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Data gaps and biases are two important issues that affect the quality of biodiversity information and downstream results. Understanding how best to fill existing gaps and account for biases is necessary to improve our current information most effectively. Two current main approaches for obtaining and improving data include (1) curation of biological collections, and (2) fieldwork. However, the comparative effectiveness of these approaches in improving biodiversity data remains little explored. We used the Flora de Bogotá project to study the magnitude of change in species richness, spatial coverage, and sample coverage of plant records based on curation versus fieldwork. The process of curation resulted in a decrease in species richness (synonym and error removal), but it significantly increased the number of records per species. Fieldwork contributed to a slight increase in species richness, via accumulation of new records. Additionally, curation led to increases in spatial coverage, species observed by locality, the number of plant records by species, and localities by species compared to fieldwork. Overall, curation was more efficient in producing new information compared to fieldwork, mainly because of the large number of records available in herbaria. We recommend intensive curatorial work as the first step in increasing biodiversity data quality and quantity, to identify bias and gaps at the regional scale that can then be targeted with fieldwork. The stepwise strategy would enable fieldwork to be planned more cost-effectively given the limited resources for biodiversity exploration and characterization.
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Cable cars are a viable alternative to improve citizens' accessibility in zones with limitations on urban public transport supply due to the topography. In Latin America, such systems have recently been implemented in zones with high levels of poverty and vulnerability. Although the social implications of their implementation are relevant, individual expectations of these systems and how current changes in travel conditions and quality of life are perceived have not been widely reported in the literature. This paper aims to evaluate users' expectations and perceptions of a new cable car in the southern periphery of Bogotá (Colombia). We conducted a panel survey before (n = 341) and after (n = 301) the cable car started operations to evaluate the ranking of preferences toward a set of possible benefits of the project. We estimated discrete choice models to analyze the statistical differences between the expectations and perceptions before and after changes. Results suggest that travel time reductions, comfort improvements, and in-vehicle security are the benefits most valued by the users. Even though the project meets expectations of these aspects, it seems to fall short in expectations of reductions of pollution. Individuals' experience with the cable car shapes their perceptions of the system. We found that perceptions differ between those who have used the service at least once and those who never did. Policy implications derived from this study might be of interest to decision-makers seeking to guarantee the public acceptability of urban projects.
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Introducción: El cierre con pérdida masiva de tejido de la pared abdominal constituye un reto en la cirugía. Objetivo: Presentar un caso de cierre abdominal difícil donde se utilizó la técnica plicatura de la bolsa Bogotá hasta lograr aproximación de los planos cutáneo, muscular y aponeurótico. Caso clínico: Paciente recibido en emergencias con herida perforo-cortante en fosa lumbar izquierda. En la intervención se encontró hemoperitoneo por lesión esplénica, diafragmática y sección del ángulo esplénico del colon. Se le realizó esplenectomía, pleurostomía izquierda y rafia de lesión colónica. Pasadas cinco horas se reintervino por signos de choque y se encontró hematoma retroperitoneal y sección completa del polo superior del riñón izquierdo. Se le realizó nefrectomía izquierda. Al quinto día del posoperatorio mostró signos peritoneales y la exploración confirmó peritonitis fecaloidea por dehiscencia de sutura de colon. Se lavó cavidad y se le ejecutó colostomía tipo Devine. La pérdida masiva de pared abdominal obligó a emplear una plicatura de la bolsa Bogotá para aproximar ambos colgajos, se obtuvo aproximación paulatina hasta la síntesis de la pared. Conclusiones: El abdomen catastrófico es una condición grave y de difícil tratamiento. La bolsa Bogotá es una alternativa viable para esta condición y modificada con plicaturas paulatinas permite el acercamiento de los dos colgajos cutáneos y garantiza el cierre de la pared abdominal, además de ser una técnica fácil de usar y económica(AU)
Introduction: Closure with massive loss of abdominal wall tissue is a challenge in surgery. Objective: To report a case of difficult abdominal closure where the Bogotá bag technique was used until the approximation of the cutaneous, muscular and aponeurotic planes was achieved. Clinical case report: This patient was received in the emergency room with a perforating-cutting wound in the left lumbar fossa. In the intervention, hemoperitoneum was found due to splenic and diaphragmatic injury and section of the splenic flexure of the colon. Splenectomy, left pleurostomy and colonic injury raffia were performed. After five hours, the patient was operated again due to signs of shock. We found a retroperitoneal hematoma and a complete section of the upper pole of the left kidney. It was decided to perform left nephrectomy. On the fifth postoperative day, this patient showed peritoneal signs and examination confirmed fecal peritonitis due to dehiscence of the colon suture. Cavity was washed and a Devine-type colostomy was performed. The massive loss of the abdominal wall made it necessary to use a plication of the Bogotá bag to approximate both flaps, a gradual approximation was obtained until the synthesis of the wall. Conclusions: The catastrophic abdomen is a serious condition that is difficult to treat. The Bogotá bag is a viable alternative for this condition and modified with gradual plications, it allows the two skin flaps to approach each other and guarantees the closure of the abdominal wall, in addition to being an easy-to-use and economical technique(AU)
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Colostomia/métodos , Parede Abdominal/cirurgia , Colo Transverso/cirurgia , Serviço Hospitalar de Emergência , Esplenectomia/métodos , Relatório de Pesquisa , Nefrectomia/efeitos adversosRESUMO
Following the end of World War II, when the world learned about the Holocaust, manifestations of antisemitism grew in Colombia as echoes of what was happening in other countries, both in the region and globally. This paper examines three such manifestations that occurred between 1945 and 1948: Echo 1 concerns an urban campaign against Jews during 1945 by conspirators who handed out flyers or pamphlets with antisemitic messages. Echo 2 concerns the only violence against Jewish traders in Colombian history. It happened in 1946 and culminated in 44 warehouses being destroyed and several Jews being beaten. And Echo 3 concerns the renowned case of the SS Exodus (1947), whose 4500 Jewish travelers presented Colombian visas to leave Europe. The recognition of these activities constitutes a contribution to the field of history, to Jewish communities, and to the study of antisemitism, with the aim of remembering those minorities excluded and challenged in such contexts.
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Based on a comparative case study on two neighborhoods in Bogota and Rio de Janeiro (2017-2019) and a comprehensive literature review, this article proposes a critical Public Health approach to urban violence and makes a case for understanding the phenomenon in the context of market-driven urban territorial restructuring processes that assume specific qualities in cities of the Global South. The case studies are based on focus groups and semi-structured interviews with residents, specialists and community leaders. It is argued that urban violence is a key public health challenge, particularly in Latin America, given its dimensions and its impact on the populations' life and health. In this regard it configures "fractured lives" in what urban scholars have termed "fractured cities" - essentially unequal and polarized cities that are not merely sites of urban violence but, as we argue in this article, fundamentally shape urban violence, its qualities, dynamics and dimensions. The study is informed by a unique theoretical articulation between Latin American Social Medicine and Collective Health, critical (Latin American) geographical theory and authoritarian neoliberalism literature and shows how urban violence is directly implied in the territorial making and un-making of the cities, driven by commodification as well as both legal and illegal capitalist market logics, that include but are not limited to drug trade. The cases reflect the violence implied in permanent threats of eviction and displacement, "necropolitical" police/military interventions and what is described as a silent imposition of a "slow death" on infrastructure, the neighborhood and ultimately also its residents, which "fracture" the lives of significant parts of the urban population, produce "ill-being" and bring about health consequences that are rarely considered in relation to urban violence.
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Violência , Brasil/epidemiologia , Cidades , Colômbia , Humanos , América Latina , População UrbanaRESUMO
BACKGROUND: Air pollution in most countries exceeds the levels recommended by the World Health Organization, causing up to one-third of deaths due to noncommunicable diseases. Fine particulate matter (PM2.5) and black carbon (BC) from mobile sources are the main contaminants. OBJECTIVE: The aim of this study is to assess the relationship of exposure to air pollutants (PM2.5 and BC) in microenvironments according to respiratory health and physical activity in users traveling by different types of transportation in Bogotá, Colombia. METHODS: A mixed methods study based on a convergent parallel design will be performed with workers and students. The sample will include 350 healthy transport users traveling by different urban transportation modes in three main routes in Bogotá. The study is broken down into two components: (1) a descriptive qualitative component focused on assessing the individual perception of air pollution using semistructured interviews; and (2) a cross-sectional study measuring the individual exposure to PM2.5 and BC using portable instruments (DustTrak and microAeth, respectively), pulmonary function by spirometry, and physical activity with accelerometry. The analysis will include concurrent triangulation and logistic regression. RESULTS: The findings will be useful for the conception, design, and decision-making process in the sectors of health and mobility from public, academy, and private perspectives. This study includes personal measurements of PM2.5 and BC during typical trips in the city to assess the exposure to these contaminants in the major roadways in real time. The study further compares the performance of two different lung tests to identify possible short-term respiratory effects. As a limitation, the protocol will include participants from different institutions in the city, which are not necessarily representative of all healthy populations in Bogotá. In this sense, it is not possible to draw causation conclusions. Moreover, a convergent parallel design could be especially problematic concerning integration because such a design often lacks a clear plan for making a connection between the two sets of results, which may not be well connected. Nevertheless, this study adopts a procedure for how to integrate qualitative and quantitative data in the interpretation of the results and a multilevel regression. The time that participants must live in the city will be considered; this will be controlled in the stratified analysis. Another limitation is the wide age range and working status of the participants. Regional pollution levels and episodes (PM2.5) will be handled as confounding variables. The study is currently in the enrollment phase of the participants. Measurements have been made on 300 participants. Pandemic conditions affected the study schedule; however, the results are likely to be obtained by late 2022. CONCLUSIONS: This study investigates the exposure to air pollutants in microenvironments in Bogotá, Colombia. To our knowledge, this is the first mixed methods study focusing on PM2.5, BC, and respiratory health effects in a city over 2 meters above sea level. This study will provide an integration of air pollution exposure variables and respiratory health effects in different microenvironments. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/25690.
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OBJECTIVES: Aortic coarctation is the most frequent structural anomaly out of congenital heart diseases. This congenital defect is an important cause of death worldwide. We sought to determine the prevalence of aortic coarctation in Colombia and whether new policies have had an impact on its diagnosis. METHODS: In this study information from the Bogotá birth defect surveillance program during the years 2001-2018 from 63 hospitals was used. 537,026 live births of any weight and stillbirths of any weight were analyzed. The information was stored in a database on the servers of the Health Secretariat and the Pontificia Universidad Javeriana. We analyzed the presence of aortic coarctation according to the newborn's sex, weight, size, mother's age, and gestational age at the time of birth and when coarctation is accompanied by other types of congenital malformations. RESULTS: The prevalence of aortic coarctation in Bogotá during the years 2001-2018 found in this study was 1.25 in 10,000 live births. We also found that prevalence of aortic coarctation in Bogotá changes throughout the years having a significant increase in the year 2018 with 6.57 cases in 10,000 live births. CONCLUSIONS: This prevalence is higher than the one found in a study with data from 2001 to 2014, which suggests an improvement in the country's epidemiological surveillance and medical training. However, the prevalence found in Bogotá is still lower compared to the prevalence worldwide and from other continents, the prevalence for Latinamerica was significantly lower as compared to those in Asia, Europe, and United States so we emphasize the importance of continuing with improvements, such as standardizing screening methods and sensitivity of said methods in a local scale as well as a continental scale.
OBJETIVOS: La coartación aórtica es la anomalía estructural más frecuente de las cardiopatías congénitas. Este defecto congénito es una causa importante de muerte en todo el mundo. Buscamos determinar la prevalencia de la coartación aórtica en Colombia y si las nuevas políticas han tenido un impacto en su diagnóstico. MÉTODOS: En este estudio se utilizó información del programa de vigilancia de defectos de nacimiento de Bogotá durante los años 2001-2018 en 63 hospitales. Se analizaron 537,026 nacidos vivos de cualquier peso y nacidos muertos de cualquier peso. La información fue almacenada en una base de datos de los servidores de la Secretaría de Salud y de la Pontificia Universidad Javeriana. Se analizó la presencia de coartación aórtica de acuerdo al sexo del recién nacido, peso, tamaño, edad de la madre y edad gestacional en el momento del nacimiento y cuando la coartación se acompañó de otros tipos de malformaciones congénitas. RESULTADOS: La prevalencia de la coartación aórtica en Bogotá durante los años 2001-2018 encontrados en este estudio fue de 1.25 en 10,000 nacidos vivos. También encontramos que la prevalencia de coartación aórtica en Bogotá ha cambiado a lo largo de los años, teniendo un aumento significativo en el año 2018 con 6.57 casos en 10,000 nacidos vivos. CONCLUSIONES: Esta prevalencia es mayor que la encontrada en un estudio con datos de 2001 a 2014, lo que sugiere una mejora en la vigilancia epidemiológica y la formación médica del país. Si bien, la prevalencia encontrada en Bogotá es menor en comparación con la prevalencia a nivel mundial y de otros continentes, la prevalencia para el continente de Latinoamérica también es significativamente menor con respecto a Asia, Europa y Estados Unidos, por lo que enfatizamos la importancia de continuar con las mejoras, como la estandarización de los métodos de detección y la sensibilidad de dichos métodos tanto a nivel local como a nivel del continente.
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Coartação Aórtica , Cardiopatias Congênitas , Coartação Aórtica/diagnóstico , Coartação Aórtica/epidemiologia , Colômbia/epidemiologia , Idade Gestacional , Cardiopatias Congênitas/epidemiologia , Humanos , Recém-Nascido , PrevalênciaRESUMO
Reporte lesionados pólvora 1 de enero.
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Humanos , Queimaduras , Gunpowder , Saúde Pública , PessoasRESUMO
Balance lesionados con pólvora 2 de enero.
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Humanos , Queimaduras , Gunpowder , Saúde Pública , PessoasRESUMO
Campaña donde se realiza una 'matriculatón' en colegios de las seis localidades donde hay mayor demanda, para que las familias puedan tramitar nuevos cupos para el año escolar 2022.
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Humanos , Adolescente , Vacinação em Massa , Programas de Imunização , Esquemas de ImunizaçãoRESUMO
Entendiendo como un asunto de salud pública el consumo, la producción y los diferentes usos que se le pueden dar al cannabis, la Secretaría Distrital de Salud acompañó este sábado el evento 4-20 Fest, en el cual se dio cita la comunidad cannábica de Bogotá.
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Humanos , Cannabis , Saúde , Saúde PúblicaRESUMO
Resumen: La infección por el nuevo SARS-COV-2 ha impactado de diversas maneras a toda la sociedad, incluidos los niños. Se describe el comportamiento de esta enfermedad en una población pediátrica de escasos recursos localizada por encima de 2500 m. s. n. m. Este es un trabajo retrospectivo transversal entre marzo y octubre de 2020 en Bogotá involucró niños entre 1 mes y 14 años con RT-PCR positiva para SARS-COV-2. Se estudiaron antecedentes, características sociodemográficas, clínicas, de laboratorio, radiológicas y evolutivas, agrupando los pacientes según la gravedad y analizando su significancia (p < 0.05). Como resultado, se obtuvieron 416 casos, de los cuales 43.3 % eran asintomáticos, 46.6 % sintomáticos leves, 8.9 % graves y 1.2 % críticos. De los consultantes a urgencias, los menores de 1 año fueron los más frecuentes (56.79 %) y los que más se hospitalizaron (35.8 %). El tiempo entre el inicio de los síntomas y la consulta fue en promedio de 2 días, El diagnóstico más frecuente en los pacientes no hospitalizados fue rinofaringitis (58.97 %), y en los que se hospitalizaron fue bronquiolitis (50 %). La mediana del tiempo de hospitalización de todo el grupo fue de 4 días la cual ser prolongó a 7 días para los que requirieron UCI. Con la hospitalización se asocia, entre otras causas, los índices nutricionales < 2 de, taquipnea, dificultad respiratoria, hipoxemia, linfopenia (en mayores de 2 años) (p < 0.05), no influyendo el hacinamiento ni el nivel socioeconómico. Después del estudio, se pudo concluir que la enfermedad es, generalmente, mucho más leve en niños que en adultos, diferenciándose de estos tanto en los factores predisponentes, los paraclínicos y en la evolución. Sin embargo, algunas variables demográficas, clínicas y de laboratorio podrían asociarse con una mayor gravedad en este grupo poblacional.
Abstract: Infection with the new SARS-COV-2 has impacted the entire society, including children, in various ways. The behavior of this disease in a low-income pediatric population located above 2500 m. a. s. I. is described. This is a cross-sectional retrospective study carried out between March and October 2020 in Bogotá involving children between 1 month and 14years old with positive RT-PCR for SARS-COV-2. History, sociodemographic, clinical, laboratory, radiological and evolutionary characteristics were studied, grouping the patients according to severity and analyzing their significance (p < 0.05). As a result, 416 cases were obtained, of which 43.3 % were asymptomatic, 46.6 % mildly symptomatic, 8.9 % severe, and 1.2 % critical. Of the consultants to the emergency room, those under 1 year of age were the most frequent (56.79 %) and those who were hospitalized the most (35.8 %). The time between the onset of symptoms and consultation was an average of 2 days. The most frequent diagnosis in non-hospitalized patients was rhinopharyngitis (58.97 %), and in those who were hospitalized it was bronchiolitis (50 %). The median hospitalization time for the entire group was 4 days, which was extended to 7 days for those who required ICU. Hospitalization is associated with, among other causes, nutritional indices < 2 SD, tachypnea, respiratory distress, hypoxemia, lymphopenia (in those older than 2 years) (p < 0.05), with neither overcrowding nor socioeconomic status as influencing factors. After the study, it was possible to conclude that the disease is generally much milder among children than in adults, differing from these in predisposing factors, paraclinical factors, and evolution. However, some demographic, clinical and laboratory variables could be associated with greater severity in this population group.
Resumo: A infecção com o novo SARS-COV-2 impactou toda a sociedade de várias maneiras, incluindo crianças. O comportamento desta doença em urna população pediátrica de baixa renda localizada acima de 2.500 m. s. n. m. é descrito. Este é um estudo transversal retrospectivo entre margo e outubro de 2020 em Bogotá, envolvendo crianças entre 1 mês e 14 anos com RT-PCR positiva para SARS- COV-2. Foram estudados antecedentes, características sociodemográficas, clínicas, laboratoriais, radiológicas e evolutivas, agrupando os pacientes de acordo com a gravidade e analisando sua significância (p < 0.05). Como resultado, foram obtidos 416 casos, sendo 43.3 % assintomáticos, 46.6 % sintomáticos leves, 8.9 % graves e 1.2 % críticos. Dos pacientes em pronto-socorro, os menores de 1 ano foram os mais frequentes (56.79 %) e os que mais internaram (35.8 %). O tempo entre o inicio dos sintomas e a consulta foi em média de 2 dias, sendo o diagnóstico mais frequente nos pacientes não internados a rinofaringite (58.97 %), e nos internados foi a bronquiolite (50 %). A mediana do tempo de internação para todo o grupo foi de 4 dias, que foi estendida para 7 dias para aqueles que necessitaram de UTI. A hospitalização está associada, entre outras causas, a índices nutricionais < 2 DP, taquipneia, desconforto respiratório, hipoxemia, linfopenia (nos maiores de 2 anos) (p < 0.05), não influenciando a superlotação ou o nível socioeconómico. Após o estudo, foi possível concluir que a doença geralmente é muito mais branda em crianças do que em adultos, diferindo destes em fatores predisponentes, fatores para clínicos e evolução. No entanto, algumas variáveis demográficas, clínicas e laboratoriais podem estar associadas á maior gravidade nesse grupo populacional.
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Resumen Introducción: Los estomas flotantes se definen como un estoma que no está fijado a la piel de la pared abdominal, esta técnica se ha descrito en cirugía para fístulas entero-atmosféricas y de control de daños. Caso Clínico: Presentamos un reporte de caso de manejo de absceso paraostomal en paciente con antecedente de laparotomía por abdomen agudo, por lo que se decide uso de terapia de presión negativa asociada a estoma flotante, demostrando su utilidad en este tipo complejo de pacientes.
Introduction: Floating stomata are defined as a stoma that is not attached to the skin of the abdominal wall, this technique is described in surgery for entero-atmospheric fistulas and damage control. Clinical Case: We present a case report of the management of paraostomal abscess in a patient with a history of laparotomy due to acute abdomen, it was decided to use negative pressure therapy associated with a floating stoma, demonstrating its usefulness in this complex type of patient.
Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Estomas Cirúrgicos , Técnicas de Fechamento de Ferimentos Abdominais , Traumatismos Abdominais/cirurgia , LaparoscopiaRESUMO
Ciclovia, also known as Open Streets initiatives in other countries, are city streets that are closed to motorized traffic and opened during certain times to residents for engaging in physical activity (PA). These initiatives are viewed by policy makers and health and community advocates as being beneficial to social, environmental, and community health. This study explores the geographic distribution of Ciclovia and Recreovia and the differences in geographic access assessed via distance-based measures, based on the socioeconomic status (SES) of the area. Results from this study show that the median distance to the Ciclovia according to SES ranges from 2930 m for SES 1 (most disadvantaged) to 482 m for SES 6 (wealthiest). The median distance to the Recreovia sites ranges from 5173 m for SES 1 to 3869 m for SES 6. This study found revealing urban inequities in the distribution of Ciclovia, whereas there was less inequalities within the Recreovia sites. This study shows that urban interventions are needed to promote recreational activity and reduce health disparities in under resourced, low SES areas.
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Características de Residência , Classe Social , Colômbia , Exercício Físico , Humanos , Saúde Pública , Fatores SocioeconômicosRESUMO
Intra-abdominal hypertension (IAH) is the persistent increase of intra-abdominal pressure (IAP) that could be caused by several pathologies. It is capable of promoting organ dysfunction, thereby increasing the mortality rate of human patients. As for cats and dogs, there are still few reports on how this pressure can be monitored and treated as a routine for admitted and hospitalized animals and on its relationship with the mortality of the patients. Therefore, the objective of this paper was to report a case of IAH secondary to chronic diaphragmatic rupture in a dog, which was treated with a temporary abdominal closure (TAC). A bitch was admitted to the veterinary hospital to undergo an elective ovariohysterectomy when it was diagnosed with a diaphragmatic rupture and displacement of the liver and intestinal loops in the chest. After repositioning these structures in the abdominal cavity, tension was observed in the abdomen. A temporary abdominal closure was then performed with a Bogota bag. Immediately after the surgery, the IAP was measured, presenting a value of 15 mmHg, indicating that there was an increase in intra-abdominal pressure. The animal was hospitalized, and IAP was monitored. After 24 hours, IAP was 5.8 mmHg when the Bogota bag was removed, and definitive celiorraphy was performed. The patient showed satisfactory clinical progress and was discharged 72 hours after the surgical procedure. The treatment used for IAH proved to be effective and contributed to the quick and satisfactory recovery of the patient.
A hipertensão intra-abdominal (HIA) é o aumento persistente da pressão intra-abdominal (PIA), podendo ser causada por diversas afecções e caraterizada por promover disfunções orgânicas, aumentando a taxa de mortalidade no homem. Em cães e gatos, ainda há poucos relatos da monitoração dessa pressão e do seu tratamento na rotina dos animais admitidos e internados, e sua relação com a mortalidade dos pacientes. Assim, objetivou-se relatar um caso de HIA secundária à ruptura diafragmática crônica em cão, a qual foi tratada com o fechamento abdominal temporário (FAT). Uma cadela foi admitida no hospital veterinário para realização de uma cirurgia de ovário-histerectomia eletiva, quando foi diagnosticada com ruptura diafragmática com fígado e alças intestinais deslocadas para o interior do tórax. Após reposicionamento dessas estruturas na cavidade abdominal, observou-se tensão no abdômen. Realizou-se então o fechamento abdominal temporário com bolsa de Bogotá. Imediatamente após o término da cirurgia, a PIA foi aferida e seu valor era de 15 mmHg, indicando aumento da mesma. O animal foi mantido internado e sua PIA monitorada. Após 24 horas seu valor era de 5,8 mmHg, quando a bolsa de Bogotá foi removida e realizada a celiorrafia definitiva. O paciente teve evolução clínica satisfatória e 72h após a cirurgia recebeu alta hospitalar. O tratamento utilizado para a HIA se mostrou eficaz, contribuindo para a rápida e satisfatória recuperação da paciente.
Assuntos
Feminino , Animais , Cães , Doenças do Cão/cirurgia , Hipertensão Intra-Abdominal/cirurgia , Hipertensão Intra-Abdominal/veterinária , Músculos Abdominais/lesões , Ruptura/veterináriaRESUMO
ABSTRACT: Intra-abdominal hypertension (IAH) is the persistent increase of intra-abdominal pressure (IAP) that could be caused by several pathologies. It is capable of promoting organ dysfunction, thereby increasing the mortality rate of human patients. As for cats and dogs, there are still few reports on how this pressure can be monitored and treated as a routine for admitted and hospitalized animals and on its relationship with the mortality of the patients. Therefore, the objective of this paper was to report a case of IAH secondary to chronic diaphragmatic rupture in a dog, which was treated with a temporary abdominal closure (TAC). A bitch was admitted to the veterinary hospital to undergo an elective ovariohysterectomy when it was diagnosed with a diaphragmatic rupture and displacement of the liver and intestinal loops in the chest. After repositioning these structures in the abdominal cavity, tension was observed in the abdomen. A temporary abdominal closure was then performed with a Bogota bag. Immediately after the surgery, the IAP was measured, presenting a value of 15 mmHg, indicating that there was an increase in intra-abdominal pressure. The animal was hospitalized, and IAP was monitored. After 24 hours, IAP was 5.8 mmHg when the Bogota bag was removed, and definitive celiorraphy was performed. The patient showed satisfactory clinical progress and was discharged 72 hours after the surgical procedure. The treatment used for IAH proved to be effective and contributed to the quick and satisfactory recovery of the patient.
RESUMO: A hipertensão intra-abdominal (HIA) é o aumento persistente da pressão intra-abdominal (PIA), podendo ser causada por diversas afecções e caraterizada por promover disfunções orgânicas, aumentando a taxa de mortalidade no homem. Em cães e gatos, ainda há poucos relatos da monitoração dessa pressão e do seu tratamento na rotina dos animais admitidos e internados, e sua relação com a mortalidade dos pacientes. Assim, objetivou-se relatar um caso de HIA secundária à ruptura diafragmática crônica em cão, a qual foi tratada com o fechamento abdominal temporário (FAT). Uma cadela foi admitida no hospital veterinário para realização de uma cirurgia de ovário-histerectomia eletiva, quando foi diagnosticada com ruptura diafragmática com fígado e alças intestinais deslocadas para o interior do tórax. Após reposicionamento dessas estruturas na cavidade abdominal, observou-se tensão no abdômen. Realizou-se então o fechamento abdominal temporário com bolsa de Bogotá. Imediatamente após o término da cirurgia, a PIA foi aferida e seu valor era de 15 mmHg, indicando aumento da mesma. O animal foi mantido internado e sua PIA monitorada. Após 24 horas seu valor era de 5,8 mmHg, quando a bolsa de Bogotá foi removida e realizada a celiorrafia definitiva. O paciente teve evolução clínica satisfatória e 72h após a cirurgia recebeu alta hospitalar. O tratamento utilizado para a HIA se mostrou eficaz, contribuindo para a rápida e satisfatória recuperação da paciente.
RESUMO
Intra-abdominal hypertension (IAH) is the persistent increase of intra-abdominal pressure (IAP) that could be caused by several pathologies. It is capable of promoting organ dysfunction, thereby increasing the mortality rate of human patients. As for cats and dogs, there are still few reports on how this pressure can be monitored and treated as a routine for admitted and hospitalized animals and on its relationship with the mortality of the patients. Therefore, the objective of this paper was to report a case of IAH secondary to chronic diaphragmatic rupture in a dog, which was treated with a temporary abdominal closure (TAC). A bitch was admitted to the veterinary hospital to undergo an elective ovariohysterectomy when it was diagnosed with a diaphragmatic rupture and displacement of the liver and intestinal loops in the chest. After repositioning these structures in the abdominal cavity, tension was observed in the abdomen. A temporary abdominal closure was then performed with a Bogota bag. Immediately after the surgery, the IAP was measured, presenting a value of 15 mmHg, indicating that there was an increase in intra-abdominal pressure. The animal was hospitalized, and IAP was monitored. After 24 hours, IAP was 5.8 mmHg when the Bogota bag was removed, and definitive celiorraphy was performed. The patient showed satisfactory clinical progress and was discharged 72 hours after the surgical procedure. The treatment used for IAH proved to be effective and contributed to the quick and satisfactory recovery of the patient.(AU)
A hipertensão intra-abdominal (HIA) é o aumento persistente da pressão intra-abdominal (PIA), podendo ser causada por diversas afecções e caraterizada por promover disfunções orgânicas, aumentando a taxa de mortalidade no homem. Em cães e gatos, ainda há poucos relatos da monitoração dessa pressão e do seu tratamento na rotina dos animais admitidos e internados, e sua relação com a mortalidade dos pacientes. Assim, objetivou-se relatar um caso de HIA secundária à ruptura diafragmática crônica em cão, a qual foi tratada com o fechamento abdominal temporário (FAT). Uma cadela foi admitida no hospital veterinário para realização de uma cirurgia de ovário-histerectomia eletiva, quando foi diagnosticada com ruptura diafragmática com fígado e alças intestinais deslocadas para o interior do tórax. Após reposicionamento dessas estruturas na cavidade abdominal, observou-se tensão no abdômen. Realizou-se então o fechamento abdominal temporário com bolsa de Bogotá. Imediatamente após o término da cirurgia, a PIA foi aferida e seu valor era de 15 mmHg, indicando aumento da mesma. O animal foi mantido internado e sua PIA monitorada. Após 24 horas seu valor era de 5,8 mmHg, quando a bolsa de Bogotá foi removida e realizada a celiorrafia definitiva. O paciente teve evolução clínica satisfatória e 72h após a cirurgia recebeu alta hospitalar. O tratamento utilizado para a HIA se mostrou eficaz, contribuindo para a rápida e satisfatória recuperação da paciente.(AU)
Assuntos
Animais , Feminino , Cães , Doenças do Cão/cirurgia , Hipertensão Intra-Abdominal/cirurgia , Hipertensão Intra-Abdominal/veterinária , Ruptura/veterinária , Músculos Abdominais/lesõesRESUMO
Colombia, like many developing nations, does not have a strong health system able to respond to a pandemic of the magnitude of Covid-19. There is an increasing need to create a model that allows particular clinics and hospitals to estimate the number of patients that require Intensive Care Units-ICU care (critical), and the number of patients that require hospital care (severe), but not ICU care, in order to manage their limited resources. This paper presents a prediction of the total number of ICU and regular beds that will be needed in Bogotá, Colombia, during the COVID-19 pandemic. We use an SEIR model that includes three different categories of infection: those who can stay at home, those who need regular hospital beds, and those who need ICU treatment. The model allows for a time varying transmission rate which we use to incorporate the measures introduced by the government over the period of one semester. The model predicts that by mid November 2020, the city will need 1362 ICU beds and more than 9000 regular hospital beds. The number of active cases will be 67,866 by then and the death toll will reach 13,268 people by the end of December. We provide a Shiny app available at https://claudia-rivera-rodriguez.shinyapps.io/shinyappcovidclinic/. The original values in the app reproduce the results of this paper, but the parameters and starting values can be changed according to the user's needs. COVID-19 has posed too many challenges to health systems around the globe. This model is a useful tool for cities, hospitals and clinics in Colombia that need to be prepared for the excess demand of services that a pandemic like this one generates. Unfortunately, the model predicts that by mid-November the projected capacity of the system in Bogotá will not be enough. We expect the lockdown rules to be strengthened in future days, so the death toll will not be as bad as predicted by this model.
Assuntos
COVID-19 , Pandemias , Colômbia/epidemiologia , Controle de Doenças Transmissíveis , Hospitais , Humanos , SARS-CoV-2RESUMO
Resumen La literatura reconoce que las condiciones estructurales de vulnerabilidad de las mujeres que se derivan de los roles asociados al cuidado y al trabajo doméstico y de su precarización laboral, entre otros, favorecen el aumento de la violencia en su contra, y esta se exacerba en las condiciones de confinamiento y aislamiento social generadas por la pandemia de la COVID-19. El artículo estudia los mecanismos dispuestos en Bogotá (Colombia) para enfrentar la violencia contra las mujeres y los desafíos que aún se presentan.
Abstract The literature recognizes that the structural conditions of women's vulnerability derived from the roles associated with care and domestic work and their job insecurity, among others, allow the violence increase against them, which is exacerbated in confinement conditions and social isolation generated by the Covid-19 pandemic. The article studies the mechanisms developed in Bogotá (Colombia) to face violence against women and the challenges related.
Assuntos
Humanos , COVID-19 , Isolamento Social , Vulnerabilidade a Desastres , Violência contra a MulherRESUMO
The Level of Traffic Stress (LTS) is an indicator that quantifies the stress experienced by a cyclist on the segments of a road network. We propose an LTS-based classification with two components: a clustering component and an interpretative component. Our methodology is comprised of four steps: (i) compilation of a set of variables for road segments, (ii) generation of clusters of segments within a subset of the road network, (iii) classification of all segments of the road network into these clusters using a predictive model, and (iv) assignment of an LTS category to each cluster. At the core of the methodology, we couple a classifier (unsupervised clustering algorithm) with a predictive model (multinomial logistic regression) to make our approach scalable to massive data sets. Our methodology is a useful tool for policy-making, as it identifies suitable areas for interventions; and can estimate their impact on the LTS classification, according to probable changes to the input variables (e.g., traffic density). We applied our methodology on the road network of Bogotá, Colombia, a city with a history of implementing innovative policies to promote biking. To classify road segments, we combined government data with open-access repositories using geographic information systems (GIS). Comparing our LTS classification with city reports, we found that the number of bicyclists' fatal and non-fatal collisions per kilometer is positively correlated with higher LTS. Finally, to support policy making, we developed a web-enabled dashboard to visualize and analyze the LTS classification and its underlying variables.