The 10,000-year biocultural history of fallow deer and its implications for conservation policy.

Over the last 10,000 y, humans have manipulated fallow deer populations with varying outcomes. Persian fallow deer (Dama mesopotamica) are now endangered. European fallow deer (Dama dama) are globally widespread and are simultaneously considered wild, domestic, endangered, invasive and are even the national animal of Barbuda and Antigua. Despite their close association with people, there is no consensus regarding their natural ranges or the timing and circumstances of their human-mediated translocations and extirpations. Our mitochondrial analyses of modern and archaeological specimens revealed two distinct clades of European fallow deer present in Anatolia and the Balkans. Zooarchaeological evidence suggests these regions were their sole glacial refugia. By combining biomolecular analyses with archaeological and textual evidence, we chart the declining distribution of Persian fallow deer and demonstrate that humans repeatedly translocated European fallow deer, sourced from the most geographically distant populations. Deer taken to Neolithic Chios and Rhodes derived not from nearby Anatolia, but from the Balkans. Though fallow deer were translocated throughout the Mediterranean as part of their association with the Greco-Roman goddesses Artemis and Diana, deer taken to Roman Mallorca were not locally available Dama dama, but Dama mesopotamica. Romans also initially introduced fallow deer to Northern Europe but the species became extinct and was reintroduced in the medieval period, this time from Anatolia. European colonial powers then transported deer populations across the globe. The biocultural histories of fallow deer challenge preconceptions about the divisions between wild and domestic species and provide information that should underpin modern management strategies.

Identification of constrained sequence elements across 239 primate genomes.

Noncoding DNA is central to our understanding of human gene regulation and complex diseases1,2, and measuring the evolutionary sequence constraint can establish the functional relevance of putative regulatory elements in the human genome3-9. Identifying the genomic elements that have become constrained specifically in primates has been hampered by the faster evolution of noncoding DNA compared to protein-coding DNA10, the relatively short timescales separating primate species11, and the previously limited availability of whole-genome sequences12. Here we construct a whole-genome alignment of 239 species, representing nearly half of all extant species in the primate order. Using this resource, we identified human regulatory elements that are under selective constraint across primates and other mammals at a 5% false discovery rate. We detected 111,318 DNase I hypersensitivity sites and 267,410 transcription factor binding sites that are constrained specifically in primates but not across other placental mammals and validate their cis-regulatory effects on gene expression. These regulatory elements are enriched for human genetic variants that affect gene expression and complex traits and diseases. Our results highlight the important role of recent evolution in regulatory sequence elements differentiating primates, including humans, from other placental mammals.

CAAStools: a toolbox to identify and test Convergent Amino Acid Substitutions.

MOTIVATION: Coincidence of Convergent Amino Acid Substitutions (CAAS) with phenotypic convergences allow pinpointing genes and even individual mutations that are likely to be associated with trait variation within their phylogenetic context. Such findings can provide useful insights into the genetic architecture of complex phenotypes. RESULTS: Here we introduce CAAStools, a set of bioinformatics tools to identify and validate CAAS in orthologous protein alignments for predefined groups of species representing the phenotypic values targeted by the user. AVAILABILITY AND IMPLEMENTATION: CAAStools source code is available at http://github.com/linudz/caastools, along with documentation and examples.

A global catalog of whole-genome diversity from 233 primate species.

The rich diversity of morphology and behavior displayed across primate species provides an informative context in which to study the impact of genomic diversity on fundamental biological processes. Analysis of that diversity provides insight into long-standing questions in evolutionary and conservation biology and is urgent given severe threats these species are facing. Here, we present high-coverage whole-genome data from 233 primate species representing 86% of genera and all 16 families. This dataset was used, together with fossil calibration, to create a nuclear DNA phylogeny and to reassess evolutionary divergence times among primate clades. We found within-species genetic diversity across families and geographic regions to be associated with climate and sociality, but not with extinction risk. Furthermore, mutation rates differ across species, potentially influenced by effective population sizes. Lastly, we identified extensive recurrence of missense mutations previously thought to be human specific. This study will open a wide range of research avenues for future primate genomic research.

The landscape of tolerated genetic variation in humans and primates.

Personalized genome sequencing has revealed millions of genetic differences between individuals, but our understanding of their clinical relevance remains largely incomplete. To systematically decipher the effects of human genetic variants, we obtained whole-genome sequencing data for 809 individuals from 233 primate species and identified 4.3 million common protein-altering variants with orthologs in humans. We show that these variants can be inferred to have nondeleterious effects in humans based on their presence at high allele frequencies in other primate populations. We use this resource to classify 6% of all possible human protein-altering variants as likely benign and impute the pathogenicity of the remaining 94% of variants with deep learning, achieving state-of-the-art accuracy for diagnosing pathogenic variants in patients with genetic diseases.

The landscape of tolerated genetic variation in humans and primates.

Personalized genome sequencing has revealed millions of genetic differences between individuals, but our understanding of their clinical relevance remains largely incomplete. To systematically decipher the effects of human genetic variants, we obtained whole genome sequencing data for 809 individuals from 233 primate species, and identified 4.3 million common protein-altering variants with orthologs in human. We show that these variants can be inferred to have non-deleterious effects in human based on their presence at high allele frequencies in other primate populations. We use this resource to classify 6% of all possible human protein-altering variants as likely benign and impute the pathogenicity of the remaining 94% of variants with deep learning, achieving state-of-the-art accuracy for diagnosing pathogenic variants in patients with genetic diseases. One Sentence Summary: Deep learning classifier trained on 4.3 million common primate missense variants predicts variant pathogenicity in humans.

Evolutionary constraint and innovation across hundreds of placental mammals.

Zoonomia is the largest comparative genomics resource for mammals produced to date. By aligning genomes for 240 species, we identify bases that, when mutated, are likely to affect fitness and alter disease risk. At least 332 million bases (~10.7%) in the human genome are unusually conserved across species (evolutionarily constrained) relative to neutrally evolving repeats, and 4552 ultraconserved elements are nearly perfectly conserved. Of 101 million significantly constrained single bases, 80% are outside protein-coding exons and half have no functional annotations in the Encyclopedia of DNA Elements (ENCODE) resource. Changes in genes and regulatory elements are associated with exceptional mammalian traits, such as hibernation, that could inform therapeutic development. Earth's vast and imperiled biodiversity offers distinctive power for identifying genetic variants that affect genome function and organismal phenotypes.

Variation in predicted COVID-19 risk among lemurs and lorises.

The novel coronavirus SARS-CoV-2, which in humans leads to the disease COVID-19, has caused global disruption and more than 2 million fatalities since it first emerged in late 2019. As we write, infection rates are at their highest point globally and are rising extremely rapidly in some areas due to more infectious variants. The primary target of SARS-CoV-2 is the cellular receptor angiotensin-converting enzyme-2 (ACE2). Recent sequence analyses of the ACE2 gene predict that many nonhuman primates are also likely to be highly susceptible to infection. However, the anticipated risk is not equal across the Order. Furthermore, some taxonomic groups show high ACE2 amino acid conservation, while others exhibit high variability at this locus. As an example of the latter, analyses of strepsirrhine primate ACE2 sequences to date indicate large variation among lemurs and lorises compared to other primate clades despite low sampling effort. Here, we report ACE2 gene and protein sequences for 71 individual strepsirrhines, spanning 51 species and 19 genera. Our study reinforces previous results while finding additional variability in other strepsirrhine species, and suggests several clades of lemurs have high potential susceptibility to SARS-CoV-2 infection. Troublingly, some species, including the rare and endangered aye-aye (Daubentonia madagascariensis), as well as those in the genera Avahi and Propithecus, may be at high risk. Given that lemurs are endemic to Madagascar and among the primates at highest risk of extinction globally, further understanding of the potential threat of COVID-19 to their health should be a conservation priority. All feasible actions should be taken to limit their exposure to SARS-CoV-2.

Variation in predicted COVID-19 risk among lemurs and lorises.

The novel coronavirus SARS-CoV-2, which in humans leads to the disease COVID-19, has caused global disruption and more than 1.5 million fatalities since it first emerged in late 2019. As we write, infection rates are currently at their highest point globally and are rising extremely rapidly in some areas due to more infectious variants. The primary viral target is the cellular receptor angiotensin-converting enzyme-2 (ACE2). Recent sequence analyses of the ACE2 gene predicts that many nonhuman primates are also likely to be highly susceptible to infection. However, the anticipated risk is not equal across the Order. Furthermore, some taxonomic groups show high ACE2 amino acid conservation, while others exhibit high variability at this locus. As an example of the latter, analyses of strepsirrhine primate ACE2 sequences to date indicate large variation among lemurs and lorises compared to other primate clades despite low sampling effort. Here, we report ACE2 gene and protein sequences for 71 individual strepsirrhines, spanning 51 species and 19 genera. Our study reinforces previous results and finds additional variability in other strepsirrhine species, and suggests several clades of lemurs have high potential susceptibility to SARS-CoV-2 infection. Troublingly, some species, including the rare and Endangered aye-aye (Daubentonia madagascariensis), as well as those in the genera Avahi and Propithecus, may be at high risk. Given that lemurs are endemic to Madagascar and among the primates at highest risk of extinction globally, further understanding of the potential threat of COVID-19 to their health should be a conservation priority. All feasible actions should be taken to limit their exposure to SARS-CoV-2.

NEOTROPICAL ALIEN MAMMALS: a data set of occurrence and abundance of alien mammals in the Neotropics.

Biological invasion is one of the main threats to native biodiversity. For a species to become invasive, it must be voluntarily or involuntarily introduced by humans into a nonnative habitat. Mammals were among first taxa to be introduced worldwide for game, meat, and labor, yet the number of species introduced in the Neotropics remains unknown. In this data set, we make available occurrence and abundance data on mammal species that (1) transposed a geographical barrier and (2) were voluntarily or involuntarily introduced by humans into the Neotropics. Our data set is composed of 73,738 historical and current georeferenced records on alien mammal species of which around 96% correspond to occurrence data on 77 species belonging to eight orders and 26 families. Data cover 26 continental countries in the Neotropics, ranging from Mexico and its frontier regions (southern Florida and coastal-central Florida in the southeast United States) to Argentina, Paraguay, Chile, and Uruguay, and the 13 countries of Caribbean islands. Our data set also includes neotropical species (e.g., Callithrix sp., Myocastor coypus, Nasua nasua) considered alien in particular areas of Neotropics. The most numerous species in terms of records are from Bos sp. (n = 37,782), Sus scrofa (n = 6,730), and Canis familiaris (n = 10,084); 17 species were represented by only one record (e.g., Syncerus caffer, Cervus timorensis, Cervus unicolor, Canis latrans). Primates have the highest number of species in the data set (n = 20 species), partly because of uncertainties regarding taxonomic identification of the genera Callithrix, which includes the species Callithrix aurita, Callithrix flaviceps, Callithrix geoffroyi, Callithrix jacchus, Callithrix kuhlii, Callithrix penicillata, and their hybrids. This unique data set will be a valuable source of information on invasion risk assessments, biodiversity redistribution and conservation-related research. There are no copyright restrictions. Please cite this data paper when using the data in publications. We also request that researchers and teachers inform us on how they are using the data.

Correction: Summer habitat use and activity patterns of wild boar Sus scrofa in rangelands of central Argentina.

[This corrects the article DOI: 10.1371/journal.pone.0206513.].

Summer habitat use and activity patterns of wild boar Sus scrofa in rangelands of central Argentina.

Biological invasions are one of the main components of human-caused global change and their negative impact on invaded ecosystems have long been recognized. Invasive mammals, in particular, can threaten native biodiversity and cause economic impacts in the region where they are introduced, often through a wide range of conflicts with humans. Although the wild boar, Sus scrofa, is considered by the IUCN as one of the 100 invasive species most damaging to biodiversity in the world, in Argentina there have only been a few studies focused on its ecology with most of them conducted in protected areas. In this study, we evaluated the effect of several factors related with human disturbance, landscape composition, degree of fragmentation and the presence of a potential competitor and a predator on the habitat use of wild boar using data from camera traps and site-occupancy modeling. Additionally, we described the daily activity pattern of the species and we studied the level of overlap with both a potential competitor and a predator. The sampling effort totaled 7,054 camera trap days. Farm density, proportion of shrubland and proportion of grassland with bushes were the detection variables included in the most supported model whereas proportion of grassland and capture rate of the Pampas fox Lycalopex gymnocercus were the occupancy variables included in the most supported model. However, the proportion of grassland was the only variable that showed statistically significant support in the averaged model, indicating that habitat use of wild boar in this area was significantly negatively affected by the level of grass cover. Wild boars were mostly nocturnal, with more activity between 21:00 and 3:00 and a peak around midnight. Wild boars showed a high level of overlap with the activity pattern of the Pampas fox and a low overlap with the activity pattern of the puma Puma concolor. Despite wild boar being introduced in Argentina a few decades ago, this study is the first landscape-scale research carried out in an agricultural landscape in Argentina and the first one based on camera-trapping data. Our study contributes valuable information that could be used to design strategies to reduce wild boar population or to minimize the damage caused by this invasive species in Argentina.

Latin American Consensus for Pediatric Cardiopulmonary Resuscitation 2017: Latin American Pediatric Critical Care Society Pediatric Cardiopulmonary Resuscitation Committee.

OBJECTIVES: To develop a Latin American Consensus about Pediatric Cardiopulmonary Resuscitation. To clarify, reinforce, and adapt some specific recommendations for pediatric patients and to stimulate the implementation of these recommendations in clinical practice. DESIGN: Expert consensus recommendations with Delphi methodology. SETTING: Latin American countries. SUBJECTS: Experts in pediatric cardiopulmonary resuscitation from 19 Latin American countries. INTERVENTIONS: Delphi methodology for expert consensus. MEASUREMENTS AND MAIN RESULTS: The goal was to reach consensus with all the participating experts for every recommendation. An agreement of at least 80% of the participating experts had to exist in order to deliver a recommendation. Two Delphi voting rounds were sent out electronically. The experts were asked to score between 1 and 9 their level of agreement for each recommendation. The score was then classified into three groups: strong agreement (score 7-9), moderate agreement (score 4-6), and disagreement (score 1-3). Nineteen experts from 19 countries participated in both voting rounds and in the whole process of drafting the recommendations. Sixteen recommendations about organization of cardiopulmonary resuscitation, prevention, basic resuscitation, advanced resuscitation, and postresuscitation measures were approved. Ten of them had a consensus of 100%. Four of them were agreed by all the participants except one (94.7% consensus). One recommendation was agreed by all except two experts (89.4%), and finally, one was agreed by all except three experts (84.2%). All the recommendations reached a level of agreement. CONCLUSIONS: This consensus adapts 16 international recommendations to Latin America in order to improve the practice of cardiopulmonary resuscitation in children. Studies should be conducted to analyze the effectiveness of the implementation of these recommendations.

Proteinuria asociada al dengue

Objetivos: describir el grado de proteinuria y albuminemia en pacientes con dengue, correlacionar la proteinuria con la fuga capilar medida por el nivel de hemoconcentración de la hemoglobina y hematocrito. Metodología: diseño observacional, descriptivo, prospectivo, de corte transversal. Población de estudio: varones y mujeres, mayores de edad, portadores de dengue, internados en el Dpto. de Medicina Interna entre diciembre 2012 y mayo 2013. Criterios de inclusión: dengue grave con signos de alarma, confirmado por antígeno NS1 y/o IgM positivo, en periodo crítico o postfebril. Criterios de exclusión: portadores de afecciones renales conocidas. Muestreo no probabilístico de casos consecutivos. Variables: datos demográficos, hemograma, proteinuria de 24 hs, albuminemia. Resultados: ingresaron al estudio 26 varones con edad media 42±21 años y 28 mujeres con edad media 41±21 años. Se detectó proteinuria en 43 sujetos (79,6%). La misma se hallaba en rango nefrótico (media 3184±916 mg/24 hs) en 8 casos (14,8%) y dentro de valores elevados (media 669±494 mg/24 hs) en 35 casos (64,8%). La albuminemia en los sujetos con rango nefrótico fue 3±0,7 mg/dL, en los que tenían valores elevados de proteinuria fue 2,9±0,4 mg/dL y en los sujetos sin proteinuria fue 2,6±0,4 mg/dL (p 0,09 prueba ANOVA). La correlación entre proteinuria y grado de hemoconcentración de hemoglobina fue -0,01 y con el grado de hemoconcentración del hematocrito fue -0,04. Conclusiones: el dengue produjo proteinuria en 79,6% de los pacientes, llegando a rango nefrótico en 14,8%. La proteinuria no se asoció con el grado de hemoconcentración de la hemoglobina ni del hematocrito, parámetros utilizados como indicadores de gravedad de la fuga capilar. Se recomienda agregar el dosaje de proteínas en orina de 24 hs al protocolo de tratamiento del dengue y el seguimiento prospectivo de los afectados con rango nefrótico.

Objectives: To describe the degree of proteinuria and serum albumin in patients with dengue and correlate the proteinuria with the capillary leakage measured by the level of hemoglobin and hematocrit hemoconcentration. Methods: This was a cross-sectional, prospective, descriptive and observational study. Study population: adult men and women, dengue carriers and admitted in the Department of Internal Medicine between December 2012 and May 2013. Inclusion criteria: severe dengue with warning signs, confirmed by positive NS1 antigen and/or IgM in post-febrile or critical period. Exclusion criteria: known kidney disease carriers. Non-probabilistic sampling of consecutive cases. Variables: demographic data, hemogram, 24-hour proteinuria, serum albumin. Results: Twenty six men with a mean age of 42 ± 21 years and 28 women with a mean age of 41±21 years were included in the study. Proteinuria was detected in 43 subjects (79.6%). The proteinuria was in nephrotic range (mean 3,184±916 mg/24 h) in 8 cases (14.8%) and in high values (mean 669±494 mg/24 h) in 35 cases (64.8%). The serum albumin was 3±0.7 mg/dL in patients with nephrotic range, 2.9±0.4 mg/dL in those with high levels of proteinuria and 2.6±0.4 mg/dL (p=0.09 ANOVA test) in subjects without proteinuria. The correlation between the proteinuria and degree of hemoglobin hemoconcentration was -0.01 while the correlation between the proteinuria and degree of hematocrit hemoconcentration was -0.04. Conclusions: Proteinuria associated with dengue was observed in 79.6% of the patients reaching the nephrotic range in 14.8%. The proteinuria was not associated with the degree of hemoglobin or hematocrit hemoconcentration, the parameters commonly used as indicators of the severity of the capillary leakage. It is recommended to add protein dosage in 24-hour urine in the treatment protocol of dengue as well as the prospective follow-up of those patients with nephrotic range.

[Reference Intervals for total triiodothyronine (TT3), free thyroxine (FT4), and thyrotropin (TSH) by chemiluminescence immunoassay in children younger than six years old from northeastern Mexico]. / Valores de referencia de triyodotironina total (TT3), tiroxina libre (FT4) y tirotropina (TSH) obtenidos por quimioluminiscencia en niños menores de seis años del noreste de México.

BACKGROUND: Reference values according to age groups for each population are needed for the diagnosis and follow-up of pediatric patients with thyroid diseases. Such values are unknown for Mexican infants and children younger than six years. OBJECTIVE: To determine the reference values of total TT3, FT4 and TSH by chemiluminescence immunoassay in infants and children younger than six year old in Northeastern Mexico. MATERIAL AND METHODS: Thyroid hormone serum levels were determined by chemiluminescence immunoassay in healthy infants and children younger than six years old. RESULTS were analyzed according to gender in seven age groups: Newborns (NB), 1 to 6, 7 to 12, 13 to 18, 19 to 23, 24 to 35, and 36 to 71 months. RESULTS: A total of 405 infants and children were included, 209 male and 196 female, 1.6 ± 1.4 years of age (4 days to 5.6 years). Thyroid hormones: Although there were not significant differences according to gender, in NB TSH and FT4 serum levels were higher (p = 0.001 and p = 0.000, respectively) and TT3 levels were lower (p = 0.000). CONCLUSIONS: Serum levels of TSH and TT4 were higher and TT3 lower in newborns, which has been previously reported even for other measurement methods and other populations. These results allow counting with reference values of these hormones for this region.

Síndrome de Guillain Barré asociado al dengue. Reporte de dos casos / Guillain Barré syndrome associated with dengue. Report of two case

Se presentan dos pacientes con parálisis aguda, fláccida y arrefléctica iniciada en las siguientes semanas a dengue confirmado por serología. La electromiografía confirmó síndrome de Guillain Barré. Ambos tuvieron notable recuperación tras el tratamiento con inmunoglobulina humana.

We report two patients with acute flaccyd and arreflexic paralysis, innitiated weeks after serologically confirmed dengue. Electromyography confirmed Guillain Barré syndrome. Both had remarkable recovery after treatment with human immunoglobulin

Leptin and leptin receptor polymorphisms are associated with poor outcome (death) in patients with non-appendicular secondary peritonitis.

INTRODUCTION: Leptin (LEP) and its receptor (LEPR) participate in the immunological response during infection. LEP serum levels rise during sepsis. In patients with peritonitis, an insufficient elevation in serum LEP is associated with an increased risk of death. As gene variants of LEP and LEPR have been associated with diverse pathologic conditions, we explored the association of genetic polymorphisms of LEP or LEPR with death in patients with secondary peritonitis. METHODS: A case control study was undertaken. LEP Gene -2548G > A and the LEPR Gene 223A > G polymorphism were determined in 74 patients. The odds ratio of genotype and allele distribution in survival (control) versus death (case) among patients was calculated. Serum LEP, interleukin (IL)-6, tumour necrosis factor alpha, C-reactive protein (C-RP), IL-10 and IL-13 levels were analyzed in 34 patients. RESULTS: There were significant differences in genotype and allele distribution between survivors and non-survivors for -2548G > A and 223A > G polymorphisms. The presence of the mutant allele A, in -2548, had an odds ratio of 4.64 (95% CI 1.22, 17.67) with significance (P = 0.017) in the risk of death. The presence of mutant allele G, in 223, had an odds ratio of 3.57 (95% CI 1.06, 12.01) with significance in the risk of death (P = 0.033). The presence of allele A in the -2548 polymorphism was associated with differences in serum LEP (P = 0.013), and IL-10 (P = 0.0001). The presence of allele G in 223 polymorphism was likewise correlated with differences in serum LEP (P < 0001), C-RP (P = 0.033), and IL-10 (P = 0.043). CONCLUSIONS: The polymorphisms studied are associated with death in patients with peritonitis of non-appendicular origin. This association is stronger than many known risk-factors related to peritonitis severity, and is independent of body mass. The physiopathologic mechanism is possibly related to an insufficient increase in the elevation of serum LEP levels, and is unrelated to body mass.

The grade-response relation between severity of peritonitis and serum cytokine concentrations explains Mannheim Peritonitis Index threshold.

AIM: To explore the gradient between the acute-phase response (APR) and peritonitis of differing severity. METHODS: In 202 patients with peritonitis, we determined serum concentrations of interleukin (IL)-6, IL-10, IL-13, tumor necrosis factor (TNF)-alpha, and C-reactive protein (CRP). The severity of peritonitis was graded in accordance with the Mannheim Peritonitis Index (MPI). The grade-response relation between the severity of peritonitis and each analyte was explored. RESULTS: A statistically significant association was found between the medians of severity of peritonitis and IL-6 (p < 0.025), TNF-alpha (p < 0.01), CRP (p < 0.033), IL-10 (p < 0.0001), and IL-13 (p < 0.004). Both TNF-alpha and IL-10 had a direct, and IL-13 an indirect, relation to severity, whereas CRP and IL-6 tended toward linear behavior in equilibrium. A significant association persisted between individual MPI scores and IL-6 (p < 0.002), TNF-alpha (p < 0.002), CRP (p < 0.002), and IL-10 (p < 0.001), but not IL-13 (p = 0.646). CONCLUSION: Around the mean value of grade II peritonitis, the equilibrium between pro-inflammatory and anti-inflammatory cytokines is lost. This change coincides with the 26-point threshold for the MPI.

Reacciones adversas asociadas a la vacunación con bacilo de Calmette y Guérin en una población infantil de la ciudad de Zacatecas, México / Adverse reactions in association with Bacillus Calmette-Guerin immunization in Mexican children

Introducción. La vacuna BCG (bacilo de Calmette y Guérin) previene formas graves de tuberculosis, los efectos adversos son poco frecuentes: abscesos locales, linfadenopatías, lesiones músculo-esqueléticas y enfermedad diseminada; manifestándose meses posteriores y persistiendo varias semanas, asociados con la técnica de aplicación, dosis, edad del niño y estados de inmuno-supresión. Métodos. Mediante un estudio retrospectivo, se evaluó la frecuencia de manifestaciones clínicas secundarias a BCG en niños atendidos durante el período de 8 años y 5 meses en una clínica pública de la ciudad de Zacatecas, México. Además, se determinaron las características demográficas, clínicas, perinatales y antropométricas. Resultados. Se identificaron 22 casos, con una frecuencia de eventos adversos de 1.47 x 10-3 (intervalo de confianza de 95% [IC95%): 0.8, 2.1 x 0-3); 12 fueron del sexo masculino. La manifestación más común fue linfadenopatía (10 casos), seguido por pústula persistente (5), nódulo persistente (4) y úlcera (2 casos), en 4 casos se identificaron factores de inmunosupresión. Conclusiones. La prevalencia de reacciones secundarias es baja, no hubo asociación con sexo, peso y talla al nacimiento, ni con antecedentes maternos. La mayor frecuencia fue de linfadenopatías (IC95%: 22.4, 68.5%). La secuela postratamiento más importante fue la hiperqueratosis. Se observaron bajos eventos adversos, y cuando éstos se presentaron fueron bien resueltos, médica y quirúrgicamente, sin secuelas de importancia.

Introduction. The vaccine BCG (bacillus Calmette and Guerin) prevents severe forms of tuberculosis. Adverse effects are rare and such as local abscesses, lymphadenopathy, skeletal muscle injury and disseminated disease; they usually occur months later and persist for several weeks. Adverse effects are related to technical implementation, doses, age and state of immunosuppression. Methods. A retrospective study assessed the frequency of clinical manifestations secondary to BCG, in children attended over 5 years and 8 months in a government clinic in the city of Zacatecas, Mexico. Demographic, clinical, perinatal, and anthropometric characteristics were determined. Results. Twenty-two cases were identified with an adverse event frequency of 1.47 x 10-3 (IC95%: 0.8, 2.1 x 10-3), 12 male/ 10 female children. The most frequent event was lymphadenopathy (10 cases), followed by persistent pustules (5), persistent nodule (4) and ulcer (2 cases). Immunosuppression was identified in 4 cases. Conclusions. The prevalence of adverse effects is low. There was no association with sex, height or weight at birth, neither with maternal background. The most frequent event was lymphadenopathy (IC95%: 22.4). Hyperkeratosis was the most important post-treatment sequela. BCG is a vaccine with few adverse events; they are clinically well resolved with no important sequelae.

[Risk factors associated with neurocysticercosis in a public hospital in Mexico]. / Factores de riesgo asociados a neurocisticercosis en un hospital público de México.

OBJECTIVE: A case-control study was carried out to determine risk factors associated with neurocysticercosis in a public hospital in Mexico. METHODS: The following factors were analyzed: Socioeconomic, sociodemographic, hygiene, eating habits, and family history of neurocysticercosis in 85 cases and 170 controls. Cases were patients with cranial computed tomography images compatible with neurocysticercosis. The densitometric analysis (Hounsfield units) allowed us to distinguish normal tissue from physiological and pathological calcifications, and other types of lesions. Controls were admitted for neurocysticercosis but findings were not compatible with initial diagnosis. Statistical analysis was done using SPSS and Epi-info 2002. RESULTS: The most common clinical manifestation in patients was epileptic seizures OR=4.2 (IC 95% 2.40-9.67). With regards to risk factors, consumption of street food OR=2.33 (IC 95% 1.25-4.38), and family history of neurocysticercosis OR= 2.37 (IC 95% 1.11-5.04) were found to be associated with neurocysticercosis. In the north central region of Mexico where this study was performed, the disease was more frequent among urban populations.