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Risk Transfer for Populations in Precarious Urban Environments

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International Journal of Disaster Risk Science 2020年第1期11卷 74-86页

作者： juan.pablo Sarmiento Ana María torres-Munoz Extreme Events Institute/Disaster Risk and Resilience in the Americas(DRRA) Florida International UniversityMiamiFL 33199USA

This study explores risk transfer options that precarious and marginal urban communities could use to protect themselves from future damages and losses generated by socio-natural hazards and disasters at the individual and community levels. The design is framed within an evidence-based disaster risk reduction(DRR) strategy and follows the case study research approach. We analyze the2018 Neighborhood Approach for DRR programming evaluation carried out in four Latin American cities’ informal settlements and review relevant risk transfer experiences aimed at vulnerable populations. We calculate the pure risk premium for the four cases selected, using a previous catastrophe risk assessment for earthquakes and landslides. We propose three risk transfer options based on our analysis:(1) voluntary collective insurance;(2) structural reinforcement with a comprehensive housing insurance;and(3) hybrid parametric insurance. Risk transfer mechanisms conventionally focus on residual risk management. Here, due to the precariousness of the analyzed urban settings, the proposed alternatives go beyond the management of just residual risk to positively impact the beneficiaries’ quality of life and the reduction of the built environment’s physical vulnerability in the short and medium terms. Our study proposes a prospective estimation of future risk despite the limitations of data availability. This study opens a window to new approaches and proposes a systematic process to design DRR policy aimed at the poor and vulnerable strata of society.

关键词： Case study research Catastrophe risk assessment Informal settlements Risk transfer Urban precariousness Urban risk

Management of Helicobacter pylori infection in Latin America: A Delphi technique-based consensus

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World Journal of Gastroenterology 2014年第31期20卷 10969-10983页

作者： Antonio Rollan juan.pablo Arab M Constanza Camargo Roberto Candia Paul Harris Catterina Ferreccio Charles S Rabkin juan Cristóbal Gana pablo Cortés Rolando Herrero Luisa Durán Apolinaria García Claudio Toledo alberto Espino Nicole Lustig alberto Sarfatis Catalina Figueroa Javier torres Arnoldo Riquelme Clínica Alemana de Santiago Facultad de Medicina Clínica Alemana Universidad del Desarrollo Departamento de Gastroenterología Facultad de Medicina Pontificia Universidad Católica de Chile Division of Cancer Epidemiology and Genetics National Cancer InstituteRockville MD 20852 United States Programa de Salud Basada en Evidencia Pontificia Universidad Católica de Chile Departamento de Gastroenterología y Nutrición Pediátrica Facultad de Medicina Pontificia Universidad Católica de Chile Departamento de Salud Pública Facultad de Medicina Pontificia Universidad Católica de Chile International Agency for Research on Cancer World Health Organization Departamento de Microbiología Facultad de Ciencias Biológicas Universidad de Concepción Unidad de Gastroenterología Hospital de Valdivia. Facultad de Medicina Universidad de Austral de Chile Unidad de Investigación en Enfermedades Infecciosas Instituto Mexicano del Seguro Social

AIM: To optimize diagnosis and treatment guidelines for this geographic region, a panel of gastroenterologists, epidemiologists, and basic scientists carried out a structured evaluation of available literature.

关键词： Helicobacter pylori Consensus development conference Delphi technique Latin America

Prevalence of and risk factors for erectile dysfunction in young nondiabetic obese men:results from a regional study

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Asian Journal of Andrology 2020年第4期22卷 372-378页

作者： María Molina-Vega Maite Asenjo-Plaza María JoséBanderas-Donaire María Dolores Hernández-Ollero Silvia Rodríguez-Moreno juan Jálvarez-Millán pablo Cabezas-Sanchez Fernando Cardona-Díaz juan Alcaide-torres Lourdes Garrido-Sánchez Daniel Castellano-Castillo Francisco J Tinahones JoséC Fernández-García Department of Endocrinology and Nutrition Virgen de la Victoria University Hospital(IBIMA)Málaga UniversityMálaga 29010Spain Centro de Investigación Biomédica en Red de la Fisiopatología de la Obesidad y Nutrición(CIBEROBN) Instituto de Salud Carlos IIIMadrid 28029Spain Cruz de Humilladero Primary Care Center Málaga 29010Spain Teatinos Primary Care Center Málaga 29010Spain Chemical Sanitary Consulting(CQS Lab) Madrid 28003Spain

Erectile dysfunction(ED),a condition closely related to cardiovascular morbidity and mortality,is frequently associated with *** this study,we aimed to determine the prevalence of ED and evaluate the associated risk factors in a cohort of 254 young(18–49 years)nondiabetic obese(body mass index[BMI]≥30 kg m−2)men from primary *** function(International Index of Erectile Function[IIEF-5]questionnaire),quality of life(Aging Males'Symptoms[AMS scale]),and body composition analysis(Tanita MC-180MA)were *** testosterone was determined using high-performance liquid chromatography–mass *** logistic regression analysis was used to study the factors associated with *** prevalence was 42.1%.Subjects with ED presented higher BMI,waist circumference,number of components of the metabolic syndrome,AMS score,insulin resistance,and a more unfavorable body composition than those without *** logistic regression analysis showed that a pathological AMS score(odds ratio[OR]:4.238,P40%of subjects.A pathological AMS score,the degree of obesity,and age were positively associated with ED,while elevated HDL-cholesterol levels were inversely associated with the odds of presenting *** prospective studies are needed to evaluate the long-term consequences of ED in this population.

关键词： Aging Males'Symptoms score erectile dysfunction International Index of Erectile Function-5 questionnaire obesity testosterone

Nonsteroidal anti-inflammatory drug effectivity in preventing postendoscopic retrograde cholangiopancreatography pancreatitis: A systematic review and meta-analysis

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World Journal of Gastrointestinal Endoscopy 2020年第11期12卷 469-487页

作者： juan.pablo Román Serrano JoséJukemura Samuel Galante Romanini Paúl Fernando Guamán Aguilar Juliana Silveira Lima de Castro Isabela Trindade torres JoséAndres Sanchez Pulla Otavio Micelli Neto Eloy Taglieri JoséCelso Ardengh Department of Gastroenterology University of Sao PauloSão Paulo 05403-000São PauloBrazil Department of Gastrointestinal Endoscopy Service Hospital 9 de JulhoSão Paulo 01409002São PauloBrazil Department of Gastroinestinal Catholic University of CuencaCuenca 010101Ecuador Department of General Surgery Servidor Municipal HospitalSão Paulo 01532-001Brazil

BACKGROUND Endoscopic retrograde cholangiopancreatography(ERCP)is the primary therapeutic procedure for the treatment of diseases affecting the biliary tree and pancreatic *** the therapeutic success rate of ERCP is high,the procedure can cause complications,such as acute pancreatitis[post-ERCP pancreatitis(PEP)],bleeding and *** To assess the efficacy of non-steroidal anti-inflammatory drugs(NSAIDs)in preventing PEP during *** Databases such as MEDLINE,EMBASE and Cochrane Central Library were *** randomized controlled trials(RCTs)comparing the efficacy of NSAIDs and placebo for the prevention of PEP were *** evaluated included the incidence of PEP,severity of pancreatitis,route of administration,types,dose,and timing of administration of *** Twenty-six RCTs were considered eligible with a total of 8143 patients ***,4020 patients used NSAIDs before ERCP and 4123 did not use NSAIDs(control group).Ultimately,298 cases of post-ERCP acute pancreatitis were diagnosed in the NSAID group and 484 cases in the placebo *** risk of PEP was lower in the NSAID group risk difference(RD):-0.04;95%confidence interval(CI):-0.07 to-0.03;number needed to treat(NNT),25;P<*** use effectively prevented mild pancreatitis compared to placebo use(2.5%vs 4.1%;95%CI:-0.05 to-0.01;NNT,33;P<0.05),but information on moderate PEP and severe PEP could not be fully *** rectal administration reduced the incidence of PEP with RD:-0.06;95%CI:-0.08 to-0.04;NNT,17;P<0.05).Furthermore,only the use of diclofenac or indomethacin was effective in preventing PEP,at a dose of 100 mg,which must be administered before performing *** Rectal administration of diclofenac and indomethacin significantly reduced the risk of developing mild *** RCTs are needed to compare the efficacy between NSAID routes of administration in preventing PEP.

关键词： Pancreatitis Endoscopic retrograde cholangiopancreatography Diclofenac Indomethacin Rectal

HIV screening and retention in care in people who use drugs in Madrid, Spain: a prospective study

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Infectious Diseases of Poverty 2021年第4期10卷 77-85页

作者： pablo Ryan Jorge Valencia Guillermo Cuevas Jesus Troya juan torres-Macho Maria Jose Munoz-Gomez Nuria Munoz-Rivas Isabel Canorea Sonia Vazquez-Moron Salvador Resino Hospital Universitario Infanta Leonor MadridSpain Universidad Complute nse de Madrid(UCM) MadridSpain Instituto de Investigacion Sanitaria Gregorio Maranon(liSGM) MadridSpain Unidad de Reduccion de Darios"SMASD"Madrid Spain Unidad de Infeccion Viral e Inmunidad Centro Nacional de MicrobiologiaInstituto de Salud Carlos IIICarretera Majada-honda-PozueloKm 2.228220 MajadahondaMadridSpain

Background::The burden of human immunodeficiency virus(HIV)infection in people who use drugs(PWUD)is *** aimed to screen HIV infection among PWUD and describe their retention in HIV ***,we also screen for hepatitis C virus(HCV)infection among HIV-seropositive PWUD and describe their linkage to ***::We conducted a prospective study in 529 PWUD who visited the"Ca?ada Real Galiana"(Madrid,Spain).The study period was from June 1,2017,to May 31,*** diagnosis was performed with a rapid antibody screening test at the point-of-care(POC)and HCV diagnosis with immunoassay and PCR tests on dried blood spot(DBS)in a central *** PWUD were referred to the *** used the Chi-square or Fisher’s exact tests,as appropriate,to compare rates between ***::Thirty-five(6.6%)participants were positive HIV antibodies,but 34 reported previous HIV diagnoses,and 27(76%)had prior antiretroviral *** patients with a positive HIV antibody test,we also found a higher prevalence of homeless(P<0.001)and injection drug use(PWID)(P<0.001),and more decades of drug use(P=0.002).All participants received HIV test results at the *** the 35 HIV positives,28(80%)were retained in HIV medical care at the end of the HIV screening study(2018),and only 22(62.9%)at the end of ***,12/35(34.3%)were positive for the HCV RNA *** the latter,10/12(83.3%)were contacted to deliver the HCV results test(delivery time of 19 days),5/12(41.7%)had an appointment and were attended at the hospital and started HCV therapy,and only 4/12(33.3%)cleared ***::We found almost no new HIV-infected PWUD,but their cascade of HIV care was low and remains a challenge in this population at *** high frequency of active hepatitis C in HIV-infected PWUD reflects the need for HCV screening and reinforcing the link to care.

关键词： HIV Point-of-care Screening People who use drugs Retention in care Hepatitis C Dried blood spot Antiviral treatment

Prevalence of sensitive skin and its biophysical response in a Mexican population

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World Journal of Dermatology 2013年第1期2卷 1-7页

作者： Diana Hernández-Blanco juan.pablo Castanedo-Cázares Adriana Ehnis-Pérez Isabel Jasso-ávila Luis Conde-Salazar Bertha torres-álvarez Department of Dermatology Hospital Central "Dr. Ignacio Morones Prieto" Instituto Nacional de Medicina y Seguridad en el Trabajo CNNT-Madrid

AIM: To describe the frequency and biophysical response of sensitive skin in Mexican subjects, using the lactic acid ***: The lactic acid stinging test was applied to 250 healthy volunteers, both sexes, 18 years of age or older, without any active dermatoses on the test site. Volunteers were university students, workers of public institutions, and general population from San Luis Potosi, Mexico. Participants were not excluded based on socioeconomic status. Demographic data were obtained through a questionnaire. Skin phototype was obtained through colorimetry. Subjects were randomized to receive 10% lactic acid on one nasolabial fold and placebo on the other side. The presence and intensity of adverse sensations, such as itching, burning, or stinging, was evaluated through a 10-point VisualAnalogue Scale(VAS) prior to treatment and at 3, 5, 8 and 10 min after the intervention. Subjects with a VAS of 2 or higher were considered positive for the test. A VAS lower than 2 was considered a normal response to skin manipulation. Simultaneously, biophysical changes and barrier function were assessed by colorimetry, transepidermal water loss(TEWL), and capacitance. To decrease measurement variations by skin manipulation, the nasolabial fold was segmented in four areas of 1 cm2 for each time measurement. Descriptive analyses were made using central tendency measures. Analyses of data were performed using two-tailed c2 test, Fisher's test, t-test, logistic regression, or Mann-Whitney U test for non-parametric values between groups. RESULTS: Of the included 246 subjects, 68% were women and the mean age was 32 years. The most frequent skin phototype was Ⅴ(ranges Ⅱ-Ⅴ). Thirty-six percent of the subjects identified themselves as having sensitive skin. Fifty-two percent of the subjects were positive to the lactic acid stinging test, with a mean VAS of 4.5 at 3 min. Subjects with the self-diagnosis of sensitive skin were more likely to be positive for the test(80% vs 36%, P

关键词： Sensitive skin Lactic acid test Transepidermal water loss Colorimetry Capacitance