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  • COVID-19

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  • image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/
    Authors: Niu, Hao;

    El síndrome respiratorio agudo severo (Severe Acute Respiratory Syndrome) es conocido como SARS. Los principales síntomas del SARS son fiebre alta (> 38ºC), tos, falta de aliento o dificultad para respirar. Puede estar acompañada de otros síntomas como dolor de cabeza, pérdida de apetito, rigidez muscular, trastorno de conciencia, fatiga, erupciones en la piel y diarrea, y en radiografías de tórax se pueden encontrar lesiones pulmonares. Cuando el SARS es más grave puede aparecer la neumonía difusa, donde disminuye el intercambio de oxígeno, lo que resulta en hipoxia pulmonar. Por lo tanto, el paciente padecerá hipoxia que puede conducir a la muerte. Desde la aparición del primer caso en China en 2002, un total de 32 países y regiones del mundo informan de casos diagnosticados clínicamente (Xiu et al., 2003). De noviembre de 2002 a agosto de 2003, se notifican un total de 8.422 casos, 916 casos de muerte, siendo la tasa de mortalidad promedio de los casos notificados de 9,3% (Peng, 2012). La enfermedad es una fuerte infección, que causa un cierto impacto en la economía mundial y la política. El SARS, como una nueva enfermedad infecciosa, todavía no se ha entendido completamente. Máster Universitario en Salud Pública por la Universidad Pública de Navarra Osasun Publikoko Unibertsitate Masterra Nafarroako Unibertsitate Publikoan

    image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/ Recolector de Cienci...arrow_drop_down
    image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/
    image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/
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    Master thesis . 2014
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      image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/ Recolector de Cienci...arrow_drop_down
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      image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/
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      Master thesis . 2014
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  • image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/
    Authors: Ricardo Vivas Reyes; José Luis Ruiz; Roger Caraballo;

    En este estudio se ha evaluado por medio de la metodología de acoplamiento molecular una serie de 5 ligandos borados, que son variantes de la molécula FL-078. Estas moléculas tienen actividad inhibitoria frente a la proteasa Mpro responsable de la replicación del SARS-CoV. Haciendo uso del programa SYBYL7.0 se optimizó el homodímero de la Mpro (código 1Q2W), y a través del software FlexX se hizo el acople molecular con el fin de escoger el confórmero más estable de los ligandos aril borados frente a la macromolécula Mpro, encontrándose que la estructura FL-166 fue la de mejor conformación. Los 5 ligandos aril borados tienen la propiedad de interaccionar con el grupo hidroxilo (OH) presente en los residuos tales como serinas, treoninas y tirosinas. Los resultados acople molecular muestran que el mejor acercamiento sobre la cavidad se da sobre el conjunto de treoninas 21, 24, 25 y 26, y no como se afirma en la literatura: que se da sobre el conjunto de serinas 139, 144 y 147.

    image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/ LAReferencia - Red F...arrow_drop_down
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  • image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/
    Authors: Delgado-Romero, Andrés Kamilo; Salazar-Palechor, Yined Marcela; Díaz, Rosalba; Solano, Victoria Eugenia; +3 Authors

    Introducción: la infección respiratoria aguda baja (IRAB) es uno de los principales problemas de salud pública en menores de 5 años en países en desarrollo. El objetivo de este estudio fue describir la incidencia, mortalidad y factores pronósticos en pacientes menores de 5 años con diagnóstico de irab grave, en 2 hospitales de referencia de Popayán, Colombia. Materiales y métodos: estudio de cohorte. Se incluyeron niños entre 2 meses y 5 años con diagnóstico de IRAB grave (neumonía adquirida en comunidad o bronquiolitis). Se recolectaron datos sociodemográficos, paraclínicos y de pronóstico. Los desenlaces de interés fueron la incidencia de muerte, de ingreso a uci y el tiempo de estancia hospitalaria. Se realizó análisis multivariante para evaluar el efecto de factores pronósticos. Resultados: se incluyeron 121 casos. La incidencia de irab grave durante seis meses de seguimiento fue 4% ic95% (3,3-4,7). La mortalidad estimada durante el seguimiento fue 0,8% ic95% (0,1-4,4) —1 paciente—. El 33% de los niños requirió ingreso aucip. La mediana de hospitalización global fue 5 días y de estancia en ucip 4 días. El antecedente de nacimiento pretérmino se asoció de forma independiente con el ingreso a UCIP (or=5,1 ic95% [1,3-20] p=0,019). Discusión: la incidencia de IRAB grave fue de 4%. La mortalidad asociada fue baja y el tiempo de estancia hospitalaria corto. Los factores relacionados a la presentación de IRAB son consistentes con los documentados en la literatura nacional e internacional; único factor pronóstico de importancia para ingreso a UCIP fue el nacimiento prematuro. Introduction: Acute lower respiratory infection (ALRI: community-acquired and/or bronchiolitis) is one of the main public health issues for children under five years of age. The main purpose of this research was to describe the epidemiological prole, associated factors, and prognosis of ALRI in two hospitals in Popayán, Colombia. Materials and Methods: This was a cohort study. We included children from 2 months to 5 years of age with diagnoses of severe ALRI. Sociodemographic proles, clinical features, and prognostic factors were collected. The main outcomes under study were mortality, admission to ICU, and length of stay. Multivariable analyses were performed to establish the independent contributions of prognostic factors. Results: 121 patients were included. The incidence of ALRI was 4% ci95% [3,3-4,7] during 6 months of follow-up. Mortality during follow-up was 0,8% (ci95% 0,1–4,4) (one patient). Thirty-three percent of children required admission to ICU. The median length of stay was 5 days and length of stay in ICU was 4 days. Preterm birth was independently associated with ICU admission (or=5,1 ci95% [1,3-20] p=0,019). Discussion: The incidence of severe ALRI was 4%. Mortality was low and length of stay was short. Factors related to the diagnosis of ALRI in this cohort are consistent with those reported in the national and international literature, and the only independent prognostic factor for admission to ICU was preterm birth. Introdução: a infeção respiratória aguda baixa (IRAB) é um dos principais problemas de saúde pública em crianças menores de 5 anos em países em desenvolvimento. O objetivo deste estudo foi descrever a incidência, mortalidade e fatores prognósticos em pacientes menores de 5 anos com diagnóstico de IRAB grave em 2 hospitais de referência de Popayán, Colômbia. Materiais e métodos: estudo de coorte. Incluíramse crianças entre 2 meses e 5 anos com diagnóstico de IRAB grave (pneumonia adquirida em comunidade e/ou bronquite). Coletaramse dados sociodemográficos, paraclínicos e de prognóstico. Os desenlaces de interesse foram a incidência de morte, de ingresso a UCI e o tempo de estadia hospitalar. Se realizou uma análise multivariada para avaliar o efeito de fatores prognósticos. Resultados: incluíramse 121 casos. A incidência de irab grave durante seis meses de seguimento foi 4% IC95% [3,3-4,7]. A mortalidade estimada durante o seguimento foi 0,8% IC95% [0,1-4,4] (1 paciente). O 33% de crianças requereu ingresso a ucip. A mediana de hospitalização global foi 5 dias e de estadia na ucip 4 dias. O antecedente de nascimento prétermo associouse de forma independente com o ingresso à UCIP (or=5,1 ic95% [1,3-20] p=0,019). Discussão: a incidência de IRAB grave foi de 4%. A mortalidade associada foi baixa e o tempo de estadia hospitalar curto. Os fatores relacionados à apresentação de IRAB são consistentes com os documentados na literatura nacional e internacional e o único fator prognóstico de importância para ingresso à ucip foi a história de prematuridade.

    image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/ Scientific Electroni...arrow_drop_down
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      image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/ Scientific Electroni...arrow_drop_down
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    Authors: Nieto-Duarte, Gina; Pichilingue, Patricia; Aivasovsky-Trotta, Iván; Castellanos-Fernandez, Marianna; +1 Authors

    15 páginas In the context of the COVID-19 pandemic, the adequate selection and appropriate use of previously acquired knowledge from similar historical situations and the one acquired lately amid the pandemic is vital to guarantee correct decision-making regarding the prevention, management and treatment of this disease in the pediatric population. Since the beginning of 2020, attention has shifted to controlling the pandemic and managing patients with this disease, the majority being those in the adult population. However, more severe courses of the disease have recently been observed in pediatric patients, and what was initially considered to be a harmless pathology in this population has generated greater alerts due to the presence of severe complications. Therefore, this review seeks to determine the latest prevention, diagnosis and treatment strategies endorsed and supported by scientific evidence, in order to provide the necessary tools to guarantee proper management and to reduce, as far as possible, the fatal outcomes in the pediatric population. En el contexto de la pandemia por COVID-19, es importante la selección y el uso adecuado de los conocimientos nuevos y de aquellos adquiridos en situaciones históricas similares, para garantizar una correcta toma de decisiones en cuanto a la prevención, manejo y tratamiento de esta enfermedad en la población pediátrica. Desde inicios del 2020, la atención se ha focalizado en el control de la pandemia y en el manejo de los pacientes con esta enfermedad, cuya mayoría se encuentra en la población adulta. Sin embargo, recientemente se han observado cursos más severos de la enfermedad en pacientes pediátricos y lo que inicialmente se consideraba como una patología inofensiva ha generado mayores alertas en esta población por la presencia de complicaciones severas. Por lo anterior, la presente revisión busca determinar las últimas estrategias de prevención, diagnóstico y tratamiento avaladas y soportadas por la evidencia científica, de manera que se aporten las herramientas necesaria para garantizar un manejo adecuado y disminuir, en la medida de lo posible, los desenlaces fatales en la población pediátrica.

    image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/ LAReferencia - Red F...arrow_drop_down
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    Authors: Peña-López, Brigitte-O.; Rincón-Orozco, Bladimiro;
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    Authors: Calatroni, MI;

    RESUMEN. El SARS o síndrome agudo respiratorio severo, es una nueva enfermedad que consiste en una neumonía atípica severa causada por un nuevo coronavirus. Se ha propuesto el nombre de Urbani para esta enfermedad. El SARS es una enfermedad infecciosa altamente contagiosa y rápidamente progresiva. La organización Mundial de la Salud (OMS) ha reportado entre el 1° de Noviembre 2002 y el 1° de Mayo 2003, 5865 casos y 391 muertes. Después de un período de incubación de 6 días, los síntomas más comunes son: fiebre, tos seca, escalofríos, cefalea, y disnea. Al examen físico pulmonar hay crepitantes y matidez a la percusión. Los exámenes paraclinicos son leucocitosis o leucopenia moderada y linfopenia. En la radiografía de tórax suele haber un consolidado focal unilateral o bien, una consolidación multifocal o bilateral. Hasta ahora se ha tratado de manera empírica con ribavirina e hidrocortisona. ABSTRACT: SARS or acute severe respiratory syndrome is a new illness. SARS is a serious respiratory illness. A novel coronavirus is associated with this outbreak; the name Urbani SARS-associated coronavirus is proposed. The cumulative number of cases from November 2002 to may 2003 is 5865 and 391 deaths. The most common symptoms include fever, chills or rigor, cough, dyspnea and headache. Inspiratory crackles are the most common physical finding. Patients had abnormal chest radiographs, all of which showed air-space consolidation. The only empirically treatment until now is ribavirina and hydrocortisone.

    image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/ Scientific Electroni...arrow_drop_down
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    Authors: Wu H., Elba;

    El objetivo de este artículo es revisar la historia y resaltar la epidemiología, etiología, presentación clínica y manejo del Síndrome Respiratorio Agudo Severo (SARS). El SARS es una enfermedad infecciosa aguda transmisible producida por un agente totalmente nuevo para el ser humano, un coronavirus (SARS-CoV). Iniciada en China, se ha diseminado en pocas semanas a varios otros países del mundo con miles de casos y cientos de muertes, con una letalidad global de casi el 10%. Por ello, la OMS ha declarado a esta enfermedad como de notificación inmediata a dicho organismo y ha instaurado una serie de medidas para contener/evitar su diseminación global y a nivel hospitalario y extra-hospitalario. El diagnóstico de esta enfermedad inicialmente es epidemiológico y clínico: aparición dentro de 10 días del antecedente epidemiológico (contacto estrecho con una persona sospechosa o con probable SARS; viaje a un área con transmisión reciente o actual de SARS) de un cuadro con una fase febril inicial, semejante a un cuadro gripal, y una fase respiratoria posterior, que puede llevar a insuficiencia respiratoria severa; en esta fase destaca lo pobre del examen físico pulmonar en contraste con la gran cantidad de imágenes radiológicas; otros hallazgos son leucopenia con linfopenia y disminución de plaquetas; aumento de dehidrogenasa láctica, creatinfosfoquinasa y alanino-aminotransferasa, y algunas alteraciones de la coagulación. El diagnóstico de infección por SARS-CoV puede ser confirmado con RT-PCR y detección de anticuerpos. El manejo, empírico, ha contemplado antivirales (oseltamivir, ribavirina) y corticoides, con respuestas variables. Comentarios: el SARS ha sido una enfermedad severa, pero que ha dejado muchas enseñanzas , y también pérdidas, a nivel mundial. The objective of this paper is to review the history, epidemiology, aetiology, clinical presentation and management of SARS. SARS is a transmissible acute infectious disease produced by a corona virus totally new to humans (SARS-CoV). The disease appeared in China and from there disseminated in a few weeks to several areas of the world, causing thousands of cases and hundreds of deaths, with a total mortality of almost 10%. For this reason the WHO ordered the immediate notification of cases and the implementation of measures to contain or prevent the global, local and intra-hospital transmission. Initially the disease was epidemiological and clinical; appearence within 10 days of an epidemiological risk factor, close contact with a person with suspected or possible SARS, travel to an area affected, and clinically a flu-like disease with fever followed by a respiratory phase that can be complicated by severe respiratory failure. In this phase it is noteworthy the absence of pulmonary signs and florid radiographic changes. Leucopenia, lymphopenia, thrombocitopenia, elevation of LDH, creatine-kinase and alanine aminotransferase as well as diturbances in coagulation can be seen. The diagnosis of SARS-CoV is confirmed by RT-PCR and antibody detection. It´s management is empirical and consists in the use of anti-virals, oseltamivir, ribavirin and steroids, with varying results. Commentary: SARS is a severe disease that has given the worlds population several lessons and losses.

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    Authors: Franco-Paredes Carlos; Kuri-Morales Pablo; Alvarez-Lucas Carlos; Palacios-Zavala Ethel; +4 Authors

    A principios de febrero de 2003 la Organización Mundial de la Salud comenzó a recibir reportes de pacientes con un síndrome caracterizado por neumonía atípica, con rápida progresión hacia insuficiencia respiratoria sin una causa identificada. Los casos aparentemente se iniciaron en el sur de China y se han diseminado a otras regiones en Asia, Europa, Sudáfrica, Norte América y Sur América. La causa de este síndrome es una nueva variedad de Coronavirus, aislado en secreciones respiratorias y en otras. El síndrome ha sido definido en inglés como SARS (Severe acute respiratory syndrome) por la Organización Mundial de la Salud y se caracteriza por un periodo de incubación de 1 a 10 días (promedio de cinco días), una fase febril prodrómica que aparece entre los días 1 a 3. Posteriormente, aparecen síntomas respiratorios como tos, disnea, y signos como hipoxemia, que en 10 a 40% de los casos requieren de ventilación mecánica. La tasa de letalidad ha variado de 3% hasta 16%. Los hallazgos de laboratorio incluyen trombocitopenia, leucopenia, elevación de creatinin-fosfokinasa, y, en ocasiones, de transaminasas hepáticas y deshidrogenasa láctica. El tratamiento incluye medidas de apoyo; la utilización empírica del antiviral ribavirina es controvertida, debido a que hasta el momento no existe un tratamiento específico. Se recomienda el aislamiento respiratorio de los pacientes, la utilización de máscaras protectoras y el lavado estricto de manos como principales medidas de prevención. Desde el inicio de esta epidemia México estableció un sistema de vigilancia, así como recomendaciones al personal de salud para la identificación, prevención de casos secundarios y manejo clínico de casos sospechosos.

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    Authors: Mendes, Sheila Chagas; Oliveira, Juliane Vismari de; Ferrari, Ana Carolina; Gois, Katharyna Cardoso de; +6 Authors

    Introduction: There are seven known species of human coronavirus capable of causing respiratory diseases. The most recent is SARS-CoV-2, the etiologic agent of COVID-19. Objective: To evaluate the main characteristics of SARS-CoV-2, the pathophysiology of COVID-19 and the main measures for prevention and containment of disease progression. Methods: An integrative review was carried out between 2003 and 2020, based on: PubMed, Medline, SciELO, LILACS and Google Academic, using the descriptors: COVID-19, coronavirus, novel coronavirus, human, SARS virus, outbreak disease, viral pneumonia, all listed in MESH and DECS. Results: Of the 65 selected articles, 28 met the inclusion criteria. Conclusion: SARS-CoV-2 is an RNA virus whose protein S is involved in adsorption to the target cell membrane. It is transmitted through contact with contaminated surfaces, secretions or aerosols. In these, it remains viable for three hours, and up to three days on surfaces. Frequent hand washing, disinfecting surfaces, not sharing personal items, social distance of two meters and wearing facemasks when leaving home are recommended. Non-severe patients should be isolated at home for 14 days. Healthcare professionals should use PPE and be careful with potential sources of contamination, including urine and feces of patients during hygiene. Introducción: Hay siete especies conocidas de coronavirus humanos capaces de causar enfermedades respiratorias. El más reciente es el SARS-CoV-2, el agente etiológico de COVID-19. Objetivo: Evaluar las principales características del SARS-CoV-2, la fisiopatología del COVID-19 y las principales medidas para prevenir y contener la progresión de la enfermedad. Métodos: Se realizó una revisión integradora entre 2003 y 2020, basada en: PubMed, Medline, SciELO, LILACS y Google Academic, utilizando los descriptores: COVID-19, coronavirus, nuevo coronavirus, humano, virus SARS, brote de enfermedad, neumonía viral. , todos listados en MESH y DECS. Resultados: De los 65 artículos seleccionados, 28 cumplieron los criterios de inclusión. Conclusión: el SARS-CoV-2 es un virus de ARN cuya proteína S participa en la adsorción a la membrana celular diana. Se transmite por contacto con superficies, secreciones o aerosoles contaminados. En estos, permanece viable durante tres horas y hasta tres días en superficies. Se recomienda lavarse las manos con frecuencia, desinfectar superficies, no compartir objetos personales, distancia social de dos metros y usar máscaras al salir de casa. Los pacientes no graves deben aislarse en casa durante 14 días. Los profesionales de la salud deben usar EPP y tener cuidado con las posibles fuentes de contaminación, incluida la orina y las heces de los pacientes durante la higiene. Introdução: Há sete espécies conhecidas de coronavírus humanos capazes de causar doenças respiratórias. O mais recente é o SARS-CoV-2, o agente etiológico do COVID-19. Objetivo: Avaliar as principais características do SARS-CoV-2, a fisiopatologia do COVID-19 e as principais medidas de prevenção e contenção da progressão da doença. Métodos: Foi realizada uma revisão integrativa entre 2003 e 2020, com base em: PubMed, Medline, SciELO, LILACS e Google Academic, utilizando os descritores: COVID-19, coronavirus, novel coronavirus, human, SARS virus, outbreak disease, viral pneumonia, todos listados em MESH e DECS. Resultados: Dos 65 artigos selecionados, 28 atenderam aos critérios de inclusão. Conclusão: SARS-CoV-2 é um vírus de RNA cuja proteína S está envolvida na adsorção à membrana da célula alvo. É transmitido por contato com superfícies contaminadas, secreções ou aerossóis. Nestes, permanece viável por três horas e até três dias em superfícies. Recomenda-se lavagem frequente das mãos, desinfecção de superfícies, não compartilhamento de objetos pessoais, distância social de dois metros e uso de máscaras na saída de casa. Pacientes não graves devem ser isolados em casa por 14 dias. Os profissionais de saúde devem usar EPI e ter cuidado com as fontes potenciais de contaminação, incluindo urina e fezes de pacientes durante a higiene.

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    Authors: Hincapié, Doracelly; Ospina, Juan;

    Objetivo Se ilustra el análisis de la propagación del síndrome respiratorio agudo severo en Canadá en 2003, mediante modelos simples, comparando la influencia de las medidas de aislamiento en dos ondas epidémicas. Métodos Se utilizan los modelos Susceptible-Infectado y Susceptible- Infectado-Removido en versión determinista para ambas ondas epidémicas, utilizando información oficial publicada. Se estiman los parámetros deterministas con el programa NLREG 6,2 y se obtienen soluciones analíticas con Maple 9. Se obtienen indicadores para el análisis de la dinámica de la epidemia. Resultados Se observó un adecuado ajuste de los datos con ambos modelos pero en la segunda onda se observó un menor ajuste con el modelo sin remoción. En la segunda onda, con un R0 ligeramente menor a 1, a pesar de presentar la mayor incidencia (8,8 casos por día), se tuvo el más alto ritmo de infección (35 caso nuevos por 10 000 susceptibles) compensado con un alto ritmo de remoción (11,5 casos por día), lo que llevó a una menor duración de la epidemia (11,1 días) y una menor tasa de ataque (1 caso por cada cien susceptibles). Conclusiones El modelo susceptible - infectado puede ser útil en la fase inicial de la epidemia, previo a la instauración de la remoción pero se requiere una vigilancia estrecha de la evolución de la epidemia para incorporar la modelación de la fuerza de remoción y derivar información que sustente las decisiones. Objective Severe acute respiratory syndrome propagation in Canada during 2003 is analysed by means of simple models, comparing the influence of isolation measures on two epidemic waves. Methods Deterministic susceptible-infected and susceptible-infected-removed models were used for both epidemic waves, using official published information. NLREG 6.2 was used for estimating deterministic parameters and analytical solutions were obtained with Maple 9 software. Dynamical indicators were obtained for the epidemic. Results Suitable adjustment of the data was observed with both models, but smaller adjustment was observed during the second wave with the non- removed model. The highest rate of infectiousness was shown (35 new cases per 10 000 susceptible people) during the second wave (with R0 near to one), in spite of presenting greater incidence (8.8 cases per day), compensated for by a high rate of removal (11,5 cases per day) which lasted less than the epidemic (11,1 days), and a lower rate of attack (1 case per each 100 susceptible people). Conclusions The susceptible-infected model can be useful during an epidemic's initial phase (prior to removal); however, closer monitoring of an epidemic's development is required for modelling the strength of removal and deriving useful information for decision-making.

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    Authors: Niu, Hao;

    El síndrome respiratorio agudo severo (Severe Acute Respiratory Syndrome) es conocido como SARS. Los principales síntomas del SARS son fiebre alta (> 38ºC), tos, falta de aliento o dificultad para respirar. Puede estar acompañada de otros síntomas como dolor de cabeza, pérdida de apetito, rigidez muscular, trastorno de conciencia, fatiga, erupciones en la piel y diarrea, y en radiografías de tórax se pueden encontrar lesiones pulmonares. Cuando el SARS es más grave puede aparecer la neumonía difusa, donde disminuye el intercambio de oxígeno, lo que resulta en hipoxia pulmonar. Por lo tanto, el paciente padecerá hipoxia que puede conducir a la muerte. Desde la aparición del primer caso en China en 2002, un total de 32 países y regiones del mundo informan de casos diagnosticados clínicamente (Xiu et al., 2003). De noviembre de 2002 a agosto de 2003, se notifican un total de 8.422 casos, 916 casos de muerte, siendo la tasa de mortalidad promedio de los casos notificados de 9,3% (Peng, 2012). La enfermedad es una fuerte infección, que causa un cierto impacto en la economía mundial y la política. El SARS, como una nueva enfermedad infecciosa, todavía no se ha entendido completamente. Máster Universitario en Salud Pública por la Universidad Pública de Navarra Osasun Publikoko Unibertsitate Masterra Nafarroako Unibertsitate Publikoan

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    Master thesis . 2014
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      Master thesis . 2014
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    Authors: Ricardo Vivas Reyes; José Luis Ruiz; Roger Caraballo;

    En este estudio se ha evaluado por medio de la metodología de acoplamiento molecular una serie de 5 ligandos borados, que son variantes de la molécula FL-078. Estas moléculas tienen actividad inhibitoria frente a la proteasa Mpro responsable de la replicación del SARS-CoV. Haciendo uso del programa SYBYL7.0 se optimizó el homodímero de la Mpro (código 1Q2W), y a través del software FlexX se hizo el acople molecular con el fin de escoger el confórmero más estable de los ligandos aril borados frente a la macromolécula Mpro, encontrándose que la estructura FL-166 fue la de mejor conformación. Los 5 ligandos aril borados tienen la propiedad de interaccionar con el grupo hidroxilo (OH) presente en los residuos tales como serinas, treoninas y tirosinas. Los resultados acople molecular muestran que el mejor acercamiento sobre la cavidad se da sobre el conjunto de treoninas 21, 24, 25 y 26, y no como se afirma en la literatura: que se da sobre el conjunto de serinas 139, 144 y 147.

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    Authors: Delgado-Romero, Andrés Kamilo; Salazar-Palechor, Yined Marcela; Díaz, Rosalba; Solano, Victoria Eugenia; +3 Authors

    Introducción: la infección respiratoria aguda baja (IRAB) es uno de los principales problemas de salud pública en menores de 5 años en países en desarrollo. El objetivo de este estudio fue describir la incidencia, mortalidad y factores pronósticos en pacientes menores de 5 años con diagnóstico de irab grave, en 2 hospitales de referencia de Popayán, Colombia. Materiales y métodos: estudio de cohorte. Se incluyeron niños entre 2 meses y 5 años con diagnóstico de IRAB grave (neumonía adquirida en comunidad o bronquiolitis). Se recolectaron datos sociodemográficos, paraclínicos y de pronóstico. Los desenlaces de interés fueron la incidencia de muerte, de ingreso a uci y el tiempo de estancia hospitalaria. Se realizó análisis multivariante para evaluar el efecto de factores pronósticos. Resultados: se incluyeron 121 casos. La incidencia de irab grave durante seis meses de seguimiento fue 4% ic95% (3,3-4,7). La mortalidad estimada durante el seguimiento fue 0,8% ic95% (0,1-4,4) —1 paciente—. El 33% de los niños requirió ingreso aucip. La mediana de hospitalización global fue 5 días y de estancia en ucip 4 días. El antecedente de nacimiento pretérmino se asoció de forma independiente con el ingreso a UCIP (or=5,1 ic95% [1,3-20] p=0,019). Discusión: la incidencia de IRAB grave fue de 4%. La mortalidad asociada fue baja y el tiempo de estancia hospitalaria corto. Los factores relacionados a la presentación de IRAB son consistentes con los documentados en la literatura nacional e internacional; único factor pronóstico de importancia para ingreso a UCIP fue el nacimiento prematuro. Introduction: Acute lower respiratory infection (ALRI: community-acquired and/or bronchiolitis) is one of the main public health issues for children under five years of age. The main purpose of this research was to describe the epidemiological prole, associated factors, and prognosis of ALRI in two hospitals in Popayán, Colombia. Materials and Methods: This was a cohort study. We included children from 2 months to 5 years of age with diagnoses of severe ALRI. Sociodemographic proles, clinical features, and prognostic factors were collected. The main outcomes under study were mortality, admission to ICU, and length of stay. Multivariable analyses were performed to establish the independent contributions of prognostic factors. Results: 121 patients were included. The incidence of ALRI was 4% ci95% [3,3-4,7] during 6 months of follow-up. Mortality during follow-up was 0,8% (ci95% 0,1–4,4) (one patient). Thirty-three percent of children required admission to ICU. The median length of stay was 5 days and length of stay in ICU was 4 days. Preterm birth was independently associated with ICU admission (or=5,1 ci95% [1,3-20] p=0,019). Discussion: The incidence of severe ALRI was 4%. Mortality was low and length of stay was short. Factors related to the diagnosis of ALRI in this cohort are consistent with those reported in the national and international literature, and the only independent prognostic factor for admission to ICU was preterm birth. Introdução: a infeção respiratória aguda baixa (IRAB) é um dos principais problemas de saúde pública em crianças menores de 5 anos em países em desenvolvimento. O objetivo deste estudo foi descrever a incidência, mortalidade e fatores prognósticos em pacientes menores de 5 anos com diagnóstico de IRAB grave em 2 hospitais de referência de Popayán, Colômbia. Materiais e métodos: estudo de coorte. Incluíramse crianças entre 2 meses e 5 anos com diagnóstico de IRAB grave (pneumonia adquirida em comunidade e/ou bronquite). Coletaramse dados sociodemográficos, paraclínicos e de prognóstico. Os desenlaces de interesse foram a incidência de morte, de ingresso a UCI e o tempo de estadia hospitalar. Se realizou uma análise multivariada para avaliar o efeito de fatores prognósticos. Resultados: incluíramse 121 casos. A incidência de irab grave durante seis meses de seguimento foi 4% IC95% [3,3-4,7]. A mortalidade estimada durante o seguimento foi 0,8% IC95% [0,1-4,4] (1 paciente). O 33% de crianças requereu ingresso a ucip. A mediana de hospitalização global foi 5 dias e de estadia na ucip 4 dias. O antecedente de nascimento prétermo associouse de forma independente com o ingresso à UCIP (or=5,1 ic95% [1,3-20] p=0,019). Discussão: a incidência de IRAB grave foi de 4%. A mortalidade associada foi baixa e o tempo de estadia hospitalar curto. Os fatores relacionados à apresentação de IRAB são consistentes com os documentados na literatura nacional e internacional e o único fator prognóstico de importância para ingresso à ucip foi a história de prematuridade.

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    Authors: Nieto-Duarte, Gina; Pichilingue, Patricia; Aivasovsky-Trotta, Iván; Castellanos-Fernandez, Marianna; +1 Authors

    15 páginas In the context of the COVID-19 pandemic, the adequate selection and appropriate use of previously acquired knowledge from similar historical situations and the one acquired lately amid the pandemic is vital to guarantee correct decision-making regarding the prevention, management and treatment of this disease in the pediatric population. Since the beginning of 2020, attention has shifted to controlling the pandemic and managing patients with this disease, the majority being those in the adult population. However, more severe courses of the disease have recently been observed in pediatric patients, and what was initially considered to be a harmless pathology in this population has generated greater alerts due to the presence of severe complications. Therefore, this review seeks to determine the latest prevention, diagnosis and treatment strategies endorsed and supported by scientific evidence, in order to provide the necessary tools to guarantee proper management and to reduce, as far as possible, the fatal outcomes in the pediatric population. En el contexto de la pandemia por COVID-19, es importante la selección y el uso adecuado de los conocimientos nuevos y de aquellos adquiridos en situaciones históricas similares, para garantizar una correcta toma de decisiones en cuanto a la prevención, manejo y tratamiento de esta enfermedad en la población pediátrica. Desde inicios del 2020, la atención se ha focalizado en el control de la pandemia y en el manejo de los pacientes con esta enfermedad, cuya mayoría se encuentra en la población adulta. Sin embargo, recientemente se han observado cursos más severos de la enfermedad en pacientes pediátricos y lo que inicialmente se consideraba como una patología inofensiva ha generado mayores alertas en esta población por la presencia de complicaciones severas. Por lo anterior, la presente revisión busca determinar las últimas estrategias de prevención, diagnóstico y tratamiento avaladas y soportadas por la evidencia científica, de manera que se aporten las herramientas necesaria para garantizar un manejo adecuado y disminuir, en la medida de lo posible, los desenlaces fatales en la población pediátrica.

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    Authors: Peña-López, Brigitte-O.; Rincón-Orozco, Bladimiro;
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    Authors: Calatroni, MI;

    RESUMEN. El SARS o síndrome agudo respiratorio severo, es una nueva enfermedad que consiste en una neumonía atípica severa causada por un nuevo coronavirus. Se ha propuesto el nombre de Urbani para esta enfermedad. El SARS es una enfermedad infecciosa altamente contagiosa y rápidamente progresiva. La organización Mundial de la Salud (OMS) ha reportado entre el 1° de Noviembre 2002 y el 1° de Mayo 2003, 5865 casos y 391 muertes. Después de un período de incubación de 6 días, los síntomas más comunes son: fiebre, tos seca, escalofríos, cefalea, y disnea. Al examen físico pulmonar hay crepitantes y matidez a la percusión. Los exámenes paraclinicos son leucocitosis o leucopenia moderada y linfopenia. En la radiografía de tórax suele haber un consolidado focal unilateral o bien, una consolidación multifocal o bilateral. Hasta ahora se ha tratado de manera empírica con ribavirina e hidrocortisona. ABSTRACT: SARS or acute severe respiratory syndrome is a new illness. SARS is a serious respiratory illness. A novel coronavirus is associated with this outbreak; the name Urbani SARS-associated coronavirus is proposed. The cumulative number of cases from November 2002 to may 2003 is 5865 and 391 deaths. The most common symptoms include fever, chills or rigor, cough, dyspnea and headache. Inspiratory crackles are the most common physical finding. Patients had abnormal chest radiographs, all of which showed air-space consolidation. The only empirically treatment until now is ribavirina and hydrocortisone.

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    Authors: Wu H., Elba;

    El objetivo de este artículo es revisar la historia y resaltar la epidemiología, etiología, presentación clínica y manejo del Síndrome Respiratorio Agudo Severo (SARS). El SARS es una enfermedad infecciosa aguda transmisible producida por un agente totalmente nuevo para el ser humano, un coronavirus (SARS-CoV). Iniciada en China, se ha diseminado en pocas semanas a varios otros países del mundo con miles de casos y cientos de muertes, con una letalidad global de casi el 10%. Por ello, la OMS ha declarado a esta enfermedad como de notificación inmediata a dicho organismo y ha instaurado una serie de medidas para contener/evitar su diseminación global y a nivel hospitalario y extra-hospitalario. El diagnóstico de esta enfermedad inicialmente es epidemiológico y clínico: aparición dentro de 10 días del antecedente epidemiológico (contacto estrecho con una persona sospechosa o con probable SARS; viaje a un área con transmisión reciente o actual de SARS) de un cuadro con una fase febril inicial, semejante a un cuadro gripal, y una fase respiratoria posterior, que puede llevar a insuficiencia respiratoria severa; en esta fase destaca lo pobre del examen físico pulmonar en contraste con la gran cantidad de imágenes radiológicas; otros hallazgos son leucopenia con linfopenia y disminución de plaquetas; aumento de dehidrogenasa láctica, creatinfosfoquinasa y alanino-aminotransferasa, y algunas alteraciones de la coagulación. El diagnóstico de infección por SARS-CoV puede ser confirmado con RT-PCR y detección de anticuerpos. El manejo, empírico, ha contemplado antivirales (oseltamivir, ribavirina) y corticoides, con respuestas variables. Comentarios: el SARS ha sido una enfermedad severa, pero que ha dejado muchas enseñanzas , y también pérdidas, a nivel mundial. The objective of this paper is to review the history, epidemiology, aetiology, clinical presentation and management of SARS. SARS is a transmissible acute infectious disease produced by a corona virus totally new to humans (SARS-CoV). The disease appeared in China and from there disseminated in a few weeks to several areas of the world, causing thousands of cases and hundreds of deaths, with a total mortality of almost 10%. For this reason the WHO ordered the immediate notification of cases and the implementation of measures to contain or prevent the global, local and intra-hospital transmission. Initially the disease was epidemiological and clinical; appearence within 10 days of an epidemiological risk factor, close contact with a person with suspected or possible SARS, travel to an area affected, and clinically a flu-like disease with fever followed by a respiratory phase that can be complicated by severe respiratory failure. In this phase it is noteworthy the absence of pulmonary signs and florid radiographic changes. Leucopenia, lymphopenia, thrombocitopenia, elevation of LDH, creatine-kinase and alanine aminotransferase as well as diturbances in coagulation can be seen. The diagnosis of SARS-CoV is confirmed by RT-PCR and antibody detection. It´s management is empirical and consists in the use of anti-virals, oseltamivir, ribavirin and steroids, with varying results. Commentary: SARS is a severe disease that has given the worlds population several lessons and losses.

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    Authors: Franco-Paredes Carlos; Kuri-Morales Pablo; Alvarez-Lucas Carlos; Palacios-Zavala Ethel; +4 Authors

    A principios de febrero de 2003 la Organización Mundial de la Salud comenzó a recibir reportes de pacientes con un síndrome caracterizado por neumonía atípica, con rápida progresión hacia insuficiencia respiratoria sin una causa identificada. Los casos aparentemente se iniciaron en el sur de China y se han diseminado a otras regiones en Asia, Europa, Sudáfrica, Norte América y Sur América. La causa de este síndrome es una nueva variedad de Coronavirus, aislado en secreciones respiratorias y en otras. El síndrome ha sido definido en inglés como SARS (Severe acute respiratory syndrome) por la Organización Mundial de la Salud y se caracteriza por un periodo de incubación de 1 a 10 días (promedio de cinco días), una fase febril prodrómica que aparece entre los días 1 a 3. Posteriormente, aparecen síntomas respiratorios como tos, disnea, y signos como hipoxemia, que en 10 a 40% de los casos requieren de ventilación mecánica. La tasa de letalidad ha variado de 3% hasta 16%. Los hallazgos de laboratorio incluyen trombocitopenia, leucopenia, elevación de creatinin-fosfokinasa, y, en ocasiones, de transaminasas hepáticas y deshidrogenasa láctica. El tratamiento incluye medidas de apoyo; la utilización empírica del antiviral ribavirina es controvertida, debido a que hasta el momento no existe un tratamiento específico. Se recomienda el aislamiento respiratorio de los pacientes, la utilización de máscaras protectoras y el lavado estricto de manos como principales medidas de prevención. Desde el inicio de esta epidemia México estableció un sistema de vigilancia, así como recomendaciones al personal de salud para la identificación, prevención de casos secundarios y manejo clínico de casos sospechosos.

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