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This research determines the critical factors for implementing ergonomics programs related to health and safety benefits in the manufacturing industries of Ciudad Juarez, Mexico, from the middle/upper management perspective. The sample was non-probabilistically selected for convenience, comprising individuals in middle and senior management positions. An original questionnaire containing 105 items measuring five latent variables was developed, reviewed, and validated for data collection. The sample size totalled 206 participants. Structural equation models using partial least squares (PLS) were employed to analyse interrelationships between variables. This research demonstrated acceptable reliability and quality indices. Management commitment emerged as the most significant factor, exerting the highest direct, indirect, and total effects on the work environment and prevention activities, significantly enhancing health and safety benefits. Consequently, manufacturing companies in Juarez City must strive to improve management commitment in the working environment and prevention activities since both strategies can increase employee health and safety benefits.
This paper presents a method focusing on the critical success factors of ergonomics programs associated with health and safety benefits in Mexico's manufacturing industries. The study uses structural equation modelling from the middle/upper management perspective. The proposed approach has potential applications across various industries.
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High-fat and high-carbohydrate (HF-HC) diets induce metabolic syndrome via mitochondrial dysfunction and oxidative stress. We have previously shown that this may be prevented by avocado oil, a source of bioactive molecules with antioxidant properties. However, it is unknown if these effects are mediated by the unsaponifiable fraction of avocado oil (UFAO). Thus, we tested if this fraction improves glucose metabolism, bioenergetics and oxidative stress in mitochondria from the kidney and liver of rats fed an HF-HC diet. We found that 12 weeks of an HF-HC diet impaired glucose utilization and increased insulin resistance, which was prevented by UFAO administration. The HF-HC diet decreased respiration, membrane potential and electron transport chain (ETC) function in liver and kidney mitochondria. These mitochondrial dysfunctions were prevented by UFAO intake. Unexpectedly, UFAO increased ROS levels in the mitochondria of control animals and did not decrease them in rats with an HF-HC diet; however, UFAO protects liver and kidney mitochondria from iron-induced oxidative stress. These findings suggest that impairments in glucose metabolism and mitochondrial function by an HF-HC diet may be prevented by UFAO, without decreasing ROS generation but protecting mitochondria from oxidative damage.
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Abstract: Routine use of human papillomavirus (HPV) vaccines is recommended in adolescents under 15 years of age worldwide. Still, effective programs remain suboptimal for several factors, making the WHO strategy to eradicate cervical cancer public health with an uncertain future. Objective: To review the literature on the effectiveness, long-term protection, and safety of HPV vaccination programs and vaccination as adjuvant management. This review aims to describe the current state of vaccination programs and demonstrate the long-term protection and safety of vaccines implemented worldwide targeting adolescent girls, with the most recent published evidence of the three prophylactic HPV vaccines - bivalent (bHPV), quadrivalent (qHPV), and nonavalent (nHPV)-. We mainly focus on publications evaluating efficacy, dosing schemes, and HPV vaccination, as well as studies contributing to the mounting evidence for the real-life effectiveness of prophylactic HPV vaccines from several countries. Findings: Human Papillomavirus vaccination programs have made remarkable strides in preventing HPV-related diseases; countries with robust vaccination efforts have witnessed substantial reductions in HPV-related diseases with a decline in high-grade cervical abnormalities and genital warts (54%-83%). However, global coverage remains uneven, with disparities between high-income (HICs) and low-income countries (LMICs). The long-term efficacy of the available human papillomavirus (HPV) goes up to 9.4 years and continues to be immunogenic and well tolerated with an excellent safety profile. Conclusions and relevance: As these are crucial topics in HPV vaccination, it is essential to establish systems for continued monitoring of vaccine immunogenicity, efficacy, and safety over time.
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BACKGROUND: Malaria is a major global public health issue with varying epidemiologies across countries. In Colombia, it is a priority endemic-epidemic event included in the national public health policy. However, evidence demonstrating nationwide variations in the disease behavior is limited. This study aimed to analyze changes in the levels and distribution of endemic-epidemic malaria transmission in the eco-epidemiological regions of Colombia from 1978 to 1999 and 2000 to 2021. METHODS: We conducted a comprehensive time-series study using official secondary data on malaria-associated morbidity and mortality in Colombia from 1978 to 2021. Temporal-spatial and population variables were analyzed, and the absolute and relative frequency measures of general and regional morbidity and mortality were estimated. RESULTS: We observed an 18% reduction in malaria endemic cases between the two study periods. The frequency and severity of the epidemic transmission of malaria varied less and were comparable across both periods. A shift was observed in the frequency of parasitic infections, with a tendency to match and increase infections by Plasmodium falciparum. The risk of malaria transmission varied significantly among the eco-epidemiological regions during both study periods. This study demonstrated a sustained decrease of 78% in malarial mortality. CONCLUSIONS: Although the endemic components of malaria decreased slightly between the two study periods, the epidemic pattern persisted. There were significant variations in the risk of transmission across the different eco-epidemiological regions. These findings underscore the importance of targeted public health interventions in reducing malarial morbidity and mortality rates in Colombia.
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Enfermedades Endémicas , Colombia/epidemiología , Humanos , Epidemias , Malaria/epidemiología , Malaria/transmisión , Malaria Falciparum/epidemiología , Malaria Falciparum/transmisión , IncidenciaRESUMEN
ANTECEDENTES: Las gestaciones múltiples sugieren un mayor riesgo de mortalidad perinatal. Dentro de estas estadísticas, la muerte de un solo gemelo ocurre en hasta el 6% de los embarazos múltiples. La incidencia general después de las 20 semanas de gestación (sdg) se estima entre el 2.6% y el 6.2% de todos estos embarazos. Se ha demostrado que es la coriónicidad, más que la cigosidad, la que influye en el resultado de esta complicación, debido a la angioarquitectura placentaria de las circulaciones en los embarazos monocoriónicos. Las tasas de pérdida de hasta el 30-50% se han asociado con embarazos monocoriónicos y monoamnióticos. Si ocurre antes de las 14 sdg, el embrión puede desaparecer; entre las 14 y las 20 sdg, el feto se reduce en tamaño y volumen. Y, si ocurre después de 20 sdg, el feto permanece dentro del útero hasta el final de la gestación. CASO CLÍNICO: femenina de 18 años de edad, quien acudió a revisión obstétrica con reporte ultrasonográfico de un embarazo gemelar monocorial biamniótico de 30.4 sdg, y muerte de uno de los gemelos. Tras demostrar estabilidad hemodinámica del feto sobreviviente, así como estabilidad materna, se decidió internamiento para monitoreo estrecho. Una semana después desarrolló trabajo de parto pretérmino y se decidió la interrupción de la gestación de manera urgente. Se obtuvo un recién nacido masculino con edad gestacional sugestiva de 32 sdg, con dificultad respiratoria y requirió hospitalización para monitoreo estrecho del recién nacido prematuro. Madre egresó a las 48 horas, nunca desarrolló datos de coagulación intravascular diseminada (CID) y el recién nacido se mantuvo en hospitalización aproximadamente 3 semanas y media hasta que se egresó por adecuada adaptación. Nunca se demostró afectación neurológica o de algún otro órgano o sistema. CONCLUSIONES: Los factores más importantes al considerar el riesgo para el gemelo sobreviviente son la edad gestacional a la que ocurre la muerte del otro feto, y la corionicidad. El manejo debe incluir ecografías seriadas y programadas para el crecimiento. Estudios de Doppler arterial/venoso periférico e intracardiaco y una resonancia magnética al menos 3 semanas después de la muerte fetal para buscar cambios en el cerebro del gemelo sobreviviente. A pesar de que existen casos reportados de manejo conservador, es necesario el seguimiento estricto de datos de CID maternos, así como de desprendimiento prematuro de placenta normoinserta. (provisto por Infomedic International)
BACKGROUND: Multiple gestations suggest an increased risk of perinatal mortality. Within these statistics, death of a single twin occurs in up to 6% of multiple pregnancies. The overall incidence after 20 weeks gestation (sdg) is estimated to be between 2.6% and 6.2% of all such pregnancies. Chorionicity, rather than zygosity, has been shown to influence the outcome of this complication, due to the placental angioarchitecture of the circulations in monochorionic pregnancies. Loss rates of up to 30-50% have been associated with monochorionic and monoamniotic pregnancies. If it occurs before 14 sdg, the embryo may disappear; between 14 and 20 sdg, the fetus is reduced in size and volume. And, if it occurs after 20 sdg, the fetus remains inside the uterus until the end of gestation. CLINICAL CASE: 18-year-old female, who attended an obstetric check-up with an ultrasonographic report of a biamniotic monochorionic twin pregnancy of 30.4 sdg, and death of one of the twins. After demonstrating hemodynamic stability of the surviving fetus, as well as maternal stability, it was decided to hospitalize her for close monitoring. One week later she developed preterm labor and it was decided to terminate the pregnancy urgently. A male newborn was obtained with a gestational age suggestive of 32 sdg, with respiratory distress and required hospitalization for close monitoring of the premature newborn. Mother was discharged at 48 hours, never developed disseminated intravascular coagulation (DIC) and the newborn remained in hospital for approximately 3 and a half weeks until he was discharged due to adequate adaptation. No neurologic or other organ or system involvement was ever demonstrated. CONCLUSIONS: The most important factors when considering the risk to the surviving twin are the gestational age at which the death of the other fetus occurs, and chorionicity. Management should include serial and scheduled ultrasounds for growth. Peripheral arterial/venous and intracardiac Doppler studies and MRI at least 3 weeks after fetal death to look for changes in the brain of the surviving twin. Although there are case reports of conservative management, close monitoring of maternal DIC data, as well as normoinsert placental abruption, is necessary. (provided by Infomedic International)
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Volatile organic compounds (VOCs) in exhaled human breath serve as pivotal biomarkers for disease identification and medical diagnostics. In the context of diabetes mellitus, the noninvasive detection of acetone, a primary biomarker using electronic noses (e-noses), has gained significant attention. However, employing e-noses requires pre-trained algorithms for precise diabetes detection, often requiring a computer with a programming environment to classify newly acquired data. This study focuses on the development of an embedded system integrating Tiny Machine Learning (TinyML) and an e-nose equipped with Metal Oxide Semiconductor (MOS) sensors for real-time diabetes detection. The study encompassed 44 individuals, comprising 22 healthy individuals and 22 diagnosed with various types of diabetes mellitus. Test results highlight the XGBoost Machine Learning algorithm's achievement of 95% detection accuracy. Additionally, the integration of deep learning algorithms, particularly deep neural networks (DNNs) and one-dimensional convolutional neural network (1D-CNN), yielded a detection efficacy of 94.44%. These outcomes underscore the potency of combining e-noses with TinyML in embedded systems, offering a noninvasive approach for diabetes mellitus detection.
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Diabetes Mellitus , Compuestos Orgánicos Volátiles , Humanos , Nariz Electrónica , Pruebas Respiratorias/métodos , Algoritmos , Diabetes Mellitus/diagnóstico , Aprendizaje Automático , BiomarcadoresRESUMEN
A two decades-long epidemic of Rocky Mountain spotted fever in northern México reached the U.S. border city of Tijuana in 2021. Cases were near the city periphery in marginalized areas, some lacking infrastructure such as streets or utilities. We worked in the three census areas where human cases were reported and in 12 additional control Áreas Geoestadisticas Básicas. There were dogs, the primary tick host and Rickettsia rickettsii reservoir, in 76% of homes, with 2.2 owned dogs per home on average, approximately equal numbers of roaming dogs were seen, and 46.2% of owned dogs were allowed to roam in the street. Sixty-eight percent of people had heard of Rocky Mountain spotted fever (RMSF), and 35% self-reported tick infestation, including 19% of homes without dogs. Ticks appeared to move among houses of adjacent neighbors. Of 191 examined dogs, 61.8% were tick-infested, with 6-fold increased odds if they were allowed to roam. Although no dogs were Rickettsia polymerase chain reaction-positive, we found one R. rickettsii- and 11 Rickettsia massiliae-infected ticks. The rickettsial IgG seroprevalence by immunofluorescence antibody assay was 76.4%, associated with unhealthy body condition, adults, dogs with >10 ticks, more dogs being seen in the area, and dogs being permitted in the street. Insufficient medical and canine management resources have contributed to a case fatality rate of RMSF that has exceeded 50% in areas. High canine seroprevalence suggests risks to people and dogs; unfortunately, herd immunity is impeded by high turnover in the canine population owing to the birth of puppies and high death rates. Binational One Health workers should monitor disease spread, enact canine population management and tick eradication, and provide prevention, diagnostic, and treatment support.
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Enfermedades de los Perros , Rhipicephalus sanguineus , Fiebre Maculosa de las Montañas Rocosas , Infestaciones por Garrapatas , Perros , Adulto , Animales , Humanos , Fiebre Maculosa de las Montañas Rocosas/epidemiología , Fiebre Maculosa de las Montañas Rocosas/veterinaria , Infestaciones por Garrapatas/epidemiología , Infestaciones por Garrapatas/veterinaria , Rhipicephalus sanguineus/microbiología , México/epidemiología , Estudios Seroepidemiológicos , Rickettsia rickettsii , Enfermedades de los Perros/microbiologíaRESUMEN
The world is facing a major pulse of ecological and social changes that may favor the risk of zoonotic outbreaks. Such risk facilitation may occur through the modification of the host's community diversity and structure, leading to an increase in pathogen reservoirs and the contact rate between these reservoirs and humans. Here, we examined whether anthropization alters the relative abundance and richness of zoonotic reservoir and non-reservoir rodents in three Socio-Ecological Systems. We hypothesized that anthropization increases the relative abundance and richness of rodent reservoirs while decreasing non-reservoir species. We first developed an Anthropization index based on 15 quantitative socio-ecological variables classified into five groups: 1) Vegetation type, 2) Urbanization degree, 3) Water quality, 4) Potential contaminant sources, and 5) Others. We then monitored rodent communities in three regions of Northwestern Mexico (Baja California, Chihuahua, and Sonora). A total of 683 rodents of 14 genera and 27 species were captured, nine of which have been identified as reservoirs of zoonotic pathogens (359 individuals, 53%). In all regions, we found that as anthropization increased, the relative abundance of reservoir rodents increased; in contrast, the relative abundance of non-reservoir rodents decreased. In Sonora, reservoir richness increased with increasing anthropization, while in Baja California and Chihuahua non-reservoir richness decreased as anthropization increased. We also found a significant positive relationship between the anthropization degree and the abundance of house mice (Mus musculus) and deer mice (Peromyscus maniculatus), the most abundant reservoir species in the study. These findings support the hypothesis that reservoir species of zoonotic pathogens increase their abundance in disturbed environments, which may increase the risk of pathogen exposure to humans, while anthropization creates an environmental filtering that promotes the local extinction of non-reservoir species.
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Colubridae , Humanos , Animales , Ratones , México , Brotes de Enfermedades , Ecosistema , CabezaRESUMEN
ABSTRACT Background: Malaria is a major global public health issue with varying epidemiologies across countries. In Colombia, it is a priority endemic-epidemic event included in the national public health policy. However, evidence demonstrating nationwide variations in the disease behavior is limited. This study aimed to analyze changes in the levels and distribution of endemic-epidemic malaria transmission in the eco-epidemiological regions of Colombia from 1978 to 1999 and 2000 to 2021. Methods: We conducted a comprehensive time-series study using official secondary data on malaria-associated morbidity and mortality in Colombia from 1978 to 2021. Temporal-spatial and population variables were analyzed, and the absolute and relative frequency measures of general and regional morbidity and mortality were estimated. Results: We observed an 18% reduction in malaria endemic cases between the two study periods. The frequency and severity of the epidemic transmission of malaria varied less and were comparable across both periods. A shift was observed in the frequency of parasitic infections, with a tendency to match and increase infections by Plasmodium falciparum. The risk of malaria transmission varied significantly among the eco-epidemiological regions during both study periods. This study demonstrated a sustained decrease of 78% in malarial mortality. Conclusions: Although the endemic components of malaria decreased slightly between the two study periods, the epidemic pattern persisted. There were significant variations in the risk of transmission across the different eco-epidemiological regions. These findings underscore the importance of targeted public health interventions in reducing malarial morbidity and mortality rates in Colombia.
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Se presenta un caso de enfermedad de Chagas en fase aguda en un paciente masculino de 40 años, proce-dente de la Vereda Buenos Aires, Municipio de Miraflores, Departamento del Guaviare. El paciente acudió a urgencias con fiebre, cefalea, astenia, adinamia y disuria. Se realizó un frotis de sangre y un análisis de orina, con resultados positivos para infección urinaria sintomática, pero negativos para malaria. Cinco días más tarde se confirmó el diagnóstico de enfermedad de Chagas en fase aguda tras recibir un resultado positivo para Trypanosoma cruzi. El paciente recibió tratamiento con nifurtimox y benznidazol, y se llevó a cabo una investigación de contactos y zonas de riesgo, búsqueda activa comunitaria e institucional, entomológica y de reservorios, y una vigilancia de laboratorio para detectar posibles casos de infección en la comunidad. Se identificaron cinco casos con síntomas similares, pero las pruebas parasitológicas fueron negativas. Se aplic-aron medidas de educación sanitaria para prevenir la propagación de la enfermedad.
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Humanos , MasculinoRESUMEN
The aim of this report is to describe TransOrbital NeuroEndoscopic Surgery (TONES) as a safe alternative for obtaining a cavernous sinus (CS) biopsy. We describe this technique in a patient with a diffuse large B cell lymphoma mimicking Tolosa-Hunt's syndrome. Articles were gathered querying PubMed, Embase, and Scopus databases with terms related to a "transorbital neuroendoscopic approach." The literature search was performed by two independent authors (N.L.F. and J.R.), with inconsistencies resolved by the senior author (M.M.D.V.). After screening abstracts for relevance, full-length articles were reviewed for pertinent variables. A comparison was conducted with the illustrative case of a 69-year-old woman who presented to the emergency department with vertigo, ophthalmoplegia, and diplopia for 2 months. A brain magnetic resonance imaging revealed an infiltrative lesion at the left CS. A presumptive diagnosis of Tolosa-Hunt syndrome was made, but a confirmatory biopsy was performed using TONES. Based on our cadaveric study, literature review, and case report, the TONES approach was safe, effective for tissue diagnosis, and associated with minor morbidity and reduced hospital stay. Additional prospective studies are required to study its viability and safety in a larger group of patients.
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Objective: To quantify the volume of the follicular spaces of impacted lower third molars (ILTMs) with different impaction positions and angulations using cone-beam computed tomography (CBCT) and to determine its association with the histopathological findings. Study design: This study included 103 ILTMs of 33 men and 70 women aged 18-46 years (mean age, 29.18 years). The follicular space volumes were measured on CBCT by manual segmentation and correlated with the histopathological diagnosis of each ILTM having different impaction positions and angulations. Statistical Product and Service Solutions, version 24, was used for statistical analyses by applying the t-test and binary logistic regression and multiple linear regression tests (p < 0.05). Results: Overall, 83 (80.6%) dental follicles presented a non-pathological diagnosis (mean follicular volume, 0.10 cm3), whereas 20 (19.4%) presented a pathological diagnosis (mean follicular volume, 0.32 cm3; p = 0.001). Similarly, the impaction depth in Position C cases was associated with a pathological diagnosis (p = 0.010). Conclusion: The follicular volume of the ILTMs varied significantly in teeth with a histopathological diagnosis of a follicular cyst and was associated with the impaction depth, mainly in Position C cases, and its relationship with the mandibular ramus. A mean follicular volume of 0.32 cm3 was associated with a greater probability of a pathological diagnosis.
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This was a retrospective study that included 114 women younger than 40 years with induced primary ovarian insufficiency. Patients who presented vasomotor symptoms had a higher proportion (26 [63.41%] versus 58 [79.45%], OR 2.23, 95% CI 0.95-5.23, p = .065) to initiate hormone replacement therapy. Vasomotor symptoms were present in patients with ovarian cancer (OR 0.27, 95% CI 0.09-0.8, p = .18), haematologic cancer (OR 0.11, 95% CI 0.2-0.65, p = .014), radiotherapy (OR 2.62, 95% CI 1.04-6.54, p = .039) and chemotherapy with radiotherapy (OR 2.72, 95% CI 1.01-7.35, p = .049). Having ovarian or haematological cancer, being managed with radiotherapy and/or chemotherapy, and having follicle-stimulating hormone parameters higher than 35 mUI/mL are factors that significantly increase the risk of presenting vasomotor symptoms.Impact StatementWhat is already known on this subject? In young women with cancer, induced primary ovarian insufficiency can result as an ovarian surgery or as an adverse effect of chemotherapy or radiotherapy. Regardless of aetiology, patients are going to manifest early climacteric symptoms with an increased risk for cardiovascular disease, metabolic syndrome and osteoporosis.What do the results of this study add? Patients who presented vasomotor symptoms had initially a higher proportion of hormone replacement therapy. Patients that were treated exclusively with radiotherapy or with chemotherapy and concomitant radiotherapy have a significantly increased risk to manifest vasomotor symptoms.What are the implications of these findings for clinical practice and/or future research? Having ovarian or haematological cancer, being managed with radiotherapy and/or chemotherapy and having follicle-stimulating hormone parameters higher than 35 mUI/mL are factors that significantly increase the risk of presenting vasomotor symptoms.
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Neoplasias Hematológicas , Neoplasias Ováricas , Insuficiencia Ovárica Primaria , Femenino , Humanos , Hormona Folículo Estimulante , Neoplasias Hematológicas/terapia , Insuficiencia Ovárica Primaria/etiología , Insuficiencia Ovárica Primaria/tratamiento farmacológico , Estudios Retrospectivos , México , AdultoRESUMEN
BACKGROUND: The COVID-19 pandemic has generated uncertainty about the management of appendicitis. AIM: The aim of this study was to evaluate differences in the evolution and treatment of acute appendicitis in patients with COVID-19 infection compared to patients without the infection. METHODS: A case-control study of adult patients hospitalized for acute appendicitis was performed, having as cases those who presented COVID-19. Data were extracted from the medical records. The logistic regression model was used to calculate crude (cOR) and adjusted odds ratios (aOR) with their respective 95% confidence intervals (95% CI). RESULTS: We evaluated 38 cases and 76 controls, the mean age of the patients was 38.2 years (± 16.8), of whom 55.3% were women. Multivariate analysis showed, in cases, a lower probability of intraoperative findings (aOR: 0.21; 95% CI: 0.05-0.90) and a surgery time of more than 60 min (aOR: 0.21; 95% CI: 0.06-0.80), while there was a greater probability of management by open surgery (aOR: 3.83; 95% CI: 1.42-10.32) and a hospitalization time of more than 3 days after surgery (aOR: 3.33; 95% CI: 1.34-8.26). CONCLUSION: Significant differences were observed in terms of intraoperative findings, type of surgery, intraoperative time, and hospitalization time in patients with acute appendicitis and COVID-19.
ANTECEDENTES: La pandemia de COVID-19 ha generado incertidumbre sobre el manejo de la apendicitis. OBJETIVO: Evaluar las diferencias en la evolución y el tratamiento de la apendicitis en pacientes con COVID-19 en comparación con los pacientes sin la infección. MÉTODOS: Se realizó un estudio de casos y controles de pacientes adultos hospitalizados por apendicitis aguda, teniendo como casos aquellos que presentaron COVID-19. Los datos se extrajeron de las historias clínicas. Se utilizó el modelo de regresión logística para calcular las odds ratios (OR) crudas y ajustadas con sus respectivos intervalos de confianza del 95% (IC 95%). RESULTADOS: Se evaluaron 38 casos y 76 controles, la edad media de los pacientes fue de 38.2 años (± 16.8), de los cuales el 55,3% eran mujeres. El análisis multivariante mostró, en los casos, una menor probabilidad de hallazgos intra operatorios (ORa: 0,21; IC 95%: 0.05-0.90) y un tiempo de cirugía superior a 60 min (ORa: 0.21; IC 95%: 0.06-0.80), mientras que hubo una mayor probabilidad de manejo mediante cirugía abierta (ORa: 3.83; IC 95%: 1.42-10.32) y un tiempo de hospitalización superior a tres días tras la cirugía (ORa: 3.33; IC 95%: 1.34-8.26). CONCLUSIONES: Se observaron diferencias significativas en cuanto a los hallazgos intraoperatorios, el tipo de cirugía, el tiempo intraoperatorio y el tiempo de hospitalización en pacientes con apendicitis aguda y COVID-19.
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COVID-19 , Pandemias , Humanos , Femenino , Adulto , Masculino , Estudios de Casos y ControlesRESUMEN
La malaria en Colombia tiene un comportamiento heterogéneo y variable, entre las regiones. Para establecer su comportamiento epidemiológico en la región del Caribe colombiano entre 1960 y 2019 se realizó un estudio observacional, descriptivo y retrospectivo a partir de registros del Ministerio de Salud y otras fuentes secundarias. Se definieron variables epidemiológicas y se elaboraron medidas de frecuencia y tendencia central. Se registraron 155 096 casos. Las décadas con mayor número de casos fueron 1990-1999 (20,5%) y 1980-1989 (18,9%). El promedio de casos por década fue de 25 849,3. Los índices parasitarios más elevados se registraron en 1970 (3,3 por 1000 habitantes) y 1981 (3,9 por 1000 habitantes). La especie Plasmodium vivax fue la más frecuente y la mayoría de la carga por grupos de edad se registró en menores de 29 años, entre 2010-2019. La malaria presentó un patrón endemo-epidémico de baja y muy baja intensidad de transmisión, con una tendencia al descenso.
Malaria has a heterogeneous and variable behavior among Colombian regions. In order to establish its epidemiological behavior in the Colombian Caribbean region between 1960 and 2019, we carried out an observational, descriptive and retrospective study based on records from the Ministry of Health and other secondary sources. We defined epidemiological variables and used measures of frequency and central tendency. A total of 155,096 cases were registered. The decades with the highest number of cases were 1990-1999 (20.5%) and 1980-1989 (18.9%). The average number of cases per decade was 25,849.3. The highest parasite rates were recorded in 1970 (3.3 per 1000 population) and 1981 (3.9 per 1000 population). Plasmodium vivax was the most frequent species and most of the burden by age group was found in people under 29 years of age, between 2010-2019. Malaria showed an endemic-epidemic pattern of low and very low transmission intensity, with a decreasing trend.
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Plasmodium vivax , Salud Pública , Enfermedades Transmitidas por Vectores , Malaria , Plasmodium falciparum , Factores Epidemiológicos , Brotes de Enfermedades , Región del CaribeRESUMEN
OBJECTIVE: To provide a descriptive analysis of the indications and the intraoperative and postoperative complications of eye enucleations and eviscerations, and orbital exenterations performed at the only academic institution in Puerto Rico providing supratertiary care. METHODS: A retrospective medical record review of patients who underwent enucleations, eviscerations, and exenterations from January 2015 through June 2020 was conducted. The data were analyzed to generate a descriptive profile of the demographic characteristics of the patients, their clinical indications and surgical complications, and a histopathological diagnosis per type of eye-removal procedure. RESULTS: A total of 118 eyes were removed via enucleation, evisceration, or exenteration over the 66-month study period. The average patient age was 64 (±17.5) years and 63.8% of the patients were male. The most frequently performed eye-removal procedure was enucleation (73.7%), followed by evisceration (18.6%) and exenteration (7.6%). The main clinical indications for enucleations and eviscerations were infectious processes, namely panophthalmitis, endophthalmitis, and/or perforated corneal ulcers, that failed medical management. In our sample, squamous cell carcinoma was the most common diagnosis (both clinically and histopathologically) leading to exenteration. Postoperative complications in our patient cohort were minimal. CONCLUSION: At our institution, enucleations predominate over eviscerations. Retrospective reviews published in recent years indicate that the rate of eviscerations at our institution is comparatively low. The results of this study, the first of its kind at our institution, may encourage a re-evaluation of the indications for evisceration versus enucleation in our patient population.