RESUMO
BACKGROUND: Different modalities of quarantines were one of the main measures implemented worldwide to avoid the spread of SARS-CoV2 virus. AIM: To analyze and compare retrospectively the implementation of the Step- to-Step plan devised by the Chilean Ministry of Health during the pandemic. To propose a decision-making path based on an artificial intelligence fuzzy system to determine confinements in specific territories. MATERIAL AND METHODS: The Step-to-Step Plan threshold values such hospital network capacity, epidemic spreading, testing and contact tracing capability were modeled using fuzzy numbers and fuzzy rule-based systems. RESULTS: Ministry of Health's decision-making opportuneness were unrelated with the Step-to-Step Plan indicators for deconfinement. Such disagreements undermined epidemiological indicators. CONCLUSIONS: Using an artificial intelligence system could improve decision-making transparency, emergency governance, and risk communication to the population.
Assuntos
Humanos , Inteligência Artificial , Quarentena , RNA Viral , Estudos Retrospectivos , Lógica FuzzyRESUMO
BACKGROUND: Different modalities of quarantines were one of the main measures implemented worldwide to avoid the spread of SARS-CoV2 virus. AIM: To analyze and compare retrospectively the implementation of the Step- to-Step plan devised by the Chilean Ministry of Health during the pandemic. To propose a decision-making path based on an artificial intelligence fuzzy system to determine confinements in specific territories. MATERIAL AND METHODS: The Step-to-Step Plan threshold values such hospital network capacity, epidemic spreading, testing and contact tracing capability were modeled using fuzzy numbers and fuzzy rule-based systems. RESULTS: Ministry of Health's decision-making opportuneness were unrelated with the Step-to-Step Plan indicators for deconfinement. Such disagreements undermined epidemiological indicators. CONCLUSIONS: Using an artificial intelligence system could improve decision-making transparency, emergency governance, and risk communication to the population.
Assuntos
Inteligência Artificial , Quarentena , Humanos , RNA Viral , Estudos Retrospectivos , Lógica FuzzyRESUMO
Chile has been viewed as an exemplar of social and economic progress in Latin America, with its health system attracting considerable attention. Eruption of widespread civil disorder marred this image in 2019. We trace the evolution of Chilean health policy and place it in context with developments in other sectors, pensions and education. We argue that much has been achieved, but further progress will necessitate politicians tackling the enduring power of elites that has prevented reform of a two-tier system enshrined in policies of the dictatorship.
Assuntos
Programas Governamentais , Política de Saúde , Chile , Atenção à Saúde , Reforma dos Serviços de Saúde , Humanos , América LatinaRESUMO
ABSTRACT Introduction: The volumetric preservation of bone and soft tissue after a tooth extraction has special relevance in the esthetic zone when it will be rehabilitated by a dental implant. Objective: Describe the prosthodontics treatment in a socket with advanced buccal bone resorption, with a flapless technique for guided bone regeneration and with a dental implant and implant-supported single fixed prosthesis. Case presentation: A case is presented of a male 62-year-old partially dentate patient. Radiographic examination showed the presence of advanced buccal bone resorption in relation to the maxillary left lateral incisor. It was a result of the root displacement secondary to root fracture. In a first surgical phase the lateral incisor was extracted using an atraumatic periotome technique. Particulate cortical bone allograft was compacted into the site to fill the space that was previously occupied by the root of the tooth. Temporary restoration was performed using the extracted natural tooth, which was adhesively bonded to the adjacent teeth. Four months after grafting the extraction site showed an adequate height and width of the bone. In a second surgical phase, an implant was placed. Six months after implant placement, osseointegration was clinically confirmed and a provisional crown was screwed on the implant performed. The final restoration with a zirconium dioxide abutment and a full ceramic crown was obtained and cemented. Conclusions: Regeneration of the buccal plate was possible through the use of particulate cortical bone allograft and a resorbable collagen membrane adapted to the bone defect and placed in a position to recreate the buccal plate. This allowed the installation of an implant 4 months later, the procedure allowing esthetic and functional results using a single fixed prosthesis(AU)
RESUMEN Introducción: La preservación volumétrica de los huesos y tejidos blandos después de una extracción dental tiene especial relevancia en la zona estética cuando será rehabilitada por un implante dental. Objetivo: Describir el tratamiento de prótesis en una cavidad con reabsorción ósea bucal avanzada, con una técnica sin colgajo para la regeneración ósea guiada y con un implante dental y una prótesis fija única con soporte de implante. Presentación del caso: Paciente masculino de 62 años, edente parcial. El examen radiográfico mostró la presencia de reabsorción ósea bucal avanzada en relación con el incisivo lateral superior izquierdo. Fue el resultado del desplazamiento de la raíz secundario a la fractura de esta. En una primera fase quirúrgica, el incisivo lateral se extrajo utilizando una técnica de periotoma atraumático. El aloinjerto de hueso cortical particulado se compactó en el sitio para llenar el espacio que anteriormente ocupaba la raíz del diente. La restauración temporal se realizó utilizando el diente natural extraído, que se unió adhesivamente a los dientes adyacentes. Cuatro meses después del injerto, el sitio de extracción mostró una altura y anchura adecuadas del hueso. En una segunda fase quirúrgica, se colocó un implante. Seis meses después de la colocación del implante, se confirmó clínicamente la osteointegración y se realizó una corona provisional atornillada al implante. La restauración final con un pilar de dióxido de circonio y una corona de cerámica completa se obtuvo y se cementó. Conclusiones: La regeneración de la placa bucal fue posible mediante el uso de aloinjerto de hueso cortical particulado y una membrana de colágeno reabsorbible adaptada al defecto óseo y colocada en una posición para recrear la placa bucal. Esto permitió la instalación de un implante 4 meses después. El procedimiento permitió la estética y los resultados funcionales utilizando una única prótesis fija(AU)
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Implantes Dentários/efeitos adversos , Osseointegração/fisiologia , Regeneração Tecidual Guiada/métodos , Aloenxertos/transplanteRESUMO
PURPOSE OF REVIEW: In this review, we discuss the current implications of the changing genomic epidemiology of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), etiological agent of the Coronavirus Disease 2019 (COVID-19) and its potential relationship with the change of clinical manifestations in patients with confirmed infection. RECENT FINDINGS: Over the course of the current pandemic, the virus has been found more diverse in new countries. Simultaneously, also new clinical manifestations are observed, particularly more prominent gastrointestinal and neurological findings. SUMMARY: SARS-CoV-2/COVID-19 is changing not only its epidemiology, but also its genomic diversity and clinical manifestations, both aspects coupled, needs to be considered in the study of this ongoing pandemic.
Assuntos
Infecções por Coronavirus/epidemiologia , Coronavirus , Pandemias , Pneumonia Viral , Betacoronavirus , Brasil , COVID-19 , Saúde Global , Humanos , América Latina , SARS-CoV-2 , Medicina de Viagem , Estados UnidosRESUMO
[RESUMEN]. En Chile se ha producido un desarrollo económico que no ha resuelto profundas desigualdades. Hoy en día, se intenta resolver una intensa crisis política y social que irrumpe de modo explosivo en octubre de 2019 motivada por un alza del transporte público. Una década después de que se iniciara la implementación de la última reforma al sistema de salud, este sigue siendo un ámbito prioritario en la preocupación de la población y parte de las actuales demandas ciudadanas. Desde el movimiento social, se proponen nuevas reformas que requerirán de consensos para ser viables desde un punto de vista técnico y político. Los cambios necesarios en el ámbito de la salud son impostergables. Entre otras medidas, es preciso implementar transformaciones en el sector prestador, tanto público como privado, en la lógica de un modelo estructurado en redes integradas y basado en la estrategia de la atención primaria de salud. Esto permitirá la consecuente alineación de los recursos humanos y financieros con el acceso y cobertura de salud universal y, de esta manera, resolver de manera efectiva y eficiente las necesidades de salud de las personas y sus comunidades.
[ABSTRACT]. In Chile, economic development has not resolved deep inequalities. Today, attempts are being made to solve an intense political and social crisis sparked in October 2019 by a hike in public transport fares. A decade after initial implementation of the last health system reform, this continues to be a priority area of public concern––and part of what citizens are now demanding. This social movement is proposing new reforms that will require consensus in order to be viable from a technical and political standpoint. The necessary changes in the health field cannot be postponed. Among other measures, it is necessary to implement transformations in health providers in both the public and private sectors, toward a model that is structured around integrated networks and based on a primary health care strategy. This will make it possible to align human and financial resources with universal access to health and universal health coverage, effectively and efficiently meeting the health needs of people and communities.
[RESUMO]. O crescimento econômico alcançado no Chile não foi capaz de resolver as profundas desigualdades. O país tenta hoje encontrar uma saída à enorme crise política e social que irrompeu com violência em outubro de 2019 contra o aumento no preço da passagem do transporte público. Passada uma década desde a última reforma do sistema de saúde, a saúde continua sendo um tema prioritário que preocupa a população e figura entre as demandas atuais dos cidadãos chilenos. As novas reformas propostas pelo movimento social exigem o consenso técnico e político para serem viabilizadas. As mudanças necessárias em saúde são impreteríveis. Entre outras medidas, é preciso transformar o setor de prestação de serviços, tanto público como privado, criando um modelo estruturado em redes integradas baseado na estratégia de atenção primária à saúde. Isto possibilitará o consequente alinhamento dos recursos humanos e financeiros com o acesso universal à saúde e cobertura de saúde universal e, assim, atender com efeito e eficiência às necessidades de saúde das pessoas e suas comunidades.