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Hist Cienc Saude Manguinhos ; 30Suppl 1(Suppl 1): e2023060, 2023 Oct.
Artigo em Espanhol, Inglês | MEDLINE | ID: mdl-37971058


The interest of this article is to study how the covid-19 pandemic, by intensifying work routines, enhanced structural conflicts in the nursing sector of Argentina. For this purpose, we use a quantitative and qualitative methodological strategy that allows us to understand in depth the practices and representations of nurses during the pandemic by means of a self-administered survey and in-depth interviews. This proposal will have two axes. First, we will analyze the conflicts that occurred due to work overload and lack of supplies for protection against covid-19. Secondly, we will review the strategies of collective claims through unions and self-organized movements.

El interés de este artículo es estudiar cómo la pandemia de la covid-19, al intensificar rutinas laborales, potenció conflictos estructurales en el sector de enfermería en Argentina. Para ello, utilizamos una estrategia metodológica cuantitativa y cualitativa que nos permite comprender en profundidad las prácticas y las representaciones de enfermeros y enfermeras durante la pandemia a partir de la realización de una encuesta autoadministrada y entrevistas en profundidad. En primer lugar, analizamos los conflictos acontecidos por la sobrecarga laboral y la falta de insumos para la protección contra la covid-19. En segundo lugar, revisamos las estrategias de reclamos colectivos por medio de sindicatos y de movimientos autoconvocados.

COVID-19 , Humanos , COVID-19/epidemiologia , COVID-19/prevenção & controle , Pandemias/prevenção & controle , Argentina/epidemiologia , Movimento , Pesquisa Qualitativa
Int J Inj Contr Saf Promot ; : 1-5, 2023 Nov 08.
Artigo em Inglês | MEDLINE | ID: mdl-37938125


The aim of this study was to assess space-time clustering of suicide in Argentina between 2017 and 2020. A spatio-temporal scan statistic using a space-time permutation model was employed to retrospectively detect clusters of total suicides by sex and by age group. From 2017 to 2020, six statistically significant spatio-temporal clusters were identified in Argentina with either more or less suicides than expected. Two clusters extended from May 2019 to July and September 2020, while the remaining four clusters were detected only during 2020. The start of the COVID-19 pandemic seems to have changed the spatio-temporal patterns of suicide in Argentina. Despite the national decrease in the number of suicides during 2020 compared to previous years, the spatio-temporal analysis revealed both areas with decreases and increases in suicide. This heterogeneous scenario highlights the need for the study of local effects behind the emergence of these spatio-temporal suicide clusters.

J Clin Rheumatol ; 2023 Nov 20.
Artigo em Inglês | MEDLINE | ID: mdl-37936271


OBJECTIVE: To describe characteristics of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in patients with rheumatic immune-mediated inflammatory diseases (IMIDs) from Argentina, Mexico and Brazil, and to assess factors associated with mortality in this population. METHODS: Data from 3 national registries, SAR-COVID (Argentina), CMR-COVID (Mexico), and ReumaCoV-Brasil (Brazil), were combined. Adult patients with IMIDs and SARS-CoV-2 infection were recruited. Sociodemographic data, comorbidities, IMID clinical characteristics and treatment, and SARS-CoV-2 infection presentation and outcomes were recorded. RESULTS: A total of 4827 individuals were included: 2542 (52.7%) from SAR-COVID, 1167 (24.2%) from CMR-COVID, and 1118 (23.1%) from ReumaCoV-Brasil. Overall, 82.1% were female with a mean age of 49.7 (SD, 14.3) years; 22.7% of the patients were hospitalized, and 5.3% died because of COVID-19 (coronavirus disease 2019). Argentina and Brazil had both 4% of mortality and Mexico 9.4%. In the multivariable analysis, older age (≥60 years; odds ratio [OR], 7.4; 95% confidence interval [CI], 4.6-12.4), male sex (OR, 1.5; 95% CI, 1.1-2.1), living in Mexico (OR, 3.0; 95% CI, 2.0-4.4), comorbidity count (1 comorbidity: OR, 1.5; 95% CI, 1.0-2.1), diagnosis of connective tissue disease or vasculitis (OR, 1.8; 95% CI, 1.3-2.4), and other diseases (OR, 2.6; 95% CI, 1.6-4.1) compared with inflammatory joint disease, high disease activity (OR, 4.2; 95% CI, 2.5-7.0), and treatment with glucocorticoids (OR, 1.9; 95% CI, 1.4-2.5) or rituximab (OR, 4.2; 95% CI, 2.7-6.6) were associated with mortality. CONCLUSIONS: Mortality in patients with IMIDs was particularly high in Mexicans. Ethnic, environmental, societal factors, and different COVID-19 mitigation measures adopted have probably influenced these results.

Artigo em Inglês | MEDLINE | ID: mdl-37941927


Cryptosporidium spp. are enteroparasitic protozoans that cause cryptosporidiosis in newborn calves. Clinical signs of the infection are diarrhoea and dehydration leading to decreased productivity and economic losses in cattle farms around the world. Additionally, cryptosporidiosis is a relevant zoonotic disease since the ingestion of oocysts can be fatal for children under five years of age, the elderly, and/or immunocompromised adults. This review aims to integrate existing knowledge on the epidemiological situation of calf cryptosporidiosis and associated risk factors in Argentina. In addition, the GP60 subtype diversity of the pathogen was analysed and related with the global distribution of corresponding GP60 subtypes. Depending on the study region and applied diagnostics, prevalence among calves up to 20 days of age varied between 25.2% and 42.5%, while a prevalence of 16.3-25.5% was observed at the age of 1-90 days. So far, molecular studies have determined exclusively Cryptosporidium parvum in preweaned calves. In addition, C. parvum infection was reported as the major cause of calf diarrhoea, followed by rotavirus A (RVA), while enteropathogens such as coronavirus, Escherichiacoli, and Salmonella sp. played a negligible role. Calf age of 20 days or less, incidence of diarrhoea, poorly drained soils, and large farm size were identified as risk factors for C. parvum-infection in Argentina. A total of nine GP60 subtypes (IIaAxxG1R1, xx = 16 to 24) were identified, showing a stepwise increase of the trinucleotide motif TCA, and including the zoonotic subtypes IIaA16G1R1, IIaA17G1R1, IIaA18G1R1, IIaA19G1R1, and IIaA20G1R1. We found that an increase in the A16→A24 trinucleotide repeat was accompanied by a gradual decrease in the global distribution of GP60 alleles, strongly suggesting that IIaA16G1R1 represents the primordial allelic variant of this group. Since identified GP60 alleles have a similar genetic background, we hypothesize that the continuous trinucleotide repeat array has been generated by stepwise repeat expansion of A16. The information gathered and integrated in this study contributes to an improved understanding of the epidemiological characteristics of bovine cryptosporidiosis in and beyond Argentina, which in turn can help to develop control strategies for this parasitosis of veterinary and medical relevance.

Arch Argent Pediatr ; : e202310130, 2023 Nov 09.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-37917026


Introduction. During 2020 and 2021, the circulation of influenza virus remained below expectations worldwide. In Argentina, in 2022, we observed an uninterrupted circulation of influenza all year round. Our objectives were to describe the circulation patterns and clinical characteristics of hospitalized children with influenza. Population and methods. Retrospective, analytical, observational study. All children with influenza virus admitted to a children's hospital during the 2019-2022 period were included. Results. A total of 138 patients were admitted over 4 years; in 2019, the rate of hospital discharges was 4.5/1000, compared to 15.1/1000 in 2022. No cases were recorded in 2020 and 2021. In 2019, most cases were observed in the winter; in 79%, the cause was acute lower respiratory tract infection (ALRTI); influenza A was detected in 92%. In 2022, most cases occurred in the spring; 62% developed ALRTI; and influenza A was detected in 56%. Similar rates of vaccination and comorbidities were observed in both periods. Conclusions. In 2022, more hospitalizations due to influenza were recorded, which may have correlated with the use of more sensitive molecular diagnostic testing and a change in seasonality, with more cases observed in the spring. In 2019, influenza A predominated in lower respiratory tract infections, while in 2022, cases of influenza A and B were similar, with more extra-pulmonary forms.

Introducción. Durante 2020 y 2021, la circulación de los virus influenza se mantuvo por debajo de lo esperado en todo el mundo. En Argentina, en el año 2022 observamos una circulación ininterrumpida de influenza todo el año. Nuestros objetivos fueron describir los patrones de circulación y las características clínicas de niños internados con influenza. Población y métodos. Estudio retrospectivo, analítico, observacional. Se incluyeron todos los niños internados en un centro pediátrico con detección del virus influenza durante los años 2019-2022. Resultados. Se internaron 138 pacientes en 4 años; en 2019 se observó una tasa del 4,5/1000 egresos hospitalarios mientras que en 2022, fue del 15,1/1000. En 2020 y 2021 no hubo casos. En el 2019 la mayoría de los casos ocurrieron en invierno, la causa de la internación fue la infeccción respiratoria aguda baja (IRAB) en el 79 % y se detectó influenza A en el 92 % de los casos. En el 2022, la mayoría de los casos ocurrieron en primavera, el 62 % presentó IRAB y en el 56 % se detectó influenza A. Ambos períodos tuvieron similares frecuencias de vacunación y de comorbilidades. Conclusiones. En el 2022 se registraron más internaciones por influenza, lo que podría corresponder a que se realizaron métodos diagnósticos moleculares, que son más sensibles, y se observó un cambio en la estacionalidad con más casos en primavera. En 2019 predominó influenza A en infecciones del tracto respiratorio inferior, mientras que en el 2022 influenza A y B fueron similares, y hubo más formas extrapulmonares.

Trials ; 24(1): 678, 2023 Oct 19.
Artigo em Inglês | MEDLINE | ID: mdl-37858249


BACKGROUND: The Unified Protocol (UP) is a transdiagnostic intervention based on emotional regulation for the treatment of emotional disorders. Its application in individual and group formats has been studied worldwide, obtaining similar results to specific protocols but with a lower drop-out rate and improving the cost-benefit ratio, since a larger number of patients can benefit from it. Moreover, the inclusion of digital technologies in psychotherapy aims to improve the accessibility of treatments, especially since the pandemic of COVID-19 that forced the implementation of treatments through teletherapy increasing its use. To date, no studies have been carried out in Argentina on the application of the UP in a group format and through teletherapy. The aim of the present study is to evaluate the efficacy of the UP in a group format and through teletherapy in the Argentine population. METHODS: A parallel-group, controlled, randomized trial, with pre-post and repeated follow-up measures intergroup design will be conducted. One hundred eighty patients will be randomized to one of the following conditions: an online, group-based UP intervention or a waiting list. The Beck Depression Inventory-II and the Beck Anxiety Inventory will be used to compare primary outcomes and the Beck Hopelessness Scale, Difficulties in Emotion Regulation Scale, Positive Affect and Negative Affect Scale, and Multicultural Quality of Life Index will be administered for secondary outcomes at baseline, post-intervention, and 3 months follow-up. Ad-hoc questionnaires will be used to assess patients' experiences and treatment satisfaction. DISCUSSION: The purpose of this trial is to evaluate the efficacy of the online and group application of the UP in the Argentine population, as well as to evaluate the patient's experience and satisfaction with the treatment. It is expected that the findings of this study will be useful in reducing anxious and depressive symptomatology, will allow us to adapt the UP to our culture, and will improve accessibility to treatment. TRIAL REGISTRATION: NCT05275322. Registered on 11 March 2022.

Transtornos de Ansiedade , COVID-19 , Humanos , Transtornos de Ansiedade/terapia , Qualidade de Vida , Argentina , Protocolos Clínicos , COVID-19/terapia , Resultado do Tratamento
Lancet Reg Health Am ; 27: 100607, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-37808936


Background: After primary vaccination schemes with rAd26-rAd5 (Sputnik V), ChAdOx1 nCoV-19, BBIBP-CorV or heterologous combinations, the effectiveness of homologous or heterologous boosters (Sputnik V, ChAdOx, Pfizer-BioNTech, Moderna) against SARS-CoV-2 infections, hospitalisations and deaths has been scarcely studied. Methods: Test-negative, case-control study, conducted in Argentina during omicron BA.1 predominance, in adults ≥50 years old tested for SARS-CoV-2 who had received two or three doses of COVID-19 vaccines. Outcomes were COVID-associated infections, hospitalisations and deaths after administering mRNA and vectored boosters, < or ≥60 days from the last dose. Findings: Of 422,124 individuals tested for SARS-CoV-2, 221,993 (52.5%) tested positive; 190,884 (45.2%) and 231,260 (54.8%) had received 2-dose and 3-dose vaccination schemes, respectively. The 3-dose scheme reduced infections, hospitalisations and death (OR 0.81 [0.80-0.83]; 0.28 [0.25-0.32] and 0.25 [0.22-0.28] respectively), but protection dropped after 60 days to 1.04 [1.01-1.06]; 0.52 [0.44-0.61] and 0.38 [0.33-0.45]). Compared with 2-dose-schemes, homologous boosters after primary schemes with vectored-vaccines provided lower protection against infections < and ≥60 days (0.94 [0.92-0.97] and 1.05 [1.01-1.09], respectively) but protected against hospitalisations (0.30 [0.26-0.35]) and deaths (0.29 [0.25-0.33]), decreasing after 60 days (0.59 [0.47-0.74] and 0.51 [0.41-0.64], respectively). Heterologous boosters protected against infections (0.70 [0.68-0.71]) but decreased after 60 days (1.01 [0.98-1.04]) and against hospitalisations and deaths (0.26 [0.22-0.31] and 0.22 [0.18-0.25], respectively), which also decreased after 60 days (0.43 [0.35-0.53] and 0.33 [0.26-0.41], respectively). Heterologous boosters protected against infections when applied <60 days (0.70 [0.68-0.71], p < 0.001), against hospitalisations when applied ≥60 days (0.43 [0.35-0.53], p < 0.01), and against deaths < and ≥60 days (0.22 [0.18-0.25], p < 0.01 and 0.33 [0.26-0.41], p < 0.001). Interpretation: During omicron predominance, heterologous boosters such as viral vectored and mRNA vaccines, following Sputnik V, ChAdOx1, Sinopharm or heterologous primary schemes might provide better protection against death; this effect might last longer in individuals aged ≥50 than homologous boosters. Funding: None.

Medicina (B Aires) ; 83(5): 719-726, 2023.
Artigo em Espanhol | MEDLINE | ID: mdl-37870329


INTRODUCTION: During the SARS-CoV-2 pandemic, Argentina population suffered from significant changes in population mobility due to non-pharmaceutical interventions. The aim of this study was to describe the impact of the mobility restrictions to the rates of positivity and diversity among different respiratory viruses. METHODS: Retrospective analytical study performed at Instituto Médico Platense in La Plata that included 458 patients with nasopharyngeal swab to search for respiratory pathogens by multiplex PCR. Changes in mobility were studied using "Community Mobility Reports", data set developed by Google and publicly available. RESULTS: Community mobility had significant correlation with the percentages of viral test positivity (p = < 0.01; R2=0.89) and viral diversity (p = 0.04; R2 = 0.78). DISCUSSION: Non-pharmaceutical interventions established to contain SARS-CoV-2 spread had a significant impact in the circulation patterns of other respiratory viruses.

Introducción: Durante la pandemia de SARS-CoV-2 en Argentina se implementaron intervenciones no farmacológicas que produjeron cambios en la movilidad de la población. El objetivo de este estudio fue relacionar los porcentajes de positividad y la diversidad viral con la movilidad poblacional durante parte del período de restricciones. Métodos: Estudio retrospectivo analítico realizado en el Instituto Médico Platense durante los años 2020 a 2022 que incluyó 458 pacientes a los que se les tomó un hisopado nasofaríngeo para la búsqueda de patógenos respiratorios por PCR multiplex. Se analizaron los cambios en la movilidad de la población utilizando los "Informes de Movilidad Local", herramienta desarrollada por Google, cuyos datos son de público acceso. Resultados: La movilidad poblacional se correlacionó significativamente con el porcentaje de positividad de las muestras (p = <0.01; R2 = 0.89) y la diversidad viral (p = 0.04; R2 = 0.78). Discusión: Las intervenciones no farmacológicas destinadas a limitar la propagación del SARS-CoV-2 tuvieron efecto en la circulación de otros virus respiratorios, hallándose mayor porcentaje de positividad y diversidad a medida que las mismas disminuyeron su grado de restricción.

COVID-19 , Humanos , SARS-CoV-2 , Pandemias , Estudos Retrospectivos , Argentina/epidemiologia
Vaccines (Basel) ; 11(10)2023 Oct 14.
Artigo em Inglês | MEDLINE | ID: mdl-37896994


This article analyzes the media coverage of the COVID-19 vaccine by major media outlets in five Latin American countries: Argentina, Colombia, Chile, Mexico, and Peru. For this purpose, the XLM-roBERTa model was applied and the sentiments of all tweets published between January 2020 and June 2023 (n = 24,243) by the five outlets with the greatest online reach in each country were analyzed. The results show that the sentiment in the overall media and in each nation studied was mostly negative, and only at the beginning of the pandemic was there some positivity. In recent months, negative sentiment has increased twelvefold over positive sentiment, and has also garnered many more interactions than positive sentiment. The differences by platform and country are minimal, but there are markedly negative media, some more inclined to neutrality, and only one where positive sentiment predominates. This paper questions the role of journalism in Latin America during a health crisis as serious as that of the coronavirus, in which, instead of the expected neutrality, or even a certain message of hope, the media seem to have been dragged along by the negativity promoted by certain discourses far removed from scientific evidence.

Medicina (B Aires) ; 83(5): 683-691, 2023.
Artigo em Espanhol | MEDLINE | ID: mdl-37870326


INTRODUCTION: There is little information on the presence of COVID-19 in clinical trial participants. The objective of the study was to evaluate the cumulative infection rate for SARS-CoV-2 in this population. Additionally, we investigated the risk, lethality, and mortality from COVID-19. METHODS: The design was observational retrospective that included adult subjects participating in clinical intervention trials approved by our ethics committee during the first two years of the pandemic (March 31, 2020 to March 31, 2022). Pediatric, observational, shortterm, and inpatient protocols were excluded. RESULTS: We included 513 adult subjects who participated in clinical trials during the first two years of the COVID-19 pandemic. Patients with COVID-19 were characterized as being 59.7 ± 13.7 years old (50% female), and 92% had an increased risk of fatality from COVID-19. The cumulative rate of COVID-19 was 9.74% (95% CI: 7.32-12.64%) and its confidence intervals were below 17% of the population aged 60 to 69 in Argentina (p< 0.0001). The case fatality rate for COVID-19 was 14% (95% CI: 5.8%-26.7%) and its confidence intervals were above 2.45% of the population aged 50 to 69 in Argentina (p< 0.0001). CONCLUSION: The rate of COVID-19 in adult subjects participating in clinical trials was below the figures for the Argentine population of similar age. The fatality rate was above the population figures, and it is explained by the high risk of the population.

Introducción: Existe poca información sobre la presencia de COVID-19 en participantes de ensayos clínicos. El objetivo del estudio fue evaluar la tasa de infección acumulada por SARS-CoV-2 en esta población. Además, investigamos el riesgo, letalidad y mortalidad por COVID-19. Métodos: Diseño observacional retrospectivo que incluyó adultos participantes en ensayos clínicos de intervención aprobados por nuestro comité de ética durante los dos primeros años de la pandemia (31/3/2020 a 31/3/2022). Se excluyeron protocolos pediátricos, observacionales, de corta duración y con sujetos internados. Resultados: Se incluyeron 513 sujetos adultos que participaron en ensayos clínicos durante ese período de la pandemia por COVID-19. Los pacientes con COVID-19 se caracterizaron por tener una edad de 59.7 ± 13.7 años (50% sexo femenino) y el 92% presentó riesgo incrementado de letalidad por COVID-19. La tasa acumulada de COVID-19 fue de 9.74% (IC 95%: 7.32-12.64%) que se situó por debajo del 17% de la población de 60 a 69 años de la Argentina (p<0.0001). La tasa de letalidad por COVID-19 fue de 14% (IC 95%: 5.8-26.7), que se situó por encima del 2.45% de la población de 50 a 69 años de la Argentina (p<0.0001). Conclusión: La tasa de COVID-19 en los sujetos adultos participantes de ensayos clínicos estuvo por debajo de las cifras de la población argentina de similar edad. La tasa de letalidad estuvo por encima de las cifras poblacionales y se explica por el alto riesgo de esa población.

COVID-19 , Adulto , Idoso , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Argentina/epidemiologia , Pandemias , Estudos Retrospectivos , SARS-CoV-2
Microbiol Spectr ; : e0204723, 2023 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-37695063


Bats are reservoirs of various coronaviruses that can jump between bat species or other mammalian hosts, including humans. This article explores coronavirus infection in three bat species (Tadarida brasiliensis, Eumops bonariensis, and Molossus molossus) of the family Molossidae from Argentina using whole viral metagenome analysis. Fecal samples of 47 bats from three semiurban or highly urbanized areas of the province of Santa Fe were investigated. After viral particle enrichment, total RNA was sequenced using the Illumina NextSeq 550 instrument; the reads were assembled into contigs and taxonomically and phylogenetically analyzed. Three novel complete Alphacoronavirus (AlphaCoV) genomes (Tb1-3) and two partial sequences were identified in T. brasiliensis (Tb4-5), and an additional four partial sequences were identified in M. molossus (Mm1-4). Phylogenomic analysis showed that the novel AlphaCoV clustered in two different lineages distinct from the 15 officially recognized AlphaCoV subgenera. Tb2 and Tb3 isolates appeared to be variants of the same virus, probably involved in a persistent infectious cycle within the T. brasiliensis colony. Using recombination analysis, we detected a statistically significant event in Spike gene, which was reinforced by phylogenetic tree incongruence analysis, involving novel Tb1 and AlphaCoVs identified in Eptesicus fuscus (family Vespertilionidae) from the U.S. The putative recombinant region is in the S1 subdomain of the Spike gene, encompassing the potential receptor-binding domain of AlphaCoVs. This study reports the first AlphaCoV genomes in molossids from the Americas and provides new insights into recombination as an important mode of evolution of coronaviruses involved in cross-species transmission. IMPORTANCE This study generated three novel complete AlphaCoV genomes (Tb1, Tb2, and Tb3 isolates) identified in individuals of Tadarida brasiliensis from Argentina, which showed two different evolutionary patterns and are the first to be reported in the family Molossidae in the Americas. The novel Tb1 isolate was found to be involved in a putative recombination event with alphacoronaviruses identified in bats of the genus Eptesicus from the U.S., whereas isolates Tb2 and Tb3 were found in different collection seasons and might be involved in persistent viral infections in the bat colony. These findings contribute to our knowledge of the global diversity of bat coronaviruses in poorly studied species and highlight the different evolutionary aspects of AlphaCoVs circulating in bat populations in Argentina.

Hist Cienc Saude Manguinhos ; 30Suppl 1(Suppl 1): e2023048, 2023.
Artigo em Espanhol | MEDLINE | ID: mdl-37729238


The article explores the mutations in the practices of health professionals in the context of covid-19. It focuses on "the covid area" of a hospital in the province of Buenos Aires, Argentina, seeking to know the rearrangement of hospital space and routines, and the ways of communicating death. In a short period of time, adjustments in professional practices and attempts at new routines and rituals are observed. In the doctor/patient relationship and in the way of communicating a death, both "exceptional" actions (which violate routines) and attempts to recover care techniques linked to the paradigm of humanized medicine are condensed.

El artículo explora las mutaciones en las prácticas de los profesionales de la salud en el contexto de la covid-19. Se centra en "el área covid" de un hospital de la provincia de Buenos Aires, Argentina, buscando conocer el reordenamiento del espacio y rutinas hospitalarias, y las formas de comunicar la muerte. En un período corto de tempo se observan ajustes en las prácticas profesionales e intentos de nuevas rutinas y rituales. En el vínculo médico/paciente y en la forma de comunicar una muerte se condensan tanto las acciones "excepcionales" (que vulneram rutinas) como intentos de recuperar técnicas de cuidado vinculados al paradigma de la medicina humanizada.

COVID-19 , Humanos , Argentina/epidemiologia , COVID-19/epidemiologia , Pandemias , Relações Médico-Paciente , Hospitais
Qual Life Res ; 2023 Sep 22.
Artigo em Inglês | MEDLINE | ID: mdl-37736844


PURPOSE: The transition from childhood to adolescence is a period of developmental changes, with social influences. Few previous studies have analyzed changes in health-related quality of life (HRQoL) during childhood and adolescence based on longitudinal studies in high-income countries. This study aimed to describe the evolution of HRQoL scores by gender in a school sample over a 7-year period in Argentina. METHODS: Prospective cohort of children attending fourth grade in public schools. HRQoL was measured using the KIDSCREEN-52 questionnaire. Trajectories of HRQoL were estimated for girls and boys through multilevel models, adjusted by socioeconomic status (SES). RESULTS: The study began in 2014 with a sample of 494 school children, reaching an 85.6% response rate in 2016, 31.4% in 2018, and 41.9% in 2021. Most of the predicted scores are negatively associated with linear age or/and quadratic age, suggesting a decrease in scores over the 7-year follow-up. Interactions between gender and age denote an increase in the differences in scores between girls and boys over time in favor of the latter. For the Index, Physical Well-being, Psychological Well-being, Autonomy, Parent relations, Social support and peers and Financial resources, individuals with medium or high SES have significantly higher scores than those with low SES. CONCLUSIONS: HRQoL scores decrease during the transition period from childhood to adolescence, with girls showing the greatest decrease. There were also socioeconomic inequalities in the evolution of HRQoL in a context characterized by social segregation and economic crisis, possibly aggravated by the COVID-19 pandemic.

Arch Virol ; 168(10): 251, 2023 Sep 13.
Artigo em Inglês | MEDLINE | ID: mdl-37702836


One of the challenges associated with introducing a vaccine is monitoring its impact through clinical and molecular surveillance. The aims of this study were to analyze the genetic diversity of rotavirus A in Argentina between 2019 and 2022 and to assess the phylogenetic and phylodynamic features of the unusual G6 strains detected. A significant decline in the Wa-like genogroup strains was observed, and G6 strains were detected for the first time in Argentina, in association with P[8] and P[9]. Spatiotemporal analysis showed that the G6-lineage I strains detected recently in Argentina and Brazil might have emerged from European strains. This study provides recent evidence of the genetic diversity of rotaviruses in isolated cases. It is considered important to support continuous surveillance of rotavirus in the post-vaccine scenario, mainly to evaluate potential changes that may occur after the COVID-19 pandemic.

COVID-19 , Rotavirus , Humanos , Rotavirus/genética , Argentina/epidemiologia , Pandemias , Filogenia , COVID-19/epidemiologia , Variação Genética
Int J Equity Health ; 22(1): 198, 2023 Sep 28.
Artigo em Inglês | MEDLINE | ID: mdl-37770868


BACKGROUND: The COVID-19 pandemic has shown how intraurban inequalities are likely to reinforce health and social inequalities. Studies at small area level help to visualize social inequialities hidden in large areas as cities or regions. AIM: To describe the spatial patterning of COVID-19 death rates in neighborhoods of the medium-sized city of Bariloche, Argentina, and to explore its relationship with the socioeconomic characteristics of neighborhoods. METHODS: We conducted an ecological study in Bariloche, Argentina. The outcome was counts of COVID-19 deaths between June 2020 and May 2022 obtained from the surveillance system and georeferenced to neighborhoods. We estimated crude- and age-adjusted death rates by neighborhood using a Bayesian approach through a Poisson regression that accounts for spatial-autocorrelation via Conditional Autoregressive (CAR) structure. We also analyzed associations of age-adjusted death rates with area-level socioeconomic indicators. RESULTS: Median COVID-19 death rate across neighborhoods was 17.9 (10th/90th percentile of 6.3/35.2) per 10,000 inhabitants. We found lower age-adjusted rates in the city core and western part of the city. The age-adjusted death rate in the most deprived areas was almost double than in the least deprived areas, with an education-related relative index of inequality (RII) of 2.14 (95% CI 1.55 to 2.96). CONCLUSION: We found spatial heterogeneity and intraurban variability in age-adjusted COVID-19 death rates, with a clear social gradient, and a higher burden in already deprived areas. This highlights the importance of studying inequalities in health outcomes across small areas to inform placed-based interventions.

COVID-19 , Pandemias , Humanos , Cidades , Argentina/epidemiologia , Teorema de Bayes , Fatores Socioeconômicos , Mortalidade
Interdisciplinaria ; 40(2): 445-460, ago. 2023. tab
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1448504


Resumen La pandemia ha generado un nuevo entorno que establece determinadas exigencias o demandas de actuación a las personas, potenciales estresores que pueden desencadenar el proceso de estrés, al que se le podría denominar Estrés de Pandemia (EDP). A este contexto, se sumaron los cambios en la jornada laboral que derivaron en mayor interferencia entre la familia y el trabajo. De esta manera, se volvió relevante generar conocimiento sobre la temática durante este contexto particular. El objetivo del presente estudio fue determinar la asociación entre el (EDP) y el Conflicto Trabajo-Familia (CTF) y Familia-Trabajo (CFT). Además, se indagaron diferencias de grupos según factores laborales como la modalidad de trabajo y la tenencia o no de niños a cargo, entre otros. Se utilizó el Inventario SISCO de EDP (Macías, 2020), la escala de CTF y CFT (Netemeyer et al., 1996) y un cuestionario ad-hoc. Los participantes fueron 637 adultos (M.edad = 38.14, DS = 13.05, femenino = 487). Se encontraron asociaciones positivas entre las variables CFT y CTF y ambas se asociaron de manera positiva con el EDP. Quienes trabajaron de manera virtual evidenciaron mayor CFT y quienes lo hicieron, tanto virtual como presencialmente fueron los que más puntuaron en CTF. Finalmente, quienes tenían niños a cargo tuvieron mayor CFT y CTF. En conclusión, el estrés en torno al COVID-19 se vincula con mayor interferencia y conflictos entre el ámbito laboral y el familiar.

Abstract Pandemic Stress can be defined as a psychological state produced by an adaptation process where the individual values ​​the environment demands, determined by the pandemic, as overflowing with their resources to carry them out effectively (Macías, 2020). The change in routine carries the possibility of an increase in relation to work-family conflict. Family conflict involves two directions: work can interfere with the family (family work conflict or FWC) and the family can interfere with work (work family conflict, or WFC) (Bellavia y Frone, 2005) because of the incompatibility of responsibilities in the workplace and family (Greenhaus y Beutell, 1985). Added to this context are changes in the working day and, since there are no studies that analyze the relationships between SP and family and work conflict, it becomes relevant to generate knowledge on this issue during this context that humanity is going through. In this way, the aim was to establish the association between Pandemic Stress (PS), Work-Family Conflict (WFC) and Family-Work Conflict (FWC). In addition, the possible existence of group differences was analyzed according to work factors such as work modality, and the possession or not of dependent children. SISCO Pandemic Stress Inventory (Macías, 2020), the Work-Family Conflict and Family-Work Conflict scale (Netemeyer et al., 1996) and an ad-hoc questionnaire were used. The participants were 637 adults (M.age = 38.14, SD = 13.05, female = 487). Positive associations were found between the variables WFC and FWC, and both were positively associated with PS. Those who worked virtually showed higher FWC and those who did it both virtually and in person, were the ones who scored the most in WFC, realizing the difficulty in balancing family and work demands. This could be due to the difficulty for parents who worked outside the home, since they had to organize alternative solutions to take care of their children, which is hampered by the closure of establishments, difficulty in mobilizing and preventive and mandatory isolation of social networks that, in another context, contribute to the care of children. It is of great relevance to consider that the majority of those surveyed have been women, being the most likely to report that the excessive amount of housework made it difficult for them to combine work and family (Blasko, 2020). Finally, those who had children had higher WFC and FWC. In this sense, Gutierrez et al. (2020) explain that in households the unpaid workload and care has increased, which falls unequally on women, a fact that further limits their availability of time to develop productive and / or work activities. Following Park et al. (2020), being young, being female, and being a caregiver increase the risk of exposure to stressors and a greater level of stress. In conclusion, the lawsuits surrounding COVID-19 interfere in conflicts between the workplace and the family. This shows the importance of carrying out evidence-based interventions aimed at mitigating the effects of SP due to COVID-19 and reducing WFC and FWC. In this sense, the present research provides an advance in the understanding of interference between home and work, as well as the impact of the pandemic in both spheres of daily life.

Interdisciplinaria ; 40(2): 461-477, ago. 2023. tab, graf
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1448505


Resumen El objetivo de este estudio fue conocer si la temporalidad subjetiva -perspectiva y foco temporales- y la capacidad de autocontrol e impulsividad repercuten en el malestar psicológico, en particular durante la pandemia por COVID-19. La conjetura teórica es que el tiempo psicológico está estrechamente vinculado a la autorregulación, que influye en el desarrollo de la impulsividad y el autocontrol e impacta en el malestar psicológico. Se diseñó un modelo y se realizó un estudio empírico cuantitativo, no experimental y transversal (. = 279; 78 % mujeres; ME = 30.14 años; DE = 11.21). Los resultados del análisis de correlación mostraron relaciones significativas entre las variables de interés. Para determinar las variables predictoras del malestar psicológico se realizó un análisis de regresión lineal múltiple. El 48 % de la varianza del malestar psicológico fue explicado por el pasado negativo, autocontrol e impulsividad, y focos temporales futuro y presente. Finalmente, se probó el modelo teórico diseñado para analizar los efectos directos e indirectos del malestar psicológico a través de un análisis de senderos que presentó un buen ajuste a los datos, ya que explicó el 50 % de la varianza de aquel. La perspectiva y el foco temporal explicaron el 53 % de la variabilidad del autocontrol, y presentaron efectos indirectos sobre el malestar psicológico a través del autocontrol. El autocontrol influyó de manera inversa en el malestar. Los hallazgos indican que el tiempo subjetivo y el autocontrol sirven para explicar estados psicológicos, incluso en pandemia, lo cual confirma estudios previos que muestran la importancia de las variables de personalidad -además de las biológicas y contextuales- en la aparición de malestar psicológico.

Abstract Psychological time is an essential aspect of humans. Two of the most important notions of subjective temporality are time perspective and temporal focus. Time perspective is a process by which the flow of personal and social experiences are framed in five different temporal categories: past negative, past positive, present hedonistic, present fatalistic and future. Temporal focus refers to the attention people devote to thinking about the past, present, and future. Previous research shows there is a strong relation between psychological time and self-regulatory processes, specifically self-control and impulsivity. Self-control is the ability to inhibit impulsive behaviors or reactions that can keep the person from pursuing the proposed goals. On the other hand, impulsivity refers to a short attention span and a tendency to engage in risky behaviors, and to prefer immediate rewards. Both subjective temporality and self-regulatory processes influence behaviors and psychological states such as psychological distress. In particular, the objective of this study was to find out if subjective temporality -time perspective and temporal focus-- and self-control and impulsivity have repercussions on psychological distress, particularly during the COVID-19 pandemic, in an Argentinian sample. The theoretical conjecture is that subjective temporality is closely linked to self-regulation, which influences the development of impulsivity and self-control, and impacts psychological distress. A quantitative, non-experimental, and cross-sectional empirical study was carried out (. = 279; 78 % women; ME = 30.14 years old; SD = 11.21). Firstly, the results of the correlational analysis showed significant relations between the variables. Then, to facilitate further analyses, an index variable of self-control was created, which included the scores of self-control and three dimensions of impulsivity. An optimal parallel analysis was performed. It indicated the existence of a single dimension. Then a semi-confirmatory factor analysis was ran, which showed acceptable results (KMO = .68; X. (6) = 198.8, . < .001; GFI = .99; RMSR = 0.03). Thirdly, to determine the predictive variables of psychological distress, a multiple linear regression analysis was performed. It was found that 48 % of the variance of psychological distress was explained by negative past, self-control index, and future and present temporal focuses (. (4, 266) = 64.66, . < .001, R. = .49, R. adjusted = .48). The best predictor variable was past negative. Afterwards, a theoretical model was tested to explain the direct and indirect causes of psychological distress. It presented a good fit (X./gl = 1.63; GFI = .99; RMSEA = .04). Time perspective and temporal focus explained 53 % of the variability of self-control and presented indirect effects on psychological distress through self-control. Self-control inversely influenced psychological distress; more self-control generates less psychological distress. The model explained half of the variance of psychological distress (R. = .50). The findings indicate that subjective temporality and self-control explain psychological states, even during a pandemic, which confirms previous studies that show the importance of personality variables -in addition to biological and contextual variables- in the manifestation of psychological distress. The results support the theory that psychological time can be considered as a personality trait underlying self-control and psychological distress. A theoretical and practical discussion of the results is presented.

Medicina (B.Aires) ; 83(3): 358-365, ago. 2023. graf
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1506689


Abstract Introduction : The objective was to assess the im munogenicity and effectiveness of vaccines against SARSCoV-2 in multiple sclerosis (MS) patients included in the Argentinean MS registry. Methods : A prospective cohort study between May and December 2021. The primary outcome was im munogenicity and effectiveness of vaccines during a three-month follow-up. Immunogenicity was evalua ted based on detection of total antibodies (Ab) against spike protein and neutralizing Ab in serum 4 weeks after the second vaccine dose. A positive COVID-19 case was defined according to Argentinean Ministry of Health. Results : 94 patients were included, mean age: 41.7 ± 12.1 years. Eighty (85.1%) had relapsing remitting mul tiple sclerosis (RRMS); 30 (31.9%) were under fingolimod treatment. The Sputnik V vaccine was the first dose in 33 (35.1%), and AstraZeneca in 61 (64.9%). In 60 (63.8%), the vaccine elicited a specific humoral response. Immu nological response according to the vaccination schemes showed no qualitative differences (p = 0.45). Stratified analysis according to the MS treatment showed that a significantly smaller number of subjects developed anti bodies against spike antigen among those that were on ocrelizumab compared to other groups (p ≤ 0.001), while a reduced number of patients under ocrelizumab where evaluated (n = 7). This was also observed for neutralizing antibodies in the ocrelizumab group (p < 0.001). During the three-month follow-up, two individuals were diag nosed with COVID-19. Conclusion: We found that MS patients that recei ved Sputnik V or AstraZeneca vaccines for SARS-CoV-2 developed a serological response with no differences between the vaccines used.

Resumen Introducción : El objetivo fue evaluar la inmunogeni cidad y efectividad de las vacunas contra el SARS-CoV-2 en pacientes con esclerosis múltiple (EM) incluidos en el registro argentino de EM (RelevarEM, NCT 03375177). Métodos : Estudio de cohorte prospectivo entre mayo y diciembre 2021. Se evaluó la inmunogenicidad (detec ción de anticuerpos totales (Ab) contra proteína espiga y anticuerpos neutralizantes en suero) y eficacia (nueva infección por COVID-19) durante seguimiento de tres meses. El momento de detección de anticuerpos fue 4 semanas después de segunda dosis de vacuna. Un caso positivo de COVID-19 se definió de acuerdo con la defi nición del Ministerio de Salud. Resultados : Se incluyeron 94 pacientes, edad media de 41.7 ± 12.1 años. Ochenta (85.1%) tenían EM remiten te-recurrente; 30 (31.9%) en tratamiento con fingolimod. La vacuna Sputnik V fue usada en 33 (35.1%), mientras que AstraZeneca se administró en 61 (64.9%). En 60 pa cientes (63.8 %), la vacuna provocó respuesta humoral específica. La respuesta inmunológica según esquemas de vacunación (Sputnik V, Astra Zeneca o esquemas he terólogos) no mostró diferencias cualitativas (p = 0.45). El análisis estratificado según tratamiento recibido para la EM mostró que número significativamente menor de sujetos desarrolló anticuerpos contra el antígeno espiga en los pacientes que recibieron ocrelizumab (p ≤ 0.001), aunque con un número reducido de pacientes evaluados bajo este tratamiento (n = 7). Esto también se observó para anticuerpos neutralizantes en el grupo bajo ocrelizumab (p < 0.001). Durante el seguimiento de tres meses, dos personas fueron diagnosticadas con COVID-19. Conclusión : Encontramos que los pacientes con EM que recibieron vacunas Sputnik V o AstraZeneca para el SARS-CoV-2 desarrollaron respuesta serológica sin diferencias entre las vacunas utilizadas.

Medicina (B.Aires) ; 83(3): 442-454, ago. 2023. graf
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1506698


Resumen El hospital Muñiz es una institución con patrimonio histórico, cultural y sanitario. Se realiza aquí un análisis histórico de las diferentes epidemias/pandemias y bro tes, valorando los manejos epidemiológicos (vigilancia, prevención, control y gestión de emergencias) en la institución y el porqué de su arquitectura. Para tal fin se lleva a cabo una revisión sistemática de la literatura sobre la historia del hospital Muñiz y sus referentes desde 1980 hasta 2023, siguiendo el formato PRISMA. Se encontraron 36 publicaciones que cumplieron con los criterios metodológicos y epidemiológicos requeridos. La revisión muestra los problemas relevantes en salud, los eventos presentes en una epidemia/pandemia, la importancia de medidas de prevención y de evaluar la necesidad de un sistema de vigilancia epidemiológica continuo, así como el aporte de referentes históricos metodológicos que permita obtener información útil en el área de salud. Hemos abordado grandes momentos históricos en la epidemiología explicando el manejo de las enfermedades o epidemias/pandemias en el hospital Muñiz, las cuales se relacionaron en gran medida a la sociedad de la época (paradigmas). Cabe resaltar que el crecimiento poblacional extendió las enfermedades a lo largo del planeta generando amenazas y que las epide mias/pandemias transformaron las sociedades y muy posiblemente han cambiado decisivamente el curso de la historia, tal como paso con la pandemia por COVID-19.

Abstract The Muñiz hospital is an institution with historical, cultural and health heritage. A historical analysis of the different epidemics/pandemics and outbreaks is carried out here, assessing the epidemiological man agement (surveillance, prevention, control and emer gency management) in the institution and the reason for its architecture. To this end, a systematic review of the literature on the history of the Muñiz hospital and its references was carried out, since 1980 to 2023, following the PRISMA format. Thirty-six publications were found that met the required methodological and epidemiological criteria. The review shows the relevant health problems, the events present in an epidemic/ pandemic, the importance of preventive measures and to assess the need for a continuous epidemiological surveillance system, as well as the contribution of historical methodological references that allow obtaining useful information in the health area. We have addressed great historical moments in epidemiology, explaining the management of diseases or epidemics/pandemics at the Muñiz hospital, which were largely related to the society of the time (paradigms). It should be noted that population growth spread diseases throughout the planet, generating threats, and that epidemics/pan demics transformed societies and quite possibly have decisively changed the course of history, as happened with the COVID-19 pandemic.