Letalidad de la COVID-19: ausencia de patrón epidemiológico

ObjectiveAnalyze a set of indicators to understand the variability of the evolution and impact of the COVID-19 epidemic in a set of selected countries.MethodEcological study of a group of countries with more than 200 reported cases. Demographic variables, health expenditure variables, and variables about characteristics of health services were included as explanatory variables. and incidence, mortality and fatality rates have been analyzed as response variables. In addition, a relative fatality index has been created. Data are from international organizations. Spearman's correlation coefficient was used to estimate the magnitude of the associations.ResultsNumber of tests and of medical professionals are associated with a higher incidence rate. Mortality and case fatality rate are not associated with demographic, health expenditure, or health services variables.ConclusionDifferences suggest a general underestimation of the magnitude of the epidemic. Improvement of case identification and effectiveness of epidemiological surveillance systems is necessary.     

Monoclonal antibodies in man that neutralized H3N2 influenza viruses were classified into three groups with distinct strain specificity: 1968-1973, 1977-1993 and 1997-2003

We tried to reveal the strain specificity of neutralizing mAbs against H3N2 influenza viruses in individuals. A large number of B lymphocytes of a pediatrician were collected by apheresis and two Ab libraries were constructed at 2004 and 2007 by using the phage-display technology. The libraries were screened against 12 different H3 strains of flu isolated between 1968 and 2004. Large numbers of clones that bound to the Ags were isolated and mAbs that specifically bound to H3 strain viruses were selected. Their binding activity to the 12 strains and neutralizing activity were studied by ELISA and focus reduction test, respectively. Furthermore, the binding activity to hemagglutinin (HA) was examined by Western blot. The majority of clones showing the neutralizing activity turned out to be anti-HA mAbs and could be divided into three major groups showing distinct strain specificity: 1968-1973, 1977-1993 and 1997-2003.     

Encephalitis lethargica epidemic milestones in early sleep neurobiology researches

Around 100 years ago, the outbreak of peculiar encephalitis promoted knowledge advancement regarding sleep and psychomotricity control. This epidemic is believed to have disappeared ten years after it started, and it remained from 1916 to 1927. Since then, only a few sporadic cases have been reported, but previously, they happened in occasional and epidemics forms. Two pioneers in describing the cases were Jean-René Cruchet and his collaborators, and Constantin Von Economo. The firsts described diffuse symptomatology, “sub-acute encephalomyelitis.” However, the reports by the Austrian aristocrat had a localized aspect which was admitted by him as a new disease, “Encephalitis lethargica” (EL). In his suppositions, based on clinical and anatomopathological material analysis, von Economo found distinct centers for sleep, in the rostral hypothalamus, and wakefulness, posterior hypothalamus. He plays an essential role in new achievements about EL and sleep neurobiology comprehension.These basic structural sleep-arousal regulatory neural systems had a lasting impact on contemporary sleep research, unfolded initially mainly by Frédéric Bremer, Giuseppe Moruzzi, and Horace Winchell Magoun, based on a passive theory of sleep induction. The lasts arrived at the conception of “diffuse” and “unspecific” ascending reticular activating system (ARAS) of the brain stem. This notion was unfolding until the idea of various interconnected “waking centers” and “sleep centers” levels, and also, active sleep induction.     

A qualitative study of the duty to care in communicable disease outbreaks

Health care providers' (HCPs') duty to care during communicable disease outbreaks has resurfaced as an important and contentious topic. This renewed interest follows the re-emergence of communicable diseases, largely thought to have disappeared and therefore irrelevant to modern day practitioners. The 2003 SARS outbreak particularly presented propitious circumstances for reconsidering this issue. This study seeks to characterize the views of individuals on the nature and limits of this duty. The authors employed qualitative methods to gather lay and expert perspectives. Individual interviews were conducted with 67 participants consisting of HCPs, spiritual leaders, regulators, and members of the public from the greater Toronto area. Participants' views were analyzed and organized according to three main themes, constituting a framework that combines micro-, meso-, and macro-level structures and processes: the scope of obligations of HCPs, the roles of health care institutions, and the broader social context, respectively. Our data suggest that the duty to care must be placed in a wider context to include considerations that transcend individual provider obligations. It thus follows, based on our data, that the duty to care cannot be left to personal choice or an appeal to morality based on an ethic derived entirely from individual obligations. The micro-meso-macro analytical framework that we have developed can guide the articulation of accepted norms of duty to care during epidemics and the development of policy for public health crises. It can also enhance the focus of our current expectations of HCPs' duty during epidemics. This can be achieved by informing regulatory bodies, collaborating with policy makers and engaging the public.     

人畜禽共患结核病防控现状及展望

结核病是人、畜、禽共患的慢性传染病,已发现50种哺乳动物和25种禽类可感染该病。牛结核病是世界动物卫生组织规定必须通报的疫病,在我国属于二类动物传染病,不仅给畜牧业造成经济损失,而且严重威胁人群健康,是终止结核病流行,消除结核病危害的障碍和挑战。本文中,笔者从人、畜、禽共患结核病在畜间和人间的流行情况,人、畜、禽共患结核病防控现状,包括机制、防控意识、防治措施等方面,以及人、畜、禽共患结核病防控展望等方面进行了论述,旨在号召农业农村、畜牧、动物防疫、疾病控制等多部门充分意识到人、畜、禽共患结核病的流行形势和防控现状不容乐观,应尽快采取行动,多部门联防联控,以助力终止结核病流行策略目标的实现。     

A computer simulation model of a rubella epidemic

This paper presents a deterministic computer simulation model of the rubella epidemic process. The model consists of four difference equations which relate the number of infectant individuals in a closed population to the number of susceptible individuals, the number of immune individuals, the contact rate, the birth and death rates, and the proportion of vaccinated susceptibles. After computer simulation, the model is validated using data from the East North Central section of the United States. Satisfactory agreement between predicted and reported cases is obtained. It is demonstrated that under reporting of actual cases is a significant factor in modeling the epidemic process. The efficiency of various vaccination programs in eradicating rubella is investigated.     

石家庄地区2005-2011年肺结核病疫情分析

目的了解石家庄地区肺结核病疫情情况,为本地区的结核病控制提供决策依据。方法根据《中国疾病预防控制系统》之疾病监测信息报告管理子系统结核病报病资料,采用描述性流行病学方法对2005-2011年石家庄肺结核的疫情状况进行分析。结果①2005-2011年共有新发活动性肺结核患者39 621例,其中新涂阳肺结核患者23314例,新涂阳肺结核发病率从2005年的36.17/10万下降到2011年的29.63/10万,呈不断下降趋势。②由非结防机构转诊诊断为新涂阳肺结核病人占全年新涂阳肺结核病人从2005年的14.43%上升到2011年的49.05%。③新发活动性肺结核患者的男女性别构成比在2.31∶1～3.78∶1之间。新发涂阳肺结核患者的男女性别构成在2.27∶1～2.62∶1之间。④女性在15～24岁为高发病年龄组,男性在55～64岁为高发病年龄组;⑤就职业分布来看,以患者绝对数计,新发活动性肺结核职业分布前3位分别为农民、学生、工人。结论采取多种方式宣传,加大对农村地区的结核病防治经费投入,重视学校结核病防治知识普及,达到以点带面、小手拉大手的宣传效果,减少本地区结核病的发病率。     

医科大学生中焦虑流行状况的调查

目的 了解当前医科大学生考试焦虑的现状水平,探求考试焦虑与特质焦虑、状态焦虑之间的关系.方法 考试焦虑量表采用特质-状态焦虑问卷对一所大学内医科大学生进行1/10的抽样调查,观察人群整体及不同性别间、不同年级间的焦虑水平的有症状人群检出率.结果 考试焦虑整体得分与国内其他专业大学生得分基本一致,但女性分值明显偏高,该人群状态焦虑、特质焦虑得分高于国内中学生人群.结论 医科大学生总体焦虑水平偏高,提示今后应加强对此人群的心理干顶.     

鼻用中药预防疫病的古今应用与科学内涵

流感、新型冠状病毒感染等呼吸道传染病属于中医学疫病范畴,其重在预防,鼻用中药具有效优价良、安全便携的特点,且经鼻给药可直接、快速激活细胞、体液以及黏膜三重免疫应答。因此,鼻用中药近年来在疫病预防中的应用逐渐增多。通过梳理鼻用中药防疫的中医理论基础及古代应用,总结鼻腔独特的生理结构及鼻用中药防疫的现代临床应用,并从鼻腔黏膜免疫角度阐述鼻用中药防疫的科学内涵及其研究前景,以期丰富疫病预防方法并为鼻用中药未来研发提供新思路。