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BACKGROUND: The COVID-19 pandemic prompted varied policy responses globally, with Latin America facing unique challenges. A detailed examination of these policies' impacts on health systems is crucial, particularly in Bolivia, where information about policy implementation and outcomes is limited. OBJECTIVE: To describe the COVID-19 testing trends and evaluate the effects of quarantine measures on these trends in Cochabamba, Bolivia. METHODS: Utilizing COVID-19 testing data from the Cochabamba Department Health Service for the 2020-2022 period. Stratified testing rates in the health system sectors were first estimated followed by an interrupted time series analysis using a quasi-Poisson regression model for assessing the quarantine effects on the mitigation of cases during surge periods. RESULTS: The public sector reported the larger percentage of tests (65%), followed by the private sector (23%) with almost double as many tests as the public-social security sector (11%). In the time series analysis, a correlation between the implementation of quarantine policies and a decrease in the slope of positive rates of COVID-19 cases was observed compared to periods without or with reduced quarantine policies. CONCLUSION: This research underscores the local health system disparities and the effectiveness of stringent quarantine measures in curbing COVID-19 transmission in the Cochabamba region. The findings stress the importance of the measures' intensity and duration, providing valuable lessons for Bolivia and beyond. As the global community learns from the pandemic, these insights are critical for shaping resilient and effective health policy responses.
Main findings: The findings highlight the importance of stringent quarantine measures in managing infectious disease outbreaks, offering valuable insights for policymakers worldwide in strategizing effective public health interventions.Added knowledge: By providing a detailed analysis of testing disparities and quarantine policies' effectiveness within a specific Latin American context, our research fills a critical gap in understanding their impacts on health system responses and disease control.Global health impact for policy and action: The findings highlight the importance of stringent quarantine measures in managing infectious disease outbreaks, offering valuable insights for policymakers worldwide in strategizing effective public health interventions.
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COVID-19 , Análise de Séries Temporais Interrompida , Quarentena , SARS-CoV-2 , Humanos , COVID-19/prevenção & controle , COVID-19/epidemiologia , Bolívia/epidemiologia , Política de Saúde , Teste para COVID-19/estatística & dados numéricos , Pandemias/prevenção & controleRESUMO
In 2021, the 88th General Session of the World Assembly of National Delegates to the World Organisation for Animal Health (OIE) recognized the estates of Acre, Paraná, the Rio Grande do Sul, and Rondônia as being free of foot-and-mouth disease (FMD) without vaccination. The certification was also extended to some cities in Amazonas and Mato Grosso. The new national strategic plan for 2026, which focuses on creating and maintaining sustainable conditions to expand FMD-free zones without vaccination, imposes new challenges and requires continuous evaluation of the FMD surveillance system. The objective of this research was to evaluate the FMD surveillance system in Brazil using quantitative models through Bayesian network approaches. The research was conducted using the Continental Surveillance and Information System (SivCont) database for Official Veterinary Services in Brazil, which refers to notified vesicular syndromes. The data on states, reported diseases, source of notification, disease confirmation, and timeliness (TL in days) of the delay by owners in notifying (TL.1) after a suspected case of the disease, and the response of Brazilian Veterinary Services after being notified (TL.2), were analysed. The collected data were analysed using Bayesian networks. It was observed that diseases with symptoms identical to FMD are the most notified events. TL.1 was long (mean of 18.96, CI: 18.33-19.59), and a low number of notifications was observed throughout the study period, which increases the chances of disseminating FMD in the population. Meanwhile, TL.2 suggests appropriate effectiveness of the Veterinary Services responding to suspected cases of FMD with interventions in less than 24 h (mean of 1, CI: 0.68-1.31). This study evaluated the performance of Brazilian Veterinary Services facing the report of vesicular diseases in the period 2004-2018. The results can help the states improve the surveillance system and the transition to the vaccination stop. Furthermore, the analytical method presented in the paper could serve as a model for other countries to evaluate the effectiveness of FMD surveillance systems.
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Vírus da Febre Aftosa , Febre Aftosa , Animais , Teorema de Bayes , Brasil/epidemiologia , Surtos de Doenças/veterinária , Febre Aftosa/epidemiologia , Febre Aftosa/prevenção & controle , Saúde Global , Vacinação/veterináriaRESUMO
Haemotrophic mycoplasmas (haemoplasmas) are unculturable, epicellular, cell wall-less gram-negative bacteria distributed worldwide, which infect several mammalian species. In dogs, Mycoplasma haemocanis and 'Candidatus Mycoplasma haematoparvum' have been reported as causative agents of infectious anaemia, especially in splenectomised or immunocompromised animals. The present cross-sectional study aims to assess the prevalence, risk factors, and molecular characterization of canine haemoplasmas in Cuba. A total of 391 dog blood samples and 247 tick samples were tested for the presence of canine haemoplasmas by species-specific quantitative TaqMan® real-time PCR assays. Overall, 17.9% (70/391; 95% CI: 14.1-21.7) blood samples were PCR-positive for at least one canine haemoplasmas species, where 15.1% (59/391; 95% CI: 11.5-18.7) for Mycoplasma haemocanis, 4.4% (17/391; 95% CI: 2.3-6.4) for 'Candidatus Mycoplasma haematoparvum', and 1.5% (6/391; 95% CI: 0.3-2.8) were co-infected. All collected ticks were identified morphologically as Rhipicephalus sanguineus sensu lato, and none of the tested tick samples was found PCR-positive for the presence of Mycoplasma haemocanis and 'Candidatus Mycoplasma haematoparvum'. Risk factors for canine haemoplasmas species infection included the presence of tick infestation, crossbreeding and living in kennels, while no association was found with the occurrence of anaemia. Phylogenetic analyses based on the 16S rRNA gene sequences of Mycoplasma haemocanis and 'Candidatus Mycoplasma haematoparvum' revealed >99% identity to other isolates distributed worldwide, indicating low genetic variability amongst these canine haemoplasmas species. To the best of the authors´ knowledge, this is the first molecular evidence of Mycoplasma haemocanis and 'Candidatus Mycoplasma haematoparvum' infections in dogs from Cuba.
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Doenças do Cão , Infecções por Mycoplasma , Mycoplasma , Rhipicephalus sanguineus , Animais , Estudos Transversais , Cuba/epidemiologia , Doenças do Cão/epidemiologia , Doenças do Cão/microbiologia , Cães , Mamíferos , Infecções por Mycoplasma/epidemiologia , Infecções por Mycoplasma/microbiologia , Infecções por Mycoplasma/veterinária , Filogenia , RNA Ribossômico 16S/genética , Reação em Cadeia da Polimerase em Tempo RealRESUMO
BACKGROUND: Femicide is a very important public health problem in Ecuador. Since regional and country-level femicide rates can obscure significant variations at the sub-national level, it is important to provide information at the lowest relevant level of disaggregation to be able to develop targeted preventive policies. The aim of this study was to assess the spatial distribution of the femicide rate and to examine its spatial clustering at the canton level in Ecuador in the period 2018-2019. METHODS: Data on cases were collected by a national network of non-governmental organizations. Two age-disaggregated analyses were done, one for the 15 to 24 years-olds and the other for the female population of 15 and older. Age-specific population data were obtained from the National Institute of Statistics for the study period. Standardized mortality ratios for mapping the mortality were calculated using hierarchical Bayesian models and spatial scan statistics were applied to identify local clusters. Thematic maps of age-specific femicide rates were also constructed. RESULTS: During the two-year period, 61 and 183 women were killed in the age ranges 15-24 and 15 years and older, respectively. The annual rate of femicides in Ecuador was 1.0 and 0.8 per 100,000 in the female population aged 15-24 and 15+, respectively, with substantial variations among cantons. The spatial analysis contributed to visualize high risk cantons, which were mainly located in a small area in the central part of the country (for those 15+) but especially in the Amazon region, for both of the studied age groups. CONCLUSIONS: This study has shown the usefulness of applying spatial analysis to the problem of femicides in Ecuador. The study has revealed important variations among cantons but also a spatial clustering, mainly in the Amazon region of the country. The results should help policymakers to focus on current prevention programmes for violence against women into these high-risk areas. Continuous monitoring of femicides at low-level geographical areas is highly recommended.
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Homicídio , Adolescente , Equador/epidemiologia , Feminino , Geografia , Homicídio/estatística & dados numéricos , Humanos , Análise Espacial , Adulto JovemRESUMO
Canine hepatozoonosis caused by Hepatozoon canis is a worldwide distributed tick-borne disease of domestic and wild canids that is transmitted by ingestion of Rhipicephalus sanguineus sensu lato (s.l.) ticks. The present study was aimed to determine the prevalence of Hepatozoon infections in 80 stray dogs from Havana Province in Cuba, and to confirm the species identity and phylogenetic relationships of the causative agent. Samples were screened by microscopical examination of thin blood smears for the presence of Hepatozoon spp. gamonts and by genus-specific SYBR green-based real-time PCR assay targeting the 18S rRNA gene. Direct microscopy examination revealed Hepatozoon gamonts in the peripheral blood of 8 dogs (10.0%; 95% CI: 4.80-18.0%), while 38 animals (47.5%; 95% CI: 36.8-58.4%) were PCR-positive, including all microscopically positive dogs. Hence, the agreement between the two detection methods was 'poor' (κâ¯=â¯0.20). Hematological parameters did not differ significantly between PCR-positive and PCR-negative dogs (pâ¯>â¯0.05). The DNA sequences of the 18S rRNA gene of the Hepatozoon spp. from Cuban dogs showed a nucleotide identity >99% with those of 18S rRNA sequences of Hepatozoon canis isolates from Czech Republic, Brazil and Spain. Phylogenetic analysis revealed that obtained sequences clustered within the Hepatozoon canis clade, different from the Hepatozoon felis or Hepatozoon americanum clades. The present study represents the first molecular characterization of Hepatozoon canis in stray dogs within Cuba.
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Coccidiose/veterinária , Doenças do Cão/epidemiologia , Eucoccidiida/isolamento & purificação , Animais , Coccidiose/epidemiologia , Coccidiose/parasitologia , Cuba/epidemiologia , Doenças do Cão/parasitologia , Cães , Eucoccidiida/classificação , Eucoccidiida/genética , Incidência , Prevalência , RNA de Protozoário/análise , RNA Ribossômico 18S/análiseRESUMO
The present study aimed to determine the prevalence of zoonotic vector-borne pathogens, including Anaplasma platys, Anaplasma phagocytophilum, Borrelia burgdorferi sensu lato, Ehrlichia canis and Rickettsia spp. in shelter dogs from Cuba. Blood samples were collected from 100 shelter dogs and examined by molecular methods. Overall, 85 (85%; 95% CI: 77.88-92.12) dogs tested positive for at least one vector-borne pathogen using species-specific qPCR assays. Among the positive samples, E. canis was the most prevalent 62% (95% CI: 52.32-71.68), followed by A. platys 40% (95% CI: 30.23-49.77) and Rickettsia felis 27% (95% CI: 18.15-35.85), whereas 36% (95% CI: 26.43-45.57) showed co-infections. All samples were negative for A. phagocytophilum and B. burgdorferi s.l. The presence of 248 Rhipicephalus sanguineus ticks collected from the dogs was not statistically associated with the occurrence of infections. Thrombocytopenia was the most frequent haematological alteration found in PCR-positive dogs; it was statistically associated with the presence of E. canis, as well as co-infections (p < 0.05). The phylogenetic analyses of A. platys and E. canis based on 16S rRNA, groEL and gltA genes showed a low genetic diversity between Cuban strains. The present study demonstrates the high prevalence of vector-borne pathogens with zoonotic potential in shelter dogs from Cuba.
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Leptospirosis is a zoonotic disease with worldwide distribution. The disease affects dairy and beef cattle, causing infertility, abortion, and reduced milk yield. A cross-sectional study was conducted to determine the seroprevalence of leptospirosis in cattle and the associated risk factors in the province of Manabí, Ecuador. Serum samples from 749 animals from 55 cattle herds were analyzed using the microscopic agglutination test (MAT). Animals were considered positive when titers were ≥ 1:100. The association between the potential risk factors and the positive Leptospira result was modeled at both animal and herd level using a generalized linear model with a binomial distribution and logarithmic link. The seroprevalence was 56.21% at the individual level and 98.18% at the herd level. The most prevalent serovars were Pomona (28.57%) and Icterohaemorragiae (22.30%). At the animal level, only the age was associated with leptospirosis seropositivity. Seroprevalence in animals over three years of age was 1.197 (95% confidence intervals (CI), 1.032 - 1.390), higher compared to animals up to three years old. The seroprevalence of Leptospira spp. was higher in farms with no veterinary assistance (PRâ¯=â¯1.209; 95%CI 1.053 - 1.388) and without a vaccination program against Leptospira (PRâ¯=â¯1.399; 95%CI 1.09 - 1.794). In addition, herds from Junín canton had a significantly higher seroprevalence of Leptospira spp (PRâ¯=â¯1.548; 95%CI 1.213 - 1.977) compared to the Bolívar canton, which had the lowest seroprevalence. In conclusion, more than half of the animals were positive to Leptospiraspp, and almost all herds had at least one positive animal. Furthermore, veterinary assistance and vaccination of cattle must be considered as essential aspects of the disease control program.
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Doenças dos Bovinos , Leptospira , Leptospirose , Animais , Anticorpos Antibacterianos/sangue , Bovinos , Doenças dos Bovinos/epidemiologia , Estudos Transversais , Equador/epidemiologia , Leptospirose/epidemiologia , Leptospirose/veterinária , Fatores de Risco , Estudos SoroepidemiológicosRESUMO
Classical Swine Fever (CSF) is an endemic disease in Cuba, and an eradication strategy by zones is planned by the Official Veterinary Service. The aim of this study was to identify high-risk areas of CSF and the risk factors associated with the disease occurrence in the Pinar del Río province, one of the prioritized areas in the eradication strategy. The outbreak occurrence at district level was analyzed through a 7-year period (2009 to 2015). A high-risk cluster (RR = 5.13, 95% CI 3.49-7.56) was detected during the last 2 years of the study period in the eastern half of the province, with 38 out of 97 districts included. The rate of CSF-affected holdings had a significant increase during 2014-2015 and seems to have occurred mainly in the high-risk cluster area. Swine population density by district (heads/km2) and road length (km) by district were associated with the disease outbreak occurrence. These results provide new insights into the knowledge of the epidemiology of the disease in Cuban endemic conditions and can contribute to improving the control and the eradication strategy in this situation.
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Anaplasmosis and theileriosis are considered the most important tick-borne diseases for livestock production worldwide, causing significant economic losses in tropical and subtropical regions. The present study was aimed to develop a multiplex TaqMan® qPCR assay to simultaneously detect Anaplasma marginale and Theileria annulata and to applied it to investigate naturally infected cattle in Cuba. The assay was highly specific, sensible, and efficient; it was more sensitive than a well-established nested PCR and detected 1 DNA copy of each target. Consistent repeatability and reproducibility within and between multiplex qPCR runs was shown. A total of 223 blood samples collected in western Cuba were analyzed for haemoparasites infection in cattle. The multiplex qPCR assay detected A. marginale in 213 samples (95.5%; CI: 95%; 91.9%-97.5%), but all samples were negative for T. annulata. Additionally, the genetic diversity of A. marginale was assessed using 16S rRNA, MSP1a and MSP4 nucleotide and protein sequences. The MSP1a tandem repeats ranged from three to five, and twelve different MSP1a tandem repeats of A. marginale were found, which presented genotypes C, E, and G in the 5'UTR microsatellite region. Phylogenetic analysis using the msp4 gene showed that Cuban strains were closely related to others previously reported in Mexico, Brazil and Asian countries. The multiplex qPCR described here proved to be a rapid, specific and cost-effective mean for the simultaneous detection of A. marginale and T. annulata. Further epidemiological studies using this assay will improve the surveillance of the associated diseases in regions where they are endemic.
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Anaplasma marginale/isolamento & purificação , Anaplasmose/epidemiologia , Doenças dos Bovinos/epidemiologia , Reação em Cadeia da Polimerase Multiplex/veterinária , Reação em Cadeia da Polimerase em Tempo Real/veterinária , Theileria annulata/isolamento & purificação , Theileriose/epidemiologia , Anaplasmose/microbiologia , Animais , Bovinos , Doenças dos Bovinos/microbiologia , Doenças dos Bovinos/parasitologia , Cuba/epidemiologia , Reação em Cadeia da Polimerase Multiplex/métodos , Reação em Cadeia da Polimerase em Tempo Real/métodos , Reprodutibilidade dos Testes , Theileriose/parasitologiaRESUMO
Classical swine fever (CSF), caused by CSF virus (CSFV), is considered one of the most important infectious diseases with devasting consequences for the pig industry. Recent reports describe the emergence of new CSFV strains resulting from the action of positive selection pressure, due mainly to the bottleneck effect generated by ineffective vaccination. Even though a decrease in the genetic diversity of the positively selected CSFV strains has been observed by several research groups, there is little information about the effect of this selective force on the virulence degree, antigenicity and pathogenicity of this type of strains. Hence, the aim of the current study was to determine the effect of the positive selection pressure on these three parameters of CSFV strains, emerged as result of the bottleneck effects induced by improper vaccination in a CSF-endemic area. Moreover, the effect of the positively selected strains on the epidemiological surveillance system was assessed. By the combination of in vitro, in vivo and immunoinformatic approaches, we revealed that the action of the positive selection pressure induces a decrease in virulence and alteration in pathogenicity and antigenicity. However, we also noted that the evolutionary process of CSFV, especially in segregated microenvironments, could contribute to the gain-fitness event, restoring the highly virulent pattern of the circulating strains. Besides, we denoted that the presence of low virulent strains selected by bottleneck effect after inefficient vaccination can lead to a relevant challenge for the epidemiological surveillance of CSF, contributing to under-reports of the disease, favouring the perpetuation of the virus in the field. In this study, B-cell and CTL epitopes on the E2 3D-structure model were also identified. Thus, the current study provides novel and significant insights into variation in virulence, pathogenesis and antigenicity experienced by CSFV strains after the positive selection pressure effect.
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Vírus da Febre Suína Clássica/patogenicidade , Peste Suína Clássica/genética , Seleção Genética , Proteínas do Envelope Viral/genética , Animais , Peste Suína Clássica/virologia , Doenças Endêmicas , Evolução Molecular , Vigilância da População , Suínos , VirulênciaRESUMO
In Brazil, glanders remains a serious problem, with the obligatory sacrifice of disease-positive animals without compensation. Each year, glanders cases are reported in several regions of the country, causing severe economic losses and trade restrictions. The present study describes and discusses the occurrence of glanders foci in Brazil during a 12-year period from 2005 to 2016. The highest frequency of reported affected holdings during the study period was in the northeast region. Moreover, during this period, the disease incidence in Brazil showed an overall increasing tendency. The number of affected holdings significantly increased during the last four years of the period, and more cases were noted during the months of May and June. Spatiotemporally, there are four high-risk glanders clusters: (1) cluster A (relative risk [RR = 6.51, P < .0001) involved the northeast region from March 2008 to February 2014; (2) cluster B (RR = 17.37, P < .0001) involved a southeast region state from March 2013 to June 2015; (3) cluster C (RR = 6.92, P < .0001) involved the states in the midwest, southeast, and south regions of Brazil from March 2015 to May 2016; and (4) cluster D (RR = 19.07, P < .0001) involved a north region state from October 2015 to April 2016. Only two states of the north region (Acre and Amapá) did not experience glanders during the study period.
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Mormo , Animais , Brasil , Cavalos , Morbidade , Análise Espaço-TemporalRESUMO
BACKGROUND: Hemotropic mycoplasmas (aka hemoplasmas) are small bacteria which cause infectious anemia in several mammalian species including humans. Information on hemoplasma infections in Cuban bovines remains scarce and no studies applying molecular methods have been performed so far. The aim of the present study was to utilize real-time PCR and sequence analysis to investigate dairy cattle and buffalo from Cuba for the presence of bovine hemoplasma species. RESULTS: A total of 80 blood samples from 39 buffalo and 41 dairy cattle were investigated for the presence of Mycoplasma wenyonii and "Candidatus Mycoplasma haemobos" using two species-specific real-time TaqMan PCR assays. PCR results revealed overall 53 (66.2%; 95% CI: 55.3-75.7%) positive animals for M. wenyonii and 33 (41.2%; 95% CI: 31.1-52.2%) for "Ca. M. haemobos"; the latter were all co-infections with M. wenyonii. The sample prevalences were similar in cattle and buffalo. Based on the sequence analysis of the nearly full-length 16S rRNA gene from two cattle and two buffalo, the presence of M. wenyonii and "Ca. M. haemobos" was confirmed. Statistical analysis revealed that buffalo and cattle one year of age or older were more frequently infected with M. wenyonii or "Ca. M. haemobos" than younger animals. PCR-positivity was not associated with anemia; however, the infection stage was unknown (acute infection versus chronic carriers). CONCLUSIONS: The high occurrence of bovine hemoplasma infections in buffalo and dairy cattle may have a significant impact on Cuban livestock production. To the best of our knowledge, this is the first molecular evidence of bovine hemoplasma species infection in dairy cattle and buffalo from Cuba and the Caribbean.
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Búfalos/microbiologia , Doenças dos Bovinos/epidemiologia , Infecções por Mycoplasma/veterinária , Mycoplasma/genética , Animais , Bovinos/microbiologia , Doenças dos Bovinos/sangue , Doenças dos Bovinos/microbiologia , Coinfecção/epidemiologia , Coinfecção/microbiologia , Coinfecção/veterinária , Cuba/epidemiologia , Indústria de Laticínios , Feminino , Gado , Masculino , Mycoplasma/isolamento & purificação , Infecções por Mycoplasma/sangue , Infecções por Mycoplasma/epidemiologia , Prevalência , RNA Ribossômico 16S/genética , Reação em Cadeia da Polimerase em Tempo Real , Especificidade da EspécieRESUMO
Ehrlichia canis is a rickettsia transmitted by the tick, Rhipicephalus sanguineus, and is the causative agent of canine monocytic ehrlichiosis (CME). In Cuba, the first diagnosis of CME was made in 2001, but few studies have since investigated this disease locally. The objective of this study was to estimate the prevalence of E. canis in dogs domiciled in four municipalities within the western region of Cuba and determine the associated risk factors. Blood was drawn from 378 selected dogs living in four municipalities in two provinces of western Cuba. From the total number of samples, 206 plasma samples were selected to perform an enzyme-linked immunosorbent assay (ELISA) to detect antibodies against E. canis. Using the original 378 samples of extracted DNA, a nested polymerase chain reaction (nPCR) was performed to amplify a specific fragment of the 16S rRNA gene of E. canis. Analysis of the 206 plasma samples revealed a total of 162 animals that were seropositive for E. canis (78.64%) with a density index between 109.5 and 970.7. In contrast, 179 samples were positive based on the nPCR assay (47.35%). As well, there was a high concordance (kappaâ¯=â¯0.7), calculated through the Kappa index, between the animals found to be positive based on nPCR and those determined based on ELISA. The analysis of risk factors showed that residing in the municipality of Boyeros in addition to having a history of infestation by ticks increases the probability of having a positive result based on nPCR.
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Doenças do Cão/diagnóstico , Cães/microbiologia , Ehrlichiose/veterinária , Animais , Anticorpos Antibacterianos/sangue , Vetores Aracnídeos/microbiologia , Cuba/epidemiologia , Doenças do Cão/epidemiologia , Ehrlichia canis , Ehrlichiose/epidemiologia , Ensaio de Imunoadsorção Enzimática , Feminino , Masculino , Reação em Cadeia da Polimerase , Prevalência , RNA Ribossômico 16S/genética , Rhipicephalus sanguineus/microbiologia , Fatores de Risco , Análise de Sequência de DNARESUMO
Fundamento: la epicondilosis lateral de codo, también conocida como epicondilitis o codo de tenista, es una condición común resultante de una tendinopatía no inflamatoria del origen de los tendones extensores en el epicóndilo lateral con una incidencia entre el 1 % y el 3 % de la población adulta por año. La clínica se caracteriza por dolor a nivel del epicóndilo lateral, asociado a debilidad al agarrar o elevar objetos con el antebrazo en pronación. Un 15 % de los enfermos son tributarios de cirugía. Objetivo: caracterizar los resultados de la técnica de Nirschl en los pacientes con epicondilosis lateral de codo desde septiembre de 2012 hasta septiembre de 2015. Métodos: se realizó un estudio prospectivo, descriptivo y transversal. La muestra no probabilística quedó constituida por 46 pacientes y 48 codos, seleccionados según criterios. Se utilizaron las técnicas de estadísticas descriptivas e inferenciales. Resultados: predominaron las mujeres con 36 casos. Los enfermos se encontraban en el grupo de 30 a 59 años y 35 casos iniciaron los síntomas entre ocho y 12 meses de la cirugía. El miembro dominante predominó con 43 casos y en dos casos la afectación fue bilateral. La evaluación posoperatoria de los pacientes, mostró una evolución entre excelente y bueno en 46 codos al año de operados. Conclusiones: la técnica de Nirschl para la epicondilosis lateral de codo es efectiva en la mayoría de los pacientes, se logra una mejoría clínica que se mantuvo en el transcurso del tiempo. Se considera una terapia segura al acompañarse de un mínimo de complicaciones. La efectividad y seguridad del procedimiento dependen de una técnica depurada y de una selección adecuada de los pacientes.
ABSTRACT Background: lateral elbow epicondylosis, also known as epicondylitis or tennis elbow, is a common condition resulting in a non inflammatory tendinopathy of the extensor tendons at the lateral epicondyle, with an incidence between one and three percent in adult population per year. The clinical group of signs is characterized by pain in the lateral epicondyle, associated with weakness of the grip force and difficulties to lift objects in prone position. About a 15 % of the cases can undergo surgery. Objective: to characterize the results of the Nirschl technique in patients with lateral elbow epicondilosis from September 2012 to September 2015. Methods: a prospective, descriptive and transversal study was conducted. The non probabilistic sample was composed of 46 patients and 48 elbows, selected by criteria. Descriptive and inferential statistics techniques were used. Results: women prevailed with 36 cases. The ill patients were in the 30 to 59 age group, and 35 cases began with the symptoms between eight and twelve month after surgery. The dominant limb was predominant with 43 cases and in two patients the affection was bilateral. Postoperatory evaluation showed excellent and good results in 46 elbows up to a year after surgery. Conclusions: Nirschl technique for lateral epicondilosis is effective in the majority of the patients, because of the clinical improvement which last in time. It is considered a save therapy with less complications. The effectiveness and safety of this procedure depend on a pure technique and adequate selection of patients.
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En la investigación "Alcances de la aplicación del modelo de reducción de daños al campo asistencial en las adicciones" (Alicia Donghi), ubicamos la siguiente particularidad: ciertos usuarios de sustancias "resistían" con sus cuerpos el Ideal de la ciencia del siglo XXI: la salud, el bienestar. Algunos pacientes adictos se presentaban con niveles de deterioro mental y corporal, debido a la ingesta o la abstinencia de sustancias duras. Nuestra tarea en la función pública y en la atención por obras sociales nos exige el diagnóstico según el DSM-IV. En muchas becas de derivación para internación de usuarios de PBC el rotulo de "Psicosis" abunda, a pesar de haber sido entrevistados bajo efectos"tóxicos" del consumo. Así comenzó nuestra investigación sobre diagnóstico diferencial de psicosis según el psicoanálisis y el DSM-IV, a in de garantizar al consultante la derivación a un dispositivo acorde a su patología de base, para un tratamiento posible.
In the research "Scope of the application of the model of harm reduction to the health care ield in addiction" (Alicia Donghi), are located the following peculiarity: certain users of substances "resisted" with their bodies the Ideal of the science of the 21st century: health, well-being. Some addicted patients presented with levels of mental and physical, deterioration due to the intake or the withdrawal of harsh substances. Our task in the public service and care by social work requires us according to the DSM-IV diagnosis. In many scholarships for placement of PBC users bypass the tagline of "Psycho" abounds, despite having been interviewed under "toxic" effects of consumption. Thus began our research on differential diagnosis of psychosis in psychoanalysis and the DSM-IV, in order to ensure the consultant referral to a device according to their pathology of basis, for a possible treatment.
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En el marco de la Programación UBACyT 2008/10 sobre indicadores diferenciales entre el diagnóstico de trastorno psicótico inducido por sustancias -DSM IV- y el diagnóstico estructural de psicosis -psicoanálisis- en consumidores de pasta base de cocaína, se propusieron criterios diagnósticos y de derivación de dichos usuarios al sistema de atención pública en Salud mental. Peculiaridades del consumo de este tóxico en cuanto a los modos de acceso, características de la ingesta y efectos a nivel del sistema nervioso deben tenerse en cuenta, para evaluar niveles de impulsividad que comprometen severamente el lazo social. También a la hora de un diagnóstico y una derivación- sin desestimar los efectos tóxicos - debemos interrogar las diferencias entre el consumo en la adolescencia - como una etapa de puesta a prueba de la estructura subjetiva- y en adultos policonsumidores cuya estructura subjetiva, al momento del encuentro con la PBC, ha alcanzado previamente cierta consistencia.
In the framework of the UBACyT 2008/10 programming on indicators differentials between the diagnosis of substance - DSM IV - induced psychotic disorder and structural diagnosis of psychosis - psychoanalysis-consumers of pasta base cocaine, proposed criteria diagnostic and referral of those users to the system of public care in Mental health. Peculiarities of the consumption of this poison as modes of access, intake and effects to the nervous system level must be taken into account, to assess levels of impulsivity that severely compromise the social link. Also at the time of a diagnosis and a derivation - without rejecting the toxic effects - must examine the differences between consumption in adolescence - as a stage of testing of the subjective structure - and policonsumidores adults whose subjective structureat the time of the encounter with the PBC, has previously reached some consistency.
RESUMO
Entre R.S.I. el tiempo se lo pasa tironeando, sucesión de instantes de tirónO presencias del objeto a. Dice Lacan en El Seminario 21, desbaratando la ilusión de continuidad al plantear la inconsistencia del tiempo. Esto demuestra que la hora justa o la cantidad precisa constituyen formas de leer la falta de proporción sexual. La prisa sin acto, la urgencia desorientada hacen de la aceleración el funcionamiento privilegiado de esta época. Desde estas referencias vamos a interrogar el tiempo en la compulsión al consumo, no tanto desde la perspectiva más clásica de fijación a un objeto, sino como adicción a un cambio de estado inmediato en el yo. No es posible gestionar este goce sin la emergencia de angustia. De gobernarla y educarla, se ocupan las psicoterapias y los dispositivos que, creyendo en la voluntad, obedecen a formas de control social que propician la dilución de singularidades en pro de la masa. El psicoanálisis, con su intervalo entre el impulso y la acción, por un lado y el manejo de la transferencia por el otro, objetan el presente continuo del no pienso. Su principal misión: vectorizar el goce de una eternidad con prescindencia del tiempo del Otro hacia la intemporalidad de la repetición del goce fálico del síntoma con un analista, advertido de la finitud en su acto.(AU)
Assuntos
Humanos , Teoria Psicanalítica , Tempo , PsicanáliseRESUMO
Entre R.S.I. el tiempo se lo pasa tironeando, sucesión de instantes de tirón presencias del objeto a. Dice Lacan en El Seminario 21, desbaratando la ilusión de continuidad al plantear la inconsistencia del tiempo. Esto demuestra que la hora justa o la cantidad precisa constituyen formas de leer la falta de proporción sexual. La prisa sin acto, la urgencia desorientada hacen de la aceleración el funcionamiento privilegiado de esta época. Desde estas referencias vamos a interrogar el tiempo en la compulsión al consumo, no tanto desde la perspectiva más clásica de fijación a un objeto, sino como adicción a un cambio de estado inmediato en el yo. No es posible gestionar este goce sin la emergencia de angustia. De gobernarla y educarla, se ocupan las psicoterapias y los dispositivos que, creyendo en la voluntad, obedecen a formas de control social que propician la dilución de singularidades en pro de la masa. El psicoanálisis, con su intervalo entre el impulso y la acción, por un lado y el manejo de la transferencia por el otro, objetan el presente continuo del no pienso. Su principal misión: vectorizar el goce de una eternidad con prescindencia del tiempo del Otro hacia la intemporalidad de la repetición del goce fálico del síntoma con un analista, advertido de la finitud en su acto.
Assuntos
Humanos , Teoria Psicanalítica , Tempo , PsicanáliseRESUMO
Contenido: La clínica de siempre. Lo diferencial. La cura. La clínica actual. Del consumo. Del cuerpo. Clínica en las instituciones.
Assuntos
Humanos , Saúde Mental , PsicanáliseRESUMO
La educación sexual constituye una necesidad en la sociedad porque tiene entre sus objetivos capacitar al hombre para que en sus relaciones con el otro sexo pueda disfrutar de los más humanos valores y crear las condiciones materiales y espirituales óptimas para el fortalecimiento de los más legítimos sentimientos de amor, respeto y solidaridad que sobre la base de la plena igualdad deben existir entre sus miembros. Por ello es necesario determinar qué grado de conocimiento e información sexual tienen los jóvenes y adolescentes entre 15 y 17 años de edad pertenecientes a una escuela de nivel medio superior. La muestra estuvo integrada por 250 adolescentes que voluntariamente decidieron participar en la investigación, a quienes se les realizó una entrevista por parte del médico en condiciones de privacidad, sobre algunos temas de sexualidad. Predominó el sexo masculino, estado civil soltero, y el décimo grado como nivel escolar. Todos los adolescentes habían recibido información sexual, cuya fuente fundamental fue la escuela; existe deficiente comunicación padres-hijos por la falta de confianza entre ellos. El nivel cognoscitivo sobre las enfermedades de transmisión sexual y su prevención es buena, aunque uno de cada 9 adolescentes ha padecido una de dichas enfermedades. Predominó la precocidad en la edad de realización del primer coito