Identifying gaps on health impacts, exposures, and vulnerabilities to climate change on human health and wellbeing in South America: a scoping review.

There is an important gap in regional information on climate change and health, limiting the development of science-based climate policies in South American countries. This study aims to identify the main gaps in the existing scientific literature on the impacts, exposure, and vulnerabilities of climate change on population health. A scoping review was performed guided by four sub-questions focused on the impacts of climate change on physical and mental health, exposure and vulnerability factors of population to climate hazards. The main findings showed that physical impacts mainly included infectious diseases, while mental health impacts included trauma, depression, and anxiety. Evidence on population exposure to climate hazards is limited, and social determinants of health and individual factors were identified as vulnerability factors. Overall, evidence on the intersection between climate change and health is limited in South America and has been generated in silos, with limited transdisciplinary research. More formal and systematic information should be generated to inform public policy. Funding: None.

Association between prehospital lactate categories with short- and long-term mortality: a prospective, observational multicenter study.

BACKGROUND: Lactate is an already recognized biomarker for short-term mortality in emergency medical services (EMS). However, how different levels of lactate are associated with short-, mid- and long-term outcomes should be unveiled. AIM: To determine how different categories of hyperlactatemia are associated with mortality. We also aim to clinically characterize hyperlactatemia groups. DESIGN: A multicenter, prospective, observational study performed between January 2019 and February 2022, considering 48 basic life support units and 5 advanced life support units referring to 4 tertiary care hospitals (Spain). Patients were recruited from phone requests for emergency assistance in adults, evacuated to emergency departments. The primary outcome was in-hospital mortality from any cause within the first to the 365-day period following EMS attendance. The main measures were demographical and biochemical variables, prehospital advanced life support techniques used and patient condition categorized in 24 diseases. METHODS: Univariate and Cox regression analysis. RESULTS: A total of 5072 participants fulfilled inclusion criteria. Group #1 (non-hyperlactatemia) was composed of 2389 subjects (47.1%), Group #2 (mild hyperlactatemia) of 1834 (36.1%), Group #3 (hyperlactatemia) of 333 (6.6%) and, finally, Group #4 (severe hyperlactatemia) of 516 (10.2%). The 1-day mortality was 0.2%, 1.1%, 9% and 22.3% in the four lactate groups, respectively. Long-term mortality (365 days) was 10.2%, 22.7%, 38.7% and 46.7% in the four lactate groups, respectively. Differences between patients' conditions of lactatemia groups were also found. CONCLUSIONS: Our results demonstrated that prehospital lactate categories were associated with short- and long-term outcomes in a different manner. These results will allow EMS to establish different risk states according to the prehospital lactate categories.

Scattering of light by ZnO nanorod arrays.

The optical properties of ZnO nanorod (NR) arrays were investigated by optical total transmittance (TT) and diffuse reflectance (DR) spectroscopy in the visible region. The NRs were grown electrochemically in a three-electrode cell over a glass/fluorine-doped tin oxide (FTO) substrate. The mean length, radius, and density of NR samples were characterized by scanning electron microscopy. The results were correlated with the observed optical properties. Since light scattering for these NR arrays is highly dependent on their morphology, therefore, a model for light scattering based in the Mie theory for cylinders was implemented to understand the observed spectra. The mean scattering and extinction cross sections were calculated from the morphology of the samples. They were used to fit the DR spectra. From the fittings, the TT spectra of the samples could be calculated. A good agreement with the experimental results was obtained. This indicates that the implemented model represents well the observed scattering phenomena.

A solid-state integrated photo-supercapacitor based on ZnO nanorod arrays decorated with Ag2S quantum dots as the photoanode and a PEDOT charge storage counter-electrode.

A planar solid-state photocapacitor with two electrodes has been prepared for the first time using a passivated film of ZnS with Ag2S quantum dots deposited on ZnO nanorods, which were electrochemically grown on ZnO seed layers, as the photoanode. The supercapacitor part is composed of a electrodeposited poly(3,4-ethylene-dioxythiophene) PEDOT film as the counter-electrode and an ionic liquid-based electrolyte between them deposited by the dip coating method. The different nanostructures and electrodes were morphologically and structurally characterized, and the device was electrochemically characterized and could reach a potential of 0.33 V during photocharge and a storage efficiency of 6.83%.

A new concept of a transparent photocapacitor.

A solid-state transparent photocapacitor has been prepared for the first time by the use of two transparent electrodes (TiO2 and LiFeO2) and also a transparent ion gel-based electrolyte between them, reaching a transmittance of 57% at λ = 555 nm, a specific capacitance of 2.98 µF cm-2 and a specific energy of 0.54 µJ cm-2.

Reporte clínico: registro piezográfico de la zona neutra, en un paciente con espasmos musculares involuntarios / Clinical report: piezographyc record of the neutral zone in a complete edentulous patient with involuntary muscle spasms

Toda función del sistema estomatognático involucra la acción sinérgica de la musculatura paraprotética, representada por estructuras complejas tales como lengua, labios, mejillas y piso de boca. Al rehabilitar a través de prótesis completas no siempre se considera la influencia de la dinámica muscular, y menos aún cuando alguna de estas estructuras presenten alguna patología, por ejemplo, el compromiso del nervio facial que genera espasmos musculares involuntarios. En tal situación, la ubicación de los dientes y la forma de las superficies pulidas pueden llegar a ser decisivos entre éxito o fracaso de la rehabilitación. Se sabe que los implantes oseointegrados proveen retención, soporte y estabilidad, sin embargo existen situaciones especiales en que no es posible acceder a este tipo de tratamiento, tanto por razones médico quirúrgicas o costos asociados. En este estudio se ha utilizado un registro Piezográfico de la Zona Neutra en un paciente con compromiso del nervio facial que genera espasmos musculares involuntarios del lado afectado, obteniéndose una rehabilitación protésica basada en la apropiada relación entre superficie protésica externa y tejidos circundantes, mejorando requisitos funcionales tales como retención y estabilidad. Se ha utilizado el sistema de tomografía computarizada Cone Beam, con el objetivo de evidenciar el registro piezográfico. Los resultados obtenidos con estas prótesis piezográficas demuestran ser superior en factores como comodidad y fonoarticulación pero inferior en eficiencia masticatoria comparada con la técnica convencional.

Every function of the stomatognathic system involves the synergistic action of the musculature around the prosthesis, consisting of complex and individual structures such as tongue, lips, cheeks and mouth floor. When planning and making complete prostheses, the muscular dynamic is not always considered. This can generate instability of the device during function, the location of the artificial teeth is made arbitrarily on the top and middle parts of the flange, and the configuration of the polished areas is made according to mechanistic concepts. This factor takes more relevance in patients with severe atrophy of their residual flanges, where the prosthetic stability can be a decisive factor between the success or failure of the rehabilitation. It is known that the osseointegrated implants provide retention, support and stability. However, there are special situations in which it is not possible to access to this type of treatment, both for medical surgical reasons or associated costs. In this study, a Piezographyc record of the Neutral Zone was used in a patient with facial nerve involvement generating involuntary muscle spasms of the affected side. A prosthetic rehabilitation based on the appropriate relation between external prosthetic surface and surrounding tissues was obtained, improving functional requirements such as retention and stability. The computerized tomographic Cone Beam system was used, with the objective to show the piezographic record. The results obtained with these piezographic prostheses prove to be superior in factors like comfort and speech articulation, but inferior in masticatory efficiency, where the conventional technique is still better.

Naftifine cream in the treatment of cutaneous candidiasis.

Naftifine, a member of a new class of synthetic antifungal drugs, the allylamines, was evaluated for the treatment of cutaneous candidiasis. In a double-blind, parallel-group clinical trial, sixty patients with cutaneous candidiasis were randomly assigned to receive either naftifine cream 1 percent or its vehicle twice a day for three weeks. Two weeks after the end of therapy, 77 percent of the naftifine-treated patients were mycologically cured (negative results on potassium hydroxide preparations and culture) and had no clinically apparent disease, compared with 3 percent of the patients treated with vehicle (p less than 0.001). Side effects reported with naftifine cream were few and minor.

Bifonazole cream in the treatment of superficial candidosis. A double-blind comparative study.

This is the summary of a prospective, randomized, double-blind study comparing four therapeutic regimens: bifonazole cream applied once or twice daily, clotrimazole and placebo twice daily during 4 weeks for the treatment of cutaneous candidosis. The study is multicentric and was accomplished in four centres of different climate: Costa Rica, Dominican Republic, Sweden and Yugoslavia. The trial was carried out with approximately identical numbers of patients: 275 in total. The duration of treatment was 4 weeks and the check-ups were done before, during and 2 weeks after the end of the therapy. The results have shown the great efficacy of bifonazole cream (65-75%) in comparison to placebo (19.4%). There was no significant difference in applying bifonazole cream once or twice daily. So the reasonable therapy with bifonazole as to apply it only once a day, is confirmed. The excellent tolerance and absence of side-effects in such an extended study have once more proved the value of this antimycotic in topical treatment of cutaneous candidosis.

Liquen plano eritematoso. / Erythematosus lichen planos

Se presenta y comenta el caso de un hombre de 65 con una dermatosis que clinicamente surgio el diagnostico de liquen plano eritematoso, rara variedad de liquen plano cuya histopatologia no es definitiva para el diagnostico. En este caso nuestros hallazgos histopatologicos concuerdan con los de Arnold. Consideramos que el presente podria ser el primer caso de esta entidad en Centroamerica

[Treatment of chromoblastomycosis with amphotericin B and 5-fluorocytosine]. / Tratamiento de la cromoblastomicosis con anfotericina B y 5-fluorocitosina.

The authors are confirming the efficacy of the combination of Anfotericina B y 5-fluorocitosine in the treatment of Cromoblastomicosis. The used program was as follows: 50 mg. of Anfotericine-B by intravenous injection every two days during 13 weeks (39 dosis). Simultaneously tablets of 500 mg. of 5-fluorocitesina, every 6 hours, oral, also daily during 13 weeks (194 gramos dosis total) were given. The two treated patients were under monthly control during 10 months and observing no relapse of the disease, with other words there exists already a clinical and histological cure (healing). In one case it was observed a change in the ble blood chemistry which spontaneously normalized when suspending the combined treatment for one week and did not repeat when starting a new treatment.