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Based on probability theory, a methodology that allows diagnosing neonatal cardiac dynamics was previously developed; however, diagnostic applications of this method are required to validate it to the neonatal cardiac dynamics was conducted, allowing to differentiate normal from pathological dynamics. The hourly maximum and minimum heart rate values from 39 continuous and ambulatory electrocardiographic records with a minimum length of 21 hours were taken, from newborns between 0 and 10 days of life, 9 clinically within normality limits and 30 with cardiac pathologies. The probability of occurrence of heart rates in ranges of 5 beats/minute was calculated. The distributions of probability were analysed, and finally the diagnosis was determined by the physical-mathematical methodology. Then, a statistical validation of sensitivity, specificity, and diagnostic agreement was performed. Normal registries showed probability distributions with absent or minimal presence of heart rates of the ranges between 125 and 135 beats/minute, while the abnormal ones had values within these ranges, as well as absence or minimal presence of heart rates from 75 beats/minute to 85 beats/minute. The sensitivity and specificity were 100%, and the Kappa coefficient had a value of 1. Hereby, it is concluded that through an application of a physical-mathematical methodology of neonatal cardiac diagnosis, it is possible to differentiate normality from disease.

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Dos novelas sucesivas del escritor y matemático argentino Guillermo Martínez, "Crímenes imperceptibles" (2004) y "La muerte lenta de Luciana B." (2007) fueron llevadas al cine. En ambas se abordan las categorías lógico-matemáticas de azar y necesidad, permitiendo abrir una brecha entre ellas para conjeturar una hipótesis clínica sobre la responsabilidad subjetiva de los personajes. Este trabajo pone el foco en la versión "La ira de Dios" (Schindel, 2022), introduciendo la cuestión de las leyes del azar, la respuesta de un sujeto a ese encuentro con el azar, para concluir con la venganza como rechazo de la responsabilidad.

Two successive novels by Argentine writer and mathematician Guillermo Martínez, "Imperceptible Crimes" (2004) and "The Slow Death of Luciana B." (2007) were made into movies. In both, the logical-mathematical categories of chance and necessity are addressed, allowing a gap to be opened between them to conjecture a clinical hypothesis about the subjective responsibility of the characters. This work focuses on the version "The Wrath of God" (Schindel, 2022), introducing the question of the laws of chance, the response of a subject to that encounter with chance, to conclude with revenge as a rejection of the responsibility

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Resumen Introducción: la infección por COVID 19 corresponde actualmente al evento infeccioso con mayor impacto en salud púbica a nivel mundial, en Colombia, al 30 de abril de 2020 se registraron 6465 casos acumulados, 360 defunciones y 2186 casos recuperados, dado el aumento en los casos reportados mediante los sistemas de vigilancia epidemiológica se precisa de herramientas que faciliten el diagnóstico oportuno y la predicción en el comportamiento de los casos a nivel nacional. Objetivos: proponer un modelo estadístico que permita predecir la probabilidad de cursar con diagnóstico de COVID-19 en la población atendida por sospecha de infección por el mismo en una institución de tercer nivel del municipio de Pereira- Risaralda entre marzo y abril de 2020. Materiales y métodos: se presenta un estudio descriptivo de corte trasversal en el cual se analizaron 82 casos, se realizó un modelo predictivo basado en compuertas lógicas AND y OR, y análisis por estadística descriptiva e inferencial. Resultados: de los 82 registros analizados se encontró una relación hombre: mujer de 1:2; el 6% de los pacientes tuvo alta probabilidad para diagnóstico de COVID 19, el 20% tuvo probabilidad intermedia y el 72% registró baja probabilidad para COVID19, la concordancia del modelo con los resultados de las pruebas fue inferior a 0,5. Conclusiones: el modelo estadístico planteado fue insuficiente para lograr la predicción de la totalidad de los casos de COVID-19 basados en el perfil de riego de la población, se precisan nuevas investigaciones con tamaños de muestra superiores, diseños y análisis distintos. MÉD.UIS.2022;35(1): 57-69.

Abstract Introduction: COVID 19 infection currently corresponds to the infectious event with the greatest impact on public health worldwide, in Colombia, as of April 30, 2020, 6465 accumulated cases, 360 deaths and 2186 recovered cases were registered, given the increase in cases reported through epidemiological surveillance systems, tools are needed to facilitate timely diagnosis and prediction in the behavior of cases at the national level. Objectives: to propose a statistical model that allows predicting the probability of a diagnosis of COVID-19 in the population treated for suspected coronavirus infection in a third-level institution in the population of Pereira-Risaralda between March and April 2020. Materials and methods: a descriptive cross-sectional study is presented, in which 82 cases were analyzed, a predictive model based on AND and OR logic gates, analyzes by descriptive and inferential statistics were performed. Results: of the 82 records analyzed, a male: female ratio of 1: 2 was found; 6% of the patients had a high probability for the diagnosis of COVID 19, 20% had an intermediate probability and 72% had a low probability for COVID19, the agreement of the model with the test results was less than 0.5. Conclusions: the proposed statistical model was insufficient to achieve the prediction of all the cases of COVID-19 based on the irrigation profile of the population. New investigations are required with larger sample sizes associated with longitudinal designs and combined statistical analyzes that allow to refine the proposed model. MÉD.UIS.2022;35(1): 57-69.

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Introduction: The name Statistics was probably used in Egypt in 1549. The term Statistics, which was connected to the development of sovereign states, was coined in Germany in 1749 and used to designate the systematic collection of demographic and economic data by states. Objective: To present the most relevant and current statistical techniques in clinical medicine and epidemiology, as well as to show examples of the use of these techniques. Material and Methods: Review of the literature on the subject; presentation of some examples developed in class by professors of the subject Research Methodology and Statistics in Medical Sciences. Development: From the very beginnig, Statistics was used to characterize data based on their properties, as well as to develop information summary measures. In the modern era, procedures and techniques were designated to facilitate valid inferences to the universe from the sampling theory, whose foundation is the probability theory. Conclusions: There is a need for the application of modern techniques and especially the multivariate ones used to explain biological phenomena, which cannot be explained by one or two variables. This makes possible that our universities, scientific research centers, and companies conduct studies using statistical techniques that involve many variables, which are supposed to be related to the variable under study(AU)

Introducción: El nombre de Estadística probablemente se usó en Egipto en 1549. El término Estadística se acuñó en Alemania en 1749, conectado con el desarrollo de estados soberanos y designando la recopilación sistemática de datos demográficos y económicos por estados. Objetivo: Presentar las técnicas estadísticas más relevantes en el campo de la clínica médica y la epidemiología actualmente y mostrar ejemplos del uso de dichas técnicas. Material y métodos: Revisión de la literatura sobre el tema, algunos ejemplos desarrollados en clases por profesores de la asignatura Metodología de la investigación y Estadística en carreras de Ciencias Médicas. Desarrollo: En sus inicios la Estadística caracterizaba los datos basados en sus propiedades, desarrollaron medidas de resumen de información. En la era moderna se diseñaron procedimientos y técnicas para realizar inferencias válidas al universo a partir de la teoría del muestreo, cuyo fundamento es la teoría de probabilidades. Conclusiones: Necesidad de la aplicación de las técnicas modernas y especialmente las multivariadas para explicar los fenómenos biológicos, que no pueden ser explicados por una o dos variables, esto hace que nuestras universidades, centros de investigaciones científicas y empresas realicen sus estudios, utilizando técnicas estadísticas que envuelvan muchas variables que se suponen se relacionen con la variable objeto de estudio(AU)

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Introduction: The analysis of injuries caused by traffic from a physical and mathematical perspective can help improve road safety strategies. Objective: Predict the dynamics of traffic fatalities in the states of Maryland and Massachusetts for the years 2004 and 2014 in the context of probabilistic random walk. Methods: An analysis was made of the number of total fatalities caused by traffic per year, in the states of Maryland and Massachusetts between the years 1994-2003 and 1994-2013. The behavior of these values was analyzed as a probabilistic random walk; for this, the probabilistic lengths were found for each year, during the period studied and four probability spaces were analyzed, with which it was possible to analyze their behavior, to establish a prediction of the number of total fatalities caused by traffic for the years 2004 and 2014. Results: The predictions for the years 2014 and 2004 for Maryland and Massachusetts when compared with the real values, the percentage of success was 98%. Main conclusion: The predictions for the years 2014 and 2004 for Maryland and Massachusetts when compared with the real values, the percentage of success was 98%. Conclusions: the behavior of traffic fatalities in Maryland and Massachusetts presented a predictable self-organization from the context of probabilistic random walk, constituting a useful tool for analyzing the operation of road safety strategies.

Antecedentes: El análisis de los accidentes de tránsito desde una perspectiva física y matemática puede ayudar a mejorar las estrategias viales de seguridad. Objetivo: Obtener una predicción de la dinámica de fatalidades a causa del tráfico en los estados de Maryland y Massachusetts para los años 2004 y 2014 en el contexto de la caminata al azar probabilista. Métodos: Se realizó un análisis del número de fatalidades totales causadas por el tráfico al año, en los estados de Maryland y Massachusetts entre los años 1994-2003 y 1994-2013. El comportamiento de estos valores fue analizado como una caminata al azar probabilista; para ello se hallaron las longitudes probabilistas para cada año, durante el periodo estudiado y se analizaron cuatro espacios de probabilidad, con los que fue posible analizar su comportamiento, para establecer una predicción del número de fatalidades totales causadas por el tráfico para los años 2004 y 2014. Resultados: Las predicciones para los años 2014 y 2004 para Maryland y Massachusetts al ser comparados con los valores reales el porcentaje de acierto fue del 98%. Conclusión principal: el comportamiento de las fatalidades de tráfico en Maryland y Massachusetts presentó una autoorganización predecible desde el contexto de la caminata al azar probabilista, constituyéndose como una herramienta útil para el análisis del funcionamiento de las estrategias de seguridad vial.

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ABSTRACT Objective: To evaluate Streptococcus pneumoniae serotypes isolated from an inpatient population at a tertiary care hospital, in order to determine the theoretical coverage of the 13-valent pneumococcal conjugate vaccine (PCV13) and the 23-valent pneumococcal polysaccharide vaccine (PPV23). Methods: This was a cross-sectional study involving 118 inpatients at the Hospital São Lucas, in the city of Porto Alegre, Brazil, whose cultures of blood, cerebrospinal fluid, or other sterile body fluid specimens, collected between January 2005 and December 2016, yielded pneumococcal isolates. The theoretical vaccine coverage was studied in relation to the serotypes identified in the sample and their relationship with those contained in the pneumococcal vaccines available in Brazil. Results: The majority of the population was male (n = 66; 55.9%), with a median age of 57 years (interquartile range: 33-72 years). The most common manifestation was pneumonia, and the pneumococcus was most commonly isolated from blood cultures. More than one fourth of the study population had some degree of immunosuppression (n = 34; 28.8%). Of the total sample, 39 patients (33.1%) died. There were no significant associations between mortality and comorbidity type, ICU admission, or need for mechanical ventilation. The theoretical vaccine coverage of PPV23 alone and PCV13 plus PPV23 was 31.4% and 50.8%, respectively. Conclusions: If the patients in this sample had been previously vaccinated with PCV13 plus PPV23, theoretically, 50.8% of the cases of invasive pneumococcal disease that required hospital admission could potentially have been prevented. Invasive pneumococcal disease should be prevented by vaccination not only of children and the elderly but also of adults in their economically productive years, so as to reduce the socioeconomic costs, morbidity, and mortality still associated with the disease, especially in underdeveloped countries.

RESUMO Objetivo: Avaliar os sorotipos de Streptococcus pneumoniae isolados de uma população internada em um hospital terciário para verificar a cobertura vacinal teórica das vacinas conjugada pneumocócica 13-valente (VCP13) e pneumocócica polissacarídica 23-valente (VPP23). Métodos: Estudo transversal envolvendo 118 pacientes internados no Hospital São Lucas, na cidade de Porto Alegre (RS), cujas amostras de cultura de sangue, líquor ou outro líquido estéril apresentaram isolados de pneumococos entre janeiro de 2005 e dezembro de 2016. A cobertura vacinal teórica foi estudada em relação aos sorotipos observados na amostra e sua relação com os contidos nas vacinas pneumocócicas disponíveis no Brasil. Resultados: A maioria da população era masculina (n = 66; 55,9%), com mediana de idade de 57 anos (intervalo interquartil: 33-72 anos). O agravo mais frequente foi pneumonia, e o pneumococo foi mais frequentemente isolado em hemocultura. Mais de um quarto da população estudada tinha algum grau de imunossupressão (n = 34; 28,8%). Na amostra geral, 39 pacientes (33,1%) foram a óbito. Não houve associações significativas do número de óbitos com o tipo de comorbidades, internação em UTI ou necessidade de ventilação mecânica. A cobertura vacinal teórica da VPP23 e da combinação VCP13 + VPP23 foi de 31,4% e 50,8%, respectivamente. Conclusões: Nesta amostra, se os pacientes tivessem sido previamente vacinados com a combinação VCP13 seguida de VPP23, teoricamente, 50,8% dos casos de doença pneumocócica invasiva que necessitaram de internação hospitalar poderiam ter sido prevenidos potencialmente. Essa doença deve ser prevenida com a vacinação não só de crianças e idosos, mas também de adultos em idade economicamente ativa, para reduzir o custo socioeconômico, a morbidade e a mortalidade ainda associados à doença, especialmente em países subdesenvolvidos.

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OBJECTIVE: To evaluate Streptococcus pneumoniae serotypes isolated from an inpatient population at a tertiary care hospital, in order to determine the theoretical coverage of the 13-valent pneumococcal conjugate vaccine (PCV13) and the 23-valent pneumococcal polysaccharide vaccine (PPV23). METHODS: This was a cross-sectional study involving 118 inpatients at the Hospital São Lucas, in the city of Porto Alegre, Brazil, whose cultures of blood, cerebrospinal fluid, or other sterile body fluid specimens, collected between January 2005 and December 2016, yielded pneumococcal isolates. The theoretical vaccine coverage was studied in relation to the serotypes identified in the sample and their relationship with those contained in the pneumococcal vaccines available in Brazil. RESULTS: The majority of the population was male (n = 66; 55.9%), with a median age of 57 years (interquartile range: 33-72 years). The most common manifestation was pneumonia, and the pneumococcus was most commonly isolated from blood cultures. More than one fourth of the study population had some degree of immunosuppression (n = 34; 28.8%). Of the total sample, 39 patients (33.1%) died. There were no significant associations between mortality and comorbidity type, ICU admission, or need for mechanical ventilation. The theoretical vaccine coverage of PPV23 alone and PCV13 plus PPV23 was 31.4% and 50.8%, respectively. CONCLUSIONS: If the patients in this sample had been previously vaccinated with PCV13 plus PPV23, theoretically, 50.8% of the cases of invasive pneumococcal disease that required hospital admission could potentially have been prevented. Invasive pneumococcal disease should be prevented by vaccination not only of children and the elderly but also of adults in their economically productive years, so as to reduce the socioeconomic costs, morbidity, and mortality still associated with the disease, especially in underdeveloped countries.

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BACKGROUND: The Trauma and Injury Severity Score (TRISS) has been criticized for being based on data from the USA and Canada-high-income countries-and therefore, it may not be applicable to low-income and middle-income countries. The present study evaluated the accuracy of three adjustments to the TRISS equation model (NTRISS-like; TRISS SpO2; NTRISS-like SpO2) in a high-income and a middle-income country to compare their performance when derived and applied to different groups. METHODS: This was a retrospective study of trauma patients admitted to two institutions: a university medical center in São Paulo, Brazil (a middle-income country), and a level 1 university trauma center in San Diego, USA (a high-income country). Patients were admitted between January 1, 2006, and December 31, 2010. The subjects were 2416 patients from Brazil and 8172 patients from the USA. All equations had adjusted coefficients for São Paulo and San Diego and for blunt and penetrating trauma. Receiver operating characteristic (ROC) curves were used to evaluate performance of the models. RESULTS: Regardless of the population where the equation was generated, it performed better when applied to patients in the USA (AUC from 0.911 to 0.982) compared to patients in Brazil (AUC from 0.840 to 0.852). When the severity was considered and homogenized, the performance of equations were similar to both application in the USA and Brazil. CONCLUSIONS: Survival probability models showed better performance when applied in data collected in the high-income countries (HIC) regardless the country they were derived. The severity is an important factor to consider when using non-adjusted survival probability models for the local population. Adjusted models for severely traumatized patients better predict survival probability in less severely traumatized populations. Other factors besides physiological and anatomical data may impact final outcomes and should be identified in each environment if they are to be used in the development of the trauma care performance improvement process in middle-income countries.

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Introducción: la dinámica cardiaca se ha evaluado desde teorías físico' matemáticas como la probabilidad y los sistemas dinámicos, lo que ha permitido desarrollar diagnósticos y predicciones de aplicación clínica. Objetivo: medir la probabilidad de distribuciones de frecuencias cardiacas (FC) neonatales normales, para hacer una caracterización matemática, objetiva y reproducible. Metodología: se analizaron diez dinámicas normales mediante registros continuos y holters, tomando los máximos y mínimos de FC por hora durante 21 horas. Se generaron rangos de 5 latmin, y se estableció cuántas frecuencias pertenecen a cada rango. Se analizaron las distribuciones obtenidas en el espacio de probabilidades para las frecuencias cardiacas, en busca de características matemáticas de normalidad para la dinámica cardiaca neonatal. Resultados: las probabilidades de los rangos evaluados variaron entre 0,02272 y 0,2826-, y en tres de los rangos, todas las dinámicas presentaron probabilidad mínima o cero. Conclusiones: se desarrolló una caracterización general de la dinámica cardiaca neonatal normal, objetiva y reproducible.

Background: Cardiac dynamics have been evaluated from physicah mathematical theories like probability and dynamícal Systems, allowing to developing diagnosis and dinical application predictions. Objective: To measure the probability of normal neonatal heart rates distribution, for doing a mathematical characterization, objective and reproducible. Methods: It have been analyzed 10 normal dynamics through continuous records and holters, taking máximum and mínimum valúes of heart rates per hour during 21 hours. Ranges of 5 beats/min were generated; obtained distributions in probability space for heart rates were analyzed, to search normality mathematical characteristics for neonatal cardiac dynamics. Results: The probabilities of the evaluated ranges varied between 0.02272 and 0.2826; also, in three of the ranges, all the dynamics showed a minimum probability or zero. Condusions: A general characterization, objective and reproductible, of normal neonatal cardiac dynamics, was developed.

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Objetivo: confirmar la capacidad diagnóstica de una metodología basada en la teoría de probabilidad en casos de arritmia. Materiales y métodos: se realiza un estudio ciego, en el que se analizaron 10 Holter normales y 90 con diferentes tipos de arritmia, de pacientes mayores de 21 años. Se enmascara el diagnóstico convencional y se calcula la probabilidad de rangos de frecuencias cardiacas máximas, mínimas e intermedias cada hora, y de número de latidos por hora, para determinar el diagnóstico matemático de acuerdo con los tres parámetros establecidos previamente. Finalmente, se desenmascara el diagnóstico convencional, que fue tomado como Estándar de Oro, y se realiza un análisis de la concordancia diagnóstica para diferenciar normalidad y arritmia aguda. Resultados: los Holternormales, presentan valores matemáticos característicos de normalidad o en evolucióna enfermedad, mientras que todos los casos patológicos son diagnosticados por la metodología como en evolución a enfermedad o enfermos. Se obtiene una sensibilidad del 100%, una especificidad del 70%, un VPP de 93,33% y un VPNde 100%, y el coeficiente Kappa presenta un valor de 0,82. Conclusiones: la aplicación de la metodología en el estudio de alteraciones arrítmicas, evidencia un orden matemático mediante el cual se logra diferenciar normalidad de enfermedad y detectar estados de evolución a la enfermedad aun en estados clínicos con diagnóstico normal, de posible utilidad preventiva a nivel clínico.

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