108 research outputs found
Will dengue vaccination be cost-effective for Argentina? Reply to letter by Urueña et al. regarding “Cost-utility analysis of dengue vaccination in a country with heterogeneous risk of dengue transmission”
No full textFil: Orellano, Pablo Wenceslao. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Tecnológica Nacional; ArgentinaFil: Salomón, Oscar Daniel. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto Nacional de Medicina Tropical; Argentin
Las vacunas contra el dengue ¿una realidad para la Argentina?
No full textLos brotes de dengue se suceden anualmente en Argentina desde el año 1998. Existen vacunas contra esta enfermedad en distintos grados de desarrollo que han sido probadas en países endémicos. La más avanzada hasta el momento fue autorizada para su comercialización en tres países de América Latina, para niños mayores de 9 años. En este artículo se discuten los beneficios e inconvenientes de las vacunas, así como los desafíos para la implementación de una estrategia de vacunación. Asimismo, se plantea la necesidad de una estratificación de riesgo con nuevos criterios y visión multidisciplinaria como un camino posiblepara evaluar la pertinencia de un programa de vacunación en las áreas con mayor riesgo de transmisión, y/o en individuos con mayor riesgo de dengue grave. Se sugiere también que la definición del estatus de endemicidad debe tomar en cuenta a las realidades locales. Por último, este artículo propone una discusión amplia de las evidencias, impacto esperado y aspectos instrumentales que estarían involucrados en la incorporación de una vacuna contra el dengue, ya en mercado o en desarrollo, en el programa nacional de inmunizaciones, y especialmente a qué subpoblaciones debería ser dirigida para que la estrategia de inmunización sea costo-efectivaDengue outbreaks have occurred yearly in Argentina since 1998. A number of candidate vaccines have been tested in endemic countries. The most advanced one was licensed in three countries of Latin America for children over 9 years of age. In the present article the benefits and drawbacks of these vaccines as well as the challenges for the implementation of a vaccination strategy in Argentina are discussed. Furthermore, a risk stratification strategy with new criteria and a multidisciplinary vision is suggested as a possible path for the assessment of the pertinence of a vaccination program in areas showing the highest risk of dengue transmission and/or for people at the greatest risk of developing severe dengue. It is also suggested that the definition regarding the status of endemicity should take into account the local realities. Finally, this paper proposes a broad discussion on the evidences, the expected impact and instrumental aspects that would be involved in the incorporation of a dengue vaccine, marketed or in development, into the national immunization program, and especially which subpopulation should be targeted for the immunization strategy to be cost-effective.Fil: Orellano, Pablo Wenceslao. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Tecnológica Nacional. Facultad Regional San Nicolás; ArgentinaFil: Salomón, Oscar Daniel. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Ministerio de Salud. Instituto Nacional de Medicina Tropical; Argentin
Estudio del impacto del crecimiento de la actividad urbana en un tramo del Río Neuquén mediante la aplicación del modelo Aquatox
No full textEl objetivo de este estudio fue predecir los impactos que el aumento de la actividad urbana produce sobre el estado trófico del tramo regulado del río Neuquén en la localidad de Añelo, y analizar los efectos mediante escenarios de desarrollo: el escenario 1 con un aumento en el ingreso de nutrientes por incremento de la población, el escenario 2 con una disminución del caudal del río y el escenario 3 con la combinación de los dos anteriores. La dinámica ecotoxicológica de este ecosistema lótico fue modelada mediante el programa AQUATOX que es un modelo de simulación de sistemas acuáticos que predice el destino de nutrientes, sedimentos, productos químicos orgánicos en los cuerpos de agua, y los efectos, tanto directos como indirectos, en los organismos residentes. Luego se realizó un análisis de sensibilidad para tres macroinvertebrados, considerados como especies indicadoras de la calidad del agua: Trichoptera, Ephemeroptera y Amphipoda. A efectos de evaluar cómo se ven afectados los macroinvertebrados debido a la variación de los parámetros y datos de entrada, se realizó un análisis de incertidumbre para los parámetros biológicos más relevantes y para los nutrientes. La modelación indicó que el estado trófico actual es bueno, pero que los escenarios de desarrollo futuro disminuirán la calidad del agua.Fil: Orellano, Giselle Luciana. Universidad Nacional del Comahue; Argentina.Fil: Orellano, Giselle Luciana. Universidad Nacional de la Patagonia San Juan Bosco; Argentina.Fil: Orellano, Giselle Luciana. Universidad Nacional de la Patagonia Austral; Argentina
Informe científico de Beca Doctoral 1º año: Orellano, Romina Belén (2016)
No full textLa becaria durante el desarrollo de la beca, en gran medida, se dedicó al estudio de trabajos científicos vinculados al tema de investigación, lo cual permitió un acercamiento del tema a investigar y de las técnicas que se emplearán durante el próximo período, como por ejemplo la programación de métodos numéricos.
Por otra parte, la becaria realizó cursos de nivelación y lecturas de distintas bibliografías para complementar su formación académica
Google Trends relacionado a la influenza
No full textThe recent paper on Using Google Trends (GT) to Estimate the Incidence of Influenza-Like Illness in Argentina 1 is very interesting. Orellano et al. studied Google Flu Trends (GFT) and GT with a conclusion regarding “the utility of GT to complement influenza surveillance”. Indeed, the usefulness of GFT and GT has been mentioned in some earlier reports 2,3. However, as a computational model, there are several things to be considered in the simulation 4. Under- or over-estimation can be expected and this is still the present problem in using the Google system for predicting influenza 4. There is a need for modifications of GT and GFT into a more specific tool that is appropriate for each context. A good example of this is the development of FluBreaks by Pervaiz et al.Fil: Wiwanitkit, Viroj. Wiwanitkit House; Tailandia. Surin Rajabhat University; Tailandia. Hainan Medical College; ChinaFil: Orellano, Pablo Wenceslao. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Surin Rajabhat University; TailandiaFil: Reynoso, Julieta Itati. Wiwanitkit House; TailandiaFil: Antman, Julián. Hainan Medical College; ChinaFil: Argibay, Osvaldo. Hainan Medical College; Chin
Custo-efetividade de estratégias de prevenção contra a leishmaniose tegumentar americana na Argentina
No full textThe aim of this study was to estimate the cost-effectiveness
of reducing tegumentary leishmaniasis
transmission using insecticide-impregnated
clothing and curtains, and implementing training
programs for early diagnosis. A societal perspective
was adopted, with outcomes assessed in
terms of costs per disability adjusted life years
(DALY). Simulation was structured as a Markov
model and costs were expressed in American dollars
(US
156.46 per DALY averted, while that of prevention
of transmission with insecticide-impregnated
curtains and clothing was US$ 13,155.52 per
DALY averted. Both strategies were more sensitive
to the natural incidence of leishmaniasis, to
the effectiveness of mucocutaneous leishmaniasis
treatment and to the cost of each strategy. Prevention
of vectorial transmission and early diagnosis
have proved to be cost-effective measures.Fil: Orellano, Pablo Wenceslao. Ministerio de Salud de Misiones. Instituto Nacional de Medicina Tropical; Argentina;Fil: Vazquez, n. Universidad de Buenos Aires. Facultad de Medicina; Argentina;Fil: Salomon, Oscar Daniel. Ministerio de Salud de Misiones. Instituto Nacional de Medicina Tropical; Argentina
Evidence-Based Implementation Process for the Development of an Assistive Technology Self-Management Intervention
No full textAbstract
Date Presented 3/31/2017
We describe the use of a four-step systematic method to develop an evidence-based and theory-driven health intervention. Our results support the use of a systematic framework to guide occupational therapy researchers and practitioners through a comprehensive intervention development process.
Primary Author and Speaker: Elsa Orellano
Additional Authors and Speakers: Salim Pérez
Contributing Authors: Mailin Aquino, Andrea García, Jomaly Guilbe, Roxana López, Marta Rivero</jats:p
Long-Term Exposure to Nitrogen Dioxide and Ozone and Mortality: Update of the WHO Air Quality Guidelines Systematic Review and Meta-Analysis
No full textObjectives: We performed a systematic review and meta-analysis on long-term exposure to nitrogen dioxide (NO2) and ozone (O3) with mortality, to expand evidence that informed 2021 the WHO Air Quality Guidelines and guide the Health Risks of Air Pollution in Europe project.Methods: We included cohorts investigating NO2 and O3 mortality from all-causes, respiratory diseases, chronic obstructive pulmonary disease (COPD), acute lower respiratory infections (ALRI); and NO2 mortality from circulatory, ischemic heart, cerebrovascular diseases and lung cancer. We pooled estimates by random-effects models and investigated heterogeneity. We assessed the certainty of the evidence using the Grading of Recommendations Assessment Development approach and Evaluation (GRADE).Results: We selected 83 studies for NO2 and 26 for O3 for the meta-analysis. NO2 was associated with all outcomes, except for cerebrovascular mortality. O3 was associated with respiratory mortality following annual exposure. There was high heterogeneity, partly explained by region and pollutant levels. Certainty was high for NO2 with COPD and ALRI, and annual O3 with respiratory mortality.Conclusion: An increasing body of evidence, with new results from countrywide areas and the Western Pacific, supports certainty, including new outcomes.Fil: Kasdagli, Maria Iosifina. Kapodistrian University Of Athens; GreciaFil: Orellano, Pablo Wenceslao. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Tecnológica Nacional. Facultad Regional San Nicolás; ArgentinaFil: Pérez Velasco, Román. Organizacion Mundial de la Salud; ArgentinaFil: Samoli, Evangelia. Kapodistrian University Of Athens; Greci
Association of outdoor air pollution with the prevalence of asthma in children of Latin America and the Caribbean: A systematic review and meta-analysis
No full textOBJECTIVE:This study aimed to evaluate the association between asthma prevalence and outdoor air pollution in children in Latin America and the Caribbean.DATA SOURCES:We searched studies in global and regional databases: PubMed, Scopus, LILACS and SciELO.STUDY SELECTION:Articles following a cross-sectional design, studying children from 0 to 18 years old, and comparing the prevalence of asthma in two or more areas of LAC countries with different air pollution levels were included. The exclusion criteria comprised air pollution not related to human activities.RESULTS:Database searches retrieved 384 records, while 20 studies were retained for qualitative and 16 for quantitative analysis, representing 48 442 children. We found a positive association, i.e. a higher prevalence of asthma in children living in a polluted environment, with pooled odds ratio (OR) of 1.34 (95% CI: 1.17-1.54). Heterogeneity between studies was moderate (I2: 68.39%), while the risk of bias was intermediate or high in 14 studies. In all the subgroup and sensitivity analyses, the pooled ORs were significant and higher than those found in the general analysis Conclusions: Our results showed that living in a polluted environment is significantly associated with children having asthma in LAC. Limitations of this study include the low number of studies performed in LAC countries, differences in methodologies and the risk of bias in individual studies.Fil: Orellano, Pablo Wenceslao. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Tecnológica Nacional. Facultad Regional San Nicolás; ArgentinaFil: Quaranta, Nancy Esther. Universidad Tecnológica Nacional. Facultad Regional San Nicolás; Argentina. Provincia de Buenos Aires. Gobernación. Comisión de Investigaciones Científicas; ArgentinaFil: Reynoso, Julieta. Hospital Interzonal General de Agudos “San Felipe”; ArgentinaFil: Balbi, Brenda. Hospital Interzonal General de Agudos “San Felipe”; ArgentinaFil: Vasquez, Julia. Hospital Interzonal General de Agudos “San Felipe”; Argentin
Effects of air pollution on restricted activity days: systematic review and meta-analysis
No full textBackground: The adverse effects of air pollution on human health include many diseases and health conditions associated with mortality, morbidity and disability. One example of these outcomes that can be translated into economic costs is the number of days of restricted activity. The aim of this study was to assess the effect of outdoor exposure to particulate matter with an aerodynamic diameter less than or equal to 10 and 2.5 μm (PM10, PM2.5), nitrogen dioxide (NO2), and ozone (O3), on restricted activity days. Methods: Observational epidemiological studies with different study designs were included, and pooled relative risks (RR) with 95% confidence intervals (95%CI) were calculated for an increase of 10 μg/m3 of the pollutant of interest. Random-effects models were chosen because of the environmental differences between the studies. Heterogeneity was estimated using prediction intervals (PI) and I-Squared (I2) values, while risk of bias was assessed using a tool developed by the World Health Organization specifically designed for air pollution studies, and based on different domains. Subgroup and sensitivity analyses were performed where possible. The protocol for this review was registered with PROSPERO (CRD42022339607). Results: We included 18 articles in the quantitative analysis. Associations between pollutants and restricted activity days in time-series studies of short-term exposures, measured as work-loss days, school-loss days, or both were significant for PM10 (RR: 1.0191; 95%CI: 1.0058–1.0326; 80%PI: 0.9979–1.0408; I2: 71%) and PM2.5 (RR: 1.0166; 95%CI: 1.0050–1.0283; 80%PI: 0.9944–1.0397; I2: 99%), but not for NO2 or O3. Some degree of heterogeneity between studies was observed, but sensitivity analysis showed no differences in the direction of the pooled relative risks when studies with a high risk of bias were excluded. Cross-sectional studies also showed significant associations for PM2.5 and restricted activity days. We could not perform the analysis for long-term exposures because only two studies analysed this type of association. Conclusion: Restricted activity days and related outcomes were associated with some of the pollutants under evaluation, as shown in studies with different designs. In some cases, we were able to calculate pooled relative risks that can be used for quantitative modelling.Fil: Orellano, Pablo Wenceslao. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Tecnológica Nacional. Facultad Regional San Nicolás; ArgentinaFil: Reynoso, Julieta Itati. Hospital General “San Felipe”; ArgentinaFil: Quaranta, Nancy Esther. Universidad Tecnológica Nacional; Argentina. Provincia de Buenos Aires. Gobernación. Comisión de Investigaciones Científicas; Argentin
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