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1.
Med Gas Res ; 12(1): 18-23, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-34472498

RESUMEN

Cytoreg is an ionic therapeutic agent comprising a mixture of hydrochloric, sulfuric, phosphoric, hydrofluoric, oxalic, and citric acids. In diluted form, it has demonstrated efficacy against human cancers in vitro and in vivo. Although Cytoreg is well tolerated in mice, rats, rabbits, and dogs by oral and intravenous administration, its mechanism of action is not documented. The acidic nature of Cytoreg could potentially disrupt the pH and levels of ions and dissolved gases in the blood. Here, we report the effects of the intravenous administration of Cytoreg on the arterial pH, oxygen and carbon dioxide pressures, and bicarbonate, sodium, potassium, and chloride concentrations. Our results demonstrate that Cytoreg does not disturb the normal blood pH, ion levels, or carbon dioxide content, but increases oxygen levels in rats. These data are consistent with the excellent tolerability of intravenous Cytoreg observed in rabbits, and dogs. The study was approved by the Bioethics Committee of the University of the Andes, Venezuela (CEBIOULA) (approval No. 125) on November 3, 2019.

2.
Heliyon ; : e08091, 2021 Sep 30.
Artículo en Inglés | MEDLINE | ID: mdl-34608445

RESUMEN

Objective: We assessed the prevalence of food insecurity (FI) and its associated factors in Latin American and the Caribbean (LAC) early during the COVID-19 pandemic. Methods: We performed secondary data analysis of a survey conducted by Facebook and the University of Maryland. We included adults surveyed from April to May 2020. FI was measured by concerns about having enough to eat during the following week. Sociodemographic, mental health, and COVID-19-related variables were collected. We performed generalized Poisson regressions models considering the complex sampling design. We estimated crude and adjusted prevalence ratios with their 95% confidence intervals. Results: We included 1,324,272 adults; 50.5% were female, 42.9% were under 35 years old, 78.9% lived in a city, and 18.6% had COVID-19 symptoms. The prevalence of food insecurity in LAC was 75.7% (n=1,016,841), with Venezuela, Nicaragua, and Haiti with 90.8%, 86.7%, and 85.5%, respectively, showing the highest prevalence. Gender, area of residence, presence of COVID-19 symptoms, and fear of getting seriously ill or that a family member gets seriously ill from COVID-19 were associated with a higher prevalence of food insecurity. In contrast, increasing age was associated with a lower prevalence. Conclusion: The prevalence of food insecurity during the first stage of the COVID-19 pandemic in LAC was high and was associated with sociodemographic and COVID-19-related variables.

3.
Microbiol Spectr ; : e0065221, 2021 Oct 13.
Artículo en Inglés | MEDLINE | ID: mdl-34643453

RESUMEN

Trypanosomatid infections are an important public health threat affecting many low-income countries across the tropics, particularly in the Americas. Trypanosomatids can infect many vertebrate, invertebrate, and plant species and play an important role as human pathogens. Among these clinically relevant pathogens are species from the genera Leishmania and Trypanosoma. Mixed trypanosomatid infections remain a largely unexplored phenomenon. Herein, we describe the application of an amplicon-based next-generation sequencing (NGS) assay to detect and identify trypanosomatid species in mammalian reservoirs, human patients, and sand fly vectors throughout regions of Leishmania endemicity. Sixty-five samples from different departments of Colombia, including two samples from Venezuela, were analyzed: 49 samples from cutaneous leishmaniasis (CL) patients, 8 from sand flies, 2 from domestic reservoirs (Canis familiaris), and 6 from wild reservoirs (Phyllostomus hastatus). DNA from each sample served to identify the presence of trypanosomatids through conventional PCR using heat shock protein 70 (HSP70) gene as the target. PCR products underwent sequencing by Sanger sequencing and NGS, and trypanosomatid species were identified by using BLASTn against a reference database built from trypanosomatid-derived HSP70 sequences. The alpha and beta diversity indexes of amplicon sequence variants were calculated for each group. The results revealed the presence of mixed infections with more than two Leishmania species in 34% of CL samples analyzed. Trypanosoma cruzi was identified in samples from wild reservoirs, as well as in sand fly vectors. Coinfection events with three different Leishmania species were identified in domestic reservoirs. These findings depose the traditional paradigm of leishmaniasis as being a single-species-driven infection and redraw the choreography of host-pathogen interaction in the context of multiparasitism. Further research is needed to decipher how coinfections may influence disease progression. This knowledge is key to developing an integrated approach for diagnosis and treatment. IMPORTANCE Traditionally, there has been a frequent, yet incorrect assumption that phlebotomine vectors, animal reservoirs, and human hosts are susceptible to Leishmania infection by a single parasite species. However, current evidence supports that these new vector-parasite-reservoir associations lend vectors and reservoirs greater permissiveness to certain Leishmania species, thus promoting the appearance of coinfection events, particularly in disease-endemic regions. The present study describes the application of an amplicon-based next-generation sequencing (NGS) assay to detect and identify trypanosomatid species in mammalian reservoirs, human patients, and sand fly vectors from regions of endemicity for leishmaniasis. This changes our understanding of the clinical course of leishmaniasis in areas of endemicity.

4.
Hum Vaccin Immunother ; : 1-6, 2021 Oct 06.
Artículo en Inglés | MEDLINE | ID: mdl-34614378

RESUMEN

The ongoing humanitarian crisis in Venezuela has made it difficult to satisfactorily manage the COVID-19 pandemic in that nation. A vaccination program has begun, but its pace has been slow, as compared to vaccination in other countries. One considerable obstacle faced by vaccination efforts in Venezuela is vaccine hesitancy. Differences across religious groups regarding vaccine hesitancy in Venezuela have not been sufficiently explored. The present study consists of a sample of 230 university students in Venezuela, assessing their intention to get the COVID-19 vaccine. Their responses are compared across religious affiliations, and correlated with three variables: belief in vaccine conspiracy theories, religiosity, and acceptance of the theory of evolution. Results come out showing that Protestants are the religious group most hesitant to get the COVID-19 vaccine, followed by Catholics and the non-religious. Results also show that vaccine hesitancy is correlated with vaccine conspiracy theories and acceptance of the theory of evolution, but not with religiosity itself.

5.
Curr Hypertens Rev ; 2021 Oct 05.
Artículo en Inglés | MEDLINE | ID: mdl-34636304

RESUMEN

BACKGROUND: As a syndrome of physiological vulnerability and multifactorial progressive decline tightly related to age, frailty has been associated with several illnesses, and in particular cardiovascular disease.

Objective: To assess the factors associated with the frailty syndrome in older adults evaluated in the outpatient clinic of a tertiary hospital from Maracaibo city, Venezuela.

Materials and Methods: An observational, analytical, cross-sectional study was performed on subjects of both genders, over 60 years old, that went to the Internal Medicine outpatient clinic of the Hospital General del Sur "Dr. Pedro Iturbe" from Maracaibo city, Venezuela. Sampling was performed via a non-probabilistic, intentional method. For each subject with frailty or pre-frailty, a control subject was selected in a 1:1 ratio according to gender; several risk factors were interrogated. The state of frailty was determined through the FRAIL scale.

Results: Of the 201 assessed patients, 49.3% (n=99) were non-frail, 19.9% (n=40) were pre-frail and 30.8% (n=62) were frail. The population's overall age was 68.8±6.8 in non-frails, 69.1±7.7 in pre-frails, and 68.6±7.1 in frails. In the multivariate analysis, subjects with frailty and pre-frailty were most likely to be receiving polypharmacy (OR: 2.36, CI95%: 1.05-5.37; P=0.04) and have hypertension during the study (OR: 10.19, CI95%: 3.86-26.89; P<0.01).

Conclusion: The newly diagnosed hypertension and presence of polypharmacy were the factors most associated with frailty and pre-frailty in older adults evaluated in a tertiary hospital from Maracaibo city, Venezuela.

6.
Washington, D.C.; OPS; 2021-10-14.
en Español | PAHO-IRIS | ID: phr-54999

RESUMEN

In 2021, three countries in the Region of the Americas (Brazil, Peru, and Venezuela) have reported confirmed yellow fever cases. In 2020, two countries in the Region of the Americas reported confirmed cases of yellow fever: Bolivia and Peru. A situation summary of the countries that reported confirmed yellow fever cases in 2021 is provided here.


En 2021, tres países de la Región (Brasil, Perú y Venezuela) notificaron casos confirmados de fiebre amarilla. En 2020 fueron dos los países de la región de las Américas que notificaron casos confirmados de fiebre amarilla: Brasil y Perú. Aquí se presenta un resumen de la situación los países que notificaron casos confirmados de fiebre amarilla en 2021.


Asunto(s)
Fiebre Amarilla , Vacuna contra la Fiebre Amarilla , Reglamento Sanitario Internacional , Urgencias Médicas , Brasil , Perú , Fiebre Amarilla , Vacuna contra la Fiebre Amarilla , Reglamento Sanitario Internacional , Urgencias Médicas , Brasil , Perú
7.
Pak J Biol Sci ; 24(4): 468-476, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-34486306

RESUMEN

<b>Background and Objective:</b> Forage production in the tropics is generally asymmetrically distributed. Hence the need to use more complex models, especially when multiple comparisons are made and there are very large deviations from normality. The objective of this research is to fit a Generalized Additive Model for Location, Scale and Shape (GAMLSS) model on accumulated dry matter data from <i>Brachiaria brizantha</i> using a model selection algorithm. <b>Materials and Methods:</b> A Box-Cox Power Exponential (BCPE) distribution was adjusted on the dry matter from <i>Brachiaria brizantha</i> data implementing GAMLSS in R (programming language). The accumulated dry matter data for <i>B. brizantha</i> were obtained from a study carried out on a farm in the state of Portuguesa, Venezuela. The explanatory covariate x was the interval between cuts (21, 28, 35 and 42 days). <b>Results:</b> The dependent variable (dry matter) exhibited both skewness and kurtosis. GAMLSS allowed flexible modeling of both the distribution of the dry matter yield from <i>B. brizantha</i> and the dependence of all the parameters of the distribution on intervals between cuttings. For the dry matter yield from <i>B. brizantha</i>, which exhibited skewness and leptokurtosis, the BCPE distribution, provided the best fit. <b>Conclusion:</b> The interval between cuttings showed an effect that is reflected in the average yield of dry matter from <i>B. brizantha</i>. The interval between cuts affected the skewness and the kurtosis of the distribution.

8.
J Spec Oper Med ; 21(3): 126-133, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34529820

RESUMEN

Venezuela is living in a delicate social and political crisis that has taken thousands of lives. Beginning in March 2017, a series of continuous and increasingly violent demonstrations has taken place, with a high number of civilian casualties. These demonstrations typically have been outside the range of action of the government prehospital services. In addition, the number of casualties frequently overwhelmed the abilities of the available rescue services. Out of the need for a first aid team that could operate in this violent scenario, First Aid UCV (Central University of Venezuela) was created. A large number of professionals with medical, rescue, and tactical medicine experience integrated this new team, modifying their training and practice to adapt to a scenario in which unarmed medical students and medical doctors performed extractions, provided first aid, and managed the transport of demonstration casualties, doing so even when team members were sometimes targeted by the government police and military forces. This method has had successful results in all 60 operations conducted to date, with a total of 5,000 casualties being extracted among civilians, the military, and the police force. Only one member of the team was injured during the operations, and no deaths were reported during the process.


Asunto(s)
Servicios Médicos de Urgencia , Medicina Militar , Personal Militar , Primeros Auxilios , Humanos
9.
Acta Odontol Latinoam ; 34(1): 104-1112, 2021 Aug 01.
Artículo en Inglés | MEDLINE | ID: mdl-34570154

RESUMEN

Great variation has been reported in worldwide prevalence of Molar Incisor Hypomineralization (MIH) and Hypomineralized Second Primary Molar (HSPM). South America has the highest regional prevalence. The aim of this study was to determine the prevalence and distribution of MIH HSPM in 6- to 12-year-old children who received care at two dental healthcare services (public and private) in Caracas Metropolitan Area, Venezuela. A cross-sectional prospective study was conducted on 145 children, of whom 121 were selected in the stratified random sample. A calibrated examiner (Kappa=0.878/0.831) evaluated all patients following the MIH diagnosis criteria established by the European Academy of Paediatric Dentistry and using a valid and reliable instrument. Data were analyzed with a significance level of 5%. Of the 121 children, 46.28% (56) were male and 53.72% (65) female, average age 8.83 ± 1.61. The prevalence of MIH/HSPM was 25.6%/20%. Both enamel defects were more prevalent in females (p-value=0.026/0.005). Severe MIH/HSPM was present in 21.8%/31.2% of cases. Average number of affected teeth was 4.16 ± 2.19/1.68 ± 0.74; and the condition was more frequent in upper molars (67.7%/51.4%). It was concluded that prevalence of MIH in 6- to 12-year-old Venezuelan children who received care in Caracas Metropolitan Area was higher than the previously estimated prevalence for South America, with predominance of mild affectation and more frequently occurring in upper molars.


Asunto(s)
Hipoplasia del Esmalte Dental , Niño , Estudios Transversales , Atención Odontológica , Hipoplasia del Esmalte Dental/epidemiología , Femenino , Humanos , Masculino , Prevalencia , Estudios Prospectivos , Venezuela/epidemiología
10.
Acta Odontol Latinoam ; 34(2): 104-1112, 2021 Aug 01.
Artículo en Inglés | MEDLINE | ID: mdl-34570857

RESUMEN

Great variation has been reported in worldwide prevalence of Molar Incisor Hypomineralization (MIH) and Hypomineralized Second Primary Molar (HSPM). South America has the highest regional prevalence. The aim of this study was to determine the prevalence and distribution of MIH HSPM in 6- to 12-year-old children who received care at two dental healthcare services (public and private) in Caracas Metropolitan Area, Venezuela. A cross-sectional prospective study was conducted on 145 children, of whom 121 were selected in the stratified random sample. A calibrated examiner (Kappa=0.878/0.831) evaluated all patients following the MIH diagnosis criteria established by the European Academy of Paediatric Dentistry and using a valid and reliable instrument. Data were analyzed with a significance level of 5%. Of the 121 children, 46.28% (56) were male and 53.72% (65) female, average age 8.83 ± 1.61. The prevalence of MIH/HSPM was 25.6%/20%. Both enamel defects were more prevalent in females (p-value=0.026/0.005). Severe MIH/HSPM was present in 21.8%/31.2% of cases. Average number of affected teeth was 4.16 ± 2.19/1.68 ± 0.74; and the condition was more frequent in upper molars (67.7%/51.4%). It was concluded that prevalence of MIH in 6- to 12-year-old Venezuelan children who received care in Caracas Metropolitan Area was higher than the previously estimated prevalence for South America, with predominance of mild affectation and more frequently occurring in upper molars.


Asunto(s)
Hipoplasia del Esmalte Dental , Niño , Estudios Transversales , Atención Odontológica , Hipoplasia del Esmalte Dental/epidemiología , Femenino , Humanos , Masculino , Prevalencia , Estudios Prospectivos , Venezuela/epidemiología
11.
Vet Parasitol Reg Stud Reports ; 25: 100594, 2021 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-34474787

RESUMEN

Trypanosoma vivax is a protozoan parasite that causes trypanosomosis in ruminants and is widely distributed in tropical areas in the world. The control of this disease depends on the sensitivity and specificity of the diagnostic tests implemented for naturally infected samples, where parasitaemias are usually low. This study aimed to evaluate the analytical sensitivity and specificity of several primers for T. vivax detection in experimental infections and their implementation for the diagnosis of trypanosomosis in naturally infected bovine and ovine samples. Using a T. vivax Venezuelan isolate, five sets of primers were evaluated: TviSL1/2, ITS1CF/BR, TVMF/R, ILO1264/1265, TVWA/B. Additionally, we tested the PCR protocols using different DNA quantities. The best set of primers (ILO1264/1265) was used to detect T. vivax DNA from whole blood and buffy coat samples of 12 sheep (ovine) and 45 cattle (bovine) of small farms from Venezuela, and compared to the micro-haematocrite centrifugation technique (MHCT). The highest sensitivity was 0.0001 ng for ILO1264/1265 and TVWA/B primers. Using 100 ng of DNA extracted from the buffy coat and the ILO1264/1265 primers for trypanosomosis diagnosis from naturally infected samples, yielded 66.7% (8/12) and 35.7% (16/45) positives in ovine and bovine respectively. The percentage of positives samples increased to 83.3% (10/12) and 64.4% (29/45), with 300 ng in the assays. Contrary, using 300 ng of DNA extracted from the whole blood yielded only 50% (6/12) and 28.9% (13/45) of positives samples for T. vivax respectively. MHCT only detected the parasite in bovine samples with 17.8% (8/45) of positives. Based on our results, we recommend the use of the ILO1264/1265 primers and 300 ng of DNA extracted from the buffy coat for epidemiological studies of naturally infected animals. Moreover, detection of the parasite in ovine herds highlights a possible role of this host in the epidemiology of trypanosomosis in Venezuela.

12.
Biomedica ; 41(3): 531-540, 2021 09 22.
Artículo en Inglés, Español | MEDLINE | ID: mdl-34559498

RESUMEN

Introduction: Breast cancer is the most frequent malignancy in women worldwide. Different intrinsic subtypes have different prognoses and their prevalence varies significantly according to the criteria established in the Saint Gallen Consensus. Objective: To classify the luminal subtypes of breast carcinoma according to Saint Gallen 2009, 2011, 2013, and 2015 consensuses in a group of Venezuelan patients. Materials and methods: We conducted a retrospective study in 209 patients with infiltrating ductal carcinoma of the breast followed up at the Institute of Oncology "Dr. Miguel Pérez Carreno" in Valencia, Venezuela. Results: The distribution of the luminal A and B subtypes changed after the reclassification of the cases according to 2011, 2013, and 2015 Saint Gallen Consensuses. The luminal B subtype was the most common in the study series. Conclusions: With the use of a classification based on the latest Saint Gallen criteria we identified more luminal B tumors. This could contribute to selecting those patients who can avoid adjuvant chemotherapy and/or benefit from the adjuvant hormonal therapy in clinical practice.

13.
Vacunas ; 2021 Sep 07.
Artículo en Español | MEDLINE | ID: mdl-34512219

RESUMEN

OBJECTIVE: To assess if seven demographic variables (age, gender, religion, ethnicity, income, educational level, and political views) are predictive of Covid-19 vaccine hesitancyMaterial and methods: 327 participants completed a survey asking questions regarding each of the variables. RESULTS: Age, gender and political views have no statistically significant correlation with vaccine hesitancy. Ethnicity and religion are predictive of vaccine hesitancy. Income has a weak negative correlation with Covid-19 vaccine hesitancy, and educational level has a moderate negative correlation with Covid-19 vaccine hesitancy. CONCLUSION: In order to curb Covid-19 vaccine hesitancy, public health authorities in Venezuela need to focus efforts on marginalized ethnic groups, Protestants, and those with lower levels of education.

14.
PLoS Med ; 18(9): e1003097, 2021 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-34520466

RESUMEN

BACKGROUND: The World Health Organization (WHO) has reframed health and healthcare for older people around achieving the goal of healthy ageing. The recent WHO Integrated Care for Older People (ICOPE) guidelines focus on maintaining intrinsic capacity, i.e., addressing declines in neuromusculoskeletal, vitality, sensory, cognitive, psychological, and continence domains, aiming to prevent or delay the onset of dependence. The target group with 1 or more declines in intrinsic capacity (DICs) is broad, and implementation may be challenging in less-resourced settings. We aimed to inform planning by assessing intrinsic capacity prevalence, by characterising the target group, and by validating the general approach-testing hypotheses that DIC was consistently associated with higher risks of incident dependence and death. METHODS AND FINDINGS: We conducted population-based cohort studies (baseline, 2003-2007) in urban sites in Cuba, Dominican Republic, Puerto Rico, and Venezuela, and rural and urban sites in Peru, Mexico, India, and China. Door-knocking identified eligible participants, aged 65 years and over and normally resident in each geographically defined catchment area. Sociodemographic, behaviour and lifestyle, health, and healthcare utilisation and cost questionnaires, and physical assessments were administered to all participants, with incident dependence and mortality ascertained 3 to 5 years later (2008-2010). In 12 sites in 8 countries, 17,031 participants were surveyed at baseline. Overall mean age was 74.2 years, range of means by site 71.3-76.3 years; 62.4% were female, range 53.4%-67.3%. At baseline, only 30% retained full capacity across all domains. The proportion retaining capacity fell sharply with increasing age, and declines affecting multiple domains were more common. Poverty, morbidity (particularly dementia, depression, and stroke), and disability were concentrated among those with DIC, although only 10% were frail, and a further 9% had needs for care. Hypertension and lifestyle risk factors for chronic disease, and healthcare utilisation and costs, were more evenly distributed in the population. In total, 15,901 participants were included in the mortality cohort (2,602 deaths/53,911 person-years of follow-up), and 12,939 participants in the dependence cohort (1,896 incident cases/38,320 person-years). One or more DICs strongly and independently predicted incident dependence (pooled adjusted subhazard ratio 1.91, 95% CI 1.69-2.17) and death (pooled adjusted hazard ratio 1.66, 95% CI 1.49-1.85). Relative risks were higher for those who were frail, but were also substantially elevated for the much larger sub-groups yet to become frail. Mortality was mainly concentrated in the frail and dependent sub-groups. The main limitations were potential for DIC exposure misclassification and attrition bias. CONCLUSIONS: In this study we observed a high prevalence of DICs, particularly in older age groups. Those affected had substantially increased risks of dependence and death. Most needs for care arose in those with DIC yet to become frail. Our findings provide some support for the strategy of optimising intrinsic capacity in pursuit of healthy ageing. Implementation at scale requires community-based screening and assessment, and a stepped-care intervention approach, with redefined roles for community healthcare workers and efforts to engage, train, and support them in these tasks. ICOPE might be usefully integrated into community programmes for detecting and case managing chronic diseases including hypertension and diabetes.

15.
Parasitol Int ; 86: 102468, 2021 Sep 11.
Artículo en Inglés | MEDLINE | ID: mdl-34520840

RESUMEN

Parastrigea brasiliana (Szidat, 1928) Dubois, 1964, was described from (Cochlearius cochlearius) in South America. The taxonomy of this species has been unstable due that it was described as a member of Strigea Abildgaard, 1790. However, the same author one year later transferred it to Apharyngostrigea Ciurea, 1927 and since then, it has been alternatively placed in the genus Apharyngostrigea or Parastrigea Szidat, 1928 from Strigeidae. In the current research, specimens identified as P. brasiliana were collected from type host in southeastern Mexico. We sequenced three molecular markers: the internal transcribed spacers ITS1 and ITS2 including the 5.8S gene (ITS region), the D1-D3 domains of the large subunit (LSU) from nuclear DNA and cytochrome c oxidase subunit I (cox 1) from mitochondrial DNA. These sequences were aligned with other sequences available in the GenBank dataset from Strigeidae. Maximum likelihood and Bayesian analyses inferred with three molecular markers consistently showed that P. brasiliana is not closely related to other members of the genus Parastrigea and are placed in a reciprocal monophyletic clade inside Apharyngostrigea, with very low genetic divergence, varying from 0 to 0.09% for the ITS, from 0 to 0.08% for the LSU and from 0.21 to 0.43% for cox 1. Consequently, we proposed to reallocate it to A. brasiliana. The phylogenetic analyses obtained are key and very useful for re-evaluate the morphology of A. brasiliana because this species share morphological characters with the genera Parastrigea (concentration of vitelline follicles distributed in two lateral expansions on the forebody) and Apharyngostrigea (absence of pharynx). Finally, the current record of A. brasiliana expands its distribution range in four countries, namely, the USA, Mexico, Venezuela and Brazil, in the Neotropical region.

16.
Soc Sci Q ; 2021 Aug 11.
Artículo en Inglés | MEDLINE | ID: mdl-34548705

RESUMEN

Objective: While the aim of COVID-19 policies is to suppress the pandemic, many fear that the burden of the restrictions will fall more heavily on less privileged groups. We show one potential mechanism for COVID-19 responses to increase inequality by examining the intersection of business restrictions and business political connections. Methods: We fielded an online survey of 2735 business employees and managers in Ukraine, Egypt, and Venezuela over the summer of 2020 to collect data on companies' closures due to COVID-19 and nuanced information about their political connections. Findings: We show that businesses with political connections to government officials were significantly less likely to shut down as a result of COVID-19 policies. This finding suggests that measures designed to mitigate COVID-19 are ineffective in countries with a weak rule of law if politically connected firms are able to circumvent restrictions by leveraging political connections to receive preferential treatment. In addition, politically connected firms are no more likely-and sometimes even less likely-to engage in social-distancing policies to mitigate the pandemic despite the fact that they are more likely to remain open.

17.
Malar J ; 20(1): 375, 2021 Sep 20.
Artículo en Inglés | MEDLINE | ID: mdl-34544438

RESUMEN

BACKGROUND: Venezuela accounted for 55% of the cases and 73% of the malaria deaths in the Americas in 2019. Bolivar state, in the southeast, contributes > 60% of the country's Plasmodium vivax and Plasmodium falciparum cases every year. This study describes the clinical-epidemiological characteristics of clinical malaria patients in this high-transmission area. METHODS: A prospective study was conducted on patients seeking medical attention in three medical centres in the state capital, Ciudad Bolivar, between June and October 2018. Malaria diagnosis was carried out using microscopy following national standards. Malaria-positive patients were examined for clinical symptoms, and haematological tests were performed at the time of diagnosis. Patients were followed up by telephone to evaluate malaria recurrences. RESULTS: Out of 287 patients, 200 (69.7%) were positive for P. vivax, 69 (24%) for P. falciparum, and 18 (6.3%) had mixed (P. vivax/P. falciparum) infections. Patients' median age was 33 years (IQR 20), 168 (69%) were men, and 40% practiced gold mining as the main occupation. Fever (96.5%), chills (91.3%), and headaches (90.6%) were the most frequent symptoms. At least one symptom associated with severe malaria was observed in 69 out of 161 patients with complete clinical evaluation (42.9%). Plasmodium vivax infections were found in 42 out of 69 (60.9%) severe cases; by contrast, P. falciparum and mixed malaria caused 34.8% (24/69) and 4.4% (3/69) of infections, respectively. Two patients died of cerebral malaria. Mean hemoglobin was lower in the patients infected with P. falciparum than those infected with P. vivax. Regardless of the parasite causing the infection, patients presented high levels of total bilirubin, aminotransferases (AST, ALT), and lactate dehydrogenase (LDH). Out of the 142 patients followed up by phone for three months (49.5% of the 287 patients), 35 (24.7%) reported recurrences. CONCLUSIONS: The high malaria prevalence among young male adults practicing gold mining suggests that this occupation is a significant risk factor. The unexpected high prevalence of P. vivax patients with at least one criteria of severe clinical disease is a matter of concern. Whether it is the result of a lack of timely diagnosis and effective treatment should be explored.

18.
Eur J Obstet Gynecol Reprod Biol ; 265: 150-155, 2021 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-34500212

RESUMEN

OBJECTIVE: To describe clinical and demographic characteristics, ultrasound appearance, and hysteroscopic outcomes of patients with endometrial osseous metaplasia. STUDY DESIGN: We conducted a multicenter retrospective study. We retrospectively reviewed the medical records of all consecutive patients who were referred for hysteroscopy at fourteen institutions in Venezuela, Spain, Morocco, India, Ukraine, Argentina, the United States, and Italy between 1994 and 2018. We identified and included all patients who had a diagnosis of osseous metaplasia at the pathologic report, and data were retrieved from the medical records. RESULTS: Between January 1st, 1994, and December 31st, 2018, 63 patients out of a total of 419,673 women who underwent hysteroscopy had a diagnosis of osseous metaplasia (0.015%). Most patients were 31-40 years old (53.7%), were Caucasian or Hispanic (95.5%), and had at least one previous pregnancy (86.9%). Forty-one out of 63 patients (65.1%) had at least one miscarriage before the index hysteroscopy. Dysmenorrhea, abnormal uterine bleeding, and infertility were reported by 34.9%, 27.0%, and 23.8% of patients. 14.3% of women were asymptomatic. Preoperative transvaginal ultrasound was available and identified a hyperechoic area of variable size with posterior acoustic shadowing in all cases. Hysteroscopy was successful without complications in all 63 cases. Follow-up data were available in 30.2% of patients: 69.2% of patients were infertile, and 44.4% of them conceived and achieved a live birth; all other symptoms improved after hysteroscopic treatment in all patients. CONCLUSIONS: Osseous metaplasia appears associated with multiple unspecific gynecologic symptoms without the predominant role of infertility, as previously suggested. Although endometrial osseous metaplasia is rare, gynecologists should consider this pathologic condition when the characteristic ultrasound appearance is detected, being hysteroscopic treatment effective.


Asunto(s)
Coristoma , Adulto , Endometrio/diagnóstico por imagen , Femenino , Humanos , Histeroscopía , Metaplasia/diagnóstico por imagen , Embarazo , Estudios Retrospectivos
19.
Washington, D.C.; OPS; 2021-09-24. (OPS/ONUSIDA/CDE/COVID-19/21-0013).
en Español | PAHO-IRIS | ID: phr-54912

RESUMEN

El flujo de personas refugiadas y migrantes desde la República Bolivariana de Venezuela constituye el mayor movimiento de personas de la historia de América Latina y la segunda más numerosa a nivel mundial. Hasta el 2020, más de 5 millones de personas habían abandonado el país en busca de mejores condiciones de vida y de acceso a servicios básicos, entre ellos, la atención de salud. Esta publicación ha sido elaborada por ONUSIDA y la OPS en el marco del proceso de coordinación regional, técnica y financiera para el apoyo a personas refugiadas y migrantes de la República Bolivariana de Venezuela. Presenta orientaciones prácticas para incrementar la cobertura de salud a las personas refugiadas y migrantes del país, considerando el actual contexto de la COVID-19. Se estructura en cinco líneas de acción estratégicas dirigidas a ampliar las políticas de prevención, atención y tratamiento del VIH. Esta propuesta se dirige a los responsables de la formulación de políticas de los ministerios de salud de la Región y a funcionarios de los sistemas de salud, así como a otras instituciones que aborden cuestiones relacionadas con las poblaciones refugiadas y migrantes a nivel regional, nacional y subnacional, en especial a las que desarrollan actividades en las zonas fronterizas y en las comunidades de destino. Las recomendaciones se han adaptado al contexto de la pandemia de COVID-19, que ha sumado nuevos desafíos a las respuestas en salud, y en especial al VIH/sida en la Región de las Américas.


Asunto(s)
Refugiados , Migrantes , VIH , COVID-19 , Venezuela
20.
Washington, D.C.; PAHO; 2021-09-24. (PAHO/UNAIDS/CDE/COVID-19/21-0013).
en Inglés | PAHO-IRIS | ID: phr-54911

RESUMEN

The flow of refugees and migrants from the Bolivarian Republic of Venezuela is the largest movement of people in the history of Latin America and the second largest in the world. By 2020, more than 5 million people had left the country in search of better living conditions and access to basic services, including health care. This publication was prepared by PAHO and UNAIDS as part of the regional process of coordinating technical and financial support for refugees and migrants in the Bolivarian Republic of Venezuela. It presents practical guidelines for expanding health care coverage for Venezuelan refugees and migrants, taking into consideration the current context of COVID-19. It is structured along five strategic lines of action aimed at expanding HIV prevention, care, and treatment policies. This proposal is aimed at policymakers in the Region’s ministries of health, health system officials, and other institutions that deal with issues related to refugee and migrant populations at regional, national, and subnational levels, especially those active in border areas and destination communities. The recommendations have been adapted to the context of the COVID-19 pandemic, which has created new challenges in relation to health responses, especially the response to HIV/AIDS in the Region of the Americas.


Asunto(s)
COVID-19 , VIH , Refugiados , Migrantes , Emigración e Inmigración , Venezuela
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