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Bogotá, Colombia

Sanchez-Abanto J.,Instituto Nacional Of Salud
Revista Peruana de Medicina Experimental y Salud Publica | Year: 2012

Child chronic malnutrition is one of the main problems of Public Health in Peru, according to WHO's reference values, national prevalence is 19.5% in children under five. Child chronic malnutrition has a negative impact on people throughout their lives, limits the development of society and hinders poverty eradication. To attain the goal of reducing chronic malnutrition in children to 10% by 2016, the Peruvian government will continue to strengthen, mainly, the efficient use of economic resources, the assessment of interventions, the implementation of investigations that help define causal relations and provide information for the design of public policies, health capacity building and the articulation of different government levels. This article goes over the main interventions implemented in the country. Source

Kohn C.G.,Saint - Joseph University | Mearns E.S.,University of Connecticut | Parker M.W.,Hartford Hospital | Hernandez A.V.,Cleveland Clinic Lerner Research Institute | And 2 more authors.
Chest | Year: 2015

BACKGROUND: Studies suggest outpatient treatment or early discharge of patients with acute pulmonary embolism (aPE) is reasonable for those deemed to be at low risk ofearly mortality. We sought to determine clinical prediction rule accuracy for identifying patients with aPE at low risk for mortality. METHODS: We performed a literature search of Medline and Embase from January 2000 to March 2014, along with a manual search ofreferences. We included studies deriving/validating a clinical prediction rule for early post-aPE all-cause mortality and providing mortality data over at least the index aPE hospitalization but ≤ 90 days. A bivariate model was used to pool sensitivity and specificity estimates using a random-effects approach. Traditional randomeff ects meta-analysis was performed to estimate the weighted proportion of patients deemed at low risk for early mortality and their ORs for death compared with high-risk patients. RESULTS: Forty studies (52 cohort-clinical prediction rule analyses) reporting on 11 clinical prediction rules were included. The highest sensitivities were observed with the Global Registry of Acute Coronary Events (0.99, 95% CI 5 0.89-1.00), Aujesky 2006 (0.97, 95% CI 5 0.95-0.99), simplified Pulmonary Embolism Severity Index (0.92, 95% CI 5 0.89-0.94), Pulmonary Embolism Severity Index (0.89, 95% CI 5 0.87-0.90), and European Society of Cardiology (0.88, 95% CI 5 0.77-0.94) tools, with remaining clinical prediction rule sensitivities ranging from 0.41 to 0.82. Of these five clinical prediction rules with the highest sensitivities, none had a specificity. 0.48. They suggested anywhere from 22% to 45% of patients with aPE were at low risk and that low-risk patients had a 77% to 97% lower odds of death compared with those at high risk. CONCLUSIONS: Numerous clinical prediction rules for prognosticating early mortality in patients with aPE are available, but not all demonstrate the high sensitivity needed to reassure clinicians. © 2015 American College of Chest Physicians. Source

Gavilan R.G.,University of Santiago de Compostela | Gavilan R.G.,Institute for Scientific Research and Technology Services INDICASAT | Zamudio M.L.,Instituto Nacional Of Salud | Martinez-Urtaza J.,University of Santiago de Compostela | Martinez-Urtaza J.,U.S. Center for Disease Control and Prevention
PLoS Neglected Tropical Diseases | Year: 2013

Vibrio parahaemolyticus is a foodborne pathogen that has become a public health concern at the global scale. The epidemiological significance of V. parahaemolyticus infections in Latin America received little attention until the winter of 1997 when cases related to the pandemic clone were detected in the region, changing the epidemic dynamics of this pathogen in Peru. With the aim to assess the impact of the arrival of the pandemic clone on local populations of pathogenic V. parahaemolyticus in Peru, we investigated the population genetics and genomic variation in a complete collection of non-pandemic strains recovered from clinical sources in Peru during the pre- and post-emergence periods of the pandemic clone. A total of 56 clinical strains isolated in Peru during the period 1994 to 2007, 13 strains from Chile and 20 strains from Asia were characterized by Multilocus Sequence Typing (MLST) and checked for the presence of Variable Genomic Regions (VGRs). The emergence of O3:K6 cases in Peru implied a drastic disruption of the seasonal dynamics of infections and a shift in the serotype dominance of pathogenic V. parahaemolyticus. After the arrival of the pandemic clone, a great diversity of serovars not previously reported was detected in the country, which supports the introduction of additional populations cohabitating with the pandemic group. Moreover, the presence of genomic regions characteristic of the pandemic clone in other non-pandemic strains may represent early evidence of genetic transfer from the introduced population to the local communities. Finally, the results of this study stress the importance of population admixture, horizontal genetic transfer and homologous recombination as major events shaping the structure and diversity of pathogenic V. parahaemolyticus. © 2013 Gavilan et al. Source

Gonzalez C.,University of Los Andes, Colombia | Paz A.,Instituto Alexander von Humboldt | Ferro C.,Instituto Nacional Of Salud
Acta Tropica | Year: 2013

Visceral leishmaniasis (VL) is caused by the trypanosomatid parasite Leishmania infantum (=Leishmania chagasi), and is epidemiologically relevant due to its wide geographic distribution, the number of annual cases reported and the increase in its co-infection with HIV. Two vector species have been incriminated in the Americas: Lutzomyia longipalpis and Lutzomyia evansi. In Colombia, L. longipalpis is distributed along the Magdalena River Valley while L. evansi is only found in the northern part of the Country. Regarding the epidemiology of the disease, in Colombia the incidence of VL has decreased over the last few years without any intervention being implemented. Additionally, changes in transmission cycles have been reported with urban transmission occurring in the Caribbean Coast. In Europe and North America climate change seems to be driving a latitudinal shift of leishmaniasis transmission. Here, we explored the spatial distribution of the two known vector species of L. infantum in Colombia and projected its future distribution into climate change scenarios to establish the expansion potential of the disease. An updated database including L. longipalpis and L. evansi collection records from Colombia was compiled. Ecological niche models were performed for each species using the Maxent software and 13 Worldclim bioclimatic coverages. Projections were made for the pessimistic CSIRO A2 scenario, which predicts the higher increase in temperature due to non-emission reduction, and the optimistic Hadley B2 Scenario predicting the minimum increase in temperature. The database contained 23 records for L. evansi and 39 records for L. longipalpis, distributed along the Magdalena River Valley and the Caribbean Coast, where the potential distribution areas of both species were also predicted by Maxent. Climate change projections showed a general overall reduction in the spatial distribution of the two vector species, promoting a shift in altitudinal distribution for L. longipalpis and confining L. evansi to certain regions in the Caribbean Coast. Altitudinal shifts have been reported for cutaneous leishmaniasis vectors in Colombia and Peru. Here, we predict the same outcome for VL vectors in Colombia. Changes in spatial distribution patterns could be affecting local abundances due to climatic pressures on vector populations thus reducing the incidence of human cases. © 2013 The Authors. Source

Roda T.B.,Instituto Nacional Of Salud
Revista Peruana de Medicina Experimental y Salud Publica | Year: 2016

This article compiles the conclusions and results of several studies conducted by global and intergovernmental organizations involved in the research and promotion of policies and strategies for a successful and efficient management of the negative effects of climate change in public health. It is also a call for awareness the health community regarding their protagonist and strategic role to be assumed in relation to this global phenomenon which requires the coordinated cross-sectoral and inter-institution collaboration to achieve true social and environmental resilience. © 2016, Instituto Nacional de Salud. All Rights Reserved. Source

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