Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 53.001
Filtrar
1.
Environ Sci Technol ; 55(12): 8203-8214, 2021 06 15.
Artigo em Inglês | MEDLINE | ID: mdl-34081443

RESUMO

Air pollution exposure is a risk factor for arrhythmia. The atrioventricular (AV) conduction axis is key for the passage of electrical signals to ventricles. We investigated whether environmental nanoparticles (NPs) reach the AV axis and whether they are associated with ultrastructural cell damage. Here, we demonstrate the detection of the shape, size, and composition of NPs by transmission electron microscopy (TEM) and energy-dispersive X-ray spectrometry (EDX) in 10 subjects from Metropolitan Mexico City (MMC) with a mean age of 25.3 ± 5.9 and a 71-year-old subject without cardiac pathology. We found that in every case, Fe, Ti, Al, Hg, Cu, Bi, and/or Si spherical or acicular NPs with a mean size of 36 ± 17 nm were present in the AV axis in situ, freely and as conglomerates, within the mitochondria, sarcomeres, lysosomes, lipofuscin, and/or intercalated disks and gap junctions of Purkinje and transitional cells, telocytes, macrophages, endothelium, and adjacent atrial and ventricular fibers. Erythrocytes were found to transfer NPs to the endothelium. Purkinje fibers with increased lysosomal activity and totally disordered myofilaments and fragmented Z-disks exhibited NP conglomerates in association with gap junctions and intercalated disks. AV conduction axis pathology caused by environmental NPs is a plausible and modifiable risk factor for understanding common arrhythmias and reentrant tachycardia. Anthropogenic, industrial, e-waste, and indoor NPs reach pacemaker regions, thereby increasing potential mechanisms that disrupt the electrical impulse pathways of the heart. The cardiotoxic, oxidative, and abnormal electric performance effects of NPs in pacemaker locations warrant extensive research. Cardiac arrhythmias associated with nanoparticle effects could be preventable.


Assuntos
Resíduo Eletrônico , Mercúrio , Nanopartículas , Taquicardia por Reentrada no Nó Atrioventricular , Idoso , Arritmias Cardíacas/induzido quimicamente , Nó Atrioventricular , Humanos , Resíduos Industriais , México , Titânio
2.
Artigo em Inglês | MEDLINE | ID: mdl-34070295

RESUMO

The aim of this study was to explore the knowledge, emotions and perceived stressors by healthcare workers who were in contact with infected patients during the COVID-19 outbreak. An online cross-sectional survey was applied. Data were collected from N = 263 healthcare workers in Tabasco State, Mexico. We developed and administered a questionnaire, which consisted of sociodemographic characteristics, plus four sections. The sections evaluated were (1) knowledge of COVID-19; (2) feelings/emotions during the COVID-19 outbreak; (3) factors that caused stress and (4) factors that helped to reduce stress. Surveyed individuals were divided into three groups: physicians, nurses and other healthcare workers. When we evaluated their knowledge of COVID-19 we observed that the majority of healthcare workers in the three groups reported that they knew about COVID-19. Physicians indicated that they felt insecure about practicing their profession (62.5%) due to the high risk of being in contact with SARS-CoV-2. With regards to stressor factors, the risk of transmitting COVID-19 to their families was the main factor causing moderate to high stress (95.4%). Finally, we found that "your profession puts your life at risk" was the only factor associated with feeling nervous and scared (PR: 3.15; 95% CI: 1.54-6.43). We recommended health education campaigns, introductory courses on COVID-19 and other infectious diseases, management protocols and the provision of protection equipment to health workers in order to reduce personal and professional fears of contagion and to improve the health system in Mexico when facing epidemics.


Assuntos
COVID-19 , Estudos Transversais , Surtos de Doenças , Emoções , Pessoal de Saúde , Humanos , México/epidemiologia , SARS-CoV-2 , Inquéritos e Questionários
3.
Sensors (Basel) ; 21(11)2021 May 30.
Artigo em Inglês | MEDLINE | ID: mdl-34070754

RESUMO

Today, the world is experiencing the COVID-19 health contingency, which prevents people from being exposed to one another and restricts physical contact. Under this context, the use of technology has become an essential tool to face the challenges of daily life, and virtual reality can be an alternative in the development of solutions that effectively support the acquisition of learning skills and knowledge transmission through the execution of tasks designed by multi-disciplinary groups. In addition, it can encourage the user to continue with the acquisition of learning skills in a friendly and fun way in a health and education context. This work proposes the use of virtual reality environments as an alternative to support the learning process in children with special educational needs such as Attention Deficit Hyperactivity Disorder (ADHD) and other associated disorders that occur in basic education. These proposed reality environments are designed under the Lean UX process model and their contents are designed according to expert therapeutic guidelines. As a result of this proposal, a case study is presented in which the user experience is evaluated through the use of an interactive environment to support the special educational needs of elementary school children attending an educational institution in Mexico.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , COVID-19 , Realidade Virtual , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Criança , Humanos , México , SARS-CoV-2 , Instituições Acadêmicas
4.
Artigo em Inglês | MEDLINE | ID: mdl-34067094

RESUMO

Background: Suicide and suicidal behaviors were already a global public health problem, producing preventable injuries and deaths. This issue may worsen due to the COVID-19 pandemic and may differentially affect vulnerable groups in the population, including children, adolescents, and young adults. The current study evaluated the association of affective variables (depression, hopelessness, and anxiety), drug use (alcohol, tobacco, and others), emotional intelligence, and attachment with suicidal behaviors. Methods: A state-wide survey included 8033 students (51% female, 49% male; mean age of 16 years) from science and technology high-schools using a standardized questionnaire that was distributed online. Multinomial logistic regression models tested associations between suicidal behaviors and several covariates. The analyses accommodated the complex structure of the sample. Results: Approximately 21% of all students reported a suicidal behavior (11% with a low-lethality suicide attempt, 6% with self-injuries, and 4% with a high-lethality suicide attempt). Variables associated with higher odds of suicidal behavior included: female sex, depression, hopelessness, anxiety, alcohol and tobacco use, childhood trauma, and having to self-rely as issues affecting attachment, and low self-esteem. Security of attachment was associated with lower odds of suicidal behavior. Conclusions: The complexity of suicidal behavior makes it clear that comprehensive programs need to be implemented.


Assuntos
COVID-19 , Pandemias , Adolescente , Criança , Estudos Transversais , Feminino , Humanos , Masculino , México/epidemiologia , Fatores de Risco , SARS-CoV-2 , Ideação Suicida , Adulto Jovem
5.
Artigo em Inglês | MEDLINE | ID: mdl-34069747

RESUMO

BACKGROUND: The aim of the present study was to determine the association between the health-related quality of life (HRQoL) with sociodemographic parameters and lifestyle during COVID-19 confinement in Mexico, Chile, and Spain. METHODS: A cross-sectional pilot study, with 742 observations of online surveys in 422, 190, and 130 individuals from Mexico, Chile, and Spain, respectively. Sociodemographic data, presence of comorbidities, food habits, and physical activity (PA) patterns were evaluated. The HRQoL was evaluated according to the SF-36 Health Survey. The multilinear regression analysis was developed to determine the association of variables with HRQoL and its physical and mental health dimensions. RESULTS: The female sex in the three countries reported negative association with HRQoL (Mexico: ß -4.45, p = 0.004; Chile: ß -8.48, p < 0.001; Spain: ß -6.22, p = 0.009). Similarly, bad eating habits were associated negatively with HRQoL (Mexico: ß -6.64, p < 0.001; Chile: ß -6.66, p = 0.005; Spain: ß -5.8, p = 0.032). In Mexico, PA limitations presented a negative association with HRQoL (ß -4.71, p = 0.011). In Chile, a sedentary lifestyle (h/day) was linked negatively with HRQoL (ß -0.64, p = 0.005). In Spain, the highest associations with HRQoL were the presence of comorbidity (ß -11.03, p < 0.001) and smoking (ß -6.72, p = 0.02). Moreover, the PA limitation in Mexico (ß -5.67, p = 0.023) and Chile (ß -9.26, p = 0.035) was linked negatively with mental health. CONCLUSIONS: The bad eating habits, PA limitations, female sex, comorbidity presence, and smoking were parameters linked negatively with HRQoL.


Assuntos
COVID-19 , Qualidade de Vida , Chile/epidemiologia , Estudos Transversais , Feminino , Humanos , Estilo de Vida , México/epidemiologia , Projetos Piloto , SARS-CoV-2 , Espanha/epidemiologia , Inquéritos e Questionários , Estados Unidos
6.
Cien Saude Colet ; 26(suppl 1): 2471-2482, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34133627

RESUMO

To describe a general overview of health services delivery in Mexico and geospatially analyze the current distribution and accessibility of Primary Health Care (PHC) facilities to contribute to new approaches to improve healthcare planning in Mexico. We performed a spatial analysis of official data to analyze current distances from health facilities to population, to determine the underserved areas of health services delivery in three selected states using a ranking of indicators. We estimated service area coverage of PHC facilities with road networks of three Mexican states (Chiapas, Guerrero, and Oaxaca). Our estimations provide an overview of spatial access to healthcare of the Mexican population in Mexico's three most impoverished states. We did not consider social security nor private providers. Geospatial access to health facilities is critical to achieving PHC and adequate coverage. Countries like Mexico must measure this to identify underserved areas with a lack of geospatial access to healthcare to solve it. This type of analysis provides critical information to help decision-makers decide where to build new health facilities to increase effective geospatial access to care and to achieve Universal Health Coverage.


Assuntos
Sistemas de Informação Geográfica , Acesso aos Serviços de Saúde , Instalações de Saúde , Humanos , México , Cobertura Universal do Seguro de Saúde
7.
Water Sci Technol ; 83(11): 2724-2731, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34115626

RESUMO

Mezcal is an alcoholic artisanal drink made from agave plants in Mexico. Its production causes the generation of wastewater called vinasses, which are highly polluting residues due to its concentration of organic matter as chemical oxygen demand (COD) (35,000-122,000 mg/L) and acidity (pH < 4). Due to their organic content, these residues can be used in dark fermentation to obtain biogas, which is rich in hydrogen. In this work, the acclimation of inoculum by means of a dark fermentation process, in the presence of toxic compounds from mezcal vinasses was studied. The strategy of increasing the initial concentration of vinasse in each treatment cycle in a sequencing batch reactor (SBR) reactor was applied. It was possible to obtain a maximum biogas production of 984 ± 187 mL/L, from vinasses (18,367 ± 1,200 mg COD/L), with an organic matter removal efficiency of 20 ± 1%. A maximum generation of volatile fatty acids (VFA) of 980 ± 538 mg/L equivalent to a production of 74 ± 21% of the influent concentration and removal rate of organic matter of 1,125 ± 234 mg COD/L d-1 equivalent to a removal efficiency of 20 ± 4% was obtained from vinasses with a concentration of 19,648 ± 1,702 mg COD/L.


Assuntos
Biocombustíveis , Eliminação de Resíduos Líquidos , Aclimatação , Anaerobiose , Reatores Biológicos , Ácidos Graxos Voláteis , Fermentação , México
8.
Environ Monit Assess ; 193(7): 418, 2021 Jun 13.
Artigo em Inglês | MEDLINE | ID: mdl-34120273

RESUMO

Mexican Lake Chapala is used as water supply for human consumption. Consequently, water quality of this lake is of paramount importance for the lake's wellbeing. The contribution presented in this paper investigates monitoring and assessment of lake water quality using water quality index (WQI), metal chemical speciation, and multivariate statistical techniques. Descriptive statistics shows total metal concentrations undetected conferring the lake a healthy status. Dissolved Cd and Pb exceed criterion continuous concentration limit, whereas Zn is below this limit indicating that water quality is satisfactory for aquatic life. However, WQI indicates poor water quality attributed to failure of conductivity, total solids, nitrogen, and phosphates, due to industrial and agro-industrial effluents. Metal speciations indicate that the presence of low concentrations of dissolved metals reflect interactions with gills of fish through metal-biotic ligand complexes affecting water quality. Positive correlations are obtained between conductivity and nitrates, indicating that agricultural activities and fertilizer runoffs increase the conductivity and that the environmental state of lake is being altered by human activities. Factors F1 (31%), F2 (19%), and F3 (11%) represent 61% of variability; F1 and F2 corroborate the pressure exerted by pollutants related with fertilizers and agrochemicals; F3 contains Zn and Pb with positive loads attributed to influx of tourist visitors. Sites S4, S5, S6, and S9 are identified as the most environmentally affected by COD, Alk*, pH, Cl-, nitrites, phosphates, and TS. Multivariate techniques permit to conclude that environmental stress of Lake Chapala is caused by variables pertaining to agrochemical, fertilizers and municipal wastes.


Assuntos
Metais Pesados , Poluentes Químicos da Água , Animais , Monitoramento Ambiental , Humanos , Lagos , Metais Pesados/análise , México , Poluentes Químicos da Água/análise , Qualidade da Água
9.
BMC Infect Dis ; 21(1): 510, 2021 May 31.
Artigo em Inglês | MEDLINE | ID: mdl-34059022

RESUMO

OBJECTIVE: To determine the prevalence of Latent Tuberculosis in patients with hematological neoplasms at the Instituto Nacional de Cancerología in Mexico City using the Tuberculin skin test (TST). METHODS: This retrospective study included all patients with a recent diagnosis of hematological neoplasms who were admitted for treatment from 2017 to 2018 and who were screened for latent tuberculosis with the TST. The prevalence of latent tuberculosis in this group, tolerance and therapeutic adherence in treated patients are described. RESULTS: The files of 446 patients with hematological malignancy who had a TST were reviewed. The prevalence of latent tuberculosis was 31.2% (n = 139). Ninety-three patients received isoniazid, 15.1% had some adverse reactions, but only 4 (4.3%) had to discontinue treatment. Two patients with latent tuberculosis under treatment with Isoniazid reactivated tuberculosis infection. CONCLUSIONS: The prevalence in our study was within the range of other similar Mexican populations. Isoniazid treatment had an adequate tolerance and adherence. Longer follow-up could offer more information on the risk of reactivation in both groups.


Assuntos
Neoplasias Hematológicas/epidemiologia , Tuberculose Latente/epidemiologia , Adulto , Antituberculosos/efeitos adversos , Antituberculosos/uso terapêutico , Institutos de Câncer , Feminino , Neoplasias Hematológicas/microbiologia , Humanos , Isoniazida/efeitos adversos , Isoniazida/uso terapêutico , Tuberculose Latente/diagnóstico , Tuberculose Latente/tratamento farmacológico , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Mycobacterium tuberculosis/efeitos dos fármacos , Prevalência , Estudos Retrospectivos , Teste Tuberculínico , Tuberculose/epidemiologia , Tuberculose/etiologia
10.
Braz Oral Res ; 35(suppl 01): e054, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34076078

RESUMO

Dental caries remains highly prevalent in Latin American and Caribbean countries (LACC). However, this disease can be controlled through interventions that implement evidence-based strategies in an affordable manner and that target all population groups instead of the most affluent only. Therefore, the aim of this report was to summarize the main scientifically documented community interventions and strategies based on restriction of sugars consumption, use of fluoride, and the use of occlusal sealants for caries control in LACC. A critical literature review was carried out in a systematic manner that included defined search strategies, independent review of the identified publications, and compilation of results in this report. Three systematic searches were conducted using the PubMed, LILACS, and SciELO databases to identify studies related to community interventions and strategies for caries control in LACC. Of the 37 publications identified, twenty-six focused on fluoride use, eight on occlusal sealant use, and three on the restriction of sugar consumption. Documented community interventions for sugars restriction were scarce in the region and were based on food supplementation, sugar replacement, and education. Thus, local and/or national policies should prioritize investment in upstream, coherent, and integrated population-wide policies such as taxes on sugary drinks and stronger regulation of advertising and promotion of sugary foods and drinks mainly targeting children. The main fluoride-based strategies used drinking water, refined domestic salt, cow milk, toothpaste and, to a lesser extent, mouth-rinses, acidulated phosphate fluoride (APF) gels, and varnishes to deliver fluoride to the population. Evidence of fluoride use was seen in Argentina, Belize, Bolivia, Brazil, Chile, Colombia, Costa Rica, Cuba, Dominican Republic, Ecuador, El Salvador, Guatemala, Haiti, Honduras, Mexico, Nicaragua, Panama, Paraguay, Peru, Uruguay, and Venezuela. Studies reporting the use of occlusal sealants were mainly located in Brazil, Chile, Colombia, Costa Rica, Peru, Mexico, and Venezuela. Community interventions restricting sugar consumption should be implemented at the individual level and through public policies. The use of fluoride must be monitored at the local, regional, and national levels so as to achieve maximum anti-caries effect while also minimizing the risk of dental fluorosis. Moreover, fluoridated water and salt programs, used as a mutually exclusive community level strategy for caries control, should expand their benefits to reach non-covered areas of the LACC while also simultaneously providing adequate surveillance of the fluoride concentration delivered to the population. Regulating the concentration of soluble fluoride (for anti-caries effect) in dentifrice formulations is also necessary in order to provide the population with an effective strategy for disease control. Targeting culturally appropriate, economically sustainable caries control interventions to rural populations and native ethnic groups such as indigenous people, quilombolas (African-origin), and riverside Amazonian people remains a crucial challenge.


Assuntos
Cariostáticos , Cárie Dentária , Argentina , Brasil , Região do Caribe , Cariostáticos/uso terapêutico , Criança , Chile , Colômbia , Cárie Dentária/epidemiologia , Cárie Dentária/prevenção & controle , Suscetibilidade à Cárie Dentária , Guatemala , Humanos , América Latina/epidemiologia , México , Nicarágua , Panamá , Peru , Uruguai
11.
Exp Appl Acarol ; 84(2): 365-388, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34061290

RESUMO

Citrus leprosis is a viral disease vectored by the mites Brevipalpus californicus and Brevipalpus yothersi. This work aimed to determine the potential areas for establishment of both mites and viruses in Mexico, based on the geographical distribution of the hosts and the climatic suitability for the vectors. Life tables of both mites were constructed to determine their thermal requirements-base temperature and degree-days required to complete life cycle-and population growth parameters-net reproduction rate, generation time, and intrinsic growth rate. For this, the mites were confined in Citrus aurantium fruits at 20, 22.5, 25 or 30 °C, 60 ± 5% RH and L14:D10 h photoperiod. Maps were generated where the climatic suitability for establishment of the mites and the citrus leprosis viruses was estimated in citrus-producing municipalities. The climatic suitability was determined through historical temperature records to calculate the potential number of generations per year, and ecological niche modeling based on collecting localities and bioclimatic variables using the algorithm Maxent. The base temperature was 9.5 °C for B. californicus and 10.2 °C for B. yothersi; degree-days required to reach adulthood were 372.1 and 331.7 °C, respectively. Potential sites for establishment of B. yothersi are mostly lowlands, whereas for B. californicus they are both lowlands and highlands. Temperature data indicate that B. californicus has fewer sites where it can develop > 16 generations per year than B. yothersi. According to our results, the sites where citrus leprosis is most likely to present high incidence are the sweet orange cultivars bordering the Gulf of Mexico.


Assuntos
Citrus , Ácaros , Rhabdoviridae , Animais , México , Doenças das Plantas
12.
PLoS One ; 16(6): e0251722, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34061864

RESUMO

BACKGROUND: Mexican state governments' actions are essential to control the COVID-19 pandemic within the country. However, the type, rigor and pace of implementation of public policies have varied considerably between states. Little is known about the subnational (state) variation policy response to the COVID-19 pandemic in Mexico. MATERIAL AND METHODS: We collected daily information on public policies designed to inform the public, as well as to promote distancing, and mask use. The policies analyzed were: School Closure, Workplace Closure, Cancellation of Public Events, Restrictions on Gatherings, Stay at Home Order, Public Transit Suspensions, Information Campaigns, Internal Travel Controls, International Travel Controls, Use of Face Masks We use these data to create a composite index to evaluate the adoption of these policies in the 32 states. We then assess the timeliness and rigor of the policies across the country, from the date of the first case, February 27, 2020. RESULTS: The national average in the index during the 143 days of the pandemic was 41.1 out of a possible 100 points on our index. Nuevo León achieved the highest performance (50.4); San Luis Potosí the lowest (34.1). The differential between the highest versus the lowest performance was 47.4%. CONCLUSIONS: The study identifies variability and heterogeneity in how and when Mexican states implemented policies to contain COVID-19. We demonstrate the absence of a uniform national response and widely varying stringency of state responses. We also show how these responses are not based on testing and do not reflect the local burden of disease. National health system stewardship and a coordinated, timely, rigorous response to the pandemic did not occur in Mexico but is desirable to contain COVID-19.


Assuntos
COVID-19/epidemiologia , COVID-19/prevenção & controle , Regulamentação Governamental , Política de Saúde/legislação & jurisprudência , Pandemias , Distanciamento Físico , SARS-CoV-2/patogenicidade , COVID-19/transmissão , Humanos , Máscaras/provisão & distribuição , México/epidemiologia , Quarentena/legislação & jurisprudência , Quarentena/organização & administração , Viagem
13.
Exp Appl Acarol ; 84(2): 473-484, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34089463

RESUMO

In total, 57 ticks were collected from six white-tailed deer (Odocoileus virginianus) and three mule deer (O. hemionus) in northern Mexico during the 2017, 2018 and 2019 hunting seasons. Morphological features of adult male and female ticks were observed and photographed using a stereo-microscope and scanning electron micrography. The ticks were identified as Dermacentor albipictus based on taxonomic keys. Molecular analysis using DNA amplification of the 16S rDNA and cytochrome oxidase 1 (COI) genes was employed to resolve the phylogenetic relationships from 18 strains of Dermacentor species. Bayesian phylogenetic analysis was performed in order to obtain a phylogenetic tree based on the concatenated sequence in the D. albipictus clade. The geometric morphometric analysis compared the body shape of ticks collected from specimens of two deer species by analyzing nine dorsal and ventral landmarks from both males and females. The results suggest that body shape variation in dorsal structures might be related to the host.


Assuntos
Cervos , Dermacentor , Animais , Teorema de Bayes , Feminino , Masculino , México , Filogenia
14.
Medicina (Kaunas) ; 57(5)2021 May 03.
Artigo em Inglês | MEDLINE | ID: mdl-34063699

RESUMO

Since the onset of the COVID-19 pandemic, there have been multiple questions regarding reinfections associated with SARS-CoV-2. Healthcare workers on duty, due to overexposure in environments where there are more cases of COVID-19, are more prone to become infected by this virus. Here, we report 4 cases that meet the definition of clinical reinfection by SARS-CoV-2, as well as a literature review on this subject; all occurred in healthcare workers in Acapulco Guerrero, Mexico who provide their services in a hospital that cares for patients with COVID-19. The time between the manifestation of the first and second infection for each case was 134, 129, 107 and 82 days, all patients presented symptomatology in both events. The time between remission of the first infection and onset of second infection was 108, 109, 78 and 67 days for each case, while the time to confirmation by reverse transcription polymerase chain reaction (RT-PCR) between infections was 134, 124, 106 and 77 days. In two of the four cases the reinfection resulted in a more severe case, while in the remaining two cases the manifestation of symptoms and complications was similar to that presented in the first infection. Given this scenario, greater care is needed in the management of the pandemic caused by SARS-CoV-2 to protect healthcare workers and the general public from risks and complications caused by a possible reinfection by SARS-CoV-2.


Assuntos
COVID-19 , SARS-CoV-2 , Pessoal de Saúde , Humanos , México/epidemiologia , Pandemias , Reinfecção
15.
Artigo em Inglês | PAHO-IRIS | ID: phr-54151

RESUMO

[ABSTRACT]. Objective. To describe the immunogenicity and safety of a tetravalent dengue vaccine (TAK-003) in healthy adolescents living in Mexico City, an area considered non-endemic for dengue (NCT03341637). Methods. Participants aged 12–17 years were randomized 3:1 to receive two doses (Month 0 and Month 3) of TAK-003 or placebo. Immunogenicity was assessed by microneutralization assay of dengue neutralizing antibodies at baseline, Months 4 and 9. Solicited and unsolicited adverse events (AEs) were recorded after each vaccination. Serious (SAEs) and medically-attended AEs (MAAEs) were recorded throughout the study. Results. 400 adolescents were enrolled, 391 (97.8%) completed the study. Thirty-six (9%) were baseline seropositive to ≥1 serotypes (reciprocal titer ≥10). Geometric mean titers (GMTs) in baseline seronegative TAK-003 recipients were 328, 1743, 120, and 143 at Month 4, and 135, 741, 46, and 38 at Month 9 against DENV-1, -2, -3, and -4, respectively. Placebo GMTs remained <10. Tetravalent seropositivity rates in vaccine recipients were 99.6% and 85.8% at Months 4 and 9, respectively. One MAAE in each group was considered treatment-related (TAK-003: injection-site erythema, and placebo: pharyngitis). Conclusion. TAK-003 was immunogenic against all four serotypes and was well tolerated in dengue-naïve adolescents living in Mexico City.


[RESUMEN]. Objetivo. Describir la inmunogenicidad y la seguridad de una vacuna tetravalente contra el dengue (TAK-003) en adolescentes sanos residentes en Ciudad de México, considerada un área no endémica de dengue (NCT03341637). Métodos. Se asignó de manera aleatoria a un grupo de participantes de 12 a 17 años en una proporción 3:1 para que recibieran dos dosis (en el mes 0 y en el mes 3) de la vacuna TAK-003 o de un placebo. Se evaluó la inmunogenicidad mediante un análisis de microneutralización de anticuerpos neutralizantes del virus del dengue al inicio del estudio y en los meses 4 y 9. Se registraron los eventos adversos de notificación solicitada y los referidos por iniciativa propia después de cada vacunación. A lo largo del estudio se registraron los eventos adversos graves y los que requirieron atención médica. Resultados. Participaron 400 adolescentes y 391 (97,8%) finalizaron el estudio. 36 adolescentes (9%) fueron seropositivos a ≥1 serotipos (título recíproco ≥10) al inicio del estudio. La media geométrica de los títulos en las personas seronegativas vacunadas con TAK-003 al inicio del estudio fue de 328, 1743, 120 y 143 en el mes 4 y 135, 741, 46 y 38 en el mes 9 en relación con DENV-1, -2, -3 y -4, respectivamente. La media geométrica de los títulos de las personas que recibieron un placebo se mantuvo en <10. Las tasas de seropositividad tetravalente en los vacunados fueron 99,6% y 85,8% a los meses 4 y 9, respectivamente. Se consideró relacionado con el tratamiento un evento adverso con atención médica que tuvo lugar en cada grupo (TAK-003: eritema en el lugar de la inyección; placebo: faringitis). Conclusiones. TAK-003 fue inmunogénica ante los cuatro serotipos y bien tolerada en los adolescentes sin exposición previa al dengue que vivían en Ciudad de México.


[RESUMO]. Objetivo. Descrever a imunogenicidade e a segurança de uma vacina tetravalente contra dengue (TAK-003) em adolescentes saudáveis residentes da Cidade do México, área considerada não endêmica para dengue (ClinicalTrials.gov: NCT03341637). Métodos. Participantes com idade entre 12 e 17 anos foram randomizados a uma proporção de 3:1 para receber duas doses da vacina TAK-003 ou placebo (no mês 0 e no mês 3). A imunogenicidade foi avaliada pelos títulos de anticorpos neutralizantes contra dengue determinados em ensaio de microneutralização ao início do estudo, no mês 4 e no mês 9. A ocorrência de eventos adversos solicitados ou espontâneos foi registrada após cada rodada de vacinação. Eventos adversos graves e eventos adversos que exigiram atendimento médico foram monitorados ao longo de todo o estudo. Resultados. De 400 adolescentes incluídos na amostra estudada, 391 (97,8%) completaram o estudo. Trinta e seis (9%) apresentaram positividade basal a um ou mais sorotipos virais da dengue (título recíproco ≥10). A média geométrica dos títulos de anticorpos nos vacinados com TAK-003 que eram soronegativos ao início do estudo foi de 328, 1743, 120 e 143 no mês 4 e 135, 741, 46 e 38 no mês 9, contra os sorotipos virais DENV-1, DENV-2, DENV-3 e DENV-4, respectivamente. A média geométrica dos títulos de anticorpos no grupo placebo se manteve abaixo de 10. A taxa de soropositividade tetravalente nos vacinados foi de 99,6% no mês 4 e 85,8% no mês 9. Um único evento adverso que exigiu atendimento médico em cada grupo foi considerado relacionado ao tratamento (eritema no local de aplicação no grupo TAK-003 e faringite no grupo placebo). Conclusão. A vacina TAK-003 demonstrou ser imunogênica contra os quatro sorotipos virais da dengue e foi bem tolerada em adolescentes residentes da Cidade do México sem história pregressa de infecção pela dengue.


Assuntos
Vacinas , Adolescente , Imunogenicidade da Vacina , Segurança , Dengue , México , Vacinas , Adolescente , Imunogenicidade da Vacina , Segurança , México , Vacinas , Imunogenicidade da Vacina , Segurança
16.
BMC Infect Dis ; 21(1): 432, 2021 May 07.
Artigo em Inglês | MEDLINE | ID: mdl-33962563

RESUMO

BACKGROUND: Low testing rates and delays in reporting hinder the estimation of the mortality burden associated with the COVID-19 pandemic. During a public health emergency, estimating all cause excess deaths above an expected level of death can provide a more reliable picture of the mortality burden. Here, we aim to estimate the absolute and relative mortality impact of COVID-19 pandemic in Mexico. METHODS: We obtained weekly mortality time series due to all causes for Mexico, and by gender, and geographic region from 2015 to 2020. We also compiled surveillance data on COVID-19 cases and deaths to assess the timing and intensity of the pandemic and assembled weekly series of the proportion of tweets about 'death' from Mexico to assess the correlation between people's media interaction about 'death' and the rise in pandemic deaths. We estimated all-cause excess mortality rates and mortality rate ratio increase over baseline by fitting Serfling regression models and forecasted the total excess deaths for Mexico for the first 4 weeks of 2021 using the generalized logistic growth model. RESULTS: We estimated the all-cause excess mortality rate associated with the COVID-19 pandemic in Mexico in 2020 at 26.10 per 10,000 population, which corresponds to 333,538 excess deaths. Males had about 2-fold higher excess mortality rate (33.99) compared to females (18.53). Mexico City reported the highest excess death rate (63.54) and RR (2.09) compared to rest of the country (excess rate = 23.25, RR = 1.62). While COVID-19 deaths accounted for only 38.64% of total excess deaths in Mexico, our forecast estimate that Mexico has accumulated a total of ~ 61,610 [95% PI: 60,003, 63,216] excess deaths in the first 4 weeks of 2021. Proportion of tweets was significantly correlated with the excess mortality (ρ = 0.508 [95% CI: 0.245, 0.701], p-value = 0.0004). CONCLUSION: The COVID-19 pandemic has heavily affected Mexico. The lab-confirmed COVID-19 deaths accounted for only 38.64% of total all cause excess deaths (333,538) in Mexico in 2020. This reflects either the effect of low testing rates in Mexico, or the surge in number of deaths due to other causes during the pandemic. A model-based forecast indicates that an average of 61,610 excess deaths have occurred in January 2021.


Assuntos
COVID-19/mortalidade , COVID-19/epidemiologia , Cidades/epidemiologia , Feminino , Humanos , Masculino , México/epidemiologia , Mídias Sociais
17.
BMC Health Serv Res ; 21(1): 508, 2021 May 26.
Artigo em Inglês | MEDLINE | ID: mdl-34039345

RESUMO

BACKGROUND: Asylum evaluations are highly specialized medico-legal encounters to collect physical or mental health evidence for use in immigration proceedings. Although the field of asylum medicine is growing, access to these evaluations is still inadequate, particularly for those in United States immigration detention or other forms of custody, such as under the U.S. Migrant Protection Protocols or "Remain in Mexico" policy. Given advances in telehealth in recent years and growing evidence of similar outcomes with in-person management, it seems prudent to examine whether remote modalities may also be effective for conducting mental health asylum evaluations in hard-to-reach populations. METHODS: We analyzed the responses of 12 U.S. clinicians who conducted 25 cross-border remote mental health evaluations with clients in Mexico prior to the COVID-19 pandemic, and completed a post-evaluation survey regarding their impressions and experiences of the remote encounter. Data were coded through a process of thematic analysis. RESULTS: The average evaluation time was 2.3 h, slightly shorter than might be expected from an in-person encounter. Five themes emerged from the coding process: rapport building, achieving overall goal, comparison of in-person vs. remote, technical issues, and coordination. Clinicians encountered a number of challenges including technical difficulties and a decreased ability to establish rapport. Nearly uniformly, however, clinicians noted that despite difficulties, they were able achieve the goals of the evaluation, including rapport building and diagnosis. CONCLUSION: Remote evaluations appear to achieve their intended goal and may be useful in expanding legal options for hard-to-reach asylum seekers.


Assuntos
COVID-19 , Refugiados , Migrantes , Humanos , México , Pandemias , Projetos Piloto , SARS-CoV-2 , Estados Unidos
18.
Environ Res ; 198: 111242, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-33933488

RESUMO

BACKGROUND: Epidemiological evidence associates chronic exposure to particulate matter (PM) with respiratory damage and lung cancer. Inhaled PM may induce systemic effects including inflammation and metastasis. This study evaluated whether PM induces expression of adhesion molecules in lung cancer cells promoting interaction with monocytes. METHODS: The expression of early and late adhesion molecules and their receptors was evaluated in A549 (human lung adenocarcinoma) cells using a wide range of concentrations of PM2.5 and PM10. Then we evaluated cellular adhesion between A549 cells and U937 (human monocytes) cells after PM exposure. RESULTS: We found higher expression of both early and late adhesion molecules and their ligands in lung adenocarcinoma cells exposed to PM2.5 and PM10 particles present in the air pollution at Mexico City from 0.03 µg/cm2 with a statistically significant difference (p ≤ 0.05). PM10 had stronger effect than PM2.5. Both PM also stimulated cellular adhesion between tumor cells and monocytes. CONCLUSIONS: This study reveals a comprehensive expression profile of adhesion molecules and their ligands upregulated by PM2.5 and PM10 in A549 cells. Additionally these particles induced cellular adhesion of lung cancer cells to monocytes. This highlights possible implications of PM in two cancer hallmarks i.e. inflammation and metastasis, underlying the high cancer mortality associated with air pollution.


Assuntos
Adenocarcinoma de Pulmão , Poluentes Atmosféricos , Poluição do Ar , Neoplasias Pulmonares , Poluentes Atmosféricos/análise , Poluentes Atmosféricos/toxicidade , Poluição do Ar/análise , Linhagem Celular , Cidades , Humanos , México , Material Particulado/análise , Material Particulado/toxicidade
19.
Salud Publica Mex ; 63(2, Mar-Abr): 160-162, 2021 Feb 27.
Artigo em Espanhol | MEDLINE | ID: mdl-33989476

RESUMO

OBJECTIVE: To describe a Covid-19 outbreak in a gerontological center in Mexico City. MATERIAL AND METHODS: Cross-sectional study in older adults. The association of risk factors for dying from Covid-19 was analyzed using a multiple logistic regression model. RESULTS: One hundred and two elders with an average age of 82.5 ± 8.8 years were included. Fifty-five (54%) tested positive and 47 (46%) were negative for the new coronavirus. Using the multiple logistic regression model, people with frailty had an OR of 11.6 of dying from Covid-19 compared to robust people (p-value = 0.024). CONCLUSION: The Covid-19 outbreak was initially caused by a resident of the center and spread by cross infection. In vulnerable populations, early detection, isolation, and follow-up of contacts should be carried out, as well as the identification of risk factors in order to reduce the spread and mortality caused by SARSCoV-2.


Assuntos
COVID-19/epidemiologia , Surtos de Doenças , Instituição de Longa Permanência para Idosos , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Humanos , Masculino , México
20.
Salud Publica Mex ; 63(2, Mar-Abr): 316-323, 2021 Jan 15.
Artigo em Espanhol | MEDLINE | ID: mdl-33989477

RESUMO

Este artículo propone intervenciones estructurales dirigidas a la reorganización del trabajo para evitar un repunte de casos de Covid-19, permitiendo la continuidad de la actividad económica. Se resume la evidencia disponible acerca de los ciclos de trabajo-confinamiento y la posible aplicación de ciclos de cuatro días de trabajo por tres de confinamiento (4x3) en el contexto mexicano. También se discuten otras intervenciones como la continuación del teletrabajo en algunos sectores y el escalonamiento de las jornadas de trabajo como medidas complementarias a los ciclos de trabajo-confinamiento. Esta discusión se da en el contexto de alta informalidad y escasos recursos para absorber una pérdida importante de la productividad por las empresas medianas y pequeñas en México. Se considera la necesidad de implementar apoyos para que personas y empresas puedan mitigar pérdidas en salarios y ganancias tanto del sector formal como informal.


Assuntos
COVID-19/prevenção & controle , Emprego/organização & administração , Quarentena , COVID-19/epidemiologia , COVID-19/transmissão , Guias como Assunto , Humanos , México/epidemiologia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...