Efficiency, Kinetics and Mechanism of 4-Nitroaniline Removal from Aqueous Solutions by Emulsion Liquid Membranes Using Type 1 Facilitated Transport.

4-Nitroaniline (4NA) is a common organic pollutant that is released into the environment during the manufacture and processing of a wide variety of industrial products. This article describes the use of an emulsion liquid membrane process to remove 4NA from aqueous solutions using a type 1 facilitated transport mechanism. Optimization of the removal process was carried out by analyzing the efficiency of 4NA removal from the feed phase and the initial apparent feed/membrane fluxes and permeabilities under different experimental conditions. The kinetics of the removal process was analyzed using a simplified mass transfer model involving an empirical mass transfer coefficient calculated from experimental data, assuming that the concentrations of 4NA in the external aqueous phase and in the internal w/o emulsion are uniform. The results show that there is a very good fit between the experimental and model data and that the variation in the values of the overall mass transfer coefficients with the experimental conditions coincides with that of the removal efficiency mentioned above. The transport mechanism was studied by identifying the rate-controlling step of the removal process, using models described for adsorption processes, due to the strong parallelism between the transport mechanisms in adsorption and emulsion liquid membrane processes.

Application of Biostimulant in Seeds and Soil on Three Chickpea Varieties: Impacts on Germination, Vegetative Development, and Bacterial Facilitation of Nitrogen and Phosphorus.

Chickpeas (Cicer arietinum L.) are a valuable legume crop due to their nutritional value. To maintain chickpea productivity and avoid the adverse effects of climate change on soil and plant processes, it is crucial to address demand. Achieving this necessitates implementing sustainable agricultural practices incorporating the use of biostimulants, adaptable crops for arid conditions, as well as pest and disease-resistant crops that are sustainable over time. Three varieties of chickpeas were analysed to determine the effect of two different biostimulant application methods on both germination and vegetative growth. Possible effects due to location were also examined by conducting tests at two different sites. Significant variations in biostimulant response were evident only during the germination period, but not during the vegetative development stage, where the observed statistical differences were influenced more by the location or variety of chickpeas employed. Furthermore, this study examined the effect of biostimulants on nutrient cycling within the soil-plant microbiota system. Nitrogen-fixing bacteria (NFB) are present in the soil of chickpea crops at an order of magnitude of 107 CFU/g DS. Additionally, an average concentration of 106 CFU/g DS of phosphorus-mobilising bacteria was observed. Applying biostimulants (BioE) to seeds resulted in a successful germination percentage (GP) for both Amelia (AM) and IMIDRA 10 (IM) varieties.

Rapid and sensitive method for the simultaneous determination of PAHs and alkyl-PAHs in scrubber water using HS-SPME-GC-MS/MS.

Scrubber water, a waste stream generated by ships exhaust gas cleaning systems, may pose a threat when released into the marine environment due to potential contamination with polycyclic aromatic hydrocarbons (PAHs) and their alkyl derivatives (alkyl-PAHs). This study aims to develop a reliable analytical procedure combining headspace solid-phase microextraction (HS-SPME) with gas chromatography coupled to triple quadrupole tandem mass spectrometry (GC-MS/MS) to simultaneously separate and determine target compounds in aqueous samples. Method validation demonstrated good linearity up to 200 ng L-1 (r2> 0.996) and low limits of detection (0.33 to 1.67 ng L-1, except for naphthalene at 3.3 ng L-1). The method shows good precision (RSD<20%) and satisfactory analytical recoveries. The methodology was successfully applied to scrubber water samples collected from a container ship and the results highlight the prevalence of naphthalene, phenanthrene, and their alkyl derivatives.•Rapid and reproducible HS-SPME-GC-MS/MS method for the analysis of PAHs and alkyl-PAHs in scrubber water.•The capacity of SPME to analyze both filtered and unfiltered samples was assessed, showing that the more hydrophobic PAHs may be lost during filtration.

Shape memory cycle conditions impact human bone marrow stromal cell binding to RGD- and YIGSR-conjugated poly (glycerol dodecanedioate).

Bioresorbable shape memory polymers (SMP) are an emerging class of polymers that can help address several challenges associated with minimally invasive surgery by providing a solution for structural tissue repair. Like most synthetic polymer networks, SMPs require additional biorelevance and modification for biomedical applications. Methodologies used to incorporate bioactive ligands must preserve SMP thermomechanics and ensure biofunctionality following in vivo delivery. We have previously described the development of a novel thermoresponsive bioresorbable SMP, poly (glycerol dodecanedioate) (PGD). In this study, cell-adhesive peptide sequences RGD and YIGSR were conjugated with PGD. We investigated 1) the impact of conjugated peptides on the fixity (Rf), recovery (Rr), and recovery rate (dRr/dT), 2) the impact of conjugated peptides on cell binding, and 3) the impact of the shape memory cycle (Tprog) on conjugated peptide functionality towards binding human bone marrow stromal cells (BMSC). Peptide conjugation conditions impact fixity but not the recovery or recovery rate (p < 0.01). Peptide-conjugated substrates increased cell attachment and proliferation compared with controls (p < 0.001). Using complementary integrin binding cell-adhesive peptides increased proliferation compared with using single peptides (p < 0.05). Peptides bound to PGD substrates exhibited specificity to their respective integrin targets. Following the shape memory cycle, peptides maintained functionality and specificity depending on the shape memory cycle conditions (p < 0.001). The dissipation of strain energy during recovery can drive differential arrangement of conjugated sequences impacting functionality, an important design consideration for functionalized SMPs. STATEMENT OF SIGNIFICANCE: Shape memory elastomers are an emerging class of polymers that are well-suited for minimally invasive repair of soft tissues. Tissue engineering approaches commonly utilize biodegradable scaffolds to deliver instructive cues, including cells and bioactive signals. Delivering these instructive cues on biodegradable shape memory elastomers requires modification with bioactive ligands. Furthermore, it is necessary to ensure the specificity of the ligands to their biological targets when conjugated to the polymer. Moreover, the bioactive ligand functionality must be conserved after completing the shape memory cycle, for applications in tissue engineering.

Marine Microbiota Responses to Shipping Scrubber Effluent Assessed at Community Structure and Function Endpoints.

The use of novel high-throughput sequencing (HTS) technologies to examine the responses of natural multidomain microbial communities to scrubber effluent discharges to the marine environment is still limited. Thus, we applied metabarcoding sequencing targeting the planktonic unicellular eukaryotic and prokaryotic fraction (phytoplankton, bacterioplankton, and protozooplankton) in mesocosm experiments with natural microbial communities from a polluted and an unpolluted site. Furthermore, metagenomic analysis revealed changes in the taxonomic and functional dominance of multidomain marine microbial communities after scrubber effluent additions. The results indicated a clear shift in the microbial communities after such additions, which favored bacterial taxa with known oil and polycyclic aromatic hydrocarbons (PAHs) biodegradation capacities. These bacteria exhibited high connectedness with planktonic unicellular eukaryotes employing variable trophic strategies, suggesting that environmentally relevant bacteria can influence eukaryotic community structure. Furthermore, Clusters of Orthologous Genes associated with pathways of PAHs and monocyclic hydrocarbon degradation increased in numbers at treatments with high scrubber effluent additions acutely. These genes are known to express enzymes acting at various substrates including PAHs. These indications, in combination with the abrupt decrease in the most abundant PAHs in the scrubber effluent below the limit of detection-much faster than their known half-lives-could point toward a bacterioplankton-initiated rapid ultimate biodegradation of the most abundant toxic contaminants of the scrubber effluent. The implementation of HTS could be a valuable tool to develop multilevel biodiversity indicators of the scrubber effluent impacts on the marine environment, which could lead to improved impact assessment. Environ Toxicol Chem 2024;43:1012-1029. © 2024 The Authors. Environmental Toxicology and Chemistry published by Wiley Periodicals LLC on behalf of SETAC.

Identifying delays in healthcare seeking and provision: The Three Delays-in-Healthcare and mortality among infants and children aged 1-59 months.

Delays in illness recognition, healthcare seeking, and in the provision of appropriate clinical care are common in resource-limited settings. Our objective was to determine the frequency of delays in the "Three Delays-in-Healthcare", and factors associated with delays, among deceased infants and children in seven countries with high childhood mortality. We conducted a retrospective, descriptive study using data from verbal autopsies and medical records for infants and children aged 1-59 months who died between December 2016 and February 2022 in six sites in sub-Saharan Africa and one in South Asia (Bangladesh) and were enrolled in Child Health and Mortality Prevention Surveillance (CHAMPS). Delays in 1) illness recognition in the home/decision to seek care, 2) transportation to healthcare facilities, and 3) the receipt of clinical care in healthcare facilities were categorized according to the "Three Delays-in-Healthcare". Comparisons in factors associated with delays were made using Chi-square testing. Information was available for 1,326 deaths among infants and under 5 children. The majority had at least one identified delay (n = 854, 64%). Waiting >72 hours after illness recognition to seek health care (n = 422, 32%) was the most common delay. Challenges in obtaining transportation occurred infrequently when seeking care (n = 51, 4%). In healthcare facilities, prescribed medications were sometimes unavailable (n = 102, 8%). Deceased children aged 12-59 months experienced more delay than infants aged 1-11 months (68% vs. 61%, P = 0.018). Delays in seeking clinical care were common among deceased infants and children. Additional study to assess the frequency of delays in seeking clinical care and its provision among children who survive is warranted.

First-episode psychosis intervention programme versus standard care for the clinical management of early phases of psychosis: cost analysis.

BACKGROUND: Early intervention programmes (EIPs) in psychosis have gained attention as specialised interventions to improve health-related and societal impacts for people with psychotic disorders. Previous studies have presented evidence in favour of EIPs over the first year of intervention, despite none considering the critical period before psychosis onset (5 years). AIMS: To compare the associated costs of the First Episode Psychosis Intervention Program (CRUPEP) and treatment as usual (TAU) in a real-world cohort in a non-specialised psychiatric community setting. METHOD: Direct and indirect mental health-related costs were calculated over 1 year and up to 7 years. Healthcare and societal costs were calculated from economic data related to the consumption of all healthcare resources, including emergency department attendances, hospital admissions, psychotropic medication prescriptions and societal costs. RESULTS: From a healthcare perspective, the intervention (CRUPEP) group initially showed a marginally higher cost per patient than the TAU group (€7621 TAU group v. €11 904 CRUPEP group) over the first year of follow-up. However, this difference was reversed between the groups on considering the entire follow-up, with the TAU group showing considerably higher associated costs per patient (€77 026 TAU v. €25 247 CRUPEP). CONCLUSIONS: The EIP (CRUPEP) showed clinical benefits and minimised the direct and indirect health-related costs of the management of psychosis. Although the CRUPEP intervention initially reported increased costs over 1 year, TAU surpassed the global costs over the entire follow-up.

Vigilancia del consumo de antimicrobianos en 10 instituciones de salud entre 2013 y 2020 en Colombia / Antibiotic consumption surveillance in 10 health institutions between 2013 and 2020 in Colombia

INTRODUCCIÓN: El uso de antimicrobianos es el principal factor de resistencia bacteriana. OBJETIVO: Determinar el consumo de antimicrobianos en instituciones de salud de Santiago de Cali entre 2013 y 2020. MATERIAL Y MÉTODO: Se empleó la Dosis Diaria Definida por 100 camas-día. Se definieron como criterios de inclusión las instituciones que tuvieran como mínimo 9 reportes anuales y que el reporte fuese superior a 95%. En este caso quedaron incluidas 10 instituciones. RESULTADOS: El consumo en Unidades de Cuidados Intensivos (UCI) fue mayor que en servicios diferentes a UCI. Se consumió más ceftriaxona e imipenem en servicios diferentes a UCI, mientras que meropenem, piperacilina/tazobactam y vancomicina lo fueron en UCI. En servicios diferentes a UCI, dos instituciones aumentaron el consumo para ceftriaxona, ciprofloxacina y piperacilina/tazobactam y una para vancomicina, mientras que en UCI en una institución el consumo aumentó para piperacilina/tazobactam. CONCLUSIÓN: El sistema brindó herramientas de vigilancia prospectiva que mostraron necesidades de intervención en instituciones.

BACKGROUND: The use of antibiotics is the main factor of microbial resistance. Aim: To determine the consumption of antibiotics in health care institutions in Santiago de Cali between 2013 and 2020. METHODS: The methodology of the Defined Daily Dose per 100 beddays was employed. Institutions that had at least 9 annual reports and that the report is greater than 95% were defined as inclusion criteria. In this case, 10 institutions were included. RESULTS: Consumption in Intensive Care Units (ICU) was higher than in other units. Ceftriaxone and imipenem were more consumed in units other than ICU, whereas meropenem, piperacillin/tazobactam and vancomycin were more consumed in the ICU. In units other than ICU, two institutions increased the consumption of ceftriaxone, ciprofloxacin and piperacillin/tazobactam and one the consumption of vancomycin, whereas in the ICU, one institution increased the consumption of piperacillin/tazobactam. The endemic range identified that vancomycin located itself in the epidemic zone in one institution. CONCLUSION: The system provided tools for prospective surveillance that showed the need for intervention in institutions.

Chemical composition and antifungal properties of commercial essential oils against the maize phytopathogenic fungus Fusarium verticillioides / Composición química y propiedades antifúngicas de aceites esenciales comerciales contra el hongo fitopatógeno de maíz Fusarium verticillioides

ABSTRACT The aim of the present study was to analyze the chemical composition ofCurcuma longa,Pimenta dioica,Rosmarinus officinalis, andSyzygiumaromaticumessential oils (EOs) and their antifungal and anti-conidiogenic activity againstFusarium verticillioides. The chemical profile of the EOs was determined by GC/MS. The antifungal and anti-conidiogenic activities were evaluated by the agar dilution method. The tested concentrations were 1000ppm, 500ppm, 250ppm and 125ppm.S. aromaticumEO exhibited the highest antifungal effect, followed byP. dioicaand to a lesser extentC. longa. The major compounds of these EOs were eugenol (88.70% inS. aromaticumand 16.70% inP. dioica), methyl eugenol (53.09% inP. dioica), and α-turmerone (44.70%), β-turmerone (20.67%), and Ar-turmerone (17.27%) inC. longa.Rosmarinus officinalispoorly inhibited fungal growth; however, it was the only EO that inhibited conidial production, with its major components being 1,8-cineole (53.48%), α-pinene (15.65%), and (−)-camphor (9.57%). Our results showed that some compounds are capable of decreasing mycelial growth without affecting sporulation, and vice versa. However, not all the compounds of an EO are responsible for its bioactivity. In the present work, we were able to identify different major compounds or mixtures of major compounds that were responsible for antifungal and anti-conidiogenic effects. Further experiments combining these pure components are necessary in order to achieve a highly bioactive natural formulation against the phytopathogenic fungusF. verticillioides.

RESUMEN El objetivo del presente estudio fue analizar la composición química de los aceites esenciales (AE) deCurcuma longa,Pimenta dioica,RosmarinusofficinalisySyzygiumaromaticum, y su actividad antifúngica y anti-esporuladora contraFusarium verticillioides. La composición de los AE se analizó por CG-EM. La actividad antifúngica y anti-esporuladora se evaluó a través del método de dilución en agar usando las siguientes concentraciones: 1.000, 500, 250 y 125ppm. El AE deS. aromaticumdemostró el mayor efecto antifúngico, seguido del deP. dioicay, en menor medida, delC. longa. Los compuestos principales de estos AE fueron eugenol (88,70% enS. aromaticumy 16,70% enP. dioica), metileugenol (53,09% enP. dioica) y α-turmerona (44,70%), β-turmerona (20,67%) y Ar-turmerona (17,27%) enC. longa. El AE deR. officinalisfue el que menor efecto inhibitorio presentó sobre el crecimiento fúngico, pero fue el único que inhibió la producción de conidias; sus principales componentes fueron 1,8-cineol (53,48%), α-pineno (15,65%) y (−)-alcanfor (9,57%). Nuestros resultados demostraron que algunos compuestos son capaces de disminuir el crecimiento del micelio deF. verticillioidessin afectar la esporulación, y vice versa. Sin embargo, no todos los compuestos de un AE son responsables de su bioactividad. En el presente trabajo, pudimos identificar diferentes compuestos o mezclas de compuestos que fueron responsables de los efectos antifúngicos y anti-esporuladores. Se necesitan nuevos experimentos que evalúen la combinación de estos compuestos puros para lograr una formulación bioactiva y de origen natural para el control deF. verticillioides.

Características demográficas de la población con las principales patologías otorrinolaringológicas en Colombia / Demographic characteristics of the population with the main ENT pathologies in Colombia

Introducción: las patologías otorrinolaringológicas son de alta prevalencia en el mundo; en Colombia se han realizado pocos estudios sobre la frecuencia de estas patologías. A través del sistema integrado de protección social (SISPRO) y los códigos de Registros Individuales de Prestación de Servicios de salud (RIPS) es posible tener información oportuna, suficiente y estandarizada para la toma de decisiones en el sector de la salud. Objetivo: el objetivo del presente estudio fue realizar un análisis descriptivo de las principales características demográficas de la población con las principales patologías otorrinolaringológicas en Colombia. Resultados: se encontró que la rinitis alérgica y las patologías vertiginosas corresponden a las principales causas de consulta en este país, y las patologías infecciosas ocupan un papel importante especialmente en la población menor de 5 años. Adicionalmente, la gran mayoría de las patologías prevalentes en Colombia pueden ser manejadas en instituciones de primer nivel o atención primaria. Conclusión: es importante conocer la prevalencia de patologías en otorrinolaringología en Colombia para implementar campañas que divulguen su diagnóstico y tratamiento entre los médicos generales, médicos familiares y pediatras, con el fin de tener una adecuada cobertura a nivel nacional.

Introduction: ENT pathologies are highly prevalent in the world and few studies have been carried out in Colombia regarding this topic. Through the integrated social protection system (SISPRO by its acronym in Spanish) and the codes of Individual Registries for the Provision of Health Services (RIPS by its acronym in Spanish) it is possible to have standardized information for decision-making in the health sector. Objective: The purpose of this study was to carry out a descriptive analysis of the main demographic characteristics of the population with the main ENT pathologies in Colombia. Results: It was found that allergic rhinitis and vertiginous pathologies correspond to the main causes of consultation in this country and infectious pathologies occupy an important role in the population under 5 years of age. Additionally, the vast majority of the prevalent pathologies in Colombia can be managed in first-level institutions or primary care. Conclusions: It is important to know the prevalence of the main ENT pathologies in Colombia so we can implement campaigns that disseminate their diagnosis and treatment among general practitioners, family doctors and pediatricians in order to have adequate national coverage.

Caracterización de la disfonía en la población infantil en un centro de laringología en Bogotá, Colombia / Characterization of dysphonia in pediatric age in a laryngology center in Bogotá, Colombia

Introducción: la disfonía en edad infantil está presente entre el 6 % al 23 % de los niños entre los 4-12 años y su estudio supone un reto diagnóstico y terapéutico debido a que los procedimientos actualmente utilizados requieren de una completa colaboración del paciente. En Colombia, hasta el momento, no se ha realizado un estudio sobre la caracterización de las principales patologías que causan disfonía en niños. Los hallazgos son similares a los reportados en la literatura mundial; sin embargo, los nódulos vocales no son la principal causa de disfonía en niños en nuestra población como se había reportado hasta ahora. Es por esto por lo que el objetivo del presente estudio es proporcionar los resultados de nuestra casuística en cuanto a patologías de cuerdas vocales en la población pediátrica con disfonía crónica (mayor a 4 semanas), que asisten a consulta externa de laringología en el Hospital Universitario San Ignacio en Bogotá, Colombia, con el fin de conocer su frecuencia y características asociadas. Materiales y métodos: se realiza un estudio retrospectivo de tipo descriptivo, en el que se analizaron historias clínicas y estroboscópias realizadas a pacientes menores de 18 años con síntomas vocales crónicos (mayores a 4 semanas), que asistieron a consulta de laringología en los últimos 10 años. Posteriormente se realizó un análisis estadístico y descriptivo de las mismas. Resultados: se seleccionaron 141 pacientes; de estos, 73 % tuvo lesiones de ambos pliegues vocales, 9,9 % lesiones unilaterales y 16,3 % disfonía por tensión muscular primaria. La mayoría de las lesiones fueron adquiridas, con leve predominio en el pliegue vocal izquierdo y sexo masculino. La patología más prevalente fue el sulcus vocalis (17,37 %), seguido de la disfonía por tensión muscular primaria y nódulos vocales (13,22 %). El 41,06 % de los pacientes se catalogaron como abusadores de la voz, y dentro de este grupo, los nódulos vocales fueron más frecuentes. Discusión: se encontró una predominancia del sulcus vocalis, lo cual difiere con la literatura en la que, tradicionalmente, se describen los nódulos; en este estudio se encontró que estos estaban relacionados con el abuso de la voz en la mitad de los pacientes. Adicionalmente se identificó una relación entre la disfonía por tensión muscular y el canto, además de síntomas de reflujo gastroesofágico en algunos niños. Conclusiones: este es el primer estudio de su tipo en Colombia y el segundo en Latinoamérica. Los hallazgos en general son consistentes con la literatura, siendo la única diferencia que la primera causa de disfonía fue el sulcus vocalis. Se encontró una relación entre los nódulos y los quistes con el abuso de la voz, lo que apoya la teoría de la naturaleza adquirida de estos últimos.

Introduction: dysphonia is present in 6 % to 23 % of children between 4-12 years of age and its study suppose a diagnostic and therapeutic challenge because the procedures currently used require a complete collaboration from de patient. In Colombia, a study on the characterization of the main pathologies that cause dysphonia in children has not been carried out so far. The findings are like those reported in the world literature, however, vocal nodules are not the main cause of dysphonia in children in our population as reported so far. The objective of this study is to provide our results in stroboscopies regarding pathologies of vocal cords in children with chronic dysphonia (more than 4 weeks) that attend to the laryngology service of the San Ignacio University Hospital, in Bogotá, Colombia, and compare them with the international literature. Materials and methods: we performed a retrospective descriptive study where a revision of clinical histories and stroboscopies of patients younger than 18 years with chronical voice symptoms (greater than 4 weeks) that assisted to a laryngology consultation at the San Ignacio University Hospital, in Bogotá, Colombia within the last 10 years was done. A statistical and descriptive analysis was made with the collected data. Results: 141 patients were selected, 73 % had bilateral vocal fold lesions, 9.9 % unilateral lesions and 16.3 % had primary muscle tension dysphonia. Most of the lesions where acquired, with a slight predominance for the left vocal fold and male sex. The most common finding was vocal sulcus (13.37 %), followed by muscle tension dysphonia and vocal nodules (13.2 %). 41.06 % of patients referred vocal abuse, and within this group, vocal nodules where most prevalent. Discussion: there was a predominance of vocal sulcus, this differs from the literature in which vocal nodules are the most frequent finding. In this study, vocal nodules where related to chronic voice abuse, which was referred by half of the patients. A relation between muscle tension dysphonia and singing was also observed, an important number of patients referred gastroesophageal reflux symptoms as well. Conclusions: this is the first study in Colombia and the second one in Latin America of its kind. The results are generally consistent with the literature, but the first cause of dysphonia in our study is vocal sulcus, as opposed to vocal nodules which are typically the most common cause. There was a relation between chronic voice abuse, vocal nodules and cysts, this supports the theory that cysts are acquired lesions and not congenital.

Seroprevalencia de dengue en municipios con transmisión hiperendémica y mesoendémica, Valle del Cauca, Colombia / Seroprevalence of dengue in municipalities with hyperendemic and mesoendemic transmission in Valle del Cauca, Colombia

Introducción: El dengue se ha convertido en una de las enfermedades de mayor impacto epidemiológico, social y económico para la salud pública a nivel mundial. Objetivo: Determinar la seroprevalencia de dengue en cinco municipios del Valle del Cauca con transmisión hiperendémica y mesoendémica de la enfermedad. Métodos: Estudio de prevalencia mediante muestreo probabilístico por conglomerados multietápico. Se evaluaron 822 personas. Resultados: La seroprevalencia de dengue fue del 91,36 por ciento obtenida a partir de la aplicación de la prueba de ensayo por inmunoabsorción ligado a enzimas para dengue indirecta IgG. Al aplicar la prueba de captura para IgM para dengue, la seroprevalencia fue de un 21,41 por ciento. La seropositividad conjunta de anticuerpos IgM e IgG fue del 20,3 por ciento. Conclusiones: La alta seroprevalencia de dengue en el Valle del Cauca muestra el impacto de esta enfermedad en la historia de vida de sus residentes. Su reemergencia impacta negativamente en los que tienen como antecedentes haber padecido la enfermedad provocando un desarrollo de su variante más grave, lo que se puede evitar con la administración de una vacuna tetravalente contra el dengue(AU)

Introduction: Dengue has become one of the largest epidemiological, social, and economic impacts for global public health. Objective: To determine the seroprevalence of dengue in five municipalities of Valle del Cauca with hyperendemic and mesoendemic transmission of the disease. Methods: Prevalence study through multistage probability sampling by clusters. 822 people were assessed. Results: Seroprevalence of dengue was of 91.36 percent, it was obtained from the implementation of the enzyme-linked immunosorbent´s trial test for indirect dengue IgG. When applying the capture test IgM for dengue, seroprevalence was of 21.41 percent. The joint seropositivity of IgM and IgG antibodies was 20.3 percent. Conclusions: The high seroprevalence of dengue in Valle del Cauca shows the impact of this disease in the life history of the residents. Dengue re-emergence impacts negatively on those who have a background of having suffered from the disease which caused a development of its most severe variant that can be avoided with the administration of a quadrivalent vaccine against dengue(AU)

Recomendaciones ante el COVID-19 para la práctica de otología y audiología / Recomendations for the practice of otology and audiology during COVID-19

Hasta el momento, no se conoce con certeza si el virus SARS-CoV-2 se encuentra en la mucosa que recubre la trompa de Eustaquio, el oído medio o la mastoides, aunque es bastante probable que sí lo esté, dada la relación de vecindad anatómica y fisiológica que existe con la mucosa de la naso y orofaringe, ubicaciones en las que claramente se ha documentado alta carga viral. Actualmente, se encuentra en construcción científica la definición de los aspectos relacionados con la seguridad en la práctica integral otológica en el contexto de la pandemia de la enfermedad por coronavirus 2019 (COVID-19). Este documento pretende recopilar el conocimiento y las experiencias nacionales e internacionales relacionados con la pandemia, para ser aplicados en el día a día en la práctica médica como especialistas. Es pertinente aclarar que el contenido de estos lineamientos deberá ser actualizado a medida que se conozca nueva información o evidencia, puesto que esta se encuentra en constante y rápida evolución.

Until now, it is not known with certainty if the SARS-CoV-2 virus is found in the mucosa that covers the Eustachian tube, the middle ear and the mastoid, but it is quite probable that it is, given the relationship that exists with the mucosa of the nasopharynx and oropharynx, anatomical sites where a high viral load has clearly been documented. The definition of safety-related aspects for the otological practice is currently under construction in the context of the 2019 coronavirus disease pandemic (COVID-19). This document aims to gather the national and international knowledge and experiences related in order to be applied in the day to day of our medical practice as specialists. It is important to mention that the content of these guidelines should be updated as new information or evidence becomes known since it is constantly changing.

Ralstonia spp. in a dialysis unit: an experience in the identification and control of an outbreak / Ralstonia spp. en una unidad de diálisis: experiencia en la identificación y control de brote

Abstract Objective: to describe an experience in identification and control of an outbreak of Ralstonia spp. in a renal unit. Material and Method: an epidemiological investigation of a hospital outbreak in 2 sites and extramural service of a renal unit. The investigation included patients who presented fever or chills, during or after dialysis, and who had positive blood culture for Ralstonia spp. Results: Of 769 hemodialysis patients, 124 were identified with bacteremia by Ralstonia spp.; of these, 98.4% had catheter access and 1.6% had fistula. The overall attack rate was 16.1% and the case fatality rate was 0.8%. Environmental cultures were taken and drugs and devices were tracked. Several cultures were taken of the prefilled heparin following the methods described in the International Pharmacopoeia. However, it was the technique of microbial isolation recommended by experts that enabled the isolation of the microorganism and confirmed the source. Conclusions: The outbreak described exceeded the number of patients affected documented in literature. It was caused by a contaminated batch of heparin. Evidence is provided of a recommended by expert technique used for the isolation of Ralstonia spp. in order to achieve control of outbreaks in a timely manner, minimizing clinical, economic, and social impact.

Resumen Objetivo: describir la experiencia en la identificación y control de un brote por Ralstonia spp. en una unidad renal. Material y Método: investigación epidemiológica de brote hospitalario en 2 sedes y servicio extramural de una unidad renal. Se incluyeron pacientes que presentaron fiebre o escalofrío, durante o después de la terapia dialítica, y que tuvieran hemocultivo positivo para Ralstonia spp. Resultados: De los 709 pacientes para hemodiálisis, se identificaron 124 con bacteriemia por Ralstonia spp., 98,4% tenían acceso por catéter. La tasa de ataque global fue del 16,1% y la tasa de letalidad 0,8%. Se realizaron cultivos ambientales y trazabilidad de medicamentos y dispositivos, pero ante la presencia de casos extramurales la hipótesis fue redireccionada. La heparina prellenada había sido cultivada en varias oportunidades siguiendo la metodología de la farmacopea internacional. Sin embargo, la técnica de aislamiento microbiano recomendada por expertos fue la que permitió aislar el microorganismo y confirmar la fuente. Conclusiones: El brote que se describe excedió el número de pacientes documentados en la literatura y fue causado por un lote contaminado de heparina. Se aporta evidencia de una técnica recomendada por expertos utilizada para el aislamiento de Ralstonia spp. a fin de lograr el control de brotes de manera oportuna, minimizando el impacto clínico, económico y social.

Trabajo decente: representaciones de trabajo y anticipaciones de futuro en jóvenes en situación de vulnerabilidad social / Decent work: representations of work and turure prospects in vulnerable young workers

El artículo presenta resultados de una investigación cualitativa que buscó comprender las valoraciones y representaciones sobre el trabajo, y las anticipaciones de futuro vinculadas con la esfera laboral, en jóvenes en situación de vulnerabilidad social. El análisis se ha realizado a la luz de las variables que caracterizan el concepto de trabajo decente. Nos preguntamos: ¿cómo significan sus trabajos?, ¿cómo impactan estos sentidos en la construcción de la subjetividad y de sus trayectorias de vida?, ¿qué representaciones de trabajo decente tienen?, ¿cómo se relacionan con sus anticipaciones de futuro? Observamos que el mercado laboral actual- reflejado en difíciles condiciones de acceso y permanencia en los trabajos y en su alta precariedad- incide en los sentidos del trabajo y en las intenciones de futuro. Consecuentemente, se advierte una naturalización - y una resignación - frente a estas condiciones. El divorcio entre trabajo e intereses personales afectan la posibilidad de proyectar futuros en los que puedan expresarse dimensiones personales vinculadas al bienestar y a una vida satisfactoria

This article presents the results of a qualitative research that aims to understand and compare the values, representations and future prospects of work in vulnerable young workers. The analysis considers the variables that characterize decent work. We ask: what does their work mean to them?, what impact do those meanings have on their subjectivity and life paths construction?, what do they understand by "decent work"?, how do their jobs and work representations relate to their future prospects? We observe that the context of the employment market, -where jobs lack continuity, are difficult to access and are highly unstable-, affects the purpose of work and people's future prospects. Consequently, it has been noted that there is an acceptance and conformity to these conditions. The divergence between work and personal interests affects the possibility of having future prospects in which personal dimensions can be linked to well-being and a satisfactory life

Abuso sexual en mujeres de 10 a 13 años en el Valle del Cauca, Colombia / Sexual abuse against women aged 10-13 in Valle del Cauca, Colombia

Objetivo: describir características del abuso sexual en mujeres de 10 a 13 años en el Valle del Cauca notificados a través del sistema de vigilancia en salud pública. Materiales y métodos: estudio observacional de corte transversal, la población objeto fueron mujeres entre 10 y 13 años víctimas de abuso sexual notificadas al sistema de vigilancia en salud pública del departamento del Valle del Cauca. A través de análisis secundario, se evaluaron características sociodemográficas de la víctima, información del agresor e información relacionada con el evento. Resultados: se utilizó el total de 431 casos de mujeres de 10 a 13 años violentadas sexualmente. 17,9% de las víctimas eran afrodescendientes, 58,2% pertenecían al régimen subsidiado, 6,3% no tenían afiliación, 75,9% eran estudiantes y 15,1% residían en la zona rural. La edad promedio de los agresores fue 24,9 años, 94,1% del sexo masculino y 94% eran personas conocidas por la víctima. En términos de atención en salud, 23,9% fueron hospitalizadas, 61,3% de los abusos fueron reportados a las autoridades, 53,6% recibieron atención en salud mental y 13,6% anticonceptivos de emergencia. Conclusiones: el abuso sexual afecta principalmente población con bajas condiciones sociales y económicas.La mayoría de victimarios son menores de edad con vínculos familiares con la víctima.Se hace imperativo fortalecer la atención integral en salud que se brinda a las víctimas y la complementariedad con los sectores de justicia y protección...(AU)

Objective: to describe characteristics of sexual abuse in women aged 10 to 13 years in the Valle del Cauca reported through the public health surveillance system. Materials and methods: a cross-sectional observational study, the target population was women between 10 and 13 years old, victims of sexual abuse notified to the public health surveillance system of the department of Valle del Cauca. Sociodemographic characteristics of the victim, information of the aggressor, and information related to the event were evaluated through secondary analysis. Results: a total of 431 cases of sexually abused women aged 10 to 13 years were used. 17.9% of the victims were Afro-descendants, 58.2% belonged to the subsidized regime, and 6.3% had no affiliation. 75.9% were students and 15.1% lived in rural areas. The average age of the perpetrators was 24.9 years, 94.1% were male and 94% were persons known to the victim. In terms of health care, 23.9% were hospitalized, 61.3% of the abuses were reported to the authorities, 53.6% received mental health care and 13.6% received emergency contraceptives. Conclusions: sexual abuse mainly affects the population with low social and economic conditions. The majority of perpetrators are minors with family ties to the victim. It is imperative to strengthen the comprehensive health care provided to victims, and the integration with the justice and protection sectors...(AU)

Actitud de los estudiantes en tres facultades de odontología en Santiago de Cali, Colombia, frente a pacientes con VIH / Atitude dos estudantes em três faculdades de odontologia em Santiago de Cali, Colômbia, frente a pacientes com HIV / Attitudes of students at three dental schools in Santiago de Cali, Colombia, toward HIV+ patients

Objetivos: Conocer la actitud de estudiantes de odontología de Cali respecto del manejo de personas con diagnóstico de VIH/SIDA. Método: Estudio observacional descriptivo mediante aplicación de una encuesta aplicada en 1.173 estudiantes de tres facultades de odontología de Cali, clasificados en tres grupos (preclínica, clínica inicial y clínica final). Resultados: participó un 63,4 por ciento; 50 por ciento tenía menos de 20 años, 68 por ciento mujeres. 92 por ciento solteros y 82 por ciento católicos. Se encontró actitud positiva entre 86 por ciento y 92 por ciento, la disposición de atender pacientes fue más favorable en preclínica (p=0.03). Aunque 88,7 por ciento mostró disposición de atender pacientes VIH+; entre los que pensaban que sería difícil hacerlo para su personal auxiliar, se encontró 33 por ciento de estudiantes con probabilidad de hacerlo, (p= 0.03). Cuando se interrogó sobre conocimientos acerca del VIH/SIDA, 66,7 por ciento (clínica final) y 82,2 por ciento (preclínica) percibían que no habían recibido entrenamiento previo (p<0,001). Conclusiones: Se evidenció que la intención de atender pacientes VIH+ era similar a lo reportado en otros países americanos e Irlanda. Los estudiantes necesitan recibir un mejor entrenamiento con el fin de disminuir sus temores y mejorar su actitud para atenderlos.

Objective: To know attitude of students at three dental schools in Santiago de Cali, Colombia, toward HIV+ patients. Methods: This is a cross-sectional study with using a questionnaire to 1173 invited to attend students from three dental schools in Cali. Students were classified in three groups (Pre-clinic: semester I-IV; initial clinic: V to VII and last clinical: VIII to X). Results: Participation rate was 63.4 percent. 50 percent under 20 years old, 68 percent female, 92 percent single, and 82 percent Catholics. Between 86 percent and 92 percent had positive attitudes; when asked about their willingness to care patients being more favorable preclinical students (p=0.03). Although, 88.7 percent of all students showed a willingness to address HIV patients. Among those who believed that it would be difficult for assistant staff to accept treating such patients there was a 33 percent chance of doing so (p=0.003). When we asked about training to manage, between 67 percent (clinical) and 82 percent (preclinical) perceive not receiving any. Conclusions: The intention to dental care was similar to that reported in the other American countries, and Ireland. Dental students need better training, because they do not perceived adequate training, to reduce their fear and increase positive attitudes to care for HIV/AIDS patients.

Objetivos: Conhecer a atitude de estudantes de odontologia de Cali a respeito do manejo de pessoas com diagnóstico de HIV/AIDS. Método: Estudo observacional descritivo mediante aplicação de um questionário aplicado em 1.173 estudantes de três faculdades de odontologia de Cali, classificados em três grupos (pré-clínica, clínica inicial e clínica final). Resultados: participaram 63,4 por cento; 50 por cento tinham menos de 20 anos, 68 por cento mulheres. 92 por cento solteiros e 82 por cento católicos. Foi encontrada atitude positiva entre 86 por cento e 92 por cento; a disposição de atender pacientes foi mais favorável na pré-clínica (p=0.03). Ainda que 88,7 por cento mostraram disposição de atender pacientes HIV+; entre os que pensavam que sería difícil fazê-lo para o seu pessoal auxiliar, foram encontrados 33 por cento de estudantes com probabilidade de fazê-lo, (p= 0.03). Quando se interrogou a cerca de conhecimentos sobre HIV/AIDS, 66,7 por cento (clínica final) e 82,2 por cento (pré-clínica) perceberam que não haviam recebido treinamento prévio (p<0,001). Conclusões: Foi evidenciado que a intenção de atender pacientes HIV+ era similar ao reportado em outros países americanos e Irlanda. Os estudantes necessitam receber um melhor treinamento com a finalidade de diminuir seus temores e melhorar sua atitude para atendê-los.

Muestreo por conglomerados en encuestas poblacionales / Cluster sampling in health surveys

Objetivo Describir la técnica estadística del muestreo por conglomerados en encuestas de salud poblacionales. Métodos Se describen los aspectos más importantes de cada uno de los pasos metodológicos haciendo énfasis en los fundamentos del Muestreo por Conglomerados. Éste se aplicó sobre una población de aproximadamente 100 000 habitantes de la comuna 18 de Cali. La muestra abarcó 30 manzanas y se encuestaron 3 026 personas. La información se recolectó usando el Sistema de Información de base Comunitaria para Atención Primaria en Salud. Resultados La técnica de muestreo aplicada generó información precisa y confiable para la estimación de prevalencias poblacionales de eventos de salud en un estudio de corte transversal. En población general, el error de muestreo fue de 2,5 por ciento; en menores de 5 años fue del 10 por ciento; en niños de 5 a 14 años fue de 5,7 por ciento; en población de 10 a 59 años estuvo alrededor del 3,0 por ciento y en población de 60 y más años fue de 7,2 por ciento. Conclusión El método descrito permitió garantizar un error de muestreo de 2,5 por ciento en la estimación de parámetros de prevalencia en la población general y errores de muestreo inferiores al 10 por ciento para los grupos poblacionales establecidos.

Objective Describing how the cluster sampling statistical technique can be applied to health surveys. Methods The article describes the most important aspects for each methodological step, emphasising cluster sampling's foundations. It was applied to a population of around 100,000 inhabitants from commune 18 in Cali. The sample covered 30 city blocks and 3,026 people were interviewed. The information was gathered using the Community-based Information System for Primary Health Attention. Results The sampling technique produced precise and reliable information for estimating population health event prevalence in a cross-sectional study. Sampling error was 2.5 percent in the general population, 10 percent in children aged less than 5 years, 5.7 percent in children aged 5 to 14, around 3.0 percent in those aged 10 to 59 and 7.2 percent in the population aged more than 60. Conclusion The method guaranteed a 2.5 percent sampling error in estimating general population prevalence and less than 10 percent sampling errors for established population groups.

Lineamientos ante el COVID-19 para la práctica de la otorrinolaringología: procedimientos quirúrgicos y no quirúrgicos / COVID-19

La pandemia de infección por Coronavirus 2019 ha revolucionado el ejercicio médico, en especial para los otorrinolaringólogos debido a su alto riesgo de infección, dado el contacto con secreciones de vía respiratoria superior. En la actualidad enfrentamos uno de los desafíos más grandes a nivel mundial; como médicos y personal de la salud es nuestro deber estar informados, promover prevención de la enfermedad y actuar acorde a los lineamientos basados en la evidencia. Por lo anterior, se presentan las siguientes recomendaciones basadas en información recolectada de guías y lineamientos a nivel mundial hasta marzo de 2020, relacionado con la práctica del otorrinolaringólogo en los procedimientos quirúrgicos y no quirúrgicos durante esta pandemia. Algunas recomendaciones no se aplican en Colombia debido a que los insumos o infraestructura no se encuentran disponibles o no se consiguen. Sin embargo, se considera que deben estar incluidas para que, en la medida de lo posible, se pueda contar con las mismas más adelante. El contenido de estos lineamientos debe ser actualizado a medida que se conozca nueva información o evidencia, ya que esta se encuentra en constante cambio.