This study analyzes the effects of the Pedernales earthquake (April 2016) on Ecuador's health care system.
A research was carried out in Chone Canton, which combined documentary, quantitative, and ...qualitative techniques. Epidemiological and service production information taken from official documents was analyzed systematically. In-depth interviews and surveys were conducted with health care program directors and technicians from the Health Centres of the Ministry of Public Health and the users.
Deficiencies in the health care system were already observed in Chone Canton prior to the earthquake mainly due to the lack of doctors, nurses, and hospital beds. According to the interviewees, the health district was not prepared for an emergency like the earthquake. Some buildings fell after the earthquake, and Chone Hospital was disabled. These problems coupled with preventive action failures at the community level led to an increase in diseases after the earthquake.
The shortage of personnel and physical infrastructure, weaknesses in primary health care in the Ecuadorian health system, the lack of preparation, and limited availability of information on health indicators were the causes of the sharp increase in pre-existing diseases in the area, and of new epidemic outbreaks after the earthquake.
Daily glucose variability is higher in diabetic mellitus (DM) patients which has been related to the severity of the disease. However, it is unclear whether glycemic variability displays a specific ...pattern oscillation or if it is completely random. Thus, to determine glycemic variability pattern, we measured and analyzed continuous glucose monitoring (CGM) data, in control subjects and patients with DM type-1 (T1D). CGM data was assessed for 6 days (day: 08:00-20:00-h; and night: 20:00-08:00-h). Participants (n = 172; age = 18-80 years) were assigned to T1D (n = 144, females = 65) and Control (i.e., healthy; n = 28, females = 22) groups. Anthropometry, pharmacologic treatments, glycosylated hemoglobin (HbA1c) and years of evolution were determined. T1D females displayed a higher glycemia at 10:00-14:00-h vs. T1D males and Control females. DM patients displays mainly stationary oscillations (deterministic), with circadian rhythm characteristics. The glycemia oscillated between 2 and 6 days. The predictive model of glycemia showed that it is possible to predict hyper and hypoglycemia (R
= 0.94 and 0.98, respectively) in DM patients independent of their etiology. Our data showed that glycemic variability had a specific oscillation pattern with circadian characteristics, with episodes of hypoglycemia and hyperglycemia at day phases, which could help therapeutic action for this population.
During an apnea, changes in PaO
activate peripheral chemoreceptors to increase respiratory drive. Athletes with continuous apnea, such as breath-hold divers, have shown a decrease in hypoxic ...ventilatory response (HVR), which could explain the long apnea times; however, this has not been studied in swimmers. We hypothesize that the long periods of voluntary apnea in swimmers is related to a decreased HVR. Therefore, we sought to determine the HVR and cardiovascular adjustments during a maximum voluntary apnea in young-trained swimmers. In fifteen trained swimmers and twenty-seven controls we studied minute ventilation (V
), arterial saturation (SpO
), heart rate (HR), and autonomic response through heart rate variability (HRV) analysis, during acute chemoreflex activation (five inhalations of pure N
) and maximum voluntary apnea test. In apnea tests, the maximum voluntary apnea time and the end-apnea HR were higher in swimmers than in controls (
< 0.05), as well as a higher low frequency component of HRV (
< 0.05), than controls. Swimmers showed lower HVR than controls (
< 0.01) without differences in cardiac hypoxic response (CHR). We conclude that swimmers had a reduced HVR response and greater maximal voluntary apnea duration, probably due to decreased HVR.
Tropical South America is one of the three main centres of the global, zonal overturning circulation of the equatorial atmosphere (generally termed the 'Walker' circulation). Although this area plays ...a key role in global climate cycles, little is known about South American climate history. Here we describe sediment cores and down-hole logging results of deep drilling in the Salar de Uyuni, on the Bolivian Altiplano, located in the tropical Andes. We demonstrate that during the past 50,000 years the Altiplano underwent important changes in effective moisture at both orbital (20,000-year) and millennial timescales. Long-duration wet periods, such as the Last Glacial Maximum-marked in the drill core by continuous deposition of lacustrine sediments-appear to have occurred in phase with summer insolation maxima produced by the Earth's precessional cycle. Short-duration, millennial events correlate well with North Atlantic cold events, including Heinrich events 1 and 2, as well as the Younger Dryas episode. At both millennial and orbital timescales, cold sea surface temperatures in the high-latitude North Atlantic were coeval with wet conditions in tropical South America, suggesting a common forcing.
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