Health and wellbeing of staff working at higher education institutions globally during the post-COVID-19 pandemic period: evidence from a cross-sectional study.

BACKGROUND: The ongoing global crisis of Higher Education (HE) institutions during the post-COVID-19 pandemic period has increased the likelihood of enduring psychological stressors for staff. This study aimed to identify factors associated with job insecurity, burnout, psychological distress and coping amongst staff working at HE institutions globally. METHODS: An anonymous cross-sectional study was conducted in 2023 with staff at HE institutions across 16 countries. Job insecurity was measured using the Job Insecurity Scale (JIS), burnout using the Perceived Burnout measure question, psychological distress using the Kessler Psychological Distress Scale (K10), and coping using the Brief Resilient Coping Scale. Multivariable logistic regression with a stepwise variable selection method was used to identify associations. RESULTS: A total of 2,353 staff participated; the mean age (± SD) was 43(± 10) years and 61% were females. Most staff (85%) did not feel job insecurity, one-third (29%) perceived burnout in their jobs, more than two-thirds (73%) experienced moderate to very high levels of psychological distress, and more than half (58%) exhibited medium to high resilient coping. Perceived job insecurity was associated with staff working part-time [Adjusted Odds Ratio 1.53 (95% Confidence Intervals 1.15-2.02)], having an academic appointment [2.45 (1.78-3.27)], having multiple co-morbidities [1.86 (1.41-2.48)], perceived burnout [1.99 (1.54-2.56)] and moderate to very high level of psychological distress [1.68 (1.18-2.39)]. Perceived burnout was associated with being female [1.35 (1.12-1.63)], having multiple co-morbidities [1.53 (1.20-1.97)], perceived job insecurity [1.99 (1.55-2.57)], and moderate to very high levels of psychological distress [3.23 (2.42-4.30)]. Staff with multiple co-morbidities [1.46 (1.11-1.92)], mental health issues [2.73 (1.79-4.15)], perceived job insecurity [1.61 (1.13-2.30)], and perceived burnout [3.22 (2.41-4.31)] were associated with moderate to very high levels of psychological distress. Staff who perceived their mental health as good to excellent [3.36 (2.69-4.19)] were more likely to have medium to high resilient coping. CONCLUSIONS: Factors identified in this study should be considered in reviewing and updating current support strategies for staff at HE institutions across all countries to reduce stress and burnout and improve wellbeing.

The influence of the prolactin/vasoinhibin axis on post-stroke lesion volume, astrogliosis, and survival.

Ischemic stroke is a significant global health issue, ranking fifth among all causes of death and a leading cause of serious long-term disability. Ischemic stroke leads to severe outcomes, including permanent brain damage and neuronal dysfunction. Therefore, decreasing and preventing neuronal injuries caused by stroke has been the focus of therapeutic research. In recent years, many studies have shown that fluctuations in hormonal levels influence the prognosis of ischemic stroke. Thus, it is relevant to understand the role of hormones in the pathophysiological mechanisms of ischemic stroke for preventing and treating this health issue. Here, we investigate the contribution of the prolactin/vasoinhibin axis, an endocrine system regulating blood vessel growth, immune processes, and neuronal survival, to the pathophysiology of ischemic stroke. Male mice with brain overexpression of prolactin or vasoinhibin by adeno-associated virus (AAV) intracerebroventricular injection or lacking the prolactin receptor (Prlr-/-) were exposed to transient middle cerebral artery occlusion (tMCAO) for 45 min followed by 48 h of reperfusion. Overexpression of vasoinhibin or the absence of the prolactin receptor led to an increased lesion volume and decreased survival rates in mice following tMCAO, whereas overexpression of prolactin had no effect. In addition, astrocytic distribution in the penumbra was altered, glial fibrillary acidic protein and S100b mRNA expressions were reduced, and interleukin-6 mRNA expression increased in the ischemic hemisphere of mice overexpressing vasoinhibin. Of note, prolactin receptor-null mice (Prlr-/-) showed a marked increase in serum vasoinhibin levels. Furthermore, vasoinhibin decreased astrocyte numbers in mixed hippocampal neuron-glia cultures. These observations suggest that increased vasoinhibin levels may hinder astrocytes' protective reactivity. Overall, this study suggests the involvement of the prolactin/vasoinhibin axis in the pathophysiology of ischemic stroke-induced brain injury and provides insights into the impact of its dysregulation on astrocyte reactivity and lesion size. Understanding these mechanisms could help develop therapeutic interventions in ischemic stroke and other related neurological disorders.

Prolactin Inhibits or Stimulates the Inflammatory Response of Joint Tissues in a Cytokine-dependent Manner.

The close association between rheumatoid arthritis (RA), sex, reproductive state, and stress has long linked prolactin (PRL) to disease progression. PRL has both proinflammatory and anti-inflammatory outcomes in RA, but responsible mechanisms are not understood. Here, we show that PRL modifies in an opposite manner the proinflammatory actions of IL-1ß and TNF-α in mouse synovial fibroblasts in culture. Both IL-1ß and TNF-α upregulated the metabolic activity and the expression of proinflammatory factors (Il1b, Inos, and Il6) via the activation of the nuclear factor-κB (NF-κB) signaling pathway. However, IL-1ß increased and TNF-α decreased the levels of the long PRL receptor isoform in association with dual actions of PRL on synovial fibroblast inflammatory response. PRL reduced the proinflammatory effect and activation of NF-κB by IL-1ß but increased TNF-α-induced inflammation and NF-κB signaling. The double-faceted role of PRL against the 2 cytokines manifested also in vivo. IL-1ß or TNF-α with or without PRL were injected into the knee joints of healthy mice, and joint inflammation was monitored after 24 hours. IL-1ß and TNF-α increased the joint expression of proinflammatory factors and the infiltration of immune cells. PRL prevented the actions of IL-1ß but was either inactive or further increased the proinflammatory effect of TNF-α. We conclude that PRL exerts opposite actions on joint inflammation in males and females that depend on specific proinflammatory cytokines, the level of the PRL receptor, and the activation of NF-κB signaling. Dual actions of PRL may help balance joint inflammation in RA and provide insights for development of new treatments.

Dual Roles of Prolactin and Vasoinhibin in Inflammatory Arthritis.

The term inflammatory arthritis defines a family of diseases, including rheumatoid arthritis (RA), caused by an overactive immune system, and influenced by host aspects including sex, reproductive state, and stress. Prolactin (PRL) is a sexually dimorphic, reproductive, stress-related hormone long-linked to RA under the general assumption that it aggravates the disease. However, this conclusion remains controversial since PRL has both negative and positive outcomes in RA that may depend on the hormone circulating levels, synthesis by joint tissues, and complex interactions at the inflammatory milieu. The inflamed joint is rich in matrix metalloproteases that cleave PRL to vasoinhibin, a PRL fragment with proinflammatory effects and the ability to inhibit the hyperpermeability and growth of blood vessels. This review addresses this field with the idea that explanatory mechanisms lie within the PRL/vasoinhibin axis, an integrative framework influencing not only the levels of systemic and local PRL, but also the proteolytic conversion of PRL to vasoinhibin, as vasoinhibin itself has dual actions on joint inflammation. In this review, we discuss recent findings from mouse models suggesting the upregulation of endogenous vasoinhibin by the pro-inflammatory environment and showing dichotomous actions and signaling mechanisms of PRL and vasoinhibin on joint inflammation that are cell-specific and context-dependent. We hypothesize that these opposing actions work together to balance the inflammatory response and provide new insights for understanding the pathophysiology of RA and the development of new treatments.

Vasoinhibin is Generated and Promotes Inflammation in Mild Antigen-induced Arthritis.

Inflammatory arthritis defines a family of diseases influenced by reproductive hormones. Vasoinhibin, a fragment of the hormone prolactin (PRL), has antiangiogenic and proinflammatory properties. We recently showed that vasoinhibin reduces joint inflammation and bone loss in severe antigen-induced arthritis (AIA) by an indirect mechanism involving the inhibition of pannus vascularization. This unexpected finding led us to hypothesize that a severe level of inflammation in AIA obscured the direct proinflammatory action of vasoinhibin while allowing the indirect anti-inflammatory effect via its antiangiogenic properties. In agreement with this hypothesis, here we show that the intra-articular injection of an adeno-associated virus type-2 vector encoding vasoinhibin reduced joint inflammation in a severe AIA condition, but elevated joint inflammation in a mild AIA model. The proinflammatory effect, unmasked in mild AIA, resulted in joint swelling, enhanced leukocyte infiltration, and upregulation of expression of genes encoding proinflammatory mediators (Il1b, Il6, Inos, Mmp3), adhesion molecule (Icam1), and chemokines (Cxcl1, Cxcl2, Cxcl3, Ccl2). Furthermore, vasoinhibin induced the expression of proinflammatory mediators and chemokines in cultured synovial fibroblasts through nuclear factor-κB. Finally, matrix metalloproteases and cathepsin D, upregulated in the arthritic joint, cleaved PRL to vasoinhibin, and vasoinhibin levels increased in the circulation of mice subjected to AIA. We suggest that vasoinhibin is generated during inflammatory arthritis and acts on synovial fibroblasts and endothelial cells to initially promote and later inhibit inflammation, respectively. These opposite effects may work together to help keep joint inflammation under balance.

Vasoinhibin reduces joint inflammation, bone loss, and the angiogenesis and vasopermeability of the pannus in murine antigen-induced arthritis.

Increased permeability and growth (angiogenesis) of blood vessels play a key role in joint swelling and pannus formation in inflammatory arthritis, a family of diseases influenced by reproductive hormones. The hormone prolactin (PRL) protects against joint inflammation, pannus formation, and bone destruction in adjuvant-induced arthritis and these effects may involve its proteolytic conversion to vasoinhibin, a PRL fragment that inhibits angiogenesis and vasopermeability. Here, we show that the intra-articular injection of an adeno-associated virus type-2 (AAV2) vector encoding vasoinhibin reduced joint inflammation, the hyperplasia, vascular density, and vasopermeability of the pannus, and the loss of bone in mice subjected to antigen-induced arthritis. In agreement, the AAV2 vasoinhibin vector reduced the expression of proinflammatory cytokines (interleukin-1ß, interleukin-6), an endothelial cell marker (platelet endothelial cell-adhesion molecule 1), and proangiogenic molecules [vascular endothelial growth factor (VEGF), VEGF receptor 2, and hypoxia-inducible factor 1α] in the arthritic joint. Also, vasoinhibin reduced the synovial vasopermeability induced by the intra-articular injection of VEGF in healthy mice. Finally, vasoinhibin signals by blocking the phosphorylation/activation of endothelial nitric oxide synthase (eNOS) at Ser1179 and the AAV2 vasoinhibin vector inhibited the enhanced phosphorylation of eNOS Ser1179 in the arthritic joint. We conclude that vasoinhibin reduces joint inflammation and bone loss in arthritis by inhibiting pannus angiogenesis and vasopermeability via the blockage of VEGF-induced eNOS activation. These findings suggest the potential therapeutic benefit of AAV2-mediated vasoinhibin gene delivery in arthritis.

Repeated Paced Mating Increases the Survival of New Neurons in the Accessory Olfactory Bulb.

In female rats, the first sexual experience under paced mating conditions increases the number of newborn cells that migrate into the granular layer of the accessory olfactory bulb (AOB). Repeated paced mating has a potentiating effect on the number of new neurons that migrate to the AOB compared with a single session 15 days after paced mating. On the other hand, one paced mating session does no increases the survival of new cells 45 days after mating. In the present study, we evaluated if four paced mating sessions could increase the survival of new neurons in the AOB and main olfactory bulb (MOB) 45 days after females mated. Sexually naive female rats were ovariectomized, hormonally supplemented and randomly assigned to one of five groups: (1) Control, no sexual contact (C); (2) Four sessions in which females were exposed, without mating, to a sexually experience male rat (SE); (3) One session of paced mating (PM1); (4) Four sessions of paced mating (PM4); and (5) Four sessions of non-paced mating (NPM4). In the first behavioral test, females received the DNA synthesis marker 5-bromo-2'deoxyuridine and were euthanized 45 days later. Our data showed that the number of new cells that survived in the mitral cell layer of the AOB decreased when females were exposed to a sexually active male, in comparison to females that mated once pacing the sexual interaction. Repeated sexual behavior in pacing conditions did not increase the survival of new cells in other layers of the MOB and AOB. However, a significant increase in the percentage of new neurons in the granular and glomerular layers of the AOB and granular layer of the MOB was observed in females that mated in four sessions pacing the sexual interaction. In the group that paced the sexual interaction for one session, a significant increase in the percentage of neurons was observed in the glomerular layer of the AOB. Our data suggest that repeated paced mating increases the percentage of new neurons that survive in the olfactory bulb of female rats.

Reduced fish diversity despite increased fish biomass in a Gulf of California Marine Protected Area.

Multi-use marine protected areas (MUMPAs) are a commonly applied tool for marine conservation in developing countries, particularly where large no-take reserves are not socially or politically feasible. Although MUMPAs have produced benefits around the world, the persistence of moderate fishing pressure reduces the likelihood of achieving the primary objective of these areas, which is the conservation of ecosystems. In this study we used traditional and functional metrics to evaluate how fish assemblages changed through time in a MUMPA, including shifts in species responses and in ecological processes. We conducted visual censuses of fishes at Espíritu Santo Island, México (MUMPA; N = 320; 24°N, 110°W) from 2005 to 2017 to assess fish richness, size-distribution and density. Three functional indices were calculated using six traits (size, mobility, period of activity, aggregation, position in water column and diet): functional richness (volume occupied by species), dispersion (complementarity between species) and originality (inverse of functional redundancy). We compared fish diversity among three management zone types (sustainable fishing, traditional fishing and no-take zones), through a 13-year period, assessing which species increased or decreased in occurrence, density, and biomass, and how indices respond over time. Despite a general increase in biomass and stability in density and originality, we detected a reduction in fish biodiversity in the form of declines in species and functional richness, which could imply the risk of local extinction and decrease in certain ecosystem processes. In addition, changes in functional dispersion showed that some functions are losing representation through time. Although no single cause is apparent, such factors as competitive interactions, habitat loss and persistence of fishing pressure potentially explain these decreases. The rise in biomass was associated with a general increase in the average size, rather than increased biomass of commercial species, as the latter remained stable during the study period. Expansion of no-take areas, enforcement of fishing regulations, and surveillance in core zones, should be implemented to reverse the decline in particular species and to promote conservation of fish functional diversity in this MUMPA.

Prolactin blocks the expression of receptor activator of nuclear factor κB ligand and reduces osteoclastogenesis and bone loss in murine inflammatory arthritis.

BACKGROUND: Prolactin (PRL) reduces joint inflammation, pannus formation, and bone destruction in rats with polyarticular adjuvant-induced arthritis (AIA). Here, we investigate the mechanism of PRL protection against bone loss in AIA and in monoarticular AIA (MAIA). METHODS: Joint inflammation, trabecular bone loss, and osteoclastogenesis were evaluated in rats with AIA treated with PRL (via osmotic minipumps) and in mice with MAIA that were null (Prlr-/-) or not (Prlr+/+) for the PRL receptor. To help define target cells, synovial fibroblasts from Prlr+/+ mice were treated or not with proinflammatory cytokines ((Cyt), including TNFα, IL-1ß, and interferon (IFN)γ) with or without PRL, and these synovial cells were co-cultured or not with bone marrow osteoclast progenitors from Prlr+/+ or Prlr-/- mice. RESULTS: In AIA, PRL treatment reduced joint swelling, increased trabecular bone area, lowered osteoclast density, and reduced mRNA levels of osteoclast-associated genes (tartrate-resistant acid phosphatase (Trap)), cathepsin K (Ctsk), matrix metalloproteinase 9 (Mmp9), and receptor activator of nuclear factor κB or RANK (Tnfrsf11a)), of genes encoding cytokines with osteoclastogenic activity (Tnfa, Il1b, Il6, and receptor activator of nuclear factor κB ligand or RANKL (Tnfrsf11)), and of genes encoding for transcription factors and cytokines related to T helper (Th)17 cells (Rora, Rorc, Il17a, Il21, Il22) and to regulatory T cells (Foxp3, Ebi3, Il12a, Tgfb1, Il10). Prlr-/- mice with MAIA showed enhanced joint swelling, reduced trabecular bone area, increased osteoclast density, and elevated expression of Tnfa, Il1b, Il6, Trap, Tnfrsf11a, Tnfrsf11, Il17a, Il21, Il22, 1 l23, Foxp3, and Il10. The expression of the long PRL receptor form increased in arthritic joints, and in synovial membranes and cultured synovial fibroblasts treated with Cyt. PRL induced the phosphorylation/activation of signal transducer and activator of transcription-3 (STAT3) and inhibited the Cyt-induced expression of Il1b, Il6, and Tnfrsf11 in synovial fibroblast cultures. The STAT3 inhibitor S31-201 blocked inhibition of Tnfrsf11 by PRL. Finally, PRL acted on both synovial fibroblasts and osteoclast precursor cells to downregulate Cyt-induced osteoclast differentiation. CONCLUSION: PRL protects against osteoclastogenesis and bone loss in inflammatory arthritis by inhibiting cytokine-induced expression of RANKL in joints and synovial fibroblasts via its canonical STAT3 signaling pathway.

Densidad poblacional y distribución espacial de erizos de mar (Echinodermata: Echinoidea) en la Isla Socorro, Archipiélago de Revillagigedo, México / Population density and spatial distribution of sea urchins (Echinodermata: Echinoidea) at Socorro island, Revillagigedo archipelago, Mexico

Resumen Los estudios sobre los equinodermos de la costa del Pacifico de México se han enfocado en la taxonomía y biogeografía y hay escasos datos sobre ecología comunitaria o poblacional del grupo. En el presente trabajo analizamos los cambios estacionales de la densidad poblacional y la distribución espacial de cuatro especies de erizos regulares (Diadema mexicanum, Echinometra mathaei oblonga. Eucidaris thouarsii y Tripneustes depressus) en tres bahías de la Isla Socorro, Archipiélago de Revillagigedo, México. Las especie más abundante en la isla fue E. mathaei oblonga (3.96 + 0.83 ind m-2; promedio y error típico), seguida de D. mexicanum (2.13 + 0.59 ind m-2), T. depressus y E. thouarsii (entre 0.50 y 0.11 ind m-2, respectivamente). La Bahía Binners tuvo la mayor densidad con 15.98 + 0.43 ind m-2, en gran medida debido a la alta incidencia de E. mathaei oblonga en el sitio. Estacionalmente, T. depressus y E. thouarsii no variaron significativamente su abundancia durante el año, pero D. mexicanum fue más abundante en invierno-primavera, y E. mathaei oblonga en el otoño. En relación al patrón de distribución espacial, dos de las especies (D. mexicanum y E. mathaei oblonga) presentaron una distribución agregada a lo largo del año y en las tres localidades de estudio, pero los otros dos equinoideos se dispusieron de forma azarosa. Hay varias razones para explicar el comportamiento de agregación en erizos de mar, pero para el caso de Isla Socorro aquí se argumenta a favor de que es un modo de defensa contra los abundantes peces depredadores que habitan los arrecifes. En contraste, las especies que no muestran agrupaciones residen en refugios durante el día (E. thouarsii) o bien su morfología y tamaño dificultan su captura por los peces (T. depressus).

Abstract The studies on echinoderms of the Mexican Pacific have focused on taxonomy and biogeography, and there are limited data on their ecology. We used transect to study Diadema mexicanum, Echinometra mathaei oblonga, Eucidaris thouarsii and Tripneustes depressus at three bays in Socorro Island, Revillagigedo Archipelago, Mexico (1989 and 1990). The most abundant species in the island was E. mathaei oblonga (3.96 + 0.83 ind m-2; average and standard error), followed by D. mexicanum (2.13 + 0.59 ind m-2), T. depressus and E. thouarsii (between 0.50 and 0.11 ind m-2, respectively). Binners Bay had the highest density with 15.98 + 0.43 ind m-2, mostly due to the high incidence of E. mathaei oblonga at the site. Seasonally, T. depressus and E. thouarsii did not significantly varied its abundance during the year, while D. mexicanum was more abundant in winter-spring, and E. mathaei oblonga in the fall. Two species (D. mexicanum and E. mathaei oblonga) had an aggregated distribution along the year and in the three study locations, but the other two echinoids followed a random distribution. This may be a defense against the abundant predatory fishes. In contrast, the species that do not aggregate inhabit in refuges during the day (E. thouarsii), or their shape and size makes them difficult to capture by fishes (T. depressus). Rev. Biol. Trop. 63 (Suppl. 2): 221-232. Epub 2015 June 01.

¿Qué sabemos? ¿qué hacemos? ¿por qué lo hacemos? usando antibióticos en infecciones pediátricas / What do we know? What do we do? Why do we do it? using antibiotics in pediatric infections

El uso inadecuado de antibióticos involucra al prescriptor: sobre él influyen diversos factores académicos, sociales, ambientales, económicos, culturales y políticos; ocurre principalmente en el primer nivel de atención en el área pediátrica.Objetivos: Determinar conocimientos, actitudes y prácticas en la prescripción de antibióticos en infecciones prevalentes respiratorias y diarreicas en menores de 5 años. Metodología: Estudio transversal realizado en la región amazónica Morona Santiago, Área de Salud 3, Ecuador. Se valoraron conocimientos y actitudes al universo de 16 prescriptores, mediante casos clínicos elaborados por Herranz, adaptados al medio, relacionados a rinofaringitis, otitis media aguda, neumonía, bronquiolitis, gastroenteritis; para las prácticas se revisaron el universo de 225 historias clínicas de niños diagnosticados en los dos meses previos. La prescripción se valoró mediante los protocolos actualizados de la Organización Panamericana de la Salud. Se tabuló mediante SPSS y se utilizó estadística descriptiva como promedios, frecuencias y porcentajes.Resultados: Existió dificultad en la prescripción de otitis media aguda, neumonía, gastroenteritis bacteriana, especialmente en dosis y duración. La prescripción inadecuada en rinofaringitis fue similar tanto en la teoría como en la práctica (18,7%). El caso de rinosinusitis fue poco diagnosticado (31,3%); en la práctica no se mencionó algún caso. Frente al cuadro hipotético que superpone datos para neumonía como bronquiolitis, el 75% lo diagnosticó como neumonía; en la práctica ningún diagnóstico indicó bronquiolitis. Conclusiones: Existe dificultad en la prescripción de antibióticos siendo necesaria la implementación de un programa integral de educación continua sobre Uso Racional de Antibióticos que considere factores asociados tales como: contexto laboral, ecosistema, nivel socio-económico y cultural de sus pacientes, rol del sistema de salud, y organización política entre otros.

Inappropriate use of antibiotics involves prescribers and occurs mainly in the primary health care units. Academic, social, environmental, economic, cultural and political factors are linked to this health problem. Objectives: To determine knowledge, attitudes and practices in antibiotic prescription in respiratory and diarrheal prevalent infectious affecting children under 5 years.Methods: Cross-sectional study conducted in Morona Santiago province, Health Area: 3, Ecuador.Knowledge and attitudes to the world of prescri-berswere assessed using hypothetical clinical cases made by Herranz, adapted to the environment, about rinopharyngitis, acute otitis media, pneumonia, bronchiolitis, gastroenteritis. The practice was evaluated through the clinical histories of 225 children diagnosed two months before. The pres-cription was analyzed according to Pan American Health Organization protocols. It was tabulated using SPSS and analyzed using descriptive statistics as means, frequencies and percentages. Results: There was difficulty in the acute otitis media, pneumonia, bacterial gastroenteritis prescription; especially in doses and treatment duration. Inappropriate prescription in nasopharyngitis was similar in both theory and practice (18.7%). The rhinosinusitis was diagnosed in the 31.3%; in the practice none case was mentioned. In the hypothetical cli-nical case about low respiratory infection, 75% was diagnosed like pneumonia; in the practice none bronchiolitis case was diagnosed.Conclusions: There is difficulty in prescribing antibiotics. A comprehensive program of continuing education on rational use of antibiotics is being neces-sary. Analysis of the associated factors such as: the employment and ecosystem context, ecosystem, socio economic and cultural level of their patients, the role of health system, and political organization, should be considered.

Coral-associated decapods (Crustacea) from the Mexican Tropical Pacific coast.

Our study provides a checklist of 36 crustacean decapods from the Mexican tropical Pacific coastline. Most of the species were previously recorded from coral communities in the Gulf of California. Data were obtained by visual censuses of coral communities and some specimens were collected by extractions of coral branches (approximately eight liters of coral volume). We found new geographic records for three species from the Eastern Pacific and seven species that have extended ranges into Mexican waters. Only one species is documented with a northerly range from Central America to Mexican waters.

Determinants of blood-lead levels in children in Callao and Lima metropolitan area.

OBJECTIVES: To determine blood lead levels in urban populations of children (n = 2,510) and women (n = 874) in the early postpartum in certain districts of Lima and Callao, and to correlate those levels with particular exposures. MATERIAL AND METHODS: Between July 1998 and January 1999 cross sectional study was conducted. The study population was selected using three sampling strategies in the government operated school system and from public pediatric and maternity hospitals at Lima and Callao, Peru. Study personnel were trained to collect finger stick blood samples with a protocol that minimizes external lead contamination. Lead determinations in blood and environmental samples were performed at the study site using portable anodic striping voltamenters. To determine the simultaneous effects of different predictors on blood lead levels, multivariate regression models were used to estimate adjusted mean differences. RESULTS: The mean blood lead level in the children studied was 9.9 micrograms/dl ranging from 1 microgram/dl to 64 micrograms/dl with 29% of the children displaying values greater than 10 micrograms/dl and 9.4% at levels greater than 20 micrograms/dl. Among the women, the mean was 3.5 micrograms/dl (SD = 2.4 micrograms/dl), and 2.4% (n = 21) displayed levels greater than 10 micrograms/dl. Important differences were observed between the sample locations, and the highest levels were documented in the port region near Callao. The mean level of blood lead in this group was 25.6 micrograms/dl (SD = 4.6 micrograms/dl), while among the rest of the sample it was 7.1 micrograms/dl (SD = 5.1 micrograms/dl). The presence of a mineral storage area signified a difference in exposure in excess of 13 micrograms/dl for children living near the port area in contrast to the other children who were not as close to such fixed sources of lead exposure. For the participants in Lima, the risk of showing levels above 10 micrograms/dl was associated with exposure to high vehicular traffic. CONCLUSIONS: In metropolitan Lima, we conclude that the mean blood lead levels of the populations studied were not alarming and that a positive health impact can be made by a reduction of lead in gasoline. With regard to the port area, the study demonstrates that the presence of mineral storage areas pose a detrimental risk factor for the health of the children living in this area. The English version of this paper is available too at: http://www.insp.mx/salud/index.html.

Determinants of blood-lead levels in children in Callao and Lima metropolitan area

OBJETIVO: Determinar los niveles de plomo en sangre en una muestra compuesta por niños y mujeres en el posparto temprano, residentes en Lima y El Callao. Investigar los determinantes de estos niveles y algunas fuentes de exposición. MATERIAL Y MÉTODOS: Entre julio de 1998 y enero de 1999 se llevó a cabo una encuesta en el área metropolitana de Lima y en El Callao, Perú. La población de estudio fue identificada mediante tres estrategias de muestreo y con la cual se seleccionaron escuelas públicas y hospitales pediátricos y gineco-obstétricos. El personal que participó en el estudio recibió entrenamiento para la técnica de punción digital y puso especial énfasis en controlar la contaminación externa con plomo. Las determinaciones del metal en sangre y muestras ambientales se llevaron a cabo utilizando voltametría anódica. Para determinar los efectos simultáneos de diferentes predictores sobre los niveles de plomo en sangre se usaron modelos de regresión multivariada para estimar diferencias de media y ajustadas. RESULTADOS: Los niveles promedio de plomo en sangre fueron de 9.9 µg/dl de una variación entre 0 y 64 µg/dl. El 29 y 9.4% de los niños presentaron valores por encima de 10 µg/dl y 20 µg/dl,respectivamente. Para las mujeres el promedio de plomo en sangre fue de 3.5 µg/dl (DE=2.4) y 2.4% (n=2l) presentaron niveles superiores a 10 µg/dl. Se observaron diferencias importantes en relación con el sitio de residencia; los niveles más altos se documentaron en la zona de El Callao. Para este grupo la media de plomo en sangre fue de 25.6 µg/dl (DE=4.6) mientras que para el resto de la muestra el promedio de plomo en sangre fue de 7.1 µg/dl (DE=5.l). En esta zona se detectó un área de almacenamiento de minerales como una fuente importante de exposición. Los niños que viven cerca de esta área tenían en promedio un exceso de 13 µg/dl en sangre. Para los participantes de la zona de Lima el riesgo de presentar niveles por encima de 10 µg/dl se asoció con la exposición a tráfico vehicular. CONCLUSIONES: Para Lima Metropolitana se puede concluir que los niveles de plomo en sangre no representan un problema urgente, sin embargo, el reducir el plomo de la gasolina se acompaña de un beneficio importante. En contraste, para el área cercana al puerto de El Callao, nuestro estudio demuestra la presencia de sitios de almacenamiento de minerales que representan un riesgo importante para la salud de los niños que viven en esta zona.

Bacterias anaeróbicas en hemocultivo / Anaerobic bacteria in hemocultures

Se estudiaron 6 178 muestras de hemocultivos tomadas a pacientes ingresados. Durante el año 1985 se cultivaron 3 154 muestras por el método anterior de cultivo aerobio, se logró una positividad de 18,8 %. A partir de enero de 1987 se comenzó un nuevo método que incluyó un medio de cultivo único para bacterias aerobias y facultativas, hongos y bacterias anaerobias, se procesaron 3 024 muestras y se alcanzó una positividad total del 22,6 %; de éstas el 91,6 % correspondió a bacterias aerobias y facultativas, el 6,2 a bacterias anaerobias y el 2,2 a hongos levaduriformes. Para lograr las condiciones de anaerobiosis se empleó el sistema "Anaerocult P" de la fábrica Merck (alemán), que resultó de gran utilidad práctica, permitió aislar 42 cepas anaerobias pertenecientes a 5 especies diferentes