Effect of salinity acclimation on osmoregulation, oxidative stress, and metabolic enzymes in the invasive Xenopus laevis.

Aquatic animals often display physiological adjustments to improve their biological performance and hydrosaline balance in saline environments. In addition to energetic costs associated with osmoregulation, oxidative stress, and the activation of the antioxidant system are common cellular responses to salt stress in many species, but the knowledge of osmoregulation-linked oxidative homeostasis in amphibians is scarce. Here we studied the biochemical responses and oxidative responses of Xenopus laevis females exposed for 40 days to two contrasting salinities: hypo-osmotic (150 mOsm·kg-1 ·H2 O NaCl, HYPO group) and hyper-osmotic environments (340 mOsm·kg-1 ·H2 O NaCl, HYPER group). We found an increase of plasma osmolality and plasma urea concentration in the animals incubated in the HYPER treatment. Increases in electrolyte concentration were paralleled with an increase of both citrate synthase and cytochrome c oxidase activities in liver and heart. Interestingly, HYPO group had higher catabolic activity of the skin and liver total antioxidant capacity (TAC), compared with animals from the HYPER group. Moreover, there was an inverse relationship between liver TAC and plasma osmolality; and with the metabolic enzymes from liver. These findings suggest that salinity induces changes in urea metabolism and specific activity of metabolic enzymes, which appears to be tissue-dependent in X. laevis. Contrary to our expectations, we also found a moderate change in the oxidative status as revealed by the increase in TAC activity in the animals acclimated to low salinity medium, but constancy in the lipid peroxidation of membranes.

Enfrentamiento de adultos mayores con sospecha de covid-19 en el servicio de urgencia

En Diciembre 2019, surge una enfermedad emergente, COVID-19, que es debida a un coronavirus (SARS-CoV-2) que empieza en Wuhan, China y que se ha propagado rápidamente a nivel mundial. La Organización Mundial de la Salud (OMS) lo declara como pandemia el 12 de Marzo del 2020. En Chile, el día 14 de Marzo se decretó fase 3 y el 16 de Marzo se pasó a fase 4. Al 24 de Marzo del 2020, en Chile existen 922 casos confirmados de COVID-19, con una mediana de edad de 34 años, correspondiendo 51 casos (6%) a adultos mayores (AM).

Differential West Nile fever ascertainment in the United States: a multilevel analysis.

We evaluated the completeness of West Nile fever (WNF) surveillance within the U.S. public health system. We surveyed laboratory and surveillance programs on policies, practices, and capacities for testing, confirmation, and reporting (collectively called ascertainment) from 2003 through 2005. We calculated syndrome ascertainment ratios by dividing WNF counts by neuroinvasive disease counts; separately, we performed multilevel modeling. Jurisdictions were more likely to ascertain at least one WNF cases per West Nile neuroinvasive disease case when ≤ 1 testing restrictions existed (odds ratio [OR] = 7.7, 95% confidence interval [CI] = 1.3-46.4), when conducting ≥ 4 activities to enhance reporting (OR = 9.3, 95% CI = 1.6-54.8), and when ≥ 5.0 staff per million residents were dedicated to arboviral surveillance (OR = 6.4, 95% CI = 1.0-40.3). Ascertainment of WNF was less likely among Blacks (OR = 0.56, 95% CI = 0.31-0.99) and Hispanics (OR = 0.69, 95% CI = 0.48-0.98) than among Whites. Ascertainment was more complete when testing and reporting were enhanced, but differentially incomplete for minorities.

[Delirium in Chilean elderly inpatients: an overlooked problem]. / Subdiagnóstico de delirium en adultos mayores hospitalizados.

BACKGROUND: Delirium is a common underdiagnosed and undertreated problem in elderly inpatients, associated to higher morbidity, mortality and health cost. AIM: To evaluate the prevalence of delirium at hospital admission in medically ill elderly patients and the attending physician's diagnosis and treatment of delirium. PATIENTS AND METHODS: In a prospective and descriptive study, consecutive patients aged 65 years or more, admitted to an internal medicine ward were evaluated by independent physicians, during the first 48 h of admission, to asses the presence of delirium. Diagnosis of delirium was based on the Confusion Assessment Method. Medical and nurse records were reviewed. Family was interviewed when necessary. RESULTS: One hundred eight patients (52% women, age range 65-94 years) with an APACHE II score of 11.6+/-5, were evaluated. Fifty seven patients (53%) had delirium (32% hyperactive, 72% hypoactive and 5% mixed). Delirium prevalence was significantly higher in older patients (66% among those aged 75 years or older versus 30% in younger, p <0.05) and among patients with more severe conditions (88% among those with an APACHE score over 16 versus 47% below that value, p <0.05). Medical records of patients with delirium showed that this diagnosis was present only in 32% and cognitive deficit was described in 73%. Ten percent of patients with delirium received sedative medication and 38% were physically restricted. There were no environmental interventions to prevent or control delirium. CONCLUSIONS: Delirium in elderly inpatients at this unit is an extraordinarily prevalent problem, seriously under diagnosed (68%) and under treated. This study should alerts our medical community to improve the diagnosis and management of delirium in elderly inpatients.