Americanos , Animais , Argentina/epidemiologia , Doenças do Cão/epidemiologia , Doenças do Cão/prevenção & controle , Cães , Equinococose/epidemiologia , Equinococose/prevenção & controle , Equinococose/veterinária , Echinococcus granulosus/genética , Doenças das Cabras/epidemiologia , Doenças das Cabras/prevenção & controle , Cabras , Humanos , Ovinos , Doenças dos Ovinos/epidemiologia , Doenças dos Ovinos/prevenção & controle , Suínos , Vacinação/veterinária
2.
Front Public Health ; 10: 983174, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36091556

RESUMO

Background: Antibiotic-resistant gram-negative bloodstream infections (BSI) remain a leading cause morbidity and mortality in pediatric patients with a high impact on the public health system. Data in resource-limited countries, including those in Latin America and the Caribbean region, are scarce. The aim of the study was to identify risk factors for acquiring carbapenem-resistant Enterobacteriaceae (CRE) bacteremia in children and to assess the use of resources. Methods: A retrospective case-control study was conducted to analyze demographic, epidemiological, clinical, microbiological, and outcome data as well as the use of resources between 2014 and 2019. Univariate and logistic regression analysis was performed in order to identify risk factors associated with CRE-BSI. The R software version 4.1.2 was used. Results: A total of 46 cases with CRE-BSI and 92 controls with gram-negative non-CRE-BSI were included. No statistical difference was observed regarding: median age (36 months; IQR, 11.2-117 vs. 48 months, IQR 13-119), male sex (50 vs. 60%), and underlying disease (98 vs. 91%) in cases vs. controls, respectively. The most frequent mechanism of CRE bacteremia were: KPC in 74%, OXA in 15%, and NDM in 6.5%. A total of 54.3% of cases vs. 32.6 % (p = 0.016) of controls were admitted to the pediatric intensive care unit (PICU), and 48 vs. 21% (p = 0.001) required mechanical ventilation. Bacteremia secondary to intra-abdominal infection was observed in 56.5% of cases vs. 35% of controls (p = 0.032). Previous colonization with CRE was detected in 76% of cases vs. 8% of controls. Combination antimicrobial treatment was most frequent in cases vs. control (100 vs. 56.5%). No difference was observed in median length of hospital stay (22 days; IQR, 19-31 in cases vs. 17.5 days; IQR, 10-31 in controls; p = 0.8). Overall case fatality ratio was 13 vs. 5.5%, respectively. The most statistically significant risk factors included previous PICU stay (OR, 4; 95%CI, 2-8), invasive procedures/surgery (OR, 3; 95%CI, 1-7), central venous catheter placement (OR, 6.5; 95%CI, 2-19), urinary catheter placement (OR, 9; 95%CI 4-20), mechanical ventilation (OR, 4; 95%CI, 2-10), liver transplantation (OR, 8; 95%CI, 2-26), meropenem treatment (OR, 8.4; 3.5-22.6) in univariate analysis. The logistic regression model used for multivariate analysis yielded significant differences for previous meropenem treatment (OR, 13; 95%CI, 3-77; p = 0.001), liver transplantation (OR, 13; 95%CI, 2.5-100; p = 0.006), and urinary catheter placement (OR, 9; 95%CI, 1.4-94; p = 0.03). Conclusion: CRE-BSI affects hospitalized children with underlying disease, mainly after liver transplantation, with previous urinary catheter use and receiving broad-spectrum antibiotics, leading to high PICU requirement and mortality. These risk factors will have to be taken into account in our region in order to establish adequate health policies and programs to improve antimicrobial stewardship.


Assuntos
Bacteriemia , Enterobacteriáceas Resistentes a Carbapenêmicos , Infecções por Enterobacteriaceae , Sepse , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Argentina/epidemiologia , Bacteriemia/tratamento farmacológico , Bacteriemia/epidemiologia , Bacteriemia/microbiologia , Carbapenêmicos/farmacologia , Carbapenêmicos/uso terapêutico , Estudos de Casos e Controles , Criança , Pré-Escolar , Infecções por Enterobacteriaceae/tratamento farmacológico , Infecções por Enterobacteriaceae/epidemiologia , Infecções por Enterobacteriaceae/microbiologia , Hospitais Pediátricos , Humanos , Lactente , Masculino , Meropeném/uso terapêutico , Encaminhamento e Consulta , Estudos Retrospectivos , Sepse/tratamento farmacológico
3.
Rev Chilena Infectol ; 39(3): 304-310, 2022 06.
Artigo em Espanhol | MEDLINE | ID: mdl-36156691

RESUMO

BACKGROUND: The spread of SARS-CoV-2 required widespread lockdown to mitigate the pandemic. Argentine authorities imposed preventive social isolation for 234 days (March 20th to November 9th 2020). This measure led to major changes in the population's lifestyle. AIM: To examine the influence of COVID-19 lockdown measures on the metabolic profile of HIV-infected patients in Argentina. METHODS: Retrospective cohort study of 10,239 HIV-infected patients under follow up in a private clinic for HIV care. Adult patients with ongoing antiretroviral therapy (ART) and a baseline determination of blood glucose, total cholesterol, HDL-cholesterol and triglycerides done before lockdown (BL: second semester of 2019) and a second determination during lockdown (DL: May 2020) were included. Patients with recent changes in ART that may have metabolic impact, those starting lipid/glucose lowering agents and pregnant women were excluded. Categorical variables were compared using the χ2 test or Fisher's exact test, and continuous variables using the t-test or the Mann-Whitney test. A two-tailed value of p < 0.05 was considered significant. RESULTS: 540 individuals were included, median of age was 47 years and 74.6% were male. Median body mass index was 26.1 and 94.6% had low cardiovascular risk. There was a significant increase in the percentage of patients that met criteria for hyperglycemia (BL 4.8% and DL 8.5%, p < 0.001). We also observed significant (p < 0.001) increase in median (IQR) BL vs DL values in LDL-cholesterol [109 (90-128) vs 118 (97-139) mg/dL]; and triglycerides [120 (87-172) vs. 132 mg/dL (96-184)]. The proportion of patients with hyper-LDL cholesterolemia according to individual cardiovascular risk increased from 12.6 to 17.2% (p = 0.04). CONCLUSION: Our results suggest that quarantine, at least in its initial phases, may have a negative impact on the metabolic profile of this population.


Assuntos
COVID-19 , Infecções por HIV , Adulto , Argentina/epidemiologia , Glicemia , HDL-Colesterol , Controle de Doenças Transmissíveis , Feminino , Infecções por HIV/epidemiologia , Humanos , Masculino , Metaboloma , Pessoa de Meia-Idade , Gravidez , Estudos Retrospectivos , SARS-CoV-2 , Triglicerídeos
4.
Rev Fac Cien Med Univ Nac Cordoba ; 79(3): 248-253, 2022 09 16.
Artigo em Espanhol | MEDLINE | ID: mdl-36149070

RESUMO

Introduction: Gestational diabetes mellitus (GDM) is defined as glucose intolerance diagnosed during pregnancy. This pathology can be associated with maternal and feto-neonatal complications, both in the short and long term. The prevalence of GDM in Argentina (based on the diagnostic criteria of the Latin American Diabetes Association (ALAD), is estimated between 7.5-10% of pregnant women. Information in Argentina on the incidence of GDM is scarce. The objective of this work was to estimate the incidence of GDM, evaluate its treatment and the frequency of screening for postpartum reclassification of diabetes in a population of pregnant women treated at a private hospital in the city of Buenos Aires. Materials and methods: Retrospective cohort of pregnant women evaluated at the Hospital Italiano de Buenos Aires, Argentina between 2015 and 2018. Results: The cumulative incidence of GDM was 7.6% (95% CI 7.0-8, two). All patients received nutritional advice (food plan). Of the total number of pregnant women studied 229 (39.3%) required pharmacological treatment; Of these, 97 patients received insulin (16.7%) and 132 metformin (22.7%). Regarding the follow-up of the pathology, between six weeks and one year postpartum, 267 women (45.9%) underwent diabetes screening for reclassification. Screening frequency was higher in the insulin-treated group. Of the patients who underwent screening, 36 women (13.5%) had impaired fasting blood glucose, 16 women (6.0%) had impaired glucose tolerance, and 3 women (1.1%) were diagnosed with type 2 diabetes mellitus. two.Of these, 36 women (13.5%) had impaired fasting blood glucose, 16 women (6.0%) had impaired glucose tolerance, and 3 women (1.1%) were diagnosed with type 2 diabetes mellitus. Conclusion: GDM incidence was 7.6%. Less than half of the women diagnosed with GDM required pharmacological treatment. The frequency of diabetes screening up to one year postpartum for reclassification was similar to that reported.


Introducción: La diabetes mellitus gestacional (DMG) se define como la intolerancia a la glucosa diagnosticada en el embarazo. Esta patología puede asociarse a complicaciones maternas y feto-neonatales, tanto a corto como a largo plazo. La prevalencia de DMG en Argentina (basada en el criterio diagnóstico de la Asociación Latinoamericana de Diabetes (ALAD), se estima entre 7,5-10% de las mujeres embarazadas.  Es escasa la información en Argentina sobre la incidencia de DMG. El objetivo de este trabajo fue estimar la incidencia de DMG, evaluar su tratamiento y la frecuencia de tamizaje para reclasificación postparto de la diabetes en una población de mujeres embarazadas atendidas en un hospital privado de la ciudad de Buenos Aires. Materiales y métodos: cohorte retrospectiva de embarazadas evaluadas en el Hospital Italiano de Buenos Aires, Argentina entre los años 2015 a 2018. Resultados: La incidencia acumulada de DMG fue 7,6 % (IC 95% 7,0-8,2). Todas las pacientes recibieron consejo nutricional (plan alimentario). Del total de embarazadas estudiadas requirieron tratamiento farmacológico 229 (39.3%); recibieron insulina 97 (16,7%) y 132 metformina (22,7%). En cuanto al seguimiento de la patología, entre las seis semanas y el año postparto realizaron tamizaje de diabetes para reclasificación 267 mujeres (45,9%). La frecuencia de tamizaje fue mayor en el grupo tratado con insulina. De las pacientes que realizaron el tamizaje, presentaron glucemia alterada en ayuno 36 mujeres (13,5%), tolerancia a la glucosa alterada 16 mujeres (6,0%) y 3 mujeres (1,1%) fueron diagnosticadas con diabetes mellitus tipo 2. Conclusión: la incidencia de DMG fue 7,6%. Menos de la mitad de las mujeres diagnosticadas con DMG requirió tratamiento farmacológico. La frecuencia de tamizaje de diabetes hasta el año postparto para la reclasificación similar a la reportada.


Assuntos
Diabetes Mellitus Tipo 2 , Diabetes Gestacional , Intolerância à Glucose , Insulinas , Metformina , Argentina/epidemiologia , Glicemia , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/epidemiologia , Diabetes Gestacional/diagnóstico , Diabetes Gestacional/epidemiologia , Feminino , Intolerância à Glucose/diagnóstico , Teste de Tolerância a Glucose , Hospitais , Humanos , Incidência , Recém-Nascido , Gravidez , Estudos Retrospectivos
5.
Rev Fac Cien Med Univ Nac Cordoba ; 79(3): 228-234, 2022 09 16.
Artigo em Espanhol | MEDLINE | ID: mdl-36149077

RESUMO

Introduction: Hereditary predisposition syndromes to cancer represent 5-10% of cancer cases, the most studied being HBOC produced by mutations in the BRCA1/2 genes. Objectives: To describe clinical, histopathological and PV characteristics in patients with HBOC in Córdoba, Argentina and compare it with those without BRCA1/2 mutations. Methods: Cross-sectional, correlational and observational analysis of patients from Córdoba. The ANOVA, Student's t test contingency tables and Fisher exact test were used the significance level was α = 0.05. Results: 155 women with BC, OC and BC/OC were studied. 40 BRCA1 / 2 mutations were identified. No differences were found in the age of diagnosis between patients with and without BRCA1/2 mutations. A significant association was found between VP in BRCA1/2 and the type of cancer (p = 0.003); all cases with BC/OC presented mutations in BRCA1/2. No significant association was found between mutated/non-mutated and personal history, family background, and ER-PR-HER2. 23.1% and 38.1% of BC cases were TN in individuals with VP in BRCA 1 and 2, respectively. The prevalence of mutations was 25.8% and the prevalence of novel PV was 10.0%. Conclusions: Patients with BC-VP BRCA1/2 are associated with ductal histology, and younger age of presentation with VP BRCA1. We did not find significant differences in the age at diagnosis of BC between patients with BRCA1 and BRCA2 mutations, a higher proportion of BC TN is observed than in the general population. In our sample, the prevalence of BRCA1/2 mutations among patients who meet criteria for HBOC is 25.8%, with 10% new pathogenic variant.


Introducción: Los síndromes de predisposición hereditaria al cáncer representan un 5-10% de los casos de cáncer, el más estudiado es HBOC producido por mutaciones en los genes BRCA1/2. Objetivos: Describir características clínicas, histopatológicas y VP en pacientes con HBOC en Córdoba, Argentina y compararla con aquellas sin mutaciones en BRCA1/2. Métodos: Análisis transversal, correlacional y observacional de pacientes de Córdoba. Se utilizó la prueba ANOVA, t de Student, tablas de contingencia y prueba exacta de Fisher, el nivel de significancia fue α=0,05. Resultados: Se estudiaron 155 mujeres con CM, CO y CM/CO. Se identificaron 40 mutaciones en BRCA1/2. No se encontraron diferencias en edad de diagnóstico entre pacientes con y sin mutaciones en BRCA1/2. Se encontró asociación significativa entre VP en BRCA1/2 y el tipo de cáncer (p=0,003); todos los casos con CM/CO presentaron mutaciones en BRCA1/2. No se encontró asociación significativa entre mutados/no mutados y AP, AF, RE-RP-HER2. El 23.1% y 38.1% de los casos de CM fueron TN en individuos con VP en BRCA 1 y 2 respectivamente. La prevalencia de mutaciones fue 25,8% y la prevalencia de VP noveles del 10,0%. Conclusiones: Las pacientes con CM-VP BRCA1/2 están asociadas con histología ductal, y menor edad de presentación con VP BRCA1. No encontramos diferencias significativas en edad de diagnóstico del CM entre pacientes con mutaciones BRCA1 y BRCA2, se observa una mayor proporción CM TN que en la población en general. En nuestra muestra, la prevalencia de mutaciones en BRCA1/2 entre los pacientes que reúnen criterios para HBOC es del 25,8%, con 10% de VP noveles.


Assuntos
Neoplasias da Mama , Neoplasias Ovarianas , Argentina/epidemiologia , Proteína BRCA1/genética , Proteína BRCA2/genética , Neoplasias da Mama/genética , Estudos Transversais , Feminino , Genes BRCA2 , Humanos , Mutação , Neoplasias Ovarianas/diagnóstico , Neoplasias Ovarianas/genética , Neoplasias Ovarianas/patologia
6.
PLoS One ; 17(8): e0271519, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35913940

RESUMO

BACKGROUND: Centrifugal-flow pumps are novel treatment options for patients with advanced heart failure (HF). This study estimated the incremental cost-effectiveness ratio (ICER) of centrifugal-flow pumps for patients with advanced HF in Argentina. METHODS: Two Markov models were developed to estimate the cost-effectiveness of a centrifugal-flow pump as destination therapy (DT) in patients with contraindication for heart transplantation, and as bridge-to-transplant (BTT), with a lifetime horizon using the third-party payer Social Security (SS) and Private Sector (PS) perspectives. Clinical, epidemiological, and quality-adjusted life years (QALY) parameters were retrieved from the literature. Direct medical costs were estimated through a micro-costing approach (exchange rate USD 1 = ARS 59.95). RESULTS: The centrifugal-flow pump as a DT increased the per patient QALYs by 3.5 and costs by ARS 8.1 million in both the SS and PS, with an ICER of ARS 2.3 million per QALY. Corresponding values for a centrifugal-flow pump as BTT were 0.74 QALYs and more than ARS 8 million, yielding ICERs of ARS 11 million per QALY (highly dependent on waiting times). For the 1, 3, and 5 GDP per QALY thresholds, the probability of a centrifugal-flow pump to be cost-effective for DT/BTT was around 2%/0%, 40%/0%, and 80%/1%, respectively. CONCLUSION: The centrifugal-flow pump prolongs life and improves the quality of life at significantly higher costs. As in Argentina there is no current explicit cost-effectiveness threshold, the final decision on reimbursement will depend on the willingness to pay in each subsector. Nevertheless, the centrifugal-flow pump as a DT was more cost-effective than as a BTT.


Assuntos
Insuficiência Cardíaca , Qualidade de Vida , Argentina/epidemiologia , Análise Custo-Benefício , Insuficiência Cardíaca/terapia , Humanos , Anos de Vida Ajustados por Qualidade de Vida
7.
Soc Sci Med ; 309: 115290, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-35985244

RESUMO

Globally, the question of how to improve the living standards of the inhabitants of informal settlements is a key political concern. These neighborhoods are characterized by economic vulnerability, social marginalization, and inaccessibility of basic services. The aim of this study is to provide evidence about the environmental risk factors faced by these populations in Argentina, and to identify whether their greater exposure to risk factors is associated with greater accessibility of healthcare services. We analyzed an original database that provides information about basic characteristics of the neighborhood, environmental risk factors (proximity to garbage dumps, industrial waste, and high-voltage towers), and accessibility of basic healthcare services on over 2000 informal settlements in Argentina. We calculated descriptive statistics and developed multivariate econometric models to estimate the probability of accessibility of healthcare services. On average, 31% of informal settlements were close to a garbage dump, 19% were close to a high-voltage tower, and 10% were close to industrial waste. In addition, 39% of these neighborhoods do not have a healthcare center nearby, 65% do not have an accessible hospital, and 39% are not consistently served by ambulances in the event of an emergency. The econometric estimates suggest that the accessibility of hospital healthcare service and to an ambulance service is positively associated with the age of the neighborhood, and whether the neighborhood is a slum, but there is no evidence of association with the exposure to environmental risk factors. In short, the populations living in informal settlements in Argentina are exposed to harmful environmental risk factors. Access to basic healthcare services is limited and does not reflect the elevated exposure to environmental risks. Health, environmental, and economic dimensions should be considered when designing and implementing public policies for vulnerable populations.


Assuntos
Resíduos Industriais , Vulnerabilidade Social , Argentina/epidemiologia , Atenção à Saúde , Humanos , Áreas de Pobreza , Fatores de Risco , População Urbana
8.
Emerg Infect Dis ; 28(10): 2123-2125, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-35960545

RESUMO

We report detection of cases of monkeypox virus infection in Argentina in the context of a marked increase in confounding cases of atypical hand-foot-and-mouth syndrome caused by enterovirus coxsackie A6. We recommend performing an accurate differential virological diagnosis for exanthematous disease in suspected monkeypox cases.


Assuntos
Enterovirus , Doença de Mão, Pé e Boca , Varíola dos Macacos , Argentina/epidemiologia , Diagnóstico Diferencial , Enterovirus/genética , Humanos , Varíola dos Macacos/diagnóstico , Varíola dos Macacos/epidemiologia
9.
Health Place ; 77: 102870, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-35933852

RESUMO

The Covid-19 pandemic has stimulated new appraisals of how social cohesion, including neighborhood-level social capital, fosters resilience in the face of crisis. Several studies suggest better health outcomes in neighborhoods with higher level of social capital, in general and during the pandemic. Building on a growing body of research which suggests that those who live in close-knit neighborhoods have fared better during the pandemic, this article analyzes how social capital influences individual and collective perceptions and attitudes about the experiences of the Covid-19 pandemic in Tucumán, Argentina. To assess this question, we used a mixed-methods approach, combining focus groups, semi-structured interviews, and an online survey (n = 701 respondents) conducted in September 2021. We find widespread experiences of resilience in response to the Covid-19 pandemic, in spite of difficult socioeconomic conditions and perceived poor government performance. Results from logistic regression analysis indicate that perceptions of high neighborhood social capital are associated with more positive outcomes in many dimensions, including personal resilience, ability to cope with uncertainty, perceptions of community solidarity, and reported compliance with public health measures. We further argue that conceptualizations of social cohesion need to be adjusted to local or national-level cultural norms to accurately capture the experience of countries of the Global South.


Assuntos
COVID-19 , Capital Social , Argentina/epidemiologia , COVID-19/epidemiologia , Humanos , Pandemias , Características de Residência
10.
BMC Genomics ; 23(1): 495, 2022 Jul 08.
Artigo em Inglês | MEDLINE | ID: mdl-35804311

RESUMO

BACKGROUND: Shigella specie is a globally important intestinal pathogen disseminated all over the world. In this study we analyzed the genome and the proteomic component of two Shigella flexneri 2a clinical isolates, collected from pediatric patients with gastroenteritis of the Northwest region of Argentina (NWA) in two periods of time, with four years of difference. Our goal was to determine putative changes at molecular levels occurred during these four years, that could explain the presence of this Shigella`s serovar as the prevalent pathogen in the population under study. RESULTS: As previously reported, our findings support the idea of Shigella has a conserved "core" genome, since comparative studies of CI133 and CI172 genomes performed against 80 genomes obtained from the NCBI database, showed that there is a large number of genes shared among all of them. However, we observed that CI133 and CI172 harbors a small number of strain-specific genes, several of them present in mobile genetic elements, supporting the hypothesis that these isolates were established in the population by horizontal acquisition of genes. These differences were also observed at proteomic level, where it was possible to detect the presence of certain secreted proteins in a culture medium that simulates the host environment. CONCLUSION: Great similarities were observed between the CI133 and CI172 strains, confirming the high percentage of genes constituting the "core" genome of S. flexneri 2. However, numerous strain specific genes were also determined. The presence of the here identified molecular elements into other strain of our culture collation, is currently used to develop characteristic markers of local pathogens. In addition, the most outstanding result of this study was the first description of a S. flexneri 2 producing Colicin E, as one of the characteristics that allows S. flexneri 2 to persist in the microbial community. These findings could also contribute to clarify the mechanism and the evolution strategy used by this pathogen to specifically colonize, survive, and cause infection within the NWA population.


Assuntos
Disenteria Bacilar , Shigella , Argentina/epidemiologia , Criança , Genômica , Humanos , Lactente , Proteômica , Shigella flexneri/genética
11.
Salud Colect ; 18: e3730, 2022 03 02.
Artigo em Espanhol | MEDLINE | ID: mdl-35896324

RESUMO

This article analyzes factors affecting food access and consumption on the part of domestic groups during COVID-19 lockdown in Villa 21-24 of the City of Buenos Aires during April and June 2020. In a context marked by high rates of poverty and malnutrition due to excess, it was possible to observe the influence of food environments with abundant ultra-processed and industrialized products, especially flour, through different access channels. The relationship between the role of women and intra-household food management shows that those who bear the burden of hunger are women. Food availability is assured without questioning its quality, but access to food depends on individual management, rendering them invisible as rights-bearing subjects, with a particular impact on children and adolescents.


Se analizan los aspectos que inciden en el acceso y consumo de alimentos, con especial énfasis en aquellos obesogénicos, por parte de grupos domésticos, durante el aislamiento social a causa del COVID-19, en la Villa 21-24 de la Ciudad de Buenos Aires, en los meses de abril y junio de 2020. En un contexto atravesado por graves índices de malnutrición por exceso y por pobreza emerge el peso que poseen los entornos en los que abundan los productos industrializados, sobre todo harinas, y ultraprocesados a través de los distintos canales de acceso. La relación entre el rol de la mujer y la gestión alimentaria intrahogar muestra que quien asume la carga del hambre son las mujeres. La disponibilidad alimentaria está asegurada sin cuestionar su calidad, pero el acceso a los alimentos depende de la gestión individual, invisibilizándose como sujetos de derechos, con especial impacto en niñas, niños y adolescentes.


Assuntos
COVID-19 , Segurança Alimentar , Abastecimento de Alimentos , Quarentena , Adolescente , Argentina/epidemiologia , COVID-19/prevenção & controle , Criança , Cidades , Controle de Doenças Transmissíveis , Feminino , Humanos , Masculino , Pobreza
12.
Artigo em Inglês | MEDLINE | ID: mdl-35897259

RESUMO

This study measured the socioeconomic inequalities in the prevalence of diabetes between 2005 and 2018 in an urban Argentinian population. Data were obtained from the repeated cross-sectional surveys "National Survey of Risk Factors" (ENFR is its acronym in Spanish). From 2005 to 2018, four rounds of ENFR were administered to men and women over 18 years of age. Concentration curves (CC) and the Erreygers concentration index (ECI) were used to describe the socioeconomic inequalities in diabetes' prevalence. A decomposition analysis was performed to determine the contribution of each variable to inequality in diabetes' prevalence. Data from 41,219 (2005), 34,583 (2009), 32,232 (2013), and 29,094 (2018) individuals were analyzed. Women reported a greater prevalence of diabetes compared with men for all the years included. According to the CC and ECI, we found no evidence of inequality in men throughout all study years. For women, throughout all years, the CCs were above the line of equity, and the ECIs during all the years were negative and different from zero (p < 0.01). For women, we found no evidence of a reduction in inequalities between 2005 and 2018 (p = 0.475). The socioeconomic inequality for women was largely driven by public insurance, primary and secondary education, and employment. Diabetes' prevalence was not associated with socioeconomic status in men, while the prevalence of diabetes in women was more concentrated among poorer women. During the 13 years, there was no evidence of a reduction of inequality in women, noting that interventions must prioritize and should focus on the main contribution of inequalities, such as education and employment.


Assuntos
Diabetes Mellitus , Adolescente , Adulto , Argentina/epidemiologia , Estudos Transversais , Diabetes Mellitus/epidemiologia , Feminino , Disparidades nos Níveis de Saúde , Humanos , Masculino , Prevalência , Classe Social , Fatores Socioeconômicos
13.
Endocrine ; 77(3): 493-499, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-35799079

RESUMO

PURPOSE: Non-invasive encapsulated follicular variant of papillary thyroid cancer was reclassified as non-invasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP). These neoplasms have an extremely low malignant potential. The aim of this study was (1) to assess the prevalence of NIFTP in patients with papillary thyroid carcinoma, (2) to evaluate their outcomes, and (3) to determine their molecular profile. METHODS: Multicenter, descriptive, retrospective study. Patients with papillary thyroid cancer diagnosed from January 2006 to December 2016 from 11 referral centers were included. Diagnosis of NIFTP was based on criteria described by Nikiforov et al. in 2018. At least two pathologists agreed on the diagnosis. Two thousand six hundred and seventy-seven papillary thyroid cancer patients were included; 456 (17%) of them were follicular variant papillary thyroid cancer, and 30 (1.12%) fulfilled diagnostic criteria for NIFTP. RESULTS: Each of the 30 included patients underwent a total thyroidectomy, and 50% were treated with radioiodine (median dose 100 mCi). After a median follow-up of 37 months, 84% of patients had an excellent response, 3% had an indeterminate response and data was missing in the remaining 13%. No metastatic lymph nodes, distant metastases or recurrences were found. RAS mutations were detected in 4 patients (13%). CONCLUSION: The prevalence of NIFTP in our series is amongst the lowest reported. Excellent outcomes of patients underscore their low malignant potential. Molecular findings differ from other series, probably related to environmental or ethnic features of our population and the meticulous criteria for diagnosing NIFTP.


Assuntos
Adenocarcinoma Folicular , Neoplasias da Glândula Tireoide , Adenocarcinoma Folicular/diagnóstico , Adenocarcinoma Folicular/epidemiologia , Adenocarcinoma Folicular/genética , Argentina/epidemiologia , Humanos , Radioisótopos do Iodo , Estudos Retrospectivos , Câncer Papilífero da Tireoide/diagnóstico , Câncer Papilífero da Tireoide/epidemiologia , Câncer Papilífero da Tireoide/genética , Neoplasias da Glândula Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/epidemiologia , Neoplasias da Glândula Tireoide/genética
14.
Parasit Vectors ; 15(1): 257, 2022 Jul 13.
Artigo em Inglês | MEDLINE | ID: mdl-35831874

RESUMO

BACKGROUND: Triatomine elimination efforts and the interruption of domestic transmission of Trypanosoma cruzi are hampered by pyrethroid resistance. Fluralaner, a long-lasting ectoparasiticide administered to dogs, substantially reduced site infestation and abundance of pyrethroid-resistant Triatoma infestans Klug (Heteroptera: Reduviidae) in an ongoing 10-month trial in Castelli (Chaco Province, Argentina). We assessed the effects of fluralaner on vector infection with T. cruzi and blood meal sources stratified by ecotope and quantified its medium-term effects on site infestation and triatomine abundance. METHODS: We conducted a placebo-controlled, before-and-after efficacy trial of fluralaner in 28 infested sites over a 22-month period. All dogs received either an oral dose of fluralaner (treated group) or placebo (control group) at 0 month post-treatment [MPT]. Placebo-treated dogs were rescue-treated with fluralaner at 1 MPT, as were all eligible dogs at 7 MPT. Site-level infestation and abundance were periodically assessed by timed manual searches with a dislodging aerosol. Vector infection was mainly determined by kDNA-PCR and blood meal sources were determined by enzyme-linked immunosorbent assay. RESULTS: In fluralaner-treated households, site infestation dropped from 100% at 0 MPT to 18-19% over the period 6-22 MPT while mean abundance plummeted from 5.5 to 0.6 triatomines per unit effort. In control households, infestation dropped similarly post-treatment. The overall prevalence of T. cruzi infection steadily decreased from 13.8% at 0-1 MPT (baseline) to 6.4% and subsequently 2.3% thereafter, while in domiciles, kitchens and storerooms it dropped from 17.4% to 4.7% and subsequently 3.3% thereafter. Most infected triatomines occurred in domiciles and had fed on humans. Infected-bug abundance plummeted after fluralaner treatment and remained marginal or nil thereafter. The human blood index of triatomines collected in domiciles, kitchens and storerooms highly significantly fell from 42.9% at baseline to 5.3-9.1% over the period 6-10 MPT, increasing to 36.8% at 22 MPT. Dog blood meals occurred before fluralaner administration only. The cat blood index increased from 9.9% at baseline to 57.9-72.7% over the period 6-10 MPT and dropped to 5.3% at 22 MPT, whereas chicken blood meals rose from 39.6% to 63.2-88.6%. CONCLUSION: Fluralaner severely impacted infestation- and transmission-related indices over nearly 2 years, causing evident effects at 1 MPT, and deserves larger efficacy trials.


Assuntos
Doença de Chagas , Inseticidas , Piretrinas , Triatoma , Trypanosoma cruzi , Animais , Argentina/epidemiologia , Doença de Chagas/tratamento farmacológico , Doença de Chagas/prevenção & controle , Doença de Chagas/veterinária , Cães , Humanos , Insetos Vetores , Inseticidas/farmacologia , Isoxazóis , Piretrinas/farmacologia
15.
BMC Genomics ; 23(1): 510, 2022 Jul 14.
Artigo em Inglês | MEDLINE | ID: mdl-35836127

RESUMO

BACKGROUND: The SARS-CoV-2 virus is responsible for the COVID-19 pandemic. To better understand the evolution of SARS-CoV-2 early in the pandemic in the Province of Cordoba, Argentina, we performed a comparative genomic analysis of SARS-CoV-2 strains detected in survivors and non-survivors of COVID-19. We also carried out an epidemiological study to find a possible association between the symptoms and comorbidities of these patients with their clinical outcomes. RESULTS: A representative sampling was performed in different cities in the Province of Cordoba. Ten and nine complete SARS-CoV-2 genomes were obtained by next-generation sequencing of nasopharyngeal specimens from non-survivors and survivors, respectively. Phylogenetic and phylodynamic analyses revealed multiple introductions of the most common lineages in South America, including B.1, B.1.1.1, B.1.499, and N.3. Fifty-six mutations were identified, with 14% of those in common between the non-survivor and survivor groups. Specific SARS-CoV-2 mutations for survivors constituted 25% whereas for non-survivors they were 41% of the repertoire, indicating partial selectivity. The non-survivors' variants showed higher diversity in 9 genes, with a majority in Nsp3, while the survivors' variants were detected in 5 genes, with a higher incidence in the Spike protein. At least one comorbidity was present in 60% of non-survivor patients and 33% of survivors. Age 75-85 years (p = 0.018) and hospitalization (p = 0.019) were associated with non-survivor patients. Related to the most common symptoms, the prevalence of fever was similar in both groups, while dyspnea was more frequent among non-survivors and cough among survivors. CONCLUSIONS: This study describes the association of clinical characteristics with the clinical outcomes of survivors and non-survivors of COVID-19 patients, and the specific mutations found in the genome sequences of SARS-CoV-2 in each patient group. Future research on the functional characterization of novel mutations should be performed to understand the role of these variations in SARS-CoV-2 pathogenesis and COVID-19 disease outcomes. These results add new genomic data to better understand the evolution of the SARS-CoV-2 variants that spread in Argentina during the first wave of the COVID-19 pandemic.


Assuntos
COVID-19 , SARS-CoV-2 , Idoso , Idoso de 80 Anos ou mais , Argentina/epidemiologia , COVID-19/epidemiologia , Genoma Viral , Genômica , Humanos , Pandemias , Filogenia , SARS-CoV-2/genética
16.
Arch Soc Esp Oftalmol (Engl Ed) ; 97(7): 396-401, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35779896

RESUMO

OBJECTIVES: To evaluate myopia risk factors, mainly outdoor exposure and reading habits, in a country with low prevalence of myopia (Buenos Aires Province, Argentina). METHODS: Consecutive children interviewed in a clinical private practice setting were autorefracted under cycloplegia with cyclopentolate 1%. Their parents consented to fill a questionnaire about schooling, tutorial classes, outdoor exposure, reading habits, and cellphone use, both on weekdays and weekends. The Spanish questionnaire was based on past English questionnaires of myopia clinical trials. The spherical equivalent of the right eye was used for the refractive distribution. The average daily hours spent for each activity were calculated. RESULTS: This study involved 115 children aged 10.48 ±â€¯3.65 years (range 5-18 years), with 56.5% being girls. Children had 8 h of schooling per day in 62.6% of cases, and only 14.8 % had tutorial classes after school. There were 38.3% myopes (<-0.50 D), 24.3% hyperopes (>+2.00 D) and the rest were emmetropes. The mean time that these children spent outdoors per day was 3.94 ±â€¯1.45 h (27.60 ±â€¯10.16 h per week). The total mean time spent reading and writing per day was 1.50 ±â€¯0.98 h, and that spent using cellphones and tablets was 2.43 ±â€¯1.66 h. CONCLUSION: In an environment with low myopia prevalence, children spend almoast 4 h per day outdoors, much more than the usual recommendation of 2 h a day for myopia prevention.


Assuntos
Hiperopia , Miopia , Argentina/epidemiologia , Criança , Olho , Feminino , Humanos , Masculino , Miopia/epidemiologia , Miopia/etiologia , Refração Ocular
17.
Rev Bras Epidemiol ; 25: e220018, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35792798

RESUMO

OBJECTIVE: To assess the impact of the COVID-19 pandemic on mortality in Argentina, considering temporal trends in life expectancy at birth and premature mortality rate during 2010-2020. METHODS: Based on demographic projections, this ecological time-series study compares a "normal" versus a "COVID-19" mortality scenario for 2020 over a set of 11 Argentine provinces. Annual life expectancy at birth and age-standardized rates of premature mortality were estimated from 2010 to 2020. Joinpoint regression and multilevel models were used. RESULTS: A potential reduction in life expectancy at birth (a gap between scenarios >1 year) was observed. A significant (negative) point of inflection in temporal trends was identified for the country and most of the provinces, under the COVID-19 mortality scenario. However, our findings reveal disparities between provinces in the estimated life expectancy reduction toward 2020 (values range from -0.63 to -1.85 year in females and up to -2.55 years in males). While men showed more accentuated declines in life expectancy at birth in 2020 (a national gap between scenarios of -1.47 year in men vs. -1.35 year in women), women experienced more unfavorable temporal trends of premature mortality. In the absence of COVID-19, an improvement in both indicators was estimated toward 2020 in both sexes, while a return to levels reported in the past was observed under the COVID-19 scenario. CONCLUSION: The COVID-19 pandemic might seriously affect the trends of mortality and exacerbate health disadvantages in Argentina. A temporal and contextual perspective of health inequities merits special attention in the COVID-19 research.


Assuntos
COVID-19 , Argentina/epidemiologia , Brasil , Feminino , Humanos , Recém-Nascido , Expectativa de Vida , Masculino , Pandemias
18.
Med. intensiva (Madr., Ed. impr.) ; 46(7): 372-382, jul. 2022. ilus, tab, graf
Artigo em Espanhol | IBECS | ID: ibc-207848

RESUMO

Objetivo Describir las prácticas relacionadas a ventilación mecánica (VM) en Argentina y explorar los factores asociados a la mortalidad en UCI en esta población. Diseño Se realizó un estudio observacional, prospectivo, multicéntrico. Ámbito Unidad de Cuidados Intensivos. Pacientes Incluimos pacientes mayores de 18 años ingresados en las UCI participantes que requirieron VM invasiva durante al menos 12 horas desde el ingreso a la institución de salud. Intervenciones Ninguna. Variables Todas las variables se clasificaron en tres categorías: variables relacionadas con factores demográficos y clínicos antes de la VM, factores relacionados con el primer día de VM, y factores relacionados con los eventos ocurridos durante la VM (complicaciones y destete de la VM). El destete de la ventilación mecánica y la mortalidad se clasificaron según WIND (Weaning according to a New Definition). Resultados El análisis primario incluyó a 950 pacientes. La principal indicación de VM fue insuficiencia respiratoria aguda (58% de los pacientes). El modo de ventilación inicial fue ventilación mandatoria continua con control de volumen en el 75% de los casos. La mortalidad en UCI y hospitalaria fue del 44,6% y 47,9%, respectivamente. Las variables identificadas como predictoras independientes de mortalidad en UCI fueron edad (OR 3,48 IC 95%, 1,22-11,66; p=0,028), fracaso en la implementación de ventilación mecánica no invasiva (VNI) antes de VM (OR 2,76, IC 95%, 1,02-7,10; p=0,038), diagnóstico de sepsis (OR 2,46, IC 95%, 1,09-5,47; p=0,027) y fracaso de la extubación (OR 4,50, IC 95%, 2,05-9,90; p<0,001). Conclusiones El presente estudio permitió describir las características y evolución clínica de los pacientes que recibieron ventilación mecánica en Argentina, encontrando como principal resultado que la mortalidad fue mayor a la reportada en estudios internacionales (AU)


Objetive To describe mechanical ventilation (MV) practices in Argentina, and to explore factors associated with ICU mortality in this population. Design A prospective, multicenter, observational study was carried out. Setting Intensive Care. Patients We enrolled patients above 18 years old admitted to any of the participating ICUs requiring invasive MV for at least 12hours since the admission to the healthcare institution, including MV initiation in emergency department, operating room or other hospitals. Interventions None. Variables All variables were classified into three categories: variables related to demographic and clinical factors before the MV, factors related to the first day on MV, and factors related to events happening during the MV (complications and weaning from MV). Mechanical ventilation weaning and mortality were classified according to WIND. Results The primary analysis included 950 patients. The main indication for MV was acute respiratory failure (58% of patients). Initial ventilation mode was volume control-continuous mandatory ventilation in 75% of cases. ICU and hospital mortality were 44.6% and 47.9% respectively. The variables identified as independent predictors of mortality in ICU were age (OR3.48 IC95% 1.22-11.66; p=0.028), failure to implement NIV before MV (OR 2.76, IC 95%, 1.02-7.10; p=0.038), diagnosis of sepsis (OR 2.46, IC 95%, 1.09-5.47; p=0.027) and extubation failure (OR 4.50, IC 95%, 2.05-9.90; p<0.001). Conclusions The present study allowed us to describe the characteristics and clinical course of the patients who received mechanical ventilation in Argentina, finding as the main result that mortality was higher than that reported in international studies (AU)


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Unidades de Terapia Intensiva/estatística & dados numéricos , Respiração Artificial/estatística & dados numéricos , Desmame do Respirador , Mortalidade Hospitalar , Estudos Prospectivos , Argentina/epidemiologia
20.
Stud Health Technol Inform ; 290: 219-221, 2022 Jun 06.
Artigo em Inglês | MEDLINE | ID: mdl-35673004

RESUMO

WHO and UNICEF highlight vaccination as the most cost-effective method of prevention of infectious diseases. An effective public health strategy requires efficient tracking of vaccination to assess coverage, safety, and efficacy of these vaccines. Paper-based immunization records are still being used in most low and middle-income countries. Adequate Electronic Logistic Management Information Systems, Immunization Registries and Records are crucial for proper data collection and analysis, and for making better decisions at an individual and at a population level. In this paper we share our experience in the redesign of an interoperable immunization record to track vaccination, including the recently developed vaccines for the novel coronavirus SARS-CoV-2 (COVID-19).


Assuntos
COVID-19 , Vacinas , Argentina/epidemiologia , COVID-19/epidemiologia , COVID-19/prevenção & controle , Hospitais , Humanos , Imunização , Programas de Imunização , Pandemias/prevenção & controle , SARS-CoV-2 , Vacinação
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