RESUMEN La Organización Panamericana de la Salud (OPS) y sus Estados Miembros han liderado los esfuerzos para erradicar el poliovirus salvaje en la Región de las Américas desde la eliminación exitosa de la viruela en 1971. En 1994, la Región fue la primera en obtener la certificación de libre del poliovirus salvaje. Sin embargo, en julio del 2022, se diagnosticó poliomielitis a un paciente de Estados Unidos de América no vacunado y sin antecedentes de viajes recientes. Para responder a la aparición de un poliovirus circulante derivado de la vacuna en ese país, la OPS creó el equipo de apoyo a la gestión de incidentes de poliomielitis. Este equipo ha asumido la coordinación de los esfuerzos de respuesta y se ha centrado en la coordinación, la planificación y seguimiento; la comunicación de riesgos y la participación de la comunidad; la vigilancia e investigación de casos; la vacunación; y la respuesta rápida. En este artículo, se determinan y documentan las mejores prácticas observadas después de la creación del equipo de apoyo a la gestión de incidentes (septiembre del 2022-2023) mediante una revisión y un análisis pormenorizados de datos procedentes de diversas fuentes y de datos específicos de los países del panel de vigilancia de la poliomielitis. El objetivo fue poner en común estas mejores prácticas y resaltar el apoyo técnico y la aplicación de medidas contra la poliomielitis por parte de los Estados Miembros. A pesar de los diversos desafíos, la Región de las Américas se mantiene libre de poliomielitis. El riesgo de esta enfermedad es cada vez menor, y la evaluación de julio del 2023 muestra una disminución del número de países con un riesgo medio, alto o muy alto. Este progreso refleja la mejora de la cobertura de inmunización, la vigilancia, la contención, los determinantes de la salud y la preparación y respuesta ante brotes. El equipo de apoyo a la gestión de incidentes relacionados con la poliomielitis de la OPS ha desempeñado un papel fundamental para brindar apoyo a estas iniciativas.

RESUMO Desde a eliminação bem-sucedida da varíola em 1971, a Organização Pan-Americana da Saúde (OPAS) e seus Estados Membros têm estado à frente de iniciativas para erradicar o poliovírus selvagem na Região das Américas. Em 1994, a região foi a primeira do mundo a ser certificada como livre do poliovírus selvagem. Entretanto, em julho de 2022, um paciente não vacinado e sem histórico de viagens recentes foi diagnosticado com poliomielite nos Estados Unidos da América. Em resposta ao surgimento de um poliovírus derivado de vacina circulante nos Estados Unidos, a OPAS criou a Equipe de Apoio à Gestão de Incidentes de Poliomielite. A equipe vem administrando os esforços de resposta, concentrando-se em: coordenação, planejamento e monitoramento; comunicação de risco e envolvimento da comunidade; vigilância e investigação de casos; vacinação; e resposta rápida. Neste documento, identificamos e documentamos as melhores práticas observadas após a criação da Equipe de Apoio à Gestão de Incidentes (setembro de 2022 a 2023) por meio de uma revisão e análise abrangentes de diversas fontes de dados e dados específicos de cada país fornecidos por meio do painel de vigilância da poliomielite. O objetivo foi compartilhar essas melhores práticas, destacando o apoio técnico e a implementação de medidas contra a poliomielite pelos Estados Membros. Apesar de vários desafios, a Região das Américas continua livre da poliomielite. Um levantamento de julho de 2023 demonstrou que o risco da poliomielite vem diminuindo, com menos países com risco médio, alto ou muito alto. Essa evolução é resultado de melhoras na cobertura vacinal, vigilância, contenção, preparação, determinantes de saúde e resposta a surtos. A Equipe de Apoio à Gestão de Incidentes de Poliomielite da OPAS foi fundamental para apoiar esses esforços.

ABSTRACT The Pan American Health Organization (PAHO) and its Member States have been leading the efforts to eradicate wild poliovirus in the Region of Americas since smallpox's successful elimination in 1971. The region became the first to be certified free of wild poliovirus in 1994. However, in July 2022, an unvaccinated patient with no recent travel history was diagnosed with poliomyelitis in the United States of America. In response to the emergence of a circulating vaccine-derived poliovirus in the United States, PAHO established the Polio Incident Management Support Team. This team has been coordinating response efforts, focusing on: coordination, planning, and monitoring; risk communication and community engagement; surveillance and case investigation; vaccination; and rapid response. In this paper, we identified and documented best practices observed following establishment of the Incident Management Support Team (September 2022–2023) through a comprehensive review and analysis of various data sources and country-specific data from the polio surveillance dashboard. The aim was to share these best practices, highlighting technical support and implementation of polio measures by Member States. Despite several challenges, the Americas region remains polio-free. Polio risk is declining, with a July 2023 assessment showing fewer countries at medium, high, and very high risk. This progress reflects improved immunization coverage, surveillance, containment, health determinants, and outbreak preparedness and response. The PAHO Polio Incident Management Support Team has played a key role in supporting these efforts.

Resumen: A veces existen límites claros y naturales del campo de acción de una ciencia, y en otros casos son simples límites de conveniencia. La Ciencia de la Información Geográfica (CIG) es una ciencia transversal, que tiene contactos con todas las geociencias y con diversas ciencias formales como las Matemáticas, la Lógica y la Informática. Una primera aproximación razonable a los límites de una ciencia sería a través de su definición. Sin embargo, las definiciones existentes de CIG a menudo son tan amplias que han sido criticadas con razón por practicar el gerrymandering, en particular con el resto de las geociencias. Para evitar el gerrymandering se propone una definición operacional que ubica a la CIG entre las ciencias que manejan Datos y no Información. Esto resuelve el problema del gerrymandering sin implicar realmente un recorte significativo de lo que normalmente se considera dentro de CIG. Una consecuencia no prevista es que esto permitirá caracterizar a la CIG como Ciencia Formal.

Abstract: Sometimes there are clear and natural limits to the scope of action of a science, and in other cases they are simply convenient ones. Geographic Information Science (GISc) is a transversal science, with contacts with all geosciences but also with various formal sciences such as Mathematics, Logic and Computer Science. A first approach to specifying the limits of a science is through its definition. Definitions of GISc are often so expansive that they have been rightly criticized for practicing gerrymandering, in particular with the rest of the geosciences. To avoid this, an operational definition is proposed that places GISc among the sciences that handle Data and not Information. This solves the gerrymandering problem without really implying a significant cut of what is usually considered within GISc. As an unforeseen consequence, this delimitation will allow it to be characterized as Formal Science, leaving it as the only geoscience with this characteristic.

Resumen En el contexto bélico actual y ante la creciente preocupación de la población a un posible evento nuclear, cobra importancia una revisión bibliográfica como la presente en la que se recogen los actuales y potenciales tratamientos que la Farmacia Hospitalaria debería tener disponible tanto para paliar como para prevenir los posibles daños derivados de la radiación. Así, se detallan los seis medicamentos comercializados y cuatro fórmulas magistrales que deberían formar parte de un stock de emergencia en lugares cercanos amenazados por la exposición a radionúclidos de yodo, cesio, talio, galio, polonio, tecnecio y uranio. Por otra parte, se recogen nuevos compuestos naturales que, por sus propiedades antioxidantes, antiinflamatoria y/o potencial quelante de metales, podrían llegar a utilizarse como radioprotectores en este tipo de eventos, estando la mayoría disponibles como materia prima y siendo por tanto valorable su elaboración como formulación magistral.

Summary In the current war context and given the growing concern of the population in a possible nuclear event, a bibliographic review such as the current one is important, in which the present and potential treatments that the Hospital Pharmacy should have available both to palliate and to prevent possible damage from radiation. This review includes the 6 marketed drugs and 4 compounding drugs that should form part of an emergency stock in nearby places threatened by exposure to radionuclides of iodine, cesium, thallium, gallium, polonium, technetium and uranium. On the other hand, we describe 9 natural compounds that, due to their antioxidant, anti-inflammatory and/or metal-chelating potential properties, could be used as radioprotectors in this type of event, most of them being available as active pharmaceutical ingredients and their elaboration being therefore valuable as compounded drugs.

Resumen Introducción. Duponchelia fovealis Z. es una plaga en la producción de cultivos en el continente europeo y en Estados Unidos. Ha sido detectada en producción fresera en Brasil, México y en una finca en el Cantón de Vásquez de Coronado, en San José, Costa Rica. Objetivo. Determinar la presencia y distribución de Duponchelia fovealis Z. en fincas freseras de Costa Rica. Materiales y métodos. Durante las épocas secas del 2020-2021 y 2021-2022, trampas cebadas con la feromona de D. fovealis fueron colocadas en la finca del reporte inicial en Vásquez de Coronado y en otras seis fincas localizadas en las principales regiones freseras de Costa Rica: La Cima de Dota, Llano Grande, Poás y Vara Blanca. Resultados. El monitoreo demostró que las poblaciones más altas estuvieron establecidas en la finca de Vásquez de Coronado, mientras que se obtuvieron capturas ocasionales en fincas como en La Cima de Dota en San José y dos en Llano Grande de Cartago. Conclusiones. Se determinó la presencia de D. fovealis Z. en Costa Rica, con distribución limitada. Ante esto se sugiere un análisis de riesgo de la plaga y la implementación de medidas que disminuyan la dispersión del insecto.

Abstract Introduction. Duponchelia fovealis Z. is a pest of production crops in Europe and in the United States. It has recently been detected in strawberry production in Brazil, Mexico, and in a farm in the Vásquez de Coronado canton, San José, Costa Rica. Objective. To determine the presence and distribution of Duponchelia fovealis Z. in strawberry farms in Costa Rica. Materials and methods. During the dry seasons of 2020-2021 and 2021- 2022, traps baited with the D. fovealis pheromone were placed in the initially reported farm in Vásquez de Coronado and in six other farms located in the main strawberry regions of Costa Rica: La Cima of Dota, Llano Grande, Poás, and Vara Blanca. Results. The monitoring showed that the highest populations were established in the Vásquez de Coronado farm, while occasional captures were obtained in farms such as La Cima of Dota in San José and two in Llano Grande in Cartago. Conclusions. The presence of D. fovealis Z. in Costa Rica was determined, with limited distribution. Given this, an analysis of the risk of the pest and the implementation of measures to reduce the insect’s dispersal are suggested.

Abstract Introduction The management of complex anal fistulae remains a topical surgical problem. The choice and success of surgical management are based on the balance between healing and continence. Although porcine dermal collagen (Permacol Collagen Paste [PCP]- Covidien plc, Gosport, Hampshire, UK) represents a new generation of non-solid biomaterials, its results in anal fistulae are mixed. Methods A multicenter observational retrospective analysis of consecutive patients with cryptoglandular anal fistula treated in four colorectal surgery units was performed between 2015 and 2020. Clinical cure of the fistula was the main outcome measure. Adverse events and alterations in anal continence were secondary outcomes. Results The study included 119 patients (87 males, 71.1%), with a mean age of 53 years (IR 44-65). Most patients had complex (80.6%) and recurrent (91.6%) fistulae. With the first PCP treatment, the overall cure rate was 41.2% (49 patients) and 45.4% with the second treatment (5 out of 17 patients). The mean follow-up period was 17 months (IR 5-25). Healing was not affected by the location and type of fistula, the existence or not of a cavity, the number of tracts, or the administration of prophylactic antibiotics. After the PCP treatment, no patient in the series had worsening of continence. Morbidity affected 22.7% of the patients (27), with postoperative abscesses being the most frequent adverse event. There were no statistical differences between the four hospitals studied. Conclusions Permacol collagen paste is a safe and easily reproducible therapy for complicated anal fistulae that has moderate efficacy. The overall success rate is slightly over 40%, with no detriment to fecal continence.

RESUMO Objetivo: Descrever e comparar as variáveis da aptidão física de acordo com o cumprimento da recomendação de atividade física, medida por acelerometria. Métodos: A amostra foi composta de 120 escolares, sendo 57 meninos e 63 meninas, de 9 a 11 anos de idade. As variáveis analisadas foram: peso, estatura, índice de massa corpórea (IMC), dobras cutâneas, circunferências, agilidade, flexibilidade, velocidade e força de membros superiores, inferiores e abdominal. A atividade física foi mensurada de forma objetiva por meio de acelerômetro. Os escolares foram divididos em dois grupos: “cumpre a recomendação” (≥60min/dia) e “não cumpre a recomendação” (<60min/dia). Para verificar a normalidade dos dados, foi utilizado o teste de Kolmogorov-Smirnov. A comparação dos valores médios dos escolares que cumprem ou não a recomendação de atividade física foi feita pelos testes t de Student e U de Mann-Whitney. O nível de significância adotado foi de p<0,05. Resultados: Os escolares que cumpriram a recomendação, comparados com os que não cumpriram, apresentaram valores significativamente menores para adiposidade (somatória das sete dobras cutâneas), peso corporal, IMC e força abdominal. Não foram encontradas diferenças significativas nas variáveis de velocidade e agilidade; quanto à força de membros superiores (MMSS), constatou-se que ela foi maior em quem não cumpriu a recomendação. Conclusões: Crianças que cumpriram a recomendação de atividade física apresentaram melhor composição corporal e força abdominal que as crianças que não cumpriram.

Abstract Objective: To describe and compare physical fitness variables according to compliance with the recommendations of physical activity, measured by accelerometry. Methods: The sample gathered 120 students, 57 boys and 63 girls aged 9 to 11 years. The variables analyzed were: weight, stature, BMI, skinfolds, waist circumference, agility, flexibility, speed and strength of upper and lower limbs, and abdominal strength. Physical activity was measured objectively using an accelerometer. The students were divided into two groups: “complies with recommendations” (≥60min/day) and “does not comply with recommendations” (<60min/day). To verify the normality of the data, the Kolmogorov-Smirnov test was used. The mean values of students who do or do not comply with the physical activity recommendation were compared using Student's t and U-Mann Whitney tests. The level of significance was set at p<0.05. Results: The students who followed the recommendation showed significantly lower values compared to those who did not for adiposity (sum of 7 skinfolds); body weight; body mass index (BMI) and abdominal strength. No significant differences were found in the variables of speed and agility, and the upper limbs’ strength was greater in subjects who did not comply with recommendations. Conclusions: Students who complied with physical activity recommendations had better body composition and more abdominal strength than those who did not.

RESUMO Este relatório tem como objetivo apresentar o trabalho realizado sobre o delineamento, publicação e impacto das atualizações para intervenções em COVID-19 baseadas em evidências, que visam fornecer sínteses de evidências atualizadas provenientes de revisões sistemáticas vivas sobre intervenções terapêuticas para apoiar a tomada de decisões. Para isso, foi criado um grupo de trabalho específico no âmbito da Comissão Nacional de Avaliação de Tecnologias de Saúde (CONETEC, na sigla em espanhol), do Ministério da Saúde da Argentina, em parceria com a Organização Pan-Americana da Saúde (OPAS). Foi desenhada uma metodologia para a elaboração e publicação de documentos de avaliação destinados a apoiar a tomada de decisões. Esses relatórios de atualização se basearam na exploração de três domínios: efeitos na saúde, viabilidade da implementação e recomendações baseadas em evidências. As conclusões foram adaptadas a uma escala semafórica de acordo com o equilíbrio entre os benefícios e os aspectos negativos para os diferentes cenários clínicos, de forma a melhorar a sua interpretação e aplicação. Durante o ano de 2021, foram publicados 16 relatórios de síntese de evidências (13 originais e 3 atualizações completas), que receberam um número significativo de consultas no site da CONETEC e da Base Regional de Informes de Avaliação de Tecnologias em Saúde das Américas (BRISA). Assim, tornou-se visível a necessidade de contar com resumos de evidências robustos, atualizados e confiáveis adaptados ao contexto de aplicação no sistema de saúde do país. A atualização constante das informações, sua divulgação adequada e a manutenção do rigor na elaboração dos relatórios também apresentam desafios.

ABSTRACT This report presents the work done on the design, publication, and impact of updates on evidence-based COVID-19 interventions, in order to support decision-making with updated evidence syntheses based on living systematic reviews of therapeutic interventions. To this end, a specific working group was created within the National Commission for Health Technology Assessment (CONETEC) of the Ministry of Health of Argentina, in collaboration with the Pan American Health Organization (PAHO). A methodology was designed to develop and publish assessment documents aimed at supporting decision-making. These update reports were based on the exploration of three areas: health effects, feasibility of implementation, and evidence-based recommendations. A color-coded system was used to present the conclusions according to the balance between their positive and negative effects in different clinical scenarios, in order to improve their interpretation and implementation. In 2021, 16 evidence synthesis reports were published (13 original reports and three full updates). These were downloaded many times from the CONETEC website and the Regional Database of Health Technology Assessment Reports of the Americas (BRISA), highlighting the need for robust, up-to-date, reliable evidence summaries adapted for implementation in the country's health system. Other challenges include constant updating of information, appropriate dissemination, and sustained rigorous preparation of the reports.

RESUMEN Este informe tiene por objetivo exponer el trabajo realizado sobre el diseño, la publicación y el impacto de las actualizaciones para intervenciones en COVID-19 basadas en la evidencia, para brindar síntesis de evidencia actualizadas a partir de revisiones sistemáticas vivas sobre intervenciones terapéuticas para dar soporte en la toma de decisiones. Para ello, se generó un grupo específico de trabajo en el ámbito de la Comisión Nacional de Evaluación de Tecnologías de Salud (CONETEC) en el Ministerio de Salud de Argentina en colaboración con la Organización Panamericana de la Salud (OPS). Se diseñó una metodología para elaborar y publicar documentos de evaluación orientados a dar apoyo en la toma de decisiones. Estos informes de actualización se respaldaron en la exploración de tres dominios: los efectos en la salud, la factibilidad de la implementación y las recomendaciones basadas en evidencia. Las conclusiones se adaptaron en un esquema semaforizado según el balance entre los beneficios y los aspectos negativos para los distintos escenarios clínicos, a fin de mejorar su interpretación y aplicación. Durante el año 2021 se publicaron 16 informes de síntesis de evidencia (13 originales y 3 actualizaciones completas) que recibieron un destacado número consultas desde la página web de CONETEC y la Base Regional de Informes de Evaluación de Tecnologías en Salud de las Américas (BRISA). Así se hizo visible la necesidad de disponer de resúmenes de evidencia robustos, actualizados y confiables con adaptación al contexto de aplicación en el sistema sanitario del país. El desafío se presenta, además, en la actualización constante de la información, la diseminación apropiada y el sostenimiento en la rigurosidad en el desarrollo de los informes.

Abstract Introduction: Spinal injuries are common among young adult men. Recognizing kinematics can help reduce the number of late diagnoses, especially if there are consciousness disorders. Vertebral fractures can be single or multiple, and they are often associated with extravertebral injuries. Objectives: To examine the distribution of the lesion based on the mechanism of production, to characterize the neurological condition, to evaluate the lesion pattern and its relationship with extravertebral lesions, and to analyze the treatment. Materials and Methods: This was a multicenter, prospective study of patients admitted with post-trauma vertebral injuries between July 1, 2018 and June 30, 2020. Age, gender, kinematics, neurological condition, affected sector, pattern of injury, and associated extravertebral injuries were all examined. Results: There were 281 patients (60% men) evaluated, with 400 vertebral and 118 extravertebral lesions. The causes were as follows: polytrauma in 62 cases, falls from great heights in 147 patients, and traffic accidents in 98. ASIA E was the most frequently observed neurological picture (8 cases), which was not determined at admission. The T2-L5 sector was the most affected, mostly by compression injuries. Head and chest trauma were the most common extravertebral injuries; there was one case of SCIWORA and one early death. Conclusions: The most commonly affected spinal sectors were thoracolumbar, thoracic, and lumbar; the injuries are typically caused by falls from great heights and, in general, are isolated, with no neurological injuries. The treatment is determined by the stability and neurological condition.

Resumen Introducción: Las lesiones raquídeas son frecuentes en hombres adultos jóvenes. Reconocer la cinemática ayuda a disminuir la tasa de diagnósticos tardíos, principalmente si hay trastornos de la conciencia. Las fracturas vertebrales pueden ser únicas o múltiples, y asociarse con lesiones extravertebrales. Los objetivos de este estudio fueron analizar la distribución de la lesión según el mecanismo de producción, caracterizar el cuadro neurológico, evaluar el patrón de lesión y la asociación con lesiones extravertebrales, y analizar el tratamiento. Materiales y Métodos: Estudio multicéntrico, prospectivo de pacientes con lesiones vertebrales postrauma, que ingresaron entre el 1 de julio de 2018 y el 30 de junio de 2020. Se analizaron los siguientes parámetros: edad, sexo, cinemática, cuadro neurológico, sector afectado, patrón de lesión, lesiones extravertebrales asociadas. Resultados: Se evaluó a 281 pacientes (60% hombres) con 400 lesiones vertebrales y 118 extravertebrales que, en 62 casos, conformaban un cuadro de politraumatismo; 147 con trauma por caída de altura y 98, por accidente de tránsito. El cuadro neurológico más observado fue ASIA E (8 casos), no determinado al ingreso. El sector T2-L5 fue el más afectado, en su mayoría, por lesiones por compresión. Las lesiones extravertebrales más frecuentes fueron el trauma de cráneo y de tórax; hubo un caso de SCIWORA y un óbito temprano. Conclusiones: Los sectores raquídeos más afectados fueron: el toracolumbar, el torácico y el lumbar; las lesiones suelen deberse a caídas de altura y suelen ser únicas, sin cuadro neurológico. El tratamiento se decide según la estabilidad y el cuadro neurológico.

ABSTRACT Environmental surveillance of water sources is important to monitoring viral hepatitis transmission in clinical settings. This study investigated the circulation of hepatitis A (HAV) and E (HEV) viruses in sewage and clinical samples from Argentina. Between 2016 and 2017, 80 raw sewage samples and 86 clinical samples (stool and serum) from suspected cases of hepatitis A and hepatitis E were obtained. HAV and HEV were tested by both real-time and nested PCR. Positive samples were sequenced for genotype determination and phylogenetic analysis. Overall, HAV was recovered in 39% of sewage samples and 61.1% of clinical samples. HEV was detected in 22.5% of sewage samples and 15.9% of clinical samples. HAV was found more frequently in sewage during the winter and in clinical samples in spring; HEV was more prevalent in sewage during summer and in clinical samples in autumn. All HAV isolates belonged to genotype IA and HEV isolates belonged to genotype 3, the most prevalent genotypes in South America. High prevalence of HAV and HEV in environmental and clinical samples in Mendoza, Argentina was observed. These findings reinforce the importance of environmental surveillance and implementation of health strategies to control the spread of HAV and HEV in developing countries.

ABSTRACT Fused deposition modeling (FDM) has gained popularity recently due to its versatility and low cost. Considering that the quality of printed parts depends on many variables, a 3^3 factorial design of experiments was conducted, where three influential parameters in the process were studied: layer height (0.15, 0.2, and 0.25 mm), infill percentage (30%, 60%, and 90%), and shell count (2, 3, and 4), using polylactic acid as the material. Their effects on tensile strength, flexural strength, printing time, and interactions were measured. The maximum tensile and flexural stress obtained were 33.5 MPa and 87.3 MPa, respectively, at a 90% infill percentage. It was found that layer height does not significantly affect mechanical strength, while infill percentage has the most significant influence, followed by the number of shells. The latter two factors show a meaningful interaction. Furthermore, all the studied parameters have a significant impact on printing time.

ABSTRACT Objective: Evaluating clinical factors associated with mortality in older patients who underwent surgical correction of hip fractures. Methods: This observational and retrospective study analyzed the medical records of 67 patients (aged older than 60 years), both men and women, who underwent surgical correction of hip fractures from 2019 to 2020 at Hospital São Paulo. The following variables were analyzed: age, sex, presence of comorbidities, affected hip region, and trauma mechanism. Statistical analyses were performed using the SPSS software. Results: The mean age of patients was 78.12 ± 9.80 years and 80.6% of the sample were women. The prevalence of hip fractures on the right side (52.2%), in the transtrochanteric region (53.7%), and due to fall on the same level (88.1%) was higher. Systemic arterial hypertension (77.6%), diabetes mellitus (37.3%), and dementia (16.4%) were frequent comorbidities. The prevalence of death after fracture was 17.9% and it was associated with longer hospital stay after surgery (p = 0.028). Conclusion: The prevalence of mortality of patients with hip fractures who underwent surgery was 17.9%. A longer hospital stay due to pre-existing comorbidities was the main factor related to this outcome. Level of Evidence III, Retrospective Study.

RESUMO Objetivo: Avaliar os fatores clínicos associados à mortalidade em pacientes idosos submetidos ao tratamento cirúrgico para correção de fraturas do quadril. Métodos: Estudo observacional e retrospectivo de análise de prontuários de 67 pacientes (idade superior a 60 anos). Foram incluídos indivíduos de ambos os sexos, submetidos ao tratamento cirúrgico para correção de fraturas do quadril, entre 2019 e 2020, no Hospital São Paulo. Foram analisadas as variáveis: idade, sexo, presença de comorbidades, região do quadril acometido e mecanismo de trauma. As análises estatísticas foram realizadas pelo software SPSS. Resultados: A idade média dos participantes foi de 78,12 ± 9,80 anos, e 80,6% da amostra era constituída por mulheres. Houve maior prevalência de fraturas do quadril no lado direito (52,2%), na região transtrocantérica (53,7%) e causada por queda sem desnível (88,1%). Hipertensão arterial sistêmica (77,6%), diabetes mellitus (37,3%) e demência (16,4%) foram frequentes. A prevalência de óbito após a fratura foi de 17,9%, sendo associada a maior tempo de internação hospitalar após a cirurgia (p = 0,028). Conclusão: A prevalência de mortalidade dos pacientes com fratura do quadril submetidos à cirurgia foi de 17,9%. O tempo prolongando de internação hospitalar por comorbidades pré-existentes foi o principal fator relacionado a este desfecho. Nível de Evidência III, Estudo Retrospectivo.

ABSTRACT Broad bean cultivation is considered a productive strategy and a component of food sovereignty in Southern Colombia. Therefore, this study was carried out in order to evaluate twelve promising genotypes and two commercial controls, to expand the improved varieties supply of this legume in the future. For this, an experimental assay was established with 14 treatments and four repetitions. Where, 13 agronomic traits and the reaction to the pathogen Botrytis fabae were estimated. The information was analyzed by a simple ANOVA test. Also, a Principal Component Analysis (PCA) was developed with the traits with the highest coefficient of variation. Results showed genetic diversity, with promising genotypes in relation to the controls. The number of stems, flowering days, pod formation days, pods per plant, weight of one hundred seeds, and yield allowed three groups to be identified by PCA. The first one was made up of two controls, the second group characterized by higher yields, and a third group represented by an intermediate yield added to an earliness condition. These results allow the recognition of candidate genotypes to be included into breeding programs and contribute to the crop protection.

RESUMEN El cultivo de haba en el sur de Colombia es considerado una estrategia productiva y un componente de soberanía alimentaria. Por tanto, esta investigación buscó evaluar doce genotipos promisorios y dos testigos comerciales, para ampliar en el futuro la oferta de variedades mejoradas en esta leguminosa. Para esto, se estableció un cultivo experimental con 14 tratamientos y cuatro repeticiones. En donde, se estimaron 13 variables agronómicas y la reacción al patógenoBotrytis fabae. La información de las variables fue analizada mediante ANDEVA simple y se desarrolló un Análisis de Componentes Principales con las variables de mayor coeficiente de variación. Los resultados evidenciaron diversidad genética, sobresaliendo los genotipos promisorios respecto a los testigos. Las variables número de tallos, días a floración, días a formación de vainas, vainas por planta, peso de cien semillas y el rendimiento, permitieron identificar mediante ACP tres grupos. El primero conformado por los dos testigos, un segundo grupo caracterizado por presentar mayor rendimiento y el tercero caracterizado por un rendimiento intermedio sumado a una condición de precocidad. Estos resultados permiten reconocer materiales candidatos para ser integrados a programas de mejoramiento y contribuir a la protección del cultivo.

Resumen El análisis de células sanguíneas es una parte importante de la evaluación de la salud y la inmunidad. Hay tres componentes principales de los glóbulos rojos, los glóbulos blancos y las plaquetas. El recuento y la densidad de estas células sanguíneas se utilizan para encontrar múltiples trastornos como infecciones de la sangre como anemia, leucemia, etc. Los métodos tradicionales consumen mucho tiempo y el costo de las pruebas es alto. Por tanto, surge la necesidad de métodos automatizados que puedan detectar diferentes tipos de células sanguíneas y contar el número de células. Se propone un marco basado en una red neuronal convolucional para la detección y el recuento de las células. La red neuronal se entrena para las múltiples iteraciones y se guarda un modelo que tiene una menor pérdida de validación. Los experimentos se realizan con el fin de analizar el rendimiento del sistema de detección y los resultados con alta precisión en el recuento de células. La precisión promedio se logra al analizar las respectivas etiquetas que hay en la imagen. Se ha determinado que el valor de la precisión promedio, oscila entre el 70% y el 99,1% con un valor medio de 85,35%. El coste computacional de la propuesta fue de 0.111 segundos, procesar una imagen con dimensiones de 640 × 480 píxeles. El sistema también se puede implementar en ordenadores con CPU de bajo costo, para la creación rápida de prototipos. La eficiencia de la propuesta, para identificar y contar diferentes células sanguíneas, se puede utilizar para ayudar a los profesionales médicos a encontrar los trastornos y la toma decisiones, a partir de la identificación automática.

Resumo O exame de células sanguíneas é uma parte importante da avaliação de saúde e imunidade. Há três componentes principais dos glóbulos vermelhos, glóbulos brancos e plaquetas. A contagem e a densidade dessas células sanguíneas são usadas para encontrar múltiplos distúrbios, tais como infecções no sangue: anemia, leucemia, etc. Os métodos tradicionais são demorados e o custo dos testes é alto. Portanto, surge a necessidade de métodos automatizados que possam detectar diferentes tipos de células sanguíneas e contar o número de células. É proposta uma estrutura baseada em rede neural convolucional para a detecção e contagem de células. A rede neural é treinada para múltiplas iterações e é salvo um modelo que tem uma menor perda de validação. São realizados experimentos para analisar o desempenho do sistema de detecção e os resultados com alta precisão na contagem de células. A precisão média é obtida analisando os respectivos rótulos na imagem. Foi determinado que o valor médio de precisão oscila entre 70 % e 99,1 % com um valor médio de 85,35 %. O custo computacional da proposta foi de 0,111 segundos, processando uma imagem com dimensões de 640 × 480 pixels. O sistema também pode ser implementado em computadores com CPUs de baixo custo para prototipagem rápida. A eficiência da proposta, para identificar e contar diferentes células sanguíneas, pode ser usada para ajudar os profissionais médicos a encontrar distúrbios e tomar decisões, com base na identificação automática.

Abstract Blood cell analysis is an important part of the health and immunity assessment. There are three major components of the blood: red blood cells, white blood cells, and platelets. The count and density of these blood cells are used to find multiple disorders like blood infections (anemia, leukemia, among others). Traditional methods are time-consuming, and the test cost is high. Thus, it arises the need for automated methods that can detect different kinds of blood cells and count the number of cells. A convolutional neural network-based framework is proposed for detecting and counting the cells. The neural network is trained for the multiple iterations, and a model having lower validation loss is saved. The experiments are done to analyze the performance of the detection system and results with high accuracy in the counting of the cells. The mean average precision is achieved when compared to ground truth provided to respective labels. The value of the average precision is found to be ranging from 70% to 99.1%, with a mean average precision value of 85.35%. The proposed framework had much less time complexity: it took only 0.111 seconds to process an image frame with dimensions of 640×480 pixels. The system can also be implemented in lowcost, single-board computers for rapid prototyping. The efficiency of the proposed framework to identify and count different blood cells can be utilized to assist medical professionals in finding disorders and making decisions based on the obtained report.

Abstract Introduction: Tracheostomy (TCT) is the most frequently performed surgical procedure among COVID-19 patients. In Argentina, survival and decannulation rates are unknown. The main objectives of this study were to evaluate mortality and decannulation rates after 90 days of the percutaneous TCT performance. Secondarily, airway injury rate, days on invasive mechanical ventilation (IMV) and days of hospitalization in the intensive care unit (ICU) were also evaluated. Methods: This observational analytic prospective cohort study included patients over 18 years old with SARS-CoV-2 who were admitted into the ICU requiring IMV and percutaneous TCT in the period covering from 1 February 2021 to 31 July 2021. Results: the mortality rate in 95 patients was 66.3%. Among the survivors, 67% were decannulated. The youngest patients were the ones who survived [mean 50.6 (SD 10.2) years versus mean 58.9 (SD 13.4) years; p = 0.001] and presented lower Charlson index scores [median 1 (IQR 0-2) versus 2 (1-3) points; p = 0.007]. Patients who were tracheostomized ten days before the start of IMV were fewer days on IMV and had a shorter stay in the ICU, p < 0.01 and p = 0.01, respectively. Charlson Index was identified as an independent factor of mortality for both decannulation mortality at 90 days. Discussion: In our cohort of patients, those who were younger and presented less c omorbidities benefited from TCT. Charlson Index could be used as a prognostic marker among this patient population.

Resumen Introducción: La traqueostomía (TQT) es el procedimiento quirúrgico más frecuentemente realizado en pacientes COVID-19. La tasa de supervivencia y decanulación en Argentina se desconoce. El objetivo principal de este estudio fue evaluar la mortalidad y la tasa de decanulación al día 90 de realizada la TQT percutánea. Secundariamente se evaluó la tasa de lesión en la vía aérea, días de ventilación mecánica invasiva (VMI) y días de internación en unidad de cuidados intensivos (UCI). Métodos: Estudio observacional analítico de cohorte prospectiva que incluyó 95 pacientes mayores de 18 años infectados por SARS-CoV-2 ingresados de forma consecutiva a la UCI con requerimiento de VMI y TQT percutánea en el periodo compren dido entre 1 de febrero al 31 de julio del 2021. Resultados: La mortalidad fue del 66.3%. De los supervivientes se logró decanular al 67%. Los supervivientes fueron más jóvenes [media 50.6 (DE 10.2) años versus media 58.9 (DE 13.4) años; p = 0.001] y presentaron puntajes más bajos de índice de Charlson [mediana 1 (RIQ 0-2) versus 2 (1-3) puntos; p = 0.007]. Los pacientes TQT antes del día 10 desde el inicio de VMI tuvieron menos días de VMI y menor estadía en UCI, p < 0.01 y p = 0.01 respectivamente. El índice de Charlson se identificó como factor independiente de mortalidad a los 90 días y de decanulación a los 90 días. Discusión: En nuestra cohorte de pacientes fueron los más jóvenes y con menos comorbilidades los que se beneficiaron con la TQT. El índice de Charlson podría utilizarse como marcador pronóstico en esta población de pacientes.