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  1. Article ; Online: Organización de la atención médica en la Epidemia de Dengue hemorrágico en el Hospital "Dr. Enrique Baltodano" de Liberia, 2003

    Anabelle Alfaro Obando / Mónica Guardia Caldera / Cristian Angulo Jaubert

    Acta Médica Costarricense, Vol 48, Iss 4, Pp 185-

    2006  Volume 189

    Abstract: ... en 1153 casos internados en el Hospital "Dr. Enrique Baltodano" de la ciudad de Liberia, durante 2003 ...

    Abstract Justificación y objetivos: El dengue es una enfermedad endémica, lo que implica que todos los años se presentan brotes en el país que justifican establecer una organización especial de los servicios de salud para garantizar una atención oportuna a la población. Método: Se realizó un estudio transversal descriptivo en 1153 casos internados en el Hospital "Dr. Enrique Baltodano" de la ciudad de Liberia, durante 2003. Se efectuó un análisis descriptivo de sexo, edad, estancia hospitalaria y diagnóstico de egreso. Se describió la organización de la atención y el manejo médico de los pacientes en una epidemia de dengue. En ese año el laboratorio de referencia de dengue de Instituto Costarricense de Investigación en Nutrición y Salud (INCIENSA) detectó la circulación del virus dengue serotipo 2. No se reportaron defunciones en el país por dengue hemorrágico. Resultados: Se estudiaron 1153 pacientes hospitalizados por dengue, 549 (47.6%) del sexo masculino y 604 (52.4%) del sexo femenino. La edad promedio fue de 33 años, con un rango de 2 a 94, de los cuales 52 (5%) cumplieron criterios para dengue hemorrágico; del resto, 949 (82%) tenían conteo de plaquetas menores de 100.000/mm³, y 152 (13%) presentaron manifestaciones hemorrágicas; no se detectó en estos dos grupos datos de extravasación de plasma por ultrasonido. No se presentaron complicaciones ni fallecidos durante la hospitalización. La estancia hospitalaria promedio fue de 2.26 días (IC95%=2.32 - 2.19). Conclusión: Los resultados obtenidos evidencian la necesidad de contar con una estrategia para organizar la atención en epidemias de dengue. Esto garantiza una tasa de letalidad del 0% y estancias hospitalarias bajas. Lo anterior se logra mediante la identificación temprana de criterios de ingreso, utilizando datos clínicos y de laboratorio. Esta metodología disminuye los costos económicos y está al alcance de todos los servicios de salud.
    Keywords Dengue clásico con trombocitopenia ; tratamiento del dengue hemorrágico ; ultrasonido en dengue ; Medicine ; R
    Language English
    Publishing date 2006-10-01T00:00:00Z
    Publisher Colegio de Médicos y Cirujanos de Costa Rica
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  2. Article ; Online: Organización de la atención médica en la Epidemia de Dengue hemorrágico en el Hospital "Dr. Enrique Baltodano" de Liberia, 2003

    Anabelle Alfaro Obando / Mónica Guardia Caldera / Cristian Angulo Jaubert

    Acta Médica Costarricense, Vol 48, Iss 4, Pp 185-

    2006  Volume 189

    Abstract: ... en 1153 casos internados en el Hospital "Dr. Enrique Baltodano" de la ciudad de Liberia, durante 2003 ... Enrique Baltodano Hospital throughout 2003. The descriptive phase was done by sex, age, admission stay ...

    Abstract Justificación y objetivos: El dengue es una enfermedad endémica, lo que implica que todos los años se presentan brotes en el país que justifican establecer una organización especial de los servicios de salud para garantizar una atención oportuna a la población. Método: Se realizó un estudio transversal descriptivo en 1153 casos internados en el Hospital "Dr. Enrique Baltodano" de la ciudad de Liberia, durante 2003. Se efectuó un análisis descriptivo de sexo, edad, estancia hospitalaria y diagnóstico de egreso. Se describió la organización de la atención y el manejo médico de los pacientes en una epidemia de dengue. En ese año el laboratorio de referencia de dengue de Instituto Costarricense de Investigación en Nutrición y Salud (INCIENSA) detectó la circulación del virus dengue serotipo 2. No se reportaron defunciones en el país por dengue hemorrágico. Resultados: Se estudiaron 1153 pacientes hospitalizados por dengue, 549 (47.6%) del sexo masculino y 604 (52.4%) del sexo femenino. La edad promedio fue de 33 años, con un rango de 2 a 94, de los cuales 52 (5%) cumplieron criterios para dengue hemorrágico; del resto, 949 (82%) tenían conteo de plaquetas menores de 100.000/mm³, y 152 (13%) presentaron manifestaciones hemorrágicas; no se detectó en estos dos grupos datos de extravasación de plasma por ultrasonido. No se presentaron complicaciones ni fallecidos durante la hospitalización. La estancia hospitalaria promedio fue de 2.26 días (IC95%=2.32 - 2.19). Conclusión: Los resultados obtenidos evidencian la necesidad de contar con una estrategia para organizar la atención en epidemias de dengue. Esto garantiza una tasa de letalidad del 0% y estancias hospitalarias bajas. Lo anterior se logra mediante la identificación temprana de criterios de ingreso, utilizando datos clínicos y de laboratorio. Esta metodología disminuye los costos económicos y está al alcance de todos los servicios de salud. Aim: Dengue is an endemic disease that causes outbreaks in the country every year. This validates the requirement of a special organization of Health Service that would guarantee immediate attention to the population. Methods: A transversal descriptive study was done in 1153 inpatients at Dr. Enrique Baltodano Hospital throughout 2003. The descriptive phase was done by sex, age, admission stay, and discharge diagnosis. The patient assessment and management in a dengue epidemic is described. The reference laboratory for dengue was INCIENSA laboratory, which detected serotype 2 dengue circulation. No deceased were reported in the country due to dengue hemorrhagic fever. Results: The study population was 1153 dengue patients, 549 (47.6%) males and 604 (52.4%) females. The mean age was 33 years with a range from 2 to 94 years, from which 52 (5%) satisfied the criteria for dengue hemorrhagic fever, 949 (82%) had platelet count less than 100.000/mm³, 152 (13 %) presenting hemorrhagic manifestations. There were no complications throughout the hospital stay. The mean admission stay was 2.26 days (IC95%=2.32-2.19). Conclusions: These results show the need of a strategy for the management of patients during dengue epidemics. This guarantees a death rate of 0% and a shorter admission stay. These results were achieved by means of early identification of the admission criterion and using the clinical and laboratory signs for dengue diagnosis. The economic impact and abolition of lethality can be reached by every Health Service.
    Keywords Dengue clásico con trombocitopenia ; tratamiento del dengue hemorrágico ; ultrasonido en dengue ; Clasic dengue fever ; treatment of dengue ; hemorragic dengue ; ultrasonid in dengue ; Medicine ; R
    Language English
    Publishing date 2006-10-01T00:00:00Z
    Publisher Colegio de Médicos y Cirujanos de Costa Rica
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  3. Article: Diagnosis and Treatment of

    Alfaro, Enrique / Sostres, Carlos / Lanas, Angel

    Diagnostics (Basel, Switzerland)

    2023  Volume 13, Issue 11

    Abstract: Helicobacter ... ...

    Abstract Helicobacter pylori
    Language English
    Publishing date 2023-05-30
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2662336-5
    ISSN 2075-4418
    ISSN 2075-4418
    DOI 10.3390/diagnostics13111918
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Diagnosis and Treatment of Helicobacter pylori Infection in Real Practice—New Role of Primary Care Services in Antibiotic Resistance Era

    Enrique Alfaro / Carlos Sostres / Angel Lanas

    Diagnostics, Vol 13, Iss 1918, p

    2023  Volume 1918

    Abstract: Helicobacter pylori ( H. pylori ) is a key agent in several upper gastrointestinal diseases. Treatment of H. pylori infection is the main strategy for resolving the associated gastroduodenal damage in infected patients and for the prevention of gastric ... ...

    Abstract Helicobacter pylori ( H. pylori ) is a key agent in several upper gastrointestinal diseases. Treatment of H. pylori infection is the main strategy for resolving the associated gastroduodenal damage in infected patients and for the prevention of gastric cancer development. Infection management is becoming complex due to the increase in antibiotic resistance, which already represents a global healthcare problem. Resistance to clarithromycin, levofloxacin or metronidazole have forced the adaptation of eradication regimens in this new reality to reach the eradication rate target recommended in most international guidelines (>90%). In this challenging scenario, molecular methods are revolutionizing the diagnosis of antibiotic-resistant infections and the detection of antibiotic resistance and opening a path towards personalized treatments, although their use is not yet widespread. Moreover, the infection management by physicians is still not adequate, which contributes to aggravating the problem. Both gastroenterologists and mainly primary care physicians (PCPs), who currently routinely manage this infection, perform suboptimal management of the diagnosis and treatment of H. pylori infection by not following the current consensus recommendations. In order to improve H. pylori infection management and to increase PCPs’ compliance with guidelines, some strategies have been evaluated with satisfactory results, but it is still necessary to design and evaluate new different approaches.
    Keywords H. pylori infection ; management ; antibiotic resistance ; primary care services ; Medicine (General) ; R5-920
    Language English
    Publishing date 2023-05-01T00:00:00Z
    Publisher MDPI AG
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  5. Book ; Online: Engaging urban research in policy making

    Alfaro d'Alençon, Paola / Boanada-Fuchs, Anthony / Greene, Margarita / Krishnamurthy, Sukanya / Michelutti, Enrico / Moretto, Luisa / Smit, Warren

    Towards equitable economic growth. A partnership between Cities Alliance, AURI, REDEUS_LAC and N-AERUS

    2023  

    Keywords Urban & municipal planning ; Economic growth ; equitable economic growth ; knowledge (co-)production ; research-policymaking interfaces ; international urban studies ; global south
    Language English
    Size 1 electronic resource (130 pages)
    Publisher Universitätsverlag der Technischen Universität Berlin
    Publishing place Berlin
    Document type Book ; Online
    Note English
    HBZ-ID HT030374797
    ISBN 9783798332270 ; 3798332274
    Database ZB MED Catalogue: Medicine, Health, Nutrition, Environment, Agriculture

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  6. Article: Evaluation of Different Strategies to Improve the Management of

    Alfaro, Enrique / Martínez-Domínguez, Samuel J / Laredo, Viviana / Lanas, Ángel / Sostres, Carlos

    Antibiotics (Basel, Switzerland)

    2022  Volume 11, Issue 12

    Abstract: Helicobacter ... ...

    Abstract Helicobacter pylori
    Language English
    Publishing date 2022-12-03
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2681345-2
    ISSN 2079-6382
    ISSN 2079-6382
    DOI 10.3390/antibiotics11121746
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  7. Article ; Online: Dynamic hyperinflation is a risk factor for mortality and severe exacerbations in COPD patients.

    Lorenzana, Isabel / Galera, Raúl / Casitas, Raquel / Martínez-Cerón, Elisabet / Castillo, María Alejandra / Alfaro, Enrique / Cubillos-Zapata, Carolina / García-Río, Francisco

    Respiratory medicine

    2024  Volume 225, Page(s) 107597

    Abstract: Objective: To assess if dynamic hyperinflation is an independent risk factor for mortality and severe exacerbations in COPD patients.: Methods: A cohort of 141 patients with stable COPD and moderate to very severe airflow limitation, treated ... ...

    Abstract Objective: To assess if dynamic hyperinflation is an independent risk factor for mortality and severe exacerbations in COPD patients.
    Methods: A cohort of 141 patients with stable COPD and moderate to very severe airflow limitation, treated according to conventional guidelines, was followed for a median of 9 years. Clinical characteristics were recorded and arterial blood gases, pulmonary function tests, 6-min walk and incremental exercise test with measurement of respiratory pattern and operative lung volumes were performed. Endpoints were all-cause mortality and hospitalization for COPD exacerbation.
    Results: 58 patients died during the follow-up period (1228 patients x year). The mortality rate was higher in patients with dynamic hyperinflation (n = 106) than in those without it (n = 35) (14.6; 95% CI, 14.5-14.8 vs. 7.2; 95% CI, 7.1-7.4 per 1000 patients-year). After adjusting for sex, age, body mass index, pack-years and treatment with inhaled corticosteroids, dynamic hyperinflation was associated with a higher mortality risk (adjusted hazard ratio [aHR], 2.725; 95% CI, 1.010-8.161), and in a multivariate model, comorbidity, peak oxygen uptake and dynamic hyperinflation were retained as independent predictors of mortality. The time until first severe exacerbation was shorter for patients with dynamic hyperinflation (aHR, 3.961; 95% CI, 1.385-11.328), and dynamic hyperinflation, FEV
    Conclusion: In stable COPD patients, dynamic hyperinflation is an independent prognostic factor for mortality and severe exacerbations.
    MeSH term(s) Humans ; Lung ; Pulmonary Disease, Chronic Obstructive ; Risk Factors ; Comorbidity ; Respiratory Function Tests
    Language English
    Publishing date 2024-03-16
    Publishing country England
    Document type Journal Article
    ZDB-ID 1003348-8
    ISSN 1532-3064 ; 0954-6111
    ISSN (online) 1532-3064
    ISSN 0954-6111
    DOI 10.1016/j.rmed.2024.107597
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Ui III Zs.19: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular
    ab Jg. 2022: Lesesaal (EG)

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  8. Article ; Online: Mixture-Based Probabilistic Graphical Models for the Label Ranking Problem.

    Rodrigo, Enrique G / Alfaro, Juan C / Aledo, Juan A / Gámez, José A

    Entropy (Basel, Switzerland)

    2021  Volume 23, Issue 4

    Abstract: The goal of ... ...

    Abstract The goal of the
    Language English
    Publishing date 2021-03-31
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2014734-X
    ISSN 1099-4300 ; 1099-4300
    ISSN (online) 1099-4300
    ISSN 1099-4300
    DOI 10.3390/e23040420
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Nutritional Support in Pancreatic Diseases.

    Cañamares-Orbís, Pablo / García-Rayado, Guillermo / Alfaro-Almajano, Enrique

    Nutrients

    2022  Volume 14, Issue 21

    Abstract: This review summarizes the main pancreatic diseases from a nutritional approach. Nutrition is a cornerstone of pancreatic disease and is sometimes undervalued. An early identification of malnutrition is the first step in maintaining an adequate ... ...

    Abstract This review summarizes the main pancreatic diseases from a nutritional approach. Nutrition is a cornerstone of pancreatic disease and is sometimes undervalued. An early identification of malnutrition is the first step in maintaining an adequate nutritional status in acute pancreatitis, chronic pancreatitis and pancreatic cancer. Following a proper diet is a pillar in the treatment of pancreatic diseases and, often, nutritional counseling becomes essential. In addition, some patients will require oral nutritional supplements and fat-soluble vitamins to combat certain deficiencies. Other patients will require enteral nutrition by nasoenteric tube or total parenteral nutrition in order to maintain the requirements, depending on the pathology and its consequences. Pancreatic exocrine insufficiency, defined as a significant decrease in pancreatic enzymes or bicarbonate until the digestive function is impaired, is common in pancreatic diseases and is the main cause of malnutrition. Pancreatic enzymes therapy allows for the management of these patients. Nutrition can improve the nutritional status and quality of life of these patients and may even improve life expectancy in patients with pancreatic cancer. For this reason, nutrition must maintain the importance it deserves.
    MeSH term(s) Humans ; Acute Disease ; Quality of Life ; Pancreatitis/therapy ; Pancreatitis/complications ; Nutritional Support/adverse effects ; Enteral Nutrition/adverse effects ; Pancreatic Neoplasms/complications ; Pancreatic Neoplasms/therapy ; Malnutrition/etiology ; Malnutrition/therapy ; Pancreatic Neoplasms
    Language English
    Publishing date 2022-10-31
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2518386-2
    ISSN 2072-6643 ; 2072-6643
    ISSN (online) 2072-6643
    ISSN 2072-6643
    DOI 10.3390/nu14214570
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article: Temperature dependence of the dielectric function of dehydrated biological samples in the THz band.

    Helminiak, Jan / Alfaro-Gomez, Mariana / Hernandez-Cardoso, Goretti G / Koch, Martin / Castro-Camus, Enrique

    Biomedical optics express

    2023  Volume 14, Issue 4, Page(s) 1472–1479

    Abstract: Terahertz technology has demonstrated enormous potential for the analysis of biological systems and the diagnosis of some medical conditions, given its high sensitivity to detect water content. In previously published papers, effective medium theories ... ...

    Abstract Terahertz technology has demonstrated enormous potential for the analysis of biological systems and the diagnosis of some medical conditions, given its high sensitivity to detect water content. In previously published papers, effective medium theories are used to extract the water content from the terahertz measurements. When the dielectric functions of water and dehydrated bio-material are well known, the volumetric fraction of water can be left as the only free parameter in those effective medium theory models. While water complex permittivity is very well known, the dielectric functions of dehydrated tissues are normally measured for each individual application. In previous studies, it has been traditionally assumed that, unlike water, the dielectric function of the dehydrated tissues is temperature independent, measuring it only at room temperature. Yet, this is an aspect that has not been discussed and that is relevant in order to get THz technology closer to clinical and in-the-field applications. In this work, we present the characterization of the complex permittivity of dehydrated tissues; each studied at temperatures ranging from 20°C to 36.5°C. We studied samples of different organism classifications to have a wider confirmation of the results. We find that, in each case, the dielectric function changes of dehydrated tissues caused by temperature are smaller than for water across the same temperature interval. Yet, the changes in the dielectric function of the dehydrated tissue are not negligible and should, in many cases, be taken into account for the processing of terahertz signals that interact with biological tissues. While this study gives a first introduction into the probable relevancy of temperature-dependent optical behavior of biological samples, this work only focuses on the experimental proof for this relationship and will, therefore, not give a deeper analysis of how the underlying models have to be modified.
    Language English
    Publishing date 2023-03-08
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2572216-5
    ISSN 2156-7085
    ISSN 2156-7085
    DOI 10.1364/BOE.478787
    Database MEDical Literature Analysis and Retrieval System OnLINE

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